United States District Court, W.D. Missouri, Central Division
NANETTE K. LAUGHREY, District Judge.
Before the Court is Plaintiff William Houston's appeal of the Commissioner of Social Security's final decision denying his application for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. [Doc. 8]. For the following reasons, the Commissioner's decision is affirmed.
Houston was born in 1966 and has some college education. He alleges he became disabled on June 8, 2009. When he filed for disability benefits in July 2011, he alleged disability from the combined effects of gastroesophageal reflux disease, arthritis in his hips, shoulders, and knees, depression, stomach ulcers, heart palpitations, and high stroke risk. [Tr. 207]. At a hearing in January 2013, Houston also alleged debilitating back pain which began in late 2010 and which was worse than his knee pain. [Tr. 46, 49].
A. Medical History
Because Houston does not challenge the ALJ's conclusions related to his mental impairments, the Court will focus on the medical history related to Houston's physical impairments. Houston worked as a mall security officer until June 8, 2009, the day of his alleged onset of disability. Houston testified that he quit his job because he was having issues with coworkers, was required to work extra hours, and often had to do both his job and that of his subordinates. [Tr. 40-41]. He testified that his foot patrol duties added stress to his knee and that his paperwork duties were mentally stressful. [Tr. 41]. He stated he was "physically and mentally burned out" and could no longer handle the burden of the job. [Tr. 41-42]. He suffered depression from being reprimanded by his supervisors and was stressed because he was away from his family. [Tr. 42-43].
Houston's primary physical complaints are related to knee pain and back pain. In August 2010, Houston sought treatment for bilateral knee pain. [Tr. 278]. An MRI of left knee revealed a complex grade tear of the posterior horn of the medial meniscus, a grade 1 signal in the posterior horn of the lateral meniscus without any tear, and minimal soft tissue edema anterior to the patellar tendon. [Tr. 277]. An MRI of the right knee revealed changes in the lateral patellofemoral joint, suggestive of lateral femoral condyle friction syndrome, a small grade 3 tear in the posterior horn of medial meniscus, and a chronic tear of the femoral attachment of the anterior cruciate ligament. Id. Houston was diagnosed with a right knee chronic anterior cruciate ligament tear, a medial meniscal tear, and patellofemoral degenerative changes. Id. The left knee had a medial meniscal tear. Id. Houston's doctors opined that knee surgery was the best treatment option for him, but his surgery was cancelled due to uncontrolled hypertension and EKG changes. [Tr. 270, 300-01]. Houston returned to a cardiology clinic on multiple occasions in September and October 2010 for follow-up appointments regarding hypertension, but was not cleared for surgery. [Tr. 289, 291, 298].
In November 2010, Houston complained of back pain and a headache. [Tr. 358]. Houston's back was tense and tender on the left lower thorax. He was diagnosed with thoracic back pain, neck pain, and a headache and prescribed medication. Id. In July 2011, Houston complained of chest, shoulder, and knee pain and headaches. [Tr. 333-37]. Houston told his doctor that he stopped taking his blood pressure medication because it was causing side effects and that he was still not cleared for knee surgery. [Tr. 356]. He was diagnosed with uncontrolled hypertension, anxiety, obesity, and bilateral knee pain. He was prescribed a new blood pressure medication. In late July 2011, Houston complained of shoulder and hip pain. Examination revealed decreased range of motion in the shoulders. Houston's doctor remarked that Houston's insurance would not pay for physical therapy for his shoulders and hips. [Tr. 354].
In August 2011, Houston complained of sleep apnea, anxiety, irritability, and pain in his lower back and left hip. [Tr. 352]. An x-ray of the left hip and lumbar spine revealed no abnormalities. [Tr. 520-21]. A sleep study revealed severe obstructive sleep apnea, and it was recommended that Houston use a CPAP machine while sleeping. In November 2012, Houston was diagnosed with lumbar foraminal stenosis with neurogenic claudication, chronic pain syndrome, lumbar facet syndrome, depression, and insomnia secondary to pain. [Tr. 586]. An MRI of the lumbar spine revealed mild to moderate lumbar spondylosis. [Tr. 594]. Houston was prescribed a front-wheeled walker at his request. [Tr. 587].
In late November 2012, Houston's primary care physician, Dr. Sarah Yong, M.D., completed a Medical Source Statement-Physical. [Tr. 497-98]. Dr. Yong opined that Houston could frequently and occasionally lift and carry ten pounds, could stand or walk continuously for fifteen minutes for a total of two hours in an eight hour day, and could sit continuously for thirty minutes for a total of four hours in an eight hour day. [Tr. 497]. Houston was limited in his ability to push or pull ("he only does light housework"). [Tr. 497]. Houston could never crawl or climb ladders. He could occasionally climb stairs, balance, stoop, kneel, crouch, and reach. He could frequently handle/grip, finger, feel, see, speak, and hear. [Tr. 498]. He should avoid any exposure to extreme temperatures, weather, hazards, and heights. He should avoid moderate exposure to dust/fumes, wetness/humidity, and vibration. Id. Dr. Yong opined that Houston would need to lie down three times per day for one to two hours. She also stated that Houston's medication would cause a decrease in his persistence to finish a task and a decrease in his pace. Id.
In December 2012, Houston reported pain in his posterior thigh which was initiated by standing. [Tr. 575]. Houston also stated that once his pain has started, sitting down did not bring relief and at times made the pain worse. Id. Houston's hypertension was still uncontrolled. [Tr. 570]. Houston was diagnosed with hyperlipidemia, bilateral knee structural damage, L5-S1 lumbar foraminal stenosis with neurogenic claudication and lumbar spondylosis, and left hip mild osteoarthritis with pain on the left. [Tr. 573].
At his hearing in January 2013, Houston testified that he had been using a walker for the past eight weeks to help him balance and to relieve back pain. [Tr. 37-38]. He testified that his lower back caused him the most pain and that pain medication did not help. [Tr. 46-47]. He testified that bending down, standing for periods of longer than twenty minutes, and twisting caused the pain. [Tr. 47]. To relieve his back pain, sitting down sometimes relieved the pain and lying on his stomach was one of the best ways to relieve the pain. [Tr. 48]. His back pain started in late 2010, after he stopped working, and became "really noticeable" in the summer of 2013. [Tr. 51].
As to his knees, Houston testified that both knees hurt, but that the right knee hurt more. His right knee hurt while he was working, but his left knee started hurting after he stopped working. [Tr. 49-50]. Houston testified that his back pain is "far worse" than his knee pain. [Tr. 50]. He uses knee braces. [Tr. 51]. His knees hurts when he cleans, helps the children clean the living room, and ...