Guthrie v. Social Security Administration, Commissioner

Filing 17

MEMORANDUM OPINION. Signed by Judge Abdul K Kallon on 11/19/2021. (AKD)

FILED
2021 Nov-19 AM 10:08
U.S. DISTRICT COURT
N.D. OF ALABAMA

UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
JASPER DIVISION
ANNETTE GUTHRIE,

)
)
Plaintiff,
)
)
v.
)
)
KILOLO KIJAKAZI, Acting
)
Commissioner of the Social Security )
Administration,
)
)
Defendant.
)

Civil Action Number
6:20-CV-01095-AKK

MEMORANDUM OPINION
Annette Guthrie brings this action under 42 U.S.C. § 405(g) of the Social
Security Act seeking review of the final adverse decision of the Acting
Commissioner of the Social Security Administration. Doc. 1. Guthrie argues that
the ALJ’s decision, which became the final decision of the Acting Commissioner,
was not supported by substantial evidence because the ALJ failed to properly
evaluate Guthrie’s chronic knee pain and did not find that Guthrie’s mental
impairments precluded her from working. See doc. 13 at 13–16. After careful
examination, the court finds that the ALJ’s decision is due to be affirmed.
I.
Guthrie previously worked as a dispatcher for a gas company before she
ceased working due to depression and anxiety. Doc. 13 at 2. Guthrie filed for

disability and disability insurance benefits, alleging a disability onset of September
29, 2018, based on post-traumatic stress disorder, chronic lower back pain, spinal
arthritis, severe depression, chronic knee pain, anxiety with panic attacks, insomnia,
vertigo, hypertension, hypothyroidism, and carpal tunnel. Id.; R. 17–18. After
Guthrie’s claims were denied, an ALJ held a hearing with Guthrie, her attorney, and
a vocational expert and found that Guthrie was not disabled. Doc. 13 at 1; R. 12, 15,
26. The SSA Appeals Council denied Guthrie’s request for review, rendering the
ALJ’s decision the final decision of the Acting Commissioner. R. 1. Guthrie
thereafter filed this petition for review. Doc. 1.
II.
The court reviews only whether (1) the record contains substantial evidence
to sustain the ALJ’s decision and (2) the ALJ applied the correct legal standards.
See 42 U.S.C. § 405(g); Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986).
Under 42 U.S.C. §§ 405(g) and 1383(c), the Commissioner’s factual findings
are conclusive if they are supported by “substantial evidence.” Martin v. Sullivan,
894 F.2d 1520, 1529 (11th Cir. 1990). Substantial evidence refers to “such relevant
evidence as a reasonable person would accept as adequate to support a conclusion.”
Id.; Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). The threshold for
this evidentiary sufficiency “is not high.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154
(2019). Rather, substantial evidence falls somewhere between a “scintilla” and a
2

“preponderance of evidence.” Martin, 894 F.2d at 1529; Moore, 405 F.3d at 1211.
If substantial evidence supports the Commissioner’s factual findings, then the court
must affirm, even if the evidence preponderates against those findings. Noble v.
Comm’r of Soc. Sec., 963 F.3d 1317, 1323 (11th Cir. 2020).
When determining whether substantial evidence supports the Commissioner’s
decision, the court cannot decide the facts anew, reweigh the evidence, or substitute
its judgment for the Commissioner’s. Id. at 1323; Bloodsworth v. Heckler, 703 F.2d
1233, 1239 (11th Cir. 1983). Despite this limited scope of review, however, the
court must not automatically affirm the decision of the Commissioner. Lamb v.
Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Bloodsworth, 703 F.2d at 1239. The
court “retain[s] an important duty to ‘scrutinize the record as a whole’ and determine
whether the agency’s decision was reasonable.” Simon v. Comm’r of Soc. Sec., 7
F.4th 1094, 1104 (11th Cir. 2021) (quoting MacGregor v. Bowen, 786 F.2d 1050,
1053 (11th Cir. 1986)). Courts review de novo the legal conclusions upon which the
Commissioner’s decision is based. Id. at 1103; Moore, 405 F.3d at 1211.
III.
To qualify for disability benefits, a claimant must show the “inability to
engage in any substantial gainful activity by reason of any medically determinable
physical or mental impairment which can be expected to result in death or which has
lasted or can be expected to last for a continuous period of not less than twelve
3

