United States District Court, D. Connecticut
RULING ON CROSS-MOTIONS FOR JUDGMENT ON THE
R. Underhill United States District Judge.
Social Security appeal, Mark Dziamalek moves to reverse the
decision by the Social Security Administration
(“SSA”) denying his claim for disability
insurance benefits or, in the alternative, to remand the case
for an additional hearing. Mot. to Reverse, Doc. No. 23. The
Commissioner of the Social Security
Administration (“Commissioner”) moves to
affirm the decision. Mot. to Affirm, Doc. No. 24. For the
reasons set forth below, Dziamalek's Motion to Reverse
(doc. no. 23) is DENIED and the Commissioners Motion to
Affirm (doc. no. 24) is GRANTED.
Standard of Review
follows a five-step process to evaluate disability claims.
Selian v. Astrue, 708 F.3d 409, 417 (2d Cir. 2013)
(per curiam). First, the Commissioner determines whether the
claimant currently engages in “substantial gainful
activity.” Greek v. Colvin, 802 F.3d 370, 373
n.2 (2d Cir. 2015) (per curiam) (citing 20 C.F.R. §
404.1520(b)). Second, if the claimant is not working, the
Commissioner determines whether the claimant has a
“‘severe' impairment, ” i.e., an
impairment that limits his or her ability to do work-related
activities (physical or mental). Id. (citing 20
C.F.R. §§ 404.1520(c), 404.1521). Third, if the
claimant does not have a severe impairment, the Commissioner
determines whether the impairment is considered “per se
disabling” under SSA regulations. Id. (citing
20 C.F.R. §§ 404.1520(d), 404.1525, 404.1526). If
the impairment is not per se disabling, then, before
proceeding to step four, the Commissioner determines the
claimant's “residual functional capacity”
based on “all the relevant medical and other evidence
of record.” Id. (citing 20 C.F.R. §§
404.1520(a)(4), (e), 404.1545(a)). “Residual functional
capacity” is defined as “what the claimant can
still do despite the limitations imposed by his [or her]
impairment.” Id. Fourth, the Commissioner
decides whether the claimant's residual functional
capacity allows him or her to return to “past relevant
work.” Id. (citing 20 C.F.R. §§
404.1520(e), (f), 404.1560(b)). Fifth, if the claimant cannot
perform past relevant work, the Commissioner determines,
“based on the claimant's residual functional
capacity, ” whether the claimant can do “other
work existing in significant numbers in the national
economy.” Id. (citing 20 C.F.R. §§
404.1520(g), 404.1560(b)). The process is “sequential,
” meaning that a petitioner will be judged disabled
only if he or she satisfies all five criteria. See
claimant bears the ultimate burden to prove that he or she
was disabled “throughout the period for which benefits
are sought, ” as well as the burden of proof in the
first four steps of the inquiry. Id. at 374 (citing
20 C.F.R. § 404.1512(a)); Selian, 708 F.3d at
418. If the claimant passes the first four steps, however,
there is a “limited burden shift” to the
Commissioner at step five. Poupore v. Astrue, 566
F.3d 303, 306 (2d Cir. 2009) (per curiam). At step five, the
Commissioner need only show that “there is work in the
national economy that the claimant can do; he [or she] need
not provide additional evidence of the claimant's
residual functional capacity.” Id.
reviewing a decision by the Commissioner, I conduct a
“plenary review” of the administrative record but
do not decide de novo whether a claimant is
disabled. Brault v. Soc. Sec. Admin., Comm'r,
683 F.3d 443, 447 (2d Cir. 2012) (per curiam); see
Mongeur v. Heckler, 722 F.2d 1033, 1038 (2d Cir. 1983)
(per curiam) (“[T]he reviewing court is required to
examine the entire record, including contradictory evidence
and evidence from which conflicting inferences can be
drawn.”). I may reverse the Commissioner's decision
“only if it is based upon legal error or if the factual
findings are not supported by substantial evidence in the
record as a whole.” Greek, 802 F.3d at 374-75.
