Watson v. Astrue

Filing 24

MEMORANDUM OPINION AND ORDER entered. It is ORDERED that the decision of the Commissioner of Social Security denying plaintiff benefits be affirmed. Signed by Magistrate Judge William E. Cassady on 3/19/2012. (eec)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION

DORIS WATSON,

:

Plaintiff,

:

vs.

:

MICHAEL J. ASTRUE,
Commissioner of Social Security,

CA 11-0292-C

:
:

Defendant.
MEMORANDUM OPINION AND ORDER
Plaintiff brings this action, pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3), seeking
judicial review of a final decision of the Commissioner of Social Security denying her
claims for disability insurance benefits and supplemental security income. The parties
have consented to the exercise of jurisdiction by the Magistrate Judge, pursuant to 28
U.S.C. § 636(c), for all proceedings in this Court. (Docs. 22 & 23 (“In accordance with the
provisions of 28 U.S.C. 636(c) and Fed.R.Civ.P. 73, the parties in this case consent to
have a United States Magistrate Judge conduct any and all proceedings in this case, . . .
order the entry of a final judgment, and conduct all post-judgment proceedings.”).)
Upon consideration of the administrative record, plaintiff’s brief, the Commissioner’s
brief, and the arguments of the parties at the March 14, 2012 hearing before the

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Magistrate Judge, it is determined that the Commissioner’s decision denying plaintiff
benefits should be affirmed.1
Plaintiff alleges disability due to coronary artery disease and hypertension. The
Administrative Law Judge (ALJ) made the following relevant findings:
The claimant’s severe physical impairments are coronary artery disease
and hypertension. The claimant’s physical residual functional capacity is:
lifting/carrying of 10 pounds occasionally and 5 pounds frequently;
sitting and standing for 6 hours each in an 8 hour day; no exposure to
dust, fumes, and gases or temperature extremes; no dangerous heights or
machinery; and no operation of foot controls or the pushing and pulling of
arm controls. These limitations accommodate, inter alia, the claimant’s
occasional mild to moderate pains, headaches, and fatigue. The claimant
denied having any medication side effects in Exhibit 2E at 7.
The residual functional capacity is supported, inter alia, by the objective
findings set out in the Stanton Road Clinic office notes indicating
consistently that claimant’s hypertension and coronary artery disease are
controlled with medication and exercise regimen; by the absence of
disabling complaints in Exhibits 3F and 6F; by the absence of disabling
coronary artery disease symptoms for the duration period and the
observations at Exhibit 5F at 1-2, 4 (no return needed for 6 months), 9
(quite well), 12, 13; by the observations in Exhibit 9F at 1 (doing well in
September of 2008); by the University of South Alabama Hospital records
in Exhibit 10F at 1 (condition stable with negative testing); by the
information in Exhibit 12 at 2 (merely follow up in 6 months) and 12F at 6
(claimant denies having any problems) and 12F at 12 (no renal artery
stenosis); by the results of testing including METS at 10.2 and normal
stress test; by the heart rating of Class I by Dr. Stephen Landreneau; and
by the claimant’s activities of daily living which include driving a car,
shopping, cooking, and light housework. The residual functional capacity
is further supported by the conservative treatment received; by the

