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Shelton-Cox v. Social Security Administration

United States District Court, M.D. Tennessee, Nashville Division

September 11, 2017




         Pending before the court is the plaintiff Myscellent Christina Shelton-Cox's Motion for Judgment on the Administrative Record (ECF No. 14), to which the defendant Social Security Administration (SSA) has responded (ECF Nos. 16), and the plaintiff has filed a reply (ECF No. 17). Upon consideration of the parties' briefs and the transcript of the administrative record (ECF No. 10), [1] and for the reasons given herein, the plaintiff's Motion for Judgment on the Administrative Record will be denied and the decision of the SSA will be affirmed.

         I. Magistrate Judge Referral

         To avoid any further delay in the resolution of this matter, the court will VACATE the referral to the magistrate judge.

         II. Motion for Judgment on the Administrative Record

         The plaintiff filed an application for disability insurance benefits under Title II of the Social Security Act and an application for supplemental security income (“SSI”) under Title XVI of the Social Security Act[2] on November 16, 2011, (Tr. 177-80, 181-89), alleging disability onset as of April 30, 2010, (Id.), due to mild retardation and learning disabilities. (Tr. 229). The plaintiff subsequently amended the disability onset date to February 14, 2011. (Tr. 60.) The plaintiff's claim to benefits was denied at the initial and reconsideration stages of state agency review. As a result, the plaintiff requested de novo review of her case by an Administrative Law Judge (ALJ). The ALJ heard the case on May 27, 2014, when the plaintiff appeared with counsel and gave testimony. (Tr. 57-82.)[3] Testimony was also received from a vocational expert. (Id.) At the conclusion of the hearing, the matter was taken under advisement until July 1, 2014, when the ALJ issued a written decision finding that the plaintiff was not disabled. (Tr. 18-45.) That decision contains the following enumerated findings:

1. The claimant meets the insured status requirements of the Social Security Act through December 31, 2015.
2. The claimant has not engaged in substantial gainful activity since February 14, 2011, the alleged onset date (20 CFR 404.1571 et seq., and 416.971 et seq.).
3. The claimant has the following severe impairments: Urge Incontinence Disorder, Attention Deficit Hyperactivity Disorder, Major Depressive Disorder, and Borderline Intellectual Functioning (20 CFR 404.1520(c) and 416.920(c)).
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. [T]he claimant has the residual functional capacity to perform a full range of work at all exertional levels but with the following nonexertional limitations: She is limited to jobs where there is no concentrated exposure to pulmonary irritants, and where the claimant requires access to a restroom within the work area. From a mental perspective, the claimant can understand, remember, carry out and maintain attention, concentration, persistence and pace for simple tasks with normal breaks spread throughout the day. In addition, she can interact appropriately with others and adapt to routine changes within this type of work environment.
6. The claimant is unable to perform any past relevant work (20 CFR 404.1565 and 416.965).
7. The claimant was born on August 14, 1976 and was 34 years old, which is defined as a younger individual, age 18-49, on the alleged disability onset date (20 CFR 404.1563 and 416.963).
8. The claimant has at least a high school 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 82-41 and 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 national economy that the claimant can perform (20 CFR 404.1569, 404.1569(a), 416.969, and 416.969(a)).
11. The claimant has not been under a disability, as defined in the Social Security Act, from February 14, 2011, through the date of this decision (20 CFR 404.1520(g) and 416.920(g)).

(Tr. 23-24, 29, 36-38.)

         On November 30, 2015, the Appeals Council denied the plaintiff's request for review of the ALJ's decision (Tr. 1-6), thereby rendering that decision the final decision of the SSA. This civil action was thereafter timely filed, and the court has jurisdiction. 42 U.S.C. § 405(g). If the ALJ's findings are supported by substantial evidence based on the record as a whole, then those findings are conclusive. Id.

         A. Review of the Record

         The following summary of the medical record is taken from the ALJ's decision:

