Mullins v. SSA

Filing 14

MEMORANDUM OPINION & ORDER: 1. Plaintiff's Motion for Summary Judgment 12 is DENIED; 2. Defendant's Motion for Summary Judgment 13 is GRANTED. 3. JUDGMENT in favor of the Defendant will be entered contemporaneously. Signed by Judge Gregory F. VanTatenhove on 2/27/2015.(LC)cc: COR

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF KENTUCKY
CENTRAL DIVISION
LEXINGTON
MELISSA D. MULLINS,
Plaintiff,
V.
CAROLYN COLVIN,
Commissioner of Social Security,
Defendant.

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Civil No. 13-114-GFVT

MEMORANDUM OPINION
&
ORDER

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Plaintiff Melissa D. Mullins brought this action pursuant to 42 U.S.C. § 405(g) to obtain
judicial review of an administrative decision of the Commissioner of Social Security
(Commissioner) denying Mullins’ application for disability insurance benefits (DIB) and
supplemental security income (SSI). The Court, having reviewed the record and for the reasons
set forth herein, will deny Mullins’ Motion for Summary Judgment [R. 12] and grant the
Commissioner’s [R. 13].
I
Mullins protectively filed applications for DIB and SSI on February 7, 2011. [Transcript
(Tr.) 191-94]. She alleges a disability beginning on January 20, 2011, due to Charcot-MarieTooth (CMT) syndrome and severe allergies. [Tr. 229]. Mullins’ applications were denied
initially and upon reconsideration [Tr. 51, 66, 81, 108-121]. Subsequently, at Mullins’ request,
an administrative hearing was conducted before Administrative Law Judge (ALJ) Don C. Paris
on August 21, 2012. [Tr. 156-76]. During the hearing, the ALJ heard testimony from Mullins
and vocational expert (VE) Tina Stambaugh. [Tr. 25-50]. Mullins, who was thirty-seven years

old at the time of the hearing, has a high school education, and she has past relevant work
experience as a cook at a detention center cafeteria and a retail clerk/cashier. [Tr. 229]. Although
the VE testified that Mullins could no longer perform her past work, she found that there are jobs
that exist in significant numbers in the national economy that Mullins could perform, and the
ALJ accepted that testimony. [Tr. 46-50.]
In evaluating a claim of disability, an ALJ conducts a five-step analysis. See 20 C.F.R.
§§ 404.1520, 416.920.1 First, if a claimant is working at a substantial gainful activity, she is not
disabled. 20 C.F.R. § 404.1520(b). Second, if a claimant does not have any impairment or
combination of impairments which significantly limit her physical or mental ability to do basic
work activities, then she does not have a severe impairment and is not disabled. 20 C.F.R. §
404.1520(c). Third, if a claimant’s impairments meet or equal an impairment listed in 20 C.F.R.
Part 404, Subpart P, Appendix 1, she is disabled. 20 C.F.R. § 404.1520(d). Fourth, if a
claimant’s impairments do not prevent her from doing past relevant work, she is not disabled. 20
C.F.R. § 404.1520(e). Fifth, if a claimant’s impairments (considering her residual functional
capacity, age, education, and past work) prevent her from doing other work that exists in the
national economy, then she is disabled. 20 C.F.R. § 404.1520(f).
In this case, at Step 1, the ALJ found that Mullins has not engaged in substantial gainful
activity since January 20, 2011, the alleged onset date. [Tr. 13]. At Step 2, the ALJ found that
1

The Sixth Circuit summarized this process in Jones v. Comm’r of Soc. Sec., 336 F.3d 469 (6th Cir. 2003):
To determine if a claimant is disabled within the meaning of the Act, the ALJ employs a five-step
inquiry defined in 20 C.F.R. § 404.1520. Through step four, the claimant bears the burden of
proving the existence and severity of limitations caused by her impairments and the fact that she is
precluded from performing her past relevant work, but at step five of the inquiry, which is the
focus of this case, the burden shifts to the Commissioner to identify a significant number of jobs in
the economy that accommodate the claimant’s residual functional capacity (determined at step
four) and vocational profile.

