Peden v. Social Security Administration, Commissioner
Filing
12
MEMORANDUM OPINION. Signed by Judge Abdul K Kallon on 10/31/12. (CVA)
FILED
2012 Oct-31 AM 10:16
U.S. DISTRICT COURT
N.D. OF ALABAMA
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
NORTHEASTERN DIVISION
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LORI PEDEN,
Plaintiff,
vs.
MICHAEL J. ASTRUE,
COMMISSIONER OF SOCIAL
SECURITY
ADMINISTRATION,
Defendant.
Civil Action Number
2:12-cv-00081-AKK
MEMORANDUM OPINION
Plaintiff Lori Peden (“Peden”) brings this action pursuant to section 405(g)
of the Social Security Act (“the Act”), 42 U.S.C. § 405(g), 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.
I. Procedural History
Peden filed her application for Title II disability insurance benefits on July
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17, 2009, alleging a disability onset date of March 3, 2009, due to back, foot, hip,
and leg pain. (R. 157, 165). After the SSA denied her application on October 8,
2009, Peden requested a hearing on November 5, 2009. (R. 117-121, 122). At the
time of the hearing on April 13, 2011, Peden was 51 years old with a GED, and
her past relevant work included working as an assistant manager of a large
discount retail store. (R. 93-114, 165, 163, 158). Peden has not engaged in
substantial gainful activity since March 3, 2009. (R. 157).
The ALJ denied Peden’s claims on August 25, 2011, which became the final
decision of the Commissioner when the Appeals Council refused to grant review
on November 8, 2011. (R. 9-17, 1-4). Peden then filed this action on January 9,
2012, pursuant to 42 U.S.C. § 405(g). Doc. 1.
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
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(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.
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
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months.” 42 U.S.C. § 423(d)(1)(A); 42 U.S.C. § 416(I). 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).
Determination of disability under the Act requires a five step analysis.
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;
(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
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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
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
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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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.
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
In performing the five step analysis, the ALJ initially determined that Peden
met the insured status requirements of the Act through December 31, 2013. (R.
11). Moving to the first Step, the ALJ found that Peden had not engaged in
substantial gainful activity since March 3, 2009, her alleged disability onset date,
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and therefore met Step One. (R. 11). Next, the ALJ found that Peden met Step
Two because she suffered from the severe impairments of “degenerative disc
disease of the spine [and] myocardial infarction.” Id. The ALJ then proceeded to
the next step and found that Peden 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. 12). Although the ALJ answered Step
Three in the negative, consistent with the law, see McDaniel, 800 F.2d at 1030, the
ALJ proceeded to Step Four, where he determined that Peden
can lift 20 pounds occasionally, 10 pounds frequently. . . can stand,
sit, and walk 6 of 8 hours. . . must never climb ladders, ropes or
scaffolds. . . can occasionally climb, balance, stoop, kneel, crouch,
and crawl. . . must avoid concentrated exposure to extreme
temperatures and hazards.
(R. 13). Moreover, in light of these findings, the ALJ determined that Peden is
“capable of performing her past relevant work as an assistant manager.” (R. 17).
Consequently, the ALJ found that Peden “was not under a ‘disability,’ as defined
in the Social Security Act, from March 3, 2009 through the date of [the ALJ’s]
decision.” (R. 17).
V. Analysis
Peden’s sole contention of error is that the ALJ failed to properly assess her
credibility regarding her pain complaints under the Eleventh Circuit Pain Standard
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and the Social Security Regulations.2 Doc. 10 at 6-7. Based on Hale v. Brown,
831 F.2d 1007, 1012 (11th Cir. 1987), Peden asserts that because the ALJ’s
reasons for refusing to credit her pain testimony are not supported by substantial
evidence, this court must accept her pain testimony as true. The court disagrees.
As a threshold matter, the court notes that subjective complaints of pain
alone are insufficient to prove disability. See 20 C.F.R. § 416.929(a); see also
Holt, 921 F.2d at 1223. Rather, 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. Id. It is undisputed that
Peden has a underlying medical condition and, in fact, the ALJ found as such in
Step Two. (R. 11). The disagreement centers on whether Peden’s conditions can
be reasonably expected to cause the alleged pain Peden claims. Unfortunately for
Peden, a review of the ALJ’s opinion and the medical evidence shows that the ALJ
properly considered the pain documented in connection with Peden’s back
2
The ALJ found that “[Peden’s] medically determinable impairments could reasonably be
expected to cause the alleged symptoms; however, the claimant’s statements concerning the
intensity, persistence and limiting effects of these symptoms are not credible to the extent they
are inconsistent with the . . . residual functional capacity assessment.” (R. 14).
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surgeries and properly concluded that Peden’s complaints were not credible. As
such, the ALJ’s findings are supported by substantial evidence.
A.
Peden’s inconsistent statements
The ALJ found Peden’s testimony inconsistent as it relates to the relief her
July 10, 2008 and March 26, 2009 back surgeries provided. (R. 14, 256, 253).
The evidence shows that Peden had initial relief from both surgeries, but that some
pain resurfaced later after each surgery. (R. 247, 245, 244, 239, 238). Indeed,
although Peden testified that the surgeries did not eliminate her back pain and that
the pain is “constant” and always present, she added that “it’s not as painful as it
was before [she] had the surgery.” (R. 101). The issue of contention is the ALJ’s
determination that Peden’s testimony regarding her “constant pain” was not
completely credible. (R. 15).
Unfortunately for Peden, the record supports the ALJ’s determination
regarding Peden’s credibility. For example, the evidence shows that Dr. Cheng
Tao gave Peden a left-side sacroiliac joint injection in May 2009 which provided
Peden with significant relief, including Peden’s own report that the injection
eliminated her radiating leg pain. (R. 237). The ALJ noted also that the
examinations performed by other physicians showed Peden had normal range of
motion of the spine, nontender extremities, and no neurological deficits. Id.
