Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-1_10-cv-00967/USCOURTS-almd-1_10-cv-00967-0/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)

---

IN THE DISTRICT COURT OF THE UNITED STATES

FOR THE MIDDLE DISTRICT OF ALABAMA

SOUTHERN DIVISION

BELINDA MADDOX GUNTER, )

)

Plaintiff, )

)

v. ) CIVIL ACTION NO. 1:10CV967-SRW

) (WO)

MICHAEL J. ASTRUE, )

Commissioner of Social Security, )

)

Defendant. )

MEMORANDUM OF OPINION

Plaintiff Belinda Maddox Gunter brings this action pursuant to 42 U.S.C. § 405(g)

seeking judicial review of a decision by the Commissioner of Social Security

(“Commissioner”) denying her application for a period of disability and disability insurance

benefits under Title II of the Social Security Act. The parties have consented to entry of final

judgment by the Magistrate Judge, pursuant to 28 U.S.C. § 636(c). Upon review of the record

and briefssubmitted by the parties, the court concludes that the decision of the Commissioner

is due to be affirmed.

BACKGROUND

Plaintiff completed eighth grade in 1981; she began but did not finish ninth grade.

(R. 147). Plaintiff was not in special education classes, but she performed poorly in her

regular classes. She did, however, attain scores of 70 or above in academic courses of

science, math and social studies for one semester each during her seventh and eighth grade

years. (R. 9, 11, 137). Plaintiff testified that “they kept on passing [her] on” even though

Case 1:10-cv-00967-SRW Document 19 Filed 03/27/12 Page 1 of 22
there were things she could not do and that “[n]obody seemed to want to help.” (R. 11).

Plaintiff also testified that she is unable to read or write. (R. 11). She has worked as a short1

order cook and as a garment inspector, both semi-skilled jobs. (R. 34, 174).

Plaintiff filed the present application for disability insurance benefits on August 30,

2007, when she was forty-two years old, alleging that she became disabled on May 15, 2008,

due to “Ld/slow learner, nerves, [and] headaches.” (R. 113-20, 168). She reported that she

“had problems with remembering the instructions that were given to [her,] [f]ollowing those

instructions and learning to do the tasks [she] was required to know in order to hold down

a job.” (R. 168). She stated that she is not able to handle any job-related pressure or

responsibilities and that she is “very paranoid and just cannot cope with the day to day

activities required in a public environment.” (Id.).

After plaintiff’s claim was denied initially, she requested a hearing before an ALJ,

which was held on August 26, 2009. (R. 5-41, 61-70). The ALJ issued a decision on

2

October 8, 2009, concluding that plaintiff has severe impairments of “anxiety disorder and

The disability report completed in support of plaintiff’s application for benefits indicates 1

that she is able to “read and understand English” and to “write more than [her] name in English[.]”

(R. 167). It is not clear whether plaintiff or her husband provided this information to the DDS

interviewer. (See R. 140).

Plaintiff also filed an application for supplemental security income (see R. 121-24); the 2

decision on that claim is not before the court for review, as there is no final decision of the

Commissioner after a hearing on the Title XVI claim. See 42 U.S.C. § 405(g). The transcript before

the court does not include copies of the administrative action on the SSI claim. By notice dated June

29, 2009, the ALJ identified the issue before him as plaintiff’s entitlement to a period of disability

and disability insurance benefits (Exhibit 8B, R. 89-90, 94-95); his written decision indicates that

it pertains to plaintiff’s Title II application. (R. 47, 58). 

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depressive disorder and an inability to read and write from an undiagnosed cause[.]” (R. 49).

The ALJ determined that plaintiff’s impairments, considered in combination, did not meet

or medically equal a listing. (R. 51). He found that, as a result of her impairments, plaintiff

is limited to light work with no reading requirement, in a low-stress work environment with

few changes in the workplace and no more than occasional simple decision-making, only

occasional contact with the general public, and brief superficial contact with coworkers. (R.

53). The ALJ concluded that, while plaintiff’s RFC precluded performance of her past

relevant work, there are other jobs existing in significant numbers in the national economy

that plaintiff can perform and, therefore, that plaintiff was not disabled from her alleged

onset date through December 31, 2008, her date last insured. (R. 56-58). Plaintiff sought

review of the ALJ’s decision by the Appeals Council, which – after considering additional

evidence submitted by the plaintiff – denied review on September 22, 2010, leaving the

ALJ’s unfavorable decision as the final decision of the Commissioner. (R. 1-4). Plaintiff

commenced the present appeal on November 12, 2010. (Doc. # 1).

