Opinion
CIVIL ACTION NO. 98-0885-P-L
May 15, 2000
REPORT AND RECOMMENDATION
The Plaintiff brings this action under 42. U.S.C. § 405(g) and § 1383(c)(3) seeking judicial review of a final decision of the Commissioner of Social Security denying her claim for disability insurance benefits, and a period of disability.
This action was referred to the undersigned for report and recommendation pursuant to 29 U.S.C. § 636(b)(1)(B). The undersigned has determined that oral argument is unnecessary to resolve the matter. See LR 7-3. Upon consideration of the administrative record and the memoranda of the parties, it is recommended that the decision of the Commissioner be affirmed.
I. ISSUES ON APPEAL
The plaintiff presents one issue on appeal:
1. WHETHER THE ALJ ERRED IN FAILING TO FIND PLAINTIFF PRESUMPTIVELY DISABLED BASED ON MEETING THE REQUIREMENTS AT PARAGRAPH 12.05C (mental retardation) OF THE LISTINGS.
II. BACKGROUND FACTS
Plaintiff was born January 7, 1944, and was 52 years old at the time of the hearing decision (Tr. 23, 52). Plaintiff has an eighth grade education (Tr. 43) and has past work experience as creeler operator in a carpet plant (Tr. 16). Plaintiff has not worked since December 13, 1993 (Tr. 52). Plaintiff filed for supplemental security income, a period of disability, and disability insurance benefits on January 13, 1994, alleging disability since December 13, 1993. ( Id.)
Plaintiffs applications were denied both initially and on reconsideration. (Tr. 58, 82.) The ALJ held a hearing on August 2, 1995 (Tr. 42). At the hearing, plaintiff testified that she suffered from knee pain, and that she had seen a psychologist. (Tr. 45, 47.) The ALJ issued a decision with attached psychiatric review technique form denying plaintiffs claim on March 6, 1996. (Tr. 23.) The Appeals Council denied review on July 11, 1997, and the plaintiff filed the present action on August 31, 1998. (Tr. 4; Doc. I.)
III. ALJ FINDINGS
The ALJ found as follows (Tr. 22-23):
2. The claimant has not engaged in substantial gainful activity since April 30, 1994.
3. The medical evidence establishes that the claimant had video arthoscopy to both knees and has a low borderline range of functioning, but that she does not have an impairment or combination of impairments listed in, or medically equal to one listed in Appendix 1, Subpart P, Regulations No. 4.
4. The claimant's subjective complaints of pain and resultant functional limitations are not credible as they are inconsistent and not supported by the medical evidence of record.
5. The claimant has the residual functional capacity to perform her past relevant work as a creel operator ( 20 C.F.R. § 404.1545).
6. The claimant's impairments do not prevent the claimant from performing her past relevant work.
7. The claimant was not under a "disability" as defined in the Social Security Act, at any time through the date of the decision ( 20 C.F.R. § 404.1520(e)).
The Dictionary of Occupational Titles defines a "creeler" as one who "creels looms, twisters, warpers, tufting, or other textile machines to change style of yarn or to replace exhausted yarn packages: Places yarn packages on spindle of creel, according to supervisor's instructions, color-coded spools, or number on yarn packages. Threads yarn through eyelet play (yarn guides) or ties yarn ends to ends of yarn from preceding package to maintain continuous yarn supply. Cuts yarn ends from knots, using scissors, and discards yarn ends in waste container to prevent entanglement of yarn while moving through creel. Removes old yarn from machines before changing to different size of type of yarn. Cleans dust and lint from creel. May repair yarn breaks in creel. May replace yarn packages or spools when faulty yarn appears." DOT. 689.687-030. (1991 ed.) Creel is defined as "a bar with skewers for holding bobbins in a spinning machine. Merriam Webster's Collegiate Dictionary (10th Ed. 1993).
