Hobbs v. Commissioner of the Social Security Administration
Filing
18
Memorandum of Opinion and Order: Because the Administrative Law Judge applied proper legal procedures and reached a decision supported by substantial evidence, the Commissioner of Social Security's final decision denying Plaintiff Hobbs' applications for supplemental security income and disability insurance benefits is AFFIRMED. IT IS SO ORDERED. Magistrate Judge Thomas M. Parker on 1/23/2019. Related document 1 . (D,JJ)
IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
RICHARD HOBBS,
Plaintiff,
v.
COMMISSIONER OF
SOCIAL SECURITY,
Defendant.
I.
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Case No. 5:18-cv-446
MAGISTRATE JUDGE
THOMAS M. PARKER
MEMORANDUM OF OPINION
AND ORDER
Introduction
Plaintiff, Richard Hobbs, seeks judicial review of the final decision of the Commissioner
of Social Security (the “Commissioner”) denying his applications for disability insurance
benefits and supplemental security income under Titles II and XVI of the Social Security Act.
This matter is before the court pursuant to 42 U.S.C. § 405(g) and 1383(c)(3), and the parties
consented to my jurisdiction under 28 U.S.C. § 636(c) and Fed. R. Civ. P. 73. ECF Doc. 12.
Because the ALJ applied proper legal procedures and reached a decision supported by substantial
evidence, the Commissioner’s final decision denying Hobbs’ applications for supplemental
security income and disability insurance benefits must be AFFIRMED.
II.
Procedural History
On December 19, 2014, Hobbs applied for supplemental security income and disability
benefits. (Tr. 263–72). Hobbs alleged that he became disabled on June 16, 2010, due to
“arthritis, hearing loss in both ears/wears hearing aids, rotat[o]r disc both shoulders, hep[atitis] C
with liver damage, knees give out, [and] immune system breaking down/low white blood
count.”1 (Tr. 103, 118, 135–36, 149–50, 263, 267). The Social Security Administration denied
Hobbs’ claims initially and upon reconsideration. (Tr. 103–32, 135–62). Hobbs requested an
administrative hearing. (Tr. 187–88). Administrative Law Judge (“ALJ”) Charles Shinn heard
Hobbs’ case on November 10, 2016, and May 1, 2017, and he denied the claim in a May 17,
2017, decision. (Tr. 15–46, 54–71, 73–102). On January 17, 2018, the Appeals Council denied
further review, rendering the ALJ’s decision the final decision of the Commissioner. (Tr. 1–6).
On February 26, 2018, Hobbs filed a complaint to seek judicial review of the Commissioner’s
decision. ECF Doc. 1.
III.
Evidence
A.
Personal, Educational and Vocational Evidence
Hobbs was born on September 8, 1964 and was 45 years old on the alleged onset date.
(Tr. 79, 263, 267). He turned 50 years old on September 8, 2014. Hobbs had a high school
education and past work as a lawnmower mechanic. (Tr. 79, 350).
B.
Relevant Medical Evidence
On December 23, 2010, Hobbs told Joshua Jacquet, M.D., at Akron General Medical
Center (“AGMC”) that he was in pain after his knee “popped out” while he was loading logs
onto a truck. (Tr. 602). Hobbs reported that he had knee problems in the past, but it was never
painful. (Tr. 602). On examination, Hobbs’ knee was not tender and did not have any other
observable issues requiring further evaluation. (Tr. 602–603). Dr. Jacquet determined that
1
In his decision, the ALJ noted that Hobbs alleged mental impairments, including substance abuse
disorder, depression, and intellectual disability that the ALJ found were non-severe; however, Hobbs has
not raised any issues related to mental impairments before this court. (Tr. 20–22); see generally ECF
Docs. 14 and 17. He also has not raised any issues related to his hearing impairments, ankle injury, or
hepatitis. See generally ECF Docs. 14 and 17. Accordingly, any challenges to the Commissioner’s
decisions regarding Hobbs’ mental impairments, drug abuse, hearing impairments, ankle injury, and
hepatitis are waived. See Swain v. Comm’r of Soc. Sec., 379 F. App’x 512, 517–18 (6th Cir. 2010)
(noting that a plaintiff waives any argument not raised in his brief before the district court).
2
Hobbs’ leg pain was due to a hamstring strain and that Hobbs was able to walk without
difficulty. (Tr. 603). On December 27, 2010, Hobbs returned to AGMC and told Erin Simon,
D.O., that he needed additional medications due to ongoing pain from his hamstring strain.
(Tr. 597). Dr. Simon gave Hobbs two narcotic pain reliever pills and prescribed over-thecounter pain relievers to transition him off the narcotic pain reliever. (Tr. 598). Dr. Simon also
offered Hobbs crutches, which he refused. (Tr. 598).
On May 23, 2011, Hobbs saw Jeanette Porubovich-Mizenko, M.D., at the VA, to
establish care. (Tr. 570). He reported that he had a history of arthritis in his shoulders and back,
for which he saw a chiropractor, took a narcotic pain reliever, and received steroid injections.
(Tr. 570). Dr. Porubovich-Mizenko prescribed Hobbs an oral, non-narcotic pain reliever.
(Tr. 573). Hobbs’ treatment with Dr. Porubovich-Mizenko and other VA providers throughout
2011 was related to his alcoholism, hepatitis, and depression. (See generally Tr. 532–79). On
May 3, 2011, Hobbs told his VA counselor that he worked enough to buy beer and cigarettes,
and on June 13, 2011, he told his VA dietician that he did his own cooking and grocery
shopping. (Tr. 508–09, 568). Hobbs did not see Dr. Porubovich-Mizenko from September 2011
until May 2013, when he requested placement in a detox program. (Tr. 526). On June 21, 2013,
Hobbs told Dr. Porubovich-Mizenko that he had “sharp, shooting” pain in his left shoulder, that
his shoulder was “frozen,” and that he received injections from outside providers. (Tr. 519, 523).
Dr. Porubovich-Mizenko noted additional injections or physical therapy might be helpful.
(Tr. 519). She referred Hobbs to radiologist Craig George, M.D., for an x-ray of his left
shoulder, which revealed mild degenerative changes in the joint at the top of his shoulder, but
that his “shoulder [was] otherwise unremarkable.” (Tr. 467). Hobbs did not follow up with
Dr. George or Dr. Porubovich-Mizenko for treatment of his shoulder and back issues. (Tr. 512–
17).
3
On July 2, 2013, Hobbs told Anna Sandhu, M.D., at Internal Medicine Center (“IMC”)
that he had pain and a limited range of motion in his left shoulder since May 2013. (Tr. 652).
Hobbs told Dr. Sandhu that he took naproxen for pain relief. (Tr. 652). Dr. Sandhu noted that
Hobbs had crepitus in his left shoulder, that his passive range of motion on reaching to the side
was greater than reaching overhead, and that he did not have any pain reaching down. (Tr. 653).
Dr. Sandhu referred Hobbs to physical therapy for evaluation and treatment. (Tr. 653). On July
23, 2013, Hobbs told Dr. Sandhu that his left shoulder pain was worse, but he was “doing fine
still.” (Tr. 649). Dr. Sandhu referred Hobbs to St. Thomas Hospital Orthopedic Clinic (“St.
Thomas”) for an MRI, instructed Hobbs to continue using naproxen, and reiterated her physical
therapy referral. (Tr. 650).
On August 6, 2013, Hobbs had an MRI at St. Thomas, which showed a tear in his left
shoulder muscle and osteoarthritis.2 (Tr. 647–48). At a September 13, 2013, follow-up, Hobbs
told Bradley Inkrott, M.D., that he had left shoulder pain for 6 months that became progressively
worse. (Tr. 663). Hobbs told Dr. Inkrott that he worked as an auto mechanic, and that his
inability to lift heavy objects or “do any sort of overhead activities” made his job difficulty.
(Tr. 663). Hobbs told Dr. Inkrott that a steroid injection improved similar symptoms in his right
shoulder. (Tr. 663). On examination, Dr. Inkrott noted that Hobbs had significant muscle
atrophy, poor posture, tenderness, and resisted forward flexion in his left shoulder. (Tr. 663).
Dr. Inkrott noted that an MRI and other images of Hobbs’ left shoulder revealed a
partial-thickness tear in a shoulder tendon, muscle atrophy, and a bone spur. (Tr. 663).
Dr. Inkrott gave Hobbs a steroid injection, prescribed an anti-inflammatory medication, and
2
Hobbs did not submit medical records from his August 2013 treatment at St. Thomas, but this treatment
is noted in medical records from IMC. See generally Doc. 10, Page ID# 52–53; (Tr. 655–66).
4
referred Hobbs for physical therapy to strengthen his rotator cuff and shoulder muscles.
(Tr. 663–64).
On May 12, 2014, Hobbs told Richard Gradsick, M.D, at AGMC that his right knee was
painful and swollen after he rode his bike into a tree. (Tr. 582). Dr. Gradsick determined that
Hobbs did not fracture his knee, but that he had an abnormal range of motion in it. (Tr. 583).
Dr. Gradsick instructed Hobbs to follow up with Phillip Wilcox, M.D., or an orthopedic
physician at the VA, placed Hobbs’ knee in an immobilizer, and prescribed him a narcotic pain
reliever. (Tr. 583). Dr. Wilcox determined that Hobbs did not have any significant joint line
tenderness in his knees, but he had “some very mild” tenderness in the middle of his shin and
“mild patellofemoral crepitus.” (Tr. 590). Dr. Wilcox took four CT scans of Hobbs’ knee,
which showed degenerative changes including small joint effusion, mild osteoarthritis, mild soft
tissue swelling in the kneecap, and a few loose bodies or bone spurs near his shin indicating a
shin fracture. (Tr. 590, 592–95). Dr. Wilcox prescribed ice, elevation, immobilization, and
crutches. (Tr. 590).
On November 4, 2014, Jonathan Kanam, D.O., at IMC noted that Hobbs had complained
to Dr. Sandhu about shoulder pain in July 2013 and had an MRI at St. Thomas in August 2013.
