Champlin v. Astrue

Filing 18

ORDER. The decision of the ALJ is reversed. The case is remanded to the Commissioner for proceedings consistent with this order. By Judge R. Brooke Jackson on 01/28/13. (alvsl)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLORADO
Judge R. Brooke Jackson

Civil Action No. 12-cv-00425-RBJ
TAMMI L. CHAMPLIN,
Plaintiff,
v.
MICHAEL J. ASTRUE, Commissioner of Social Security Administration,
Defendant.

ORDER

The Court here reviews the Commissioner’s denial of Tammi L. Champlin’s application
for disability benefits under Titles II and XVI of the Social Security Act. Jurisdiction is proper
under 42 U.S.C. § 405(g).
Facts
Procedural Background
On March 3, 2009 Ms. Champlin filed a Title II application for a period of disability and
disability insurance benefits as well as a Title XVI application for supplemental security income.
R. at 10. In both applications Ms. Champlin alleged a disability onset date of June 1, 2007. Id.
Ms. Champlin met the insured status requirement through March 31, 2010. R. at 12.
Accordingly, the issue is whether Ms. Champlin was disabled between June 1, 2007 and March
31, 2010 (the “relevant period”).
Ms. Champlin’s applications were initially denied on July 15, 2009. She then requested a
hearing before an Administrative Law Judge. The hearing was held via video conference, with
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Ms. Champlin and her attorney appearing in Grand Junction, Colorado and the ALJ presiding
over the hearing from Fargo, North Dakota. Kent Granat, a vocational expert (“VE”), appeared
at the hearing by telephone. On January 24, 2011, ALJ Hallie Larson issued an unfavorable
decision denying Ms. Champlin social security benefits. R. at 7. Ms. Champlin pursued an
internal appeal and provided additional evidence (medical records from the Midwestern
Colorado Mental Health Center dated October 26, 2011 through November 9, 2011 and from Dr.
David Adkisson dated December 18, 2010) in addition to a legal brief. R. at 4. However the
Appeals Council denied her request to review the ALJ’s decision. R. at 1. The present case was
filed on February 17, 2012.
Ms. Champlin
Ms. Champlin was born on September 4, 1967, making her 39 years old on the alleged
onset date and 43 years old at the ALJ hearing. She completed three years of college. Her past
relevant work included accounting clerk, general clerk and human resources clerk. R. at 202.
She last worked on May 29, 2007 in a daycare center. R. at 56. She indicated that her job ended
because she went into the hospital with gestational diabetes and possible preeclampsia. Id. She
had a baby on July 17, 2007. She testified that she did not return to work after that because of
her weight and back pain. R. at 57.
Ms. Champlin, who is five feet six inches tall, weighed approximately 245 pounds on the
date of the hearing, January 7, 2011. R. at 55. However, she had lost 80 pounds between June
2007 and January 2011, due in part to surgery and in part to a reduced appetite. R. at 55-56. Her
weight fluctuated between 285 pounds and 322 pounds during the relevant period. R. at 65.
Ms. Champlin described her medical problems as including degenerative disc disease
with protruding discs, causing back pain that sometimes causes pain between her shoulder blades

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and muscle spasms; occasional left knee pain from her kneecap rubbing against the joint (for
which she had arthroscopic surgery that helped); left leg weakness that turns to numbness after
standing for 15 minutes; and bipolar disorder. R. at 57-60, 63. At the time of the hearing she
was taking Gabapentin and medical marijuana for back pain and Abilify for depression. R. at 57,
65.
In response to the ALJ’s questions, Ms. Champlin testified that her doctor told her to
avoid lifting more than 20 to 30 pounds and to avoid going up and down stairs because of her
back and knee pain. R. at 58. She can walk approximately half a block and sit for approximately
fifteen minutes. R. at 59. Her most comfortable position was lying down or reclining Id. Her
bipolar disorder causes her to lack concentration and to cry a lot, and she is seeing a nurse
practitioner named Carol for that. R. at 59-60. She says she spends her days reclining in a chair
at home. R. at 60. However, she does the cooking, cleaning, laundry, sweeping, vacuuming, and
grocery shopping. Id. She cares for her son’s needs and her own personal needs. R. at 60-61.
Her husband, who does not work outside the home, takes care of the yard and the four dogs. R.
at 56, 61.
Ms. Champlin also told the ALJ that she has no hobbies. She testified that she used to
like to bowl, but that she hasn’t bowled for many years, since she lived in Arizona. That
apparently would have been prior to 2005 when she moved to Colorado. R. at 61-62. She used
to do needlepoint but doesn’t anymore. R. at 61-62. She does spend about two hours a day at
the computer, checking her e-mail, playing games and looking things up. R. at 62. She does not
belong to social groups or do volunteer work. Id.
In response to questions from counsel, Ms. Champlin indicated that although she cooks
dinner, it takes two hours, because she has to sit down about every 15 minutes. R. at 63-64. She

