Elliott v. Social Security Administration, Commissioner
MEMORANDUM OPINION. Signed by Chief Judge Karon O Bowdre on 2/9/2015. (AVC)
2015 Feb-09 AM 09:13
U.S. DISTRICT COURT
N.D. OF ALABAMA
IN THE UNITED STATES DISTRICT COURT FOR THE
NORTHERN DISTRICT OF ALABAMA
CLARA JEAN DOSS ELLIOTT,
CAROLYN W. COLVIN,
ACTING COMMISSIONER OF
CIVIL ACTION NO.
On October 13, 2010, the claimant, Clara Jean Doss Elliott, protectively applied for
widow’s insurance benefits under Title II and supplemental security income under Title XVI of
the Social Security Act. The claimant initially alleged disability commencing on January 15,
2003 because of ankle, knee, wrist, and lower back pain, as well as arthritis. (R. 39-42, 162-68).
The claimant later amended her alleged onset date to October 13, 2010. (R. 26). The
Commissioner denied the claim on February 23, 2011. (R. 45-49). The claimant filed a timely
request for a hearing before an Administrative Law Judge, and the ALJ held a hearing on June
14, 2012. (R. 23-38, 50).
In a decision dated July 24, 2012, the ALJ found that the claimant was not disabled as
defined by the Social Security Act and was, therefore, ineligible for social security benefits. (R.
8-18). On July 15, 2013, the Appeals Council denied the claimant’s request for review. (R. 1-4).
Consequently, the ALJ’s decision became the final decision of the Commissioner of the Social
Security Administration. (R. 1-3). The claimant has exhausted her administrative remedies, and
this court has jurisdiction pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). For the reasons stated
below, this court AFFIRMS the decision of the Commissioner.
II. ISSUE PRESENTED
The claimant presents the following issue for review: whether the ALJ properly assessed
the claimant’s credibility and subjective complaints of pain.
III. STANDARD OF REVIEW
The standard for reviewing the Commissioner’s decision is limited. This court must
affirm the Commissioner’s decision if the Commissioner applied the correct legal standards and
if her factual conclusions are supported by substantial evidence. See 42 U.S.C. § 405(g);
Graham v. Apfel, 129 F.3d 1420, 1422 (11th Cir. 1997); Walker v. Bowen, 826 F.2d 996, 999
(11th Cir. 1987).
“No . . . presumption of validity attaches to the [Commissioner’s] legal conclusions,
including determination of the proper standards to be applied in evaluating claims.” Walker, 826
F.2d at 999. This court does not review the Commissioner’s factual determinations de novo. The
court will affirm those factual determinations that are supported by substantial evidence.
“Substantial evidence” is “more than a mere scintilla. It means such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402
U.S. 389, 402 (1971).
The court must keep in mind that opinions such as whether a claimant is disabled, the
nature and extent of a claimant’s residual functional capacity, and the application of vocational
factors “are not medical opinions, . . . but are, instead, opinions on issues reserved to the
Commissioner because they are administrative findings that are dispositive of a case; i.e., that
would direct the determination or decision of disability.” 20 C.F.R. §§ 404.1527(d), 416.927(d).
Whether the claimant meets the listing and is qualified for Social Security disability benefits is a
question reserved for the ALJ, and the court “may not decide facts anew, reweigh the evidence,
or substitute [its] judgment for that of the Commissioner.” Dyer v. Barnhart, 395 F.3d 1206,
1210 (11th Cir. 2005). Thus, even if the court were to disagree with the ALJ about the
significance of certain facts, the court has no power to reverse that finding as long as substantial
evidence in the record supports it.
The court must “scrutinize the record in its entirety to determine the reasonableness of the
[Commissioner]'s factual findings.” Walker, 826 F.2d at 999. A reviewing court must not only
look to those parts of the record that support the decision of the ALJ, but also must view the
record in its entirety and take account of evidence that detracts from the evidence relied on by the
ALJ. Hillsman v. Bowen, 804 F.2d 1179, 1180 (11th Cir. 1986).
IV. LEGAL STANDARD
Under 42 U.S.C. § 423(d)(1)(A), a person is entitled to disability benefits when the
person is unable 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 12 months . . . .” 42
U.S.C. § 423(d)(1)(A). To make this determination the Commissioner employs a five-step,
sequential evaluation process:
(1) Is the person presently unemployed?
