Prescott v. Commissioner of the Social Security Administration
OPINION AND ORDER RULING ON REPORT AND RECOMMENDATION: This court adopts the Magistrate Judge's Report and Recommendation and incorporates it herein by reference. For the reasons set out hereinabove and in the Report and Recommendation, the Commissioner's final decision of no disability is affirmed. Signed by Honorable Margaret B Seymour on 9/27/2017. (gnan )
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF SOUTH CAROLINA
Erica Anne Prescott,
Nancy A. Berryhill,
Acting Commissioner of Social Security, 1
C/A No. 4:16-cv-01161-MBS
OPINION AND ORDER
This is an action brought pursuant to Section 205(g) of the Social Security Act (the
“Act”), codified as amended at 42 U.S.C. § 405(g), to obtain judicial review of the final decision
of the Commissioner of Social Security (“Commissioner”).
Plaintiff Erica Anne Prescott (“Plaintiff”) protectively filed an application for Disability
Insurance Benefits (“DIB”) on November 4, 2014, alleging disability beginning on March 20,
2011. R. 9. She amended her onset date to April 27, 2013. 2 R. 326. Her application was denied
initially on March 12, 2015, and upon reconsideration on July 10, 2015. Plaintiff requested a
hearing before an administrative law judge (“ALJ”). The ALJ held a hearing on December 10,
Nancy A. Berryhill is now the Acting Commissioner of Social Security Administration and is
hereby substituted for Carolyn W. Colvin, pursuant to Rule 25(d) of the Federal Rules of Civil
Plaintiff’s prior application for DIB benefits was denied on April 26, 2013. After this denial,
Plaintiff amended her onset date to April 27, 2013. R. 9.
2015, at which Plaintiff and a vocational expert testified. R. 9. The ALJ issued a decision dated
January 12, 2016, in which she concluded that Plaintiff was not “disabled” as defined in the
Social Security Act. R. 9-24. Accordingly, the ALJ determined that Plaintiff was not entitled to
disability insurance benefits under Sections 216(i) and 223(d) of the Social Security Act.
Plaintiff filed a request for review of the ALJ’s decision, which was denied by the Appeals
Council on March 9, 2016. R. 1-4. Thus, the decision of the ALJ became the “final decision” of
the Commissioner. Plaintiff thereafter brought this action pursuant to 42 U.S.C. § 405(g),
seeking judicial review.
In accordance with 28 U.S.C. § 636(b) and Local Rule 73.02, D.S.C., this matter was
referred to United States Magistrate Judge Thomas E. Rogers, III for a Report and
Recommendation. On May 23, 2017, the Magistrate Judge filed a Report and Recommendation
in which he recommended that the Commissioner’s decision to deny benefits be affirmed. ECF
No. 21. Plaintiff filed objections to the Report and Recommendation on June 6, 2017. ECF No.
23. The Commissioner filed a response to Plaintiff’s objections on June 15, 2017. ECF No. 25.
This matter now is before the court for review of the Magistrate Judge’s Report and
Recommendation. The court is charged with making a de novo determination of any portions of
the Report to which a specific objection is made. The court may accept, reject, or modify, in
whole or in part, the recommendation made by the Magistrate Judge or may recommit the matter
to the Magistrate Judge with instructions. 28. U.S.C. § 636(b).
STANDARD OF REVIEW
The role of the federal judiciary in the administrative scheme established by the Social
Security Act is a limited one. Section 205(g) of the Act provides that “[t]he findings of the
Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be
conclusive . . . .” 42 U.S.C. § 4059(g). “Substantial evidence has been defined innumerable times
as more than a scintilla, but less than a preponderance.” Thomas v. Celebrezze, 331 F.2d 541,
543 (4th Cir. 1964). This standard precludes a de novo review of the factual circumstances that
substitutes the court’s findings for those of the Commissioner. Vitek v. Finch, 438 F.2d 1157 (4th
Cir. 1971). The court must uphold the Commissioner’s decision as long as it is supported by
substantial evidence. Blalock v. Richardson, 483 F.2d 773, 775 (4th Cir. 1972). “From this it
does not follow, however, that the findings of the administrative agency are to be mechanically
accepted. The statutorily granted right of review contemplates more than uncritical rubber
stamping of the administrative action.” Flack v. Cohen, 413 F.2d 278, 279 (4th Cir. 1969).
