Opinion
5:20-CV-00071-D
01-13-2022
Donna Macklin Ward, Plaintiff, v. Kilolo Kijakazi, Acting Commissioner of Social Security, Defendant.
MEMORANDUM & RECOMMENDATION
Robert T. Numbers, II United States Magistrate Judge.
Plaintiff Donna Macklin Ward challenges Administrative Law Judge (“ALJ”) Mason Hogan's denial of her application for social security income. Ward claims that ALJ Hogan erred in (1) determining her residual functional capacity RFC and (2) evaluating her subjective statements. Both Ward and Defendant Kilolo Kijakazi, Acting Commissioner of Social Security, have moved for a judgment on the pleadings in their favor. D.E. 22, 25.
After reviewing the parties' arguments, the undersigned concludes that ALJ Hogan reached the appropriate determination. Substantial evidence supports ALJ Hogan's RFC determination that Ward can perform a reduced range of light work. And the undersigned finds that ALJ Hogan explained how Ward's subjective statements differed from the record. So the undersigned recommends that the court deny Ward's motion, grant Kijakazi's motion, and affirm the Acting Commissioner's determination.
The court has referred this matter to the undersigned for entry of a Memorandum and Recommendation. 28 U.S.C. § 636(b).
I. Background
In August 2016, Ward applied for disability benefits and supplemental security income. In both applications, she alleged a disability that began three months earlier. After the Social Security Administration denied her claim at the initial level and upon reconsideration, Ward appeared before ALJ Hogan for a hearing to determine whether she was entitled to benefits. ALJ Hogan determined that Ward had no right to benefits because she was not disabled. Tr. at 22-38.
ALJ Hogan found that Ward's degenerative disc disease, left rotator cuff tendonitis with AC joint osteoarthritis, right knee meniscus tear with chondromalacia and patellofemoral syndrome, status post surgical arthropathy and repair, hip bursitis, depression, and anxiety were severe impairments. Tr. at 25. ALJ Hogan also found that Ward's impairments, either alone or in combination, did not meet or equal a Listing impairment. Tr. at 26.
ALJ Hogan then determined that Ward had the residual functional capacity to perform light work with other limitations. Tr. at 28. She can occasionally climb ramps and stairs but she cannot climb ladders, ropes, or scaffolds. Id. Ward can occasionally balance, stoop, kneel, crouch, and crawl, and she can occasionally reach with her non-dominant upper extremity. Id.
Ward must avoid concentrated exposure to fumes, odors, dust, gases, and poor ventilation. Id. She must also avoid exposure to hazards such as unprotected heights and dangerous machinery. Id.
Ward can understand, remember, and carry out simple instructions, defined as activity consistent with reasoning level of two or three under the Dictionary of Occupational Titles (DOT). Id. She can sustain attention, concentration, and pace sufficient to carry out those simple instructions over the course of an eight-hour workday in two-hour intervals. Id. Ward can work in proximity to, but not in coordination with, coworkers and supervisors. Id. She can work in a low- stress setting, defined as no fast-paced production, with only simple work-related decisions, few or no changes in the work setting, only superficial contact with the public, and no dealings with emergent situations as an essential function of the job. Id.
ALJ Hogan concluded that Ward could not perform her past work as a mail carrier. Tr. at 35. But considering her age, education, work experience, and RFC, ALJ Hogan found that jobs existed in significant numbers in the national economy that Ward could perform. Tr. at 36. These include mail clerk, garment sorter, and x-ray inspector. Id. Thus, ALJ Hogan found that Ward was not disabled. Tr. at 37.
After unsuccessfully seeking review by the Appeals Council, Ward began this action in February 2020. D.E. 5.
II. Analysis
A. Standard for Review of the Commissioner's Final Decision
When a social security claimant appeals a final decision of the Commissioner, the district court's review is limited to determining whether, based on the entire administrative record, there is substantial evidence to support the Commissioner's findings. 42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389, 401 (1971). Substantial evidence is defined as “evidence which a reasoning mind would accept as sufficient to support a particular conclusion.” Shively v. Heckler, 739 F.2d 987, 989 (4th Cir. 1984) (quoting Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966)). The court must affirm the Commissioner's decision if it is supported by substantial evidence. Smith v. Chater, 99 F.3d 635, 638 (4th Cir. 1996).
