Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-6_04-cv-06106/USCOURTS-arwd-6_04-cv-06106-0/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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AO72A

(Rev. 8/82)

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

HOT SPRINGS DIVISION

STELLA DAVIS PLAINTIFF

v. Civil No. 04-6106

JO ANNE B. BARNHART, 

Commissioner, Social 

Security Administration DEFENDANT

MEMORANDUM OPINION

Factual and Procedural Background:

The plaintiff, Stella Davis, appeals from the decision of the Commissioner of the Social

Security Administration (hereinafter “Commissioner”), denying her applications for disability

insurance benefits (hereinafter “DIB”), and supplemental security income benefits (hereinafter

“SSI”), pursuant to §§ 216(i) and 223 of Title II of the Social Security Act (hereinafter "the

Act"), 42 U.S.C. §§ 416(i) and 423, and § 1602 of Title XVI, 42 U.S.C. § 1381a,

respectively.

Plaintiff was 59 years of age at the time of the administrative hearing and has a ninth 

grade education (T. 187). She has past relevant work as: a greeter at Wal-Mart, a lumber

stacker, assembly line worker and sewing machine operator (T. 189-191, 233-234, 79). 

Plaintiff alleges a disability onset date of July 31, 2002 (T. 53), due to: seizure disorder and the

residuals therefrom; carpal tunnel syndrome (hereinafter “CTS”); lumbar and thoracic back

strain; edema; anxiety/depression; headaches; weakness/dizziness; fatigue/insomnia; bursitis of

the left shoulder; and, confusion and impaired memory. She filed her applications on August

22, 2002 (T. 53-55, 173-178).

 The Social Security Administration denied plaintiff’s application initially and on

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 Plaintiff alleges an onset date of July 31, 2002 (T. 53), and remains insured through 1

December 31, 2007 (T. 20). 

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reconsideration. She then requested and received a hearing before an Administrative Law

Judge (hereinafter “ALJ”), which hearing was held on November 18, 2003 (T. 185-244). The

ALJ rendered an unfavorable decision on March 4, 2004 (T. 12-21). By Order entered June 25,

2004, the Appeals Council denied the plaintiff’s Request for Review of the hearing decision (T.

5-7), thus making the ALJ’s decision the final decision of the Commissioner. Plaintiff now

seeks judicial review of that decision. The parties have filed appeal briefs (Doc. #7 & 8), and

this matter is now ready for consideration.

Applicable Law:

The ALJ evaluated the plaintiff’s claim according to the five-step sequential evaluation

analysis prescribed by the social security regulations. See 20 C.F.R. §§ 404.1520(a)-(f); see

also Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987) (describing five-step analysis). At the first

step, the ALJ found the plaintiff had not engaged in substantial gainful activity since her alleged

onset date. In the next two steps, the ALJ determined that plaintiff has an impairment 1

considered “severe”, in the form of a seizure disorder (T. 20), but that she does not have an

impairment or combination of impairments listed in, or medically equal to one listed in part B

of Appendix 1, Subpart P, 20 C.F.R. Part 404 (“Listing of Impairments”). Neither are the

plaintiff’s impairments functionally equivalent in severity to any listed impairment. The ALJ

found that the plaintiff’s subjective complaints, are not entirely credible. The ALJ determined

that plaintiff has no physical restrictions, but due to her seizure disorder, she should avoid

climbing ladders or scaffolds, working on unprotected heights, and around moving equipment

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and hazardous machinery. Thus, the ALJ found that plaintiff’s occupational base is reduced by

non exertional limitations (T. 20). Next, the ALJ found that considering the plaintiff’s age,

educational background, and residual functional capacity (hereinafter “RFC”), she is able to

make a successful vocational adjustment to other work which exists in significant numbers in

the national economy. And, considering the Medical-Vocational Guidelines and using Rule

204.00 as a framework for decision making, the jobs of linen attendant and laundry worker fit

that category. Finally, the ALJ found that the claimant has not been under a “disability,” as

defined in the Act, at any time through the date of the decision (T. 21). 

