Hargis v. Social Security Administration

Filing 21

MEMORANDUM OPINION OF THE COURT & ORDER re 15 First MOTION for Judgment on the Record filed by Cynthia Ann Hargis. In light of the foregoing, Hargis's Motion for Judgment on the Administrative Record (Doc. No. 15) is DENIED and the decision of the ALJ is AFFIRMED. Signed by District Judge Aleta A. Trauger on 8/29/17. (DOCKET TEXT SUMMARY ONLY-ATTORNEYS MUST OPEN THE PDF AND READ THE ORDER.)(am)

UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF TENNESSEE
NASHVILLE DIVISION

CYNTHIA ANN HARGIS,
Plaintiff,

Case No. 3:13-1096

v.

Judge Trauger
Magistrate Judge Newbern

NANCY A. BERRYHILL, Acting
Commissioner of Social Security, 1
Defendant.

MEMORANDUM AND ORDER
Pending before the court in this Social Security action is Plaintiff Cynthia Ann Hargis’s
motion for judgment on the administrative record (Doc. No. 15), to which the Commissioner of
Social Security has responded (Doc. No. 16). Hargis has filed a reply. (Doc. No. 17.) Upon
consideration of these filings and the administrative record (Doc. No. 11), 2 and for the reasons
given below, the court will DENY Hargis’s motion for judgment and AFFIRM the decision of
the Commissioner.
I.

Statement of the Case
Hargis filed applications for disability insurance benefits and supplemental security

income under Titles II and XVI of the Social Security Act on October 5, 2009, alleging disability
onset as of September 15, 2008, due to severe depression and spinal stenosis. (Tr. 235.)
1

Nancy A. Berryhill became the Acting Commissioner of Social Security on January 23, 2017,
replacing Carolyn W. Colvin in that role. Berryhill is therefore appropriately substituted for Colvin as the
defendant in this action, pursuant to Federal Rule of Civil Procedure 25(d) and 42 U.S.C. § 405(g).
2

Referenced hereinafter by page number(s) following the abbreviation “Tr.”
1

Tennessee Disability Determination Services denied Hargis’s claims upon initial review and
again following her request for reconsideration. Hargis subsequently requested de novo review
of her case by an Administrative Law Judge (ALJ). The ALJ heard the case on January 25, 2012,
when Hargis appeared with counsel and gave testimony. (Tr. 45–82.) A vocational expert also
testified. At the conclusion of the hearing, the ALJ took the matter under advisement until April
3, 2012, when she issued a written decision finding Hargis not disabled. (Tr. 14–36.)
That decision contains the following enumerated findings:
1.

The claimant meets the insured status requirements of the Social Security Act
through December 31, 2013.

2.

The claimant has engaged in substantial gainful activity since September 15,
2008, the alleged onset date (20 CFR 404.1571 et seq., and 416.971 et seq.).

3.

The claimant has the following severe impairments: Degenerative Disc
Disease, lumbar spine; Degenerative Joint Disease; Chronic Obstructive
Pulmonary Disease; Major Depressive Disorder versus Bipolar Disorder;
Obesity; Anxiety Disorder; Borderline Personality Disorder; Polysubstance
Abuse, in remission (20 CFR 404.1520(c) and 416.920(c)).

4.

The 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 (20 CFR 404.1520(d), 404.1525,
404.1526, 416.920(d), 416.925 and 416.926).

5.

After careful consideration of the entire record, the undersigned finds that the
claimant has the residual functional capacity to perform light work as defined
in 20 CFR 404.1567(b) and 416.967(b), including the ability to lift and/or
carry 20 pounds occasionally and 10 pounds frequently, sit for about six
hours, stand for about six hours, and walk for about six hours––each with
normal breaks––during the course of an eight-hour work day, except as
follows: From a mental perspective, the claimant is limited to jobs allowing
for the ability to understand short and simple instructions, but she can
appropriately interact with others, is able to adapt to work-related change, and
is able to make simple work-related decisions.

6.

The claimant is unable to perform any past relevant work (20 CFR 404.1565
and 416.965).

7.

The claimant was born on September 18, 1958 and was 50 years old, which is
defined as an individual closely approaching advanced age, on the alleged
disability onset date (20 CFR 404.1563 and 416.963).
2

8.

The claimant has a limited education and is able to communicate in English
(20 CFR 404.1564 and 416.964).

9.

Transferability of job skills is not material to the determination of disability
because using the Medical-Vocational Rules as a framework supports a
finding that the claimant is “not disabled,” whether or not the claimant has
transferable job skills (See SSR 82-41 and 20 CFR Part 404, Subpart P,
Appendix 2).

10.

Considering the claimant’s age, education, work experience, and residual
functional capacity, there are jobs that exist in significant numbers in the
national economy that the claimant can perform (20 CFR 404.1569,
404.1569(a), 416.969, and 416.969(a)).

11.

The claimant has not been under a disability, as defined in the Social Security
Act, from September 15, 2008, through the date of this decision (20 CFR
404.1520(g) and 416.920(g)).

(Tr. 16, 18–19, 22, 33–35.)
On August 1, 2013, the Appeals Council denied Hargis’s request for review of the ALJ’s
decision, rendering that decision final. (Tr. 1–3.) This civil action seeking review was timely
filed on October 4, 2013. 42 U.S.C. § 405(g).
II. Review of the Record
The following summary of the evidence is taken from Hargis’s motion for
judgment on the record:
Plaintiff Cynthia Ann Hargis was born on September 18, 1958, and was with[in] a
week of 50 years old on her alleged disability onset date, October 5, 2009. Tr. 34.
As such, she was an individual closely approaching advanced age under the
regulations.
In January 2008, Ms. Hargis was treated by Dr. James Seeley related to her back
pain, as well as neck pain, arm pain and leg pain. Tr. 1005, 1008. She also
reported shortness of breath, chest pain, cough, wheezes, nausea, vomiting,
tiredness, weakness, joint pain or swelling, numbness, and dizziness, as well as a
history of broken leg, knee surgery, and dog bite to her hand. Id. X-rays of her
lumbar spine revealed lumbar spondylosis and facet arthropathy at L4-5 and L5S1. Tr. 1007. She was also noted to have decreased strength/tone/range of motion
and positive straight leg raise testing. Tr. 1006. Dr. Seeley also treated her
regarding pulmonary and/or respiratory difficulties, and x-rays of her chest noted
spondylosis of the thoracic spine. Tr. 998. By June 2008, she continued to report
persistent back pain which was exacerbated by range of motion, and objective
3

