Wrenn v. SSA CV-04-344-PB 06/27/05 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Charles Wrenn
v. Case No. 04-CV-344-PB ____________________________________ Opinion NO. 2005 DNH 098 Jo Anne B. Barnhart, Commissioner, Social Security Administration
MEMORANDUM AND ORDER
Charles Wrenn moves to reverse the Commissioner of Social
Security's ("Commissioner") decision denying his application for
disability insurance benefits. See 42 U.S.C. § 405(g). Wrenn
argues that the Administrative Law Judge ("ALJ") failed to
consider the combined effect of his impairments, erroneously
interpreted the medical evidence, and did not properly consider
the effect of his subjective pain complaints. The Commissioner
objects and moves for an order affirming his decision. For the
reasons set forth below, I conclude that the ALJ's decision is
supported by substantial evidence. I therefore affirm the
Commissioner's decision and deny Wrenn's motion to reverse. I. BACKGOUND1
A. Procedural History
Charles Wrenn filed an application for disability benefits
on September 6 , 1 9 9 6 , alleging that he had been disabled since
February 11, 1991. His application was initially denied on
November 19, 1996, and denied again on reconsideration on March
11, 1997. Upon Wrenn's reguest, a hearing was held before a
Administrative Law Judge ("ALJ") Robert S. Klingebiel on June 25,
1997. Wrenn did not appear at the hearing.
The ALJ issued his decision on September 9, 1997, finding
that Wrenn was not disabled at any time through December 31,
1996.2 Specifically, the ALJ found that Wrenn retained the
residual functional capacity ("RFC") to perform a significant
number of jobs that existed in the national economy. The Appeals
1 Unless otherwise noted, the background facts recited in this Memorandum and Order are drawn from the Joint Statement of Material Facts (Doc. No. 8) submitted by the parties pursuant to Local Rule 9.1. Citations to the Joint Statement are in the form wT /r
2 Because Wrenn acguired sufficient guarters of coverage to remain insured for disability insurance benefits ("DIB") only through December 31, 1996, he had the burden of showing that he was disabled on or before his insured status expired. See 20 C.F.R. §§ 404.101, 404.130-404.131.
- 2 - Council denied Wrenn's request for review on November 30, 1998.
Wrenn then filed a complaint in this court. On July 6, 1999, I
remanded the case "for the purpose of obtaining additional
testimony and evidence which shows [Wrenn's] medical condition
through December 31, 1996, and to obtain testimony from a
vocational expert as to the extent to which [Wrenn's]
nonexertional limitations erode his ability to perform light
w o r k ."
On July 18, 2000, ALJ Klingebiel held a second hearing at
which Wrenn appeared and was represented by counsel. A
vocational expert also testified. The ALJ issued his second
decision on August 7, 2000. Again, he found that Wrenn was not
disabled at any time through December 31, 1996. The Appeal's
Council denied Wrenn's request for review on July 12, 2004,
making the ALJ's August 7, 2000 decision the final decision of
the Commissioner. 20 C.F.R. § 404.955.
B. Education and Work History
Wrenn was forty-four years old on August 7, 2000.3 He
completed the ninth grade and had both carpentry and electrical
3 Mr. Wrenn was born on August 18, 1955.
- 3 - vocational training. Prior to February 11, 1991, his last day of
work and the alleged onset date of his disability, he had been
employed at various times as a windshield installer, window
assembler, truck driver, baker's helper, dishwasher, and
injection molding machine operator.
C. Medical History
From February 23, 1988, through May 17, 1993, Wrenn was
treated by Dr. Garrett Gillespie for injuries and pain in his
neck, left hand, and back. Dr. Gillespie opined on December 11,
1990 that Wrenn should not do any heavy lifting or repetitive
bending because of his neck problems.
According to Dr. Gillespie's March 12, 1991 office visit
note, Wrenn continued to have neck pain that extended out to his
left shoulder. Dr. Gillespie noted that Wrenn's neck extension
and lateral flexion to the left were limited by spasms in the
left trapezius muscle group. Nevertheless, Dr. Gillespie
reported that Wrenn's strength was intact, his shoulder motion
was good, and his reflexes were symmetrical. Wrenn continued to
experience neck and arm pain for the next two years, as Dr.
