Dennison v. Astrue
Filing
20
OPINION. Signed by Judge James P. Jones on 8/7/12. (sc)
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF VIRGINIA
ABINGDON DIVISION
)
)
)
)
)
)
)
)
)
)
)
TIMOTHY DWAYNE DENNISON,
Plaintiff,
v.
MICHAEL J. ASTRUE,
COMMISSIONER OF
SOCIAL SECURITY,
Defendant.
Case No. 1:11CV00086
OPINION
By: James P. Jones
United States District Judge
Ginger J. Largen, Morefield & Largen, P.L.C., Abingdon, Virginia, for
Plaintiff. Nora Koch, Acting Regional Chief Counsel, Region III, and Robert W.
Kosman, Special Assistant United States Attorney, Office of the General Counsel,
Social Security Administration, Philadelphia, Pennsylvania, for Defendant.
In this social security case, I affirm the final decision of the Commissioner.
I
Plaintiff Timothy Dwayne Dennison filed this action challenging the final
decision of the Commissioner of Social Security (the “Commissioner”) denying his
claims for disability insurance benefits (“DIB”) and supplemental security income
(“SSI”) benefits pursuant to Titles II and XVI of the Social Security Act (“Act”),
42 U.S.C.A. §§ 401-433 (West 2011); 42 U.S.C.A. §§ 1381-1383d (West 2012).
Jurisdiction of this court exists pursuant to 42 U.S.C.A. §§ 405(g) and 1383(c)(3).
Dennison filed for benefits on September 9, 2008, alleging that he became
disabled on May 15, 2008.
His claim was denied initially and upon
reconsideration. Dennison received a hearing before an administrative law judge
(“ALJ”), during which Dennison, represented by counsel, and a vocational expert
testified.
The ALJ denied Dennison’s claim, and the Social Security
Administration Appeals Council denied his Request for Reconsideration.
Dennison then filed his Complaint with this court, objecting to the Commissioner’s
final decision.
The parties have filed cross motions for summary judgment, which have
been briefed and argued. The case is ripe for decision.
II
Dennison was born on July 2, 1966, making him a younger person under the
regulations. 20 C.F.R. §§ 404.1563(c), 416.963(c) (2012). Dennison has a ninth
grade education and has worked in the past as an assembler for a trailer
manufacturer, a furniture assembly sprayer, and a laborer in a brick factory. He
originally claimed he was disabled due to degenerative disc disease, arthritis,
tendonitis, and gout.
Dennison sought treatment with Deborah Weddington, M.D., a family
practitioner, from January 2005 through April 2008. During this time period,
-2-
Dennison complained of gout, arthritis, high blood pressure, knee pain, back pain,
neck pain, right shoulder pain, depression, and anxiety.
He was prescribed
medications such as Lortab, Percocet, Indocin, Flexeril, Lisinopril, and Norvasc.
Dr. Weddington repeatedly encouraged Dennison to watch his diet and to exercise
more frequently. (R. at 230, 233-34, 248, 268.) The record reflects that Dennison
told Dr. Weddington during several office visits that he experienced only moderate
pain when taking his medications. (R. at 229, 264-65, 269-70.) In April 2008, Dr.
Weddington noted that Dennison was scheduled to be laid off from his job “soon.”
(R. at 270.)
In May 2006, a series of X rays were performed at Smyth County
Community Hospital. An X ray of the right shoulder was normal. X rays of the
cervical spine revealed C5-6 degenerative changes with disc space narrowing,
sclerosis, and osteophytes, and mild foraminal encroachment at C5-6. In June
2006, an MRI of the lumbar spine showed slight left foraminal narrowing, mild
ventral extradural defect at L1-2 without any demonstrated focal lesion or canal
stenosis, small Schmorl’s nodes in the lower thoracic levels, and mild degenerative
changes and disc space narrowing at L2-3 and L3-4.
Dennison presented to the emergency room on May 15, 2008, with
complaints of a right ankle injury. X rays showed soft tissue swelling, but no
-3-
evidence of fracture or dislocation. (R. at 281.) Dennison was prescribed Lortab
and placed in a posterior splint. (R. at 343-45.)
On May 21, 2008, Dennison sought treatment with Christy M. McGhee,
MSN, FNP, at Abingdon Orthopedic Associates.1 Upon examination, Dennison’s
right ankle was moderately swollen, and he reported tenderness over the lateral
malleoli and medial malleous. McGhee provided Dennison with a moonboot and
prescribed Ibuprofen and Vicodin.
