United States District Court, D. New Jersey
DOMINICK A. FEELEY, Plaintiff,
COMMISSIONER OF SOCIAL SECURITY, Defendant.
KEVIN McNULTY, District Judge.
Dominick Feeley's application for Social Security disability benefits was denied by the Administration. Feeley has appealed to this Court. He argues that the ALJ did not properly consider his obesity and also did not consider the combined effects of all of Feeley's impairments. He adds that the ALJ erred in rejecting the opinion of Feeley's treating physician without sufficient cause. Feeley argues that the ALJ erred in assessing Feeley's residual functional capacity. Finally, he contends that the ALJ relied on an outdated publication when he determined that there were a significant number of jobs in the national economy that Feeley could perform. I find, however, that the ALJ properly applied the governing legal standards and that his decision was supported by substantial evidence. I will therefore affirm ALJ Kilgannon's decision.
Dominick Feeley suffers from several medical conditions. He has various heart problems including coronary artery disease, hypertension, and obesity. (Decision,  3-4) He also suffers from diabetes and from mental health issues including an adjustment disorder and anxiety. (Decision, 3-4) In addition, Feeley reports experiencing several additional symptoms including blurry vision, sleep apnea, left hand numbness, and bilateral knee and back pain. (Hearing, 20-22; Decision, 4)
Before applying for disability benefits, Feeley worked as a data entry clerk, a hospital admitting clerk, and a general clerk. (Decision, 10). Feeley applied for benefits in October of 2011, claiming disability beginning as of January 4, 2011. (Decision, 1). On March 28, 2013, an Administrative Law Judge, Patrick Kilgannon, affirmed the determination that Feeley was not disabled during the relevant period. (Decision, 12). That denial proceeded through the administrative appeal process and was affirmed, rendering it a final decision.
To determine whether Feeley met the criteria to be considered disabled, the ALJ followed the familiar five-step process outlined at 20 C.F.R. 404.1520(a). Under that framework, an ALJ first asks whether the claimant is presently engaged in substantial gainful activity. 20 C.F.R. § 404.1520(b). At Step 2, an ALJ asks whether the claimant has a medically determinable impairment, or a combination of impairments, that is "severe." 20 C.F.R. § 404.1520(c). At Step 3, the ALJ asks whether the claimant's impairments are so severe as to meet or medically equal the criteria for an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. 20 C.F.R. § 404.1520(d). The ALJ will then assess the claimant's residual functional capacity ("RFC"). 20 C.F.R. § 404.1520(e). In layman's terms, this means that the ALJ will determine what is the most the claimant can do despite the limitations that have been established. 20 C.F.R. § 404.1545(a)(1). At Step 4, the ALJ determines whether, given that RFC, the claimant can still perform past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv). Finally, at Step 5 the ALJ will determine whether the claimant can perform another kind of work that exists in the national economy. 20 C.F.R. § 404.1520 (a)(4)(v).
In this case, the ALJ determined at Step 1 that Feeley had not engaged in substantial gainful activity since the alleged disability onset date. (Decision, 3) The ALJ noted that, after applying for disability benefits, Feeley briefly attempted to work as a delivery driver at a restaurant, and then behind the counter, but was unable to keep up. (Hearing Tr., 6; Decision, 3) Feeley was forced to leave that position after only two weeks. The ALJ's determination was proper; the regulations explain that any work activity that ends within three months because to an impairment should be considered an unsuccessful work attempt, and should not be considered substantial gainful activity. (Decision, 3 citing 20 C.F.R. § 404.1574)
At Step 2, the ALJ determined that Feeley had six severe impairments: coronary artery disease (in a post-bypass status); hypertension; hyperlipidemia; obesity; diabetes; and adjustment disorder. (Decision, 3) The ALJ did not, however, find any severe impairments associated with various other maladies of which Feeley complained. (Decision, 4) These included blurry vision, sleep apnea, left hand numbness, and bilateral knee and back pain. (Decision, 4) These symptoms, wrote the ALJ, were not supported by "medical signs and/or laboratory findings demonstrating the existence of a medically determinable physical impairment." (Decision, 4) Accordingly, the ALJ found they could not form the basis for a finding of disability. (Decision, 4)
At Step 3, the ALJ considered whether Feeley's impairments, alone or in combination, met or medically equaled the severity of one of the listed impairments in Appendix 1 to 20 C.F.R. Part 404, Subpart P. The ALJ found that none of the impairments individually or collectively met the required level of severity. (Decision, 4-6)
