White v. Social Security Administration, Commissioner

Filing 19

MEMORANDUM OPINION. Signed by Judge R David Proctor on 7/12/2018. (KAM)

FILED
2018 Jul-12 AM 09:05
U.S. DISTRICT COURT
N.D. OF ALABAMA

UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
BONNIE E. WHITE,
Plaintiff,
v.
NANCY A. BERRYHILL, Acting
Commissioner of Social Security,
Defendant.

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Case No.: 2:17-cv-00528-RDP

MEMORANDUM DECISION
Plaintiff Bonnie E. White (“Plaintiff” or “White”) brings this action pursuant to Section
205(g) of the Social Security Act (the “Act”), seeking review of the decision of the Commissioner
of Social Security (the “Commissioner”) denying her claims for supplemental security income
(“SSI”). See 42 U.S.C. § 405(g). Based on the court’s review of the record and the briefs submitted
by the parties, the court finds that the decision of the Commissioner is due to be affirmed.
I.

Proceedings Below
On February 10, 2014, Plaintiff protectively filed an application for SSI, alleging a

disability onset date of January 5, 2011. (Tr. 42, 88-89, 162-64, 176). She later amended her
alleged disability onset date to the date she filed her application, February 10, 2014. (Tr. 59-60,
88). Plaintiff’s initial application was denied by the Social Security Administration (“SSA”) on
May 30, 2014.

(Tr. 88-101).

After the denial, Plaintiff requested a hearing before an

Administrative Law Judge (the “ALJ”). (Tr. 57-82, 110-12). That hearing was held in front of
ALJ Perry Martin on February 10, 2016. (Tr. 57-82, 126-130, 149). In his decision dated April
20, 2016, the ALJ concluded that Plaintiff has not been under a disability, as defined by the Act,

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since February 10, 2014. (Tr. 52). The Appeals Council denied Plaintiff’s request for review on
February 3, 2017. (Tr. 1-7). That denial was the final decision of the Commissioner, and is
therefore a proper subject for this court’s appellate review.
II.

Facts
Plaintiff was born on December 17, 1958 and was 55 years old on the date of her alleged

disability onset. (Tr. 39, 64, 89, 163, 176). She alleges disability due to migraines, bulging discs,
a pinched nerve, and irritable bowel syndrome (“IBS”). (Tr. 179). Plaintiff has a GED and last
worked for Spring Air Cleaners sorting and delivering clothes. (Tr. 65). She was let go from that
job in September 2007 and has not worked since. (Tr. 66, 179).
Plaintiff’s physician, Dr. Larry Alford with Norwood Clinic, began treating her for
headaches on January 18, 2010. (Tr. 282). Plaintiff complained of headaches with photophobia,
but denied nausea, vomiting, and phonophobia.

(Id.).

She described the headaches as

“bitemporal” and “throbbing” and indicated they were brought on by stress. (Id.). She reported
that her last headache had occurred the day before her meeting with Dr. Alford. (Id.). Plaintiff
was instructed to follow up with neurology. (Tr. 283).
Almost a year later, on November 3, 2010, Plaintiff returned to the Norwood Clinic,
complaining of headaches with nausea, photophobia, and phonophobia but no vomiting. (Tr. 279).
She again described the headaches as “bitemporal” and “throbbing,” with her last headache
occurring the day of her meeting with the doctor. (Id.). Dr. Grinder noted a long history of
migraines and that various medications had provided no relief. (Id.). Dr. Grinder prescribed “IM
or SQ injection,” Toradol, and an increased dose of Phenergan. (Tr. 280).
Plaintiff returned to the doctor in January 2011 complaining of diarrhea. (Tr. 276). She
denied nausea and vomiting, but reported that her symptoms had been present for months, with

