Rivers v. Colvin

Filing 17

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 9/9/2015. (eec)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
KAREN L. RIVERS,

:

Plaintiff,

:

vs.

:

CA 14-0251-C

CAROLYN W. COLVIN,
:
Acting Commissioner of Social Security,
:
Defendant.
MEMORANDUM OPINION AND ORDER
In this action under 42 U.S.C. §§ 405(g) and 1383(c)(3), Plaintiff seeks judicial
review of an adverse social security ruling denying a claim for disability insurance
benefits (Docs. 1, 10). 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.
14 & 15 (“In accordance with 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 postjudgment proceedings.”).) Upon consideration of the administrative record, plaintiff’s
brief, the Commissioner’s brief and having the benefit of oral arguments, it is
determined that the Commissioner’s decision denying benefits should be affirmed and
this action dismissed.

1

Any appeal taken from this memorandum opinion and order and judgment shall be made to the
Eleventh Circuit Court of Appeals. (See Docs. 19 & 20 (“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.”))

1

Plaintiff applied for a period of disability and disability insurance benefits on
November 4, 2001 (Tr. 62), alleging a disability onset date of June 30, 2008 (Tr. 113-17).
At the administrative hearing, Plaintiff was fifty-three years old (Tr. 46), had completed
a GED (Tr. 47), and had a previous work as a telemarketer, cashier, and cafeteria
attendant (Tr. 58). Plaintiff claimed disability due to coronary artery disease, bladder
cancer, neck, back, and leg pain, and restless leg syndrome (Tr. 132).

The

Administrative Law Judge (ALJ) made the following relevant findings:
1.

The claimant meets the insured status requirements of the Social
Security Act through December 31, 2013.

2.

The claimant has not engaged in substantial gainful activity since June
30, 2008, the alleged onset date (20 CFR 404.1571 et seq.).

3.

The claimant has the following severe impairments: major depressive
disorder, degenerative disc disease of the lumbar spine, status post
bladder cancer, migraine headaches, coronary artery disease, and
restless leg syndrome (20 CFR 404.1520(c)).

4.

The claimant does not have an impairment or combination of
impairments that meets or medically equals the severity of one of the
listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR
404.1520(d), 404.1525 and 404.1526).
…
In activities of daily living, the claimant has mild restriction. At the
consultative examination, the claimant indicated that she is able to feed,
bathe, groom, and dress herself without assistance. She could also use a
telephone, manage money, prepare meals, shop for groceries, and drive an
automobile all without assistance. Her hygiene was good and her
appearance was neat. The claimant also indicated that she watched
television, cooked, and did dishes (10F).
In social functioning, the claimant has mild difficulties. The claimant
indicated that she went to the grocery store and to church. She stated that
she liked to visit a friend in her free time (10F). She lives with her
husband and two children.
With regard to concentration, persistence or pace, the claimant has
moderate difficulties. At the consultative examination, the claimant was
alert and oriented to person, place, time, day, date, and purpose for the
evaluation. She was able to focus and sustain attention, with no
2

significant distraction from extraneous stimuli. She completed the serial
3’s task without error and accurately spelled WORLD backwards. She
performed basic mathematical evaluations accurately (10F). The claimant
indicated that she enjoyed watching television, which suggests at least
some degree of concentration/attention.
As for episodes of decompensation, the claimant has experienced no
episodes of decompensation, which have been of extended duration.
Because the claimant’s mental impairment does not cause as least two
“marked” limitations or one “marked” limitation and “repeated” episodes
of decompensation, each of extended duration, the “paragraph B” criteria
are not satisfied.
The undersigned has also considered whether the “paragraph C” criteria
are satisfied. In this case, the evidence fails to establish the presence of the
“paragraph C” criteria that satisfies medical listing 12.04, Affective
Disorders. Medical evidence of record does not indicate that the claimant
has a medically documented history of a chronic affective disorder of at
least two years’ duration that has caused more than a minimal limitation
of ability to do basic work with repeated episodes of decompensation.
The claimant is not adversely affected by minimal change and does not
require a highly supportive living arrangement.
The limitations identified in the “paragraph B” criteria are not a residual
functional capacity assessment but are used to rate the severity of mental
impairments at steps 2 and 3 of the sequential evaluation process. The
mental residual functional capacity assessment used at steps 4 and 5 of the
sequential evaluation process requires a more detailed assessment by
itemizing various functions contained in the the broad categories found in
paragraph B of the adult mental disorders listings in 12.00 of the Listings
of Impairments (SSR 96-8p). Therefore, the following residual functional
capacity assessment reflects the degree of limitation the undersigned has
found in the “paragraph B” mental function analysis.
5.

After careful consideration of the entire record, the undersigned finds
that the claimant has the residual functional capacity to perform light
work as defined in 20 CFR 404.1567(b) except the claimant can lift and
carry no more [than] 20 pounds occasionally and ten pounds frequently.
The claimant is not capable of overhead reaching or climbing ladders,
ropes, or scaffolds. She cannot work around unprotected heights or
dangerous equipment. She can occasionally operate foot controls, climb
stairs and ramps, stoop, kneel, crouch, and crawl. The claimant would
need to alternate between sitting and standing positions every 30
minutes but would not need to leave the workstation. The claimant
cannot make judgments on anything except simple work-related
decisions. Changes to the work setting or routine must be minimal.
She must avoid work tasks involving a variety o[f] instructions or tasks
but is able to understand and carry out simple one-to-two-step
3

instructions. The claimant is able to understand and carry out detailed
but uninvolved oral or written instructions involving few concrete
variables from standardized situations.
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 SSRs 96-4p and 96-7p. The
undersigned has also considered opinion evidence in accordance with the
requirements of 20 CFR 404.1527 and SSRs 96-2p, 96-5, 96-6p and 06-3p.
…
At the hearing, the claimant stated that she lives in a mobile home with
her husband and two children ages 13 and 15. She has a GED and can
read and write. The claimant indicated that she last worked in 2008 as an
assistant manager at a Hardees restaurant. She stated that she could not
physically do the work and could not concentrate on mental aspects of the
work. For example, when making a hamburger, she could not remember
what ingredients to use. She worked at Dollar General in 2007 but stated
that she could no longer do the job of a cashier. She also worked as a
cafeteria attendant for about three to four months. She stated that she has
not looked for work since 2008. The claimant noted that she does have
health insurance.
When asked about her impairments, the claimant stated that she has
ongoing issues related to her back and neck. She has pain in her hips that
radiates upward. She takes hydrocodone, Soma, and something for
headaches. She indicated that hydrocodone makes her very sleepy. The
claimant stated that she saw a surgeon from 2003-2006 but does not have
those records. This physician referred her to pain management.
The claimant stated that she was diagnosed with bladder cancer in July of
2010, and her bladder was removed. She stated that she has been cancer
free for about a year. She noted that she has heart disease, and a
cardiologist monitors her condition.
As for her mental health, the claimant stated that she had a psychiatrist
about 12 years ago when she noticed that she could not focus. She stated
that she was also very irritable. Treatment helped somewhat. She started
treatment again in January 2012.
In terms of activities of daily living, the claimant stated that she cannot do
chores as quickly as she once could. She washes her children’s school
clothes. She does not vacuum or dust. She noted that this makes her feel
useless because her husband must do her chores in addition to his own.
She walks around indoors and tries to concentrate on what needs to be
done. She watches some television but does not do crafts or garden. She
4

