Ingram v. Social Security Administration, Commissioner

Filing 13

MEMORANDUM OPINION. Signed by Judge L Scott Coogler on 10/9/2014. (KAM, )

FILED
2014 Oct-09 PM 02:47
U.S. DISTRICT COURT
N.D. OF ALABAMA

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
TRACI INGRAM,
Plaintiff,
vs.
CAROLYN W. COLVIN,
Commissioner of Social Security,
Defendant.

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2:13-cv-01444-LSC

MEMORANDUM OF OPINION
I.

Introduction
The plaintiff, Traci Ingram, appeals from the decision of the Commissioner of

the Social Security Administration (“Commissioner”) denying her application for
Disability Insurance Benefits (“DIB”). Ms. Ingram timely pursued and exhausted her
administrative remedies and the decision of the Commissioner is ripe for review
pursuant to 42 U.S.C. §§ 405(g), 1383(c)(3).
Ms. Ingram was forty-four years old at the time of the Administrative Law
Judge’s (“ALJ’s”) decision, and she has a twelfth grade education. (Tr. at 58, 46-47.)
Her past work experience includes employment as a manager at a fast food restaurant.
(Tr. at 19, 59.) Ms. Ingram claims that she became disabled on November 1, 2008, due
to pain and limitations from peripheral neuropathy and lymphedema caused by her

radical hysterectomy and treatment she received for cervical cancer. (Tr. at 67, Doc.
11 at 6.)
When evaluating the disability of individuals over the age of eighteen, the
regulations prescribe a five-step sequential evaluation process. See 20 C.F.R. §§
404.1520, 416.920; see also Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). The
first step requires a determination of whether the claimant is “doing substantial
gainful activity.” 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If he or she is, the
claimant is not disabled and the evaluation stops. Id. If he or she is not, the
Commissioner next considers the effect of all of the physical and mental impairments
combined. 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). These impairments
must be severe and must meet the durational requirements before a claimant will be
found to be disabled. Id. The decision depends on the medical evidence in the record.
See Hart v. Finch, 440 F.2d 1340, 1341 (5th Cir. 1971). If the claimant’s impairments
are not severe, the analysis stops. 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii).
Otherwise, the analysis continues to step three, which is a determination of whether
the claimant’s impairments meet or equal the severity of an impairment listed in 20
C.F.R. pt. 404, Subpart P, Appendix 1. 20 C.F.R. §§ 404.1520(a)(4)(iii),
416.920(a)(4)(iii). If the claimant’s impairments fall within this category, he or she

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will be found disabled without further consideration. Id. If they do not, a
determination of the claimant’s residual functional capacity (“RFC”) will be made
and the analysis proceeds to the fourth step. 20 C.F.R. §§ 404.1520(e), 416.920(e).
The fourth step requires a determination of whether the claimant’s impairments
prevent him or her from returning to past relevant work. 20 C.F.R. §§
404.1520(a)(4)(iv), 416.920(a)(4)(iv). If the claimant can still do his or her past
relevant work, the claimant is not disabled and the evaluation stops. Id. If the claimant
cannot do past relevant work, then the analysis proceeds to the fifth step. Id. Step five
requires the court to consider the claimant’s RFC, as well as the claimant’s age,
education, and past work experience in order to determine if he or she can do other
work. 20 C.F.R. §§ 404.1520(a)(4)(v) 416.920(a)(4)(v). If the claimant can do other
work, the claimant is not disabled. Id.
Applying the sequential evaluation process, the ALJ found that Ms. Ingram
meets the insured status for disability benefits through March 31, 2009, her date last
insured. (Tr. at 17.) He further determined that Ms. Ingram has not engaged in
substantial gainful activity since the alleged onset of her disability. (Id.) According to
the ALJ, Plaintiff’s impairment of “status post left foot fracture” is considered
“severe” based on the requirements set forth in the regulations. (Id.) The ALJ found

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that this impairment neither meets nor medically equals any of the listed impairments
in Appendix 1, Subpart P, Regulations No. 4. (Id.) The ALJ did not find Ms. Ingram’s
pain allegations to be totally credible, and determined that she has the following RFC:
“to perform sedentary work as defined in 20 C.F.R. 404.1567(a) except claimant
graduated high school, can sit for six hours out of an eight hour day, can stand up to
two hours in an eight hour day and can basically perform sedentary work. Further,
claimant also requires a sit-stand option.” (Tr. at 18.)
Based on this RFC, the ALJ found that Ms. Ingram is unable to perform her
past relevant work as a fast food manager, she is an “individual of younger age,” and
she has “at least a high school education,” as those terms are defined by the
regulations. (Tr. at 19.) He determined that transferability of skills was not an issue in
this case because “using the Medical-Vocational Rules as a framework supports a
finding that the claimant is ‘not disabled,’ whether or not the claimant has transferable
job skills.” (Id.) Even though Plaintiff cannot perform the full range of sedentary
work, the ALJ relied on the Vocational Expert (“VE”) in finding that there are a
significant number of jobs in the national economy that the plaintiff is capable of
performing, such as surveillance system monitor, eye glass frames polisher, and toy
stuffer. (Tr. at 19-20.) The ALJ thus concluded his findings by stating that Plaintiff

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was not disabled within the meaning of the Social Security Act at any time from her
alleged onset date of disability through the date last insured. (Tr. at 20.)
II.

