United States District Court, S.D. New York
March 30, 2004.
JERRY L. CRAWN Plaintiff, -against- JO ANNE B. BARNHART, Commissioner of Social Security Defendant
The opinion of the court was delivered by: SIDNEY STEIN, District Judge
OPINION & ORDER
Plaintiff Jerry L. Crawn Sr. brings this action pursuant to section
205(g) of the Social Security Act, ("the Act"), 42 U.S.C. § 405(g).
Crawn seeks review of the final decision of Jo Anne B. Barnhart,
Commissioner of Social Security, who previously denied Crawn's
application for Social Security disability insurance ("SSDI") benefits.
Both parties have moved for judgment on the pleadings pursuant to Federal
Rule of Civil Procedure 12(c). As set forth below, the Commissioner's
judgment is affirmed because the determination is free of legal error and
is supported by substantial evidence.
I. Procedural History
Crawn applied for Social Security disability insurance benefits on July
2, 2001, alleging an inability to work since December 9, 2000. (R.
60-62).*fn1 The application was denied initially and Crawn requested a
hearing before an Administrative Law Judge ("ALT"). (R. 37-41, 45). On
June 21, 2002, Crawn appeared with counsel at the hearing before ALJ
Dennis G. Katz. (R. 19-36). After a de novo
consideration of the case, Judge Katz issued a decision on August 8,
2002, finding Crawn not disabled because he retained the residual
functional capacity to perform the fall range of light exertion level
work. (R 9-18). The ALJ's decision became the Commissioner's final
decision when, on February 6, 2003, the Social Security Appeals Council
denied Crawn's request for review of the decision of the ALJ. (R3-4).
II. Factual Background
A. Non-medical Evidence
Crawn was fifty-one years old on the date of the healing. (R60). He
attended school through the 11th grade and worked as an auto mechanic
from March 1985 through October 1999 and then as a self-employed
electrician from October 1999 through December 2000. (R. 74, 81). When
describing his activities as a mechanic, Crawn reported he walked, stood,
sat, climbed, stooped, knelt, crouched, crawled, handled objects, knelt,
occasionally lifted up to 100 pounds and frequently up to 50 pounds
throughout the day, placing the work in the Social Security
category. (R. 83). As an electrician, he reported the same
activities, however only lifting up to 50 pounds "occasionally" and up to
10 pounds "frequently," classifying the work in the Social Security
Administration's "medium" category. (R. 82). Crawn's earnings record
shows earnings in all years from 1978 through 2000. (R. 64, 65).
At the hearing before Judge Katz, Crawn testified as follows. He
stopped working in December 2000 as a result of diarrhea, vomiting,
nausea, headaches and dizziness, furthermore, the medications prescribed
for his symptoms made him lethargic and he subsequently experienced joint
pain. (R. 24, 27, 29). When referred to a rheumatologist, Crawn was
prescribed medications for his joint pain that irritated his colon and
esophagus. (R. 23). Crawn claimed that despite treatment he continues to
experience diarrhea two to three days a week lasting sometimes all day
and accompanied by stomach pains. (R. 26-31). Additionally, Crawn
testified that he suffered from shooting pains in his back, swelling in
his hands and feet, joint pain especially in his shoulder
and constant fatigue. (R. 31-34).
B. Medical Evidence
1. Evidence Prior to the Asserted Onset date. December 9,
Dr. Jeffrey Brooks detailed in 1991 that Crawn had received a dozen
endoscopies and colonoscopies over the prior twelve years while under the
care of another gastroenterologist (R. 286). Crawn continued to visit
Brooks throughout the 1990s and in December 1999, Dr. Brooks treated him
for an episode of diverticulitis.*fn2 (R. 137, 259-60, 262, 285-86). By
January 3, 2000, the diverticulitis had subsided and on January 19,
2000, Brooks performed a colonoscopy revealing diverticulosis*fn3,
without evidence of neoplastic disease. (R. 259, 137). Brooks recommended
a high fiber diet avoiding nuts and seeds. (R. 137). On September 20,
2000, Brooks treated Crawn for complaints of nausea and "dry heaves."
Crawn's bowel sounds recorded normal, yet he had tenderness without
hepatosplenomegaly or distension which Brooks judged infectious gastritis
rather than cholecystoses and therefore recommended a low fat diet. (R.
