1

Reynaud’s phenomenon is “a condition in which cold temperatures or strong emotions

cause blood vessel spasms that block blood flow to the fingers, toes, ears, and nose.”

MedlinePlus, http://www.nlm.nih.gov/medlineplus/ency/article/000412.htm (Accessed

September 21, 2012).“Strong emotions or exposure to the cold causes the fingers, toes, ears, or

nose to become white, then turn blue. When blood flow returns, the area becomes red and then

later returns to normal color. The attacks may last from minutes to hours.” Id.

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF OHIO

EASTERN DIVISION

Brazil M. Lee, :

Plaintiff : Civil Action 2:11-cv-1149

v. : Judge Watson

Michael J. Astrue, : Magistrate Judge Abel

Commissioner of Social Security,

Defendant :

REPORT AND RECOMMENDATION

Plaintiff Brazil M. Lee brings this action under 42 U.S.C. §§405(g) and 1383(c)(3)

for review of a final decision of the Commissioner of Social Security denying her

application for Supplemental Security Income benefits. This matter is before the 

Magistrate Judge for a report and recommendation on the parties’ cross-motions for

summary judgment.

Summary of Issues.

Plaintiff argues that the decision of the Commissioner denying benefits should be

reversed because:

• The mental residual functional capacity formulated by the administrative law

judge is not supported by substantial evidence; and,

• The administrative law judge's failure to recognize Raynaud's phenomenon1

as a severe impairment was erroneous.

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Procedural History. Plaintiff Brazil M. Lee filed her application for disability

insurance benefits on September 15, 2006, alleging that she became disabled on January

1, 2006, at age 41, by Raynaud's disease, autoimmune disease, Sjogren’s syndrome,

rheumatoid arthritis, depression, memory loss, chronic pain, circulation loss, chemical

allergies, food allergies, vitiligo of skin, and cervical stenosis. (R. 177, 181.) The

application was denied initially and upon reconsideration. Plaintiff sought a de novo

hearing before an administrative law judge. On October 28, 2010, an administrative law

judge held a hearing at which plaintiff, represented by counsel, appeared and testified. 

(R. 64.) A vocational expert and a medical advisor also testified. On July 28, 2010, the

administrative law judge issued a decision finding that Lee was not disabled within the

meaning of the Act. (R. 18.) On November 16, 2011, the Appeals Council denied

plaintiff’s request for review and adopted the administrative law judge’s decision as the

final decision of the Commissioner of Social Security. (R. 1.)

Age, Education, and Work Experience. Brazil M. Lee was born August 17, 1964. 

 (R. 177.) She has a high school education and completed one year of college. (R. 188.) 

She has worked as a animal care handler, dancer, mail clerk, package handler and stock

person. She last worked October 6, 2006. (R. 181.) 

Plaintiff’s Testimony. Plaintiff testified that she graduated from high school but

she flunked out of college her first year. She lived with her stepmother and at a friend's

house. She drove a car approximately twice a week to the store. Once every two weeks,

she went to a park where she walked. 

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She has had allergic reactions to her medications. She developed an ulcer as a

side effect of her medications. She also broke into a rash.

She could only walk for or five minutes before needing a break. She could be on

her feet for a total of about an hour. With breaks, she could sit for a couple of hours.

With her left hand, she could carry a gallon of milk. 

In 2006, she was in treatment for a year. She stopped treatment when she could

no longer afford it. She recently began treatment again because she had insurance. 

She slept inconsistently. She usually woke up at 8:00 a.m. She ate breakfast and

tried to walk if she could. If she could not walk, she slept or watched television. Her

friend and sister performed household chores for her. Lee also testified that she was not

comfortable being around people. 

She had to soak her hands to increase circulation and to relieve the numbness.

She took medication to improve her circulation. She no longer used the computer

because it was too hard to see and to control it. The numbness in her hands started

seven or eight years ago, and it has become increasingly worse. Small tasks like opening

things or flipping things are difficult for her. She cannot fix her hair or tie her shoes

anymore. She had a special, big pen that she could use to write. 

