WILLIAM S. DUFFEY, Jr., District Judge.
This matter is before the Court on Plaintiff Stanley T. Page's Objections [13] to Magistrate Judge Janet F. King's Final Report and Recommendation ("R&R") [11] in Plaintiff's Social Security Disability Action.
On December 30, 2008, Plaintiff Stanley T. Page ("Plaintiff") filed for disability insurance benefits and Supplemental Security Income ("SSI") under the Social Security Act (the "Act"), alleging that he became disabled on October 1, 1999. On March 26, 2009, the Social Security Administration (the "SSA") denied Plaintiff's applications. On February 25, 2010, upon a request for reconsideration, the SSA Commissioner (the "Commissioner") again denied Plaintiff's applications. On April 20, 2010, Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). On September 14, 2010, December 16, 2010, and July 26, 2011, administrative hearings were held before the ALJ. On August 26, 2011, the ALJ issued a "Notice of Decision-Unfavorable" because she found that Plaintiff was not under a "disability" as defined by the Act, and there were jobs in significant numbers in the national economy that Plaintiff could perform.
On September 27, 2012, Plaintiff filed this action. On November 4, 2013, the Magistrate Judge issued her R&R, recommending that the ALJ's decision be affirmed because substantial evidence supports the ALJ's findings and conclusion. On November 18, 2013, Plaintiff filed his Objections [13].
On December 30, 2008, Plaintiff submitted his applications for SSI, claiming severe back pain. On March 14, 2009, Plaintiff was examined by Dr. Charles Carnel, who found that Plaintiff ambulated effectively and was "able to transfer on and off the exam table independently." (R&R at 22-23.) Dr. Carnel also noted that Plaintiff "demonstrate[d] poor suboptimal effort throughout the exam[,] particularly with manual motor testing of the right lower extremity and with squatting." (
On March 30, 2009, Plaintiff underwent an MRI and was diagnosed with L5-S1 grade 1 to 2 anterolisthesis, in association with a pars defect contributing to severe bilateral formaminal stenosis and nerve root impingement. (
At his December 16, 2010, hearing, Plaintiff complained of sharp, stinging, and burning back pains, which radiate to his right leg. Plaintiff testified that he could only stand for brief periods before pain and numbness in his back and leg required him to sit or lie down. (
Plaintiff testified that his last job was in 1998 or 1999, and he stopped working because he was incarcerated for aggravated assault. (
On February 24, 2011, Dr. Charles Hancock submitted his responses to a medical interrogatory on Plaintiff's disability status. Dr. Hancock determined that Plaintiff would be able to lift 20 pounds occasionally and 10 pounds frequently. Dr. Hancock found that Plaintiff would be able to do a restricted range of light work. (
The ALJ considered the medical opinions of Dr. Carnel and Dr. Hancock, giving them slight and moderate weight, respectively. (
The ALJ analyzed whether the Plaintiff's back pain meets, medically equals, or exceeds the severity of any impairments found in the Listing of Impairments ("Listings") identified in the Social Security regulations. The ALJ determined that Plaintiff's back pain did not meet the Listing for disorders of the spine because the record did not support his subjective pain testimony, and because he was able to ambulate effectively. The ALJ made the following findings of fact in support of her conclusion:
(
At Plaintiff's July 26, 2011, supplemental hearing before the ALJ, Plaintiff's counsel cross examined Dr. Hancock regarding his answers to the medical interrogatory. Plaintiff's counsel questioned Dr. Hancock extensively. (
Plaintiff objects to the Magistrate Judge's recommendation that the decision of the ALJ be affirmed. Plaintiff first objects to the Magistrate Judge's finding that the ALJ did not err by relying on Dr. Carnel's March 14, 2009, examination report. Plaintiff next objects to the Magistrate Judge's conclusion that the ALJ did not prejudice Plaintiff when she limited Plaintiff's counsel's questions at the July 26, 2011, supplemental hearing. Plaintiff finally objects to the Magistrate Judge's recommendation that the Court affirm the ALJ's finding that Plaintiff does not meet the requirements for a listed impairment.
After conducting a careful and complete review of the findings and recommendations, a district judge may accept, reject, or modify a magistrate judge's report and recommendation. 28 U.S.C. § 636(b)(1) (Supp. V 2011);
The Court may conduct a limited review of a denial of benefits by the SSA Commissioner. The Court must affirm the Commissioner's decision if it is supported by "substantial evidence" and if the correct legal standards are applied.
The Commissioner's findings of fact must be supported by substantial evidence, which the Eleventh Circuit defines as less than a preponderance of the evidence but such relevant evidence as a reasonable person would accept as adequate to support a conclusion.
Plaintiff objects to the Magistrate Judge's and the ALJ's reliance on the medical testimony of Dr. Carnel, because Dr. Carnel examined Plaintiff on March 14, 2009, and he submitted his report without viewing the results of an MRI Plaintiff underwent on March 30, 2009.
Plaintiff argues that Dr. Carnel's evaluation of Plaintiff and any subsequent medical opinions based on Dr. Carnel's report are invalid because Dr. Carnel's report does not take into account the March 30, 2009, MRI. It is unclear to the Court, however, how lack of access to the MRI results invalidates Dr. Carnel's physical assessment of Plaintiff. Dr. Carnel examined Plaintiff and agreed that Plaintiff suffered from degenerative disc disease. The purpose of Dr. Carnel's examination was to evaluate and determine Plaintiff's physical abilities. (R&R at 22.) Dr. Carnel observed that Plaintiff had normal gait and posture. Dr. Carnel also noted that Plaintiff had full range of motion of the cervical and lumbar spine, and could "ambulate independently without an assistive device." (
The ALJ, having considered all of the medical opinion evidence offered in the record, found that Plaintiff was not disabled, and Dr. Carnel's failure to review the MRI before making his opinion does not discredit that there is substantial evidence to support the finding that Plaintiff is not disabled. Upon de novo review, the Court overrules Plaintiff's objection.
