United States District Court, W.D. New York
DECISION & ORDER
MARIAN W. PAYSON, Magistrate Judge.
Plaintiff Dennis Harrington ("Harrington") brings this action pursuant to Section 205(g) of the Social Security Act (the "Act"), 42 U.S.C. § 405(g), seeking judicial review of a final decision of the Commissioner of Social Security (the "Commissioner") denying his application for Disability Insurance Benefits ("DIB"). Pursuant to 28 U.S.C. § 636(c), the parties have consented to the disposition of this case by a United States magistrate judge. (Docket # 8).
Currently before the Court are the parties' motions for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure. (Docket ## 7, 10). For the reasons set forth below, this Court finds that the decision of the Commissioner is supported by substantial evidence in the record and is in accordance with applicable legal standards. Accordingly, the Commissioner's motion for judgment on the pleadings is granted, and Harrington's motion for judgment on the pleadings is denied.
I. Procedural Background
Harrington applied for DIB on March 23, 2011, alleging disability beginning on December 31, 2010, due to diabetes, arthritis, right hip replacement, high cholesterol and high blood pressure. (Tr. 60, 123, 150, 153). On May 10, 2011, the Social Security Administration denied Harrington's claim for benefits, finding that he was not disabled. (Tr. 71-74). Harrington requested and was granted a hearing before Administrative Law Judge Brian Kane (the "ALJ"). (Tr. 79, 87-91). The ALJ conducted a hearing on June 27, 2011 in Rochester, New York. (Tr. 27-61). Harrington was represented at the hearing by his attorney Gregory Phillips, Esq. (Tr. 27, 69). In a decision dated September 26, 2012, the ALJ found that Harrington was not disabled and was not entitled to benefits. (Tr. 12-23).
On December 11, 2013, the Appeals Council denied Harrington's request for review of the ALJ's decision. (Tr. 1-5). Harrington commenced this action on January 30, 2014, seeking review of the Commissioner's decision. (Docket # 1).
II. Relevant Medical Evidence
A. Treatment Records
1. Darren Tabechian, MD
Treatment records indicate that Harrington began treatment for his rheumatoid arthritis with Darren Tabechian ("Tabechian"), MD and the Allergy/Immunology/Rheumatology Clinical Group and University of Rochester Medical Center ("URMC") in March 2005. (Tr. 210). Prior to that time, Harrington had treated with at least two other doctors, but had not been at the URMC clinic in several years. (Id. ). After an examination, Tabechian indicated that Harrington's arthritis was "well controlled" by his medication regimen, which included Methotrexate and Remicade. (Id. ). In July 2005, Harrington reported to Tabechian that he was not having any joint symptoms and wanted to explore reducing the frequency of his Remicade infusions. (Tr. 208). Tabechian planned to reduce the frequency of Harrington's Remicade infusions and also decreased his Methotrexate dose from ten to five milligrams. (Id. ).
In April 2006, Harrington returned to the clinic complaining of a "trigger finger at the right thumb." (Tr. 204). Harrington reported that his symptoms in general had "been going much better for him, " although Tabechian noted that Harrington had not had lab work done as instructed. (Id. ). According to Harrington, he experienced no morning stiffness and "is enjoying a regular way of life." (Id. ). Upon examination, Tabechian noted a nodule in Harrington's hand and treated it by injecting ten milligrams of Depo-Medrol. (Id. ).
In September 2006, Harrington had an appointment with Tabechian and reported that he was doing well. (Tr. 202). Harrington complained of recurrent triggering and limited range of motion in his right hand and indicated that he experienced some pain in his ankles and knees after refereeing soccer matches, an activity that he had recently recommenced. (Id. ). Upon examination, Tabechian observed tenderness in Harrington's right thumb, but did not detect any effusion in his knees or ankles and indicated that the examination was otherwise normal. (Id. ). Tabechian recommended an analgesic and ice for exercise-related joint pain and referred Harrington to a surgeon to assess surgical options for the ongoing stenosis in his right thumb. (Id. ).
During the same visit, imaging was conducted on Harrington's ankles, feet, knees and hands in order to assess the progression of his rheumatoid arthritis. (Tr. 212-29). The images were compared to radiographs taken on October 31, 2003. (Id. ). Vanessa Zayas-Colon ("Zayas-Colon"), MD, opined that the images of Harrington's hands and feet showed "stable appearance" cystic or erosive changes and that his ankles and knees demonstrated no evidence of new erosive changes. (Id. ). Zayas-Colon's overall impression was stable appearance bilateral sequelae of remote MCL injury with no erosive changes identified and stable diffuse bilateral osteopenia. (Tr. 214).