STANDARD OF REVIEW

The court’s review of the Commissioner’s decision is narrowly circumscribed. The

court does not reweigh the evidence or substitute its judgment for that of the Commissioner.

Rather, the court examines the administrative decision and scrutinizes the record as a whole

to determine whether substantial evidence supports the ALJ’s factual findings. Davis v.

Shalala, 985 F.2d 528, 531 (11th Cir. 1993); Cornelius v. Sullivan, 936 F.2d 1143, 1145

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(11th Cir. 1991). Substantial evidence consists of such “relevant evidence as a reasonable

person would accept as adequate to support a conclusion.” Cornelius, 936 F.2d at 1145.

Factual findings that are supported by substantial evidence must be upheld by the court. The

ALJ’s legal conclusions, however, are reviewed de novo because no presumption of validity

attaches to the ALJ’s determination of the proper legal standards to be applied. Davis, 985

F.2d at 531. If the court finds an error in the ALJ’s application of the law, or if the ALJ fails

to provide the court with sufficient reasoning for determining that the proper legal analysis

has been conducted, the ALJ’s decision must be reversed. Cornelius, 936 F.2d at 1145-46.

DISCUSSION

Plaintiff contends that the ALJ erred by failing to accept her IQ scores as valid and,

as a result, in concluding that her impairments did not satisfy Listing 12.05C. Plaintiff

further argues that the ALJ erred in assessing her credibility and in relying on vocational

expert testimony based on a hypothetical question that did not represent her limitations. She

contends that – since the ALJ concluded that plaintiff could not perform her past relevant

work as a garment inspector – he erred by finding that she could perform the job of

“inspector” identified by the vocational expert in response to the ALJ’s hypothetical

question. Finally, plaintiff maintains that the Appeals Council erred in declining to review

3

Plaintiff argues that, in his statement of the issues, “[t]he ALJ erred in basing his decision 3

on the ‘hypothetical’ opinion of vocational expert, Joe Mann that there are a significant number of

jobs existing in the national economy that the claimant could perform, while also holding that she

could NOT perform them.” (Doc. # 13, p. 6). In the argument portion of her brief, plaintiff points

more specifically to the ALJ’s findings at steps four and five of the sequential analysis regarding the

job of “inspector.” (Id., pp. 12-13). 

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the ALJ’s decision, in light of the additional evidence submitted to the Appeals Council.

Listing 12.05C

For a claimant to be found disabled under Listing 12.05, she must have “significantly

subaverage general intellectual functioning with deficits in adaptive functioning initially

manifested during the developmental period,” and, in addition, meet one of the four

requirements described in subparagraphs A through D. See Listing 12.00A. Listing 12.05C

requires “a valid verbal, performance, or full scale IQ of 60 through 70 and a physical or

other mental impairment imposing an additional and significant work-related limitation of

function.” The standard for an “additional and significant” limitation is the same as for a

“severe” impairment under 20 C.F.R. 404.1520(c) or 416.920(c).

4

Plaintiff submitted evidence to the ALJ that when she was tested by psychometrist

Jamie Abshire on February 15, 2008, her WAIS-III scores resulted in a verbal IQ of 62, a

performance IQ of 69 and a Full Scale IQ of 62 – scores that fall within the range of mild

mental retardation. (Exhibit 10F). If these IQ scores were accepted as a valid indication of

Under earlier versions of the regulation as interpreted by the Eleventh Circuit, the 4

“additional and significant” standard was lower than the “severe” standard. See Edwards v. Heckler,

755 F.2d 1513, 1515-16 (11th Cir. 1985); see also Davis v. Shalala, 985 F.2d 528, 531-32 (11th Cir.

1993). However, the Commissioner modified the introductoryparagraph 12.00A and Listing 12.05C

to clarify that the additional physical or mental impairment must be “severe.” See 65 Fed. Reg.

50,746 at 50,754 (Aug. 21, 2000)(“In final listing 12.05C ... we used the word ‘an’ before the word

‘additional’ to clarify that the additional impairment must be ‘severe’ in order to establish ‘an

additional and significant work-related limitation of function.”); id. at 50772 (“We have always

intended the phrase [significant work-related limitation of function] to mean that the other

impairment is a ‘severe’ impairment, as defined in §§ 404.1520(c) and 416.920(c)... . Therefore, ... 

we revised the fourth paragraph of final 12.00A, which explains how we assess the functional

limitations of an additional impairment under listing 12.05C.”).