255). Later, Crawn underwent an upper endoscopy and colonoscopy; Brooks
assessed both "negative." Blood tests were normal and Brooks diagnosed
irritable bowel syndrome and recommended medications and a strict
irritable bowel diet. (R. 251).
Following complaints of back pain, Brooks examined Crawn on October 11,
2000. The examination revealed tenderness from T10-T11 vertebrae and
Brooks appraised musculoskeletal back pain with a history of a slipped
lumbar disc twenty-five years earlier; Brooks subsequently adjusted
Crawn's medications. (R. 201). Crawn's abdominal examination was negative
and on October 24, 2000, Brooks reported Crawn's irritable bowel syndrome
to be under "fair control." (R. 200).
2. Evidence During the Period at Issue
a. Gastrointestinal Impairment
On December 14, 2000, when examined by Brooks, Crawn appeared
well-developed and in no acute distress. (R. 199). Dr. Brooks based this
conclusion on the absence of masses, distension or hepatosplenomegaly,
accompanied by negative blood
tests and a non-tender, soft, benign abdomen. (R. 202-05). An
esophagogastro-duodenscopy and biopsy did reveal mild gastritis. (R.
Crawn returned the next month, informing Brooks of stomach pains and
accompanying diarrhea after eating; he denied relief from the medications
and suggested they caused constipation. (R. 198). Brooks' examination
showed a soft and benign stomach, and all test results were negative.
Brooks noted Crawn's stable weight over the prior six years and concluded
irritable bowel syndrome suggesting Crawn "may have to live with it." (R.
Brooks again examined Crawn in February 2001, and noted that he
appeared well-nourished and in no acute distress. (R. 212). Crawn's
abdomen was soft, benign and non-tender. (R. 212). Again, he exhibited no
masses, distension or hepatosplenomegaly and self-reported the
medications were helping control the abdominal cramps. (R. 212). Brooks
concluded the medications were bringing the irritable bowel syndrome
under control and stated, "I told him I'd like him to
start moving on with his life and go back to work once he gets his
fibromyalgia under control." (R. 212).
That summer from July 27-29 Crawn was treated with
intravenous medication at Arden Hill Hospital for a flare-up of
diverticulitis. (R. 193-94, 207-08, 210). Once the symptoms subsided,
Crawn was discharged and was prescribed antibiotic medications. (R.207).
Dr. Lance Siegel, Dr. Brooks' associate, examined Crawn for a follow-up
visit. (R. 209). The patient reported discomfort in the lower quadrants,
denied reflux symptoms and reported having two to three loose bowel
movements per day. (R. 209).
Upon examination, the patient's abdomen was soft with mild
tenderness to deep palpation. (R. 209). Siegel opined the patient showed
healing diverticulitis with no need for further antibiotics. (R.209).
Siegel requested a CT scan of Crawn's pelvis, which revealed marked
improvement of the diverticulitis with minimal residual thickening. (R.
186). Siegel also conducted a colonoscopy in September 2001, which
revealed small polyps, which were subsequently removed, and
diverticulosis, but no evidence of diverticulitis. (R. 183-84). Biopsies
of the sigmoid colon showed "lymphoid aggregate," without significant
abnormality; a biopsy of the ileocecal valve suggested mild chronic
inflammation and "lymphoid aggregate." (R. 181). A barium enema revealed
no obstruction. (R. 179).
Siegel again examined Crawn in January 2002. Crawn walked without
apparent distress, was feverless, and his abdomen was soft. However, he
did exhibit tenderness in the lower left quadrant, which indicated to
Siegel a flare-up of diverticulitis, (R. 297). He prescribed medication
and called for a CT scan the following day, which revealed persistent
thickening of the sigmoid consistent with diverticulitis without
significant changes since November 2001. (R. 207, 302, 303).
The next month, Dr. Daryas Mobed, a surgeon, performed a bowel
resection and, in the pathology report, indicated "multiple diverticula
with focal chronic diverticulitis." (R. 299-301, 304, 306-07, 309). Dr.
Mobed examined Crawn intermittently following the surgery and each time
reported the patient was "doing well" post-surgically, finally
discharging him with "no complaints." He indicated that
follow-up would be by Siegel. (R. 304-05, 308).
In April 2002, Crawn informed Dr. Siegel that he had "some intermittent
abdominal cramping" and "about three bowel movements a day, but this was
nothing similar to what he had when he had his diverticulitis." (R. 298).
Upon examination, Siegel noted the patient was "doing well," his abdomen
was soft and non-tender and he walked without apparent distress. (R.