(Tr. 647). Hobbs told that he did not have any shoulder pain since his September 2013 steroid
injection. (Tr. 647–48). At a follow-up on November 26, 2014, Hobbs told Jesson Baumgartner,
D.O., that he had sharp pain in his left shoulder that started after he “la[id] some hardwood
flooring.” (Tr. 644). Hobbs told Dr. Baumgartner that Aleve and Advil gave him “mild relief,”
and he said that this was the first time he had pain since receiving a September 2013 steroid
injection at St. Thomas. (Tr. 644). Dr. Baumgartner referred Hobbs to St. Thomas for further
evaluation and treatment, prescribed an anti-inflammatory medication, and instructed Hobbs to
“remain as active as possible with shoulder to avoid frozen shoulder.” (Tr. 645). At a January 5,
5
2015, follow-up, Hobbs told Dr. Kanam that he had right shoulder pain and was scheduled to
receive a left shoulder injection on January 7, 2015. (Tr. 641). Dr. Kanam did not note any
abnormalities in Hobbs’ extremities on examination but stated that he had a decreased range of
motion in his back. (Tr. 641). Dr. Kanam stated that he would “inquire about [a right] shoulder
injection,” and instructed Hobbs to continue taking his anti-inflammatory medication. (Tr. 642).
On August 1, 2016, Hobbs told Dr. Kanam that he had lower back pain after falling off a ladder,
but he denied any weakness. (Tr. 853). Hobbs told Dr. Kanam that he self-medicated with
Percocet that he had left over from dental surgery, and Dr. Kanam told him to stop. (Tr. 855).
Dr. Kanam noted that Hobbs had a decreased range of motion and tenderness in his back on
examination, recommended that Hobbs pursue conservative therapy, and continued Hobbs’s
Neurontin prescription. (Tr. 855).
On January 7, 2015, Hobbs told Inkrott that he had pain in both his shoulders. (Tr. 659).
Dr. Inkrott noted that he had given Hobbs a shoulder injection a year and a half earlier, which
Hobbs said gave him relief for “roughly 6–8 months.” (Tr. 659). Dr. Inkrott also noted that he
had prescribed physical therapy and an anti-inflammatory medication to treat his shoulder pain,
but that Hobbs did not follow up on either. (Tr. 659). On examination, Hobbs did not have any
changes in his extremities, and Dr. Inkrott gave Hobbs injections in both shoulders. (Tr. 659).
Dr. Inkrott also repeated his physical therapy prescription. (Tr. 659). On May 6, 2015, Hobbs
told Dr. Inkrott that his January shoulder injections gave him “pretty good relief” in his right
shoulder that was “greater than [his] left shoulder.” (Tr. 687). Dr. Inkrott gave Hobbs additional
injections and stated that Hobbs “will continue physical therapy” and taking anti-inflammatory
medication. (Tr. 687). On December 18, 2015, Hobbs told Dr. Inkrott that he had “mild relief”
from over-the-counter pain medications and physical therapy and stated that he “sometimes
work[ed] a labor related job.” (Tr. 717). Dr. Inkrott noted that Hobbs had crepitus in his
6
shoulders and some limited forward flexion in his left shoulder; however, he had full strength.
(Tr. 717–18). Dr. Inkrott stated that Hobbs had “no true weakness,” but exaggerated his left
shoulder pain on examination. (Tr. 718). Dr. Inkrott gave Hobbs shoulder injections and told
Hobbs that his “problem [would] not improve unless he [made] a rehab effort, which to [that]
point [had] been minimal.” (Tr. 719). He also gave Hobbs literature on home exercises to
improve rotator cuff strength and range of motion. (Tr. 720–26). On March 23, 2016, Dr.
Inkrott’s assessment of Hobbs’ condition did not change, and he gave Hobbs additional
injections. (Tr. 709–11, 779–80). Hobbs told Dr. Inkrott that he could not do home exercises as
instructed because he did not understand what rotator cuff rehabilitation was, and Dr. Inkrott
stated that Hobbs would need two to three months of intensive therapy to determine whether
conservative management was effective. (Tr. 711, 781). Dr. Inkrott stated that he wanted Hobbs
to give him physical therapy notes to verify attendance and that he would order x-rays if Hobbs’
symptoms worsened or only marginally improved. (Tr. 711, 781). On August 17, 2016, Hobbs
denied having any weakness in his shoulder, but said that he had pain with activity. (Tr. 765,
775). Dr. Inkrott noted that Hobbs had a poor history of compliance with rehabilitation and
physical therapy, and that Hobbs had never given him any verification that he actually went to
physical therapy. (Tr. 766, 775). Dr. Inkrott gave Hobbs additional injections and stated that
Hobbs was a poor operative candidate due to his lack of rehabilitation effort. (Tr. 766, 777).
On January 14, 2015, Hobbs told Ryan Urchek, M.D., at St. Thomas that his right
shoulder felt better after his injection, but that his left shoulder pain continued. (Tr. 656). On
examination, Dr. Urchek noted that Hobbs had “much better” motion in his right shoulder than
his left shoulder, and that Hobbs had pain with external rotation of his left shoulder. (Tr. 656).
Dr. Urchek noted that he would not give Hobbs a second injection, as he had had one a week
earlier, and instructed Hobbs to follow up after physical therapy. (Tr. 656). At a follow-up on
7
September 16, 2015, Hobbs told Dr. Urchek that, in addition to injections in both his shoulders,
he had “mild relief” from over-the-counter pain medications and physical therapy. (Tr. 682). On
examination, Dr. Urchek noted that Hobbs had crepitus in his shoulders and some limited
forward flexion in his left shoulder; however, he had full strength. (Tr. 682). Dr. Urchek noted
that Hobbs was doing well with conservative care and wished to proceed with it. (Tr. 683).
Dr. Urchek gave Hobbs steroid injections in his shoulders and instructed him to continue home
exercises. (Tr. 683).
On February 5, 2015, Hobbs went to physical therapist (“PT”) Christ Perry for an
assessment of his bilateral shoulder pain and plan for physical therapy. (Tr. 668–74). Hobbs
told Perry that his January 7, 2015, injections gave him “good relief,” and that he did carpentry
on the side. (Tr. 671). Hobbs told Perry that his pain increased when he was active, and that the
only thing that helped was injections. (Tr. 671). Perry noted that Hobbs had decreased range of
motion, strength, and functional mobility. (Tr. 668, 673). Perry noted that Hobbs would need
two months of physical therapy and a home exercise program, but that he expected poor
compliance the home exercise program. (Tr. 668, 673). Perry stated that Hobbs’s overall
rehabilitation potential was poor. (Tr. 668, 673).
On March 23, 2016, Hobbs had an MRI, which revealed a full-thickness tear of a right
shoulder tendon and mild fatty muscular atrophy. (Tr. 741). He also had severe tendinosis and
interstitial partial tearing in another right shoulder tendon. (Tr. 741). His left shoulder had mild
tendon weakness, “very slight” to minimal fraying, and mild to moderate tendinosis. (Tr. 739).
On April 28, 2016, Hobbs told Aaron Lear, M.D., that he “ha[d] trouble with
Dr. Inkrott,” felt worse after going to physical therapy, and was told to find a new doctor by his
disability attorney. (Tr. 847). Hobbs told Dr. Lear that he took oxycodone “from wherever [he
could] get it” (including oxycodone prescribed to his cousin), an anti-inflammatory medication,
8
and injections for his shoulder pain. (Tr. 847). Hobbs said injections did not help him.
(Tr. 849). Dr. Lear noted that Hobbs had a normal gait and intact sensation in his upper
extremities. (Tr. 849). Hobs refused further physical therapy, and Dr. Lear told Hobbs that he
would not prescribe narcotic pain relievers. (Tr. 849). Dr. Lear noted that he was suspicious of
Hobbs’ complaints. (Tr. 849). On June 9, 2016, Dr. Lear gave Hobbs shoulder injections and
told him that he would not get additional injections without physical therapy. (Tr. 842–43).
Hobbs said that he would get physical therapy and did exercises at home, but he did not feel
better. (Tr. 842).
On July 21, 2016, nurse practitioner (“NP”) Christina Gabele noted that Hobbs had lower
back pain with sciatica traveling down his left leg. (Tr. 729). Hobbs told Gabele that he could
walk without difficulty, and that he did not have any weakness in his back. (Tr. 729). On
examination, Gabele noted that Hobbs’ back had a normal range of motion, was not tender, and
had some pain on the left. (Tr. 730–31). Hobbs’ upper extremities had a normal range of
motion, and Gabele noted no abnormalities. (Tr. 731). Gabele determined that Hobbs had “mild
multilevel spondylosis,” and treated him for low back pain with sciatica. (Tr. 731). Gabele
ordered imaging of Hobbs’ back, which indicated that he had some bone spurs between his
vertebrae, “mild multilevel lumbar spondylosis,” and “trace” displacement of a lumbar vertebra.
(Tr. 737). Gabele gave Hobbs an injection, prescribed a muscle relaxing medication, and
instructed him to continue taking his anti-inflammatory medication. (Tr. 732).
On August 8, 2016, Hobbs told Dean Rich, D.O., that he had pain in his lower left back,
which began after he fell off a four-foot ladder a month or two earlier. (Tr. 762). Hobbs said
that he was prescribed Neurontin for his back pain. (Tr. 762). On examination, Dr. Rich noted
that Hobbs had tenderness in his back and a decreased range of motion secondary to reported
pain. (Tr. 763). Dr. Rich diagnosed Hobbs with a ligament sprain and sciatica, prescribed
9
Neurontin for the pain, and gave him an anti-inflammatory medication with no refills. (Tr. 763).
On August 16, 2016, Hobbs told Dr. Rich that his back pain was much better, and Dr. Rich
continued Hobbs’ Neurontin and anti-inflammatory treatment. (Tr. 760). On September 13,
2016, Hobbs told Dr. Rich that his pain was worse with bending. (Tr. 758). Dr. Rich continued
Hobbs’ Neurontin, ordered an x-ray of Hobbs’ back, and recommended that Hobbs get an
orthopedic evaluation. (Tr. 759). On October 24, 2016, Hobbs told Dr. Rich that he was in
physical therapy, and that his naproxen helped with his lower back pain. (Tr. 793). Dr. Rich
continued Hobbs’ medications and physical therapy recommendation. (Tr. 793–94). On January
5, 2017, Hobbs requested that Dr. Rich refer him to a chronic pain management specialist for
management of his shoulder and lower back pain. (Tr. 887–88).
