Wrenn v. SSA CV-04-344-PB 06/27/05 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Charles Wrenn

v. Case No. 04-CV-344-PB ____________________________________ Opinion NO.

Jo Anne B. Barnhart, Commissioner, Social Security Administration

MEMORANDUM AND ORDER

Charles Wrenn moves to reverse the Commissioner of Social

Security's ("Commissioner") decision denying his application for

disability insurance benefits. See

(g). Wrenn

argues that the Administrative Law Judge ("ALJ") failed to

consider the combined effect of his impairments, erroneously

interpreted the medical evidence, and did not properly consider

the effect of his subjective pain complaints. The Commissioner

objects and moves for an order affirming his decision. For the

reasons set forth below, I conclude that the ALJ's decision is

supported by substantial evidence. I therefore affirm the

Commissioner's decision and deny Wrenn's motion to reverse. I. BACKGOUND1

A. Procedural History

Charles Wrenn filed an application for disability benefits

on September 6 , 1 9 9 6 , alleging that he had been disabled since

February 11, 1991. His application was initially denied on

November 19, 1996, and denied again on reconsideration on March

11, 1997. Upon Wrenn's reguest, a hearing was held before a

Administrative Law Judge ("ALJ") Robert S. Klingebiel on June 25,

1997. Wrenn did not appear at the hearing.

The ALJ issued his decision on September 9, 1997, finding

that Wrenn was not disabled at any time through December 31,

1996.2 Specifically, the ALJ found that Wrenn retained the

residual functional capacity ("RFC") to perform a significant

number of jobs that existed in the national economy. The Appeals

1 Unless otherwise noted, the background facts recited in this Memorandum and Order are drawn from the Joint Statement of Material Facts (Doc. No. 8) submitted by the parties pursuant to Local Rule 9.1. Citations to the Joint Statement are in the form wT /r

2 Because Wrenn acguired sufficient guarters of coverage to remain insured for disability insurance benefits ("DIB") only through December 31, 1996, he had the burden of showing that he was disabled on or before his insured status expired. See

, 404.130-404.131.

- 2 - Council denied Wrenn's request for review on November 30, 1998.

Wrenn then filed a complaint in this court. On July 6, 1999, I

remanded the case "for the purpose of obtaining additional

testimony and evidence which shows [Wrenn's] medical condition

through December 31, 1996, and to obtain testimony from a

vocational expert as to the extent to which [Wrenn's]

nonexertional limitations erode his ability to perform light

w o r k ."

On July 18, 2000, ALJ Klingebiel held a second hearing at

which Wrenn appeared and was represented by counsel. A

vocational expert also testified. The ALJ issued his second

decision on August 7, 2000. Again, he found that Wrenn was not

disabled at any time through December 31, 1996. The Appeal's

Council denied Wrenn's request for review on July 12, 2004,

making the ALJ's August 7, 2000 decision the final decision of

the Commissioner.

.

B. Education and Work History

Wrenn was forty-four years old on August 7, 2000.3 He

completed the ninth grade and had both carpentry and electrical

3 Mr. Wrenn was born on August 18, 1955.

- 3 - vocational training. Prior to February 11, 1991, his last day of

work and the alleged onset date of his disability, he had been

employed at various times as a windshield installer, window

assembler, truck driver, baker's helper, dishwasher, and

injection molding machine operator.

C. Medical History

From February 23, 1988, through May 17, 1993, Wrenn was

treated by Dr. Garrett Gillespie for injuries and pain in his

neck, left hand, and back. Dr. Gillespie opined on December 11,

1990 that Wrenn should not do any heavy lifting or repetitive

bending because of his neck problems.

According to Dr. Gillespie's March 12, 1991 office visit

note, Wrenn continued to have neck pain that extended out to his

left shoulder. Dr. Gillespie noted that Wrenn's neck extension

and lateral flexion to the left were limited by spasms in the

left trapezius muscle group. Nevertheless, Dr. Gillespie

reported that Wrenn's strength was intact, his shoulder motion

was good, and his reflexes were symmetrical. Wrenn continued to

experience neck and arm pain for the next two years, as Dr.

