WILLIAMS v. ASTRUE
Filing
15
ORDER: Decision of the Commissioner is AFFIRMED. Clerk directed to enter final judgment and close the file. Signed by MAGISTRATE JUDGE GARY R JONES on 5/10/2013. (jws)
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IN THE UNITED STATES DISTRICT COURT FOR THE
NORTHERN DISTRICT OF FLORIDA
GAINESVILLE DIVISION
ERIC B. WILLIAMS, SR.,
Plaintiff,
v.
CASE NO. 1:12-cv-115-GRJ
CAROLYN W. COLVIN,1
Acting Commissioner of Social Security,
Defendant.
________________________________/
ORDER
Plaintiff appeals to this Court from a final decision of the Commissioner of Social
Security (the “Commissioner”) denying Plaintiff’s application for supplemental security
income pursuant to Title XVI of the Social Security Act (the Act). (Doc. 1.) The
Commissioner has answered, and both parties have filed briefs outlining their
respective positions. (Docs. 7, 13, 14.) The parties have consented to have the
undersigned U.S. Magistrate Judge conduct all proceedings in this case. (Docs. 9, 10.)
For the reasons discussed below, the Commissioner’s decision is due to be
AFFIRMED.
I. PROCEDURAL HISTORY
Plaintiff filed applications for disability insurance benefits and supplemental
security income benefits under Title II and Title XVI of the Social Security Act on August
1
Carolyn W . Colvin becam e the Acting Com m issioner of Social Security on February 14, 2013.
Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Carolyn W . Colvin should be substituted
for Michael J. Astrue as the defendant in this case.
Page 2 of 12
12, 2008 alleging a disability due to bladder cancer, diabetes, and hypertension
beginning April 17, 2008. (R. 129-37.) Plaintiff was 46 years old at the time of his
alleged onset of disability. Plaintiff’s applications were denied initially and upon
reconsideration. (R. 73-79, 84-88.) An administrative hearing was held before an
Administrative Law Judge (“ALJ”) on July 8, 2010. (R. 34-51.) On August 17, 210, the
ALJ issued a written decision finding that Plaintiff was not disabled. (R. 21-29.) The
Appeals Council denied Plaintiff’s request for review on April 11, 2012. (R. 1-3.)
Plaintiff then filed his Complaint in this case on May 30, 2012. (Doc. 1.)
II. STANDARD OF REVIEW
The Commissioner's findings of fact are conclusive if supported by substantial
evidence.2 Substantial evidence is more than a scintilla, i.e., the evidence must do more
than merely create a suspicion of the existence of a fact, and must include such
relevant evidence as a reasonable person would accept as adequate to support the
conclusion.3
Where the Commissioner's decision is supported by substantial evidence, the
district court will affirm, even if the reviewer would have reached a contrary result as
finder of fact, and even if the reviewer finds that the evidence preponderates against
the Commissioner's decision.4 The district court must view the evidence as a whole,
2
See 42 U.S.C. § 405(g) (2000).
3
Foote v. Chater, 67 F.3d 1553, 1560 (11 th Cir. 1995) (citing W alden v. Schweiker, 672 F.2d 835,
838 (11 Cir. 1982) and Richardson v. Perales, 402 U.S. 389, 401, 91 S. Ct. 1420, 28 L. Ed. 2d 842
(1971)); accord, Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11 th Cir. 1991).
th
4
Edwards, 937 F.2d at 584 n.3; Barnes v. Sullivan, 932 F.2d 1356, 1358 (11 th Cir. 1991).
Case No. 1:12-cv-115-GRJ
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taking into account evidence favorable as well as unfavorable to the decision.5
However, the district court will reverse the Commissioner's decision on plenary review if
the decision applies incorrect law, or if the decision fails to provide the district court with
sufficient reasoning to determine that the Commissioner properly applied the law.6
The law defines disability as the inability to do any substantial gainful activity by
reason of any medically determinable physical or mental impairment that can be
expected to result in death, or has lasted or can be expected to last for a continuous
period of not less than twelve months.7 The impairment must be severe, making
Plaintiff unable to do his previous work, or any other substantial gainful activity which
exists in the national economy.8
The ALJ must follow five steps in evaluating a claim of disability.9 First, if a
claimant is working at a substantial gainful activity, he is not disabled.10 Second, if a
claimant does not have any impairment or combination of impairments which
significantly limit his physical or mental ability to do basic work activities, then he does
5
Foote, 67 F.3d at 1560; accord, Lowery v. Sullivan, 979 F.2d 835, 837 (11 th Cir. 1992) (holding
that the court m ust scrutinize the entire record to determ ine reasonableness of factual findings); Parker v.
