Schmidt v. Commissioner of Social Security Administration

Filing 16

ORDER - IT IS THEREFORE ORDERED that the final decision of the Commissioner of Social Security is affirmed. The Clerk shall enter judgment accordingly and shall terminate this case. (See document for further details). Signed by Senior Judge Neil V Wake on 7/22/16. (LAD)

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IN THE UNITED STATES DISTRICT COURT

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FOR THE DISTRICT OF ARIZONA

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John Schmidt,

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No. CV-15-08139-PCT-NVW
Plaintiff,

ORDER

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v.

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Carolyn W. Colvin, Acting Commissioner
of Social Security,

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Defendant.

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Plaintiff John Schmidt seeks review under 42 U.S.C. § 405(g) of the final decision
of the Commissioner of Social Security (“the Commissioner”), which denied him
supplemental security income under section 1614(a)(3)(A) of the Social Security Act.
Because the decision of the Administrative Law Judge (“ALJ”) is supported by
substantial evidence and is not based on legal error, the Commissioner’s decision will be
affirmed.
I.

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BACKGROUND
Plaintiff was born in February 1972 and was 39 years old on the date his

application was filed.

Plaintiff has a limited education, is able to communicate in

English, and has no past relevant work. In December 2013, Plaintiff lived with his wife,
15-year-old stepson, and 2-year-old grandson. He is able to drive, perform personal care,
and watch television. He uses a cane sometimes, but it has not been prescribed.

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Plaintiff applied for supplemental security income disability benefits in 1990,
1993, 1994, and 1998. He received benefits for approximately ten years due to lower
back problems. During that time, Plaintiff received fusion surgery at the L4/L5 and
L5/S1 levels. Plaintiff’s receipt of benefits ceased due to incarceration between 2006 and
2009. Plaintiff applied for benefits on June 17, 2009, alleging back and leg pain, and
received an unfavorable decision on April 11, 2011. Plaintiff’s request for review of that
decision was denied by the Appeals Council on April 19, 2012.

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On July 27, 2011, Plaintiff applied for supplemental security income, alleging
disability beginning April 12, 2011, due to back and leg problems. On December 19,
2013, he appeared with his attorney and testified at a video hearing before the ALJ.
Plaintiff’s attorney argued that Plaintiff’s back impairment had worsened since the April
11, 2011 denial of benefits and that it meets or equals Listing 1.04A. Plaintiff testified
that he had back surgery in 2003 and in August 2013 he had surgery to correct a deviated
nasal septum. He also testified that about twice a week he cares for his 2-year-old
grandson while his wife is at work. He reported pain and numbness in his back, feet,
legs, right hip, neck, head, hands, and between his shoulders.

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On February 28, 2014, the ALJ issued a decision that Plaintiff was not disabled
within the meaning of the Social Security Act. The Appeals Council denied Plaintiff’s
request for review of the hearing decision, making the ALJ’s decision the
Commissioner’s final decision. On August 4, 2015, Plaintiff sought review by this Court.
II.

STANDARD OF REVIEW
The district court reviews only those issues raised by the party challenging the

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court
may set aside the Commissioner’s disability determination only if the determination is
not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d
625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, less than a
preponderance, and relevant evidence that a reasonable person might accept as adequate

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to support a conclusion considering the record as a whole. Id. In determining whether
substantial evidence supports a decision, the court must consider the record as a whole
and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id.
Generally, when the evidence is susceptible to more than one rational interpretation,
courts must uphold the ALJ’s findings if they are supported by inferences reasonably
drawn from the record. Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012). “Overall,
the standard of review is highly deferential.” Rounds v. Comm’r Soc. Sec. Admin., 807
F.3d 996, 1002 (9th Cir. 2015).

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Harmless error principles apply in the Social Security Act context. Molina v.
Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012). An error is harmless if there remains
substantial evidence supporting the ALJ’s decision and the error does not affect the
ultimate nondisability determination. Id. The claimant usually bears the burden of
showing that an error is harmful. Id. at 1111.
III.

