Opinion
CAUSE NO. 1:02-CV-296
February 21, 2003
MEMORANDUM OF DECISION AND ORDER
I. INTRODUCTION
This matter is before the Court for judicial review of a final decision of the defendant, Commissioner of Social Security ("Commissioner"), denying the application of the Plaintiff, Carol Frecker (the "Plaintiff'), for Disability Insurance Benefits ("DIB") beginning September 2, 1994.
Jurisdiction of the undersigned Magistrate Judge is based on 28 U.S.C. § 636(c), all parties consenting.
Section 205(g) of the Social Security Act ("the Act") provides, inter alia, "[a]s part of his answer, the [Commissioner] shall file a certified copy of the transcript of the record including the evidence upon which the findings and decision complained of are based. The court shall have the power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the [Commissioner], with or without remanding the case for a rehearing." It also provides, "[t]he findings of the [Commissioner] as to any fact, if supported by substantial evidence, shall be conclusive. . . ." 42 U.S.C. § 405(g).
The Plaintiff seeks a remand to Social Security for further review under 42 U.S.C. § 405(g).
II. THE PROCEDURAL AND FACTUAL BACKGROUND
A. The Procedural Background
On August 14, 1996, the Plaintiff filed an application for DIB, alleging an inability to work beginning September 2, 1994. The Plaintiff's claims were denied initially and upon reconsideration. On January 26, 1999, a hearing was held before the Administrative Law Judge Richard C. Ver Wiebe (the "ALJ"). The Plaintiff was represented by counsel, and testifying at the hearing were the Plaintiff and her sister, Marianne Barlow. In a decision dated February 18, 1998, the ALJ denied her benefits. (Tr. at 62-73). The Plaintiff timely appealed and on August 18, 1999, the Appeals Council remanded the case to the ALJ for further consideration. (Tr. at 83-85.)
Subsequently, on February 20, 2001, a new hearing was held involving the same ALJ, witnesses, and attorney. On June 26, 2001, the ALJ issued his decision wherein he made the following findings:
1. The claimant meets the nondisability requirements for a period of disability and Disability Insurance Benefits set forth in Section 216(i) of the Social Security Act and is insured for benefits through December 31, 1999.
2. The claimant has not engaged in substantial gainful activity since the alleged onset of disability.
3. The claimant has an impairment or a combination of impairments considered "severe" based on the requirements in the Regulations 20 C.F.R. § 404.1520(b).
4. These medically determinable impairments do not meet or medically equal one of the listed impairments in Appendix 1, Subpart P, Regulation No. 4.
5. The undersigned finds the claimant's allegations regarding her limitations are not totally credible for the reasons set forth in the body of the decision.
6. The undersigned has carefully considered all of the medical opinions in the record regarding the severity of the claimant's impairments ( 20 C.F.R. § 404.1527).
7. From September 2, 1994, through October 29, 1997, the claimant had the following residual functional capacity: lift and carry 5-10 pounds. Beginning on October 30, 1997, she was unable to perform even a limited range of sedentary exertional activity.
8. The claimant's past relevant work as an office clerical did not require the performance of work-related activities precluded by her residual functional capacity ( 20 C.F.R. § 404.1565).
9. The claimant's medically determinable low back pain did not prevent the claimant from performing her past relevant work from September 2, 1994, through October 29, 1997.
10. From September 2, 1994, through October 29, 1997 the claimant was not under a "disability' as defined in the Social Security Act ( 20 C.F.R. § 404.1520(e)).
11. The claimant was under a "disability" as defined in the Social Security Act ( 20 C.F.R. § 404.1520(e)) which began on October 30, 1997, and continues through the date of this decision.
12. Neither alcohol nor drug abuse are material to a finding of disability.
(Tr. at 24-25.)
Based on these findings, the ALJ determined that the Plaintiff was not entitled to DIB between September 2, 1994 and October 29, 1997, but that she was entitled to benefits thereafter. The Plaintiff requested review by the Appeals Council, which was denied on July 10, 2002, leaving the ALJ's decision as the final decision of the Commissioner. This appeal followed.
The Plaintiff filed her opening brief on December 30, 2002. The Commissioner filed her "Memorandum in Support of the Commissioner's Decision" on February 11, 2003. The Plaintiff replied on February 19, 2003.
