Opinion
Civil Action No. 16-11143-FDS
04-27-2017
DAVID J. NOVICK, Plaintiff, v. CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.
MEMORANDUM AND ORDER ON PLAINTIFF'S MOTION TO REVERSE AND REMAND AND DEFENDANT'S MOTION TO AFFIRM THE DECISION OF THE COMMISSIONER SAYLOR, J.
This is an appeal of the final decision of the Commissioner of the Social Security Administration ("SSA") denying the application of plaintiff David J. Novick for Social Security Disability Insurance ("SSDI") benefits. Plaintiff appeals the denial of his claim on the grounds that the decision was not supported by substantial evidence as required under 42 U.S.C. § 405(g), and is therefore incorrect as a matter of law. Specifically, plaintiff contends that the Administrative Law Judge ("ALJ") incorrectly weighed medical evidence, failed to give appropriate weight to his limited Residual Functional Capacity ("RFC"), incorrectly assessed his exertional level, and incorrectly found that he could perform other work in the national economy.
Plaintiff has moved to reverse the ALJ's decision and grant him disability benefits, retroactive from the date of disability. Alternatively, plaintiff moved to remand the decision of the Commissioner for further proceedings. Defendant has cross-moved for an order affirming the ALJ's decision. For the reasons stated below, plaintiff's motion to reverse and remand will be denied, and defendant's motion to affirm the ALJ's decision will be granted.
I. Background
A. Factual Background
Plaintiff David J. Novick was born on October 13, 1960. (A.R. 35). He graduated from Southern New England Law School in 2000. (A.R. 36-37). He worked as both a paralegal and as an attorney at a law firm from January 2000 to September 2011. (A.R. 212). Between January 2006 and September 2011 he also worked intermittently as a real estate agent. (Id.). After a September 14, 2011 car accident, Novick did not work again until May 2014. (A.R. 42, 202, 286).
In May 2014, Novick began working approximately ten hours per week at his father's law office. (A.R. 286). At the time of his hearing before the ALJ on February 19, 2015, he was working for his father for approximately seven hours per week. (A.R. 37). The ALJ found that Novick had engaged in substantial gainful activity since September 14, 2011, the alleged disability onset date. (A.R. 13).
1. Medical History
a. Dysfunction Prior to Alleged Disability Date
Novick experienced functional limitations and pain in his back, neck, and shoulder prior to the alleged onset of his disability. (A.R. 411-28). He was prescribed Valium for pain, which he took as needed. (A.R. 754). On June 2, 2010, he went to a chiropractor complaining of pain in his neck and right shoulder, which he rated a 4 out of 10. (A.R. 411). His chiropractor noted hypomobility at vertebrae C5 and C1 vertebrae and muscle spasticity. (Id.).
Valium is a benzodiazepine (central nervous system depressant) used to relieve anxiety, muscle spasms, and seizures. See Mayo Clinic, Diazepam (Oral Route), MAYO CLINIC (March 8, 4:18 PM), http://www.mayoclinic.org/drugs-supplements/diazepam-oral-route/description/drg-20072333.
Novick was treated four more times within a two-month span by the chiropractor, who noted that his prognosis was "fair." (A.R. 413-16). On May 6, 2011, his chiropractor diagnosed him with thoracic intervertebral joint dysfunction, thoracic outlet syndrome, cervical intervertebral joint dysfunction, and lumbar intersegmental joint dysfunction. (A.R. 419). He saw the chiropractor eight times between May and July 2011. (A.R. 418-428). By June 7, 2011, his condition had reached a point of stability. (A.R. 426).
b. Car Accident and Resulting Injuries
Novick's automobile was rear-ended in a low-speed accident on September 14, 2011, the date of the alleged onset of disability. (A.R. 430). A computerized axial tomography scan ("CT scan") revealed bulged disks in his neck from an old injury, but no concussion. (A.R. 473). On September 16, 2011, he saw his chiropractor and reported constant pain in his cervical vertebrae, with pain self-rated as a 7 out of 10, and a constant occipital headache, with pain self-rated 10 out of 10. (A.R. 430). Additionally, he reported photophobia. (Id.). The chiropractor found a decreased range of motion in cervical vertebrae flexion and extension, right and left lateral flexion, and left and right rotation. (A.R. 430-31). Tests for foraminal compression, distraction, and spinal percussion were all positive. (A.R. 431). The chiropractor diagnosed cervical strain/sprain, a thoracic strain/sprain, and cervical radiculitis. (Id.). The chiropractor concluded that the prognosis was poor, citing the severity of the injury and complicating comorbidities. (Id.).