298). Siegel noted, `I suspect his symptoms are due to healing and
irritable bowel-type syndrome rather than diverticulitis." (R. 298).
b. Musculoskeletal Impairment
Dr. Jerome Meyer treated Crawn for complaints of musculoskeletal pain
from January 2001 through June 2002 (R. 135-36, 172-78, 196-97, 287-92).
In a January 2002 examination, Meyer noted that the patient appeared slim
and healthy, walked with a normal gait, his extremities revealed no
clubbing, cyanosis or edema, and his neurological examination was normal
with no evidence for carpal tunnel syndrome. (R. 135-36). A rheumatologic
examination revealed some tenderness at the left metacarpophalangeal
(MCP) joints and the joint margin of the radial humeral joint of the
right elbow; however no synovitis appeared. The patient exhibited
tenderness at the lateral epicondyle of the right elbow, but the range of
motion remained full and painless. (R. 136). Meyer reported "There is no
synovitis throughout the exam nor is there evidence for fibromyalgia
syndrome" he further stated, "the lumbar spine shows some pain" and
failure to reverse the lumbar lordosis, yet no spasm or abnormal
curvature was itself. (R. 136). Meyer found the patient's reported
symptoms and pain unconfirmed by his exam results, stating "[d]espite the
history of arthritis and morning stiffness, I could
find minimal evidence on exam to substantiate an inflammatory
arthritis. There is also not much evidence for osteoarthritis or
fibromyalgia . . ." (R. 136).
In a report submitted in June 2001 to the Social Security
Administration, Meyer noted that Crawn suffered from an undetermined
"pain syndrome," that he walked flexed at the lumbosacral spine due to
pain, but there were no clinical findings pointing to a specific
diagnosis. (R. 172-73). Various blood tests and X-rays all showed normal;
however, a February 2001 MRI of the lumbosacral spine reportedly showed a
central L5-S1 herniated disc. (R. 174). Meyer was unable to provide a
medical opinion regarding Crawn's ability to engage in work-related
activities and reported that his physical findings were inconsistent with
the patient's level of pain. (R. 176-78).
Three other physicians examined Crawn for complaints of musculoskeletal
pain during the summer of 2001 Drs. Stuart Lestch, Michael
Robinson, and Thomas King. (R. 169-70, 215-16, 218-20). Lestch performed
a neurological consultative examination on July 23, 2001, and reported
mostly normal findings with a few exceptions; he noted straight leg
raising was positive on the right at approximately sixty degrees and
negative on the left. (R. 169). Internal rotation at the right hip
reportedly caused aggravated pain, while the same test on the left caused
minimal pain and deep tendon reflexes were two plus at the
knees and one-to-two plus at the ankles and upper extremities. (R. 169).
Lestch noted, "I find no primary neurologic process to explain the
patient's symptomatology." (R. 170). The doctor also noted, "there may be
a sciatic component to [Crawn's sacroiliac region] pain, and described an
earlier MRI finding showing a very small and slightly right of midline
disc herniation in the lumbar spine as being "of no
clinical significance," concluding that "no further neurological
evaluation is warranted . . ." (R. 170).
When Robinson consultatively evaluated Crawn on August 14, 2001, he
noted that he appeared well-developed and in no apparent distress, could
get on and off the examination table and dress and undress independently.
(R.216). When tested, Crawn exhibited intact sensation to light touch,
pinprick and vibration; strength was normal throughout all muscle groups,
and range of motion across all joints was full. (R. 216). The deep tendon
reflexes were two out of four in the upper and lower extremities, and the
cervical region movements were within normal limits. (R.216). In the
lumbar region, Crawn could flex forward 80 degrees; extend 30 degrees and
side bend 45 degrees. (R. 216). There was no atrophy or asymmetry of any
muscle groups in the upper or lower extremities and lumbosacral X-rays
revealed minimal facet joint degeneration at the L5-S1 position. (R.
Robinson deducted that Crawn suffered from mild right S1 radiculopathy,
likely attributable to disc herniation at that level. (R.216).
Furthermore, the doctor found that Crawn had no focal neurological
defects, did not meet the criteria for fibromyalgia, and lacked
significant trigger points in the thoracic or lumbar regions. (R. 216).
In Robinson's opinion, the patient "would have minimal limitation in
regard to climbing, sitting, walking, standing, lifting, and carrying and
no significant limitations in regard to handling, hearing or speaking."
