After careful consideration of the entire record, the undersigned makes the following findings:

1. The claimant’s date last insured is December 31, 2012.

2. The claimant has not engaged in substantial gainful activity since January 1, 2011, the amended alleged onset date (20 CFR 404.1520(b), 404.1571 et seq., 416.920(b) and 416.971 et seq.).

3. The claimant has the following severe impairments: obesity; cervical stenosis;
hypertension; diabetes; headaches; cognitive disorder; antisocial personality disorder; and poor visual acuity (20 CFR 404.1520(r) and 416.910(c)).

4. The claimant docs not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925 and 416.926).

The claimant has the following degree of limitation in the broad areas of functioning set out in the disability regulations for evaluating mental disorders and in the mental disorders listings in 20 CFR, Part 404, Subpart P, Appendix 1: mild restriction in activities of daily living, moderate difficulties maintaining social functioning, moderate difficulties in maintaining concentration, persistence or pace, and no episodes of decompensation, each of extended duration.

5. pounds frequently; stand/walk for six hours in an eight-hour period; and sit for six hour in an eight-hour period. The claimant can occasionally stoop, climb, kneel, crouch, crawl, and balance. He can perform only simple repetitive tasks. He cannot interact with the general public and cannot perform work requiring a rigid time schedule. He cannot work in close coordination with supervisors or co-workers to complete tasks and cannot work around strong odors.

In making this finding, the undersigned considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and
other evidence, based on the requirements of 20 CFR 404.1529 and 416.929 and SSRs 96-4p and
96-7p. The undersigned has also considered opinion evidence in accordance with the requirements of 20 CFR 404 .1527 and 416.927 and SSRs 96-2p, 96-6p and 06-3p.

The claimant testified that he cannot work due to high blood pressure, diabetes, headaches, and back spasms. He also said that he is 6 feet tall and weighs 312 pounds. He said he can only lift or cars 20 pounds and has difficulty bending and climbing steps. He also testified that he can stand for 20 mins. But then he experiences severe back pain and spasms. He also testified that he has frequent headaches

Similar to the claimant’s allegations, treatment records reflect uncontrolled hypertension despite prescription for Lisinopril. (Exhibits 5F and 11F) These treatment records also reflect persistent posttraumatic headaches following a motor vehicle accident in August 2010. The claimant has been treated with pain and anti-inflammatory medication for sciatic-type pain in his lower extremity and cervicalgia along with numbness and back pain. Diagnostic imagining revealed disc bulging at multiple levels of the claimant’s lumbar spine along with degenerative narrowing and electromyography was consistent with early state polyneuropathy explaining the numbness and sciatica. Considering the claimant’s testimony and the medical evidence including the type and frequency of treatment and the objective findings along with the claimant’s level of daily activities, the undersigned finds the claimant is restricted to light exertional and occasional postural activities

At the hearing, the claimant also described difficulty with his long-term and short-term memory. Following a psychological evaluation in September 2010, Dr. Robert Paulillo noted signs of dementia and antisocial personality disorder. (Exhibit 7F) Dr. Paulillo stated that an interview, observations, and testing reflected significant impairment in memory functioning along with
signs of antisocial personality traits characterized by anger problems and disregard for societal regulations. Provided with these findings, the undersigned finds the claimant is limited to simple tasks and limited interaction with the public, co-workers., and supervisors, as described above.

The claimant also alleged poor vision. In September 2010, the claimant had visual acuity of
20/40 bilaterally. (Exhibit 6F) Subsequent vision testing showed extensive peripheral field loss in her left eye. (Exhibit 15F)

After considering the evidence of record, the undersigned finds that the claimant’s medically determinable impairments could reasonably be expected to produce the alleged symptoms and that the claimant’s statements concerning the intensity, persistence and limiting effects of these symptoms are generally credible.

The State agency medical consultant’s physical assessment is given little weight because evidence received at the hearing level shows that the claimant is more limited than determined by the State agency consultant.

However, the State agency psychological consultant’s mental assessment is given great weight because it is consistent with the record as a whole.

6. The claimant is unable to perform any past relevant work (20 CFR 404.1565 and 416.965).

The vocational expert testified that the claimant has past relevant work as a tractor trailer truck driver, DOT #904.382-010, medium with a svp of 4/semi-skilled, and construction superintendent, DOT # 182.167-026, light with a svp of 7/skilled. Given the residual functional capacity set forth above, the vocational expert testified that the demands of the claimant’s past relevant work exceed his residual functional capacity.

7. Applying the age categories non-mechanically, and considering the additional vocational adversities in this case, the claimant was an individual of advanced age on the established disability onset date (20 CFR 404.1563 and 416.963).

Hallex II-5-3-2 describes -situations in which the Medical- Vocational Guidelines may be applied in borderline age situations. The undersigned finds a non-mechanical application is appropriate in the instant situation because the claimant is within four months of changing age categories and the claimant has additional vocational adversities such as impairments infringing on the
remaining occupational base. Thus, non-mechanically applying age categories is justified.

8. The claimant has at least a high school education and is able to communicate in English (20 CFR 404.1564 and 416.964).

9. The claimant’s acquired job skills do not transfer to other occupations within the residual functional capacity defined above (20 CFR 404.1568 and 416.968).

10. Considering the claimant’s age, education, work experience, and residual functional capacity, there are no jobs that exist in significant numbers in the national economy that the claimant can perform (20 CFR 404.1 560(c), 404.1566, 416.960(c), and 41 6.966).

In determining whether a successful adjustment to other work can be made, the undersigned
must consi der the claimants residual functional capacity, age, education, and work experience in conjunction with the :lv1eclical-Vocational Guidelines, 20 CFR Part 404, Subpart P, Appendix 2. If the claimant can perform all or substantially all of the exertional demands at a given level of exertion, the medical -vocational rules direct a conclusion of either “disabled” or ”not disabled” depending upon the claimant’s specific vocational profile (SSR 83-11).

Even if the claimant had the residual functional capacity for the full range of light work, a finding of “disabled” would be directed by Medical -Vocational Rule 202.06.

The Claimant has been under a disability as defined in the Social Security Act since January 1, 2011, the amended alleged onset date of disability (20 CFR 404.152 (g) and 416.920 (g)).

DECISION

Based on the application for a period of disability and disability insurance benefits protectively filed on August 6, 2010, the claimant has been disabled under sections 216(i) and 223(d) of the Social Security Act since January 1, 2011.

Based on the application for supplemental security income protectively filed on August 6, 2010, the claimant has been disabled under section 1614(a)(3)(A) of the Social Security Act since January 1, 2011

The component of the Social Security Administration responsible for authorizing supplemental security income will advise the claimant regarding the non-disability requirements for these payments and if the claimant is eligible, the amount and the months for which payment will be made

Willie L. Rose
Administrative Law Judge

March 28, 2012 Date

After careful consideration of the entire record, the undersigned makes the following findings:

1. The claimant’s date last insured is December 31, 2017.

2. The claimant has not engaged in substantial gainful activity since January 30, 2013, the alleged onset date (20 CFR 404.1520(b) and 404.1571 et seq.).

