United States District Court, M.D. Tennessee, Nashville Division
REPORT AND RECOMMENDATION
E. CLIFTON KNOWLES, Magistrate Judge.
This is a civil action filed pursuant to 42 U.S.C. § 405(g), to obtain judicial review of the final decision of the Commissioner of Social Security denying Plaintiff Disability Insurance Benefits ("DIB"), as provided under Title II of the Social Security Act ("the Act"). The case is currently pending on Plaintiff's Motion for Judgment on the Administrative Record. Docket No. 12. Defendant has filed a Response, arguing that the decision of the Commissioner was supported by substantial evidence and should be affirmed. Docket No. 15.
For the reasons stated below, the undersigned recommends that Plaintiff's Motion for Judgment on the Administrative Record be DENIED, and that the decision of the Commissioner be AFFIRMED.
Plaintiff filed his application for Disability Insurance Benefits ("DIB") on September 8,, with a protective filing date of August 29, 2011, alleging that he had been disabled since January 19, 2010,  due to rheumatoid arthritis and Marfan's syndrome. See, e.g., Docket No. 10, Attachment ("TR"), pp. 162, 196. Plaintiff's application was denied both initially (TR 75) and upon reconsideration (TR 76). Plaintiff subsequently requested (TR 91) and received (TR 101) a hearing. Plaintiff's hearing was conducted on May 21, 2012, by Administrative Law Judge ("ALJ") Michelle Thompson. TR 33, 27. Plaintiff and vocational expert ("VE"), Melissa Neel, appeared and testified. Id.
On July 3, 2012, the ALJ issued a decision unfavorable to Plaintiff, finding that Plaintiff was not disabled within the meaning of the Social Security Act and Regulations. TR 14-27. Specifically, the ALJ made the following findings of fact:
1. The claimant meets the insured status requirements of the Social Security Act through September 30, 2016.
2. The claimant has not engaged in substantial gainful activity since October 10, 2010, the amended alleged onset date (20 C.F.R. 404.1571 et seq. ).
3. The claimant has the following severe impairments: Marfan's syndrome with related cardiac disease of aortic dilation, degenerative disc disease, rheumatoid arthritis, post-traumatic stress disorder and mood disorder. (20 C.F.R. 404.1520(c)).
4. The claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. 404.1520(d), 404.1525 and 404.1526).
5. After careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to lift/carry, push/pull ten pounds and up to 20 pounds occasionally; sit, stand and/or walk six hours; has to avoid concentrated exposure to noise and fumes; can understand and perform simple, detailed, multi-step and executive level decisions; has the ability to sustain attention and concentration throughout a typical eight hour day; can work with and around others to include the general public; has the ability to relate appropriately with peers and supervisors and maintain appropriate social behaviors, but would do better dealing with things rather than people; and can adapt to infrequent workplace changes.
6. The claimant is unable to perform any past relevant work (20 C.F.R. 404.1565).
7. The claimant was born on May 1, 1968 and was 41 years old, which is defined as a younger individual age 18-49, on the amended alleged disability onset date (20 C.F.R. 404.1563).
8. The claimant has at least a high school education and is able to communicate in English (20 C.F.R. 404.1564).
9. Transferability of job skills is not material to the determination of disability because using the Medical-Vocational Rules as a framework supports a finding that the claimant is "not disabled, " whether or not the claimant has transferable job skills (See SSR 82-41 and 20 C.F.R. Part 404, Subpart P, Appendix 2).
10. Considering the claimant's age, education, work experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that the claimant can perform (20 C.F.R. 404.1569 and 404.1569(a)).
11. The claimant has not been under a disability, as defined in the Social Security Act, from October 10, 2010, through the date of this decision (20 C.F.R. 404.1520(g)).
On August 25, 2012, Plaintiff timely filed a request for review of the hearing decision. TR 128. On January 17, 2013, the Appeals Council issued a letter declining to review the case (TR 1-3), thereby rendering the decision of the ALJ the final decision of the Commissioner. This civil action was thereafter timely filed, and the Court has jurisdiction. 42 U.S.C. § 405(g). If the Commissioner's findings are supported by substantial evidence, based upon the record as a whole, then these findings are conclusive. Id.
II. REVIEW OF THE RECORD
The parties and the ALJ have thoroughly summarized and discussed the medical and testimonial evidence of Record. Accordingly, the Court will discuss those matters only to the extent necessary to analyze the parties' arguments.
