Caseflicks

Court of Appeals for the Eleventh Circuit • 2004

Renee S. Phillips v. Jo Anne B. Barnhart

357 F.3d 1232 | 2004 U.S. App. LEXIS 1050

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Takeaway

In short, this case requires an ALJ to make explicit findings on how exertional and nonexertional limitations affect the sedentary occupational base before using the grids instead of vocational-expert testimony.

Background

Renee Phillips applied for Social Security disability insurance benefits, alleging disability beginning July 31, 1997, from conditions including Sjogren’s syndrome, fibromyalgia, chronic fatigue, neck and back pain, a herniated disk, irritable bowel syndrome, urinary problems, and depression. Her long-time rheumatologist, Dr. Sam Schatten, later completed a restrictive functional assessment stating that she could work only three hours in an eight-hour day, could sit, stand, or walk only briefly, needed to lie down several times daily, and could lift no more than ten pounds.

The administrative record also contained evidence that undercut parts of that assessment. Dr. Schatten had earlier reported that Phillips generally felt good and that some symptoms were less severe. Phillips reported activities including household chores, shopping, dining out, travel, water aerobics, walking, light weights, and social visits. Her urinary symptoms had improved with medication, and her depression had been treated successfully.

The ALJ found that Phillips had not engaged in substantial gainful activity and had severe impairments of Sjogren’s syndrome and fibromyalgia, but that her impairments did not meet a listed impairment. The ALJ gave little weight to Dr. Schatten’s restrictive opinion, found Phillips capable of entry-level sedentary work, and concluded that she could not return to her past work. At step five, however, the ALJ relied exclusively on the Medical-Vocational Guidelines, or grids, rather than obtaining vocational-expert testimony, and found Phillips not disabled. The district court affirmed the Commissioner’s denial of benefits.

Issues

Issue #1

Whether the ALJ had good cause, supported by substantial evidence, to give little weight to Dr. Schatten’s treating-physician opinion.

Holding

Yes. The ALJ adequately articulated good cause for discounting Dr. Schatten’s restrictive assessment, and the resulting sedentary-work RFC was supported by substantial evidence.

Reasoning

A treating physician’s opinion ordinarily receives substantial or considerable weight. But an ALJ may discount it for good cause when the opinion is unsupported by the evidence, contradicted by other evidence, or conclusory or inconsistent with the physician’s own records. The ALJ must clearly state the reasons for doing so.

The ALJ identified a concrete inconsistency between Dr. Schatten’s January 2000 functional assessment and his May 1999 treatment notes. The treatment notes reported that Phillips generally felt good before the visit, had intermittent symptoms, and had less severe neck and trapezius pain. Those observations were difficult to reconcile with an assessment that she could work only three hours a day, required several daily periods of lying down, and had extensive postural and lifting restrictions.

The ALJ also reasonably relied on Phillips’s reported daily activities. Her household tasks, errands, shopping, dining out, visits with friends, travel by automobile and airplane, exercise regimen, and occasional yard work were evidence inconsistent with the extreme limitations described by Dr. Schatten. Other evidence also showed that Phillips usually slept through the night and that medication had resolved her urinary symptoms.

Because the ALJ clearly gave legitimate, record-based reasons for assigning little weight to the treating physician’s opinion, the court would not reweigh the evidence. The ALJ’s decision to limit Phillips to sedentary work, rather than accept Dr. Schatten’s more restrictive limitations or the consultants’ light-work findings, was supported by substantial evidence.

Issue #2

Whether the ALJ could rely exclusively on the Medical-Vocational Guidelines at step five without making findings about the effect of Phillips’s exertional and nonexertional limitations.

Holding

No. The ALJ could not rely solely on the grids without first determining whether Phillips could perform a full range of sedentary work and whether her restriction to entry-level, non-multitasking work significantly limited her basic work skills.

Reasoning

At step five, once a claimant cannot return to past relevant work, the Commissioner bears the burden of showing that other jobs exist in significant numbers in the national economy. The Commissioner may ordinarily use the grids, which combine a claimant’s residual functional capacity with vocational factors such as age, education, and work experience. But the grids are not conclusive in every case.

Exclusive reliance on the grids is improper when exertional limitations prevent the claimant from performing a full range of work at the assigned exertional level. In this context, a full range means unlimited types of work at that level. If Phillips’s impairments limited her ability to sit, stand, walk, lift, carry, push, or pull so that she could not perform the full range of sedentary work, the ALJ was required to obtain vocational-expert evidence about the jobs she could still perform.

The ALJ did not make the necessary finding on Phillips’s exertional capacity. Although the ALJ found her Sjogren’s syndrome and fibromyalgia severe and limited her to sedentary work, the decision did not resolve whether those conditions also prevented her from performing unlimited types of sedentary jobs. The court could not make that fact-dependent determination in the first instance.

A distinct rule applies to nonexertional limitations, including mental restrictions, pain-related limitations, and limitations outside the seven strength demands of work. The grids may be used only if those limitations do not significantly limit basic work skills—that is, do not preclude a wide range of work at the relevant exertional level.

Here, the ALJ expressly limited Phillips to entry-level work because she said she could handle only one thing at a time to avoid stress. That restriction potentially excluded sedentary jobs requiring multitasking. Before relying on the grids, the ALJ had to make a specific finding whether a wide range of sedentary jobs remained available despite that restriction. Because the ALJ made neither required finding, the court vacated and remanded for further administrative consideration, including vocational-expert testimony if the limitations require it.