United States District Court, N.D. Alabama, Southern Division
DAVID PROCTOR UNITED STATES DISTRICT JUDGE.
Christine Mosley (“Plaintiff”) brings this action
pursuant to Section 205(g) of the Social Security Act (the
“Act”), seeking review of the decision of the
Commissioner of Social Security (the
“Commissioner”) denying her claims for a period
of disability insurance benefits (“DIB”) and
supplemental security income (“SSI”) under Titles
II and XVI of the Act. See 42 U.S.C. §§
405(g) and 1383(a).
filed her application for Social Security Disability (SSD)
benefits on September II, 2013 and for SSI on January 31,
2014. (R. 172, 174). In both applications Plaintiff alleged
that her disability began on May 31, 2013. (Id.).
Both Plaintiff's SSD and SSI applications were initially
denied by the Social Security Administration
(“SSA”) on April 10, 2014. (R. 110, 117).
Plaintiff then requested and received a hearing before
Administrative Law Judge (“ALJ”) J. L. Munford on
November 9, 2015. (R. 36, 108, 131). In his decision, dated
January 27, 2016, the ALJ determined that Plaintiff had not
been under disability within the meaning of §
1614(a)(3)(A) of the Act since September 11, 2013, the date
the application was filed. (R. 17-30). After the Appeals
Council denied Plaintiff's request for review of the
ALJ's decision, (R. 1), the ALJ's decision became the
final decision of the Commissioner, and therefore a proper
subject of this court's appellate review.
twenty-five (25) years old at the time of the administrative
hearing, has formal education consisting of a high school
diploma, some college courses, and a course in “patient
care assistance.” (R. 42, 51). Her previous work
experience, which ended in approximately May or June 2013,
includes employment characterized as “caregiver”
and “patient care assistant.” (R. 52, 57 - 58).
Plaintiff alleges she is unable to work because of chronic,
debilitating nausea and vomiting resulting from
gastroparesis and migraines. (R. 42). Plaintiff's
alleged onset date for disability is May 31, 2013. (R. 42).
During her alleged period of disability, Plaintiff received
treatment from multiple in-state and out-of-state medical
facilities. (R. 278-1481, 1490-1660, 1669-2178).
of background, Plaintiff is an obese female who has been seen
by multiple medical doctors for treatment relating to,
inter alia, gastroparesis, gastroesophageal reflux
disease (GERD),  migraine headaches, depression, anxiety,
and obesity. Plaintiff's medical history includes,
inter alia, a laparoscopic
fundoplication (with prolonged postop nasogastric
feedings) and cholecystectomy in 2006, and a
laparoscopic placement of gastric electric stimulator in
April 2015. (R. 1579). As a possible result of these
operations, Plaintiff has suffered from a history of
nondiabetic gastroparesis. (R. 1582). Additionally, Plaintiff
weighed 225 pounds, with a body mass index (BMI) of 32.3, in
January 2013 and 215 pounds, with a BMI of 31.8, in April
2015. (R. 1171, 1579). Because Plaintiff has a body mass
index greater than 30, she is classified as obese. (R. 1171,
was hospitalized for treatment related to her nausea and
vomiting in July 2013; during which time Dr. Halama performed
an esophagogastroduodenoscopy (EGD) with biopsy. (R. 1563-64).
Following this procedure, Dr. Halama noted, “[n]o
abnormalities were seen on today's study to suggest a
cause for [Plaintiff's] symptoms.” (R. 1563).
During her hospital stay, Plaintiff's complaints of
either nervousness, anxiety, or depression were inconsistent,
as she complains of these symptoms on July 17, 2013, but
denies them on the following day, July 18, 2013. (R.
1558-61). Plaintiff was hospitalized a second time in July
2013, again for chronic nausea. During that stay she
underwent a CT scan of her abdomen and pelvis, which showed
“a number of colonic diverticula are present
without evidence of diverticulitis.” (R. 1547).
Following her discharge on August 2, 2013, Plaintiff received
treatment from a gastroenterologist. (R. 1172-1187).
Plaintiff presented to the ER again on August 3, 2013, one
day after being released, complaining of mental health issues
and exhibited signs she had overused her medications, which
she has a history of doing, and left the hospital against
medical advice. (R. 1544). Plaintiff attended a follow-up
appointment with Dr. Craig Philpot, a gastroenterologist, in
September 2013, at which time Plaintiff reported that her
symptoms were much improved, and she had not experienced any
nausea, vomiting, abdominal pain, or weight loss. (R. 1474).
Dr. Philpot's examination of Plaintiff showed that her
bowel sounds were normal with no hepatosplenomegaly,
tenderness, distention, or abdominal masses. (R. 1474).
October 2014, Plaintiff was referred to Dr. William Palmer, a
gastroenterologist at the Mayo Clinic, again reporting nausea
and gastroparesis, and stating “the only thing that she
is able to tolerate are specifically foods like a fast food
burger.” (R. 1889-90). Dr. Palmer's examination
revealed a non-distended abdomen with positive bowel sounds
and no organomegaly, and faint pain on deep palpation. (R.
