Civil Action No. 02-1538 GMS.
September 30, 2004
On January 4, 2001, the plaintiff, Catherine Mantilla ("Mantilla") applied for disability insurance benefits ("DIB") and supplemental security income ("SSI") under Title II and XVI, respectively, of the Social Security Act (the "Act"). In her application, Mantilla alleged that she had been disabled since February 8, 1999 due to two pinched nerves in her back and neck, loss of feeling in her right leg, and hepatitis C. Her application was denied on August 2, 2001, and again upon reconsideration on September 19, 2001. Mantilla then timely filed a request for a hearing before an Administrative Law Judge ("ALJ"). The ALJ held the requested hearing on February 20, 2002, and by a decision dated March 7, 2002, denied Mantilla's applications. Mantilla subsequently filed a request for review by the Appeals Council. On September 6, 2002, the Appeals Council denied her request, as it found no basis to review the ALJ's decision.
Having exhausted her administrative remedies, Mantilla filed the above-captioned complaint on October 15, 2002. Mantilla moved for summary judgment on August 20, 2003, and the Commissioner of Social Security ("the Commissioner") filed a cross-motion for summary judgment on September 29, 2003. Because this court finds that the ALJ's decision is supported by substantial evidence, the court will deny Mantilla's motion, grant the Commissioner's motion, and enter judgment accordingly.
A. Medical Evidence
Following an automobile accident on January 4, 1996, Mantilla went to the emergency room complaining of lower back pain. The emergency room doctors took cervical spine x-rays, which indicated no fracture, subluxation, or dislocation. Mantilla was discharged later that day with diagnosis of cervical and lumbar strains.
On May 28, 1996, Mantilla's primary care physician, referred her to the emergency room because she was complaining of back pain and pain radiating to the right leg. The diagnoses included low back pain and sciatica, and Mantilla was told to stay home from work for two days.
From June 1996 to October 1996, Mantilla was treated by Dr. William R. Atkins, Jr. ("Dr. Atkins"), at the Delaware Diagnostic and Rehabilitation Center. Dr. Atkins's examinations revealed a decreased lumbosacral range of motion, paralumbar muscle spasms, and a positive straight leg raising test on the right. As a result of these examinations, he ordered an EMG on the right lower extremity and an MRI of the lumbar spine on July 3, 1996. The MRI of the lumbar spine showed degenerative changes of the facet joints, a right spur formation, prominence of the posterior longitudinal ligament at L4-5, which was not compressing the nerve roots, and annular radial tears and disc bulging of L4-5 and L5-S1 with no evidence of a herniated disc. Because Mantilla was complaining of continued low back pain, as well as pain when she walked and performed daily activities, Dr. Atkins referred her to Dr. Otto R. Medinilla ("Dr. Medinilla"), a neurosurgeon, for possible surgery. Dr. Medinilla referred Mantilla back to Dr. Atkins for further treatment and informed Dr. Atkins that surgery was not needed because Mantilla did not have a definite surgical lesion.
Mantilla received physical therapy at the Delaware Diagnostic and Rehabilitation Center from July 9, 1996 to November 11, 1996. On October 29, 1996, Dr. Atkins's physical examination revealed a mildly restricted range of motion over the C5-7 and L4-S1 regions of the spine. His diagnoses included cephalgia/occipital neuralgia, status post chest wall contusion, cervical and lumbosacral sprain and strain, right wrist sprain, cervical radiculitis, lumbosacral radiculopathy, and lumbar disc herniation. Dr. Atkins concluded that Mantilla was disabled and incapable of performing her previous job.
Mantilla was also treated by her physical therapist on October 29, 1996, and reported that she was "doing very well," had no leg pain or spasms, and no tenderness or tightness of the lumbosacral paraspinals. In addition, on October 31, 1996, two days after Dr. Atkins opined that Mantilla was disabled, she reported that she had no pain, tenderness or tightness in the lumbosacral area.