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plaintiff’s intellectual ability, plaintiff would be entitled to a finding of disability under

Listing 12.05C, because the ALJfound thatshe has othersevere impairments. However, even

“[a] valid IQ score is not conclusive of mental retardation when the IQ score is inconsistent

with other evidence in the record about claimant’s daily activities.” Outlaw v. Barnhart, 197

Fed. Appx. 825, 827 (11th Cir. 2006)(citing Popp v. Heckler, 779 F.2d 1497, 1499 (11th Cir.

1986)). While the ALJ need not accept the IQ scores as conclusive, he is required to consider

the IQ testing results in conjunction with other evidence of record, including medical

evidence and the claimant’s daily activities, in determining whether the claimantsuffersfrom

mental retardation. Popp, 779 F.2d at 1500.

In this case, the ALJ found that the IQ scores were not valid (R. 51), stating a number

of reasons for his conclusion that they were not indicative of plaintiff’s actual level of mental

functioning (R. 50-51). Some of his reasons, as plaintiff argues, do not have merit (e.g., the

fact that plaintiff maintains an intimate relationship with her husband, a police officer who

does not suffer from retardation). However, the ALJ also identified valid evidence weighing

against a finding of mental retardation. The ALJ noted that while plaintiff performed poorly

in school, she was not in special education and she occasionally attained grades greater than

70 in academic courses. (R. 50-51). This is supported by plaintiff’s education record from

junior high school. (R. 137). The ALJ also pointed to plaintiff’s work history, noting that

5

Plaintiff argues that there is no evidence of record regarding whether she was in special

5

education. (Doc. # 13, p. 1). However, plaintiff’s school transcript does not affirmatively indicate

that she was in special education classes. Further, the report of plaintiff’s consultative psychological

examination states that she “attended regular classes, but states she never knew anything and was

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she “succeeded at a number of jobs that were lost for reasons other than an inability to

understand and perform the requirements of the job[.]” (R. 50).

Plaintiff notes that the ALJ “never discussed ‘success’ in any job with her, or the

other factors involved in her work environment[,]” pointing out that, at her job at Pizza Hut,

plaintiff had the support of all of her sisters. (Doc. # 13, p. 8). Significantly, however, the

record demonstrates that plaintiff worked in the semi-skilled position of garment inspector

for three and a half years (R. 34, 174), and that she left her most recent garment inspector job

because the factory closed (R. 18). Plaintiff held a number of jobs as a cook – also semiskilled work (R. 34, 174) – other than at Pizza Hut. She testified that she quit her job as a

cook at a grocery store after about six months because, on the day after she called in sick on

one occasion, her supervisor “jumped all over [her] and it hurt [her] feelings[.]” (R. 13-14).

She testified that she left her job as a cook at a nursing home after about four months because

she “was the only white person there that worked in the kitchen and they treated [her]

terribly.” (R. 14-15). Thus, the record supports the ALJ’s conclusion that plaintiff

“succeeded” in these jobs to the extent that she was able to perform the requirements of the

positions, and left for reasons other than her inability to understand or perform those

requirements.

The ALJ further observed that plaintiff manages a home and drives a car. (R. 50).

Plaintiff reported that her son and husband depend on her “to wash their clothes, clean the

socially promoted.” (R. 242). The ALJ’s conclusion that plaintiff attended regular classes and

attained scores above 70 on occasion is supported by the record. 

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house and cook for them[,]” that she can mow the grass, and that her condition does not limit

her in cooking and preparing meals or performing household chores. (R. 142-44). Although

plaintiff prefers to have her mother or husband accompany her to the grocery store because

she does not “do math very well,” plaintiff’s husband reported that plaintiff shops in stores

for food, clothing and household items. (R. 144, 152). Plaintiff is also able to drive a car.

(R. 145, 152). The ALJ further relied on evidence that, in all of plaintiff’s “other doctor

visits, no doctor has noted that she appears to have mental retardation. (R. 50). This

observation is supported by the medical record, including the record of plaintiff’s treatment

at South Central Alabama Mental Health. (See Exhibits 1F, 4F, 5F, 6F, 11F; see also

Exhibits 12F, 13F, 14F (SCAMH records describing plaintiff as “poorly educated” and

“illiterate” (R. 310) but making no diagnosis of or reference to mental retardation or

intellectual deficit); R. 308 (August 2008 SCAMH intake evaluation assessing mental illness

and indicating that there is no “dual diagnosis” of mental illness and mental retardation); R.

391, 399 (no mental retardation assessed in August 2009 SCAMH annual update)).