IV. DISCUSSION
A. Standard of Review .
In reviewing claims brought under the Act, this court's role is a limited one. This Court may not decide the facts anew, reweigh the evidence, or substitute its judgment for that of the Commissioner of Social Security. Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1986). Instead, this Court must determine whether the Commissioner's decision to deny Plaintiffs benefits is supported by substantial evidence and correct application of legal principles.
Substantial evidence is defined as "more than a scintilla but less than a preponderance," and consists of "such relevant evidence as a reasonable person would accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 390, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971); Bloodsworth, 703 F.2d at 1239. The Commissioner's decision must be affirmed if it is supported by substantial evidence even when a court finds that the preponderance of the evidence is against the decision of the Commissioner. Richardson, 402 U.S. at 401, 91 S.Ct. at 1427 (1971); Bloodsworth, 703 F.2d at 1239. "In determining whether substantial evidence exists, we must view the record as a whole, taking into account evidence favorable as well as unfavorable to the [Commissioner's] decision." Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). Also, as set forth in 42 U.S.C. § 405(g), "The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive."
Moreover, "[t]he Secretary's failure to apply the correct law or to provide the reviewing court with sufficient reasoning for determining that the proper legal analysis has been conducted mandates reversal." Cornelius v. Sullivan, 936 F.2d 1143, 1145-46 (11th Cir. 1991). This Court's review of the Commissioner's application of legal principles, however, is plenary. Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987).
B. Statement of the Law
An individual who files an application for Social Security disability benefits must prove that she is disabled. See 20 C.F.R. § 416.912 (1998). The Social Security regulations provide a five-step sequential evaluation process for determining if a claimant has proven that she is disabled. See 20 C.F.R. § 416.920. At the first step, the claimant must prove that she has not engaged in substantial gainful activity. At the second step, she must prove that she has a severe impairment or combination of impairments. If, at the third step, she proves that her impairment or combination of impairments meets or equals a listed impairment, she is automatically found disabled regardless of age, education, or work experience. If she cannot prevail at the third step, she must proceed to the fourth step where she must prove that she is unable to perform her past relevant work. Jones v. Bowen, 810 F.2d 1001, 1005 (11th Cir. 1986). In evaluating whether plaintiff has met this burden, the examiner must consider the following four factors: (1) objective medical facts and clinical findings; (2) diagnoses of examining physicians; (3) evidence of pain; (4) the claimant's age, education and work history. Id., at 1005. Once plaintiff meets this burden, it becomes the Commissioner's burden to prove at the fifth step that plaintiff is capable of engaging in another kind of substantial gainful employment which exists in the national economy, given age, education, and work history. Sryock v. Heckler, 764 F.2d 834 (11th Cir. 1985). If the Commissioner can demonstrate that there are jobs the claimant can perform, the claimant must prove she is unable to perform those jobs in order to be found disabled. Jones v. Apfel 190 F.3d 1224, 1228 (11th Cir. 1999); Powell o/b/o Powell v. Heckler, 773 F.2d 1572, 1575 (11th Cir. 1985); Ambers v. Heckler, 736 F.2d 1467, 1469 (11th Cir. 1984). See also Hale v. Bowen, 831 F.2d 1007, 1011 (11th Cir. 1987), citing Francis v. Heckler, 749 F.2d 1562, 1564 (11th Cir. 1985).
C. Medical Evidence
1. MENTAL RETARDATION
Blaine C. Crum, Ph.D., has signed a report of a clinical interview and battery of tests administered to plaintiff on July 20, 1995. On the Wechsler Adult Intelligence Scale, revised version (WAIS-R), plaintiff scored a verbal IQ of 69, a performance IQ of 74, and a full scale IQ of 70. (Tr. 216.) On the Wide Range Achievement Test, Revised Version, plaintiff scored .2, .9, and 4th percentile performances on the reading, spelling and math sections respectively. ( id.) Dr. Crum diagnosed plaintiff as "Borderline Intellectual Functioning." Id The summary stated,
[Plaintiff's] capabilities fall in the low borderline range of intellectual ability, with limited attention and concentration processes. She has a very short attention span, and a generally low frustration tolerance. She will have difficulty following simple sequential directions requiring more than two steps. Her inability to read and write with any effectiveness, combined with her health problems has restricted her ability to hold employment. She has relied heavily on physical types of employment due to her intellectual and achievement limitations. She has actively pursued employment over the years, and appears well motivated to do so. At this point, it is questionable whether she will be able to return to any form of steady employment due to the previously mentioned factors. (Tr. 217.)
