Opinion
Case No. A1-01-88
March 13, 2003
MEMORANDUM AND ORDER
The plaintiff, Clyde Aalund, seeks judicial review of the Social Security Commissioner's denial of his application for disability insurance benefits. For the reasons set forth below, the Defendant's Motion for Summary Judgment is GRANTED and the Plaintiff's Motion for Summary Judgment is DENIED.
I. PROCEDURAL HISTORY
The plaintiff, Clyde Aalund [Aalund], protectively applied for disability insurance benefits in late December 1999, alleging that he had been disabled since February 1, 1991. (Tr. 101-103). Aalund's application for benefits was denied initially and again upon reconsideration. (Tr. 88-94). He subsequently requested a de novo hearing before an administrative law judge [ALJ]. (Tr. 95).
On March 29, 2001, ALJ James D. Geyer conducted an administrative hearing in Minot, North Dakota. (Tr. 26). The ALJ issued a decision on April 17, 2001, wherein he concluded that Aalund was not disabled and was not entitled to disability benefits under the Social Security Act. (Tr. 10-23). On July 13, 2001, the Appeals Council denied Aalund's request for review. (Tr. 5-6). The Appeals Council adopted the ALJ's decision as the final decision of the Commissioner.
Aalund then filed a complaint with this Court on September 11, 2001, seeking judicial review of the decision of the Commissioner of Social Security.
II. BACKGROUND OF THE CASE
Clyde Aalund was born on November 2, 1952, and was 49 years old at the time of his administrative hearing. (Tr. 30, 101). Aalund has worked at various times as an auto mechanic, oil field driller, derrick hand, scrub hand, railroad section hand, and farm laborer. (Tr. 31, 115, 127, 151).
In addition to graduating from high school, Aalund also attended college. In the late 1970's he completed a course of study in auto mechanics at the State School of Science in Grafton, North Dakota. In January 1997, he enrolled at the University of North Dakota — Williston, where he completed two semesters. (Tr. 64-65). However, he quit school in 1999, on account of his back pain. (Tr. 65).
Aalund injured his back on December 20, 1990, while working on an oil rig. (Tr. 153, 178). He was subsequently diagnosed with a bulged disc at the L3-L4 level and with mild subluxation at L3-L4. (Tr. 153). Since the accident, Aalund has experienced back pain, hip and leg pain, headaches, and numbness in his hands and feet. (Tr. 114). He has been prescribed the following pain medications: Oxycontin, Hydrocodone, Hydromorphone, Diazepan, and Stadal NS. (Tr. 119, 137). Although these medications have been moderately effective, Aalund has experienced side effects such as drowsiness, nervousness, and blurred vision. (Tr. 137).
In addition to prescription drugs, Aalund has utilized a regimen of over-the-counter ointments, hot showers, swimming, and chiropractic treatments for pain relief. (Tr. 64, 138). He has also participated in physical therapy after sustaining his back injury. (Tr. 152-62).
Although Aalund continues to ride horse on occasion, he can no longer participate in rodeos as he did before his accident. He has also been unable to ride bike, snowmobile, dance, run, or engage in other activities that involve twisting or turning. (Tr. 61, 138). Aalund's condition has reportedly deprived him of regular sleep and affected his ability to drive, stand or sit for extended periods, and concentrate while reading. (Tr. 56-57, 135, 138). He insists that he is unable to dust, scrub, or perform yard work. (Tr. 138). Nevertheless, Aalund remains capable of caring for his horses, hunting, caring for his personal needs, and working occasionally doing combine work and repairing fences. (Tr. 44, 48, 138, 141,149).