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the pain worse with meals. (Id.). Plaintiff was diagnosed with IBS and anxiety disorder. (Tr.
278).
In March 2011 Plaintiff complained of abdominal pain at a visit with Dr. Alford. (Tr. 271).
Dr. Alford noted that the “[p]ain is worse with meals and movement. Pain appears better with rest.
Past history for abdominal pain shows history of IBS. Ineffective treatments include the following
antacids. Prior diagnostic testing to date for abdominal pain includes colonoscopy.” (Id.).
Plaintiff was diagnosed with a recurrent UTI. (Tr. 273).
In January 2012, Plaintiff was seen by Dr. Alford for a six-month checkup. (Tr. 263). She
complained of bitemporal headaches without nausea or vomiting. (Id.). Plaintiff also complained
of right neck and shoulder pain she described as “dull.” (Id.). Dr. Alford made no specific
diagnosis but discussed exercises and use of hot and cold therapy and medication to treat the pain.
(Tr. 265). He noted decreased range of motion in the neck and the cervical spine. (Tr. 264-65).
He once again referred Plaintiff to neurology for evaluation of the headaches. (Tr. 266).
In May 2012, Plaintiff again complained of bitemporal headaches to Dr. Alford, this time
with nausea, but denied vomiting, photophobia, and phonophobia. (Tr. 260). Plaintiff reported
her last headache had occurred a few days prior and described the pain as throbbing and sharp.
(Id.). On physical exam, Dr. Alford noted decreased range of motion in her neck and the cervical
spine. (Tr. 261). Plaintiff was told to follow up with neurology. (Tr. 262). In November 2012,
Plaintiff saw Dr. Alford again for six-month checkup and complained of bitemporal headaches
with throbbing pain yet without nausea or vomiting. (Tr. 256). She reported her last headache
had occurred the day before, but Dr. Alford noted that Botox therapy at the neurologist was
working. (Tr. 256, 259). On physical exam, Dr. Alford noted decreased range of motion of the
cervical spine. (Tr. 258).

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On March 31, 2013, Plaintiff completed a Headache Questionnaire for the disability office
and stated severe headaches occur “every day two-three times a day” lasting “about 2-3 hours”
and precipitated by stress. (Tr. 187-88).
In May 2013, Plaintiff saw Dr. Alford again complaining of dull, sharp headaches without
nausea or vomiting. (Tr. 251). She reported her last headache occurred that day. (Id.). Dr. Alford
noted that effective treatment for the headaches included Maxalt and Botox injections, and that
Plaintiff was being followed by Dr. Newton, a neurologist. (Id.). During the same visit, Plaintiff
complained of lower back pain, “radiating to right buttock, radiating to right knee, and radiating
to right foot … The pain is described as sharp and constant.” (Id.). She claimed to have had
constant pain for the previous two years that had gotten progressively worse, with pain currently
at an 8/10. (Id.). Upon physical exam, Dr. Alford noted decreased range of motion in the neck
and referred Plaintiff to physical therapy. (Tr. 253-54).
On January 27, 2014, Plaintiff saw Dr. Newton who noted that Plaintiff “failed to follow
up as scheduled” after Botox treatment was given for migraines. (Tr. 294). Plaintiff told Dr.
Newton that she did not want to stay on the Botox injections and that her current medication for
headaches was Maxalt as needed. (Id.). “She says [the Maxalt] works good, but still has about six
headaches per month.” (Id.). Dr. Newton prescribed Topamax in addition to Maxalt to treat the
migraines. (Id.). Dr. Newton wanted to see Plaintiff back in one month to find an effective dose
of Topamax. (Id.).
In February 2014, Plaintiff saw Dr. Smith at Adamsville Family Medicine to establish care
as a new patient and for recheck of chronic conditions. (Tr. 297). She reported suffering from
migraines, anxiety and depression, back and chest pain, and irritable bowel. (Id.). Dr. Smith

