Hamby v. Social Security Administration, Commissioner
MEMORANDUM OPINION, as set out. Signed by Judge R David Proctor on 8/5/13. (CTS, )
2013 Aug-05 PM 04:00
U.S. DISTRICT COURT
N.D. OF ALABAMA
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
LINNE ANNE HAMBY,
CAROLYN W. COLVIN, Commissioner }
of Social Security,
Civil Action No.: 5:11-CV-03617-JFG
MEMORANDUM OF DECISION
Plaintiff Linne Anne Hamby brings this action pursuant to Title XVI of Section 1631(c)(3)
of the Social Security Act (the “Act”), seeking review of the decision by the Commissioner of the
Social Security Administration (“Commissioner”) denying her claim for Supplemental Security
Income (“SSI”). See 42 U.S.C. § 1383(c). Based upon 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.
This action arises from Plaintiff’s application for SSI, filed protectively on March 31, 2009,
alleging disability beginning March 31, 2009. (Tr. 18, 81-88, 95, 106).1 The Social Security
Administration denied Plaintiff’s claim on June 8, 2009. (Tr. 61-66). Unsatisfied with the
Commissioner’s decision, Plaintiff requested a hearing before an Administrative Law Judge. (Tr.
69). Plaintiff’s request was granted, and a hearing was held on September 13, 2010, before
Administrative Law Judge Patrick R. Digby (“ALJ”). (Tr. 40-59). In his decision dated November
Plaintiff initially alleged she became disabled on May 1, 2005, but she amended her onset date via a letter sent
by her representative to the Administrative Law Judge. (Tr. 81, 95).
18, 2010, the ALJ concluded that Plaintiff had not been under a disability within the meaning of §
1614(a)(3)(A) of the Act since March 31, 2009, the amended alleged onset date. (Tr. 28). The
Appeals Council then denied Plaintiff’s request for review of the ALJ’s decision (Tr. 1-3), thus
making the Commissioner’s decision final and a proper subject of this court’s judicial review. See
42 U.S.C. § 1383(c)(3).
Plaintiff was forty-seven years of age at the time of the ALJ’s decision. (Tr. 81). Plaintiff has
a limited education (Tr. 27), and has prior work experience as a swing machine operator, sleeve
setter, zipper setter and material handler. (Tr. 54-55). Plaintiff alleged disability based on back and
neck pain. (Tr. 98).
At the ALJ hearing Plaintiff testified that the biggest reason she believed she was unable to
work was her back pain. (Tr. 46). There is only one treatment note in the record for Plaintiff’s back
impairment. On February 11, 2005, Plaintiff was referred to Dr. Ellis, at the Decatur Orthopaedic
Clinic by her gynecologist, Dr. Manifold. (Tr. 220). She reported she had suffered pain in her back
for the previous year. Id. Examination of the lumbar spine revealed some tenderness in the midline
and paraspinal muscles. Id. There was also some tenderness over the sacroiliac joints bilaterally. Id.
Range of motion in the lumbar spine was within normal limits for flexion/extension, both of which
“cause[d] a little bit of pain.” Id. Plaintiff’s neurological strength in the lower extremity myotomes
was 5/5, and sensation was intact to the corresponding dermatomes.2 Id. Plaintiff was able to heel
“Testing of myotomes, in the form of isometric resisted muscle testing, provides the clinician with information
about the level in the spine where a lesion may be present.” http://en.wikipedia.org/wiki/Myotome. Dermatome is “the
area of skin supplied with afferent nerve fibers by a single posterior spinal root.” Dorland’s Illustrated Medical
Dictionary 449 (28th Edition).
and toe walk, and performed a deep knee bend without difficulty. Id. She had a positive Patrick’s
test bilaterally, and a negative straight leg raise test.3 Id.
Dr. Ellis interpreted X-rays of the lumbar spine as showing “degenerative changes primarily
at L5-S1 with loss of the normal disc height.” Id. Otherwise he did “not detect any significant
abnormality.” Id. Dr. Ellis diagnosed degenerative disc disease and lumbosacral radiculitis. Id.
Plaintiff was prescribed Relafen4 and home exercise. Id. She was to return in about a month to assess
her progress. Id.
