KATHERINE P. NELSON, Magistrate Judge.
Social Security Claimant/Plaintiff Charles Wilson 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 his 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. With the consent of the parties, 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 Docs. 17, 18).
Upon consideration of the parties' briefs (Docs. 12, 13, 14) and the administrative record (Doc. 11) (hereinafter cited as "(R. [page number(s) in lower-right corner of transcript])"),
On April 19, 2012, Wilson filed applications for DIB and SSI with the Social Security Administration ("SSA"),
Wilson requested review of the ALJ's decision by the Appeals Council for the SSA's Office of Disability Adjudication and Review, also submitting new evidence for the Council's consideration. The Commissioner's decision on Wilson's applications became final when the Appeals Council denied Wilson's request for review on June 25, 2015. (R. 1-6). On August 21, 2015, Wilson 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). See also Owens v. Heckler, 748 F.2d 1511, 1516 (11th Cir. 1984) (per curiam) ("We are neither to conduct a de novo proceeding, nor to rubber stamp the administrative decisions that come before us. Rather, our function is to ensure that the decision was based on a reasonable and consistently applied standard, and was carefully considered in light of all the relevant facts."). "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).
Where, as here, the ALJ denied benefits and the Appeals Council denied review of that decision, the Court "review[s] the ALJ's decision as the Commissioner's final decision." Doughty, 245 F.3d at 1278. "[W]hen the [Appeals Council] has denied review, [the Court] will look only to the evidence actually presented to the ALJ in determining whether the ALJ's decision is supported by substantial evidence." Falge v. Apfel, 150 F.3d 1320, 1323 (11th Cir. 1998). If the applicant attacks only the ALJ's decision, the Court may not consider evidence that was presented to the Appeals Council but not to the ALJ. See id. at 1324.
(Doc. 13 at 1).
At Step One, the ALJ determined that Wilson was insured through December 31, 2014, and had "not engaged in substantial gainful activity since February 1, 2012, the alleged [disability] onset date . . ." (R. 61). At Step Two, the ALJ determined that Wilson had the following severe impairments: morbid obesity, mild-to-moderate osteoarthritic changes, bilateral knees, lumbago, and diabetes. (R. 61-63). At Step Three, the ALJ found that Wilson did not have an impairment or combination of impairments that meets or equals the severity of one of the specified impairments in the relevant Listing of Impairments. (R. 63-64).
At Step Four,
Phillips, 357 F.3d at 1238-39 (footnote omitted).
The ALJ determined that Wilson had the RFC "to perform light work as defined in 20 CFR 404.1567(b) except [Wilson] can sit at least three hours without interruption and a total of at least six hours over the course of an eight-hour workday[;] can stand and or [sic] walk a total of two hours combined over the course of an eight-hour workday[;] does not suffer any manipulative limitations[;] can occasionally use his lower extremities for pushing, pulling, and the operation of controls[;] cannot climb ladders, ropes, scaffolds, or poles[;] can occasionally climb ramps and stairs[;] can occasionally stoop[;] can occasionally balance, crouch, and kneel[;] cannot crawl[;] can occasionally work in extreme cold[;] can occasionally work in wetness[;] cannot work in humidity, or extreme heat[;] can occasionally work in dusts, gases, fumes, and odors[;] cannot work in poorly ventilated areas[;] cannot work at unprotected heights[;] cannot work with operating hazardous machinery[;] can occasionally operate motorized vehicles[;] can occasionally work while exposed to vibration[;] can at least perform simple, routine, and repetitive work activity, as well as attend all customary work pressures over the course of an eight-hour workday with the following exceptions[;] can perform production rate work; however, the claimant cannot perform work activity that requires his response to rapid and/or frequently multiple demands[; and c]hanges in [his] work activity and work setting must be infrequent and gradually introduced." (R. 64). Based on this RFC, the ALJ determined that Wilson was unable to perform any past relevant work. (Doc. 70). At Step Five, the ALJ then determined that there exist significant numbers of jobs in the national economy that Wilson can perform given his RFC, age, education, and work experience. (R. 71-72). Thus, the ALJ found that Wilson was not disabled under the Social Security Act. (R. 72).
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.
