Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-1_10-cv-00700/USCOURTS-almd-1_10-cv-00700-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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IN THE DISTRICT COURT OF THE UNITED STATES

FOR THE MIDDLE DISTRICT OF ALABAMA

SOUTHERN DIVISION

GANETTE L. GRIMSLEY, )

)

Plaintiff, )

)

v. ) CIVIL ACTION NO. 1:10cv700-CSC

) (WO)

MICHAEL J. ASTRUE, )

COMMISSIONER OF SOCIAL )

SECURITY, )

)

Defendant. )

MEMORANDUM OPINION and ORDER

I. Introduction

Contending she was disabled, the plaintiff applied on June 18, 2008, for child’s

insurance benefits (CIB) pursuant to Title II of the Social Security Act. The ALJ found that

Grimsley has severe impairments of “chronic cysts/infections, obesity, migraine-type

headaches, asthma, borderline intellectual functioning, cyclothymic personalitydisorder, and

history of learning disorder.” (R. at 11) Her application was denied at the initial 1

administrative level. The plaintiff then requested and received a hearing before an

Administrative Law Judge (“ALJ”). Following the hearing, the ALJ also denied her claim. 

The Appeals Council rejected a subsequent request for review. The ALJ's decision

consequently became the final decision of the Commissioner of Social Security

In her application for benefits Grimsley claimed she was disabled due to a learning disability, 1

asthma, narcolepsy, and migraines. (R. at 125) Upon completion of high school, she received an occupational

diploma.

Case 1:10-cv-00700-CSC Document 14 Filed 09/08/11 Page 1 of 14
(Commissioner). See Chester v. Bowen, 792 F.2d 129, 131 (11 Cir. 1986). That final 2 th

decision is now before the court for review based on the plaintiff’s complaint filed on August

17, 2010. Based on the court's review of the record in this case and the briefs of the parties,

the court concludes that the decision of the Commissioner must be reversed and this case

remanded to the Commissioner for further proceedings consistent with this opinion.

II. Standard of Review

Pursuant to the Social Security Act, a person may be entitled to “child's insurance

benefits” if she is eighteen years old or older and has a disability that began before the age

of twenty-two. 20 C.F.R. § 404.350(a)(5). Under 42 U.S.C. § 423(d)(1)(A), a person is

entitled to disability benefits 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.

42 U.S.C. § 423(d)(1)(A).3

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

evaluation process. See 20 C.F.R. §§ 404.1520.

(1) Is the person presently unemployed?

(2) Is the person's impairment severe?

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

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.

A "physical or mental impairment" is one resulting from anatomical, physiological, or

3

psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory

diagnostic techniques.

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(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?

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

question, or, on steps three and five, to a finding of disability. A negative

answer to any question, other than step three, leads to a determination of "not

disabled."

McDaniel v. Bowen, 800 F.2d 1026, 1030 (11 Cir. 1986). th 4

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); Ingram v. Comm. of Soc. Sec. Admin., 496 F.3d 1253, 1260 (11 Cir. th

2007). "Substantial evidence is more than a scintilla, but less than a preponderance. It is

such relevant evidence as a reasonable person would accept as adequate to support a

conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971); Crawford v. Comm'r of Soc.

Sec., 363 F.3d 1155, 1158–59 (11 Cir. 2004). A reviewing court may not look only to those th

parts of the record which supports the decision of the ALJ but instead must view the record

in its entirety and take account of evidence which detracts from the evidence relied on by the

ALJ. Hillsman v. Bowen, 804 F.2d 1179, 1180 (11 Cir. 1986). The court "may not decide th

the facts anew, reweigh the evidence, or substitute . . . [its] judgment for that of the

[Commissioner]." Phillips v. Barnhart, 357 F.3d 1232, 1240 n. 8 (11 Cir. 2004) (alteration th

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

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 (5 Cir. 1981) (Unit A).

th

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in original) (quotation marks omitted).

[The court must, however,] . . . scrutinize the record in its entirety to determine

the reasonableness of the [Commissioner's] . . . factual findings . . . No similar

presumption of validity attaches to the [Commissioner's] . . . legal conclusions,

including determination of the proper standards to be applied in evaluating

claims.

Walker v. Bowen, 826 F.2d 996, 999 (11 Cir. 1987). th

III. Issues

As stated by the plaintiff, there are four issues in this case.