examination again noted decreased strength/tone/range of motion and positive
straight leg raise testing. Tr. 988–992.
An MRI of her lumbar spine from June 2008 revealed mild disc desiccation at L45 with bilateral facet arthropathy at L4-5 and L5-S1, as well as mild right
foraminal stenosis at L4-5 and mild left foraminal stenosis at L5-S1. Tr. 286. She
then underwent physical therapy for her persistent back pain with radiation to her
lower extremities. Tr. 288–300. She reported pain rated as a five out of ten at rest,
increased to eight or nine at times, worse with bending, sitting, standing, walking,
or lying for long periods, progressively worsening during the day, and with
varying lower extremity symptoms increased to moderately severe at times. Tr.
298–299. Nonetheless, she continued to suffer from persistent back pain and
lower extremity symptoms despite her treatment and physical therapy. Tr. 288–
300. She was also advised on multiple occasions to avoid flexion (such as
bending, stooping and/or leaning forward). Id. An MRI of her lumbar spine from
December 2008 again revealed facet joint arthropathy at L4-5 and L5-S1, as well
as mild disc desiccation at L4-5. Tr. 285.
Dr. Seeley’s treatment notes throughout this period also show Ms. Hargis’
persistent difficulties with her back pain and lower extremity symptoms with
decreased strength/tone/range of motion and positive straight leg raise testing
despite treatment and medications. Tr. 962–986. These treatment notes also show
her diagnosis of lumbar radiculopathy and disc displacement, and she was noted
to have limited range of motion of the thoracic spine with tenderness, as well as
bilateral rhonchi and wheezes in February 2009. Id.; see Tr. 968.
X-rays of Ms. Hargis’ thoracic spine from March 2009 revealed mild focal T8-9
spondylosis with a small bridging osteophyte anteriorly and laterally. Tr. 973. Xrays of her cervical spine from August 2009 revealed no specific abnormality,
although C6 and C7 were obscured. Tr. 972.
In [April] 2009, Ms. Hargis presented for a consultative medical examination with
Dr. Roy Johnson. Tr. 323–325. Dr. Johnson’s objective medical examination
revealed tenderness of the lumbar spine with significantly decreased range of
motion (and tearfulness), as well as decreased range of motion of the shoulders
and hips, with a short and guarded gait and inability to squat and difficulty with
tandem walk and balance. Tr. 324–325. Dr. Johnson diagnosed her with low back
syndrome, decreased visual acuity, history of carpal tunnel bilaterally, and
depression. Tr. 325. He also assessed her with limitations to lifting only 10
pounds occasionally, and standing or walking only 4.5-5 hours total with normal
breaks. Tr. 325.
Ms. Hargis . . . presented to the emergency department in May 2009 related to her
worsening back pain after being involved in a motor vehicle accident. Tr. 938–
947. She reported low back pain rated as an eight out of ten, as well as some left

4

arm pain. Tr. 945–946. X-rays revealed degenerative subluxation of L5 on S1
related to advanced facet arthropathy. Tr. 938 (emphasis [in original]).
Dr. James Moore reviewed the evidence in June 2009 and provided an opinion
regarding Ms. Hargis’ capabilities and limitations due to her impairments. Tr.
362–370. Dr. Moore assessed her with limitations to light work with only
occasional climbing ladders, ropes or scaffolds, frequent climbing ramps or stairs,
balancing, stooping, kneeling, crouching or crawling, limited far acuity, and only
frequent bilateral handling and fingering due to diagnostic evidence supporting
carpal tunnel syndrome. Id.
Ms. Hargis presented for another consultative medical examination at SSA’s
request in December 2009 with Dr. Ashok Mehta. Tr. 371–382. Similar to Dr.
Johnson, Dr. Mehta’s examination revealed significantly decreased range of
motion of the lumbar spine, as well as lumbar tenderness and muscle spasm,
decreased range of motion of the lower extremities, and an unsteady, slow gait.
Tr. 372, 374–375. Dr. Mehta also assessed Ms. Hargis with limitations to lifting
or carrying only 10 pounds occasionally (no frequent lifting or carrying); sitting,
standing and walking a total of less than an eight-hour workday; occasional
climbing and balancing; and never stooping, kneeling, crouching or crawling
(among other limitations). Id.
Ms. Hargis underwent a consultative psychological examination in January 2010
and was diagnosed with major depressive disorder, moderate, and obsessive
compulsive disorder, mild-to-moderate. Tr. 386. She was further assessed with a
global assessment of functioning (GAF) score of 54, indicating moderate
symptoms, and assessed with moderate impairment in maintaining persisten[ce]
and concentration for a full workday and work week, as well as social
relationship. Tr. 386.
Dr. Saul Juliao reviewed the evidence in February 2010 and provided an opinion
regarding Ms. Hargis’ physical capabilities and limitations due to her
impairments. Tr. 389–397. Dr. Juliao assessed her with limitations to light work
with no climbing ladders, ropes or scaffolds, occasional climbing ramps or stairs,
balancing, stooping, kneeling, crouching or crawling, and limited far acuity. Id.
Dr. Rudy Warren reviewed the evidence in March 2010 and provided an opinion
regarding Ms. Hargis’ mental capabilities and limitations due to her impairments.
Tr. 398–411. Dr. Warren assessed her with moderate impairment in concentration,
persistence or pace, as well as maintaining social functioning. Tr. 408.
Ms. Hargis received treatment for her chronic back pain in April 2010 through the
emergency department of Nashville General Hospital. Tr. 417. She reported back
pain for the prior two years and was noted to have a TENS unit in place. Id. She
was noted to be “significantly obese” and was somewhat uncomfortable and

