United States District Court, D. Arizona
Davila, United States Magistrate Judge.
Penny Duvall filed this action pursuant to 42 U.S.C. §
405(g) seeking judicial review of a final decision by the
Commissioner of Social Security. (Doc. 1.) Before the Court
are Duvall’s opening brief, the Commissioner’s
response brief, and Duvall’s reply brief. (Docs. 19,
20, 21.) For the following reasons, the Commissioner’s
decision will be affirmed.
applied for disability insurance benefits on August 3, 2015,
claiming a disability onset date of January 1, 2010.
AR 60. Her application was denied on November
13, 2015, and again on reconsideration on March 2, 2016.
AR 87, 92. On March 9, 2016, Duvall
requested a hearing before an administrative law judge
(“ALJ”). AR 95. At the hearing,
held on August 9, 2017, Duvall testified about her medical
conditions and past work, and a Vocational Expert
(“VE”) testified about which jobs a hypothetical
person with Duvall’s characteristics can perform.
AR 36–58. On December 7, 2017, the ALJ
issued a written decision finding Duvall not disabled and
denying benefits. AR 15–30. On
November 13, 2018, the Appeals Council denied review.
AR 1–3. Duvall now seeks judicial
review of the ALJ’s decision denying benefits. (Doc.
was born with Turner syndrome, a chromosomal condition that
affects only women. See AR 378.
Duvall has several conditions associated with Turner
syndrome, including heart defects, short stature, obesity,
and deficient interpersonal skills. AR 24, 378,
380. Duvall has congenital heart disease, including
coarctation (narrowing) and dilation of the aorta and a
bicuspid aortic valve. AR 339. She had two
heart-related surgeries as a child: one in 1983 to insert a
synthetic conduit between the ascending and descending
aortas, and a pericardiectomy in 1985 to address constrictive
pericarditis. AR 315. She underwent cardiac
catheterization in 2012. AR 529–32.
has a bachelor’s degree. AR 185. She
was a substitute middle-school teacher from 2000 to 2005, and
a fulltime elementary-school teacher from 2005 to 2009.
AR 186. According to Duvall, she was let go
from her teaching positions due to “interpersonal
relations with co-workers, management in particular.”
Daniela Lax is Duvall’s treating cardiologist. On March
18, 2013, Dr. Lax wrote an assessment letter on behalf of
Duvall. AR 380. On April 18, 2016, after
Duvall’s date last insured, Dr. Lax completed a Cardiac
Impairment Questionnaire. AR 514–519.
The substance of Dr. Lax’s reports, as well as the
ALJ’s treatment of them, are discussed below as
hearing before the ALJ, Duvall testified that she has Turner
syndrome and suffers from many of the effects of that
condition, including congenital heart disease, short stature
(she is five feet tall), obesity (she weighed 180 pounds on
the date of the hearing), and difficulty functioning in
social situations. AR 40–41, 46.
According to Duvall, prior to her date last insured, she was
able to dress and bathe herself, assist her mother with
household chores, go grocery shopping, do laundry, mow the
lawn, go swimming for 20 to 30 minutes at a time, and drive a
car. AR 41–44. However, she testified
that she often requires two to three days of recovery after
doing some of these tasks, and two to three times per month
she will feel “sharp pains” while doing them.
AR 46, 49–50.
also testified that she has a college degree and used to be a
teacher. AR 40. When asked how she was able
to achieve this with Turner syndrome, she explained that the
symptoms of Turner syndrome were often ignored or incorrectly
characterized while she was growing up (e.g., she was called
a “strong-willed child”), and that without her
parents pushing her to go to college and get a job, she
probably would not have done so. AR
46–47. She testified that her lack of
interpersonal skills caused her to be fired from three
teaching jobs for being “unprofessional” and not
“follow[ing] instructions.” AR 47–
48. As an example, she stated that she was
reprimanded for being “assertive and aggressive towards
the students, ” including taking a deck of cards from a
student. AR 51–53.
testified that Duvall’s teaching work is within the
light exertion range. AR 56. The ALJ asked
the VE about a hypothetical claimant with Duvall’s age,
education, and work history who can sit, stand, or walk for
six hours per eight-hour workday, occasionally lift and carry
20 pounds, frequently lift and carry 10 pounds, frequently
climb, balance, stoop, kneel, crouch, and crawl, and
occasionally interact with coworkers, supervisors, and the
public. AR 56. The VE testified that the
hypothetical claimant could not perform Duvall’s past
teaching job. AR 56. According to the VE,
however, the hypothetical claimant could perform other jobs
in the national economy, including marking clerk, hand
packager, and production helper. AR 56. The
VE confirmed that her testimony was consistent with the
Dictionary of Occupational Titles. AR 57.
followed the five-step sequential evaluation process for
determining whether an individual is disabled. AR
19–30. At step one, the ALJ found that Duvall
was not engaged in “substantial gainful
activity.” AR 20. At step two, the ALJ
found that Duvall has three “severe” impairments:
Turner syndrome, congenital heart disease, and obesity.
AR 20. The ALJ found that Duvall’s
lack of interpersonal skills is a “non-severe”
mental impairment. AR 20–23. At step
three, the ALJ found that Duvall does not have an impairment
or combination of impairments that meets or medically equals
the severity of one of the impairments listed in 20 C.F.R.
Part 404, Subpart P, Appendix 1. AR 23.
steps three and four, the ALJ found that Duvall has the
residual functional capacity (“RFC”) to sit,
stand, or walk for six hours per eight-hour workday,
occasionally lift or carry 20 pounds, frequently lift or
carry 10 pounds, frequently climb, balance, stoop, kneel,
crouch, or crawl, and occasionally interact with coworkers,
supervisors, and the public. AR 24. In
determining Duvall’s RFC, the ALJ found that
Duvall’s statements about her symptoms were “not
entirely consistent with the medical evidence and other
evidence in the record.” AR 25. The
ALJ gave “controlling weight” to Dr. Lax’s
assessment of Duvall in 2013, which noted only that Duvall
requires ongoing monitoring due to Turner syndrome, not that
Duvall has functional limitations. AR 26.
The ALJ gave “limited weight” to opinions
rendered by Dr. Lax in 2016, including that Duvall cannot
lift or carry more than five pounds, because they were
rendered after Duvall’s date last insured and lack
evidentiary support. AR 27. The ALJ gave
“substantial weight” to the opinions of the
agency physicians because “they reviewed available
information, ” and “[s]ubsequent treatment
records have not documented any significant change in the
claimant’s condition through the date last
insured.” AR 27.
four, the ALJ found that Duvall cannot perform her past
relevant work, either as actually performed or as generally
performed in the national economy. AR 28. At
step five, the ALJ noted that Duvall’s vocational
profile under 20 C.F.R. Part 404, Subpart P, Appendix 2
supports a finding that she is not disabled. AR
28–29. The ALJ, considering Duvall’s
age, education, work experience, and RFC, then found that
Duvall could have performed jobs other than teaching prior to
her date last insured, and, therefore, that she is not
disabled. AR 28–30.