Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-1_05-cv-01095/USCOURTS-arwd-1_05-cv-01095-0/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 (DIWC)

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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

EL DORADO DIVISION

BARBARA ANDERSON PLAINTIFF

v. Civil No. 05-1095

COMMISSIONER OF SOCIAL 

SECURITY ADMINISTRATION DEFENDANT

MEMORANDUM OPINION

Now on this 20th day of March, 2007, comes on for review the

decision of the Commissioner of the Social Security Administration

("Commissioner") denying plaintiff Barbara Anderson's application

for a period of disability and for Social Security Disability

Insurance benefits. Review is conducted pursuant to 42 U.S.C.

§405(g). 

1. The Court's role upon review of the decision of a Social

Security Administrative Law Judge ("ALJ") is to determine whether

the decision is supported by substantial evidence on the record as

a whole. Ramirez v. Barnhart, 292 F.3d 576 (8th Cir. 2002).

Substantial evidence is less than a preponderance but enough that

a reasonable mind would find it adequate to support a conclusion.

Id. The Court must consider not only the evidence supporting the

ALJ's decision, but also that which fairly detracts from it, and

must affirm if the record -- viewed as a whole -- contains

substantial evidence to support it. Id. The Court may not

reverse simply because the record also contains substantial

evidence that would have supported a contrary decision. Haley v.

Case 1:05-cv-01095-JLH Document 11 Filed 03/20/07 Page 1 of 23 PageID #: <pageID>
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Massanari, 258 F.3d 742 (8th Cir. 2001). 

The burden rests on the claimant to prove that she has a

disability, mental or physical, that has lasted -- or can be

expected to last -- at least one year and that prevents her from

engaging in any substantial gainful activity. Pearsall v.

Massanari, 274 F.3d 1211 (8th Cir. 2001).

2. Following a hearing, the ALJ found that Anderson either

had -- or had a diagnosis of -- hypertension, lupus, joint pain,

and obesity, but did not have an impairment or combination of

impairments listed in or medically equal to one listed in Appendix

1, Subpart P, Regulations No. 4. He found Anderson's own testimony

about her symptoms, limitations, and restrictions "credible only

insofar as they are supported by the medical evidence." He further

found that Anderson has the residual functional capacity to perform

a full range of light work-related activities, and that such jobs

exist in significant numbers in the national economy. He concluded

that Anderson was not disabled according to the Social Security Act

at any time from the alleged onset date of disability -- February,

2003 -- to the date of his decision -- June 24, 2005.

3. Anderson contends that the ALJ erred in seven ways in

making his determination, to-wit:

* failing to recognize that Anderson has lupus, and failing

to consider the effects of lupus;

* failing to recognize the impact of obesity;

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* giving improper weight to the receipt of unemployment

benefits;

* failing to consider her consistent employment record;

* failing to consider the effect of pain in combination

with other impairments;

* improperly applying Polaski v. Heckler; and

* posing an improper hypothetical to the Vocational Expert.

4. In order to evaluate Anderson's contentions, the Court

has reviewed the Administrative Record, and finds that it reflects

the following relevant facts:

* In December 17, 1993, Anderson complained to her doctor

about shortness of breath, left-sided paralysis, and

chronic swelling in left ankle and leg.

* On October 18, 1995, Anderson was treated for left

shoulder pain at the Bearden Medical Clinic.

* In February, 1996, Anderson was involved in an automobile

accident and injured her neck. Her medical records

following this accident reported neck problems and their

treatment with a variety of muscle relaxers and pain

medications.

* On May 27, 1998, Anderson saw Nurse Patti Rivers at the

Bearden Medical Clinic, who noted that Anderson was

"hurting in her shoulder area," and drew blood for

arthritis testing.

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Indicated "as an adjunct to rest and physical therapy for relief of muscle spasm 1

associated with acute painful musculoskeletal conditions." Physicians' Desk Reference,

1995 Ed.

Indicated for "the relief of moderate to moderately severe pain." Physicians' Desk 2

Reference, 1995 Ed.

-4-

* On June 3, 1998, Nurse Rivers reported that "[l]ab work

obtained on 5-27-98 was all within normal limits."

