Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-2_14-cv-02098/USCOURTS-alnd-2_14-cv-02098-0/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

NORTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION

KELLIE MARIE LAWRENCE,

Plaintiff,

vs.

CAROLYN W. COLVIN, Acting

Commissioner of Social Security,

Defendant.

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CASE NO. 2:14-CV-2098-SLB

MEMORANDUM OPINION

Plaintiff Kellie Marie Lawrence brings this action pursuant to 42 U.S.C. § 405(g),1

seeking review of the Commissioner of Social Security’s final decision denying her

applications for a period of disability, disability insurance benefits [“DIB”], and

supplemental security income [“SSI”]. Upon review of the record and the relevant law, the

court is of the opinion that the Commissioner’s decision is due to be reversed and remanded

for further proceedings.

I. PROCEDURAL HISTORY

Ms. Lawrence filed applications for a period of disability and DIB and for SSI on

April 18, 2011, alleging disability beginning November 20, 2010. (Doc. 7-3 at R.10; doc.

1The judicial review provisions for a DIB claims, 42 U.S.C. § 405(g), apply to claims

for SSI. See 42 U.S.C. § 1383(c)(3).

FILED

 2015 Nov-06 AM 11:55

U.S. DISTRICT COURT

N.D. OF ALABAMA

Case 2:14-cv-02098-SLB Document 12 Filed 11/06/15 Page 1 of 10
7-6 at R.105-06, R.112.)2 Her applications were denied initially. (Doc. 7-3 at R.10; doc. 7-4

at R.56-57.) Thereafter, she requested a hearing before an Administrative Law Judge

[“ALJ”], which was held on December 4, 2012. (Doc. 7-3 at R.10, R.24; doc. 7-5 at R.9.) 

After the hearing, the ALJ found that Ms. Lawrence was unable to perform her past relevant

work but that other jobs existed in the national economy in significant numbers that Ms.

Lawrence could perform. (Doc. 7-3 at R.16-18.) Therefore, the ALJ determined that Ms.

Lawrence was not under a disability at any time through the date of his decision, March 11,

2013. (Id. at R.18.)

Ms. Lawrence then requested review of the ALJ’s decision by the Appeals Council. 

(Id. at R.5.) The Appeals Council “found no reason under [its] rules to review the [ALJ]’s

decision,” and it denied Ms. Lawrence’s request for review. (Id. at R.1.) Therefore, the

ALJ’s decision is the final decision of the Commissioner. (See id.)

Following denial of review by the Appeals Council, Ms. Lawrence filed an appeal in

this court. (Doc. 1.)

II. STANDARD OF REVIEW

In reviewing claims brought under the Social Security Act, this court’s role is a

narrow one: “Our review of the Commissioner’s decision is limited to an inquiry into

2Reference to a document number, [“Doc.”], refers to the number assigned to each

document as it is filed in the court’s record. Reference to a page numbers in the

Commissioner’s record, [“R.”], refers to the page number assigned to the record by the

Commissioner.

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whether there is substantial evidence to support the findings of the Commissioner, and

whether the correct legal standards were applied.” Wilson v. Barnhart, 284 F.3d 1219, 1221

(11th Cir. 2002); see also Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988). The court

gives deference to factual findings and reviews questions of law de novo. Cornelius v.

Sullivan, 936 F.2d 1143, 1145 (11th Cir. 1991). The court “may not decide the facts anew,

reweigh the evidence, or substitute [its] judgment for that of the [Commissioner], rather [it]

must scrutinize the record as a whole to determine if the decision reached is reasonable and

supported bysubstantial evidence.” Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990)

(quoting Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir.1983)) (internal quotations

and other citation omitted). “The Commissioner’s factual findings are conclusive if

supported by substantial evidence.” Wilson, 284 F.3d at 1221 (citing Martin v. Sullivan, 894

F.2d 1520, 1529 (11th Cir. 1990); Allen v. Bowen, 816 F.2d 600, 602 (11th Cir. 1987)). 

“Substantial evidence” is “more than a scintilla and is such relevant evidence as a reasonable

person would accept as adequate to support a conclusion.” Winschel v. Commissioner of

Social Sec., 631 F.3d 1176, 1178 (11th Cir. 2011) (internal quotations and citations omitted). 

