Bell v. Social Security Administration

Filing 15

MEMORANDUM RULING re 1 Complaint filed by Newton Edward Bell, Jr.: For the reasons stated in the Memorandum Ruling, the Commissioner's decision to deny benefits is affirmed, and Plaintiff's complaint is dismissed with prejudice. Signed by Magistrate Judge Mark Hornsby on 12/17/09. (crt,Cassanova, M)

UNITED STATES DISTRICT COURT W E S T ER N DISTRICT OF LOUISIANA S H R E V EP O R T DIVISION

N E W T O N EDWARD BELL, JR. VERSUS U .S . COMMISSIONER SOCIAL S E C U RI TY ADMINISTRATION

C I V I L ACTION NO. 09-cv-0117

M A G I S T R A T E JUDGE HORNSBY

M E M O R A N D U M RULING I n t r o d u c t io n N e w t o n Edward Bell, Jr. ("Plaintiff") applied for disability benefits based primarily o n complications related to rheumatoid arthritis. An ALJ found that Plaintiff had the residual f u n c t io n a l capacity ("RFC") to perform the requirements of light work and that the guidelines d i r e c te d a finding of not disabled. Plaintiff applied to the Appeals Council and made r e p r e se n t a ti o n s that he was being treated for depression/anxiety. The Appeals Council re m a n d e d the case to the ALJ to obtain additional evidence concerning the alleged mental impa irmen t. Plaintiff was referred to Thomas E. Staats, Ph.D., a clinical neuropsychologist, f o r a consultative evaluation. The ALJ reviewed that evaluation and other materials and f o u n d that Plaintiff had the RFC to perform light work, reduced by the ability to occasionally h a n d l e , and a minimal limitation in the ability to concentrate. A VE opined that Plaintiff c o u l d , with his RFC, perform other jobs, and the ALJ found that Plaintiff was not disabled. T h e Appeals Council denied review, and Plaintiff appealed to this court in an earlier civil action. Bell v. Commissioner, 05-cv-0587. This court noted inconsistencies between

Dr. Staats' report and the ALJ's assessed RFC. For example, Dr. Staats found that Plaintiff " w a s able to interact poorly on a 1:1 basis" and that his social interaction was poor, but the A L J did not discuss why those limitations were not included in his RFC. The

Com missio n er's decision was reversed, and the matter was remanded to the agency for f u r t h e r proceedings. Tr. 269-75. T h e Appeals Council directed that an ALJ conduct further proceedings post-remand (T r. 282-85), and ALJ Charles Lindsay conducted a hearing and issued a written decision to again deny benefits. Tr. 243-52. Plaintiff presented to the Appeals Council arguments that Dr. Staats' opinion was misinterpreted and a copy of a post-decision physical evaluation by a physical therapist. T h e Appeals Council denied the request for review. Plaintiff filed this civil action s e e k i n g judicial review pursuant to 42 U.S.C. § 405(g). Pursuant to 28 U.S.C. § 636(c) and t h e standing order of the district court governing social security cases, the action was referred to the undersigned for decision and entry of judgment. For the reasons that follow, the Co mm issio ner 's decision to deny benefits will be affirmed. Standard of Review; Substantial Evidence This court's standard of review is (1) whether substantial evidence of record supports t h e ALJ's determination, and (2) whether the decision comports with relevant legal s t a n d a r d s . Villa v. Sullivan, 895 F.2d 1019, 1021 (5th Cir. 1990). "Substantial evidence is more than a scintilla and less than a preponderance. It is such relevant evidence as a

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reaso nable mind might accept as adequate to support a conclusion." Muse v. Sullivan, 925 F . 2 d 785, 789 (5th Cir. 1991). A finding of no substantial evidence is justified only if there a r e no credible evidentiary choices or medical findings which support the ALJ's dete rmin ation . Johnson v. Bowen, 864 F.2d 340, 343-44 (5th Cir. 1988). M e n t a l Limitations Dr. Staats was not a treating physician but conducted a consultative examination of P l a i n t if f in January 2004. Plaintiff complained to him of problems including anxiety, d e p r e s s io n , and isolation. Plaintiff's chief complaints were physical, related to his claimed rheu mato id arthritis. Dr. Staats stated that Plaintiff's concentration was adequate, his p e r s is t e n c e was marginal from a psychological standpoint but appeared quite poor from a p h y s ic a l standpoint, and he had adequate social judgment. Dr. Staats added that Plaintiff " w a s able to interact poorly on a 1:1 basis due to limping and shuffling with a cane, a lot of pain behavior, restlessness, tension, dysphoria, and anxiety." Tr. 92-95. Counsel, in his letter to the Appeals Council (on the most recent appeal) reported that h e had written Dr. Staats and asked for clarification regarding some of the terms Staats used a n d how they related to the levels of severity in the regulations. Dr. Staats replied in a brief f a x that his use of the term "poor" corresponded to a marked or extreme limitation. Counsel a r g u e d that Dr. Staats' report therefore supported additional or greater mental limitations in Plaintiff's RFC. Tr. 221-24. The Appeals Council considered Plaintiff's submissions r e g a r d in g Dr. Staats' intention when he described an ability as poor. It nonetheless found

