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Ayala v. Colvin

United States District Court, D. Massachusetts

March 27, 2017

VIRGEN M. AYALA, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security Administration, Defendant.


          KATHERINE A. ROBERTSON United States Magistrate Judge.

         I. Introduction

         On January 13, 2016, plaintiff Virgen M. Ayala (“Plaintiff”) filed a complaint pursuant to 42 U.S.C. § 405(g) against the Acting Commissioner of the Social Security Administration (“Commissioner”), appealing the denial of her claims for Supplemental Security Income (“SSI”) and Social Security Disability Insurance (“SSDI”). Plaintiff asserts that the Commissioner's decision denying her such benefits - memorialized in an April 15, 2015 decision by an administrative law judge (“ALJ”) - is in error. Specifically, Plaintiff alleges that the ALJ erred by not assessing the severity of her tendonitis of the elbow and not finding it to be severe and by not granting a treating physician's assistant's opinion controlling weight when assessing her RFC. Plaintiff has moved for judgment on the pleadings requesting that the Commissioner's decision be reversed, or, in the alternative, remanded for further proceedings (Dkt. No. 15). The Commissioner has moved for an order affirming the decision of the Commissioner (Dkt. No. 23). The parties have consented to this court's jurisdiction (Dkt. No. 14). See 28 U.S.C. § 636(c); Fed.R.Civ.P. 73. For the following reasons, the court will deny Plaintiff's motion and allow the Commissioner's motion.

         II. Procedural Background

         Plaintiff applied for SSI and SSDI with a protective filing date of July 11, 2013, alleging a March 1, 2010 onset of disability due to asthma, bacterial infection, hip pain, tendonitis, and high blood pressure (Administrative Record (“A.R.”) at 17, 227-38, 247, 262). Plaintiff's applications were denied initially and on reconsideration (id. at 136-49, 155-60). Plaintiff requested a hearing before an ALJ, and one was held on March 31, 2015, at which time Plaintiff claimed disability due to arthritis and osteoarthritis in her back, hands, neck, and leg, tendonitis of the elbow and arms, tinnitus, bilateral sensory hearing loss, and asthma (id. at 72-99, 161-62). Following the hearing, the ALJ issued a decision on April 15, 2015, finding that Plaintiff was not disabled and denying Plaintiff's claims (id. at 11-28). The Appeals Council denied review on November 19, 2015, and the ALJ's decision became the final decision of the Commissioner (id. at 1-10). This appeal followed.

         III. Legal Standards

         A. Standard for Entitlement to Social Security Disability Insurance

         In order to qualify for SSI and SSDI, a claimant must demonstrate that she is disabled within the meaning of the Social Security Act.[1] A claimant is disabled for purposes of SSI and SSDI if she “is unable to engage in any substantial gainful activity by reason of any 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 twelve months.” 42 U.S.C. § 1382c(a)(3)(A); 42 U.S.C. § 423(d)(1)(A). A claimant is unable to engage in any substantial gainful activity when she “is not only unable to do his previous work, but cannot, considering h[er] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which [s]he lives, or whether a specific job vacancy exists for h[er], or whether [s]he would be hired if [s]he applied for work.” 42 U.S.C. § 1382c(a)(3)(B); 42 U.S.C. § 423(d)(2)(A).

         The Commissioner evaluates a claimant's impairment under a five-step sequential evaluation process set forth in the regulations promulgated under each statute. See 20 C.F.R. § 416.920; 20 C.F.R. § 404.1520. The hearing officer must determine: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant suffers from a severe impairment; (3) whether the impairment meets or equals a listed impairment contained in Appendix 1 to the regulations; (4) whether the impairment prevents the claimant from performing previous relevant work; and (5) whether the impairment prevents the claimant from doing any work considering the claimant's age, education, and work experience. See id. See also Goodermote v. Sec'y of Health & Human Servs., 690 F.2d 5, 6-7 (1st Cir. 1982) (describing the five-step process). If the hearing officer determines at any step of the evaluation that the claimant is or is not disabled, the analysis does not continue to the next step. 20 C.F.R. § 416.920; 20 C.F.R. § 404.1520.

