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Gruhler v. Berryhill

United States District Court, D. New Hampshire

December 20, 2017

Marie Carmo Gruhler
Nancy Berryhill, Acting Commissioner, Social Security Administration



         Marie Gruhler 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 benefits under Title II the Social Security Act. Gruhler moves to reverse on the grounds that the Administrative Law Judge (“ALJ”) erred in weighing opinion evidence, in considering her impairments, and in failing to find that she is disabled. The Acting Commissioner moves to affirm.

         Standard of Review

         In reviewing the final 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 Cir. 2016). Substantial evidence is “more than a mere scintilla.” Richardson v. Perales, 402 U.S. 389, 401 (1971). When the record could support differing conclusions, the court must uphold the ALJ's findings “if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support his conclusion.” Irlanda Ortiz v. Sec'y of Health & Human Servs., 955 F.2d 765, 769 (1st Cir. 1991) (internal quotation marks omitted).


         Gruhler applied for social security benefits in June of 2014 when she was sixty-one years old. She completed the twelfth grade in school and had previously worked as an electronics inspector at Sylvania.

         After a fall in August of 2012, Gruhler was examined in the emergency room at Concord Hospital. Despite tender spots along her spine, Gruhler's strength, sensation, and gait were normal. A CT scan and xrays showed were negative. A second review of her xrays showed “a non-displaced proximal scaphoid wrist fracture.”

         Gruhler began physical therapy in September of 2012, because of constant head and neck pain, back pain, and short-term memory problems. At an appointment in October of 2012, Gruhler's right ankle was swollen after a two-mile walk. Gruhler was referred to a foot doctor because of right ankle pain.

         Dr. Ronald Resnick noted swelling in Gruhler's foot and ankle. Gruhler explained that when she hurt her wrist in the August fall she also injured her ankle. Dr. Resnick noted that x-rays did not show a fracture but put Gruhler in a removable cast boot. A CT scan of Gruhler's ankle on October 11, 2012, “showed a tiny avulsion type fracture at the tip of the lateral malleolus with focal soft tissue swelling.” At subsequent appointments Gruhler continued to complain of right ankle pain.

         Gruhler also began physical therapy for her ankle. The physical therapist noted that Gruhler had exceeding hypersensitivity in the ankle and was concerned about potential Complex Regional Pain Syndrome (“CRPS”). Dr. Resnick referred Gruhler to pain management.

         Gruhler continued to have pain in her wrist following the fall. Dr. Mollano recommended that she use a stimulator and wrist splints.

         Through November of 2012, Gruhler continued to complain of pain in her ankle and continued to wear the boot, although she was told she did not need the boot. Dr. Resnick told Gruhler to take off the boot and “to push through the pain.” Dr. Resnick believed that Gruhler's pain was due to CRPS because nothing was structurally wrong with her ankle.

         An occupational therapist, Paul Bonzani, evaluated Gruhler's wrist pain in November of 2012. He concluded that her pain suggested CRPS and planned a therapy program to control pain and increase her function.

         Gruhler saw Dr. James Mirazita in December of 2012 for pain management related to her ankle. Dr. Mirazita diagnosed myofascial pain syndrome and scheduled a right lumbar sympathetic block. Dr. Resnick saw Gruhler in January of 2013 for reevaluation of her ankle. Dr. Resnick noted that there was no structural cause for the pain Gruhler claimed.

         Dr. Davis Clark evaluated Gruhler's back pain in January of 2013. He found that Gruhler had tenderness at some spinal points but not others and that her range of motion in her legs and hips was limited. Gruhler's neurological examination of her legs was normal.

         Dr. Mirazita did nerve blocks in February and March of 2013, which improved Gruhler's pain level and mobility. During his examinations between January and July of 2013, Dr. Mirazita found that Gruhler was not in acute distress, her neck and back ranges of motion were normal, no evidence of spasms, and no pain due to facet joint disease. Her arm and leg ranges of motion were also normal, except for a reduced range of motion in her right ankle. Gruhler's ankle pain reduced to two out of ten by July of 2013.

         Dr. Clark found minimal lumbar spine tenderness in April of 2013. During physical therapy, the therapist noted that Gruhler continued to be very limited in her functioning because of her “right ankle fracture.” Dr. Mirazita noted that Gruhler had increased ankle pain with walking.

         In September of 2014, Gruhler reported worsened ankle pain. Dr. Russell Brummett noted that Gruhler had a difficult time standing and walking but was in no acute distress, her cervical range of motion was intact, motor testing on her legs was normal and she was walking with a stable upright gait. Dr. Mollano diagnosed Gruhler with bilateral carpal tunnel syndrome in October of 2014.

         Dr. Peter Loeser did a consultative examination of Gruhler on October 2, 2014. Based on Gruhler's records, Dr. Loeser noted early degenerative disease in the lumbar spine. He found on examination that Gruhler was in no apparent distress, had normal cervical range of motion, no tender points on spinal palpation, and no spasms. The examination of her thoracic spine was also normal. Gruhler had mild tenderness in the lower lumbar areas. Dr. Loeser found that Gruhler had normal range of motion and strength in her arms and legs with no pain. She had mild pain in her right ankle. Dr. Loeser found that Gruhler had a normal ability to sit, stand, get on and off the examination table, squat, and walk.

         Gruhler had an MRI of the lumbar spine the week after her examination with Dr. Loeser. Dr. Brummett examined Gruhler in mid-October and found that the MRI indicated only mild degenerative changes. He noted that it would be reasonable for Gruhler to try exercise and therapy, although Gruhler found it exacerbated her issues. Dr. Brummett recommended chiropractic treatment and a physiatrist.

         Dr. John MacEachran assessed Gruhler's functional capacity on October 21, 2014. He found that Gruhler could do work at the light exertional level and could occasionally do postural activities. Gruhler saw Dr. Sarah Glover on October 25, 2014, who found on examination that Gruhler was tender over lower back muscles but had normal strength in her ...

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