Smith v. Social Security Administration, Commissioner
MEMORANDUM OPINION. Signed by Judge Sharon Lovelace Blackburn on 12/23/14. (CTS, )
2014 Dec-23 PM 01:40
U.S. DISTRICT COURT
N.D. OF ALABAMA
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
TERRI BANKS SMITH,
CAROLYN W. COLVIN, Acting
Commissioner of Social Security,
Case Number 5:13-cv-1412-SLB
Plaintiff Terri Banks Smith brings this action pursuant to 42 U.S.C. § 405(g), seeking
review of the final decision of the Commissioner of Social Security denying her application
for a period of disability and disability insurance benefits [“DIB”]. Upon review of the
record, the submissions of the parties, and the relevant law, the court is of the opinion that
the Commissioner’s decision is due to be affirmed.
I. PROCEDURAL HISTORY
Plaintiff initially filed an application for a period of disability and DIB on December
17, 2010, alleging a disability onset date of January 31, 2010. (R. 185.)1 This application was
denied on June 3, 2011 by the Social Security Administration [“SSA”]. (R. 108.)
Subsequently, plaintiff requested a hearing before an Administrative Law Judge [“ALJ”],
Reference to a document number, [“Doc.___”], refers to the number assigned to each
document as it is filed in the court’s record. References to page numbers in the
Commissioner’s record are set forth as [“R.___”].
which was held on March 27, 2012. (R. 114, 144.) After the hearing, the ALJ found that,
while plaintiff was unable to perform any past relevant work, she was capable of making a
vocational adjustment to other occupations, such as inspector, sorter, and gluer, which are
jobs that exist in significant numbers in the national economy. (R. 47-48.) In light of these
findings, the ALJ denied plaintiff’s request for a period of disability and DIB on May 31,
2012. (R. 48.)
On June 20, 2012, plaintiff petitioned the Appeals Council to review the ALJ’s
decision. (R. 27.) On July 1, 2013, the Appeals Council denied plaintiff’s request for review.
(R. 1.) Therefore, the ALJ’s decision is the final decision of the Commissioner of Social
Security. (Id.) Following denial of review by the Appeals Council, plaintiff filed an appeal
in this court on July 31, 2013. (Doc. 1.)
II. STANDARD OF REVIEW
In reviewing claims brought under the Social Security Act, this court “is limited to an
inquiry into whether there is substantial evidence to support the findings of the
Commissioner, and whether the correct legal standards were applied.” Wilson v. Barnhart,
284 F.3d 1219, 1221 (11th Cir. 2002); see also Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir.
1988). The court gives deference to factual findings and reviews questions of law de novo.
Cornelius v. Sullivan, 936 F.2d 1143, 1145 (11th Cir. 1991). The court “may not decide the
facts anew, reweigh the evidence, or substitute [its] judgment for that of the [Commissioner];
rather the court must scrutinize the record as a whole to determine if the decision reached is
reasonable and supported by substantial evidence.” Martin v. Sullivan, 894 F.2d 1520, 1529
(11th Cir. 1990) (quoting Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983))
(internal quotations and other citation omitted). “The Commissioner’s factual findings are
conclusive if supported by substantial evidence.” Wilson, 284 F.3d at 1221 (citing Martin,
894 F.2d at 1529; Allen v. Bowen, 816 F.2d 600, 602 (11th Cir. 1987)). “Substantial evidence
is more than a scintilla and is such relevant evidence as a reasonable person would accept as
adequate to support a conclusion.” Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178
(11th Cir. 2011) (internal quotations and citations omitted).
Conclusions of law made by the Commissioner are reviewed de novo. Cornelius, 936
F.2d at 1145. “[N]o . . . presumption of validity attaches to the [Commissioner’s] conclusions
of law.” Wiggins v. Schweiker, 679 F.2d 1387, 1389 (11th Cir. 1982).
A. THE FIVE-STEP EVALUATION
The regulations require the Commissioner to follow a five-step sequential evaluation
to determine whether a claimant is eligible for a period of disability and DIB.2 See 20 C.F.R.