Aalund initially sought treatment from Richard Nelson, M.D. shortly after the accident. In May 1991, Dr. Nelson examined Aalund. (Tr. 257). Aalund claimed to have injured himself while working on an oil rig in December 1990. (Tr. 257). He complained that his right hand went numb and that he had back pain. His mental status was intact and his reflexes were normal. He had a decrease in sensation over the left foot. (Tr. 257). Dr. Nelson's impression was a lumbosacral disc protrusion. (Tr. 257). An MRI revealed no evidence of disc herniation. (Tr. 256). Dr. Nelson recommended conservative treatment and weight loss. (Tr. 256). Dr. Nelson opined that Aalund could perform work in a "light duty capacity." (Tr. 255). With work hardening, Dr. Nelson thought Aalund might be able to perform medium to heavy labor. (Tr. 255).
In October 1991, Dr. Nelson indicated that Aalund should undergo a Functional Capacities Evaluation (FCE). (Tr. 254). The FCE revealed that Aalund could perform at the medium labor status. (Tr. 254).
In September 1992, Dr. Nelson thought Aalund could lift 10-39 pounds. (Tr. 253). Dr. Nelson believed Aalund could perform sedentary and light work. In November 1993, Dr. Nelson opined that Aalund could perform light duty work. (Tr. 248). In July 1994, Dr. Nelson reiterated that Aalund could perform light duty work (Tr. 246), but he expressed the opinion that Aalund could not perform medium duty work. (Tr. 246).
Aalund underwent another FCE on January 9, 1997. (Tr. 231-34). He was able to sit, stand, crawl, stepladder climb, rotate, bend, and squat without significant functional limitations. (Tr. 232). The assessor believed Aalund could work at the medium exertion level. (Tr. 233). However, Dr. Nelson did not believe the FCE for medium level work was accurate. (Tr. 235). In August 1997, Dr. Nelson opined that Aalund could perform sedentary work. (Tr. 229).
In March 1998, Aalund told Dr. Nelson he was in school. (Tr. 228). In April 1998, Dr. Nelson noted an EMG nerve conduction study was abnormal, revealing venous congestion of the left leg and possible phlebitis. (Tr. 228). In May 1998, Dr. Nelson noted that studies were normal for veins. (Tr. 226). In June 1998, Aalund reported he had a 3.4 grade point average. In October 1998, Dr. Nelson recommended Aalund stop school due to an exacerbation of low back pain. (Tr. 221). Dr. Nelson's notes indicate Aalund continued to complain of pain through November 1999. (Tr. 207-211).
In a letter written to the ALJ dated March 24, 2001, Dr. Nelson opined that Aalund was "capable of doing light duty or sedentary work" but as a practical matter, he was "unable to sustain any kind of work or any description." (Tr. 285).
In November 1998, Aalund underwent a neurosurgical evaluation by Lashman Soriya, M.D. (Tr. 216). According to Dr. Soriya's report, Aalund exhibited normal muscle strength and tone in the upper and lower extremities, normal flexion and minimal limitation and extension in the lumbar spine, and a normal gait. (Tr. 217-218). The report also indicated that Dr. Soriya could find no "evidence of an ongoing radiculopathy or myelopathy." (Tr. 218).
Aalund also sought out the chiropractic services of Dr. Woodrow Sveen in October 1998. (Tr. 277). In Dr. Sveen's opinion, Aalund's lower back condition precluded him from returning to any gainful employment. Dr. Sveen expressed the same opinion again in May 2000 and March 2001 (Tr. 277-278).
Pierre Andre, a longtime friend and former co-worker, testified at the administrative hearing that Aalund suffered from acute back pain. (Tr. 72-73). Additionally, Andre testified that, in his opinion, Aalund was depressed due to his inability to return to work in the oil fields. (Tr. 74-75).
