Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alsd-1_07-cv-00846/USCOURTS-alsd-1_07-cv-00846-0/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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IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION

VICKIE A. COSEY, :

Plaintiff, :

vs. : CA 07-0846-C

MICHAEL J. ASTRUE, :

Commissioner of Social Security, 

:

Defendant.

MEMORANDUM OPINION AND ORDER

Plaintiff brings this action pursuant to 42 U.S.C. § 1383(c)(3), seeking

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

denying her claim for supplemental security income benefits. The parties have

consented to the exercise of jurisdiction by the Magistrate Judge, pursuant to

28 U.S.C. 636(c), for all proceedings in this Court. (Doc. 17 (“In accordance

with the provisions of 28 U.S.C. 636(c) and Fed.R.Civ.P. 73, the parties in this

case consent to have a United States Magistrate Judge conduct any and all

proceedings in this case . . . and order the entry of a final judgment, and

conduct all post-judgment proceedings.”); see also Doc. 18 (order of

reference)) Upon consideration of the administrative record, plaintiff's

Case 1:07-cv-00846-C Document 19 Filed 06/25/08 Page 1 of 13
1 Any appeal taken from this memorandum opinion and order and judgment shall

be made to the Eleventh Circuit Court of Appeals. (See Doc. 17 (“An appeal from a judgment

entered by a Magistrate Judge shall be taken directly to the United States Court of Appeals for

this judicial circuit in the same manner as an appeal from any other judgment of this district

court.”))

2

proposed report and recommendation, the Commissioner’s brief, and the

parties’ arguments at the June 18, 2008 hearing before the Court, it is

determined that the Commissioner’s decision denying plaintiff benefits should

be reversed and remanded for further proceedings not inconsistent with this

decision.1

Plaintiff alleges disability due to lumbar and cervical degenerative disc

disease, generalized osteoarthritis, hypertension, morbid obesity, depression,

and panic attacks. The Administrative Law Judge (ALJ) made the following

relevant findings:

2. The claimant has the following severe impairments:

lumbar and cervical degenerative disc disease; generalized

osteoarthritis; hypertension; morbid obesity (20 CFR

416.920(c)).

...

3. The claimant does not have an impairment or

combination of impairments that meets or medically equals

one of the listed impairments in 20 CFR Part 404, Subpart

P, Appendix 1 (20 CFR 416.920(d), 416.925 and 416.926).

...

Case 1:07-cv-00846-C Document 19 Filed 06/25/08 Page 2 of 13
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4. After careful consideration of the entire record, the

undersigned finds that the claimant has the residual

functional capacity to perform a full range of unskilled to

simple semi-skilled, sedentary work as defined in Social

Security Ruling 83-10.

Her degenerative disc disease and/or osteoarthritis in

combination with obesity preclude her from standing and

walking for the majority of an 8-hour workday.

As a result of mental impairments in combination with mild to

moderate pain, she experiences moderate limitation of ability to

maintain attention and concentration for extended periods; and

moderate limitation of ability to understand, remember, and

carry out detailed instructions. The undersigned adopted the

conclusions of the state agency consultant in determining these

limitations (8F).

...

As for the opinion evidence, the Administrative Law Judge

assigned significant evidentiary weight to the findings and

opinions of Dr. Ellis with regard to the claimant’s physical

limitations, and Dr. DeFrancisco with regard to her mental

limitations. Their conclusions are consistent with the objective

medical evidence of record, and with the claimant’s history of

conservative medical treatment and no mental health treatment.

The undersigned has considered and rejects Dr. Barnes’s

opinions in Exhibit 13F because the extreme degree of limitation

described is inconsistent with the claimant’s report of her daily

activities, and inconsistent with Dr. Barnes own treatment notes

which document only conservative treatment primarily for

arthralgias and myalgias, exacerbated by obesity. Specifically,

Dr. Barnes’s opinion that the claimant can sit for no more than

1 hour total in an 8-hour workday is inconsistent with the

claimant’s report that she attends church twice on Sundays and

does various household chores while sitting (5E at 3; 9E at 5).

The undersigned further rejects Dr. DeFrancisco’s opinions

Case 1:07-cv-00846-C Document 19 Filed 06/25/08 Page 3 of 13
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regarding the degree of functional limitation the claimant

experiences as a result of pain and obesity, since these matters

are outside the scope of his professional qualification as a

psychologist. In summary, the undersigned finds no convincing

evidence that any of the claimant’s impairments would

significantly limit her ability to sit for extended periods, walk

occasionally, and perform simple work-related tasks using her

hands.

