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Talbert v. Berryhill

United States District Court, E.D. Wisconsin

January 18, 2019

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



         Plaintiff Barbara Talbert applied for social security disability benefits, alleging that she could no longer work due to chronic back and foot pain. The Administrative Law Judge (“ALJ”) assigned to the case accepted that plaintiff experienced pain but concluded that she remained capable of a range of sedentary work, consistent with her past employment. Plaintiff seeks judicial review of that determination.


         A. Disability Standard

         Under the Social Security Act, a person qualifies as disabled 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 12 months. Barnhart v. Walton, 535 U.S. 212, 214 (2002) (citing 42 U.S.C. §§ 423(d)(1)(A), § 1382c(a)(3)(A)). The agency has adopted a sequential, five-step test for determining disability. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).

         At step one, the ALJ asks whether the claimant is currently working, i.e., engaging in “substantial gainful activity” (“SGA”). If not, the analysis proceeds to the second step, where the ALJ determines whether the claimant suffers from any “severe” impairments. An impairment is “severe” if it “significantly limits [the claimant's] physical or mental ability to do basic work activities.” 20 C.F.R. § 404.1520(c).

         If the claimant has severe impairment(s), at step three the ALJ determines whether any of those impairments meet or medically equal the requirements of one of the conclusively disabling impairments listed in the regulations (the “Listings”). If the impairments do not meet or equal a Listing, the analysis proceeds to the fourth step, which involves a determination of whether the claimant has the residual functional capacity (“RFC”) to return to her past relevant work. RFC is the most an individual can still do, on a regular and continuing basis, despite her impairments. SSR 96-8p, 1996 SSR LEXIS 5, at *5. At step four, a claimant will be deemed “not disabled” if it is determined that she retains the RFC to perform the actual functional demands and job duties of a particular past relevant job or the functional demands and job duties of the occupation as generally required by employers throughout the national economy. SSR 82-61, 1982 SSR LEXIS 31, at *4. In evaluating a job as performed, the ALJ will often rely on the claimant's reports and statements regarding how she did the job. In evaluating the job generally, the ALJ will often rely on the generic job descriptions contained in the Dictionary of Occupational Titles (“DOT”). Id. at *5. Some jobs “have significant elements of two or more occupations and, as such, have no counterpart in the DOT.” Id. When dealing with one of these so-called “composite jobs, ” the ALJ will focus on the job as performed. See, e.g., Michalski v. Berryhill, No. 16-C-1590, 2017 U.S. Dist. LEXIS 149090, at *17 (E.D. Wis. Sept. 14, 2017).

         Finally, if the claimant cannot perform her past work, the inquiry proceeds to the fifth and final step, which involves a determination of whether she can, given her age, education, work experience, and RFC, make the adjustment to other work in the national economy. The claimant bears the burden of presenting evidence at steps one through four, but if she reaches step five the burden shifts to the agency to show that the claimant can make the adjustment to other work. The agency may carry this burden by relying on the Medical-Vocational Guidelines (i.e., the “Grid”), a chart that classifies a person as disabled or not disabled based on her age, education, work experience, and exertional ability, or by summoning a vocational expert (“VE”) to offer an opinion on other jobs the claimant can do despite her limitations. E.g., McQuestion v. Astrue, 629 F.Supp.2d 887, 892 (E.D. Wis. 2009).

         B. Standard of Review

         The court will reverse an ALJ's decision only if it is not supported by “substantial evidence” or if it is the result of an error of law. Stephens v. Berryhill, 888 F.3d 323, 327 (7thCir. 2018). Substantial evidence means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Chavez v. Berryhill, 895 F.3d 962, 968 (7th Cir. 2018). The reviewing court may not re-weigh the evidence, make independent credibility determinations, or otherwise substitute its judgment for the ALJ's; if conflicting evidence would allows reasonable minds to differ as to whether the claimant is disabled, the court must defer to the ALJ's resolution of that conflict. See Brown v. Colvin, 845 F.3d 247, 251 (7th Cir. 2016); Stepp v. Colvin, 795 F.3d 711, 718 (7th Cir. 2015); Beardsley v. Colvin, 758 F.3d 834, 836-37 (7th Cir. 2014). Finally, while the ALJ must in rendering her decision build a logical bridge from the evidence to his conclusion, she need not provide a complete written evaluation of every piece of testimony and evidence. Pepper v. Colvin, 712 F.3d 351, 362 (7th Cir. 2013).


