FILED U.S. COURT OF AP P E A LS E LE V EN T HC IRC U IT OCTOB ER 2, 2006 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- 11550 N on -A rgum entC al endar

________________________ D . C . D ocketN o. 04 -003 82 -C V -W D O -5 P A T R I C I A E A S T , P la in tif f - A p p e lla n t, v ersu s J O A N N E B . B A RN H A R T , 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 M id d le D is tr ic t o f G e o r g ia

_________________________ ( O c t ob e r 2, 2006) B efo re C A RN E S , H U L L an d P R Y O R , C i rcu i tJu d g es. P E R C U R I A M: P a tr i c i a E a s ta ppe a l s f

r om the di s tr i c tc our t ’ s or de ra f f i r m i ng theEast orig inally alleg ed an onset date of N ovember 1999, but later amended her onset 1 date to September

30, 2001. 2 C om m i ss i on er ’ s deni al of her app l i ca t i on for s up pl em ent al se curi ty i ncom e ( “ S S I” ) pur s ua ntt o 42 U . S . C . § 1383( c ) ( 3) . B e c a us e s ubs t a nt i a l e vi de nc e s uppor t s the A d mi n i s tr a t i v e La w J u d g e ’ s ( “ A LJ ” ) d e c i s i o n , w e a f f i r m. I . B AC KG RO UN D O n O c t obe r31, 2001, E a s ta ppl i e d f orS S I be ne f

i t s . E a s ta l l e ge d tha t , a s of S ept em ber 30, 20 01 , she w as di sabl ed du e t o h erph ys i ca l i m pai rm ent s of bac k 1 i nj uri es , as thm a a nd se i zure s, and h erm ent al i m pai rm ent s of bi po l ardi sorder , depres si on , sui ci de att em pt s a nd a l ea rni ng di sabi l i ty. T he C om m i ss i on erdeni ed E a s t ’ s appl i c a t i on i ni t i a l l y a nd upon r e c ons i de r a t i on. E a s tthe n r e que s t e d a nd recei v ed a h eari n g b efo re an A L J. D u r i n g th e h e a r i n g , th e A LJ h e a r d t e s t i mo n y f r o m Ea s ta n d f

r o m a vo ca t i on al expert(“ V E ”) . T he A L J a l so consi dere d E as t ’ s e xt ensi ve m edi ca l r e c or ds a nd va r i ous e va l ua t i ons c om pl e t e d by both E a s t ’ s tr e a t i ng s our c e s a nd co n su l t i n g d o ct o rs an d p sych o l o g i st s. A f te rr e v ie w in g th e e v id e n c e , th e A L J c o n c lu d e d th a t E a s t w a s n o t d is a b le d . T he A L J f

ou nd that , al tho ug h E as t ’ s a sthm a, degenerat i ve di sc di se as e a nd bi po l ar d i so rd er w ere sev ere i m p ai rm en t s th atp recl u d ed E astfro m p erfo rm i n g h er p ast r e l e va ntw or k, E a s tr e t a i ne d the r e s i dua l f unc t i ona l c apa c i ty t o pe r f or m l i ghtWe re view a Commis sio ner’ s d e nial of bene fits t o d e terminewh e ther t hede c isi on

is 2 supported by

substantial evidencein the rec ord and whether the cor rec t leg al standard was applied. Mar

tin v. Sul livan, 894 F.2d 1520, 1529 ( 11th Cir. 1990). Substantial evidence is more tha n a sc intill a , b ut l e ss t

ha n a prepo nd e ra

nc e . It is “ su c h re le va

nt evide nc ea s a

re a so na ble person would accept as ade quate to support a c onclusion.” Hale v. B owen, 831 F .2d 1007, 1011 (1 1th Cir . 1 98 7) . “ I f t

heCommis sio ner’ s d e c isi on is s uppo rt e d b y

su bs tanti a l e vide nc ewemus t a ff ir m, even if

theproo f p repo nd e rate s ag ains t it .”Mil e s v . Ch ater, 84 F .3 d 1 39 7, 14 00 (1 1th Cir. 1996). East also argues that the ALJerred in failing to consider the consultingpsycholog ist’s 3 repor t by Dr. Priscilla Wilson. P h.D. However, a ny error in failingto addre ss this report expli citly in the ALJ ’s deter

