St. Laurent v. US Social Security Administration, Commissioner

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW HAMPSHIRE
Theresa St. Laurent
v. Civil No. 17-cv-053-LM
Opinion No. 2018 DNH 068
Nancy A. Berryhill, Acting
Commissioner of Social Security
O R D E R
Theresa St. Laurent seeks judicial review, pursuant to 42
U.S.C. §§ 405(g) & 1383(c)(3), of the decision of the Acting
Commissioner of the Social Security Administration, denying her
application for disability insurance benefits and supplemental
security income. St. Laurent moves to reverse the Acting
Commissioner’s decision, contending that the Administrative Law
Judge (“ALJ”) erred in his residual functional capacity
assessment and in his Step Five determination. For the reasons
that follow, the decision of the Acting Commissioner is
affirmed.
STANDARD OF REVIEW
In reviewing the final decision of the Acting Commissioner
in a social security case, the court “is limited to determining
whether the ALJ deployed the proper legal standards and found
facts upon the proper quantum of evidence.” Nguyen v. Chater,
172 F.3d 31, 35 (1st Cir. 1999); accord Seavey v. Barnhart, 276
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F.3d 1, 9 (1st Cir. 2001). The court defers to the ALJ’s
factual findings as long as they are supported by substantial
evidence. § 405(g); see also Fischer v. Colvin, 831 F.3d 31, 34
(1st Cir. 2016). “Substantial evidence is more than a
scintilla. It means such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.” Astralis
Condo. Ass’n v. Sec’y Dep’t of Housing & Urban Dev., 620 F.3d
62, 66 (1st Cir. 2010).
BACKGROUND1
On April 30, 2013, Theresa St. Laurent applied for
disability benefits and supplemental security income, claiming a
disability that began on January 2, 2012. St. Laurent alleged
that she was disabled because of fibromyalgia and heart
problems. She was 46 years old at the time of her application,
and had previously worked as a newspaper packager and cleaner,
as well as in positions in a greenhouse and in a retail provider
selling specialty foods.
I. Medical Records
St. Laurent was admitted to Portsmouth Regional Hospital in
April 2011 for chest pain due to a myocardial infarction, which
required a stent placement and follow-up cardiac rehabilitation.
1 A detailed statement of the facts can be found in the
parties’ Joint Statement of Material Facts (doc. no. 10).
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Over the next four-plus years, St. Laurent consulted at various
times with her physicians at Barrington Family Practice and Walk
In Care Center and at the York Family Practice regarding her
cardiac condition and chest pains, which she suffered from
routinely.
In 2011, she also developed lower back pain that radiated
down her right leg, which was related to fibromyalgia. St.
Laurent’s back pain was exacerbated by a fall in October 2014,
and she was continually treated conservatively for the pain,
such as with oral medications.
II. Functional Assessments
On December 15, 2014, physical therapist Danielle Amero
completed a functional assessment for St. Laurent. Amero opined
that St. Laurent had significant limitations in her ability to
do any prolonged lifting, sitting, or standing, and that she was
incapable of performing full-time sedentary work.
On January 21, 2015, Holly Brunner James, FNP, completed a
“Medical Source Statement (Physical).” In that assessment,
James, like Amero, opined that St. Laurent was significantly
limited in her ability to do any prolonged lifting, sitting, or
standing. James also found that St. Laurent’s ability to
maintain attention and concentration was significantly
compromised by pain and/or prescribed medication, and that she
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“could reach less than two-and-a-half hours a day.” Doc. no. 10
at 8.2
III. Hearing and Decision
On September 15, 2015, a hearing before an ALJ was held on
St. Laurent’s application for benefits. St. Laurent was
represented by an attorney and testified at the hearing. Also
appearing and testifying were Dr. John Pella, an independent
medical expert, and Albert Sabella, a vocational expert.
Dr. Pella discussed St. Laurent’s medical records and
opined that prior to October 1, 2014, St. Laurent was capable of
performing “overall light” work. As of October 1, 2014, Dr.
Pella opined that St. Laurent was limited to sedentary work.
On June 26, 2015, the ALJ issued an unfavorable decision.
