Watkins v. Social Security Administration
Filing
9
ORDER denying request for relief 1 filed by Pamela Jean Watkins and affirming the Commissioner's decision. Signed by Judge James M. Moody on 8/23/12. (kpr)
IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF ARKANSAS
Pamela Jean Watkins
No. 4:11‐CV‐673‐JMM
Michael J. Astrue, Commissioner,
Social Security Administration
Defendant
ORDER AFFIRMING THE COMMISSIONER’S DECISION
In this case, plaintiff‐claimant Pamela Jean Watkins sought judicial review of
defendant Commissioner Michael J. Astrue’s denial of her application for disability
income benefits (DIB). Watkins asked the court to reverse the Commissioner’s decision
and remand her case to the Social Security Administration (SSA) for the award of
benefits.1 In the alternative, she asked the court to remand this case for further
proceedings. After considering the record, the arguments of the parties, and the
applicable law, this court affirms the Commissioner’s decision.
Scope of judicial review. In reviewing a decision denying an application for
disability benefits, the court must determine whether substantial evidence supports the
Commissioner’s decision and whether the Commissioner made a legal error.2
1
Docket entry # 1.
2
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); Slusser v. Astrue, 557 F.3d 923,
925 (8th Cir. 2009) (stating that the court’s “review of the Commissioner’s denial of
benefits is limited to whether the decision is ‘supported by substantial evidence in the
Substantial evidence is more than a mere scintilla of evidence; it means such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion.3 In
determining whether substantial evidence supports the Commissioner’s decision, the
court must consider evidence that detracts from the Commissioner’s decision as well as
evidence that supports the decision, but the court may not reverse the Commissioner’s
decision simply because substantial evidence supports a contrary decision.4
The disputed issues. The parties do not dispute that Watkins exhausted her
administrative remedies5 or that the Commissioner’s administrative law judge (ALJ)
followed the required five‐step process for determining whether a DIB claimant is
disabled.6 Instead, the parties disagree about the following aspects of the
Commissioner’s decision:
record as a whole’”); Long v. Chater, 108 F.3d 185, 187 (8th Cir. 1997) (“We will uphold
the Commissioner’s decision to deny an 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
See Slusser, 557 F.3d at 925.
4
See Sultan v. Barnhart, 368 F.3d 857, 863 (8th Cir. 2004); Woolf v. Shalala, 3 F.3d
1210, 1213 (8th Cir. 1993).
5
See Anderson v. Sullivan, 959 F.2d 690, 692 (8th Cir. 1992) (stating that “the Social
Security Act precludes general federal subject matter jurisdiction until administrative
remedies have been exhausted” and explaining that the Commissioner’s appeal
procedure permits claimants to appeal only final decisions).
6
See 20 C.F.R. § 404.1520 (setting forth the five‐step sequential evaluation process
used for determining whether a claimant is disabled and entitled to disability benefits).
2
(1) the ALJ’s evaluation of Watkins’s credibility,
(2) the weight given to an examining physician’s opinion, and,
(3) the Commissioner’s consideration of new evidence.
Disputing these matters, Watkins argued that substantial evidence does not support the
Commissioner’s conclusion that she was not disabled. Watkins also maintained the
Commissioner’s decision does not comport with required legal standards.
The Commissioner’s decision. Before applying for disability benefits, Watkins
worked on the assembly line for the IC Corporation bus plant7 in Conway, Arkansas.
Watkins operated a large, ceiling‐suspended drill, drilling holes in bus window frames
and engine covers, and riveting windows into place.8 Watkins worked at the plant for
15 years.9 She lost her job on January 4, 2010, when the plant closed and bus‐assembly
operations moved to Tulsa, Oklahoma.10
The following month, Watkins applied for DIB11 and based disability on
7
SSA record at pp. 44, 160 & 166.
8
Id. at pp. 45 & 166.
9
Id. at p. 176.
10
Watkins initially based her on‐set date on the date the plant closed, but she
amended the date at her hearing to coincide with her last work day in 2009, Dec. 31,
2009. Id. at p, 44.
11
Id. at p. 125.