The Regulations state:
The sequential evaluation process is a series of five “steps” that we follow in a set
order. . . . If we can find that you are disabled or not disabled at a step, we make
our determination or decision and do not go on to the next step. If we cannot find
that you are disabled or not disabled at a step, we go on to the next step. Before we
go from step three to step four, we assess your residual functional capacity. . . . We
use this residual functional capacity assessment at both step four and step five
when we evaluate your claim at these steps.
§ 404.1520(a)(1)-(2); Bowen v. City of New York, 476 U.S. 467, 470 (1986). For the purposes
of this evaluation, the meaning of disability is 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 has lasted or can be expected to last for a
continuous period of not less than 12 months.” 42 U.S.C. § 416(i)(1); 42 U.S.C.
§ 423(d)(1)(A). The specific steps in the evaluation process are as follows:
1. Substantial Gainful Employment
First, the Commissioner must determine whether the claimant is engaged in
“substantial gainful activity.” Bowen v. Yuckert, 482 U.S. 137, 137 (1987).3 If the claimant
is engaged in substantial gainful activity, the Commissioner will find that the claimant is not
20 C.F.R. § 404.1520(a)(4).
The Regulations define “substantial gainful activity”:
(a) Substantial work activity. Substantial work activity is work activity that
involves doing significant physical or mental activities. Your work may be
substantial even if it is done on a part-time basis or if you do less, get paid
less, or have less responsibility than when you worked before.
(b) Gainful work activity. Gainful work activity is work activity that you
do for pay or profit. Work activity is gainful if it is the kind of work usually
done for pay or profit, whether or not a profit is realized.
(c) Some other activities. Generally, we do not consider activities like
taking care of yourself, household tasks, hobbies, therapy, school
attendance, club activities, or social programs to be substantial gainful
20 C.F.R. § 404.1572.
disabled, regardless of the claimant’s medical condition or her age, education, and work
experience. 20 C.F.R. § 404.1520(b); § 416.920(b). “Under the first step, the claimant has
the burden to show that she is not currently engaged in substantial gainful activity.”
Reynolds-Buckley v. Comm’r of Soc. Sec., 457 F. App’x 862, 863 (11th Cir. 2012).4
The ALJ found that plaintiff had not engaged in substantial gainful activity since
January 31, 2010, the alleged onset date. (R. 38.)
2. Severe Impairments
If the claimant is not engaged in substantial gainful activity, the Commissioner must
next determine whether the claimant suffers from a severe impairment or combination of
impairments that significantly limits the claimant’s physical or mental ability to do basic
work activities. 20 C.F.R. § 404.1520(a)(4)(ii), (c); § 416.920(a)(4)(ii), (c). “[A] ‘physical
or mental impairment’ is an impairment that results from anatomical, physiological, or
psychological abnormalities which are demonstrable by medically acceptable clinical and
laboratory diagnostic techniques.” 42 U.S.C. § 423(d)(3); § 1382c(a)(3)(D). The regulations
provide: “[I]f you do not have any impairment or combination of impairments which
significantly limits your physical or mental ability to do basic work activities, we will find
Eleventh Circuit Rule 36-2 provides, in pertinent part, “An opinion shall be unpublished
unless a majority of the panel decides to publish it. Unpublished opinions are not
considered binding precedent, but they may be cited as persuasive authority.” 11th Cir.
R. 36-2 (emphasis added).
that you do not have a severe impairment and are, therefore, not disabled. We will not
consider your age, education, and work experience.” 20 C.F.R. § 404.1520(c); § 416.920(c).
An impairment is “severe” if it “significantly limits [a] claimant’s physical or mental
ability to do basic work activities.”5 Crayton v. Callahan, 120 F.3d 1217, 1219 (11th Cir.