The “substantial evidence” standard is
“very deferential, ” but it requires “more
than a mere scintilla.” Brault, 683 F.3d at
447-48. Rather, substantial evidence means “such
relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Greek, 802
F.3d at 375. Unless the Commissioner relied on an incorrect
interpretation of the law, “[i]f there is substantial
evidence to support the determination, it must be
upheld.” Selian, 708 F.3d at 417.
filed for Social Security benefits on October 21, 2013. App.
for Benefits, Ex. 1D, R. at 260. In his application,
Dziamalek alleged a period of disability beginning April 1,
2010. Id. at 261. Dziamalek alleged in his
application that he suffered from mental illness; curved
spine; arthritis in arms, hands, and legs; lumps in lungs;
and right bundle blockage of heart. Int'l Disability
Determination Explanation, Ex. 2A, R. at 126. As discussed
more fully below, Dziamalek's application was denied at
each level of review, and he seeks an order reversing the
relevant time period for Dziamalek's medical history is
April 1, 2010, the alleged disability onset date, to December
31, 2015, the date last insured. Just before the alleged
onset date, on March 15, 2010, Dziamalek was seen at the
cardiology department at HeartCare Associates, LLC, and
treatment notes reflect that he had no swelling or pain in
extremities, but had shortness of breath. Ex. 2F, R. at 451.
Treatment notes from the same provider similarly reflected no
swelling or pain in extremities on September 20, 2010, but no
shortness of breath. Ex. 2F, R. at 448. Dziamalek was
hospitalized at Yale New Haven on February 16, 2011 for a
Tylenol overdose, in which he took roughly 180 pills. Ex.
13F, R. at 763. He was released on February 18, 2011.
Id. On March 14, 2011, treatment notes from
HeartCare Associates, LLC again reflected that he had no
swelling or pain in his extremities and no shortness of
breath. Ex. 2F, R. at 449.
August 8, 2011, Dziamalek underwent an exercise stress test,
which was terminated after eleven minutes and one second for
shortness of breath. Ex. 2F, R. at 453. Treatment notes
reflect that Dziamalek had no arrythmias and had
“[v]ery good exercise capacity.” Id. On
August 26, 2011, Dziamalek underwent a pulmonary function
test with Dr. Michael Imevbore at Connecticut Pulmonary
Specialists, PC, which showed that his Forced Vital Capacity
(“FVC”) was “mildly reduced”, but
that his total lung capacity was normal. Ex. 3F, R. at 485.
On the same day, Dr. Imevbore noted that Dziamalek was a
“pleasant gentleman with multiple lung nodules and
active nicotine addiction” as well as Chronic
Obstructive Pulmonary Disorder (“COPD”). Ex. 3F,
R. at 491-92. Dziamalek reported “progressive shortness
of breath” and a physical examination revealed
“reduced air entry bilaterally.” Id. On
September 12, 2011, Dziamalek underwent a CT Scan of his
chest for a follow up on “lung nodules, ” which
revealed “tiny” nodules that were “most
likely benign.” Ex. 13F, R. at 760. HeartCare
Associates treatment notes from July 23, 2012 again reflected
no swelling or pain in Dziamalek's extremities nor
shortness of breath. Ex. 2F, R. at 447.
November 5, 2012, Dziamalek returned to BH Care, Inc.
“for an evaluation in order to ‘please' the
courts” because he was on probation for two charges of
breach of peace stemming from an argument with his
fiancé's son. Ex. 4F, R. at 493. Treatment notes
reflect that Dziamalek had been unemployed since 2010, and
had drug possession charges from 2009 and one from 10-15
years prior. Id. On January 28, 2013, Dziamalek
returned to Heartcare Associates for a transthoracic
echocardiogram. Ex. 2F, R. at 473. The report from that
procedure and treatment notes revealed an abnormal
electrocardiogram, right bundle branch block, essential
hypertension, and hyperlipidemia. Id.; see
also Ex. 2F, R. at 436. On March 14, 2013, Dziamalek
went to Yale New Haven Hospital for shortness of breath and a
cough. Ex. 1F, R. at 423. Treatment records reflect that
Dziamalek had no swelling in his lower extremities, but had
“blood-tinged sputum” most likely due to
bronchitis. Ex. 1F, R. at 424. Outpatient treatment care was
continued and Dziamalek was prescribed pain medication as
needed. Id. Progress notes from Dr. D'Aria from
April 9, April 30, and May 23, 2013 reflect that Dziamalek
had normal gait and no leg swelling. Ex. 1F, R. at 329, 331,
333. HeartCare Associates treatment notes from April 18 and
May 20, 2013 further reflect no swelling in Dziamalek's
lower extremities. Ex. 2F, R. at 438, 441.