Id. at 474 (internal citations omitted).

2

Mullins’ Charcot-Marie-Tooth (CMT) syndrome2 and obesity constituted severe impairments.
[Tr. 13-14]. At Step 3, the ALJ found that Mullins’ impairments did not meet or medically equal
one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix I. [Tr. 14-15]. At Step
4, the ALJ determined that Mullins has the residual functional capacity (RFC) to perform a range
of sedentary work, with limitations. [Tr. 15-17]. The ALJ therefore found that Mullins is unable
to perform any past relevant work. [Tr. 17-18]. However, at Step 5, the ALJ relied on the
testimony of the VE to find that, based on Mullins’ residual functional capacity, there are jobs
that exist in significant numbers in the national economy that Mullins could perform. [Tr. 1819]. Accordingly, on August 21, 2012, the ALJ issued an unfavorable decision, finding that
Mullins was not disabled and was therefore ineligible for DIB and SSI. [Tr. 19]. The Appeals
Council declined to review the ALJ’s decision on March 21, 2013 [Tr. 1-3] and Mullins now
seeks judicial review in this Court.
II
This Court’s review is limited to whether there is substantial evidence in the record to
support the ALJ’s decision. 42 U.S.C. § 405(g); Wright v. Massanari, 321 F.3d 611, 614 (6th
Cir. 2003); Shelman v. Heckler, 821 F.2d 316, 319-20 (6th Cir. 1987). “Substantial evidence” is
“more than a scintilla of evidence but less than a preponderance; it is such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion.” Cutlip v. Sec’y of Health &
Human Servs., 25 F.3d 284, 286 (6th Cir. 1994). The substantial evidence standard “presupposes
that there is a zone of choice within which decision makers can go either way, without

2

CMT syndrome is a genetic nerve disorder that affects peripheral nerves and causes peroneal muscular atrophy,
which leads to weakness in extremities, including legs, ankles, feet, and hands. High foot arching or hammertoes are
early symptoms. [Tr. 14; see also MedLine Plus, U.S. National Library of Medicine, “Charcot-Marie-Tooth
Disease,” available at http://www.nlm.nih.gov/medlineplus/charcotmarietoothdisease.html.]

3

interference from the court.” Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986) (en banc)
(quotes and citations omitted).
In determining the existence of substantial evidence, courts must examine the record as a
whole. Id. (citing Kirk v. Sec’y of Health & Human Servs., 667 F.2d 524, 535 (6th Cir. 1981),
cert. denied, 461 U.S. 957 (1983)). However, courts are not to conduct a de novo review, resolve
conflicts in evidence, or make credibility determinations. Id. (citations omitted); see also Bradley
v. Sec’y of Health & Human Servs., 862 F.2d 1224, 1228 (6th Cir. 1988). Rather, if the
Commissioner’s decision is supported by substantial evidence, it must be affirmed even if the
reviewing court would decide the matter differently, and even if substantial evidence also
supports the opposite conclusion. See Her v. Comm’r of Soc. Sec., 203 F.3d 388, 389-90 (6th
Cir. 1999); see also Casey v. Sec’y of Health & Human Servs., 987 F.2d 1230, 1233 (6th Cir.
1993); Kinsella v. Schweiker, 708 F.2d 1058, 1059 (6th Cir. 1983); Mullen, 800 F.2d at 545.
A
Mullins first argues that ALJ Paris improperly discounted the opinion of her treating
specialist without providing adequate reasons for doing so. “In general, the opinions of treating
physicians are accorded greater weight than those of physicians who examine claimants only
once.” Walters v. Comm’r of Social Sec., 127 F.3d 525, 529-530 (6th Cir. 1997) (citing Kirk v.
Secretary of Health and Human Servs., 667 F.2d 524, 536 (6th Cir. 1981), cert. denied, 461 U.S.
957 (1983)). Under 20 C.F.R. § 404.1527(d)(2), however, a treating source’s opinion on the
issues of the nature and severity of a claimant’s impairments will be given controlling weight
only if it is “well-supported by medically acceptable clinical and laboratory diagnostic
techniques” and is not “inconsistent with other substantial evidence in [the] case record.” Wilson
v. Comm’r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004) (quoting 20 C.F.R. § 404.1527(d)(2)).
4

