F I L E D
United States Court of Appeals
Tenth Circuit
UNITED STATES COURT OF APPEALS
DEC 18 2000
FOR THE TENTH CIRCUIT
PATRICK FISHER
Clerk
SHANNON GARDNER-RENFRO,
Plaintiff-Appellant,
v. No. 00-6077
(D.C. No. 98-CV-697)
KENNETH S. APFEL, Commissioner, (W.D. Okla.)
Social Security Administration,
Defendant-Appellee.
ORDER AND JUDGMENT *
Before TACHA , EBEL , and BRISCOE , Circuit Judges.
After examining the briefs and appellate record, this panel has determined
unanimously to grant the parties’ request for a decision on the briefs without oral
argument. See Fed. R. App. P. 34(f); 10th Cir. R. 34.1(G). The case is therefore
ordered submitted without oral argument.
*
This order and judgment is not binding precedent, except under the
doctrines of law of the case, res judicata, and collateral estoppel. The court
generally disfavors the citation of orders and judgments; nevertheless, an order
and judgment may be cited under the terms and conditions of 10th Cir. R. 36.3.
Plaintiff Shannon Gardner-Renfro appeals the district court’s affirmance of
the final decision of the Commissioner of Social Security denying her
applications for disability insurance benefits and supplemental security income.
We exercise jurisdiction under 42 U.S.C. § 405(g) and 28 U.S.C. § 1291.
Because the Commissioner’s decision is supported by substantial evidence and no
legal errors occurred, we affirm.
Plaintiff was born in 1970 and has a high school education plus vocational
training as a beautician. She has worked as a secretary, bank teller, tour guide,
and a cashier/general office clerk. She filed an application for disability benefits
on February 6, 1991, claiming she was unable to work after December 11, 1990,
due to the combined effects of chronic fatigue syndrome and dysthymia, a mild
form of depression. A hearing was held in December 1991 before an
administrative law judge (ALJ) who found that plaintiff was not disabled at step
four because she could still perform her past work. See Williams v. Bowen , 844
F.2d 748, 750-52 (10th Cir. 1988) (outlining five-step sequential process for
determining disability). The Appeals Council affirmed, and plaintiff appealed in
federal district court.
In 1994, the district court remanded plaintiff’s case for further
consideration, stating that:
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On remand, the ALJ must proceed to step five to determine whether
[plaintiff] can return to work elsewhere in the national economy. As
part of the remand, the ALJ must order an examination of [plaintiff]
by a consulting specialist in the area of Chronic Fatigue Syndrome.
In addition, the ALJ must re-evaluate his examination of the evidence
of Drs. Soto and Anderson[, plaintiff’s treating physicians,] in light
of this opinion. The ALJ must also conduct a supplemental hearing
where a Vocational Expert and the consulting specialist can testify,
considering the whole of the newly found medical evidence and
testimony, above.
Appellant’s App., Vol. II at 426-27.
On remand, plaintiff was examined by Dr. Susan Dimick, a board certified
specialist in internal medicine. The ALJ conducted a second de novo
administrative hearing at which plaintiff, Dr. Dimick, and a vocational expert
(VE) testified. In her report, Dr. Dimick opined that plaintiff met none of the
criteria established by the Center for Disease Control for a diagnosis of chronic
fatigue syndrome. Id. at 478. Dr. Dimick also opined that plaintiff had received
“very bizarre” and “very unconventional” and “unorthodox” treatment from her
treating physicians. Id. at 472.
Dr. Dimick performed a medical assessment of plaintiff’s ability to work-
related activities and concluded that plaintiff had no limitations in
lifting/carrying, standing/walking, or sitting; had no limitations in any of her
postural activities, such as climbing, stooping or crouching; no limitations in any
of her physical functions, such as reaching, handling, fingering, or pushing; and
had no environmental restrictions. Id. at 481-82. Dr. Dimick did note that
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plaintiff exhibited possible signs of fibromyalgia or Raynauld’s syndrome, and
believed that plaintiff should undergo an immunological profile. Id. at 478-79.
Following the hearing, but prior to the ALJ’s decision, plaintiff was also
examined by a consulting psychologist, Dr. Hickman, who found no evidence of
any organic mental disorder, very mild language-based learning disability and
undifferentiated somatoform disorder. Dr. Hickman opined that plaintiff’s ability
to make occupational, performance, and personal-social adjustments was good or
very good in all areas.
The ALJ issued a decision in April 1996, concluding that plaintiff was not
disabled at step four. The Appeals Council remanded the case, however, because,
contrary to the district court’s remand order, the ALJ had failed to proceed to step
five. The Appeals Council directed the ALJ to proceed to step five, obtain further
medical evidence from a rheumatologist and, if warranted, obtain further
vocational evidence. Id. at 565.