...

5. The claimant is unable to perform any past relevant

work (20 CFR 416.965).

...

6. The claimant was born on July 7, 1960 and was 44

years old, which is defined as a younger individual age 18-

44, on the date the application was filed (20 CFR 416.963).

7. The claimant has at least a high school education and

is able to communicate in English (20 CFR 416.964).

8. Transferability of job skills is not material to the

determination of disability because applying the MedicalVocational Rules directly supports a finding of “not

disabled,” whether or not the claimant has transferable job

skills (See SSR 82-41 and 20 CFR Part 404, Subpart P,

Appendix 2).

9. Considering the claimant’s age, education, work

experience, and residual functional capacity, there are jobs

that exist in significant numbers in the national economy

that the claimant can perform (20 CFR 416.960(c) and

416.966). 

...

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10. The claimant has not been under a disability, as

defined in the Social Security Act, since August 16, 2004, the

date the application was filed (20 CFR 416.920(g)).

(Tr. 17, 19, 19-20, 22 & 23 (emphasis in original)) The Appeals Council

affirmed the ALJ's decision (Tr. 7-9) and thus, the hearing decision became the

final decision of the Commissioner of Social Security.

DISCUSSION

In all Social Security cases, the claimant bears the burden of proving

that she is unable to perform her previous work. Jones v. Bowen, 810 F.2d

1001 (11th Cir. 1986). In evaluating whether the claimant has met this burden,

the examiner must consider the following four factors: (1) objective medical

facts and clinical findings; (2) diagnoses of examining physicians; (3) evidence

of pain; and (4) the claimant's age, education and work history. Id. at 1005.

Once the claimant meets this burden, as here, it becomes the Commissioner's

burden to prove that the claimant is capable, given her age, education and work

history, of engaging in another kind of substantial gainful employment which

exists in the national economy. Sryock v. Heckler, 764 F.2d 834, 836 (11th

Cir. 1985).

The task for the Court is to determine whether the Commissioner's

decision to deny claimant benefits, on the basis that she can perform those

Case 1:07-cv-00846-C Document 19 Filed 06/25/08 Page 5 of 13
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sedentary jobs identified by the vocational expert (“VE”), is supported by

substantial evidence. Substantial evidence is defined as more than a scintilla

and means such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 91

S.Ct. 1420, 28 L.Ed.2d 842 (1971). "In determining whether substantial

evidence exists, we must view the record as a whole, taking into account

evidence favorable as well as unfavorable to the [Commissioner's] decision."

Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986).

In this case, plaintiff contends that the following errors were made: (1)

the ALJ erred in rejecting the opinions of the treating physician, Dr. Stanley

Barnes; (2) the ALJ erred in finding plaintiff can perform the full range of

sedentary work; (3) the ALJ posed an improper hypothetical to the VE; and (4)

the ALJ erred in concluding her depression is not a severe impairment.

Because the undersigned agrees with the plaintiff that the ALJ erred in finding

that she can perform the full range of sedentary work and in finding her

depression to be a non-severe impairment, this Court need not consider the

other errors raised by Cosey. See Pendley v. Heckler, 767 F.2d 1561, 1563

(11th Cir. 1985) (“Because the ‘misuse of the expert’s testimony alone

warrants a reversal,’ we do not consider the appellant’s other claims.”).

Case 1:07-cv-00846-C Document 19 Filed 06/25/08 Page 6 of 13
2 The opinion of a non-examining, reviewing physician “is entitled to little weight

and taken alone does not constitute substantial evidence to support an administrative decision.”

Swindle v. Sullivan, 914 F.2d 222, 226 n.3 (11th Cir. 1990). Obviously, therefore, the RFC

opinion of a disability specialist (Tr. 215-222), the only other physical RFC assessment of record

(i.e., besides the one completed by Dr. Barnes), would be entitled to no weight. 

