JOHN E. OTT, Magistrate Judge.
Plaintiff Dovie Renee Owens brings this action pursuant to 42 U.S.C. § 405(g), seeking review of the final decision of the Acting Commissioner of Social Security ("Commissioner") denying her application for supplemental security income ("SSI"). (Doc. 1).
Plaintiff filed her current SSI application in April 2013, alleging she became disabled beginning January 31, 2011. It was initially denied. An administrative law judge ("ALJ") held a hearing on January 9, 2015 (R. 37) and issued an unfavorable decision on April 10, 2015 (R. 7-14). The Appeals Council ("AC") denied Plaintiff's request for review. (R. 1-6).
Plaintiff was 46 years old at the time of the ALJ's decision. (R. 25). Plaintiff alleged onset of disability due to physical impairments of diabetes mellitus with peripheral neuropathy, rheumatoid arthritis, chronic bronchitis, chronic obstructive pulmonary disease ("COPD"), and obesity, and mental impairments of depression and panic disorder. (Id.)
Following a hearing, applying the five-step sequential evaluation process, the ALJ found that Plaintiff had the just-mentioned severe impairments. (R. 20). He noted that Plaintiff also alleged fibromyalgia and hyperlipidemia impairments, but determined that those conditions were not severe. (Id.) The ALJ also found Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 20 C.F.R. pt. 404, subpt. P, app. 1. (R. 21). He further found Plaintiff retained the residual functional capacity ("RFC") to perform a reduced range of light work, with various postural limitations and no exposure to hazards. (R. 15). The ALJ then found that Plaintiff was limited to work that requires no more than understanding, remembering, and carrying out simple instructions; she can sustain such activity for two hours with normal breaks over an eight-hour workday; she is capable of occasional decision making and interaction with the public, coworkers, and supervisors, but can have no more than infrequent changes in the work setting; instructions or tasks of the job cannot be conveyed in a written format and can only be conveyed or demonstrated orally. (R. 25). Lastly, the ALJ found Plaintiff is likely to miss two or fewer days per month from work. (Id.)
The ALJ found that Plaintiff could perform work that exists in significant numbers in the national economy, considering Plaintiff's age, education, work experience, and RFC. (R. 31-32, 74-75). He then concluded that Plaintiff was not disabled. (R. 33).
The court's review of the Commissioner's decision is narrowly circumscribed. The function of the court is to determine whether the Commissioner's decision is supported by substantial evidence and whether proper legal standards were applied. Richardson v. Perales, 402 U.S. 389, 390, 91 S.Ct. 1420, 1422 (1971); Mitchell v. Comm'r Soc. Sec., 771 F.3d 780, 782 (11th Cir. 2015; Wilson v. Barnhart, 284 F.3d 1219, 1221 (11th Cir. 2002). The court must "scrutinize the record as a whole to determine if the decision reached is reasonable and supported by substantial evidence." Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983). Substantial evidence is "such relevant evidence as a reasonable person would accept as adequate to support a conclusion." Id. It is "more than a scintilla, but less than a preponderance." Id.
The court must uphold factual findings that are supported by substantial evidence. However, it reviews the ALJ's legal conclusions de novo because no presumption of validity attaches to the ALJ's determination of the proper legal standards to be applied. Davis v. Shalala, 985 F.2d 528, 531 (11th Cir. 1993). If the court finds an error in the ALJ's application of the law, or if the ALJ fails to provide the court with sufficient reasoning for determining that the proper legal analysis has been conducted, it must reverse the ALJ's decision. See Cornelius v. Sullivan, 936 F.2d 1143, 1145-46 (11th Cir. 1991). The court must affirm the ALJ's decision if substantial evidence supports it, even if other evidence preponderates against the Commissioner's findings. See Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir. 2004) (quoting Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir.1990)).
To qualify for benefits a claimant must show the inability to engage in "any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 1382c(a)(3)(A). A physical or mental impairment is "an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques." 42 U.S.C. § 1382c(a)(3)(D).
Determination of disability under the Social Security Act requires a five step analysis. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). Specifically, the Commissioner must determine in sequence:
Evans v. Comm'r of Soc. Sec., 551 F. App'x 521, 524 (11th Cir. 2014)
Plaintiff argues the ALJ "did not fully consider the combination of [her] impairments before determining her residual function capacity [("RFC")]." (Doc. 12 at 12). She next argues that the ALJ's "finding that [she] is likely to miss work two or fewer days per month is not supported by substantial evidence." (Id. at 12-13). Plaintiff requests that his court reverse and remand this case for reconsideration of her "physical impairments and pain complaints in combination." (Id. at 13).
