FILED U.S. COURT OF AP P EALS E LEVEN T HC IRC U IT MAY 02, 2007 THOMAS K. KAH

N CLERK [ DO NO T P UB L I S H] I N THE UN I TE D STATE S C OU RT OF APPE ALS F O R T H E E L E V E N T H C IR C U IT

________________________ N o. 06- 15109 N on -A rgum entC al endar

________________________ D. C . Do c k e tNo . 0 5 - 0 1 7 9 1 - C V- R DP M A R T H A G R E E N , P la in tif f - A p p e lla n t, v ersu s S O C I A L S E C U R I T Y A D M I N I S T R A T I O N , D e f e n d a n t- A p p e lle e .

________________________ A pp ea l fr om the U ni t ed S t at es D i stri ctC ou rt f o rth e N o r th e rn D i s tr i c to f A l ab a ma

_________________________ ( M ay 2, 2007) B efo re A N D E R S O N , B IR C H an d B A R K E T T , C i rcu i tJu d g es. P E R C U R I A M: P u rs u an t t o 4 2 U .S .C . § 4 0 5 (g ) M ar th a G re en ap p ea ls th e d istrict co u rt’s2

order af fi rm i ng the deci si on by the adm i ni stra t i ve l aw j ud ge (“ A L J” ) denyi ng her appl i ca t i on for S oci al S ec uri ty di sabi l i ty i nsurance benef i t s. O n app ea l , G re en a lle g e s th a t th e A L J e rr e d b y : ( 1 ) m is ap p ly in g th e th r e e - p a r t p a in s ta n d a r d in a s s e s s i ng G r e e n’ s c ondi t i on; ( 2) di s c r e di t i ng the opi ni on of G r e e n’ s tr e a t i ng p h y s ic ia n ; a n d ( 3 ) c o n c lu d in g th a t G r e e n h a dth e r e s id u a l f u n c tio n a l c ap a c ity ( “ R F C ” ) t o pe r f

orm as i gni f

i c a ntnum be rof

j obs a tthe l i ghte xe r t i ona l l e ve l . U pon rev i ew o f th e reco rd , w e A F F IR M th e d en i al o f b en efi t s. I . B AC KG RO UN D G re en fi l ed an appl i ca t i on for aperi od of di sabi l i ty a nd di sabi l i ty i nsurance b e n e f its a lle g in g ad is ab ility o n s e t d a te o f 5 J a n u a ry 2 0 0 1 . S h e lis te d c h r o n ic obs truc t i ve pul m ona ry di s e a s e ( “ C O P D ” ) , t e ndoni t i s , ba c k pr obl e m s , a nxi e ty , a nd d e p r e s s io n a s c o n d itio n s f o r c in g h e rto d is c o n tin u e w o rk . G r e e n in d ic a te d th a t a t a j ob s he he l d unt i l J a nua ry 2001, s he s a t7 hour s ada y i n a n 8- hourw orkda y , s t ood orw a l ke d f

orat ot a l of

1 hourpe rda y , l i f

t e d am a xi m um of

20 pounds , a nd f r e q u e n tly lif

te d 1 0 p o u n d s . T h e C o m m is s io n e rd e n ie d G r e e n ’s ap p lic a tio n b o th i ni t i a l l y a nd on r e c ons i de r a t i on. G r e e n r e que s t e d, a nd w a s gr a nt e d, ahe a r i ng b efo re an A L J. D r. D avi d B ry antexam i ned G re en i n A ug ust19 91 , re gardi ng pai n i n h er ri g h tfo rearm t o th e el b o w area th ath ad b een b o th eri n g h er fo r sev en m o n th s.3

G re en had a sl i gh ti ncre as ed pai n u po n p er form i ng a dee p g ri p. D r. B ry antno t ed thatX -r ay s s ho w ed no ob vi ou s abn orm al i ty a nd di agno se d h erw i th l at er al e p ic o n d y litis . H e p r e s c r ib e d N ap r o s y n a n d in s tru c te d h e rto ap p ly ic e a n d to exer ci se . D r. B ry antsa w G re en agai n i n M ay19 97 , du e t o com pl ai nt s of pai n i n h er a rm s . H e di a gnos e d he rw i th bi l a t e r a l t e ndi ni t i s of the uppe re xtr e m i t i e s a nd advi se d h ert o con t i nu e w i th p hysi ca l therapy and w ri stspl i nt s. G re en al so vi si t ed D r . B ry a nti n M a y 2000, c om pl a i ni ng of pa i n i n both a rm s f

ortw o w e e ks a nd a b u rn in g s e n s a tio n in h e rle f t h ip f o ray e a r . H e d ia g n o s e d th e a rm p a in a s te n d in itis a n d th e h ip p a in a s p o s s ib le o s te o a r th r itis . A nerve condu ct i on t es tperf orm ed that m on th reveal ed a norm al stud y i n the bi l at er al up per e xtre m i t i es and n o evi dence o f m u scl e atro p h y, sen so ry l o ss, en trap m en tn eu ro p ath y, o r p eri p h eral n eu ro p ath y. G r e e n w a s hos pi t a l i z e d by D r . B ry a nti n J a nua ry 2001, w i th c om pl a i nt s of i nc r e a s e d s hor tne s s of

