Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-4_15-cv-01054/USCOURTS-alnd-4_15-cv-01054-0/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)

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UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ALABAMA

MIDDLE DIVISION

BARBARA LINDSEY GREEN,

Plaintiff,

v.

CAROLYN W. COLVIN, Acting

Commissioner of Social Security,

Defendant.

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}

}

}

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}

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}

Case No.: 4:15-CV-1054-RDP

MEMORANDUM OF DECISION

Plaintiff Barbara Green (“Plaintiff” or “Green”) brings this action pursuant to Section

205(g) of the Social Security Act (the “Act”), seeking review of the decision of the 

Commissioner of Social Security (“Commissioner”) denying her claims for a period of disability

and disability insurance benefits (“DIB”). See also, 42 U.S.C. § 405(g). Based on the court’s 

review of the record and the briefs submitted by the parties, the court finds that the decision of 

the Commissioner is due to be affirmed.

I. Proceedings Below

Plaintiff filed her application for disability and DIB on May 7, 2012 in which she alleged 

that her disability began on September 10, 2010. (Tr. 184). Plaintiff’s application was initially 

denied by the Social Security Administration on July 25, 2012. (Tr. 122). Plaintiff requested 

and received a hearing before an Administrative Law Judge. (Tr. 140). The hearing was set for 

August 15, 2013 with Administrative Law Judge Renita Barnet-Jefferson (“ALJ”). (Tr. 147-51). 

In her decision, dated November 22, 2013, the ALJ determined that, contrary to her assertion 

otherwise, Green had not been under a disability within the meaning of Sections 216(i) and 223 

FILED

 2016 Aug-02 PM 02:41

U.S. DISTRICT COURT

N.D. OF ALABAMA

Case 4:15-cv-01054-RDP Document 17 Filed 08/02/16 Page 1 of 17
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(d) of the Social Security Act since September 10, 2010. (Tr. 61). On January 24, 2014, 

Plaintiff requested review from the Appeals Council and her request was denied on April 24, 

2015. (Tr. 1, 15). This denial was the final decision of the Commissioner, and therefore a 

proper subject of this court’s appellate review. 

II. Facts

Plaintiff was forty-seven years old at the time of her hearing. (Tr. 86). She alleges that 

she has been disabled since September 10, 2010 because of high blood pressure, fibromyalgia, 

arthritis, lupus (dormant), and panic and anxiety attacks. (Tr. 108). At the hearing, she also 

alleged that she suffers from depression and insomnia. (Tr. 90, 96). She has an eleventh grade 

education and completed her GED. (Tr. 88). Plaintiff has worked numerous jobs in her lifetime, 

including building electrical panels for buses, sewing, spinning yarn, waitressing, and fast food 

service. (Tr. 97-98). She did not work any of these jobs during the more than four-and-a-half 

year period prior to her hearing. (Tr. 98). 

At her hearing, Plaintiff testified that she has fibromyalgia, high blood pressure, panic 

and anxiety attacks, and that she experiences a lot of pain. (Tr. 88). She stated that she takes 

pain medications and while they help they also make her “groggy and sleepy.” (Tr. 88). She 

alleged that her pain is so severe that it affects her ability to sleep through the night and she is 

only able to sleep a few hours at a time (Tr. 89). She claimed that her activities are limited 

during the day and mainly she watches television and looks at magazines, but she has trouble 

remembering what she reads or watches. (Tr. 89). She can do light housework, such as light 

dusting, but not much more than that due to the pain. (Tr. 90). She is depressed and cries a lot 

and has daily panic attacks (Tr. 90, 92). She says that she has no interest in doing activities 

which she used to enjoy because of her depression and her alleged inability to do those things 

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(e.g., playing with her grandchildren). (Tr. 90). She rated the pain level in her back and knees as 

an eight out of ten and the pain in her hands at a 5 or 6, even with pain medication. (Tr. 94). She 

stated that she can only walk or sit for around ten minutes at a time and can only lift around five 

pounds. (Tr. 95-96). She spends most of her day lying down. (Tr. 95). 