(2) Is the person’s impairment severe?
(3) Does the person’s impairment meet or equal one of the specific
impairments set forth in 20 C.F.R. Pt. 404, Subpt. P, App. 1?
(4) Is the person unable to perform his or her former occupation?
(5) Is the person unable to perform any other work within the
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.”
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986)1; 20 C.F.R. §§ 404.1520, 416.920.
In evaluating pain and other subjective complaints, the Commissioner must consider
whether the claimant demonstrated an underlying medical condition, and either (1) objective
medical evidence that confirms the severity of the alleged pain arising from that condition or (2)
that the objectively determined medical condition is of such a severity that it can reasonably be
expected to give rise to the alleged pain. Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991).
The ALJ may consider the claimant’s daily activities in evaluating and discrediting complaints of
disabling pain. Harwell v. Heckler, 735 F.2d 1292, 1293 (11th Cir. 1984).
If the ALJ decides to discredit the claimant’s testimony as to her pain, she must
articulate explicit and adequate reasons for that decision; failure to articulate reasons for
discrediting claimant’s testimony requires that the court accept the testimony as true. Foote v.
Chater, 67 F.3d 1553, 1561-62 (11th Cir. 1995). A reviewing court will not disturb a clearly
articulated credibility finding with supporting substantial evidence in the record. Id. at 1562.
McDaniel v. Bowen, 800 F.2d 1026 (11th Cir. 1986) was a supplemental security income case
(SSI). The same sequence applies to disability insurance benefits. Cases arising under Title II are
appropriately cited as authority in Title XVI cases. See, e.g., Ware v. Schweiker, 651 F.2d 408 (5th Cir.
1981) (Unit A).
The claimant was 54 years old at the time of the ALJ’s final decision. (R. 89). The
claimant has a fifth grade education and past relevant work as a fast food worker and a plastics
trimmer. (R. 27, 37, 164, 183). The claimant alleges disability based on ankle, knee, wrist, and
lower back pain, as well as arthritis. (R. 162-68).
On June 14, 2010, the claimant visited Birmingham Health Care for a follow-up on her
hypertension.2 She complained of arthritis pain in her wrists, arms, hips, and back. At this visit,
the claimant weighed 214 pounds at a height of 5'7". The claimant’s treating source at
Birmingham Health Care3 noted that the claimant had no edema, no clubbing, and no cyanosis in
her extremities. The treating source also noted that the claimant had normal gait and normal and
mild tightness of both CMC (carpometacarpal) joints in both hands. The treating source
diagnosed the claimant with benign essential hypertension and osteoarthritis of the first
metatarsalphalangeal joint. At this visit, Amin Islam, a physician assistant at Birmingham Health
Care, prescribed the claimant Enalapril, a medication used to treat high blood pressure, and
Ibuprofen. On June 28, 2010, the claimant visited Birmingham Health Care for a refill on her
Enalapril and Ibuprofen prescriptions. At this visit, the claimant’s treating source noted that she
had swelling of the carpometacarpal joints. (R. 233-38).
No records exist from Birmingham Health Care before June 14, 2010. The report from
this date indicates that the claimant’s visit was a follow-up on her hypertension, but the report
does not provide any information about prior visits.
The providers’ signatures on the claimant’s records from Birmingham Health Care are
On November 15, 2010, Sharon Elliott Hand4 completed a function report on behalf of
the claimant. In this report, Ms. Hand indicated that on a normal day, the claimant wakes up,
makes coffee, takes a shower, makes breakfast, watches TV, washes clothes or dishes if needed,
makes dinner, and then lays in bed watching TV until she falls asleep. Ms. Hand further stated
that at night, the claimant wakes up every few hours to take pain pills. Ms. Hand indicated that
the claimant is capable of preparing her own quick meals and doing household chores, such as
laundry and washing dishes. Ms. Hand indicated that the claimant does not drive because she
does not have a car or license and cannot see very well. Ms. Hand stated that the claimant’s
hobbies include watching TV and playing cards, and that she goes out every other week to her
daughter’s house or to the grocery store. Ms. Hand reported that the claimant has trouble with
lifting, squatting, bending, standing, reaching, walking, sitting, kneeling, stair climbing,
completing tasks, concentration, and using her hands. Specifically, Ms. Hand wrote that the
claimant could only lift ten to twenty pounds, could only walk one block, could not sit in one
position for long, and could not kneel at all. Ms. Hand stated that the claimant could not follow
written instructions because she could not read well, but that she could follow spoken
instructions. (R. 169-78).
