The ALJ concluded that Davis' testimony regarding headaches and leg
pain was not convincing. Specifically, the ALJ found Davis' allegations of
headaches not credible because "she does not seem haggard or effete and
the consulting doctor described her as well developed and well
nourished." (Id. at 16, ALJ Decision.) The ALJ also noted that although
Davis began taking medication in July 1998, it was for shoulder pain and
not headaches. (Id.) Finally, the ALJ observed that progress notes
reported that Davis "feels well" and concluded that "there is nothing in
the medical records of any real complaints about headaches." (Id.)
With regard to the leg pain, the ALJ concluded that Davis' complaints
were not credible because they were not "narrowed to any degree in the
medical records and the pain seems to be wandering." (Id.) The ALJ found
a history of high blood pressure, but also concluded that "the evidence
of record does not establish that the claimant's history of high blood
pressure would have more than a minimal effect on her ability to perform a
full range of heavy work and considering her age, education and work
Following the ALJ's decision, Davis requested review by the Appeals
Council. In addition to the evidence considered by the ALJ, the Appeals
Council received the additional CCH records from March 1999 through
November 1999. On June 21, 2001, the Appeals Council denied Davis'
request for review, concluding that the additional evidence did not
provide a basis for changing the ALJ's decision. ALJ Miller's decision
thus became the Commissioner's final decision.
Currently before this Court are Davis' and the Commissioner's motions
for summary judgment. On appeal, Davis contends that the ALJ's decision
to deny her benefits was not supported by substantial evidence. In
addition, Davis argues that the ALJ erred as a matter of law in
determining that Davis did not have severe impairments, and that the
Appeals Council also erred as a matter of law in finding that the newly
submitted evidence was not material or not a basis for changing the ALJ's
decision. For the reasons set out herein, we deny Davis' motion and
affirm the Commissioner's decision.
The standard of review for final decisions of the Commissioner (here
the ALJ's decision) in federal benefits cases is deferential. Kendrick
v. Shalala, 998 F.2d 455, 458 (7th Cir. 1993). The Social Security Act
establishes that the Commissioner's findings of fact are conclusive if
they are supported by substantial evidence in the record.
42 U.S.C. § 405(g). Substantial evidence is "such relevant evidence
as a reasonable mind might accept as adequate to support a conclusion."
Richardson v. Perales, 402 U.S. 389, 401 (1972) (citation and quotation
omitted). In other words, the ALJ's findings must be supported by more
than a mere scintilla of the evidence. Id. The Commissioner is
responsible for weighing the evidence, resolving conflicts and making
independent findings of fact. Powers v. Apfel, 207 F.3d 431, 434 (7th
Cir. 2000) (citation omitted). As such, this Court may not "decide the
facts anew, re-weigh the evidence or substitute its own judgment for that
of the Commissioner to decide whether a claimant is or is not disabled."
Id. at 434-35 (citation omitted).
To receive disability benefits, a claimant must be "disabled" as
defined by the Social Security Act. An individual is disabled if he
cannot "engage in any substantial gainful activity by reason of any
medically determinable physical or mental impairment."
42 U.S.C. § 416(i). Social Security regulations require the ALJ to
engage in a five-step
inquiry to determine whether a claimant is
disabled. Dixon v. Massanari, 270 F.3d 1171, 1176 (7th Cir. 2001). The
ALJ must inquire: (1) whether the claimant is currently working; (2)
whether the claimant has a severe impairment; (3) whether the claimant's
impairment meets or equals a listed impairment; (4) if the claimant does
not suffer from a listed impairment, whether she can perform past
relevant work; and (5) whether the claimant is capable of performing any
work in the national economy. 20 C.F.R. § 404.1520. If the ALJ finds
the claimant disabled or not disabled at any step, the ALJ will not
proceed to the next step of the review.
The Court's review of the Appeals Council's denial of review is also
limited because the Appeals Council's refusal to review the ALJ's
decision is discretionary. Eads v. Sec'y of the Dep't of Health and Human
Servs., 983 F.2d 815, 817 (7th Cir. 1993) (citation omitted). We can
reverse the Appeals Council's decision if it rests on a mistake of law,
such as an erroneous determination that newly submitted evidence was not
material to the disability determination. Id. at 817 (citing Nelson v.
Bowen, 855 F.2d 503, 506-08 (7th Cir. 1988)).
The issues set forth in this case are: (1) whether the ALJ's decision
at step two that Davis did not have a severe impairment and thus was not
disabled was supported by substantial evidence; and (2) whether the
Appeals Council erred as a matter of law in finding that the newly
submitted evidence was not material and denying review.
