Diane K. Dolph v. Jo Anne B. Barnhart, Commissioner of Social Security
Docket: 01-3910
Court: Court of Appeals for the Eighth Circuit; October 21, 2002; Federal Appellate Court
Diane K. Dolph applied for social security disability benefits, claiming disabilities stemming from polycystic kidney disease, degenerative cervical spine disease, and carpal tunnel syndrome, which she argued caused significant pain. The administrative law judge (ALJ) dismissed her claims of disabling pain and determined that she retained the residual functional capacity to perform her previous work as an apartment and hotel manager. The district court upheld the ALJ's decision, affirming that the ALJ had properly evaluated her pain complaints in accordance with relevant legal standards and that substantial evidence supported the conclusion of non-disability.
Dolph appealed, contending that the ALJ improperly disregarded the uncontradicted opinion of her treating physician and did not adequately credit her pain complaints. The case included extensive medical documentation and testimonies over three hearings. The Court of Appeals evaluated whether the ALJ's findings were backed by substantial evidence, emphasizing that they could not overturn the Commissioner’s decision merely because evidence might favor a different conclusion. Ultimately, the court affirmed the lower court's ruling.
Dolph was 53 years old at the time of her application and had a varied employment history. Her medical treatment began with nephrologist Dr. Craig Shadur, who noted that her kidney condition had remained stable, with controlled blood pressure and primarily stomach pain due to enlarged kidneys. In a 1996 statement, Dr. Shadur indicated that Dolph was unable to perform work involving prolonged sitting and typing because of stomach discomfort. Additionally, Dr. Robert Jones, who treated her for neck and arm pain, recorded her history of surgeries related to these issues. Although Dolph initially reported relief after surgeries, she later returned with complaints of pain, leading to recommendations for physical therapy and medication without identifying any significant abnormalities.
Dr. Sol Iqbal treated Dolph for chronic neck and shoulder pain starting in 1996, diagnosing mild arthritis and suspecting degenerative spinal changes. His treatments included steroid injections and various pain relief procedures such as selective epidurals, facet rhizotomy, occipital nerve blocks, and ganglion blocks between 1997 and 1998. An August 1998 nerve conduction test indicated normal function in Dolph's left upper arm and cervical paraspinal muscles. Despite ongoing complaints of headaches, neck pain, and reduced mobility, a psychological assessment revealed no significant depression but noted a focus on somatic complaints. In November 1998, Dr. Iqbal implanted a spinal cord stimulator, which was later removed due to discomfort.
In 1999, Dolph continued treatment with Dr. Iqbal and Dr. Shadur, who monitored her kidney function and other health metrics. A neurologist, Dr. Steven Adelman, found mild cervical spine motion limitation but no neurologic impairment correlating with Dolph's reported pain, suggesting she could perform basic movements with some restrictions, particularly in lifting and certain physical activities.
The Administrative Law Judge (ALJ) determined that Dolph does not have a listed impairment but suffers from multiple severe conditions, including polycystic kidney disease, cervical spine issues, myofascial pain syndrome, and pain associated with psychological factors. The ALJ considered Dolph's testimony regarding her limitations—specifically her inability to sit or stand for extended periods and her reduced capacity for repetitive hand use—concluding that she could not perform her previous jobs. However, the ALJ found that she could still work as an apartment and hotel manager, as that role allows for more movement and does not require prolonged sitting.
In May 1998, Dr. Shadur provided updated work restrictions for Dolph, indicating limitations on sitting, standing, and walking. Specifically, Dolph should not sit or stand for more than thirty minutes or walk over 500 yards, with a maximum of two hours of sitting and walking and one hour of standing in an eight-hour workday, allowing for breaks. Dolph contends that the ALJ improperly disregarded these opinions. According to 20 C.F.R. 404.1527(d)(2), a treating physician's opinion is given "controlling weight" if well-supported by clinical evidence and not inconsistent with substantial evidence. The ALJ acknowledged Dr. Shadur’s assessment of stomach pain preventing prolonged sitting but assigned less weight to his opinions regarding Dolph's cervical condition, noting that he had not treated her for neck and arm issues and lacked relevant clinical findings, as his specialty is nephrology. The ALJ relied on assessments from Dr. Jones, Dr. Iqbal, and consulting neurologist Dr. Adelman, who did not find the cervical condition disabling. The ALJ's detailed analysis demonstrates a comprehensive understanding of the medical evidence. Notably, Dr. Shadur's opinion that Dolph can only sit and walk for limited durations was deemed inconclusive, especially since Dolph's reported job as an apartment manager involved tasks that allowed for activity variation. Additionally, Dr. Shadur did not address whether Dolph could work part-time or full-time. The evaluation of Dr. Shadur's opinions by the ALJ is supported by substantial evidence.
Regarding Dolph's subjective complaints of pain, the ALJ must consider her work history, daily activities, and physician observations relating to the pain's characteristics and the effects of medication. The ALJ has the discretion to discount pain complaints if inconsistencies are found in the overall record but must provide explicit credibility findings and explain the supporting record inconsistencies, as established in relevant case law.
The ALJ evaluated Dolph's work history and determined that her inability to sit for long periods precludes her from working as a transcriptionist or secretary but does not render her totally disabled, as her daily activities suggest she could still perform as a hotel or apartment manager. The ALJ reviewed substantial medical evidence, concluding that Dolph's cervical pain and carpal tunnel syndrome had been adequately managed through surgery, and her polycystic kidney disease showed stable renal function without severe ongoing discomfort. Although Dolph experiences pain, the central question is whether it is disabling. The ALJ applied the Polaski factors to assess the credibility of Dolph's pain claims and found inconsistencies in the record that justified discounting her complaints. The district court's judgment was affirmed based on the ALJ's decisions being supported by substantial evidence. However, Circuit Judge Richard S. Arnold dissented, arguing that the ALJ inadequately justified dismissing the treating physician Dr. Craig Shadur's opinion regarding the impact of Dolph's pain on her functionality. Arnold contended that the interconnectedness of bodily systems should not lead to a dismissal of Shadur's insights simply due to his lack of treatment for Dolph's neck and arm disorders and suggested that either benefits should be awarded or the case remanded for further consideration of Shadur's opinions.
