Letson v. Social Security Administration, Commissioner

Filing 11

MEMORANDUM OPINION. Signed by Judge Virginia Emerson Hopkins on 12/18/2013. (AVC)

FILED
2013 Dec-18 PM 04:15
U.S. DISTRICT COURT
N.D. OF ALABAMA

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
JASPER DIVISION
EVELYN LETSON,
Plaintiff,
v.
CAROLYN W. COLVIN,1
ACTING COMMISSIONER,
SOCIAL SECURITY
ADMINISTRATION,
Defendant.

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) Case No.: 6:12-CV-3866-VEH
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MEMORANDUM OPINION
Plaintiff Evelyn Letson brings this action under 42 U.S.C. § 405(g), Section
205(g) of the Social Security Act. She seeks review of a final adverse decision of
the Commissioner of the Social Security Administration (“Commissioner”), who
denied her application for Disability Insurance Benefits (“DIB”) and Supplemental
Security Income (“SSI”).2

Ms. Letson timely pursued and exhausted her

Carolyn W. Colvin became the Acting Commissioner of Social Security on February
14, 2013. Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Acting Commissioner
Carolyn W. Colvin should be substituted for Commissioner Michael J. Astrue as the Defendant
in this suit. (“Any actions instituted in accordance with this subsection shall survive
notwithstanding any change in the person occupying the office of Commissioner of Social
Security or any vacancy in such office.”).
2
In general, the legal standards applied are the same regardless of whether a claimant
seeks DIB or SSI. However, separate, parallel statutes and regulations exist for DIB and SSI
claims. Therefore, citations in this opinion should be considered to refer to the appropriate
parallel provision as context dictates. The same applies to citations of statutes or regulations
found in quoted court decisions.
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administrative remedies available before the Commissioner. The case is ripe for
review under 42 U.S.C. § 405(g).3
FACTUAL AND PROCEDURAL HISTORY
Ms. Letson was 55 years old at the time of the administrative hearing before
the Administrative Law Judge (“ALJ”). (Tr. 20, 36). She has completed the 10th
grade. (Tr. 132). She has past relevant work as school cafeteria cook. (Tr. 20).
She claims she became disabled on September 13, 2008, due to: leg and back pain;
migraines; and chronic obstructive pulmonary disease (COPD). (Tr. 125). Her last
period of work ended on August 1, 2004. Id.
On November 14, 2008, Ms. Letson protectively filed a Title II application
for a period of disability and DIB. (Tr. 55). She also protectively filed a Title XVI
application for SSI on November 14, 2008. (Tr. 56). On February 13, 2009, the
Commissioner initially denied these claims. (Tr. 15). Ms. Letson then filed a
written request for a hearing on March 16, 2009. Id.
The ALJ conducted a hearing on the matter on December 14, 2010. Id. On
February 8, 2011, she issued her opinion concluding Ms. Letson was not disabled
and denying her benefits. (Tr. 22). Ms. Letson timely petitioned the Appeal

42 U.S.C. § 1383(c)(3) renders the judicial review provisions of 42 U.S.C. § 405(g)
fully applicable to claims for SSI.
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Council to review the decision on April 6, 2011. (Tr. 7). On September 14, 2012,
the Appeals Council denied a review on her claim. (Tr. 1-3).
Ms. Letson filed a Complaint with this court on November 13, 2012. (Doc.
1). The Commissioner answered on April 9, 2013. (Doc. 7). Ms. Letson filed a
supporting brief (Doc. 9) on May 22, 2013, and the Commissioner responded with
her own brief (Doc. 10) on June 20, 2013. With the parties having fully briefed the
matter, the court has carefully considered the record and finds the case should be
reversed and remanded.
STANDARD OF REVIEW
The function of this court is to determine whether the decision of the
Commissioner is supported by substantial evidence and whether proper legal
standards were applied.

Richardson v. Perales, 402 U.S. 389, 390 (1971);