In an attached questionnaire on plaintiffs residual functional capacity, Dr. Crum found moderate limitations on plaintiffs activities of daily living and maintaining social functioning; frequent deficiencies of concentration, persistence, or pace; frequent episodes of deterioration or decompensation in work or work-like settings; marked limitations in plaintiffs ability to understand, carry out, and remember instructions in a work setting; moderate restrictions in plaintiffs ability to respond appropriately to supervision or co-workers in a work setting; moderate limitations in plaintiffs ability to perform simple tasks in a work setting; marked limitations in plaintiffs performing repetitive tasks in a work setting. (Tr. 218-19.) Dr. Crum concluded that plaintiffs limitations had lasted or could be expected to last for 12 months or longer, but offered no opinion as to the earliest date the same level of severity existed. (Tr. 219.) Dr. Crum commented, "this individual's intellectual limitations combined with her health restrictions severely limit her ability to hold employment. ( Id)
2. KNEE PAIN
Joe B. Ray, M.D., a board-certified orthopedic surgeon, performed arthroscopic knee surgery on plaintiffs right knee in April, 1991 and on her left knee in August of 1993. The record contains treatment records from Dr. Ray dating from March 27, 1991, to March 23, 1994. (Tr. 127-207.) The treatment notes show a slow improvement after video arthroscopic surgery on the right knee, followed by physical therapy, although plaintiff did not do as well in post operative treatment as was hoped. (Tr. 197.) In an August 21, 1991 visit, plaintiff told Dr. Ray that she would "like to go back to carpet work." (Tr. 191). On September 4, 1991, Dr. Ray noted that he wanted to start plaintiff on a home physical therapy regimen so that she could get back to work. (Tr. 190.) Dr. Ray reiterated the same goal after a September 18, 1991 appointment with plaintiff. (Tr. 189.) Plaintiff returned to work in October 1991 and worked until August 1993 when she had surgery on her left knee. (Tr. 117.)
After the August 1993 surgery, Dr. Ray's notes focus on patient's recovery from the second procedure. (Tr. 169-171.) Post-op treatment originally consisted of biweekly visits with a good prognosis. However, in an October 6, 1993, visit Dr. Ray noted that he threatened to send plaintiff back to work if she did not comply with her treatment. (Tr. 168.) In October 20, 1993, notes, Dr. Ray prescribed more therapy and stated his intent to send plaintiff back to work. (Tr. 167.) On November 3, 1993, Dr. Ray stated that the plaintiff could return to work but later recommended half-days at work after plaintiff left work complaining of knee pain. Dr. Ray hoped to "gradually increase the comfort and strength of her left knee." (Tr. 164, 166, 170.) After a December 8, 1993, visit, Dr. Ray recorded that plaintiff complained a lot of knee pain from work. (Tr. 163.) But Dr. Ray found "pretty good range of motion" and "pretty good strength" without any tenderness. ( Id)
By December, 1993, plaintiff began to express her belief that she could not return to work. (Tr. 162.) Consistent with earlier treatments, Dr. Ray prescribed physical therapy and medication (Dolobid 500 mg). (Tr. 162.) Dr. Ray also stated his belief that the plaintiff could return to work. (Tr. 163.)
