Medley v. Social Security Administration, Commissioner
MEMORANDUM OPINION. Signed by Judge Madeline Hughes Haikala on 3/23/2015. (KEK)
2015 Mar-24 AM 08:44
U.S. DISTRICT COURT
N.D. OF ALABAMA
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
JOHN DOUGLAS MEDLEY,
CAROLYN W. COLVIN
Commissioner of the
Social Security Administration,
Case No.: 5:14-CV-00287-MHH
Pursuant to 42 U.S.C. §§ 405(g) and 1383(c), claimant John Douglas
Medley seeks judicial review of a final adverse decision of the Commissioner of
Social Security denying his claims for a period of disability and disability
insurance benefits and supplemental security income. After careful review, the
Court affirms the Commissioner’s decision.
STANDARD OF REVIEW:
The scope of review in this matter is limited. “When, as in this case, the
ALJ denies benefits and the Appeals Council denies review,” the Court “review[s]
the ALJ’s ‘factual findings with deference’ and [his] ‘legal conclusions with close
scrutiny.’” Riggs v. Comm’r of Soc. Sec., 522 Fed. Appx. 509, 510-11 (11th Cir.
2013) (quoting Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001)).
The Court must determine whether there is substantial evidence in the record
to support the ALJ’s findings. “Substantial evidence is more than a scintilla and is
such relevant evidence as a reasonable person would accept as adequate to support
a conclusion.” Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir.
2004). In making this evaluation, the Court may not “reweigh the evidence or
decide the facts anew,” and the Court must “defer to the ALJ’s decision if it is
supported by substantial evidence even if the evidence may preponderate against
it.” Gaskin v. Comm’r of Soc. Sec., 533 Fed. Appx. 929, 930 (11th Cir. 2013)
(citing Dyer v. Barnhart, 395 F.2d 1206, 1210 (11th Cir. 2005)).
With respect to the ALJ’s legal conclusions, the Court must determine
whether the ALJ applied the correct legal standards. If the Court finds an error in
the ALJ’s application of the law, or if the Court finds that the ALJ failed to provide
sufficient reasoning to demonstrate that the ALJ conducted a proper legal analysis,
then the Court must reverse the ALJ’s decision. Cornelius v. Sullivan, 936 F. 2d
1143, 1145-46 (11th Cir. 1991).
PROCEDURAL AND FACTUAL BACKGROUND:
Mr. Medley applied for disability insurance benefits on July 22, 2011 and
supplemental security income on August 2, 2011. (Doc. 5-6, pp. 109-110)
alleges that his disability began July 15, 2011. (Doc. 5-6, pp. 109-110). The
Commissioner initially denied Mr. Medley’s claims, and Mr. Medley requested a
hearing before an Administrative Law Judge (ALJ). (Doc. 5-5, pp. 4-6 & Doc. 5-3,
pp. 22-23). Mr. Medley appeared before the ALJ and testified at the hearing on
September 7, 2012. (Doc. 5-3, pp. 26-52). The ALJ denied Mr. Medley’s claim on
October 5, 2012. (Doc. 5-3, pp. 8-21). On January 14, 2014, the Appeals Council
declined Mr. Medley’s request for review (Doc. 5-3, pp. 2-7), making the
Commissioner’s decision final and a proper subject of this Court’s judicial review.
See 42 U.S.C. §§ 405(g) and 1383(c)
Mr. Medley was 42 years old at the time of the hearing, and he had a tenth
grade education. (Doc. 5-3, pp. 16, 20). Mr. Medley has past relevant work as a
painter. (Doc. 5-6, pp. 15, 16).
Mr. Medley claims he cannot work due to
degenerative disc disease. (Doc. 5-3, p. 14). At the hearing Mr. Medley testified
that he has pain in his lower back on the right side, which goes into his hip and
sometimes causes tingling in his leg. (Doc. 5-3, pp. 30-31). Mr. Medley also
complained of knee pain, but he admitted that this pain was caused by a recent
injury where he stepped in a hole and twisted his knee. (Doc. 5-3, p.31). Before
this recent jury, Mr. Medley had knee pain occasionally due to a childhood knee
injury. (Doc. 5-3, p. 31).
Mr. Medley testified that to relieve his pain, he must alternate among
standing, walking, and sitting down. (Doc. 5-3, p. 31) According to Mr. Medley,
the pain eases when he stands, straightens his back, and walks, but the pain comes
back within 20 minutes. (Doc. 5-3, p. 32). Mr. Medley testified that he can walk
for 20 minutes, and then he has to sit down for 20 to 30 minutes. He must repeat
this cycle throughout the day. (Doc. 5-3, p. 37). When he takes his medication as
prescribed, Mr. Medley rates his pain as a seven on a 10-point scale (Doc. 5-3, p.
