McCarroll v. Colvin

Filing 19

MEMORANDUM OPINION AND ORDER entered. After considering the administrative record and the memoranda of the parties, it is ORDERED that the decision of the Commissioner be AFFIRMED and that this action be DISMISSED, as further set out. Signed by Magistrate Judge Bert W. Milling, Jr on 7/25/2016. (clr)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
ROSALIND L. McCARROLL,

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Plaintiff,
vs.
CAROLYN W. COLVIN,
Social Security Commissioner,
Defendant.

CIVIL ACTION 16-004-M

MEMORANDUM OPINION AND ORDER
In this action under 42 U.S.C. § 405((g), Plaintiff seeks
judicial review of an adverse social security ruling denying a
claim for disability insurance benefits (Docs. 1, 12).

The

parties filed written consent and this action has been referred
to the undersigned Magistrate Judge to conduct all proceedings
and order judgment in accordance with 28 U.S.C. § 636(c),
Fed.R.Civ.P. 73, and S.D.Ala. Gen.L.R. 73(b) (see Doc. 18).
Oral argument was waived in this action (Doc. 17).

After

considering the administrative record and the memoranda of the
parties, it is ORDERED that the decision of the Commissioner be
AFFIRMED and that this action be DISMISSED.
This Court is not free to reweigh the evidence or
substitute its judgment for that of the Secretary of Health and
Human Services, Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th
Cir. 1983), which must be supported by substantial evidence.

1

Richardson v. Perales, 402 U.S. 389, 401 (1971).

Substantial

evidence requires “that the decision under review be supported
by evidence sufficient to justify a reasoning mind in accepting
it; it is more than a scintilla, but less than a preponderance.”
Brady v. Heckler, 724 F.2d 914, 918 (11th Cir. 1984), quoting
Jones v. Schweiker, 551 F.Supp. 205 (D. Md. 1982).
At the time of the administrative hearing, McCarroll was
forty-four years old, had completed a ninth-grade education (Tr.
47), and had previous work experience as a nurse’s aide and
cafeteria cook/worker (Tr. 67).

Plaintiff alleges disability

due to degenerative disc disease of the lumbar spine with
radiculopathy, traumatic osteoarthritis of the right knee,
chronic pain, obesity, and dysthymia (Doc. 12 Fact Sheet).
Plaintiff applied for disability benefits on August 22,
2012, alleging a disability onset date of February 23, 2012 (Tr.
25, 155-61).

An Administrative Law Judge (ALJ) denied benefits,

determining that although McCarroll could not return to her
previous relevant work, she was capable of performing specific
light and sedentary jobs (Tr. 25-34).

Plaintiff requested

review of the hearing decision (Tr. 15), but the Appeals Council
denied it (Tr. 1-6).
Plaintiff claims that the opinion of the ALJ is not
supported by substantial evidence.
alleges that:

Specifically, McCarroll

(1) The ALJ substituted her opinion for that of a

2

medical professional; and (2) the ALJ did not properly develop
the record (Doc. 12).

Defendant has responded to—and denies—

these claims (Doc. 13).

The Court’s summary of the relevant

record evidence follows.
On March 28, 2011, McCarroll was examined by Dr. Andre J.
Fontana, Orthopaedic, for complaints of right foot pain with
mild swelling and right shoulder pain; the Doctor noted foot
tenderness and mild impingement in the shoulder with some pain
(Tr. 236, 476).

Plaintiff got a 3-D boot, a shoulder injection,

and a prescription for Lortab.1

On April 11, Fontana noted

continued pain in McCarroll’s lower back; Lortab was again
prescribed (Tr. 237, 475).

An MRI of the lumbar spine, taken

two weeks later, revealed mild herniation at L3-4, degenerative
changes at L4-5, and a possible pelvic lobular mass (Tr. 238,
472-73).

