Caudle v. Social Security Administration, Commissioner
Filing
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MEMORANDUM OPINION as more fully set out therein.Signed by Magistrate Judge Herman N Johnson, Jr on 8/31/2018. (BJL)
FILED
2018 Aug-31 AM 08:22
U.S. DISTRICT COURT
N.D. OF ALABAMA
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
MIDDLE DIVISION
MONICA CAUDLE,
Plaintiff
vs.
COMMISSIONER, SOCIAL SECURITY
ADMINISTRATION,
Defendant
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)
)
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) Case No. 4:17-cv-00947-HNJ
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MEMORANDUM OPINION
Plaintiff Monica Caudle seeks judicial review pursuant to 42 U.S.C. § 405(g) of an
adverse, final decision of the Commissioner of the Social Security Administration
(“Commissioner” or “Secretary”), regarding her claim for Supplemental Security
Income (SSI). The undersigned has carefully considered the record, and for the
reasons stated below, AFFIRMS the Commissioner’s decision.
LAW AND STANDARD OF REVIEW
To qualify for disability benefits and establish entitlement for a period of
disability, the claimant must be disabled as defined by the Social Security Act and the
Regulations promulgated thereunder.
The Regulations 1 define “disabled” as the
“inability to do any substantial gainful activity by reason of any medically determinable
1
The “Regulations” promulgated under the Social Security Act are listed in 20 C.F.R. Parts 400 to 499.
Although the Social Security Administration amended the regulations effective January 17, 2017, the
physical or mental impairment which can be expected to result in death or which has
lasted or can be expected to last for a continuous period of not less than twelve (12)
months.” 20 C.F.R. § 404.1505(a). To establish an entitlement to disability benefits, a
claimant must provide evidence of a “physical or mental impairment” which “must
result from anatomical, physiological, or psychological abnormalities which can be
shown by medically acceptable clinical and laboratory diagnostic techniques.” 20
C.F.R. § 404.1508.
In determining whether a claimant suffers a disability, the Commissioner,
through an Administrative Law Judge (ALJ), works through a five-step sequential
evaluation process. See 20 C.F.R. § 404.1520. The burden rests upon the claimant on
the first four steps of this five-step process; the Commissioner sustains the burden at
step five, if the evaluation proceeds that far. Jones v. Apfel, 190 F.3d 1224, 1228 (11th
Cir. 1999).
In the first step, the claimant cannot be currently engaged in substantial gainful
activity. 20 C.F.R. § 404.1520(b). Second, the claimant must prove the impairment is
amendment applies only to Social Security applications filed after the effective date, March 27, 2017.
Watkins v. Berryhill, No. 7:16-CV-242-FL, 2017 WL 3574450, at *4 (E.D.N.C. Aug. 1, 2017), report and
recommendation adopted, No. 7:16-CV-242-FL, 2017 WL 3568406 (E.D.N.C. Aug. 17, 2017); Jordan v.
Commissioner of Social Security, 2017 WL 3034386 (N.D. Ohio July 18, 2017) (applying version of Listing
12.05(C) in effect at time of ALJ’s decision, but finding error in ALJ analysis and remanding for new
hearing and analysis under new version). Accordingly, the undersigned relies upon the prior versions
in effect at the time of the ALJ’s decision.
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“severe” in that it “significantly limits his physical or mental ability to do basic work
activities . . . .” 20 C.F.R. § 404.1520(c).
At step three, the evaluator must conclude the claimant is disabled if the
impairments meet or are medically equivalent to one of the impairments listed at 20
C.F.R. Part 404, Subpart P, App. 1, §§ 1.00–114.02. 20 C.F.R. § 404.1520(d). If a
claimant’s impairment meets the applicable criteria at this step, that claimant’s
impairments would prevent any person from performing substantial gainful activity.