months.” 42 U.S.C. §§ 423(d)(1)(A); 416(i)(1). A physical or mental impairment
is “an impairment that results from anatomical, physiological, or psychological
abnormalities which are demonstrated by medically acceptable clinical and
laboratory diagnostic techniques.” Id. § 423(d)(3). Determinations of disability
require a five-step analysis in which the ALJ determines:
(1) whether the claimant is currently unemployed;
(2) whether the claimant has a severe impairment;
(3) whether the impairment meets or equals one listed by the
Commissioner;
(4) whether the claimant is unable to perform his or her past work; and
(5) whether the claimant is unable to perform any work in the national
economy.
20 C.F.R. § 404.1520(a); McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986).
“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, 800 F.2d at 1030 (citing 20 C.F.R. § 416.920(a)-(f)). 1 If the claimant

1

If a claimant’s impairments do not meet or equal a listed impairment, as determined at Step Three,
the ALJ determines the claimant’s “residual functional capacity” on the basis of “all of the relevant
medical and other evidence” in the claimant’s case record. 20 C.F.R. § 404.1520(e). See also 20
C.F.R. § 404.1545(a)(1) (“Your impairment(s), and any related symptoms, such as pain, may cause
physical and mental limitations that affect what you can do in a work setting. Your residual
functional capacity is the most you can still do despite your limitations.”). The ALJ uses the
residual functional capacity at Step Four to determine if the claimant can perform past relevant
work and at Step Five to determine if the claimant can adjust to other work. 20 C.F.R.
§ 404.1520(e).

4

cannot return to prior work, the Commissioner bears the burden of showing other
work the claimant can do. Foote v. Chater, 67 F.3d 1553, 1559 (11th Cir. 1995).
Under 20 C.F.R. § 404.1520c, for claims filed on or after March 27, 2017, the
ALJ will not “defer or give any specific evidentiary weight, including controlling
weight, to any medical opinion(s) or prior administrative medical finding(s),
including those from [a claimant’s] medical sources.” 20 C.F.R. § 404.1520c(a). To
determine whether a medical opinion or prior administrative medical finding is
“persuasive,” the ALJ must focus on factors that include supportability,2
consistency, 3 the medical source’s relationship with the claimant, 4 and the medical
source’s specialization. 5 Id. § 404.1520c(c). See also Nix v. Saul, No. 4:20-CV00790-RDP, 2021 WL 3089309, at *6 (N.D. Ala. July 22, 2021). The most

2

“The more relevant the objective medical evidence and supporting explanations presented by a
medical source are to support his or her medical opinion(s) or prior administrative medical
finding(s), the more persuasive the medical opinions or prior administrative medical finding(s)
will be.” Id. § 404.1520c(c)(1).
3

“The more consistent a medical opinion(s) or prior administrative medical finding(s) is with the
evidence from other medical sources and nonmedical sources in the claim, the more persuasive the
medical opinion(s) or prior administrative medical finding(s) will be.” Id. § 404.1520c(c)(2).
4

This includes the length of the treatment relationship, the frequency of the examinations, the
purpose of the treatment relationship, the extent of the treatment relationship (e.g., the kinds of
testing performed), and the examining relationship (i.e., whether the medical source actually
examined the claimant or only reviewed the claimant’s file). Id. § 404.1520c(c)(3).
5

“Specialization” refers to whether the medical source has received “advanced education and
training to become a specialist,” which may render that source’s findings more persuasive than
findings from a non-specialist. Id. § 404.1520c(c)(4). In addition, the ALJ may consider evidence
showing that a medical source “has familiarity with the other evidence in the claim or an
understanding of [the SSA’s] disability program’s policies and evidentiary requirements.” Id.
§ 404.1520c(c)(5).