1997); 20 C.F.R. § 404.1520(c); 20 C.F.R. § 404.1521(a). When an impairment “is a slight
abnormality which has such a minimal effect on the individual that it would not be expected
to interfere with the individual’s ability to work, irrespective of age, education, or work
experience,” it will be classified as non-severe. Brady v. Heckler, 724 F.2d 914, 920 (11th
Cir. 1984); see also SSR 85-28, 1985 WL 56856 (1985). A claimant may be found disabled
based on a combination of impairments even though none of the individual impairments
alone are disabling. Walker v. Bowen, 826 F.2d 996, 1001 (11th Cir. 1987); see also 20
C.F.R. § 404.1523; § 416.923. A claimant has the burden to show that she has a severe
impairment or combination of impairments. Reynolds-Buckley, 457 F. App’x at 863.
Basic work activities include:
(1) Physical functions such as walking, standing, sitting, lifting,
pushing, pulling, reaching, carrying, or handling; (2) [c]apacities for
seeing, hearing, and speaking; (3) [u]nderstanding, carrying out and
remembering simply instructions; (4) [u]se of judgment; (5)
[r]esponding appropriately to supervision, co-workers and usual
work situations; and (6) [d]ealing with changes in a routine work
20 C.F.R. § 404.1521(b)(1)-(6).
The ALJ found that plaintiff had the following severe impairments: “bilateral carpal
tunnel syndrome (CTS), osteoarthritis of the bilateral knees, hypothyroidism due to Graves’
disease,6 lumbar degenerative disc disease (DDD), depressive disorder and pain disorder.”
3. The Listings
If the claimant has a severe impairment, the Commissioner must then determine
whether the claimant’s impairment meets the duration requirement and whether it is
equivalent to any one of the listed impairments. 20 C.F.R. § 404.1520(a)(4)(iii), (d)-(e);
§ 404.1525; § 404.1526. Listed impairments are so severe that they prevent an individual
from performing substantial gainful activity. 20 C.F.R. § 416.920(a)(4)(iii), (d)-(e); see 20
C.F.R. pt. 404, Subpart P, Appendix 1 [The Listings]. If the claimant’s impairment meets or
equals a Listing, the Commissioner must find the claimant disabled, regardless of the
“Graves' disease is an immune system disorder that results in the overproduction of
thyroid hormones,” Graves’ Disease, MAYO CLINIC,
5811 (last visited Dec. 2, 2014), and is the most common cause of hyperthyroidism,
Hyperthyroidism, MEDLINEPLUS: A SERVICE OF THE NAT’L INST. OF HEALTH,
http://www.nlm.nih.gov/medlineplus/hyperthyroidism.html (last visited Dec. 2, 2014).
The ALJ found that plaintiff suffered from hypothyroidism due to Graves’ disease, (R.
38), and at least one other report refers to plaintiff’s hypothyroidism, (see R. 401). Dr.
Bobby Johnson had previously diagnosed plaintiff with hyperthyroidism. (R. 348.) It is
unclear if only one thyroid diagnosis is accurate, or if plaintiff experienced both
hypothyroidism and hyperthyroidism at different times.
claimant’s age, education, and work experience. 20 C.F.R. § 404.1520(d); § 416.920(d). The
claimant has the burden of proving that her impairment meets or equals the criteria contained
in one of the Listings. Reynolds-Buckley, 457 Fed. Appx. at 863.
The ALJ found that plaintiff did not have an impairment or combination of
impairments that met or medically equaled a Listing. (R. 39.) Specifically, the ALJ found that
medical evidence did not establish impairments equaling listings 1.02 (major dsyfunction of
a joint(s) due to any cause), 1.04 (disorders of the spine), 12.04 (affective disorder), or 12.07
(somatoform disorders). (R. 39-41.)
4. Residual Functional Capacity and Past Relevant Work
If the impairment does not meet or equal the criteria of a Listing, the claimant must
prove that her impairment prevents her from performing her past relevant work. See 20
C.F.R. § 404.1520(a)(4)(iv), (f); § 416.920(a)(4)(iv), (f). At step four, the Commissioner
“will first compare [the Commissioner’s] assessment of [the claimant’s] residual functional
capacity [“RFC”] with the physical and mental demands of [the claimant’s] past relevant
work.” 20 C.F.R. § 404.1560(b); § 416.960(b). “Past relevant work is work that [the claimant
has] done within the past 15 years, that was substantial gainful activity, and that lasted long
enough for [her] to learn to do it.” 20 C.F.R. § 404.1560(b)(1); § 416.960(b)(1). If the
claimant is capable of performing her past relevant work, the Commissioner will find that
she is not disabled. 20 C.F.R. § 404.1560(b)(3); § 416.920(f). The claimant bears the burden
of establishing that the impairment prevents her from performing past work.