The ALJ found that St. Laurent had severe impairments due to
heart disease/non-obstructive coronary artery disease and lumbar
degenerative disease.3 The ALJ also found that St. Laurent’s
fibromyalgia was not a severe impairment and that her
impairments did not meet or equal a listed impairment.
2 The record does not make clear what sort of “reaching” James
refers to.
3 The ALJ gave little weight to the opinions of two state
agency consultants that St. Laurent had no severe impairments,
as he found those opinions to be inconsistent with Dr. Pella’s
opinion.
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Relying primarily on Dr. Pella’s testimony and St.
Laurent’s testimony concerning her daily activities and attempts
to return to work, the ALJ concluded that prior to October 1,
2014, St. Laurent had the residual functional capacity to do
light work under 20 C.F.R. §§ 404.1567(b) & 416.967(b),4 except
that she could not work at unprotected heights or operate
dangerous moving machinery, and she was limited to uncomplicated
tasks and required regular work breaks, on average of every two
hours during an eight-hour work day due to pain/medication side
effects. The ALJ also determined that as of October 1, 2014,
St. Laurent was limited to sedentary work, as defined by 20
C.F.R. § 404.1567(a), except that she could not work at
unprotected heights or operate dangerous moving machinery, and
she was limited to uncomplicated tasks and required regular work
breaks, on average of every two hours during an eight-hour work
day due to pain/medication side effects.
Based on that functional assessment, the ALJ found that
prior to October 1, 2014, St. Laurent could perform her past
relevant work as an apartment housekeeper. The ALJ also found
that as of October 1, 2014, St. Laurent could perform other jobs
4 Because the pertinent regulations governing disability
insurance benefits at 20 C.F.R. Part 404 are the same as the
pertinent regulations governing supplemental security income at
20 C.F.R. Part 416, the court will cite only Part 404
regulations. See Reagan v. Sec’y of Health & Human Servs., 877
F.2d 123, 124 (1st Cir. 1989).
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existing in the national economy, including the representative
occupations of assembler and inspector. Therefore, the ALJ
found that St. Laurent was not disabled within the meaning of
the Social Security Act. The Appeals Council denied St.
Laurent’s request for review, making the ALJ’s decision the
Acting Commissioner’s final decision.
DISCUSSION
In support of her motion to reverse the Acting
Commissioner’s decision, St. Laurent contends that the ALJ 1)
erred in his residual functional capacity assessment by
improperly substituting his lay judgment for that of the medical
experts and 2) erred in his Step Five determination because the
vocational expert’s testimony relied on improper hypotheticals
and was based on an invalid assessment of available jobs. The
Acting Commissioner moves to affirm.
In determining whether a claimant is disabled, the ALJ
follows a five-step sequential analysis. 20 C.F.R. § 404.1520.
The claimant bears the burden through the first four steps of
proving that his impairments preclude his from working.5 Freeman
5 The first four steps are (1) determining whether the
claimant is engaged in substantial gainful activity; (2)
determining whether he has a severe impairment; (3) determining
whether the impairment meets or equals a listed impairment; and
(4) assessing the claimant’s residual functional capacity and
his ability to do past relevant work. 20 C.F.R. § 404.1520(a).
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v. Barnhart, 274 F.3d 606, 608 (1st Cir. 2001). At the fourth
step of the sequential analysis, the ALJ assesses the claimant’s
residual functional capacity, which is a determination of the most
a person can do in a work setting despite her limitations caused
by impairments, see 20 C.F.R. § 404.1545(a)(1), and his past
relevant work, see id. at § 404.1520(a)(4)(iv)). If the claimant
can perform his past relevant work, the ALJ will find that the
claimant is not disabled. See id. at § 404.1520(a)(4)(iv). If
the claimant cannot perform her past relevant work, the ALJ
proceeds to Step Five, in which the ALJ has the burden of showing
that jobs exist in the economy which the claimant can do in light
of his residual functional capacity assessment. See id. at
§ 404.1520(a)(4)(v).
