Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-5_04-cv-05184/USCOURTS-arwd-5_04-cv-05184-0/pdf.json

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

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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

KATHRYN A. WARING PLAINTIFF

v. CIVIL NO. 04-5184

JO ANNE B. BARNHART, Commissioner

Social Security Administration DEFENDANT

MEMORANDUM OPINION

Plaintiff Kathryn A. Waring brings this action pursuant to 42 U.S.C. § 405(g), seeking

judicial review of a decision of the Commissioner of the Social Security Administration

(Commissioner) denying her claims for period of disability and disability insurance benefits

(DIB) and supplemental security income (SSI) benefits under the provisions of Titles II and XVI

of the Social Security Act (Act). 

Procedural Background:

The applications for DIB and SSI presently before this court were filed on November 16,

2001, alleging an inability to work since October 31, 2001, due to chronic back pain,

fibromyalgia, mitral valve prolapse, angina, anxiety, depression, asthma, borderline intellectual

functioning and sciatic nerve problems. (Tr. 96-98, 616-618). An administrative hearing was

held on September 11, 2002. (Tr. 626-660). On January 30, 2003, the ALJ issued an

unfavorable decision. (Tr. 47-53).

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The Appeals Council vacated the ALJ’s January 30, 2003, decision on April 25, 2003,

and remanded the case back the an ALJ for further review. (Tr. 84-87). A supplemental hearing

was held on January 29, 2004. (Tr. 661-696). 

By written decision dated April 27, 2004, the ALJ found that plaintiff has an impairment

or combination of impairments that are severe. (Tr. 38). However, after reviewing all of the

evidence presented, he determined that plaintiff’s impairments do not meet or equal the level of

severity of any impairment listed in the Listing of Impairments found in Appendix I, Subpart P,

Regulation No. 4. (Tr. 38). The ALJ found plaintiff retained the residual functional capacity

(RFC) to perform the exertional requirements of a wide range of light work. (Tr. 378). From a

mental standpoint, the ALJ found plaintiff had limited but satisfactory ability to follow work

rules, interact with supervisors, and maintain her personal appearance. The ALJ found plaintiff

was seriously limited but not precluded, in her ability to relate to co-workers, deal with the

public, use judgment, deal with work stresses, function independently, maintain attention and

concentration, understand remember and carry out simple, as well as, detailed instructions,

behave in an emotionally stable manner, relate predictably in social situations, and demonstrate

reliability. The ALJ found plaintiff would be unable to understand, remember and carry out

complex instructions. With the help of vocational expert testimony, the ALJ found plaintiff could

perform other work as a cleaner/housekeeper, cashier and hand packager. (Tr. 39).

Plaintiff appealed the decision of the ALJ to the Appeals Council. Plaintiff's request for

review of the hearing decision was denied. (Tr. 7). When the Appeals Council declined review,

the ALJ’s decision became the final action of the Commissioner. Plaintiff now seeks judicial

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review of that decision. (Doc. #1). Both parties have submitted appeal briefs and this case is

before the undersigned pursuant to the consent of the parties. (Doc. # 7,8).

Applicable Law:

This court's role is to determine whether the Commissioner's findings are supported by

substantial evidence on the record as a whole. Ramirez v. Barnhart, 292 F.3d 576, 583 (8th Cir.

2002). Substantial evidence is less than a preponderance but it is enough that a reasonable mind

would find it adequate to support the Commissioner's decision. The ALJ's decision must be

affirmed if the record contains substantial evidence to support it. Edwards v. Barnhart, 314 F.3d

964, 966 (8th Cir. 2003). As long as there is substantial evidence in the record that supports the

Commissioner's decision, the court maynot reverse it simply because substantial evidence exists

in the record that would have supported a contrary outcome, or because the court would have

decided the case differently. Haley v. Massanari, 258 F.3d 742, 747 (8th Cir. 2001). In other

words, if after reviewing the record it is possible to draw two inconsistent positions from the

evidence and one of those positions represents the findings of the ALJ, the decision of the ALJ

must be affirmed. Young v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000).

It is well-established that a claimant for Social Security disability benefits has the burden

of proving her disability by establishing a physical or mental disability that has lasted at least one

year and that prevents her from engaging in any substantial gainful activity. Pearsall v.

Massanari, 274 F.3d 1211, 1217 (8th Cir.2001); see also 42 U.S.C. § § 423(d)(1)(A),

1382c(a)(3)(A). The Act defines “physical or mental impairment” as “an impairment that results

from anatomical, physiological, or psychological abnormalities which are demonstrable by

medically acceptable clinical and laboratory diagnostic techniques.” 42 U.S.C. § § 423(d)(3),

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1382(3)(c). A plaintiff must show that her disability, not simply her impairment, has lasted for

at least twelve consecutive months.

The Commissioner's regulations require her to apply a five-step sequential evaluation

process to each claim for disability benefits: (1) whetherthe claimant has engaged in substantial

gainful activity since filing her claim; (2) whether the claimant has a severe physical and/or

mental impairment or combination of impairments; (3) whether the impairment(s) meet or equal

an impairment in the listings; (4) whether the impairment(s) prevent the claimant from doing past

relevant work; and, (5) whether the claimant is able to perform other work in the national

economy given her age, education, and experience. See 20 C.F.R. §§ 404.1520, 416.920. Only

if the final stage is reached does the fact finder consider the plaintiff's age, education, and work

experience in light of her residual functional capacity. See McCoy v. Schwieker, 683 F.2d 1138,

1141-42 (8th Cir. 1982); 20 C .F.R. §§ 404.1520, 416.920.

