United States District Court, W.D. Virginia, Roanoke Division
LINDA E. CARR, Plaintiff,
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.
Glen E. Conrad Senior United States District Judge.
has filed this action challenging the final decision of the
Commissioner of Social Security denying plaintiffs claim for
a period of disability and disability insurance benefits
under the Social Security Act, as amended, 42 U.S.C.
§§ 416(i) and 423. Jurisdiction of this court is
established pursuant to 42 U.S.C. § 405(g). This
court's review is limited to a determination as to
whether there is substantial evidence to support the
Commissioner's conclusion that plaintiff failed to meet
the requirements for entitlement to benefits under the Act.
If such substantial evidence exists, the final decision of
the Commissioner must be affirmed. Laws v.
Celebrezze, 368 F.2d 640 (4th Cir. 1966). Stated
briefly, substantial evidence has been defined as such
relevant evidence, considering the record as a whole, as
might be found adequate to support a conclusion by a
reasonable mind. Richardson v. Perales, 402 U.S.
389, 401 (1971).
plaintiff, Linda E. Carr, was born on May 3, 1961, and
eventually completed the tenth grade in school. Ms. Carr has
been employed as a cashier and kitchen helper. She last
worked on a regular and sustained basis in 2006. On October
2, 2013, Ms. Carr filed an application for a period of
disability and disability insurance benefits. In filing her
current claim, Ms. Carr alleged that she became disabled for
all forms of substantial gainful employment on June 30, 2006,
due to pain in her back and right shoulder, numbness and
weakness in her toes and right hand, fibromyalgia, irritable
bowel syndrome, memory problems, depression, and anxiety.
(Tr. 216). Ms. Carr now maintains that she has remained
disabled to the present time. The record reveals that Ms.
Carr met the insured status requirements of the Act through
the fourth quarter of 2010, but not thereafter. See
generally 42 U.S.C. §§ 416(i) and 423(a).
Consequently, plaintiff is entitled to a period of disability
and disability insurance benefits only if she has established
that she became disabled for all forms of substantial gainful
employment on or before her date last insured, December 31,
Carr's application was denied upon initial consideration
and reconsideration. She then requested and received a de
novo hearing and review before an Administrative Law
Judge. In an opinion dated August 19, 2016, the Law Judge
also determined, after applying the five-step sequential
evaluation process, that Ms. Carr was not disabled on or
before her date last insured. See 20 C.F.R. §
404.1520. The Law Judge found that Ms. Carr suffered from
several severe impairments through that date, including
lumbar spine degenerative disc disease, degenerative joint
disease of the shoulder, gall stones, irritable bowel
syndrome, obesity, anxiety disorder, and depressive disorder,
but that these impairments did not, either individually or in
combination, meet or medically equal the requirements of a
listed impairment. (Tr. 17-18). The Law Judge then assessed
Ms. Carr's residual functional capacity as follows:
After careful consideration of the entire record, the
undersigned finds that, through the date last insured, the
claimant had the residual functional capacity to perform
light work as defined in 20 C.F.R. 404.1567(b) except the
claimant could occasionally kneel, crawl, crouch, stoop, or
climb ramps and stairs. She could not climb ladders, ropes,
and scaffolds. She should have avoided exposure to workplace
hazards, such as hazardous machinery and unprotected heights.
She could perform simple, routine tasks of no more than four
steps. She could occasionally interact with the public.
(Tr. 21). Given such a residual functional capacity, and
after considering testimony from a vocational expert, the Law
Judge determined that Ms. Carr was unable to perform any past
relevant work through the date last insured. (Tr. 23).
However, the Law Judge found that she retained the capacity
to perform other work roles existing in significant number in
the national economy. (Tr. 27). Accordingly, the Law Judge
concluded that Ms. Carr was not disabled at any time from the
alleged onset date through the date last insured, and that
she is not entitled to a period of disability or disability
insurance benefits. See 20 C.F.R. § 404.1520(g). The Law
Judge's opinion was adopted as the final decision of the
Commissioner by the Social Security Administration's
Appeals Council. Having exhausted all available
administrative remedies, Ms. Carr has now appealed to this
plaintiff may be disabled for certain forms of employment,
the crucial factual determination is whether plaintiff was
disabled for all forms of substantial gainful employment.
