Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-4_06-cv-04023/USCOURTS-arwd-4_06-cv-04023-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

---

Michael J. Astrue became the Social Security Commissioner on February 12, 2007. 1

Pursuant to F.R.C.P. 25(d)(1), he has been substituted for Jo Anne B. Barnhart as the

defendant in this suit.

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

TEXARKANA DIVISION

LISA CAMPBELL PLAINTIFF

v. Civil No. 06-4023

MICHAEL J. ASTRUE , COMMISSIONER 1

OF SOCIAL SECURITY ADMINISTRATION DEFENDANT

J U D G M E N T

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

consideration plaintiff Lisa Campbell's Complaint for judicial

review of the decision of the Commissioner of the Social Security

Administration, denying her a period of disability and disability

benefits under the Social Security Act.

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 the decision. Id. The Court may

not reverse simply because the record also contains substantial

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 1 of 38 PageID #: <pageID>
-2-

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

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. Campbell filed the application for benefits now under

consideration on July 8, 2003, alleging a disability onset date of

May 31, 2003. She alleged the following disabling conditions:

chemical allergies, high blood pressure, and back and neck

problems.

At the time of her hearing before the Administrative Law Judge

("ALJ") on March 31, 2005, Campbell was 46 years old. She had a

high school education, and past relevant work experience as a

revenue agent for the State of Arkansas. 

On September 16, 2005, the ALJ rendered an unfavorable

decision. He found that Campbell had significant limitations in

her capacity for heavy lifting and carrying and for prolonged

walking and standing, but did not have an impairment that met or

equaled any impairment or combination of impairments listed in

Appendix 1 to Subpart P, Regulations No. 4.

The ALJ did not fully credit either Campbell's testimony or

that of her treating physician Dr. Keith Mitchell. He discredited

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 2 of 38 PageID #: <pageID>
-3-

Campbell because the objective medical evidence and her daily

activities were not consistent with the level of pain she alleged.

He discredited Dr. Mitchell because his residual functional

capacity ("RFC") evaluation "contrasts sharply with the other

evidence of record" and appeared to be based on taking "the

claimant's subjective allegations at face value."

The ALJ found that Campbell had the residual functional

capacity for sedentary work, but could not return to her past

relevant work. He relied upon the testimony of a Vocational Expert

to the effect that there were significant numbers of jobs that

Campbell could perform, such as assembly, data entry, and cashier,

available in the regional and national economies. He thus

concluded that Campbell was not disabled.

On March 17, 2006, the Appeals Council declined to review the

ALJ's decision, making that decision the Commissioner's final

decision. This appeal followed.

3. Although she is represented by counsel, Campbell did not

file a brief in this matter, and her Complaint makes only the

generalized allegations that the ALJ erred in finding that she was

not disabled and applied an erroneous standard of law. The Court

has reviewed the record in light of these allegations, and finds

the following factual scenario:

* The medical records commence with one dated January 4,

2002, when Campbell saw her family doctor, Dr. Mitchell,

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 3 of 38 PageID #: <pageID>
A non-steroidal anti-inflammatory pain medication useful in treating joint pain. 2

Physicians' Desk Reference, 2007 Ed.

A hypnotic agent used to treat insomnia. Physicians' Desk Reference, 2007 Ed. 3

-4-

for post-operative pain. The medical records relating

to the surgery are not in the record, but context

indicates that this operation was on her neck and/or

back. Campbell's blood pressure at this visit was

142/86. Prescriptions for Celebrex and Ambien were 2 3

refilled.

* On March 18, 2002, Campbell saw Dr. Mitchell with

complaints of ear, back and neck pain. Her blood

pressure was 138/90. Anti-inflammatory treatment was

continued.

* On May 23, 2002, Campbell saw Dr. Mitchell with

complaints of continued neck and back pain. Dr. Mitchell

noted that "she feels like she is becoming disabled and

is not able to work a full day." Campbell's blood

pressure was 140/98. He assessed her with cervical

degenerative disc disease and back pain, scheduled

physical therapy, and made an appointment with Dr. Mason

for followup on her surgery.

* On June 7, 2002, Campbell had an MRI of the lumbar spine,

which showed "[s]mall to moderate recurrent right lateral

disc extrusion at L4-5 with associated moderate scarring.

This compromises the right L5 nerve root in the lateral

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 4 of 38 PageID #: <pageID>
The active ingredient of Darvocet is propoxyphene, a narcotic pain reliever, 4

indicated in the treatment of mild to moderate pain. Physicians' Desk Reference, 1995

Ed.

-5-

recess."

* On June 26, 2002, Campbell saw Dr. Mitchell for a

checkup, and to have lab work done. Her blood pressure

was 130/80. Lumbar disc disease, low back pain, and

hypercholesterolemia were assessed. Dr. Mitchell

refilled prescriptions for Darvocet and Ambien. 4

* On August 6, 2002, Campbell saw Dr. Mitchell complaining

of continuing to have "a lot of pain in her legs." She

had seen Dr. Mason, who sent her for orthopedic

evaluation, and she had been told to go back to see Dr.

Mason, who reportedly was "reluctant to do surgery." Her

blood pressure was 136/76. Dr. Mitchell's assessment was

"lumbar back pain with degenerative changes of the disc,"

and he refilled her prescription for Darvocet "until she

has a chance to go back and see Dr. Mason."

* On September 12, 2002, Campbell saw Dr. Mitchell "to

discuss her appointments with Dr. Mason," which she had

not kept. She was still having a lot of pain, and

thought she was going to have to see Dr. Mason. Her blood

pressure was 128/90. Dr. Mitchell assessed cervical disc

disease, depression, and post-menopausal syndrome, and

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 5 of 38 PageID #: <pageID>
An oral psychotropic drug used in the treatment of major depressive disorder, 5

panic disorder, social anxiety disorder, and pre-menstrual dysphoric disorder.

Physicians' Desk Reference, 2007 Ed.

"A common syndrome of chronic widespread soft-tissue pain accompanied by weakness, 6

fatigue, and sleep disturbances; the cause is unknown." Stedman's Medical Dictionary,

28th Ed.