Plaintiff experienced panic attacks. She can go several weeks without having one,

but at times she had several panic attacks in a week. She was uncomfortable in small

spaces, like elevators, or around crowds. She had crying spells. She had difficulty

eating. Her medications made her groggy and sleepy. She had mood swings. 

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Lee had constant nerve pain in shoulders, hips, and in the center of her back. It

felt like fire. A hot bath provided some relief. The amount of medication she had to take

to alleviate the pain made her sick. She could not tolerate that amount of medication.

The medications caused constipation, diarrhea, and vomiting. She also broke out in tiny

bumps like a heat rash. 

Lee slept only three or four hours a night. She had to keep moving or she would

go numb. She had difficulty with her memory and concentration. (R. 70-94.) 

Medical Evidence of Record.

Physical Impairments. 

On July 1, 2001, Lee was treated at the emergency room for a strained neck

following a motor vehicle accident. (R. 232-37.)

On February 12, 2005, plaintiff was seen for follow up care after twisting her

knee. She reported a significant improvement in her pain. She was diagnosed with a

medial meniscal tear with a healing MCL strain. (R. 259-60.)

On April 6, 2005, Lee was treated at the emergency room for a twisted knee. (R.

238-44.) On June 14, 2005, plaintiff was treated for a knee injury. (R. 261-62.) 

Marc A. Antonchak, M.D. On August 15, 2005, Dr. Antonchak began treating

plaintiff. Plaintiff Lee reported being diagnosed with vitiligo in 1992. She reported

constipation. She was cold all the time and excessively tired. She reported right-sided

chest pain and headaches. Dr. Antonchak diagnosed vitiligo. He wanted to rule out

hypothyroidism given her history of autoimmune disease and constipation. He believed

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that her headaches were vascular in nature. He also noted the presence of a left knee

meniscal tear. (R. 256-58.)

An August 19, 2005 echo report was normal (R. 272-73.) On September 2, 2005,

plaintiff had a normal chest x-ray. (R. 266.) A September 2, 2005 right upper quadrant

ultrasound revealed no signs of cholelithiasis or cholecystitis. There were

nonobstructing calculi within the right kidney. There were calcified granulomas within

the right hepactic lobe. (R. 267-68.) 

On September 19, 2005, plaintiff reported that her right-sided chest pain with

radiation into her right shoulder had worsened. She reported that her hands turned

blue and white when exposed to cold. Her salivary glands enlarge and squirt water

when she pushes on them. Dr. Antonchak noted that Lee had done extensive reading on

autoimmune diseases. (R. 254-55.)

On April 10, 2006, Dr. Antonchak examined plaintiff for follow up of dyspnea.

(R. 251-52.) She reported continued shortness of breath and pressure on her chest. Dr.

Antonchak noted that there was no identifiable cause of the dyspnea. Lee reported

seeing a holistic medicine doctor who indicated that it could be due to a wheat allergy.

Plaintiff believed that eliminating wheat had provided some relief. She reported ear

ringing, “lymph nodes in her neck,” occasional hypoglycemia, curled nails, and easily

cold hands. (R. 251.) She had intermittent temperatures up to 103 degrees. She reported

joint pain all over. She had headaches and “digestive pains.” Id. She also experienced

changes in her vision, dizziness, and an inability to sleep. 

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Dr. Antonchak diagnosed vitiligo, an autoimmune process, headaches, and

Raynaud’s phenomenon. He wrote, “[s]he gives a good history of Raynaud’s

phenomenon where her fingers turn really red, then white to blue. She is well-read on

this subject but she claims [this] happens to her especially when going outside. We

discussed starting short acting nifedipine 30 mg daily for her Raynaud and see if this

gives her any relief.” (R. 252.) 

Teresa M. George, M.D. On May 2, 2006, Dr. George performed a consultative

examination. Plaintiff reported that she developed vitiligo at age 17. A year ago, she

developed joint pain in her left shoulder and bilateral hip region. Plaintiff also

complained of dry eyes, dry mouth, and Raynaud’s phenomenon. An initial laboratory

evaluation showed a positive ANA, positive rheumatoid factor, positive SSA, positive

SSB, elevated sedimentation rate and increased total protein with a polyclonal

hypergammaglobulinemia. On physical examination, she had synovitis and vitiligo. Dr.