B. Standard for Evaluating Disability
In making a disability determination, the ALJ engages in a five-step evaluation process. 20 C.F.R. § 404.1520; see Johnson v. Barnhart, 434 F.3d 650 (4th Cir. 2005). The ALJ must consider the factors in order. At step one, if the claimant is engaged in substantial gainful activity, the claim is denied. At step two, the claim is denied if the claimant does not have a severe impairment or combination of impairments significantly limiting him or her from performing basic work activities. At step three, the claimant's impairment is compared to those in the Listing of Impairments. See 20 C.F.R. Part 404, Subpart P, App. 1. If the impairment is listed in the Listing of Impairments or if it is equivalent to a listed impairment, disability is presumed. But if the claimant's impairment does not meet or equal a listed impairment, the ALJ assesses the claimant's RFC to determine, at step four, whether he can perform his past work despite his impairments. If the claimant cannot perform past relevant work, the analysis moves on to step five: establishing whether the claimant, based on his age, work experience, and RFC can perform other substantial gainful work. The burden of proof is on the claimant for the first four steps of this inquiry but shifts to the Commissioner at the fifth step. Pass v. Chater, 65 F.3d 1200, 1203 (4th Cir. 1995).
C. Medical Background
Ward has a history of physical impairments. In May 2016, an x-ray of her spine showed degenerative changes with no fracture or abnormal soft tissue detected. Tr. at 29.
The next month, Ward saw Dr. William Hage at EmergeOrtho for her shoulder pain. Tr. at 30. Her left shoulder was tender with positive Hawkin's and Neer's impingement signs. Id.
Dr. Hage assessed left shoulder rotator cuff tendonitis and AC joint distal clavicle osteolysis. Id. An x-ray of Ward's left shoulder revealed osteolysis of the distal clavicle and acromion but no glenohumeral arthritis. Id. Dr. Hage restricted Ward to lifting no more than ten pounds with her left upper extremity for the next six weeks.
Further examination revealed slightly reduced rotator cuff strength, with no neck swelling or evidence of back trauma. Id. Dr. Hage administered an injection and instructed Ward to use a nonsteroidal anti-inflammatory medication and perform home exercises. Id.
In June 2016, Ward underwent an MRI which showed a medial meniscus tear, lateral meniscus degeneration, patellofemoral friction syndrome, and chondromalacia in her right knee. Tr. at 29.
One month later, x-rays disclosed partial sacralization and mild to moderate degenerative disc disease in Ward's lumbar spine. Tr. at 29. Ward returned to EmergeOrtho complaining of neck and low back pain. Tr. at 30. She displayed tenderness and a decreased range of motion in her neck. Id. An examination showed a symmetric gait, painless range of motion in her extremities, and negative straight leg raise testing. Id. Providers assessed degenerative disc disease in her cervical and lumbar spines. Id. They recommended that she continue her pain medications, use ice, and perform activities as tolerated. Id. She declined a referral for physical therapy. Id.
In May 2017, Ward received an injection for her left shoulder rotator cuff tendonitis and AC joint arthritis. Id. Dr. Richard Alioto noted that the injection provided “excellent relief” to Ward's symptoms. Id.
Dr. Enrique Galang examined Ward in July 2017 for complaints of low back pain. Tr. at 31. An examination showed no tenderness, a range of motion within functional limits, normal gait, and negative straight leg raise tests. Id. Dr. Galang prescribed medication and recommended physical therapy, and directed Ward to follow-up as needed. Id.
In September 2017, Dr. Alioto performed arthroscopic surgery on Ward's right knee with medial meniscectomy and patellofemoral chondroplasy. Tr. at 30. Two months later, Ward received an injection for bilateral trochanteric and sacroiliac joint pain. Id.
A January 2018 post-surgical visit noted that physical therapy had improved her strength and range of motion in her right knee. Id. Ward had no swelling and her pain had improved significantly, so she no longer needed pain medication. Id. Providers advised Ward to work on her right knee range of motion and continue home exercises. Id.