3. The claimant has the following severe impairments: colon cancer status post hemicolectomy; diverticulosis; chronic severe diarrhea with stomach cramps; right knee pain status post total knee replacement; anxiety; and depression (20 CFR 404.1520(c)).

4. The claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpa11 P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526).

The claimant has the following degree of limitation in the four broad areas of mental functioning set out in the disability regulations for evaluating mental disorders and in the mental disorders listings in 20 CFR, Part 404, Subpart P, Appendix 1: moderate limitations in understanding, remembering, or applying information, moderate limitations in interacting with others, moderate limitations in concentrating, persisting, or maintaining pace, and mild limitations in adapting or managing oneself

5. The claimant has the residual functional capacity to lift and/or carry 10 pounds occasionally and frequently; stand and/or walk for a total of two hours in an eight-hour workday; sit for a total of six hours in an eight-hour workday; and push and/or pull unlimited, other than as shown for lift and/or carry. However, the claimant needs at least eight unscheduled breaks lasting from 5 to 25 minutes.

In making this finding, the undersigned has considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements of 20 CFR 404.1529 and SSR 96-4p. The undersigned has also considered opinion evidence in accordance with the requirements of 20 CFR 404.1527 and SSRs 96-2p, 96-6p and 06-3p.

In considering the claimant’s symptoms, the undersigned must follow a two-step process in which it must first be determined whether there is an underlying medically determinable physical or mental impairment(s)–i.e., an impairment(s) that can be shown by medically acceptable clinical and laboratory diagnostic techniques–that could reasonably be expected to produce the claimant’s pain or other symptoms.

Second, once an underlying physical or mental impairment(s) that could reasonably be expected to produce the claimant’s pain or other symptoms has been shown, the undersigned must evaluate the intensity, persistence, and effects of the claimant’s symptoms to determine the extent to
which they limit the claimant’s work-related activities. For this purpose, whenever statements about the intensity, persistence, or functionally limiting effects of pain or other symptoms are not substantiated by objective medical evidence, the undersigned must consider other evidence in the record to determine if the claimant’s symptoms limit the ability to do work-related activities.

At the hearing, the claimant testified that she needed knee surgery, but went for a colonoscopy and found out that she had cancer. She testified that she could not have the knee surgery because she had surgery for cancer and was hospitalized for two weeks. She stated that she could not stop going to the bathroom and has never been the same since. The claimant testified that she wakes up every morning with abdominal pain and goes to the restroom where she spends 5 to 25 minutes each time. She testified that she cannot drink coffee anymore. She stated that she cannot eat in the morning if she is going anywhere because she has to stop to go to the bathroom. She related that she goes to the same stores because she has to know where the bathroom is. The claimant testified that the cramping is so painful that the medications do not take effect. She testified that she takes Imodium every morning. She stated that she has loose stool. The claimant testified that they removed a section of her colon. She testified that they did five procedures. She stated that one of her medications costs $1,000.00 per month. She related that she has different insurance now and has to pay 20%. The claimant testified that she has tried different diets, but that it does not matter what she eats because she has diarrhea and cramping after 10 minutes. She testified that she is exhausted by early afternoon. She stated that she has knee pain, but that it is not what keeps her from working. She related that she has been receiving treatment for 10 years because the total knee replacement did not work. The claimant testified that she has degenerative joint disease and arthritis of her right knee. She testified that she underwent a total knee replacement nine months after her cancer surgery. She stated that she did rehabilitation, but that her knee is still very painful. She related that an x-ray showed that something is loose, but that she would need another knee replacement to fix it.

The claimant testified that she receives treatment for depression and anxiety. She testified that she takes medication for anxiety. She stated that she has lost 40 pounds in the past year and a half due to an inability to eat. The claimant testified that she did not eat anything prior to coming to the hearing and went to the bathroom three times. She testified that she took extra Imodium.
She stated that she goes to the bathroom an average of seven or eight times per day. She related that she has a college degree, a master’s degree, and past work as a guidance counselor.

After careful consideration of the evidence, the undersigned finds that the claimant’s medically determinable impairments could reasonably be expected to cause the alleged symptoms. The claimant’s statements concerning the intensity, persistence and limiting effects of these

symptoms are reasonably y consistent with the medical evidence and other evidence in the record for the reasons explained in this decision .

The claimant’s medical records and other evidence support her allegations regarding her impairments and symptoms, and the treatment given for her conditions. In January of 2013, the claimant was found to have adenocarcinoma of the ascending colon, consisting of a 3 x 2 cm mass. The claimant underwent open, right hemicolectomy and ended up in the hospital for two weeks with green diarrhea. Progress notes from Peter A. Koretsky, M.D. reflect the claimant’s complaints of anywhere from four to five loose to watery stools per day. A one-year surveillance colonoscopy in January of 2014 revealed mild diverticulosis and grade I internal hemorrhoids. (Exhibit l F) She continued to complain of chronic diarrhea (Exhibits l F, 2F, 6F). A progress note in August of 2014 reflected that the claimant’s bowel movements could exceed seven movements per day (Exhibit 6F). A consultation note on November 29, 2016 indicated that the claimant had lost 30 pounds over a period of six months (Exhibit 15F).

The record reflects that the claimant underwent right total knee arthroplasty in September of 2013. She went to physical therapy and although her knee pain continued to slowly improve, she complained of pain more prominently on the right lateral meniscal region. (Exhibit 2F) X-rays of the right knee on June 16, 2014 showed prosthesis in place, no bone or soft tissue abnormality, normal density, and normal joint spaces (Exhibit 4F). A progress note in September of 2014 reflects the claimant’s complaints of right knee pain. A bone scan on September 30, 2014 showed delayed phase images demonstrating patchy increased uptake about the right knee arthroplasty, which may represent loosening. (Exhibit 8F) A bone scan on March 30, 201 5 showed similar findings (Exhibit 1OF).

The undersigned notes that the claimant has other diagnosed conditions including mental disorders as well as medical opinions regarding mental functioning that are not further developed or analyzed for purposes of this decision and could further delay adjudication because she can be found disabled based on her physical impairments detailed above. Social Security Ruling 83-14 states that where a person’s residual functional capacity coincides with the criteria of an exertionally based rule and direct a finding of disabled, there is no need to consider the additional effects of a non-exertional impairment since consideration would add nothing to the face of disability. Accordingly, the claimant’s alleged mental impairments are not considered as she is found disabled on her exertional limitations.