FIVE-STEP SEQUENTIAL EVALUATION PROCESS
To determine whether a claimant is disabled for purposes of the Social Security

Act, the ALJ follows a five-step process. 20 C.F.R. § 416.920(a). The claimant bears the
burden of proof on the first four steps, but the burden shifts to the Commissioner at step
five. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999).
At the first step, the ALJ determines whether the claimant is engaging in
substantial gainful activity. 20 C.F.R. § 416.920(b). If so, the claimant is not disabled
and the inquiry ends. Id. At step two, the ALJ determines whether the claimant has a
severe medically determinable physical or mental impairment. § 416.920(c). If not, the
claimant is not disabled and the inquiry ends. Id. At step three, the ALJ considers
whether the claimant’s impairment or combination of impairments meets or medically
equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404. If so, the
claimant is automatically found to be disabled. If not, the ALJ proceeds to step four. At
step four, the ALJ assesses the claimant’s residual functional capacity and determines

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whether the claimant is still capable of performing past relevant work. § 416.920(e), (f).
If so, the claimant is not disabled and the inquiry ends. Id. If not, the ALJ proceeds to
the fifth and final step, where he determines whether the claimant can perform any other
work based on the claimant’s residual functional capacity, age, education, and work
experience. § 416.920(g). If so, the claimant is not disabled. Id. If not, the claimant is
disabled. Id.

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At step one, the ALJ found that Plaintiff has not engaged in substantial gainful
activity since July 27, 2011, the application date. At step two, the ALJ found that
Plaintiff has the following severe impairments: degenerative disc disease of the lumbar,
cervical, and thoracic spine; status post lumbar spine infusion; history of small spinal
canal; and obstructive sleep apnea. At step three, the ALJ determined that Plaintiff does
not have an impairment or combination of impairments that meets or medically equals an
impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1.

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At step four, the ALJ found that Plaintiff:

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has the residual functional capacity to perform light work as defined in 20
CFR 416.967(b) except he can never climb ladders, ropes or scaffolds and
he can never crawl. He can occasionally climb ramps and stairs and
occasionally stoop, kneel and crouch. He can frequently balance. He
should avoid concentrated exposure to extreme cold, wetness, vibration and
hazards including unprotected heights and moving machinery.

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The ALJ further found that Plaintiff has no past relevant work. At step five, the ALJ
concluded that, considering Plaintiff’s age, education, work experience, and residual
functional capacity, there are jobs that exist in significant numbers in the national
economy that Plaintiff could perform.
IV.

ANALYSIS
A.

The ALJ Did Not Err in Weighing NP Brown’s Opinion.

In determining whether a claimant is disabled, the ALJ considers all evidence in
the claimant’s case record. 20 C.F.R. § 416.920(a)(3). However, a claimant must submit
evidence from an acceptable medical source to establish that he has a medically

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determinable impairment or impairments.

20 C.F.R. § 416.913(a).

Only licensed

physicians, licensed or certified psychologists, licensed optometrists, licensed podiatrists,
and qualified speech-language pathologists are considered “acceptable medical sources.”
Id. A nurse practitioner is not an acceptable medical source. Only “acceptable medical
sources” can be considered treating sources whose medical opinions may be entitled to
controlling weight. SSR 06-03P, 2006 WL 2329939, at *2.
“Medical opinions are statements from physicians and psychologists or other
acceptable medical sources that reflect judgments about the nature and severity of [the
claimant’s] impairment(s), including [the claimant’s] symptoms, diagnosis and prognosis,
what [the claimant] can still do despite impairment(s), and [the claimant’s] physical or
mental restrictions.” 20 C.F.R. § 416.927(a)(2). Because a nurse practitioner is not an
acceptable medical source, a statement by a nurse practitioner is not a “medical opinion.”
“The fact that a medical opinion is from an ‘acceptable medical source’ is a factor that
may justify giving that opinion greater weight than an opinion from a medical source who
is not an ‘acceptable medical source.’” SSR 06-03P, 2006 WL 2329939, at *5.
However, “evaluation of an opinion from a medical source who is not an
‘acceptable medical source’ depends on the particular facts in each case.”

Id.

