“A claimant may establish that he has a disability ‘through his own testimony of pain or other subjective symptoms.’”
How later courts described this case
- “A claimant may establish that he has a disability ‘through his own testimony of pain or other subjective symptoms.’”
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
NORTHEASTERN DIVISION
JOANNA SANDERS, }
}
Plaintiff,
}
}
v.
}
}
KILOLO KIJAKAZI,
} CASE NO.: 5:21-cv-00383-MHH
ACTING COMMISSIONER OF
}
SOCIAL SECURITY,
}
}
Defendant. }
MEMORANDUM OPINION
Ms. Joanna Sanders has asked the Court to review a final adverse decision of
the Commissioner of Social Security. The Commissioner denied Ms. Sanders’s
claims for disability insurance benefits and supplemental security income based on
an Administrative Law Judge’s finding that Ms. Sanders was not disabled. Ms.
Sanders argues that, in denying her request for benefits, the Administrative Law
Judge—the ALJ—improperly evaluated Ms. Sanders’s subjective complaints of
pain under the Eleventh Circuit pain standard. After careful review, the Court
affirms the Commissioner’s decision.
ADMINISTRATIVE PROCEEDINGS
To succeed in her administrative proceedings, Ms. Sanders had to prove that
she was disabled. Gaskin v. Comm’r of Soc. Sec., 533 Fed. Appx. 929, 930 (11th
Cir. 2013). “A claimant is disabled if [s]he is unable to engage in substantial gainful
activity by reason of a medically-determinable impairment that can be expected to
result in death or which has lasted or can be expected to last for a continuous period
of at least 12 months.” Gaskin, 533 Fed. Appx. at 930 (citing 42 U.S.C. §
423(d)(1)(A)).1
To determine whether a claimant has proven that she is disabled, an ALJ
follows a five-step sequential evaluation process. The ALJ considers:
(1) whether the claimant is currently engaged in substantial gainful
activity; (2) whether the claimant has a severe impairment or
combination of impairments; (3) whether the impairment meets or
equals the severity of the specified impairments in the Listing of
Impairments; (4) based on a residual functional capacity (“RFC”)
assessment, whether the claimant can perform any of his or her past
relevant work despite the impairment; and (5) whether there are
significant numbers of jobs in the national economy that the claimant
can perform given the claimant’s RFC, age, education, and work
experience.
1 Title II of the Social Security Act governs applications for benefits under the Social Security
Administration’s disability insurance program. Title XVI of the Act governs applications for
Supplemental Security Income or SSI. “For all individuals applying for disability benefits under
title II, and for adults applying under title XVI, the definition of disability is the same.” See
https://www.ssa.gov/disability/professionals/bluebook/general-info.htm (lasted visited September
15, 2023).
Winschel v. Comm’r of Soc. Sec. Admin, 631 F.3d 116, 1178 (11th Cir. 2011). “The
claimant has the burden of proof with respect to the first four steps.” Wright v.
Comm’r of Soc. Sec., 327 Fed. Appx. 135, 136-37 (11th Cir. 2009). “Under the fifth
step, the burden shifts to the Commissioner to show that the claimant can perform
other jobs that exist in the national economy.” Wright, 327 Fed. Appx. at 137.
Ms. Sanders applied for disability insurance benefits on August 28, 2017 and
for supplemental security income on September 16, 2017. (Doc. 8-4, pp. 69-70;
Doc. 8-6, pp. 2-9).2 Ms. Sanders initially alleged that her disability began on
February 1, 2014. (Doc. 8-6, p. 4). Ms. Sanders later amended her disability onset
date to October 7, 2017. (Doc. 8-6, p. 28). The Commissioner initially denied Ms.
Sanders’s claims, and Ms. Sanders requested a hearing before an ALJ. (Doc. 8-4,
pp. 46, 66, 68; Doc. 8-5, pp. 11-12). Ms. Sanders and her attorney attended a hearing
before the ALJ on June 27, 2019. (Doc. 8-3, p. 52). A vocational expert testified
via telephone at the hearing. (Doc. 8-3, pp. 54, 69-73).
The ALJ issued an unfavorable decision on August 29, 2019. (Doc. 8-4, pp.
75-86). On March 26, 2020, the Appeals Council vacated the ALJ’s August 29,
2019 decision and remanded the case to the ALJ to consider evidence submitted by
2 Ms. Sanders filed previous applications under Title II and Title XVI that an ALJ fully
adjudicated and denied on October 3, 2016; Ms. Sanders did not appeal that final decision to a
district court. (Doc. 8-3, p. 15; Doc. 8-4, pp. 5-16). Therefore, the ALJ in the present appeal
applied the doctrine of res judicata and did not consider any period on or before October 3, 2016
in reaching her October 16, 2020 decision denying Ms. Sanders disability benefits. (Doc. 8-3, p.
15).
Ms. Sanders before the ALJ’s August 29, 2019 decision. (Doc. 8-4, pp. 92-94). On
September 17, 2020, Ms. Sanders and her attorney attended a second hearing via
telephone before an ALJ. (Doc. 8-3, pp. 38, 40). A vocational expert testified at the
hearing. (Doc. 8-3, pp. 69-73).
The ALJ issued another unfavorable decision on October 16, 2020. (Doc. 8-
3, pp. 15-30). On January 15, 2021, the Appeals Council declined Ms. Sanders’s
request for review, (Doc. 8-3, p. 2), making the Commissioner’s decision final and
a proper candidate for this Court’s judicial review. See 42 U.S.C. § 405(g).
EVIDENCE IN THE ADMINISTRATIVE RECORD
Ms. Sanders’s Medical Records
To support her application, Ms. Sanders submitted medical records that relate
to the diagnoses and treatment of degenerative disc disease, degenerative joint
disease, chronic pain syndrome, lumbar and cervical radiculopathy, numbness, mild
joint degenerative arthrosis, major depressive disorder, and anxiety. The Court has
reviewed Ms. Sanders’s complete medical history and summarizes the following
medical records because they are most relevant to Ms. Sanders’s arguments in this
appeal.3
3 Ms. Sanders did not raise an issue regarding her alleged mental limitations. (See Doc. 12). The
Court has reviewed the medical records and medical opinions in the administrative record, but the
Court will discuss only the records that relate to Ms. Sanders’s alleged physical limitations and
symptoms.