III. CONCLUSIONS OF LAW
A. Standard of Review
This Court's review of the Commissioner's decision is limited to the record made in the administrative hearing process. Jones v. Secretary, 945 F.2d 1365, 1369 (6th Cir. 1991). The purpose of this review is to determine (1) whether substantial evidence exists in the record to support the Commissioner's decision, and (2) whether any legal errors were committed in the process of reaching that decision. Landsaw v. Secretary, 803 F.2d 211, 213 (6th Cir. 1986).
"Substantial evidence" means "such relevant evidence as a reasonable mind would accept as adequate to support the conclusion." Her v. Commissioner, 203 F.3d 388, 389 (6th Cir. 1999) ( citing Richardson v. Perales, 402 U.S. 389, 401 (1971)). "Substantial evidence" has been further quantified as "more than a mere scintilla of evidence, but less than a preponderance." Bell v. Commissioner, 105 F.3d 244, 245 (6th Cir. 1996) ( citing Consolidated Edison Co. v. N.L.R.B., 305 U.S. 197, 229, 59 S.Ct. 206, 216, 83 L.Ed. 126 (1938)).
The reviewing court does not substitute its findings of fact for those of the Commissioner if substantial evidence supports the Commissioner's findings and inferences. Garner v. Heckler, 745 F.2d 383, 387 (6th Cir. 1984). In fact, even if the evidence could also support a different conclusion, the decision of the Administrative Law Judge must stand if substantial evidence supports the conclusion reached. Her, 203 F.3d at 389 ( citing Key v. Callahan, 109 F.3d 270, 273 (6th Cir. 1997). However, if the Commissioner did not consider the record as a whole, the Commissioner's conclusion is undermined. Hurst v. Secretary, 753 F.2d 517, 519 (6th Cir. 1985) ( citing Allen v. Califano, 613 F.2d 139, 145 (6th Cir. 1980) ( citing Futernick v. Richardson, 484 F.2d 647 (6th Cir. 1973))).
In reviewing the decisions of the Commissioner, courts look to four types of evidence: (1) objective medical findings regarding Plaintiff's condition; (2) diagnosis and opinions of medical experts; (3) subjective evidence of Plaintiff's condition; and (4) Plaintiff's age, education, and work experience. Miracle v. Celebrezze, 351 F.2d 361, 374 (6th Cir. 1965).
B. Proceedings At The Administrative Level
The claimant carries the ultimate burden to establish an entitlement to benefits by proving his or her "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). "Substantial gainful activity" not only includes previous work performed by Plaintiff, but also, considering Plaintiff's age, education, and work experience, any other relevant work that exists in the national economy in significant numbers regardless of whether such work exists in the immediate area in which Plaintiff lives, or whether a specific job vacancy exists, or whether Plaintiff would be hired if he or she applied. 42 U.S.C. § 423(d)(2)(A).
At the administrative level of review, the claimant's case is considered under a five-step sequential evaluation process as follows:
(1) If the claimant is working and the work constitutes substantial gainful activity, benefits are automatically denied.
(2) If the claimant is not found to have an impairment which significantly limits his or her ability to work (a "severe" impairment), then he or she is not disabled.
(3) If the claimant is not working and has a severe impairment, it must be determined whether he or she suffers from one of the "listed" impairments or its equivalent. If a listing is met or equaled, benefits are owing without further inquiry.
(4) If the claimant does not suffer from any listing-level impairments, it must be determined whether the claimant can return to the job he or she previously held in light of his or her residual functional capacity (e.g., what the claimant can still do despite his or her limitations). By showing a medical condition that prevents him or her from returning to such past relevant work, the claimant establishes a prima facie case of disability.
(5) Once the claimant establishes a prima facie case of disability, the burden shifts to the Commissioner to establish the claimant's ability to work by proving the existence of a significant number of jobs in the national economy which the claimant could perform, given his or her age, experience, education, and residual functional capacity.
20 C.F.R. §§ 404.1520, 416.920 (footnote added). See also Moon v. Sullivan, 923 F.2d 1175, 1181 (6th Cir. 1990).
The Commissioner's burden at the fifth step of the evaluation process can be satisfied by relying on the medical-vocational guidelines, otherwise known as "the grid, " but only if the claimant is not significantly limited by a nonexertional impairment, and then only when the claimant's characteristics identically match the characteristics of the applicable grid rule. Otherwise, the grid cannot be used to direct a conclusion, but only as a guide to the disability determination. Id. In such cases where the grid does not direct a conclusion as to the claimant's disability, the Commissioner must rebut the claimant's prima facie case by coming forward with particularized proof of the claimant's individual vocational qualifications to perform specific jobs, which is typically obtained through vocational expert testimony. See Varley v. Secretary, 820 F.2d 777, 779 (6th Cir. 1987).
