United States District Court, M.D. Tennessee, Nashville Division
H.SHARP, UNITED STATES DISTRICT JUDGE
before the Court is Plaintiff's Motion for Judgment
on the Administrative Record (Docket Entry No. 14). The
motion has been fully briefed by the parties.
filed this action pursuant to 42 U.S.C. § 405(g) to
obtain judicial review of the final decision of the
Commissioner of Social Security (“Commissioner”)
denying Plaintiff's claim for disability insurance under
Title II and Supplemental Security Income
(“SSI”), as provided by the Social Security Act
(“the Act”). Upon review of the administrative
record as a whole and consideration of the parties'
filings, the Court finds that the Commissioner's
determination that Plaintiff is not disabled under the Act is
supported by substantial evidence in the record as required
by 42 U.S.C. § 405(g). Plaintiff's motion will be
Marilyn Ruth Elliott, filed a Title II application for
disability insurance and a Title XVI application for SSI on
August 5, 2009, alleging disability as of July 31, 2007,
although she later amended her onset date to January 18,
2008. (Tr. 130, 137, 152). Plaintiff's claims were denied
at the initial level on February 19, 2010, and on
reconsideration on June 21, 2010. (Tr. 78-83, 88-93).
Plaintiff requested a hearing before an administrative law
judge (“ALJ”), which was held on April 10, 2012.
(Tr. 10, 31). On April 25, 2102, the ALJ issued a decision
finding that Plaintiff was not disabled. (Tr. 10-30).
Plaintiff timely filed an appeal with the Appeals Council,
which issued a written notice of denial on October 9, 2013.
(Tr. 1-5). This civil action was thereafter timely filed, and
the Court has jurisdiction. 42 U.S.C. § 405(g).
issued an unfavorable decision on April 25, 2102. (AR p. 10).
Based upon the record, the ALJ made the following enumerated
1. The claimant meets the insured status requirements of the
Social Security Act through March 31, 2013.
2. The claimant has not engaged in substantial gainful
activity since January 18, 2008, the amended alleged onset
date (20 CFR 404.1571 et seq., and 416.971 et
3. The claimant has the following severe impairments: Back
Disorder, Diabetes Mellitus, Hypertension, Borderline
Intellectual Functioning, and a Mood Disorder (adjustment
disorder versus depressive disorder) (20 CFR 404.1520(c) and
4. The claimant does not have an impairment or combination of
impairments that meets or medically equals the severity of
one of the listed impairments in 20 CFR Part 404, Subpart P,
Appendix 1 (20 CFR 404.1520(d), 404.1525, 404.1526,
416.920(d), 416.925 and 416.926).
5. After careful consideration of the entire record, the
undersigned finds that the claimant has the residual
functional capacity to perform light work as defined in 20
CFR 404.1567(b) and 416.967(b), including the ability to lift
and/or carry 20 pounds occasionally and 10 pounds frequently,
sit for six hours, and stand and/or walk for six hours, each
with normal breaks in the course of an eight-hour day, except
as follows: She is limited to jobs requiring no more than
occasional climbing of ladders, ropes or scaffolds; no more
than frequent posturals of climbing, balancing, stooping,
crouching, kneeling, or crawling (as to stairs and ramps);
with no concentrated exposure to vibrations. From a mental
perspective, she is further limited to unskilled jobs
involving no more than simple tasks and instructions.
6. The claimant is unable to perform any past relevant work
(20 CFR 404.1565 and 416.965).
7. The claimant was born on May 31, 1962 and was 45 years
old, which is defined as a younger individual (age 18-49), on
the alleged disability onset date (20 CFR 404.1563 and
8. The claimant has a limited education and is able to
communicate in English (20 CFR 404.1564 and 416.964).
9. Transferability of job skills is not material to the
determination of disability because using the
Medical-Vocational Rules as a framework supports a finding
that the claimant is “not disabled, ” whether or
not the claimant has transferable job skills (See SSR
82-41and 20 CFR Part 404, Subpart P, Appendix 2).