Later that month, a lumbar spine MRI showed multilevel degenerative changes with a disc protrusion and moderate neuroforaminal narrowing. Tr. at 30. Two months later, an examination showed a normal gait and full range of motion in all extremities. Tr. at 31.
Several professionals offered opinions on Ward's physical functioning. In October 2016, state agency physician Dr. Dakota Cox found that Ward could perform light work with postural, manipulative, and environmental limitations. Tr. at 33. Two months later, Dr. Melvin Clayton, another state agency physician, noted Ward's shoulder and back conditions were severe impairments. Id. He opined she could perform work at the medium exertional level. Id.
In May 2017, Dr. Chawki Lahoud, a treating provider, concluded that Ward could stand for 30 minutes, up to two hours a day, sit for 60 minutes, up to two hours per day, lift no more than five pounds, and work two hours per day. Id. Dr. Lahoud also found that Ward had postural, manipulative, and environmental restrictions. Id.
Ward also has a history of depression and anxiety. Tr. at 31. In July 2016, providers noted that she was alert and oriented with a normal affect. Id. One year later, Ward reported her history of anxiety and depression, and stated that she worried constantly. Id. Based on these reports, providers assessed depression. Tr. at 32. Examinations found that Ward was alert, oriented, and had linear thoughts and an affect within normal limits. Id. Ward reported that medications improved her mood when she started them, but were no longer working as well. Tr. at 500. So providers increased her dosage. Id.
In January 2018, providers performed a behavioral health assessment. Tr. at 32. Ward reported a history of depression with “losing control” being her main complaint for which she sought assistance with coping. Id. She stated she had anxiety when driving or dealing with others. Id. Other symptoms included difficulty concentrating, feelings of hopelessness and worthlessness, and trouble sleeping. Id.
Ward had a depressed mood, but normal speech, intact memory, and a normal thought process. Id. She was calm, cooperative, and oriented. Id. Providers assessed recurrent major depressive disorder and recommended medication and therapy. Id.
Two months later, her symptoms were improving, and she reported more good days since starting Effexor. Id. Providers recommended that Ward continue therapy and medications. Id.
Ward's husband provided a Third Party Function Report. Tr. at 34. He reported that Ward was independent in personal care, although she needed help showering and dressing because of her shoulder impairment. Id. Ward could prepare simple meals, drive, shop, handle finances, watch television, and do laundry, with some assistance. Tr. at 34-35.
Ward testified that she has a college degree. Tr. at 28. She is separated, and her daughter lives with her. Id. Ward worked as a mail carrier for 18 years but stopped working because of her medical conditions. Id.
Ward has treated her conditions with physical therapy, injections, and medications, which cause drowsiness. Tr. at 29. She described her left shoulder pain as excruciating, and planned to undergo surgery to repair her torn rotator cuff. Id. Ward underwent right knee arthroscopy, followed by physical therapy and home exercises. Id. She estimated that she could sit and stand for 30 minutes, lift five to ten pounds, and walk one city block in 25 minutes. Id.
Ward also testified that her depression and anxiety result in panic attacks and feeling overwhelmed. Id. Her symptoms include stress, agitation, worry, becoming nervous when going out in public, and sleeping three to four hours per night. Id. Ward sees a therapist and takes medication for her mental impairments. Id.
D. Residual Functional Capacity
Ward contends that ALJ Hogan erred in determining his RFC by failing to explain the limitations he assessed. The Acting Commissioner asserts that the evidence supports a finding that Ward can perform light work with other limitations. The undersigned finds that substantial evidence supports ALJ Hogan's RFC determination.
The RFC is a determination, based on all the relevant medical and non-medical evidence, of what a claimant can still do despite her impairments; the assessment of a claimant's RFC is the responsibility of the ALJ. See 20 C.F.R. §§ 404.1520, 404.1545, 404.1546; Social Security Ruling (“SSR”) 96-8p, 1996 WL 374184, at *2. If more than one impairment is present, the ALJ must consider all medically determinable impairments, including medically determinable impairments that are not “severe, ” when determining the claimant's RFC. Id. §§ 404.1545(a), 416.945(a). The ALJ must also consider the combined effect of all impairments without regard to whether any such impairment, if considered separately, would be of sufficient severity. Id. § 404.1523; see Walker v. Bowen, 889 F.2d 47, 50 (4th Cir. 1989) (“[I]n evaluating the effect[] of various impairments upon a disability benefit claimant, the [Commissioner] must consider the combined effect of a claimant's impairments and not fragmentize them.”).
