Administrative — Medicaid – Disability Determination – Physicians’ Opinions – Residual Functional Capacity

Tester v. North Carolina Department of Health & Human Resources (Lawyers Weekly No. 14-16-1000, 22 pp.) (Martha Geer, J.) Appealed from Watauga County Superior Court (Joseph Crosswhite, J.) N.C. App. Unpub.

Holding: Even though two of petitioner’s physicians said that petitioner was unable to undertake gainful employment, a claimant’s residual functional capacity is a determination reserved to the agency. Furthermore, the physicians failed to describe why petitioner is unable to work and stated no restrictions petitioner would have; thus, the hearing officer could conclude that their opinions’ lack of “supportability” entitled them to little weight.

We affirm the superior court’s order upholding the denial of Medical Assistance for the Disabled.

We disagree with petitioner’s contention that the hearing officer improperly interposed herself as a medical expert when she discredited Dr. Haibach’s opinion on the basis that “[t]here are no imaging studies in the available medical records that show any significant arthritis in her joints.” This finding is relevant to the factor of supportability and is consistent with 20 C.F.R. Pt. 404, Subpt. P, App. 1, Pt. A § 1.00(C)(1), which provides that “diagnosis and evaluation of musculoskeletal impairments should be supported, as applicable, by … laboratory findings, including findings on x-ray or other appropriate medically acceptable imaging.”

The hearing officer did not discredit the existence of petitioner’s symptoms; rather, the hearing officer discredited the degree to which the symptoms affected petitioner. The hearing officer’s credibility determination is supported by petitioner’s medical records and her own statements, which contradicted her testimony regarding the intensity and limiting effects of petitioner’s Crohn’s disease.

Despite frequent trips to the bathroom and some abdominal pain, there was still substantial evidence in the record to support the conclusion that petitioner has the residual functional capacity to engage in light work, as the hearing officer found. The hearing officer’s conclusion that petitioner can engage in light work is supported by substantial evidence in the record.

Petitioner complains that the hearing officer’s job description was too general. However, under SSR 82-61, a claimant should still be found “not disabled” if she is able to perform the job as defined in the Dictionary of Occupational Titles, even if she is unable to perform the job as actually required in her former position. Petitioner’s claimed inability to demonstrate that the DOT job description was not exactly the same as the job as actually performed by petitioner was, therefore, immaterial under this test.

Affirmed.