“If the opinion of a treating source is not accorded controlling weight, an ALJ must apply certain
factors – namely, the length of the treatment relationship and the frequency of examination, the
nature and extent of the treatment relationship, supportability of the opinion, consistency of the
opinion with the record as a whole, and the specialization of the treating source – in determining
what weight to give the opinion.” Id. at 544. Further, an ALJ is required to give “good reasons”
for not giving weight to opinions from the treating physician in a disability determination. 20
C.F.R. § 404.1527(d)(2). The purpose of this requirement is to “let claimants understand the
disposition of their cases,” to “ensure[] that the ALJ applies the treating physician rule,” and to
“permit[] meaningful review of the ALJ’s application of the rule.” Wilson, 378 F.3d at 544
(citing Soc. Sec. Rul. 96-2p, 1996 WL 374188, at *5; Snell v. Apfel, 177 F.3d 128, 134 (2d Cir.
1999); Halloran v. Barnhart, 362 F.3d 28, 32-33 (2d Cir. 2004)); see also Gayheart v. Comm’r
of Social Security, 710 F.3d 365, 376 (6th Cir. 2013).
Dr. Lisa Degnore, an orthopaedic surgeon, is Mullins’ treating specialist. [Tr. 16]. Dr.
Degnore diagnosed Mullins with CMT Syndrome on September 24, 2010. [Tr. 718]. After
conducting foot x-rays, Dr. Degnore noted that Mullins had a “significant deformity” in her right
foot, which was arching and causing her great toe to claw. [Tr. 718-20]. Her notes also indicate
that Mullins said she was experiencing weakness in her hands. [Tr. 718]. Dr. Degnore scheduled
Mullins for surgery to attempt to level the foot so that it could be braced, and she stated in her
treatment notes that, since the disease is progressive in nature, surgery is performed in a
“stepwise fashion” for this disease and Mullins “will definitely have more surgery in her future.”
[Tr. 719-20]. Later, Dr. Degnore stated in a prescription slip dated October 18, 2010: “[Patient]
has new diagnosis of Charcot Marie Tooth Syndrome and is permanently 100% disabled.” [Tr.
723].
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Mullins underwent surgery on April 8, 2011. [Tr. 737-43]. According to Dr. Degnore’s
post-surgery notes, Mullins was “doing well” and the surgery was successful in correcting the
arch and claw toes into a better position. [Tr. 730-31]. She was prescribed physical therapy, a 3D walker, and a knee compression brace or hose. [Tr. 728, 733]. In notes from Mullins’ her final
post-operative follow-up on August 3, 2011, Dr. Degnore reiterated that “[Mullins] has done
well” and advised that additional procedures may be required to enable Mullins to walk “if her
foot tips back again . . . or if the other foot gets worse.” [Tr. 713]. Dr. Degnore also stated that
“[Mullins] is not able to go to work on her feet all day as a cook.” [Tr. 733]. Mullins has not
returned to Dr. Degnore. [Tr. 35].
Dr. Degnore completed medical assessment questionnaire on August 11, 2011. [Tr. 71216]. She opined that that Mullins had functional limitations due to “weakness and deformity [in
her] legs and feet, [as well as] weakness [in her] upper extremities” caused by CMT Syndrome.
[Tr. 715, 712]. Dr. Degnore recommended that Mullins could only lift or carry less than ten
pounds on a frequent basis. [Id.] Mullins could stand or walk for less than two hours in an eighthour workday, and she could sit for four hours in an eight-hour workday. [Id.] Dr. Degnore
opined that Mullins could never perform postural maneuvers such as climbing, balancing,
stooping, and crawling, and she noted that Mullins’ manipulative functions (i.e., reaching,
handling, and feeling, and pushing/pulling) were also affected by her impairments. [Tr. 714].
ALJ Paris afforded Dr. Degnore’s opinions little weight for all periods beyond the acute
healing stages of Mullins’ surgery because her opinion of complete disability was inconsistent
with her own treatment notes. [Tr. 17]. First, he noted that Dr. Degnore’s comments about
Mullins’ ultimate work functionality or disability seen in her prescription pad note or in various
medical records were not controlling and were, instead, a determination that is left to the
