Luttrell v. Social Security Administration

Filing 13

ORDER AFFIRMING THE COMMISSIONER. The Court denies Luttrell's request for relief and affirms the Commissioner's decision. Signed by Magistrate Judge J. Thomas Ray on 9/12/2014. (jak)

IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF ARKANSAS
Lisa Marie Luttrell
v.

Plaintiff
CASE NO. 3:13CV00125 JTR

Carolyn W. Colvin, Acting Commissioner,
Social Security Administration

Defendant

ORDER AFFIRMING THE COMMISSIONER
Lisa Marie Luttrell seeks judicial review of the denial of her application for
disability insurance benefits (DIB). Luttrell last worked in 2009 as a certified nurse’s
assistant.1 Luttrell applied for DIB on January 24, 2011, with an alleged onset date of
May 1, 2010.2 Luttrell’s date last insured (DLI) is December 31, 2014.3 Luttrell bases
disability on syncope, chronic obstructive pulmonary disease (COPD), anxiety and
severe depression.4
The Commissioner’s decision. The Commissioner’s ALJ determined that
Luttrell has not engaged in substantial gainful activity since the alleged onset date.5
Luttrell has severe impairments - syncope disorder, COPD, bilateral wrist dysfunction,

1

SSA record at p. 116.

2

Id. at p. 104.

3

Id. at p. 113.

4

Id. at p. 124.

5

Id. at p. 10.

lumbar spine dysfunction, anxiety, depression and an affective mood disorder.6 None
of Luttrell’s severe impairments meet the listings,7 and Luttrell can perform sedentary
work with the following non-exertional limitations: Luttrell is able to occasionally
stoop, crouch, crawl, kneel, and climb ramps or stairs; she is unable to engage in
balancing; and she is unable to climb ladders, ropes, or scaffolds; she must avoid all
respiratory irritants, extreme heat, and extreme cold; she must avoid all driving; she
can have no exposure to hazards such as unprotected heights, moving machinery, or
open flames; she is able to perform work where interpersonal contact is incidental to
the work performed, with “incidental” defined as: interpersonal contact requiring a
limited degree of interaction such as meeting and greeting the public, answering
simple questions, accepting payment and making change; she is capable of learning
the complexity of tasks by demonstration or repetition within thirty days with few
variables and little judgment; she requires supervision that is simple, direct and
concrete.8
The ALJ held that Luttrell cannot perform any past relevant work,9 but can

6

Id. at p. 10.

7

Id.

8

Id. at p. 12.

9

Id. at p. 16.
2

perform the positions of binder or mounter of small parts, positions identified by the
vocational expert (VE) as available in the regional and national economies.10 Luttrell’s
application was denied.11
After the Commissioner’s Appeals Council denied a request for review, the
ALJ’s decision became a final decision for judicial review.12 Luttrell filed this case to
challenge the decision. In reviewing the decision, the Court must determine whether
substantial evidence supports the decision and whether the ALJ made a legal error.13
Luttrell’s allegations. Luttrell maintains that the decision of the ALJ is not
supported by substantial evidence because (1) the ALJ erred in giving little weight to
the opinion of Luttrell’s treating physician; (2) the ALJ erred in giving little weight
to a portion of the state consultative medical examiner’s opinion; and (3) the ALJ
10

Id. at p. 17.

11

Id. at p. 18.