37). One of Mr. Medley’s doctors suggested treatment by injection, but Mr.
Medley refused the treatment. (Doc. 5-3, p. 35).
Although no doctor has
prescribed a cane, Mr. Medley told the ALJ that he would not be able to walk more
than a few feet without the cane. (Doc. 5-3, p 43).
Mr. Medley lives with his wife and young daughter. Mr. Medley cannot
help with household chores. (Doc. 5-3, p. 32). Mr. Medley testified that he sits and
watches television most of the day. He also takes brief walks. (Doc. 5-3, p. 32).
After conducting the hearing and reviewing the medical records that Mr.
Medley submitted in support of his claim, the ALJ denied Mr. Medley’s claim for
benefits. (Doc. 5-3, pp. 11-18). The ALJ found that Mr. Medley suffers from the
severe impairment of degenerative disc disease. (Doc. 5-3, p. 13). The ALJ
determined that Mr. Medley’s impairment does not meet the severity of listing 1.04
because the evidence fails to demonstrate compromise of a nerve root or the spinal
cord. (Doc. 5-3, p. 13).
After careful consideration of the entire record, the ALJ concluded that Mr.
Medley has the residual function capacity (RFC) to preform light work, except Mr.
Medley can only occasionally climb, balance, stoop, kneel, crouch, and crawl.
(Doc. 5-3, p.14). Mr. Medley also should avoid unprotected heights. (Doc. 5-3, p.
14). In reaching this determination, the ALJ considered Mr. Medley’s symptoms
and the extent to which these symptoms can reasonably be accepted as consistent
with the medical evidence and Mr. Medley’s various statements, his testimony at
the hearing in this matter, and the medical treatment history that Mr. Medley
(Doc. 5-3, p. 14).
Based on Mr. Medley’s age, education, work
experience, and RFC, the ALJ found that there are jobs exist in the national
economy and in Alabama that Mr. Medley can perform, including ticket marker,
assembler, and mail sorter. (Doc. 5-3, p. 17). Accordingly, the ALJ determined that
Mr. Medley is not disabled as defined in the Social Security Act. (Doc. 5-3, p 17).
To be eligible for disability benefits, a claimant must be disabled. Gaskin,
533 Fed. Appx. at 930. “A claimant is disabled if he is unable to engage in
substantial gainful activity by reason of a medically-determinable impairment that
can be expected to result in death or which has lasted or can be expected to last for
a continuous period of at least 12 months.” Id. (citing 42 U.S.C. § 423(d)(1)(A)).
A claimant must prove that he is disabled. Id. (citing Ellison v. Barnhart, 355 F.3d
1272, 1276 (11th Cir. 2003)). To determine whether a claimant is disabled, the
Social Security Administration applies a five-step sequential analysis.
This process includes a determination of whether the claimant (1) is
unable to engage in substantial gainful activity; (2) has a severe and
medically-determinable physical or mental impairment; (3) has such
an impairment that meets or equals a Listing and meets the duration
requirements; (4) can perform his past relevant work, in the light of
his residual functional capacity; and (5) can make an adjustment to
other work, in the light of his residual functional capacity, age,
education, and work experience.
Gaskin, 533 Fed. Appx. at 930 (citation omitted).
“The claimant’s residual
functional capacity is an assessment, based upon all relevant evidence, of the
claimant’s ability to do work despite his impairments.” Id. at 930 (citing Lewis v.
Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997)); see also 20 C.F.R. §
Mr. Medley argues that he is entitled to relief from the ALJ’s decision
because: (1) the ALJ did not give proper weight to the opinion of Mr. Medley’s
treating physician, Dr. Aggarwal; (2) the ALJ improperly assigned “great weight”
to the opinion of a non-examining state agency consultant; (3) the ALJ did not
properly evaluate Mr. Medley’s credibility; and (4) the ALJ’s questions to the
vocational expert were not supported by substantial evidence. The Court examines
these arguments in turn.
The ALJ Properly Evaluated Dr. Aggarwal’s Opinion
An ALJ must give the opinion of a treating physician “substantial or
considerable weight unless ‘good cause’ is shown to the contrary.” Phillips v.
Barnhart, 357 F.3d 1232, 1240-41 (11th Cir. 2004). Good cause exists when “(1)
[the] treating physician’s opinion was not bolstered by the evidence; (2) [the]
evidence supported a contrary finding; or (3) [the] treating physician’s opinion was
conclusory or inconsistent with the doctor’s own medical records.” Id.; see also
Crawford, 363 F.3d at 1159. “The ALJ must clearly articulate the reasons for
giving less weight to a treating physician’s opinion, and the failure to do so
constitutes error. ‘Moreover, the ALJ must state with particularity the weight
given to different medical opinions and the reasons therefor.’” Gaskin, 533 F.