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vacuums once a month and just the living room, which takes half an hour to an hour because she
can’t go very fast. R. at 64. She does the laundry every three weeks. Id. She uses an electric
cart when she does the grocery shopping and has help loading and unloading the car. R. at 6465. In addition to the medical problems she had mentioned, she indicated that she had asthma,
which causes shortness of breath on any exertion. R. at 65. She said that she does not read,
because she can’t concentrate. R. at 66. She does not sleep well. Id. She cannot reach overhead
with any strength. She said that her finger coordination is fine, but she can’t work at a
“typewriter” for any length of time because of back pain which affects her concentration. Id. at
66-67. She says that she has weak balance and has to grab something “all the time” to keep from
falling. Id. at 67. She testified that she is manic and has extra energy maybe twice a month for a
day at a time but otherwise is just depressed. Id. at 68.
Ms. Champlin’s Medical History
Ms. Champlin has seen several doctors in the past few years regarding her numerous
afflictions. She began seeing Stan Adkisson, M.D. (an internal medicine specialist in Delta,
Colorado), in 2005 and continued to see him through April 2009 when her Disability Report was
completed for her disability benefits application and at least twice thereafter. R. 164, 384, 524.
He frequently noted that she suffered from ailments such as obesity, asthma, hypertension,
sciatica, restless leg syndrome, bipolar disorder, depression, sleep apnea, and back pain. R. at
230, 232–34, 385–87, 498, 524.
Ms. Champlin saw was Jacqueline Garrard, M.D. for a vaginal hysterectomy in February
2008. R. at 265. Dr. Garrard encountered some issues during the operation that forced her to
convert the vaginal hysterectomy into a full abdominal hysterectomy. Id. Dr. Garrard’s

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discharge notes show that Ms. Champlin suffered from menometrorrhagia, chronic hypertension,
asthma, sleep apnea, bipolar disorder, morbid obesity, and borderline diabetes mellitus. Id.
Ms. Champlin first visited David Good, M.D. (a psychiatrist) at the Midwestern Colorado
Mental Health Center in Delta, Colorado on August 21, 2008. R. 164, 219. The medical records
indicate that she saw him a total of 11 times between August 2008 and October 2009.

R. at

213-19, 376-80. He diagnosed bipolar disorder, depressed phase, tried different medications,
and noted minimal to some progress over the course of the visits. Each time he graded her risk
level on a one to five scale as “no risk,” although there is no key explaining what this means.
Ms. Champlin saw Steve Padua, M.D. in the emergency department at the Delta
Memorial Hospital on September 19, 2008. Dr. Padua filled out an emergency physician report
that appears to say that Ms. Champlin suffered a knee injury that required arthroscopy while
bowling. R. at 293. The record also appears to indicate that the injury occurred three weeks
earlier. R. at 295.
Douglas Huene, M.D., an orthopedic surgeon, performed a left knee arthroscopy with
debridement on October 13, 2008. R. at 205. The records from two follow-up visits noted no
complaints from Ms. Champlin. The wound was healing nicely, and there was no evidence of
infection. R. at 203–04.
As indicated above, Ms. Champlin filed her disability application on March 3, 2009.
Denise Eschenbaum, DDS disability examiner, referred her to Lynn Holliday, M.D., of
Disability Examination Services, L.L.C. who saw her on June 27, 2009 for a consultative
physical examination. R. 337. Dr. Holliday noted that her chief complaints were left leg
numbness and left knee pain. Id. Dr. Holliday diagnosed her with left leg numbness, left knee

