Kshir v. Saul

• Decision Date: 11 June 2020
• Docket Number: Civil No. 1:19-CV-1754
• Parties: DONNA KSHIR, Plaintiff v. ANDREW SAUL, Commissioner of Social Security, Defendant
• Court: U.S. District Court — Middle District of Pennsylvania

DONNA KSHIR, Plaintiff v. ANDREW SAUL, Commissioner of Social Security, Defendant

Civil No. 1:19-CV-1754

UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

June 11, 2020

(Magistrate Judge Carlson)

MEMORANDUM OPINION

I. Introduction

The Supreme Court has recently underscored for us the limited scope of our review when considering Social Security appeals, noting that:

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. Substantial evidence, 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).

In the instant case, Donna Kshir applied for supplemental security income benefits under Title XVI of the Social Security Act on October 24, 2016, alleging that she had been disabled since April 1, 2009, due to degenerative disc disease, radiculopathy, and a left shoulder impingement. (Tr. 18, 20). Yet for much of this expansive period of alleged disability, Kshir reported an active lifestyle which included regularly walking three miles a day, cardio exercise, child care responsibilities, and participating in Zumba classes. (Tr. 256-61). Further, medical examination of Kshir over the years often reported intact range of motion and motor/sensory responses. (Tr. 264, 273, 278, 282, 386, 389). While Kshir's complaints of back and shoulder pain became more pronounced after she suffered a fall in October of 2016, even after this incident, x-rays and MRI examinations of her shoulder and back were largely unremarkable, and she received conservative treatment for these conditions. (Tr. 285-95, 353-55, 373-74). These medical records led a state agency expert to opine that Kshir could perform light work. (Tr. 78-87). After a consideration of the medical records and opinion evidence, the Administrative Law Judge ("ALJ") who reviewed this case concluded that Kshir could perform a range of light work with limitations and denied her disability application. (Tr. 18-26).

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, 139 S. Ct. at 1154, we find that substantial evidence supported the ALJ's findings in this case. Therefore, for the reasons set forth below, we will affirm the decision of the Commissioner denying this claim.

II. Statement of Facts and of the Case

Donna Kshir applied for supplemental security income benefits under Title XVI of the Social Security Act on October 24, 2016, alleging that she had been disabled since April 1, 2009, due to degenerative disc disease, radiculopathy, and a left shoulder impingement. (Tr. 18, 20). Kshir's claimed period of disability spanned some seven years, from 2009 through 2016. At the time of the alleged onset of this disability, Kshir was in her late 30's and by the time of the agency adjudication of this claim she was in her mid-40s, making her a younger worker under the Commissioner's regulations. (Tr. 25). She had a high school education and prior employment as a nursing aide and free-lance writer. (Id.)

According to her application, Kshir's disabling medical conditions included degenerative disc disease, radiculopathy, and a left shoulder impingement. (Tr. 18, 20). While it was apparent from Kshir's medical records that she had periodically complained of back pain since the late 1990's, for a number of years following the claimed onset of her disability in April of 2009, medical records and Kshir'sactivities of daily living seemed to conflict with her claim of total disability. For example, in 2013 and 2014, in multiple medical encounters Kshir described a physically active lifestyle to care-givers. According to Kshir, at this time she cared for a grandchild, walked 3 miles per day, attended Zumba classes, and actively engaged in cardio exercises. (Tr. 256-61, 265). These treatment records also indicated that through the Fall of 2016, Kshir's range of motion was largely intact, (Tr. 264, 273, 278, 282), and her reports of leg pain and chronic lumbago were treated in a conservative fashion through heat, ice, and ibuprofen. (Tr. 268). These records further indicated that Kshir had become interested in applying for disability benefits as early as October 2015. (Tr. 269).

The adult function report completed by Kshir in November of 2016 as part of her disability application also suggested that she retained the ability to perform some work. (Tr. 150-57). In that report, Kshir stated that she could drive, prepare, meals, shop, and had no problems with her personal care. (Id.)