Appx. at 931 (citing Lewis, 125 F.3d at 1440, and quoting Winschel v. Comm’r of
Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 2011)).
In this case, the ALJ articulated his reasons for affording Dr. Aggarwal’s
opinion less weight. Dr. Aggarwal’s opinion that Mr. Medley is precluded from
gainful employment due to severe pain and medication side effects contradicts his
own medical records, as well as medical findings by other physicians.
example, Dr. Aggarwal’s notes describe no side effects.
His records do not
suggest that Mr. Medley complained about side effects from his pain medication.
(Doc. 5-8, pp. 28-34). To the contrary, during clinic visits in March 2011, June
2011, and November 2011, Mr. Medley denied experiencing side effects from his
medications. (Doc. 5-8, pp. 31-33). Dr. Aggarwal commented that Mr. Medley
“has good days and bad days,” and that Mr. Medley either has “continued pain
despite the meds” or has “continued benefit with medication.” (Doc. 5-8, pp. 1114; 28-33).1
During Dr. Aggarwal’s initial evaluation of Mr. Medley, Dr. Aggarwal
found that Mr. Medley’s motor strength was 5 out of 5 bilaterally and that Mr.
Medley’s sensation was intact. Mr. Medley’s reflexes were 2+ bilaterally, but he
did have a slow gait. (Doc. 5-8, pp. 13-14). A number of Dr. Aggarwal’s followup treatment notes indicate that Mr. Medley experienced “moderate tenderness” in
his lumbar muscles. (Doc. 5-8, pp. 28-32). However, Dr. Aggarwal conducted no
additional testing and made no specific medical findings other than notes on three
visits that Mr. Medley had a 25% reduction in range of motion in the lumbar spine.
In his opinion, the ALJ offers the following accurate assessment of Dr. Aggarwal’s treatment
notes: “Dr. Aggarwal’s notes reflect that the claimant has visited this pain clinic approximately
every three months since February 9, 2011. The records for each visit are very similar. Dr.
Aggarwal consistently notes that patient ‘has good days and bad days’ and also notes either
‘continued pain despite the meds’ or ‘continued benefit with the medications.’ The examination
notes generally consist of the statement ‘Patient has moderate tenderness in the lumbar
paraspinal muscles. Neuromuscular exam is otherwise unchanged.’ There are no specific tests
described, nor any specific findings noted other than on three visits noting a 25% reduction in
range of motion in the lumbar spine.” (Doc. 5-3, p. 16).
(Doc. 5-3, p. 16; Doc. 5-8, pp. 30-32). These findings are inconsistent with Dr.
Aggarwal’s opinion that Mr. Medley cannot work due to severe pain. Thus, the
Court finds good cause to give the treating physician’s opinion less weight; in this
respect, the ALJ’s decision is supported by substantial evidence. Crawford, 363
F.3d at 1159–61 (finding that substantial evidence supported the ALJ’s decision to
discredit the opinions of the claimant’s treating physicians where those physicians’
opinions regarding the claimant’s disability were inconsistent with the physicians’
treatment notes and unsupported by the medical evidence); see also ReynoldsBuckley v. Comm’r of Soc. Sec., 457 Fed. Appx. 862 (11th Cir. 2012) (substantial
evidence supported the ALJ’s decision to give less weight to a treating physician’s
opinion when the doctor’s opinion was “inconsistent with the medical evidence on
record and was not supported by any treatment notes or by an analysis of any test
The ALJ Properly Considered the Opinion of the State Agency
The ALJ was free to rely upon the opinion of state agency consultant Dr.
