Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-5_14-cv-01885/USCOURTS-alnd-5_14-cv-01885-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (SSID)

---

UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ALABAMA

NORTHEASTERN DIVISION

SHARON ANN SANDLIN,

Plaintiff,

v.

CAROLYN W. COLVIN,

Commissioner of the

Social Security Administration,

Defendant.

}

}

}

}

}

}

}

}

}

}

}

Case No.: 5:14-CV-1885-MHH

MEMORANDUM OPINION 

Pursuant to 42 U.S.C. §§ 405(g) and 1383(c), plaintiff Sharon Ann Sandlin

seeks judicial review of a final adverse decision of the Commissioner of Social 

Security. The Commissioner denied Ms. Sandlin’s claims for a period of disability 

and disability insurance benefits and supplemental security income. After careful 

review, the Court remands so that the Commissioner may fully consider Ms. 

Sandlin’s request for a closed period of disability covering the months during 

which Ms. Sandlin was treated for breast cancer. 

I. PROCEDURAL HISTORY

Ms. Sandlin applied for a period of disability and disability insurance 

benefits and supplemental security income on September 22, 2011. (Doc. 5-3, pp. 

FILED

 2016 Sep-14 AM 10:30

U.S. DISTRICT COURT

N.D. OF ALABAMA

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 1 of 22
2

88, 96). Ms. Sandlin alleges that her disability began on March 16, 2011. (Id.

88). Initially, Ms. Sandlin sought an indeterminate finding of disability. The 

Commissioner denied Ms. Sandlin’s claims on November 3, 2011. (Doc. 5-4, p. 

2).1 

Ms. Sandlin requested a hearing before an Administrative Law Judge (ALJ). 

(Id. at 7). During the administrative hearing, Ms. Sandlin’s attorney suggested to 

the ALJ that Ms. Sandlin might qualify for a “closed period of disability from 

March 16, [2011] through at least November the 7th, 2012.” (Doc. 5-3, p. 59). 

The ALJ issued an unfavorable decision on March 28, 2013. (Doc. 5-3, p. 32). 

The ALJ’s opinion does not mention Ms. Sandlin’s request for a closed period of 

disability. 

Ms. Sandlin sought relief from the Appeals Council. In the proceedings 

before the Appeals Council, Ms. Sandlin’s attorney argued that the ALJ: 

 

1 Ms. Sandlin would not have been eligible for a closed period of disability at this stage of the 

proceedings because she had not yet been absent from her job for more than 12 months. 

Disability is defined as “an inability to 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 last for a continuous period of not less than 12 

months.” 42 U.S.C. § 423(d)(1)(A); see also Barnhart v. Walton, 535 U.S. 212, 217 (2002) (A 

claimant’s impairments and inability to work must last for a continuous period of at least twelve 

months); Harvey v. Astrue, 2009 WL 2634399, at *8 (M.D. Fla. Aug. 24, 2009) (“A closed 

period of disability may be considered when a claimant had an impairment that: 1) prevented 

substantial gainful activity for at least twelve (12) months, 2) continued to or through the month 

of filing, and 3) ceased in or after the month of filing but prior to the date of adjudication. 

POMS § DI 25510.01(A). Thus, a claimant who is unable to point to a period of twelve (12) 

consecutive months in which she was unable to engage in substantial gainful activity[] is not 

entitled to a closed period of social security benefits. Phillips v. Barnhart, 91 Fed. Appx. 775, 

782 (3rd Cir. 2004); Kennedy v. Comm'r of Soc. Sec., 87 Fed. Appx. 464 (6th Cir. 2003).”). 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 2 of 22
3

did not consider a closed period of disability from March 16, 2011 to 

January 1, 2013. That closed period of disability reflects the period of 

time that Ms. Sandlin was unable to work because of her cancer and 

treatment for her cancer. Therefore, we believe that the decision of 

the Administrative Law Judge for the closed period is not supported 

by substantial evidence. . . .

(Doc. 5-3, p. 9). On September 16, 2014, the Appeals Council declined Ms. 

Sandlin’s request for review (Id. at 2), making the Commissioner’s decision final 

and a proper candidate for this Court’s judicial review. See 42 U.S.C. §§ 405(g) 

and 1383(c).

