Opinion ID: 2979223
Heading Depth: 3
Heading Rank: 1

Heading: Boseley’s Disability Claim

Text: Boseley, a forty-five-year-old truck driver, injured his knees and sustained a partial amputation of his left thumb in a motor vehicle accident on October 31, 2002. In December 2002, he began physical therapy at the referral of his treating physician Dr. Ronald J. French, Jr. On January 27, 2003, French cleared Boseley for “Limited Duty”—work that involved a limited use of his injured hand, no heavy gripping or use of vibrating tools, and allowed for pushing, pulling, or lifting of up to five pounds. French later noted that Boseley still “ha[d] a lot of stiffness in the hand,” exhibited symptoms of reflex sympathetic dystrophy (“RSD”), and “almost” did not use his left hand at all during an appointment in February 2003. Throughout the next several months, French reported “slow progress” with regard to Boseley’s left-hand range of motion. Similarly, Boseley’s own statements demonstrated slow but steady improvement as to both his fine and gross motor skills. In April 2003, he told his physical therapist that he had been unable to pick up a bean. Days later, however, he reported stripping radiators with his son and noted that he could “use [his] hand better.” By the end of the month he was “us[ing] [his left hand] to push a wheelbarrow.” In May, he stated that his hand, while stiff, allowed him to hold a fishing pole. In June, he noted that he could hold pliers, but to use them he had to “switch hands.” Around the same 2 No. 09-6058 Boseley v. Comm’r of Soc. Sec. time, his physical therapist recorded that by then he “was able to use [his left] hand normally to clip the nails on [his] right hand,” and he had “made gains in [range of motion] and strength.” Also in June, French charted improvements in Boseley’s grip strength and range of motion. In July, French reduced Boseley’s physical therapy visits to once a week, although his notes indicated that Boseley “[s]till had a lot of stiffness” and was “unable to make a full fist.” In August, the physical therapist observed that Boseley demonstrated a ten-pound increase in his left-hand grip strength. Boseley reported that he still had “trouble picking up small objects,” but he also acknowledged that he could “hook up a boat a lot easier.” As a result, French concluded that Boseley no longer needed physical therapy, should continue his exercises at home, and recommended that the Functional Capacity Evaluation (“FCE”) be postponed for one or two months “to make sure he has reached his end point in terms of improvement.” French also cleared Boseley for “medium duty” work with a thirty-pound lifting restriction and “limited use of [his left] hand/arm.” French reexamined Boseley in October, at which point Boseley was “able to bring all the fingers down into the palm [of his left hand] with the exception of the index finger where he still lack[ed] about a [centimeter].” In December 2003, French reported that Boseley had “plateaued in terms of range of motion and strength of the left hand.” Specifically, French noted that while Boseley had “good grip strength on the ulnar side of his hand,” he lacked “full flexion and ability to grasp with the index finger and of course the thumb.” Based on his opinion that Boseley had “reached maximum medical improvement,” French approved an FCE “for the left hand to assess [Boseley’s] ability to work in the future.” 3 No. 09-6058 Boseley v. Comm’r of Soc. Sec. Boseley participated in the FCE in January 2004. The FCE concluded that Boseley suffered from the following “Significant Deficits”: Difficulty with waist to crown lifts due to [left] hand decreased strength. Below average coordination with [left] hand specially [sic] when working with small objects. [Left] hand decreased grip strength and tip pinch. The FCE Grid tracked Boseley’s grip strength and tip pinch, and it also noted that he could engage in activity involving coordination with his left hand for just one to five percent of the work day. After reviewing the FCE, French was unable to opine as to whether Boseley could return to his job as a truck driver, but he did state that Boseley “has reached maximum medical improvement and he needs to be evaluated for a return to some sort of employment.” Finally, after an April 2004 followup appointment, French concluded that Boseley “can drive and . . . [has] good functional use of the left hand within the stated guidelines [i.e. a fifty-pound permanent lifting restriction].” In January 2005, Dr. Joseph Johnson examined Boseley at the request of the Tennessee Disability Determination Services. He concluded that Boseley’s left-hand range of motion was “nearly normal,” and his left-hand motor strength was a “4/5.” He noted that Boseley’s ability to make “[r]apid alternating movements in the left hand” was “slightly slow due to tendinous stiffness.” That same month, a physician reviewed Boseley’s medical records for the Social Security Administration in order to determine his RFC. He indicated that Boseley could stand, walk, and sit six hours in an eight-hour workday, could lift fifty pounds occasionally and twenty-five pounds frequently; and had no push or pull limitations in his upper extremities. Furthermore, he found that Boseley suffered from no limitations in reaching and feeling. 4 No. 09-6058 Boseley v. Comm’r of Soc. Sec. In 2006, Boseley submitted to a vocational evaluation by Mark Boatner. Specifically, Boatner was retained “to administer a standardized measure of [Boseley’s] finger dexterity” and “to get insight into [Boseley’s] capacity for performing daily activities and for return to his regular job of tractor-trailer driver.” After administering a Purdue Pegboard Test, Boatner noted that Boseley performed “poor[ly]” as to both his right and left hands and concluded that Boseley “does not possess the functional dexterity or fingering ability to successfully work in basic assembly jobs, production occupations, maintenance or service occupations.” Moreover, due to French’s opinion that Boseley would likely be absent from work one day per month, Boatner concluded that Boseley was not employable for any entry-level unskilled jobs. French later checked “yes” on a letter from Boseley’s lawyer, indicating that he agreed with these findings.