Information from “other sources” “may be based on special knowledge of the individual
and may provide insight into the severity of the impairment(s) and how it affects the
individual’s ability to function.” SSR 06-03P, 2006 WL 2329939, at *2. The ALJ may
consider evidence from “other sources,” including nurse practitioners, regarding the
severity of a claimant’s impairment and how it affects the claimant’s ability to work. 20
C.F.R. § 416.913(d). The ALJ may discount testimony from “other sources” if the ALJ
gives reasons germane to the witness for doing so. Molina v. Astrue, 674 F.3d 1104,
1111 (9th Cir. 2012); Dale v. Colvin, __ F.3d __, 2016 WL 2909237, at *2 (9th Cir. May
19, 2016).

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Plaintiff contends the ALJ erred in giving Certified Family Nurse Practitioner
Cindy Brown’s opinion little weight based on finding (1) the opinion was inconsistent
with the greater objective medical record and Plaintiff’s reported activity levels; (2) the
assessment of the effect of Plaintiff’s pain on his ability to concentrate was excessive and
contradicted by progress notes; and (3) NP Brown is not an acceptable medical source.
Because NP Brown is a nurse practitioner and not an acceptable medical source, the ALJ
was required to consider her opinion as evidence regarding the severity of Plaintiff’s
impairments and how they affect Plaintiff’s ability to work, but was not required to weigh
her opinion as though she were a treating medical source. The ALJ was required only to
provide reasons germane to NP Brown for discounting her opinion.
Although the ALJ gave NP Brown’s opinion “little weight,” much of the ALJ’s
residual functional capacity assessment is fairly consistent with NP Brown’s opinion. NP
Brown opined that a medically required hand-held assistive device was not necessary for
ambulation. She opined that Plaintiff can never climb; the ALJ concluded that Plaintiff
can never climb ladders, ropes, or scaffolds, but occasionally climb ramps and stairs. NP
Brown opined that Plaintiff can never stoop, kneel, or crouch; the ALJ limited Plaintiff to
occasional stooping, kneeling, and crouching. NP Brown opined that Plaintiff can never
crawl; the ALJ concluded the same. NP Brown opined that Plaintiff can frequently
balance; the ALJ concluded the same. NP Brown opined, and the ALJ agreed, that
Plaintiff should avoid unprotected heights and extreme cold. The ALJ also restricted
Plaintiff from moving machinery, which NP Brown did not.
The ALJ found that Plaintiff is capable of performing light work as defined in 20
C.F.R. § 416.967, which involves lifting no more than 20 pounds at a time with frequent
lifting or carrying of objects weighing up to 10 pounds. NP Brown opined that Plaintiff
could lift and carry less than 10 pounds, sit for a total of 2 hours in an 8-hour work day,
and stand and/or walk for a total of less than 2 hours in an 8-hour work day. The ALJ
gave greater weight to the opinion of Dr. Bradley Werrell, the State agency examining

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physician, who opined that Plaintiff can lift and carry 20 pounds occasionally and 10
pounds frequently, stand and/or walk 4 hours in an 8-hour work day, and sit without
limitation, because Dr. Werrell’s examination was objective in nature and his opinion
was more consistent with the greater record. The ALJ also gave greater weight to the
opinions of the State agency reviewing physicians, who opined that Plaintiff could
perform light work with some limitations, because the opinions were not inconsistent
with the greater objective record.
The ALJ specifically identified Plaintiff’s reported activities that were inconsistent
with NP Brown’s opinion that Plaintiff can sit, stand, and/or walk for a total of less than 4
hours in an 8-hour work day and can never carry more than 10 pounds. The reported
activities included being responsible for and caring for his 2-year-old grandson, driving
his own vehicle, maintaining personal care independently, making meals for himself and
his grandson, watching television, and performing stretching exercises.
Further, the ALJ specifically identified NP Brown’s December 17, 2012 treatment
note as inconsistent with her opinion that Plaintiff has severe pain that precludes his
ability to function and constantly interferes with his attention and concentration. The
treatment note stated that Plaintiff’s judgment and insight was intact, his memory for
recent and remote events was intact, and his mood and affect did not indicate depression,
anxiety, or agitation.
Therefore, the ALJ did not err by discounting NP Brown’s opinion.
B.

