Johnson v. Comm Social Security ( 2008 )


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  •                                                                                                                            Opinions of the United
    2008 Decisions                                                                                                             States Court of Appeals
    for the Third Circuit
    6-13-2008
    Johnson v. Comm Social Security
    Precedential or Non-Precedential: Precedential
    Docket No. 07-2132
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    Recommended Citation
    "Johnson v. Comm Social Security" (2008). 2008 Decisions. Paper 939.
    http://digitalcommons.law.villanova.edu/thirdcircuit_2008/939
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    PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    No. 07-2132
    STACI JOHNSON
    Appellant
    v.
    COMMISSIONER OF SOCIAL SECURITY
    On Appeal from the United States District Court
    for the Eastern District of Pennsylvania
    D.C. Civil Action No. 05-cv-05060
    (Honorable John P. Fullam)
    Submitted Pursuant to Third Circuit LAR 34.1(a)
    April 17, 2008
    Before: SLOVITER, JORDAN and ALARCÓN * , Circuit
    Judges.
    (Opinion Filed: April 22, 2008)
    *
    The Honorable Arthur L. Alarcón, United States Circuit
    Judge for the Ninth Judicial Circuit, sitting by designation.
    Jason L. Thompson
    Leventhal Sutton & Gornstein
    3600 Horizon Boulevard
    Suite 150
    Trevose, PA 19053
    Attorney for Appellant
    David F. Chermol
    Special Assistant United States Attorney
    Andrew Lynch
    Social Security Administration
    Office of the General Counsel
    P.O. Box 41777
    Philadelphia, PA 19101
    Attorneys for Appellee
    OPINION OF THE COURT
    ALARCÓN, Circuit Judge.
    Staci K. Johnson appeals the District Court’s order
    affirming the Commissioner of Social Security’s denial of
    Johnson’s claim for disability insurance benefits (“DIB”) under
    Title II of the Social Security Act. Johnson contends that the
    Commissioner’s finding was erroneous for two reasons. First,
    she alleges that the Administrative Law Judge (“ALJ”)
    overlooked several of her treating physician’s opinions. Those
    opinions, she argues, supported a finding that Johnson was
    disabled. Second, Johnson contends that the ALJ’s disability
    conclusion was based on an answer a vocational expert provided
    to an incomplete hypothetical question posed by the ALJ. She
    alleges that the expert’s answer did not constitute substantial
    evidence that Johnson was not disabled because the hypothetical
    question, which pertained to her ability to secure gainful
    2
    employment, omitted some of Johnson’s impairments.
    We have appellate jurisdiction pursuant to 28 U.S.C. §
    1291. Neither of Johnson’s contentions undermines the ALJ’s
    conclusion. Therefore, we affirm the District Court’s decision.
    I
    Until she stopped working in December 1989, Johnson
    was a hairdresser and salon manager. She quit as a result of an
    on-the-job injury, which caused pain in her right arm and
    shoulder. In 1990, she was diagnosed with thoracic outlet
    syndrome of her right shoulder. Johnson applied for disability
    insurance benefits on April 25, 1997, alleging that she became
    disabled on December 7, 1989 due to “thoracic outlet syndrome
    of the right shoulder.” Johnson was last insured for DIB on
    March 31, 1991, and in her application, she attempted to
    establish that she was disabled on or before that date.
    Johnson’s DIB application was denied. She challenged
    that initial denial in a hearing before an ALJ. On July 22, 1998,
    the ALJ denied Johnson’s claim, finding that she was not
    disabled during the relevant time period because her
    impairments did not prevent her from performing work in the
    national economy. Johnson appealed, and the Appeals Council
    remanded the case back to the ALJ because the tape recording of
    the hearing before the ALJ was partially inaudible. After a
    second hearing, the same ALJ again found that Johnson was not
    disabled during the relevant time period because there were “a
    significant number of jobs in the national economy that she
    could perform.” Johnson appealed that decision, and the
    Appeals Council remanded the case once more, with specific
    instructions regarding the evidence the ALJ should consider.
    The case was reassigned to a different ALJ.