As for the opinion evidence, Christopher Scott Nunes, M.D. completed a medical questionnaire indicating that the claimant has severe work limitations due to frequent need to go to the bathroom for prolonged time (Exhibit SF). Dr. Koretsky completed a similar questionnaire indicating that the claimant is unable to work due to very unpredictable, intermittent, explosive diarrhea averaging 8 to 10 stools per day with intense abdominal pain. Dr. Koretsky indicated that the claimant’s diarrhea episodes often last for prolonged periods of time. (Exhibit 7F) The undersigned accords the opinions of Dr. Nunes and Dr. Koretsky controlling weight for several reasons. First, the undersigned notes that the claimant has treated with Dr. Nunes and Dr.Koretsky for a considerable time period. Consequently, Dr. Nunes and Dr. Koretsky have had the opportunity to examine the claimant on many different occasions. Based upon this longitudinal treatment base, the undersigned believes and concludes that Dr. Nunes and Dr. Koretsky are the physicians in the nest position to understand the nature and severity of the claimant’s impairments and how these impairments affect her ability to perform work related activates. Second, the undersigned accepts the opinions from Dr. Nunes and Dr. Koretsky since their opinions are uncontroverted. There is no medical evidence of record from an examining source, which contradicts the opinions from Dr. Nunes and Dr. Koretsky since they are supported by the objective medical findings.

Based upon the foregoing, the undersigned finds that the opinions from the treating physicians, Dr. Nunes and Dr. Koretsky, are well supported by the objective medical evidence of record when considered in its entirety. Consequently, the undersigned accords controlling weight to the opinions of Dr. Nunes and Dr. Koretsky. (20 CFR § 404.1527 and Social Security Ruling 96-2p)

The undersigned accords little weight to the Medical Source Statement of Ability to do Work Related-Activities (Physical) provided by the consultative examiner (Exhibit 14F). Dr. Daria only examined the claimant one time and did not adequately consider the claimant’s subjective complaints. Furthermore, his opinion is not consistent with the record as a whole and the undersigned accords deference to the opinions of the claimant’s treating physicians. (Social Security Ruling 96-6p)

The State agency medical consultant’s physical assessment is given little weight because other medical opinions, specifically those of Dr. Nunes and Dr. Koretsky, are more consistent with the record as a whole (Exhibit 4A). Furthermore, evidence received at the hearing level shows that the claimant is more limited than determined by the State agency consultant. (Social Security Ruling 96-6p)

6. The claimant is unable to perform any past relevant work (20 CFR 404.1565).

The vocational expert testified that the claimant’s past relevant work as a social worker and a guidance counselor are skilled and require sedentary exertion. Dictionary of Occupational Titles, Volumes I and II, Fourth Edition, Revised 1991, Sections 195.107-010 and 045.107-010. This work was substantial gainful activity, performed long enough to achieve average performance, and performed within the relevant period. The vocational expert also testified that the demands of the claimant’s past relevant work exceed the residual functional capacity.

7. The claimant was an individual closely approaching advanced age on the established disability onset date (20 CFR 404.1563).

8. The claimant has at least a high school education and is able to communicate in
English (20 CFR 404.1564).

9. The claimant’s acquired job skills do not transfer to other occupations within the residual functional capacity defined above (20 CFR 404.1568).

10. Considering the claimant’s age, education, work experience, and residual fm1ctional capacity, there are no jobs that exist in significant numbers in the national economy that the claimant can perform (20 CFR 404.1560(c) and 404.1566).

In determining whether a successful adjustment to other work can be made, the undersigned
Must consider the claimant’s residual functional capacity, age, education, and work experience in conjunction with the Medical-Vocational Guidelines, 20 CFR Part 404, Subpart P, and Appendix 2. If the claimant can perform all or substantially y all of the exertional demands at a given level of exertion, the medical-vocational rules direct a conclusion of either “disabled” or “not disabled” depending upon the claimant’s specific vocational profile (SSR 83-11).

Even if the claimant had the residual functional capacity for the full range of sedentary work, a finding of “disabled” would be directed by Medical -Vocational Rule 201 .14.

11. The claimant has been under a disability as defined in the Social Security Act since January 30, 2013, the alleged onset date of disability (20 CFR 404.1520(g)).

DECISION

Based on the application for a period of disability and disability insurance benefits filed on April 2, 2014, the claimant has been disabled under sections 216(i) and 223(d) of the Social Security Act since January 30, 2013.

Wendy Hunn
Administrative Law Judge

March 27, 2017

After careful consideration of the entire record, the undersigned makes the following findings:

1. The claimant’s date last insured is December 31, 2018.

2. The claimant has not engaged in substantial gainful activity since January 4, 2011, the alleged onset date through February 20, 2013 (20 CFR 404.1520(b) and 404.1571 et seq.).

Regulation 20 C.F.R. § 416.920(b) state that if a disability applicant is working and the work he is doing is substantial gainful activity (SGA), he will be found not disabled regardless of his medical condition, age, education, and work experience. Regulation 20 C.F.R. § 404.1572(a) defines “substantial gainful activity” (SGA) in general terms. SGA involves doing significant physical or mental activities, and it may be substantial even if it is done on a part-time basis, or it is the kind of work usually done for pay or profit, whether or not a profit is realized. For a person who is an employee, earnings may show that he has done SGA if monthly earnings in year 2011 average more than $1,000.00, in year 2012 average more than $1,010.00, and in year 2013 average more than $1,040.00 (Regulations 20 C.F.R. §§ 404.1574 and 416.974).

The claimant earned $6871.00 in 2011, $9980.00 in 2012 and $5425.00 in 2013. Since the claimant’s earnings do not rise to the level or above SGA, the undersigned finds that the claimant has not performed SGA during any of the requisite period.

3. The claimant has the following severe impairments: Paraplegic spinal disorde1·s and migraines (20 CFR 404.1520(c)).

4. The claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR P u1404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526).

5. The claimant has the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) except the claimant could lift and carry twenty pounds occasionally, ten pounds frequently; he could sit for six hours out of an eight hour work day, and stand and walk for slightly less than two hours out of an eight-hour workday. The claimant had an unlimited ability to push and pull. The claimant could occasionally climb ramps and stairs, balance, kneel, crouch, or crawl; but he could never climb ladders, ropes, or scaffolds. The claimant had to avoid all exposure to hazards such as heights and moving machinery. Due to the intensity of pain in his legs and severe migraines, the claimant would be off task approximately fifty percent of an eight-hour workday.

In making this finding, the undersigned considered all symptoms and the evident to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements of 20 CFR 404.1529 and SSRs 96-4p and 96-7p. The undersigned has also considered opinion evidence in accordance with the requirements of 20 CFR 404.1527 and SSRs 96-2p, 96-6p and 06-3p.

The Administration found the claimant disabled as of February 21, 2013, as of an initial determination dated August 15, 2013. The claimant originally alleged an onset date of January 4, 2011. The undersigned concluded that the claimant was disabled as of January 4, 2011, and the findings below are restricted to the period of January 4, 2011 through February 20, 2013, the
date before the determination of disability made by the Agency. The undersigned does not want to disturb the findings of the Administration after the established disability onset date of February 21, 2013, as discussed below.