Any appeal taken from this memorandum opinion and order and judgment shall
be made to the Eleventh Circuit Court of Appeals. (See Docs. 22 & 23 (“An appeal from a
judgment entered by a Magistrate Judge shall be taken directly to the United States Court of
Appeals for this judicial circuit in the same manner as an appeal from any other judgment of
this district court.”).)
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medical findings arising from medically acceptable clinical and laboratory
diagnostic techniques; and by the absence of recent hospital admissions.
In arriving at the residual functional capacity, I have also considered the
claimant’s subjective complaints. I have ascertained that there are
underlying medical conditions that could cause some symptoms, but that
the objective medical evidence does not confirm the degree of limitation
alleged to be arising from those conditions. I have also determined that
the objectively determined medical conditions are not of such severity that
they can be reasonably expected to give rise to the alleged symptoms. The
claimant’s credibility on the severity of her symptoms has been
undermined by the factors identified above that support her residual
functional capacity.
The assessment form prepared by Dr. Landreneau is given considerable
weight. Its (sic) opinion that the claimant warrants a mere Class I rating
and that the degree of limitation associated with her condition was slight
to moderate is consistent with the record as a whole; the simultaneous
opinion that the claimant’s fatigue would be distracting to adequate
performance of work has been accommodated with the extraordinary
reduction of her residual functional capacity to a mere range of sedentary
work that also precludes the repetitive use of arm or foot controls. It is
also read in the context of the opinion that her limitation is slight to
moderate. The indication that the claimant would need to nap one hour a
day several times a week does not require that it be done during work
hours or that it could not be accommodated during the worker’s lunch
hour or permitted breaks. It again must be read as part of the overall
opinion that the limitation involved is consistent with a Class I
classification. Moreover, there is no discussion of the need for a nap in any
office note of Dr. Landreneau or any other physician who examined her.
See e.g. Exhibits 5F at 1-2, 4, 9, 12, 13; 12F at 2, 6, 12; 9F at 1; and 13F at 3.
I find that the claimant can return to her past relevant work as a payroll
clerk, as that work is performed in the national economy. The Dictionary
of Occupational Titles [] at # 215.382-014 describes how that job is
performed. It is sedentary, semi-skilled job that requires frequent
reaching, handling, fingering, occasional hearing and accommodation,
and constant near acuity, and moderate noise intensity. All of these
functions are within her residual functional capacity.
The claimant is not disabled.
.

.

.
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1.
The claimant meets the insured status requirements of the Act
through September 30, 2007.
2.
The claimant has not engaged in SGA since October 24, 2003, the
alleged onset date.
3.
The claimant has the following severe impairments: coronary
artery disease and hypertension.
4.
The claimant does not have an impairment or combination of
impairments that meets or medically equals one of the listed
impairments in 20 CFR Part 404, Subpart P, Appendix 1.
.

.

.

5.
The claimant has the residual functional capacity to occasionally
lift 10 pounds and frequently lift 5 pounds; to sit for 6 hours in an 8
hour work day; to stand for 2 hours in an 8 hour work day. She cannot
be exposed to dangerous heights, dangerous machinery, and
temperature extremes; she can be exposed occasionally to dust, fumes,
and gases; she cannot be engaged in the operation of foot controls or the
pushing and pulling of arm controls.
In making this finding, the undersigned has considered all symptoms and
the extent to which these symptoms can reasonably be accepted as
consistent with the objective medical evidence and other evidence, based
on the requirements of 20 CFR 404.1529 and 416.929 and SSRs 96-4p and
96-7p. The undersigned has also considered opinion evidence in
accordance with the requirements of 20 CFR 404.1527 and 416.927 and
SSRs 96-2p, 96-5p, 96-6p and 06-3p.
In considering the claimant’s symptoms, the undersigned must follow a
two-step process in which it must first be determined whether there is an
underlying medically determinable physical or mental impairment(s)—
i.e., an impairment(s) that can be shown by medically acceptable clinical
and laboratory diagnostic techniques—that could reasonably be expected
to produce the claimant’s pain or other symptoms.
Second, once an underlying physical or mental impairment(s) that could
reasonably be expected to produce the claimant’s pain or other symptoms
has been shown, the undersigned must evaluate the intensity, persistence,
and limiting effects of the claimant’s symptoms to determine the extent to
which they limit the claimant’s ability to do basic work activities. For this
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purpose, whenever statements about the intensity, persistence, or
functionally limiting effects of pain or other symptoms are not
substantiated by objective medical evidence, the undersigned must make
a finding on the credibility of the statements based on a consideration of
the entire case record.
.

.

.