cooks for her children but stares out the window most of the day. She
attends church each week.
The claimant estimated that she could walk about 10 minutes at a time.
She can stand 15 minutes at a time and can sit 20-25 minutes at [a] time.
The claimant indicated that the external bag that holds urine also affects
her daily activities. She stated that she must be careful when lifting or the
bag will break. She noted that sweating or sleeping also cause difficulties
with the bag.
After careful consideration of the evidence, the undersigned finds that the
claimant’s medically determinable impairments could reasonably be
expected to cause the alleged symptoms; however, the claimant’s
statements concerning the intensity, persistence and limiting effects of
these symptoms are not entirely credible for the reasons explained in this
decision.
After complaints of back pain and leg numbness, a November 2003 MRI
indicated very mild bulging disc of L4-5. There was also very mild []s
ligamentous hyperthrophy of L3-4 but there was no spinal or foraminal
stenosis (1F).
A September 2008 MRI of the lumbar spine showed mild degenerative
disc disease of the lubar spine and a mild annular bulge with small left
foraminal protrusion at L2-3 creating mild to moderate narrowing of the
left exiting foramina and mild narrowing of the right exiting foramina.
The[re] was also a mild annular bulge of the L3-4 disc with mild
narrowing to the origin of each exiting foramina. A mild broad based
annular bulge with small central protrusion at L5-S1 was also observed.
Disc material flattened the thecal sac anteriorly creating borderline
narrowing to the origin of each exiting foramina (2F, 17). Thomas R.
Dempsey, M.D., noted that the MRI showed only degenerative changes
and no herniated discs; therefore, she was not a surgical candidate.
Additionally, the claimant noted that Lortab and Soma were helping with
pain (2F).
Hematuria was noted in July 2010, and the claimant underwent
cystoscopy, bilateral retrograde pyelogram, and a bladder biopsy (4F).
High-grade transitional cell carcinoma in situ was noted. Bacillus
Calmette-Guerin (BCG) treatment was started soon afterwards. Notes
from August 11, 2010, indicate that the claimant had a lot of pain,
frequency, and urgency after her second BCG treatment. Notes from
August 18, 2010 indicate that the claimant’s urine culture was negative,
but she still had voiding complaints. Impressions included carcinoma in
situ on BCG and acute cystitis. By September 30, 2010, the claimant had
completed her six-week course of BCG. She did well. Weight loss was
noted but it was not likely related to her bladder issues (8F).

5

A cystoscopy, bladder biopsies, and extensive fulguration of the bladder
tumor were performed on October 6, 2010, and pathologic findings
included transitional cell carcinoma (4F). A three-week maintenance
round of BCG was started in December 2010. She had irritative voiding
symptoms suggestive of persistent cancer or possibly BCG effect (8F).
On February 7, 2011, the claimant again underwent cystoscopy, bladder
biopsy, and fulguration of the biopsy sites. Pathologic findings indicated
active chronic cystitis and transitional cell dysplasia (4F).
The claimant was admitted to Providence Hospital on March 13, 2011, and
underwent radical cystectomy and ileal conduit formation. She recovered
uneventfully and was transferred to the intensive care unit where she had
a good recovery. She did have some postoperative pain that lasted for
five to six days. After she was weaned [] from intravenous antibiotics, an
oral medication[] controlled her pain as well. On discharge on March 19,
2011, the claimant was able to tolerate a normal diet and ambulate without
assistance. Her ostomy bag was functioning properly with clear drainage,
and she had a good output. She still had her ureteral stents in place, and
she was to follow up in two weeks. Her pathology returned showing that
she had transitional cell carcinoma in situ of the bladder with no evidence
of malignancy in the surgical margins, lymph nodes, or ureters (5F).
…
The claimant went to Springhill Center on August 24, 2011, with a chief
complaint of chronic lumbar and abdominal pain. The claimant indicated
that she had recovered from surgical excision of the bladder secondary to
cancer, and her pain was stable on her current medication. She also
indicated that her activity level had increased. She denied neurologic
changes. The claimant rated her pain a 5/10 in severity. Diagnoses
included bladder cancer, sacrolitis, lumbar degenerative disc disease,
cervical pain, and spasm. Her treatment plan included Zanaflex and
Lortab (7F).
Notes from October 7, 2011, about six months after the claimant’s radical
cystectomy and ileal loop, reflected that she was doing well. She had no
weight loss, bone pain, or gross hematuria. Physical examination revealed
a healthy woman. A renal ultrasound showed normal kidneys bilaterally
(8F, 1).
In a January 18, 2012, check-up, the claimant indicated that she was doing
well and was not having any real problems with her conduit. There was
no bone pain or weight loss. A CT scan of the abdomen and pelvis
showed some small renal cysts bilaterally, but otherwise, there were no
abnormalities. The claimant reported that she was easily fatigued and
tired most of the time. Because her CT showed no concerns, she was told
that she could return in six months for follow-up (15F).
6