Abe Hardoon M.D. evaluated the claimant on August 22, 2010, through May 3, 2013, for medication management and follow up. The claimant also complained of ear pain on the right side with a headache (Exhibit 2F, page 18). Dr. Hardoon indicated that the claimant’s restless leg symptom versus neuropathic pain was the cause of the claimant’s pain. The claimant was given a trial of Lyrica. For the claimant’s vague chest discomfort, Dr. Hardoon wanted to perform further testing. Dr. Hardoon continued the claimant on Topamax for migraines and on prophylactic medication. Dr. Hardon diagnosed gastroesopheal reflux disease, obstructive sleep apnea, hyperlipidemia, hyperglycemia, and migraine headaches (Exhibit 2F, pages 15-16). Dr. Hardoon indicated in subsequent treatment notes that the claimant continued to experience migraines and leg pain with no relief. The claimant continued to be treated with medication management (Exhibit 2F, pages 10-14). On May 3, 2013, the Dr. Hardoon indicated that the claimant had multiple skeletal issues that caused a paraplegic spinal disorder (Exhibit 2F, page 9). The claimant also had abnormalities of the hea11due to a heat1 murmur. An echocardiogram revealed pulmonic insufficiency (Exhibit 8F, pages 8-9). The claimant continued to experienced problems with cervical and lumbar spine. The claimant walked with an abnormal gait and required a cane for ambulation. The claimant also had arthritis that caused pain. The claimant had mild diminished sensation in the right leg (Exhibit 4F, Exhibit 8F, and Exhibit 9F). Edwin Chan, M.D., a partner of Dr. Hardoon, indicated that the claimant had back pain that radiated into the extremities that was aggravated by walking, sitting, and standing along with lifting. Dr. Chan indicated that the claimant had paraplegic spinal disorder. Dr. Chan was of the opinion that the claimant could lift and carry three to five pounds occasionally. He could stand and walk

6. The claimant is unable to perform any past relevant work (20 CFR -‘04.1565).

The vocational expert testified that the claimant’s past work as a mo1tgage loan processor was skilled (SVP 5) and required sedentary exertion; as a credit clerk was semi-skilled (SVP 4) and required sedentary exertion; as a receptionist was semi-skilled (SVP 4) and required sedentary exertion; as a supervisors of route sales was skilled (SVP 5) and required light exertion; as a civil preparedness officer was skilled (SVP 6) and required light exertion; as a business opportunity prope1ty investment broker was skilled (SVP 7) and required light exertion; as a department manager was skilled (SVP 7) and required sedentary exertion; and as an appointment clerk was semi-skilled (SVP 3) and required sedentary exe1tion. Dictionary of Occupation a l Titles,
Volumes I and II, Fourth Edition, Revised 1991, Sections 249.362-022, 205.367-022, 237.367- 038, 292.137-014, 188.177-022, 189.157-010, 189.167-022, and 237.367-010, respectively. The
Vocational expert further testified that the demands of the claimant’s past relevant work exceed the residual functional capacity.

7. The claimant was a younger’ individual age 18-49 on the established disability onset date (20 CFR 404.1563).

8. The claimant has at least a high school education and is able to communicate in English (20 CFR 404.1564).

9. The claimant’s acquired job skills do not transf’e1·to other occupations within the residual functional capacity defined above (20 CFR 404.1568).

10. Considering the claimant’s age, education, work experience, and residual functional capacity, there are no jobs that exist in significant numbers in the national economy that the claimant can perform (20 CFR 404.1560(c) and 404.1566).

In determining whether a successful adjustment to other work can be made, the undersigned
must consider the claimant’s residual functional capacity, age, education, and work experience in conjunction with the Medical-Vocational Guidelines, 20 CFR Part 404, Subpart P, Appendix 2. If the claimant can perform all or substantially all of the exertional demands at a given level of exertion, the medical -vocational rules direct a conclusion of either “disabled” or “not disabled” depending g upon the claimant’s specific vocational profile e (SSR 83-11). When the claimant cannot perform substantially all of the exertional demands of work at a given level of exe11ion and/or has non-exertional limitations, the medical-vocational rules are used as a framework for decision-making unless there is a rule that directs a conclusion of “disabled” without considering the additional exertional and/or non-exertional limitations (SSRs 83-12 and 83-14). If the
claimant has solely non-exertional limitations, section 204.00 in the Medical-Vocational Guidelines provides a framework for decision-making (SSR 85-15).

for one hour out of an eight-hour workday, and sit for three hours out of an eight-hour workday. The claimant could never climb, balance, stoop, crouch, kneel, or crawl. The claimant had a problem with handing, feeling, pushing, pulling, seeing, and hearing (Exhibit S F). The undersigned gives the opinion of Dr. Chan some weight because the treatment notes demonstrate that the claimant was limited by his leg pain, his back and neck pain, which caused him to have a paraplegic spinal disorder, and the claimant had to ambulate with a cane. Laboratory findings revealed herniations at C3-4, C4-5, and C6-7; and L3-4. There was degenerative retrolisthesis at L4-S (Social Security Ruling 96-2p).

An MRI scan of the thoracic spine revealed mid thoracic dextroscoliosis from TS to T12 (Exhibit 5F, page 8). An MRI of the cervical spine revealed subligamentous central herniations at C3-4 and C4-5. There was a focal subligamentous central herniation at C6-7 with severe left osseous foraminal stenosis caused by broad uncovertebral osteophytes (Exhibit SF, page 9). An MRI scan of the lumbar spine revealed biforarninal zone disc herniations at L3-4 that extended along the inferior foraminal recesses. There was degenerative retrolisthesis as well as broad based contained central and bilateral foraminal zone disc herniations. There were bilateral parsintera1ticularis defects at LS. There was a broad based contained central disc herniation (Exhibit 5F).

At the hearing, the claimant testified that he could not work any longer because he could not focus or concentrate. As a result, the claimant was let go from his job. The claimant had made too many errors. The claimant stated that he last worked January 4, 2011, at full-time. The claimant related that he experiences severe leg and hip pain. Additionally, he experienced low back pain. The claimant indicated that Dr. Chan prescribed Lyrica for the pain. At one point, the Ly1ica had to be increased to minimize the pain. The claimant testified that he experiences severe headaches to the point that he becomes bedridden. He lies down for one to two hours. He indicated that when the migraines are severe, he cries. He experiences migraines three to four times a week. The claimant related that he takes Topamax and Amitriptyline. The Topamax did help for a while.

After considering the evidence of record, the undersigned finds that the claimant’s medically determinable impairments could reasonably be expected to produce the alleged symptoms and that the claimant’s statements concerning the intensity, persistence and limiting effects of these symptoms are generally credible.

