WALLACE CAPEL, Jr., Magistrate Judge.
Ladonna Creamer ("Plaintiff") filed an application for social security income under Title XVI of the Social Security Act, 42 U.S.C. § 1381, et seq., on December 5, 2011. Her application was denied at the initial administrative level. Plaintiff then requested and received a hearing before an Administrative Law Judge ("ALJ"). Following the hearing, the ALJ issued a decision finding Plaintiff not disabled from the application date of December 5, 2011, through the date of the decision. Plaintiff appealed to the Appeals Council, which rejected her request for review of the ALJ's decision. 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 benefits when the person is unable to
42 U.S.C. § 423(d)(1)(A).
To make this determination, the Commissioner employs a five-step, sequential evaluation process. See 20 C.F.R. §§ 404.1520, 416.920 (2011).
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986).
The burden of proof rests on a claimant through Step Four. See Phillips v. Barnhart, 357 F.3d 1232, 1237-39 (11th Cir. 2004). A claimant establishes a prima facie case of qualifying disability once they have carried the burden of proof from Step One through Step Four. At Step Five, the burden shifts to the Commissioner, who must then show there are a significant number of jobs in the national economy the claimant can perform. Id.
To perform the fourth and fifth steps, the ALJ must determine the claimant's Residual Functional Capacity ("RFC"). Id. at 1238-39. The RFC is what the claimant is still able to do despite the claimant's impairments and is based on all relevant medical and other evidence. Id. It may contain both exertional and nonexertional limitations. Id. at 1242-43. At the fifth step, the ALJ considers the claimant's RFC, age, education, and work experience to determine if there are jobs available in the national economy the claimant can perform. Id. at 1239. To do this, the ALJ can either use the Medical Vocational Guidelines
The grids allow the ALJ to consider factors such as age, confinement to sedentary or light work, inability to speak English, educational deficiencies, and lack of job experience. Each factor can independently limit the number of jobs realistically available to an individual. Phillips, 357 F.3d at 1240. Combinations of these factors yield a statutorily-required finding of "Disabled" or "Not Disabled." Id.
The court's 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); Graham v. Apfel, 129 F.3d 1420, 1422 (11th Cir. 1997). "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." Richardson v. Perales, 402 U.S. 389, 401 (1971); see also Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir. 2004) ("Even if the evidence preponderates against the Commissioner's findings, [a reviewing court] must affirm if the decision reached is supported by substantial evidence."). A reviewing court may not look only to those parts of the record which support the decision of the ALJ, but instead must view the record in its entirety and take account of evidence which detracts from the evidence relied on by the ALJ. Hillsman v. Bowen, 804 F.2d 1179 (11th Cir. 1986).
Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987).
Plaintiff was twenty years old on the application date, and had completed the ninth grade. Tr. 36, 39. Following an administrative hearing, and employing the five-step process, the ALJ found at Step One that Plaintiff "has not engaged in substantial gainful activity since December 5, 2011, the application date[.]" Tr. 14. At Step Two, the ALJ found that Plaintiff suffers from the following severe impairments: "obesity; bipolar disorder; malingering; and intellectual disability — borderline intellectual functioning ("BIF")." Tr. 14. At Step Three, the ALJ found that Plaintiff "does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments[.]" Tr. 15. Next, the ALJ articulated Plaintiff's RFC as follows:
Tr. 17. Having consulted with a VE at the hearing, the ALJ concluded at Step Four that Plaintiff had no past relevant work experience. Tr. 22. Finally, at Step Five, and based upon the testimony of the VE, the ALJ determined that "[c]onsidering the claimant's age, education, work experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that the claimant can perform." Tr. 22. The ALJ identified several representative occupations, including "Packager," "Store Laborer," and "Dietary Aide." Tr. 23. Accordingly, the ALJ determined that Plaintiff "has not been under a disability . . . from December 5, 2011, the date the application was filed[.]" Tr. 23-24.