Plaintiff saw Dr. Manifold on February 23, 2005, for treatment of “[s]ymptomatic uterine
prolapse with pelvic pain and lower back ache.” (Tr. 161). Plaintiff told Dr. Manifold that Dr. Ellis
believed her “uterine prolapse and dysmenorrhea was contributing greatly to her added discomfort.”
Id. On February 24, 2005, Dr. Manifold discussed Plaintiff’s condition with Dr. Ellis. Id. His note
of the conversation indicates the treatment plan was for Plaintiff to proceed with surgical correction
of her uterine prolapse, and then follow-up with Dr. Ellis for any residual spinal symptoms. Id.
On February 25, 2005, Dr. Manifold performed a total abdominal hysterectomy with removal
of the left ovary. (Tr. 165). The follow-up treatment notes show Plaintiff was “doing very well since
her surgery” when seen by Dr. Manifold on March 8, 2005. (Tr. 259). On June 16, 2005, Plaintiff
was seen by Dr. Manifold, whose exam indicated evidence of early rectal prolapse. (Tr. 156).
Plaintiff was to consult with Dr. Varner concerning corrective surgery. Id. Dr. Varner performed
A positive Patrick’s test indicates arthritis of the hip. Dorland’s Illustrated Medical Dictionary 1688 (27th
Edition). The SLR test is also known as Lasègue’s sign: “In sciatica, flexion of the hip is painful when the knee is
extended, but painless when the knee is flexed. This distinguishes the disorder from disease of the hip joint.” Dorland’s
Illustrated Medical Dictionary 1525 (28th Edition).
“Relafen belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by
reducing hormones that cause inflammation and pain in the body. Relafen is used to treat pain or inflammation caused
by arthritis.” http://www.drugs.com/relafen.html (visited Mar. 26, 2013).
corrective surgery on July 7, 2005. (Tr. 210). On August 9, 2005, Dr. Varner noted that overall
Plaintiff was “doing quite well.” (Tr. 182). She was to return to her primary care physician for
general care. Id.
There are no treatment notes in the record after August 2005 until January 14, 2009, when
Plaintiff was seen by Dr. Sparks at the Decatur Orthopaedic Clinic. (Tr. 219). Plaintiff reported
painful swelling in her right knee that started three days previously “when she fell in the bathtub.”
Id. Dr. Sparks suspected Plaintiff had sustained a medial collateral sprain. Id. She was put in a knee
immobilizer and physical therapy was prescribed. Id. She was to return in 10 to 14 days if she did
not respond to treatment. Id. On January 26, 2009, Dr. Sparks noted Plaintiff had not been to
physical therapy. Id. She still had effusion and an MRI was ordered. Id. The MRI showed a tear in
the posterior horn of the medial meniscus. Id. Plaintiff was referred to Dr. Tapscott for consideration
of surgical repair. Id.
On February 17, 2009, Dr. Tapscott examined Plaintiff and recommended arthroscopic
surgery of the right knee. (Tr. 218). Surgery was performed on February 18, 2009. (Tr. 221-222). On
April 3, 2009, Plaintiff followed up with Dr. Tapscott. She continued to report “some pain and
swelling,” but she was ambulating better. (Tr. 218). At her April 8, 2009, follow-up with Dr.
Tapscott, Plaintiff had good range of motion of her right knee and “some tenderness to palpation
along the medial joint line.” Id. Dr. Tapscott’s plan was for Plaintiff to “continue with activities as
tolerated” and return as needed. (Tr. 217). This is the final treatment note in the record.
On May 26, 2009, Plaintiff was referred by the Social Security Administration to Dr.
Jampala, a rheumatologist, for a consultative physical evaluation. (Tr. 228-29). On physical
examination Dr. Jampala noted mild swelling of Plaintiff’s right knee. (Tr. 229). Flexion and
extension of the right knee was normal with no limitation, but there was pain on motion. Id.
Plaintiff’s gait was normal and she was able to walk on heels and tiptoes. Id. Extension and flexion
of the lumbar spine was normal, but with pain. Id. Dr. Jampala observed no deformity in the lumbar
spine. Id. Dr. Jampala included charts showing completely normal range of motion in all areas. (Tr.