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described her current conditions as generally stable except for the back and chest pain. (Id.). Upon
examination of Plaintiff’s joints and neck, Dr. Smith noted no abnormalities. (Tr. 298).
Sometime after February 2014, Plaintiff completed a disability report appeal form and
stated that since her last report on February 26, 2014, “all of my conditions are worse.” (Tr. 219).
She noted that she has “trouble walking due to back pain. I have to alternate sitting and standing.
I get migraines everyday.” (Id.). She also noted that “I do not socialize often. I get migraines
almost everyday and I have to stay in the bedroom in the dark, I take several naps during the day.”
(Tr. 221). Plaintiff referenced medical records from Dr. West Newton at St. Vincent’s. (Tr. 22021).
Plaintiff saw Dr. Parish with the Disability Office on April 28, 2014 and reported lower
back pain radiating to her leg and foot. (Tr. 322). Dr. Parish found that Plaintiff could walk half
a mile and climb half a flight of stairs. (Id.). Plaintiff reported being able to take care of her
personal needs, cook, wash dishes, lift pots and pans, vacuum, sweep, mop, do yard work, use a
push mower, and buy groceries. (Tr. 323). Dr. Parish found this physical activity was average,
that Plaintiff could walk without assistance, lift, carry, handle objects, and sit comfortably. (Id.).
Plaintiff’s neck examination was unremarkable and her gait and station were described as normal.
(Tr. 324). Plaintiff’s cervical spine examination was normal but her dorsolumbar spine had some
diminished flexion and extension. (Tr. 326-27). No scoliosis was found in Plaintiff’s back, but
there was some midline tenderness in the L-spine and S-spine. (Tr. 328). Dr. Parish diagnosed
Plaintiff with chronic lower back pain including probable degenerative joint disease, history of
bulging disc, right sacroiliac dysfunction, and bilateral paravertebral lumbar fibromyalgia. (Id.).
On May 28, 2014, an image of Plaintiff’s lumbar spine revealed “mild scoliosis.” (Tr. 330).

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Plaintiff was thereafter referred to neurologist Dr. Jane Pearson. (Tr. 331). During her
visit with Dr. Pearson on March 17, 2015, Plaintiff reported having “a headache all the time for
the past 10 or 12 years” and having had depression “for 10 or 12 years.” (Id.). She reported that
the Maxalt helped her headaches, but that she had not been on any antidepressants. (Id.). Dr.
Pearson took Plaintiff off Topamax and prescribed Amitriptyline. (Tr. 332). Four days later,
Plaintiff called Dr. Pearson’s office to report that the medicine was working great. (Id.). Seven
days after that, Plaintiff called the office to say that headaches were worse, so the dosage of
Amitriptyline was increased. (Id.).
Plaintiff saw Dr. Alford again in June 2015, and reported having her last headache a week
before. (Tr. 333). She again denied nausea, vomiting, photophobia, and phonophobia. (Id.). She
described the headache as “pressure,” but Dr. Alford noted she was doing “much better on her
current regimen” with the Amitriptyline. (Id.). In January 2016, Plaintiff returned to Dr. Alford’s
office for a six-month checkup, and reported experiencing headaches without nausea or vomiting,
with the last headache occurring a week prior to the appointment. (Tr. 345). The headache pain
was described as “sharp” and precipitated by stress. (Id.). Dr. Alford noted that Plaintiff “is totally
debilitated from the headaches.” (Tr. 348).
III.

ALJ Decision
Disability under the Act is determined using a five-step test. 20 C.F.R. § 404.1520. First,

the ALJ must determine whether the claimant is engaging in substantial gainful activity. 20 C.F.R.
§ 404.1520(a)(4)(i). “Substantial gainful activity” is work activity that involves doing significant
physical or mental activities for pay or profit. 20 C.F.R. § 404.1572. Work activity may be
considered substantial even if it is part-time or if the claimant does less, gets paid less, or has less
responsibility than when she worked before. 20 C.F.R. § 404.1572(a). Even if no profit is realized,

