Griffith v. Colvin

Filing 13

MEMORANDUM OPINION denying Plaintiff's 11 Motion for judgment on the pleadings; granting Defendant's 12 Motion for judgment on the pleadings; and dismissing this action from the docket of the Court. Signed by Magistrate Judge Cheryl A. Eifert on 6/27/2017. (cc: counsel of record) (jsa)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA
HUNTINGTON DIVISION
DONALD GREGORY GRIFFITH,
Plaintiff,
v.

Case No.: 3:16-cv-07183

NANCY A. BERRYHILL,
Acting Commissioner of the
Social Security Administration,
Defendant.

MEMORANDUM OPINION
This is an action seeking review of the decision of the Commissioner of the Social
Security Administration (hereinafter the “Commissioner”) denying Plaintiff’s application
for disability insurance benefits (“DIB”) and supplemental security income (“SSI”) under
Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 401-433, 1381-1383f. The case is
presently before the court on the parties’ motions for judgment on the pleadings as
articulated in their briefs. (ECF Nos. 11, 12). Both parties have consented in writing to a
decision by the United States Magistrate Judge. (ECF Nos. 4, 5). The court has fully
considered the evidence and the arguments of counsel. For the reasons that follow, the
Court FINDS that the decision of the Commissioner is supported by substantial evidence
and is therefore AFFIRMED.
I.

Procedural History
On January 22, 2013, Plaintiff Donald Gregory Griffith (“Claimant”) completed

applications for DIB and SSI alleging a disability onset date of January 1, 2012 due to
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uncontrollable high blood pressure; “hepatitis C; “eye stroke double vision, vision
blockage; prediabetes, [and] pre-glaucoma.” (Tr. at 226, 233, 259). The Social Security
Administration (“SSA”) denied the applications initially and upon reconsideration. (Tr.
at 99-112, 202-211). Claimant filed a request for a hearing, which was held on December
3, 2014 before the Honorable Jane A. Crawford, Administrative Law Judge (“ALJ”). (Tr.
at 26-53). By written decision dated December 31, 2014, the ALJ determined that
Claimant was not entitled to benefits. (Tr. at 7-25). The ALJ’s decision became the final
decision of the Commissioner on June 2, 2016 when the Appeals Council denied
Claimant’s request for review. (Tr. at 1-5).
On August 3, 2016, Claimant filed the present civil action seeking judicial review
of the administrative decision pursuant to 42 U.S.C. § 405(g). (ECF No. 2). The
Commissioner filed an Answer and a Transcript of the Proceedings on October 7, 2016.
(ECF Nos. 9, 10). Thereafter, the parties filed their briefs in support of judgment on the
pleadings. (ECF Nos. 11, 12). The time period for the filing of a reply has expired.
Accordingly, this matter is fully briefed and ready for disposition.
II.

Claimant’s Background
Claimant was 52 years old at the time of his alleged onset of disability and 55 years

old at the time of the ALJ’s decision. (Tr. at 18, 166). He has a tenth grade education and
communicates in English. (Tr. at 258, 260). Claimant previously worked as an
Ironworker. (Tr. at 260).
III.

Summary of ALJ’s Findings
Under 42 U.S.C. § 423(d)(5), a claimant seeking disability benefits has the burden

of proving a disability. See Blalock v. Richardson, 483 F.2d 773, 775 (4th Cir. 1972). A
disability is defined as the “inability to engage in any substantial gainful activity by reason
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of any medically determinable impairment which has lasted or can be expected to last for
a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). The Social
Security regulations establish a five-step sequential evaluation process for the
adjudication of disability claims. If an individual is found “not disabled” at any step of the
process, further inquiry is unnecessary and benefits are denied. 20 C.F.R. §§
404.1520(a)(4), 416.920(a)(4). The first step in the sequence is determining whether a
claimant is currently engaged in substantial gainful employment. Id. §§ 404.1520(b),
416.920(b). If the claimant is not, then the second step requires a determination of
whether the claimant suffers from a severe impairment. Id. §§ 404.1520(c), 416.920(c). A
severe impairment is one that “significantly limits [a claimant’s] physical or mental ability
to do basic work activities.” Id. If severe impairment is present, the third inquiry is
whether this impairment meets or equals any of the impairments listed in Appendix 1 to
Subpart P of the Administrative Regulations No. 4 (the “Listing”). Id. §§ 404.1520(d),
416.920(d). If so, then the claimant is found disabled and awarded benefits.
However, if the impairment does not meet or equal a listed impairment, the
adjudicator must assess the claimant’s residual functional capacity (“RFC”), which is the
measure of the claimant’s ability to engage in substantial gainful activity despite the
limitations of his or her impairments. Id. §§ 404.1520(e), 416.920(e). After making this
determination, the fourth step is to ascertain whether the claimant’s impairments prevent
the performance of past relevant work. Id. §§ 404.1520(f), 416.920(f). If the impairments
do prevent the performance of past relevant work, then the claimant has established a
prima facie case of disability, and the burden shifts to the Commissioner to demonstrate,
in the fifth and final step of the process, that the claimant is able to perform other forms
of substantial gainful activity, given the claimant’s remaining physical and mental
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capacities, age, education, and prior work experiences. 20 C.F.R. §§ 404.1520(g),
416.920(g); see also McLain v. Schweiker, 715 F.2d 866, 868-69 (4th Cir. 1983). The
Commissioner must establish two things: (1) that the claimant, considering his or her age,
education, skills, work experience, and physical shortcomings has the capacity to perform
an alternative job, and (2) that this specific job exists in significant numbers in the
national economy. McLamore v. Weinberger, 538 F.2d 572, 574 (4th Cir. 1976).
Here, the ALJ determined as a preliminary matter that Claimant met the insured
status for disability insurance benefits through December 31, 2015. (Tr. at 12, Finding No.
1). At the first step of the sequential evaluation, the ALJ confirmed that Claimant had not
engaged in substantial gainful activity since January 1, 2012, the alleged disability onset
date. (Id., Finding No. 2). At the second step of the evaluation, the ALJ found that
Claimant had the following severe impairments: “hypertension, obesity, deficit in visual
acuity, and mild loss of field of vision.” (Id., Finding No. 3). The ALJ also considered
Claimant’s Hepatitis C, but concluded that such impairment was nonsevere. (Tr. at 1213). As for the third inquiry, the ALJ found that Claimant did not have an impairment or
combination of impairments that met or medically equaled any of the impairments
contained in the Listing. (Tr. at 13-14, Finding No. 4). Accordingly, the ALJ determined
that Claimant possessed:
[T]he residual functional capacity to perform medium work as defined in 20
CFR 404.1567(c) and 416.967(c) with the following additional limitations:
The claimant cannot work with vibrating equipment; cannot climb ladders,
ropes, or scaffolds; and cannot work at unprotected heights or around
dangerous machinery. The claimant has some difficulty with his vision but
can avoid hazards in the workplace.
(Tr. at 14-18, Finding No. 5). At the fourth step, the ALJ determined that Claimant was
unable to perform his past relevant work. (Tr. at 18, Finding No. 6). Under the fifth and

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final inquiry, the ALJ reviewed Claimant’s prior work experience, age, and education in
combination with his RFC to determine his ability to engage in substantial gainful activity.
(Tr. at 18-19, Finding Nos. 7-10). The ALJ considered that (1) Claimant was born in 1959,
and was defined as an individual closely approaching advanced age on the alleged
disability onset date, but subsequently changed age category to advanced age; (2) he had
limited education and could communicate in English; and (3) transferability of job skills
was not material to the disability determination because the Medical-Vocational Rules
(the “Grids”) supported a finding that Claimant was “not disabled,” regardless of his
transferable job skills. (Tr. at 18, Finding Nos. 7-9). Given these factors, Claimant’s RFC,
and the testimony of a vocational expert, the ALJ determined that Claimant could
perform jobs that existed in significant numbers in the national economy, including
unskilled work as a janitor cleaner, warehouse worker, or bottling line attendant at the
medium exertional level. (Tr. at 18-19, Finding No. 10). Therefore, the ALJ found that
Claimant was not disabled and was not entitled to benefits. (Tr. at 19-20, Finding No. 11).
IV.

