Trussell v. Social Security Administration, Commissioner

Filing 12

MEMORANDUM OPINION as more fully set out in order. Signed by Magistrate Judge Harwell G Davis, III on 08/22/14. (SPT )

FILED
2014 Aug-22 PM 02:04
U.S. DISTRICT COURT
N.D. OF ALABAMA

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
JASPER DIVISION

REGINA TRUSSELL,
Plaintiff
vs.
CAROLYN COLVIN,
COMMISSIONER, SOCIAL SECURITY
ADMINISTRATION,
Defendant

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) Case No. 6:13-cv-01404-HGD
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MEMORANDUM OPINION
In this action under 42 U.S.C. § 405(g), plaintiff seeks judicial review of an
adverse social security ruling which denied claims for disability insurance benefits
(DIB). (Doc. 1). The parties have consented to the jurisdiction of the undersigned
Magistrate Judge to conduct all proceedings and order the entry of judgment in
accordance with 28 U.S.C. § 636(c) and Fed.R.Civ.P. 73.

(Doc. 6).

Upon

consideration of the administrative record and the memoranda of the parties, the court
finds that the decision of the Commissioner is due to be affirmed and this action
dismissed.

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I.

Proceedings Below
Plaintiff, Regina Trussell, filed an application for a period of disability

insurance benefits on December 1, 2010, alleging that she became disabled on
December 5, 2008. (Tr. 67, 134-35). Her claim was initially denied and she
requested a hearing before an Administrative Law Judge (ALJ). (Tr. 68-73, 75).
Following that hearing (Tr. 35-58), the ALJ issued a decision on July 16, 2012,
finding that plaintiff was not disabled from December 5, 2008, through June 30,
2011, the date for which she was last insured for DIB. (Tr. 19-31). The Appeals
Council denied plaintiff’s request for review of the ALJ’s decision. (Tr. 1-6, 17).
The Commissioner’s decision is ripe for review under 42 U.S.C. §§ 405(g) and
1383(c)(3).
II.

ALJ Decision
Disability under the Act is determined under a five-step test. 20 C.F.R.

§ 404.1520. First, the ALJ must determine whether the claimant is engaging in
substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). “Substantial work
activity” is work that involves doing significant physical or mental activities. 20
C.F.R. § 404.1572(a). “Gainful work activity” is work that is done for pay or profit.
20 C.F.R. § 404.1520(b). Second, the ALJ must determine whether the claimant has
a medically determinable impairment or a combination of medical impairments that
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significantly limits the claimant’s ability to perform basic work activities. 20 C.F.R.
§ 404.1520(a)(4)(ii). Absent such impairment, the claimant may not claim disability.
Id. Third, the ALJ must determine whether the claimant’s impairment meets or
medically equals the criteria listed in 20 C.F.R. § 404, Subpart P, Appendix 1. See
20 C.F.R. §§ 404.1520(d), 404.1525 and 404.1526. If such criteria are met, the
claimant is declared disabled. 20 C.F.R. § 404.1520(a)(4)(iii).
If the claimant does not fulfill the requirements necessary to be declared
disabled under the third step, the ALJ still may find disability under the next two
steps of the analysis. The ALJ first must determine the claimant’s residual functional
capacity (RFC), which refers to the claimant’s ability to work despite his
impairments. 20 C.F.R. § 404.1520(e). In the fourth step, the ALJ determines
whether the claimant has the RFC to perform past relevant work. 20 C.F.R.
§ 404.1520(a)(4)(iv). If the claimant is determined to be capable of performing past
relevant work, then the claimant is deemed not disabled. Id. If the ALJ finds that the
claimant is unable to perform past relevant work, then the analysis proceeds to the
fifth and final step. 20 C.F.R. § 404.1520(a)(4)(v). In the last part of the analysis, the
ALJ must determine whether the claimant is able to perform any other work
commensurate with his RFC, age, education and work experience. 20 C.F.R.
§ 404.1520(g). Here, the burden of proof shifts from the claimant to the ALJ to prove
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the existence in significant numbers of jobs in the national economy that the claimant
can do given the RFC, age, education and work experience.