5

important of these factors are supportability and consistency, and the ALJ must
articulate how persuasive he or she finds the medical opinions and prior
administrative medical findings in a claimant’s record. Id. § 404.1520(a)-(b).
Moreover, when a claimant seeks to establish a disability through her own
testimony concerning “pain or other subjective symptoms,” courts in the Eleventh
Circuit apply a three-part test that requires “(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 (11th Cir. 2002); Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir.
1991). If the ALJ discredits subjective testimony, the ALJ must “articulate explicit
and adequate reasons for doing so,” and the failure to articulate the reasons for
discrediting subjective testimony “requires, as a matter of law, that the testimony be
accepted as true.” Wilson, 284 F.3d at 1225 (citing Hale v. Bowen, 831 F.2d 1007,
1011 (11th Cir. 1987)). The ALJ need not expressly refer to this test, but the ALJ’s
decision must indicate the standard was applied. See id. at 1226.
Finally, if the record shows the claimant has a “medically determinable
impairment that could reasonably be expected to produce her symptoms,” the ALJ
must assess the “intensity and persistence of the symptoms in determining how they
limit the claimant’s capacity for work.” Costigan v. Comm’r of Soc. Sec., 603 F.
6

App’x 783, 786 (11th Cir. 2015) (citing 20 C.F.R. § 404.1529(c)(1)). The ALJ must
consider “all of the record,” including the objective medical evidence, the claimant’s
history, and statements by the claimant and the claimant’s doctors, and the ALJ may
consider factors like the claimant’s daily activities; the location, duration, frequency,
and intensity of the claimant’s pain or other symptoms; the type, dosage,
effectiveness, and side effects of the claimant’s medication; and treatments other
than medication. Id. Last, the ALJ must examine the claimant’s symptom-related
testimony in relation to all of the other evidence, considering whether there are any
“inconsistencies or conflicts between those statements and the record.” Id.
IV.
In this case, at Step One, the ALJ determined that Guthrie had not engaged in
substantial gainful activity since her alleged onset date. R. 17. At Step Two, the
ALJ classified Guthrie’s generalized anxiety disorder, depression, PTSD, vertigo,
and carpal tunnel syndrome as severe impairments.6 Id. The ALJ determined that
the other impairments that Guthrie alleged did not count as severe—namely, that
Guthrie’s

discogenic

degenerative

change,

hypothyroidism,

gastritis,

appendectomy, lysis of adhesions, oophorectomy, gastric bypass surgery, and
restless leg syndrome either caused “minimal symptoms” or lacked evidence

6

Though the ALJ did not expressly mention Guthrie’s osteoarthritis in this list, later in the opinion
the ALJ noted that Guthrie had been diagnosed with osteoarthritis in March 2019 and that this
constituted a severe impairment. See R. 18.

7

indicating Guthrie had experienced work-related limitations in connection with these
impairments. 7 R. 18. At Step Three, the ALJ found that Guthrie did not have an
impairment or a combination of impairments that met or medically equaled the
severity of one of the listed impairments in the SSA regulations. See id.
The ALJ determined that Guthrie had a moderate limitation in understanding,
remembering, or applying information. R. 19. Here, the ALJ highlighted that
Guthrie could prepare her own meals, sweep, dust, load the dishwasher, wash
clothes, shop for groceries, take care of her pets, and comply with treatment from
medical providers, although Guthrie reported that her impairments affected her
memory and ability to understand and follow instructions. Id. Based on Guthrie’s
self-report and the opinion of Dr. Robert Estock, a state agency reviewing
psychiatrist, the ALJ found that Guthrie had a marked limitation in interacting with
others, a moderate limitation in concentrating, persisting, or maintaining pace, and
a moderate limitation in adapting or managing herself. See R. 19–20. The ALJ also
concluded that the record failed to establish “the medical signs, symptoms,
laboratory findings or degree of functional limitation required to equal the criteria
of any listed impairment” and that “no acceptable medical source . . . ha[d]
concluded that [Guthrie’s] impairments medically equal[ed] a listed impairment.”

7

One issue in this appeal is whether the ALJ should have classified Guthrie’s chronic knee pain
as severe. The court notes that although the ALJ did not list Guthrie’s chronic knee pain when
referencing her non-severe impairments, the ALJ did mention it later in the decision. See R. 21.