1. Whether the ALJ failed to properly apply the evaluation

standard for children’s disability claims.

2. Whether the ALJ erred by failing to properly use the Vocational

Expert.

 3. Whether the ALJ erred by failing to properly evaluate Ms.

Grimsley’s residual functional capacity.

4. Whether the ALJ’s credibility finding is based on substantial evidence. 

(Pl’s Br., doc. # 11 at 1). The court will discuss the issues, but not in the order presented by

Grimsley.

IV. Discussion

A. The Sequential Evaluation Claim. Grimsley was 17 years old at the time she

applied for benefits. She, therefore, contends that the ALJ should have evaluated her claim

under the three step sequential evaluation process established for children’s disabilityclaims. 

The five step sequential evaluation process applies to claims for CIB based on disability. 20

C.F.R. § 404.1520(a)(2). Thus, plaintiff’s contention that the ALJ should have applied the

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three step sequential evaluation for child impairment cases is simply wrong as a matter of

law.

B. The Credibility Issue. This is the fourth issue raised by the plaintiff who states

the claim in this manner. “In Ms. Grimsley’s case, the ALJ found that the claimant’s

statements concerning her impairments and their impact on her ability to work are

considerablymore limited and restricted than is established by the medical evidence. (R. 17).

This finding is not based on substantial evidence.” (Pl. Br. at 10). Where an ALJ decides

not to credit a claimant ’s testimony about pain (or other non-exertional impairments), the

ALJ must articulate specific and adequate reasons for doing so, or the record must be obvious

as to the credibility finding. Foote v.Chater, 67 F.3d 1553, 1561-62 (11 Cir. 1995); Jones th

v. Department of Health & Human Servs., 941 F.2d 1529, 1532 (11 Cir. 1991)(articulated th

reasons must be based on substantial evidence). A reviewing court will not disturb a clearly

articulated credibility finding with substantial supporting evidence in the record. See Hale

v. Bowman, 831 F.2d 1007, 1012 (11 Cir. 1987); MacGregor v. Bowen, 786 F.2d 1050, th

1054 (11 Cir. 1986). th

The ALJ found that the plaintiff could perform a limited range ofsedentary work. (R.

at 19). Part of that finding is based on her impairment of chronic cysts and infections, and

it is that impairment which is at the center of this issue. As to the cysts, the ALJ said this:

The claimant has been diagnosed with chronic cysts/infections. She has had

nodules recurring in the left axilla, left inguinal area, and the left buttocks.

Treatment has included antibiotics and incisions and drainages. She had an

incision and drainage of a recurrent pilonidal abscess in June 2008 (Exhibits

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10F and 18F). The cyst returned and she underwent a subsequent incision and

drainage approximately two weeks after the first (Exhibits 16F and 18F). She

underwent an excisional debridement of a left breast mass, abscess in

November 2008 (Exhibit 15F). She was treated for abscesses in March, May,

and August 2009 (Exhibit 17F). She was treated for sores around the groin

and/or vulva in September 2008 and June, October, and November

2009(Exhibits 23F and 22F). In January 2010, the claimant was evaluated for

these cysts at the University of Alabama at Birmingham clinic (Exhibit 26F).

She was diagnosed with recurrent cellulitis, furuncles and scarring on

examination consistent with hidradenitis suppurative. Physical examination

of the external genitalia, vagina, and/or skin in November and December2008

and April and December 2009 revealed no inflammatory lesions (Exhibits 23F

and 24F).The absence of any lesions at these examinations shows that the

cysts/infections are not constant and that treatment is effective; however, the

claimant credibly has limitations resulting from the cysts and infections. She

has periodic flare-ups that are treated with antibiotics and incisions and

drainages, but these exacerbations do not occur to such an extent as to require

consistently significant absences from work for ongoing treatment. On the

other hand, the pain and discomfort limit the claimant's ability to perform

exertional activities. As a result, she is able to lift and carry up to ten pounds

occasionally, sit for six hours in an eight hour workday, and stand and/or walk

for two hours in an eight hour workday.

(R. at 15).

Most of Grimsley’s argument about credibility is a legal argument reciting case law. 

The only contention directly related to the facts of this case is as follows.

In corroboration with her medical records, testimony at Ms. Grimsley’s

hearing revealed that she had six active lesions at that time. (R. 31). She

testified that the painful lesions around her buttocks and groin area made it

difficult for her to sit and she often had to seek hospital treatment for removal

and drainage of the boils. (R. 40, 42). Had the ALJ found the claimant’s

testimony as fully credible, she would be unemployable due to her physical

impairment and absences from work for continuous treatment.