B. The Factual Background
The Plaintiff was fifty-eight (58) years old in September 1994, the alleged onset date of disability, a person of advanced age under the Act. See 20 C.F.R. § 404.1563(e).
The Plaintiff was sixty-four years old on the date of the second hearing.
The Plaintiff has a high school education and has previous work experience as an optician, an office clerical worker, and a bookkeeper.
The Plaintiff claims a disability due to lumbar fusion with low back syndrome, Dysthymic Disorder, and Pain Disorder.
On November 3, 1993, the Plaintiff was admitted to Lutheran hospital, where she underwent a lumbar fusion from L-4 vertebra to the sacrum because of her lower back pain and spondylolisthesis. (Tr. at 162). The Plaintiff's postoperative course was "for the most part, uncomplicated, " and she was discharged from the hospital on November 7, 1993. ( Id.)
On September 9, 1994, seven days after the Plaintiff alleges that she became disabled, she underwent an examination at the Parkview Hospital Emergency Room for complaints of right hand pain. (Tr. 165-68). An X-ray revealed that she had fractured a bone in her right hand.
On October 10, 1994, the Plaintiff underwent surgery on her left thumb. (Tr. 170-71). After the surgery, she was discharged in satisfactory condition.
On June 29, 1995, the Plaintiff saw Dr. Mark V. Reecer, M.D., with complaints of chronic low back pain, which she indicated had been on-going since 1993. (Tr. at 186). She reported recently having had two epidural injections that did not significantly improve her lower back pain. ( Id.) The Plaintiff also noted that she had numbness in her left lower extremity involving the interior thigh and calf, and right knee pain. ( Id.)
On examination, Dr. Reecer noted moderate tenderness of the Plaintiff's lumbar spine area upon palpation, and moderate reduction in her lumbar range of motion with complaints of discomfort. ( Id.) A neurological examination of the Plaintiff's legs revealed no focal deficits, her reflexes were normal, and there was no atrophy. ( Id.) Manual muscle testing revealed normal strength in the Plaintiff's legs, and her sensory testing was normal. ( Id.) Dr. Reecer diagnosed the Plaintiff with chronic low back pain and right knee pain, possibly plica. (Tr. at 187). He recommended that the Plaintiff use a back brace and try a Transcutaneous Electrical Nerve Stimulation (TENS) unit for relief of her pain.
The Plaintiff followed up with Dr. Reecer on July 28, 1995, and she reported that her back pain was worse now than it was prior to her 1993 surgery. (Tr. at 185). Dr. Reecer recommended that she undergo an MRI scan of her lumbar spine.
The Plaintiff returned to Dr. Reecer on August 1, 1995. (Tr. at 184). Dr. Reecer reported that the Plaintiff's MRI revealed expected postoperative changes, but there was no significant stenosis, disk herniation, or any surgical legion.
On November 15, 1995, the Plaintiff saw Dr. G. Bojrab for a sacroiliac sac injection, and on December 6, 1995, a second injection was performed. (Tr. at 177-183.)
In a letter dated January 29, 1996, Dr. Reecer responded to the Plaintiff's written request for his help in obtaining DIB. (Tr. at 183). He informed the Plaintiff that objective medical findings were an important part of the disability inquiry and that, based on her lack of positive objective findings, she would not likely meet the standard. ( Id.)
On April 18, 1996, the Plaintiff saw Dr. Leon J. Grobler, M.D., at the Wake Forest University School of Medicine, with complaints of low back and left leg pain aggravated by sitting, standing, walking, lifting, and pushing/pulling. (Tr. at 193-95). The Plaintiff noted that lying down helped reduce her pain, and that she took ibuprofen and extra strength Tylenol for her pain. On examination, Dr. Grobler noted that the Plaintiff appeared to be in moderate discomfort, and that her lumbar range of motion was decreased with pain at the extremes and she could walk on her heels and toes with pain. Dr. Grobler stated that the Plaintiff's past MRI revealed an grade 1-2 spondylolisthesis at the L5-S1.
The Plaintiff followed up with Dr. Grobler on April 23, 1996. (Tr. at 192). The X-rays showed a grade 1-2 spondylolisthesis at L5-S1 and a solid fusion at L4-LS, with no other local findings. Dr. Grobler recommended that the Plaintiff undergo a myelo computed tomography (CT) scan in order to exclude lumbar spinal stenosis.