8

R. 20. The ALJ noted the Guthrie did not specifically allege that any of her
impairments met or medically equaled the criteria of a listed impairment. Id.
The ALJ also considered Guthrie’s pain- and symptom-related testimony
through Guthrie’s disability report and her testimony at the hearing. R. 20–21. The
ALJ noted that Guthrie listed PTSD, chronic lower back pain, spinal arthritis, severe
depression, chronic knee pain, anxiety with panic attacks, insomnia, vertigo,
hypertension, hypothyroidism, and carpal tunnel in her disability report. R. 21. The
ALJ referenced that Guthrie also reported issues with her memory and her ability to
lift, squat, bend, stand, reach, walk, sit, kneel, talk, hear, climb stairs, see, complete
tasks, concentrate, follow instructions, use her hands, and get along with others as a
result of her conditions. Id. And the ALJ acknowledged that Guthrie testified that
pain in her leg and back made it difficult to squat and that her anxiety attacks had
overwhelmed her to the point that she could not work. Id.
While the ALJ determined that Guthrie’s “medically determinable
impairments could reasonably be expected to cause some symptoms and functional
limitations,” the ALJ concluded that Guthrie’s statements about the intensity,
persistence, and limiting effects of these symptoms “[were] not entirely consistent
with the medical evidence and other evidence in the record.” See id. In particular,
the ALJ stated that Guthrie’s treatment records and diagnostic imaging “[did] not
indicate disabling functional limitations.” Id. The ALJ discussed Guthrie’s medical
9

appointments from February 2018 to February 2019, during which Guthrie reported
chronic pain, depression, and anxiety and “was conservatively treated for her
symptoms.” Id. In March 2019, Guthrie visited the emergency room due to
abdominal pain, and a computed tomography and ultrasound revealed a right pelvic
mass. R. 21–22. Guthrie thereafter underwent a laparoscopic bilateral salpingooophorectomy, lysis of adhesions, and an appendectomy, and the ALJ stated that
Guthrie “recovered well without limitations.” R. 22.
In addition, the ALJ described that in May 2019, during an examination with
Dr. Eric Bready, Guthrie could get up and out of her chair, get on and off the
examination table, and ambulate without difficulty. Id. Dr. Bready also apparently
detected no evidence of spinal spasm or scoliosis and found that Guthrie had normal
grip strength, reflexes, motor strength, and range of motion. Id. Dr. Bready noted
that Guthrie had some limitations in bending or stooping due to mild back pain but
concluded that Guthrie “was largely within normal limits.” Id. Likewise, the ALJ
cited Dr. Krishna Reddy, a state agency reviewing physician, who considered
Guthrie’s medical records and determined that Guthrie could occasionally lift and/or
carry 50 pounds, frequently lift and/or carry 25 pounds, stand and/or walk for a total
of six hours in an eight-hour workday, and sit for a total of six hours in an eight-hour
workday. Id. On this basis, Dr. Reddy concluded that Guthrie could work at a
medium level of exertion. Id.
10

Finally, the ALJ cited Guthrie’s August 2019 visit to the emergency room. Id.
During this visit, Guthrie complained of abdominal pain but apparently of no other
issues. Id. Guthrie’s examination revealed tenderness, but X-rays purportedly
returned normal results. See id.
Turning to Guthrie’s psychological conditions, in light of “the substantial
overlap in symptomology between different mental impairments, as well as the
inherently subjective nature of mental diagnoses,” the ALJ evaluated Guthrie’s
psychological symptoms together. R. 22. Reflecting on Guthrie’s self-report, the
ALJ highlighted that although Guthrie reported limitations in her memory and
abilities to complete tasks, concentrate and follow directions, and interact with
others, Guthrie also reported performing activities (e.g., preparing her own meals,
grocery shopping, and taking care of her pets) that apparently indicated she did not
have disabling mental limitations. Id. The ALJ also referred to a May 2019
psychological evaluation by Dr. William Higgs in which Dr. Higgs concluded that
Guthrie had mild functional impairments in managing self-care, executing short
instructions, and managing finances and a marked limitation in maintaining socially
appropriate interactions in the workplace. Id.
The ALJ found Dr. Reddy’s opinion that Guthrie could work at a medium
level of exertion consistent with the objective medical evidence, Guthrie’s
symptoms, and her daily activities and noted that Dr. Reddy, as a state agency
11

