Crowder v. Social Security Administration, Commissioner

Filing 11

MEMORANDUM OPINION Signed by Judge Karon O Bowdre on 9/20/12. (SAC )

FILED
2012 Sep-20 AM 10:14
U.S. DISTRICT COURT
N.D. OF ALABAMA

IN THE UNITED STATES DISTRICT COURT FOR THE
NORTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
FRANCES MELINDA CROWDER,
Plaintiff
v.

MICHAEL J. ASTRUE,
Commissioner of the Social,
Security Administration
Defendant.

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CIVIL ACTION NO.
2:11-CV-02478-KOB

MEMORANDUM OPINION
I. INTRODUCTION
On March 27, 2009, the claimant, Frances Crowder, filed an application for disability
insurance benefits under Title II of the Social Security Act. The claimant alleged disability
commencing on February 9, 2009, because of bipolar disorder and panic disorder without
agoraphobia. (R. 57). The Commissioner denied the claim, and the claimant filed a timely request
for a hearing before an Administrative Law Judge, which the ALJ held on May 5, 2010. (R. 27, 8081). In a decision dated July 14, 2010, the ALJ found the claimant not disabled as defined by the
Social Security Act and, thus, ineligible for disability insurance benefits or supplemental security
income. On June 23, 2011, the Appeals Council refused to grant review; consequently, the ALJ’s
decision became the final decision of the Commissioner of the Social Security Administration. (R.
1-3, 16). The claimant has exhausted her administrative remedies, and this court has jurisdiction
pursuant to 42 U.S.C. §§ 405(g) and 1631(c)(3). For the reasons stated below, this court affirms the
decision of the Commissioner.
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II. ISSUE PRESENTED
Whether the ALJ failed to consider the cyclical nature of the claimant’s mental
impairments.

III. STANDARD OF REVIEW
The standard for reviewing the Commissioner’s decision is limited. This court must
affirm the Commissioner’s decision if the Commissioner applied the correct legal standards and
if the factual conclusions are supported by substantial evidence. See 42 U.S.C. § 405(g); Graham
v. Apfel, 129 F.3d 1420, 1422 (11th Cir. 1997); Walker v. Bowen, 826 F.2d 996, 999 (11th Cir.
1987). “Substantial evidence is more than a scintilla, but less than a preponderance. It is such
relevant evidence as a reasonable person would accept as adequate to support a conclusion.”
Richardson v. Perales, 401 U.S. 389, 401 (1971). A reviewing court may not look only to those
parts of the record that support the decision of the ALJ, but instead must view the record in its
entirety and take account of evidence that conflicts with the evidence relied on by the ALJ.
Hillsman v. Bowen, 804 F.2d 1179 (11th Cir. 1986). The court must scrutinize the totality of the
record “to determine the reasonableness of the [Commissioner’s] . . . factual findings . . . No
similar presumption of validity attaches to the [Commissioner’s] . . . legal conclusions, including
determination of the proper standards to be applied in evaluating claims.” Walker v. Bowen, 826
F.2d 996, 999 (11th Cir. 1987).
IV. LEGAL STANDARD
Under 42 U.S.C. § 423(d)(1)(A), a person is entitled to disability benefits when the
person is unable to “engage in any substantial gainful activity by reason of any medically
determinable physical or mental impairment which can be expected to result in death or which

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has lasted or can be expected to last for a continuous period of not less than 12 months . . . .” To
make this determination the Commissioner employs a five-step, sequential evaluation process.
See 20 C.F.R. §§ 404.1520, 416.920.
(1) Is the person presently unemployed?
(2) Is the person’s impairment severe?
(3) Does the person’s impairment meet or equal one of the specific impairments
set forth in 20 C.F.R. Pt. 404, Subpt. P, App. 1?
(4) Is the person unable to perform his or her former occupation?
(5) Is the person unable to perform any other work within the economy?
An affirmative answer to any of the above questions leads either to the next
question, or, on steps three and five, to a finding of disability. A negative answer
to any question, other than step three, leads to a determination of “not disabled.”
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986).1
To establish disability, the claimant has the burden of proving the first three steps: namely
that (1) she is not engaged in substantial gainful activity; (2) she has a severe impairment or
combination of impairments; and (3) her impairment or impairments meet or exceed the criteria
in the Listings found in 20 C.F.R. Pt. 404, Subpt. P, App. 1. If the claimant cannot prove that she
has a listed impairment, she must prove alternatively that she is unable to perform her previous
work. Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir. 1999); see also Lucas v. Sullivan, 918 F.2d
1567, 1571 (11th Cir. 1990). Once the claimant shows that she cannot perform her previous
work, the burden shifts to the Commissioner “to show the existence of other jobs in the national
economy which, given the claimant’s impairments, the claimant can perform.” Jones v. Apfel,
190 F.3d at 1228.

