administrative hearing should be taken into account when determining whether findings are
supported by substantial evidence; then, we will address each of her remaining Step 3 arguments,
in turn.

A.

Ms, Pera contends that this Court should consider new evidence submitted after the
administrative hearing when determining whether the ALJ’s findings are supported by substantial
evidence, Specifically, Ms. Pera alleges thal a short note from Dr. Tonino (R. 208) indicating that
she was limited to lifting less than five pounds overhead, and should avoid repetitive tasks with
either arm supports her subjective complaints of pain and limitation in both arms, and must be taken
into account when determining whether the ALJ’s decision at Step 3 is supported by substantial
evidence.

The relevant regulation for Ms. Pera’s argument is 20 C.F.R. § 404.970(b). This regulation
provides:

If new and material evidence is submitted, the Appeals Council shall consider

additional evidence only where it relates to the period on or before the date of the

administrative law judge hearing. The Appeals Council shall cvaluate the entire
record, including the new and material evidence submitted if it relates to the period

onor before the date of the administrative law judge’s action, findings, or conclusion

is contrary to the weight of the evidence currently of record.

The Court’s review of whether the Appeals Council made an error of law in applying this
regulation is de nove. See Eads v. Sec'y of Health and Human Services, 983 F.2d 815, 817 (7" Cir.

1993). Unless there is an error of law, the Council’s decision whcther to review is discretionary and

unreviewable. See Damato vy, Sullivan, 945 F.2d 982, 988 (7" Cir. 1992). Where the Council’s



from her waist to above her head; occasionally lift 40 pounds from the floor to her knuckle;
occasionally carry 30 pounds with both hands; frequently carry 15 pounds with both hands;
occasionally push 27 pounds with both hands; frequently push 20 pounds with both hands;
occasionally pull less than 20 pounds with both hands; and frequently pull less than 17 pounds with
both hands (R. 63). In addition, the individual could frequently bend, squat, climb, stoop, and reach
aceasionally (/d.). Additionally, the individual could sit, stand, or walk seven to eight hours per day.
And, there were no restrictions on the use of either hand (/d.).

In response, the VE testified that such an individual could not do work as a bottle warchouse
worker (R. 63), but could perform the work of a receptionist described by Ms. Pera as a part of her
past work experience (R. 63-67). The VE stated that there are approximately 8,000 receptionist jobs
regionally in the receptionist category (R. 64). The VE noted that these jobs are categorized as
sedentary, semi-skilled and that the prior receptionist work described by Ms. Pera would be
categorized as sedentary and unskilled work (/d.).

The VE was thon questioned by Ms. Pera’s attorney. Ms. Pcra’s attorney first asked the VE
how many unskilled receptionist jobs were available regionally (R, 64), The V E answered that she
would estimate 2000 to 3000 such jobs existed regionally (R. 64-65). Ms. Pera’s attorney then asked
the VE to consider someone whose inability to keep her arm in any one position would force her to
use her other arm 99 percent of the time (R, 65). Such a person would have effectively only one
functional arm (/d.). The VE said that no receptionist jobs would exist for an individual with those

limitations (/d.).

13



unable to lifta gallon of midk with her left arm. These limitations are contradicted by the functional
capacity lest performed on December 1, 1999 (R. 202)(Ex. 10F), Ms. Pera demonstrated an ability
to do light to medium work, including occasionally lifting 10 pounds from waist to overhead and
frequently lifting five pounds from waist to overhead (/d.). In addition, the functional capacity test
indicated (hat Ms. Pera was capable of occasional reaching and had no restrictions on the usc of
either hand (Jd.), Additionally, Ms. Pera’s treating physician found that Ms. Pera had a “full range
of motion” and that her “strength is equal bilaterally” (R. 161) (Ex. 2F),

Ms. Pera also testified that her left arm hurt all the time, even when it was resting at her side,
and that medication did not help the pain (R. 55-56). These statements are inconsistent with Ms.
Pera’s statements to Dr. Tonino on March 9, 2000. At this examination, Ms. Pera stated that she was
feeling betler, and Dr. Tonino indicated that Ms, Pera was a good candidate for home therapy and
should continue to see him on an “as needed basis” (R. 161). Accordingly, he rcleased Ms. Pera to
work within the limitations of her residual functional capacity exam (Id).

The ALJ also wrote that he “carefully scrutinized the record for a treating physician’s
opinion, including hard to find evidence .. . [such as] a check mark on a form indicating that the
claimant was disabled(,]” but found no cvidence that a physician had indicated that Ms, Pera “was
unable to work for 12 continuous months” (R. 18). Thus, although Ms. Pera’s subjective complaints
indicate that she cannot work, the AL] found nothing in the medical record supporting her complaint.
These medical records are substantial and detail Ms. Pera’s lengthy patient-doctor relationship with
Dr. Tonino, examinations by Dr. Bertolini, and examination of the medical records by a reviewing
physician. Despite this wealth of medical evidence, nothing in the record supports a finding that Ms.

Pera’s pain and limitation is as severe as she claims. In fact, on March 9, 2000, her last medical

23


out a tear if her condition did not improve with therapy. A re-examination was ordered for three
weeks later (/d.).

On July 6, 1998, Ms. Pera again visited Dr. Bertolini (R. 194). At this time, her left shoulder
was quite sore, and she did not think that therapy was helping (/d.). Dr. Bertolini’s examination
revealed that Ms. Pera could abduct to 120 degrees (/d.), At 90 degrees, resisted abduction was
painful but did not give way (/d.). Impingement sign was positive and there was a definite click in
the shoulder during the test (/d.). Additionally, Ms. Pera’s internal rotation was limited (/d.).

Dr. Bertolini’s impression after this examination was that there was probably a partial tear
of the rotator cuff tendon in the left shoulder (R, 194), Based on this impression, Dr. Bertolini
recommended an injection to the bursa (/d.). However, Ms. Pera refused the injection because she
is afraid of needles (/d.). Dr. Bertolini then suggested that she continue taking Relafen and
continuing light duties and physical therapy (/d.). Dr. Bertolini also ordered an MRI scan for Ms.
Pera and scheduled another visit in two weeks to check her progress and the results of the MRT scan
(7d.).