The State agency medical consultants’ physical assessments are given little weight because other medical opinions are more consistent with the record as a whole and evidence received at the hearing level shows that the claimant is more limited than determined by the State agency consultants.

If the claimant had the residual functional capacity to perform the full range of light work, considering the claimant’s age, education, and work experience, a finding of “not disabled” would be directed by Medical-Vocational Rule 202.21. To determine the extent to which the claimant’s additional limitations erode the unskilled light occupational base, the Administrative Law Judge asked the vocational expert whether jobs exist in the national economy for an individual with the claimant’s age, education, work experience, and residual functional capacity. The vocational expert testified that given all of these factors there are no jobs in the national economy that the individual could perform.

Based on the testimony of the vocational expe1t, the undersigned concludes that, considering the claimant’s age, education, work experience, and residual functional capacity, a finding of “disabled” is appropriate under the framework of the above-cited rule.

11. The claimant has been under a disability as defined in the Social Security Act since January 4, 2011, the alleged onset date of disability (20 CFR 404.1520(g)).

DECISION

Based on the application for a period of disability and disability insurance benefits filed on May 10, 2013, the claimant has been disabled under sections 216(i) and 223(d) of the Social Security Act since January 4, 2011.

Rossana L. D’Alessio
Administrative Law Judge

February 11, 2016 Date

After careful consideration of the entire record, the undersigned makes the following findings:

1. The claimant’s date last insured is December 31, 2013.

2. The claimant has not engaged in substantial gainful activity since January 6, 2009, the alleged onset date (20 CFR 404.1520(b) and 404.1571 et seq.).

3. The claimant has the following severe impairments: status/post multiple arthroscopic rotator cuff repair and subacromial decompression light and left shoulders with osteoarthritis of the acromioclavicular joint and chronic pain; degenerative disc disease of the cervical and lumbar spine; severe osteoarthritis of the bilateral knees; dyshidrotic eczema of tbc bottom of the feet and palms of the hands; diabetes; depression; and anxiety (20 CFR 404.1520(c)).

The above medically determinable impairments significantly limit the ability to perform basic work activities as required by SSRs 85-28 and 96-3p.

4. The claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpai1 P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526).

The record does not establish the medical signs, symptoms, laboratory findings or degree of functional limitation required to meet or equal the criteria of any listed impairment and no acceptable medical source designated to make equivalency findings has concluded that the claimant’s impairment(s) medically equal a listed impairment.

The claimant has the following degree of limitation in the four broad areas of mental functioning set out in the disability regulations for evaluating mental disorders and in the mental disorders listings in 20 CFR, Part 404, Subpart P, Appendix 1: moderate limitation in understanding, remembering, or applying information, moderate limitation in interacting with others, moderate limitation in concentrating, persisting, or maintaining pace, and mild limitation in adapting or managing oneself

5. The claimant has the residual functional capacity to perform light work as defined in 20 CFR 404.1567(a) except: sit for 4 to 5 hours of an 8 hour day, stand for 2 to 3 hours of an 8 hour day, and walk for 1 to 2 hours of an 8 hour day. Standing and walking must be done on an intermittent basis using a cane. The claimant is able to occasionally reach overhead with the right and left upper extremity. She can frequently handle and continuously feel with the right and left hand. She can occasionally push/pull up to 20 pounds. She can never climb ramps, stairs, ladders, or scaffolds, never stoop, kneel, crouch, or crawl, and occasionally balance. She must avoid unprotected heights and occasionally work near moving mechanical parts, extreme humidity and wetness, and extreme dust, fumes, and other irritants or operate a motor vehicle. She can work on an occasional basis in extreme cold and heat or near vibrations. She can work in quiet to moderate noise. The clamant is limited to simple, routine tasks, make simple work-related decisions, and can occasionally respond appropriately to supervisors, co-workers, and the public.

In making this finding, the undersigned has considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements of 20 CFR 404.1529. The undersigned has also considered opinion evidence in accordance with the requirements of 20 CFR 404.1527.

In considering the claimant’s symptoms, the undersigned must follow a two-step process in which it must first be determined whether there is an underlying medically determinable physical or mental impairment(s)–i.e. , an impairment(s) that can be shown by medically acceptable clinical and laboratory diagnostic techniques–that could reasonably be expected to produce the claimant’s pain or other symptoms.

Second, once an underlying physical or mental impairment(s) that could reasonably be expected to produce the claimant’s pain or other symptoms has been shown, the undersigned must evaluate the intensity, persistence, and effects of the claimant’s symptoms to determine the extent to
which they limit the claimant’s work-related activities. For this purpose, whenever statements about the intensity, persistence, or functionally limiting effects of pain or other symptoms are not substantiated by objective medical evidence, the undersigned must consider other evidence in the record to determine if the claimant’s symptoms limit the ability to do work-related activities.

The residual functional capacity is supported by overall objective findings, laboratory test results and the claimant’s activities of daily living. The record reflects the claimant had undergone arthroscopy surgery times three of the right shoulder and arthroscopic surgery times two of the left shoulder between January 23, 2003 and May 10, 2013. An MRI of the right and left shoulders of August 12, 2012 revealed partial thickness rotator cuff tears involving the supraspinatus and infraspinatus tendons and osteoarthritis of the acromioclavicular joint. (Ex. I F, 3F, 4F, 5F, 6F) In a surgical follow up of the final surgery of the right shoulder of May 10, 2013, the claimant reported by November 13, 2013 she had 50 to 60% improvement. However, an examination revealed she had not regained full strength of the right upper extremity, which was tested as only 3+/5. If she continued to improve, she indicated she may consider having surgery of the left shoulder. She returned to Dr. Jeffrey Greenspoon on January 21, 2014 and complained of increasing pain in the past two to three weeks and pain with reaching and sleeping on the right side. An examination revealed positive bicep groove tenderness, positive AC joint tenderness, and positive subacrom space tenderness. She also had a positive impingement sign, a painful arc, and a positive cross body flexion with pain. Exam of the left shoulder was felt to be within normal limits. She was assessed with chronic bilateral shoulder pain, given a cortisone injection, and prescribed Mobic, an anti-inflammatory. Dr. Greenspoon limited the claimant to no lifting over 5 pounds, no repetitive motion, no overhead lifting, only occasional reaching above the shoulders, occasional pushing/pulling, no reaching below the knees, and no squatting or kneeling. (Ex. 6F/ l 76) She was referred to pain management.