20 C.F.R.

§§ 404.1520(g) and 404.1560(c).
The ALJ strictly followed this protocol in evaluating plaintiff’s allegations of
disability. The ALJ found that plaintiff last met the insured status requirements of the
Social Security Act on June 30, 2011. She did not engage in substantial gainful
activity during the period from her alleged onset date of December 5, 2008, through
her date of last insured, June 30, 2011. Through the date last insured, the ALJ found
that plaintiff had the following severe impairments: obesity, arthritis, cervical and
lumbar degenerative disc disease, status post left rotator cuff surgery with
impingement, carpal tunnel syndrome, mitral valve prolapse, diabetes mellitus,
depression, anxiety, and borderline intellectual functioning. (Tr. 20).
In support of this finding, the ALJ noted that, on January 31, 2011, State
agency physician M. Tosi Gilford, M.D., specifically endorsed obesity, cervical and
lumbar degenerative disc disease, status post left rotator cuff surgery with
impingement, and carpal tunnel syndrome as confirmed severe impairments. (Tr. 25,
citing Ex. 10F). The ALJ noted that treatment records from Maude Whatley Health
Services submitted after January 31, 2011, confirm plaintiff’s mitral valve prolapse,
arthritis and developing diabetes mellitus as additional severe physical impairments,
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as well as plaintiff’s treatment for depression and anxiety. (Id., citing Exs. 8F and
9F). Finally, the ALJ noted that Dr. Alan D. Blotcky, Ph.D., a psychologist,
examined plaintiff at the request of plaintiff’s representative and determined that her
intellectual functioning was at the borderline intellectual level. (Id., citing Ex. 7F).
Plaintiff also was examined by Dr. Samia S. Moizuddin, M.D., on January 25,
2011. According to Dr. Moizuddin, plaintiff is five feet four inches tall and weighed
225 pounds. He assigned a body mass index (BMI) score of 39. The ALJ found that
this impairment has more than minimal impact on plaintiff’s ability to engage in work
related activities and is, therefore, severe. (Id.).
According to the ALJ, plaintiff has a medically documented history of the
following impairments: bipolar disorder, bronchitis, allergies, asthma, hypertension,
and tobacco abuse. Dr. Gilford found that, though poorly controlled, there was no
end-organ damage or complications related to the plaintiff’s hypertension. Therefore,
it was not severe. (Tr. 25, citing Ex. 10F). The ALJ stated that plaintiff has not
alleged any substantial limitations due to these conditions. Therefore, he concluded
that they were non-severe. (Id., citing 20 C.F.R. §§ 404.1512 and 416.921).
The ALJ also noted that plaintiff also alleged, or the medical record indicates
a history of or complaints for rheumatoid arthritis. However, plaintiff has not alleged
any substantial limitations due to this condition and there is no documented diagnosis
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of an underlying impairment for this complaint.

Consultative examiner Dr.