Dennison returned to McGhee for follow-up examinations from June 2008
through August 2008. During this time period, Dennison declined a suggested
injection into his ankle joint, as well as an offer to be placed in a short leg cast for
a few weeks. He began physical therapy, but discontinued treatment after only
three sessions due to cost concerns. In June 2008, an MRI of the right ankle
revealed contusions and a small amount of fluid in the sheath of the posterior tibial
tendon, but no occult fractures or ligament tears. (R. at 280.) In August 2008,
Dennison reported overall improvement of his right ankle, but stated that he
continued to have some soreness. (R. at 275.)
In October 2008, Dr. Weddington opined that Dennison was “unable to work
due to multiple medical problems.” (R. at 283.) Dr. Weddington’s opinion was
1
McGhee’s supervising physician was Melvin Heiman, M.D..
-4-
not accompanied by any explanatory report, and she had not treated Dennison
since August 2008.
William Humphries, M.D., a state agency physician, reviewed Dennison’s
medical records in January 2009. He diagnosed Dennison with hypertension;
chronic lumbar strain; gouty arthritis; mild degenerative joint disease in both hands
and feet; tendonitis in both shoulders, right being worse than left; chronic cervical
strain; and moderate venous insufficiency in the right lower extremity.
Dr.
Humphries opined that Dennison was capable of performing a range of light work.
Two other state agency physicians, Robert McGuffin, M.D., and Frank Johnson,
M.D., also reviewed Dennison’s medical records and reported similar findings.
In February 2009, Dennison returned to Dr. Weddington with complaints of
general pain. Dr. Weddington’s evaluation was largely unremarkable. Dennison
was alert, oriented, lethargic, and in no acute distress. (R .at 307.)
Dr. Weddington completed an assessment of Dennison’s physical ability to
do work-related activities in April 2009. Dr. Weddington indicated that Dennison
would have significant occupational limitations. She also opined that Dennison
experienced incapacitating pain, and that his medications rendered him unable to
function at a productive level. (R. at 312.) However, Dr. Weddington provided no
explanation for her findings.
-5-
Dennison sought treatment from Uzoma Obuekwe, M.D., from November
2009 through May 2011.
During this time period, Dennison complained of
constant pain from his neck down to his legs, gout in his left ankle, right shoulder
pain, and high blood pressure.
Dr. Obuekwe prescribed medications such as
Lortab, Ibuprofen, Lisinopril, Flexeril, and Norvasc. Dr. Obuekwe repeatedly
noted normal orientation, memory, mood, affect, insight, and judgment; normal
station and gait; normal sinus rhythm; elevated blood pressure; and decreased
range of motion in the lumbosacral spine. In September 2010, X rays of the right
shoulder showed degenerative changes that had progressed since May 2006, but
normal joint alignment and no indication of fracture or deformity. (R. at 389.)
In March 2010, Dr. Obuekwe completed a form entitled “Patient Injury and
Work Status,” on which he indicated that Dennison was unable to work “at this
time” but should be able to return to work within six months, provided he was
limited to lifting no more than twenty pounds. (R. at 391.)
At the administrative hearing held in November 2010, Dennison testified on
his own behalf. Dennison claimed that he stopped working because he “got to
hurtin’ so bad [he] couldn’t stand to do it no more.” (R. at 28.) He stated that he
was unable to do any housework and spent most of the day watching television and
-6-
talking to his daughter. 2 Annmarie Cash, a vocational expert, also testified. She
classified Dennison’s past work as an assembler as heavy, semi-skilled; his past
work as a furniture assembly sprayer as medium, semi-skilled; and his past work as
a laborer in a brick factory as medium, unskilled.
After reviewing all of Dennison’s records and taking into consideration the
testimony at the hearing, the ALJ determined that he had severe impairments of
degenerative disc disease, low back pain, mild degenerative joint disease of both
hands and feet, tendonitis in the shoulders right worse than left, arthritis, and gout,
but that none of these conditions, either alone or in combination, met or medically
equaled a listed impairment.
Taking into account Dennison’s limitations, the ALJ determined that
Dennison retained the residual functional capacity to perform sedentary work
subject to some additional limitations.