On remand, plaintiff was examined by Dr. Raymond Dougherty, a board
certified specialist in internal medicine. Dr. Dougherty’s report indicated that
physical findings did not support plaintiff’s claims of fatigue, joint and muscle
pain. Id. at 584. He reported that plaintiff had a full range of motion of all joints
and completely normal findings of her back. Id. at 585-88. He reported that
plaintiff described being able to perform light housework and was taking only
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Premarin and occasional pain and nerve medicine. In addition, Dr. James Lowell,
also a board certified specialist in internal medicine, reviewed plaintiff’s medical
records. The ALJ held a third de novo administrative hearing in October 1997 at
which plaintiff, Dr. Lowell and a VE testified.
In November 1997, the ALJ concluded at step five of the sequential
analysis that plaintiff was not disabled because she retained the residual
functional capacity (RFC) to perform jobs existing in significant numbers in the
local and national economies. The Appeals Council affirmed, making it the
Commissioner’s final decision.
On appeal, plaintiff argues that the ALJ (1) breached his duty to develop
the record by refusing to obtain a consultative examination by a specialist as
ordered by the district court and the Appeals Council; and (2) failed to apply
properly the step five burden of proof by substituting his opinion of the medical
evidence, relying instead on his credibility determination to support his step five
denial. In a detailed and thoughtful report and recommendation, the magistrate
judge addressed plaintiff’s issues and rejected her arguments. The district court
affirmed the decision of the Commissioner based upon the magistrate judge’s
report and recommendation. We have reviewed the record as a whole to
determine whether the Commissioner’s findings are supported by substantial
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evidence and whether he applied the correct legal standards. See Castellano v.
Sec’y of Health & Human Servs. , 26 F.3d 1027, 1028 (10th Cir. 1994).
Development of the Record
An ALJ has a responsibility in the nonadversarial social security setting “to
ensure that an adequate record is developed during the disability hearing
consistent with the issues raised.” Henrie v. United States Dep’t of Health &
Human Servs. , 13 F.3d 359, 360-61 (10th Cir. 1993). This responsibility to
develop the record may require the ALJ to order a consultative examination. See
Hawkins v. Chater , 113 F.3d 1162, 1166 (10th Cir. 1997).
Plaintiff claims the ALJ erred in not obtaining a consultative examination
from a specialist in rheumatology, as recommended by Dr. Dimick and as ordered
by the Appeals Council. We conclude that the ALJ did not fail to comply with the
remand instructions of the district court or the Appeals Council. Following the
Appeals Council’s 1997 remand order, the ALJ explained that he was unable to
obtain a consultative examination from a rheumatologist through the disability
determination office in plaintiff’s state. Thus, he substituted a consultative
examination by a board certified internist, Dr. Dougherty, and called on
Dr. Lowell, also a board certified internist, to testify. The Appeals Council
concluded that the ALJ “did his utmost to follow the Council’s remand order and
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. . . that the consultative examination obtained and the further medical expert
testimony obtained, does satisfy the directives in the Council’s remand order.”
Appellant’s App. Vol. II at 337.
Plaintiff contends that the district court directed that she be examined by a
rheumatology specialist. Appellant’s Br. at 25. This misrepresents the district
court’s remand order. The district court ordered that she be examined by a
specialist in chronic fatigue syndrome, not by a rheumatologist. The ALJ
appropriately complied with the district court’s remand order in obtaining
medical evaluations with respect to chronic fatigue syndrome. Dr. Lowell
testified that he did not know of a speciality in chronic fatigue syndrome and that
a specialist in internal medicine was qualified to evaluate chronic fatigue
syndrome. Plaintiff was evaluated by three internists, Drs. Dimick, Dougherty
and Lowell. Dr. Dougherty found no limitations in plaintiff’s exertional
activities, postural activities, physical functions, or environmental restrictions.
Dr. Dimick opined that plaintiff did not meet the criteria for chronic fatigue
syndrome and Dr. Lowell agreed with her conclusion.
The ALJ’s inability to obtain a consultative examination from a
rheumatology specialist did not violate his duty to develop the record. As noted,
Dr. Dougherty determined that plaintiff did not have any restrictions in her
exertional activities, postural activities, physical functions, or environmental
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restrictions. This report was consistent with the medical opinions of Drs. Dimick
and Lowell. Dr. Lowell reviewed plaintiff’s medical record and testified that it
was complete and that there were not inconsistencies in the record requiring that
further medical evidence be obtained. The ALJ considered all of the medical
evidence, and concluded that further medical evaluations were not warranted.
“The ALJ does not have to exhaust every possible line of inquiry in an attempt to
pursue every potential line of questioning. The standard is one of reasonable
good judgment.” Hawkins , 113 F.3d at 1168 (citation omitted).