Discussion, physical. With regard to the claimant's urge incontinence disorder, it is needful to reiterate that her testimony regarding the medical condition factoring into her employment terminations goes to general credibility, since it directly contradicts what she told an evaluator at Ex. IF or mental health professionals at Ex. 2F about such incidents as fighting on the job, sleeping during duty time, and so forth. Such credibility items do not require belaboring, but it does mean that one must rely more fully on the objective medical evidence in such matters. Even then, one finds multiple reasons for pause:
• Records from Dr. Swan from February 2011 reflect the claimant's urinary incontinence impairment dates back to childhood, and as such, would be very remote to the point of alleged onset. In objective testing, the claimant did demonstrate a loss of urine related with an urge at a volume of infusion as low as 180 ml, consistent with her stated symptoms (Ex. 18F at 5). In March of 2011, it was determined that she had failed medical therapy, so the treatment plan called for the trial of a sacral nerve stimulator, and the same was implanted.
• In a January 2012 office visit, the claimant alleged that the sacral nerve stimulator had never worked; however an interrogation of the unit was within normal limits and it was also determined that there were multiple settings the claimant had not tried; she was shown how to change these in order to optimize the results (Ex. 18F).4 There was no further mention of difficulty in Dr. Swan's records until July 2013, with onset of renewed difficulties only two months earlier (id.).
4 According to the January 18, 2012 treatment notes: “Patient was not feeling stimulation. Using the physician programmer [it was determined] only program 1 had been used. I reviewed with the patient how to use the patient programmer. She was able to turn the amps up to 3.8 and did feel stimulation vaginally. We also tested program 2 and she did feel stimulation vaginally at 2.5 amps.” (Ex. 18F).
• The claimant's consultative evaluation occurred during the above sequence, in May 2012. She does not appear to allege genitourinary difficulty at that time, but rather, the complaints were musculoskeletal or pulmonary in nature. Although this was a limited exam, and the genitourinary system is typically out of scope even with a regular physical exam, it must also be pointed out that she exhibited normal ambulation, and there was no mention of her needing to interrupt the evaluation at any time secondary to impending or actual loss of bladder control (Ex. 10F).
• Although the impairment is not specific to kidney function, it should also be observed that an ultrasound of the kidneys was normal as of January 2012, and later, kidney function labs in October 2012 were within normal limits as well (Ex. 22F).
• Well woman exam at the Vine Hill Community Clinic (March 2013): In the range of symptoms, no mention of complaints specific to the bladder or genitourinary system, but only mention regarding the absence of menstruation. Female genitourinary exam was unremarkable and included a non-tender bladder (Ex. 22F).
• Well woman exam at the Vine Hill Community Clinic (October 2013): Range of symptoms negative for bladder habits and dysmenorrhea. Unremarkable exam. Urine culture was sent off; however, there were no reports of abnormalities associated with the culture (Ex. 22F).
• One finds no significant information regarding genitourinary complaints following July 2013.
The picture that emerges is one where the claimant indeed has a severe impairment involving her urge incontinence disorder. However, the treatment evidence also indicates that the use of a sacral nerve stimulator was useful in controlling symptoms once the claimant learned how to program it correctly according to the treating physician's instructions. Thus, the weight of the evidence indicates that although the claimant would need access to a restroom within the work area, she would not have episodes of a frequency or magnitude as was alleged, in the setting of such treatment.
* * *
Discussion, mental. With regard to the claimant's alleged borderline intellectual functioning, . . . it suffices to say that the claimant's robust activities of daily living-with a correspondingly high level of adaptive functioning-are clearly inconsistent with the notion that the impairment was severe enough to prevent simple and unskilled work. Again, one finds a number of inconsistencies that call into question the accuracy of her cognitive measurements from both 2011 and 2014.
Although one may suppose that the 1994 cognitive assessment at Ex. 15E would be limited in its probative value in relation to her current level of functioning, it remains highly relevant for three purposes. First, the assessment stands for the proposition that at all times during the period in question, the claimant's borderline intellectual functioning was medically determinable, since it appears to be the only one where the validity of the scores is not terribly subject to question.
Second, the claimant's performance or processing speed indices were consistently in the 70's over all WAIS administrations, consistent with a finding that the claimant has the impairment. However, third, one does not find a reasonable explanation as to how it was the claimant achieved high-borderline indices as far as the full-scale or verbal components were concerned (which had been 78 and 81, respectively), yet scored one or more standard deviations below that in her 2011 and 2014 evaluations (which were both 63 as to the 2014 evaluation).
Ultimately, the claimant's borderline intellectual functioning results in a limitation in favor of simple and unskilled work. However, because of the substantial doubts that were raised by the last two WAIS administrations, together with the other objective evidence . . ., together with the claimant's activities of daily living, the weight of the evidence did not support a finding of greater functional limitations by virtue of this impairment.
Attention turns to the claimant's remaining severe mental impairments, one finds reason to doubt the veracity of her subjective allegations. To summarize significant items from the medical evidence:
• Centerstone (intake: December 2008, termination: January 2010)(Ex. 1F)
o Entire interval prior to alleged onset date
o Did not resume treatment until intake on March 11, 2011, just after the alleged onset date, and more than a year after termination
o She reports that she has worked in security and is licensed to carry a gun (this, in turn, is certainly inconsistent with someone who also alleges intellectual disability)
o Was noted at the time as friendly, cooperative, open and attentive
• Centerstone (March-August 2011, formal termination: December 2011) (Ex. 3F)
o In April 2011psychiatric evaluation:
• Reports graduating with special education diploma and is currently taking classes towards her GED (see p. 70)
• Mental status exam largely unremarkable with euthymic mood, average intelligence, intact judgement
• ADHD was the only diagnosis at the time; however, it goes on to say that the basis for the diagnosis was unclear
• GAF score of 60
o May 2011: Medical management: Unremarkable mental status; reports feeling okay but wants something for distractibility; ...

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