King consultatively examined Crawn on August 17, 2001, and reported
similar findings to Robinson's with respect to his general demeanor,
appearance, and ability to care for himself without assistance. (R. 219).
King reported no clubbing, cyanosis or
edema of the extremities, pulses were two plus and symmetrical
throughout, the range of motion was normal in all major joints, the
cervical region and in the lumbar spine. (R. 219). There were no joint
abnormalities and straight leg raising was negative, while deep tendon
reflexes symmetrical and sensation remained intact. (R. 219). However, an
X-ray of the lumbar spine showed minimal facet joint degenerative changes
at the L5-S1 level, as evidenced by joint spacing narrowing and
subchondral sclerosis. (R. 221). King reported Crawn to have no
limitation in speaking, hearing, handling, sitting, walking, or
manipulative activities. (R. 219). However, lifting or carrying heavy
objects for long periods would be moderately limited because of a history
of low back syndrome, fibromyalgia, vomiting and diarrhea. (R. 220).
At the suggestion of Dr. Meyer, Crawn attended six sessions of physical
therapy during August and September 2001. (R. 223-31).
The following summer, in June 2002, Dr. Meyer prepared a functional
capacity questionnaire for the Social Security Administration reporting
that while the clinical findings were limited and no formal diagnosis had
been established, the patient suffered from severe low back pain of
uncertain etiology and a painful shoulder impingement. Nevertheless, he
reported that Crawn did not meet the American Rheumatological criteria
for fibromyalgia. (R. 287). Meyer certified that the patient's symptoms
were not severe enough to interfere with attention and concentration or
limit his ability to deal with work stress: "he can walk two blocks, sit
or stand continuously for one hour and in an eight hour workday sit for
about four hours and stand or walk for about two hours." (R. 289-90).
Nevertheless, the doctor also certified that Crawn even should not lift
objects weighing "less than ten pounds" as part of "a competitive work
situation," and was
restricted from bending and twisting more than ten percent of a
workday. (R. 289-91). Furthermore, he marked "yes" to the questions "does
your patient need a job which permits shifting positions at will from
sitting, standing or walking?" and "will your patient sometimes need to
take unscheduled breaks during an 8 hour working day?" (R. 290).
I. Standard of Review
In reviewing a denial of SSDI benefits, a court may reverse the
Commissioner's finding only if that finding is "based upon a legal error
or is not supported by substantial evidence" in the record. See
42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389,
401 (1971); Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999).
The U.S. Supreme Court defined substantial evidence thus: "substantial
evidence is more than a mere scintilla. It means such relevant evidence
as a reasonable mind might accept as adequate to support a conclusion."
Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938));
see Rosa, 168 F.3d at 77.
However, in order to maintain objectivity, "the Court must carefully
consider the whole record, examining evidence from both sides `because an
analysis of the substantiality of the evidence must also include that
which detracts from its weight.'" Tejada v. Apfel,
167 F.3d 770, 774 (2d Cir. 1999) (quoting Quinones v. Carter,
117 F.3d 29, 33 (2d Cir. 1997).
Nevertheless, a court "`may not substitute its own judgment for that of
the [Commissioner], even if it might justifiably have reached a different
result upon a de
novo review.'" Jones v. Sullivan, 949 F.2d 57,
59 (2d Cir. 1991) (quoting Valente v. Secretary of Health and Human
Servs., 733 F.2d 1037, 1041 (2d Cir. 1984)). Administration of
social security benefits are conducted by an agency "presumably equipped
or informed by experience to deal with a specialized field of knowledge,
whose findings within that field carry the authority of an expertness
which courts do not possess and therefore must respect" Universal
Camera Corp. 340 U.S. at 488. Lastly, regarding the breadth of the
review, "the substantial evidence rule applies not only with respect to
findings as to basic evidentiary facts, but also to inferences and
conclusions drawn therefrom." Rodriguez v. Califino,
431 F. Supp. 421, 423 (S.D.N.Y. 1977).
II. The Definition of Disability
In order to establish disability under the Act, a plaintiff first
carries the burden of demonstrating he was unable to engage in any
substantial gainful activity by reason of a physical or mental impairment
that had lasted or could have been expected to last for a continuous
period of at least twelve months. Second, the impairment must be
demonstrated by medically acceptable clinical and laboratory techniques.
