ETHRIDGE v. ASTRUE

Filing 10

MEMORANDUM OPINION re: 6 MOTION for Summary Judgment filed by MARK B. ETHRIDGE; and 8 MOTION for Summary Judgment filed by the Commissioner of Social Security. Signed by Judge William L. Standish on 4/24/2012. (md)

IN THE UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF PENNSYLVANIA

MARK B. ETHRIDGE,

Plaintiff,
vs.

Civil Action No. 11-543

MICHAEL J. ASTRUE,
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
MEMORANDUM OPINION
INTRODUCTION
plaintiff, Mark B. Ethridge, seeks judicial review of a
decision of Defendant, Commissioner of Social Security ("the
Commissioner"), denying his applications for disability
insurance benefits ("DIB") and supplemental security income
("SS!") under Titles II and XVI, respectively, of the Social
Security Act, 42 U.S.C.

§§

401-433 and

§§

1381-1383f. 1

Presently

before the Court are the parties' cross-motions for summary
judgment pursuant to Fed.R.Civ.P. 56.

For the reasons set forth

below, Plaintiff's motion for summary judgment will be denied,

'The Social Security system provides two types of benefits based on an
inability to engage in substantial gainful activity: the first type/ DIB,
provides benefits to disabled individuals who have paid into the Social
Security system through past employment, and the second type, SSI, provides
benefits to disabled individuals who meet low-income requirements regardless
of whether the individuals have ever worked or paid into the Social Security
system. With respect to Plaintiff's claim for DIB, he acquired sufficient
quarters of coverage through past employment to remain insured through
December 31/ 2010.
(R. 104). Therefore, to be eligible for DIB, Plaintiff
must establish that he became disabled before that date.

1

and the Commissioner's cross-motion for summary judgment will be
granted.
PROCEDURAL HISTORY

Plaintiff filed applications for DIB and SSI on August 25,
2008, alleging disability since January 26, 2008 due to a left
hip replacement, right hip problems, arthritis in both shoulders
and bursitis in the left elbow. 2

(R. 166-72, 173-75, 180).

Following the denial of Plaintiff's applications on November 6,
2008, he requested a hearing before an administrative law judge
( "ALJ") .

(R. 121-24, 125-29, 130-32).

Plaintiff, who was

represented by counsel, testified at the hearing which was held
on June 30, 2010.

A vocational expert ("VEil) also testified.

(R. 26-45).
The ALJ issued a decision on July 16, 2010, denying
Plaintiff's applications for DIB and SSI based on a
determination that, despite severe impairments, Plaintiff
retained the residual functional capacity ("RFC") to perform

20n May 24, 2006, Plaintiff filed applications for DIB and SSI alleging
disability beginning October 31, 2005 due to a left hip replacement resulting
from Stage VII avascular necrosis, status post right hip cord depression with
trabecular screw resulting from Stage I avascular necrosis, left shoulder
rotator cuff tendonitis and right shoulder degenerative arthritis.
Following
a hearing, an ALJ issued a decision on January 25, 2008 denying Plaintiff's
applications.
(R. 104-12). Plaintiff's request for review was denied by the
Appeals Council and he apparently did not file an appeal to the district
court. Thus, the ALJ's decision dated January 25, 2008 became final and
binding and the earliest date on which Plaintiff may allege disability with
regard to his current DIB and SSI applications is January 26, 2008.
(R. 16).

2

work existing in significant numbers in the national economy.3
(R.

16-29).

Plaintiff's request for review of the ALJ's

decision was denied by the Appeals Council on April 1, 2011.
(R. 1-6, 11-12).

Thus, the ALJ/s decision became the final

decision of the Commissioner.

This appeal followed.

BACKGROUND

Plaintiff/s testimony during the hearing before the ALJ in
June 2010 may be summarized as follows:
Plaintiff/s date of birth is February 211 1972.
time of the hearing

1

At the

Plaintiff resided with his parents.

with

respect to education , Plaintiff did not complete the 10 th grade
and he has never obtained a General Equivalency Diploma.
Between 1990 and 2005
(R.

1

Plaintiff was employed as a plasterer. 4

84-85).