br e a th, c ough, c onge s t i on, a nd i nabi l i ty t o br e a th. S he w as tr e a te d w ith in tr a v e n o u s b r o n c h o d ila to r s , a n tib io tic s , a n d n e b u liz e rtr e a tm e n ts al on g w i th o xygen. S he w as di agno se d w i th C O P D exac erbat i on , em ph ys em a, bron chi t i s, hypo xi a, hypert ensi on , t ob ac co abuse, and al coho l abuse. D r . B ry a ntc onduc t e d pul m ona ry f unc t i on t e s t i ng i n F e brua ry 2001. He di s c ove r e d am i l d obs truc t i ve l ung de f e c ta nd c onf

i rm e d a i rw a y obs truc t i on by the4

decr ea se i n fl ow ra t es . H e det erm i ned thather l un g v ol um es w er e w i thi n n orm al l i m i t s. G re en m etw i th D r. W al t erR oss i n M ar ch 20 01 , and D r. R oss not ed that G re en had b ee n o n o xygen and bl oo d p re ss ure m edi ca t i on , and o bserved reduced br e a th s ounds . I n A pr i l 2001, D r . R os s not e d tha tG r e e n w a s “ doi ng qui t e w e l l not s m o k i n g ” a n d h a d n o s i g n i f i c a n tc o u g h o rs p u tu m p r o d u c t i o n . R 2 - 5 a t1 2 1 . He concl ud ed thather c hestw as cl ea r a nd her C O P D had i m prov ed. H e i nstruct ed her to d is c o n tin u e o x y g e n tr e a tm e n ts a n d s to p th e n e b u liz e rin tw o w e e k s , r e s ta r tin g if n e e d e d . D r . R o s s n o te d th a t G r e e n w a s “f e e lin g q u ite w e ll” w h e n s h e v is ite d in M a y 2001 a s w e l l . I d. H e not i c e d no s i gni f i c a ntc ough ors putum pr oduc t i on a nd th a th e rc h e s twa s e n t i r e l y c l e a rwi th o n l y s l i g h t l y d i m i n i s h e d b r e a th s o u n d s . He in d ic a te d th a t s h e w a s o n ly u s in g h e rn e b u liz e ro n c e in aw h ile , a n d w a s ab le to di s c ont i nue oxy ge n tr e a tm e nt , e xc e ptf orw he n s he oc c a s i ona l l y ge t s t i r e d. G re en sa w D r. R oss a gai n i n A ug ust20 01 , and h e i nd i ca t ed thatshe w as do i ng w el l and n otsm ok i ng , bu tst i l l fa t i gu ed fa i rl y e as i l y, di d n otw al k, and w as notw orki ng. H e not i c e d c l e a r , butr e duc e d br e a th s ounds . C ons ul t a t i ve pu l m on ary f

un ct i on t es t i ng w as perf orm ed i n O ct ob er20 01 , and i tre veal ed m ode r a t e obs truc t i ve a i rw a y di s e a s e a nd l ow f l ow r a t e . G r e e n “ ga ve [ a ] good e f f or t ” i n c om pl e t i ng the t e s tbute xpe r i e nc e d di z z i ne s s , s hor tne s s of br e a th,5

c o u g h in g , a n d w h e e z in g . I d . a t 1 2 2 . T here w er e no si gn s of i m prov em entno t ed on the bron chod i l at or use. In O cto b er2 0 0 1 , D r. B ry an t n o ted o steo ar th riti s r eg ar d in g p ain in G re en ’s r ig h t m id d le f

in g e r . S h e a ls o s a w h im in D e c e m b e r2 0 0 1 , c o m p la in in g o f a c h e s in her knees, hand s, and b ac k. D r. B ry antdi agno se d h erw i th C O P D , t endi ni t i s i n h er f o r e a rm s , h yp e r te n s io n , a n d o s te o a r th r itis a t m u ltip le s ite s , a n d in s tru c te d h e rto c ont i nue ove r - the - c ount e rpa i n r e l i e f . D ur i ng tha tof

f i c e vi s i t , D r . B ry a nt c om pl e t e d aP hy s i c a l C apa c i t i e s E va l ua t i on, aC l i ni c a l A s s e s s m e ntof P a i n, a nd a C lin ic a l A s s e s s m e n t o f

F a tig u e /W e a k n e s s . D r . B ry a n t c o n c lu d e d th a t G r e e n c o u ld l i f tf i v e p o u n d s o rl e s s o c c a s i o n a l l y , s i tf o rtwo h o u r s , a n dwa l ko rs t a n d f o rtwo ho urs duri ng ea ch ei gh tho ur w orkd ay . H e det erm i ned thatshe c ou l d n otw ork ar ou nd haza rdou s m ac hi neryor du st , al l er gens, or fum es . D r. B ry antconcl ud ed th a t “[ p ]a in is p r e s e n t to s u c h a n e x te n t a s to b e d is tr a c tin g to a d e q u a te p e r f o rm a n c e o f

d a ily a c tiv itie s o rw o rk ,” a n d th a t p h y s ic a l a c tiv ity w o u ld le a d to