20 C.F.R. §§ 404.1520(a)(4)(iii), 404.1525. That is, a claimant who satisfies steps one
and two qualifies automatically for disability benefits if they suffer from a listed
impairment. See Jones, 190 F.3d at 1228 (“If, at the third step, [the claimant] proves that
[an] impairment or combination of impairments meets or equals a listed impairment,
[the claimant] is automatically found disabled regardless of age, education, or work
experience.”) (citing 20 C.F.R. § 416.920).
If the claimant’s impairment or combination of impairments does not meet or
medically equal a listed impairment, the evaluation proceeds to the fourth step where
the claimant demonstrates an incapacity to meet the physical and mental demands of
past relevant work.
20 C.F.R. § 404.1520(e).
At this step, the evaluator must
determine whether the plaintiff has the residual functional capacity (“RFC”) to perform
the requirements of past relevant work. See 20 C.F.R. § 404.1520(a)(4)(iv). If the
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claimant’s impairment or combination of impairments does not prevent performance
of past relevant work, the evaluator will determine the claimant is not disabled. See id.
If the claimant is successful at the preceding step, the fifth step shifts the burden
to the Commissioner to prove, considering claimant’s RFC, age, education and past
work experience, whether the claimant is capable of performing other work. 20 C.F.R.
§ 404.1520(f)(1). If the claimant can perform other work, the evaluator will not find
the claimant disabled. See 20 C.F.R. § 404.1520(a)(4)(v); see also 20 C.F.R. § 404.1520(g).
If the claimant cannot perform other work, the evaluator will find the claimant disabled.
20 C.F.R. § 404.1520(a)(4)(v), (g).
The court reviews the ALJ’s “‛decision with deference to the factual findings and
close scrutiny of the legal conclusions.’” Parks ex rel. D.P. v. Comm’r, Social Sec. Admin.,
783 F.3d 847, 850 (11th Cir. 2015) (quoting Cornelius v. Sullivan, 936 F.2d 1143, 1145 (11th
Cir. 1991)). The court must determine whether substantial evidence supports the
Commissioner’s decision and whether the Commissioner applied the proper legal
standards. Winschel v. Comm’r of Social Sec., 631 F.3d 1176, 1178 (11th Cir. 2011).
Although the court must “scrutinize the record as a whole . . . to determine if the
decision reached is reasonable and supported by substantial evidence,” Bloodsworth v.
Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983) (citations omitted), the court “may not
decide the facts anew, reweigh the evidence, or substitute [its] judgment” for that of the
ALJ. Winschel, 631 F.3d at 1178 (citations and internal quotation marks omitted).
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“Substantial evidence is more than a scintilla and is such relevant evidence as a
reasonable person would accept as adequate to support a conclusion.” Id. (citations
omitted). Nonetheless, substantial evidence exists even if the evidence preponderates
against the Commissioner’s decision. Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir.
2005).
FACTUAL AND PROCEDURAL HISTORY
Ms. Caudle protectively filed an application for SSI on January 5, 2016, alleging
disability beginning July 18, 2015. (Tr. 18, 123). The Commissioner denied her
claims, and Caudle timely filed a request for a hearing on April 26, 2016. (Tr. 96-98).
The Administrative Law Judge (“ALJ”) held a hearing on October 18, 2016. (Tr.
35-71). The ALJ issued an opinion denying Caudle’s claim on January 30, 2017. (Tr.
15-30).
Applying the five-step sequential process, the ALJ found at step one that Ms.
Caudle had not engaged in substantial gainful activity since January 15, 2016. (Tr. 20).
At step two, the ALJ found that Ms. Caudle’s impairments of obesity, borderline
intellectual functioning, personality disorder, and depression were “severe”
impairments during the relevant time period. (Tr. 20). At step three, the ALJ found
that Ms. Caudle’s impairments, or combination of impairments, did not meet or equal
any impairment for presumptive disability listed in 20 C.F.R. Part 404, Subpart P,
Appendix 1. (Tr. 21).
