Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-5_18-cv-01576/USCOURTS-alnd-5_18-cv-01576-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ALABAMA

NORTHEASTERN DIVISION

TIMOTHY WAYNE UPTON,

Plaintiff,

v.

ANDREW M. SAUL,1 Commissioner, 

Social Security Administration,

Defendant.

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Case No. 5:18-cv-1576-GMB

MEMORANDUM OPINION AND ORDER

Plaintiff Timothy Wayne Upton filed an application for disability insurance 

benefits and an application for supplemental security income in 2014. His alleged 

disability onset date is August 4, 2014. Upton’s applications for benefits were

denied at the initial administrative level. He then requested a hearing before an 

Administrative Law Judge (“ALJ”). The ALJ held a hearing on May 9, 2017 and 

denied Upton’s claims on July 6, 2017. Upton requested a review of the ALJ’s 

decision by the Appeals Council, which declined review on July 27, 2018. As a 

result, the ALJ’s decision became the final decision of the Commissioner of the 

Social Security Administration (the “Commissioner”) as of July 27, 2018.

1 Andrew M. Saul became the Commissioner of Social Security on June 5, 2019. Pursuant to Rule 

25(d) of the Federal Rules of Civil Procedure, Saul is substituted for Nancy Berryhill as the proper 

defendant in this case.

FILED

 2020 Feb-19 PM 02:24

U.S. DISTRICT COURT

N.D. OF ALABAMA

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Upton’s case is now before the court for review pursuant to 42 U.S.C. 

§§ 405(g) and 1383(c)(3). Under 28 U.S.C. § 636(c)(1) and Rule 73 of the Federal 

Rules of Civil Procedure, the parties have consented to the full jurisdiction of a

United States Magistrate Judge. Based on its review of the parties’ submissions, the 

relevant law, and the record as a whole, the court concludes that the decision of the 

Commissioner is due to be REVERSED and REMANDED to the ALJ for 

proceedings consistent with this opinion. 

I. STANDARD OF REVIEW

The court reviews a Social Security appeal to determine whether the 

Commissioner’s decision “is supported by substantial evidence and based upon 

proper legal standards.” Lewis v. Callahan, 125 F.3d 1436, 1439 (11th Cir. 1997). 

The court will reverse the Commissioner’s decision if it is convinced that the 

decision was not supported by substantial evidence or that the proper legal standards 

were not applied. Carnes v. Sullivan, 936 F.2d 1215, 1218 (11th Cir. 1991). The 

court “may not decide the facts anew, reweigh the evidence, or substitute its 

judgment for that of the Commissioner,” but rather “must defer to the 

Commissioner’s decision if it is supported by substantial evidence.” Miles v. Chater, 

84 F.3d 1397, 1400 (11th Cir. 1997) (citation and internal quotation marks omitted). 

“Even if the evidence preponderates against the Secretary’s factual findings, [the 

court] must affirm if the decision reached is supported by substantial evidence.” 

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Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990). Moreover, reversal is not 

warranted even if the court itself would have reached a result contrary to that of the 

factfinder. See Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991). 

The substantial evidence standard is met “if a reasonable person would accept 

the evidence in the record as adequate to support the challenged conclusion.” 

Holladay v. Bowen, 848 F.2d 1206, 1208 (11th Cir. 1988) (quoting Boyd v. Heckler, 

704 F.2d 1207, 1209 (11th Cir. 1983)). The requisite evidentiary showing has been 

described as “more than a scintilla, but less than a preponderance.” Bloodsworth v. 

Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983). The court must scrutinize the entire 

record to determine the reasonableness of the decision reached and cannot “act as 

[an] automaton[] in reviewing the [Commissioner’s] decision.” Hale v. Bowen, 831 

F.2d 1007, 1010 (11th Cir. 1987). Thus, the court must consider evidence both 

favorable and unfavorable to the Commissioner’s decision. Swindle v. Sullivan, 914 

F.2d 222, 225 (11th Cir. 1990). 

The court will reverse the Commissioner’s decision on plenary review if the 

decision applies incorrect law or fails to provide the court with sufficient reasoning 

to determine that the Commissioner properly applied the law. Grant v. Astrue, 255 

F. App’x 374, 375–76 (11th Cir. 2007) (citing Keeton v. Dep’t of Health & Human 

Servs., 21 F.3d 1064, 1066 (11th Cir. 1994)). There is no presumption that the 

Commissioner’s conclusions of law are valid. Id.