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province of the Commissioner. [Tr. 17]. “The responsibility for determining a claimant’s
residual functional capacity rests with the ALJ, not a physician.” Poe v. Comm’r of Soc. Sec.,
342 Fed. App’x 149, 157 (6th Cir. 2009) (citing 20 C.F.R. § 404.1527(e)(1)). As a result, “[n]o
special significance [is] given to opinions of disability, even if they come from a treating
physician.” Id. (citing 20 C.F.R. § 404.1527(e)(3) (2006); SSR96–5: Policy Interpretation Ruling
Titles II and XVI: Medical Source Opinions on Issues Reserved to the Commissioner, 61 Fed.
Reg. 34471, 34473 (Soc. Sec. Admin. July 2, 1996)) (internal quotes omitted). Dr. Degnore’s
statements regarding Mullins’ functionality and ultimate disability cannot be a medical opinion,
but are instead determinations of disability, which is reserved to the Secretary. ALJ Paris
properly refused to give significant weight to those particular comments on this ground.
Even though a treating physician’s opinion on an issue reserved to the Commissioner
does not receive controlling weight, the ALJ must still “explain the consideration given to the
treating source’s opinion(s).” Id. (citing SSR 96–5: Policy Interpretation Ruling Titles II and
XVI: Medical Source Opinions on Issues Reserved to the Commissioner, 61 Fed. Reg. at 34474).
ALJ Paris explained that, although he agreed with Dr. Degnore’s clinical notations that Mullins
could not return to work as a cook, the objective medical evidence from Mullins’ post-operative
progress is inconsistent with Dr. Degnore’s finding of complete disability. [Tr. 17]. ALJ Paris
stated that Dr. Degnore’s findings of “good alignment [of the foot], therapy, bracing and
progressive ambulation” supported an RCF for sedentary exertion. [Id.]
Elsewhere in the decision, ALJ Paris offers specific examples and direct citation to the
record that demonstrate how Dr. Degnore’s functionality opinions are inconsistent with medical
evidence in her own treatment notes. [Tr. 16]. ALJ Paris points out that Dr. Degnore’s clinical
notes state that the surgery was successful in correcting the arch and claw toes into a better
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position. [Tr. 730-31]. He also notes that records from both follow-up appointments state that,
aside from some pain and swelling associated with the acute healing stages from her surgery,
Mullins was “doing well” post-surgery. [Tr. 730-31, 733-34]. Shortly after surgery, Dr. Degnore
noted that Mullins should be able to walk with a 3-D walker and “slowly give up [the] crutches
or cane” that she relied upon in her acute healing stages after surgery. [Tr. 730]. Indeed, the
stated goal of her successful February 2011 surgery and her continued treatment is “to keep the
feet straight so that [Mullins] can walk.” [Tr. 733]. Her treatment notes demonstrate that –
contrary to Dr. Degnore’s comments about a total disability – Mullins is capable of sedentary
exertion. Moreover, as ALJ Paris indicates in his decision, Dr. Degnore’s treatment relationship
did not continue past the acute healing stages of recovery, so her opinion and treatment notes do
not accurately reflect or predict Mullins’ post-surgery capacity. [See Tr. 17]. ALJ Paris’
explanation, complete with specific examples and direct citation to the record, is sufficiently
detailed to enable Mullins to understand why her treating physician’s opinion was granted little
weight and also to permit judicial review. Wilson, 378 F.3d at 544 ; Hall v. Comm'r of Soc. Sec.,
148 F. App'x 456, 464 (6th Cir. 2005); see also Nelson v. Comm'r of Soc. Sec., 195 F. App'x 462,
470 (6th Cir. 2006). Given the substantial evidence of the record, ALJ Paris was justified in
according little weight to Dr. Degnore for periods after Mullins’ acute healing stage.
B
Mullins’ next argues that this case should be remanded because Dr. David Swan, a state
agency consultative physician to whom the ALJ accorded significant weight, was not a qualified
expert and was unreliable. Dr. Swan is a state agency consultative physician who completed an
RFC assessment on June 1, 2011. [Tr. 71-80]. Projecting his opinion to assess Mullins’ RFC
after full surgical recovery, he opined that Mullins’ maximum sustained work capacity was
8

