UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Jennifer Lawton

v. Civil No. ll-cv-189-JD Opinion No.

Michael Astrue, Commissioner Social Security Administration

O R D E R

Jennifer Lawton seeks judicial review of the denial of her

application for Social Security Disability Benefits. See

(g). Lawton contends that the administrative law

judge ("ALJ") incorrectly found that despite her severe

impairments due to ACL strain of the left knee, obesity, post-

traumatic stress disorder, and panic disorder, she retained the

residual functional capacity to perform light work with certain

additional limitations. The Commissioner moves to affirm the

decision. For the reasons that follow, the decision is affirmed.

Background

The background information is taken from the parties' joint

statement of material facts, augmented, as necessary, by the

administrative record. See LR 9.1(b). Lawton filed an application for disability insurance

benefits on June 30, 2009, alleging a disability that began on

July 17, 2008, when she was thirty-five years old. At that time,

Lawton worked as a cook at a restaurant, Bagel Works, where she fell on a wet floor, injuring her hip and knee. Her other past

work included jobs as a waitress, a cook, a restaurant manager, a

personal care assistant, and a production assembler at a factory.

At the time of her application, she was taking online college

classes at Franklin Pierce University toward a Bachelor's Degree

in criminal justice.

A . Medical Records of Physical Impairments

After the fall on July 17, 2008, Lawton was examined at

Cheshire Medical Center by Dr. Karoline Kimball who noted a superficial abrasion on her left knee but no swelling or other

deformity. The x-ray was "perfect," showing no evidence of

degenerative change or fracture. Dr. Kimball assessed Lawton

with a bruised left knee and a strained left hip. Vicodin was

prescribed for pain, and Lawton was given crutches. During

subsequent treatment visits, Lawton continued to report knee pain

and continued to use crutches. Dr. Kimball wrote in her medical

notes that Lawton's complaints of tenderness and pain were "a

2 little over reactive." Dr. Kimball stated that Lawton "certainly could work doing a sit-down job only."

Lawton did physical therapy to strengthen her knee. On

August 8, 2008, Dr. Kimball reported that an MRI of Lawton's knee

showed evidence of an ACL strain. Dr. Kimball instructed Lawton

to be more active and released her to work at her job at Bagel

Works but only three to four hours each day. Because Bagel Works

did not have light duty work Lawton could do, Dr. Kimball restricted her from working.

On August 29, 2008, Dr. Kimball referred Lawton to an

orthopedic surgeon, Dr. Wade Penny. Lawton had a consultative examination with Dr. Penny on September 11, 2008. Dr. Penny

concluded that Lawton's MRI scans and x-rays suggested a minor strain-type injury with very mild inflammation. On examination,

Dr. Penny concluded that Lawton's bruise was not significant. He

concurred with Dr. Kimball's opinion that Lawton was capable of sedentary work.

Lawton sought a second opinion from Dr. Shawn Harrington on

September 16, 2008. Dr. Harrington also found no basis from his

examination and Lawton's scans that would indicate chronic

difficulty with her left knee. Dr. Harrington stated that Lawton could do sedentary full-time work. On October 3, 2008, Dr.

Harrington reported that Lawton had improved and cleared her for

3 light duty work with certain limitations. Dr. Harrington again

cleared Lawton for light duty work with certain restrictions on

October 31, 2008. An MRI of Lawton's knee done on December 3,

2008, was negative except for a possible small increase in fluid

in the joint. Dr. Harrington suggested injections for knee pain. Dr. Harrington restricted Lawton to avoid kneeling, squatting,

and climbing and gave her a temporary limitation to standing and

walking for no more thanthirty minutes each hour. Her ability

to sit, reach, and drive was unrestricted.

In January of 2009, Lawton reported considerable improvement and that she was looking for work. Dr. Harrington stated that

Lawton could lift and carry weight at the light exertional level

and could frequently stand and walk. She was limited in kneeling, squatting, and climbing but not restricted in sitting,

bending, reaching, or driving.