On June 9, Plaintiff received several lumbar epidural

steroid injections, without complication (Tr. 241-42, 469-70).
On July 7, she received several more injections (Tr. 243, 467).
On February 23, 2012, Dr. Fontana examined McCarroll’s back,
noting that sensory and motor function was intact; she had
spasms and severely restricted range of motion (hereinafter ROM)
in the lumbar spine (Tr. 245, 466).

The Orthopaedist prescribed

1Error! Main Document Only.Lortab is a semisynthetic narcotic

analgesic used for “the relief of moderate to moderately severe pain.”
Physician's Desk Reference 2926-27 (52nd ed. 1998).

3

Tylox2 and a Medrol Dosepak3 and noted McCarroll was off work.
On March 1, 2012, Plaintiff was doing a little better though she
still had pain, spasm, and radicular pain down the leg; she was
to continue off work (Tr. 246, 465).

On March 10, an MRI showed

that the lumbar spine was preserved; further findings showed
disk desiccation, annular bulge at L4-5, and bulge at L2-3 for
which she received a lumbar epidural and a prescription for
Skelaxin4 (Tr. 247-48, 464).

On March 15, Plaintiff said that

she continued to have pain, spasm, and restricted ROM (Tr. 248,
463); Fontana said that she could not work for approximately
three weeks (Tr. 460-62).
On March 22, Dr. Donald R. Tyler, II, Neurosurgeon,
examined McCarroll for chronic low back pain, radiating into her
right buttock, knee, and heel; she rated the pain as seven on a
ten-point scale (Tr. 253-57).

The Doctor noted full ROM of all

joints, but some diffuse lumbar tenderness; gait, strength in
the lower extremities, and deep tendon reflexes in the upper and
lower extremities were all normal.

Diagnosing mechanical

2Error! Main Document Only.Tylox, a class II narcotic, is used

“for the relief of moderate to moderately severe pain”. Physician's
Desk Reference 2217 (54th ed. 2000).
3A Medrol Dosepak (methylprednisolone) is a steroid that prevents

the release of substances in the body that cause inflammation. See
http://www.drugs.com/mtm/medrol-dosepak.html
4Error! Main Document Only.Skelaxin is used “as an adjunct to rest,

physical therapy, and other measures for the relief of discomforts
associated with acute, painful musculoskeletal conditions.”
Physician's Desk Reference 830 (52nd ed. 1998).

4

instability, Tyler prescribed a back brace and Tylox, Lortab,
and Skelaxin.

On March 27, 2012, Tyler noted bilateral lumbar

spasm (Tr. 258-61).

On April 3, McCarroll agreed to undergo

surgery; Zanaflex5 was prescribed (Tr. 262-65).

The Neurosurgeon

stated on April 5 that Plaintiff could return to light duty work
(Tr. 277).
On April 18, McCarroll was admitted to Mobile Infirmary
Medical Center for three nights to undergo an L3-4 and L4-5
transverse lumbar interbody fusion because of mechanical
instability (Tr. 228-34).

The surgery went without complication

and Plaintiff was discharged home in stable condition.
On May 10, Plaintiff told Dr. Tyler that she had lots of
low back pain and spasm with right calf numbness, tingling, and
pain; her right leg was weak and shaky, so she was using a cane
(Tr. 266-70).

The Neurosurgeon noted normal posture and gait

with lumbosacral spasm and limited ROM; sitting straight leg
raise was negative.

Though diminished in the right lower

extremity, all other strength measurements were full; Oxycontin,6

5Error! Main Document Only.Zanaflex “is a short-acting drug for the

acute and intermittent management of increased muscle tone associated
with spasticity.” Physician's Desk Reference 3204 (52nd ed. 1998).
6Error! Main Document Only.“OxyContin tablets are a controlled
release oral formulation of oxycodone hydrochloride indicated for the
management of moderate to severe pain where use of an opioid analgesic
is appropriate for more than a few days.” Physician's Desk Reference
2344-46 (52nd ed. 1998).

5

Percocet,7 and Flexeril8 were prescribed.