5

tearful during exam. Tr. 418. Examination revealed tenderness, muscle spasms,
and decreased range of motion of the back and spine. Tr. 419.
Dr. Charles Settle reviewed the evidence in July 2010 and provided an opinion
regarding Ms. Hargis’ physical capabilities and limitations due to her
impairments. Tr. 424–432. Dr. Settle assessed her with limitations to light work
with no climbing ladders, ropes or scaffolds, occasional climbing ramps or stairs,
balancing, stooping, kneeling, crouching or crawling, limited far acuity, and
limited bilateral handling and fingering due to diagnostic evidence supporting
carpal tunnel syndrome. Id.
Ms. Hargis was treated through the emergency department in July 2010 related to
her hypertension and depression. Tr. 544–549. She was noted to have a flat affect
and poor eye contact consistent with depression. Tr. 546.
Shortly thereafter, Ms. Hargis began mental health treatment through Centerstone
for diagnoses of Major Depressive Disorder, recurrent, severe without psychotic
features[;] borderline personality disorder[;] and obsessive-compulsive disorder,
as well as cannabis and sedative/hypnotic/anxiolytic abuse. Tr. 558, 757–758,
924. She was noted to have symptoms of depression and anxiety, including
sadness, loss of interest, loss of appetite, sleep disturbance, hopelessness, fatigue,
and suicidal ideation, as well as counting corners and lines, twisting her hair,
panic-type symptoms, and a very anxious appearance. Tr. 757, 891, 921. She was
noted to have poor adaptive functioning, anxious and depressed mood, obsessive
thought content, appetite disturbance, crying, lack of energy, loss of interest and
pleasure, sleep disturbance, and poor insight, and she was assessed with a marked
impairment in emotional/behavioral health. Tr. 759, 909–910, 921–922.
More specifically, she was assessed with marked impairment in activities of daily
living and concentration, task performance and pace, as well as an inability to
interact appropriately and communicate effectively with others, and regular or
frequent difficulty in accepting and adjusting to change. Tr. 552–553; see also Tr.
555–557. Likewise, she was assessed with a GAF score of 45 (with her GAF
ranging from 45-50 during the prior six months), indicating serious symptoms or
serious impairment in social or occupational functioning. Tr. 554, 558, 758, 909–
910, 921, 924; see also Tr. 555-557. These treatment notes document Ms. Hargis’
abstinence from any substance abuse beginning sometime around March 2011,
with persistent symptoms and difficulties despite her ongoing treatment and
abstinence. See Tr. 679, 734, 755, 793; see also Tr. 552–924.
In February 2011, Ms. Hargis reported exacerbation of her back pain for the prior
three months after a fall that injured her left knee, resulting in her favoring that
leg which in turn aggravated her back. Tr. 461. She rated her pain as a six out of
ten with intermittent episodes of pain rated as a ten out of ten. Id. It was also
noted that she was previously managed by Dr. Seeley when she had insurance. Id.
She also reported episodes of hypertension with lightheadedness, palpitations,
6

headache, blurry vision and feeling like a hot flash with heart pounding. Tr. 451,
457. In April 2011, Ms. Hargis presented for follow up regarding her chronic back
pain [which] was progressively worsening, as well as knee pain, depression, and
shortness of breath. Tr. 442. Records from June 2011 continued to show Ms.
Hargis’ reports of significant low back and hip pain with difficulty sleeping and
radiation of her low back pain into her lower extremities. Tr. 434.
Ms. Hargis underwent psychiatric hospitalization in June 2011 related to her
depression with suicidal ideation and plan to overdose on medications. Tr. 481.
She reported decreased sleep, decreased appetite, poor concentration,
hopelessness, helplessness, and possible auditory hallucinations. Tr. 481–482. She
was diagnosed with major depressive disorder, recurrent, severe; borderline
personality disorder; and cocaine dependence in early partial remission (last
reported use November 2010). Tr. 481–482. She was also assessed with a GAF
score of 50 at discharge, indicating serious symptoms or serious impairment in
social or occupational functioning. Tr. 481.
Shortly thereafter, in July 2011, she again presented to the emergency department
with depression and suicidal ideation and attempt. Tr. 930–937. Her urine drug
screen was negative for any illicit substances. Tr. 936.
She returned in October 2011 with complaints of shortness of breath related to her
asthma and COPD, and stated that she thought she had pulled a muscle from
coughing so hard. Tr. 925–929. She was diagnosed with dyspnea and bronchitis
with acute COPD exacerbation. Tr. 926. X-rays of her chest revealed moderate
degenerative changes of the thoracic spine. Tr. 929.
In November 2011, Dr. Robert Miller completed a Medical Source Statement
(Physical) in which he assessed Ms. Hargis with the following limitations: lifting
20 pounds occasionally and 10 pounds frequently; carrying 10 pounds
occasionally; sitting 2 hours at one time and 4 hours total; standing 20 minutes at
one time and 1 hour total; walking 15 minutes at one time and 1 hour total;
occasional use of the bilateral upper extremities for reaching and handling;
frequently using the bilateral upper extremities for fingering and feeling; . . .
never pushing or pulling with the bilateral upper extremities; never operating foot
controls; occasional climbing stairs and ramps; and never balancing, stooping,
kneeling, crouching, crawling, or climbing ladders or scaffolds. Tr. 956–959.
Ms. Hargis was then treated at Shade Tree Clinic in November and December
2011 related to diagnoses of COPD, hypertension, and bipolar I disorder. Tr. 952.
She continued to report chronic cough and chronic, persistent lower back and mid
back pain (averaging a six out of ten), as well as persistent symptoms related to
her depression and anxiety. Id. She returned in January 2012 with persistent
complaints of pain and/or numbness in multiple locations, including her bilateral
hands, back and shoulders. Tr. 948. She also continued to endorse significant
mental health symptoms, including decreased sleep, decreased interest, decreased
7