At an appointment with the chiropractor on September 19, 2011, Novick reported only minor improvement in his spine and no improvement in his occipital headache. (A.R. 433). The following day, he reported significantly reduced pain in his occipital headache, with pain self-rated as a 6 out of 10. (A.R. 435). Over the following week, his self-report of occipital headache pain ranged from a 3 to 6 out of 10 and his cervical pain rated a 4 out of 10. (A.R. 439). By October 11, 2011, the chiropractor changed his prognosis to "fair," noting that his "body pain is improving."
c. Reoccurrence of Pain and Surgeries
On December 12, 2011, Novick was admitted to Beth Israel Deaconess Medical Center after a resurgence in photophobia and occipital headache pain (self-reported as 10 out of 10) during a bowel movement. (A.R. 471). He denied motor or sensory changes, visual changes, or speech difficulty. (Id.). He also reported occasional marijuana use. (Id.). At the time of admission, he was prescribed Valium, Venlafaxine, and Naproxen. A physical examination revealed that Novick was awake and alert, oriented to person, place, and date, and that he had fluent speech with good comprehension and repetition. (A.R. 472). A physical assessment revealed no abnormal movements, full strength (5/5) throughout, and no pronator drift. (Id.).
Venlafaxine is a serotonin and norepinephrine reuptake inhibitor used to treat depression, general anxiety disorder, social anxiety disorder, and panic disorders. See Mayo Clinic, Venlafaxine (Oral Route), MAYO CLINIC (March 8, 4:21 PM), http://www.mayoclinic.org/drugs-supplements/venlafaxine-oral-route/description/drg-20067379.
Naproxen is a nonsteroidal antiinflammatory drug used to relieve symptoms of arthritis and joint pain. It can relieve symptoms of ankylosing spondylitis, a type of arthritis that affects the joints in the spine. See Mayo Clinic, Naproxen (Oral Route), MAYO CLINIC (March 8, 4:25 PM), http://www.mayoclinic.org/drugssupplements/naproxenoralroute/description/drg20069820.
A lumbar puncture contained bloody cerebral spinal fluid, but a cerebral angiography ruled out an aneurism. (A.R. 479, 486). A CT scan was negative for vascular abnormality. (A.R. 479). After an argument with Beth Israel doctors, in which Novick claimed he was receiving insufficient pain medication, he refused to see the hospital's pain-management specialists and was discharged against medical advice. (A.R. 510-11).
As of January 9, 2012, Novick was taking Verapamil, Diazepam, and Hydrocodone, as needed. (A.R. 618). He reported driving difficulties, including hitting the curb three times and hitting the mirror on another car. (Id.). Despite this, his doctor noted that he was alert and oriented, had fluent speech, and could follow commands well. (Id.).
Verapamil is a calcium channel blocker used to treat heart rhythm problems, severe chest pain, and/or high blood pressure. See Mayo Clinic, Verapamil (Oral Route), MAYO CLINIC (March 13, 10:32 AM), http://www.mayoclinic.org/drugs-supplements/verapamil-oral-route/description/drg-20071728. Novick's doctors prescribed the drug to treat his headaches. (A.R. 618).
Diazepam is a benzodiazepine used to relieve symptoms of anxiety and alcohol withdrawal. It may also help relax muscles or relieve muscle spasms. See Mayo Clinic, Verapamil (Oral Route), MAYO CLINIC (March 13, 10:35 AM), http://www.mayoclinic.org/drugssupplements/diazepamoralroute/description/drg20072333.
Hydrocodone is a narcotic analgesic used to treat severe pain. Its use over an extended period of time may lead to mental and/or physical dependence. See Mayo Clinic, Hydrocodone (Oral Route), MAYO CLINIC (March 13, 10:38 AM), http://www.mayoclinic.org/drugssupplements/hydrocodoneoralroute/description/drg20084881.