10. Considering the claimant's age, education, work
experience, and residual functional capacity, there are jobs
that exist in significant numbers in the regional and
national economy that the claimant can perform (20 CFR
404.1569, 404.1569(a), 416.969, and 416969(a)).
11. The claimant has not been under a disability, as defined
in the Social Security Act, from January 18, 2008, through
the date of this decision (20 CFR 404.1520(g) and
(AR pp. 12-25).
REVIEW OF THE RECORD
following summary of the medical record is taken from the
What follows is a synopsis of each of the treatment exhibits
in an approximate chronological sequence. This is generally
done on an exhibit-by-exhibit basis, bearing in mind there
may be some chronological overlap as between a portion of the
As to Exhibit 1-F, from the Dickson County Health Department,
all of the medical records predate the amended alleged onset
date, with nothing covering the relevant period. In April of
2006, there is mention of a 3.5 cm lipoma in the middle back
near the spine that was tender to palpation, the onset of
which was about four months earlier (p. 9). There is also
mention of a hypothyroid condition, but this well predated
the point of the alleged onset as well (p. 2-7).
Exhibit 2-F, from Dickson Medical Associates, covering the
period between November of 2006 and May of 2007, also
predates the amended alleged onset date. On the former date,
the claimant presented with coughing symptoms and was
diagnosed with sinusitis and bronchitis (p. 5). On the latter
date, the claimant requested an estrogen injection for
symptoms of menopause, but also mentioned the back lipoma(s)
Exhibit 7-F, from the Dickson County Health Department,
covers an interval between November of 2007 and May of 2010.
There is mention of elevated liver enzymes on the former
date, and the claimant expressed concern that she acquired an
infection because she was exposed to a used needle. The
treatment plan called for repeat liver enzyme tests in two
weeks, and this was done (pp. 20-21). Separately, blood tests
for all forms of Hepatitis infection were negative (p. 39).
On the month of amended alleged onset, the claimant also
experienced disturbances in eyesight in the setting of
markedly elevated blood glucose levels, and was started on
metformin; shortly after this, she stated that she felt
better (p. 18-19). Still, her blood sugar levels were not
well controlled in the beginning, and there was a report of
elevated liver enzymes the following month (p. 15). As of
June of 2008, most blood sugar readings was in the range of
110-140, though there was a spike at one point (p. 14).
On August 6, 2009, she had a well-woman physical examination
which was unremarkable in all respects, except for notations
regarding unrelated gynecological concerns (p. 2). On August
19, 2008, the claimant had experienced lower back and flank
pain in the setting of a urinary tract infection and possibly
dehydration as well; she stated she felt better after
drinking cranberry juice and a lot of water (p. 12). By March
of 2009, lab work and treatment had mainly been for diabetes,
hypothyroidism, and dyslipidemia (p. 8). In June of 2009, the
claimant alleged itching in the left ear and was treated for
otitis externa (p. 6). In September of 2009, the claimant
alleged back and abdominal pain, but also mentioned the back
lipoma; this prompted x-rays of the thoracic and lumbar
spine, but these reports do not appear in the file (p. 5).
In reviewing the historical lab tests, the only instance of
especially elevated liver enzyme levels, from November of
2007, occurred in the setting of undiagnosed diabetes (and
therefore, uncontrolled blood sugar levels), together with
poor fluid intake (p. 21, 42). Subsequent to that event,
these tests returned to a point at or near normal limits,
with a rough correlation between elevated enzyme levels and
elevated blood glucose and A1c levels (pp. 22-40; see also
Ex. 11-F at 13-17). A number of the notes were of a terse
and/or routine nature. In all of these things, there was no
evidence outline liver dysfunction or damage.
Exhibit 4-F represents the consultative evaluation report of
S. Mark Watson, M.D., dated November 19, 2009. In a nutshell,
the claimant's main allegation on this occasion related
to her back pain, yet on exam she presented a globally normal
range of motion with an unremarkable gait and no abnormal
neurological findings. The examining physician opined the
claimant could only lift and/or carry 10 pounds occasionally,
stand and/or walk for at least two hours, and sit for six
hours (to this extent, consistent only with sedentary work),
but with no other identified restrictions.