Notes from January 23, 2012, indicated that [t]he claimant had
hypertension and hyperlipidemia. She was only taking Metarprolol at
that time. The claimant also indicated that she was having mood swings
that were not controlled by the Effexor she had been prescribed (14F).
Springhill Center notes from February 13, 2012, indicated a chief
complaint of chronic lumbar and cervical pain. She continued to do well
after bladder excision secondary to cancer. The claimant stated that her
pain level was stable. She denied complications from medications. The
claimant reported that her pain was a 3/10 in severity. Cardiac pulses
were normal and of regular rate and rhythm. Cervical range of motion
was decreased but stable. Lumbar range of motion was decreased but
stable. There was mild posterior cervical tenderness diffusely without
trigger points. There was moderate tenderness over both sacroiliac joints.
There was mild facet tenderness from L3 to sacrum. Upper and lower
extremity range of motion was unchanged and appropriate. Treatment
plan included continuation of Lortab and Zanaflex. She was also taking
Topirmate, Soma, Oxybutin, Metaprolol, potassium chloride, Effexor ER,
Quinapril, Omeprazole and HCTZ (13F).
Notes from March 5, 2012 indicated that the claimant reported swelling of
the legs and feet. She had been prescribed Abilify, and she noted that she
was doing much better on medication (14F).
On March 27, 2012, the claimant went to Mobile Heart Specialists
complaining of increasing dyspnea on minimal exertion. She had been
place[d] on an inhaler but was not on statin due to an elevated liver
function test. She was not having angina. She did have some orthpstatic
presyncope, and her blood pressure was 136/90. An EKG showed
bradycardia but was otherwise normal (17F, 2). Notes from May 8, 2012,
indicated that the claimant’s stress test and echocardiogram looked okay.
Impressions included known coronary disease with a low-risk stress test,
carotid stenosis without stroke, controlled hypertension, and
dyslipidemia. She was given nitroglycerin to use as needed (17F, 1).
During that period, the claimant also returned for a back pain treatment
on May 7, 2012. She complained of low back pain with numbness and
tingling. Diagnosis included chronic low back pain with radiculopathy.
A May 31, 2012, x-ray showed normal alignment of the spine. There was
no fracture or destructive bony lesion. Disc space narrowing with
minimal anterior spurring was present at L2-3 and L4-5 (19F).
On August 30, 2012, the claimant complained of bilateral leg pain and
lower back pain. Michael Ederer, D.O., noted that x-rays showed some
worsening from the previous study. She underwent a left hip steroid
injection on October 26, 2012 and November 13, 2012 (19F).
A November 5, 2012 CT scan of the abdomen and pelvis showed no
metastatic disease with the abdomen or pelvis. There was [] no significant
7

change from January study (18F, 4). A chest x-ray showed that the
claimant’s heart size was within normal limits. Degenerative spurring
was seen in the lumbar spine (18F, 2).
The claimant underwent a cervical spine MRI on January 7, 2013,
impressions included mild degenerative changes of the cervical spine with
no canal or neural foraminal stenosis (20F, 11).
On January 21, 2013, the claimant went to Mobile Diagnostic Center to
discuss her conditions. Examination revealed that the claimant’s active
problems to be arteriosclerotic cardiovascular disease (ACD), benign
hypertension, hyperlipidemia, depression, and vitamin D deficiency (21F).
Turning to the claimant’s mental health, in a consultative mental
examination report dated January 5, 2012, the claimant reported that she
had bladder cancer effectively treated by surgery; however, she noted that
the ostomy bag interfered with work because it could leak at any time.
She also reported a 17-year history of problems with heart disease, a
seven-year history of problems with back pain (attributed to deteriorating
disc disease), and a nine-year history of problems with apparent
depression (marked by periods of irritable and sad mood). The claimant
denied having symptoms of any other medical or psychiatric problem that
might interfere with work. Kenneth R. Starkey, Psy.D., indicated that the
claimant’s speech was generally clear and coherent and of appropriate
rate and volume. Her thinking was rational and there was no evidence of
significant deficits for reasoning or judgment. There was no evidence of
delusional thought processes or paranoia. There was no loosening of
associations, flight of ideas, or ideation or tendencies. Intellectual
functioning was estimated to be in the Low Average range. The
claimant’s attention and immediate memory appeared generally intact. In
regard to recent memory functions, she reported the day’s activities
without difficulty and the prior day’s activities also without difficulty. As
for remote memory, she reported employment dates and school dates
with only mild difficulty. Her fund of knowledge appeared generally
adequate. There was no evidence of auditory or visual hallucinations.
Her mood was generally euthymic and her affect was congruent with this
mood. Her insight and judgment appeared adequate. Dr. Starkey’s
diagnostic impressions included depressive disorder in partial remission.
He reported that the [] claimant’s Global Assessment of Functioning
(GAF) was 67. According to the Diagnostic and Statistical Manual of
Mental Disorders, 4 Edition, a GAF of between 61 and 7 represents some
mild symptoms or some difficulty in social, occupational, or school
functioning. Dr. Starkey opined that the claimant’s ability to understand,
remember, and carry out simple/concrete instructions appeared adequate
(from a psychological perspective). Her ability to work independently
also appeared adequate. Her ability to work with supervisors, coworkers
and public appeared adequate, as did her ability to manage common work
pressures (10F).
th

8

In a psychiatric review technique dated January 6, 2012, M. Hope Jackson,
Ph.D., opined that the claimant had mild restrictions in activities of daily
living, maintaining social functioning, and maintaining concentration,
persistence, or pace. She noted no episodes of decompensation of
extended duration (11F).
Records reflect that John I. Bailey, Jr., M.D., first examined the claimant on
January 16, 2013. She complained of feeling worthless. He noted that the
claimant had good attention a[nd] was able to establish rapport. She had
a blunt affect and was tearful at times. Her thoughts were logical and
memory seemed intact. A bipolar screen was positive. Assessment
included bipolar depression and adjustment reaction with anxiety and
depression. Abilify was continued. Dr. Bailey met with the claimant
again on February 20, 2013, and she complained of being sluggish and
sleepy. Her Effexor was increased a lithium augmentation or increase in
Ability was recommended (22F).
In a note dated March 6, 2013, Dr. Bailey opined that the claimant’s
chronic psychiatric burdens were unusually severe and extensive, and to
that point, they had not responded to medication well at all. He stated
that she had a predisposition to severe depression and had more than one
kind of depression. He indicated that the claimant knew there was no
possibility of improvement in any of her serious medical problems (disc
disease, heart disease, gastric bypass, absence of bladder, and ostomy).
He opined that any emotional improvement would be slow. He also
opined that the claimant could not achieve any gainful or practical
employment (22F).
In a residual functional capacity questionnaire dated March 6, 2013, Dr.
Bailey opined that the claimant had marked limitations in activities of
daily living and in maintaining concentration, persistence, or pace. She
had extreme limitations in social functioning. He also noted marked
limitations in her ability to understand, remember, and carry out
instructions, respond appropriately to co-worker, and perform repetitive
tasks in a work setting (24F).
After a thorough examination of the evidence, the undersigned finds the
claimant’s testimony less than fully credible. For example, the objective
evidence regarding the claimant’s back, hip, and neck problems is
minimal. There are objective findings that would establish a condition
that would cause some pain; however, the level of pain the claimant
alleges is not credible. Disc bulging and degenerative changes were
repeatedly referred to as “mild” (1F and 2F), and no foraminal or neural
stenosis was noted (13F). The claimant also reported improvement with
Lortab and Soma (2F). Although the claimant had minimal treatment for
her musculoskeletal complaints, she alleged that the pain [] has kept her
from working. Nevertheless, the claimant has been able to care for her
family by doing the laundry and cooking quick meals. Her pain does not
9