The record reflects no further treatment for low back pain for Mantilla until August 28, 1998, when she was seen by Dr. Yvette Gbemudu ("Dr. Gbemudu"), at The Family Medicine Center of Christiana Care Health System (the "center"). At that time she complained of a headache and right hip pain which radiated into her right leg. She received injections for the hip pain and stated that she "could live with" the leg pain. On October 14, 1998, Mantilla was again treated at the center for exacerbating low back pain, which she attributed to lifting heavy boxes at Federal Express, where she was employed. She complained that the pain radiated down the right leg and she occasionally experienced numbness of her right foot. Mantilla was treated in the emergency room and prescribed Percoset for the pain. On October 21, 1998, when she went to the center for a follow-up, Dr. Gbemudu noted that her symptoms had improved with "exercises/rest."
On January 2, 1999, Mantilla was involved in a second motor vehicle accident, but did not undergo an emergency evaluation. Rather, she sought treatment for back pain at the center on January 5, 1999. Although there was some point tenderness, a physical examination showed that Mantilla had a full range of motion in the joints with good mobility. Her straight leg raising test was negative, her hip examination was normal, and there was no indication of crepitus or atrophy. In addition, her neurologic evaluation was normal, her motor strength was 5/5 bilaterally (normal), her reflexes were equal bilaterally, and her coordination, gait, and sensation to light touch were all normal. At a February 2, 1999 follow-up appointment, Mantilla complained of low back and hip pain that radiated down the right leg to her foot. She also stated that the pain was lasting longer.
On May 11, 1999, a state agency medical consultant, Vinod Keterie ("Keterie"), performed a residual functional capacity ("RFC") assessment and determined that Mantilla could lift and/or carry twenty pounds occasionally and ten pounds frequently, stand and/or walk for about six hours in an eight-hour workday, sit for about six hours in an eight-hour workday, and that Mantilla's ability to push and/or pull was unlimited. Keterie also found that Mantilla could climb, balance, stoop, kneel, crouch, and crawl occasionally. He did not find that Mantilla had any manipulative, visual, or communicative limitations. In addition, he did not find any environmental limitations, except for the need to avoid hazards such as machinery and heights.
On July 28, 1999 Mantilla returned to the center because she was again experiencing pain. She was diagnosed with a lumbosacral strain and sacrolilitis and was prescribed Ultram and Flexoril. She returned to the center again on October 22, 1999, complaining of exacerbating low back pain. It was noted that Mantilla complained of a three day history of recurring back pain, and that she complained of "numbness shooting down her right leg and followed by low back pain."
In July 2000, Mantilla complained of right hand pain, but reported that it had improved with Vioxx. A physical examination showed that Mantilla had a full range of motion throughout with 5/5 strength of all extremities. The treating physician determined that her gait was normal, her cranial nerves II-XII were grossly intact, and her reflexes and sensation were symmetric throughout.
Mantilla was not treated again for back and leg problems until September 26, 2000, six days after she experienced exacerbating pain while moving furniture. She complained of pressure in her right hip when bearing weight and an occasional tingling of her entire right leg and the third through fifth toes of her right foot. The treating physician prescribed Baclofen and Ultram.
In January 2001, Mantilla reported that her pain had gotten much worse within the course of a week. She complained of right lower extremity pain, numbness, tingling, and early loss of bladder control. She had been taking Percoset, Flexoril, and Vioxx. She also stated she needed a cane because her leg gave out. An MRI was taken on January 11, 2001, which showed a small right lateral disc herniation at the L4-5 level.
On February 9, 2001, Mantilla was evaluated by Dr. Pramod K. Yadhati ("Dr. Yadhati"), who reviewed the January 2001 MRI and referred her to Dr. Richard Zamarin ("Dr Zamarin"), at St. Francis Hospital, for a lumbar epidural steroid injection. The injection did not relieve Mantilla's pain. Thus, when she returned to the center on March 14, 2001, Dr. Yadhati noted that she most likely would need surgery.