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t h a t the ALJ's rationale and findings were supported by the overall record. Tr. 200. Plaintiff a r g u e s on appeal that the agency lacked substantial evidence to find an RFC that did not i n c l u d e mental limitations consistent with Dr. Staats' findings, as interpreted in light of his e x p l a n a to r y fax. T here was, however, other evidence before the ALJ regarding Plaintiff's mental s t a tu s . The agency asked Dr. Barbara Felkins, a board certified psychiatrist, to review the m e d i c a l records (including Dr. Staats' evaluation) and answer interrogatories about Plaintiff's condition. She wrote that after "careful reading" of Dr. Staats' report she o b s e r v e d that Staats appeared to have been more worried about physical limitations than m e n t a l issues, and she opined that Plaintiff "may have been in a flare of rheumatoid arthritis a t that time." Later medical records, discussed more below, suggested that the arthritis was n o t a serious problem and required little if any treatment. Dr. Felkins determined that psycho logica lly "there is no longitudinal evidence of significant or even severe mental illne ss." Plaintiff had only mild anxiety that he used small amounts of Xanax to treat. T r. 469-73. Dr. Felkins completed an assessment form in which she indicated that Plaintiff h a d only a moderate limitation with regard to the ability to understand, remember, and carry o u t detailed instructions. He had no limitation, however, with regard to simple instructions. S h e added that by moderate she meant satisfactory, and that moderate was used to cover t i m e s when Plaintiff might have some pain or anxiety. Tr. 474-75.

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T h e ALJ wrote that he afforded "significant weight" to Dr. Felkins' opinion and only " so m e weight" to the other medical source's opinion. He noted that Dr. Felkins is a p s y c h i a tr i s t who reviewed the long-term record and that the body of evidence supported her c o n c l u s io n that Plaintiff had a flare up at the time of his consultative examination. Later c l i n ic a l notes showed little, if any, objective medical signs or diagnostic findings of rhe um atoid arthritis. Tr. 250-51. The undersigned finds that the agency's decision is supported by substantial evidence, l a r g ely from Dr. Felkins' report. Even if Dr. Staats' report is read to suggest, as Plaintiff a r g u e s , greater limitations than one might discern from the terms used, Dr. Felkins offered a well-reasoned opinion from a specialist who did not examine the patient but did review a more long-term body of medical evidence. The ALJ is entitled to determine the credibility o f medical experts and assign weight to their opinions. Greenspan v. Shalala, 38 F.3d 232, 2 3 7 (5th Cir. 1984). The ALJ gave adequate reasons for the relative weight he afforded the re p o r t s , his evidentiary choice is rational and supported by the record, and his RFC with r e g a r d to mental limitations is supported by substantial evidence. P h y s i c al Limitations P l a i n ti f f argues that the ALJ's decision that he can perform most demands of light work is not supported by substantial evidence. The ALJ reviewed evidence regarding Plaintiff's claims of rheumatoid arthritis, including a report from treating physician Dr. Theresa Rinderle. She wrote that Plaintiff requested a note regarding her treatment to

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s e e if it would help in his attempt to get benefits. Dr. Renderle wrote that she explained to P l a i n ti f f that she had no knowledge of Plaintiff's rheumatological disorder but would be h a p p y to review records if received from LSU-HSC. Plaintiff responded that he was not on L SU 's active clinic roster. Dr. Rinderle wrote that her records did confirm some

ab no rm ali ty, including a rheumatoid positive factor in 1997. She recommended over-thec o u n t e r medication. Tr. 161. There were also reports from Dr. Werner and Dr. Senff that s u g g e s t ed no significant physical problems caused by rheumatoid arthritis, with a normal gait a n d station, full grip strength and dexterity, and no swelling of the joints. The ALJ relied on s u c h evidence to find that Plaintiff could perform the physical demands of light work. P l a i n ti f f submitted to the Appeals Council a post-decision report from a physical therap ist, Steve Allison, who found that Plaintiff had the RFC to perform work he classified a s restricted-light. In a chart summary of functional abilities, Allison stated without

e x p l a n a ti o n that Plaintiff would need hourly 20-minute interruptions to sitting, standing, w a l k i n g , and carrying. Tr. 225-29. Plaintiff argued that these 20-minute interruption r e q u i re m e n t s are inconsistent with the ability to perform light work. The Appeals Council wro te that the evaluation was considered but its "overall conclusion" of the ability to perform l i g h t work was consistent with the ALJ's RFC. Tr. 200-01. S o m e of the physical therapy report findings may be inconsistent with light work, but their presence in the record does not deprive the ALJ's decision of substantial evidence. T here were ample medical findings that Plaintiff had little, if any, physical limitations caused

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b y rheumatoid arthritis or any other objectively verifiable medical impairment. The ALJ did n o t use that as an excuse to find that Plaintiff had no physical limitations. Rather, he found desp ite the lack of medical evidence that Plaintiff was capable of no more than mere light w o r k . The Allison report's rather extreme requirements of 20-minute hourly interruptions is n o t consistent with the medical evidence. Furthermore, the court has now reviewed a number o f such reports from Mr. Allison and notes that he often lists in the summary chart a finding t h a t a claimant will need a break from sitting to stand/walk for 20 minutes each hour. Such b r e a k s , which take a person away from their work station, often preclude most or all jobs. S u c h a devastating limitation requires a firm and explained foundation in the medical and o t h e r evidence, and that foundation is not present in this case. Accordingly, the agency's d e c i s io n is supported by substantial evidence, and a judgment will be entered affirming the C o m m i s s i o n e r ' s decision to deny benefits. T H U S DONE AND SIGNED in Shreveport, Louisiana, this 17th day of December, 2009.

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