On April 30, 1996, Dr. Grobler noted that the CT scan showed no distinct abnormality (Tr. at 191). There was a slight narrowing at the L3-L4 vertebrae, but no distinct instability or frank nerve root compression. Based on these findings, Dr. Grobler did not recommend surgery. He stated that he would refer the Plaintiff to the pain clinic of her choice.
On October 18, 1996, the Plaintiff saw Dr. W. Joseph Martin, D.O., a pain management specialist at the Piedmont Institute of Pain Management. (Tr. at 203-204). The Plaintiff complained about severe back pain and stated that she took 800mg of ibuprofen daily to help control it. On examination, Dr. Martin noted that the Plaintiff had increased lumbar lordosis, but that her cervical range of motion was appropriate. (Tr. at 204.) She was able to heel walk, but could not toe walk due to discomfort and left leg weakness. ( Id.) The Plaintiff's straight leg raising was negative bilaterally while in the sitting position, and there was no sacroiliac tenderness on deep palpation. ( Id.) Dr. Martin further noted mild facet joint tenderness with five degrees of extension at L4-S1, primarily on the left, and piriformis tenderness on the left. Based on these findings, Dr. Martin diagnosed back pain (low back syndrome); radiculopathy at L5-S1 on the left, likely due to epidural fibrosis; and facet joint pain. ( Id.) Dr. Martin scheduled a myeloscopy for the next morning.
The Plaintiff followed up with Dr. Martin on October 31, 1996, two days after undergoing the myeloscopy and related injection of pain medication. (Tr. at 200). The Plaintiff reported that her back pain was significantly better, and that she could stand for longer periods of time without discomfort. Dr. Martin repeated his earlier diagnosis and prescribed Relafen for her pain.
The Plaintiff next saw Dr. Martin on January 27, 1997. (Tr. at 198-99). She reported that her low back pain had improved considerably, but that her left leg pain continued. Dr. Martin stated that the Plaintiff's symptoms were due to extensive scarring in the posterior epidural space that created a filling defect at L5-S1 on the left. ( Id.) Therefore, he performed a transcaudal nerve plasty. As a result of the success of this procedure, Dr. Martin stated that he was encouraged about being able to alleviate her radicular pain over time. However, he anticipated that the Plaintiff would experience some discomfort as a result of the procedure, so he prescribed Demerol.
The Plaintiff saw Dr. Martin again on March 24, 1997, reporting that her lower back pain had been alleviated. (Tr. 196-197). Consequently, the Plaintiff underwent another transcaudal nerve plasty, and after the procedure, the Plaintiff reported that her leg pain was gone.
The Plaintiff saw Dr. Martin on May 22, 1997, reporting that her leg pain had been eliminated, but she noted that she still experienced some mild discomfort with prolonged standing. (Tr. 195).
On August 5, 1997, the Plaintiff returned to Dr. Martin, reporting that she had increased her activities, including housework, and that as a result, she noticed a "slight" reemergence of her left leg pain. (Tr. at 212.) At that time, he performed a transcaudal neurolytic injection, which eliminated her left radicular pain. ( Id.)
The Plaintiff saw Dr. Rudy Kachmann, a neurosurgeon, on October 30, 1997, who noted that she had chronic pain problems and had been told that she had scar tissue. (Tr. at 241.) Dr. Kachmann reported that the Plaintiff had poor range of motion in her lumbar spine, that straight leg raise tests were positive bilaterally, that her ankle and knee reflexes were absent, and that there was no distinct paralysis or muscle atrophy. He concluded that the Plaintiff had a failed back syndrome and a chronic pain problem. (Tr. at 242.)
On November 17, 1997, the Plaintiff returned to Dr. Kachmann. (Tr. at 237). In reviewing some plain X-rays, Dr. Kachmann noted that they showed a "fairly solid fusion, " and an MRI indicated a good-sized spinal canal without development of any type of stenosis. ( Id.) Dr. Kachmann opined that the Plaintiff was totally unemployable because of her failed back syndrome, and he referred her to Dr. Eric Schreier, a physiatrist, for help improving her situation.