* On June 22, 1998, Nurse Rivers noted that Anderson "had

had swelling in her feet, off and on for numerous years

as well as lots of musculoskeletal discomfort," and that

on the May 27 arthritis panel, Anderson had "an ANA

positive at 1:160 with homogenous pattern. RA was

negative. Sed rate was 17. We will do anti-DNA's and

1 and 2 for lupus screening today. This definitely could

be a very good indication why she has had musculoskeletal

discomforts and swelling."

* On November 3, 1999, Anderson saw Dr. Abbott with a

complaint of -- among other things -- headache for three

to five months.

* On December 8, 1999, Dr. Abbott noted that the numbness

in Anderson's arms had been related to a car accident,

and was diagnosed as carpal tunnel syndrome.

* On May 19, 2000, Anderson saw Dr. Wiseman with complaints

of neck pain from the back of her head down the left side

of her neck and into her left shoulder for about five

days. Dr. Wiseman prescribed Flexeril , Lorcet Plus ,

1 2

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Used for "minor aches and pains." Physicians' Desk Reference, 2007 Ed. 3

Ultram "is indicated for the management of moderate to moderately severe chronic 4

pain in adults who require around-the-clock treatment of their pain for an extended

period of time." Physicians' Desk Reference, 2007 Ed.

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and Motrin .

3

* On September 25, 2000, Anderson saw Dr. Wiseman for lower

back pain starting three days earlier. Dr. Wiseman

prescribed Motrin and Flexeril.

* On October 3, 2000, Anderson complained to Dr. Wiseman

about "intermittent back pain and neck pain," bad enough

that some days "she can hardly move." Dr. Wiseman

reassured her, tried to motivate her to exercise, and

continued her on Flexeril and Motrin.

* On December 19, 2000, Anderson consulted Dr. Wiseman for,

among other things, bursitis pain in her right shoulder.

Ultram and a sling for her right arm were prescribed. 4

* On February 13, 2001, Dr. Wiseman noted that Anderson

reported episodes of "heavy pressure sensation" and

shortness of breath over the past 3-4 weeks, with

numbness in her left arm. She was referred for a stress

test and cardiology consultation.

* On February 1, 2002, Dr. Wiseman noted that Anderson

reported headaches about every other week, increasing in

frequency, with pain rated at 10 on a scale of 1 to 10.

* On June 7, 2002, Dr. Wiseman reported that Anderson was

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Norvasc "is indicated for the treatment of hypertension." Physicians' Desk 5

Reference, 2007 Ed.

This company is also referred to as "Prestilite," "Presc-o-Lite," and "Fresco 6

Lite" in the Administrative Record.

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complaining of pain in her joints, elbows, knees and

hands for the last three weeks, rated as 10 on a scale

of 1-10. At that time Anderson was taking Norvasc ,

5

Lasix, Motrin and Flexeril.

* On August 7, 2002, Dr. Wiseman reported that Anderson

continued to have intermittent pain in her left arm and

shoulder, for which she took Flexeril and Motrin.

* Until February, 2003, Anderson worked regularly. Her

last two jobs were at a Wal-Mart store from October,

1998, to September, 2002; and at a factory, Pres-O-Lite ,

6

from September, 2002, until February, 2003. At Wal-Mart

she worked in the grill, running the cash register,

cooking, cleaning, and stocking, standing for six hours

a day and lifting about ten pounds frequently. At PresO-Lite, she assembled and packed light fixtures, standing

for eight hours every day, and regularly lifting 20-25

pounds.

* On February 11, 2003, Pres-O-Lite laid Anderson off work.

In a Work Activity Report completed March 18, 2003, she

indicated that she had been planning to quit when she was

laid off, because her feet and legs were swelling.

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A diuretic used to treat "edema associated with congestive heart failure, 7

cirrhosis of the liver, and renal disease. . . . particularly useful when an agent with

greater diuretic potential is desired." Physicians' Desk Reference, 2007 Ed.

-7-

* On February 14, 2003, when giving a history to her

gynecologist, Anderson listed the following as "all

medications" that she was taking: Norvasc, Furosamide ,

7

and Motrin. Her musculoskeletal system and skin were

shown as "abnormal," although there is no explanation of

why.

