The opinion of the court was delivered by: Joseph A. DiClerico, Jr. United States District Judge
Joseph T. Noonan seeks judicial review, pursuant to 42 U.S.C. § 405(g), of the decision of the Commissioner of the Social Security Administration, denying his application for disability insurance benefits and supplemental security income. Noonan contends that the Administrative Law Judge ("ALJ") erred in failing to consider all of his impairments when assessing his residual functional capacity and erred in finding that Noonan's subjective complaints were not fully credible. The Commissioner moves to affirm the decision.
Joseph T. Noonan applied for disability insurance benefits and Supplemental Security Income on April 30, 2009, alleging a disability onset date of November 10, 2008. Noonan was thirty-two years old when he applied for benefits and had a General Educational Development ("GED") diploma. He had worked sporadically as a mechanic during the nine years preceding his application. Noonan contends that he is disabled due to mental health issues and physical limitations caused by carpal tunnel syndrome, shoulder bursitis, back pain, and problems with his hip joints.
Noonan saw his family practitioner, Dr. Melissa Hanrahan, in October of 2008 for bilateral hand pain. Noonan also told Dr. Hanrahan about increased anxiety and trouble sleeping. Dr. Hanrahan prescribed Trazadone, Effexor, and Klonopkin for anxiety and referred Noonan to Dr. Clingman, an orthopedic surgeon, because of his hand pain. After medication did not provide relief of the hand pain, Dr. Clingman did bilateral carpal tunnel surgery in November of 2008.
Post surgery, Noonan's hands improved. In March of 2009, Dr. Clingman found that both of Noonan's wrists and hands had normal examination results. Noonan reported that he could hammer and do push ups but that using an air gun made his right hand tingle. Dr. Clingman recommended that Noonan use power tools to gradually desensitize the nerve in his hand. In April, Noonan told Dr. Clingman that his left hand was perfect but his right hand still had symptoms although he was able to hammer nails and split wood with only minimal problems. Dr. Clingman thought that scar adhesions in the carpal tunnel were causing "traction neuritis" in the right hand.
In May of 2009, Noonan was injured in a car accident, suffering a right hip dislocation and a displaced femoral head fracture. Dr. Alexander Hennig, an orthopedic surgeon, did closed reduction surgery to repair the fracture. Ten days later, Noonan reported left shoulder pain, and examination showed reduced strength and pain when lifting his arm. In June, Noonan told Dr. Hennig that he still had soreness and muscle tightness in his hip and some pain in his left shoulder. On examination, Dr. Hennig found that while sitting in his wheelchair Noonan had sixty degrees of flexion in his hip, that sensation and strength were intact in his right leg, and that his left shoulder had no limitation in range of motion. An MRI of Noonan's shoulder was consistent with a muscle bruise and a possible tear of the superior labrum. Noonan's strength was normal but he had pain with resisted lifting. He was scheduled for physical therapy for his hip and shoulder.
Noonan told Dr. Hanrahan in July of 2009 that his depression was a little worse but he did not need an adjustment of his medications. Dr. Hanrahan thought Noonan was doing well under the circumstances.
In August of 2009, Noonan reported to Dr. Hennig that he was gaining motion and strength in his right hip and had minimal pain. He was using a cane for assistance in walking. He also said that his left shoulder pain had improved dramatically. On examination, Dr. Hennig found that Noonan walked with a limp, had 110 degrees of flexion in his hip without pain, and had a full range of motion in his left shoulder without pain. Later that month, Dr. Clingman noted that Noonan's left hand had recovered from carpal tunnel surgery but that the right hand had persistent symptoms probably due to scar entrapment around the nerve.
At an appointment in October of 2009, Noonan told Dr. Hennig that he was doing quite well, that he had returned to walking and light cycling, that he had almost no hip pain, and that his left shoulder pain had improved. On examination, Dr. Hennig noted that Noonan walked without a limp, that he had a good range of motion and full strength in his hip, and that x-rays showed full healing of the fracture and a properly located hip. Dr. Hennig told Noonan that he could begin more aggressive biking and could begin light jogging in about a month and a half. He was discharged from physical therapy. When Noonan reported increased hip pain in November, Dr. Hennig diagnosed bursitis and prescribed physical therapy.