The Plaintiff saw Dr. Schreier on December 17, 1997, who suggested that she engage in a restorative rehabilitation treatment program. (Tr. at 225-226.) Additionally, he completed an "Arthritis Residual Functional Capacity Questionnaire," in which he diagnosed her with functional low back syndrome, spondylothesis grade 1-2 at the L5-S1, moderate lumbar spondylosis, and lumbar fusion at the L4-S1. (Tr. at 218-223.) He found that the Plaintiff could sit for 45 minutes at a time, stand for 20 minutes, but could sit for only 4 hours, and could stand/walk for less than 2 hours in a eight-hour workday. (Tr. at 221.) Additionally, he noted that the Plaintiff needed to walk around every 30 minutes for about 5 minutes, take unscheduled breaks of 5-10 minutes, lift less than 10 pounds, and could not stoop or crouch during the workday. (Tr. at 223.)
On April 1, 1998, Dr. Lee performed a lateral Plica excision, a lateral release, and chondroplasty of the medual femoral condole and the patellofemoral joint of the left knee. (Tr. at 259-260).
On April 27, 1998, the Plaintiff saw Dr. Alan McGee, a neurosurgeon, who noted that laboratory studies showed some questionable sacroilitis, and he noted poor range of motion during his physical examine. (Tr. at 262-263.)
On June 26, 1998, the Plaintiff saw Dr. Stephen Wright who opined that the Plaintiff had mild degenerative changes and that the numbness in her foot was caused by sciatica. (Tr. at 254.)
Between May 27, 1998 and August 16, 1999, the Plaintiff saw Dr. William Miskelly, a chiropractor, frequently for chiropractic treatment. (Tr. at 305-315.)
On October 14, 1998, the Plaintiff saw Dr. Scott A. Shapiro, a neurosurgeon at Indiana University School of Medicine. (Tr. at 264.) Dr. Shapiro noted that additional surgery would not improve the Plaintiff's back pain, but would only make it worse, additionally he opined that since she had exhausted all other therapies, she would have to learn to live with the pain. ( Id.)
On March 22, 1999, the Plaintiff saw Dr. Peter Jakacki at the request of Dr. Miskelly for evaluation of possible cardiac and other medical problems. (Tr. at 297-298.)
The Plaintiff returned to Dr. Jakacki on April 9, 1999, and he noted that a lumber MRI revealed severe fibrofatty replacement to the lower lumbar musculature. (Tr. at 286.) A physical examination revealed several trigger points in the longissimum thoracic and quadratus lumborum. ( Id.)
On May 26, 1999, Dr. Jakacki again notice several trigger points in various muscles, and he administered a trigger point injection. (Tr. at 280.) He repeated this procedure on July 14, 1999, and August 11, 1999. (Tr. at 277 and 288.)
On February 16, 2000, the Plaintiff saw Dr. Birijis Chinoy for a Social Security examination, and she reported that she feels about 95% worse since the surgery. (Tr. at 316.) During the physical examination, the Plaintiff was able to walk on her heels but was unsteady and complained of pain in her lower back. ( Id.) Dr. Chinoy diagnosed the Plaintiff with post lumbar fusion surgery, mild peripheral neuropathic pain in the S1 left gluteal region, and somatoform depression. ( Id.)
On February 22, 2000, the Plaintiff saw Dr. Sherwin Kepes, Ph.D., a consultative psychologist for a mental status evaluation at the request of Social Security. (Tr. at 321-323.) Dr. Kepes noted that during the exam, the Plaintiff did not appear to be in emotional distress or discomfort, but she did appear to be physically uncomfortable and continuously shifted positions. ( Id.) Dr. Kepes found that the Plaintiff did not have problems with cognition despite some slight attention problems, but he noted that she showed signs of depression directly related to her back condition. He diagnosed the Plaintiff with Dysthymic Disorder and Pain Disorder associated with a general medical condition in her lower back. ( Id.)
Dr. Kepes completed a Medical Source Statement dated February 1, 2001, in which he found the Plaintiff had "good" ability to understand, remember, and carry out detailed instructions; "fair" ability to maintain attention and concentration for extended periods; and "fair" ability to attain precise set limits, tolerances, and standards (for example, preparing exact verbal and numerical records). Dr. Kepes stated that these limitations "appli[ed] now and soon after pain disorder." (Tr. at 343.)