The ALJ stated that Dennison could
occasionally climb ramps and stairs, but not ladders, ropes, or scaffolds. He could
occasionally balance, crouch, stoop, crawl, and kneel.
The ALJ stated that
Dennison should avoid reaching overhead or repetitive gripping, grasping,
pushing, or pulling with the right upper extremity, and that he should avoid hazards
2
When Dennison completed a Function Report in October 2008, he claimed much
fewer limitations in his activities and capabilities. For instance, he reported that he
drove, did laundry, mowed the yard, performed light cleaning, exercised for about thirty
minutes each day, shopped in stores for groceries, prepared simple meals, spent time
socializing with his neighbors or other people on a regular basis, and could pay attention
as long as necessary. (R. at 171-78.)
-7-
such as moving machinery and unprotected heights.
The vocational expert
testified that someone with Dennison’s residual functional capacity could work as
a general office clerk, a corporate and order clerk, or an office receipt and
information clerk. The vocational expert testified that those positions existed in
significant numbers in the national economy. Relying on this testimony, the ALJ
concluded that Dennison was able to perform work that existed in significant
numbers in the national economy and was therefore not disabled under the Act.
Dennison argues that the ALJ’s decision is not supported by substantial
evidence because the ALJ improperly accorded “great weight” to the opinions of
the state agency physicians, and failed to consider the combined effects of his
impairments. For the reasons below, I disagree.
III
The plaintiff bears the burden of proving that he is under a disability.
Blalock v. Richardson, 483 F.2d 773, 775 (4th Cir. 1972). The standard for
disability is strict. The plaintiff must show that his “physical or 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 . . . .” 42 U.S.C.A. §§ 423(d)(2)(A), 1382c(a)(3)(B).
-8-
In assessing DIB and SSI claims, the Commissioner applies a five-step
sequential evaluation process. The Commissioner considers whether the claimant:
(1) has worked during the alleged period of disability; (2) has a severe impairment;
(3) has a condition that meets or equals the severity of a listed impairment; (4)
could return to his past relevant work; and (5) if not, whether he could perform
other work present in the national economy. See 20 C.F.R. §§ 404.1520(a)(4),
416.920(a)(4) (2012). If it is determined at any point in the five-step analysis that
the claimant is not disabled, the inquiry immediately ceases.
Id.; McLain v.
Schweiker, 715 F.2d 866, 868-69 (4th Cir. 1983). The fourth and fifth steps of the
inquiry require an assessment of the claimant’s residual functional capacity, which
is then compared with the physical and mental demands of the claimant’s past
relevant work and of other work present in the national economy. Id. at 869.
In accordance with the Act, I must uphold the Commissioner’s findings if
substantial evidence supports them and the findings were reached through
application of the correct legal standard. Craig v. Chater, 76 F.3d 585, 589 (4th
Cir. 1996). Substantial evidence means “such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.” Richardson v. Perales,
402 U.S. 389, 401 (1971) (internal quotation marks and citation omitted).
Substantial evidence is “more than a mere scintilla of evidence but may be
somewhat less than a preponderance.” Laws v. Celebrezze, 368 F.2d 640, 642 (4th
-9-
Cir. 1966). It is the role of the ALJ to resolve evidentiary conflicts, including
inconsistencies in the evidence. Seacrist v. Weinberger, 538 F.2d 1054, 1956-57
(4th Cir. 1976). It is not the role of this court to substitute its judgment for that of
the Commissioner. Hays v. Sullivan, 907 F.2d 1453, 1456 (4th Cir. 1990).
Dennison argues that the ALJ’s decision is not supported by substantial
evidence. He presents two arguments.
First, Dennison argues that the ALJ improperly accorded “great weight” to
the opinions of the state agency physicians, Dr. McGuffin and Dr. Johnson.
Instead, Dennison contends that the ALJ should have given more weight to the
medical opinions of his treating physicians, Dr. Weddington and Dr. Obuekwe.
In weighing medical opinions, the ALJ must consider factors such as the
examining relationship, the treatment relationship, the supportability of the
opinion, and the consistency of the opinion with the record.
20 C.F.R. §§
404.1527(d), 416.927(d) (2012). Although treatment relationship is a significant
factor, the ALJ is entitled to afford a treating source opinion “significantly less
weight” where it is not supported by the record. Craig, 76 F.3d at 590.