George suspected plaintiff had Sjogren’s syndrome, but she could not rule out early

rheumatoid arthritis. (R. 246-48.) 

Sandra M. Pinkham, M.D. Dr. Pinkham began treating plaintiff on January 20,

2006. Plaintiff had an autoimmune disease. She had had migraines and injured her

knee. After ongoing many tests, she had more joint pain in her hips and shoulders. She

had migraines, severe headaches, light sensitivity, vomiting, and diarrhea. Dr. Pinkham

recommended several dietary changes including eliminating wheat. (R. 293-94.)

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Dr. Pinkham had seen plaintiff only once at the time she completed a

questionnaire for the Rehabilitation Services Commission. Dr. Pinkham noted that

plaintiff had autoimmune problems, headaches, and joint pain in her knee, hips, and

shoulders. Plaintiff was not limited in her motion in the joints or spine. She could

perform fine and gross manipulation. Her gait was described as okay but she had pain

with walking. (R. 291-92.)

Jeffrey Vasiloff, M.D. On December 19, 2006, Dr. Vasiloff, a state agency

physician, reviewed the medical record and completed a physical residual functional

capacity assessment Dr. Vasiloff opined that plaintiff could occasionally lift and/or

carry 50 pounds and frequently lift and/or carry 25 pounds. She could stand and/or

walk about 6 hours in an 8-hour day. She could sit for a total of about 6 hours in an 8-

hour day. She was unlimited in her ability push and/or pull. Dr. Vasiloff determined

that plaintiff’s allegations of limitations appeared credible in nature but exaggerated in

degree. (R. 326-33.) 

On May 10, 2007, Maria Congbalay, M.D. reviewed the evidence of record and

the December 19, 2006 assessment and concurred in the findings. (R. 357.)

Kevin Hackshaw, M.D. On August 9, 2006, Dr. Hackshaw evaluated plaintiff at

the arthritis clinic. She had a history of autoimmune disorders. Her vitiligo had started

to reverse with hyperpigmentation. An MRI documented Chiari I malformation. Her

main symptoms were tiredness, sleeping for 10-12 hours but not getting restful sleep,

and a lack of energy. (R. 360-61.)

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On February 6, 2007, Dr. Hackshaw evaluated Lee. Dr. Hackshaw noted that Lee

had a history of vitiligo, positive ANA, and Raynaud’s. She also had secondary

fibromyalgia, possibly related to an underlying Chiari malformation. Her joints hurt.

When laying down, plaintiff had numbness all over and tingling in the legs. She had

blurred vision. She had a history of positive SSA-SSB and dryness of the eyes, which he

believed was a Sjorgen’s component of her undifferentiated connective tissue disorder

process. (R. 358-59.) 

On August 20, 2007, plaintiff reported that she was concerned that her Raynaud’s

was worsening. On examination, her hands had good capillary refill. She described a

sharp pain in her scalp consistent with fibromyalgia. (R. 393-94.) 

On March 5, 2009, plaintiff complained of chest pain, shortness of breath, sleep

difficulties, and ringing in her ears. (R. 395-96.) 

Marvin H. Thomas M.D. On November 24, 2009, Dr. Thomas performed a

rheumatological consultation. Her rheumatic symptoms were positive for dry mouth,

dry eyes, and butterfly rash. She had variable morning stiffness and night pain. She had

numbness and tingling in her hands. (R. 392.)

On April 27, 2010, plaintiff complained that her medication had given her rash.

Plaintiff reported continued symptoms of Raynaud’s although she did not have any

ulcerations. She reported having dry mouth and dry eyes. She also complained of

fatigue. Plaintiff showed Dr. Thomas a photograph which was “somewhat certainly”

consistent with Raynaud’s and a photo of a rash, which may have had autoimmune

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characteristics. Dr. Thomas believed that she had Sjogren’s primarily and Raynaud’s

although it was not typical. He believed that fibromyalgia was the source of plaintiff’s

pain. (R. 390-91.) 

Psychological Impairments. 