An anti-hypertensive with side effects known to include dizziness and fatigue. 7

-6-

placed her on Paxil and continued her hormone 5

medication.

* On September 18, 2002, Campbell saw Dr. Mason, "to

discuss her options for treatment for her right hip

pain." He recommended conservative treatment.

* On December 30, 2002, Campbell saw Dr. Mitchell for an

upper respiratory infection. Her blood pressure on that

visit was 170/90.

* On January 7, 2003, Campbell saw Dr. Mitchell for her

high blood pressure, which was 160/90 at that visit. He

diagnosed hypertension, osteoarthritis, depression and

chronic back pain, and discussed Campbell's

"fibromyalgia type symptoms." Her medications at that 6

time included Vioxx, Estratest, Lipitor, Ambien,

Darvocet, and Paxil. Lipitor was discontinued, Paxil

increased, and Accupril added. 7

* On January 17, 2003, Dr. Mitchell recorded Campbell's

blood pressure as 140/90.

* On January 24, 2003, Campbell saw Dr. Mitchell for blood

pressure that "continues to be very elevated, even at

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 6 of 38 PageID #: <pageID>
An anti-hypertensive agent. Physicians' Desk Reference, 2007 Ed. 8

-7-

home at times." Her blood pressure was 156/102 at that

time. Dosage of Accupril was increased.

* On February 11, 2003, Campbell saw Dr. Mitchell for a

blood pressure check. She told Dr. Mitchell that her

blood pressure "continues to run high at home as well as

in the office," and it was recorded as 150/70 that day.

Accupril dosage was adjusted this date. 

* On February 21, 2003, Campbell saw Dr. Mitchell for

complaints of elevated blood pressure. Her blood

pressure was recorded as 150/110 at that visit. Benicar8

was added to her drug regimen. 

* On March 6, 2003, Dr. Mitchell recorded Campbell's blood

pressure as 144/94. 

* On May 1, 2003, Dr. Mitchell recorded Campbell's blood

pressure as 130/86, and noted "some tenderness

subjectively on her left side." He assessed her with

hypertension and cervical disc disease, and referred her

to Dr. Mason "for evaluation of her neck and her hip to

see if it is neurological." 

* On May 8, 2003, Campbell had a complete physical

examination by Dr. Mitchell. She told Dr. Mitchell that

her blood pressure had "been bouncing up and down," and

she had elevated cholesterol and triglycerides, but had

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 7 of 38 PageID #: <pageID>
-8-

not been taking her medications. Dr. Mitchell recorded

Campbell's blood pressure as 130/86. He assessed her

with hypertension, hypercholesterolemia, postmenopausal

syndrome, hypothyroidism, and depression.

* On May 23, 2003, Dr. Mitchell recorded Campbell's blood

pressure as 130/98. 

* On May 30, 2003, Dr. Mitchell recorded Campbell's blood

pressure as 170/100, and assessed her with "uncontrolled

hypertension." He referred her to Dr. Fine for

evaluation and treatment.

* May 31, 2003, was Campbell's last day to work.

* On June 16, 2003, Dr. Mitchell noted that Campbell was

having "some slight chest pain and getting real short of

breath, mostly when she walks" and that "her blood

pressure has been very hard to control." It was 150/92

on this visit. Dr. Mitchell referred Campbell to Dr. Lee

for a treadmill stress test.

* On June 26, 2003, Campbell saw Dr. Mitchell. Her blood

pressure was 130/80. She had an appointment scheduled

with Dr. Mason for July 9, and Dr. Mitchell prescribed

Darvocet and Ambien until that appointment. His

assessment was lumbar disc disease, low back pain, and

hypercholesterolemia.

* On July 1, 2003, Campbell saw Dr. Robert Spray,

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 8 of 38 PageID #: <pageID>
"A chronic mood disorder manifested as depression for most of the day, more days 9

than not, accompanied by some of the following symptoms: poor appetite or overeating,

insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration,

difficulty making decisions, and feelings of hopelessness." Stedman's Medical

Dictionary, 28th Ed.

-9-

Psychologist, at the behest of her attorney. Campbell

told Dr. Spray that she was unable to work "due to severe

back and neck problems resulting in uncontrollable high

blood pressure and shortness of breath." She reported

pain increasing "with walking, sitting, standing, or any

type of physical exertion," high blood pressure, a

"pinched nerve in her left shoulder resulting in some

numbness in her hands and arms," depression, weight gain

of 60-80 pounds over five years, and poor sleep. Dr.

Spray diagnosed Campbell with dysthymia.9

* On July 7, 2003, Campbell saw Dr. Allen Lee for her chest

pain. Dr. Lee recorded Campbell's blood pressure as

140/80, and noted that he had "multiple risk factors for

coronary artery disease which include hypertension,

hyperlipidemia, a strong family history of coronary

artery disease, cigarette smoking, and obesity." A

resting electrocardiogram was abnormal, showing "a sinus

rhythm and poor R-wave progression." He sent Campbell

for nuclear stress testing.

* In an undated Disability Report (which the Court believes

to have been filled out close to the time Campbell

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 9 of 38 PageID #: <pageID>
Known side effects of this blood pressure lowering agent include weakness, 10

fatigue, nervousness and agitation, depression, weight gain, and muscle or joint pain.

Physicians' Desk Reference, 2007 Ed.

Another anti-hypertensive medication. Physicians' Desk Reference, 2007 Ed. 11

Known side effects of this anti-hypertensive include weight gain, decreased mental 12

acuity, weakness, depression, joint pain, and muscle pain. Physicians' Desk Reference,

2007 Ed.

Side effects may include depression, joint pain, and muscle pain. Physician's 13

Desk Reference, 2007 Ed.

Side effects may include fatigue, nervousness, anxiety, irritability, emotional 14

lability, insomnia, and muscle weakness. Physicians' Desk Reference, 2007 Ed.

Arthritis is a known side effect of Lipitor usage, although its incidence is 15

small. Physicians' Desk Reference, 2007 Ed.

