# Christian v. Social Security Administration, Commissioner

> District Court, N.D. Alabama · October 9, 2019

URL: https://www.frixlaw.com/law-library/cases/9988986

## Case

- **Court:** District Court, N.D. Alabama
- **Decided:** October 9, 2019
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/9988986

## How later opinions describe it (automated extraction)

- noting it was not necessary to address claimant’s argument ALJ failed to develop a full medical record because it was clear claimant’s counsel would present additional medical evidence on remand for other reasons
- holding ALJ erred by failing to address claimant’s diagnosed bipolar disorder
- holding any error in determining at step two that claimant’s cervical spine impairment was not severe was harmless because elsewhere in sequential evaluation ALJ specifically considered and discussed symptoms claimant allegedly experienced because of that impairment
- holding any error in failing to indicate severity of claimant’s chronic back pain at step two was harmless because at step three ALJ discussed in detail claimant’s testimony and medical history, which included pain complaints

## Opinion text

UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION

ANGELA H. CHRISTIAN, )
)
Plaintiff, )
)
v. )
) Case No.: 2:18-cv-01076-SGC
SOCIAL SECURITY )
ADMINISTRATION, Commissioner, )
)
Defendant. )

MEMORANDUM OPINION1
The plaintiff, Angela H. Christian, appeals from the decision of the
Commissioner of the Social Security Administration (the “Commissioner”) denying
her applications for Disability Insurance Benefits (“DIB”) and Supplemental
Security Income (“SSI”). Christian timely pursued and exhausted her administrative
remedies, and the Commissioner’s decision is ripe for review pursuant to 42 U.S.C
§§ 405(g) and 1383(c)(3). For the reasons discussed below, the Commissioner’s
decision is due to be reversed and remanded.
I. Procedural History
Christian has a high school education and has previously been employed as a
certified nursing assistant, home health aide, and teacher aide. (Tr. at 122, 419-25).

1 The parties have consented to the exercise of full dispositive jurisdiction by a magistrate judge
pursuant to 28 U.S.C. § 636(c). (Doc. 20).
In her applications for DIB and SSI, Christian alleged she became disabled on
August 22, 2014, due to a variety of impairments. (Id. at 117). After her claims

were denied initially and on reconsideration, Christian requested a hearing before an
administrative law judge (“ALJ”). (Id.). Following a hearing, the ALJ denied
Christian’s claims. (Id. at 117-24). Christian was forty-seven years old when the

ALJ issued the decision. (Id. at 122, 124). After the Appeals Council denied review
of the ALJ’s decision (id. at 1-4), that decision became the final decision of the
Commissioner, see Frye v. Massanari, 209 F. Supp. 2d 1246, 1251 (N.D. Ala. 2001)
(citing Falge v. Apfel, 150 F.3d 1320, 1322 (11th Cir. 1998)). Thereafter, Christian

commenced this action. (Doc. 1).
II. Statutory and Regulatory Framework
To establish eligibility for disability benefits, a claimant must show “the

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
twelve months.” 42 U.S.C. §§ 416(i)(1)(A), 423(d)(1)(A), 1382c(a)(3)(A); 20

C.F.R. §§ 404.1505(a), 416.905(a). Furthermore, a claimant must show she was
disabled between her alleged initial onset date and her date last insured. Mason v.
Comm’r of Soc. Sec., 430 F. App’x 830, 831 (11th Cir. 2011) (citing Moore v.

Barnhart, 405 F.3d 1209, 1211 (11th Cir. 2005); Demandre v. Califano, 591 F.2d
1088, 1090 (5th Cir. 1979)). The Social Security Administration (“SSA”) employs
a five-step sequential analysis to determine an individual’s eligibility for disability

benefits. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).
First, the Commissioner must determine whether the claimant is engaged in
“substantial gainful activity.” Id. at §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If the

claimant is engaged in substantial gainful activity, the Commissioner will find the
claimant is not disabled. Id. at §§ 404.1520(a)(4)(i) and (b), 416.920(a)(4)(i) and
(b). At the first step, the ALJ determined Christian would meet the SSA’s insured
status requirements through June 30, 2017, and had not engaged in substantial

gainful activity since August 22, 2014. (Tr. at 119).
If the claimant is not engaged in substantial gainful activity, the
Commissioner must next determine whether the claimant suffers from a severe