seem to prevent her from watching television, and she is able to attend
church.
While the claimant’s bladder cancer required aggressive medical
management, it did not appear to preclude[] all work for a full 12 months.
The undersigned notes that the claimant must wear an ostomy bag, and
because of that, she should not do strenuous work as accounted for in the
residual functional capacity. Notes show that the claimant’s pain was
under control (5F), and she was not having problems with her conduit
(15F).
As for her other impairments, a recent echocardiogram and EKG were
normal (17F), and the claimant’s reports of headache or restless leg
symptoms were infrequent at most.
The claimant’s biggest problem appeared to be her depression; she
testified that she spends a portion of her day staring out a window. Dr.
Bailey’s statements that the claimant was essentially non-functional seem
to be out of proportion with what has [been] her lifelong level of
functioning and even her current testimony. Dr. Bailey indicated that the
claimant had extreme social functioning deficits, yet she testified that she
goes to church each week. Further, other medical records fail to establish
this level of depression. Although the condition was listed in other
doctors’ reports along with anxiety, the claimant also reported that she
was doing much better on Abilify (14F). Additionally, Dr. Bailey has a
rather short treatment history with the claimant. He first examined the
claimant in January 2013. While he indicated marked daily living
difficulties and marked concentration difficulties, such deficits are not
evidenced from treatment notes. In fact, although the claimant had had
some treatment for depression in the way of medication, none of her other
doctors in the past five years referred her to a mental health specialist or
mentioned that she was in a non-functioning state due to her mental
health. In fact, Dr. Jackson actually indicated that the claimant did not
have a severe mental impairment at all (11F). Thus, little weight is
accorded to [] Dr. Bailey’s opinion.
Although non-examining, Dr. Jackson’s opinion deserves some weight,
particularly in a case like this in which there exist a number of other
reasons to reach similar conclusions as discussed above.
6.

The claimant is capable of performing past relevant work as cashier II.
This work does not require the performance of work-related activities
precluded by the claimant’s residual functional capacity (20 CFR
404.1565).
At the beginning, the vocational expert testified that given the above
residual functional capacity, the claimant would be capable [of
performing] her past relevant work as cashier II, DOT# 211.462-010. It is
performed at the light exertional level and has a specific vocational
10

preparation of 2. The vocational expert indicated that the claimant could
perform the job as it is actually performed.
In comparing the claimant’s residual functional capacity with the physical
and mental demands of this work, the undersigned finds that the claimant
is able to perform it as actually performed.
…
7.

The claimant has not been under a disability, as defined in the Social
Security Act, from June 30, 2008, through the date of this decision (20
CFR 404.1520(f)).

(Tr. 26, 28 & 29-36 (emphasis in original)). The Appeals Council affirmed the ALJ’s
decision (Tr. 1-4) and thus, the hearing decision became the final decision of the
Commissioner of Social Security.
DISCUSSION
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. An ALJ, in turn, uses a five-step sequential evaluation to
determine whether the claimant is disabled, which considers: (1) whether the claimant
is engaged in substantial gainful activity; (2) if not, whether the claimant has a severe
impairment; (3) if so, whether the severe impairment meets or equals an impairment in
the Listing of Impairments in the regulations; (4) if not, whether the claimant has the
RFC to perform h[is] past relevant work; and (5) if not, whether, in light of the
claimant’s RFC, age, education and work experience, there are other jobs the claimant
can perform. Watkins v. Commissioner of Soc. Sec., 457 Fed. App’x 868, 870 (11th Cir. Feb.

11

9, 2012) (per curiam) (citing 20 C.F.R. §§ 404.1520(a)(4), (c)-(f), 416.920(a)(4), (c)-(f);
2

Phillips v. Barnhart, 357 F.3d 1232, 1237 (11th Cir. 2004)) (footnote omitted).
If a plaintiff proves that she cannot do her past relevant work, it then becomes
the Commissioner’s burden—at the fifth step—to prove that the plaintiff is capable—
given her age, education, and work history—of engaging in another kind of substantial
gainful employment that exists in the national economy. Id.; Jones v. Apfel, 190 F.3d
1224, 1228 (11th Cir. 1999), cert. denied, 529 U.S. 1089, 120 S.Ct. 1723, 146 L.Ed.2d 644
(2000); Sryock v. Heckler, 764 F.2d 834, 836 (11th Cir. 1985). Finally, but importantly,
although “a claimant bears the burden of demonstrating an inability to return to his
past relevant work, the [Commissioner of Social Security] has an obligation to develop a
full and fair record.” Schnorr v. Bowen, 816 F.2d 578, 581 (11th Cir. 1987) (citations
omitted).
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 cahier II, 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). Courts are precluded, however, from “deciding the facts anew or re3

weighing the evidence.” Davison v. Astrue, 370 Fed. Appx. 995, 996 (11th Cir. Apr. 1,
“Unpublished opinions are not considered binding precedent, but they may be cited as persuasive
authority.” 11th Cir.R. 36-2.

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).

3

12

2010) (per curiam) (citing Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005)). And,
“’[e]ven if the evidence preponderates against the Commissioner’s findings, [a court]
must affirm if the decision reached is supported by substantial evidence.’” Id. (quoting
Crawford v. Commissioner of Social Security, 363 F.3d 1155, 1158-1159 (11th Cir. 2004)).
On appeal to this Court, Rivers asserts three reasons why the Commissioner’s
decision to deny her benefits is in error (i.e., not supported by substantial evidence): (1)
the ALJ erred as a matter of law by failing to properly assess the opinions of treating
physician, John I. Bailey, M.D.; (2) the ALJ’s mental and physical residual functional
capacity determination is not supported by substantial evidence; and (3) the ALJ failed
to properly assess the credibility of the claimant. The Court will address each issue in
turn.
A.