Ms. Sanders underwent neck surgery in 2006 or 2007. (Doc. 8-7, p. 47). A
September 2012 MRI showed “mild diffuse disc bulging” in Ms. Sanders’s lumbar
spine at L3-L4 and “facet arthropathy bilaterally” at L4-L4 and L5-S1 without
stenosis. (Doc. 8-11, p. 129).4 She had an anterior cervical discectomy and fusion
at C5-C-6 and C6-C7 in 2013. (Doc. 8-12, pp. 125, 143).5 The procedure was
successful, but Ms. Sanders’s pain gradually returned. (Doc. 8-12, p. 18).
On February 13, 2017, Ms. Sanders saw Dr. Roddie Gantt at Tennessee Valley
Pain Consultants and complained of low back pain, joint stiffness and pain,
numbness and tingling in her legs, and falls. (Doc. 8-12, pp. 15, 20-21). Ms. Sanders
rated her pain at 8/10. (Doc. 8-12, p. 18). She reported that standing and walking
aggravated her pain; rest, lying down, medication and massage alleviated her pain.
(Doc. 8-12, p. 19). Dr. Gantt’s physical examination revealed that Ms. Sanders had
a normal range of motion, normal gait, and normal muscle mass. (Doc. 8-12, p. 21).
4 “Facet arthropathy, also known as facet osteoarthritis, is a type of wear-and-tear arthritis affecting
the spine. It affects the bony protrusions, called facet joints, that connect the bones of the spine.
Symptoms include neck and back pain which can get worse with standing, twisting, or bending.”
See https://www.verywellhealth.com/facet-arthropathy-treatment-190440 (last visited September
15, 2023).
5 Anterior cervical discectomy and fusion (ACDF) is a type of neck surgery that involves removing
a damaged disc to relieve spinal cord or nerve root pressure and alleviate corresponding pain,
weakness, numbness, and tingling. . . . A fusion surgery is done at the same time as the discectomy
operation . . . to stabilize the cervical segment. A fusion involves placing bone graft and/or
implants where the disc originally was in order to provide stability and strength to the area.” See
https://www.spine-health.com/treatment/spinal-fusion/acdf-anterior-cervical-discectomy-and-
fusion (last visited September 18, 2023).
Ms. Sanders’s medications included oxycodone and meloxicam for pain. (Doc. 8-
12, p. 23). Dr. Gantt administered a lumbar epidural steroid injection to relieve Ms.
Sanders’s back pain. (Doc. 8-12, p. 25).
Ms. Sanders returned to Dr. Gantt on April 25, 2017 and reported that the
epidural steroid injection relieved her pain for only two weeks. (Doc. 8-12, p. 6).
She complained of low back pain that radiated down her right buttock and calf and
numbness from her calf to her foot. (Doc. 8-12, pp. 2-3). Ms. Sanders described her
pain as “sharp” and “aching” and “worse than it [had] even been,” but she reported
the intensity of her pain at “6/10.” (Doc. 8-12, pp. 3, 6). She indicated that her
medication “barely help[ed].” (Doc. 8-12, p. 6). She stated that she “would have
gone to the ER a lot” had it not been for the $400 deductible. (Doc. 8-12, p. 6).
When CRNP Quattlebaum examined Ms. Sanders, Ms. Sanders was “either
unable/unwilling to bend forward due to pain.” (Doc. 8-12, p. 7).
Dr. Gantt’s physical examination showed a normal gait, tenderness to
palpitation in the lumbar spine, decreased range of motion, pain with flexion, and
intact sensation to touch. (Doc. 8-12, p. 9). Dr. Gantt indicated that he was “unable
to accurately evaluate” the range of motion in Ms. Sanders’s lower extremities
because of her “effort during the exam.” (Doc. 8-12, p. 9). Ms. Sanders’s
medications included oxycodone and meloxicam for pain. (Doc. 8-12, p. 10). Dr.
Gantt cancelled a lumbar epidural steroid injection scheduled for May 12, 2017 and
referred Ms. Sanders for further spinal and neurological evaluation for her back pain.
(Doc. 8-12, pp. 7, 10).
On Dr. Gantt’s referral, Ms. Sanders saw Dr. Jason Banks at Huntsville
Hospital Spine and Neuro Center on June 5, 2017. (Doc. 8-12, p. 33). Ms. Sanders
complained of low back pain that radiated into both hips and buttocks and down her
calves to her feet. (Doc. 8-12, p. 33). Ms. Sanders reported that her pain became
“more severe” after the February 2017 epidural steroid injection at Tennessee Valley
Pain Consultants. (Doc. 8-12, p. 33). Ms. Sanders indicated numbness in both legs;
difficulty walking; joint pain, stiffness, weakness, and swelling; and muscle pain and
weakness. (Doc. 8-12, pp. 33-34). Dr. Banks noted that Ms. Sanders had not
received physical or chiropractic therapy for her pain. (Doc. 8-12, p. 33). The record
of this visit is cut off and incomplete, so the Court cannot tell what finding Dr. Banks
made. (Doc. 8-12, pp. 33-34).
On June 5, 2018, Ms. Sanders saw neurologist Dr. Anjaneyulu Alapati and
complained of back pain, tingling in her legs and arms, leg and muscle weakness,
join pain and swelling, and difficulty walking. (Doc. 8-12, p. 102). Ms. Sanders
reported that she had fallen six times in the preceding six months, and she had
headaches “at least 4 times a week” that she attributed to shoulder and neck pain.
(Doc. 8-12, pp. 102-03). She indicated that she could provide self-care in her
activities of daily living, could ambulate independently, had no “limitation to
mobility,” and had a normal range of motion. (Doc. 8-12, p. 105). Dr. Alapati noted
that Ms. Sanders’s neurological exam was normal and that her overall symptoms
were “suggestive of fibromyalgia.” (Doc. 8-12, p. 104). An MRI of Ms. Sanders’s
brain was normal. (Doc. 8-12, p. 114). Dr. Alapati ordered a nerve conduction study
of Ms. Sanders’s extremities and prescribed Neurontin for her neuropathy. (Doc. 8-
12, p. 104).
On May 23, 2019, Ms. Sanders saw Dr. Morris Seymour at the Orthopedic
Center after falling “off of a barstool.” (Doc. 8-12, p. 143). She complained of an
“extreme amount of neck pain with radiating symptoms into her left arm.” (Doc. 8-
12, p. 143). Dr. Seymour’s physical examination revealed a “grossly normal” gait;
no tenderness in Ms. Sanders’s spine, joints, or shoulders; normal strength in all her
upper extremities; no muscle atrophy; intact sensation; normal deep tendon reflexes;
and normal range of motion in her cervical spine. (Doc. 8-12, p. 143). X-rays
revealed that her hardware at C5-6 and C6-7 was “well positioned,” she had no
instability on flexion extension, and she had an “extreme amount of arthritic change
above her fusion at C3-4 and 4-5.” (Doc. 8-12, p. 143). Dr. Seymour ordered an
MRI of Ms. Sanders’s spine and prescribed pain medication and muscle relaxers.
