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Wade v. Saul

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

August 6, 2019

ANDREW SAUL, Commissioner of the Social Security Administration, [1] Defendant.



         Pursuant to 42 U.S.C. § 405(g), Elizabeth Wade seeks judicial review of a final adverse decision of the Commissioner of Social Security. The Commissioner denied her claim for a period of disability and disability insurance benefits. After careful review, the Court reverses the Commissioner's decision.


         Ms. Wade applied for a period of disability and disability insurance benefits on March 27, 2015. (Doc. 6-3, p. 23; Doc. 6-6, p. 2). Ms. Wade alleges that her disability began June 19, 2014. (Doc. 6-5, p. 74; Doc. 6-6, p. 2). The Commissioner initially denied Ms. Wade's claim. (Doc. 6-3, p. 23; Doc. 6-7, p. 2). Ms. Wade requested a hearing before an Administrative Law Judge (ALJ). (Doc. 6-3, p. 23; Doc. 6-7, p. 9). The ALJ issued an unfavorable decision. (Doc. 6-3, pp. 20, 38). The Appeals Council declined Ms. Wade's request for review (Doc. 6-3, p. 2), making the Commissioner's decision final for this Court's judicial review. See 42 U.S.C. § 405(g).


         The scope of review in this matter is limited. “When, as in this case, the ALJ denies benefits and the Appeals Council denies review, ” the Court “review[s] the ALJ's ‘factual findings with deference' and [his] ‘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)).

         The Court must determine whether there is substantial evidence in the record to support the ALJ's 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, the 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. Admin., 631 F.3d 1176, 1178 (11th Cir. 2011) (internal quotations and citation omitted). If the ALJ's decision is supported by substantial evidence, then the Court “must affirm even if the evidence preponderates against the Commissioner's findings.” Costigan v. Comm'r, Soc. Sec. Admin., 603 Fed.Appx. 783, 786 (11th Cir. 2015) (citing Crawford, 363 F.3d at 1158).

         With respect to the ALJ's legal conclusions, the 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 Court must reverse the ALJ's decision. Cornelius v. Sullivan, 936 F.2d 1143, 1145-46 (11th Cir. 1991).


         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.

Winschel, 631 F.3d at 1178.

         In this case, the ALJ found that Ms. Wade meets the insured status requirements through December 31, 2019. (Doc. 6-3, p. 26). Ms. Wade has not engaged in substantial gainful activity since June 19, 2014, the onset date. (Doc. 6-3, p. 26). The ALJ determined that Ms. Wade suffers from the following severe impairments: history of adhesions with pelvic/abdominal pain, history of lumbar spondylosis with stenosis with L4 and L5 decompressive laminectomies and foraminotomies with back pain and sciatica, degenerative joint disease of the knee, and chronic lymphocytic leukemia in remission. (Doc. 6-3, p. 26).[2] The ALJ found that Ms. Wade suffers from the following non-severe physical impairments: hyperlipidemia, vitamin D deficiency, tobacco use disorder, abscesses with cellulitis, benign colon polyp, sigmoid diverticulosis, hemorrhoids, hiatal hernia with mild erosive esophagitis, diffuse gastritis, history of MRSA infection, irritable bowel syndrome, history of breast reduction surgery, history of bladder sling times two, TMJ syndrome, and headaches. (Doc. 6-3, p. 30). The ALJ determined that Ms. Wade's anxiety, somatic symptom disorder, and depressive disorder with dysthymic syndrome are non-severe mental impairments. (Doc. 6-3, pp. 31, 33). Based on a review of the medical evidence, the ALJ found that Ms. Wade does not have an impairment or combination of impairments that meets or medically equals the severity of any of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Doc. 6-3, p. 33).

         The ALJ determined that Ms. Wade has the RFC to perform medium work as defined in 20 C.F.R. § 404.1567(c) except with occasional stooping and crouching; no right lower extremity pushing or pulling; and no climbing. (Doc. 6-3, p. 34). “Medium work involves lifting no more than 50 pounds at a time with frequent lifting or carrying of objects weighing up to 25 pounds.” 20 C.F.R. § 404.1567(c). The ALJ concluded that Ms. Wade is able to perform her past relevant work as a licensed practical nurse, work that Ms. Wade previously did in a nursing home, because this position does not require work-related activities precluded by Ms. Wade's RFC. (Doc. 6-3, p. 38; Doc. 6-5, p. 80).[3] Accordingly, the ALJ determined that Ms. Wade has not been under a disability within the meaning of the Social Security Act. (Doc. 6-3, p. 38).