Dr. Sachin Dave did a neurological examination on February

27, 2009, because of Lawton's complaints of numbness in her left foot. Lawton denied any symptoms or pain in her back, arms, or

her right leg. On examination, Lawton had normal strength in her

left leg and foot muscles, normal reflexes, normal sensory responses, and normal gait. An additional test showed no

significant abnormalities.

4 Dr. Pamela Deberghes, examined Lawton on March 31, 2009, at

Dr. Harrington's request, because of Lawton's continued

complaints of pain in her left knee. She noted that Lawton's

complaints of pain were out of proportion to the minimal

objective findings, suggesting that Lawton's pain might be

exaggerated because of secondary gains. She concluded that

Lawton probably had patellar chondromalacia, which was

exacerbated by her bruise and her obesity.1 Dr. Deberghes stated

that losing weight might be the best option but also recommended

arthroscopic surgery.

Lawton had arthroscopic surgery on her left knee with

resection of the symptomatic medial plica on April 28, 2009.2 At

her postoperative examination, Lawton complained of difficulty

with pain control. Dr. Ronald E. Michalak stated that Lawton's

chronic use of narcotics for "benign musculoskeletal pain" had increased her tolerance for pain medication. Although Lawton was

walking without crutches or medication in May of 2009, in August

of 2009 she reported to Dr. Harrington that she had global pain

throughout her left leg. Dr. Harrington found that Lawton's

complaints of pain were out of proportion to his findings on

1Patellar chondromalacia is a pain syndrome related to the cartilage under the kneecap.

2The medial plica is part of the joint lining of the knee.

5 examination and stated that Lawton's obesity worked against her recovery. On September 16, 2009, Lawton had a left lumbar nerve

block and reported that she was doing better by October 1

although she continued to complain of left knee and hip pain. X-

rays and bone scans were normal. In January of 2010, Dr. Yulan Wang, a pain specialist,

prescribed a low dose of Hydrocodone, a pain medication, and a

trial of Topamax, a medication used to treat seizures. An MRI

done on March 10, 2010, of Lawton's hip produced normal results,

and a radiological examination of her left ankle in April showed

that her ankle was normal.

Dr. Burton Nault, a state agency consultant, reviewed

Lawton's medical records on October 21, 2009. Dr. Nault assessed

Lawton's residual functional capacity in light of Lawton's knee

problem and obesity since July 17, 2008. He concluded that Lawton could lift, carry, push, or pull twenty pounds

occasionally and ten pounds frequently; that she could stand or walk for about six hours during an eight-hour work day, and that

she could sit for about six hours in an eight-hour work day. Dr.

Nault found no other limitations.

On August 26, 2010, Joan Van Saun, a licensed occupational

therapist, did a functional capacity evaluation of Lawton. Van

6 Saun concluded that Lawton could only do part-time sedentary work

and could not return to her job as a cook at Bagel Works.

B . Medical Evidence of Mental Impairments Lawton had an appointment with her primary care provider on

July 7, 2008, for assessment of her mood symptoms. Lawton

discussed having felt depressed for years and the sources of

stress in her life. The nurse practitioner suggested

psychotherapy and prescribed medication for depression and

anxiety.

On October 13, 2009, Lawton had a consultative examination

done by Richard W. Root, Ed.D., to assess her anxiety. Root

concluded that Lawton experienced post traumatic stress disorder

("PTSD"), panic attacks with agoraphobia, and a mood disorder

related to her knee problem. Root found that Lawton's

impairments did not impact her ability to perform activities of

daily living, allowed her to remember simple instructions and to

concentrate on and complete normal work tasks.

Nicholas Kalfas, Ph.D., completed a Psychiatric Review

Technique form on October 20, 2009, based on his review of

Lawton's records pertaining to mental impairment. Dr. Kalfas

concluded that Lawton's mood disorder, PTSD, and panic disorder

with agoraphobia caused a mild degree of limitation in Lawton's

7 daily activities and her ability to maintain concentration,

persistence, or pace. Her impairments caused a moderate degree of limitation in her ability to maintain social functioning. Dr.

Kalfas concluded that Lawton was able to understand, remember,

and carry out simple instructions; to maintain attention and

complete a normal work week; to make simple work decisions; and

to interact appropriately with peers and supervisors. Dr. Kalfas

also noted that Lawton could adapt to a work setting when

supervisors were not overly critical and when she could avoid the

general public and large groups of people.