mination was harmless g iven that Dr. Wilson’s observations in the

3 si m pl e w ork. B as ed on the V E ’ s t es t i m on y, the A L J f ou nd thatsuch l i gh tw ork e xi s t e d a tthe na t i ona l a nd r e gi ona l l e ve l . T he A L J di s c ount e d the c r e di bi l i ty of E a s t ’ s tr e a t i ng phy s i c i a n a nd tr e a t i ng ps y c hi a tr i s ta s w e l l a s E a s t ’ s he a r i ng t est i m o n y reg ard i n g h er su b j ect i v e co m p l ai n t s. T h e A p p ea l C o u n se l d en ied E as t’ s r eq u es t fo r r ev iew , m ak in g th e A L J’s deci si on the fi nal deci si on of the C om m i ss i on er . E as tappeal ed t o t he di stri ct court . T he m agi stra t e j ud ge i ss ued a reportand recom m endat i on (“ R & R ”) , re com m endi ng thatthe di stri ctcourtaf fi rm the C om m i ss i on er ’ s dec i si on . O ver E a s t ’ s obj e c t i ons , the di s tr i c tc our ta dopt e d the R & R a nd a f f i r m e d the C o m m is s io n e r ’s d e c is io n . E a s t ap p e a le d to th is C o u r t. 2 I I . DI S CUS S I ON A . E a s t ’ s B o r d e r lin e P e r s o n a lit y D is o r d e r D ia g n o s is E a s ta r gue s tha tthe A L J e r r e d by f a i l i ng t o c ons i de rhe rbor de r l i ne p e r s o n a lity d is o r d e rd ia g n o s is . W e d is a g r e e . 3repor

t wereconsistent with the ALJ ’s deter mination. See Diorio v. Hec kler, 721 F .2d 726, 728 (1 1th Cir . 1 98 3) (f

indingha rm le ss ALJ’s m isc ha

rac teri zation

of c laima nt’ s p a st w or

k b e c a us e the er ror did not contradict the ALJ ’s ultimate finding s). East also complains that the ALJfailed e xplicitly to acc ept or re

ject the daily

activities questionnaire c ompleted by her mother , L inda B og g s. Be causeBog g s’s statements in the questionnaire duplicated and c orroborated Ea st’s testimony , which the ALJexpli citly found not cre dible, it is “obvious” that the ALJimplicitl y reje cted B og g s’s statements. See Tieniber v. He c kler, 72 0 F .2 d 1 25 1, 12 55 (1 1th Cir . 1 98 3) (“ [T]hi s c irc uit do e s n ot re quirean e xplic it findingas to cre dibility ,” but rather finding s may be by implication if they

are“obvious to the reviewingcourt” ). B eca

use B og g s’s cre dibility

was not critical to the outcome of thecase , the lack of an explicit credibility

findingas to her que stionnaire does not providea basis for rema nd. See F oote v. Chater, 67 F .3d 1553, 1562 (11th Cir. 1995). For example, on October

23, 2001, Dr. Kathleen Klotz, M.D., noted “1997 B ipolar 4 disorder a nd personality

disorder”in the “Past Medical History” portion of her treatment notes. After repor ting to the emerg ency

room, East wa s seen by

Dr. Klotz for frequent he adaches. Dr. Kl otz p re sc ribe d Imitre x an d o rde re d v ari ou s te sts , in c ludingan M RI of Ea st’ s b rain. In s um, Dr. Klotz was not treating Ea st for any alleg ed mental impairments, and it does not appea r she 4 E a s tdi d notl i s tbor de r l i ne pe r s ona l i ty di s or de ra s one of he ri m pa i r m e nt s on he rappl i c a t i on ori n a ny othe rpape r w or k s he c om pl e t e d dur i ng the a dm i ni s tr a t i ve p ro ce ss . F u rth er m o re , th e r ec o rd co n tain s n o ev id en ce o f th e e ff ec t th at E as t’ s b o r d e r lin e p e r s o n a lity d is o r d e rh a d o n h e ra b ility to p e r f o r m b a s ic w o r k a c tiv itie s . S he di d n otdesc ri be the ef fe ctbo rder l i ne pers on al i ty di sorderhad o n h erabi l i t i es i n ei ther her dai l y l i vi ng qu es t i on nai re or her hear i ng t es t i m on y. N on e of her d o c to r s c o m p le te d a n y p ap e r w o r k e v a lu a tin g h o w E a s t’s b o r d e r lin e p e r s o n a lity di sorderl i m i t ed her abi l i t i es . Indeed, a des cr i pt i on of the sy m pt om s of thi s m ent al di s or de rc a nnote ve n be f ound i n the r e c or d. I ns t e a d, E a s t ’ s m e di c a l r e c or ds c o n ta in b r ie f