Moizuddin’s review of plaintiff’s bodily systems returned no finding of rheumatoid
arthritis. (Id., citing Ex. 1F). Dr. Gilford also noted that there was no confirmed
medically determinable impairment of rheumatoid arthritis in his review of plaintiff’s
medical records. (Id., citing Ex. 10F).
The ALJ also determined that, through the date last insured, plaintiff did not
have an impairment or combination of impairments that met or medically equaled the
severity of one of the impairments included in 20 C.F.R. Part 404, Subpart P,
Appendix 1 (20 C.F.R. §§ 404.1520(d), 404.1525 and 404.1526). (Tr. 26). Plaintiff
has not contested this finding.
In considering plaintiff’s mental impairments under Step Three, the ALJ found
that they did not meet or medically equal the criteria of §§ 12.04, 12.05 or 12.06. He
specifically considered whether the “paragraph B” criteria were satisfied. To satisfy
“paragraph B” criteria, the mental impairments must result in at least two of the
following: marked restriction of activities of daily living; marked difficulties in
maintaining social functioning; marked difficulties maintaining concentration,
persistence or pace; and repeated episodes of decompensation, each of extended
duration. A “marked limitation” means more than moderate, but less than severe.
(Tr. 26-27).
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The ALJ found that, in activities of daily living, social functioning, and
concentration, persistence or pace, plaintiff had a moderate restriction. (Tr. 27). The
ALJ considered the assessment of plaintiff by Dr. Alan D. Blotcky, Ph.D., a
psychologist who examined plaintiff. He reported that plaintiff had borderline
intellectual abilities and suffered from a severe depressive disorder. However, the
ALJ found that Dr. Blotcky’s assessment is dramatically inconsistent with plaintiff’s
own reported activities (Ex. 3E) and level of functioning. Further, plaintiff’s medical
records do not indicate that plaintiff has ever sought treatment other than medication
from a treating physician for her alleged mental limitations. Therefore, the ALJ
concluded that Dr. Blotcky’s assessment (Ex. 7F) was not supported by the medical
record as a whole and was given limited weight. (Id.).
The ALJ further noted that plaintiff reported no problems with personal care
on her Function Report-Adult that she completed on December 23, 2010, except
difficulties with small buttons and zippers; cooking simple meals; household chores
and laundry, but no yard work; driving and walking; weekly shopping for up to two
hours; lifting up to 20 pounds without pain; and walking up to a quarter mile before
needing to stop and rest for 10 to 15 minutes. (Tr. 27, citing Ex. 3E). There is no
evidence that plaintiff experienced any episodes of decompensation which have been
of extended duration. (Id.). Because plaintiff’s mental impairments did not cause at
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least two “marked” limitations or one “marked’ limitation and “repeated” episodes
of decomposition, each of extended duration, the ALJ held that the “paragraph B”
criteria were not satisfied.
However, while the limitations identified in “paragraph B” are not a residual
functional capacity (RFC) assessment, but are used to rate the severity of mental
impairments at Steps Two and Three, the mental RFC capacity assessments used in
Steps Four and Five require a more detailed assessment by itemizing various
functions contained in the broad categories found in paragraph B of the adult mental
disorders in section 12.00 of the Listing of Impairments (SSR 96-8p). Therefore, the
ALJ included the degree of limitations he found in the “paragraph B” mental function
analysis in his analysis of plaintiff’s RFC. (Tr. 27).
Under Step Four, the ALJ found that, through the date last insured, plaintiff
had the RFC to perform light work as defined in 20 C.F.R. § 404.1567(b), except she
can lift up to 20 pounds occasionally and ten pounds frequently; can stand and walk
combined, or sit, with normal breaks, for a total of six hours in an eight-hour
workday; is unable to climb ladders, ropes or scaffolds; can occasionally climb ramps
or stairs, balance, stoop, kneel, crouch or crawl; should avoid concentrated exposure
to extreme cold, wetness, humidity and vibration; and should avoid all exposure to
hazardous machinery and heights. (Tr. 28).
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In making this determination, the ALJ followed the two-step process in which