See 42 U.S.C. § 423(d)(2). There are four
elements of proof which must be considered in making such an
analysis. These elements are summarized as follows: (1)
objective medical facts and clinical findings; (2) the
opinions and conclusions of treating physicians; (3)
subjective evidence of physical manifestations of
impairments, as described through a claimant's testimony;
and (4) the claimant's education, vocational history,
residual skills, and age. Vitek v. Finch, 438 F.2d
1157, 1159-60 (4th Cir. 1971); Underwood v. Ribicoff
298 F.2d 850, 851 (4th Cir. 1962).
review of the record in this case, the court is constrained
to conclude that the Commissioner's final decision is
supported by substantial evidence. The Law Judge's
opinion reflects a throughout evaluation of Ms. Carr's
medical problems and the extent to which they affected her
ability to work. Although Ms. Carr suffered from a
combination of physical and emotional impairments,
substantial evidence supports the Law Judge's
determination that she retained the residual functional
capacity to perform a limited range of light work through her
date last insured.
record reflects that Ms. Carr presented to Carilion Clinic
with complaints of back and hip pain in November of 2005,
prior to her alleged onset date. (Tr. 295). She was examined
by Dr. Dallas Crickenberger, an orthopedic specialist. During
the examination, plaintiff reported that the pain was worse
after standing for her job as a cashier, and that cortisone
injections provided by her primary care physician, Dr. David
Cummings, provided pain relief for approximately two months.
Plaintiff indicated that she had been stressed because of the
pain and that she was taking Lortab and Xanax for "her
nerves." (Tr. 295). Plaintiff advised Dr. Crickenberger
that she wanted to be able to "work a little bit more in
terms of standing time" and increase her time mowing the
lawn from "1-2 hours to 2-4 hours because her lawn is
about 10 acres" in size. (Tr. 295). On physical
examination, Ms. Carr exhibited some tenderness to
palpitation in the left hip and paralumbar area, but her
motor strength, sensation, and reflexes were normal. X-rays
of plaintiff s left hip revealed "good joint
space," "no spurs," and "no destructive
changes." (Tr. 296). Lumbar spine x-rays showed mild
degenerative changes and spondylosis at L3-4. (Tr. 310-11).
The remainder of the lumbar spine appeared "essentially
unremarkable." (Tr. 311).
Carr saw Dr. Cummings on several occasions in 2006. While few
treatment notes were compiled, it was indicated that
plaintiff complained of back and hip pain in October and
December. Dr. Cummings continued plaintiff on Lortab and
Xanax. (Tr. 396).
April of 2007, plaintiff presented to Dr. John Hagy with
complaints of abdominal pain and intermittent rectal
bleeding. (Tr. 301). She was noted to be obese, but her
physical examination was otherwise normal with no signs of
tenderness in her back or lower extremities. (Tr. 302-03). An
abdominal CT scan revealed the presence of gallstones but was
"otherwise unremarkable." (Tr. 312). Dr. Hagy
recommended that plaintiff undergo a colonoscopy. (Tr.
301-02). He refilled plaintiffs prescriptions for Lortab and
Xanax, and started her on Prevacid. (Tr. 303).
April of 2008, Ms. Carr was taken by ambulance to Carilion
Franklin Memorial Hospital from a local funeral home. (Tr.
257). Plaintiff reported that her brother-in-law had just
passed away, and that she had experienced hyperventilation
and dizziness. She was given Ativan and released a few hours
later. The attending physician's diagnostic impression
included "grief reaction" and "panic
attack." (Tr. 257).
August of 2008, Ms. Carr returned to the emergency room and
reported that she had experienced a panic attack the previous
day while eating. (Tr. 263). She indicated that it felt like
food would not go down her throat. (Tr. 263). Plaintiff
acknowledged that this had "only happened twice"
and that she was no longer having difficulty swallowing. (Tr.
263). On physical examination, there was no airway
obstruction, back tenderness, neck tenderness, or edema in
her extremities. She was diagnosed with an "anxiety
reaction" and prescribed Xanax and Prilosec. (Tr. 263).
December of 2008, Ms. Carr presented to the emergency room
with complaints of abdominal pain and diarrhea. (Tr. 270).
Aside from exhibiting mild abdominal tenderness, her physical
examination was normal and she walked with a steady gait.
(Tr. 270-76). The attending physician noted that she was