See 42 U.S.C. § 423(d)(1)(A), (d)(3); Rosa, 168
F.3d at 77. Establishing the mere presence of a disease or impairment is
not sufficient for a finding of disability under the Act; the disease or
impairment must result in severe functional limitations that prevent the
claimant from engaging in any substantial gainful activity. See
42 U.S.C. § 423(d)(2)(A); Rosa, 168 F.3d at 77.
The Commissioner employs a five-step sequential evaluation when
considering disability claims. See 20 C.F.R. § 404.1520.
The Second Circuit articulates the doctrine as follows:
First, the [Commissioner] considers whether the
claimant is currently engaged in substantial
gainful activity. If he is not, the
[Commissioner's second inquiry] considers whether
the claimant has a "severe impairment" which
significantly limits his physical or mental
ability to do basic work activities. If the
claimant suffers such an impairment, the third
inquiry is whether, based solely on medical
evidence, the claimant has an impairment which is
listed in Appendix 1 of the regulations. If the
claimant has such an impairment, the
[Commissioner] will consider him disabled without
considering vocational factors such as age,
education, and work experience . . . Assuming the
claimant does not have a listed impairment, the
fourth inquiry is whether, despite the claimant's
severe impairment, he has the residual functional
capacity to perform his past work. Finally, if the
claimant is unable to perform his past work, the
[Commissioner] then determines whether there is
other work which the claimant could perform.
Rosa, 168 F.3d at 77 (quoting Berry v. Schweiker,
675 F.2d 464
, 467 (2d Cir. 1982)).
If the claimant fulfills his burden of proving the first four steps,
the burden then shifts to the Commissioner to determine the fifth step
whether there is substantial alternative gainful work in the
national economy that the claimant can perform. See
id. The Commissioner must consider four factors: (1) the
objective medical facts; (2) the medical opinions of the examining or
treating physicians; (3) the subjective evidence of the claimant's
symptoms submitted by the claimant, his family or others; and (4) the
claimant's educational background, age, and work experience. See
Brown v. Apfel 174 F.3d 59, 62 (2d Cir. 1999).
III. The Decision Lacks Legal Error and is Supported by
The task before this Court is to review the actions of the ALJ and
determine if a legal error occurred and if the judge relied on
substantial evidence when determining that
Crawn did not qualify for SSDI benefit. This review consists of
both procedural and substantive safeguards for the claimant.
Procedurally, the court looks for legal error by ensuring all procedural
steps deemed necessary to determine disability benefits eligibility were
followed. See, e.g., Jones v. Barnhart No. 00 Civ. 9584 (GEL)
2002 WL 655204, at *3 (S.D.N.Y. Apr. 22, 2002) (Failure to follow the
"procedural obligations to which ALJs must scrupulously adhere . . . "is
treated as `legal error.'") (citing Santiago v. Massanari, 00
Civ. 3847, 2001 U.S. Dist. LEXIS, 9881 at *24-*25 (S.D.N.Y. July 16,
2001)). Substantively, the review looks at the total body of evidence to
determine if a reasonable mind could conclude as did the ALJ. See,
e.g., id. ("The substantial evidence standard applies
to . . . findings of fact, . . . inferences and conclusions.") (citing
Figueroa v. Apfel, 99 Civ. 3185, 2000 U.S. Dist LEXIS 5759 at
*16-*17 (S.D.N.Y. Apr. 28, 2000).
A. The Commissioner's Determination is Free of Legal Error
The ALJ has an affirmative obligation to develop a complete record and
provide the claimant with a fair and adequate trial. See Melville v.
Apfel, 198 F.3d 45, 52 (2d Cir. 1999); Pratts v. Chatter,
94 F.3d 34, 37 (2d Cir 1996). This obligation was met, the record
contained objective medical documentation from physicians in the employ
of both parties involved, and Judge Katz himself wrote that "in reaching
a decision [he] considered the testimony at the hearing, the arguments
presented, and the documentary evidence contained in the record." (R.
12). The ALJ further ensured that a reasonably complete record was
compiled by providing Crawn with a fair and adequate trial. Crawn
not only appeared before the ALJ, but also was represented by
counsel; both Crawn and his attorney addressed the court freely.
