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Horn v. Colvin

United States District Court, N.D. Alabama, Southern Division

July 27, 2015

CAROLYN W. COLVIN, Acting Commissioner, Social Security Administration, Defendant.


C. LYNWOOD SMITH, Jr., District Judge.

Claimant, Nepheteria Delshawn Horn, commenced this action on October 6, 2014, pursuant to 42 U.S.C. § 405(g), seeking judicial review of a final adverse decision of the Commissioner, affirming the decision of the Administrative Law Judge ("ALJ") denying her claim for supplemental security income benefits. For the reasons stated herein, the court finds that the Commissioner's ruling is due to be affirmed.

The court's role in reviewing claims brought under the Social Security Act is a narrow one. The scope of review is limited to determining whether there is substantial evidence in the record as a whole to support the findings of the Commissioner, and whether correct legal standards were applied. See Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Tieniber v. Heckler, 720 F.2d 1251, 1253 (11th Cir. 1983).

Claimant contends that the Commissioner's decision is neither supported by substantial evidence nor in accordance with applicable legal standards. Specifically, claimant asserts that the ALJ improperly considered the opinion of her treating physician, and failed to recontact that physician for an additional assessment, and that new evidence submitted for the first time to the Appeals Council warrants remand. Upon review of the record, the court concludes those contentions are not correct.

The opinion of a treating physician "must be given substantial or considerable weight unless good cause' is shown to the contrary." Phillips v. Barnhart, 357 F.3d 1232, 1240-41 (11th Cir. 2004) (internal citations omitted). Good cause exists when "(1) [the] treating physician's opinion was not bolstered by the evidence; (2) [the] evidence supported a contrary finding; or (3) [the] treating physician's opinion was conclusory or inconsistent with the doctor's own medical records." Id. (alterations supplied). Additionally, the ALJ is not required to accept a conclusory statement from a medical source, even a treating source, that a claimant is unable to work, because the decision whether a claimant is disabled is not a medical opinion, but is a decision "reserved to the Commissioner." 20 C.F.R. § 416.927(d)(1). Social Security regulations also provide that, in considering what weight to give any medical opinion (regardless of whether it is from a treating or non-treating physician), the Commissioner should evaluate: the extent of the examining or treating relationship between the doctor and patient; whether the doctor's opinion can be supported by medical signs and laboratory findings; whether the opinion is consistent with the record as a whole; the doctor's specialization; and other factors. See 20 C.F.R. § 416.927(c). See also Wheeler v. Heckler, 784 F.2d 1073, 1075 (11th Cir. 1986) ("The weight afforded a physician's conclusory statements depends upon the extent to which they are supported by clinical or laboratory findings and are consistent with other evidence as to claimant's impairments.").

Dr. John D. Morgan, claimant's treating rheumatologist, stated in an October 19, 2011 office note that "[i]t appears that largely she has not been working because of the difficult generalized national economic conditions but it appears unlikely that she would have the physical vigor to do work if there were a job available to her."[1] Dr. Morgan completed a "Physical Capacities Evaluation" form on December 27, 2011. He indicated that claimant could occasionally lift and/or carry ten pounds. She could sit for a total of four hours, and stand and walk (combined) for a total of two hours, during an eight-hour work day. She did not need an assistive device to ambulate. She could never climb, balance, bend, or stoop. She could occasionally push, pull, perform gross and fine manipulation, and reach. She could operate motor vehicles, but she could not work around hazardous machinery, dust, allergens, or fumes.[2]

Dr. Roberts also completed a "Clinical Assessment of Pain" form the same date. He indicated that pain was present to such an extent as to be distracting to adequate performance of daily activities or work, that physical activity would greatly increase pain to such a degree as to cause distraction from or abandonment of tasks, and that claimant would experience some side effects from her medication, but not to such a degree as to create serious problems in most instances. Claimant did have an underlying condition consistent with the pain she experienced.[3]