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osteoarthritis, history of bipolar disorder, uncontrolled hypertension, and morbid obesity. R. at
343. Dr. Holliday provided a functional assessment in which she opined that
[t]he number of hours [Ms. Champlin] should be able to stand and walk during a
normal 8-hour workday is about 2 hours. The number of hours she should be able
to sit during a normal 8-hour workday is 8 hours. . . . I would recommend that
she be limited in lifting and carrying no more than 20 pounds. No postural
limitations are recommended at this time. No manipulative limitations are
recommended at this time.
No visual, communicative, or workplace
environmental limitations are recommended at this time.
Id.
On July 14, 2009, James F. Dyde, M.D. a DDS psychiatrist, filled out a form entitled
“Psychiatric Review Technique.” R. at 354. It indicates that he conducted an assessment for the
period June 1, 2007 to July 13 2009, and that included a consultation with Ms. Champlin. R. at
354, 366. He indicated that she had an impairment, specifically “Bipolar DO, depressed,” that
was not severe and that was in remission. R. at 354, 357. His assessment was that this
impairment did not cause any functional limitations on her activities of daily living; social
functioning; maintaining concentration, persistence, or pace; or episodes of decompensation. R.
at 364. He indicated that she was doing well on her psychiatric medications, had normal motor
activity on gross exam, appropriate affect, euthymic (non-depressed) mood, no thought disorder,
and no psychosis. He reported, based on Ms. Champlin’s statements which he deemed to be
“credible,” that she usually starts her day between 8:00 and 10:00 a.m., gets herself in and out of
bed, dresses herself, bathes herself without specified difficulty, drives, cooks, cleans, takes care
of her son, runs errands, prepares meals, and rests in bed. She retires between midnight and 1:00
a.m. R. at 366.

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On July 14, 2009, Ms. Eschenbaum filled out a Physical Residual Functional Capacity
Assessment for Ms. Champlin. R. at 346-53. Ms. Eschenbaum determined that Ms. Champlin
could occasionally lift twenty pounds, frequently lift ten pounds, stand (with normal breaks) at
least two hours in an eight-hour workday, sit (with normal breaks) for about six hours in an
eight-hour day, and pull or push for an unlimited time during the day. R. at 347. Ms.
Eschenbaum said Ms. Champlin had no postural, visual, communicative, environmental, or
manipulative limitations. R. at 348–50.
As indicated above, Ms. Champlin’s disability claim was denied on July 15, 2009. At
Ms. Champlin’s next visit to her psychiatrist, Dr. Good, on August 10, 2009, she told him that
her disability claim had been denied, attributing this to their not paying attention to her physical
problem, i.e., numbness in her left leg. R. at 377. She asked Dr. Good to support her disability
claim on the basis of her bipolar disorder. His record states, “I advised her that I did not feel we
were at a point of declaring her disabled because of that. She clearly was unhappy with my
answer.” Id.
In late 2009 Dr. Huene, the orthopedic surgeon who performed the left knee arthroscopy,
referred her to Wenshu Yu, M.D., a rheumatologist, for evaluation of joint pain, in particular
right wrist pain. Dr. Yu saw her on December 10, 2009. R. at 455, 458. In the History section
of his report, he states,
She used to go bowling on a weekly basis. She noted more pain when she is
bowling… She typically takes 5 aleve on a daily basis, typically after bowling and
also uses vicodin pm for breakthrough pain. She thinks her wrist is worst after
bowling. She has not restricted her bowling activity due to the wrist pain.
R. at 455. Dr. Yu also noted that Ms. Champlin suffered back pain, neurological deficits,
insomnia, and bipolar disorder. R. at 457.