Standard of Review
This Court’s role in reviewing claims brought under the Social Security Act is

a narrow one. The scope of its review is limited to determining (1) whether there is
substantial evidence in the record as a whole to support the findings of the
Commissioner, and (2) whether the correct legal standards were applied. See
Richardson v. Perales, 402 U.S. 389, 390, 401 (1971); Wilson v. Barnhart, 284 F.3d
1219, 1221 (11th Cir. 2002). The Court approaches the factual findings of the
Commissioner with deference, but applies close scrutiny to the legal conclusions. See
Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996). The Court may not decide facts,
weigh evidence, or substitute its judgment for that of the Commissioner. Id. “The
substantial evidence standard permits administrative decision makers to act with
considerable latitude, and ‘the possibility of drawing two inconsistent conclusions
from the evidence does not prevent an administrative agency’s finding from being
supported by substantial evidence.’” Parker v. Bowen, 793 F.2d 1177, 1181 (11th Cir.
1986) (Gibson, J., dissenting) (quoting Consolo v. Fed. Mar. Comm’n, 383 U.S. 607,
620 (1966)). Indeed, even if this Court finds that the evidence preponderates against

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the Commissioner’s decision, the Court must affirm if the decision is supported by
substantial evidence. Miles, 84 F.3d at 1400. No decision is automatic, however, for
“despite this deferential standard [for review of claims] it is imperative that the Court
scrutinize the record in its entirety to determine the reasonableness of the decision
reached.” Bridges v. Bowen, 815 F.2d 622, 624 (11th Cir. 1987). Moreover, failure to
apply the correct legal standards is grounds for reversal. See Bowen v. Heckler, 748
F.2d 629, 635 (11th Cir. 1984).
III.

Discussion
Plaintiff contends that the ALJ’s decision should be reversed and remanded

because the ALJ failed to properly evaluate the credibility of her testimony of disabling
symptoms in accordance with the Eleventh Circuit’s “pain standard.” (Doc. 11 at 5.)
Specifically, Ms. Ingram alleges that the ALJ failed to give credit to the Plaintiff’s
testimony of disabling pain and limitations resulting from peripheral neuropathy and
lymphedema. (Doc. 11 at 6.)
Disability benefits may not be paid solely on the basis of a claimant’s own
self-serving complaints. See 42 U.S.C § 423(d)(5)(A). However, subjective testimony
of pain and other symptoms may establish the presence of a disabling impairment if
it is supported by medical evidence. See Foote v. Chater, 67 F.3d 1553, 1561 (11th

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Cir.1995). To establish disability based upon pain and other subjective symptoms, the
Eleventh Circuit has set forth a two-part standard: “The pain standard requires (1)
evidence of an underlying medical condition and either (2) objective medical evidence
that confirms the severity of the alleged pain arising from that condition or (3) that the
objectively determined medical condition is of such a severity that it can be reasonably
expected to give rise to the alleged pain.” Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th
Cir.2005) (citing Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir.1991)).
Once the plaintiff has met the pain standard, the ALJ then considers the
plaintiff’s subjective testimony of his symptoms. Foote, 67 F.3d at 1560; see also 20
C.F.R. § 404.1529 (2013). The ALJ may discredit Plaintiff’s subjective testimony, but
he must provide sufficient reasons for this decision. Wilson, 284 F.3d at 1225; see also
Soc. Sec. Rul. 96-7p, 1996 WL 374186 (1996) (“[T]he adjudicator must carefully
consider the individual’s statements about symptoms with the rest of the relevant
evidence in the case record in reaching a conclusion about the credibility of the
individual’s statements.”). There is no precise formula that the ALJ must follow
when explaining why he has discredited a plaintiff’s testimony, however “the
implication must be obvious to the reviewing court.” Tieniber v. Heckler, 720 F.2d
1251, 1255 (11th Cir. 1983). In determining credibility, the ALJ may consider evidence