3
rheumatoid arthritis, osteoarthritis and depression.12 Watkins complained about
headaches, depression, and pain in her arms, neck, and lower back. She reported
getting up every couple of hours at night because of pain.13 Watkins testified that she
lacked grip strength in her right hand and that she could not straighten out the right
hand.14 Although the bus plant closed, Watkins reported that she stopped working
because of her medical condition.15
After considering Watkins’s application, the ALJ determined that despite having
severe impairments—rheumatoid arthritis and a mood disorder16—Watkins had the
residual functional capacity (RFC)17 to perform to perform light work, except that she
could only occasionally climb, balance, crawl, kneel, stoop, crouch, and work
overhead.18 The ALJ determined that Watkins must do work in which interpersonal
contact is incidental to the work performed, the complexity of the tasks is learned and
12
Id. at p. 158.
13
Id. at p. 190.
14
Id. at p. 49.
15
Id. at p. 158.
16
Id. at p. 15.
17
The Commissioner’s regulations define RFC as “the most [the claimant] can still
do despite [the claimant’s] limitations.” 20 C.F.R. § 404.1545(a)(1).
18
SSA record at p. 17.
4
performed by rote with few variables and little judgment involved, and the supervision
is simple, direct, and concrete.19 The ALJ consulted a vocational expert and determined
that there were jobs in the national economy that Watkins could perform. The ALJ
concluded that Watkins was not disabled under the Social Security Act.20 The ALJ’s
decision became the final decision of the Commissioner for the purpose of judicial
review pursuant to 42 U.S.C. § 405(g).
Substantial evidence supports the Commissioner’s decision. The following
substantial evidence supports the Commissioner’s conclusion that Watkins was not
disabled: (1) evidence about arthritis, (2) evidence about depression, and (3) vocational
expert testimony.
Evidence about arthritis. On November 13, 2009, Watkins’s primary care
physician diagnosed Watkins as having polyarticular arthritis.21 Polyarticular arthritis
is a form of rheumatoid arthritis that causes pain and swelling in five or more joints.22
19
Id.
20
Id. at p. 21. To be disabled under the Social Security Act, a claimant must be
“unable to engage in any substantial gainful activity by reason of any medically
determinable physical or mental impairment which can be expected to result in death or
which has lasted or can be expected to last for a continuous period of not less
than twelve months.” 42 U.S.C. § 1382c(a)(3)(A).
21
SSA record at p. 307.
22
4‐14B Courtoom Med. ‐ Pain & Suffering § 14B.03 (explaining that polyarticular
arthritis involves five or more joints; the disease is characterized by joint swelling,
5
Rheumatoid arthritis primarily affects the joints, but the disease can cause problems
throughout the body like inflammation of the blood vessels, bumps in various parts of
the body, lung disease, blood disorders and weakening of the bones.23 The diagnosis of
polyarticular arthritis supports the ALJ’s determination that rheumatoid arthritis is a
severe impairment because, in the later stages of the disease, “inflamed cells release
substances that start destroying bone and cartilage, causing joint deformity, more pain,
and loss of function.”24
Treatment of rheumatoid arthritis focuses on combating inflammation with anti‐
rheumatic drugs and exercising to maintain flexibility and mobility.25 Watkins’s doctor
prescribed anti‐inflammatory drugs26 and encouraged Watkins to exercise.27 After
stiffness and pain”).
23
5 The Gale Encyclopedia of Med. 3787 & 3789 (4th ed.).
24
Id. at 3787. See Mikel A. Rothenberg, MD, Preparing Orthopedic Disability
Cases § 1.09 (characterizing rheumatoid arthritis as “a severe and progressive disease of
the joints that results in a diminished quality of life and in a decreased life expectancy”);
Stedman’s Med. Dictionary 160 (28th ed.) (defining rheumatoid arthritis as “a
generalized disease…which primarily affects connective tissue; arthritis is the dominant
clinical manifestation, involving many joints, especially those of the hands and feet,
accompanied by thickening of articular soft tissue, with extension of synovial tissue
over articular cartilages, which become eroded; the course is variable but often is
chronic and progressive, leading to deformities and disability”).