Bowen, 793 F.2d 1177 (11th Cir. 1986) (finding that the court also m ust consider evidence detracting from
evidence on which the Com m issioner relied).
6
Keeton v. Dep’t Health and Hum an Servs., 21 F.3d 1064, 1066 (11 th Cir. 1994).
7
42 U.S.C. §§ 416(i), 423(d)(1); 20 C.F.R. § 404.1505 (2005) (All further references to 20 C.F.R.
will be to the 2005 version unless otherwise specified.).
8
42 U.S.C. § 423(d)(2); 20 C.F.R. §§ 404.1505-404.1511.
9
20 C.F.R. §§ 404.1520, 416.920. The claim ant has the burden of proving the existence of a
disability as defined by the Social Security Act. Carnes v. Sullivan, 936 F.2d 1215, 1218 (11 th Cir. 1991).
10
20 C.F.R. § 404.1520(b).
Case No. 1:12-cv-115-GRJ
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not have a severe impairment and is not disabled.11 Third, if a claimant's impairments
meet or equal an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1, he is
disabled.12 Fourth, if a claimant's impairments do not prevent him from doing past
relevant work, he is not disabled.13 Fifth, if a claimant's impairments (considering his
residual functional capacity (“RFC”), age, education, and past work) prevent him from
doing other work that exists in the national economy, then he is disabled.14
The burden of proof regarding the plaintiff’s inability to perform past relevant
work initially lies with the plaintiff.15 The burden then temporarily shifts to the
Commissioner to demonstrate that “other work” which the claimant can perform
currently exists in the national economy.16 The Commissioner may satisfy this burden
by pointing to the Medical-Vocational Guidelines (the “Grids”) for a conclusive
11
20 C.F.R. § 404.1520(c).
12
20 C.F.R. § 404.1520(d).
13
20 C.F.R. § 404.1520(e).
14
20 C.F.R. § 404.1520(f).
15
W alker v. Bowen, 826 F.2d 996, 1002 (11th Cir. 1987); see also Doughty v. Apfel, 245 F.
3d 1274, 1278 (11 th Cir. 2001).
16
Doughty, 245 F.3d at 1278 n.2. In Doughty the court explained this burden shifting as follows:
In practice, the burden tem porarily shifts at step five to the Com m issioner. The
Com m issioner m ust produce evidence that there is other work available in significant
num bers in the national econom y that the claim ant has the capacity to perform . In order
to be considered disabled, the claim ant m ust then prove that he is unable to perform the
jobs that the Com m issioner lists. The tem porary shifting of the burden to the Com m issioner
was initiated by the courts, and is not specifically provided for in the statutes or
regulations.) (Internal citations om itted).
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determination that a claimant is disabled or not disabled.17
However, the ALJ should not exclusively rely on the Grids when “the claimant
has a non-exertional impairment which significantly limits his or her basic work skills or
when the claimant cannot perform a full range of employment at the appropriate level of
exertion.”18 In a situation where both exertional and non-exertional impairments are
found, the ALJ is obligated to make specific findings as to whether they preclude a wide
range of employment.19
The ALJ may use the Grids as a framework to evaluate vocational factors so
long as he introduces independent evidence of the existence of jobs in the national
economy that the claimant can perform.20 Such independent evidence may be
introduced by a Vocational Expert’s (“VE”) testimony, but this is not the exclusive
means of introducing such evidence.21 Only after the Commissioner meets this burden
does the burden shift back to the claimant to show that he or she is not capable of
performing the “other work” as set forth by the Commissioner.
III. SUMMARY OF THE RECORD
Because Plaintiff’s challenge on appeal pertains only to his cardiac impairment,
17
W alker, 826 F.2d at 1002 (“[T]he grids m ay com e into play once the burden has shifted to the
Com m issioner to show that the claim ant can perform other work.”).
18
W olfe v. Chater, 86 F.3d 1072, 1077 (11th Cir. 1996). See Jones v. Apfel, 190 F.3d 1224, 1229
(11 Cir. 1999); W alker, 826 F.2d at 1003 (“The grids m ay be used only when each variable on the
appropriate grid accurately describes the claim ant’s situation.”).
th
19
W alker, 826 F.2d at 1003.
20
W olfe, 86 F.3d at 1077-78.
21
See id.
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the summary of the record will focus on that impairment.
A.