Side effects include depression, nervousness, mood disturbances, irritability, 16

and weight increase. Physicians' Desk Reference, 2007 Ed.

-10-

applied for benefits on July 8, 2003), Campbell stated

that she had pain in her lower back, right hip, and right

leg; was unable to sit or stand for any length of time

or to work at her computer without her hands and arms

becoming numb; had uncontrollable high blood pressure;

and had severe chemical allergies. She had worked at the

Sevier County Revenue Office since 1977, but stopped work

on May 31, 2003, because of inability to tolerate the

pain. She indicated that she was taking Clonidine ,

10

Benicar , and Methyldopa daily for her blood pressure, 11 12

and that these medications caused her extreme weakness.

She was taking Vioxx and Propoxy/Acetominophen for pain,

Paxil CR for depression, and Ambien for rest. She was 13

also taking Synthroid for low thyroid, Lipitor for 14 15

high cholesterol, Estratest for hormone replacement, 16

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 10 of 38 PageID #: <pageID>
-11-

and carrying an Epi-pen in case of anaphylactic shock.

* In an undated Disability Supplemental Interview Outline,

(which the Court also believes was filled out in July,

2003) Campbell indicated that she could do laundry, wash

dishes, change sheets, iron, vacuum, and sweep, although

doing so caused her pain. She could also shop for

groceries and clothes, prepare meals, drive, watch

television and listen to the radio. She said that she

could not walk for errands or exercise because it caused

pain in her back, hip, and right leg and made her short

of breath. She said she could not sit or stand for any

period of time, and that her hands and arms stayed numb

from working on the computers (presumably the computers

at work). She said she had fatigue, necessitating a two

hour nap each day, and that she had pain in her lower

back, right hip and leg, left shoulder, neck and both

arms that "never stops," was helped by rest, and was made

worse by standing, sitting, walking, lifting, laying

down, or doing any type of work. She listed the same

medications as on the previous Disability Report. She

stated that she did not "want to do anything, see anyone

or try to go anywhere. I'm in pain and depressed."

* On July 14, 2003, Dr. Lee recorded Campbell's blood

pressure as 140/82. He noted that her nuclear stress

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 11 of 38 PageID #: <pageID>
-12-

testing "shows a bit or reverse wash out but really this

looks like she has good perfusion with exercise." He

considered her stable, and asked her to return for

recheck in three months.

* On July 29, 2003, Campbell saw Dr. Fine for her blood

pressure problems. He recorded her blood pressure as

134/78 and then, on recheck, 116/66 on the right and

120/70 on the left. 

* On August 4, 2003, Campbell had a renal scan related to

her hypertension. The scan was read as normal. A letter

from Dr. Fine to Dr. Mitchell this date notes the

following problems: 20-year history of hypertension;

history of degenerative disc disease; high dose Vioxx

therapy plus Darvocet; history of hypothyroidism,

hyperlipedemia, anxiety and depression; obesity; and

smoking. He noted Grade I hypertensive changes of the

fundi, and decreased pulses distally. Dr. Fine believed

that "her hypertension is likely multifactorial

exacerbated by both her ongoing tobacco abuse, high dose

non-steroidal therapy and her obesity," but wanted to

rule out "a secondary renovascular lesion." 

* On August 19, 2003, Campbell saw Dr. Mitchell for some

moles on her leg and medication refills. She told Dr.

Mitchell she was "feeling better." Her blood pressure

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 12 of 38 PageID #: <pageID>
-13-

was 154/94, and the assessment was hypertension,

hypercholesterolemia, and nevi. Dr. Mitchell refilled

prescriptions for Benicar, Paxil, Ambien, and Darvocet.

* On September 9, 2003, Dr. Fine recorded Campbell's blood

pressure as 132/84 and then 148/84 on recheck, and noted

that she complained of back pain. He noted that her

blood pressure was under better control, that she

believed its fluctuation was related to pain, and that

she had retired. She was "still smoking A[gainst]

M[edical] [A]dvice."

* On September 16, 2003, Campbell saw Dr. Mitchell. She

told him she had been doing "very well," and wanted her

prescriptions renewed so they were all refillable on the

same date. Her blood pressure was 146/80. The

assessment was hypertension, depression,

hypercholesterolemia, and myalgia. Prescriptions were

refilled for Lipitor, Paxil, and Estratest.

* On October 7, 2003, Dr. Michael Jameson performed a

mental status examination of Campbell at the request of

the Social Security Administration. Dr. Jameson noted

"apparent discomfort sitting through the exam, but "no

physical problems or limitations." He found no evidence

of mental disease or defect, or of exaggeration or

malingering. 

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 13 of 38 PageID #: <pageID>
-14-

* On October 14, 2003, Campbell saw Dr. Lee. He recorded

her blood pressure as 120/70, and noted that she "really

is doing pretty well," and "I see no problems with her.

I will check her in six months."

* On October 24, 2003, Dr. Michael Young conducted a

General Physical Examination of Campbell at the request

of the Social Security Administration. At that time

Campbell's blood pressure was 116/64. The examiner noted

some limitation in her cervical range of motion, but the

report is not particularly useful for purposes of

determining disability. All the examiner indicated, in

response to the inquiry about limitations and their

severity, was "Lisa was able to dress and undress

herself. She was able to get on and off the exam table

without assistance." 

* On October 28, 2003, Campbell saw Dr. Weems for problems

with her right knee, which had "popped" or "snapped" the

preceding week. In the Orthopedic History taken at the

time of that exam, Campbell noted that her high blood

pressure "is currently controlled by medication," but

that she had numbness and tingling in her hands, and

arthritis in her neck and back. Dr. Weems diagnosed

"arthritic right knee," and injected the knee with

Lidocaine and Kenalog. He directed Campbell to return

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 14 of 38 PageID #: <pageID>
-15-

in six weeks.