r e f e r e n c e s to e ith e rh is to r ic a l o r“b y r e p o r t” b o r d e r lin e p e r s o n a lity di sorderdi agno se s, m ostof w hi ch occurre d p ri or t o E as t ’ s a l l eged on se tdat e. In 4diagno se d E a st w ithbo rde rl inepers on a lity dis order. Ins te a d, it a

pp e ars Dr . Klotz wa s mere ly no tin gEa st’ s h ist oric a l di a gno sis of bo rde rl inepers on a lity

dis order a s repo rt e d b y

Ea st. An oth e r e xamp lea

pp e ars on an Augus t 10 , 2 00 3 re ferra l f or m, which in dic ate s th at E a st had been ref

erred to the Oc onee Center for individual counseling . The for m states that the Oc on e eCe nter w a s una

bleto re a c h E a st at th enumber l ist e d o n th ere ferra l. They then s e nt E a st a letter informingher howto contact them to set up a n initial meeting. The“Diagnoses” se ction of the re fer

ral for m list s bipolar disorder

under “Axi s I ” and borderline personality disorder under “Axi s II .” Given that East had not yet appe are d for a n initial meeting, this form doe s not appea r to constitute a diagnosis of borderline personality disorder by

the staff at the Oc onee Center, but merely

a report of Ea st’s historical diagnosis of borderline personality disorder. 5 fa ct , i tdo es no tappear f rom the re cord thatany of E as t ’ s tre at i ng ph ys i ci ans, af t er h e ra lle g e d o n s e t d a te , in d e p e n d e n tly d ia g n o s e d E a s t w ith b o r d e r lin e p e r s o n a lity di sorder . Inst ea d, si nce E as t ’ s a l l eged on se tdat e, her pri m ary di agno se s of m ent al im p a ir m e n ts h a v e b e e n d e p r e s s io n a n d b ip o la rd is o r d e r . E a s t h a s th e b u r d e n to p r e s e n t e v id e n c e o f h e rim p a ir m e n ts a n d th e ir s e ve r i ty . S e e J one s v. A pf e l , 190 F . 3d 1224, 1228 ( 11th C i r . 1999) . A l though the A L J m ustconsi der a l l the i m pai rm ent s the cl ai m antal l eges i n d et erm i ni ng w hether the c l a i m a nti s di s a bl e d, s e e J one s v. D e p’ tof H e a l th & H um a n S e r vs . , 941 F . 2d 1529, 1533 ( 11th C i r . 1991) , the A L J ne e d nots c ourthe m e di c a l r e c or d s e a r c hi ng f o ro th e rim p a ir m e n ts th a t m ig h t b e d is a b lin g , e ith e rin d iv id u a lly o rin c om bi na t i on, tha tha ve notbe e n i de nt i f i e d by the c l a i m a nt . U nde rthe c i r c um s t a nc e s , w e c a nnots a y the di s tr i c tc our tc om m i t t e d r e ve r s i bl e e r r ori n f a i l i ng t o con si der E as t ’ s borderl i ne pers on al i ty di sorder . B. Tr e a t i ng Phys i c i a ns ’ O pi ni o ns6

E as tal so ar gu es thatthe A L J e rr ed i n rej ec t i ng the m edi ca l op i ni on s of D r. R o b e r t H a r tm a n n , M .D ., E a s t’s tr e a tin g p s y c h ia tr is t, a n d D r . A lic e H o u s e , M .D ., E as t ’ s tre at i ng ph ys i ci an. T hese tre at i ng ph ys i ci ans’ op i ni on s m ustbe gi ven s u b s ta n tia l a n d c o n s id e r a b le w e ig h t u n le s s “g o o d c a u s e ” is s h o w n to th e c o n tr a r y . C raw fo rd v . C o m m ’ r o f S o c. S ec. , 3 6 3 F . 3 d 1 1 5 5 , 1 1 5 9 (1 1 th C i r. 2 0 0 4 ); see al so 2 0 C .F .R . § § 4 0 4 .1 5 2 7 ( d ) ( 2 ) , 4 1 6 .9 2 7 ( d ) ( 2 ) .