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work activity may still be considered gainful so long as it is the kind of work usually done for pay
or profit. 20 C.F.R. § 404.1572(b). If the ALJ finds that the claimant is engaging in substantial
gainful activity, then the claimant cannot claim disability. 20 C.F.R. § 404.1520(b).
Second, the ALJ must determine whether the claimant has a severe medical impairment or
a combination of impairments that is severe. 20 C.F.R. § 404.1520(a)(4)(ii). If the claimant does
not have a severe impairment or combination of impairments, then she may not claim disability.
Id. If the impairment is not expected to result in death, the claimant must also meet the 12-month
duration requirement. 20 C.F.R. § 404.1509.
Third, the ALJ must determine whether the claimant’s impairment meets or medically
equals the criteria of an impairment listed in 20 C.F.R. § 404, Subpart P, Appendix 1. See 20
C.F.R. §§ 404.1520(a)(4)(iii), 404.1525, and 404.1526. If the claimant meets or equals a listed
impairment and meets the duration requirement, she will be found disabled without considering
age, education, and work experience. 20 C.F.R. § 404.1520(d).
If the claimant does not meet the requirements for disability under the third step, she may
still be found disabled under steps four and five of the analysis. The ALJ must first determine the
claimant’s residual functional capacity (“RFC”), which refers to the claimant’s ability to work
notwithstanding her impairments. 20 C.F.R. § 404.1520(e). In the fourth step, the ALJ must
determine whether the claimant has the RFC to perform past relevant work. 20 C.F.R. §
404.1520(a)(4)(iv). If the claimant is capable of performing past relevant work, then the claimant
is deemed not disabled. Id. If the ALJ finds the claimant is unable to perform past relevant work,
then the analysis moves to the fifth and final step of the analysis.
In the fifth and final step of the analysis, the ALJ must determine whether the claimant is
able to perform any other work commensurate with her RFC, age, education, and work experience.

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20 C.F.R. § 404.1520(g). At this point, the burden of proof shifts from the claimant to the ALJ to
prove the existence, in significant numbers, of jobs in the national economy that the claimant can
do given her RFC, age, education, and work experience. 20 C.F.R. § 404.1520(g), 404.1560(c).
Here, the ALJ determined that Plaintiff has not been engaged in substantial gainful activity
since February 10, 2014, the alleged disability onset date. (Tr. 44). The ALJ found that Plaintiff
has the severe impairments of migraine headaches, depression, and irritable bowel syndrome.
(Id.). Bulging discs, a pinched nerve, neck pain, joint tenderness, hyperlipidemia, and GERD were
all found to be non-severe. (Tr. 44-46).
At step three of the analysis, the ALJ found that Plaintiff did not have an impairment or
combination of impairments that met or medically equaled the severity of one of the listed
impairments in CFR Part 404, Subpart P, Appendix 1. (Tr. 46). In his residual functional capacity
finding, the ALJ found that Plaintiff could perform a full range of work at all exertional levels
subject to certain non-exertional limitations. (Tr. 47-48). Based on her age, education, work
experience, and residual functional capacity, the ALJ found that there were jobs existing in the
national economy in significant numbers that Plaintiff could perform. (Tr. 51). Thus, Plaintiff
was found not disabled. (Tr. 52).
Plaintiff’s Argument for Remand or Reversal

IV.

In her Memorandum of Law, Plaintiff argues that the ALJ’s RFC determination is flawed
in its exertional and non-exertional findings. (Doc. #12 at 1, 8). The court disagrees. For the
reasons detailed herein, the court finds that substantial evidence exists to support the ALJ’s
findings.

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V.

Standard of Review
The only relevant question for this court to decide is whether the record contains substantial

evidence to support the ALJ’s decision, see 42 U.S.C.A. § 405; Walden v. Schweiker, 672 F.2d
835, 838 (11th Cir. 1982), and whether the correct legal standards were applied. See Lamb v.
Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Chester v. Bowen, 92 F.2d 129, 131 (11th Cir. 1990).
Under Title 42 U.S.C. § 405(g), the Commissioner of Social Security’s findings are conclusive so
long as they are supported by “substantial evidence.” The district court may not reconsider the
facts, reweigh the evidence, or substitute its judgment for that of the Commissioner. Martin v.
Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990). The reviewing court must review the record in its
entirety to determine whether the decision reached is reasonable and supported by the substantial
evidence. Id. (citing Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)). Substantial
evidence is more than a mere scintilla but less than a preponderance of the evidence. Id. It is
relevant evidence that a reasonable person would accept as adequate to support the conclusion
reached. Id. (citing Bloodsworth, 703 F.2d at 1239). Even if the evidence preponderates against
the Commissioner’s findings, the Commissioner’s factual findings must be affirmed if they are
supported by substantial evidence. Id. Despite the limited review of the ALJ’s findings, review
does not lead to an automatic affirmance. Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988).
VI.