7

A. Full Range of Sedentary Work Activity. It is clear that the

burden is on the Commissioner at the fifth step of the sequential evaluation

process to establish capacity to perform other work and thereby to establish the

claimant’s residual functional capacity. See Foote v. Chater, 67 F.3d 1553,

1559 (11th Cir. 1995). This Court has held on numerous occasions that the

Commissioner’s fifth-step burden cannot be met by a lack of evidence or,

where available, by the residual functional capacity assessment of a nonexamining, reviewing physician;2

 instead, this fifth-step burden must be

supported by the residual functional capacity (and pain) assessment of a

treating or examining physician. Such an assessment particularly is warranted

where, as here, the ALJ has rejected the only RFC assessment in the record

completed by an examining physician. (See Tr. 237-239) The ALJ specifically

rejected the physical RFC form completed by plaintiff’s treating physician, Dr.

Stanley Barnes, same establishing Cosey’s inability to perform any work (see

Tr. 304 (VE’s testimony that based upon Dr. Barnes’ assessment, plaintiff

would be incapable of performing any work)). Having rejected Dr. Barnes’

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RFC assessment, the ALJ purports to and rely upon the examination findings

of Dr. Mark Ellis (Tr. 187-192), to establish that plaintiff can perform the

physical requirements of sedentary work. However, Ellis nowhere equates his

examination findings to the ability to perform sedentary (or other) work

activity. Instead, the ALJ performs this function while at the same time

rejecting Dr. Barnes’ PCE. This was error and need be corrected on remand.

B. Plaintiff’s Depression is a Non-severe Impairment. The

Commissioner's severity regulation requires the claimant to make a threshold

showing that she has an impairment which significantly limits her physical or

mental ability to perform basic work activities. 20 C.F.R. §§ 416.920(c),

416.921(a) (1998); Bowen v. Yuckert, 482 U.S. 137, 147 n.5, 107 S.Ct. 2287,

2294 n.5, 96 L.Ed.2d 119 (1987); Jones v. Apfel, 190 F.3d 1224, 1228 (11th

Cir. 1999) (“At the second step, [the claimant] must prove that she has a severe

impairment or combination of impairments.”), cert. denied, 529 U.S. 1089,

120 S.Ct. 1723, 146 L.Ed.2d 644 (2000). Basic work activities include

functions such as walking, standing, sitting, lifting, pushing, pulling, reaching,

carrying, or handling; understanding, carrying out and remembering simple

instructions; use of judgment, responding appropriately to supervision, coworkers, and usual work situations; and dealing with changes in a routine work

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3 It is clear that in Yuckert, the Supreme Court did not impose a standard higher

than the de minimis standard set out in Brady. See Stratton v. Bowen, 827 F.2d 1447, 1451 n.7,

1452 n.9, 1452-1453 (11th Cir. 1987).

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setting. 20 C.F.R. § 416.921(b). An impairment can be considered not severe

“only if it is a slight abnormality which has such a minimal effect on the

individual that it would not be expected to interfere with the individual's ability

to work, irrespective of age, education, or work experience.” Brady v. Heckler,

724 F.2d 914, 920 (11th Cir. 1984); see Yuckert, supra, 482 U.S. at 153, 107

S.Ct. at 2297 ("The severity regulation increases the efficiency and reliability

of the evaluation process by identifying at an early stage those claimants

whose medical impairments are so slight that it is unlikely they would be

found to be disabled even if their age, education and experience were taken

into account").3

 

Inherent in a finding of a medically not severe impairment or

combination of impairments is the conclusion that the

individual’s ability to engage in SGA [substantial gainful

activity] is not seriously affected. Before this conclusion can be

reached, however, an evaluation of the effects of the

impairment(s) on the person’s ability to do basic work activities

must be made. A determination that an impairment(s) is not

severe requires a careful evaluation of the medical findings

which describe the impairment(s) and the informed judgment

about its (their) limiting effects on the individual’s physical and

mental ability(ies) to perform basic work activities; thus, an

assessment of the function is inherent in the medical process

itself.

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SSR 85-28. The claimant's burden at step two of the sequential evaluation

process is mild. McDaniel v. Bowen, 800 F.2d 1026, 1031 (11th Cir. 1986)

(“Step two is a threshold inquiry. It allows only claims based on the most

trivial impairments to be rejected.”). A claimant need only show that “her

impairment is not so slight and its effect is not so minimal.” Id.

The record in this case is replete with evidence establishing that the

claimant suffers from depression, an impairment which, not surprisingly, is

recognized as a severe impairment. See, e.g., Hoopai v. Astrue, 499 F.3d 1071,

1075 (9th Cir. 2007) (“The ALJ held that Hoopai had established a prima facie

case of disability. In particular, Hoopai was deemed to have proven at steps

one and two that he was not presently engaged in a substantial gainful activity

and that medical evidence demonstrated that the combination of his low back

pain and depression was severe within the meaning of the regulations.”);

Griffeth v. Commissioner of Social Security, 217 Fed.Appx. 425, 426 (6th Cir.