Claimant’s Challenge to the Commissioner’s Decision
Claimant raises one challenge to the Commissioner’s decision; that being, the ALJ

erred by finding Claimant capable of medium exertional level work. According to
Claimant, the evidence unequivocally demonstrates that he is limited to sedentary work.
Thus, Grid Rule 201.10 directs a finding that he was disabled as of the date of his alleged
onset of disability.1 (ECF No. 11 at 4-6). In the alternative, Claimant contends that even if
he were restricted to light exertional level work, the ALJ should have deemed him
disabled as of his fifty-fifth birthday under Grid Rule 202.02. (Id. at 6). In support of his
As more fully explained below, the Grids “contain numbered table rules which direct conclusions of
‘disabled’ or ‘not disabled’ where all of the individual findings coincide with those of a numbered rule.” SSR
83–12, 1983 WL 31253, at *1 (S.S.A.1983); see 20 C.F.R. Pt. 404, Subpart P, Appendix 2.

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argument, Claimant cites his age, education, previous work experience, testimony, and
the findings of consultative examining physicians, Eugene Lin, M.D., and Paul W. Craig,
M.D., as well as those of treating physician, Zachary Hansen, M.D. (Id. at 5-6). In
response to Claimant’s arguments, the Commissioner contends that substantial evidence
supports the ALJ’s finding that Claimant was capable of medium level work. (ECF No. 12
at 8-12).
V.

Relevant Evidence
The court has reviewed the transcript of proceedings in its entirety, including the

treatment records, medical source opinions, and Claimant’s statements. The following
summary is confined to those entries most relevant to the issue in dispute.
A. Treatment Records
On February 11, 2011, Claimant presented to Damia Hayman, Certified Family
Nurse Practitioner (“CFNP”), at Valley Health Systems (“Valley Health”) for follow-up of
hypertension, insomnia, and generalized anxiety. (Tr. at 356-57). Claimant’s physical
examination was normal and his chronic medical conditions were stable. Nurse Hayman
observed that Claimant’s blood pressure was elevated at 188/104 in the left arm and
156/86 in the right arm, but also noted that he had not taken his anti-hypertensive
medications for three weeks. Nurse Hayman explained to Claimant the importance of
never being without his medications and instructed him to continue with his current
treatment regimen. Claimant verbalized his understanding.
Later that year, on October 20, 2011, Claimant returned to Valley Health for a
blood pressure check. (Tr. at 354-55). Claimant stated that he felt “good,” although his
blood pressure was measured at 190/124. Claimant admitted that he had run out of his
blood pressure medications and had not taken any for two days. His blood pressure was
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rechecked, and this time measured 168/90. Nurse Hayman emphasized the need for
Claimant taking all of his medications as prescribed. Upon learning that Claimant was
uninsured, Nurse Hayman educated Claimant on available assistance programs and
sliding scales to help him pay for his prescriptions. She also provided him with medication
samples.
Claimant returned ten days later, on October 30, 2011, for follow-up. (Tr. at 35253). He reported feeling good, but his blood pressure was measured at 188/102. Claimant
was given Clonidine, and his pressure dropped to 158/96, with a reading of 138/90 in the
left arm. Claimant also reported a history of Hepatitis C; although, he indicated that he
had never gotten any treatment for the illness. Nurse Hayman documented that Claimant
needed to stop smoking and drinking and needed to get medical care for Hepatitis C. She
also instructed Claimant not to use salt in his diet and to return in one week. Claimant
returned on November 15, and his blood pressure was 159/96 when taken automatically
and 148/92 when checked manually. (Tr. at 351).
Over one year later, on November 7, 2012, Claimant had a follow-up visit at Valley
Health with Julie Vannoy, Certified Nurse Practitioner (“CNP-BC”). (Tr. at 350). Claimant
reported that his blood pressure had been “off” since July 2012; he had a history of
Hepatitis C; and he was experiencing double vision, headache, and dizziness. Claimant’s
blood pressure was taken, and it measured 200/118. However, he denied chest pain,
palpitations, and shortness of breath. His physical examination was normal, and he was
neurologically intact. Nurse Vannoy assessed Claimant to be in hypertensive crisis. He
was administered Clonidine, and when his blood pressure was rechecked 15 minutes later,
it had decreased to 190/110. Claimant was prescribed Clonidine for hypertension, Exforge
for blurred vision, and Celexa for generalized anxiety disorder.
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The following month, on December 12, 2012, Claimant returned to Valley Health
and saw Nurse Vannoy. (Tr. at 345). Claimant reported that Exforge was helping to reduce
his blood pressure, but admitted that he had run out of the medication several days
earlier. Claimant’s blood pressure was taken, and it measured 202/133. His blood
pressure was re-checked twice during the visit and decreased to 196/124 and then to
187/122. With respect to his Hepatitis C, Claimant still had not received treatment. He
explained that at the time of his diagnosis, he was told by a gastroenterologist that
treatment could not be initiated until Claimant was alcohol-free for six months. However,
Claimant had continued to drink. Nurse Vannoy encouraged Claimant to stop using
alcohol, to follow-up with a gastroenterologist, and to continue taking his medications.
She told him to return for a blood pressure check in one week.
One week later, Claimant returned as instructed. (Tr. at 344). He denied chest
pain, palpitations, or shortness of breath, and his blood pressure was 174/105. A review
of systems revealed no new complaints. Claimant’s physical examination was normal,
except for his blood pressure and weight. He was prescribed Metformin to treat diabetes,
Metoprolol for high blood pressure, and Ambien for insomnia. Nurse Vannoy counseled
Claimant regarding the need to watch his diet and to exercise.
On January 2, 2013,2 Claimant presented to Valley Health for regular follow-up.
(Tr. at 379). His blood pressure was 187/115, but he had not taken his medication that
morning. Claimant reported that his blood pressure was generally measuring 155/90 at
home. He denied chest pain, palpitations, and shortness of breath. Claimant had no
particular complaints on a review of systems and his physical examination was normal,

The clinic visit is incorrectly hand-stamped January 2, 2012, but the computer-generated stamp and other
records confirm the visit occurred on January 2, 2013.