Conclusions of law made by the Commissioner are reviewed de novo. Cornelius, 936

F.2d at 1145. “No . . . presumption of validity attaches to the [Commissioner’s] conclusions

of law.” Wiggins v. Schweiker, 679 F.2d 1387, 1389 (11th Cir. 1982).

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Case 2:14-cv-02098-SLB Document 12 Filed 11/06/15 Page 3 of 10
III. DISCUSSION

On appeal, Ms. Lawrence argues the Commissioner’s decision denying her claim for

benefits is not supported by substantial evidence and improper legal standards were applied. 

Specifically, she contends the ALJ failed to properly evaluate the credibility of her subjective

complaints of pain, and he did not give appropriate weight to the opinion of her treating

physician, Dr. LarryDoug Alford. The Commissioner has responded, arguing that the ALJ’s

findings are supported by substantial evidence and that he applied the correct law.

Ms. Lawrence filed applications for disability benefits, alleging she was disabled

because of fibromyalgia, pain, depression, and fatigue. (See doc. 7-7 at R.146.) She testified

that she was disabled due to constant pain. (See doc. 7-3 at R.32-33.) The ALJ found that

Ms. Lawrence had the severe impairment of obesity. (Id. at R.12.) He found that Ms.

Lawrence’s “upper respiratory infections, urinary tract infections, acute bronchitis,

constipation, and headaches,” which were impairments shown by her medical records, were 

not severe impairments; her opiate dependency was non-severe; and her fibromyalgia was

not a medically-determinable impairment. (Id. at R.13-14.) He did not discuss any

impairment caused by low back pain. (See id. at 12-14.)

In his decision, the ALJ found Ms. Lawrence could perform a limited range of light

work. (Id. at 14.) He wrote:

The claimant testified that she is unable to work because she does not know

how she will feel from one day to the next. The claimant testified that she has

7 to 8 knots across her back. She estimated she has [4] good days per month. 

She reported difficulty functioning mentally due to pain. The claimant

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testified she has migraine headaches [4] days per week that last 4 to 24 hours. 

The claimant is treated at a pain clinic with medication. She also soaks in

a hot bath. The claimant admitted that medication has reduced the knots, or

trigger points, in her back to 3 to 4. She reported an inability to lift more than

20 pounds or walk more than half a block. The claimant testified to difficulty

doing housework, and has a need to alternate sitting and standing. She stated

she moves every few minutes.

The longitudinal medical evidence of record does not fully support the

claimant’s allegation of disability. Medical records from Gene Watterson, Jr.,

M.D., in February 2001 documented subjective clouding of sensorium and

reports of pain. Neurologically, the claimant was intact, and appeared in no

apparent distress. No palpable abnormalities or spasms were identified in the

lumbar spine. Hepatitis panel, thyroid screening, and other laboratory testing

was negative. The claimant was treated symptomatically for her complaints

(Exhibits 1F and 2F).

Progress notes from Larry Alford, M.D., in February 2011 show the claimant

was taking Suboxone for past opioid dependence. She reported little pain

relief with narcotic medications. Records in March 2011 show complaints of

increased pain and poor sleep. The claimant weighed 180 pounds, and her

BodyMass Index (BMI) was 32%. In April 2011, the claimant presented with

a weight of 179 pounds, and BMI of 31.82%. Physical examination showed

joint tenderness, decreased range of motion in the cervical and lumbar spine,

and multiple trigger points. Dr. Alford opined that the claimant was totally

and permanently disabled (Exhibit 2F).

Updated records fromDr. Alford in September 2012 noted improved pain with

analgesics. The claimant denied neck pain, shoulder pain, and upper back

pain. The claimant weighed 177 pounds, and her BMI was 31.47% (Exhibit

5F).

After careful consideration of the evidence, the [ALJ] finds that the claimant’s

medicallydeterminable impairments could reasonablybe expected to cause the

alleged symptoms; however, the claimant’s statements concerning the

intensity, persistence and limiting effects of these symptoms are not entirely

credible . . . .

In terms of the claimant’s alleged limitations, the [ALJ] finds her testimony

less than credible. The claimant alleges multiple complications due to pain. 