On August 11, 2016, Hobbs saw PT Perry for a physical therapy initial evaluation for
treatment of his shoulder pain. (Tr. 829–32). Hobbs told Perry that a doctor recommended he
have right shoulder surgery in April 2016, but he declined. (Tr. 830). He told Perry that he was
in and out of therapy for the previous eight years, and that he also had back pain. (Tr. 830).
Perry noted that Hobbs’ physical therapy order was written in March 2016, and that Hobbs gave
several excuses for not attending therapy sooner, including having dental work done and having
a long waiting period for a second opinion. (Tr. 830). Hobbs told Perry that he rode his bike
during the day, and that mowing grass did not bother his shoulders. (Tr. 830). On examination,
Hobbs had moderate crepitus in his shoulders, +4/5 strength in his upper extremities, and some
reduced range of motion. (Tr. 831). Perry noted that Hobbs had a history of noncompliance
with doctors’ recommendations, did not appear to be compliant with his current doctor’s
recommendations, and was given a home exercise program to perform. (Tr. 832). Perry
discontinued services with Hobbs because he had an “apparent lack of motivation to perform
therapy in an attempt to address his shoulder pain.” (Tr. 832–33).
10
On September 22, 2016, David Rosenbaum, D.O., took x-rays of Hobbs’ lower back.
(Tr. 882). The x-rays showed that he had mild lumbar degenerative spondylosis. (Tr. 882).
On September 27, 2016, Hobbs told James Kennedy, M.D., that his back pain started a
week after he fell from a three-foot ladder in June 2016. (Tr. 796). Hobbs told Dr. Kennedy that
his prescribed pain reliever gave him relief, and that his symptoms were aggravated with lifting,
walking, sitting, standing, changing positions, extended inactivity, and lying down. (Tr. 796).
On examination, Dr. Kennedy noted that Hobbs could walk without difficulty and with a normal
gait, appeared balanced, had full strength in his legs, and had normal sensation and reflexes in
his back. (Tr. 798). Dr. Kennedy determined that Hobbs had degenerative disc disease in his
lower spine with sciatica. (Tr. 798). Dr. Kennedy continued Hobbs on non-narcotic pain
relievers and prescribed him an anti-inflammatory medication. (Tr. 798). On November 4,
2016, Hobbs told Dr. Kennedy that his back was 90% better with his medication and physical
therapy, and that his pain was a 1/10. (Tr. 790, 802, 903). Dr. Kennedy’s examination findings
did not change, he instructed Hobbs to continue his medications and physical therapy, and he
stated that Hobbs could proceed to home exercise after he finished physical therapy. (Tr. 792,
803–04, 904–05). On December 5, 2016, Hobbs told Dr. Kennedy that his aquatic therapy
helped a lot, and that he could do normal daily activities without pain. (Tr. 901). On December
19, 2016, Hobbs told Dr. Kennedy that he aggravated his back pain when he was sanding a
coffee table, and that he was in aquatic physical therapy. (Tr. 889, 898). On examination,
Dr. Kennedy found that Hobbs had full strength in his lower back and lower extremities, but he
demonstrated a shuffling gait. (Tr. 890, 899). On January 17, 2017, Hobbs told Dr. Kennedy
that he had sharp back pain in the morning and was scheduled to begin pain management in
February 2017. (Tr. 884, 893). On examination, Dr. Kennedy found that Hobbs had full
strength in his lower back and lower extremities and a normal gait. (Tr. 885, 894–95).
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Dr. Kennedy noted that Hobbs’ “sciatica [was] about gone,” and he prescribed a non-narcotic
pain reliever. (Tr. 886, 895). On April 14, 2017, Hobbs told Dr. Kennedy that going to pain
management was too inconvenient due to the bus schedule, and that his insurance denied a
steroid injection. (Tr. 921). Hobbs told Dr. Kennedy that his prescribed narcotic pain reliever
helped. (Tr. 921). On examination, Dr. Kennedy noted that Hobbs had full strength in his lower
back but walked with an antalgic gait. (Tr. 922). He discussed operative treatment with Hobbs
but decided to proceed with steroid injections. (Tr. 923).
On October 20, 2016, Hobbs saw PT Perry for a physical therapy initial evaluation for
treatment of his lower back pain. (Tr. 823–26). Hobbs told Perry that he hurt his back when he
fell off a ladder, and that he spent his day working on mowers in his garage, helping out at a
local convenience store, and watching TV. (Tr. 823). On examination, Hobbs had an
independent and normal gait, mild to moderate restrictions in his flexibility, 4/5 to +4/5 strength
in his hips, full strength in his knees and ankles, poor posture, 25% range of motion in his
standing spine, and 75% range of motion in his seated spine. (Tr. 824). Hobbs told Perry that
steroids helped his pain and was prescribed therapy a month before his evaluation. (Tr. 825).
Hobbs attended physical therapy sessions on October 27, 2016, November 3, 2016, and
November 11, 2016. (Tr. 814–21). On November 11, 2016, Perry noted that Hobbs’ progress
was slow, he refused aquatic therapy for “several reasons,” and he was not proactive enough
with his rehabilitation. (Tr. 815). At a re-evaluation on November 17, 2016, Perry noted that
Hobbs had improved, did not meet any of his objective goals, was independent in his home
exercise program, and would go to another facility for aquatic therapy. (Tr. 810).
On November 14, 2016, Hobbs told Derek Klaus, M.D., that he was diagnosed with
“bilateral massive rotator cuff tears,” and that he received serial injections every few months for
his pain. (Tr. 769). Hobbs said that he had difficulty performing overhead activities, but that his
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pain was relieved with ice and activity. (Tr. 769). Hobbs also said that he was in physical
therapy. (Tr. 769). On examination, Dr. Klaus noted that Hobbs had some reduced range of
motion in his shoulders, 3/5 strength in his upper rotator cuff muscles, 4/5 strength in his middle
and lower rotator cuff muscles, and full strength in his arms. (Tr. 772). Dr. Klaus noted that
imaging showed early rotator cuff tear arthropathy, a massive rotator cuff tear on the left
shoulder, and evidence of a high-grade tendon tear. (Tr. 772). Dr. Klaus gave Hobbs steroid
injections in his shoulders and stated that Hobbs’ rotator cuffs were likely not repairable due to
the amount of atrophy and retraction shown in imaging. (Tr. 773). Dr. Klaus prescribed aquatic
therapy at Hobbs’ request. (Tr. 773). On February 13, 2017, Hobbs told Dr. Klaus that his
symptoms had not changed, and that he had severe pain (6/10 to 8/10). (Tr. 914). Hobbs told
Dr. Klaus that his injection helped for a few weeks, and that his physical therapy was helpful.
(Tr. 915). Hobbs told Dr. Klaus that he wanted more injections, and that he was “not interested
in having surgery because he [felt] that he [was] very functional [in] his current state.” (Tr. 915,
918). On examination, Dr. Klaus found that Hobbs had a normal gait, full forward flexion in
both shoulders, normal external rotation in both shoulders, and full strength in both shoulders.
(Tr. 917).
On December 14, 2016, Hobbs saw Joshua Magleby, Ph.D., for a psychological
evaluation on referral from the Division of Disability Determination. (Tr. 863–68). During the
evaluation, Hobbs told Dr. Magleby that his daily activities included repairing lawnmowers that
people brought him, watching TV, getting dressed, and bathing (but it hurt to shower). (Tr. 865).
Hobbs said that he had trouble sleeping due to his shoulder pain. (Tr. 865).
On December 28, 2016, Charles Muncrief, D.O., examined Hobbs’ knees and spine.
(Tr. 874). Dr. Muncrief determined that Hobbs did not have any issues in his left knee, mild to
13
moderate degenerative changes in his right knee, and moderate multilevel degenerative changes
in his lumbar spine. (Tr. 874).
On February 2, 2017, Hobbs told Maged Fouad, M.D., that he had constant lower back
pain that ranged from a 3/10 to a 10/10. (Tr. 908). He said that bending, standing a long time,
lifting, sitting a long time, climbing steps, and cold made his pain worse. (Tr. 908). Hobbs said
that he had modest relief from aquatic therapy, and that he had several lumbar injections in the
past. (Tr. 908). On examination, Dr. Fouad found that Hobbs had normal range of motion in his
spine, no trigger points, left joint tenderness, limited and painful bilateral shoulder abduction,
very limited left shoulder flexion, normal left shoulder extension, and mildly limited right
shoulder flexion and extension. (Tr. 910). Hobbs’ right knee had limited flexion. (Tr. 910).
Dr. Fouad gave Hobbs a narcotic pain reliever for his lower back pain and referred Hobbs to a
physical therapist for further evaluation of his back, knee, and shoulder problems. (Tr. 911).
On February 14, 2017, Joe Holcomb, M.D., interpreted x-rays of Hobbs’ right knee to show mild
to moderate degenerative changes in the knee joint, but no acute abnormalities. (Tr. 881).
C.
Relevant Opinion Evidence
1.
Treating Physician—Steven Lippitt, M.D.
On July 11, 2016, Hobbs told orthopedic surgeon Steven Lippitt, M.D., that Dr. Lear
requested he get a second opinion regarding treatment for his bilateral shoulder complaints.
(Tr. 836). Hobbs told Dr. Lippitt that steroid injections helped him, and that he did not go to
physical therapy for his shoulder. (Tr. 836). Hobbs rated his shoulder pain as a 1 to 2 out of 10.