“[T]he courts must not abdicate their responsibility to give careful scrutiny to the whole record to
assure that there is a sound foundation for the [Commissioner’s] findings, and that [her]
conclusion is rational.” Vitek, 438 F.2d at 1157-58.
The Commissioner’s findings of fact are not binding if they were based upon the
application of an improper legal standard. Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir. 1987).
However, the Commissioner’s denial of benefits shall be reversed only if no reasonable mind
could accept the record as adequate to support that determination. Richardson v. Perales, 402
U.S. 389, 401 (1971).
Plaintiff was forty-six years old at the time of her hearing before the ALJ regarding her
application for DIB. R. 23. She graduated from college with a BA degree in legal studies. R. 3536. Plaintiff worked as a paralegal until she was laid off in May 2010. R. 36. She then worked as
a substitute teacher until June 2013. R. 243. The ALJ found that Plaintiff had the following
severe impairments: “affective disorder, anxiety disorder, and diffuse disease of connective
tissues,” but “claimant does not have an impairment or combination of impairments that meets or
medically equals the severity of one of the listed impairments in 20 CFR Part 404 Subpart P,
Appendix 1.” R. 11-12. The ALJ found that Plaintiff “has the residual functional capacity to
perform light work as defined in 20 CFR § 404.1567(b) except climb ladders; ropes; scaffolds;
concentrated exposure to extreme cold; and is limited to occasional interaction with the general
public.” R. 14. Lastly, the ALJ found that, even with these limitations, Plaintiff could perform a
number of jobs in the national economy. R. 23-24. Plaintiff asserts specific objections to the
Report and Recommendation. The court will review each of these objections in turn.
A. Objection One: Plaintiff’s Credibility
Plaintiff objects to the Magistrate Judge’s finding that the ALJ properly evaluated
Plaintiff’s credibility and adequately reviewed the record. ECF No. 23 at 1. The ALJ found
[C]laimant’s medically determinable impairments could reasonably be expected to
cause some of the alleged symptoms; however, the claimant’s statements
concerning the intensity, persistence, and limiting effects of these symptoms are
not entirely credible for the reasons explained in this decision.
R. 16. Plaintiff argues that the ALJ’s credibility determination does not take into account the
entire record and gives heavier weight to a few medical visits. ECF No. 23 at 1. Plaintiff claims
that the Magistrate Judge “[f]ails to deal with any of these errors” and improperly finds that
“[t]he ALJ conducted the proper credibility analysis and cited substantial evidence to support her
credibility finding.” ECF No. 23 at 3-4. Plaintiff concedes that “[t]he ALJ discussed the medical
evidence in great detail,” but disputes the weight given to the medical evidence. ECF No. 23 at 4.
Plaintiff alleges that the ALJ gave more weight to scattered medical evidence, without an
explanation for the weight given, that was inconsistent with the totality of the evidence. ECF No.
23 at 4. The court finds Plaintiff’s objection is without merit.
Plaintiff focuses on one medical report that the ALJ claims to have relied on: Plaintiff’s
May 27, 2014, medical visit to Ms. El-Taher. ECF No. 23 at 1-2. The ALJ found Plaintiff’s
statement to Ms. El-Taher that “her quality of life was good, quality of diet was good, and she
exercised frequently [is] inconsistent with her allegations of ongoing symptoms of disabling
severity throughout the relevant period.” R. 16, 361. Plaintiff disputes this conclusion and points
to a letter written by Ms. El-Taher the following day, May 28, 2014, which states, “[Plaintiff]
had very limited use of her hands and has great difficulty with walking.” R. 372. Plaintiff argues
this letter was ignored by the ALJ. ECF No. 23 at 2. After reviewing the record, the court finds
that the ALJ did not ignore but discounted Ms. El-Taher’s medical opinion based upon Plaintiff’s
normal physical examinations throughout the relevant period. See R. 18.
The ALJ reviewed and discussed in detail the ambiguities in the record regarding
Plaintiff’s May 27, 2014, medical visit to Ms. El-Taher, a nurse practitioner at John Hopkins
Community Physicians. R. 17-18, 372. The ALJ found Ms. El-Taher’s opinion was inconsistent
with her own examination of Plaintiff. R. 17-18. As noted above, Ms. El-Taher asserted Plaintiff
had “[v]ery limited use of her hand and great difficulty walking.” R. 372. However, Ms. ElTaher reported Plaintiff had “normal range of motion and strength in limbs with no significant
arthropathy.” R. 18. Furthermore, the ALJ noted the extreme limitations listed in Ms. El-Taher’s
medical opinion were “inconsistent with Plaintiff’s May 2014 statement to Ms. El-Taher that her
quality of life was good and [she] exercised frequently.” R. 18. The ALJ considered Ms. ElTaher’s medical opinion even though Ms. El-Taher is not an “acceptable medical source”
pursuant to 20 CFR § 404.1513(a). R. 18. In concluding, the ALJ found that Ms. El-Taher’s
opinion provided “little insight into the severity of the [Plaintiff’s] impairments and how they
affect her ability to function,” and therefore she accorded little weight to the opinion. R. 18.