On December 13, 1993, physical therapist Van Dailey, treated plaintiff at the Atmore Community Hospital for knee pain. He noted that plaintiff "returned to full duty [at work] in August [1993] walking on cement floors and she has complained of pain in the knee and swelling since that time. Today we note just minimal swelling." (Tr. 149.) Mr. Dailey's suggested that treatment with "moist heat, exercise, and ice should continue." Id. He concluded that "prognosis should be good for [plaintiff] to improve. She just has to be a little more patient with it." Id.
On January 5, 1994, plaintiff returned to Dr. Ray after three weeks of physical therapy. Dr. Ray stated,
I don't detect any specific effusion of either knee. She has a pained expression on her face which is something she has assumed. She mentions something about retirement and disability. . . . I really think she would be better off to try to return to work and I really think she has the potential to do this. (Tr. 161.)
Dr. Ray then prescribed more weeks of physical therapy and ordered a thorough report from the physical therapist so that Dr. Ray could go over the evaluation and "hopefully return [plaintiff] to work." id After completing physical therapy, she returned to Dr. Ray on January 26, 1994. Dr. Ray found a "good range of motion of both knees, fair strength. She is feeling pretty good. . . . We will let her go back to work on Monday." (Tr. 160.) Although Dr. Ray scheduled their next appointment three months later, plaintiff returned on February 16, complaining "that her legs swell and ache when she works." (Tr. 159.) In response, Dr. Ray ordered noninvasive vascular studies. ( Id.) Larry Arcement, M.D., a radiologist with Atmore Community Hospital, conducted a venous study at Dr. Ray's request on February 18, 1994. Dr. Arcement found "no evidence of thrombus formation. The veins show normal compressibility and augmentation. IMPRESSION: Normal venous study." (Tr. 157.) After reviewing the study, Dr. Ray made the following note in plaintiffs case:
I talked with Dr. Harry Moore about Dorothy House. I keep trying to send her back to work; she keeps trying to stay off work saying that she can't work because her legs and feet swell. Seems to me that her knees are doing pretty good after arthroscopy of both knees and after extensive rehab. We got noninvasive vascular studies which were normal, and other than wearing elastic stockings to try to work against dependent edema, I don't know what else to do. . . . As far as I am concerned I think she should continue to try to work. (Tr. 156.)
In notes from a March 23, 1994, visit, Dr. Ray stated that "Ms. House has pretty good result for her knee surgeries but she continues to complain of the swelling of her legs and feet and associated pain in her feet. We got pressure prints that don't show anything dramatic, a little increased intensity of pressure on the medial side of her heel and forefoot on the left, medial heel and left forefoot on the right." (Tr. 154.) Dr. Ray prescribed elastic stockings, arch supports, and pressure absorbent orthotic shoe inserts. ( Id) A June 22, 1994 visit to Dr. Ray included the following notation:
Dorothy House comes back in. She is taking herself off work. She is trying to get disability. She has been to P.T. That seems to have helped her. She says she does better on the left leg now than the right. She has very mild effusion on the right. She has pretty good range of motion, pretty good muscular control. No specific tenderness that I can find on examination." (Tr. 237.)
Hampton Smith, M.D. consulted on plaintiffs case and completed a residual functional capacity assessment on March 15, 1994. (Tr. 66.) Dr. Smith found that plaintiff could occasionally lift or carry 50 pounds; frequently lift of carry 25 pounds; stand and/or walk about 6 hours in an 8 hour workday; sit about six hours in an eight hour workday; no limitations on ability to push and/or pull. He considered the mild swelling and pain in both knees, but noted that arthroscopy in both knees had produced "good results" with "good range of motion". (Tr. 60.) Dr. Smith also found no postural, manipulative, visual, communicative, or environmental limitations. (Tr. 61-65.)