B. The Commissioner's Determination is Supported by Substantial
Judge Katz adhered to the required five-step evaluation to determine
Crawn's benefits eligibility. (R. 13-16). Crawn does not challenge his
determination concerning the first four points. Both parties agree that
Crawn has not worked since December 9, 2000, and the ALJ considered
Crawn's symptoms a severe impairment. However, because none were listed
in Appendix 1 of the regulations, the ALJ must consider vocational
factors such as age, education, and work experience before considering a
claimant disabled. (R. 17). When considering such factors, the ALJ
determined Crawn unable to perform past relevant work and then proceeded
to step five, which focused upon whether there existed other work the
claimant could perform. (R. 13-17). The ALJ determined such work did
exist in significant numbers in the national/regional economy and that
Crawn "retain[ed] the Residual functional capacity' to perform the full
range of light exertion level work." (R. 17).
As previously noted, the ALJ is called upon to examine four factors
when considering whether there is other work the claimant can perform.
This Court's substantive review will examine the same four points,
evaluating the existence of substantial evidence supporting each, and a
final analysis of the collective weight of the arguments together. The
factors are: (1) the objective medical facts; (2) the medical opinions of
the examining or treating physicians; (3) the subjective evidence of the
claimant's symptoms submitted by the claimant, his family, or others; and
claimant's educational background, age, and work experience.
See Brown v. Apfel 174 F.3d 59, 62 (2d Cir. 1999).
1. Objective Medical Facts
Crawn suggested his disability stemmed from his irritable bowel
syndrome, fibromyalgia, and a painful "bad disc in his back." However,
the record provides substantial evidence that while Crawn suffered from
episodic periods of diarrhea and constipation, his symptoms responded to
medical treatment and were not disabling. Crawn's medical records support
this. Over successive visits, Dr. Brooks reported that Crawn appeared in
no acute distress, his abdomen was soft, benign and non-tender, and there
were no masses, distension or hepatosplenomegaly. (R. 199).
On later visits, Brooks reported, Crawn's weight had been stable for
the prior six years and that the medications helped ease the abdominal
cramps. (R. 198, 212). The doctor continued to note the abdomen was soft,
benign and non-tender, and there were no masses, distension or
hepatosplenomegaly, and importantly, that the irritable bowel syndrome
was coming under control with medication. (R.212). These records were
corroborated when Dr. Siegel found that Crawn had two to three bowel
movements a day in August 2001 and April 2002. (R. 209, 298).
While the record shows that Crawn suffered from two episodes of more
serious symptoms, this did not demonstrate continuous disability for a
period of twelve months, as required by statute. See
42 U.S.C. § 423(d)(1)(A). Crawn suffered a flare up of diverticulitis that was
treated by a brief hospitalization, coupled with intravenous medications
and antibiotics upon discharge. (R. 193-94, 207-08). The patient later
described only twinges of discomfort and a CT scan of the abdomen
revealed marked improvement of the diverticulitis. (R. 209, 186). Crawn
later underwent a bowel resection for diverticulitis, and did well
post-operatively, telling the surgeon he had "no complaints." (R.
305-307). Although Crawn still experienced occasional cramping and loose
bowel movements, Siegel attributed the symptoms to healing and irritable
bowel-type syndrome rather than diverticulitis. (R. 298).
Aside from the gastrointestinal ailments, Crawn also claimed to suffer
from musculoskeletal impairments, such as fibromyalgia, a "bad disc" in
his back, and back pain. Judge Katz' ultimate conclusion is substantiated
by objective medical facts contradicting these claims. For example, the
doctors noted Crawn ambulated without the use of an assistive device,
could dress and undress himself without assistance and got on and off the
examination table unassisted. (R. 216, 219). Crawn's doctors ruled out a
diagnosis of fibromyalgia, and dismissed the MRI finding of a herniated
disc as not clinically significant. (R. 136, 169-170, 287). Meyer
reported that Crawn's alleged level of pain could not be substantiated by
the physical findings as he had not exhibited any significant clinical
signs supporting a diagnosis for his complaints; there was no spasm or
abnormal curvature of the spine, his neurologic examination was
unremarkable and all laboratory tests had been negative. (R. 135-36, 174,
Additionally, Dr. Lestch reported that motor testing revealed no
evidence of weakness or ataxia, and Crawn exhibited a lack of tenderness
over the spine, paraspinal muscles, or sciatic notches. (R. 159, 169).
Robinson reported no significant tenderness in the spine and no muscle
atrophy, that deep tendon reflexes were equal, sensation intact, strength
normal in all muscle groups, and range of motion full in all joints. (R.
216). The doctor also noted that Crawn exhibited an extensive range
of motion in his back and remained able to flex forward to 80 degrees,
extend 30 degrees, and side bend 45 degrees, his straight leg raising was
negative and range of motion in the cervical spine was normal. (R.