On November 15, 2010, Ms. Hand also completed a Work History Report on behalf of
the claimant. In this report, Ms. Hand indicated that the claimant had previously worked as a fast
food worker, a cashier, and a plant worker. In the fast food positions, the claimant’s primary
responsibilities included making sandwiches, running the grill, and cooking french fries. In these
The record does not indicate Ms. Hand’s relationship to the claimant. The court suspects
that both Sharon Elliott Hand and Charles Hand, mentioned on the following page, are relatives
of the claimant.
positions, Ms. Hand indicated that the claimant would have to lift large bags of flour, large boxes
of meat, and bags of fries, and carry them somewhere between fifteen to thirty feet, three to ten
times a day. As a cashier, the claimant ran the cash register and unloaded large boxes from trucks
and put the items on the shelves daily. As a plant worker, Ms. Hand indicated that the claimant
was responsible for trimming excess plastic, loading items onto lifts, and adding color to the
plastic machines. Ms. Hand stated that the claimant would constantly lift large boxes of plastic
and lift five-gallon buckets of color and pour the color into the machines around 25 times a shift.
On December 9, 2010, Charles Hand completed a Third Party Drug and Alcohol Use
Questionnaire. In this questionnaire, Mr. Hand indicated that the claimant was on drugs for a
little over a year and went to prison for her drug use, but that she no longer used any drugs or
alcohol. (R. 196-97). The claimant also completed a Drug and Alcohol Use Questionnaire and
indicated the same facts regarding her drug use. She indicated that she used drugs in the past and
went to prison for manufacturing a controlled substance, but stopped using drugs in July of 2009.
On December 17, 2010, the claimant visited the emergency room at Cooper Green
Hospital, complaining that she had experienced hip pain for eight months or longer that was
getting worse. The claimant’s treating source5 diagnosed her with arthralgia in her left hip and
noted that her gait was impaired. (R. 242-45).
At the request of the Social Security Administration, Dr. Marlin D. Gill performed a
The providers’ signatures on the claimant’s records from Cooper Green Hospital are
consultative examination of the claimant on February 17, 2011. Dr. Gill noted that the claimant
complained of lower back pain. Dr. Gill reported that the claimant did not currently have a
treating doctor and was not taking any medications for her back condition. He noted that the
claimant took over-the-counter BC Powders or Goody Powers for her pain occasionally. Dr. Gill
stated that the claimant also complained of multiple joint pains, but that no physician had ever
evaluated the claimant for this condition. He stated that the claimant also had problems with
hypertension and had a history of polysubstance abuse, but had not used drugs for a year. At this
visit, the claimant was 231 pounds at a height of 5'7". (R. 268-70).
Dr. Gill further noted that the claimant’s gait was normal and that she walked without the
assistance of an ambulatory device. He reported that the claimant had a full range of motion in
her joints and her arm strength was 5/5 bilaterally. He noted that her hands were normal, with no
joint tenderness, no bone or joint deformities, the ability to form a full fist and oppose her thumb
to all fingertips bilaterally, and a grip strength of 4-5/5 bilaterally. Dr. Gill reported that the
claimant’s back looked normal and was not tender, that she could bend forward to 70 degrees,
come back up erect, and rotate 20 degrees bilaterally. Dr. Gill noted that her legs appeared
normal and symmetrical with good muscle tone. He also reported that from the supine position,
the claimant could lift her legs off the exam table with no difficulty, and that her leg strength was
5/5 bilaterally. Dr. Gill noted that, although the claimant complained of hip pain, her hips were
nontender, and she was able to flex them to 100 degrees and extend to 0 bilaterally. Dr. Gill
noted that the claimant also complained of discomfort with knee movement, but stated that her
knees appeared normal, and that she did not have bone or joint deformity or swelling. Dr. Gill
noted that the claimant was capable of flexing her knees to 130 degrees and extending them to 0
bilaterally. He stated that from the standing position, the claimant could squat down half way and
come back up again holding onto the table. Dr. Gill reported that the claimant was also capable
of walking across the room on her tiptoes and heels. (R. 270).