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On March 31, 2010 (the last day of the relevant period) Ms. Champlin saw a nurse
practitioner, Carol Ibach, APRN (Advanced Practice Registered Nurse) at the Mental Health
Center in Delta. R. at 372-75. This is the “Carol” to whom Ms. Champlin referred in her
testimony at the ALJ hearing. She indicated that she had previously seen Dr. Good, and she was
there for a “second opinion.” R. at 372. She noted that she had applied for disability benefits but
had been denied. Id. She mentioned problems with medications; chronic pain related to three
discs; left leg numbness; excessive cleaning; lack of sleep; racing thoughts; and episodes of
depression. Id. She was diagnosed with bipolar disorder and depression. However, the
diagnosis seems to have been done by Stacee Curry, M.A., not by nurse practitioner Ibach. R. at
374. No therapy was provided. The “Treatment Plan” states that “[o]besity is a grave concern”
and indicates that she would begin taking Abilify, which “has the least chance of weight gain,”
for her mental health issues. R. at 375. She saw Ms. Ibach again on April 16, 2010, for bipolar
disorder, chronic leg and back pain, and obesity. Among other things she reported increased
stress from her husband’s lack of a job. R. at 368. The treatment plan was to increase the
Abilify. R. at 370.
On April 21, 2010 Ms. Champlin returned to Dr. Adkisson. She reported that she was not
able to do much with her exercise and weight program because of sciatica. His assessment was
“morbid obesity,” and he indicated that she qualified for bariatric surgery. R. at 384. In May
2010 Ms. Champlin had another (the first being while pregnant in 2007) hernia repair, followed
by debridement of necrotic tissue in May and June 2010, and then panniculectomy surgery on
July 5, 2010. See R. at 415. The latter appears to be the surgery to which Ms. Champlin referred
as a “tummy tuck” at the ALJ hearing. She subsequently received treatment, including surgical
procedures, relating to cellulitis and post-surgical infection. R. at 399-415.

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On December 9, 2010 Dr. Adkisson completed a “Medical Source Statement.” R. 498.
The copy in the record is incomplete, omitting the first of two pages. It is unclear who provided
the form to him or why. He responded to one question on page two, namely, to identify Ms.
Champlin’s primary diagnoses: obesity, hypertension, asthma, depression, chronic low back
pain, history of anemia, and gestational diabetes. Dr. Adkisson added, “I am not qualified to
perform functional evaluation nor to quantify work capacity. Suggest referral to occupational or
physical medicine specialist for this.” Id.
The ALJ denied her disability claim on January 24, 2011. On July 7, 2011 Ms. Champlin
visited Dr. Adkisson again, seeking a determination that she was unable to work. R. at 524. Dr.
Adkisson noted as “subjective” findings that she was having difficulty losing weight and
exercising. Objectively, he reported an “extremely obese female who is lucid and cooperative
[and] [i]n no acute distress. His assessment was hypertension, obesity and mental illness. Id.
His notes state, “I agree in general that she cannot work, but I am not qualified to fill out a form
as to exactly how many minutes and how many pounds she is able to move, lift or exercise. She
will need to see an occupational therapist for this.” Id.
Vocational Expert
During the ALJ hearing, the ALJ posed the following hypothetical to Mr. Granat, the
vocational expert:
[P]lease assume an individual of claimant’s younger age, high school education,
past work experience as you have previously summarized who has the residual
functional capacity to lift up to ten pounds frequently and twenty pounds
occasionally, to sit and stand or walk about six hours each in an eight-hour day
with normal breaks. The individual should never climb ladders, ropes or scaffolds
and only occasionally climb stairs or ramps, balance, stoop, kneel, crouch or
crawl. The individual is limited to understanding, remembering and carrying out
short, simple instructions and interacting appropriately with coworkers and the
general public on a brief and superficial basis.

