Duffy v. Saul

JOHN DUFFY, Plaintiff, v. ANDREW M. SAUL, ACTING COMMISSIONER OFSOCIAL SECURITY ADMINISTRATION, Defendant.

Civil Action No.: 18-cv-12342-DJC

UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS

February 21, 2020

MEMORANDUM AND ORDER

CASPER, J.

I. Introduction

Plaintiff John Duffy ("Duffy") filed an application for supplemental security income ("SSI") with the Social Security Administration ("SSA") on August 3, 2016. R. 212.¹ Pursuant to the procedures set forth in the Social Security Act, 42 U.S.C. §§ 405(g), 1383(c)(3), Duffy brought this action for judicial review of the final decision of Defendant Acting Commissioner² of the SSA ("the Commissioner"), issued by the Appeals Council, denying Duffy's application for SSI benefits on September 25, 2018. R. 1-7. Before the Court are Duffy's motion to reverse,D. 16, and the Commissioner's motion to affirm that decision, D. 17. In his motion, Duffy argues that the administrative law judge ("ALJ") erred in denying his claim because the ALJ's Residual Functional Capacity ("RFC") finding is internally inconsistent and does not represent a light work RFC and because the ALJ's credibility finding is not consistent with the record. D. 16 at 4, 11, 16. For the reasons discussed below, the Court DENIES Duffy's motion, D. 16, and ALLOWS the Commissioner's motion, D. 17.

II. Standard of Review

This Court has the power to affirm, modify, or reverse a decision of the Commissioner upon review of the pleadings and record. 42 U.S.C. § 405(g). Such review, however, is "limited to determining whether the ALJ deployed the proper legal standards and found facts upon the proper quantum of evidence." Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999) (citing Manso-Pizarro v. Sec'y of Health and Human Servs., 76 F.3d 15, 16 (1st Cir. 1996)). Issues of credibility and inferences drawn from the facts on record are the responsibility of the Commissioner, who ultimately resolves conflicts in the evidence and determines the disability status of the claimant. Lizotte v. Sec'y of Health & Human Servs., 654 F.2d 127, 128 (1st Cir. 1981) (citing Rodriguez v. Sec'y of Health and Human Servs., 647 F.2d 218, 222 (1st Cir. 1981)). The ALJ's findings of fact are conclusive when supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence exists "if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support [the Commissioner's] conclusion." Rodriguez, 647 F.2d at 222. As such, the Court must affirm the Commissioner's decision if it is supported by substantial evidence "even if the record arguably could justify a different conclusion." Rodriguez Pagan v. Sec'y of Health & Human Servs., 819 F.2d 1, 3 (1st Cir. 1987); see Am. Textile Mfrs. Inst., Inc. v. Donovan, 452 U.S. 490, 523 (1981).

III. Procedural Background

A. Prior SSA Claim

Duffy stopped working on April 1, 2009. R. 256. Duffy previously worked as a glazier, metal fabricator and warehouse worker. R. 70, 257. Duffy filed a claim for SSI benefits with the SSA on June 25, 2013, alleging disability with an onset date of November 1, 2011. R. 85. His claim was denied upon initial review on September 26, 2013, and upon reconsideration on December 10, 2013. Id. On February 10, 2014, Duffy filed a timely request for a hearing before an ALJ and a hearing was held on October 15, 2014. Id. In a decision dated December 18, 2014, the ALJ found that Duffy did not have a disability within the definition of the Social Security Act and denied Duffy's claims. R. 94. The Appeals Council denied Duffy's request for review on March 10, 2016. R. 121. Duffy appealed the final decision of the Commissioner to this Court (Saris, D.J.), which denied Duffy's motion to reverse the decision of the Commissioner on August 7, 2017. Duffy v. Colvin, 268 F. Supp. 3d 282, 291 (D. Mass. 2017). Prior to that decision, however, Duffy reapplied for SSI alleging disability due to a neck injury and back problem, R. 223, which is the subject of this appeal.

B. Present SSA Claim

Duffy filed this claim for SSI benefits with the SSA on August 3, 2016, alleging disability with an onset date of December 10, 2014,³ R. 212, later amended to April 28, 2016. Id.; R.38; R. 94. His claim was initially denied on September 26, 2016, R. 22, and was denied upon reconsideration on December 6, 2016. Id. On December 20, 2016, Duffy filed a timely request for a hearing before an ALJ and a hearing was held on September 14, 2017. Id. The ALJ foundthat Duffy did not have a disability within the definition of the Social Security Act and denied Duffy's claims. R. 19-29.