         A. Medical Evidence

         Plaintiff alleged that she became disabled as of May 8, 2013. The agency collected the pertinent medical records from before and after that alleged onset date.

         In October 2011, plaintiff began seeing Dr. Roman Berezovski, a pain management physician, for low back pain. (Tr. at 263-64.) In a January 27, 2012, certification, Dr. Berezovski indicated that he expected plaintiff to experience a severe flare-up of pain, preventing her from working, once every two to three months. (Tr. at 264.) On January 31, 2012, Dr. Berezovski provided a slip excusing plaintiff from work from January 27 through January 30. (Tr. at 306.)

         On August 30, 2012, plaintiff saw Dr. Jason Boudreau, a podiatrist, for recurring gout flare-ups. She had taken prednisone, which helped, but Dr. Boudreau indicated that was not a long-term solution. Plaintiff denied pain in any other part of her body and admitted that she had not been doing recommended stretching exercises. (Tr. at 413.) Dr. Boudreau advised plaintiff that she could not be on steroids several times per year and needed to get her uric acid level under control. He sent her for an arthritis panel. (Tr. at 414.)

         Plaintiff returned to Dr. Boudreau on October 16, 2012, reporting severe pain in both feet, which she related to a recent move into a new house. She indicated that she could barely walk and could not work, as her job required her to be on her feet all day. She also reported a history of gouty arthritis, for which she received steroid packs in the past, but this pain was different, more in her heels. On exam, she had a severely antalgic gait, with severe pain on palpation of the plantar fascia. However, range of motion was excellent and muscle strength 5/5 bilaterally. (Tr. at 266.) Dr. Boudreau diagnosed plantar fasciitis and provided cortisone injections to both feet. He also instructed plaintiff to wear tennis shoes with arch support; she had not yet bought arch supports. (Tr. at 267.)

         On November 6, 2012, plaintiff told Dr. Boudreau that the injection “amazingly improved” her pain. (Tr. at 403.) He provided a second injection and told her to do stretching exercises. (Tr. at 404.) On November 12, Dr. Berezovski provided injections to treat plaintiff's back pain. (Tr. at 335.)

         On December 27, 2012, plaintiff returned to Dr. Boudreau, requesting a third injection to get rid of the rest of her discomfort, which the doctor provided. (Tr. at 398.) She was also reminded of the importance of compliance with stretching exercises and wearing orthotics, which she had not been doing. (Tr. at 399.)

         On January 3, 2013, plaintiff saw Dr. Berezovski regarding her low back pain, which she related to accidents on October 21, 2011 and December 31, 2012. (Tr. at 269.) Plaintiff also reported treatment for depression from 2005-08, with her symptoms improving a lot. Regarding her back, plaintiff reported that the pain was severe and did not vary much. Washing and dressing increased the pain, but she managed not to change her way of doing it. She could lift only very light weights and could not walk at all without increasing pain. She also avoided sitting because it increased the pain. She could not stand for longer than 10 minutes without increasing pain. Pain had also restricted social life to her home. (Tr. at 270.) On exam, she was alert, cooperative, and oriented. She had a limping gait, with an antalgic lean to the right, mildly decreased range of motion of the cervical spine, and moderately decreased range of motion of the lumbar spine. (Tr. at 271.) She displayed tenderness of the cervical spine, but tests for foraminal compression were negative. Evaluation of the lumbar spine revealed tender areas; plaintiff also reported radiating pain during the test. (Tr. at 272.) Strength was 5/5 throughout the upper and lower extremities bilaterally. Dr. Berezovski diagnosed lumbosacral spondylosis without myelopathy, lumbago (low back pain), degeneration of lumbar disc, lumbosacral spondylolysis, sprains and strains of the foot, and cervicalgia. Plaintiff reported 90% improvement following the November 12 injection, though the pain increased after the December 31, 2012 accident. Dr. Berezovski decided to do a repeat injection. She appeared to be taking medications appropriately, without side effects, and the medications helped with activities of daily living, pain control, and functions. Dr. Berezovski continued her on Oxycodone. (Tr. at 273.) He also recommended a rehabilitation program to maintain functioning, range of motion, flexibility, and strength, providing a referral to physical therapy. (Tr. at 274, 342.) On January 7, Dr. Berezovski provided the injection. (Tr. at 319.) On January 8, a physician's assistant provide a slip indicating plaintiff could return to work on January 10, with no prolonged sitting, standing, or walking (more than one hour without breaks to change positions). (Tr. at 331.)