1

McDaniel v. Bowen, 800 F.2d 1026 (11th Cir. 1986) was a supplemental security income case
(SSI). The same sequence applies to disability insurance benefits. Cases arising under Title II are
appropriately cited as authority in Title XVI cases. See e.g. Ware v. Schweiker, 651 F.2d 408 (5th Cir.
Unit A 1981).

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Substantial evidence does not exist when a decision focuses on one aspect of the evidence
while ignoring other contrary evidence. See Hillsman v. Bowen, 804 F.2d 1179, 1180 (11th Cir.
1986). A reviewing court must scrutinize the entire record “to determine the reasonableness of
the decision reached.” Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1989). However, “credibility
determinations are the province of the ALJ.” Moore v. Barnhart, 405 F.3d 1208, 1212 (11th Cir.
2005). A court may not re-weigh the evidence or substitute its own judgment for that of the
Commissioner, even if it finds that the evidence preponderates against the Commissioner’s
decision. See Dyer v. Barhart, 395 F.3d 1206, 1212 (11th Cir. 2005).
In evaluating pain and other subjective complaints, the Commissioner must consider
whether the claimant demonstrated an underlying medical condition, and either “(1) objective
medical evidence that confirms the severity of the alleged pain arising from that condition or (2)
that the objectively determined medical condition is of such a severity that it can reasonably be
expected to give rise to the alleged pain.” Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991)
(emphasis added); see also Wilson v. Barnhart, 284 F.3d 1219, 1225-56 (11th Cir. 2002); 20
C.F.R. § 404.1529.
V. FACTS
The claimant has a college education, having a masters degree in both social work and
education; she was thirty-nine years old at the time of the hearing. Her past work experience
includes employment as a kindergarten teacher and social worker. The claimant’s alleged
disabilities stem from bipolar disorder, irritable bowel syndrome (IBS), migraine headaches, and
obesity. (R. 15, 32, 51-52).

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Physical Limitations
On February 25, 2010, the claimant visited Dr. Kelli Grinder, an examining physician, at
Norwood Clinic. (R. 265). Dr. Grinder noted that the claimant complained of heartburn, acid
reflux, and a sour taste in her mouth. Dr. Grinder diagnosed the claimant with hypertension and
IBS. (R. 267). On May 5, 2010, the claimant visited Dr. Linda Thompson, an examining
physician, at Brookwood Medical Center. (R. 276). Dr. Thompson diagnosed the claimant with
abdominal pain and described the claimant as overweight. Dr. Thompson noted that the claimant
has a normal appendix and no abnormalities of the bowels. (R. 276).
Mental Limitations
On Decemeber 2, 2004, the claimant visited Dr. John Holcombe at UAB Health Center
Hueytown. (R. 200). Dr. Holcombe diagnosed the claimant with acute depression with anxiety
and panic non-suicidal escalating. (R. 200). He wrote the claimant a note excusing her from work
for the rest of week. At the time, the claimant taught a 5th grade class at an elementary school
and felt considerable stress related to her job. Dr. Holcombe stated that the claimant would have
a follow-up visit with her psychiatrist, Dr. Stone, though the record contains no records of the
follow-up visit.
On August 5, 2008, the claimant visited Eastside Mental Health Center, where she saw
Nancy Mitchell (credentials unspecified). (R. 209). Ms. Mitchell’s status exam shows the
following observations of the claimant: appropriate appearance; cooperative demeanor; normal
speech; euthymic mood; good memory; and good insight. (R. 209). On February 4, 2009, the
claimant visited Dr. Timothy Stone, an examining psychiatrist, at Eastside Mental Health Center.
(R. 208). Dr. Stone diagnosed the claimant with bipolar disorder and panic disorder without