On March 29, 2001, Mantilla began treating with Dr. Camilo A. Gopez ("Dr. Gopez"), a neurosurgeon. He observed that her straight leg raising was positive on the right side, her gait was abnormal, she had decreased sensation in her right big toe, her range of motion was limited, and she had muscle weakness. In April 2001, Dr. Gopez performed a right lumbar laminectomy, diskectomy, and root decompression, L4-L5, right side. Eight weeks after Mantilla's surgery, on May 31, 2001, Dr. Gopez noted that Mantilla was doing "very well" and that she had almost total relief of her right leg pain, as well as the numbness and paresthesia. Mantilla also stated that she was pleased with the results of the surgery. A neurological examination revealed that Mantilla had a normal gait, that her wound was well healed, and that her motor strength was normal in the extensor hallucis longus.
On July 24, 2001, Dr. Irwin L. Lifrak ("Dr. Lifrak"), performed a consultative examination at the request of the state agency. Mantilla complained of pain in her lower back, with radiation to the right hip, and throughout her entire right lower extremity. Based upon his physical examination, Dr. Lifrak found no evidence of joint effusion, muscle atrophy, or muscle wasting. Further, Dr. Lifrak determined that Mantilla's grip strength in the upper extremities was 5/5 on the left and 5/5 on the right (both normal), and the muscle tone in the lower extremities was 5/5 bilaterally (normal). Moreover, Dr. Lifrak found that while Mantilla's range of motion was reduced in the lumbosacral spine and in both hips, there was no evidence of a paravertebral muscle spasm. Based upon his examination findings, as well as Mantilla's medical history, Dr. Lifrak opined that Mantilla could sit for a total of five hours, stand for a total of three hours, and that she could lift up to ten pounds with either hand on a regular basis.
On July 24, 2001, Mantilla also had an appointment with her primary care physician, Dr. Amy Robinson ("Dr. Robinson"), at the center. During that examination, she complained of right leg numbness and stated that the pain was relieved only by lying down. Dr. Robinson prescribed Oxycontin. However, when Mantilla returned to the center on September 6, 2001, the prescription for Oxycontin was discontinued, and Morphine and Vicodin were prescribed instead.
Mantilla returned to Dr. Gopez on September 10, 2001, complaining of recurring low back pain with right leg radiation. Dr. Gopez took an MRI of the lumbar spine, which showed postoperative fibrosis in the anterolateral epidural space at L4-L5, without evidence of disc fragment or herniation. There was a small central disc protrusion at L5-S1. Based upon these results, Dr. Gopez recommended an epidural block.
In September 2001, Keterie performed another RFC assessment, which was consistent with his May 1999 assessment previously described in this memorandum. As a result of the assessment, Keterie determined that Mantilla had the ability to perform work at the light exertional level.
On November 5, 2001, Mantilla saw Dr. Gopez for follow-up care and reported that she had much less back pain, leg pain, and soreness after the injection. One week later, however, on November 12, 2001, Mantilla returned to see Dr. Gopez complaining of severe low back pain with right sciatica. Her gait and motor strength were normal, although a straight leg raising test showed restriction at fifty degrees on the right.
On November 28, 2001, Dr. Gopez performed surgery including a lumbar laminectomy, lysis of adhesions and root decompression at L4-L5, right side, and a lumbar lam and exploration, foraminotomy at L5 and S1, right side. After the surgery, Dr. Gopez observed that Mantilla had "significant improvement" in terms of the pain she was experiencing. For example, she was able to get out of bed and walk with no significant difficulty.
On January 29, 2002, when Mantilla had a follow-up appointment with Dr. Maria C. Mancuso ("Dr. Mancuso"), at the center, she reported that her back pain was bearable. A physical examination revealed the following: (1) the right low back and right leg were non-tender to palpation; (2) her patellar and achilles reflexes were equal bilaterally; (3) her strength was 5/5 bilaterally in the lower extremities; (4) her sensation was grossly intact bilaterally in the lower extremities; and (5) her gait and station were normal.
