The opinion
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
GLORIA THOMAS, )
)
Plaintiff, )
)
v. ) Civil Action Number
) 2:19-cv-02085-AKK
COMMISSIONER OF SOCIAL )
SECURITY ADMINISTRATION, )
)
Defendant.
MEMORANDUM OPINION
Gloria Thomas brings this action under 42 U.S.C. § 405(g) of the Social
Security Act (the “Act”), seeking review of the final adverse decision of the
Commissioner of the Social Security Administration (“SSA”). The court finds that
the Administrative Law Judge (“ALJ”) applied the correct legal standard and that
his decision, which has become that of the Commissioner, is supported by substantial
evidence. The court therefore affirms the decision denying benefits.
I.
Thomas worked from home as a part-time, self-employed customer services
representative before the onset of her alleged disability. R. 34, 142, 201–02. In
January 2017, Thomas applied for Title II disability insurance benefits and Title XVI
Supplemental Security Income based on shortness of breath, asthma, hypertension,
and migraines. R. 65–66, 181. Thomas initially alleged a disability onset date of
May 30, 2016, but she later amended it to February 1, 2017. R. 34, 65, 141.
After the SSA denied Thomas’s application, R. 69, she requested a formal
hearing before an ALJ. R. 82. The ALJ likewise denied her claim. R. 23. The SSA
Appeals Council declined to review the ALJ’s decision, rendering it the final
decision of the Commissioner. R. 1. Thomas then filed this action for judicial
review under 42 U.S.C. § 405(g). Doc. 1.
II.
This court’s review is limited to determining whether the record contains
substantial evidence to sustain the ALJ’s decision and whether the ALJ applied the
correct legal standards. See 42 U.S.C. § 405(g); Chester v. Bowen, 792 F.2d 129,
131 (11th Cir. 1986). Under 42 U.S.C. §§ 405(g) and 1383(c), the Commissioner’s
“factual findings are conclusive if supported by ‘substantial evidence.’” Martin v.
Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990). Thus, the court cannot reconsider
the facts, reevaluate the evidence, or substitute its judgment for the Commissioner’s.
Id. Instead, it must review the final decision as a whole and determine if it is
“‘reasonable and supported by substantial evidence.’” Id. (quoting Bloodsworth v.
Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)).
Substantial evidence refers to “such relevant evidence as a reasonable person
would accept as adequate to support a conclusion.” Id. (quoting Bloodsworth, 703
F.2d at 1239). As the Supreme Court recently emphasized, this burden “is not high.”
Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019). Rather, substantial evidence falls
somewhere between a “scintilla” and a “preponderance of evidence.” Martin, 894
F.2d at 1529. If substantial evidence supports the Commissioner’s factual findings,
then the court must affirm even if the evidence preponderates against those
findings. See id. However, this “does not yield automatic affirmance” despite the
limited scope of judicial review, Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988),
and reviewing courts are not to act as mere “automatons.” Bloodsworth, 703 F.2d
at 1239 (quotation omitted). Conclusions of law, in contrast, receive de novo
review. Martin, 894 F.2d at 1529.
III.
To qualify 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. §§ 423(d)(1)(A); 416(i)(1). A physical or mental impairment
is “an impairment that results from anatomical, physiological, or psychological
abnormalities which are demonstrated by medically acceptable clinical and
laboratory diagnostic techniques.” Id. § 423(d)(3).
Determination of disability under the Act requires a five-step analysis. 20
C.F.R. § 404.1520(a). Specifically, the ALJ must determine in sequence:
(1) whether the claimant is currently unemployed;
(2) whether the claimant has a severe impairment;
(3) whether the impairment meets or equals one listed by the Commissioner;
(4) whether the claimant is unable to perform his or her past work; and
(5) whether the claimant is unable to perform any work in the national
economy.
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986). “An affirmative answer
to any of the above questions leads either to the next question, or, on steps three and
five, to a finding of disability. A negative answer to any question, other than step
three, leads to a determination of ‘not disabled.’” Id. (citing 20 C.F.R. § 416.920(a)-
(f)). “Once [a] finding is made that a claimant cannot return to prior work the burden
of proof shifts to the [Commissioner] to show other work the claimant can
do.” Foote v. Chater, 67 F.3d 1553, 1559 (11th Cir. 1995).