“ T hi s C our tha s c onc l ude d ‘ good c a us e ’ e xi s t s w he n the : ( 1) tr e a t i ng phy s i c i a n’ s opi ni on w a s notbol s t e r e d by the e vi de nc e ; ( 2) e vi de nc e s uppor t e d a c ontr a r y f

i ndi ng; or( 3) tr e a t i ng phy s i c i a n’ s opi ni on w a s c onc l us or y ori nc ons i s t e nt w i th the doc t or ’ s ow n m e di c a l r e c or ds . ” P hi l l i ps v. B a r nha r t , 357 F . 3d 1232, 1 2 4 0 -4 1 (1 1 th C ir. 2 0 0 4 ). W h en th e A L J d o es n o t g iv e th e tre atin g p h ys ician ’s op i ni on cont rol l i ng w ei gh t , the A L J app l i es ot her f ac t ors f or det erm i ni ng w hether a c l a i m a nti s “ di s a bl e d, ” s uc h a s the l e ngth of tr e a tm e nt , the f

r e que nc y of e x a m in a tio n , th e n a tu r e a n d e x te n t o f th e r e la tio n s h ip , a s w e ll a s th e s u p p o r ta b ility of the opi ni on, i t s c ons i s t e nc y w i th othe re vi de nc e a nd the s pe c i a l i z a t i on of the phy s i c i a n. S e e 20 C . F . R . § 416. 927( d) ( 2) - ( 6) . I f the A L J doe s notgi ve a tr e a t i ng phy s i c i a n’ s opi ni on c ontr ol l i ng w e i ght , “ [ t ] he A L J m us tc l e a r l y a r t i c ul a t e the re as on s f or gi vi ng l es s w ei gh tt o t he op i ni on of a tre at i ng ph ys i ci an, and t he fa i l ure t o d o so i s r ever si bl e e rr or. ” L ew i s v. C al l ahan, 12 5 F . 3d 14 36 , 14 40 (11t h C i r.7

19 97 ); se e a l so 20 C . F . R . §§ 40 4. 15 27 (d)( 2), 41 6. 92 7(d)(2) (r equi ri ng the agency t o “ gi ve go od re as on s” for notgi vi ng w ei gh tt o a tre at i ng ph ys i ci an’ s opi ni on ). T h e A L J p ro v i d ed sp eci fi c “ g o o d cau se” reaso n s fo r rej ect i n g th ese op i ni on s. A s t o D r. H ar tm ann, the A L J e xp l ai ned t hatshe “ re j ec t [e d] D r. H a r tm a n[ n] ’ s c onc l us i ons , a s the y [ w e r e ] i nc ons i s t e ntw i th hi s ow n tr e a tm e nt n o te s ,” h e h a d o n ly b r ie f ly tr e a te d E a s t a n d “h is r e c o r d s s h o w im p r o v e m e n t in s y m pt om s w i th m e di c a t i on. ” T hus , the A L J ga ve s pe c i f i c r e a s ons f

orhe rde c i s i on t o gi ve l e s s w e i ghtt o D r . H a r tm a nn’ s opi ni on a nd c ons i de r e d the f a c t or s i n 20 C .F .R . § 4 1 6 .9 2 7 . F urtherm ore, the A L J’ s r ea sons for r ej ec t i ng D r. H ar tm ann’ s opi ni on ar e s u p p o r te d b y s u b s ta n tia l e v id e n c e b e c a u s e h is o p in io n w a s in c o n s is te n t w ith h is ow n t re atm entno t es re gardi ng E as t . W hen E as t ’ s psy chol og i ca l tre atm entw i th D r. H a r tm a nn be ga n i n M a y 2003, D r . H a r tm a nn i ni t i a l l y not e d “ m i l d de pr e s s i on, ” a nd i n A ug ust20 03 foun d E as tt o b e “ [n] otcl ea rl y m ani c or depres se d” despi t e the fa ct th atsh e h ad n o tb een t ak i n g h er m ed i cat i o n s fo r a m o n th an d a h al f. A d d i t i o n al l y, E as tse l f- re po rt ed thather m edi ca t i on s had been w orki ng i n S ept em ber 200 3, ye t w he n D r . H a r tm a nn a s s e s s e d E a s t ’ s a bi l i ty t o w or k i n N ove m be r2003, he c onc l ude d tha ts he ha d e i the rs e r i ous l y l i m i t e d a bi l i ty t o f unc t i on orno us e f