During the alleged period of disability, Plaintiff received treatment from Oxford Family 

Practice, Quality of Life Health Services, Inc, Northeast Alabama Regional Medical Center 

Radiation/Oncology, and The Crawford Clinic. (Tr. 418, 437, 444, 445). She also received 

treatment from Dr. Wyndol Hamer; however, this treatment was sought after the ALJ’s final 

decision in November 22, 2013. (Tr. 22-45). On November 11, 2011, she was diagnosed with 

fibromyalgia, obesity, and anthropathy at Quality of Life Health Services and was prescribed 

Flexeril and Savella. (Tr. 393). The doctors at Oxford Family Practice also diagnosed her with 

hypertension and anxiety on March 8, 2012, and fibromyalgia and dyslipidemia on March 12, 

2012. (Tr. 418-19). Oxford Medical prescribed her Clonazepam and Flexeril. (Id.). Plaintiff 

has taken numerous other medications during her alleged period of disability, including: 

Lisinopril, Cymbalta, HCTZ, Ibuprofen, Lyrica, Darvocet, and Lortab. (Tr. 401, 421, 437-38).

In addition, she was diagnosed with breast cancer on August 22, 2012. (Tr. 445). She received 

treatment for this, including chemotherapy and radiation, and was in remission at the time of her 

hearing. (Tr. 87). Plaintiff also had surgery to remove the cancerous lump in March 2013 (Tr. 

470-73). 

After filing for disability, a physician and a psychologist both evaluated Plaintiff on July 

14, 2012 and July 17, 2012, respectively. (Tr. 427-30, 434). The physician, Dr. Antonio Rozier 

diagnosed her with degenerative disc disease and fibromyalgia. (Tr. 430). He also said that she 

suffered from “mildly decreased grip strength in holding objects” but had normal sensation in all 

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five fingers. (Id.). In terms of Plaintiff’s abilities, Dr. Rozier determined that she could walk 

without assistance and sit comfortable, but she did have some reduced range of motion in her 

neck and back. (Tr. 429-30). The psychologist, Dr. Dana Davis, diagnosed her as suffering from 

lingering symptoms of bereavement following the death of her mother, and Generalized Anxiety 

Disorder. (Tr. 434). She described Plaintiff’s symptoms as “mild-to-moderate.” (Id.). At the 

time of Dr. Davis’s examination, she was taking Lisinopril, clonazepam, hydrochlorot, and 

Percogesic. (Tr. 433). In her evaluation, Dr. Davis noted that Plaintiff was able to drive on her 

own and is largely independent. (Id.). She told Dr. Davis that she spends her time watching 

television, visiting with her boyfriend, children, and grandchildren, gardening, painting, and

puzzles. (Id.). In addition, Dr. Davis reported that Plaintiff was cooperative, oriented, engaged 

in logical thought process, mildly dysphoric, and her affect was “appropriate with occasional 

tearfulness when discussing her mother.” (Tr. 434). 

In December 2013, Dr. Hamer diagnosed Plaintiff with osteoarthritis, musculoskeletal 

pain, malaise and fatigue, kyphoscoliosis/scoliosis, panic disorders with agoraphobia, 

hypertension, mixed hyperlipidemia, and joint pain in multiple sites. (Tr. 22-45). On January 

27, 2014, he diagnosed her with cervicalgia, depressive disorder, hyperlipidemia, sinusitis, 

bronchitis, and degenerative disc disease. (Tr. 29-37). Dr. Hamer also found that she had 

moderate tendering to palpation in her back (although this finding is inconsistent with the 

opinion of another doctor who examined Plaintiff in May 2013 and determined this was not an 

issue). (Tr. 30, 494). Dr. Hamer also ordered a bone density study, which came back normal,

and an MRI, which showed only mild posterior disc protrusion at C5-6 and no protrusion at other 

discs. (Tr. 17, 20). He later diagnosed her with insomnia and generalized anxiety disorder. (Tr. 