* On November 4, 2003, Dr. Steve Owens completed a Physical

Residual Functional Capacity Assessment based on

Campbell's records, without benefit of a medical source

statement. Dr. Owens indicated that Campbell could

occasionally lift 20 pounds; could frequently lift or

carry 10 pounds; could sit, stand or walk six hours in

an 8-hour workday; and could perform unlimited pushing

and pulling operations of hand or foot controls. No

other limitations were noted.

* On December 2, 2003, Campbell saw Dr. Fine. He recorded

her blood pressure as 122/74, and 118/68 on recheck. 

* On December 5, 2003, Campbell saw Dr. Mitchell, who

recorded her blood pressure as 152/92. Campbell told Dr.

Mitchell she had been doing "very well." He assessed

osteoarthritis and degenerative disc disease. Dr.

Mitchell completed a Medical Source Statement of Ability

to do Work-Related Activities (Physical) during the

visit. He indicated that Campbell could sit for 15

minutes before moving about, and could sit for five hours

in an 8-hour workday. She could stand for 15 minutes

before needing to change postures, and could stand for

a total of four hours in an 8-hour workday. She could

walk less than 15 minutes continuously, and could walk

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 15 of 38 PageID #: <pageID>
-16-

only two hours in an 8-hour workday. He indicated that

Campbell's maximum combined walking and standing capacity

in an 8-hour day would be five hours. He indicated that

Campbell could lift and carry 20 pounds occasionally and

10 pounds frequently. These restrictions, in Dr.

Mitchell's opinion, were supported by MRI results showing

disk herniation, high blood pressure, and "muscle spasms

- requiring treatment 2-5X per month." Dr. Mitchell also

indicated that Campbell could not squat, crawl or kneel,

and only occasionally bend, climb, reach overhead, stoop

or crouch. He noted - as objective signs of pain -

redness, joint deformity, and muscle spasm, and rated the

pain as "moderate (could be tolerated but would cause

marked handicap in the performance of the activity

precipitating the pain)." He indicated that Campbell

would sometimes need unscheduled breaks in an 8-hour

workday; that her impairments would be likely to produce

"good days" and "bad days," and that she could be

expected to be absent more than four days a month because

of those impairments.

* On January 5, 2004, Dr. Mitchell recorded Campbell's

blood pressure as 120/80. She had complaints of knee

pain, and said that Dr. Weems had told her "not to ever

walk on her leg again and there is nothing he can do

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 16 of 38 PageID #: <pageID>
-17-

about it." She told Dr. Mitchell she "can't live this

way and wants to know if somebody else can do this." Dr.

Mitchell made her an appointment with Dr. David Gilliam.

* On January 12, 2004, Campbell saw Dr. Gilliam. He took

a history of progressive knee problems, with "severe,

progressive pain since November. She had a pop in the

knee at that time and has had a sensation of instability

since that time."

* On January 16, 2004, Campbell saw Dr. Mitchell about her

knee pain, wanting a second opinion. Her blood pressure

at that time was 130/82. Dr. Mitchell assessed

degenerative joint disease with knee pain, noted the

bone-on-bone condition and arthritic spurs shown on the

MRI, and told Campbell that he was "not real sure if they

would be willing to operate with that much damage and it

may cause more problems than benefits."

* On January 23, 2004, Campbell again saw Dr. Gilliam. He

assessed post-traumatic osteoarthritis, meniscus tear,

and loose body. It was agreed that surgery was the best

option, but Dr. Gilliam noted that "this will not cure

her arthritis and in the future she is likely facing knee

replacement surgery."

* On February 12, 2004, Dr. Gilliam operated on Campbell's

right knee. Dr. Gilliam addressed the meniscus tear and

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 17 of 38 PageID #: <pageID>
-18-

loose bodies, but noted that there was "bone-on-bone

posttraumatic osteoarthritis of the lateral compartment."

* On February 23, 2004, Dr. Gilliam saw Campbell for a

recheck following her knee surgery. The knee was doing

well, and had full range of motion, but Dr. Mitchell

noted that there was "bone-on-bone" in the medial

compartment. Campbell also had trochanteric bursitis, and

complained of "lateral hip pain and difficulty sleeping

on the right side at night." She was to return to Dr.

Gilliam for recheck in six weeks.

* On March 7, 2004, Campbell completed a Disability

Supplemental Interview Outline. She indicated that she

did not do any of the activities listed in the previous

Outline except shop for groceries, drive, watch

television and listen to the radio. She used a cane and

it helped her function better. She was fatigued, and

needed a two-hour nap daily. She had pain "all the time"

in her neck, left shoulder, down both arms, in her lower

back, right hip and knee; her hands "tingle all the

time." Her medications were the same.

* On March 10, 2004, Dr. Dan Donahue completed a

Psychiatric Review Technique, indicating that Campbell

suffered from "depressive syndrome." Dr. Donahue did not

indicate the symptoms which were felt to justify this

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 18 of 38 PageID #: <pageID>
-19-

diagnosis. The diagnosis was said to pose a mild

limitation on Campbell's activities of daily living, and

a moderate limitation on maintaining concentration,

persistence, or pace. In a Mental Residual Functional

Capacity Assessment completed that same day, Dr. Donahue

indicated that Campbell was moderately impaired in the

following categories: ability to understand, remember,

and carry out detailed instructions; ability to maintain

attention and concentration for extended periods; ability

to complete a normal workday and workweek without

interruptions from psychological symptoms; ability to

perform at a consistent pace without an unreasonable

number and length of rest periods; ability to interact

appropriately with the general public; and ability to set

realistic goals or make plans independently. He

indicated that she "is able to perform work where

interpersonal contact is routine but superficial, e.g.

grocery checker; complexity of tasks is learned by

experience, several variables, uses judgment with limits;

supervision required is little for routine but detailed

for non-routine."

* On March 12, 2004, Campbell saw Dr. Mitchell for

medication refills. She told him that she had been doing

"relatively well." Her blood pressure was 140/88. Dr.

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 19 of 38 PageID #: <pageID>
A non-steroidal anti-inflammatory used in the treatment of arthritis. Physicians' 17

Desk Reference, 1995 Ed.