         On January 16, 2013, plaintiff returned to Dr. Berezovski with continued lower back pain, made better by medication and resting, aggravated by bending, lifting, and prolonged sitting standing, and walking. (Tr. at 275.) She also complained of bilateral leg pain. (Tr. at 275-76.) She indicated that pain prevented her from walking more than 1/4 mile or sitting/standing for more than 10 minutes. (Tr. at 276-77.) On exam, she was again alert, cooperative, and oriented. She had a limping gait, with an antalgic lean to the right, mildly decreased range of motion of the cervical spine, and moderately decreased range of motion of the lumbar spine. (Tr. at 277-78.) She displayed tenderness of the cervical spine, but tests for foraminal compression were again negative. (Tr. at 278.) Evaluation of the lumbar spine revealed tender areas, and plaintiff again reported radiating pain during the test. (Tr. at 278-79.) Strength was 5/5 throughout the upper and lower extremities bilaterally. (Tr. at 279.) Dr. Berezovski diagnosed lumbago (low back pain), lumbosacral spondylolysis, and cervicalgia. Plaintiff expressed distress regarding her job with Milwaukee County, and she was working with her supervisor regarding restrictions. The repeat injection on January 7 produced less than 50% improvement. (Tr. at 279.) Dr. Berezovski increased her Oxycodone and again recommended a rehabilitation program. (Tr. at 280.) On January 16, Dr. Berezovski provided a slip indicating that plaintiff could return to work on January 17. (Tr. at 299.)

         On January 31, 2013, plaintiff reported 20% improvement in her condition overall and 40% since her last visit. (Tr. at 281.) She indicated that the pain prevented her from walking more than 1/4 mile or sitting/standing longer than ½ hour. (Tr. at 282.) Physical exam revealed the same findings as previously. (Tr. at 282-85.) Her cervical pain was significantly improved, and she was working for Milwaukee County without restrictions. She had received an ergonomic chair, which helped. Dr. Berezovski prescribed Oxycontin. (Tr. at 285.) She had not yet scheduled an appointment with the chiropractor but intended to do so. (Tr. at 285-86.) They planned another lumbar epidural injection. (Tr. at 286.)

         Also on January 31, 2013, plaintiff saw Dr. Boudreau, the podiatrist, for evaluation of her plantar fasciitis. She had been severely non-compliant with stretching exercises. She stated she had been doing well since her third injection to her right foot on December 27, 2012. She indicated that she only got pain in the morning when she got out of bed for a few minutes or when she had been sitting for a long period of time getting back up. Dr. Boudreau indicated he wanted to get plaintiff back to physical therapy. Plaintiff indicated she had been in a car accident on December 31, 2012, and reported needing therapy for her back as well. (Tr. at 394-95.) Otherwise she was doing really well. On exam, swelling was gone and strength normal. Dr. Boudreau wanted her to go to therapy to try to get her to become compliant with stretching exercises. He also informed her she should be wearing supportive shoes with arch supports; she came in that day wearing sloppy boots with no support. “Of note, the patient was on the phone paying one of her bills over the phone during most of the visit this date.” (Tr. at 395.) Dr. Boudreau held off on further injections since most of her pain was gone; she was to have therapy to get rid of the rest. She was informed of the importance of compliance with her stretching and wearing good supportive shoes. (Tr. at 395.)

         On February 20, 2013, Dr. Berezovski provided a slip indicating that plaintiff could not work on that day due to some temporary increased pain and discomfort from a procedure she had on February 18. She could return to work on February 21, 2013. (Tr. at 299.)

         On April 8, 2013, plaintiff returned to Dr. Berezovski, with continued pain in her low back and bilateral legs. She reported a severe exacerbation on Friday-Saturday, which she related to strenuous activity at work on Thursday, requiring her to go to the ER, where she received a morphine shot and fentanyl patch. That treatment helped initially, but her pain was now returning. (Tr. at 287.) Physical exam findings were essentially the same as previous visits. (Tr. at 288-91.) Dr. Berezovski diagnosed neuritis or radiculitis thoracic, pain in the thoracic region, lumbosacral neuritis or radiculitis, and degeneration of lumbar disc. (Tr. at 291.) He discontinued Oxycontin and started plaintiff on Duragesic patch, with Oxycodone for breakthrough pain. (Tr. at 291-92.) For inflammatory pain, he started a Medrol Dosepak. He also ordered a thoracic MRI and provided a slip excusing her from work until April 12, 2013. (Tr. at 268, 292, 317.)