From November 5, 2009, to June 29, 2010, Lawton was treated

at Antioch Psychological Services Center. The final diagnosis

made there was PTSD. Lawton was assessed as having a Global

Assessment of Functioning ("GAF") score of 50.3 Lawton began treatment with Dr. Pamela Olsson on April 5,

2010, for management of her medication to address psychological

symptoms and sleep problems. On September 1, 2010, Dr. Olsson

completed a "Medical Source Statement of Ability to Do Work-

Related Activities (Mental)." Dr. Olsson indicated that Lawton

had no limitation in her ability to understand, remember, and

3A GAF score of 50 or below indicates serious impairments in social and occupational functioning. See Pate-Fires v. Astrue, 564 F .3d 935, 944 (8th Cir. 2009).

8 carry out simple instructions; mild limitations in her ability to

make judgments and simple work decisions; and moderate limitation

in her ability to understand, remember, and carry out complex

instructions. Dr. Olsson also assessed Lawton with moderate

limitations in her ability to interact with the public,

supervisors, and coworkers and to respond appropriately to work

situations.

C . Administrative Process and Decision A hearing was held before an ALJ on October 8, 2010. Lawton

was represented by counsel and testified at the hearing. A

vocational expert also testified. Lawton testified that she was

thirty-seven years old and was a college sophomore taking online

classes toward a degree in criminal justice through Franklin

Pierce University. Lawton described her daily activities as follows. On a

typical day, she would wake at 5:00 a.m., put ice on her lower back and her knee, wake her thirteen-year old son, lie down,

watch a movie, and soak in the bathtub. During the remainder of

the day, she would attend therapy appointments, apply more ice,

and occasionally use her computer. As to daily chores, Lawton

explained that she tried to wash dishes and do laundry but she

also got help from her son and her mother. She said that she

9 could only sit, stand, or walk for fifteen minutes at a time and

that she took Ativan three times a day which made her tired. She

testified that her symptoms due to PTSD and anxiety had worsened over the past year.

The vocational expert provided opinions about available work

in response to three hypothetical questions posed by the ALJ.

The first posed a woman who could do work at the light exertional

level, had limited use of her hands and feet to operate push and

pull controls, and no other limitations. The vocational expert

stated that person could do Lawton's past work as a production assembler, waitress, and short-order cook, along with other jobs

such as an electronics worker or a production worker. In the

second hypothetical, the ALJ added mild impairment in making

simple decisions and judgments and moderate impairment in complex understanding; memory; interacting with the public, supervisors

and coworkers; and in responding to usual workplace situations.

The vocational expert responded that she could still do her past

work and the other work he had identified. In the third

hypothetical, the person could lift no weight to waist level,

could lift eight pounds above her waist, could carry ten pounds,

could push and pull two pounds, could occasionally stand and walk

for fifteen minutes, could sit for thirty minutes, and could

never or rarely do postural activities. She could do sedentary

10 work only part time. In response, the vocational expert said

that the part-time restriction ruled out all full-time work so

that she could not do any occupation.

Lawton's counsel asked the vocational expert to consider

additional limitations of being able to sit, stand, or walk for

only fifteen minutes at a time. The vocational expert responded

that she would need a job with a sit or stand option, which would

preclude Lawton's past work. Counsel then asked the vocational

expert to consider an anxiety disorder that would cause

distractions and difficulty with focus. The vocational expert

asked counsel to rephrase the question in terms of a percentage

of the day in which the person would be unable to focus or

concentrate. Counsel said the person would not be able to focus

for more than fifteen minutes at a time. The vocational expert

responded that impairment would limit the ability to work. The ALJ issued a decision on November 23, 2010, in which he

found that Lawton had severe impairments due to ACL strain of the

left knee, obesity, PTSD, and panic disorder with agoraphobia.