On February 29, 2012, Novick underwent a C6-7 and C7-T1 posterior keyhole foraminotomies with microdissections at Southcoast Hospitals Group to treat chronic pain. (A.R. 551). The procedure was performed without incident. (A.R. 551-53).
In June 2012, Novick was involved in a motorcycle accident, injuring the proximal-interphalangeal joint ("PIP") of the fifth finger on his left hand. (A.R. 597). He developed a PIP contracture on that finger. (Id.). Radiographs taken at Partners Healthcare revealed that a prior right-wrist fracture was not displaced. (A.R. 601).
At a September 11, 2012 visit to Southcoast Health System, Dr. Matthew Philips noted that Novick showed "marked improvement in his pain syndrome" with only intermittent pain, "good range of motion in his neck," and a 5/5 on a motor examination. (A.R. 603).
A November 2012 examination showed that Novick had 5/5 strength in both hands with full range of motion in his fingers, wrist, and elbows. (A.R. 551-53). In November, Novick was taking Lyrica, Baclofen, and Naproxen one to two times per day. (A.R. 851).
Lyrica is the brand name version of the drug pregabalin. It can be used to treat pain from shingles and nerve damage from diabetes or spinal cord injuries. See Mayo Clinic, Pregabalin (Oral Route), MAYO CLINIC (March 13, 10:45 AM), http://www.mayoclinic.org/drugs-supplements/pregabalin-oral-route/description/DRG-20067411.
Baclofen is a muscle relaxant used to treat spasms, cramping, and tightness. See Mayo Clinic, Baclofen (Oral Route), MAYO CLINIC (March 13, 10:51 AM), http://www.mayoclinic.org/drugssupplements/baclofenoralroute/description/drg20067995.
In March 2013, Novick had surgery for C5-C6 and C6-T1 anterior cervical disectomies, fusions, and fixations. (A.R. 908). An x-ray one month later revealed good placement of the fusion-fixation construct. (A.R. 930). Only weeks after that surgery, he reported that his pain symptoms were almost completely resolved in his upper-right extremity, to the point that he had ceased most or all of his pain medications. (A.R. 838, 891). He reported decreased strength and muscle mass in that area. (A.R. 838). He reported taking Cymbalta, Baclofen, Clonazepam, and Verapamil at that time. (Id.). He reported that his pain was a 2 out of 10 when not on pain medications. (A.R. 931). April 9, 2013, Dr. Philips noted that Novick stated he was "much improved" with minimal pain in injured areas. (A.R. 930).
Cymbalta is the brand name for the drug duloxetine. Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor used primarily to treat depression and anxiety. See Mayo Clinic, Duloxetine (Oral Route), MAYO CLINIC (March 13, 10:56 AM), http://www.mayoclinic.org/drugs-supplements/duloxetine-oral-route/description/drg-20067247.
Clonazepam is a benzodiazepine used to treat seizures and panic disorders. It is a central nervous system depressant. See Mayo Clinic, Clonazepam (Oral Route), MAYO CLINIC (March 13, 11:33 AM), http://www.mayoclinic.org/drugssupplements/clonazepamoralroute/description/drg20072102.
d. Mental Impairments
Novick contends that he suffered from depression, anxiety, anhedonia, and difficulty concentrating during the relevant time. (A.R. 905). He has occasionally reported suicidal ideation and difficulty sleeping. (A.R. 887, 903). He also reports that the opioid and muscle relaxant medications that he has taken to manage his physical ailments have affected his ability to concentrate. (A.R. 945).
In a December 9, 2010 visit with his primary-care physician, Dr. Robert Gagnon, Novick reported symptoms of depression, including anhedonia and altered sleep habits, for a five-month period. (A.R. 759). He was prescribed Zoloft. (Id.). At the time of his admission to Beth Israel Deaconess Hospital in December 2011, he reported that he was going through a divorce which, combined with his physical ailments, had led to emotional difficulties. (A.R. 477, 944-45).
Zoloft is the brand name for the drug sertraline. Sertraline is a selective serotonin reuptake inhibitor used to treat depression, panic disorder, and social anxiety disorder, as well as other conditions. See Mayo Clinic, Sertraline (Oral Route), MAYO CLINIC (March 13, 11:36 AM), http://www.mayoclinic.org/drugs-supplements/sertraline-oral-route/description/drg-20065940.