    Johnson testified at her third ALJ hearing. Her testimony
    from the two prior hearings was read into the record. A
    vocational expert also testified. Johnson was again found to be
    not disabled during the relevant time period. The ALJ
    concluded that Johnson has not engaged in substantial gainful
    3
    activity since her alleged onset of disability date. However, the
    ALJ concluded that prior to April 1, 1991, “the claimant retained
    the residual functional capacity to perform a sedentary work-
    related activity.” Although the ALJ concluded that Johnson
    could not perform any of her past relevant work, the ALJ did
    find that Johnson could find other work. Based on testimony
    provided by the vocational expert, the ALJ concluded that
    Johnson could work as a “surveillance system monitor . . . call-
    out operator . . . and . . . order clerk.” Therefore, Johnson was
    not entitled to DIB because prior to April 1, 1991, she “retained
    the capacity for work that exists in significant numbers in the
    national economy.”
    Johnson sought review of the Commissioner’s decision
    before the District Court pursuant to 42 U.S.C. § 405(g). The
    District Court adopted a Magistrate Judge’s Report and
    Recommendation, which recommended denying Johnson’s
    motion for summary judgment, and granting the Commissioner’s
    motion for summary judgment. The District Court agreed with
    the Magistrate Judge that substantial evidence supported the
    Commissioner’s finding that Johnson was not entitled to DIB.
    II
    “While we exercise plenary review with respect to the
    order for summary judgment, our review of the ALJ’s decision is
    more deferential as we determine whether there is substantial
    evidence to support the decision of the Commissioner.” Knepp
    v. Apfel, 
    204 F.3d 78
    , 83 (3d Cir. 2000). “Substantial evidence
    does not mean a large or considerable amount of evidence, but
    rather such relevant evidence as a reasonable mind might accept
    as adequate to support a conclusion.” Hartranft v. Apfel, 
    181 F.3d 358
    , 360 (3d Cir. 1999) (internal quotations and citations
    omitted).
    As a preliminary matter, we note that to receive disability
    insurance benefits pursuant to Title II of the Social Security Act,
    a claimant must show that she was insured under the program at
    the time of onset of her disability. Kane v. Heckler, 
    776 F.2d 1130
    , 1131 n.1 (3d Cir. 1985). Johnson was insured for DIB
    4
    through March 31, 1991. Therefore, the relevant period for
    purposes of establishing whether she qualifies for DIB is the
    time between December 7, 1989, her alleged disability onset
    date, and March 31, 1991, the date she was last insured.
    A
    Johnson first argues for reversal alleging that “the ALJ
    improperly disregarded the opinions of Appellant’s treating hand
    specialist.” She breaks this argument into three subparts; she
    contends that each mandates reversal because the treating
    doctor’s opinions supported a finding that she was disabled
    during the relevant time period.
    Johnson claims that testimony Dr. Hunter provided during
    her Workers’ Compensation claim hearing on October 13, 1993
    is the evidence the ALJ should not have overlooked. She cites to
    the following portion of Dr. Hunter’s testimony:
    The early studies showed that, in fact, [Johnson]
    did have an early involvement of the brachial
    plexus, which are the nerves that run the extremity,
    but more clearly were defined to two specific
    points in the median nerve. One near the elbow
    and the other one at the wrist and the hand, in
    which there was slowing. It was documented on
    two occasions by electromyographic studies as
    well as the clinical evaluations, that in this nerve is
    the one specifically involved in how you feel with
    your thumb, index and middle finger. The
    proximal part of this nerve as you pass into the
    neck under the collar bone and join the brachial
    plexus was also involved and it’s a run down both
    back and forth. So its [sic] strange to me another
    physician on consultation can’t observe that the
    patient had really almost no feeling in this part of
    her hand. She couldn’t hold small objects. If she
    was blindfolded she couldn’t pick up a nickel
    because she couldn’t find it with her hand. She
    couldn’t handle earrings and clasps.
    5
    Pet’r Br. at 25-26 (citing R. 555) (emphasis added in Petitioner’s
    Brief). Johnson also cites to Dr. Hunter’s testimony from the
    same hearing in which he stated that despite a number of
    conservative measures, Johnson “was failing . . . [i]n August of
    ‘91, our median nerve problem was that she couldn’t feel and
    she couldn’t hold small things with her hand.” 
    Id. at 26
    (citing
    R. 556). “During this same deposition, Dr. Hunter read from his
    office note of August 15, 1991, at which time he recommended
    surgery.” 
    Id. In analyzing
    Johnson’s DIB claim, the ALJ followed the
    Social Security Administration’s five-step evaluation process.
