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Medina v. Berryhill

United States District Court, M.D. Pennsylvania

June 8, 2018

NANCY BERRYHILL, Acting Commissioner of Social Security, Defendant.

          Mannion Judge.


          Martin C. Carlson United States Magistrate Judge

         I. Introduction

         One recurring aspect of Social Security disability litigation entails assessing the adequacy of an Administrative Law Judge's (“ALJ's”) evaluation of the disabling effects of obesity upon individual claimants. In this regard, it is undeniable that the physical challenges presented by obesity have a cascading and compounding effect upon disability claimants. Therefore, it is well-settled that it is incumbent upon ALJs to fully consider the medical complications that may arise for those persons who suffer from severe obesity and have other significant medical impairments.

         Yet, this obligation on the part of the Court to ensure that ALJs fully consider the role that obesity may play in exacerbating a claimant's medical impairments is tempered by another countervailing legal principle. In evaluating Social Security appeals we are enjoined to apply a highly deferential standard of review, which calls upon us simply to determine whether substantial evidence, a quantum of proof that is less than a preponderance but more than a scintilla of evidence, supports the ALJ's findings.

         We are mindful of these familiar principles governing judicial review of Social Security determinations as we turn to the instant case, a Social Security appeal filed by Angel Medina. Mr. Medina doubtless faces some significant medical challenges and limitations, challenges that are compounded by his obesity. Nonetheless, an ALJ who heard Medina's case directly addressed the effects of Medina's obesity, in conjunction with his other impairments, when the ALJ entered a decision denying Medina's disability claim. Despite this ruling, on appeal Medina invites us to set aside this adverse administrative ruling based largely upon an argument that the ALJ's evaluation of Medina's obesity was legally insufficient.

         Given the deferential standard of review that applies here, and the analysis of Medina's obesity set forth in the ALJ's decision, for the reasons set forth below, we conclude that the ALJ's decision is supported by substantial evidence and is adequately explained in a written decision that conforms to the legal and regulatory guidelines governing Social Security claims. Accordingly, it is recommended that the decision be affirmed and the plaintiff's appeal denied.

         II. Statement of Facts

         On April 4, 2014, Angel Medina protectively applied for disability insurance benefits pursuant to Title II of the Social Security Act (“Act”). (Tr. 10.) In his disability application Medina alleged that he had become disabled due to the combined effects of an array of impairments, including, degenerative disc disease, diabetes, neuropathy, a mood disorder and obesity. (Tr. 12.) According to Medina the alleged onset of this disability occurred on or about August 5, 2013. (Tr. 10.)

         Medina was in his 40's at the time of the alleged onset of his disability. (Tr. 34.) He had a twelfth grade education and a prior employment history as a truck driver, mechanic, automotive parts salesman and paint line operator. (Tr. 34, 45-6, 141, 156-60.) Medina also suffered from obesity. He was approximately five feet eleven inches tall, and reportedly weighed between 326 and 369 pounds during the period encompassed by this disability claim. (Tr. 33, 50, 140, 195, 203, 242, 246, 250-57, 364-65, 470-86.)

         Following the administrative denial of Medina's disability claim, (Tr. 68-72), Medina requested a hearing before an ALJ. (Tr. 73-74.) That hearing was scheduled for June 2016, and in anticipation of that hearing substantial treatment records from a variety of medical sources relating to the care Medina received for his diabetes, disc disease, neuropathy and obesity were received and reviewed by the ALJ. (Tr. 184-711.)

         A hearing was then conducted on Medina's disability application on June 28, 2016. (Tr. 30-49.) Medina and a Vocational Expert both appeared and testified at this hearing. In his testimony Medina described his employment history, and indicated that he became unemployed with the trucking firm due to his diabetes. (Tr. 35-7.) Medina also testified that he collected unemployment benefits after the date of the alleged onset of his disability. (Tr. 37.) The Vocational Expert, in turn, testified and responded to hypothetical questions posed by the ALJ regarding whether a person of Medina's age, with his medical conditions, could perform light work jobs in the regional and national economy. The Vocational Expert responded to these hypothetical questions by identifying a series of positions regionally and nationally that existed for a person facing challenges similar to those confronting Medina. (Tr. 45-49.)

         On September 19, 2016, the ALJ issued a decision denying Medina's application for disability benefits. (Tr. 7-20.) In this ruling, the ALJ discussed and addressed all of Medina's presenting impairments, including his obesity. Thus, at Step 1 of the five-step sequential process that applies in these cases, the ALJ found that Medina met the insured status requirements of the Act through December 2018. (Tr. 12.) At Step 2 of this analysis, the ALJ concluded that Medina had the following severe impairments: degenerative disc disease, diabetes with neuropathy, a mood disorder and obesity. (Tr. 12.)

         At Step 3 of this sequential analysis the ALJ found that none of Medina's impairments met or medically equaled a listing under the Act which would define Medina as per se disabled. (Tr. 12-14.) In reaching this result the ALJ specifically took into account the exacerbating effect of Medina's obesity, stating that:

[B]ecause there is no listing for obesity, I also considered this impairment in combination with the claimant's other impairments, but, once again, none of the claimant's impairments meets or medically equals the listings. Nevertheless, I did consider the effect of both obesity and diabetes throughout each of the remaining steps of the sequential evaluation process.

(Tr. 13.)

         The ALJ's decision then addressed the issue of Medina's obesity at several junctures as the ALJ weighed and assessed the medical evidence before concluding that Medina retained the residual functional capacity to perform light work. Thus, the ALJ observed that in 2013, at the time of the alleged onset of Medina's disability “his physical exams were relatively normal. His only positive finding was an obese body habitus.” (Tr. 15.) Yet, despite this obesity finding, according to the ALJ examination results in 2013:

[G]enerally displayed regular and unlabored respirations, a normal heart rate and rhythm, and a smooth, even, and well-balanced gait. He was neurologically intact, had normal motor strength in his upper and lower extremities, and displayed normal ranges of motion. Even his diabetic exams were normal, i.e. no open wounds or sores on his feet, normal monofilament wire testing, and no evidence of retinopathy.


         According to the ALJ examination results from 2014 and 2015 continued to reveal that, despite his obesity, Medina retained significant residual capabilities. Thus, “his symptoms worsened in late 2014, but not to a disabling degree.” (Tr. 16.) Medina “did not require help changing for the exam or getting on or off the exam table, and he was able to rise from the chair without difficulty.” (Id.) Medina also “exhibited normal deep tendon reflexes, intact sensation, 5/5 strength, and intact hand and finger dexterity, suggesting he was neurologically intact.” (Id.) Furthermore, “[d]uring his December [2014] PCP follow-up visit, he was reportedly ‘doing well' in terms of ...

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