Lorna Mathias, a vocational expert, also testified at the administrative hearing. Accepting Aalund's claims as credible, Mathias concluded that Aalund could not return to his past relevant work. Mathias concluded that a hypothetical person of Aalund's age, experience, education, and work background would be unable to perform his past relevant work. Assuming that the person suffered from the limitations described in the residual functional capacity assessment dated February 6, 2000, Mathias testified that the hypothetical individual could work as a scrub hand, a driller, or a farm worker. Next, assuming that the hypothetical person suffered from limitations described in the functional capacity evaluation dated March 25, 1997, Mathias testified that the individual would remain capable of performing a full range of light work. (Tr. 79). Further, Mathias testified that assuming that the hypothetical person suffered from limitations described in Dr. Nelson's letter of September 1, 1992, the individual could perform light work. (Tr. 79). Finally, assuming that the hypothetical person suffered from the limitations described in Dr. Nelson's letter of August 11, 1997, Mathias testified that the person could probably perform sedentary, unskilled jobs that existed in sufficient numbers throughout the national economy. (Tr. 80).
III. ALJ'S DECISION
At the outset of his analysis, the ALJ emphasized that Aalund was insured for disability insurance benefits through December 31, 1997, and was required to establish disability on or prior to that date. (Tr. 14). The ALJ then proceeded to review Aalund's claim in accordance with the following five-step sequential framework: (1) whether the claimant is presently engaged in a substantial gainful activity, (2) whether the claimant has a severe impairment that significantly limits the claimant's physical or mental ability to perform basic work activities, (3) whether the claimant has an impairment that meets or equals a presumptively disabling impairment listed in the regulations, (4) whether the claimant has the residual functional capacity to perform his or her past relevant work, and (5) if the claimant cannot perform the past work, whether the Commissioner can prove that there are other jobs in the national economy that the claimant can perform. (Tr. 14-19).
This framework is set forth in 20 C.F.R. § 404.1520.
Initially, the ALJ noted that Aalund had engaged in work activities since February 1991, the alleged onset date of disability, but that such activities constituted unsuccessful work attempts because they had not generated monthly income at substantial gainful activity levels. (Tr. 14). The ALJ then moved on to the second and third steps of his analysis wherein he determined that Aalund had a severe impairment, but that it was not severe enough to meet or equal the requirements of an impairment in the listing of impairments. (Tr. 16). Moving to the fourth step of his analysis, the ALJ undertook a review of Aalund's residual functional capacity. (Tr. 16). After assessing his symptoms and subjective pain complains, the ALJ concluded that the greater weight of the evidence did not support a finding that Aalund was precluded from performing all work activity prior to December 31, 1997. (Tr. 15-16, 22).
The ALJ reviewed the medical evidence and emphasized that the functional capacity evaluations and statements made by Aalund's treating physician had shown that he was capable of performing light duty work. (Tr. 15-21). The ALJ noted that the activities described by Aalund at his administrative hearing were inconsistent with debilitating pain or other symptoms that would preclude him from working. (Tr. 20). The ALJ then proceeded to the final step of the analysis. (Tr. 21). Finding that Aalund was capable of performing light work, the ALJ identified jobs such as a telemarketer, parking lot attendant, or security guard that were available in significant numbers in the national economy. (Tr. 22). The ALJ found that Aalund could perform a significant number of jobs in the regional and national economies. (Tr. 22). In short, while the ALJ recognized that Aalund had experienced some limitations on account of pain, he did not believe that the claims of pain and of limitations of a totally disabling nature were supported by the evidence as a whole, or that Aalund was precluded from performing sedentary or light duty work prior to December 27, 1997, as described by the vocational expert. (Tr. 20-22). The ALJ found that Aalund was not disabled.
IV. STANDARD OF REVIEW
The Court plays a limited role when reviewing the Commissioner's decisions. Wiseman v. Sullivan, 905 F.2d 1153, 1155 (8th Cir. 1990). The Court does not conduct a de novo review. Keller v. Shalala, 26 F.3d 856, 858 (8th Cir. 1994). Rather, it looks at the record as a whole to determine whether the decision is supported by substantial evidence. Upon review of the pleadings and transcript of the record, the Court can affirm, modify, or reverse the decision of the Commissioner, with or without remanding the cause for a rehearing. 42 U.S.C. § 405(g). To affirm the Commissioner's decision, the Court must find that it is supported by substantial evidence appearing in the record as a whole. Cruse v. Bowen, 867 F.2d 1183, 1184 (8th Cir. 1989). "Substantial evidence is less than a preponderance, but enough so that a reasonable mind might find it adequate to support the conclusion." Robinson v. Sullivan, 956 F.2d 836, 838 (8th Cir. 1992). The review of the record is more than a search for evidence supporting the Commissioner's decision. The Court must also take into account matters that detract from the ALJ's findings and apply a balancing test to weigh evidence which is contradictory. Kirby v. Sullivan, 923 F.2d 1323, 1326 (8th Cir. 1991); Sobania v. Secretary of Health Human Services, 879 F.2d 441, 444 (8th Cir. 1989).
