Wright v. Social Security Administration, Commissioner

Filing 11

MEMORANDUM OPINION Signed by Judge William M Acker, Jr on 2/7/14. (SAC )

FILED
2014 Feb-07 AM 09:25
U.S. DISTRICT COURT
N.D. OF ALABAMA

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
MIDDLE DIVISION
KAREN G. WRIGHT,

)
)
)
)
)
)
)
)
)
)
)

Plaintiff
v.
CAROLYN W. COLVIN,
Acting Commissioner of
Social Security,
Defendant.

Case No. 4:11-CV-3421-WMA

MEMORANDUM OPINION
Plaintiff, Karen G. Wright, sought and was denied Social
Security disability benefits in an administrative proceeding below.
She brings this action for judicial review of the administrative
decision pursuant to 42 U.S.C. § 405(g).

For the reasons that

follow, the decision below will be affirmed.
Background
Plaintiff is a 50 year old woman with an 11th grade education
and past work experience as a fast food worker, deli worker, and
fast

food

shift

manager.

On

April

21,

2008,

she

filed

an

application for disability benefits, claiming that symptoms related
to neurofibromatosis, including headaches and back pain, rendered
her disabled and unable to work, with a disability onset date of
January 18, 2008.

At about the same time, she began a lengthy

medical evaluation to address these issues.
Neurofibromatosis is a genetic condition that causes fibromas

1

(benign tumors) to form in those with the condition. Plaintiff has
a history of neurofibromatosis that “covers her entire body,” and
has previously undergone successful surgery to remove one fibroma
from her lung.
case

R. at 195.

concerned

fibromas

The medical evaluations central to this
in

two

especially

dangerous

areas:

plaintiff’s brain and her sacrum.
A possible brain issue, a cystic lesion in the medulla, was
first discovered by doctors through a March, 2008 MRI scan.
230.

R. at

The lesion was followed closely over at least the next three

years (the extent of the record before this court) by three
doctors: Dr. Pamela Quinn, a neurologist; Dr. Joel Pickett, a
neurospine surgeon; and Dr. Noel Estopinal, a radiation oncologist.
The doctors agreed on a plan of “watchful waiting.”

R. at 239.

They felt that the location of the lesion made “surgical or even
radiosurgical intervention” too dangerous. See id. Moreover, they
felt

that

Subsequent

the
MRIs

lesion

was

revealed

“stable”
that

and

the

“asymptomatic.”

lesion

had

“not

Id.

changed

appreciably,” R. at 227, and that “her headache was stable and well
controlled with Tylenol,” R. at 288.

In May, 2009, an MRI revealed

“some new findings . . . at the C1 level of the brainstem, as well
as . . . a questionable third lesion in the right cerebellum,” id.,
but these findings did not change the doctors’ watchful waiting
approach, see id. at 289.
In June, 2009, the same doctors observed a lytic lesion in

2

plaintiff’s sacrum.

R. at 305.

They found that the lesion caused

plaintiff “some discomfort in the low back region, but [classified]
it as mild to moderate, and . . . not significant when she [took]
analgesics.”

R. at 290.

Over the course of several examinations,

they found that her “clinical symptoms [were] essentially stable.”
R. at 295.

Finally, they noted that this type of lesion “tend[ed]

to be relatively slow growing.”
earlier lesions,

the

doctors

R. at 305.

concluded

that

Thus, as with the
in light

of

the

mildness of plaintiff’s symptoms, the stability of her disease, and
the risks of surgical intervention, a wait-and-see approach was
best.

See R. at 290.

In December, 2009, plaintiff was evaluated by Dr. Eston
Norwood specifically to determine the degree to which her symptoms
made her disabled.

R. at 276.

Dr. Norwood’s report was generally

positive, finding that plaintiff had normal range of motion, gait,
strength, proprioception, and reflexes, and that plaintiff could
independently perform daily activities such as arising from a
sitting position, walking on her heels and toes, and using her
hands to open doors and tie her shoes.

R. at 276.

From this, Dr.

Norwood found that plaintiff “does not have a neurologic deficit to
cause difficulty doing work-related activities including sitting,
standing, walking, lifting, carrying, [and] handling objects.” Id.
Administrative Proceedings
Plaintiff’s initial claim was denied by the Social Security

3

Administration on September 23, 2008.

R. at 73.

Plaintiff

promptly requested a hearing before an Administrative Law Judge
(ALJ), R. at 81-82, and a hearing was held on July 19, 2010, R. at
33-70.

On September 20, 2010, the ALJ issued a thorough opinion

confirming the initial denial.