The ALJ Erred as a Matter of Law by Failing to Properly Assess the

Opinions of Treating Physician, John I. Bailey, M.D. Plaintiff challenges whether the
ALJ properly evaluated and gave appropriate weight to the opinions of Dr. John I.
Bailey, M.D., a family physician. (Plaintiff’s Brief, Doc. 10 at 9-16) His opinions are
contained in a questionnaire that he completed on March 6, 2013, a questionnaire
designed to obtain the opinions of a treating physician as to a patient’s residual
functional capacity. (Tr. 441, 467-68). Dr. Bailey’s answers to questions 11 and 12 of the
questionnaire include a diagnosis of atypical bipolar disorder associated with chronic
pain, degenerative disc disease of the cervical lumbar spine, ischemic heart disease,
status post gastric bypass and status post bladder cancer with cystectomy and
urostomy. (Tr. 441).

Given these problems, he opined that Plaintiff has marked

restrictions in activities of daily living and extreme difficulties with maintaining social
functioning. (Tr. 467) He also found that she would have a marked deficiency in the
areas of concentration, persistence or pace that would significantly erode her ability to
13

complete tasks in a timely manner. (Id.) Dr. Bailey also determined that she would have
marked limitations in her ability to understand, carry out, and remember instructions,
respond appropriately to co-workers and perform repetitive tasks in the work place.
(Id.) In response to question eight as to when the plaintiff first suffered the functional
limitations at the level of severity indicated by his responses in the questionnaire, Dr.
Bailey estimated the time period to be “10-20 years ago (from 2013) but was serious
even before then.” (Tr. 468). The final question (#12) asked for his comments and
prognosis to which he responded:
The chronic psychiatric burdens of this pleasant, legitimately ill
(both medically and psychiatrically) woman are unusually severe and
extensive and to this point have not responded to medication well at all. I
doubt they will ever respond what most people would call well. She
clearly has a predisposition to severe depression and has more than one
kind of depression. Worse, there is, and she knows there is, no real
possibility of improvement in any of her most serious medical problems
(disc disease, heart disease, gastric bypass, absence of bladder, ostomy).
Any emotional improvement will be slow. This woman cannot achieve
any gainful or practical employment.
(Tr. 441).
The ALJ gave little weight to Dr. Bailey’s opinions of March 6, 2013 for a number
of reasons:
The claimant’s biggest problem appeared to be her depression; she
testified that she spends a portion of her day staring out a window. Dr.
Bailey’s statements that the claimant was essentially non-functional seem
to be out of proportion with what has [been] her lifelong level of
functioning and even her current testimony. Dr. Bailey indicated that the
claimant had extreme social functioning deficits, yet she testified that she
goes to church each week. Further, other medical records fail to establish
this level of depression. Although the condition was listed in other
doctors’ reports along with anxiety, the claimant also reported that she
was doing much better on Abilify (14F). Additionally, Dr. Bailey has a
rather short treatment history with the claimant. He first examined the
claimant in January 2013. While he indicated marked daily living
difficulties and marked concentration difficulties, such deficits are not
evidenced from treatment notes. In fact, although the claimant had had
some treatment for depression in the way of medication, none of her other
doctors in the past five years referred her to a mental health specialist or
14

mentioned that she was in a non-functioning state due to her mental
health. In fact, Dr. Jackson actually indicated that the claimant did not
have a sever mental impairment at all (11F). Thus, little weight is
accorded to [] Dr. Bailey’s opinion.
(Tr. 34).
As the plaintiff’s treating physician, Dr. Bailey’s opinions “must be given
substantial or considerable weight unless ‘good cause’ is shown to the contrary.”
Gilabert v. Comm’r of Soc. Sec., 396 F. App’x 652, 655 (11th Cir. Sept. 21, 2010) (per
curiam) (quoting Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997)). Good cause is
shown when the: “(1) treating physician’s opinion was not bolstered by the evidence;
(2) evidence supported a contrary finding; or (3) treating physician’s opinion was
conclusory or inconsistent with the doctor’s own medical records.” Id. (quoting Phillips
v. Barnhart, 357 F.3d 1232, 1241 (11th Cir. 2004)). Where the ALJ articulate[s] specific
reasons for failing to give the opinion of a treating physician controlling weight, and
those reasons are supported by substantial evidence, there is no reversible error. Id.
(quoting Moore [v. Barnhart], 405 F.3d [1208,] 1212 [(11th Cir. 2005)]).
Here, the ALJ gave little weight to Dr. Bailey’s opinions regarding the Plaintiff’s
functional abilities given her psychiatric impairment because the ALJ found that Dr.
Bailey’s assessment is inconsistent with Plaintiff’s “lifelong level of functioning,” her
testimony before the ALJ and the other medical evidence in the record. On appeal, the
Plaintiff argues that Dr. Bailey’s opinions should have been given controlling weight
but after a review of the record, the briefs and conducting oral argument, it is
determined that the ALJ had good cause to give little weight to Dr. Bailey’s opinions
because his conclusions regarding the Plaintiff’s ability to work are inconsistent with
Plaintiff’s vocational and treatment history.

15

The ALJ noted that Dr. Bailey had only begun treating Plaintiff in January 2013
(Tr. 34, 456-64). See 20 C.F.R. § 404.1527(c)(2)(i) (treating physician's opinion merits less
weight when treating relationship is shorter).

When he completed the Residual

Functional Capacity Questionnaire, approximately two months after his initial
examination, his opinions were based on clinical evaluations without any psychological
testing. (Tr. 468).
Even though the Plaintiff clearly had a relevant work history prior to 2008, the
alleged onset year, Dr. Bailey opined that she had been suffering from incapacitating
bipolar depression for as many as twenty years and possibly longer. (Id.). Not only is
this opinion inconsistent with Plaintiff’s work history but as the ALJ noted, even though
Plaintiff had received some treatment for depression in the way of medication, none of
her physicians in the five years preceding her relationship with Dr. Bailey had referred
her to a mental health specialist or mentioned that she was in a non-functioning state
due to her mental health (Tr. 34, 190-440).
Approximately one year before Plaintiff first visited Dr. Bailey, a consultative
examination had been performed in January 2012. (Tr. 346). Dr. Kenneth R. Starkey
reported that Plaintiff had rational thinking and no evidence of significant deficits for
reasoning or judgment (Id). Her intellectual functioning was estimated at low average,
and her attention and immediate memory appeared generally intact. Her fund of
knowledge was generally adequate, and her GAF was 67. Dr. Starkey opined Plaintiff
could understand, remember, and carry out simple instructions; work independently;
work with supervisors, coworkers, and the public; and manage common work
pressures (Tr. 347).
The record also contains an opinion by the state agency consultant, Dr. M. Hope
Jackson, Ph. D. She opined, based on the evidence through January 6, 2012, that the
16

Plaintiff did not have a severe mental impairment, let alone one of disabling severity.
(Tr. 357). Although non-examining, Dr. Jackson’s opinion deserves some weight,
particularly when assessing whether good cause exists for not affording controlling
weight to the opinions of a treating physician.
For the foregoing reasons, the undersigned finds that the ALJ did not err by
giving little weight to Dr. Bailey’s opinions.
B.