Discussion
Plaintiff contends that the ALJ’s RFC is flawed in two ways. (Doc. #12 at 1, 8). First, she

contends the RFC contains no exertional limitations. (Id.). Second, she argues that the nonexertional limitations found do not properly account for her migraine headaches. (Id.).
The RFC is “an assessment of an individual’s ability to do sustained work-related physical
and mental activities in a work setting on a regular and continuing basis. A ‘regular and continuing

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basis’ means 8 hours a day, for 5 days a week, or an equivalent work schedule.” Social Security
Ruling (“SSR”) 96-8p. In determining a claimant’s RFC, the ALJ must base his findings on “all
of the relevant medical and other evidence,” including a claimant’s testimony regarding the
limitations imposed by her impairments. 20 C.F.R. § 416.945(a)(3). The RFC represents the most
an individual can do despite her limitations. Id. at 416.945(a). “In making the RFC determination,
the ALJ must consider all the record evidence, including evidence of non-severe impairments.”
Phillips v. Barnhart, 357 F.3d 1232, 1238 (11th Cir. 2004).
As part of the RFC analysis, a plaintiff claiming disabling pain must satisfy the standard
adopted by the Eleventh Circuit by showing “(1) evidence of an underlying medical condition; and
(2) either (a) objective medical evidence confirming the severity of the alleged pain; or (b) that the
objectively determined medical condition can reasonably be expected to give rise to the claimed
pain.” Wilson v. Barnhart, 284 F.3d 1219, 1255 (11th Cir. 2002) (citing Holt v. Sullivan, 921 F.2d
1221, 1223 (11th Cir. 1991)). If the ALJ determines that Plaintiff has a medically determinable
impairment that could reasonably be expected to produce her pain, he must then evaluate the
intensity and persistence of Plaintiff’s symptoms to determine if they limit her capacity to work.
20 C.F.R. § 404.1529(c)(1).
If the ALJ rejects Plaintiff’s testimony regarding pain, the ALJ must “articulate explicit
and adequate reasons” for doing so. Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005).
Further, if proof of disability is based upon subjective evidence and a credibility determination is
critical to the decision, “the ALJ must either explicitly discredit such testimony or the implication
must be so clear as to amount to a specific credibility finding.” Foote v. Chater, 67 F.3d 1553,
1561 (11th Cir. 1995). The reasons for discrediting pain testimony must be based on substantial
evidence. Hale v. Bowen, 831 F.2d 1007, 1012 (11th Cir. 2007). Thus, although the ALJ’s

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“credibility determination does not need to cite ‘particular phrases or formulations,’ … it cannot
merely be a broad rejection which is not enough to enable the district court . . . to conclude that
the ALJ considered her medical condition as a whole.” Dyer, 395 F.3d at 1210 (citing Foote, 67
F.3d at 1562).
A. Exertional Limitations
The ALJ found Plaintiff able to perform a full range of work at all exertional levels. (Tr.
47). Plaintiff argues that her “longitudinal history of back and neck problems, and carpal tunnel
syndrome indicates that some physical exertional restrictions should have been placed in the RFC
determination.” (Doc. #12 at 11).
Contrary to Plaintiff’s argument, the record contains substantial evidence which supports
a finding that Plaintiff is subject to no exertional work limitations. First, Plaintiff herself all but
admitted that she is not limited by bulging discs, a pinched nerve, neck pain, and joint tenderness.
See Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001) (holding that the claimant bears the
burden of proving a severe impairment). When testifying for the ALJ in February 2016, Plaintiff
noted that the most severe physical or mental conditions preventing her from returning to work
were “headaches and IBS.” (Tr. 66). She later mentioned “what they call arthritis and bursitis in
my joints” and that the doctor gave her “a shot to see if that would help to eliminate the pain and
let that muscle start working again. So far it’s working good if I don’t stay out in the cold air for
it. … If I’m in the cold air, it freezes up.” (Tr. 73). In her opinion, this “bunchy disc” would limit
her to lifting or carrying no more than 10 pounds but it would not limit her in terms of standing or
walking. (Tr. 76-77). She said that she might sometimes be limited with her sitting only if she
was “real, real sick with a cold virus or something.” (Tr. 77).