Accordingly, the court concludes that the evidence outlined above is sufficient to

support the ALJ’s determination that plaintiff does not satisfy the requirements of Listing

12.05C and, further, that this determination is supported by substantial evidence of record.

See Outlaw, 197 Fed. Appx. at 827, 827 n. 1 (plaintiff’s adult IQ scores were “not consistent

with his daily activities” in view of plaintiff’s history of employment in semi-skilled

positions; plaintiff “had worked for several years as an adult as a van driver, a security

8

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guard, and in the shipping and receiving department at a pecan plant”).

The Credibility Assessment and the Vocational Expert’s Testimony

In the Eleventh Circuit, a claimant’s assertion of disability through testimony of pain

or other subjective symptoms is evaluated pursuant to a three-part standard. “The pain

standard requires ‘(1) evidence of an underlying medical condition and either (2) objective

medical evidence that confirms the severity of the alleged pain arising from that condition

or (3) that the objectively determined medical condition is of such a severity that it can be

reasonably expected to give rise to the alleged pain.’” Dyer v. Barnhart, 395 F.3d 1206, 1210

(11th Cir. 2005)(quoting Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991)). If this

standard is met, the ALJ must consider the testimony regarding the claimant’s subjective

symptoms. Marbury v. Sullivan, 957 F.2d 837, 839 (11th Cir. 1992). Although the ALJ is

required to consider the testimony, the ALJ is not required to accept the testimony as true;

the ALJ may reject the claimant’s subjective complaints. However, if the testimony is

critical, the ALJ must articulate specific reasons for rejecting the testimony. Id. “The

6

 See also Social Security Ruling 96-7p, 61 Fed. Reg. 34483-01 (July 2, 1996): 6

When evaluating the credibility of an individual’s statements, the adjudicator must

consider the entire case record and give specific reasons for the weight given to the

individual’s statements. The finding on the credibility of the individual’s statements

cannot be based on an intangible or intuitive notion about an individual’s credibility. 

The reasons for the credibility finding must be grounded in the evidence and

articulated in the determination or decision. It is not sufficient to make a conclusory

statement that “the individual’s allegations have been considered” or that “the

allegations are (or are not) credible.” It is also not enough for the adjudicatorsimply

to recite the factors that are described in the regulations for evaluating symptoms. 

The determination or decision must contain specific reasons for the finding on

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credibility determination does not need to cite particular phrases or formulations but it cannot

merely be a broad rejection which is not enough to enable [the court] to conclude that [the

ALJ] considered [the claimant’s] medical condition as a whole.” Dyer, supra, 395 F.3d at

1210 (citations and internal quotation marks omitted).

At the administrative hearing, plaintiff testified that she takes Lexapro and Xanax.

In response to the ALJ’s question about how well the medications controlled her symptoms,

plaintiff responded, “Well when it comes up bad weather nothing does. And if somebody

makes me mad or, it doesn’t do any good either.” (R. 19). She testified, “When it rains I’m

scared. I have to go somewhere to feel safe. I have to be with somebody and out of my trailer

to feel safe.” The ALJ asked plaintiff whether she felt safe inside the various shops or

buildings where she worked during bad weather; plaintiff responded, “No, sometimes I

would leave there because I wouldn’t feel safe there and I would go somewhere like to my

sister[’]s or down to my sister’s law office to feel safe.” (R. 19-20). In response to

questioning by her attorney, plaintiff testified that she does not like the dark and does not

drive in the dark. She stated that her husband drove her to the hearing and she rode in a

reclined position, with a pillow over her face, because she is “just concerned about having

a wreck.” (R. 22). She does not attend her son’s medical appointments in Birmingham

because she “can’t get in the car to go” and is afraid that “something is gonna happen.” (R.

credibility, supported by the evidence in the case record, and must be sufficiently

specific to make clear to the individual and to any subsequent reviewers the weight

the adjudicator gave to the individual’s statements and the reasons for that weight.

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22).

In response to her attorney’s question about whether she “drives a car sometimes

around town,” plaintiff responded that she does so when the weather is bad, and she goes to

her sister’s house and stays there. Sometimes, she goes to her mother’s house. (R. 21). She

testified that she hears “voices in [her] head” and that the voice tells her “if I just go ahead

and kill my son and kill myself then I won’t have to worry about it.” She hears the voice

“[e]very day.” (R. 23). She stated that she also “sees things” that are not there “[e]very day

of [her] life.” Sometimes she sees things on the ceiling at night. (R. 24). Sometimes, when

7

she is under stress, she shakes and cries and sometimes says that she wants to kill herself.