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agoraphobia. (R. 208).
On June 26, 2009, at the request of the ALJ, the claimant received a consultative
examination from Dr. John Neville, a psychologist. (R. 215). Dr. Neville diagnosed the claimant
with bipolar disorder and panic disorder without agoraphobia. (R. 217). Dr. Neville found that
the claimant’s ability to respond to coworkers would decline when her mood reaches more
extreme states. He found that the claimant’s ability to cope with ordinary work pressures would
also vary with the cycles of her illness. (R. 217-18). Dr. Neville stated that the claimant does
housework, drives, but does not have any recreational activities; Dr. Neville found the claimant’s
prognosis over the next six to twelve months fair. (R. 217). Dr. Neville recommended psychiatric
treatment and psychotherapy for the claimant, and he found her ability to carry out instructions
mildly to moderately impaired by her mood disorder. (R. 217).
On July 10, 2009, Dr. Robert Estock, a non-examining state psychiatrist, completed a
psychiatric review technique regarding the claimant. (R. 219). Dr. Estock recounted the mental
health history of the claimant described above; he then opined that the claimant had mental
limitations but should be expected to function in at least an unskilled environment. (R. 231). Dr.
Estock also completed a mental residual functional capacity assessment. (R. 233). Dr. Estock
found that the claimant had no marked limitations related to her mental impairments. (R. 233).
Dr. Estock concluded that the claimant can perform simple tasks without significant restrictions;
however, the claimant requires a flexible schedule in a spaced work setting with all allowable
rest breaks. Dr. Estock found that the claimant’s contact with the public should be casual and
limited and her supervision should be tactful and supportive. Lastly, Dr. Estock stated that
changes in the claimant’s work setting or routine should be introduced gradually. (R. 235).

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From June, 2009 to January 14, 2010, the claimant visited Eastside Mental Health Center
seven times, where the record reflects the diagnosis of bipolar disorder ( June 6, 2009; June 9,
2009; July 14, 2009; August 6, 2009; September 10, 2009; November 2, 2009; and January 14,
2009). On September 10, 2009, Eastside Mental Health Center’s record reflect that the claimant
had a global assessment function (GAF) level of seventy, indicating mild limitations in
functionality. (R. 238). The records indicated that the claimant has a long history of depression
and anxiety characterized by increased sleep; increased appetite; decreased energy; crying spells;
depressed mood; and panic attacks. Also, the records indicated that the claimant had feelings of
hopelessness and fatigue. The records note that the claimant has never needed hospitalization for
these symptoms. (R. 238). On November 11, 2009, Eastside Mental Health Center records
indicated that the claimant described her depression as mild. The claimant stated concern over
the change in seasons, because she gets depressed when the days shorten. The records indicated a
normal mental status with no manic symptoms, panic attacks, or side effects from medication.
(R. 244).
The ALJ Hearing
After a denial of the claimant’s request for disability insurance benefits by the
Commissioner, the claimant received a hearing before the ALJ on May 5, 2010. (R. 27, 80-81).
At the hearing, the claimant testified that she was able to drive, but crying spells limit her ability
to do so at times. (R. 32). The claimant testified that her depression is always present; however,
she sometimes experiences worse depression. The claimant testified that when she was fired in
February 2009, her depression had worsened. (R. 34-35). The claimant asserted she was fired
because her mental illness stopped her from performing her work duties. (R. 35). From February

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2009 through the summer of 2009, the claimant stated her depression worsened; yet, the claimant
testified that her depression became more manageable when the school year started again. The
claimant expressed hope that she gets better every day. Although the claimant stated her
depression is better than when she was fired in February 2009, she claims that she is not yet a
“completed person.” (R. 36).
The claimant testified that, in addition to her depression, her IBS is a disabling
impairment. (R. 37). She stated that she believes that her IBS and depression are linked. The
claimant testified that her IBS episodes start with abdominal pain that lead her to the bathroom
where she sometimes passes out. (R. 37). The claimant testified that, during IBS episodes, she is
nauseated and drained of her energy. (R. 37). The claimant stated that, because of her IBS
causing severe abdominal pains, she visited the emergency room the morning of the hearing.
When asked by the ALJ to describe what happens during her IBS episodes, the claimant stated
that she keeps her hand in the sink; keeps a towel on her face; remains seated on the toilet; and
keeps a bucket in front of her in which to throw up. The claimant testified that these episodes
occur once a month on average. (R. 39).
The claimant stated that her hypertension and gastroesophagael reflux (GERD) are
controllable with medication. (R. 40). The claimant testified that she has three children, and that
she takes care of her home by doing laundry, making dinner, washing dishes, and vacuuming. (R.
41). The claimant stated that she avoids the grocery store because she has trouble making
decisions. (R. 41). The claimant testified that she sweeps and reads but does not mop. In addition
to reading, the claimant stated the she can watch and follow movies. (R. 41-42.). The claimant
testified that she goes to church and has no difficulty doing so. Also, the claimant goes to her