2

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except for his blood pressure and weight, which was 266 pounds. Claimant continued to
smoke and was encouraged to quit. He was scheduled for an ultrasound of his kidneys
and prescribed Exforge for his hypertension.
Two days later, on January 4, 2013, Claimant had an eye examination at University
Eye Surgeons. (Tr. at 333). His vision was 20/40 in the right eye and 20/80 in the left
eye, although, Claimant stated that his visual acuity fluctuated and his eyes burned and
felt “gravely.” He was not taking any medications for his eyes. Claimant’s chief medical
complaints were uncontrolled hypertension and diabetes. Claimant explained that he had
received a diagnosis of high blood pressure ten years earlier and took blood pressure
medications; however, his blood pressure was not controlled. Claimant’s blood pressure
was taken, and it measured 170/104. He also complained of a history of blurred vision
and horizontal diplopia (double vision), which had lasted two weeks, but was now
resolved.
On January 16, 2013, Claimant returned to Nurse Vannoy to follow up on the
results of the renal ultrasound and to obtain documentation for a disability claim. (Tr. at
342). Nurse Vannoy advised Claimant that his ultrasound showed no evidence of renal
artery stenosis. Claimant reported doing well on his medications, and a review of systems
was unremarkable. Claimant’s physical examination revealed no abnormalities, except for
his blood pressure, which was elevated at 171/90, and his weight, which was 246 pounds.
Claimant was prescribed additional medication to treat his hypertension, was encouraged
to quit smoking, and was referred to a cardiologist for work-up. Nurse Vannoy also
recommended that Claimant undergo a sleep study, but he refused.
On February 26, 2013, Claimant saw cardiologist, Choudhary Rayani, M.D., at the
Holzer Clinic. (Tr. at 412-15). Claimant was referred for uncontrolled hypertension, with
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recurrent transient ischemic attacks involving his vision. He reported a long history of
hypertension, indicating that he was currently taking five different medications for
hypertension; however, his systolic blood pressure remained in the “180s to 200s.”
Claimant also admitted to a history of heavy drinking, but stated he was now only a
“social” drinker. Claimant smoked 5-6 cigarettes each day. He denied exertional chest
pain, syncope, orthopnea, pparoxysmal nocturnal dyspnea, and edema, but had mild
shortness of breath and dizziness. With respect to his cardiac history, Claimant advised
that he was negative for coronary artery disease. He reported having congestive heart
failure in March 2009, which resulted in a diagnostic cardiac catheterization that was
normal.
On physical examination, Claimant was observed to be obese, with a blood
pressure of 178/106 and a heart rate of 90. His physical findings were otherwise normal.
Dr. Rayani counseled Claimant on the negative effect of tobacco on his health and the
availability of cessation options. He also discussed the management of Claimant’s
uncontrolled hypertension with Claimant and his wife. Dr. Rayani did not feel a cardiac
workup was necessary, but scheduled a nephrology evaluation and suggested a referral to
the Ohio State University Hypertension Clinic. Claimant requested that Dr. Rayani
complete disability paperwork; however, Dr. Rayani declined on the basis that he had only
seen Claimant on the one occasion and did not feel he knew Claimant well enough to
provide disability opinions.
On March 13, 2013, Claimant saw Zachary Hansen, M.D., at Valley Health “for
assistance in his blood pressure control as well as for paperwork applying for disability
through local and workers’ union.” (Tr. at 452-54). Claimant reported a history of
uncontrolled hypertension, congestive heart failure, strokes in the eye secondary to
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hypertension, and prediabetes. He denied cardiac symptoms and indicated that he had a
heart catheterization in 2010 that was normal. Claimant provided his medication and
health history, as well as his family and social history. He admitted to smoking four to five
cigarettes and drinking two cans of beer per day. Claimant stated that he had worked as
an Ironworker until he was laid off in 2011. Based on the history provided, Dr. Hansen
expressed concern that Claimant’s vision might prevent him from performing his prior
work, and his dizziness and poor balance would place him at high risk for work place
injury. On examination, Claimant’s blood pressure was 195/106, but he appeared alert
and oriented with essentially normal physical findings. Dr. Hansen diagnosed Claimant
with hypertension, prediabetes, Hepatitis C, and anxiety/depression. Dr. Hansen agreed
to complete Claimant’s disability paperwork and to provide an opinion that Claimant was
likely not able to work due to visual limitations. Claimant was instructed to follow up with
the nurse practitioner.
On March 18, 2013, Claimant followed up with Nurse Vannoy. (Tr. at 378). He
advised that he had seen a cardiologist, who did not change any of his medications, but
referred him to a nephrologist. Claimant denied chest pain, palpitations, and shortness of
breath. His review of systems and physical examination were normal, except for his blood
pressure, which was 160/112, and his weight. Nurse Vannoy instructed Claimant to keep
his appointment with the nephrologist, to follow up with his cardiologist, and to return in
one month.
Claimant saw Nurse Vannoy again on May 13, 2013. (Tr. at 377). His prescriptions
for Clonidine, Exforge, Metoprolol, and Hydrochlorothiazide were refilled. Claimant
denied chest pain, palpitations, and shortness of breath, and he had no new or specific
complaints. His physical examination was normal, except for his blood pressure, which
11

was 187/113, and his weight. To further evaluate Claimant’s resistant hypertension, Nurse
Vannoy planned to check Claimant’s aldosterone-to-renin ratio.3 She also increased
Claimant’s dosage of Clonidine and encouraged him to quit smoking. Nurse Vannoy again
suggested that Claimant participate in a sleep study to evaluate his complaint of insomnia,
but he refused.
On May 28, 2013, Claimant advised Nurse Vannoy that he had canceled his
appointment with the nephrologist. (Tr. at 376). Nurse Vannoy noted that Claimant had
no new or specific complaints and his physical examination was normal, except for his
weight, which was 250 pounds. Claimant’s blood pressure was measured and was only
slightly abnormal at 147/91. Nurse Vannoy renewed Claimant’s referral to a nephrologist
and encouraged him to quit smoking. (Id.).
Claimant eventually consulted with a nephrologist, Raheela Rehman, M.D., on
July 10, 2013. (Tr. at 425-26). Claimant reported a ten to twelve year history of diagnosed
high blood pressure. He advised that his blood pressure had measured 230/160s at the
initial diagnosis, which prompted his admission to the hospital. Claimant was
hospitalized a second time in 2009; however, this admission was for congestive heart
failure. Claimant stated that he had been taking his current medications, including
Exforge, Metoprolol, HCT, Clonidine, and Aspirin, for approximately one year, and his
blood pressure was generally measuring 160-180/110. Claimant reported experiencing
dizziness, blurry vision, and visual strokes when his blood pressure was high. He admitted
to smoking half of a pack of cigarettes and drinking two cups of coffee per day. Claimant’s
review of systems was normal, with him denying current chest pain or palpitations,
3 This test evaluates whether an individual suffers from Hyperaldosteronism, a disorder in which the
adrenal gland releases too much of the hormone aldosterone into the blood, and often causes high blood
pressure, headache, and other symptoms. See https://medlineplus.gov/ency/article/000330.htm