B. Hearing Testimony
During the administrative hearing, Mantilla testified that she could currently walk three to four city blocks, stand for twenty to twenty-five minutes, and sit for three to four hours if able to stand to shift positions. She also testified that she could lift twenty-five pounds. See Tr. at 374. She claimed that, prior to her surgeries, she could not sit for more than five minutes, that her legs would go numb after five or ten minutes, and that she was in bed sixteen hours per day. Id. at 375, 377.
Mantilla further testified that she was living with and caring for three of her children, the youngest of whom was thirteen years old. Id. at 364. In describing a typical day, Mantilla testified that she woke up at 5:30 a.m., made coffee, woke her children, made sure that they were ready for school, cleaned, vacuumed the floors, and washed the dishes if her daughter had not already done so. She then went back to sleep until 12:00 p.m. After waking up, she cooked dinner for her children, helped them with their homework, and occasionally shopped for groceries with the help of her daughters. Id. at 367-368. In addition, she testified that she drove, two times a week, a distance of fifteen to twenty miles. Id. at 365. Mantilla also testified that she attended meetings at her daughter's school approximately once a month, and occasionally took her children out to dinner. Id. at 369-70.
Mantilla testified that she had back pain, but that her legs felt better since her second operation, and that she only had problems with her legs when she performed strenuous activities. Id. at 371. She further testified that her surgeries helped to alleviate much of her pain, that she wanted to go back to work, and that it was her goal to get a degree and become a bilingual social worker. Id. at 377.
A vocational expert testified that Mantilla's past work as a mail clerk was unskilled in nature and light in exertional level, as customarily performed, but medium in exertional level as she performed it. Id. at 378. The ALJ asked the vocational expert to assume a situation in which an individual was capable of: (1) lifting twenty pounds at a time, with frequent lifting and carrying of objects weighing over ten pounds; (2) sitting for six hours, alternating her position in an eight hour work day; (3) standing and walking for three hours out of an eight hour work day; and (4) having unlimited ability to push and pull with her upper extremities. Tr. At 378-79. Based on the above limitations, the ALJ asked the vocational expert to opine as to the type of work Mantilla could perform. He testified that Mantilla could perform jobs that exist at the light exertional level, such as gate tender, laundry grader or assorter, and production inspector.
C. The ALJ's Findings
The ALJ evaluated Mantilla's testimony and found that it was not entirely credible because her alleged pain and other symptoms did not preclude her performance of some physical and social activities, as described in her testimony and in her written statements submitted into evidence. Tr. at 17. Written documentation, submitted for the record, tended to reflect a greater level of activity than did Mantilla's testimony. Id. At the administrative hearing, Mantilla testified that she was bedridden for basically the entire day before her surgeries. Tr. at 376-77. However, Mantilla's testimony was inconsistent with her responses to a March 2001 Daily Activities Questionnaire (the "Questionnaire"), in which she reported a level of activity that was inconsistent with her hearing testimony. Tr. at 17. In the Questionnaire, Mantilla indicated that she woke her children up for school, fixed meals, performed household chores, cooked, visited her parents weekly, and shopped. Id. at 136. In addition, Mantilla stated that she did not require any assistance with personal care. Id. at 141. Mantilla's testimony was further undermined by the fact that she moved heavy furniture in September 2000. Id. at 18, 235.