I. Residual Functional Capacity Assessment
A claimant’s residual functional capacity (“RFC”) is “the
most [the claimant] can still do despite [his] limitations.” 20
C.F.R. § 404.1545(a)(1). The ALJ is responsible for determining
a claimant’s RFC based on all relevant evidence in the record.
Id. In making that determination, the ALJ is responsible for
resolving any conflicts in the evidence. See Gonzalez Garcia v.
Sec’y of Health & Human Servs., 835 F.2d 1, 3 (1st Cir. 1987).
The ALJ’s residual functional capacity assessment is reviewed to
determine whether it is supported by substantial evidence.
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Irlanda Ortiz v. Sec’y of Health & Human Servs., 955 F.2d 765,
769 (1st Cir. 1991).
St. Laurent contends that the ALJ relied on his lay
assessment of the medical evidence when he failed to account for
her “fibromyalgia-related functional limitations.”6 Doc. no. 8
at 6. Specifically, she points to Amero’s and James’s
functional assessments that showed much more limited functional
capacity than the ALJ found. St. Laurent contends that the ALJ
had no basis in the medical record for disregarding the
limitations found by Amero and James.
In making his RFC assessment, the ALJ addressed the
opinions provided by Amero and James and gave them little weight
because he concluded that they were “inconsistent with both the
medical expert (Dr. Pella) testimony and the objective medical
evidence of record.” Admin. Rec. at 18. Dr. Pella testified
that James’s functional assessment was inconsistent with the
record and was based on St. Laurent’s “primarily subjective”
6 St. Laurent also appears to contend that the ALJ erred in
failing to take into account her fibromyalgia diagnosis itself
in his RFC assessment. To the extent St. Laurent intended to
raise such a challenge, it is without merit. The diagnosis
alone is not relevant to an ALJ’s RFC assessment. Rather, the
functional limitations associated with a diagnosis govern the
RFC assessment. See, e.g., Whitney v. Berryhill, No. 1:16-CV-
00354-JAW, 2017 WL 2839632, at *9 (D. Me. July 2, 2017) (noting
that “the diagnosis of a condition, without more, fails to
inform a fact-finder about a condition’s severity” and is not
sufficient to establish functional limitations).
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reports of her fibromyalgia symptoms. Id. at 50. Dr. Pella
also discounted James’s assessment because it referenced a
lumbar MRI report that was not included with the record. Id.
In addition, Dr. Pella discounted James’s opinion concerning St.
Laurent’s limited ability to maintain attention or concentration
due to pain medication since St. Laurent was no longer taking
that medication.
With regard to Amero’s assessment, Dr. Pella was concerned
that the assessment could not be considered “long-term” because
Amero completed it shortly after St. Laurent had exacerbated her
back pain by falling. Dr. Pella testified that Amero’s and
James’s functional assessments stood in contrast to St.
Laurent’s medical records which did not show the limitations in
those assessments.
In addition to considering the medical record, the ALJ
determined that Amero’s and James’s opinions were inconsistent
with St. Laurent’s day-to-day life. He found that St. Laurent’s
“extensive daily activities,” which included caring for her
home, as well as her attempts to return to work, were
inconsistent with any significant limitations, such as those
contained in Amero’s and James’s assessments. Admin Rec. at 18.
In other words, although St. Laurent asserts that the ALJ
relied on his “lay interpretation of the medical evidence” when
he disregarded the limitations in Amero’s and James’s opinions,
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that is not the case. Rather, the ALJ based his RFC assessment
on evidence in the record, including Dr. Pella’s medical opinion
and St. Laurent’s testimony concerning her daily activities.7 As
such, St. Laurent has not shown that the ALJ committed error in
making his RFC assessment.8
II. Vocational Expert Testimony
St. Laurent contends that the ALJ erred in relying on the
vocational expert’s testimony in making his Step Five
determination for two reasons. First, she contends that the
ALJ’s hypotheticals were based on his erroneous RFC assessment
and, therefore, the vocational expert’s testimony is invalid.
Second, she contends that the vocational expert’s testimony
concerning job number estimates was “facially inadequate”
because it did not provide a specific number of available jobs.