2007) (“An Administrative Law Judge . . . determined that Griffeth’s

degenerative disc disease and depression were ‘severe’ impairments.”). The

evidence of record in this case regarding Cosey’s depression includes her

treating physician’s recognition of this problem and treatment of same (Tr.

223–224, 228-232, 234-236, 240-245 & 249), a consultative psychological

Case 1:07-cv-00846-C Document 19 Filed 06/25/08 Page 10 of 13
4 Section 416.920a(d)(1) of the Commissioner’s regulations clearly establishes that

a degree of functional limitation of moderate in the functional area of concentration, persistence

or pace, necessarily lends itself to a finding that a mental impairment is severe. See id. (“If we

rate the degree of your limitation in the first three functional areas as ‘none’ or ‘mild’ and ‘none’

in the fourth area, we will generally conclude that your impairment(s) is not severe[.]”). In this

particular case, the non-examining, reviewing psychologist, Dr. Donald E. Hinton, completed a

PRTF on November 30, 2004 (Tr. 197-214), following a review of all psychological evidence of

record (see Tr. 209), and determined plaintiff’s depression/anxiety was severe and resulted in

moderate limitations with respect to concentration, persistence and pace (Tr. 197 & 207). The

ALJ’s determination that plaintiff’s depression is non-severe is clearly at odds with the nonexamining, reviewing physician’s PRTF.

11

report in December of 2004 which recognized that her current medications

included Soma, Ativan, and Zoloft and that she suffers from an adjustment

disorder with probable depressed mood (Tr. 193 & 196), and a psychiatric

review technique form completed by a non-examining psychologist, Dr.

Donald Hinton, in November of 2004, which recognized that plaintiff’s mental

impairment is a severe impairment warranting a residual functional capacity

(RFC) assessment and noting a moderate degree of limitation with respect to

maintaining concentration, persistence and pace (Tr. 197-214).4

 In addition,

the same ALJ who found plaintiff’s depression non-severe in this his most

recent decision on August 10, 2007 (Tr. 17-19 & 23), a year earlier found this

impairment to be severe (Tr. 46). Finally, the ALJ’s conclusion that plaintiff’s

depression is a non-severe impairment is at odds with his later determination

that “[a]s a result of mental impairments in combination with mild to moderate

pain, she experiences moderate limitation of ability to maintain attention and

Case 1:07-cv-00846-C Document 19 Filed 06/25/08 Page 11 of 13
5 Although the plaintiff’s application in this case is solely for supplemental security

income benefits pursuant to 42 U.S.C. § 1383(c)(3), remand is proper under sentence four of §

405(g) because § 1383(c)(3) provides that “[t]he final decision of the Commissioner of Social

Security after a hearing under paragraph (1) shall be subject to judicial review as provided in

section 405(g) of this title to the same extent as the Commissioner’s final determinations under

section 405 of this title.”

12

concentration for extended periods[] and moderate limitation of ability to

understand, remember, and carry out detailed instructions.” (Compare Tr. 17-

19 with Tr. 20) 

In light of the foregoing, this Court is unable to find that the ALJ’s

determination that plaintiff’s depression is non-severe is supported by

substantial evidence. Accordingly, on remand, the ALJ should address this

issue as well. 

CONCLUSION

It is ORDERED that the decision of the Commissioner of Social

Security denying plaintiff benefits be reversed and remanded pursuant to

sentence four of 42 U.S.C. § 405(g),5

 see Melkonyan v. Sullivan, 501 U.S. 89,

111 S.Ct. 2157, 115 L.Ed.2d 78 (1991), for further proceedings not

inconsistent with this decision. The remand pursuant to sentence four of §

405(g) makes the plaintiff a prevailing party for purposes of the Equal Access

to Justice Act, 28 U.S.C. § 2412, Shalala v. Schaefer, 509 U.S. 292, 113 S.Ct.

2625, 125 L.Ed.2d 239 (1993), and terminates this Court’s jurisdiction over 

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this matter. 

DONE and ORDERED this the 25th day of June, 2008.

s/WILLIAM E. CASSADY 

UNITED STATES MAGISTRATE JUDGE

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