physical or mental impairment or combination of impairments that has lasted or is
expected to last for a continuous period of at least twelve months. 20 C.F.R. §§
404.1520(a)(4)(ii), 416.920(a)(4)(ii). If the claimant does not have a severe
impairment or combination of impairments, the Commissioner will find the claimant

is not disabled. Id. at §§ 404.1520(a)(4)(ii) and (c), 416.920(a)(4)(ii) and (c). At the
second step, the ALJ determined Christian has the following severe impairments:
diabetes with peripheral neuropathy, degenerative joint disease, chronic obstructive

pulmonary disease, seizure disorder, and bladder dysfunction. (Tr. at 119). The ALJ
determined Christian’s diagnoses of depression and human immunodeficiency virus
infection (“HIV”) constitute non-severe impairments. (Id. at 120).

If the claimant has a severe impairment or combination of impairments, the
Commissioner must then determine whether the impairment or combination of
impairments meets or equals one of the “Listings” found in 20 C.F.R. Part 404,

Subpart P, Appendix 1. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If the
claimant’s impairment or combination of impairments meets or equals one of the
Listings, the Commissioner will find the claimant is disabled. Id. at §§
404.1520(a)(4)(iii) and (d), 416.920(a)(4)(iii) and (d). At the third step, the ALJ

determined Christian does not have an impairment or combination of impairments
that meets or medically equals the severity of one of the Listings. (Tr. at 120).
If the claimant’s impairment or combination of impairments does not meet or

equal one of the Listings, the Commissioner must determine the claimant’s residual
functional capacity (“RFC”) before proceeding to the fourth step. 20 C.F.R. §§
404.1520(e), 416.920(e). At the fourth step, the Commissioner will compare an
assessment of the claimant’s RFC with the physical and mental demands of the

claimant’s past relevant work. Id. at §§ 404.1520(a)(4)(iv) and (e), 416.920(a)(4)(iv)
and (e). If the claimant is capable of performing her past relevant work, the
Commissioner will find the claimant is not disabled. Id. at §§ 404.1520(a)(4)(iv),

416.920(a)(4)(iv).
Before proceeding to the fourth step, the ALJ determined Christian has the
RFC to perform a limited range of sedentary work. (Tr. at 120-21). At the fourth

step, the ALJ determined Christian is not able to perform her past relevant work.
(Id. at 122).
If the claimant is unable to perform her past relevant work, the Commissioner

must finally determine whether the claimant is capable of performing other work
that exists in substantial numbers in the national economy in light of the claimant’s
RFC, age, education, and work experience. 20 C.F.R. §§ 404.1520(a)(4)(v) and
(g)(1), 416.920(a)(4)(v) and (g)(1). If the claimant is capable of performing other

work, the Commissioner will find the claimant is not disabled. Id. at §§
404.1520(a)(4)(v) and (g)(1), 416.920(a)(4)(v) and (g)(1). If the claimant is not
capable of performing other work, the Commissioner will find the claimant is

disabled. Id. at §§ 404.1520(a)(4)(v) and (g)(1), 416.920(a)(4)(v) and (g)(1).
At the fifth step, considering Christian’s age, education, work experience, and
RFC, the ALJ determined there were jobs existing in significant numbers in the
national economy that Christian could perform through her date last insured, such as

those of ticket counter, order clerk, and information clerk. (Tr. at 123). Therefore,
the ALJ concluded Christian is not disabled. (Id. at 124).
III. Standard of Review

Review of the Commissioner’s decision is limited to a determination of
whether that decision is supported by substantial evidence and whether the
Commissioner applied correct legal standards. Crawford v. Comm’r of Soc. Sec.,

363 F.3d 1155, 1158 (11th Cir. 2004). A district court must review the
Commissioner’s findings of fact with deference and may not reconsider the facts,
reevaluate the evidence, or substitute its judgment for that of the Commissioner.

Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1260 (11th Cir. 2007); Dyer
v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005). Rather, a district court must
“scrutinize the record as a whole to determine if the decision reached is reasonable
and supported by substantial evidence.” Bloodsworth v. Heckler, 703 F.2d 1233,

1239 (11th Cir. 1983) (internal citations omitted). Substantial evidence is “such
relevant evidence as a reasonable person would accept as adequate to support a
conclusion.” Id. It is “more than a scintilla, but less than a preponderance.” Id. A

district court must uphold factual findings supported by substantial evidence, even
if the preponderance of the evidence is against those findings. Miles v. Chater, 84
F.3d 1397, 1400 (11th Cir. 1996) (citing Martin v. Sullivan, 894 F.2d 1520, 1529
(11th Cir. 1990)).