II. STANDARD OF REVIEW

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 factual 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. 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 3 of 22
4

2011) (internal quotations and citation omitted). If the ALJ’s factual findings are 

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). 

III. SUMMARY OF THE ALJ’S DECISION

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. 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 4 of 22
5

In this case, the ALJ found that Ms. Sandlin has not engaged in substantial 

gainful activity since March 16, 2011, the alleged onset date. (Doc. 5-3, p. 26). 

The ALJ determined that Ms. Sandlin’s “breast cancer stage III status post double 

mastectomy and reconstructive surgery with residual effects of chemotherapy” are 

non-severe impairments. (Doc. 5-3, p. 27).2 However, the ALJ concluded that

“these medically determinable impairments may create functional deficits in 

combination with other symptoms that are severe.” (Doc. 5-3, p. 27; see also Doc. 

5-3, p. 30 (“[Considering the totality of the evidence in the light most favorable to 

the claimant, the undersigned finds the combination of the claimant’s impairments 

to be severe. . . .”)). Based on a review of the medical evidence in the 

administrative record, the ALJ concluded that Ms. Sandlin did not have an 

impairment or a combination of impairments that met or medically equaled the 

severity of any of the listed impairments in 20 C.F.R. Part 404, Subpart P, 

Appendix 1. (Id. at 27-28). 

In light of Ms. Sandlin’s impairments, the ALJ evaluated her residual 

functional capacity (RFC). The ALJ determined that Ms. Sandlin has the RFC to 

“perform the full range of light work as defined in 20 C.F.R. 404.1567(b) and 

416.967(b).” (Doc. 5-3, p. 28). Based on this RFC, the ALJ concluded Ms. 

 

2

The residual effects of Ms. Sandlin’s chemotherapy include diarrhea, cramping, nausea, 

migraine headaches, fatigue, and neuropathy. (Doc. 5-3, p. 29).

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 5 of 22
6

Sandlin is able to perform her past relevant work as an assembly operator and a 

general clerk. (Id. at 31). Accordingly, the ALJ determined that Ms. Sandlin has 

not been under a disability within the meaning of the Social Security Act. (Id. at 

32). 

IV. ANALYSIS

Ms. Sandlin argues the ALJ’s decision is subject to remand or reversal 

because the ALJ did not:

address the issue of a closed period of disability for the Plaintiff, but 

instead determined that the Plaintiff was not disabled under the Social 

Security Act. The Plaintiff contends that she was disabled for a 

closed period from March 16, 2011 to January 10, 2013 and that 

benefits should have been granted for that period and that the ALJ 

improperly applied 42 U.S.C.A. § 423(d)(5)(A) during that period and 

that the reasons given for rejecting the Plaintiff’s testimony during 

that period are not supported by substantial evidence.

(Doc. 9, pp. 24-25) (citations omitted).3 The Court agrees that it is appropriate to 

ask the ALJ to address Ms. Sandlin’s claim for a closed period of disability. 

“A claimant may request benefits for a finite period of disability, even if she 

is later able to work. In such ‘closed period’ cases, ‘the decision maker determines 

that a new applicant for disability benefits was disabled for a finite period of time 

 

3 Ms. Sandlin also argues that the ALJ’s reliance on the opinion of Dr. Robert Estock to help 

determine the severity of her (Ms. Sandlin’s) physical impairments is not supported by 

substantial evidence and that the ALJ’s decision that the “general clerk” position was past 

relevant work is not supported by substantial evidence. Because the Court finds that Ms. 

Sandlin’s argument concerning the ALJ’s failure to consider a closed period of disability is 

meritorious, the Court will not address Ms. Sandlin’s alternative arguments. 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 6 of 22
7

which started and stopped prior to the date of his decision.’” Mitchell v. Comm’r

of Soc. Sec., 393 Fed. Appx. 651, 652 (11th Cir. 2010) (quoting Pickett v. Bowen, 

833 F.2d 288, 289 n.1 (11th Cir. 1987)). A claimant may raise the issue of a 

closed period of disability on appeal if the claimant has specified the dates that 

define the closed period for which benefits are sought. Jones v. Comm’r of Soc. 

