1

IN THE UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF PENNSYLVANIA

SHIRLEY C. HUFF, )

)

Plaintiff, )

) Civil Action No. 04-364 Erie

)

v. )

)

JO ANNE BARNHART, )

Commissioner of Social Security, )

)

Defendant. )

MEMORANDUM OPINION

McLAUGHLIN, SEAN, J.

Plaintiff, Shirley C. Huff, commenced the instant action pursuant to 42 U.S.C. §§ 405(g)

and 1383(c)(3), seeking judicial review of the final decision of the Commissioner of Social

Security, who found that she was not entitled to supplemental security income (“SSI”) under

Title XVI of the Social Security Act, 42 U.S.C. §§ 1381-1383f. Huff filed an application for SSI

on December 12, 2002, alleging disability since February 19, 2001 due to anxiety, depression,

posttraumatic stress disorder, and neck and back pain (Administrative Record, hereinafter “AR”,

at 82-83, 93). Her application was denied initially, and Huff requested a hearing before an

administrative law judge (“ALJ”) (AR 61-66). A hearing was held on April 14, 2004, and

following this hearing, the ALJ found that Huff was not disabled at any time through the date of

his decision, and therefore was not eligible for SSI benefits (AR 17-23, 28-58). Huff’s request

for review by the Appeals Council was denied (AR 5-8), rendering the Commissioner’s decision

final under 42 U.S.C. § 405(g). The instant action challenges the ALJ’s decision. Presently

pending before the Court are cross-motions for summary judgment. For the reasons that follow,

we will deny the Plaintiff’s motion, and grant the Defendant’s motion. 

I. BACKGROUND

Huff was born on May 25, 1967 and was thirty-seven years old on the date of the ALJ’s

decision (AR 82). She completed school through the 11th grade, and worked in the past as a

cashier, stock person, teacher’s aide, and child care provider (AR 94-99). 

Huff was hospitalized on February 19, 2001 following a motor vehicle accident in which

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she suffered an injury to her cervical spine (AR 151). She complained of left shoulder and left

leg pain (AR 134). A CT scan of the neck demonstrated a subtle, nondisplaced fracture of the

lamina of C5 (AR 133). She was treated conservatively by Elio DeMeira, M.D., a neurological

surgeon, with immobilization of the neck and a soft cervical collar (AR 151). On February 23,

2001, Huff was seen for a follow-up by her family physician, Bernard Proy, M.D. (AR 206). She

complained of headaches, nausea, and left leg pain (AR 206). Dr. Proy recommended a trial of

Ultram and Phenergan (AR 206). On February 26, 2001, Huff was seen by Mary Evelyn Pifer,

RPA-C, from Dr. Proy’s office and reported that although she was sore, she was getting along

well with her pain medications (AR 206). 

Huff returned to Dr. DeMeira on March 1, 2001 for follow-up of her cervical injury (AR

151). She complained of left shoulder pain and left-sided jaw tenderness with some swelling

(AR 151). A neurological examination revealed that Huff was alert and oriented times three, her

deep tendon reflexes and cranial nerves were normal, and her sensation and motor power were

intact (AR 151). Dr. DeMeira ordered diagnostic studies, and recommended that she continue

with her pain medications on a symptomatic basis (AR 151). 

An MRI of Huff’s cervical spine conducted on March 6, 2001 was negative (AR 155). 

Additional diagnostic tests, including a nerve conduction study, doppler venous sonogram of the

lower extremities, left and right tibia/fibula x-rays, a bone scan, a CT scan of Huff’s brain, and an

x-ray of her left shoulder were all normal (AR 217, 219-222). 

Huff complained of lower leg swelling when seen by Ms. Pifer on March 14, 2001,

however, no swelling was detected on physical examination (AR 203). Ms. Pifer felt the

swelling was the result of inactivity (AR 203). She was instructed to continue her medication

regime (AR 203). On the same date, Ms. Pifer completed a Department of Public Welfare

Employability Assessment Form opining that Huff was temporarily disabled from February 19,

2001 until May 19, 2001, due to a C5 lamina fracture and multiple contusions secondary to a

motor vehicle accident (AR 209-210). On March 20, 2005, Huff was placed on Zoloft and

Inderal for complaints of sleep disturbances, nightmares and headaches (AR 201). 