The ALJ then determined Feeley's residual functional capacity. Feeley, the ALJ found, retained the capacity to perform "a range of sedentary work." (Decision, 6) Although Feeley could not "climb ladders, ropes, or scaffold, " he could occasionally "climb ramps or stairs, balance, kneel, crouch, crawl, and stoop." (Decision, 6) The ALJ found that any work to be done by Feeley would have to be "limited to unskilled work in a low stress job, " i.e., one "having only occasional decision-making required and only occasional changes in the work setting." (Decision, 6)
At Step 4, the ALJ considered whether, given this RFC, Feeley could return to his prior work as a clerk. To help answer this question, the ALJ consulted a vocational expert named Louis Szollosy. (Decision, 10) Szollsy testified that work as a clerk is semi-skilled, and that it may be performed at a sedentary level, but is typically performed at a "light exertional" level. Based on Feeley's description, the vocational expert said that Feeley had in fact performed his prior work at light exertional level. (Decision, 10) The ALJ concluded that Feeley was not capable of returning to his prior job, either as he performed it or as it is generally performed. (Decision, 10)
Finally, at Step 5, the ALJ considered whether there are jobs available in the national economy that Feeley could perform. At this step, the ALJ was again assisted by the vocational expert. The ALJ concluded, based on the vocational expert's testimony, that Feeley could perform work as a call out operator, a charge account clerk, or a telephone quotation clerk. In each of those positions, the ALJ found, a sufficient number of jobs exist in the national economy for Feeley to find work. (Decision, 11)
Feeley raises four principal objections to the ALJ's decision. First, he challenges the ALJ's decision at Step 3 that Feeley's impairments do not meet or equal one of the impairments listed in Appendix 1. Second, Feeley argues that the ALJ erred in rejecting the opinion of Feeley's treating physician. Third, Feeley argues that the ALJ erred in assessing his residual functional capacity. Finally, Feeley argues that the Commissioner was wrong to conclude that there are jobs in the national economy that Feeley could perform. (Feeley Brief, 12-16) I have respectfully considered these contentions, but I disagree with them.
I. Standard of review
This Court has jurisdiction pursuant to 42 U.S.C § 405(g). Under that statute, a district court's review is limited to deciding whether the ALJ's decision was supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate." Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir.1995) (internal quotation marks and citation omitted). It is "less than a preponderance of the evidence but more than a mere scintilla." Jesurum v. Sec'y of U.S. Dep't of Health & Human Servs., 48 F.3d 114, 117 (3d Cir. 1995). If the ALJ's decision is supported by substantial evidence and is free from legal error, I must affirm that decision, even if I might have decided the case differently. Monsour Medical Ctr. v. Heckler, 806 F.2d 1185, 1190-91 (3d Cir. 1986).
II. Step 3 Determination
Feeley's objection to the ALJ's evaluation of his impairments at Step 3 has three components. First, Feeley argues that the ALJ did not properly consider Feeley's obesity as an impairment on its own, nor did he consider how obesity might be exacerbating other impairments. (Feeley Brief, 20) Second, Feeley argues that although the ALJ considered Feeley's impairments separately, he did not properly consider whether those impairments, in combination, were equivalent in severity to one of the listed impairments. (Feeley Brief, 16-24) Third, Feeley argues that the ALJ improperly rejected the opinion of Feeley's treating physician, which was entitled to deference. (Feeley Brief, 11, 23)
I find that the ALJ properly applied the regulations and that his conclusion was supported by substantial evidence. The ALJ considered whether the plaintiff's impairments met or equaled the criteria provided in Appendix 1 for three categories of impairments: endocrine disorders, cardiovascular disorders, and mental disorders. The symptoms and afflictions that the ALJ considered in his discussion of each category were not limited to any one impairment. For example, the symptoms that the ALJ considered in discussing the claimant's cardiovascular disorders included symptoms attributable to the claimant's obesity such as mobility restrictions and swelling of the legs. Likewise, the ALJ's discussion of Feeley's mental capacity included an assessment of areas that would be affected by Feeley's obesity, including limitations on the activities of daily living and feelings of depression. In general, the ALJ's opinion embodies a holistic approach to Feeley's impairments at Step 3.
