Kilgore v. Saul

CourtDistrict Court, M.D. Pennsylvania
DecidedDecember 3, 2021
Docket1:20-cv-01613
StatusUnknown

This text of Kilgore v. Saul (Kilgore v. Saul) is published on Counsel Stack Legal Research, covering District Court, M.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kilgore v. Saul, (M.D. Pa. 2021).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

MELANIE KILGORE, : Civil No. 1:20-CV-1613 : Plaintiff : : v. : : KILOLO KIJAKAZI, : (Magistrate Judge Carlson) Acting Commissioner of Social Security1, : : Defendant :

MEMORANDUM OPINION

I. Factual and Procedural Background Social Security appeals are judged by a deferential standard of review, but the courts have imposed a clear burden of articulation upon Administrative Law Judges (ALJs) in order to facilitate this review. At a minimum, this articulation responsibility means that the ALJ’s decision must provide a logical nexus between any factual findings and ultimate functional capacity and disability determinations. One aspect of this duty of articulation entails ensuring that there is a legal and logical consistency between the ALJ’s determination of a claimant’s residual functional

1 Kilolo Kijakazi became the Acting Commissioner of Social Security on July 9, 2021. Accordingly, pursuant to Rule 25(d) of the Federal Rules of Civil Procedure and 42 U.S.C. § 405(g) Kilolo Kijakazi is substituted for Andrew Saul as the defendant in this suit. 1 capacity and the testimony of the Vocational Expert concerning whether there are jobs in the national economy that the claimant can perform.

This principle applies with particular force to cases involving claimants who have a medical need for a cane or other assistive device. Because the use of a cane to ambulate may significantly undermine the ability to work, courts have held that

where a claimant has been deemed by a physician to medically require a cane, and a vocational expert has opined that use of the cane could render the claimant unemployable, the ALJ must make specific, well-articulated findings in order to deny the claim for benefits. Failure to fully address this issue may compel a remand

of the case for further consideration by the Commissioner. So it is here. The plaintiff, Melanie Kilgore, is a woman in her 40’s who suffers from

chronic regional pain syndrome, left foot drop, neuropathy, and osteopenia as a result of a severe left ankle fracture she suffered in 2014. These injuries were deemed so severe and disabling that Kilgore received disability benefits for a closed period of time between 2014 and 2015 as a result of her impairments. (Tr. 93-104). In

August of 2018, Kilgore submitted a renewed application for disability benefits, alleging an onset of disability in June of 2017 as a result of the exacerbation of these conditions. (Tr. 16).

2 Three medical sources opined regarding the severity of Kilgore’s impairments. A treating source, Dr. Phillipe Chemaly, stated that the conditions were

totally disabling. (Tr. 380-82). An examining consulting physician, Dr. Marielle Strone, concluded that Kilgore’s leg impairments were severe and severely limiting, but indicated that she might be able to perform a very limited range of sedentary

work. (Tr. 313-26). A nontreating and nonexamining source, Dr. Ruth Arnold, concluded that Kilgore could perform light work notwithstanding her significant left leg impairments. (Tr. 105-17). While these physicians reached differing conclusions regarding the degree of

Kilgore’s impairment, there was a clear consensus among the doctors who actually treated or examined Kilgore that she required a cane to ambulate. Dr. Chemaly explicitly stated that a cane was medically necessary for Kilgore when standing and

walking. (Tr. 380). Dr. Stone reached the same conclusion, albeit in slightly different terms, stating that Kilgore “does not use a cane but in my medical opinion she needs one.” (Tr. 318). Given this medical consensus that Kilgore needed a cane to stand or walk, in fashioning a residual functional capacity (RFC) for Kilgore the ALJ

concluded that “[s]he would require a cane to ambulate.” (Tr. 22).

3 It is against the backdrop of this evidence that an ALJ conducted a hearing concerning Kilgore’ disability application on September 24, 2019. (Tr. 34-62).

During this hearing, Kilgore and a Vocational Expert both testified. (Id.) In the course of her testimony, Kilgore reaffirmed her constant need to use a cane to stand and walk. (Tr. 42-43). Kilgore also confirmed that she was right hand dominant and

used the cane with her right hand when standing and walking. (Tr. 59). A Vocational Expert also testified, describing jobs that a person with Kilgore’s impairments might be able to perform. (Tr. 53-61). In the course of this testimony, the Vocational Expert was presented with a series of hypothetical

questions regarding a worker with impairments similar to those experienced by Kilgore, including a hypothetical which closely matched the RFC ultimately adopted by the ALJ in this decision. (Id.) In response, the Vocational Expert initially

identified three jobs that she testified Kilgore could perform—order clerk, receptionist, and account clerk.2 However, as the ALJ’s hypothetical questions entailed greater restrictions and incorporated the need for a cane, the Vocational Expert’s testimony became mired in some confusion and riddled with contradictions.

2 209.567-014 Order Clerk, Food and Beverage, DICOT 209.567-014; 237.367-046 Telephone Quotation Clerk, DICOT 237.367-046; 205.367-014 Charge-account Clerk, DICOT 205.367-014.

4 Thus, when the ALJ inquired about the employability of a hypothetical worker who was limited to sedentary work, could only walk for 90 minutes in an 8 hour day,

required a cane to ambulate, needed a sit/stand option at work, and could only stand for 15 minutes and walk for 5 minutes at a time, the Vocational Expert expressed some confusion and sought clarification from the ALJ regarding these limitations.

(Tr. 56-57). The Vocational Expert then initially testified that even with these restrictions, the three jobs she had previously identified would remain available. (Tr. 57). However, the Vocational Expert then almost immediately contradicted this

testimony when, on cross examination, she was asked to focus on a specific aspect of the hypothetical—Kilgore’s need to frequently sit or stand and walk—and was directed to consider the necessity of Kilgore’s use of her dominant hand to hold a

cane when standing and walking. With the Vocational Expert’s attention focused on these work-related factors, the following exchange took place: Q. [A]ll of these jobs require bilateral manual dexterity. Is that correct? A. Correct.

Q. So those jobs would be eliminated by the change in the hypothetical [focusing on cane usage when standing and walking]? A. Correct.

5 (Tr. 60). Therefore, in the course of her testimony the Vocational Expert seemingly

asserted mutually inconsistent propositions and appeared to testify that Kilgore’s use of a cane both would and would not allow her to perform these jobs. Following this hearing, on October 30, 2019, the ALJ issued a decision denying Kilgore’s

application for benefits. (Doc. 13-31). In that decision, the ALJ first concluded that Kilgore met the insured requirements of the Act through December of 2022. (Tr. 18). At Step 2 of the sequential analysis that governs Social Security cases, the ALJ found that Kilgore’s chronic regional pain syndrome, left foot drop, neuropathy, and

osteopenia as a result of a severe left ankle fracture she suffered in 2014 were all severe impairments. (Tr. 19). At Step 3, the ALJ determined that Kilgore did not have any impairment or combination of impairments that met or medically equaled

the severity of one of the listed impairments. (Tr. 21-22).

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Kilgore v. Saul, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kilgore-v-saul-pamd-2021.