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38-45). Plaintiff also contends that Dr. Hamer filled out a Physical Capacities Form that stated 

Plaintiff: 

can sit 3 hrs at one time, stand 2 hrs at one time, walk 3 hrs at one time; would 

expect her to be lying down, sleeping, sitting w/ legs propped x3 hrs in 8 hr 

workday; limitations existed back to 9/10/10; last greater than 12 months; can 

perform a task for 2 hrs before needing a rest/break; can maintain 

attention/concentration x2 hrs.

(Pl.’s Mem. 24). However, Plaintiff’s contentions notwithstanding, it does not appear this piece 

of evidence was before the ALJ.

III. ALJ Decision

Disability under the Act is determined under a five-step test. 20 C.F.R. § 404.1520. 

First, the ALJ must determine whether the claimant is engaging in substantial gainful activity. 

20 C.F.R. § 404.1520(a)(4)(i). “Substantial work activity” is work activity that involves doing 

significant physical or mental activities. 20 C.F.R. § 404.1572(a). “Gainful work activity” is 

work that is done for pay or profit. 20 C.F.R. § 404.1572(b). If the ALJ finds that the claimant 

engages in substantial gainful activity, then the claimant cannot claim disability. 20 C.F.R. § 

404.1520(b). Second, the ALJ must determine whether the claimant has a medically 

determinable impairment or a combination of medical impairments that significantly limits the 

claimant’s ability to perform basic work activities. 20 C.F.R. § 404.1520(a)(4)(ii). Absent such 

impairment, the claimant may not claim disability. Id. Third, the ALJ must determine whether 

the claimant’s impairment meets or medically equals the criteria of an impairment listed in 20 

C.F.R. § 404, Subpart P, Appendix 1. See 20 C.F.R. §§ 404.1520(d), 404.1525, and 404.1526. 

If such criteria are met, the claimant is declared disabled. 20 C.F.R. § 404.1520(a)(4)(iii).

If the claimant does not fulfill the requirements necessary to be declared disabled under 

the third step, the ALJ may still find disability under the next two steps of the analysis. The ALJ 

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must first determine the claimant’s residual functional capacity (“RFC”), which refers to the 

claimant’s ability to work despite her impairments. 20 C.F.R. § 404.1520(e). In the fourth step, 

the ALJ determines whether the claimant has the RFC to perform past relevant work. 20 C.F.R. 

§ 404.1520(a)(4)(iv). If the claimant is determined to be capable of performing past relevant 

work, then the claimant is deemed not disabled. Id. If the ALJ finds the claimant unable to 

perform past relevant work, then the analysis proceeds to the fifth and final step. 20 C.F.R. § 

404.1520(a)(4)(v). In the last part of the analysis, the ALJ must determine whether the claimant 

is able to perform any other work commensurate with her RFC, age, education, and work 

experience. 20 C.F.R. § 404.1520(g). At this point, the burden of proof shifts from the claimant 

to the ALJ to prove the existence, in significant numbers, of jobs in the national economy that 

the claimant can do given her RFC, age, education, and work experience. 20 C.F.R. §§ 

404.1520(g), 404.1560(c).

Here, the ALJ determined that Plaintiff had not engaged in a substantial gainful activity 

since her alleged onset date of September 10, 2010. (Tr. 63). The ALJ also determined that 

Plaintiff has six severe impairments including: fibromyalgia, degenerative disc disease cervical 

spine, obesity, hypertension, status post lumpectomy, Generalized Anxiety Disorder, and 

depression (id.), but did not suffer from any of the listed impairments under 20 C.F.R Part 404, 

Subpart P, Appendix 1. The ALJ also concluded that Plaintiff’s physical impairments, 

“singularly and in combination” were not enough to meet the requirements of the listing for 

Musculoskeletal Systems (Tr. 64), and she does not meet any of the standards for the mental 

impairment listing as she had no restrictions “in activities of daily living” and only moderate 

difficulties in social functioning and with concentration, persistence, or pace. (Id.). In addition, 

Plaintiff never experienced any episodes of decompensation as required by the listing. (Id.). 

