United States District Court, N.D. Ohio, Eastern Division
MEMORANDUM OF OPINION AND ORDER
JONATHAN D. GREENBERG UNITED STATES MAGISTRATE JUDGE.
Danyel Giacomelli (“Plaintiff” or
“Giacomelli”), challenges the final decision of
Defendant, Nancy A. Berryhill,  Acting Commissioner of Social
Security (“Commissioner”), denying her
applications for a Period of Disability (“POD”)
and Disability Insurance Benefits (“DIB”) under
Title II of the Social Security Act, 42 U.S.C. §§
416(i), 423, and 1381 et seq. (“Act”).
This Court has jurisdiction pursuant to 42 U.S.C. §
405(g) and the consent of the parties, pursuant to 28 U.S.C.
§ 636(c)(2). For the reasons set forth below, the
Commissioner's final decision is AFFIRMED.
November 2015, Giacomelli filed an application for POD and
DIB alleging a disability onset date of December 1, 2014 and
claiming she was disabled due to arthritis and carpal tunnel
syndrome. (Transcript (“Tr.”) at 134, 149.) The
applications were denied initially and upon reconsideration,
and Giacomelli requested a hearing before an administrative
law judge (“ALJ”). (Tr. 75, 82, 89.)
December 13, 2017, an ALJ held a hearing, during which
Giacomelli, represented by counsel, and an impartial
vocational expert (“VE”) testified. (Tr. 25.) On
January 31, 2018, the ALJ issued a written decision finding
Giacomelli was not disabled. (Tr. 8.) The ALJ's decision
became final on July 23, 2018, when the Appeals Council
declined further review. (Tr. 1.)
August 23, 2018, Giacomelli filed her Complaint to challenge
the Commissioner's final decision. (Doc. No. 1.) The
parties have completed briefing in this case. (Doc. Nos. 13,
15.) Giacomelli asserts the following assignment of error:
(1) Whether substantial evidence supports the ALJ's
finding that Ms. Giacomelli can perform frequent handling,
fingering and feeling.
(Doc. No. 13.)
Personal and Vocational Evidence
was born in August 1970 and was forty seven years-old at the
time of her administrative hearing, making her a
“younger” person under social security
regulations. (Tr. 19.) See 20 C.F.R. §§
404.1563. She has a high school education and is able to
communicate in English. (Id.) She has past relevant
work as a data entry clerk. (Tr. 18.)
Relevant Medical Evidence
19, 2013, Giacomelli visited orthopedist Alan L. Panteck,
M.D. for a right foot injury. (Tr. 203.) She reported
injuring her foot eight months prior on a set of stairs.
(Id.) Giacomelli denied any treatment for this
injury but indicated she was waking up at night with pain.
(Id.) On examination, she displayed no obvious
swelling, but had tenderness and a minimally antalgic gait.
(Id.) X-rays of the right foot revealed a possible
old fracture at the base of the third metatarsal.
(Id.) Dr. Panteck ordered an MRI to evaluate
Giacomelli for a Lisfranc sprain. (Id.) A June 25,
2013 right foot MRI indicated Lisfranc joint arthrosis, but
no discrete stress fracture or definite sprain. (Tr. 209.)
returned to Dr. Panteck on January 19, 2016, reporting a
three-month history of right upper extremity pain. (Tr. 204.)
She described pain along the medial aspect of the right elbow
and right thumb. (Id.) Giacomelli denied treating
this pain with anti-inflammatory medication, but indicated
she modified her activities without much relief.
(Id.) On examination, she had a full range of motion
in her right elbow, wrist, and fingers. (Id.) She
was “exquisitely tender over the medial epicondyle,
” but had no tenderness over the lateral epicondyle or
radial tunnel. (Id.) Giacomelli displayed
significant pain with resisted wrist and finger flexion and
tenderness at her first CMC joint. (Id.) However,
x-rays of her right thumb revealed essentially no arthritic
changes at her first CMC joint or any evidence of STT
arthritis. (Id.) Dr. Panteck diagnosed Giacomelli
with right medial epicondylitis and administered a Kenolog
and Lidocaine injection on the right side. (Id.)
January 20, 2016, Giacomelli visited primary care physician
Jason Sustersic, D.O., for bilateral hand eczema and ear
pain. (Tr. 213.) Dr. Sustersic observed redness in both ears
and diagnosed bilateral ear infections. (Tr. 214.) He
prescribed a course of antibiotics for this issue.