Plaintiff underwent a left hip replacement in 2006 and a
right hip replacement in 2007. 5
when he bends

1

Plaintiff/s left hip squeaks

and , a year before the hearing in June 2010

1

The Social Security Regulations define RFC as the most a disability claimant
can still do despite his or her physical or mental limitations. See 20
C.F.R. §§ 404.1545(a), 416.945(a).
4Plaintiff's earnings record shows no earned income since 2005.
(R. 176-78).
sAs noted in footnote 2, Plaintiff's severe hip problems were due to avascular
necrosis which can be caused by heavy alcohol consumption.
(R. 209-10, 252).
Avascular necrosis is a disease resulting from the temporary or permanent
loss of blood supply to the bones. Without blood, the bone tissue dies and,
ultimately, the bone may collapse. Excessive alcohol use is a common cause
of avascular necrosis.
People who drink alcohol in excess can develop fatty
substances that may block blood vessels, causing a decreased blood supply to
the bones.
J

3

Plaintiff dislocated his right hip when he fell in the shower. 6
(R. 86, 89-90, 93).

Plaintiff, who is right handed, also has

problems with his shoulders.

The left shoulder, which has a

torn rotator cuff, bothers Plaintiff more than the right
shoulder.

Plaintiff has had cortisone injections in both

shoulders to obtain relief from the pain.

He has been advised

that the next step for his left shoulder is surgery.
87).

(R.

86­

Plaintiff's pain is exacerbated by rain and cold weather. 7

(R. 95).

At the time of the hearing, Plaintiff was not taking

any prescribed medications.

(R. 88-90).

Plaintiff smoked a pack of cigarettes a day, and he had
stopped drinking a month before the hearing.

(R. 88-89).

With

respect to limitations, Plaintiff can walk a few blocks and
stand for 15 to 20 minutes before he has to sit down to rest. s
If he sits too long, Plaintiff has to get up and stretch.

Due

to his shoulder problems, Plaintiff tries not to reach to lift
anything. s

(R. 90-91).

With respect to activities, Plaintiff

Apparently, Plaintiff was intoxicated when he fell.
(R. 238).
7Plaintiff testified that a few times a month his pain is so severe that he
has to lie down. In this connection, Plaintiff's counsel asked him: " ... if
you had a job, ... , that didn't require you to really do a whole lot
physically, when you are feeling pain, like you were just describing, those
two to three times a month, would you have to call off because of that pain?1t
Plaintiff responded: "Yes. 1t
(R. 95-96).
8Plaintiff testified that he was given a cane following his hip surgeries and
that he uses the cane to relieve pressure when he is standing or walking too
long.
(R. 87-88).
9During the hearing, Plaintiff was asked by his counsel how long he could
perform a seated job if it required some amount of reaching. Plaintiff
responded as follows: "Maybe an hour or two, I don't know if even an hour, I
mean, that bothers me right there already.1t (R. 94-99).
6

4

takes short walks; he goes to the store; and he is visited by
friends.

Plaintiff has no hobbies.

(R. 91-93).

VE TESTIMONY

The ALJ asked the VE whether there were jobs a hypothetical
person of Plaintiff's age, education and work experience who was
limited to sedentary work that did not involve extended reaching
and permitted a sit/stand option could perform.

The VE

responded affirmatively, identifying the jobs of a telephone
solicitor, a cashier and a ticket seller.

If, in addition, the

hypothetical person should avoid repetitive handling and
fingering, the VE testified that the only sedentary job
previously identified that he or she could still perform is the
job of a telephone solicitor.

If, in addition, the hypothetical

person needed a 15-minute break every

1~

that he or she would not be employable.

hours, the VE testified
In response to a

question by Plaintiff's counsel, the VE testified that a
hypothetical individual who needed to call off work 2 to 3 days
a month due to pain could not maintain employment.

(R. 97-100).

MEDICAL EVIDENCE

The administrative record in this case includes the
following medical evidence: 1o

IOThe sole argument raised by Plaintiff in support of his motion for summary
judgment relates to the limitations resulting from his shoulder problems. As
a result, the Court's summary of the medical evidence will be limited, in
large part, to Plaintiff's treatment for shoulder pain.

5

The record of an office visit at Premier Medical Associates
on September 10, 2007 includes right shoulder pain among the
doctor's assessment of Plaintiff's medical problems.
therapy ("PT") is mentioned in the record.

