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Trammell v. Berryhill

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

April 6, 2017

KRISTEN TRAMMELL, Claimant,
v.
NANCY A. BERRYHILL, Acting Commissioner, Social Security Administration, Defendant.

          MEMORANDUM OPINION AND ORDER

         Claimant, Kristen Trammell, commenced this action 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"), and thereby denying her claim for a period of disability and disability insurance 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, 847F.2d698, 701 (11th Cir. 1988); Tieniber v. Heckler, 120 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 her subjective testimony, and that he improperly determined her residual functional capacity. Upon review of the record, the court concludes that these contentions are without merit.

         A. Credibility

         To demonstrate that pain or another subjective symptom renders her disabled, claimant must "produce 'evidence of an underlying medical condition and (1) objective medical evidence that confirms the severity of the alleged pain arising from that condition or (2) that the objectively determined medical condition is of such severity that it can be reasonably expected to give rise to the alleged pain.'" Edwards v. Sullivan, 937 F.2d 580, 584 (11th Cir. 1991) (quoting Landry v. Heckler, 782 F.2d 1551, 1553 (11th Cir. 1986)). If an ALJ discredits a claimant's subjective testimony of pain, "he must articulate explicit and adequate reasons." Hale v. Bowen, 831 F.2d 1007, 1011 (11th Cir. 1987) (citing Jones v. Bowen, 810 F.2d 1001, 1004 (11th Cir. 1986); MacGregor v. Bowen, 786 F.2d 1050, 1054 (11th Cir. 1986)). Furthermore, "[a]fter considering a claimant's complaints of pain, the ALJ may reject them as not creditable, and that determination will be reviewed for substantial evidence." Marbury v. Sullivan, 957 F.2d 837, 839 (11th Cir. 1992) (citing Wilson v. Heckler, 734 F.2d 513, 517 (11th Cir. 1984)) (alteration supplied).

         The ALJ properly applied these legal principles. Claimant testified during the administrative hearing that she could no longer work because of her migraine headaches, rheumatoid arthritis, and anxiety.[1] She stated that she experiences constant stinging, burning, and throbbing pain in her wrists, ankles, neck, and low back.[2] Standing renders the pain "unbearable, " but she is comfortable when she lies down with an ice pack, which she does five or six times a day.[3] She experiences migraine headaches with nausea and light sensitivity twice a day for up to four or five hours. She is only able to treat the migraines by taking Tylenol and lying still in the dark.[4] She takes Prozac and Xanax (prescribed by her family physician) for anxiety.[5]She cannot stand or walk for very long, and she can only carry the "bare minimum."[6]She can prepare very simple meals, but she mostly stays in bed all day.[7]

         The subjective symptoms and limitations described by claimant, if fully credited, would render her unable to sustain full-time employment. But the ALJ did not fully credit claimant's testimony. Instead, while the ALJ found that claimant's medically determinable impairments could reasonably be expected to cause the symptoms claimant alleged, he concluded nonetheless that claimant's statements about the intensity, persistence, and limiting effects of her symptoms were not credible to the extent they were inconsistent with the residual functional capacity finding.[8] The ALJ reasoned:

The claimant has described daily activities that are limited. Two factors weigh against considering these allegations to be strong evidence in favor of finding the claimant disabled. First, her allegedly limited daily activities cannot be objectively verified with any reasonable degree of certainty. Even if the claimant's daily activities are truly as limited as alleged, it is difficult to attribute that degree of limitation to the claimant's medical condition, as opposed to other reasons. The record reflects inconsistencies in her reports to her various doctors, . Considering the level of pain alleged by the claimant in her testimony, there is no mention in Dr. Paul's treatment records of her headaches and cervical issues. Her rheumatoid arthritis is stable. . . . Similarly, when she was admitted to Shelby Baptist Medical Center for treatment of her abdominal pain, the claimant makes [sic] no mention of any headache issues and stated that her Percocet was for treatment of her rheumatoid arthritis. Overall, the claimant's treatment records are more supportive of the findings of the consultative psychologist and Dr. Jacobs and do not support the degree of limitation alleged by the claimant. . . .[9]

         Claimant challenges the ALJ's rejection of her subjective testimony. First, she asserts that "it is not valid to discredit a claimant's testimony regarding their daily activities because those daily activities cannot be objectively verified."[10] It would be pointless to allow a claimant to testify about her daily activities if those activities had to be independently verified. Thus, the court agrees with claimant that the ALJ's statement about verifying claimant's activities "simply makes no sense."[11] The court also agrees that the ALJ's statement about the difficulty in attributing the degree of claimant's limitation to her medical condition, as opposed to other reasons, is unhelpful, speculative, and has nothing to do with any evidence in the record. Finally, as claimant points out, the ALJ incorrectly observed that plaintiff failed to report headaches and cervical pain to Dr. Paul, as Dr. Paul's records consistently mention claimant's complaints of migraine headaches and neck pain.[12]