The ALJ must provide “findings and determinations sufficiently articulated to permit meaningful judicial review.” DeLoatche v. Heckler, 715 F.2d 148, 150 (4th Cir. 1983); see also Wyatt v. Bowen, 887 F.2d 1082, 1989 WL 117940, at *4 (4th Cir. 1989) (per curiam). The ALJ's RFC determination “must include a narrative discussion describing how the evidence supports each conclusion, citing specific medical facts (e.g. laboratory findings) and nonmedical evidence (e.g. daily activities, observations).” Mascio v. Colvin, 780 F.3d 632, 636 (4th Cir. 2015) (quoting SSR 96-8p). Furthermore, “[t]he record should include a discussion of which evidence the ALJ found credible and why, and specific application of the pertinent legal requirements to the record evidence.” Radford v. Colvin, 734 F.2d 288, 295 (4th Cir. 2013). Fourth Circuit precedent “makes it clear that it is not [the court's] role to speculate as to how the ALJ applied the law to [her] findings or to hypothesize the ALJ's justifications that would perhaps find support in the record. Fox v. Colvin, 632 Fed.Appx. 750, 755 (4th Cir. 2015).
Social Security Ruling 96-8p explains how adjudicators should assess residual functional capacity. The Ruling instructs that the residual functional capacity “assessment must first identify the individual's functional limitations or restrictions and assess his or her work-related abilities on a function-by-function basis, including the functions” listed in the regulations. “Only after that may [residual functional capacity] be expressed in terms of the exertional levels of work, sedentary, light, medium, heavy, and very heavy.” SSR 96-8p. The Ruling further explains that the residual functional capacity “assessment must include a narrative discussion describing how the evidence supports each conclusion, citing specific medical facts (e.g., laboratory findings) and nonmedical evidence (e.g., daily activities, observations).” Id.
There is no “per se rule requiring remand when the ALJ does not perform an explicit function-by-function analysis[.]” Mascio, 780 F.3d at 636. But “[r]emand may be appropriate . . . where an ALJ fails to assess a claimant's capacity to perform relevant functions, despite contradictory evidence in the record, or where other inadequacies in the ALJ's analysis frustrate meaningful review.” Id. (quoting Cichocki v. Astrue, 729 F.3d 172, 177 (2d Cir. 2013)). The function-by-function requirement can be satisfied by reference to a properly conducted analysis by a state agency consultant. See, e.g., Linares v. Colvin, No. 5:14-CV-00129, 2015 WL 4389533, at *3 (W.D. N.C. July 17, 2015) (“Because the ALJ based his RFC finding, in part, on the function-by-function analysis of the State agency consultant, the ALJ's function-by-function analysis complied with [Soc. Sec. Ruling] 96-8p.” (citing Lemken v. Astrue, No. 5:07-CV-33-RLV-DCK, 2010 WL 5057130, at *8 (W.D. N.C. July 26, 2010))).
ALJ Hogan determined that Ward could perform light work with postural, manipulative, environmental, and nonexertional limitations. Tr. at 28. But Ward asserts that ALJ Hogan failed to conduct a function-by-function analysis or explain how the evidence supports his conclusions. She also contends that the RFC fails to address her restrictions in standing and walking as well as those arising from the side effects of her medications. Despite Ward's claims, the undersigned finds that substantial evidence supports ALJ Hogan's RFC determination.
As noted above, Mascio does not create a per se rule requiring remand where an ALJ does not perform an explicit function-by-function analysis. 780 F.3d at 636. But an ALJ must assess a plaintiff's relevant functions where the record offers contradictory evidence. Id. A review of ALJ Hogan's decision discloses a sufficient basis for his conclusions and establishes how the evidence supports his findings.
