United States District Court, M.D. Tennessee, Nashville Division
Crenshaw, Chief Judge
REPORT AND RECOMMENDATION
BROWN, UNITED STATES MAGISTRATE JUDGE
Honorable Waverly D. Crenshaw, Jr., Chief United States
before the court is Plaintiff's motion for judgment on
the administrative record (Docket Entry No. 19), to which
Defendant Commissioner of Social Security
(“Commissioner”) filed a response (Docket Entry
No. 22). Plaintiff has filed a reply to Defendant's
response. (Docket Entry No. 23). Upon consideration of the
parties' filings and the transcript of the administrative
record (Docket Entry No. 12),  and for the reasons given herein,
the Magistrate Judge RECOMMENDS that
Plaintiff's motion for judgment be
DENIED and that the decision of the
Commissioner be AFFIRMED.
Charles Allen Rideout, filed an application for Disability
Insurance Benefits (“DIB”) under Title II of the
Social Security Act on January 27, 2015, alleging disability
onset as of July 1, 2013, due to type 2 diabetes, ADHD,
anxiety, depression, high blood pressure and high
cholesterol. (Tr. 12, 44, 145). Plaintiff's claim was
denied at the initial level on July 1, 2015, and on
reconsideration on December 29, 2015. (Tr. 12, 79, 83).
Plaintiff subsequently requested de novo review of
his case by an administrative law judge (“ALJ”).
(Tr. 12, 89, 91). The ALJ heard the case on July 19, 2017,
when Plaintiff appeared with counsel and gave testimony. (Tr.
12, 24-39). Testimony was also received by a vocational
expert. (Tr. 39-40). At the conclusion of the hearing, the
matter was taken under advisement until January 9, 2018, when
the ALJ issued a written decision finding Plaintiff not
disabled. (Tr. 12-19). That decision contains the following
1. The claimant meets the insured status requirements of the
Social Security Act through December 31, 2018.
2. The claimant has not engaged in substantial gainful
activity since July 1, 2013, the alleged onset date (20 CFR
404.1571 et seq.).
3. The claimant has the following medically determinable
impairments: obstructive sleep apnea, hypertension, diabetes
mellitus type II, degenerative disc disease, hyperlipidemia,
chronic fatigue syndrome, obesity, hyperlipidemia,
attention-deficit hyperactivity disorder (ADHD), depression,
and anxiety (20 CFR 404.1521 et seq.).
4. The claimant does not have an impairment or combination of
impairments that has significantly limited (or is expected to
significantly limit) the ability to perform basic
work-related activities for 12 consecutive months; therefore,
the claimant does not have a severe impairment or combination
of impairments (20 CFR 404.1521 et seq.).
5. The claimant has not been under a disability, as defined
in the Social Security Act, from July 1, 2013, through the
date of this decision (20 CFR 404.1520(c)).
(Tr. 14, 19).
14, 2018, the Appeals Council denied Plaintiff's request
for review of the ALJ's decision (Tr. 1-5), thereby
rendering that decision the final decision of the
Commissioner. This civil action was thereafter timely filed,
and the Court has jurisdiction. 42 U.S.C. § 405(g).
REVIEW OF THE RECORD
following summary of the medical record is taken from the
The claimant was diagnosed with anxiety, depression, sleep
apnea, and ADHD several years before the alleged onset date
and continued to work despite the conditions (Ex. 4F/2-3). In
November of 2013, Robert Mangialardi, MD, confirmed
obstructive sleep apnea, controlled with CPAP (Ex. 1F/2). In
April of 2015, Murail Kolli, MD, confirmed unspecified chest
pain, generalized hyperhidrosis (excessive sweating),
intermediate coronary syndrome, diabetes without
complication, hyperlipidemia, hypertension, gastro-esophageal
reflux disease (GERD), and history of abdominal aortic
aneurysm (Ex. 2F/1). Dr. Kolli found the hypertension to be
well-controlled on medication (Ex. 2F/7). In May of 2015, Dr.
Hanket found the claimant's anxiety to be mainly in
remission with treatment (Ex. 4F/4). Through most of 2015,
Deepinder Bal, MD, reported that hypertension and
hyperlipidemia were controlled or at goal (Ex. 5F/2). The
claimant generally only attended annual physical exams
without need for condition management (Ex. 9F/23). In 2016,
Dr. Ball generally found the claimant to be doing well on
medications (Ex. 9F/27). There were no hospitalizations for
uncontrolled blood sugar or heart complaints. The
observations of treating physicians, the extremely
conservative medical management of conditions, and the lack
of emergency or intensive medical care do not support more
than minimal limitations.
The medical images and laboratory findings do not show at
least minimal limitations (20 CFR 404.1512(b); 404.1529(c);
SSR 16-3p, 96-8p).In April of 2015, EKGs showed asymptomatic
right bundle branch block. Cardiac enzymes and chest x-rays
were normal (Ex. 2F/5). A stress test showed no ischemic
changes, adequate blood pressure and heart rate response, and
low risk for cardiac chest pain due to unremarkable results
(Ex. 2F/26). In October of 2016, a CT scan of the abdomen
showed small inguinal hernias, multilevel degenerative
changes, severe central canal stenosis at two levels,
moderate canal stenosis at one level, minimal atherosclerotic
disease in the abdominal aorta, and otherwise normal organs
and bony structures (Ex. 7F/23). In October of 2016, a
colonoscopy showed minimal diverticulosis (Ex. 9F/5-6).
Pelvis ultrasound showed moderate post-void residual in the
urinary bladder (Ex. 9F/10). The negative tests, the mild
symptoms associated with findings (reviewed below), and the
incidental findings without objective clinical signs
(reviewed below) do not support more than minimal physical
The clinical signs[FN1] do not show significant limitations
(20 CFR 404.1529(c); SSR 16-3p; 96-8p). In 2013, Dr.
Mangialardi reported a completely normal physical examination
aside from obesity (Ex. lF/3). In April of 2015, the claimant
appeared at the emergency department with epigastric and
chest pain with some nausea. Dr. Kolli linked symptoms to
GERD, which abated with medication. Hospital physicians noted
obesity with a body mass index (BMI) of 35 but otherwise
reported normal physical exams with negative cardiovascular,
gastrointestinal, respiratory, neurological, and
musculoskeletal signs (Ex. 2F/6, 17). Post hospitalization,
Dr. Kolli reported normal physical exams except for
asymptomatic hyperlipidemia (Ex. 3F/1). From the alleged
onset date through October of 2016, Deepinder Bal, MD,
reported obesity (BMI in the 30s), elevated triglycerides,
and elevated blood sugars depending on dietary and medication
compliance. Regardless of blood sugar and cholesterol, Dr.
Bal recorded grossly normal physical examinations with no
objective deficit of functioning in any body system (Ex. 5F).
In 2016, ED physicians noted one instance of subjective
abdominal pain, one instance of earache, and obesity but
otherwise normal physical exams with intact motor strength in
all extremities, gait, ambulation, and neurological signs
(Ex. 7F; 8F). Dr. Bal noted improving obesity, mildly
elevated blood pressure, one instance of ...