         On April 26, 2013, plaintiff underwent a thoracic MRI, which revealed normal alignment of the thoracic spine, disc dessication throughout the thoracic spine, and no focal disc pathology. (Tr. at 326.) On April 29, Dr. Berezovski completed a certification of serious health condition indicating that plaintiff would experience flare-ups one or two times every one to two months lasting three to four days per episode. (Tr. at 351.)

         On May 23, 2013, plaintiff followed up with Dr. Berezovski, with continued lower back pain. She also stated she had been under a lot of stress since she lost her job. She reported 30% improvement overall and since her last visit. (Tr. at 293.) She stated the pain seemed to be getting better but improvement was slow at present. (Tr. at 294.) Physical exam results were again the same. (Tr. at 295-97.) Plaintiff had recently started Nucynta, but that was discontinued due to GI upset and Oxycodone restarted. She would also continue with the Duragesic patch. (Tr. at 297.)

         On June 11, 2013, plaintiff commenced physical therapy on the referral of Dr. Boudreau. (Tr. at 366.) She reported foot pain for the past two to three years. She walked with a very antalgic gait and displayed exquisite tenderness to palpation of the soles of the feet. She also displayed reduced strength of the ankles and knees. She reported inability to stand after sitting for prolonged periods without severe foot pain, inability to walk without severe foot pain, and difficulty with stairs. The therapist assessed severe plantar fasciitis, along with chronic low back issues and radiculopathy. Plaintiff was to participate in therapy three times per week for 12 visits. (Tr. at 374.) A June 13 note indicated plaintiff had been compliant with home stretching, and she felt that improved her discomfort. (Tr. at 376.) On June 20, plaintiff reported ability to walk longer before needing a seated rest. (Tr. at 378.) A June 21 note indicated plaintiff moved her appointment, then failed to show. (Tr. at 380.) On June 24, plaintiff underwent a lumbar epidural steroid injection (Tr. at 386), which limited her performance of exercises during her June 27 therapy session (Tr. at 381). On July 2, plaintiff reported her feet were much better, and she was able to walk around with minimal discomfort in shoes. She declined orthotics. She was to continue with home stretching and exercises. (Tr. at 383.)

         On October 23, 2013, plaintiff returned to Dr. Berezovski regarding her low back and bilateral leg pain. She reported trouble finding a doctor, as she had no job or insurance. She also reported that she just got back from a trip, and all the traveling increased her pain. She had received Hydrocodone from her primary care physician but was now out. (Tr. at 449, 452.) On psychological exam, she was alert and oriented, but somewhat frustrated because still had pain. (Tr. at 450.) She displayed severely to moderately decreased lumbar range of motion, tenderness on palpation, and positive straight leg raise left and right. (Tr. at 451.) Muscle strength of the bilateral upper and lower extremities was grossly within functional limits. Dr. Berezovski started plaintiff on morphine sulfate, with continued Oxycodone for breakthrough pain. (Tr. at 452.)

         On December 18, 2013, plaintiff returned to Dr. Berezovski for lower back and bilateral leg pain. (Tr. at 453.) Exam results were essentially the same as the last visit. (Tr. at 455-56.) She was given a 10-day supply of MS Contin. (Tr. at 457.) On January 30, 2014, exam results were again the same, and the doctor again provided a 10-day supply of MS Contin. (Tr. at 458-61.)

         On March 5, 2014, plaintiff appeared alert, cooperative, and oriented. She had a limping gait on the left and an antalgic lean to the left. (Tr. at 421-22.) Lumbar spine range of motion was moderately decreased, she displayed tenderness on palpation, and straight leg raise tests was positive on the left and right. (Tr. at 423.) Lower extremity strength was normal except for the feet (4/5). Dr. Berezovski recommended another steroid injection and continued Oxycodone for breakthrough pain. (Tr. at 424.)