was sent by the police to the hospital via ambulance on June
12, 2013 because he was found with alcohol and cocaine, and
was “aggressive, agitated, and want[ed] to
fight.” Ex. 1F, R. at 420. He was given a toxicology
screening, which was positive for both alcohol and cocaine,
and discharged. Id. Progress notes from Dr.
D'Aria from September 6, 2013 reflect that Dziamalek
complained of shoulder pain, and was given pain medication,
but had normal gait and no leg swelling. Ex. 1F, R. at
327-28. Dziamalek was seen by Dr. D'Aria again on
September 16, 2013 and treatment notes make no mention of
shoulder pain. Id. at 325. On September 20, 2013,
Dziamalek underwent an x-ray on his left foot which showed
“[m]oderate degenerative changes” when compared
to 2010. Ex. 13F, R. at 785. Shortly thereafter, on September
30, 2013, Dziamalek presented to HeartCare Associates with
palpitations. Ex. 1F, R. at 417. Treatment notes from that
visit reflect that Dziamalek had completed alcohol
rehabilitation and was sober. Id. Further, notes
reflect that he had no lower extremity swelling. Ex. 1F, R.
at 418; see also Ex. 2F, R. at 440. Providers
discussed Dziamalek's nutrition and healthier daily
habits, provided him with medication, and discharged him. Ex.
1F, R. at 418-19.
October 4, 2013, Dziamalek underwent a chest CT scan which
revealed “new scattered subtle [lung] nodules”
and COPD. Ex. 3F, R. at 481. On October 7, 2013, treatment
notes from BH Care, revealed “unremarkable”
thought process and content, orientation, and energy. Ex. 4F,
R. at 504. Further, notes reflect that Dziamalek was
“irritable” but “cooperative” and
“attentive”, and had minimally impaired judgment
and insight and was making progress in his sobriety.
Id. On October 11, 2013, Dziamalek was described by
Dr. Imevbore as a “pleasant active smoker with COPD and
lung nodules.” Ex. 1F, R. at 396. A pulmonary function
test revealed worsening airflow limitation. Id.
October 20, 2013, Dziamalek was again sent to the hospital by
the police via ambulance because he was using drugs (heroin
and cocaine) and drinking at home and his family feared that
he was suicidal. Ex. 1F, R. at 414. Treatment records reveal
that Dziamalek had no leg swelling, no edema, no swelling or
deformity in his right shoulder, and normal range of motion.
Ex. 10F, R. at 549. He did complain of right elbow pain
because he was struck with a crowbar in an altercation.
Id.; see also Ex. 1F, R. at 411. Dziamalek
was evaluated as anxious and agitated, with impulsivity and
inappropriate judgment, but without homicidal or suicidal
ideations. Ex. 10F, R. at 549. He was released that day but
returned to the emergency room on October 31, 2013 after a
suicide attempt via drug overdose. Ex. 1F, R. at 406. He was
released and was seen again on November 3, 2013 for right
lower arm pain, but tests revealed no acute fracture. Ex. 1F,
R. at 400.
was hospitalized on November 6, 2013 for substance abuse,
altered mental state (likely due to alcohol withdrawal),
unsteadiness, COPD, abnormal chest CT scan, and left wrist
pain. Ex. 10F, R. at 648. Treatment notes from that time
frame reflect that Dziamalek also had shoulder pain, left
wrist pain, and finger numbness resulting from the restraints
needed for evaluation because he was “aggressive and
combative.” Id. at 649. A hand and wrist x-ray
were normal and showed “no acute fracture or
dislocation”, and notes reflect that “a full
neurological exam was inconsistent” because Dziamalek
was seen “walking briskly and performing fine motor
tasks with excellent coordination” but, during testing,
“his grip strength [was] weak and coordination [was]
off balance.” Id. Further, Dziamalek had
“good balance and coordination with standing” but
walked to the door with “slow gait and into
hallway”. Id. at 650. Treatment notes also
reflect that he had “poor short term memory.”
