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Vance v. Saul

United States District Court, W.D. Wisconsin

November 7, 2019

DONYA VANCE, Plaintiff,
v.
ANDREW M. SAUL, Commissioner of Social Security, Defendant.

          OPINION AND ORDER

          WILLIAM M. CONLEY District Judge.

         Pursuant to 42 U.S.C. § 405(g), plaintiff Donya Vance seeks judicial review of a final determination that she was not disabled within the meaning of the Social Security Act. Vance contends that remand is warranted because the administrative law judge (“ALJ”) erred in (1) finding that her degenerative disc disease did not meet Listing 1.04, and (2) failing to support her residual functional capacity (“RFC”) with substantial evidence. The court held a telephonic hearing on plaintiff's appeal on November 6, 2019. For the reasons that follow, the court rejects both challenges and will affirm the denial of benefits.

         BACKGROUND[1]

         A. Overview of Claim

         Plaintiff Donya Vance applied for social security disability benefits and supplemental social security income in November 2014, claiming an alleged onset date of August 16, 2014. With a birth date of January 31, 1975, Vance was “a younger individual” for the relevant period of her social security appeal. Vance has past relevant work as a nurse assistant and nursey school attendant. Her claimed disability was based on her heart condition, lower back pain, and asthma. (AR 265.)

         B. ALJ's Decision

         ALJ John Martin held an in-person hearing on July 6, 2017, in Madison, Wisconsin, at which plaintiff appeared personally and by counsel. As of the alleged onset date, the ALJ found that Vance suffered from the following severe impairments: degenerative disc disease, osteoarthritis and allied disorders, obesity, cardiomyopathy, degenerative joint disease, and asthma. (AR 30.) Plaintiff's appeal concerns the ALJ's treatment of her degenerative disc disease and obesity. As such, the court's review of the ALJ's opinion and the medical record will similarly focus on those areas.

         At step three, the ALJ considered whether Vance's impairments met or medically equaled the severity of the listed impairments. Particularly material to this appeal, the ALJ explained that:

The severity of the claimant's degenerative disc disease does not meet the requirements under Listing 1.04 because there is no evidence of nerve root compression, spinal arachnoiditis resulting in the need for changes in posture more than once every two hours, or lumbar spinal stenosis resulting in inability to ambulate effectively. Medical imaging of her back found a disc protrusion at ¶ 5-S1 and L4-L5 (Exhibit 4F/8). However, the claimant is able to walk without assistive devices, is able to perform activities of daily living, and examinations have consistently found normal muscle strength.

(AR 30.) At the same time, the ALJ acknowledged that Vance's “impairments are compounded by obesity, ” and stated specifically that he considered these impacts in formulating her RFC.

Ultimately, the ALJ determined that Vance had the RFC:
to perform sedentary work as defined in 20 CFR 404.1567(a) and 416.967(a) except the claimant can stand for a total of 2 hours and walk for a total of 2 hours in an 8-hour workday. The claimant must avoid concentrated exposure to dust, odors, fumes, pulmonary irritants, and temperature extremes.

(AR 31.) With respect to Vance's degenerative disc disease and obesity in particular, the ALJ concluded that “the record supports some back pain, but not to the extent that would preclude the claimant from performing all work.” (AR 32.) In support of that finding, the ALJ explained that: (1) “the claimant appears to be able to perform some activities of daily living such as driving, going shopping in stores, and taking care of her three young children”; (2) while acknowledging the 2014 MRI showing a disc protrusion at ¶ 5-S1 and L4-L5, a “May 2013 examination noted that the claimant had full muscle strength but also had a slow and steady gait”; (3) physical therapy has “helped with overall improvement in mobility and activity level, ” and she was noted as having “good rehab potential”; (4) an “April 2015 consultative examination found some limited range of motion in her joints, but also found that the claimant had normal muscle strength, normal motor strength, and was able to get up from a lying position to a standing position without support”; and (5) doctor's records stated that Vance “has some pain relief from medication.” (AR 32-33.) The ALJ further explained that he accommodated her back pain and obesity by limiting her to sedentary exertional level of work and by limiting her to “standing/walking up to two hours during an eight hour workday.” (AR 33.)

         The ALJ also placed great weight on the opinions of state agency medical consultants Pat Chan, M.D., and Mina Khorshidi, M.D., both of whom determined that Vance could perform work at the sedentary level and can stand or walk for a total of 2 hours out of an 8-hour day. (AR 34; AR 104-11 (Chan); AR 136-38 (Khorshidi).) In addition, Dr. Chan considered plaintiff's impairments, determining that they did not “meet or equal a listing.” (AR 106.) Chan's and Khorshidi's reports were completed in April 2015 and September 2015, respectively.

         The ALJ next noted a consultative examination report by Kauseruzzaman Khan, M.D., dated April 6, 2015, but only placed partial weight on this opinion because the record “supports a conclusion that claimant's pain is managed with medication and . . . [p]hysical therapy notes also support that the claimant has good rehab potential, and the claimant appears to be able to perform activities of daily living despite her chest and back pain.” (AR 34.)

         Finally, relying on the vocational expert's testimony, the ALJ concluded that Vance could not perform her past relevant work, but that there were jobs in significant numbers in the national economy that Vance could perform, including telephone solicitor, order clerk, and travel clerk. (AR 36.) As such, the ALJ concluded that Vance was not under a disability from August 16, 2014, through the date of his decision.

         C. Medical Record

         The court will also focus its review of the medical records on Vance's back condition and pain.[2] Vance saw Allysa Watring, PA-C, for low back and right lower extremity pain on May 1, 2013. She complained that the pain started during her pregnancy, rating it as “10/10 at its worse, but improves slightly after taking medication.” (AR 348.) At that time, Vance was taking Vicoprofen and Zanaflex for pain relief. She also stated that the pain is at its worst when “she is walking and staying in one position for too long.” (Id.) While her physical examination showed full range of motion, “except for limited right hip flexion due to pain, ” Watring also noted “3/5 motor strength in right hip flexion, ” and that straight leg raises elicited pain. (AR 351.) Finally, Watring noted a “[s]low but steady gait.” (Id.)

         These findings prompted Watring to refer Vance to neurosurgery and to physical therapy. The record reflects that Vance subsequently attended aqua therapy and showed some improvement. (AR 387.) The record also shows that Vance underwent an MRI on April 18, 2013, which revealed:

1. Right paracentral disk protrusion L5-S1 with effacement of the right anterolateral aspect of the thecal sac and ...

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