The claimant’s medically determinable impairments could reasonably be
expected to cause some symptoms; however, the claimant’s statements
concerning the intensity, persistence and limiting effects of these
symptoms are not credible to the extent they are inconsistent with the
above residual functional capacity.
The claimant’s pain complaints were considered in formulating her
residual functional capacity.
6.
The claimant capable of performing her past relevant work as a
payroll clerk. This work does not require her performance of workrelated activities precluded by the claimant’s residual functional
capacity.
The claimant has past relevant work as a payroll clerk. See e.g. Exhibit 9E
at 3. That work was performed on a full time basis 5 days per week and 8
hours per day. As performed in the national economy, it is a sedentary,
semi-skilled occupation that requires frequent reaching, handling,
fingering, occasional hearing and accommodation, and constant near
acuity, and moderate noise intensity. Its description is found at DOT #
215.382-014. The claimant’s residual functional capacity would permit her
to perform that work again. The claimant’s reduction to the sedentary
exertional level does reflect her occasional mild to moderate pain that can
be expected to exist with her condition.
7.
The claimant has not been disabled from October 24, 2003
through the date of this decision.
(Tr. 21-22, 22, 22-23, & 25-26 (some emphasis supplied).) The Appeals Council affirmed
the ALJ’s decision (Tr. 1-3) and thus, the hearing decision became the final decision of
the Commissioner of Social Security.
DISCUSSION
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In all Social Security cases, the claimant bears the burden of proving that she is
unable to perform her previous work. Jones v. Bowen, 810 F.2d 1001 (11th Cir. 1986). In
evaluating whether the claimant has met this burden, the examiner must consider the
following four factors: (1) objective medical facts and clinical findings; (2) diagnoses of
examining physicians; (3) evidence of pain; and (4) the claimant’s age, education and
work history.

Id. at 1005.

Once the claimant meets this burden, it becomes the

Commissioner’s burden to prove that the claimant is capable, given her age, education
and work history, of engaging in another kind of substantial gainful employment which
exists in the national economy. Sryock v. Heckler, 764 F.2d 834, 836 (11th Cir. 1985).
The task for the Magistrate Judge is to determine whether the Commissioner’s
decision to deny claimant benefits, on the basis that she can perform her past relevant
work as a payroll clerk, is supported by substantial evidence. Substantial evidence is
defined as more than a scintilla and means such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 91
S.Ct. 1420, 28 L.Ed.2d 842 (1971). “In determining whether substantial evidence exists,
we must view the record as a whole, taking into account evidence favorable as well as
unfavorable to the [Commissioner’s] decision.” Chester v. Bowen, 792 F.2d 129, 131 (11th
Cir. 1986).2

This Court’s review of the Commissioner’s application of legal principles,
however, is plenary. Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987).
2

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In this case, the plaintiff contends that the ALJ’s RFC opinion is not supported by
substantial evidence and, as well, that his credibility finding is not supported by
substantial evidence.
A.

RFC Determination. The ALJ determined that plaintiff has the residual

functional capacity “to occasionally lift 10 pounds and frequently lift 5 pounds; to sit
for 6 hours in an 8 hour work day; [and] to stand for 2 hours in an 8 hour work day.”
(Tr. 22; see also Tr. 21.) This determination, as plaintiff notes, is all but consistent with
the ability to perform sedentary work. Compare id. with 20 C.F.R. § 404.1567(a) (2011)
(“Sedentary work involves lifting no more than 10 pounds at a time and occasionally
lifting or carrying articles like docket files, ledgers, and small tools. Although a
sedentary job is defined as one which involves sitting, a certain amount of walking and
standing is often necessary in carrying out job duties. Jobs are sedentary if walking and
standing are required occasionally and other sedentary criteria are met.”).
Plaintiff