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shortness of breath, dizziness, headache, and vision changes. On initial testing, Claimant’s
blood pressure was 187/112, but decreased to 180/102 on a subsequent manual recheck.
His physical examination revealed no additional concerns. Dr. Rehman suggested that
Claimant undergo a comprehensive workup to investigate the cause of his persistent
hypertension. Noting that Claimant did not have any evidence of renal artery stenosis, Dr.
Rehman decided to check renin and aldosterone levels. He switched Claimant’s diuretic
from hydrochlorothiazide to chlorthalidone and set a goal blood pressure of “150s/85s95s to start with.” Dr. Rehman counseled Claimant to follow a low salt diet and provided
a list of foods to avoid.
On August 1, 2013, Claimant presented to a second nephrologist, Nasim Mastouri,
M.D., who was also a hypertension expert. (Tr. at 479-81). Claimant brought a blood
pressure log, which showed that his systolic blood pressure was measuring between 150
and 180 at home “despite being on 3 max anti hypertensive medications plus one
diuretic.” However, Claimant admitted that he was not following the recommended low
salt diet and was smoking about a pack of cigarettes per day. Claimant denied having
double vision or any other issues on the review of symptoms. His blood pressure at the
time of examination was 148/98. No abnormalities were noted on his physical
examination, except his weight, which was 242 pounds. Dr. Mastouri examined the
results of Claimant’s urinalysis and renal profile taken on July 22, 2013. After considering
all of the findings, Dr. Mastouri diagnosed Claimant with congestive heart failure, benign
essential hypertension, stage II chronic kidney disease, exogenous obesity, and nicotine
dependence. Dr. Mastouri ordered additional laboratory studies and added the
medication, Spironolactone, to Claimant’s medication regimen.
Later that month, on August 27, 2013, Claimant saw Dr. Mastouri in follow-up.
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(Tr. at 475-78). Claimant reported that he was following a low salt diet, and his systolic
blood pressures, when taken at home, were measuring between 140 and 160. He reported
some episodes of double vision and dizziness, but expressed no other complaints.
Claimant’s physical examination was unremarkable, except for his blood pressure, which
was 150/102, and his weight. Dr. Mastouri renewed most of Claimant’s medications,
desisting Metoprolol, and adding Coreg to the regimen. He recommended that Claimant
quit smoking, but Claimant stated that he was not interested in stopping at that time. Dr.
Mastouri also discussed with the Claimant the potential consequences of not taking his
medications as instructed.
Claimant saw Dr. Mastouri again on September 12, 2013. (Tr. at 471-74). Claimant
brought his blood pressure log, which reflected improved blood pressure control, with
systolic measurements “running … between 130-160.” Claimant reported one episode of
a blood pressure measuring 200/119, but explained that it occurred when he was very
upset about a situation at work. Claimant took Clonidine at that time, and his blood
pressure dropped to 150/90. Claimant denied episodes of blurry vision, dizziness, vertigo,
or shortness of breath, but admitted that he continued to smoke. A review of systems was
normal. Claimant’s blood pressure was 150/92, and his physical examination was normal,
except for his weight, which was 247 pounds. An MRA of Claimant’s renal arteries was
also negative. Dr. Mastouri diagnosed Claimant with benign essential hypertension,
spending nearly an hour counseling Claimant about the importance of taking his
medications in the manner prescribed. Dr. Mastouri increased Claimant’s dosage of
carvedilol, instructed him to continue with a low salt diet, and advised him to quit
smoking given the significant negative affect that smoking had on his kidney function and
blood pressure.
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On November 4, 2013, Claimant saw Dr. Mastouri for a six-week blood pressure
recheck. (Tr. at 468-70). Claimant brought his blood pressure log, which documented
systolic blood pressures “running between 130-160s at home.” Claimant reported that he
had not filled the spironolactone prescription and continued to smoke; however, he had
no particular complaints on a review of systems, specifically denying episodes of double
vision, visual changes, chest pain or palpitations, labored breathing, and psychological
issues. Claimant’s blood pressure was 140/80, and his physical examination was normal,
except for his weight, which had increased to 258 pounds. Dr. Mastouri diagnosed
Claimant with congestive heart failure, benign essential hypertension, chronic stage II
kidney disease, and nicotine dependence. Dr. Mastouri increased Claimant’s dosage of
Coreg and instructed him to continue taking his other medications as prescribed, with the
exception of Aldactone.
On December 30, 2013, Claimant returned to Dr. Mastouri for follow-up. (Tr. at
465-67). Claimant admitted that had not been taking all of his blood pressure medications
as prescribed, and his blood pressure was averaging “between 140s-160s at home.” He
also admitted to continued tobacco use. Nevertheless, Claimant denied symptoms,
including headache, blurry vision, and chest pain. His blood pressure was 170/124, and
his heart rate was 76 beats per minute. Despite the blood pressure reading, Claimant
appeared alert, oriented, and in no acute distress. His physical examination was normal,
except for his weight, which was now 264 pounds. Dr. Mastouri diagnosed Claimant with
congestive heart failure, benign essential hypertension, stage II chronic kidney disease,
and exogenous obesity. Noting that Claimant was unable to afford some of his blood
pressure medications, Dr. Mastouri exchanged the more expensive prescriptions with less
expensive alternatives. Claimant advised that he was losing his Medicaid coverage and
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could not return until his insurance was “fixed.”
Nearly a year later, on November 12, 2014, Claimant presented to an internist,
Rodica Chele, M.D., for an evaluation. (Tr. at 460-63). Dr. Chele documented that
Claimant was obese with untreated Hepatitis C due to alcohol consumption. Claimant
indicated that he continued to drink three to four beers per night and for that reason could
not receive Hepatitis C treatment. Claimant also reported uncontrolled hypertension, but
admitted that he was noncompliant with his medication regimen and recommended diet.
He continued to smoke a pack of cigarettes per day and complained that he had gained
20 pounds in the past eight months. Claimant reported episodes of blurry vision and
dizziness when his blood pressure was elevated, advising that his blood pressure
measured in the 190/110 range when he took it at home. Claimant admitted that he was
not taking the prescribed dosage of Clonidine and did not exercise regularly. On a review
of systems, Claimant denied having double vision, changes in vision, chest pain or
palpitations, labored breathing, muscle pain, altered mental status, or emotional lability.
His blood pressure was 170/110. Claimant had a steady gait, clear lungs, and his
cardiovascular, abdominal, and neurological examinations were all normal. Dr. Chele
diagnosed Claimant with mild stage II chronic kidney disease, benign essential
hypertension, anxiety, exogenous obesity, nicotine dependence, congestive heart failure
with no overt signs of decompensation, and chronic Hepatitis C for which he must cease
drinking to pursue treatment. She instructed him to obtain laboratory work before his
next appointment, take his medications as prescribed, log his blood pressure and bring
the log to his next visit, follow the recommended diet, lose weight, exercise, and cease
using tobacco and alcohol.