Physical

(R. 219-20).

The record of Plaintiff's next office visit at Premier
Medical Associates on October 8, 2007 indicates that Plaintiff
continued to complain of right shoulder pain that was
interfering with his ability to sleepi that his range of motion
("ROM") in the right shoulder was limitedi that an MRI of his
right shoulder recently had been performed; and that he was
scheduled to see Dr. Michael Rogal, an orthopedic surgeon, in a
few days. 11

(R. 215-16).

By letter dated December 17, 2007, Dr. Rogal informed
Plaintiff that he had rotator cuff tendinitis in the left
shoulder and severe arthritis in the right shoulder.

Plaintiff

was given a slip for PT and instructed to take ibuprofen for
pain, stretch, apply heat for stiffness and cold for overuse and
avoid activities that aggravated his shoulders.

(R. 238).

Plaintiff attended six PT sessions at the Centers for Rehab
Services between December 20, 2007 and January 15, 2008.
239-49) .

Dr. Rogal is the orthopedic surgeon who performed Plaintiff's hip
replacements in May 2006 and July 2007.
(R. 256-57, 261-62).

II

6

(R.

In an office note dated March 24, 2008, Dr. Rogal noted
that Plaintiff continued to experience shoulder pain - left
greater than right.

He also complained of left elbow pain from

leaning on his elbow.

An x-ray of Plaintiff's left elbow was

negative, and Dr. Rogal's diagnosis was left olecranon bursitis.
As to Plaintiff's shoulder problems, Dr. Rogal's impression
included " [p]ersistent pain in the left shoulder with rotator
cuff tendonitis and impingement syndrome" and "[m]oderately
severe right shoulder degenerative arthritis with probably (sic)
anterior dislocation in 1992 and a Hill-Sachs lesion
posterolaterally."
shoulder.

(R.

Dr. Rogal ordered an MRI of Plaintiff's left

250).

The findings of the MRI of Plaintiff's left shoulder, which
was performed on April 22, 2008, were consistent with shoulder
impingement and included advanced degenerative arthosis of the
AC joint, moderate subacromial and subdeltoid bursitis,
sclerosis of the anterolateral margin of the acromion, rotator
cuff tendinopathy throughout the supraspinatus and infraspinatus
with a central cuff tear involving the middle third of the
supraspinatus tendon, mild myotendinous junction edema of the
infraspinatus, advanced tendinopathy of the subscapularis,
articular sided partial tearing, tendinopathy of the long head
of the biceps, and a small cyst beneath the biceps groove.
313-14) .
7

(R.

On June 10, 2008, Plaintiff presented to the Emergency Room
of UPMC McKeesport reporting that he got lime in his left eye
the previous day while renovating his girlfriend's house.

He

was given a prescription and instructed to follow-up with his
primary care physician and ophthalmologist.

(R. 267-68).

An office note by Dr. Rogal dated August 28, 2008 indicates
that Plaintiff showed up for his appointment inebriated and
security had to be called.

The note also indicates that

Plaintiff had shown up for office visits inebriated on numerous
occasions.

Plaintiff was instructed by Dr. Rogal's staff that

they would send his records "wherever he would like to go for
his followup.

12
1/

(R.

324).

The next day, Plaintiff called the

office of Dr. Rudolph Antoncic requesting referral to an
orthopedic specialist for a cortisone shot. 13

(R. 272).

On October 20, 2008, Dr. Wendy M. Helkowski performed a
consultative disability examination of Plaintiff. 14

In her

report, Dr. Helkowski noted that Plaintiff's chief complaints

12Despite a significant history of alcohol abuse, the ALJ found that
alcoholism was not a material factor in the determination of disability
because the residual effects of Plaintiff's musculoskeletal conditions exist
independently of his history of alcohol abuse. Moreover, there was no
evidence of blackouts, delirium tremors or other indications of severe
alcoholism.
(R. 19).
13Plaintiff's initial visit with Dr. Antoncic occurred on June 17, 2008. The
doctor's assessment was hepatomegaly (a swelling of the liver beyond its
normal size) and probable early chronic obstructive pulmonary disease. Full
blood work was ordered for Plaintiff.
(R. 272). An abdominal x-rayon July
29, 2008 showed "probable fatty infiltration of the liver" and a pulmonary
function test the same day was normal.
(R. 269, 271). An office note dated
November 18, 2008 indicates that Dr. Antoncic "pleaded" with Plaintiff to
stop smoking and drinking completely.
(R. 297).
14 Dr . Helkowski is Board certified in Physical Medicine and Rehabilitation.