Medical Records
Plaintiff was treated at Shands at UF Clinic from January 10, 2007 to February
13, 2009. On visits in October 2007, December 2007, and January 2008, Plaintiff
denied any chest pain. (R. 220, 221, 223.) On May 6, 2008, Plaintiff complained of
some chest pain, and was given a treadmill exercise test. That test was stopped
because of Plaintiff’s altered gait and right arm pain. (R. 238.) Notably, the treating
physician Dr. Ajay Mehta determined that Plaintiff’s “chest pain is not likely cardiac in
origin,” and recommended that if further pain developed, other treatments could be
considered. (R. 241-42.) On May 7, 2008, Plaintiff received myocardial perfusion
testing, and had an ejection fraction of 52%. (R. 372.) The physician’s impression was
that this result was “normal,” and Plaintiff’s “prognosis [was] good.” (R. 372-73.)
Medical records from that same day disclose that Plaintiff had “a history of unstable
angina,” but this statement appears only in Plaintiff’s “history,” not in the physician’s
findings or impressions. (R. 374.) Plaintiff was discharged on May 8, 2008, and the
physician noted that his adenosine thallium test was “normal with a sum stress score of
zero,” Plaintiff’s EKG results were “unremarkable,” and that an upper extremity Doppler
and CT scan did not show any evidence of deep venous thrombosis or thromboembolic disease. (R. 243.) The physician further recommended that Plaintiff consume
a low-fat, low-salt, low-cholesterol diet, but placed no restriction on “bathing or
activities.” (R. 243.) The treatment records of May 6-8, 2008 are the only medical
records in this record disclosing any treatment for any chest pain. There are no other
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records documenting a history of unstable angina or any treatment for this condition.
On August 25, 2008, Plaintiff was treated at Shands HealthCare for abdominal
issues, but was “[n]egative for any chest pain or chest tightness.” (R. 246.) Plaintiff
similarly denied chest pain on a visit to UF Family Practice on November 21, 2008 and
January 16, 2009, and at the Shands Emergency Department on December 26, 2008
and January 31, 2009. (R. 251, 387, 280, 276.)
B.
Hearing Testimony
At his administrative hearing, Plaintiff testified that he last worked in 2006 as a
waterproof specialist. He described his current inability to work as due to stomach pain
as a result of his surgery for bladder cancer. Plaintiff also testified that he experiences
pain from the bag associated with his urinary stoma. He stated that he attempted to
return to his waterpoof specialist position in 2007, but was unable to do so because he
had not been “released” to work. (R. 45.) Plaintiff made no mention that he had been
diagnosed with unstable angina, and he did not testify to any limitations related to that
condition.
David Piue, a vocational expert, testified at the hearing that an individual with
Plaintiff’s RFC could not perform Plaintiff’s past relevant work, but could perform the
following occupations that existed in significant numbers in the regional and national
economies: Gate Guard, Security Guard, and Deliverer/ Car Rental. (R. 48.)
C.
Findings of the ALJ
The ALJ found that the Plaintiff had the following severe impairments: urinary
Case No. 1:12-cv-115-GRJ
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stoma and degenerative joint disease. The ALJ found that Plaintiff’s kidney stones,
diabetes mellitus, hypertension, and history of bladder cancer were non-severe
impairments. The ALJ found that Plaintiff’s severe impairments did not meet or equal
the listings. The ALJ determined that Plaintiff’s RFC was as follows:
[T]he claimant has the residual functional capacity to perform light work
with occasional lifting/ carrying 20 pounds, frequent lifting/ carrying 10
pounds; standing/ walking 6 hours in an 8-hour workday; and sitting 6
hours in an 8-hour workday; with occasional climbing, balancing,
stooping, kneeling, crouching and crawling or bending from the waist.
(R. 24.)
The ALJ found that Plaintiff was unable to perform his past relevant work. The
ALJ found, relying on the testimony of a vocational expert (“VE”), that there were jobs
that existed in substantial numbers in the national economy that Plaintiff could perform.
(R. 29.) These jobs included Gate Guard, Security Guard, and Deliverer/ Car Rental.
(R. 29.) Accordingly, the ALJ found that Plaintiff was not disabled.
IV. DISCUSSION
Plaintiff raises one issue on appeal, whether the ALJ erred in failing to consider
Plaintiff’s unstable angina as a severe impairment at step two. Plaintiff argues that as a
result of this error, the ALJ failed to properly consider the combined effects of all of
Plaintiff’s impairments. (Doc. 13.) For the reasons discussed below, the Court
concludes that the ALJ properly considered all of Plaintiff’s impairments in making a
finding that Plaintiff was not disabled.
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Severity of Impairments
Plaintiff argues that the ALJ erred at step two of the sequential evaluation by not
finding that Plaintiff’s “unstable angina” was a severe impairment, in addition to urinary
stoma and degenerative joint disease.
