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CRAWN v. BARNHART

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. Page 2

BACKGROUND

 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 Administration's "heavy" Page 3 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, 2000

  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, Page 4 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 Page 5 tests and a non-tender, soft, benign abdomen. (R. 202-05). An esophagogastro-duodenscopy and biopsy did reveal mild gastritis. (R. 213-14).

  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. 198).

  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). Page 6 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 ...


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