* On February 27, 2003, as part of an evaluation of the

side effects of contraceptive management, Anderson

reported occasional headaches, but denied leg and chest

pain.

* On March 17, 2003, Anderson completed a Disability

Report. She listed the following conditions as limiting

her ability to work: lupus; swelling of legs, feet,

hands, and face; shortness of breath; chest pain;

irregular heart beat; joint pain and body soreness; face

breaking out when in the sun too long; high blood

pressure; and problems with the nerves in both hands and

her neck. She indicated that these conditions limited

her ability to pick things up, bend, stand, walk, sit,

and move around. She got out of breath, and hurt all the

time. She first began to be bothered by these problems

in June, 1998. She listed her medications as Motrin,

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Furosomide, and Norvasc.

* Also on March 17, 2003, Anderson completed a Disability

Supplemental Interview Outline. She indicated that she

could do laundry and dishes and change sheets sometimes,

but not vacuum, sweep or take out trash. The swelling

in her hands made it difficult to grip objects, and she

sometimes dropped things. She indicated that her

disability had caused her to either quit or be fired from

two jobs, due to pain and swelling in her arms, hands,

feet, legs and back. She estimated her pain most of the

time as 7-8 on a scale of 1-10, occurring off and on

every day, mostly in her hands and arms, and sometimes

in her feet, legs, back and neck. Her medications at

that time were Motrin and Extra Strength Tylenol.

* On June 26, 2003, as part of another evaluation of the

side effects of contraceptive management, Anderson denied

headaches, leg pain, and chest pain.

* An ANA screen on August 1, 2003, was reported as

negative.

* During a cardiac consultation with Dr. Georges Chahoud,

apparently on September 2, 2003, Anderson complained of

joint pain and headache.

* On October 23, 2003, Anderson completed a second

Disability Supplemental Interview Outline. She stated

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Indicated for "relief of the signs and symptoms of rheumatoid arthritis." 8

Physicians' Desk Reference, 2007 Ed.

Used to relieve "minor aches and pains." Physicians' Desk Reference, 2007 Ed. 9

"Pain in mid and lower back; a descriptive term not specifying cause." PDR 10

Medical Dictionary, 2nd Ed.

-9-

that she could do dishes, change sheets and take out

trash, but not do laundry, vacuum, or sweep. She needed

help with driving sometimes, and had trouble with pain

and swelling in her feet, legs, hands, and back. She

stated that she had pain all the time, no matter what she

was doing. Her medications at that time were Motrin,

Naprosen , and Aleve .

8 9

* On December 2, 2003, Anderson underwent a physical exam

by Dr. Jerry Grant in connection with her application for

Social Security benefits. Dr. Grant noted that Anderson

gave a history of lupus for five years, as well as

"achiness, swelling, & occasional lumbago ." He noted 10

that she had occasional shortness of breath of unknown

etiology, but denied shortness of breath upon walking.

His findings on the exam were almost all "normal,"

although he did note grip strength at 80% of normal and

found some swelling. It was Dr. Grant's opinion that

Anderson had no limitations.

* On January 17, 2004, Anderson completed another

Disability Supplemental Interview Outline. She stated

that she could not bathe, dress, or care for her hair

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A diuretic and antihypertensive, according to Physicians' Desk Reference, 2007 11

Ed.

Used to treat angina pectoris and hypertension. PDR Medical Dictionary, 2nd Ed. 12

Indicated for treatment of "erosive or ulcerative gastroesophageal reflux 13

disease." Physicians' Desk Reference, 2007 Ed. 

-10-

without assistance; could not wash dishes, change sheets,

iron, vacuum, sweep, or take out the trash; that walking

or doing housework made her out of breath and caused leg

and back pain; that using her hands made her fingers

cramp; and that she could not lift over 15-20 pounds.

She estimated her pain at 9 to 10 on a scale of 0 to 10,

and said that she hurt all the time in her legs, arms,

hands, back, and neck. She listed her medications as

Motrin 600, Flexeril, Norvasc, and Tylenol.

* On March 3, 2004, the Social Security Administration

denied Anderson's application for benefits.

