HUNNICUTT v. COMMISSIONER OF SOCIAL SECURITY

Filing 10

ORDER The parties consented to have a United States Magistrate Judge conduct all proceedings in this case, and as a result, any appeal from this judgment may be taken directly to the Eleventh Circuit Court of App eals in the same manner as an appeal from any other judgment of the United States District Court. Because the ALJ's decision is supported by substantial evidence, the Commissioner's decision in Plaintiffs case is hereby AFFIRMED. Ordered by US MAGISTRATE JUDGE CHARLES H WEIGLE on 03/11/2025. (rka)

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF GEORGIA
MACON DIVISION
J.S.H.,

:
:
Plaintiff,
:
:
v.
:
:
COMMISSIONER
:
OF SOCIAL SECURITY,
:
:
Defendant.
:
___________________________________ :

Case No. 5:23-cv-463-CHW
Social Security Appeal

ORDER
This is a review of a final decision of the Commissioner of Social Security denying Plaintiff
J.S.H.’s application for disability benefits. The parties consented to have a United States
Magistrate Judge conduct all proceedings in this case, and as a result, any appeal from this
judgment may be taken directly to the Eleventh Circuit Court of Appeals in the same manner as
an appeal from any other judgment of the United States District Court. Because the ALJ’s decision
is supported by substantial evidence, the Commissioner’s decision in Plaintiff’s case is hereby
AFFIRMED.
BACKGROUND
Plaintiff applied for Title II disability benefits on August 17, 2020, alleging disability
beginning on March 10, 2018, based on the following impairments: depression, herniated disc,
diabetes, high blood pressure, anxiety, migraines, and right shoulder rotator cuff surgery. (Ex. 1A).
Her date last insured (DLI) was March 31, 2022. (R. 12). After Plaintiff’s applications were denied
initially and on reconsideration at the state agency level of review (Exs. 1A-4A), Plaintiff
requested further review before an administrative law judge (ALJ). The reviewing ALJ held a

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telephonic hearing on April 20, 2023, at which Plaintiff was represented by counsel. (R. 38-58).
The ALJ issued an unfavorable opinion on June 28, 2023. (R. 7-29). Plaintiff’s request for review
of that decision by the Appeals Council was denied on September 27, 2023. (R. 1-6). The case is
now ripe for judicial review. See 42 U.S.C. § 405(g).
STANDARD OF REVIEW
Judicial review of a decision of the Commissioner of Social Security is limited to a
determination of whether that decision is supported by substantial evidence, as well as whether the
Commissioner applied the correct legal standards. Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176,
1178 (11th Cir. 2011). “Substantial evidence” is defined as “more than a scintilla,” and as “such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Id. The
Eleventh Circuit has explained that reviewing courts may not decide the facts anew, reweigh the
evidence, or substitute their judgment for that of the Commissioner. Id. Rather, if the
Commissioner’s decision is supported by substantial evidence, the decision must be affirmed even
if the evidence preponderates against it.
EVALUATION OF DISABILITY
Social Security claimants are “disabled” if they are 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 12 months. 42 U.S.C. § 423(d)(1)(A). To be eligible for benefits, Plaintiff’s
disability must be established prior to her date last insured. See id.
The Social Security Regulations outline a five-step sequential evaluation process for
determining whether a claimant is disabled: “(1) whether the claimant is currently engaged in
substantial gainful activity; (2) whether the claimant has a severe impairment or combination of
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impairments; (3) whether the impairment meets or equals the severity of the specified impairments
in the Listing of impairments; (4) based on a residual functional capacity (“RFC”) assessment,
whether the claimant can perform any of his or her past relevant work despite the impairment; and
(5) whether there are significant numbers of jobs in the national economy that the claimant can
perform given the claimant’s RFC, age, education, and work experience.” Winschel, 631 F.3d at
1178 (citing 20 C.F.R. §§ 404.1520(a)(4)(i)-(v); 416.920(a)(4)(i)-(v)).
MEDICAL RECORD
The record reflects Plaintiff’s treatment with primary care physicians and specialists,
emergency room visits, hospital stays, and consultative exams. As Plaintiff’s challenge in this case
concerns whether the ALJ properly considered medication side effects, this summary focuses on
records where any such side effects would likely have been discussed with or addressed by a
physician during the relevant period. However, the entire record has been reviewed in
consideration of this case.
The record shows that Plaintiff had several prescriptions, including pain medications,
throughout the relevant period. Psychiatric records from August 2018 confirm that Plaintiff was
prescribed hydrocodone for pain. (R. 432). Notes indicate that in September, October, and
December 2018, Plaintiff reported no side effects from her medications, and none were observed
by her provider. (R. 438, 441, 447). In November 2018, she reported seeking emergency treatment
for hallucinations, which an emergency room doctor attributed to the combination of muscle
relaxers and Lunesta. (R. 444); see also (R. 477-485) (corresponding emergency room record
reflecting that Plaintiff had taken Lunesta, Zanaflex, Ultram prior to her arrival at the ER). No
indications of hallucinations were present at the November 2018 appointment. (R. 444).