(Doc. 8-12, p. 143).
Ms. Sanders underwent EMG nerve conduction testing on June 10, 2019 and
September 18, 2019 that showed normal results with no “definite evidence of
peripheral neuropathy, carpel tunnel syndrome[,] or lower lumbar radiculopathy on
either side.” (Doc. 8-13, pp. 15, 27).6
On June 12, 2019, Dr. Saranya Nadella administered to Ms. Sanders an
epidural steroid injection in her neck at C7-T1. (Doc. 8-12, p. 136). A June 26,
2019 MRI of Ms. Sanders’s lumbar spine showed multilevel degenerative changes,
“mild left and right protrusion of the disc” at L2 through S1, and mild canal and
neural foraminal narrowing. (Doc. 8-12, p. 123). An MRI of her cervical spine
showed normal realignment but degenerative and postoperative changes with
moderate disc bulging at C3-C5 with no “definite bone deformity or compression.”
(Doc. 8-12, p. 124).7 On July 8, 2019, Dr. Nadella performed facet joint injections
in Ms. Sander’s spine at L3-L4, L4-L5, and L5-S1 for pain relief. (Doc. 8-12, p.
134).8
6 “Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the
nerve cells that control them (motor neurons). EMG results can reveal nerve dysfunction, muscle
dysfunction or problems with nerve-to-muscle signal transmission.” See
https://www.mayoclinic.org/tests-procedures/emg/about/pac-20393913 (last visited September
15, 2023).
7 “A bulging, or herniated, disk occurs when the spongy center of a disk in the spine pushes out
through a tear in the outer, rubbery portion of the disk. It can press on the spinal cord and nerve
roots, leading to pain and problems with mobility.” See
https://www.medicalnewstoday.com/articles/bulging-disk-in-back (last visited September 15,
2023).
8 “A facet joint injection is performed to treat neck and back pain in combination with other non-
surgical spine treatments like rest, medications, chiropractic manipulations, and physical therapy”
and “place[s] medication directly into the joint.” See
https://www.treatingpain.com/treatments/facet-joint-injections/ (last visited September 18, 2023).
Ms. Sanders returned to Dr. Alapati on July 11, 2019 and complained of
numbness in her feet. (Doc. 8-13, p. 29). Ms. Sanders reported that the Neurontin
helped the burning and pain in her feet and that she had no muscle spasms. (Doc. 8-
13, p. 29). She indicated that she was independent in all her activities of daily living.
(Doc. 8-13, p. 34). Dr. Alapati’s physical examination showed normal muscle
strength, a normal gait, and normal and full range of motion in Ms. Sanders’s
cervical and lumbar spine. (Doc. 8-13, p. 30). Dr. Alapati diagnosed fibromyalgia
and increased Ms. Sanders’s dosage of Neurontin. (Doc. 8-13, p. 30).
On October 17, 2019, Ms. Sanders saw Dr. Vytautas Pukis at Blossomwood
Medical to establish care. (Doc. 8-13, p. 78). Ms. Sanders complained of “pain in
multiple joints,” lower back pain that radiated to her legs, muscle aches, and
dizziness. (Doc. 8-13, pp. 78-79). Ms. Sanders denied having weakness or
“sensation changes in the extremities.” (Doc. 8-13, p. 79). Dr. Pukis referred Ms.
Sanders to pain management and prescribed Flexeril for muscle spasms and
indomethacin for pain. (Doc. 8-13, p. 79). At a follow-up with Dr. Pukis on
November 19, 2019, Ms. Sanders complained of pain in her back, neck, hips, and
muscles and rated her pain at 8/10. (Doc. 8-13, pp. 82, 86). Dr. Pukis’s physical
examination revealed paraspinal muscle tenderness but “[n]o spinal process
tenderness to palpitation.” (Doc. 8-13, p. 87).
Upon referral by Dr. Pukis, on January 20, 2020, Ms. Sanders saw Dr. James
Thacker at Huntsville Pain Management. (Doc. 8-13, p. 40). Ms. Sanders
complained of neck and back pain that she rated at 8/10. (Doc. 8-13, p. 40). Dr.
Thacker’s physical examination showed mild tenderness in Ms. Sanders’s cervical
and lumbar spine, a mildly reduced range of motion in the lumbar spine, normal
range of motion in the upper and lower extremities, full strength in all areas, intact
sensation in all extremities, a normal gait, and normal deep tendon reflexes. (Doc.
8-13, p. 44). Dr. Thacker prescribed tizanidine as a muscle relaxer and hydrocodone
for pain. (Doc. 8-13, p. 46).
At a February 4, 2020 follow up with Dr. Thacker, Ms. Sanders reported her
pain level a 5/10 and stated that she had “no real improvement in pain levels or
symptoms.” (Doc. 8-13, p. 51). She reported her “daily activity level to be 9 out of
10” and denied having “joint swelling, limitation of motion, muscle cramps, back
pain, back spasms, painful joints, stiffness, leg cramps, head pain, neck pain,
shoulder[] pain, [and] hip[] pain.” (Doc. 8-13, pp. 51, 53). At follow up
examinations with Dr. Thacker on February 18, March 5 and 25, and April 29, 2020,
Ms. Sanders had mild to moderate tenderness in her spine, mild limitation in the
range of motion in her spine, back pain, muscle stiffness and spasms, and neck pain.
(Doc. 8-13, pp. 56-57, 61-62, 69-70, 74-75). Ms. Sanders reported pain levels of
5/10 and 6/10 at these visits. (Doc. 8-13, pp. 55, 60, 68, 73).
On May 27, 2020, Ms. Sanders saw Nurse Practitioner Kelly Young at
Huntsville Pain Management and reported a pain level of 4/10 and “some
improvement” in her symptoms with her treatment plan. (Doc. 8-13, p. 105). By a
June 24, 2020 visit, Ms. Sanders reported that she was “doing well.” (Doc. 8-13, pp.
110-11). At a July 29, 2020 visit with Dr. Thacker, Ms. Sanders reported her pain
at 5/10. Ms. Sanders had reduced range of motion and mild tenderness in her spine.
(Doc. 8-13, pp. 115, 117).
Ms. Sanders underwent hernia surgery in September 2020 and recovered
“well” from the operation. (Doc. 8-13, p. 123). Dr. Ravindra Mailapur instructed
Ms. Sanders to avoid lifting objects “more than 10-15 pounds” for six weeks. (Doc.