He found that Lawton had the residual functional capacity to

perform light work with moderate limitations in her ability to

interact appropriately with the public, accept instructions,

respond appropriately to criticism from supervisors, and respond

appropriately to changes in the work settings. He also found

11 that she could understand and carry out instructions, maintain

attention for extended periods, complete a normal work week, make

simple work-related decisions, and deal appropriately with

supervisors and peers. Based on those findings, the ALJ

concluded that Lawton could return to her past work as a production assembler, waitress, and short-order cook. As a

result, the ALJ found that Lawton was not disabled. When the

Decision Review Board did not complete its review within the time

allowed, the ALJ's decision became the decision of the Commissioner.

Standard of Review

"Judicial review of a Social Security claim is limited to

determining whether the ALJ used the proper legal standards and

found facts upon the proper quantum of evidence." Ward v. Comm'r of Social Security,

(1st Cir. 2000) (citing

Nguyen v. Chater,

(1st Cir. 1999)). The court

defers to the ALJ's factual findings as long as they are supported by substantial evidence, even if other evidence would

support a different conclusion. § 405(g); Tsarelka v. Sec'y of Health & Human Servs.,

(1st Cir. 1988).

"Substantial evidence is more than a scintilla. It means such relevant evidence as a reasonable mind might accept as adequate

12 to support a conclusion." Astralis Condo. Ass'n v. Sec'y Dep't

of Housing & Urban Dev..

(1st Cir. 2010).

Discussion

The ALJ follows a five-step sequential evaluation to

determine whether a claimant is disabled.

. The claimant bears the burden, through the first

four steps, of proving that her impairments preclude her from

working. Freeman v. Barnhart,

(1st Cir. 2001).

At Step Five, the burden shifts to the Commissioner to show that

jobs exist in the relevant economies that the claimant can

perform. Seavey v. Barnhart.

(1st Cir. 2001).

All five steps are not applied to every claimant, as in this

case, where the evaluation ended at Step Four. See Bowen v. Yuckert,

, 146 n.5 (1987); Freeman.

.

Lawton challenges the ALJ's conclusion that she is capable

of doing her past work on a variety of grounds, which are neither

clearly stated nor well developed. In response, the Commissioner

argues that because Lawton failed to develop arguments to support

her motion, she has waived any alleged errors that she might have

raised for review. Alternatively, the Commissioner interpreted

Lawton's motion to raise nine errors in the ALJ's findings at

13 Step Two, Step Three, and Step Four and addressed those matters.

Lawton did not respond to the Commissioner's motion to affirm.

A . Waiver

As is noted above, it is the claimant's burden to prove that

she was disabled through the first four steps of the sequential evaluation. Freeman,

. When presented with an

inadequate motion to reverse the Commissioner's decision, it is

not the court's job to create and develop arguments to support

the motion.4 Lovern v. Astrue,

, at *6 (D. Mass. Sept. 26, 2011) (citing Shaner v. Chase Bank USA,

(1st Cir. 2009), and United States v. Zannino.

(1st Cir. 1990)); Tarantino v. Astrue.

, at *4 (D.

Mass. Apr. 19, 2011) ("[Pro se] Plaintiff's failure to make any

argument is reason enough to deny his motion to reverse and,

concomitantly, allow the Commissioner's motion to affirm.");

Nelson ex rel. S.N. v. Astrue,

, at *11 n.5 (D. Mass. Aug. 6, 2010); Flannery v. Chater,

, at *2

(D.N.H. Sept. 26, 1996).

Lawton lists one "general issue," which is whether the ALJ

erred "by finding a residual functional capacity for the

4A s is noted above, Lawton is represented by counsel.

14 plaintiff to return to past relevant work." In the argument

section that follows her statement of the issue, Lawton provides

a rambling and undeveloped discussion of a variety of issues.

Despite the shortcomings of Lawton's motion and memorandum, the

court will address the issues raised, to the extent that is

possible, following the sequential order provided by § 404.1520.

B. Sequential Evaluation

Section 404.1520 provides a five-step sequential evaluation

to determine whether a claimant is disabled.

1. Step One

The ALJ found at Step One that Lawton had not engaged in

substantial gainful activity since her alleged onset date of July

17, 2008.