Gillespie's office visit notes indicate.

- 4 - Following a May 11, 1993 office visit. Dr. Gillespie

reported that Wrenn was able to do light activity, and he

encouraged Wrenn to be retrained to do light mechanical repair

work. Dr. Gillespie recommended that Wrenn avoid prolonged

bending, lifting, crawling, and climbing, and should not lift

more than 15 pounds on a non-repetitive basis.

Wrenn was examined by a neurologist. Dr. Robert Thies, on

July 7, 1994. Dr. Thies noted that Wrenn had a cervical

discectomy4 with fusion in 1988, and that he began experiencing

lower back pain after falling while running in the park in 1992.

Dr. Thies found that Wrenn's neck movement was limited in all

directions, but that the strength in his upper and lower

extremities was full and his reflexes were symmetrical. Because

Wrenn experienced discomfort in his lower back when performing a

straight leg raise. Dr. Thies ordered a lumbar x-ray and CT scan.

After his July 7, 1994 appointment, Wrenn failed to return

to Dr. Thies for a follow-up until February 21, 1996. Dr. Thies

reported that the 1994 CT scan of Wrenn's spine showed some disc

4 A cervical discectomy is the excision, in part or in whole, of an intervertebral disk of the cervical spine. Stedman's Medical Dictionary 442-43 (25th ed. 19 9 0 ) ("Stedman's" ) .

- 5 - bulging at L3-4 and L5-S1, but no frank disc herniation. At this

time, Wrenn was taking several medications, including Soma and

Aleve for physical pain, and Zoloft for his mood.5 Wrenn told

Dr. Thies that Zoloft had greatly improved his mood.

When Dr. Thies examined Wrenn in February 1996, he found

Wrenn's strength remained excellent in both his upper and lower

extremities, but that his neck movement had decreased in all

directions. Dr. Thies thus concluded that Wrenn's discomfort may

have resulted from musculoskeletal etiology6 and prescribed

Metaxalone.7 Four weeks later, on March 18, 1996, Dr. Thies

noted that Wrenn's MRI testing showed mild bulging at C4-5, an

apparently stable fusion at C5-6, and disc degeneration at L3-4,

but no marked abnormalities in the spinal canal. Dr. Thies

therefore diagnosed Wrenn with cervical and lumbar strain rather

5 Zoloft is prescribed to treat Major Depressive Disorder. Physician's Desk Reference 2691 (58th ed. 2004) ("PDR") . Soma is used as an adjunct to rest, physical therapy, and other measures for the relief of discomfort from musculoskeletal conditions. PDR 1919.

6 Musculoskeletal etiology is a disease of the muscles or skeleton. Stedman's 994, 542 (25th ed. 1990).

7 Metaxalone is used as an adjunct to rest, physical therapy, and other measures for the relief of discomfort from musculoskeletal conditions. PDR 2181.

- 6 - than discogenic radiculopathy.8 He encouraged Wrenn to get

"going on his activities of daily living a bit better" and

scheduled physical therapy.

Wrenn started physical therapy with Lori Le Barnes on April

9 , 1996. At the initial session, he expressed scepticism about

physical therapy, but agreed to try it for one month. On May 7,

1996, Le Barnes discharged Wrenn from physical therapy because he

was not satisfied with the results.

On September 13, 1996, Wrenn completed an Activities of

Daily Living form. He indicated that he showered daily, cooked,

walked for 15 to 20 minutes twice each day, and did chores around

the house. Wrenn also reported that he shopped for groceries

with his wife and daughter, did the dishes, and tried to fix

things around the house. Wrenn indicated that he had difficulty

concentrating when he was experiencing stress, and that he had

trouble finishing tasks because of the problems with his neck,

arm, and back. He explained that he had not tried to return to

work because no one would hire him due to his condition.

8 Radiculopathy is a "disease of the nerve roots." Borland's Illustrated Medical Dictionary 1562 (30th ed. 2 0 0 3 ) ("Dorland's").

- 7 - Wrenn was admitted to New Hampshire Hospital on October 1,

1996, after threatening to kill his neighbors and attempting

suicide by cutting his abdomen and left hand. He said that he

felt overwhelmed because he did not have enough money for food.

