United States District Court, D. New Hampshire
McCafferty United States District Judge.
Therrien seeks judicial review, pursuant to 42 U.S.C. §
405(g), of the decision of the Acting Commissioner of Social
Security, denying her application for disability insurance
benefits under Title II and supplemental security income
under Title XVI of the Social Security Act, 42 U.S.C. §
423 and § 1382. In support, Therrien contends that the
Administrative Law Judge (“ALJ”) erred at Step
Two of the sequential analysis, failed to properly weigh the
medical opinion evidence, and improperly assessed her
subjective complaints of pain. The Acting Commissioner moves
reviewing the decision of the Acting Commissioner in a social
security case, the court “is limited to determining
whether the ALJ deployed the proper legal standards and found
facts upon the proper quantum of evidence.” Nguyen
v. Chater, 172 F.3d 31, 35 (1st Cir. 1999); accord
Seavey v. Barnhart, 276 F.3d 1, 9 (1st Cir. 2001).
The court defers to the ALJ's factual findings as long as
they are supported by substantial evidence. § 405(g);
see also Fischer v. Colvin, 831 F.3d 31, 34 (1st
evidence is more than a mere scintilla. It means such
relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Castillo Condo.
Ass'n v. U.S. Dep't of Housing & Urban Dev.,
821 F.3d 92, 97 (1st Cir. 2016) (internal quotation marks
omitted). The court will uphold the ALJ's findings, even
if the record could support another conclusion, as long as
“a reasonable mind, reviewing the evidence in the
record as a whole, could accept it as adequate to support his
conclusion.” Irlinda Ortiz v. Sec'y of Health
& Human Servs., 955 F.2d 765, 769 (1st Cir. 1991).
Therrien filed for social security benefits in May 2013, when
she was 33 years old. She has a high school education and
previously worked in a fast food restaurant and as a parking
lot cashier. She lives with her children, as a single parent.
medical records begin in December 2012 when she was admitted
for in-patient mental health treatment because of depression
and suicidal thoughts. On admission, Dr. David M. Ledner
recorded that Therrien's physical examination was
“essentially unremarkable.” Therrien received
medication and group therapy. She was discharged a week later
with a diagnosis of “major depressive disorder,
February 2013, Therrien's carpal tunnel syndrome was
treated with a decompression procedure. Therrien had a normal
mood and affect during an appointment with Peter Barr,
Physician's Assistant, in March 2013.
saw her treating physician, Dr. David Kehas, in May 2013,
because of right neck and shoulder pain that Therrien said
had been intermittent over the past few years. On
examination, Dr. Kehas found that Therrien was alert,
cooperative, and in no distress. He found her cranial nerves
were intact, decreased sensation to touch and temperature in
her right arm and fingers, her right arm reflexes were brisk,
and her strength was four out of five due to pain.
days later, Dr. Kehas filled out a “Physical
Capacities” section of a document titled
“Physician/Clinician Statement of Capabilities.”
He noted Therrien's diagnoses for cervical radiculopathy,
plantar fasciitis, carpal tunnel syndrome, and low back pain.
In Dr. Kehas's opinion, Therrien could do work at the
sedentary and light physical levels, with some limitations on
postural activities and a need to avoid heights and hard
floors. He found that she could occasionally do manipulative
activities and pushing and pulling. Dr. Kehas also found that
Therrien could do work activities for only 20 to 25 hours per
had her annual examination with Dr. Kehas on May 14, 2013.
She reported back pain without help from medication. Dr.
Kehas noted that Therrien had a body mass index
(“BMI”) of 53.75, which correlates to obesity. On
examination, Dr. Kehas found that Therrien was in no acute
distress and her gait, sensation, reflexes, cranial nerves,
and motor strength were all normal. Dr. Kehas told Therrien
to come back in a year.
same day, Leslie Clukay, A.P.R.N., completed the
“Psychological Capacities” part of the
“Physician/Clinician Statement of Capabilities.”
Clukay stated that Therrien's psychological condition
began in August 2008. Despite her condition, Clukay indicated
that Therrien had no deficits and was not limited in her
ability to perform a list of activities, including socially
acceptable behavior, remembering work procedures, and
driving. In some other areas, Clukay responded
“unknown.” She wrote that other medical issues
had exacerbated Therrien's psychiatric symptoms. Clukay
then stated that Therrien was unable to work.
had an MRI of her cervical spine, also done in May 2013.
Because she moved during the study, the results were limited.
The reviewing doctor reported no significant disc desiccation
or disc height loss, a disc protrusion, and mild bulging and
narrowing at ¶ 6-C7. Therrien had an MRI of her right
shoulder in June 2013. The reviewing doctor reported mild to
moderate tendinosis and narrowing.
Hugh Fairley, a state agency physician, reviewed
Therrien's records on July 19, 2013. He found that
Therrien had severe impairments due to obesity; a skin
disease, hidradenitis suppurativa (“HS”);
disorders of muscle, ligament, and fascia; and carpel tunnel
syndrome. Despite those impairments, Dr. Fairley found that
Therrien could frequently lift up to 10 pounds, could stand
or walk for two hours in an eight-hour work day, could sit
for six hours, had an unlimited ability to push or pull up to
10 pounds, and could occasionally climb ramps or stairs. She
could not do some postural activities but could occasionally
do others. Her ability to do manipulative activities was not
had a consultative mental health evaluation on August 14,
2013, with Juliana Read, Ph.D. Dr. Read found that Therrien
could communicate effectively and interact appropriately with
others, could understand and remember all instructions and
procedures, and could maintain attention and concentration.
Dr. Read also found that Therrien could make simple decisions
and tolerate stress in the work setting.
Schneider, Psy.D., a state agency psychologist, reviewed
Therrien's records on August 15, 2013. Dr. Schneider
found that Therrien had a severe anxiety disorder and a
nonsevere affective disorder. Because of those issues,
Therrien had mild restrictions in her daily activities and
maintaining concentration, persistence, or pace, and moderate
difficulties in maintaining social functioning. In assessing
Therrien's specific functions, Dr. Schneider found no
limitations or no significant limitations in most functions
and moderate limitation in her ability to interact
appropriately with the general public. Dr. Schneider's
opinion was that Therrien would be able to work without
problems from psychological symptoms except that she should
not work directly with the public.
of complaints of back, knee, and hip pain, Dr. Brian Klagges
ordered an MRI for Therrien in December 2013. The results
were completely normal. Dr. Klagges wrote that he had no
explanation for Therrien's complaints of pain.
had gastric bypass surgery on December 23, 2013. In February
2014, Therrien saw Dr. Klagges because of debilitating back
pain and pain radiating to her right knee. Dr. Klagges noted
Therrien's described pain and that the pain had not been
controlled by other treatment. ...