Hightower v. Social Security Administration, Commissioner
Filing
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MEMORANDUM OF OPINION. Signed by Judge L Scott Coogler on 2/20/2018. (PSM)
FILED
2018 Feb-20 AM 10:52
U.S. DISTRICT COURT
N.D. OF ALABAMA
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
MIDDLE DIVISION
ANITRA HIGHTOWER,
Plaintiff,
vs.
NANCY A. BERRYHILL,
Acting Commissioner of
Social Security,
Defendant.
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4:16-CV-2039-LSC
MEMORANDUM OF OPINION
I.
Introduction
The plaintiff, Anitra Hightower, appeals from the decision of the
Commissioner of the Social Security Administration (“Commissioner”) denying
her applications for Supplemental Security Income (“SSI”) and Disability
Insurance Benefits (“DIB”). Ms. Hightower 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. Hightower was thirty-eight years old at the time of the Administrative
Law Judge’s (“ALJ’s”) decision, and she attended school through the twelfth
grade, although she did not graduate. (Tr. at 42, 205.) Her past work experiences
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include employment as a hair stylist, fast food employee, and store manager. (Tr. at
21, 34-36, 191.) Ms. Hightower claims that she became disabled on September 27,
2012, due to migraines, anxiety, shortness of breath, and degenerative joint disease
in both knees. (Tr. at 37-41, 178, 204.) During the hearing, Ms. Hightower also
alleged problems with depression and sleep apnea. (Tr. at 37-41).
The Social Security Administration has established a five-step sequential
evaluation process for determining whether an individual is disabled and thus
eligible for DIB or SSI. See 20 C.F.R. §§ 404.1520, 416.920; see also Doughty v.
Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). The evaluator will follow the steps in
order until making a finding of either disabled or not disabled; if no finding is made,
the analysis will proceed to the next step. See 20 C.F.R. §§ 404.1520(a)(4),
416.920(a)(4). The first step requires the evaluator to determine whether the
plaintiff is engaged in substantial gainful activity (“SGA”). See id. §§
404.1520(a)(4)(i), 416.920(a)(4)(i). If the plaintiff is not engaged in SGA, the
evaluator moves on to the next step.
The second step requires the evaluator to consider the combined severity of
the plaintiff’s medically determinable physical and mental impairments. See id. §§
404.1520(a)(4)(ii), 416.920(a)(4)(ii). An individual impairment or combination of
impairments that is not classified as “severe” and does not satisfy the durational
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requirements set forth in 20 C.F.R. §§ 404.1509 and 416.909 will result in a finding
of not disabled. See 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). The
decision depends on the medical evidence contained in the record. See Hart v.
Finch, 440 F.2d 1340, 1341 (5th Cir. 1971) (concluding that “substantial medical
evidence in the record” adequately supported the finding that plaintiff was not
disabled).
Similarly, the third step requires the evaluator to consider whether the
plaintiff’s impairment or combination of impairments meets or is medically equal
to the criteria of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix
1. See 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If the criteria of a listed
impairment and the durational requirements set forth in 20 C.F.R. §§ 404.1509
and 416.909 are satisfied, the evaluator will make a finding of disabled. 20 C.F.R.
§§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).
If the plaintiff’s impairment or combination of impairments does not meet or
medically equal a listed impairment, the evaluator must determine the plaintiff’s
residual functional capacity (“RFC”) before proceeding to the fourth step. See id.
§§ 404.1520(e), 416.920(e). The fourth step requires the evaluator to determine
whether the plaintiff has the RFC to perform the requirements of his past relevant
work.
See id. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv).
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If the plaintiff’s
impairment or combination of impairments does not prevent him from performing
his past relevant work, the evaluator will make a finding of not disabled. See id.
The fifth and final step requires the evaluator to consider the plaintiff’s
RFC, age, education, and work experience in order to determine whether the
plaintiff can make an adjustment to other work. See id. §§ 404.1520(a)(4)(v),
416.920(a)(4)(v). If the plaintiff can perform other work, the evaluator will find
him not disabled. Id.; see also 20 C.F.R. §§ 404.1520(g), 416.920(g). If the plaintiff
cannot perform other work, the evaluator will find him disabled. 20 C.F.R. §§
404.1520(a)(4)(v), 404.1520(g), 416.920(a)(4)(v), 416.920(g).
Applying the sequential evaluation process, the ALJ first found that Ms.