Wrenn later explained that he became upset when his treating

physician refused to prescribe his medication over the telephone,

and he could not get a ride to the doctor's office. He indicated

that this episode was directly related to consuming alcohol.

At New Hampshire Hospital, Wrenn admitted that he had been

smoking up to ten marijuana joints per day since he was 12 years

old. He also admitted to having two alcoholic drinks per day.

At that time, Wrenn had been taking Zoloft and BuSpar for one

year, and reported that these medications were very helpful.

However, he was not seeing any mental health counselors and had

no past psychiatric admissions.

According to the hospital's intake assessment, Wrenn had a

logical and goal directed thought process, clear and normal

speech, a depressed mood and angry affect, concrete reasoning,

poor judgment, and fair insight. He exhibited no delusions,

hallucinations, suicidal thoughts or plans, or homicidal thoughts

or plans. There was no evidence of cognitive or affective disorder, and his level of control was excellent. Wrenn did not

display any symptoms of formal mental illness, and he stated that

he was no longer suicidal. Accordingly, he was discharged on

October 4, 1996, and was given a one week supply of Zoloft and

BuSpar. Dr. Howard Suls, Wrenn's treating physician, renewed

these prescriptions on October 7, 1996.

At the reguest of the Social Security Administration, Dr.

Burton Nault, a non-examining state agency physician, completed a

physical RFC assessment of Wrenn on October 8, 1996 .9 Dr. Nault

determined that Wrenn could occasionally lift 20 pounds,

freguently lift ten pounds, stand and/or walk for about six hours

in an eight hour workday, sit for about six hours in an eight

hour workday, and push or pull without any limitations. He also

determined that Wrenn could occasionally climb, balance, stoop,

kneel, crouch, and crawl, but could not perform repetitive

overhead reaching. Dr. Nault thus concluded that Wrenn had the

capacity to do light work without repetitive bending, lifting, or

overhead reaching.

Similarly, at the reguest of the Social Security Disability

9 Dr. Nault's RFC was affirmed by a nonexamining state agency physician on January 28, 1997. Determination office, psychologist John T. Bourpos, Ph.D.,

completed a consultative evaluation of Wrenn on October 30, 1996.

Dr. Bourpos noted that Wrenn had been on a regimen of Zoloft and

BuSpar for over one year. According to Dr. Bourpos, Wrenn

claimed that he was unable to return to work because of his

physical limitations. Upon examination. Dr. Bourpos found that

Wrenn had good overall hygiene, was appropriately friendly and

cooperative, with good persistence and patience. Wrenn was also

found to be alert and responsive, despite an expression that

indicated sadness and depression. There were no indications of

loose associations, pressured speech, or flight of ideas, and

Wrenn's affect was appropriate.

Dr. Bourpos noted that Wrenn had experienced continuous

depression and feelings of anxiety over the previous six months.

Wrenn told Dr. Bourpos that during this time, he had experienced

depressed moods, loss of interest in activities, feelings of

guilt, motor retardation, sleep disturbances, fatigue, difficulty

concentrating, and diminished libido. He also reported symptoms

of anxiety, including palpitations, light headedness, sweating,

muscle aches, clammy hands, gastro-intestinal problems, nausea,

muscle twitching, and a dry mouth. Dr. Bourpos indicated that it

- 10 - was unclear whether Wrenn's pattern of anxiety symptoms occurred

only during depressive episodes and noted that he wanted to

explore this issue further.

Based on these observations. Dr. Bourpos concluded that

Wrenn's concentration and attention were mildly impaired and that

his short term memory and orientation were intact. He estimated

that Wrenn's intellectual ability is in the low average range and

his computational skills are adeguate. Based on this evaluation.