8-13, p. 123).
Dr. E.L. Mollohan’s Consultative Examination
At the request of the Social Security Administration, Dr. Mollohan examined
Ms. Sanders on February 12, 2018. (Doc. 8-12, pp. 58-61). Ms. Sanders reported
neuropathy, chronic back pain, and carpal tunnel syndrome. She described
numbness and tingling down her legs and arms, muscle spasms, dull to sharp pain in
her back, and numbness and tingling in her fingers that caused her to lose her grip.
(Doc. 8-12, pp. 58-59). She indicated that gripping, lifting more than eight pounds,
bending, climbing stairs, sitting more than 20 minutes, standing or walking more
than ten minutes, laying flat, and weather changes aggravated her pain; medication,
heat, ice, stretches, and wearing a brace relieved her pain. (Doc. 8-12, p. 58). She
rated her pain at 5/10 to 6/10 at best and 9/10 to 10/10 at worst. (Doc. 8-12, p. 58).
During Dr. Mollohan’s physical examination, Ms. Sanders rated her shoulder
pain at 2/10, lumbar back pain at 3/10, bilateral hip pain at 3/10, and left knee pain
at 3/10. (Doc. 8-12, p. 60). Dr. Mollohan noted that Ms. Sanders reported “no
[c]ervical or [l]umbar radicular pain or . . . neurological symptoms [or] complaints”
when he performed the “exam testing maneuvers.” (Doc. 8-12, p. 61). Dr. Mollohan
reported that Ms. Sanders complained of generalized musculoskeletal soreness but
exhibited “none of the 18 palpable muscular tender points,” which he found
inconsistent with the “diagnostic criteria for the [d]iagnosis of [f]ibromyalgia.”
(Doc. 8-12, p. 60). Ms. Sanders had normal deep tendon reflexes, normal muscle
strength, and no muscular atrophy. (Doc. 8-12, p. 60).
Dr. Mollohan reported that Ms. Sanders had an antalgic gait with localized
lower back pain when she walked 20 feet; she did not use an ambulatory assistive
device. (Doc. 8-12, p. 61).9 Dr. Mollohan noted that Ms. Sanders “could sit and/or
stand for 30 minutes without complaint during the exam” and could “stand up from
a seated position and get on/off the examination table without difficulty.” (Doc. 8-
12, p. 61).
9 “An antalgic gait occurs when [someone] walk[s] with a limp because of pain.” See
https://www.webmd.com/pain-management/what-is-antalgic-gait (last visited September 17,
2023).
Dr. Mollohan found that Ms. Sanders showed no neurological deficits
consistent with carpel tunnel syndrome; could perform bilateral hand and finger
dexterity repetitive movements; and had “mild difficulty grasping/lifting small to
medium sized books and turning a door knob with both hands.” (Doc. 8-12, p. 60).
Ms. Sanders had no difficulty “picking up coins, paper clips, [and] buttoning [her]
[s]hirt with both hands.” (Doc. 8-12, p. 60).
Dr. Thomas Amason’s Consultative Physical Residual Functional
Capacity Assessment
On March 8, 2018, at the request of the Social Security Administration, Dr.
Amason reviewed Ms. Sanders’s medical records and assessed her physical residual
functional capacity. (Doc. 8-4, pp. 59-63). Dr. Amason opined that Ms. Sanders
could occasionally lift and carry 20 pounds, frequently lift and carry 10 pounds, and
could stand, walk, and sit with normal breaks six hours in an eight-hour workday.
(Doc. 8-4, p. 59). Dr. Amason stated that Ms. Sanders had unlimited ability to push
and pull; frequently could balance; frequently could climb ramps and stairs but never
climb ladders, ropes, or scaffolds; frequently could stoop, kneel, crouch, and crawl;
and frequently could reach overhead and handle bilaterally. (Doc. 8-4, pp. 59-60).
Dr. Amason found that Ms. Sanders should avoid exposure to extreme cold and heat,
vibration, and machinery and height hazards. (Doc. 8-4, pp. 60-61). Based on these
findings, Dr. Amason opined that Ms. Sanders could perform unskilled work at the
light exertional level, including jobs as a checker, subassembler, and ticket printer
and tagger. (Doc. 8-4, pp. 65-66).
Ms. Sanders’s Function Report
At the request of the Social Security Administration, Ms. Sanders completed
a function report in 2017. (Doc. 8-7, pp. 36-43).10 She stated that she lived alone in
her home and had no pets. (Doc. 8-7, p. 37). Ms. Sanders reported that she got up
around 11:00 am each day and was “in bed again” by 8:00 pm; took hours to dress;
had to stop and rest when bathing; could wash her hair; and needed help with
cleaning. (Doc. 8-7, pp. 36-41). She indicated that she could make a sandwich and
cook simple meals in the microwave, do one load of laundry a week, drive, and shop
online. (Doc. 8-7, pp. 36-41). Ms. Sanders stated that she did not go out much and
wanted to be left alone. (Doc. 8-7, pp. 40-41).
Ms. Sanders indicated that her impairments affected her ability to lift, squat,
bend, stand, reach, walk, sit, kneel, climb stairs, complete tasks, concentrate, use her
hands, and get along with others. (Doc. 8-7, p. 41). She stated that she could walk
for 20 minutes at a time, but she did not “really walk [-] pain” and that a doctor
prescribed a cane in 2009. (Doc. 8-7, p. 42).11 Ms. Sanders reported that she could
10 Ms. Sanders did not date or sign her function report, but the index for the administrative record
indicates that Ms. Sanders dated the report “10/10/2017.” (Doc. 8-3, p. 3).
11 Other than in Ms. Sanders’s and her mother’s function reports, the Court found no mention of
a prescription for or Ms. Sanders’s use of a cane in the medical records. (Doc. 8-3, pp. 34, 42).
pay attention depending on her pain level, did not handle changes in routine well,
could pay her bills, and could not handle a savings account or a checkbook. (Doc.
8-7, pp. 39, 42).
Ms. Sanders’s Mother’s Third-Party Function Report
Ms. Sanders’s mother, Sandra Bailey, completed a third-party function report
on October 7, 2017. (Doc. 8-7, p. 28). Ms. Bailey indicated that Ms. Sanders lived
alone and had a small dog. (Doc. 8-7, p. 29). She reported that Ms. Sanders took “a
while” to dress because she could not stand for long; could microwave a meal or
make a sandwich; could do laundry and cleaning, but Ms. Bailey did the “deep
cleaning”; could drive; shopped only for groceries; watched TV constantly; and
spent time with family and grandchildren weekly. (Doc. 8-7, pp. 28-32).