ul abi l i ty t o fun ct i on i n al l bu ton e ( m ai nt ai n p er sonal appeara nce) w ork-re l at edOn appe al East also a rgues that the ALJerred by failingto rec ontact Dr . Har tmann or 5 Dr. Housepursuant to 20 C.F.R. § 404.1512(e ) prior to re jectingtheir opinions. We do not consider this argument, which wa s not tim ely raised be foreeither theAppeals Council or the district court. See Stewa

rt v. Dep’ t of Health & Human Ser vs., 26 F.3d 115, 115 (11th Cir. 1994) (notingthat issues raised f or the fir st tim e on appe al are not addressed) .

8 a c t i vi ty . I n a ddi t i on, the pr ogr e s s not e s of the s t a f f a tthe O c one e C e nt e r , i nc l udi ng D r . H a r tm a nn, i ndi c a t e tha tE a s t ’ s s y m pt om s i m pr ove d w he n s he f a i thf ul l y t ook her m edi ca t i on s. M oreover, base d o n E as t ’ s hea ri ng t es t i m on y, D r. H ar tm ann h ad se en E as ton l y s i x t i m es ov ersi x m on ths and for on l y 15 m i nu t es ea ch vi si tbefore he c om pl e t e d hi s m e di c a l a s s e s s m e ntc ont a i ni ng hi s opi ni on. 5 A s to D r . H o u s e , th e A L J e x p r e s s ly n o te d th a t s h e “a f f o r d e d little e vi de nt i a r y w e i ghtt o D r . H ous e ’ s l i m i t a t i ons ” be c a us e the y w e r e “ outof p r o p o r tio n to th e o b

je c tiv e m e d ic a l f

in d in g s ,” b a s e d o n D r . H o u s e ’s o w n f in d in g s . T h e A L J a ls o a c k n o w le d g e d D r . H o u s e ’s d ia g n o s is o f f ib r o m y a lg ia , b u t f

o u n d it to be no n-se vere base d o n t he fa ctthatthere w as “ l i t t l e e vi dence i n t he fi l e t o con fi rm the di agno si s. ” T hese re as on s a re supp ort ed by subst ant i al evi dence. W hi l e D r. H o u s e c o n c lu d e d in h e rO c to b e r2 1 , 2 0 0 3 P a in E v a lu a tio n th a t E a s t’s c o m p la in ts of pai n w er e c re di bl e a nd coul d p re venther f rom w orki ng , she c on cl ud ed i n h er Ja nu ary 15, 20 04 P hysi ca l C apabi l i t i es E val uat i on thatE as t ’ s pai n al l egat i on s w er e

“ grea t erthan [the] fi nd i ng s” and ref erre d t o E as t ’ s x-r ay re po rt . N ot abl y, Ja nu ary 20 02 m edi ca l i m agi ng of E as t ’ s l um bar s pi ne re veal ed no subl ux at i on or fr ac tureEast argues that the ALJ“misunderstood” her bac k impairment and emphasizes her 6 1996 MRI , which she c ontends the ALJignored. This MRI , which wa s perf ormed almost five year s before Ea st’s alleg ed onset date, found a “disc protr

usion with mi ld resultant spinal stenosis,” but “no evidence of direc t impingement or

displacement of adjac ent ner ve roots.” Un der t hec irc ums tanc e s, theALJ properly c on c lude d th at E a st’ s b a c k c on dition wa s severe , ju st no t so se verea s to pre c ludeher f ro m all ty pe s o f j ob s in