Plaintiff was diagnosed with type II diabetes mellitus in 2007. (R. 26). She has been steroid dependent for her rheumatoid arthritis since at least 2008. (Id.) She was diagnosed with COPD in February 2009 when an x-ray of her chest showed her lungs to be hyperexpanded from COPD with prominence of retrosternal space. (Id.) She also experiences infrequent episodes of chronic bronchitis. (Id.) The ALJ summarized her hearing testimony as follows: The claimant testified that she last worked as a security guard in 2011, but had to stop due to her impairments. She testified that she has had diabetes mellitus for eight years, and takes five shots of insulin per day. She stated that her medications help her manage her blood sugar levels, but they take a long time to lower her blood sugars. The claimant stated that her blood sugars fluctuate a lot due to her diet. She has been placed on a restrictive diet, and drinks diet coke, eats wheat bread, only eats one egg a day, and has overall reduced her portions. She testified that when her blood sugars are high, she feels exhausted, gets light headed and dizzy, and has to lie down. Her blood sugars normally range over 300, but have been as high as 600 or 700, such as after thanksgiving.
(R. 25-26 (citations omitted)).
The medical records show that Plaintiff has suffered with diabetes mellitus since around 2007.
Plaintiff has been steroid dependent for her rheumatoid arthritis since at least 2008. (R. 238). She had knee and leg pain in January 2012 after she experienced a ten pound weight gain. (R. 332). In March 2012, she complained of swelling and numbness in her feet and pain when walking. (R. 333). Her rheumatoid factor was high at 1:128. (Id.) In June 2012, she complained of joint pain and rheumatoid nodules in her hips. (R. 330). She was taking Tylenol for the pain. (Id.)
Plaintiff was diagnosed with COPD in February 2009. She also experiences intermittent chronic bronchitis. Her most recent episode was July 2014, when she reported to the DeKalb Regional Medical Center ER with complaints of shortness of breadth and coughing. (R. 361). Her chest x-rays showed her lungs were fully expanded and essentially clear. (R. 365). She was diagnosed with COPD with exacerbation due to pneumonia and pulmonary edema. (R.362). She was discharged with a prescription for prednisone. (R. 363).
Plaintiff was diagnosed in May 2009 with cylclothymia, anxiety, and depression due to complaints relating to situational stresses and family problems. (R. 230). She was prescribed Lexapro. (Id.) In March 2013, she was seen for depression. She was prescribed Prozac. (R. 318). She reported that her depression was better in April 2013. (R. 317). She was continued on Prozac. (Id.) In May 2013, she again reported that her depression was better. (R. 316). Her Prozac was increased from 20mg a day to 40mg a day in October 2013. (R. 315).
Plaintiff underwent a consultative psychiatric evaluation with Dr. June Nichols in May 2013. Dr. Nichols found Plaintiff's cognitive abilities to be grossly intact, but somewhat limited. (R. 298). She diagnosed Plaintiff as experiencing major depressive, recurrent, moderate panic disorder with agoraphobia. (R. 300). She also assigned the claimant a Global Assessment of Functioning score of 45, indicating serious symptoms or moderate difficulty in social and occupational functioning. (R. 301). In the "Prognosis" section of her report, she stated, in pertinent part:
(Id.)
Plaintiff also underwent a consultative internal medicine examination in May 2013 with Dr. Alvin Tenchavez. (R. 304). During a neuromuscular examination, Dr. Tenchavez observed that Plaintiff was able to "heel, toe, tandem walk, and stoop and rise on her knees"; she had no sensory defects on general review; her straight leg raising was negative bilaterally in the sitting and supine positions; she had 5/5 grip strength in all muscle groups, and showed no signs of edema, dermatitis, ulcerations, or varicosities; she had the ability to make fists, oppose her thumbs to her fingers, tie her shoelaces, pick up small objects, button, hold a glass, and turn a doorknob; and she was able to ambulate without any assistive device. (R. 306). During a musculoskeletal examination, he noted crepitation in Plaintiff's knees bilaterally and rheumatoid nodules in her left forearm and knees and on the dorsum of both her feet, and that she had no pain, restrictions, or swelling on review of her other joints. (Id.) He diagnosed Plaintiff's conditions to include type II diabetes mellitus, hyperlipidemia, depression, peripheral neuropathy, rheumatoid arthritis, and COPD. (Id.)
Plaintiff argues, as noted above, that the ALJ did not fully consider the combination of her impairments before determining her RFC or the amount of work she would be able to endure. (Doc. 12 at 12). Specifically, she argues the ALJ merely considered her impairments singularly and made only conclusory reference to her combined impairments. (Id.) She also argues that her various conditions in combination cause extreme discomfort and fatigue. (Id.) The Commissioner responds that the ALJ adequately considered the entire record in making his determination. (Doc. 14 at 7). The court agrees with the Commissioner.