Sec., 181 Fed. Appx. 767, 772-73 (11th Cir. 2006). As noted above, counsel for 

Ms. Sandlin identified the closed period for which she seeks benefits both during 

the administrative hearing in this case and in the proceedings before the Appeals 

Council, and she has presented the time frame clearly to this Court. (Doc. 5-3, pp. 

9, 59).4 

The administrative record contains sufficient evidence of pain during the 

closed period to warrant remand for further proceedings. “To establish a disability 

based on testimony of pain and other symptoms, the claimant must satisfy two 

parts of a three-part test by showing ‘(1) evidence of an underlying medical 

condition; and (2) either (a) objective medical evidence confirming the severity of 

the alleged pain; or (b) that the objectively determined medical condition can 

 

4

In Jones, the claimant argued that “the ALJ should have considered [her] eligibility for a closed 

period of disability because [her] debilitating symptoms exceeded a 12-month duration.” 181 

Fed. Appx. at 772. The Eleventh Circuit concluded that the ALJ did not err in failing to consider 

the claimant’s eligibility for a closed period of disability because “Jones’s argument on appeal 

does not sufficiently provide us with the specific 12–month time period for which she believes 

she is entitled to a closed period of disability” and because substantial evidence supported the 

ALJ’s finding “that Jones was not disabled for any time during that entire period.” Id. at 773. 

Here, Ms. Sandlin requested that the ALJ consider a closed period of disability and provided the 

ALJ, the Appeals Council, and this Court with the specific time period.

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 7 of 22
8

reasonably be expected to give rise to the claimed pain.’” Zuba-Ingram v. 

Commissioner of Social Sec., 600 Fed. Appx. 650, 656 (11th Cir. 2015) (quoting 

Wilson v. Barnhart, 284 F.3d 1219, 1225 (11th Cir. 2002) (per curiam)). A 

claimant’s testimony coupled with evidence that meets this standard “is itself 

sufficient to support a finding of disability.” Holt v. Sullivan, 921 F.2d 1221, 1223 

(11th Cir. 1991) (citation omitted). 

If the ALJ discredits a claimant’s subjective testimony, then the ALJ “must 

articulate explicit and adequate reasons for doing so.” Wilson, 284 F.3d at 1225. 

“While an adequate credibility finding need not cite particular phrases or 

formulations[,] broad findings that a claimant lacked credibility . . . are not enough. 

. . .” Foote v. Chater, 67 F.3d 1553, 1562 (11th Cir. 1995) (per curiam); see SSR 

16-3P, 2016 WL 1119029 at *9 (“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.”). 

During her administrative hearing, Ms. Sandlin testified that while she was 

undergoing treatment for breast cancer, “I was throwing up. I had cramps. I had 

diarrhea. I had migraines. I stayed in the bed. . . Pretty much 24 hours a day.” 

(Doc. 5-3, p. 49). She stated: “I wasn’t sleeping. I had neuropathy in my hands 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 8 of 22
9

and my feet. And I was numb halfway down both arms and across my back and 

chest from the surgery.” (Id. at 53). She explained that her chemotherapy lasted 

from May 2011 until May 2012. (Id. at 49). 

Ms. Sandlin acknowledged that she worked for short periods during her

cancer treatment to avoid losing her insurance and to keep her job, but she could 

not do her previous work as a press operator. (Id. at 51-53). Ms. Sandlin testified 

that she received accommodations from a supervisor who “had a family member 

that was also going through cancer and chemo.” Ms. Sandlin explained that her 

supervisor:

put a chair in the bathroom where I could stay because he knew I was 

just trying to get my 30 days in and that I wasn’t able to work. . . . I 

spent all my time sitting.... I had to keep a garbage can with me all 

the time. I was throwing up, or I would spend the time in the 

bathroom because I had diarrhea so bad.” 

(Id. at 54). 

Ms. Sandlin underwent reconstructive surgery on both breasts in August 

2012 and again in January 2013. She then returned to work. (Doc. 5-3, p. 29; Doc. 

5-10, pp. 103-105).5 Ms. Sandlin testified that as of January 2013, she was “trying 

to work an eight hour day.” (Doc. 5-3, pp. 43-44). When she returned to work in 

January 2013, Ms. Sandlin handled paperwork rather than operating machinery. 