sedentary exertion, and that she had significant exertional and postural limitations due to what he
considered a “severe impairment in her right foot and a more modest impairment in her left
foot.” [Tr. 62].3
Mullins first claims that Dr. Swan is not a qualified expert specializing in the field of
hereditary motor sensory neuropathy. [Pl.’s Mot. Summ. J., R. 12-1 at 10]. Citing a website
listing Dr. Swan’s practice areas, Mullins argues that Dr. Swan’s qualifications are questionable
since he is a gynecologist, not an orthopaedic surgeon like Dr. Degnore. [Pl.’s Mot. Summ. J., R.
12-1 at 10-11].
“State agency medical and psychological consultants . . . are highly qualified physicians .
. . who are also experts in Social Security disability evaluation,” and whose findings and
opinions the ALJ “must consider . . . as opinion evidence.” Lee v. Comm'r of Soc. Sec., 529 Fed.
Appx. 706, 712 (6th Cir. 2013) (citing 20 C.F.R. § 404.1527(e)(2)(i)); see also Leach v. Comm'r
of Soc. Sec., 2013 U.S. Dist. LEXIS 108858, *39 (E.D. Mich. June 11, 2013); Social Sec. Ruling
96-6p, 1996 SSR LEXIS 3, *4 (1996). An ALJ is required to weigh the opinions of nonexamining sources, including state agency medical consultants, with reference to a number of
factors, “such as the consultant’s medical specialty and expertise in our rules, the supporting
evidence in the case record, supporting explanations the medical or psychological consultant
provides, and any other factors relevant to the weighing of the opinions.” 20 C.F.R.
404.1527(e)(2)(ii). The specialization of a State agency medical consultant may have a bearing
on the weight to which an opinion is entitled. Social Sec. Ruling 96-6p, 1996 SSR LEXIS 3 at
*6. Specifically, the regulations explain that “[the ALJ will] generally give more weight to the
opinion of a specialist about medical issues related to his or her area of specialty than to the
3