Claimants, such as Thomas, alleging disability based on their subjective pain
must meet additional criteria. The Eleventh Circuit applies a three-part “pain
standard” when a claimant seeks to establish disability through her own testimony
of pain or other subjective symptoms. Holt v. Sullivan, 921 F.2d 1221, 1223 (11th
Cir. 1991). Under that standard, the claimant must show “(1) evidence of an
underlying medical condition; and (2) either (a) objective medical evidence
confirming the severity of the alleged pain; or (b) that the objectively determined
medical condition can reasonably be expected to give rise to the claimed pain.”
Wilson v. Barnhart, 284 F.3d 1219, 1225 (11th Cir. 2002). But medical evidence of
pain or its intensity is not required. Elam v. R.R. Ret. Bd., 921 F.2d 1210, 1215 (11th
Cir. 1991). “A claimant’s subjective testimony supported by medical evidence that
satisfies the pain standard is itself sufficient to support a finding of disability.” Holt,
921 F.2d at 1223. Thus, if a claimant testifies to disabling pain and satisfies the
three-part pain standard, the ALJ must find a disability unless the ALJ properly
discredits the claimant’s testimony.
An ALJ cannot discredit testimony without articulating “explicit and adequate
reasons for doing so.” Foote, 67 F.3d at 1561. If the ALJ does not provide reasons
for rejecting subjective pain testimony, then the ALJ is deemed as a matter of law to
have accepted the testimony as true. Hale v. Bowen, 831 F.2d 1007, 1012 (11th Cir.
1987). “Implicit in this rule is the requirement that such articulation of reasons by
the [ALJ] be supported by substantial evidence.” Id. Therefore, if the ALJ either
fails to articulate reasons for refusing to credit the claimant’s pain testimony, or if
the ALJ’s reasons are not supported by substantial evidence, the court must accept
as true the claimant’s pain testimony and render a finding of disability. Id.
IV.
In performing the five-step sequential analysis, the ALJ initially determined
that Thomas had not engaged in substantial gainful activity since the date of her
application, thereby meeting Step One. R. 18. At Step Two, the ALJ found that
Thomas had the following severe impairments: hypertension, chronic obstructive
pulmonary disorder (COPD), asthma, morbid obesity, anemia, degenerative joint
disease of the left knee, coronary artery disease, and migraines. R. 18. The ALJ
then found that Thomas did not satisfy Step Three because she “does not have an
impairment or combination of impairments that meets or medically equals the
severity of one of the listed impairments.” R. 19.
After answering Step Three negatively, the ALJ concluded that Thomas “has
the residual functional capacity [(“RFC”)] to perform medium work” except that
Thomas “can never climb ladders, ropes, and scaffolds. She can have occasional
exposure to temperature extremes, dust, odors, fumes, and pulmonary irritants,
humidity, wetness, and vibration.” R. 19. The ALJ added that “[t]here should be no
exposure to unprotected heights, hazardous machinery, or commercial driving.” R.
19. At Step Four, the ALJ observed that Thomas lacked any past relevant work. R.
21. In the final step, the ALJ concluded that “there are jobs that exist in significant
numbers in the national economy that [Thomas] can perform.” R. 22. To reach that
conclusion, the ALJ considered Thomas’s age, education, work experience, and RFC
alongside the Medical-Vocational Guidelines found in 20 C.F.R. Part 404, Subpart
P, Appendix 2, and a vocational expert’s testimony. R. 22–23. Because the ALJ
answered Step Five negatively, she concluded that Thomas was not disabled. R. 23.
V.
On appeal, Thomas contends that the ALJ erred when she concluded that
Thomas has the RFC to perform medium work with certain exceptions. See doc. 11
at 15. Specifically, Thomas says that the ALJ improperly discredited her pain
testimony by applying the wrong legal standard and that substantial evidence does
not support the ALJ’s decision. Id. Thomas makes several arguments supporting
her contention that the ALJ applied the incorrect legal standard; none are persuasive.