Dr. Jakacki completed a Chronic Pain Questionnaire, in which he found that the Plaintiff's obesity and emotional factors affected the severity of her symptoms and the functional limitations. He also found that sitting, standing, or alternate sitting/standing for 6 to 8 hours a day would aggravate her pain. (Tr. at 347-348.) He found that she had a "fair" ability to maintain attention and concentration for an extended period, and interact appropriately with the public.
On April 3, 2001, Dr. Kachmann completed a chronic pain questionnaire, in which he opined that the Plaintiff could not sit, stand, or walk for any period of time without extreme pain. (Tr. 352-356). He concluded, based on objective medical evidence, that the Plaintiff was disabled at the time of his initial exam on October 30, 1997.
III. STANDARD OF REVIEW
To be entitled to Social Security benefits, the Plaintiff must establish an "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to last for a continuous period of not less than 12 months. . . ." 42 U.S.C. § 416(i)(1); 42 U.S.C. § 423(d)(1)(A). A physical or mental impairment is "an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques." 42 U.S.C. § 423(d)(3). It is not enough for the Plaintiff to establish that an impairment exists. It must be shown that the impairment is severe enough to preclude the Plaintiff from engaging in substantial gainful activity. Gotshaw v. Ribicoff, 307 F.2d 840, 844 (4th Cir. 1962), cert. denied, 372 U.S. 945 (1963); Garcia v. Calfano, 463 F. Supp. 1098 (N.D. Ill. 1979). A five step test has been established to determine whether a claimant is disabled. See Singleton v. Bowen, 841 F.2d 710, 711 (7th Cir. 1988); Bowen v. Yuckert, 482, U.S. 137, 107 S.Ct. 2287, 2290-91 (1987). The United States Court of Appeals for the Seventh Circuit has summarized that test as follows:
The following steps are addressed in order: (1) Is the claimant presently unemployed? (2) Is the claimant's impairment "severe"? (3) Does the impairment meet or exceed one of a list of specific impairments? (4) Is the claimant unable to perform his or her former occupation? (5) Is the claimant unable to perform any other work within the economy? An affirmative answer leads either to the next step or, on steps 3 and 5, to a finding that the claimant is disabled. A negative answer at any point, other than step 3, stops the inquiry and leads to a determination that the claimant is not disabled.Nolen v. Sullivan, 939 F.2d 516, 518 (7th Cir. 1991) (citing Bowen v. Yuckert, 482 U.S. 137, 140-42, 107 S.Ct. 2287, 96 L.Ed.2d 119 (1987)); Nelson v. Bowen, 855 F.2d 503, 504 n. 2 (7th Cir. 1988); accord Dixon v. Massanari, 270 F.3d 1171, 1176 (7th Cir. 2001); Zurawski v. Halter, 245 F.3d 881, 887 (7th Cir. 2001). A claimant has the joint burdens of production and persuasion through at least step four, where the individual's residual functional capacity ("RFC") is determined. Yuckert, 482 U.S. at 146 n. 5; 20 C.F.R. § 404.1545, 416.945. At step five, the Commissioner bears the burden of proving that there are jobs in the national economy the plaintiff can perform. Herron v. Shalala, 19 F.3d 329, 333 n. 18 (7th Cir. 1994). From the nature of the ALJ's decision to deny benefits, it is clear that step four was the determinative inquiry.
IV. DISCUSSION
Given the foregoing framework, "[t]he question before [this court] is whether the record as a whole contains substantial evidence to support the [Commissioner's] findings." Garfield v. Schweiker, 732 F.2d 605, 607 (7th Cir. 1984) (citing Whitney v. Schweiker, 695 F.2d 784, 786 (7th Cir. 1982); 42 U.S.C. § 405(g)); Burnett v. Bowen, 830 F.2d 731, 734 (7th Cir. 1987). "Substantial evidence" has been described as "more than a mere scintilla." Anderson v. Bowen, 868 F.2d 921, 923 (7th Cir. 1989). It means, "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. . . ." Id. (quoting Richardson v. Perales, 402 U.S. 389 (1971); see also Allen v. Weinberger, 552 F.2d 781, 784 (7th Cir. 1977). "If the record contains such support [it] must [be] affirmed . . . unless there has been an error of law." Garfield, 732 F.2d at 607; see also Schnoll v. Harris, 636 F.2d 1146, 1150 (7th Cir. 1980).