An x-ray taken at this visit indicated severe degenerative disc disease at L5-S1. Dr. Gill
noted that the claimant’s other discs appeared well-preserved. He also indicated that the x-ray
showed bilateral facet arthrosis at L5 and no other bony abnormalities. (R. 270).
At the request of the Social Security Administration, Dr. Robert Estock performed a
psychiatric review of the claimant on February 23, 2011. Dr. Estock did not examine the claimant
in person, but completed his assessment based on the claimant’s medical records. Dr. Estock
concluded that the claimant had no medically determinable impairment. Dr. Estock noted that the
claimant reported a history of polysubstance abuse and was incarcerated for manufacturing and
using drugs, but now claimed that she no longer used drugs or alcohol. (R. 246-58).
Dr. Estock concluded that the objective medical evidence did not support a diagnosis of
either substance abuse or any other mental impairment. Furthermore, Dr. Estock noted that the
claimant had not reported any symptoms or functional limitations resulting from a mental
impairment. Dr. Estock indicated that the claimant had complained of difficulty with
concentration, but that she had attributed this difficulty to her severe pain, not to a mental
condition. Consequently, Dr. Estock concluded that the claimant did not have a medically
determinable impairment and did not recommend any limitations in the claimant’s basic work
activity because of any potential impairments. (R. 246-58).
On February 23, 2011, Dr. Robert H. Heilpern also completed a physical residual
functional capacity assessment on the claimant at the request of the Social Security
Administration. Dr. Heilpern similarly did not evaluate the claimant in person, but based his
conclusions on the claimant’s medical records. Dr. Heilpern found that the claimant could
occasionally lift twenty pounds; could frequently lift ten pounds; could stand or walk about six
hours of an eight-hour work day; could sit with normal breaks for a total of about six hours in a
eight-hour workday; and could push or pull without limits. Dr. Heilpern noted that the claimant
could frequently climb ramps and stairs and balance; could occasionally stoop, kneel, crouch, and
crawl; and could never climb ladders, ropes, or scaffolds. Dr. Heilpern also stated that the
claimant should avoid concentrated exposure to extreme cold, and all exposure to unprotected
heights, open bodies of water, and hazardous machinery. Dr. Heilpern concluded that the
claimant’s medically determinable impairments could reasonably produce some of her alleged
symptoms and functional limitations; however, her statements were only partially credible in
light of the fact that her allegations were not consistent with the objective medical evidence on
file. Specifically, Dr. Heilpern cited the claimant’s full range of motion of the bilateral hands,
strength of 4-5/5 in her hands, ability to create a full fist, and lack of evidence of joint tenderness
or deformity as objective evidence in conflict with the claimant’s allegations. Dr. Heilpern also
stated that the claimant’s ability to cook, clean, do laundry, and wash dishes supported his
conclusions about the claimant’s ability to perform basic work. (R. 260-67).
The claimant’s records indicate that she occasionally visited the Good Samaritan Health
Clinic for treatment of her impairments from February 2011 to May 2012. On February 25,
2011, nurse practitioner Carol Livingston noted that the claimant had severe hypertension, for
which she was not receiving treatment. Ms. Livingston prescribed Lisinopril, a medication used
to treat high blood pressure, and HCTZ, or hydrochlorothiazide, a diuretic used to treat
hypertension. Ms. Livingston also noted that the claimant had arthralgia, or joint pain, in her
back, knees, and ankles. (R. 290).
On March 31, 2011, the claimant’s daughter called Good Samaritan Health Clinic
requesting to pick up the claimant’s medications because the claimant was in jail. Good
Samaritan informed the claimant’s daughter that she should let the jail handle her mother’s
medical treatment. No medical records exist from the jail during the claimant’s incarceration. (R.
On July 7, 2011, once the claimant was released from jail, she visited Good Samaritan
Health Clinic again. Nurse practitioner Carol Livingston noted that the claimant was now off her
medications and would have to restart her treatment plan. Ms. Livingston again prescribed the
claimant Lisinopril and HCTZ. (R. 287-88).
