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Michael Lloyd Hanson v. Michael J. Astrue

January 30, 2012

MICHAEL LLOYD HANSON, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Michael T. Mason, United States Magistrate Judge.

Magistrate Judge Mason

MEMORANDUM OPINION AND ORDER

Claimant Michael Lloyd Hanson ("Hanson" or "claimant") brings this motion for summary judgment [23] seeking judicial review of the final decision of the Commissioner of Social Security ("Commissioner"). The Commissioner denied Hanson's claim for disability insurance benefits under Sections 216 and 223 of the Social Security Act (the "SSA"), 42 U.S.C. §§ 416(I) and 423(d), and his claim for supplemental security income under Section 1614(a)(3)(A) of the SSA, 42 U.S.C. § 1382a(a)(3)(A). The Commissioner filed a cross-motion for summary judgment [34], requesting that this Court uphold the decision of the Administrative Law Judge ("ALJ"). This Court has jurisdiction to hear this matter pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). For the reasons set forth below, claimant's motion for summary judgment [23] is granted and the Commissioner's cross-motion for summary judgment [34] is denied.

I. BACKGROUND

A. Procedural History

On March 28, 2007, Hanson filed applications for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI"). (R. 106-118). His applications were initially denied on September 25, 2007. Hanson filed a timely request for a hearing, which was held on January 27, 2009 before Administrative Law Judge Joel G. Fina (the "ALJ"). On March 5, 2009, the ALJ issued a written decision denying Hanson's request for benefits. (R. 45-52). Hanson filed a timely Request for Review, and on December 3, 2009, the Appeals Council denied this request, which made the ALJ's decision the final decision of the Commissioner. (R. 1); Estok v. Apfel, 152 F.3d 636, 637 (7th Cir. 1998); 20 C.F.R. § 416.1481. Hanson subsequently filed this action in the District Court.

B. Medical Evidence

Claimant seeks DIB and SSI for disabling conditions stemming from discogenic and degenerative disorders of the spine, lumbar radiculopathy, obesity, and essential hypertension. (R. 47). He claims he sustained a back injury after lifting a 50 pound cement block while working in a warehouse. (R. 48). He alleges an onset of disability of July 5, 2005. (R. 45).

1. Will-Grundy Medical Clinic

On January 27, 2005, before he suffered his back injury at work, Hanson visited Will-Grundy Medical Clinic, a free clinic, complaining of lower back pain. (R. 525). At Will-Grundy, he was diagnosed with high blood pressure and instructed to take Aleve for his pain. (Id.) A report dated April 21, 2005 states that Hanson claimed "[l]ow back pain especially when standing going down. [Right] leg. Had an old injury 30 yrs ago -- starting to hurt again." (R. 546). Hanson returned with the same complaint on May 25, June 23 and July 7, 2005, with pain in his lower back and radiating down his right leg.

(R. 548). Hanson was prescribed a variety of medications to help with the pain and hypertension. (R. 569).

On December 15, 2005 and several times in 2006, Hanson visited the clinic for check-ups. The December 15, 2005 report states "feels good except for back." (R. 550). A September 1, 2006 report states that Hanson suffers from back pain and a herniated disc, and that he cannot exercise due to the pain. (R. 551).

2. Will County Medical Associates, S.C.

Hanson was examined by Dr. Michael Dorning at Will County Medical Associates on August 22, 2005. (R. 235). After assessing the claimant's reflexes and x-rays, Dr. Dorning determined that Hanson suffers from "L5/S1 spondylolisthesis with right-sided radiculopathy." (Id.) The report stated: "He can forward flex to about 80 degrees then complains of pain radiating down his right leg into his right calf area. Exam...reveals patellar and Achilles tendon reflex to be � bilaterally. It appears he has a positive straight leg raise on the right in both the seated and supine position." (Id.) Dr. Dorning ordered an MRI, which was conducted at Open Advanced MRI on September 29, 2005.

Hanson saw Dr. Dorning again on October 11, 2005 to review the results of the MRI. (R. 238). The MRI revealed "degenerative disc disease with foraminal stenosis at L5-S1 and lateral recess stenosis at L4-5. There are multiple level disc bulges, but no evidence of disc herniation or nerve root impingement." (Id.) The report states that Hanson can "forward flex to 90 degrees...but does complain of some pain in his lower back." The final assessment was "[l]umbar degenerative disc disease with lumbar spondylosis." (Id.) Dr. Dorning recommended that Hanson continue with physical therapy three times weekly for two weeks and that he return to work, but not lift anything more than 15 pounds with occasional bending but no squatting. (Id.)

