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Grevich v. Berryhill

United States District Court, W.D. Wisconsin

February 11, 2019

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



         Plaintiff Lauren Grevich is seeking review of a final decision by defendant Nancy A. Berryhill, Acting Commissioner of Social Security, denying her claim for disability insurance benefits and supplemental security income under the Social Security Act. 42 U.S.C. § 405(g). Plaintiff seeks remand of that decision, arguing that the administrative law judge who decided the case did not give adequate consideration to the opinions of her treating physicians or the third-party statements of her mother and boyfriend. For the reasons explained below, I am not persuaded by plaintiff's arguments. Therefore, I will affirm the acting commissioner's decision.

         The following facts are drawn from the administrative record (AR).


         Plaintiff Lauren Grevich contends that she became disabled on October 1, 2013 because of a variety of physical conditions, including chronic neck and left arm pain. AR 13, 15, 35. Her pain began on July 15, 2010, when she injured herself at work carrying a large bucket of fish as a biological technician with the United States Fish and Wildlife Service. AR 19, 59, 358. She continued working, but four to five months later, she developed tingling and weakness in her left arm. AR 79, 358.

         Plaintiff has been employed regularly since 2002. She last worked from January 2011 to August 2014 as a property manager at a private estate. AR 59. She resigned from that position after her son was born in June 2014. AR 16, 36. Plaintiff was 30 years old when she applied for benefits on October 6, 2014. AR 13.

         A. Relevant Medical Evidence

         1. Treating physicians

         Plaintiff continued to experience neck and left arm and shoulder pain after injuring herself at work in 2010. Her physicians ordered various nerve conduction studies, x-rays and magnetic resonance imaging studies between 2010 and 2013. AR 717. The nerve studies revealed only mild denervation at ¶ 6 on the left side and mild ulnar radiculopathy at the left elbow but no significant nerve damage. AR 717-19. Her imaging studies showed osteophytosis, disc disease and protrusion and mild to moderate neural foraminal narrowing in portions of her cervical spine (the C5, C6 and C7 vertibrae). Id.

         On March 15, 2012, plaintiff saw Dr. Jane Stark, who performed an independent medical examination for plaintiff's worker's compensation claim. AR 357. Dr. Stark noted that plaintiff had been diagnosed with cervical disc disease and ulnar neuropathy and had symptoms of myofascial pain, but Dr. Stark found significant inconsistencies in plaintiff's history and examination. For example, plaintiff's examination revealed no difference in tone or strength in her upper extremities, which did not support plaintiff's reports of significant weakness and reduced use of her left arm. Dr. Stark also noted that plaintiff reported very high levels of pain but exhibited no guarding or pulling away. Dr. Stark told plaintiff that she suspected a psychological component to her symptoms, but plaintiff stated that she would rather “be dead” than talk with a psychologist. AR 362. Plaintiff also stated that she would rather have surgical intervention than medications or steroid injections. Id. Dr. Stark did not provide plaintiff with a disability rating and would not recommend any treatment unless plaintiff first agreed to a psychological evaluation. AR 363.

         On May 15, 2013, plaintiff saw Dr. Kamal Thapar for a neurosurgical consult for neck and left arm pain. AR 376. He recommended that plaintiff have a steroid injection in her cervical spine and noted surgery as a possible future option. AR 378. After receiving an injection, plaintiff saw Dr. Thapar again on June 25, 2013 and reported no change in her symptoms. AR 386. Although plaintiff was uncomfortable and had a reduced range of motion in her cervical spine (45 degrees on either side), her examination was otherwise normal with respect to strength, tone and weakness. Id. Dr. Thapar stated that surgery should be an option of last resort and told plaintiff that her failure to respond to non-operative pain management made him question whether she would respond well to surgery. He recommended a second steroid injection, which plaintiff never had. AR 387, 404.

         Plaintiff saw Dr. Thapar again on August 14, 2013, reporting no substantial change in her symptoms and no relief from pain medications that she had tried in the past. Dr. Thapar prescribed Lyrica and referred plaintiff to the Mayo Clinic for a second opinion. AR 390-91.

         On September 10, 2013, plaintiff was evaluated by Dr. Jeffrey Brault at the Mayo Clinic. AR 404. Plaintiff reported constant neck and left arm pain of variable intensity for which she had unsuccessfully tried chiropractic manipulation, physical therapy, massage and various medications. Plaintiff had not tried the Lyrica that Dr. Thapar prescribed. Id. Plaintiff had normal strength and reflexes bilaterally, but decreased sensation in her left hand and limited range of motion in her neck. AR 405. Dr. Brault ordered further x-rays of her cervical spine, nerve studies and an ultrasound of her ulnar nerve. AR 405-06.

         The ultrasound showed a dislocating ulnar nerve, the nerve studies were normal and showed no cervical or ulnar radiculopathy and the x-rays showed loss of cervical lordosis (or curvature), minimal disc degeneration and anterolisthesis (slippage) at the C4 and C5 vertibrae. AR 402, 407-08. Dr. Brault reviewed these findings with plaintiff on October 2, 2013, and referred her to an elbow surgeon to discuss possible ulnar nerve transposition. AR 402. The day before, plaintiff had refused to be evaluated for a pain management program ...

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