1. Neck, Shoulder, Back Impairments
Ward contends that ALJ Hogan failed to explain how the evidence showed she can perform a reduced range of light work. She argues that the record shows that pain in her neck, shoulder, and back result in greater limitations that the RFC identifies. For example, that an MRI revealed multilevel disc changes in her lumbar spine, with disc protrusion contacting the nerve root. This condition led to radiculopathy and required an injection. And Ward reported that activity exacerbated her back pain.
ALJ Hogan noted Ward's left rotator cuff tendonitis and AC joint osteoarthritis. An examination revealed tenderness and positive Hawkin's and Neer's impingement signs, but also showed almost full strength. Providers recommended only anti-inflammatory medication and home exercises to strengthen her shoulder. And Ward reported an injection provided “excellent relief” of her symptoms.
ALJ Hogan also reviewed evidence about Ward's back impairment. He remarked that MRIs in 2017 showed mild to moderate degenerative changes. The next year, imaging showed multilevel degenerative changes with disc protrusion and moderate neuroforaminal narrowing.
When examining her for back pain in July 2016, providers found tenderness and reduced range of motion in her neck. But Ward retained full strength, normal gait, and full range of motion in her extremities, with negative straight leg raise tests. Providers treated this condition conservatively, recommending that Ward apply ice, engage in home exercises, and perform activities as tolerated. And Ward declined an offer for physical therapy.
Although Ward again complained of back pain the next year, an examination found no tenderness and a normal gait, functional range of motion, and negative results on straight leg raise testing. Providers recommended medication and physical therapy.
ALJ Hogan's decision showed that he thoroughly considered the evidence. Although Ward alleged significant neck, back, and shoulder symptoms, the objective evidence did not support the severity Ward claimed. Testing showed mild to moderate finings, examinations revealed few significant indices, and treatment-with medication, physical therapy, and injections-was conservative.
As ALJ Hogan stated, the RFC determination accommodates these conditions by limiting her to light work with restrictions on postural and manipulative demands and environmental exposure. So the undersigned finds that ALJ Hogan properly examined the evidence and explained how it supported his RFC determination as it relates to Ward's neck, back, and shoulder impairments. The court should thus reject Ward's claim on this issue.
2. Hip, Knee, and Low Extremity Impairments
Ward also challenges the RFC determination asserting she cannot perform the standing and walking demands correlated with light work. Ward claims that ALJ Hogan overlooked evidence of her radiculopathy, which causes leg pain that affects her daily activities. She points out that the record noted she displayed a slow gait. And Ward testified that it would take her 25 minutes to walk one block.
Light work generally involves standing or walking for six hours in an eight-hour workday. See SSR 83-10.
ALJ Ward noted that a June 2017 MRI showed a meniscus tear, degeneration, patellofemoral friction syndrome, and chondromalacia in Ward's right knee. Ward underwent arthroscopic surgery three months later. And she received an injection for hip and sacroiliac pain.
Following her surgery, physical therapy improved Ward's strength. Her pain symptoms improved so significantly that she no longer needed pain medication. Providers observed that Ward progressed well after surgery, with no swelling and normal gait, strength, and range of motion. They advised Ward to continue her home exercise program.
Again, the evidence shows that Ward's hip, knee, and lower extremity conditions are not as disabling as she claims. The RFC accommodates these conditions by limiting her to light work with postural and environmental limitations. Ward has not shown that these conditions present greater limitation that the RFC determined. So the undersigned recommends that the court deny her claim on this issue.
3. Nonexertional Impairments
Ward also maintains that the RFC determination fails to address her mental limitations, including fatigue, a side effect of her medications. And she asserts that ALJ Hogan failed to explain how the evidence supports his finding that she can maintain attention and concentration for two-hour intervals.
In support of her claim, Ward contends that she has trouble concentrating and completing tasks. She reported that while she had some initial improvement in depressive symptoms with medication, a year later it was not working as well and she had more stress.
The next year, Ward reported difficulty concentrating, needing help coping, losing control, and trouble sleeping. A mental status examination found she was calm, cooperative, and oriented, with normal speech and thought content and intact memory. But providers also noted anhedonia, depressed mood, difficulty concentrating, and impaired sleep.