Plaintiff presents two issues for the court to consider in its review of the Commissioner's decision. First, Plaintiff argues that the Commissioner's decision should be reversed because the ALJ "erred by failing to provide adequate rationale addressing the medical opinions of record expressed by [Plaintiff's] treating physician." Pl.'s Br. (Doc. 14) at 3. Second, Plaintiff argues that the Commissioner's decision should be reversed because the ALJ "failed to apply the correct legal standards in evaluating [Plaintiff's] Intellectual Disability." Id.
"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." 20 C.F.R. §§ 404.1527(a)(2), 416.927(a)(2). Absent "good cause," an ALJ is to give the medical opinions of treating physicians "substantial or considerable weight." Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997); see also 20 C.F.R. §§ 404.1527(d)(1)-(2), 416.927(d)(1)-(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." Phillips v. Barnhart, 357 F.3d 1232, 1241 (11th Cir. 2004). With good cause, an ALJ may disregard a treating physician's opinion, but he "must clearly articulate [the] reasons" for doing so. Id. at 1240-41.
Moreover, the ALJ must state with particularity the weight given to different medical opinions and the reasons therefor. Sharfarz v. Bowen, 825 F.2d 278, 279 (11th Cir. 1987) (per curiam). "In the absence of such a statement, it is impossible for a reviewing court to determine whether the ultimate decision on the merits of the claim is rational and supported by substantial evidence." Cowart v. Schweiker, 662 F.2d 731, 735 (11th Cir.1981). Therefore, when the ALJ fails to "state with at least some measure of clarity the grounds for his decision," a court will decline to affirm "simply because some rationale might have supported the ALJ's conclusion." Owens v. Heckler, 748 F.2d 1511, 1516 (11th Cir. 1984) (per curiam). In such a situation, "to say that [the ALJ's] decision is supported by substantial evidence approaches an abdication of the court's duty to scrutinize the record as a whole to determine whether the conclusions reached are rational." Cowart, 662 F.2d at 735 (quoting Stawls v. Califano, 596 F.2d 1209, 1213 (4th Cir.1979)) (internal quotation marks omitted).
Plaintiff argues that the ALJ erred because he failed to provide adequate rationale for discounting the medical opinions expressed by Plaintiff's treating physician, Dr. Schuster. (Doc. 14) at 3. The court agrees.
With regards to his consideration of Dr. Schuster's medical opinion, the ALJ states:
Tr. at 21. (emphasis in original).
The ALJ's justification for discounting Dr. Schuster's medical opinion — that Dr. Schuster identified some of Plaintiff's limitations as "moderate" and others as "marked" in Plaintiff's MSS — in no way provides the "good cause" required to discount a treating physician's medical opinion. Indeed, the fact that Dr. Schuster identified differing degrees of Plaintiff's limitations is the point of the MSS. To the extent the ALJ made such a statement with the implication that Dr. Schuster's findings of marked and/or moderate limitations contradicted the medical evidence presented in the record, that implication would be unfounded. Plaintiff's medical records from Dr. Schuster support, and do not contradict, his determinations concerning Plaintiff's limitations as measured by the MSS.
The ALJ's discount of Dr. Schuster's MSS is also concerning considering that the ALJ afforded the opinions of Dr. Clark and Dr. Brantley, who were both one-time consultative physicians, with "substantial weight." Tr. 20. Other than a blanket statement regarding the consistency, or lack thereof, of Dr. Schuster's medical opinion with the objective record, the ALJ provides no additional support for discrediting Dr. Schuster's medical opinion. Tr. 21. Without more, the court "cannot affirm based on a post hoc rationale that `might have supported the ALJ's conclusion.'" Dempsey v. Comm'r of Soc. Sec., 454 F. App'x 729, 733 (11th Cir. 2011) (citing Owens v. Heckler, 748 F.2d 1511, 1516 (11th Cir. 1984)). Accordingly, this case is due to be remanded back to the ALJ. See, e.g., Dempsey, 454 F. App'x at 733 ("Without a clear explanation of the ALJ's treatment of [a treating physician's] opinion, we cannot determine whether the ALJ's ultimate decision on the merits was rational and supported by substantial evidence.") On remand, if the ALJ decides to discount Dr. Schuster's medical opinion, adequate reasons supported by substantial evidence should be clearly articulated.