Dr. Jack Reed, another state agency consultant, subsequently reached the same opinion in his RFC assessment
dated July 12, 2011. [Tr. 82-94].

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opinion of a source who is not a specialist.” 20 CFR 404.1527(c)(3). The regulations also
require that
The plain language in the regulations states that Dr. Swan, as a state agency medical
consultant, is a qualified physician who is an expert in the area of Social Security disability
evaluations. 20 C.F.R. § 404.1527(e)(2)(i). Moreover, the fact that Dr. Swan is not a specialist
in the particular area at issue is not dispositive. The regulations make clear that state agency
consultant’s specialty – if any – is just one factor that “could have a bearing on the weight to
which [a consultant’s] opinion is entitled.” Social Sec. Ruling 96-6p, 1996 SSR LEXIS 3 at *6
(emphasis added). Here, ALJ Paris’ decision focuses on the most persuasive factors in the
analysis: the consistency and supportability of Dr. Swan’s opinion with the objective medical
evidence in the record. [Tr. 17]. ALJ Paris stated that Dr. Swan’s RFC assessment for
“sedentary activities, with significant postural limitations, and the need to avoid workplace
hazards” was “supported by the overall case record.” [Id.] As has already been explained in
detail above, the RFC determination reflected in Dr. Swan’s opinion is indeed supported by
substantial, objective evidence in the record. The Court will not disturb the ALJ’s reasonable
weighing of the relevant factors in this analysis.
Mullins also argues that remand is warranted since Dr. Swan was the subject of
disciplinary proceedings before Kentucky Board of Medical Licensure in 1996 and, according to
a 1999 Tennessee Court of Appeals opinion,4 testified falsely about the state of his license while
being deposed as an expert witness deposition in a medical malpractice lawsuit filed in 1993.
Though she cites no legal basis for this claim, Mullins ostensibly contends that, in light of this

4

Mullins cites and attaches as an exhibit Sneed v. Stovall, 156 S.W.3d 1, 2004 Tenn. App. LEXIS 201 (Tenn. Ct.
App. 2004) (citing Sneed v. Stovall, 22 S.W.3d 277 (Tenn. Ct. App. 1999)). [R. 12-2].

10

newly submitted evidence, this Court should remand her claim under sentence six of 42 U.S.C. §
405(g).
The Sixth Circuit has long held that evidence submitted “after the ALJ’s decision cannot
be considered part of the record for purposes of substantial evidence review.” Foster v. Halter,
279 F.3d 348, 357 (6th Cir. 2001) (citing Cline v. Comm'r of Social Security, 96 F.3d 146, 148
(6th Cir. 1996)). However, pursuant to sentence six of § 405(g), a district court may remand the
case for further proceedings in light of the new evidence, “but only upon showing that there is
new evidence which is material and that there is good cause for the failure to incorporate such
evidence into the record in a prior proceeding. . . ." Oliver v. Secretary of Health & Human
Services, 804 F.2d 964, 966 (6th Cir. 1986) (citing 42 U.S.C. § 405(g)) (emphasis in original).
The claimant bears the burden of showing that a remand is appropriate. Foster, 279 F.3d at 357.
Mullins implies that Dr. Swan’s past discipline renders him unqualified within the
meaning of 20 C.F.R. 404.1529(b). That regulation states that the medical source “must be
currently licensed . . . [and] must not be barred from participation in [Social Security] programs
under the provisions of 20 C.F.R. 404.1503a, which precludes the use of “any individual . . .
whose license to provide health care services is currently revoked or suspended by any State
licensing authority.” 20 C.F.R. 404.1529(b) (emphasis added); 20 C.F.R. 404.1503a (emphasis
added). But Mullins has not provided any new or material evidence that Dr. Swan currently fails
to meet any of those requirements. Moreover, to the extent Mullins suggests this evidence could
be used for impeachment purposes, such a use is not contemplated in the above-cited factors for
an ALJ’s analysis of a non-examining source, and Mullins has cited no authority allowing such
an unprecedented use. On the facts in her brief, she cannot show that there is “a reasonable
probability that the Secretary would have reached a different disposition of the disability claim if
11

