United States District Court, E.D. Arkansas
JEROME T. KEARNEY, Magistrate Judge.
The following recommended disposition will be sent to U.S. District Judge Susan W. Wright. A party to this dispute may file written objections to this recommendation. An objection must be specific and state the factual and/or legal basis for the objection. An objection to a factual finding must identify the finding and the evidence supporting the objection. Objections must be filed with the clerk of the court no later than 14 days from the date of this recommendation. The objecting party must serve the opposing party with a copy of an objection. Failing to object within 14 days waives the right to appeal questions of fact. If no objections are filed, Judge Wright may adopt the recommended disposition without independently reviewing all of the record evidence.
Catherine Elizabeth Stewart seeks judicial review of the denial of her application for social security disability benefits. Stewart last worked in December 2007 for Winn Dixie as a cashier and deli manager. She quit her job when she moved to be closer to her daughter. She looked for other work, but did not find another job. At that time, Stewart's husband was ill and unable to work. She became her husband's care-giver. She based disability on her nerves, hands, lower back, depression, and headaches. Shortly after applying for disability benefits, she underwent triple bypass surgery.
The Commissioner's decision. The Commissioner's ALJ initially determined that Stewart can do some light work,  but the Commissioner's Appeals Council remanded the claim back to the ALJ to provide a reasoned resolution of conflicts in the medical opinion evidence. After doing so, the ALJ determined Stewart can do some sedentary work. Because a vocational expert identified available sedentary work,  the ALJ determined Stewart is not disabled and denied the application.
Stewart asked the Appeals Council to review the second decision. The Appeals Council denied the request. Stewart filed this case to challenge the decision. In reviewing the decision, the court must determine whether substantial evidence supports the decision and whether the ALJ made a legal error. This recommendation explains why substantial evidence supports the decision and why the ALJ made no legal error.
Stewart's allegations. Stewart's primary argument challenges the ALJ's resolution of conflicts in medical opinion evidence; she says the ALJ's explanation lacks rationale. She disagrees with the evaluation of her credibility. She contends she is unable to do sedentary work. She maintains the ALJ should have included a limited use of the hands, more balance restrictions, and an older age in determining her ability to work. For these reasons, she maintains substantial evidence does not support the ALJ's decision.
Applicable legal principles. For substantial evidence to exist, a reasonable mind must accept the evidence as adequate to show Stewart can do some sedentary work. Sedentary work "involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools." Sedentary work "represents a significantly restricted range of work. Individuals who are limited to no more than sedentary work by their medical impairments have very serious functional limitations." The ALJ reduced sedentary work by the following limitations: (1) occasional balancing, stooping, kneeling, crouching, crawling, and climbing ramps or stairs; (2) no climbing ladders, ropes, or scaffolds; (3) no overhead work; and (4) no concentrated exposure to temperature extremes, humidity, fumes, odors, dusts, gases or poor ventilation. The question before the court is whether a reasonable mind would accept the evidence as adequate to show Stewart can work within these parameters.
Medical evidence. The ALJ's determination about a claimant's ability to work must be supported by medical evidence; a claimant's subjective allegations are not enough to prove she is disabled. The medical evidence in this case establishes the following impairments:
1. Osteoarthritis. "Osteoarthritis is a chronic joint disease involving degenerative changes in joint cartilage and the underlying bones." It is part of the aging process. The disease is diagnosed using clinical findings and osteoarthritic changes shown on x-rays. X-rays show Stewart has mild osteoarthritic changes in the spine, shoulders, and right hand. Mild changes suggest minimal impairment. Mild osteoarthritic changes have not limited Stewart's ability to walk, stand, or sit. During her consultative exams, she walked normally, got on and off the exam table without difficulty, squatted and rose, bent over without pain, sat without difficulty, and grasped objects with full muscle strength. She demonstrated no limitation during three exams. The mild changes in the right hand required no additional limitation on sedentary work.
2. Coronary artery disease. A few months after applying for disability benefits, Stewart learned she has coronary artery disease. She had three blocked arteries. She underwent coronary artery bypass grafts to improve the blood flow to the heart. Since that time, Stewart hasn't had any problems, despite risk factors. Her risk factors include smoking, obesity, lack of exercise, high blood pressure, and high cholesterol.
People with coronary artery disease often experience chest pain, shortness of breath, fatigue, and disturbed sleep. Stewart complains about these symptoms. Stewart's symptoms might improve if she complied with medical recommendations, but for now, Stewart's symptoms support the reduction of work to a sedentary level. Stewart attributes her symptoms to physical exertion. Sedentary work requires little physical exertion. Stewart's failure to comply with medical recommendations weighs against her credibility.
3. Breathing problems. Stewart complains about shortness of breath. The record includes a diagnosis of chronic obstructive pulmonary disease (COPD). COPD is a progressive disease of the respiratory system which makes it harder to breathe. Smoking cigarettes is the primary cause of COPD. Stewart has smoked cigarettes for 40 years,  but a "history of heavy smoking is not enough to diagnose COPD."
COPD is diagnosed using pulmonary function testing (PFT) or a diffusion study. The record includes no diagnostic test. Without test results, there is no way to determine the extent of Stewart's breathing difficulty, but her continued smoking indicates her problems are not significant. Without test results, the medical evidence lacks the medically acceptable clinical and laboratory diagnostic findings needed to establish COPD as an impairment. Even if ...