Merkle v. Social Security Administration, Commissioner

Filing 11

MEMORANDUM OPINION. Signed by Judge Abdul K Kallon on 06/25/12. (CVA)

FILED
2012 Jun-25 PM 02:28
U.S. DISTRICT COURT
N.D. OF ALABAMA

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
NORTHEASTERN DIVISION
AMANDA K. MERKLE,
Plaintiff,
vs.
MICHAEL J. ASTRUE,
COMMISSIONER OF SOCIAL
SECURITY
ADMINISTRATION,
Defendant.

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Civil Action Number
5:11-cv-2263-AKK

MEMORANDUM OPINION
Plaintiff Amanda K. Merkle (“Merkle”) brings this action pursuant to
sections 205(g) and 1631(c)(3) of the Social Security Act (“the Act”), 42 U.S.C.
§§ 405(g) and 1383(c)(3), seeking review of the final adverse decision of the
Commissioner of the Social Security Administration (“SSA”). Doc. 1. This court
finds that the Administrative Law Judge’s (“ALJ”) decision - which has become
the decision of the Commissioner - is supported by substantial evidence.
Therefore, for the reasons elaborated herein, the Court will AFFIRM the decision
denying benefits.

Page 1 of 23

I. Procedural History
Merkle filed her application for Title XVI Supplemental Security Income
(“SSI”) on February 20, 2008, and originally alleged a disability onset date of
April 1, 2007, due to disorders of the back (discogenic and degenerative) and
anxiety related disorders. (R. 64). Merkle subsequently amended her alleged
disability onset date to February 20, 2008, the date of her SSI application. (R. 91).
After the SSA denied her application on May 30, 2008, (R. 65-69), Merkle
requested a hearing on June 19, 2008, (R. 72-74), which she received on
December 22, 2009, (R. 39-62). At the time of the hearing, Merkle was 37 years
old with a seventh grade education. (R. 41). Her past relevant work included light
to heavy unskilled work as a cashier/manager at fast food restaurants, mental
health worker at a residential facility, chicken vaccinator at a poultry hatchery, and
laundry folder at a uniform cleaning facility. (R. 29). Merkle has not engaged in
substantial gainful activity since February 20, 2008. (R. 19).
The ALJ denied Merkle’s SSI claim on February 8, 2010, (R. 30), which
became the final decision of the Commissioner when the Appeals Council refused
to grant review on April 28, 2011, (R. 1-4). Merkle then filed this action on June
24, 2011, pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). Doc. 1.

Page 2 of 23

II. Standard of Review
The only issues before this court are whether the record contains substantial
evidence to sustain the ALJ’s decision, see 42 U.S.C. § 405(g); Walden v.
Schweiker, 672 F.2d 835, 838 (11th Cir. 1982), and whether the ALJ applied the
correct legal standards, see Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988);
Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). Title 42 U.S.C. §§ 405(g)
and 1383(c) mandate that the Commissioner’s “factual findings are conclusive if
supported by ‘substantial evidence.’” Martin v. Sullivan, 894 F.2d 1520, 1529
(11th Cir. 1990). The district court may not reconsider the facts, reevaluate the
evidence, or substitute its judgment for that of the Commissioner; instead, it must
review the final decision as a whole and determine if the decision is “reasonable
and supported by substantial evidence.” See id. (citing Bloodsworth v. Heckler,
703 F.2d 1233, 1239 (11th Cir. 1983)).
Substantial evidence falls somewhere between a scintilla and a
preponderance of evidence; “[i]t is such relevant evidence as a reasonable person
would accept as adequate to support a conclusion.” Martin, 849 F.2d at 1529
(quoting Bloodsworth, 703 F.2d at 1239) (other citations omitted). If supported by
substantial evidence, the court must affirm the Commissioner’s factual findings
even if the preponderance of the evidence is against the Commissioner’s findings.
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See Martin, 894 F.2d at 1529. While the court acknowledges that judicial review
of the ALJ’s findings is limited in scope, it notes that the review “does not yield
automatic affirmance.” Lamb, 847 F.2d at 701.
III. Statutory and Regulatory Framework
To qualify for disability benefits, a claimant must show “the inability to
engage in any substantial gainful activity by reason of any medically determinable
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
months.” 42 U.S.C. § 416(i); 42 U.S.C. § 423(d)(1)(A). A physical or mental
impairment is “an impairment that results from anatomical, physiological, or
psychological abnormalities which are demonstrated by medically acceptable
clinical and laboratory diagnostic techniques.” 42 U.S.C. § 423(d)(3); see also 42
U.S.C. § 416(i)(1).
Determination of disability under the Act requires a five step analysis. See
20 C.F.R. §§ 404.1520(a)-(f), 416.920(a)-(f). Specifically, the Commissioner
must determine in sequence:
(1)

whether the claimant is currently unemployed;