(Pl. Br. at 12).

The mere fact that at the time of the hearing Grimsley had active lesions does not

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refute the conclusion of the ALJ that the lesions “do not occur to such an extent as to require

consistently significant absences from work for ongoing treatment.” (R. at 15). A review of

the medical records supports that conclusion with substantial evidence. No relief is

warranted as to this issue.

C. The Vocational Expert and the Jobs Issues.5

After carefully considering all of the plaintiff’s impairments, the ALJ found that

Grimsley has 

the residual functional capacity to perform less than a full range of sedentary

work as defined in 20 CFR 404.1567(a). She must avoid concentrated

exposure to pulmonary irritants. She is able to understand, remember, and

carry out very short and simple instructions. She can attend to tasks for two

hour periods. She is limited to jobs where changes in the work environment

are kept to a minimum.

(R. at 14).

Having made that finding, the ALJ then used the Medical-Vocational Guidelines, 20

CFR Part 404, Subpart P, Appendix 2, (the grids) as a framework for his decision making to

conclude the following.

If the claimant had the residual functional capacity to perform the full range

of sedentary work, considering the claimant's age, education, and work

experience, a finding of "not disabled" would be directed by

Medical-Vocational Rule 201.24. However, the additional limitations have

little or no effect on the occupational base of unskilled sedentary work. The

As will be seen, the court conflates consideration of the second and third issues raised by the 5

plaintiff. As stated by the plaintiff, the second issue was that the ALJ failed to properly use the vocational

expert. Actually, the ALJ didn’t use him at all, and that failure really matters in this case. The third issue

was the failure of the ALJ at step five of the sequential analysis to articulate specific jobs the plaintiff could

perform. 

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need to avoid concentrated exposure to pulmonary irritants does not

significantlyerode the occupational base ofsedentarywork according toSocial

SecurityRulings 83-14, 85-15, and 96-9P. The remaining limitations regarding

the claimant's mental abilities do not significantly erode the occupation base

of sedentary work according to Social Security Ruling 96-6P. Therefore, a

finding of "not disabled" is appropriate under the framework of

Medical-Vocational Rule 201.24.

This conclusion was error. “There are two avenues by which the ALJ may determine

whether the claimant has the ability to adjust to other work in the national economy.”

Phillips, 357 F.3d at 1239. First, the ALJ may apply the grids. Secondly, the ALJ may

consult a vocational expert (VE) by posing hypothetical questions to the VE to establish

whether someone with the claimant's impairments would be able to find work in the national

economy. Id. at 1239-40. The grids provide tables based on work classifications of

sedentary, light, medium, heavy or very heavy. These classifications are based on the

exertional level, or “primary strength activities,” the work requires, such as sitting, standing,

walking, lifting, carrying, pushing, and pulling. S.S.R. 83-10. Each table considers

vocational factors, such as age, education and work experience, to “direct a conclusion” of

either disabled or not disabled. See generally, 20 C.F.R. pt. 404, subpt. P, app. 2 § 200.00(a).

These tables constitute “administrative notice” as to the number of unskilled jobs that exist

in the national economy at the various exertional levels. Thus, when all the claimant's

vocational factors coincide with the criteria in the table, “the existence of jobs is established.”

20 C.F.R. pt. 404, subpt. P, app. 2 § 200.00(b).

The Eleventh Circuit repeatedly has recognized that “exclusive reliance on the grids

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is not appropriate either” (1) “when the claimant is unable to perform a full range of work

at a given residual functional level”; or (2) “when a claimant has non-exertional impairments

[i.e., impairments not related to strength] that significantly limit basic work skills.” See 6

Phillips, 357 F.3d at 1242 (internal brackets omitted); Allen v. Sullivan, 880 F.2d 1200, 1202

(11 Cir. 1989); Passopulos v. Sullivan, 976 F.2d 642, 648 (11 Cir. 1992) (“This court has th th

recognized that the grids may be used in lieu of vocational testimony on specific jobs if none

of the claimant's nonexertional impairments are so severe as to prevent a full range of

employment at the designated level.”). See also 20 C.F.R. pt. 404, subpt. P, app. 2 §