Ms. Bailey reported that Ms. Sanders could walk only short distances, had a
hard time getting “back up,” and had pain in her neck with reaching. (Doc. 8-7, p.
33). Ms. Bailey stated that Ms. Sanders could pay attention for 30 minutes, finished
what she started, and used a cane when she went out. (Doc. 8-7, pp. 33-34). Ms.
Bailey indicated that “because of pain,” Ms. Sanders’s personality had changed, she
was depressed, and she spent “too much time alone.” (Doc. 807, pp. 32-33).
Ms. Sanders’s First Administrative Hearing
During her first administrative hearing on June 27, 2019, Ms. Sanders testified
that she was in the process of divorcing her husband and lived with her mother so
that her mother could help her. (Doc. 8-3, pp. 60-61). Ms. Sanders stated that she
had degenerative disc disease that caused lower back pain that ran down her legs and
caused tingling and numbness in her calves. (Doc. 8-3, pp. 63-64). She explained
that she received “shots” for her back pain. (Doc. 8-3, p. 63). Ms. Sanders testified
that the “second shot . . . hit [her] sciatic nerve,” but her doctors told her there was
nothing they could do for her. (Doc. 8-3, p. 63). Ms. Sanders stated that she had a
fusion in her neck that was “messed up now” and caused pain down her arm and
numbness in her hands. (Doc. 8-3, p. 64).
She testified that she could lift and carry “probably eight to ten pounds,” but
could not do so for “40 minutes” or longer. (Doc. 8-3, p. 64). Ms. Sanders explained
that she could stand for “10 to 15 minutes” before her legs went “numb,” could sit
for “about 10 to 15 minutes” before her back pain shot down her legs, and could do
dishes or cook for “15 [to] 20 minutes.” (Doc. 8-3, pp. 64-66). She stated that each
day, she elevated her feet four hours or more and lied down about two hours. (Doc.
8-3, p. 66). Ms. Sanders testified that she had a hard time reaching overhead and
could not squat, crawl, or twist and turn at the waist level. (Doc. 8-3, p. 67).
Regarding her medication side effects, Ms. Sanders testified that her
medications made her drowsy and caused her to take naps. (Doc. 8-3, pp. 67-68).
Cherice Powell testified as a vocational expert. (Doc. 8-3, p. 69). She
classified Ms. Sanders’s past work as a hospital cleaner as unskilled, medium
exertional level work. (Doc. 8-3, p. 69). The ALJ asked Ms. Powell to consider the
work available to an individual with the same education, training, and work
experience as Ms. Sanders, who could perform light work with the following
limitations:
frequent postural maneuvers. No climbing of ropes, ladders, or
scaffolds. Frequent gross handling and overhead reaching with the
bilateral upper extremities. Avoid concentrated hot or cold
temperature extremes or extreme vibration. Avoid dangerous,
moving, or unguarded machinery or unprotected heights. Would be
able to understand, remember, or apply simple instructions and tasks.
Limited to jobs involving infrequent and well explained workplace
changes. And would be able to concentrate and remain on task for
two hours at a time sufficient to complete an eight-hour workday.
(Doc. 8-3, p. 69). The ALJ assumed that an individual with those limitations could
not perform Ms. Sanders’s past work as a hospital cleaner. Ms. Powell testified that
the individual could work as a cleaner, with approximately 445,000 jobs available
in the national economy; a shipping and receiving weigher, with approximately
72,000 jobs available in the national economy; and a marker, with approximately
249,000 jobs available in the national economy. (Doc. 8-3, pp. 69-70).
In the ALJ’s second hypothetical, she asked Ms. Powell to assume the
limitations in the first hypothetical, but the individual was limited to occasional
postural maneuvers and needed a sit or stand option “during the workday one or two
minutes at a time at the workstation.” (Doc. 8-3, p. 70). Ms. Powell testified that
the individual could work as a shipping and receiving weigher from the first
hypothetical; a small parts assembler, with approximately 196,000 jobs available in
the national economy; and a folder, with approximately 430,000 jobs available in
the national economy. (Doc. 8-3, pp. 70-71).
In her third hypothetical, the ALJ added the limitation that the individual
would miss two or more days of work per month on a consistent basis. (Doc. 8-3,
p. 71). Ms. Powell explained that limitation would preclude all competitive work.
(Doc. 8-3, p. 71).
Ms. Sanders’s attorney asked Ms. Powell to assume an individual with the
previous limitations and added that the individual needed a sit or stand option at will,
needed additional breaks outside of the customary breaks to nap for an “unknown
duration,” and could not maintain concentration or pace for two hours at a time
because of medications. (Doc. 8-3, p. 72). Ms. Powell testified those limitations
would preclude all competitive work. (Doc. 8-3, p. 72).
Ms. Sanders’s Second Administrative Hearing
After the Appeals Council’s remand, the ALJ held a second hearing via
telephone on September 17, 2020. Ms. Sanders stated that she continued to live with
her mother and that she (Ms. Sanders) had hernia surgery the day before the hearing.
(Doc. 8-3, p. 43). Ms. Sanders testified that after her first hearing, she contacted the
Alabama Department of Vocational Rehabilitation for help finding a job. (Doc. 8-
3, p. 42). Ms. Sanders indicated that she contacted vocational rehabilitation near the
end of 2019 but did not know who she met with. (Doc. 8-3, pp. 42-43). She stated
that “[t]hey didn’t have a job, but of course, the COVID.” (Doc. 8-3, p. 42). The
ALJ pointed out that COVID was not prevalent at the end of 2019. (Doc. 8-3, pp.
42-43).
Ms. Sanders testified that she had back and neck pain daily, but her neck pain
was her “main problem.” (Doc. 8-3, p. 45). She stated that her medications helped
her pain, and she had no side effects from her medications. (Doc. 8-3, pp. 45-46).
Ms. Sanders testified that she had to lay down about three hours each day because
of her pain, could stand about ten to fifteen minutes at a time, experienced more pain
in a seated position, and could not pick up anything “real heavy.” (Doc. 8-3, pp. 46-
47).
Regarding her activities of daily living, Ms. Sanders testified that she did
“very little” throughout the day and “sometimes” needed help with personal needs
such as bathing and dressing. (Doc. 8-3, pp. 45-46). She indicated that her mother
helped her put on shoes, and her mother and a friend shopped for her. (Doc. 8-3, p.