“ [ g] r e a t l y i nc r e a s e d pa i n a nd t o s uc h ade gr e e a s t o c aus e di s tr a c t i on f r om t a s ks or t ot a l aba ndonm e ntof

t a s ks . ” I d. a t145. H e s t a t e d tha tG r e e n s uf f e r e d f r om fa t i gu e/w ea kn es s thathe “ foun d t o b e vi rtual l y i ncapaci t at i ng ” t o h er , and that ph ys i ca l ac t i vi ty w ou l d g re at l y i ncre as e the fa t i gu e/w ea kn es s “ t o such a degree a s to c au s e to ta l ab a n d o n m e n t o f ta s k s .” I d . a t 1 4 7 .6

D r . R os s e xa m i ne d G r e e n i n J a nua ry 2002, a nd not e d tha ts he w a s “ doi ng qu i t e w el l , ” a nd had “ m i ni m al coug h, m i ni m al sputum prod uct i on , [a nd ] m i ni m al s h o r tn e s s o f

b r e a th .” I d . a t 1 5 0 . H e d ia g n o s e d h e ra s h a v in g m ild C O P D . I n J u ly 2002, D r . R os s not e d tha tG r e e n, a ga i n, w a s “ doi ng qui t e w e l l , ” w i th no s i gni f i c a nt coug h o r s pu tum prod uct i on . Id. H e i nd i ca t ed thatshe w as sl ee pi ng w i th o xygen a tni ghta nd he rhype r t e ns i on w a s c ontr ol l e d w i th m e di c a t i on. D u r in g G r e e n ’s a d m in is tr a tiv e h e a r in g in S e p te m b e r2 0 0 2 , N o rm a - J ill Jaco b so n , a v o cat i o n al ex p ert(V E ), t est i fi ed th atG reen ’ s em p l o ym en th i st o ry as a se w i ng m ac hi ne op er at or w as “ atthe l i gh tl evel of exert i on , ” a nd her e xp er i ence w a s “u n s k ille d o rv e ry lo w e n d o f s e m is k ille d w ith n o tr a n s f e r ab ility .” I d . a t 1 7 4 . T he A L J a s ke d J a c obs on f orhe ropi ni on r e ga r di ng: a hypothet i ca l pers on of M s. G re en’ s a ge, educat i on and w ork e x p e r ie n c e . A n d le t’s a s s u m e th a t th is h yp o th e tic a l p e r s o n c o u ld occa si on al l y l i ftand carry 20 p ou nd s, coul d fre qu ent l y l i ftand carry 10 pounds , c oul d s t a nd a nd w a l k f orup t o s i x hour s i n a n e i ght - hour da y a nd s i tf

orup t o s i x hour s i n m ode r a t e pa i n a nd f a t i gue w i th a m o d e r a te [ e ]f

f e c t o n th e p e r s o n ’s ab ility to c o n c e n tr a te . A n d th is h yp o th e tic a l p e r s o n n e e d s aw o rke n v ir o n m e n t th a t is f r e e o f d u s t, f um e s a nd ga s e s , a nd ha s at e m pe r a tur e a nd hum i di ty c ontr ol atm osph er e. Id. Ja cobson re spon ded thatsuch a hypothet i ca l pers on w ou l d b e unabl e t o return t o a nyof the pa s tw ork tha tG r e e n pe r f orm e d, be c aus e of

c ott on f abr i c dus tpr e s e nt i n th e ai r i n th o se en v i ro n m en t s. Jaco b so n st at ed th ata p erso n w i th th o se7

hypo thet i ca l cond i t i on s c ou l d w ork i n the l ocal or nat i on al ec on om y a s adayc ar e he l pe r , ki nde r ga r t e n a i de , ort e a c he ra s s i s t a nt , of w hi c h the r e a r e about2000 pos i t i ons i n A l aba m a . A ddi t i ona l s e de nt a ry j obs i nc l ude d: t a ki ng or de r s or s o lic itin g a s ate le p h o n e o p e r a to r( 2 0 0 0 p o s itio n s ) ; in f o rm a tio n c le rk , b o th a t a lig h t a n d as e d e n ta ry le v e l o f e x e r tio n ( ac o u p le th o u s a n d p o s itio n s in c o m b in a tio n ) ; ac a s h ie r , b o th a t alig h t a n d as e d e n ta ry le v e ls o f e x e r tio n ( 1 5 ,0 0 0 to 20, 000 pos i t i ons ) ; a nd othe rpos s i bi l i t i e s i ns i de A l aba m aa nd e l s e w he r e . J a c obs on st at ed thatany possi bi l i ty of e m pl oym entw ou l d b e e l i m i nat ed i f thathypo thet i ca l pe r s on w e r e t o e xpe r i e nc e f a t i gue t o the e xt e nttha tthe pe r s on c oul d onl y s t a nd a nd w a lkf o rtw o h o u r s a n d s it f

o rtw o h o u r s d u r in g e v e ry e ig h t h o u rs h if t. A ther hear i ng , G re en t es t i fi ed thatshe i s an u nem pl oyed 49 -y ea r ol d w om an w i th a n e i ghth gr a de e duc a t i on, w ho ha d notpa s s e d the G E D t e s tort a ke n a ny voc a t i ona l tr a i ni ng. T o tr e a the rC O P D , s he t e s t i f i e d tha ts he us e s a n oxy ge n t a nk w hi l e s l ee pi ng atni gh tand d uri ng i nfre qu enttri ps ou t si de w hen the t em pera ture w a s h o t. S h e te s tif