a. Cardiovascular impairment
The ALJ properly treated the claimed impairments of the cardiovascular system. Feeley's medical records do not reflect diagnosable heart conditions of sufficient severity to meet the listings in section 4.00. As of January 2012 Feeley's heartbeat showed a "regular rate and rhythm" (Hoffman Evaluation, 2) His heart tones were "a little distant" but there was no evidence of arrhythmia. (Hoffman Evaluation, 2) There was only a "very fain ejection murmur." (Hoffman Evaluation, 2) A "stress rest myocardial perfusion scan" revealed "no definitive evidence of fixed or eversible defect, a top normal to enlarged left ventricle, and an ejection fraction of 47%." (Decision, 7) There was no evidence of significant arterial narrowing. (Decision, 4)
Likewise, the record indicates that the symptoms that Feeley suffers from these heart problems are not sufficiently severe to meet the Appendix 1 criteria. Feeley reported no negative side effects from his medications. (Decision, 9) He walks with a "normal gait" and without the use of an assistive device. (Hoffman Evaluation, 2) He had no difficulty getting on and off an examination table in the doctor's office. (Hoffman Evaluation, 2) As of January 2012, he was not wheezing. (Hoffman Evaluation, 2) Feeley does report occasional swelling of his legs, for which his doctor recommended a water pill which Feeley does not take. (Hoffman Evaluation, 1; Hearing Tr., 10, 20) Overall, the record did not reflect any significant or severe cardiac symptoms, and Feeley has pointed to none. (Decision, 4)
Feeley's own statements about his cardiovascular health are consistent with the ALJ's conclusions. In August of 2010 ( i.e., prior to the alleged disability onset date) Feeley reported that "from a cardiac standpoint he fe[lt] well, " and he denied "effort-related chest pain, shortness of breath, palpitations, or exertional dyspnea." (Gatz Records, 3; Decision, 7) As of January 2012 (approximately one year after the alleged disability onset date) Feeley reported experiencing no chest pain. (Hoffman Evaluation, 1) He was able to walk a number of blocks at a time. He could climb three flights of stairs (he lived in a third-floor walk-up), sometimes without stopping. (Hoffman Evaluation, 1) By February of 2013, at his hearing before the ALJ, Feeley testified that his symptoms were "somewhat" controlled. (Hearing Tr., 16; Decision, 6) The only symptoms he reported were shortness of breath, difficulty lifting objects over five pounds, and swelling of the legs. (Hearing Tr., 16) As the ALJ found, Feeley has not reported "any significant cardiac symptoms such as chest pain or syncope during his many follow-up appointments with his primary care physician." (Decision, 9)
The evidence also supported a conclusion that Feeley's heart condition was not severely restricting his daily living activities. (Decision, 4) Feeley reported that he is able to bathe, dress, and have breakfast on his own. (Hearing Tr., 17; Decision, 4) He attempts to "do little things around the house, " and runs errands and pays bills "as needed." (Hearing Tr., 17-18; Decision, 4) Every week he goes to church and goes shopping with his wife. He took a bus to his appointment with Dr. Hoffman, and he is able to drive. (Hoffman Evaluation, 1)
b. Mental impairment
The ALJ also considered Feeley's mental impairment, identified as adjustment disorder. The ALJ accepted the evidence that Feeley does suffer from an adjustment disorder. He cries about three to four times per week, and "becomes depressed" two to three times a week. (Figurelli Evaluation, 3) He takes Xanax three times per day for anxiety. (Hearing Tr., 17, 15; Decision, 6) Feeley reported one instance in which he "though about not wanting to live." (Figurelli Evaluation, 3) Feeley also reports losing his temper on a regular basis. (Figurelli Evaluation, 2-3) While I do not doubt that Feeley's psychological impairment is a serious challenge for him, there is substantial evidence to support the ALJ's conclusion that this impairment does not rise to the level of severity required to meet the Appendix 1 criteria.
Appendix 1 contains three lists of criteria for severity relating to mental disorders, contained in section 12.04, paragraphs A, B, and C. To satisfy step 3, the claimant must meet either: (1) the requirements of Paragraph A and the requirements of Paragraph B; or (2) the requirements of Paragraph C. See 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.04.
As to the first alternative, the ALJ bypassed Paragraph A and focused on Paragraph B (both are required). Paragraph B requires that the claimant's impairment include ...