contends

that

in

reaching

his

RFC

determination,

the

ALJ

mischaracterized the opinion of her treating source, Dr. Stephen Landreneau, set forth
in a heart questionnaire completed by the doctor on April 28, 2008. (See Tr. 327-328.)
That questionnaire reflects the following opinions of Dr. Landreneau regarding the
nature of plaintiff’s coronary artery disease and hypertension, the limitations imposed
by her heart condition, and the impact of Watson’s subjective complaints of fatigue: (1)
she has a New York Heart Association Class I heart condition; (2) her condition causes a
slight to moderate degree of limitation on her ability to perform work activity; (3) he
had no opinion on whether plaintiff could maintain work activity for an eight hour
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workday; (4) her condition would not require her to elevate her legs during the day;
and (5) with respect to fatigue, he indicated that fatigue is present to such an extent as
to be distracting to adequate performance of daily activities or work, that physical
activity such as standing and walking will produce some increase in the level of fatigue
but not to such an extent as to prevent adequate functioning, and plaintiff’s fatigue
forces her to recline or nap one hour a day several days per week. (See id.) The ALJ
assigned considerable weight to Landreneau’s assessment (Tr. 21) and analyzed it in the
following manner:
[Landreneau’s] opinion that the claimant warrants a mere Class I rating
and that the degree of limitation associated with her condition was slight
to moderate is consistent with the record as a whole; the simultaneous
opinion that the claimant’s fatigue would be distracting to adequate
performance of work has been accommodated with the extraordinary
reduction of her residual functional capacity to a mere range of sedentary
work that also precludes the repetitive use of arm or foot controls. It is
also read in the context of the opinion that her limitation is slight to
moderate. The indication that the claimant would need to nap one hour a
day several times a week does not require that it be done during work
hours or that it could not be accommodated during the worker’s lunch
hour or permitted breaks. It again must be read as part of the overall
opinion that the limitation involved is consistent with a Class I
classification. Moreover, there is no discussion of the need for a nap in any
office note of Dr. Landreneau or any other physician who examined her.
(Id.) The problem plaintiff has with this analysis is the ALJ’s statement that “the
simultaneous opinion that the claimant’s fatigue would be distracting to adequate
performance of work has been accommodated with the extraordinary reduction of her
residual functional capacity to a mere range of sedentary work that also precludes the
repetitive use of arm or foot controls.” (Compare id. with Doc. 14, at 3-6.) Plaintiff
contends that with this one sweep of the pen, the ALJ has wrongly “equated”
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Landreneau’s opinion regarding her fatigue with the ability to perform sedentary work
or, otherwise, that the ALJ did not properly accord Landreneau’s opinion the
considerable weight it was due. (See id.)
While the Court agrees with plaintiff that the ALJ’s opinion appears to “equate”
Landreneau’s finding that plaintiff’s fatigue is present to such an extent as to be
distracting to adequate performance of daily activities or work with her ability to
perform sedentary work, any error in this regard is harmless given that substantial
evidence in the record, including most of Landreneau’s heart questionnaire, supports
the ALJ’s determination that plaintiff retains the residual functional capacity to
occasionally lift 10 pounds and frequently lift 5 pounds, sit for 6 hours in an 8 hour
workday, and stand for 2 hours in an 8 hour workday. Indeed, it would have been
appropriate for the ALJ to give no weight to this particular fatigue observation made by
Landreneau both because it is internally inconsistent with the other findings made by
Landreneau and because it is inconsistent with the other evidence of record produced
during this time period.3 More to the point, Landreneau’s finding that plaintiff’s fatigue
Landreneau’s April 28, 2008 office notes do not contain evidence that plaintiff
complained of fatigue (see Tr. 331) nor are there many office notes from 2008 or early 2009
which contain reference to plaintiff’s complaints of fatigue (see, e.g., Tr. 329-330, 368-369, 371-374
& 411-417). Indeed, there are just as many office notes from this time period in which plaintiff
reported that she was doing well (see Tr. 303 & 334-335).
3

During the hearing on March 14, 2012, counsel for plaintiff noted that fatigue is
mentioned throughout the medical records on pages 240-271 of the administrative record. The
undersigned would simply note that such complaints of fatigue by plaintiff prior to the
placement of stents in October of 2005 would not be unusual and the medical records reflected
on pages 240-271 of the administrative record produced in this case fall within that time period.
(See Tr. 240-271.)