energy, suicidal thoughts, mood swings, and expressing a desire to kill people
who are making her angry. Id.
(Doc. No. 15-1, PageID# 1049–1056.)
At her hearing before the ALJ, Hargis testified that she had problems with her knees, had
undergone surgery on her right knee, and had been prescribed a brace to wear on that knee. (Tr.
50.) She further testified that she had been told she would need a total knee replacement within
ten or fifteen years. (Id.) She also has carpal tunnel syndrome in both hands, for which she wears
splints at night. (Tr. 51.) She testified that she did not have private health insurance but had
coverage under Safety Net, a government program through which she obtained medical
treatment at the Shade Tree Clinic. (Tr. 51–52.)
Hargis testified that her other physical impairments included COPD, emphysema, and
asthma. (Tr. 52.) She treated these conditions with inhalers and breathing treatments. (Tr. 52–
53.) She continued to smoke cigarettes but had cut back since being put on the breathing
treatments, with one pack lasting slightly more than a day. (Tr. 53.) She testified that she had not
done street drugs for the past year, other than one relapse use of cocaine about six months prior
to the hearing. (Tr. 53–54.) When asked by her attorney how she could afford to buy the drugs
prior to quitting, Hargis testified “[w]ell, I worked.” (Tr. 54.) She then clarified that she was not
working one year prior to her hearing, but just “[s]mok[ed] with friends.” (Id.)
Hargis testified that an automobile accident on May 23, 2009, worsened her back
problems, and that “a numb tingling” was running from between her shoulders up to her neck.
(Tr. 55.) She stated that she can sit for about fifteen minutes, but then the pain starts running up
her back. (Tr. 55–56.) When she stands, the pain starts in her mid-to-lower back and then
radiates down the sides of both legs and into the tops of her feet. (Tr. 56–57.) She stated that this

8

pain distribution had been happening since her back problems began when she was seven years
old. (Tr. 57.)
She testified that she put on a lot of weight after being prescribed steroids and currently
weighed around two hundred pounds at 4’9” height. (Id.) She stated that she had gained thirty
pounds in the past month. (Tr. 57, 59.) She testified that her pain keeps her from walking more
than short distances and that a doctor whose name she could not recall had recommended a cane
in either 2005 or 2007. (Tr. 58–59.)
Hargis testified that she took a pain pill and Neurontin and also used a transcutaneous
electrical nerve stimulation (TENS) unit to help relieve pain. (Tr. 60–62.) She stated that she
could not lift any weight frequently and had to use both hands to pour from a gallon of tea. (Tr.
63.) She could not take a shower without excruciating pain in her back and legs. (Tr. 64.) She
had to use a shower chair. (Id.) She had been living with a friend for the past two years. (Id.) She
tried to help with the household chores, which took a long time because she had to take frequent
breaks from standing. (Tr. 65.) She testified that she owned a car and could drive about ten
minutes before her pain began. (Tr. 72.)
Hargis testified that she had received mental health treatment for depression and anxiety,
but had been out of her prescription medication for about a month prior to the hearing. (Tr. 66.)
She stated that she had been hospitalized twice for mental health issues. (Tr. 66–67.) She was
brought to the hospital by ambulance in June 2011 after attempting to overdose on her
medications. (Tr. 69–70.)
In its response brief, the Government summarized the testimony of the vocational expert
as follows:
Dr. Gordon Doss, a vocational expert (“VE”), testified at the administrative
hearing. The ALJ asked the VE to consider an individual with Plaintiff’s
9

vocational profile who was capable of occasionally lifting 20 pounds; frequently
lifting ten pounds; sitting for four hours out of an eight-hour workday, for up to
two hours at a time; standing and walking for an hour out of an eight-hour
workday, for up to 15-20 minutes at a time; never pushing or pulling; occasionally
reaching, handling, and fingering; never operating foot controls; occasionally
climbing stairs and ramps; never climbing ladders, ropes, and scaffolds; never
balancing, stooping, kneeling, crouching, or crawling; and never tolerating
unprotected heights, moving mechanical parts, humidity, wetness, dust, odors,
fumes, or extreme temperatures (Tr. 28). The VE responded that such an
individual could not work (Tr. 79).
The ALJ then asked the VE to consider a hypothetical individual with Plaintiff’s
vocational profile who could lift, carry, push, and pull up to 20 pounds; stand for
six hours out of an eight-hour workday; walk for six hours out of an eight-hour
workday; sit for six hours our of an eight-hour workday; understand and
remember short and simple instructions; appropriately interact with others; adapt
to change; and make simple work-related decisions (Tr. 79). The VE responded
that such an individual could adjust to other work and provided examples
including work as a house sitter (280 local jobs; 35,000 national jobs), a parking
lot attendant (1,132 local jobs; 93,000 national jobs), or a courier (3,000 local
jobs; 155,845 national jobs) (Tr. 80).
(Doc. No. 16, PageID# 1078–79.)
III.

Analysis
A.

Legal Standard

Judicial review of “any final decision of the Commissioner of Social Security made after
a hearing” is authorized by the Social Security Act, which empowers the district court “to enter,
upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing
the decision of the Commissioner of Social Security, with or without remanding the cause for a
rehearing.” 42 U.S.C. § 405(g). This court reviews the final decision of the Commissioner to
determine whether substantial evidence supports the agency’s findings and whether the correct
legal standards were applied. Miller v. Comm’r of Soc. Sec., 811 F.3d 825, 833 (6th Cir. 2016).
“Substantial evidence is less than a preponderance but more than a scintilla; it refers to relevant
evidence that a reasonable mind might accept as adequate to support a conclusion.” Gentry v.
Comm’r of Soc. Sec., 741 F.3d 708, 722 (6th Cir. 2014). The court also reviews the decision for
10

procedural fairness. “The Social Security Administration has established rules for how an ALJ
must evaluate a disability claim and has made promises to disability applicants as to how their
claims and medical evidence will be reviewed.” Id. at 723. Failure to follow agency rules and
regulations, therefore, “denotes a lack of substantial evidence, even where the conclusion of the
ALJ may be justified based upon the record.” Id. (quoting Cole v. Astrue, 661 F.3d 931, 937 (6th
Cir. 2011)).
The agency’s decision must stand if substantial evidence supports it, even if the record
contains evidence supporting the opposite conclusion. See Hernandez v. Comm’r of Soc. Sec.,
644 F. App’x 468, 473 (6th Cir. 2016) (citing Key v. Callahan, 109 F.3d 270, 273 (6th Cir.
1997)). This court may not “try the case de novo, resolve conflicts in evidence, or decide
questions of credibility.” Ulman v. Comm’r of Soc. Sec., 693 F.3d 709, 713 (6th Cir. 2012)
(quoting Bass v. McMahon, 499 F.3d 506, 509 (6th Cir. 2007)). “However, a substantiality of
evidence evaluation does not permit a selective reading of the record . . . [but] ‘must take into
account whatever in the record fairly detracts from its weight.’” Brooks v. Comm’r of Soc. Sec.,
531 F. App’x 636, 641 (6th Cir. 2013) (quoting Garner v. Heckler, 745 F.2d 383, 388 (6th Cir.
1984)).
B.