Reynolds-Buckley, 457 F. App’x at 863.
The ALJ found that plaintiff is a younger individual (43 years old on the alleged onset
date) with a high school education. (R. 47.) The ALJ made the following findings regarding
[T]he claimant has the residual functional capacity to perform light
work . . . that is further limited by standing and walking four hours in
an eight-hour workday with normal breaks. The claimant can
occasionally use the lower left extremity for pushing and pulling and
operation of foot controls, and frequently use the bilateral upper
extremity for carrying, grasping, pointing, using the computer, pinching
and writing. She can occasionally climb ramps and stairs, kneel, crouch
or crawl, but can never climb ladders, ropes or scaffolds. The claimant
can understand and remember simple instructions, sustain attention,
concentration, persistence and pace in two-hour segments with
customary breaks in an eight-hour workday, and can occasionally have
contact with coworkers. She will be best suited for an independent
workstation apart from coworkers, require a gradual introduction to
changes in the work environment, and will be expected to miss one day
of work per month due to limitations and the treatment for those
(R. 41.) The ALJ found that plaintiff’s RFC restricts her from performing any past relevant
work. (R. 47.)
5. Other Work in the National Economy
If the claimant establishes that she is unable to perform her past relevant work, the
Commissioner must show that the claimant—in light of her RFC, age, education, and work
experience—is capable of performing other work that exists in substantial numbers in the
national economy. Reynolds-Buckley, 457 F. App’x at 863; see also 20 C.F.R.
§ 404.1520(c)(1); § 416.920(g). The regulations provide:
If we find that your residual functional capacity does not enable you to do any
of your past relevant work . . . we will use the same residual functional
capacity assessment when we decide if you can adjust to any other work. We
will look at your ability to adjust to other work by considering your residual
functional capacity and the vocational factors of age, education, and work
experience . . . . Any other work (jobs) that you can adjust to must exist in
significant numbers in the national economy (either in the region where you
live or in several regions in the country).
20 C.F.R. § 404.1560(c)(1); § 416.960(c)(1). If the claimant is not capable of performing
such other work, the Commissioner must find the claimant disabled. 20 C.F.R.
§ 404.1520(g); § 416.920(g).
The ALJ consulted a Vocational Expert [“VE”] to determine whether any jobs exist
in the national economy that plaintiff could perform, considering her RFC, age, education,
and work experience. The VE testified that an individual with plaintiff’s limitations and
vocational factors could perform the jobs of inspector, sorter, and gluer, which are jobs that
exist in significant numbers in the national economy. (R. 48.)
Because the ALJ found that jobs consistent with plaintiff’s RFC and vocational
factors exist in significant numbers, the ALJ found that plaintiff was not disabled. (Id.)
B. MS. SMITH’S CLAIMS
Plaintiff raises three issues on appeal: (1) whether the ALJ properly assessed the
credibility of plaintiff’s testimony regarding pain and depression; (2) whether the ALJ
appropriately weighed the medical opinion of Dr. Haney; and (3) whether the ALJ considered
the combined effects of plaintiff’s multiple impairments. (Doc. 9 at 4, 9, 12.)
1. Credibility of Plaintiff’s Statements
First, plaintiff alleges that the ALJ failed to credit her testimony regarding pain and
debilitating depression and, in refusing to credit her testimony, the ALJ failed to properly
consider her complete medical history. (Doc. 9 at 4-12.) Specifically, plaintiff contends that
her daily activities did not constitute substantial evidence on which the ALJ could rely to
discredit her testimony, that the ALJ failed to consider plaintiff’s medical history of disabling
back pain in finding plaintiff’s testimony not credible, and that the ALJ erred in finding
plaintiff’s allegations of disabling depression not credible. (Id.)