The ALJ’s Mental and Physical RFC Determination is not Supported by

Substantial Evidence. In her brief, plaintiff argued that the ALJ’s mental and physical
RFC determination is not supported by substantial evidence (Doc. 10, at 16). This Court
finds, however, that the physical and mental limitations noted by the ALJ are supported
by substantial evidence in the record as is the RFC assessment.
Initially, the Court notes that the responsibility for making the residual
functional capacity determination rests with the ALJ. Compare 20 C.F.R. §§ 404.1546(c) &
416.946(c) (“If your case is at the administrative law judge hearing level . . ., the
administrative law judge . . . is responsible for assessing your residual functional
capacity.”) with, e.g., Packer v. Commissioner, Social Security Admin., 542 Fed. Appx. 890,
891-892 (11th Cir. Oct. 29, 2013) (per curiam) (“An RFC determination is an assessment,
based on all relevant evidence, of a claimant’s remaining ability to do work despite her
impairments. There is no rigid requirement that the ALJ specifically refer to every piece
of evidence, so long as the ALJ’s decision is not a broad rejection, i.e., where the ALJ
does not provide enough reasoning for a reviewing court to conclude that the ALJ
considered the claimant’s medical condition as a whole.” (internal citation omitted)). A
plaintiff’s RFC—which “includes physical abilities, such as sitting, standing or walking,
and mental abilities, such as the ability to understand, remember and carry out
instructions or to respond appropriately to supervision, co-workers and work
17

pressure[]”—“is a[n] [] assessment of what the claimant can do in a work setting despite
any mental, physical or environmental limitations caused by the claimant’s
impairments and related symptoms.” Watkins, supra, 457 Fed. Appx. at 870 n.5 (citing 20
C.F.R. §§ 404.1545(a)-(c), 416.945(a)-(c)). In this case, the ALJ found that Plaintiff had
the residual functional capacity (RFC) to perform light work , except that she:
4

•
•
•
•
•
•
•
•

could not reach overhead or climb ladders, ropes, or scaffolds;
could not work around unprotected heights or dangerous equipment;
could occasionally stoop, kneel, crouch, crawl, climb ramps or stairs, and
operate foot controls;
would need to alternate standing and sitting every thirty minutes but would
not have to leave the workstation;
could not make judgments except as to simple, work-related decisions;
required minimal changes to the work setting or routine;
must avoid tasks involving a variety of instructions or tasks but was able to
understand and carry out one-to-two-step instructions; and
could understand and carry out detailed but uninvolved oral or written
instructions involving few concrete variables from standardized situations.

(Tr. 28).
To find that an ALJ’s RFC determination is supported by substantial evidence, it
must be shown that the ALJ has “’provide[d] a sufficient rationale to link’” substantial
record evidence “’to the legal conclusions reached.’” Ricks v. Astrue, 2012 WL 1020428,
*9 (M.D. Fla. Mar. 27, 2012) (quoting Russ v. Barnhart, 363 F. Supp. 2d 1345, 1347 (M.D.
Fla. 2005)); compare id. with Packer v. Astrue, 2013 WL 593497, *4 (S.D.Ala. Feb. 14, 2013)
(“’[T]he ALJ must link the RFC assessment to specific evidence in the record bearing
upon the claimant’s ability to perform the physical, mental, sensory, and other

The full range of light work requires standing or walking six hours in an eight-hour workday. See
Social Security Ruling (SSR) 83-10, 1983 WL 31251, at *5 (S.S.A. 1983). As such, Plaintiff's contention
that the ALJ did not articulate how much Plaintiff could stand or walk during the day (Doc. 10 at 16-17)
lacks merit.

4

18

requirements of work.’”), aff’d, 542 Fed. Appx. 890 (11th Cir. Oct. 29, 2013) ; see also
5

Hanna v. Astrue, 395 Fed. Appx. 634, 636 (11th Cir. Sept. 9, 2010) (per curiam) (“The ALJ
must state the grounds for his decision with clarity to enable us to conduct meaningful
review. . . . Absent such explanation, it is unclear whether substantial evidence
supported the ALJ’s findings; and the decision does not provide a meaningful basis
upon which we can review [a plaintiff’s] case.” (internal citation omitted)).

6

In order to find the ALJ’s RFC assessment supported by substantial evidence, it is
not necessary for the ALJ’s assessment to be supported by the assessment of an
examining or treating physician. See, e.g., Packer, supra, 2013 WL 593497, at *3
(“[N]umerous court have upheld ALJs’ RFC determinations notwithstanding the
absence of an assessment performed by an examining or treating physician.”);
McMillian v. Astrue, 2012 WL 1565624, *4 n.5 (S.D. Ala. May 1, 2012) (noting that

In affirming the ALJ, the Eleventh Circuit rejected Packer’s substantial evidence
argument, noting, she “failed to establish that her RFC assessment was not supported by
substantial evidence[]” in light of the ALJ’s consideration of her credibility and the medical
evidence. Id. at 892.

