Ennis v. Saul

• Decision Date: 22 October 2019
• Docket Number: Civil No. 3:19-CV-291
• Parties: TERRY LYNNE ENNIS, Plaintiff v. ANDREW SAUL, Commissioner of Social Security, Defendant
• Court: U.S. District Court — Middle District of Pennsylvania

TERRY LYNNE ENNIS, Plaintiff v. ANDREW SAUL,Commissioner of Social Security, Defendant

Civil No. 3:19-CV-291

UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

October 22, 2019

(Judge Mariani)

(Magistrate Judge Carlson)

REPORT AND RECOMMENDATION

I. Introduction

Terry Lynne Ennis is a disability claimant, a younger worker who was approximately 23 years old at the time of the alleged onset of her disability in 2003. Despite asserting that she became disabled in 2003, Ennis waited some twelve years—until 2015—before she filed for disability benefits. In this application, Ennis alleged that she was disabled due to degenerative disc disease, obesity, migraines, and depression.

With respect to these impairments, the record before the Administrative Law Judge (ALJ) was marked by contrasting and inconsistent themes. Ennis had undeniably experienced significant back problems and had undergone back surgery on three separate occasions between 2008 and 2016. However, treatment notes repeatedly described her condition in terms that were not fully disabling, and one treating doctor had observed in April of 2017 that Ennis was independent in her activities of daily living. Further, Ennis provided no expert medical opinion evidence in support of her disability application, although it was apparent from the record that she had sought such opinions from treating physicians. Moreover, Ennis' treatment history was marked by notations that Ennis may have been engaging in some narcotic drug-seeking behavior. Finally, an outside expert who was asked to review Ennis' medical history concluded that she was capable of performing some work.

Presented with this conflicting evidence, the ALJ concluded that Ennis could perform a limited range of sedentary work and denied her claim for disability benefits. Ennis now challenges this decision on appeal, but as the Supreme Court has recently underscored, we employ a limited scope of review when considering Social Security appeals. Our task is simply to determine whether substantial evidence supports the ALJ's decision. On this score:

The phrase "substantial evidence" is a "term of art" used throughout administrative law to describe how courts are to review agency factfinding. T-Mobile South, LLC v. Roswell, 574 U.S. —, —, 135 S.Ct. 808, 815, 190 L.Ed.2d 679 (2015). Under the substantial-evidence standard, a court looks to an existing administrative record and asks whether it contains "sufficien[t] evidence" to support the agency's factual determinations. Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) (emphasis deleted). And whatever the meaning of "substantial" in other contexts, the threshold for such evidentiary sufficiency is not high. Substantialevidence, this Court has said, is "more than a mere scintilla." Ibid.; see,e.g., Perales, 402 U.S. at 401, 91 S.Ct. 1420 (internal quotation marks omitted). It means—and means only—"such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Consolidated Edison, 305 U.S. at 229, 59 S.Ct. 206. SeeDickinson v. Zurko, 527 U.S. 150, 153, 119 S.Ct. 1816, 144 L.Ed.2d 143 (1999) (comparing the substantial-evidence standard to the deferential clearly-erroneous standard).

Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).

Mindful of the fact that substantial evidence "means only—'such relevant evidence as a reasonable mind might accept as adequate to support a conclusion,' " Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019), we find that substantial evidence supported the ALJ's findings in this case. Therefore, for the reasons set forth below, we recommend that the district court affirm the decision of the Commissioner denying this claim.

II. Statement of Facts and of the Case

Terry Lynne Ennis was born on March 21, 1980 (Tr. 20) and was 23 years old at the time of the alleged onset of her disability on May 1, 2003. (Tr. 13). Curiously, despite the reported onset of her disability in May of 2003, Ennis delayed for more than twelve years before submitting her Title II application for disability benefits on July 30, 2015, and her Title XVI application for supplemental security income on August 3, 2015. (Tr. 13). Given her relative youth, Ennis was deemed a younger worker under the Commissioner's regulations, both at the time of the alleged onsetof her disability, and more than a decade later when she first claimed that her impairments were totally disabling. In these disability applications Ennis asserted that she had become disabled many years prior due to the combined effects of degenerative disc disease and back surgery, depression, obesity, and migraines. (Tr. 16). With respect to these impairments, the medical record, while extensive, was at most mixed and equivocal.