The ALJ Did Not Err in His Severity Finding.

At step two of the five-step sequential analysis, the ALJ was required to determine
whether Plaintiff has a medically determinable impairment or combination of
impairments that is severe, i.e., it significantly limits physical or mental ability to do
basic work activities and is expected to last for a continuous period of at least twelve
months. 20 C.F.R. §§ 416.920(c), 416.921(a), 416.909. “Basic work activities” refers to
abilities and aptitudes necessary to do most jobs, such as walking, standing, sitting,

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lifting, pushing, pulling, reaching, carrying, handling, seeing, hearing, speaking,
understanding and carrying out simple instructions, use of judgment, responding
appropriately to others, and dealing with changes in a routine work setting. 20 C.F.R.
§ 416.921(b). In determining a claimant’s residual functional capacity, the ALJ must
consider the combined effect of multiple conditions, including those that are not severe.
See 20 C.F.R. § 416.945(a)(2).
The ALJ found that Plaintiff has the following severe impairments: degenerative
disc disease of the lumbar, cervical, and thoracic spine; status post lumbar spine infusion;
history of small spinal canal; and obstructive sleep apnea. The ALJ expressly found the
following impairments not to be severe because they result in no more than minimal
functional restrictions in basic work activities:

gastroesophageal reflux disease/acid

reflux; chronic obstructive pulmonary disease with tobacco dependence; chronic
sinusitis; deviated nasal septum, status post 2013 corrective surgery; bilateral shoulder
osteoarthritis; and obesity (height 6 feet, weight 215 pounds). The ALJ also concluded
that Plaintiff’s “medically determinable mental impairments of methamphetamine
dependence, in remission, alcohol abuse, in remission, and cannabis dependence—
without medical recommendation to use/medical marijuana card, considered singly and in
combination, do not cause more than minimal limitation in the claimant’s ability to
perform basic mental work activities and are therefore nonsevere.”
In his opening brief, Plaintiff contends that the ALJ committed legal error by
finding Plaintiff’s chronic obstructive pulmonary disease, sinusitis, deviated nasal
septum, and shoulder osteoarthritis to be non-severe. However, Plaintiff does not argue
that his chronic obstructive pulmonary disease, sinusitis, and/or deviated nasal septum
significantly limit his physical or mental ability to do basic work activities. In his reply
brief, Plaintiff does not respond to Defendant’s contention regarding these impairments
and addresses only whether his shoulder osteoarthritis should have been found to be
severe.

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The ALJ based his conclusion that Plaintiff’s bilateral shoulder osteoarthritis was
non-severe on NP Brown’s most recent physical examination notes. On December 5,
2013, NP Brown observed that Plaintiff had normal range of motion and strength in the
upper extremities with no joint enlargement or tenderness bilaterally. Plaintiff contends
the ALJ should have considered NP Brown’s November 25, 2013 opinion that the
shoulder osteoarthritis would pose significant functional limitations instead of relying on
her December 5, 2013 examination findings. The ALJ’s proper discounting of NP
Brown’s November 25, 2013 opinion does not require the ALJ to disregard her
examination findings.

Moreover, NP Brown’s observations on December 5, 2013,

indicate that if Plaintiff had significant functional limitations due to shoulder
osteoarthritis on November 25, 2013, they did not last for a continuous period of at least
twelve months. Further, the ALJ was not required to adopt Dr. Werrell’s opinion that
Plaintiff be restricted to occasional reaching based only on his physical examination
without reviewing any medical records showing shoulder osteoarthritis.
Therefore, the ALJ did not err in finding only Plaintiff’s degenerative disc disease
of the lumbar, cervical, and thoracic spine; status post lumbar spine infusion; history of
small spinal canal; and obstructive sleep apnea to be severe impairments.
C.

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The ALJ Provided Clear and Convincing Reasons for Discrediting
Plaintiff’s Symptom Testimony.

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If a claimant’s statements about pain or other symptoms are not substantiated by

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objective medical evidence, the ALJ must consider all of the evidence in the case record,

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including any statement by the claimant and other persons, concerning the claimant’s

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symptoms. SSR96-7p. Then the ALJ must make a finding on the credibility of the

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claimant’s statements about symptoms and their functional effects. Id.