Discussion:

In determining whether the ALJ properly disregarded plaintiff’s subjective complaints

of pain, the court must determine if the ALJ properly followed the requirements of Polaski v.

Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984) (subsequent history omitted), in evaluating her

pain and credibility. 

The absence of an objective medical basis which supports the degree of severity

of subjective complaints alleged is just one factor to be considered in evaluating

the credibility of the testimony and complaints. The adjudicator must give full

consideration to all of the evidence presented relating to subjective complaints,

including the claimant's prior work record, and observations by third parties and

treating and examining physicians relating to such matters as:

1. the claimant's daily activities;

2. the duration, frequency and intensity of the pain;

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Treatment notes completed by a treating doctor prior to her alleged onset date noted that he had a difficult time

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 treating her symptoms due to plaintiff’s inability to take many prescription medications. (Tr. 373).

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3. precipitating and aggravating factors;

4. dosage, effectiveness and side effects of medication;

5. functional restrictions.

The adjudicator is not free to accept orreject the claimant's subjective complaints

solely on the basis of personal observations. Subjective complaints may be

discounted if there are inconsistencies in the evidence as a whole. 

Polaski, 739 F.2d at 1322 (emphasis in original).

However, in addition to the requirement that the ALJ consider the plaintiff’s allegations

of pain, he also has a statutory duty to assess the credibility of plaintiff and other witnesses.

Nelson v. Sullivan, 966 F.2d 363, 366 (8th Cir. 1992). The ALJ may discredit subjective

complaints of pain inconsistent with the record as a whole. Ownbey v. Shalala, 5 F.3d 342, 344

(8th Cir. 1993). 

When determining plaintiff maintained the RFC to perform light work, the ALJ failed

to develop the evidence as to plaintiff’s medications side effects. Bowman v. Barnhart, 310 F.3d

1080, 1085 (8 Cir. 2002). A review of the medical records show plaintiff has been diagnosed th

with chronic intractable pain syndrome. Plaintiff has sought frequent treatment and has been

prescribed numerous medications which have caused varying side effects including nausea,

vomiting, drowsiness. (Tr. 333, 335, 353, 356, 372-373, 375, 389, 497, 502). Plaintiff also 1

reported experiencing side effects to her medication in the forms she completed for the SSA.

(Tr. 111, 125). In October of 2003, plaintiff reported to Dr. Alice M. Martinson that she was

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Darvocet N-100 is indicated for the relief of mild to moderate pain, either when pain is present alone or when it is 2

 accompanied by fever. Physicians' Desk Reference, 56th Ed., p.1907-1909 (2002).

Oxycontin is prescribed for "the management of moderate to severe pain when a continuous, around the clock 3

 analgesic is needed for an extended period of time." Physicians' Desk Reference, 60th Ed., p.2701 (2006).

Flexeril is indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful 4

 musculoskeletal conditions. Physicians' Desk Reference, 57th Ed., p. 1897 (2003).

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taking Cardizem, Etradiol, Ativan, Darvocet, Oxycontin, Flexeril, Phenergan, Miacalcin, 2 3 4

Calcium and three inhalers and in November of 2003, Dr. R. David Cannon opined that opioid

therapy was appropriate. (Tr. 577, 583). We further note Oxycontin is an opioid with an abuse

liability similar to morphine. Physicians' Desk Reference, 60th Ed., p.2701 (2006).

Therefore, because the ALJ improperly discredited plaintiff’s subjective complaints

considering the impact of the side effects caused by her medications, we find that his conclusion

that plaintiff is not disabled is not supported by substantial evidence in the record as a whole.

Accordingly, we believe remand is necessary in order to allow the ALJ to further develop the

record regarding plaintiff’s medication side effects. On remand the ALJ should re-evaluate

plaintiff's subjective allegations in accordance with Polaski, 739 F.2d at 1322, specifically

discussing each Polaski factor in the context of plaintiff's particular case.

While on remand, we strongly suggest that ALJ address interrogatories to plaintiff’s

treating physicians, including Dr. Jennifer Bingham, asking them to review plaintiff’s medical

records, complete an RFC assessment regarding plaintiff’s capabilities during the time period

in question, and to give the objective basis for their opinions so that an informed decision can

be made regarding plaintiff’s ability to perform basic work activities on a sustained basis during

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the relevant time period in question. Chitwood v. Bowen, 788 F.2d 1376, 1378 n.1 (8th Cir.

1986); Dozier v. Heckler, 754 F.2d 274, 276 (8th Cir. 1985). 

With regard to plaintiff’s mental capabilities, on remand, we recommend the ALJ address

plaintiff’s diagnosis of borderline intellectual functioning and how this diagnosis effects her

ability to perform substantial gainful activity. 

Conclusion:

Based on the foregoing, we hereby reverse the decision of the ALJ and remand this case

for further consideration pursuant to sentence four of 42 U.S.C. § 405(g).

DATED this13 day of December 2005. th

/s/Beverly Stites Jones 

HON. BEVERLY STITES JONES

UNITED STATES MAGISTRATE JUDGE

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