She has problems remembering things and does not “even want to get out of the bed.” Her

situation has grown worse over the years. She suffered sexual abuse and some physical abuse

as a child and as a young adult; for some time, she could not remember those events. She

testified that “I always wanted to just forget about what happened back then but it seems like

it’s coming back.” (R. 25-26). She does not stay at home by herself and usually goes to her

sister’s home. She testified that she would not be able to drive herself to work and that, if

her husband drove her to work, he would have to come get her if it stormed or if they “put

[her] under pressure to get on the phone or take an order.” (R. 27). She does not socialize

with friends. (R. 27-28).

Plaintiff later clarified that she has had the visual hallucinations for about three or four 7

years and has heard voices in her head for about five years but that these have been getting worse.

(R. 28-29). 

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Plaintiff contends that the ALJ erred in failing to find her testimony regarding her

symptoms to be “entirely credible,” in view of the record as a whole. (Doc. # 13, pp. 10-12).

The ALJ found that the evidence satisfied the requirements of the pain standard – i.e., “that

the claimant’s medically determinable impairments could reasonably be expected to cause

the alleged symptoms[.]” (R. 54). However, the ALJ concluded that plaintiff’s allegations

regarding “the intensity, persistence, and limiting effects” of her symptoms were not fully

credible. (Id.). The ALJ credited plaintiff’stestimony of anxiety, panic attacks and depression

to a large extent, finding that she “can only occasionally have contact with the general public

and brief superficial contact with co-workers” and that she requires “a low stress work

environment with few changes in the workplace and no more than occasional simple

decision-making.” (R. 53). However, he found that her symptoms are not as severe as

alleged, stating a number of reasons for this conclusion. (R. 54-55).

The ALJ observed that – except for a single instance in February 2005 – the record

8

contains no mental illness diagnosis until August 2008. He concluded that plaintiff’s failure

to seek mental health treatment until August 7, 2008 – two years after her alleged onset date

– “suggests that the claimant’s mental illness was not so severe as to require her to seek

On February 4, 2005, plaintiff sought treatment at the emergency room for chest pain and

8

dizziness, and she was admitted overnight for evaluation after she “deferred referral to

cardiology.” (R. 212-21). In a February 7, 2005, visit to her physician at Enterprise Medical

Clinic, she complained of shortness of breath, chest pain, palpitations, and left arm pain.

After reviewing the hospital records, her doctor diagnosed anxiety with panic attacks and

prescribed Effexor and Xanax. (R. 234).

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treatment until that date.” (R. 54, 55; see Exhibits 4F, 11F, 12F). The ALJ also observed

that treatment notes for plaintiff’s office visits to Enterprise Medical Clinic in 2007 and 2008

for other medical problems include no indication of psychological symptoms and, on a

couple of these visits, expressly indicate no abnormalities as to the psychological portion of

the examination. (R. 55; R. 228-29, 282-83, 288). The ALJ further noted that – again, with

the exception of the February 2005 ER visit – plaintiff did not seek treatment at an

emergency room or require inpatient treatment for psychological symptoms. (Id.). He also

reasoned, with regard to plaintiff’s allegations of persistent daily auditory hallucinations

telling her to kill herself and her child, that plaintiff’s treatment records do not indicate that

her doctors modified her medication regimen in an attempt to overcome such hallucinations.

(R. 55; see Exhibits 12F-14F).

9

Plaintiff testified that she sees a mental health counselor and gets prescriptions from the 9

doctor. She stated that the doctor increased her Lexapro to two pills a day “about four months or

[maybe] longer” before the hearing but that, while it calms her nerves, it did not stop the

hallucinations. She further testified that her doctor had not changed the dosage of her other

medications or tried her on different medications for short periods of time. Plaintiff stated that when

she told her mental health provider about hearing voices telling her to kill herself and her son, “[t]hey

just tell [her] not to do it.” (R. 29-30). Her treatment records from South Central Alabama Mental

Health indicate that plaintiff reported hallucinations on initial intake in August 2008 (R. 311, 326). 

In plaintiff’s monthly counseling sessions from intake through July 2009, however, her counselor

marked “N/A” in the section of the treatment note for recording thought or perceptional disturbances,

including hallucinations (R. 303, 304, 325, 334, 335) for most visits and made no annotation at all

in that section on one occasion. (R. 333). On January 29, 2009 – a month after plaintiff’s date last

insured – the SCAMH staff psychiatrist evaluated the plaintiff and indicated that plaintiff’s thought

content was “Normal,” making no annotation in the space for “Hallucinations.” (R. 329). She noted

plaintiff’s depressed mood and wrote, “Pt has negative thoughts about herself. Feels depressed and

sometimes suicidal.” (Id.). In a treatment note for August 3, 2009, submitted to the Appeals Council

but not to the ALJ, plaintiff’s counselor noted “Hallucinations” and “Paranoid.” (R. 415). However,

no hallucinations were noted in mental status evaluations in September, October or November 2009. 