12

See Anderson v. Sullivan, 959 F.2d 690, 692 (8th Cir. 1992) (stating, “the
Social Security Act precludes general federal subject matter jurisdiction until
administrative remedies have been exhausted” and explaining that the appeal
procedure permits claimants to appeal only final decisions).
13

See 42 U.S.C. § 405(g) (requiring the district court to determine whether the
Commissioner’s findings are supported by substantial evidence and whether the
Commissioner conformed with applicable regulations); Long v. Chater, 108 F.3d 185,
187 (8th Cir. 1997) (“We will uphold the Commissioner’s decision to deny any
applicant disability benefits if the decision is not based on legal error and if there is
substantial evidence in the record as a whole to support the conclusion that the
claimant was not disabled.”).
3

erred in substituting his opinion for the opinion of physicians in determining Luttrell’s
residual functional capacity (RFC).
Substantial evidence is “less than a preponderance but . . . enough that a
reasonable mind would find it adequate to support the conclusion.”14 For substantial
evidence to exist in this case, a reasonable mind must accept the evidence as adequate
to support the ALJ’s denial of benefits.15
Opinion of treating physician. Luttrell maintains that the ALJ erred in giving
little weight to the opinion of her treating physician. This argument is not persuasive.
The ALJ’s decision to assign little weight to the treating physician’s opinion is
supported by substantial evidence. Although the opinion of a treating physician is
usually granted controlling weight, “an ALJ may grant less weight . . . when that
opinion conflicts with other substantial medical evidence contained within the
record.”16
In a physical medical source statement, the treating physician opined that
Luttrell is limited by the following restrictions:
•

Lifting and carrying less than ten pounds on an occasional basis

14

Jones v. Astrue, 619 F.3d 963, 968 (8th Cir. 2010) (internal quotations and
citations omitted).
15

Britton v. Sullivan, 908 F.2d 328, 330 (8th Cir. 1990).

16

Prosch v. Apfel, 201 F.3d 1010, 1013-14 (8th Cir. 2000).
4

•

Lifting and carrying less than ten pounds on a frequent basis

•

Standing and walking three hours of an eight hour day

•

Sitting for four hours of an eight hour day

•

Needing the ability to change positions frequently, have frequent
rest periods, have longer than normal breaks, and have the
opportunity to shift at will from sitting or standing/walking

•

No reaching

•

Avoiding concentrated exposure to extreme cold, extreme heat
and high humidity

•

Avoiding all exposure to fumes, odors, dust and gas; perfumes;
soldering fluxes; solvents/cleaners; and chemicals17

The treating physician determined that due to her impairments, Luttrell would be
absent from work more than three days per month.18 He based these findings on
Luttrell’s “multiple radiology exams.”19
In a mental medical source statement, the treating physician opined that
Luttrell’s performance would be unreliable with respect to remembering locations and
work procedures, arriving on time to work and completing a normal workday or

17

SSA record at p. 353.

18

Id.

19

Id.
5

workweek without excessive absences, and dealing with work stress.20 Further,
Luttrell has no ability to perform at a pace and consistency required for production or
assembly line.21 As in the physical medical source statement, the treating physician
determined that Luttrell’s mental impairments would cause her to be absent from work
more than three days a month.22 This opinion was based on Luttrell’s multiple office
visits with the treating physician.23
The two medical source statements from Luttrell’s treating physician render
Luttrell unable to perform any work. The ALJ gave little weight to the opinion of the
treating physician because the opinion was not supported by the record or by Luttrell’s
own admissions of her abilities and daily activities. Indeed, the treating physician’s
own notes do not support the extensive physical or mental restrictions placed on
Luttrell. Luttrell’s syncopal episodes began following the May 27, 2010, motor
vehicle accident. In the first note, the treating physician states that Luttrell has had
four syncopal episodes.24 The following three notes each denote one to two syncopal

20

Id. at p. 354.

21

Id.

22

Id.

23

Id.

24

Id. at p. 269.
6

episodes.25 The July 21, 2010, note states that Luttrell suffered a syncopal episode that
day, but at the time of the appointment was alert to “person, place and time.”26 Three
of the notes fail to mention syncopal episodes,27 and the October 11, 2011, note states
that Luttrell has had no seizures.28 Although most of the notes reference symptoms of
pain, it appears that the pain is not severe. One note states, “pain doing well with
meds.”29 The notes establish that Luttrell’s pain level ranges between a one and four
with the use of medication.30 Issues of depression and anxiety are mentioned in a
number of the treatment notes.31 The July 21, 2010, note, however, refers Luttrell to
counseling, and yet there are no records indicating that Luttrell sought such
counseling.32 The March 8, 2011, note indicates that there has been some
improvement with Luttrell’s depression and anxiety, and that her mood is “better.”33

25

Id. at pp. 266-68.