Dr. Bourpos reported that Wrenn's mental condition did not appear

to interfere with his daily activities, social functioning, or

his concentration and task completion. He used public

transportation and telephones, was able to do light chores and

could manage his own funds, and was capable of appropriately

interacting and communicating with others. Wrenn also appeared

capable of following and completing oral and written instructions

of intermediate difficulty. Nonetheless, Dr. Bourpos concluded

that Wrenn's depression, anxiety, and thoughts of self-harm would

compromise current vocational functioning and that in a work

setting, he would likely have limited attendance, a slow pace,

and low energy. Dr. Bourpos also noted, however, that Wrenn did

not report any past difficulties in complying with reguired

- 11 - attendance, work schedules, decision making, or interactions with

co-workers or supervisors.

Ultimately, Dr. Bourpos diagnosed Wrenn with Major

Depression, recurrent,10 but ruled out Generalized Anxiety

Disorder11 and Personality Disorder with borderline paranoid

features. He determined that without some form of therapeutic

intervention, in addition to medication, Wrenn's prospects for

rehabilitation were poor. Finally, he recommended further

evaluation of Wrenn's cognitive functioning and potential for

vocational rehabilitation.

On November 19, 1996, Dr. Udo Rauter, a nonexamining state

agency psychologist, completed a Psychiatric Review Technigue

Form ("PRTF") of Wrenn.12 Dr. Rauter found that Wrenn suffered

10 "Major Depression, recurrent," is characterized by the presence of two or more major depressive episodes. Diagnostic and Statistical Manual of Mental Disorders 376 (4th ed. 2000)("DSM").

11 "The essential feature of Generalized Anxiety Disorder is excessive anxiety and worry (apprehensive expectation), occurring more days than not for a period of at least [six] months, about a number of events or activities." DSM 472 (4th e d . 2 0 0 0).

12 Dr. Rauter's PRTF was affirmed by Dr. Michael A. Schneider, a nonexamining state agency psychologist, on February 28, 1997.

- 12 - from severe mental impairments consisting of depression, not

otherwise specified, and personality disorder, but that his

impairments were not expected to last twelve months. Dr. Rauter

noted that there was insufficient medical evidence to assess

whether Wrenn had a medically determinable mental impairment

prior to October 1, 1996. Furthermore, Dr. Rauter opined that

Wrenn had only slight restrictions on his activities of daily

living and in maintaining social functioning, and that he seldom

experienced deficiencies in concentration, persistence, or pace

that would result in failure to complete a task. Finally, Dr.

Rauter noted that Wrenn had only one or two episodes of

deterioration or decompensation in a work-like setting.

At the reguest of Dr. Suls, Kathleen C. Leahy, an

osteopathic physician, evaluated Wrenn for his neck and back pain

on November 25, 1996. Wrenn denied drinking alcohol, but

admitted to smoking between five and ten marijuana joints per

day. Dr. Leahy assessed chronic pain, mostly myofascial13 in

origin, involving the lower cervical and trapezius areas, a

13 Myofascial pain involves the "sheet or band of fibrous tissue such as lies deep to the skin or forms an investment for muscles and various other organs of the body." Dorland's at 674, 1213 .

- 13 - history of left biceps tendon injury, generalized musculoskeletal

deconditioning with muscle imbalance and abdominal weakness, and

chronic pain secondary to his conditions. She indicated that

Wrenn had low motivation to return to work, but nevertheless

recommended that he proceed with a trial of vocational

rehabilitation for a light duty or sedentary position. Dr. Leahy

further recommended an active rehabilitation program and

encouraged Wrenn to attend, although she was not optimistic that

he would participate.

Dr. Leahy examined Wrenn again on January 10, 1997. in her

office notes, she reported that he suffered from chronic pain,

including mild myofascial pain in the lower cervical and

trapezius areas. She assessed lumbar spine degenerative disc

disease without clear findings of radiculopathy and general

muscle deconditioning of the hip and abdominal muscles.

Notwithstanding these findings. Dr. Leahy reported that Wrenn's

attitude had improved and that he was more motivated with a

positive outlook. Dr. Leahy recommended physical therapy and

again discussed with Wrenn a return to gainful employment.