    Johnson’s arguments regarding Dr. Hunter’s opinions challenge
    the ALJ’s conclusions regarding Johnson’s ability to perform
    “past relevant work” and “several other jobs” in the national
    economy. We construe this as a challenge to the ALJ’s step four
    finding regarding Johnson’s residual functional capacity, “that
    which an individual is still able to do despite the limitations
    caused by his or her impairment(s).” Fargnoli v. Halter, 
    247 F.3d 34
    , 40 (3d Cir. 2001) (internal quotations and citations
    omitted). “The ALJ must consider all relevant evidence when
    determining an individual's residual functional capacity in step
    four.” 
    Id. at 41.
    1
    We first turn to Johnson’s contention that Dr. Hunter’s
    testimony should have determined the outcome of Johnson’s
    claim because it was a treating physician’s opinion entitled to
    “significant, if not controlling evidentiary weight.”
    “Under applicable regulations and the law of this Court,
    opinions of a claimant's treating physician are entitled to
    substantial and at times even controlling weight.” 
    Fargnoli, 247 F.3d at 43
    (citing 20 C.F.R. § 404.1527(d)(2)). However, the
    treating source’s opinion is entitled to controlling weight only
    when it is “‘well-supported by medically acceptable clinical and
    laboratory diagnostic techniques and is not inconsistent with the
    other substantial evidence in [the claimant's] case record .’” 
    Id. at 43
    (quoting 20 C.F.R. § 404.1527(d)(2)).
    6
    Johnson does not distinguish between any of the
    statements in Dr. Hunter’s cited testimony, but rather contends
    that each of them was entitled to controlling weight. However,
    there are important differences between the statements. The first
    two underlined portions of Dr. Hunter’s testimony (“The early
    studies showed that, in fact, [Johnson] did have an early
    involvement of the brachial plexus” and “[i]t was documented
    on two occasions by electromyographic studies as well as the
    clinical evaluations”), were given controlling weight by the ALJ.
    The ALJ expressly noted that: “[o]n February 7, 1991, Dr.
    Hunter reported that clear positive studies of EMG’s were read,
    implicating a brachial plexus traction injury on the right with
    brachial plexus fixation and chronic neuropathy.” This
    statement supports the ALJ’s conclusion that “[b]ased upon a
    complete review of the medical evidence, the undersigned finds
    the medical evidence established that prior to April 1, 1991,
    thoracic outlet syndrome and depression were medically
    determinable conditions that resulted in more than minimal
    functional and vocation limitations and required significant
    medically appropriate treatment regiments.”
    Similarly, the final piece of cited evidence, that “[d]uring
    this same deposition, Dr. Hunter read from his office note of
    August 15, 1991, at which time he recommended surgery,” was
    not improperly overlooked. This exact testimony, and Dr.
    Hunter’s August 15, 1991 office note, are missing from the
    ALJ’s conclusions. However, the ALJ noted that at some time
    between February 7, 1991, and July 2, 1991, Dr. Hunter “noted
    that [Johnson] would need surgery.” The ALJ’s inclusion of this
    piece of evidence does not support Johnson’s contention that the
    ALJ failed to give Dr. Hunter’s surgery conclusion controlling
    weight.1
    The section of Dr. Hunter’s testimony regarding
    Johnson’s fine manipulation (“the patient had really almost no
    1
    We are aware of no authority that requires an ALJ to
    quote from a treating doctor’s opinion verbatim in order to
    evidence the ALJ’s grasp of the information contained within.
    7
    feeling in this part of her hand. She couldn’t hold small objects.
    If she was blindfolded she couldn’t pick up a nickel because she
    couldn’t find it with her hand. She couldn’t handle earrings and
    clasps”) did not make it into the ALJ’s opinion. Similarly, Dr.
    Hunter’s testimony that Johnson “was failing . . . [i]n August of
    ‘91, our median nerve problem was that she couldn’t feel and
    she couldn’t hold small things with her hand” is not part of the
    ALJ’s conclusions. However, these portions of testimony were
    not entitled to controlling weight because they are inconsistent
    with the other substantial evidence in the record.
