Filed: Feb. 26, 2015
Latest Update: Mar. 02, 2020
Summary: Case: 14-11950 Date Filed: 02/26/2015 Page: 1 of 12 [DO NOT PUBLISH] IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT _ No. 14-11950 Non-Argument Calendar _ D.C. Docket No. 3:12-cv-01114-PDB JANE E. COSTIGAN, Plaintiff-Appellant, versus COMMISSIONER, SOCIAL SECURITY ADMINISTRATION, Defendant-Appellee. _ Appeal from the United States District Court for the Middle District of Florida _ (February 26, 2015) Before WILSON, JORDAN, and JILL PRYOR, Circuit Judges. PER CURIAM: Case: 14-1
Summary: Case: 14-11950 Date Filed: 02/26/2015 Page: 1 of 12 [DO NOT PUBLISH] IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT _ No. 14-11950 Non-Argument Calendar _ D.C. Docket No. 3:12-cv-01114-PDB JANE E. COSTIGAN, Plaintiff-Appellant, versus COMMISSIONER, SOCIAL SECURITY ADMINISTRATION, Defendant-Appellee. _ Appeal from the United States District Court for the Middle District of Florida _ (February 26, 2015) Before WILSON, JORDAN, and JILL PRYOR, Circuit Judges. PER CURIAM: Case: 14-11..
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Case: 14-11950 Date Filed: 02/26/2015 Page: 1 of 12
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 14-11950
Non-Argument Calendar
________________________
D.C. Docket No. 3:12-cv-01114-PDB
JANE E. COSTIGAN,
Plaintiff-Appellant,
versus
COMMISSIONER, SOCIAL SECURITY ADMINISTRATION,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Middle District of Florida
________________________
(February 26, 2015)
Before WILSON, JORDAN, and JILL PRYOR, Circuit Judges.
PER CURIAM:
Case: 14-11950 Date Filed: 02/26/2015 Page: 2 of 12
Jane E. Costigan appeals the district court’s order affirming the
administrative law judge’s (“ALJ”) denial of disability insurance benefits (“DIB”)
pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). We affirm.
I.
On December 9, 2009, Costigan, then 55 years old, filed an application for
Social Security Disability (“SSD”) benefits alleging disability commencing on
August 3, 2008. Her claims were denied initially and upon re-consideration. At
her request, a hearing was held before an ALJ in June 2011. At the hearing,
Costigan attributed her disability to chronic neck, back and hip pain, anxiety,
insomnia, and hypertension, all of which interfered with her ability to perform the
duties of her prior work as a restaurant waitress. Medical records considered by
the ALJ reflected treatment for those conditions by Dr. David Kemp, M.D. She
was prescribed various medications including Lortab and Flexeril for her neck and
back pain, Restoril for her insomnia, and Valium for her anxiety. Following a May
2009 visit, Dr. Kemp noted that Costigan’s pain was controlled and that she was
functional on the medications and without side effects. He further noted that
Costigan had taken a new job at a convenience store. Additional notes stated that
her chronic pain was stable, she was functional with medication, and her mood was
stable.
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The ALJ examined a vocational expert (“VE”) who classified Costigan’s
past work experience as “waitress, informal,” which had a “light” exertion level
and was a semi-skilled position according to the Dictionary of Occupational Titles.
The VE opined that an individual based on Costigan’s hypothetical could not
perform her past work of “waitress, informal,” but that there were other positions
in the national economy that the individual could perform including office helper,
ticket taker, and nut and bolt assembler.