At a March 19, 2012 visit with Dr. Gagnon, Novick reported a mild degree of depression. (A.R. 767). Symptoms included anhedonia, decreased appetite, altered mood, altered sleeping habits, and a decreased ability to concentrate. (Id.). He denied having suicidal thoughts. (Id.). His symptoms of depression were treated with Effexor. (Id.). He maintained a similar mental state over the following months, but reported an inability to leave his home at a December 18, 2012 visit with Dr. Gagnon. (A.R. 768-76). On March 4, 2013, he consented to being treated by Michael Carter, a psychotherapist. (A.R. 826).
Effexor is the brand name for the drug venlafaxine, an antidepressant. See Mayo Clinic, Venlafaxine (Oral Route), MAYO CLINIC (March 13, 11:39 AM), http://www.mayoclinic.org/drugs-supplements/venlafaxine-oral-route/description/drg-20067379.
On September 12, 2013, Dr. Sol Pittenger examined Novick in connection with his application for disability benefits. (A.R. 944-49). Dr. Pittenger noted that Novick drove himself to the appointment and was on time, but that he avoids taking his Clonazepam when he knows that he needs to drive. (A.R. 944, 947). Dr. Pittenger also noted that he "describes a history of overuse of opioid pain medication," reports "mental status changes associated with treatment with medication for pain and anxiety," and "describes a pattern of depressed and anxious mood in the context of physical pain, his divorce, and both functional and financial difficulties." (A.R. 944-45). Novick reported that his depression and use of medications, which at that time included Baclofen, Clonazepam, and Abilify, led to an "inability to think." (A.R. 945).
Dr. Pittenger's notes indicate that Novick was taking Klonopin, the brand name version of clonazepam. See Mayo Clinic, Clonazepam (Oral Route), MAYO CLINIC (March 13, 11:33 AM), http://www.mayoclinic.org/drugs-supplements/clonazepam-oral-route/description/drg-20072102.
Abilify is the brand name version of the drug Aripiprazole, an antipsychotic used to treat mental conditions such as bipolar I disorder, major depressive disorder, and schizophrenia. See Mayo Clinic, Aripiprazole (Oral Route), MAYO CLINIC (March 13, 1:25 PM), www.mayoclinic.org/drugssupplements/aripiprazoleoralroute/description/drg20066890.
Novick reported to Dr. Pittenger that he usually had a low, sad, and anxious mood that improved when he was able to distract himself. (Id.). He reported extremely disrupted sleep patterns. (A.R. 946). Despite those issues, he reported occasional visits to a few friends, occasionally dating, and interacting with members of his synagogue. (Id.).
Dr. Pittenger diagnosed adjustment disorder with depressed and anxious mood, as well as a history of opioid abuse. (A.R. 949). Dr. Pittenger noted that he had symptoms of both major depression and anxiety disorder, but not enough to make a conclusive diagnosis. (Id.).
B. Procedural Background
Novick filed for SSDI benefits on January 4, 2013, alleging an onset date of September 14, 2011. (A.R. 11). His SSDI claim was denied on September 26, 2013, and again denied after reconsideration on January 15, 2014. (Id.). He then requested a hearing with an ALJ, which took place on February 19, 2015. (Id.).
The ALJ denied his application for benefits. (A.R. 23). Novick requested review from the Appeals Council on May 1, 2015, which was denied on May 10, 2015. (A.R. 1).
On June 20, 2016, Novick filed a complaint in this Court. On October 10, 2016, he moved for an order reversing the decision of the Commissioner. On December 21, 2016, the Commissioner cross-moved for an order affirming that decision.