    The ALJ cited to an overwhelming amount of evidence in
    support of her conclusion that Johnson retained some use of her
    hands after March 31, 1991. The ALJ noted that Johnson was
    examined on May 28, 1991; at that time, “she had full motion of
    the shoulder, elbow, wrist, and fingers.” On November 25,
    1991, Johnson was evaluated by an occupational therapist, who
    determined that she had “hand grip strength of 5 pounds on the
    right and 25 to 30 pounds on the left. Pinch strength was also 5
    pounds on the right and 18 pounds on the left.” Also, the ALJ
    noted that although Johnson testified that her condition had only
    worsened, the evidence also established that:
    [Johnson] married and gave birth to two children
    since March 31, 1991. While she testified that she
    was and remains unable to hold, bathe, feed, lift or
    do any other physical activity for the children at
    any time, the undersigned finds it odd that there is
    no record of the claimant having mentioned these
    limitations to a doctor . . . Currently, she testifies
    that she never drives, but the written evidence
    shows she described vision difficulties interfering
    with night driving only.
    Johnson’s arguments that the above-cited testimony was
    improperly disregarded and entitled to controlling weight are
    8
    without merit.2
    2
    Johnson also contends that the ALJ should be reversed
    because an ALJ cannot reject evidence without reason. She
    asserts that the ALJ had a duty to explain why Dr. Hunter’s
    opinions were credited or not. Much of the testimony Johnson
    claims was not relied upon by the ALJ was in fact sufficiently
    incorporated into the ALJ’s findings, as explained above. With
    regard to Dr. Hunter’s statements regarding Johnson’s ability to
    use her hands for fine manipulation, we reject Johnson’s
    argument that the ALJ was required to consider it.
    Johnson relies on Burnett v. Comm’r, 
    220 F.3d 112
    , 121
    (3rd Cir. 2000), for the proposition that an ALJ must “‘give
    some indication of the evidence which he rejects and his
    reason(s) for discounting such evidence.’” Johnson has
    selectively quoted from the paragraph in which this sentence
    appears. The paragraph provides:
    The ALJ did err by reason of his failure to consider
    and explain his reasons for discounting all of the
    pertinent evidence before him in making his
    residual functional capacity determination. In
    making a residual functional capacity
    2
    Johnson also cites to Dr. Hunter’s testimony that
    Johnson’s impairments rendered her “unable to perform not only
    her past relevant work, but several other jobs which were offered
    during the course of her Workers’ Compensation claim.” This is
    not the sort of treating source medical opinion entitled to any kind
    of weight. The applicable regulations provide that “[a] statement
    by a medical source that you are ‘disabled’ or ‘unable to work’
    does not mean that we will determine that you are disabled.” 20
    C.F.R. § 404.1527 (e)(1). Conclusions of this kind are “reserved
    to the Commissioner . . . because they are administrative findings
    that are dispositive of a case; i.e., that would direct the
    determination or decision of disability.” § 404.1527 (e).
    9
    determination, the ALJ must consider all evidence
    before him. . . . Although the ALJ may weigh the
    credibility of the evidence, he must give some
    indication of the evidence which he rejects and his
    reason(s) for discounting such evidence.
    
    Burnett, 220 F.3d at 121
    (emphasis added). The paragraph
    concludes with the admonishment that “‘[i]n the absence of such
    an indication, the reviewing court cannot tell if significant
    probative evidence was not credited or simply ignored.’” 
    Id. (quoting Cotter
    v. Harris, 
    642 F.2d 700
    , 705 (3d Cir. 1981))
    (emphasis added).
    Citation to the entire paragraph clarifies that an ALJ may
    not reject pertinent or probative evidence without explanation.
    See 
    Cotter, 642 F.2d at 706
    (“[T]here is a particularly acute need
    for some explanation by the ALJ when s/he has rejected relevant
    evidence or when there is conflicting probative evidence in the
    record.”); 
    id. at 706-07
    (“[A]n explanation from the ALJ of the
    reason why probative evidence has been rejected is required so
    that a reviewing court can determine whether the reasons for
    rejection were improper.”). Johnson has cited no authority for
    the proposition that an ALJ must cite all evidence a claimant
    presents, including evidence that is irrelevant to her case.
    The ALJ was entitled to overlook Dr. Hunter’s testimony
    regarding Johnson’s fine manipulations because it was neither
    pertinent, relevant nor probative. It was elicited on October 13,
    1993, in response to the question: “[b]ased not only upon [the
    October 7, 1993] exam but the exams preceding that, I don’t
    want to go through each one since your treatment spans over
    three years, but do you have an opinion as to [Johnson’s] current
    medical condition and her diagnosis?” To the extent that the
    quoted testimony addresses Johnson’s health as of October 13,
    1993, it does not undercut the ALJ’s disability conclusion.
    Johnson had to establish that she was disabled before April 1,
    1991. See Bacon v. Sullivan, 
    969 F.2d 1517
    , 1518 (3d Cir.