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Next, the ALJ found that Ms. Caudle exhibited the residual functional capacity
(“RFC”) to perform medium work with the following non-exertional limitations: the
claimant can lift 50 pounds occasionally, but never climb ladder, crouch, or perform
around workplace hazards.
simple instructions.
The claimant can understand, remember, and carry out
She can sustain attention to routine and familiar tasks for
extended periods. The claimant can tolerate ordinary work pressure, but should avoid
quick decision-making, rapid changes, and multiple demands. She would benefit from
regular breaks and slower pace, but is able to maintain a work pace consistent with
mental demands of competitive level work. The claimant’s contact with the public
should be occasional and brief, no more than 30 minutes at a time. Feedback should
be supportive. She can adapt to infrequent and well-explained changes in work setting
and work expectations. (Tr. 23).
At step four, the ALJ determined that Caudle cannot perform her past relevant
work as a floor hanger and retail sales clerk. (Tr. 28). At step five, based on the
testimony of a vocational expert, the ALJ determined that, considering Ms. Caudle’s
age, education, work experience, and RFC, a significant number of other jobs exist in
the national economy that Ms. Caudle could perform, including line machine tender.
(Tr. 29). Accordingly, the ALJ determined that Ms. Caudle has not been under a
disability, as defined by the Social Security Act, since January 5, 2016. (Tr. 29).
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Ms. Caudle timely requested review of the ALJ’s decision. (Tr. 14). Ms. Caudle
submitted new evidence to the Appeals Council that postdated the ALJ’s decision:
medical records from Dr. William Meador dated February 22, 2017. (Tr. 8-13).
On April 11, 2017, the Appeals Council denied review, which deems the ALJ’s
decision as the Commissioner’s final decision. Ms. Caudle filed her complaint with the
court seeking review of the ALJ’s decision. (Doc. 1).
ANALYSIS
In this appeal, Ms. Caudle argues (1) the ALJ erred at step two in finding Caudle’s
foot pain and dermatofibroma as slight abnormalities or non-severe; and (2) the AC
improperly rejected Dr. Meador’s evidence because it qualifies as new, material, and
chronologically relevant evidence. For the reasons discussed below, the undersigned
finds that the Commissioner’s decision is based on substantial evidence
notwithstanding Ms. Caudle’s contentions.
I. The ALJ Properly Found Severe Impairments at Step Two
The Social Security Act defines disability as the “inability to engage in any
substantial gainful activity by reason of any medically determinable physical or mental
impairment which . . . has lasted or can be expected to last for a continuous period of not
less than 12 months.” 42 U.S.C. § 423(d)(1)(A) (emphasis in original); see 20 C.F.R.
§ 404.1505(a). Both the impairment(s) and the inability to work must last for at least
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twelve consecutive months. See 42 U.S.C. § 423(d)(1)(A); 20 C.F.R. §§ 404.1505(a),
404.1509; SSR 82-52, 1982 WL 31376; Barnhart v. Walton, 535 U.S. 212, 217-20 (2002).
The Social Security Handbook § 601 defines a “medically determinable” physical
or mental impairment as:
an impairment that results from anatomical, physiological, or
psychological abnormalities, which can be shown by medically acceptable
clinical and laboratory diagnostic techniques. A physical or mental
impairment must be established by objective medical evidence from an
acceptable medical source. Objective medical evidence is signs,
laboratory findings, or both. We will not use your statement of
symptoms, a diagnosis, or a medical opinion to establish the existence of
an impairment(s).
Social Security Administration, Social Security Handbook, § 601, available at
https://www.ssa.gov/OP_Home%2Fhandbook/handbook.06/handbook-0601.html.
Further, SSP 96-4p emphasizes that “[a] ‘symptom’ is not a ‘medically determinable
physical or mental impairment’ and no symptom by itself can establish the existence of
such an impairment.” See also 20 C.F.R. §§ 404.1508 (what evidence depicts an
impairment); 404.1527(a)(1) (evaluating opinion evidence); 404.1528 (defining
symptoms, signs, and laboratory findings).