(Id.) Dr. Susteric also prescribed steroids for the
severely dry skin on Giacomelli's hands. (Id.)
February 16, 2016, Giacomelli visited neurologist Augusto C.
Juguilon, M.D., for neck, shoulder, hand, and wrist pain.
(Tr. 226.) She described “generalized aches and
pains” on a constant and daily basis. (Id.)
She reported constant hand pain, despite undergoing bilateral
carpal tunnel release procedures over a decade prior.
(Id.) On examination, Giacomelli was tender in her
cervical spine and shoulders, with minimal discomfort to
palpation in the lumbar region. (Id.) Her motor
strength was good in both her upper and lower extremities and
she displayed no tremor. (Id.) She had decreased
pinprick sensation in both hands. (Id.) An EMG/nerve
conduction study of her arms and neck revealed (1) bilateral
mild recurrent carpal tunnel syndrome; (2) bilateral mild
ulnar compression neuropathy at the elbow; (3) bilateral
multi-level cervical radiculopathy; (4) no evidence of ulnar
compression neuropathy at the canal of the guyon; (5) no
peripheral neuropathy; and (6) no myopathy. (Tr. 221.)
returned to Dr. Juguilon on April 19, 2016. (Tr. 225.) Dr.
Juguilon reviewed Giacomelli's recent labwork, which
revealed an elevated sedimentation rate of 30, satisfactory
C-reactive protein levels, severe anemia, and low B12 levels.
(Id.) Her CCP antibodies were highly elevated and
the remainder of the testing was negative. (Id.) Dr.
Juguilon noted Giacomelli “claims that she is unable to
do any daytime job because [she] is constantly fatigued plus
having generalized aches and pains.” (Id.) He
referred her to rheumatology for a connective tissue disease
and hematology for anemia and B12 deficiency. (Id.)
April 25, 2016 cervical MRI revealed the following: (1)
degeneration of the left paramedian protrusion of the C5-6
disc causing mild flattening of the left side of the spinal
cord; (2) a diminished T1 signal in the marrow, possibly due
to marrow replacement disease; and (3) prominent adenoidal
tissue, which was unusual for Giacomelli's age. (Tr.
saw Dr. Sustersic on May 24, 2016, for left shoulder, hip,
and groin pain. (Tr. 310.) She indicated her left shoulder
pain began after dropping a bag of groceries two weeks prior.
(Id.) Dr. Sustersic noted Giacomelli needed to start
B12 shots due to her recent labwork results. (Id.)
On examination, Giacomelli had tenderness in her left AC
joint, with a normal range of motion and muscle strength.
(Tr. 311.) Dr. Sustersic prescribed a course of steroids for
her symptoms. (Tr. 312.)
October 25, 2016, Giacomelli visited Dr. Panteck for left hip
pain. (Tr. 292.) She described this pain as radiating
distally, but not going into her knee. (Id.) She
denied any numbness or back pain. (Id.) On
examination, Giacomelli tended to “lurch towards her
left side” and was tender along her left greater
trochanter. (Id.) She had no tenderness along her IT
band. (Id.) Giacomelli voiced no complaints of groin
pain with hip range of motion testing or heel tap.
(Id.) X-rays of her left hip confirmed no arthritic
changes, acute dislocation, or fracture. (Id.) Dr.
Panteck concluded Giacomelli's hip pain was likely due to
greater trochanteric bursitis and administered a Kenalog and
Lidocaine injection. (Id.)
visited Dr. Sustersic several days later, on October 28,
2016. (Tr. 307.) She described myalgias and pain in her back
and neck. (Id.) On examination, she had tenderness
and skin sensitivity in multiple joints, but her range of
motion and strength testing was normal. (Tr. 308.) Dr.
Sustersic diagnosed fibromyalgia, recommended regular
exercise, and prescribed Cymbalta. (Tr. 309.)
followed up with Dr. Sustersic on December 23, 2016. (Tr.
304.) She felt “much better” on Cymbalta and her
chronic pain levels had dropped from an 8/10 to a 4/10.
(Id.) She reported continued bilateral hip and lower
back pain, but it was improved. (Id.) She requested
an increased dosage of Cymbalta, which Dr. Sustersic
provided. (Tr. 304, 306.) On examination, she had no joint
swelling and a normal range of motion and movement in her
extremities. (Tr. 305.)