    1992) (explaining that to receive disability insurance benefits, an
    applicant must establish that she was disabled prior to “the date
    her status as an insured expired”).
    10
    To the extent that Dr. Hunter’s fine manipulation
    testimony speaks to a relevant time period, the ALJ was still
    entitled to reject it without explanation. Overwhelming evidence
    in the record discounted its probative value, rendering it
    irrelevant. As explained above, substantial evidence supports
    the ALJ’s conclusion that as of March 31, 1991, and for several
    months after that date, Johnson’s fine manipulation was not as
    impaired as Dr. Hunter suggested it was in his testimony.
    Johnson’s Opening Brief anticipates our conclusion that
    Dr. Hunter’s testimony regarding fine manipulation was
    irrelevant, and offers several rebuttals. First, she contends that
    the District Court’s rejection of Dr. Hunter’s workers’
    compensation testimony on the ground that the testimony was
    irrelevant requires reversal. She argues that the District Court’s
    affirmance on this ground was “legally erroneous” because an
    administrative order must be judged on the grounds upon which
    “‘the record discloses that its action was based.’” Pet’r Br. at 27
    n.23 (quoting 
    Fargnoli, 247 F.3d at 44
    n.7). That is, Johnson
    alleges that the District Court cannot reject evidence for reasons
    that the ALJ failed to mention.
    Johnson’s argument distorts the cited authority. Fargnoli
    criticized the district court for “recognizing the ALJ's failure to
    consider all of the relevant and probative evidence,” but yet
    attempting “to rectify this error by relying on medical records
    found in its own independent analysis, and which were not
    mentioned by the 
    ALJ.” 247 F.3d at 44
    n.7. Fargnoli does not
    establish that a district court may not explain an ALJ’s failure to
    cite irrelevant evidence, and we cannot reverse the District Court
    on this ground.
    Second, Johnson argues that if Dr. Hunter’s testimony
    was chronologically ambiguous, pursuant to 20 C.F.R. §
    416.912(e)(1), Dr. Hunter should have been recontacted to
    clarify the ambiguity in his testimony. That is, the ALJ should
    have contacted Dr. Hunter to ask him if his comments regarding
    Johnson’s fine manipulation limitations pertained to the time
    during which she was insured.
    11
    Section 416.912(e)(1) provides that a medical source will
    be recontacted for purposes of clarification “when the report
    from your medical source contains a conflict or ambiguity that
    must be resolved, the report does not contain all the necessary
    information, or does not appear to be based on medically
    acceptable clinical and laboratory diagnostic techniques.”
    However, the language in Section 416.912(e)(1) is preceded by
    the following qualification: recontact will proceed if “the
    evidence we receive from your treating physician or psychologist
    or other medical source is inadequate for us to determine
    whether you are disabled.” This is an important prerequisite.
    See Thomas v. Barnhart, 
    278 F.3d 947
    , 958 (9th Cir. 2002)
    (“[T]he requirement for additional information is triggered only
    when the evidence from the treating medical source is
    inadequate to make a determination as to the claimant’s
    disability.”).
    In failing to cite Dr. Hunter’s testimony, the ALJ
    implicitly rejected it. That rejection did not trigger the ALJ’s
    duty to give Dr. Hunter an opportunity to explain testimony that
    the record overwhelming disputed.
    3
    We next turn to Johnson’s argument that the ALJ should
    be reversed because “despite a specific and direct mandate from
    the Appeals Council . . . the ALJ completely failed to address
    any of Dr. Hunter’s opinions.”
    On remand, “[t]he administrative law judge shall take any
    action that is ordered by the Appeals Council and may take any
    additional action that is not inconsistent with the Appeals
    Council's remand order.” 20 C.F.R. § 404.977(b).
    In remanding Johnson’s case to a third hearing before an
    ALJ, the Appeals Council noted that “[t]he record contains
    statements from Dr. Hunter regarding the claimant’s work
    limitations that are not addressed in the decision.” App. at 58
    (citing Exhibit 11F, and pages 141 and 142 of Exhibit 1F).
    Contrary to Johnson’s assertions, the Appeals Council did not
    12
    order the ALJ to expressly consider those exhibits. Rather, it
    ordered the ALJ to: “[g]ive consideration to the treating source
    opinion . . . [f]urther evaluate the claimant’s mental impairment .
