United States District Court, N.D. Florida, Gainesville Division
REPORT AND RECOMMENDATION
R. JONES UNITED STATES MAGISTRATE JUDGE
appeals from a final decision of the Commissioner of Social
Security (“the Commissioner”) denying his
application for a Period of Disability and Disability
Insurance Benefits under Title II of the Social Security Act.
(ECF No. 1). The Commissioner has answered (ECF No. 8), and
both parties have filed briefs outlining their respective
positions. (ECF Nos. 17 & 18). For the reasons discussed
below, the Commissioner's decision is due to be affirmed.
filed his applications for disability and supplemental income
benefits on January 12, 2012, alleging a disability onset
date of June 18, 2011, due to gout and anxiety. (R. 220.)
Plaintiff's applications were denied initially and upon
reconsideration. (R. 94-97, 126-46.) An administrative law
judge (“ALJ”) conducted a hearing on December 17,
2013, and entered a partially favorable decision on January
16, 2014. (R. 98-117.) The Appeals Council granted
Plaintiff's request for review, vacated the ALJ's
decision, and remanded the case for further proceedings on
November 9, 2015. (R. 119-23.)
second hearing on May 26, 2016, Plaintiff amended the alleged
onset date of disability to July 29, 2013. (R. 13.) Following
the hearing, the ALJ issued an unfavorable decision on June
22, 2016, denying Plaintiff's claim. (R. 29-44, 9-28.)
The Appeals Council denied Plaintiff's subsequent request
for review on October 28, 2016. (R. 1-3.) Plaintiff then
filed the complaint in this case on December 27, 2016. (ECF
STANDARD OF REVIEW
Commissioner's findings of fact are conclusive if
supported by substantial evidence. See 42 U.S.C.
§ 405(g) (2000). Substantial evidence is more than a
scintilla, i.e., the evidence must do more than merely create
a suspicion of the existence of a fact, and must include such
relevant evidence as a reasonable person would accept as
adequate to support the conclusion. Foote v. Chater,
67 F.3d 1553, 1560 (11th Cir. 1995) (citing Walden v.
Schweiker, 672 F.2d 835, 838 (11th Cir. 1982),
Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct.
1420, 28 L.Ed.2d 842 (1971)); accord Edwards v.
Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991).
the Commissioner's decision is supported by substantial
evidence, the district court will affirm, even if the
reviewer would have reached a contrary result as finder of
fact, and even if the reviewer finds that the evidence
preponderates against the Commissioner's decision.
Edwards, 937 F.2d at 584 n.3; Barnes v.
Sullivan, 932 F.2d 1356, 1358 (11th Cir. 1991). The
district court must view the evidence as a whole, taking into
account evidence favorable as well as unfavorable to the
decision. Foote, 67 F.3d at 1560. However, the
district court will reverse the Commissioner's decision
on plenary review if the decision applies incorrect law, or
if the decision fails to provide the district court with
sufficient reasoning to determine that the Commissioner
properly applied the law. Keeton v. Dep't Health
& Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994).
defines disability as the inability to do any substantial
gainful activity by reason of any medically determinable
physical or mental impairment that can be expected to result
in death, or has lasted or can be expected to last for a
continuous period of not less than twelve months. 42 U.S.C.
§§ 416(I), 423(d)(1); 20 C.F.R. § 404.1505
(2005). The impairment must be severe, making
Plaintiff unable to do his previous work, or any other
substantial gainful activity which exists in the national
economy. 42 U.S.C. § 423(d)(2); 20 C.F.R. §§
must follow five steps in evaluating a claim of disability.
20 C.F.R. §§ 404.1520, 416.920. The claimant has
the burden of proving the existence of a disability as
defined by the Social Security Act. Carnes v.
Sullivan, 936 F.2d 1215, 1218 (11th Cir. 1991). First,
if a claimant is working at a substantial gainful activity,
he is not disabled. 20 C.F.R. § 404.1520(b). Second, if
a claimant does not have any impairment or combination of
impairments which significantly limit his physical or mental
ability to do basic work activities, then he does not have a
severe impairment and is not disabled. 20 C.F.R. §
404.1520(c). Third, if a claimant's impairments meet or
equal an impairment listed in 20 C.F.R. Part 404, Subpart P,
Appendix 1, he is disabled. 20 C.F.R. § 404.1520(d).