II. Legal Standard
A. Standard of Review
Under § 405(g) of the Social Security Act, this Court may affirm, modify, or reverse the Commissioner's decision, with or without remanding the case for a rehearing. 42 U.S.C. § 405(g). The ALJ's finding on any fact shall be conclusive if it is supported by substantial evidence, and must be upheld "if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support his conclusion," even if the record could justify a different conclusion. Rodriguez v. Sec'y of Health and Human Servs., 647 F.2d 218, 222 (1st Cir. 1981); see also Evangelista v. Sec'y of Health and Human Servs., 826 F.2d 136, 144 (1st Cir. 1987). Moreover, "the responsibility for weighing conflicting evidence, where reasonable minds could differ as to the outcome, falls on the Commissioner and his designee, the ALJ. It does not fall on the reviewing Court." Seavey v. Barnhart, 276 F.3d 1, 10 (1st Cir. 2001) (citation omitted). In applying the "substantial evidence" standard, the Court must bear in mind that it is the province of the ALJ, not the courts, to find facts, decide issues of credibility, draw inferences from the record, and resolve conflicts of evidence. Ortiz v. Sec'y of Health and Human Servs., 955 F.2d 765, 769 (1st Cir. 1991). Reversal is warranted only if the ALJ committed a legal or factual error in evaluating Plaintiff's claim, or if the record contains no "evidence rationally adequate . . . to justify the conclusion" of the ALJ. Roman-Roman v. Comm'r of Soc. Sec., 114 Fed. Appx. 410, 411 (1st Cir. 2004); see also Manso-Pizarro v. Secretary of Health and Human Servs., 76 F.3d 15, 16 (1st Cir. 1996).
B. Standard for Entitlement to Disability Benefits
In order to qualify for disability benefits, a claimant must demonstrate that he or she is "disabled" within the meaning of the Social Security Act. The Social Security Act defines a "disability" as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). The impairment must be severe enough to prevent the claimant from performing not only his past work, but also any substantial gainful work existing in the national economy. See 42 U.S.C. § 423(d)(2)(A); 20 C.F.R. § 404.1560(c)(1).
An applicant's impairment is evaluated under a five-step analysis set forth in the regulations promulgated under the statute. See 20 C.F.R. § 404.1520. The First Circuit has described the analytical sequence as follows:
First, is the claimant currently employed? If he is, the claimant is automatically considered not disabled.Goodermote v. Secretary of Health and Human Servs., 690 F.2d 5, 6-7 (1st Cir. 1982).
Second, does the claimant have a severe impairment . . . mean[ing] an impairment 'which significantly limits his or her physical or mental capacity to perform basic work-related functions[?]' If the claimant does not have an impairment of at least this degree of severity, he is automatically considered not disabled.
Third, does the claimant have an impairment equivalent to a specific list of impairments contained in . . . Appendix 1 [of the Social Security regulations]? If the claimant has an impairment of so serious a degree of severity, the claimant is automatically found disabled. . . . If, however, his ability to perform basic work-related functions is impaired significantly (test 2) but there is no 'Appendix 1' impairment (test 3), the [ALJ] goes on to ask the fourth question:
Fourth, does the claimant's impairment prevent him from performing work of the sort he has done in the past? If not, he is not disabled. If so, the agency asks the fifth question.
Fifth, does the claimant's impairment prevent him from performing other work of the sort found in the economy? If so, he is disabled; if not, he is not disabled.
The burden of proof is on the applicant as to the first four inquiries. See 42 U.S.C. § 423(d)(5)(A) ("An individual shall not be considered to be under a disability unless he furnishes such medical and other evidence of the existence thereof as the [ALJ] may require.").
If the applicant has met his or her burden as to the first four inquiries, then the burden shifts to the Commissioner to present "evidence of specific jobs in that national economy that the applicant can still perform." Freeman v. Barnhart, 274 F.3d 606, 608 (1st Cir. 2001). In determining whether the applicant is capable of performing other work in the economy, the ALJ must assess the applicant's RFC in combination with vocational factors, including the applicant's age, education, and work experience. 20 C.F.R. § 404.1560(c).
III. Analysis
A. The Administrative Law Judge's Findings
The ALJ followed the five-part analysis called for by the regulations to determine whether plaintiff had been under a disability from the alleged disability onset date through the date of decision. See 20 C.F.R § 404.1520.
At step one, the ALJ found that plaintiff had engaged in work activity since September 14, 2011, the alleged date of onset, but it appears that the ALJ did not find that the work reached the level of substantial gainful activity. (A.R. 13).
At step two, the ALJ found that plaintiff has several severe impairments, including "degenerative disc disease in the cervical spine, depression, anxiety, and a history of opioid abuse." (A.R. 14).