Lumbar spine x-rays

demonstrated satisfactory alignment and appearance of L3 through
L5 fusion (Tr. 281).
On May 29, 2012, Plaintiff had increased knee pain; x-rays
showed some trauma for which Dr. Fontana gave her a cortisone
injection (Tr. 249, 461).

McCarroll had another injection on

June 21 for crepitus and mild effusion of the right knee; the
Doctor told her not to return to work for another month (Tr.
250, 458-59).
On June 7, McCarroll went to Coastal Health Occupational
Pain Management for therapy9 for the pain in her lumbar spine,
radiating into her right leg; she rated her pain at five ((Tr.
298-301).

On examination, Dr. J. Steven Hankins, Osteopath,

noted normal ROM in the cervical spine, no tenderness, and upper
extremity strength at 5/5; in the lumbar spine, ROM was limited,
with pain, and spasm in the paraspinous muscles.

Plaintiff

could not squat and could not walk or stand on her heels or
toes; she had full strength in all muscle groups.

Hankins

7Percocet

is used for the relief of moderate to moderately
severe pain. Error! Main Document Only.Physician's Desk Reference
1125-28 (62nd ed. 2008).
8Error! Main Document Only.Flexeril is used along with “rest and

physical therapy for relief of muscle spasm associated with acute,
painful musculoskeletal conditions.” Physician's Desk Reference 145557 (48th ed. 1994).
9Physical/occupational therapy records from Providence Hospital,

dating June 13, 2012 through October 16, 2012, can be found at Tr.
302-87. Those records will not be summarized herein.

6

recommended aquatic therapy three times a week for four weeks
and prescribed Neurontin,10 MS Contin,11 Mobic,12 and baclofen.13
On June 26, 2012, McCarroll told the Ostoepath that the aquatic
therapy had increased her pain, so she had been moved to land
physical therapy; she was still using a walker (Tr. 294-97).
Plaintiff still experienced pain (rated at seven), was having
medication side effects, and required assistance with some of
her activities of daily living (hereinafter ADL’s); she had
difficulty rising from a seated position.

On examination,

Hankins noted no difference in the cervical and lumbar spine; he
gave McCarroll an injection and stated that she was functioning
at a very sedentary level and was not able to perform meaningful
work at that time.
On July 10, McCarroll told Dr. Tyler that she still had
right leg pain that increased with activity and was worse with
therapy; she was using a walker (Tr. 271-74).

He noted full ROM

in all joints and ordered tests; he also indicated that she
should be excused from work for two months (Tr. 278).

X-rays of

10Error! Main Document Only.Neurontin is used in the treatment of

partial seizures.
Physician's Desk Reference 2110-13 (52nd ed. 1998).
11MS Contin is a narcotic for around-the-clock pain.

See
https://www.drugs.com/ms_contin.html
12Error! Main Document Only.Mobic is a nonsteroidal anti
inflammatory drug used for the relief of signs and symptoms of
osteoarthritis and rheumatoid arthritis. Physician's Desk Reference
855-57 (62nd ed. 2008).
13Baclofen is a muscle relaxer used in treating muscle symptoms

such as spasm, pain, and stiffness. See
http://www.drugs.com/baclofen.html

7

the lumbar spine were unchanged from two months earlier (Tr.
282).

An MRI of the lumbar spine showed right hemilaminectomy

and mild right and minimal left foraminal encroachment at L3-4;
at L4-5, there was right hemilaminectomy, moderate stenosis at
the right L4 rootlet and mild-to-moderate stenosis due to
marginal osteophyte formation (Tr. 283-84).
On July 19, 2012, Dr. Fontana noted that knee ROM and
strength were good; he released Plaintiff to light duty work
with no squatting, stooping, or kneeling (Tr. 251, 456-57).
On July 25, Plaintiff appeared before Dr. Hankins’s P.A.
with a slow, antalgic gait, using a walker; on examination,
there was decreased strength (4/5) in the muscle groups of the
right lower extremity (Tr. 290-93).