Huff returned to Dr. Proy’s office on April 9, 2001 complaining of continued headaches,

nightmares, and extremity pain (AR 199). She was not wearing her neck brace since she had

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been advised to go without for neck strengthening (AR 199). Nicholas Fusco, PA-C, found her

reflexes were intact, but she exhibited weakness, pain, and decreased range of motion in her

upper and lower extremities (AR 199). Mr. Fusco diagnosed generalized pain, anxiety,

depression, and possible post traumatic stress disorder (“PSTD”) (AR 199). She was advised to

continue her medications, including Darvocet, Ibuprofen, Zoloft, Propranolol and Promethazine

(AR 199). He also referred her to Dr. Jeffrey Esper for evaluation of her headaches, and

recommended counseling to address her nightmares (AR 199). 

A cervical spine x-ray conducted May 7, 2001 showed a very minor anterior displacement

of the C5 on C6 similar to Huff’s prior exam, most likely on a post traumatic basis (AR 153). 

Disc spaces were maintained, and no significant degenerative changes were present (AR 153). 

Huff telephoned Dr. Proy’s office on May 29, 2001 stating that while packing to move,

she experienced a severe headache, neck pain and left leg pain (AR 195). She requested stronger

pain medication, and was prescribed Darvocet (AR 195). On July 12, 2001, Huff again

telephoned Dr. Proy’s office requesting stronger pain medication, and was prescribe Lodine (AR

194). 

On August 17, 2001, Huff was seen by Ms. Pifer and complained of cervical pain, left leg

pain, and headaches (AR 190). On physical examination, Ms. Pifer noted neck tenderness and

decreased range of motion, but the remainder of the exam was intact (AR 190). Ms. Pifer

recommended physical therapy for her complaints of cervical and left leg pain (AR 190). 

Huff underwent physical therapy for six visits, from August 23, 2001 to September 13,

2001 (AR 158-163). At the conclusion of her therapy, Huff reported no significant improvement

in her pain symptoms (AR 158). Her physical therapist noted that she tolerated physical therapy

poorly, and showed absolutely no progress since her initial evaluation (AR 158). Following a

discussion of her status with Ms. Pifer, her therapist discharged her from further therapy due to a

lack of progress (AR 158).

On August 31, 2001, Huff continued to complain of chronic left knee discomfort, left leg

pain, and cervical pain (AR 190). On exam, she exhibited tenderness in the left paraspinous

cervical musculature, as well as the left trapezius area, but her neurological examination was

normal (AR 190). Dr. Proy and Ms. Pifer advised Huff that other than physical therapy, they had

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nothing else to offer her except pain management (AR 190). Since there were insurance issues,

Huff was to get back with them and let her know how she wished to proceed (AR 190).

Huff returned to Dr. Proy’s office on September 18, 2001, and stated that she could not

afford pain management since her car accident insurance had run out (AR 189). She also

reported that she had discontinued counseling since she could not afford the sessions (AR 189). 

Ms. Pifer instructed Huff that she was going to have to learn to deal with her pain, and pain

management was her only alternative (AR 189). 

On December 17, 2001, Huff reported continuing pain in her neck (AR 183). She had

resumed counseling (AR 183). Physical examination revealed tenderness of the cervical spine

and decreased range of motion (AR 183). Her medications were continued, and she was referred

to pain management (AR 183). 

Huff returned to Ms. Pifer on January 24, 2002 complaining of neck and leg pain. 

Physical examination showed neck tenderness and decreased range of motion (AR 182). She

was restarted on Lodine, and given a prescription for Darvocet (AR 182). 

Ms. Pifer wrote a letter to Huff’s counsel on February 4, 2002 summarizing her treatment

(AR 180). Ms. Pifer indicated that Huff continued to complain of cervical and left femur pain,

but that she and Dr. Proy had both examined her and could not find any physical findings that

correlated with her subjective complaints AR 180). She further indicated they had nothing else

to offer her, other than to recommend that she be seen by a pain management specialist (AR

180).

Huff was seen by Tina Hawley, CRNP at Dr. Proy’s office on April 17, 2002, who

examined her for neck pain complaints (AR 179). Ms. Hawley found she had a good grip, good

color, and no neck swelling (AR 179). She noted that Huff’s EMG study and previous bone scan

was “fine,” and recommended a repeat bone scan (AR 179). 

Huff presented to the emergency room on May 17, 2002 after her left leg had given out on

her causing her to fall (AR 164-165). She complained of neck, wrist and knee pain (AR 164). 

On physical examination, it was noted that her neck was mildly tender with a decreased range of

motion, but her knee was non-tender and she exhibited an adequate range of motion (AR 164). 

A cervical spine x-ray showed slight scoliosis, and left wrist and left knee x-rays were normal

Case 1:04-cv-00364-SJM Document 17 Filed 12/08/05 Page 4 of 17
1The GAF score considers psychological, social, and occupational functioning on a

hypothetical continuum of mental health-illness. Scores between 51 and 60 indicate “[m]oderate

symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate

difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or

co-workers).” See Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR 34 (4th

ed. 2000). 