The ALJ also considered opinions of various other non-examining
consultants, including Dr. Ronald Chase, M.D. and Dr. Martin Falb, Ph.D., who
concluded that Costigan’s anxiety resulted in a mild restriction of activities of daily
living and maintaining social functioning. Upon review of the medical and other
evidence, the ALJ issued an unfavorable decision concluding that Costigan had not
been under a disability within the meaning of the Social Security Act from August
3, 2009, through the date of the decision, July 26, 2011, applying the five-step
sequential evaluation process required by 20 C.F.R. § 416.920(a). In reaching its
conclusion, the ALJ determined that Dr. Kemp’s opinion was not entitled to
controlling or substantial weight, even though he was Costigan’s treating
physician, because it was not well-supported by medically acceptable clinical or
laboratory diagnostic techniques and was inconsistent with his own reports. The
ALJ gave great weight to the opinions of Dr. Falb and Dr. Chase. In addition, the
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ALJ concluded that the overall record indicated that, while Costigan had some
limitations in her physical and mental abilities, she did not have the type of
limitations which would preclude her from performing her past relevant work as a
waitress.
On appeal to the Appeals Council, Costigan requested that the Council
consider additional evidence, including an MRI of her cervical and lumbar spine
conducted by Dr. J.H. Kim, M.D., a radiologist. The MRI indicated severe
degenerative disc disease. Dr. John C. Stevenson, M.D., an orthopaedic surgeon,
also saw Costigan and reported scoliosis with multi-level degenerative disc
disease.
The Appeals Council denied Costigan’s request for benefits. The Appeals
Council noted that it looked at the additional medical records, but because the
records post-dated the ALJ’s decision, they did not affect the decision about
whether Costigan was disabled on or before July 26, 2011. Costigan then filed this
appeal. A later decision by the Commissioner found that she was disabled as of
the next day—July 27, 2011.
II.
Costigan first argues that the ALJ erred by applying incorrect legal standards
in evaluating her subjective pain complaints and her credibility, and that his
credibility findings are not supported by substantial evidence. She argues that Dr.
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Kim’s MRI reports provide substantial evidence to support her credibility
regarding her pain and symptom testimony. She further argues that the ALJ failed
to properly challenge her credibility regarding the chronicity or severity of her pain
because he did not call a medical expert or otherwise produce competent evidence
that her condition would not reasonably be expected to cause her subjective neck
and back pain.
In Social Security appeals, we review the decision of an ALJ as the
Commissioner’s final decision when the ALJ denies benefits and the Appeals
Council denies review of the ALJ’s decision. Doughty v. Apfel,
245 F.3d 1274,
1278 (11th Cir. 2001). We review the ALJ’s decision “to determine if it is
supported by substantial evidence and based on proper legal standards.” Crawford
v. Comm’r of Soc. Sec.,
363 F.3d 1155, 1158 (11th Cir. 2004) (per curiam)
(internal quotation marks omitted). “Substantial evidence is more than a scintilla
and is such relevant evidence as a reasonable person would accept as adequate to
support a conclusion.”
Id. If the decision reached is supported by substantial
evidence, we must affirm even if the evidence preponderates against the
Commissioner’s findings.
Id.
A claimant for disability benefits must prove that she is disabled. Moore v.
Barnhart,
405 F.3d 1208, 1211 (11th Cir. 2005) (per curiam). There is a five-step
evaluation process to determine whether the claimant is disabled, which is as
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follows: “(1) whether the claimant is currently engaged in substantial gainful
activity; (2) whether the claimant has a severe impairment or combination of
impairments; (3) whether the impairment meets or equals the severity of the
specified impairments in the Listing of Impairments; (4) based on a residual
functional capacity (“RFC”) assessment, whether the claimant can perform any of
his or her past relevant work, [even with] the impairment; and (5) whether there are
significant numbers of jobs in the national economy that the claimant can perform
in light of the claimant’s RFC, age, education, and work experience.” Winschel v.
Comm’r of Soc. Sec.,
631 F.3d 1176, 1178 (11th Cir. 2011).
When a claimant attempts to establish a disability through her own
testimony concerning pain or other subjective symptoms, we apply a three-part
test, which requires (1) evidence of an underlying medical condition; and (2) either
(a) objective medical evidence that confirms the severity of the alleged pain
stemming from that condition, or (b) that the objectively determined medical
condition is of a severity that can reasonably be expected to cause the alleged pain.
Wilson v. Barnhart,
284 F.3d 1219, 1225 (11th Cir. 2002) (per curiam). “After
considering a claimant’s complaints of pain, the ALJ may reject them as not
creditable, and that determination will be reviewed for substantial evidence.”