 

5

The ALJ noted that there are no medical records for the January 2013 procedure in the 

administrative record. (Doc. 5-3, p. 30). That is accurate, but there is a pre-op record from 

December 11, 2012. (Doc. 5-10, pp. 108-109). 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 9 of 22
10

(Id. at 44). She worked seven to eight hours a day, five days a week and made

$17.00 an hour. (Id. at 45). She testified that Dr. Rayburn placed restrictions on 

lifting more than “5 pounds.” (Id. at 48). 

The ALJ accurately summarized Ms. Sandlin’s subjective testimony. (Doc. 

5-3, p. 29). The ALJ correctly applied the first part of the pain standard, finding 

“that the claimant’s medically determinable impairments could reasonably be 

expected to cause the alleged symptoms.” (Id.). The ALJ then found that Ms. 

Sandlin’s testimony concerning the “intensity, persistence and limiting effects” of 

her symptoms was not entirely credible. (Id.). 

The ALJ explained that Ms. Sandlin’s medical records and treatment history 

are not consistent with her allegations of disabling pain. The ALJ stated: 

Notably, the claimant alleges that during the period of chemotherapy 

treatment, she was unable to get out of bed most days and experienced 

nausea, vomiting, headaches and pain related to neuropathy; however 

complaints to this degree are not seen in the medical record.

(Doc. 5-3, p. 30). Although some medical records in the administrative record 

indicate that Ms. Sandlin managed the side effects of chemotherapy well for 

periods of time, other records reflect that Ms. Sandlin suffered with severe side 

effects at other times during the treatment. 

The medical records that were before the ALJ indicate that Ms. Sandlin was 

diagnosed with breast cancer on March 16, 2011. (Doc. 5-8, pp. 13-14). Two 

weeks later she underwent a double mastectomy. (Doc. 5-9, pp. 4-6). Ms. Sandlin 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 10 of 22
11

had a post-surgical check up with Dr. Seth Rayburn on April 4, 2011. (Id. at 7). 

Ms. Sandlin reported that “she [had] pain and nausea with movement of either 

arm,” but Dr. Rayburn found that Ms. Sandlin was “able to move her arms with 

good motion,” and her drains were intact. (Id.). Dr. Rayburn noted that Ms. 

Sandlin was doing well and instructed her to continue wearing compressive 

garments to aid her recovery. (Id. at 8). Three days later, Dr. Rayburn saw Ms. 

Sandlin again. She had less pain, but she had developed a burning sensation on her 

right side. (Id. at 9). Dr. Rayburn prescribed Neurotin for the burning sensation 

and told Ms. Sandlin that she could begin to ease the compressive garments. (Id. at 

10). 

By April 14, 2011, Ms. Sandlin reported that her pain had subsided, and her 

range of motion was good. (Doc. 5-9, p. 11). On April 21, 2011, Ms. Sandlin 

stated that “she [was] doing well.” (Doc. 5-9, p. 13). Ms. Sandlin received ports 

for chemotherapy on May 4, 2011, and she began her chemotherapy regime eight 

days later. (Id. at 15). When she began chemotherapy, Ms. Sandlin was still sore 

from her surgical procedure, but otherwise, she was relatively healthy. (Id. at 15-

16). 

On May 5, 2011, Ms. Sandlin saw Dr. Brian Mathews. Dr. Mathews started 

Ms. Sandlin on the “standard protocol” medications for chemotherapy: 

“[C]arboplatin, Taxotere, and Herceptin.” (Doc. 5-9, p. 83). To address nausea, 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 11 of 22
12

Dr. Mathews prescribed Alovi, Decadron, and Emend. (Id.). Dr. Mathews also 

noted that Ms. Sandlin could take Zofran and Decafrom to treat her nausea. (Id.). 

Dr. Mathews evaluated Ms. Sandlin after her first round of chemotherapy. 

(Doc. 5-9, p. 78). Overall, Ms. Sandlin was “stable.” (Id.). Dr. Mathews noted 

that Ms. Sandlin “did have quite a bit of diarrhea after her first cycle. It is not clear 

if this was chemo related or if she could have a coincidental virus.” (Id.). Dr. 