26

Id. at p. 268.

27

Id. at pp. 264, 320 & 383.

28

Id. at p. 384.

29

Id. at p. 385.

30

Id. at pp. 265-66.

31

Id. at pp. 264-65, 268, 270, 320, 382 & 384-85.

32

Id. at p. 268.

33

Id. at p. 320.
7

The radiology reports relied on by the treating physician do not support the
limitations. The record contains five pertinent radiology reports.34 On May 27, 2010,
the day of Luttrell’s motor vehicle accident, CT scans of Luttrell’s lumbar spine,
cervical spine and head were conducted.35 The CT scans showed no acute fracture and
minimal degenerative change in the lumbar spine, no acute fracture in the cervical
spine and no acute intracranial hemorrhage in the head.36 Two days later another CT
scan was performed on Luttrell’s head.37 The scan showed no acute intracranial
findings.38 On June 9, 2010, imaging was done of Luttrell’s carotid system, and no
hemodynamically significant stenosis was identified.39
In August of 2010, an MRI of Luttrell’s brain was conducted with the following
impressions: 1) no acute intracranial hemorrhage or enhancing mass; 2) several 3 mm.
focal increased T-2 and flare signal intensity at bilateral corona radiata which may
represent tiny focal ischemic change versus other etiology, recommend to correlate

34

Id. at pp. 188, 190, 201, 210 & 212.

35

Id. at pp. 210 & 212.

36

Id.

37

Id. at p. 201.

38

Id.

39

Id. at p. 190.
8

clinically; and 3) minimal mucosal thickening in bilateral ethmoid sinuses with
bilateral nasal turbinate hypertrophy.40 Nothing of serious concern was noted from the
MRI. Throughout the report, words like “minimal,” “normal,” “tiny” and
“unremarkable” are used.41
Also contained in the record is the report from an electroencephalogram (EEG)
conducted on Luttrell on June 9, 2010.42 The report concluded that the EEG was
normal and there was no brain activity resembling epilepsy.43
Luttrell’s treating physician referred her to the University of Arkansas for
Medical Sciences (UAMS) Neurology Clinic in July of 2010.44 The notes from
Luttrell’s appointment indicate that Luttrell is in no pain, ambulates without difficulty,
has a steady gait and adequate joint function.45 Further, it is noted that Luttrell had
only two syncopal episodes in the past two months, and, apart from some sleepiness,
is tolerating Dilantin, the medication prescribed by her treating physician to address

40

Id. at p. 188.

41

Id.

42

Id. at p. 191.

43

Id.

44

Id. at p. 268.

45

Id. at pp. 257-262.
9

syncopal episodes.46 In his impression, the physician states that the nature of Luttrell’s
syncopal episodes is unclear, and suggests an autonomic/tilt table test be administered
to assess for neurocardiogenic syncope.47 A return appointment was recommended to
be scheduled within two months.48 Luttrell did not return.
In May of 2011, Luttrell sought treatment at a pain center. The May 6, 2011,
note from the pain center puts Luttrell’s pain level at 4 out of 10 and indicates that this
is her usual level of pain.49 She is prescribed multiple medications to address her
pain.50 Notes from the following appointment indicate that the effectiveness of the
drugs has “somewhat improved.”51 One additional medication is prescribed to Luttrell
and two of her medications are refilled.52 As referenced above, during Luttrell’s
subsequent appointment with her treating physician, the physician noted that Luttrell’s
pain was “doing well with meds.”53

46

Id.

47

Id. at p. 262.

48

Id.

49

Id. at p. 348.

50

Id. at p. 351.

51

Id. at p. 343.