On July 20, 1998, Ms. Pera was re-examined by Dr. Bertolini (R. 194). During this visit, Ms.
Pera indicated that she was feeling better after doing her therapy and had not even taken Relafen for
two wecks (/d.). Dr. Bertolini’s examination revealed that Ms. Pera has abduction to 130 degrees,
flexion to 120 degrees, and resisted abduction with grade four out of five strength without much pain
and impingement sign that is only slightly positive (/d.). Ms. Pera’s MRI scan did not reveal any
rotator cuff tear or any other pathology (/d.). Dr. Bertolini's impression after this exam was that Ms.
Pera most likcly sprained her rotator cuff and that the sprained rotator cuff was healing better than

he expected (/d.), Accordingly, Dr. Bertolini told Ms. Pera to continue therapy for another three



decision is unreviewable, the ALJ’s decision is the final decision reviewed under 20 C.F.R. § 405(g).
See also Perkins v. Chater, 107 F.3d 1290, 1294 (7" Cir. 1997).

To the extent that Ms. Pera argues that the Council erred in its application of Section
404,970(b), that argument is without merit. ‘The Council considered the new evidence submitted by
Ms. Pera: a short note from Dr. Tonino dated September 20, 2000, which was after the evidentiary
hearing held on August 10, 2000 and afler the ALJ’s written decision of August 17, 2000. The
Council observed that “a portion of the [new] medical evidence is a duplicate ofevidence in Exhibits
7F and 10F” (R. 7) (compare Exs. 7F and 10K and AC-2), And, we note, to the extent it added new
restrictions, the note did so without offering any accompanying cxplanation. Upon its review, the
Council concluded “that neither the contentions [of Ms. Pera concerning the evidence presented to
the ALJ} nor the additional evidence provides a basis for changing the [ALJ's] decision” (R. 7-8).
Since the Council considered the new evidence presented by Ms. Pera, and we find no error of law
in the way that it did so, this Court will not review the Council’s diserctionary decision denying
review of the ALJ’s decision. Perkins, 107 F.3d at 1294.

Equally unavailing is Ms. Pera’s argument that this Court should assess the ALJ's
determination in light of the new evidence thal never was presented to the ALJ. Although Ms. Pera
argues that decisions from other courts of appeals “support the notion that the substantial evidence
review ... [should not be] limited to the record before the ALJ[,]” (PI.’s Reply at 4-5), the Seventh
Circuit’s decision in Lads squarely forecloses that argument. In £ads, the Seventh Circuit explained
that when the Appeals Council has refused to review the case, “the decision reviewed in the courts
is the decision of the administrative law judge .... The correctness of that decision depends on the

evidence that was before him... He cannot be faulted for having failed to weigh evidence never

20



3,000 in this region (R. 64-65).? The Court finds that the VE’s testimony is a sufficient basis upon
which the ALJ could base his determination that Ms. Pera could perform her past relevant work at
Step 4,

A conclusion at Step 4 that the claimant can perform her past relevant work and that such
work exists in substantial numbers in the regional economy ends the disabilily inquiry. Young v.
See’y of Health and Human Services, 957 F.2d 386, 389 (7th Cir. 1992) (an answer at Step 4 that
indicates that the claimant is able to perform her past relevant work precludes a finding of disability).
Ms. Pera, however, secks to create a Step 5 issue by arguing that substantial evidence does not
support the ALJ’s Step 4 finding, and that there is not substantial evidence in the record to support
a finding a Step 5 that Ms. Pera has the RFC to preform any work in the regional economy (R. 10-
11). Ms. Pera also argues that the social security rules “mandate” a finding of disability if the
“[c]laimant is of advanced age, .. . no longer can perform past relevant work and has limitations .. .
tegarding [a] functional restriction to light work” such as the inability to cngage in repetitive motion
with cither arm (PI.’s Mem. at 11) (citing 20 CF.R. Pt. 404, Subpt. P § 202.00C (“SSR 202.00C”).
According to Ms. Pera, SSR 202.00C “states that disability is warranted when the range of either
light or sedentary work is reduced due to limitations of movement concerning the upper extremities”
(R. 11).

But, Ms, Pera’s contention that she has limitations on repetitive motion with cither arm is
nol supported by the medical evidence. All of her medical consultations and treatment focused on

her /eft arm problem. As stated above, there is no medical evidence — other than the unexplained

*A “substantial number” of jobs has been interpreted by courts within this Circuit as numbers far less than the
2-3,000 jobs cited by the VE in this case. See, e.g., Hawkins v. Rarnhart, No. 02 C 2097, 2003 WL 1717076, * 9 (N.D.
TH 2003).

26



even though they were corroborated by Dr. Tonino’s records. In his opinion, the ALJ wrote, “[t]he
record docs not show underlying medically determinable impairments, which could reasonably cause
(Ms. Pera’s] alleged pain and other symptoms” (R. 19), Because he did not find Ms. Pera “fully
credible,” the ALJ discounted her subjective complaints of pain (R. 18).

Ms. Pera’s argument that the ALJ ignored her subjective claims of pain and limitation in her
left arm relies, in part, on the cxamination conducted by Dr. Tonino after Ms. Pera’s ALJ hearing,
However, as we discussed above, this evidence is not reviewable. Since evidence submitted after
the administrative hearing is not reviewable, we must decide whether, absent the new cvidence, the
ALJ's finding about the credibility of Ms. Pera’s subjective claims is supported by substantial
evidence.

The ALJ found Ms. Pera “not fully credible” because her complaints about her restrictions
were “not reasonably consistent with the medical or other evidence” (R. 18). Had the ALJ rested
his determination of Ms, Pera’s credibility only on this statement, the Court would remand for
clarification of the ALJ’s reasoning. See generally Zurawski, 245 F.3d at 887 (lower court’s decision
to deny benefits remanded in order for ALJ to explain why the ALJ concluded claimant’s testimony
was “inconsistent”). However, here the ALJ sufficiently — albeit succinctly — explained his
credibility determination.

The ALJ explaincd that Ms. Pera’s “reported daily activities, the location, duration,
frequency, and intensity of the symptoms; precipitating and aggravating factors; medications, and
side effects and other factors conceming functional limitations were not reasonably consistent with
the medical... evidence” (R. 18). The daily activities Ms. Pera reported included limitations such

as being only able to dust or fold clothes, being unable to open a jar with her left arm, and being

22



evidence as a reasonable mind might accept as adequate to support a conclusion." Herron, 19 F.3d
at 333 (quotations omitted), Where conflicting evidence allows reasonable minds to differ, the
responsibility for determining whether a claimant is disabled falls upon the Commissioner (or the
ALJ), not the courts. See Herr v. Sullivan, 912 F.2d 178, 181 (7th Cir. 1990). See alse Stuckey v.
Sullivan, 881 F.2d 506, 509 (7th Cir.1989) (the ALJ has the authority to assess medical evidence and
give greater weight to that which the ALJ finds more credible). The Court is limited to determining
whether the Commissioner's final decision is supported by substantial evidence and based upon
proper legal criteria. Ehrhart v. Sec’y of Health and Human Services, 969 F.2d 334, 538 (7th Cir.
1992), A finding may be supported by substantial evidence cven if a reviewing court might have
reached a different conclusion. See Delgado v. Rowen, 782 F.2d 79, 83 (7th Cir.1986) (per curium).