In December 2006, Harrington returned to the clinic for evaluation of his arthritis. (Tr. 200). Harrington reported general improvement in his symptoms. (Id. ). According to Harrington, surgery for his trigger finger was successful, and although he was experiencing some transient joint symptoms, he reported that he was generally feeling well and looking forward to retirement. (Id. ). Upon examination, Tabechian noted strong grip strength and normal hips and knees, although he noted some pain with left lateral rotation of the neck. (Id. ). Tabechian opined that Harrington's arthritis was well-controlled with his current medication regimen. (Id. ).
In November 2008, Harrington returned to the clinic for continued evaluation of his arthritis. (Tr. 198). He reported that although he occasionally experienced joint pain or swelling lasting approximately a day, he generally continued to do well. (Id. ). After an examination in which Tabechian noted strong grip strength, no knee tenderness and a contracture of the left elbow at 170 degrees, Tabechian opined that Harrington's arthritis was stable on his current regimen. (Id. ).
Approximately five months later, in April 2009, Harrington attended a follow-up appointment with Tabechian. (Tr. 196). During the appointment, Harrington complained of increased pain in his right hip that caused him to stop refereeing soccer games. (Id. ). Tabechian noted that Harrington had undergone a total hip arthroplasty in 2003 and recommended that he follow up with his arthroplasty physician to determine whether his pain could be alleviated. (Id. ). Upon examination, Tabechian noted that Harrington's grip strength was strong and that he had no deformity in his hands or wrists. (Id. ). Further, his gait was not antalgic during the appointment. (Id. ). Tabechian opined that Harrington's arthritis was stable and recommended imaging to confirm his impression that the arthritis had not progressed. (Id. ).
Harrington did not return to the clinic until November 2010, approximately one and a half years later. (Tr. 194). During the visit he reported that his symptoms had been generally stable, although he had experienced right thigh pain for which he received treatment from Dr. Drinkwater. (Id. ). With respect to his arthritis, Harrington reported some "left lateral epicondylar discomfort on a mechanical basis, " but no other arthritis-related symptoms. (Id. ). Tabechian's impression was that the arthritis was adequately controlled, and he considered ordering the Remicade infusions for every ten weeks instead of every eight weeks. (Id. ).
On May 25, 2011, Harrington returned to Tabechian for an assessment of his arthritis. (Tr. 306). Harrington reported that he experienced some crepitus from his prosthetic hip, but that he did not experience significant discomfort and was generally doing well. (Id. ). He experienced no significant morning stiffness, but reported that he did not believe he could meet the duties of his previous employment with the state, although he was working part-time as a security guard. (Id. ). Upon examination, Tabechian noted that he appeared "well without significant deformity of his hands, wrists or elbows" and that he walked with a normal gait. (Id. ). Tabechian recommended that Harrington continue with his current medication regimen. (Id. ).
That same day, images were taken of Harrington's wrists, hands and feet. (Tr. 296-305). The radiologist, Steven Weiss ("Weiss"), observed "subtle radiolucent/erosive changes within multiple carpal bones" of Harrington's wrists, but observed that there was no significant change from the images taken in 2006. (Tr. 296-99). With respect to Harrington's feet, Weiss observed erosive changes in the base of the first proximal phalanx on both feet and mild superimposed osteoarthritic degenerative change at the first MTP joint of the left foot, but noted that bone mineralization was within normal limits for the right foot and slightly decreased for the left foot and that there had not been any significant interval change since the images were taken in 2006. (Tr. 300-03). The images of Harrington's hands, according to Weiss, demonstrated radiolucent/erosive osseous changes in both hands, although bone mineralization was within normal limits and there had been no significant interval change since the images were taken of Harrington's hands in 2006. (Tr. 304-05).
In December 2011, Harrington returned to the clinic for a follow-up appointment with Tabechian. (Tr. 294). Tabechian noted that historically Harrington had suffered arthritis-related pain in his ankles, hands and knees. (Id. ). Harrington reported experiencing increasing pain in his hands at the MCP joints causing a loss of endurance for prolonged work activity. (Id. ). Harrington also complained of episodes of low back pain that he associated with his ongoing, chronic hip problems. (Id. ). Harrington reported hearing grinding or crepitus in his right hip. (Id. ). Tabechian noted that Harrington's increased arthritic-symptoms were "interestingly" not occurring in all of the joints that historically had been symptomatic and that the symptoms appeared to be fluctuating with the Remicade infusions. (Id. ). Tabechian recommended increasing Harrington's Methotrexate dose to determine whether that alleviated his symptoms. (Id. ).