Our role on review is to determine whether the Commissioner’s findings are supported

by substantial evidence in the record as a whole. See Prosch v. Apfel, 201 F.3d 1010, 1012 (8th

Cir.2000). Substantial evidence is less than a preponderance but is enough that a reasonable

mind would find it adequate to support the Commissioner’s decision. Id. In determining

whether existing evidence is substantial, we consider evidence that detracts from the

Commissioner's decision as well as evidence that supports it. See Craig v. Apfel, 212 F.3d 433,

436 (8th Cir.2000). As long as substantial evidence in the record supports the Commissioner's

decision, we may not reverse it because substantial evidence exists in the record that would

have supported a contrary outcome, see id., or because we would have decided the case

differently. See Woolf v. Shalala, 3 F.3d 1210, 1213 (8th Cir.1993).

To establish entitlement to benefits, the plaintiff must show that she had been unable to

engage in any substantial gainful activity by reason of a medically determinable impairment

which had lasted or could have been expected to last for not less than 12 months. See 42

U.S.C. §§ 423(d)(1)(A) and 1382c(a)(3)(A). 

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Discussion:

Plaintiff argues that the ALJ erred: in finding that the plaintiff does not meet or equal a

listed impairment; and, in failing to take into account the combined effect of her impairments. 

We agree with the plaintiff’s concern regarding the combined effect of her impairments. 

The plaintiff alleges numerous subjective complaints and nonexertional limitations,

including: seizure disorder with residuals (T. 196, 200-201, 226, 227, 153, 118-119, 141, 155,

199, 228, 188, 202-203, 92, 93, 94, 100, 108-109, 110, 169, 154, 153, 145); back pain (T. 195,

161, 192, 209, 211, 97); edema (T. 194, 86, 157); numbness (T. 195); anxiety/depression (T.

205, 164, 229, 196, 200, 228, 90); headaches (T. 202, 153, 143, 164, 108-109, 200-201, 89,

104, 111, 10, 160, 154); weakness/dizziness (T. 203, 201, 87, 94, 99, 111, 170),

fatigue/insomnia (T. 211, 89, 91, 170); bursitis of the shoulder (T. 139, 168, 97, 162); and,

confusion and decreased memory (T. 207-208, 216, 223, 228, 87, 99, 111, 108-109). Further,

the plaintiff states that she has no money, and suffers from side effects from her prescription

medication (T. 89, 91, 97, 153, 219-220, 222, 196-197, 147, 170, 88). 

The objective medical evidence contains documentation of the existence of conditions

which could be expected to cause the alleged pain and other subjective allegations and

nonexertional limitations. See Dixon v. Sullivan, 905 F.2d 237, 238 (8th Cir.199). The ALJ

who determines that a plaintiff’s testimony as to pain is not credible must make specific

findings explaining that conclusion. E.g., Baker v. Secretary of Health and Human Services,

955 F.2d 552, 555 (8th Cir.1992). 

 In determining the plaintiff’s residual functional capacity (hereinafter “RFC”), the ALJ

failed to consider the plaintiff’s numerous alleged impairments in combination. Under these

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circumstances, the Social Security Act requires the Commissioner to consider the combined

effect of all impairments without regard to whether any such impairment, if considered

separately, would be of sufficient medical severity to be disabling. See 20 C.F.R. § 404.1523;

Cunningham v. Apfel, 222 F.3d 496, 501 (8th Cir.2000); Delrosa v. Sullivan, 922 F.2d 480,

484 (8th Cir.1991). In the present case, the ALJ was obligated to consider the combined effects

of plaintiff’s numerous physical impairments, as well as her asserted mental impairment. See

id. Nonetheless, the only indication that the ALJ did so, is the following statement:

It is next necessary to establish whether the claimant has a “severe” impairment

or combination of impairments. An impairment is severe within the meaning of

the regulations if it imposes significant restrictions in the ability to perform basic

work activities. The evidence supports a finding that Ms. Davis has seizure

disorder, an impairment that causes significant vocationally relevant limitations.

(T. 13). 

While similar statements referring to an impairment or combination of impairments

have been found by the United States Court of Appeals for the Eighth Circuit to evidence

sufficient consideration of the combined effect of a plaintiff’s multiple impairments, we cannot

arrive at the same conclusion, herein. See Hajek v. Shalala, 30 F.3d 89, 92 (8th Cir.1994). A

careful reading of the ALJ’s decision, along with a review of the administrative record, reveals

an inadequate assessment of the totality of plaintiff’s impairments. Rather, each impairment

was discussed singly, not at all, or found to have no medical evidence in support of its existence

(T. 13-16). 