Of course, the Commissioner (or ALJ) is not entitled to unlimited judicial deference. The
ALJ must consider all relevant evidence and may not select and discuss only that evidence which
favors his or her ultimate conclusion. See Herron, 19 F.3d at 333. Although the ALJ need not
evaluate in writing every piece of evidence in the record, the ALJ's analysis must be articulated at
some minimal level and must state the reasons for accepting or rejecting "entire lines of evidence."
dd. See also Young, 957 F.2d at 393 (ALJ must articulate reason for rejecting evidence "within
reasonable limits" if there is to be meaningful appellate review); Guercio v. Shalala, No. 93 C 323,
1994 WL 66102, at *9 (N.D. Ill. March 3, 1994) (ALJ need not spell out every step in reasoning,
provided the ALJ has given sufficient direction (hat the full course of the decision may be discerned)
(citing Brown v. Bowen, 847 F.2d 342, 346 (7th Cir, 1988)), The written decision must provide a
“logical bridge from the evidence to [the] conclusion" that allows the reviewing court a "glimpse into

the reasoning behind [the] decision to deny benefits.” See, e.g., Zurawski v. Halter, 245 F.3d 881,

17



she needed to discuss the matter with her employer or seek legal advice (/d.). Instead of pursuing
the surgery at this time, however, Dr. Bertolini advised Ms. Pera to continue therapy for another iwo
weeks to further strengthen her shoulder (/d.). He also indicated that, at the end of the two weeks,
especially if there was no improvement, they should make a definitive decision on treatment (R.
198).

On November 16, 1998, Dr. Pietro Tonino (“Dr. Tonino”), an orthopedist, saw Ms. Pera for
complaints of a “tearing sensation” in her left shoulder (R. 17) (Ex. 6F), Dr. Tonino reported that
the MRI scan that was taken of Ms. Pera’s left shoulder was “unremarkable,” and the pain injections
failed to “abate her symptoms” of pain (although there were no symptoms of numbness or instability)
(/d.). Dr. Tonino reported that Ms. Pera tried to return to work after her accident, but stopped again
due to pain. Dr. Toning recommended surgery based on x-rays which showed subacromial spur and
degenerative changes. Dr. Tonino opined that although the “September 30" injury was clinically
insignificant” because the spur probably “predated her injury,” that mjury aggravated the spur (R.
17).

In December 1998, Dr. Bertolini performed the surgery recommended by Dr. Tonino, a
resection of the lefi distal clavicle and anterior acromioplasty of the left shoulder at St. Joseph
Medical Center (R. 17) (Ex. 9F), The postoperative diagnosis was impingement syndrome and
osteoarthritis of the acromioclavicular joint in the left shoulder.

In June 1999, after the surgery, Ms. Pera complained of continued left shoulder pain to Dr.
Tonino (R, 17) (Ex. 7F). Dr. Tonino’s impression was that Ms. Pera suffered from a subacromial
spur, which required arthroscopy and decompression. Based on this diagnosis, Ms, Pera underwent

arthroscopy on September 8, 1999, which revealed a partial thickness lear of the rotator cuff (R. 17,



Additionally, Ms. Pera was tender and spastic over the left trapezius and paraspinal muscles (Jd.).
Ms. Pera’s neck had a full range of motion with pain on extremes of rotation, especially to the left
(d.). Dr. Bertolini obtained an x-ray of Ms. Pera’s cervical spine (/d.). The x-ray showed no disc
narrowing. However, it did show reversal of the cervical lordosis consistent with spasm (/d.).

Dr. Bertolini’s impression was that (1) Ms. Pera’s teft shoulder was about the same with
continued impingement syndrome aggravated by repetitive occupational trauma; and (2) there was
cervical tension possibly from the same cause (R. 195), Accordingly, Dr. Bertolini recommended
more physical therapy, and started Ms. Pera on 10 mg of Flexeril every six hours as needed for
muscle spasm (/d.). Dr. Bertolini also continued Ms. Pera on Relafen (/d.). Because there were
“apparently no light job duties” available to Ms. Pera at her job, Dr. Bertolini took Ms. Pera off work
for two weeks to allow her shoulder to rest (/d.). He also ordered a re-examination in two weeks to
determine if Ms. Pera’s condition had improved enough for her to retum to work (dd.).

During an examination on September 11, 1998, Ms. Pera told Dr. Bertolini that her left
shoulder was feeling better as time passed, although it still gave her some pain anteriorly (R. 196).
Dr. Bertolini’s examination revealed a full range of motion and “just a click with resisted abduction”
(/d.). Ms. Pera’s impingement sign was now negative and her resisted abduction grade was 5 out
of 5 (id.). Dr. Bertolini also noted that Ms. Pera’s therapist reported grade 5 out of 5 strength on all
motions except horizontal adduction, which was grade 4 out of 5.

Dr. Bertolini’s impression was that Ms. Pera’s left shoulder had improved, but had not
completely healed (R. 196). He also told her that he thought she could avoid surgery (/d.). Ms. Pera
indicated that she fell pressured to return to full dutics at work (/d.). Dr. Bertolini said he understood

the pressurc because treatment was costly, but felt that the conservative course of treatment was in



weeks to further strengthen her shoulder (/d.). A rc-cxamination was ordered for three weeks to
check on Ms, Pera’s progress, but Dr. Bertolini told Ms. Pera she had a good chance of healing (/d.).