The ALJ also determined that the medical evidence did not overcome his doubts regarding Mantilla's credibility. Id. at 17-18. The ALJ acknowledged that Mantilla had a history of bulging lumbar discs, that her hip and low back were tender to palpation, and that flexing her hip was painful. In addition, the ALJ considered physical examinations, in which the treating physicians found that Mantilla's motor strength, reflexes, coordination, gait and sensation were all normal, and that she had a full range of motion in all extremities. Id. at 17, 237, 251-52. After carefully considering all of the above described medical evidence, functional assessments, and Mantilla's testimony, the ALJ determined that she had a maximum exertional capacity for light work and was not disabled within the meaning of the Act. The sole issue presented by this appeal is whether the ALJ's determination that Mantilla was not disabled is supported by substantial evidence. Specifically, Mantilla argues that, the ALJ employed selective use of her inarticulate responses to questions about her daily activities on the Questionaire and failed to credit her subjective complaints of pain. For the following reasons, the court finds the ALJ's conclusions to be supported by substantial evidence.
III. STANDARD OF REVIEW
The court must uphold the Commissioner's factual decisions if they are supported by "substantial evidence." See 42 U.S.C. §§ 405(g), 1383(c)(3). Substantial evidence does not mean a large or a considerable amount of evidence. Pierce v. Underwood, 487 U.S. 552, 565 (1988) (citing Consolidated Edison Co. V. NLRB, 305 U.S. 197, 229 (1938)). Rather, it has been defined as "more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate." Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir. 1995) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)).
Credibility determinations are the province of the ALJ, and should only be disturbed on review if not supported by substantial evidence. Pysher v. Apfel, Civ. A. No. 00-1309, 2001 WL 793305, at *2 (E.D. Pa. Jul. 11, 2001) (citing Van Horn v. Schweiker, 717 F.2d 871, 973 (3d Cir. 1983)). To demonstrate that the ALJ's opinion is based on substantial evidence, the ALJ must make specific findings of fact to support his or her ultimate findings. Portlock v. Apfel, Civ. A. No. 99-931, 2001 WL 753879, at *7 (D. Del. Jul. 3, 2001) (citing Stewart v. Secretary of HEW, 714 F.2d 287, 290 (3d Cir. 1983)). Thus, the inquiry is not whether the court would have made the same determination, but rather, whether the Commissioner's conclusion was reasonable. See Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir. 1988). In social security cases, this substantial evidence standard applies to motions for summary judgment brought pursuant to Fed.R.Civ.P. 56(c). See Woody v. Sec. of the Dep't of Health and Human Serv., 859 F.2d 1156, 1159 (3d Cir. 1988).
The Act defines "disability" in terms of the effect that a physical or mental impairment has on an individual's ability to function in the workplace. See Heckler v. Campbell, 461 U.S. 458, 459-60 (1983). In order to be eligible for benefits, the claimant must not only show that she has a medically determinable physical or mental impairment, she must also show that it is so severe that it prevents her from engaging in any substantial gainful activity that exists in the national economy. See 42 U.S.C. §§ 423 (d)(1)(A), (d)(2)(A); see also Heckler, 461 U.S. at 460. Thus, under the Act, and its implementing regulations, the claimant bears the burden of proving that she is "disabled." See 42 U.S.C. § 423(d)(5)(A); 20 C.F.R. § 404.1512 (2004).
The Commissioner uses a sequential five-step process in evaluating claims. Specifically, the Commissioner considers whether the claimant: (1) is engaged in substantial gainful activity; (2) has a severe impairment; (3) has an impairment that meets or equals the requirements of a listed impairment; (4) can return to his or her past relevant work; and (5) if not, whether a significant number of other jobs exist in the national economy that he or she can perform. See 20 C.F.R. § 404.1520 (2004). If the Commissioner finds that the claimant is "disabled" or "not disabled" at any point in the sequential evaluation, review does not need to proceed to the next step. See id.
According to the governing regulations, an ALJ may not find a claimant disabled based on subjective symptoms alone. See 20 C.F.R. §§ 404.1529(a), 416.929(a) (2004). Indeed, as the ALJ in the present case recognized, an RFC assessment must be based upon a consideration of all symptoms, including pain, and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence. See 20 C.F.R. §§ 404.1529, 416.929 (2004); see also Social Security Ruling (SSR) 96-7p. The ALJ also correctly noted that the regulations mandate that he consider any medical opinions from acceptable medical sources that reflect judgments about the nature and severity of the impairments and resulting limitations. See 20 C.F.R. §§ 404.1527, 416.927 (2004), SSRs 96-5p, 96-6p.