-20-

Mitchell refilled prescriptions for Darvocet, Paxil,

Relafen , Benicar, and Ambien. 17

* On April 6, 2004, Campbell saw Dr. Fine. Her blood

pressure was 124/78, then 124/76 on recheck.

* On May 17, 2004, Campbell saw Dr. Lee. Her blood

pressure was 140/80, and Dr. Lee noted that "her blood

pressure remains relatively well controlled."

* On June 28, 2004, Campbell saw Dr. Mitchell for a

checkup. She told him that she was "doing much better

since she has retired." Her blood pressure at that visit

was 130/80. Dr. Mitchell refilled her prescriptions for

Darvocet, Paxil, Relafen, Benicar, and Ambien.

* On July 1, 2004, Campbell saw Dr. Fine. Her blood

pressure was 140/82, then 126/86 on recheck.

* On September 16, 2004, Campbell saw Dr. Mitchell for

conjunctivitis. Her blood pressure was recorded as

130/82 at that visit. In addition to medication for the

conjunctivitis, Dr. Mitchell refilled Campbell's

prescriptions for Darvocet, Synthroid, and Paxil.

* On October 19, 2004, Campbell saw Dr. Mitchell for a flu

shot. Her blood pressure that day was recorded as

120/92.

* On November 16, 2004, Campbell saw Dr. Lee. He reported

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 20 of 38 PageID #: <pageID>
-21-

that following "an episode of hypertension," she "now has

her blood pressures under control."

* On December 23, 2004, Campbell was involved in an

automobile accident. Hospital records describe her

injuries as "multi system trauma," but she did not suffer

life-threatening injuries.

* On January 3, 2005, Campbell saw Dr. Mitchell for followup from the accident. Her blood pressure was 140/90, and

she had back and shoulder pain, along with multiple

bruises. Dr. Mitchell reassured Campbell that she was

healing.

* On February 4, 2005, Campbell saw Dr. Fine. Her blood

pressure was 160/100, and then 150/74 on recheck.

* On February 14, 2005, Campbell had an MRI of the left

knee and left shoulder. The knee showed a meniscus tear,

small cyst, and degenerative arthritis with joint space

narrowing and osteophyte formation; the shoulder

findings were "most consistent with tendinosis and/or

bursitis."

* On February 17, 2005, Campbell saw Dr. Gilliam about her

left knee and left shoulder, and it was agreed that

Campbell would undergo arthroscopy of the left knee with

partial meniscectomy. He injected her shoulder with

triamcinolone, Lidocaine, and Marcaine.

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 21 of 38 PageID #: <pageID>
-22-

* On March 10, 2005, Dr. Gilliam performed the left knee

surgery.

* On March 11, 2005, Dr. Mitchell filled out another

Medical Source Statement of Ability to Do Work-Related

Activities (Physical). He indicated that Campbell could

sit, stand, or walk for less than 15 minutes before

having to change her posture, and could sit, stand or

walk for less than one hour, separately or combined, in

an 8-hour workday. She could lift or carry five pounds

occasionally, but never more than that. He stated that

these conclusions were supported by her MRI results,

elevated blood pressure, chronic pain and muscle spasms

requiring monthly visits, and specialist evaluation. She

could use her hands for simple grasping and fine

manipulation, but not for pushing or pulling, and could

not use her feet for repetitive movements such as

operating foot controls. She could occasionally bend,

climb, reach above her head, and stoop, but never squat,

crawl, crouch or kneel. Objective signs of pain were

listed as redness, joint deformity, muscle spasm, and

"other," described as "[p]atient has trouble walking when

she rises from sitting position. Patient has been

involved in an auto accident 12/04 that will require

surgery." Dr. Mitchell described Campbell's pain as

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 22 of 38 PageID #: <pageID>
This actually appears to be a thyroid replacement agent, with side effects that 18

include fatigue, nervousness, anxiety, irritability, emotional lability, and muscle

weakness. Physicians' Desk Reference, 2007 Ed.

A constituent of Flexeril, with side effects that include drowsiness, weakness, 19

depression, and anxiety. Physicians' Desk Reference, 1995 Ed.

A constituent of Paxil. Side effects include somnolence, nervousness, muscle 20

pain, anxiety, and burning or pricking sensations. Physicians' Desk Reference, 2007 Ed.

The active ingredient in Klonopin, used to treat panic disorder, with side effects 21

that include somnolence, depression, and nervousness. Physicians' Desk Reference, 2007

Ed.

An opiod analgesic used for management of moderate to severe pain. Physicians' 22

Desk Reference, 2007 Ed.

-23-

"moderate," and stated that she would sometimes need

unscheduled breaks in an 8-hour shift, would be likely

to have "good days" and "bad days," and could be expected

to miss more than four days of work each month.

* On March 17, 2005, Campbell had an MRI of her right knee

(showing multicompartment degenerative arthropathy);

cervical spine (showing generalized disc bulging at C4-5

and C6-7); and lumbar spine (showing advanced

intervertebral disc degeneration at L-4-5 and minimal

generalized annular bulging at L-3-4).

* On March 31, 2005, in Claimant's Statement When Request

For Hearing Is Filed, Campbell listed her previous

medications, along with Levothyroxin for high blood 18

pressure, Cyclobenzapine for pain, Paroxetine for 19 20

nerves, Bextra for arthritis, Tylenol as needed,

Clonozepam as needed, Oxycodone for pain, and Pentazol 21 22

Noloxone for pain. In the hearing before the ALJ held

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 23 of 38 PageID #: <pageID>
-24-

this date, Campbell testified that she was 46 years old,

and had worked for the State Revenue Department for over

26 years, being just a few years short of retirement.