In the present case, the ALJ considered the opinions of Dr. Weddington and
Dr. Obuekwe, but gave little weight to their assessments, for several reasons. First,
Dr. Weddington’s and Dr. Obuekwe’s statements that Dennison was “unable to
work” are not medical opinions and are due no special significance, because they
-10-
are opinions on an issue reserved to the Commissioner.
404.1527(e)(1), 416.927(e)(1) (2012).
See 20 C.F.R. §§
Second, their opinions regarding
Dennison’s functional limitations are not well-supported by their own treatment
records. For example, Dr. Weddington consistently indicated no extreme objective
findings and noted that Dennison reported only moderate pain when taking his
medications. (R. at 229, 264-65, 269-70.) Dr. Obuekwe similarly recorded no
extreme objective findings and repeatedly indicated that Dennison’s orientation,
memory, affect, judgment, station, and gait were generally normal. Furthermore,
Dr. Weddington’s and Dr. Obuekwe’s opinions are inconsistent with Dennison’s
conservative treatment history, as well as certain admissions that he was able to
complete daily activities such as driving, doing laundry, performing light cleaning,
shopping in stores for groceries, and preparing simple meals.
Moreover, the ALJ did not err by according great weight to the opinions of
Dr. McGuffin and Dr. Johnson that Dennison retained the physical residual
functional capacity to engage in a range of light work. Dr. McGuffin and Dr.
Johnson are “highly qualified” physicians; therefore, their findings are considered
valid expert opinion evidence. 20 C.F.R. §§ 404.1527(e)(2)(i), 416.927(e)(2)(i)
(2012). Additionally, the opinions of Dr. McGuffin and Dr. Johnson are consistent
with the evidentiary record as a whole.
See 20 C.F.R. 404.1527(d)(4),
416.927(d)(4) (providing that the more consistent a medical opinion is with the
-11-
record as a whole, the more weight it will generally be given). Accordingly, I find
that substantial evidence supports the ALJ’s weighing of the medical evidence.
Next, Dennison argues that the ALJ erred by failing to consider the
combined effects of his impairments. Specifically, Dennison contends that the
ALJ failed to take into account his mental impairments.
The Commissioner must consider the combined effects of all of the
claimant’s impairments and “not fragmentize them.” Walker v. Bowen, 889 F.2d
47, 50 (4th Cir. 1989). After reviewing the ALJ’s decision, I find that the ALJ
properly considered the combined effects of Dennison’s various ailments. The
ALJ carefully examined the medical opinions of Dennison’s treating physicians
and state agency medical consultants before determining that Dennison had the
severe impairments of degenerative disc disease, mild degenerative joint disease of
the hands and feet, tendonitis in the shoulders, arthritis, and gout, as well as the
nonsevere impairments of depression, anxiety, high blood pressure, and
tachycardia. (R. at 15-16.) The ALJ accommodated the combined effects of these
impairments by restricting Dennison, who previously performed heavy and
medium work, to sedentary work with additional limitations. (R. at 14-16, 41-42.)
While it is true that the ALJ classified Dennison’s depression and anxiety as
nonsevere impairments, I find that this conclusion was appropriate.
An
impairment or combination of impairments is not severe if it does not significantly
-12-
limit a claimant’s physical or mental ability to do basic work activities as defined
by the regulations. 20 C.F.R. §§ 404.1521, 416.921 (2012). Although Dennison
was diagnosed with depression and anxiety by his treating physicians, there are no
medical records indicating any formal inpatient, outpatient, or emergency care for
these impairments. Furthermore, Dennison did not describe any activities of daily
living that were significantly limited by a psychiatric condition. Dr. Johnson, a
state agency physician, also agreed that Dennison did not have significant mental
impairments. (R. at 328.) The ALJ was required to consider the opinion of this
“highly qualified” physician who is an “expert” in Social Security disability
evaluations. 20 C.F.R. §§ 404.1527(e)(2)(i), 416.927(e)(2)(i). Thus, I find that
substantial evidence supports the ALJ’s conclusion.
IV
For the foregoing reasons, the plaintiff’s Motion for Summary Judgment will
be denied, and the defendant’s Motion for Summary Judgment will be granted. A
final judgment will be entered affirming the Commissioner’s final decision
denying benefits.
DATED: August 7, 2012
/s/ James P. Jones
United States District Judge
-13-
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?