Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_16-cv-00323/USCOURTS-almd-2_16-cv-00323-0/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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IN THE DISTRICT COURT OF THE UNITED STATES

FOR THE MIDDLE DISTRICT OF ALABAMA

NORTHERN DIVISION

ELMER KITTRELL )

)

Plaintiff, )

)

v. ) CASE NO. 2:16-cv-323-TFM

) [wo]

NANCY A. BERRYHILL,

1 )

Acting Commissioner of Social Security, )

)

Defendant. )

MEMORANDUM OPINION AND ORDER

I. PROCEDURAL HISTORY

Plaintiff Elmer Kittrell filed for an application for disability insurance benefits on March 

14, 2013, alleging disability beginning March 5, 2013. Mr. Kittrell’s application was denied at 

the initial administration level, and his request for a hearing before an Administrative Law Judge 

(“ALJ”) was granted. Following the hearing, the ALJ concluded that the plaintiff was not under a 

“disability” as defined in the Social Security Act and denied the plaintiff’s claim for benefits. 

The Appeals Council rejected a subsequent request for review on March 3, 2016, consequently 

the ALJ’s decision became the final decision of the Commissioner of Social Security

(“Commissioner”).2 See Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). The case is now 

before the court for review pursuant to 42 U.S.C. §§ 405(g), and 28 U.S.C. § 636(c). Based on 

 1 Nancy A. Berryhill is now the Acting Commissioner of Social Security. Pursuant to Rule 25(d) of the 

Federal Rules of Civil Procedure, Nancy A. Berryhill should be substituted for Acting Commissioner 

Carolyn W. Colvin as the defendant in this suit. No further action needs to be taken to continue this suit 

by reason of the last sentence of section 205(g) of the Social Security Act, 42 U.S.C. § 405(g).

2 Pursuant to the Social Security Independence and Program Improvements Act of 1994, Pub. L. No. 103-

296, 108 Stat. 1464, the functions of the Secretary of Health and Human Services with respect to Social 

Security matters were transferred to the Commissioner of Social Security.

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the court’s review of the record in this case, the parties’ briefs (Docs. 12-13), and the relevant 

law, the court concludes that the Commissioner’s decision is AFFIRMED.

II. STANDARD OF REVIEW

Under 42 U.S.C. § 423(d)(1)(A), a person is entitled to disability when the person is 

unable to 

Engage in any substantial gainful activity by reason of any medically 

determinable physical or mental impairment which can be expected to result in 

death or which has lasted or can be expected to last for a continuous period of not 

less than 12 months...

To make this determination,3 the Commissioner employs a five-step, sequential

evaluation process. 

(1) Is the person presently unemployed?

(2) Is the person’s impairment severe?

(3) Does the person’s impairment meet or equal one of the specific impairments set forth 

in 20 C.F.R. Pt. 404, Subpt. P, App. 1?

(4) Is the person unable to perform his or her former occupation?

(5) Is the person unable to perform any other work within the economy?

See 20 C.F.R. § 404.1520.

An affirmative answer to any of the above questions leads either to the next question, or, 

on steps three and five, to the finding of a disability. A negative answer to any question, other 

than step three, leads to a determination of “not disabled.” 20 C.F.R. § 416.920(a)-(f); McDaniel 

v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986).4 This five-step analysis is a fair and just way 

for determining disability applications to conform to the Social Security Act. See Bowen v. 

Yuckert, 482 U.S. 137, 153 (1987)(citing Heckler v. Campbell, 461 U.S. 458, 461 (1983)) (The 

 3

 A “physical or mental impairment” is one resulting from anatomical, physiological, or psychological 

abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic 

techniques. 

4 McDaniel v. Bowen, 800 F.2d 1026 (11th Cir. 1986) is a supplemental security income case (SSI). The 

same sequence applies to disability insurance benefits. Cases arising under Title II are appropriately cited 

as authority in Title XVI cases. See e.g. Ware v. Schweiker, 651 F.2d 408 (5th Cir. 1981)(Unit A). 

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use of the sequential evaluation process “contribute[s] to the uniformity and efficiency of 

disability determinations”). 