ie d th a t tw ic e aw e e k , a t th e d ir e c tio n o f h e rd o c to r , s h e a tte m p ts t o w a l k tw o l aps a tthe tr a c k f ore xe r c i s e butc a n onl y c om pl e t e one l ap be f or e s he ne e ds t o r e tr e a tt o he rc a rf orhe roxy ge n. S he not e d tha ts he s uf f e r s s hor tne s s of b r e a th ab o u t h a lf

w a y a r o u n d th e tr a c k . S h e in d ic a te d th a t h o u s e w o rkis d if f ic u lt f orhe r , butpos s i bl e i f

s he w orks s l ow l y . S he s t a t e d tha ts he ha s tr oubl e s i tt i ng f or8

l ong pe r i ods be c aus e of l ow e rba c k pa i n. T he A L J not i ce d thatG re en had b ra ce s on b oth arm s f rom her f

i ng er s t o h er e l bow s a nd s he r e s ponde d tha ts he w or e the m c ons t a nt l y f ort e ndi ni t i s , w hi c h s he t es t i fi ed thatshe began t o suffe r f rom i n 1 99 0. S he expl ai ned thatshe t akes B u fferi n fo r th e p ai n , b u ti tw as th e t en d i n i t i s th atfo rced h er t o q u i th er j o b as a s e w e rin 1 9 9 4 . S h e s ta te d th a t s h e c a n o n ly lif t ab o u t f iv e p o u n d s a n d n e e d s b o th ha nds t o pi c k up aga l l on of m i l k. S he a s s e r t e d tha ts he c a n gr i p as m a l l pape rc up w i th o ne hand , bu ti s unabl e t o o pen a j ar . T he A L J det erm i ned thatG re en w as no tdi sabl ed af t erconcl ud i ng thatG re en w as un abl e t o return t o h erform erem pl oym ent , bu tw as “ abl e t o m ake a n adj ustm entt o o ther w ork w hi ch exi st s i n si gn i fi ca ntnu m bers i n the nat i on al e c onom y . ” I d. a t16. T he A L J f ound tha tG r e e n l a s te nga ge d i n s ubs t a nt i a l ga i nf ul a c t i vi ty on 5 J a nua ry 2001. T he A L J f ound tha the rC O P D a nd hype r t e ns i on am ou nt ed t o sever e i m pai rm ent s, bu tthather t endi ni t i s and ost eoarthri t i s w er e c o n s id e r e d to b e n o n - s e v e r e im p a irm e n ts b e c au s e th e y “d o n o t s ig n if ic a n tly lim it h e rab ility to p e r f

o rm b a s ic w o rk - r e la te d f u n c tio n s ” a n d “a r e in te rm itte n t.” I d . T h e A L J a ls o f

o u n d n o lim ita tio n s o f

f u n c tio n r e s u ltin g f

r o m a n y a lle g e d a n x ie ty orde pr e s s i on. T he A L J de t e rm i ne d tha tG r e e n di d notha ve “ a n i m pa i rm e ntor com bi nat i on of i m pai rm ent s w hi ch, ei ther s i ng l y or i n com bi nat i on , m ee tor equal9

al i s t e d i m pa i rm e nt ” i n 20 C . F . R § 404. 1520( d) . I d. a t20. T he A L J the n e xa m i ne d G r e e n’ s R F C by c ons i de r i ng he rs ubj e c t i ve c o m p la in ts a n d o u rs ta n d a r d f o rr e v ie w in g s u b

je c tiv e c o m p la in ts o f

p a in . Th e ALJ f ound tha t“ [ a ] l though the doc um e nt a ry e vi de nc e e s t abl i s he s a n unde r l y i ng m edi ca l cond i t i on capabl e of produ ci ng som e pai n and l i m i t at i on , subst ant i al evi dence does notsupp orta c on cl usi on thatthe obj ec t i vel y det erm i ned m edi ca l c ondi t i on i s of

s uc h s e ve r i ty tha ti tc oul d r e a s onabl y be e xpe c t e d t o gi ve r i s e t o the l evel of pai n and l i m i t at i on s a l l eged by [G re en] . ” I d. T he A L J det erm i ned that G re en “ experi ence s no m ore than m od er at e l i m i t at i on s r es ul t i ng fr om her [ C O P D ],” a n d th a t “[ h ]e rte s tim o n y [ w a s ] f o u n dc r e d ib ly o n ly to th e e x te n t th a t it [ w a s ] c ons i s t e ntw i th” l i m i t a t i ons of “ m ode r a t e f

a t i gue w i th i t s m ode r a t e e f f e c tof h e rab ility to m a in ta in c o n c e n tr a tio n , p e r s is te n c e , a n d p a c e .” I d . a t 2 1 . W ith re gard t o G re en’ s t endi ni t i s a nd ost eoarthri t i s, the A L J f ou nd thatthe m edi ca l evi dence “ si m pl y do[es ] no tsupp ortthe l i m i t at i on s i m po se d” by the P hysi ca l C apa c i t i e s E va l ua t i on, C l i ni c a l A s s e s s m e ntof P a i n, a nd C l i ni c A s s e s s m e ntof F a t i gue /W e a kne s s c om pl e t e d by D r . B ry a nt , a nd the r e f or e , the A L J a f