Scott Lewis Donaldson, Ph.D. On December 12, 2006, Dr. Donaldson, a

psychologist, evaluated Lee. On mental status examination, Lee exhibited flat affect

with an anxious mood. Her eye contact was minimal. She reported a poor appetite and

having lost thirty pounds. Her sleep was also poor. She was tearful three to four times a

week. She felt helpless and hopeless. She suffered from mood swings and symptoms of

depression. She had diminished interest in activities, psychomotor retardation, fatigue,

and a lack of concentration. Lee reported suffering from anxiety and undue worry

about her health. She was restless, edgy, fatigued, and irritable. 

Dr. Donaldson diagnosed a mood disorder, not otherwise specified and

generalized anxiety disorder. He assigned a Global Assessment of Functioning (“GAF”)

score of 50-60. Dr. Donaldson opined that plaintiff’s ability to understand, remember

and carry out one- and two-step job instructions may be weak, but not impaired. Her

ability to perform repetitive tasks may be limited moderately due to chronic pain;

however, her level of motivation may be lacking moderately due to her mood and

anxiety disorders. Her ability to attend to relevant stimuli was likely mildly impeded.

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workers was mildly limited. Her ability to withstand the stress and pressures associated

with day-to-day work activity appears to be moderately limited. (R. 301-07.)

Irma Johnston, PSAT On December 13, 2006, Dr. Johnston completed a

psychiatric review technique and mental residual functional capacity assessment. Dr.

Johnston indicated that plaintiff was diagnosed with borderline intellectual functioning, 

a mood disorder, not otherwise specified and a generalized anxiety disorder. 

Dr. Johnston noted plaintiff had mild restriction of activities of daily living,

moderate difficulties in maintaining social functioning and in maintaining

concentration, persistence or pace. She had no episodes of decompensation. 

With respect to understanding and memory, plaintiff was moderately limited in

her ability to understand and remember detailed instructions. With respect to sustained

concentration and persistence, plaintiff was moderately limited in her abilities to carry

out detailed instructions, to maintain attention and concentration for extended periods,

to perform activities within a schedule, maintain a regular attendance, and be punctual

within customary tolerances, to work in coordination with or proximity to others

without being distracted by them, and to complete a normal workday and workweek

without interruptions from psychologically based symptoms and to perform at a

consistent pace without an unreasonable number and length of rest periods. Plaintiff

was markedly limited in her ability interact appropriately with the general public. With

respect to adaption, plaintiff was moderately limited in her ability to respond

appropriately to changes in the work setting. 

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Dr. Johnston found plaintiff’s allegations to be credible. She opined that plaintiff

was capable of simple, repetitive tasks in a low stress environment, with few coworkers, and where interactions with co-workers and supervisors were minimal and

superficial. (R. 308-24.)

On May 1, 2007, Caroline Lewin, Ph.D. reviewed the December 12, 2006 mental

residual functional capacity assessment and concurred in the findings. (R. 356.) 

Jeffrey Lodge, M.D. On December 9, 2009, Dr. Lodge, a psychiatrist, began

treating plaintiff. Dr. Lodge diagnosed plaintiff with bipolar disorder. He noted

symptoms of depression, mania, poor concentration, loss of interest, loss of energy,

poor motivation and anxiety. He assigned a GAF score of 60. (R. 403-09.) 

Medical expert.

At the hearing before the administrative law judge, Dr. Ronald Kendrick, a board

certified orthopedic surgeon, testified as a medical expert. He said that the diagnoses

documented by objective medical evidence of record were fibromyalgia, an unclassified

autoimmune disorder, and a mood disorder. June 17, 2010 Hearing, Doc. 9-2, PageID ##

129-30. Dr. Kendrick stated the opinion that plaintiff Lee’s pain limited to lifting up to

10 pounds occasionally and 5 pounds frequently. She could stand or walk for 30

minutes at a time for a total of 2 hours during an 8 hour work day. She could set for 1

hour at a time for at least 6 hours a day. She was limited to occasional stooping,

kneeling, crawling and bending. Id., PageID # 131. She retained the ability to work an 8

hour day, 5 days a week. Id., PageID # 132. 

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Dr. Kendrick testified that there is no medical test for Raynaud’s phenomenon. It

can only be verified by observation. Warm water will usually reverse the symptoms. Id.,

PageID ## 133-35.

Administrative Law Judge’s Findings. 