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II. STATUTORY AND REGULATORY FRAMEWORK

To qualify for disability benefits, a claimant must show the “inability 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) & 416(i). A physical or mental impairment is “an 

impairment that results from anatomical, physiological, or psychological 

abnormalities which are demonstrated by medically acceptable clinical and 

laboratory diagnostic techniques.” 42 U.S.C. § 423(d)(3). Upton bears the burden 

of proving that he is disabled, and is responsible for producing evidence sufficient 

to support his claim. See Ellison v. Barnhart, 355 F.3d 1272, 1276 (11th Cir. 2003). 

A determination of disability under the Social Security Act requires a fivestep analysis. 20 C.F.R. § 404.1520(a). The Commissioner must determine in 

sequence:

(1) Is the claimant presently unable to engage in substantial gainful 

activity?

(2) Are the claimant’s impairments severe?

(3) Do the claimant’s impairments satisfy or medically equal one of the 

specific impairments set forth in 20 C.F.R. Pt. 404, Subpt. P, 

App. 1?

(4) Is the claimant unable to perform her former occupation?

(5) Is the claimant unable to perform other work given her residual 

functional capacity, age, education, and work experience?

See Frame v. Comm’r, Soc. Sec. Admin., 596 F. App’x 908, 910 (11th Cir. 2015). 

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

question, or, [at] steps three and five, to a finding of disability. A negative answer 

to any question, other than at step three, leads to a determination of ‘not disabled.’” 

McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986) (quoting 20 C.F.R. 

§ 416.920(a)−(f)). “Once the finding is made that a claimant cannot return to prior 

work the burden of proof shifts to the Secretary to show other work the claimant can 

do.” Foote v. Chater, 67 F.3d 1553, 1559 (11th Cir. 1995) (citing Gibson v. Heckler, 

762 F.2d 1516 (11th Cir. 1985)). 

III. FACTUAL BACKGROUND

Timothy Wayne Upton lives in Hazel Green, Alabama with a roommate and 

her 14-year-old daughter. R. 57. He was 49 years old at the time of the ALJ’s 

decision. R. 20 & 191. At the hearing before the ALJ, Upton asserted that a heart 

condition, fatigue, and post traumatic stress disorder prevent him from working. 

R. 66. On his disability report, Upton recorded that his heart condition, anxiety, 

depression, shortness of breath, and inability to sit or stand for long periods of time 

prevent him from working. R. 245. He testified at the hearing before the ALJ that 

he had feelings of hopelessness, helplessness, and thoughts of suicide. R. 78. He 

tried counseling sessions, but he found the sessions to be too painful. R. 78. 

Upton obtained his GED and has had some vocational training. R. 58. His 

past employment has included positions as a locksmith, cashier, security officer, 

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customer service representative, taxi driver, and airport shuttle driver. R. 62 & 246. 

Past employers include Shell Food Mart and DirectTV. R. 246. He last worked in 

August 2014. R. 246. 

The ALJ held a hearing in Upton’s case on May 9, 2017. R. 53. During the 

hearing, the ALJ posed the following hypothetical to a Vocational Expert (“VE”):

Please consider an individual the same age, education, and work 

experience as Mr. Upton. For hypothetical #1, I’d like you to consider 

that such an individual can lift and carry 50 pounds occasionally, and 

25 pounds frequently; can stand and/or walk with normal breaks for a

total of six hours in an eight-hour workday; sit with normal breaks for 

a total of six hours in an eight-hour workday; pushing and pulling is the 

same as for lifting and carrying; frequently climb ramps and stairs; 

never climb ladders, ropes and scaffolds; frequently balance, 

occasionally stoop, occasionally kneel, occasionally crouch, 

occasionally crawl; avoid concentrated exposure to extreme heat; avoid 

concentrated exposure to fumes, odors, dust, gases and poor ventilation; 

avoid all exposure to hazards, such as moving unguarded machinery, 

unprotected heights, frequently handle, frequently finger, frequently 

feel. 

R. 84. The VE testified that this hypothetical individual could perform Upton’s past 

work as a cashier, locksmith, security guard, car deliverer, and customer service 

representative. R. 85. The VE also testified that this individual could perform other 

work in the national economy. R. 85. Specifically, he could work as a bagger, 

laundry worker, and assembler. R. 85. The ALJ asked whether this hypothetical

individual could perform work if limited to lifting and carrying 20 pounds 

occasionally and 10 pounds frequently. R. 85. The VE explained that he could still 

work as a locksmith, security guard, cashier, car deliverer, and customer service 

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representative. R. 86. This individual also could perform work as a marker, router, 

and bottling wine attendant. R. 86. 