A district court reviews the Commissioner’s legal conclusions de novo. Davis
v. Shalala, 985 F.2d 528, 531 (11th Cir. 1993). “The [Commissioner’s] failure to
apply the correct law or to provide the reviewing court with sufficient reasoning for

determining that the proper legal analysis has been conducted mandates reversal.”
Cornelius v. Sullivan, 936 F.2d 1143, 1145-46 (11th Cir. 1991).
IV. Discussion

On appeal, Christian argues the ALJ erred by (1) determining her HIV is not
a severe impairment and (2) failing to determine whether her headaches constitute a
severe impairment. (Doc. 12). Additionally, Christian argues the Appeals Council

erred in refusing to consider new evidence she submitted to the Appeals Council
after the ALJ issued his decision. (Id.).
A. Determination HIV is Non-Severe Impairment
Step two of the sequential evaluation undertaken by an ALJ serves as a “filter”

or “screen” to weed out claims involving no severe impairment or combination of
impairments. Jamison v. Bowen, 814 F.2d 585, 588 (11th Cir. 1987); Stratton v.
Bowen, 827 F.2d 1447, 1452, 1452 n.9 (11th Cir. 1987). “[T]he finding of any

severe impairment . . . is enough to satisfy the requirement of step two.” Jamison,
814 F.2d at 588 (emphasis added); see also Tuggerson-Brown v. Comm’r of Soc.
Sec., 572 F. App’x 949, 951 (11th Cir. 2014) (“Based on our precedent and the
regulations . . . it is apparent that there is no need for an ALJ to identify every severe

impairment at step two.”). Thus, an error committed at step two of the sequential
evaluation may be harmless. See, e.g., Gray v. Comm’r of Soc. Sec., 550 F. App’x
850, 853-54 (11th Cir. 2013) (holding any error in determining at step two that

claimant’s cervical spine impairment was not severe was harmless because
elsewhere in sequential evaluation ALJ specifically considered and discussed
symptoms claimant allegedly experienced because of that impairment); Delia v.

Comm’r of Soc. Sec., 433 F. App’x 885, 887 (11th Cir. 2011) (holding that while
ALJ erred in determining claimant’s mental impairments were not severe, error was
harmless because ALJ considered claimant’s mental impairments at steps three, four,

and five); Heatly v. Comm’r of Soc. Sec., 382 F. App’x 823, 824-25 (11th Cir. 2010)
(holding any error in failing to indicate severity of claimant’s chronic back pain at
step two was harmless because at step three ALJ discussed in detail claimant’s
testimony and medical history, which included pain complaints).

However, if a case advances beyond step two, an ALJ must consider all
impairments, severe or not, at later steps in the sequential evaluation. Tuggerson-
Brown, 572 F. App’x at 951; Gray, 550 F. App’x at 853 (citing Bowen v. Heckler,

748 F.2d 629, 634-35 (11th Cir. 1984)). Where an ALJ fails to do so, he or she
commits reversible error. See, e.g., Ashford v. Barnhart, 347 F. Supp. 2d 1189,
1193-94 (M.D. Ala. 2004) (holding ALJ erred by failing to address claimant’s
diagnosed bipolar disorder); Williams v. Barnhart, 186 F. Supp. 2d 1192, 1197-98

(M.D. Ala. 2002) (holding ALJ erred by failing to address a number of claimant’s
impairments, including one not specifically listed by claimant, which were grounded
in medical evidence); Wuerth v. Astrue, 2008 WL 680211, at *5 (M.D. Fla. Mar. 7,

2008) (holding ALJ erred by failing to discuss a number of claimant’s impairments
in any meaningful manner).
More specifically, when assessing a claimant’s RFC, an ALJ must consider

all severe and non-severe impairments and any related symptoms that may cause
physical and mental limitations. 20 C.F.R. §§ 404.1545(a), 416.945(a). To the
extent a claimant offers testimony of disabling pain or other subjective symptoms,

an ALJ must articulate explicit and adequate reasons for discrediting the testimony.
Foote v. Chater, 67 F.3d 1553, 1561-62 (11th Cir. 1995).
Christian was diagnosed with HIV in January 2015. (Tr. at 1086, 1089).2
During the hearing before the ALJ, Christian testified as follows: after her HIV

diagnosis, her “whole body just went down completely.” (Id. at 157). She always
feels sick. (Id. at 147). After she takes approximately fifteen pills each morning,
which make her nauseated, she requires between an hour and an hour-and-a-half to

get herself together. (Id.). She will cough “[e]very day, all day” for two or three
months at a time. (Id. at 147, 150-51). She “constantly go[es] to the bathroom all
the time.” (Id. at 157). More specifically, she may have to urinate three times within
one hour. (Id.).