In the present case, the ALJ found that the Plaintiff had not engaged in any substantial gainful activity since the alleged onset date. At step two, the ALJ found that the Plaintiff's impairments were severe; however, the ALJ found that the Plaintiff's impairments do not meet or exceed one of the listed impairments under step three. Under step four, the ALJ found that between September 2, 1994 and October 29, 1997, the Plaintiff maintained the RFC to return to her former employment as a clerical worker, but after that date, she was unable to perform that work and was disabled.
The Plaintiff contends that the ALJ improperly assessed the date on which she became disabled because he failed to sufficiently articulate his reasons for rejecting the opinion of Dr. Kepes, and because his reasons supporting a October 30, 1997 onset date are not supported by substantial evidence.
A. The ALJ Properly Articulated his Consideration of Dr. Kepes' Opinion
The Plaintiff argues that the ALJ improperly assessed the onset date of her physical disability because he failed to adequately articulate his consideration of Dr. Kepes' somewhat cryptic comment that the Plaintiff's mental limitations "apply now [February 2000] soon after pain disorder." (Tr. at 343.)
However, the ALJ did not err in considering Dr. Kepes' statement because it simply does not support the Plaintiff's claim of physical disability beginning September 2, 1994. After all, Dr. Kepes is a psychologist who assessed the Plaintiff's mental capacity to perform basic work-related tasks. (Tr. at 342-343.) While Dr. Kepes noted the Plaintiff's slight limitations on her mental capacity were brought about by pain induced depression, he made no finding about the date that the Plaintiff's pain itself became physically disabling, nor could he considering he was only evaluating the Plaintiff's mental state.
Dr. Kepes opined that the Plaintiff's depression resulted in a "good" ability to understand, remember, and carry out details, and a "fair" ability to maintain attention and concentrate for extended periods and attain precise set limits, tolerances, and standards.
Nevertheless, the Plaintiff attempts to translate Dr. Kepes' ambiguous comment into a more definitive statement of an earlier onset date by drawing in evidence from other doctors. Indeed, the Plaintiff cites statements by Dr. Reecer, Dr. Gobbler, Dr. Martin, and Dr. Kachmann, all indicating that the Plaintiff told them, some years later, that she had experienced some back and leg pain as early as 1993 or 1994. However, because Dr. Kepes offers no clue as to when it is that the Plaintiff's "pain disorder" actually began, it is not the job of either the ALJ or the Court to divine such an explanation for him. Moreover, even accepting that the Plaintiff had some pain at that time, as will be discussed infra, there is no indication that the pain was disabling.
Accordingly, the ALJ properly articulated his consideration of Dr. Kepes' opinion, and his decision is supported by substantial evidence on this point.
B. The ALJ's Onset Determination is Supported by Substantial Evidence
The Plaintiff also argues that the ALJ's onset determination is not supported by substantial evidence, and that he should have chosen an earlier date.
Because the ALJ determined that the Plaintiff was disabled, "the [only] issue [before this Court] is whether there is substantial evidence in the record to support the date chosen . . . not whether an earlier date could have been supported." See Henderson v. Apfel, 179 F.3d 507, 512 (7th Cir. 1999) (quoting Stein v. Sullivan, 892 F.2d 43, 46 (7th Cir. 1990)). To establish the onset date of a disability, Social Security Ruling ("SSR") 83-20 requires an ALJ to consider (1) the claimant's allegations as to the onset date; (2) the date that the claimant left work; and (3) medical evidence of the onset. Id.; Henderson, 179 F.3d at 512-13; Nolan v. Sullivan, 939 F.2d 516, 519 (7th Cir. 1991). Medical evidence is the most important factor, and the chosen onset date must be consistent with it. Henderson, 179 F.3d at 513. Nevertheless, with slowly progressing impairments, like the Plaintiff's low back pain, an onset date must often be inferred when sufficient medical records are unavailable. Id.