200.00(a). In either of these cases, a claimant's occupational base (the number of jobs she

is able to perform based on her residual functional capacity, age, education and work

experience) may be affected. See S.S.R. 83-12 (explaining that when a claimant's exertional

limitations do not coincide with a particular exertional level in the grids, the adjudicator may

need to consult a vocational expert to determine the extent of any erosion in the occupational

base); S.S.R. 83-14 (explaining that when nonexertional impairments are present, the

occupational base may be significantly narrowed and the ALJ may need to consult a

vocational expert). Thus, in these kinds of cases, the ALJ must make an individualized

assessment and consult a vocational expert to determine whether there are jobs in the

Nonexertional activities include maintaining bodyequilibrium, crouching, bending,stooping, using

6

fingers, seeing, hearing or speaking, mental functions and tolerating environmental working conditions.

S.S.R. 83-14. Reliance solely on the gridsisinappropriate when nonexertional limitations are present because

the grids take into account only exertional limitations in classifying levels of work as sedentary, light,

medium or heavy and do not address nonexertional limitations. See Sryock v. Heckler, 764 F.2d 834, 836

(11 Cir. 1985). th

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economy the claimant can perform. See Phillips, 357 F.3d at 1242-43.

When the ALJ cannot rely solely on the grids, the ALJ nonetheless “may use [the

grids] as a framework to evaluate vocational factors, but must also introduce independent

evidence, preferably through a vocational expert's testimony, of existence of jobs in the

national economy that the claimant can perform.” Wilson v. Barnhart, 284 F.3d 1219, 1227

(11 Cir. 2002); Smith v. Bowen, 792 F.2d 1547, 1554-55 (11 Cir. 1986) (stating that the th th

grids “may serve as a framework for consideration of the combination of the exertional and

nonexertional limitations”). The regulations likewise recognize that the grids can “still

provide guidance for decision making.” 20 C.F.R. pt. 404, subpt. P, app. 2 § 200.00(d);

accord id. § 200.00(e)(2).7

In Grimsley’s case, the ALJ did not obtain independent evidence of the existence of

jobs as required by the law of this circuit. That error alone is enough to warrant reversal and

remand. However, even if the ALJ were correct that reliance on the framework of the grids

was sufficient in a case like this, he still committed error. The ALJ relied on S.S.R. 96-9p,

The regulations state that when there is a combination of exertional and nonexertional limitations,

7

the grids "are considered in determining first whether a finding of disabled may be possible based on the

strength limitations alone." 20 C.F.R. pt. 404, subpt. P, app. 2 § 200.00(e)(2). If not, then the grids "provide

a framework for consideration of how much the individual's work capability is further diminished in terms

of any types of jobs that would be contraindicated by the nonexertional limitations." Id. "Also, in these

combinations of nonexertional and exertional limitations which cannot be wholly determined under" the

grids, "full consideration must be given to all of the relevant facts in the case in accordance with the

definitions and discussion of each factor in the appropriate sections of the regulations, which will provide

insight into the adjudicative weight to be accorded each factor." Id. If the issue of occupational base erosion

is complex, the ALJ "may use the services of a vocational expert or other specialist." 20 C.F.R. §

404.1566(e); see also S.S.R. 83-14 (stating that in complex situations, "the assistance of a vocational

resource may be necessary").

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a Social SecurityRuling which deals with “the impact of a residual functional capacity (RFC)

assessment for less than a full range of sedentary work on an individual's ability to do other

work.” Specifically, with respect to Grimsley’s mental impairments, the ALJ relied upon

S.S.R. 96-9p for his conclusion that her “mental abilities do not significantly erode the

occupation base of sedentary work according to Social Security Ruling 96-6P.” That ruling

states as follows:

A substantial loss of ability to meet any one of several basic work-related

activities on a sustained basis (i.e., 8 hours a day, 5 days a week, or an

equivalent work schedule), will substantially erode the unskilled sedentary

occupational base and would justify a finding of disability. These mental

activities are generallyrequired by competitive, remunerative, unskilled work:

* Understanding, remembering, and carrying out simple instructions.

* Making judgments that are commensurate with the functions of unskilled

work--i.e., simple work- related decisions.

* Responding appropriately to supervision, co- workers and usual work

situations.

* Dealing with changes in a routine work setting.