Hightower met the insured status requirements of the Social Security Act through
September 30, 2015. (Tr. at 13.) She found that Ms. Hightower has not engaged in
SGA since the alleged onset date. (Id.) According to the ALJ, Plaintiff’s
osteoarthritis of the bilateral knees, migraine headaches, obstructive sleep apnea,
morbid obesity, generalized anxiety disorder, depressive disorder and somatic
symptom disorder are considered “severe” based on the requirements set forth in
the regulations. (Id.) However, the ALJ found that these impairments in
combination neither meet nor medically equal any of the listed impairments in 20
C.F.R. Part 404, Subpart P, Appendix 1. (Tr. at 14.)
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The ALJ determined that Ms. Hightower has the RFC to perform sedentary
work with the following limitations: she cannot have concentrated exposure to
extreme temperatures or exposure to hazards; she can only occasionally stoop,
kneel, crouch, or crawl; she can understand, remember, and carry out simple
instructions and attend to those for two-hour periods; she should have limited and
casual contact with the general public; and changes to her work environment
should be infrequent and introduced gradually. (Tr. at 16.) The ALJ next
determined that Plaintiff could not perform her past relevant work. (Tr. at 21.) She
noted that she was a “younger individual age 18-44,” had a “limited education”
and could communicate in English, as those terms are defined in the regulations.
(Id.) The ALJ then determined that considering Plaintiff’s age, education, work
experience, and RFC, there are jobs that exist in significant numbers in the national
economy that she can perform, including general office clerk, inspector/sorter, and
production and table worker. (Tr. at 21-22, 55-57.) The ALJ concluded her findings
by stating that Ms. Hightower “was not under a ‘disability,’ as defined in the
Social Security Act,” at any time through the date of her decision. (Tr. at 21-23.)
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
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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 Stone
v. Comm’r of Soc. Sec., 544 F. App’x 839, 841 (11th Cir. 2013) (citing Crawford v.
Comm’r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir. 2004)). This Court gives
deference to the factual findings of the Commissioner, provided those findings are
supported by substantial evidence, but applies close scrutiny to the legal
conclusions. See Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996).
Nonetheless, this Court may not decide facts, weigh evidence, or substitute
its judgment for that of the Commissioner. Dyer v. Barnhart, 395 F.3d 1206, 1210
(11th Cir. 2005) (quoting Phillips v. Barnhart, 357 F.3d 1232, 1240 n.8 (11th Cir.
2004)).
“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
proof preponderates against the Commissioner’s decision, it must affirm if the
decision is supported by substantial evidence. Miles, 84 F.3d at 1400 (citing Martin
v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990)).
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However, no decision is automatic, for “despite th[e] deferential standard
[for review of claims], it is imperative that th[is] 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) (citing Arnold v. Heckler, 732 F.2d 881,
883 (11th Cir. 1984)). 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
Ms. Hightower argues that the Commissioner’s decision should be reversed
for one reason: the ALJ did not adequately consider her obesity in combination
with her other impairments and, when her obesity is properly taken into
consideration, her medical condition is essentially “equivalent in severity to a listed
impairment.” 1
Where a claimant has multiple impairments, the ALJ considers the combined
effect of all impairments without regard to whether any individual impairment
would demonstrate disability. 20 C.F.R. § 404.1523. At step three of the sequential
Additionally, Plaintiff’s brief devotes one sentence each to referencing her low full-scale
IQ score, depression, and migraines, and the potential effects of these conditions on absenteeism
and her ability to adapt to jobs, but fails to develop any argument on these issues. The issues
before this Court are deemed limited to those issues properly raised and supported by either
party. Outlaw v. Barnhart, 197 F. App’sx 825, 826 n.3 (11th Cir. 2006) (citing Cheffer v. Reno, 55
F.3d 1517, 1519 n.1 (11th Cir. 1995)); see also N.L.R.B. v. McClain of Ga., Inc., 138 F.3d 1418, 1422
(11th Cir. 1998) (“Issues raised in a perfunctory manner, without supporting arguments and
citation to authorities, are generally deemed to be waived.”).
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process, the ALJ determines whether a claimant has “impairment(s)” that meets
one of the listed disabilities. Id. § 404.1520(a)(4)(iii). The regulations state that,
where no individual impairment meets a listing, the ALJ will consider whether a
combination of impairments is medically equivalent to a listing. Id. § 404.1526; see
also Wilson v. Barnhart, 284 F.3d 1219, 1224 (11th Cir. 2002).