2. Step Two

At step two, the ALJ considers the "the medical severity of

[the claimant's] impairment(s)." § 404.1520(a)(4)(ii). To

provide a basis for a disability determination, an impairment

"must have lasted or must be expected to last for a continuous

period of at least 12 months" unless the impairment "is expected

to result in death." § 404.1509. A claimant will be found not

15 disabled at Step Two if she does not have an impairment or a

combination of impairments that is severe. § 404.1520(a) (4) (ii) .

The ALJ found that Lawton had severe impairments due to ACL

strain of the left knee, obesity, PTSD, and panic disorder with

agoraphobia. Lawton asserts that she also had a severe

impairment due to Reflex Sympathetic Dystrophy Syndrome or

Complex Regional Pain Syndrome ("RSDS/CRPS") that was diagnosed

by her neurologist, Dr. Theodore Ruel, and she cites Exhibit

23F.5 She contends that the ALJ failed to follow the policy

guidelines for assessing RSDS/CRPS that are provided in SSR 03-2p

and erroneously failed to give Dr. Ruel's opinions controlling

weight as provided in SSR 96-2p.

Lawton did not mention Dr. Ruel in the joint statement of

material facts. The plaintiff is required to "describe all facts

pertinent to the decision of the case and all significant

procedural developments" in the joint statement. LR 9.1(b)(2). Therefore, by failing to include Dr. Ruel's treatment and

diagnosis in the joint statement, Lawton likely has waived any

argument based on those records.

5Exhibit 23F consists of sixteen pages of office treatment notes from Cheshire Medical Center, most of which are not Dr. Ruel's notes. Lawton also cites page 935, stating that Dr. Ruel's diagnosis is consistent with the findings there. Page 935 is a copy of a Workers' Compensation Form, dated February 15, 2010 .

16 Even if the matter were not waived, because Lawton bears the

burden of proof at Step Two, "including the burden to demonstrate the degree of functional limitation resulting from [her]

impairments, an error in describing a given impairment as non-

severe at step 2 is considered 'harmless,' unless the claimant

can demonstrate that the error proved outcome determinative in

connection with the later assessment of [her residual functional

c a p a c i t y ] Fernald v. Social Sec. Admin. Com'r,

, *2 (D. Me. Apr. 19, 2012) (citing cases). As long as

the ALJ found at least one severe impairment so that the

sequential evaluation progressed to the next step, an error at

Step Two does not require reversal. Hines v. Astrue.

, *12-*13 (D.N.H. Mar. 26, 2012) (citing cases).

Therefore, to the extent Lawton challenges the ALJ's findings at

Step Two, her motion fails on that issue.

3. Step Three

At Step Three, the ALJ determines whether the claimant's

impairment or combination of impairments meets or equals one of

the Listings at Part 404, Subpart p, Appendix 1.

§ 404.1520(a)(4)(iii). To meet a Listing, the claimant must show

that her impairment or combination of impairments "satisfies all

of the criteria of that listing, including any relevant criteria

17 in the introduction, and meets [twelve-month] durational

requirement." § 404.1525(c)(3). In the alternative, a claimant

will be found disabled if the impairment or combination of

impairments equals a Listing meaning that "it is at least equal

in severity and duration to the criteria of any listed

impairment." § 404.1526(a). The claimant bears the burden of

showing that her impairment or combination of impairments meets

or equals a listed impairment. Dudley v. Sec'y of Health & Human

Servs..

(1st Cir. 1987) .

The ALJ found that Lawton's combination of psychological

impairments did not meet or equal Listing 12.06, which relates to

anxiety disorders. Lawton does not challenge that finding but

instead contends that the ALJ erred in failing to find that her

impairment due to PTSD meets Listing 12.04.6

Listing 12.04 pertains to affective disorders

" [c]haracterized by a disturbance of mood, accompanied by a full

or partial manic or depressive syndrome." "The required level of

severity for these disorders is met when the requirements in both

A and B are satisfied, or when the requirements in C are

6In the same paragraph, Lawton also states that the ALJ failed to consider the combined effect of her physical and mental impairments, but that statement appears to be a general summary rather than part of the issue pertaining to the Step Three finding.