Gillespie's office visit notes indicate.
- 4 - Following a May 11, 1993 office visit. Dr. Gillespie
reported that Wrenn was able to do light activity, and he
encouraged Wrenn to be retrained to do light mechanical repair
work. Dr. Gillespie recommended that Wrenn avoid prolonged
bending, lifting, crawling, and climbing, and should not lift
more than 15 pounds on a non-repetitive basis.
Wrenn was examined by a neurologist. Dr. Robert Thies, on
July 7, 1994. Dr. Thies noted that Wrenn had a cervical
discectomy4 with fusion in 1988, and that he began experiencing
lower back pain after falling while running in the park in 1992.
Dr. Thies found that Wrenn's neck movement was limited in all
directions, but that the strength in his upper and lower
extremities was full and his reflexes were symmetrical. Because
Wrenn experienced discomfort in his lower back when performing a
straight leg raise. Dr. Thies ordered a lumbar x-ray and CT scan.
After his July 7, 1994 appointment, Wrenn failed to return
to Dr. Thies for a follow-up until February 21, 1996. Dr. Thies
reported that the 1994 CT scan of Wrenn's spine showed some disc
4 A cervical discectomy is the excision, in part or in whole, of an intervertebral disk of the cervical spine. Stedman's Medical Dictionary 442-43 (25th ed. 19 9 0 ) ("Stedman's" ) .
- 5 - bulging at L3-4 and L5-S1, but no frank disc herniation. At this
time, Wrenn was taking several medications, including Soma and
Aleve for physical pain, and Zoloft for his mood.5 Wrenn told
Dr. Thies that Zoloft had greatly improved his mood.
When Dr. Thies examined Wrenn in February 1996, he found
Wrenn's strength remained excellent in both his upper and lower
extremities, but that his neck movement had decreased in all
directions. Dr. Thies thus concluded that Wrenn's discomfort may
have resulted from musculoskeletal etiology6 and prescribed
Metaxalone.7 Four weeks later, on March 18, 1996, Dr. Thies
noted that Wrenn's MRI testing showed mild bulging at C4-5, an
apparently stable fusion at C5-6, and disc degeneration at L3-4,
but no marked abnormalities in the spinal canal. Dr. Thies
therefore diagnosed Wrenn with cervical and lumbar strain rather
5 Zoloft is prescribed to treat Major Depressive Disorder. Physician's Desk Reference 2691 (58th ed. 2004) ("PDR") . Soma is used as an adjunct to rest, physical therapy, and other measures for the relief of discomfort from musculoskeletal conditions. PDR 1919.
6 Musculoskeletal etiology is a disease of the muscles or skeleton. Stedman's 994, 542 (25th ed. 1990).
7 Metaxalone is used as an adjunct to rest, physical therapy, and other measures for the relief of discomfort from musculoskeletal conditions. PDR 2181.
- 6 - than discogenic radiculopathy.8 He encouraged Wrenn to get
"going on his activities of daily living a bit better" and
scheduled physical therapy.
Wrenn started physical therapy with Lori Le Barnes on April
9 , 1996. At the initial session, he expressed scepticism about
physical therapy, but agreed to try it for one month. On May 7,
1996, Le Barnes discharged Wrenn from physical therapy because he
was not satisfied with the results.
On September 13, 1996, Wrenn completed an Activities of
Daily Living form. He indicated that he showered daily, cooked,
walked for 15 to 20 minutes twice each day, and did chores around
the house. Wrenn also reported that he shopped for groceries
with his wife and daughter, did the dishes, and tried to fix
things around the house. Wrenn indicated that he had difficulty
concentrating when he was experiencing stress, and that he had
trouble finishing tasks because of the problems with his neck,
arm, and back. He explained that he had not tried to return to
work because no one would hire him due to his condition.
8 Radiculopathy is a "disease of the nerve roots." Borland's Illustrated Medical Dictionary 1562 (30th ed. 2 0 0 3 ) ("Dorland's").
- 7 - Wrenn was admitted to New Hampshire Hospital on October 1,
1996, after threatening to kill his neighbors and attempting
suicide by cutting his abdomen and left hand. He said that he
felt overwhelmed because he did not have enough money for food.