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Plaintiff received primary care at Internal Medicine Associates of Middle Georgia, (Ex.
4F; R. 619). At an appointment on March 2, 2018, Plaintiff reported worsening chronic low and
mid back pain, for which Tramadol, injections, and physical therapy had been ineffective. (R. 619620). She reported quitting her job as a hairdresser to stay home with her children. (R. 619). Due
to painful cramps, Plaintiff was prescribed Norco and Tramadol in May 2018. (R. 626). Five days
after a July 2018 fall, which fractured her coccyx and for which she went to the ER (R. 527),
Plaintiff was still in significant pain. (R. 629). Plaintiff received another Norco prescription. (R.
630). At her next appointment, Plaintiff noted a recent visit to Emory Spine Center and a physical
therapy recommendation. (R. 631-632). Plaintiff continued to report back pain in February 2019
and admitted she had not done the recommended physical therapy. (R. 641). Tramadol continued
to be ineffective to manage her pain. (Id.) At Plaintiff’s request, another physical therapy referral
was made, but Dr. Goodwin only prescribed a limited amount of Norco tablets until Plaintiff could
be seen at a pain clinic. (R. 642). Plaintiff also reported to the emergency room in February 2019
for thoracic pain. (R. 1827-1833). A shoulder injury in April 2019 led Dr. Goodwin to give Plaintiff
another limited prescription for Norco. (R. 645, 646). A should x-ray showed osteoarthritis on the
shoulder but no fractures. (R. 648).
Plaintiff began treating at a pain clinic in June 2019 for her chronic back pain. (Ex. 5F; see
R. 682). At her initial appointment, Plaintiff had tenderness at T-10 and pain with extension of her
thoracic spine. (R. 680). Notes did not reflect low back pain upon physical examination but
recognized Plaintiff’s history of low back pain. (R. 680-681). A June 2019 MRI of Plaintiff’s
thoracic spine showed no abnormalities. (R. 657). At her second appointment, notes indicated that
while mediations were not working well, Plaintiff reported no side effects from the medication.
(R. 678).

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It is unclear how long Plaintiff reported to the pain clinic as the record only reflects
treatment from June and July 2019. (Ex. 5F). Records from Dr. Goodwin noted that in January
2020, Plaintiff wanted to be weaned off methadone, which she had received from a methadone
clinic over the previous 3 months to ease the effects of quitting Norco. (R. 944). Dr. Goodwin
conferred with the pain clinic, where providers agreed to titrate Plaintiff’s methadone dose. (R.
945). Plaintiff also reported to the ER in January 2020 for cramps and abdominal pain following
her attempts to self-detox from methadone. (R. 1087-1101).
During the relevant period, Plaintiff was admitted in November 2020 to the hospital from
the emergency room for a pelvic abscess and other complications after her hysterectomy. (R. 989
993, 1006; Exs. 9F, 10F). Plaintiff also reported a hospitalization for possible complications from
methadone to Dr. Goodwin (R. 944), but that hospitalization is not documented in the treatment
record before the Court. In February and March 2023, after her DLI, Plaintiff was hospitalized for
complications related to COVID. (Ex. 30F).
The medical record also includes treatment occurring at the end of and after the relevant
period. This includes treatment from Vineville Internal Medicine, whose staff became Plaintiff’s
primary care providers in February 2022. (Exs. 22F, 25F, 29F; R. 1883). Dr. Vaughn also
completed a clinical pain assessment in September 2022, which greatly limited Plaintiff’s
functional limitations. (Ex. 23F).
Consultative Examinations
Dr. Larmia Robbins-Brinson conducted a psychological consultative examination for
Plaintiff in June 2021. (Ex. 11F). At the time of the examination, Plaintiff denied overuse of any
pain medication. (R. 1277). She was not under the care of a mental health professional and received
her mental health medication from her primary care provider. (Id.) Plaintiff drove herself to the