McRoberts v. Bowen, 841 F.2d 1077, 1080 (11th Cir. 1988); Graham v. Bowen,
790 F.2d 1572, 1575 (11th Cir. 1983); Bloodsworth v. Heckler, 703 F.2d 1233,
1239 (11th Cir. 1983). This court must “scrutinize the record as a whole to
determine if the decision reached is reasonable and supported by substantial
evidence.” Bloodsworth, 703 F.2d at 1239. This court will determine that the
ALJ’s opinion is supported by substantial evidence if it finds “such relevant
evidence as a reasonable person would accept as adequate to support a
conclusion.” Id. Substantial evidence is “more than a scintilla, but less than a
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preponderance.” Id. 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) (citation omitted). The ALJ’s legal conclusions,
however, are reviewed de novo, because no presumption of validity attaches to the
ALJ’s determination of the proper legal standards to be applied. Davis v. Shalala,
985 F.2d 528, 531 (11th Cir. 1993). If the court finds an error in the ALJ’s
application of the law, or if the ALJ fails to provide the court with sufficient
reasoning for determining that the proper legal analysis has been conducted, the
ALJ’s decision must be reversed. Cornelius v. Sullivan, 936 F.2d 1143, 1145-46
(11th Cir. 1991).
STATUTORY AND REGULATORY FRAMEWORK
To qualify for disability benefits and establish her entitlement for a period of
disability, the claimant must be disabled as defined by the Social Security Act and
the Regulations promulgated thereunder.4 The Regulations define “disabled” as
the “inability to do any substantial gainful activity by reason of any medically
determinable physical or mental impairment which can be expected to result in
death or which has lasted or can be expected to last for a continuous period of not
less than [twelve] 12 months.”

20 C.F.R. § 404.1505(a).

To establish an

The “Regulations” promulgated under the Social Security Act are listed in 20 C.F.R.
Parts 400 to 499, as current through October 18, 2013.
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entitlement to disability benefits, a claimant must provide evidence of a “physical
or mental impairment” which “must result from anatomical, physiological, or
psychological abnormalities which can be shown by medically acceptable clinical
and laboratory diagnostic techniques.” 20 C.F.R. § 404.1508.
The Regulations provide a five-step process for determining whether a
claimant is disabled. 20 C.F.R. § 404.1520(a)(4)(I-v). The Commissioner must
determine in sequence:
(1) whether the claimant is currently employed;
(2) whether the claimant has a severe impairment;
(3) whether the claimant's impairment meets or equals an impairment
listed by the [Commissioner];
(4) whether the claimant can perform his or her past work; and
(5) whether the claimant is capable of performing any work in the
national economy.
Pope v. Shalala, 998 F.2d 473, 477 (7th Cir. 1993) (citing to formerly applicable
C.F.R. section), overruled on other grounds by Johnson v. Apfel, 189 F.3d 561,
562–63 (7th Cir.1999); accord McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th
Cir.1986). The sequential analysis goes as follows:
Once the claimant has satisfied steps One and Two, she will automatically
be found disabled if she suffers from a listed impairment. If the claimant
does not have a listed impairment but cannot perform her past work, the
burden shifts to the [Commissioner] to show that the claimant can perform
some other job.

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Pope, 998 F.2d at 477; accord Foote v. Chater, 67 F.3d 1553, 1559 (11th
Cir.1995). The Commissioner must further show that such work exists in the
national economy in significant numbers. Id.
FINDINGS OF THE ADMINISTRATIVE LAW JUDGE
First, the ALJ found that Ms. Letson met the insured status requirements of
the Social Security Act through March 31, 2009, and had not engaged in
substantial gainful activity since September 13, 2008, the alleged onset date. (Tr.
17).

She then found that Ms. Letson had the following severe impairments:

degenerative disc disease of the cervical and lumbar spine and osteoarthritis of the
right knee.

Id.

However, she concluded that Ms. Letson did not have an

impairment or combination of impairments that met or medically equaled one of
the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Tr. 18).
Next, the ALJ determined that Ms. Letson retained the residual functional
capacity (“RFC”) to perform light work,5 except that she was limited to no more
than occasional balancing, stooping, and crouching; was unable to climb ladders,
“Light work involves lifting no more than 20 pounds at a time with frequent lifting or
carrying of objects weighing up to 10 pounds. Even though the weight lifted may be very little, a
job is in this category when it requires a good deal of walking or standing, or when it involves
sitting most of the time with some pushing and pulling of arm or leg controls. To be considered
capable of performing a full or wide range of light work, you must have the ability to do
substantially all of these activities. If someone can do light work, we determine that he or she
can also do sedentary work, unless there are additional limiting factors such as loss of fine
dexterity or inability to sit for long periods of time.” 20 C.F.R. § 404.1567
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ropes, and scaffolds; was unable to kneel or crawl; must avoid concentrated
exposure to extreme hot and cold temperatures, dampness, humidity, fumes, odors,
and gases; and was unable to work around machinery, unprotected heights, large
bodies of water, and concentrated or extreme vibration. (Tr. 18-19).
Finally, the ALJ concluded that although she was unable to perform any past
relevant work, Ms. Letson could perform occupations that existed in significant
number in the national economy.

(Tr. 20-21).