(Tr. 836). Hobbs said he used Percocet, which he “g[ot] from the street at times,” and Dr. Lippitt
encouraged him to stop. (Tr. 836, 838). On examination, Hobbs had a “mild neck ache” when
reaching overhead, no shoulder pain on overhead reaching, no swelling, mild crepitus, mild
tenderness, mild stiffness on cross-body reaching, good shoulder strength, 4/5 right rotator cuff
14
strength, 4+/5 left rotator cuff strength, and normal joint alignment. (Tr. 837). Dr. Lippitt noted
that a May 2016 MRI showed a complete right rotator cuff tear and partial left rotator cuff tear.
(Tr. 838). Dr. Lippitt encouraged Hobbs to avoid repeated steroid injections because they would
defer any surgery and continued his anti-inflammatory medication. (Tr. 838). Dr. Lippitt stated
that Hobbs should avoid pushing, pulling, or lifting more than 10 pounds with either shoulder.
(Tr. 838).
2.
Examining Physician—Mark Vogelgesang, M.D.
On December 28, 2016, Hobbs saw Mark Vogelgesang, M.D., for an orthopedic
evaluation on referral from the Division of Disability Determination. (Tr. 869–78). Hobbs told
Dr. Vogelgesang that he had 8/10 pain in his left shoulder and 3/10 pain in his right shoulder,
both knees, and lower back. (Tr. 870). Hobbs also said that he could walk a half mile and carry
and lift 10 pounds. (Tr. 870). Hobbs told Dr. Vogelgesang that he had trouble putting on shirts
due to his shoulder pain, did a little cleaning, worked as a mechanic and a carpenter in the past,
and could not lift anything overhead. (Tr. 870). Hobbs told Dr. Vogelgesang that a surgeon said
he would not operate on his shoulder due to the extensive damage. (Tr. 873). On examination,
Dr. Vogelgesang noted that Hobbs had an adequately aligned spine, intact range of motion in his
spine and extremities, no joint erythema or tenderness, normal muscular development, full
strength in all extremities, normal reflexes, and a normal gait without a limp. (Tr. 872). Hobbs
had some tenderness at the top of his back, but he had “good lower back mobility.” (Tr. 872).
He had decreased shoulder mobility due to pain, could not lift his shoulders over his head, mildly
affected internal rotation, good extension, abduction difficulty, good strength in his arms, and
good mobility in the rest of his shoulder joints. (Tr. 872, 876). Dr. Vogelgesang rated Hobbs’
shoulder strength as 4+/5 and noted that he did not have any muscle atrophy. (Tr. 875–76).
Hobbs’ knees did not have any crepitus, joint changes, or tenderness. (Tr. 872).
15
Dr. Vogelgesang diagnosed Hobbs with bilateral shoulder pain, history of low back pain, and
history of bilateral knee pain. (Tr. 872). Based on the examination and a review of Hobbs’
medical records, Dr. Vogelgesang opined that Hobbs could tolerate sedentary work. (Tr. 873).
He stated that Hobbs might be able to tolerate light to sedentary work after his shoulder was
examined further in March, and that physical therapy would possibly help resolve his left
shoulder and allow him to do light to sedentary work. (Tr. 873).
3.
State Agency Reviewing Physicians
On March 6, 2015, state agency consultant Paul Morton, M.D., evaluated Hobbs’
physical abilities based on a review of the record. (Tr. 108–16, 123–30). Dr. Morton determined
that Hobbs had medically determinable impairments, including osteoarthritis and degenerative
disorders of the back. (Tr. 110, 125). Dr. Morton sated that Hobbs could occasionally lift or
carry 20 pounds, frequently lift or carry 10 pounds, stand or walk for 6 hours in an 8-hour day,
sit for 6 hours in an 8-hour day, and push or pull without limitation. (Tr. 112, 127). Hobbs
could never climb ladders, ropes or scaffolds, but he could frequently stoop, kneel, crouch, and
crawl. (Tr. 112–13, 127–28). Hobbs had no limitation to his ability to climb ramps or stairs,
handle, finger, feel, and endure cold, heat, wetness, humidity, vibration, and fumes. (Tr. 112–14,
127–29). Hobbs was limited to occasional bilateral overhead reaching. (Tr. 113–14, 128–29).
Based on his findings, Dr. Morton opined that Hobbs could perform light work. (Tr. 115, 130).
On June 4, 2015, state agency consultant Anne Prosperi, D.O., reviewed Hobbs’ medical
records and concurred with Dr. Morton’s findings. (Tr. 141–47, 155–61). Dr. Prosperi added
that Hobbs could only occasionally crawl. (Tr. 144, 158).
D.
Relevant Testimonial Evidence
Hobbs testified at both the November 10, 2016, and May 17, 2017, ALJ hearings.
(Tr. 79–92, 57–65). Hobbs testified that he lived at his mother’s house with his uncle, and he
16
had three adult children who did not live with him. (Tr. 59–60, 81, 87). He did not have a
bathroom on the floor of his mother’s house, so he had to walk up and down the stairs two or
three times per day. (Tr. 60). He last had a driver’s license in 1996. (Tr. 59, 80). On a typical
day he would watch TV, “mess around” in the garage, “tinker around with” and paint furniture,
cook in the microwave, and do laundry. (Tr. 60, 87–89). He said it was difficult to reach back
when he showered, and that reaching down while getting dressed and putting on a shirt hurt. (Tr.
90). Hobbs testified that he last worked in 2007, and that he worked for “about an hour or two”
at Ring’s Market in 2016. (Tr. 65). He said he did not work on lawnmowers. (Tr. 65).
Hobbs testified that he “sometimes” had lower back pain, which radiated down his legs
when he stood for an hour and prevented him from walking. (Tr. 83, 88, 91). Hobbs said that
his back pain got worse between the November 2016 and May 2017 ALJ hearings, but he no
longer had pain raiding down his legs. (Tr. 58, 61). He could stand for about an hour, sit for a
half hour, and walk a quarter mile. (Tr. 62). Hobbs said he had constant pain in his shoulders
(worse in his left than right), which caused him difficulty sleeping. (Tr. 58, 63, 81, 83, 85). He
said he could “sometimes” lift his arms over his head but that lifting as much as a gallon jug hurt.
(Tr. 84, 89). Hobbs said that he could move something in front of him without difficulty, but
that it hurt to reach. (Tr. 86). He had a torn left rotator cuff that hurt worse than his right
shoulder, and his doctors told him he needed surgery on his right rotator cuff. (Tr. 82). At the
May 2017 ALJ Hearing, Hobbs said that he could not do anything with his left arm due to his
shoulder pain. (Tr. 59). Hobbs also stated that he also had knee pain sometimes. (Tr. 63).
Hobbs testified that he did physical therapy for his lower back pain, which he said his
doctors wanted him to complete before he got therapy for his shoulders. (Tr. 82–84). Hobbs
said that he was in physical therapy for his shoulders, but his physical therapist cancelled
services because “it wasn’t’ doing no good” and “they want[ed] to do a[n] operation on [his]
17
right [shoulder].” (Tr. 85). Hobbs said that he did not tell his doctor he was not interested in
surgery. (Tr. 64). Hobbs took Naprosyn and gabapentin for his pain, which helped “a little bit,”
but made him feel tired and dizzy. (Tr. 81, 84). He also got steroid injections every three
months, which helped with the throbbing pain in his shoulders for “a couple weeks.” (Tr. 58, 85,
90).
Even with injections, moving his arms hurt. (Tr. 90). Nonetheless, he said that he could
lift 10 pounds after his injections and more than 10 pounds “very little.” (Tr. 63). Hobbs also
got steroid shots for his back, which helped “a little bit.” (Tr. 61).
Lynn Smith, a vocational expert (“VE”), testified at the November 10, 2016, ALJ
hearing. (Tr. 94–99). Smith testified that Hobbs did not have any skills from prior work that
would transfer to light or sedentary work. (Tr. 95). The ALJ asked Smith whether a
hypothetical individual who was born in September 1964, had a high school education, and no
relevant skills from past work could work if he could:
Lift, carry push, and pull 20 pounds occasionally and 10 pounds frequently. This
person can sit for six hours; stand and/or walk for six hours in a normal work day.
This person cannot climb ladders, ropes, or scaffolds. This person can
occasionally kneel and crawl. This person cannot reach overhead bilaterally.
This person must avoid work place hazards, such as unprotected heights or
exposure to dangerous moving machinery. This person[ is] limited to occasional
interaction with others. And this person is limited to work settings that involve no
more than moderate sound level, which I’ll describe as a business office where
typewriters are used, department store, grocery store, light traffic situations, or the
noise level in a fast-food restaurant during off hours.
(Tr. 96). Smith testified that such an individual could work as a ticket marker, office helper, and
office cleaner. (Tr. 96–97). The ALJ asked if the above-described individual could work if he
were additionally limited to occasional reaching in other directions with no overhead reaching.
(Tr. 97). Smith testified that such an individual could not work. (Tr. 97). The ALJ asked if the
individual described in the first hypothetical question could work if he would also be off task
33% of the time due to pain. (Tr. 97–98). Smith testified that such an individual could not work,
as the threshold for off-task time was 10%. (Tr. 98). Finally, the ALJ asked if the individual
18
described in the first hypothetical question could work if he had to take two unscheduled
15-minute breaks, beyond the normal breaks and lunch period, due to pain and fatigue. (Tr. 98).
Smith said that such an individual could not work. (Tr. 98).
Roxanne Benoit, a VE, testified at the May 17, 2017, ALJ hearing. (Tr. 67–68). Hobbs’
attorney asked Benoit if a hypothetical individual could work at the light level, if he could lift
and carry no more than 10 pounds at maximum, walk for one hour at a time, sit for a half-hour
before needing to alternate position, never reach overhead, and frequently reach in other
directions. (Tr. 67). Benoit stated that such an individual could work at the sedentary level and
could not perform any work at the light level. (Tr. 67–68).
IV.
The ALJ’s Decision
On May 17, 2017, the ALJ issued a decision determining that Hobbs was not disabled
and denying his applications for supplemental security income and disability insurance benefits.
