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Andrea Lashawn Grant v. Michael J. Astrue

April 30, 2012


The opinion of the court was delivered by: John D. Bates United States District Judge


Plaintiff Andrea Lashawn Grant seeks a judgment reversing the denial of her claim for Social Security Disability Benefits ("DIB") and Supplemental Security Income Benefits ("SSI"). In the alternative, she seeks a remand to the Social Security Administration for a new administrative hearing. Before the Court are Grant's motion for a judgment of reversal or for remand [Dkt. 9] and defendant's motion for a judgment of affirmance [Dkt. 11], which were filed pursuant to 42 U.S.C. § 405(g). For reasons explained below, the Court will deny plaintiff's motion for judgment of reversal and grant defendant's motion for judgment of affirmance.


Grant is a 38-year-old high school graduate who has suffered from problems with her hands, arms, back and neck since at least November 15, 2001. Through 2009, she was treated fairly regularly by orthopedist Rida Azer, M.D. Grant ceased working in April 2006, and thereafter applied for disability benefits. Her first application was denied in October 2006 and she applied again on February 15, 2007. *fn1 Id. at 172-190. She was subsequently examined by two State Agency consultants -- orthopedic surgeon Rafael Lopez, M.D., and neurologist Chitra Chari, M.D. Her medical records were then also evaluated by four other State Agency consultants, neurologist Albert Heck, M.D., internist Currie Ball, M.D., orthopedic surgeon Leopoldo Salazar, M.D., and pediatrician Fizzeh Nelson-Desiderio, M.D.*fn2 Based on the medical evidence and Grant's testimony at an administrative hearing on August 14, 2009, Grant was denied disability benefits.

Before 2011, Grant had worked as an administrative assistant, hospital clerk, dental assistant and data entry clerk. Administrative Record ("A.R.") at 15. She was diagnosed with bilateral carpal tunnel syndrome and had decompression surgery and tenosynovectomy, both of which relieve pressure on nerves in the hand, on both wrists on November 15, 2001. A.R. at 425. She returned to work after recovering from her surgery. In January 2004 Grant visited Dr. Azer, complaining of pain in both wrists. A.R. at 272. Both a compression test and Tinnel's sign were negative. Id. Grant had good grip but slightly diminished sensation on the left hand. Id. An electromyogram ("EMG") and nerve conduction study were both normal. A.R. at 271.

On February 24, 2004, Grant returned to Dr. Azer's office and reported that she had been injured at work when a door crushed her right wrist. A.R. at 271, 265. An MRI revealed a synovial cyst which was surgically removed on April 20, 2004. A.R. at 270-71. On July 14, 2004, Dr. Azer reported that Grant was progressing well but should refrain from pushing, pulling and lifting heavy objects with her hands, repetitive movements, and strenuous use of the hands.

A.R. at 265. She noted that Grant had been working between 4 and 6 hours per day and opined that the limitations would be permanent. Id.

On October 13, 2004, Grant reported pain in her right elbow and tenderness over the medial epicondyle of the right humerus and the right ulnar nerve. A.R. at 264. She had a positive Tinnel sign. Id. She was prescribed Daypro, an anti-inflammatory. On October 27, 2004, Dr. Azer noted that Grant had satisfactory grip and satisfactory sensation of the left median nerve.

A.R. at 263. Grant followed up on December 22, 2004, complaining of pain in her left upper arm, elbow, and forearm. Id. at 262. Dr. Azer opined that she had severe tendonitis. Id. She had satisfactory grip and normal sensation. Id. Dr. Azer prescribed ibuprofen. Id.

On March 2, 2005, Grant visited Dr. Azer reporting symptoms of increasing pain in both shoulders and elbows as well as numbness at the elbow. Id. at 359. Dr. Azer opined that this was evidence of ulnar neuritis. Id. Grant had an EMG and nerve conduction test on March 7 and an xray on March 11. Id. at 357-58. The x-ray was normal except for evidence of a reversal of cervical lordosis. Id. at 358. The EMG and nerve conduction tests revealed "bilateral ulnar neuritis with probable entrapment syndrome at the elbow," "right c5-6 cervical neuritis" and "chronic bilateral carpal tunnel syndrome." Id. at 357. Dr. Azer ordered an MRI and recommended surgical intervention. Id.

During a visit on March 3, 2006, Dr. Azer noted that Grant had been "unable to work." Id. at 355. She indicated that Grant was to refrain from the same activities she had earlier noted, including "pushing, pulling, lifting heavy objects, strenuous use of the hands, repetitive use of the hands, and having her hands close to machinery." Id. She continued to recommend surgery but noted that Grant was waiting to resolve problems with her insurance.

On May 31, 2006, Dr. Azer indicated that Grant was developing ulnar clawhand palsy, but that "surgery performed on her right and left carpal tunnel syndrome was progressing well." Id. at 401. She opined that Grant was "totally disabled and not fit for employment." Id. Grant's symptoms remained the same during follow-ups on June 28, 2006 and August 30, 2006. Id. at 352-53.

On September 5, 2006, after applying for Social Security benefits, Grant was examined by State Agency orthopedic surgeon Rafael Lopez, M.D. Id. at 342-44. Dr. Lopez estimated grip strength at 4/5. Id. at 342. He observed no limitations of motion, full rotator cuff strength, and normal hand function. Id. 343. He found no evidence of atrophy, swelling, or tenderness. Id. He noted diminished sensation in the hands in a "stocking glove configuration" and good motor strength with the exception of grip strength. Id. His diagnosis was that there was some disability related to Grant's upper extremities regarding repetitive work-related activities or heavy lifting, but no specific limitations in the use of hands, arms or fingers. Id. at 344

On September 12, 2006, State Agency neurologist Albert Heck, M.D., reviewed Grant's medical records, noting the "sparse medical evidence of record." Id. at 347. Dr. Heck noted considerable discrepancies between diagnoses and observations provided by Dr. Azer and the results of electrophysical tests and the subsequent clinical evaluation by Dr. Lopez. Id. Dr. Heck commented that Grant's carpal tunnel syndrome was "non-severe" and that ...

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