The burden of proof rests on the claimant for steps 1-4. On the fifth step, the burden 

shifts to the ALJ, who must show that there are significant jobs in the economy that claimant can 

perform. See Ostborg v. Comm’r of Soc. Sec., 610 Fed. Appx. 907, 915 (11th Cir. 2015); 

McDaniel 800 F.2d at 1030. The ALJ must determine the claimant’s Residual Functioning 

Capacity (“RFC”) for steps four and five. 20 C.F.R. § 404.1520(a)(4). The claimant’s RFC is 

what he can still do in spite of his physical or mental impairment(s) based on all medical 

evidence. Phillips v. Barnhart 357 F.3d 1232, 1239 (11th Cir. 2004). For the fifth step, the ALJ 

relies on a vocational expert (VE) to determine if there are jobs in the national and local 

economy that claimant can perform considering the claimant’s RFC, age, education, and 

previous work experience. Id. At 1239-40. A vocational expert is an expert on what kinds of jobs 

individuals can perform with regard to his capacity and impairment(s). Id. The ALJ must pose a 

hypothetical scenario which includes all of the claimant’s impairment(s), to the VE for testimony 

to be considered substantial evidence. Jones v. Apfel, 190 F.3d 1224, 1229 (11th Cir. 1999) 

(citing McSwain v. Bowen, 814 F.2d 617, 619-20 (11th Cir. 1987)).

The standard of review of the Commissioner’s decision is a limited one. This court must 

find the Commissioner’s decision conclusive if it is supported by substantial evidence. 42 U.S.C. 

§405(g). “Substantial evidence is more than a scintilla and is such relevant evidence as a 

reasonable person would accept as adequate to support a conclusion.” Winschel v. Comm’r of 

Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011) (quoting Crawford v. Comm’r of Soc. Sec., 363 

F.3d 1155, 1158 (11th Cir. 2004)).

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III. BACKGROUND

A. The Commissioner’s Decision

The plaintiff was 43 years old which is defined as a younger individual age 18-44, on the 

alleged disability onset date, has a limited education, and is able to communicate in English (R. 

21-22). He has prior work history as a mechanic, where he repaired machines. (R. 14). The 

plaintiff alleges he became disabled on March 5, 2013, due to fibromyalgia and obesity. (R. 13). 

After the hearing, the ALJ found that Kittrell suffers from severe impairments of fibromyalgia 

and obesity. (R. 13). The ALJ determined that the claimant has the (RFC) to perform sedentary 

work as defined in 20 CFR § 404.1567(a). (R. 14). 

To make this determination, the ALJ must follow a two-step process. (R. 14). The first 

step is to determine whether there is an underlying medically determinable physical or mental 

impairment(s)—i.e. impairment(s) that can be determined by medically acceptable diagnostic 

techniques—that could be reasonably expected to cause claimant’s pain or other symptoms. (R. 

14). The second step is to evaluate whether the underlying physical or mental impairment(s) 

limit the claimant’s functioning due to the intensity, or persistence of the claimant’s symptoms. 

(R. 14). 

Here, the ALJ looked at the entirety of the medical records and the claimant’s reports to 

make her determination. The ALJ found that Kittrell is not able to perform his past relevant work 

as a mechanic based on limitations as prescribed by his treating physician. (R. 21). In 

determining whether the underlying physical or mental impairment(s) limited the claimant’s 

functioning, the ALJ relied on the expertise of a vocational expert (VE)5 by providing a series of 

hypotheticals to determine if the claimant could find work with limitations as prescribed. (R. 61-

65). A person with the same vocational profile as the claimant, with the capacity to perform light 

 5 Joshua S. Tilton, Ph.D., C.R.C., L.R.C.

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work activity, with the following limitations; sit/stand intervals every 60 minutes, no climbing, 

and no more than occasional overhead reaching, etc. would be limited to unskilled work activity 

due to the side effects of pain and medication. With this hypothetical in mind, VE was able to 

determine three examples of unskilled work activity the claimant could do with those limitations. 

(R. 61-62). 

(1) Storage facility rental clerk

a. Nationally there are approximately 416,000 jobs.

b. In Alabama there are approximately 8,700 jobs.

(2) Cashier

a. Nationally there are approximately 3,400,000 jobs.

b. In Alabama there are approximately 66,000 jobs. 

(3) Self-service store attendant

a. Nationally there are approximately 4,200,000 jobs.

b. In Alabama there are approximately 57,000 jobs.

The second hypothetical given, with the claimant’s vocational profile, limited to 

sedentary work activity; no climbing, occasional overhead reaching, etc. and limited to unskilled 

work, the VE was able to determine three examples of work the claimant could with those 

limitations. (R. 63).

(1) Food and beverage order clerk

a. Nationally there are approximately 227,000 jobs. 

b. In Alabama there are approximately 2,700 jobs. 