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The ALJ determined that Plaintiff does have some residual functional capacity to perform 

certain types of work. (Tr. 65). She found that Plaintiff had the capacity to perform:

sedentary work as defined in 20 C.F.R. 404.1567(a) except with the following 

limitations: with a sit/stand option at will; push/pull as much as can lift/carry; can 

frequently use bilateral hands for hand controls; can handle with bilateral hands; 

occasionally climb ramps and stairs; never climb ladders or scaffolds; 

occasionally balance, stoop, kneel, crouch, and crawl; never work at unprotected 

heights, around moving mechanical parts; and avoid concentrated exposure to 

humidity and wetness and extreme cold. She is limited to simple, routine, and 

repetitive tasks; occasionally interact with the public; and limited to tolerating few 

changes in routine work setting. 

(Id.). In light of Plaintiff’s residual functional capacity, the ALJ determined that she is no longer 

capable of performing any of her past relevant jobs as they would be classified as light or 

medium as opposed to sedentary. (Tr. 75). However, after considering the testimony of the 

Vocational Expert, the ALJ found that there are jobs “that exist in significant numbers in the 

national economy” that Plaintiff is capable of performing given all of her impairments. (Tr. 76). 

Based on her impairments, Plaintiff should be able to perform any job classified as sedentary, 

unskilled. (Id.). For example, she could work as an addressing clerk, table worker, or inspector 

with thousands of these jobs available regionally and nationally. (Id.). Based on Plaintiff’s 

residual functional capacity and the possible jobs that exist for her in the national economy, the 

ALJ determined that she “had not been under a disability as defined in the Social Security Act, 

from September 10, 2010, through the date of this decision.” (Id.). 

IV. Plaintiff’s Argument for Reversal

Plaintiff makes six arguments on appeal: (1) the Appeals Council failed to consider 

records from Dr. Hamer, the treating physician, that discussed Plaintiff’s treatment after the date 

of decision (Pl.’s Mem. 18); (2) the Appeals Council erred by not giving substantial weight to 

Dr. Hamer’s opinion (Pl.’s Mem. 24); (3) the ALJ failed to consider all of Plaintiff’s severe 

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impairments (Pl.’s Mem. 26); (4) the ALJ did not state adequate reasons for finding Plaintiff’s 

testimony was less than credible (Pl.’s Mem. 27); (5) the ALJ erred in drawing adverse 

inferences from Plaintiff’s lack of medical treatment; and (6) the ALJ’s decision was not based 

on substantial evidence because the hypothetical question posed to the Vocational Expert did not 

accurately state Plaintiff’s impairments.

V. Standard of Review

The only issues before this court are whether the record reveals substantial evidence to 

sustain the ALJ’s decision, see 42 U.S.C. § 405(g); Walden v. Schweiker, 672 F.2d 835, 838 

(11th Cir. 1982), and whether the correct legal standards were applied. See Lamb v. Bowen, 847 

F.2d 698, 701 (11th Cir. 1988); Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). Title 42 

U.S.C. § 405(g) mandates that the Commissioner’s findings are conclusive if supported by 

“substantial evidence.” Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990). The district 

court may not reconsider the facts, reevaluate the evidence, or substitute its judgment for that of 

the Commissioner; instead, it must review the final decision as a whole and determine if the 

decision is reasonable and supported by substantial evidence. See Id. (citing Bloodsworth v. 

Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)). 

Substantial evidence falls somewhere between a scintilla and a preponderance of 

evidence; “[i]t is such relevant evidence as a reasonable person would accept as adequate to 

support a conclusion.” Martin, 894 F.2d at 1529 (quoting Bloodsworth, 703 F.2d at 1239) (other 

citations omitted). If supported by substantial evidence, the Commissioner’s factual findings 

must be affirmed even if the evidence preponderates against the Commissioner’s findings. See

Martin, 894 F.2d at 1529. While the court acknowledges that judicial review of the ALJ’s 

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findings is limited in scope, the court also notes that review “does not yield automatic 

affirmance.” Lamb, 847 F.2d at 701. 

VI. Discussion

After careful review, the court concludes the ALJ’s findings are supported by substantial 

evidence and that she correctly applied the law.

A. The Appeals Council Properly Considered New Evidence and Denied 

Plaintiff’s Request for Review. 