Listing 12.05 sets forth the requirements for mental retardation.
20 C.F.R. pt. 404, subpt. P, app. 1 § 12.05 (2012). Thus, to meet the introductory paragraph, a claimant must at least (1) have significantly subaverage general intellectual functioning; (2) have deficits in adaptive behavior; and (3) have manifested deficits in adaptive behavior before age 22. Crayton v. Callahan, 120 F.3d 1217, 1219 (11th Cir. 1997).
If a claimant satisfies the introductory paragraph, she must then meet the requirements in paragraphs A, B, C, or D to satisfy the listing. To meet paragraph C,
Plaintiff argues that the ALJ erred in his evaluation of paragraph C when he found that "while [Plaintiff] had other impairments — they did not significantly impact her functional ability to do basic work." (Doc. 14) at 14. Specifically, Plaintiff asserts that the ALJ's finding directly conflicts with the ALJ's Step Two determination in which he found that Plaintiff "suffered from the additional medically severe impairments of obesity and bipolar disorder" under 20 CFR 416.920(c). Id. The court agrees, and notes an additional concern with the ALJ's analysis.
With regards to Listing 12.05(C), the ALJ states:
Tr. 16. Of initial concern is the ALJ's failure to explicitly address whether Plaintiff met the requirements of the introductory paragraph of the listing. Instead, the ALJ proceeded directly to analyze whether Plaintiff met the requirements for paragraph C, in addition to Listing 12.05's paragraphs A, B and D, as well as Listing 12.04's paragraphs B and C. It appears from that progression of analysis that the ALJ may have concluded that Plaintiff met the diagnostic description set forth in the introductory paragraph of Listing 12.05. While that would make logical sense, the ALJ does not explicitly make such a finding. Therefore, the court is unable to conduct a proper meaningful review of whether substantial evidence supported the ALJ's determination that Plaintiff did not meet the listing.
Assuming arguendo that the ALJ determined — albeit implicitly — that Plaintiff met the introductory paragraph of Listing 12.05, the ALJ's reason for concluding that Plaintiff did not meet Listing 12.05(C) is legally inadequate. Because the ALJ determined, at Step Two, that Plaintiff suffered from the severe impairments of obesity and bipolar disorder, the ALJ could not then determine in paragraph C that those impairments did not significantly impact the claimant's functional ability to do basic work. The court agrees with Plaintiff that the ALJ's determination directly conflicts with his previous finding that plaintiff suffers from the severe impairments of obesity and bipolar disorder. Accordingly, the reason expressed by the ALJ for determining that Plaintiff failed to meet Listing 12.05(C) is legally inadequate. See Carroll v. Astrue, No. 1:08cv74-SRW, 2009 WL 1708073, at *1-2 (M.D. Ala. June 17, 2009). Accordingly, this case is due to be remanded back to the ALJ. On remand, the ALJ should evaluate whether Plaintiff meets the introductory paragraph for Listing 12.05, and make those findings explicit in his opinion. Further, if the analysis proceeds to an evaluation of paragraph C, the ALJ may not find that Plaintiff does not meet the listing because she does not have a physical or other mental impairment imposing an additional and significant work-related limitation of function if the ALJ determined that Plaintiff had severe impairments at Step Two.
Because the ALJ failed to explicitly evaluate whether Plaintiff met the introductory paragraph of Listing 12.05, and because the ALJ determined Plaintiff failed to meet paragraph C on a legally insufficient basis, the matter is due to be remanded so that the ALJ can clarify his findings and determine if Plaintiff meets Listing 12.05.
The court has carefully and independently reviewed the record and concludes that, for the reasons given above, the decision of the Commissioner is REVERSED and this matter is REMANDED back to the Commissioner. A separate judgment will issue.