On July 28, 2011, Ms. Livingston noted that the claimant alleged that she had been
suffering from daily headaches for about a year. Ms. Livingston substituted Accupril for the
claimant’s Lisinopril and also prescribed the claimant Atenolol for her high blood pressure and
Tramadol (the generic version of Ultram) for her pain.
On August 26, 2011, Ms. Livingston noted that the claimant still complained of having
headaches, but said she did not have as many. Ms. Livingston noted that she did not want to give
the claimant Triptan, a medication used to treat migraines. Ms. Livingston instead put the
claimant on a trial of Neurontin, a drug used to relieve nerve pain. On September 9, 2011, Ms.
Livingston noted that the claimant indicated that the Neurontin prescription helped her more than
the Tramadol, but that she still had frequent headaches and pressure around her eyes. (R. 28186).
On March 23, 2012, Ms. Livingston noted that the claimant was non-compliant with her
treatment because she had not picked up her Accupril or Neurontin prescriptions. Ms. Livingston
restarted the claimant on these prescriptions at this visit. On April 24, 2012, the claimant visited
Good Samaritan again, complaining of a tight chest, coughing, allergies, and pain in the back of
her knees that was not relieved by Tylenol or Aleve. At this visit, Ms. Livingston prescribed
Norvasc for the claimant’s high blood pressure and Cyclobenzaprine for her muscle spasms. On
May 8, 2012, Ms. Livingston noted that the claimant’s hypertension was at goal and substituted
Methocarbonal for the claimant’s Cyclobenzaprine. (R. 273-80).
The ALJ Hearing
After the Commissioner denied the claimant’s request for disability insured benefits, the
claimant requested and received a hearing before an ALJ. (R. 50, 53-55). At the hearing, the
claimant testified that she previously worked as a biscuit cook at Hardee’s. Prior to this position,
the claimant worked as mold machine operator, running a machine that made various plastic
items. The claimant testified that she also worked for this company as a floor person “that pulled
the merchandise after they got it stacked on a dolly and pulled it down, about the length of a
football field.” The claimant testified that the heaviest thing she lifted in this position was at least
75 pounds. The claimant also indicated that she worked at Fred’s retail store and Jack’s fast food
restaurant as a cook. At Fred’s, the claimant indicated that she lifted boxes that were around 50
to 75 pounds. At Jack’s, the claimant indicated that the heaviest things she lifted were around 50
pounds, if not a little more. (R. 27-29).
The claimant indicated she did not drive because she did not have a current driver’s
license. She testified that she did not need any help taking care of her personal needs, such as
getting dressed and putting on socks or shoes, but had difficulty sometimes. (R. 29-30).
The claimant testified that, when she wakes up, she will make breakfast, and then go back
to sitting and watching TV; that she then makes a sandwich for lunch and makes dinner, by either
microwaving her food or by cooking something in the oven; and that she spends most of her day
on the couch or in the recliner. The claimant further testified that she does not read or have any
hobbies and just sits in her recliner and watches TV all day; she occasionally visits her daughter,
but that she does not stay out that long and usually her daughter just comes to visit her; she can
go shopping for about twenty minutes and then has to sit down because she would have
throbbing pain in her lower back, feet, and knees. The claimant stated that standing in one spot
was harder for her than walking, and that she could sit upright in a chair for about thirty minutes
before she would have to get up and move or change positions. (R. 30-31).
The claimant testified that she was not capable of lifting a case of 24 cans of Coke, but
could lift a gallon of milk; her granddaughter does most of the laundry, but that every once in a
while, she does a load herself; when walking up the four stairs on the porch to her house, she has
to hold onto the rails; she cannot squat or bend down to pick things up off the floor, but did not
have any problems with getting things out of the kitchen cupboards. She testified that she did
have trouble washing her hair sometimes, but does not have any trouble holding onto small items
such as forks, pens, or the remote control, and did not have trouble holding larger items like a
glass or the doorknob. (R. 32-34).