Exhibit 10-F represents a consultative evaluation report by
Wyatt E. Harper, III, M.A., a licensed senior psychological
examiner, dated July 23, 2011. The claimant testified she saw
this individual only twice, that she had paid him $100, and
that her boyfriend pays this professional sometimes. In any
event, the report indicates she was referred there mainly to
report on her intellectual functioning although stating that
she was also being treated for depression.
The report itself was terse in places, and contained few
objective observations, aside from the cognitive test
results-She was oriented to place, person, time, and
situation. Eye contact, posture, speech, and motor behavior
all appeared unremarkable. She was able to count backward
from 100 subtracting 3 until 88, when she began to make
errors. She could perform simple arithmetic problems. Short
term memory appeared moderately intact. She could recall
recent events and knew the U.S. president's name. She was
able to make and keep the appointments for testing with the
She was able to comprehend and answer in writing the
questions on the examiner's client questionnaire that
reads at the fifth grade level.
During the evaluation, the claimant asserted that she
required special education classes before dropping out of
school in the 9th grade for unspecified reasons. In an
administration of the Wechsler Adult Intelligence Scale-IV
Ed. (WAIS-IV), she achieved a full-scale IQ of 68, based on a
verbal comprehension index of 66, a perceptual reasoning
index of 77, a working memory index of 80, a processing speed
index of 71 and a general ability index of 69. In an
administration of the Wide Range Achievement Test-Third Ed.
(WRAT-3), the claimant achieved standard scores of 81 and 82
in spelling and reading, respectively; but she obtained only
a 68 in math. Her activities of daily living can be
interpreted as fairly robust, because although the claimant
asserted she spends her day watching television, she also
said she is able to cook and care for herself and her mother,
drives a motor vehicle, shops as needed, and has a boyfriend.
The examiner concluded as follows- Ms. Elliott's general
cognitive ability is in the extremely low range as estimated
by the WAIS-IV. She does not learn verbal tasks nor
non-verbal tasks well. Her general verbal comprehension
abilities are in the extremely low range. Perceptual
reasoning abilities are in the borderline range. She will not
be able to comprehend and follow verbal or written directions
well. Her ability to sustain attention, concentrate, and
exert mental control is in the low average range. She will
have difficulty maintaining extended performance in a work
setting. . . . Ms. Elliott will have difficulty dealing with
co-workers, work stresses, and maintaining attention and
In a separate form, the examiner went on to opine the
claimant would only have mild limitations in her ability to
understand, remember, and carry out simple instructions and
to make judgments on simple work-related decisions, but would
have marked limitations in her ability to do these things as
to complex instructions. He further opined in favor of marked
limitations in the claimant's ability to interact
appropriately with co-workers and the public, moderate
limitations in her ability to interact with supervisors, and
moderate limitations in her ability to adapt to work-related
Exhibit 11-F, from the White Bluff Health Department, covers
the interval between April of 2010 and February of 2012. It
shows that on April 16, 2010, the claimant presented for a
well woman physical examination, which was unremarkable in
all respects; in fact, she reported no symptoms at all (pp.
9-10). In June of 2010, the claimant reported only groin pain
while attempting to lift a heavy trash bag only nine days
before the encounter, and was diagnosed with muscular strain
In the earliest available indication of mental illness within
the treatment records, the claimant reported being depressed
and tearful on January 19, 2011; she also reported a low
energy level and disturbances in sleep. Notes included an
impression of "situational stress, " suggesting
that symptoms could have been acute in onset, rather than
because of a long-standing or chronic problem. She was
prescribed Flouxitine (the generic for Prozac) on this
occasion. Of note, this incident came about only a few months
prior to the date of the her evaluation with Mr. Hyatt in
July of 2011 (see Ex. 10-F). She reported back and leg pain
in July of 2011, but the musculoskeletal portion of the exam
was unremarkable, her straight leg test was negative, and she
had no spinal tenderness (p. ...