The ALJ determined Christian’s HIV constitutes a non-severe impairment
because treatment records show that with antiretroviral therapy Christian’s viral load

2 Christian raises the possibility she may have been diagnosed with HIV in March 2013. (Doc. 12
at 10). It is not necessary to determine this factual issue because it makes no difference to the
disposition of her appeal from the Commissioner’s decision.
has been below the level of detectability, her CD4 count has been within the normal
range, and her medical providers have consistently described her HIV as well-

controlled. (Id. at 458, 1261, 1325, 1375, 1411, 1440).3 Assuming this
determination was not in error, the ALJ nonetheless erred at later steps in the
sequential evaluation by failing to articulate any reason for apparently discrediting

Christian’s testimony regarding subjective symptoms she experiences, whether
those symptoms are related to her HIV or one of her other medically determinable
impairments. See Foote, 67 F.3d at 1561-62. This credibility determination is
critical because it is not clear whether Christian would be able to perform any of the

jobs identified by the ALJ at step five if, for example, she had an unrelenting cough
and needed to use the restroom three times every hour. Id. at 1562 (“A lack of
explicit credibility finding becomes a ground for remand when credibility is critical

to the outcome of the case.”).
B. Failure to Determine Severity of Headaches
Although Christian’s applications do not identify headaches as a basis for her
alleged disability, Christian testified during the hearing before the ALJ that she

3 The amount of HIV in a person’s blood is referred to as the “viral load.” A person’s CD4 count
helps determine how well his or her immune system works and how much damage HIV has done.
A healthy person typically has a CD4 count of 500 to 1,000 cells per microliter of blood. See
https://www.merckmanuals.com/home/infections/human-immunodeficiency-virus-hiv-
infection/human-immunodeficiency-virus-hiv-infection (last visited October 9, 2019). Christian’s
CD4 count was 1,454 in January 2016 and 1,874 in February 2017. (Tr. at 1261, 1440).
suffers from headaches. (Tr. at 147-50). More specifically, she testified she
experiences approximately one migraine per week and that even with her current

course of clinical treatment it takes her two or three days to recover. (Id. at 149-50).
Additionally, Christian’s headaches are well-documented in the medical evidence of
record. (See, e.g., id. at 520, 721, 1020, 1240, 1264, 1385, 1388, 1395).

However, the ALJ neither addressed the severity of Christian’s headaches at
step two, nor considered the impairment at later steps in the sequential evaluation,
including by failing to articulate explicit and adequate reasons for discrediting
Christian’s testimony regarding her headache symptoms. See Ashford, 347 F. Supp.

2d at 1193-94; Williams, 186 F. Supp. 2d at 1197-98; Wuerth v. Astrue, 2008 WL
680211, at *5; Foote, 67 F.3d at 1561-62.4
V. Conclusion

Having reviewed the administrative record and considered all the arguments
presented by the parties, the undersigned find the Commissioner’s decision is not in
accordance with applicable law or supported by substantial evidence. Therefore, the
Commissioner’s decision is due to be reversed and remanded for further

4 Because the foregoing errors warrant reversal and remand of this case to the Commissioner for
further consideration, it is not necessary to address Christian’s argument the Appeals Council erred
by refusing to consider new evidence she submitted to the Appeals Council after the ALJ issued
his decision. Presumably, counsel for Christian will present this evidence on remand. See Jackson
v. Bowen, 801 F.2d 1291, 1294 n.2 (11th Cir. 1986) (noting it was not necessary to address
claimant’s argument ALJ failed to develop a full medical record because it was clear claimant’s
counsel would present additional medical evidence on remand for other reasons).
consideration. A separate order will be entered.
DONE this 9th day of October, 2019.

STACI G. CORNELIUS
U.S. MAGISTRATE JUDGE

12

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/9988986. Public record. Not legal advice.