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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 UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF ARKANSAS

Lydia Ann Killian Plaintiff

v. No. 3:15‐CV–182‐JLH‐JTK

Carolyn W. Colvin, Acting Commissioner,

Social Security Administration Defendant

Recommended Disposition

Instructions

The following recommended disposition was prepared for U.S. District Judge

J. Leon Holmes.  A party to this dispute may file written objections to this

recommendation.  An objection must be specific and state the factual and/or legal basis

for the objection.  An objection to a factual finding must identify the finding and the

evidence supporting the objection.  Objections must be filed with the clerk of the court

no later than 14 days from the date of this recommendation.1  The objecting party must

serve the opposing party with a copy of an objection.  Failing to object within 14 days

waives the right to appeal questions of fact.2

  If no objections are filed, Judge Holmes

may adopt the recommended disposition without independently reviewing all of the

record evidence.

1

28 U.S.C. § 636(b)(1); Fed. R. Civ. P. 72(b).

2

Griffini v. Mitchell, 31 F.3d 690, 692 (8th Cir. 1994) (failure to file objections

waives right to de novo review and to appeal magistrate judge’s findings of fact).

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 1 of 10
Reasoning for Recommended Disposition

Lydia Ann Killian seeks judicial review of the denial of her application for

disability insurance benefits (DIB).3  In the past, Killian worked primarily as a

bookkeeper.  She last worked in October 2011,4 when she underwent back surgery.  A

few months later, Killian applied for DIB and based disability on diabetes, arthritis,

back problems, congestive heart failure, neuropathy, high blood pressure, high

cholesterol, bad heart valves, and shingles.5

The Commissioner’s decision.  After considering the application, the ALJ

identified lumbar degenerative disc disease (status post‐lumbar surgery) and diabetic

neuropathy as severe impairments.6

  The ALJ determined Killian can do some sedentary

work, to include her past work as a bookkeeper.7

  Because a person who can do her past

work is not disabled under social security law, the ALJ denied the application.8

3

SSA record at p. 100 (applying on Jan. 3, 2012 and alleging disability beginning

Oct. 3, 2011.

4

Id. at pp. 47, 119, 131 & 163.

5

Id. at p. 142.

6

Id. at p. 11.

7

Id. at pp. 13 & 16 (excluding workplace hazards and climbing, and limiting

postural functions).

8

Id. at p. 17.

2

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 2 of 10
After the Appeals Council denied review,9 the ALJ’s decision became the

Commissioner’s final decision for the purpose of judicial review.10  Killian filed this case

to challenge the decision.11  The recommended disposition explains why the court

should affirm the decision.

Killian’s allegations.  Killian challenges the evaluation of her credibility.  She

faults the ALJ for not specifying particular medical listings; she contends she meets

listings 9.00 and 1.02A.  She complains about the omission of a walker from the

hypothetical question.  She maintains her primary care provider’s (PCP) medical

statement deserved more weight.  For these reasons, she says substantial evidence does

not support the decision.12

Applicable legal principles.  When reviewing a decision denying an application

for DIB, the court must determine whether substantial evidence supports the decision

and whether the ALJ made a legal error.13  For substantial evidence to exist, a

9

Id. at p. 1.

10See Anderson v. Sullivan, 959 F.2d 690, 692 (8th Cir. 1992) (stating that “the Social

Security Act precludes general federal subject matter jurisdiction until administrative

remedies have been exhausted” and explaining that the Commissioner’s appeal

procedure permits claimants to appeal only final decisions).

11Docket entry # 1.

12Docket entry # 9.

13See 42 U.S.C. § 405(g) (requiring the district court to determine whether the

Commissioner’s findings are supported by substantial evidence and whether the

3

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 3 of 10
reasonable mind must accept the evidence as adequate to support the determination

that Killian can do some sedentary work, to include her past work.14  For the following

reasons, a reasonable mind will accept the evidence as adequate to support the decision:

1.  The record establishes no very serious functional limitation

preventing sedentary work.  Sedentary work “involves lifting no more

than 10 pounds at a time and occasionally lifting or carrying articles like

docket files, ledgers, and small tools.”15  Sedentary work “represents a

significantly restricted range of work.  Individuals who are limited to no

more than sedentary work by their medical impairments have very

serious functional limitations.”16

Killian based her claim, in significant part, on back surgery.17  Medical

evidence shows Killian underwent back surgery on October 3, 2011.18

Post‐surgery treatment notes are probative of Killian’s claim.  Treatment

Commissioner conformed with applicable regulations); Long v. Chater, 108 F.3d 185, 187

(8th Cir. 1997) (“We will uphold the Commissioner’s decision to deny an applicant

disability benefits if the decision is not based on legal error and if there is substantial

evidence in the record as a whole to support the conclusion that the claimant was not

disabled.”).

