United States District Court, W.D. Virginia, Roanoke Division
BRIAN D. BROWN, Plaintiff,
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.
GLEN E. CONRAD, SENIOR UNITED STATES DISTRICT JUDGE.
has filed this action challenging the final decision of the
Commissioner of Social Security denying plaintiffs claims for
disability insurance benefits and supplemental security
income benefits under the Social Security Act, as amended, 42
U.S.C. §§ 416(i) and 423, and 42 U.S.C. § 1381
et seq., respectively. Jurisdiction of this court is
pursuant to 42 U.S.C. § 405(g) and 42 U.S.C. §
1383(c)(3). This court's review is limited to a
determination as to whether there is substantial evidence to
support the Commissioner's conclusion that plaintiff
failed to meet the requirements for entitlement to benefits
under the Act. If such substantial evidence exists, the final
decision of the Commissioner must be affirmed. Laws v.
Celebrezze, 368 F.2d 640 (4th Cir. 1966). Stated
briefly, substantial evidence has been defined as such
relevant evidence, considering the record as a whole, as
might be found adequate to support a conclusion by a
reasonable mind. Richardson v. Perales, 402 U.S.
389, 401 (1971).
plaintiff, Brian D. Brown, was born on April 8, 1971. He did
not graduate from high school but eventually earned a GED.
Mr. Brown has been employed as a warehouse worker, automotive
accessory installer, and truck driver. (Tr. 30, 231). He last
worked on a regular and sustained basis in 2014. (Tr. 29,
231). On April 7, 2014, Mr. Brown filed applications for
disability insurance benefits and supplemental security
income benefits. In filing his current claims, Mr. Brown
alleged that he became disabled for all forms of substantial
gainful employment on March 31, 2014, due to back problems
and arthritis. (Tr. 230). At the time of an administrative
hearing on October 25, 2016, plaintiff amended his
applications so as to reflect an alleged disability onset
date of January 1, 2016. (Tr. 30). Mr. Brown maintains that
he has remained disabled to the present time. With respect to
his application for disability insurance benefits, the record
reveals that Mr. Brown met the insured status requirements of
the Act at all relevant times covered by the final decision
of the Commissioner. See generally 42 U.S.C.
§§ 416(i) and 423(a).
Brown's applications were denied upon initial
consideration and reconsideration. He then requested and
received a de novo hearing and review before an
Administrative Law Judge. In an opinion dated December 6,
2016, the Law Judge also determined, after applying the
five-step sequential evaluation process, that Mr. Brown is
not disabled. See 20 C.F.R. §§ 404.1520 and
416.920. The Law Judge found that Mr. Brown suffers
from several severe impairments, including dysfunction of the
major joints, osteoarthritis and allied disorders,
degenerative disc disease, lumbar spondylosis, and lumbar
postlaminectomy syndrome, but that these impairments do not,
either individually or in combination, meet or medically
equal the requirements of a listed impairment. (Tr. 13-14).
The Law Judge then assessed Mr. Brown's residual
functional capacity as follows:
After careful consideration of the entire record, the
undersigned finds that the claimant has the residual
functional capacity to perform a range of light work as
defined in 20 C.F.R. [§§] 404.1567(b) and
416.967(b) except the claimant would retain the capacity to
lift/carry twenty pounds occasionally and ten pounds
frequently; sit for six hours in an eight hour workday;
stand/walk six hours in an eight hour workday;
pushing/pulling as much as lift/carry; occasionally use the
right foot in operating of foot controls; frequently balance;
and occasionally climb ramps and stairs, knee[l], stoop,
crouch, and crawl. The claimant would additionally retain the
capacity to withstand occasional exposure to unprotected
heights, moving mechanical parts, and occasional operation of
a motor vehicle.
(Tr. 14). Given such a residual functional capacity, and
after considering testimony from a vocational expert, the Law
Judge determined that Mr. Brown is unable to perform any of
his past relevant work. (Tr. 17). However, the Law Judge
found that Mr. Brown retains sufficient functional capacity
to perform other work roles existing in significant number in
the national economy. (Tr. 18). Accordingly, the Law Judge
concluded that Mr. Brown is not disabled, and that he is not
entitled to benefits under either federal program. See
generally 20 C.F.R. §§ 404.1520(g) and
416.920(g). The Law Judge's opinion was adopted as the
final decision of the Commissioner by the Social Security
Administration's Appeals Council. Having exhausted all
available administrative remedies, Mr. Brown has now appealed
to this court.
plaintiff may be disabled for certain forms of employment,
the crucial factual determination is whether plaintiff is
disabled for all forms of substantial gainful employment.
See 42 U.S.C. §§ 423(d)(2) and 1382c(a).
There are four elements of proof which must be considered in
making such an analysis. These elements are summarized as
follows: (1) objective medical facts and clinical findings;
(2) the opinions and conclusions of treating physicians; (3)
subjective evidence of physical manifestations of
impairments, as described through a claimant's testimony;
and (4) the claimant's education, vocational history,
residual skills, and age. Vitek v. Finch, 438 F.2d
1157, 1159-60 (4th Cir. 1971); Underwood v.