Plaintiff next objects to the Magistrate Judge's finding that the ALJ's limiting of Plaintiff's cross examination of Dr. Hancock did not prejudice Plaintiff. Plaintiff argues that the Magistrate Judge should have concluded, as a matter of law, that Plaintiff did not receive a fair hearing before the ALJ on July 26, 2011.
According to the SSA's regulations, claimants "may present any witnesses and question any witnesses" at their administrative hearings. 20 C.F.R. § 416.1416(b)(4). At these hearings, it is the ALJ's responsibility "to develop a full and fair record."
Plaintiff argues that the ALJ's limiting of Plaintiff's cross examination is prejudicial because the ALJ "relied solely upon . . . Dr. Hancock's opinion to support the ALJ's conclusion that Plaintiff does not meet a listed impairment." (Pl.'s Objections [13] at 6.) Plaintiff essentially argues that the ALJ exclusively relied on Dr. Hancock's medical opinion to find that Plaintiff does not meet a Listing, and the ALJ's limitation of Plaintiff's cross examination of Dr. Hancock produced an evidentiary gap rising to the level of clear prejudice.
Plaintiff's claim is not supported by the administrative record. The ALJ applied moderate weight to Dr. Hancock's opinion, and she considered the medical testimony of Dr. Carnel. The ALJ analyzed the credibility of Plaintiff's testimony and evaluated Plaintiff's daily activity and complaints of pain in light of objective medical evidence. The ALJ considered the entire record in making her ruling on Plaintiff's disability status. The ALJ did not rely solely on Dr. Hancock's opinion, and Plaintiff was given ample opportunity to cross examine Dr. Hancock at his July 26, 2011, supplemental hearing. Plaintiff had three separate hearings before the ALJ, and the ALJ developed and analyzed a sizeable administrative record in this case. The limitation of Plaintiff's cross examination, after he had already questioned Dr. Hancock extensively, did not produce an evidentiary gap, and Plaintiff has not presented a credible argument or evidence even to support that the ALJ's limitation on counsel's examination impacted, at all, the evidence available or that any prejudice resulted from it. Upon de novo review, the Court overrules Plaintiff's objection based on a cross examination limitation.
Plaintiff next objects to the Magistrate Judge's recommendation that the Court affirm the ALJ's finding that Plaintiff is not disabled because he does not meet or medically equal a Listing. The Listings describe, for each of the major body systems, impairments which are considered severe enough to prevent an adult from doing any gainful activity.
In determining whether an applicant suffers from a "disability" for purposes of benefits under the Act, the ALJ performs a five-step evaluation, prescribed in 20 C.F.R. § 404.1520. The five steps include:
"When a claimant contends that he has an impairment meeting the listed impairments, the burden is on the claimant to present specific medical findings that meet the various tests listed under the description of the applicable impairment. . . ."
To prove a disability meeting or medically equaling Listing 1.04C (lumbar spinal stenosis), a claimant must show "pseudoclaudication" as well as the inability to "ambulate effectively, as defined in 1.00B2b." 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 1.04C. Pseudoclaudication is "manifested as pain and weakness, and may impair ambulation. . . . The pain is provoked by extension of the spine, as in walking or merely standing, but is reduced by leaning forward."
A claimant's subjective testimony of pain is analyzed according to the Eleventh Circuit's three-part pain standard: "The pain standard requires (1) evidence of an underlying medical condition and either (2) objective medical evidence that confirms the severity of the alleged pain arising from that condition or (3) that the objectively determined medical condition is of such a severity that it can be reasonably expected to give rise to the alleged pain."
The ALJ determined Plaintiff's condition did not meet Listing 1.04C because she found Plaintiff's subjective pain testimony was not supported by objective evidence in the record. The ALJ also gave explicit and adequate reasons to doubt Plaintiff's credibility: "The claimant has described daily activities which are not limited to the extent one would expect, given the complaints of disabling symptoms and limitations." (R&R at 29.) According to Plaintiff's own testimony, he is able to do his own shopping. He can walk up stairs with the assistance of a railing. Plaintiff has always had full range of motion of the cervical and lumbar spine. In his examination with Dr. Carnel, Plaintiff squatted to 3/4 depth and demonstrated good strength and mobility, even though he gave "suboptimal effort." The ALJ also examined Plaintiff's treatment program. Plaintiff has never been recommended for surgery, and he has been treated conservatively with oral pain medications and one epidural injection. Substantial evidence supports the ALJ's finding that Plaintiff does not meet the requirements for Listing 1.04C because Plaintiff did not meet his burden to prove pseudoclaudication.
The ALJ also determined that Plaintiff is not disabled because he is able to ambulate effectively. Plaintiff testified that he can complete a number of tasks indicative of effective ambulation, and he showed full range of motion and good strength during his examination with Dr. Carnel. The only evidence in the record that indicates Plaintiff cannot ambulate effectively is Plaintiff's own testimony that pain prevents him from walking more than 10 to 15 yards. Substantial evidence clearly supports the ALJ's finding that Plaintiff can ambulate effectively and does not meet the requirements of Listing 1.04C for this reason. Upon de novo review, the Court overrules Plaintiff's objection based on a finding of no impairment.
Accordingly, for the foregoing reasons,