Wrenn later explained that he became upset when his treating
physician refused to prescribe his medication over the telephone,
and he could not get a ride to the doctor's office. He indicated
that this episode was directly related to consuming alcohol.
At New Hampshire Hospital, Wrenn admitted that he had been
smoking up to ten marijuana joints per day since he was 12 years
old. He also admitted to having two alcoholic drinks per day.
At that time, Wrenn had been taking Zoloft and BuSpar for one
year, and reported that these medications were very helpful.
However, he was not seeing any mental health counselors and had
no past psychiatric admissions.
According to the hospital's intake assessment, Wrenn had a
logical and goal directed thought process, clear and normal
speech, a depressed mood and angry affect, concrete reasoning,
poor judgment, and fair insight. He exhibited no delusions,
hallucinations, suicidal thoughts or plans, or homicidal thoughts
or plans. There was no evidence of cognitive or affective disorder, and his level of control was excellent. Wrenn did not
display any symptoms of formal mental illness, and he stated that
he was no longer suicidal. Accordingly, he was discharged on
October 4, 1996, and was given a one week supply of Zoloft and
BuSpar. Dr. Howard Suls, Wrenn's treating physician, renewed
these prescriptions on October 7, 1996.
At the reguest of the Social Security Administration, Dr.
Burton Nault, a non-examining state agency physician, completed a
physical RFC assessment of Wrenn on October 8, 1996 .9 Dr. Nault
determined that Wrenn could occasionally lift 20 pounds,
freguently lift ten pounds, stand and/or walk for about six hours
in an eight hour workday, sit for about six hours in an eight
hour workday, and push or pull without any limitations. He also
determined that Wrenn could occasionally climb, balance, stoop,
kneel, crouch, and crawl, but could not perform repetitive
overhead reaching. Dr. Nault thus concluded that Wrenn had the
capacity to do light work without repetitive bending, lifting, or
overhead reaching.
Similarly, at the reguest of the Social Security Disability
9 Dr. Nault's RFC was affirmed by a nonexamining state agency physician on January 28, 1997. Determination office, psychologist John T. Bourpos, Ph.D.,
completed a consultative evaluation of Wrenn on October 30, 1996.
Dr. Bourpos noted that Wrenn had been on a regimen of Zoloft and
BuSpar for over one year. According to Dr. Bourpos, Wrenn
claimed that he was unable to return to work because of his
physical limitations. Upon examination. Dr. Bourpos found that
Wrenn had good overall hygiene, was appropriately friendly and
cooperative, with good persistence and patience. Wrenn was also
found to be alert and responsive, despite an expression that
indicated sadness and depression. There were no indications of
loose associations, pressured speech, or flight of ideas, and
Wrenn's affect was appropriate.
Dr. Bourpos noted that Wrenn had experienced continuous
depression and feelings of anxiety over the previous six months.
Wrenn told Dr. Bourpos that during this time, he had experienced
depressed moods, loss of interest in activities, feelings of
guilt, motor retardation, sleep disturbances, fatigue, difficulty
concentrating, and diminished libido. He also reported symptoms
of anxiety, including palpitations, light headedness, sweating,
muscle aches, clammy hands, gastro-intestinal problems, nausea,
muscle twitching, and a dry mouth. Dr. Bourpos indicated that it
- 10 - was unclear whether Wrenn's pattern of anxiety symptoms occurred
only during depressive episodes and noted that he wanted to
explore this issue further.
Based on these observations. Dr. Bourpos concluded that
Wrenn's concentration and attention were mildly impaired and that
his short term memory and orientation were intact. He estimated
that Wrenn's intellectual ability is in the low average range and
his computational skills are adeguate. Based on this evaluation.