(2) Charge account clerk

a. Nationally there are approximately 215,000 jobs. 

b. In Alabama there are approximately 3,800 jobs. 

(3) Addressing clerk

a. Nationally there are approximately 109,000 jobs. 

b. In Alabama there are approximately 710 jobs. 

The third hypothetical given, with the addition of the sit/stand option to limitations given 

in hypothetical two, all three of the jobs presented would still be available, in the same numbers. 

(R. 64). The last hypothetical given, if an individual was only able to work six hours in a normal 

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work day and that if the individual was absent three or more times in a typical month, would the 

individual be able to perform competitive work activity, and the VE confirmed that it would be 

unlikely based on his training and experience. (R. 65). 

Because there are jobs that exist in significant numbers in the national and local economy 

that the claimant can perform with consideration to claimant’s age, education, work experience, 

and RFC, the ALJ determined that the claimant was not disabled. (R. 22). 

B. The Plaintiff’s Claims

Kittrell raises the issue of whether the Commissioner’s decision should be reversed 

because the ALJ erred in rejecting the medical opinions of record of Mr. Kittrell’s treating 

specialist. (Doc. 12, Pl. Br. 3).

IV. DISCUSSION

Kittrell argues that the ALJ erred in rejecting the medical opinions of record of Mr. 

Kittrell’s treating specialist. On May 15, 2007,6 Mr. Kittrell was seen by Wael Hamo, M.D. with 

a history7 of upper back pain with features of left thoracic radiculopathy with negative MRI of 

cervical and lumbosacral spine. During multiple consultations with Dr. Hamo, Kittrell reported 

constant upper and lower back pain. Dr. Hamo’s assessments included “tenderness of the 

thoracic spine area.” Treatment included occipital nerve block and trigger point injections, as 

well as prescriptions to Lyrica, Cymbalta, Pristique, and Ultram for “fibromyalgia pain.” (R. 

244-257). 

However, the ALJ appropriately assessed the opinion of Dr. Hamo. When determining 

the weight to give to a doctor’s opinion, an ALJ considers many factors, including whether the 

 6 Kittrell has medical records dating back to October 11, 2005. However, Plaintiff states the error relates 

to May 15, 2007 forward. 

7 Kittrell had seen Dr. Hamo since May 2, 2006. 

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doctor examined the claimant, the evidence the doctor presents to support his opinion, whether 

the doctor’s opinion is consistent with the record as a whole, the doctor’s specialty, and other 

factors. See 20 C.F.R. § 404.1527(c); Schuhardt v. Astrue, 303 F. App’x 757 (11th Cir. 2008). A 

treating doctor’s opinion is generally entitled to more weight, thus an ALJ must articulate 

specific reasons for discounting a treating doctor’s opinion. See 20 C.F.R. § 404.1527(c)(2); 

Phillips 357 F.3d at 1240 (citing Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997) (The 

ALJ must clearly articulate the reasons for giving less weight to the opinion of a treating 

physician, and failure to do so is reversible error). 

Absent “good cause,” the ALJ is to give medical opinions of treating physicians 

“substantial weight.” Winschel 631 F.3d at 1179 (citing Lewis v. Callahan, 125 F.3d at 1440).

Good cause exists when the treating physician’s opinion is not supported by evidence, the 

evidence supports and contrary finding, or the treating physician’s opinion was inconsistent with 

the doctor’s medical records. See 20 C.F.R. § 404.1527(c); Phillips, 357 F.3d at 1241. Although 

a physician’s opinion about what a claimant can or cannot do is relevant, these opinions are not 

determinative because the ALJ has the responsibility of assessing the claimant’s RFC. See 20 

C.F.R. § 404.1546(c); see also Beegle v. Soc. Sec. Admin., Comm’r, 482 F. App’x 483, 486 (11th 

Cir. 2012)(“A claimant’s residual functional capacity is a matter reserved for the ALJ’s 

determination, and while a physician’s opinion on the matter will be considered, it is not 

dispositive”). There is substantial evidence to support the ALJ’s assessment of Dr. Hamo’s 

opinion. (R. 19, 21, 328-29). 

On June 9, 2014, Dr. Hamo completed the “Medical Statement Regarding Fibromyalgia 

for Social Security Disability Claim” form. (R. 328-29). Dr. Hamo check-marked a list of 

symptoms, history or widespread pain for three or more months, pain in eleven or more pressure 

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points, stiffness, tension headaches, parethesias, and chronic fatigue. (R. 328). Dr. Hamo 

indicated that Kittrell could work six hours a day, stand for ten minutes at a time and for a total 

of 30 minutes in a workday, sit for 60 minutes at a time and for a total of less than six hours in a 

workday. (R. 328). Kittrell could lift 10 or 20 pounds occasionally, not lift any weight 

frequently, and occasionally bend, stoop, and raise his arms above shoulder level. (R. 328). Dr. 