Mathews prescribed Bentyl to treat the diarrhea, and he maintained Ms. Sandlin’s 

other medications. (Id.). 

Less than a week later on June 21, 2011, Ms. Sandlin returned to Clearview 

Cancer Institute “due to an urgent complaint of severe abdominal pain with 

cramping. The pain was so severe that [] a STAT CT of the abdomen and pelvis”

was ordered. (Doc. 5-9, p. 72). CT results showed a possible “benign bone 

island.” (Id.). Although the CT was negative with regard to diarrhea and 

cramping, Ms. Sandlin was prescribed “Librax three times a day” to alleviate both 

conditions. (Id. at 73). Ms. Sandlin also continued to suffer gastroesophageal 

reflux, and she was instructed to continue taking Prilosec. (Id.). The record from 

Ms. Sandlin’s June 21, 2011 visit to the Cancer Institute does not make clear 

whether Ms. Sandlin saw a doctor or a physician’s assistant or a nurse. The record 

indicates that Ms. Sandlin did not have an appointment and that she was a “workCase 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 12 of 22
13

in” because of her urgent condition. The record states that Ms. Sandlin was 

scheduled to see Dr. Mathews again on June 23, 2011. (Doc. 5-9, pp. 72-73). 

Records ranging from July 14, 2011 to September 15, 2011 indicate that Ms. 

Sandlin’s severe symptoms subsided. Dr. Mathews noted that Ms. Sandlin had 

“[n]o major problems to report,” (Doc. 5-9, p. 67); she “overall is doing well,” (Id.

at 62) and had “no complaints,” (Id. at 57). In fact, based on his examination of 

Ms. Sandlin on July 14, 2011, Dr. Mathews wrote that Ms. Sandlin “had fantastic 

tolerance of her chemotherapy last time,” and she was preparing for her last two 

rounds of treatment. (Doc. 5-9, p. 67). Between July and September 2011, nausea 

was a reoccurring problem, but Ms. Sandlin received medication to treat the 

nausea. (Id. at 58, 67). A July 12, 2011 note from Ms. Sandlin’s plastic surgeon 

stated that Ms. Sandlin “has a history of migraines, which are frequent with her 

chemotherapy.” (Doc. 5-10, p. 116). 

When Ms. Sandlin visited the Cancer Institute on October 6, 2011, she had 

completed six cycles of TCH chemotherapy, and she was taking a weekly regimen 

of Herceptin and Taxol. Ms. Sandlin reported “that she [had] noticed she has been 

having more migraine like headaches lately, not relieved by her regular pain 

medications.” (Doc. 5-10, p. 96). Dr. Mathews prescribed Fiorinal to treat the 

migraine headaches. (Id. at 95-97). 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 13 of 22
14

One week later, Ms. Sandlin reported that the Fiorinal “did not help a great 

deal” and that she was “still having some joint pain,” though her Lortab seemed “to 

help more.” (Doc. 5-10, p. 94). Her nausea continued, but it was “better than last 

time.” (Id.). To address the nausea, Dr. Mathews moved Ms. Sandlin to a 

“Sancuso patch.” (Id. at 94-95). Ms. Sandlin planned to take Excedrin migraine 

and Lortab “as needed” to treat her headaches. (Id. at 95).

On October 20, 2011, Dr. Mathews noted that, “[o]verall, [Ms. Sandlin] is 

much better. Counts are stable. Nausea has been eliminated for now. Headaches 

have been better. Pain has been controlled. She still has fatigue, but otherwise is 

doing well.” (Doc. 5-10, p. 92). Dr. Mathews reported that the Sancuso patch 

helped Ms. Sandlin’s nausea “a good bit.” (Doc. 5-10, p. 93). Dr. Mathews gave 

Ms. Sandlin a work note limiting her to “light duty” because her employer 

instructed her to return to work for 30 days to qualify for additional short term 

disability. (Id.). Ms. Sandlin was concerned “that she simply [would not] have 

enough energy to do her previous full time work, but she is in a hard situation 

needing to keep her financial and insurance status stable.” (Id.). 