5

It is the ALJ’s (or, in some cases, the Appeals Council’s) responsibility, not the
responsibility of the Commissioner’s counsel on appeal to this Court, to “state with clarity” the
grounds for an RFC determination. Stated differently, “linkage” may not be manufactured
speculatively by the Commissioner—using “the record as a whole”—on appeal, but rather,
must be clearly set forth in the Commissioner’s decision. See, e.g., Durham v. Astrue, 2010 WL
3825617, *3 (M.D. Ala. Sept. 24, 2010) (rejecting the Commissioner’s request to affirm an ALJ’s
decision because, according to the Commissioner, overall, the decision was “adequately
explained and supported by substantial evidence in the record”; holding that affirming that
decision would require that the court “ignor[e] what the law requires of the ALJ[; t]he court
‘must reverse [the ALJ’s decision] when the ALJ has failed to provide the reviewing court with
sufficient reasoning for determining that the proper legal analysis has been conducted’”
(quoting Hanna, 395 Fed. App’x at 636 (internal quotation marks omitted))); see also id. at *3 n.4
(“In his brief, the Commissioner sets forth the evidence on which the ALJ could have relied . . . .
There may very well be ample reason, supported by the record, for [the ALJ’s ultimate
conclusion]. However, because the ALJ did not state his reasons, the court cannot evaluate
them for substantial evidentiary support. Here, the court does not hold that the ALJ’s ultimate
conclusion is unsupportable on the present record; the court holds only that the ALJ did not
conduct the analysis that the law requires him to conduct.” (emphasis in original)); Patterson v.
Bowen, 839 F.2d 221, 225 n.1 (4th Cir. 1988) (“We must . . . affirm the ALJ’s decision only upon
the reasons he gave.”).

6

19

decisions of this Court “in which a matter is remanded to the Commissioner because
the ALJ’s RFC determination was not supported by substantial and tangible evidence
still accurately reflect the view of this Court, but not to the extent that such decisions are
interpreted to require that substantial and tangible evidence must—in all cases—
include an RFC or PCE from a physician” (internal punctuation altered and citation
omitted)); but cf. Coleman v. Barnhart, 264 F.Supp.2d 1007 (S.D. Ala. 2003). In this case, of
course, there is a mental RFC assessment of record from a treating physician and a
mental examination report from an examining physician; however, as discussed above,
the opinions of Dr. John Bailey were given little weight for good cause. On the other
hand, the report of the mental examination performed by a psychologist, Dr. Kenneth R.
Starkey (Tr. 344-347), was accorded significant weight, a determination consistent with
substantial evidence in the record, as explained more fully below.
Importantly, in establishing Rivers’ RFC, which means determining Rivers’
“remaining ability to do work despite [his] impairments[,]” Packer, 542 Fed.Appx. at
891—keeping a focus on the extent of those impairments as documented by the credible
record evidence—the ALJ sifted through the medical evidence of record (see Tr. 28-35),
along with the claimant’s testimony (see Tr. 42-56), to conclude that the residual
functional capacity assessment is fully supported by the objective evidence, treatment
records, the claimant’s activities, and the record as a whole.

Although Plaintiff's

functioning is not unlimited, her mild imaging findings, uneventful recovery from her
cystectomy, and benign mental examination provide substantial evidence in support of
the ALJ's finding that Plaintiff could perform a reduced range of light work.
For instance, the ALJ considered the September 2008 MRI showing mild
degenerative disc disease, a mild broad-based annular bulge with small central
protrusion at L5-S1, and a mild annular bulge with mild to moderate narrowing of the
20

left exiting foramina and mild narrowing of the right exiting foramina (Tr. 30, 212). At
that time, Dr. Dempsey noted Plaintiff was not a surgical candidate because she had no
herniated discs, and Plaintiff reported Lortab and Soma helped with her pain (Tr. 30,
203, 213).
The ALJ further considered evidence that had Plaintiff completed her six-week
course of BCG treatment for carcinoma, and did well (Tr. 30, 293). The ALJ noted that
Plaintiff underwent a radical cystectomy in March 2011, recovering uneventfully, with
pain controlled by oral medications (Tr. 30, 238). At discharge, the ALJ noted, Plaintiff
could ambulate without assistance and tolerate a normal diet (Tr. 30, 238). The ALJ
further considered that in October 2011 Plaintiff was doing well, with physical
examination revealing a healthy woman (Tr. 31, 278). Similarly, a January 2012 checkup showed Plaintiff was doing well, with some small renal cysts but no other
abnormalities (Tr. 31, 381).
The ALJ also noted that, the following month, Plaintiff had a stable pain level
and denied complications from medications (Tr. 31, 367). Her cervical and lumbar
ranges of motion were decreased but stable, but her arm and leg range of motion was
unchanged and appropriate (Tr. 31, 368). A May 2012 stress test and echocardiogram
looked okay (Tr. 32, 386). A May 2012 x-ray showed normal spinal alignment with disc
space narrowing and minimal anterior spurring (Tr. 32, 406). An August x-ray showed
some worsening, but a January 2013 MRI showed mild degenerative changes in the
cervical spine (Tr. 32, 409, 431).
In terms of mental impairments, the ALJ noted that, at a consultative
examination in January 2012, Plaintiff had rational thinking and no evidence of
significant deficits for reasoning or judgment (Tr. 32-33, 346).

Her intellectual

functioning was estimated at low average, and her attention and immediate memory
21

appeared generally intact (Tr. 33, 346). Her fund of knowledge was generally adequate,
and her GAF was 67 (Tr. 33, 346-47). Dr. Starkey opined Plaintiff could understand,
remember, and carry out simple instructions; work independently; work with
supervisors, coworkers, and the public; and manage common work pressures (Tr. 33,
347).
When the ALJ considered restrictions to daily living, she only found mild
restrictions. Plaintiff informed Dr. Starkey that she was able to “feed, bathe, groom, and
dress herself without assistance.” (Tr. 27, 345). In addition, she told him that she could
also “use a phone, manage money, prepare meals, shop for groceries, and drive an auto,
all without assistance.” (Id.) Included in her daily activities that were reported to Dr.
Starkey were caring for her ostomy bag, washing off, getting coffee, smoking cigarettes,
taking medicine, eating, watching TV, occasionally cooking for her children, sometimes
doing the laundry, dishwashing, visiting her friend, going to the doctor, grocery
shopping and attending church. (Tr. 347).
This analysis has convinced this Court that the ALJ appropriately considered
Rivers’ condition as a whole in determining his RFC. Accordingly, the ALJ’s RFC
determination provides an articulated linkage to the medical evidence of record. The
linkage requirement is simply another way to say that, in order for this Court to find
that an RFC determination is supported by substantial evidence, ALJs must “show their
work” or, said somewhat differently, show how they applied and analyzed the
evidence to determine a plaintiff’s RFC. See, e.g., Hanna, 395 Fed. Appx. at 636 (an ALJ’s
“decision [must] provide a meaningful basis upon which we can review [a plaintiff’s]
case”); Ricks, 2012 WL 1020428, at *9 (an ALJ must “explain the basis for his decision”);
Packer, 542 Fed.Appx. at 891-892 (an ALJ must “provide enough reasoning for a
reviewing court to conclude that the ALJ considered the claimant’s medical condition as
22

