KATHERINE P. NELSON, Magistrate Judge.
Social Security Claimant/Plaintiff Yvonne Kirkland has brought this action under 42 U.S.C. §§ 405(g) and 1383(c)(3) seeking judicial review of a final decision of the Defendant Commissioner of Social Security ("the Commissioner") denying her applications for disability insurance benefits ("DIB") under Title II of the Social Security Act, 42 U.S.C. § 401, et seq., and supplemental security income ("SSI") under Title XVI of the Social Security Act, 42 U.S.C. § 1381, et seq. By the consent of the parties (see Doc. 19), the Court has designated the undersigned Magistrate Judge to conduct all proceedings and order the entry of judgment in this civil action, in accordance with 28 U.S.C. § 636(c), Federal Rule of Civil Procedure 73, and S.D. Ala. GenLR 73. (See Doc. 20).
Upon consideration of the parties' briefs (Docs. 14, 15, 16) and the administrative record (Doc. 13) (hereinafter cited as "(R. [page number(s) in lower-right corner of transcript])"),
On May 4, 2011, Kirkland protectively filed applications for DIB and SSI with the Social Security Administration ("SSA"),
Kirkland requested review of the ALJ's decision by the Appeals Council for the SSA's Office of Disability Adjudication and Review, submitting additional evidence for the Appeals Council's consideration. The Commissioner's decision on Kirkland's applications became final when the Appeals Council denied Kirkland's request for review on December 4, 2014. (R. 1-5). On January 30, 2015, Kirkland filed this action under §§ 405(g) and 1383(c)(3) for judicial review of the Commissioner's final decision. (Doc. 1). See 42 U.S.C. § 405(g) ("Any individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil action commenced within sixty days after the mailing to him of notice of such decision or within such further time as the Commissioner of Social Security may allow."); 42 U.S.C. § 1383(c)(3) ("The final determination of the Commissioner of Social Security after a hearing [for SSI benefits] shall be subject to judicial review as provided in section 405(g) of this title to the same extent as the Commissioner's final determinations under section 405 of this title."); Ingram v. Comm'r of Soc. Sec. Admin., 496 F.3d 1253, 1262 (11th Cir. 2007) ("The settled law of this Circuit is that a court may review, under sentence four of section 405(g), a denial of review by the Appeals Council.").
"In Social Security appeals, [the Court] must determine whether the Commissioner's decision is `"supported by substantial evidence and based on proper legal standards. Substantial evidence is more than a scintilla and is such relevant evidence as a reasonable person would accept as adequate to support a conclusion."'" Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011) (quoting Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir. 2004) (per curiam) (internal citation omitted) (quoting Lewis v. Callahan, 125 F.3d 1436, 1439 (11th Cir. 1997))). However, the Court "`may not decide the facts anew, reweigh the evidence, or substitute our judgment for that of the [Commissioner].'" Winschel, 631 F.3d at 1178 (quoting Phillips v. Barnhart, 357 F.3d 1232, 1240 n.8 (11th Cir. 2004) (alteration in original) (quoting Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983))). "`Even if the evidence preponderates against the [Commissioner]'s factual findings, we must affirm if the decision reached is supported by substantial evidence.'" Ingram, 496 F.3d at 1260 (quoting Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990)).
"Yet, within this narrowly circumscribed role, [courts] do not act as automatons. [The court] must scrutinize the record as a whole to determine if the decision reached is reasonable and supported by substantial evidence[.]" Bloodsworth, 703 F.2d at 1239 (citations and quotation omitted). "In determining whether substantial evidence exists, [a court] must . . . tak[e] into account evidence favorable as well as unfavorable to the [Commissioner's] decision." Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). Moreover, "[t]here is no presumption . . . that the Commissioner followed the appropriate legal standards in deciding a claim for benefits or that the legal conclusions reached were valid. Instead, [the court] conduct[s] `an exacting examination' of these factors." Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996) (per curiam) (citing Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990)) (internal citation omitted). In sum, courts "review the Commissioner's factual findings with deference and the Commissioner's legal conclusions with close scrutiny." Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). See also Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005) (per curiam) ("In Social Security appeals, we review de novo the legal principles upon which the Commissioner's decision is based. Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). However, we review the resulting decision only to determine whether it is supported by substantial evidence. Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1158-59 (11th Cir. 2004)."). "`The [Commissioner]'s failure to apply the correct law or to provide the reviewing court with sufficient reasoning for determining that the proper legal analysis has been conducted mandates reversal.'" Ingram, 496 F.3d at 1260 (quoting Cornelius v. Sullivan, 936 F.2d 1143, 1145-46 (11th Cir. 1991)).
