Caustic v. Commissioner of Social Security
Filing
24
OPINION AND ORDER reversing and remanding the decision of the Commissioner. The Clerk of Court is directed to enter judgment consistent with this opinion and, thereafter, to close the file. Signed by Magistrate Judge Douglas N. Frazier on 3/11/2016. (CAS)
UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
TAMPA DIVISION
PRISCILLA ANN CAUSTIC,
Plaintiff,
v.
Case No: 8:14-cv-3105-T-DNF
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
_____________________________
OPINION AND ORDER
Plaintiff, Priscilla Ann Caustic, seeks judicial review of the final decision of the
Commissioner of the Social Security Administration (“SSA”) denying her claim for Disability
Insurance Benefits (“DIB”).
The Commissioner filed the Transcript of the proceedings
(hereinafter referred to as “Tr.” followed by the appropriate page number), and the parties filed a
legal memoranda setting forth their respective positions. For the reasons set out herein, the decision
of the Commissioner is REVERSED AND REMANDED pursuant to § 205(g) of the Social
Security Act, 42 U.S.C. § 405(g).
I.
Social Security Act Eligibility, Standard of Review, Procedural History, Factual
Background and the ALJ’s Decision
A. Social Security Act Eligibility
The law defines disability as the inability to do 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. §§ 416(i), 423(d)(1)(A), 1382(a)(3)(A); 20 C.F.R. §§ 404.1505, 416.905. The
impairment must be severe, making the claimant unable to do her previous work, or any other
substantial gainful activity which exists in the national economy. 42 U.S.C. §§ 423(d)(2),
1382(a)(3); 20 C.F.R. §§ 404.1505-404.1511, 416.905-416.911.
B. Standard of Review
The Commissioner’s findings of fact are conclusive if supported by substantial evidence.
42 U.S.C. § 405 (g). “Substantial evidence is more than a scintilla and is such relevant evidence
as a reasonable person would accept as adequate support to a conclusion. Even if the evidence
preponderated against the Commissioner’s findings, we must affirm if the decision reached is
supported by substantial evidence.” Crawford v. Comm’r, 363 F.3d 1155, 1158 (11th Cir. 2004)
(citing Lewis v. Callahan, 125 F.3d 1436, 1439 (11th Cir. 1997)); Martin v. Sullivan, 894 F.2d
1520, 1529 (11th Cir. 1990). In conducting this review, this Court may not reweigh the evidence
or substitute its judgment for that of the ALJ, but must consider the evidence as a whole, taking
into account evidence favorable as well as unfavorable to the decision. Martin v. Sullivan, 894
F.2d 1329, 1330 (11th Cir. 2002); Foote v. Chater, 67 F.3d 1553, 1560 (11th Cir. 1995). However,
the District Court will reverse the Commissioner’s decision on plenary review if the decision
applied incorrect law, or if the decision fails to provide sufficient reasoning to determine that the
Commissioner properly applied the law. Keeton v. Dep’t of Health & Human Servs., 21 F.3d 1064,
1066 (11th Cir. 1994).
The Court reviews de novo the conclusions of law made by the
Commissioner of Social Security in a disability benefits case. Social Security Act, § 205(g), 42
U.S.C. § 405(g).
The ALJ must follow five steps in evaluating a claim of disability. 20 C.F.R. §§ 404.1520,
416.920. At step one, the claimant must prove that she is not undertaking substantial gainful
employment.
Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001), see 20 C.F.R. §
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404.1520(a)(4)(i). If a claimant is engaging in any substantial gainful activity, she will be found
not disabled. 20 C.F.R. § 404.1520(a)(4)(i).
At step two, the claimant must prove that she is suffering from a severe impairment or
combination of impairments. Doughty, 245 F.3d at 1278, 20 C.F.R. § 1520(a)(4)(ii). If the
claimant’s impairment or combination of impairments does not significantly limit her physical or
mental ability to do basic work activities, the ALJ will find that the impairment is not severe, and
the claimant will be found not disabled. 20 C.F.R. § 1520(c).
At step three, the claimant must prove that her impairment meets or equals one of
impairments listed in 20 C.F.R. Pt. 404, Subpt. P. App. 1; Doughty, 245 F.3d at 1278; 20 C.F.R. §
1520(a)(4)(iii). If she meets this burden, she will be considered disabled without consideration of
age, education and work experience. Doughty, 245 F.3d at 1278.