There are situations in which an individual's alleged or reported symptoms, such as pain, suggest the possibility of a greater restriction of the individual's ability to function than can be demonstrated by objective medical evidence alone. 20 C.F.R. §§ 404.1529(c)(2); 416.929(c)(2) (2004); SSR 96-7p. In such cases, the ability to perform basic work activities can be derived from consideration of other information in conjunction with the medical evidence. See 20 C.F.R. § 416.929(c)(3), (4) (2004) (providing that, in evaluating the intensity and persistence of symptoms including pain, the ALJ must consider a claimant's daily activities; the type, dosage, and effectiveness, of pain medication; the treatment; other than medication, received for relief of other symptoms; and any other measures used to relieve pain or other symptoms).
Finally, the responsibility for deciding a claimant's RFC rests squarely with the ALJ. As such, he or she may properly challenge the credibility of a claimant who asserts eligibility based on subjective evidence. 20 C.F.R. §§ 404.1527(e)(2), 404.1546, 416.927(e)(2), 416.949 (2004); see also Hartranft v. Apfel, 181 F.3d 358, 362 (3d Cir. 1999) (stating that the ALJ's duty under § 404.1529(c) to evaluate the intensity and persistence of the pain or symptom, and the extent to which it affects the individual's ability to work, obviously requires the ALJ to determine the extent to which a claimant is accurately describing pain symptoms).
In the present case, in evaluating the credibility of Mantilla's testimony alleging pain, the ALJ complied with the governing regulations by considering the objective diagnostic and clinical findings, as well as Mantilla's daily activities and medical treatments. See Tr. at 17-18. Only then did the ALJ conclude that Mantilla's allegations of pain and resultant limitations were not "entirely credible." Id. More specifically, the ALJ noted that the objective medical evidence failed to alter his opinion of Mantilla's allegations that her impairments were capable of producing severe and debilitating pain as alleged. See id. As support for this conclusion, physical examination findings in 1999 revealed that Mantilla had some joint tenderness but had a full range of motion in the joints with good mobility, her motor strength was normal, her reflexes were equal bilaterally, and her coordination, gait, and sensation to touch were all normal. Tr. at 252.
Additionally, upon examination in July 2000, Mantilla had a full range of motion, a normal gait, intact cranial nerves II-XII, and her reflexes and sensation were symmetric throughout. Id. at 237. A neurological examination following her April 2001 surgery also revealed that Mantilla had a normal gait, that her wound was well healed, and that her motor strength was normal in the extensor hallucis longus. Id. at 332.
Although Mantilla complained to Dr. Lifrak in July 2001 of pain in the lower back, with radiation to the right hip and throughout her entire right lower extremity, there was no evidence of joint effusion, muscle atrophy or muscle wasting, her grip strength in the upper extremities was 5/5 on the left and on the right (both normal), and her muscle tone in the lower extremities was 5/5 bilaterally (normal). Id. at 288-90. Even though her range of motion was reduced in the lumbosacral spine and in both hips, there was no evidence of paravertebral muscle spasms. Id. at 290.
Moreover, when Mantilla was treated by Dr. Gopez in September 2001, an MRI of the lumbar spine showed post-operative fibrosis in the anterolateral epidural space at L4-L5 without evidence of disc fragment or herniation. Id. at 330-31.
In addition, she was examined following her second surgery and it was determined that her right low back and right leg were non-tender to palpation, her patellar and achilles reflexes were equal bilaterally, her strength was 5/5 bilaterally in the lower extremities, her sensation was grossly intact bilaterally in the lower extremities, and her gait and station were normal. Id. at 314. Therefore, the court must conclude that the ALJ complied with the regulations in finding that the objective diagnostic and clinical signs were inconsistent with Mantilla's claim of disabling pain.