Thornton v. Comm'r, Soc. Sec. Admin., 597 F. App'x 604, 609 (11th Cir. Feb. 11, 2015) (per curiam) (unpublished).
Winschel, 631 F.3d at 1178 (citing 20 C.F.R. §§ 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v); Phillips, 357 F.3d at 1237-39).
"These regulations place a very heavy burden on the claimant to demonstrate both a qualifying disability and an inability to perform past relevant work." Moore, 405 F.3d at 1211 (citing Spencer v. Heckler, 765 F.2d 1090, 1093 (11th Cir. 1985)). "In determining whether the claimant has satisfied this initial burden, the examiner must consider four factors: (1) objective medical facts or clinical findings; (2) the diagnoses of examining physicians; (3) evidence of pain; and (4) the claimant's age, education, and work history." Jones v. Bowen, 810 F.2d 1001, 1005 (11th Cir. 1986) (per curiam) (citing Tieniber v. Heckler, 720 F.2d 1251, 1253 (11th Cir. 1983) (per curiam)). "These factors must be considered both singly and in combination. Presence or absence of a single factor is not, in itself, conclusive." Bloodsworth, 703 F.2d at 1240 (citations omitted).
If, in Steps One through Four of the five-step evaluation, a claimant proves that he or she has a qualifying disability and cannot do his or her past relevant work, it then becomes the Commissioner's burden, at Step Five, to prove that the claimant is capable—given his or her age, education, and work history—of engaging in another kind of substantial gainful employment that exists in the national economy. Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir. 1999); Sryock v. Heckler, 764 F.2d 834, 836 (11th Cir. 1985). Finally, but importantly, although the "claimant bears the burden of demonstrating the inability to return to [his or] her past relevant work, the Commissioner of Social Security has an obligation to develop a full and fair record." Shnorr v. Bowen, 816 F.2d 578, 581 (11th Cir. 1987). "This is an onerous task, as the ALJ must scrupulously and conscientiously probe into, inquire of, and explore for all relevant facts. In determining whether a claimant is disabled, the ALJ must consider the evidence as a whole." Henry v. Comm'r of Soc. Sec., 802 F.3d 1264, 1267 (11th Cir. 2015) (per curiam) (citation and quotation omitted).
"When no new evidence is presented to the Appeals Council and it denies review, then the administrative law judge's decision is necessarily reviewed as the final decision of the Commissioner, but when a claimant properly presents new evidence to the Appeals Council, a reviewing court must consider whether that new evidence renders the denial of benefits erroneous." Ingram, 496 F.3d at 1262.
(Doc. 15 at 1).
At Step One, the ALJ determined that Kirkland had "not engaged in substantial gainful activity since January 11, 2010, the alleged onset date . . ." (R. 37). At Step Two, the ALJ determined that Kirkland had the following severe impairments: degenerative disk disease of the cervical spine, status post C-6 surgery, degenerative disk disease of the lumbar spine per x-ray, and obesity (R. 37). At Step Three, the ALJ found that Kirkland did not have an impairment or combination of impairments that meets or equals the severity of one of the specified impairments in the Listing of Impairments. (R. 37-38).
At Step Four,
Phillips, 357 F.3d at 1238-39 (footnote omitted).
