Bowerman v. Social Security Administration Commissioner

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

GINA G. BOWERMAN PLAINTIFF

V. CASE NO. 5:23-CV-5050

COMMISSIONER,

Social Security Administration DEFENDANT

OPINION AND ORDER

Before the Court is the Report and Recommendation (“R&R”) (Doc. 13) of the

Honorable Christy Comstock, United States Magistrate Judge for the Western District of

Arkansas, regarding Plaintiff Gina G. Bowerman’s request for judicial review of the

decision to deny her claim for supplemental security income benefits under the provisions

of Title XVI of the Social Security Act. The Administrative Law Judge (“ALJ”) who reviewed

Ms. Bowerman’s case on administrative appeal determined that she was capable of

performing light work with limitations and was not disabled. Ms. Bowerman appealed that

decision to this Court.

The Magistrate Judge recommends remanding the case to the Commissioner to

more fully develop the record regarding a condition identified variously as “lower-leg

edema,” “lower-leg swelling,” or “veinous insufficiency.” Ms. Bowerman testified before

the ALJ in January 2022 that this condition restricted her ability to remain on her feet and

required her to sit for periods of time and elevate her legs. (Doc. 8, p. 65). Ms. Bowerman

underwent a vein ablation procedure on her right leg in October 2019, which at the time

improved the condition of this leg. However, her medical records following that procedure

contain contradictory reports about the persistence of this condition. Compare Doc. 8-4,

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p. 448 (September 2021, “No pedal edema.”), with Doc. 8, p. 394 (July 2020, “lower

ext[remity] edema comes and goes . . . swelling around the ankles”), and Doc, 8-1, p. 411

(March 2021, “She went to her PCP today who has ordered some test[s], she is having

increased swelling in her legs and shortness of breath.”), and id. at pp. 387 & 390 (May

2021, “She does have palpitations and leg swelling.”; “Positive for palpitations and leg

swelling.”), and id. at p. 789 (August 2021, “[S]he is having some swelling in both legs.”).

Further, in October 2020—a year after Ms. Bowerman’s right leg vein ablation

procedure—Ms. Bowerman’s physical therapist directed her to perform exercises

designed “to address decreased activity tolerance, decreased range of motion, decreased

strength, gait disturbance and pain.” Id. at p. 458 (emphasis added). These exercises

were to target, at least in part, “[e]dema [r]eduction.” Id.

The ALJ reviewed the medical records and consulting doctor reports and

determined that this condition was not severe. See Doc. 8, p. 19. Though he noted that

Ms. Bowerman “complained of significant lower extremity edema that occurred when she

was on her feet or sitting for periods of time,” he determined that her “physical exams

usually showed no edema or swelling in her lower extremities.” Id. at p. 28. The law allows

an ALJ the discretion to deem a physical ailment non-severe, so long as the ailment is

considered when assessing the claimant’s residual functional capacity (“RFC”). See Igo

v. Colvin, 839 F.3d 724, 730 (8th Cir. 2016). In the Magistrate Judge’s view, Ms.

Bowerman’s RFC was not supported by substantial evidence because the ALJ failed to

properly develop the record regarding the leg-edema condition and failed to adequately

consider that condition’s impact on the RFC. The Magistrate Judge recommended the

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following on remand:

[T]he ALJ is directed to clarify his RFC findings, specifically addressing

Plaintiff’s bilateral lower extremity impairments. The ALJ is directed to

address interrogatories to a qualified physician requesting that said

physician review all of Plaintiff’s medical records; complete an RFC

assessment regarding Plaintiff’s capabilities during the time period in

question; and provide the objective basis for the assessment so that an

informed decision can be made regarding Plaintiff’s ability to perform basic

work activities on a sustained basis. The ALJ may also order a consultative

examination, in which, the consultative examiner should be asked to review

the medical evidence of record, perform examinations and appropriate

testing needed to properly diagnose Plaintiff’s condition(s), and complete a

medical assessment of Plaintiff’s abilities to perform work related activities.