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(AR 165). She was prescribed pain medication, a wrist splint, and instructed to wear a cervical

collar at night and during the day as needed (AR 164).

On July 30, 2002, Huff telephoned Dr. Proy’s office and stated that she had seen John

Balmer, D.O., who felt that pain management was a waste of time and money (AR 175). Dr.

Balmer recommended that she undergo osteopathic manipulation, which he was willing to

perform (AR 175). Dr. Proy’s office advised her to continue follow-up with Dr. Balmer for her

neck pain (AR 175). 

Huff returned to the emergency room on August 25, 2002 again stating that her left leg

had given out on her causing her to fall (AR 166-167). Cervical spine, left wrist, and

lumbosacral spine studies were all negative (AR 167-168). An EEG was also normal (AR 214). 

She was prescribed pain medication and a muscle relaxant (AR 166).

Huff underwent a psychiatric evaluation performed by Asha Prabhu, M.D. on September

4, 2002 (AR 235-236). Huff reported anxiety, sleep disturbances, nightmares, poor

concentration, crying spells, and feelings of helplessness and hopelessness (AR 235). She denied

any suicidal or homicidal ideations, paranoia or hallucinations (AR 235). On mental status

exam, her mood was depressed and her affect constricted, she was alert and oriented times three,

and her speech was relevant and goal directed (AR 236). Her memory, insight and judgment

were all intact (AR 236). Dr. Prabhu diagnosed major depression, single episode, and PTSD, and

assigned her a global assessment of functioning (“GAF”) score of 55 to 60 (AR 236).1 She

prescribed Paxil, Ambien and Xanax (AR 236). 

Huff returned to Dr. Proy’s office on September 9, 2002 for follow-up (AR 174). She

reported that she had seen Dr. Balmer on September 5, 2002 for an adjustment of her neck which

somewhat helped the pain (AR 174). She was still wearing a neck brace and left wrist splint (AR

174). Huff exhibited neck tenderness and decreased range of motion on physical examination

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(AR 174). She still had some mild wrist pain and tenderness, but had a good range of motion

(AR 174). She was referred to physical therapy for her neck and wrist pain, and was to continue

with Dr. Balmer for her neck pain (AR 174). 

Huff began a course of physical therapy on September 16, 2002 continuing until October

29, 2002 (AR 225-234). On initial evaluation, the therapist noted that her “signs and symptoms

were inconsistent with diagnosis. Patient’s functional movement pattern does not coincide with

ROM limitations and functional limitations and impairments ... .” (AR 233). On discharge, Huff

reported that her low back pain had improve with treatment, but her neck continued to stiffen

(AR 225). She was discharged with a home exercise program (AR 225). 

On September 23, 2002, Huff reported that her wrist pain had greatly improved with

physical therapy, but her neck pain had not (AR 171). She claimed to have pain radiating pain

down her back and into her left leg, but her straight leg raising test was negative (AR 171). She

exhibited tenderness on palpation of the cervical spine and lumbar spine, with a decreased range

of motion of the cervical spine (AR 171). She had no tenderness of her left forearm or wrist, and

a good range of motion (AR 171). She was prescribed physical therapy for low back pain, and

was to continue therapy for her wrist and neck pain (AR 171). 

On October 3, 2002, treatment notes from Dr. Prabhu’s office show Huff’s sleep was

better with the Ambien although it knocked her out, and her anxiety was controlled with Xanax

(AR 230). October 30, 2002, treatment notes reflect that Huff’s symptoms were well managed

with medication (AR 237). 

Huff returned to Dr. Prabhu on November 27, 2002 complaining of bad dreams (AR

237). Her mood was depressed and her affect was constricted (AR 237). She denied feelings of

helplessness and hopelessness, and reported that her anxiety was more in control with the Xanax

(AR 237). Dr. Prabhu assessed major depression, and advised her to continue her medications

(AR 237). 

On March 1, 2003, Huff underwent a consultative physical examination performed by

Curtis Helgert, D.O. (AR 250-252). On physical examination, she had a reduced neck range of

motion, some decreased left upper arm sensation, slight left arm weakness, and limited range of

motion of the lumbar spine (AR 251-252). Her gait was stiff and slow, but she was able to walk

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on her heels and toes (AR 252). Examination of her lower extremities showed no significant

findings (AR 252). Dr. Helgert formed an impression of fracture of C5, depression and post

traumatic stress syndrom by history (AR 252). He opined that Huff was unemployable “based on

her demeanor in the exam room with regard to motion of her neck and so on” and that her

limitations appeared to have “a pretty significant emotional component to it” (AR 252). 