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In evaluating the credibility of a claimant’s testimony regarding subjective pain or

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other symptoms, the ALJ is required to engage in a two-step analysis: (1) determine

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whether the claimant presented objective medical evidence of an impairment that could

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reasonably be expected to produce some degree of the pain or other symptoms alleged;
and, if so with no evidence of malingering, (2) reject the claimant’s testimony about the
severity of the symptoms only by giving specific, clear, and convincing reasons for the
rejection. Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009). “This is not an easy
requirement to meet: ‘The clear and convincing standard is the most demanding required
in Social Security cases.’” Garrison v. Colvin, 759 F.3d 995, 1015 (9th Cir. 2014)
(quoting Moore v. Comm’r of Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir. 2002)).

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To ensure meaningful review, the ALJ must specifically identify the testimony
from a claimant the ALJ finds not to be credible and explain what evidence undermines
the testimony. Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1102 (9th Cir.
2014).

“General findings are insufficient.”

Id.

The ALJ must make findings

“sufficiently specific to permit the court to conclude that the ALJ did not arbitrarily
discredit claimant’s testimony.” Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002);
accord Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008).
In making a credibility determination, an ALJ “may not reject a claimant’s
subjective complaints based solely on a lack of objective medical evidence to fully
corroborate the claimant’s allegations.” Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d
1219, 1227 (9th Cir. 2009).

But “an ALJ may weigh inconsistencies between the

claimant’s testimony and his or her conduct, daily activities, and work record, among
other factors.” Id. Further, the claimant is not required to produce objective medical
evidence of the symptom or its severity. Garrison, 759 F.3d at 1014. The ALJ must
consider all of the evidence presented, including the claimant’s daily activities; the
location, duration, frequency, and intensity of the pain or other symptoms; factors that
precipitate and aggravate the symptoms; effectiveness and side effects of any medication
taken to alleviate pain or other symptoms; treatment other than medication; any measures
other than treatment the claimant uses to relieve pain or other symptoms; and any other

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factors concerning the claimant’s functional limitations and restrictions due to pain or
other symptoms. SSR 96-7p.
First, the ALJ found that Plaintiff’s “medically determinable impairments could
reasonably be expected to cause the alleged symptoms.”

Second, the ALJ found

Plaintiff’s “statements regarding the intensity, persistence, and limiting effects of the
symptoms not entirely credible to the extent they are inconsistent with the residual
functional capacity assessment.”
The ALJ stated that Plaintiff testified he cannot work due to back pain, and he
experiences a burning, tingling, and sharp pain in his right hip when he lies down. He
said Plaintiff also complained of neck pain, severe headaches, dizziness, numbness and
pressure in his head, numbness in his shoulders, and finger and hand numbness. The ALJ
further noted that Plaintiff testified that he has difficulty standing to shave and sometimes
needs to lie down during episodes of heightened back pain for up to 2½ hours.
The ALJ found Plaintiff’s allegations regarding the severity and limitations
associated with his impairments to be unsupported by the medical evidence and
inconsistent with his activity levels, including being responsible for and caring for his
2-year-old grandson, driving his own vehicle, maintaining personal care independently,
making meals for himself and his grandson, watching television, and performing
stretching exercises. The ALJ noted that Plaintiff had reported his pain medications were
working well to control his pain, he drove himself to Dr. Werrell’s evaluation, and he
appeared to be in only mild distress during the examination.

The ALJ found that

Plaintiff’s credibility was undermined by his criminal history, inconsistent reports
regarding alcohol and illegal drug use, and continued smoking against medical advice.
These findings are sufficiently specific to conclude that the ALJ did not arbitrarily
discredit Plaintiff’s testimony and did not err in his credibility determination.

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Substantial Evidence Supports the ALJ’s Determination that Plaintiff
Does Not Have an Impairment or Combination of Impairments that
Meet or Medically Equal the Severity of a Listed Impairment in 20
C.F.R. Part 404, Subpart P, Appendix 1.

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During the December 19, 2013 hearing before the ALJ, counsel for Plaintiff stated

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that Plaintiff’s theory of the case was that Plaintiff’s lumbar spine impairment meets or at

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least equals Listing 1.04A.

