Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-1_13-cv-01518/USCOURTS-alnd-1_13-cv-01518-0/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

NORTHERN DISTRICT OF ALABAMA

EASTERN DIVISION

TAMMY R. MURPHY,

Claimant,

vs.

CAROLYN W. COLVIN, Acting

Commissioner, Social Security

Administration, 

Defendant.

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Civil Action No. CV-13-S-1518-E

MEMORANDUM OPINION AND ORDER OF REMAND

Claimant, Tammy Murphy, commenced this action on August 16, 2013,

pursuant to 42 U.S.C. § 405(g), seeking judicial review of a final adverse decision of

the Commissioner, affirming the decision of the Administrative Law Judge (“ALJ”),

and thereby denying her claim for a period of disability, disability insurance, and

supplemental security income benefits. For the reasons stated herein, the court finds

that the Commissioner’s ruling is due to be reversed, and this case should be

remanded to the Commissioner for further proceedings. 

The court’s role in reviewing claims brought under the Social Security Act is

a narrow one. The scope of review is limited to determining whether there is

substantial evidence in the record as a whole to support the findings of the

Commissioner, and whether correct legal standards were applied. See Lamb v.

FILED

 2014 Jun-12 PM 01:10

U.S. DISTRICT COURT

N.D. OF ALABAMA

Case 1:13-cv-01518-CLS Document 11 Filed 06/12/14 Page 1 of 8
Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Tieniber v. Heckler, 720 F.2d 1251, 1253

(11th Cir. 1983).

Claimant contends that the Commissioner’s decision is neither supported by

substantial evidence nor in accordance with applicable legal standards. Specifically,

claimant asserts that the ALJ improperly considered the opinions of Dr. Sathyan V.

Iyer, M.D, the consultative examiner, resulting in a hypothetical question posed to the

vocational expert that did not include all of claimant’s limitations. Upon

consideration, the court concludes that contention is correct, and remand is warranted

for further consideration of the medical evidence.

Social Security regulations provide that, in considering what weight to give any

medical opinion, regardless of whether it isfrom a treating or consultative physician,

the Commissioner should evaluate: the extent of the examining or treating

relationship between the doctor and patient; whether the doctor’s opinion can be

supported by medicalsigns and laboratory findings; whether the opinion is consistent

with the record as a whole; the doctor’s specialization; and other factors. See 20

C.F.R. § 404.1527(d). See also Wheeler v. Heckler, 784 F.2d 1073, 1075 (11th Cir.

1986) (“The weight afforded a physician’s conclusory statements depends upon the

extent to which they are supported by clinical or laboratory findings and are

consistent with other evidence as to claimant’s impairments.”). 

2

Case 1:13-cv-01518-CLS Document 11 Filed 06/12/14 Page 2 of 8
Dr. Iyer first examined claimant on July 9, 2011. Claimant reported anxiety,

depression, fibromyalgia resulting in “arthritis affecting several different joints,” and

migraines three times a week. The physical examination was essentially normal. Of 1

the most relevance, the examination of claimant’s joints and musculoskeletal system

revealed the following: 

She has full range of motion of neck, shoulder, elbows and wrists. 

Grip strength is normal. Muscle power of the upper extremities is

normal. She can place her hands behind her head and lower back. 

Spine: Anterior flexion 80 degrees. She has full lateral flexion,

extension, and rotation motions. She has full range of motion of hips,

knees, and ankles. [Straight Leg Raising test] is negative. There is

tenderness over the elbows, anterior chest wall, suprascapular areas,

greater trochanters, and medial knees. She also has flat feet bilaterally. 

Her gait is normal. She can walk on her heels, tiptoes, and squat.2

Dr. Iyer’s diagnostic impressions included a history of chronic anxiety and

depression, a history of migraines, a history of fibromyalgia, and Stage 1

hypertension. Dr. Iyer opined that, in claimant’s current condition, “she may have

some impairment of functions involving bending, lifting, carrying, and overhead

activities. She does not have limitation of functions involving sitting, standing,

handling, hearing, orspeaking. Underlying anxiety and depression may impair some

functioning ability.”3

 Tr. 508. 1

 Tr. 509 (alteration supplied). 2

 Tr. 510. 3

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Case 1:13-cv-01518-CLS Document 11 Filed 06/12/14 Page 3 of 8
Dr. Iyer also completed a “Medical Source Statement of Ability To Do WorkRelated Activities(Physical)” form on July 9, 2011. He indicated that claimant could

frequently lift and carry up to ten pounds, occasionally lift and carry between eleven

and twenty pounds, and never lift or carry more than twenty pounds. She could sit,

stand, and walk for one hour at a time each. During an eight-hour workday, she could

sit for a total of four hours, stand for a total of four hours, and walk for a total of four

hours. She did not require the use of a cane to ambulate. She could frequently

handle, finger, feel, push, and pull with both hands, but she could only occasionally

reach. She could frequently use both feet to operate foot controls. She could

occasionally climb stairs, ramps, ladders, and scaffolds; balance; stoop; kneel;

crouch; and crawl. She did not have visual or hearing impairments. She could

occasionally be exposed to unprotected heights, moving mechanical parts, operation

of a motor vehicle, humidity, wetness, dust, odors, fumes, pulmonary irritants,

extreme heat and cold, and vibrations. She could tolerate moderate noise levels. She

would be able to shop, travel without a companion for assistance, ambulate without

using a wheelchair or assistive device, walk a block at a reasonable pace on rough or

uneven surfaces, use standard public transportation, climb a few steps at a reasonable

pace with the use of a single hand rail, prepare a simple meal and feed herself, care

for her personal hygiene, and work with paper files.4

 Tr. 513-18. 4

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Case 1:13-cv-01518-CLS Document 11 Filed 06/12/14 Page 4 of 8
Dr. Iyer completed some additional forms on August 28, 2011. Claimant

explains the circumstances under which those forms were generated as follows:

Since Dr. Iyer’s assessment ofresidual functional capacity did not

mention pain and since it did not take into account absenteeism directly

related to recurrent migraine headaches (fibromyalgia and migraine

headaches being the two severe impairments acknowledged by the ALJ

to exist in this case), Dr. Iyer was approached by the attorney for the

plaintiff and a request was made for a supplemental physical capacities

evaluation based on the earlier physical examination of the plaintiff.5

The first form completed by Dr. Iyer on August 28, 2011 was a Physical

Capacities Evaluation form. Dr. Iyer indicated that claimant could occasionally lift

ten pounds and frequently lift five pounds — a greater limitation than he imposed a

month earlier. Claimant could sit and stand, or walk, for four hours each during an

eight-hour workday. She would not need an assistive device to ambulate, and she did

not need to avoid dust, fumes, gasses, extreme temperatures, humidity, and other

environmental pollutants. She could only rarely climb, balance, perform gross

manipulation, bend, and stoop. Some of those limitations also were greater than what

Dr. Iyer imposed a month earlier, when he opined that claimant could perform some

of these activities “occasionally” or even “frequently.” Claimant could occasionally

push and pull with her arms and legs, perform fine manipulation, reach overhead,

operate motor vehicles, and work with or around hazardous machinery — again

representing a change from Dr. Iyer’s earlier opinion, in which he opined that some

 Doc. no. 8 (claimant’s brief), at 8. 5

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Case 1:13-cv-01518-CLS Document 11 Filed 06/12/14 Page 5 of 8
of these activities could be performed “frequently.” Claimant likely would be absent

from work three days each month as a result of her impairments. Dr. Iyer stated that

the medical basis for the restrictions he imposed was fibromyalgia and migraines.6

Dr. Iyer also completed a Clinical Assessment of Pain form in August. He

indicated that claimant experienced pain to such an extent as to be distracting to the

adequate performance of daily activities or work. Physical activity — such as

walking, standing, sitting, bending, stooping, or moving extremities — would cause

some increase in her pain level, but not so much as to prevent adequate functioning

in such tasks. The side effects of prescribed medication would cause some limitations

on claimant’s ability to do work, but not to such a degree asto cause serious problems

in most instances.

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The ALJ afforded great weight to Dr. Iyer’s July opinions, but “no weight

whatsoever” to his August opinion, because that opinion was “totally at odds with

[Dr. Iyer’s] medical opinion, a month earlier, performed without a re-examination by

said doctor and lacking any explanation for said conflicts in the medical findings a

month later.” The ALJ found that there was “no objective medical evidence” 8

supporting Dr. Iyer’s later opinion, and “no credible evidence that the claimant would

 Tr. 520. 6

 Tr. 521. 7

 Tr. 87 (alteration supplied). 8

6

Case 1:13-cv-01518-CLS Document 11 Filed 06/12/14 Page 6 of 8
miss work three days a month.” 

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The distinction between Dr. Iyer’s two assessments is significant, because the

vocational expert testified during the administrative hearing that an individual who

consistently missed three days of work every month would not be able to perform

claimant’s past work, or any other work existing in significant numbers in the

national economy. The problem is that there is no way, based on the current record,

10

to determine which one of Dr. Iyer’s inconsistent assessments to credit. The ALJ

credited the first assessment, which was consistent with his residual functional

capacity finding of the ability to perform a limited range of light work, and entirely

discredited the second assessment, which would support a finding of disability. The

ALJ’s reasons for doing so were that the second opinion was inconsistent with the

first opinion, that Dr. Iyer did not give any explanation for the conflicts in the two

opinions, and that Dr. Iyer did not re-evaluate claimant before issuing the second

pinion. All of those premises are factually correct, but the court disagrees with the

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ALJ that they are adequate reasons for an outright rejection of Dr. Iyer’s second

opinion, and total reliance on the first opinion, to support a finding of no disability. 

The other medical evidence of record does not clearly support either a finding of

Id. 9

 Tr. 125-26. 10

 Tr. 87. 11

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Case 1:13-cv-01518-CLS Document 11 Filed 06/12/14 Page 7 of 8
disability or non-disability. Thus, it was appropriate and necessary for the ALJ to

rely upon the opinion of a consultative examiner. But, because the consultative

physician’s opinion was internally inconsistent, it cannot constitute substantial

evidence to support the ALJ’s finding of no disability. Remand is warranted for the

ALJ to gather additional medical evidence to support his findings, whether by

recontacting Dr. Iyer to resolve the inconsistencies in his two previous opinions, or

by ordering an additional consultative examination, or by other means. 

In accordance with the foregoing, the decision of the Commissioner is

REVERSED, and this action is REMANDED to the Commissioner of the Social

Security Administration for further proceedings consistent with this memorandum

opinion and order. 

The Clerk is directed to close this file.

DONE this 12th day of June, 2014.

______________________________

United States District Judge

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