Opinions of the United
2009 Decisions States Court of Appeals
for the Third Circuit
3-27-2009
Linda Williams v. Comm Social Security
Precedential or Non-Precedential: Non-Precedential
Docket No. 08-2603
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NOT PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
No. 08-2603
LINDA WILLIAMS,
Appellant
v.
MICHAEL ASTRUE,
Commissioner of Social Security
On Appeal from the United States District Court
for the Eastern District of Pennsylvania
(Civil No. 2-07-cv-04389)
District Judge: Honorable J. Curtis Joyner
Submitted Under Third Circuit LAR 34.1(a)
January 9, 2009
Before: CHAGARES, HARDIMAN, Circuit Judges, and ELLIS, Senior District Judge.*
(Opinion Filed: March 27, 2009)
OPINION OF THE COURT
ELLIS, Senior District Judge.
*
The Honorable T. S. Ellis III, Senior District Judge, United States District Court
for the Eastern District of Virginia, sitting by designation.
Linda Williams appeals from a district court order denying her request for review
of the decision of an Administrative Law Judge (“ALJ”) denying her Supplemental
Security Income and entering judgment in favor of the Commissioner of Social Security
(“Commissioner”). Because we agree with the district court that substantial evidence
supports the ALJ’s decision that Williams is not disabled within the meaning of the Social
Security Act, we will affirm.
I.
Because we write solely for the benefit of the parties, we only briefly summarize
the essential facts. At the time she applied for benefits, Williams was 56 years old. The
record reflects she completed the eleventh grade and then studied computers. She worked
full time for over a year as a collection agent for television service in a hospital in 2003
and 2004. More recently, she volunteered part time at a friend’s child care center. The
record also indicates that Williams’s medical history includes (i) a seizure disorder that
appears to be successfully controlled by medication, (ii) hypertension also well controlled
by medication, (iii) a small ganglion cyst in her left foot, (iv) urge incontinence that
significantly improved with medication, (v) gastroesophageal reflux disease, (vi) a history
of ovarian cysts, (vii) osteoarthritis in her knees, and (viii) disc degeneration in her
lumbar spine.
On September 20, 2005, Williams protectively filed for Supplemental Security
Income, alleging disability as of May 14, 2005, due to (i) her seizure disorder, (ii) high
2
blood pressure, (iii) a tumor in her foot, (iv) dizziness, and (v) nerves.1 Her initial claim
was denied on March 6, 2006. At Williams’s request, an ALJ held a hearing on
November 15, 2006, at which Williams testified to the above-listed ailments, as well as
pain in her knees and back. On March 6, 2007, the ALJ issued a decision denying
Williams’s application for benefits.
In reaching this decision, the ALJ employed the sequential evaluation process
required by Social Security regulations. See 20 C.F.R. § 404.1520; Plummer v. Apfel,
186 F.3d 422, 428–29 (3d Cir. 1999). First, the ALJ found that Williams was not
engaging in substantial gainful activity. Second, the ALJ determined that Williams’s
seizure disorder, hypertension, and osteoarthritis of the back and knees represented severe
impairments. Third, the ALJ found that none of Williams’s impairments, individually or
in combination, met or equaled any of the impairments listed in 20 C.F.R. 404, subpt. P,
app. 1. As required by the fourth step of the analysis, the ALJ determined that Williams
had the residual functional capacity to perform the full range of work at the medium
exertional level, but should avoid heights and moving machinery.2 Based on this finding,
the ALJ determined that Williams was capable of performing her past relevant work as a
1
Although Williams alleged an onset date of May 14, 2005, the period relevant to
her disability determination began on September 20, 2005, her protective filing date. See
20 C.F.R. §§ 416.305, 416.335.
2
Under Social Security regulations, medium work “involves lifting no more than
50 pounds at a time with frequent lifting or carrying of objects weighing up to 25
pounds.” 20 C.F.R. § 416.967(c).
3
collection agent and a daycare worker, both of which he found she had performed at a
light level.3 Accordingly, the ALJ concluded that Williams was not disabled.
The Appeals Council denied Williams’s request for review, making the ALJ’s
decision the Commissioner’s final decision. See 20 C.F.R. § 416.1481. Williams then
filed this civil action in district court pursuant to 42 U.S.C. § 405(g), and the matter was
referred to a magistrate judge pursuant to 28 U.S.C. § 636(b)(1)(B). The magistrate judge
issued a report and recommendation concluding that substantial evidence supported the
ALJ’s determination that Williams could perform her past relevant work, to which
Williams filed objections. On April 21, 2008, the district court accepted the report and
recommendation, denied Williams’s request for review, and entered judgment in favor of
the Commissioner. Williams timely appealed, and we have jurisdiction pursuant to 28
U.S.C. § 1291.