f or de d “ no w e i ght. . . [ t o] D r . R os s ’ s opi ni on of the c l a i m a nt ’ s l i m i t a t i ons . ” I d. B a s e d on the e nt i r e r e c or d, the A L J de t e rm i ne d “ tha t[ G r e e n] i s l i m i t e d t o oc c a s i ona l l y l i f t i ng a n d c a rry in g tw e n ty p o u n d s , f r e q u e n tly lif

tin g a n d c a rry in g te n p o u n d s ;” th a t, “in10

a n e i ght - hourw orkda y , s he c a n s t a nd a nd/ orw a l k s i x hour s a nd s i ts i x hour s ; ” a nd th a t “[ s ]h e e x p e r ie n c e s m o d e r a te f a tig u e w ith its m o d e r a te e f f e c t o n h e rab ility to concentra t e, and requi re s at em pera ture a nd hu m i di ty c on trol l ed envi ronm ent , fr ee of dus t , f um e s , a nd ga s s e s . ” I d. C on si st entw i th the t es t i m on y of the V E , the A L J f ou nd thatG re en w as unabl e t o pe r f

orm he rpa s tr e l e va ntw ork a s as e w i ng m a c hi ne ope r a t orbe c aus e of the preval ence of cott on du sti n thatenvi ronm ent . T he A L J det erm i ned, ho w ever , that“ consi deri ng [G re en’ s] age, educat i on al backgrou nd , pri or w ork exp er i ence , a nd [ R F C ] , [ s he ] i s c apabl e of pe r f orm i ng w ork w hi c h e xi s t s i n s i gni f i c a nt nu m bers i n the nat i on al ec on om y. ” I d. at22 . A cc ordi ng l y, the A L J rul ed that G r e e n w a s “ notdi s abl e d. ” I d. T he A pp ea l s C ou nci l deni ed G re en’ s r equestfor r evi ew . T he di stri ctcourt a f f i rm e d the C om m i s s i one r ’ s de c i s i on. T hi s appe a l f ol l ow e d. I I . STA N D A R D O F R EVI EW W e r e v ie w th e C o m m is s io n e r ’s d e c is io n in aS o c ia l S e c u r ity c a s e “to det erm i ne i f i ti s s up po rt ed by subst ant i al evi dence and based on p roper l egal st andards. ” C raw ford v. C om m ’ r of S oc. S ec . , 36 3 F . 3d 11 55 , 11 58 (11th C i r. 20 04 ) ( per c uri am ) ( ci t at i on and i nt ernal qu ot at i on s om i tt ed). W e have defi ned su b st an t i al ev i d en ce as “m o re th an a sci n t i l l a” an d as “ su ch rel ev an tev i d en ce as a11

r e a s onabl e pe r s on w oul d a c c e pta s a de qua t e t o s uppor tac onc l us i on. ” I d. ( c i t a t i on a nd i nt e rna l quot a t i ons om i tt e d) . T he l e ga l c onc l us i ons e m pl oy e d by the C om m i s s i one ra r e r e vi e w e d de novo. L e w i s v. B a rnha r t , 285 F . 3d 1329, 1330 (11th C i r. 20 02 ) ( per c uri am ). I I I . DI S CUS S I ON A . P ai n S t andard G r e e n a r g u e s th a t h a d th e A L J p r o p e r ly c o n s id e r e d th e m e d ic a l e v id e n c e in th e r e c o r d , h e w o u ld h a v e f o u n d h e rd is ab le d b a s e d o n h e rc o m p la in ts o f p a in . “A n in d iv id u a l c la im in g S o c ia l S e c u r ity d is ab ility b e n e f its m u s t p r o v e th a t s h e is d i s ab l e d . ” M o o r e v . Ba rn h a r t , 4 0 5 F. 3 d 1 2 0 8 , 1 2 1 1 ( 1 1 th Ci r . 2 0 0 5 ) ( p e rc u r i a m) ( c i t a t i on om i tt e d) . W e ha ve he l d tha t“ [ i ] n or de rt o e s t abl i s h adi s abi l i ty ba s e d on t es t i m on y of pai n and other s ym pt om s, the cl ai m antm ustsa t i sf y tw o p art s of a thr e e - pa r tt e s ts how i ng: ( 1) e vi de nc e of a n unde r l y i ng m e di c a l c ondi t i on; a nd ( 2) e i the r( a ) obj e c t i ve m e di c a l e vi de nc e c onf i rm i ng the s e ve r i ty of

the a l l e ge d pa i n; or (b) thatthe obj ec t i vel y det erm i ned m edi ca l cond i t i on ca n rea sonabl y be e xp ec t ed to g iv e r is e to th e c la im e d p a in .” W ils o n v . B a rn h a r t, 2 8 4 F .3 d 1 2 1 9 , 1 2 2 5 ( 1 1 th C ir . 2 0 0 2 ) ( p e rc u r ia m ) ( c ita tio n o m itte d ) . W e h a v e ap p lie d th a t s ta n d a r d to c om pl a i nt s of

s ubj e c t i ve c ondi t i ons othe rtha n pa i n. H ol tv. S ul l i va n, 921 F . 2d 12 21 , 12 23 (11th C i r. 19 91 ) ( per c uri am ) ( ci t at i on om i tt ed). A n A L J that12