Id. On November 11, he underwent an x-ray on his
left shoulder which showed “no acute fracture or
dislocation” and joints that were
“well-maintained” and “intact.” Ex.
13F, R. at 786. He was released from the hospital on November
13, 2013. Ex. 10F, R. at 648. He returned to the emergency
room on November 15 and was “confused” with
slurred speech and complaining of left ear pain. Ex. 10F, R.
at 613, 617. His family reported they thought Dziamalek took
too much Valium. Id. at 617. After a few hours,
Dziamalek was “completely conversant, interactive, and
alert and oriented with steady gait and speech.”
Id. at 615.
was hospitalized at Yale New Haven Psychiatric Hospital on
November 20, 2013 after he cut his left wrist in a suicide
attempt. Ex. 1F, R. at 342. He sustained lacerations to his
ulnar nerve and artery and his flexor carpi ulnaris and
palmaris longus tendons. Ex. 10F, R. at 668. He underwent
surgery to repair the lacerations and “tolerated the
procedure well” and had no complications. Id.
He was given pain medication and discharged back to the
psychiatric hospital on November 25, 2013. Ex. 1F, R. at 360.
Treatment notes reflect that Dziamalek reported that his
change in medication caused his suicidal ideations.
Id. at 361. He was given a hand splint and notes
reflect that, upon discharge from the hospital, his wrist and
fingers flexed and extended, but he had no sensation over his
small finger, and diminished feeling over his ring finger.
Id. at 362. He was discharged on November 28, 2013.
Id. at 360.
December 4, 2013, Dziamalek was seen at Yale New Haven
Hospital for a post-operation evaluation where notes reflect
that he was “doing well” and was “able to
make a fist easily”, but had “no sensation in
[his] small finger” and “decreased
sensation” in his fourth finger. Ex. 6F, R. at 517,
519. Treatment notes report that the wound was “healing
well” and Dziamalek was given an “anticlaw
splint” to wear at night, a wrist brace to protect the
wound, and referred to occupational therapy. Id. at
519. He returned to BH Care on December 4, 2013 and reported
“feeling significantly better” after his
hospitalization. Ex. 11F, R. at 722.
December 16, 2013, Dziamalek began occupational therapy for
his hand. Ex. 10F, R. at 678. Progress notes reflect that he
disliked the night splint and was wearing the hand splint
full time and had “no edema in [his] digits.”
Id. at 679. He put in “fair” effort,
could manipulate common objects, “[w]orked well on
focused tasks for [one hour]”, and was
“[c]omplying well w[ith] appropriate
precautions.” Id. He returned to occupational
therapy on December 23, 2013, and progress notes reflect that
Dziamalek put in “good” effort and
“performed self massage well after instruction and
encouragement” but that “raised thick fibrotic
area may impede ulnar nerve regeneration.” Ex. 10F, R.
at 681. He returned on December 30, 2013 and notes reflect
“good” effort and active range of motion, and a
“hard, raised scar tissue at site of repair” but
that “scar massage very effective today.” Ex.
10F, R. at 683. His left-hand grip strength was 45 pounds,
and pinch strength was 8 pounds. Id. at 684.
Progress notes from January 6, 2014 reflected that Dziamalek
complained that his pinky hurt, that he “lack[ed] fine
motor control” and “digital extension
deficit” was persistent. Ex. 10F, R. at 686. Further,
notes reflected that there were “signs of atrophy from
denervated muscles” and Dziamalek was instructed to
“stop covering the area to allow it to
desensitize” and to use the scar pad at night rather
than the day. Id. Further, notes reflect that
Dziamalek “tend[ed] to minimize left hand
deficits” but that “gains [were] noted in all
notes from January 21, 2014 reflect that Dziamalek was moving
his hand more comfortably and covering it less. Ex. 10F, R.
at 690. Notes reflect that Dziamalek “complie[d] well
with HEP and [was] trying to use his hand more often.”