Finally, Dr. Roberts completed a "Clinical Assessment of Fatigue/Weakness" form. He indicated that fatigue and weakness were present in claimant's life to such an extent as to negatively affect adequate performance of daily activities or work. Physical activity would greatly increase her fatigue and weakness to such a degree as to cause total abandonment of tasks. Claimant would experience some side effects from her medication, but not to such a degree as to create serious problems in most instances. Claimant did have an underlying condition consistent with the fatigue and weakness she experienced.[4]

The ALJ afforded little weight to Dr. Morgan's assessments, reasoning that the assessments were

rendered in November 2011, shortly after the claimant's diagnosis. As noted previously, the claimant's symptoms improved over a span of several months and her systematic lupus erythematosus was declared to be in remission in August 2012.... Limited weight has also been placed in Dr. Morgan's comments that the claimant may not have the physical vigor [for] work, this comment was made in October 2011, only a few months after her diagnosis. As discussed throughout, the claimant's condition improved significantly within the 12 months following her diagnosis. Further, Dr. Morgan also stated that the claimant was likely out of work due to the difficult economic realities of an economy in recession.[5]

Those were are all permissible considerations. Even so, claimant contends that they were not supported by the record. It cannot be denied that the ALJ erroneously stated the date of Dr. Morgan's assessments as being November of 2011, as the record clearly reveals that the assessments were generated in December of 2011. That mistake is not material, however, because the logic employed by the ALJ still is the same. Claimant still could have been adjusting to her lupus medications in December of 2011.

The ALJ also stated that claimant's systematic lupus erythematosus was in remission in August of 2012. The record on which that statement was based came from Dr. John R. Brouillette, claimant's nephrologist, on August 30, 2012. Dr. Brouillette's assessment and plan included the following statement: "Delightful 27-year-old female with lupus nephritis was in remission status post delivery by Cesarean approximately two weeks ago with some mild leg swelling. Does not appear to have ongoing nephropathy or relapse at this time of her glomerulonephritis."[6] Claimant asserts that the ALJ's confusion of systematic lupus erythematosus with lupus nephritis is significant, because "[l]upus is the medical condition and lupus nephritis is a symptom and result of lupus."[7] That is a true statement, but the record does not actually support the underlying premise that claimant's lupus itself was not in remission. Dr. Brouillette's August 2012 notes are not 100% clear on that subject. Absent any punctuation, its impossible to determine whether the "remission" referred to the "delightful 27-year-old female, " or to the lupus nephritis. Dr. Brouillette also gave the following assessment on March 8, 2012: "27-year-old African-American female with lupus, history of acute glomerulonephritis proliferative type as of 05/07/2011. In remission for less than one calendar year, now pregnant."[8] That record also could reasonably be read as stating that either the lupus or the nephritis was in remission. Accordingly, it cannot be said that the ALJ's interpretation of the notes as referring to the lupus being in remission were not supported by substantial evidence. Regardless, it appears that nephritis was the primary symptom claimant experienced as a result of her lupus, or at least that it was the primary symptom that concerned her physicians. Thus, stating that plaintiff's nephritis was in remission is actually the functional equivalent of stating that the lupus itself was in remission.

Finally, it is important to note that the mere existence of an impairment, or of a medical condition, does not determine disability. Instead, the relevant consideration is the effect of claimant's impairment, or combination of impairments, on her ability to perform substantial gainful work activities. See 20 C.F.R. § 416.905(a) (defining a disability as "the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months"). See also Bowen v. Yuckert, 482 U.S. 137, 146 (1987) ("The [Social Security] Act defines "disability" in terms of the effect a physical or mental impairment has on a person's ability to function in the workplace.'") (quoting Heckler v. Campbell, 461 U.S. 458, 459-60 (1983)). Here, there is no indication that either the lupus or the nephritis caused any disabling functional limitations.

Based on all of the foregoing considerations, the ALJ's decision to afford only little weight to Dr. Morgan's opinion was ...

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