Hamo opined that Kittrell would miss more than four days of work each month and could not 

work an eight hour day, five days a week from March 5, 2013, Kittrell’s alleged disability onset 

date. (R. 329). The medical findings to support this assessment were listed as “chronic neck pain, 

chronic upper and lower back pain, thoracic radiculopathy, thoracic and L [4-]5 spine disease, 

fibromyalgia.” (R. 329). 

The ALJ accepted Dr. Hamo’s limitations to standing for ten minutes at a time and sitting 

for 60 minutes at a time and limiting Kittrell to lifting 10 pounds and occasionally reaching 

overhead. (R. 14, 21, 328-29). However, the ALJ discussed how the remainder of Dr. Hamo’s 

opinion is inconsistent with Kittrell’s treating records and Dr. Hamo’s more recent examination 

findings. (R. 21). The ALJ devoted a substantial part of her decision discussing the relevant 

medical evidence. (R. 14-21, 244-47, 177-83, 185-92, 198-99, 310-11, 334-35). Additionally, the 

ALJ noted specifically why she found that Kittrell’s fibromyalgia was not disabling, as alleged 

by Kittrell and Dr. Hamo. (R. 20). 

Additional evaluation of Kittrell by a consulting M.D. Dimtcho Popov, at the State 

Agency’s request, was conducted on April 30, 2013. Dr. Popov observed that Kittrell was not in 

acute distress and recorded normal findings. (R. 20, 280-83). The ALJ also referenced the 

treatment notes of Kittrell’s rheumatologist, Elizabeth Perkins, M.D. (R. 20, 314-15). On 

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October 21, 2013, Dr. Perkins observed that Kittrell was not in acute distress and noted full 

strength, intact sensation, full range of motion, and normal gait (R. 316). 

Dr. Hamo’s own treatment records in June 2014 do not support Kittrell’s allegations of 

legs going out or being unable to “do anything.” (R. 20). Kittrell was not followed on a monthly 

basis, rather told to follow up three or four months after each visit with Dr. Hamo beginning in 

May 2013. (R. 20, 286, 189, 335). Dr. Hamo’s treatment records during the relevant period of 

time consistently show full strength in extremities, mild tenderness in left and right occipital 

area, no restriction on neck movement, and normal gait. (R. 286, 288-89, 335). Dr. Hamo’s postalleged disability onset date treatment notes are largely unchanged from those treatment notes 

dating back to 2006, years before Kittrell stopped working. (R. 244-57). These findings support 

the ALJ’s determination that Dr. Hamo’s June 2014 opinion was not supported by Kittrell’s 

treatment notes. (R. 20-21). 

The ALJ referenced Dr. Hamo’s most recent treatment notes as not being fully consistent 

with his contemporaneous opinion. (R. 21, 328-29, 334-35). The ALJ specifically highlighted 

that although Dr. Hamo’s opinion was expressed on the “Medical Statement Regarding 

Fibromyalgia for Social Security Disability Claim” form and listed fibromyalgia as a “finding,” 

his treatment notes from the same day do not list fibromyalgia with the other diagnoses in the 

“Assessment” section of the form. (R. 21, 328-29, 334-35). These inconsistencies further support 

the ALJ’s determination to put little weight in Dr. Hamo’s opinion that Kittrell had disabling 

limitations. (R. 21). 

In short, the ALJ gave good reasons for her determination to assign little weight to Dr. 

Hamo’s opinion, and is supported by substantial evidence. (R. 21, 328-29). Dr. Hamo’s opinion 

was inconsistent with Kittrell’s treatment notes, including Dr. Hamo’s own records. (R. 21). The 

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evidence as a whole supports the ALJ’s finding that Kittrell had the Residual Functional 

Capacity to perform a range of sedentary work and was thus not disabled. (R. 14-23). 

V. CONCLUSION

Pursuant to the findings and conclusions detailed in this Memorandum Opinion, the Court 

AFFIRMS the Commissioner’s decision. A separate judgment will be entered.

DONE this 24th day of February 2017.

/s/ Terry F. Moorer

TERRY F. MOORER

UNITED STATES MAGISTRATE JUDGE

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