(2)

whether the claimant has a severe impairment;

(3)

whether the impairment meets or equals one listed by the Secretary;
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(4)

whether the claimant is unable to perform his or her past work; and

(5)

whether the claimant is unable to perform any work in the national
economy.

McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986). “An affirmative
answer to any of the above questions leads either to the next question, or, on steps
three and five, to a finding of disability. A negative answer to any question, other
than step three, leads to a determination of ‘not disabled.’” Id. at 1030 (citing 20
C.F.R. § 416.920(a)-(f)). “Once a finding is made that a claimant cannot return to
prior work the burden shifts to the Secretary to show other work the claimant can
do.” Foote v. Chater, 67 F.3d 1553, 1559 (11th Cir. 1995) (citation omitted).
Lastly, where, as here, a plaintiff alleges disability because of pain, she must
meet additional criteria. In this circuit, “a three part ‘pain standard’ [is applied]
when a claimant seeks to establish disability through his or her own testimony of
pain or other subjective symptoms.” Holt v. Barnhart, 921 F.2d 1221, 1223 (11th
Cir. 1991). Specifically,
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.1

1

This standard is referred to as the Hand standard, named after Hand v. Heckler, 761
F.2d 1545, 1548 (11th Cir. 1985).
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Id. However, medical evidence of pain itself, or of its intensity, is not required:
While both the regulations and the Hand standard require objective
medical evidence of a condition that could reasonably be expected to
cause the pain alleged, neither requires objective proof of the pain
itself. Thus under both the regulations and the first (objectively
identifiable condition) and third (reasonably expected to cause pain
alleged) parts of the Hand standard a claimant who can show that his
condition could reasonably be expected to give rise to the pain he
alleges has established a claim of disability and is not required to
produce additional, objective proof of the pain itself. See 20 CFR §§
404.1529 and 416.929; Hale [v. Bowen, 831 F.2d 1007, 1011 (11th
Cir. 1987)].
Elam v. R.R. Ret. Bd., 921 F.2d 1210, 1215 (11th Cir. 1991) (parenthetical
information omitted) (emphasis added). Moreover, “[a] claimant’s subjective
testimony supported by medical evidence that satisfies the pain standard is itself
sufficient to support a finding of disability.” Holt, 921 F.2d at 1223. Therefore, if
a claimant testifies to disabling pain and satisfies the three part pain standard, the
ALJ must find a disability unless the ALJ properly discredits the claimant’s
testimony.
Furthermore, when the ALJ fails to credit a claimant’s pain testimony, the
ALJ must articulate reasons for that decision:
It is established in this circuit that if the [ALJ] fails to articulate reasons for
refusing to credit a claimant’s subjective pain testimony, then the [ALJ], as
a matter of law, has accepted that testimony as true. Implicit in this rule is
the requirement that such articulation of reasons by the [ALJ] be supported
by substantial evidence.

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Hale, 831 F.2d at 1012. As such, if the ALJ either fails to articulate reasons for
refusing to credit the plaintiff’s pain testimony, or if the ALJ’s reasons are not
supported by substantial evidence, the court must accept as true the pain testimony
of the plaintiff and render a finding of disability. Id.
IV. The ALJ’s Decision
The court turns now to the ALJ’s decision to ascertain whether Merkle is
correct that the ALJ committed reversible error. In that regard, the court notes
that, performing the five step analysis, the ALJ initially determined that Merkle
had not engaged in substantial gainful activity since her alleged onset date, and
therefore met Step One. (R. 19). Next, the ALJ found that Merkle suffers from
the following severe impairments: “low back pain with early spondylosis of
thoracic and lumbar spine and spina bifida occulta at S1, sacroilitis, degenerative
joint disease of the right hip, and obesity,” id., but that Merkle’s edema,
headaches, fibromyalgia, osteoporosis, medication side effects, and alleged mental
impairments are not severe impairments, (R. 19-23). The ALJ then proceeded to
the next step and found that Merkle failed to satisfy Step Three because she “does
not have an impairment or combination of impairments that meets or medically
equals one of the listed impairments.” (R. 18). Although the ALJ answered Step
Three in the negative, consistent with the law, see McDaniel, 800 F.2d at 1030, the