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appointment and explained that she was able to do chores and tasks, including childcare, but that
she easily tired. (R. 1277-1278). Dr. Robbins-Brinson described Plaintiff as having a depressed
mood but a good ability to concentrate. (R. 1278). Dr. Robbins-Brinson did not severely limit
Plaintiff’s abilities to function. See (R. 1279).
In July 2021, Plaintiff saw Dr. Chelukala Reddy for a physical consultative examination.
(Ex. 12F). Plaintiff explained her history of back pain and attempts to treat her pain, including pain
clinic treatment. (R. 1281). She was not taking any prescription pain medication at the time and
had not for one year, but she would take Tylenol for pain. (R. 1281-1282). She showed lumbar
spine tenderness upon physical examination. (R. 1284). Dr. Reddy opined that Plaintiff had no
functional restrictions. (Id.)
Plaintiff’s Testimony Before the ALJ
Plaintiff testified at the April 2023 hearing before the ALJ. At that time, she lived with her
husband and minor children in a one-story house. (R. 42-43, 45). Although she had a valid license,
Plaintiff stated she had not driven in about eight or nine months due to vision issues. (R. 43).
Plaintiff described her past work as a hair stylist and the demands of that position, which her back
conditions prevented her from doing. (R. 43, 46). She was able to bathe herself, but she sometimes
required help getting in and out of the bath. (R. 45). She was able to wash dishes but could not do
laundry because she had trouble bending over and lifting the basket. (R. 45, 52). She tried to cook,
run errands, and do other chores, but often became tired and needed to stop and rest. (R. 45-46).
Her activities and hobbies were limited to watching TV or reading. (R. 46).
Plaintiff described various ailments, such as back pain, rotator cuff surgery, diabetes,
retinopathy, high blood pressure, migraines, and associated complications and limitations. (R. 4652). Plaintiff had been hospitalized a few times, mostly for breathing issues related to COVID,

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such as pneumonia, for which she had been on ventilator. (R. 49-50). Due to remaining issues,
Plaintiff received home health services, but only recently before the hearing. (R. 50). She described
her various prescription medications and testified that she experienced drowsiness and nausea as
side effects, for which she takes Phenergan. (R. 49, 53-54). She explained that the nausea “is
associated more with the migraines” and her stomach issues. (R. 53). Plaintiff severely limited her
ability to stand, sit, and lift. (R. 51-52).
DISABILITY EVALUATION
Following the five-step sequential evaluation process, the reviewing ALJ made the
following findings in this case. At step one, the ALJ found that Plaintiff had not engaged in
substantial gainful activity between March 10, 2018, the alleged onset date, and March 31, 2022,
Plaintiff’s date last insured. (R. 12). At step two, the ALJ found that Plaintiff suffered from a single
severe impairment, degenerative disc disease of the lumbar spine. (R. 13). The ALJ found that
Plaintiff also suffered from right rotator cuff repair, diabetes with proliferative diabetic retinopathy
and decreased vision, hypertension, COVID, migraines, panic disorder, anxiety, and major
depressive disorder, but that these impairments were non-severe. (Id.) At step three, the ALJ found
that Plaintiff did not have an impairment or combination of impairments meeting or medically
equaling the severity of one of the listed impairments. (R. 15). Therefore, the ALJ assessed
Plaintiff’s RFC and determined that Plaintiff was capable of performing light work with the
following exceptions:
[T]he claimant was limited to lifting and/or carrying 20 pounds occasionally and
10 pounds frequently. She could occasionally climb ramps and stairs. Further, the
claimant could frequently balance, kneel, or crawl. She could occasionally stoop or
crouch. Additionally, the claimant could never climb ladders, ropes, or scaffolds.
She could no more than frequently reach overhead with the bilateral upper