However, Dr. Helgert considered it premature to “suggest that she is disabled for life”, and felt

that “whether she is physically capable of it or not, she would not tolerate any sort of lifting or

postural maneuvering” and had restrictions with regard to prolonged sitting (AR 252).

Ronald R. Zelazowski, Ph.D., performed a consultative psychological evaluation on

March 7, 2003 (AR 253-258). Huff reported she was unable to work because she was scared to

drive (AR 253). She was however, able to drive to the grocery store but not on highways (AR

253). She complained of difficulty concentrating, irritable moods, difficulty in being in enclosed

places, crying spells, insomnia, nightmares and fear of crowds (AR 254-255). She further

claimed that since the accident, she suffered from panic attacks approximately two times per

week or more for no apparent reason (AR 255). 

On mental status examination, Dr. Zelazowski observed that Huff’s posture, bearing,

hygiene and degree of eye contact were within normal limits, and no shifts in anxiety level were

observed during the interview (AR 255). He noted that she walked somewhat slowly and stiffly,

holding herself in a somewhat stiff posture while seated (AR 255). He found her speech was

coherent, relevant, and goal-directed, with normal rate, rhythm, and tone, with no evidence of a

formal thought disorder (AR 255). Her affect was somewhat constricted, but was appropriate to

the thought content and situation (AR 255). She described her mood as “not too bad” (AR 255). 

She denied hallucinations, illusions, delusions, depersonalization, derealization, obsessions,

compulsive behavior, phobias, homicidal ideation, and hypochondriacal symptoms (AR 255). 

She had below average fund of intelligence, but was capable of abstract thinking (AR 256). Her

memory processes were grossly intact, and she reported adequate social judgment (AR 256). She

reported difficulty controlling her temper at times (AR 256). 

Huff’s self-described activities of daily living included shopping once or twice per week

for a few things, cooking four nights per week with her daughter’s help, washing a few dishes,

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vacuuming twice per week, and doing a load of laundry each day (AR 257). Although she had

trouble with irritability, she was able to communicate with others (AR 258). With respect to

concentration, persistence and pace, Huff reported that she could read for ten minutes and watch

television for up to a half-hour (AR 258). 

Dr. Zelazowski diagnosed Huff with major depressive disorder, single episode, moderate

severity, chronic PTSD, and panic disorder with agoraphobia (AR 257). He indicated that her

prognosis was guarded, and recommended continuation of her appointments with the psychiatrist

to adjust her medications, and more frequent visits with her counselor (AR 257). He opined that

some improvement in her condition could be expected if she followed these recommendations

(AR 257). 

Based upon his evaluation of Huff, Dr. Zelazowski completed a mental capacity

assessment form (AR 259-260). He opined that Huff had a “good” ability to use judgment and

interact with supervisors; a “fair” ability to follow work rules, relate to co-workers, deal with

work stresses, function independently, maintain attention/concentration, understand, remember

and carry out simple job instructions, maintain personal appearance, relate predictably in social

situations, and demonstrate reliability; and a “poor/none” ability to deal with the public,

understand, remember and carry out complex or detailed job instructions, and behave in an

emotionally stable manner (AR 259-260).

On March 9, 2003, a cervical spine MRI which showed a central to right-sided mild to

moderate size herniated disc with slight upward migration and compromise of the right neural

foramina (AR 218). 

On April 1, 2003, Dr. Proy referred Huff to Dr. Balmer for pain management (AR 338-

340). Huff denied suffering from back or neck pain, and denied suffering from any anxiety or

depression (AR 338). On physical examination, she exhibited full neck range of motion, with no

spasm, swelling or tenderness (AR 338). She walked with a normal gait, had no spine

tenderness, and exhibited normal strength in her upper and lower extremities (AR 339). Dr.

Balmer recommended that she undergo epidural injections (AR 339). Pursuant to Dr. Balmer’s

recommendation, Huff underwent cervical epidural steroid injections on April 2, 2003, April 30,

2003 and May 22, 2003 (AR 293-324). 

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In an undated letter, Dr. Balmer wrote Huff’s insurance company and opined that she had

suffered severe injuries that were permanent, and despite medical and psychiatric care, her

condition had shown little lasting improvement (AR 243). He diagnosed neck pain, somatic

dysfunction of the neck, left leg pain, post traumatic stress syndrome, somatic dysfunction of the

head, thoracic, lumbar, sacrum, pelvis, and extremities (AR 243). 