47). She stated that for chores, she picked up items and “wipe[d] stuff.” (Doc. 8-3,
p. 45).
Mr. James Adams testified as a vocational expert. (Doc. 8-3, p. 48). He noted
Ms. Sanders’s past work as a hospital cleaner and testified that Ms. Sanders also had
past relevant work as a gate guard, classified as light exertional work, and as a
“material handler or receiving and unloading,” classified as heavy exertional work.
(Doc. 8-3, p. 48). The ALJ asked Mr. Adams to consider the work available to an
individual with the same education, training, and work experience as Ms. Sanders,
who could perform light work with the following limitations:
occasional postural maneuvers[;] no climbing of ropes, ladders, or
scaffolds[;] frequent overhead reaching with the bilateral upper
extremities[;] would need to avoid dangerous moving, unguarded
machinery or unprotected heights[;] would be able to understand,
remember[,] or apply simple instructions and tasks[;] would be
limited to jobs involving infrequent and well explained workplace
changes[;] and would be able to concentrate and remain on task for
two hours at a time sufficient to complete an eight-hour workday.
(Doc. 8-3, p. 49). Mr. Adams testified that individual could perform Ms. Sanders’s
past work as a gate guard as actually and generally performed. (Doc. 8-3, p. 49).
Mr. Adams stated that individual also could perform the light, unskilled jobs of a
salvage bagger, with 65,000 jobs available in the national economy; a garment
sorter, with 135,000 jobs available in the national economy; and a hand sander, with
41,000 jobs available in the national economy. (Doc. 8-3, pp. 49-50).
In the ALJ’s second hypothetical, she asked Mr. Adams to assume the
limitations in the first hypothetical with the added limitation that the individual
would miss two or more days of work a month on a consistent basis. (Doc. 8-3, p.
50). Mr. Adams testified that in his experience, larger employers would dismiss
unskilled workers for missing two days in a single month. (Doc. 8-3, p. 50).
THE ALJ’S DECISION
The ALJ found that Ms. Sanders had last engaged in substantial gainful
activity on October 7, 2017, the alleged onset date, and met the insured status
requirements through June 30, 2019. (Doc. 8-3, p. 18).12 The ALJ determined that
Ms. Sanders suffered from the severe impairments of degenerative disc disease,
degenerative joint disease, major depressive disorder, and anxiety. (Doc. 8-3, p. 18).
The ALJ also determined that Ms. Sanders had the non-severe impairments of post-
hernia surgery lifting restrictions, post laparoscopy and splenectomy restrictions,
and carpal tunnel syndrome. (Doc. 8-3, p. 18). The ALJ acknowledged Ms.
Sanders’s fibromyalgia diagnosis but found it was not a medically determinable
12 A claimant is eligible for disability insurance benefits if she had a disability on or before the
date last insured. See 42 U.S.C. §§ 416(i)(3), 423(a)(1)(A). If a claimant becomes disabled after
her insured status expires, the ALJ must deny the disability insurance benefits claim. The date of
last insured requirement does not apply to a claim for SSI benefits.
impairment under Social Security Ruling 12-2p because the record contained “no
evidence she met the requisite tender point exam criteria.” (Doc. 8-3, p. 19). Based
on a review of the medical evidence, the ALJ concluded that Ms. Sanders did not
have an impairment or a combination of impairments that met or medically equaled
the severity of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1.
(Doc. 8-3, p. 19).
Considering Ms. Sanders’s impairments, the ALJ evaluated Ms. Sanders’s
residual functional capacity. (Doc. 8-3, p. 21). The ALJ determined that Ms.
Sanders had the RFC to:
perform light work as defined in 20 CFR 404.1567(b) and 416.967(b).
The claimant is limited to occasionally performing postural maneuvers,
including balancing, stooping, kneeling, crouching, crawling, &
climbing ramps and stairs. The claimant cannot climb ladders, ropes, or
scaffolds. She can perform frequent overhead reaching with the
bilateral upper extremities. She must avoid dangerous moving
unguarded machinery, or unprotected heights. She can understand,
remember, and apply simple instructions and tasks; she is limited to
jobs involving infrequent and well-explained workplace changes; she
can concentrate and remain on task for two hours at a time, sufficient
to complete an eight-hour workday.
(Doc. 8-3, pp. 21).
Based on this RFC and relying on the testimony from the vocational expert,
the ALJ concluded that Ms. Sanders could not perform her past relevant work as a
hospital cleaner or material handler, but Ms. Sanders could perform her past relevant
work as a gate guard because this job did “not require the performance of work-
related activities precluded by” Ms. Sanders’s RFC. (Doc. 8-3, p. 27). Relying on
testimony from the vocational expert, the ALJ found that other jobs existed in
significant numbers in the national economy that Ms. Sanders could perform,
including salvage bagger, garment sorter, and hand sander. (Doc. 8-3, pp. 28-29).
Accordingly, the ALJ determined that Ms. Sanders was not disabled as defined by
the Social Security Act. (Doc. 8-3, p. 29).
STANDARD OF REVIEW
The scope of review in this matter is limited. “When, as in this case, the ALJ
denies benefits and the Appeals Council denies review,” a district court “review[s]
the ALJ’s ‘factual findings with deference’ and her ‘legal conclusions with close
scrutiny.’” Riggs v. Comm’r of Soc. Sec., 522 Fed. Appx. 509, 510-11 (11th Cir.
2013) (quoting Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001)).
A district court must determine whether substantial evidence in the record
supports the ALJ’s factual findings. “Substantial evidence is more than a scintilla
and is such relevant evidence as a reasonable person would accept as adequate to
support a conclusion.” Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1158 (11th
Cir. 2004). In making this evaluation, a district court may not “decide the facts
anew, reweigh the evidence,” or substitute its judgment for that of the ALJ. Winschel
v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011) (internal quotations
and citation omitted). If the ALJ’s decision is supported by substantial evidence, the
district court “must affirm even if the evidence preponderates against the
Commissioner’s findings.” Costigan v. Comm'r of Soc. Sec., 603 Fed. Appx. 783,
786 (11th Cir. 2015) (citing Crawford, 363 F.3d at 1158).
With respect to the ALJ’s legal conclusions, a district court must determine
whether the ALJ applied the correct legal standards. If the court finds an error in the
ALJ’s application of the law, or if the court finds that the ALJ failed to provide
sufficient reasoning to demonstrate that the ALJ conducted a proper legal analysis,
then the district court must reverse the ALJ’s decision. Cornelius v. Sullivan, 936
F. 2d 1143, 1145-46 (11th Cir. 1991).
DISCUSSION
Ms. Sanders argues that the ALJ improperly applied the pain standard and that
substantial evidence did not support the ALJ’s reasons for discrediting her
description of her subjective symptoms. (Doc. 12). The Court disagrees.