Dr. Bourpos reported that Wrenn's mental condition did not appear
to interfere with his daily activities, social functioning, or
his concentration and task completion. He used public
transportation and telephones, was able to do light chores and
could manage his own funds, and was capable of appropriately
interacting and communicating with others. Wrenn also appeared
capable of following and completing oral and written instructions
of intermediate difficulty. Nonetheless, Dr. Bourpos concluded
that Wrenn's depression, anxiety, and thoughts of self-harm would
compromise current vocational functioning and that in a work
setting, he would likely have limited attendance, a slow pace,
and low energy. Dr. Bourpos also noted, however, that Wrenn did
not report any past difficulties in complying with reguired
- 11 - attendance, work schedules, decision making, or interactions with
co-workers or supervisors.
Ultimately, Dr. Bourpos diagnosed Wrenn with Major
Depression, recurrent,10 but ruled out Generalized Anxiety
Disorder11 and Personality Disorder with borderline paranoid
features. He determined that without some form of therapeutic
intervention, in addition to medication, Wrenn's prospects for
rehabilitation were poor. Finally, he recommended further
evaluation of Wrenn's cognitive functioning and potential for
vocational rehabilitation.
On November 19, 1996, Dr. Udo Rauter, a nonexamining state
agency psychologist, completed a Psychiatric Review Technigue
Form ("PRTF") of Wrenn.12 Dr. Rauter found that Wrenn suffered
10 "Major Depression, recurrent," is characterized by the presence of two or more major depressive episodes. Diagnostic and Statistical Manual of Mental Disorders 376 (4th ed. 2000)("DSM").
11 "The essential feature of Generalized Anxiety Disorder is excessive anxiety and worry (apprehensive expectation), occurring more days than not for a period of at least [six] months, about a number of events or activities." DSM 472 (4th e d . 2 0 0 0).
12 Dr. Rauter's PRTF was affirmed by Dr. Michael A. Schneider, a nonexamining state agency psychologist, on February 28, 1997.
- 12 - from severe mental impairments consisting of depression, not
otherwise specified, and personality disorder, but that his
impairments were not expected to last twelve months. Dr. Rauter
noted that there was insufficient medical evidence to assess
whether Wrenn had a medically determinable mental impairment
prior to October 1, 1996. Furthermore, Dr. Rauter opined that
Wrenn had only slight restrictions on his activities of daily
living and in maintaining social functioning, and that he seldom
experienced deficiencies in concentration, persistence, or pace
that would result in failure to complete a task. Finally, Dr.
Rauter noted that Wrenn had only one or two episodes of
deterioration or decompensation in a work-like setting.
At the reguest of Dr. Suls, Kathleen C. Leahy, an
osteopathic physician, evaluated Wrenn for his neck and back pain
on November 25, 1996. Wrenn denied drinking alcohol, but
admitted to smoking between five and ten marijuana joints per
day. Dr. Leahy assessed chronic pain, mostly myofascial13 in
origin, involving the lower cervical and trapezius areas, a
13 Myofascial pain involves the "sheet or band of fibrous tissue such as lies deep to the skin or forms an investment for muscles and various other organs of the body." Dorland's at 674, 1213 .
- 13 - history of left biceps tendon injury, generalized musculoskeletal
deconditioning with muscle imbalance and abdominal weakness, and
chronic pain secondary to his conditions. She indicated that
Wrenn had low motivation to return to work, but nevertheless
recommended that he proceed with a trial of vocational
rehabilitation for a light duty or sedentary position. Dr. Leahy
further recommended an active rehabilitation program and
encouraged Wrenn to attend, although she was not optimistic that
he would participate.
Dr. Leahy examined Wrenn again on January 10, 1997. in her
office notes, she reported that he suffered from chronic pain,
including mild myofascial pain in the lower cervical and
trapezius areas. She assessed lumbar spine degenerative disc
disease without clear findings of radiculopathy and general
muscle deconditioning of the hip and abdominal muscles.
Notwithstanding these findings. Dr. Leahy reported that Wrenn's
attitude had improved and that he was more motivated with a
positive outlook. Dr. Leahy recommended physical therapy and
again discussed with Wrenn a return to gainful employment.