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children’s sporting events. (R. 42-43).
The claimant testified that she gets along well with family and friends but that her IBS
keeps her from strenuous activity. (R. 43). The claimant testified that she could walk or stand for
two hours out of an eight hour day and that physical or mental impairments do not limit her
ability to lift or carry objects. (R. 44). The claimant noted, however, that she was probably
incapable of lifting more than ninety pounds.(R. 44). The claimant testified that when she
experiences depression and IBS, she has difficulty bending, stooping, and squatting. (R. 45). The
claimant stated that, since February 2008, she has had no problems with pain other than her IBS
and that her IBS causes her pain once or twice every two weeks. (R. 45).
After the testimony described above, claimant’s counsel asked the claimant questions.
The claimant testified that she has migraine headaches that accompany her IBS; however, over
the counter medication treats her migraine pain well. The claimant testified that she has to lay
down every day for a couple of hours. (R. 48). The claimant stated that she experiences panic
attacks—described as anxiety to the point of confusion—three to four times a month, on average,
and additionally while at the grocery store. (R. 49-50).
The ALJ then questioned Dr. Mary Kessler, a vocational expert. Dr. Kessler testified that
the claimant had previous work experience as a kindergarten teacher and a social worker;
however, the claimant could not perform her past relevant work. (R. 52.) The ALJ asked Dr.
Kessler hypothetical questions. First, the ALJ asked Dr. Kessler if an individual the same age,
education, and work experience as the claimant and the residual functional capacity to perform
simple tasks without significant restrictions could maintain gainful employment. Additionally for
this first hypothetical, the ALJ asked Dr. Kessler to assume that the job would allow for a

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flexible schedule; a spaced work setting; all allowable rest breaks; limited and casual contact
with the public; tactful and supportive supervision; and gradually introductions to changes in
routine or work setting. Dr. Kessler testified that such an individual under the described
circumstances could be a packer, packager, inspector, tester, assembler, or machine feeder. (R.
53.)
The ALJ then asked Dr. Kessler to take the hypothetical and add the limitation of only
being able to stand or sit for two hours out of the day. Dr. Kessler testified that such an individual
could work as a general office clerk, order clerk, production worker, or table worker. (R. 54).
Lastly, the ALJ asked Dr. Kessler to take all the previous limitations and then add the limitation
of having to miss two or more days of work per month. Dr. Kessler testified that such an
individual would not be able to maintain gainful employment.
The ALJ’s Decision
On July 14, 2010, the ALJ issued her decision. The ALJ found that the claimant last met
the insured status requirements of the Social Security Act through June 30, 2011. (R. 15). The
ALJ found that the claimant had not engaged in substantial gainful activity since February 9,
2009, the alleged onset date of disability. (R. 15). The ALJ determined that the claimant had the
following severe impairments: bipolar disorder, panic disorder, IBS, migraine headaches, and
obesity. (R. 15). Additionally, the ALJ found that the claimant had a history of the following
medically determinable impairments: hypertension, GERD, and arthritis; however, given the lack
of supporting evidence in the record and the fact that the claimant did not claim hypertension,
GERD, and arthritis as severely limiting, the ALJ determined that they were not severe
impairments. (R. 15).