Id. at 691. Progress notes from January 27, 2014
reflect that Dziamalek had “mild ulnar clawing”
and that he “tend[ed] to over stretch and flex/extend
with all his might” but showed “sig[nificant]
improvement.” Ex. 10F, R. at 694. Progress notes from
February 6, 2014 reflect Dziamalek put in “excellent
effort” but complained that he could not use his left
hand because the “small finger [was] always in the
way” and it was “tingly all the time.” Ex.
10F, R. at 696. His left-hand grip and pinch strength showed
“sig[nificant] gain” since his last visit.
Id. at 697. Progress notes from February 10, 2014
showed that he lacked digital abduction/adduction and
Dziamalek was encouraged to follow up with the surgeon about
his progress. Ex. 10F, R. at 698-99. Progress notes from
February 17, 2014 reflected that Dziamalek's hand was
“much improved” but that he had a “classic
claw deformity” and was “unable to extend ulnar
digits” but showed “sig[nificant] gains in all
areas.” Ex. 10F, R. at 701-02. On February 24, 2014,
Dziamalek complained that he continued to have
“inabilities in [his] left hand” and could not
peel potatoes or open cans, and had “great
difficulty” cutting a tomato. Ex. 10F, R. at 705. Notes
reflect a “decreased palmar arch” and “claw
hand deformity.” Ex. 10F, R. at 706.
the time while Dziamalek was doing occupational therapy for
his hand, he was also continuing with group therapy for his
substance abuse at BH Care. See Ex. 8F, R. at
521-36. Progress notes from all sessions reflect that
Dziamalek's affect, mood, thought process, orientation,
and behavior were unremarkable. See id. Dziamalek
expressed that he was serious about his recovery and also
wanted to learn to “manag[e] his anger and emotions in
a way that support[ed] his recovery and maintain[ed] healthy
relationships.” Ex. 8F, R. at 527. Further, as of
February 24, 2014, Dr. Riordan determined that Dziamalek had
a Global Assessment of Functioning (“GAF”) score
of 45 which reflected either moderate symptoms or
“moderate difficulty in social, occupational, or school
functioning. Ex. 11F, R. at 721. That had improved from Dr.
Riordan's assessment from December 4, 2013 in which he
found that Dziamalek had serious impairment in social,
occupational, or school functioning. Ex. 11F, R. at 718.
6, 2014, Dziamalek was seen by Dr. Imevbore for a follow up
chest CT scan that was compared to two prior scans from
September 2011 and October 2013. Ex. 17F, R. at 849. Notes
from the visit reflect that the “few small bilateral
lung nodules” were “stable, ”
“unchanged, ” and “consistent with benign
findings.” Id. There was, however, a
“changed pattern of patchy groundglass parenchymal
disease in upper lobes, ” likely caused by
inflammation, infection, or idiopathy. Id. Dr.
Imevbore recommended “continued interval CT
follow-up.” Id. Dziamalek underwent another CT
scan on September 17, 2014 which was compared to the May 2014
scan which again showed the nodule was
“unchanged” and “consistent with a benign
finding.” Ex. 19F, R. at 1066. Further, on November 17,
2015, Dziamalek underwent another CT scan which reflected
that, when compared to March 2013 and May 2014, the right
nodule was unchanged. Ex. 17F, R. at 843.
was incarcerated from August 20, 2014 to January 16, 2015 for
violation of probation. See Ex. 16F, R. at 809.
Dziamalek returned to BH Care on January 29, 2015 for
treatment following his incarceration, and intake notes
reflect that he had minimally impaired judgment and insight.
Ex. 16F, R. at 801, 804. Treatment notes reflect that
Dziamalek continued to have unremarkable judgment, thought
process and content, orientation, and behavior. See
Ex. 16F, R. at 814-28.