8

were bilateral hip and shoulder pain.

With respect to his

shoulder pain, Plaintiff reported that cortisone injections in
the past had provided moderate relief; that he was unable to
elevate his left arm due to pain and weakness from rotator cuff
tendonitis; and that he had not achieved good results from PT.
Plaintiff's physical examination revealed right shoulder flexion
of 80 0 (00 - 150 0 , abduction of 80 0 (0 0 - 150 0 ) and normal
internal and external rotation, and left shoulder flexion of 30 0
(00 - 150 0 , abduction of 30 0 (0 0 - 150 0 ), internal rotation of
10 0 (00 - 40 0 ) and external rotation of 30 0 (00 - 90 0 ).

With

regard to motor power, Dr. Helkowski's testing revealed 5/5
strength throughout Plaintiff's upper extremities including
deltoids, biceps and wrist extensors and flexors.

Plaintiff's

grip strength was 4/5 bilaterally with associated pain in his
hands due to a skin condition.
normal bilaterally.

Plaintiff's fine dexterity was

In her Impression, Dr. Helkowski noted,

among other things, that Plaintiff's bilateral shoulder problems
"would prevent him from performing activities including handling
or lifting with the upper extremities./I

(R. 273-76).

In a

Medical Source Statement of Claimant's Ability to Perform Work­
Related Physical Activities, Dr. Helkowski opined that Plaintiff
could occasionally lift and carry 10 poundsi could stand and
walk 1 to 2 hours in an 8-hour workday; could sit for 8 hours in
an 8-hour workday with a sit/stand optioni had an unlimited

9

ability to push and pull with his upper and lower extremities;
could occasionally bend and climb stairs but never stoop, crouch
or balance; and could not reach or engage in repetitive handling
and fingering due to his shoulder problems.

(R. 277-78).

On November 3, 2008, a non-examining, non-medical State
agency adjudicator completed a Physical RFC Assessment for
Plaintiff based on a review of the administrative file. ls

The

adjudicator opined that Plaintiff could lift and carry 10
pounds; could stand and/or walk at least 2 hours in an 8-hour
workday; could sit about 6 hours in an 8-hour workdaYi had an
unlimited ability to push and pull with his upper and lower
extremities; could occasionally climb, balance, stoop, kneel,
crouch and crawl; had no limitations with regard to reaching in
all directions (including overhead), handling, fingering and
feeling; and had no environmental limitations. 16

(R. 279-82).

On December 16, 2008, Plaintiff was seen by Dr. Michael
Tranovich of Pittsburgh Bone & Joint Surgeons, P.C. for
ISAs noted by the ALJ in his decision, the adjudicator's Physical RFC
Assessment does not qualify as a medical opinion because he is not a medical
professional.
(R. 26).
16 The adjudicator found Plaintiff's complaints of pain only partially
credible. With respect to Plaintiff's shoulder problems, he noted that
Plaintiff reported "good pain relief from shoulder injections" and "takes
Ibuprofen and Aleve to relieve pain." As to the differences between his
Physical RFC Assessment of Plaintiff and Dr. Helkowski's opinions concerning
Plaintiff's work-related physical limitations, the adjudicator stated that
Dr. Helkowski's opinions were inconsistent with the totality of the evidence
in the file and an overestimate of the severity of Plaintiff's functional
restrictions.
Interestingly, the adjudicator only refers to Dr. Helkowski's
opinions regarding the limitations in Plaintiff's ability to sit, bend,
kneel, stoop, crouch and balance. He does not mention Dr. Helkowski's
opinions regarding the limitations resulting from Plaintiff's shoulder
problems, i.e., reaching, handling and fingering.
(R. 284).