"A `treating source' (i.e., a treating physician) is a claimant's `own physician, psychologist, or other acceptable medical source who provides[], or has provided[],[ the claimant] with medical treatment or evaluation and who has, or has had, an ongoing treatment relationship with [the claimant].'" Nyberg v. Comm'r of Soc. Sec., 179 F. App'x 589, 591 (11th Cir. May 2, 2006) (per curiam) (unpublished) (quoting 20 C.F.R. § 404.1502). "Absent `good cause,' an ALJ is to give the medical opinions of treating physicians `substantial or considerable weight.'" Winschel, 631 F.3d at 1179 (quoting Lewis, 125 F.3d at 1440). That is so because treating sources are likely in a better position "to provide a detailed, longitudinal picture of [a claimant's] medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations, such as consultative examinations or brief hospitalizations." 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2). "Good cause exists `when the: (1) treating physician's opinion was not bolstered by the evidence; (2) evidence supported a contrary finding; or (3) treating physician's opinion was conclusory or inconsistent with the doctor's own medical records.' With good cause, an ALJ may disregard a treating physician's opinion, but he `must clearly articulate [the] reasons' for doing so." Winschel, 631 F.3d at 1179 (quoting Phillips, 357 F.3d at 1240-41) (internal citation omitted). See also, e.g., Bloodsworth, 703 F.2d at 1240 ("[T]he opinion of a treating physician may be rejected when it is so brief and conclusory that it lacks persuasive weight or where it is unsubstantiated by any clinical or laboratory findings. Further, the Secretary may reject the opinion of any physician when the evidence supports a contrary conclusion." (citation omitted)).
In evaluating Wilson's applications, the ALJ considered medical records and opinions from treating physician Dr. Roseann Cook and from consultative examining physician Dr. Huey Kidd. The ALJ summarized Dr. Cook's records and opinions as follows:
(R. 66-68).
Fulfilling the requirement that he "state with particularity the weight given to [Dr. Cook's] medical opinions and the reasons therefor[,]" Winschel, 631 F.3d at 1179, the ALJ "afford[ed] little weight to Dr. Cooks' [sic] conclusions[,]" explaining as follows:
(R. 66-70).
Wilson presents three arguments why the ALJ erroneously discounted Dr. Cook's opinions: (1) the ALJ mischaracterized Dr. Cook's opinion as being based entirely on Wilson's lumbago (i.e. lower back pain) and did not consider the impairments that Dr. Cook's opinions asserted were disabling — lumbago, osteoarthritis, and morbid obesity — in combination; and (2) the ALJ "misrepresented" Dr. Cook's May 2013 treatment notes as being from her "last examination" of Wilson and as not containing indications of lumbago or osteoarthritis; and (3) Dr. Cook's opinions are bolstered by those of Dr. Kidd. Having considered these arguments, the Court finds that substantial evidence supports the ALJ's decision to assign "little weight" to Dr. Cook's opinions.
As set forth above, the ALJ noted specific examples of how Dr. Cook's opinions were both internally inconsistent and inconsistent with other record evidence. While the strength of these inconsistencies as good cause to reject the opinion is debatable standing alone, the ALJ also observed that Dr. Cook "apparently relied quite heavily on the subjective report of symptoms and limitations provided by the claimant, and seemed to uncritically accept as true most, if not all, of what the claimant reported." Wilson fails to address this additional reason for discounting Dr. Cook's opinion, which also constitutes good cause to reject a treating physician's opinion. See Freeman v. Barnhart, 220 F. App'x 957, 960 (11th Cir. Mar. 23, 2007) (per curiam) (unpublished) (one "factor[] that may weigh in favor of discounting a treating physician's opinion" is "when the opinion appears to be based primarily on the claimant's subjective complaints of pain." (citing Crawford, 363 F.3d at 1159); Costigan v. Comm'r, Soc. Sec. Admin., 603 F. App'x 783, 788 (11th Cir. Feb. 26, 2015) (per curiam) (unpublished) ("Substantial evidence supports the ALJ's stated reasons, first, because the [treating]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 at 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."); Markuske v. Comm'r of Soc. Sec., 572 F. App'x 762, 766 n.3 (11th Cir. July 17, 2014) (per curiam) (unpublished) ("`A treating physician's report may be discounted when it is not accompanied by objective medical evidence or is wholly conclusory.' Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1159 (11th Cir. 2004) (quotation marks omitted). Thus, an ALJ may discount a treating physician's opinion where it `appears to be based primarily on [the claimant's] subjective complaints of pain.' Id."). As the Commissioner correctly notes in her brief, Dr. Cook answered "no" when asked on the opinion form if her "diagnoses in this case [were] confirmed by objective medical findings[,]" (R. 461), and the ALJ noted that Dr. Cook did not attempt to support her opinions by ordering x-rays or an MRI (R. 68-69). Taken together, the ALJ's articulated reasons for discounting Dr. Cook's opinions are supported by substantial evidence.