di s c r e di t s s ubj e c t i ve t e s t i m ony “ m us ta r t i c ul a t e e xpl i c i ta nd a de qua t e r e a s ons f or doi ng s o, ” a nd “ f

a i l ur e t o a r t i c ul a t e the r e a s ons f ordi s c r e di t i ng s ubj e c t i ve t es t i m on y r equi re s, as a m att erof l aw , thatthe t es t i m on y be a cc ept ed as true. ” W i l son, 28 4 F . 3d at12 25 (c i t at i on s om i tt ed). W e f i nd tha ts ubs t a nt i a l e vi de nc e s uppor t s the A L J ’ s c onc l us i on, w hi c h he b o ls te r e d w ith a r tic u la te d e x p lic it a n d a d e q u a te r e a s o n s , th a t th e o b je c tiv e ly de t e rm i ne d m e di c a l c ondi t i on doe s not“ gi ve r i s e t o the l e ve l of pa i n a nd lim ita tio n s a lle g e d b y [ G r e e n ].” R 2 - 5 a t 2 0 . G r e e n w a s i ni t i a l l y hos pi t a l i z e d, a nd r e nde r e d unabl e t o w ork, i n e a r l y J a nua ry 2001, f orbr e a thi ng c om pl i c a t i ons re sul t i ng fr om C O P D . T he ac com panyi ng do cum ent ary e vi dence, ho w ever , in d ic a te s th a t h e rc o n d itio n h a d s te a d ily im p r o v e d . A t a n e x a m in a tio n in A p r il 2001, a f t e rs he ha d qui ts m oki ng, D r . R os s , the phy s i c i a n tr e a t i ng he rl ung cond i t i on , i nstruct ed G re en t o d i sc on t i nu e oxygen tre atm ent s bec ause she w as “d o in g q u ite w e ll” a n d h a d n o s ig n if ic a n t c o u g h o rs p u tu m p r o d u c tio n . I d. a t121. S i m i l a rpos i t i ve c om m e nt s appe a ron D r . R os s ’ s c ha r t s thr oughoutthe c our s e of hi s e xa m i na t i ons , i nc l udi ng hi s l a s ta nd m os tr e c e ntc ont a i ne d i n the r e c or d, f r om Jul y of 200 2. W i th regard t o h erost eoarthri t i s and t endi ni t i s, D r. B ry ant , her p r im a ry c a r e p h y s ic ia n , tr e a te d G r e e n o n 4 D e c e m b e r2 0 0 1 , a n d c h o s e n o t to pres cr i be narcot i cs ; i nst ea d, he i nstruct ed her t o con t i nu e usi ng ov er -the-c ou nt er13

p a in m e d ic a tio n . T h e A L J p r o p e r ly f o u n d th a t G r e e n h a d n o m o r e th a n m o d e r a te l i m i t at i on s f

rom C O P D / em ph ys em a a nd had m od er at e f at i gu e. W e f

i nd that s u b s ta n tia l e v id e n c e s u p p o r ts th e A L J ’s f in d in g th a t G r e e n ’s s u b

je c tiv e c o m p la in ts do notr i s e t o the l e ve l of adi s abi l i ty , ba s e d on the c ontr ol l i ng pa i n s t a nda r d. B . G re en’ s T re at i ng P hysi ci an G re en ar gu es thatthe A L J e rr ed by di sm i ss i ng D r. B ry an’ s opi ni on thather di sabi l i t i es prevent ed her f rom w orki ng , as expres se d i n the P hysi ca l C apac i t i es E va l ua t i on, C l i ni c a l A s s e s s m e ntof P a i n, a nd C l i ni c a l A s s e s s m e ntof F a t i gue /W e a kne s s . W e ha ve not e d tha t“ [ i ] ti s w e l l - e s t abl i s he d tha tthe t e s t i m ony o f a treat i n g p h ysi ci an m u stb e g i v en su b st an t i al o r co n si d erab l e w ei g h tu n l ess good c aus e i s s how n t o the c ontr a ry . ” C r a w f or d, 363 F . 3d a t1159 ( c i t a t i on a nd i n t ern al q u o t at i o n s o m i tt ed ). G o o d cau se t o d i sco u n ta treat i n g p h ysi ci an m ay ari se w h e r e ar e p o r t “is n o t a c c o m p a n ie d b y o b je c tiv e m e d ic a l e v id e n c e o ris w h o lly co n cl u so ry. ” Id . (ci t at i o n an d i n t ern al q u o t at i o n s o m i tt ed ). T h e A L J m ay al so de va l ue the opi ni on of

atr e a t i ng phy s i c i a n w he r e the opi ni on i s c ontr a di c t e d by o b je c tiv e m e d ic a l e v id e n c e . E llis o n v . B a rn h a r t, 3 5 5 F .3 d 1 2 7 2 , 1 2 7 5 - 7 6 ( 1 1 th C ir . 2 0 0 3 ) ( p e rc u r ia m ) ( c ita tio n o m itte d ) . H er e, the A L J had go od cause t o d i sc re di tD r. B ry ant ’ s opi ni on . S ee C r a w f or d, 363 F . 3d a t1159. T he A L J a f f or de d no w e i ghtt o D r . B ry a nt ’ s opi ni on–Although the ALJ states that “no we ight is af forde d to Dr. Ross’s opinion of the claimant’s 1 limit ations,” R2-5 at 21, it appe ars c lear fr o m the contex t, and Gre en conc edes, that the ALJwas actually ref erring to Dr . Br