McCarroll was having

trouble sleeping because of her pain (six of ten), having
difficulty with ADL’s, and could stand and walk for only a
limited period of time; she had stopped physical therapy until
further tests could be performed.

Medication amounts were

adjusted with Ambien14 and Oxycodone15 added to the mix.

An MRI

of the lumbar spine on July 26 showed right hemilaminectomy at
L3-L5 levels and mild central disc protrusion without

14AmbienError! Main Document Only. is a class four narcotic used

for the short-term treatment of insomnia. Physician's Desk Reference
2799 (62nd ed. 2008).
15Error! Main Document Only.Oxycodone is a pure agonist opioid whose

principal therapeutic action is analgesia. Physician's Desk Reference
2680-81 (62nd ed. 2008).

8

significant stenosis of central canal or foramina at L2-3 (Tr.
286).

On August 22, 2012, Plaintiff reported constant, stabbing

pain (7-9/10) in her lumbar back, radiating into her right leg;
she asserted that her pain was worse than before the surgery
(Tr. 286-90).

Examination results were, essentially, the same.

On October 22, McCarroll was examined by Dr. Hunt Hapworth,
at Comprehensive Pain and Rehabilitation, to evaluate her back
pain, radiating down to her right foot, that had only gotten
worse in spite of medications, a brace, surgery, and physical
therapy (Tr. 406-09).

The Doctor noted full strength in all

muscle groups except in the lower right extremity (4+/5); she
also had decreased sensation in the extremity.

Supine straight

leg raising test produced back and right button pain; there was
diminished ROM on extension, flexion, lateral bending, and
rotation in the lumbar spine.

Lab results demonstrated that

Plaintiff was not abusing her medications.

Hapworth’s

diagnostic impression was lumbar post-laminotomy syndromes,
lumbar radiculitis, and lumbar degenerative disc disease; the
Doctor adjusted her medication regimen, adding Cymbalta,16 and
discussed different plans for addressing the pain.

The Doctor

stated that she should be off of work until her condition
improved (Tr. 409).

The next day, Plaintiff underwent a Right

16Cymbalta is used in the treatment of major depressive disorder.

Error! Main Document Only.Physician's Desk Reference 1791-93 (62nd ed.
2008).

9

L1 sympathetic block, performed by Osteopath Matthew Barfield,
with no obvious complications; good pain relief was achieved
(Tr. 403-05).

On November 6, 2012, McCarroll told Dr. Barfield

that the block had decreased her pain, by half, for a few hours,
but that it returned to the same level; the examination showed
continued decreased ROM in the lumbar spine as well as mild
myofascial tender points bilaterally at L4-5 (Tr. 401-02).

On

November 8, the Osteopath performed an L5 nerve root block with
transforaminal epidural injection on the right with no
complications; good pain relief was noted (Tr. 399-400).

On

November 26, McCarroll told Dr. Hapworth that the nerve block
was still experiencing pain; she reported being unable to
perform many of her ADL’s and was usually limited to ambulating
between her chair and bed (Tr. 396-98).

The Doctor noted a

recent nerve study, revealing acute chronic L5 radiculopathy; on
exam, Plaintiff had full muscle strength in all extremities and
full ROM in the lumbar spine with no obvious myofascial
trigger/tender points or facet tenderness.

On November 27,

2012, Dr. Hapworth indicated that McCarroll was disabled and
would not be able to return to work (Tr. 398).
On November 27, Psychologist Jake Epker examined Plaintiff
on referral “for a behavioral medicine evaluation to help
identify potential psychosocial risk factors for poor surgical
outcome and generate appropriate treatment recommendations” (Tr.

10

433; see generally Tr. 433-35).

McCarroll said she had been

depressed since surgery; she reported having low energy,
attention problems, sleeping only one-to-two hours nightly, and
difficulty with having to depend on others to help her.

Epker

stated that her claim of level-ten pain for three weeks
indicated exaggeration.

McCarroll underwent psychometric

testing, demonstrating borderline intellectual abilities; Epker
thought the results were valid.

