United States District Court, N.D. Ohio, Eastern Division
MEMORANDUM OF OPINION AND ORDER
M. Parker, United States Magistrate Judge
Michael Kance, seeks judicial review of the final decision of
the Commissioner of Social Security, denying his applications
for disability insurance benefits (“DIB”) and
supplemental security income (“SSI”) under Titles
II and XVI of the Social Security Act. This matter is before
me pursuant to 42 U.S.C. § 405(g) and the parties
consented to my jurisdiction under 28 U.S.C. § 636(c)
and Fed.R.Civ.P. 73. ECF Doc. 12. Because the Administrative
Law Judge (“ALJ”) failed to apply proper legal
standards in evaluating the medical opinions, the
Commissioner's final decision denying Kance's
application for DIB and SSI must be VACATED and the matter
REMANDED for further proceedings consistent with this
memorandum of opinion and order.
December 24, 2015, Kance applied for DIB and SSI. (Tr. 216,
220). Kance alleged that he became disabled on
December 30, 2014 (Tr. 216, 220) due to Dupuytren's
contracture, depression, anxiety, nervousness and hives. (Tr.
97). The Social Security Administration denied Kance's
applications initially and upon reconsideration. (Tr. 146,
149, 157, 164). Kance requested an administrative hearing.
(Tr. 69). ALJ Scott R. Canfield heard Kance's case on
November 7, 2017, and denied the claim in a February 20,
2018, decision. (Tr. 14-29). On June 20, 2018, the Appeals
Council denied further review, rendering the ALJ's
decision the final decision of the Commissioner. (Tr. 1-5).
On August 16, 2018, Kance filed a complaint to seek judicial
review of the Commissioner's decision. ECF Doc. 1.
Relevant Medical Evidence
noted above, Kance claimed disability due to several
conditions. (Tr. 97). However, he has limited his appeal to
the ALJ's analysis of his Dupuytren's contractures of
the hands and the related symptoms, restrictions and
limitations in the use of his hands. ECF Doc. 14 at 5. For
this reason, the court summarizes only the evidence related
to the challenged issues.
2014, Kance's treating physician, Dr. Carl A. Robson,
referred him for an assessment of the pain and contractures
in his hands. (Tr. 348). The assessment showed that Kance had
bilateral contractures with decreased pinch and grip
strength. (Tr. 350).
August 27, 2015, Kance was diagnosed with palmer
fibromatosis/Dupuytren's contracture, which had
progressed since his appointment a year earlier. (Tr. 348).
Examination showed contractures of the ring and small fingers
to 80 degrees at the metacarpophalangeal (MP) joint and 60
degrees at the proximal interphalangeal (PIP) joint, with
palpable cords, notable tenderness about the cord to the
small finger, and decreased pinch and grip strength. Surgery
was scheduled to treat Kance's condition. (Tr. 348).
October 9, 2015, Kance underwent left arm partial palmer
fasciectomy with excision of digital extension ring and small
fingers. (Tr. 342). His post-surgical diagnosis was left-hand
palmar fibromatosis with digital extensions ring and small
fingers. (Tr. 342).
his surgery, Kance attended physical therapy. (Tr. 325-340).
At his initial evaluation, he was fitted for splints and was
instructed on their use. (Tr. 339). On November 10, 2015,
Kance reported that he did not have pain unless pushing and
then it was 4/10. (Tr. 332). On December 1, 2015, Kance
reported 2/10 pain in his small finger. He stated that he was
trying to use his hand as much as he could. He reported
moving furniture, taking out trash and raking. (Tr. 317,
321). The therapist noted gradual gains in Kance's range
of motion in his left hand with the exception of his small
finger PIP joint. (Tr. 318). However, at his sixth
appointment on December 8, 2015, Kance continued to lack
range of motion in his hand and he had decreased grip
strength. (Tr. 326).
January 27, 2016, Kance saw Dr. Robson, who noted that Kance
still had very poor function and a weak grip, with the right
hand worse than the left. He was unable to hold tools or
perform any manual labor. (Tr. 355).
January 2016, Kance's sister assisted him in filling out
a function report. (Tr. 262-269). Kance reported struggling
with grip strength and stiffness in his hands. He reported
that he did not cook; his sister cooked for him. He
didn't do any household chores except washing the dishes
sometimes. (Tr. 264).
saw Dr. Robson on May 18, 2016. (Tr. 359) Kance's
left-hand grip strength was 2/5 with contractures moderately
reducing his left-hand range of motion. (Tr. 360-361). His
right-hand grip strength was 3/5 with contractures moderately
reducing the range of motion in his right-hand fingers. (Tr.