A diagnosis alone does not indicate a disability or limitations on a claimant’s
ability to work. See Moore v. Barnhart, 405 F.3d 1208, 1213 n. 6 (11th Cir. 2005) (“[T]he
mere existence of [ ] impairments does not reveal the extent to which they limit [a
claimant’s] ability to work. . . .”); Wilkinson ex rel. Wilkinson v. Bowen, 847 F.2d 660, 662-63
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(11th Cir. 1987) (diagnosis does not equate to existence of impairment); Mansfield v.
Astrue, 395 F. App’x 528, 531 (11th Cir. 2010) (diagnosis insufficient to establish
disability); Osborn v. Barnhart, 194 F. App’x 654, 667 (11th Cir. 2006) (while doctor’s letter
reflected diagnoses, “it does not indicate in any way the limitations these diagnoses
placed on Osborn’s ability to work, a requisite to a finding of disability.”).
As an initial matter, “step two [of the sequential process] requires only a finding
of ‘at least one’ severe impairment to continue on to the later steps.” Tuggerson-Brown v.
Comm’r of Soc. Sec., 572 F. App’x 949, 951 (11th Cir. 2014) (per curiam) (citing Jamison, 814
F.2d at 588). Where an ALJ recognizes at least one severe impairment and proceeds to
step three of the sequential evaluation process, there exists no per se requirement to
identify additional impairments at the second step where the decision demonstrates the
ALJ properly considered all impairments at subsequent steps. Id.; see also Williams v.
Berryhill, No. 17-00260-N, 2018 WL 1092019, *5 (S.D. Ala. Feb. 28, 2018); Vangile v.
Comm’r, Soc. Sec. Admin., 695 F. App’x 510, 513-14 (11th Cir. 2017); Gray v. Comm’r of Soc.
Sec., 550 F. App’x 850, 853-54 (11th Cir. 2013) (any error in the severity finding rendered
harmless by ALJ’s later discussion of objective evidence regarding impairment and
symptoms; ALJ thus performed analysis that would have been required had he
determined a severe impairment at step two); Heatly v. Comm’r of Soc. Sec., 382 F. App’x
823, 824-25 (11th Cir. 2010) (“Nothing requires that the ALJ must identify, at step two,
all of the impairments that should be considered severe” and even if the ALJ erred by
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not recognizing every severe impairment, the error was harmless since he found at least
one such impairment).
Plaintiff’s argument in favor of reversal rests heavily on her claims of disabling
foot pain. However, given the evidence of record, the ALJ’s determination that
Caudle’s foot pain did not constitute a severe impairment rests on substantial evidence.
The ALJ noted Caudle’s history of psoriasis, dermatofibroma, gastroesophageal
reflux disease, restless leg syndrome, systemic lupus, tobacco abuse, and caffeine-related
disorder. However, he found Caudle failed to demonstrate any ongoing or continuous
restrictions from these conditions, and the record established they were well-controlled,
non-symptomatic, or of less than a 12-monh duration.
Further, the conditions
constituted no more than slight abnormalities not reasonably expected to produce more
than minimal, if any, work-related limitations. (Tr. 20).
Regarding Caudle’s foot pain, the ALJ found her testimony about the intensity,
persistence, and limiting effects of the symptoms lacked corroboration in objective
medical evidence, daily activities, and responses to conservative treatment. He noted
Caudle lives with and takes care of her disabled son, performs household chores, and
quit her last job due to the fast pace and difficulty with a co-worker. (Tr. 24). He also
discussed a 2000 bilateral metatarsectomy, after which Caudle voiced complaints of
foot pain. Yet, she continued to work for 15 years after the surgery. The ALJ noted
Caudle’s obesity may engender her aches and pains. (Tr. 26). An independent review
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of the record medical evidence establishes the ALJ’s determination as to Caudle’s severe
impairments has substantial support in the evidence.