It is true that none of the internists performed any tests related to
fibromyalgia or Raynaud’s syndrome, as suggested by Dr. Dimick. However, an
individual is not considered to be disabled under the Social Security Act unless
her “physical or mental impairment or impairments are of such severity that [she]
is not only unable to do [her] previous work but cannot, considering [her] age,
education, and work experience, engage in any other kind of substantial gainful
work which exists in the national economy. . . .” 42 U.S.C. §§ 423(d)(2)(A),
1382c(a)(3)(B). Thus, as pointed out by the district court, “the operative question
for disability benefits under the Act is whether [p]laintiff experiences functional
limitations due to her impairments.” Appellant’s App., Vol. I at 21. Regardless
of whether plaintiff could have been diagnosed with a particular medical
condition, none of the consultative physicians found her to have functional
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impairments which precluded the performance of all work during the relevant
period. Under these circumstances, the ALJ was not required to seek further
medical opinions or consultative examinations.
Plaintiff contends that even if the ALJ had good cause to not obtain a
consultative examination from a rheumatologist, he erred in failing to provide
Dr. Dougherty with all of plaintiff’s prior medical records. Our review of the
record shows that Dr. Dougherty’s report was prepared based on a thorough
examination of plaintiff and a sufficient understanding of her medical history to
render the report legally sufficient. See id . Vol. II at 582-92. Moreover, the ALJ
also obtained a report from a third internist, Dr. Lowell, who did review all of
plaintiff’s medical records. Id. at 398.
Plaintiff contends that the tone of the ALJ’s questioning and his refusal to
follow the dictates of the Appeals Council and the district court demonstrate an
obvious bias against her and her counsel, preventing her from obtaining a full and
fair hearing. As noted above, the ALJ substantially complied with the appellate
remand orders. We conclude from our review of the record, read in full and in
context, that the ALJ provided plaintiff with a full and fair opportunity to develop
the record and did not exhibit bias against her.
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Step Five Determination
Plaintiff next contends the ALJ failed to apply properly the step five burden
of proof by substituting his personal opinion for medical evidence and relying on
his determination that plaintiff’s subjective complaints lacked credibility. At step
five, the burden is on the agency to show that a claimant retains the RFC to
perform work that exists in the national economy. Miller v. Chater , 99 F.3d 972,
975 (10th Cir. 1996). Plaintiff contends that, while the ALJ may have been
within his province to reject her testimony of disabling pain, this credibility
determination is not dispositive at step five because he failed to point to
affirmative evidence that she could work on a regular basis and maintain
employment. Plaintiff claims, erroneously, that the ALJ relied solely on the
testimony of Dr. Lowell in making his step five determination, which she claims
was insufficient because Dr. Lowell did not examine plaintiff or give an opinion
as to her functional limitations.
Contrary to plaintiff’s contention, the record and the ALJ’s decision
demonstrate that the ALJ did not rely solely on Dr. Lowell’s opinion, but
considered the totality of the evidence presented in making his step five
determination. The ALJ’s determination that plaintiff had the RFC to perform
work is supported by numerous medical assessments of her physical ability to
work as well as assessments of her mental ability to work, and by the testimony of
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the VE, as fully detailed in the magistrate judge’s report and recommendation.
This is not a case in which the absence of evidence is made to serve as substantial
evidence to meet the Commissioner’s burden at step five, cf. Thompson v.
Sullivan , 987 F.2d 1482, 1491 (10th Cir. 1993).
Plaintiff also complains that the ALJ should have given more weight to
Dr. Dimick’s recommendation that she be evaluated by a rheumatologist than to
Dr. Lowell’s opinion that no further medical examination was necessary. The
ALJ has the duty to weigh evidence and resolve any evidentiary conflicts,
however, and we will not reweigh the evidence. Rutledge v. Apfel , 230 F.3d
1172, 1174 (10th Cir. 2000). Plaintiff claims that the ALJ should at least have
explained why he rejected Dr. Dimick’s testimony that plaintiff would not be able
to work with her extreme fatigue and pain. This misstates Dr. Dimick’s
testimony, who stated in her report only that plaintiff reported being physically
too fatigued and in too much pain to work. Appellant’s App., Vol. II at 480. The
ALJ properly evaluated plaintiff’s allegations of disabling fatigue and pain and
his credibility determination was supported by substantial evidence.
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We conclude that the agency applied the correct legal standards and that
substantial evidence supports the agency’s decision. Thus, we AFFIRM the
judgment of the United States District Court for the Western District of Oklahoma.
Entered for the Court
David M. Ebel
Circuit Judge
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Renfro v. Apfel
Combined Opinion