(Tr. 15–46). The ALJ first noted that Hobbs had filed a previous application covering a period
between 2009 and August 28, 2012, and that he had not shown good cause for reopening that
application, which was denied. (Tr. 16). The ALJ also noted that Hobbs had insured status only
through December 31, 2012, and, thus, had to show he was disabled on or before that date to
receive disability insurance benefits. (Tr. 17, 19). The ALJ found that Hobbs had “the following
severe impairments: degenerative disc disease of the lumbar spine, degenerative joint disease of
the bilateral shoulders, degenerative joint disease of the right knee, bilateral sensorineural
hearing loss, and hepatitis-C.” (Tr. 19). The ALJ determined that Hobbs had no impairment or
combination of impairments that met or medically equaled the severity of any of the listed
impairments in 20 C.F.R. § 404, Subpart P, Appendix 1. (Tr. 22–23).
The ALJ determined that Hobbs had the RFC to perform light work, except that he:
Cannot climb ladders ropes or scaffolds; can occasionally kneel and crawl;
Cannot reach overhead bilaterally; Must avoid workplace hazards such as
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unprotected heights and exposure to dangerous moving machinery; Can work in
environments with no more than “Moderate” noise intensity level, defined to
mean business offices where typewriters are used, department stores, grocery
stores, light traffic, and fast-food restaurants during off-hours; and Can have
occasional interactions with others.
(Tr. 23).
In assessing Hobbs’ RFC, the ALJ explicitly stated that he “considered all symptoms” in
light of the medical and other evidence in the record. (Tr. 24). The ALJ noted that Hobbs
alleged that: (1) his shoulder, back, and knee pain prevented him from reaching above his head
and in front of his body and lifting more than 10 pounds or a gallon of milk; (2) his arms and
shoulders constantly hurt; and (3) his pain got worse if he walked “a couple of blocks” or stood
for one hour. (Tr. 24–25). The ALJ stated that Hobbs’ medically determinable impairments
could reasonably be expected to cause the alleged symptoms; however, the ALJ found that
Hobbs’ complaints regarding the intensity, persistence, and limiting effects of his symptoms
were “not entirely consistent with the medical evidence and other evidence in the record.” (Tr.
25).
The ALJ explained that Hobbs’ subjective complaints were inconsistent with medical
records showing that: (1) Hobbs’ medical history was more limited than would be expected in
light of his complaints, including first complaining of left shoulder pain in July 2013, first
complaining of bilateral shoulder pain in January 2015, not receiving treatment from September
2013 through November 2014, and first complaining of his back pain in July 2016; (2) he did not
comply with several physicians’ recommendations for physical therapy for his shoulders and had
only limited physical therapy for his back; (3) his pain symptoms were adequately managed and
improved with conservative treatment, including injections and medication; (4) he had nearly full
strength in his shoulders, arms, knees, and back; and (5) diagnostic imaging and examination
findings showed only mild to moderate problems in his shoulders, knees, and back. (Tr. 25–35,
20
38). Further, the ALJ stated that Hobbs’ subjective complaints were inconsistent with his
reported daily activities and informal work activities, including: showering, dressing (with some
reaching difficulty), cooking with a microwave, doing laundry, cutting grass, riding his bike,
“tinkering with” and painting furniture, carpentry, climbing ladders, helping at stores, working
on lawnmowers. (Tr. 39–40). The ALJ also noted that Hobbs appeared to try to bolster the
evidence supporting his subjective complaints by misrepresenting to Dr. Vogelgesang and
testifying that he was given narcotic pain relievers, when his medical records indicated that his
physicians told him to stop “self-medicating” with narcotic pain relievers he received from his
cousin and off the street. (Tr. 38).
The ALJ noted that although Dr. Lippitt had a treating relationship with Hobbs (Tr. 41),
his opinion was not due controlling weight because it was inconsistent with physical
examinations that did not show Hobbs had progressive weakness in his arms or shoulders,
Hobbs’ daily activities, his informal work activities, and his statements that he was “very
functional” after conservative treatment. (Tr. 41). Further, the ALJ stated that Dr. Lippitt’s
opinion was due little weight for the same reasons, and because: (1) Dr. Lippitt had seen Hobbs
only once for a second opinion encounter; (2) his opinion was inconsistent with other medical
records that did not find similar lifting restrictions and his own notes showing nearly full strength
in Hobbs’ shoulders and elbows; and (3) Hobbs’ conservative care for his shoulder pain. (Tr.
41).
The ALJ stated that Dr. Vogelgesang’s opinion also was due little weight for many of the
same reasons he had expressed in limiting the weight assigned to Dr. Lippitt’s opinion. (Tr. 41).
Further, the ALJ explained that Dr. Vogelgesang’s opinion was inconsistent with his
unremarkable objective findings on physical examinations, his findings that Hobbs had only
slightly reduced strength in his shoulders, Hobbs’ reports that he improved with injections and
21
oral pain medications, and Hobbs’ reported daily living and work activities. (Tr. 41–42).
Moreover, the ALJ noted that Dr. Vogelgesang’s opinion that Hobbs was limited to light to
sedentary work was incomplete, because he did not evaluate Hobbs’ knee and back impairments
or his alleged walking and standing limitations. (Tr. 42).
The ALJ stated that the state agency consultants’ opinions were due great weight because
they were consistent with: (1) the objective medical findings showing only mildly decreased
strength in the shoulders and some limited range of motion; and (2) the supplemental medical
records submitted at the hearing level. (Tr. 43). The ALJ also explained that the state agency
consultants’ evaluations were particularly reliable due to their expertise and familiarity with the
Social Security regulations for evaluating a claimant’s RFC. (Tr. 43). Nonetheless, the ALJ
stated that the state agency consultants’ opinions that Hobbs was limited from frequent stooping
and crouching were due “less weight” because they were not supported by the medical evidence
as a whole. (Tr. 43).
The ALJ noted that Hobbs turned 50 on September 7, 2014, and remained a person
closely approaching advanced age as of the date of the decision. (Tr. 44). The ALJ noted that, if
Hobbs were able to perform the full range of light work, the Medical Vocational Guidelines
would direct a finding of not-disabled. (Tr. 45). However, because Hobbs had additional
limitations, the ALJ relied on the VE’s testimony to determine whether Hobbs could perform a
significant number of jobs. (Tr. 45). Based on the VE’s testimony and considering Hobbs’ RFC,
age, education, and experience, the ALJ found that Hobbs could work as a marker, office helper,
or office cleaner. (Tr. 45). He noted that he accepted the VE’s testimony that none of those jobs
would require Hobbs to reach overhead, because it was based on the VE’s years of professional
experience in vocational rehabilitation. (Tr. 45–46). In light of his findings, the ALJ determined
22
that Hobbs was not disabled from August 28, 2012, through the date of his decision and denied
Hobbs’ applications for supplemental security income and disability insurance benefits. (Tr. 46).
V.
Law & Analysis
A.
Standard of Review
The court’s review is limited to determining whether the ALJ applied proper legal
standards and reached a decision supported by substantial evidence. 42 U.S.C. §§ 405(g) and
1383(c)(3); Elam v. Comm’r of Soc. Sec., 348 F.3d 124, 125 (6th Cir. 2003); Kinsella v.
Schweiker, 708 F.2d 1058, 1059 (6th Cir. 1983). Substantial evidence is any relevant evidence,
greater than a scintilla, that a reasonable person would accept as adequate to support a
conclusion. Rodgers v. Comm’r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007).
Under this standard of review, a court cannot decide the facts anew, make credibility
determinations, or re-weigh the evidence. See 42 U.S.C. §§ 405(g), 1383(c)(3) (providing that, if
the Commissioner’s findings as to any fact are supported by substantial evidence, those findings
are conclusive); Jones v. Comm’r of Soc. Sec., 336 F.3d 469, 476 (6th Cir. 2003) (“Upon review,
we are to accord the ALJ’s determinations of credibility great weight and deference particularly
since the ALJ has the opportunity, which we do not, of observing a witness’s demeanor when
testifying.”). Even if the court does not agree with the Commissioner’s decision, or substantial
evidence could support a different result, the court must affirm if the Commissioner’s findings
are reasonably drawn from the record and supported by substantial evidence. See Elam, 348
F.3d at 125 (“The decision must be affirmed if the administrative law judge’s findings and
inferences are reasonably drawn from the record or supported by substantial evidence, even if
that evidence could support a contrary decision.”); Rogers, 486 F.3d at 241 (“[I]t is not necessary
that this court agree with the Commissioner’s finding, as long as it is substantially supported in
the record.”). This is so because the Commissioner enjoys a “zone of choice” within which to
23
decide cases without risking being second-guessed by a court. Mullen v. Bowen, 800 F.2d 535,
545 (6th Cir. 1986).
Though the court’s review is deferential, the court will not uphold the Commissioner’s
decision if the ALJ failed to apply proper legal standards, unless the legal error was harmless.
Bowen v. Comm’r of Soc. Sec., 478 F.3d 742, 746 (6th Cir. 2006) (“Even if supported by
substantial evidence, however, a decision of the Commissioner will not be upheld [when] the
SSA fails to follow its own regulations and [when] that error prejudices a claimant on the merits
or deprives the claimant of a substantial right.”); Rabbers v. Comm’r Soc. Sec. Admin., 582 F.3d
647, 654 (6th Cir. 2009) (“Generally, however, we review decisions of administrative agencies
for harmless error. Accordingly, . . . we will not remand for further administrative proceedings
unless the claimant has been prejudiced on the merits or deprived of substantial rights because of
the agency’s procedural lapses.” (citations and quotation omitted)). Furthermore, the court will
not uphold a decision, even when supported by substantial evidence, when the Commissioner’s
reasoning does “not build an accurate and logical bridge between the evidence and the result.”
Fleischer v. Astrue, 774 F. Supp. 2d 875, 877 (N.D. Ohio 2011) (quoting Sarchet v. Charter, 78
F.3d 305, 307 (7th Cir. 1996); accord Shrader v. Astrue, No. 11-13000, 2012 U.S. Dist. LEXIS
157595 (E.D. Mich. Nov. 1, 2012) (“If relevant evidence is not mentioned, the court cannot
determine if it was discounted or merely overlooked.”); McHugh v. Astrue, No. 1:10-CV-734,
2011 U.S. Dist. LEXIS 141342 (S.D. Ohio Nov. 15, 2011); Gilliams v. Astrue,
No. 2:10-CV-017, 2010 U.S. Dist. LEXIS 72346 (E.D. Tenn. July 19, 2010); Hook v. Astrue,
No. 1:09-CV-19822010, 2010 U.S. Dist. LEXIS 75321 (N.D. Ohio July 9, 2010). Requiring an
accurate and logical bridge ensures that a claimant will understand the ALJ’s reasoning.