Marbury v. Sullivan,
957 F.2d 837, 839 (11th Cir. 1992) (per curiam). The ALJ
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must explicitly and adequately articulate his reasons if he discredits subjective
testimony.
Id.
If the record shows that the claimant has a medically determinable
impairment that could reasonably be expected to produce her symptoms, the ALJ
must evaluate the intensity and persistence of the symptoms in determining how
they limit the claimant’s capacity for work. 20 C.F.R. § 404.1529(c)(1). In doing
so, the ALJ must consider all of the record, including the objective medical
evidence, the claimant’s history, and statements of the claimant and her doctors.
Id. § 404.1529(c)(1)-(2). The ALJ may consider other factors, such as: (1) the
claimant’s daily activities; (2) the location, duration, frequency, and intensity of
the claimant’s pain or other symptoms; (3) any precipitating and aggravating
factors; (4) the type, dosage, effectiveness, and side effects of the claimant’s
medication; (5) any treatment other than medication; (6) any measures the claimant
used to relieve her pain or symptoms; and (7) other factors concerning the
claimant’s functional limitations and restrictions due to her pain or symptoms.
Id.
§ 404.1529(c)(3). The ALJ must then examine the claimant’s statements regarding
her symptoms in relation to all other evidence, and consider whether there are any
inconsistencies or conflicts between those statements and the record.
Id.
§ 404.1529(c)(4).
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We find that the ALJ applied the correct legal standard in concluding that
Costigan’s impairment could reasonably be expected to cause her alleged
symptoms, but that her report of pain was subjective and in excess of the medical
evidence of record and other evidence in her file, and, therefore, not credible to the
extent that it was inconsistent with the RFC assessment. See
Wilson, 284 F.3d at
1225; 20 C.F.R. §§ 404.1529(c)(1). Second, there was no objective medical
information before the ALJ to otherwise support Costigan’s credibility. See
Wilson, 284 F.3d at 1225; 42 U.S.C. § 423(d)(5)(A); 20 C.F.R. §§ 404.1528(a),
404.1512(b)(1). Third, the ALJ specifically articulated his reasons for discrediting
Costigan’s subjective pain testimony, including inconsistencies regarding side
effects of her medications, her pain rating, and her under-reporting of daily
activities. See
Marbury, 957 F.2d at 839; see also 20 C.F.R. § 404.1529(c)(3), (4).
As to the MRI report by Dr. Kim, a claimant is generally allowed to present
new evidence at each stage of the administrative process. See 20 C.F.R.
§ 404.900(b). The Appeals Council must consider new, material evidence if it
relates to the period on or before the ALJ’s decision, and must then review the case
if the ALJ’s decision is contrary to the weight of the evidence currently of record.
Id. § 404.970(b). When a claimant properly presents new evidence to the Appeals
Council and it denies review, a reviewing court essentially considers the claimant’s
evidence anew to determine whether “that new evidence renders the denial of
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benefits erroneous.” Ingram v. Comm’r of Soc. Sec.,
496 F.3d 1253, 1262 (11th
Cir. 2007).
Because the MRI report by Dr. Kim that Costigan provided to the Appeals
Council did not bear directly on Costigan’s subjective complaint of pain at the time
of the hearing before the ALJ, the new evidence does not render the ALJ’s denial
of benefits erroneous. See
Ingram, 496 F.3d at 1262. The information post-dated
the hearing by four to eight months, and thus does not bear directly on Costigan’s
subjective complaint of pain at the time of the hearing. Even if, however, the new
evidence applied to the relevant timeframe, substantial evidence supports the
ALJ’s credibility finding because multiple inconsistencies called into doubt the
reliability of Costigan’s testimony. See
Marbury, 957 F.2d at 839. First, although
Costigan testified that her medications caused side effects such as drowsiness, Dr.