The ALJ further followed the regulations in determining that Mantilla's medical sources consistently opined that Mantilla was capable of working. The ALJ considered the findings and opinions of Keterie, a state agency physician. In May 1999, he determined that Mantilla was not precluded from all work activity. Id. at 266-73. In his opinion, Mantilla had the capacity to stand and/or walk for about six hours in an eight-hour workday, sit for about six hours in an eight-hour workday, and her ability to push and/or pull was unlimited. Id. at 267. Keterie also found that she could lift and/or carry twenty pounds occasionally, and ten pounds frequently. Id.; see also 20 C.F.R. §§ 404.1527(f)(2)(I), 416.927(f)(2)(I) (2004); Jones v. Sullivan, 954 F.2d 125, 129 (3d Cir. 1991) (stating that the ALJ may give great weight to the opinion of a non-examining physician, and such opinion may constitute substantial evidence to support the ALJ's decision). Likewise, the ALJ considered Keterie's September 2001 assessment, which was consistent with the May 1999 evaluation, determining that Mantilla had the ability to perform work at the light exertional level. Id. at 266-73, 301-08.
Similarly, Dr. Lifrak did not opine that Mantilla had limitations of such severity that she was precluded from performing all work activity. See id. at 288-93. Based upon his examination findings, as well as Mantilla's medical history, he concluded in July 2001 that Mantilla could sit for a total of five hours, stand for a total of three hours, and that she could lift up to ten pounds with either hand on a regular basis. Id. at 291.
Substantial evidence also supports the ALJ's determination that Mantilla's treatment history did not bolster her allegations of disabling pain for an entire year. See Tr. at 14-15. Although Mantilla initially alleged that she had been disabled since 1999, the record evidence shows, and Mantilla herself acknowledged her inability to establish a continuous disability from 1999 to 2002. Pl.'s Br. at 22. Her claim that she was disabled from January 2001 through her surgery in November 2001 is not persuasive. Specifically, only eight weeks after her April 2001 surgery, she told Dr. Gopez that she was pleased with the result of the surgery and was doing "very well." Tr. at 332. Moreover, Mantilla did not return to see Dr. Gopez for back pain until September 2001, and she did not complain of severe low back pain again until November 12, 2001. Id. at 326, 331. Dr. Gopez then performed her second surgery which resulted in "significant improvement" of her right leg pain. Id. at 337. Two months later, at Mantilla's follow-up appointment with Dr. Gopez, she stated that her back pain was bearable. Significantly, at the administrative hearing, Mantilla testified that her back and leg pain were much better since her second operation. Id. 371. Thus, substantial evidence supports the ALJ's findings that Mantilla's treatment history did not bolster her allegations of disabling pain for an entire year.
The ALJ also complied with the regulations in finding that Mantilla's own admissions of her capabilities and daily activities belie her allegations of total disability. Importantly, Mantilla's testimony was inconsistent with her responses to the Questionnaire. Tr. at 136-42. When asked to describe her daily activities in March 2001, one month before her first surgery, Mantilla stated that she woke her children up for school, made breakfast for them, cleaned, shopped, and cooked dinner. Id. at 136. She performed household chores such as cleaning, dusting, washing dishes and straightening things up. Id. at 137. She reported that she visited with family on a weekly basis and that she did not require any assistance with personal care. Id. at 140-41. In sum, Mantilla's regular course of daily activities supports the ALJ's determination that she was able to perform at least sedentary work that accommodated her limitation resulting from prolonged position and exposure to certain conditions.
The ALJ considered the inconsistencies between Mantilla's testimony and the documentation that she submitted in support of her claim, her activities of daily living, and the medical evidence of record. When viewed in this light, there can be no question that there is substantial evidence that supports the ALJ's findings that Mantilla's subjective complaints of pain were not entitled to full credence. The totality of the evidence simply does not support a finding that Mantilla is disabled.