10

complaints of pain and tenderness in his left shoulder.
Plaintiff reported that he had been diagnosed with a rotator
cuff tear and received cortisone injections in the past, and
that he had experienced episodic pain and tenderness for over a
year that was exacerbated by overhead activity and movement.
Plaintiff's physical examination revealed prominence of the AC
joint in the left shoulderi abduction limited about 100 (0° ­
150°); positive impingement sign; exquisite tenderness over the
greater tuberosity; and mild superior riding of the humeral
head.

No impression or plan was included in the record of this

office visit.

(R. 311-12).

Plaintiff's next office visit with Dr. Tranovich took place
on November 5, 2009.

At the time, Plaintiff complained of hipi

shoulder and hand pain and numbness. 17

Plaintiff/s physical

examination revealed psoriasis over the dorsal aspect of his
hands, marked pitting of his nails, restricted ROM of the MCP
and PIP joints of his fingers; and overall stiffness.

An anti-

inflammatory medication was prescribed for the psoriasis.
309-10).

(R.

A month later, Plaintiff was seen by Dr. Tranovich for

a complaint of right knee pain.

At that time, Plaintiff

continued to report multiple musculoskeletal problems as well as

17 With respect to the length of time between office visits, Dr. Tranovich
noted that Plaintiff had elected to see Dr. Rogal for his follow-up care
after his initial visit with Dr. Tranovich in December 2008.

11

psoriasis and psoriatic arthritic changes in his hands.

(R.

307-08) .
During an office visit with Dr. Rogal on January 8, 2010,
Plaintiff complained of mechanical left shoulder pain, stiffness
in his hands, occasional pain in his hips and pain over a "bump"
in the palm of his right hand.

X-rays of Plaintiff's hands

showed some carpometacarpal joint degenerative arthritis and x­
rays of Plaintiff's left shoulder showed some moderate
acromioclavicular degenerative arthritis.

Dr. Rogal's

assessment included moderately severe right shoulder
degenerative arthritis with probable anterior dislocation in
1992 and Hills-Sachs lesion posterolaterallYi impingement
syndrome of the left shoulderi bilateral flexor tendinitis of
the handsi and a neuroma of the median nerve of the right palm
with a small mass.

As to his plan for Plaintiff, Dr. Rogal

indicated that he would order an MRI or remove the mass on
Plaintiff's right palm if it began to cause pain or increased in

sizei he would approve Plaintiff for Social Security disabilitYi
and he would continue conservative treatment for Plaintiff's
left shoulder impingement and flexor tendinitis of the hands.
(R.

321).
By letter dated January 8, 2010, Dr. Rogal informed

Plaintiff that he had impingement syndrome of the left shoulder
and instructed him to stretch to avoid a frozen shoulder, to
12

apply heat for stiffness and ice after overactivity, to avoid
strenuous physical mechanical activity and to take ibuprofen.
Dr. Rogal also informed Plaintiff that the bump on his right
palm was probably a small neuroma and that he had flexor
tendinitis.

Dr. Rogal instructed Plaintiff to stretch his hand

by pulling his fingers backward, to avoid repetitive strenuous
mechanical activity with the fingers and to take ibuprofen.

(R.

323) .
In a Medical Assessment Form completed for the Pennsylvania
Department of Public Welfare on January 8, 2010, Dr. Rogal
opined that Plaintiff had been disabled since 2005 and a
candidate for DIB or SSI due to bilateral total hip
replacements, a neuroma in his right palm, right shoulder
osteoarthritis and an impingement in his left shoulder.

(R.

299-302) .
ALJ'S DECISION

In order to establish a disability under the Social
Security Act, a claimant must demonstrate an inability to engage
in any substantial gainful activity due to a medically
determinable physical or mental impairment which can be expected
to result in death or which has lasted or can be expected to
last for a continuous period of not less than 12 months.
U.S.C.

§

423(d) (1).

See 42

A claimant is considered unable to engage

in any substantial gainful activity only if his physical or
13

mental impairment or impairments are of such severity that he is
not only unable to do his previous work but cannot, considering
his age, education, and work experience, engage in any other
kind of substantial gainful work which exists in the national
economy.

See 42 U.S.C.

§

423(d) (2) (A).

When presented with a claim for disability benefits, an ALJ
must follow a sequential evaluation process.
§§

404.1520(a) (4), 416.920(a) (4).