yant. 14 a s e xpr e s s e d i n the P hy s i c a l C apa c i t i e s E va l ua t i on, C l i ni c a l A s s e s s m e ntof P a i n, a nd C l i ni c a l A s s e s s m e ntof F a t i gue /W e a kne s s –tha tG r e e n s uf f e r e d f r om di s tr a c t i ng p a in a n d v ir tu a lly in c ap a c ita tin g f a tig u e a n dw e a k n e s s th a t c o u ld le a d to abando nm entof t as ks. T he offi ce re cords of D r. R oss i nd i ca t e thatG re en w as 1

“ [ d] oi ng qui t e w e l l ” w i th he rr e s pi r a t ory pr obl e m s hor t l y a f t e rD r . B ry a nt c o m p le te d th e f

o rm s in D e c e m b e r2 0 0 1 . R 2 - 5 a t 1 5 0 ; s e e a ls o id . a t 1 2 1 ( n o tin g in other off i ce vi si t s thatG re en w as “ [f ] ee l i ng qu i t e w el l ” a nd “ [d] oi ng w el l ”) . D r. B ry a nt ’ s tr e a tm e ntnot e s i ndi c a t e tha ton the s a m e da y he c om pl e t e d the f orm s , he exam i ned h erand d i d n otpres cr i be any narc ot i cs for herpai n rel at ed t o h er t endi ni t i s; ra ther he i nstruct ed her t o con t i nu e the use of over-the-c ou nt er m e di c a t i on. M or e ove r , G r e e n t e s t i f i e d tha tthe us e of

ove r - the - c ount e rm e di c a t i on

“ e a s e s [ the pa i n] of

f . ” I d. a t170. D r . R os s ’ s of f i c e r e c or ds a nd G r e e n’ s t e s t i m ony a m ountt o s ubs t a nt i a l e vi de nc e s uppor t i ng the A L J ’ s de c i s i on t o de va l ue the o p in io n o f

D r . B ry a n t. S e e W ils o n , 2 8 4 F .3 d a t 1 2 2 6 ( f in d in g th e d e c is io n to di sc re di tsubj ec t i ve pai n t es t i m on y w as supp ort ed by evi dence thatt es t i m on y w as in c o n s is te n t w ith c la im a n t’s c o n d itio n , a c tiv itie s , a n d lim ite d u s e o f p a in m edi ca t i on ).15

C . R e s id u a l F u n c tio n a l C ap a c ity G r e e n a r gue s tha tw i thoutD r . B ry a nt ’ s opi ni on, the r e i s nothi ng i n the r e c o r d f o rth e AL J t o b a s e h i s R F C c o n c l u s i o n th a ts h e c a n p e r f o rm l i g h two rk . As m e n tio n e d p r e v io u s ly , th e b u r d e n lie s w ith th e c la im a n t to p r o v e h e rd is ab ility . M oo re , 40 5 F . 3d at12 11 . In the fourth st ep of thatanal ys i s, the A L J det erm i nes the c l a i m a nt ’ s R F C a nd he rabi l i ty t o r e turn t o he rpa s tr e l e va ntw ork. P hi l l i ps v. B ar n h ar t, 3 5 7 F .3 d 1 2 3 2 , 1 2 3 8 (1 1 th C ir. 2 0 0 4 ). In d eter m in in g th e c laim an t’ s R F C , the A L J “ m ustdet erm i ne i f the cl ai m anti s l i m i t ed t o a part i cul arw ork l e ve l . ” I d. T he l i ghtw ork l e ve l r e qui r e s the abi l i ty t o l i f t“ no m or e tha n 20 pounds a tat i m e w i th f

r e que ntl i f

t i ng orc a rry i ng of

obj e c t s w e i ghi ng up t o 10 pounds ” a nd “ag o o d d e a l o f

w a lk in g o rs ta n d in g , o rw h e n it in v o lv e s s ittin g m o s t o f th e tim e [ ,] . . . s o m e p u s h in g a n d p u llin g o f a rm o rle g c o n tr o ls .” 2 0 C .F .R § 4 0 4 .1 5 6 7 ( b ) . A l though ac l a i m a ntm a y pr ovi de as t a t e m e ntc ont a i ni ng aphy s i c i a n’ s opi ni on of he rr e m a i ni ng c apabi l i t i e s , the A L J w i l l e va l ua t e s uc h as t a t e m e nti n l i ghtof the other e vi dence pres ent ed and the ul t i m at e det erm i nat i on of di sabi l i ty i s r es erved f o rth e A L J . 2 0 C .F .R § § 4 0 4 .1 5 1 3 , 4 0 4 .1 5 2 7 , 4 0 4 .1 5 4 5 . I f ac la im a n t p r o v e s th a t s h e is u n ab le to p e r f o rm h e rp a s t r e le v a n t w o rk , in the fi fth st ep, “ the bu rden shi ft s t o the C om m i ss i on ert o d et erm i ne i f there i s other w o rka v a ilab le in s ig n if ic a n t n u m b e r s in th e n a tio n a l e c o n o m y th a t th e c la im a n t is16

abl e t o pe r f

orm . ” J one s v. A pf

e l , 190 F . 3d 1224, 1228 ( 11th C i r . 1999) ( c i t a t i on om i tt e d) . T he “ pr e f

e rr e d m e thod” f

orthe C om m i s s i one rt o de m ons tr a t e , by s ubs t a nt i a l e vi de nc e , tha tthe c l a i m a ntc a n pe r f orm othe rj obs i s thr ough the t es t i m on y of avo ca t i on al expert(“ V E ”) . Id. at12 29 . S ho ul d the C om m i ss i on er