14Britton v. Sullivan, 908 F.2d 328, 330 (8th Cir. 1990) (substantial evidence exists if

a reasonable mind will accept evidence as adequate to support conclusion).

1520 C.F.R. § 404.1567(a).

16SSR 96‐9p, Pol’y Interpretation Ruling Titles II & XVI: Determining Capability to Do

Other Work‐‐Implications of a Residual Functional Capacity for Less Than a Full Range of

Sedentary Work.

17SSA record at p. 101 (reporting that she stopped working because she had back

surgery).

18Id. at p. 385.

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Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 4 of 10
notes show surgery alleviated pre‐surgery symptoms.19

The source of post‐surgery symptoms is diabetic neuropathy.  When

Killian complained about left sided pain, the surgeon ordered a nerve

conduction study.20  The study showed mild peripheral neuropathy in

both legs.21  The surgeon attributed neuropathy to diabetes.  Diabetic

peripheral neuropathy can cause symptoms in the legs and feet like

numbness, tingling, burning, pain, and loss of balance and coordination,

and interfere with walking and standing.22  Killian complained about

similar symptoms.

The nerve conduction study confirming the presence of peripheral

neuropathy supports reported symptoms, but not disabling symptoms.

The descriptor “mild” suggests no disabling symptoms.  A reasonable

mind will accept the evidence as adequate to show Killian can do

sedentary work because symptoms of peripheral neuropathy can interfere

with walking and standing, and because sedentary work involves mostly

sitting.

2.  The PCP statement contradicts other substantial evidence.  Killian’s

19Id. at p. 506 (Nov. 29, 2011, reporting near complete relief of back pain and

some residual right leg pain), p. 398 (Dec. 15, 2011, low back pain completely gone but

still complaining about right leg pain, albeit diminished; doing much better than before

surgery), p. 623 (Feb 29, 2012, some right sided pain after surgery but overall much

better than before surgery, now complaining about pain radiating to left leg), p. 617

(July 12, 2012, back and right leg pain completely resolved, she complains about left

sided neuropathy most probably from diabetes), p. 666 (Nov. 8, 2012, it’s been a year

since back surgery, back and right leg pain completely resolved, she has some

numbness and tingling in the legs from diabetic neuropathy).

20Id. at p. 622.

21Id. at p. 549.

22Gary Gilles, Ken R. Wells & Laura Jean Cataldo, Diabetic Neuropathy, 2 The

Gale Encyclopedia of Med. 1356 (4th ed.); id. at p. 1347 of vol. 2, Altha Roberts Edgren &

Ken R. Wells, Diabetes Mellitus.

5

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 5 of 10
PCP — an advanced practice nurse — provided a letter, stating that

Killian is quite limited in her ability to perform even simple activities of

daily living, requires a walker and frequently a wheel chair, needs daily

assistance to bathe, and has been unable to work since back surgery.23

Killian contends the statement deserved more weight.

A treating PCP medical statement is entitled to controlling weight if it is

well‐supported and consistent with the other substantial evidence.24  The

ALJ rejected the statement because: (1) the PCP is not an acceptable

medical source,25 (2) PCP exam results were significantly different from

the exam results of acceptable medical sources, and (3) Killian’s reports to

the PCP were significantly different than her reports to acceptable medical

sources.26  If supported by the record, these reasons are good reasons for

rejecting the statement.

The following excerpt from the challenged decision shows why the record

supports the ALJ’s reasons:

For example, in November 2012, Ms. Killian told her back

surgeon that her pain had significantly improved.  A

neurological examination was stable.  The claimant also

acknowledged that her right leg pain had resolved and that

she was using a walker only intermittently.  That same

month, Ms. Killian told [the PCP] that she continued to

experience back pain that was severe enough to prevent her

from sleeping.  The claimant had decreased sensation in both

legs.  [The PCP] noted that the claimant had an unstable gait

and she used a rolling walker.  These two examinations

23SSA record at p. 704.

24SSR 96‐2p, Pol’y Interpretation Ruling Titles II & XVI, Giving Controlling Weight to

Treating Source Med. Opinions.

25See 20 C.F.R. § 404.1513 (listing sources who can provide medical evidence to

establish impairment).

26SSA record at pp. 15‐16.

6

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 6 of 10
occurred within days of each other yet ... findings and

reported symptoms are very different from one another.

The undesigned notes that when [the orthopedist] examined

the claimant in January 2013 he found very few objective

abnormalities.  The claimant indicated she was experiencing

only intermittent back pain and numbness in the extremities.

Two months later, the claimant complained [to the PCP] of

severe ongoing back pain.  The claimant had limited range of

motion in her back and used a walker at all times.27

The cited inconsistencies are supported by the record and provide a

sufficient basis for rejecting the PCP statement.