A claimant is generally allowed to introduce new evidence at each stage of the process 

and the Appeals Council must consider the evidence if it is new, material, and chronologically 

relevant. Ingram v. Comm’r of Soc. Sec., 496 F.3d 1253, 1261 (11th. Cir. 2007). Under this 

standard, evidence is material if “there is a reasonable possibility that the new evidence would 

change the administrative outcome.” Hyde v. Bowen, 823 F.2d 456, 459 (11th Cir. 1987). In 

order to be chronologically relevant, the new evidence must “relate to the period on or before the 

date of the [ALJ] hearing decision.” 20 C.F.R. § 404.970(b) (2016). Evidence is not rendered 

chronologically irrelevant solely because it is dated after the ALJ decision if it relates back to the 

relevant period of time. See Washington v. SSA, 806 F.3d 1317, 1322 (11th Cir. 2015) (holding 

that treating physician’s opinion give after ALJ decision was still chronologically relevant 

because Plaintiff told the doctor he had experienced hallucinations before and the doctor 

examined medical records from the relevant period). When a claimant presents new evidence, 

the Appeals Council must grant review when the ALJ’s decision is against the weight of the 

current record. Harrison v. Comm’r of Soc. Sec., 569 F.Appx. 874, 881 (11th Cir. 2014). 

The opinion of a treating physician is normally entitled to substantial weight, but that rule 

is inapplicable when the opinion at issue is not based on objective medical evidence or is merely 

conclusory. Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1159 (11th Cir. 2004). There is no

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error when the Appeals Council refuses to remand based on new medical evidence that is 

conclusory. See Harrison, 569 F.Appx. at 881. 

In the present case, the record shows that Plaintiff submitted thirty-six pages of medical 

records from Dr. Hamer to the Appeals Council. (Tr. 2). Those records were dated from 

December 30, 2014 through August 30, 2014. (Id.). The Appeals Council properly considered 

this evidence in their decision, but decided that it was not chronologically relevant because it 

does not relate to the time period prior to the ALJ’s decision. (Id.). Dr. Hamer did not treat 

Plaintiff until December 2013, the month after the ALJ decision; therefore, his diagnoses are not 

related to the relevant time period. (Id.).

Plaintiff has also claimed that she submitted a Physical Capacities Form, completed by 

Dr. Hamer on May 30, 2014, that stated she would have to lay down or sit with her legs propped 

up at least three hours in an eight-hour work day and that this condition would have existed on 

September 10, 2010, the alleged onset date.

1 (Pl.’s Mem. 24). However, nothing in the record 

indicates this evidence was ever before the Appeals Council. (Tr. 1-4). There is no mention of it 

in the decision of the Appeals Council, and it was not included in the record. 

B. The Appeals Council Had Good Cause to Discount Dr. Hamer’s Opinion in 

the Physical Capacities Form.

The Eleventh Circuit has established that “the testimony of a treating physician must be 

given substantial or considerable weight unless ‘good cause’ is shown to the contrary.” 

 1 The court notes that even if this form were before the Appeals Council, any failure to consider it would 

not be an error because it would not affect the outcome of this case. Based on Plaintiff’s assertions, such a form 

would seem to be chronologically relevant under Washington because it relates back to the alleged onset date. (Pl.’s 

Mem. 24). But there is another issue related to the missing form. There is no evidence that Dr. Hamer (1) examined 

any of Plaintiff’s prior medical records from this time or (2) based his opinion on anything other than her subjective 

complaints (Pl.’s Mem. 19, 21). Therefore, his opinion is not based on objective medical evidence and is merely 

conclusory (that is, he merely stated that Plaintiff had limitations but gave no reason for his conclusion) and 

therefore would not be entitled to any significant weight. This renders the evidence immaterial as it would not 

change the administrative outcome and therefore, the Appeals Council would not be required to consider the 

evidence.

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Crawford, 383 F.3d at 1159 (quoting Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997)). 

However, the treating physician’s opinion may be properly discounted “when it is not 

accompanied by objective medical evidence or is wholly conclusory.” Crawford, 363 F.3d at 

1159. 