Due to a lack of health insurance, the claimant sought treatment with the Volunteers in Medicine. An x-ray of the right clavicle revealed moderate osteoarthritis of the acromioclavicular joint. An x-ray of the cervical spine showed multilevel degenerative disc disease and cervical spondylosis. An MRI of the lumbar spine revealed degenerative disc disease Ll -L2 through L4-L5. In addition, an x-ray of the right and left knees had revealed severe osteoa11hritis of the patellofemoral joint space. (Ex. l lF)

The claimant underwent examination by Dr. Carter, orthopedist, on December 17, 2015. Along with the MRI findings of the bilateral shoulders and the lumbar spine, he noted she displayed a limited range of motion of the lumbar spine with a positive straight leg raise on the left and weakness of the left quads. She was diagnosed with bilateral shoulder pain and degenerative and disc disease of the lumbar spine with radiculitis, as well as diabetes, and dermatitis of the
bilateral feet and palms. The clamant advised Dr. Carter on February 17, 2015 she had cancelled the left shoulder surgery due to the poor results from the previous surgery on the right. She complained of bilateral knee pain and received a cortisone injection to the left knee. On March 24, 2016, Dr. Carter indicated she was ambulating with the assistance of a cane. An x-ray of the lungs of August 8, 2016 revealed a mild left lower lobe fibrosis or atelectasis. In a final exam of October 13, 2016, the claimant was noted to have extensive peeling and excoriation of the bilateral feet and erythema and peeling of the outer aspects of the hands and palms. She complained of constant joint and muscle pain and cramping and stiffness of the legs. She had been prescribed Cymbalta and Lyrica with little improvement. It was noted she had maintained reasonable control of the diabetes on Metformin. She was also prescribed a topical ointment, Elidel and Lorezepam for anxiety. (Ex. 13F)

The claimant had also remained in the care of the Brevard Health Department since January 4, 2013 for management of symptoms of diabetes, and eczema of the hands and bottom s of the feet. She also complained of left leg numbness. (Ex. 7F, 15F) She had undergone workup by a dermatologist on January 24, 2013 and undergone a skin patch test that revealed dyshidrotic eczema of the hands and feet. (Ex. 8F)

At the request of the undersigned, the claimant underwent a thorough consultative evaluation
with mental status performed by Dr. Homi S. Cooper on November 18, 2016. She complained of bilateral shoulder pain, and neck and back pain. Dr. Cooper observed the claimant was 5 ‘8″ in height and weighed 232 pounds which is consistent with obesity and a BMI of 34.8. She walked with the assistance of a cane and appeared to be in considerable physical and emotional distress
in the form of depression. Exam of the shoulders revealed positive findings of pain on conducting and elevating the shoulder girdles beyond 90 to 130 degrees; decreased posterior shoulder reach; and reduced rotator cuff strength of 4/5. Internal and external rotation was accompanied by palpable subacromial crepitis with positive impingements signs, bilaterally.

Exam of the knees revealed severe bilateral retropatellar crepitus with bilateral genu valgus right worse than left. Range of motion was reduced. She also had reduced range of motion in the cervical spine and tightness in the cervical paraspinals. Range of motion of the lumbar spine was reduced with flexion to only 40 degrees and extension 5. There was prominence of the right sternoclavicular joints suggestive of arthritis.

Examination of the hands revealed thickened and cracked skin over the thenar and hypothenar areas with early cracking of the skin with marked roughening and peeling of the skin. Exam of the soles of the feet showed a more severe form of thickening, cracking and peeling of the skin with a matador. There appeared to be some area where the skin may have bled.

The clamant displayed decreased sensation to light touch and vibration in the left lower leg. Gait was attempted without the cane and it was wide-based genu valgus gait, slow and cautious. She had considerable difficulty transferring from the sitting to standing and vice versa. Sidestepping was done slowly and with caution. Walking on the heels and tandem gait was not requested due to safety concerns. Based upon the recent x-ray reports of the cervical and lumbar spine and
MRI findings of the bilateral shoulders and lumbar spine, Dr. Cooper diagnosed the following.

1. Class I obesity with BMI of 34.8.
2. Bilateral knee, severe osteoarthritis left, greater than right.
3. Low back pain due to severe lumbar spondylosis with bilateral radiculopathy.
4. Cervical pain due to moderately severe spondylosis, with history of bilateral radiculopathy.
5. Right stemoclavicular joint arthritis.
6. Postoperative state for 3 right and 2 left shoulder surgeries, with recurrent impingement syndrome, bilaterally.
7. Subacute spongiotic dermatisis, both hands and severe (and malodorous) on both soles.
8. Type II diabetes mellitus.
9. Depression.
10. Hypertension.
11. Chronic obstructive pulmonary by history, with chest expansion of 11/2 inches.

Dr. Cooper also completed a medical source statement and indicated the claimant can

1. Sit for 4 to 5 hours, stand for 2 to 3 hours and walk for 1to 2 hours at intervals from 5 to 30 minutes;
2. Use a cane, which is medically necessary;
3. Lift and carry 5 pounds up to 20 pounds on an occasional basis;
4. Occasionally reach and push/pull;
5. Frequently handle and finger and continuously feel;
6. Never climb stairs, ramps, ladders, scaffolds and rarely stoop, kneel, crouch and never crawl;
7. Never work around unprotected heights and occasionally work around moving mechanical parts, operate a motor vehicle, humidity and wetness, dust, odors, fumes and
pulmonary irritants, extreme cold and heat and vibrations with quiet to moderate exposure to noise. (Ex. 14F)

The clamant testified she has had her ongoing problems since 2010. She reported she experiences pain in the back and knees, numbness and tingling in the feet and cramping and numbness and tingling of the hands. She indicated she uses a TENS unit, a muscle rub, and hydrocodone for her pain. She uses a cane for walking that was prescribed by Dr. Carter.
Functionally, she testified she has difficulty caring for her personal needs in getting in and out of the shower. She is able to prepare simple meals, do small loads of laundry and light dusting.
She has difficulty lifting a gallon of milk with both hands. She can reach up with her arms but not for very long. She can walk in the grocery store with a cart down one aisle. She can stand for 20 to 30 minutes. She would need to lie down and rest for more than one-half hour during an eight-hour day. She also has symptoms of dermatitis in the hands and feet, which would make it difficult to hold a mouse or walk. She has had her ongoing problems since 2010.

After careful consideration of the evidence, the undersigned finds that the claimant’s medically determinable impairments could reasonably be expected to cause the alleged symptoms. The claimant’s statements concerning the intensity, persistence and limiting effects of these symptoms are generally consistent with the medical and other evidence.

As for the opinion evidence, the undersigned accords great weight to the opinion of the consultative examiner, Dr. Cooper. (Ex. 14F) It is based upon a thorough examination and review of all relevant medical evidence. It is well supported by the objective findings and laboratory test results. It is consistent with the other substantial evidence of record.