On June 25, 1997, Dr. Virginia Emery, Ph.D., examined Wrenn
for the first time. She reported that he suffered from Major
- 14 - Depressive Disorder and severe Anxiety Disorder of the Post
Traumatic Stress Disorder subtype. Dr. Emery opined that Wrenn
had suffered from these disorders for many years, but that their
severity had recently escalated.14
D. Hearing Testimony of Charles Wrenn and Vocational Expert
1. Wrenn's Testimony
At the July 18, 2000 hearing, Wrenn testified that he
suffered a neck injury at work in 1985, and had surgery on his
neck in 1987. Wrenn explained that he reinjured his neck while
doing physical labor at Portland Glass, where he was employed as
a windshield, sunroof, and door glass installer, and that he took
Soma for the pain. Wrenn also reported that he injured his
biceps tendon in 1985, but never had surgery and the injury thus
failed to heal properly. Wrenn testified that he suffered a back
injury in 1992 when he fell in the park while walking his dog and
14 On January 15, 2000, Dr. Emery completed a medical assessment of Wrenn's ability to do work-related activities. Based on this assessment, she concluded that he was too unpredictable and unreliable with respect to rage responses to be absorbed into the work force. She reported that he met the full criteria for Post Traumatic Stress Disorder and that he suffered from Intermittent Rage Disorder. Dr. Emery noted that Wrenn was not actively suicidal and his rage responses were less freguent due to psychotherapy. She further concluded that his stability was dependant upon medication.
- 15 - that pool therapy improved his back pain. According to Wrenn,
his back condition remained the same until January 2000, when he
aggravated it in a car accident.
Wrenn explained that he could turn his neck to the right,
but felt pain when he tried to turn it to the left. Nonetheless,
he was able to cut his neighbor's hedges, take care of her
property, take out her trash, and work on cars at his own pace.
Wrenn testified that he started having trouble dealing with
people the day Portland Glass let him go. He stated that he
tried looking for work after he lost his job, but was unable to
find anything. Wrenn explained that he "lost it" when his son
was sent to prison for assault in 1993. He conceded that he had
a problem with alcohol and had used marijuana, but denied that he
was addicted to either drugs or alcohol.
Finally, Wrenn testified that he began seeing Dr. Emery, a
psychologist, in 1997. Prior to that, his primary care physician
had prescribed Zoloft and BuSpar for depression and anxiety. At
the time of the hearing, Wrenn was taking both Zoloft and BuSpar,
as well as Soma and medication for nausea and stomach cramps.
Wrenn stated that when he was off his medication for two weeks in
the fall of 1996, he became very distressed and inflicted wounds
- 16 - on himself. He was ultimately taken to the New Hampshire
Hospital for evaluation.
2. Testimony of The Vocational Expert Howard Steinberg
Vocational expert ("VE") Howard Steinberg testified that
Wrenn's past work as a windshield installer was skilled medium
work, his job as a window assembler was semi-skilled medium work,
his job as a baker's helper was unskilled heavy work, his job as
a truck driver was semi-skilled medium work, his job as an
injection molding machine operator was unskilled light work and
his job as a dishwasher was unskilled medium work.
The ALJ asked VE Steinberg to assume that an individual of
Wrenn's age, education, and work experience had the following
restrictions: (a) no strenuous lifting and carrying of objects
(limited to twenty pounds maximum lifting but not on a repetitive
or very freguent basis); (b) no reaching over the shoulder more
than periodically (less than one third of the time); (c) no
waiting on the public; and (d) no working in close, critical
situations with other people, such as on an assembly line or
where a great deal of interaction among co-workers is reguired.
Presented with these limitations, VE Steinberg opined that such
an individual could not perform any of Wrenn's past relevant
- 17 - work. VE Steinberg further testified that such an individual
could perform other work that existed in significant numbers in
the national economy, including security guard at the light duty
level, security guard at the sedentary level, courier, and mail
clerk.
The ALJ then asked VE Steinberg to evaluate the stress
associated with each of the jobs he identified on a scale of 1 to
5, with 1 as the least stressful and 5 as the most stressful.
The ALJ explained that he wanted to rule out jobs at levels 4 and
5. VE Steinberg then testified that all of the jobs he listed
were either 2 or 3 on the scale except courier, which, at times,
could be at level 4. He explained that the security jobs he
listed did not involve interacting with the public, but instead
involved watching space, and that the mail clerk job would not
typically involve high stress situations. VE Steinberg's
testimony was uncontradicted.