1. The claimant meets the insured status requirements of the Social

Security Act through December 31, 2011.

2. The claimant has not engaged in substantial gainful activity since

January 1, 2006, the alleged onset date (20 CFR §§ 404.1571 et seq.,

and 416.971 et seq.).

3. The claimant has the severe impairments best described as:

fibromyalgia; autoimmune disorder, unclassified; mood disorder

with anxiety; and borderline intellectual functioning (20 CFR §§

404.1520(c) and 416.920(c)). 

4. The claimant does not have an impairment or combination of

impairments that meets or medically equals one of the listed

impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR §§

404/1520(d), 404.1525, 404.1526, 416.920(d), 416.925 and 416.926). 

After careful consideration of the entire record, it is found that the

claimant has the residual functional capacity to perform less than

the full-range of "sedentary" work as defined in 20 CFR §§

404.1567(a) and 416.967(a) in that she has the following abilities and

limitations: (1) able to lift five pounds frequently and 10 pounds

occasionally; (2) able to sit for one hour at a time for a total of six

hours in an eight-hour workday; (3) able to stand and walk for 30

minutes each at a time for a total of two hours in an eight-hour

workday; (4) able to stoop, kneel, crouch and crawl only

occasionally; (5) must avoid work environments under 40 degrees

Fahrenheit; (6) able to understand, remember and carry out one- or

two-step job instructions; (7) moderate limitations on her ability to

perform repetitive tasks; (8) mild limitations on her interpersonal

relationship skills and ability to relate to supervisors and coworkers; and (9) moderate limitations on her ability to withstand

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the stress in the work place, which is defined as impacting on her

ability to perform work with production quotas and time pressures.

5. Thee claimant is unable to perform any past relevant work (20 CFR

§§ 404.1565 and 416.965).

6. The claimant was born on August 17, 1964 and was 41 years old,

which is defined as a "younger individual" age 18-44, on the alleged

disability onset date (20 CFR §§ 404.1563 and 416.963).

7. The claimant has at least a high school education and is able to

communicate in English (20 CFR §§ 404.1564 and 416.964).

8. Transferability of job skills is not an issue in this case because the

claimant's past relevant work is "unskilled" (20 CFR §§ 404.1568

and 416. 968).

9. Considering the claimant's age, education, work experience, and

residual functional capacity, there are jobs that exist in significant

numbers in the national economy that the claimant can perform (20

CFR §§ 404.1569, 404.1569(a), 416.969, and 416.969(a)).

10. The claimant has not been under a disability, as defined in the

Social Security Act, from January 1, 2006, through the date of this

decision (20 CFR §§ 404.1520(g) and 416.920(g)). 

(R. 11-17.) 

Standard of Review. Under the provisions of 42 U.S.C. §405(g), "[t]he findings

of the Commissioner as to any fact, if supported by substantial evidence, shall be

conclusive. . . ." Substantial evidence is "'such relevant evidence as a reasonable mind

might accept as adequate to support a conclusion.'" Richardson v. Perales, 402 U.S. 389,

401 (1971)(quoting Consolidated Edison Company v. NLRB, 305 U.S. 197, 229 (1938)). It is

"'more than a mere scintilla.'" Id. LeMaster v. Weinberger, 533 F.2d 337, 339 (6th Cir.

1976). The Commissioner's findings of fact must be based upon the record as a whole. 

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Harris v. Heckler, 756 F.2d 431, 435 (6th Cir. 1985); Houston v. Secretary, 736 F.2d 365, 366

(6th Cir. 1984); Fraley v. Secretary, 733 F.2d 437, 439-440 (6th Cir. 1984). In determining

whether the Commissioner's decision is supported by substantial evidence, the Court

must "'take into account whatever in the record fairly detracts from its weight.'" Beavers

v. Secretary of Health, Education and Welfare, 577 F.2d 383, 387 (6th Cir. 1978)(quoting

Universal Camera Corp. v. NLRB, 340 U.S. 474, 488 (1950)); Wages v. Secretary of Health and

Human Services, 755 F.2d 495, 497 (6th Cir. 1985).