3.  The ALJ properly discounted Killian’s credibility.  Killian contends

the ALJ failed to follow the law in evaluating her credibility.  She

maintains the ALJ ignored favorable evidence and erred in evaluating her

allegations of disabling symptoms.  Because the ALJ followed the required

two‐step process and considered the required factors,28 the question before

the court is whether substantial evidence supports the credibility

evaluation.

An ALJ may discount subjective complaints “if there are inconsistencies in

the evidence as a whole.”29  The ALJ identified inconsistencies

undermining credibility.  The following excerpt from the challenged

decision illustrates inconsistency:

While the claimant testified at the hearing that her pain

medication caused side effects, the medical records clearly

show that she failed to report these symptoms to medical

providers.  In January 2013, [the orthopedist] specifically

noted that the claimant denied that she was experiencing

27Id.

28See SSR 96‐7p, Pol’y Interpretation Ruling Titles II & XVI: Evaluation of Symptoms

in Disability Claims: Assessing the Credibility of an Individual’s Statements.

29Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984).

7

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 7 of 10
any medication side effects.30

The cited inconsistency, especially considered with inconsistent

statements to medical providers, provided a sufficient basis for

discounting credibility.

The ALJ discounted the disabling aspects of Killian’s subjective

allegations, but the reduction to sedentary work shows the ALJ credited

some alleged symptoms.  Agency medical experts limited Killian to light

work requiring occasional performance of postural functions,31 but after

considering all of the evidence, the ALJ limited Killian to sedentary work.

4.  The medical evidence does not support disability under a listing. If a

claimant has more than one impairment, she may rely on the combined

effect of her impairments to prove she meets a listing.32   “For a claimant to

show that [her] impairment matches a listing, it must meet all of the

specified medical criteria.  An impairment that manifests only some of

those criteria, no matter how severely, does not qualify.”33

Killian relies on listing 9.00 (endocrine disorders) based on diabetes, and

listing 1.02A based on the effect of diabetes on the legs in the form of an

alleged inability to ambulate effectively.

“Ineffective ambulation is defined generally as having insufficient lower

extremity functioning ... to permit independent ambulation without the

use of a hand‐held assistive device(s) that limits the functioning of both

upper extremities.” 1.002b(1).  Requiring a walker meets this requirement,

but the ALJ discounted credibility about requiring a walker.  Killian’s

30SSA record at p. 16.

31Id. at pp. 587, 592 & 655.

32Shontos v. Barnhart, 328 F.3d 418, 424 (8th Cir. 2003).

33Sullivan v. Zebley, 493 U.S. 521, 530 (1990).

8

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 8 of 10
statements about using a walker are inconsistent34 — inconsistent enough

to provide a sufficient basis for discounting the allegation of an inability to

ambulate effectively.  In the absence of an inability to ambulate effectively,

Killian does not meet listing 1.02A based on diabetic peripheral

neuropathy.

5.  Vocational evidence indicates Killian can do her past work.  A person

who can do her past work is not disabled under social security law.35

Killian worked as an office bookkeeper for many years.  According to the

vocational  expert, a bookkeeper is sedentary work.36  Killian complains

because the ALJ didn’t include a walker in the hypothetical question, but

the requirement for walker flows from subjective allegations.  The ALJ

discounted subjective allegations.  

Conclusion and Recommended Disposition

Substantial evidence supports the ALJ’s decision because a reasonable mind will

accept the evidence as adequate to support the decision.  The ALJ made no reversible

legal error.  For these reasons, the undersigned magistrate judge recommends

DENYING Killian’s request for relief (docket entry # 2) and AFFIRMING the

34SSA record at p. 508 (57 days post surgery, walked with significant limp on

right even with walker), p. 624 (149 days post surgery, she’s using a walker), p. 595 (191

days post surgery, using wheelchair), p. 606 (260 days post surgery, in a wheelchair),

p. 617 (283 days post surgery, using a walker intermittently), p. 686 (627 days post

surgery, using a walker, slow unsteady gait), p. 666 (402 days post surgery, using

walker intermittently), p. 669 ( 409 days post surgery, using rolling walker), p. 674 (472

days post surgery, normal gait, able to stand without difficulty, able to climb stairs 5

consecutive times), p. 44 (723 days post surgery, need a walker regularly and

wheelchair 3 or 4 times per month).

3520 C.F.R. § 404.1520(a)(4) (“If you can still do your past relevant work, we will

find that you are not disabled.”).

36SSA record at p. 48.

9

Case 3:15-cv-00182-JLH Document 11 Filed 02/16/16 Page 9 of 10
Commissioner’s decision.

Dated this 16th day of February, 2016.

____________________________

United States Magistrate Judge

10

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