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To support her conclusions regarding the claimant’s severe impairments, the ALJ cited
the claimant’s history of depression, anxiety, and IBS. (R. 16). The ALJ stated the evidence of
record confirms that the claimant lost her job in February 2009 because of excessive absences.
Also, the ALJ stated that being fired exacerbated the claimant’s symptoms of depression. The
ALJ noted that the medical evidence of record indicated that the claimant’s symptoms improved
around September 2009. To support this statement, the ALJ specifically cited to records from
Eastside Mental Health Center dated September 10, 2009 that mention an improved condition of
the claimant. (R. 16). The ALJ additionally cited to records from Eastside Mental Health Center
dated November 2, 2009 and January 14, 2010 to show improvement in the claimant’s condition.
These records indicated that the claimant continued to do well and was not experiencing panic
attacks or crying spells. (R. 16).
The ALJ next found that the claimant’s impairments did not meet the Listings. (R. 16).
To support her conclusion, the ALJ noted that no treating, examining, or reviewing physician,
nor the claimant herself, had suggested the existence of a Listing level impairment regarding her
IBS. (R. 16). The ALJ also determined that the claimant’s mental impairments considered
singularly and in combination do not meet the Listings.
In reaching this decision, the ALJ utilized the analysis of the Psychiatric Review
Technique. The ALJ determined that the claimant had a moderate limitation in activities of daily
living. To support this conclusion, the ALJ cited the claimant’s ability to prepare meals; take care
of household chores; run errands; shop for groceries; and help her children with homework. The
ALJ determined that the claimant had moderate difficult in social functioning. The ALJ
supported this conclusion by citing the claimant’s testimony that she attends church twice a

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month and gets along well with friends and family. The ALJ found that the claimant has
moderate difficulties with concentration, persistence, or pace. To support this conclusion, the
ALJ first cited the claimant’s testimony that, when depressed, she needs more time to accomplish
her usual routines. Also, the ALJ pointed to the fact that the claimant at times needs her husband
and mother to accomplish her daily routines. However, the ALJ found only moderate limitations
with concentration, persistence, or pace because the claimant testified that she enjoyed reading
and is able to watch a movie and follow it. Further, the ALJ concluded that the claimant has
experienced no episodes of decompensation. To support this conclusion, the ALJ noted that no
report or record indicated or mentioned episodes of decompensation. (R. 17).
Based on the mental impairment analysis above, the ALJ determined that the claimant did
not meet the ‘paragraph B’ criteria of Listing 12.06; further, the ALJ determined that the
claimant’s mental impairment did not meet ‘paragraph C.’ To support her decision regarding
paragraph C, the ALJ stated that, to meet paragraph C, the claimant’s mental impairments must
have resulted in a complete inability to function independently outside of her home. Given the
claimant’s testimony regarding attending church and her children’s sporting events, the ALJ
determined that the claimant could function independently outside her home. (R. 18).
The ALJ next found that the claimant had the following residual functioning capacity:
The claimant can perform simple tasks without significant restrictions. The claimant
requires a flexible schedule and a spaced work setting with all allowable rest breaks. The
claimant’s contact with the public should be casual and limited, and supervision should
be tactful and supportive. The claimant has the ability to adapt to changes in the work
place that are routine or introduced gradually.
(R. 18).
In support of her RFC, the ALJ found the claimant’s allegations of severe functional

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limitations due to bipolar disorder and panic disorder inconsistent with the record. The ALJ
pointed to the fact that the claimant’s symptoms had been stable since September 2009 and that,
as of her last mental health treatment in January 2010, the record reflected that the claimant was
not experiencing any symptoms of depression. Additionally supporting her RFC, the ALJ
discredited the claimant’s allegations of migraine headaches and IBS. For both maladies, the ALJ
stated that while the medical evidence confirmed that the claimant was diagnosed with the
impairment, the record contained no evidence to support the frequency and severity of episodes
of which the claimant complained. More specifically, the ALJ found the claimant’s lack of
medication for both her migraines and IBS inconsistent with the claimant’s alleged frequency and
severity of illness. (R. 19-21).
Continuing to support her RFC, the ALJ discussed the claimant’s obesity. Though the
ALJ found that no physician had labeled the claimant’s obesity disabling, the ALJ considered
whether it could affect the claimant’s ability to work and perform activities of daily living
anyway. The ALJ found that the record did not reflect that the claimant’s obesity prevented her
from ambulation or reaching, nor did her obesity prevent her from working or being able to
complete a fairly full range of activities of daily living. Based on this finding, the ALJ
determined that the claimant’s obesity could not, either by itself, or in conjunction with the
claimant’s other impairments, be considered disabling. (R. 19-21).
In consideration of the claimant’s credibility and as support for her RFC, the ALJ
discussed the claimant’s daily activities. The ALJ stated that the claimant testified that she was
responsible for getting her three children to school. Also, the claimant prepares meals; does
household chores; and maintains an active life, functioning well with medications and treatment.