On August 10, 1998, Ms. Pera again was examined by Dr. Bertolini (R. 195). At this visit,
Ms. Pera reported that since she started taking Relafen, her shoulder was gradually feeling better
(Ud). She also reported that the physical therapy “really helps” (/d.). However, Ms. Pera also
reported that her employers were having her do too much at work and that she felt like she was
“going around in circles” (/d.). Dr. Bertolimi’s examination revealed a full range of motion in Ms.
Pera’s left shoulder (/d.). Ms. Pera was, however, tender at the rotator cuff insertion (/d.). Resisted
abduction was grade four out of five, and resisted flexion was grade 4+ out of 5, Impingement sign
was slightly positive (/d.), Dr. Bortolini’s impression was that Ms. Pera was gradually improving
with therapy (/d.). Accordingly, Dr. Bertolini had Ms. Pera continue therapy and renewed her light
duties (/d.). He also indicated that he would remind Ms, Pera’s cmployer that Ms. Pera should not
do any overhead lifting or reaching and no lifting of 15 pounds in general (/d.), Dr. Bertolini told
Ms. Pera to continue to take Relafen regularly and to return for a re-examination in two weeks (/d.).

On August 26, 1998, Ms, Pera was examined again by Dr. Bertolini and he reported that she
was having increased pain in her left shoulder and in the left side of her neck (R. 195). Ms. Pera said
that repetitively reaching for bottles at work seemed to be aggravating her condition (/@.). Dr.
Bertolini told Ms. Pera that he had specifically recommended light duties with no reaching (/d.).
However, Ms. Pera said she had to follow instructions at her job and that she felt she needed a rest
from her work to help her heal (/d.). Dr. Bertolini’s cxamination revealed that Ms. Pera’s left
shoulder was tender at the rotator cuff insertion, and that she had a full range of motion (/d.).

However, resisted abduction was painful at the shoulder and also over the left side of her neck (/d.).



887, 889 (7th Cir, 2001) (quoting Clifford v. Apfel, 227 F.3d 863, 872 (7th Cir, 2000)). This is
especially true regarding credibility determinations, since both the case law and the regulations
require an ALJ to minimally articulate the specific reasons for the credibility finding. Zurawski, 245
F.3d at 887. Specific reasons are required so that the revicwing Court can ultimately assess whether
the ALJ's determination was supported by substantial evidence or, if not, was "patently wrong." /d.
(quoting Powers v, Apfel, 207 F.3d 431, 435 (7th Cir. 2000)).

Ms. Pera challenges ihe ALJ’s findings at Steps 3, 4 and 5 of the sequential analysis. We
begin or analysis with Step 3.

Iv.

As indicated above, a Step 3 finding requires the ALJ to determine whether the claimant’s
limitations (which were found severe at step two) mect or equal a listed disability found within 20
C.F.R. Part 404, Appendix 1, Subpt. P. At this step, the burden of proof rests with the plaintiff who
must show (hat her impairments meet or equal any impairment listed in the regulations as being so
severe as to preclude substantial gainful activity. See Young v. Secretary of Health and Human
Services, 957 F.2d at 389,

Ms. Pera challenges the ALJ’s findings on several grounds. First, Ms. Pera contends that the
ALJ, despite corroborating medical evidence, ignored her testimony including left arm pain and
limitation (Pls Mem. at 8). Second, Ms. Pera contends that the ALJ ignored uncontroverted
evidence of her subjective complaints of pain and limitations in her right arm (PI.’s Mem. at 9).
Third, Ms. Pera argues that new evidence submitted after her ALJ hearing should be considered
when assessing whether the ALJ’s decision is supported by substantial evidence (P1.’s Reply at 4-5),

We will begin by addressing Ms. Pera’s final argument, that new evidence submitted after an

18



she felt it would only offer temporary relief (R. 196-97), Because there was no sign of impingement
on the exam, Dr. Bertolini did a block of the AC (R. 197). Ten minutes after the injection, Ms. Pcra
was completely relieved of shoulder pain, and resisted abduction no longer caused a burning pain
down her arm (/d.). Dr. Bertolini told Ms. Pera that her pain is more [rom the AC joint than the
subacromial joint space, and thal he felt a lot of the pain was from her neck (/d.). He then ordered
an MRI scan of the neck to rule out bulging al C5-6 (/d.). In addition, he told her to resume physical
therapy, especially for her neck and AC joint. Because there were no light job duties available, he
told her to stay off work (/d.).

On October 16, 1998, Ms. Pera returned to Dr. Bertolini and reported that her left shoulder
was about the same and that her neck had been sorc, mostly on the lefl side (/¢.). Dr. Bertolini’s
examination revealed that Ms. Pera’s lefi shoulder had tendemess over the AC joint (/d.). Ms. Pera
also had a full range of motion; resisted abduction was grade 5 out of 5; resisted adduction was
grade 4 out of 5; and resisted rotation was grade 4 out of 5 (/d.). Ms. Pera expericneed neck pain
on extremes of motion, and the MRI scan of her neck showed mild bulging disc at C5-6 and C6-7
(R. 197, 199) (Ex. 8F). However, the MRI revealed no foramina stenosis nor lateral recess
narrowing (R. 197, 199) (Ex. 8F).

Dr. Bertolini’s impression was that, although Ms. Pera had continued pain from the AC joint,
her left shoulder was about the same and that her rotator cuff was getling stronger. He also
diagnosed degenerative disc disease C5-6 and C6-7 with mild bulging discs at those levels (R. 197)
Based on thesc findings, Dr. Bertolini recommended a resection of the distal clavicle (/d.). However,
Ms. Pera indicated that there were problems with having her new insurance plan cover the surgery

(d.). Dr. Bertolini said it was not a new injury; that it should be covered under he old plan; and that



examination before the administrative hearing in June 2000, Ms. Pera’s treating physician, Dr.
Tonino, released her to work within hcr RFC restrictions (R. 161), In addition, he noted that at the
time of the visit, although Ms. Pera had not been able to work, “her shoulder has actually been
fecling better” (/d.). And, Dr, Tonino’s work capacity assessment of Ms. Pera were then affirmed
by a reviewing physician in a residual functional capacity exam, completed on April 25, 2000 (R.
170-77) (Ex. 3F).

Unless patently wrong, an ALJ’s credibility determination will not be overtumed. Zurawski,
245 F.3d at 887. “Tt is not patently wrong for an ALJ to cite inconsistent testimony between the
degree of pain that the claimant reports and that suggested by the medical evidence in his credibility
determination.” Powers v. Apfel, 207 F.3d 431, 435-436 (7" Cir. 2000). See also Knight v. Chater,
55 F.3d 309, 314 (7" Cir, 1995)(“[aJn ALJ may discount subjective complaints of pain that are
inconsistent with the evidence as a whole”). As the cvidence noted above indicates, there is an
inconsistency between the amount of pain and the type of pain that Ms. Pera claims and the medical
evidence. Thus, the ALJ’s finding on the credibility of Ms. Pera’s limitations is not patently wrong.
For this reason, we find that the ALI’s credibility findings regarding Ms. Pera’s subjective claims
of pain and left arm limitations are supported by substantial evidence.

