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Ames v. Astrue

April 27, 2009


The opinion of the court was delivered by: Frazier, Magistrate Judge


This case is before the Court for review of a decision denying Peggy S. Ames' applications for disability and supplemental security income. The administrative record is on file, along with supporting and opposing briefs.

Ames applied for benefits in January, 2005. An Administrative Law Judge (ALJ) collected evidence, held a hearing, and decided that Ames was not disabled. That decision became final when the Appeals Council declined to review the ALJ's decision. Judicial review of the Commissioner's final decision is authorized by 42 U.S.C. § 405(g) and 42 U.S.C. §1383(c)(3).

To receive disability benefits or supplemental security income, a claimant must be "disabled." A disabled person is one whose physical or mental impairments result from anatomical, physiological, or psychological abnormalities which can be demonstrated by medically acceptable clinical and laboratory diagnostic techniques and which prevent the person from performing previous work and any other kind of substantial gainful work which exists in the national economy.

42 U.S.C. §§ 423(d)(1)(A), 423(d)(2)(A), 1382c(a)(3)(B), 1382c(a)(3)(D).

The Social Security regulations provide for a five-step sequential inquiry that must be followed in determining whether a claimant is disabled. 20 C.F.R. §§ 404.1520, 416.920. The Commissioner must determine in sequence: (1) whether the claimant is currently employed, (2) whether the claimant has a severe impairment, (3) whether the impairment meets or equals one listed by the Commissioner as being so severe as to preclude substantial gainful activity, (4) whether the claimant can perform his or her past work, and (5) whether the claimant is not capable of performing any other work existing in significant numbers in the national economy. Briscoe ex rel. Briscoe v. Barnhart, 425 F.3d 345, 351-51 (7th Cir. 2005). An affirmative answer at step three or five results in a finding of disability. The burden of proof rests with the claimant through step four, after which the burden shifts to the Commissioner. Id.

Under the Social Security Act, a court must sustain the Commissioner's findings if they are supported by substantial evidence. 42 U.S.C. § 405(g). The substantial evidence standard is satisfied by "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971). Because the Commissioner of Social Security is responsible for weighing evidence, resolving conflicts in the evidence, and making independent findings of fact, this Court may not decide the facts anew, reweigh evidence, or substitute its own judgment for that of the Commissioner. Lopez v. Barnhart, 336 F.3d 535, 539 (7th Cir. 2003). However, the Court does not defer to conclusions of law, and if the Commissioner makes an error of law or serious mistakes, reversal is required unless the Court is satisfied that no reasonable trier of fact could have come to a different conclusion. Sarchet v. Chater, 78 F.3d 305, 309 (7th Cir. 1996).

I. Assessment of Treating Physician Opinions

Plaintiff argues that the ALJ misapplied the "treating physician rule." Specifically, she claims that the ALJ gave too little weight to medical opinions offered by Dr. Manchikanti, Dr. Howell, Dr. Jennings, Dr. Mitry, and Dr. Brummer. In her view, their medical opinions were well-supported. Defendant responds that the ALJ gave appropriate weight to extreme medical opinions that were neither well-supported nor consistent with the record as a whole.

A treating physician's opinion regarding the nature and severity of a patient's impairment is entitled to controlling weight if the opinion is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is consistent with substantial evidence in the record. Moss v. Astrue, 555 F/3d 556, 560 (7th Cir. 2009). "[M]edical opinions upon which an ALJ should rely need to be based upon objective observations and not amount merely to a recitation of a claimant's subjective complaints." Rice v. Barnhart, 384 F.3d 363, 370-71 (7th Cir. 2004).

Dr. Manchikanti. Dr. Laxmaiah Manchikanti is a pain management specialist. Plaintiff's problems began following a work injury diagnosed as a sacral contusion. She was authorized to return to work without restrictions on March 12, 2003 (R. 475). Subsequently, plaintiff often sought treatment for back and leg pain and related symptoms. In November, 2005, Dr. Manchikanti performed a comprehensive evaluation of plaintiff's pain complaints and formed the impression that she suffered from lumbar degeneration of intervertebral disc, varicose veins, a generalized anxiety disorder, and recurrent major depression. He assessed plaintiff's prognosis as fair to poor and formulated a 7 to 12-month initial treatment program consisting of drug therapy and caudal epidural injections, followed as necessary with additional injections and surgical treatment of adhesions. Medications indicated for relief of pain and muscle spasm were prescribed.

Plaintiff underwent an injection procedure on December 16, 2005. On January 27, 2006, Dr. Manchikanti noted that plaintiff achieved more than 50% relief of pain for two weeks, without experiencing side effects. He revised his treatment plan -- opting for conservative therapy -- and prescribed medication indicated for relief of pain and muscle spasm.

On February 10, 2006, Dr. Manchikanti noted that plaintiff had achieved more than 50% relief of pain for more than five weeks. He said she was "extremely pleased and says that it has helped her tremendously" but that she was "hurting some again." Dr. Manchikanti administered a second injection and discharged plaintiff with a prescription for antidepressant medicine (R. 439-457).

In March, 2007, Dr. Manchikanti assessed plaintiff's functional capacity, estimating that she could occasionally lift items weighing up to 20 pounds and occasionally carry items weighing up to ten pounds. In an eight-hour workday, she could sit for 30 minutes at a stretch for a total of three hours, stand for 20 minutes for a total of two hours, and walk for 20 minutes for a total of two hours, with an hour of rest time. She could occasionally use her hands to reach overhead, push, and pull, and frequently use her hands to reach, handle, finger, and feel. She could occasionally use her feet to operate foot controls. She could occasionally perform stooping, balancing, and stair-climbing activities but could not climb ladders or scaffolds, kneel, crouch, or crawl. She could occasionally operate a motor vehicle and tolerate humidity and wetness but could not tolerate exposure to unprotected heights, moving mechanical parts, dust, odors, pulmonary irritant, extreme cold, extreme heat, or vibrations. She could shop, travel without a companion, walk without assistance, walk on rough or uneven surfaces, use public transportation, climb a few steps with a hand rail, prepare a simple meal and feed herself, care for personal hygiene, and sort/handle/use paper files. As support for his opinions, Dr. Manchikanti referenced lumbar intervertebral disc disease, major depression, and generalized anxiety disorder (R. 463-468).

The ALJ credited Dr. Manchikanti's lifting restriction but offered these reasons for limiting the weight ...

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