II.
Our role in this appeal is identical to that of the district court. Specifically, we
review the Commissioner’s findings of fact to determine whether they are supported by
substantial evidence. See 42 U.S.C. § 405(g). Substantial evidence “‘does not mean a
large or considerable amount of evidence, but rather such relevant evidence as a
3
Light work is defined as work that “involves lifting no more than 20 pounds at a
time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though
the weight lifted may be very little, a job is in this category when it requires a good deal
of walking or standing, or when it involves sitting most of the time with some pushing
and pulling of arm or leg controls.” 20 C.F.R. § 416.967(b).
4
reasonable mind might accept as adequate to support a conclusion.’” Hartranft v. Apfel,
181 F.3d 358, 360 (3d Cir. 1999) (quoting Pierce v. Underwood, 487 U.S. 552, 565
(1988)). We exercise plenary review of all legal issues. Schaudeck v. Comm’r of Social
Sec. Admin., 181 F.3d 429, 431 (3d Cir. 1999).
To receive Supplemental Security Income, a claimant must establish that she is
disabled under the Social Security Act. The Act defines disability 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). Here, the ALJ found that although Williams had a few severe
impairments, she was not disabled. Rather, the ALJ determined that Williams retained
the residual functional capacity to perform her past relevant work. After thoroughly
reviewing the administrative record, we agree with the magistrate judge’s reasoning and
conclusion that substantial evidence supports the ALJ’s conclusion. The ALJ considered
all the medical evidence and Williams’s testimony in determining that she was not
disabled during the relevant period and thus not entitled to Supplemental Security
Income.
Williams raises essentially three challenges to this conclusion. First, Williams
argues that the ALJ’s residual functional capacity assessment was not supported by
substantial evidence because the ALJ gave greater weight to a checklist completed by a
non-examining medical consultant than a contrary checklist completed by an examining
5
medical consultant. On January 24, 2006, Williams was seen by an independent agency
examiner, who indicated in a form attached to his report of her physical examination that
although Williams had no limitations in her ability to lift and carry and could occasionally
bend, kneel, stoop, crouch, balance, and climb, she was limited to (i) standing and
walking for one to two hours per eight-hour workday and (ii) sitting less than six hours a
day, in five minute intervals. The ALJ ultimately decided not to credit these work-
preclusive findings based on his review of the rest of the record, including a non-
examining medical consultant’s March 1, 2006, report that indicated Williams could sit,
stand, and walk for about six hours in an eight-hour workday with normal breaks.4
It is well established that a non-examining physician’s opinions “have less
probative force as a general matter, than they would have had if the doctor had treated or
examined [the claimant].” Morales v. Apfel, 225 F.3d 310, 320 (3d Cir. 2000) (internal
quotation marks and citation omitted); see also 20 C.F.R. § 416.927(d)(3) (“[B]ecause
nonexamining sources have no examining or treating relationship with [the claimant], the
weight we will give their opinions will depend on the degree to which they provide
supporting explanations for their opinions.”). Yet, in this instance, the ALJ’s decision not
to credit the examining consultant’s findings as to Williams’s ability to perform work-
related physical activities was both thoroughly explained and well supported by
substantial evidence. Not only was there a conflict between the examining medical
4
The signature of the non-examining agency expert is illegible and his or her name
does not appear elsewhere on the form.
6
consultant’s restrictive assessment and the non-examining medical consultant’s findings,
but the extreme limitations found by the examining consultant also conflicted with (1)
objective testing in the form of x-rays and MRI images of Williams’s knees and spine that
showed no extreme abnormalities;5 (2) the September 14, 2006, report by Dr. Robert W.
Downie, a specialist in rehabilitation medicine who recommended that Williams attend
physical therapy and continue to take ibuprofen for her low back and knee pain;6 and (3)
the examining consultant’s own physical examination report, in which he indicated that
(i) Williams’s gait was within normal limits, although she favors her left foot; (ii) a
straight-leg raising test was negative; (iii) there was no sign of gross sensory changes,
5
The August 28, 2006, x-rays of Williams’s knees showed that “[t]he visualized
osseous structures are grossly intact without evidence of joint effusion, fracture, or joint
space narrowing.” (A.R. at 185.) The back x-rays showed a normal thoracic spine but
some disc space narrowing in her lumbar spine. The October 5, 2006, MRI of her left
knee showed early osteoarthritis with areas of full thickness cartilage loss, but with
normal ligaments, a normal extensor mechanism, and no torn menisci. Her right knee
was similar, except it also demonstrated “minimal” tendinosis. (A.R. at 182.) The MRI
of Williams’s thoracic spine was normal. The images of her lumbar spine showed
multilevel “diffuse disc bulge” and “mild bilateral facet joint arthropathy,” conditions
which resulted in “mild” neural forminal stenosis at L3-L4 and L5-S1 and “mild to
moderate left neural foraminal stenosis” at L4-L5, with “possible impingement upon the
traversing left L5 nerve root.” (A.R. at 179.)