Duffy filed a timely appeal of the ALJ's decision to the Appeals Council. R. 4. The Appeals Council modified some of the ALJ's findings and adopted the ALJ's decision as modified. R. 4-7. The Appeals Council's decision is the final decision of the Commissioner. R. 1. Duffy now seeks review from this Court. D. 1.

IV. Discussion

A. Legal Standards

1. Entitlement to Supplemental Security Income

A claimant is entitled to SSI benefits if he has a qualified "disability." 42 U.S.C. § 423(a)(1)(E). A "disability" is defined by the SSA as an "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 has lasted or can be expected to last for a continuous period of not less than 12 months." Id. §§ 416(i)(1), 423(d)(1)(A); 20 C.F.R. § 404.1505(a). The impairment must be sufficiently severe such that it renders the claimant unable to engage in any of their previous work or other "substantial gainful work which exists in the national economy." 42 U.S.C. § 423(d)(2)(A); 20 C.F.R. § 404.1505(a).

The Commissioner must follow a five-step analysis to determine whether the claimant is disabled and, thus, whether the application for Social Security benefits should be approved. 20 C.F.R. § 416.920(a)(4). The determination may be concluded at any step in the process. Id. § 416.920(a)(4). First, if the claimant is engaged in substantial gainful work activity, the application must be denied. Id. § 416.920(a)(4)(i). Second, if the claimant does not have, or has not had, within the relevant time period, a severe medically determinable impairment orcombination of impairments, the application must be denied. Id. § 416.920(a)(4)(ii). Third, if the impairment meets the conditions of one of the listed impairments in the Social Security regulations, the application must be approved. Id. § 416.920(a)(4)(iii). Fourth, if the impairment does not meet the conditions of one of the listed impairments, the Commissioner then determines the claimant's residual functional capacity ("RFC"). Id. § 416.920(a)(4)(iv). If the claimant's RFC is such that they can still perform their past relevant work, their application for benefits will be denied. Id. Fifth, if the claimant is unable to perform any other occupations in significant numbers within the national economy based on their RFC, education, work experience and age, they are disabled under the SSA and their application must be approved. Id. § 416.920(a)(4)(v). It is the ALJ's burden at step five to show that there are a significant number of jobs in the national job market that the claimant can perform. Goodermote v. Sec'y of Health & Human Servs., 690 F.2d 5, 7 (1st Cir. 1982).

B. Before the Appeals Council

1. Medical History

The ALJ considered evidence about Duffy's medical history including treatment, surgeries, assessments and diagnoses. R. 24-29. The Appeals Council relied upon the materials before the ALJ in addition to a letter from the University of Massachusetts Disability Evaluation Services that the ALJ did not address in the hearing decision. See R. 4-5.

a. Neck pain and back pain

Duffy has experienced neck pain since he was hit on his head and back with a baseball bat and pipe during an assault in 2008. R. 521. Duffy was diagnosed with "cervical radiculopathy . . . due to degenerative disk disease" and had surgery in September 2012. R. 333-338. In May 2014, an MRI scan taken at Tufts Medical Center ("Tufts") showed mild cord impingement at C3-4 andC6-7, as well as decreasing bony edema at the C5-6 fusion and progressive narrowing of the right neural foramen at C6-7. R. 368-69. In July 2014, Duffy had a consultation with Neurological Consultants, Inc. for cervical pain. R. 485-86. In January 2015, Duffy was diagnosed by a physician at Tufts with pseudoarthrosis of C5-6 and C6-7 with foraminal narrowing and he had surgery. R. 406, 424. At a visit in March 2015, Duffy's physician noted that Duffy had not significantly improved and recommended physical therapy. R. 448.

An MRI in June 2015 found lumbar spondylosis and apparent "osseous anomalies involving the posterior elements of the L5 vertebral body." R. 399-400, 420. Duffy's physician recommended Lyrica and a pain consultation. R. 444. Duffy expressed pain from extension of his neck at a checkup in August 2015 and his physician recommended aquatherapy and "aggressive conservative therapy." R. 440. Duffy mentioned continued back pain and numbness in his forearm during a medical check-up in September 2015. R. 80. Further examination found evidence of an antalgic gait from lumbar spondylosis. R. 375. A CAT scan found congenital absence of the right lamina of L5 and bulky degenerative changes at L4-5 and L5-S1 resulting in severe and moderate spinal canal narrowing. R. 405. Duffy's physician again suggested physical therapy. R. 437.

An examination in March 2016 noted that Duffy still had back pain and his physician referred him to a pain clinic, noting that "[h]is lumbar MRI looks well without any obvious disc or pathology." R. 434. After he reported similar pain to a different physician at Tufts in May 2016 that physician administered a subacromial injection to address neck and shoulder pain. R. 459. A progress note from Brigham and Women's Hospital ("BWH") from May 2016 reported that Duffy had lower...