The ALJ also posed the following hypothetical:

Let’s go hypothetical #1, and then I’m going to add that such an 

individual can understand, remember and carry out short one to threestep tasks. Can frequently interact with the public, coworkers and 

supervisors, and can adapt to infrequent well-explained changes.

R. 87. The VE testified that this individual could perform the past relevant work of 

cashier and also work as a marker, router, bottling wine attendant, bagger, laundry 

worker, and assembler. R. 87. The VE testified that this individual could not find 

work if he would be off task 20% of the day, if he would be absent two days per 

month, or if he would have to lie down and elevate his lower extremities for 50% of 

the day outside of scheduled work breaks. R. 88. The VE also testified that the 

hypothetical individual could not find work if he were required to lie down and 

elevate his legs for 40% of the work day or if he needed to lie down and elevate his 

legs for 45 minutes after a period of exertion. R. 89.

The ALJ issued her decision on July 6, 2017. R. 20. Under step one of the 

five-step evaluation process, the ALJ found that Upton has not engaged in 

substantial gainful activity since August 4, 2014. R. 13. The ALJ concluded that 

Upton suffers from the severe impairment of ischemic heart disease under 20 C.F.R. 

§ 404.1520(c) and § 416.920(c). R. 13. The ALJ concluded at step three of the 

analysis that none of Upton’s impairments satisfy or medically equal the severity of 

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one of those listed in the applicable regulations. R. 15.

At steps four and five, the ALJ found that Upton has the residual functional 

capacity (“RFC”) to perform medium level work with some limitations.2

Specifically, the ALJ determined the following:

After careful consideration of the entire record, the undersigned finds 

that the claimant has the residual functional capacity to perform 

medium work. . . . He can lift and/or carry and push and/or pull 50 

pounds occasionally, and 25 pounds occasionally. He can sit or stand 

and/or walk six hours in an eight-hour workday with normal breaks. He 

can frequently climb ramps and stairs but never climb ladders, ropes, 

or scaffolds. He can occasionally balance, stoop, kneel, crouch and 

crawl. He should avoid concentrated exposure to extreme heat and/or 

cold. He should avoid concentrated exposure to fumes, odors, gases, 

and poor ventilation. He should avoid all exposure to moving 

unguarded machinery, and unprotected heights. He can frequently 

handle, finger and feel objects with both hands. 

R. 15. Ultimately, the ALJ determined that Upton is able to perform past relevant 

work as a cashier, locksmith, security guard, car deliverer, and customer service 

representative. R. 19. Therefore, the ALJ concluded that Williams is not disabled 

within the meaning of the Social Security Act. R. 20. Based on these findings, the 

ALJ denied Williams’ claims. R. 20.

IV. DISCUSSION

Upton presents four issues on appeal: (1) the ALJ abused her discretion in 

2 “Medium work involves lifting no more than 50 pounds at a time with frequent lifting or carrying 

of objects weighing up to 25 pounds. If someone can do medium work, we determine that he or 

she can also do sedentary and light work.” 20 C.F.R. § 404.1567(c).

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finding that Upton did not meet any of the Listings; (2) the ALJ did not properly 

evaluate, individually or in combination, Upton’s complaints; (3) the ALJ erred in 

the weight she assigned to physicians’ opinions; and (4) the ALJ’s findings are not 

supported by substantial evidence. As to the first contention, the ALJ has not 

provided the court with sufficient reasoning to determine whether she properly 

applied the law. Accordingly, the decision of the Commissioner is due to reversed 

and remanded, and any discussion of the remaining arguments is pretermitted.

Upton contends that he satisfies the criteria for depression (Listing 12.04), 

anxiety disorder (Listing 12.06), and post traumatic stress disorder (Listing 12.15). 

Doc. 11 at 16. The listings of impairments in the Social Security Regulations 

identify impairments of such severity that they prevent a person from engaging in 

gainful activity. See 20 C.F.R. Pt. 404, Subpt. P, App’x 1. If a claimant meets a 

listed impairment or otherwise establishes an equivalence, the regulations establish 

that the claimant has a disability. See 20 C.F.R. § 416.920(d). However, if a claimant

manifests only some of the criteria for an impairment, then the claimant is not 

considered to be disabled, no matter how severe the impairment. Nichols v. Comm’r 

of Soc. Sec., 679 F. App’x 792, 795 (citing Sullivan v. Zebley, 493 U.S. 521, 530 

(1990)).

To meet the requirements of a Listing, a claimant must “have a medically 

determinable impairment(s) that satisfies all of the criteria in the listing.” 20 C.F.R. 