When conducting its review, the Court employs a "scrutinizing analysis" that balances the supporting and contradictory evidence on the record. Gavin v. Heckler, 811 F.2d 1195, 1199 (8th Cir. 1987). As noted, this requires more than a search for evidence that supports the Commissioner's decision. Id. The Court must review the entire record and weigh all evidence that fairly detracts from the Commissioner's findings. Cruse v. Bowen, 867 F.2d 1183, 1184 (8th Cir. 1989).
When determining whether there is substantial evidence to support the Commissioner's decision, the Court must consider:
1) the credibility findings made by the ALJ;
2) the plaintiff's vocational factors;
3) medical evidence from treating and consulting physicians;
4) the plaintiff's subjective complaints relating to exertional and non-exertional activities and impairments;
5) any corroboration by third parties of the plaintiff's impairments; and
6) the testimony of vocational experts that is based upon a proper hypothetical questions setting forth the plaintiff's impairment.
Baker v. Secretary of Health and Human Services, 955 F.2d 552, 555 (8th Cir. 1992).
The substantial evidence standard "allows for the possibility of drawing two inconsistent conclusions, thus it embodies a zone of choice within which the [Commissioner] may decide to grant or deny benefits without being subject to reversal on appeal." Culbertson v. Shalala, 30 F.3d 934, 939 (8th Cir. 1994). In other words, while the Court may weigh evidence differently, it cannot reverse a Commissioner's decision if there is sufficient evidence to support either outcome. Id.
V. LEGAL DISCUSSION
Aalund contends that the ALJ erred in that he failed to appropriately assess Aalund's subjective pain complaints and corresponding limitations. Aalund also contends that the ALJ did not take Aalund's edema into consideration and ignored the opinion of Dr. Richard Nelson, Aalund's treating physician. Next, Aalund contends that the ALJ gave little consideration to his attempts at pain management. Finally, Aalund contends that his credibility was never really called into question.
It is clear from the record that the focus of the ALJ's inquiry was whether Aalund was disabled as defined by the Social Security Act before December 31, 1997. His focus was appropriate given that "claimants who apply for benefits for a current disability after the expiration of their insured status must prove that the current disability had existed continuously since a date on or before the date that their insurance coverage lapsed." Flaten v. Secretary, Health Human Servs., 44 F.3d 1453, 1462 (9th Cir. 1995).
"Disability" is defined in the Act 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) and 42 U.S.C. § 1382c(a)(3)(A).
An examination of the record reveals that the ALJ followed the five-step sequential evaluation as required and gave careful consideration to Aalund's subjective pain complaints and corresponding limitations as mandated by the Eighth Circuit in Polaski v. Heckler, 739 F.2d 1320. (Tr. 16-23). The ALJ initially reviewed Aalund's daily activities, discussing his successful return to school as well as changes in Aalund's activity level following the accident on the oil rig. (Tr. 17). Next, the ALJ reviewed Aalund's subjective pain complaints described in the medical records submitted in support of Aalund's application and in the witnesses testimony at the administrative hearing. (Tr. 18). The ALJ reviewed the functional capacity assessment that Aalund had undergone in January 1997. (Tr. 19). The ALJ pointed out that, according to this assessment, Aalund remained capable of, among other things, carrying up to 60 pounds occasionally and pushing/pulling 79-110 pounds. (Tr. 19). The ALJ also highlighted the fact that Dr. Nelson had reported on more than one occasion that Aalund was capable of light work. (Tr. 19). The ALJ discounted the most recent statements made by Dr. Nelson, explaining that the earlier statements would have been based upon clinical examinations conducted at those times. (Tr. 20). Additionally, the ALJ discounted the reports of Aalund's chiropractor on the basis that the chiropractor's treatments commenced after the expiration of Aalund's insured status on December 31, 1997. (Tr. 20).