At step three, the ALJ determined that plaintiff does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 ("Appendix 1"). (A.R. 18).
At step four, the ALJ found that plaintiff is not capable of performing past relevant work as a real estate agent, paralegal, or attorney, as those are classified as skilled positions. (A.R. 21-22). That determination was based upon the ALJ's finding that plaintiff had the RFC to perform only semi-skilled "light work" as defined in 20 C.F.R. 404.1567(b) and 404.967(b), but that his past work was classified as "light skilled" or "sedentary skilled." (A.R. 20-21). In the RFC assessment, the ALJ found that plaintiff was neurologically intact as to his strength, sensation, and reflexes, and that he was capable of various activities including standing, sitting, walking, and driving. (A.R. 21). The ALJ also found that while he was capable of performing light work, he should have no more than occasional contact with the public; is unable to work in tandem or in a team of people; and that he is limited to semi-skilled work, given his limited ability to understand, remember, and carry out detailed instructions. (A.R. 20).
At step five, the ALJ found that there are other jobs existing in the national economy that plaintiff is able to perform. (A.R. 22). That determination was based upon plaintiff's RFC to perform light work and the opinion of a vocational expert, who determined that he could work in representative occupations, such as cleaner, courier, and manufacturing inspector. (A.R. 22). On that basis, the ALJ concluded that plaintiff was "not disabled." (A.R. 23).
B. Plaintiff's Objections
Though not perfectly clear, plaintiff appears to challenge the sufficiency of the evidence supporting two related findings of the ALJ: (1) that he has the RFC to perform "light work" and (2) that there is work in significant numbers in the national economy that he is able to perform.
In his complaint, plaintiff also alleged that he had presented sufficient evidence demonstrating that his impairments were severe. However, plaintiff's motion to reverse or remand does not address that point, and he is therefore deemed to have waived that argument. See Soto-Cedeno v. Astrue, 380 Fed. App'x 1, 4-5 (1st Cir. 2010) (deeming argument not raised in briefing to be waived). --------
1. RFC to Perform "Light Work"
The ALJ's finding regarding plaintiff's RFC is supported by substantial evidence in the record and therefore must be affirmed. The ALJ's finding that he could perform "light work," with some limitations, was supported by the opinions of the state-agency medical consultants. Those consultants determined that—based on medical evidence and plaintiff's function report—he had the capacity to perform light work with certain physical, mental, and social limitations. (A.R. 17-18; A.R. 78-93; A.R. 113-131). The ALJ's finding was also supported by evidence that he engaged in various social and recreational activities, such as attending a musical festival, regularly attending synagogue, camping, hiking, and doing yoga, as well as evidence that he was able to do some cooking and cleaning and travel independently, as well as go to the office on a part-time basis. (A.R. 16-18; A.R. 56-57; A.R. 60-61; A.R. 123-24; A.R. 947; A.R. 956). While plaintiff has pointed to some contradictory evidence in the record, he has not demonstrated why the evidence relied upon by the ALJ was insufficient or incorrect. See Greene v. Astrue, 2012 WL 1248977, at *3 (D. Mass. April 12, 2012) ("Plaintiff must show not only the existence of evidence in the record supporting her position but must also demonstrate that the evidence relied on by the ALJ is either insufficient, incorrect, or both.") (emphasis original).
Plaintiff contends that the ALJ's RFC analysis failed to account for the impact of all of his impairments throughout the claimed period of disability. Specifically, he contends that the RFC analysis failed to address the period between September 2011 and March 2013, when he experienced severe neck pain, headaches, and upper extremity pain, as well his June 2012 finger dislocation and wrist fracture. However, the ALJ's opinion detailed the full history of plaintiff's injuries and limitations. (A.R. 14-18). In fact, the ALJ specifically relied on plaintiff's injuries and impairments between 2011 and 2013, as well as his June 2012 finger dislocation and wrist facture, in determining (at step two of the analysis) that he had severe impairments. (A.R. 14-15). While the ALJ did not recount the factual history of plaintiff's impairments in the RFC section of his analysis, such repetition is not required. See Rice v. Barnhart, 384 F.3d 363, 370 n.5 (7th Cir. 2004) (noting that ALJ's decision should be read as a whole and that "it would be a needless formality to have the ALJ repeat substantially similar factual analysis" at multiple steps in the analysis). Furthermore, the RFC analysis explicitly discusses plaintiff's 2011 back and neck injuries, and the reported pain that resulted from those injuries, and it recognizes that he has some functional limitations due to his neck and back injuries. (A.R. 20-21).