25
5 The Gale Encyclopedia of Med. 3790 (4th ed.).
26
SSA record at pp. 307 & 377.
27
Id. at pp. 308 & 379.
6
Watkins continued to complain about pain, her doctor prescribed physical therapy.28
The doctor’s treatment notes support the ALJ’s RFC assessment because the notes
documented no complications—no inflammation of the blood vessels, bumps in various
parts of the body, lung disease, blood disorders or weakening of the bones.
A state agency orthopaedist examined Watkins a few months after her doctor
referred her to a physical therapist. The examining orthopaedist observed that Watkins
walked with a slight limp on the right leg.29 The doctor reported that Watkins had a
complete range of motion in the lumbar spine with minimal pain, no acute muscle
spasms, normal reflex and sensation, negative straight leg raises, and no muscle
atrophy.30 The doctor found evidence of arthritis in both hands and all finger joints, but
reported that Watkins could still grip her hand, even though the grip was weak.31 The
doctor found a complete range of motion in the hands, no acute swelling in the knees,
good range of motion in the knees, painful range of motion in right hip, and a complete
range of motion in both shoulders with no pain.32 An Xray of right shoulder was
28
Id. at p. 376.
29
Id. at p. 324.
30
Id. at p. 325.
31
Id.
32
Id.
7
normal.33 An Xray of right hip was normal and showed well‐maintained joint spacing.34
An Xray of right knee was normal.35 The examiner reported that the disease was “still
under control with medications.”36 The examiner’s findings support the ALJ’s
determination that Watkins could do light work, albeit with pain, because the findings
show that Watkins’s disease had not progressed in a degree that severely interfered
with joint movement.37
A state medical consultant reviewed Watkins’s medical records and the
orthopaedist’s report, and opined that Watkins could do light work, with occasional
climbing, balancing, stooping, kneeling, crouching and/or crawling.38 That opinion
supports the Commissioner’s decision because the opinion served as the basis of the
RFC assessment.
Evidence about depression. Nine months after diagnosing polyarticular arthritis,
33
Id.
34
Id.
35
Id.
36
Id.
37
5 The Gale Encyclopedia of Med. 3787 (4th ed.) (explaining that in later stages
of the disease, the bone, articular surfaces of the bones, and ligaments may begin to
erode, severely interfering with movements of the joints).
38
SSA record at p. 331.
8
Watkins’s primary care physician diagnosed Watkins as having depression.39
Depression is a mood disorder.40 Medical studies have associated depression with
rheumatoid arthritis.41 One study explained that “[t]he less mobile and more dependent
patients become, the more depressed they are.”42 The diagnosis of depression supports
the ALJ’s determination that a mood disorder was a severe impairment because
39
Id. at p. 379.
40
Am. Psychiatric Ass’n, Diagnostic & Statistical Manual of Mental Disorders 317
(4th ed.) (classifying depression as a mood disorder).
41
See Tanya Covic, Steven R. Cumming, Julie F. Pallant, Nick Manolios, Paul
Emery, Philip G. Conaghan & Alan Tennant, Depression & Anxiety in Patients with
Rheumatoid Arthritis: Prevalence rates based on a comparison of the Depression, Anxiety &
Stress Scale (DASS) & the Hospital, Anxiety & Depression Scale (HADS), 12 BMC
Psychiatry 6 (2012) (reporting that depression affects between 13% and 20% of people
with rheumatoid arthritis); Mary Margaretten, Laura Julian, Patricia Katz & Edward
Yelin, Depression in patients with rheumatoid arthritis: description, causes & mechanisms, 6
Int’l J. Clinical Rheumatology 617 (2011) (stating that 13% to 42% of patients with
rheumatoid arthritis have major depressive disorder—at least two to four times more
than the general population); Chris Dickens, PhD, Linda McGowan, PhD, David
Clark‐Carter, PhD & Francis Creed, MD, Depression in Rheumatoid Arthritis: A Systematic
Review of the Literature With Meta—Analysis, 64 Psychosomatic Med. (Jan./Feb. 2002), at
52, 52 & 58 (stating that depressive disorder affects between 13% and 17% of patients
with rheumatoid arthritis and reporting that the extent depression flows from pain is
unclear); Ernest T. Robinson, Luis A. Hernandez, W. Carson Dick & W. Watson
Buchanan, Depression in rheumatoid arthritis, J. of the Royal College of Gen. Practitioners
423, 426 (July 1977) (reporting that a medical study showed a significant correlation
between the articular index of joint tenderness, functional impairment and dependence
on others, but not between pain and depression).