* On October 20, 2004, Anderson consulted Dr. Pillow at

UAMS about "headache off and on." She also complained

of swelling of her lower extremities, fatigue, shortness

of breath, back pain, neck pain, and joint pain. Her

physical exam was normal. Dr. Pillow gave her samples

of Triptan for "probable migraines," and prescriptions

for hydrochlorothiazide , atenolol , and Aciphex . He 11 12 13

also prescribed aspirin.

* Included in an Inpatient History and Physical Examination

at UAMS dated October 10, 2004, is the note "lupus (never

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been treated, not followed by rheum[atologist]."

* During an office visit to the UAMS Internal Medicine

Clinic on January 26, 2005, Anderson reported that she

had been in a wreck in December and was concerned with

nerve damage to the right side of her head. She reported

dizziness and vision changes, but denied shortness of

breath, chest pain, back pain, neck pain, and joint pain.

Her medications at that time were aspirin, Aciphex,

atenolol, and hydrochlorothiazide.

* On or about March 25, 2005, the Social Security

Administration completed a Claimant's Medications form,

showing that Anderson was taking Aciphex, atenolol,

hydrochlorothiazide, and Flexeril, along with aspirin and

Aleve.

* On April 13, 2005, Anderson saw Dr. Nelson at UAMS for

leg pain with an onset of two days, not helped by Tylenol

or Aleve. She also complained of fatigue, malaise,

shortness of breath, diffuse joint pain, and swelling.

Dr. Nelson noted that lupus was "allegedly diagnosed by

Family Practice physician in 1998 (she is not sure what

test and there is no data in webchart)." Dr. Nelson

ordered tests for lupus. Medications at that time were

hydrochlorothiazide, atenolol, Aciphex, and aspirin.

* A chart note from the UAMS Eye Clinic dated April 19,

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2005, indicated that Anderson had lupus but did not

relate any eye problems to that condition, and further

indicated that she was "not on meds for lupus."

* On April 28, 2005, Dr. Nelson reported on the lupus

testing: "ESR was slightly elevated to 42. The rest of

the workup was negative, including Crithidia. I am

unable to explain this fully. Will send to Rheumatology

for further evaluation and treatment of significant

seropositive ANA, but seronegative Anti-DNA/crithidia."

* On June 24, 2005, the ALJ rendered his unfavorable

decision on Anderson's application.

* On September 29, 2005, the Appeals Council denied

Anderson's request for review of the ALJ's decision.

* On October 12, 2005, Anderson filed her Complaint seeking

judicial review of the Commissioner's decision.

5. Anderson first contends that the ALJ failed to recognize

that she has lupus, or to take that condition into account. 

The contention that the ALJ failed to recognize that Anderson

has lupus is a bit wide of the mark, because the ALJ did recognize

that Anderson had carried a diagnosis of the disease since June,

1998. As for the contention that the ALJ failed to consider the

effects of lupus, Anderson offers nothing from which it could be

concluded that there is something about having lupus that, in and

of itself, should have resulted in a finding of disability. The

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Court therefore turns to what is shown from the record about

Anderson's own particular experience with the disease. That

information does not lead to a conclusion that the ALJ improperly

failed to consider the effects of lupus. 

To begin with, although Anderson received frequent medical

care by her regular treating physicians, and saw various

specialists as needed, none of her doctors ever took her off work

because of lupus or any other condition.

Moreover, the nature of the condition is very vague. "Lupus"

covers a wide range of related conditions, and the particular form

of lupus that Anderson claims to suffer from is not specified. The

Court has, however, addressed Anderson's allegations as though they

relate to systemic lupus erythematosus ("SLE"), because this is the

form that seems to most closely parallel Anderson's complaints.

SLE is defined as

an inflammatory connective tissue disease with variable

features, frequently including fever, weakness and

fatigability, joint pains or arthritis resembling

rheumatoid arthritis, diffuse erythematous skin lesions

on the face, neck, or upper extremities, with

liquefaction degeneration of the basal layer and

epidermal atrophy, lymphadenopathy, pleurisy or

pericarditis, glomerular lesions, anemia,

hyperglobulinemia, and a positive LE cell test, with

serum antibodies to double-stranded DNA and other

substances.

PDR Medical Dictionary, 2nd Ed.

As explained in Gude v. Sullivan, 956 F.2d 791 (8th Cir.

