CHARLES S. COODY, Magistrate Judge.
The plaintiff applied for applied for disability insurance benefits pursuant to Title II of the Social Security Act, 42 U.S.C. §§ 401, et seq., alleging that she was unable to work because of a disability. She is seeking disability benefits for a closed period from the date of onset on May 18, 2007 until the date she was last insured on March 31, 2008. Her application was denied at the initial administrative level. The plaintiff then requested and received a hearing before an Administrative Law Judge ("ALJ"). Following the hearing, the ALJ also denied the claim. The Appeals Council rejected a subsequent request for review. The ALJ's decision consequently became the final decision of the Commissioner of Social Security (Commissioner).
Under 42 U.S.C. § 423(d)(1)(A), a person is entitled to disability benefits when the person is unable to
To make this determination,
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986).
The standard of review of the Commissioner's decision is a limited one. This court must find the Commissioner's decision conclusive if it is supported by substantial evidence. 42 U.S.C. § 405(g); Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005). Substantial evidence is "more than a scintilla," but less than a preponderance; it "is such relevant evidence as a reasonable person would accept as adequate to support a conclusion." Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1158-59 (11th Cir. 2004) (quotation marks omitted). The court "may not decide the facts anew, reweigh the evidence, or substitute . . . [its] judgment for that of the [Commissioner]." Phillips v. Barnhart, 357 F.3d 1232, 1240 n. 8 (11th Cir. 2004) (alteration in original) (quotation marks omitted).
Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987).
(Doc. # 12, Pl's Br. at 1-2, 6-7).
A disability claimant bears the initial burden of demonstrating an inability to return to her past work. Lucas v. Sullivan, 918 F.2d 1567 (11th Cir. 1990). In determining whether the claimant has satisfied this burden, the Commissioner is guided by four factors: (1) objective medical facts or clinical findings, (2) diagnoses of examining physicians, (3) subjective evidence of pain and disability, e.g., the testimony of the claimant and her family or friends, and (4) the claimant's age, education, and work history. Tieniber v. Heckler, 720 F.2d 1251 (11th Cir. 1983). The ALJ must conscientiously probe into, inquire of and explore all relevant facts to elicit both favorable and unfavorable facts for review. Cowart v. Schweiker, 662 F.2d 731, 735-36 (11th Cir. 1981). The ALJ must also state, with sufficient specificity, the reasons for his decision referencing the plaintiff's impairments.
42 U.S.C. § 405(b)(1) (emphases added). Within this analytical framework, the court will address the plaintiff's claims.
Presley applied for disability income benefits on February 17, 2010, alleging disability due to an aneurysm, heart problems, high blood pressure and thyroid problems. (R. 156). She alleged an onset date of May 18, 2007. (R. 175). On May 18, 2007, Presley presented to her family doctor, Dr. Vester, complaining of being lightheaded and dizzy. (R. 192). According to Presley, these symptoms began three weeks earlier, and were getting worse. (Id.) Dr. Vester referred Presley to Dr. Reddy, a cardiologist.
Dr. Reddy saw Presley on June 14, 2007. (R. 259-60). At that time, she complained of palpitations, chest discomfort, frank syncope and issues with her blood pressure. (R. 259).
(Id.)
Dr. Reddy suspected uncontrolled hypertension, prescribed medication and scheduled cardiac studies. A nuclear perfusion study was within normal limits. (R. 191, 200, 258). A carotid study was normal. (Id.) On August 9, 2007, Dr. Reddy noted that Presley's palpitations had improved with medication, and there was no evidence of ischemia. (R. 258).
On September 20, 2007, Presley returned to Dr. Reddy. At that time, she complained of "occasional chest pain, heart rate beating fast and feeling lightheaded." (R. 257). She had no further episodes of fainting. (Id.) A stress test was equivocal; the "GXT portion was abnormal, but the perfusion portion was normal." (Id.)
Presley underwent a heart catheterization which revealed "only mild coronary artery disease, mild peripheral vascular disease, and no renovascular hypertension." (R. 256, 186). Her thyroid function was also normal. (Id.) On October 23, 2007, Dr. Reddy opined that
(Id.)