The undersigned also accords great weight to the medical source statement of Dr. Jeffrey Greenspoon of January 21, 2014, the claimant’s treating orthopedic surgeon. (Ex. 6F/ 176) The opinion is well supported by the examination findings and test results that occurred over an extended period of time. (Ex. lF, 3F, 4F-6F)

Little weight is given to the opinion of the State agency medical consultant as it is not consistent with the record as a whole. (Ex. 4A)

6. The claimant is unable to pe1·form any past relevant work (20 CFR 404.1565).

A vocational expert classified the claimant’s past relevant work as a civil drafter, DOT code 005.281-010 as requiring sedentary exertion and skilled with an SVP of 7. This work was substantial gainful activity, performed long enough to achieve average performance, and performed within the relevant period. The vocational expert testified a hypothetical claimant would be unable to perform past relevant work.

Accordingly, the undersigned finds claimant is unable to perform past relevant work.

7. The claimant was an individual of advanced age on the established disability onset date (20 CFR 404.1563).

8. The claimant has at least a high school education and is able to communicate in English (20 CFR 404.1564).

9. The claimant’s acquired job skills do not transfer to other occupations within the residual functional capacity defined above (20 CFR 404.1568).

The vocational expert testified there would be no transferability of skills.

10. Considering the claimant’s age, education, work experience, and residual functional capacity, there are no jobs that exist in significant numbers in the national economy that the claimant can perform (20 CFR 404.1560(c) and 404.1566).

In determining whether a successful adjustment to other work can be made, the undersigned
must consider the claimant’s residual functional capacity, age, education, and work experience in conjunction with the Medical-Vocational Guidelines, 20 CFR Part 404, Subpart P, Appendix 2. If the claimant can perform all or substantially all of the exertional demands at a given level of exertion, the medical-vocational rules direct a conclusion of either “disabled” or “not disabled” depending upon the claimant’s specific vocational profile (SSR 83-11).

Even if the claimant had the residual functional capacity for the full range of light work, a finding of “disabled” would be directed by Medical-Vocational Rule 202.06.

11. The claimant has been under a disability as defined in the Social Security Act since January 6, 2009, the alleged onset date of disability (20 CFR 404.1520(g)).

DECISION

Based on the application for a period of disability and disability insurance benefits filed on April 24, 2014, the claimant has been disabled under sections 216(i) and 223(d) of the Social Security Act since January 6, 2009.

The workers’ compensation offset provisions at 20 CFR 404.408 may be applicable.

Mary Chrzanowski
Administrative Law Judge

March 31, 2017

After careful consideration of the entire record, the undersigned makes the following findings:

1. The claimant’s date last insured is September 30, 2014.

2. The claimant has not engaged in substantial gainful activity since January 27, 2010, the alleged onset date (20 C’F’R 404.1520(b), 404.1571 et seq., 416.9’20(b) and 416.971 et seq.).

The claimant collected unemployment compensation benefits from the second quarter in 2010 through the fourth quarter of 2010 (Exhibit 3D). The undersigned finds that the claimant’s receipt of unemployment compensation benefits is not substantial gainful activity. The claimant’s activities do not meet the definition of substantial gainful activity as outlined in 20 CFR § 404.1572. Specifically, the claimant did not perform work activity that involved significant physical or mental activities or that is usually performed for pay or profit.

3. The claimant has the following severe Impairments: generalized anxiety disorder, attention deficit hyperactivity disorder, borderline personality disorder, and alcohol abuse (20 CFR 404.1520(c) and 416.920©).

These impairments are “severe” impairments within the meaning of the Social Security Act because they result in more than minimal limitations in the claimants ability to perform basic work activities.

4. The severity of the claimant’s generalized anxiety disorder meets the criteria of section 12.06 of 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(,I), 404.1525, 416.920(d) and 416.925).

In making this finding, the undersigned considered all symptoms and the extent to which these symptoms can reasonably be accepted as consisten1with the objective medical evidence and other evidence, based on the requirements of 20 CFR 404.1529 and 416.929 and SSRs 96-4p and 96-7p. The undersigned has also considered opinion evidence in accordance with the requirements of 20 CFR 404.1527 and 416.927 and SSRs 96-2p, 96-6p and 06-3p.

The severity of the claimant’s generalized anxiety disorder meets listing 12.06. The claimant has the following degree of limitation in the broad :areas of functioning set out in the disability, regulations for evaluating mental disorders and in the mental disorders listings in 20 CFR, Part 404, Subpart P. Appendix 1: mild restrictions in activities of daily living marked difficulties in maintaining social functioning, marked difficulties maintaining concentration, persistence or pace, and one to two episodes of decompensation, each of extended duration.

The claimant’s medical records are reflective of the claimant’s suffering from an assortment of impairments, are consistent with the claimant’s testimony, and support a finding of disability by the undersigned. The claimant underwent a psychiatric examination with Dr.Linda Callagham on May 24, 2010. The claimant reported that she had been cutting herself to relieve her tension. She also exhibited feelings of worthlessness and abandonment (Exhibit 3F/Page 1). The claimant admitted that she suffered from mood swings and flight of ideas. At times, the claimant even talked to herself and was very circumstantial. The claimant had difficulty focusing and concentrating (Exhibit 3F/Page 2). She exhibited no interest during the evaluation (Exhibit 3F/Page 3). Dr. Callagham’s diagnoses included generalized disorder (Exhibit 3F/Page 4). Additionally, Dr. Callagham assessed that the claimant had a Global Assessment of Functioning (GAF) score of 40 (Exhibit 3I•’/Page 4). A GAF score is used to report a clinician’s judgment of an individual’s overa1 level of functioning and this particular GAF score is indicative of a major impairment in several areas such as work, school, family relations, judgment, thinking, or mood (Diagnostic and Statistics Manual of Mental Disorders, Fourth Edition, Washington D.C., American Psychiatric Association, 1994).

The claimant’s subjective complaints are supported by the numerous office visit notes, which reflect the claimant’s regular trips to her doctors in order to seek relief from the alleged symptoms. The description of the symptoms and limitations the claimant has provided throughout the record has also generally been consistent and persuasive. Despite the claimant’s consistent compliance with prescribed treatment and physician recommendations, the evidence is clear that the claimant’s symptoms have persisted. As such, it is clear that the claimant is precluded from any work due to her disabling impairments.

At the hearing before the undersigned, the claimant testified that she is unable to work due to her state of agitation, confusion, and anxiety. She recently got out of abusive relationship, and has a history of cutting herself. The claimant alleged that she also suffered from depression. She reported difficulty with sleeping. The claimant stated that she experienced panic attacks approximately three days per week. She becomes overwhelmed and tense. She experiences headaches that stem from her anxiety. She does not socialize with friends or family members. The claimant admitted that she had three DUI’s in the past. The claimant stated, however, that she completed a. 12 step programs for alcohol abuse. The claimant further explained that she does not abuse alcohol. In fact, she asserted that she has not had anything to drink for approximately one year.

After considering the evidence of record, the undersigned finds that the claimant’s medically determinable impairments could reasonably be expected to produce the alleged symptoms, and that the claimants statements concerning the intensity, persistence and limiting effects of these symptoms are generally credible.