SSR 96-7p explains the two step process set out in 20 C.F.R. § 404.1529 and
§ 416.929 that the ALJ must follow7: “First, the adjudicator must consider whether there is
an underlying medically determinable physical or mental impairment—i.e., an impairment(s)
that can be shown by medically acceptable clinical and laboratory diagnostic
techniques—that could reasonably be expected to produce the individual’s pain or other
symptoms.” This determination does not consider the “intensity, persistence, or functionally
limiting effects of the individual’s symptoms.” SSR 96-7p. If the ALJ finds that the
Apparently the Eleventh Circuit considers the standard set out in the regulations and the
standard in Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir.1991), as one and the same.
Wilson v. Barnhart, 284 F.3d 1219, 1226 (11th Cir. 2002) (“Furthermore, the ALJ cites to
20 C.F.R.§ 404.1529, which contains the same language [as Holt] regarding the
subjective pain testimony that this Court interpreted when initially establishing its
three-part pain standard. In citing to § 404.1529 and based on the findings and discussion,
it is clear that the ALJ applied this Circuit's pain standard [from Holt].”). Because SSR
96-7p offers an in-depth explanation of the regulations and is more recent than Holt, the
court looks to it for guidance.
plaintiff’s case survives the first step, then
the adjudicator must evaluate the intensity, persistence, and
limiting effects of the individual’s symptoms to determine the
extent to which the symptoms limit the individual’s ability to do
basic work activities. For this purpose, whenever the
individual’s statements about the intensity, persistence, or
functionally limiting effects of pain or other symptoms are not
substantiated by objective medical evidence, the adjudicator
must make a finding on the credibility of the individual’s
statements based on a consideration of the entire case record.
The ALJ found that, under step one, “the claimant’s medically determinable
impairments could reasonably be expected to cause the alleged symptoms,” but under step
two, “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 above residual
functional capacity assessment.” (R. 45.) To discredit plaintiff’s testimony of pain and
depression, the ALJ relied on reports of plaintiff’s daily activities and plaintiff’s inconsistent
statements, as well as plaintiff’s medical history.
The ALJ found that plaintiff “has described daily activities, which are not limited to
the extent one would expect, given her complaints,” and that plaintiff “has admitted certain
abilities and engaged in activities, which provide support for the residual functional capacity
in this decision.” (R. 45.) The ALJ found plaintiff’s testimony of disabling pain and
depression inconsistent with a Function Report, in which plaintiff stated that she prepares
meals daily, sometimes does laundry, drives occasionally, shops for short periods of time at
the grocery store, attends church weekly, and maintains her personal hygiene without
assistance. (R. 45, 200-03.) The ALJ also relied on inconsistent testimony from an Employer
Questionnaire and a Third Party Function Report completed by plaintiff’s mother in
discrediting plaintiff’s testimony.
First, the court notes that plaintiff’s daily activities are largely consistent with
plaintiff’s testimony. For example, plaintiff stated that, while she used to prepare full course
meals, she prepares meals that take only “10 minutes or less” since her impairments began.
(R. 201.) Additionally, plaintiff stated in her Function Report from February 2011 that she
drives “sometimes,” (R. 202), but in the hearing on May 27, 2012, plaintiff clarified that she
no longer drives because of two car accidents she had after being diagnosed with Graves’
disease, (R. 78). Plaintiff’s activities of occasionally doing laundry and grocery shopping and
taking care of her personal hygiene also do little to discredit plaintiff’s testimony that she
experiences pain throughout the day. “[A]n applicant need not be completely bedridden or
unable to perform any household chores to be considered disabled,”Easter v. Bowen, 867
F.2d 1128, 1130 (8th Cir. 1989), and this court does not “believe that participation in
everyday activities of short duration, such as housework or fishing, disqualifies a claimant
from disability or is inconsistent with the limitations recommended by [the claimant’s]
treating physicians,” Lewis v. Callahan, 125 F.3d 1436, 1441 (11th Cir. 1997).