Richard Whitney even though he never examined Mr. Medley. The Eleventh
Circuit has recognized that the “opinions of non-examining, reviewing physicians,
when contrary to the opinion of a treating physician, are entitled to little weight
and do not, ‘taken alone, constitute substantial evidence.’” Gray v. Comm’r of
Soc. Sec., 550 Fed. Appx. 850, 854 (11th Cir. 2013) (per curiam) (quoting
Broughton v. Heckler, 776 F.2d 960, 962 (11th Cir. 1985)). Nevertheless, if an
ALJ properly discounts a treating physician’s opinion, then an ALJ may rely on
opinions of non-examining physicians. See Wainwright v. Comm’r of Soc. Sec.,
2007 WL 708971 (11th Cir. Mar. 9, 2007) (per curiam) (holding that the ALJ
properly assigned substantial weight to non-examining sources when he rejected a
treating psychologist’s opinion and stated proper reasons for doing so); Ogranaja
v. Comm’r of Soc. Sec., 186 Fed. Appx. 848, 850-51 (11th Cir. 2006) (per curiam)
(noting that an ALJ may consider reports and assessments of state agency
physicians as expert opinions and finding that the ALJ’s decision was supported by
substantial evidence because the ALJ “arrived at his decision after considering the
record in its entirety and did not rely solely on the opinion of the state agency
The ALJ adopted Dr. Whitney’s RFC after properly rejecting the other
opinion evidence of record and considering other medical evidence in the record
that did not support Mr. Medley’s reports of disabling limitations. Therefore,
substantial evidence supports the ALJ’s decision to deny benefits. See e.g.,
Forrester v. Comm’r of Soc. Sec., 455 Fed. Appx. 899, 902-03 (11th Cir. 2012)
(“[T]he ALJ did not err by relying on the opinions of the non-treating physicians,
taken alone, in a way that left its decision unsupported by substantial evidence. The
evidence supported a contrary conclusion to [the claimant’s examining
physician’s] opinion, and the ALJ was not prohibited from reaching that
conclusion simply because non-treating physicians also reached it.”); Osborn v.
Barnhart, 194 Fed. Appx. 654, 667 (11th Cir. 2006) (per curiam) (holding that the
ALJ did not err in giving more weight to a non-examining physician and minimal
weight to the treating physician because the treating physician’s opinion was not
supported by objective medical evidence).
Substantial Evidence Supports the ALJ’s Credibility Finding
The Eleventh Circuit applies a three part pain standard when a claimant
attempts to establish disability based on subjective complaints of pain.
In order to establish a disability based on testimony of pain and other
symptoms, the claimant must satisfy two parts of a three-part test
showing: (1) evidence of an underlying medical condition; and (2)
either (a) objective medical evidence confirming the severity of the
alleged pain; or (b) that the objectively determined medical condition
can reasonably be expected to give rise to the claimed pain.
Wilson v. Barnhart, 284 F.3d 1219, 1225-26 (11th Cir. 2002) (per curiam) (citing
Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991)). “If the ALJ discredits
subjective testimony, he must articulate explicit and adequate reasons for doing
so.” Id. at 1225. (Internal citation omitted).
The ALJ found that Mr. Medley’s degenerative disc disease “could
reasonably be expected to cause [his] alleged symptoms.” (Doc. 5-3., p.15). But,
according to the ALJ, Mr. Medley’s “statements concerning the intensity,
persistence and limiting effects of [his] symptoms” are not credible. (Doc. 5-3, p.
15). In support of this conclusion, the ALJ made the following findings: (1) Mr.
Medley received limited treatment since his alleged onset date; (2) Mr. Medley’s
medical records indicate that he benefitted from his pain medication;2 (3) although
Mr. Medley testified that he experiences constant pain at a seven on a 10-point
scale, Mr. Medley told his doctor that “he has good days and bad days”; 3 (4) before
Mr. Medley’s alleged onset date, he “reported experiencing low back pain for five
years, but then stated at another visit with his physician that he had back pain for
10 to 15 years”; (5) Mr. Medley told one doctor that his “back gave out on him
when he bent over, but later stated that he had no specific injury and did not
mention that episode”; (6) Mr. Medley’s work despite back pain 10 to 15 years ago
“suggests that [the pain] would not currently prevent work”; (7) Mr. Medley
walked with a cane at the hearing and testified that he needed the cane to walk, but
no treating source prescribed a cane; and (8) Mr. Medley complained of muscle
spasms “most of the time,” but Mr. Medley’s medical records refer to spasms only
three times.4 (Doc. 5-3, p 15).
The record supports the ALJ’s credibility findings. In the Disability Report
that he completed, Mr. Medley answered “no” when asked if his condition caused
During two visits with Dr. Aggarwal, Mr. Medley reported continued pain despite his
medication. (See Doc. 5-8, pp. 28-29). But, on five separate visits, Mr. Medley reported that he
benefitted from his medication. (See Doc. 5-8, pp. 11, 12, 30, 31, 32).
See Doc. 5-8, pp. 28-33.
See Doc. 5-8, pp. 5, 29-30.
pain or other symptoms. (Doc. 5-7, p. 6).
When Dr. Newlin examined Mr.
Medley, Mr. Medley stated that his injury was due to “toting concrete in a
wheelbarrow.” (Doc. 5-8, p. 8). In another statement to his treating physician, Dr.