Ribicoff, 298 F.2d 850, 851 (4th Cir. 1962).
review of the record in this case, the court is constrained
to conclude that the Commissioner's final decision is
supported by substantial evidence. The record reveals that
Mr. Brown received treatment for back pain from doctors at
Coastal Spine & Pain Center in Jacksonville, Florida in
2013 and 2014, prior to his alleged onset date. On March 4,
2013, Mr. Brown received a thirty-day supply of prescription
medication for back pain. (Tr. 312). Dr. Kenneth Powell noted
that plaintiffs past medical history included a herniated
disc, and that he had undergone a lumbar laminectomy at L4-L5
and a lower lumbar fusion. (Tr. 311). Although plaintiff
continued to complain of pain at subsequent monthly
appointments, examination notes indicate that he was
"doing well," that the prescribed medications
helped "improve pain and function," and that
plaintiff was "stable on current medications." (Tr.
297, 302, 303, 305, 308).
August 19, 2013, Mr. Brown underwent a lumbar facet nerve
block injection at Coastal Spine & Pain Center. X-rays of
the lumbosacral spine were obtained prior to the procedure,
which revealed "degenerative joint disease with no
appreciable subluxations or fractures." (Tr. 295).
Although Mr. Brown "tolerated the injections well
without any complications or side effects," he
complained of increased back pain in October and November
2013. (Tr. 285, 289, 295). Dr. Powell ultimately prescribed a
fentanyl patch, which plaintiff found to be "very
helpful" in controlling his pain. (Tr. 285). In February
of 2014, Dr. Powell noted that plaintiff had "remained
compliant with his medications" and reported
"excellent pain control." (Tr. 272). Dr. Powell
also noted that Mr. Brown would be starting a different job
in Virginia the following week, and that he would forward his
examination notes to Mr. Brown's new physician. (Tr.
14, 2014, Mr. Brown presented to Ability Physical Medicine
and Rehabilitation, Inc. in Blacksburg, Virginia, where he
was seen by Dr. Richard Wilson. Plaintiff advised Dr. Wilson
that he was "currently unemployed [and] considering
application for social security disability," but that he
also hoped to "possibly get back into youth
coaching." (Tr. 317). Dr. Wilson noted that plaintiff
demonstrated "some pain behaviors" during the
appointment but did "not have a full histrionic
disability presentation." (Tr. 317). On physical
examination, plaintiff complained of leg and back pain, his
reflex at the right Achilles was absent, and his straight leg
raising test was "generally positive on the right"
and "equivocal on the left." (Tr. 317). Dr. Brown
noted that the examination was otherwise "pretty
normal." (Tr. 317). He prescribed hydrocodone and
tizanadine for pain, and recommended an "increase of
exercise." (Tr. 318).
January 4, 2016, Mr. Brown sought treatment from Dr. Anthony
Dragovich at Blue Ridge Pain Management Specialists in Salem,
Virginia. Plaintiff primarily complained of pain in his lower
back and right leg. (Tr. 320). He reported that the pain was
aggravated by activity, but that he was "able to perform
cooking, cleaning, and personal hygiene" activities.
(Tr. 320). An examination of plaintiffs lumbosacral spine
revealed decreased range of motion and some tenderness. (Tr.
322). However, the straight leg raising test was negative
bilaterally and plaintiff exhibited normal paraspinal muscle
strength and increased tone. Likewise, plaintiff displayed
normal range of motion in his upper and lower extremities
with no edema, tenderness to palpation, or pain on motion.
(Tr. 322-23). Although plaintiffs gait was
"antalgic," he was able to stand without
difficulty. (Tr. 323). Dr. Dragovich diagnosed plaintiff with
lumbar degenerative disc disease, lumbar postlaminectomy
syndrome, lumbar spondylosis, and sacroiliitis. (Tr. 323). He
performed a right sacroiliac joint injection that provided
"some pain relief." (Tr. 323). Mr. Brown underwent
a second injection on January 22, 2016. (Tr. 325).
Brown returned to Dr. Dragovich for a follow-up appointment
on February 25, 2016. At that time, plaintiff reported that
the injections "were not helpful," that he was
"still miserable," and that the pain was
"greatly affecting his ability to do basic
activities." (Tr. 330-31). Dr. Dragovich performed a
physical examination that yielded findings consistent with
the previous examinations. (Tr. 332). He prescribed
hydrocodone-acetaminophen and cyclobenzaprine, and instructed
plaintiff to return in one month. (Tr. 332-33).
progress notes from March, April, May, and July of 2016
indicate that the addition of hydrocodone-acetaminophine
(Norco) proved to be "helpful" and
"without side effects!" (Tr. 334-45, 338-39,
342-43, 346-47). Although plaintiff continued to exhibit
reduced range of motion in his lumbosacral spine, his
musculoskeletal examinations were otherwise normal. (Tr. 336,
340, 344, 348). During a follow-up examination on September
16, 2016, plaintiff reported that his prescription for Norco
was not working as well as it once did, and he inquired about
adding a fentanyl patch. (Tr. 354). Dr. Dragovich
"slightly" adjusted plaintiffs existing
prescription, but declined to order a fentanyl patch since
they were "managing his pain fairly well" with
Norco. (Tr. 354).
administrative hearing conducted the following month, Mr.
Brown testified that he is in pain "24 hours a
day," and that the pain "continuously interrupts
his sleep" and causes him to require assistance
"washing [his] lower extremities." (Tr. 32-33). Mr.
Brown further testified that he is only able to cook simple
meals approximately twice a week. (Tr. 34-35). Plaintiff
estimated that he can stand approximately fifteen or twenty
minutes before he needs to sit and stretch, and that he can
sit for approximately ten minutes before he needs to readjust
himself. (Tr. 36). Plaintiff also testified that he can only
walk approximately fifty yards before he needs to stop, and
that he is unable to bend over due to severe pain. (Tr. 38).