Garrett v. Commissioner of Social Security, 5:14-cv-01066

Plaintiff Kevin L. Garrett applied for SSI alleging disabling back/neck pain, COPD, depression/anxiety, and related limitations; ALJ denied benefits and Appeals Council declined review.
Medical record shows lumbar and cervical degenerative changes, severe L5-S1 foraminal stenosis, COPD with at least one acute exacerbation requiring hospitalization, and conservative outpatient treatment including inhalers and periodic nebulizer prescriptions.
Treating physician Dr. Schuster completed a November 2011 physical RFC limiting lifting, standing/walking, and many postural activities and restricting exposure to respiratory irritants; ALJ gave that opinion only some weight.
At hearing Garrett testified he uses a nebulizer 5–6 times daily for 20–30 minutes each time and uses a cane at home; vocational expert (VE) testified such off-task time would preclude competitive employment.
ALJ found Garrett had severe impairments but retained capacity for a limited range of light/sedentary work with restrictions (e.g., stand/walk 2 hours, sit 6 hours, avoid concentrated respiratory irritants, simple routine tasks) and relied on VE to find available jobs.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether ALJ erred by not accounting for frequent nebulizer use in the RFC/hypothetical	Garrett: needs nebulizer 5–6 times/day for 20–30 minutes, which would make him off-task and preclude work	Commissioner: medical record does not corroborate frequency/duration or need to use nebulizer during work hours; ALJ not required to adopt unsubstantiated testimony	Court: ALJ did not err — claimant’s nebulizer testimony was not supported by medical evidence and ALJ permissibly discounted credibility; no RFC modification required
Whether ALJ erred by not accounting for occasional use of a cane	Garrett: cane use would interfere with required reaching/handling for identified jobs	Commissioner: no treating physician prescribed or established medical necessity for a cane; testimony equivocal	Court: ALJ did not err — only a single, non-specific note referenced cane use and claimant’s testimony was equivocal; ALJ reasonably omitted cane limitation
Whether the ALJ’s RFC and hypotheticals sufficiently captured Garrett’s limitations	Garrett: ALJ failed to include limitations the VE relied on to say employment would be precluded; RFC should reflect those limits	Commissioner: RFC incorporated supported limitations; hypotheticals need only include credible, supported restrictions	Court: ALJ’s RFC and hypotheticals were supported by the record and properly limited to credible, medically supported restrictions

Elam v. Comm’r of Soc. Sec., 348 F.3d 124 (6th Cir. 2003) (review limited to whether ALJ’s findings are supported by substantial evidence)
Rogers v. Comm’r of Soc. Sec., 486 F.3d 234 (6th Cir. 2007) (definition of substantial evidence)
Cutlip v. Sec’y of Health & Human Servs., 25 F.3d 284 (6th Cir. 1994) (substantial evidence standard explained)
Buxton v. Halter, 246 F.3d 762 (6th Cir. 2001) (ALJ decision need not be overturned simply because record could support contrary conclusion)
Mullen v. Bowen, 800 F.2d 535 (6th Cir. 1986) (appellate courts may not substitute their judgment for ALJ within zone of choice)
Varley v. Sec’y of Health & Human Servs., 820 F.2d 777 (6th Cir. 1987) (hypothetical to VE must include all limitations the ALJ accepts as true)
Blacha v. Sec'y of Health & Human Servs., 927 F.2d 228 (6th Cir. 1990) (ALJ need not include unsubstantiated allegations in hypotheticals)
Newkirk v. Shalala, 25 F.3d 316 (6th Cir. 1994) (VE testimony based on inadequate hypotheticals undermines decision)