The Eleventh Circuit, as well as numerous other circuits, have held that step two
of the sequential analysis may do no more than screen out de minimis claims.22 An
impairment or combination of impairments is severe at step two of the sequential
evaluation if it significantly limits a clainant’s physical or mental ability to do basic work
activities.23 To be considered “severe” a medical condition must constitute more than a
“deviation from purely medical standards of bodily perfection or normality.”24
The ALJ is not required to identify all of the impairments that should be
considered severe. See Heatly v. Commissioner of Social Sec., 382 F. App’x 823 (11th
Cir. 2010) (finding harmless error where the ALJ determined the claimant’s only severe
impairment was status-post cervical fusion, despite a separate diagnosis of back pain).
The only requirement at step two is to identify if any severe impairment exists. Id.
(“Nothing requires that the ALJ must identify, at step two, all of the impairments that
should be considered severe.”). Here, the ALJ determined at step two that Plaintiff
suffered from the severe impairments of urinary stoma and degenerative joint disease,
22
Stratton v. Bowen, 827 F.2d 1447, 1453 (11th Cir. 1987); see also Anthony v. Sullivan, 954
F.2d 289, 294-95 (5th Cir. 1992); Bailey v. Sullivan, 885 F.2d 52, 56-57 (3rd Cir. 1989).
23
20 C.F.R. § 404.1520(c).
24
McCruter v. Bowen, 791 F.2d 1544, 1547 (11th Cir. 1986).
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a finding sufficient to satisfy step two.25
It is also clear that the ALJ considered all of Plaintiff’s impairments in
combination, having discussed in detail Plaintiff’s testimony and medical history, which
includes his complaints of stomach pain from his stoma, his history of treatment for
diabetes and non-compliance with his medication, his complaint of chest pain in May
2008 and the ensuing normal test results, his treatment for kidney stones, and his
complaints of pain in the shoulders and knees. The ALJ discussed Plaintiff’s limitations
due to these symptoms, and the diagnoses documented by his treating physicians.
With regard to Plaintiff’s argument that the ALJ should have included “Plaintiff’s
heart problems” as a severe impairment at step two, the record does not evidence any
medical documentation that Plaintiff’s heart problems effected his ability to engage in
basic work skills. As an initial matter – although dispostive of the issue – Plaintiff never
listed unstable angina as a reason for seeking disability benefits in his initial
applications. Moreover, he never even mentioned this condition during his testimony at
the administrative hearing.
The medical records submitted to the ALJ do not evidence that Plaintiff was
diagnosed with or treated for severe heart problems. Rather the medical records
evidence that Plaintiff repeatedly denied any chest pain when treated by physicians in
October 2007, December 2007, January 2008, August 2008, November 2008,
25
Jam ison v. Bowen, 814 F.2d 585, 588 (11th Cir. 1987)(“[w]hether or not it [the im pairm ent]
qualifies as a disability and whether or not it results from a single severe im pairm ent ... is enough to satisfy
the requirem ent of step two.”); Maziarz v. Secretary of Health and Hum an Services, 837 F.2d 240, 244
(6th Cir. 1987).
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December 2008, and January 2009. (R. 220, 221, 223, 251, 387, 280, 276.) The
medical records include only one incident in which Plaintiff complained of chest pain, in
May 2008. Plaintiff’s treating physician administered a treadmill exercise test, an upper
extremity Doppler test, a CT scan, and an adenosine thallium test. The diagnosis and
results of these tests were found to be “unremarkable” and “normal.” (R. 243.) After
examination and review of the test results Dr. Mehta concluded that Plaintiff’s “chest
pain is not likely cardiac in origin.” (R. 241-42.) On May 7, 2008, Plaintiff received
myocardial perfusion testing, and had an ejection fraction of 52%. (R. 372.) The
physician’s impression was that this result was “normal,” and Plaintiff’s “prognosis [was]
good.” (R. 372-73.) Other than Plaintiff’s self reporting comment that he had a history
of unstable angina there is no medical record evidence that Plaintiff was ever
diagnosed by any medical professional with unstable angina, nor are there any
treatment records evidencing that Plaintiff ever received treatment for this condition.
Accordingly, based upon this record the Court has no problem concluding that
the ALJ did not err in his step two determination by not listing heart problems as a
severe condition, and did not err by failing to consider Plaintiff’s impairments in
combination. The Court finds that the ALJ’s determination is supported by substantial
evidence, and therefore the decision of the Commissioner is due to be affirmed.
V. CONCLUSION
In light of the foregoing it is ORDERED that the decision of the Commissioner is
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AFFIRMED. The Clerk is directed to enter final judgment and close the file.
DONE AND ORDERED this 10th day of May 2013.
s/ Gary R. Jones s/GaryR.Jone
GARY R. JONES
United States Magistrate Judge
Case No. 1:12-cv-115-GRJ
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