9, 2017, Giacomelli visited Dr. Panteck for bilateral hand
and elbow pain, the right side worse than the left. (Tr.
316.) On examination, her right arm was tender to palpation
over the lateral epicondyle and she had significant pain with
resisted wrist and finger extension. (Id.) There was
no tenderness over the medial epicondyle. (Id.) On
the left side, Giacomelli again had tenderness over the
lateral epicondyle, but not to the same degree as the right
side. (Id.) She had mild pain with resisted wrist
and finger extension. (Id.) Dr. Panteck administered
Kenalog and Lidocaine injections in Giacomelli's lateral
continued to report bilateral wrist and elbow pain on May 18,
2017. (Tr. 336.) She indicated the recent injections provided
minimal relief. (Id.) On examination, Giacomelli had
no joint swelling, a normal range of motion, and normal
movements in all of her extremities. (Tr. 337.) Dr. Sustersic
advised her to wear wrist braces at bedtime and ice her hands
for 20-30 minutes, 2-3 times a day. (Tr. 338.) Giacomelli
returned to Dr. Sustersic for right elbow pain on July 21,
2017. (Tr. 333.) On examination, her lateral epicondyle was
tender. (Tr. 335.) Dr. Sustersic prescribed a course of
State Agency Reports
April 30, 2016, Giacomelli underwent a consultative
examination with physician Kyle E. Walker, M.D. (Tr.
259-266.) She reported arm and hip pain. (Tr. 259.) She
indicated her bilateral carpal tunnel release procedures only
alleviated her hand pain for about 2-3 years. (Id.)
On examination, Giacomelli had 4/5 strength in her left
shoulder and 3/5 strength in her left hip flexor. (Tr. 260.)
Otherwise, she had full strength in her upper and lower
extremities. (Id.) She reported numbness and
paresthesia in her 1st, 2nd,
4th, and 5th digits, but her light
touch sensation was otherwise intact in her arms and legs.
(Id.) Her gait favored the left side. (Id.)
of the left hip indicated “mild joint space narrowing
but no other signs of chronic inflammation or
degeneration.” (Tr. 261.) Her right shoulder x-ray was
normal. (Id.) Her grasp was slightly weak
bilaterally, but she had normal manipulation, pinch, and fine
motor coordination. (Tr. 263.) Her cervical spine, shoulder,
elbow, hand, and finger ranges of motion were all normal.
(Tr. 264-265.) Her hip, knee, and ankle ranges of motion were
also normal. (Tr. 266.)
upon this examination, Dr. Walker provided the following
Ms. Giacomelli's history and physical, except for the
1st and second digit parethesias, is typical for
ulnar neuropathy that can be the result of [carpal tunnel
syndrome] or cubital tunnel syndrome. The
numbness/parenthesis of the 1st and 2nd
digits might be attributed to polyneuropathy. An EMG could
better support this. Despite this minor inconsistency, I
believe Ms. Giacomelli's exam to be reliable and would
expect she would have mild to moderate limitations with
lifting and carrying. This is especially true when performing
these activities with heavier objects or for long periods of
time. She may also have mild limitations with handling
The claimant does not have any limitations with sitting,
standing, walking, hearing, speaking, traveling or with
12, 2016, state agency physician Stephen Sutherland, M.D.,
reviewed Giacomelli's medical records and completed a
Physical Residual Functional Capacity (“RFC”)
Assessment. (Tr. 68-70.) Dr. Sutherland determined Giacomelli
could lift and carry 20 pounds occasionally and 10 pounds
frequently; stand and/or walk for 6 hours in an 8-hour
workday; and sit for about 6 hours in an 8-hour workday. (Tr.
68-69.) He further found Giacomelli was limited to occasional
climbing of ramps and stairs, never climbing ladders, ropes,
or scaffolds, frequent stooping, kneeling, and crouching, and
could occasionally crawl. (Tr. 69.) Dr. Sutherland opined
Giacomelli was limited to frequent handling, fingering, and
feeling with the bilateral upper extremities. (Tr. 70.) He
concluded Giacomelli would need to avoid concentrated
exposure to extreme cold, vibration, and hazards and could
not work at unprotected heights or perform commercial
August 26, 2016, state agency physician Dimitri Teague, M.D.,
reviewed Giacomelli's medical records and completed a
Physical RFC Assessment. (Tr. 56-58.) He adopted Dr.
Sutherland's findings. (Id.)