         IV. ANALYSIS

         Ms. Wade argues that she is entitled to relief from the ALJ's decision because the ALJ did not properly evaluate her claim under the Eleventh Circuit pain standard. (Doc. 11, p. 5). Based on its review, the Court finds that the record does not contain substantial evidence to support the ALJ's negative credibility determination as it pertains to the ALJ's conclusion that Ms. Wade can perform medium work.[4]

         The Eleventh Circuit pain standard “applies when a disability claimant attempts to establish disability through his 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., No. 18-11954, 2019 WL 1975989, at *3 (11th Cir. May 3, 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., No. 18-11708, 2019 WL 1758438, at *2 (11th Cir. Apr. 18, 2019) (citing Wilson). If the ALJ does not demonstrate “proper application of the three-part standard[, ]” reversal is appropriate. McLain v. Comm'r, Soc. Sec. Admin., 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, Soc. Sec. Admin., 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, the ALJ “must articulate explicit and adequate reasons for doing so.” Wilson, 284 F.3d at 1225; Coley, 2019 WL 1975989, at *3. As a matter of law, the Secretary must accept the claimant's testimony if the ALJ inadequately or improperly discredits it. 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); see Hale v. Bowen, 831 F.2d 1007, 1012 (11th Cir. 1987) (“It is established in this circuit if the Secretary fails to articulate reasons for refusing to credit a claimant's subjective pain testimony, then the Secretary, as a matter of law, has accepted that testimony as true.”).

         When credibility is at issue, 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, 2016 WL 1119029, at *4. Concerning the ALJ's burden when discrediting a claimant's subjective symptoms, SSR 16-3p clarifies:

[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, 2016 WL 1119029, at *10. Additionally, in evaluating a claimant's reported symptoms, an ALJ must consider the following factors:

(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 Soc. Sec., 377 Fed.Appx. 944, 947 (11th Cir. 2010).

         The ALJ found that Ms. Wade's medical records and daily activities do not support her testimony regarding her subjective pain and limitations. (Doc. 6-3, pp. 35-37). An ALJ may discount a claimant's pain based on conflicting evidence in medical records and in reports of daily activities. See Crow, 571 Fed.Appx. At 808 (“Given Crow's quick and sustained improvement using prednisone, and daily activity that indicated a greater capacity for work than alleged, the ALJ made a clearly articulated credibility finding that was supported by substantial evidence.”) (citing Foote v. Chater, 67 F.3d 1553, 1562 (11th Cir. 1995)); Loveless v. Massanari, 136 F.Supp.2d 1245, 1249-1250 (N.D. Ala. 2001) (affirming the ALJ's decision to discredit the claimant's subjective pain testimony because it did not align with the claimant's objective medical evidence and reported daily activities). Accordingly, the Court first examines Ms. Wade's testimony and then compares her testimony to the medical evidence in the record and to the evidence relating to her daily activities.

         A. Ms. Wade's Testimony

         At the administrative hearing on August 2, 2017, Ms. Wade testified that she was 58 years old. (Doc. 6-5, pp. 69, 78, 79). Ms. Wade stopped working in 2014 because she did not recover well from a surgical procedure (pelvic), and she began experiencing back problems which required additional surgery. (Doc. 6-5, pp. 74-75). Ms. Wade stated that she suffered from back, abdominal, and knee pain, and she lacked energy. (Doc. 6-5, pp. 75, 78).[5] Ms. Wade stated that her pain and fatigue prevented her from working. (Doc. 6-5, pp. 75, 78). Ms. Wade was using a pain management plan to treat her pain, taking oxycodone (20 mg) four times daily. (Doc. 6-5, p. 76).[6] Medication helped Ms. Wade manage her pain, but she reported that medication did not eliminate her pain. (Doc. 6-5, p. 76).

         On a scale of one to ten - with ten being pain so severe a person would need to go to the emergency room - at the administrative hearing, Ms. Wade rated her pain as a six with rest and medication. (Doc. 6-5, p. 76). Ms. Wade stated that her pain increased to eight with activity. (Doc. 6-5, p. 76). Ms. Wade stated that she was most comfortable in a recliner and reclined “four and a half to five hours” daily to manager her pain. (Doc. 6-5, p. 77). Ms. Wade has received pain injections for her back and knees. (Doc. 6-5, p. 78). Ms. Wade stated that the last knee injections before the administrative hearing helped a little bit, but other pain procedures did not. (Doc. 6-5, p. 78).

         Ms. Wade and her husband have three children ages ten, six, and five. (Doc. 6-5, p. 76). Ms. Wade does household chores with a lot of help from her husband. (Doc. 6-5, p. 76). Her oldest child helps too. (Doc. 6-5, p. 77).

         Ms. Wade breaks up chores because of her pain: “Yeah, it takes a little bit, you know. I'll go and I'll sweep … then I go and I rest because it'll stir my back up.” (Doc. 6-5, p. 76). Ms. Wade drives her children to and from school, which is a quarter mile from home. (Doc. 6-5, p. 76). She drives herself and her children to doctor's appointments. (Doc. 6-5, pp. 76-77). Ms. Wade testified that she occasionally shops for groceries, but her “husband does the most part.” (Doc. 6-5, p. 77).

         B. ...

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