Betty Zerby sought disability benefits retroactive to January 1, 2010. She was denied and we filed an appeal. Betty appeared and testified at a hearing on April 5, 2012 in Altoona, PA. An impartial vocational expert also appeared at the hearing.
After careful consideration of the entire record, the Judge made the following findings: Betty has not engaged in substantial gainful activity since January 1, 2010, the alleged onset date. Betty worked after the established disability onset date, but this work activity did not rise to the level of substantial gainful activity. She works part time answering telephones and proofreading but her impairments are accommodated as she is allowed to change positions when needed and go home twice per month due to headaches.
The Judge found Betty has the following severe impairments: advanced degenerative joint disease of the left hip (after a total hip replacement in June of 2009), Dandy Walker cyst in the posterior fossa, hydrocephalus, and chronic daily headaches. The Judge also found Betty has the residual functional capacity to perform sedentary work, except she is limited to occasional walking and standing two hours per day, must avoid balancing, stooping, kneeling, crouching, crawling, and climbing ladders, ropes and scaffolds. She must be afforded the option to sit and stand during the work day, 1-2 minutes every 20 minutes or so; must avoid gross handling, reaching, pushing, and pulling with the upper left extremity including griping or grasping; must avoid concentrated exposure to fumes, odors, dusts, gases, hot/cold temperature extremes, and excessive vibrations; is limited to two hours of sitting out of an eight-hour work day; and would require breaks, absences and time off task in excess of customary industry allowances.
The greatly reduced range of sedentary work was found reasonable. In April 2009, Betty underwent a total left hip replacement due to left hip dysplasia and failure of conservative treatment. She continued follow up treatment with the Orthopedic Clinic at Hershey Medical Center and in April 2010, progress notes revealed she was about one-year status post total hip arthoplasty with persistent adductor spasticity and valgus left knee. The examination showed persistent knocked-knee deformity since surgery with the left leg continuing to be several millimeters shorter than the right leg. She was also reporting low back pain.
Additionally, Dr. Cohen, a treating physician, reported in February 2011, that Betty had severe congenital dislocation of the left hip and hydrocephalus causing severe hip pain, headaches, frequent falls, and back pain. Dr. Cohen also opined that she could only occasionally lift and carry 2-3 pounds; had no appreciable ability to stand and walk due to severe hip pain, leg length discrepancy, hydrocephalus headaches, and frequent falls; could sit one hour in an eight-hour workday; was unable to perform pushing and pulling with the upper and lower extremities; and was unable to perform postural maneuvers. The Judge assigned this opinion great weight because it was provided by a treating source who has a longitudinal perspective of the effect of Betty’s symptoms on her functioning, it is well supported by clinical and objective findings, and it is consistent with the substantial evidence of record.
Furthermore, Betty underwent a consultative physical examination with Dr. Khalid in May 2012. The history provided included complaints of constant hip pain, use of can on bad days, and the need about once a month for her mother to come help her dress, shower, and get on/off the toilet. Betty reported daily headaches due to improper spinal fluid circulation. The examination revealed a three inch leg length discrepancy causing severe gait disturbances; valgus deformity of the left leg; straddling to get on and off the exam table; tearfulness during the examination with a depressed affect; inability to make a fist with the left hand due to prior CVA; significant weakness and lack of mobility on the left side of her body; and inability to grip or grasp with the left (grip was 80% on the right and 0% on the left). Dr Khalid opined that she could occasionally lift/carry five pounds and frequently two to three pound; stand and walk two hours in and eight-hour workday but no more than 15 minutes at one time; sit two hours in and eight-hour work day but no more than 15-30 minutes at one time; no climbing or balancing; occasional stooping, kneeling, crouching, and crawling; limited handling, reaching and pushing/pulling with the left upper extremity; and must avoid temperature extremes. The Judge found this opinion to be very persuasive and assigns it great weight as it is well supported by clinical and objective findings from his physical examination as discussed above and it’s consistent with the substantial evidence of record.
After considering the evidence of record, The Judge found that Betty’s medically determinable impairments could reasonably be expected to produce the alleged symptoms, and her statement concerning the intensity, persistence, and limiting effects of these symptoms to be generally credible. The Judge found Betty’s testimony to be very credible.
The Judge also established that Betty is unable to perform any past relevant work because the demands of past relevant work exceed the residual functional capacity and her acquired job skills do not transfer to other occupations within the residual functional capacity. Residual functional capacity means the ability to perform sustained work-related physical and mental activities on a full-time basis, i.e. eight hours a day five days a week. The Judge determined that Betty’s symptoms would prevent her from performing competitive work on a sustained and full-time basis without excessive and frequent breaks and time off-task.
The Judge found that Betty was a younger individual (27 at the time of the hearing) and has at least a high school education and is able to speak English. Considering Betty’s age, education, work experience, and residual functional capacity there are no jobs that exist in significant numbers in the national economy that she can perform. The vocational expert testimony at the hearing stating, given all of these factors there are no jobs in that national economy that the individual could perform, supported the Judges findings. For that reason, the Judge ruled Betty has been under a disability as defined in the Social Security Act since January 1, 2012 and awarded her Social Security benefits.