medical consultant, was a “highly qualified” “expert” in Social Security disability
evaluations. R. 23. The ALJ thus concluded that Dr. Reddy was persuasive. Id.
Likewise, the ALJ deemed Dr. Bready persuasive due to the consistency of his
observations with the evidence. Id. On the other hand, the ALJ found Drs. Estock’s,
Higgs’, Charles Shipman’s, 8 and Joseph Marino’s and Justin Anderson’s 9 opinions
inconsistent with this evidence and thus unpersuasive. Id.
Accordingly, the ALJ determined that Guthrie had the residual functional
capacity to perform “medium work” with the following limitations:
[Guthrie] can stand or walk for six hours and sit for six hours in an eight
hour workday; can frequently balance, stoop, kneel, crouch, crawl, and
climb ramps and stairs; never climb ladders, ropes, or scaffolds; can
tolerate no exposure to unprotected heights and dangerous machinery;
can frequently handle, finger, and feel with bilateral upper extremities;
is able to understand, remember, and carry out simple instructions and
make simple work related decisions; can tolerate occasional interaction
with coworkers, supervisors, and the public; can tolerate occasional
changes in work setting; and can work at a consistent pace throughout
the workday but not at a production rate pace where tasks must be
performed quickly.
R. 20. At Step Four, using testimony provided by the vocational expert 10 at the
hearing, the ALJ concluded that Guthrie could not perform her past work as a

8

According to the ALJ, Dr. Shipman’s opinion was inconsistent with the medical records as a
whole and with Dr. Bready’s examination. R. 23–24. Moreover, the ALJ noted that she was not
required to credit Dr. Shipman’s conclusion that Guthrie was disabled and unable to work. R. 24.
9

According to the ALJ, Drs. Marino and Anderson evaluated Guthrie in 2016, and the SSA
regulations did not require her to review evidence this far in the past. See R. 24.
10

At the hearing, the ALJ asked the vocational expert to “assume an individual limited to medium
work as defined in the regulations except that the individual [could] stand or walk for six hours

12

dispatcher given her age, education, and limitations. R. 24. At Step Five, the ALJ
again considered the vocational expert’s testimony 11 to conclude that Guthrie could
perform jobs existing in “significant numbers in the national economy.” R. 25. As
a result, the ALJ concluded that Guthrie was not disabled. R. 26.
V.
Guthrie argues that the ALJ’s decision was not supported by substantial
evidence because the ALJ (1) did not find Guthrie’s chronic knee pain “severe,” doc.
13 at 13; (2) failed to account for Guthrie’s chronic knee pain in determining
Guthrie’s limitations, as evidenced by Guthrie’s testimony and Dr. Shipman’s
opinion, see id. at 14–15; and (3) improperly concluded that Guthrie’s mental
impairments did not preclude work, id. at 16. The court addresses these arguments
in turn.

and sit for six hours in an eight hour work day.” R. 55. The ALJ specified that the hypothetical
individual could “frequently balance, stoop, kneel, crouch, crawl and climb ramps and stairs” but
“[n]ever climb ladders, ropes or scaffolds” or be exposed to “unprotected heights or dangerous
machinery.” Id. The ALJ included that the individual could “frequently handle, finger and feel
with bilateral upper extremities” and “[was] able to understand, remember and carry out simple
instructions and make simple work-related decisions” with “occasional interaction with
coworkers, supervisors and the public” and “occasional changes in work setting.” Id.
11

The expert testified that the hypothetical individual could work as a laundry worker, cleaner, or
plastics products laborer. R. 56. The ALJ then asked the expert to assume that the individual
could not work at a quick pace; the vocational expert replied that the jobs would remain the same.
Id. The ALJ also asked the expert to limit the exertional level to light work, permitted the
individual could occasionally balance, stoop, kneel, crouch, and crawl and climb ramps and stairs
(but not ropes, ladders, or scaffolds). R. 56–57. The vocational expert replied that the individual
could serve as a small parts assembler, electronics worker, or hand packager. Id.