In determining residual functional capacity for purposes of the analysis required at stages four and five above, the Commissioner is required to consider the combined effect of all the claimant's impairments; mental and physical, exertional and nonexertional, severe and nonsevere. See 42 U.S.C. § 423(d)(2)(B).
C. Plaintiff's Statement Of Errors
Plaintiff contends that the ALJ: (1) "significantly misrepresent[ed] and/or mischaracteriz[ed]" evidence in the record when considering his subjective complaints of neck pain; (2) made "inconsistent findings" regarding the paragraph B criteria of mental disorder listings and in Plaintiff's residual functional capacity finding; (3) rendered an RFC assessment that warranted a finding of disability; (4) "violated HALLEX II-1-11-12" by failing to properly consider that Plaintiff had been awarded 90% disability benefits from the Department of Veterans Affairs with "individual unemployability"; and (5) failed to properly consider opinions from Plaintiff's good friend regarding the severity of his impairments. Docket No. 12-1 at 1-2. Accordingly, Plaintiff maintains that, pursuant to 42 U.S.C. § 405(g), the Commissioner's decision should be reversed, or in the alternative, remanded. Id .
Sentence four of § 405(g) states as follows:
The court shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing.
42 U.S.C. §§ 405(g), 1383(c)(3).
"In cases where there is an adequate record, the Secretary's decision denying benefits can be reversed and benefits awarded if the decision is clearly erroneous, proof of disability is overwhelming, or proof of disability is strong and evidence to the contrary is lacking." Mowery v. Heckler, 771 F.2d 966, 973 (6th Cir. 1985). Furthermore, a court can reverse the decision and immediately award benefits if all essential factual issues have been resolved and the record adequately establishes a plaintiff's entitlement to benefits. Faucher v. Secretary, 17 F.3d 171, 176 (6th Cir. 1994). See also Newkirk v. Shalala, 25 F.3d 316, 318 (1994).
1. Subjective Complaints of Neck Pain
Plaintiff contends that the ALJ erred in "significantly misrepresenting and/or mischaracterizing" parts of the record regarding Plaintiff's complaints of neck pain. Docket No. 12-1 at 17. Specifically, Plaintiff argues that, while the ALJ did acknowledge that "the claimant has complained of neck pain, " the ALJ failed to note that the record shows consistent reports of "significant, persistent neck pain." Id. Plaintiff maintains that his complaints are supported by the medical evidence. Id., referencing TR 932, 970, 985. Plaintiff also asserts that the ALJ "misrepresented" evidence when she indicated that only pain management was recommended for treatment. Id. at 18. Plaintiff argues first that "the fact that pain management was recommended is an erroneous basis for discrediting Plaintiff's subjective allegations, as this is treatment which is specifically recommended [for] his severe pain." Id. Plaintiff next argues, "More importantly, this is a misrepresentation of the evidence, as Plaintiff was instructed to follow up with the pain clinic and neurosurgery related to these impairments, " and was "recommended for medical management with narcotics, gabapentin, epidural injections done by the pain clinic and then [follow up] with them in 3 months for additional surgical consideration.'" Id., citing TR 880, 985. Plaintiff notes that the record reflects that he was being referred to neurosurgery for his cervical disc disease with moderate spinal canal and foraminal stenosis. Id., referencing TR 880. Plaintiff argues that since the ALJ "mischaracterized and/or misrepresented" parts of the record, the ALJ's decision was unsupported by substantial evidence. Id.
Defendant responds that the ALJ did not significantly misrepresent or mischaracterize the evidence of record. Docket No. 15 at 10. Defendant argues that the ALJ did, in fact, discuss Plaintiff's complaints of neck pain, including his testimony regarding his neck issues and use of a neck brace, as well the objective evidence, including Plaintiff's diagnosis of Marfan's syndrome and diagnostic imaging of Plaintiff's cervical spine, which indicated degenerative disc disease and moderate central canal stenosis. Id., citing TR 22-24. Defendant concedes that the ALJ's statement that "only pain management was recommended for treatment" was imprecise, but asserts that this was not harmful error, as it "has little effect on her overall analysis and falls well short of significantly representing evidence." Id. Defendant further asserts that, although the treatment notes indicate that Plaintiff was to have follow-up treatment with the neurosurgical department, there is no indication in the record that Plaintiff actually followed-up with neurosurgery as instructed, and Defendant cites other evidence in the record inconsistent with Plaintiff's complaints of neck pain. Id. at 10-11, citing TR 841-44.
Defendant also maintains that the ALJ engaged in a proper credibility determination and discussed substantial evidence supporting her conclusion that Plaintiff's allegations of disabling neck pain were not entirely credible. Id. at 11, citing TR 24. As support, Defendant points to numerous inconsistencies between the record and ...