ABDUL K. KALLON, District Judge.
Plaintiff Brenda Roberson ("Roberson") brings this action pursuant to Section 205(g) of the Social Security Act ("the Act"), 42 U.S.C. § 405(g), seeking review of the final adverse decision of the Commissioner of the Social Security Administration ("SSA"). This court finds that the Administrative Law Judge's ("ALJ") decision — which has become the decision of the Commissioner — is not supported by substantial evidence and that the ALJ failed to apply proper legal standards in considering Roberson's claim. Therefore, for the reasons elaborated herein, the court will reverse the decision denying benefits and remand the case for further proceedings.
Roberson, whose past relevant experience includes work as a payroll clerk and truck dispatcher, filed an application for Title II disability insurance benefits and Title XVI Supplemental Security Income on June 20, 2008, alleging a disability onset date of March 30, 2008, due to migraine headaches, sleep apnea, and back pain. (R. 9, 248). After the SSA denied Roberson's claim, she requested a hearing before an ALJ. (R. 99-100). The ALJ subsequently denied Roberson's claim, (R. 6-13), which became the final decision of the Commissioner when the Appeals Council refused to grant review. (R. 1-5). Roberson then filed this action for judicial review pursuant to § 205(g) of the Act, 42 U.S.C. § 405(g). Doc. 1.
The only issues before this court are whether the record contains substantial evidence to sustain the ALJ's decision, See 42 U.S.C. § 405(g); Walden v. Schweiker, 672 F.2d 835, 838 (11th Cir. 1982), and whether the ALJ applied the correct legal standards, see Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). Title 42 U.S.C. § 405(g) mandates that the Commissioner's "factual findings are conclusive if supported by `substantial evidence.'" Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990). The district court may not reconsider the facts, reevaluate the evidence, or substitute its judgment for that of the Commissioner; instead, it must review the final decision as a whole and determine if the decision is "reasonable and supported by substantial evidence." See id. (citing Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)). Substantial evidence falls somewhere between a scintilla and a preponderance of evidence; "[i]t is such relevant evidence as a reasonable person would accept as adequate to support a conclusion." Martin, 849 F.2d at 1529 (quoting Bloodsworth, 703 F.2d at 1239) (other citations omitted). If supported by substantial evidence, the court must affirm the Commissioner's factual findings even if the preponderance of the evidence is against the Commissioner's findings. See Martin, 894 F.2d at 1529. While the court acknowledges that judicial review of the ALJ's findings is limited in scope, it notes that the review "does not yield automatic affirmance." Lamb, 847 F.2d at 701.
To qualify for disability benefits, a claimant must show "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairments 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 twelve months." 42 U.S.C. § 423(d)(1)(A); 42 U.S.C. § 416(i). A physical or mental impairment is "an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrated by medically acceptable clinical and laboratory diagnostic techniques." 42 U.S.C. § 423(d)(3).
Determination of disability under the Act requires a five step analysis. 20 C.F.R. § 404.1520(a)-(f). Specifically, the Commissioner must determine in sequence:
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986). "An affirmative answer to any of the above questions leads either to the next question, or, on steps three and five, to a finding of disability. A negative answer to any question, other than step three, leads to a determination of `not disabled.'" Id. at 1030 (citing 20 C.F.R. § 416.920(a)-(f)). "Once a finding is made that a claimant cannot return to prior work the burden shifts to the Secretary to show other work the claimant can do." Foote v. Chater, 67 F.3d 1553, 1559 (11th Cir. 1995) (citation omitted).
Lastly, where, as here, a plaintiff alleges disability because of pain, she must meet additional criteria. In this circuit, "a three part `pain standard' [is applied] when a claimant seeks to establish disability through his or her own testimony of pain or other subjective symptoms." Holt v. Barnhart, 921 F.2d 1221, 1223 (11th Cir. 1991). Specifically,
Id. However, medical evidence of pain itself, or of its intensity, is not required:
Elam v. R.R. Ret. Bd., 921 F.2d 1210, 1215 (11th Cir. 1991) (parenthetical information omitted) (emphasis added). Moreover, "[a] claimant's subjective testimony supported by medical evidence that satisfies the pain standard is itself sufficient to support a finding of disability." Holt, 921 F.2d at 1223. Therefore, if a claimant testifies to disabling pain and satisfies the three part pain standard, the ALJ must find a disability unless the ALJ properly discredits the claimant's testimony.