Additionally, the ALJ considered an Employer Questionnaire, completed by plaintiff’s
former employer, Steel Case, which reported that, while an employee, plaintiff maintained
satisfactory work attendance, performed an ordinary work routine without supervision,
understood and carried out simple one and two-step tasks and detailed instructions, and
maintained concentration for extended periods of time. (R. 45, 219-20.) Contrary to Steel
Case reporting that plaintiff maintained a satisfactory work attendance, plaintiff testified that
she would “stay off from work more than [she] worked when [she] was there.” (R. 64, 219.)
Plaintiff also testified that she “could barely make it back to [her] car” after work because
of chronic back pain. (R. 45, 64.) While plaintiff’s testimony appears inconsistent with the
Employer Questionnaire, the Questionnaire provides little relevant evidence of plaintiff’s
abilities, considering plaintiff worked at Steel Case before her alleged disability onset date.
The ALJ also considered a Third Party Function Report completed by plaintiff’s
mother, which states that plaintiff “sleeps a lot.” (R. 46, 224.) The ALJ compared this
statement with plaintiff’s statements that “the medication makes me sleepy and drowsy
sometimes,” (R. 46, 202), and that “it might seem like I’m sleeping, but I’m really not
sleeping,” (R. 46, 77). The sleeping habits described by plaintiff’s mother are not inconsistent
with plaintiff’s testimony. Plaintiff testified that it may appear as if she is sleeping even when
she is not. Plaintiff’s mother may have incorrectly believed plaintiff was sleeping at night and
testified according to her inaccurate perception of plaintiff’s sleeping habits. Furthermore,
the fact that medication makes an individual drowsy is not determinative of getting natural
and habitual restful sleep.
The ALJ also pointed to inconsistencies between plaintiff’s statements about her
symptoms and testimony from the Function Report completed by plaintiff’s mother. Plaintiff
testified that her medication made her sleepy, she spent her days lying around in pain, she
woke up every hour with pain, she stayed to herself because of mood swings, she went
outside infrequently, and she had a difficult time sitting for more than five minutes. (R. 46,
71, 199, 202, 204.) However, plaintiff’s mother testified that plaintiff spent time with people
who came to visit and would “join in the conversation every once in a while,” that plaintiff
did not have to be reminded to go places because “she really loves to go,” and that plaintiff
attended church almost every Sunday and sometimes on Wednesday nights. (R. 46, 228.) The
Third Party Function Report completed by plaintiff’s mother is inconsistent with plaintiff’s
complaints of disabling pain and provides at least some evidence to discredit plaintiff’s
testimony. But even if plaintiff’s daily activities, as reported by plaintiff and her mother, do
not constitute substantial evidence, the ALJ relied on additional evidence in discrediting
The ALJ considered Dr. Troy Layton’s treatment records for plaintiff’s knee
osteoarthritis. (R. 40, 42, 272-77.) Despite plaintiff’s testimony that constant pain prevents
her from working, (R. 64), plaintiff told Dr. Troy Layton that she was ready to return to work
“full duty” on February 4, 2010, almost a week after the alleged onset date of plaintiff’s
disability, and Dr. Layton permitted plaintiff to return to work without restrictions on March
2, 2010, although plaintiff did not actually return to work, (R. 274). During a follow-up
appointment on March 12, 2010, Dr. Layton noted that plaintiff “is doing well. Everything
looks good. The pain is absent.” (R. 273.) The ALJ relied on substantial evidence in finding
that plaintiff’s allegations of pain are not as limiting as alleged.
Additionally, the ALJ considered plaintiff’s medical history of lower pain back. The
ALJ noted that two magnetic resonance imagining (“MRI”) scans of plaintiff’s lumbar
spine—from August 27, 2009 and April 23, 2010—revealed “bulging discs at the L3-4, L4-5,
and L5-S1 levels with neuroforaminal narrowing and spinal stenosis.” (R. 43, 263, 270.)
Because the MRI scans revealed degenerative disc disease, Dr. Cheng Tao recommended
surgery involving an anterior lumbar interbody fusion at the L4-5 and L5-S1 levels. (R. 256.)