The Eleventh Circuit pain standard “applies when a disability claimant
attempts to establish disability through h[er] own testimony of pain or other
subjective symptoms.” Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991);
Coley v. Comm’r of Soc. Sec., 771 Fed. Appx. 913, 917 (11th Cir. 2019). When
relying upon subjective symptoms to establish disability, “the claimant must satisfy
two parts of a three-part test showing: (1) evidence of an underlying medical
condition; and (2) either (a) objective medical evidence confirming the severity of
the alleged [symptoms]; or (b) that the objectively determined medical condition can
reasonably be expected to give rise to the claimed [symptoms].” Wilson v. Barnhart,
284 F.3d 1219, 1225 (11th Cir. 2002) (citing Holt, 921 F.2d at 1223); Chatham v.
Comm’r of Soc. Sec., 764 Fed. Appx. 864, 868 (11th Cir. 2019) (citing Wilson). If
the ALJ does not properly apply the three-part standard, reversal is appropriate.
McLain v. Comm’r of Soc. Sec., 676 Fed. Appx. 935, 937 (11th Cir. 2017) (citing
Holt).
A claimant’s credible testimony coupled with medical evidence of an
impairing condition “is itself sufficient to support a finding of disability.” Holt, 921
F.2d at 1223; see Gombash v. Comm’r of Soc. Sec., 566 Fed. Appx. 857, 859 (11th
Cir. 2014) (“A claimant may establish that he has a disability ‘through his own
testimony of pain or other subjective symptoms.’”) (quoting Dyer v. Barnhart, 395
F.3d 1206, 1210 (11th Cir. 2005)). If an ALJ rejects a claimant’s subjective
testimony, then the ALJ “must articulate explicit and adequate reasons for doing so.”
Wilson, 284 F.3d at 1225. The Commissioner must accept the claimant’s testimony,
as a matter of law, if the ALJ inadequately discredits the testimony. Cannon v.
Bowen, 858 F.2d 1541, 1545 (11th Cir. 1988); Kalishek v. Comm’r of Soc. Sec., 470
Fed. Appx. 868, 871 (11th Cir. 2012) (citing Cannon).
In evaluating a claimant’s symptoms, the provisions of Social Security
Regulation 16-3p apply. SSR 16-3p provides:
[W]e recognize that some individuals may experience symptoms
differently and may be limited by symptoms to a greater or lesser extent
than other individuals with the same medical impairments, the same
objective medical evidence, and the same non-medical evidence. In
considering the intensity, persistence, and limiting effects of an
individual’s symptoms, we examine the entire case record, including
the objective medical evidence; an individual’s statements about the
intensity, persistence, and limiting effects of symptoms; statements and
other information provided by medical sources and other persons; and
any other relevant evidence in the individual’s case record.
SSR 16-3p, 2017 WL 5180304, at *4. Concerning the ALJ’s burden when
evaluating a claimant’s subjective symptoms, SSR 16-3p provides:
[I]t is not sufficient . . . to make a single, conclusory statement that “the
individual’s statements about his or her symptoms have been
considered” or that “the statements about the individual’s symptoms are
(or are not) supported or consistent.” It is also not enough . . . simply
to recite the factors described in the regulations for evaluating
symptoms. The determination or decision must contain specific reasons
for the weight given to the individual’s symptoms, be consistent with
and supported by the evidence, and be clearly articulated so the
individual and any subsequent reviewer can assess how the adjudicator
evaluated the individual’s symptoms.
SSR 16-3p, 2017 WL 5180304, at *10.
In evaluating a claimant’s reported symptoms, an ALJ must consider:
(i) [the claimant’s] daily activities;
(ii) [t]he location, duration, frequency, and intensity of [the
claimant’s] pain or other symptoms;
(iii) [p]recipitating and aggravating factors;
(iv) [t]he type, dosage, effectiveness, and side effects of any
medication [the claimant] take[s] or ha[s] taken to alleviate . . . pain or
other symptoms;
(v) [t]reatment, other than medication, [the claimant] receive[s] or
ha[s] received for relief of . . . pain or other symptoms;
(vi) [a]ny measures [the claimant] use[s] or ha[s] used to relieve . . .
pain or other symptoms (e.g., lying flat on your back, standing for 15
to 20 minutes every hour, sleeping on a board, etc.); and
(vii) [o]ther factors concerning [the claimant’s] functional limitations
and restrictions due to pain or other symptoms.
20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3); Leiter v. Comm’r of SSA, 377 Fed.
Appx. 944, 947 (11th Cir. 2010).
The ALJ found that Ms. Sanders’s “medically determinable impairments
could reasonably be expected to cause the alleged symptoms,” but the ALJ
determined that Ms. Sanders’s “statements concerning the intensity, persistence, and
limiting effects of these symptoms [were] not entirely consistent with the medical
evidence and other evidence in the file.” (Doc. 8-3, pp. 22, 27). In applying the pain
standard, the ALJ recounted in detail Ms. Sanders’s medical records, (Doc. 8-3, pp.
22-25); the consultative medical opinions of Dr. Mollohan and Dr. Amason, (Doc.
8-3, pp. 25-26); Ms. Sanders’s hearing testimony and function report, (Doc. 8-3, pp.
22, 25-26); and the function report Ms. Sanders’s mother completed, (Doc. 8-3, p.
26). The ALJ correctly applied the pain standard, and substantial evidence supports
the ALJ’s findings regarding Ms. Sanders’s subjective symptoms of pain.
The ALJ found that Ms. Sanders’s allegations of disabling pain were
inconsistent with the objective medical evidence that showed only “mild to moderate
physical limitations.” (Doc. 8-3, p. 26). Ms. Sanders argues that the ALJ minimized
the significance of objective medical evidence that “could reasonably cause [Ms.
Sanders’s] pain and limitations,” citing Ms. Sanders’s November 2016 and June
2019 MRIs of her cervical and lumbar spine. (Doc. 12, p. 12). The record
demonstrates that the ALJ addressed each of these pieces of evidence and
appropriately factored them into Ms. Sanders’s RFC.
The ALJ noted Ms. Sanders’s 2013 fusion surgery and discussed the
November 2016 MRI that showed mild disc bulging. (Doc. 8-3, p. 22). The ALJ
cited the June 2019 lumbar and cervical spine MRIs that revealed “multilevel
degenerative changes, including a mild narrowing of the neural foramina” and
“degenerative and postoperative changes with moderate disc bulging at C3-C5.”