it first must be determined whether there is an underlying medically determinable
physical or mental impairment(s) and, second, the ALJ must evaluate the intensity,
persistence and limiting effects of plaintiff’s symptoms to determine the extent to
which they limit her functioning. (Tr. 28-29).
According to the ALJ, plaintiff argued that she was unable to work primarily
because of her affective disorder as it is defined under section 12.04. She testified
that she suffered from anxiety and was recently diagnosed with bipolar disorder. In
addition, she testified that she also has chest pain, vertigo and arthritis in her hands
that results in numbness and aching.
Regarding her mental impairments, plaintiff testified that her treatment consists
of medication from her treating physician at Maude Whatley Health Care Clinic.
Plaintiff stated that she could not deal with people or work with anyone. Regarding
her physical impairments, plaintiff testified that she has problems with her hands, left
knee and left shoulder. It also was noted that she had mitral valve prolapse,
developing diabetes mellitus, and depression and anxiety. (Tr. 29, citing Exs. 8F and
9F). Plaintiff stated also that she has a problem picking up a gallon of milk and,
because of the pain, often lies on a heating pad for three or four hours during the day.
She takes only over-the-counter medications for relief of from her pain because she
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does not wish to take narcotics. On a scale of 1 to 10, plaintiff stated that her average
level of pain was a 7. In addition to the pain, plaintiff has a limited range of motion
in her left arm. Finally, plaintiff testified that she is pre-diabetic and has been
prescribed medications to control her blood sugar. (Tr. 29).
The ALJ noted that medical records from the University of Alabama Hospital
Birmingham (UAB) indicate that plaintiff underwent rotator cuff repair in November
2002 and April 2003. (Tr. 29, citing Ex. 2F). X-rays from the Kirkland Clinic at
UAB in January 2006 reflect a stable degree of mild acromioclavicular degenerative
joint disease in her left shoulder. (Id., citing Ex. 5F). She was diagnosed with
arthritis and carpal tunnel syndrome in the right hand at the Winston County Medical
Center in August 2006. She was treated for vertigo and shortness of breath at
Sumiton Medical Clinic in December 2008. In February 2009, it was noted that
plaintiff’s diabetes mellitus and her chronic musculoskeletal pain were controlled.
On May 19, 2009, she was diagnosed with cervical and lumber degenerative joint
disease and right knee pain on December 29, 2009. She reportedly also suffered a
muscle strain in her left chest while reaching overhead. (Id., citing Ex. 4F).
According to the ALJ, plaintiff was seen by a consulting physician, Dr. Samia
S. Moizuddin, M.D., on January 25, 2011. Dr. Moizuddin diagnosed plaintiff with
low back pain, degenerative disc disease, left knee pain, left shoulder rotator cuff
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injuries with impingement status post surgery, and hypertension. He observed some
limitations in her range of motion in her dorsolumbar spine, left knee and left
shoulder, and observed dexterity and grip strength were normal. (Tr. 29-30, citing
Ex. 1F). The ALJ gave significant weight to the findings and opinions of Dr.
Moizudden. (Tr. 30).
The ALJ also noted that the State agency physician, Dr. M. Tosi Gilford, M.D.,
endorsed the consulting physician and, in his own review of the medical records,
found that the plaintiff can lift up to 20 pounds occasionally and 10 pounds
frequently. He also found that she can stand and walk combined, or sit, with normal
breaks for a total of six hours each in an eight-hour workday. According to Dr.
Gilford, plaintiff was unable to climb ladders, ropes and scaffolds; could occasionally
climb ramps or stairs, balance, kneel, crouch or crawl; should avoid concentrated
exposure to extreme cold, wetness, humidity and vibration; and should avoid all
exposure to hazardous machinery and heights. (Tr. 30, citing Ex. 10F).
The ALJ determined that plaintiff’s medically determinable impairments could
reasonable be expected to cause the alleged symptoms. However, her statements
concerning the intensity, persistence and limiting effect of these symptoms were not
credible to the extent they were inconsistent with the objective medical evidence. (Tr.
30).