Here, the ALJ found at step three of the sequential process that Plaintiff did
not have “an impairment or a combination of impairments” that met or medically
equaled a listed impairment, further stating that she considered such combined
effects of Plaintiff’s alleged impairments both “singly and in combination.” (Tr. at
14.) In Wilson, the ALJ acknowledged that Wilson suffered multiple impairments
and then stated that he “did not have an impairment or combination of
impairments” that equaled a listing. 284 F.3d at 1224. The Eleventh Circuit held
that statement was sufficient to demonstrate that the ALJ considered the
cumulative effect of the claimant’s impairments. Id. at 1224–25; see also Jones v.
Dep’t of Health & Human Servs., 941 F.2d 1529, 1533 (11th Cir. 1991) (reaching the
same conclusion based on similar language). The ALJ went even farther here,
specifically considering whether Plaintiff met listings for osteoarthritis of the knees
(Listing 1.02), sleep apnea (Listing 3.10), and migraines (Listing 11.03). (Tr. at 1415.)
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Substantial evidence supports the ALJ’s assessment that Plaintiff did not
meet or medically equal a listing, as well as her RFC determination. Plaintiff
contends that the ALJ did not properly consider the effects of her obesity.
Although Social Security Ruling 02-1p, cited by Plaintiff, provides that the effects
of a claimant’s obesity along with the claimant’s other impairments “may” be a
factor in the “meets” and “equals” conclusion at step three of the sequential
process, Plaintiff fails to demonstrate that her obesity precludes her from working
with limitations. In any event, the ALJ specifically noted that she considered
Plaintiff’s morbid obesity in connection with her other impairments as required by
SSR 12-2p. (Tr. at 14.) See also Lewis v. Comm’r of Soc. Sec., 487 F. App’x 481, 483
(11th Cir. 2012) (holding ALJ complied with SSR 02-1p where ALJ considered
evidence of claimant’s obesity and found obesity was a severe impairment and
claimant could perform light work); Castel v. Comm’r of Soc. Sec., 355 F. App’x
260, 263-64 (11th Cir. 2009) (holding ALJ properly considered claimant’s obesity
where ALJ referenced SSR 02-1p and found obesity was a severe impairment, but
did not result in any specific functional limitations).
Moreover, Plaintiff fails to note that the mere diagnosis of obesity, a
claimant’s weight, or any other condition does not automatically establish workrelated limitations. Moore v. Barnhart, 405 F.3d 1208, 1213 n.6 (11th Cir. 2005); see
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also Wind v. Barnhart, 133 F. App’x 684, 690 (11th Cir. 2005) (“a diagnosis or a
mere showing of ‘a deviation from purely medical standards of bodily perfection or
normality’ is insufficient; instead, the claimant must show the effect of the
impairment on her ability to work”) (quoting McCruter v. Bowen, 791 F.2d 1544,
1547 (11th Cir. 1986)). As the Eleventh Circuit has stated, “Disability is
determined by the effect an impairment has on the claimant’s ability to work,
rather than the diagnosis of an impairment itself.” Davis v. Barnhart, 153 F. App’x
569, 572 (11th Cir. 2005).
The record, as discussed by the ALJ, provides substantial evidence that
Plaintiff’s obesity, taken in combination with her other impairments, did not
prevent her from performing the range of sedentary work in her RFC. Plaintiff’s
osteoarthritis of her knees has been treated with prescription medication with
minimal changes since 2010. (Tr. at 17-18, 273-313.) Over the next several years of
treatment, Plaintiff repeatedly reported that she could carry out her daily activities.