There was “evidence of

significant depression, anxiety, somatization, and symptom
dependency.

Likewise there [was] evidence of extremely high

levels of pain catastrophizing” (Tr. 444).

The Psychologist

indicated there was a likely chance of opioid abuse; he did not
think she was a candidate for implanting a spinal cord
stimulator but that she would benefit from a pain management
group.

Records show that Plaintiff attended four sessions over

the next six months.
On December 3, 2012, Dr. Hapworth performed an S1 selective
nerve root block with a transforaminal epidural injection on the
right without complications; good pain relief was noted (Tr.
394-95).

On December 17, McCarroll reported no benefit from the

recent procedure; Hapworth noted mildly restricted lumbar ROM in
flexion and extension and low back pain on the right (Tr. 41718).

She had preserved strength in the lower extremity but some

fatigability on repeated testing within the right ankle but no

11

evidence of deep vein thrombosis; an ankle foot orthotic was
ordered, but she could not afford it (Tr. 415, 418).

On January

17, 2013, a CRNP noted that Plaintiff could complete ADL’s and
that a drug screen suggested compliance; McCarroll rated her
pain at five

(Tr. 415-16).

Tenderness was noted at L3 through

S1 with lumbar facet tenderness, greater on the right, at L2
through L5.

Plaintiff’s gait was stable and she had a positive

straight leg raise on the right; subjective fine touch sensation
was diminished in the right calf.

On January 18, Dr. Barfield

gave her a sympathetic injection on the right L2 (Tr. 412-14).
On February 13, Plaintiff reported that the injection had no
appreciable benefit and that she was through with additional
injections and nerve blocks; she could complete ADL’s (Tr. 41011).

The CRNP noted facet tenderness, greater on the right, at

L4-L5, and that straight leg raise produced back pain; sensation
was diminished in an L5-S1 distribution in the right lower
extremity.
On February 21, Dr. Tyler noted no spinal deformity or
scoliosis with normal posture and gait; McCarroll had full ROM
of all joints (Tr. 432-35).

She had lumbar spasm bilaterally

and decreased strength in the right upper extremity.

On

February 27, Plaintiff underwent surgery to remove infected
hardware from the transverse lumbar interbody fusion, performed
ten months earlier (Tr. 427-31).

12

On March 21, Plaintiff

reported that her leg pain was much better though she still had
local soreness with activity; she rated her pain at six (Tr.
423-26).

Dr. Tyler noted full ROM of all joints; he diagnosed

back pain with radiculopathy and mechanical instability and
continued her medicinal regimen.

On May 2, 2013, McCarroll

reported that her leg pain continued to improve, though she
experienced activity-related leg cramping; overall, she was
doing much better since surgery and was continuing to improve
(Tr. 419-22).

Plaintiff reported her pain at five.

On October 7, McCarroll reported to Dr. Fontana that her
right knee pain had flared up over the last two months; he found
mild swelling and crepitus though she was neurovascularly
intact, but gave her an injection (Tr. 454-55).

On October 29,

Plaintiff received a second injection (Tr. 450-51); on November
5, she received a third injection (Tr. 448-49).
On November 22, Plaintiff went to the Mobile Infirmary
Medical Center ER for two weeks of lower back pain, aggravated
by activity and movement; though there was tenderness, she had
normal ROM (Tr. 491-98).

X-rays showed lower lumbar disc

disease with previous fusion, but no new acute abnormality; she
was discharged to see her personal physician.
On December 3, McCarroll reported that the injections had
not helped much; Dr. Fontana noted crepitus (Tr. 446-47).
On April 1, 2014, Plaintiff went to the UAB Medicine

13

Neurology Department for low back pain rated at a level ten;
because of it, she could not perform ADL’s (Tr. 499-506). On
exam, McCarroll had diminished strength and altered sensation in
her right foot; she had very little lumbar spine ROM and was
tender over the sacroiliac and right piriformis region.
Prescriptions for pain relief were given.