The Plaintiff argues that the ALJ should have chosen an earlier onset date because there is "little or no difference" between the objective medical evidence before and after October 30, 1997. However, substantial medical evidence supports the ALJ's onset determination. of particular importance, Dr. Reecer stated, in a January 1996 response to a letter from the Plaintiff requesting assistance securing DIB, that it was doubtful that the Plaintiff could demonstrate disability because she lacked objective findings to support such a claim. (Tr. at 183.) Nevertheless, the Plaintiff suggests that the ALJ should not have relied on this opinion because it amounted to a "general [opinion]" and that it was not adequately supported. However, this argument overlooks the rather obvious point that Dr. Reecer specifically evaluated the Plaintiff's low back and leg on June 29, July 28, and August 1, 1995, and did not note any significant findings. This is particularly significant since he ordered an MRI, but it only revealed expected conditions, without any significant stenosis, disc herniation, or surgical lesions. Accordingly, it is clear that Dr. Reecer's opinion that the Plaintiff lacks objective evidence is adequately supported by his own examinations and medical testing.
Equally unavailing is the Plaintiff's claim that Dr. Reecer's opinion should be ignored because he is not familiar with all of Social Security's rules. Dr. Reecer only stated that Social Security typically requires objective evidence of disability, but that the Plaintiff lacked the necessary objective findings because she only had subjective complaints on her side. This is consistent with Social Security's regulations. See 20 C.F.R. § 404.1529(a) ("In determining whether you are disabled, we consider all your symptoms, including pain, and the extent to which your symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence.") And while the Plaintiff argues that the ALJ should have ignored Dr. Reecer's opinion because the determination of disability is left to the ALJ, see 20 C.F.R. § 404.1527(e)(1), there is nothing in the regulations to prevent the ALJ from considering treating physicians' opinions that a claimant is not disabled.
Furthermore, other medical evidence in the record supports the ALJ's determination. For example, Dr. Grobler noted that a myelo CT scan in April 1996 revealed no distinct abnormalities, and only slight column narrowing, but with no distinct instability or frank nerve root compression. (Tr. at 191.) And while the Plaintiff complained that epidural injections did not relive her pain, the evidence shows that pain was at least temporarily alleviated after epidural injections in March, May, and August 1997. (Tr. at 196-197, 210). Additionally, as the ALJ properly noted, none of the Plaintiff's physicians prior to October 30, 1997, ever opined that the Plaintiff was disabled.
Moreover, the ALJ properly considered Dr. Kachmann's opinion that the Plaintiff has objective evidence of chronic low back symptoms superimposed on her lumbar spondylosis and Grade I II spondylolisthesis of the L5-S1 vertebrae and that she was completely disabled as of October 30, 1997. And while the Plaintiff apparently suffered from spondylolisthesis prior to her 1993 spinal fusion, this fact alone does not prove the Plaintiff was disabled prior to October 30, 1997, given that the Plaintiff's condition is one that has progressively deteriorated over time. The ALJ properly recognized this fact, and appropriately determined an onset date beginning when the Plaintiff's physicians first noted objective evidence of disability.
Still, the Plaintiff argues that the ALJ should have called for a medical expert to assess the Plaintiff's onset date, presumably because she suffers from a chronic, deteriorating condition. See Henderson, 179 F.3d at 513. However, Henderson also counsels that a medical advisor is not needed when the claimant's medical chronology is complete. Id. Here, the ALJ had the Plaintiff's complete medical history covering the whole time frame of her asserted disability from the claimed onset date though the time of the hearing. In fact, the ALJ had the Plaintiff's medical records dating back to 1993, nearly a full year before her claimed onset date, and four years before her first diagnosis of disability. That extensive medical background allowed the ALJ to follow the progression of the Plaintiff's condition based on opinions and diagnoses made by the many physicians who examined her. Those physicians had the opportunity to speak with the Plaintiff, to take into consideration her symptoms, and to make first hand observations. Yet despite all this, none of the physicians restricted the Plaintiff's ability to perform work or found her unable to perform her former jobs, and none opined that the Plaintiff was disabled prior to October 30, 1997. In fact, as noted supra, one physician actually doubted whether she was disabled during this period.
In short, the medical evidence provided the ALJ with a thorough history of the Plaintiff's medical background during the period in question. It must be concluded that the ALJ had a complete medical background with which to make an informed decision, negating the need for further consultation with a medical expert.
Accordingly, the ALJ's determination that the Plaintiff was disabled as of October 30, 1997, but not before is supported by substantial evidence.
CONCLUSION
Because the decision of the ALJ is supported by substantial evidence, it is hereby AFFIRMED. SO ORDERED.