Noonan also had an appointment with Dr. Hanrahan in November of 2009, when he told her that his hip pain was worse in the morning but did not require medication. He said that he was not sleeping well, which happened every fall, and was taking Excedrin for headaches. He said that his current medication was managing his panic disorder. Because Noonan had a depressed affect, Dr. Hanrahan suggested that he find a new therapist.
Noonan also saw Dr. Clingman in November and reported that he had recently developed tingling in both hands, had been having frequent headaches since the car accident, and had frequent but not severe neck pain. On examination, Dr. Clingman found that Noonan had a full range of motion in both wrists and the fingers of both hands. Compression over the nerve at the right wrist crease and the median nerve caused some discomfort but not tingling or numbness. X-rays showed some cervical disc narrowing but normal bone structure.
On November 12, 2009, Ernie R. Downs, Ph.D., did a consultative psychological evaluation of Noonan as part of Noonan's social security application. Noonan told Dr. Downs that he had been depressed and had had anxiety since his brother died in 1999. Noonan cried almost constantly through the evaluation but remained cooperative and on target.
Dr. Downs found that Noonan was fully oriented and appeared to have normal intelligence. Noonan reported that his long-term memory was intact, that his short-term memory was "garbage", and that he could not concentrate well enough to watch television or read. In response to testing, Noonan was able to recount events from the day before, identify bordering states, repeat a five-digit number and a four-digit number backward with one error, did serial seven subtraction slowly but accurately, and was able to recall two out of three events after a two-minute delay. Dr. Downs concluded that Noonan could understand and remember instructions, interact appropriately, communicate effectively, sustain attention and complete tasks, make simple decisions, maintain attendance and schedule, and interact appropriately with supervisors. Dr. Downs also noted that Noonan might have a bipolar disorder, rather than depression, based on his reported history.
Noonan began counseling sessions with D. Patrick McGuinness, MA, LCMHC, in December of 2009. Noonan reported increased anger and irritability since his car accident, along with headaches, concentration problems, and memory loss. In January of 2010, McGuinness noted Noonan's depressed and anxious mood and sad affect. He said that Noonan's wife was supportive, that Noonan tried to complete chores and tasks despite his physical and mental challenges, and used planners to help him cope. McGuinness also noted that Noonan's angry outbursts had caused problems with his family. McGuinness assessed Noonan's global functioning, GAF, at 48, which indicates serious symptoms or serious difficulty in social, occupational, or school functioning.
Dr. Hugh Fairley, a state agency physician, reviewed Noonan's medical records in December of 2009, and evaluated his physical residual functional capacity. Dr. Fairley found that Noonan could do work activities at the light exertional level, could occasionally stoop, crouch, and crawl, could never climb ladders, should avoid handling very hot or cold objects, and should avoid working at heights.
In January of 2010, Dr. Martin, a state agency psychologist, reviewed Noonan's records and found there was insufficient evidence of a medically severe mental impairment.
In March of 2010, Noonan told Dr. Hennig that his hip and thigh pain had improved significantly, that he had been quite active, and that he was walking for exercise. Dr. Hennig noted that Noonan walked without a limp and had excellent motion. Noonan told McGuinness that he had bought a car by trading in some of his guns at the urging of his wife because of an episode of "decompensation" with "some passive suicidal ideation." He also said that he had significantly improved with medication.
Noonan went to the emergency room at Franklin Regional Hospital in April of 2010 because of acute back pain after bending over to pick up a bag from the floor. He was examined by Dr. Lange who diagnosed acute lumbar strain. Dr. Lange released Noonan to rest at home with pain relievers and muscle relaxants.
At his counseling session in April, Noonan told McGuinness that bankruptcy problems were causing him increased stress. Noonan said that his wife was attacking him about the situation and that he was looking for work despite doctors' orders. Noonan also explained that he ...