The claimant also testified that she takes medicine for blood pressure, allergies, and
headaches, as well as a prescription for muscle spasms in her back and a generic Ultram
prescription for her pain. The claimant indicated that the Ultram helps some with her pain. The
claimant stated that she takes the Ultram every day, but just takes the muscle spasm medicine on
bad days; a doctor at Good Samaritan prescribed these medications, but she did not know the
doctor’s name. She used to go to Good Samaritan once every two weeks to a month for
problems with her blood pressure, but that her blood pressure was now under control, and she
only had one future appointment at Good Samaritan. The claimant testified that the doctors at
Good Samaritan had not recommended to her any kind of additional treatment or exercises that
she could do to strengthen her back. (R. 34-35).
A vocational expert, Ms. GleeAnn Kehr,6 testified concerning the type and availability of
jobs that the claimant could perform. Ms. Kehr testified that claimant’s work experience as a
mold machine operator would be classified as a plastics trimmer, and her other work would be
classified as a fast food worker. The vocational expert testified that the plastics trimmer position
would be medium, semiskilled work, and the fast food worker position would be light, unskilled
work. (R. 35-37).
The ALJ asked the vocational expert whether a hypothetical individual of the claimant’s
age, education, and work experience could work in a fast food position, with the following
limitations: light work; only occasionally crouching, crawling, stooping, or kneeling; and no
climbing ladders. The vocational expert responded that this individual would be capable of
working in a fast food position. The vocational expert testified that the individual could be off
task no more than 15 percent of the work day as a fast food worker and still maintain
employment. (R. 37).
The court notes that the court reporter incorrectly refers to the vocational expert as
“Brianne O’Hare” in the transcript of the ALJ Hearing. (R. 35). The vocational expert’s name is
actually GleeAnn Kehr. (R. 79).
The ALJ’s Decision
On July 24, 2012, the ALJ issued a decision finding that the claimant was not disabled
under the Social Security Act. (R. 8). First, the ALJ found that the claimant met the nondisability requirements for disabled widow’s benefits under section 202(e) of the Social Security
Act through the prescribed period ending October 31, 2017. (R. 13).
Second, the ALJ found that the claimant had not engaged in substantial gainful activity
since her amended alleged onset date of October 13, 2010. (R. 13).
Next, the ALJ found that the claimant had the severe impairments of degenerative disc
disease of the lumbar spine, arthritis, headaches, and hypertension. The ALJ found that these
conditions more than minimally impacted the claimant’s ability to lift, carry, crouch, crawl,
stoop, kneel, climb, understand, and remember. The ALJ found that the claimant’s history of a
substance abuse was a non-severe impairment because the claimant had maintained her sobriety
for over a year, and her medical records did not indicate any limitations resulting from her drug
use. (R. 13-14).
The ALJ next determined that the claimant did not have an impairment or combination of
impairments that met or medically equaled the severity of one of the listed impairments in 20
C.F.R. Part 404, Subpart P, Appendix 1. The ALJ considered whether the claimant met the
criteria for listing 1.04 concerning disorders of the spine, and found that the claimant did not
meet the criteria for this listing because her medical record did not demonstrate compromise of a
nerve root or the spinal cord with additional findings of evidence of nerve root compression,
limitation of motion of the spine, or motor loss.
Finally, the ALJ determined that the claimant had the residual functional capacity to
perform light, unskilled work as defined in 20 C.F.R. 404.1567(b) and 416.967(b), with only
occasional crouching, crawling, stooping, and kneeling, and no climbing ladders. In making this
finding, the ALJ considered the claimant’s symptoms and corresponding medical record. The
ALJ concluded that, although the claimant’s medically determinable impairments could
reasonably be expected to cause symptoms, the claimant’s allegations regarding the intensity,
persistence, and limiting effects of these symptoms were not fully consistent with the evidence.
The ALJ found that the objective medical evidence supported the claimant’s diagnosis of
severe degenerative disc disease. She relied on a February 2011 lumbar x-ray that demonstrated
severe degenerative disc disease with facet arthrosis at L5-S1. (R. 270). This x-ray was consistent
with the claimant’s allegations of pain in her lumbar spine. Based on this evidence, the ALJ
limited the claimant to light work, with only occasional crouching, crawling, stooping, and
kneeling, and no climbing stairs. (R. 15).