R. at 10-29.

The ALJ found that

plaintiff’s neurofibromatosis and related symptoms did constitute
a “severe” impairment under Social Security definitions, R. at 28
¶ 3, but that the “impairments have not been of such severity that
they could

reasonably

limitations,” id. ¶ 5.

be expected

to

give

rise

to

disabling

He found that plaintiff had “the residual

functional capacity to perform light work as defined [by the Social
Security

Administration]”,

id.

¶

6,

and

plaintiff’s request for disability benefits.

therefore

denied

Plaintiff’s request

for review of the decision by the Social Security Appeals Council
and that request was denied.

R. at 1-3.

With all administrative

remedies thus exhausted, plaintiff brought this action.
Discussion
The district courts have a limited role in reviewing decisions
of the Social Security Administration.

The court decides only

whether the decision below is supported by substantial evidence and
whether proper legal standards were applied.
Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983).

See Bloodsworth v.
Plaintiff’s only

argument in this appeal is that the ALJ failed to correctly apply
the “pain standard” devised by the Eleventh Circuit to evaluate the

4

credibility of subjective pain complaints.
In the Eleventh Circuit, a “pain standard” is applied “when a
claimant attempts to establish disability through his or her own
testimony of pain or other subjective symptoms.”
67 F.3d 1553, 1560 (11th Cir. 1995).

Foote v. Chater,

Under this standard, a

claimant testifying about his own pain must show “evidence of an
underlying medical condition and (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 be reasonably expected to give
rise to the alleged pain.”

Landry v. Heckler, 782 F.2d 1551, 1553

(11th Cir. 1986) (citation omitted).

Once this standard is met,

the

“is

claimant’s

subjective

testimony

itself

sufficient

to

support a finding of disability.” Holt v. Sullivan, 921 F.2d 1221,
1223 (11th Cir. 1991) (citations omitted).

The ALJ may still

decide not to credit the pain testimony, but “he must articulate
explicit and

adequate

reasons for

doing

so.”

Id. (citation

omitted); see also Foote, 67 F.3d at 1562 (“A clearly articulated
credibility finding with substantial supporting evidence in the
record will not be disturbed by a reviewing court.”).
According to plaintiff, the pain standard is met in this case
because

the

medical

records

“document

the

[p]laintiff’s

longitudinal attempts to find medical treatment for her disabling
symptoms.”

Pl.’s Br. at 6.

In short, plaintiff argues that the

5

simple fact that she continued to see doctors over the course of
years is evidence that she continued to experience severe pain.
See id. at 5-8.

As plaintiff correctly points out, the Social

Security Administration regulations specifically provide that “[i]n
general,

a

longitudinal

medical

record

demonstrating

an

individual's attempts to seek medical treatment for pain or other
symptoms and to follow that treatment once it is prescribed lends
support to an individual's allegations of intense and persistent
pain or other symptoms . . . .”

SSR 96-7P, 1996 WL 374186, at *7

(July 2, 1996).
Plaintiff’s

error

is

her

assumption

that

providing

some

objective evidence to meet the “pain standard” is the end of the
inquiry.

The ALJ remained permitted to choose not to credit the

pain testimony so long as he “articulate[d] explicit and adequate
reasons for doing so.”

Holt, 921 F.2d at 1223.

The ALJ in this

case specifically recognized and cited the Eleventh Circuit’s pain
standard cases and SSR 96-7p.

See R. at 24-25.

With these rules

in mind, he took care to conclude that plaintiff’s pain testimony
was “not fully credible,” but only after a detailed and thorough
consideration of “the medical history, the reports of the treating
and examining practitioners, and the clinical findings made on
examination.”

R. at 25.

He found significant the facts that the

doctors never deviated from their “conservative and non-invasive
plan of treatment,” id.; that plaintiff “consistently reported much

6

milder pain to her doctors” than she did to the Social Security
Administration, id.; that her headaches were relieved by Tylenol,
id.; and that her range of motion was good, id.

The ALJ thus had

“explicit and adequate reasons,” Holt, 921 F.2d at 1223, and in
fact

compelling

reasons,

for

his

ultimate

conclusion

that

“susbstantial evidence does not support a conclusion that the
objectively determined medical conditions are of such severity that
they could reasonably be expected to give rise to disabling pain
and other limitations as alleged by the claimant,” R. at 26.
CONCLUSION
The
supported

ALJ
by

decision

below applied

substantial

the

evidence.

correct

The

Commissioner is therefore due to be affirmed.

law

decision

and

was

of

the

The court will

contemporaneously issue an order consistent with this opinion.
DONE this 7th day of February, 2014.

_____________________________
WILLIAM M. ACKER, JR.
UNITED STATES DISTRICT JUDGE

7