CHRISTI E. TRAMBLE Plaintiff,
CAROLYN W. COLVIN Commissioner of Social Security Defendant.
MEMORANDUM OPINION AND ORDER
LANNY KING, Magistrate Judge.
Christi Tramble filed this action pursuant to 42 U.S.C. § 405(g), seeking judicial review of an administrative decision of the Commissioner of Social Security, who denied her application for disability benefits. The parties have consented to the jurisdiction of the undersigned Magistrate Judge to determine this case, with any appeal lying before the Sixth Circuit Court of Appeals.
Ms. Tramble asserts that the administrative law judge (ALJ) made several errors in her opinion, but primarily argues that the controlling vocational hypothetical was incomplete.
After reviewing the parties' fact and law summaries (docket nos. 9 and 11) and the administrative record, the Magistrate Judge concludes that the ALJ committed reversible error by not presenting a hypothetical that was complete in the sense that it reflected an adequate evaluation of Plaintiff's testimony and allegations regarding her limitations. The Magistrate Judge further concludes that this was not harmless error, and therefore REMANDS this matter to the Commissioner for a new credibility assessment and presentation of a new vocational hypothetical contemplating all of the credible limitations alleged by Plaintiff and supported by the record as a whole.
Summary of the Evidence
Plaintiff suffers from psoriatic arthritis, a chronic, episodic condition characterized by periods of alternating flare-up and remission.
Plaintiff testified that her psoriatic arthritis results in all of the classic symptoms of swollen fingers and toes, foot pain, and lower back pain. Approximately three to four times a month, her feet allegedly are so blistered and her toes so curled up with spasms that she cannot wear shoes and is reduced to rubbing her toes and feet. AR, p. 46. During these episodes she also has problems with her hips, fingers, and back. AR, p. 46. She has to sit down in a tub of hot water to ease the pain. AR, p. 47.
In addition, Plaintiff's condition has resulted in loss of fingernails. AR, p. 274. At the administrative hearing, Plaintiff showed the ALJ how the arthritis "eats away at my fingernails... kills my fingernails is what it does." AR, p. 53. When the ALJ asked whether this affects her grip, Plaintiff responded in the affirmative.
The vocational expert (VE) testified that an individual with the limitations described by Plaintiff would be unemployable. AR, p. 63.
The ALJ denied Plaintiff's disability claim at the fifth and final step of the sequential evaluation process based upon a vocational hypothetical that contemplated the Medical Source Statement of Nicole Kershner, M.D. AR, pp. 62-63 On July 17, 2010, Dr. Kershner examined Plaintiff at the request of the Commissioner and opined as follows (AR, p. 472):
Medical Source Statement: The claimant can sit without any difficulties. She can stand for 10 to 15 minutes and walk half a block before experiencing pain with her lower feet requiring her to rest. She has no lifting or carrying restrictions. She is able to drive and handle objects without difficulty. Fine motor skills are not impaired. Her communication, hearing, speaking, reasoning are not limited.
The ALJ gave "great weight" to Dr. Kershner's residual functional capacity (RFC) finding for sedentary work, which she found to be "consistent with the record when considered as a whole." AR, pp. 27 and 30.
However, Dr. Kershner herself observed that the examination of Plaintiff occurred during a period of relative remission of symptoms in which Plaintiff "[did] not appear to have any psoriatic lesions demonstrated today. She does have some cracking of the skin on her plantar feet, but no active blisters or weeping lesions are noted." AR, p. 471. Dr. Kershner found Plaintiff's gait and station to be "within normal limit" and stated that Plaintiff's "complaint was not supported at all on physical exam today." AR, pp. 471-472.
The ALJ discounted the possibility that, over time and notwithstanding the episodic nature of Plaintiff's impairment, Plaintiff will have greater vocationally-relevant limitations than identified by Dr. Kershner during a period of relative remission. The ALJ's rationale for discounting the presence of additional restrictions is that the record does not reflect the type of ongoing treatment one would expect if such additional limitations were present (AR, pp. 27 and 30):
Although the examination was essentially normal, the undersigned recognizes the fact that the claimant has experienced exacerbations of her psoriatic arthritis which did give her restriction consistent with those set out by Dr. Kershner.... The record shows that the claimant has experienced severe exacerbations of her psoriasis but does not have regular ongoing symptoms which require ongoing treatment. At times the claimant does not have any pustules on her hands or feet and does not experience any ...