361). Dr. Robson noted that due to “weakness of grip
strength and dexterity” Kance was “totally unable
to do any carpentry or any other work requiring hand grip and
dexterity due to Dupuytren's contractures.” (Tr.
saw Dr. Robson at his office on August 18, 2016. (Tr. 387).
Dr. Robson noted, “hands - left surg scars, contraction
5th, Range of motion: mild pain w/motion, poor grip, Right:
4th tendon contracture, range of motion: mild pain with grip,
poor grip…grip strength left, cannot register any
change, right hand = 14mm change, :me: about 180 mm grip
bilateral for comparison.” (Tr. 388). Dr. Robson also
noted that “with no significant grip strength either
hand, he is absolutely disabled for any type of manual labor,
total and permanent.” He referred Kance back to the
hand clinic to see if injections might help. (Tr. 389). Dr.
Robson's treatment notes on September 15th restated his
opinion that Kance was totally disabled. (Tr. 391, 393).
March 28, 2017, Dr. Robson noted that Kance's strength
was 1-2/5 in the left with weak grip and contractures and
2-3/5 in the right; he was unable to extend or make a fist.
The left side was similar with poor strength and grasp. (Tr.
Relevant Opinion Evidence
Physician - Carl A. Robson, M.D.
Robson completed the first of two medical source statements
on May 18, 2016. (Tr. 381-382). Dr. Robson opined that
Kance's ability to lift/carry, stand/walk, and sit were
not affected by his impairment. (Tr. 381). He opined that
Kance could rarely climb or perform fine and gross
manipulation. (Tr. 381-382). He opined that Kance should not
be exposed to heights or moving machinery due to his unsafe
gripping. He reported that Kance experienced moderate pain
that would interfere with his concentration but would not
take him off task or cause absenteeism. At the bottom of the
questionnaire, Dr. Robson wrote that Kance “had
experience as carpenter - now totally disabled for this work.
Has no other skills or training- cannot use hands for any
occupation due to poor grip and dexterity.” (Tr. 382).
August 18, 2016, after examining Kance, Dr. Robson wrote a
note stating, “In my opinion he is totally, permanently
disabled for any type of labor with his hands, including
dishwashing. His grip strength is virtually zero (measured).
I don't think the state doc measured this.” (Tr.
October 18, 2017, Dr. Robson completed his second medical
source statement. (Tr. 428-429). Dr. Robson opined that
Kance's ability to lift and carry was limited by his
impairment and that he was limited to lifting 10-15 pounds
occasionally and “none” frequently due to his
palmar fasciitis and Dupuytren's contractures in both
hands. He opined that Kance could never climb and could only
occasionally balance, crouch, kneel and crawl. (Tr. 428). He
opined that Kance's abilities to reach and pull were
limited due to his poor grip and that he was unable to
perform fine or gross manipulation. He noted that Kance's
pain was minor and that it did not interfere with his
concentration; would not take him off task; or cause
absenteeism. (Tr. 429).
Examiner - Robin Benis, M.D.
February 8, 2016, Robin Benis, M.D. examined Kance and
completed a report. (Tr. 363-367). Dr. Benis reported that
Kance had contractures in both hands, decreased ability to
flex all his fingers, especially the 4th and 5th fingers on
both hands. (Tr. 365). He had decreased range of motion in
the bilateral PIP and DIP joints and decreased grip strength
and fine motor manipulation in both hands. (Tr. 365, 370).
Dr. Benis opined that Kance had marked limitations using both
hands due to Dupuytren's contractures. He was unable to
hold objects for a long period of time, had difficulty
writing and difficulty with fine motor manipulation of both
hands. Dr. Benis opined that Kance's prognosis was fair.
February 22, 2016, state agency physician, Anne Prosperi,
D.O., reviewed Kance's records and opined that he could
perform light work; (Tr. 108) that he was able to
occasionally lift and/or carry up to 20 pounds; and
frequently lift and/or carry up to 10 pounds. (Tr. 105) She
further opined that he was limited to occasional handling and
fingering with both hands. (Tr. 109).
Das, M.D., reviewed Kance's records on July 3, 2016 and
agreed with the functional limitations ...