Overall, we conclude that the record does not contain substantial evidence to support the

ALJ's decision that plaintiff is capable of performing other work which exists in significant

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numbers in the national economy. The ALJ’s decision must be reversed on this basis. 

As has been noted, the plaintiff asserts the existence of disabling nonexertional

limitations consisting of: insomnia/fatigue; weakness/dizziness; headache pain;

confusion/memory loss; and, anxiety/depression.

In determining a plaintiff’s RFC to perform a range of work activities in spite of her

impairments, the ALJ must evaluate the credibility of the testimony regarding subjective pain

complaints. See Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir.1984). In so doing, the ALJ

must consider: (1) a claimant's daily activities, (2) the duration, frequency, and intensity of

pain, (3) precipitating and aggravating factors, (4) dosage, effectiveness, and side effects of

medication, and (5) residual functions. Id. 

It is well settled that an ALJ may not disregard subjective pain allegations solely

because they are not fully supported by objective medical evidence, see Chamberlain v.

Shalala, 47 F.3d 1489, 1494 (8th Cir.1995). However, an ALJ is entitled to make a factual

determination that a plaintiff's subjective pain complaints are not credible in light of objective

medical evidence to the contrary. See 20 C.F.R. §§ 416.908, 416.929 (requiring that an

individual's subjective complaints of pain alone shall not be conclusive evidence of disability,

but must be documented by medical evidence which reasonably could be expected to produce

the pain or symptoms alleged); Sarna v. Barnhart, 32 Fed.Appx. 788, 791 (8th Cir.2002)

(explaining that "it is the ALJ's function to resolve conflicts among the physicians and

witnesses"); Black v. Apfel, 143 F.3d 383, 388 (8th Cir.1998) (upholding denial of benefits

where no objective medical evidence supported claimant's subjective pain complaints). See

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also, Ramirez v. Barnhart 292 F.3d 576, 580 -582 (8th Cir.2002). While the ALJ

acknowledged the plaintiff’s complaints, he found that it was not “unreasonable to associate

some of the claimant’s seizure-like symptoms as anxiety related (Exhibit 9F)” (T. 16). Finding

further, the ALJ stated:

The undersigned has considered the claimant’s treating physician opinion about

her condition, along with her therapeutic controls. Evaluation related to the

claimant’s mental component did not appear severely limiting, as she testified

that she is able to complete activities of daily life, such as caring for personal

needs, cooking, minor cleaning, and she does ambulate independently. While

she sometimes becomes nervous and reports that she has headaches and poor

memory, the evidence contains no clinical or laboratory findings supporting

disabling conditions in these areas. She has undergone various medication

changes, and exhibited no adverse side effects to medications, and there is no

indication that these medications do not adequately control impairments, or she

has had any psychological or physiological abnormalities, which would preclude

all work activities.

(T. 18). 

Our reading of the record indicates that while the plaintiff can care for her personal

needs, she doesn’t bathe or shower unless her husband is present in the home, due to her fear of

having a seizure while completing this task (T. 87, 97). She stated she can do laundry, dishes,

change sheets and wash the car, but qualifies her answer, explaining she can only do a little bit

at a time, she “can’t hold out very long at a time. I get weak and shakey” (T 87, 90, 99). 

Further, the record documents that plaintiff clearly has complained of adverse side effects from

her medication (T. 147, 170, 88, 89, 97, 196-197). Finally, the record draws into question the

ALJ’s statement to the effect that there is no indication plaintiff’s medications do not

adequately control her impairments (T. 141, 197, 223, 108-109, 95, 93). 

Conclusion:

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Accordingly, the ALJ’s decision denying benefits to the plaintiff is not supported by

substantial evidence and should be reversed. This matter should be remanded to the

Commissioner for consideration of the combined effect of plaintiff’s alleged impairments, and

reconsideration of her subjective allegations and nonexertional limitations, with particular focus

on the alleged side effects of her medications. 

ENTERED this 12 day of September, 2005. th

/s/ Bobby E. Shepherd 

HONORABLE BOBBY E. SHEPHERD 

 UNITED STATES MAGISTRATE JUDGE

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