7 St. Laurent does not challenge the ALJ’s determination that
her testimony concerning her daily activities supports the ALJ’s
RFC assessment.
8 St. Laurent also asserts that the additional limitations in
the ALJ’s RFC assessment were not supported by the medical
record. Even if that were true, however, that error is
harmless. See Yearling v. Colvin, No. CV 16-11155-NMG, 2017 WL
5196380, at *4 (D. Mass. Nov. 9, 2017) (“If the RFC includes
greater limitations than those in a physician’s assessment, such
limitations cannot be used to discount the ALJ’s
determination.”).
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A. RFC Assessment
The ALJ relied on the vocational expert’s responses to
hypothetical questions that accurately reflected St. Laurent’s
limitations as found in the RFC assessment. As discussed above,
that assessment is supported by substantial evidence.
Therefore, the ALJ committed no error. Sunshine v. Berryhill,
No. 16-CV-446-LM, 2018 WL 582576, at *8 (D.N.H. Jan. 29, 2018).
B. Job Numbers
At Step Five, the ALJ found that beginning on October 1,
2014, St. Laurent had the residual functional capacity to do
jobs that exist in significant numbers in the national economy.
Relying on the vocational expert’s testimony, and finding it
consistent with the information contained in the Dictionary of
Occupational Titles, the ALJ found that as of October 1, 2014,
St. Laurent could perform the job of an assembler and an
inspector.
St. Laurent contends that the ALJ erred in relying on the
vocational expert’s testimony regarding job estimates. She also
criticizes the ALJ for failing to cite specific jobs and their
availability in the economy.
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1. Aggregate Job Numbers
St. Laurent notes that in opining that an individual with
her RFC could perform jobs that exist in significant numbers in
the economy, the vocational expert gave job number estimates
related to aggregate job groupings, rather than individual jobs.
She contends that, as such, his testimony was invalid and the
ALJ erred in relying on the vocational expert’s opinion in
making his Step Five determination.
St. Laurent’s challenge to the vocational expert’s opinion
stems from his testimony that he relied on job statistics
published in the Bureau of Labor Statistics and in the census
codes published in the Occupational Employment Quarterly. See
Admin. Rec. at 76. The vocational expert testified that the
numbers derived from those sources are for groups of jobs rather
than individual jobs. See id.
St. Laurent raised this issue with the ALJ in a post-
hearing motion. She submitted the affidavit of another
vocational expert, David Meuse, who stated that the testimony at
the hearing was “not supportable” because it relied on aggregate
numbers.
The ALJ addressed St. Laurent’s objection in his decision:
The vocational expert testified at the hearing that
the source of the numbers of jobs he provided to the
hypothetical were from the State Department of Labor,
Bureau of Labor Statistics and the census codes from
the occupational categories noted in the Occupational
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Employment Quarterly which lists groupings of
jobs. 20 CFR 404.1566 provides that when we determine
that unskilled, sedentary, light, and medium jobs
exist in the national economy (in significant numbers
either in the region where you live or in several
regions of the country), we will take administrative
notice of reliable job information available from
various governmental and other publications. For
example, we will take notice of - (1) Dictionary of
Occupational Titles, published by the Department of
Labor; (2) County Business Patterns, published by the
Bureau of the Census; (3) Census Reports, also
published by the Bureau of the Census; (4)
Occupational Analyses, prepared for the Social
Security Administration by various State employment
agencies; and (5) Occupational Outlook Handbook,
published by the Bureau of Labor Statistics.
Admin. Rec. at 20 n.2. The ALJ further noted:
The undersigned concludes that the vocational expert
based his opinion and testimony on his personal and
professional knowledge of the regional labor market,
his labor market research, Bureau of Labor Statistics,
and the Dictionary of Occupational Titles. Obviously,
the vocational expert had applied his experience and
knowledge of the regional labor market in using his
research and the aforementioned sources in providing
other jobs that the claimant could perform both
regionally and nationally.
Id. at 21 n.2. Therefore, the ALJ found that the vocational
expert’s testimony was valid, and he relied on it in his Step
Five determination.