In Plaintiff’s case, Dr. Hamer, one of her treating physicians, completed a Physical 

Capacities Form that stated she can “sit three hours at a time, stand two hours at a time, walk 

three hours at one time” and she would have to lie down or prop her legs up three hours in an 

eight-hour work day. (Pl.’s Mem. 24). He also stated that these limitations would have existed 

back to September 10, 2010, the alleged onset date. (Id.). There is no evidence that this opinion 

was even before the Appeals Council when the Council made its decision. (Tr. 2). But even if 

this piece of evidence was before the Council, it nevertheless would have been justified in 

discounting it. Dr. Hamer first met with Plaintiff in December 2013, a month after the ALJ 

decision. (Tr. 22). He had not met with her during the time period between the alleged onset 

date and the date of the ALJ decision. (Id.). In making his determination that Plaintiff had the 

above mentioned limitations back to her alleged onset date, the record shows Dr. Hamer did not 

rely on objective medical evidence and his opinion was conclusory. He did not examine Plaintiff 

during the relevant time period; therefore, in making this determination he could only rely on her 

subjective complaints and what she told him she could (or could not) do during that time period. 

(Id.). In addition, Dr. Hamer did not explain how he arrived at the conclusion that Plaintiff could 

only sit or stand for periods or time or that these limitations existed in 2010; therefore, his 

opinion was conclusory. (Pl.’s Mem. 24). 

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C. The ALJ Properly Considered All of Plaintiff’s Severe Impairments

The burden is on a claimant to prove that she has a severe impairment. Bowen v. Yuckart, 

482 U.S. 137, 146 n.5 (1987). A severe impairment is one that “significantly limits [a person’s]

physical or mental ability to do basic work activities” without taking that person’s age, 

education, or work experience into consideration. 20 C.F.R. § 404.1520(c) (2016). The severe 

impairment must be proven by medical evidence. 20 C.F.R. § 404.1508 (2016). In addition, the 

ALJ has no “obligation to investigate a claim not presented at the time of the application for 

benefits and not offered at the hearing as a basis for disability.” Street v. Barnhart, 133 F. Appx. 

621, 627 (11th Cir. 2005). It is only necessary to find a single severe impairment for a 

claimant’s case to proceed past the second step of the analysis. Burgin v. Comm’r Soc. Sec., 420 

F. Appx. 901, 902 (11th Cir. 2011). 

In the present case, Plaintiff only claimed the disabilities of “high blood pressure, 

fibromyalgia, arthritis, lupus, and panic and anxiety attacks” in her initial application for 

disability. (Tr. 108). At her hearing, she alleged that she suffered from fibromyalgia, high blood 

pressure, and was in a lot of pain. (Tr. 88). She also claimed that she suffered from depression, 

arthritis, degenerative disc disease, and lupus. (Tr. 90-93). Plaintiff now claims that her severe 

impairments include Sicca Syndrome, osteoarthritis, idiopathic scoliosis, and coronary artery 

disease.

2

 (Pl.’s Mem. 26). But she never mentioned coronary artery disease, Sicca Syndrome, or 

osteoarthritis in either her application or to the ALJ at her hearing. Therefore, the ALJ had no 

obligation to investigate these claims. Plaintiff failed to meet her burden of showing that these 

additional impairments would interfere with her abilities to perform basic work activities. 

 2 Plaintiff did mention that she has been previously diagnosed with lupus at her hearing; however, she 

admitted that it was in a dormant state. (Tr. 93). Similarly, although she did state that she had some form of 

scoliosis and it causes her pain, she did not specifically claim it as a severe impairment. (Tr. 91).

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Finally, even if the ALJ erred in not considering these additional impairments to be 

severe (and, to be clear, the court finds there was no such error), any error was harmless error. 