presented with [this] new evidence,” Sizemore v. Sec'y of Health & Human Servs., 865 F.2d 709,
711 (6th Cir. 1988), and remand is not warranted on this ground.
C
Finally, Mullins argues that the state agency consultative physicians’ assessments and the
ALJ’s RFC determination fail to take into account her alleged hand and arm weakness and
numbness resulting from CMT Syndrome. First, Mullins contends that the opinions of state
agency consultative physicians Dr. Swan and Dr. Reed are inconsistent with the record because
they indicate that Mullins has no manipulative limitations, while – according to Mullins – Dr.
Degnore’s treatment notes reflect that “Mullins’ hand [sic] show profound intrinsic weakness.”
[Pl.’s Mot. Summ. J., R. 12-1 at 11]. She also argues that ALJ Paris failed to consider the effect
that CMT Syndrome would have on the use of her hands in an employment setting. [Id. at 11-].
In relevant part, Dr. Degnore’s RFC assessment on August 11, 2011 opined that Mullins’
reaching, handling, feeling, and pushing and pulling were affected by her impairment. [Tr. 713].
Contrary to Mullins’ characterization of Dr. Degnore’s treatment notes, Dr. Degnore’s
notes and the objective evidence in the record as a whole do not document how, if at all, CMT
Syndrome has affected Mullins’ hands. The only fleeting reference to Mullins’ upper extremities
to be found in Dr. Degnore’s clinical notes is Mullins’ subjective statement that she “has noted
some” hand weakness and “has started dropping things.” [Tr. 718]. The rest of Dr. Degnore’s
notes, and indeed, the rest of the relevant portions of the medical record, are focused on Mullins’
foot deformities and lower extremity weakness. Mullins’ surgery was for her foot deformity. [R.
737-43]. The x-rays and studies ordered by Dr. Degnore only pertain to Mullins’ feet, [Tr. 721,
719, 731, 734]. Dr. Degnore did not appear to perform any tests or detailed examination of
Mullins’ hands, and, though prompted to identify the medical findings that supported her
12

manipulative limitations assessment, Dr. Degnore only cited “weakness [at] UE [upper
extremities].” [Tr. 714]. Even the physical therapy prescribed by Dr. Degnore relates only to
Mullins’ lower extremities. [E.g., Tr. 708-10].
Indeed, although Mullins correctly notes that CMT Syndrome can potentially affect all
extremities, including hands,5 the Court’s careful review of the administrative record does not
reveal – and Mullins has not specifically cited – any objective documentation of such an
impairment. Clinic notes, medical tests, and imaging ordered by other doctors also focused on
the impairments in Mullins’ lower extremities – not the upper extremities. For instance, after
ordering a Nerve Conduction Study and Electromyography Report to assess all of Mullins’ nerve
functioning, Dr. Andrew Schneider concluded that she had a “chronic neuropathic process in the
legs,” but found that Mullins’ upper extremities and ulnar nerve conduction studies were “normal
except for mild slowing of median conduction velocity.” [Tr. 495-96]. See, e.g., Tr. 470-71 (xray of foot); Tr. 472 (MRIs of brain, brainstem, and cervical spine requested “due to lower
extremity symptoms”). In fact, elsewhere in the medical record, Dr. Gregory Cooper of the
Baptist Neurology Center noted in June 2010 that, aside from motor responses that were
indicative of carpal tunnel syndrome, “upper extremity nerve studies appeared relatively
normal.” [Tr. 455]. In light of the foregoing, the state agency consultants’ assessments on
Mullins’ manipulative limitations are therefore not inconsistent with the record, and the ALJ did
not err in declining to include Mullins’ alleged upper extremity weakness in his impairment
determination and his RFC determination.

See, e.g., MedLine Plus, U.S. National Library of Medicine, “Charcot-Marie-Tooth Disease,” available at
http://www.nlm.nih.gov/medlineplus/charcotmarietoothdisease.html (cited by ALJ Paris in his decision at [Tr. 1314]).
5

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III
Accordingly, for the foregoing reasons, it is hereby ORDERED as follows:
(1)

Plaintiff’s Motion for Summary Judgment [R. 12] is DENIED;

(2)

Defendant’s Motion for Summary Judgment [R. 13] is GRANTED

(3)

JUDGMENT in favor of the Defendant will be entered contemporaneously

herewith.
This the 27th day of February, 2015.

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