On April 3, 2003, Sanford Golin, Ph.D., a state agency reviewing psychologist,

completed a Psychiatric Review Technique form and concluded that Huff had a mild degree of

limitation in her activities of daily living, a moderate degree of difficulty in maintaining social 

social functioning and in maintaining concentration, persistence or pace, and no repeated

episodes of decompensation (AR 275). On the same date, Dr. Golin completed a Mental

Residual Functional Capacity Assessment form (AR 261-264). Dr. Golin concluded that Huff

was not significantly limited in her ability to remember locations and work-like procedures;

understand, remember, and carry out very short and simple instructions; sustain an ordinary

routine; work in coordination with others; make simple work-related decisions; ask simple

questions; accept instructions and respond appropriately to criticism from supervisors; maintain

socially appropriate behavior; and be aware of normal hazards (AR 262-262). He further

concluded that Huff was only moderately limited in her ability to understand, remember, and

carry out detailed instructions; maintain attention and concentration for extended periods;

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

normal workday and workweek without interruptions from psychologically based symptoms;

interact appropriately with the general public and co-workers; respond appropriately to changes

in the work setting; travel in unfamiliar places; and set realistic goals or make plans

independently of others (AR 261-262). 

In making this assessment, Dr. Golin reviewed Dr. Prabhu’s evaluation and treatment

notes, as well as Dr. Zelazowski’s evaluation (AR 263). He gave great weight to their opinions,

and opined that although Huff had a problem dealing with the general public, she could

adequately adjust to a work setting (AR 263). 

On April 7, 2003, a state agency adjudicator concluded that Huff could occasionally lift

and carry twenty pounds; frequently lift and carry ten pounds; stand and/or walk about six hours

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in an 8-hour workday; sit about six hours in an 8-hour workday; and was unlimited in her

push/pull ability (AR 280). 

Huff returned to Dr. Balmer on September 18, 2003 claiming that the epidurals had not

relieved her neck pain (AR 336). She also reported anxiety and depression (AR 336). Huff’s

physical examination showed neck spasms, swelling and tenderness, but she exhibited a full

range of motion (AR 337). She was prescribed Neurontin and Vioxx (AR 337). 

On October 15, 2003, Huff reported neck pain, but denied anxiety or depression (AR

334). She had a limited range of motion on physical exam, but her strength in the upper and

lower extremities was normal (AR 335). Dr. Balmer prescribed Oxycodone (AR 335). 

Huff returned to Dr. Balmer on November 24, 2003 for routine follow-up (AR 331). She

complained of persistent neck pain, but denied anxiety and depression (AR 331). She reported

that the Oxycodone had significantly helped her pain (AR 331). She had a limited range of

motion with discomfort on extremes, and normal strength in her upper and lower extremities (AR

332). Flexeril was added to her medication regime (AR 332). 

On December 24, 2003, Huff reported that she had presented to the emergency room the

previous week with head, neck and back pain (AR 328). She had however, been able to resume

cleaning, cooking and shopping (Ar 328). She further reported that Paxil and Xanax were

controlling her anxiety and depression symptoms (AR 328). Dr. Balmer found limited range of

motion with discomfort on extremes, reduced strength in her upper left extremity, and normal

strength in her lower extremities (AR 329). 

On January 19, 2004, Huff requested a refill of Oxycontin and Percocet, reporting that

these medications had been effective in controlling her pain (AR 325). She denied suffering

from anxiety or depression (AR 325). Her physical examination remained essentially the same,

although she had regained full strength in her upper left extremity (AR 326). 

Huff was evaluated by James Macielak, M.D., an orthopedic surgeon, on January 22,

2994, for cervical pain pursuant to the request of Dr. Balmer (AR 342-345). Huff’s gait was

normal, and an examination of her neck revealed no anterior masses or tenderness (AR 343). 

She did exhibit markedly restricted range of motion in all planes (AR 343). In her upper

extremities, there was some cog wheel giveaway on manual motor testing (AR 343). There was

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no dermatomal sensory loss (AR 343). Dr. Macielak reviewed Huff’s previous studies, and

formed an impression of herniated disc at C5-6, chronic cervical shoulder girdle myofascial

syndrome, chronic pain syndrome, tobacco abuse, and post traumatic stress difficulties (AR 344). 

He advised against surgery, opining that it would not result in any substantial improvement (AR

344). He recommended that she reduce the amount of anti-inflammatory medications, and that

her treatment include traction (AR 344). 

Finally, on August 30, 2004, Dr. Balmer completed a Pennsylvania Department of

Welfare form stating that Huff was incapacitated due to cervical disc displacement and

cervicalgia (AR 348).