The ALJ also found that the objective medical evidence supported the claimant’s
complaints of pain in the hands and wrists bilaterally. She found objective medical support in a
June 2010 physical exam, which revealed tightness in the claimant’s CMC (carpometacarpal)
joints bilaterally. She also found support in the claimant’s diagnosis of osteoarthritis of the first
metatarsalphalangeal joint from her treating source at Birmingham Health Care. (R. 237).
The ALJ also cited the claimant’s February 2011 consultative physical exam, in which
Dr. Martin Gill noted that the claimant had 4-5/5 strength in her hands bilaterally and difficulty
squatting. (R. 268-271). The ALJ concluded that based on this objective medical evidence, the
claimant should be limited to light work, with only occasional crouching, crawling, stooping and
kneeling, and no climbing stairs. (R. 15-16).
The ALJ also limited to the claimant to light work because of a February 25, 2011
treatment note from Good Samaritan Health Clinic that characterized the claimant’s hypertension
as severe. (R. 16, 290).
The ALJ considered the claimant’s allegations of constant headaches. The ALJ concluded
that the claimant should be limited to unskilled work, as the pain may interfere with her ability to
perform more strenuous mental demands. The ALJ did not find, however, that the frequency of
the claimant’s headaches was consistent with the objective medical evidence. The ALJ stated that
“[t]reatment notes fail to show frequent complaints of headache from the claimant.”
Consequently, the ALJ concluded that the claimant’s headaches would not take her off-task more
than 15% of the workday. (R. 16).
The ALJ found that many of the claimant’s other subjective complaints conflicted with
the objective medical evidence. The claimant alleged that she could sit for thirty minutes at a
time, could stand for less than twenty minutes at a time, and could walk for twenty minutes at a
time. The claimant testified that she had problems sitting, standing, and walking because of her
back and lower extremity pain; she had trouble climbing stairs and picking up items from the
floor. The ALJ found that these allegations conflicted with the findings of the February 17, 2011
consultative exam, in which Dr. Martin Gill determined that the claimant had a normal gait, full
range of motion of the joints, no joint tenderness, and 5/5 strength in the bilateral lower
extremities. Dr. Gill also indicated that the claimant could close her hands into a fist and oppose
her thumbs to all fingers bilaterally. (R. 268-71). The ALJ also considered a June 14, 2010
treatment note from Birmingham Health Care that stated that the claimant had only mild
tightness in the CMC joints bilaterally, and a May 8, 2012 treatment note from Good Samaritan
Health Clinic that stated the claimant’s hypertension was controlled. (R. 237, 273). The ALJ
concluded that these medical records rendered the claimant’s allegations of disability less than
fully credible. (R. 16).
The ALJ also cited the claimant’s testimony at the hearing that she did not have any
problems engaging in fine or gross manipulation for her conclusion that the claimant did not
experience any manipulative limitations. (R. 16).
Additionally, the ALJ considered the claimant’s current treatment plans for her
impairments. She noted that the claimant testified that she takes medication for her blood
pressure, allergies, headaches, muscle spasms, and the pain medication Ultram. The ALJ noted,
however, that the medical evidence did not indicate that the claimant had undergone any actual
treatment for her impairments. The ALJ consequently concluded that the claimant’s medication
regimen and treatment history, or lack thereof, did not support the presence of impairments more
limiting than those which she had already recognized. (R. 16).
The ALJ concluded that the claimant’s limited daily activities were not strong evidence in
favor of finding the claimant disabled. First, she stated that the allegedly limited daily activities
could not be objectively verified. Second, the ALJ stated that even if the claimant’s daily
activities were as limited as she alleged, she could not attribute those limitations to the claimant’s
impairments, rather than to other reasons, given the relatively weak medical evidence contained
in her record. (R. 16-17).
The ALJ supported her conclusions by saying that the record did not contain an opinion
from any treating or examining physician suggesting that the claimant was disabled or had
limitations greater than those that she recognized. Accordingly, the ALJ determined that the
objective medical evidence supported her findings on the claimant’s residual functional capacity
and ability to do light, unskilled work. (R. 17).
Finally, the ALJ determined that the claimant was capable of performing her past relevant
work as a fast food worker. The ALJ relied on the testimony of the vocational expert, Ms.