On June 25, 1997, Dr. Virginia Emery, Ph.D., examined Wrenn

for the first time. She reported that he suffered from Major

- 14 - Depressive Disorder and severe Anxiety Disorder of the Post

Traumatic Stress Disorder subtype. Dr. Emery opined that Wrenn

had suffered from these disorders for many years, but that their

severity had recently escalated.14

D. Hearing Testimony of Charles Wrenn and Vocational Expert

1. Wrenn's Testimony

At the July 18, 2000 hearing, Wrenn testified that he

suffered a neck injury at work in 1985, and had surgery on his

neck in 1987. Wrenn explained that he reinjured his neck while

doing physical labor at Portland Glass, where he was employed as

a windshield, sunroof, and door glass installer, and that he took

Soma for the pain. Wrenn also reported that he injured his

biceps tendon in 1985, but never had surgery and the injury thus

failed to heal properly. Wrenn testified that he suffered a back

injury in 1992 when he fell in the park while walking his dog and

14 On January 15, 2000, Dr. Emery completed a medical assessment of Wrenn's ability to do work-related activities. Based on this assessment, she concluded that he was too unpredictable and unreliable with respect to rage responses to be absorbed into the work force. She reported that he met the full criteria for Post Traumatic Stress Disorder and that he suffered from Intermittent Rage Disorder. Dr. Emery noted that Wrenn was not actively suicidal and his rage responses were less freguent due to psychotherapy. She further concluded that his stability was dependant upon medication.

- 15 - that pool therapy improved his back pain. According to Wrenn,

his back condition remained the same until January 2000, when he

aggravated it in a car accident.

Wrenn explained that he could turn his neck to the right,

but felt pain when he tried to turn it to the left. Nonetheless,

he was able to cut his neighbor's hedges, take care of her

property, take out her trash, and work on cars at his own pace.

Wrenn testified that he started having trouble dealing with

people the day Portland Glass let him go. He stated that he

tried looking for work after he lost his job, but was unable to

find anything. Wrenn explained that he "lost it" when his son

was sent to prison for assault in 1993. He conceded that he had

a problem with alcohol and had used marijuana, but denied that he

was addicted to either drugs or alcohol.

Finally, Wrenn testified that he began seeing Dr. Emery, a

psychologist, in 1997. Prior to that, his primary care physician

had prescribed Zoloft and BuSpar for depression and anxiety. At

the time of the hearing, Wrenn was taking both Zoloft and BuSpar,

as well as Soma and medication for nausea and stomach cramps.

Wrenn stated that when he was off his medication for two weeks in

the fall of 1996, he became very distressed and inflicted wounds

- 16 - on himself. He was ultimately taken to the New Hampshire

Hospital for evaluation.

2. Testimony of The Vocational Expert Howard Steinberg

Vocational expert ("VE") Howard Steinberg testified that

Wrenn's past work as a windshield installer was skilled medium

work, his job as a window assembler was semi-skilled medium work,

his job as a baker's helper was unskilled heavy work, his job as

a truck driver was semi-skilled medium work, his job as an

injection molding machine operator was unskilled light work and

his job as a dishwasher was unskilled medium work.

The ALJ asked VE Steinberg to assume that an individual of

Wrenn's age, education, and work experience had the following

restrictions: (a) no strenuous lifting and carrying of objects

(limited to twenty pounds maximum lifting but not on a repetitive

or very freguent basis); (b) no reaching over the shoulder more

than periodically (less than one third of the time); (c) no

waiting on the public; and (d) no working in close, critical

situations with other people, such as on an assembly line or

where a great deal of interaction among co-workers is reguired.

Presented with these limitations, VE Steinberg opined that such

an individual could not perform any of Wrenn's past relevant

- 17 - work. VE Steinberg further testified that such an individual

could perform other work that existed in significant numbers in

the national economy, including security guard at the light duty

level, security guard at the sedentary level, courier, and mail

clerk.

The ALJ then asked VE Steinberg to evaluate the stress

associated with each of the jobs he identified on a scale of 1 to

5, with 1 as the least stressful and 5 as the most stressful.

The ALJ explained that he wanted to rule out jobs at levels 4 and

5. VE Steinberg then testified that all of the jobs he listed

were either 2 or 3 on the scale except courier, which, at times,

could be at level 4. He explained that the security jobs he

listed did not involve interacting with the public, but instead

involved watching space, and that the mail clerk job would not

typically involve high stress situations. VE Steinberg's

testimony was uncontradicted.