The ALJ found that Plaintiff suffers from a variety of severe impairments. (Tr. 63). This was

enough to advance the analysis to Step Three. At that step of the analysis, the ALJ could have 

still found her to be disabled based on these impairments. After all, once the ALJ moves past 

Step Two of the analysis, she is required to consider “the claimant’s entire medical condition, 

including impairments the ALJ determined were not severe.” Burgin, 420 F. Appx. at 902. It 

follows that even though the ALJ did not consider these impairments severe, she was still 

required to take them into consideration in determining Plaintiff’s capabilities. In her decision, 

the ALJ considered all of the medical issues of which Plaintiff produced evidence, including the 

record evidence related to lupus, Sicca Syndrome, osteoarthritis, and scoliosis (Tr. 68, 72). 

D. The ALJ Adequately Stated Her Reasons for Discrediting Plaintiff’s 

Testimony

In order to establish disability based on pain testimony, a claimant must make an 

appropriate showing under the following three-part test: she must establish “(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 

reasonably be expected to give rise to the claimed pain.” Wilson v. Barnhart, 284 F.3d 1219, 

1225 (11th Cir. 2002). It is for the ALJ to determine the credibility of Plaintiff’s pain testimony. 

Of course, the ALJ must articulate specific reasons when discrediting a claimant’s testimony. 

See Foote v. Chater, 67 F.3d 1553, 1562 (11th Cir. 1995). If the ALJ does not articulate specific 

reasons for discrediting a claimant’s testimony, the testimony must be accepted as true. Id. In 

addition, the ALJ’s decision to discredit Plaintiff’s subjective testimony must be based on 

substantial evidence. Doughtry v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). 

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Here, the ALJ articulated specific reasons supporting her determination that Plaintiff’s 

testimony “regarding her impairments” is only “partially credible.” (Tr. 74). The ALJ set out 

concrete examples of why she concluded that Plaintiff’s activities are not as limited as claimed in 

her testimony. (Id.). She also pointed to specific inconsistencies in Plaintiff’s testimony, such as 

this: while Plaintiff claimed to have difficulties following written instructions, she had no 

difficulty completing written function reports for her application. (Id.). Plaintiff argues that her 

participation in daily activities does not necessarily disqualify her from receiving disability

benefits. (Pl.’s Mem. 28). But that argument misses the mark. An ALJ is permitted to take into 

consideration a claimant’s performance of daily tasks in evaluating her capabilities. Harwell v. 

Heckler, 735 F.2d 1292, 1293 (11th Cir. 1984). In addition, the ALJ noted Plaintiff’s infrequent 

trips to the doctor and the relatively conservative treatments ordered to address her impairments. 

(Tr. 74)). Generally, this type of conservative treatment may tend to negate a claimant’s claim of 

disability. Sheldon v. Astrue, 268 F. Appx. 871, 872 (11th Cir. 2008). 

Finally, the ALJ considered Plaintiff’s testimony that she suffered from negative side 

effects from her medications. As the ALJ noted, the medical evidence from her doctors did not 

support that claim. (Id.). In this case, the ALJ adequately stated her reasons for discrediting 

Plaintiff’s pain testimony, and the ALJ’s findings are supported by substantial evidence. 

E. The ALJ Did Not Err in Drawing Adverse Inferences from Plaintiff’s Lack 

of Medical Treatment

An ALJ “must not draw any inferences about an individual’s symptoms and their 

functional effects from a failure to seek or pursue regular medical treatment without first 

considering any explanations that the individual may provide.” SSR No. 97-7p, 1996 SSR 

LEXIS 4 at *22; Grier v. Colvin, 117 F. Supp. 3d 1335, 1344-45 (N.D. Ala. 2015) (holding that 

ALJ failed to consider other explanations because he did not ask claimant any questions about 

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why she did not seek medical treatment).3 And when an ALJ “‘primarily if not exclusively’ 

relies on a claimant’s failure to seek treatment, but does not consider any good cause explanation 

for the failure, [the appellate court] will remand for further consideration.” Henry v. Comm’r of 

Soc. Sec., 802 F.3d 1264, 1268 (11th Cir. 2015) (holding that reversible error existed when ALJ 

only considered a few other factors in the middle of the paragraph about conservative treatment 

and did not analyze them further). However, it is not reversible error when an ALJ bases her 

determination on “other factors, such as RFC, age, educational background, work experience, or 

ability to work despite the alleged disability.” (Tr. 74).