42
Ernest T. Robinson, Luis A. Hernandez, W. Carson Dick & W. Watson
Buchanan, Depression in rheumatoid arthritis, J. of the Royal College of Gen. Practitioners
423, 427 (July 1977).
9
depression in rheumatoid arthritis has been “associated with higher levels of disease
activity, pain, fatigue, work disability, health service use but lower treatment
compliance and increased suicide risk and mortality.”43
Untreated major depression can impair a person’s ability to work,44 but
Watkins’s doctor prescribed no treatment for depression. Watkins reported to a state
examining psychologist that she took Zoloft—a psychotropic drug—following the death
of her mother in 2004, and again in 2007,45 but medical records did not confirm that
report. The lack of treatment indicates Watkins exhibited minor symptoms that did not
prevent her from working. When asked whether Watkins could cope with the typical
mental/cognitive demands of basic work‐like tasks, the examining psychologist
responded, “the claimant can cope with the mental demands of basic work tasks. She
43
Tanya Covic, Steven R. Cumming, Julie F. Pallant, Nick Manolios, Paul Emery,
Philip G. Conaghan & Alan Tennant, Depression & Anxiety in Patients with Rheumatoid
Arthritis: Prevalence rates based on a comparison of the Depression, Anxiety & Stress Scale
(DASS) & the Hospital, Anxiety and Depression Scale (HADS), 12 BMC Psychiatry 6 (2012).
See Mary Margaretten, Laura Julian, Patricia Katz & Edward Yelin, Depression in patients
with rheumatoid arthritis: description, causes & mechanisms, 6 Int’l J. Clinical Rheumatology
617 (2011) (reporting that depression increases the risk of mortality and stating that
depression is “an independent risk factor for cardiovascular disease and myocardial
infarction, suicidal ideation and death”).
44
2 The Gale Encyclopedia of Med. 1324‐25 (4th ed.).
45
SSA record at p. 313.
10
was just working two months ago until her plant closed down.”46 This response
indicates Watkins could work.
After reveiwing the examining psychologist’s report, a state consulting physician
opined that Watkins could do work “where interpersonal contact is routine but
superficial, e.g. grocery checker; complexity of tasks is learned by experience, several
variables, uses judgment with limits; supervision required is little for routine but
detailed for non‐routine.”47 That opinion supports the Commissioner’s decision
because the ALJ included those limitations the RFC assessment.
Vocational expert testimony. The vocational expert testified that a person with
Watkins’s RFC could do light, unskilled work.48 As representative jobs, the witness
testified that the person could work as a machine tender, motel maid or assembly
worker.49 The witness estimated that there are 2,599 light, unskilled machine tender
jobs in Arkansas, and 248,177 nationwide; 3,297 motel maid jobs in Arkansas, and
367,779 nationwide; and 11,184 light, unskilled production and assembly worker jobs in
Arkansas, and 657,969 nationwide.50 This testimony supports the ALJ’s determination
46
Id. at p. 319.
47
Id. at p. 342.
48
Id. at p. 63.
49
Id.
50
Id.
11
that Watkins could do other work that existed in significant numbers in the national
economy because it incorporated limitations flowing from Watkins impairments and
because the testified‐to numbers are significant.
The foregoing evidence constituted more than a mere scintilla of evidence. A
reasonable mind would accept this evidence as adequate to support the conclusion that
Watkins was not disabled. For these reasons, the foregoing evidence constitutes
substantial evidence.