With this evidence, the ALJ should then re-evaluate Plaintiff’s RFC and

specifically list in a hypothetical to a vocational expert any limitations that

are indicated in the RFC assessments and supported by the evidence.

(Doc. 13, p. 6) (citation omitted).

On January 12, 2024, the Commissioner filed Objections to the R&R (Doc. 14).

The Commissioner disagrees that the record supports any restrictions related to lower-

leg edema and maintains that the Magistrate Judge’s citations to the medical record

“largely” referred to Ms. Bowerman’s medical visits in “April, May, and August 2019, prior

to the ablation procedure and improvement.” (Doc. 14, p. 3).

Though the ALJ’s decision contradicts Ms. Bowerman’s testimony and some of the

medical evidence, these contradictions are not sufficient for reversal and remand. The

Court may not reverse simply because substantial evidence exists in the record that could

have supported a different outcome, or because the Court could have decided the case

differently. McNamara v. Astrue, 590 F.3d 607, 610 (8th Cir.2010). Specifically,

“[s]ubjective complaints may be discounted if there are inconsistencies in the evidence

as a whole.” Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984) (internal quotations

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marks omitted). Here, the ALJ considered Ms. Bowerman’s complaints and found that

they were not “entirely consistent” with treatment and medical records. (Doc. 8, p. 28).

Additionally, though there is medical evidence of edema and leg swelling that could

support additional limitations beyond the current RFC, there is substantial evidence that

Ms. Bowerman’s “physical exams usually showed no edema or swelling in her lower

extremities.” Id.; see Brown v. Colvin, 825 F.3d 936, 939 (8th Cir. 2016) (Substantial

evidence exists when a reasonable mind would accept the evidence as “adequate to

support a conclusion.” (citations omitted)). In some cases, evidence may so contradict

the ALJ’s conclusion that it becomes clear the conclusion is not based on substantial

evidence on the record as a whole (i.e., it suggests the ALJ did not consider certain

impairments), but that is not the case here. In the RFC discussion, the ALJ cites a doctor’s

visit from July 2020, where Ms. Bowerman complained of—but the doctor’s exam did not

find—edema and leg swelling. (Doc. 8, p. 25). The ALJ also cited a doctor’s visit from

August 2021, where an exam showed no significant edema, but her diagnosis still

included “varicose veins of both legs with edema.” Id. at p. 26. Further, the ALJ’s language

that the exams “usually showed no edema or swelling” indicates consideration of the

record as a whole, including the medical evidence identified in this Order that the ALJ did

not explicitly discuss. Id. at p. 28 (emphasis added). “Although required to develop the

record fully and fairly, an ALJ is not required to discuss every piece of evidence

submitted.” Black v. Apfel, 143 F.3d 383, 386 (8th Cir. 1998).

Overall, the ALJ’s discussion shows that he weighed all the medical evidence,

including several exams that reported no edema or swelling, Ms. Bowerman’s subjective

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complaints, and Ms. Bowerman’s testimony regarding her day-to-day capabilities. See

Doc. 8, pp. 23-30. Based on this, the ALJ found that Ms. Bowerman retains the RFC to

perform light work with certain limitations. /d. at p. 22. Whether this Court agrees with the

ALJ’s decision is of no moment. “If substantial evidence supports the decision, then [the

Court] may not reverse, even if inconsistent conclusions may be drawn from the evidence,

and even if [the Court] may have reached a different outcome.” McNamara, 590 F.3d at

610. Here, the Court finds that the ALJ’s decision is supported by substantial evidence

on the record as a whole.

Accordingly, IT IS ORDERED that the Commissioner’s Objections (Doc. 14) are

SUSTAINED. The Court DECLINES TO ADOPT the Magistrate Judge’s R&R (Doc. 13),

and the decision of the ALJ is AFFIRMED.

Judgment will enter concurrently with this Order.

IT 1S SO ORDERED on this 315 day of March, 2024.

UNITED STATES DISTRICT JUDGE