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Despite this, she is able to prepare simple meals, take her children to school,

and shop 2-3 times per week. She can also do laundry and help her children

with homework without assistance. The claimant also alleges back spasms,

but this is not documented in the medical evidence. The most recent progress

report from Dr. Alford in September 2012 showed an improvement in pain

with analgesics. The claimant also denied pain in the neck, shoulders, and

upper back during her appointment. (Exhibits 2F and 5F).

As for the opinion evidence, the [ALJ] gives little weight to Dr. Alford’s

opinion that the claimant is disabled, which is not a medical opinion, but rather

goes to the ultimate issue of disability, which is reserved to the Commissioner

pursuant to SSR 96-5p. Further, Dr. Alford’s opinion is based on the

claimant’s reports of an inability to get out of bed, and her subjective pain

levels. Dr. Alford admitted in December 2010 that the claimant had no clear

etiology of her symptoms, as rheumatologic labs were negative. There is no

objective testing to substantiate Dr. Alford’s opinion. Despite continued

warnings regarding opiate dependence, and diagnosis of that impairment,

narcotic pain medication was continually prescribed without any objective

basis for any impairment that could produce moderate to severe pain. 

(Exhibits 2F and 5F).

The [ALJ] gives significant weight to the State agency physical residual

functional capacity assessments and Psychiatric Review Technique form

indicating the ability to perform a range of light work, and no mental

limitations. Findings are consistent with the claimant’s activities of daily

living, andmedical records showing improvement in pain levels with analgesic

medication (Exhibits 3F and 4F).

In sum, the above residual functional capacity assessment is supported by the

claimant’s self-report of her activities of daily living which include laundry

three times per week, shopping 2 to 3 times per week, preparation of simple

meals, and assisting her children with homework. Her activities of daily living

are commensurate with light work activity. Additional limitations were added

based [on] the possible side effects of medication, and the effect her body

habitus may have on her ability to perform certain postural activities (Exhibits

5E, 2F, and 5F).

(Doc. 7-3 at 15-16 [emphasis added.)

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Despite Ms. Lawrence’s testimonythat she was currentlybeing treated at a pain clinic,

together with evidence from the pain clinic in the record with her list of medications, (see

doc. 7-7 at R.190-92), the ALJ did not attempt to obtain her treatment records from the pain

clinic nor did he discuss the diagnosis and treatment that is evident from the letters, beyond

noting the fact of this treatment in his summary of Ms. Lawrence’s testimony, (doc. 7-3 at

15). This was error and the court, sua sponte, reverses and remands to the Commissioner

pursuant to sentence 4 of 405(g).3

The record contains two letters, addressed to Ms. Lawrence from Dr. Michael Scott

Kendrick, providing a “summary” of Ms. Lawrence’s visits with Dr. Richard Maughon at

Southside Pain Specialists. (Doc. 7-7 at 190, 192.) The letters were included in Exhibit 9E,

which is a list of Ms. Lawrence’s medications from her pharmacy. The court finds these

letters significant because they indicate that Ms. Lawrence, who has a history of treatment

for opiate dependency, was receiving treatment with opioid pain medication, including

morphine and Percocet, for neck pain and lower back pain. (See id. at 190-92.) Therefore,

the records from this treating source, compared with other evidence of record, could support

3The court notes that the Eleventh Circuit has not had occasion to address whether a

district court may remand a case under sentence four sua sponte. “However, there is

precedent for a court to sua sponte remand a case back to the ALJ under sentence four of 42

U.S.C. § 405(g).” Seay v. Colvin, No. 12-CV-14410, 2013 WL 5785782, at *12 n.4 (E.D.

Mich. Oct. 28, 2013)(citing, inter alia, Martin v. Comm'r of Soc. Sec., 61 Fed. Appx. 191

(6th Cir. 2003) (Moore J., dissenting)(quoting Iognia v. Califano, 568 F.2d 1383, 1387 (D.C.

Cir. 1977)); Wenzlick v. Astrue, 2009 WL 2777711 (E.D. Mich. Aug. 28,. 2009)).

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either a finding that Ms. Lawrence suffers from pain so significant as to preclude all work

or that Ms. Lawrence has exaggerated her symptoms to obtain opiates.4

On appeal, neither partyaddresses Ms. Lawrence’s treatment for pain byDr. Kendrick

and Dr. Maughon, although the record contains evidence of such treatment in the form of

letters to Ms. Lawrence and her testimony. (Doc. 7-7 at R.190-92; doc. 7-3 at R.26, R.28-29,

R.31-33.) The letters to Ms. Lawrence, purporting to be “summaries” of her visits, state,

inter alia, that she was prescribed morphine and Percocet, among other medications, for pain. 