She had been having wide fluctuations in her blood

pressure, and on May 30, 2003, her doctor recorded it as

"extremely high" in spite of the fact that she was taking

"up to nine pills a day" for it. She related her

multiple joint problems to misalignment over the years

to compensate for knee injuries in her youth, and

testified that she could not stand or sit for any length

of time due to pain in her right knee, which needed to

be replaced. She obtained relief only by sitting propped

on pillows in a recliner, and even slept there. She

drank her coffee out of a plastic mug because she had

problems with dropping things she tried to pick up. A

neighbor came in to help with the housework. She did

not cook. She wore slip-on shoes and avoided clothes

that button. She kept her hair short because of

difficulty in caring for it. Her medications -

particularly Clonidine - made her extremely sleepy. She

had quit driving because she was "so groggy most of the

time," and felt her judgment was seriously impaired. She

had gained 70 pounds in the past four years. She did not

socialize, and felt worthless and hopeless. She

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 24 of 38 PageID #: <pageID>
-25-

described the pain in her leg as like an abscessed tooth,

or a bone sticking through her hip.

* On July 14, 2005, Dr. Roshan Sharma examined Campbell at

the request of the Social Security Administration.

Campbell gave Dr. Sharma a brief history of her head,

neck, shoulder, back, hip and knee problems, and told Dr.

Shama that her blood pressure was "uncontrolled because

of pain." She also reported "a lot of nervousness,

anxiety, tension, irritability, anger and fatigue." Dr.

Sharma recorded Campbell's blood pressure as 130/82, and

noted that she had reduced range of motion in her

cervical and lumbar spine, both knees and both hips. In

Dr. Sharma's opinion, Campbell was capable of lifting and

carrying 10 pounds frequently, and of standing or walking

about six hours in an 8-hour workday. Dr. Sharma did not

find any impairment in Campbell's ability to sit or

perform pushing or pulling motions. She could

occasionally climb, balance and stoop, but never kneel,

crouch, or crawl, and was limited from being around

machinery and heights, but had no other limitations.

* On September 16, 2005, the ALJ rendered an unfavorable

decision on Campbell's claim.

4. From the foregoing review of the administrative record,

the Court concludes that the ALJ erred in discrediting Dr.

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 25 of 38 PageID #: <pageID>
-26-

Mitchell's opinion. He did so, according to the written report of

decision, because that opinion "contrasts sharply with the other

evidence of record" and appeared to be based on taking "the

claimant's subjective allegations at face value." The Court does

not find substantial evidence to support these conclusions.

Dr. Mitchell was Campbell's treating physician, and as such,

his medical opinion should be given controlling weight if it is

not inconsistent with other substantial evidence in the record,

and is supported by medically acceptable laboratory and diagnostic

techniques. Hacker v. Barnhart, 459 F.3d 934 (8th Cir. 2006). 

Dr. Mitchell's medical opinion about Campbell's ability to

sit, stand, walk, push and pull is supported by the objective

evidence found in MRIs showing Campbell to have generalized disc

bulging at C4-5 and C6-7; advanced intervertebral disc

degeneration at L4-5; minimal generalized annular bulging at L3-

4; and bone-on-bone arthritis of her right knee. It is also

supported by his own observation of her joint deformity and

redness, his referrals of Campbell to specialists for treatment of

her joint problems, and his prescription over a period of years of

multiple medications for arthritis and pain. The change in Dr.

Mitchell's opinion about Campbell's functional capacity that can

be seen between his RFC of December 5, 2003, and the one dated

March 11, 2005, is supported by the degenerative nature of joint

disease and by what Campbell herself described as "massive" weight

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 26 of 38 PageID #: <pageID>
-27-

gain.

The only evidence that contradicts Dr. Mitchell's opinion

comes from the consultative physicians for the Social Security

Administration, Dr. Michael Young, Dr. Steve Owens, and Dr. Roshan

Sharma. When considered with the evidence as a whole, these

opinions do not constitute substantial evidence that would support

the ALJ's decision to discredit the testimony of Dr. Mitchell. 

Dr. Michael Young, when asked about Campbell's limitations

and their severity, offered nothing more enlightening than the

information that Campbell could dress herself and get on and off

the examination table without assistance. 

Dr. Steve Owens completed an RFC finding Campbell could sit,

stand or walk for six hours in an 8-hour workday, and push and

pull without limitation, but did so without benefit of an

examination or a medical source statement. 

Dr. Roshan Sharma did examine Campbell and her medical

records, but her report suggests that she did not seriously

consider the overall picture of Campbell's health, including the

effect of her joint disease, her medications, and her obesity.

Dr. Sharma observed abnormalities in Cambpell's cervical, lumbar,

hip and knee ranges of motion, but evaluated those abnormalities

as not being particularly limiting. She reviewed the MRI showing

generalized disc bulging at C4-5 and C6-7, but dismissed it as

"[d]oes not show anything significant." She noted the MRI showing

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 27 of 38 PageID #: <pageID>
-28-

advanced intervertebral disc degeneration at L4-5 and minimal

generalized annular bulging at L3-4, and bone-on-bone arthritis of

the right knee, but did not consider these conditions to limit the

functionality of an individual weighing, at the time, 263 pounds.

She "reassured" Campbell that her blood pressure was under

control, but did not consider the side effects of the medication

regimen required to keep it that way. She noted that Campbell had

a driver's license, but did not note that Campbell was too groggy

from blood pressure pills to use it. 

In addition, nothing in the reports of Drs. Young, Owens, or

Sharma contradicts Dr. Mitchell's opinion that Campbell would need

to take unscheduled breaks, and would be expected to miss more

than four days' work a month because of her impairments, and Dr.

Mitchell's opinion on these aspects of Campbell's condition is

supported by the objective medical evidence of her joint condition

and her medication regimen.

It is axiomatic that "[t]he ALJ should give more weight to

the opinion of doctors who have treated a claimant regularly over

a period of months or years because they have a 'longitudinal

picture of [the] impairment'." Strongson v. Barnhart, 361 F.3d

1066, 1070 (8th Cir. 2004). As provided in 20 C.F.R.