1992),

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"[m]ild" SLE includes fever, arthritis, pleurisy,

pericarditis, headaches, and rash, while "severe" SLE

includes life-threatening diseases. As many as ninety

percent of SLE patients complain of symptoms ranging from

intermittent joint pains to acute polyarthritis, and

general hair loss is frequent during active phases of the

disease. The course of SLE is chronic and relapsing with

long periods of remission and is totally unpredictable.

(Citing Merck Manual of Diagnosis and Therapy, 15th Ed., 1275-76.)

Turning to the Administrative Record to determine whether

Anderson's particular case of lupus was disabling, the Court finds

that while Anderson's physicians were all aware that she had a

"history" of having been diagnosed with lupus, none of them found

it medically necessary to do any follow-up until April 13, 2005,

when Dr. Nelson ordered tests to assess the situation. (The

equivocal results of that follow-up are not explained by any

medical record before the Court.) In addition, no doctor found it

necessary to prescribe any treatment for lupus other than

medications designed to alleviate mild to moderate pain. On many

doctor visits Anderson complained of no pain at all. No doctor

ever placed any restrictions on Anderson's ability to work because

of lupus. Thus the medical record does not reflect that Anderson

suffered from severe or unremitting lupus, or from a level of the

disease that would constitute a disabling impairment. 

In addition, the Administrative Record reflects that Anderson

was able to hold down a job in October, 2000, when she reported

"intermittent back pain and neck pain" bad enough that some days

"she can hardly move." She was able to hold down a job in June,

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2002, when she was complaining of pain in her joints, elbows, knees

and hands, lasting for three weeks, that she rated as 10 on a scale

of 1-10. Thus Anderson's own conduct is evidence that her lupus

was not disabling even when she found it to be extremely painful.

For all these reasons, the Court finds no error in the weight

the ALJ assigned to Anderson's diagnosis of lupus.

6. Anderson next argues that the ALJ failed to recognize the

impact of her obesity on her other conditions, citing 20 C.F.R. Pt.

404, Subpt. P, App.1, §1.00(Q), to the effect that

[o]besity is a medically determinable impairment that is

often associated with disturbance of the musculoskeletal

system, and disturbance of this system can be a major

cause of disability in individuals with obesity. The

combined effects of obesity with musculoskeletal

impairments can be greater than the effects of each of

the impairments considered separately. Therefore, when

determining whether an individual with obesity has a

listing-level impairment or combination of impairments,

and when assessing a claim at other steps of the

sequential evaluation process, including when assessing

an individual's residual functional capacity,

adjudicators must consider any additional and cumulative

effects of obesity.

It is not accurate to say that the ALJ failed to take

Anderson's obesity into account. He specifically included obesity

in his hypothetical question to the Vocational Expert. 

In addition, the Administrative Record reflects that

Anderson's weight changed very little over the time period here

under consideration. It is significant that Anderson was able to

work -- from 1998 to 2003 -- with all of the conditions, including

obesity, that she now claims are disabling. 

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Anderson's case is easily distinguishable from her cited

authority of Roberts v. Barnhart, 283 F.Supp.2d 1058 (S.D. Iowa

2003). Roberts was about the same height as Anderson, but weighed

over a hundred pounds more than Anderson. Depression and other

psychological factors, from which Anderson fortunately does not

suffer, contributed to Roberts' disability. Roberts' doctors

opined that her obesity contributed to her pain and depression, and

thus all three conditions were interrelated. The court there

pointed out that none of Roberts' doctors offered "so much as a

scintilla of evidence that Plaintiff is able to work." 

The Court concludes that Anderson's obesity was not overlooked

by the ALJ, and there is no evidence that it has the synergistic

effect on her ability to work that she claims.

7. Anderson next argues that the ALJ gave improper weight

to the receipt of unemployment benefits -- as evidence that she was

ready, willing, and able to work -- while overlooking her

consistent employment record -- as evidence that she is not a

malingerer. She cites Polaski v. Heckler, 751 F.2d 943 (8th Cir.

1984)(subsequent history omitted) for the proposition that "[t]he

adjudicator must give full consideration to all of the evidence

presented relating to subjective complaints, including the

claimant's prior work record."