Plaintiff further contends the ALJ ignored all other medical evidence from John Hopkins
Community Physicians that documented Plaintiff’s symptoms of mixed connective tissue
disorder. ECF No. 23 at 2. In her objections to the Report and Recommendation, Plaintiff
included examples of ignored medical evidence such as: (1) painful swollen right knee with
locking up and muscle joint pain on October 18, 2013; (2) positive lab results ANA factor,
Heberden’s nodes on finger joints, and tender points on muscles upon exam on October 21,
2013; and (3) difficulty closing her fingers to make a fist on November 15, 2013. ECF No. 23 at
2. The record demonstrates that, overall, the ALJ reviewed Plaintiff’s medical visits of 2013 in
determining Plaintiff’s residual functional capacity. R. 17-18.
Additionally, Plaintiff argues that her symptoms cannot be verified by a physical
examination and multiple blood tests over the years confirm a diagnosis for mixed connective
tissue disease. ECF No. 23 at 3. Plaintiff asserts that her symptoms are consistent with this
disease, which provides a valid explanation for why medical providers believed her symptoms
and limitations. ECF No. 23 at 3. The ALJ noted Plaintiff’s symptoms of mixed connective
tissue disease and found that the disease appeared to respond to treatment. R. 19. In addition, the
ALJ indicated that she “included the restriction against concentrated exposure to extreme cold in
the residual functional capacity based on Dr. Bhargava’s recommendation that [Plaintiff] should
avoid cold exposure.” R. 19. Plaintiff claims the ALJ applied “[h]er own medical judgment in
dismissing both the claimant’s complaints and medical opinions because certain symptoms
cannot be documented by physical examination.” ECF No. 23 at 3.
In making a credibility determination of a claimant’s allegations of pain, the Fourth
Circuit has set forth a two-part test: (1) a plaintiff must make a threshold showing of a
“medically determinable impairment which could reasonably be expected to cause . . . the pain
that the claimant alleges [she] suffers;” and (2) “the intensity and persistence of the claimant’s
pain, and the extent to which it affects [her] ability to work, must be evaluated.” Craig v. Chater,
76 F.3d 585, 594 (4th Cir. 1996) (internal quotations omitted). Under the first prong, the ALJ
acknowledges that Plaintiff’s medically determinable impairments “could reasonably be
expected to cause [Plaintiff’s] alleged symptoms.” R. 16. However, despite Plaintiff’s threshold
showing, the ALJ evaluated Plaintiff’s allegations of pain and found them to be “not entirely
credible.” R. 16. The ALJ compared Plaintiff’s statements with medical evidence and treatment
history from the case record and found inconsistencies. See Felton-Miller v. Astrue, 459 F.
App’x 226, 229 (4th Cir. 2011) (“Factors in evaluating the claimant’s statements include
consistency in the claimant’s statement, medical evidence, medical treatment history, and
adjudicator’s observation of the claimant.”). The ALJ highlighted the following pieces of
evidence as being inconsistent with Plaintiff’s statements: treatment notes showed no more than
mild to moderate abnormalities inconsistent with Plaintiff’s allegations of symptoms of
incapacitating severity; Plaintiff’s condition was improving overall with treatment; numerous
medical reports noted Plaintiff’s medical examinations as generally unremarkable; and adverse
medication side effects were adjusted accordingly. R. 18-20.
It is not the role of this court to review the evidence relied upon by the ALJ and make an
alternative credibility determination; rather, it is the role of this court to determine if the ALJ
relied on substantial evidence in making a credibility determination. See Mastro v. Apfel, 270
F.3d 171, 176 (4th Cir. 2001) (“In reviewing for substantial evidence, the court should not
undertake to re-weigh conflicting evidence, make credibility determinations, or substitute its
judgment for that of the [Commissioner].”).