II. STANDARD OF REVIEW

After a final decision by the Commissioner denying a

claimant's application for benefits, and upon a claimant's timely

- 18 - request, I am authorized to review the pleadings submitted by the

parties and the administrative record and enter a judgment

affirming, modifying, or reversing that decision. See

0 5 (g) (2003). My review is limited in scope, however, as the

ALJ's factual findings are conclusive if they are supported by

substantial evidence. See i d .; Irlanda Ortiz v. Sec'y of Health

& Human Servs.,

(1st Cir. 1991) (per curiam).

The ALJ is responsible for making credibility determinations,

drawing inferences from the evidence, and resolving evidentiary

conflict. Irlanda Ortiz,

; Frustaglia v. Sec'y of

Health & Human Servs.,

(1st Cir. 1987). I

therefore must "uphold the [Commissioner's] findings . . . if a

reasonable mind, reviewing evidence in the record as a whole,

could accept it as adequate to support [the Commissioner's]

conclusion." Irlanda Ortiz,

(quoting Rodriguez

v. Sec'y of Health & Human Servs.,

(1st Cir.

1981)(internal quotation marks omitted).

The ALJ's findings of fact are not conclusive, however, if

they are "derived by ignoring evidence, misapplying the law, or

judging matters entrusted to experts." Nguyen v. Chater,

(1st Cir. 1999)(citations omitted). If the

- 19 - Commissioner, through the ALJ, has misapplied the law or has

failed to provide a fair hearing, deference to the Commissioner's

decision is not appropriate, and remand for further development

of the record may be necessary. See Seavey v. Barnhart,

(1st Cir. 2001). I apply these standards in reviewing

Wrenn's motion to reverse the Commissioner's decision.

III. ANALYSIS

The Social Security Act defines "disability" for the

purposes of Title II as the "inability to engage in any

substantial gainful activity by reason of any medically

determinable physical or mental impairment which can be expected

to result in death or which has lasted or can be expected to last

for a continuous period of not less than 12 months."

(d)(1)(A) (2003). When evaluating whether a claimant is

disabled due to a physical or mental impairment, an ALJ's

analysis is governed by a five-step seguential evaluation

process. See

. An ALJ is reguired to

consider the following issues when determining if a claimant is

disabled: (1) whether the claimant is engaged in substantial

- 20 - gainful activity; (2) whether the claimant has a severe

impairment; (3) whether the impairment meets or equals a listed

impairment; (4) whether the impairment prevents or prevented the

claimant from performing past relevant work; and (5) whether the

impairment prevents or prevented the claimant from doing any

other work.

. An affirmative answer at one

step leads to the next step in the analysis.

If the answer

to question (3) or (5) is affirmative, the claimant is disabled.

If the answer to any question other than (3) is negative,

the claimant is not disabled.

The claimant bears the burden

on the first four steps. At step five, the burden shifts to the

Commissioner to show "that there are jobs in the national economy

that [the] claimant can perform."

(f);

Heggarty v. Sullivan,

(1st Cir. 1991) . The

Commissioner must show that the claimant's limitations do not

prevent him from engaging in substantial gainful work, but need

not show that the claimant could actually find a job. See

Keating v. Sec'y of Health & Human Servs.,

(1st

Cir. 1988).

Here, the ALJ determined at step five that Wrenn was not

entitled to benefits because he found Wrenn's residual functional

- 21 - capacity allowed him to perform jobs existing in the national

economy such as security guard, courier, and mail clerk. Wrenn

now argues that the ALJ (1) failed to consider the combined

affect of his physical and mental impairments; (2) erroneously

interpreted the medical evidence; and (3) did not properly

consider his subjective pain complaints. I address each argument

in turn.

A. The Combined Effect of Wrenn's Impairments

Wrenn first argues that at step three the ALJ failed to

consider the combined effect of his physical and mental

impairments on his ability to perform substantial gainful work.