The Court is not persuaded that the ALJ improperly weighed

Anderson's receipt of unemployment benefits. Anderson herself

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blurred the line between working, and being unable to work. She at

first claimed that she became disabled on June 11, 2000, but

continued to work until February 1, 2003. After being informed by

her attorney at the hearing before the ALJ that working and being

disabled were "two different concepts," Anderson amended her claim

to allege on onset date of February 1, 2003. 

In addition, the ALJ noted that Anderson had worked with her

condition for a long time; had been actively working until laid

off; and showed no evidence of "a significant deterioration" of her

condition since the lay-off. He took all these factors into

consideration, not just the isolated fact that Anderson was

receiving unemployment benefits, in evaluating the evidentiary

value of Anderson's willingness to accept those benefits. Taken

together, these factors do not place improper emphasis on the

receipt of unemployment benefits.

8. Anderson also argues that the ALJ failed to consider the

effect of pain in combination with her other impairments, and

improperly applied the Heckler factors for evaluating subjective

complaints of pain, because the determination of disability must

include an evaluation of the combined effects of various

impairments suffered by a claimant. Johnson v. Secretary of HHS,

872 F.2d 810 (8th Cir. 1989). Here, however, the ALJ did consider

Anderson's pain, but found that it was not as severe as she

claimed, and that "the symptomatology suffered by the claimant

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would not more than minimally affect her ability to carry on

gainful activity at the light exertional level." Unless these

findings are unsupported by substantial evidence, they justify the

ALJ in not giving more weight to the effect of pain in combination

with Anderson's other impairments. When the Court considers the

contradictory statements made by Anderson about her pain, the fact

that she worked with pain she rated as very intense, and her

medication record, it cannot say these findings are unsupported by

substantial evidence.

9. Anderson contends that the ALJ improperly applied the

five factors found in Polaski v. Heckler, 739 F.2d 1320 (8th Cir.

1984)(prior work history; daily activities; duration, frequency and

intensity of pain; dosage, effectiveness and side effects of

medication; precipitating and aggravating factors; and functional

restrictions) when evaluating her complaints of pain. She contends

that the ALJ must point out the inconsistencies in the record in

order to make a credibility determination on complaints of pain, in

order to demonstrate that he evaluated all the evidence. Herbert

v. Heckler, 783 F.2d 128 (8th Cir. 1986). The ALJ found that

Anderson's "testimony and allegations as to the extent of her

symptoms, limitations and restrictions are considered credible only

insofar as they are supported by the medical evidence." This

determination was based on the following inconsistencies noted by

the ALJ:

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* Anderson's alleged disability was inconsistent with her

prior work history, in that she "stopped working because of a

business-related layoff rather than because of the allegedly

disabling impairments," and had "worked for a long period of time

after being diagnosed with the alleged conditions."

* Anderson's complaints were inconsistent with her daily

activities, in part because she acknowleged at times the ability to

do such activities as look after grandchildren, attend church,

drive, mop and sweep, and in part because there was "relatively

weak" medical evidence to support the degree of limitation

subjectively perceived by Anderson.

* The ALJ found that Anderson's description of the

duration, frequency and intensity of her pain was "not borne out by

the record," but Anderson is correct that he failed to explain why.

The Court does not, however, find that lack sufficient to reverse,

because there is substantial evidence in the record which detracts

from Anderson's testimony that she suffered pain all the time. At

the hearing, Anderson testified that she had pain just about every

day, and that "the days that I don't hurt I don't even notice that

I'm not hurting because I hurt 95 percent of the time." In the

Court's view, this testimony effectively undermines all Anderson's

other testimony about pain. For someone who suffers from the level

of pain Anderson claims, the absence of that pain could not go

unnoticed. In addition, if Anderson's pain were truly as severe

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Anderson testified at the hearing that her doctor had given her some samples of 14

Ultram, but that was for migraines, which she now seldom has.

-20-

and unremitting as she claims, the Court believes her physicians

would have been prescribing much stronger pain medication than was

the case. While the ALJ failed to point out these inconsistencies

with specificity, they exist and the Court finds it would serve no

purpose to remand to allow them to be stated.