Another DDS consultation was completed on June 1, 1994. The consultant reached almost identical conclusions on plaintiffs exertional limitations, finding only that plaintiffs ability to push/pull was limited in the lower extremities (Tr. 75). The consultant noted that after two knee surgeries, plaintiff has "good range of motion of the knees with no neurological deficits or sensory changes. Motor exam is within normal limits. Has some dependent edema of the extremities (lower)." (Tr. 75.) The consultant found only one postural limitation; plaintiff can only occasionally climb ladders, ropes, or scaffolds. Otherwise, the consultant found no manipulative, visual, communicative, or environmental limitations (77-80).
Elmer Bresetan, M.D., consulted on plaintiffs case on September 6, 1994. After examining the plaintiff, he noted his impressions as "bilateral knee surgery for ligamentous damage" and "mild leukopenia and neutropenia, possibly of viral etiology." (Tr. 234.)
Allen Patton, M.D., examined plaintiff on October 11, 1994 at the Atmore Community Hospital. His examination "confirmed the absence of any adenopathy or organomegaly," and Dr. Patton concluded that plaintiff suffered "very slight neutropenia — chronic — of uncertain significance." (Tr. 232.) Dr. Patton recommended that plaintiff return for another blood test in six months.
On June 6, 1995, Plaintiff returned to Dr. Ray. Dr. Ray noted that plaintiff had relative demineralization on the right knee but also found that plaintiff had extra mobility and that she balanced well on standing films. (Tr. 230.) Dr. Ray concluded that plaintiff walked and stood well, and that there was no need for joint replacement. Id
Plaintiff then returned to Dr. Ray for a checkup on June 21, 1995. and Dr. Ray made the following note:
Dorothy House comes back in for reevaluation. She has been babysitting and not working, claiming that her right knee is not doing as well as the left; therefore she is not able to work. Everything seems to be okay to me. She has full range of motion; seems to have adequate strength. She doesn't appear to have any specific tenderness or pain, but this is hard to evaluate. We will get some new x-rays and see her back next week. Id.
After viewing the x-rays on June 28, 1995, Dr. Ray found that plaintiff "doesn't have any specific findings to suggest that she has come to the end of the road, that she needs a joint replacement or anything." Id Dr. Ray concluded that seeing him was no longer necessary and recommended that Dr. Moore treat her from then on for routine complaints. Id
On July 26, 1995, Harry Moore, M.D., completed a Physical Capacities Evaluation of plaintiff. He found that plaintiff could lift and/or carry 20 pounds occasionally and 10 pounds frequently; sit two hours in an eight hour workday; stand or walk two hours in an eight hour workday. (Tr. 220.) Dr. Moore marked that plaintiff was restricted in pushing and pulling movements, climbing and balancing, and bending or stooping. (Id) Plaintiff returned to Dr. Moore on July 27, 1995 for an evaluation of her disability. Dr. Moore found "some crepitance on the right knee," with flexion and extension causing some pain. (Tr. 228.) Plaintiff walked "without limp, but very slowly." Id. Dr. Moore diagnosed plaintiff with chondramalacia of the knees status post surgery on both knees. Id.
D. Plaintiff's Argument
1. MENTAL RETARDATION
The plaintiff argues that the ALJ erred by failing to find plaintiff presumptively disabled because the record establishes that she met the requirements of 12.05(c) of the Listing of Impairments. In discussing the purpose and application of the Listing of Impairments, the Eleventh Circuit has provided the following guidance:
The Listings include medical criteria for specified disorders of thirteen major body systems. These impairments are so severe that an individual who has a listed impairment is generally considered unable to work based upon medical considerations alone. 20 C.F.R. § 416.925(a). A claimant may prove that he is disabled by either (I) meeting the Listings or (2) equaling the Listings. In order to meet a Listing, the claimant must (1) have a diagnosed condition that is included in the Listings and (2) provide objective medical reports documenting that this condition meets the specific criteria of the applicable Listing and the duration requirement. A diagnosis alone is insufficient. 20 C.F.R. § 416.925(c)-(d). In order to equal a Listing, the medical findings must be at least equal in severity and duration to the listed findings.Wilkinson on behalf of Wilkinson v. Bowen, 847 F.2d 660, 662 (11th Cir. 1987); see also Bell v. Bowen, 796 F.2d 1350, 1353 (11th Cir. 1986)("[W]hen a claimant contends that he has an impairment meeting the listed impairments . . ., he must present specific medical findings that meet the various tests listed under the description of the applicable impairment or, if in the alternative he contends that he has an impairment which is equal to one of the listed impairments, the claimant must present medical evidence which describes how the impairment has such equivalency."); Carnes v. Sullivan, 936 F.2d 1215, 1218 (11th Cir. 1991)("Diagnosis of a listed impairment is not alone sufficient; the record must contain corroborative medical evidence supported by clinical and laboratory findings.")