Furthermore, Dr. King reported there were no joint abnormalities,
straight leg raising was negative and range of motion of the cervical and
lumbar spine and all major joints were within normal limits. (R. 219).
Motor functioning was five out of five, deep tendon reflexes were
symmetrical and sensation intact (R. 219).
The ALJ's determination was based on substantial evidence because it
was supported by adequate relevant evidence in the objective medical
2. Medical Opinions of the Examining or Treating Physicians
In bringing this action, Crawn may believe that the ALJ did not give
proper weight to the evidence presented by treating physician Dr. Meyer,
whose evaluation differed from the consultative physicians. Normally, an
ALJ gives controlling weight to the "opinions of the treating physician
based on the view that opinions based on a patient-physician relationship
are more reliable than opinions based, say, solely on an examination for
purposes of the disability proceedings themselves." Schisler v.
Sullivan, 3 F.3d 563, 568 (2d Cir. 1993). Yet, the regulations
issued pursuant to 42 U.S.C. § 405(a) state that an ALJ need not give
controlling weight to the opinions of a treating physician when those
opinions are "inconsistent with . . . other substantial evidence in [the]
case record." Schisler, 3 F.3d at 567. Nevertheless, "[a]n ALJ
who refuses to accord controlling weight to the medical opinion of a
treating physician must consider various
"factors" to determine how much weight to give to the opinion."
Halloran v. Barnhart 2004 WL 423191, *3 (2nd Cir. (N.Y.)).
"Among those factors are: (i) the frequency of examination and the
length, nature and extent of the treatment relationship; (ii) the
evidence in support of the treating physician's opinion; (iii) the
consistency of the opinion with the record as a whole; (iv) whether the
opinion is from a specialist; and (v) other factors brought to the Social
Security Administration's attention that tend to support or contradict
the opinion." Id.
In Dr. Meyer's opinion, Crawn should never lift even less than 10
pounds and was restricted from bending more than 10 percent of a workday,
precluding him from engaging in even sedentary work, a work level below
the light work level of which the consultative physicians estimated Crawn
was capable. (R. 17 see 289-291). The medical evaluations submitted by
Lestch, Robinson and King differed from Meyer's evaluation and Crawn's
own testimony about his abilities. Each of those physicians was more
favorable in his assessment of Crawn's abilities and Crawn himself
estimated he could lift approximately 15 pounds. (R.215). The fact that
the consensus among the medical professionals who evaluated Crawn goes
against the lone discrepant conclusion supplied by a treating physician
Dr. Meyer supports the ALJ's decision for giving less
weight to that opinion. As required by the regulations, Judge Katz
accurately detailed his reasons for giving less weight to Dr. Meyer's
opinions when he wrote, "the basis for this extreme conclusory assessment
was not explained . . . consequently, it is only of marginal utility."
(R. 14) (original bracketing omitted).
Concerning the other factors the ALJ is required to examine,
particularly the consistency of the opinion with the record as a whole,
Judge Katz was justified in giving
more weight to the opinions of the consultative physicians rather
than the treating physician. See 20 C.F.R. § 4041572(d)(3)
(more weight is given to an opinion supported by medical signs and
findings and consistent with the record as a whole). Judge Katz' decision
that Crawn retained the residual functional capacity for light work is
supported by the conclusions of the record and the majority of the
physicians. The term "light work" refers to jobs that require "lifting no
more than 20 pounds at a time with frequent lifting or carrying of
objects weighing up to ten pounds." 20 C.F.R. § 404.1567(b). Dr. King
wrote that Crawn appeared to have no limitations in his ability to sit or
walk, and had only a moderate limitation in his ability to lift or carry
heavy objects for long periods. (R. 220). Besides being consistent with
his overall findings, Dr. King's opinion is consistent with the overall
record as is Dr. Robinson's, which noted that the patient "would have
minimal limitation in regard to climbing, sitting, walking, standing,
lifting, and carrying and no significant limitations in regard to
handling, hearing or speaking." (R. 216). As a result, the ALJ reasonably
declined to accord controlling weight to Dr. Meyer's opinion and
substantial evidence supports this conclusion. See Schaal v.
Apfel 134 F.3d 496, 504 (2d. Cir 1998).
3. The Subjective Evidence of the Claimant's Symptoms
In addition to the medical evidence and opinions, the ALJ also
considered Crawn's allegations of disabling pain and other symptoms.