The Five-Step Inquiry

The claimant bears the ultimate burden of establishing an entitlement to benefits by
proving his or her “inability 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). The claimant’s “physical or mental impairment” must
“result[] from anatomical, physiological, or psychological abnormalities which are demonstrable

11

by medically acceptable clinical and laboratory diagnostic techniques.” Id. § 423(d)(3). The
agency considers a claimant’s case under a five-step sequential evaluation process, described by
the Sixth Circuit court of Appeals as follows:
1. A claimant who is engaging in substantial gainful activity will not be found to
be disabled regardless of medical findings.
2. A claimant who does not have a severe impairment will not be found to be
disabled.
3. A finding of disability will be made without consideration of vocational
factors, if a claimant is not working and is suffering from a severe impairment
which meets the duration requirement and which meets or equals a listed
impairment in Appendix 1 to Subpart P of the Regulations. Claimants with
lesser impairments proceed to step four.
4. A claimant who can perform work that he has done in the past will not be
found to be disabled.
5. If a claimant cannot perform his past work, other factors including age,
education, past work experience and residual functional capacity must be
considered to determine if other work can be performed.
Miller, 811 F.3d at 835 n.6; 20 C.F.R. §§ 404.1520, 416.920. The claimant bears the burden
through step four of proving the existence and severity of the limitations her impairments cause
and the fact that she cannot perform past relevant work; however, at step five, the burden shifts
to the Commissioner to “identify a significant number of jobs in the economy that accommodate
the claimant’s residual functional capacity and vocational profile.” Johnson v. Comm’r of Soc.
Sec., 652 F.3d 646, 651 (6th Cir. 2011).
When determining a claimant’s residual functional capacity (RFC) at steps four and five,
the ALJ must consider the combined effect of all the claimant’s impairments, mental and
physical, exertional and nonexertional, severe and nonsevere. See 42 U.S.C. § 423(d)(2)(B),
(5)(B); Glenn v. Comm’r of Soc. Sec., 763 F.3d 494, 499 (6th Cir. 2014) (citing 20 C.F.R.
§ 404.1545(e)). The agency can carry its burden at the fifth step of the evaluation process by
12

relying on the Medical-Vocational Guidelines, otherwise known as “the grids,” but only if a
nonexertional impairment does not significantly limit the claimant, and then only when the
claimant’s characteristics precisely match the characteristics of the applicable grid rule. See
Anderson v. Comm’r of Soc. Sec., 406 F. App’x 32, 35 (6th Cir. 2010); Wright v. Massanari, 321
F.3d 611, 615–16 (6th Cir. 2003). Otherwise, the grids function only as a guide to the disability
determination. Wright, 321 F.3d at 615–16; see also Moon v. Sullivan, 923 F.2d 1175, 1181 (6th
Cir. 1990). Where the grids do not direct a conclusion as to the claimant’s disability, the agency
must rebut the claimant’s prima facie case with proof of the claimant’s individual vocational
qualifications to perform specific jobs, typically through vocational expert testimony. Anderson,
406 F. App’x at 35; see Wright, 321 F.3d at 616 (quoting SSR 83-12, 1983 WL 31253, *4 (Jan.
1, 1983)).
C.

Plaintiff’s Statement of Errors
1.

The ALJ’s Step One Determination

As an initial matter, the ALJ found that Hargis’s disability claim should be denied at step
one of the sequential evaluation because Hargis had engaged in substantial gainful activity by
selling cocaine and marijuana. (Tr. 16–18, 482.) Hargis alleges error in this determination and
the Government does not defend it in its brief. (Doc. No. 16, PageID# 1082.) The ALJ based this
finding on a statement in a discharge summary from Middle Tennessee Mental Health made on
June 24, 2011, after Hargis attempted suicide. (Tr. 481–85.) That summary records a statement
from Hargis that she “use[d] to sell cocaine and pot for the last four to five years.” (Tr. 482.) The
ALJ also notes that Hargis testified that she “worked” to support her daily marijuana habit and
helped babysit a friend’s children in exchange for a place to stay. (Tr. 17.)
The ALJ correctly found that illegal activity may constitute “substantial gainful activity”
within the meaning of the disability regulations. See Bell v. Comm’r of Soc. Sec., 105 F.3d 244,
246 (6th Cir. 1996). However, in making the step one determination, the amount of money

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earned by the claimant’s activities is “key.” Id. Indeed, there is a presumption against finding
that a claimant engaged in substantial gainful activity if earnings from the work do not meet the
amount set by regulation. 20 C.F.R. § 404.1574(b)(3). Here, the ALJ made no finding as to the
amount Hargis may have earned from any illegal or legal activity during the relevant time period.
Instead, she noted that Hargis’s “[c]ertified earning records reflect a drop in reported earnings
consistent with the alleged onset date, with no income during the 2009 calendar year and later,”
apparently assuming that Hargis had substantial income that she did not report. (Tr. 17.)
The Government does not argue that the ALJ’s step one analysis is supported by
substantial evidence (Doc. No. 16, PageID# 1082), and the court finds little in the record to
indicate that it was. However, the court need not decide this issue. The ALJ continued with the
sequential evaluation process “to establish that there were multiple grounds against a finding of
disability in this case, as relating to all times since the alleged onset date until the date of the
decision,” ultimately also finding Hargis not disabled at step five of her analysis (Tr. 18, 34–35.)
The court now considers that alternative basis for the ALJ’s not-disabled determination.
2.