(Doc. 8-3, p. 23). The ALJ noted Ms. Sanders’s epidural steroid injections in June
and July 2019. (Doc. 8-3, p. 24). The ALJ also addressed Ms. Sanders’s nerve
conduction testing in June 2019 and September 2019 that showed a “fully normal
result in the lower extremities with no evidence of peripheral neuropathy.” (Doc. 8-
3, p. 24). The MRI and nerve conduction evidence showing mild to moderate
physical limitations, coupled with other substantial evidence in the record, supports
the ALJ’s RFC finding that Ms. Sanders could perform work at the light exertional
level with postural limitations.
Ms. Sanders asserts that the ALJ “overlooked portions of the medical record”
in assessing her subjective symptoms. (Doc. 12, p. 8). Ms. Sanders argues that the
ALJ failed to properly consider the notes of treating physicians that describe
subjective complaints of pain. (Doc. 12, p. 12). The record does not support the
argument. In applying the pain standard, the ALJ considered Ms. Sanders’s
longitudinal medical history, including “positive and negative progress notes” from
various doctors. (Doc. 8-3, p. 27). The ALJ specifically noted medical records
showing Ms. Sanders’s complaints that her medications at times barely helped and
that she had pain, tenderness, and decreased range of motion in her spine at times.
(Doc. 8-3, pp. 22-23). The ALJ’s opinion indicates that she examined the entire
medical record in applying the pain standard.
To support her finding that Ms. Sanders’s pain was not as limiting as she
claimed, the ALJ pointed to Ms. Sanders’s longitudinal physical examinations with
various doctors that “consistently demonstrated good strength, range of motion, and
sensation with varying degrees of tenderness to palpation.” (Doc. 8-3, p. 26). The
ALJ cited Dr. Gantt’s April 2017 examination that showed that Ms. Sanders had a
normal gait, some decreased range of motion in her spine, normal muscle strength,
and intact sensation. (Doc. 8-3, pp. 22-23). The ALJ also noted Dr. Seymour’s May
2019 physical examination that showed full motor strength in all extremities, intact
sensation, normal deep tendon reflexes, and normal range of motion in the cervical
spine. (Doc. 8-3, p. 23). The ALJ pointed to Dr. Alapati’s July 2019 examination
that showed no motor weakness, intact sensation to pinprick and vibration, and a full
range of motion in both the cervical and lumbar spine. (Doc. 8-3, p. 24). The ALJ
also cited Dr. Thacker’s examinations from January through July 2020 that showed
a mild limitation in Ms. Sanders’s range of motion in her spine, a normal gait, full
muscle strength in all areas, and normal deep tendon reflexes. (Doc. 8-3, pp. 24-25).
Ms. Sanders medical records indicate that she reported her pain at 4/10 to 6/10
during many of her appointments. (Docs. 8-12, pp. 3; Doc. 8-13, pp, 51, 55, 60, 68,
73, 105, 117). Although Ms. Sanders’s rated her pain at 5/10 to 6/10 at best, she
reported pain levels between 2/10 and 3/10 during Dr. Mollohan’s examination in
February 2018. (Doc. 8-12, pp. 58, 60). These pain levels do not indicate disabling
pain that would cause Ms. Sanders to lie down and sleep for hours each day.13
Substantial evidence in the record supports the ALJ’s finding that Ms. Sanders’s
physical examinations revealed no significant abnormalities or debilitating pain that
would prevent her from working at a light exertional level with additional
limitations.
13 The Court recognizes that Ms. Bailey attributed Ms. Sanders’s change in personality and her
lack of interest in activities to her back pain. Though back pain may have contributed to Ms.
Sanders’s depression and anxiety, her lack of activity appears to be more a consequence of her
depression than her back pain.
The ALJ also considered Dr. Mollohan’s and Dr. Amason’s opinions to
support her conclusion that Ms. Sanders’s pain was not as limiting as she claimed.
(Doc. 8-3, pp. 23, 25). The ALJ cited Dr. Mollohan’s examination that indicated
Ms. Sanders did not have cervical or lumbar radicular pain or neuropathy and had a
normal range of motion and full muscle strength in her extremities. (Doc. 8-3, p.
23). Although Dr. Amason opined that Ms. Sanders could frequently perform all
postural maneuvers for work at the light exertional level, the ALJ found Dr.
Amason’s opinion “mostly persuasive” and limited Ms. Sander’s RFC to only
occasional postural maneuvers. (Doc. 8-3, p. 25). Dr. Mollohan’s and Dr. Amason’s
medical opinions support the ALJ’s assessment of Ms. Sanders’s subjective
symptoms and the ALJ’s RFC finding that Ms. Sanders could work at the light
exertional level with additional limitations.
Ms. Sanders argues that the ALJ erred in applying the pain standard regarding
daily activities. (Doc. 12, p. 13). Ms. Sanders asserts that the ALJ omitted several
limitations that Ms. Sanders mentioned when reporting her daily activities, including
difficulties dressing, shopping, cooking, and cleaning. (Doc. 12, p. 14). In fact, the
ALJ cited Ms. Sanders’s function report and noted that Ms. Sanders “reported
difficulty tending to her personal care and did limited housework.” (Doc. 8-3, p.
22). The ALJ noted Ms. Sanders’s mother’s third-party report that Ms. Sanders
could “perform most personal care without a problem, do light housework, prepare[]
dinner, lift light weight, and walk for short distances.” (Doc. 8-3, p. 26). The ALJ
also considered Ms. Sanders reports to Dr. Alapati in June 2018 and July 2019 that
she could provide self-care in all her activities of daily living. (Doc. 8-3, pp. 23-24;
Doc. 8-12, p. 105; Doc. 8-13, p. 34). The ALJ did not ignore Ms. Sanders’s
limitations in her daily activities and properly considered them in applying the pain
standard.
In sum, substantial evidence supports the ALJ’s findings that Ms. Sanders’s
physical limitations because of her back pain did not prevent her from doing light
exertional work with additional exertional and non-exertional limitations. Because
the ALJ properly applied the Eleventh Circuit pain standard, and substantial
evidence supports her analysis under this standard, Ms. Sanders is not entitled to
relief on this issue.
CONCLUSION
For the reasons discussed above, the Court affirms the Commissioner’s
decision. The Court will enter a final judgment consistent with this memorandum
opinion.
DONE and ORDERED this September 29, 2023.
adil Bi Hosa
Maddlist.
UNITED STATES DISTRICT JUDGE
33