* Anderson's use of medications did not suggest the

presence of an "impairment which is more limiting than found in

this decision." As with the preceding factor, the ALJ failed to

flesh out this finding, but it is clearly supported by substantial

evidence in the record. Anderson's physicians treated her pain

with Tylenol, Aleve, Motrin, Flexeril, and Naprosen, medications

which are used to treat mild to moderate pain. The only strong

pain medications she was prescribed -- Lorcet Plus and Ultram --

were prescribed in 2000, and not thereafter . The fact that a 14

claimant is not taking strong pain medication is inconsistent with

a finding of disabling pain. Haynes v. Shalala, 26 F.3d 812 (8th

Cir. 1994).

* The ALJ did not specifically determine that Anderson's

testimony about the precipitating and aggravating factors for her

pain was inconsistent with other evidence, but that was not

necessary for his decision, since it appears that he accepted

Anderson's testimony that her pain did not have a trigger, it "just

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happens." He did, however, note that "the mere fact that work

activity may cause some degree of pain or other discomfort does not

require the finding of disability," Jones v. Chater, 86 F.3d 823,

826 (8th Cir. 1996). 

* The ALJ found that Anderson's testimony about her

functional restrictions was inconsistent with the record evidence,

in that no doctor ever placed any functional restrictions on her,

and Dr. Grant specifically found that she had no limitations.

On balance, the Court finds that, while the ALJ could have

more fully detailed the specifics about why he found Anderson's

testimony credible only to the extent supported by the medical

evidence, when considered as a whole those findings are supported

by substantial evidence.

10. Anderson contends that the ALJ posed an improper

hypothetical, basically instructing the Vocational Expert that

plaintiff could perform light work. The question is as follows:

Assume an individual of the same age, same education,

background and work experience as the claimant. Further

considering the effects of the impairment and also

considering the effects of obesity and mild to moderate

pain. This individual has the ability to perform work

within the full range of the light classification

exertionally. The individual would have the ability to

occasionally climb, balance, stoop, bend, crouch, kneel

and crawl. Could this individual perform any of the

claimant's past relevant work as you described it, as

claimant actually performed the jobs or as that work is

performed in the national economy?

Anderson's contention is that this hypothetical should have

included the following aspects of her physical condition: obesity;

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lupus, swelling of hands and feet; musculoskeletal discomfort;

bursitis and rotator cuff tendonitis; shortness of breath;

irregular heartbeat; joint pain; high blood pressure; bilateral

carpal tunnel syndrome; small hiatal hernia; possible left lung

base airspace disease; and migraine headaches. 

As has been explained by Judge Melloy, then of the Northern

District of Iowa,

[a]n improper hypothetical cannot serve as substantial

evidence under §405(g), and can result in a remand or

reversal. A hypothetical must completely describe a

plaintiff's individual impairments so that the vocational

expert may accurately assess whether jobs exist for the

plaintiff. The question must include only those

impairments which actually exist, supported by

substantial evidence, not those rejected by the ALJ. In

analyzing the appropriateness of a hypothetical question,

therefore, the court must determine whether the

impairments excluded from the question were appropriately

rejected by the ALJ.

Cripe v. Apfel, 21 F.Supp.2d 944, 948 (N.D. Iowa, 1998)(internal

citations omitted).

The hypothetical specifically included obesity. In addition,

it included "mild to moderate pain," which on the record in this

case would be the basis for any functional impairment caused by

lupus, swelling of hands and feet, musculoskeletal discomfort,

bursitis and rotator cuff tendonitis, joint pain, carpal tunnel

syndrome, and migraine headaches. As for shortness of breath,

irregular heartbeat, high blood pressure, small hiatal hernia, and

possible left lung base airspace disease, there is no evidence that

even Anderson herself seriously contends these are disabling

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conditions, whether alone or in conjunction with her other

ailments. The Court, therefore, concludes that the hypothetical

was not deficient.

11. Upon consideration of all the various errors alleged by

Anderson, the Court finds that substantial evidence in the

Administrative Record, taken as a whole, supports the decision of

the ALJ, and it will be affirmed by separate Judgment entered

concurrently herewith.

IT IS SO ORDERED.

 /s/ Jimm Larry Hendren 

JIMM LARRY HENDREN

UNITED STATES DISTRICT JUDGE

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