13

A.
Guthrie first claims that the ALJ erred by failing to deem Guthrie’s chronic
knee pain a “severe impairment.” Id. at 13. Guthrie asserts that “[a]n impairment
can be considered as not severe only if it is a slight abnormality which has such a
minimal effect on the individual that it would not be expected to interfere with the
individual’s ability to work, irrespective of age, education, or work experience.” Id.
(citing Brady v. Heckler, 724 F.2d 914 (11th Cir. 1984)). And Guthrie is correct that
the severeness inquiry performed at Step Two is a “threshold inquiry” that “allows
only the most trivial impairments to be rejected.” Id. at 14; Jamison v. Bowen, 814
F.2d 585, 588 (11th Cir. 1987); McDaniel, 800 F.2d at 1031. See also Hearn v.
Comm’r, Soc. Sec. Admin., 619 F. App’x 892, 895 (11th Cir. 2015).
But Guthrie is incorrect that the classification of her chronic knee pain as “not
severe” means that the ALJ’s decision was unsupported by substantial evidence. To
be sure, it is possible the ALJ did not properly consider Guthrie’s testimony or Dr.
Shipman’s opinion about the extent to which Guthrie’s knee pain limited her, and
the court addresses these contentions in the next section. However, as to the
argument that the ALJ must have found Guthrie’s knee pain “severe,” the court notes
that the “finding of any severe impairment, whether or not it qualifies as a disability
and whether or not it results from a single severe impairment or a combination of
impairments that together qualify as severe,” satisfies Step Two. Jamison, 914 F.2d
14

at 588 (emphasis added). Thus, “[a]ny error” at Step Two must be “harmless
because the ALJ found in [Guthrie’s] favor as to impairment” by determining that
Guthrie’s generalized anxiety disorder, depression, PTSD, vertigo, and carpal tunnel
syndrome counted as severe impairments. Hearn, 619 F. App’x at 895; R. 17.12
In other words, regardless of whether the ALJ should have determined that
Guthrie’s chronic knee pain was severe, the ALJ answered “yes” to the Step Two
threshold inquiry and therefore proceeded to Step Three on the basis of Guthrie’s
other impairments. See Tuggerson-Brown, 572 F. App’x at 951. Given Guthrie’s
contentions, the real issue at hand is whether the ALJ properly considered Guthrie’s
chronic knee pain in the later steps. See Hearn, 619 F. App’x at 895 (citing Jones v.
Dep’t of Health & Human Servs., 941 F.2d 1529, 1533 (11th Cir. 1991)).
B.
To that end, Guthrie asserts that the ALJ’s “failure to discuss [Guthrie’s]
chronic knee pain [was] not harmless error” in light of Guthrie’s testimony and the
opinions of Dr. Shipman. See doc. 13 at 14–15. Guthrie basically makes two
arguments on this point: that the ALJ did not properly evaluate Guthrie’s testimony
about her chronic knee pain and that the ALJ inappropriately discredited Dr.

12

See also Tuggerson-Brown v. Comm’r of Soc. Sec., 572 F. App’x 949, 951 (11th Cir. 2014)
(citing 20 C.F.R. § 404.1520(a)(4)(ii)) (“[T]he regulations state that the only consequence of the
analysis at [S]tep [T]wo is that, if the ALJ finds no severe impairment or impairments, he should
reach a conclusion of no disability. . . . Based on our precedent and the regulations, therefore, it is
apparent that there is no need for an ALJ to identify every severe impairment at [S]tep [T]wo.”).