See 20 C.F.R.

The process was described by

the Supreme Court in Sullivan v. Zebley, 493 U.S. 521 (1990), as
follows:

*

*

*

Pursuant to his statutory authority to implement the
SSI Program, (footnote omitted) the Secretary has
promulgated regulations creating a five-step test to
determine whether an adult claimant is disabled.
Bowen v.
Yuckert, 482 U.S. 137, 140-42 (1987).
(footnote omitted) .
The first two steps involve threshold determinations that
the claimant is not presently working and has an impairment
which is of the required duration and which significantly
limits his ability to work. See 20 C.F.R. §§ 416.920(a)
through (c) (1989).
In the third step, the medical evidence
of the claimant's impairment is compared to a list of
impairments presumed severe enough to preclude any gainful
work. See 20 C.F.R. pt. 404, subpt. P, App. 1 (pt.
A) (1989).
If the claimant's impairment matches or is
"equal" to one of the listed impairments, he qualifies for
benefits without further inquiry.
§ 416.920(d).
If the
claimant cannot qualify under the listings, the analysis
proceeds to the fourth and fifth steps. At these steps,
the inquiry is whether the claimant can do his own past
work or any other work that exists in the national economy,
in view of his age, education, and work experience.
If the
claimant cannot do his past work or other work, he
qualifies for benefits.

*

*
14

*

493 U.S. at 525-26.
The claimant bears the burden of establishing steps one
through four of the sequential evaluation process for making
disability determinations.

At step five

l

the burden shifts to

the Commissioner to consider "vocational factors"

(the

claimant/s age, education and past work experience) and
determine whether the claimant is capable of performing other
jobs existing in significant numbers in the national economy in
light of his or her RFC.

Ramirez v. Barnhart, 372 F.2d 546,

550-51 (3d Cir.2004) .
With respect to the ALJ's application of the five-step
sequential evaluation process in the present case, steps one and
two were resolved in Plaintiff's favor: that is, the ALJ found
that Plaintiff had not engaged in substantial gainful activity
since January 26, 2008, the alleged onset date of disability,
and the medical evidence established that Plaintiff suffers from
the following severe impairments: multiple musculoskeletal
conditions including status-post bilateral hip replacement,
bilateral arthritis of the shoulders, left shoulder impingement,
left rotator cuff tendinitis and tendinitis of the hands.

(R.

18) .
Turning to step three t

the ALJ found that Plaintiff/s

impairments were not sufficiently severe to meet or equal the
requirements of any impairment listed in 20 C.F.R., Pt. 404,

15

Subpt. P, App. 1, and, in particular, Listing 1.00, relating to
the musculoskeletal system.

(R.

19-20).

Before proceeding to step four, the ALJ assessed
Plaintiff's RFC, concluding that Plaintiff retained the RFC to
perform sedentary work with a sit/stand option that does not
involve extended reaching, strenuous repetitive handling
(meaning jobs requiring a grip strength over 70 pounds) or
exposure to temperatures under 35 degrees. 18

(R. 20-28).

The

ALJ then proceeded to step four, finding that Plaintiff is
unable to perform his past relevant work as a plasterer.

(R.

28) .
Finally, at step five, considering Plaintiff's age,
education, work experience, RFC and the VE's testimony, the ALJ
found that Plaintiff could perform other work existing in the
national economy, including the jobs of a telephone solicitor, a
cashier and a ticket seller.

(R. 28-29).

STANDA:RD OF REVIEW

The Court's review of the Commissioner's decision is
limited to determining whether the decision is supported by
substantial evidence, which has been described as "such relevant

ISUnder the Social Security Regulations, "sedentary work" involves "lifting no
more than 10 pounds at a time and occasionally lifting or carrying articles
like docket files, ledgers, and small tools. Although a sedentary job is
defined as one which involves sitting, a certain amount of walking and
standing is often necessary in carrying out job duties.
Jobs are sedentary
if walking and standing are required occasionally and other sedentary
criteria are met.· 20 C.F.R. §§ 404.1567(a), 416.927(a).

16

evidence as a reasonable mind might accept as adequate to
support a conclusion."
(1971).