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ALJ proceeded to Step Four, where he determined that “claimant has the residual
functional capacity [‘RFC’] to perform the full range of sedentary work as defined
in 20 CFR 416.967(a).” (R. 23). Moreover, in light of Merkle’s RFC, the ALJ
held that Merkle is “unable to perform any past relevant work.” (R. 29). Lastly, in
Step Five, the ALJ considered Merkle’s age, education, work experience, and
RFC, and determined—based exclusively on the Medical Vocational Guidelines
found in 20 C.F.R. Part 404, Subpart P, Appendix 2, section 201.24—that “there
are jobs that exist in significant numbers in the national economy that the claimant
can perform.” (R. 30). Because the ALJ answered Step Five in the negative, the
ALJ determined that Merkle “has not been under a disability, as defined in the
Social Security Act, from February 20, 2008 through the date of this decision.” Id.
See also McDaniel, 800 F.2d at 1030.
V. Analysis
The court turns now to Merkle’s contention of error that “[b]y finding no
severe mental impairment and a capacity for a full range of sedentary work, and
directly applying [the Medical Vocational Rules or the ‘Grids’], the ALJ
circumvented the need to identify specific and available jobs in establishing that
Plaintiff is capable of other than past work.” Doc. 9, at 5. Stated differently,
Merkle contends that the ALJ erroneously utilized the Grids, as opposed to a
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Vocational Expert (“VE”), in performing Step Five because she suffers from a
“severe” mental impairment and her obesity and pain prevent performance of the
full range of sedentary work. Id. at 5-8. The court disagrees and finds the ALJ’s
decision supported by substantial evidence.
In finding that Merkle can perform jobs that exist in the national economy,
the ALJ utilized the Grids found in 20 C.F.R. Part 404, Subpart P, Appendix 2,
rather than employ the services of a VE. (R. 19-30). See also 20 C.F.R. §
416.969. The agency regulations provide that “when all factors coincide with the
criteria of a [Grid] rule, the existence of such jobs is established. However, the
existence of such jobs for individuals whose remaining functional capacity or
other factors do not coincide with the criteria of a [Grid] rule must be further
considered in terms of what kinds of jobs or types of work may be either
additionally indicated or precluded.” 20 C.F.R. Part 404, Subpart P, Appendix 2,
section 200.00(b). In other words, where, as here, “the claimant has established
that she cannot return to her past relevant work, the burden shifts to the Secretary
to prove that the claimant is capable, considering her age, education, and work
experience, of engaging in any other kind of employment. At this stage, the
Medical Vocational Guidelines, 20 C.F.R. pt. 404, subpt. P, app. II (the grids),
may come into play.” Walker v. Bowen, 826 F.2d 996, 1002 (11th Cir. 1987).
Page 9 of 23

And indeed, “[t]he grids may be used only when each variable on the appropriate
grid accurately describes the claimant’s situation.” Id. at 1003.
The ALJ found that Merkle squarely met the requirements for Grid section
201.24. (R. 30). This Grid provides that if (a) the claimant’s “maximum sustained
work capability [is] limited to sedentary work as a result of severe medically
determinable impairment(s);” (b) the claimant is between the age of 18-44; (c) the
claimant is at least literate and able to communicate in English; and (d) the
claimant has either unskilled or no previous work experience, then the claimant is
not disabled. 20 C.F.R. Part 404, Subpart P, Appendix 2, section 201.24.
Conversely, “‘[e]xclusive reliance on the grids is not appropriate either
when claimant is [1] unable to perform a full range of work at a given functional
level or [2] when a claimant has non-exertional impairments that significantly
limit basic work skills.’” Id. at 1002-03 (quoting Francis v. Heckler, 749 F.2d
1562, 1566 (11th Cir. 1985)). For “exertional” impairments, the claimant must be
able to do “‘unlimited’ types of work at the given exertional level.” Phillips v.
Barnhart, 357 F.3d 1232, 1242 (11th Cir. 2004). Thus, for the “sedentary”
exertional level:
Sedentary work involves lifting no more than 10 pounds at a time and
occasionally lifting or carrying articles like docket files, ledgers, and
small tools. Although a sedentary job is defined as one which
Page 10 of 23