The ALJ’s Characterization of Radiological Evidence

Hargis argues that, in considering the radiological evidence of her spinal impairment, the
ALJ “significantly misrepresent[ed] and/or mischaracterize[ed]” that evidence by failing to note
that x-rays from May 2009 revealed advanced facet arthropathy and by omitting any reference to
an October 2011 x-ray report of moderate degenerative changes of the thoracic spine.
As the Government points out, the May 2009 radiologist’s report is internally
inconsistent. It states, with regard to alignment, “[s]light anterior subluxation of L5 on S1 is
related to moderate facet arthropathy. Alignment elsewhere is normal.” (Tr. 938.) With regard to
facets it states, “[f]acet arthropathy at L4–L5 and L5–S1.” (Id.) Finally, the report states the
radiologist’s impression as “[n]o acute abnormality. Degenerative sublaxation of L5 on S1 is
related to advanced facet arthropathy.” (Id.) The radiologist’s report thus variously describes
Hargis’s facet arthropathy as moderate, advanced, and without qualification. The ALJ described
the report as showing “Slight anterior subluxation of L5 on S1 related to facet arthropathy;
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normal alignment elsewhere; unspecified spondylosis in the lower thoracic spine; and no
evidence of acute change.” (Tr. 25.) The ALJ thus recognized the finding of facet arthropathy
and resolved the conflicting descriptors in a way that is consistent with the overall tenor of the
radiologist’s report. The ALJ did not significantly misrepresent the evidence in doing so.
Likewise, the ALJ’s failure to mention the October 11, 2011 chest x-ray report that found
“[n]o evidence of acute intrathoracic process” and noted moderate degenerative changes of the
thoracic spine (Tr. 929) does not misrepresent significant medical evidence. The ALJ noted that
Hargis’s October 11, 2011 visit to Skyline Medical Center was to address shortness of breath,
though it was “incidentally noted that there was a full range of motion in all extremities.” (Tr.
27.) The ALJ further found that, “[a]lthough there is evidence of some degenerative change,
particularly in the thoracic and lumbar regions, the weight of the evidence does not come
anywhere near [supporting] what has been alleged [i]n this case.” (Tr. 28.) The ALJ thus
accounted for the radiological evidence of degenerative changes and did not misstate the
objective severity of the conditions that this evidence revealed. The court finds no reversible
error here.
3.

The ALJ’s Rejection of Treating Physician Dr. Miller’s Opinion

Hargis next argues that the ALJ erroneously rejected the opinion of her treating
physician, Dr. Miller. In a checkbox assessment dated November 1, 2011, Dr. Miller opined that,
as of January 1, 2011, Hargis was capable of occasionally lifting up to twenty pounds and
frequently lifting up to 10 pounds, could only carry up to 10 pounds occasionally, could sit for
two hours at a time and four hours total in an eight-hour workday, and could only stand or walk
for a total of one hour each during her workday. (Tr. 956–57.) Dr. Miller further opined that
Hargis was limited in handling and was totally precluded from operating foot controls. (Tr. 958.)
He also stated that Hargis had almost no capability to perform postural activities like climbing,
balancing, stooping, kneeling, or crawling, and that her visual impairment left her unable to
avoid ordinary workplace hazards. (Tr. 959.) Finally, Dr. Miller opined that Hargis could never
be exposed to any irritating or dangerous environmental conditions, except for moderate noise
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exposure, occasional vibrations, and occasional operation of a motor vehicle. (Tr. 960.) Dr.
Miller found that Hargis could engage in activities such as shopping and could travel without a
companion for assistance, ambulate without assistance, and walk a block at a reasonable pace on
rough or uneven surfaces. (Tr. 961.)
If an ALJ finds a treating physician’s opinion not entitled to controlling weight because it
is inconsistent with other substantial evidence in the record, the ALJ must then weigh the opinion
in light of factors including “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 any specialization of the treating
physician,” and give good reasons for the weight she ultimately assigns to the opinion. Blakley v.
Comm’r of Soc. Sec., 581 F.3d 399, 406 (6th Cir. 2009) (citing 20 C.F.R. § 404.1527(c)(2)).
“When deciding if a physician’s opinion is consistent with the record [as a whole], the ALJ may
consider evidence such as the claimant’s credibility, whether or not the findings are supported by
objective medical evidence, as well as the opinions of every other physician of record.” Coldiron
v. Comm’r of Soc. Sec., 391 F. App’x 435, 442 (6th Cir. 2010).
The ALJ weighed Dr. Miller’s opinion as follows:
Although [Dr. Miller’s November 2011 assessment] was written by a treating
physician, the undersigned must consider it in view of Social Security Ruling 962p, which directs that controlling weight may not be given to a treating source’s
medical opinion unless it is well supported by medically acceptable clinical and
laboratory diagnostic techniques, and which further directs that the undersigned
cannot decide a case in reliance on a medical opinion without some reasonable
basis for that opinion. In this instance, the reasonable basis does not exist. First,
[Miller] did not even attempt to provide a reason for the limitations he gave.
Second, the limitations were poorly supported within the objective medical
evidence. Third, a portion of the limitations were facially invalid: For instance, a
restriction against any use of the lower extremities in the working of foot controls
prohibits all driving, yet Dr. Miller allowed for occasional operation of a motor
vehicle. Fourth and finally, by [his] statement’s own terms, a substantial interval
following the alleged onset date is outside the scope of the opinion, because Dr.
Miller stated the claimant’s impairments only began as of January of 2011. For all
of these reasons, the undersigned provides little weight to the conclusions of Dr.
Miller, except to agree that the claimant does not require aids to ambulation.