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Similarly, the medical evidence also fails to establish exertional limitations. The ALJ
thoroughly considered whether Plaintiff’s allegations of bulging discs, a pinched nerve, neck pain,
and joint tenderness could be considered severe impairments and found that they could not. (Tr.
47-48). Plaintiff underwent a consultative examination in April 2014. During that exam, she
claimed that she had an MRI in 2012 which revealed bulging discs. (Tr. 93, 254, 322). However,
no MRI results exist in Plaintiff’s records. (Tr. 93, 254, 322). During the same consultative exam,
Plaintiff claimed that she experienced pain at 9/10 which radiated to the outside of her right leg
down to her foot. (Tr. 322). While she did exhibit some decreased ability with lumbar flexion,
extension, and right lateral flexion and rotation, Plaintiff’s range of motion was found to be
otherwise normal. (Tr. 326-27). The consultative examiner noted normal gait and station, normal
coordination, a normal neurological examination, normal muscle tone with no atrophy, normal
reflexes, normal muscle power, negative straight leg raise testing, and normal sensation
throughout. (Tr. 324-28). X-rays of Plaintiff’s lumbar spine showed preserved vertebral body and
disc heights with no spondylosis. (Tr. 330). The films showed some scoliosis, but it was so mild
that Dr. Parish did not observe any signs of curvature on his physical exam. (Tr. 328, 330). See
20 C.F.R. § 416.929(c)(3)(i), (c)(4) (“We will consider … any inconsistencies in the evidence and
… conflicts between your statements and the rest of the evidence.”).
Finally, the ALJ considered Plaintiff’s daily activities. (Tr. 45). A claimant’s daily
activities may properly be considered by the ALJ in evaluating a claimant’s symptoms, including
pain. 20 C.F.R. 416.929(c)(3)(i); Dyer v. Barnhart, 395 F.3d 1206, 1212 (11th Cir. 2005). In
March 2015, Plaintiff reported to her neurologist that she worked in the yard and was physically
active. (Tr. 331). She reported that she could take care of her personal needs, including cooking,
washing dishes, vacuuming, sweeping, mopping, using a push mower, and buying groceries. (Tr.

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322-23). She testified that she could drive, pick up brush in the yard, take out the garbage, shop
for groceries, cook, do housecleaning, cut her grass, use a weed eater, and plant bushes and flowers.
(Tr. 75-76). The only factors that she claimed limited her ability to do that work was the weather,
her IBS, and her migraine headaches. (Tr. 76).
Based on the foregoing, substantial evidence supports the ALJ’s decision that exertional
limitations do not affect Plaintiff’s ability to work.1
B. Non-Exertional Limitations
The ALJ also found that certain non-exertional limitations applied to Plaintiff’s RFC, yet
Plaintiff contends that those limitations inadequately explain her severe migraine headaches.
(Doc. #12 at 13-17). She contends that the RFC does not provide for any “off task” time, which
is the primary problem presented by her headaches. (Id. at 14). Specifically, Plaintiff testified that
when she has a migraine, which is “daily,” she must lie down in the bed with the lights off. (Id.)
She will take Maxalt as prescribed, but the medication causes her to sleep for two hours. (Id.).
This, Dr. Alford opined, completely debilitates Plaintiff. (Tr. 348). However, the ALJ found that
Plaintiff’s statements regarding her symptoms were “not entirely consistent with the medical
evidence and other evidence in the record.” (Tr. 48). A “clearly articulated credibility finding
with substantial supporting evidence in the record will not be disturbed by a reviewing court.”
Foote v. Chater, 67 F.3d 1553, 1562 (11th Cir. 1995); see also Mitchell v. Commissioner, 771 F.3d
780, 782 (11th Cir. 2014) (“[C]redibility determinations are the province of the ALJ …”).

