United States District Court, N.D. Alabama, Northwestern Division
OWEN BOWDRE CHIEF UNITED STATES DISTRICT JUDGE.
February 22, 2012, the claimant, Pamela Bond, protectively
applied for disability and disability insurance benefits
under Titles II and XVI of the Social Security Act. (R. 237).
In both applications, the claimant alleged disability
beginning on September 10, 2009, because of sarcoidosis,
atypical microbacteria, and neuropathy. (R. 273). The
Commissioner denied the claims initially on September 19,
2012, and again on reconsideration on February 8, 2013. (R.
175, 184). The claimant filed a timely request for a hearing
before an Administrative Law Judge, and the ALJ held a
hearing on August 7, 2014. (R. 38).
decision dated October 22, 2014, the ALJ found that the
claimant was not disabled under the Social Security Act and
thus not entitled to social security benefits. (R. 27). On
February 12, 2016, the Appeals Council denied the
claimant's request for review. (R. 1). The ALJ's
decision thus became the final decision of the Commissioner.
The claimant has exhausted her administrative remedies, and
this court has jurisdiction pursuant to 42 U.S.C.
§§ 405(g) and 1383(c)(3). For the reasons stated
below, this court reverses the decision of the Commissioner
and remands the case to the Commissioner for further
claimant presents the following issue for review:
(1) whether substantial evidence supports the ALJ's
decisions to assign little weight to treating sources Dr.
Jack Lichtenstein, rheumatologists; Dr. Daniel Hexter,
neurologist; and Dr. Kioumarce Yazdani, internist.
STANDARD OF REVIEW
standard for reviewing the Commissioner's decision is
limited. This court must affirm the Commissioner's
decision if the Commissioner applied the correct legal
standards and if the factual conclusions are supported by
substantial evidence. See 42 U.S.C. § 405(g);
Graham v. Apfel, 129 F.3d 1420, 1422 (11th Cir.
1997); Walker v. Bowen, 826 F.2d 996, 999 (11th Cir.
. . . presumption of validity attaches to the
[Commissioner's] legal claims.” Walker,
826 F.2d at 999. This court does not review the
Commissioner's factual determinations de novo.
The court will affirm those factual determinations that are
supported by substantial evidence. “Substantial
evidence” is “more than a mere scintilla. It
means such relevant evidence as a reasonable mind might
accept as adequate to support a conclusion.”
Richardson v. Perales, 402 U.S. 389, 401 (1971).
court must keep in mind that opinions such as whether a
claimant is disabled, the nature and extent of a
claimant's residual functional capacity, and the
application of vocational factors “are not medical
opinions, . . . but are, instead, opinions on issues reserved
to the Commissioner because they are administrative findings
that are dispositive of a case; i.e., that would direct the
determination or decision of disability.” 20 C.F.R.
§§ 404.1527(d), 416.927(d). Whether the claimant
meets the listing and is qualified for Social Security
disability benefits is a question reserved for the ALJ, and
the court “may not decide facts anew, reweigh the
evidence, or substitute [its] judgment for that of the
Commissioner.” Dyer v. Barnhart, 395 F.3d
1206, 1210 (11th Cir. 2005). Thus, even if the court were to
disagree with the ALJ about the significance of certain
facts, the court has no power to reverse that finding as long
as substantial evidence in the record supports it.
court must “scrutinize the record in its entirety to
determine the reasonableness of the [Commissioner]'s
factual findings.” Walker, 826 F.2d at 999. A
reviewing court must not look only to those parts of the
record that support the decision of the ALJ, but also must
view the record in its entirety and take account of evidence
that detracts from the evidence relied on by the ALJ.
Hillsman v. Bowen, 804 F.2d 1179, 1180 (11th Cir.
42 U.S.C. § 423(d)(1)(A), a person is entitled to
disability benefits when the person cannot “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 result in death or which has lasted or can be
expected to last for a continuous period of not less than 12
months.” 42 U.S.C. § 423(d)(1)(A). To make this
determination, the Commissioner employs a five-step,
sequential evaluation process:
(1) Is the person presently unemployed?
(2) Is the person's impairment severe?
(3) Does the person's impairment meet or equal one of the
specific impairments set forth in 20 C.F.R. Pt. 404, Subpt.
P, App. 1?
(4) Is the person unable to perform his or her former
(5) Is the person unable to perform any other work within the
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
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir.
1986); 20 C.F.R. §§ 404.1520, 416.920.
claimant was forty-five years old at the time of the
ALJ's final decision (R. 89); had completed some college
(R. 42); had past relevant work as a seal coat technician,
billing manager, and medical billing specialist (R. 104); and
alleges disability based on sarcoidosis, atypical
microbacteria, and neuropathy. (R. 273).
and Mental Impairments
Mark Mossey admitted the claimant to Anne Arundel Medical
Center in Maryland on September 10, 2009. Examinations found
a 1.7 centimeter mass in the claimant's left lung, and a
biopsy showed that the mass was a non-caseating granuloma.
Further exams identified large hypodense lesions in the left
and right lobes of the liver. (R. 388-397).
claimant visited Dr. Kioumarce Yazdani on October 8, 2009
complaining of difficulty swallowing. Dr. Yazdani noted that
the claimant had non-caseating granulomas and was
experiencing pain after eating. (R. 645). The claimant saw
Dr. Yazdani again on November 17, 2009 (complaining of
incontinence and pain after eating); on December 14, 2009
(complaining of tender bowels); and on March 18, 2010 (for
tests showing small colonic polyps). (R. 387, 645).