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such as a plaintiff’s medical history, medical treatment plan, and reported daily
activities. 20 C.F.R. § 404.1529(c)(3) (2013).
Here, the ALJ found that Plaintiff’s medically determinable impairments, which
included her status post cervical cancer, could reasonably be expected to cause the
symptoms she was alleging, including peripheral neuropathy. (Tr. at 18-19.) However,
as noted, meeting the pain standard does not automatically end the ALJ’s analysis if
the ALJ rejects the plaintiff’s complaints for lack of credibility. See Foote, 67 F.3d at
1560-61 (meeting the judicial pain standard is only a threshold inquiry and the ALJ
may reject the complaints by offering specific reasons); Marbury v. Sullivan, 957 F.2d
837, 839 (11th Cir.1992) (“After considering a claimant’s complaints of pain [under
the above standard], the ALJ may reject them as not credible, and that determination
will be reviewed for substantial evidence.”) (citing Wilson v. Heckler, 734 F.2d 513, 517
(11th Cir.1984)). The ALJ correctly continued the analysis of whether Plaintiff’s
complaints of pain and swelling were credible by taking her subjective testimony into
account. (Tr. at 19.) During this analysis, the ALJ found “the claimant simply alleges
a greater degree of debilitation than what the other evidence can support.” (Id.)
Plaintiff complains that “[the ALJ’s] decision gives little guidance as to the
reasons why he actually found the Plaintiff did not meet the standard.” (Doc. 11 at 6.)

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However, the Court finds that the ALJ provided sufficient reasons for discrediting
Plaintiff’s testimony, such as pointing out that Plaintiff’s subjective allegations of pain
were inconsistent with her medical records and her reported daily activities. (Tr. at
18-19.)
As an initial matter, the Court notes that Plaintiff’s case involves an issue of
insured status. To be eligible for DIB, a claimant must prove she became disabled
prior to the expiration of her disability insured status. See 42 U.S.C. §§ 416(i)(3),
423(a), (c); 20 C.F.R. §§ 404.101, 404.130, 404.131; Moore v. Barnhart, 405 F.3d
1208, 1211 (11th Cir. 2005). Plaintiff’s disability insured status expired on March 31,
2009, which was her date last insured. (Tr. 17). Plaintiff, therefore, had to prove she
was disabled during the five-month period from November 1, 2008, her alleged onset,
until on or before March 31, 2009, to be eligible for DIB. The record includes
numerous medical records from after Plaintiff’s date last insured, which Plaintiff
argues supports her allegations of disabling symptoms, but these records do not
support her allegations of disabling limitations on or before the date last insured. See
Demandre v. Califano, 591 F.2d 1088, 1090 (5th Cir. 1979) (any indication that
claimant’s condition may have worsened after her date last insured is irrelevant to the

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issue of disability).1
Even if these records were relevant to Plaintiff’s condition prior to the date last
insured, they still do not support her allegations of disabling symptoms. The ALJ first
called attention to a letter to Plaintiff’s insurance company dated January 29, 2009,
from Dr. Mack Barnes, Plaintiff’s gynecologist, in which Dr. Barnes indicated “the
swelling in Plaintiff’s lower bilateral extremities was minimal.” (Tr. at 227.) He
prescribed the Flexitouch system for truncal/genital swelling. (Tr. at 227.) The
insurance company denied the claim for the Flexitouch system because the
photographs of Plaintiff’s swelling did not demonstrate severe lymphedema. (Tr. at
229.) Dr. Barnes’s letter of May 11, 2009, stated the plaintiff not only tolerated the
Flexitouch system treatment well, but it was effective and reduced her symptoms. See
Stout v. Shalala, 988 F.2d 853, 855 (8th Cir.1993) (“If an impairment can be
controlled by treatment or medication, it cannot be considered disabling.”); Gross v.
Heckler, 785 F.2d 1163, 1166 (4th Cir.1986) (noting that a symptom reasonably
controlled by medication or treatment is not disabling). The ALJ also noted that
during a followup visit with Dr. Barnes on November 2, 2011, one month before the

1

In Bonner v. City of Pritchard, 661 F.3d 1206, 1207 (11th Cir. 1981), the Eleventh Circuit
adopted as binding precedent all decisions of the former Fifth Circuit handed down prior to
October 1, 1981.
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ALJ’s decision was issued, Plaintiff’s physical exam was generally normal; she had no
leg swelling; the neurological exam and musculoskeletal exams were normal; bladder
was normal; and no genital swelling was noted. (Tr. at 636-37.)
The plaintiff alleged that the ALJ failed to properly consider her longitudinal
medical history. (Doc. 11 at 14.) However, Plaintiff only cited one medical record, the
initial letter from Dr. Barnes to her insurance company, that is dated before March 31,
2009, the date last insured, that corroborates her subjective complaint of pain caused
by lymphedema. (Tr. at 227.) The remainder of the medical records Plaintiff cited
were dated after the date last insured. For example, Plaintiff cites treatment notes
from August 20, 2009, after the date last insured. These notes document Plaintiff’s
complaints of numbness, tingling, and weak limbs for the year prior to the treatment
date; but she also indicated that her condition had become progressively worse. See
Demandre, 591 F.2d at 1090 (any indication that claimant’s condition may have
worsened after her date last insured is irrelevant to the issue of disability). Moreover,
the notes indicated that Plaintiff had not previously sought treatment for these
symptoms and did not include any objective clinical findings supporting her
complaints. (Tr. at 262). Plaintiff did not identify any further treatment for
numbness, tingling, or weak limbs, until over a year later, on September 23, 2010. (Tr.