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(Tr. 33.)
In assigning little weight to Dr. Miller’s opinion, the ALJ appropriately considered both
the opinion’s internal inconsistency and its inconsistency with the objective medical evidence as
a whole, as well as the length of the treatment relationship vis-à-vis the period of alleged
disability under review. Hargis acknowledges that Dr. Miller’s assessment is not supported by
contemporaneously cited evidence but argues that it is supported by his treatment notes and is
consistent with the findings and opinions of the consultative examiners Dr. Johnson and Dr.
Mehta. However, the ALJ thoroughly reviewed the treatment notes from Shade Tree Clinic,
where Dr. Miller practices, beginning February 5, 2011 (Tr. 26–27, 434–80), as well as the
findings and assessments of the consultative examiners (Tr. 26), noting inconsistencies in each
between Hargis’s reported symptoms and the objective measurements obtained upon
examination. The ALJ’s conclusion after reviewing this evidence is set out in full below:
The evidence, as thus described, does not point to any event, significant objective
finding, or circumstance that would validate any degree of exertional limitation in
a way that is inconsistent with the above residual functional capacity. Neither do
they support postural, environmental, or other limitations. Although the claimant
manifested an abnormal gait, was unable to squat or rise, and showed
considerable range of motion limitations in the lumbar spine and hips during both
consultative examinations (and to a lesser extent, the shoulders as well, see Ex. 4F, 10-F), these are not well supported because of numerous credibility concerns,
as previously identified. Although there is evidence of some degenerative change,
particularly in the thoracic and lumbar regions, the weight of the evidence does
not come anywhere near [supporting] what has been alleged [i]n this case.
Regarding the need for a cane, brace, crutch, splint, or any other type of
ambulatory aid whatsoever, there was again very little support for any of these
devices . . . contained in the limited record before us. And although the claimant
alleged she did not receive medical care for substantial intervals secondary to a
lack of health insurance, the records reflect that in fact, she did avail of services
for people of limited means, such as the Shade Tree Clinic, and she also used the
emergency room on a number of occasions for various complaints. So that there is
no room for doubt or ambiguity on the point, let there be plainness: The
claimant’s allegations were flatly not believable, and in places bordered on
dishonesty.

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(Tr. 27–28.)
In highlighting the objective clinical and radiological evidence obtained by Dr. Miller
and others, which shows a lesser degree of impairment than is found in Dr. Miller’s assessment
of Hargis’s 2011 functioning, the ALJ has given good reasons for rejecting Dr. Miller’s opinion,
particularly when combined with the identification of internal inconsistencies and the
overarching finding that Hargis’s reports of symptoms and limitations to her providers and to the
SSA were not credible. See Coldiron, 391 F. App’x at 440 (finding good reason for according
reduced weight to treating physician opinion where it lacked internal consistency and was
undermined by other medical evidence and claimant’s reduced credibility). Substantial evidence
thus supports the ALJ’s affording Dr. Miller’s opinion little weight.
4.

The ALJ’s Adverse Credibility Determination

Hargis challenges the ALJ’s determination of her credibility, arguing that the ALJ found
her not credible based solely on her history of drug use and that her consistent effort to seek
relief from her pain and the consistency of the consultative examiners’ opinions should have
bolstered her credibility regarding her limitations. However, the ALJ meticulously established
that her adverse credibility finding was based not only on Hargis’s criminal activity but also on
her lack of candor with her treating sources, with the consultative examiners retained by the
Government, and with the ALJ herself from the witness stand. (Tr. 23–32.) The ALJ considered
Hargis’s credibility in great detail, and her finding is supported by substantial evidence,
especially given the deference due to credibility determinations by ALJs who, unlike reviewing
judges on appeal, have the opportunity to observe a claimant’s demeanor while testifying. Jones
v. Comm’r of Soc. Sec., 336 F.3d 469, 476 (6th Cir. 2003) (citing Walters v. Comm’r of Soc.
Sec., 127 F.3d 525, 531 (6th Cir. 1997)). Such credibility findings are not to be disturbed

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“absent compelling reason,” Smith v. Halter, 307 F.3d 377 (6th Cir. 2001), and no such reason
exists in this case.
5.

The ALJ’s RFC Determination

Hargis argues that the ALJ’s determination of her RFC did not track any of the medical
opinions of record, that it was less limiting than all assessments from examining and
nonexamining sources, and that the ALJ therefore “essentially substituted her own lay opinion”
for the opinions of the experts. (Doc. No. 15-1, PageID# 1065.) She points to medical evidence
from her consultative physical examinations that supports her alleged limitations, arguing that
those “findings are more credible and reliable than any potential, vague contrary findings from
other evidence in the record” upon which the ALJ relied. (Id. at PageID# 1064.) This argument is
directed to the evidence regarding postural and range-of-motion limitations considered by the
examining and nonexamining consultants and amounts to an invitation to this court to reweigh
that evidence. However, this court may not “try the case de novo, resolve conflicts in evidence,
or decide questions of credibility,” Ulman, 693 F.3d at 713, nor may the ALJ’s decision, if
supported by substantial evidence, be set aside on grounds that the record contains significant
evidence supporting the opposite conclusion. See Hernandez, 644 F. App’x at 473. Moreover,
“[t]he Social Security Act instructs that the ALJ––not a physician––ultimately determines a
claimant’s RFC.” Coldiron, 391 F. App’x at 439. In Coldiron, the Sixth Circuit rejected the
argument that “because each of [Coldiron’s] treating and examining physicians concluded that he
could not perform sedentary work during the challenged period, the ALJ impermissibly acted as
a medical expert by rendering a sedentary work RFC. . . .” Id. The court recognized that the ALJ
is charged with weighing the non-medical evidence, including the claimant’s testimony, against