St. Laurent contends that the ALJ erred in rejecting her
challenge to the vocational expert’s testimony. In support, she
relies on St. Pierre v. Astrue, No. 1:10-CV-104-JAW, 2010 WL
5465635, at *2-3 (D. Me. Dec. 29, 2010), in which the court
remanded the Commissioner’s decision, in part, because in making
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his Step Five determination, the ALJ relied on the vocational
expert’s testimony based only on publications that provided
aggregate job groupings. Assuming for the sake of argument that
a vocational expert may not rely solely on publications that
discuss aggregate job groupings,9 that is not what the vocational
expert did in this case. In response to the ALJ’s questions,
the vocational expert testified that the job numbers he provided
were consistent with information in the Dictionary of
Occupational Titles and Selected Characteristics of Occupations,
as well as with his own knowledge of the regional labor market.
See Admin. Rec. at 71. Therefore, unlike the expert in St.
Pierre, the vocational expert here used his personal knowledge
and other documentary evidence to substantiate his job numbers.
In short, St. Laurent has not shown that the ALJ committed error
in relying on the vocational expert’s testimony. See Nichols v.
Astrue, No. CIV.A. 10-11641-DPW, 2012 WL 474145, at *13 (D.
Mass. Feb. 13, 2012) (holding that the ALJ did not err in
relying on vocational expert’s testimony concerning aggregate
job groupings and distinguishing St. Pierre because the
vocational expert testified that the aggregate numbers were “the
9 Contra Vandevoort v. Berryhill, No. 3:16-CV-05493-DWC, 2017
WL 413203, at *8 (W.D. Wash. Jan. 31, 2017) (holding that the
ALJ’s reliance on vocational expert’s testimony relying on only
publications that provided aggregate job numbers was not
improper).
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best information that’s out there”); Woodard v. Astrue, No.
1:10-CV-327-DBH, 2011 WL 2580641, at *5 (D. Me. June 28, 2011),
report and recommendation adopted, No. 1:10-CV-327-DBH, 2011 WL
2890371 (D. Me. July 19, 2011) (distinguishing St. Pierre
because, unlike in that case, the vocational expert testified
that the aggregate job groupings were consistent with her
professional experience).
2. Specific Occupations
St. Laurent asserts that the ALJ failed to cite specific
occupations and the exact number of available jobs and argues,
in brief fashion, that such a failure requires reversal. She
cites Morris v. Astrue, No. 3:12-CV-538-TLS, 2014 WL 1259958, at
*11 (N.D. Ind. Mar. 26, 2014), in which the court remanded the
case for further proceedings because the ALJ failed to comply
with Social Security Ruling 83-14. That ruling requires that:
Whenever a vocational resource is used and an
individual is found to be not disabled, the
determination or decision will include (1) citations
of examples of occupations/jobs the person can do
functionally and vocationally and (2) a statement of
the incidence of such work in the region in which the
individual resides or in several regions of the
country.
SSR 83–14, 1983 WL 31254, at *6.
In Morris, the ALJ adopted the vocational expert’s
testimony that an individual with the claimant’s RFC could do
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“at least 120,000 unskilled jobs at the medium exertional level
in Indiana.” Morris, 2014 WL 1259958, at *11. The vocational
expert did not supply any specific examples of jobs that an
individual with the claimant’s RFC could do. Here, however, the
vocational expert provided several specific jobs that could be
performed by an individual with St. Laurent’s RFC, including an
electronics worker, an assembler, and an inspector. Thus, the
ALJ complied with SSR 83-14.10
CONCLUSION
For the foregoing reasons, the claimant’s motion to reverse
and remand (doc. no. 8) is denied. The Acting Commissioner’s
motion to affirm (document no. 9) is granted.
The clerk of court shall enter judgment accordingly and
close the case.
SO ORDERED.
__________________________
Landya McCafferty
United States District Judge
March 28, 2018
cc: Counsel of Record
10 St. Laurent also contends that the ALJ erred in relying on
the vocational expert’s testimony because “some of the cited
jobs are no longer available as unskilled work.” Doc. no. 8 at
15. However, she fails to provide any support for that
assertion.
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