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Forry v. Berryhill

United States District Court, M.D. Pennsylvania

July 23, 2018

SANDRA E. FORRY, Plaintiff,
NANCY A. BERRYHILL[1]Deputy Commissioner for Operations of Social Security Defendant.


          Martin C. Carlson United States Magistrate Judge.

         I. Introduction and Litigation History

         Sandra E. Forry (“Forry”) presents a claim for disability which is largely premised upon limitations caused by severe lower back pain. In the instant case we are called upon to review the sufficiency of the Administrative Law Judge's (“ALJ”) evaluation of Forry's claim under the Social Security listings which describe those cases where claimants are deemed disabled, per se; his evaluation of the medical opinions; and his consideration of the side effects Forry alleges she suffers from her medications. On January 30, 2014, Ms. Forry protectively filed claims under Titles II and XVI of the Social Security Act for disability, disability insurance benefits, and supplemental security income. (Tr. 18.) In both applications, she alleged the onset date of disability as September 1, 2011. (Id.) Her claims were initially denied on September 30, 2014, and subsequently, she filed a written request for an administrative law hearing on December 2, 2014. (Id.) Represented by counsel, Forry appeared and testified at a hearing held on October 25, 2016. (Id.) On November 15, 2016, the ALJ issued a written decision finding that Forry was not disabled within the meaning of the Social Security Act. (Id. at 30.) In turn, Forry filed a request for review with the Appeals Council, which was denied on November 7, 2017. (Id. at 1.) Following this rejection, Forry filed the instant appeal with the District Court on January 1, 2018. (Doc. 1.)

         Both parties have fully briefed this case, and it is ripe for resolution. For the reasons set forth below, we conclude that the ALJ's findings are supported by substantial evidence, and therefore, this decision will be affirmed.

         II. Factual Background

         Ms. Forry is a 47 year old woman who has an associate's degree in business management (Tr. 904), and has previously worked as a wire harness assembler and driver dispatcher. (Id. at 28.) When Forry applied for disability benefits, she listed pars defect, a spinal condition, as a severe condition that limited her ability to work. (Id. at 172.) On May 29, 2013, Forry saw her treating primary care physician, Dr. Raymond J. Kraynak (“Dr. Kraynak”) for issues related to ongoing lower back pain. (Id. at 904.) Forry reported that the lower back pain was severe and rated it between a six and a seven on a scale of one to ten for pain intensity. (Id.) At this appointment, Dr. Kraynak noted that Forry walked “with a wide, stiff gait;” (Id.), she had difficulty walking on her heels and toes; her straight leg test was negative; and she had a lot of muscle spasm. (Id. at 905.) Dr. Kraynak further noted at this appointment that Forry had pars defect and a history of chronic lumbar pain that was secondary to degenerative arthritis. (Id.)

         Forry treated with Dr. Kraynak until at least October 17, 2016. At every appointment documented in the record after her May 29, 2013 appointment, Dr. Kraynak noted that Forry was able to function better with her medications; the medications improved her quality of life and caused no adverse side effects; and she gets pain relief, or analgesia, with her medication. (Id. at 673-728, 906-943.) Additionally, on January 20, 2014, Ms. Forry reported that her then current medications caused her to feel drowsy, (Id. at 727), however, Dr. Kraynak continued to note after that appointment that Forry did not experience any adverse side effects from her medications. The doctor consistently made this same kind of somewhat contradictory report concerning the effects of Forry's medications at every subsequent appointment in the record, stating that she both experienced no adverse side effects but felt fatigue as a result of her medication. (Id. at 673-726, 920-943.) On October 21, 2015, Dr. Kraynak started to regularly opine in his treatment notes that even though Ms. Forry's quality of life and functionality was improved with medication, she has severe debilitation and she is unable to work because “[s]he is profoundly disabled.” (Id. at 673, 674.) On May 6, 2014, Dr. Kraynak opined in a letter to the Pennsylvania Department of Labor and Industry's Bureau of Disability Determination that Forry cannot climb, bend, stoop, or crawl because of her back pain, and “[s]he is totally disabled from any employment.” (Id. at 495.)

         In addition to these treatment notes, the medical record disclosed that on November 20, 2013, Forry had an MRI of her lumbar spine which revealed that she had multilevel degenerative changes with severe canal narrowing at ¶ 4-5; a “[q]uestion of stable right pars defects with stable minimal anterolisthesis of L5 on S1;” stable, benign hemangiomas in her vertebral bodies; and large gallstones. (Tr. 236-237.) Subsequently, Forry had her gallbladder removed on February 20, 2014. (Id. at 322.)

