Lutz-Stoker v. Saul

• Decision Date: 08 May 2020
• Docket Number: Civil No. 3:19-CV-1601
• Parties: MEGAN LUTZ-STOKER, Plaintiff v. ANDREW SAUL, Commissioner of Social Security, Defendant
• Court: U.S. District Court — Middle District of Pennsylvania

MEGAN LUTZ-STOKER, Plaintiff
v.
ANDREW SAUL, Commissioner of Social Security, Defendant

Civil No. 3:19-CV-1601

UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

May 8, 2020

(Magistrate Judge Carlson)

MEMORANDUM OPINION

I. Introduction

This case comes before us for consideration of the plaintiff's claims that a Social Security Administrative Law Judge erred in evaluating medical opinion evidence, assessing the disabling effect of a claimant's pain, and formulating a residual functional capacity assessment for the plaintiff, a younger worker in her 30's. With respect to this appeal, the Supreme Court has recently underscored for us the limited scope of our review when considering Social Security disability determinations, 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

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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. See Dickinson 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, while it is apparent that the plaintiff at one time faced significant impairments due to jaw pain, when we consider the ALJ's decision through the deferential lens required by the law, we are constrained to conclude that substantial evidence supported the ALJ's decision. 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

On December 29, 2015, Megan Lutz-Stoker applied for disability and supplemental security income benefits under Titles II and XVI of the Social Security Act, alleging that she had become disabled as of June, 2014. (Tr. 17, 67, 72-73, 139-55). At the time that she applied for these disability benefits, the plaintiff was 31

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years old and qualified as a younger worker under the Commissioner's regulations. (Tr. 71). Lutz-Stoker was a high school graduate, had attended college, and had previously worked in the health care field. (Tr. 71-72, 183, 1432).

In her disability application, the plaintiff identified an array of medical and emotional impairments including fibromyalgia, diabetes, migraines, obesity, arthritis, depression, and anxiety, but her principal presenting physical condition was jaw pain which exacerbated both her physical and emotional impairments. (Tr. 20). This jaw pain began after Lutz-Stoker underwent surgery in 2010 and became progressively more severe over time. (Tr. 202-11).

The medical records relating to this jaw pain are both extensive and somewhat equivocal. For example, these records reveal that Lutz-Stoker repeatedly sought emergency room treatment for her pain, (Tr. 512, 558, 572, 684, 706, 714, 749, 759, 768, 780, 785, 800), but also often reflected generally unremarkable findings upon examination of the plaintiff. (Tr. 515, 574, 763, 811). Likewise, Lutz-Stoker obtained mental health treatment for depression and anxiety that she attributed to this chronic pain. (Tr. 313, 328, 337, 346, 356, 386, 406, 416, 446, 458, 976, 1511, 1553, 1722, 1742, 1752, 1790, 1828, 1846, 1868, 1911). Yet, during these sessions she often exhibited normal speech and language, intact recent and remote memory, and intact attention span and concentration, mental health status findings which

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suggested some ability to work. (Tr. 319, 546, 561, 589, 600, 757, 783, 1254, 1444, 1448, 1452, 1454, 1475, 1478).

Lutz-Stoker's self-reported activities of daily living also provided a mixed medical picture. While she reported frequent, severe, and intractable pain, the plaintiff also: cared for her seven-year old son, taking him to and from school, feeding him, making dinner, and supervising his bath time; (Tr. 203) spent time with her husband - "doing chores, running errands, watching tv, doing homework with [their] son, eating dinner as a family;" (Tr. 206) regularly attended church, doctor's appointments, support group, her son's school, and boy scouts; (Tr. 206) experienced no problems with personal care; (203-04) and did not need reminders to take her medication (Tr. 204). Lutz-Stoker reported that she prepared simple meals, performed light housecleaning including laundry, shopped for groceries and clothing, got outside every day, enjoyed reading, watching television, playing games, hiking trails, playing in the creek, fishing, and attending bible studies. (Tr. 204-06). According to the plaintiff, she could follow written instructions and get along with authority figures "very well", and follow spoken instructions "well." (Tr. 207-08).