II. STANDARD OF REVIEW
After a final decision by the Commissioner denying a
claimant's application for benefits, and upon a claimant's timely
- 18 - request, I am authorized to review the pleadings submitted by the
parties and the administrative record and enter a judgment
affirming, modifying, or reversing that decision. See 42 U.S.C.
§ 4 0 5 (g) (2003). My review is limited in scope, however, as the
ALJ's factual findings are conclusive if they are supported by
substantial evidence. See i d .; Irlanda Ortiz v. Sec'y of Health
& Human Servs., 955 F.2d 765, 769 (1st Cir. 1991) (per curiam).
The ALJ is responsible for making credibility determinations,
drawing inferences from the evidence, and resolving evidentiary
conflict. Irlanda Ortiz, 955 F.2d at 769; Frustaglia v. Sec'y of
Health & Human Servs., 829 F.2d 192, 195 (1st Cir. 1987). I
therefore must "uphold the [Commissioner's] findings . . . if a
reasonable mind, reviewing evidence in the record as a whole,
could accept it as adequate to support [the Commissioner's]
conclusion." Irlanda Ortiz, 955 F.2d at 769 (quoting Rodriguez
v. Sec'y of Health & Human Servs., 647 F.2d 218, 222 (1st Cir.
1981)(internal quotation marks omitted).
The ALJ's findings of fact are not conclusive, however, if
they are "derived by ignoring evidence, misapplying the law, or
judging matters entrusted to experts." Nguyen v. Chater, 172
F.3d 31, 35 (1st Cir. 1999)(citations omitted). If the
- 19 - Commissioner, through the ALJ, has misapplied the law or has
failed to provide a fair hearing, deference to the Commissioner's
decision is not appropriate, and remand for further development
of the record may be necessary. See Seavey v. Barnhart, 276 F.3d
1, 11 (1st Cir. 2001). I apply these standards in reviewing
Wrenn's motion to reverse the Commissioner's decision.
III. ANALYSIS
The Social Security Act defines "disability" for the
purposes of Title II 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) (2003). When evaluating whether a claimant is
disabled due to a physical or mental impairment, an ALJ's
analysis is governed by a five-step seguential evaluation
process. See 20 C.F.R. § 404.1520. An ALJ is reguired to
consider the following issues when determining if a claimant is
disabled: (1) whether the claimant is engaged in substantial
- 20 - gainful activity; (2) whether the claimant has a severe
impairment; (3) whether the impairment meets or equals a listed
impairment; (4) whether the impairment prevents or prevented the
claimant from performing past relevant work; and (5) whether the
impairment prevents or prevented the claimant from doing any
other work. 20 C.F.R. § 404.1520. An affirmative answer at one
step leads to the next step in the analysis. Id. If the answer
to question (3) or (5) is affirmative, the claimant is disabled.
Id. If the answer to any question other than (3) is negative,
the claimant is not disabled. Id. The claimant bears the burden
on the first four steps. At step five, the burden shifts to the
Commissioner to show "that there are jobs in the national economy
that [the] claimant can perform." 20 C.F.R. § 416.920(f);
Heggarty v. Sullivan, 947 F.2d 990, 995 (1st Cir. 1991) . The
Commissioner must show that the claimant's limitations do not
prevent him from engaging in substantial gainful work, but need
not show that the claimant could actually find a job. See
Keating v. Sec'y of Health & Human Servs., 848 F.2d 271, 276 (1st
Cir. 1988).
Here, the ALJ determined at step five that Wrenn was not
entitled to benefits because he found Wrenn's residual functional
- 21 - capacity allowed him to perform jobs existing in the national
economy such as security guard, courier, and mail clerk. Wrenn
now argues that the ALJ (1) failed to consider the combined
affect of his physical and mental impairments; (2) erroneously
interpreted the medical evidence; and (3) did not properly
consider his subjective pain complaints. I address each argument
in turn.
A. The Combined Effect of Wrenn's Impairments
Wrenn first argues that at step three the ALJ failed to
consider the combined effect of his physical and mental
impairments on his ability to perform substantial gainful work.