Fourth, if a claimant's impairments do not prevent him
from doing past relevant work, he is not disabled. 20 C.F.R.
§ 404.1520(e). Fifth, if a claimant's impairments
(considering his residual functional capacity
(“RFC”), age, education, and past work) prevent
him from doing other work that exists in the national
economy, then he is disabled. 20 C.F.R. § 404.1520(f).
SUMMARY OF THE RECORD
medical records cover the time period from 2009 to 2015 and
are from Helping Hands Clinic, the Alachua County Health
Department, and Shands. Because Plaintiff's arguments on
appeal relate to his gout and anxiety, the relevant portions
of the medical record, hearing testimony, and the ALJ's
findings are summarized below.
Plaintiff amended his alleged onset date at the hearing to
July 29, 2013, the majority of his medical records are from
prior to this alleged onset date.
records from Helping Hands Clinic from August 2009 through
January 2012 reveal treatment for diabetes and high blood
pressure, but there is no mention of gout or anxiety.
Additionally, his records from June 6, 2011, state “no
edema.” (R. 326-32.)
records from the Alachua County Health Department from
February 2010 to February 2012 reveal findings of gout, but
his physical examinations do not support the severity of his
complaints. In February and March 2010 Plaintiff had no edema
in any of his extremities. Then on June 18, 2010, Plaintiff
complained of intermittent episodes of right ankle pain and
stated that he “was told he had gout at [the emergency
room] years ago.” On examination he did not have any
swelling or erythema in the ankle. Then in July 2010 he was
doing well. On October 14, 2010, Plaintiff complained of
difficulty performing his job due to gout episodes and stated
he had occasional leg numbness, but he presented in no acute
distress and had no evidence of edema. (R. 333-59.)
September 13, 2012, Plaintiff visited the Shands Emergency
Department and was diagnosed with a gout flare. The only
treatment notes show that Plaintiff was prescribed
medication. (R. 403.)
returned to Helping Hands from 2013 until June 2015. In June
2013 Plaintiff complained of very painful gout, and the
treating physician noted that Plaintiff complained that his
medication was not helping and that his gout was preventing
him from working. On exam he had mild stiffness, tenderness,
and swelling of the right ankle, and the record discloses
exacerbation of chronic gout. His medication was then
switched. By July, however, there was no mention of gout, and
Plaintiff complained of difficulties working due to breathing
issues. In September 2013 Plaintiff presented for gout
medication refills and told doctors he had “a
few” gout flares in the last month. In October he told
medical personnel that he had gout flares two times per week,
but he stated that shortness of breath, not gout, impacted
his ability to work. By December 2013 Plaintiff reported no
flares in gout. (R. 396-402, 418-20.)
early 2014 Plaintiff reported doing well. His gout was well
controlled and he said he had no acute flares in pain in the
past year. In June 2014 Plaintiff complained that his gout
medication was not working and complained of itchy feet, but
in early July 2014 Plaintiff's gout was controlled. Later
that month Plaintiff was seeking prescriptions for gout and
complaining of edema in his legs and swollen feet as well as
pain. The doctor, however, told Plaintiff that his pain is
not gout. In September 2014 Plaintiff stated he has
“chronic gout” and complained of recent upper
extremity gout. But by May and June 2015, there is only
mention of prescription refills for gout but not severe
complaints of pain. Plaintiff did complain of ankle swelling
in May, and in June edema was noted on lower extremities, but
Plaintiff requested foot cream for itchy and peeling feet.
. Dr. Chodosh
Chodosh performed a consultative examination on Plaintiff in
April 2012. Plaintiff's chief complaints were diabetes,
high blood pressure, gout, schizophrenia, and a heart
condition. Regarding gout, Plaintiff complained of suffering
from gout for approximately three years and stated he has
almost constant pain in his ankles, toes, and hands.
Additionally, Plaintiff complained of poor stamina, general
weakness, and aches and pain that interfered with his ability
to work. (R. 364.)
the physical examination of Plaintiff, Dr. Chodosh noted that
there was no edema, cyanosis, clubbing, deformity, or
varicosity in his extremities. Additionally, Plaintiff's
range of motion was normal in the majority of the areas
recorded. He also had grossly normal motor function in all
four extremities with strength judged as 5/5, as well as
normal manual dexterity and good ...