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The ALJ stated that, although plaintiff alleged in her testimony daily activities
that are limited, two factors weighed against considering these allegations to be
strong evidence in favor of finding the claimant disabled. First, her limited daily
activities cannot be verified with any reasonable degree of certainty because they are
inconsistent with her earlier report on activities of daily living. Second, even if her
daily activities are as limited as she has alleged, it is difficult to attribute that degree
of limitation to plaintiff’s medical condition, as opposed to other reasons, in view of
the relatively weak medical evidence and other factors discussed in the ALJ’s
decision. He noted that the medical records reflect infrequent trips to the doctor,
especially considering the degree of pain alleged by plaintiff in her testimony.
Overall, the ALJ believed that plaintiff’s treatment was more supportive of the
findings of the State agency physician and did not support the degree of limitation
alleged by plaintiff. (Id., citing Ex. 10F).
According to the ALJ, the vocational expert testified that a claimant with the
above-stated RFC could perform at the light level of exertion the jobs of fast food
worker, cashier, hand presser at a cleaner and clerical worker. Based on this
testimony, the ALJ determined that plaintiff could return to her past relevant work.
(Tr. 30). There, he concluded that she was not under a disability, as defined by the

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Social Security Act, at any time from December 5, 2008, the alleged onset date,
through June 30, 2011, the date last insured. (Tr. 31).
III. Plaintiff’s Argument for Reversal
Plaintiff complains that the ALJ failed to send plaintiff for an MRI regarding
her complaints that her hands go numb and her fingers swell as a result of arthritis.
Plaintiff asserts that the pain in her hands is so great that she cannot sustain
competitive employment. (Doc. 9, Plaintiff’s Brief, at 14-15). She also states that the
ALJ erred in failing to consider the combined effects of her pain, fatigue and
depression or her newly diagnosed bipolar condition. (Id. at 15-16). She asserts that
the case should be remanded for the Commissioner to consider whether her bipolar
disorder could be related to her mental impairment during her insured period. (Id. at
17).
IV.

Standard of Review
The only issues before this court are whether the record reveals substantial

evidence to sustain the ALJ’s decision, see 42 U.S.C. § 405(g); Walden v. Schweiker,
672 F.2d 835, 838 (11th Cir. 1982), and whether the correct legal standards were
applied. See Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Chester v. Brown,
792 F.2d 129, 131 (11th Cir. 1986). Title 42 U.S.C. § 405(g) mandates that the
Commissioner’s findings are conclusive if supported by “substantial evidence.”

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Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990). The district court may not
reconsider the facts, re-evaluate the evidence or substitute its judgment for that of the
Commissioner; instead, it must review the final decision as a whole and determine if
the decision is reasonable and supported by substantial evidence. See id. (citing
Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)).
Substantial evidence falls somewhere between a scintilla and a preponderance
of evidence; “[i]t is such relevant evidence as a reasonable person would accept as
adequate to support a conclusion.” Martin, 894 F.2d at 1529 (quoting Bloodsworth,
703 F.2d at 1239) (other citations omitted). If supported by substantial evidence, the
Commissioner’s factual findings must be affirmed even if the evidence preponderates
against the Commissioner’s findings. See Martin, 894 F.2d at 1529. While the court
acknowledges that judicial review of the ALJ’s findings is limited in scope, the court
also notes that review “does not yield automatic affirmance.” Lamb, 847 F.2d at 701.
V.

Discussion
Plaintiff asserts that the ALJ failed to develop the record by not ordering an

MRI of her hands. She notes that in September 2011, she complained of bilateral
numbness to Whatley Health Services and her health provider recommended that she
undergo an MRI. (Tr. 287). However, she did not undergo this procedure due to lack
of money. (Tr. 40).