§416.927(d)(2)(i), "the longer a treating source has treated you

and the more times you have been seen by a treating source, the

more weight we will give to the source's medical opinion. When

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 28 of 38 PageID #: <pageID>
-29-

the treating source has seen you a number of times and long enough

to have obtained a longitudinal picture of your impairment, we

will give the source's opinion more weight than we would give it

if it were from a nontreating source." In this case, Campbell

testified that Dr. Mitchell had been her family doctor since 1997,

and the medical records available to the ALJ indicated that

between January 4, 2002, and the date of the administrative

hearing, March 31, 2005, Dr. Mitchell saw Campbell 29 times.

While a treating physician's opinion does not automatically

control, it should be discounted only where other medical opinions

are supported by better or more thorough medical evidence, or the

opinion of the treating physician is inconsistent. Goff v.

Barnhart, 421 F.3d 785, 790 (8th Cir. 2005). That is not the case

here. Indeed, the ALJ "acknowledge[d] that greater weight should

be placed on Dr. Mitchell's observations of the claimant, by

reason of his position as the claimant's treating physician," but

then went on to say "in this case, I place greater weight on the

consultative examination by Dr. Sharma." He suggests no reason

why the opinion of Dr. Sharma, who saw Campbell only one time, is

more credible than that of Dr. Mitchell, whose records present a

truly longitudinal picture of treatment for intractable

hypertension and multiple joint disorders, for which appropriate

medications were prescribed, and for which Dr. Mitchell referred

Campbell to specialists who also monitored and treated her various

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 29 of 38 PageID #: <pageID>
-30-

condition.

The Court is particularly concerned about the ALJ's comment,

at page 342 of the administrative record, wherein he stated - about

a blood pressure reading of 152/92 - "[t]hat don't sound to me like

it's too awfully bad." For a person who was at the time of the

reading taking multiple medications to lower her blood pressure,

the reading is "awfully bad." A basic medical reference, Stedman's

Medical Dictionary, 28th Ed., defines hypertension as:

High blood pressure; transitory or sustained elevation

of systemic arterial blood pressure to a level likely to

induce cardiovascular damage or other adverse

consequences. H[ypertension] has been arbitrarily

defined as a systolic blood pressure above 140 mmHg or

a diastolic blood pressure above 90 mmHg. Consequences

of uncontrolled h[ypertension] include retinal damage .

. . cerebrovascular disease and stroke, left ventricular

hypertrophy and failure, myocardial infarction,

dissecting aneurysm, and renovascular disease. . . .

h[ypertension] is recognized as a major cause of diseases

and death in industrialized societies.

Campbell's problems with getting and keeping her blood

pressure under control are objectively documented by the many

office visits with blood pressure checks in the dangerous range.

Those visits also reflect that it was only after Campbell stopped

working that her blood pressure medications began to successfully

control her hypertension. This coincidence calls for further

medical investigation to determine if there is a correlation

between stress, pain, and elevated blood pressure in Campbell's

case.

5. The Court finds that the ALJ also erred in discrediting

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 30 of 38 PageID #: <pageID>
-31-

Campbell on the stated basis that the objective medical evidence

and her daily activities were not consistent with the level of pain

she alleged. Specifically, the Court believes the ALJ's conclusion

that "the medical findings that are present are not consistent with

the disabling level of pain alleged by the claimant" is not

supported by substantial evidence in the record as a whole. The

medical findings of bulging intervertebral discs at C4-5, C6-7, L3-

4, and L4-5, and bone-on-bone arthritis of the right knee may well

be consistent with complaints of disabling levels of pain,

particularly when coupled with excessive weight. 

The ALJ's conclusion that Campbell's testimony about her daily

activities is inconsistent with her testimony about level of pain

is not supported by substantial evidence. The administrative

record contains three "snapshots" in which Campbell described her

daily activities, and they show an evolving picture of disabling

pain. 

The first snapshot is in the undated Disability Supplemental

Interview Outline which the Court believes to have been filled out

around the time Campbell applied for benefits in July, 2003.

There, Campbell indicated that she could do laundry and wash

dishes, change sheets, vacuum and sweep, shop for groceries and

clothes, prepare meals, drive, watch television and listen to the

radio, but could not walk for errands or exercise, or sit or stand

for any period of time, and that her hands and arms stayed numb

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 31 of 38 PageID #: <pageID>
-32-

from working on the computers (apparently at her workplace). She

said that she had constant pain in her lower back, right hip and

leg, left shoulder, neck and both arms. She took multiple

medications for arthritis and pain, as well as other conditions.

The second snapshot is of Campbell's condition on March 7,

2004, when she indicated that she could no longer do any of the

activities listed in the earlier Disability Supplemental Interview

Outline except shop for groceries, drive, watch television, and

listen to the radio. She was using a cane to get around, and

described constant pain in her neck, left shoulder, down both arms,

in her lower back, right hip, and right knee. Her hands "tingle[d]

all the time." She took multiple medications for arthritis and

pain.

The third snapshot is Campbell's testimony at the hearing

before the ALJ on March 31, 2005. At that time, Campbell testified

that she spent most of the day in a recliner with pillows propped

under her leg to try to relieve the pain in her right hip and leg;

that she would start out the night sleeping in bed but would have

to move back to the recliner in a few hours because of pain; that

she used a plastic mug to drink out of because she had problems

dropping things that she picked up; that she no longer did any

housework, relying on outside help; that she did not cook, do yard

work, or wash the car; and that she wore slip-on shoes and clothes

without buttons to simplify dressing, and kept her hair short

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 32 of 38 PageID #: <pageID>
-33-

because of trouble with blow-drying it.

These snapshots of daily activity are consistent with

Campbell's allegations of disabling pain, and their gradual

progression is consistent with the progressive nature of

degenerative joint disease and "massive" weight gain.

Before rejecting a claimant's subjective complaints of pain,

the ALJ must demonstrate that he examined all the evidence, making

express credibility determinations and setting forth the

inconsistencies in the evidence that lead to his conclusion.

Douthit v. Bowen, 821 F.2d 508 (8th Cir. 1987). There must, of

course, be objective medical evidence of an impairment which could

reasonably be expected to cause pain - in this case supplied by

the MRIs - but as to the severity, the following factors should be

considered in evaluating the credibility of claimant's subjective

complaints of pain:

* prior work record;

* daily activities;

* duration, frequency and intensity of pain;

* precipitating and aggravating factors;

* dosage, effectiveness and side effects of medication;

and 

* functional restrictions.