The Social Security regulations outline a five-step process the ALJ must use to determine
whether a claimant is entitled to supplemental security income or disability benefits: (1) whether
24
the claimant is engaged in substantial gainful activity; (2) if not, whether the claimant has a
severe impairment or combination of impairments; (3) if so, whether that impairment, or
combination of impairments, meets or equals any of the listings in 20 C.F.R. § 404, Subpart P;
(4) if not, whether the claimant can perform her past relevant work in light of her RFC; and (5) if
not, whether, based on the claimant’s age, education, and work experience, she can perform
other work found in the national economy. 20 C.F.R. §§ 404.1520(a)(4)(i)–(v) and
416.920(a)(4)(i)–(v); Combs v. Comm’r of Soc. Sec., 459 F.3d 640, 643 (6th Cir. 2006). The
claimant bears the ultimate burden to produce sufficient evidence to prove that she is disabled
and, thus, entitled to benefits. 20 C.F.R. §§ 404.1512(a) and 416.912(a).
B.
Medical Opinions
Hobbs argues that the ALJ failed to apply proper legal procedures and reach a conclusion
supported by substantial evidence in weighing the medical opinion evidence. ECF Doc. 14, Page
ID# 996–1001. Specifically, Hobbs asserts that the ALJ improperly gave little weight to
examining physicians Dr. Lippitt’s and Dr. Vogelgesang’s opinions regarding the limitations
caused by his impairments. Id. at 996–97. He contends that Dr. Lippitt’s and Dr. Vogelgesang’s
opinions were due great weight because Dr. Lippitt was an orthopedic surgeon, both had
examined Hobbs, and Hobbs’ treatment notes, including diagnostic imaging, supported their
opinions. Id. at 997–1001. Further, Hobbs argues that the ALJ should not have given great
weight to the state agency consultants’ opinions or concluded that their opinions were consistent
with Hobbs’ MRI results showing the full extent of his shoulder issues, in part because their
opinions were issued before Hobbs had his MRI revealing more extensive shoulder damage. Id.
at 997, 1000–01.
The Commissioner responds that the ALJ applied proper legal procedures and reached
conclusions supported by substantial evidence in evaluating the medical opinion evidence. ECF
25
Doc. 16, Page ID# 1023–27, 1029. The Commissioner argues that the ALJ reasonably gave
great weight to the state agency consultants’ opinions after explaining that their opinions were
supported by diagnostic imaging studies of Hobbs’ shoulders, the June 2015 ENT consultation
findings, and the consultants’ expertise in Social Security programs. Id. at 1023. Further, the
Commissioner asserts that the ALJ adequately considered the entire record in evaluating the state
agency consultants’ opinions and noted that their opinions were consistent with Hobbs’ May
2016 MRI results. Id. at 1024. Finally, the Commissioner argues that the ALJ properly gave
Dr. Lippitt’s and Dr. Vogelgesang’s opinions little weight, because: (1) Dr. Lippitt had only
examined Hobbs once; (2) their opinions conflicted with their own treatment notes and other
medical evidence; and (3) their opinions conflicted with Hobbs’ daily activities and informal
work activities. Id. at 1024–27.
Hobbs replies by repeating his argument that the ALJ erred by not evaluating Dr.
Lippitt’s opinion as a treating source opinion, and by giving little weight to Dr. Lippitt’s and Dr.
Vogelgesang’s opinions. ECF Doc. 17, Page ID# 1034–35. Hobbs asserts that Dr.
Vogelgesang’s treatment notes supported his opinion, and that this court should disregard the
Commissioner’s arguments supporting the ALJ’s decision to give little weight to Dr. Lippitt’s
and Dr. Vogelgesang’s opinions as improper post hoc rationalizations. Id. at 1035–36. Further,
Hobbs reiterates his argument that the ALJ erred in giving great weight to the state agency
consultants’ opinions, because regulations require treating and examining physicians’ opinions to
be given greater weight than non-examining physicians’ opinions. Id. at 1036.
At Step Four, an ALJ must weigh every medical opinion that the Social Security
Administration receives. 20 C.F.R. §§ 404.1527(c), 416.927(c). An ALJ must give a treating
physician’s opinion controlling weight, unless the ALJ articulates good reasons for discrediting
that opinion. Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365, 376 (6th Cir. 2013). “Treating26
source opinions must be given ‘controlling weight’ if two conditions are met: (1) the opinion is
‘well-supported by medically acceptable clinical and laboratory diagnostic techniques’; and
(2) the opinion ‘is not inconsistent with the other substantial evidence in [the] case record.’” Id.
(Quoting 20 C.F.R. § 404.1527(c)(2)). Good reasons for rejecting a treating physician’s opinion
may include that: “(1) [the] treating physician’s opinion was not bolstered by the evidence;
(2) evidence supported a contrary finding; or (3) [the] treating physician’s opinion was
conclusory or inconsistent with the doctor’s own medical records.” See Winschel v. Comm’r of
Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 2011) (quotation omitted); 20 C.F.R. §§ 404.1527(c),
416.927(c). Inconsistency with nontreating or nonexamining physicians’ opinions alone is not a
good reason for rejecting a treating physician’s opinion. See Gayheart, 710 F.3d at 377 (stating
that the treating physician rule would have no practical force if nontreating or nonexamining
physicians’ opinions were sufficient to reject a treating physician’s opinion).
If an ALJ does not give a treating physician’s opinion controlling weight, he must
determine the weight it is due by considering the length of the length and frequency of treatment,
the supportability of the opinion, the consistency of the opinion with the record as a whole, and
whether the treating physician is a specialist. See Gayheart, 710 F.3d at 376; 20 C.F.R.
§§ 404.1527(c)(2)–(6), 416.927(c)(2)–(6). Nothing in the regulations requires the ALJ to explain
how he considered each of the factors. See 20 C.F.R. §§ 404.1527(c), 416.927(c). But the ALJ
must provide an explanation “sufficiently specific to make clear to any subsequent reviewers the
weight the [ALJ] gave to the treating source’s medical opinion and the reasons for that weight.”
Gayheart, 710 F.3d at 376; see also Cole v. Astrue, 661 F.3d 931, 938 (6th Cir. 2011) (“In
addition to balancing the factors to determine what weight to give a treating source opinion
denied controlling weight, the agency specifically requires the ALJ to give good reasons for the
weight he actually assigned.”). When the ALJ fails to adequately explain the weight given to a
27
treating physician’s opinion, or otherwise fails to provide good reasons for rejecting a treating
physician’s opinion, remand is appropriate. Cole, 661 F.3d at 939.
“[O]pinions from nontreating and nonexamining sources are never assessed for
‘controlling weight.’” Gayheart, 710 F.3d at 376. Instead, an ALJ must weigh such opinions
based on: (1) the examining relationship; (2) the degree to which supporting explanations
consider pertinent evidence; (3) the opinion’s consistency with the record as a whole; (4) the
physician’s specialization related to the medical issues discussed; and (5) any other factors that
tend to support or contradict the medical opinion. Id.; 20 C.F.R. §§ 404.1527(c), 416.927(c).
Generally, an examining physician’s opinion is due more weight than a nonexamining
physician’s opinion. 20 C.F.R. § 404.1527(c)(2), 416.927(c)(2); Gayheart, 710 F.3d at 375. An
ALJ does not need to articulate good reasons for rejecting a nontreating or nonexamining
opinion. See Smith v. Comm’r of Soc. Sec., 482 F.3d 873, 876 (6th Cir. 2007) (declining to
address whether an ALJ erred in failing to give good reasons for not accepting non-treating
physicians’ opinions). An ALJ may rely on a state agency consultant’s opinion and may give
such opinions greater weight than other nontreating physicians’ opinions if they are supported by
the evidence. Reeves v. Comm’r of Soc. Sec., 618 F. App’x 267, 274 (6th Cir. 2015). Further, an
ALJ may rely on a state agency consultant’s opinion that predates other medical evidence in the
record, if the ALJ considers any evidence that the consultant did not evaluate. McGrew v.
Comm’r of Soc. Sec., 343 F. App’x 26, 32 (6th Cir. 2009).
Notwithstanding the requirement that an ALJ consider and weigh medical opinion
evidence, the ALJ is not required to give any deference to opinions on issues reserved to the
Commissioner. 20 C.F.R. §§ 404.1527(d), 416.927(d). These issues include: (1) whether a
claimant has an impairment or combination of impairments that meets or medically equal an
impairment in the Listing of Impairments; (2) the claimant’s RFC; (3) the application of
28
vocational factors; and (4) whether a claimant is “disabled” or “unable to work.” 20 C.F.R.
§§ 404.1527(d)(1)–(2), 416.927(d)(1)–(2).
The ALJ applied proper legal procedures in weighing Hobbs’ medical opinion evidence.