I disagree. As a preliminary matter, I note that it is Wrenn's
burden to show that he has an impairment or impairments that meet
or egual a listed impairment in Appendix 1. Torres v. Sec'y of
Health & Human Servs., 870 F.2d 742, 745 (1st Cir. 1989) (per
curiam). Wrenn has not stated, nor has he otherwise indicated,
which listing his impairments purportedly "egual." See Garcia v.
Sec'y Health & Human Servs., 25 F.3d 1037 (1st Cir.
1994) (unpublished table opinion) .
In any event, I reject Wrenn's assertion that there is no
evidence in the record that the ALJ considered either the
- 22 - combined effect of his multiple impairments or the medical
equivalence of his impairments. To the contrary, the ALJ
specifically concluded in Finding 3 of his August 7, 2000
decision that "[t]he medical evidence establishes that . . .
[Wrenn] had depression with symptoms of anxiety, a personality
disorder, cervical and lumbar disc disease, impairments which are
severe, but which did not meet or equal the criteria of any of
the impairments listed in Appendix 1, Subpart P." Tr. 2 69.
The ALJ's ultimate conclusion is buttressed by his thorough
examination of the record and the questions he directed to VE
Steinberg. For example, the ALJ found that "due to the effects
of mental illness, [Wrenn] was unable to deal with the public,
perform assembly line tasks, and perform work functions requiring
close interaction with co-workers." Tr. 267. The ALJ thus
determined that Wrenn's "capacity for light work was diminished
by significant non-exertional limitations in addition to the
prohibition on repetitive overhead reaching and handling." Tr.
267. Thus, the record reveals, the ALJ specifically examined the
impact of Wrenn's mental impairments on his ability to perform
light and sedentary work.
- 23 - Moreover, the ALJ specifically directed VE Steinberg to
consider not only Wrenn's age, educational background, employment
history, and the prohibition on overhead reaching and handling,
but also his inability to deal with the public, perform assembly
line tasks and have close interaction with co-workers. The ALJ
expressly stated that he wanted to excluded from the analysis
jobs involving high levels of stress. Assuming these
restrictions, VE Steinberg identified four jobs that Wrenn could
perform. At the ALJ's direction, VE Steinberg testified that all
four of the cited jobs involve relatively low stress levels. As
these guestions clearly indicate, the ALJ properly and reasonably
considered the combined effect of Wrenn's physical and mental
impairments at step three of his analysis.
B. Interpretation of the Medical Evidence
I also reject Wrenn's argument that the medical evidence
submitted by Dr. Emery and Dr. Bourpos support a finding of
disability. With respect to the evidence from Dr. Bourpos, the
ALJ properly evaluated his contradictory conclusions. For
example, on October 30, 1996, Dr. Bourpos noted that although
Wrenn's depression, anxiety, and thoughts of self-harm would
- 24 - likely make it difficult for him to cope with work pressures and
would compromise his current vocational functioning, he also
stated that Wrenn's mental condition did not interfere with his
daily activities, social functioning, or his concentration and
ability to complete tasks. Likewise, Dr. Bourpos opined that
Wrenn appeared capable of following and correctly completing oral
or written instructions of intermediate difficulty, and that his
short-term memory and orientation were intact, his thought
process was reasonable and coherent, and his persistence and
patience were both "good." Nonetheless, he concluded that
without some form of therapeutic intervention, in addition to
medication, Wrenn's prospects for rehabilitation were poor. The
ALJ considered this conflicting evidence and reasonably
determined that, when viewed in concert with the other medical
evidence in the record, particularly Dr. Rauter's November 19,
1996 psychiatric review that classified his impairment as severe
but not expected to last 12 months, Wrenn's impairments did not
meet or egual the criteria of any of the impairments listed in
Appendix 1. Such a resolution of conflicting medical evidence is
properly within the ALJ's province and must not be disturbed
where, as here, the resolution is reasonable.
- 25 - Furthermore, the ALJ reasonably considered and appropriately
declined to accept the record evidence from Dr. Emery because her
opinions could not be related to the relevant time period. Dr.