230-231). Dr. Jampala’s assessment was as follows:
The patient is a 46-year-old white female with history of back pain, obesity,
headaches, and hemorrhoids has back pain and knee pain. She does have some mild
right knee swelling but otherwise her exam is the [sic] normal. She has no muscle
At her ALJ hearing Plaintiff testified she was primarily unable to work due to her back pain.
(Tr. 46-47). Plaintiff testified that ibuprofen no longer relieved her pain. (Tr. 48). Plaintiff testified
she also had pain in her vaginal area, legs, and hips. (Tr. 50). She testified that her knee ached and
was swollen all of the time. (Tr. 51). Plaintiff testified that because of her pain she had to lie down
at least five times per day. (Tr. 51).
Disability under the Act is determined under 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 work activity” is work activity that involves doing significant
physical or mental activities. 20 C.F.R. § 404.1572(a). “Gainful work activity” is work that is done
for pay or profit. 20 C.F.R. § 404.1572(b). If the ALJ finds that the claimant engages 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 medically determinable impairment or a combination of
medical impairments that significantly limits the claimant’s ability to perform basic work activities.
20 C.F.R. § 404.1520(a)(4)(ii). Absent such impairment, the claimant may not claim disability. Id.
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(d), 404.1525, and 404.1526. If such criteria are met, the claimant is declared disabled. 20
C.F.R. § 404.1520(a)(4)(iii).
If the claimant does not fulfill the requirements necessary to be declared disabled under the
third step, the ALJ may still find disability under the next two steps of the analysis. The ALJ must
first determine the claimant’s residual functional capacity (“RFC”), which refers to the claimant’s
ability to work despite her impairments. 20 C.F.R. § 404.1520(e). In the fourth step, the ALJ
determines whether the claimant has the RFC to perform past relevant work. 20 C.F.R. §
404.1520(a)(4)(iv). If the claimant is determined to be capable of performing past relevant work,
then the claimant is deemed not disabled. Id. If the ALJ finds the claimant unable to perform past
relevant work, then the analysis proceeds to the fifth and final step. 20 C.F.R. § 404.1520(a)(4)(v).
In the last part of the analysis, the ALJ must determine whether the claimant is able to perform any
other work commensurate with his RFC, age, education, and work experience. 20 C.F.R. §
404.1520(g). Here, 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 his RFC, age,
education, and work experience. 20 C.F.R. §§ 404.1520(g), 404.1560(c).
In the instant case, the ALJ determined that Plaintiff has not engaged in substantial gainful
activity since her application for SSI benefits, and that Plaintiff is afflicted with several severe
impairments—degenerative disk disease (DDD) of the lumbar spine, history of medial meniscus tear
status post arthroscopic partial medial meniscectomy, and obesity. (Tr. 20). However, the ALJ found
that despite these impairments, Plaintiff “does not have an impairment or combination of
impairments that meets or medically equals the severity of one of the listed impairments in 20 C.F.R.
Part 404, Subpart P, Appendix 1.” (Tr. 21). After consideration of the record, the ALJ then
determined that Plaintiff has the residual functional capacity to lift and carry twenty pounds
occasionally, and ten pounds frequently. Id. The ALJ determined Plaintiff “can sit a total of six hours
and stand and/or walk a total of six hours with normal breaks during an eight-hour workday.” Id.
Finally, the ALJ found that Plaintiff is capable of performing past relevant work “as a sewing
machine operator, specifically a sleeve setter and a zipper setter.” (Tr. 26). Based upon this analysis,
the ALJ concluded that Plaintiff is not disabled. (Tr. 28).
Plaintiff’s Argument for Reversal
Plaintiff presents two arguments why this court should reverse the decision of the ALJ. First,
Plaintiff contends “the ALJ erred in failing to include non severe impairments in his residual
functional capacity findings.” (Pl.’s Mem. 6). Second, Plaintiff contends the ALJ committed error
by failing to “properly consider Plaintiff’s impairments in combination.” (Pl.’s Mem. 8).