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the medical evidence in rendering her RFC finding and does not “improperly assume the role of
a medical expert” by doing so. Id.
Here, the ALJ properly noted inconsistencies between Hargis’s complaints and the
radiological and other objective evidence, such as test results showing full and pain-free range of
motion. (Tr. 25–26.) She also provided the following analysis in support of her RFC finding:
At the time of the hearing, counsel’s original theory of the case was that on the
amended alleged onset date, the claimant experienced a severe worsening of her
lumbar condition as the result of a motor vehicle collision in May of 2009.
However, . . . there was no evidence of acute change, and the plain films of the
lumbar spine were not inconsistent with earlier visual studies; in fact, it was
diagnosed as lumbosacral strain. What is curious to note is that on April 22, 2009,
which would have been shortly before the motor vehicle accident, she presented
to Roy Johnson, M.D., in the setting of a consultative evaluation with a
dramatically reduced range of motion, with 30 degrees of flexion, zero degrees of
extension, and 5 degrees of right and left flexion, with an inability to squat, rise,
or heel-toe walk, and could not balance, save it were briefly. These objective
findings are poorly supported, not only because of the credibility concerns that
were already identified, and not only because the longitudinal evidence both prior
to and following the encounter do not validate such profound range of motion
limitations, but also because there is so little evidence of medical treatment as
between the date of the accident and the balance of the year.
(Tr. 25–26.) This analysis, combined with the ALJ’s findings that Hargis was “flatly incredible”
in her testimony regarding pulmonary issues (Tr. 29) and demonstrated an “[in]ability to
accurately and honestly describe her actual limitations” to her doctors or to the ALJ (Tr. 32), is
sufficient to support the ALJ’s finding that Hargis can, “from a purely physical standpoint,
[perform] a full range of light work, because there was little substantial evidence pointing to a
different result.” (Tr. 33.)
6. The ALJ’s Consideration of Treating Mental Health Providers
Hargis next argues that the ALJ erred in failing to give due consideration to the opinions
of her treating mental health providers, primarily as expressed in their ratings of Hargis on the
Global Assessment of Functioning (GAF) scale and the Tennessee Clinically Related Group
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(CRG) assessment form. Hargis claims that the ALJ failed to comply with the requirements of
Social Security Ruling (SSR) 06-03p, which establishes the standard for consideration of
opinions from “other sources,” such as her mental health care providers, who are not physicians,
psychiatrists, or psychologists. The ALJ thoroughly reviewed the evidence from these providers
in determining Hargis’s mental RFC. (Tr. 29–31.)
Social Security Ruling 06-03p provides, inter alia, that the ALJ should make explicit her
consideration of “other source” evidence, if not the actual weight such evidence is given, where
that evidence could potentially sway the ultimate determination of the claimant’s case toward a
finding of disability. SSR 06-03p, 2006 WL 2329939, at *6 (Aug. 9, 2006). The Tennessee CRG
form would not be expected to affect the ALJ’s ultimate determination, however, because the
evaluation made on that form is not directed to the ultimate issue of the patient’s work-related
abilities and limitations, but is instead a means of ascertaining the patient’s mental health
treatment classification for purposes of determining her entitlement to state-sponsored
healthcare. See Rosen v. Tenn. Comm’r of Health, No. 3:98-0627, 2005 WL 3740426, at *18
(M.D. Tenn. Apr. 28, 2005) (“‘Most states have a way of identifying persons who are SPMI
[(severely and persistently mentally ill)]. . . . Tennessee uses an evaluation tool known as the
Clinically Related Group (CRG) assessment to classify individuals into the SPMI
designation. . . . Tennessee has been using the CRG assessment process since before the
inception of TennCare to identify the SPMI population.’”), rev’d on other grounds, Rosen v.
Goetz, 410 F.3d 919 (6th Cir. 2005). To the extent that any rating reflected in that form is
properly considered opinion evidence from “other sources” pursuant to SSR 06-03p, its potential
to materially impact the determination of work-related abilities and limitations is extremely
limited.

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As for Hargis’s GAF scores, such scores have long been held to be of limited utility in
the disability determination, as they are not a reasonable replacement for the more particularized
data available in actual treatment notes or reports of examination results and instead are largely
superficial descriptors representing “a clinician’s subjective rating of an individual’s overall
psychological functioning” in terms “understandable by a lay person.” See, e.g., Kennedy v.
Astrue, 247 F. App’x 761, 766 (6th Cir. 2007); see also Smith v. Astrue, 565 F. Supp. 2d 918,
925 (M.D. Tenn. 2008). The standard of SSR 06-3p is not a demanding one, Morris v. Comm’r
of Soc. Sec., No. 1:11-cv-154, 2012 WL 4953118, at *11 (W.D. Mich. Oct. 17, 2012), and was
satisfied here, where the ALJ reviewed the evidence at issue and drew the following conclusions:
Turning to the opinion evidence regarding the claimant’s mental impairments,
there were no medical source statements from any of the claimant’s treating
physicians or clinicians with respect to the claimant’s mental limitations, with the
possible exception of the GAF scores and Tennessee Clinically Related Group
(TCRG) assessments as provided through Centerstone and MTMHI. In the end,
each was given very limited weight, not only because of the relatively limited
length of contact each provider had with the claimant, and also because a number
of the assessments occurred when she was in an essentially untreated state, but
also because of the claimant’s repeated instances of noncompliance with
treatment and advice, which served to complicate treatment efforts.
(Tr. 33.) These conclusions and the ALJ’s findings with regard to Hargis’s mental RFC are
supported by substantial evidence.
7. The Vocational Expert’s Testimony
Finally, Hargis argues that the ALJ erred in relying on vocational expert testimony that is
inconsistent with the Dictionary of Occupational Titles (DOT), in violation of SSR 00-4p, 2000
WL 1898704 (Dec. 4, 2000). In response, the Government argues that there was no such
inconsistency in the expert’s testimony. However, the court need not resolve this issue because
the alleged inconsistency was not identified at the administrative hearing or otherwise brought to
the ALJ’s attention before the issuance of her decision. Where a conflict between the vocational
22

expert’s testimony and the DOT is not raised before the ALJ, she is under no obligation to
conduct an independent examination to find it. Martin v. Comm’r of Soc. Sec., 170 F. App’x 369,
374 (6th Cir. 2006). The ALJ asked the expert if his testimony was consistent with the DOT, and
the expert replied that it was. (Tr. 81.) Hargis did not bring the alleged conflict to the ALJ’s
attention and so the ALJ was entitled to rely on the expert’s testimony. Martin, 170 F. App’x at
374. The court finds no error here.

IV.

Conclusion
In light of the foregoing, Hargis’s Motion for Judgment on the Administrative Record

(Doc. No. 15) is DENIED and the decision of the ALJ is AFFIRMED.
It is so ORDERED.
ENTERED this 29th day of August, 2017.

____________________________________
ALETA A. TRAUGER
UNITED STATES DISTRICT JUDGE

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