The Commissioner’s decision comports with applicable legal standards.
Watkins’s credibility. In determining her RFC, the ALJ found Watkins could
“frequently finger and handle.”51 Watkins complained that substantial evidence does
not support this finding.52 She maintained that she was limited to only occasional
handling and less than sedentary work. She argued that the only evidence
contradicting her testimony about her limitations with fingering and handling was that
of a non‐examining physician.53 This complaint challenges the ALJ’s assessment of
Watkins’s credibility.
An ALJ has a statutory duty “to assess the credibility of the claimant and other
51
Id. at p. 17.
52
Docket entry # 7, p. 4.
53
Id. at p. 5.
12
witnesses.”54 “In assessing a claimant’s credibility, an ALJ must consider all of the
evidence related to the subjective complaints, the claimant’s daily activities,
observations of third parties, and the reports of treating and examining physicians.”55
“The ALJ may discount complaints of pain if they are inconsistent with the evidence as
a whole.”56 A reviewing court “will defer to an ALJ’s credibility finding as long as the
ALJ explicitly discredits a claimant’s testimony and gives a good reason for doing so.”57
Watkins testified that she had problems with gripping and that she had no
strength in her hands.58 She asserted that she could not straighten out her right hand.59
She stated that her hands cramped when writing60 and that she couldn’t carry a gallon
of milk with her left hand.61 She stated that some days she cannot button or zip her
jeans.62 This testimony is important to Watkins’s argument because the vocational
54
Nelson v. Sullivan, 966 F.2d 363, 366 (8th Cir. 1992).
55
McCoy v. Astrue, 648 F.3d 605, 614 (8th Cir. 2011) (citing Polaski v. Heckler, 739
F.2d 1320, 1322 (8th Cir. 1984)).
56
Dunahoo v. Apfel, 241 F.3d 1033, 1038 (8th Cir. 2001).
57
Wildman v. Astrue, 596 F.3d 959, 968 (8th Cir. 2010) (citation omitted).
58
SSA record at p. 49.
59
Id.
60
Id. at p. 50.
61
Id. at p. 52.
62
Id. at p. 53.
13
expert testified that the occupational base for a person who can only occasionally finger
and handle is very limited.63
The ALJ discounted Watkins’s testimony, stating that, “the claimant’s statements
concerning the intensity, persistence and limiting effects of [her] symptoms are not
credible to the extent they are inconsistent with the [RFC]…assessment. Furthermore,
the medical evidence does not fully support the limitations alleged.”64 The ALJ
continued to discuss Watkins’s allegations about her daily activities, her limitations,
and the medical evidence. The ALJ discussed the examining orthopaedist’s finding that
Watkins could still make a grip—although a weak grip—and had a full range of motion
in her hands. The ALJ also observed that Watkins stopped working because her
employer closed, not because of her medical condition. These reasons constitute good
reasons for discrediting Watkins’s testimony about limitations in fingering and
handling.
Nothing in the medical records substantiated Watkins’s allegations. Watkins
reported that she stopped working because of her medical condition, but she lost her
job when the bus plant closed. After the plant closed, Watkins received unemployment
payments. Watkins reported to the examining orthopaedist that “she and her husband
63
Id. at p. 64.
64
Id. at p. 18.
14
both draw unemployment until they find a job.”65 Receiving unemployment benefits
required Watkins to certify that she was able to work.66 Seeking work after the alleged
on‐set date and receiving unemployment benefits undermined Watkins’s credibility.67
The ALJ did not err in assessing Watkins’s credibility.68
Weight given to an examining physician’s opinion. The ALJ gave the examining
orthopaedist’s opinion “great weight.”69 Watkins challenged that assessment. She
complained that the examiner did not consider her employer medical records which
documented 49 clinic visits for right arm pain and 69 visits for left arm pain.70
Nevertheless, she maintained the examiner’s findings supported her allegation of
65
SSA record at p. 325.
66
See Ark. Code Ann. § 11‐10‐507(3) (setting eligibility conditions for
unemployment benefits and including as a condition that the claimant “is unemployed,
is physically and mentally able to perform suitable work, and is available for such
work”).