Furthermore, when the ALJ fails to credit a claimant's pain testimony, the ALJ must articulate reasons for that decision:
Hale, 831 F.2d at 1012. Therefore, if the ALJ either fails to articulate reasons for refusing to credit the plaintiff's pain testimony, or if the ALJ's reasons are not supported by substantial evidence, the court must accept as true the pain testimony of the plaintiff and render a finding of disability. Id.
In performing the five step analysis, the ALJ found that Roberson had not engaged in substantial gainful activity since March 30, 2008, and, therefore, met Step One. (R. 10). Next, the ALJ found that Roberson satisfied Step Two because she suffered from the severe impairment of "headaches." Id. The ALJ then proceeded to the next step and found that Roberson failed to satisfy Step Three because she "does not have an impairment or combination of impairments that meets or medically equals one of the listed impairments." Id.. Although the ALJ answered Step Three in the negative, consistent with the law, see McDaniel, 800 F.2d at 1030, the ALJ proceeded to Step Four where he determined that Roberson has the residual functional capacity (RFC) to perform "sedentary work as defined in 20 CFR 404.1567(a) and 416.967(a) that would not be precluded by six to eight headaches monthly." (R. 11). In light of her RFC, the ALJ held that Roberson "is capable of performing past relevant work as a payroll clerk and truck dispatcher." (R. 12). Therefore, the ALJ found that Roberson "has not been under a disability, as defined in the Social Security Act, from March 30, 2008, through the date of this decision." (R. 13).
The court now turns to Roberson's contentions that (1) substantial evidence does not support the ALJ's decision to reject Roberson's testimony; and (2) the ALJ failed to consider Roberson's testimony of disabling migraine headaches in accordance with the relevant legal standards.
Roberson testified that she suffers from six to eight migraine headaches per month that require her to lie down in a dark room, (R. 42), and contends substantial evidence does not support the ALJ's decision to reject her testimony. As mentioned in Section III, supra, the pain standard in this circuit requires in part that the ALJ determine whether the objective medical evidence confirms the severity of the alleged pain or that the objectively determined medical condition is of such severity that it can reasonably be expected to give rise to the alleged pain. Holt, 921 F.2d at 1223. Here, the ALJ never mentioned the pain standard, nor explicitly made findings regarding whether objective medical evidence confirmed the severity of Roberson's alleged pain, or if Roberson's medical condition could reasonably be expected to cause disabling migraine headaches. Still, because the ALJ made credibility findings, which clearly implies that he found Roberson met the pain standard, this omission is not fatal. See Tieniber v. Heckler, 720 F.2d 1251, 1255 (11th Cir. 1983) ("Although this circuit does not require an explicit finding as to credibility . . . the implication must be obvious to the reviewing court."). Therefore, the court must review the ALJ's credibility finding to determine if it is supported by substantial evidence.
Although this court defers to the ALJ's fact finding, it "must still make certain that [the ALJ] has exercised reasoned decision making," which requires the court to "evaluate the ALJ's findings in light of the entire record, not only that evidence which supports [his decision]." Owens v. Heckler, 748 F.2d 1511, 1514 (11th Cir. 1984). Based on its review of the entire record, the court finds that the ALJ improperly focused on one aspect of the evidence, to the exclusion of others, to find Roberson was not credible. Specifically, the ALJ's entire credibility finding is based on Roberson's reported activities and the ALJ's inference of an active lifestyle based on physical examination findings:
(R. 12). In making this finding, the ALJ overlooks that in this circuit, "participation in everyday activities of short duration, such as housework or fishing, [does not] disqualif[y] a claimant from disability." Lewis v. Callahan, 125 F.3d 1436, 1441 (11th Cir. 1997). Rather, an ALJ may rely on "inconsistencies between [a claimant's] descriptions of her diverse daily activities and her claims of infirmity" to discredit her allegations of disabling pain. Moore v. Barnhart, 405 F.3d 1208, 1212 (11th Cir. 2005) (emphasis added).