         On April 7, 2014, Dr. Berezovski and his physician's assistant, Kristin Pingel, completed a physical RFC questionnaire. The form listed symptoms of pain, fatigue, insomnia, weakness, numbness, and tingling, and clinical findings of limited range of motion and tenderness of the lumbar spine, and disc dessication throughout the spine on MRI. (Tr. at 432.) Based on information obtained through a patient interview, the report indicated that plaintiff's symptoms would frequently interfere with attention and concentration, and that she was incapable of even low stress jobs. (Tr. at 433.) Plaintiff could walk less than one block, continuously sit for 20 minutes and stand for 30 minutes, and in an eight hour day sit about two hours and stand/walk about two hours. (Tr. at 433-34.) She needed to included periods of walking around every 45 minutes for 10 minutes and needed a job that allowed her to shift positions at will from sitting, standing, or walking. She sometimes needed to take unscheduled breaks during an eight-hour workday, two times per hour for 10-15 minutes. She could occasionally lift less than 10 pounds, rarely 10 pounds, never more. (Tr. at 434.) She could rarely twist, stoop, crouch, or climb stairs, and never climb ladders. She could use her arms, hands, and fingers less than 10% of the day for repetitive activities. She would have good and bad days and more than four absences per month. She should avoid extreme temperatures and have an ergonomic environment. (Tr. at 435.)

         On May 8, 2014, plaintiff saw Dr. Pamela Thomas King at the Pain Management Treatment Center for lower back pain. (Tr. at 515.) On review of systems, she complained of back pain, joint pain, muscle cramps, stiffness, leg pain at night, difficulty walking, anxiety, and heat intolerance. (Tr. at 516.) On exam, she appeared well developed, well nourished, and no acute distress, with normal gait and station and normal upper and lower extremity strength and range of motion. (Tr. at 517-18.) She also had a normal neurologic and mental status exam. Dr. Thomas King diagnosed spondylosis and degenerative disc disease. (Tr. at 518.) She would consider Oxycodone after reviewing plaintiff's records and provided orders to start physical therapy. (Tr. at 519.) A May 15 Pain Management Treatment Center note indicated that plaintiff was to continue with conservative treatment, medications and therapy. (Tr. at 505, 508.)

         On June 16, 2014, plaintiff saw Dr. Berezovski for low back and left hip pain. (Tr. at 437.) On exam, plaintiff was alert and oriented but somewhat frustrated because she still had pain. She was well-nourished, well-developed, and in no acute distress. (Tr. at 438.) Lumbar spine range of motion was moderately decreased. Muscle strength testing was normal except for foot flexors and extensors. (Tr. at 439.) Dr. Berezovski noted that plaintiff's pain was severe enough to require daily, around-the-clock analgesia to improve her quality of life, activities of daily living, and sleep. He continued Oxycodone. (Tr. at 440.)

         On July 10, 2014, Dr. Thomas King withdrew from providing further care due to plaintiff's failure to keep appointments and follow the treatment plan. (Tr. at 478.) Therapy notes indicate: “Goals not met due to limited treatment sessions. (Tr. at 479.) The record contains additional physical therapy notes dated December 2014 to January 2015 from Columbia St. Mary's. These notes indicated that she was 15 minutes late for one session, a no call no show for another. (Tr. at 529-20.)

         On February 11, 2015, March 11, 2015, and September 2, 2015, plaintiff received lumbar epidural steroid injections. (Tr. at 541, 543, 544.) An April 29, 2015, head CT revealed no acute intracranial process. (Tr. at 542.)

         A September 23, 2015, MRI of the right shoulder revealed a full-thickness tear through the mid to posterior fibers of the supraspinatus tendon; mild tendinopathy, biceps tendon; and cystic changes of the greater tuberosity. (Tr. at 539.) On December 14, 2015, Dr. Jeffrey Stephany performed a right shoulder arthroscopy with rotator cuff repair. (Tr. at 548-49.) At a December 29, 2015, follow-up, plaintiff reported doing well and was referred for therapy. (Tr. at 606.)

         On January 13, 2016, plaintiff reeceived lumbar medial branch blocks from Dr. Laurie Kabins. (Tr. at 537.) A January 14, 2016 note from Dr. Stephany's office related a contact from the pharmacy about prescriptions for OxyContin from both Dr. Stephany and Dr. Kabins. Dr. Stephany canceled his prescription and indicated that medications should be managed by Dr. Kabins. On being advised of this, plaintiff became very angry and verbally aggressive. (Tr. at 607.)

         On January 27, 2016, plaintiff saw Dr. Stephany, doing very well. (Tr. at 608.) On February 9, she again reported doing well until she tripped and fell. On exam, she displayed reduced range of motion compared to last time. She had 5/5 strength internal/external, 4 abduction with moderate discomfort throughout. X-rays showed good overall alignment, and no re-tear was noted on exam. (Tr. at 609.)