(Tr. at 17, 269-271, 283.) Even in September 2012, the month of Plaintiff’s alleged
onset of disability, Plaintiff denied any “severe exacerbation of knee pain.” (Tr. at
17, 262.) When Plaintiff presented to V. Snehaprabha Reddy, M.D., for a disability
examination on September 26, 2013, Dr. Reddy noted that while Plaintiff could not
walk on her heels or toes and that there was some limitation with flexion in her
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knees, leading to a diagnosis of osteoarthritis of both knees, there was no specific
limitation on Plaintiff’s ability work. (Tr. at 17, 322-323.) From September 2013
through June 2014, Plaintiff reported being able to carry out her activities of daily
living. (Tr. at 18, 188, 347-353.) Given that Plaintiff’s knee pain was managed with
medication and that there were no severe exacerbations of knee pain, no limitations
were placed on her ability to perform work. (Tr. at 341.) In fact, the ALJ specifically
noted in her decision that Plaintiff’s obesity “likely contributes to her pain, [but]
there is no substantial evidence that [her] obesity precludes her from work at the
sedentary level of exertion.” (Tr. at 20). The ALJ also specifically found that
Plaintiff’s “physical examinations are basically normal and no treating or
examining physician has placed any restrictions on the claimant due to her obesity
but has only recommended that she reduce her weight.” (Tr.at 20, 244-320, 322325, 340-359, 361-368).
The ALJ also considered Plaintiff’s migraine headaches. Plaintiff asserted
multiple times since the onset of worsening, daily headaches in April 2012 that she
was still able to carry out her activities of daily living. (Tr. at 269.) The medications
prescribed to control her headache pain, including Topamax, managed her pain
effectively enough that Plaintiff reported she had not experienced a migraine since
starting Topamax. (Tr. at 18, 257.) Even Plaintiff’s claims of worsening headaches
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in September 2013 were counteracted by the fact that Plaintiff admitted to Dr.
Reddy that her headaches were eliminated within three hours when she took her
medication. (Tr. at 18, 322.) For these reasons, Dr. Reddy diagnosed Plaintiff with
migraines but did not place any limitations on her ability to work. (Tr. at 322, 323.)
From December 2013 through June 2014, Plaintiff had not reported any symptoms
of headache pain and has been able to carry out her daily activities. (Tr. at 18, 341353.)
The ALJ also considered Plaintiff’s sleep apnea. After a sleep study in
October 2013, Plaintiff was diagnosed with obstructive sleep apnea that required a
CPAP machine, but Plaintiff did not complain of symptoms related to her sleep
apnea when she returned for follow ups in December 2013, January 2014, February
2014, and June 2014. (Tr. at 19, 327-338, 341-353.) The ALJ correctly concluded
that this condition was not severe and did not preclude Plaintiff from performing
work at the sedentary level. (Tr. at 19.) For instance, Plaintiff was only instructed
not to drive when drowsy, to elevate her head in bed, and reduce her weight. (Tr. at
341.)
Finally, the ALJ considered Plaintiff’s alleged anxiety, depression, and
somatic symptom disorder. The record indicated no more than mild to moderate
limitations from these impairments. (Tr. at 14-16, 19.) Plaintiff’s reported history
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of depression stops in 2012, with only one complaint of depression in September
2013 and no complaints in 2014. (Tr. at 20, 341, 347, 350, 353.) Plaintiff reported
that her anxiety was well-controlled with prescription medication from 2012
through 2014. (Tr. at 19-20, 254-256, 257-271.) Dr. Reddy’s evaluation in
September 2013 yielded a diagnosis of anxiety or depression, but no limitations
were placed on her ability to work. (Tr. at 322-325.) Similarly, when Plaintiff saw
Dr. Rogers, Ph.D., for a psychological evaluation in February 2015, Dr. Rogers
diagnosed her with somatic symptom disorder with predominate pain, unspecified
depressive disorder, and anxiety disorder, but noted that it was Plaintiff’s physical
impairments (as opposed to her psychiatric complaints) that appeared to be the
major obstacle to employment. (Tr. at 361-368.) The ALJ determined that these
findings were consistent with the record and gave great weight to these findings,
adjusting her RFC determination accordingly. (Tr. at 16.) Dr. Rogers also
diagnosed Plaintiff with mild intellectual disability based on WAIS testing,
estimating that Plaintiff had only moderate limitations in her intellectual ability.
The ALJ considered this diagnosis, but afforded it less weight since Plaintiff is less
limited, as evidenced by her history of performing skilled work. (Tr. at 21.)
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In conclusion, Plaintiff failed to prove that her obesity, taken in combination
with her other impairments, should have led the ALJ to find that she equaled a
Listing.
IV.
Conclusion
Upon review of the administrative record, and considering all of Ms.
Hightower’s arguments, the Court finds the Commissioner’s decision is supported
by substantial evidence and in accord with the applicable law. A separate order will
be entered.
DONE and ORDERED on February 20, 2018.
_____________________________
L. Scott Coogler
United States District Judge
160704
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