18 satisfied." Listing 12.04. In support of her claim, Lawton

cites the Termination Summary prepared by John Lynch who met with

Lawton for psychological therapy sessions and repeats, verbatim,

some of the requirements for Parts A and B of Listing 12.04. Lawton does not explain how Lynch's Termination Summary

shows that she meets the criteria of Listing 12.04. Notably,

Lynch did not make any finding that Lawton had "a disturbance of

mood, accompanied by a full or partial manic or depressive

syndrome" as is required to meet the criteria for Listing 12.04.

Further, Lynch's summary does not include findings, as required

by Part B, that she had marked restrictions in specific

functions. In contrast, as the ALJ explained, neither Dr. Olsson

nor Dr. Kalfas found that Lawton had marked restrictions in functioning.

Therefore, Lawton has not met her burden to show that she met Listing 12.04, eliminating her claim that the ALJ erred in

failing to find her disabled at Step Three.

4. Step Four

At Step Four, the ALJ makes a finding as to the claimant's residual functional capacity and whether, based on the residual

functional capacity assessment, the claimant can return to her past relevant work. § 404.1520(a)(4)(iv). In this case, the ALJ

19 found that Lawton had the residual functional capacity to perform

work at the light exertional level with certain limitations in

her ability to cope in a work setting. Specifically, the ALJ

found that Lawton had moderate limitations in her ability to

interact appropriately with the public, to accept instructions

and respond appropriately to criticism from supervisors, and to

respond appropriately to changes in the work setting. He further

found that Lawton could understand, remember, and carry out

instructions; maintain attention for extended periods; complete a

normal work week; make simple work related decisions; deal with

changes in a routine work setting; and interact appropriately

with peers and supervisors. He also found that with those

limitations, Lawton could accommodate changes in her work setting

and could generally understand and remember enough for most

employment situations. Based on that residual functional

capacity and the vocational expert's testimony, the ALJ found that Lawton could return to her past work as a production

assembler, waitress, and short-order cook.

Lawton contends that the ALJ erred in the residual

functional capacity assessment and that the error means that the

finding that she could return to her past work is unsupported by

substantial evidence. She argues, in skeletal form, that the ALJ

erred in the weight he gave to the opinions of Dr. Olsson and Dr.

20 Kalfas and failed to assess the medical opinions under the

guidelines provided by SSR 96-2p; erred in assessing her daily

activities for purposes of determining her residual functional

capacity; erred in failing to consider the effects of RSDS/CRPS,

as diagnosed by Dr. Ruel, under the guidelines provided in SSR

03-2p; and erred in failing to find that the extent of her

psychological impairments caused her to be disabled as was found

in Moriartv v. Astrue.

,

(D.N.H. Aug.

29, 2008) .

a . Medical opinions

Lawton contends that the ALJ gave too much weight to the

opinion of Dr. Kalfas, a state agency consultant psychologist,

and too little weight to the opinion of Dr. Olsson, one of her

treating physicians. The ALJ attributes weight to a medical opinion based on the nature of the relationship between the

medical source and the claimant, the extent to which the opinion

includes supporting information, the consistency of the opinion

with the record as a whole, the specialization of the source, and other factors, including the source's understanding of the

administrative process and the source's familiarity with the

claimant's record. § 404.1527(d); see also SSR 96-2p,

(July 2, 1996). An ALJ gives weight to an opinion of a

21 state agency consultant based on the relevant criteria used in § 404.1527(d).

In this case, the ALJ discussed the opinions of Dr. Kalfas

and Dr. Olsson and gave weight to both. As the Commissioner

points out, their opinions are not materially different. Lawton

does not explain why the ALJ's reliance on Dr. Kalfas's opinion

was error. Therefore, Lawton provides no basis to reverse the

decision based on the ALJ's evaluation of the medical opinions.

b . Daily activities Lawton asserts that the ALJ erred in considering her daily

activities for purposes of determining her residual functional

capacity. She contends that the activities the ALJ considered

were things she could do only on "a sporadic basis." Lawton does

not specify what activities she objects to or where in the decision the error occurred.

For purposes of assessing residual functional capacity, an ALJ must evaluate "the intensity and persistence of [a

claimant's] symptoms, such as pain, and determin[e] the extent to which [the claimant's] symptoms limit [her] capacity for work . .