67
Accord Black v. Apfel, 143 F.3d 383, 387 (8th Cir. 1998) (upholding ALJ’s
credibility assessment which noted that although claimant’s long work history
supported her subjective complaints of disabling pain, the claimant stopped working
because she was laid off, she sought work after her alleged disability on‐set date, and
she received unemployment benefits after her alleged disability on‐set date).
68
Accord Dunahoo v. Apfel, 241 F.3d 1033, 1039 (8th Cir. 2001) (“Seeking work and
working at a job while applying for benefits, are activities inconsistent with complaints
of disabling pain.”).
69
SSA record at p. 20.
70
Docket entry # 7, p. 11.
15
disabling pain.71
“Generally, if a consulting physician examines a claimant only once, his or her
opinion is not considered substantial evidence, especially if the treating physician
contradicts the consulting physician’s opinion.”72 In this case, the treating physician did
not contradict the examining orthopaedist’s opinion. Instead, the examining
orthopaedist opined on an area implicated by Watkins’s allegations.
The Commissioner’s regulations direct the ALJ to “give more weight to the
opinion of a specialist about medical issues related to his or her area of specialty than to
the opinion of a source who is not a specialist.”73 Watkins’s allegations implicated the
musculoskeletal system because Watkins complained about arm, shoulder, leg, hip, and
back pain. An orthopaedist specializes in the musculoskeletal system.74 Watkins had
never been examined by a orthopaedist.
Rather than base a decision on treatment records alone, the ALJ ordered an
71
Id. at p. 8.
72
Charles v. Barnhart, 375 F.3d 777, 783 (8th Cir. 2004).
73
20 C.F.R. § 404.1527(d)(5).
74
Stedman’s Med. Dictionary 1383 (28th ed.) (defining an orthopedist as “[o]ne
who practices orthopaedics”). See id. (defining orthopedics as “[t]he medical specialty
concerned with the preservation, restoration, and development of form and function of
the musculoskeletal system, extremities, spine, and associated structures by medical,
surgical, and physical methods.”).
16
orthopaedic exam to ascertain the scope of Watkins’s medical condition. The examining
orthopaedist provided specific findings about Watkins’s musculoskeletal system. In
doing so, the ALJ fulfilled the duty to fully and fairly develop the record.75 The
examining orthopaedist did not need to review Watkins’s employer medical records
because those records were not relevant to a musculoskeletal examination. The ALJ
properly relied on the orthopaedist’s findings in determining whether Watkins was
disabled.
Notably, Watkins’s treating physician never referred Watkins to specialist.76 A
referral would have evidenced complications or serious symptoms. To the extent that
Watkins relied on years of physical therapy for her shoulders,77 the ALJ limited Watkins
to light work requiring occasional overhead work. To the extent Watkins challenged
the weight given to the consulting physician’s opinion,78 the consulting physician
reviewed Watkins’s medical records and the examining orthopaedist’s report before
75
Barrett v. Shalala, 38 F.3d 1019, 1023 (8th Cir. 1994) (“The ALJ is required to
order medical examinations and tests only if the medical records presented to him do
not give sufficient medical evidence to determine whether the claimant is disabled.”).
76
SSA record at p. 377 (stating on Jan. 7, 2011 that “[i]f she is much improved on
the prednisone, a rheumatology referral may be in order); p. 376 (writing on Feb. 15,
2011, “Will have her doing some physical therapy for 3 weeks then reevaluate.…If no
better after physical therapy, will refer to the orthopedist.”).
77
Docket entry # 7, p. 10.
78
Id. at pp. 8‐9.
17
opining about Watkins’s ability to work. The ALJ did not err.