An MRI taken two

weeks later demonstrated granulation tissue within the right L4L5 lateral recess encroaching upon and possibly contacting the
descending right L5 nerve root; in addition, there was mild to
moderate degenerative disk changes at L2-L3 with mild central
canal narrowing (Tr. 505-06).
This concludes the Court’s summary of the evidence.
McCarroll brought this action, first claiming that the ALJ
substituted her opinion for that of a medical professional.

She

specifically refers to a report by Dr. Fontana that Plaintiff
asserted was mischaracterized (Doc. 12, p. 8).

The Court notes

that another component of this argument is that the residual
functional capacity (hereinafter RFC), as determined by the ALJ,
is unsupported by the evidence.
The Court first notes that “[t]he RFC assessment is a
function-by-function assessment based upon all of the relevant
evidence of an individual’s ability to do work-related
activities.”

Social Security Ruling 96-8p, Titles II and XVI:

Assessing Residual Functional Capacity in Initial Claims, 1996

14

WL 374184, *3.

The Court notes that the ALJ is responsible for

determining a claimant’s RFC.

20 C.F.R. § 404.1546 (2015).

That decision cannot be based on “sit and squirm” jurisprudence.
Wilson v. Heckler, 734 F.2d 513, 518 (11th Cir. 1984).

However,

the Court also notes that the social security regulations state
that Plaintiff is responsible for providing evidence from which
the ALJ can make an RFC determination.
404.1545(a)(3).

20 C.F.R. §

The Court further notes that a treating

physician’s opinion “must be given substantial or considerable
weight unless ‘good cause’ is shown to the contrary,” existing
when the:

(1) treating physician’s opinion was not bolstered by

the evidence; (2) evidence supported a contrary finding; or (3)
the treating physician’s opinion was conclusory or inconsistent
with the doctor’s own medical records.

Phillips v. Barnhart,

357 F.3d 1232, 1240-41 (11th Cir. 2004)(quoting Lewis v.
Callahan, 125 F.2d 1436, 1440 (11th Cir. 1997)).

The ALJ’s assessment of Plaintiff’s RFC is as follows:
[T]he claimant had the residual functional
capacity to perform a reduced level of light
work as defined in 20 C.F.R. 404.1567(b).
She can lift and carry up to ten pounds
frequently and twenty pounds occasionally.
She needs to alternate between sitting and
standing about every 30 minutes to an hour
but would not need to leave the workstation.
She is precluded from operating foot
controls and can only occasionally climb
stairs and ramps and never climb ladders,
ropes or scaffolds. She can occasionally

15

bend, crouch, or stoop and never kneel or
crawl. She can have no exposure to
unprotected heights or dangerous equipment.
She needs to avoid tasks that involve a
variety of instructions or tasks but is able
to perform jobs with only 1-2 step
instructions and able to carry out tasks
involving detailed written or oral
instructions involving a few concrete
variables in or from standardized
situations. She is to have no work in
crowds and only occasionally contact with
the public.
(Tr. 29-30).
It appears to the Court that McCarroll’s argument focuses
on the ALJ’s findings regarding Dr. Fontana’s report as no
particular objection is made as to the specific abilities or
limitations found in the RFC determination (see Doc. 12, pp. 29).

The objection put forth was that the ALJ gave more weight

to Dr. Fontana’s evaluation in a Worker’s Compensation
Assessment than it deserved (Docs. 12, pp. 7-8).

On that form,

completed on December 3, 2013, Dr. Fontana indicated that
Plaintiff had traumatic osteoarthritis of the right knee, but no
other diagnoses; he went on to mark N/A17 on every specific
question regarding her treatment and work restrictions with no
further explanation (Tr. 446).
While admitting that Fontana’s Assessment amounts to no
more than the diagnosis of one impairment, the Court cannot find

17The Court understands this to mean any of the following:

applicable, not available, or no answer.

16

not

that it demonstrates any error in the ALJ’s RFC assessment.
Furthermore, it does not demonstrate that the ALJ substituted
her opinion for that of the Orthopedist.