The undersigned accords great weight to the objective medical findings contained in .the treating physical records (Exhibits I 4F and 16F) as they are consistent with the substantial evidence of record and the .findings made herei11(Social Security Ruling, 96-2p).

The State agency psychological consultant’s mental assessment is given little weight because the State agency consultant did not adequately consider the claimant’s subjective complaints or the combine effect of the claimant’s impairments.

5. The claimant has been under a disability as defined in the Social Security Act since January 27, 2010, the alleged on set date of disability (20 CFR 404.1520(d) and 416.920(d))

6.The claimant’s substance use disorder(s) is not a contributing factor material to the determination of d:isflbility (20 CFR 404.1535 and 416.935).

Since the claimant’s medical records reflect alcohol abuse, it must be decided whether it is a contributing factor material to the determination of the claimant’s disability. The medical evidence establishes that the claimant would continue to be disabled if she stopped using alcohol. Specifically, the severity of the claimant’s impairments would continue to meet the requirements of Section 12.06 of 20 CFR Prut 404, Subpart P, Appendix 1 of the Social Security Regulations. Accordingly, the undersigned concludes that alcoholism is not a contributing factor or material to the determination of the claimant’s disability.

DECISION

Based on the application for a period of disability and disability .insurance benefits protectively filed on February 17, 2010, the claimant has been disabled under sections 216(i) and 223(d) of the Social Security Act since January 27, 2010.

Based on the application for supplemental security income protectively filed on February 17, 2010, the claimant bas been disabled under section 1614(a)(3)(A) of the Social Security Act since January 27, 2010.

The component of the Social Security Administration responsible for authorizing supplemental security income will advise the claimant regarding the nondisability
requirements for these payments and if the claimant is eligible, the amount and the months for which payment will be made.

It is recommended th.at a determination be made concerning the appointment of a representative payee who can manage payments in the claimant’s interest.

D. Kevin Dugan
Administrative Law Judge

February 16, 2012

After careful consideration of the entire record, the undersigned makes the following findings:

1. The claimant’s date last insured is December 31, 2010.

2. The claimant has not engaged in substantial gainful activity since August 1, 2009, the amended alleged onset date (20 CFR 404.1520(b) and 404.1571 et seq.).

3. The claimant has the following severe impairments: atherosclerotic disease, cervical and lumbar disk disease, fibromyalgia, hype1iension and cervical radiculopathy (20 CFR 404.1520(c)).

4. The claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1(20 CFR 404.1520(cl), 404.1525 and 404.1526).

5. The claimant has the residual functional capacity to perfo11n light work as defined in 20 CFR 404.1567(b) except she can only occasionally finger and occasionally hm1dle with her hands due to cervical radiculopathy.

In making this finding, the undersigned considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements of 20 CFR 404.1529 and SSRs 96-4p and 96 -7p. The undersigned has also considered opinion evidence in accordance with the requirements of 20 CFR 404. 1527 and SSRs 96-2p, 96-6p and 06-3p.

At the initial level of administrative review, a medical consultant affiliated with Disability Determinations Services concluded the claimant retained the ability to perform the exertional demands of light work as defined in the Social Security regulations, rulings and jurisprudence, and the Dictionary of Occupational Titles. However, nowhere on the analysis found in Exhibit 2A does it appear that effects of the claimant’s cervical radiculopathy on her hands were considered. No manipulative limitations were found although the evidence shows the presence of a condition that could reasonably result in such limitations.

On April 28, 2010, the claimant told Dr. Sonali Agarwal at St. Luke’s Hospital that she had a long history of problems with her neck. In August 2009 she began feeling more pain in the neck with aching and numbness in the left arm. This aching and numbness went down the arm into two fingers. Her fingers felt tingly.

Her history and complaints are consistent with the reports from Dr. Robert Dehgan. Dr. Dehgan saw the claimant on November 11, 2009 to perform an-electrodiagnostic study of the left arm. The claimant report having neck pain that radiated to both arms with tingling in the fingers. The testing confirmed chronic C5 and C6 radiculopathy.

The claimant reported similar symptoms to Dr. Sharma at Heartland Regional Medical Center on March 6, 2010. She was having pain in her hands and wrists and numbness in both hands. He diagnosed cervical radiculopathy.

At the hearing the claimant testified regarding the problems using her hands. After considering the evidence of record, the undersigned finds that the claimant’s medically determinable impairments could reasonably be expected to produce the alleged symptoms and that the claimant’s statements concerning the intensity, persistence and limiting effects of these symptoms are generally credible. The evidence is persuasive that the claimant cannot finger or handle more than occasionally due to her impairment s.

6. The claimant is unable to perform any past relevant work (20 CFR 404.1565).

The demands of the claimant’s past relevant work exceed the residual functional capacity. The vocational expert testified the claimant’s past relevant work as an area manager (DOT 183-117- 010), a bookkeeper (DOT 210.382-014) and an office administrator (DOT 169. 167-010) is sedentary as it is commonly performed in the national economy. However, each of these jobs requires more than occasional handling and/or fingering.

7. Applying the age categories non-mechanically, and considering the additional
vocational adversities in this case, the claimant was an individual of advanced age on the established disability onset date (20 CFR 404.1563).

The claimant was born on December 5, 1954 and attained the age of 55 in 2009. This occurred approximately 4 months after the alleged onset date. The short period of time between the alleged onset date and the claimant’s fifty-fifth birthday warrants a non-mechanical application of the age category rules.

8. The claimant has at least a high school education and is able to communicate in English (20 CFR 404.1564).

9. The claimant’s acquired job skills do not transfer to other occupations within the residual functional capacity defined above (20 CFR -W4.1568).

10. Considering the claimant’s age, education, work experience, and residual functional capacity, there are no jobs that exist in significant numbers in the national economy that the claimant can perform (20 CFR 404.1560(c) and 404. 1566).

In determining whether a successful adjustment to other Nork can be made, the under signed
must consider the claimant’s residual functional capacity, age, education, and work experience in conjunction with the Medical-Vocational Guidelines, 20 CFR Part 404, Subpart P, Appendix 2 . If the claimant can perform all or substantially y all of the exertional demands at a given level of exertion, the medical-vocational rules direct a conclusion of either ”disabled” or ”not disabled” depending upon the claimant’ s specific vocational profile (SSR 83-11).

Even if the claimant had the residual functional capacity for the full range of light work, a finding of “disabled” would be directed by Medical- Vocational Rule 202.0G.

The claimant has been under a disability as defined in the Social Security Act since August 1, 2009, the amended alleged onset date of disability (20 CFR 404.1520(g)).

DECISION

Based on the application for a period of di ability and disability insurance benefits filed on September 13, 2010, the claimant has been disabled under Sections 216(i) and 223(d) of the Social Security Act since August 1, 2009.

Rowena E DeLoach
Administrative Law Judge

February 29, 2012