On February 29, 2012, Harrington attended a follow-up appointment with Tabechian. (Tr. 292). During the appointment, Harrington reported that the increased Methotrexate had reduced his stiffness and that he was feeling better. (Id. ). Harrington complained that he had begun to experience a loss of grip strength in his hands that had begun the previous year. (Id. ). According to Harrington, the loss of strength was particularly evident when he gripped the clutch while riding his motorcycle. (Id. ). Harrington also complained of some pain in his femur and hip. (Id. ). Upon examination, Tabechian noted some degenerative changes of the DIP joints and a somewhat reduced grip strength. (Id. ). Tabechian opined that the arthritis remained adequately controlled and suspected that the hand symptoms were likely due to chronic damage, as opposed to inflammatory activity. (Id. ). Tabechian recommended continuing with the current medication regimen. (Id. ).
Harrington returned to the clinic for an appointment with Tabechian on July 18, 2012. (Tr. 323). During the appointment, Harrington reported that he continued to experience numbness in his hands when riding his motorcycle and holding the clutch or brake. (Id. ). He also reported that his morning stiffness lasted approximately sixty minutes, which Tabechian noted was "much less severe than it had been years ago." (Id. ). According to Tabechian, Harrington's inflammatory symptoms were milder than they had been and Harrington appeared to be experiencing symptoms due to degeneration, rather than inflammation. (Id. ). Harrington reported that he was unable to work and had attempted to assist his brother with farmwork, but was unsuccessful because of joint discomfort and weakness. (Id. ).
2. Christopher Drinkwater, MD
Harrington was referred to Christopher Drinkwater ("Drinkwater"), MD, of the URMC Orthopaedics Department for evaluation of right hip pain. (Tr. 234-35). Treatment notes from his visit with Drinkwater on August 25, 2009 indicate that Harrington had undergone a complete arthroplasty in 2003. (Id. ). Harrington complained of intermittent right thigh pain that resulted in episodes of instability. (Id. ). According to Harrington, during the last episode, the pain lasted approximately three weeks at a level of about five out of ten. (Id. ). Harrington reported that walking and climbing stairs were aggravating activities. (Id. ). Upon examination, Harrington demonstrated painless internal and external rotation, painless axial load and neurovascularly, and his right leg was intact. (Id. ). According to Drinkwater, images of Harrington's hip revealed satisfactory alignment and a well-fixed prosthesis, although pedestal bone formation was present. (Id. ). Drinkwater opined that the intermittent thigh pain was due to the right hip prosthesis and that Harrington should undergo imaging every two years to monitor the prosthesis. (Id. ).
Harrington attended a follow-up appointment with Drinkwater on February 9, 2010. (Tr. 232-34). During the appointment, Harrington indicated that he continued to work for the Department of Corrections, but indicated that he was contemplating retiring and "possibly going onto Social Security." (Id. ). Harrington informed Drinkwater that he may need paperwork completed. (Id. ). Harrington continued to complain of intermittent thigh pain and stiffness. (Id. ). Drinkwater reviewed images taken of Harrington's right hip and opined that the images remained satisfactory with some mild sclerotic line around the body of the femoral stem and some mild heterotopic ossification. (Tr. 232, 238). Otherwise, according to Drinkwater, there were no abnormalities. (Id. ). Drinkwater opined that he expected Harrington to experience some residual symptoms and noted that Harrington should be re-evaluated every two years. (Id. ).
Harrington had another appointment with Drinkwater on March 29, 2011. (Tr. 230). On that day, images were taken of Harrington's right hip. (Tr. 236). According to Drinkwater, the images demonstrated that Harrington's prosthesis was in a stable position with no obvious sign of destruction of the articulation. (Tr. 230). The radiologist who reviewed the images opined that they were unchanged from Harrington's previous x-rays. (Tr. 236). Harrington reported that he was experiencing grating and clunking in his right hip with associated mild thigh pain. (Tr. 230). Upon examination, Harrington was able to walk without a limp, had full range of motion and had no distal neurovascular loss. (Id. ). According to Drinkwater, there was no tenderness and no audible or palpable clunking or grating. (Id. ). A Trendelenburg test was negative. (Id. ). Drinkwater advised that Harrington's experiences were normal and that he should contact Drinkwater if the symptoms became aggravated. (Id. ).
On March 6, 2012, Harrington attended a routine follow-up appointment with Drinkwater. (Tr. 308). Harrington reported that he continued to experience intermittent noises, grating and thigh pain, although he reported that he was managing fairly well and that the noises and grating had not increased since his last visit. (Id. ). Drinkwater's examination produced the same results as the last examination with no limp, tenderness, distal nerve loss or audible or palpable clunking or grating. (Id. ). Again, the Trendelenburgh test was negative. (Id. ). According to Drinkwater, Harrington's x-rays remained satisfactory with no evidence of complications. (Id. ). Drinkwater opined ...