52

Id. at p. 345.

53

Id. at p. 385.
10

In her Function Report, Luttrell states that she does laundry and light house
work depending on how she feels.54 She also takes care of pets, prepares her own
meals, watches television every day and talks on the phone with her family and friends
multiple times a day.55 She can walk 150 yards before needing to stop and rest, has no
problems paying attention, and can follow written and spoken instructions very well.56
During the hearing Luttrell testified that although she can start laundry and put dishes
in the dishwasher, she “never seem[s] to manage to be able to finish anything.”57
However, she also testified that she has no problems sitting, can walk 15 to 20
minutes, and has little problems lifting, carrying, and picking things up.58 She thinks
she can pick up approximately 10 pounds.59
A reasonable mind would find the above evidence adequate to support the
ALJ’s decision to give little weight to the opinion of Luttrell’s treating physician that
rendered Luttrell unable to perform any work. The medical evidence and testimony

54

Id. at p. 143.

55

Id. at pp. 144-45 & 147.

56

Id. at p. 148.

57

Id. at p. 32.

58

Id. at pp. 33 & 37.

59

Id. at p. 33.
11

of Luttrell regarding daily activities conflict with the treating physician’s medical
source statements.
Opinion of the state consultative medical examiner. Luttrell further asserts
that the ALJ erred in dismissing a portion of the state consultative medical examiner’s
opinion. In light of the medical evidence discussed above, and the assertions made by
Luttrell concerning her abilities, substantial evidence supports the ALJ’s decision to
assign little weight to the opinion.
Following the Mental Diagnostic Evaluation, the state consultative medical
examiner concluded that Luttrell “is not likely to be able to cope with the typical
mental demands of basic work-like tasks,”60 and “does not appear to have the capacity
to complete work-like tasks within an acceptable timeframe.”61 The ALJ rejected this
portion of the state consultative medical examiner’s opinion because it is not
supported by the evidence. The ALJ points out that the medical evidence of record and
Luttrell’s own admissions support a finding that she can perform unskilled work. As
discussed above, the medical records support the determination that Luttrell can
perform sedentary work with the limitations established by the ALJ. Further, Luttrell
maintains that she has no problems paying attention and can follow both written and

60

Id. at p. 291.

61

Id. at p. 292.
12

spoken instructions very well.62 The state consultative medical examiner also found
that Luttrell “is able to communicate and interact in a socially adequate manner,”
“appears to have the capacity to communicate in an intelligible and effective manner,”
“appears to have the ability to attend and sustain concentration on basic tasks,” and
“appear[s] to have the capacity to sustain persistence in completing tasks.”63
Additionally, the record establishes that Luttrell never sought treatment from a mental
health professional. Substantial evidence supports the ALJ’s assignment of little
weight to the above quoted portion of the state consultative medical examiner’s
opinion.
Substitution of medical opinion. Finally Luttrell argues that the ALJ erred in
substituting his opinion for the opinion of physicians in determining the RFC. “Even
though the RFC assessment draws from medical sources for support, it is ultimately
an administrative determination reserved to the Commissioner.”64 The ALJ reviewed
all the medical evidence and made his own RFC determination as required. The
medical records, Luttrell’s own reported activities and abilities, and the opinions

62

Id. at p. 148.

63

Id. at pp. 291-92.

64

20 C.F.R. §§ 416.927(e)(2), 416.946 (2006); Cox v. Astrue, 495 F.3d 614,
619 -620 (8th Cir. 2007).
13

offered by other state agency examiners constitute substantial evidence supporting the
ALJ’s RFC determination.
Conclusion. Substantial evidence supports the ALJ’s decision. The ALJ
made no legal error. For these reasons, the court DENIES Luttrell’s request for
relief (docket entry # 2) and AFFIRMS the Commissioner’s decision.
It is so ordered this 12th day of September, 2014.

___________________________________
UNITED STATES MAGISTRATE JUDGE

14