Aggarwal, Mr. Medley stated that he had back pain in the same level of intensity
for 10-15 years. (Doc. 5-8, p. 13).
When Dr. Saranya Nadella examined Mr. Medley, he complained that he
had suffered from lower back pain for five years. (Doc. 5-8, p. 27). Dr. Nadella
found Mr. Medley to have no acute distress, no focal motor deficits in the lower
extremities, no focal sensory deficits, and deep tendon reflexes of 2 out of 4
bilaterally. (Doc. 5-8, pp. 26-27). Dr. Nadella found that Mr. Medley showed
severe spondylitis at the L5-S1 and L1-L2 levels. (Doc. 5-8, p. 27). Dr. Nadella
recommended a course of treatment that included a lumbar epidural steroid
injection and trigger point injections, but Mr. Medley refused to try either
treatment option. (Doc. 5-8, p. 27). Mr. Medley asked to be referred to Dr.
Aggarwal at the Chronic Pain Care Clinic instead. (Doc. 5-8, p. 27).
Even as late as July 25, 2012, Dr. Aggarwal noted that Mr. Medley had
some moderate tenderness in the lumbar paraspinal muscles; otherwise Mr.
Medley’s neuromuscular exam was unchanged. (Doc. 5-8, p. 28). This change in
muscle tenderness was the only change noted since the initial examination in
February of 2011. (Doc. 5-8, pp. 11-15).
Discrepancies between Mr. Medley’s testimony and other items in the record
provide substantial evidence undermining his credibility. The ALJ did not err in
her determination. See Wilcox v. Comm’r of Soc. Sec., 442 Fed. Appx. 438 (11th
Cir. 2011) (affirming the ALJ’s credibility determination because the ALJ
“considered [the claimant’s] testimony together with all of the medical evidence in
the record”). Because the ALJ properly applied the pain standard and “articulated
the reasons for discrediting [Mr. Medley’s] subjective testimony,” the ALJ was not
required to accept Mr. Medley’s testimony as true. See id. (citing Cannon v.
Bowen, 858 F.2d 1541, 1545 (11th Cir. 1988)).
Substantial Evidence Supports the ALJ’s Hypothetical Questions
to the Vocational Expert
For the testimony of a VE to “constitute substantial evidence, the ALJ must
pose a hypothetical question which comprises all of the claimant’s impairments.”
Wilson, 284 F.3d at 1227 (internal citation omitted). However, when an ALJ
questions a VE about the capabilities of the claimant, the Eleventh Circuit has held
that the ALJ is “not required to include findings in the hypothetical that the ALJ
[has] properly rejected as unsupported.” Crawford, 363 F.3d at 1158; see also
Allen v. Barnhart, 174 Fed. Appx. 497 (11th Cir. 2006).
Based upon his review of Mr. Medley’s testimony and the medical evidence,
the ALJ posed a number of hypotheticals to the VE. (Doc. 5-3, pp. 45-48). Based
upon these hypotheticals, the VE responded that an individual with Mr. Medley’s
age, education, work experience, and RFC could perform jobs including assembler,
ticket taker, and mail sorter. (Doc. 5-3, pp. 45-46). Mr. Medley asserts that the
hypothetical questions did not include all of Mr. Medley’s impairments because
the ALJ told the VE that “what [Mr. Medley] testified to, is not really important as
to this particular hypothetical.” (Doc. 5-3, p. 49). The hearing transcript indicates
that the ALJ attempted to clarify Mr. Medley’s counsel’s hypothetical. The ALJ
permitted Mr. Medley’s counsel to ask a series of questions of the VE; the ALJ did
not limit the number of questions. Despite Mr. Medley’s argument to the contrary,
the ALJ was not required to include in his hypothetical impairments that are not
supported by the record.
The ALJ did not improperly limit the hypothetical
questions that Mr. Medley’s attorney posed to the VE.
supports the ALJ’s finding that Mr. Medley’s description of the limiting effects of
his symptoms is inconsistent with the record. See Crawford, 363 F.3d at 1158.
The ALJ’s hypothetical questions to the VE represented all of Mr. Medley’s
impairments that were supported by the record. See id.
For the reasons discussed above, the Court finds that the ALJ’s decision is
supported by substantial evidence, and the ALJ applied proper legal standards.
The Court will not reweigh the evidence or substitute its judgment for that of the
Commissioner. Accordingly, the Court affirmed the Commissioner. The Court
will enter a separate final judgment consistent with this memorandum opinion.
DONE and ORDERED this March 23, 2015.
MADELINE HUGHES HAIKALA
UNITED STATES DISTRICT JUDGE
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