42 U.S.C. §§ 405(g), 1383(c)(3); Elam, 348 F.2d at 125; Kinsella, 708 F.2d at 1059. The ALJ
complied with the regulations when he specifically stated that treating physician Dr. Lippitt’s
opinion was not due controlling weight, and explained that Dr. Lippitt’s opinion was due little
weight because: (1) it was inconsistent with Dr. Lippitt’s and other physicians’ physical
examinations notes showing full strength in Hobbs’ shoulders and elbows, Hobbs’ daily
activities and work activities, Hobbs’ conservative treatment, and Hobbs’ statements that he was
“very functional” with conservative treatment; and because (2) Dr. Lippitt had seen Hobbs only
once for a second opinion encounter. Gayheart, 710 F.3d at 376–77; 20 C.F.R. §§ 404.1527(c),
416.927(c); Cole, 661 F.3d at 938; (Tr. 41). Here, the ALJ’s decision to assess Dr. Lippitt’s
opinion for controlling weight belies Hobbs’ argument that the ALJ erred by not evaluating
Dr. Lippitt’s opinion a treating source. Gayheart, 710 F.3d at 375–76; (Tr. 41). The ALJ also
complied with the regulations when he explained that consulting physician Dr. Vogelgesang’s
opinion was due little weight because it was inconsistent with his own examination notes,
Hobbs’ reports that he improved with conservative care, and Hobbs’ reported daily living and
work activities. Gayheart, 710 F.3d at 376–77; 20 C.F.R. §§ 404.1527(c), 416.927(c); Cole, 661
F.3d at 938; (Tr. 41–42). Furthermore, the ALJ followed proper legal procedures in giving great
weight to the state agency consultants’ opinions, because: (1) the ALJ adequately explained that
their opinions were consistent with the objective medical evidence and supported by the
consultants’ expertise; and (2) the ALJ considered all the evidence in the record, including the
medical records submitted after the state agency consultants issued their opinions. Reeves, 618
F. App’x at 274; McGrew, 343 F. App’x at 32; (Tr. 43).
29
Substantial evidence also supported the ALJ’s weighing of the medical opinion evidence.
42 U.S.C. §§ 405(g), 1383(c)(3); Elam, 348 F. 2d at 125; Kinsella, 708 F.2d at 1059. Here,
Dr. Lippitt’s opinion – that Hobbs should avoid pushing, pulling, and lifting more than
10 pounds – was inconsistent with his own treatment notes showing that Hobbs had only 1/10 to
2/10 pain in his shoulders, no pain with overhead reaching, good shoulder strength (4/5 in the
right and 4+/5 in the left), and only mild stiffness on cross-body reaching. (Tr. 836–38).
Similarly, Dr. Vogelgesang’s opinion – that Hobbs was limited to sedentary work – was
inconsistent with his own notes showing that Hobbs could walk half a mile, could carry and lift
10 pounds, had an intact range of motion in his spine and extremities, had a normal gait, and had
full strength in all extremities (4+/5 in his shoulders). (Tr. 870, 872, 875–76). Furthermore,
Dr. Lippitt’s and Dr. Vogelgesang’s opinions were inconsistent with, and the state agency
consultants’ opinions were consistent with: (1) other medical records finding that Hobbs had full
or good strength in his shoulders, only mild to moderate physical symptoms, a normal gait, and
improvement through conservative treatment (injections, medications, and back physical
therapy); (2) Hobbs’ daily and informal work activities, including riding his bike, mowing lawns,
repairing lawnmowers, painting and sanding furniture, laying hardwood flooring, climbing
ladders, carpentry, walking up and down stairs, and doing laundry; and (3) Hobbs’ statements
that he was doing fine and felt “very functional.” (Tr. 58, 60, 63, 81, 84–85, 87–89, 590, 592–
95, 642, 644, 649, 653, 656, 659, 671, 682, 687, 717–18, 729, 731, 760, 772, 790, 792–94, 798,
802–04, 824, 831, 849, 853, 865, 874, 881–82, 885, 889–90, 894–95, 898–99, 901, 903–05, 908,
910, 914–15, 917–18). Thus, even if other evidence could support a different result, the ALJ’s
weight determinations fall within the Commissioner’s “zone of choice” because they were
reasonably drawn from the record. Elam, 348 F.3d at 125; Rogers, 486 F.3d at 241; Mullen, 800
F.3d at 545.
30
C.
Subjective Symptom Complaints
Hobbs argues that the ALJ wrongly determined that his subjective symptom complaints
were inconsistent with the record evidence. ECF Doc. 14, Page ID# 1003.
The Commissioner responds that the ALJ thoroughly analyzed the record evidence and
provided an adequate, detailed explanation for rejecting Hobbs’ subjective symptom complaints.
ECF Doc. 16, Page ID# 1017–19. The Commissioner argues that evidence supported the ALJ’s
decision to reject Hobbs’ subjective complaints, including: (1) medical records showing that
Hobbs repeatedly failed to comply with his physician’s physical therapy prescriptions; (2) notes
indicating that Hobbs reported his conservative treatment through medication and injections
helped and allowed him to function well; (3) Hobbs’ ability to care for his personal hygiene,
shop, cook, clean his house, paint furniture, ride his bicycle, mow grass, and do laundry; and (4)
Hobbs’ reported work activities involving laying flooring, climbing ladders, sanding tables,
working on lawn mowers, helping at convenience and liquor stores, and doing carpentry. Id. at
1017–23.
Hobbs replies that the ALJ erred in determining that he did not attend physical therapy,
denied working since 2007, and engaged in daily activities that were inconsistent with his
subjective complaints. ECF Doc. 17, Page ID# 1033–34. He asserts that he testified that he
worked for an hour or two in 2015, he attended physical therapy for his back, he had difficulty
showering and dressing himself, and his activities were restricted to watching TV, tinkering in
his basement, and cooking in the microwave. Id. at 1033–34.
A claimant’s subjective symptom complaints may support a disability finding only when
objective medical evidence confirms the alleged severity of the symptoms. Blankenship v.
Bowen, 874 F.2d 1116, 1123 (6th Cir. 1989). Nevertheless, an ALJ is not required to accept a
claimant’s subjective symptom complaints and may properly discount the claimant’s testimony
31
about his symptoms when it is inconsistent with objective medical and other evidence. See
Jones, 336 F.3d at 475–76; SSR 16-3p, 82 Fed. Reg. 49462, 49465 (Oct. 25, 2017) (“We will
consider and individual’s statements about the intensity, persistence, and limiting effects of
symptoms, and we will evaluate whether the statements are consistent with objective medical
evidence and the other evidence.”). In evaluating a claimant’s subjective symptom complaints,
an ALJ may consider several factors, including the claimant’s daily activities, the claimant’s
efforts to alleviate his symptoms, and the type and efficacy of any treatment. SSR 16-3p, 82
Fed. Reg. at 49465–66; 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3); see also Temples v. Comm’r
of Soc. Sec., 515 F. App’x 460, 462 (6th Cir. 2013) (stating that an ALJ properly considered a
claimant’s ability to perform day-to-day activities in determining whether his testimony
regarding his pain was credible).
Here, the ALJ applied proper legal procedures and reached a conclusion supported by
substantial evidence when he determined that Hobbs’ statements regarding the intensity,
persistence, and limiting effects of his symptoms were not entirely consistent with the medical
and other evidence in the record. 42 U.S.C. §§ 405(g), 1383(c)(3); Elam, 348 F.3d at 125;
Kinsella, 708 F.2d at 1059. First, the ALJ applied the correct legal standard by assessing Hobbs’
subjective symptom complaints based on their consistency with the medical and other evidence,
and by articulating that Hobbs’ complaints were not entirely consistent with the other evidence in
the record. Jones, 336 F.3d at 475–76; Temples, 515 F. App’x at 462; SSR 16-3p, 82 Fed. Reg.
at 49465–66; 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3); (Tr. 24–40). Further, substantial
evidence supported the ALJ’s determination that Hobbs’ subjective symptom complaints were
not entirely consistent with the other evidence in the record, which revealed that: (1) Hobbs
consistently told treatment providers that his pain symptoms improved with injections and
medication; (2) Hobbs’ treatment providers generally found that his physical symptoms were
32
mild to moderate, he had good to full strength in his upper and lower extremities, and he had a
normal gait; (3) Hobbs told: Dr. Sandhu that he did not have any pain reaching down, Dr. Lippitt
that he had no pain reaching overhead, and Dr. Kennedy that he had no pain from performing
normal daily activities; (4) Dr. Inkrott believed that Hobbs exaggerated his pain symptoms;
(5) Hobbs could ride a bike, lay hardwood flooring, climb ladders, sand and paint furniture,
repair lawn mowers, walk up and down stairs, and do his own laundry; (6) Hobbs was noncompliant with his physicians’ recommendations that he commit to physical therapy for his
shoulder pain; (7) physical therapy helped Hobbs’ back pain improve; and (8) Hobbs told
Dr. Klaus that he did not want to have shoulder surgery because he felt he was “very functional.”
(Tr. 58, 60, 63, 81, 84–85, 87–89, 590, 592–95, 642, 644, 649–50, 653, 656, 659, 663–64, 668,
671, 673, 682, 687, 717–18, 729, 731, 760, 766, 772, 775, 790, 792–94, 798, 802–04, 815, 824,
830–33, 842–43, 849, 853, 855, 865, 874, 881–82, 885, 889–90, 894–95, 898–99, 901, 903–05,
908, 910, 914–15, 917–18). Thus, the ALJ had a proper basis upon which to determine that the
objective medical and other evidence did not confirm Hobbs’ description of his symptoms; and
this court may not disturb the ALJ’s finding that Hobbs’ subjective symptom complaints were
not entirely consistent with the objective medical and other evidence in the record, even if one
could lay out a basis for reaching a different result. 42 U.S.C. §§ 405(g), 1383(c)(3); Jones, 336
F.3d at 476; Elam, 348 F.3d at 125; Rogers, 486 F.3d at 241; Blankenship, 874 F.2d at 1123.
D.
Improper Medical Judgment
Hobbs argues that the ALJ improperly made medical judgments when he disregarded
Hobbs’s treatment notes, MRIs, and X-rays to support his findings that Hobbs’ subjective
symptom complaints and Dr. Lippitt’s and Dr. Vogelgesang’s opinions were inconsistent with
the medical record. ECF Doc. 14, Page ID# 1000–01, 1003. The Commissioner responds that
the ALJ did not make improper medical findings, or “play doctor,” but instead evaluated the
33
medical findings in the record to determine Hobbs’ residual functional capacity, as required
under the regulations. Id. at 1027–28. Hobbs replies that the ALJ made improper medical
judgments when he evaluated whether Dr. Lippitt’s and Dr. Vogelgesang’s opinions were
consistent with their own treatment notes. ECF Doc. 17, Page ID# 1035.
