United States District Court, W.D. Wisconsin
OPINION AND ORDER
D. PETERSON, DISTRICT JUDGE.
Linda Key Elsen seeks judicial review of a final decision of
defendant Andrew Saul, Commissioner of Social Security,
denying her application for disability benefits. The
administrative law judge (ALJ) found that Elsen had several
severe impairments but determined that she retained the
residual functional capacity (RFC) to perform light work with
several additional movement restrictions. The ALJ concluded
that Elsen could meet the demands of her past work as a
teacher aide, so the ALJ found her not disabled.
appeal, Elsen contends that the ALJ erred by relying on
outdated medical opinions from state agency consultants and
by attempting to interpret later medical findings herself.
Elsen notes that if the ALJ had deemed her capable of
sedentary work rather than light work, the medical vocational
guidelines would have directed a finding that she was
disabled. But Elsen fails to point to evidence that would
support such a limitation in the period between the agency
consultant opinions and Elsen's date last insured.
Although Elsen underwent a total hip replacement in July
2016, the record shows that the surgery was effective and
that Elsen recovered quickly. The ALJ did not err by relying
on medical records documenting this improvement, or by
failing to solicit updated agency consultant opinions. So the
court will affirm the commissioner's decision.
determined that between September 1, 2014 (Elsen's
alleged disability onset date) and June 30, 2017 (her date
last insured), Elsen suffered from numerous severe
impairments, including degenerative disc disease of the
lumbar spine; osteoporosis; degenerative joint disease of the
left hip; left trochanteric bursitis; mild degenerative joint
disease of the right hip; and degenerative joint disease of
both knees. R. 30. In light of these impairments, the ALJ
found in her RFC assessment that Elsen could perform light
work, with the additional restrictions that she could only
occasionally climb, stoop, kneel, crouch, and crawl; and only
frequently reach overhead with her left arm. R. 32. Relying
on the testimony of a vocational expert, the ALJ found that
Elsen could perform her past relevant work as a teacher aide.
Agency consultant opinions
gave “significant weight” to the opinions of two
state agency medical consultants, Drs. Mina Khorshidi and
Ronald Shaw. R. 36. At the initial level, Khorshidi opined
that Elsen was capable of light exertional work with only
frequent stooping. R. 111-12. She based this assessment on
medical records received from Elsen's health care
providers, which indicated that despite complaints of
significant pain, Elsen had reported that “she was
doing much better and had ceased her pain meds on her own
accord.” R 111. At the time that Khorshidi issued this
opinion on August 12, 2015, the medical records she reviewed
were current as of that summer. See R. 109
(indicating that Elsen's medical records were received in
June and July of 2015).
reconsideration level, Shaw found the same functional
limitations that Khorshidi had. R. 122. He based his
assessment on the same records that Khorshidi reviewed, plus
some additional physical therapy records received in October
and November of 2015. R. 117-18. He issued his opinion on
December 8, 2015.
Subsequent medical developments
does not contend that Khorshidi and Shaw's opinions
failed to capture her limitations at the time they issued
them. Instead, Elsen says that in the nearly 30 months that
passed between the agency consultant opinions and the
ALJ's decision on April 27, 2018, she experienced several
medical events that further limited her functional capacity.
She points specifically to developments in the condition of
her right foot, left shoulder, and left hip. She asserts that
“[a]ny of these three conditions could have reduced
[her] ability to stand or lift such that Elsen would be no
longer able to perform light work, ” which, given
Elsen's age, would have rendered her disabled under the
medical vocational guidelines. Dkt. 10, at 10 (citing 20 C.F.R.
Pt. 404, Subpt. P, App. 2, Rule 201.14).
her foot, x-rays taken in October 2015 revealed a metatarsal
deformity and hammertoe deformity, and Elsen's provider
discussed possible surgical interventions to address the
problem. R. 364. The ALJ noted these deformities
and mentioned that Elsen's doctor scheduled the surgery
for January 29, 2016. R. 34 (citing R. 366). The parties
don't say whether this surgery ever happened, and Elsen
cites no additional records related to her foot problems.
her shoulder, x-rays taken in May 2017 revealed left shoulder
impingement, for which Elsen received two injections. R. 1133
and R. 1158. The ALJ made note of this. R. 35. The ALJ also
noted that Elsen reported to her doctor in June 2017 that the
injection, taping, and chiropractic care “had been
helping her shoulder pain, and that overall her shoulder pain
was fairly controlled.” Id. In February 2018
(almost eight months after Elsen's date last insured),
Elsen's doctor discussed operative and nonoperative
treatment possibilities for her shoulder. R. 1250. Elsen
indicated that she wanted a total shoulder arthroplasty, but
that surgery had not yet been scheduled as of July 25, 2019,
when she filed her brief in this case. Dkt. 10, at 15.
most significant medical development Elsen experienced in the
period between the agency consultant opinions and the ALJ
decision concerned her hip. An x-ray taken on March 11, 2016
showed “severe narrowing of the left hip joint with
spurring, reactive sclerosis, and subchondral cysts on either
side” that had “worsened in appearance since the
last exam.” R. 433. Her doctor characterized it as
“severe osteoarthritis. She is bone on bone.” R.
406. He concluded that her “severely arthritic left
hip” was “inhibiting her from many day-to-day
activities, ” and that a total hip arthroplasty was
reasonable under the circumstances. R. 406. So on July 11,
2016, Elsen underwent a total hip replacement. R. 725-26. The
ALJ recounted all of this in her opinion, and noted that two
weeks post-surgery, Elsen reported that she “was doing
well, was controlling her pain with medication, was able to
ambulate with the assistance of her walker, and was doing
well with her exercises.” R. 34-35 (citing R. 425-26).