education, and work experience as well as the claimant's residual functional capacity ("RFC") to determine what work the individual is able to perform. Id. "RFC is expressed in terms of a claimant's maximum sustained work capacity for either 'sedentary,' 'light,' 'medium,' 'heavy,' or 'very heavy' work as those terms are defined by 20 C.F.R. § 404.1567." Id. In determining if work is available for the claimant in the national economy, the ALJ may use a vocational expert. 20 C.F.R. § 404.1566(e). If work that the Grid suggests the claimant is able to perform is available, then a finding of not disabled must result. See 20 C.F.R. § 404.1566(b).
Standard of Review
Section 405(g) of the Social Security Act provides that a district court "shall have the power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing." 42 U.S.C. § 405(g). In considering the appeal, "the findings of the Commissioner . . . as to any fact, if supported by substantial evidence, shall be conclusive." Id. Thus, the function of the reviewing court is to determine whether the ALJ's decision is supported by substantial evidence. Substantial evidence means "'such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Luna v. Shalala, 22 F.3d 687, 689 (7th Cir. 1994) (quoting Richardson v. Perales, 402 U.S. 389, 401, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971)). A reviewing court will not "re-evaluate the facts, reweigh the evidence, or substitute its own judgment for that of the Secretary." Id.
The ALJ determined that Halbrook has a narcissistic personality disorder, hypertension, and obesity. R. 22. She found, however, that he has no condition or combination of conditions which meets or equals in severity a condition listed in Appendix I. R. 23. Halbrook contends that the ALJ's decision is not supported by substantial evidence because the ALJ failed to consider significant medical evidence of muscle spasms causing paresthesia and sleep apnea. Halbrook further contends that the ALJ failed properly to credit his mental impairments given the diagnosis of sleep apnea. Finally, Halbrook argues that the ALJ's credibility findings were patently wrong on the record and were based on improper inferences.
At the outset, we begin with the general principle that the ALJ is not required "to evaluate in writing every piece of testimony and evidence submitted." Zalewski v. Heckler, 760 F.2d 160, 166 (7th Cir. 1985). Instead, we require only "a minimal level of articulation by the ALJ as to [her] assessment of the evidence." Id. Thus, "if a sketchy opinion assures us that the ALJ considered the important evidence, and the opinion enables us to trace the path of the ALJ's reasoning, the ALJ has done enough." Stephens v. Heckler, 766 F.2d 284, 287 (7th Cir. 1985).
"A court must examine the entire record of the proceedings to determine whether there is 'substantial evidence' for the decision." Id. at 288. For the reasons set forth more fully below, the Court finds that the ALJ's decision is substantially supported by the evidence in the record.
Muscle Spasms Causing Paresthesia and Sleep Apnea
Halbrook contends that the ALJ completely ignored substantial evidence that he suffers from muscle spasms causing paresthesia and sleep apnea. Specifically, Halbrook argues that the ALJ ignored evidence that muscle spasms in the trapezius muscle cause Halbrook's excessive sleep patterns, loss of strength in his right arm with paresthesia, and weakness and numbness. The ALJ noted Halbrook's claim that he has neck problems that negatively affect his eyesight, speech, and balance, but she did not agree with his assertions that the problems rose to the level of severity required by the SSI regulations. R. 17.
We begin by re-articulating the standard for assessing a disability. "[A] claimant is not guaranteed disability benefits merely because [he] suffers from a medically verifiable impairment. A claimant also must show that, due to [his] impairment, [he] is precluded from engaging in any substantial gainful activity within the entire national economy." Oliveras v. Shalala, 870 F. Supp. 411, 414 (D. Mass. 1994) (citing Bowen v. Yuckert, 482 U.S. 137, 142, 96 L. Ed. 2d 119, 107 S. Ct. 2287 (1987)).
Drs. Stanfield and Stephens have both treated Halbrook for discomfort in his neck and back. R. 234, 237-38. Dr. Stanfield provided the most extensive evaluation and treatment of Halbrook. In addition to performing physical examinations, Dr. Stanfield ordered and evaluated lumbar and cervical spine series. R. 238. Dr. Stanfield found mild spurring in the cervical spine, some spurring in the lumbar area, spasms in the neck and right shoulder, mild back discomfort, and a mild limitation of motion. Id. He stated that Halbrook's disc spaces were well developed and maintained, and there were no fractures, subluxation, or dislocation noted. Id.
Medical records indicate that Halbrook's neck and back problems, diagnosed as mild to begin with, improved with treatment and medication. Dr. Stanfield noted that while Halbrook's paresthesia in his right upper extremity returns "during the month or so in between his treatments," regular chiropractic treatment appears to alleviate the problem. Id. Dr. Stanfield also reported a 70% improvement in the originally mild limitation in Halbrook's range of motion five months after beginning chiropractic treatment. R. 237-38. Halbrook himself told Dr. Stanfield that discomfort in his arm, lower back, and right upper extremities had improved with treatment. Id. In addition, Dr. Stephens reported that a single trigger point injection in Halbrook's trapezius resolved his pain and muscle spasms. R. 234. Neither Dr. Stanfield nor Dr. Stephens indicated that the muscle spasms affected Halbrook's ability to lift objects or work generally. In fact, Dr. Stanfield repeatedly recommended that Hal brook exercise and stretch and encouraged him to work. R. 237. Finally, no physician has described a link between Halbrook's muscle spasms and his sleepiness.
In light of medical evidence that his condition is mild and improves with treatment and medication, and that no doctors have listed any functional restrictions, Halbrook has failed to show that his muscle spasms preclude him from "engaging in substantial gainful activity." Oliveras, 870 F. Supp. at 414. Thus, we find that substantial evidence supports the ALJ's determination that Halbrook is not disabled as a result of his muscle spasms.
Halbrook next contends that the ALJ improperly ignored evidence that he suffers from sleep apnea. In response, the Commissioner points out that the ALJ specifically took Halbrook's sleep disorder into consideration in her hypothetical to the vocational expert, stating that Halbrook should not be considered for jobs that would require him to operate hazardous machinery or work at heights unprotected. R. 23, 275. Halbrook maintains, however, that the ALJ never specifically addressed medical evidence indicating that he suffers from sleep apnea. Because the ALJ only mentions "drowsiness" in her opinion, R. 18, Halbrook argues that she "never assessed the severity and functional limitations of the sleep apnea."
We reiterate that the ALJ is not required "to evaluate in writing every piece of testimony and evidence submitted." Zalewski, 760 F.2d at 166. Despite the ALJ's failure to mention Halbrook's sleep apnea by name, it is clear that she did in fact consider the evidence regarding sleep apnea, as she noted that she had specifically reviewed the disability standards that might apply to such a condition. R. 17 (ALJ reviewed § 3.02, related to chronic respiratory insufficiency, and § 3.10, concerned with sleep-related breathing disorders). In addition, we find that the record supports the ALJ's conclusion that Halbrook's condition did not meet the standards for a disability.
In order to determine whether the ALJ's decision is supported by substantial evidence, we must first determine the standards that the ALJ should have applied in evaluating Halbrook's claim of sleep apnea. Social Security regulations provide that:
Medical signs and laboratory findings, established by medically acceptable clinical or laboratory diagnosis techniques, must show the existence of a medical impairment(s) which results from anatomical, physiological, or psychological abnormalities and which could reasonably be expected to produce the pain or other symptoms alleged.