25, 2015, Dziamalek presented at Back to Health Branford LLC
with arm and shoulder pain that had been occurring for three
weeks. Ex. 224, R. at 1509. Dziamalek reported that he had
numbness, tingling, and pain in his arms as well as pain and
a “grinding sensation” in his shoulders.
Id. Treatment notes reflect that Dziamalek had an
“extremely limited” range of motion in his
shoulders, “shuddered” with pain with light
palpation of both shoulders, and refused to attempt shoulder
rotation due to pain. Id. Dziamalek was sent for an
MRI, but refused physical therapy because he could not move
his shoulders and also refused anti-inflammatory medication.
Id. He returned to Back to Health on July 20, 2015
to review the MRI and reported that he still had numbness in
his arms. Ex. 22F, R. at 1506. Treatment notes reflect that
Dziamalek reported continuing “exquisite pain” in
his shoulders “with even the slightest palpation”
as well as “numbness and tingling down both arms when
elevated over his head.” Id. The MRI reflected
that Dziamalek had right shoulder tendinopathy and had small
bony fragment anterior to acromion in his left shoulder.
Id. at 1507. Dziamalek was referred to an
orthopedist but was “extremely resistant to the idea of
any form of surgery” and continued to refuse physical
therapy because “he [could] not ‘move his
arms.'” Id. Treatment notes reflect that
Dziamalek was told he was “out of options”
because he refused everything else. Id.
continued to treat with Back to Health Branford through 2016
and 2017, with Dr. Michael Wong, beyond his disability
coverage date. See Ex. 22F. Treatment notes reflect
that Dziamalek complained regularly of hip and back pain,
back spasms, and difficulty breathing. See R. at
filed for Social Security benefits on October 21, 2013. App.
for Benefits, Ex. 1D, R. at 260. The SSA initially denied
Dziamalek's disability benefits claim on March 11, 2014.
Denial of App., Ex. 1A, R. at 125. The SSA found that
Dziamalek's condition resulted in “some limitations
in [his] ability to perform work related activities”
but that his condition was “not severe enough to keep
[him] from working.” DIB Int'l Explanation, Ex. 2A,
R. at 139. Further, although it did “not have
sufficient vocational information to determine whether [he
could] perform any of [his] past relevant work”, the
SSA determined that Dziamalek could “adjust to other
work.” Id. Dziamalek's claim was again
denied upon reconsideration on October 27, 2014.
Reconsideration Transmittal, Ex. 3A, R. at 140. In doing so,
the SSA stated that Dziamalek was “responsible for
furnishing evidence to support [his] claim, and, despite
SSA's requests for him to do so, Dziamalek failed to
provide anything additional. DIB Reconsid. Explanation, Ex.
4A, R. at 154. The SSA concluded that “a determination
[had] been made based on the evidence in file”, which
“[did] not show that [Dziamalek was] disabled.”
December 12, 2014, Dziamalek requested a hearing before an
Administrative Law Judge (“ALJ”). Hr'g
Request, Ex. 4B, Doc. No. 166. The hearing was held on July
11, 2016 before ALJ Matthew Kuperstein. Tr. of ALJ Hr'g,
R. at 79. The hearing record consisted, in part, of medical
records from various treatment providers from December 2010
to May 2014. See id. at 86; see also Ex.
1F-15F, R. at 325-800. At the hearing, Dziamalek's
attorney submitted hospital records from Yale New Haven
Health from July 2015 through March 2016, which were marked
at 19F. Tr. of ALJ Hr'g, R. at 82. Even though
it was a late submission, the ALJ accepted them into the
record. Id., R. at 82-84. The ALJ then left the
record open for three weeks for any additional medical
records to be submitted. Id. at 85. Dr. Chukwuemeka
Efobi was present for the hearing, but the ALJ released him
without testimony because the supplemental medical records
related to Dziamalek's physical health, rather than
mental health. Id. at 87. The ALJ stated that if any
further records came in that stated anything different from
earlier mental health treatment notes, then he would hold a
supplemental hearing. Id.