On October 27, 2011, Dr. Mathews noted “no issues to report aside” from 

Ms. Sandlin continuing on her plan to switch chemotherapy drugs. (Doc. 5-10, p. 

90). On November 21, 2011, the physician’s assistant reported that Ms. Sandlin 

was “feeling well” with some fatigue issues after returning to work “but is 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 14 of 22
15

otherwise stable.” (Id. at 88). Ms. Sandlin’s nausea was no longer an issue, and 

she was “doing better with Lortab” treatment for her migraines. (Id. at 89). Ms. 

Sandlin received “notes for work to return to work but to remain at the light duty 

post” she was filling. (Id.).

By December 15, 2011, Ms. Sandlin’s condition had worsened. Dr. 

Mathews noted that Ms. Sandlin “had nausea, vomiting, and headaches over the 

past week.” (Doc. 5-10, p. 86). Dr. Mathews attributed the symptoms to a virus. 

(Doc. 5-10, pp. 86-87). He prescribed “fluids and Aloxi” for nausea and “a Z-pak 

and Medrol-Dosepak” for sinusitis. (Id.). 

On January 3, 2012, Dr. Mathews noted that while Ms. Sandlin was “stable,” 

she “continues to have a number of problems.” (Doc. 5-10, p. 84). She suffered 

“nausea with occasional episodes of vomiting” and “headaches... not clearly sinus 

in nature.” She also complained of “decreased energy and appetite,” and “hot 

flashes.” (Id.). Dr. Mathews decided to adjust Ms. Sandlin’s medication, and he

ordered a CT scan to explore the cause of her sinusitis and headaches. (Id. at 84-

85).

Treatment notes from January 12, 2012 state that Ms. Sandlin suffered from 

“numerous and frequent headaches which have not been alleviated by NSAIDS or 

prescription butabital.” (Id. at 82). The headaches occasionally caused nausea. 

(Id.). Ms. Sandlin’s hot flashes and decreased energy continued, but Ms. Sandlin 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 15 of 22
16

was “feeling much better,” and her hot flashes had improved in response to Celexa. 

(Id. at 83). 

When Dr. Mathews examined Ms. Sandlin on January 26, 2012, he noted 

that Ms. Sandlin was “stable,” though she “continues to have lots of headaches” 

and required an “urgent” appointment with a neurologist. (Doc. 5-10, p. 80). Dr. 

Mathews stated that he hoped to see improvement because Ms. Sandlin was “off 

chemotherapy.” (Id.). On February 16, 2012, a physician’s assistant indicated that 

Ms. Sandlin was still “on maintenance Herceptin.” (Doc. 5-10, p. 78). Ms. 

Sandlin “continue[d] to have persistent headaches although Imitrex has helped 

quite a bit. She is having to take Imitrex on a daily basis so we certainly have not 

lessened her headaches.” (Id.). The physician’s assistant noted that Ms. Sandlin 

suffered from “[c]hronic pain issues.” (Id. at 79). 

On March 5, 2012, Dr. Mathews reported that Ms. Sandlin’s “[h]eadaches 

[had] almost completely resolved within several days of starting amitriptyline,”

and he remarked that “except for grade I or II peripheral neuropathy she is doing 

very well.” (Doc. 5-10, p. 76). With respect to the neuropathy, Dr. Mathews 

stated “unfortunately I have little to offer,” and he suggested increasing Ms. 

Sandlin’s dosage of amitriptyline. (Id.). 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 16 of 22
17

Ms. Sandlin saw Dr. Scott Hitchcock, a neurologist, on March 3, 2012. Dr. 

Hitchcock noted that Ms. Sandlin’s chief complaint was headaches. With respect 

to those headaches, Dr. Hitchcock reported:

She has a history of previous headaches. Typically, when she had a 

headache it would be around her menstrual cycle. Her headaches 

were not really much of a problem until after the chemo. She then 

developed a daily headache. It was usually left-sided and throbbing, 

as well as quite severe. It was associated with photophobia, 

phonophobia, as well as osmophobia. Sometimes the headaches 

would be triggered by smells. She would have to hibernate in a dark 

quite [sic] room. Imitrex 50 mg was of some help. The headaches 

would go on for hours at a time. They were worse with activity and 

better with sleep. Since she started a small dose of amitriptyline, her 

headaches have completely resolved. She tells me that she has not 

had a headache for about two to three weeks now.