Plaintiff’s Arguments. Plaintiff argues that the decision of the Commissioner

denying benefits should be reversed because:

• The mental residual functional capacity formulated by the administrative law

judge is not supported by substantial evidence. Plaintiff argues that the

vocational expert’s response to the hypothetical question posed by the

administrative law judge does not constitute substantial evidence that other

jobs could be performed because the administrative law judge improperly

defined the term “moderate” limitation. Plaintiff maintains that a “moderate”

limitation significantly limits the ability to do basic work activities. The

administrative law judge defined moderate as more than a slight limitation in

the area, but the individual is still able to function satisfactorily. This definition

eliminated any difference between mild and moderate limitations. Plaintiff

also argues that the mental residual functional capacity formulated by the

administrative law judge fails to explain what Lee can and cannot do under its

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limitations. The administrative law judge asked the vocational expert separate

hypothetical questions based on the state agency MRFC and the examination

report of the consulting physician, but he did not ask the vocational expert to

consider the two reports in tandem. The administrative law judge also gave

equal weight to the opinions despite the fact that there were inconsistent

findings contained within them. No attempt was made to resolve

contradictions within the reports with respect to Lee’s ability to understand,

remember and carry out one- or two-step job instructions. Lee also argues that

the administrative law judge violated Social Security Rule 96-6p by failing to

evaluate the evidence produced by her treating mental health source that

rendered the opinion of a non-examining physician out of date. 

• The administrative law judge's failure to recognize Raynaud's phenomenon as

a severe impairment was erroneous. Plaintiff maintains that the statement of

the medical expert and treating physicians’ observations are more nuanced

than the administrative law judge acknowledged. The medical expert

indicated that there were no objective tests documenting Raynaud’s

phenomenon; it simply had to be observed by the physician. The

administrative law judge ignored the fact that plaintiff’s treating doctor

indicated that plaintiff showed him a photograph consistent with Raynaud’s

phenomenon. Plaintiff maintains that the administrative law judge’s

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conclusion that plaintiff’s research was the basis for symptom magnification

was erroneous. 

Analysis. Plaintiff argues that the administrative law judge failed to properly

define what constituted moderate limitations in posing her hypothetical question to the

vocational expert. At the hearing, the administrative law judge stated, “moderate means

that she could be doing repetitive tasks for at least up to a third of the workday or more.

. . . I think that’s how Social Security defines it.” (R. 109.) She further elaborated by

saying that an individual with moderate limitations would still be able to function

satisfactorily. With that definition of moderate limitations, the vocational expert

testified that plaintiff could perform approximately 50% of sedentary, unskilled jobs.

The administrative law judge adequately distinguished between slight, moderate, and

marked limitations. 

Plaintiff also argues that the administrative law judge failed to combine the

limitations identified by Dr. Johnston and Dr. Donaldson when formulating a residual

functional capacity assessment. Dr. Donaldson opined that plaintiff’s ability to

understand, remember and carry out one- or two step job instructions was not

impaired. Her ability to perform repetitive tasks was moderately limited due to her

chronic pain. Her ability to attend to relevant stimuli was mildly impeded. Her ability

to withstand the stress and pressures associated with day-to-day work activity was

moderately limited. Dr. Johnston opined that plaintiff was capable of simple, repetitive

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tasks in a low stress environment, with few co-workers, and where interactions with

co-workers and supervisors were minimal and superficial. (R. 308-24.)

The administrative law judge concluded that plaintiff’s mental impairments

resulted in the following mental residual functional capacity: able to understand,

remember and carry out one- or two-step job instructions; moderate limitations on her

ability to perform repetitive tasks; mild limitations on her interpersonal relationship

skills and ability to relate to supervisors and co-workers; and moderate limitations on

her ability to withstand the stress in the work place, which is defined as impacting on

her ability to perform work with production quotas and time pressures. Plaintiff has not

identified any limitation found by Dr. Donaldson or Dr. Johnston that is not adequately

accounted for in the residual functional capacity formulated by the administrative law

judge. As a result, the administrative law judge’s residual functional capacity is

supported by substantial evidence. 