Two months later, medications had improved Ward's symptoms, and she had no serious mental functioning abnormalities. Yet Ward still experienced stress, anxiety, and poor sleep.
Addressing her nonexertional impairments, ALJ Hogan determined that Ward could understand, remember, and carry out simple instructions, and sustain attention, concentration, and pace sufficient to carry out those simple instructions in two-hour intervals. Tr. at 28. Ward can have limited interactions with coworkers and supervisors and superficial contact with the public. Id. She requires a low-stress setting with simple, work-related decisions, few changes, and no dealings with emergent situations as an essential function of the job. Id. ALJ Hogan remarked that Ward's depression and anxiety support the nonexertional limitations in the RFC determination. Tr. at 32.
ALJ Hogan discussed the evidence of Ward's mental health conditions. He acknowledged her drowsiness from medication and difficulty sleeping. But ALJ Hogan pointed out that from 2016 through 2018, treatment records showed several unremarkable findings, such as being alert, oriented, and cooperative, with a normal affect, normal thought process, and intact memory and judgment. And in March 2018, Ward reported improvement in her symptoms with medication.
In limiting Ward to performing her work in two-hour interval, it appears that ALJ Hogan gave her the benefit of the doubt about trouble she experienced in maintaining attention and concentration. So even though there were many normal findings upon mental status examination, he assessed restrictions on her work pace, skill level, interactions, and stress level.
Ward incorrectly frames her position by arguing that ALJ Hogan did not establish that she could maintain attention and concentration for two-hour intervals. As Kijakazi notes, Ward bears the burden of showing she cannot function within the parameters of the RFC.
And the two-hour interval is an assessment of mental abilities needed for any job. See Program Operations Manual (POMS) DI 25020.010, available at: https://secure.ssa.gov/poms.NSF/lnx/0425020010 (last visited Jan, 7, 2022) (mental abilities needed to understand, remember, and carry out simple instructions include “the ability to maintain concentration and attention for extended periods (the approximately 2-hour segments between arrival and first break, lunch, second break, and departure.))
In sum, despite her reports of trouble with concentration and attention, Ward remained alert and oriented, with no deficits in her thought process, insight, judgment, or memory. The record discloses no functional limitations caused by Ward's medications. No medical source opined that Ward's conditions caused nonexertional limitations. And Ward has not shown greater nonexertional limitations than the RFC assessed.
Finding no error in ALJ Hogan's RFC determination or his evaluation of Ward's mental health conditions, the undersigned recommends that the court affirm the Acting Commissioner as to the nonexertional limitations in the RFC.
E. Subjective Statements
Ward contends that ALJ Hogan erred in evaluating her statements about the intensity, persistence, or limiting effects of her impairments. Kijakazi posits that ALJ Hogan provided sufficient reasons why he declined to endorse all of Ward's statements about her functioning. The undersigned finds no error in ALJ Hogan's consideration of this evidence.
Under the regulations implementing the Social Security Act, an ALJ follows a two-step analysis when considering a claimant's subjective statements about impairments and symptoms. SSR 16-3p, 2017 WL 5180304 (Oct. 25, 2017); 20 C.F.R. §§ 404.1529(b)-(c), 416.929(b)-(c). First, the ALJ looks for objective medical evidence showing a condition that could reasonably produce the alleged symptoms, such as pain. Id. at *3, §§ 404.1529(b), 416.929(b). Second, the ALJ must evaluate the intensity, persistence, and limiting effects of the claimant's symptoms to determine how much they limit the claimant's ability to work. Id. §§ 404.1529(c), 416.929(c). In making that determination, the ALJ must “examine the entire case record, including the objective medical evidence; an individual's statements about the intensity, persistence, and limiting effects of symptoms; statements and other information provided by medical sources and other persons; and any other relevant evidence in the individual's case record.” Id.
The ALJ has full discretion to weigh the subjective statements with the objective medical evidence and other matters of record. Craig v. Chater, 76 F.3d 585, 595 (4th Cir. 1996) (holding that claimant's allegations of pain need not be accepted to extent that they conflict with the record). The ALJ may not discredit a claimant's subjective complaints just because the objective medical evidence does not confirm them. Id. at 595-96. But neither is the ALJ obligated to accept the claimant's statements at face value. Hawley v. Colvin, No. 5:12-CV-260-FL, 2013 WL 6184954, at *15 (E.D. N.C. Nov. 14, 2013). In a district court's review, the ALJ's findings are entitled to great weight because of the ALJ's ability to observe and evaluate testimony firsthand. Shively, 739 F.2d at 989-90.