A less than substantial loss of ability to perform any of the above basic work

activities may or may not significantly erode the unskilled sedentary

occupational base. The individual's remaining capacities must be assessed and

a judgment made as to their effects on the unskilled occupational base

considering the other vocational factors of age, education, and work

experience. When an individual has been found to have a limited ability in one

or more of these basic work activities, it may be useful to consult a vocational

resource.

The ALJ concluded that Grimsley has the following limitations as a result of her

mental impairments: “She is able to understand, remember, and carry out very short and

simple instructions. She can attend to tasks for two hour periods. She is limited to jobs where

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changes in the work environment are kept to a minimum.” (R. at 17). To support this

conclusion, the ALJ places great weight on the opinion of “Dr. Green,” who is actually Dr.

Jordan, noting his agreement that Grimsley’s “ability to respond well to co-workers,

supervision, and everyday work pressures is mildly compromised secondary to psychiatric

issues.” (R. at 17). The record, however, is replete with references to Grimsley’s behavioral

difficulties, especially with her mother and teachers, who are all authority figures. A fair

reading of all of Grimsley’s treatment records show episodes of behavioral difficulty

followed by improvement followed by relapse. For example, Dr. McDowell’s March 9,

2006, clinic notes poignantly report that Grimsley “is doing poorly. She has been physically

aggressive toward her mother. Police were called but there was no place to put her.” (R. at

261). This occurred after a January 26, 2006, report that Grimsley and her mother were

“much better” tolerating each other. (R. at 262). This improvement came after a January 17,

2006, report that Grimsley and her mother “are having a terrible time . . . [Grimsley] is

having difficulty controlling her behavior and is speaking disrespectfully.” (R. at 263). 

Dr. Jordan observed that Grimsley’s ability to respond to coworkers, supervision and

everyday work pressure “is mildly compromised secondary to psychiatric issues, and he also

noted Grimsley’s intermittent explosive disorder, additionally commenting that “there is no

sorrow post-explosion.” (R. at 385). Other that the work pressure observation, there is

absolutely nothing in Dr. Jordan’s report about Grimsley’s ability to deal with changes in a

routine work setting. Of course, when he describes Grimsley’s mental impairments, the ALJ

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does preface that description with the phrase “[b]ased on the evidence of record, including

Dr. Green’s report . . .” The only evidence that the court could find in the record about that

aspect of S.S.R. 96-9p’s mental activities required for a job is an assessment done by a nonexamining psychologist. (R. at 402). And that assessment, of course, unless it is consistent

with other medical evidence is not entitled to much if any weight. See Swindle v. Sullivan,

914 F.2d 222, 226 n. 3 (11 Cir. 1990); Broughton v. Heckler, 776 F.2d 960, 962 (11 Cir. th th

1985).

All of this is simply to say that the ALJ failed to explain why in this complex and

difficult case, he chose to base his opinion on the grids as a framework, especially when a

vocational expert was present to testify. Undoubtedly, creating a hypothetical question which

accounted for all of Grimsley impairments might have been difficult, but that is no reason

to not use the services of a vocational expert. S.S.R. 96-9p says 

The individual's remaining capacities must be assessed and a judgment made

as to their effects on the unskilled occupational base considering the other

vocational factors of age, education, and work experience. When an individual

has been found to have a limited ability in one or more of these basic work

activities, it may be useful to consult a vocational resource.

Grimsley’s abilities in numerous areas are limited to the extent that the ALJ concluded

that she could not perform a full range of sedentary work. As a consequence, the court

concludes that the law of this circuit demands that in order for the ALJ to conduct the

required individualized assessment of Grimsley a vocational expert should have been

consulted at step five of the sequential analysis to determine whether someone with her

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compromised abilities can perform any jobs in the national economy.

V. Conclusion

Accordingly, this case will be reversed and remanded to the Commissioner for further

proceedings consistent with this opinion.

A separate order will be entered.

It is further

ORDERED that, in accordance with Bergen v. Comm’r of Soc. Sec., 454 F.3d 1273,

1278 fn. 2 (11 Cir. 2006), the plaintiff shall have sixty (60) days after she receives notice th

of any amount of past due benefits awarded to seek attorney’s fees under 42 U.S.C. § 406(b). 

See also Blitch v. Astrue, 261 Fed. Appx. 241, 242 fn.1 (11 Cir. 2008). th

A separate order will issue. 

Done this 8 day of September, 2011. th

 /s/Charles S. Coody 

CHARLES S. COODY

UNITED STATES MAGISTRATE JUDGE

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