United States District Court, M.D. Pennsylvania
Richard P. Conaboy, Judge
consider here Plaintiff's appeal from an adverse decision
of the Social Security Administration (“SSA”) on
her applications for Disability Insurance Benefits
(“DIB”) and Supplemental Security Income
(“SSI”). This case was initially filed in 2012
and most recently was back before the SSA after being
remanded by this Court in July of 2016. After remand,
Plaintiff received a new hearing before an ALJ on May 25,
2017. The ALJ issued a written a decision dated August 2,
2017, which, once again, denied Plaintiff's claims. This
Court has jurisdiction over this matter pursuant to 42 U.S.C.
Testimony before the ALJ.
hearing was conducted before ALJ Randy Riley on May 25, 2017
in Harrisburg, Pennsylvania. Plaintiff Carrie Ann Bell
testified on her own behalf and Michael Kibble, a vocational
expert (“VE”), testified as to the availability
of employment in hypothetical situations proposed by the ALJ.
Also present was Plaintiff's attorney whose identity was
not placed in the record.
testified that she and her two children had lived with her
mother since some unspecified date in 2013. Her mother was
about to turn fifty-four years of age on the date of the
hearing. Plaintiff went back to work briefly in 2015 despite
the fact that neither her physical nor mental condition had
improved. (R. 553-554). In order to obtain the job a friend
helped her to complete the application. She needed assistance
because she did not understand some of the questions. (R.
did not know anyone who worked for the employer for whom she
worked in 2015. She did not have difficulty understanding the
employer's directions about how to do the job. She worked
for three months and then stopped because her back pain was
getting worse. Her daughter is autistic and required more
care as well, but the primary reason she quit the job was
constant back pain. (R. 555-56). The job in question was
part-time but she still needed to call off or go home early
four or five times during the three months she worked there.
She does not believe that she could have performed the job (a
hotel maid) if it had been on a full-time basis. (R. 557).
Bending down to make beds and clean the bathrooms was
particularly difficult for her. She was under constant
supervision and was told that she was too slow at doing the
rooms. She was also told that she was forgetting to do things
such as supplying cups or setting alarm clocks. She had
difficulty working at the pace her supervisor preferred. She
was often directed to work at a speed she found difficult to
maintain. (R. 557-58).
she left part-time employment as a hotel maid in 2013 her
primary physical problems have been back pain and instability
in her right shoulder. She takes unspecified pain medications
for these conditions but denies side effects. (R. 559). She
also has problems with her memory. She forgets things like
paying for her children's lunch tickets. She is also
reluctant to go anywhere by herself and is always accompanied
by one of her daughters, her mother, or a friend. She is
afraid that someone may hurt her and recounted an episode in
which she was alone and had an angry encounter with another
motorist. When she goes to the store she is never sure
whether she has received the correct change. Her mother helps
her manage her bills. (R. 560-63).
testified that he was familiar with the SSA's categories
of work and with the Dictionary of Occupational Titles. He
stated that he was also familiar with the Plaintiff's
work history. He indicated that Plaintiff's past relevant
work had been classified as light though medium as performed
by the Plaintiff (housekeeper-cleaner) and medium though
heavy as performed by the Plaintiff (store laborer). R.
asked the VE to assume a person of the Plaintiff's age,
education, and work experience with additional limitations to
light work; occasional use of stairs; occasional balancing,
stooping, kneeling, crouching, and crawling; never use of
ladders; no exposure to irritants; work limited to routine,
repetitive tasks; and a work environment that does not
involve fast-paced production quotas or frequent workplace
changes. Based on those assumptions, the VE stated that the
Plaintiff would not be able to perform any of her past
relevant work. However, given those limitations, light work
would be available within the hypothetical claimant's
capacities as a bindery machine feeder and a bakery racker.
Also, sedentary work would be available as a table worker.
the ALJ altered the previous hypothetical question to include
an additional limitation such that the hypothetical claimant
would also need to alternate between sitting and standing
every fifteen minutes, the VE stated that such a person could
not perform as a bindery machine feeder or bakery racker, but
would be able to perform the sedentary job of table worker.
The VE added that two other sedentary jobs - - small products
assembler and conveyer line bakery worker would also be
within the hypothetical claimant's capacities. When the
ALJ altered the hypothetical question once again to further
assume that the hypothetical claimant would be unable to
consistently perform sustained work activity over a forty
hour week, the VE responded that the addition of such a
limitation would render the hypothetical person (and hence
the claimant) unemployable. (R. 566).
counsel then questioned the VE whether the sedentary jobs she
had described required more than occasional supervision. The
VE replied that they involved occasional supervision
“on the lower end of occasional”. The VE was then
asked whether the need for a supervisor to correct an
employee's performance in some small way on a daily basis
would affect the ability of the employee to stay employed.