         Therefore, it is true that not all of the ALJ's conclusions are supported by substantial evidence - or even any evidence - of record. Even so, the inability to verify claimant's activity level, the speculative "other reasons" for her limitations, and her alleged failure to mention headaches and cervical pain to Dr. Paul were not the only grounds for the ALJ's decision. The ALJ also relied upon other inconsistencies in the medical record, and upon medical records from Dr. Jacobs and the consultative psychologist that supported a lesser degree of limitation than that which claimant alleged. Specifically, the ALJ noted that claimant's rheumatoid arthritis had been described as "stable" in Dr. Paul's records.[13] The ALJ did not, as claimant suggests, construe the word "stable" to mean "without symptoms." To the contrary, the ALJ's residual functional capacity assessment included several limitations that took into account claimant's rheumatoid arthritis. It was permissible for him to consider the fact that claimant's symptoms had not significantly progressed throughout her course of treatment with Dr. Paul. The ALJ also permissibly considered that claimant did not complain of headaches when she was admitted to Shelby Baptist Medical Center for treatment of abdominal pain. Claimant's omission may not have been entitled to much weight - after all, she was suffering acute abdominal pain from pancreatitis and did not necessarily have any reason to mention headaches. Even so, the ALJ did not err in affording some consideration to claimant's failure to mention the headaches, and there is no indication that he gave undue weight to that factor.

         Most importantly, the ALJ's observations about the consistency of claimant's complaints with the reports of Dr. Jacobs and the consultative psychologist are supported by the record. John Neville, Ph.D., the consultative psychologist, examined claimant on March 25, 2014. Claimant reported suffering from migraine headaches, neck and shoulder pain, and rheumatoid arthritis. She also reported agoraphobic symptoms, depressed mood, poor energy and appetite, impaired memory and concentration, and increased anger, all of which were not greatly improved by her medications. Upon examination, claimant demonstrated normal appearance and speech, neutral mood, good sensory input and cognition, normal thought processes and content, adequate judgment and insight, and borderline to low average intelligence. Dr. Neville's diagnoses were provisional agoraphobia, provisional borderline intellectual functioning, migraine headaches, and rheumatoid arthritis.[14]

         He gave the following assessment:

Psychotherapy and psychiatric treatment are recommended. She appears able to understand and carry out simple instructions. Ms. Trammell would be expected to struggle some with understanding and carrying out complex instructions. Her ability to maintain concentration and sustain an adequate work pace appeared mildly to moderately impaired. It seemed that once she reaches a destination she can function reasonably well there. Ms. Trammell appeared able to respond appropriately to coworkers. She seems willing to accept supervision. Ms. Trammell appears cognitively able to manage financial benefits independently.[15]

         The ALJ did not wholly accept Dr. Neville's provisional diagnoses of agoraphobia and borderline intellectual functioning, but he did consider them in making his residual functional capacity finding, and he assigned "great weight" to Dr. Neville's statements about claimant's limitations because they were "supported with explanation."[16] Claimant complains that the ALJ should not have relied upon Dr. Neville's psychological examination to reach a conclusion about the effects of claimant's migraines and rheumatoid arthritis on her ability to work, but there is no indication that the ALJ did reach such a conclusion. Instead, he permissibly relied upon Dr. Neville's statement when considering the effects of claimant's psychological conditions, and his conclusions were supported by substantial evidence. In any event, claimant has not challenged the ALJ's findings about claimant's psychological limitations on appeal.

         Dr. E. Jacob, a neurologist, conducted a workmen's compensation evaluation on January 24, 2011, to determine the lingering effects of a head injury claimant had suffered at work during 2007.[17] Upon examination, claimant was awake, alert and oriented to time and place. She demonstrated no amenia, cyanosis, jaundice, clubbing or generalized lymphadenopathy. She had moderately reduced range of motion in her cervical spine, and normal findings in her thoracic and lumber spine. Her higher intellectual functions, speech, memory, and affect all were normal. The cranial nerve examination was normal. Her muscle tone, power, and coordination were normal in both the upper and lower extremities, and she could toe-walk, heel-walk, and tandem-walk. She could stand on both her right and left legs, and her deep tendon reflexes were equal and normal. Claimant reported reduced cold sensation and vibration on the right side of her face, and reduced pinprick sensation on the left side. Other neurological findings were normal. Dr. Jacob assessed claimant with post-traumatic headache with vascular features, normal neurological examination, and a history of rheumatoid arthritis. He also stated:

I told the patient that I did not have anything new or different to offer. She is taking Cymbalta, Topamax, Lyrica and Zanaflex in spite of that her headache score is 8/10. [sic] The patient is fully functional at present. She is not in any distress in spite of the headache and under the influence of strong medication including Percocet.
Base[d] on my evaluation today I told the patient she has reached [maximum medical improvement].
After researching Florida impairment rating schedule [sic] I find that she has symptoms but no objective signs. Based on that I did not think the ...

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