United States District Court, D. Massachusetts
ORDER ON CROWE'S MOTION TO REVERSE THE
COMMISSIONER'S DECISION AND COMMISSIONER'S MOTION TO
[Docket Nos. 23, 29] AFFIRM
JENNIFER C. BOAL, UNITED STATES MAGISTRATE JUDGE
an action for judicial review of a final decision by the
Commissioner of the Social Security Administration
(“Commissioner”) denying Judith Crowe's
application for disability insurance benefits
(“DIB”). Crowe asserts that the
Commissioner's decision denying her such benefits -
memorialized in an April 5, 2017 decision of an
administrative law judge (“ALJ”) - is in error,
Docket No. 23, and the Commissioner, in turn, has moved to
affirm. Docket No. 29. Crowe filed a reply brief. Docket No. 31.
For the following reasons, this Court denies Crowe's
motion and grants the Commissioner's motion.
FACTS AND PROCEDURAL HISTORY
filed an application for DIB on February 19, 2015, alleging
disability as of June 22, 2013 from a herniated disc, spinal
stenosis, COPD and osteoarthritis. (Administrative Record
(“AR”) 216-17). The application was denied
initially (AR 130-41), and on reconsideration (AR 143-59). On
December 9, 2016, ALJ Paul W. Goodale held a hearing at which
Crowe and vocational expert (“VE”) Larry Takki
appeared and testified. (AR 40-107).
issued a decision on April 5, 2017, finding that Crowe was
not disabled from June 22, 2013, her alleged onset date,
through March 31, 2016, her date last insured (“the
relevant period”). (AR 12-31). The Appeals Council
denied Crowe's request for review on January 18, 2018,
making the ALJ's decision the final decision of the
Commissioner. (AR 1-6).
filed this action on March 15, 2018. Docket No. 1.
was fifty-three years old on her date last insured. (AR 130,
143). She graduated from high school, is married and has
three grown children. (AR 51-53).
reported past work as a secretary and cashier/stock clerk.
20, 2013, prior to her alleged onset date, Crowe visited
Michael Marciello, M.D., of Dedham Physiatry, with complaints
of ongoing neck pain and tenderness. (AR 393-95). Dr.
Marciello assessed myofascial pain and cervical spondylosis
and prescribed Vicodin and Klonopin. (AR 394). Crowe had been
taking oxycodone at the time, but Dr. Marciello recommended
that she cut back. Id. On May 28, 2013, Crowe
visited Richard Gottlieb, M.D., her primary care physician,
with complaints of neck pain and skin lesions. (AR 65, 468).
Dr. Gottlieb recommended that she consider physical therapy
and take nonsteroidal anti-inflammatory drugs for
“significant arthritis of the neck.” Id.
October 18, 2013, Crowe visited Dr. Gottlieb for a follow-up
appointment, at which she denied “any specific
problems, ” except for some difficulty falling asleep.
(AR 466). Examination of her neck and extremities revealed no
abnormal findings. Id.
November 2013, Crowe visited Dr. Marciello for follow up
regarding her neck and parascapular pain. (AR 392). She was
not as active due to pain from a slip and fall. She also
reported that her back pain had “settled down, ”
but she still had tenderness in the right side of her lower
back and numbness and tingling in her left arm and right
shoulder. Id. Dr. Marciello found that she had
tenderness in her lower back, a nonfocal neurologic
examination, tightness in her pelvis and hamstrings,
symmetric leg strength in both sides, a negative straight leg
raise, decreased strength in her right shoulder and normal
sensation and reflexes in her hands. Dr. Marciello assessed
lumbar strain/contusion of the sacroiliac joint,
“[o]verall, stable, ” and chronic cervical
spondylosis with myofascial pain and intermittent
radiculitis, also “[c]urrently stable.”
Id. He renewed Crowe's medications and
“encouraged her to keep up with the stretching
February 2014, Crowe saw Dr. Marciello for increased neck
pain and reported that she had had “some falls and
strain in the weather and continue[d] stresses.” (AR
390). On examination, she had some decreased neck movement;
right-sided neck pain which caused increased distress trying
to turn to the right or side bend to the left; and tenderness
and tightness over the right base of the neck. Id.
She had a nonfocal neurologic examination in the right arm,
“fine” reflexes and normal distal strength.
Id. Dr. Marciello administered trigger point
injections to Crowe's right cervical paraspinal muscles
and continued her on oxycodone but indicated that she should
try to reduce her opiod use. Id.
2014, Crowe visited Dr. Marciello and reported that she
“ha[d] fallen about 3-4 weeks [prior] whe[n] she
slipped being pulled forward by her dog.” (AR 388). Dr.
Marciello noted that, “[u]p to this fall, [Crowe] ha[d]
been doing about the same, ” i.e., she had
chronic daily discomfort around her neck and shoulders.
Id. She reported continuing to use Klonopin and pain
medications and following up with her primary doctor for
weight and “general health.” Id. On
examination, Crowe had some back tenderness, but showed
“excellent” lumbar range of motion with extension
and flexion, negative straight leg raise, intact sensation in
her legs, and normal neck range of motion. Dr. Marciello
assessed Crowe as “stable” and recommended that
she increase her stretching and exercise. (AR 389). Dr.
Marciello noted that he “would like to see her be able
to wean from her cigarettes and the oxycodone.”
August 2014, Crowe visited nurse Debra Brothers-Klezmer at
Dedham Physiatry with complaints of neck and shoulder pain
that radiated into her right arm. (AR 421). Crowe stated that
she had “[n]o structured exercises, ” but
reported taking care of her four-month-old granddaughter.
Id. She explained that she had “fallen because
[she] is clumsy” and took additional pain medications
if needed. (AR 422). She reported that “[p]ain
medications enable[d] more activity, and greater
functioning.” Id. She also stated that she
decreased her dosage of medications when the pain subsided
and took Aleve about once a week. (AR 422).