Consulting examiner Dr. Frederick Ernst examined Caudle on October 17, 2014,
and reported she had a normal gait and exhibited the ability to heel-toe walk, though she
could not toe walk due to pain. (Tr. 232). Caudle exhibited pain with application of
pressure to the fifth metatarsal bone. (Tr. 232). Dr. Ernst diagnosed, inter alia, status
post bilateral fifth metatarsectomy with residual chronic pain syndrome. (Tr. 233).
However, he opined Caudle can stand and walk up to four hours and sit up to six hours
in an eight-hour workday; lift and/or carry up to 15 pounds occasionally and 10 pounds
frequently; frequently reach overhead and forward, handle, finger, and feel; frequently
climb stairs, stoop, crouch, kneel, and crawl; and occasionally climb ladders. (Tr.
233-34). The ALJ accorded this opinion significant weight and found it consistent
with objective medical evidence. (Tr. 27).
Consulting examiner Dr. Celtin Robertson examined Caudle on March 4, 2016,
at which time she complained primarily of multiple joint pain, which began with her feet
but radiated to other joints and progressively worsened over the years. (Tr. 240). Dr.
Robertson observed Caudle exhibited a normal gait, the ability to heel-toe walk, and no
difficulty getting on and off the exam table without assistance. (Tr. 241, 242). Caudle
could only squat halfway down secondary to joint pain, yet had a negative straight leg
raise test for sciatica and exhibited 5/5 strength and normal muscle tone in all
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extremities. (Tr. 242, 243). Caudle displayed no tenderness to palpation at the joints.
Dr. Robertson diagnosed multiple joint pain per claimant, evidencing objective testing
did not support her claims. (Tr. 243). Dr. Robertson’s opinion, to which the ALJ
accorded significant weight (Tr. 27), found Caudle has no limitation in her ability to
stand, walk, and sit. (Tr. 243).
On April 15, 2016, Caudle complained of pain in multiple joints, shoulders, feet,
lower back, and diffuse muscle pain, and reported a previous lupus diagnosis. (Tr.
359). CRNP Phillip Rogers 2 diagnosed myalgia, restless leg syndrome, and lupus.
(Tr. 363-64).3 Dr. Aprajita Jagpal examined Caudle on June 7, 2016, when she reported
pain in her neck, back, legs, shoulders, and feet. She also reported diffuse pain all over
her body, worsened by activity and prolonged sitting and walking. (Tr. 299). A
physical examination revealed no abnormalities and normal balance.
Dr. Jagpal
diagnosed low back pain, cervicalgia, and restless leg syndrome. (Tr. 300-01).
2
A certified registered nurse practitioner does not qualify as an “acceptable medical source” under the
Social Security Regulations. See 20 C.F .R. § 1513(d)(1); see also SSR 06–3p, 2006 WL 2329939 at *3
(recognizing that nurse practitioners are medical sources that are not “acceptable medical sources”).
Though information from “other sources,” like a CRNP, cannot establish the existence of a medically
determinable impairment, opinions from medical sources who are not technically acceptable medical
sources under the Social Security regulations are important and should be evaluated in assessing the
functional effects and severity of impairments. SSR 06–3p, 2006 WL 2329939 at *3. Furthermore,
although the Social Security regulations do not explicitly address how to evaluate opinions from “other
sources,” the factors outlined in 20 C.F.R. § 404.1527 can be applied to opinion evidence from “other
sources” like a CRNP. Id. at *4.
3
In July 2016, Dr. Niharika Sharma determined after testing that Caudle had no underlying
autoimmune condition. (Tr. 297).
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Despite her claims of disabling foot pain, Caudle reported in her Function
Report that she can walk a half mile before needing to rest 10 to 15 minutes. (Tr. 178).
She also conveyed to Dr. Lucile Bodenheimer that she walks at least a mile three times
a week, taking 10 to 15 minutes to complete the walk. (Tr. 282). Caudle uses no
assistive device for walking and stated no doctor has prescribed such a device for her.