That medical record disclosed that Ennis had undergone three spinal procedures between 2008 and 2016. Thus, in May of 2008, Ennis had a disc removed due to a herniation that was impinging on a nerve root. (Tr. 328, 333). Post-operatively, her leg complaints resolved but her back pain did not. (Tr. 333). When conservative treatment failed, two years later in November of 2010, Ennis underwent a spinal fusion procedure. (Tr. 466-67). Some five years later, in July of 2016, Jonathan Slotkin, M.D., performed a revision of this spinal fusion. (Tr. 876-77, 881-83). Following this 2016 surgical procedure, physical examinations reflected that Ennis was neurologically stable with intact strength and sensation, no leg weakness, intact reflexes, a negative straight leg-raising test, and a steady gait without use of an assistive device. (Tr. 1067, 1081, 1083, 1113, 1151-52, 1165-66, 1173, 1361, 1364).

For example, Dr. Chulhyun Ahn, a pain management specialist who was treating Ennis in 2016 and 2017, observed on April 6, 2017 and June 8, 2017 that she did not use any assistive devices, was independent in her activities of daily living, and displayed no acute distress. (Tr. 1361, 1363, 1381). Despite these benign medical findings, treatment notes from a clinical encounter with Ennis on May 10, 2017 revealed that Ennis was applying for disability benefits, and was "not working, [even though] Neuorsurg[eon] didn't tell her she couldn't." (Tr. 1346). Notably, neither before the ALJ nor on appeal has Ennis identified any opinion from any treating source stating that this younger work was completely unable to work.

While Ennis' medical records did not contain any treating source opinions confirming her claim of total disability, one recurring theme in these records was a concern that Ennis might be abusing prescription painkillers. Thus, the medical records cautioned against prescribing narcotics for Ennis due to prior toxicology results (Tr.1022), identified instances in which Ennis sought narcotics and was rebuffed due to what appeared to be excessive drug use (Tr. 1147), and reflected efforts by medical providers to address her potentially problematic behaviors with opioids. (Tr. 1171).

It was against this clinical backdrop that a hearing was held on this disability application on July 25, 2017. (Tr. 28-53.) At this hearing, the plaintiff and aVocational Expert both testified. (Id.) In her testimony, Ennis described the degree of her impairment in terms that seemed inconsistent with the clinical evidence, stating that she was required to lay down for four to five hours each day. (Tr. 42).

Following this hearing, The ALJ asked an independent medical source, Dr. David Owens, to review Ennis' medical records and provide an opinion regarding the degree to which her impairments were disabling. In September 2017, Dr. Owens completed these medical interrogatories as requested by the ALJ. (Tr. 1460-62). In his response to these interrogatories, Dr. Owens indicated that Ennis' impairments included chronic back pain since 2006 which resulted in three surgical procedures. (Tr. 1460). While he acknowledged these three surgeries, Dr. Owens noted that physical examinations since the most recent surgery detected no motor, sensory, or reflex deficits on Ennis' part. (Tr. 1460). Therefore, Dr. Owens concluded that Ennis' impairments did not meet or medically equal any listed impairment. (Tr. 1461). Dr. Owens also opined that Ennis could frequently lift and carry up to 10 pounds; occasionally lift and carry up to 20 pounds; sit for 1 hour at a time and for 6 hours total; stand for 30 minutes at a time and for 4 hours total; and walk for 30 minutes at a time and for 2 hours total. (Tr. 1464). After receiving Dr. Owens' interrogatory responses, counsel for Ennis propounded separate interrogatories for the doctor. (Tr. 1469-70). In his response to these interrogatories, Dr. Owens foundthat Ennis should be able to lift and carry 10 pounds frequently and 20 pounds occasionally based on the lack of significant motor, sensory, and reflex deficits, and because her narcotic medications helped reduce her pain. (Tr. 1469).

Upon receipt of this supplemental medical information, on March 12, 2018, the ALJ issued a decision denying this application for benefits. (Tr. 10-22). In that decision, the ALJ first concluded that Ennis met the insured status requirements of the Act through 2009 and had not engaged in substantial gainful activity since the date of the alleged onset of her disability in 2003. (Tr. 15). At Step 2 of the sequential analysis that governs Social Security cases, the ALJ found that Ennis suffered from the following severe impairments: degenerative disc disease post-surgery, obesity, migraines, and depression. (Tr. 16). At Step 3, the ALJ determined that none of these impairments met or medically equaled the severity of one of the listed impairments. (Tr. 16-17).

Between Steps 3 and 4, the ALJ fashioned a residual functional capacity ("RFC") assessment for Ennis that permitted her to perform a range of sedentary work, provided that she could alternate positions occasionally, worked in a clean and temperate environment without...