I. The ALJ's Decision was Supported by Substantial Evidence
Davis argues that substantial evidence does not support the ALJ's
finding at step two that Davis does not have a severe impairment.
Specifically, Davis contends that the ALJ erroneously discounted the
opinions of Drs. Stamboli and Irshad and the CCH medical records and made
his own medical assessments. Furthermore, Davis contends that the ALJ
erred by considering Davis' hearing testimony and appearance in
concluding that Davis did not have a severe impairment.
To show an impairment, the claimant is required to establish a physical
or mental impairment with "medical findings consisting of signs,
symptoms, and laboratory findings, not only [the claimant's] statement of
symptoms." 20 C.F.R. § 416.908. The ALJ weighs this evidence and
when, as in this case, he denies benefits, he must build a logical bridge
from the evidence to his conclusion. Dixon, 270 F.3d at 116 (citation
omitted). The ALJ need not discuss his reasons for rejecting every piece
of evidence, but "he must at least minimally discuss a claimant's
evidence that contradicts the Commissioner's decision." Godbey v. Apfel,
238 F.3d 803, 808 (7th Cir. 2000) (citation omitted). If the ALJ fails to
address relevant evidence, the record will disclose that he was
improperly "playing doctor," which will likely be grounds for reversal.
Diaz, 270 F.3d at 1177 (citation omitted). The ALJ may, however, reject a
doctor's opinion "if it appears to be based on a claimant's exaggerated
subjective allegations." Dixon, 270 F.3d at 1178. See also Edwards v.
Sullivan, 985 F.2d 334, 337 (7th Cir. 1993) ("Where diagnoses are not
supported by medically acceptable clinical and laboratory diagnostic
techniques, this court need not accord such diagnoses great weight.")
In this case, the ALJ properly weighed the evidence presented by Drs.
Stamboli and Irshad and the CCH medical records. The ALJ's examination of
the evidence led him to conclude, in accord with the medical evidence,
that Davis had
a history of hypertension. The ALJ's evaluation also led
him to reject Dr. Stamboli and Dr. Irshad's diagnoses of headaches and
knee pain. The ALJ did not, however, "play doctor," or ignore relevant
evidence. He properly discounted Dr. Stamboli's opinion of headaches as
it was a diagnosis based on subjective complaints, or an attempt "to
explain the claimant's alleged symptoms." (R. 7, Admin. R. at 16, ALJ
Decision.) The ALJ also properly discounted Dr. Irshad's opinion of
tension headaches as it was based on Dr. Stamboli's diagnosis, which
itself was founded on Davis' subjective complaints. (Id.) The ALJ also
noted that the CCH records repeatedly stated that Davis was feeling
well, and that there were no real complaints about headaches in the
medical records. (Id.) Further discrediting the doctors' opinion and
Davis' allegations of headaches, the ALJ also noted that the only pain
medication taken was for shoulder pain. (Id.) Finally, the ALJ did not
find Davis' testimony regarding headache pain to be credible. In
concluding that the allegations were not credible, the ALJ noted the lack
of complaints in the CCH records, that Davis did not seem "haggard or
effete" and that "the consulting doctor described her as well developed
and well nourished."*fn2 (Id.)
Similarly, the ALJ did not "play doctor" in rejecting Davis'
allegations of knee pain. The ALJ noted that upon a physical examination
of Davis, Dr. Stamboli opined that there was "mild pain and crepitation
on movement of the knees but the range of motion was not limited." (Id.
at 15.) Dr. Stamboli diagnosed "pain in the knees which is most probably
secondary to osteoarthritis (emphasis added)." (Id. at 88, Dr. Stamboli's
Report.) The ALJ discounted Stamboli's indefinite opinion, and Dr.
Irshad's which was based upon it, because the "complaints [were] not
narrowed to any degree in the medical records and the pain seems to be
wandering. At the hearing, it was allegedly all over the leg . . . before
the consulting doctor, the claimant located the pain in her knees." (Id.
at 16, ALJ Decision.) The ALJ also noted that the body part recently
cited for pain medication was the shoulder, not the knees. (Id.)
Therefore, because the diagnosis appears to be based on Davis' subjective
complaints, the ALJ could properly discount it.*fn3
The ALJ also properly questioned Davis on her daily activities. Such
inquiries are essential to determining whether a claimant's alleged
impairment(s) significantly limit her ability to perform basic work
activities.*fn4 In this case, Davis acknowledged that she could walk
eight blocks with a five-minute break, read and clean. Thus, she failed
to show how her alleged impairment(s) significantly limited her ability
to perform basic work activities.