ALJ Hogan declined to fully credit Ward's statements about her functioning. Tr. at 29. He observed that her statements conflicted with other evidence. Id. And ALJ Hogan's decision reveals where the evidence did not track Ward's statements.
Ward contends that ALJ Hogan should have accepted her statements about her pain symptoms. Noting that pain itself can be disabling, Ward claims that ALJ Hogan improperly relied on the objective medical evidence to discredit her statements about the intensity, persistence, and limiting effects of her impairments.
Ward argues that the record documents her pain symptoms. For example, Ward underwent knee surgery and her shoulder condition may require future surgical intervention. She continued to report shoulder, back and lower extremity pain despite various treatment modalities. And her pain limited Ward's activities, including her ability to stand and walk.
Substantial evidence supports ALJ Hogan's assessment. ALJ Hogan acknowledged Ward's symptoms, including her pain. But he noted that objective testing revealed mild to moderate findings, examinations were generally unremarkable, and her treatment was mostly conservative.
ALJ Hogan pointed out inconsistencies between Ward's claims and other evidence. Despite her shoulder, back, and lower extremity pain, examinations showed a full and painless range of motion in all extremities, normal gait, and negative straight leg raises. Ward recovered well from her knee surgery and no longer needed pain medication. And she declined a recommendation for physical therapy to address her back pain. So the overall record shows that Ward's conditions are not as limiting as she alleged.
Ward also claimed a limited ability to concentrate because of her depression and anxiety. ALJ Hogan again acknowledged her conditions and symptoms. Tr. at 31-32. But the record showed generally normal findings-being cooperative, alert, and oriented, with a normal affect, intact memory, and fair judgment-upon mental status examination. Medications improved her symptoms and controlled her anxiety. Tr. at 655. She reported having more good days than bad ones. Id. And her mental functioning did not prevent Ward from reading, watching television, using a computer, or managing finances. So the evidence did not support Ward's claims that her symptoms were disabling.
Ward also argues that ALJ Hogan misstated her activities and asserts that she performs them less than the decision suggests. She needed assistance with personal care, performed chores for five or ten minutes before needing to rest, and engaged in other activities-watching television, using a computer, managing finances-that were not demanding. Ward contends her activities do not suggest she is capable of full-time work. So, she maintains, ALJ Hogan erred in failing to note the limited basis Ward performed the activities he cited.
Yet Ward's reported activities are one of several factors that ALJ Hogan used to assess her statements and conclude she could perform basic work activities. Coupled with the other evidence of record, Ward's reported activities fail to establish that she cannot engage in basic work activity. Even if her activities are limited, as she alleges, they do not suggest her symptoms are disabling.
In sum, ALJ Hogan properly considered objective evidence and Ward's activities in evaluating her statements of functioning. He did not discount Ward's symptoms because there was no objective evidence to confirm them but because they conflicted with other evidence in the record. Because substantial evidence supports ALJ Hogan's findings, the undersigned recommends that the court reject Ward's argument.
III. Conclusion
For these reasons, the undersigned recommends that the court deny Ward's Motion for Judgment on the Pleadings (D.E. 22), grant Kijakazi's Motion for Judgment on the Pleadings (D.E. 25), and affirm the Acting Commissioner's determination.
The Clerk of Court must serve a copy of this Memorandum and Recommendation (“M&R”) on each party who has appeared in this action. Any party may file a written objection to the M&R within 14 days from the date the it on them. The objection must specifically note the portion of the M&R that the party objects to and the reasons for their objection. Any other party may respond to the objection within 14 days from the date the objecting party serves it on them. The district judge will review the objection and make their own determination about the matter that is the subject of the objection. If a party does not file a timely written objection, the party will have forfeited their ability to have the M&R (or a later decision based on the M&R) reviewed by the Court of Appeals.