Given this profoundly equivocal clinical picture, it is hardly surprising that the medical opinion evidence was also marked by some competing and contrasting views. For example, with respect to Lutz-Stoker's physical impairments, the plaintiff

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presented no treating source opinion supporting her claim of complete disability. Instead, treating source records indicated that her primary care physician cleared her for return to full-time work in February 2014, (Tr. 805, 1271), and declined to write a note excusing her from work for an extended period of time in June of 2014. (Tr. 775-76). Further, Lutz-Stoker was cleared by her doctors to return to full-time work on September 27, 2017. (Tr. 80-81). Given the paucity of medical opinion support for Lutz-Stoker's physical impairments, on February 5, 2018, the ALJ requested a medical opinion regarding her physical capacity to work from medical expert Thao Le Thanh, M.D. (Tr. 17, 2528). After reviewing Lutz-Stoker's medical records and interrogatories, Dr. Thanh concluded that her medically determinable impairments did not meet listing level severity, (Tr. 2536-38), and found that Lutz-Stoker had "no functional limitations or restrictions." (Tr. 2538).

As for Lutz-Stoker's emotional impairments, the medical opinion evidence was marked by some area of consensus, as well as contrasting opinions. Two mental health professionals opined regarding the plaintiff's ability to meet the stresses of the workplace, a consulting examining expert, Dr. Everding, and a state agency non-examining expert, Dr. Mrykalo. Dr. Everding found that Lutz-Stoker experienced only mild limitations in her ability to understand, remember, carry out complex instructions, and make judgments on complex work-related decisions, and found that she had no limitations on her ability to understand, carry out, and remember simple

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instructions. (Tr. 1437). However, Dr. Everding found that Lutz-Stoker faced marked limitations in her ability to respond appropriately to usual work situations and to changes in a routine work setting, and concluded that she experienced moderate limitations when it came to interacting appropriately with the public, supervisors, and coworkers. (Tr. 1438).

In contrast, Dr. Mrykalo found that Lutz-Stoker had mild restrictions in activities of daily living, mild difficulties in maintaining social functioning, moderate difficulties in maintaining concentration, persistence, and pace, and had encountered no repeated episodes of decompensation. (Tr. 951). According to Dr. Mrykalo, Lutz-Stoker could make simple work-related decisions; cope with minor work-related demands; follow simple, one-to-two step task directives; perform simple, routine-type tasks; and comprehend and retain simple task instructions. (Tr. 104). Notably, Dr. Mrykalo reached these conclusions relying, in part, upon some of the clinical findings reported by Dr. Everding, who had noted that the plaintiff stated that she was "able to do her [activities of daily living] independently" and observed that Lutz-Stoker possessed adequate language skills, coherent and goal-directed thoughts with intact memory, average intellectual functioning, and fair insight and judgment. (Tr. 109-10).

While these medical matters involved conflicting elements of proof, on one thing all parties agree—Following jaw surgery in August 2016, the plaintiff's health

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improved. Thus, by September 2017, Lutz-Stoker was released by her surgeon to return to work. (Tr. 81). Lutz-Stoker is currently employed on a full-time basis. (Doc. 8 at 6).

It is against this clinical backdrop that a hearing was held on this disability application on November 7, 2017, where Lutz-Stoker and a vocational expert appeared and testified. (Tr. 65-96). Following this hearing, on July 3, 2018, the ALJ issued a decision denying this application for benefits, finding that Lutz-Stoker was capable of performing a range of light work in the national economy during the closed period of this disability claim. (Tr. 14).

In that decision, the ALJ first concluded that Lutz-Stoker met the insured status requirements of the Social Security Act through December 31, 2019 and had not...