The VE responded that if the small corrections were made in
response to some error that was resulting in a faulty product
the person would be unemployable as requiring too much
supervisory attention. (R. 567-568).
Medical Evidence. A. Pinnacle Health.
primary health care provider from April of 2011 to at least
September of 2014 was Pinnacle Health in Middletown,
Pennsylvania. Dr. William Albright provided the bulk of her
care. Dr. Joseph W. Lohr and Nurse Practitioner Linda Ulrich
also provided medical services to Plaintiff during this
period. Throughout Plaintiff's involvement with Pinnacle
Health, progress notes indicate diagnoses of low back pain,
migraine headaches, and fibromyalgia. Plaintiff's
treatment at Pinnacle Health consisted of prescription pain
medications, several trigger point injections, and physical
therapy. An office note of October 11, 2012 suggests that
x-rays and an MRI produced no answer regarding the etiology
of Plaintiff's back pain and that the advisability of
seeing a pain psychologist was discussed.While the office
notes from Pinnacle Health bear out the fact that Plaintiff
complained continuously of back pain throughout the relevant
period, the progress notes typically describe her distress
level as “mild” or “moderate” and, on
some occasions, as “no apparent distress”.
Practitioner Lisa Ulrich executed a Residual Functional
Capacity Questionnaire with respect to Plaintiff on July 27,
2012 (R. 388-89). Ms. Ulrich opined that Plaintiff suffered
from migraines, low back pain and fibromyalgia. Ms. Ulrich
indicated the Plaintiff's symptoms would
“seldom” interfere with her ability to perform
simple work-related tasks; that Plaintiff could walk one-half
block without rest or significant pain; that Plaintiff could
sit for thirty minutes at a time and stand-walk for fifteen
minutes at a time; that Plaintiff could sit for up to three
hours in an eight hour work day and stand/walk for up to
three hours in an eight hour work day; that Plaintiff
required a job which would permit her to shift positions at
will; that Plaintiff would need to take unscheduled breaks of
twenty to thirty minutes every two hours while at work; that
Plaintiff could frequently lift up to ten pounds and
occasionally lift up to twenty pounds; that Plaintiff had no
limitation with respect to grasping, turning, or twisting
objects or with fine manipulation; that Plaintiff would miss
three to four work days each month; that Plaintiff was not a
malinger; and that Plaintiff was incapable of sustained
December 10, 2012, Dr. Albright completed a Residual
Functional Capacity Questionnaire concerning Plaintiff. His
findings largely mirrored those of Nurse Practitioner Ulrich
five months earlier. Dr. Albright did place even more
restrictions on Plaintiff's ability to sit, stand/walk,
and lift. He also found that Plaintiff's ability to
perform repetitive reaching, handling, or fingering was
significantly limited. He stated that he could not say
whether Plaintiff was a malingerer but, like Ms. Ulrich, he
concluded that Plaintiff was incapable of full-time
Dr. Bruce Goodman.
March 24, 2010, Dr. Goodman evaluated Plaintiff at the
request of the Bureau of Disability Determination. Dr.
Goodman did not have the benefit of Plaintiff's medical
records and he relied on Plaintiff's recitation of her
medical history. Plaintiff told Dr. Goodman that she was
looking for work but had been unable to find a job that she
could tolerate. Dr. Goodman stated that Plaintiff also told
him that she had two children age two and six and that she
was capable of cooking, cleaning, grocery shopping, driving,
and child care. She walked with a normal gait, could heel/toe
walk easily, exhibited no muscle spasm, exhibited negative
straight leg raising in the supine position, and displayed no
muscular atrophy or weakness. Dr. Goodman assessed that
Plaintiff could stand/walk and sit without limitations; could
frequently lift up to twenty pounds and had no limitation
with respect to reaching, handling, fingering, or feeling.
Dr. Joseph Agliotta.
Agliotta, a psychologist evaluated Plaintiff's
intellectual functioning on March 31, 2010 at the request of
the Bureau of Disability Determination. He administered the
Wechsler Adult Intelligent Test, reviewed Plaintiff's
records, and interviewed her. Dr. Agliotta found her to be
oriented to person, place, and time with concrete thought
processes. He found also that her mood was pleasant and her
affect was full range. He assessed her verbal IQ at 66,
performance IQ at 64, and full scale IQ at 63. These scores
were indicative of mild mental retardation. He observed also
that Plaintiff “would need assistance and oversight in
managing any financial benefits.” In terms of her
ability to understand, remember, and carry out instructions,
Dr. Agliotta found only slight to moderate impairment. Dr.
Agliotta also assessed slight to moderate impairment in
Plaintiff's ability to interact with the public,
coworkers, and supervisors.