a whole[]” (emphasis added)). Thus, by “showing her work”, the ALJ has provided the
required “linkage” between the record evidence and her RFC determination necessary
to facilitate this Court’s meaningful review of her decision.
Because

substantial

evidence

of

record

supports

the

Commissioner’s

determination that Rivers can perform the physical and mental requirements of a
reduced range of light work as identified by the ALJ (see Tr. 28), and plaintiff makes no
argument that this residual functional capacity would preclude performance of her past
relevant work as a cashier II, the Commissioner’s fourth-step determination is due to be
affirmed. Compare Land v. Commissioner of Social Security, 494 Fed.Appx. 47, 49-50 (11

th

Cir. 2012) (“[S]tep four assesses the claimant’s RFC to determine whether the claimant is
capable of performing ‘past relevant work.’ . . . A claimant’s RFC takes into account
both physical and mental limitations. . . . Because more than a scintilla of evidence
supported the ALJ’s RFC assessment here, we will not second-guess the
Commissioner’s determination.”) with Phillips v. Barnhart, 357 F.3d 1232, 1238-1239 (11th
Cir. 2004) (“At the fourth step, the ALJ must assess: (1) the claimant’s residual
functional capacity []; and (2) the claimant’s ability to return to [his] past relevant work.
As for the claimant’s RFC, the regulations define RFC as that which an individual is still
able to do despite the limitations caused by his or her impairments. Moreover, the ALJ
will assess and make a finding about the claimant’s residual functional capacity based
on all the relevant medical and other evidence in the case. Furthermore, the RFC
determination is used both to determine whether the claimant: (1) can return to [his]
past relevant work under the fourth step; and (2) can adjust to other work under the
fifth step . . . . If the claimant can return to [his] past relevant work, the ALJ will
conclude that the claimant is not disabled. If the claimant cannot return to [his] past

23

relevant work, the ALJ moves on to step 5.” (internal citations, quotation marks, and
brackets omitted; brackets added)).
C. The ALJ Failed To Properly Assess the Credibility of the Plaintiff. As part
of her credibility finding, the ALJ concluded that Plaintiff’s impairments could
reasonably be expected to produce some of the alleged symptoms, but that her
statements concerning the intensity, persistence and limiting effects of these symptoms
were not entirely credible. (Tr. 29). Plaintiff agues that the ALJ erred when she decided
that Plaintiff’s ability to perform a few routine chores, watch TV and attend church
provided sufficient reasons for finding her not credible.
The Eleventh Circuit has set forth criteria to establish a disability based on
testimony about pain and other symptoms as follows:
the claimant must satisfy two parts of a three-part test showing: (1)
evidence of an underlying medical condition; and (2) either (a) objective
medical evidence confirming the severity of the alleged pain; or (b) that
the objectively determined medical condition can reasonably be expected
to give rise to the claimed pain. If the ALJ discredits subjective testimony,
he must articulate explicit and adequate reasons for doing so. Failure to
articulate the reasons for discrediting subjective testimony requires, as a
matter of law, that the testimony be accepted as true.
Wilson v. Barnhart, 284 F.3d 1219, 1225 (11th Cir.2002) (citations omitted). When such
evidence is presented, the Commissioner must articulate explicit and adequate reasons,
based on substantial evidence, whenever a claimant’s allegations of pain are rejected.
Hale v. Bowen, 831 F.2d 1007, 1011 (11th Cir.1987). When clearly articulated credibility
findings are supported by substantial evidence, a reviewing court should not disturb
them. Foote v. Chater, 67 F.3d 1553, 1562 (11th Cir.1995); MacGregor v. Bowen, 786 F.2d
1050, 1054 (11th Cir.1986).
Here, the ALJ articulated numerous examples supporting her conclusion that
Plaintiff’s subjective complaints of disabling pain were not credible. For example, while
24

Plaintiff alleged back, hip, and neck pain, the level of pain could only be described as
minimal. The MRI taken in 2003 noted only a very mild bulging disc at L4-5 and mild
ligamentous hypertrophy at L3-4 with no spinal or foraminal stenosis. At that time Dr.
Patton wrote a prescription for Tylenol with Codein elixir. He ordered a bone scan and
was to see Plaintiff in three weeks. (Tr. 190) Coming forward to 2006, Dr. Dempsey
commented that the Plaintiff appeared with a normal gait and station and did not
appear to be in distress.

She had normal grip strength, normal biceps, triceps,

brachioradialis reflexes and a normal distraction and compression test. She had full
range of motion in all extremities and the lumbar region. The diagnosis was neck pain
and back pain for which he prescribed Lortab, Soma and Lyrica. (Tr. 196-97).
Notes from the Springhill Center for Rehab Medicine dated February 13, 2012,
contain more complaints of chronic lumbar and cervical pain. It was noted that she was
doing well after her bladder excision secondary to cancer and described her pain level
as stable. She did not report any complications with medications. (Tr. 367-69). She was
prescribed Lortab and Zanaflex. The impression of the radiologist after her 2013 MRI
was “Mild degernerative change of the cervical spine with no canal or neural foraminal
stenosis.” (Tr. 431).
In addition to the medical records just discussed, the ALJ’s determination that
Plaintiff’s subjective complaints were not credible is further supported by Plaintiff’s
activities of daily living, which include driving, light cooking, grocery shopping, church
attendance and caring for herself and her daughters. These daily activities may be
considered in assessing pain. Harwell v. Heckler, 735 F.2d 1292, 1293 (11th Cir.1984).
In sum, Plaintiff’s contention that the ALJ erred in rejecting Plaintiff’s subjective
complaints regarding her pain is without merit. The ALJ carefully reviewed and relied
upon the medical evidence in the record in making her credibility finding and
25

articulated reasons supported by substantial evidence in the record supporting her
conclusion that Plaintiff’s subjective complaints were not as limiting as she contended.
Accordingly, the ALJ did not err in rejecting Plaintiff’s subjective complaints regarding
symptoms and limitations due to pain.
CONCLUSION
In light of the foregoing, it is ORDERED that the decision of the Commissioner
of Social Security denying plaintiff benefits be affirmed.
DONE and ORDERED this the 9th day of September, 2015.
s/WILLIAM E. CASSADY
UNITED STATES MAGISTRATE JUDGE

26