involves sitting, a certain amount of walking and standing is often
necessary in carrying out job duties. Jobs are sedentary if walking and
standing are required occasionally and other sedentary criteria are
met.
20 C.F.R. § 416.967(a). See also Walker, 826 F.2d at 1000. To properly utilize a
Grid level that contains a sedentary work RFC, “the ALJ must determine whether
[claimant] can perform a full range or unlimited types of work at the sedentary
level given her exertional limitations.” Phillips, 357 F.3d at 1242.
As it relates to any nonexertional limitations, “the ALJ need only determine
whether [the claimant’s] nonexertional impairments significantly limit her basic
work skills.” Id. at 1243. For purposes of the Grids, the Eleventh Circuit “has
interpreted ‘significantly limit basic work skills’ as limitations that prohibit a
claimant from performing ‘a wide range’ of work at a given work level.” Id.
(citing Foote v. Chater, 67 F.3d 1553, 1559 (11th Cir. 1995)). In sum, “[i]f the
ALJ determines that [the claimant’s] nonexertional limitations do not significantly
limit her basic work skills at the sedentary work level, then the ALJ may rely on
the grids to determine if [the claimant] is disabled. If, however, the ALJ
determines that [the claimant’s] nonexertional limitations significantly limit her
basic work skills at the sedentary level, then the ALJ must consult a vocational
expert.” Id.

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Merkle argues that her mental impairments, obesity, and pain foreclose use
of Grid section 201.24 because these impairments prohibit the performance of a
wide and/or full range of sedentary work. The court addresses each impairment in
turn.
A.

Mental Impairments
The ALJ found that, for Step Two of the sequential process, Merkle’s

mental impairments failed to rise to the level of severe impairments. Specifically,
Merkle’s “course of treatment does not suggest the presence of any symptoms or
limitations that would more than minimally interfere with her ability to engage in
work-related activities.” (R. 22). The ALJ further determined that Merkle’s
mental impairments “have resulted in no more than a mild restriction of daily
living activities, mild difficulty with maintaining social functioning, and mild
difficulty with maintaining concentration, persistence and pace. [Merkle] has
experienced no episodes of decompensation which have been of extended
duration.” (R. 23). To ascertain the severity of a mental impairment, the agency
regulations establish that the ALJ must assess four functional limitation criteria:
“Activities of daily living; social functioning; concentration, persistence, or pace;

Page 12 of 23

and episodes of decompensation.” 20 C.F.R. § 404.1520a.2 The regulations
further provide that, in some circumstances, these functional limitations may not
rise to the level of a “severe” impairment for purposes of Step Two in the
sequential process. See 20 C.F.R. § 404.1520a-(d)(1) (“If we rate the degree of
your limitation in the first three functional areas as ‘none’ or ‘mild’ and ‘none’ in
the fourth area, we will generally conclude that your impairment(s) is not severe,
unless the evidence otherwise indicates that there is more than a minimal
limitation in your ability to do basic work activities.”); 20 C.F.R. § 404.1521;
Moore v. Barnhart, 405 F.3d 1208, 1213-14 (11th Cir. 2005). Substantial
evidence supports the ALJ’s finding for Merkle’s purported mental impairments.
The medical evidence regarding Merkle’s mental impairments consists of a
May 29, 2008 Mental Examination by Barry Wood, Ph. D., (R. 256-259), and the
Psychiatric Review Technique by Dr. Robert Estock, (R. 265-278). Dr. Wood
provided in the psychiatric/behavioral history section that “claimant reported she
first received psychiatric treatment during her early 20’s. At that time she was
prescribed Xanax by a family physician to address generalized anxiety and panic
2