October 22, 2009, Dr. Stephen Cattaneo saw the claimant for a
consultation. Dr. Cattaneo noted that the claimant's
symptoms and objective testing could represent sarcoidosis, a
disease characterized by inflammatory masses, or granulomas,
in different parts of the body. On November 11, 2009, Dr.
Cattaneo admitted the claimant to Anne Arundel Medical Center
for surgery to remove the lung nodule, which was successful.
On December 3, 2009, Dr. Cattaneo wrote to Dr. Yazdani, the
claimant's internist, regarding the claimant's
further treatment. Dr. Cattaneo expressed that the claimant
reported intermittent back and abdominal pain; that she had
not eaten well and was inactive in her daily activities; and
that he encouraged the claimant increase her activity. (R.
Cattaneo referred the claimant to Dr. Glen Gibson, a surgical
oncologist, who examined the claimant on April 8, 2010. Dr.
Gibson noted lack of increase in size of the claimant's
liver masses and stated that the liver lesions were not
contributing to her severe decline in general functional
ability that manifested in September 2009. (R. 405).
April 22, 2010, Anne Arundel Medical Center admitted the
claimant because of complaints of leg pain without injury.
Dr. David Todd performed spinal x-rays which showed
scoliosis. The claimant returned to Dr. Yazdani on April 23,
2010, complaining of leg pain and on May 2, 2010, Dr. Yazdani
completed a summary of the claimant's condition to that
point. He noted that the claimant exhibited degenerative disc
disease, non-caseating granulomas, frequent back pain, and
chronic diarrhea. (R. 496, 646).
18, 2010, the claimant visited Dr. Karenga Lemmons, an
internist, for a second opinion on referral from Dr. Yazdani.
Dr. Lemmons noted bilateral leg pain radiating down ankles
with numbness that had been present for six months prior. Dr.
Lemmons further noted that the claimant appeared stressed and
lacked understanding of her treatment history. Additionally,
the claimant had 5/5 motor skills and a normal gait. (R.
28, 2010, the claimant saw Dr. Reena Thomas on referral from
Dr. Lemmons for the reported numbness in her legs. Dr. Thomas
stated that electrodiagnostic evidence showed chronic spinal
root irritation, but no electrodiagnostic evidence of a
myopathy or large fiber peripheral
neuropathy. (R. 407, 498, 782-84).
claimant returned to Dr. Lemmons' office on several
occasions from June 30, 2010 to October 25, 2010 for
follow-up with a nurse practitioner, Sharon Cave. The
claimant consistently reported chronic left leg pain and
numbness, intermittent pain in her right leg and left
forearm, and swelling in her left leg. (R. 429-33).
claimant presented for an infectious disease consultation
with Dr. Rahki Krishnan on July 22, 2010, which showed
caseating and noncaseating granulomas. Dr. Krishnan referred
the claimant to the Johns Hopkins Sarcoidosis Clinic, and the
claimant presented on November 3, 2010 for Dr. Edward Chen to
evaluate her for possible sarcoidosis. The claimant reported
experiencing burning pain in both legs. Dr. Chen observed
significant generalized fatigue; no red, hot, or swollen
joints; and normal gait and stance. Dr. Chen described the
claimant's ailments and prognosis as a nodular variant of
pulmonary sarcoidosis. Further, he recommended reassessment
of the claimant's liver and spleen; a consultation with a
gastroenterologist; repeated gadolinium MRIs to assess the
claimant's leg pain; an echocardiogram to screen for
pulmonary hypertension; and a sleep study. (R. 412-415,
claimant again returned to NP Cave in Dr. Lemmons' office
on November 8, 2010 for a follow-up. The claimant reported
that she was becoming fatigued between four to five in the
afternoon each day, at which time she would sleep until two
in the morning; further, she stated that she was using a
walker. The claimant had an MRI on November 9, 2010, which
showed signs of scoliosis, disc protrusions, and a high
intensity zone. (R. 434).
claimant followed up with Dr. Krishnan, the infectious
disease consultant, on November 11, 2010. Dr. Krishnan stated
that the final diagnosis was sarcoidosis and that the
claimant should follow up further with Johns Hopkins. The
claimant presented on November 16, 2010 for the sleep study
recommended by Dr. Chen, which showed no significant
sleep-related breathing disorder. (R. 504-08, 784).
November 19, 2010, the claimant presented to Anne Arundel
Medical Center for a right ankle fracture. The hospital
referred the claimant to Dr. Edward Holt, an orthopedist, for
further treatment. The claimant visited Dr. Holt for a foot
and ankle exam on November 26, 2010. Per the claimant, she
developed pain with weight bearing and turned abruptly,
causing her right fibula to fracture. Dr. Holt recommended
surgery to repair the claimant's fractured ankle, and
performed an open reduction and internal fixation of the
ankle fracture on December 1, 2010. (R. 510-11, 514, 586).
claimant returned to Dr. Chen on December 7th, 2010 for test
results. Dr. Chen indicated that per the MRI results the
claimant's liver showed signs of hemangioma and a
multicystic condition. Further, Dr. Chen indicated the
claimant had clear signs of vitamin D deficiency; extensive
degenerative changes in her mid-back; and disc problems in
her lower back. He further recommended that the claimant
visit a back specialist. (R. 416-17).
claimant followed up with Sharon Cave, NP on December 17,
2010. The claimant again stated that she was using a walker,
and NP Cave listed sciatica as a diagnosis. (R. 435). The
claimant returned on January 10, 2011 complaining of