a natio nal e c on omy . This c on c lus ion is supported by

substantial evidence . 9 a nd onl y “ [ e ] a r l y m i ni m a l s pondy l os i s ” be tw e e n tw o ve r t e br a . J ul y 2002 x- r a y s of E a s t ’ s l um ba rs pi ne a nd r i ghthi p r e ve a l e d onl y s om e di s c s pa c e na r r ow i ng a nd d e s c r ib e d E a s t’s c o m p la in ts a s “u n e x p la in e d c lin ic a l s y m p to m s .” 6 D r. H o u se also n o ted o n h erP h ys ical C ap ab il it ies E v alu atio n th at E as t’ s fi brom ya l gi a “ has no k no w n cl i ni ca l fi nd i ng s. ” D r. H ou se ’ s tre atm entno t es i ndi c a t e tha ton N ove m be r24, 2003, s he m a de a n a ppoi ntm e ntf orE a s tw i th a r he um a t ol ogi s tt o f

ol l ow up on E a s t ’ s f

i br om y a l gi a , butno othe rm e di c a l r e c or ds doc um e nt i ng the r e s ul t s of tha tf ol l ow up c a n be f

ound i n the r e c or d. T h u s, th e A L J g av e ad eq u at e reaso n s fo r d i scred i t i n g b o th d o ct o rs’ o p i n i o n s, and h erre as on s w er e s up po rt ed by subst ant i al evi dence. C . E ast’ s S u b je ct i ve C om p l ai n ts F i nal l y, E as tcont ends thatthe A L J e rr ed i n fi nd i ng thatE as tl ac ked c r e d ib ility w ith r e g a r d to h e rp h y s ic a l c o m p la in ts . A th ree-p art“ p ai n st an d ard ” ap p l i es w h en a cl ai m an tat t em p t s t o est ab l i sh d is a b ility th r o u g h h e ro w n te s tim o n y o f p a in o ro th e rs u b

je c tiv e s y m p to m s . W i l son v . B arnh ar t , 28 4 F . 3d 12 19 , 12 25 (11t h C i r. 20 02 ). T he pai n st andard10

re qu i re s “ (1) e vi dence of an und er l yi ng m edi ca l cond i t i on ; and (2) ei ther ( a) obj ec t i ve m edi ca l evi dence confi rm i ng the se veri ty of the al l eged pai n; or (b) that the obj e c t i ve l y de t e r m i ne d m e di c a l c ondi t i on c a n r e a s ona bl y be e xpe c t e d t o gi ve r i s e t o the c l a i m e d pa i n. ” I d. I n e va l ua t i ng a c l a i m ba s e d on di s a bl i ng s ubj e c t i ve s y m p to m s , th e A L J c o n s id e r s m e d ic a l f in d in g s , a c la im a n t’s s ta te m e n ts , s ta te m e n ts b y th e tr e a tin g p h y s ic ia n a n d e v id e n c e o f h o w th e p a in a f

f e c ts th e c la im a n t’s d a ily a c t i v i t i e s a n d a b i l i ty t o wo r k . 2 0 C. F. R. § 4 1 6 . 9 2 9 ( a ) . Fu r th e r mo r e , “ [ i ] f th e ALJ d e c id e s n o t to c r e d it a c la im a n t’s te s tim o n y a s to h e rp a in , h e m u s t a r tic u la te e xpl i c i ta nd a de qua t e r e a s ons f ordoi ng s o. F a i l ur e t o a r t i c ul a t e the r e a s ons f or di sc re di t i ng subj ec t i ve pai n t es t i m on y r equi re s . . . thatthe t es t i m on y be a cc ept ed as true. ” F oo t e v. C hat er , 67 F . 3d 15 53 , 15 61 -62 (11 th C i r. 19 95 ). H e r e , th e A L J c o n c lu d e d th a t E a s t’s s u b je c tiv e c o m p la in ts w e r e n o t c r e d ib le for the fol l ow i ng re as on s: (1) t es t s per form ed by a num ber of s peci al i st s had been negat i ve; (2) physi ca l exam i ners had n ot ed thatE as t ’ s pre se nt at i on w as funct i on al a nd r e f e r r e d he rt o ps y c hi a tr i s t s f orf ur the re va l ua t i on; ( 3) C . L . C os t e r , D . O , the consul t i ng exam i ner, strong l y s ug gest ed thatE as tw as fa ki ng du ri ng an ex am i n at i o n t o d et erm i n e h er ran g e o f m o t i o n ; (4 ) E ast ’ s d eg en erat i v e d i sk d i sease w a s m i l d, a nd no obj e c t i ve m e di c a l e vi de nc e s uppor t e d the de gr e e of pa i n a nd l i m i t at i on E as tcl ai m ed; and (5) al tho ug h E as tal l eged thatshe c ou l d n otaf ford her11