         On September 25, 2014, Forry attended a consultative examination, arranged by the Pennsylvania Bureau of Disability Determination, with Dr. Justine Magurno (“Dr. Magurno”). (Id. at 499.) At this exam, Forry reported to Dr. Magurno that with medication, her back pain can range between a one out of ten and a nine out of ten on the pain scale, and that she has previously declined surgery that would have helped with her back condition. (Id.) Dr. Magurno also noted that Forry smoked half a pack of cigarettes a day and that her activities of daily living included cooking, cleaning, doing laundry, shopping, child care, showering, watching TV, and attending her son's football games. (Id. at 500.) As a result of this exam, Dr. Magurno diagnosed Ms. Forry with lower back pain due to pars defect, iron deficiency, low vitamin D, diarrhea (status post cholecystectomy), history of depression and anxiety, tobacco abuse, and obesity. (Id. at 502.) On that same day, Dr. Magurno filled out a Medical Source Statement concerning Forry's ability to do physical, work-related activities. (Id. at 503-508.) In that Medical Source Statement, Dr. Magurno found that Ms. Forry could occasionally lift/carry up to 20 pounds; could sit for six of the eight hours in a workday; could stand and walk for two of the eight hours in a workday; did not require a cane to ambulate; could continuously use her hands for various activities; could occasionally climb stairs and ramps, stoop, crouch, and crawl; could frequently kneel; and could never balance and never climb ladders or scaffolds. (Id. at 503-506.) The ALJ gave great weight to these findings from Dr. Magurno because he found that they were “consistent with the improvement in [Forry's] condition following her prescribed course of treatment. Moreover, [Dr. Magurno's] opinion is also consistent with [Forry's] ability to independently care for her personal needs, and perform household chores.” (Id. at 28.)

         On May 4, 2015, Ms. Forry underwent another MRI of her lumbar spine, at the request of Dr. Kraynak. (Id. at 671.) This study revealed disc dessication with mild disc space narrowing that is consistent with degenerative disc disease; no clumping of the cauda equina that would suggest arachnoiditis; broad-based posterior disc herniation that minimally indents the thecal sac; no significant foraminal narrowing at ¶ 12-L1, L1-L2, and L2-L3; no significant spinal canal stenosis at ¶ 2-L3; mild spinal canal stenosis and bilateral neural foraminal narrowing at ¶ 3-L4; mild bilateral neural foraminal narrowing at ¶ 4-L5; pseudo disc bulge related to grade one anterolisthesis of L5 on S1; and severe bilateral neural foraminal narrowing of L5-S1. (Id. at 671.)

         Because of her pain and her then most recent MRI, Dr. Kraynak referred Ms. Forry to neurosurgeon Dr. Sarkar Atom (“Dr. Atom”) to evaluate Forry for surgical intervention to help alleviate her back pain due to pars defect. (Id. at 619.) As a result of this consultation, Dr. Atom concluded that before considering surgery, Ms. Forry should make an effort to stop smoking, lose weight, do pain management, and attend physical therapy to address her issues. (Id.) Consequently, on December 21, 2015, Forry started pain management with Dr. Kevin Wong (“Dr. Wong”) for her lower back pain. (Id. at 784.) As part of her pain management appointment, Forry was examined by Dr. Brian Monroe (“Dr. Monroe”), who recommended scheduling facet joint injections at ¶ 5-S1. (Id. at 788.)

         On January 28, 2016, and May 6, 2016, Dr. Monroe administered facet injections for Ms. Forry at her L4-5 and L5-S1. (Id. at 804, 843.) At the follow-up appointment for her May 2016 injections on September 2, 2016, Forry reported that she experienced 100 percent relief of her lower back pain with her last injections, but she still had pain in her legs that she rated as a two out of ten on the pain scale. On September 26, 2016, Dr. Monroe administered a caudal epidural steroid injection to Ms. Forry. (Id. at 877.)

         On October 17, 2016, Dr. Kraynak completed a Medical Source Statement concerning Ms. Forry's physical capabilities in the workplace. (Tr. 730-735.) In this medical source statement, Dr. Kraynak opined that Forry could occasionally lift/carry up to ten pounds; could sit for two of the eight ours in a workday; could stand and walk for one of the eight hours in the workday; did not need a cane to ambulate; was capable of limited activities which use her hands; could never balance, stoop, kneel, crouch, crawl, and climb stairs, ramps, ladders, or scaffolds; and she required a quiet library-like work environment. (Id. at 730-734.)