         Before proceeding to steps four and five, the Commissioner must make an assessment of the claimant's “residual functional capacity” (“RFC”), which the Commissioner uses at step four to determine whether the claimant can do past relevant work and at step five to determine if the claimant can adjust to other work. See id. “RFC is what an individual can still do despite his or her limitations. RFC is an administrative assessment of the extent to which an individual's medically determinable impairment(s), including any related symptoms, such as pain, may cause physical or mental limitations or restrictions that may affect his or her capacity to do work-related physical and mental activities.” Social Security Ruling (“SSR”) 96-8p, 1996 WL 374184, at *2 (July 2, 1996).

         The claimant has the burden of proof through step four of the analysis, Goodermote, 690 F.2d at 7, including the burden to demonstrate RFC. Flaherty v. Astrue, 2013 WL 4784419, at *9 (D. Mass. Sept. 5, 2013) (citing Stormo v. Barnhart, 377 F.3d 801, 806 (8th Cir. 2004)). At step five, the Commissioner has the burden of showing the existence of other jobs in the national economy that the claimant can nonetheless perform. Goodermote, 690 F.2d at 7.

         B. Standard of Review

         The District Court may enter a judgment affirming, modifying, or reversing the final decision of the Commissioner, with or without remanding for rehearing. See 42 U.S.C. § 1383(c)(3); 42 U.S.C. § 405(g). Judicial review “is limited to determining whether the ALJ used the proper legal standards and found facts upon the proper quantum of evidence.” Ward v. Comm'r of Soc. Sec., 211 F.3d 652, 655 (1st Cir. 2000). The court reviews questions of law de novo, but must defer to the ALJ's findings of fact if they are supported by substantial evidence. Id. (citing Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir.1999)). Substantial evidence exists “‘if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support [the] conclusion.'” Irlanda Ortiz v. Sec'y of Health & Human Servs., 955 F.2d 765, 769 (1st Cir. 1991) (quoting Rodriguez v. Sec'y of Health & Human Servs., 647 F.2d 218, 222 (1st Cir. 1981)). In applying the substantial evidence standard, the court must be mindful that it is the province of the ALJ, and not the courts, to determine issues of credibility, resolve conflicts in the evidence, and draw conclusions from such evidence. Id. So long as the substantial evidence standard is met, the ALJ's factual findings are conclusive even if the record “arguably could support a different conclusion.” Id. at 770. That said, the Commissioner may not ignore evidence, misapply the law, or judge matters entrusted to experts. Nguyen, 172 F.3d at 35.

         IV. Discussion

         A. The Evidence

         1. Medical Records[2]

         On March 27, 2009, Plaintiff went to Mercy Medical Center emergency room complaining of radiating left elbow pain with movement, but no pain at rest (id. at 439). She reported that the pain had been intermittent over the previous two months (id.). On examination, Plaintiff's epicondyles were tender to palpation with pain on flexion and extension, but her strength was full and her handgrip was strong (id. at 439). An x-ray of her elbow was negative for fracture (id. at 440). The treating physician's assistant suspected epicondylitis, prescribed Percocet and ibuprofen, and advised Plaintiff to follow-up with her primary care provider (id.).

         On April 30, 2009, Plaintiff's primary care provider referred Plaintiff to Donald Griger, M.D., at the Arthritis Treatment Center based on Plaintiff's report of experiencing left “tennis elbow” pain for three months that was not helped by nonsteroidal anti-inflammatory drugs (NSAIDs) (id. at 382-83). Dr. Griger saw Plaintiff on May 6, 2009, at which time Plaintiff stated that her left elbow pain radiated up and down her arm, was mild while at rest and worsened with activity, and benefitted to some degree from medication (id. at 366-67). Dr. Griger's physical examination of Plaintiff was normal, and he diagnosed Plaintiff with left lateral epicondylitis and left upper and lower arm pain and recommended physical therapy, exercise, and a splint (id.).

         On May 22, 2009, J. Lewin, a physical therapist at the Arthritis Treatment Center, evaluated Plaintiff (id. at 377-78). Lewin's physical examination of Plaintiff's left arm revealed tenderness in the left lateral elbow, reduced strength but normal range of motion, and spasm upon palpation (id.). Lewin's plan of care included iontophoresis and exercise, with short-term goals of education and elbow stretching and long-term goals of increasing strength and activities of daily living (id.). Plaintiff participated in eight sessions of physical therapy between May 26, ...

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