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§ 404.1525(d). In other words, to “meet a Listing, the claimant must (1) have a 

diagnosed condition that is included in the listings and (2) provide objective medical 

reports documenting that this condition meets the specific criteria of the applicable 

listing and the duration requirement.” Proctor v. Comm’r of Soc. Sec., 2016 WL 

4473187, at *4 (M.D. Fla. Aug. 25, 2016). The burden is on the claimant to show 

that his impairments meet a listed impairment. Barron v. Sullivan, 924 F.2d 227, 229 

(11th Cir. 1991). The regulations also provide that the claimant “must furnish 

medical and other evidence that [the Commissioner] can use to reach conclusions 

about his medical impairment(s).” 20 C.F.R. § 404.1512(a). Critically, the 

claimant’s impairment must “meet all of the specified medical criteria. An 

impairment that manifests only some of those criteria, no matter how severely, does 

not qualify.” Sullivan v. Zebley, 493 U.S. 521, 530 (1990).

For depression (Listing 12.04), anxiety disorder (Listing 12.06), and post 

traumatic stress disorder (Listing 12.15), the term “specified criteria” refers to three 

individual paragraphs. 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.00. These 

paragraphs are designated as “paragraph A,” “paragraph B,” and “paragraph C.” 

Paragraphs A, B, and C function the same for depression, anxiety disorder, and post 

traumatic stress disorder. To satisfy one of these listings, a claimant must show that 

he meets the criteria of paragraph A and paragraph B or, alternatively, the criteria of 

paragraph A and paragraph C. 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.06. The 

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paragraph A criteria set forth clinical findings that medically substantiate a mental 

disorder. See Listing 12.00A. The criteria in paragraphs B and C describe functional 

limitations that would prevent any gainful employment. As discussed above, the

paragraph B criteria are the same for all three of the listings Upton invokes.

To satisfy the paragraph B criteria, the claimant must establish that he has an 

extreme limitation in one, or a marked limitation in two, of certain areas of mental 

functioning. The listed areas are the claimant’s abilities to (1) understand, 

remember, or apply information; (2) interact with others; (3) concentrate, persist or 

maintain pace; and (4) adapt or manage oneself. To satisfy the criteria in paragraph 

C, a claimant must establish a mental disorder that is “serious and persistent” in that 

it has lasted for a period of at least two years and there is evidence of both of the 

following: (1) medical treatment, mental health therapy, psychosocial support, or a 

highly structured setting that is ongoing and that diminishes the symptoms and signs 

of the mental disorder; and (2) marginal adjustment (that is, a minimal capacity to 

adapt to changes in your environment or to demands that are not already part of 

daily life).

The court finds that ALJ’s analysis of whether Upton meets one of these 

Listings is insufficient. See Schink v. Comm’r of Soc. Sec., 935 F.3d 1245, 1269 

(11th Cir. 2019) (remanding case to ALJ where the ALJ provided no meaningful

assessment of how the claimant’s mental impairments affected his ability to work). 

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To begin, the ALJ’s step three discussion ostensibly consists of only one sentence: 

“Although the claimant’s impairments are ‘severe,’ none of them rises to the level 

of severity contemplated in any section of the Listings.” R. 15.

3

 Reading between 

the lines of the ALJ’s opinion, however, reveals some discussion of the paragraph 

B criteria embedded within the ALJ’s step two analysis. There, the ALJ noted that 

the 

first functional area is understanding, remembering, or applying 

information. In this area, the claimant has no limitation. He has worked 

in jobs that required some level of education; he has a GED (General 

Education Development certificate, equivalent to a high school 

diploma) and some post-secondary study. The next functional area is 

interacting with others. In this area, the claimant has no limitation. He 

lives with a “roommate” and gets along well with her. The third 

functional area is concentrating, persisting, or maintaining pace. In this 

area, the claimant has no limitation. His activities of daily living consist 

in great part of reading, watching television and playing games on the 

computer. The fourth functional area is adapting or managing oneself. 

In this area, the claimant has no limitation. He has managed his 

resources adequately so that his needs are met. Because the claimant’s 

medically determinable impairments cause no more than “mild” 

limitation in any of the functional areas, they are nonsevere.

R. 14. Nowhere in this paragraph does the ALJ reference any medical evidence in 

support of her opinions. The ALJ does not tie her reasoning to a single doctor’s 

opinion, hospital visit, or psychiatric evaluation, all of which Upton provided. She

3 The ALJ also appears to conflate her step three analysis and step five analysis. Immediately 

following the aforementioned sentence is a bolded statement of Upton’s residual functional 

capacity. R. 15. The ALJ does not explain why she performed the step five analysis before step 

four, or why this discussion seems to have been folded into the step three analysis.