. ." § 404.1529(c). Factors that an ALJ considers as relevant to the severity and persistence of a claimant's symptoms include the

claimant's daily activities. § 404.1529(c)(3)(I); see also Avery

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

(1st Cir.

1986) . In the section of the decision pertaining to residual

functional capacity, the ALJ recounted Lawton's activities as she described during her testimony at the hearing. Because Lawton

does not identify which of the listed activities she could do

only sporadically, her claim of error is insufficient for review.

c . RSDS/CRPS

As is noted above in the discussion of the ALJ's findings at

Step Two, Lawton likely waived review of the ALJ's analysis of

Dr. Ruel's opinion due to her failure to include any facts

pertaining to Dr. Ruel in the joint statement of material facts.

Further, as the Commissioner contends, Lawton's argument

pertaining to Dr. Ruel's opinion is not sufficiently developed.

To the extent the issue can be addressed, however, Lawton has not shown reversible error.

The ALJ addressed Dr. Ruel's opinions as part of his Step

Two evaluation. The ALJ noted the diagnosis of RSDS/CRPS and

that Dr. Ruel indicated that Lawton was unable to work. The ALJ

found, however, that Dr. Ruel's treatment notes did not support

that assessment and noted that Dr. Ruel's neurological

assessments of Lawton have been unremarkable.

23 In support of her claim of error, Lawton states that she was

diagnosed with RSDS/CRPS by Dr. Ruel. She also states that Dr.

Ruel's diagnosis is consistent with his finding that she could

not return to work. She criticizes the ALJ's statement that Dr.

Ruel's treatment notes showed that her neurologic examinations

have invariably been unremarkable. Lawton repeats, without

attribution, part of the section of SSR 03-2p titled "What is

RSDS/CRPS?", without explaining its relevance to her case.

Dr. Ruel's examination note dated February 15, 2010, states: "Jennifer is here for consultative evaluation regarding her

diagnosis of reflex sympathetic dystrophy. I have seen her on a

number of occasions over the past 15 years for a variety of pain-

related conditions. Her neurologic examination has invariably

been unremarkable." Dr. Ruel noted that he strongly advised

against narcotic medication, that he encouraged a therapeutic

exercise program, and that he could not offer a cure for her

condition. Therefore, Dr. Ruel's office note supports the ALJ's interpretation.

d. Effects of psychological impairments

Lawton cites Moriarty v. Astrue,

, to support her assertion that her PTSD in combination with other disorders

caused her to be disabled. In Moriarty, however, the ALJ found

24 no severe impairments at Step Two, despite record evidence

supporting a medically determinable impairment, and the case was

remanded for a determination of whether the claimant was then

disabled, and if so, a determination of the onset date.

at *3-*8. Lawton has not shown that Moriarty is

pertinent to the issues in this case.

5. Step Five

If a claimant is found to be unable to return to her past

relevant work at Step Four, the ALJ moves on to Step Five to

determine whether she can make an adjustment to other work.

§ 404.1520(a)(4)(iv). The burden shifts to the Commissioner to

show that there is work the claimant can do in the relevant

economies. Seavey.

. As is noted above, the ALJ

need not complete all five steps of the sequential evaluation if the claimant is found to not be disabled at Step Four. See.

e.g.. Brown v. Apfel,

(D.R.I. 1999) (describing sequential evaluation process).

The ALJ found, at Step Four, that Lawton could return to her

past work and did not make any finding at Step Five. In the

context of making a residual functional capacity assessment, the

ALJ discussed Lawton's ability to do sedentary work and noted

that jobs existed that she could do at that level. The

25 disability determination, however, was not made at Step Five.

Therefore, Lawton's arguments pertaining to Step Five are

inapposite.

Conclusion

For the foregoing reasons, Lawton's motion to reverse and

remand the Commissioner's decision (document no. 12) is denied.

The Commissioner's motion to affirm (document no. 15) is granted.

The Clerk of Court shall enter judgment accordingly and

close the case.

SO ORDERED.

Jos'eph A. DiClerico, Jr*. United States District Judge July 24, 2012

cc: Robert J. Rabuck, Esquire John A. Wolkowski, Esquire

26