testified that he stopped working at his last job around
April 1, 2010, and had not worked since, which is why he
picked that date as his alleged onset date. Tr. of ALJ
Hr'g, R. at 93, 98. He testified that he could not
remember if he was fired or if he quit, but he could no
longer perform the work because his depression and anxiety
were “just so bad” that he “couldn't
function anymore.” Id. at 93. From 2006 to
2010, he worked at Dunkin' Donuts as a doughnut preparer,
which included frosting the donuts and preparing them for
sale. Id. at 98. Dziamalek testified that while he
worked there he stood all day and could lift up to 20 pounds
at a time. Id. at 98-99. Before Dunkin' Donuts,
he worked in shipping and receiving at BJ's Wholesale
Club from 2001 to 2004. Id. at 99. There, he mostly
stood but sometimes sat for 20 minutes at a time and could
lift up to 50 pounds at a time. Id. at 99-100.
testified that he had not been able to work since 2010 for a
number of reasons related to his physical and mental health.
Tr. of ALJ Hr'g, R. at 100-02. With respect to his mental
health, Dziamalek testified that he had anxiety every day,
was depressed, and “[could not] concentrate anymore on
one certain thing” because his “mind [kept]
running, ” which was not helped by medication.
Id. at 100. With respect to his physical health,
Dziamalek testified that he had problems with his back, right
leg, and left hand. Id. at 100-02. He testified that
his back and leg were “shot” and his left hand
was “useless.” Id. at 100. It appears
from his testimony that his right leg problems began when he
was in the hospital in March and April of 2015, after which
he was diagnosed with a hematoma. Id. at 101-02. He
testified that his leg would swell but he had been denied
medication so he “[could not] get any help for the
pain.” Id. at 100.
testified that his health issues affected his ability to help
his father and brother around the house, and he could only do
“very little” such as “a few dishes in the
sink … and maybe pick up the newspaper”, but he
could not do any landscaping or snow removal. Tr. of ALJ
Hr'g, R. at 94. Further, he testified that his physical
health issues affected his ability to drive, which he did
“not too often, ” and he could only do so for
15-20 minutes at a time. Id. at 96. Further,
sometimes his “throwing up [was too] bad” and
someone else drove him to his appointments or meetings.
Id. at 107. Dziamalek testified that he could only
stand or walk for 15 minutes at a time because of his back
issues and because his right leg would swell up, and he could
only sit for 20 minutes at a time. Id. at 95-96.
Further, Dziamalek testified that when his leg would swell,
he would “lay in bed with [his] leg up [and] watch
TV”, which was “basically what [he did] every
day.” Id. at 100, 107. Dziamalek also
testified that in 2010 he drank and used drugs (specifically
crack cocaine, heroin, and pills), but stopped drinking in
2014 and stopped doing drugs in 2011. Id. at 105. He
testified that he smoked a half a pack of cigarettes per day.
next heard testimony from Vocational Expert
(“VE”), Ruth Baruch, who testified that
Dziamalek's prior work as a “doughnut baker”
was considered a “semi-skilled” position with
“medium” exertional level, that Dziamalek
“performed in a light capacity.” Tr. of ALJ
Hr'g, R. at 109-10. Further, she testified that his prior
work as a “floor worker” at B.J.'s was
considered a “semi-skilled” position with
“heavy” exertional level, that Dziamalek
“performed in medium capacity.” Id. The
ALJ asked Baruch to consider a hypothetical individual with
the following characteristics: the above-mentioned past jobs;
high school level education; age 51; limited to medium
exertional work with a need to avoid concentrated exposure to
fumes, odors, dusts, gases, or poor ventilation; and limited
to work that involved routine work tasks with no interaction
with the general public, and involved only occasional
collaboration or teamwork with others. Id. at
110-11. The ALJ asked Baruch whether that hypothetical
individual could perform any of Dziamalek's prior jobs,
and Baruch testified that she would rule out Dziamalek's
past work because his work at BJ's was not “totally
routine” given his work with machines, and his work at
Dunkin' Donuts would require him to be around odors and
fumes. Id. at ...