2.

Ms. Pera also contends that the ALJ impermissibly ignored her subjective claims of pain her
right arm. This argument, like thc argument discussed above, rests on both the cxamination
conducted after the hearing and on the ALJ’s determination about Ms. Pera’s credibility. The
evidence submitted afler the administrative hearing is not reviewable lor the reasons discussed

above, However, cven if the evidence were reviewed, it offers scant support for Ms. Pera’s claims

24



| a

Al United States District Court, Northern District of Tlinois
Name of Assigned Judge idney Sitting Judge if Other
aoe Magistvate Judge Sidney 1. Schenkier than Assigned Judge
CASE NUMBER 02 C4759 DATE 6/19/2003
CASE Nancy Pera vs. Jo Anne Barnhart
TITLE

[In the following box (a) indicate the party fling the motion, ¢.g., plaintitt, defendant, 3rd party plaintitY, and (b) state brielly the nature
of the tolivn being presented. ]

MOTIO:

DOCKET ENTRY:

qd) o Filed motion of [ use listing in “Motion” box above.]
(2) o Brief in support of motion due
(3) go Answer brief to motion due___._ Reply to answer bricf duc
(4) Oo Ruling/Hearing on setfor al
(3) oO Status hearing(held/continued to) (set for/re-set for]on___sset for at
(6) Oo Pretrial conference[held/continued to [sct for/re-set for|on___——scl for at
(7) Oo Trial[set for/re-set for] on at
(8) oO [Bench/Jury trial] [Hearing] held/continuedto at
a

This case is dismissed | with/without] prejudice and without costs|by/agrcement/pursuant to]
OFRcP4(m) O Local Rule 41.1 OFRCP41(ay(1) OO FRCP41(a)(2).

ao if [Other docket entry) ENTER MEMORANDUM OPINION AND ORDER. ‘The Court grants the
Commissioncr’s motion for summary judgment |doc. # 17], and denies Ms, Pera's motion for summary
judgment [doc. # 15]. The Clerk of the Court is directed to cntcr a final judgment pursuant to Rule 58.
This case is terminated.

ab ff [For further detail see order attached to the original minute order.

No notices required, advised in open court Document
Number

No notices required. ber of poli

SUN 2 0 2063

dave docketad

oY | Notices mailed by judge’s staff.

Notitied counsel by telephone,

Doeketing to mui! notices. :

Mail AO 450 form.
het epndy tis

any judgegtset jue Lunda tosrieta gin
weno
courtroom ig BLUE date mailed mptice
UK | seputy's Cis kd blk tu om
initials
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could not perform unrestricted work, particularly repetilive activities (fd.). Dr. Tonino concluded
that Ms. Pcra should be scen on an “as needed” basis (Jc).

In March 2000, Dr. Tonino relcased her for work with the restrictions he marked on the
functional capacity evaluation (Exs. 2F, at 4; 10F). Dr. Tonino indicated that Ms. Pera had a light
to medium residual functional capacity, in spite of her injuries (R. 18; Ex. 10F).

On April 25, 2000, Dr. Gerald Coffman (“Dr. Coffman”), a state agency physician, reviewed
Ms. Pera’s medical records (R. 170-77). Dr. Coffman noted that after the surgery in September
1999, Ms. Pera had a full range of motion and bilaterally equal strength (R. 177). Dr. Coffinan
concluded that Ms. Pera was capable of working within the restrictions of the functional capacity
found by Dr. Tonino, which limited her to no repetitive activities involving overhead lifling or
repetitive lifting of more than 25 pounds (/d.).

Cc.

On August 10, 2000, the ALJ held an Administrative Hearing (the “hearing”) at which Ms.
Pera, accompanied by her attorney, testified (R. 39-58), as did a Vocational Expert (“VE”) (R. 58-
67).

1,

Ms. Pera testificd that, even with the limitations indicated by the functional capacity exam,
she could not work because of her left shoulder and neck pain (R. 48). Ms. Pera indicated that her
shoulder hurt constantly and nothing, including medication, seemed to help her (R. 48-49, 52-53),
Because medications did not help, Ms. Pera testified that she only occasionally took non-prescription
Aleve or Advil for her pain, and she did not use heat or cold therapics because thesc also had proved

to be ineffective (R. 52-53), Ms. Pera said that her right arm also hurts, but she has never seen a

11



159-60, 164) (Ex. 2F, at 7). On September 27, 1999, Dr. Tonino indicated that Ms. Pera’s therapy
was progressing well (R. 164), About one month later, Dr. Tonino indicated that Ms. Pera could
relum to work the following day, but that she could only perform work with her right arm (R. 191).

On December 1, 1999, Ms. Pera underwent a work capacity evaluation (R. 202). That
evaluation revealed a work tolerance for occasionally lifting forty pounds (floor to knuckle) and
frequently lifling up to twenty pounds (floor to knuckle) (R. 202). It also revealed that Ms. Pera
could lift ten pounds (waist to overhead) occasionally and five pounds (waist to overhead) frequently
(id.). She could also carry thirty pounds occasionally and fifteen pounds frequently, push twenty-
seven pounds occasionally and twenty pounds frequently, and pull twenty pounds occasionally and
seventeen pounds frequently (/d.). Ms. Pera could also perform frequent bending (stooping),
frequent climbing, and frequent squatting, and occasional reaching (/.). Ms. Pera could sit, stand,
and walk for seven to eight hours at a time, as well as seven to eight hours total during the workday
(/d.). Finally, the evaluation revealed that Ms. Pera had no restrictions on the use of her ri ght or left
hand (/d.),

Ina visil to Dr. Tonino on February 15, 2000, Ms. Pera reported that her pain had subsided
some, but that she still experienced discomfort in her cervical spine (R. 163). Dr. Tonino’s
examination revealed that Ms. Pera was tender to palpation over the left upper trapezius and along
the left paracervical musculature (/d.). There was also tendemess to palpation of the left upper
trapezius (/d.). Dr. Tonino noted that Ms. Pera also had some lateral flexion limitation, but suffered
no motor or sensory dysfunction (/d.). Her shoulder range of motion was cqual bilaterally (/d.). Dr.
Tonino indicated that Ms. Pera was a candidate for continuing on a home exercise program and that

she was capable of working within the restrictions of her functional capacity evaluation, but she

10



her best interest (/d.). Although he noted that Ms. Pera’s condition could grow worse with full work
duties, because of her good strength he allowed Ms. Pera to return to full duties (/d.). Ms. Pera was
told to contact Dr, Bertolim within two weeks to report any worsening in her condition, as surgery
then might be required to decompress the subacromial area for the impingement (/d.). Ms. Pera was
told that if her condition remained the same or improved, she should return in four weeks for a check
on her long-term progress (/d.). Ms. Pera was also told to continuc her exercises on her own (dd.).