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extremities. Finally, the claimant needed to avoid concentrated exposure to fumes,
odors, dusts, gases, poor ventilation, and hazards, such as unprotected heights.
(Id.)
Based on this RFC, the ALJ found at step four that Plaintiff was not capable of performing
any past relevant work. (R. 21). After hearing from a vocational expert, reviewing the record, and
considering Plaintiff’s age, education, work experience, and RFC, the ALJ found that there were
jobs that existed in significant numbers in the national economy that Plaintiff could perform. (R.
21-22). Some of the representative positions noted were routing clerk, housekeeper, and price
marker. (R. 22). Accordingly, the ALJ determined that Plaintiff was not disabled within the
meaning of the Social Security Act at any time during the relevant period within the meaning of
the Social Security Act. (R. 23).
ANALYSIS
Plaintiff challenges the ALJ’s failure to consider the side effects of Plaintiff’s medication
and their impact on her ability to maintain employment. (Doc. 8). Plaintiff urges that these errors
prevent finding that substantial evidence supports the ALJ’s decision. (Id.) For the reasons
discussed below, the ALJ’s decision is supported by substantial evidence because the ALJ
considered and discussed the record-supported limitations on Plaintiff’s ability to work.
An RFC is an assessment based on all the relevant evidence of a claimant’s ability to work
despite her impairments, even if some of those impairments were not deemed severe. 20 C.F.R. §§
404.1545(a)-(b). It is not enough for an ALJ to say that all Plaintiff’s symptoms and medically
determinable impairments were considered for the RFC to be supported by substantial evidence;
the decision must demonstrate that the ALJ did so. Pupo v. Comm’r, Soc. Sec. Admin., 17 F.4th
1054, 1064-1065 (11th Cir. 2021). Here, the ALJ found that Plaintiff was capable of performing
less than the full range of light work with several limitations. (R. 15). Plaintiff argues that the ALJ
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failed to consider Plaintiff’s testimony that her medications caused nausea and dizziness and her
other complaints about drowsiness. (Doc. 8, p. 4). The record does not support this challenge.
In developing the RFC, the ALJ thoroughly discussed the record, which included state
agency physician reviews, medical records, consultative exams, and Plaintiff’s testimony. (R. 1521). The ALJ’s decision specifically recounts Plaintiff’s testimony that she experienced
drowsiness and nausea as side effects of her medication. (R. 16). In finding that Plaintiff’s
subjective symptoms were not entirely consistent with the record, the decision lists all the factors
considered, including “the type, dosage, effectiveness, and side effects of any medication the
claimant takes or has taken to alleviate pain or other symptoms.” (R. 16) (emphasis added). The
ALJ examined Plaintiff’s treatment record, including records past the relevant period that might
establish Plaintiff’s disability, before finding that Plaintiff was not as limited as her subjective
allegations suggested. (R. 15-21).
The ALJ applied the correct legal standards and appropriately considered Plaintiff’s
limitations that were supported by the record. Plaintiff argues that “she regularly complained of
medication side effects” during the relevant period, but she failed to cite to a single doctor’s visit
in over 2300 pages of medical records to support this claim. (Doc. 8, p. 4). While Plaintiff was
often treated for nausea, the nausea was related to migraines, low blood pressure, or stomach ulcers
rather than to medication side effects. See, e.g., (R. 829, 851, 865, 879, 936, 1001, 1033, 1049).
At the hearing, Plaintiff even attributed her nausea more to her migraines and stomach issues than
to her medications. (R. 53). Additionally, as the Commissioner argues, Plaintiff made no
complaints of side effects, nausea, or drowsiness at many visits in the record. (Doc. 10, p. 7). The
Court found only one medical visit that would plausibly support Plaintiff’s testimony about her
side effects: a November 2019 emergency room visit at which Plaintiff reported she had “weakness

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and [was] sleeping a lot on methadone.” (R. 693). This one record alone is not enough to show
that the ALJ failed to consider Plaintiff’s record-supported limitations as whole when the
remaining portions of the record simply fail to support Plaintiff’s suggestion that she suffered
medication side effects that limited her ability to function or work during the relevant period.
Plaintiff cites several cases in support of her argument that the ALJ did not adequately
consider the side effects of Plaintiff’s medications. (Doc. 8, p. 6-7). In those cases, the ALJ either
ignored record supported side effects, 1 misconstrued Plaintiff’s testimony, 2 or ignored a medical
opinion about how the claimant’s medications would affect their ability to work. 3 As discussed
above, the record and the ALJ’s decision in this case are distinguishable from these cases because
Plaintiff’s testimony and report of side effects are not supported anywhere in the record other than
in her subjective reports. The only medical opinion suggesting any limitations due to medication
side effects was from Dr. Vaughn in September 2022 (Ex. 23F), after the relevant period, which
the ALJ appropriately found unpersuasive. (R. 20-21). The cases cited by Plaintiff do not support
remand in this case.
An ALJ is responsible for assessing a claimant’s RFC and needs only to account for
supported limitations, including any side effects that a claimant may experience. See 20 C.F.R. §§
404.1546(c); see, e.g., Burgin v. Comm’r of Soc. Sec. 420 F. App’x 901, 904 (11th Cir. 2011)
(citing Swindle v. Sullivan, 914 F.2d 222, 226 (11th Cir. 1990)). The record here fails to support
Plaintiff’s subjective allegations that she was limited by the side effects of medication. The ALJ
adequately and thoroughly explained the decision, and the RFC and resulting decision are

Lacy v. Barnhart, 309 F. Supp. 2d 1345 (N.D. Ala. Mar. 16, 2004); Thomas v. Barnhart, 2008 WL
822514 (M.D. Ga. Mar. 26, 2008).
2
McDevitt v. Comm’r of Soc. Sec., 241 F. Appx. 615 (11th Cir. 2007); Thomas, 2008 WL 822514.
3
Yates v. Astrue, 2008 WL 1882653 (M.D. Fla. Apr. 24, 2008).
1

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supported by substantial evidence. Based on the foregoing, the Commissioner’s decision is
AFFIRMED.
SO ORDERED, this 10th day of March, 2025.
s/ Charles H. Weigle_________
Charles H. Weigle
United States Magistrate Judge

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