    . . [g]ive further consideration to the claimant’s maximum
    residual functional capacity . . . [and] [o]btain supplemental
    evidence from a vocational expert to clarify the effect of the
    assessed limitations on the claimant’s occupational base.”
    The ALJ devoted ample consideration to Johnson’s
    treating physicians. With regard to Dr. Hunter, the ALJ
    described three notes about Johnson’s impairments written by
    Dr. Hunter in detail. The ALJ’s decision complies with 20
    C.F.R. § 404.977(b).
    B
    Johnson also argues that the ALJ committed reversible
    error because she posed an incomplete hypothetical question to a
    vocational expert. Johnson contends that the hypothetical did
    not incorporate the limitations from Dr. Hunter’s opinions.
    At step five of the disability analysis, the burden shifts to
    the Commissioner “to show that other jobs exist in significant
    numbers in the national economy that the claimant could
    perform.” Rutherford v. Barnhart, 
    399 F.3d 546
    , 551 (3d Cir.
    2005). “Advisory testimony from a vocational expert is often
    sought by the ALJ for that purpose . . . and factors to be
    considered include medical impairments, age, education, work
    experience and RFC.” 
    Id. “We do
    not require an ALJ to submit
    to the vocational expert every impairment alleged by a
    claimant.” 
    Id. at 554
    (emphasis added). Rather, “the
    hypotheticals posed must ‘accurately portray’ the claimant’s
    impairments and [] the expert must be given an opportunity to
    evaluate those impairments ‘as contained in the record.’” 
    Id. (citation omitted).
    Johnson contends that the hypothetical question posed
    was incomplete because “the ALJ failed to address Dr. Hunter’s
    opinions regarding Johnson’s significant functional limitations,
    especially the limitations on fine manipulation.” Also, she
    13
    argues that “Dr. Hunter opined that Johnson had essentially no
    functional use of the dominant right upper extremity.” Johnson
    alleges that bilateral manual dexterity is necessary for
    substantially all unskilled sedentary occupations.
    The ALJ’s hypothetical question instructed the vocational
    expert that:
    I want you to assume an individual of the
    Claimant’s age, education and work experience,
    having the following residual functional capacity:
    being able to lift up to 10 pounds, sit for six hours,
    stand and walk for two hours with an at-will
    sit/stand option; no repetitive reaching, fingering
    and handling; no overhead reaching – that’s
    bilaterally; and being limited to simple, repetitive
    tasks. Could that individual return to Claimant’s
    past relevant work?
    The vocational expert answered that question “no.” The ALJ
    clarified that by “repetitive tasks” she meant “continuous” tasks.
    Also, the ALJ noted that she wanted to hear about the
    availability of jobs “with only occasional hand-use.” The
    vocational expert listed several jobs that a person only able to
    use her hands occasionally could perform.
    The hypothetical posed by the ALJ accurately portrays
    Johnson’s impairments. The only evidence Johnson presents in
    support of her contention that she had significant “fine
    manipulation” limitations is not supported by a citation to the
    record. To the extent that Johnson relies on Dr. Hunter’s
    testimony that Johnson “couldn’t hold small objects” or “pick up
    a nickel,” those statements do not accurately portray Johnson’s
    impairments; therefore, the ALJ was not required to incorporate
    them into her hypothetical question. As explained above,
    overwhelming evidence suggests that prior to April 1, 1991,
    Johnson retained “occasional hand use.” Nothing about the
    hypothetical requires reversal. For that reason, we need not
    determine whether a person who lacks bilateral manual dexterity
    is presumptively disabled.
    14
    III
    The ALJ’s decision denying Johnson’s DIB addressed
    Johnson’s medical history, from her alleged onset date of
    December 7, 1989, to the present. The ALJ’s decision cited
    treatment notes from Johnson’s orthopedist, psychologist, and
    hand surgeons, among others. The ALJ also noted Johnson’s
    own testimony regarding the severity of her pain and functional
    limitations. The ALJ resolved inconsistencies in the record, and
    gave multiple reasons in support of her conclusion that
    Johnson’s claims regarding her physical capacities prior to
    March 31, 1991 were somewhat unreliable. The ALJ also cited
    an occupational therapist’s assessment of Johnson’s functional
    capacities as of November 25, 1991.
    We conclude that the ALJ’s decision is an exhaustive
    evaluation of the evidence in this case, and that the ALJ’s
    conclusion is supported by substantial evidence.
    AFFIRMED.
    15