“When we rate the degree of limitation in the first three functional areas (activities of
daily living; social functioning; and concentration, persistence, or pace), we will use the
following five-point scale: None, mild, moderate, marked, and extreme. When we rate the degree
of limitation in the fourth functional area (episodes of decompensation), we will use the
following four-point scale: None, one or two, three, four or more.” 20 C.F.R. § 404.1520a(c)(4).
Page 13 of 23

episodes . . . . She next received psychiatric treatment during the late 1990’s. At
that time she was prescribed Xanax again to address a severe gastric ulcer she
characterized as stress-related. She reported she continued to take Xanax since
that time with good effect . . . . She denied any history of psychotropic-medication
use beyond that detailed above.” (R. 257). Furthermore, Dr. Wood stated that
Merkle “reported she visited the ER for panic on perhaps 15-20 occasions. In fact,
she reported that she was forced to visit Decatur General Hospital to address panic
on the night prior to the interview.” Id.
For “mental status,” Dr. Wood provided that Merkle “was oriented x3. Her
affect was constricted, but it became euthymic during unguarded moments. Her
mood appeared to be more dysphoric than anxious, but it also improved during
unguarded moments. Significant dramatic flair and even greater passive
aggression were evident throughout the interview. Her short-term memory
appeared to be intact as evidence by her ability to identify details of events from
the day prior to the interview. Her long term memory appeared to fall within
normal limits as evidenced by her recitation of history.” (R. 258). Finally, Dr.
Wood concluded that Merkle’s “generalized anxiety appears to be largely
controlled with medication, and her panic episodes are partially controlled. The
probability that she also struggles with personalogic deficits is high.” Id. As
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such, “[t]he examiner believes the claimant is able to understand instructions,
recall instructions, and execute the instructions to the extent allowed by her
physical status. The examiner believes her mood symptoms and likely
personalogic symptoms affect-but-do-not-preclude her ability to interact with
supervisors, coworkers, and customers.” (R. 259) (emphasis added). Therefore,
Dr. Wood diagnosed Merkle with Panic Disorder without Agoraphobia (in partial
remission with medication), Generalized Anxiety Disorder (in remission), and
Personality Disorder NOS with Features of Negativistic (passive-aggressive)
Personality Disorder (provisional). Dr. Wood also gave Merkle a Global
Assessment of Functioning (“GAF”) score of 67. Id.
Similarly, Dr. Robert Estock found that Merkle suffered from “not severe”
mental impairments after reviewing Dr. Wood’s Mental Examination and the other
medical evidence of record. (R. 277). Specifically, Dr. Estock concluded that
Merkle’s mental impairments created a mild limitation on activities of daily living,
a mild limitation in social functioning, and a mild limitation in maintaining
concentration, persistence, or pace. Dr. Estock also found that Merkle suffered
from no episodes of decompensation. (R. 275).
Furthermore, Merkle’s extensive emergency room records fail to
corroborate the assertion that she sought aggressive treatment for mental
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impairments. (R. 153-248, 279-294, 297-386). While Merkle claimed a past
medical history of anxiety for certain emergency room visits, the emergency room
records only reveal two instances of contemporaneous anxiety complaints—a
January 30, 2008 visit to the emergency room for an insect bite where Merkle
claimed anxiety, (R. 164-165), and a December 14, 2008 presentation to the
emergency room for anxiety because she was “scared to take medicine,” (R. 379384). Finally, Dr. Edwin K. Matthews diagnosed Merkle with anxiety disorder
NOS, (R. 395), but Dr. Matthews’ medical records offer no indication of treatment
for this mental impairment besides the Xanax prescription, and no indication of
limiting effects on Merkle’s daily activities, (R. 395). Indeed, in most treatment
notes from Dr. Mark A. Murphy, Merkle’s treating pain management physician, he
considers the Xanax “effective” and without side effects. (R. 399-459, 467-558).
Dr. Murphy also provided no indication of any mental impairments, let alone
severe mental impairments. Id.
Thus, the objective medical evidence reveals that Merkle takes Xanax for
anxiety, but has received no more than minimal and conservative mental health
treatment or hospitalization for mental impairments. Moreover, two medical
experts found only mild mental impairments. As such, the ALJ’s finding of “nonsevere” mental impairments is supported by substantial evidence. Moreover, by
Page 16 of 23