Consideration of new evidence. During the hearing, Watkins’s attorney
indicated she was trying to obtain a MRI report.79 The attorney submitted the report to
the Appeals Council. Watkins complained that neither the ALJ nor the Appeals Council
considered the MRI report. Watkins maintained the MRI report constituted “material
evidence regarding the objective basis of her allegations of pain and limitation.”80
“Under [the Commissioner’s regulations], if a claimant files additional medical
evidence with a request for review prior to the date of the [Commissioner’s] final
decision, the Appeals Council MUST consider the additional evidence if the additional
evidence is (a) new, (b) material, and (c) relates to the period on or before the date of the
ALJ’s decision.”81 The MRI report was new, relevant and related to the period on or
before the date of the ALJ’s decision because the report documented findings about
Watkins’s lumbar spine before the ALJ’s decision became final.
The record shows the Appeals Council considered the MRI report because the
Appeals Council acknowledged receiving the additional evidence, added the additional
79
SSA record at p. 43.
80
Docket entry # 7, p. 11.
81
Williams v. Sullivan, 905 F.2d 214, 216 (8th Cir. 1990).
18
evidence to the record, stated that it considered the additional information,82 reported
that the new evidence did not provide a basis for changing the ALJ’s decision,83 and
referred to the new evidence in an attachment to its order.84 By doing so, the Appeals
Council complied with the Commissioner’s regulations.85
“Where, as here, the Appeals Council considers new evidence but denies review,
[the real issue is] whether the ALJ’s decision was supported by substantial evidence on
the record as a whole, including the new evidence.”86 The ALJ’s decision in this case
was supported by substantial evidence on the record as a whole, including the MRI
report, because the report provided no basis for questioning the ALJ’s determination.
The report provided no basis for questioning the ALJ’s decision because it
showed that the nerve roots of the lumbar spine had not been compromised. The report
82
SSA record at p. 4
83
Id. at pp. 1‐2.
84
Id. at p. 4.
85
Accord Smith v. Astrue, No. 5:11‐CV‐160‐JLH, 2012 WL 2232264, at *5 (E.D. Ark.
June 15, 2012)(determining that the Appeals Council complied with the Commissioner’s
regulations where the Appeals Council acknowledged receiving the additional
evidence, added the new evidence to the record, stated that it considered the additional
information, determined the evidence did not provide a basis for changing the ALJ’s
decision, and referred to the new evidence in an attachment to its order); Baker v. Astrue,
No. 5:10‐CV‐194‐SWW, 2011 WL 4434530, at *2 (E.D. Ark. Sept. 23, 2011) (same
determination).
86
Davidson v. Astrue, 501 F.3d 987, 990 (8th Cir. 2007).
19
stated, ”Degenerative changes are present but no evidence for mechanical nerve root
impingement.”87 Nerve root impingement occurs when the structural integrity of a
lumbar disc deteriorates. When the nucleus of a disc ruptures and is forced out through
the outer annulus into the spaces between the vertebrae, the forced‐out material may
pressure the nerve roots and surrounding soft tissue, irritating the nerve root and
causing inflammation of the nerve and surrounding soft tissues. This is called nerve
root impingement. When a nerve root is compromised, a person can experience pain in
the lower back and hip that radiates down the back of the thigh, leg numbness, tingling,
and weakness.88 Because the MRI showed no evidence of nerve root impingement, the
report undermined Watkins’s allegation of loss of function, weakness, and pain.
In actuality, the MRI report contributed little in documenting Watkins’s back
problems. The report confirmed the presence of degenerative disc changes in lower
lumbar discs,89 but Watkins’s treating physician had already determined Watkins had
degenerative disc disease.90 Rather substantiate Watkins’s allegation of disabling pain,
the report contradicted her allegation. The Commissioner did not err.
87
SSA record at p. 382.
88
2 The Gale Encyclopedia of Med. 2112 (4th ed.); id. at vol 4, p. 2524.
89
SSA record at p. 382.
90
Id. at pp. 306‐09 & 378‐79.
20
Conclusion. Having determined that substantial evidence supports the
Commissioner’s denial of Watkins’s application, and the Commissioner made no legal
error, the court DENIES Watkins’s request for relief (docket entry # 1) and AFFIRMS the
Commissioner’s decision.
It is so ordered this 23rd day of August, 2012.
____________________________
United States District Judge
21
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