Standard of Review
The only issues before this court are whether the record reveals 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 correct legal standards were applied. 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) mandates that the Commissioner’s 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
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, 894 F.2d at 1529 (quoting Bloodsworth, 703 F.2d at 1239) (other citations
omitted). If supported by substantial evidence, the Commissioner’s factual findings must be affirmed
even if the evidence preponderates against the Commissioner’s findings. See Martin, 894 F.2d at
1529. While the court acknowledges that judicial review of the ALJ’s findings is limited in scope,
the court also notes that review “does not yield automatic affirmance.” Lamb, 847 F.2d at 701.
After careful review, the court concludes that the ALJ’s fact finding is supported by
substantial evidence and that correct legal standards were applied. The court addresses Plaintiff’s
The ALJ Did Not Err in Failing to Include Plaintiff’s Nonsevere Impairments
in His RFC Finding.
Plaintiff’s first argument is directed to Plaintiff’s alleged gynecological and abdominal
symptoms. Specifically, Plaintiff testified that she had episodes of rectal bleeding when using the
bathroom once or twice per month. She attributed this to her back problems. (Tr. 49-50). Her
testimony of other symptoms from her alleged gynecological and abdominal impairments was as
follows: “My vaginal area, my back, my legs, my hips. I hurt. I just hurt.” (Tr. 50). Much of
Plaintiff’s argument relates to conditions for which Plaintiff had corrective surgery in 2005.
The ALJ went into some detail discussing these alleged impairments in his decision. The ALJ
concluded his discussion of these alleged impairments as follows:
The undersigned finds there is no medical evidence to support these allegations by
the claimant and her representative. No treating or consulting doctor has diagnosed
a current and ongoing impairment of the claimant’s abdominal organs or rectum
since 2005. No treating or consulting doctor has assessed the claimant has workrelated limitations due to such impairments since her recovery form her 2005
(Tr. 21). Because the ALJ concluded Plaintiff had no work-related limitations due to these alleged
conditions, they would not change the ALJ’s RFC finding. Therefore, the ALJ properly considered
the vocational impact of Plaintiff’s nonsevere impairments in determining her RFC. Substantial
evidence supports the ALJ’s decision not to include restrictions from Plaintiff’s nonsevere
impairments in his RFC determination.
The ALJ Properly Considered Plaintiff’s Impairments in Combination.
Plaintiff argues the ALJ did not consider Plaintiff’s degenerative disc disease of the lumbar
spine, history of medial meniscus tear status post arthroscopic partial medial meniscectomy, and
obesity in combination. (Pl.’s Mem. at 8.) Plaintiff’s argument on this issue is as follows: “The ALJ
recites the evidence documenting these impairments, yet, nowhere in his decision does he properly
consider these impairments in combination.” Id. Plaintiff does not explain how the combination of
these impairments allegedly render the ALJ’s RFC finding incorrect. Moreover, as the record readily
evidences, the ALJ did indeed consider the combination of these impairments.
In his decision the ALJ discussed Plaintiff’s obesity. He noted that Social Security Ruling
02-01p “directs that obesity will be considered . . . when alone or in combination with other
impairments it significantly limits an individual’s physical or mental ability to do basic work
activities.” (Tr. 26 (emphasis added)). The ALJ concluded that Plaintiff’s back and right knee
impairments were conditions that could be exacerbated by obesity. Id. However, he concluded “that
even with the presence of obesity, these alleged difficulties have not been shown by objective,
medical findings to have resulted in severe limitations in her ability to perform work-related
The ALJ also considered Plaintiff’s impairments in combination in other portions of his
opinion. In considering Plaintiff’s allegations of pain the ALJ considered pain from both Plaintiff’s
back impairment and her knee impairment: “Although the claimant may experience some pain and
some functional limitations due to her back and right knee impairments, the evidence of record
indicates she is capable of performing the work-related activities as set forth in Finding No. 5.” Id.
Therefore, the ALJ properly considered Plaintiff’s impairments in combination.
The court concludes that the ALJ’s determination that Plaintiff is not disabled is supported
by substantial evidence, and the ALJ applied the proper legal standards in arriving at this decision.
Accordingly, the Commissioner’s final decision is due to be affirmed. A separate order in accordance
with this memorandum of decision will be entered.
DONE and ORDERED this
day of August, 2013.
R. DAVID PROCTOR
UNITED STATES DISTRICT JUDGE
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