Presley did not see Dr. Reddy again until July 15, 2008, over three months after her insured status expired. At that time, she "denies any of the symptoms, specifically denies chest pain, shortness of breath, orthopnea, PND, palpitations, or syncope." (R. 185, 254). Her EKG revealed a normal sinus rhythm and she had normal thyroid function. (Id.) In September 2008, Presley again reported to Dr. Reddy that she was not experiencing "any significant chest pain, shortness of breath, palpitations or syncope." (R. 182, 151). She was "feeling better overall." (Id.)
To be eligible for disability insurance benefits, Presley must demonstrate that "she is unable to engage in substantial gainful activity by reason of a medically determinable impairment that can be expected to result in death or which has lasted or can be expected to last for a continuous period of at least 12 months." 42 U.S.C. § 423(d)(1)(A) (emphasis added). See also Denomme v. Comm'r, Soc. Sec. Admin., 518 Fed. Appx. 875, 877 (11th Cir. 2013); Beegle v. Soc. Sec. Admin., Comm'r., 482 Fed. Appx. 483, 485 (11th Cir. 2012). The medical records support the ALJ's determination that Presley's heart problems did not rise to the level of an impairment because they did not last for a continuous period of at least twelve months, and they did not interfere with her ability to perform work. See Sanchez v. Comm'r of Soc. Sec., 507 Fed. Appx. 855, 857 (11th Cir. 2013) ("An impairment or combination of impairments is not severe if it does not significantly limit the claimant's physical or mental ability to do basic work activities."). Dr. Reddy, Presley's treating cardiologist, specifically opined in October 2007, during the closed period at issue, that Presley's heart condition did not prevent her from working. See R. 256.
Even if the ALJ erred, at this juncture, the error was harmless. See Diorio v. Heckler, 721 F.2d 726, 728 (11th Cir. 1983) (applying harmless error analysis in the Social Security case context). See also Gray v. Comm'r of Soc. Sec., 550 Fed. Appx. 850, 853 (11th Cir. 2013) (same); Denomme, 518 Fed. Appx. at 877-878 ("When, however, an incorrect application of the regulations results in harmless error because the correct application would not contradict the ALJ's ultimate findings, the ALJ's decision will stand."). In this case, the ALJ considered that Presley had been treated for heart problems but concluded that her heart problems did not significantly impede her ability to work. "While the ALJ could have been more specific and explicit in his findings, he did consider all of the evidence and found that it did not support the level of disability [Presley] claimed." Freeman v. Barnhart, 220 Fed. Appx. 957, 960 (11th Cir. 2007). Thus, to the extent that the ALJ erred by failing to specifically identify Presley's heart problems as an impairment that error was harmless.
Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997) (citing 20 CFR § 404.1527 (d)(2)). The ALJ's failure to give considerable weight to the treating physician's opinion is reversible error. Broughton, 776 F.2d at 961-62.
There are, however, limited circumstances when the ALJ can disregard a treating physician's opinion. The requisite "good cause" for discounting a treating physician's opinion may exist where the opinion is not supported by the evidence, or where the evidence supports a contrary finding. Good cause may also exist where a doctor's opinions are merely conclusory, inconsistent with the doctor's medical records, or unsupported by objective medical evidence. See Jones v. Dep't. of Health & Human Servs., 941 F.2d 1529, 1532-33 (11th Cir. 1991); Edwards v. Sullivan, 937 F.2d 580, 584-85 (11th Cir. 1991); Johns v. Bowen, 821 F.2d 551, 555 (11th Cir. 1987). The weight afforded to a physician's conclusory statements depends upon the extent to which they are supported by clinical or laboratory findings and are consistent with other evidence of the claimant's impairment. Wheeler v. Heckler, 784 F.2d 1073, 1075 (11th Cir. 1986). The ALJ "may reject the opinion of any physician when the evidence supports a contrary conclusion." Bloodsworth v. Heckler, 703 F.2d 1233, 1240 (11th Cir. 1983). The ALJ must articulate the weight given to a treating physician's opinion and must articulate any reasons for discounting the opinion. Schnorr v. Bowen, 816 F.2d 578, 581 (11th Cir. 1987).