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evidence of record supported finding that Plaintiff’s back impairment met or equaled the

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criteria in Listing 1.03, 1.04, 1.05, or any of the other musculoskeletal listings in 1.00,

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and found it did not. In Plaintiff’s request for review of the hearing decision, Plaintiff’s

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D.

Nevertheless, the ALJ considered whether the medical

counsel contended that the ALJ erred by failing to adequately consider Listing 1.04A.

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Plaintiff bears the burden of proof at step three. Tackett v. Apfel, 180 F.3d 1094,

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1098 (9th Cir. 1999). To meet the requirements of a listing, a claimant must have a

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medically determinable impairment that satisfies all of the criteria in the listing.

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20 C.F.R. § 416.925(d).

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degenerative disc disease, resulting in the compromise of a nerve root or the spinal cord,

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with evidence of “nerve root compression characterized by neuro-anatomic distribution

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of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle

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weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is

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involvement of the lower back, positive straight-leg raising test (sitting and supine).” On

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appeal, Plaintiff does not contend that he has a medically determinable impairment that

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satisfies all of the criteria in Listing 1.04A. Rather, Plaintiff contends that Listing 1.03 is

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the appropriate listing to consider because of Plaintiff’s failed spinal fusion.

Listing 1.04A requires a disorder of the spine, such as

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Listing 1.03 requires: “Reconstructive surgery or surgical arthrodesis [fusion] of a

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major weight-bearing joint, with inability to ambulate effectively, as defined in 1.00B2b,

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and return to effective ambulation did not occur, or is not expected to occur, within 12

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months of onset.” 20 C.F.R. § Pt. 404, Subpt. P, App. 1. Listing 1.00F states: “Major

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joints refers to the major peripheral joints, which are the hip, knee, shoulder, elbow,

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wrist-hand, and ankle-foot, as opposed to other peripheral joints (e.g., the joints of the
hand or forefoot) or axial joints (i.e., the joints of the spine).” “Inability to ambulate
effectively, as defined in 1.00B2b,” means:

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(2) To ambulate effectively, individuals must be capable of sustaining a
reasonable walking pace over a sufficient distance to be able to carry out
activities of daily living. They must have the ability to travel without
companion assistance to and from a place of employment or school.
Therefore, examples of ineffective ambulation include, but are not limited
to, the inability to walk without the use of a walker, two crutches or two
canes, the inability to walk a block at a reasonable pace on rough or uneven
surfaces, the inability to use standard public transportation, the inability to
carry out routine ambulatory activities, such as shopping and banking, and
the inability to climb a few steps at a reasonable pace with the use of a
single hand rail. The ability to walk independently about one’s home
without the use of assistive devices does not, in and of itself, constitute
effective ambulation.

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Plaintiff asserts that his impairment satisfies Listing 1.03 because he had lumbar

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fusion surgery and uses a cane. Plaintiff’s back surgery does not constitute reconstructive

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surgery of a major weight-bearing joint as defined by Listing 1.00F. Even if Listing 1.03

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does not incorporate 1.00F, Plaintiff has not shown he is unable to ambulate effectively.

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Dr. Werrell observed that Plaintiff “maneuvers well through the examination facility with

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a mildly antalgic gait pattern” and “uses a cane for pain and greater for balance.” Dr.

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Werrell opined that Plaintiff’s ability to stand and/or walk is limited to 4 hours in an

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8-hour day because of “lumbar arthropathy, sciatica, use of a cane.” Dr. Werrell opined

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that use of a cane was medically necessary, but noted it had not been prescribed. Plaintiff

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travels without companion assistance and uses only one cane. Therefore, Plaintiff’s back

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impairment does not meet or equal Listing 1.03. The ALJ’s severity determination at

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step three is supported by substantial evidence.

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/ //

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/ / /

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/ //

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IT IS THEREFORE ORDERED that the final decision of the Commissioner of
Social Security is affirmed.

The Clerk shall enter judgment accordingly and shall

terminate this case.
Dated this 22nd day of July, 2016.

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Neil V. Wake
Senior United States District
Judge

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