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R. at 70.
In response, Mr. Granat testified that such a claimant could not perform her three past
relevant jobs that Ms. Champlin had had. Id. However, he expressed the opinion that such an
individual could find and perform other work. For instance, she could work as: an office helper,
with 600 positions open regionally and 51,000 nationally; an electronics worker, with 4,100
positions open regionally and 790,000 nationally; or dye attacher in the semi-conductor industry,
with 3,100 positions open regionally and 612,000 nationally. Id.
The ALJ then posed a second hypothetical, which contained the same facts except that
now the individual “needs an opportunity to alternate positions after thirty minutes and then can
remain working in the next fixed position up to thirty minutes at a time and so on throughout an
eight-hour day.” R. at 71. The vocational expert did not change his answer. Such an individual
would be able to work the same positions as the individual with the limitations of the first
hypothetical. R. at 71.
The ALJ’s Decision
The ALJ followed the five-step sequential evaluation process for determining whether
Ms. Champlin was disabled. At step one, the ALJ found that Ms. Champlin was not engaged in
substantial gainful activity during the relevant period. R. at 12.
At step two, the ALJ found that Ms. Champlin had “the following severe impairments:
left knee osteoarthritis, degenerative disc disease, obesity, and bipolar disorder.” Id. The ALJ
found that these impairments were severe, “because they cause significant limitation in the Ms.
Champlin’s ability to perform basic work activities.” Id. The ALJ noted that Ms. Champlin has
also been diagnosed with MRSA (methicillin-resistant staphylococcus aureus), hypertension, and
asthma. The ALJ did not consider the asthma and hypertension to be severe, because “the record

10

does not establish that they cause significant limitation in Ms. Champlin’s ability to perform
basic work activities.” R. at 13. The ALJ found Ms. Champlin’s MSRA was not severe, because
it did not last for a period of at least 12 months. Id.
At step three, the ALJ found that “the claimant does not have an impairment or
combination of impairments that meets or medically equals one of the listed impairments in 20
CFR Part 404, Subpart P, Appendix 1.” Id.
At step four, the ALJ found the Ms. Champlin had
the residual functional capacity to perform light work . . . with the following
limitations: the claimant can lift up to 20 pounds occasionally and 10 pounds
frequently; the claimant can sit, stand, or walk for 6 hours in an 8 hour workday
with normal breaks; the claimant must be given the opportunity to alternate
between sitting and standing positions every 30 minutes; the claimant cannot be
required to climb ladders, ropes, or scaffolds; the claimant can occasionally climb
ramps or stairs; she can occasionally balance, stoop, kneel, crouch, and/or crawl;
the claimant is limited to understanding, remembering, and carrying out short,
simple instructions; she is limited to brief, superficial interaction with the general
public and coworkers.
R. at 14.
The ALJ indicated that she had considered all symptoms and the extent to which the
symptoms could reasonably be accepted as consistent with the objective medical evidence and
other evidence. R. at 15. She cited Dr. Holliday’s consultative physical examination of June 26,
2009 and Ms. Eschenbaum’s RFC assessment, although she found them to be only “partially
credible.” R. at 17. She noted Dr. Good’s opinions, including his refusal to declare her disabled.
Id. She noted Dr. Dyde’s opinion that her mental limitations were not severe and did not limit
her activities of daily living, etc. Id. She noted that Dr. Adkisson had declined to provide an
evaluation of Ms. Champlin’s functional limitations. R. at 18. She commented that there were
no medical opinions in the record showing a greater set of limitations than those listed in her
RFC assessment. Id.
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With respect to Ms. Champlin’s testimony, the ALJ noted that “she had indicated that she
cooks, cleans, does laundry, sweeps or vacuums, cares for her son, and shops for groceries, but
indicated that all of these activities take her longer to accomplish due to her back and knee
impairments.” R. at 16. She further noted that she takes care of her personal needs, although
bending over to put on socks is painful and uses the computer approximately two hours a day,
but that she had stated that she no longer is able to bowl or cross-stitch. R. at 16.
Summing up her findings regarding Ms. Champlin’s description of her problems, the ALJ
stated:
After careful consideration of all the evidence, the undersigned finds that the
claimant’s medically determinable impairments could reasonably be expected to
cause the alleged symptoms; however, the claimant’s statements concerning the
intensity, persistence, and limiting effects of these symptoms are not credible to
the extent they are inconsistent with the above residual functional capacity
assessment.
R. at 16.
At step five, the ALJ concluded that “[c]onsidering the claimant’s age, education, work
experience, and residual functional capacity, there are jobs that exist in significant numbers in
the national economy that the Ms. Champlin can perform.” Id. In making this determination, the
ALJ relied on the testimony of the vocational expert, Mr. Granat.
Conclusions
Plaintiff argues that the ALJ failed to properly (1) evaluate the opinions of several of Ms.
Champlin’s treating physicians and nurse practitioner Ibach; (2) consider Ms. Champlin’s
subjective complaints of pain and fatigue and assess her credibility; and (3) assess her RFC.
A. Treating Physicians and Nurse Practitioner Ibach.
“Medical opinions are statements from physicians, psychologists and other acceptable
medical sources that reflect judgments about the nature and severity of your impairment(s),
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including your symptoms, diagnoses and prognosis, what you can still do despite your
impairment(s), and your physician and mental restrictions.” 20 C.F.R. § 404.1527(a)(2). See
Mayberry v. Astrue, 461 F. App’x 705, 709–10 (10th Cir. 2012); Watkins v. Barnhart, 350 P.3d
1297, 1300 (10th Cir. 2003). Medical opinions must be considered together with other relevant
evidence. Id. at § 404.1527(b).
A treating physician’s medical opinion is entitled to controlling weight if it is wellsupported by medically acceptable clinical and diagnostic techniques” and is “not inconsistent
with other substantial evidence in the record.” 20 C.F.R. § 416.927(d)(2). See Krauser v.
Astrue, 638 F.3d 1324, 1330 (10th Cir. 2011). However, the physician must have had more than
a fleeting relationship with the claimant. 20 C.F.R. § 416.902. See Doyal v. Barnhart, 331 F.3d
758, 762-63 (10th Cir. 2003).
1. Dr. Adkisson.
Ms. Champlin complains that the ALJ did not discuss Dr. Adkisson’s consistent notation
that she is extremely obese and his opinions that her obesity contributes to other conditions such
as sciatica, degenerative joint disease, back pain, sleep apnea and restless leg syndrome. Dr.
Adkisson treated her over a period of years, and any “medical opinion” he expressed would be
entitled to controlling weight.
In the first place, although the ALJ did not discuss Dr. Adkisson’s specific diagnoses and
treatment as such, her decision reflects that she was well aware of the medical issues for which
he treated Ms. Champlin. She listed obesity as a “severe impairment” caused a significant
limitation in Ms. Champlin’s ability to perform basic work activities. R. at 12. Ms. Champlin’s
obesity and its effects are ubiquitous throughout the medical records, and the decision reflects
that the ALJ was well aware of that. The ALJ also listed degenerative disc disease and left knee