Huff and Fred Monaco, a vocational expert, testified at the hearing held by the ALJ on

April 14, 2004 (AR 28-58). Huff testified that she was able to drive with her cervical collar, but

had not been able to cook, clean or shop since the car accident (AR 35-36). She was left-handed,

and had more difficulties with her left arm than her right (AR 36). She claimed she suffered

from pain which radiated down her left arm (AR 37). Surgery had not been recommended, and

epidural injections provided no relief (AR 37). Huff testified that she was unable to sit for a long

period of time and needed to change positions (AR 39, 53). She was able to stand for about

fifteen minutes, and could lift about five pounds (AR 53). She had trouble walking, and had

fallen approximately four times because her left leg gave out (AR 39). She did not use a cane to

walk, and no doctor had recommended that she use a cane (AR 40). 

Huff testified that she used a TENS unit approximately four hours per day, as well as ice

packs and a heating pad (AR 42). She claimed that after fifteen to twenty minutes of activity, she

had to rest for approximately two hours or longer, and was in bed three to four times a week due

to pain (AR 47-48). She also experienced nightmares and migraine headaches every day (AR

48, 50). She engaged in no outside activities (AR 49-50). 

The ALJ asked the vocational expert if work existed for an individual of Huff’s age,

education and past work experience, who was limited to sedentary work that required no more

than 45 degrees of bending, using the left dominant hand only as a helping hand, required simple

instructions, and who needed to avoid interaction with co-workers, changes in the work setting,

and travel to unfamiliar places (AR 54-55). The vocational expert testified that such an

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individual could perform work as a surveillance system monitor (AR 56). 

Following the hearing, the ALJ found that Huff was not eligible for SSI benefits (AR 17-

23). Her request for an appeal with the Appeals Council was denied making the ALJ’s decision

the final decision of the Commissioner (AR 5-8). She subsequently filed this civil action.

II. STANDARD OF REVIEW

The Court must affirm the determination of the Commissioner unless it is not supported

by substantial evidence. See 42 U.S.C. § 405(g). Substantial evidence does not mean a large or

considerable amount of evidence, but only “such relevant evidence as a reasonable mind might

accept as adequate to support a conclusion.” Pierce v. Underwood, 487 U.S. 552, 564-65 (1988)

(quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)); see Richardson v.

Parales, 402 U.S. 389, 401 (1971). It has been defined as less than a preponderance of evidence

but more than a mere scintilla. See Richardson, 402 U.S. at 401; Jesurum v. Secretary of the

United States Dept. of Health and Human Servs., 48 F.3d 114, 117 (3d Cir. 1995).

III. DISCUSSION

A person is "disabled" within the meaning of the Social Security Act if he or she is unable

to "engage in any substantial gainful activity by reason of any medically determinable physical or

mental impairment which can be expected to result in death or which has lasted or can be

expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). 

The Commissioner uses a five-step evaluation process to determine when an individual meets

this definition:

In the first two steps, the claimant must establish (1) that he is not

engaged in “substantial gainful activity” and (2) that he suffers

from a severe medical impairment. Bowen v. Yuckert, 482 U.S.

137, 140-41 (1987). If the claimant shows a severe medical

impairment, the [Commissioner] determines (3) whether the

impairment is equivalent to an impairment listed by the

[Commissioner] as creating a presumption of disability. Bowen,

482 U.S. at 141. If it is not, the claimant bears the burden of

showing (4) that the impairment prevents him from performing the

work that he has performed in the past. Id. If the claimant satisfies

this burden, the [Commissioner] must grant the claimant benefits

unless the [Commissioner] can demonstrate (5) that there are jobs

in the national economy that the claimant can perform. Ferguson

v. Schweiker, 765 F.2d 31, 37 (3rd Cir. 1985).

Jesurum, 48 F.3d at 117. The ALJ resolved Huff’s case at the fifth step. At step two, the ALJ

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determined that Huff’s depressive disorder, anxiety related disorder, PSTD, and status post motor

vehicle injury, with herniated cervical disc at C6-C7 were severe impairments, but determined at

step three that she did not meet a listing (AR 19). At step four, the ALJ found she had the

residual functional capacity (“RFC”) for sedentary work, limited to simple instructions, avoiding

interaction with the general public, close interaction with co-workers, changes in the work

setting, traveling to unfamiliar places, limited to 45 degrees bending, and using her dominant left

hand as a helping hand (AR 20). At the final step, the ALJ determined that Huff could perform

the job cited by the vocational expert at the administrative hearing (AR 21-22). The ALJ

additionally determined that Huff’s allegations regarding her limitations were not totally credible

(AR 22). Again, we must affirm this determination unless it is not supported by substantial

evidence. See 42 U.S.C. § 405(g).