Thus, the ALJ ultimately

determined that Ms. Letson had not been under a disability, as defined in the Social
Security Act, from September 13, 2008, through the date of the decision. (Tr. 21).
ANALYSIS
The court may only reverse a finding of the Commissioner if it is not
supported by substantial evidence. 42 U.S.C. § 405(g). “This does not relieve the
court of its responsibility to scrutinize the record in its entirety to ascertain whether
substantial evidence supports each essential administrative finding.” Walden v.
Schweiker, 672 F.2d 835, 838 (11th Cir. 1982) (citing Strickland v. Harris, 615
F.2d 1103, 1106 (5th Cir. 1980)).6 However, the court “abstains from reweighing
the evidence or substituting its own judgment for that of the [Commissioner].” Id.
(internal citation omitted).
Strickland is binding precedent in this Circuit. See Bonner v. City of Prichard, 661
F.2d 1206, 1209 (11th Cir. 1981) (adopting as binding precedent all decisions of the former Fifth
Circuit handed down prior to October 1, 1981).
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Ms. Letson urges this court to reverse the Commissioner’s decision to deny
her benefits on the following ground: the ALJ did not properly discredit her
testimony. This court agrees and, consequently, reverses and remands the case to
the Commissioner.
I.

The ALJ’s decision to discredit Ms. Letson’s testimony was not
supported by substantial evidence.

The Eleventh Circuit “requires that an ALJ apply a three part ‘pain standard’
when a claimant attempts to establish disability through his or her own testimony
of pain or other subjective symptoms.” Foote v. Chater, 67 F.3d 1553, 1560 (11th
Cir. 1995). “The pain standard requires (1) evidence of an underlying medical
condition and either (2) objective medical evidence that confirms the severity of
the alleged pain arising from that condition or (3) that the objectively determined
medical condition is of such a severity that it can be reasonably expected to give
rise to the alleged pain.” Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991).
After a claimant satisfied the pain standard, her “subjective testimony … is itself
sufficient to support a finding of disability.” Foote, 67 F.3d at 1561.
In the present case, the ALJ concluded that the pain standard was satisfied.
(Tr. 20) (“[T]he claimant’s medically determinable impairments could reasonably
be expected to cause the alleged symptoms.”).

Despite this finding, the ALJ

determined that Ms. Letson was not disabled because she found “the claimant’s
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statements concerning the intensity, persistence and limiting effects of [her]
symptoms are not entirely credible.” Id.
The ALJ may discredit a claimant’s subjective testimony of pain if she does
so specifically and articulates her reasons for doing so. Brown v. Sullivan, 921
F.2d 1233, 1236 (11th Cir. 1991). “Failure to articulate the reasons for discrediting
subjective pain testimony requires, as a matter of law, that the testimony be
accepted as true.” Id. However, “[a] clearly articulated credibility finding with
substantial supporting evidence in the record will not be disturbed by a reviewing
court.” Foote, 67 F.3d at 1562.
The ALJ cited two reasons for her credibility determination. First, the ALJ
found that Ms. Letson had not sought “any on-going medical treatment for any
condition.” (Tr. 20). She stated that “the claimant last saw a doctor on her own
volition in June of 2008.” (Tr. 19). SSR 96-7p explicitly provides that “the
adjudicator must not draw any inferences about an individual's symptoms and their
functional effects from a failure to seek or pursue regular medical treatment
without first considering any explanations that the individual may provide.” SSR
96-7p, 61 Fed. Reg. 34,483, 34,487.

Furthermore, “poverty excuses

noncompliance … or the failure to seek treatment.” Baker v. Astrue, 1:11CV35CSC, 2012 WL 353738, at *4 (M.D. Ala. Feb. 2, 2012) (citing Dawkins v. Bowen,
848 F.2d 1211, 1213 (11th Cir. 1988)).
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At the administrative hearing, Ms. Letson explained her lack of continued
regular medical treatment by stating “I can’t afford doctor’s visits [or] medication.
I can’t afford it. The doctors won’t see you but $150 a visit [sic], and that’s money
I don’t have.” (Tr. 41). She also stated that on her last visit to the emergency
room, she could not afford the prescriptions that the doctors gave her. (Tr. 42).
Before discrediting Ms. Letson’s alleged symptoms, the ALJ discussed her poverty
excuse, stating:
While the claimant alleges she cannot afford to see a doctor to obtain pain
medications, she also confirmed that she settled with the other driver’s
insurance company after her accident [in 2006] and received $40,000.00.
However, the claimant admitted that she did not save any of that money for
future medical expenses.
(Tr. 19).
It is unclear whether or not the ALJ is suggesting that Ms. Letson’s lack of
thrift negates poverty as an excuse. Courts have found that an ability to pay for
medical treatment can negate a plea of poverty. See Poke v. Astrue, 1:10CV768CSC, 2012 WL 174472, at *5 (M.D. Ala. Jan. 23, 2012) (The claimant’s
“Medicaid card was scanned at the time of her admission. … Thus, [she] had the
ability to secure treatment, and her poverty does not excuse her failures to seek
it.”). However, the settlement in 2006 does not indicate that Ms. Letson could
have sought continued treatment in 2008. Ms. Letson testified that she used the
money for insurance payments. (Tr. 43). The ALJ did not make any findings
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about Ms. Letson’s use or misuse of the settlement funds or about Ms. Letson’s
current financial position. In fact, in her brief, the Commissioner admits that “[t]he
ALJ erred in citing Plaintiff’s lack of medical treatment as a reason for discrediting
Plaintiff’s complaints of disabling limitations.” (Def.’s Br. 11). The court agrees.
The only other reason articulated by the ALJ is a lack of support in “the
objective medical record.” (Tr. 20).7 The ALJ stated that “no doctor has described
the claimant as unable to perform all work.” Id. The ALJ further noted that the
medical record had been left open for Ms. Letson to submit additional medical
records but that she had not done so. Id. The law, however, only requires that she
produce objective medical evidence sufficient to satisfy the pain standard. The
ALJ explicitly found that she had produced such evidence.