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is present to such an extent as to be distracting to adequate performance of daily
activities or work is inconsistent not only with his additional fatigue finding that
physical activity such as standing and walking will produce some increase in the level
of fatigue but not to such an extent as to prevent adequate functioning but, as well, it is
inconsistent with the additional questionnaire findings that plaintiff has a New York
Heart Association Class I heart condition which causes a slight to moderate degree of
limitation on her ability to perform work activity. The undersigned surmises that the
ALJ read Landreneau’s questionnaire in the manner he did in order to make as much
sense out of it given the state of the other medical evidence of record, none of which
indicates plaintiff can perform no work activity given her subjective complaints of
fatigue (see Tr. 277-326, 329-336, 369-384, 411-417 & 428-431), and his undoubted
knowledge that a New York Heart Association Functional Class I “describes a patient
who, despite the presence of cardiac disease, does not exhibit any resulting physical
limitations, because exertion does not cause abnormal fatigue, palpitations, anginal pain
or shortness of breath.” Mejia v. Astrue, 719 F.Supp.2d 328, 331 n.5 (S.D.N.Y. 2010), citing
American Medical Association, Guides to the Evaluation of Permanent Impairment at 170;
see also Bartlett v. Astrue, 2010 WL 4386893, *3 n. 7 (D. Minn. Oct. 7, 2010) (“Class I
indicates no limitation of physical activity and no shortness of breath, fatigue, or heart
palpitations with ordinary physical activity.”), report & recommendation adopted, 2010 WL
4386891 (D. Minn. Oct. 28, 2010); Ray v. Sun Life & Health Ins. Co., 752 F.Supp.2d 1229,
1236 (N.D. Ala. 2010) (“The American Heart Association’s website . . . describes NYHA
Class I as ‘No symptoms and no limitation in ordinary physical activity.’”), aff’d, 443
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Fed.Appx. 529 (11th Cir. Oct. 21, 2011). Regardless of the reason for the ALJ’s analysis of
Landreneau’s one fatigue finding, the bottom line for this Court is that the ALJ could
properly ignore that finding for the reasons identified above and, moreover, could
properly concluded that the evidence of record supports a finding that plaintiff has the
residual functional capacity set forth in the decision denying benefits. Not only does
Landreneau’s assessment, on balance, support the ALJ’s RFC determination (compare Tr.
327-328 with Tr. 21 & 22) but, as well, the ALJ’s RFC determination is supported by the
claimant’s reported daily activities (see Tr. 39), and most of the remaining evidence of
record (see, e.g., Tr. 277-314, 317-326, 329-336, 369-384, 413-417 & 428-431). In particular,
no physician who examined and treated plaintiff indicated that she was incapable of
work activity because of her heart condition nor did any physician place any limitation
upon her ability to perform any physical activity, like lifting or carrying of weight,
sitting, standing or walking. (See id.)4 Accordingly, plaintiff is entitled to no relief on the
basis of this claim.
B.

Credibility Determination. Plaintiff’s only other assignment of error is

that the ALJ’s credibility determination is not supported by substantial evidence. In
particular, plaintiff faults the ALJ for failing to find credible her testimony that she
cannot work due to her extreme fatigue, same requiring her (by noon) to nap 2 to 3
hours per day. (See Tr. 36-39.)

Indeed, the last medical office notes made a part of this record simply contain the
notation that plaintiff “does not work at this time.” (Tr. 428.)
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The Eleventh Circuit has established a three-part pain standard that applies
when a claimant attempts to establish her disability through testimony of pain or other
symptoms. “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 reasonably be expected to give rise to the
alleged pain.” Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991) (citation omitted). “A
claimant may establish that her pain is disabling through objective medical evidence
that an underlying medical condition exists that could reasonably be expected to
produce the pain.