(R. 354 (“N/A”), 355 (suicidal thoughts), and 356 (slightly paranoid)).

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As to plaintiff’s alleged limitations in driving, the ALJ observed that plaintiff did not

indicate that she had lost any job because she could not drive to it and, also, that she drives

herself to the homes of family members even when the weather is adverse, and also drives

to the store. (R. 55; see R. 21 (plaintiff’s testimony that she drives to her sister’s house when

the weather is bad); see also R.141, 144,152,162, 141 (plaintiff she is “very afraid to drive

in rain or the dark” but goes to the grocery store and, because of her “poor reading and

writing,” tries to get her husband or mother to go with her when they are able). As noted

above, the ALJ credited plaintiff’s testimony to a large extent, including significant

limitations in her RFC. The reasons articulated by the ALJ are adequate to support his

decision not to credit plaintiff’s allegations regarding her symptoms fully. Those reasons are

supported by substantial evidence of record and, accordingly, the ALJ did not commit

reversible error in assessing plaintiff’s credibility.

Plaintiff also contends that the VE’s testimony assumes “no absenteeism,” an

attendance rate that plaintiff cannot attain, in view of her impairments. She points to the

VE’s testimony that a person who must leave work three times a month due to panic attacks

cannot maintain competitive employment. (Doc. # 13, p. 12). She argues that she cannot

“maintain an absentee rate below three absences per month. much less of zero” and,

therefore, that the hypothetical question to the vocational expert does not describe her

limitations. (Id.).

However, the court does not read the VE’s testimony to be that a hypothetical

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Case 1:10-cv-00967-SRW Document 19 Filed 03/27/12 Page 14 of 22
individual with the limitations identified by the ALJ can maintain employment only if there

is “no absenteeism” whatsoever. (See R. 34-39). Additionally, as noted above, the ALJ did

not credit plaintiff’s testimony fully as to her symptoms. As the Commissioner argues, the

ALJ need include in his hypothetical only those limitations that he finds are supported by the

record. See Forester v. Commissioner of Social Security, 2012 WL 45446, *3 (11th Cir. Jan.

10, 2012)(“The ALJ is not required to include findings in the hypothetical that the ALJ has

found to be unsupported.”)(unpublished opinion)(citing Crawford v. Commissioner of Social

Security, 363 F.3d 1155, 1162 (11th Cir. 2004). Because he did not credit plaintiff’s

testimony fully regarding her driving and her panic attacks, the ALJ was not required to

include all of the limitations plaintiff alleged in the hypothetical he posed to the vocational

expert.

Plaintiff’s past relevant work includes the job of garment inspector; plaintiff’s work

history report indicates that she performed this job for several years, from January of 1994

through June of 1997. (R. 174, 176; see also R. 17-19). The vocational expert testified at

the hearing that the job of “[g]arment inspector is light and is also semi-skilled having an

SVP of 3.” (R. 34). As plaintiff argues, the ALJ determined that plaintiff cannot perform her

past relevant work. The ALJ found that plaintiff is limited to occasional simple decisionmaking, with few changes in the workplace and no reading. (R. 53). He reasoned that,

“[s]ince the past relevant work is at the semi-skilled level, the claimant does not retain the

ability to return to the work without training” and, accordingly, that the demands of

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plaintiff’s past relevant work exceed her residual functional capacity. (R. 56). At the hearing,

the vocational expert testified that – while plaintiff’s past work was at a semi-skilled level

– “[t]here are a variety of light, unskilled inspecting positions. One example is DOT code

712.684-050. I’ve estimated in Alabama approximately 800 light, unskilled inspecting

positions and there are more than 10,000 in the national economy.” (R. 35). The VE further

testified that these jobs would not be precluded by limitations to only occasional contact with

the general public and a low-stress environment with few changes in the work place and only

occasional simple decision-making. (R. 36). The ALJ relied on this testimony – along with

the VE’s testimony regarding other unskilled jobs – in his step 5 analysis. Contrary to

plaintiff’s argument, there is no inconsistency in the ALJ’s conclusion that, while plaintiff

can no longer perform the requirements of her past relevant semi-skilled work as a garment

inspector, she remains capable of performing inspector jobs at the unskilled level.