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Indeed, following the second surgery, on May 26, 2009 and July 23, 2009, Dr.
Russell Ellis at the Decatur Orthopaedic Clinic reported injecting Peden with a
steroid in her left sacroiliac joint, that Peden tolerated the procedure well, and that
Peden described the injection as “very helpful.” (R. 284-85). Further, the ALJ
relied also on Dr. Vijay Jampala, who reported that his physical exam on
September 28, 2009, i.e., six months after the second surgery, showed “[Peden’s]
spine movements are normal, no pain,” “both hips, both knees and ankle exam are
normal,” and her “[j]oint exam is normal,” (R. 308), which contradicted Peden’s
report to him that the second “surgery [only] help[ed] some. . .but her numbness
and other symptoms are still troubling her.” (R. 307). Based on the medical
evidence in the record and the inconsistencies in Peden’s statements, the court
finds that the substantial evidence supports the ALJ’s determination that Peden’s
testimony was not credible.
In addition to the medical evidence, the ALJ found also that Peden’s
statements regarding her ability to undertake daily activities in her August 23,
2009 Disability Function Report were inconsistent with her testimony. (R. 14).
Peden reported in the Function Report that she washed dishes, mowed grass,
swept, and played the guitar and piano occasionally. (R. 178, 180). However,
Peden denied engaging in any of these activities during her testimony at the
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hearing. (R. 107-08, 110). Consequently, the ALJ determined that the
inconsistency detracted from Peden’s credibility. (R. 14).
Peden challenges the ALJ’s finding by contending that the “ALJ’s reasoning
ignores the high likelihood that [Peden’s] condition actually worsened over time.”
Doc. 10 at 9. Unfortunately for Peden, the medical evidence actually shows that
her condition has improved. (R. 101, 237, 284-85, 307-08). Next, Peden contends
that she provided a credible explanation for the difference in her testimony, doc.
10 at 8-9, i.e., that “[a]t the very beginning I tried to do those things, but it hurts
me so bad that my husband and one of my sons has had to pick up and do that. I
tried at first because I didn’t want to admit I couldn’t do it,” (R. 110). While
Peden’s explanation is plausible, it is also equally plausible that her
inconsistencies are exaggerations. Peden points to no specific evidence in the
record to support her contention that she can no longer perform the activities in
question. Rather, Peden argues only that the ALJ should have accepted her
explanation as reasonable. Doc. 10 at 9. Unfortunately, even if the undersigned
finds Peden’s explanation plausible, this court simply cannot say that the ALJ
erred in finding otherwise. After all, as the individual who observed Peden
directly at the hearing, the ALJ was in a far better position than this court to assess
Peden’s credibility. Moreover, a district court may not reconsider the facts,
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reevaluate the evidence, or substitute its judgment for that of the Commissioner.
See Martin, 894 F.2d at 1529. In short, based on this record, the ALJ’s assessment
that Peden’s testimony with regard to her daily activities was not credible is
supported by substantial evidence.
B.
Unemployment benefits application evidence
The ALJ found also that Peden’s application in 2010 for unemployment
benefits detracted from Peden’s credibility. (R. 14). The ALJ noted that “a person
who applies for unemployment benefits generally holds himself or herself out as
willing and able to work” and that Peden’s application for unemployment benefits
undermined her credibility about the severity of her pain. (R. 15). Again, Peden
contends that she provided a credible explanation for her conduct, i.e., that she
applied for unemployment benefits because she “didn’t know what to do,
basically” after she was initially denied Social Security benefits. (R. 100). This
assertion, however, does not rebut the ALJ’s finding. Likewise, Peden’s assertion
that she applied for benefits because she “was going to try to get a different kind
of job maybe, but [she] couldn’t,” unfortunately, supports the ALJ’s finding that
Peden’s actions discredit her testimony about her disabling pain. In short, the
ALJ’s determination that Peden’s unemployment application detracted from her
credibility is supported by substantial evidence.
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C.
Gaps in Peden’s treatment
Finally, the ALJ found that gaps in Peden’s treatment from 2009 until 2011
undermined Peden’s testimony about the alleged severity of her pain. (R. 15).
Peden last saw a doctor for treatments for her back pain in June or July of 2009.
(R. 104). Although she visited the Morgan County Community Free Clinic from
April 2010 to May 2011, and complained of pain, the clinic did not provide pain
treatment. (R. 105, 374-386, 381). As to why she sought no pain treatment after
June or July of 2009, Peden cites her lack of health insurance as the reason. (R.
106); doc. 10 at 10. The court agrees with Peden that a claimant who cannot seek
treatment on a consistent basis due to lack of medical insurance rebuts a
determination that the failure to seek treatment undermines the claimant’s pain
contention. However, ultimately, Peden has the burden of proving that she is
disabled. See 20 C.F.R. § 416.912(c). Peden failed to show how the evidence in
the record during this “gap” supported her disability determination. Consequently,
the court finds that the ALJ’s error is harmless, and that regardless of this incorrect
determination, the other reasons the ALJ provided for finding Peden’s testimony
not credible are supported by substantial evidence.
VI. Conclusion
Based on the foregoing, the court concludes that the ALJ’s determination
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that Peden is not disabled is supported by substantial evidence, and that the ALJ
applied proper legal standards in reaching this determination. Therefore, the
Commissioner’s final decision is AFFIRMED. A separate order in accordance
with the memorandum of decision will be entered.
Done the 31st day of October, 2012.
________________________________
ABDUL K. KALLON
UNITED STATES DISTRICT JUDGE
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