Listing 12.05C falls under § 12.00 MENTAL DISORDERS of the Listings and provides in pertinent part:
12.05 Mental Retardation and Autism. Mental retardation refers to a significantly subaverage general intellectual functioning with deficits in adaptive behavior initially manifested during the developmental period (before age 22). . . . [t]he required level of severity for this disorder is met when the requirements in A, B, C, or D are satisfied. . . .
C. A valid verbal, performance, or full scale IQ of 60 through 70, and a physical or other mental impairment imposing additional and significant work-related limitation of function.20 C.F.R. Part 404, Subpart P, Appendix 1, § 12.05C (emphasis added).
Generally, a claimant meets the criteria for presumptive disability under § 12.05C when the claimant presents a valid IQ score of 60 to 70, and evidence of an additional mental or physical impairment that has more than "minimal effect" on the claimant's ability to perform work activities. Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992)(citing Edwards by Edwards v. Heckler, 755 F.2d 1513, 1517 (11th Cir. 1985)).
As stated above, Plaintiff relies on Dr. Crum's July 20, 1995 psychological evaluation report in support of her contention that she meets the criteria for presumptive disability under § 12.05C of the Listings. The report indicates that Plaintiff was administered the Wechsler Adult Intelligence Scale — Revised (WAIS-R). (Tr. 215.) Plaintiff obtained a verbal IQ score of 69, a performance IQ score of 74 and a full scale IQ score of 70, placing her in the low borderline range of intellectual functioning. (Tr. 217.) The undersigned notes that there is no other reference in the record to Plaintiffs alleged mental impairment.
The undersigned finds that the ALJ's determination that the plaintiff failed to meet the listing of 12.05(c) is supported by substantial evidence. Specifically, the plaintiff failed to satisfy the requirement that a plaintiff experience "deficits in adaptive behavior initially manifested during the development period (before age 22)."
Although Dr. Crum reported that Plaintiff obtained a verbal IQ score of 69, a performance IQ score of 74 and a full scale IQ score of 70, the Eleventh Circuit has held that a valid IQ score need not be conclusive of mental retardation where the IQ score is inconsistent with other evidence in the record regarding the claimant's daily activities and behavior. Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992) (citing Popp v. Heckler, 779 F.2d 1497, 1499 (11th Cir. 1986)). In this case, the record reveals that Plaintiff completed the eighth grade, has maintained the same job for 20 years, owns a home, owns a car, has a driver's license, drives, cleans the house, looks after her two grandchildren, washes clothes, cooks every night, watches television, talks on the phone, and visits with friends (Tr. 43-49, 120.). This supports the ALJ's determination that Dr. Crum's evaluation of the plaintiff is not supported by the evidence of record.
Dr. Crum's diagnosis is also called into question because of his extremely minimal interaction with the plaintiff, which formed the basis of his report. The record contains the following exchange between the ALJ and Plaintiff:
Q So when was the fist time you saw Dr. Crum the psychologist?
A Oh, that was last Thursday.
Q How many times have you seen him?
A Just one.
Q How long were you there?
A We got there at 3:00. I think at 4:00 I left.
Q Can you tell me how he looks?