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Even though Social Security courts are inquisitorial, not adversarial, in nature,
claimants must establish that they are eligible for benefits. The ALJ has a duty to
develop the record where appropriate but is not required to order a consultative
examination as long as the record contains sufficient evidence for the ALJ to make
an informed decision. Doughty v. Apfel, 245 F.3d 1274, 1281 (11th Cir. 2001)
(citation omitted).
Despite plaintiff’s complaint, the medical record reflects no problems with her
hands. When she was examined by Dr. Moizuddin in January 2011, she reported no
problems with her hands. (Tr. 198). On examination by Dr. Moizuddin, he found
that plaintiff had a normal range of motion in her elbows, forearms, wrists and
fingers. (Tr. 197). Her dexterity and strength were normal. (Id.).
Even the health provider to whom plaintiff complained of the hand numbness
noted that she had a good range of motion in both hands and wrists. (Tr. 287). She
also had a negative Tinel’s sign, i.e., no pain upon the tapping of the median nerve
at the wrist. (Tr. 287). In addition, plaintiff’s claim of hand numbness came several
months after her date of last insured. (Tr. 132, 287). A claimant for benefits must
show that she has a disability on or before the date last insured. 42 U.S.C.
§ 423(a)(1)(A); Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005).

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In fulfilling his duty to conduct a full and fair inquiry, the ALJ is not required
to order a consultative examination unless the record establishes that such an
examination is necessary to enable the ALJ to render a decision. Reeves v. Heckler,
734 F.2d 519, 522 n.1 (11th Cir. 1984) (citing Ford v. Sec’y of Health and Human
Svcs., 659 F.2d 66, 69 (5th Cir. 1981)). In this case, the absence of an MRI made it
impossible for the ALJ to determine with absolute certainty that plaintiff does not
suffer from a disabling hand condition. However, the statute does not require
absolute certainty; it requires only substantial evidence to sustain the Secretary’s
findings. The absence of an MRI did not render the ALJ incapable of making an
overall disability determination. There was sufficient, i.e. substantial other, evidence
for him to make determination regarding plaintiff’s physical limitations, especially
given the fact that this condition arose after plaintiff’s date last insured. See Holladay
v. Bowen, 848 F.2d 1206, 1210 (11th Cir. 1988).
Plaintiff also contends that the ALJ did not consider the combined effects of
her impairments. However, this is not borne out by a review of the ALJ’s decision.
In fact, he determined, after consideration of all the evidence, that she did not have
an impairment or combination of impairments that met or medically equaled the
severity of one of the impairments included in 20 C.F.R. Part 404, Subpart P,
Appendix 1. (Tr. 26, 28). The ALJ’s determination constitutes evidence that he

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considered the combined effects of plaintiff’s impairments. Wilson v. Barnhart, 284
F.3d 1219, 1224 (11th Cir. 2004).
The ALJ clearly considered and discussed plaintiff’s impairments, both in
determining the severity of plaintiff’s impairments and her RFC.

The ALJ

specifically found that plaintiff’s obesity, arthritis, anxiety, depression, diabetes
mellitus, mitral valve prolapse, carpal tunnel syndrome, borderline intellectual
functioning, cervical and lumbar degenerative disc disease, and history of left rotator
cuff surgery with impingement were severe impairments. (Tr. 24-25). In doing so,
he outlined plaintiff’s medical history and determined that her impairments, singly
or in combination, did not preclude her from performing a range of work with certain
postural and environmental limitations. (Tr. 28-30).
Plaintiff also contends that the ALJ did not properly assess her allegations of
disabling pain. However, a review of the record refutes this. The Eleventh Circuit
has established a “pain standard” to assist in determining the extent a claimant’s pain
impairs his or her ability to work. It 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 severity that it can reasonably be expected to give rise to the
alleged pain.” Brown v. Sullivan, 921 F.2d 1233, 1236 (11th Cir. 1991). This