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The ALJ found that all of these activities undermined the credibility of the claimant’s testimony
regarding the severity of her impairments. (R. 19-21).
As the last portion of support for her RFC, the ALJ discussed the relevant opinions
contained in the record. The ALJ afforded Dr. Estock, a non-examining State Agency medical
consultant, considerable weight. The ALJ stated that Dr. Estock opined that the claimant could
perform simple tasks without significant restrictions; that she needed a flexible work schedule;
that she needed a well-spaced work setting; and that she needed all allowable rest breaks. Dr.
Estock also noted that the claimant’s ability to do detailed tasks could be limited at times by her
mood problems.
The ALJ also considered the opinion of Dr. John Neville, an examining consultant
psychologist. The ALJ afforded his opinion considerable weight. The ALJ stated that Dr. Neville
found that the claimant “was able to understand instructions, but that her ability to carry out
instructions was considered mildly to moderately impaired by her mood disorder. Dr. Neville
also opined that the claimant’s ability to respond to co-workers was good at times, but could
decline when her mood reached extreme states and her ability to cope with ordinary work
pressures would vary with the cycles of her illness.”
Lastly, to support her RFC, the ALJ considered the third-party function report completed
by the claimant’s mother in May 2009. The ALJ found that the report supported the claimant’s
testimony that she had significant problems with her anxiety and bipolar disorder in May 2009.
However, the ALJ found that, as indicated above, in or around August or September 2009, the
claimant’s condition improved significantly. (R. 21).
The ALJ then found the following: the claimant cannot perform her past relevant work;

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the claimant was a younger individual on the alleged disability onset date; and the transferability
of the claimant’s job skills is immaterial because she is not disabled. The ALJ found that the
claimant could perform jobs that exist in significant number in the national economy, such as a
packer, packager, inspector, tester, assembler, and machine feeder. Ultimately, the ALJ found
that the claimant was not disabled as defined by the Social Security Act. (R. 22-23).
VI. DISCUSSION
The claimant makes a number of assertions that all revolve around whether the ALJ failed
to consider the cyclical nature of the claimant’s mental impairments. By cyclical nature, the
claimant appears to refer to the fact that her symptoms worsen with the change in seasons and
that she is prone to flare-ups of worsened depression. For the reasons stated below, this court
finds no reversible error in the ALJ’s opinion, and, thus, the ALJ’s decision is due to be
AFFIRMED.

I.

Whether the ALJ failed to consider the cyclical nature of the claimant’s
mental impairments.

The claimant asserts that the ALJ failed to properly consider the cyclical nature of her
mental impairment. To the contrary, the ALJ cited the cyclical nature of her mental impairment
directly in the claimant’s RFC. The ALJ stated that “[i]n assessing the claimant’s residual
functional capacity, . . . I have also considered the consultative examination performed by
licensed psychologist, John Neville, Ph.D, and afford his opinions considerable weight. . . Dr.
Neville . . . opined that the claimant’s ability to . . . cope with ordinary work pressures would
vary with the cycles of her illness.”
Tellingly, the claimant does not clarify what impact giving greater weight to the cyclical