Under the Act, the claimant's statements about pain and other symptoms
are, by themselves, not enough to establish the presence of a disability.
There must also be medical signs and findings, established by medically
acceptable clinical or laboratory diagnostic techniques, which show the
existence of a medical impairment that results from the anatomical,
physiological, or psychological abnormalities which could reasonably be
expected to produce the pain or other symptoms alleged.
42 U.S.C. § 423 (d)(5)(A); 20 C.F.R. § 404.1529.
If symptoms suggest a greater severity of impairment than can be
established by the objective medical evidence alone, other factors are
considered, such as (1) daily activities, (2) location, duration,
frequency, and intensity of pain or other symptoms, (3) precipitating and
aggravating factors, (4) type, dosage, effectiveness, and side effects of
any medication taken to alleviate pain or other symptoms, (6) any
measures used to relieve pain or other symptoms, and (7) other factors
concerning functional limitations and restrictions due to pain or other
symptoms. 20 C.F.R. § 404.1529(c)(3).
In this action, Crawn's testimony of constant diarrhea, abdominal pain,
nausea, vomiting, weakness, and headaches were unsubstantiated by the
medical evidence. Numerous examinations revealed that Crawn's abdomen was
benign and non-tender and he himself lacked any acute distress. (R. 198,
199, 212, 298). Furthermore, Crawn's gastrointestinal symptoms responded
to medication and treatment. While he complained of abdominal pain in
December 2000, by February 2001, Dr. Brooks noted that the irritable
bowel syndrome was coming under control with medication. (R. 199, 212).
An episode of diverticulitis responded to treatment within a day. (R.
193-94, 207-08), and Crawn did well post-operatively subsequent to a
bowel resection, reporting "no complaints" by April 2002. (R. 304-07).
Moreover, Crawn's complaints of disabling pain in his back and joints
were not substantiated by the minimal to normal findings reported by the
treating and examining sources. See R. 135-36, 169-70, 215-16,
218-20. Crawn's treating physicians noted the
disparity in his alleged amount of pain and the lack of clinical
findings causing such pain; they further found no underlying cause for
his back pain. (R. 136, 170, 172, 176, 287). Judge Katz wrote, "The
claimant's subjective complaints are not folly corroborated by the
objective medical evidence, are somewhat consistent with the record, and
are inconsistent with disability." (R. 15). Based upon the overall
record, this Court finds substantial evidence supporting Judge Katz'
conclusion that the subjective evidence proffered by the claimant does
not establish his disability.
4. The Claimant's Education, Age, and Work Experience
Drawing near the conclusion of the fifth step, Judge Katz determined
that other work in the national economy existed that Crawn could perform
despite his limitations, using such vocational factors as age, education,
and work experience. (R. 16). The Social Security Administration created
the Medical-Vocational Guidelines to serve as an objective standardized
basis for decision making. Where vocational factors and "residual
functional capacity" coincide with all the criteria of a particular rule,
it is dispositive on the issue of disability. The ALJ correctly utilized
the administrative guidelines to determine Crawn's eligibility looking to
rules 202.11 and 202.18 set forth at 20 C.F.R. Part 404, Subpart P,
Appendix 2, and Regulation No. 4. Given Crawn's age, education, work
experience and ability to perform light work, the guidelines support a
finding that Crawn was not considered disabled. See Heckler v.
Campbell, 461 U.S. 458 (1983).
In the sequential series of questions that the ALJ must use to
determine a claimant's eligibility for SSDI when examining the fifth
step, which considers other work the claimant may perform, the ALJ
considers four points: the objective medical facts; the
medical opinions of the examining or treating physicians; the
subjective evidence of the claimant's symptoms and the claimant's
educational background, age, and work experience. This Court has reviewed
each of these points independently, as did the ALJ, looking at both the
positive and negative evidence in the record supporting the ALJ's
conclusions. In doing so, this Court finds substantial evidence to
support each of the ALJ's conclusions. Additionally, this Court has
considered these points in aggregate and concluded that a reasonable mind
could find, as did Judge Katz, that the record contains adequate relevant
evidence to support the determination of the ALJ.
The Commissioner's determination that Jerry L. Crawn Sr. is not
disabled pursuant to the Social Security Administration Act is free of
legal error and supported by substantial evidence, as set forth above.
Accordingly, defendant's motion for judgment on the pleadings is granted,
and the Commissioner's determination is affirmed.