20 C.F.R. ' 404.1529 provides that once such an impairment is

established, all evidence about the intensity, persistence, and functionally limiting
effects of pain or other symptoms must be considered in addition to the medical signs
and laboratory findings in deciding the issue of disability.” Foote v. Chater, 67 F.3d 1553,
1562 (11th Cir. 1995).
In this case, the undersigned disagrees with plaintiff’s contention that the ALJ
committed reversible error in failing to find her fatigue complaints credible. The ALJ, in
applying the Eleventh Circuit’s “pain” standard, clearly stated that “[t]he claimant’s
credibility on the severity of her symptoms has been undermined by the factors
identified above that support her residual functional capacity.” (Tr. 21; see also id. (“In
arriving at the residual functional capacity, I have also considered the claimant’s
subjective complaints. I have ascertained that there are underlying medical conditions
that could cause some symptoms, but that the objective medical evidence does not
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confirm the degree of limitation alleged to be arising from those conditions. I have also
determined that the objectively determined medical conditions are not of such severity
that they can be reasonably expected to give rise to the alleged symptoms.”).) In turn,
those factors were:
The residual functional capacity is supported, inter alia, by the objective
findings set out in the Stanton Road Clinic office notes indicating
consistently that claimant’s hypertension and coronary artery disease are
controlled with medication and exercise regimen; by the absence of
disabling complaints in Exhibits 3F and 6F; by the absence of disabling
coronary artery disease symptoms for the duration period and the
observations at Exhibit 5F at 1-2, 4 (no return needed for 6 months), 9
(quite well), 12, 13; by the observations in Exhibit 9F at 1 (doing well in
September of 2008); by the University of South Alabama Hospital records
in Exhibit 10F at 1 (condition stable with negative testing); by the
information in Exhibit 12 at 2 (merely follow up in 6 months) and 12F at 6
(claimant denies having any problems) and 12F at 12 (no renal artery
stenosis); by the results of testing including METS at 10.2 and normal
stress test; by the heart rating of Class I by Dr. Stephen Landreneau; and
by the claimant’s activities of daily living which include driving a car,
shopping, cooking, and light housework. The residual functional capacity
is further supported by the conservative treatment received; by the
medical findings arising from medically acceptable clinical and laboratory
diagnostic techniques; and by the absence of recent hospital admissions.
(Id.) The Court agrees with the ALJ that the foregoing factors undermine the credibility
of Watson’s allegations that she suffers from such extreme fatigue that by noon each
day she is napping for 2 to 3 hours. In particular, plaintiff’s testimony in this regard is at
odds with Dr. Landreneau’s description of her heart condition as a New York Heart
Association Functional Class I impairment (Tr. 327), the scope of her daily activities (Tr.
39), the very few complaints of fatigue registered with the various physicians she saw
between the placement of her stents and the date of the hearing (see Tr. 276-335, 368-374,

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380-383, 411-417 & 428-431), and the failure of any physician who examined or treated
her to indicate that she is incapable of any and all work activity.
In light of the foregoing, the undersigned finds that the ALJ did not commit
reversible error based upon the issues identified by the plaintiff and because Watson’s
past work as a payroll clerk is consistent with the residual functional capacity found by
the ALJ (compare Tr. 26 (“As performed in the national economy, [work as a payroll
clerk] is a sedentary, semi-skilled occupation that requires frequent reaching, handling,
fingering, occasional hearing and accommodation, and constant near acuity, and
moderate noise intensity. Its description is found at DOT # 215.382.014.”) with Tr. 22
(“The claimant has the residual functional capacity to occasionally lift 10 pounds and
frequently lift 5 pounds; to sit for 6 hours in an 8 hour work day; to stand for 2 hours
in an 8 hour work day. She cannot be exposed to dangerous heights, dangerous
machinery, and temperature extremes; she can be exposed occasionally to dust,
fumes, and gases; she cannot be engaged in the operation of foot controls or the
pushing and pulling of arm controls.”)), the Commissioner’s fourth-step denial of
benefits is due to be affirmed. See, e.g., Waldrop v. Commissioner of Social Security, 379
Fed.Appx. 948, 953 (11th Cir. May 21, 2010) (“The burden is on the claimant to show
that she can no longer perform her past relevant work as she actually performed it, or as
it is performed in the general economy.”).
CONCLUSION
It is ORDERED that the decision of the Commissioner of Social Security denying
plaintiff benefits be affirmed.
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DONE and ORDERED this the 19th day of March, 2012.
s/WILLIAM E. CASSADY
UNITED STATES MAGISTRATE JUDGE

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