Plaintiff initially agreed to undergo surgery, even after learning of the attendant risks, but
later decided not to undergo surgery after Dr. Bobby Johnson diagnosed plaintiff with
Graves’ disease. (R. 256, 259, 348; see R. 72.) Even though hyperthyroidism from Graves’
disease would increase the risks from surgery, Dr. Johnson explained to plaintiff that surgery
“was still safe if everyone was prepared,” (R. 40, 348), and plaintiff testified that her doctor
still recommended surgery, (R. 66). While the ALJ credited plaintiff’s testimony that she
experiences significant lower back pain, the ALJ did not fully credit plaintiff’s statements
about the intensity, persistence, and limiting effects of the pain, given that plaintiff chose not
to undergo surgery. The ALJ relied on substantial evidence in making this finding.
Regarding plaintiff’s testimony about her depression, the ALJ considered plaintiff’s
limited treatment history and plaintiff’s inconsistent statements about the effectiveness of her
medication. (R. 46.) Plaintiff testified that she has “major depression” and that she has bad
days “four to five times a week,” which consist of “not getting up out of the bed and just not
wanting to live.” (R. 73, 79.) The ALJ noted, however, that plaintiff had a conservative
treatment history for depression. (R. 46.) Plaintiff attended five counseling sessions through
her previous employer’s referral in 2011, (R. 75), and had received treatment from Alabama
Psychiatric Services for only a few months, (Id.). Plaintiff’s conservative treatment history
provides substantial evidence to discredit her allegations regarding the limiting effects of her
depression. See Wilson v. Barnhart, 284 F.3d 1219, 1223 (11th Cir. 2002) (citing the lack of
significant medical treatment as one consideration in finding that plaintiff did not meet part
two of the pain standard).
The ALJ also compared plaintiff’s testimony that her medication was not helping, (R.
46, 74), with conflicting testimony that Cymbalta was “helping a little bit,” (R. 46, 75), and
with plaintiff’s statements to Alabama Psychiatric Services on January 18, 2012 that “I’m
doing okay . . . some better,” and that “individual therapy has helped,” (R. 46, 441). While
plaintiff is correct that a report from March 6, 2012, in which plaintiff’s therapist rated
plaintiff’s overall progress as poor, shows severe depression, (Doc. 9 at 11 (citing R. 437)),
the ALJ relied on substantial evidence to find that plaintiff’s severe depression is not as
limiting as alleged.
2. Weight Given to Medical Opinion of Dr. Haney
Plaintiff next challenges the ALJ’s decision to give Dr. Haney’s opinion only “some
weight” when assessing plaintiff’s mental impairments. (Doc. 9 at 12; R. 44.) The ALJ
concluded that Dr. Haney’s opinion would be given only some weight because “it was only
somewhat consistent with the limitations outlined in the residual functional capacity.” (R.
44). “[T]he testimony of a treating physician must be given substantial or considerable
weight unless ‘good cause’ is shown to the contrary.” Lewis v. Callahan, 125 F.3d 1436,
1440 (11th Cir. 1997). “[G]ood cause exists when the: (1) treating physician’s opinion was
not bolstered by the evidence; (2) evidence supported a contrary finding; or (3) treating
physician’s opinion was conclusory or inconsistent with the doctor’s own medical records.”
Phillips v. Barnhart, 357 F.3d 1232, 1241 (11th Cir. 2004) (internal quotations omitted).
Dr. Haney found that plaintiff’s “[a]bility to function in most jobs appeared
moderately to severely impaired due to physical and emotional limitations.” (R. 406.) During
a clinical interview, Dr. Haney noted that plaintiff “had difficulty with most . . . simple
problems in change making and arithmetic” and could not recall any of three objects after
only five minutes had passed. (R. 405.) Based on this evaluation, Dr. Haney estimated
plaintiff’s intelligence “at the low average range.” (Id.) The ALJ concluded that Dr. Haney’s
assessment “was only somewhat consistent with the limitations outlined in the residual
functional capacity” because internal inconsistencies existed within Dr. Haney’s own medical
records and the record as a whole. (R. 44.) For example, after noting that plaintiff “had
difficulty with simple math and change making, Dr. Haney contradictorily noted that plaintiff
“seemed able to manage her own funds, should any be awarded to her.” (R. 405.)