The Appeals Council’s Consideration of New Evidence

After the ALJ rendered his decision, plaintiff submitted additional evidence to the

Appeals Council. (See Exhibits 21F, 22F and 28F). Plaintiff asserts that the Appeals

10

Council wrongly denied review. The Appeals Council “may deny review if, even in the light

of the new evidence, it finds no error in the opinion of the ALJ.” Pritchett v. Commissioner,

The Appeals Council noted that it considered, in addition to a letter from plaintiff’s 10

counsel, Exhibits 21F, 22F and 28F. (R. 4). A number of additional exhibits that were not before

the ALJ, designated 15F through 20F and 23F through 27F, are included in the administrative

transcript; those exhibits are duplicates of records contained within Exhibit 28F. Exhibits 21F and

22F are also duplicates of records included within Exhibit 28F. 

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Social Security Administration, 315 Fed. Appx. 806, 814 (11th Cir. 2009)(unpublished

opinion)(citing Ingram, 496 F.3d at 1262). Plaintiff submitted records of her additional

treatment at SCAMH during the period from August 2009 through November 2009,

including documentation of plaintiff’s annual update evaluation in August 2009, a year after

she began treatment with SCAMH. (Exhibit R. 354-59; 377-405). The additional evidence

also includes an undated medical source opinion signed by plaintiff’s counselor at SCAMH

and also by Sharon Brown, Ph.D., “Consultant Clinical Psychologist,” indicating that

plaintiff has marked or extreme limitations in all rated mental functions. (R. 361-63). The

11

Appeals Council concluded that the new evidence submitted by plaintiff “did not provide a

basis for changing the Administrative Law Judge’s decision.” (R. 2).

The additional medical records include an August 3, 2009, form completed by

plaintiff for her annual update evaluation, identifying her symptoms. As in her initial intake

evaluation, plaintiff reported hallucinations. (R. 379). Plaintiff checked boxesindicating that

she experiences all but sixteen of the 63 “functional deficits” listed on the form. (R. 380-81).

Although she was the clinic director and reviewed and approved plaintiff’s

11

counselor’s intake and annual update assessments and treatment plans, there is no indication

in the record that Dr. Brown ever personally evaluated the plaintiff at any time. See Exhibits

12F, 13F, 14F and 28F. Thus, she is not plaintiff’s treating psychologist. See 20 C.F.R.

§ 404.1502 (“Treating source means your own physician, psychologist, or other acceptable

medical source who provides you, or has provided you, with medical treatment or evaluation

and who has, or has had, an ongoing treatment relationship with you. Generally, we will

consider that you have an ongoing treatment relationship with an acceptable medical source

when the medical evidence establishes that you see, or have seen, the source with a frequency

consistent with accepted medical practice for the type of treatment and/or evaluation required

for your medical condition(s).”)(italics in original).

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As the Commissioner argues and as discussed above, however, the ALJ found plaintiff’s

testimony regarding her symptoms to be less than fully credible.

Plaintiff’s counselor’s notes for the monthly sessions include his handwritten

summary of plaintiff’s reports of her symptoms and a mental status examination. In the

treatment notes provided to the ALJ for the period from August 2008 to July 2009, and in

those provided to the Appeals Council for the period from August 2009 to November 2009,

the counselor’s mental status evaluations always reflect that plaintiff’s mood is anxious, her

orientation normal and her appearance and affect appropriate. (R. 303-04, 325-26, 328, 333-

35, 336). Plaintiff’s sleep was reportedly fair from August through October 2008 and, in

November, she reported hypersomnia. (R. 303-04, 325-26). Beginning in March 2009 – two

months after her date last insured – plaintiff consistently reported her sleep as poor. (R. 328,

333-35, 354-56, 358-59). In the records before the ALJ, the counselor noted “thought or

perceptional disturbances” only once; he recorded plaintiff’s reported hallucinations at the

intake appointment. (R. 326). In the treatment notes submitted to the Appeals Council, the

counselor noted “thought or perceptional disturbances” of hallucinations and paranoia at

plaintiff’s annual update appointment in August 2009 (R. 359), slight paranoia in September

2009 (R. 356), and suicidal thoughts in October 2009 (R. 355). The counselor did not always

assign GAF scores. However, those he did assign generally reflect his impression that

plaintiff’s level of functioning deteriorated, with plaintiff’s scores remaining in the low 40s

until March of 2009, dropping to 38 in May of 2009, to 34 in August of 2009, and to 20 in

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October of 2009 (R. 303-04, 325-26, 328, 335, 355). The mentalstatus evaluation conducted

closest in time to plaintiff’s date last insured occurred on January 29, 2009, a month after

plaintiff’s date last insured. On that date, plaintiff was evaluated by the SCAMH staff

psychiatrist. The psychiatrist’s “Interview Notes” state, “Pt has negative thoughts about

herself. Feels depressed and sometimes suicidal.” In her evaluation of plaintiff’s current

mental status, the psychiatrist noted no abnormalities other than a depressed mood. For

“Suicidal Estimate” – which allowed responses of ideation, threats, or attempts – the doctor

marked “None Evident.” (R. 329).