“ de m ons tr a t e tha tthe r e a r e j obs the c l a i m a ntc a n pe r f orm , the c l a i m a ntm us tpr ove s he i s unabl e t o pe r f

orm thos e j obs i n or de rt o be f ound di s abl e d. ” I d. a t1228. G r e e n a r gue s tha tonc e the A L J de c i de d t o di s c r e di tD r . B ry a nt ’ s e va l ua t i on, the re cord l ac ked sub st ant i al evi dence t o sup po rta f i nd i ng thatshe c ou l d p er form l i gh tw ork. D r. B ry ant ’ s e val uat i on , ho w ever , w as the on l y e vi dence thatG re en p r o d u c e d , o th e rth a n h e ro w n te s tim o n y , th a t r e f u te d th e c o n c lu s io n th a t s h e c o u ld pe r f orm l i ghtw ork. O nc e the A L J de t e rm i ne d tha tno w e i ghtc oul d be pl a c e d on D r. B ry ant ’ s opi ni on of the G re en’ s l i m i t at i on s, the on l y docum ent ary e vi dence thatre m ai ned w as the offi ce vi si tre cords f rom D r. B ry antand D r. R oss that i nd i ca t ed thatshe w as m anagi ng her r es pi ra t i on prob l em s w el l , thatshe had control l ed her hypert ensi on , and thather pai n cou l d b e tre at ed w i th o ver- thec ount e rm e di c a t i on. T hus , s ubs t a nt i a l e vi de nc e s uppor t s the A L J ’ s de t e rm i na t i on tha tG r e e n c oul d pe r f

orm l i ghtw ork. T he A L J di d nots ubs t i tut e hi s j udgm e ntf or tha tof D r . B ry a nt ; r a the r , he de t e rm i ne d tha tD r . B ry a nt ’ s opi ni on w a s i nc ons i s t e nt w i th obj e c t i ve m e di c a l e vi de nc e i n the r e c or d.17

A ft er th e A L J co n cl u d ed th atG reen co u l d n o tp erfo rm h er p astw o rkas a sew i n g m ach i n e o p erat o r, d u e t o th e p rev al en ce o f co tt o n d u sti n sew i n g fact o ri es, the bu rden then shi ft ed t o the C om m i ss i on ert o p rove thatG re en coul d p er form s om e w ork i n the na t i ona l e c onom y . T he V E a f f i rm e d tha t“ ahypothe t i c a l pe r s on o f M s . G r e e n ’s a g e , e d u c a tio n a n d w o rke x p e r ie n c e . . . [ w h o ] c o u ld o c c a s io n a lly l i f ta nd c a rry 20 pounds , c oul d f r e que nt l y l i f

ta nd c a rry 10 pounds , c oul d s t a nd a nd w a lkf o ru p to s ix h o u r s in a n e ig h t- h o u rd a y a n d s it f o ru p to s ix h o u r s in m o d e r a te p a in a n d f

a tig u e w ith am o d e r a te a f f e c t o n th e p e r s o n ’s ab ility to c o n c e n tr a te . . . [i n ] a w o rken v i ro n m en tth ati s free o f d u st , fu m es an d g ases, an d h as a t em pera ture a nd hu m i di ty c on trol atm osph er e, ” c ou l d w ork as adayc ar e hel per, ki nde r ga r t e n a i de , t e a c he ra s s i s t a nt , t e l e phone ope r a t or , i nf orm a t i on c l e rk, or c a s h ie r . R 2-5 at17 4-75 . A cc ordi ng t o the V E , the l ocal ec on om y c on t ai ned suff i ci entnu m bers of such po si t i on s. G re en di d n otpres entany e vi dence c ontr ove r t i ng the V E . T hus , s ubs t a nt i a l e vi de nc e s uppor t s the A L J ’ s c onc l us i on tha tG r e e n c oul d pe r f

orm j obs i n the l oc a l e c onom y a nd, the r e f or e , w a s not di s abl e d. I V . CONCL US I ON S ub st ant i al evi dence s up po rt s the deci si on of the A L J t o d eny G re en S oci al S e c ur i ty di s abi l i ty be ne f i t s . T he A L J e m pl oy e d the c ontr ol l i ng s t a nda r d r e ga r di ng18

G re en’ s a l l egat i on s of pai n and other s ubj ec t i ve cond i t i on s; j ust i fi abl y di sc re di t ed the opi ni on of

G r e e n’ s pr i m a ry c a r e phy s i c i a n i n f a vorof obj e c t i ve e vi de nc e ; a nd approp ri at el y c on cl ud ed thatG re en coul d p er form w ork atthe l i gh texert i on al l evel . A cc ordi ng l y, w e A F F I R M.