Dr. Rodrigues, a reviewing doctor, stated that “[a]lthough Haney noted the validity
of the assessment, I question it. For someone with 16 years of education8 and only some
limitations noted on the [activities of daily living assessments], you would expect for this
person to be able to at least count forward by two using her fingers. It is possible that her
pain medication was affecting her functioning during the assessment.” (R. 407.) Dr.
Rodrigues also noted, “There is no evidence of a head injury . . . that would impair her ability
that significantly.” (R. 430.) Dr. Haney’s observations were also inconsistent with Function
Reports on plaintiff’s daily activities. Contrary to Dr. Haney’s finding that plaintiff had
difficulties counting change and doing simple arithmetic, plaintiff and her mother both
testified within months of Dr. Haney’s evaluation that plaintiff was able to count change,
handle a savings account, and use a checkbook and money orders. (R. 202, 227.)
Evidence supports findings contrary to Dr. Haney’s conclusion that plaintiff’s
intelligence level is at “the low average range” and that her impairments substantially affect
her ability to work. Therefore, the ALJ did not err in assigning less weight to Dr. Haney’s
In a Disability Report, plaintiff reported that the highest grade of school completed was
“4 or more years of college.” (R. 190.)
3. Combination of Impairments
Plaintiff’s last argument is that the ALJ did not properly consider the combined effects
of her impairments. (Doc. 9 at 12.) At step two in the five-step sequential evaluation process,
the Secretary must determine whether a claimant has a severe impairment or combination of
impairments that significantly limits a claimant’s ability to function. See 20 C.F.R. §
416.920(c). “The plain language of the regulations makes it clear that the Secretary must
consider the combined effect of a claimant’s alleged impairments in sequential evaluation
step two.” Davis v. Shalala, 985 F.2d 528, 532 (11th Cir. 1993). At step three in the
sequential evaluation, “the regulations require the Secretary to consider the combined impact
of a claimant’s impairments when determining whether the claimant equals the requirements
for a listed impairment.” Id. at 534. Therefore, at steps two and three, the Secretary must
consider a claimant’s impairments in combination before moving to the next step.
At step two, the ALJ concluded that plaintiff had the following severe impairments:
“bilateral carpal tunnel syndrome (CTS), osteoarthritis of the bilateral knees, hypothyroidism
due to Graves’ disease, lumbar degenerative disc disease (DDD), depressive disorder and
pain disorder.” (R. 38.) At step three, the ALJ concluded that plaintiff did not have “an
impairment or combination of impairments that meets or medically equals the severity of one
of the listed impairments.” (R. 39.) Specifically, the ALJ found that “[t]he severity of the
claimant’s mental impairments, considered singly and in combination, do not meet or
medically equal the criteria of listings 12.04 (Affective disorder), and 12.07 (Somatoform
disorders).” (R. 40.) The ALJ also found that plaintiff’s impairments did not meet or equal
listings 1.02 (major dsyfunction of a joint(s) due to any cause) or 1.04 (disorders of the
spine). (R. 39-40.)
Where an ALJ expressly finds that a plaintiff does not have an impairment or
combination of impairments that meets or equals a listing, the Eleventh Circuit has held that
the ALJ satisfied the duty to consider a plaintiff’s impairments in combination. See
Hutchinson v. Astrue, 408 F. App’x 324, 327 (11th Cir. 2011); Jones v. Dep’t of Health &
Human Servs., 941 F.2d 1529, 1533 (11th Cir. 1991). Therefore, the court finds that the ALJ
properly evaluated plaintiff’s multiple impairments singly and in combination throughout the
Based on the reasons set forth above, the decision of the ALJ, as adopted by the
Commissioner, denying plaintiff’s claim for a period of disability and DIB is due to be
affirmed. An Order affirming the decision of the Commissioner will be entered
contemporaneously with this Memorandum Opinion.
DONE this the 23rd day of December, 2014.
SHARON LOVELACE BLACKBURN
UNITED STATES DISTRICT JUDGE
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