In October 2011, over three years after the expiration of her insured status, Dr. Vester and Dr. Reddy submitted letters in support of Presley's claim for disability benefits.
(R. 354, 357).
After reviewing the medical evidence, the ALJ afforded the opinions of Dr. Vester and Dr. Reddy "little weight" because
(R. 28). The ALJ, however, gave great weight to Dr. Reddy's October 23, 2007 opinion that "the claimant could return to work." (R. 21).
The ALJ acknowledged that Dr. Reddy and Dr. Vester treated Presley, but after a thorough review of her treatment records, discounted the doctors' assessments. (R. 26-28). The ALJ's decision to discount these assessments is supported by substantial evidence. Neither Dr. Vester nor Dr. Reddy's treatment records support their assessments of the severity of Presley's impairments during the insured period.
First, because the doctors' assessment of Presley are identical, it is clear that they were not written personally by each doctor. It is also clear that these opinions were not based on a review of their treatment notes. For example, when Presley presented to Dr. Vester on May 18, 2007, complaining of lightheadedness and dizziness, Dr. Vester referred her to Dr. Reddy for consultation and treatment. Thereafter, Dr. Vester's records simply reflect Dr. Reddy's cardiac testing and treatment of Presley. After her initial consultation with Dr. Vester in May 2007, Presley did not complain to him of any problems until April 9, 2008, after the expiration of her insured status. (R. 191, 200). There is nothing in Dr. Vester's treatment notes to indicate the level of disability he attributed to Presley.
Furthermore, Dr. Reddy's treatment notes do not support the level of disability he attributes to Presley. Her cardiac tests were normal or within normal limits. (R. 241, 258, 186). On October 23, 2007, Dr. Reddy specifically opined that Presley could return to work. (R. 256). In July 2008, almost four months after the expiration of her insured status, Presley denied that she was experiencing "chest pain, shortness of breath, orthopnea, PND, palpitations, or syncope." (R. 185, 254). On September 23, 2008, she reported "feeling better overall," and again denied "any significant chest pain, shortness of breath, palpitations, or syncope." (R. 182, 251).
The medical evidence in the record contradicts Dr. Reddy's assessment of the severity of Presley's impairments. The ALJ may disregard the opinion of a physician, provided that he states with particularity reasons therefor. Sharfarz v. Bowen, 825 F.2d 278, 280 (11th Cir. 1987). The ALJ examined and evaluated the treatment records for evidence supporting Dr. Reddy and Dr. Vester's assessments of Presley's ability to work. Only then did the ALJ discount the doctors' assessments of Presley's abilities. "Even though Social Security courts are inquisitorial, not adversarial, in nature, claimants must establish that they are eligible for benefits." Ingram v. Comm'r of Soc. Sec., 496 F.3d 1253, 1269 (11th Cir. 2007) (citing Doughty v. Apfel, 245 F.3d 1274, 1281 (11th Cir. 2001)). See also Holladay v. Bowen, 848 F.2d 1206, 1209 (11th Cir. 1988). This the plaintiff has failed to do. Based upon its review of the ALJ's decision and the objective medical evidence of record, the court concludes that the ALJ properly rejected Dr. Reddy and Dr. Vester's opinions regarding Presley's limitations during the closed period from the date of onset on May 18, 2007 until the date she was last insured on March 31, 2008.
Pursuant to the substantial evidence standard, this court's review is a limited one; the entire record must be scrutinized to determine the reasonableness of the ALJ's factual findings. Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992). Given this standard of review, the court finds that the ALJ's decision was supported by substantial evidence.
The court has carefully and independently reviewed the record, and concludes that the decision of the Commissioner is supported by substantial evidence.
A separate order will be entered affirming the Commissioner's decision.