On September 30, 1998, about two weeks later, Ms. Pera returned to Dr. Bertolini (R. 196).
At that time, Ms, Pera indicated that she was unable to tolerate the dumping portion of her job (/d.).
This dumping required a great deal of repetitive rotation of the shoulder and caused a burning pain
in Ms. Pera’s lefi shoulder and below, as well as to the medial chest wall (/d.). It also occasionally
caused a burning down to Ms, Pera’s left forearm (/d.). Dr. Bertolini’s examination revealed that
Ms. Pera’s left shoulder was still tender over the rotator cuff insertion, although she had a full range
of motion at the shoulder (/d.). Resisted abduction was grade 4+ out of 5 with buming pain radiating
to the anterior proximal humerus, and Ms, Pera was tender over her right trapezius and paraspinal
muscles as well as tender over her right trapezius and paraspinal muscles, as well as tender over het
AC joint (/d.). Impingement sign was completely negative (/d.). Ms. Pera experienced pain upon
neck rotation to the left (/d.). Finally, Ms. Pera’s left arm motor and sensory exam were intact (Jd.).

Dr. Bertolini’s impression at this time was that continued left shoulder pain with no sign of
impingement ruled out pain {rom the AC joint (R. 196). Additionally, cervical tension ruled out a
bulging dise at C5-6 on the left side (/d.). Because it had becn almost six months since the initial
injury, Dr. Bertolini told Ms. Pera that she needed to consider surgery (/d.). He also indicted that

the only other alternative was a cortisone injection; however, Ms. Pera refused the injection because



presented to him. ...” 983 F.2d at 817. The appeals court further stated that evaluating the ALJ’s
decision based on evidence never presented to him improperly “would change our role from that of
a reviewing court to that of an administrative law judge, required to sift and weigh evidence in the
first instance, rather than limited as we are to reviewing evidentiary determinations made by the
front-line factfinder.” fd, at 817-18. In so holding, the Seventh Circuit considered and rejected
contrary conclusions reached by two other circuits. /d. at 818. Accordingly, this Court declines Ms.
Pera’s invitation to ignore clearly controlling Seventh Circuit precedent.’
B.

This Court, is required {o test whether an ALJ’s analysis at least “minimally” discussed and
considered the issue of disability, including evidence that ultimately contradicts the Commissioner’s
final conclusion. See Zurawski v. (alter, 245 F.3d 881, 888 (7" Cir. 2001); Clifford v. Apfel, 227
F.3d 863, 870 (7" Cir, 2001); Green v. Shalala, 204 F.3d 780, 781 (7" Cir. 2000). As many cases
now hold, this analysis must build an “accurate and logical bridge from the evidence to the
conclusion.” Clifford, 227 1.3 at 872.

Ms. Pera contends that the ALJ’s Step 3 analysis failed to satisfy these standards, The Court
disagrees.

1

Ms. Pera contends that the ALJ ignored her subjective claims of pain and Icft arm limitation

despite the fact that they were supported by Dr. Tonino’s diagnosis. Specifically, Ms. Pcra claims

that the ALJ ignored her subjective testimony concerning her pain and limitations in her left arm,

"lhe £ucds court noted that the plaintiff there could have requested a remand so that the administrative law judge
could consider the new evidence, but failed to do su. 983 £.2d at 817. Likewisc, Ms. Pera here has not sought a remand.

21



post-decision note (R. 208) that was not before the ALJ and that we do not consider here — of any
right arm pain or limitations. The Court finds that the ALJ’s Step 4 finding, which was based on
testimony by the VE that expressly took into account the functional restrictions found by Dr. Tonino
and affirmed by Dr. Coffman, ends the disability analysis. ‘hercforc, Ms. Pera’s Step 5 arguments
need not (nor should they) be addressed by the Court.

Accordingly, this Court finds that Ms. Pera is not disabled because the substantial evidence
supports the ALJ’s determination at Step 4 that she can perform her past relevant work as a
receptionist at the unskilled, sedentary level, and that a substantial number of these jobs exist in the
national economy.

CONCLUSION

For the reasons set forth above, the Court grants the Commissioner’s motion for summary
judgment (doe. #17), and denies Ms. Pera’s motion for summary judgment (doc. 415), The Clerk
of the Court is directed to enter a final judgment pursuant to Rule 58, This case is terminated.

ENTER:

HO ZARL.

SIDNEY I. SCHENKIER
United Statés Magistrate Judge

Dated: June 19, 2003

27



Shortly after the accident, in Junc 1998, Ms. Pera began visiting Dr. Bertolini. At this initial
visit, Ms. Pera admitted that she previously had experienced left shoulder pain, but since her injury
at work she had experienced a pain ina different location, from the shoulder to the mid-humerus (R.
193). Thus, reaching above her shoulders or behind her back was especially painful (/@.). Ms. Pera
also admitted that she had previously taken 500 mg. of Relafen for this pre-injury pain, a drug
prescribed by a doctor — Dr, Metrou — who had been referred to her by her employer. The Relafen,
according to Ms. Pera, had “helped a little” (/d.).

Dr, Bertolini’s examination revealed that Ms. Pera’s lefl shoulder was tender at the rotator
cuff tendon insertion, and that resisted abduction was painful (R. 193). Ms. Pera had full abduction
and full rotation, but experienced pain on extremes (/d.). In addition, at the 90 degree position, Ms.
Pera’s left shoulder resisted flexion and resisted abduction were painful but with grade 4 out of 5
strength (/d.). Impingement sign was slightly positive, and Dr. Bertolini could palpate a click in the
subacromial space (/d.). An x-ray taken at this time was negative for fracture. Additionally, the
glenoid humeral joint appeared normal and the AC joint had a normal space with now narrowing,
although there was a small, inferior spur (/d.).

