Opinion
03 Civ. 2315 (SHS), 89884
March 30, 2004
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. 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). 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).
References to "(R.___)" are to pages of the administrative record of proceedings filed by the Commissioner as part of her answer in this action.
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" 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. (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, 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).
Diverticulitis is the inflammation of the diverticular mucosa and may be accompanied by pain, tenderness, and fever. The Merck Manual of Diagnosis and Therapy 318-19 (17th ed 1999). ("Merck's")
Diverticulosis is a condition in which multiple diverticula develop in the colon. (Merck's at 318.)
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. 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). 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 causedminimal 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. 216-17).
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." (R. 216).
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).
DISCUSSION 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 Substantial Evidence
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.") (citingFigueroa 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 Evidence
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 (4) the 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, 176).
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. 216-17).
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 facts.
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.
CONCLUSION
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.
SO ORDERED.