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does not even rely on the third-party function report submitted by Upton’s 

roommate. R. 278–85. Instead, the ALJ bases her conclusory analysis partially on 

irrelevant facts (like Upton’s employment before the alleged disability onset date) 

and on Upton’s self-reported symptoms—even though she later discounts Upton’s 

statements about the effects of his symptoms. R. 18. 

Moreover, the ALJ acknowledged these shortcomings in her analysis. In her 

opinion, the ALJ noted that steps four and five “require a more detailed assessment.” 

R. 14. But, as discussed above, this reasoning is absent from the step four analysis. 

The ALJ did not discuss whether Upton satisfies the Listings in the context of the

RFC analysis, and she did not account for mental impairments in Upton’s RFC. 

R. 15. Instead, she addressed only limitations from physical impairments. R. 15. 

And the bulk of the ALJ’s RFC analysis is a recitation of Upton’s subjective 

complaints. R. 16–18. The ALJ did reference two emergency room visits and a 

September 9, 2014 doctor’s visit (R. 18), but did not offer an opinion about or 

analysis of these visits. 

In addition, the ALJ assigned substantial weight to a state-agency medical 

consultant, but this medical consultant offered an opinion about Upton’s physical 

residual capacity and the ALJ discussed only the consultant’s conclusions about 

Upton’s physical capacities. R. 18–19 & 94–100. Absent from the RFC analysis is 

any mention of the Listings for anxiety disorder, depression, or post traumatic stress 

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disorder. The ALJ also did not discuss any medical evidence relating to Upton’s 

mental health. In short, the ALJ’s opinion does not reveal meaningful consideration

of Upton’s alleged mental limitations. This omission prevents the court from

concluding whether the ALJ properly applied the law. See Schink, 935 F.3d at 1269–

70 (“As acknowledged by the ALJ in his opinion, the mental RFC assessment used 

at steps 4 and 5 of the process ‘requires a more detailed assessment by itemizing 

various functions contained in the broad categories found in paragraph B of the adult 

mental disorders listings in 12.00 of the Listing of Impairments.’ Even if we assume 

the RFC assessment conducted by the ALJ included some silent consideration of 

[the claimant’s] mental impairments, we have no way of knowing whether it 

included the ‘more detailed assessment’ required.”).

Without more, the court simply cannot determine whether the ALJ applied the 

proper legal standards. See Keeton, 21 F.3d at 1066 (“The Secretary’s failure to 

apply the correct law or to provide the reviewing court with sufficient reasoning for 

determining that the proper legal analysis has been conducted mandates reversal.”). 

While the court has a duty to affirm if substantial evidence supports the ALJ’s 

conclusions, the ALJ must direct the court to the supporting evidence and must 

provide sufficient rationale for her decision. “When the ALJ fails to state with 

sufficient clarity the grounds for [her] evidentiary decisions, [the court] will not

affirm simply because some rationale might have supported the ALJ’s conclusion.” 

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Dempsey v. Comm’r of Soc. Sec., 454 F. App’x 729, 732 (11th Cir. 2011) (citing 

Owens v. Heckler, 748 F.2d 1511, 1514–16 (11th Cir. 1984)) (internal quotation 

marks omitted). Without sufficient reasoning to determine whether the ALJ 

conducted the proper legal analysis, this court has no choice but to reverse. See 

Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1260 (11th Cir. 2007) (noting 

that reversal is required where the ALJ failed to provide the reviewing court with 

sufficient reasoning to determine whether the proper legal standards were applied).

V. CONCLUSION

For these reasons, the court concludes that the Commissioner’s decision is not 

based upon the proper legal standards. It is therefore ORDERED that the decision 

of the Commissioner denying benefits is REVERSED and this matter is 

REMANDED to the Administrative Law Judge for the purpose of issuing a new 

disability determination consistent with this opinion.

Pursuant to Federal Rule of Civil Procedure 54(d)(2)(B), Plaintiff’s attorney 

is granted an extension of time in which to file a petition for authorization of 

attorney’s fees under 42 U.S.C. § 406(b) until 30 days after receipt of a notice to 

award benefits from the Social Security Administration. This order does not extend 

the time limits for filing a motion for attorney’s fees under the Equal Access to 

Justice Act.

A final judgment will be entered separately.

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DONE and ORDERED on February 19, 2020.

 _________________________________

 GRAY M. BORDEN

 UNITED STATES MAGISTRATE JUDGE

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