United States District Court, E.D. Tennessee, Knoxville
case is before the undersigned pursuant to 28 U.S.C. §
636(b), Rule 72(b) of the Federal Rules of Civil Procedure,
and the consent of the parties [Doc. 17]. Now before the
Court is the Plaintiff's Motion for Summary Judgment and
Memorandum in Support [Docs. 18 & 19] and the
Defendant's Motion for Summary Judgment and Memorandum in
Support [Docs. 20 & 21]. Damien Shelley (“the
Plaintiff”) seeks judicial review of the decision of
the Administrative Law Judge (“the ALJ”), the
final decision of the Defendant Nancy A. Berryhill, Acting
Commissioner of Social Security (“the
Commissioner”). For the reasons that follow, the Court
will GRANT the Plaintiff's motion, and
DENY the Commissioner's motion.
January 11, 2013, the Plaintiff filed an application for
disability insurance benefits pursuant to Title II of the
Social Security Act, 42 U.S.C. § 401 et seq.,
claiming a period of disability that began on July 7, 2012.
[Tr. 18, 136-42]. After his application was denied initially
and upon reconsideration, the Plaintiff requested a hearing
before an ALJ. [Tr. 97]. Following a hearing [Tr. 30-54], the
ALJ found the Plaintiff was “not disabled” [Tr.
15-29]. The Appeals Council denied the Plaintiff's
request for review [Tr. 1-6], making the ALJ's decision
the final decision of the Commissioner.
exhausted his administrative remedies, the Plaintiff filed a
Complaint with this Court on July 11, 2016, seeking judicial
review of the Commissioner's final decision under Section
405(g) of the Social Security Act. [Doc. 1]. The parties have
filed competing dispositive motions, and this matter is now
ripe for adjudication.
STANDARD OF REVIEW
reviewing the Commissioner's determination of whether an
individual is disabled pursuant to 42 U.S.C. § 405(g),
the Court is limited to determining whether the ALJ's
decision was reached through application of the correct legal
standards and in accordance with the procedure mandated by
the regulations and rulings promulgated by the Commissioner,
and whether the ALJ's findings are supported by
substantial evidence. Blakley v. Comm'r of Soc.
Sec., 581 F.3d 399, 405 (6th Cir. 2009) (citation
omitted); Wilson v. Comm'r of Soc. Sec., 378
F.3d 541, 544 (6th Cir. 2004).
evidence is “more than a scintilla of evidence but less
than a preponderance; it is such relevant evidence as a
reasonable mind might accept as adequate to support a
conclusion.” Cutlip v. Sec'y of Health &
Human Servs., 25 F.3d 284, 286 (6th Cir. 1994)
(citations omitted). It is immaterial whether the record may
also possess substantial evidence to support a different
conclusion from that reached by the ALJ, or whether the
reviewing judge may have decided the case differently.
Crisp v. Sec'y of Health & Human Servs., 790
F.2d 450, 453 n.4 (6th Cir. 1986). The substantial evidence
standard is intended to create a “‘zone of
choice' within which the Commissioner can act, without
the fear of court interference.” Buxton v.
Halter, 246 F.3d 762, 773 (6th Cir. 2001) (quoting
Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986)).
Therefore, the Court will not “try the case de
novo, nor resolve conflicts in the evidence, nor decide
questions of credibility.” Garner v. Heckler,
745 F.2d 383, 387 (6th Cir. 1984) (citation omitted).
review, the plaintiff “bears the burden of proving his
entitlement to benefits.” Boyes v. Sec'y. of
Health & Human Servs., 46 F.3d 510, 512 (6th Cir.
1994) (citation omitted).
Plaintiff alleges disability based on hypertrophic
cardiomyopathy. [Tr. 55, 71]. His cardiac impairment is
treated by cardiologist, Gregory Brewer, M.D. The Plaintiff
first presented to Dr. Brewer on July 17, 2012, due to a
history of chest pain. [Tr. 256]. Diagnostic testing,
including a 2D/M mode echocardiogram and color flow doppler
echocardiogram, indicated hypertrophic cardiomyopathy. [Tr.
258]. The Plaintiff often complained of chest pain, shortness
of breath, severe headaches, edema in all four extremities,
nausea, sweating, light-headedness, dizziness, and fainting
spells. [Tr. 218, 256-75, 380-89]. During a three day
hospitalization on August 31, 2012, for severe chest pain, a
heart catheterization was performed, revealing extensive
muscle bridging in the mid and distal left anterior
descending coronary artery with narrowing up to 70-80% in
multiple areas. [Tr. 266, 278].