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B. Evaluations
On November 12, 2012, Claimant’s treating nurse practitioner, Nurse Vannoy,
examined Claimant for the West Virginia Department of Health and Human Resources.
(Tr. at 347-49). Claimant advised Nurse Vannoy that he was disabled due to an inability
to see, double vision, elevated blood pressure, eye strokes, and Hepatitis C. His blood
pressure was 190/129; he was 5’10” tall; and he weighed 257 pounds. Claimant’s speech,
posture, and gait were observed to be normal. His vision without glasses was 20/50 in the
right eye and 20/30 in the left eye. Claimant denied having any pain symptoms. His
physical examination was entirely normal, except for weight and blood pressure. Nurse
Vannoy diagnosed Claimant with high blood pressure and blurred vision. She opined that
Claimant could not work full time due to double vision. However, Nurse Vannoy could
not estimate the length of time Claimant would be unable to work, indicating that he
needed to see an eye doctor. She also felt he needed to have testing to rule out an unknown
cause of his hypertension, and he needed to see a specialist in Hepatitis C.
On March 13, 2013, Dr. Hansen completed a disability pension examination report
form directed to the Iron Workers’ Pension Trust. (Tr. at 456). Dr. Hansen opined that
Claimant was totally and permanently disabled from engaging in further work as an
Ironworker or as any other type of Building Trades Craftsman. Dr. Hansen’s opinion was
based upon Claimant’s diagnoses of hypertension, congestive heart failure, prediabetes,
eye strokes, pre-glaucoma, anxiety and depression. Dr. Hansen explained that due to
Claimant’s hypertension, he had suffered damage to his vision that prevented him from
driving, reading, and balancing. Although conceding that his first and only visit with
Claimant was on the same date as the report form, Dr. Hansen opined that Claimant’s
disability began on October 27, 2011. Dr. Hansen recommended re-examination in three
17

months.
On May 13, 2013, consulting agency physician, Dominic Gaziano, M.D., completed
a physical RFC assessment of Claimant based on a review of his records. (Tr. at 57-60).
Dr. Gaziano concluded that Claimant had severe impairments of visual disturbance and
essential hypertension. Dr. Gaziano found Claimant’s allegations regarding the intensity,
persistence, and severity of his symptoms to be only partially credible, noting that while
Claimant’s vision was somewhat limited, his activities of daily living undermined his
claims of disability. Dr. Gaziano opined that Claimant had no exertional, postural,
manipulative, or communicative limitations; however, his vision was reduced in both eyes
and he required environmental restrictions. Dr. Gaziano acknowledged that Claimant was
both nearsighted and farsighted, but felt he had no major deficiencies in terms of depth
perception, accommodation, color vision, and field of vision. Dr. Gaziano added that
Claimant continued to have a mild unilateral loss of field of vision, but his visual acuity
was correctable and his double vision had resolved according to his eye examination. In
view of Claimant’s impairments, Dr. Gaziano opined that Claimant should avoid
concentrated exposure to vibrations and all exposure to hazards.
On June 4, 2013, Eugene Lin, M.D. performed an Independent Medical
Examination of Claimant at the request of the Iron Workers’ Benefit Trust. (Tr. at 44143). Dr. Lin documented that Claimant was 53 years old, weighed 249 pounds, and was 5
feet 10.5 inches tall. He had previously worked as an Ironworker until a scheduled layoff
in November 2010. Claimant was not under any work restrictions at the time of the layoff.
Claimant reported that he had stopped driving in 2008 due to episodic dizziness and high
blood pressure. He admitted to occasionally doing yard work with a riding mower, but
stated that his blood pressure and dizziness increased with the exertion and heat.
18

Claimant described his current symptoms as headache and occasional blurred vision, as
well as dizziness, and a history of Hepatitis C. He admitted to drinking three to four beers
nightly, occasionally smoking marijuana, and smoking half of a pack of cigarettes daily
for thirty years. On examination, Claimant’s blood pressure measured 178/100 in the left
arm and 170/100 in his right arm. His heart rate was 75, and he had 2+ pitting edema in
his legs. Claimant’s lungs were clear to auscultation; his extraocular motions were intact;
he had good transfers from sitting to standing; and he walked with a normal gait.
In the discussion section of the examination report, Dr. Lin described Claimant as
having a longstanding history of hypertension that had been difficult to control despite
medical management. Claimant’s symptoms of headache and dizziness were associated
with spikes in his blood pressure. Pointing out that the job description for an Ironworker
required standing six to seven and a half hours per shift while wearing a 50-pound tool
belt and performing very strenuous activities like climbing, lifting, and bending and
pulling of steel, Dr. Lin opined that Claimant was totally disabled from his prior
occupation as an Ironworker. Dr. Lin added that Claimant should be reevaluated in
approximately one year after the outcome of his pending renal evaluation and after
sufficient time had passed for optimizing his blood pressure medications.
On August 21, 2013, agency consultant, Pedro F. Lo, M.D., reviewed Claimant’s
records and Social Security file, including Dr. Gaziano’s evaluation. (Tr. at 77-80). Dr. Lo
considered additional information not available at the time of Dr. Gaziano’s review; such
as the examination and RFC assessment prepared by Dr. Hansen. Dr. Lo stated that the
new evidence confirmed that Claimant had poorly controlled hypertension, but also
showed an absence of renal stenosis and a normal aldosterone level. Dr. Lo noted that
Claimant was currently being referred to a nephrologist, but concluded that the new
19

records did not demonstrate a significant change in Claimant’s clinical status. After
considering all of the evidence, Dr. Lo agreed with Dr. Gaziano’s opinions and affirmed
his RFC assessment.
On November 26, 2014, medical consultant, Paul W. Craig II, M.D., examined
Claimant at the request of his attorney. (Tr. at 516-20). After reviewing documents,
interviewing and examining Claimant, Dr. Craig diagnosed Claimant with uncontrolled
malignant hypertension with end organ damage (hypertensive retinopathy); history of
Hepatitis C, which may or may not be active; fatigue, malaise, dizziness, headache, and
vision difficulties. Dr. Craig opined that Claimant could not work an eight-hour, five-day
per week job, in any capacity. He felt Claimant was limited to sedentary or very light
activities due to his blood pressure and associated symptoms. Dr. Craig suggested that
Claimant be re-evaluated in one year to see if he improved with aggressive intervention
or treatment, which would also require Claimant’s compliance. However, Dr. Craig
believed that “[a]t present it is simply not safe for him to work.” (Id.).
As to Claimant’s function-by-function assessment, Dr. Craig opined that Claimant
could lift or carry a maximum of 25 pounds, with a maximum of 10 pounds occasionally
(defined as up to 1/3 of an 8-hour work day), and could not frequently (defined as 1/3 to
2/3 of an 8-hour work day) lift or carry any amount of weight. He felt that Claimant could
stand and/or walk for 4 to 6 hours in an 8-hour workday, but could only do so for 1 to 2
hours without interruption. Claimant could sit for 6 to 8 hours in a workday, but only 2
to 4 hours without interruption. In addition, Claimant could only occasionally stoop,
crouch, kneel, and crawl, and could never climb or balance. In support of these
limitations, Dr. Craig relied on “examination, history and record review.” Dr. Craig
additionally opined that Claimant had no limitation in reaching, handling, feeling,
20