finding only “non-severe” mental impairments, the ALJ concluded that Merkle’s
mental impairments caused no more than minimal limitations on the ability to
engage in work related activities. (R. 22). This finding corresponds with the
Grids analysis regarding nonexertional limitations. See Phillips, 357 F.3d at 1242.
In other words, as Merkle’s mental impairments create no more than minimal
limitations on work related activities, she can still perform a “wide range” of
sedentary work. Id. (“If the ALJ determines that [the claimant’s] nonexertional
limitations do not significantly limit her basic work skills at the sedentary work
level, then the ALJ may rely on the grids to determine if [the claimant] is
disabled.”).
B.

Obesity
Merkle also contends that the ALJ erred by failing to factor her obesity into

the sedentary work RFC. Doc. 9, at 7. Generally, where, as here, the ALJ finds
that a claimant’s obesity is a medically determinable impairment, (R. 19), the ALJ
should consider any functional limitations resulting from the obesity in the RFC
assessment. SSR 02-1p, 2002 WL 34686281, at *7 (S.S.R. Sept. 12, 2002).
However, a claimant must still “specify how [her] obesity further impaired [her]
ability to work [rather than] speculate[] merely that [her] weight makes it more
difficult to stand and walk.” Skarbek v. Barnhart, 105 F. App’x 836, 840 (7th Cir.
Page 17 of 23

2004). Thus, while Merkle correctly establishes that “SSR 02-1p recognizes that
obesity can cause limitations in all exertional and postural functions; that it can
affect an individual’s ability to sustain routine movement and work activity,” doc.
9, at 7, the ALJ also correctly concluded that “the record reveals that no physician
treating [Merkle] reported that [Merkle’s] weight significantly limited her or
caused her any problems with musculoskeletal impairments,” (R. 25-26). At the
ALJ hearing Merkle maintained that her doctors “wanted [her] to start trying to
walk two miles” per day for exercise. (R. 50). However, other than this
recommendation, the medical evidence offers no other mention of functional
impairments due to obesity. As such, substantial evidence supports the ALJ’s
decision that Merkle can perform the “full range or unlimited types of work at the
sedentary level” even though she suffers from obesity. See Phillips, 357 F.3d at
1242.
C.