Brewer referred the Plaintiff to the cardiology division at
the Cleveland Clinic. [Tr. 261]. An echocardiogram and MRI
was performed on September 12, 2012, confirming hypertrophic
cardiomyopathy with mid-cavitary obliteration. [Tr. 217,
233-35]. The examining physician suggested further diagnostic
testing, including a right heart catheterization and imaging,
and for the Plaintiff to continue medication prescribed by
Dr. Brewer. [Tr. 218]. Based on recommendations from the
Cleveland Clinic, Dr. Brewer ordered a cardiac PET scan on
September 24, 2012, to evaluate for ischemia. [Tr. 268].
Imaging results were negative for transmural ischemia, but
did indicate abnormal left ventricular ejection fraction of
with mild global hypokinesis and increased septal thickness
with increased radiopharmaceutical uptake. [Tr. 269]. On
January 9, 2013, after the Plaintiff received a second
opinion from the University of Tennessee Medical Center [Tr.
274], Dr. Brewer noted that both tertiary referral centers
had reached the same conclusion: that the Plaintiff required
medial management and unroofing or stenting on the left
anterior descending artery was not recommended. [Tr. 277].
Plaintiff continued to present to Dr. Brewer through July
2014 with complaints of chest pain, shortness of breath,
edema, and elevated diastolic blood pressure. [Tr. 377, 380,
383, 386, 389]. On May 9, 2013, the Plaintiff reported
passing out six times from coughing. [Tr. 380]. On July 1,
2013, another echocardiogram was performed, revealing left
atrial enlargement with asymmetrical ventricle septal
hypertrophy with ejection-fraction of 65%. [Tr. 383]. Dr.
Brewer opined that the Plaintiff had non-obstructive
hypertrophic cardiomyopathy manifesting itself as
asymmetrical septal hypertrophy with a long segment of muscle
bridging with persistent chest pain. [Tr. 385]. Dr. Brewer
concluded that medical management was still the appropriate
course of treatment. [Id.].
record includes four medical opinions from Dr. Brewer. The
first one, dated October 29, 2012, is an attending physician
statement completed for a private insurer in connection with
a request for long term disability benefits. [Tr. 402-04].
Therein, Dr. Brewer opined that the Plaintiff suffers from
hypertrophic cardiomyopathy with muscle bridging - recurrent
refractory chest pain. [Tr. 402]. Hypertension was listed as
a secondary condition contributing to disability. [Tr. 403].
Symptoms of chest pain, shortness of breath, and edema were
also indicated. [Id.]. Dr. Brewer opined that over
the course of an eight-hour workday, the Plaintiff could not
stand, sit, walk, or drive; he could use his upper
extremities for repetitive functions such as simple grasping,
pushing and pulling, and fine manipulation; he could
occasionally bend, squat, climb, reach above shoulder level,
kneel, crawl, use feet for foot controls, and drive; and he
could lift or carry up to 10 pounds. [Tr. 404]. In terms of
mental limitations, the Plaintiff had no limitation relating
to other people beyond giving and receiving instructions, but
was moderately limited in completing and following
instructions and performing simple and repetitive tasks, and
extremely limited in performing complex and varied tasks.
[Id.]. Dr. Brewer rated the Plaintiff's cardiac
functional capacity as a “Class 4 (complete
“Chest Pain Questionnaire” was also completed by
Dr. Brewer on February 1, 2013. [Tr. 255]. Dr. Brewer
described the Plaintiff's chest pain as occurring on the
left side of his chest, lasting one hour to two days in
duration, and radiating to his neck and down his left arm.
[Id.]. Dr. Brewer did not identify any precipitating
factors but indicated that the Plaintiff experienced pain
with or without exertion and experienced evaluated blood
pressure as an associated symptom. [Id.].
second “Chest Pain Questionnaire” was completed
on May 9, 2013. [Tr. 348]. Dr. Brewer described the
Plaintiff's chest pain as occurring in the upper part of
his chest, radiating to the arms, and worsened with exertion.
[Id.]. Exertion was also identified as sometimes
being a precipitating factor of chest pain. [Id.].
When the Plaintiff ...