(Tr. 60, 180, 232).
Despite the diagnoses indicating Caudle’s foot pain, no treating or examining
physician imposed restrictions on Caudle which would prevent her from performing
any work. In fact, the consulting examining physicians found Caudle could perform
work with some or no restrictions. Inasmuch as Caudle has not challenged the RFC
assigned by the ALJ, her argument that the ALJ should have found her foot pain severe
lacks merit.
Caudle also appears to fault the ALJ for finding dermatofibroma 4 to be a slight
or non-severe abnormality at step two, to the extent he considered her foot pain. The
medical records contain only one documentation of a dermatofibroma on Caudle’s left
inner thigh on June 3, 2016. Dr. Eric Baum treated the nodule with an injection. (Tr.
310-11). The record contains no mention of recurrence or other problem with this
skin condition, nor any indication it limited her ability to work.
Further, the
A dermatofibroma is a “fibrous tumor-like nodule of the dermis.” Dorland’s Illustrated Medical
Dictionary 452 (27th ed. 1988). It also goes by the name “benign fibrous histiocytoma.”
https://www.merckmanuals.com/professional/dermatologic-disorders/benign-skin-tumors,-growth
s,-and-vascular-lesions/dermatofibromas
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dermatofibroma had no connection with Caudle’s feet. Therefore, the ALJ committed
no error by finding the dermatofibroma non-severe and only a slight abnormality. The
ALJ also did not err because he identified severe impairments at step two and
proceeded to step three.
II. The Appeals Council Did Not Err in Failing to Consider New Evidence
Ms. Caudle argues that the Appeals Council improperly refused to review Dr.
Meador’s records solely because they were dated after the date of the decision, without
considering whether the records were chronologically relevant and material. Although
the court finds Dr. Meador’s opinion chronologically relevant in part, inasmuch as he
relied on Caudle’s medical records predating the ALJ’s decision, it fails to satisfy the
materiality standard.
Generally, a claimant may present new evidence at each stage of the
administrative process. Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1261 (11th
Cir. 2007) (citing 20 C.F.R. §404.900(b)). The Appeals Council retains discretion to
decline review of an ALJ’s denial of benefits. See 20 C.F.R. §§ 404.970(b), 416.1470(b)
(2012). However, the Appeals Council must consider evidence that is (1) new,
(2) material, and (3) chronologically relevant. Ingram, 496 F.3d at 1261 (citing 20 C.F.R.
§ 404.970(b)).
New evidence is material if it is relevant and probative “so that there is a
reasonable possibility that it would change the administrative result.” Hyde v. Bowen,
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823 F.2d 456, 459 (11th Cir. 1987) (citations omitted). Such evidence is chronologically
relevant if it “relates to the period on or before the date of the [ALJ] hearing decision.”
20 C.F.R. § 404.970(b); see also Keeton v. Dep’t of Health & Human Servs., 21 F.3d 1064, 1066
(11th Cir. 1994) (holding that the Appeals Council must evaluate the entire record,
including the new and material evidence submitted to it if it relates to the period on or
before the date of the ALJ hearing decision); Washington v. Soc. Sec. Admin., 806 F.3d
1317, 1322-23 (11th Cir. 2015) (evaluation conducted after the ALJ’s decision may be
chronologically relevant if it pertains to a period that pre-exists the ALJ’s opinion).
When a claimant properly presents new evidence, and the Appeals Council denies
review, it must demonstrate in its written denial that it adequately evaluated the new
evidence. Flowers v. Comm’r of Soc. Sec., 441 F. App’x 735 (11th Cir. 2011) (citing Epps v.
Harris, 624 F.2d 1267, 1273 (5th Cir. 1980)).