Dr. Dorning examined Hanson again on October 27, 2005. (R. 240). At this visit, the physical examination showed that Hanson's condition had not changed. (Id.) Dr. Dorning restricted Hanson to "no lifting over 20 pounds with occasional bending and squatting." (R. 241).

3. Open Advanced MRI

Dr. Thomas A. Predey of Open Advanced MRI also reviewed Hanson's MRI results, and reported degenerative disc and facet joint disease. (R. 230). Specifically, he found "[m]oderate bilateral, symmetric neuroforaminal stenosis at L5-S1. Mild bilateral lateral recess stenosis at L3-4. Mild posterior disc bulging at L5-S1, L4-5, and T12-L1 and L1-2 levels." (Id.)

4. Athletic and Therapeutic Institute

Hanson underwent physical therapy between October 20, 2005 and November 28, 2005 at Athletic and Therapeutic Institute. (R. 248-277). His physical therapist reported that there was some improvement in Hanson's condition as a result of the therapy, and that Hanson was likely to continue to improve with more therapy, but that the pain might be prohibitive. (R. 248). During therapy, the claimant complained of pain amounting to an 8 out of 10 (10 being emergency room worthy pain). (Id.) His therapist also noted that he was able to carry two 40 pound weights, and could flex fully to the floor to remove tubing from his ankles, but only 2 inches inferior patella when formally tested. (Id.)

On December 19, 2005, Matthew Kruger (a key certified functional assessment specialist with Athletic and Therapeutic Institute) performed a Functional Capacity Assessment ("FCA"). The FCA demonstrated that Hanson was capable of light to medium physical exertion in the occupational setting. (R. 251). This level of exertion would allow Hanson to do some "occasionally lifting and carrying between 30-50 lbs, with frequent lifting and carrying approximately 20 lbs." (Id.) Mr. Kruger noted that Hanson "reported increased right sided low back pain and right leg pain with nearly every FCA activity." (Id.) As a result, the report states: "most activities are recommended on an occasional basis only at this time." (Id.) During the assessment, Hanson stated: "The pain in my back never goes away and sometimes the pain gets really bad depending on what I do." (Id.)

The FCA also stated that for an 8 hour work day, Hanson could tolerate the following: sit for 5-6 hours (45 minute durations, regular breaks), stand for 4 hours (45 minute durations, regular breaks) or walk for 3-4 hours (occasional, moderate distances). (R. 253). In addition, he could occasionally bend, squat, crawl, climb stairs, crouch, kneel, and balance. (Id.) The report also noted that Hanson could occasionally handle weight above 30 pounds, and could frequently handle weight in the 20-30 pound range, and that he could occasionally grasp items with his feet, and frequently with his hands. (R. 254).

5. South Chicago Orthopedics

On November 9, 2005, Hanson was examined by Dr. Blair Rhode at South Chicago Orthopedics. (R. 282). Dr. Rhode reported his belief that claimant's injury was not just the result of one isolated event at work, but rather that the pain is more likely a strain "superimposed on significant lumbar degenerative disk disease." (R. 283). Dr. Rhode noted that Hanson complained of pain that radiates from his low back to the dorsum of the right foot. (Id.) Dr. Rhode diagnosed Hanson with acute lumbar back pain with right lumbar paraspinous spasm and right L4-5 facet symptoms. He noted that Hanson had tenderness to palpation along the right lumbar paraspinous muscles and pain with extension and right lateral bend. (R. 283). He also found there was "no clinical evidence of radiculopathic findings." (Id.) He noted that Hanson had pain during forward flexion, but "provocative maneuvers are normal, including negative straight leg raise." (Id.) He stated that some of claimant's subjective symptoms are worse with standing or walking, which would "suggest posterior element pain (facet symptoms) or spinal stenosis." (Id.)

In addition, Dr. Rhode reported: "I do not feel that the claimant should require permanency for this work injury. If the claimant is unable to return to a full, unrestricted position, I do not feel that it is due to his single lifting event after he was on this job for 1 week. Rather, I feel it is due to his morbid obesity superimposed upon his significant multilevel degenerative disk/facet disease." (R. 284). He noted that it would be difficult to rehabilitate Hanson because of his morbid obesity. (Id.) He suggested that Hanson be placed on modified light duty for four to six weeks, allowing him to lift 10-20 pounds, waist to shoulders, and in a sedentary position with breaks every two hours. (R. 284).

Hanson had a follow-up visit with Dr. Rhode on January 30, 2006. (R. 286). Dr. Rhode reiterated his belief that the injury is not the underlying cause of his pain, but was just an aggravation of a degenerative condition. (R. 289). With respect to work status, Dr. Rhode reported that claimant's ...


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