United States District Court, D. Massachusetts
MEMORANDUM AND ORDER ON PLAINTIFF'S MOTION TO
REVERSE AND DEFENDANT'S MOTION TO AFFIRM DECISION OF
DENNIS SAYLOR IV UNITED STATES DISTRICT JUDGE.
an appeal of a final decision of the Commissioner of the
Social Security Administration (“SSA”). On May
20, 2016, the ALJ issued a decision concluding that plaintiff
Nelida Narvaez had been disabled since May 1, 2016, and not
earlier. The SSA Appeals Council declined review on June 2,
2017. Narvaez then filed an action with this Court.
seeks reversal of the Commissioner's decision on four
grounds. The Commissioner has moved to affirm the decision.
For the reasons stated below, the decision will be affirmed.
Narvaez was 45 years old on June 7, 2012, the date she
contends that her disability began. (A.R. 542). She graduated
from high school and attended two years of college. (A.R.
555). She has been unemployed since August 2012, when she
stopped working as a data clerk specialist at the New Bedford
Housing Authority and part-time as a cashier at a Shaw's
Supermarket. (A.R. 545). She had previously worked as a
cashier, a receptionist, a file clerk, and a customer service
representative. (A.R. 581).
has a lengthy medical record. She has reported pain in her
back since 1991 and has received treatment for a variety of
physical and mental health problems, including chronic pain
syndrome. (A.R. 875).
2011, Narvaez complained of back pain to her primary-care
provider, Dr. Anne Marie Treadup. (A.R. 829). Dr. Treadup
referred her to a physiatrist, Dr. Sergey Wortman, for pain
management. (A.R. 730).
Wortman began seeing Narvaez on an approximately monthly
basis. He first examined her in January 2012. (Id.).
He noted three impressions at that visit: (1) that she
suffered from bilateral carpal tunnel syndrome, (2) that she
had possible lumbar and cervical spondylosis, and (3) that
she had possible localized lumbar and cervical disc
protrusions/herniations. (A.R. 730-31). Dr. Wortman
prescribed Percocet (a painkiller containing a combination of
an opioid and acetaminophen) and Mobic (a nonsteroidal
anti-inflammatory drug). (Id.).
spring of 2012, Narvaez received an x-ray and an MRI of her
back. (A.R. 719, 727). Dr. Wortman noted that the tests
revealed evidence of mild spondylosis, a small disc
protrusion, and facet joint hypertrophy in her spine. (A.R.
719-20, 727-28). Dr. Wortman also had Narvaez undergo a nerve
conduction study, which revealed evidence of moderate carpal
tunnel syndrome. (A.R. 719-20).
2012, after Narvaez reported worsening pain, Dr. Wortman
prescribed 100 mg/day of Lyrica (a nerve pain medication).
and August 2012, Narvaez complained of knee pain to Dr.
September 2012, Narvaez received x-rays of both of her knees.
The x-ray of the left knee was normal, and the x-ray of the
right knee revealed only minimal degenerative changes. (A.R.
continued to take various drugs for pain, including Percocet,
Neurontin (a nerve pain medication), and Mobic. In November
2012, Dr. Treadup saw Narvaez and noted that she felt that
“a lot of [her] pain [was] from . . . narcotics . . .
and narcotic withdrawal.” (A.R. 873). Dr. Treadup
recommended that she “come off of narcotics or talk to
Dr. Wortman about” a prescription for a long-acting
narcotic. (Id.). Later that month, Dr. Wortman
prescribed 50 mg/day of Oxycontin and continued her on
Neurontin and Mobic. (A.R. 884-85).
saw Dr. Wortman a month later, on December 19, 2012. She
continued to complain of pain, and Dr. Wortman increased her
Oxycontin prescription to 60 mg/day. (A.R. 881-82).
January 2013, Narvaez received an MRI of her left knee. The
radiologist noted impressions of mild runner's knee and a
minor joint effusion. (A.R. 879). Dr. Wortman noted that the
MRI revealed mild osteoarthritis. (A.R. 877).
Wortman continued to see Narvaez regularly. Although she
frequently complained of pain, she repeatedly refused Dr.
Wortman's suggestions that she receive cortisone
injections to help manage it. (A.R. 1354).
October 13 and/or 14, 2014, Narvaez visited the emergency
room for bilateral knee pain. An examining physician's
assistant recommended icing the area and using an Ace bandage
for support. She also prescribed Motrin for pain and Percocet
for severe pain, as well as a cane to assist in walking.
2015, Narvaez tore the medial meniscus in her left knee.
(A.R. 1331). She underwent arthroscopic surgery on June 23,
2015. By October 2015, she was apparently able to walk
normally, except on her heels or toes. (A.R. 1380).
filed a claim for disability benefits in August 2012. (A.R.
234). At that time, she contended that she was suffering
from, among other things, a disc protrusion, fibromyalgia,
carpal tunnel syndrome, and rheumatoid arthritis. She
contended that her disability had begun on June 7, 2012.
November 16, 2012, the SSA concluded that Narvaez was not
disabled. (A.R. 324-27). She filed a request for
reconsideration. (A.R. 332-33). On April 2, 2013, the SSA
concluded that its earlier ...