First, Thomas cites Social Security Ruling 96-3p for the proposition that the “ALJ
failed to properly consider [her] longitudinal medical treatment.” Doc. 11 at 8. As
an initial matter, the SSA rescinded that ruling in 2018.1 In any event, the face of
the ALJ’s decision shows that she thoroughly reviewed Thomas’s treatment history
from 2016 to mid-2018, as will be discussed below.
Second, Thomas apparently argues that the ALJ failed to provide explicit and
adequate reasons for discrediting Thomas’s testimony. See doc. 11 at 6. Thomas
1 See Social Security Rulings (SSRs) 96-3p and 96-4p; Rescission of SSRS 96-3p and 96-4p, 83
Fed. Reg. 27816-01 (June 14, 2018) (explaining that SSR 96-3p was rescinded because it was
“unnecessarily duplicative of SSR 16-3p”).
cites Social Security Ruling 16-3p, which prohibits ALJs from relying on conclusory
statements and recitations of the standards when evaluating a claimant’s symptoms.
Id. at 6. But even under that ruling, the ALJ’s three pages of reasoning, including
her statements that Thomas’s testimony was “not entirely consistent with the” record
evidence, was adequate. See R. 19–21; Wilson, 284 F.3d at 1226.
Third, Thomas contends that the ALJ did not “consider the totality of the
medical records and the combined effects of [Thomas’s] severe impairments when
making her determination.” Doc. 11 at 9 (citing Bowen v. Heckler, 748 F.2d 629,
635 (11th Cir. 1984)). The ALJ wrote, however, that Thomas lacked “an impairment
or combination of impairments that” equaled a listing and that she had “considered
all symptoms” in determining Thomas’s RFC. R. 19. “[T]hose statements are
enough to demonstrate that the ALJ considered all necessary evidence” under
Eleventh Circuit precedent. Tuggerson-Brown v. Comm’r of Soc. Sec., 572 F. App’x
949, 952 (11th Cir. 2014) (citing Wilson, 284 F.3d at 1224–25). Moreover, the ALJ
specifically addressed evidence concerning Thomas’s asthma, anemia, COPD,
migraines, and obesity. R. 19–21. At bottom, the ALJ’s “findings and discussion
indicate that the [correct] standard was applied.” Wilson, 284 F.3d at 1225–26.
Pruning Thomas’s legal challenges makes clear that her true grievance with
the ALJ’s decision is that it allegedly lacks support in substantial evidence. See doc.
11 at 8–14. The court disagrees. Based on Thomas’s impairments, the ALJ
concluded that Thomas could perform medium work subject to several narrowly
tailored limitations. R. 19. Because Thomas experiences knee pain and is obese,
the ALJ limited her exposure to climbing. R. 20. And because Thomas has
breathing problems and experiences chest pain, the ALJ limited her to only
occasional exposure to potential pulmonary irritants. R. 20–21. The same
conditions, combined with Thomas’s history of migraines, led the ALJ to limit
Thomas’s exposure to other potentially hazardous conditions. R. 21. In the end, the
ALJ observed that Thomas’s impairments were “somewhat” limiting but “not
disabling.” R. 20. Substantial evidence supports that assessment.
Consider first Thomas’s alleged knee pain. Thomas testified at her
administrative hearing that her joint pain, which mostly occurs in her left knee,
contributed to her disability. R. 38. The ALJ concluded that Thomas’s joint
degeneration “reasonably causes some pain” but not to the extent alleged. R. 20.
She observed that Thomas infrequently complained of knee pain and took
medication for it only as-needed. R. 20–21. In response, Thomas points to a handful
of occasions when she reported knee pain and received steroid injections as a result.
Doc. 11 at 10–11. But treatment notes from those doctors’ visits show that her pain
was well-controlled after the injections and that she was advised to seek additional
treatment only as required. R. 557–78, 629–30. The same notes indicate that
Thomas exhibited normal joint movement and strength in all of her extremities. R.
558, 630. And although Thomas takes a prescribed medication for her knee pain,
her treatment notes establish that she uses it as needed and mostly for her headaches.
R. 529, 634. Finally, a 2018 x-ray examination revealed some degenerative change
in Thomas’s left knee, but doctors described the change as “mild.” R. 626.