Here, there are no inconsistencies between Roberson's reported activities and her testimony of disabling headaches because Roberson testified that on days when she has severe migraine headaches, she does not do housework, drive, go to the grocery store, "work outside in the garden or anything like that," or go to church. (R. 68). Moreover, there is no evidence that suggests Roberson engaged in the activities cited by the ALJ at a frequency inconsistent with her testimony that she had six to eight disabling migraine headaches per month. Therefore, Roberson's testimony was not inconsistent with the ability to perform the daily activities cited by the ALJ on days when she did not suffer a migraine headache.
(R. 29). The ME further testified that "[i]n between headaches there should not be exertional limitations beyond normal." (R. 30). In fact, to clarify the ME's testimony, the ALJ asked the following question: "Well I guess [the] point is if you're suffering a migraine basically you're incapacitated. If she's not suffering a migraine then she's okay." Id. The ME responded that the ALJ was correct. Id. Based on this evidence, the ALJ acknowledged at the hearing that Roberson's migraines would not cause limitations when she was not experiencing a headache: "I'm taking it as a given. Having had my own migraines, when you have a migraine headache it really totally incapacitates someone, you can't do work with a migraine headache. But when you don't have a migraine headache then you're okay." (R. 41).
Put simply, it was unreasonable for the ALJ to reject Roberson's testimony solely because of his unfounded assumption that Roberson's ability to engage in physical activities from time to time was inconsistent with disabling migraine headaches. Roberson testified that she did not engage in these activities on days when she had migraine headaches, (R. 68), and there is no evidence that she did so. Moreover, the ME testified that the diagnosis of migraine headaches would not affect Roberson's ability to engage in the activities cited by the ALJ when she was not actually experiencing a headache. (R. 29). Therefore, substantial evidence does not support the ALJ's credibility finding.
The ALJ also erred by failing to show that he applied the proper legal standards when considering Roberson's pain testimony. The law is clear that an ALJ "must state with sufficient clarity the rule being applied in order to assure that a rational and consistent standard guides the agency's decision." Owens v. Heckler, 748 F.2d 1511, 1514 (11th Cir.1984). For this reason, "[a] clear articulation of both fact and law is essential to [allow this court] to conduct a review that is both limited and meaningful." Id. at 1514-1515. Unfortunately, here, the only reason the ALJ articulated for not crediting Roberson's testimony of disabling migraine headaches is based on the alleged inconsistencies with her activities. However, under the regulations, Roberson's daily activities are only one of the factors that the ALJ must consider in assessing her credibility. Significant in this case, the other factors include "[t]he type, dosage, effectiveness, and side effects of any medication" or other treatment Roberson received. 20 C.F.R. § 404.1529(c)(3). As explained by Social Security Ruling (SSR) 96-7p:
1996 WL 374186 at *7 (S.S.A.). Although, the ALJ noted that Roberson had at various times had been prescribed Lortab 7.5, Diamox, Stadol, Phenergan, Demerol, Imitrex, Topamax, Paxil and Lamictal to control her pain, and that treatment notes indicate they have been of little benefit and caused significant side effects, the ALJ did not discuss how, if at all, this extensive and largely unsuccessful medication regimen factored into his credibility determination. (R. 11-12). Likewise, although the ALJ observed that in 2007 Roberson underwent a ventriculoscopy for endoscopic fenestration
Based on the foregoing, the court concludes that the ALJ's determination that Roberson's testimony was not credible is not supported by substantial evidence, and that the ALJ failed to apply proper legal standards in considering her credibility. Therefore, the Commissioner's final decision is due to be