6
Dr. Downie noted that Williams’s “[b]ilateral knee exam reveals some mild laxity
on the right knee on the medial compartment, also some mild crepitus bilaterally, but has
full range of motion and could not elicit any pain with ranging the knees.” (A.R. at 195.)
Dr. Downie’s examination of Williams’s back found “bilateral paraspinal muscle
hypertrophy starting in the mid thoracic, going down to superior sacral region, also has
tenderness, which is worse on the right than on the left in the L3, L4, and L5 area.” (A.R.
at 196.) He described her gait as essentially symmetric with normal stride length
bilaterally.
7
muscle weakness, or atrophy; (iv) her joints did not disclose any signs of acute synovitis
or arthritis; and (v) her range of motion was within normal limits. Based on this record,
substantial evidence supports the ALJ’s decision to credit the non-examining consultant’s
findings over the examining consultant’s assessment of Williams’s ability to walk, stand,
and sit.
Williams’s second argument is that the ALJ improperly relied on his own lay
evaluation of the medical evidence. Specifically, Williams asserts that the ALJ (i)
misinterpreted or ignored the findings of her October 5, 2006, MRI and (ii) summarily
concluded that Williams’s pain was controlled with ibuprofen. This challenge also fails
to persuade. Certainly, “an ALJ may not make speculative inferences from medical
reports.” Plummer, 186 F.3d at 429. Nor is the ALJ “free to employ [his] own expertise
against that of a physician who presents competent medical expertise.” Id. Yet, there is
no indication in this record that the ALJ impermissibly substituted his own assessment for
that of a qualified expert, drew speculative inferences from Williams’s medical records,
or ignored critical evidence. With regard to the MRI of her knees, Williams asserts that
although the ALJ acknowledged the scan showed some early osteoarthritis, he ignored the
additional diagnosis of “full thickness cartilage loss.” This criticism fails given that
cartilage loss is a characteristic of osteoarthritis, rather than a separate condition.7
Further, despite Williams’s claims to the contrary, the ALJ’s decision demonstrates that
7
See Stedman’s Medical Dictionary 1388 (28th ed. 2006) (defining osteoarthritis
as “arthritis characterized by erosion of articular cartilage”).
8
he considered the MRI of Williams’s lumbar spine.8 In short, the MRI does not
undermine the ALJ’s ultimate determination that her knee and back impairments would
not prevent her from performing her past relevant work. Indeed, this conclusion is further
supported by the fact that no doctor ever recommended more than over-the-counter
medication and physical therapy for her back and knee pain.9
Further, substantial evidence supported the ALJ’s conclusion that her knee and
back “pain was not that severe” because it was controlled with ibuprofen. (A.R. at 17.)
Although Williams argues that the ALJ ignored the fact that she had been prescribed
Percocet but ceased taking it because of an allergic reaction, this assertion is irrelevant as
the record reveals that she was prescribed Percocet for pelvic pain associated with an
ovarian cyst, not for her knee and back pain.10 No records indicate Williams sought
8
Although the ALJ stated that the MRI of Williams’s lumbar spine revealed no
foraminal stenosis at the L3-L4 level when it actually showed “left neural foraminal
stenosis,” this inaccuracy is minor given that the scan noted that the stenosis at that level
was “mild.” (A.R. 17, 179.)
9
Moreover, on August 18, 2006, Williams asked one of her treating physicians at
Thomas Jefferson University Hospital to fill out a disability form based on her back and
knee pain, but her doctor agreed to only one month of disability, a clear indication that
her physician did not believe Williams’s back and knee impairments rendered her
disabled within the meaning of the Social Security Act.