Dr, Bertolini’s impression was that there was impingement syndrome secondary to rotator
cuff sprain and/or partial tear in her left shoulder (R. 193). Based on this impression, Dr. Bertolini
recommended physical therapy to improve her motion and strength, and told Ms. Pera to stay on light
duties at work (/d.). Dr. Bertolini increased Ms. Pera’s Relafen to 750 mg. twice a day, and he told
her that a cortisone shot was indicated (/d.). Ms. Pera refused the injection, and Dr. Bertolini noted

that it could be given later (/d.). Dr. Bertolini also noted that Ms. Pera necded an MRI scan to rule



D.

The AL] issued his decision on August 17, 2000 (R. 14-21). The ALJ applied the standard
five-step sequential evaluation pursuant to 20 C.F.R. §§ 404.1520. Al step one, the ALJ found that
Ms. Pera had not engaged in any substantial gainful activity since May I, 1999 (R. 16). At step two,
the ALJ found that Ms. Pera’s lefl shoulder impingement was a severe impairment (R. 16-17). The
ALJ noted that Ms. Pera’s left shoulder suffered a combination of musculoskeletal impairments,
evidenced by her left shoulder impingement, and (hat these impainnents “significantly limited [Ms.
Pera’s] ability to do physical work-rclated activitics such as heavy or overhead lifting and reaching”
(R. 17). However, at step three of the sequential analysis, the ALJ found that the record does not
establish that Ms. Pera is subject to any impairment or combination of impairments that mect or
medically cqual the specifications of an impairment listed in the Agency regulations (/c.).

In making this determination at step three, the ALJ looked to the record and found that the
medical signs and findings did not support a finding that Ms. Pera’s impairments are severe enough
to prevent her from doing any gainful activity (R. 18). Specifically, the ALJ relied upon Dr.
Tonino’s diagnosis of Ms. Pera in March 2000 and the State Agency reviewing physician's April
2000 opinion (R. 17-18). The ALJ noted that Dr. Tonino, a treating physician, released Ms, Pera for
work with the restrictions of her functional capacity evaluation in March 2000, six months after her
second shoulder surgery (R. 17). In addition, the AI_J also noted the reviewing physician’s findings
that Ms. Pera’s impairments did not meet or cqual a Listed impairment and that she retained the RFC
for, at best, medium work (R. 18). The ALJ recognized that “[s]ymptoms sometimes suggest a
greater scverily of impairment than can be shown by objective medical evidence alone” (R. 18).

However, the ALJ found Ms, Pera “not fully credible" (R. 18). As support for this opinion, he noted

14



423(d)(2)(A). The social security regulations prescribe a sequential five-part test for determining
whether a claimant is disabled. See 20 C.F.R. § 404.1520 (2002). Under this rule, the ALJ must
consider: (1) whether the claimant is presently unemployed; (2) whether the claimant has a severe
impairment or combination of impairments; (3) whether the claimant's impairment meets or equals
any impairment listed in the regulations as being so severe as to preclude substantial gainful activity;
(4) whether the claimant is unable to perform his past relevant work; and (5) whether the claimant
is unable to perform any other work existing in significant numbers in the national economy. See 20
CER. § 404.1520; see also Young v. Sec’y of Health and Human Services, 957 F.2d 386, 389 (7th
Cir. 1992).

A finding of disabilily requires an affirmative answer at cither Step 3 or 5. A negative answer
at any step other than Step 3 precludes a finding of disability. Jd. The claimant bears the burden of
proof at Steps 1 through 4, afler which the burden of proof shifts to the Commissioner at Step 5. /d.
In cases of severe impairment, the ALJ's analysis at Step 4 typically involves an evaluation of the
claimant's residual functional capacity to perform the past relevant employment. See 20 C.F.R. §
404.1520(c). If a person can still do this kind of work, the Commissioner will find that the person
is not disabled. /d. The Step 5 analysis involves an evaluation of the claimant's residual functional
capacity to perform any other work in the national economy (other than the relevant past
employment). See Bowen v. Yuckert, 482 U.S. 137, 142 (1987); 20 C.F.R. § 1520(f).

In reviewing the Commissioner's (here the ALJ's) decision, this Court may not decide facts
anew, reweigh the evidence, or substitute its own judgment for that of the Commissioner. Herron
v. Shalala, 19 F.3d 329, 333 (7th Cir.1994). The Court must accept the findings of fact that are

supported by "substantial evidence," 42 U.S.C. § 405(g) (2002), which is defined as "such relevant

16



heard testimony by Ms. Pera and a vocational expert (“VE”) on August 10, 2000 (R. 14, 39-67), The
ALI issued a written decision on August 17, 2000, denying Ms. Pera’s claim for DIB (R. 14-21).
The SSA Appeals Council, considering new evidence submitted by Ms. Pera’s attorney (‘.e., a note
{rom a treating physician indicating that Ms. Pera was restricted to lifting less than 5 pounds, no
overhead lifting, and no repetitive motion with either arm), denied review of the ALJ’s decision,
thercby rendering the ALJ’s decision the final decision of the Commissioner, subject to judicial
review in this Court (R. 7-8). We now consider Ms, Pera’s claims for review.
IL
The following facts are taken from the administrative record, the administrative hearing
transcript, and the ALJ’s written decision. The Court will discuss the plaintiff's personal and
medical history first, followed by a summary of the administrative hearing testimony and the ALJ’s
written decision.
A.
Ms. Pera was bom on July 2, 1940 and was 60 years old at the time of the ALJ’s decision.
She was thus a person of “advanced age” under the Act (R. 9, 14, 16). She is a high school graduate,
and she has past relevant work experience as a receptionist and a warehouse worker (R. 14, 16, 107,
109, 112). She is right-handed (R. 52).
B.
In April 1998, while working as a warehouse worker, Ms. Pera injured her left shoulder while

reaching to pull an empty case of bottles onto a conveyor belt (R. 17, 193). Ms. Pera visited several

doctors as a result of this accident.



of right arm limitation. There is no other evidence in the record supporting this claim. Ms. Pera
never sought treatment for night arm pain and nothing in the substantial medical record corroborates
a finding that Ms. Pera suffers pain or limitations in her right arm.?