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osteoarthritis (and bipolar disorder) as “severe impairments” that significantly restricted her
ability to work. Id.
An ALJ is not required to discuss every piece of evidence. The ALJ here indicated that
she considered the entire record. Lower tribunals are taken at their word when they say they
have considered a matter. Hackett v. Barnhart, 395 F.3d 1168, 1173 (10th Cir. 2005). Taking
the ALJ’s decision as a whole, I find no basis to conclude that the ALJ did not consider
everything in Dr. Adkisson’s records.
More importantly, however, Dr. Adkisson did not provide a “medical opinion” regarding
what Ms. Champlin could still do despite her impairments or her physical or mental restrictions.
On the contrary, as the ALJ noted, Dr. Adkisson declined to provide an evaluation of Ms.
Champlin’s functional limitations. He indicated that he was not qualified to do so. Plaintiff
notes that when Ms. Champlin went back to Dr. Adkisson on July 7, 2011, seeking a
determination that she was unable to work, his notes indicate that he agreed in general that she
could not work. This visit occurred nearly six months after the ALJ’s decision. Moreover, in the
same note Dr. Adkisson once again indicated that he was not qualified to determine such things
as how many minutes she can work or how many pounds she can life, and that she should see an
occupation therapist for that. A physician’s general opinion that someone can’t work, without
more, is not particularly helpful. The responsibility for deciding the ultimate issue of whether a
claimant is “disabled” or “unable to work” is reserved for the Commissioner. 20 C.F.R. §§
404.1527(e)(1) and 416.927(e)(1). See Mayberry, 461 F. App’x. at 708.
The July 7, 2011 note was provided to the Appeals Council. However, the Appeals
Council did not find it to be a basis to question the ALJ’s decision. For the reasons set forth
above, I agree.