It is true that an ALJ “may not substitute his own medical judgment for that of the
treating physician where the opinion of the treating physician is supported by the medical
evidence.” Meece v. Barnhart, 192 F. App’x 456, 465 (6th Cir. 2006); see also Rohan v. Chater,
98 F.3d 966, 970 (7th Cir. 1996) (stating that “ALJs must not succumb to the temptation to play
doctor and make their own medical findings). But an ALJ does not “play doctor” when the
record is sufficiently developed, the ALJ reviews the medical opinion evidence in light of the
record as a whole, and the ALJ makes a legal determination supported by substantial evidence.
Griffith v. Comm’r of Soc. Sec., 582 F. App’x 555, 562 (6th Cir. 2014). Further, an ALJ does not
“play doctor” merely by deciding an issue reserved to the Commissioner, as ALJs are required to
make such determinations under the regulations. Cf. SSR 96-5p, 61 Fed. Reg. 34471, 34472
(July 2, 1996) (explaining that issues reserved to the commissioner are not medical issues, but
administrative findings dispositive to a social security case), rescinded by SSR 17-2p, 82 Fed.
Reg. 15263–65 (Mar. 27, 2017).
Here, the ALJ did not “play doctor” by substituting his own judgment for that of the
medical experts and Hobbs’ physicians. Instead, the ALJ properly and exhaustively reviewed
the medical and other evidence in the record, relied on that evidence in determining whether the
medical opinion evidence was supported, and determined the issues reserved to the
Commissioner, including Hobbs’ RFC. Griffith, 582 F. App’x at 562; SSR 96-5p, 61 Fed. Reg.
at 34472; (Tr. 15–46). Thus, the record belies Hobbs’ argument that the ALJ “played doctor.”
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E.
Disability Determination
Hobbs argues that the ALJ improperly determined that he was able to perform work at
the light exertional level, and that he was not disabled. ECF Doc. 14, Page ID# 1004–06. He
asserts that, had the ALJ incorporated Dr. Lippitt’s and Dr. Vogelgesang’s opinions that he could
not reach overhead and lift more than 10 pounds into the RFC, the VE’s testimony would have
supported a finding that he could not work at the light exertional level. Id. at 1004–05. Further,
because the Medical Vocational Guidelines provide that a person over 50 years old who is
limited to sedentary work is disabled, the ALJ should have found that he was disabled as of
September 7, 2015. Id. at 1005–06.
The Commissioner responds that, because the ALJ did not find Hobbs’ allegations
regarding the severity and limiting effects of his shoulder impairments to be consistent with the
medical evidence, the ALJ was not required to incorporate those limitations into his RFC. ECF
Doc. 16, Page ID# 1030. Because the ALJ relied upon the VE’s testimony in response to a
hypothetical question that tracked the ALJ’s RFC finding, the Commissioner argues that the ALJ
properly relied on the VE’s testimony to conclude that Hobbs could perform a significant
number of jobs. Id. at 1029–30.
Hobbs replies that the ALJ “failed to follow the regulations when he disregarded any
evidence which would have limited Hobbs to a sedentary level of exertion and/or found that he
was unable to perform any work in the national economy.” ECF Doc. 17, Page ID# 1037.
At Step Four of the sequential analysis, the ALJ must determine a claimant’s residual
functional capacity or “RFC” by considering all relevant medical and other evidence. 20 C.F.R.
§§ 404.1520(e), 416.920(e). The RFC is an assessment of a claimant’s ability to do work despite
his impairments. Walton v. Astrue, 773 F. Supp. 2d 742, 747 (N.D. Ohio 2011) (citing 20 C.F.R.
§ 404.1545(a)(1) and SSR 96-8p, 61 Fed. Reg. 34474, 34475 (July 4, 1996)). “In assessing RFC,
35
the [ALJ] must consider limitations and restrictions imposed by all of an individual’s
impairments, even those that are not ‘severe.’” SSR 96-8p, 61 Fed. Reg. at 34477. Relevant
evidence includes a claimant’s medical history, medical signs, laboratory findings, and
statements about how the symptoms affect the claimant. 20 C.F.R. § 416.929(a). A person with
the RFC to perform light work can frequently lift up to 10 pounds, and may perform work that
involves “a good deal of walking or standing, or . . . sitting with some pushing and pulling of
arm or leg controls.” 20 C.F.R. § 416.967(b).
At the final step of the sequential analysis, the burden shifts to the Commissioner to
produce evidence supporting the contention that the claimant can perform a significant number
of jobs in the national economy. Howard v. Comm’r of Soc. Sec., 276 F.3d 235, 238 (6th Cir.
2002); 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v). An ALJ may determine whether the
claimant has the ability to perform work in the national economy by applying the
medical-vocational guidelines. 20 C.F.R. §§ 404.1569, 416.969; 20 C.F.R. Pt. 404, Subpt. P,
App. 2 § 200.00. The medical-vocational guidelines establish matrices that correlate variables—
including the claimant’s RFC, age, educational background, and previous work experience. See
generally 20 C.F.R. Pt. 404, Subpt. P, App. 2. When these variables are entered into the
appropriate matrix, a finding of disabled or not disabled is directed. Id. Nevertheless, the
medical-vocational guidelines “do not cover all possible variations of factors.” 20 C.F.R.
§ 416.969. When a claimant’s particular characteristics do not coincide with a rule’s
corresponding criteria, such as when a claimant is unable to perform the full range of a category
of work, the medical-vocational guidelines do not direct a conclusion of disabled or not disabled.
20 C.F.R. Pt. 404, Subpt. P, App. 2 § 200.00(a), (d).
Age and education are vocational characteristics that affect a claimant’s ability to work.
20 C.F.R. §§ 416.963(a), 416.964. A person under age 50 is classified as “younger,” and a
36
person aged 50 to 54 is classified as “closely approaching advanced age.” 20 C.F.R.
§§ 404.1563(c)–(d), 416.963(c)–(d). A person with a 12th grade education or above is classified
as having “high school education and above,” and is generally considered to be able to do
semi-skilled through skilled work. 20 C.F.R. §§ 404.1564(b)(4), 416.964(b)(4). The
medical-vocational guidelines direct a finding of “not disabled” when a claimant is capable of
performing the full range of light work and has limited or greater education, regardless of
whether he is “closely approaching advanced age” or “younger.” 20 C.F.R. Pt. 404, Subpt. P,
App. 2 §§ 202.10–202.22.
Alternatively, an ALJ may determine that a clamant has the ability to adjust to other work
in the national economy by relying on a vocational expert’s testimony that the claimant has the
ability to perform specific jobs. Howard, 276 F.3d at 238. A vocational expert’s testimony in
response to a hypothetical question is substantial evidence when the question accurately portrays
the claimant’s RFC. See id. (stating that “substantial evidence may be produced through reliance
on the testimony of a vocational expert (VE) in response to a ‘hypothetical’ question, but only ‘if
the question accurately portrays [the claimant’s] individual physical and mental impairments”
(internal quotation marks omitted)); see also Lee v. Comm’r of Soc. Sec., 529 F. App’x 706, 715
(6th Cir. 2013) (unpublished) (stating that the ALJ’s hypothetical question must “accurately
portray[] a claimant’s vocational abilities and limitations”). “An ALJ is only required to
incorporate into a hypothetical question those limitations he finds credible.” Lee, 529 F. App’x
at 715; see also Blacha v. Sec’y of Health & Human Servs., 927 F.2d 228, 231 (6th Cir. 1990).
(“If the hypothetical question has support in the record, it need not reflect the claimant’s
unsubstantiated complaints.”)
Hobbs’ challenge of the ALJ’s RFC determination is unavailing. The ALJ applied proper
legal procedures and reached a decision supported by substantial evidence in determining that
37
Hobbs had the RFC to perform a range of light work, notwithstanding his shoulder, back, and
knee impairments. 42 U.S.C. §§ 405(g), 1383(c)(3); Elam, 348 F.3d at 125; Kinsella, 708 F.2d
at 1059. Here, the ALJ followed proper legal procedures by considering all of Hobbs’
impairments, severe or otherwise, in light of the medical and other evidence in the record. 20
C.F.R. §§ 404.1520(e), 404.1529(a), 416.920(e), 416.1529(a); SSR 96-8p, 61 Fed. Reg. at
34477; (Tr. 23–43). Evidence in the record supported the ALJ’s determination that Hobbs could
perform a range of light work, because the objective medical evidence indicated that he had good
or full strength in his upper and lower extremities, could walk without assistance, and functioned
well enough to perform normal daily living activities and various informal labor activities. (Tr.
60, 87–89, 582, 642, 644, 649, 653, 656, 659, 671, 682, 687, 717–18, 729, 731, 760, 765, 772,
775, 790, 792–94, 798, 802–04, 824, 831, 837, 849, 865, 872, 875–76, 885, 889–90, 894–95,
899, 901, 903–05, 908, 914–15, 917–18). Even though evidence showed that Hobbs had pain
when reaching, other evidence showed that he was able to control his pain through conservative
treatment and the ALJ controlled for his reaching limitations in the RFC. (Tr. 23, 58, 63, 81, 84–
85, 642, 644, 653, 656, 659, 671, 687, 760, 790, 793, 802, 837, 901, 903). Further, because the
ALJ did not find Dr. Lippitt’s and Dr. Vogelgesang’s opinions to be consistent with the medical
record and other evidence, the ALJ was not required to incorporate their opinions into the RFC
finding. Lee, 529 F. App’x at 715; Blacha, 927 F.2d at 231. Thus, this court cannot disturb the
ALJ’s conclusion that Hobbs could perform a range of light work, notwithstanding his shoulder,
back, and knee impairments. 42 U.S.C. §§ 405(g), 1383(c)(3); Jones, 336 F.3d at 476; Elam,
348 F.3d at 125; Rogers, 486 F.3d at 241; Walton, 773 F. Supp. 2d at 747.
The ALJ also applied proper legal procedures and reached a conclusion supported by
substantial evidence in determining that Hobbs was not disabled at Step Five. 42 U.S.C.
§§ 405(g), 1383(c)(3); Elam, 348 F.3d at 125; Kinsella, 708 F.2d at 1059. Because the
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