The ALJ determined that Kirkland had the RFC "to perform sedentary work as defined in 20 CFR 404.1567(a) and 20 CFR 416.967(a)[
Evidence considered by the Commissioner in making a disability determination may include medical opinions. See 20 C.F.R. §§ 404.1527(a)(2) & 416.927(a)(2). "`Medical opinions are statements from physicians and psychologists or other acceptable medical sources that reflect judgments about the nature and severity of [the claimant's] impairment(s), including [the claimant's] symptoms, diagnosis and prognosis, what [the claimant] can still do despite impairment(s), and [the claimant's] physical or mental restrictions.'" Winschel, 631 F.3d at 1178-79 (quoting 20 C.F.R. §§ 404.1527(a)(2), 416.927(a)(2)). "There are three tiers of medical opinion sources: (1) treating physicians; (2) nontreating, examining physicians; and (3) nontreating, nonexamining physicians." Himes v. Comm'r of Soc. Sec., 585 F. App'x 758, 762 (11th Cir. Sept. 26, 2014) (per curiam) (unpublished) (citing 20 C.F.R. §§ 404.1527(c)(1)-(2), 416.927(c)(1)-(2)). "In assessing medical opinions, the ALJ must consider a number of factors in determining how much weight to give to each medical opinion, including (1) whether the physician has examined the claimant; (2) the length, nature, and extent of a treating physician's relationship with the claimant; (3) the medical evidence and explanation supporting the physician's opinion; (4) how consistent the physician's opinion is with the record as a whole; and (5) the physician's specialization. These factors apply to both examining and non-examining physicians." Eyre v. Comm'r, Soc. Sec. Admin., 586 F. App'x 521, 523 (11th Cir. Sept. 30, 2014) (per curiam) (unpublished) (internal citations and quotation marks omitted) (citing 20 C.F.R. §§ 404.1527(c) & (e), 416.927(c) & (e)).
The ALJ "may reject the opinion of any physician when the evidence supports a contrary conclusion." Bloodsworth, 703 F.2d at 1240. Accord, e.g., Anderson v. Comm'r of Soc. Sec., 427 F. App'x 761, 763 (11th Cir. 2011) (per curiam) (unpublished). However,
Winschel, 631 F.3d at 1179.
Kirkland asserts that the ALJ reversibly erred in rejecting the medical opinion of examining physician Dr. R. Rex Harris. At Step Four, the ALJ summarized Dr. Harris's treatment notes and opinions as follows:
(R. 42). Fulfilling the requirement that he "state with particularity the weight given to [Dr. Harris's] medical opinions and the reasons therefor[,]" Winschel, 631 F.3d at 1179, the ALJ assigned "little weight" (R. 43) / "no weight" (R. 44), to Dr. Harris's Medical Source Statement because it "is entirely inconsistent with the actual examination and his observations." (R. 43). The ALJ further explained:
(R. 43-44).
Kirkland complains that the ALJ determined "she was magnifying her limitations" before Dr. Harris when "Dr. Harris never made any such suggestion." (Doc. 15 at 4). The ALJ apparently reached this conclusion based on his own interpretation of Dr. Harris's notes (i.e., "Initially, the claimant demonstrated no ability to flex her lumber spine much less get out of her chair; however, he commented she could bend over 80 degrees to get her handbag off the floor. Such an ability either shows a remarkable recovery or suggests she may have been magnifying her alleged inabilities to get out of the chair and flex her lumbar spine.") and his observations of Kirkland at the administrative hearing (i.e., "She also was able to sit for 35 to 40 minutes during the hearing."). It is true that an ALJ may consider "a claimant's appearance and demeanor during the hearing" when making a credibility determination of
Nevertheless, substantial evidence supports the ALJ's decision to assign little or no weight to Dr. Harris's opinion. As the ALJ noted, there were inconsistencies in Dr. Harris's opinions themselves. While his treatment notes stated it was his "medical opinion that [Kirkland] is capable of light to sedentary work in the work place" (R. 410), the limitations in his Medical Source Statement allowed only for sedentary work. Moreover, Dr. Harris's treatment notes reflected that Kirkland had "full range of motion of her neck, shoulders, elbows, wrist and fingers," normal grip, normal sensation and equal reflexes in the upper and lower extremities, "full range of motion of the hips, knees and ankles," and normal gait with 5/5 muscle groups in the lower extremities. (R. 410). As the ALJ reasonably noted, these largely "unremarkable" observations did not support the severity of limitations expressed in his Medical Source Statement.