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2. Dr. Huene.
Plaintiff complains that the ALJ did not mention Dr. Huene’s opinion that Ms.
Champlin’s obesity might have a lot to do with her knee problems. Frankly, common sense
would tell one that morbid obesity is not good for one’s knees. In any event, the ALJ was well
aware of both the obesity and the knee issues, as noted above. Dr. Huene’s role in the medical
history was that he performed successful orthopedic surgery on Ms. Champlin’s knee in October
2008. He expressed no opinion concerning her knee issues, either before or after the surgery, or
other medical problems affected such issues as standing, sitting, lifting, mobility, etc. that are
relevant to her ability to work.
Dr. Holliday.
She performed a consultative physical examination. Because she saw Ms. Champlin only
one time, she would not be classified as a treating physician whose opinions would be entitled to
controlling weight. Doyal, 331 F.3d at 763. Nevertheless, Ms. Champlin questions the fact that
the ALJ found Dr. Holliday’s opinion that she can only stand two hours in an eight-hour day
“partially credible.” R. at 17. The ALJ’s conclusion hinged on her requirement that Ms.
Champlin be given the opportunity to alternate between sitting and standing every 30 minutes.
Id. at 14, 17. I agree that some clarification of this finding is appropriate. See infra at 19-20.
Dr. Yu.
Plaintiff also complains that the ALJ did not comment on Dr. Yu’s opinions concerning
Ms. Champlin’s fatigue, insomnia, and back pain. To begin with, Dr. Yu’s relationship with Ms.
Champlin was largely if not entirely limited to his December 10, 2010 evaluation. His
relationship with her appears to be “fleeting,” and as such, would not receive controlling weight.
Doyal, 331 F.3d at 763.

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Dr. Yu saw Ms. Champlin on a referral from Dr. Huene. His notes indicate that he saw
her for evaluation and management of wrist pain. He noted Ms. Champlin’s subjective
complaint of lower back pain, and he noted his impression that she had degenerative disc disease
and joint disease with disc protrusions. The ALJ was well aware of that impairment. Dr. Yu
noted that Ms. Champlin had complained, among other things, about “generalized fatigue” and
“insomnia.” Those notations do not reflect the exercise of medical judgment, nor did Dr. Yu
express any medical opinion as to the effect of fatigue or insomnia on her ability to perform
basic activities required for work.
The record contains relatively little evidence, in comparison to some of Ms. Champlin’s
other issues, about sleep apnea and insomnia. See Adkisson note that Ms. Champlin complained
of sleep apnea, R. at 386; Garrard note that Ms. Champlin suffered from sleep apnea, R. at 265;
Ibach note that Ms. Champlin complained of sleep disturbance, R. at 519; Good note that a
symptom of Ms. Champlin’s depression was insomnia, R. at 219; and Ms. Champlin’s testimony
that she had trouble sleeping. R. at 66. The ALJ said that she considered the entire record. That
would include the brief references to the insomnia and fatigue issues. No health care
professional suggested that these issues would interfere with or limit her ability to do such things
as standing, sitting, lifting, even concentrating, that might be required for work.
Dr. Good and Nurse Practitioner Ibach
Ms. Champlin faults the ALJ for not discussing Dr. Good’s and Nurse Practitioner
Ibach’s comments regarding sleep issues. As indicated, neither they nor any other medical
professional expressed an opinion about the impact of her sleep or fatigue issues on what she
could do in terms of activities relevant to having a job.