(Doc. 7-7 at 190-92.) The letters constitute medical opinions because they are “statements

from physicians . . . that reflect judgments about the nature and severity of [Ms. Lawrence’s

impairment[s].” See Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 

2011)(quoting 20 C.F.R. § 404.1527(a)(2); 20 C.F.R. § 416.927(a)(2)). However, other than

a statement that Ms. Lawrence had been treated at a pain clinic, he did not reference any

diagnosis and treatment by the doctors at the pain clinic for low back pain. 

“In reviewing claims brought under the Social Security Act, [the court’s] role is a

limited one. [It] may not decide the facts anew, reweigh the evidence, or substitute [its]

4The court finds that the failure of counsel for Ms. Lawrence to provide these records

and to argue their significance likely caused the error. The court does not exclude the

possibility that such omissions were intentional as the pain clinic records may well support

a finding that Ms. Lawrence has made inconsistent statements to health-care providers for

the purpose of obtaining pain medication given her history of opiate dependency. 

Nevertheless, the Commissioner has a dutyto discuss relevant medical treatment records and,

ifthese records support Ms. Lawrence’s claimfor benefits, her attorney’s omissions in failing

to present these records is not a substantial reason for the denial of those benefits.

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judgment for that of the [Commissioner].” Bloodsworth v. Heckler, 703 F.2d 1233, 1939

(11th Cir. 1983.) However, “within this narrowly circumscribed role, [the court] do[es] not

‘act as [an] automaton[ ].’ [It] must scrutinize the record as a whole to determine if the

decision reached is reasonable and supported by substantial evidence.” Id. (quoting Ware

v. Schweiker, 651 F.2d 408, 411 (5th Cir.1981))(other citations omitted).

The Eleventh Circuit has held “that the opinion of a treating physician is entitled to

substantial weight unless good cause exists for not heeding the treating physician's

diagnosis.” Edwards v. Sullivan, 937 F.2d 580, 583 (11th Cir. 1991). 

[T]he ALJ must state with particularity the weight given to different medical

opinions and the reasons therefor. Sharfarz v. Bowen, 825 F.2d 278, 279 (11th

Cir. 1987)(per curiam). “In the absence of such a statement, it is impossible

for a reviewing court to determine whether the ultimate decision on the merits

of the claim is rational and supported by substantial evidence.” Cowart v.

Schweiker, 662 F.2d 731, 735 (11th Cir. 1981). Therefore, when the ALJ fails

to “state with at least some measure of clarity the grounds for his decision,” we

will decline to affirm “simply because some rationale might have supported

the ALJ's conclusion.” Owens v. Heckler, 748 F.2d 1511, 1516 (11th Cir.

1984)(per curiam). In such a situation, “to say that [the ALJ's] decision is

supported by substantial evidence approaches an abdication of the court's duty

to scrutinize the record as a whole to determine whether the conclusions

reached are rational.” Cowart, 662 F.2d at 735 (quoting Stawls v. Califano,

596 F.2d 1209, 1213 (4th Cir. 1979)) (internal quotation marks omitted).

Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 2011). 

Where, as here, the ALJ does not discuss a treating physician’s opinion and his

conclusions suggest he did not consider the opinions, the court “cannot determine whether

the ALJ's conclusions [are] rational and supported by substantial evidence.” Id.; see also

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Himes v. Comm'r of Soc. Sec., 585 Fed. Appx. 758, 766 (11th Cir. 2014). Therefore, the

decision of the Commissioner will be reversed. 

On remand, the ALJ must explicitly consider and explain the weight accorded to all

medical opinion evidence. He may also request additional information frommedical sources

of record in addition to any other action she deems appropriate.

CONCLUSION

For the reasons set forth above, the decision of the Commissioner is due to be reversed

and this cause remanded pursuant to sentence four of 42 U.S.C. § 405(g) for further

proceedings consistent with this Memorandum Opinion. An Order in conformity with the

Memorandum Opinion will be entered contemporaneously.

DONE this 5th day of November, 2015.

SHARON LOVELACE BLACKBURN

SENIOR UNITED STATES DISTRICT JUDGE 

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