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standard applies to symptoms other than pain, as well. Holt v. Sullivan, 921 F.2d
1221, 1223 (11th Cir. 1991).
Here, the ALJ properly considered plaintiff’s subjective complaints and
adequately explained his reasoning for finding her not entirely credible. (Tr. 28-30).
He concluded that plaintiff’s medically determinable impairments could reasonably
be expected to cause the alleged symptoms, but he found her statements concerning
the intensity, persistence and limiting effects of these symptoms were not credible to
the extent that they were inconsistent with the objective medical evidence, daily
activities and response to treatment. (Tr. 30). The ALJ fully explained the basis for
his decision.
First, he considered the objective medical evidence and noted that from 2008
to 2010, medication controlled plaintiff’s musculoskelatal pain. (Tr. 29, 244, 246,
248, 250, 252, 254). He also noted that the January 2011 consultative examination
reflected that plaintiff had full muscle strength except for her left shoulder. She had
normal muscle tone and could squat within normal limits though she needed
assistance in returning to an upright position due to back pain and stiffness. (Tr. 2930, 200). That examiner noted that plaintiff had a normal gait and did not need an
assistive device (such as a cane). (Tr. 200). Plaintiff did not complain to the Whatley
Health Services of the extreme limitations to which she testified. (Tr. 287-91, 298-

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99). When she presented to Whatley Health Services in March 2011 to re-establish
care, she did not complain about any pain or swelling. (Tr. 290-91). The ALJ also
noted the medical record reflects infrequent trips to the doctor, especially considering
the degree of pain alleged by plaintiff in her testimony. (Tr. 30).
The ALJ also made note of plaintiff’s daily activities when evaluating her
subjective complaints. He noted that her testimony of her extreme limitations was
inconsistent with earlier reports of her daily activities. (Tr. 30, 157-64). In addition,
consultative psychological examiner Alan Blotcky, Ph.D., who examined plaintiff in
May 2011, noted that she reported spending most of her time doing light housework,
cooking and watching television. (Tr. 281). A clearly articulated credibility finding
with substantial supporting evidence in the record will not be disturbed by a
reviewing court. MacGregor v. Bowen, 786 F.2d 1050, 1054 (11th Cir. 1986). The
ALJ articulated reasons supported by substantial evidence for his adverse credibility
determination. Therefore, the claim that the ALJ improperly evaluated her credibility
concerning her pain lacks merit.
Plaintiff asserts that the case should be remanded for the Commissioner to
consider whether her bipolar disorder could be related to her mental impairment
during her insured period. More than eight months after her date last insured,
plaintiff presented evidence to the ALJ showing that on March 12, 2012, a nurse

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practitioner with Whatley Health Services diagnosed her with a bipolar disorder. (Tr.
311-12). The ALJ found this condition to be not severe. Although the ALJ accepted
the diagnosis from the nurse practitioner, as defendant correctly points out, the
regulations state that a medically determinable impairment may only be established
by an acceptable medical source, such as a physician.

See 20 C.F.R.

§ 404.1513(a)(1). A nurse practitioner is not an acceptable medical source. See id.
at § 1513(a), (d)(1).
Plaintiff alleges that the ALJ erred by not discussing this evidence in more
detail and by not considering whether her bipolar disorder could be related to her
mental impairment during her insured period. However, there are no medical records
submitted which support a conclusion that plaintiff suffered from a bipolar disorder
prior to the expiration of her disability insured status. Even the March 2012 note
from Whatley Health Services does not explain the symptoms that led the nurse
practitioner to make a diagnosis of bipolar disorder. (Tr. 311). Thus, there is nothing
to cause the ALJ to believe that plaintiff’s bipolar disorder existed before the date last
insured. A showing that a claimant became impaired after the expiration of his
insured status is insufficient to establish eligibility for DIB. See Demandre v.
Califano, 591 F.2d 1088, 1090 (5th Cir. 1979).

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VI.

Conclusion
The ALJ’s decision reflects that he properly considered the record during the

relevant time period, and substantial evidence supports his findings and conclusion
that plaintiff was not disabled under the Social Security Act at any time from her
alleged onset date of December 5, 2008, through June 30, 2011, her date last insured.
Therefore, that decision is due to be affirmed. A separate order will be entered.
DONE this 22nd day of August, 2014.

HARWELL G. DAVIS, III
UNITED STATES MAGISTRATE JUDGE

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