hearing, and speaking, but was limited in pushing/pulling and seeing. He felt Claimant
was restricted in every environmental aspect. Dr. Craig explained these restrictions by
referring to Claimant’s symptoms of blurred vision and history of hypertensive
retinopathy. (Id.).
C. Claimant’s Statements
In an Adult Disability Form filed by Claimant shortly after applying for SSI and
DIB, he stated that he stopped working in November 2010, because he was “laid off from
work.” (Tr. at 259). Claimant indicated that prior to the lay-off, he had worked as an
Ironworker, which was a position he held for more than fifteen years. (Tr. at 260). His job
duties as an Ironworker included lifting items that weighed as much as 100 pounds and
frequently lifting 50 pounds or more. (Tr. at 261). In that positon, Claimant spent eight
hours each work day walking; four hours climbing, stooping, kneeling, crouching, and
crawling; eight hours handling large objects; and eight hours reaching. (Id.).
In an Adult Function Report completed by Claimant on January 29, 2013, he stated
that his impairments interfered with his ability to work as an Ironworker, because he had
to be able to balance, lift heavy equipment, and have excellent vision. (Tr. at 273).
According to Claimant, he spent his days trying to keep busy, helping around the house
and visiting with elderly neighbors. (Tr. at 274). He experienced dizziness upon waking
and sometimes throughout the day; however, he could attend to his own personal needs,
do laundry, take out the trash, make sandwiches and occasionally cook, and do yard work
using a riding mower. (Tr. at 275). He spent 2 hours per week shopping at stores, spent
a lot of time outdoors pacing, and watched television. Claimant stated that he “should no
longer lift anything over 50 pounds.” (Tr. at 278).
Claimant filed a supplemental Adult Function Report on July 30, 2013, in which
21

he described his limitations as being more severe. (Tr. at 298-304). For example,
Claimant indicated that he “shouldn’t lift 25-50 [pounds].” (Tr. at 302). However, he still
stated that he tried to start and take on projects around the house, paced a great deal,
completed personal care without assistance, prepared light meals, did laundry, rode the
riding mower, shopped once per month, and went to doctors’ visits. (Tr. at 298-301).
At the administrative hearing on December 3, 2014, Claimant confirmed that he
quit working due to being laid off. (Tr. at 32). Claimant indicated that after his lay-off, he
received unemployment benefits and continued to be available for work until he received
disability benefits from the Ironworkers’ union. (Tr. at 32, 35). Claimant testified that
hypertension and its related symptoms of dizziness and fatigue were the only current
obstacles to him working. (Tr. at 32-33). Claimant admitted that he had suffered from
hypertension for twelve years and had similar symptoms when he worked as an
Ironworker. When asked about daily activities, Claimant said he did not do much, but he
still mowed the yard, gardened, cooked, did laundry, and cared for his dog. (Tr. at 37-39).
However, Claimant did not feel that he could sit an entire eight-hour work day, because
he had trouble focusing. (Tr. at 43).
VI.

Scope of Review
The issue before this Court is whether the final decision of the Commissioner

denying Claimant’s application for benefits is supported by substantial evidence. The
Fourth Circuit has defined substantial evidence as:
evidence which a reasoning mind would accept as sufficient to support a
particular conclusion. It consists of more than a mere scintilla of evidence
but may be somewhat less than a preponderance. If there is evidence to
justify a refusal to direct a verdict were the case before a jury, then there is
“substantial evidence.”
Blalock, 483 F.2d at 776 (quoting Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966)).
22

Additionally, the administrative law judge, not the court, is charged with resolving
conflicts in the evidence. Hays v. Sullivan, 907 F.2d 1453, 1456 (4th Cir. 1990). The Court
will not re-weigh conflicting evidence, make credibility determinations, or substitute its
judgment for that of the Commissioner. Id. Instead, the Court’s duty is limited in scope;
it must adhere to its “traditional function” and “scrutinize the record as a whole to
determine whether the conclusions reached are rational.” Oppenheim v. Finch, 495 F.2d
396, 397 (4th Cir. 1974). Thus, the ultimate question for the Court is not whether the
Claimant is disabled, but whether the decision of the Commissioner that the Claimant is
not disabled is well-grounded in the evidence, bearing in mind that “[w]here conflicting
evidence allows reasonable minds to differ as to whether a claimant is disabled, the
responsibility for that decision falls on the [Commissioner].” Walker v. Bowen, 834 F.2d
635, 640 (7th Cir. 1987).
VII.

Analysis
Claimant contends that he should have been limited to sedentary or, alternatively,

light level exertional work, which would have directed a finding that he was disabled at
the age of 50 under Grid Rule 201.10 or at the age of 55 under Grid Rule 202.02,
respectively. Claimant argues that, inter alia, his testimony and the medical evidence,
particularly the findings and opinions of Drs. Lin, Hansen, and Craig, overwhelmingly
support his position.
The Grids are used at the fifth step of the sequential disability process, setting out
“numbered table rules which direct conclusions of ‘disabled’ or ‘not disabled’’’ when a
claimant’s characteristics coincide with those of a numbered rule. SSR 83-12, 1983 WL
31253, at *1 (S.S.A. 1983); see 20 C.F.R. Pt. 404, Subpart P, Appendix 2. In evaluating
whether there are jobs that exist in significant numbers in the national economy, the ALJ
23

may rely upon the Grids, as they “take administrative notice of the availability of job types
in the national economy for persons having certain characteristics, namely age,
education, previous work experience, and residual functional capacity.” Grant v.
Schweiker, 699 F.2d 189, 191-92 (4th Cir. 1983); see also 20 C.F.R. §§ 404.1569, 416.969.
When a claimant has only exertional impairments and his strength capacity falls neatly
within a specific exertional level, the Grids control the disability determination. However,
when a claimant has significant nonexertional impairments, or has a combination of
exertional and nonexertional impairments, the Grids often do not provide adequate
information for the ALJ to complete the disability analysis. 20 C.F.R. §§ 404.1569,
416.969. In these situations, the Grids provide only a framework for the ALJ, who must
then give “full individualized consideration” to the relevant facts of the claim in order to
establish the existence of available jobs. Id. Even in these cases, however, the ALJ must
first consult the Grids to determine whether a numbered rule directs a finding of disability
based on the exertional (or strength) requirement alone. If so, there is no need to assess
the effects of nonexertional limitations. However, if the Grids direct a finding of “not
disabled,” the ALJ cannot rely on the finding and, instead, must establish the availability
of jobs through the testimony of a vocational expert. Walker v. Bowen, 889 F.2d 47, 4950 (4th Cir. 1989).
In the instant action, the ALJ examined the Grids and concluded that the
applicable numbered rules directed a finding of “not disabled” in Claimant’s case.
Accordingly, the ALJ proceeded to give full consideration to the relevant factors and
employed the assistance of a vocational expert to determine the availability of jobs in the
national economy that Claimant was capable of performing. Claimant objects to the ALJ’s
finding under the Grids, arguing that if the ALJ had found him capable of performing only
24