Emery first examined Wrenn on June 25, 1997, nearly six months
after his date last insured. Dr. Emery opined in a July 30, 1997
letter to his attorney that Wrenn suffered from Major Depressive
Disorder and severe Anxiety Disorder. She further opined that
Wrenn had suffered from these disorders for several years but
that they had recently become more severe.15 Dr. Emery did not,
however, suggest that Wrenn's impairments were severe during the
period prior to December 31, 1996. Nor did she indicate any
restrictions in his daily activities, social functioning,
concentration, persistence, or pace. See 20 C.F.R. part 404,
Subpart P, Appendix 1, §§ 12.04B and 12.08B. I therefore
conclude that the ALJ reasonably evaluated the medical evidence
in the record for the relevant time period and properly
determined that Wrenn's impairments did not meet or egual the
15 As the ALJ noted in his August 7, 2000 decision. Dr. Emery's January 15, 2000 assessment of Wrenn's ability to perform work-related functions could not be related to his condition on or before December 31, 1996 because it was not supported by any treatment notes in the record during this period. Tr. 266.
- 26 - requirements of any impairments listed in the regulations.
C. Credibility of Wrenn's Complaints of Pain
Finally, I reject Wrenn's argument that the ALJ failed to
consider the effect of his subjective complaints of pain on his
ability to work. In determining the credibility of a person's
statements, the ALJ must consider the entire record, which
includes the objective medical evidence, the individual's
subjective statements about symptoms, information provided by
medical specialists, and any other relevant evidence in the
record. S.S.R. 96-7(p), 1996 WL 374186 at *1. A claimant's
subjective statements may suggest a more severe impairment "than
can be shown by objective medical evidence alone." 20 C.F.R. §
404.1529(c)(3). So long as a credibility determination is
supported by the evidence, the ALJ's determination is entitled to
deference since he observed the claimant, evaluated the
claimant's demeanor, and considered how his testimony
corresponded with the rest of the evidence. Frustaglia, 829 F.2d
at 195.
In assessing Wrenn's RFC, the ALJ partially credited Wrenn's
subjective complaints concerning his physical limitations and
pain allegations. Nonetheless, the ALJ reasonably determined
- 27 - that Wrenn's complaints of symptoms and disabling limitations
were not so severe as to render him disabled. Moreover, because
the ALJ did not find Wrenn's statements as to the severity of his
symptoms entirely credible, he made "specific findings as to the
relevant evidence he considered in determining to disbelieve the
[claimant]" as reguired. Da Rosa v. Sec'y of Health & Human
Servs., 803 F.2d 24, 26 (1st Cir. 1986). As the ALJ's decision
and the hearing transcript demonstrate, the ALJ properly
considered the Avery factors and supported his findings by
discussing Wrenn's daily activities, social functioning, and
functional abilities.16 See Frustaglia, 829 F.2d at 195 (stating
an ALJ's credibility assessment is given deference when he
"thoroughly guestioned the claimant regarding his daily
activities, functional restrictions, medication, prior work
record, and freguency and duration of the pain . . . in
16 In Avery v. Sec'y of Health & Human Servs., the First Circuit held that in evaluating a claimant's subjective symptoms, an ALJ must consider (1) the nature, location, onset, duration, freguency, radiation, and intensity of any pain; (2) precipitating and aggravating factors (e.g., movement, activity, environmental conditions); (3) type, dosage, effectiveness, and adverse side-effects of any pain medication; (4) treatment, other than medication, for relief of pain; (5) functional restrictions; and (6) the claimant's daily activity. 797 F.2d at 28-29.
- 28 - conformity with the guidelines set out in Avery It
was therefore reasonable for the ALJ to conclude at step five
that Wrenn retained the residual functional capacity to perform
both light duty and sedentary work.
IV. CONCLUSION
Because I have determined that the ALJ's denial of Wrenn's
benefits is supported by substantial evidence, I affirm the
Commissioner's decision. Accordingly, Wrenn's Motion to Reverse
(Doc. No. 6) is denied, and the Commissioner's Motion for an
Order Affirming the Decision of the Commissioner (Doc. No. 7) is
granted. The clerk of court shall enter judgment accordingly.
SO ORDERED.
/s/Paul Barbadoro____________ Paul Barbadoro United States District Judge
June 27, 2005
cc: James W. Craig, Esg. David L. Broderick, Esg.
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