(Doc. 5-11, p. 36). Dr. Hitchcock also noted that Ms. Sandlin developed 

neuropathy following her chemotherapy treatments. He explained: 

She has a burning and stinging pain in her fingers, toes and feet. She 

has difficulty telling the temperature of water with her hands and feet. 

She does have a significant amount of spontaneous pain, as well as 

allodynia. She has noticed that this may have improved just a bit with 

amitriptyline, but is still a significant problem.

(Doc. 5-11, p. 36). 

Dr. Hitchcock diagnosed Ms. Sandlin with peripheral neuropathy which Dr. 

Hitchcock suspected was “fairly mild.” (Doc. 5-11, p. 37). Dr. Hitchcock stated:

Her reflexes are generally intact except for being slightly decreased at 

the ankles. Vibratory sensation was only minimally decreased at the 

toes. Therefore, I suspect the neuropathy is likely not that severe. 

Hopefully over time, she will make a spontaneous recovery. 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 17 of 22
18

(Doc. 5-11, p. 37). Dr. Hitchcock described Ms. Sandlin’s migraine headaches as 

“typical,” explained the steps that Ms. Sandlin had to take to address the 

photophobia that accompanied the headaches, and prescribed an increased dose of 

amitriptyline to which Ms. Sandlin had had “an excellent response” and advised 

Ms. Sandlin that she could take two Imitrex “to help better abort the headache.” 

(Id.). 

On April 16, 2012, Dr. Mathews noted that “overall” Ms. Sandlin was 

“relatively stable,” but her “headaches have recurred,” along with “pretty 

substantial bone and muscular pain, which has worsened as well.” (Doc. 5-10, p. 

74). Dr. Mathews began to suspect Herceptin might be the cause of Ms. Sandlin’s 

problems. (Id.). Dr. Mathews decided to maintain the course of her treatment 

because Ms. Sandlin was almost done with her Herceptin treatment. (Id. at 74-75). 

On May 7, 2012, Dr. Mathews noted that Ms. Sandlin returned to “complete 

her Herceptin,” “had a lot of issues with Tamoxifen,” and had injured her back 

after her last visit. (Doc. 5-10, p. 72). Dr. Mathews indicated that Ms. Sandlin’s

headaches were “much better,” and he hoped she would continue to improve. (Id.). 

During a July 18, 2012 examination, Dr. Mathews reported that Ms. Sandlin “had 

quite a bit of intolerance” of Tamoxifen. (Id. at 70). Dr. Mathews stated that Ms. 

Sandlin’s neuropathy and headaches were “stable to improving.” (Id.). 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 18 of 22
19

On November 7, 2012, Dr. Mathews examined Ms. Sandlin, noting “[s]he 

has had quite a bit of arthritic type pain, largely associated with getting back to 

work and has also had an occasional migraine but has had good control on 

amitriptyline.” (Doc. 5-10, p. 68). Dr. Mathews wanted to start Ms. Sandlin “back 

on half a dose of tamoxifen every other day” to deal with her “substantial pain and 

other symptoms.” (Id.). Ms. Sandlin’s neuropathy was “stable to improved,” 

though Dr. Mathews found that her condition “seems to be aggravated more by 

getting up.” (Id.). He noted that Ms. Sandlin “is not attempting to go back to a 

very physical job.” (Id.). At Ms. Sandlin’s request, Dr. Mathews ordered her to 

begin taking only amitriptyline for her headaches so that she could “drop her 

medications.” (Id.). Dr. Mathews stated, “I think once she is up and about a good 

bit more, I think she will feel a lot better.” (Id. at 69). 

During a December 19, 2012 visit, Dr. Mathews noted that Ms. Sandlin’s 

arthritic pain and headaches had improved and that she had returned to work. 

(Doc. 5-10, p. 66). He explained that her previous hot flashes were due to 

menopause. (Id.). Dr. Mathews restarted Ms. Sandlin on Tamoxifen and planned 

to review her progress in two months. (Id. at 67). 