Kirkland further contends that "the marked restrictions of motion of the lumbar spine" purportedly observed by Dr. Harris at the examination do not support the ALJ's characterization of the examination as "unremarkable." (Doc. 15 at 4). Kirkland does not identify where these "marked restrictions" are found in Dr. Harris's notes. In regards to Kirkland's lumbar movement, Dr. Harrison did note that her "extension is 0 and lateral motion is 10," but Kirkland has not explained the significance of these observations. Moreover, Dr. Harris noted that, while Kirkland "initially could not do lumbar flexion," she eventually "could lean over and flex to approximately 80 degrees to get [her] handbag off the floor." (R. 410). Overall, the ALJ's determination that Dr. Harris's objective observations were overall "unremarkable" is supported by substantial evidence and will not be disturbed. See Ingram, 496 F.3d at 1260 ("Even if the evidence preponderates against the Commissioner's factual findings, we must affirm if the decision reached is supported by substantial evidence." (quotation omitted)).
Though not specifically listed as a "claim on appeal," in the final paragraph of the section addressing Claim 1 in her brief, Kirkland also argues the ALJ erred in rejecting "the statement by Dr. Timberlake that Ms. Kirkland was totally and completely disabled." (Doc. 15 at 5).
However, the ALJ provided four additional bases for rejecting Dr. Timberlake's opinion that Kirkland was "completely and totally disabled": (1) the opinion was made only 3 months after Kirkland was injured by a tornado; (2) the opinion resulted from a single, one-time office visit and was not supported by imaging or neurological/orthopedic studies; (3) medical records from another health care provider Kirkland visited right after the tornado injury did not mention appreciable back pain; and (4) this is an opinion reserved for the Commissioner. (R. 44). Kirkland fails to address, or even acknowledge, these alternative bases for rejecting Dr. Timberlake's opinion.
The ALJ correctly noted that Dr. Timberlake's opinion of disability as being an issue reserved for the Commissioner. See 20 C.F.R. §§ 404.1527(d)(1), 416.927(d)(1) (opinions that a claimant is disabled "are not medical opinions, . . . but are, instead, opinions on issues reserved to the Commissioner because they are administrative findings that are dispositive of a case; i.e., that would direct the determination or decision of disability"). Such an opinion, even from a treating source, is "never entitled to controlling weight or special significance," though it also "must never be ignored." SSR 96-5P, 1996 WL 374183 (S.S.A. July 2, 1996). Here, the ALJ expressly considered Dr. Timberlake's opinion and articulated four specific reasons why it was inconsistent with or not bolstered by the other evidence of record, only one of which Kirkland has addressed.
Accordingly, the Court
Washington v. Soc. Sec. Admin., Com'r, 806 F.3d 1317, 1320 (11th Cir. 2015) (per curiam). "When the Appeals Council refuses to consider new evidence submitted to it and denies review, that decision is subject to judicial review . . . [W]hen the Appeals Council erroneously refuses to consider evidence, it commits legal error and remand is appropriate." Id. at 1321 (quotation omitted).
In requesting that the Appeals Council review the ALJ's unfavorable decision, Kirkland presented additional medical evidence from Dr. Timberlake dated April 3-December 18, 2013. (R. 2, 14-17, 26-31).
"In reviewing decisions based on an application for benefits, if new and material evidence is submitted, the Appeals Council shall consider the additional evidence
Kirkland's primary argument is that the Appeals Council declined to review the new evidence "for no reason other than the dates being after the date of the ALJ's decision," asserting that this was reversible error because new "evidence does not have to be dated before the date of the ALJ's decision in order to relate to that period." (Doc. 15 at 5). While the Appeals Council did note the dates of Dr. Timberlake's new records, all of which were after the ALJ's decision, it also expressly stated it had "looked at" the new records and found that the "new information is about a later time" (R. 2). Given that the Appeals Council is not required to provide a detailed rationale in denying review, and Kirkland having cited no authority to the contrary, the Court finds that this statement adequately indicates the Appeals Council considered the substance of the new evidence, rather than simply the dates at the top, in finding it to be chronologically irrelevant.