At step four, if the claimant cannot prove that her impairment meets or equals one of the
impairments listed in Appendix 1, she must prove that her impairment prevents her from
performing her past relevant work. Id. At this step, the ALJ will consider the claimant’s RFC and
compare it with the physical and mental demands of her past relevant work. 20 C.F.R. §
1520(a)(4)(iv), 20 C.F.R. § 1520(f). If the claimant can still perform her past relevant work, then
she will not be found disabled. Id.
At step five, the burden shifts to the Commissioner to prove that the claimant is capable of
performing other work available in the national economy, considering the claimant’s RFC, age,
education, and past work experience. Doughty, 245 F.3d at 1278; 20 C.F.R. § 1520(a)(4)(v). If
the claimant is capable of performing other work, she will be found not disabled. Id.
In
determining whether the Commissioner has met this burden, the ALJ must develop a full and fair
record regarding the vocational opportunities available to the claimant. Allen v. Sullivan, 880 F.2d
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1200, 1201 (11th Cir. 1989). There are two ways in which the ALJ may make this determination.
The first is by applying the Medical Vocational Guidelines (“the Grids”), and the second is by the
use of a vocational expert. Phillips v. Barnhart, 357 F.3d 1232, 1239 (11th Cir. 2004). Only after
the Commissioner meets this burden does the burden shift back to the claimant to show that she is
not capable of performing the “other work” as set forth by the Commissioner. Doughty v. Apfel,
245 F.3d 1274, 1278 n.2 (11th Cir. 2001).
C. Procedural History
Plaintiff filed an application for DIB on July 18, 2011. (Tr. 72). Plaintiff’s application
was denied initially and upon reconsideration. (Tr. 72, 87-88). At Plaintiff’s request a hearing
was held before Administrative Law Judge Richard E. Ouellette (the “ALJ”) on May 2, 2013. (Tr.
32-60). The ALJ thereafter entered a decision finding Plaintiff not disabled on June 21, 2013. (Tr.
14-25). The Appeals Council denied Plaintiff’s request for review on November 13, 2014. (Tr.
1). Plaintiff initiated the instant action by filing a Complaint (Doc. 1) on December 12, 2014. The
parties having filed memoranda of law in support of their positions, this case is ripe for review.
D. Summary of the ALJ’s Decision
At step one of the sequential evaluation, the ALJ found that Plaintiff has not engaged in
substantial gainful activity since April 16, 2009, her amended alleged onset date. (Tr. 16). At step
two, the ALJ found that Plaintiff has the following severe impairments: anemia, adrenal failure,
degenerative disc disease, chronic obstructive pulmonary disease (COPD), emphysema, interstitial
lung disease, rheumatoid arthritis, fibromyalgia, anxiety and depression. (Tr. 16). At step three,
the ALJ found that Plaintiff did not have an impairment or combination of impairments that meets
or medically equals the severity of any of the listed impairments in 20 C.F.R. Part 404, Subpart P,
Appendix 1. (Tr. 16).
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Before proceeding to step four, the ALJ found that Plaintiff had the residual functional
capacity (“RFC”) to
Perform sedentary to light work as defined in 20 CFR 404.1567(b) with
an occasional limitation for bending, stooping, crouching, kneeling, and
climbing but capable of performing routine tasks in an environment with
limited public contact and where she can change position once every hour.
(Tr. 18). At step four, the ALJ found that Plaintiff is unable to perform her past relevant work as
an administrative assistant. (Tr. 23). At step five, the ALJ relied on the testimony of a vocational
expert to find that there are jobs that exist in significant numbers in the national economy that
Plaintiff can perform, namely electronic equipment assembler, hand packer/shoe packer, and office
helper. (Tr. 24). The ALJ concluded that Plaintiff has not been under a disability at any time from
April 16, 2009, through the date of the decision. (Tr. 24).
II.
Analysis
Plaintiff raises two issues on appeal: (1) whether substantial evidence supports the ALJ’s
decision; and (2) whether the ALJ erred by failing to properly evaluate Plaintiff’s fibromyalgia.
As the two issues interrelate, the Court will address them in conjunction below.
