Diane S. V. v. Kijakazi

Background

Diane S. V. applied for disability insurance benefits, alleging disability beginning August 21, 2019. The claim was denied initially and on reconsideration. After a hearing, an administrative law judge found that Diane had severe lumbar and cervical degenerative conditions and left carpal tunnel syndrome, among other impairments that were found not severe. The administrative law judge determined that Diane could perform a limited range of light work and could perform past relevant work as an estimator, office manager, and a combined estimator/motor-vehicle-dispatcher job. The administrative law judge therefore found that she was not disabled through November 8, 2021.

Issues Raised

Diane challenged three parts of the administrative decision: the rejection of her testimony that she could use her left hand for typing or fine manipulation for no more than three hours per day; the evaluation of an opinion by orthopedic surgeon Mark W. Howard, M.D.; and the Appeals Council’s treatment of a later report by Suresh Mahawar, M.D.

Diane’s Testimony

The court held that the administrative law judge gave legally sufficient reasons for discounting Diane’s testimony about the severity of her left-hand limitations. The reasons included medical evidence that did not support the extent of the claimed restrictions, a conservative and minimal course of treatment, and daily activities that provided insight into her functioning.

The court noted that testing showed moderate left carpal tunnel syndrome without denervation or axonal loss. Other examinations showed some tenderness and positive nerve tests, but also normal or near-normal findings, including normal range of motion, strength, sensation, and muscle function. The court also observed that no treating, examining, or consulting physician considered by the administrative law judge imposed a limit on typing, keyboarding, or writing to three hours per day. Some records stated that Diane could return to full work without restrictions, and she reported no difficulty or pain with writing, keyboarding, pinching, or fine manipulation.

The court further agreed that Diane’s treatment was conservative. Only one provider suggested a cortisone injection, no provider suggested surgery, and Diane did not seek further treatment for her upper-extremity issues after 2019, although she sought treatment for other issues. The court also found no error in considering her ability to care for herself, drive, perform household chores, walk, and perform activities involving writing, keyboarding, phone use, and fine manipulation.

Evaluation of Howard’s Opinion

Howard recommended that Diane be prohibited from repetitive and forceful gripping, grasping, twisting, or torquing with the left upper extremity and have an ergonomic workstation. The administrative law judge found Howard’s report less persuasive because it conflicted with other medical opinions, was prepared under workers’ compensation standards, was inconsistent with the medical record, and was vague about Diane’s maximum abilities.

The court concluded that Howard’s restrictions did not contradict the administrative law judge’s residual functional capacity finding because Howard addressed only repetitive and forceful activities. Diane did not show that keyboarding involved repetitive and forceful gripping, grasping, twisting, or torquing. The court also noted that she had reported no difficulty or pain with keyboarding. In addition, the court held that any error in evaluating Howard’s opinion would have been harmless because Diane had not shown that it affected the disability determination.

Later Medical Evidence

Diane argued that the Appeals Council should have adopted Mahawar’s report, which followed a March 7, 2022 examination. The Appeals Council considered the report but concluded that it did not relate to the period at issue and did not provide a basis for changing the administrative law judge’s decision.

The court held that the report did not require a remand. Mahawar evaluated Diane after the administrative law judge’s November 8, 2021 decision, found no elbow, forearm, or wrist tenderness or deformity, and recorded only borderline positive nerve tests in the wrists. Diane also did not report difficulty with typing, keyboarding, or fine manipulation during that evaluation. Because substantial evidence supported the administrative decision, the court concluded that the later report did not require sending the matter back for further consideration.

Disposition

The court DENIED Diane S. V.’s motion for summary judgment and GRANTED the Commissioner’s cross-motion for summary judgment. The court stated that a separate judgment would issue and that the Clerk would close the file.