Huff’s sole argument is that the medical evidence establishes that her combination of

impairments precludes her from performing any gainful employment and therefore the ALJ’s

decision is not supported by substantial evidence. We disagree, and are of the opinion that the

ALJ properly considered all of the medical evidence and other evidence of record in assessing

Huff’s RFC. “‘Residual functional capacity is defined as that which an individual is still able to

do despite the limitations caused by his or her impairment(s).’” Burnett v. Comm’r of Soc. Sec.

Admin., 220 F.3d 112, 121 (3rd Cir. 2000) (quoting Hartranft v. Apfel, 181 F.3d 358, 359 n.1 (3rd

Cir. 1999); see also 20 C.F.R. § 404.1545(a). An individual claimant’s RFC is an administrative

determination expressly reserved to the Commissioner. 20 C.F.R. § 416.927(e)(2). In making

this determination, the ALJ must consider all evidence before him. Burnett, 220 F.3d at 121. 

Social Security Ruling (“SSR”) 96-5p provides:

The assessment is based upon consideration of all relevant

evidence in the case record, including medical evidence and

relevant nonmedical evidence, such as observations of lay

witnesses of an individual’s apparent symptomatology, an

individual’s own statement of what he or she is able or unable to

do, and many other factors that could help the adjudicator

determine the most reasonable findings in light of the evidence.

 

SSR 96-5p (1996), 1996 WL 374183 *5. Here, the ALJ found that Huff retained the RFC to

perform work that did not require exertion above the sedentary level, and was limited to simple

instructions, avoiding interaction with the general public, close interaction with co-workers,

Case 1:04-cv-00364-SJM Document 17 Filed 12/08/05 Page 13 of 17
14

changes in the work setting, traveling to unfamiliar places, limited to 45 degrees bending, and

using her dominant left hand as a helping hand (AR 20). For the reasons that follow, we find that

the ALJ’s RFC determination is supported by substantial evidence.

With respect to Huff’s physical condition, it is undisputed that she has a history of

cervical injury and a herniated cervical disc. However, diagnostic studies, as well as physical

examinations, fail to demonstrate a disabling impairment. Nerve conduction studies, a doppler

venous sonogram of the lower extremities, left and right tibia/fibula x-rays, a bone scan, a CT

scan of Huff’s brain and an x-ray of her left shoulder were all normal (AR 217, 219-222). Dr.

Proy, her treating physician, was unable to find any physical findings that correlated to her

subjective complaints (AR 180). Huff’s most recent physical therapist noted that her signs and

symptoms were inconsistent with her diagnosis, and her functional movement pattern did not

coincide with ROM limitations and functional limitations and impairments (AR 233). 

Treatment notes during the relevant time frame show that while Huff experienced some

decreased neck range of motion, no spasm, swelling, or tenderness was noted, and she

consistently exhibited a normal strength in her upper and lower extremities (AR 326, 329, 332,

335, 337-339, 343). During the consultative examination with Dr. Helgert, although her gait was

stiff and slow, she was able to walk on her heels and toes and move about the exam room (AR

252). Moreover, she represented on several occasions that her medications were controlling her

pain (AR 325, 331). Finally, any objective findings of Huff’s various physician’s were consistent

with the physical limitations credited by the ALJ based upon his review of the evidence. He

restricted Huff to positions which were sedentary, that required no more than 45 degrees bending,

and only required the use of the left dominant hand as a helping hand (AR 20). 

Huff appears to suggest that the ALJ erred in rejecting Dr. Helgert’s opinion that she was

unemployable. Dr. Helgert was a consulting physician, having examined Huff at the request of

the Commissioner. The treating physician rule does not apply to a consulting physician’s

opinion. Mason v. Shalala, 994 F.2d 1058, 1067 (3rd Cir. 1993) (doctrine had no application to

physician who examined claimant once). Nonetheless, the Commissioner’s regulations do

acknowledge that, as a general principal, opinions from examining sources are given more

weight than opinions from non-examining sources. See 20 C.F.R. 416.927(d)(1). The

Case 1:04-cv-00364-SJM Document 17 Filed 12/08/05 Page 14 of 17
15

regulations do not require however, that in every case, an examining physician’s medical opinion

must be favored over that of a non-examining physician. Instead, the Commissioner must

consider a number of competing factors, such as the extent to which there is a treating

relationship, the extent to which the opinion is supported by a logical explanation, the degree of

the medical source’s specialization in a relevant field, and the extent to which the source’s

opinion is consistent with the entirety of the evidence. See generally 20 C.F.R. § 416.927(d)(1)-

(6).