light or sedentary level exertional work, the Grids would have directed a finding of
disability. Thus, this court must direct its attention to whether the ALJ properly analyzed
the exertional component of Claimant’s RFC.
“Exertional capacity addresses an individual's limitations and restrictions of
physical strength and defines the individual's remaining abilities to perform each of seven
strength demands: sitting, standing, walking, lifting, carrying, pushing, and pulling.” See
Social Security Ruling (“SSR”) 96-8p, 1996 WL 374184, at *5 (S.S.A. 1996). “To determine
the physical exertion requirements of work in the national economy,” the SSA classifies
jobs as “sedentary, light, medium, heavy, and very heavy.” 20 C.F.R. §§ 404.1567, 416.967.
Sedentary work involves lifting no more than 10 pounds at a time, sitting a majority of the
day, and occasionally walking or standing. Id. at 404.1567(a), 416.967(a). Light work
requires lifting no more than 20 pounds with frequent lifting of objects weighing up to 10
pounds, a good deal of walking or standing, and some sitting with pushing or pulling of
arm or leg controls. Id. at 404.1567(b), 416.967(b). Medium work “involves lifting no
more than 50 pounds at a time with frequent lifting or carrying of objects weighing up to
25 pounds.” Id. at 404.1567(c), 416.967(c). According to SSR 83-10:
A full range of medium work requires standing or walking, off and on, for a
total of approximately 6 hours in an 8-hour workday in order to meet the
requirements of frequent lifting or carrying objects weighing up to 25
pounds. As in light work, sitting may occur intermittently during the
remaining time. Use of the arms and hands is necessary to grasp, hold, and
turn objects, as opposed to the finer activities in much sedentary work, which
require precision use of the fingers as well as use of the hands and arms.
The considerable lifting required for the full range of medium work usually
requires frequent bending-stooping (Stooping is a type of bending in which a
person bends his or her body downward and forward by bending the spine at
the waist.) Flexibility of the knees as well as the torso is important for this
activity. (Crouching is bending both the legs and spine in order to bend the
body downward and forward.) However, there are a relatively few
occupations in the national economy which require exertion in terms of
25

weights that must be lifted at times (or involve equivalent exertion in pushing
or pulling), but are performed primarily in a sitting position, e.g., taxi driver,
bus driver, and tank-truck driver (semiskilled jobs). In most medium jobs,
being on one's feet for most of the workday is critical. Being able to do
frequent lifting or carrying of objects weighing up to 25 pounds is often more
critical than being able to lift up to 50 pounds at a time.
SSR 83-10, 1983 WL 31251, at *6 (S.S.A. 1983); see 20 C.F.R. §§ 404.1567(c), 416.967(c).
As stated, the ALJ found that Claimant had the RFC to perform less than a full range of
medium work. (Tr. at 14). Nonetheless, the ALJ determined that Claimant had the RFC
to fulfill all seven of the strength demands of medium work.
SSR 96-8p provides guidance on how an ALJ should properly assess a claimant’s
RFC, which is the claimant’s “ability to do sustained work-related physical and mental
activities in a work setting on a regular and continuing basis.” SSR 96-8p, 1996 WL
374184, at *1. RFC is a measurement of the most that a claimant can do despite his or
her limitations resulting from both severe and non-severe impairments, and the finding
is used at steps four and five of the sequential evaluation to determine whether a claimant
can still do past relevant work and, if not, whether there is other work that the claimant
is capable of performing. Id. According to the Ruling, the ALJ’s RFC determination
requires “a function-by-function assessment based upon all of the relevant evidence of an
individual’s ability to do work-related activities.” Id. at *3. The functions that the ALJ
must assess include the claimant’s seven strength abilities, as well as “other physical
functions (including manipulative or postural functions, such as reaching, handling,
stooping or crouching);” mental and psychological capacity; and other abilities, “such as
skin impairment(s), epilepsy, impairment(s) of vision, hearing or other senses, and
impairment(s) which impose environmental restrictions.” 20 CFR 404.1545(b-d) and
416.945(b-d). Only by examining specific functional abilities can the ALJ determine (1)

26

whether a claimant can perform past relevant work as it was actually, or is generally,
performed; (2) what exertional level is appropriate for the claimant; and (3) whether the
claimant “is capable of doing the full range of work contemplated by the exertional level.”
SSR 96-8p, 1996 WL 374184, at *3. Indeed, “[w]ithout a careful consideration of an
individual’s functional capacities to support an RFC assessment based on an exertional
category, the adjudicator may either overlook limitations or restrictions that would
narrow the ranges and types of work an individual may be able to do, or find that the
individual has limitations or restrictions that he or she does not actually have.” Id. at *4.
In determining a claimant’s RFC, the ALJ “must include a narrative discussion
describing how the evidence supports each conclusion, citing specific medical facts (e.g.
laboratory findings) and nonmedical evidence (e.g., daily activities, observations).” Id. at
*7. Further, the ALJ must “explain how any material inconsistencies or ambiguities in the
evidence in the case record were considered and resolved.” Id. at *7. “Remand may be
appropriate where an ALJ fails to assess a claimant’s capacity to perform relevant
functions, despite contradictory evidence in the record, or where other inadequacies in
the ALJ’s analysis frustrate meaningful review.” Mascio v. Colvin, 780 F.3d 632, 636 (4th
Cir. 2015) (quoting Cichocki v. Astrue, 729 F.3d 172, 177 (2d Cir. 2013)) (markings
omitted).
In this case, the ALJ conducted the RFC assessment, including the strength
analysis, in compliance with Social Security regulations and rulings and reached an RFC
finding that was supported by substantial evidence. The ALJ analyzed the objective and
opinion evidence, assessed Claimant’s functional abilities, and articulated her reasoning
for the RFC finding. The ALJ cited Claimant’s allegations that he was unable to work due
to symptoms of hypertension, deficits in visual acuity, and loss of field of vision. (Tr. at
27

15). She also noted Claimant’s reports that his high blood pressure caused dizziness and
fatigue and, at its worst, it caused eye strokes and/or blurred vision. (Id.). However, the
ALJ found that Claimant had worked for nearly a decade despite symptoms of
hypertension that were present at approximately the same level of severity. (Tr. at 15-16).
Indeed, Claimant testified that he quit working, not because of his hypertension and
related symptoms, but because of a scheduled lay-off, and he subsequently sought work
from 2010 to 2012. (Tr. at 15).
Further, the ALJ found that Claimant’s treatment records did not show a pattern
of deterioration in his condition since his initial diagnosis; rather, his records showed
periodic flare-ups generally following periods of noncompliance with treatment. (Tr. at
16). The ALJ determined that when Claimant followed prescribed treatment, his
hypertension was well controlled. (Id.). Unfortunately, as noted by the ALJ, Claimant’s
noncompliance with treatment stretched far into the past, well before the alleged onset of
disability, and throughout much of his employment as an Ironworker. (Id.). Nonetheless,
Claimant was fully able to meet the seven strength demands of heavy physical labor.
As to his alleged visual symptoms, the ALJ stated that Claimant did not take any
medications for an eye impairment and the record indicated that his visual symptoms
were attributed to his hypertension and were present primarily during episodes of high
blood pressure. (Id.). The ALJ concluded, based on the evidence, that Claimant could
control these symptoms by strictly adhering to his medication regimen. The above factors
strongly suggested to the ALJ that Claimant’s impairments did not prevent him from
continuing to work. (Id.). However, the ALJ accepted that, to a degree, Claimant’s
intermittent dizziness, occasional blurred vision, and fatigue, combined with his obesity,
would reduce the exertional capacity that Claimant could achieve and sustain and would
28