pr e s c r i pt i on m e di c a t i ons , s he us e d he rc hi l dr e n’ s c hi l d s uppor tt o buy up t o 45 pa c ks of c i ga r e t t e s pe rm onth. T he s e r e a s ons f ordi s c r e di t i ng E a s ta r e s uppor t e d by s u b s ta n tia l e v id e n c e in th e r e c o r d . I n d e e d , E a s t d o e s n o t a r g u e th a t th e y a r e n o t. I ns t e a d, E a s tc ont e nds tha tthe A L J i m pr ope r l y a ppl i e d the pa i n s t a nda r d by fa i l i ng t o add re ss w hether E as thad i m pai rm ent s thatcoul d rea sonabl y be e xp ec t ed t o p rodu ce the type of pai n E as tal l eged. W e di sa gree . T he A L J s peci fi ca l l y s t at ed th a t s h e w a s r e q u ir e d to “c o n s id e ra ll s y m p to m s , in c lu d in g p a in , a n d th e e x te n t to w hi c h the s e s y m pt om s c a n r e a s ona bl y be a c c e pt e d a s c ons i s t e ntw i th the obj e c t i ve me d i c a l e v i d e n c e a n d o th e re v i d e n c e b a s e d o n th e r e q u i r e me n t s o f 2 0 CFR § 4 1 6 . 9 2 9 an d S o ci al S ecu ri ty R u l i n g 9 6 -7 p . ” Iti s cl ear fro m th e A L J’ s o p i n i o n as a w h o le th a t, a lth o u g h E a s t h a d im p a ir m e n ts th a t c o u ld r e a s o n a b ly b e e x p e c te d to pr oduc e the ty pe of

pa i n a nd othe rs y m pt om s E a s ta l l e ge d, the A L J di d notbe l i e ve E a s t’s te s tim o n y a s to th e s e v e r ity o f h e rp a in a n d o th e rs y m p to m s , i.e ., th e ir i nt e ns i ty , pe r s i s t e nc e a nd f unc t i ona l l y l i m i t i ng e f

f e c t s . S e e F oot e , 67 F . 3d a t1561 ( e xpl a i ni ng tha tonc e a n i m pa i r m e ntm e e t i ng the pa i n s t a nda r d i s e s t a bl i s he d, the A L J m u s t c o n s id e re v id e n c e “a b o u t th e in te n s ity , p e r s is te n c e , a n d f u n c tio n a lly l i m i t i ng e f

f e c t s of pa i n orothe rs y m pt om s ” i n a ddi t i on t o “ the m e di c a l s i gns a nd la b o r a to r y f

in d in g s in d e c id in g th e is s u e o f d is a b ility ” ) ; s e e a ls o 2 0 C .F .R . § 41 6. 92 9(c) (“ W hen t he m edi ca l si gn s or l aborat ory f i nd i ng s s ho w thatyou h ave aEast also raises a number of other a

rguments, but they

lack merit and do not warrant 7 further discussion. 12 m e d ic a lly d e te r m in a b le im p a ir m e n t( s ) th a t c o u ld r e a s o n a b ly b e e x p e c te d to pr oduc e y ours y m pt om s , s uc h a s pa i n, w e m us tthe n e va l ua t e the i nt e ns i ty a nd p e r s is te n c e o f

y o u rs y m p to m s s o th a t w e c a n d e te r m in e h o w y o u rs y m p to m s lim it y o u rc a p a c ity f

o rw o r k . . . .” ) . W e c a n n o t s a y th a t th e A L J m is ap p lie d th e p a in s t a nda r d. 7 I I I . CONCL US I ON F o r al l th e fo reg o i n g reaso n s, w e affi rm th e A L J’ s d et erm i n at i o n th atE ast w a s notdi s a bl e d. AF F I RME D.