In October of 2016, Kshir suffered a fall in a grocery store and reported both a left shoulder injury, hip injury, and increased back pain as a result of this fall. (Tr. 285-87, 290-92). Kshir continued to complain of shoulder and back pain throughout the winter, spring, and summer of 2017. (Tr. 377-86). However, objective testing did not identify impairments which were consistent with Kshir's reported level of pain. Care-givers continued to report that Kshir's sensory and motor skills wereintact. (Tr. 386, 389). Moreover, radiological examinations conducted in October of 2016 and February of 2017 reported that Kshir's hip and shoulder were normal. (Tr. 294-95, 353-55, 373-74). Other testing in October 2016 found that Kshir experienced moderate stenosis and mild degenerative changes in her spine, but concluded that there was no need for neurosurgical management of her condition. (Tr. 298-303). Instead, only conservative treatment was recommended for Kshir. (Tr. 324, 391).

Given this clinical history, in January of 2017 a state agency expert, Dr. Angela Walker, opined that Kshir retained the residual functional capacity to perform light work. (Tr. 78-87). In April of 2018, a physician assistant who had cared for Kshir, Amanda Jones-Sutliff, reached a contrary conclusion, opining that Kshir was unable to perform even sedentary work due to her back and shoulder impairments. (Tr. 405-11).

It is against this clinical backdrop, marked by conflicting evidence and opinions, that a hearing was held on this disability application on May 21, 2018, where Kshir appeared and testified along with a Vocational Expert. (Tr. 56-77). Following this hearing, on September 19, 2018, the ALJ issued a decision denying this application for benefits, finding that Kshir remained capable of performing a range of light work jobs in the national economy. (Tr. 15-26).

In that decision, the ALJ first concluded that Kshir had not engaged in any substantial gainful activity since the date of her SSI application in October of 2016. (Tr. 20). At Step 2 of the sequential analysis that governs Social Security cases, the ALJ found that Kshir's degenerative disc disease, radiculopathy, and a left shoulder impingement were severe impairments. (Id.) At Step 3, the ALJ determined that none of these impairments met or medically equaled the severity of one of the listed impairments. (Tr. 21).

Between Steps 3 and 4, the ALJ fashioned a residual functional capacity ("RFC"), which considered all of Kshir's limitations from her impairments and found that she could perform a range of light work. (Tr. 21-22). In making this RFC determination, the ALJ considered all of the medical and opinion evidence in this case, as well as Kshir's self-reported activities of daily living. (Tr. 21-24). Thus, the ALJ noted that Kshir's active exercise program, child care duties, and activities of daily living all undermined her claim that she had been disabled since April 2009. (Tr. 22-23). The ALJ also recounted Kshir's largely unremarkable treatment history, her conservative course of treatment, and her benign radiological findings as evidence which undercut her claim of total disability. (Tr. 23). Given these clinical records, test results, and Kshir's self-reported activities of daily living, the ALJ concluded that the opinion of the state agency expert, Dr. Walker, deserved greaterweight than the extreme views expressed by Kshir's treating physician assistant, Ms. Jones-Sutliff. (Tr. 24).

Having arrived at this RFC assessment based upon an evaluation of these clinical records, medical opinions, and the claimant's statements, the ALJ found at Step 5 that there were a number of light work jobs in the national economy that Kshir could perform. (Tr. 24-25). Accordingly, the ALJ concluded that Kshir did not meet the stringent standard for disability set by the Social Security Act and denied her disability claim. (Id.)

This appeal followed. (Doc. 1). On appeal, Kshir contends the ALJ erred in considering medical evidence which pre-dated October 2015, one year prior to the submission of her disability claim. Kshir takes this position even though her disability claim asserted an onset of disability which began in April 2009. Kshir also contends that the ALJ erred in giving greater weight to the opinion of the state agency expert, Dr. Walker, than the views expressed by Kshir's...