prohibit him from climbing ladders, ropes, or scaffolds or working at unprotected heights,
around dangerous machinery, or vibrating equipment. (Id.).
In weighing the opinion evidence and explaining her RFC finding, the ALJ gave
partial weight to Dr. Lin’s opinion that Claimant could not perform the full requirements
of his past work as an Ironworker. (Tr. at 17). She also gave partial weight to Dr. Craig’s
opinion, agreeing that Claimant should not climb ladders, ropes, or scaffolds, or work at
unprotected heights. (Id.). However, she did not find Dr. Craig’s opinion that Claimant
could not work in any capacity on a full time basis to be consistent with the record, as
Claimant worked for years at a heavy exertional level with his present symptoms. (Id.).
Also, the ALJ rejected Dr. Craig’s opinion that Claimant could not lift more than 10
pounds occasionally, as Claimant acknowledged in his Function Report that he could lift
up to 50 pounds. (Id.). As to Dr. Hansen’s opinions, the ALJ gave weight to the opinion
that Claimant could not work at heights due to dizziness and poor balance. (Id.). However,
she rejected Dr. Hansen’s opinion that Claimant was unable to work at present, because
the opinion was conclusory, was on an issue reserved to the Commissioner, and was
inconsistent with the evidence of record, including Claimant’s activities of daily living and
work history. (Id.). Finally, the ALJ gave little weight to the opinion of Nurse Vannoy that
Claimant could not work because he had double vision. (Id.). As explained, the ALJ found
that Claimant’s eye impairments were related to his hypertension and tended to become
debilitating only when Claimant did not follow prescribed treatment. (Tr. at 18). Further,
the ALJ felt Claimant’s visual limitations were largely outside the scope of Nurse Vannoy’s
expertise as a family nurse practitioner, indicating that Nurse Vannoy undermined her
own opinion by conceding that Claimant should be referred to an eye doctor. (Id.).
The ALJ clearly assessed the relevant functions of medium work, resolved
29

inconsistent evidence, and articulated her rationale for concluding that Claimant could
perform the strength demands of medium work. Regarding the lifting requirements, the
ALJ emphasized Claimant’s acknowledgement that he could lift 50 pounds, (Tr. at 17,
278), noting that he regularly lifted much more than that amount as an Ironworker.
Furthermore, none of the medical source opinions ruled out Claimant’s ability to stand,
sit, and walk to the extent required by medium work. Even Dr. Craig, who provided the
most limited RFC assessment, opined that Claimant could stand or walk for up to 6 hours
in an 8-hour workday. (Tr. at 519). While Dr. Craig found more severe limitations on
lifting, stooping, and crouching than allowed by medium work, the ALJ provided her
rationale for not affording his opinion full weight. (Tr. at 17).
Overall, the record substantially supports the ALJ’s assessment that Claimant is
capable of the strength demands of medium level exertional work. The evidence
demonstrates that Claimant performed heavy to very heavy labor for nearly a decade
while he suffered from the same impairments and symptoms now alleged to be the source
of his disability. Moreover, the ALJ correctly concluded that Claimant’s symptoms were
controlled when Claimant was compliant with his medication regimen and low salt diet.
(Tr. at 468, 471, 475). Presumably, Claimant could function even better if he would simply
follow all of the directives given to him by his physicians; such as, to stop drinking and
smoking, to lose weight, to exercise, and to take his medications in the proper order and
at the recommended times. Notwithstanding the significant improvement realized by
Claimant during his brief periods of compliance, he repeatedly failed to take his blood
pressure medication as prescribed, continued to smoke up to a pack of cigarettes per day,
failed to lose weight and instead gained weight, ate foods high in sodium, and continued
to drink alcohol despite contrary instructions by his medical providers. (Tr. at 343, 345,
30

376, 377, 378, 379, 412, 425, 452, 460, 465, 468, 471, 474, 478, 479). The ALJ reasonably
considered this evidence in assessing Claimant’s credibility and determining his RFC. See
Dunn v. Colvin, 607 F. App’x 264, 275–76 (4th Cir. 2015).
Moreover, for the most part, the medical records and source statements do not
preclude medium level work. The state agency consultants found that Claimant had no
exertional, postural, or manipulative limitations, despite his impairments. (Tr. at 58, 78).
These opinions were supported by the treatment records, which generally reflected
normal physical examinations, without musculoskeletal and neurological signs and
symptoms. Other than complaints directly associated with hypertension, Claimant rarely
reported abnormalities on the review of symptoms and uniformly denied having any pain.
In the RFC assessments of record, Nurse Vannoy did not document any physical
limitations that would prevent Claimant from lifting and carrying up to fifty pounds and
standing, walking, or sitting up to six hours, each, in an eight-hour work day. Likewise,
Dr. Lin pointed out that Claimant had no work restrictions at the time he was laid off as
an Ironworker. While Dr. Lin did not believe Claimant was physically able to continue as
an Ironworker, he framed that opinion in the context of the job description provided to
him, which required Claimant to stand six to seven and half hours each day wearing a 50pound tool belt while performing strenuous climbing, lifting, and bending and pulling of
steel. Thus, the ALJ’s conclusion that Claimant was capable of performing the strength
demands of medium level work was not inconsistent with the opinion of Nurse Vannoy or
Dr. Lin. Similarly, Dr. Hansen did not find Claimant disabled from all work; to the
contrary, he merely opined that Claimant could not work as an Ironworker or in a similar
occupation.
Importantly, an RFC assessment is “an adjudicator's finding about the ability of an
31

individual to perform work-related activities.” SSR 96-5P, 1996 WL 374183, at *5 (S.S.A.
1996). Thus, while the ALJ must consider, discuss, and reconcile the evidence, including
the medical source statements, the RFC is ultimately an administrative finding. Id. (“A
medical source's statement about what an individual can still do is medical opinion
evidence that an adjudicator must consider together with all of the other relevant evidence
(including other medical source statements that may be in the case record) when
assessing an individual's RFC. Although an adjudicator may decide to adopt all of the
opinions expressed in a medical source statement, a medical source statement must not
be equated with the administrative finding known as the RFC assessment.”). As
previously noted, the ALJ is charged with weighing the evidence, resolving conflicts, and
making credibility determinations. Hays, 907 F.2d at 1456. The court’s duty is to
scrutinize the record to determine whether the ALJ’s conclusions were reached in
compliance with applicable law and were supported by substantial evidence. Id. For the
reasons stated above, the ALJ’s determination that Claimant was capable of performing
the seven strength demands of medium level work was properly reached and was
supported by substantial evidence. Consequently, the ALJ correctly applied the numbered
rules pertaining to medium exertional level work, which directed a finding of “not
disabled” under the Grids, and proceeded to properly resolve step five of the disability
process with the assistance of a vocational expert.
VIII. Conclusion
After a careful consideration of the evidence of record, the Court finds that the
Commissioner’s decision is supported by substantial evidence. Therefore, the Court will
DENY Plaintiff’s motion for judgment on the pleadings, (ECF No. 11); GRANT

32

Defendant’s motion for judgment on the pleadings, (ECF No. 12); and DISMISS this
action from the docket of the Court. A Judgment Order will be entered accordingly.

The Clerk of this Court is directed to transmit copies of this Memorandum Opinion
to counsel of record.
ENTERED: June 27, 2017

33