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at 653, 655). On that occasion, Plaintiff stated to Dr. Gwen Claussen, her neurologist,
that her symptoms had only begun in the summer of 2009, which was after the date
last insured. (Tr. at 653). She reported tingling in her fingertips that would come and
go, and denied any weakness in her hands or arms. (Tr. at 653). There was only mild
edema in the lower extremities, and no clubbing on cynosis. (Tr. at 655). The ALJ
also acknowledged that the plaintiff underwent a nerve conduction study on October
7, 2010, which showed polyneuropathy of the bilateral lower extremities. (Tr. at 649.)
However, this study was completed a year and a half after the plaintiff’s date last
insured and not does reflect her condition before her date last insured.
The ALJ’s credibility determination is further supported by the testimony of
the medical expert, Dr. Winkler, a board certified neurologist. Contrary to Plaintiff’s
testimony that she must elevate each leg for one hour after her daily Flextouch system
session and then for at least two hours during the day (tr. at 42), Dr. Winkler testified
at Plaintiff’s December 8, 2011 hearing that nowhere in Plaintiff’s medical records did
he see any instructions from a doctor directing her to elevate her legs. (Tr. at 43.) He
also testified that doing so would not be related to pain and neuropathy, but for edema,
that is, swelling of the legs. (Id.) Dr. Winkler also testified that although the October
2010 nerve conduction study demonstrated the presence of neuropathy, it was not

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useful in assessing Plaintiff’s functional limitations, e.g., her ability to walk. (Tr. at
35.) He also stated that Plaintiff’s neuropathy was not of listing-level severity. (Tr.
at 17-18, 34.) He further noted that the most recent medical records (from Dr. Barnes
in November 2011) indicated that there was no swelling. (Tr. at 43, 634.)
The ALJ also noted that Ms. Ingram’s “daily activities also suggest that
although claimant is limited, she is not disabled as a result of her impairments.” (Tr.
at 18.) Although not dispositive, a plaintiff’s activities may show that her condition is
not as limiting as she alleged. See 20 C.F.R. § 404.152(c)(3)(I); SSR 96-7p, 1996 WL
374186; Dyer, 395 F.3d at 1212; Macia v. Bowen, 829 F.2d 1009, 1012 (11th Cir.1987).
Courts have upheld an ALJ’s adverse credibility determination when it was based in
part on the claimant’s stated ability to take care of her personal needs, including
performing errands. See, e.g., Parks v. Comm’r, 353 F. App’x 194, 197 (11th Cir.2009)
(unpublished). The ALJ pointed out that while Plaintiff states she is unable to work,
she has continued to report a fairly high level of functioning. (Tr. at 180-85.) The
plaintiff testified that she is able to take care of her personal needs with little help,
including preparing simple meals daily. (Tr. at 181-82.) She also explained that she can
perform limited household chores such as light cleaning and laundry (tr. at 182), she
occasionally goes shopping for her children (tr. at 183), and states she can still

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exercise. (tr. at 184.) The ALJ also pointed out that Ms. Ingram spends time with
others (tr. at 184) and can pay bills, count change, and handle a savings account. (Tr.
at 183.) Plaintiff’s ability to perform these daily tasks provides additional support to
the ALJ’s discrediting of her testimony of disabling pain.
In sum, the ALJ specifically addressed Plaintiff’s allegations of pain and
provided explicit reasons for rejecting her testimony as not entirely credible. (Tr. at
17-19.) See Allen v. Sullivan, 880 F.2d 1200, 1203 (11th Cir.1989) (ALJ properly
discredited the plaintiff’s testimony where he specifically articulated at least three
reasons for rejecting the plaintiff’s subjective complaints). Indeed, the ALJ even
considered evidence after the plaintiff’s DLI, including the most recent treatment
notes from April and November 2011, which undermined Plaintiff’s complaints of
disabling limitations. (Tr. at 18, 634, 636-37.) The objective medical evidence and the
testimony of the plaintiff support the ALJ’s conclusion that Plaintiff’s impairments
are not of such intensity or persistence that they prevent her from performing
sedentary work with a sit-stand option. (Tr. at 18-20.)
IV.

Conclusion
Upon review of the administrative record, and considering all of Ms. Ingram’s

arguments, the Court finds the Commissioner’s decision is supported by substantial

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evidence and in accord with the applicable law. A separate order will be entered.
Done this 9th day of October 2014.

L. Scott Coogler
United States District Judge
[160704]

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