However, Kirkland is correct that "medical opinions based on treatment occurring after the date of the ALJ's decision may be chronologically relevant." Washington, 806 F.3d at 1322. This is true even when, as here, the physician "never explicitly state[s] that his opinions related back to the date of the ALJ's decision" but bases it upon consideration of issues that predate the ALJ's decision. Id.
Though the Appeals Council appears to have acknowledged that Dr. Timberlake's additional evidence was "new information" (R. 2), the Commissioner argues here that the evidence, in addition to being chronologically irrelevant, was cumulative (see Doc. 16 at 11). See Washington, 806 F.3d at 1321 n.6 (citing Caulder v. Bowen, 791 F.2d 872, 877 (11th Cir. 1986), as "recognizing that cumulative evidence is not new").
The Court finds that Dr. Timberlake's September 24, 2013 opinion is new, material, and chronologically relevant evidence that the Appeals Council was required to consider. See Washington, 806 F.3d at 1321 (opinions are "material" when, if accepted, there is a reasonable possibility that they would change the administrative result). At the time of the ALJ's decision, Dr. Timberlake was a one-time examining physician whose only given opinion was on an issue reserved to the Commissioner, which the ALJ was not required to specially credit. By the time he issued his September 24, 2013 opinion, however, Dr. Timberlake had examined Kirkland at least twice more, and he continued to examine her after that opinion. Thus, there is a reasonable probability that his September 24, 2013 opinion would be considered the opinion of a treating physician entitled to substantial or considerable weight, absent good cause.
The only other treating source to provide an opinion as to Kirkland's physical impairments was treating surgeon Dr. McKenzie. The ALJ had assigned "great weight" to the "conclusion and opinion" of Dr. McKenzie, "who in August 2011 indicated that [Kirkland's] neck radiographs looked good/excellent when releasing her from her service and refusing to give her any more Lortabs." (R. 44 (citing SSA Exs. 6F and 11F)). However, it is undisputed that Dr. McKenzie treated only Kirkland's neck pain, while Dr. Timberlake treated both Kirkland's neck and lower back pain. Moreover, Dr. McKenzie's "opinions" consist of only passing statements made in brief notes from two examinations that Kirkland's x-rays looked "excellent" and "good" and that she was doing reasonably well. (R. 406, 452). Dr. McKenzie provided no specific opinion of Kirkland's physical limitations, as Dr. Timberlake did in his September 24, 2013 Medical Source Statement.
Thus, the Court
In accordance with the foregoing analysis, it is
Under Federal Rule of Civil Procedure 54(d)(2)(B), the Court hereby grants Kirkland's counsel an extension of time in which to file a petition for authorization of attorney's fees under 42 U.S.C. § 406(b) until thirty days after receipt of a notice of award of benefits from the Social Security Administration. See Bergen v. Comm'r of Soc. Sec., 454 F.3d 1273, 1277 (11th Cir. 2006) (per curiam) ("Fed. R. Civ. P. 54(d)(2) applies to a § 406(b) attorney's fee claim."); Blitch v. Astrue, 261 F. App'x 241, 242 n.1 (11th Cir. Jan. 8, 2008) (per curiam) (unpublished) ("In Bergen v. Comm'r of Soc. Sec., 454 F.3d 1273 (11th Cir. 2006), we suggested the best practice for avoiding confusion about the integration of Fed. R. Civ. P. 54(d)(2)(B) into the procedural framework of a fee award under 42 U.S.C. § 406 is for a plaintiff to request and the district court to include in the remand judgment a statement that attorneys fees may be applied for within a specified time after the determination of the plaintiff's past due benefits by the Commission. 454 F.3d at 1278 n.2.").
Final judgment shall issue separately in accordance with this Order and Federal Rule of Civil Procedure 58.