Wilson asserts that Dr. Cook's opinions are bolstered by those of consultative examiner Dr. Kidd. However, the ALJ did not err in assigning only limited weight to Dr. Kidd's opinion. The ALJ summarized Dr. Kidd's records and opinions as follows:
(R. 66-67, 69).
Fulfilling the requirement that he "state with particularity the weight given to [Dr. Kidd's] medical opinions and the reasons therefor[,]" Winschel, 631 F.3d at 1179, the ALJ "provide[d] some weight to Dr. Kidd's opinion that he based on the findings of his examination[,]" explaining as follows:
(R. 67, 69).
As the ALJ correctly noted, Dr. Kidd's finding of "likely severe osteoarthritis" at his examination of Wilson was not bolstered by his own subsequent review of Wilson's x-rays.
Accordingly, the Court
Wilson asserts in Claim 2 that the ALJ failed to evaluate his impairments in combination. This claim is meritless under long-standing Circuit precedent. At Step Three, the ALJ expressly stated that Wilson "does not have a impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in" the relevant listing. (R. 63). At Step Four, the ALJ stated that he had "considered all symptoms" in determining Wilson's RFC. (R. 64). Though Wilson complains that such a statement "fail[s] to provide any comparative analysis of his severe impairments or their aggregate effect on his abilities[,]" the Commissioner correctly points out that such statements "constitute[] evidence that [the ALJ] considered the combined effects of Wilson's impairments." Wilson v. Barnhart, 284 F.3d 1219, 1224 (11th Cir. 2002) (per curiam) (citing Jones v. Dept. of Health and Human Servs., 941 F.2d 1529, 1533 (11th Cir. 1991) (per curiam) (holding that the following statement by an ALJ evidenced consideration of the combined effect of a claimant's impairments: while "[the claimant] has severe residuals of an injury to the left heel and multiple surgeries on that area, [the claimant does not have] an impairment or combination of impairments listed in, or medically equal to one listed in Appendix 1, Subpart P, Regulation No. 4." (emphasis removed))). Accord Tuggerson-Brown v. Comm'r of Soc. Sec., 572 F. App'x 949, 951-52 (11th Cir. July 24, 2014) (per curiam) (unpublished) ("In Wilson, the ALJ acknowledged that Wilson suffered multiple injuries and then stated that he `did not have an impairment or combination of impairments' that equaled a listing. 284 F.3d at 1224 (emphasis omitted). We held that statement was sufficient to demonstrate that the ALJ considered the cumulative effect of the applicant's impairments. Id. at 1224-25 . . . Despite Tuggerson-Brown's arguments to the contrary, it is apparent from the face of the ALJ's decision and the RFC report relied upon by the ALJ that the ALJ did, in fact, consider all medical evidence in combination in concluding that Tuggerson-Brown was not disabled. In performing his analysis, the ALJ stated that he evaluated whether Tuggerson-Brown had an `impairment or combination of impairments' that met a listing and that he considered `all symptoms' in determining her RFC. Under our precedent, those statements are enough to demonstrate that the ALJ considered all necessary evidence. See Wilson, 284 F.3d at 1224-25.").
Indeed, "[t]he ALJ went beyond those statements in his analysis, specifically discussing evidence of [Wilson]'s [knee impairment, obesity, and diabetes]. The RFC report likewise addressed many of the same symptoms. Accordingly, the record sufficiently demonstrates that the ALJ properly considered all of [Wilson]'s impairments, even those not specifically found to be severe, in reaching a conclusion that []he was not disabled. [Wilson] does not specifically challenge or assert [in Claim 2] that the ALJ's ultimate conclusion was not based on substantial evidence in some other regard . . ." Tuggerson-Brown, 572 F. App'x at 952. Accordingly, the Court
Claim 3 purports to assert errors in the ALJ's application of the three-part "pain standard," which applies when a claimant attempts to establish disability through his own testimony about his subjective symptoms. E.g., Wilson, 284 F.3d at 1225.
In accordance with the foregoing analysis, it is
Final judgment shall issue separately in accordance with this Order and Federal Rule of Civil Procedure 58.