Kemp’s records note that she denied side effects. Secondly, although Costigan
reported “burning” and “unbearable” pain, Dr. Kemp noted that her pain was
“stable” and/or “controlled.” And, although Costigan reported that she was unable
to work at all since August 3, 2009, due to her neck and back pain, records showed
that she had worked and been paid after that.
III.
Costigan next contends that the ALJ erred by rejecting her treating
physician’s (Dr. Kemp’s) opinion. When evaluating an applicant’s claim for social
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security disability benefits, the ALJ must give “substantial weight” to the opinion
of the applicant’s treating physician unless “good cause” exists for not heeding the
treating physician’s diagnosis.
Crawford, 363 F.3d at 1159; see also Broughton v.
Heckler,
776 F.2d 960, 962 (11th Cir. 1985) (per curiam) (“It is not only legally
relevant but unquestionably logical that the opinions, diagnosis, and medical
evidence of a treating physician whose familiarity with the patient’s injuries,
course of treatment, and responses over a considerable length of time, should be
given considerable weight.” (internal quotation marks and alternation omitted)).
We have held that good cause exists when: (1) the treating physician’s
opinion is not bolstered by the evidence; (2) the evidence supports a contrary
finding; or (3) the treating physician’s opinion is conclusory or inconsistent with
the doctor’s own medical records. Lewis v. Callahan,
125 F.3d 1436, 1440 (11th
Cir. 1997). If the ALJ disregards or accords less weight to the opinion of a treating
physician, the ALJ must clearly articulate his reasons, and the failure to do so is
reversible error.
Id.
The ALJ articulated good cause for rejecting Dr. Kemp’s opinion that
Costigan was disabled to the point that she could not work: (1) his findings were
based on Costigan’s subjective reports and he had no objective medical records on
which to base his opinion; (2) his opinion was not well-supported by medically
acceptable clinical and laboratory diagnostic techniques; and (3) his treatment
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notes were inconsistent with his opinion that Costigan was unable to perform even
sedentary work activity. See Lewis,
125 F.3d 1440. Substantial evidence supports
the ALJ’s stated reasons, first, because the physician’s opinion did not appear to be
based on any objective medical evidence, such as medically acceptable clinical
diagnostic techniques or laboratory findings, and, second, no such evidence was
part of the record before the ALJ. See
Crawford, 363 F.3d at 1158; Lewis,
125
F.3d 1440. Instead, he provided only conclusory statements that certain activities
would aggravate Costigan’s chronic neck and low back pain or based his findings
on Costigan’s self-reports of symptoms. Additionally, his opinion that Costigan
was unable to perform even sedentary work activity was contradicted by his own
records. Thus, the ALJ provided good cause and specific reasons for giving little
weight to the treating physician’s opinion, and the ALJ’s reasons are supported by
substantial evidence.
Crawford, 363 F.3d at 1158-59;
Lewis, 125 F.3d at 1440.
IV.
Finally, Costigan argues that her due process rights were violated because
she was found to be not disabled as of August 3, 2009 in an order by the ALJ dated
July 26, 2011, but a later decision by the Commissioner found that she was
disabled as of July 27, 2011.
The fundamental requirement of due process is the right to be heard at a
meaningful time and manner. Mathews v. Eldridge,
424 U.S. 319, 333,
96 S. Ct.
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893, 902 (1976). We have explained that a claimant who sought to reopen a
decision was afforded procedural due process where he “was represented by
counsel at an administrative hearing and had the opportunity to present all
information relevant to the reopening decision, as well as the right to appeal.”
Cherry v. Heckler,
760 F.2d 1186, 1190-91 (11th Cir. 1985).
Costigan has not shown how she was deprived of an opportunity to be heard
at a meaningful time and in a meaningful manner. See
Eldridge, 424 U.S. at 333,
96 S.Ct. at 902. Additionally, Costigan was represented by counsel at her hearing
before the ALJ and has taken full advantage of the appeals process. See
Cherry,
760 F.2d at 1190-91. Furthermore, as
explained, supra, the ALJ’s decision is
supported by substantial evidence in the record.
We therefore affirm.
AFFIRMED.
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