15

Shipman’s opinion. Because these arguments are intertwined, the court addresses
them together.
When evaluating a claimant’s testimony about pain and other symptoms, the
ALJ must follow a test that requires evidence of an underlying medical condition
and either “objective medical evidence confirming the severity of the alleged pain”
or “that the objectively determined medical condition can reasonably be expected to
give rise to the claimed pain.” Wilson, 284 F.3d at 1225. If the record shows the
claimant has a “medically determinable impairment that could reasonably be
expected to produce her symptoms,” the ALJ must assess the “intensity and
persistence of the symptoms in determining how they limit the claimant’s capacity
for work” by considering objective medical evidence, statements by the claimant
and the claimant’s doctors, and other factors related to the claimant’s daily life,
medications, and treatments. Costigan, 603 F. App’x at 786 (citing 20 C.F.R. §
404.1529(c)(1)).
Here, the ALJ expressly acknowledged this test in the written decision and
noted that Guthrie listed chronic knee pain as one of “the conditions that limit[ed]
her ability to work.” R. 21. The ALJ then found that Guthrie’s “medically
determinable impairments could reasonably be expected to cause some symptoms
and functional limitations.” Id. But the ALJ concluded that Guthrie’s statements
about the intensity, persistence, and effects of her symptoms were inconsistent with
16

the evidence, and Guthrie’s limitations “affect[ed] [her] ability to work only to the
extent [the statements could] reasonably be accepted as consistent with the objective
medical and other evidence.” Id.
The ALJ proceeded to discuss Guthrie’s treatment records and diagnostic
tests, and here, the ALJ discredited Dr. Shipman’s opinion while comparing the
opinions of Guthrie’s doctors against each other, Guthrie’s testimony, and her
examination results. See R. 21–22. Specifically, the ALJ noted that Guthrie’s
medical appointments from February 2018 through February 2019 reflected
Guthrie’s reports of chronic pain, depression, and anxiety but also “conservative[]”
treatment. R. 21. The ALJ cited records from Guthrie’s visits to Dr. Shipman in
early 2018 through mid-2019 that displayed negative findings except for what
appear to read as “chronic pain,” “depression,” and “anxiety,” see R. 552–57, and in
some cases “tender lower back” and “RLS” (presumably, restless leg syndrome), see
R. 558–59. See generally R. 546–64. Relatedly, an exam of Guthrie’s leg identified
no femur fracture but bony spurring and “[m]ild degenerative changes at the knee”
with a “possible small intra-articular loose body at the knee.” R. 565.
The ALJ next cited Guthrie’s visit to the emergency room for abdominal pain,
where Guthrie had “normal range of motion,” see R. 420–22. R. 21–22. The ALJ
noted that a visit with Dr. Bready in May 2019 demonstrated Guthrie had a history
of knee pain but could get herself in and out of her seat and on and off of the
17

examination table with “full motor strength and range of motion in all her
extremities,” R. 534–40. See R. 21–22. Finally, the ALJ cited Dr. Reddy’s review
of Guthrie’s medical records, highlighting that Dr. Reddy concluded Guthrie could
work at a medium level of exertion. See id. (citing R. 107–15).
In light of this, the ALJ found that Dr. Reddy’s opinion aligned with the
objective medical evidence and Guthrie’s testimony, and that despite Guthrie’s knee
pain, which interfered with her range of motion and ability to squat, see R. 40–41,
Guthrie could perform and manage daily activities on her own. See R. 23. The ALJ
also discounted Dr. Shipman’s opinion that Guthrie could only stand and sit for up
to 40 minutes and walk for up to 15 minutes and was limited in her ability to lift,
carry, bend, squat, and kneel, see R. 585, given, for example, the medical records
indicating Guthrie’s range of motion. See R. 23.
The court concludes that the ALJ’s decision not to fully credit Dr. Shipman’s
testimony and the ALJ’s finding that Guthrie’s chronic knee pain did not limit her
range of motion to the extent described in her testimony was supported by “such
relevant evidence as a reasonable person would accept as adequate to support a
conclusion.” Moore, 405 F.3d at 1211. Thus, these aspects of the ALJ’s decision
were supported by substantial evidence, and the ALJ’s decision is not due to be
reversed on this ground.