We find that the ALJ evaluated Dr. Helgert’s opinion consistent with the above standards.

The ALJ considered Dr. Helgert’s reported findings based upon his physical examination of

Huff, and concluded that his opinion was based on Huff’s subjective complaints, as well as the

fact that her limitations involved a “significant emotional component” (AR 19, 252). The ALJ

further pointed to Dr. Proy’s examination of Huff, wherein he was unable to find any physical

findings that correlated with her subjective complaints (AR 19). The ALJ declined to place

significant weight on Dr. Helgert’s opinion since it was inconsistent with the objective medical

evidence. Moreover, we observe that Dr. Helgert also opined that it was, in fact, premature to

consider Huff disabled (AR 252). We therefore find no error in this regard.

To the extent Huff argues that Ms. Pifer’s opinion that Huff was temporarily disabled is

also entitled to controlling weight, we disagree. Ms. Pifer, as a physicians’ assistant, is not an

“acceptable medical source” whose opinion is entitled to controlling weight. See 20 C.F.R. §

416.913(a); see also Hartranft v. Apfel, 181 F.3d 358, 361 (3rd Cir. 1999) (holding chiropractor’s

opinion not entitled to controlling weight under treating physician rule). Furthermore, we

observe that her opinion is devoid of any specific work functions Huff is incapable of

performing. Accordingly, her opinion was entitled to little weight and lends no support to Huff’s

argument. 

We reach the same conclusion with respect to Huff’s mental impairments. The ALJ

concluded that her functional limitations as supported by the evidence established only mild

restrictions in her activities of daily living, moderate limitations in maintaining social functioning

and maintaining concentration, persistence or pace, and no episodes of decompensation of

extended duration (AR 20). Again, we find no error in this regard. Dr. Prabhu, Huff’s treating

Case 1:04-cv-00364-SJM Document 17 Filed 12/08/05 Page 15 of 17
2Huff cites to Akers v. Callahan, 997 F. Supp. 648 (W.D.Pa. 1998), as determinative of

her claim for benefits. In Akers, the ALJ’s decision was “completely infested with misjudgment,

mischaracterization of testimony, disregard of competent and largely uncontradicted medical

evidence, and wholly lack[ed] substantial evidence to support the denial of benefits,” in the face

of a record that offered “compelling” support for the claimant’s disability based upon a

combination of impairments. Id. at p. 661. The ALJ’s decision in this case does not suffer from

the same infirmities. 

16

psychiatrist, found only moderate symptoms on initial evaluation in September 2002 (AR 236). 

Treatment notes reveal that her symptoms were well managed with medication (AR 236-237). 

When examined by Dr. Zelazowski, she reported her mood as “not too bad”, and although her

affect was somewhat constricted, it was appropriate to the thought content and situation (AR

255). She was capable of abstract thinking, her memory processes were grossly intact, and she

exhibited adequate social judgment (AR 256). There was no evidence of formal thought

disorder, hallucinations, delusions, depersonalization, derealizations, obsessions or compulsive

behavior (AR 255). Recent treatment notes from Dr. Balmer show that she consistently denied

suffering from either depression or anxiety during her visits (AR 325, 331, 334, 338). Finally,

we note that there is no medical opinion from any treating psychiatrist or consulting psychologist 

that indicates she is unable to work due to her mental impairments. In any event, the ALJ

incorporated any limitations with respect to Huff’s mental impairments when he concluded that 

she was limited to jobs involving simple instructions, and avoiding interaction with the general

public, close interaction with co-workers, changes in the work setting, and travel to unfamiliar

places (AR 20).2 

IV. CONCLUSION

Based upon the foregoing reasons, the Commissioner’s final decision will be affirmed. 

An appropriate Order follows. 

 

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17

IN THE UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF PENNSYLVANIA

SHIRLEY C. HUFF, )

)

Plaintiff, )

) Civil Action No. 04-364 Erie

)

v. )

)

JO ANNE BARNHART, )

Commissioner of Social Security, )

)

Defendant. )

ORDER

AND NOW, this 8th day of December, 2005, and for the reasons set forth in the

accompanying Memorandum Opinion, 

IT IS HEREBY ORDERED that the Plaintiff’s Motion for Summary Judgment [Doc. No.

11] is DENIED, and the Defendant’s Motion for Summary Judgment [Doc. No. 15] is

GRANTED. JUDGMENT is hereby entered in favor of Defendant, Jo Anne B. Barnhart,

Commissioner of Social Security, and against Plaintiff, Shirley C. Huff. The clerk is directed to

mark the case closed. 

s/ Sean J. McLaughlin

United States District Judge

cm: All parties of record. 

 

 

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