Ms. Pera argues that because her subjective claims are uncontroverted, the ALJ must accept
them. This argument, however, misrepresents the nature of the burden of proof. Here, Ms. Pera
offered no evidence other than her testimony that she suffers right arm pain and limitation. As we
noted earlier, the ALJ found Ms. Pera’s testimony “not fully credible” (R. 18), and instead based his
finding largely on the objective medical evidence in the record. Ms. Pera never sought treatment for
her right arm, or even indicated it was a concem, despite the length and frequency of the treatments
for her lefi shoulder. Because nothing in the medical record supports Ms. Pera’s claims of right ann
pain and right arm limitations, she did not meet her burden of proof. Accordingly, the ATJ’s
findings about Ms. Pera’s credibility are not patently wrong and will not be reversed.

Vv.

We now turn to the ALJ’s Step 4 determination. The ALJ found at Step 4 that Ms. Pera
could perform her past relevant work as areceptionist. The ALJ based this conclusion on testimony
elicited from the vocational expert at the administrative hearing on the relevant regulations (e.g., 20
C.F.R. § 404.1520(c) and § 404.1565). The ALJ stated in his opinion that, based on his hypothetical
regarding Ms. Pera, the VE “testilicd that such a person could return to past relevant unskilled
sedentary work as a receptionist” (R. 19; 63-65) and that the number of unskilled sedentary

receptionist jobs — although fewer than the semi-skilled variety - would be approximately 2,000-

?We note that the reviewing physician's RFC assessment indicates that Ms. Pera “alleges disability due to right
shoulder pain” (emphasis added) (R. 170)(Ex. 13F). This seems to be simply a misstatement on the reviewing
physician's part, since his notes relate to Ms. Pera’s left shoulder surgery and Iefl arm restrictions.

235



DOCKETED

IN THE UNITED STATES DI: IC
U S DISTRICT COURT JUN 9 0 2003

FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

NANCY PERA,

No, 02 C 4759
Magistrate Judge Schenkier

Plaintiff,
vs.

JO ANNE BARNHART, Commissioner
of Social Security,

we Se SS SS SS

Defendant.
MEMORANDUM OPINION AND ORDER
Plaintiff, Nancy J. Pera, seeks judicial review ofa final decision denying her application for
Disability Insurance Benefits (“DIB”) under Title 1] of the Social Security Act (“Act”), 42 U.S.C.
§ 405(g) (R. 7, 14). The parties have filed cross motions for summary judgment; the plaintiff seeks
reversal or remand of the Commissioner’s decision, and the Commissioner seeks a judgment
affirming her decision. Pursuant to 28 U.S.C. § 636(c), and the consent of the parties, the case has
been assigned to this Court for all purposes, including the entry of final judgment (doc. ## 11-13).
For the reasons set forth below, the Court grants the Commissioner’s motion for summary judgment
(doc. # 17), and denics Ms. Pcra’s motion for summary judgment (doc. # 15).
1
On February 29, 2000, Ms. Pera filed an application for DIB, alleging that she had been
disabled since September 30, 1998, duc to musculoskcletal problems of the left upper extremity (R.
14, 89-91). Ms. Pera’s claim was initially denied by the Social Security Administration (“SSA”) by
anotice dated May 4, 2000, and upon reconsideration by a notice dated May 26, 2000 (R. 14, 70-74,

76-78). After a timely request for a hearing, Ms. Pera appeared with counsel before an ALJ, who

X



doctor about the pain (/d.). Ms. Pera also has probloms with her neck and had an MRI examination
performed in October 1998 (R. 55-56).

Ms. Pera testified that she no longer docs much housework. Ms. Pera said that she could dust
and fold clothes (R. 49-50), but she relied on help from her husband and daughter to complete her
other chores (R. 50). For example, as indicated, her husband helped her with the laundry, and her
daughter would visit occasionally to do vacuuming and other cleaning (/d.). Ms, Pera was still able
to dress herself, but her pain prevented her from doing other simple tasks such as opening a jar or
moving a gallon of milk with her lefl arm (R. 52, 54). Additionally, Ms. Pera claimed that her
shoulder injury prevents her from crocheting (R. 52-54). For relaxation, Ms. Pera watches television
and does word puzzles (R. 49).

2

Ms. Hoscith, a vocational rehabilitation counselor, testified as the VE at Ms. Pera’s hearing
(R. 62). The VE began by addressing Ms. Pera’s past work expericnee (/d.), According to the VE,
Ms. Pera’s prior work as a bottle warehouse worker would be classified as heavy, unskilled work.
The VE also noted that Ms, Pera described her past work as areccptionist as requiring skills different
than those typically performed by receptionists in the general economy (R. 64). Typically,
receptionist work is sedentary, semi-skilled work, but Ms. Pera’s description of her previous work
indicated that she worked in a sedentary unskilled position (R. 64-65).

The ALJ asked the VE to answer a hypothetical question based upon Ms. Pera’s age,
education and vocational background (R. 62). In the hypothetical, the ALJ had the VE assume an
individual of Ms. Pcra’s age, with her education and vocational background (/d.) who also had left

shoulder pain (described as a lef shoulder impairment) and was able to occasionally lift 10 pounds

12


that Ms. Pera’s “reported daily activitics, local, duration, frequency, and intensity of the symptoms;
precipitating and aggravating factors; medications and side cffects; and other factors conceming
functional limitations were not reasonably consistent with the medical and other evidence” (R. 18).

Having concluded that Ms. Pera’s impairments were not medically equivalent to any of the
Listings, the ALJ moved to step four. At this step, the ALJ determined that Ms. Pera’s residual
functional capacity (RFC). In so doing, the ALJ determined that “the record does not show
underlying medically determinable impairments which could reasonably cause [Ms. Pera’s] alleged
pain and other symptoms[,]” but that “[Ms. Pera’s impairments caused exertional limitations” (R.
19). The ALJ found that Ms. Pera’s mental status was uncompromised, but that she suffered all the
impairments listed in her work capacity summary, which limited her to light-medium work with only
occasional reaching (R. 19)(Ex. 10F). The ALJ then found that these limitations do not prevent Ms.
Pera from dog some of her past relevant work (/d.). The ALJ found that, consistent with the
opinion expressed by the VE based on Ms, Pera’s limitations as found by Dr. Tonino, Ms. Pera could
not perform her previous work as a warehouse worker, she could return to past “relevant unskilled[,]
sedentary work as a receptionist” (Jd.).

Ti.

In order to establish a "disability" under the Act, a claimant must show an "inability to cngage
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 twelve months." 42 U.S.C. § 423(d)(1)(A)(2002). A claimant
must demonstrate that her impairments prevent her from performing not only his past work, but also

any other work that exists in significant numbers in the national economy. See 42 U.S.C. §

15