18

C.
Last, Guthrie argues that the ALJ should have found that Guthrie’s mental
impairments precluded her from working. See doc. 13 at 16. In support, Guthrie
cites her testimony about her intense depression and anxiety, which have led to
overwhelming panic attacks, and the opinion of Dr. Higgs, who concluded that
Guthrie’s psychological symptoms caused extreme impairments. See id. at 16–17;
R. 570–71. The ALJ found that Dr. Higgs’ opinion was unpersuasive because it was
apparently inconsistent with Dr. Higgs’ own evaluation, the medical records as a
whole, and Guthrie’s testimony about her symptoms and functioning. R. 23.
Here, the ALJ noted that Guthrie reported she could prepare her own meals,
sweep, dust, load the dishwasher, wash clothes, independently handle her finances,
shop for groceries, and take care of her pets. R. 22. The ALJ also highlighted that
Guthrie could share details about her health with doctors, follow their instructions,
and maintain good relationships with them and that Guthrie appeared comfortable
during her appointments. See id. The ALJ then turned specifically to Dr. Higgs’
mental examination, which found that Guthrie could, among other things, recall and
repeat words and count backwards. See id. See also R. 572. The ALJ found that
this evidence together contradicted Dr. Higgs’ conclusion that Guthrie had disabling
mental or psychological limitations. See R. 22–23.13
13

More specifically, the ALJ explained:

19

Given Guthrie’s testimony about her depression and anxiety and the records
indicating her history with these conditions, the court questions the extent to which
Dr. Higgs’ conclusions about Guthrie’s limitations were markedly inconsistent with
the evidence, as the ALJ opined. But the court is not permitted to reweigh the
evidence or substitute its judgment for the ALJ’s. Noble, 963 F.3d at 1323. Thus,
even if the evidence preponderates against the ALJ’s findings, the court must affirm
the ALJ’s decision if more than a scintilla of evidence supports it and a reasonable
person would accept the evidence as adequate. See id.; Moore, 405 F.3d at 1211.
Because Guthrie’s self-report indicated she could take care of pets, fix simple meals,
perform household chores, occasionally shop, and manage her finances, see R. 308–
11, and the ALJ could properly evaluate Guthrie’s testimony and doctors’ opinions

The undersigned finds Dr. Higgs’ opinion that the claimant had a mild functional
impairment in her ability to manage basic self-care, to understand, carry out, and
remember short instructions, and her ability to manage finances, but marked
limitations in her ability to maintain socially appropriate interactions in the
workplace unpersuasive because it is inconsistent with the medical records as a
whole and the claimant’s symptoms and reported level of functioning. Additionally,
Dr. Higgs’ opinion that the claimant’s psychological symptoms caused extreme
functional impairment in her ability to maintain attention, concentration, and pace
for two hours; maintain a regular schedule with punctuality; maintain regular work
attendance without absences related to psychological issues; sustain an ordinary
work routine without the need for special supervision; and seek and accept
appropriately instructions and criticism from supervisors is not persuasive because
it is inconsistent with Dr. Higgs’ own evaluation as well as the claimant’s medical
records and reported level of functioning as discussed herein.
R. 23. (internal citation omitted).

20

in light of this evidence, see Costigan, 603 F. App’x at 786 (citing 20 C.F.R. §
404.1529(c)(1)),14 the court concludes that the ALJ’s decision is due to be affirmed.
VI.
The court is mindful of Guthrie’s testimony about her intense anxiety,
depression, and panic attacks and the way these conditions appear to affect her
ability to work. However, because sufficient evidence supports the ALJ’s decision,
and the court may not substitute its judgment for that of the Commissioner, the court
will affirm the ALJ’s decision by separate order.
DONE the 19th day of November, 2021.

_________________________________
ABDUL K. KALLON
UNITED STATES DISTRICT JUDGE

14

As noted, to determine whether Guthrie’s testimony about the limiting effects of her symptoms
was consistent with the evidence, the ALJ was to consider “all of the record,” including the medical
evidence, Guthrie’s history, and statements by Guthrie and her doctors. See Costigan, 603 F.
App’x at 786. The ALJ may have also considered Guthrie’s daily activities; the location, duration,
frequency, and intensity of her pain or other symptoms; the type, dosage, effectiveness, and side
effects of her medication; and treatments other than medication. See id.

21