I disagree. As a preliminary matter, I note that it is Wrenn's

burden to show that he has an impairment or impairments that meet

or egual a listed impairment in Appendix 1. Torres v. Sec'y of

Health & Human Servs.,

(1st Cir. 1989) (per

curiam). Wrenn has not stated, nor has he otherwise indicated,

which listing his impairments purportedly "egual." See Garcia v.

Sec'y Health & Human Servs.,

(1st Cir.

1994) (unpublished table opinion) .

In any event, I reject Wrenn's assertion that there is no

evidence in the record that the ALJ considered either the

- 22 - combined effect of his multiple impairments or the medical

equivalence of his impairments. To the contrary, the ALJ

specifically concluded in Finding 3 of his August 7, 2000

decision that "[t]he medical evidence establishes that . . .

[Wrenn] had depression with symptoms of anxiety, a personality

disorder, cervical and lumbar disc disease, impairments which are

severe, but which did not meet or equal the criteria of any of

the impairments listed in Appendix 1, Subpart P." Tr. 2 69.

The ALJ's ultimate conclusion is buttressed by his thorough

examination of the record and the questions he directed to VE

Steinberg. For example, the ALJ found that "due to the effects

of mental illness, [Wrenn] was unable to deal with the public,

perform assembly line tasks, and perform work functions requiring

close interaction with co-workers." Tr. 267. The ALJ thus

determined that Wrenn's "capacity for light work was diminished

by significant non-exertional limitations in addition to the

prohibition on repetitive overhead reaching and handling." Tr.

267. Thus, the record reveals, the ALJ specifically examined the

impact of Wrenn's mental impairments on his ability to perform

light and sedentary work.

- 23 - Moreover, the ALJ specifically directed VE Steinberg to

consider not only Wrenn's age, educational background, employment

history, and the prohibition on overhead reaching and handling,

but also his inability to deal with the public, perform assembly

line tasks and have close interaction with co-workers. The ALJ

expressly stated that he wanted to excluded from the analysis

jobs involving high levels of stress. Assuming these

restrictions, VE Steinberg identified four jobs that Wrenn could

perform. At the ALJ's direction, VE Steinberg testified that all

four of the cited jobs involve relatively low stress levels. As

these guestions clearly indicate, the ALJ properly and reasonably

considered the combined effect of Wrenn's physical and mental

impairments at step three of his analysis.

B. Interpretation of the Medical Evidence

I also reject Wrenn's argument that the medical evidence

submitted by Dr. Emery and Dr. Bourpos support a finding of

disability. With respect to the evidence from Dr. Bourpos, the

ALJ properly evaluated his contradictory conclusions. For

example, on October 30, 1996, Dr. Bourpos noted that although

Wrenn's depression, anxiety, and thoughts of self-harm would

- 24 - likely make it difficult for him to cope with work pressures and

would compromise his current vocational functioning, he also

stated that Wrenn's mental condition did not interfere with his

daily activities, social functioning, or his concentration and

ability to complete tasks. Likewise, Dr. Bourpos opined that

Wrenn appeared capable of following and correctly completing oral

or written instructions of intermediate difficulty, and that his

short-term memory and orientation were intact, his thought

process was reasonable and coherent, and his persistence and

patience were both "good." Nonetheless, he concluded that

without some form of therapeutic intervention, in addition to

medication, Wrenn's prospects for rehabilitation were poor. The

ALJ considered this conflicting evidence and reasonably

determined that, when viewed in concert with the other medical

evidence in the record, particularly Dr. Rauter's November 19,

1996 psychiatric review that classified his impairment as severe

but not expected to last 12 months, Wrenn's impairments did not

meet or egual the criteria of any of the impairments listed in

Appendix 1. Such a resolution of conflicting medical evidence is

properly within the ALJ's province and must not be disturbed

where, as here, the resolution is reasonable.

- 25 - Furthermore, the ALJ reasonably considered and appropriately

declined to accept the record evidence from Dr. Emery because her

opinions could not be related to the relevant time period. Dr.