GleeAnn Kehr, for her conclusion that the claimant could perform the position of a fast food
worker both as it was actually performed by the claimant and as generally performed in the
national economy. (R. 17).
Accordingly, the ALJ determined that the claimant was not disabled as defined by the
Social Security Act. (R. 17).
The claimant argues that the ALJ improperly discredited the claimant’s subjective
complaints of pain and characterizations of her physical limitations. To the contrary, this court
finds that substantial evidence supports the ALJ’s findings and that she applied the appropriate
legal standards to her evaluation of the claimant’s subjective complaints and allegations of pain.
A Commissioner evaluating a claimant’s pain and other subjective complaints must first
consider whether the claimant demonstrated an underlying medical condition. Holt, 921 F.2d at
1223; see also Wilson v. Barnhart, 284 F.3d 1219, 1221 (11th Cir. 2002); 20 C.F.R. § 404.1529.
If the claimant demonstrates an underlying medical condition, the Commissioner must then
determine if any objective medical evidence confirms the severity of the alleged pain, or if the
underlying medical condition has been objectively confirmed and is so severe that one could
reasonably expect it to give rise to the alleged pain. Id. Subjective testimony can satisfy the pain
standard if the testimony is supported by objective medical evidence. Foote, 67 F.3d at 1561.
The ALJ must articulate reasons for discrediting the claimant’s subjective testimony.
Brown v. Sullivan, 921 F.2d 1233, 1236 (11th Cir. 1991). The reasons articulated for discrediting
the claimant’s testimony may include the claimant’s daily activities. Harwell, 735 F.2d at 1293.
However, if the ALJ does not articulate reasons, the court must accept the claimant’s testimony
as true. Holt, 921 F.2d at 1236.
The ALJ in the present case properly articulated her reasons for discrediting the
claimant’s testimony about her pain and characterization of her physical capabilities. The ALJ
concluded that, although the claimant’s medically determinable impairments could reasonably be
expected to cause symptoms, the claimant’s allegations regarding the intensity, persistence, and
limiting effects of these symptoms were not fully consistent with the evidence. (R. 15). The ALJ
set forth several reasons for finding the claimant’s allegations inconsistent with the evidence. She
found that the objective medical evidence conflicted with the claimant’s allegations. Specifically,
the ALJ noted that Dr. Gill, in his February 17, 2011 consultative physical exam, indicated that
the claimant had a full range of motion of the joint, no joint tenderness, and 5/5 strength in the
bilateral lower extremities. Dr. Gill also noted that the claimant could close her hands into a fist
and oppose her thumbs to all her fingers bilaterally. (R. 16, 270-72). The ALJ also relied on the
June 14, 2010 treatment note from Birmingham Health Care that indicated that the claimant had
only mild tightness of the CMC joints bilaterally. (R. 16, 237). Additionally, the ALJ mentioned
the May 8, 2012 treatment note from Good Samaritan Health Clinic that stated that the
claimant’s hypertension was at goal, as further evidence that the claimant’s allegations were not
fully consistent with the record. (R. 16, 273). The ALJ concluded that these records rendered the
claimant’s allegations less than fully credible.
The ALJ also discredited the claimant’s characterizations of her allegedly limited daily
activities. The ALJ did not consider the claimant’s daily activities to be strong evidence in favor
of finding the claimant disabled for two reasons. First, the claimant’s allegedly limited daily
activities could not be objectively verified with any reasonable degree of certainty. Second, the
ALJ found that, because of the relatively weak medical evidence in the claimant’s record, she
could not conclusively state that the claimant’s medical conditions were the source of the her
alleged limitations. The ALJ, therefore, determined that the objective evidence outweighed the
claimant’s allegations regarding her daily activities.
The court finds that these reasons constitute substantial evidence to support the ALJ’s
determination that the claimant’s complaints were not fully credible. Consequently, the ALJ
properly discredited the claimant’s subjective complaints.
For the reasons stated above, this court concludes that substantial evidence supports the
Commissioner’s decision. Accordingly, this court AFFIRMS the decision of the Commissioner.
The court will enter a separate order to that effect simultaneously.
DONE and ORDERED this 9th day of February, 2014.
KARON OWEN BOWDRE
CHIEF UNITED STATES DISTRICT JUDGE
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