Based on these medical records, there is some evidence that supports the 

ALJ’s decision to discount Ms. Sandlin’s testimony about the severity of her pain. 

For example, Ms. Sandlin’s medical records suggest that she was not constantly in 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 19 of 22
20

pain, and her testimony that she was bedridden is inconsistent with evidence of 

periods of controlled nausea and reduced abdominal cramping. (Doc. 5-9, pp. 42, 

57-58, 67; Doc. 5-10, p. 92). But there also is a good deal of evidence that the ALJ 

did not discuss in her opinion that supports Ms. Sandlin’s testimony. The ALJ 

properly noted that to evaluate Ms. Sandlin’s pain, she (the ALJ) would have to 

examine a variety of factors such as Ms. Sandlin’s daily activities, the types of 

medication prescribed to alleviate pain, and “[a]ny measures other than treatment 

the claimant uses or has used to relieve pain or other symptoms (e.g., lying flat on 

his or her back . . .).” (Doc. 5-3, pp. 28-29). Yet, the ALJ’s opinion contains no 

indication that the ALJ considered, for example, the amount of time that Ms. 

Sandlin reportedly had to stay in the bathroom or the cocktail of medications that 

Ms. Sandlin used to treat her nausea, diarrhea, neuropathy, and migraine 

headaches. Similarly, the ALJ’s opinion does not acknowledge the steps that Ms. 

Sandlin used to try to manage her migraine headaches such as “hibernating” in a 

darkened room. 

An ALJ does not have to mention every piece of evidence in an opinion, but 

an ALJ must acknowledge the evidence that is favorable to a claimant and explain 

how that evidence factored into her analysis of the administrative record. See 

McCruter v. Bowen, 791 F.2d 1544, 1548 (11th Cir. 1986) (If the record viewed in 

its entirety indicates that the ALJ “focus[ed] upon one aspect of the evidence and 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 20 of 22
21

ignor[ed] other parts of the record,” then the reviewing court “cannot properly find 

that the administrative decision is supported by substantial evidence. It is not 

enough to discover a piece of evidence which supports that decision, but to 

disregard other contrary evidence. The review must take into account and evaluate 

the record as a whole.”).6 On remand, the ALJ should consider the administrative 

record as it pertains to the closed period of disability that ranges from the date of 

Ms. Sandlin’s mastectomy through her return to work in January 2013.7

V. CONCLUSION

For the reasons discussed above, the Court remands the decision of the 

Commissioner for reevaluation of Ms. Sandlin’s request for benefits for the closed 

period of time ranging from March 16, 2011 through January 1, 2013. The Court 

will enter a separate order consistent with this memorandum opinion.

 

6

 The ALJ found that Ms. Sandlin had not been under a disability from March 16, 2011 through 

the date of the ALJ’s decision in part because Ms. Sandlin “completed her Associate’s degree in 

April 2011, less than a month after undergoing a double mastectomy.” (Doc. 5-3, p. 30). Ms. 

Sandlin explained “[t]hat was the year the tornados hit. So school ended early.” (Id. at 50). 

Given the evidence that Ms. Sandlin had a double mastectomy on March 30, 2011, it is unlikely 

that Ms. Sandlin had school work that she had to complete after her surgery because her classes

were cancelled. 

7 The ALJ did not discuss whether Ms. Sandlin’s intermittent work during the closed period of 

disability constituted substantial gainful activity. (Doc. 5-3, pp. 26-27). If the ALJ decides on 

remand that this employment constitutes substantial gainful activity, then the ALJ must 

determine how long Ms. Sandlin was disabled during the relevant period. The Eleventh Circuit 

has held that “[s]ubstantial gainful activity clearly does bar benefits under the statute regardless 

of any actual disability of the claimant. But it bars such benefits only for such periods of 

activity.” Powell o/b/o Powell v. Heckler, 773 F.2d 1572, 1576 (11th Cir. 1985) (emphasis in 

original). 

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 21 of 22
22

DONE and ORDERED this September 14, 2016.

 _________________________________

 MADELINE HUGHES HAIKALA

 UNITED STATES DISTRICT JUDGE

Case 5:14-cv-01885-MHH Document 12 Filed 09/14/16 Page 22 of 22