         The various opinions of Dr. Kraynak noted throughout the record were allotted little weight by the ALJ in his decision. (Id. at 27.) The ALJ explains that these opinions were afforded little weight because they are “inherently inconsistent with [Dr. Kraynak's] physical examination findings, showing that [Forry's] straight leg test was negative, and her neurologic system was normal. [Dr. Kraynak's] opinion is also inconsistent with his findings that [Forry] had increased functionality and better life quality due to her medication use.” (Id.)

         With regard to Ms. Forry's mental health, we did not find any evidence in the case record indicating that Ms. Forry had treated with a mental health specialist for her anxiety and depression. At her evaluation with the state agency psychological consultant Dr. Erin Urbanowicz (“Dr. Urbanowicz”), Dr. Urbanowicz found that Forry had only mild mental health limitations; Forry was not alleging any mental health impairment; and therefore, Forry's mental health impairment was non-severe. (Id. at 92.) The ALJ gave Dr. Urbanowicz's opinion significant weight because it is consistent with the record, which demonstrated that Ms. Forry's “mental impairments did not require formal or specialized mental health treatment.” (Id. at 23.)

         In light of the evidence presented by Ms. Forry, the ALJ issued a decision on November 15, 2016, denying this disability claim. (Tr. 15-30.) In this decision the ALJ concluded at Step 2 of the sequential analysis which applies to Social Security disability cases that Forry was severely impaired by her degenerative disc disease. (Id. at 20.) The ALJ also noted that Forry has nonsevere impairments consisting of migraine headaches, stomach pain residuals from gallbladder surgery, obesity, depression, anxiety, and seizure disorder. (Id. at 21.) The ALJ found, however, that Forry's back impairments did not meet the requirements of a Social Security listing. (Tr. 24.) In consideration of the entire record, the ALJ found that Forry had the residual functional capacity to do sedentary work, except that she could: lift, carry, push, and/or pull up to ten pounds occasionally, and two to three pounds frequently; sit for six of the eight hours in a workday; can stand and/or walk for two of the eight hours in a workday; sit for one hour at time before she needs to get up; and be on her feet for only 30 minutes until she needs to sit down. (Id. at 24.) The ALJ further found that Forry was also unable to climb ladders, ropes, or scaffolds; and must avoid exposure to unprotected, dangerous heights, unprotected, dangerous machinery, excessive vibrations, extreme temperatures, and humidity. (Id.) On the other hand, the ALJ also found that Forry could continuously reach in front, laterally, and overhead, handle, finger, and feel; understand, remember, carry out simple instructions, and make simple work-related decisions; and respond appropriately to co-workers, supervisors, the public, usual work situations and changes in a simple, routine, and repetitive job. (Id. at 24.)

         Having reached this conclusion regarding Forry's functional capacity, the ALJ determined that she could perform jobs which existed in significant numbers in the regional and national economy. (Tr. 29.) The ALJ, therefore, concluded that Forry was not disabled, and denied her disability claim. (tr. 30.)

         This appeal followed. On appeal, Forry asserts three objections to the ALJ's decision as follows: (1) the ALJ erred in finding that Forry does not meet a listing which would prescribe her as per se disabled; (2) the ALJ did not provide adequate rationale in rejecting the treating and examining source opinions; and (3) the ALJ erred because he failed to consider the type, dosage, effectiveness, and side effects of Forry's medications and her treatments other than medication in evaluating Forry's alleged symptoms. (Doc. 9 p. 3.) For the reasons set forth below, we find that the ALJ's decision denying Ms. Forry benefits is supported by substantial evidence, and therefore, the decision is affirmed.

         III. Discussion

         A. Substantial Evidence Review - the Role of the Administrative Law Judge and the Court

         Resolution of the instant social security appeal involves an informed consideration of the respective roles of two adjudicators-the ALJ and this court. At the outset, it is the responsibility of the ALJ in the first instance to determine whether a claimant has met the statutory prerequisites for entitlement to benefits. To receive benefits under the Social Security Act by reason of disability, a claimant must demonstrate an inability to “engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve months.” 42 U.S.C. §1382c(a)(3)(A); see also 20 C.F.R. §416.905(a). To satisfy this requirement, a claimant must have a severe physical or mental impairment that makes it impossible to do his or her previous work or any other substantial gainful activity that exists in the national economy. 42 U.S.C. §1382c(a)(3)(B); 20 C.F.R. §416.905(a).

         In making this determination at the administrative level, the ALJ follows a five-step sequential evaluation process. 20 C.F.R. §416.920(a). Under this process, the ALJ must sequentially determine: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals a listed impairment; (4) whether the claimant is able to do his or her past relevant work; and (5) whether the claimant is able to do any other work, ...

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