Emery first examined Wrenn on June 25, 1997, nearly six months

after his date last insured. Dr. Emery opined in a July 30, 1997

letter to his attorney that Wrenn suffered from Major Depressive

Disorder and severe Anxiety Disorder. She further opined that

Wrenn had suffered from these disorders for several years but

that they had recently become more severe.15 Dr. Emery did not,

however, suggest that Wrenn's impairments were severe during the

period prior to December 31, 1996. Nor did she indicate any

restrictions in his daily activities, social functioning,

concentration, persistence, or pace. See 20 C.F.R. part 404,

Subpart P, Appendix 1, §§ 12.04B and 12.08B. I therefore

conclude that the ALJ reasonably evaluated the medical evidence

in the record for the relevant time period and properly

determined that Wrenn's impairments did not meet or egual the

15 As the ALJ noted in his August 7, 2000 decision. Dr. Emery's January 15, 2000 assessment of Wrenn's ability to perform work-related functions could not be related to his condition on or before December 31, 1996 because it was not supported by any treatment notes in the record during this period. Tr. 266.

- 26 - requirements of any impairments listed in the regulations.

C. Credibility of Wrenn's Complaints of Pain

Finally, I reject Wrenn's argument that the ALJ failed to

consider the effect of his subjective complaints of pain on his

ability to work. In determining the credibility of a person's

statements, the ALJ must consider the entire record, which

includes the objective medical evidence, the individual's

subjective statements about symptoms, information provided by

medical specialists, and any other relevant evidence in the

record. S.S.R. 96-7(p),

at *1. A claimant's

subjective statements may suggest a more severe impairment "than

can be shown by objective medical evidence alone."

(c)(3). So long as a credibility determination is

supported by the evidence, the ALJ's determination is entitled to

deference since he observed the claimant, evaluated the

claimant's demeanor, and considered how his testimony

corresponded with the rest of the evidence. Frustaglia,

.

In assessing Wrenn's RFC, the ALJ partially credited Wrenn's

subjective complaints concerning his physical limitations and

pain allegations. Nonetheless, the ALJ reasonably determined

- 27 - that Wrenn's complaints of symptoms and disabling limitations

were not so severe as to render him disabled. Moreover, because

the ALJ did not find Wrenn's statements as to the severity of his

symptoms entirely credible, he made "specific findings as to the

relevant evidence he considered in determining to disbelieve the

[claimant]" as reguired. Da Rosa v. Sec'y of Health & Human

Servs.,

(1st Cir. 1986). As the ALJ's decision

and the hearing transcript demonstrate, the ALJ properly

considered the Avery factors and supported his findings by

discussing Wrenn's daily activities, social functioning, and

functional abilities.16 See Frustaglia,

(stating

an ALJ's credibility assessment is given deference when he

"thoroughly guestioned the claimant regarding his daily

activities, functional restrictions, medication, prior work

record, and freguency and duration of the pain . . . in

16 In Avery v. Sec'y of Health & Human Servs., the First Circuit held that in evaluating a claimant's subjective symptoms, an ALJ must consider (1) the nature, location, onset, duration, freguency, radiation, and intensity of any pain; (2) precipitating and aggravating factors (e.g., movement, activity, environmental conditions); (3) type, dosage, effectiveness, and adverse side-effects of any pain medication; (4) treatment, other than medication, for relief of pain; (5) functional restrictions; and (6) the claimant's daily activity. 797 F.2d at 28-29.

- 28 - conformity with the guidelines set out in Avery It

was therefore reasonable for the ALJ to conclude at step five

that Wrenn retained the residual functional capacity to perform

both light duty and sedentary work.

IV. CONCLUSION

Because I have determined that the ALJ's denial of Wrenn's

benefits is supported by substantial evidence, I affirm the

Commissioner's decision. Accordingly, Wrenn's Motion to Reverse

(Doc. No. 6) is denied, and the Commissioner's Motion for an

Order Affirming the Decision of the Commissioner (Doc. No. 7) is

granted. The clerk of court shall enter judgment accordingly.

SO ORDERED.

/s/Paul Barbadoro____________ Paul Barbadoro United States District Judge

June 27, 2005

cc: James W. Craig, Esg. David L. Broderick, Esg.

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