In short, the ALJ's findings, gleaned from his weighing of the medical
evidence, were supported by substantial evidence. The ALJ properly
concluded that the medical evidence did not establish an impairment or a
combination of impairments that significantly limited Davis' ability to
perform basic work activities.
II. The Appeals Council Did Not Err in Denying Review
Next, Davis argues that the Appeals Council erred as a matter of law in
determining that the newly submitted evidence was not material or not a
basis for changing the ALJ's decision. The additional medical evidence
submitted to the Appeals Council included EKG reports and an x-ray of the
right knee showing degenerative joint disease. This Court will reverse
the Commissioner's final decision if the Appeals Council's refusal to
review rests on a mistake of law, such as the determination that newly
submitted evidence was not material. Eads, 983 F.2d at 817. Evidence is
material if there is a "reasonable possibility" that it would change the
ALJ's decision. Nelson, 855 F.2d at 506 (citation omitted). In the first
instance, Davis has not explained how her allegedly abnormal EKGs relate
to the impairments presented to the ALJ. The finding of "mild
degenerative joint disease" does, however, support Dr. Stamboli's
diagnosis of "pain in knees which is most probably secondary to
osteoarthritis." (R. 7, Admin. R. at 176, Radiology Report; Id. at 88,
This Court finds that the new evidence is not material because there is
not a "reasonable possibility" that it would have changed the ALJ's
decision. Even if the ALJ had made a finding of mild arthritis, this
impairment, along with hypertension, likely would not have changed the
ALJ's decision at step two that the impairments were not severe. ALJ's
have found that claimants with arthritis, hypertension and other maladies
do not have severe impairments, and courts have affirmed these
decisions. See, e.g., Verduzco v. Apfel, 188 F.3d 1087, 1089 (9th Cir.
1999) (although claimant clearly suffered from diabetes, high blood
pressure and arthritis, he failed to show that these impairments were
severe); Riley v. Shalala, 18 F.3d 619, 622 (8th Cir. 1994) (ALJ's
determination that claimant's impairments, including osteoarthritis and
high blood pressure, were not medically severe was supported by
substantial evidence). Therefore, we decline to remand this case for a
new hearing based on the newly submitted evidence, or, in the
alternative, reverse the Commissioner's decision.
Although we sympathize with Davis' complaints, we cannot, in accordance
with the applicable standards, simply reweigh all the evidence. Instead,
we must determine if the ALJ's decision was supported by substantial
evidence and as indicated herein we conclude that it was. For the reasons
set forth in this opinion, we deny Davis' motion for summary judgment,
(R. 11), and grant the Commissioner's motion for summary judgment, (R.
12). The Clerk of the Court is instructed, pursuant
to Federal Rule of
Civil Procedure 58, to enter judgment in favor of Defendant.
*fn2 Davis argues that SSR 85-28 directs the ALJ to consider only
objective medical evidence at step two and that the ALJ's observation of
Davis' appearance is not medical evidence that could rebut the medical
evidence in the record. (R. 11, Pls. Mot. for Summ. J. at 9-12.) SSR
85-28 instructs: "At the second step of the sequential evaluation, then,
medical evidence alone is evaluated in order to assess the effects of the
impairment(s) on ability to do basic work activities." SSR 85-28, 1985
WL. 56856, at 4 (S.S.A. 1985). The ALJ is instructed to evaluate, not
simply accept, medical evidence. ALJ Miller followed SSR 85-28 by
critically evaluating the doctors' opinions and the conflicting CCH
records. He did not discount the headache diagnosis simply by commenting
on Davis' appearance at the hearing, as Davis seems to suggest. (R. 11,
Pls. Mot. for Summ. J. at 11.) Therefore, Davis' argument is not
supported by the record.
*fn3 The ALJ also rejected Dr. Stamboli's diagnosis of moderate
obesity, noting that she weighed 195 pounds at the time of the exam but
weighed only 180 pounds at the time of the hearing. (R. 7, Admin. R. at
16, ALJ Decision.) The ALJ's conclusion was proper considering that Davis
weighed significantly less than the Listing requirement for obesity
— 266 pounds — for a woman of her height. 20 C.F.R. Part
404, Subpart P, Appendix 1, § 9.09 (Table II-Women) (superseded
*fn4 Basic work activities include physical functions such as walking,
standing and sitting, as well as sensory functions and the ability to
carry out simple instructions and to use judgment. See
20 C.F.R. § 404.1521.