September 2014, Crowe visited physician's assistant
Rebecca Howard at Dedham Physiatry for a follow up
appointment regarding her neck and shoulder pain. (AR 417).
Crowe reported that she had utilized and benefitted from
trigger point injections in the past and requested them
again. She also reported that she remained stable with the
use of fifteen milligrams of oxycodone. On examination, she
had “slight limitation” of cervical range of
motion, “acceptable” shoulder range of motion,
and full strength (“5/5”) in “all muscle
groups of the upper extremities.” (AR 419). Aside from
“some mild diminished sensation in the fingertips,
” Crowe had “[n]o other areas of sensory change
noted throughout [the] exam.” Id. Howard
assessed cervical spondylosis and myofascial pain and
recommended that Crowe continue stretching and range of
motion exercises. Howard administered trigger point
injections which Crowe tolerated well. Id.
January 2015, Crowe saw Dr. Marciello for a follow up
appointment regarding her “chronic cervical neck pain,
myofascial pain, and medication management.” (AR 385).
She stated that one week prior to the visit, she had fallen
backwards, aggravating her neck and posterior shoulder.
Id. She reported that the pain depended on her
“level of activity around the house” and extended
out to her shoulder, causing general myofascial tenderness.
(AR 386). On examination, her shoulder range of motion was
“fine, ” although she had some restrictions
reaching behind her as well as tenderness in her neck and
shoulder. Id. Dr. Marciello assessed chronic
cervical and parascapular myofascial pain that was
exacerbated by her fall as well as underlying cervical
spondylosis that was stable. Id. Dr. Marciello and
Crowe discussed reducing her medications over time, but Dr.
Marciello recommended that she “keep things the same
and focus on increased resistive exercises.”
February 12, 2015, Crowe visited Dr. Gottlieb for an annual
physical examination. (AR 453). She denied headaches,
arthritis pain, joint pain, muscle weakness or any neurologic
symptoms. (AR 454). On examination, she was pleasant, alert,
fully oriented and in no acute distress. (AR 453-54). She had
normal reflexes, motor functioning, mobility and gait, and no
joint effusion or tenderness. (AR 454). Dr. Gottlieb found no
musculoskeletal or neurologic impairments, but did assess
valve prolapse, emphysema and a cough. (AR 454-55).
March 2015, Crowe saw Brothers-Klezmer because shoveling had
worsened the pain in her right neck and shoulder. (AR 411).
She described the pain as shooting, stabbing and
intermittent. Id. Brothers-Klezmer continued Crowe
on her existing medication regimen. Id.
2015, Crowe visited Dr. Marciello with increased pain in her
right shoulder, especially with activities, such as reaching
and trying to carry. (AR 436). She stated that she had
experienced a “fair amount of increased exertion trying
to care for her house” and was trying to keep up with
routine stretching, without much success. Id. She
denied any numbness or tingling in the right arm but had
persistent numbness in her left arm. (AR 436-37). She
reported taking her medications, including Klonopin regularly
and fifteen milligrams of oxycodone four times per day. (AR
437). On examination, she had “some” decreased
neck movement with side bending and rotation bilaterally and
tightness and tenderness in the upper trapezius bilaterally.
Id. She showed some signs of right shoulder
impingement and some tenderness when externally rotating the
rotator cuff, but “no clear weakness.”
Id. Dr. Marciello assessed right shoulder
impingement and bursitis as well as cervical spondylosis with
chronic myofascial pain. Id. He encouraged Crowe to
reduce her use of pain medications and “to try to
maintain some level of fitness, ” including strength
training, for her shoulder. Id.
February 28, 2016, Crowe visited Dr. Marciello with increased
pain and a loss of range of motion in her right shoulder and
parascapular area as a result of a shoveling incident. (AR
473-74). Dr. Marciello administered a trigger point injection
in her right shoulder and advised her to continue taking
Klonopin and oxycodone. (AR 474).
March 23, 2016, Crowe visited Dr. Marciello for
“chronic medication management” for her neck and
shoulder pain. (AR 524). She complained of limitations in her
daily activities due to the pain and reported increased
soreness that had lasted three weeks. The February 2016
injection was “somewhat helpful” but had provided
“no sustained benefit.” Id. On
examination, Dr. Marciello found that, although she had some
soreness and impingement to the right shoulder, she was
“a bit better than she was a couple weeks ago.”
Id. He assessed cervical spondylosis with myofascial
pain, right shoulder impingement with associated muscle
tightness, and medication dependence. (AR 525). He
administered trigger point injections and continued Crowe on
her medications. Id. Dr. Marciello indicated a
potential need for a surgery referral. Id. He
further noted that an MRI had been done in the past, but
further imaging might be required. Id.
an April 11, 2016 physical therapy evaluation, Crowe reported
that six months prior, her right shoulder pain had begun to
worsen. (AR 487). She reported that this pain coupled with
finger numbness and tingling made it difficult for her to
wash her hair and dress herself. An examination revealed
positive Neer's, Coracoid Impingement and
acromioclavicular signs. The physical therapist indicated
that Crowe would benefit from physical therapy to decrease
her pain, increase her range of motion and strength, and
improve activity tolerance, specifically, the ability to
reach and perform grooming and dressing activities without
restriction. (AR 487-88). Crowe attended five physical
therapy sessions but discontinued treatment because she felt
it was causing her more pain and resulting in less range of
motion. (AR 485-86, 516).
April 28, 2016 visit to Dedham Physiatry, Crowe reported that
she was enjoying family time and walking daily for exercise
but was frustrated that pain affected her ability to play
with her grandchildren. (AR 516-17). She requested ...