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Significantly, the ALJ did note that Dr. Good, the psychiatrist whom Ms. Champlin saw
at the Midwestern Colorado Mental Health Center, declined her request for support with her
disability claim and specifically declined to declare her disabled. The ALJ was well aware of
Ms. Champlin’s bipolar disorder, which was the primary impairment for which Ms. Champlin
was seeing Dr. Good and Ms. Ibach. Moreover, as indicated above, according to the medical
record, the underlying diagnosis on which Ms. Ibach seems to have been relying was apparently
performed by Stacee Curry, M.A. Neither Ms. Ibach nor Ms. Curry expressed any opinions
regarding the effect of Ms. Champlin’s condition on her ability to do the things that might be
required by her work.
B. The ALJ’s Finding Regarding Ms. Champlin’s Credibility.
Ms. Champlin next argues that the ALJ failed properly to assess Ms. Champlin’s
credibility and in doing so failed to properly consider Ms. Champlin’s subjective complaints of
pain and fatigue. Pl. Br. at 28. I do not know whether the ALJ improperly assessed her
credibility or whether she failed adequately to consider her subjective symptoms. I do conclude,
however, that the ALJ did not adequately explain her credibility finding.
An ALJ’s credibility determinations, like those of any finder of fact, are entitled to
substantial deference. Like other findings, however, a credibility determination must have
support in the record. Thus, “findings as to credibility should be closely and affirmatively linked
to substantial evidence and not just a conclusion in the guise of findings.” Huston v. Brown, 838
F.2d 1125, 1133 (10th Cir. 1988). Likewise, the ALJ must consider “subjective pain testimony,
and expressly reflect that consideration in the findings.” Id. The ALJ may consider, among
other things, the objective medical evidence, the claimant’s treatment and medication history,
measures the claimant has taken to alleviate her symptoms, her work history, her daily activities

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and, of course, the claimant’s statements about her impairments, her pain, and the effect of these
things on her capacity to perform work. See generally 20 C.F.R. 404.1529(c).
The ALJ found that “Ms. Champlin’s statements concerning the intensity, persistence and
limiting effects of these symptoms are not credible to the extent they are inconsistent with the
above residual capacity assessment.” R. at 16. Frankly, that does not make much sense. The
RFC is based on the entire record, including the claimant’s statements. In any event, the ALJ’s
conclusion was not linked to any particular evidence. It is, in the words of the Huston court, a
conclusion in the guise of findings.
This is not to say that there is no evidence in the record that might case doubt on Ms.
Champlin’s credibility. It is only to say that the ALJ did not explain her finding other than in
conclusory terms and did not attempt to link the finding to any specific evidence in the record.
That is not enough. Therefore, I conclude that a remand is necessary so that the ALJ can make
and express findings regarding credibility that are linked to specific evidence in the record that
supports the finding.
C. The ALJ’s RFC Determination.
Finally Ms. Champlin argues that the ALJ did not properly assess her RFC. Because the
case is being remanded for further findings, it is premature to address this issue now. However,
it would be helpful to the Court in the event that it might be called upon further to consider this
case if the ALJ could clarify the statement that Ms. Champlin has the residual functional capacity
to “sit, stand, or walk for 6 hours in an 8 hour workday with normal breaks; the claimant must be
given the opportunity to alternate between sitting and standing positions every 30 minutes,” R. at
14, and if she deems it necessary, supplement the record with additional evidence.
Specifically,

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If the ALJ means that the opportunity to alternate positions every 30 minutes would
enable Ms. Champlin to work a complete eight hour day including either (1) sitting for
six of the hours or (2) standing or (3) walking for six of the hours, as the job might
require, then can she point to evidence in the record that she believes supports this
conclusion?
If the ALJ means that the opportunity to alternate positions every 30 minutes would
enable Ms. Champlin to work a complete eight hour day including either (1) sitting for
six of the hours or (2) standing or walking for six of the hours, as the job might require,
then can she point to evidence in the record that she believes supports this conclusion?
If the ALJ did not mean either of those things, then what did she mean, and how does her
finding square with the vocational expert’s testimony which was based on a hypothetical
that assumed that the claimant could “sit and stand or walk about six hours each in an
eight-hour day”? R. at 70 (emphasis added).
Order
The decision of the ALJ is reversed. The case is remanded to the Commissioner for
proceedings consistent with this order.
DATED this 28th day of January, 2013.
BY THE COURT:

___________________________________
R. Brooke Jackson
United States District Judge

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