A No. I thought he just went in and out.
Q Did you even talk to him?
A He just came in and say hello and I was talking to his nurse, I guess.
Q Okay.
(Tr. 45).
Plaintiffs testimony support the ALJ's determination that Dr. Crum's evaluation should not be relied upon. As stated above, Social Security Regulations state that a diagnosis alone is insufficient. See 20 C.F.R. § 416.925(c)-(d). The burden is on Plaintiff to prove that she meets the 12.05C listing. Wilkinson, 847 F.2d at 662. Moreover, a finding of mental retardation is not required when based solely upon the results of a standardized intelligence test. Strunk v. Heckler, 732 F.2d 1357, 1360 (7th Cir. 1984). In this case, Plaintiffs IQ scores are invalidated by the other evidence of record. In addition, the record as a whole does not support Dr. Crum's finding of borderline intellectual functioning. Therefore, Plaintiff has failed to meet the first and threshold requirement of the § 12.05C listing; she has failed to produce evidence of a valid verbal, performance or full scale IQ of 60 through 70. Moreover, the record as a whole does not support a finding of mild mental retardation initially manifested during the developmental period, before age 22. Although Dr. Crum reported that Plaintiffs tests were "a-representative assessment of her abilities," Dr. Crum did not relate Plaintiffs scores or his diagnosis back to an earlier period nor did he state that Plaintiff had suffered mental retardation since childhood. Instead, Dr. Crum simply left blank the question concerning earliest date that Plaintiffs current level of severity existed. (Tr. 215, 219.) "[A] section 12.05C claimant must demonstrate that the retardation is a lifelong condition which manifested itself before age twenty-two." Lowery, 979 F.2d at 837 ( citing 20 (XF.R. Part 404, Subpart P, Appendix I, § 12.05C). In this case, Plaintiff has also failed to meet this burden. Since Plaintiff has failed to meet the threshold requirement of § 12.05 C, the undersigned will not address the second prong of the § 12.05C analysis, the existence of a physical or mental impairment which imposes additional and significant workrelated limitations on Plaintiff.
2. KNEE PAIN
The record also establishes by substantial evidence that plaintiffs limitations regarding her knees do not prevent her from performing her past relevant work.
Plaintiff cites the Physical Capacities Evaluation filled out by Dr. Harry Moore, plaintiffs primary physician. Dr. Moore found some limitation in plaintiffs physical capacity. However, Dr. Moore's assessment is outweighed by the evidence of plaintiffs lengthy treatment by Dr. Ray. Dr. Ray found plaintiffs statements that she could not work not credible. For example, Dr. Ray noted after a June 21, 1995 appointment, "[Plaintiff] has been babysitting and not working, claiming that her right knee is not doing as well as the left; therefore she is not able to work. Everything seems to be okay to me. She has full ROM; seems to have adequate strength." (Tr. 237.) Dr. Ray ordered x-rays of plaintiffs knees and concluded there were no "specific physical findings to suggest that she has come to the end of the road, that she needs joint replacement or anything." (Id.) Dr. Ray's conclusion is the opinion of a physician who had been treating Plaintiffs knees from March 1991 to June 1995. Although the ALJ "consider[ed] opinions from treating sources on issues such as . . . residual functional capacity . . . the final responsibility for deciding [the] issue is reserved to the Secretary." 20 C.F.R. § 404.1 527(e)(2). In this case, Dr. Moore's conclusions were certainly at odds with Dr. Ray's repeated findings that plaintiff was able to return to work. ( See part C. 2., supra.) The factual and lengthy medical evidence in the record provided substantial evidence for the ALJ to conclude the plaintiff was capable of performing her past relevant work.
VI. CONCLUSION
For the reasons set forth, and upon consideration of the administrative record, the hearing decision, and the memoranda of the parties, it is recommended that the decision of the Commissioner of Social Security be affirmed.
The attached sheet contains important information regarding objections to this report and recommendation.