Opinion ID: 3159957
Heading Depth: 2
Heading Rank: 1

Heading: Evidence of Hill’s Disabilities

Text: Hill, who is currently 56 years old, worked for more than 13 years at a steel factory, where her duties included lifting and carrying steel sheets that weighed up to 100 pounds. The manual labor took a toll on Hill’s body, and, unable to keep working at the factory, she applied for disability bene‐ fits in July 2011. She alleged an onset date in June 2011 and listed eight impairments: a total hip replacement, a recom‐ mended total shoulder replacement, carpal tunnel, a rup‐ tured disc, cervical fusion,1 knee pain, a broken left hand, and tendinitis. Hill had cervical‐fusion surgery in 1985, but there is no mention of neck pain in her available medical records before 1 The parties did not tell us what “cervical fusion” is, but they should have. This case is not a dispute about the meaning of an uncommon term or term of art. But parties should define this kind of term even if its meaning is not in dispute and does not drive the outcome. Doing so makes the case more understandable and gives clarity to readers. We have included some definitions to make this opinion more understanda‐ ble; but they were not necessary to the outcome. “Cervical fusion” is a surgery that joins bones in the neck. See Cervical Spinal Fusion, WEBMD, www.webmd.com/back‐pain/cervical‐spinal‐fusion (visited October 27, 2015, as were the other websites cited in this opinion). No. 15‐1230 3 November 2010. In November 2010, she was diagnosed with neck strain, though she was cleared for work without re‐ strictions. The next month, she saw a doctor for shoulder pain. Imaging studies revealed a likely hyperextension inju‐ ry; a bone spur; tears of the tendons in her left shoulder, left bicep, and left hip joint; a possible “loose body” in her left shoulder; osteoarthritis in her left hip; and tendinopathy2 in her left shoulder. She was prescribed pain medication and her arm was placed in a sling. During a follow‐up appoint‐ ment with orthopedic surgeon Dr. Barry Liechty, Hill report‐ ed improvement but also said that she still experienced pain in her shoulder. Hill met with Dr. Liechty again in May 2011, complaining of pain in her left hip, knee, and groin. Dr. Liechty noted se‐ vere osteoarthritis of the left hip and performed a total hip replacement two months later. A few weeks after that sur‐ gery, Dr. Liechty reported that Hill was limping and taking one or two Vicodin each week. He recommended that she not work at a job requiring pulling, pushing, or squatting. He also recommended that she not lift more than 10 pounds, but that recommendation was changed a few weeks later to restrict only “heavy lifting.” Nearly two months after her hip replacement, in August 2011, Hill met with state‐agency doctor David Ringel, an os‐ teopathic physician, who noted that Hill limped and had 2 “Tendinopathy” is another term that should have been defined for clarity. It refers to both: (1) inflammation of a tendon; and (2) small tears in a tendon. See Tendon Injury (Tendinopathy), WEBMD, www.webmd.com/hw‐popup/tendon‐injuries‐tendinopathy. 4 No. 15‐1230 “quite a bit of stiffness.” Dr. Ringel reported that Hill said she could lift 10 pounds, do most household chores, and stand 1 to 2 hours at a time and 4 hours total during an 8‐ hour workday. He described Hill as mildly obese and noted some limitations in her ability to move her shoulders, neck, lower back, and left hip. The next month, in September 2011, another state‐agency doctor, Dr. J. Sands, reviewed Hill’s medical records and prepared a Physical Residual Functional Capacity Assess‐ ment. Dr. Sands noted Hill’s history of shoulder and hip os‐ teoarthritis. He opined that her “hip replacement would be expected to improve with further therapy and time,” but said that she would be limited to occasional pulling, press‐ ing, and pushing with her left extremities. He estimated that Hill could lift 20 pounds occasionally and 10 pounds fre‐ quently, and could sit, stand, or walk 6 hours each in an 8‐ hour workday. Dr. Sands further opined that Hill occasional‐ ly could balance, stoop, kneel, crouch, crawl, and climb ramps and stairs, but could not climb ladders, ropes, or scaf‐ folds. Two weeks later Hill complained of low back pain, and an imaging study revealed minimal degenerative disc dis‐ ease, narrowing disc spaces, atherosclerotic3 vascular chang‐ es, and calcification of a portion of the pelvis. Dr. Sands and two additional state‐agency physicians reviewed this new 3 Atherosclerosis is a hardening and narrowing of the arteries. See Heart Disease and Atherosclerosis, WEBMD, www.webmd.com/heart‐ disease/guide/atherosclerosis‐faq. No. 15‐1230 5 information but concluded that it did not change the earlier assessment of Hill’s impairments. The Social Security Administration initially denied Hill’s application in October 2011, and did so again on reconsider‐ ation the next month. In September 2012, Hill testified before the ALJ. She ex‐ plained that she had to stop working at the factory because, after her hip‐replacement surgery, she could no