Plaintiff further argues that the administrative law judge improperly relied on

Dr. Johnston and Dr. Donaldson’s opinions despite the fact that medical evidence was

submitted after these assessments were written. On December 9, 2009, Dr. Lodge began

treating plaintiff’s bipolar disorder. Dr. Lodge noted symptoms of depression, mania,

poor concentration, loss of interest, loss of energy, poor motivation and anxiety. He

assigned a GAF score of 60. (R. 403-09.) Plaintiff fails to identify how Dr. Lodge’s

treatment notes discredit the conclusions reach by Dr. Johnston and Dr. Donaldson. The

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administrative law judge reviewed the treatment notes of Dr. Lodge and concluded that

the assessments of Dr. Donaldson and Johnston were entitled to great weight.

Raynaud’s Phenomenon. The administrative law judge stated:

As to her alleged hand condition, it is acknowledged that there are some

references in the claimant’s medical record in which the claimant’s

treating physicians state that the claimant’s report to hem of her alleged

symptoms “sound like Raynaud’s phenomenon” and that “she gives a

good history of Raynaud’s phenomenon” (Exhibit 3F). However, it is

found that the claimant’s allegations as to her hand condition, symptoms

and limitations are not credible to the extent that they are inconsistent

with the above residual functional capacity, particularly in light of the

following: (1) the claimant’s testimony that she suffers constant weakness

and numbness in her hands, in May 2006 the claimant reported to her

health care provider that “she has numbness in her fingers when she the

Raynaud’s but otherwise denied any weakness, numbness or tingling

(Exhibit 3F); (2) April 2006 treatment records indicate that the claimant is

well-read on the subject of Raynaud’s phenomenon (Exhibit 3F), which in

turn begs the question of whether there is some symptom magnification in

light of her readings; (3) an examining physician has observed that the

claimant showed good capillary refill of the hands (Exhibit 18F); (4) a

treating physician noted that the claimant’s ability to do fine and gross

manipulation is “ok” (Exhibit 4F); and (5) Dr. Ronald E. Kendrick, M.D.,

who reviewed the entire record, testified as an impartial medical expert

that there exists no objective medical evidence in the record, in terms of

treating physician’s observations, to confirm the diagnosis of Raynaud’s

phenomenon.

(R. 15.) Plaintiff points to the testimony of the medical expert, who indicated that there

is no objective test for diagnosing Raynaud’s phenomenon other than direct observation

of the discoloration and that she showed her physician a photograph of her hands to

demonstrate her symptoms. 

Here, the administrative law judge did not err in declining to find that Raynaud’s

phenomenon was a severe impairment. The administrative law judge properly

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considered plaintiff’s allegations concerning her hands in formulating a residual

functional capacity. The administrative law judge relied on substantial evidence in the

record to determine that plaintiff’s alleged impairment did not impact plaintiff’s ability

to work. Any error in classifying the impairment as non-severe was harmless. The

evidence of record supports a finding that plaintiff had no manipulative limitations. 

From a review of the record as a whole, I conclude that there is substantial

evidence supporting the administrative law judge's decision denying benefits. 

Accordingly, it is RECOMMENDED that the decision of the Commissioner of Social

Security be AFFIRMED. It is FURTHER RECOMMENDED that plaintiff’s motion for

summary judgment be DENIED and that defendant’s motion for summary judgment

be GRANTED.

If any party objects to this Report and Recommendation, that party may, within

fourteen (14) days, file and serve on all parties a motion for reconsideration by the

Court, specifically designating this Report and Recommendation, and the part thereof

in question, as well as the basis for objection thereto. 28 U.S.C. §636(b)(1)(B); Rule 72(b),

Fed. R. Civ. P.

The parties are specifically advised that failure to object to the Report and

Recommendation will result in a waiver of the right to de novo review by the District

Judge and waiver of the right to appeal the judgment of the District Court. Thomas v.

Arn, 474 U.S. 140, 150-52 (1985); United States v. Walters, 638 F.2d 947 (6th Cir. 1981). See

also, Small v. Secretary of Health and Human Services, 892 F.2d 15, 16 (2d Cir. 1989). 

 s/Mark R. Abel 

United States Magistrate Judge 

Case: 2:11-cv-01149-MHW-MRA Doc #: 15 Filed: 09/24/12 Page: 19 of 19 PAGEID #: <pageID>