         On February 24, 2016, Dr. Kabins provided lumbar medial branch blocks. (Tr. at 535.) On March 2, plaintiff returned to Dr. Stephany, doing exceptionally well. On exam, she displayed full strength and range of motion. The doctor noted only: “Common sense restrictions.” (Tr. at 610.) On April 20, Dr. Stephany again noted that plaintiff was doing exceptionally well. She reported no pain with most activities, and on exam she displayed full range of motion and 5/5 strength throughout with no pain. (Tr. at 611.)

         B. Procedural History

         1. Plaintiff's Application and Administrative Decisions

         Plaintiff applied for benefits in June 2013, alleging a disability onset date of May 8, 2013. (Tr. at 149.) She indicated that she could no longer work due to chronic back pain from arthritis/neuritis, gout, and plantar fasciitis. She indicated that she stopped working on May 7, 2013, because of her conditions and because of other reasons (“I believe I was laid off because of my complaints”). (Tr. at 239.)

         In a pain questionnaire, plaintiff reported that she experienced sharp, constant pain in her lower back, hips, and legs since 2005. She also reported pain in her feet. Activities such as sitting, standing, walking, lifting, or bending precipitated the pain. She used medications (Oxycodone and Oxycontin) and received injections for the pain. (Tr. at 182.) The medications caused no side effects. Plaintiff reported that pain interfered with most of her activities and she needed assistance with grocery shopping, laundry, cleaning, and cooking. (Tr. at 183-84.) She could continuously walk 1/4 block, stand 10-15 minutes, and sit 10-15 minutes. Her daughter drove her to run errands. (Tr. at 184.)

         In a function report, plaintiff indicated that she was unable to shop for herself, lift bags of groceries, or stand/walk for long periods of time. (Tr. at 193.) The pain interfered with personal care tasks such dressing, bathing, and doing her hair. (Tr. at 194.) She prepared simple meals, but her daughter also helped her. She did little housework due to back and foot pain; her daughter helped with that as well. (Tr. at 195.) She limited driving due to drowsiness from her pain medications. (Tr. at 196.) She denied hobbies other than reading and watching TV, and engaged in limited social activities. (Tr. at 197.) Her conditions limited her to lifting under five pounds and walking 1/4 block. She could pay attention for quite a while unless she got drowsy and followed instructions very well. (Tr. at 198.) However, she did not handle stress or changes in routine well. (Tr. at 199.)

         In a third party function report, plaintiff's daughter, Maya Hampton, indicated that plaintiff spent most of her time in bed due to back and foot pain. (Tr. at 185.) Hampton further indicated that the pain made personal care tasks such as dressing and bathing extremely difficult. (Tr. at 186.) When experiencing pain, plaintiff needed assistance with preparing meals. She also needed assistance with chores such as laundry, cleaning, and grocery shopping. (Tr. at 187.)

         In a work history report, plaintiff indicated that she held clerical positions for Milwaukee County from February 2002 to May 2013, a receptionist job for a hospital from 1997 to 2000, and a telemarketing job for a sales company from 1997 to 1999. (Tr. at 201, 240.) The clerical work involved lifting less than 10 pounds but lots of standing and walking. (Tr. at 202.) The receptionist job involved lifting less than 10 pounds and was mostly done seated. (Tr. at 203.) The telemarketer job involved no lifting and was also done seated. (Tr. at 204.)

         On November 12, 2013, plaintiff underwent an orthopedic disability evaluation set up by the agency with Neal Pollack, D.O. Plaintiff complained of constant back pain, reporting a slip and fall in 2005. She had been doing better but on December 31, 2012, [1] she was involved in another auto accident. She was able to care for her activities of daily living but tended to stay in the house and limit her physical activity. She stated that she could walk about half a block, sit for about 20 minutes, and stand for 20 minutes. She had also been diagnosed with gout and tended not to do a lot of walking; she denied using any walking device. She stated that sitting, standing, and driving increased her back pain. She got relief from rest, heat, and gentle massage, in addition to medication. On exam, she was alert and oriented and in no acute distress. Neck and upper extremity motions were normal. Her grip strength was 45 pounds on the right and 40 pounds on the left, and she had normal finger dexterity bilaterally. Knee motions were completely normal. Lift hip abduction was painful. She could get up from a sitting position, get up on her heels and toes, but walked antalgically and slowly. (Tr. at 417.) Lumbar flexion was about 75 degrees and side bending was normal at 20 degrees. She had straight leg sensitivity in her low back at 30 degrees with ...

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