longer per‐ form manual labor. Hill said that, despite taking aspirin and Naproxen, she could “hardly sleep at night” because of shoulder and neck pain, and she had trouble walking be‐ cause of leg and back pain. But, Hill explained, it was diffi‐ cult for her to determine the source of the pain because “[i]t’s all connected somehow.” She added that she no longer took narcotic pain relievers because her doctor was concerned that she could become addicted. (That concern may have been caused by Hill’s admission of “heavy” drinking and a family history of alcoholism.) Hill then explained that she lacked health insurance and could not afford to go a doctor “over every little pain,” nor could she afford the total shoul‐ der replacement her doctor had recommended. She de‐ scribed her daily activities, which then included babysitting, caring for her pets and her roommate (who is an amputee), going to church, visiting with family members, and doing chores like loading the dishwasher, vacuuming, taking out the garbage, and doing laundry. But she added that she needs to take breaks while performing those chores and that she is unable to lift the child she babysits. She estimated that she could sit or stand for about 10 to 15 minutes without a break, lift between 10 and 15 pounds with her right arm but much less with her left, squat or kneel with her right leg but 6 No. 15‐1230 not with her left, and slowly crawl. Hill rated her hip pain at 3 out of 10, her shoulder pain at 8, and her leg pain at 5. A longtime friend, Kim Stamate, testified that she helps walk Hill’s dogs and carry Hill’s groceries, and that she had not seen Hill walk without a limp in the past year. A vocational expert testified that Hill could not perform her past work if limited to the extent described by the ALJ: able to lift up to 20 pounds occasionally and 10 pounds fre‐ quently; able to sit, stand, or walk for 6 hours each in an 8‐ hour workday; occasionally able to balance, stoop, kneel, crouch, crawl, and climb ramps and stairs, but never able to climb ladders, ropes, or scaffolds; and limited to occasional pulling, pushing, and reaching with the left extremities. But, the VE continued, Hill still could work at jobs classified as light4 and unskilled, such as a dealer account investigator,5 a furniture rental consultant, and a counter clerk.6 In the na‐ tional economy, the VE said, there were 22,000 jobs as a deal‐ 4 Light work requires standing or walking for about 6 hours in an 8‐ hour workday and sitting during the remainder. See SSR 83‐10, 1983 WL 31251, at –6; 20 C.F.R. §§ 404.1567(b), 416.967(b). 5 A dealer account investigator is defined in the Dictionary of Occu‐ pational Titles as a person who “[v]isits dealers to verify purchases fi‐ nanced by [a] bank against physical inventory of merchandise.” Investi‐ gator, Dealer Accounts (financial), DICTIONARY OF OCCUPATIONAL TITLES, www.oalj.dol.gov/PUBLIC/DOT/REFERENCES/DOT02B.HTM. 6 This job is described in the DOT’s last update (in 1991) as pro‐ cessing film for photo printing. Counter Clerk (photofinishing), DICTIONARY OF OCCUPATIONAL TITLES, www.oalj.dol.gov/PUBLIC/DOT/ REFERENCES/DOT02C.HTM. No. 15‐1230 7 er account investigator, 40,000 jobs as a furniture rental con‐ sultant, and 50,000 jobs as a counter clerk. Those jobs, the VE asserted, would be available to a person who was unable to crouch or to push, reach, or pull with her left extremities. Fi‐ nally, the VE testified that someone with Hill’s limitations, if also unable to stand or walk more than 2 hours in an 8‐hour workday or lift more than 10 pounds occasionally, still could perform sedentary jobs, see SSR 83‐10, 1983 WL 31251, at ; 20 C.F.R. §§ 404.1567(a), 416.967(a), like a call‐out operator7 (45,000 jobs in the national economy), a semiconductor bonder8 (30,000 jobs in the national economy), and a registra‐ tion clerk9 (27,000 jobs in the national economy). 7 A call‐out operator “[c]ompiles credit information, such as status of credit accounts, personal references, and bank accounts to fulfill sub‐ scribers’ requests, using telephone.” Call‐Out Operator (business ser.; retail trade), DICTIONARY OF OCCUPATIONAL TITLES, www.oalj.dol.gov/PUBLIC/ DOT/REFERENCES/DOT02B.HTM. 8 This job involves operating an “automatic bonding machine that bonds gold or aluminum wire to integrated circuit dies to connect cir‐ cuitry to package leads.” Bonder, Semiconductor (electron. comp.), DICTIONARY OF OCCUPATIONAL TITLES, www.oalj.dol.gov/PUBLIC/DOT/ REFERENCES/DOT07C.HTM. 9 The VE gave DOT number 205.367‐030 for “registration clerk.” That’s the number for an election clerk—someone who performs admin‐ istrative tasks during elections. See Election Clerk (government ser.), DICTIONARY OF OCCUPATIONAL TITLES, www.oalj.dol.gov/PUBLIC/DOT/ REFERENCES/DOT02A.HTM. There are two jobs in the DOT titled “reg‐ istration clerk.” A registration clerk may conduct interviews “to compile information for legal or other records,” Registration Clerk (government ser.), DICTIONARY OF OCCUPATIONAL TITLES, www.oalj.dol.gov/PUBLIC/ DOT/REFERENCES/DOT02A.HTM, or record identifying information 8 No. 15‐1230