The Court’s review of

the evidence, like the ALJ’s, revealed no physician’s finding
that Plaintiff was unable to work for one year’s time, the
amount necessary for a disability finding.
404.1505(a).

See 20 C.F.R. §

The Court further notes that even though, Dr.

Hapworth, on November 27, 2012, indicated that McCarroll was
disabled and would not be able to return to work (Tr. 398),
examination notes from the Doctor less than a month later
indicated that McCarroll was suffering only mildly restricted
lumbar ROM in flexion and extension (Tr. 417-18); even those
restrictions were not noted a month later (Tr. 415-16).

The

Court finds that Plaintiff’s claim, that the ALJ improperly
substituted her opinion for that of a treating physician, is
without merit.
McCarroll next claims that the ALJ did not properly develop
the record.

More specifically, Plaintiff asserts the ALJ should

have ordered a consultative orthopedic examination to consider
the combination of all of her impairments (Doc. 12, pp. 9-10).
The Eleventh Circuit Court of Appeals has required that "a
full and fair record" be developed by the ALJ even if the
claimant is represented by counsel.
F.2d 731, 735 (11th Cir. 1981).

17

Cowart v. Schweiker, 662

However, the

ALJ “is not

required to order a consultative examination as long as the
record contains sufficient evidence for the [ALJ] to make an
informed decision.”

Ingram v. Commissioner of Social Security

Administration, 496 F.3d 1253, 1269 (11th Cir. 2007) (citing
Doughty v. Apfel, 245 F.3d 1274, 1281 (11th Cir. 2001)).
The Court has reviewed all of the medical evidence (279
pages) and finds that it was sufficient for the ALJ to make a
determination.

The failure of the record evidence to support a

disability finding does not support the gathering of more
evidence.
The Court further notes that "the Secretary shall consider
the combined effect of all of the individual's impairments
without regard to whether any such impairment, if considered
separately, would be of such severity."
423(d)(2)C).

42 U.S.C. §

The Eleventh Circuit Court of Appeals has noted

this instruction and further found that "[i]t is the duty of the
administrative law judge to make specific and well-articulated
findings as to the effect of the combination of impairments and
to decide whether the combined impairments cause the claimant to
be disabled."

Bowen v. Heckler, 748 F.2d 629, 635 (11th Cir.

1984); see also Reeves v. Heckler, 734 F.2d 519 (11th Cir.
1984); Wiggins v. Schweiker, 679 F.2d 1387 (11th Cir. 1982).
In the ALJ's findings, she lists Plaintiff's impairments
and concludes by saying that she “did not have an impairment or

18

combination of impairments that met or medically equaled the
severity of one of the listed impairments in 20 C.F.R. Part 404,
Subpart P, Appendix 1” (Tr. 27).

This language has been upheld

by the Eleventh Circuit Court of Appeals as sufficient
consideration of the effects of the combinations of a claimant's
impairments.

Jones v. Department of Health and Human Services,

941 F.2d 1529, 1533 (11th Cir. 1991) (the claimant does not have
“an impairment or combination of impairments listed in, or
medically equal to one listed in Appendix 1, Subpart P,
Regulations No. 4").

McCarroll’s claim that the ALJ did not

properly develop the record by ordering a consultative
examination to consider the combination of all of her
impairments is without merit.
Plaintiff has raised two different claims in bringing this
action.

Both are without merit.

Upon consideration of the

entire record, the Court finds "such relevant evidence as a
reasonable mind might accept as adequate to support a
conclusion."

Perales, 402 U.S. at 401.

Therefore, it is

ORDERED that the Secretary's decision be AFFIRMED, see
Fortenberry v. Harris, 612 F.2d 947, 950 (5th Cir. 1980), and
that this action be DISMISSED.

Judgment will be entered by

separate Order.
DONE this 25th day of July, 2016.

19

s/BERT W. MILLING, JR.
UNITED STATES MAGISTRATE JUDGE

20