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nature of the claimant’s impairments would have. Also, the claimant does not cite any case law
to support her assertions. This lack of citation may stem from the fact that the Eleventh Circuit
has clearly stated that opinions focusing on one aspect of evidence while ignoring other contrary
evidence lack the support of substantial evidence. See Hillsman v. Bowen, 804 F.2d 1179, 1180
(11th Cir. 1986). Here, the ALJ properly considered and balanced the medical evidence both
supporting and contradicting the cyclical nature of the claimant’s mental impairments.
The ALJ’s RFC stated that the claimant required “a flexible work schedule and spaced
work setting with all allowable rest breaks,” indicating that the claimant would need both space
and time to deal with unforeseen episodes of her mental illness. Additionally, the ALJ considered
contrary evidence to the cyclical nature of the claimant’s impairments by citing to the claimant’s
own testimony that in or around August or September 2009 (after Dr. Neville’s evaluation) the
claimant’s condition improved significantly. In terms of balancing these two pieces of slightly
contrary evidence, the ALJ had to make a determination of which set of facts to adopt. Such
“credibility determinations are the province of the ALJ.” See Moore v. Barnhart, 405 F.3d
1208, 1212 (11th Cir. 2005). The ALJ cited to the record in support of her credibility
determinations, pointing to the opinion of Dr. Neville and the testimony of the claimant herself.
Therefore, this court finds no reversible error in the ALJ’s credibility determinations.
In short, the Eleventh Circuit has charged both this court and the ALJ to look to the
entirety of the record to make their respective determinations. However, based on the claimant’s
arguments, she would have this court and the ALJ improperly focus on one aspect of the record.
Further, this court may not re-weigh the evidence or substitute its own judgment for that of the
Commissioner, but rather, must give deference to the Commissioner’s decision if substantial

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evidence supports it. See Dyer v. Barhart, 395 F.3d 1206, 1212 (11th Cir. 2005). Given the ALJ
looked to the entirety of the record and cited specific reasons for her decisions supported by
substantial evidence, this court finds that the ALJ committed no reversible error in her
consideration and treatment of the cyclical nature of the claimant’s mental impairments.
Some of the claimant’s assertions could be construed to allege that the ALJ improperly
discredited the claimant’s testimony. In evaluating pain and other subjective complaints, the
Commissioner must consider whether the claimant demonstrated an underlying medical
condition, and either “(1) objective medical evidence that confirms the severity of the alleged
pain arising from that condition or (2) that the objectively determined medical condition is of
such a severity that it can reasonably be expected to give rise to the alleged pain.” Holt v.
Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991) (emphasis added); see also Wilson v. Barnhart,
284 F.3d 1219, 1225-56 (11th Cir. 2002); 20 C.F.R. § 404.1529. To the contrary, this court finds
that the ALJ properly applied the three-part pain standard and articulated specific reasons
supported by substantial evidence to support her decision.
In support of her assessment of the claimant’s credibility regarding her mental
impairment testimony, the ALJ looked to the medical evidence, the testimony of the claimant,
and the activities of the claimant. The ALJ specifically cited the 2010 Eastside Mental Health
Center records to show that the claimant was not experiencing any symptoms of depression at the
time of her visit. The ALJ also cited the claimant’s testimony that she “is responsible for getting
her three children off to school. She also prepares meals, and tends to the household chores.” The
ALJ also pointed to Eastside Mental Health Center records again to show that the claimant
maintains an active life and “functions well with medication and treatment.” The ALJ found that

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these facts undermined the claimant’s testimony regarding the severity of her symptoms. This
court finds that the ALJ cited specific reasons supported by substantial evidence to discredit the
claimant’s testimony regarding her mental illness, and, thus, finds no reversible error.
In support of her assessment of the claimant’s credibility regarding her physical
impairment testimony, the ALJ again looked to the testimony of the claimant. While the ALJ
acknowledged that the medical record indicated that the claimant was diagnosed with migraines
and IBS, the ALJ noted that the claimant did not testify to having any prescriptions for her IBS or
migraines. In fact, the claimant did not have any medication—prescribed or over the
counter—for her IBS or migraines. The ALJ found the claimant’s lack of medication inconsistent
with the claimant’s alleged frequency and severity of impairments. Given that the ALJ cited
specific reasons supported by substantial evidence in discrediting the claimant’s testimony
regarding the severity of her physical impairments, this court finds no reversible error.
In sum, upon review of the totality of the record, this court finds that the ALJ properly
applied legal standards and supported her factual conclusions with substantial evidence.
VII. CONCLUSION
For the reasons as stated, this court concludes that the decision of the Commissioner is
supported by substantial evidence and is to be AFFIRMED.
The court will enter a separate order in accordance with this Memorandum Opinion.
Dated this 20th day of September, 2012.

____________________________________
KARON OWEN BOWDRE
UNITED STATES DISTRICT JUDGE

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