1

While the ALJ did not specifically refer to Plaintiff’s bulging discs, pinched nerve, neck pain, and joint tenderness
in the RFC, he did clearly state that he “considered all symptoms and the extent to which those symptoms [could]
reasonably be accepted as consistent with the objective medical evidence and other evidence.” (Tr. 48). The mere
diagnosis of these conditions is not sufficient to establish work-related limitations. See Wind v. Barnhart, 133 Fed.
Appx. 684, 690 (11th Cir. 2005).

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While Plaintiff consistently complained of headaches while seeing Dr. Alford, the
evidence concerning her use of Maxalt is inconsistent with the frequency of headaches she reports.
(Tr. 49). Plaintiff alleged at the hearing that she experiences headaches “at least three times a day”
lasting for “three to four hours” each. (Tr. 66, 68). However, in January 2014, she reported having
only six headaches a month to her neurologist. (Tr. 294). Despite this discrepancy, no records
indicate that Plaintiff visited the emergency room due to severe headache pain and apparent lack
of pain or relief medication. (Tr. 49, 251-350).
The ALJ also noted that Plaintiff’s records contradicted the symptoms she alleged at the
hearing. (Tr. 49). Plaintiff testified at the hearing that she would experience nausea with her
headaches if she had not had anything to eat or drink. (Tr. 66). She claimed she vomited at least
twice a day due to the headaches. (Tr. 67-68). However, Plaintiff consistently denied nausea,
vomiting, phonophobia, and photophobia, and her denials of experiencing those symptoms was as
recent as January 2016. (Tr. 251, 256, 260,2 263, 279, 282, 333, 345).
Finally, the ALJ properly accorded little weight to Dr. Alford’s characterization of Plaintiff
as “totally debilitated from the headaches.” (Tr. 50, 348). The ALJ noted that Dr. Alford’s
treatment notes had consistently characterized Plaintiff as in no more than “mild pain/distress”
even while experiencing a headache. (Tr. 50, 251-66, 333-50). Of course, Dr. Alford’s opinion
that Plaintiff is unable to work is not a medical opinion entitled to deference. That question is
emphatically reserved for the Commissioner.

20 C.F.R. § 404.127(d); see also Romeo v.

Commissioner, 686 Fed. Appx. 731, 733 (11th Cir. 2017) (finding physician’s opinion that it would
be difficult for claimant to have a full-time job was an issue reserved to the Commissioner and not
entitled to any weight).

2

Plaintiff reported nausea to her doctor on this instance in May 2012. (Tr. 260). She did not report vomiting. (Id.).

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Based on the foregoing, the ALJ was not clearly wrong in discrediting Plaintiff’s testimony.
See Jerrell v. Commissioner, 433 Fed. Appx. 812, 814 (11th Cir. 2011) (citing Holt, 921 F.2d at
1223) (holding that statements concerning the intensity, duration, and limiting effects of Plaintiff’s
symptoms were not entirely credible because the objective medical evidence did not confirm the
severity of the alleged pain arising from the condition); Werner v. Commissioner, 421 Fed. Appx.
935, 939 (11th Cir. 2011) (“The question is not … whether the ALJ could have reasonably credited
[the plaintiff’s] testimony, but whether the ALJ was clearly wrong to discredit it.”). The decision
of the Commissioner omitting certain non-exertional limitations is supported by substantial
evidence.
VII.

Conclusion

The court concludes that the ALJ’s determination that Plaintiff is not disabled is supported
by substantial evidence and proper legal standards were applied in reaching this determination.
The Commissioner’s final decision is due to be affirmed. A separate order in accordance with this
Memorandum Decision will be entered.
DONE and ORDERED this July 12, 2018.

_________________________________
R. DAVID PROCTOR
UNITED STATES DISTRICT JUDGE

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