The Appeals Council denied review in this case on April 11, 2017. In finding
the newly submitted records chronologically irrelevant, the Appeals Council stated:
We also looked at medical records from William Meador, M.D., dated
February 22, 2017 (6 pages). The Administrative Law Judge decided your
case through January 30, 2017. This new information is about a later
time. Therefore, it does not affect the decision about whether you were
disabled beginning on or before January 30, 2017.
(Tr. 2). As indicated, the Appeals Council concluded the records reflected a time
period later than that considered by the ALJ. The Appeals Council did not need to
give a more detailed explanation or to address each piece of new evidence individually.
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See Mitchell v. Comm’r, Soc. Sec. Admin., 771 F.3d 780, 784 (11th Cir. 2014); White v. Comm’r
of Soc. Sec. Admin., No. 4:16-cv-00248-JHE, 2017 WL 4246895, at *4 (N.D. Ala. Sept. 25,
2017) (finding Appeals Council explanation that “new information is about a later time”
sufficiently established Appeals Council considered substance of new records); Zanders
v. Berryhill, No. CA 16-0542-MU, 2017 WL 3710790, at *14 (S.D. Ala. Aug. 28, 2017),
citing Mitchell, 771 F.3d at 784-85, and Beavers, 601 F. App’x at 822 (finding Appeals
Council statement that it reviewed new evidence and concluded it related to “a later
time” was sufficiently directed to materiality and/or chronological relevance and did
not amount to an inadequate or perfunctory evaluation of the evidence).
Dr. Meador examined Caudle on February 22, 2017, to evaluate her foot pain.
(Tr. 8). In preparing his notes, he relied on Caudle’s self-report of her symptoms, as
well as reviewing records from the referring facility and physicians. (Tr. 8, 11). Upon
examination, Caudle displayed abnormal balance and an antalgic gait and reported pain
of 10/10, yet she had normal muscle strength and reflexes, and intact sensation in all
extremities. (Tr. 11). Dr. Meador noted bilateral tenderness to pressure at the fifth
toe joints.
(Tr. 11).
After the examination, Dr. Meador diagnosed restless leg
syndrome and bilateral foot pain, yet he found the source of her pain unclear. He
suspected a musculoskeletal issue, but also noted the possible presence of a neuropathic
or vascular component. (Tr. 11). Therefore, he recommended nerve conduction
testing and electromyogram of the lower extremities and ankle brachial indices for
16
diagnostic purposes. Dr. Meador noted Caudle’s other physician’s assessment that the
pain had no relation to a foot or bone problem, but stated he would highly question this
opinion depending on the results of his tests. (Tr. 12). Dr. Meador concluded his
report by opining “disability may be indicated” if Caudle is unable to work based on her
foot problems; however, he includes no finding of disability, restrictions, or limitations
attendant with Caudle’s reports of foot pain. (Tr. 12).
Notably absent from Dr. Meador’s report are results from any objective medical
testing or any actual opinion as to Caudle’s foot pain or its source. Dr. Meador also
imposed no restrictions or limitations on Caudle’s activities based on her foot pain.
Dr. Meador based his report primarily on Caudle’s statements to him and her other
physician about her foot pain. He conducted a basic physical examination and noted
Caudle expressed tenderness upon pressure to each little toe and exhibited an antalgic
gait. Dr. Meador’s notes reflect no new diagnoses and do not contain any opinion.
His findings also contrast with examinations conducted prior to the ALJ’s opinion, in
which Caudle exhibited a normal gait and the ability to heel-toe walk, as reviewed above.
Because the court finds no reasonable possibility that Dr. Meador’s report would
change the administrative result, his records do not constitute material evidence, and
the AC properly rejected consideration of them, other than to find they addressed a
time after the ALJ’s decision.
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CONCLUSION
Based on the foregoing analysis, the court AFFIRMS the Commissioner’s
decision.
The court will enter a separate final order in conformity with this
Memorandum Opinion.
DONE this 31st day of August, 2018.
____________________________________
HERMAN N. JOHNSON, JR.
UNITED STATES MAGISTRATE JUDGE
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