There is substantial objective evidence in the record to support the ALJ's finding that Aalund was capable of performing light work at the time his coverage lapsed. In evaluating Aalund's residual functional capacity, the ALJ noted that Aalund's activities were not consistent with his allegations of total disability. (Tr. 17-18). Although the ALJ conceded that Aalund's activities prior to December 31, 1997, were "ill defined," there was evidence of activities inconsistent with his allegations after that date. (Tr. 17). For example, Aalund had attended college and had also worked after the onset date of his injuries. See Ostronski v. Chater, 94 F.3d 413, 418 (8th Cir. 1996); Piepgras v. Chater, 76 F.3d 233, 236 (8th Cir. 1996) (working eight hours a day two days a week was inconsistent with allegations of disability). All of these factors related to the ALJ's assessment of Aalund's credibility.
Further, Aalund hunted and ice fished. (Tr. 45-48). He cared for four horses and rode horse on two occasions. (Tr. 46, 49). While these activities are not dispositive in determining disability, they are certainly persuasive evidence supporting the ALJ's assessment of his credibility. Because the ALJ discredited Aalund's subjective complaints for good reason, the Court should not disturb the decision. See Gowell v. Apfel, 242 F.3d 793, 796 (8th Cir. 2001) ("We will not disturb the decision of an ALJ who considers, but for good cause expressly discredits, a claimant's complaints of disabling pain, even in cases involving somatoform disorder.")
The ALJ also considered the medical evidence which indicated that Aalund could perform a range of light exertional work prior to December 31, 1997. (Tr. 18-20). For example, the ALJ noted that, in May 1991, Dr. Nelson had indicated that Aalund could perform light duty work. (Tr. 18; see Tr. 255). In September 1992, Dr. Nelson indicated Aalund could lift between 10 and 39 pounds. (Tr. 253). In March 1993, Dr. Nelson opined that Aalund could perform light duty work (Tr. 250), and in November 1993, Dr. Nelson opined that Aalund could perform light duty work. (Tr. 248). A treating physician's opinion should be granted substantial or controlling weight if it is well supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in the record. See Prosch v. Apfel, 201 F.3d 1010, 1014 (8th Cir. 2000) (ALJ properly discounted treating physician's opinion which was inconsistent with an earlier opinion, and which conflicted with other substantial medical evidence).
It is well-established that deference must be given to the ALJ's assessment of the credibility of Aalund and other witnesses. It is clear from the record that the ALJ reflected upon Aalund's subjective complaints of pain and took into account his daily activities, the duration and levels of pain, the effectiveness of medication, and his functional restrictions into consideration. (Tr. 25-29).
There is little dispute that Aalund has suffered from longstanding pain attributable to a gradually worsening condition. Nevertheless, this Court cannot substitute its judgment for that of the ALJ because there is substantial evidence in the record to support the ALJ's findings of fact and conclusions of law. Deference must be given to the ALJ's assessment of the credibility of Aalund and of the other witnesses. The record demonstrates that the ALJ reflected upon all of the objective medical evidence as well as Aalund's subjective complaints of pain before rendering a decision. The Court finds that there is substantial evidence in the record to support the Commissioner's decision that Aalund did not meet the disability requirements of the Social Security Act.
VI. CONCLUSION
The Court GRANTS the Defendant's Motion for Summary Judgment (Docket No. 13) and DENIES Aalund's Motion for Summary Judgment (Docket No. 14).
SO ORDERED.