Upon careful review of the additional treatment records, the court concludes that they

reflect a deterioration in plaintiff’s mental status occurring after her date last insured.

However, the records provide no additional insight into plaintiff’s mental condition before

her date last insured, and do not demonstrate that the ALJ erred in assessing plaintiff’s

functional capabilities during the relevant time period. Cf. Mackay v. Astrue, 2011 WL

6753848, 13 n. 8 (N.D. Ill. 2011)(“The Seventh Circuit has recognized that worsening of a

claimant’s condition after the date last insured does not provide a basis for granting benefits

during the relevant time period.”).

12

In the mental source opinion form plaintiff provided to the Appeals Council,

counselor Walker and Dr. Brown assert that plaintiff has marked and extreme limitations in

For some progressive diseases, post-DLI evidence may very well provide a basis for 12

reaching a conclusion about the claimant’s condition before the date last insured. This is not such

a case.

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her ability to understand, remember and carry out instructions due to her history of

depression, extreme anxiety and panic attacks and because she is illiterate and has limited

coping skills. (R. 361). They indicate that she has marked and extreme limitations in her

ability to interact appropriately with supervisors, co-workers and the public, citing her history

of “depression, anxieties and panic attacks to the point she can not sustain employment[.]”

They observe that she is poorly educated and illiterate. (R. 362). When asked to “[i]dentify

the factors (e.g., the particular medical signs, laboratory findings or other factors described

above)” that support their assessment, they respond “factors are longstanding – chronic

13

depression, anxieties – panic attacks[.]” In item 4, the form states, “The limitations above

are assumed to be your opinion regarding current limitations only. However, if you have

sufficient information to form an opinion within a reasonable degree of medical or

psychological probability asto past limitations, on what date were the limitations you[] found

above first present?” Walker and Brown responded, “Abuse by Brother at age of 6 – Severe

abuse by 1st Husband.” (R. 362). They express their opinion that plaintiff cannot manage

her own benefits. (R. 363).

The opinions expressed by counselor Walker and Dr. Brown regarding plaintiff’s

inability to sustain employment are, as the Commissioner argues, opinions on an issue

reserved to the Commissioner, rather than medical opinions that the Commissioner must

The form instructs the medical source that the opinion “should be based on your findings

13

with respect to medical history, clinical and laboratory findings, diagnosis, prescribed treatment and

response, and prognosis.” (R. 361).

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consider. See 20 C.F.R. § 404.1527(e)(1). Walker and Brown provide little rationale for the

marked and extreme functional limitations set forth in the form, for the most part citing only

plaintiff’s diagnoses as the “factors” supporting their opinion. Although they identify these

“factors” – i.e., chronic depression, anxiety and panic attacks – as “longstanding,” they do

not offer any opinion regarding the date on which the limitations they identified first existed.

Their response to the question seeking this opinion – that plaintiff was abused by her brother

at the age of six and by her first husband – cannot fairly be read to indicate that the extreme

limitations existed at age six or during plaintiff’s first marriage; it is simply non-responsive

to the query. As noted above, the additional treatment records reflect a decline in plaintiff’s

mental status after her date last insured. The undated form was submitted to the Appeals

Council on December 7, 2009 (see R. 375); there is no indication that the opinions expressed

on the form relate to the period before plaintiff’s date last insured.

Upon its review of the record as a whole, the court concludes that the evidence of

plaintiff’s continued treatment by SCAMH and the medical source opinion do not render the

Commissioner’s decision denying benefits erroneous. Accordingly, the Appeals Council did

not err by denying review.

CONCLUSION

Upon consideration of the administrative record, and plaintiff’s allegations of

reversible error, the court concludes that the decision of the Commissioner is due to be

AFFIRMED. A separate judgment will be entered.

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DONE, this 27 day of March, 2012.

th

/s/ Susan Russ Walker

SUSAN RUSS WALKER

CHIEF UNITED STATES MAGISTRATE JUDGE

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