This evidence can come from the claimant, her doctors, or

third parties. The ALJ cannot reject a claimant's subjective

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 33 of 38 PageID #: <pageID>
-34-

complaints solely on the basis of personal observations, but may

discount them if there are inconsistencies in the evidence as a

whole. Polaski v. Heckler, 739 F.2d 1320 (8th Cir. 1984). 

There is insufficient evidence that the ALJ considered the

Polaski factors. There is evidence in the record that Campbell had

worked for the same employer for over 26 years, and was very close

to retirement when she applied for benefits. This work history

supports her credibility. O'Donnell v. Barnhart, 318 F.3d 811,

817 (8th Cir. 2003).

Campbell's daily activities are consistent with her subjective

complaints of pain and of grogginess from medication side effects

that prevent her from doing much of anything. On March 7, 2004,

she described her daily activities as being limited to shopping

for groceries, driving, watching television, and listening to the

radio. By the time of the hearing, Campbell testified that she

spent the greater part of most days and nights propped on pillows

in a recliner, and had few activities other than watching

television. This evidence is not inconsistent with Campbell's

claim of disability. "The ability to perform sporadic light

activities does not mean that the claimant is able to perform full

time competitive work." Ross v. Apfel, 218 F.3d 844, 849 (8th Cir.

2000). 

Campbell gave graphic descriptions of the duration, frequency,

and intensity of her pain. She reported, in each document filled

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 34 of 38 PageID #: <pageID>
-35-

out in connection with her application for benefits, that the pain

was constant and that there was little she could do to relieve it.

Lying in her recliner with pillows propped under her hip appeared

to afford the best relief. At the hearing, Campbell testified that

"I have this bone in my leg that feels like it's sticking through

my hip." She said it felt like an abscessed tooth or "like my leg

is broke and it's not set."

Campbell also was consistent throughout the process with

regard to what precipitated or aggravated her pain: sitting,

standing, and walking. 

With regard to the dosage, effectiveness and side effects of

medication, Campbell testified to the usage of Darvocet, Vioxx,

Propoxy/Acetominophen, Cyclobenzapine, Bextra, Tylenol, Oxycodone,

and Pentazol Naloxone for pain. She also received periodic

injections of painful areas with numbing agents, and used what

appears to be a TENS unit on her shoulder. She was consistent in

seeking medical treatment over a period of years in attempts to

find relief from her pain.

The functional restrictions to which Campbell gave testimony

are reflected in the virtual suspension of all activities.

When the record as a whole is considered, the Court finds that

there is not substantial evidence to support the ALJ's decision to

discredit Campbell's subjective complaints of pain.

6. The Court also finds that the ALJ erred in not

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 35 of 38 PageID #: <pageID>
-36-

considering Campbell's depression, the side effects of Campbell's

complex drug regimen, and her obesity on her residual functional

capacity.

Dr. Donahue found that Campbell had depression that moderately

impairs her ability to pay attention, concentrate, carry out

instructions, work a normal workday and workweek, perform at a

consistent pace without an unreasonable number of rest periods,

interact with the public and set realistic goals. 

Several of the medications Campbell takes to control her blood

pressure list "somnolence" as a side effect, and Campbell testified

that the medications do have that effect on her, often causing her

to sleep for several hours at a time. She testified that she was

too "groggy" from the medications to drive. She also testified

that the ups and downs of her blood pressure caused extreme

fatigue.

Finally, Campbell is obese, weighing in the range of 260

pounds. She testified that in the five years preceding the

hearing, she had experienced a "massive" weight gain, in the range

of 70 pounds. Obesity is known to complicate both musculoskeletal

and cardiovascular conditions. See (SSR) 02-01p, 2000 WL 628049

(SSA, Sept. 12, 2002.

The ALJ did not properly consider these factors, either as

isolated factors or with regard to their synergistic effect on

Campbell's ability to work. 

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 36 of 38 PageID #: <pageID>
-37-

7. When the Court considers all the evidence - not just that

which supports the ALJ's decision, but also that which fairly

detracts from it - it concludes that there is not the requisite

measure of "substantial evidence" to support the decision in this

case. The Court, therefore, concludes that the matter should be

remanded to the Commissioner for further consideration. Upon

remand, the Court directs that the ALJ obtain appropriate medical

opinions on the following questions:

* To what degree do stress and pain contribute to

Campbell's hypertension?

* Would working, with its concomitant stress and pain, be

likely to affect Campbell's ability to safely control her

blood pressure?

* What are the side effects of Campbell's various

medications, particularly their tendency to cause

somnolence, on her ability to work?

* What is the effect of Campbell's depression, particularly

when combined with medication side effects, on her

ability to work?

* What is the effect of Campbell's obesity on her ability

to work, given her known degenerative joint disease and

high blood pressure?

The Court further directs that, if the ALJ is still persuaded

that Dr. Mitchell and Campbell are not fully credible, he

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 37 of 38 PageID #: <pageID>
-38-

specifically state the factors upon which this determination is

made.

Accordingly, the Court reverses the decision of the

Commissioner, and remands this case to the Commissioner for

further consideration pursuant to sentence four of 42 U.S.C.

§405(g), and as directed in this Order.

If plaintiff wishes to request an award of attorney's fees

and costs under the Equal Access to Justice Act, an application

may be filed up until thirty days after the judgment becomes "not

appealable," i.e., thirty days after the sixty-day time for appeal

has ended. Shalala v. Schaefer, 509 U.S. 292 (1993); 28 U.S.C. §§

2412(d)(1)(B) and (d)(2)(G).

IT IS SO ORDERED.

 /s/Jimm Larry Hendren 

JIMM LARRY HENDREN

UNITED STATES DISTRICT JUDGE

Case 4:06-cv-04023-JLH Document 15 Filed 03/20/07 Page 38 of 38 PageID #: <pageID>