10
Similarly, Williams claims that the ALJ’s assumption that ibuprofen controlled
her pain is belied by medical records documenting her complaint that the pain was
worsening over time. Yet, the document Williams points to as evidencing her complaint
of progressive pain is from a doctor’s visit on August 18, 2006, which appears to be the
first time that Williams reported her knee pain to her primary physicians at Thomas
Jefferson University Hospital and only the second time she complained of lower back
pain, with the first complaint approximately two and a half years prior. This record thus
fails to undermine the ALJ’s finding that her pain was controlled with ibuprofen and was
9
stronger medication for her knee and back pain; instead, the record reflects she told a
physical therapist she got some pain relief from ibuprofen. Based on this evidence, the
ALJ was entitled to conclude ibuprofen was sufficient to control Williams’s knee and
back pain and to take this finding into account when evaluating her level of pain. There is
thus no indication the ALJ improperly relied on his own lay opinions.
Distilled to its essence, Williams’s third challenge to the ALJ’s finding of no
disability is that the ALJ relied too heavily on the non-examining medical consultant’s
report, which did not take Williams’s back and knee impairments into account, in
determining that Williams retained the functional capacity to perform the full range of
medium exertional work. The non-examining consultant reviewed Williams’s medical
records and prepared a functional capacity assessment on March 1, 2006, before the
record in this matter was complete. As a result, the expert’s report was prepared without
the benefit of the x-rays and MRI images, which were taken in August and October of
2006, or even treatment notes from her physicians regarding this complaint.11 It is
thus not that severe.
11
Williams further argues that the Commissioner failed to inform the contracted
experts of her back and knee impairments, of which he had notice, in derogation of his
duties under Sims v. Apfel, 530 U.S. 103 (2000). In Sims, the Supreme Court held that a
claimant who had exhausted administrative remedies and sought judicial review had not
waived issues that were not included in her request for review by the Appeals Council. In
a section of his opinion in which he was not writing for the Court, Justice Thomas noted
that “Social Security proceedings are inquisitorial rather than adversarial” and that the
ALJ has a duty “to investigate the facts and develop the arguments both for and against
granting benefits.” Id. at 110-11. Although this portion of the Sims opinion was not
binding and accordingly cannot be construed as affirmatively creating duties on the
10
certainly plausible that the non-examining consultant would have found that Williams had
greater limitations had he been able to review these materials. Yet, as the magistrate
judge concluded in his report and recommendation, even assuming the ALJ’s finding that
Williams retained the functional capacity to engage in medium work lacked substantial
evidence, there clearly was substantial evidence for his ultimate conclusion that Williams
could perform her past relevant work at the light exertional level.12
Commissioner, at least two published Third Circuit decisions have quoted this language
approvingly. See N.J. Media Group v. Ashcroft, 308 F.3d 198, 223 (3d Cir. 2002);
Burnett v. Comm’r of Social Sec. Admin., 220 F.3d 112, 120 n.2 (3d Cir. 2000).
Additionally, Social Security regulations provide that when the Commissioner retains a
physician to perform a consultive examination, he will “give the examiner any necessary
background information about [the claimant’s] condition.” 20 C.F.R. §§ 404.1517,
416.917. Yet, neither these decisions, the regulations, nor any other authority require the
Commissioner to inform its contracted experts of all health problems mentioned by a
claimant, as Williams would have us find. There is thus no indication that the
Commissioner failed to develop the record fully in this matter. Although Williams
mentioned her knee pain in a form she completed on November 28, 2005, in connection
with her disability claim, her knee and back impairments were not the conditions for
which she originally claimed disability. The record clearly shows that the examining
consultant and the non-examining consultant were not aware of her back and knee
problems because Williams did not begin seeking treatment for these conditions until
after their review.
12
The ALJ considered Williams’s past relevant work to include both her position
collecting fees for television service in a hospital and her work in a daycare center.
Social Security regulations define past relevant work as “work that [the claimant] ha[s]
done within the past 15 years, that was substantial gainful activity, and that lasted long
enough for [the claimant] to learn to do it.” 20 C.F.R. § 416.960(b)(1). Regulations
further define substantial work activity as “work activity that involves doing significant
physical or mental activities” and provide that “[w]ork activity is gainful if it is the kind
of work usually done for pay or profit, whether or not a profit is realized.” Id. at §
416.972. It is unclear on this record whether the time Williams spent volunteering at her
friend’s daycare center constituted “substantial gainful activity,” as is necessary for the
work to qualify as “past relevant work.” Yet, even assuming her work as a volunteer at a
11
III.
We have considered all of Williams’s arguments on appeal and none succeed to
persuade. Because substantial evidence supports the ALJ’s determination that Williams
could perform her past relevant work and was therefore not disabled, we will affirm the
judgment of the district court.
daycare center did not constitute past relevant work, Williams bore the burden of showing
she was unable to return to her past relevant work as a hospital collection agent, a burden
she clearly failed to meet. See Plummer, 186 F.3d at 428.
12