(Tr. 20) (“[T]he

claimant’s medically determinable impairments could reasonably be expected to
cause the alleged symptoms.”).

After finding the pain standard satisfied, the

Commissioner “will not reject [the claimant’s] statements about the intensity and
persistence of [her] pain or other symptoms … solely because the available
objective medical evidence does not substantiate [her] statements.” 20 C.F.R. §

Ms. Letson contests the ALJ’s finding that the objective medical record does not
support her subjective allegations. However, because it finds the ALJ erred by requiring such
evidence, the court does not address this argument.
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404.1529(c)(2); see also Foote, 67 F.3d at 1561 (“A claimant's subjective
testimony supported by medical evidence that satisfies the pain standard is itself
sufficient to support a finding of disability.”). A lack of objective support in the
record does not, alone, provide substantial evidence to support the ALJ’s decision
to discredit Ms. Letson’s testimony.
The Commissioner cites to two non-binding cases suggesting that the
Commissioner can consider whether the medical record supports Ms. Letson’s
allegations. See Kelly v. Comm'r of Soc. Sec., 401 Fed. App'x 403, 409 (11th Cir.
2010);8 Stanton v. Astrue, 3:07-CV-015-J-TEM, 2008 WL 725595, at *4 (M.D.
Fla. Mar. 17, 2008). The regulations also support this contention. See 20 C.F.R. §
404.1529(a) (The Commissioner considers “the extent to which your symptoms
can reasonably be accepted as consistent with the objective medical evidence and
other evidence.”). However, the Commissioner neglects the important distinction
that she cannot consider the lack of objective medical evidence alone.
In Stanton, the lack of objective support was just one of the reasons
supported by substantial evidence, not the only, given to discredit the claimant’s
testimony. 2008 WL 725595, at *4. The court discussed three reasons given by
In Kelly, the issue was the Appeals Council’s consideration of new evidence, not an
application of the pain standard. 401 Fed. App'x at 408-09. Therefore, Kelly is not helpful.
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the ALJ. “First … the ALJ noted that none of Plaintiff's treating physicians had
given her any limitations on activity.” Id. at *5. Next, the ALJ “determined that
Plaintiff's use of prescription pain medication for mild to moderate pain was
inconsistent with her allegation of debilitating pain.” Id. Finally, “[t]he ALJ
considered Plaintiff's activities of daily living.” Id. Stanton is not a case where the
ALJ relied solely on the lack of supporting objective medical evidence. Instead,
the ALJ properly used multiple factors to discredit the plaintiff’s testimony. See,
e.g., Harwell v. Heckler, 735 F.2d 1292, 1293 (11th Cir. 1984) (“Claimant asserts
that the ALJ erroneously required objective medical evidence to substantiate his
testimony …. However … the ALJ properly considered a variety of factors.”).
In the present case, the ALJ did not consider a variety of factors. On the
contrary, the only other reason cited by the ALJ did not adequately consider Ms.
Letson’s poverty excuse. Thus, the ALJ improperly discredited her testimony.
CONCLUSION
Based upon the court’s evaluation of the evidence in the record and the
parties’ submissions, the court concludes that the ALJ erred in her evaluation of
Ms. Letson’s testimony. Accordingly, the decision of the Commissioner will be
reversed and remanded by separate order. On remand, the Commissioner should

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evaluate Ms. Letson’s explanation for her gaps in treatment pursuant to SSR 96-7p
and consider the objective medical evidence consistent with 20 C.F.R. §
404.1529(c)(2).
DONE and ORDERED this the 18th day of December, 2013.

VIRGINIA EMERSON HOPKINS
United States District Judge

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