In the present case, Plaintiff contends that the ALJ drew an adverse inference from her 

lack of medical treatment when she stated: “the only treatment she received was pain 

medications. She had not had any rehabilitation, spinal injections or surgery” and “she has never 

been treated in the mental health setting” prior to her consultative exam when she applied for 

disability. (Tr. 72-73). The court agrees, but to the extent the ALJ erred, any error was 

harmless. 

The ALJ did not ask Plaintiff why she had not sought more aggressive treatment for these 

problems at her hearing. (Tr. 85-100). She also did not inquire as to whether Plaintiff had a 

good reason for her lack of medical treatment in making her decision on disability. (Tr. 64-77). 

The ALJ did ask her about her source of income and how much she makes, but she did not 

inquire into whether this affected Plaintiff’s ability to pay for medical treatment. (Tr. 88). Based 

on this information from the record, the ALJ did err in drawing an adverse inference from 

Plaintiff’s lack of medical treatment because she never gave Plaintiff a chance to explain the lack 

of medical care. See Grier, 117 F. Supp. 3d at 1344-45. 

 3 Examples of good cause explanations include: the individual may not be able to afford the medical 

treatment, side effects prescription medication may make Plaintiff’s condition less tolerable, or their symptoms may 

be treatable with over-the-counter medication. 1996 SSR LEXIS 4 at *22-23. 

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However, such an error is not reversible if an ALJ properly bases her determination on 

other factors. Henry, 802 F.3d at 1268. This is what occurred here. The ALJ considered a 

number of other factors in making her determination that Plaintiff was not disabled during the 

relevant time period. For example, the ALJ considered all of Plaintiff’s medical treatment 

history and the opinions of all the doctors who treated or examined Plaintiff during the relevant 

period. (Tr. 64-77). She also considered the statements Plaintiff made about her condition in 

both her function report and hearing testimony. (Id.). In addition, she carefully analyzed 

Plaintiff’s residual functional capacity, education, and previous work as well as the vocational 

expert’s opinion to determine what, if any, jobs in the economy Plaintiff is able to perform. (Id.)

It is apparent from the ALJ’s opinion that she did not rely primarily or exclusively on Plaintiff’s 

lack of medical treatment to make her determination. 

F. The ALJ’s Decision is Based on Substantial Evidence

In order for a Vocational Expert’s testimony to qualify as substantial evidence, the ALJ 

“must pose a hypothetical question which comprises all of the claimant’s impairments.” Jones v. 

Apfel, 190 F.3d 1224, 1229 (11th Cir. 1999). Plaintiff argues that the ALJ posed a hypothetical 

to the Vocational Expert that did not include all of Plaintiff’s limitations. (Pl.’s Mem. 36). 

Specifically, Plaintiff contends that the hypothetical was inaccurate because it “did not 

accurately state claimant’s pain level or her residual functional capacity.” (Id.). As already noted 

above, the ALJ considered Plaintiff’s subjective pain testimony and properly discredited it. In 

terms of residual functional capacity, this court has examined the ALJ’s hypothetical. The ALJ 

properly incorporated Plaintiff’s hearing testimony, the opinion of Dr. Rozier, and the opinion of 

Dr. Davis to accurately state all of the limitations that Plaintiff has experiences. (Tr. 103). 

Therefore, the testimony of the Vocational Expert qualifies as substantial evidence and the 

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Vocational Expert’s opinion that there are jobs in significant numbers which Plaintiff can 

perform was properly considered and adopted by the ALJ. (Tr. 103-04). 

VII. Conclusion

The court concludes that the ALJ’s determination that Plaintiff is not disabled is 

supported by substantial evidence and the proper legal standards were applied in reaching this 

determination. The Commissioner’s final decision is therefore due to be affirmed. A separate 

order in accordance with this memorandum of decision will be entered.

DONE and ORDERED this August 2, 2016.

_________________________________

R. DAVID PROCTOR

UNITED STATES DISTRICT JUDGE

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