Richardson v. Perales, 402 U.S. 389, 401

It consists of something more than a mere scintilla,

but something less than a preponderance.
Califano, 606 F.2d 403, 406 (3d Cir.1979).

Dobrowolsky v.
Even if the Court

would have decided the case differently, it must accord
deference to the Commissioner and affirm the findings and
decision if supported by substantial evidence.

Monsour Medical

Center v. Heckler, 806 F.2d 1185, 1190-91 (3d Cir.1986) .
DISCUSSION

Plaintiff asserts the ALJ erred by failing to adequately
explain the reason for his apparent rejection of Dr. Helkowski's
opinion that Plaintiff's shoulder problems precluded him from
performing jobs that required any reaching, handling and
fingering.

After consideration, the Court finds Plaintiff's

argument unpersuasive.
First, in his decision, the ALJ did not state that he
accepted Dr. Helkowski's RFC assessment of Plaintiff following
the consultative examination in its entirety and then proceed to
ignore the doctor's reaching, handling and fingering RFC
assessment.

Rather, the ALJ stated that he accepted Dr.

Helkowski's opinion "in general," and, as a result, he limited
Plaintiff to sedentary work with a sit/stand option.

Second,

although the ALJ did not specifically discuss the basis for his
17

implicit rejection of Dr. Helkowki's assessment of Plaintiff's
RFC to reach, handle and finger immediately following his
discussion of her consultative examination, the Court knows of
no requirement that he do so and a review of the entire decision
reveals the evidence on which the ALJ relied in finding that
Plaintiff was only precluded from performing jobs that involved
extended reaching and strenuous handling.

In particular, the ALJ noted that Plaintiff's treatment by
Dr. Rogal for shoulder pain in December 2007 had been
conservative, i.e., he was instructed to take over the counter
ibuprofen for pain, stretch, apply heat for stiffness and ice
for overactivity and avoid activities which aggravated his
shoulders (R. 22)

i

an Emergency Room record in June 2008

indicated Plaintiff was treated for lime in his left eye which
he reported occurred while he was renovating his girlfriend's
house (R. 27)

i

the physical examination of Plaintiff by Dr.

Helkowski in October 2008 revealed (a) 5/5 strength throughout
Plaintiff's upper extremities (including deltoids, biceps, wrist
extensors and flexors, and hand intrinsics),

(b) 4/5 grip

strength bilaterally, and (c) normal fine dexterity in the
bilateral hands (R. 26)

i

during his office visit with Dr.

Tranovich in December 2008, Plaintiff reported episodic shoulder
pain and tenderness which was exacerbated by overhead activity
and movement (R. 23)

i

in January 2010, Dr. Rogal's treatment of
18

Plaintiff's shoulder pain remained conservative, i.e., he was
instructed to stretch to avoid a frozen shoulder, apply heat for
stiffness and ice for overactivity, avoid strenuous physical
mechanical activity and take ibuprofen (R. 27) i and, finally,
there are significant gaps in Plaintiff's treatment for shoulder
pain (R. 27).
In sum, the Court finds that the ALJ/s implicit rejection
of Dr. Helkowski/s assessment of Plaintiff/s RFC to reach l
handle and finger was adequately explained by his discussion of
the evidence in the administrative record regarding the nature
of Plaintiff/s treatment for shoulder pain and reported
activity.

Further, as noted by the ALJ, "mild-to-moderate pain

or discomfort is not necessarily incompatible with the
performance of sustained work activity at appropriate levels of
exertion.

The fact that the claimant experiences pain and

discomfort on the job does not compel a finding of disability.1I
(R. 25).

See Welch v. Heckler l 808 F.2d 264

1

270 (3d

Cir.1986) (Substantial evidence supported conclusion of Appeals
Council that claimant/s pain did not prevent him from engaging
in sedentary work)

i

Dumas v. Schweikerl 712 F.2d 1545

1

1553 (2d

Cir.1983) (Disability requires more than the mere inability to
work without pain.

To be disabling l pain must be so severe

1

by

itself or in combination with other impairments, to preclude any
substantial gainful activity).

Based on the foregoing, the

19

Commissioner's decision denying the applications of Plaintiff
for DIB and SSI is affirmed.

William L. Standish
United States District Judge

Date: April 24, 2012

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