Plaintiff argues that many of the ALJ’s findings in this case were not supported by
substantial evidence. (Doc. 20 p. 21). According to Plaintiff, the biggest finding not supported by
substantial evidence was the ALJ’s finding that there was minimal objective evidence to support
Plaintiff’s complaints of disabling pain. (Doc. 20 p. 21). Specifically, Plaintiff argues that the
ALJ completely ignored that Plaintiff’s diagnosis of fibromyalgia supports her level of pain. (Doc.
20 p. 23).
In response, Defendant argues that substantial evidence supports the ALJ’s RFC finding
and step five finding that Plaintiff can perform a significant number of jobs that exist in the national
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economy. (Doc. 21 p. 4, 6). Defendant also argues that the ALJ properly assessed the credibility
of Plaintiff’s subjective complaints. (Doc. 21 p. 8).
As noted above, “[s]ubstantial evidence is more than a scintilla and is such relevant
evidence as a reasonable person would accept as adequate support to a conclusion.” Crawford v.
Comm’r, 363 F.3d 1155, 1158 (11th Cir. 2004) (citing Lewis v. Callahan, 125 F.3d 1436, 1439
(11th Cir. 1997)).
In this case, the Court finds that the ALJ erred by failing to properly consider Plaintiff’s
diagnosis of fibromyalgia. While the ALJ thoroughly summarized Plaintiff’s nearly 1000-page
medical record and explained his findings across five pages in single-spaced paragraphs, the ALJ
nevertheless failed to sufficiently explain his determination to give only partial credence to
Plaintiff’s complaints of pain arising from her diagnosis of fibromyalgia. In his analysis, the ALJ
noted that despite Plaintiff’s chronic subjective complaints of pain and tenderness, objective
findings in the record were limited. (Tr. 20). The Eleventh Circuit, however, has noted that
fibromyalgia’s hallmark is a lack of objective evidence and found that an ALJ errs by determining
that a fibromyalgia claimant’s testimony was incredible based on the lack of objective evidence.
See Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). Where a claimant’s allegation of
disabling impairments due to fibromyalgia are belied by inconsistencies between the claimant’s
daily activities and claims of infirmity, an ALJ does not err by discrediting the claimant’s
subjective complaints. Id.
Here, the ALJ did not specify that he was discrediting Plaintiff’s subjective complaints on
the basis that her claims of impairment due to fibromyalgia were inconsistent with her activities
of daily living or for any other reason specifically. Oddly, despite specifically discussing the
medical record as it pertained to Plaintiff’s complaints of pain in her hips, ankles, knees, back, and
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hands, her adrenal insufficiency, her anemia, her headaches, her complaints of chills, fatigue, and
insomnia, her respiratory impairments, and mental health, the ALJ only mentioned in passing that
Plaintiff has been treated for fibromyalgia. Thus, the ALJ’s analysis implies that Plaintiff’s
subjective complaints were discounted on the basis of the absence of corroborating objective
findings in the medical record. While this may be a sufficient reason to discount a claimant’s
subjective complaints generally, complaints due to fibromyalgia are as special case. The ALJ
erred by discounting Plaintiff’s complaints due to fibromyalgia on the basis of such a lack of
objective evidence.
Defendant contends that the ALJ based his decision on inconsistencies in Plaintiff’s
statements and not solely on the lack of objective evidence. (Doc. 21 p. 8). The only inconsistency
Defendant identifies in its memoranda, however, is that Plaintiff testified at the administrative
hearing that she has headaches three-to-four times per week (Tr. 51), but less than two months
earlier she had reported to a doctor that she was not having headaches. (Tr. 1116). The Court
finds this alleged inconsistency insufficient to constitute substantial evidence to support the ALJ’s
decision to discredit Plaintiff’s complaints due to fibromyalgia, especially given that
fibromyalgia’s symptoms vary in severity over time and may be absent some days. See Social
Security Ruling 12-2p.
Upon remand, the Court will require the ALJ to analyze Plaintiff’s complaints of disabling
pain due to fibromyalgia and specifically articulate his reasons for finding such complaints less
than credible, if the ALJ so finds.
III.
Conclusion
The decision of the Commissioner is REVERSED AND REMANDED. The Clerk of the
Court is directed to enter judgment consistent with this opinion and, thereafter, to close the file.
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DONE and ORDERED in Fort Myers, Florida on March 11, 2016.
Copies furnished to:
Counsel of Record
Unrepresented Parties
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