1891). Dr. Palmer noted that a repeat gastric emptying study,
multiple CT scans of the abdomen and pelvis, an ultrasound of
the abdomen, an Endoscopic Retrograde
Cholangiopancreatography (ERCP), and multiple colonoscopies were
all within normal limits. (R. 1891-92). Dr. Palmer ordered an
esophagus x-ray with barium tablet and stomach x-ray, which
returned normal results, with “no narrowings, ”
“strictures, ” or “abnormalities to explain
symptoms.” (R. 1893). Additionally, multiple EGD's
have returned unremarkable results. (R. 1419).
also testified to having migraines which prevent her from
working. (R. 42). Medical records show that early in 2014
Plaintiff consulted a neurologist at Norwood Neurology for
her headaches and was prescribed Topamax during her first
visit. (R. 1480-81). During a follow-up visit in March 2014,
Plaintiff reported improvement in the frequency of her
headaches, and the neurologist increased her dosage of
Topamax and planned to see Plaintiff for a follow-up in one
month. (R. 1479). However, Plaintiff's records from
Norwood Neurology indicate she did not follow-up as directed.
(R. 1478-1481). Further, although Plaintiff has seen her
gastroenterologist multiple times since her last appointment
with her neurologist in March 2014, Plaintiff has not
reported headaches at any of these appointments. (R.
support of Plaintiff's condition, her mother Adrienne
Mosley (“Mrs. Mosley”) submitted a
“Function Report - Adult Third Party.” (R.
228-35). In this report, Mrs. Mosley states that “most
of [Plaintiff's] day is spent in bed. She suffers from
chronic nausea, abdominal pain as well as anxiety,
depression, and migraines. Some of the medicine she takes
makes her unable to function.” (R. 228). However, the
ALJ found Mrs. Moseley's testimony not entirely credible
because it is contradicted by the medical evidence. (R. 27).
Plaintiff was evaluated by a state agency medical consultant.
(R. 86-107). This evaluation included both a physical
examination and a psychological examination. (Id.).
The ALJ found that the consultant's physical assessment
was “consistent with the claimant's treatment
history, imaging reports, and physical examination
findings.” (R. 27). However, the ALJ discounted the
consultant's psychological assessment because the ALJ
found “it was unsupported by the claimant's
treatment history, mental status examinations findings, and
reported activities of daily living.” (Id.).
concluded, “[b]ased on the claimant's reported
activities of daily living, treatment history, imaging
reports, and physical and mental status examinations findings
. . . that the claimant can perform medium work with [the]
additional nonexertional limitations” described in the
residual functional capacity (“RFC”) assessment.
(Id.). Following this conclusion, the ALJ determined
that based on “the claimant's age, education, work
experience, and residual functional capacity, there are jobs
that exist in significant numbers in the national economy
that the claimant can perform.” (R. 28).
applied the five-step test. He first determined that
Plaintiff had not engaged in substantial gainful activity
during the period from her alleged onset date of May 31,
2013, through her date last insured of March 31, 2015. (R.
20). Second, the ALJ determined that Plaintiff had the
following “severe, ” medically determinable
impairments: gastroparesis, gastroesophageal reflux disease
(GERD), obesity, and migraine headaches. (R. 20). However,
the ALJ determined Plaintiff's pulmonary embolism,
leukocytosis,  anemia, and dysmenorrhea were not
“severe” disabling impairments. (R. 20).
Additionally, although Plaintiff testified to suffering from
anxiety and depression, the ALJ determined these mental
impairments did not cause more than minimal limitations in
Plaintiff's ability to perform basic mental work
activities. (R. 21, 50). The ALJ evaluated the evidence while
considering the four broad functional areas set out in
section 11.00(G)(3)(b), i.e. daily activities, social
functioning, concentration, persistence or pace, and adapting
and managing; and what evidence is needed to evaluate a
Plaintiff's mental disorder set out in section 12.00C of
the Listing of Impairment (20 C.F.R., Part 404, Subpart P,
Appendix 1, Part A2.). (R. 21).
found at least one severe impairment, the ALJ correctly
proceeded to the third step in the five-step analysis. Based
on his analysis at step three, the ALJ determined Plaintiff
“does not have an impairment or combination of
impairments that meets or equals the severity of one of the
listed impairments” found in 20 C.F.R. § 404,
Subpart P, Appendix 1. (R. 23). Because the ALJ determined
that none of Plaintiff's impairments meet or medically
equal the criteria of any listed impairment, the ALJ
continued to step four.
four, the ALJ determined that Plaintiff has a RFC to perform
medium work, “except that she cannot drive a motor
vehicle or operate hazardous machinery and should avoid all
exposure to unprotected heights.” (R. 23-24). Analyzing
Plaintiff's RFC in conjunction with her prior work
history, the ALJ determined that she did not have the RFC
necessary to perform any past relevant work. (R. 28). Thus,
the ALJ correctly proceeded to the fifth and final step.
Relying on the testimony of a vocational expert (VE), and
considering Plaintiff's age, education, work experience,
and RFC, the ALJ determined that there are jobs in
significant numbers in the national economy which Plaintiff
can perform. (R. 28). Based on these determinations, the ALJ
concluded that Plaintiff is “capable of making a
successful adjustment to other work that exists in
significant numbers in the national economy, ” and
therefore, is not disabled.
Plaintiff's Argument for Remand or Reversal
alleges that the ALJ failed to “follow the
‘slight abnormality' standard in finding that
Plaintiff's depression and anxiety are non-severe”
and failed to properly apply the Eleventh Circuit pain