At the outset, when considering whether Plaintiff had a severe impairment or combination of impairments, the ALJ noted that Plaintiff's "impairments have combined to more than minimally restrict [her] physical and mental abilities to do basis work activities, and have lasted longer than twelve months." (R. 20). When considering whether Plaintiff's impairment or combination of impairments met or exceeded a listing, the ALJ stated that Plaintiff did not have an impairment "or combination of impairments" that met or medically equaled a listing. (R. 21). By way of example, in considering Plaintiff's obesity, the ALJ stated that "the medical evidence of record shows that [her] obesity, by itself, or in combination with other impairments, does not meet or equal the criteria of a listing." (R. 22). While the ALJ did not provide a similar analysis for every impairment, he did state that he considered "all symptoms" in his RFC analysis. (R. 25). Additionally, he discussed the cumulative effect of Plaintiff's impairments throughout his decision. (See, e.g., R. 21 (obesity "has some negative impact on [Plaintiff's] physical functioning"), R. 24 (mental function analysis is considered in the RFC analysis), and R. 29 (Plaintiff's "weight exacerbates her rheumatoid arthritis and diabetes mellitus with peripheral neuropathy")). Thus, the court finds that the ALJ did consider the combined effect of Plaintiff's impairments. See Scott v. Colvin, 652 F. App'x 778, 781 (11th Cir. 2016) (finding ALJ's statement that the claimant's combined impairments did not amount to a listed impairment and specific, articulated findings as to the effect of the combination of the claimant's impairments constituted evidence that the ALJ considered the combined effects of the claimant's impairments and discussed their cumulative effect); Smith v. Berryhill, 2017 WL 6367890, *4 (N.D. Ala. Dec. 13, 2017) (ALJ's statement that he "`considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence' in determining that they did not amount to a listed impairment, and discussed the cumulative impact of Smith's impairments throughout his decision . . . establishes that the ALJ considered all of Smith's impairments and the combined effects of her impairments in reaching his decision"). Accordingly, this claim is without merit.
Plaintiff also seems to challenge the overall sufficiency of the evidence. In support of her argument, Plaintiff cites to the following evidence:
(Doc 12 at 13). The Commissioner argues that the ALJ correctly evaluated Plaintiff's RFC and that substantial evidence supports his finding. (Doc. 14 at 11). Again, the court agrees with the Commissioner.
After a detailed analysis of Plaintiff's medical conditions, the ALJ found that she could perform a reduced range of light work and would miss two or fewer days of work per month. (R. 24-31). While Plaintiff suffers from various serious maladies, the court finds that the record supports the ALJ's determinations for a number of reasons. First, Plaintiff's daily activities, at least in part, are greater than one would expect given her complaints of disabling symptoms and limitations. In reaching this conclusion, the court is well aware that participation in everyday activities of short duration, such as housework, do not disqualify a claimant. See Lewis v. Callahan, 125 F.3d 1436, 1441 (11th Cir. 1997). But this case is different. Plaintiff is able to take care of her eighteen-year-old autistic son; she goes grocery shopping twice a month, for two and a half hours at a time; and she goes to Walmart and the dollar store. This is more than simple household chores. These activities were properly considered and support the ALJ's decision.
Second, as noted by the ALJ, Plaintiff has not received the type of treatment one would expect given her complaints. For example, while Plaintiff has taken Prozac, she has never had any counseling despite the fact that she has been referred for mental health treatment. (R. 318). Additionally, although Plaintiff claims to experience constant pain at a level of 10 on a 10-point scale (see R. 68), she has not been prescribed any pain medication other than Tylenol or Motrin (see, e.g., R. 318).
Third, Plaintiff has not been compliant with medical advice. She continued to consume items that were inimical to her diabetic condition. These items, including cokes, sweet tea, and candy, were consumed despite her already elevated blood sugar levels. Additionally, Plaintiff's medical records as recent as July 24, 2014, show that she was continuing to smoke cigarettes
Fourth, other evidence in the record supports the decision of the ALJ. Dr. Tenchavez's May 2013 consultative examination of Plaintiff was largely unremarkable. He noted her prior diagnoses. He found no sensory defects or edema. He noted some expiratory wheezing, crepitation in Plaintiff's knees bilaterally, and rheumatoid nodules in her left forearm and knees and on the dorsum of both feet. (R. 304-06). State agency consultant Dr. Amy Cooper opined Plaintiff could carry out simple tasks and would miss only one to two days of work a month due to her mental condition.
To the extent Plaintiff cites her GAF score in support of her position, the court, again, is not impressed. Her GAF score of 45
For the reasons set forth above, the undersigned concludes that the case is due to be affirmed. An appropriate order will be entered separately.
(Id. (citations omitted)). Plaintiff does not challenge the accuracy of these determinations.
(R. 30 (citation omitted)).