Substantial evidence likewise supports the ALJ’s conclusion about the
limiting effect of Thomas’s shortness of breath and related chest pain. Thomas
testified that her breathing problems render her constantly exhausted. R. 35–37. But
the ALJ observed that Thomas’s pulmonary function tests and chest x-rays were
“normal” and “unremarkable,” revealing “nothing significant.” R. 19–20. The
record amply supports that assessment. Treatment notes from July 2016 to
September 2018 consistently indicate that Thomas’s lungs showed no distress and
were clear with no abnormalities or deformities. See, e.g., R. 381, 385, 391–92, 432,
548, 668. Indeed, the ALJ was clearly importing language directly from Thomas’s
treatment notes when she described Thomas’s test results as unremarkable and
normal. Those and similar words appear throughout Thomas’s medical history. See,
e.g., R. 392, 427, 468–69, 649, 668.
Although Thomas’s doctor described her asthma as “suboptimally controlled”
in early 2018, he also observed that it was “uncomplicated” and “moderate.” R. 615.
At a follow up appointment, he wrote that a “mild exacerbation” had prompted
Thomas to visit the emergency room but she was “otherwise stable.” R. 616. In
August 2018, he concluded that Thomas’s asthma was “much better controlled,”
though he acknowledged that Thomas had “fairly significant disease.” R. 621. To
be sure, Thomas points to numerous occasions where she sought treatment for her
breathing issues and chest pain from emergency room doctors. Doc. 11 at 12–13.
But most of those trips occurred before the onset of her alleged disability. And the
two more recent times that Thomas visited the emergency room involved moderate
complaints of pain that were resolved quickly after she was admitted. See R. 595,
649. Indeed, x-rays from those visits produced no significant findings and showed
that her lungs were “clear” and “normal.” R. 598, 649. In sum, the ALJ’s evaluation
of Thomas’s breathing issues and chest pain was grounded in substantial evidence.
So too was the ALJ’s assessment of Thomas’s migraines. At her hearing,
Thomas explained that she experiences debilitating migraine headaches once or
twice a week. R. 38. She says those headaches usually last for “[a] couple hours
during the day” and that her pain registers “anywhere from an eight or nine” on a
ten-point scale. R. 38–39. The ALJ observed, however, that Thomas previously
reported that she could function through most of her headaches and that doctors
attributed her worst headaches to sleep deprivation. R. 19–20. Thomas offers little
evidence to undermine that finding. Although she reported daily and worsening
migraines in 2014, treatment notes confirm the ALJ’s statement that this was “likely
due to lack of sleep.” R. 265–66. When Thomas described experiencing several
severe migraines weekly in 2017, her treatment notes nonetheless confirmed that her
prescribed medications were “working well.” R. 557–58. Notes from doctors’ visits
in 2018 confirm that Thomas reported being able to “function through” most of her
headaches, R. 577, and that her headaches were “better.” R. 633. On one of those
trips, Thomas’s doctor noted that her migraines were controlled with medication. R.
634. This evidence substantially supports the ALJ’s decision.
Finally, the court reiterates that its sole function on appeal is to determine
whether the record contains substantial evidence to support the underlying decision,
not to reweigh evidence or substitute its judgment for the Commissioner’s. Martin,
894 F.2d at 1529. “[C]redibility determinations are the province of the ALJ,” and
courts should “not disturb a clearly articulated credibility finding supported by
substantial evidence.” Mitchell v. Comm’r, Soc. Sec. Admin., 771 F.3d 780, 782
(11th Cir. 2014) (citations omitted). That is true even where the evidence
preponderates against the Commissioner’s finding. Martin, 894 F.2d at 1529.
VI.
In conclusion, substantial evidence supports the ALJ’s decision that Thomas
is not disabled, and the ALJ applied the proper legal standards in reaching that
determination. The Commissioner’s final decision is therefore due to be affirmed in
a separate order in accordance with this Memorandum Opinion.
DONE the 15th day of December, 2020.
— Apa Ze the
ABDUL K. KALLON
UNITED STATES DISTRICT JUDGE
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