The record demonstrates that, overall, the ALJ does not ignore Plaintiff’s limitations and
takes these limitations into account at arriving at a recommendation for light work. R. 14.
Moreover, the ALJ’s conclusions are based on more than just her consideration of Plaintiff’s
daily activities, but are also based on the weight of the evidence in medical records and treatment
notes. For example, the ALJ explained little weight was accorded to Ms. El-Taher’s medical
opinion, because her opinion was based on examining the Plaintiff on only one occasion and
examinations showed inconsistency with her report. R. 18. Therefore, the court finds that the
ALJ’s conclusions regarding Plaintiff’s credibility are supported by substantial evidence.
B. Objection Two: Combination of Plaintiff’s Impairments
Plaintiff objects to the Magistrate Judge’s finding that the ALJ considered the
cumulative effect the impairments had on Plaintiff’s ability to work. ECF No. 23 at 10. Plaintiff
argues that the ALJ failed to state how Plaintiff’s “particular combination of impairments
affected her ability to perform work-related activities.” ECF No. 23 at 5. The Magistrate Judge
concedes that the ALJ did not perform this step, but found that the ALJ’s written decision as a
whole reflects she considered the combined effects of Plaintiff’s impairments. ECF No. 21 at 23.
The Magistrate Judge further found that although the ALJ did not mention Plaintiff’s
impairments cumulatively, the ALJ’s decision was harmless error. ECF No. 21 at 23-25. The
court finds no merit in Plaintiff’s objection.
The Fourth Circuit in Walker v. Brown, 889 F.2d 47, 50 (4th Cir. 1989), set the standard
for considering and explaining the combined effect of impairments, stating, “the [ALJ] must
consider the combined effect of a claimant’s impairments and not fragmentize them, . . . [and]
[t]he [ALJ] must adequately explain his or her evaluation of the combined effects of the
impairments.” In interpreting Walker, the court in Brown stated
[T]he adequacy requirement of Walker is met if it is clear from the decision as a
whole that the Commissioner considered the combined effect of a claimant’s
impairments. Most importantly, when multiple impairments are present, this Court
must be satisfied that the Commissioner’s decision regarding disability is not
founded on a fragmentized analysis of those impairments.
2012 WL 3716792 at *6. Brown found that the ALJ’s determination of residual functional
capacity is “key to the analysis” of whether the ALJ considered the combined effect of
impairments. Id. “A finding that [the ALJ’s] analysis here was fragmentized would impose a
standard too strict to remain within the scope of this court’s mission under § 405(g), which
mandates great discretion to the Commissioner.” Brown, 2012 WL 3716792 at *7.
Here, the ALJ went through each alleged impairment and reviewed the medical records.
R. 14-22. The ALJ discussed both Plaintiff’s physical and mental impairments along with
medical evidence in her residual functional determination. R. 14-22. The ALJ noted that each
impairment was either controlled by medications or not as severe as Plaintiff alleged. R. 14-22.
Specifically, the ALJ discussed in detail any conflicting evidence and gave explanations on how
she analyzed that issue. R. 18, 21. The ALJ’s residual functional determination demonstrates that
she considered the combined effects of the impairments, by limiting Plaintiff “to perform light
work . . . except “climb ladders; ropes; or scaffolds; no concentrated exposure to extreme cold;
and by limiting [Plaintiff] to occasional interaction with the general public.” R. 14.
While the ALJ did not explicitly state that she considered Plaintiff’s impairments
cumulatively, the ALJ noted that she considered “all symptoms and the extent to which these
symptoms can reasonably be accepted as consistent with the objective medical evidence, other
evidence . . . [a]nd opinion evidence.” R. 14. The ALJ then proceeded to evaluate both physical
and mental medical records separately and in combination. R. 14-22. The court concludes that
the Magistrate Judge did not err in finding the ALJ’s decision considered Plaintiff’s combination
of impairments and declines to disturb the ALJ’s determination.
After reviewing the entire record, the applicable law, the briefs of counsel, the findings
and recommendations of the Magistrate Judge, and Plaintiff’s objections, this court adopts the
Magistrate Judge’s Report and Recommendation and incorporates it herein by reference. For the
reasons set out hereinabove and in the Report and Recommendation, the Commissioner’s final
decision of no disability is affirmed.
IT IS SO ORDERED.
____s/ Margaret B. Seymour ______
The Honorable Margaret B. Seymour
Senior United States District Judge
Dated: September 27, 2017
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