Pain
Finally, Merkle argues, without analysis, that the ALJ erred because he

“avoided factoring in any assessment of pain level in his blanket RFC finding for
sedentary work.” Doc. 9, at 7. The court again disagrees. The ALJ determined
that, while Merkle suffers from the severe impairments of “low back pain with
early spondylosis of thoracic and lumbar spine and spina bifida occulta at S1,
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sacroilitis, degenerative joint disease of the right hip, and obesity,” (R. 19),
Merkle’s “statements concerning the intensity, persistence, and limiting effects of
these symptoms are not credible to the extent they are inconsistent” with the
ability to perform a wide range of work at the sedentary level. See Phillips, 357
F.3d at 1242 n.11 (listing pain limitations as nonexertional limitations).
Substantial evidence supports this conclusion because Merkle’s “objectively
determined medical condition is [not] of such a severity that it can be reasonably
expected to give rise to the alleged pain.” Holt, 921 F.2d at 1223.
First, Merkle’s purported daily activities are consistent with an ability to
perform a wide range of sedentary work. Merkle testified that she walks a block
to her daughter’s house two or three times a week, (R. 50), and is able to stand for
an hour and sit for an hour, (R. 57). Merkle is the primary care giver for her nine
year old niece and prepares easy meals and shops for personal needs on a monthly
basis. (R. 44, 109). Merkle is able to independently care for her personal needs
such as bathing, grooming, and dressing, and she also performs household chores,
watches television, talks with friends on the telephone, and reads the newspaper.
(R. 108-110). Moreover, in the Disability Examination, Dr. Marlin Gill provided
that Merkle’s “[g]ait is normal. She walks unassisted and uses no devices. Upper
extremities appear normal and symmetrical. She complains of pain with shoulder
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movement but otherwise uses the extremities well.” (R. 253). While noting that
Merkle “gives questionable effort for this portion of the exam,” Dr. Gill also
provided that Merkle “jumps and complains of pain with light fingertip touch
anywhere over the lumbar spine. She complains of pain with any lumbar
movement.” Id.
However, Merkle’s medical records indicate only objectively minor spinerelated issues. On June 14, 2007, Dr. Malcolm H. Weathers performed a six view
lumbar spine x-ray and found “no evidence of fracture or subluxation. Some
degenerative changes of the lumbar and lower thoracic spine noted.” (R. 198).
Similarly, on February 21, 2008, Dr. Weathers performed another six view lumbar
spine x-ray and found “mild degenerative changes. There is no evidence of
fracture, subluxation or destructive lesions.” (R. 155). Dr. Frank P. Scalfano
performed a five view lumbosacral spine series with obliques on January 6, 2007
and determined that Merkle’s “pedicles are intact. There is no evidence of acute
fracture or subluxation. No acute disease.” (R. 215). Moreover, after a whole
body scan by Dr. Weathers on September 6, 2006, Merkle presented “no abnormal
spinal activity . . . . There is no evidence of abnormal activity to correspond with
the L3 vertebral body lesion on the 8/28/06 MRI.” (R. 227). Furthermore, the
August 7, 2006 lumbar spine x-ray by Dr. G.L. South revealed that Merkle’s
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“alignment appears within normal limits. The disc spaces appear maintained. No
bony abnormality noted,” (R. 239), and the August 26, 2007 exam by Dr. Jere
Michael Disney revealed a “mild scoliosis of the thoracic spine. No disc space
narrowings, subluxations, or acute fractures . . . . There is some early spondylosis
noted . . . . The examination of the lumbar spine reveals no disc space narrowings,
subluxations, or acute fractures. A spina bifida occulta is noted at S1. There is
some early spondylosis noted. Some mild bilateral sacroilitis is noted.” (R. 460).
Finally, on December 15, 2009, Merkle received a lumbar MRI, and Dr. Thomas
G. Harrell found: “Lower thoracic cord and conus are normal. There is benign
intraosseous hemangioma at the L3 level. It measures approximately 10 mm. The
vertebrae are otherwise negative . . . . No evidence of herniation or nerve root
abnormality.” (R. 512-514).
In addition to the spine testings performed at the Decatur Hospital
emergency room, Dr. Murphy’s treatment notes demonstrate that Merkle’s pain
was well-managed and under control. Namely, Dr. Murphy’s notes provide that,
after treatment, Merkle suffered from little if any pain. See (R. 399, 404, 409, 414,
419, 423, 427, 431, 437, 441, 448, 467, 469, 473, 477, 482, 486, 490, 494, 498,
503, 507, 515, 517, 521, 525, 529, 533, 537, 541, 545, 549, 553). And indeed, Dr.
Murphy maintained without exception that Merkle tolerated the pain medication
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and pain management well with no side effects. Id. In fact, Dr. Murphy’s records
offer no opinion that Merkle’s pain affected her daily activities or ability to
perform work-related activities. Id. Accordingly, the objective medical evidence
supports the ALJ’s statement that Merkle’s “pain was well controlled with only
the same oral medications and no special intervention, referral to any specialists,
or mention of change in regimen, any deterioration or worsening of her condition,
or any surgical intervention.” (R. 26).
In sum, the ALJ exhaustively considered Merkle’s numerous subjective pain
complaints and found the severity of these allegations not credible based on the
objective medical evidence and activities Merkle performs on a daily basis.
Accordingly, the ALJ adequately considered, and ultimately rejected, the
contention that Merkle’s pain prevents her from performing a wide range of
sedentary work. Thus, substantial evidence supports the sedentary work RFC and
the ALJ’s corresponding reliance on Grid section 201.24 to find Merkle not
disabled.
VI. Conclusion
Based on the foregoing, the court concludes that the ALJ’s determination
that Merkle is not disabled is supported by substantial evidence, and that the ALJ
applied proper legal standards in reaching this determination. Therefore, the
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Commissioner’s final decision is AFFIRMED. A separate order in accordance
with the memorandum of decision will be entered.

Done the 25th day of June, 2012.
________________________________
ABDUL K. KALLON
UNITED STATES DISTRICT JUDGE

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