Plaintiff also contends that the ALJ failed to give proper credit to the medical opinion of his psychiatric nurse, Claire Cayer. Nurse Cayer found that he was moderately impaired in his ability to understand, remember, and carry out detailed instructions; complete a normal workday; interact appropriately with the public; and respond to unexpected changes in the work setting. However, even conflicting evidence in the record is insufficient to upset the ALJ's findings where they are otherwise supported by substantial evidence. See Rodriguez, 647 F.2d at 222. As stated above, the ALJ's finding that plaintiff is capable of performing "light work" is supported by substantial evidence. Furthermore, the ALJ was not required to give substantial weight to the opinion of plaintiff's nurse. While ALJs "must give controlling weight to the opinion of a 'treating source' when that opinion is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is consistent with substantial evidence in the record," nurses are not "treating sources" under the applicable regulations. Taylor v. Astrue, 899 F. Supp. 2d 83, 87-88 (D. Mass. 2012) (explaining that a nurse is not an "acceptable medical source" under the regulations and therefore cannot be a "treating source"). As an "other medical source," the ALJ had the discretion to assign whatever weight he deemed appropriate to the nurse's opinion, provided that he adequately explained his treatment of her opinion. Id. at 88-89. The ALJ explained that he discredited her opinion because her own mental status examination findings did not support the degree of limitations that she reported in her opinion. (A.R. 21). The ALJ thus did not commit an error as to his consideration of her opinion.
Finally, the plaintiff contends that, based on his medical impairments, his RFC should be limited to sedentary work. However, as already stated, the ALJ's finding that he had the RFC to perform "light work" is supported by substantial evidence in the record and therefore must be affirmed. See Rodriguez, 647 F.2d at 222.
2. Existence of Other Work in the Economy
Plaintiff next contends that the ALJ failed to consider the effects of all of his impairments in determining whether there is any work in the national economy that he is capable of performing. He contends, in essence, that due to his pain, anxiety, and depression, there are no jobs that he is capable of performing.
Plaintiff points to no evidence support his contention that his impairments make him incapable of performing any job in the national economy, and the record makes clear that the ALJ did properly consider his limitations when determining the jobs he would be capable of performing. The ALJ noted that he did not have the capacity to perform the full range of "light work," and that his various impairments restricted him to only "semi-skilled" or "unskilled" "light work." (A.R. 20, 22). Based upon those determinations, the ALJ then relied upon the testimony of a vocational expert to identify jobs in the national economy that a person "with the claimant's age, education, work experience, and residual functional capacity" would be able to perform. (A.R. 22). The vocational expert's testimony was specifically intended to take into account any erosion of the light occupational base caused by plaintiff's limitations. (Id.). The vocational expert testified that an individual with plaintiff's qualifications and limitations would be able to perform all of the requirements of the representative occupations of courier, cleaner, and manufacturing inspector. (Id.). The vocational expert further testified that significant numbers of jobs in those identified occupations existed not only within the national economy in general, but also within Massachusetts in particular. (Id.). On the basis of that testimony, the ALJ concluded that "the claimant is capable of making a successful adjustment to other work that exists in significant numbers in the national economy" and that "[a] finding of 'not disabled' is therefore appropriate." (A.R. 23). The ALJ was entitled to rely on the testimony of the vocational expert. See Szumylo v. Astrue, 815 F. Supp. 2d 434, 441 (D. Mass. 2011). Thus, the ALJ's conclusion that plaintiff is capable of performing other work in the economy and therefore is not disabled must be affirmed, and plaintiff's specific contentions otherwise are unavailing.
Conclusion
For the foregoing reasons, the motion of the plaintiff to reverse the decision of the Commissioner is DENIED, and the motion of the defendant to affirm the decision of the Commissioner is GRANTED.
So Ordered.
/s/ F. Dennis Saylor
F. Dennis Saylor IV
United States District Judge Dated: April 27, 2017