KATHERINE P. NELSON, Magistrate Judge.
Plaintiff Lillie P. Watts ("Watts") has brought this action under 42 U.S.C. § 405(g) seeking judicial review of a final decision of the Commissioner of Social Security ("the Commissioner"). (See Doc. 1). By the consent of the parties (see Doc. 17), the Court has designated the undersigned United States Magistrate Judge to conduct all proceedings and order the entry of judgment in this civil action under 28 U.S.C. § 636(c) and Federal Rule of Civil Procedure 73.
Upon consideration of the parties' briefs (Docs. 13, 14), the relevant portions of the administrative record (Doc. 12) (hereinafter cited as "(R. [page number(s)])"), and oral argument conducted August 26, 2014, the Court finds that the Commissioner's decision is due to be
On January 13, 2011, Watts protectively filed with the Social Security Administration ("SSA") an application for a period of disability and disability insurance benefits ("DIB") under Title II of the Social Security Act, 42 U.S.C. §§ 401-433, alleging disability beginning March 14, 2003.
On January 24, 2013, the ALJ issued an unfavorable decision on Watts's application, finding that Watts "was not disabled under sections 216(i) and 223(d) of the Social Security Act through September 30, 2011, the date last insured." (R. 24-37). Watts requested review of the ALJ's decision by the Appeals Council for the SSA's Office of Disability Adjudication and Review. On December 9, 2013, the Appeals Council issued its decision declining review (R. 13-15), thus making the ALJ's January 24, 2013 decision the Commissioner's final decision. See 20 C.F.R. § 404.981 (2014) ("The Appeals Council's decision, or the decision of the administrative law judge if the request for review is denied, is binding unless you or another party file an action in Federal district court, or the decision is revised. You may file an action in a Federal district court within 60 days after the date you receive notice of the Appeals Council's action."); Crow v. Comm'r, Soc. Sec. Admin., 571 F. App'x 802, 805 (11th Cir. 2014) (per curiam)
On February 7, 2014, Watts filed this action for judicial review of the Commissioner's final decision under § 405(g). (See Doc. 1).
In all Social Security cases, a plaintiff (sometimes referred to as a claimant) bears the burden of proving that he or she is unable to perform his or her previous work. Jones v. Bowen, 810 F.2d 1001, 1005 (11th Cir. 1986). In evaluating whether that burden has been met, and thus whether a claimant has proven that he or she is disabled, the examiner (most often an ALJ) must consider the following four factors: (1) objective medical facts and clinical findings; (2) diagnoses of examining physicians; (3) evidence of pain; and (4) the plaintiff's age, education, and work history, see id.; and, in turn,
Watkins v. Comm'r of Soc. Sec., 457 F. App'x 868, 870 (11th Cir. Feb. 9, 2012) (per curiam) (citing 20 C.F.R. §§ 404.1520(a)(4), (c)-(f), 416.920(a)(4), (c)-(f); Phillips v. Barnhart, 357 F.3d 1232, 1237 (11th Cir. 2004)) (footnote omitted).
If, in steps one through four of the above-articulated five-step evaluation, a plaintiff proves that he or she cannot do his or her past relevant work, it then becomes the Commissioner's burden, at the fifth step, to prove that the plaintiff 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. Id.; 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 [plaintiff] 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) (citations omitted).
The task for this Court on judicial review is to determine whether the Commissioner's decision to deny a plaintiff benefits is supported by substantial evidence. Substantial evidence is defined as "more than a scintilla" and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 401 (1971). "In determining whether substantial evidence exists, [a court] must view the record as a whole, taking into account evidence favorable as well as unfavorable to the [Commissioner's] decision." Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). Courts are precluded, however, from "deciding the facts anew or re-weighing the evidence." Davison v. Astrue, 370 F. App'x 995, 996 (11th Cir. 2010) (per curiam) (citing Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005)). And, "[e]ven if the evidence preponderates against the Commissioner's findings, [a court] must affirm if the decision reached is
At Step Four,
Phillips, 357 F.3d at 1238-39 (footnote omitted).
"For DIB claims, a claimant is eligible for benefits where she demonstrates disability on or before the last date for which she were insured." Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005) (per curiam) (citing 42 U.S.C. § 423(a)(1)(A) (2005)). "Because [Watts]'s last insured date was [September 30, 2011
The ALJ, "[a]fter careful consideration of the entire record, . . . f[ound] that, through the date last insured, [Watts] had the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) except she can perform only frequent reaching both overhead and other reaching. She can only occasionally balance, stoop, kneel, crouch, and crawl. [She] can never climb ladders, scaffolds, and ropes. She can perform no work around unprotected heights or dangerous moving equipment. She must avoid crowds, and can have only occasional contact with the public. She must avoid tasks involving a variety of instructions or tasks but is able to understand to carry out simple one- or two-step instructions and is able to understand to carry out `detailed but uninvolved' written or oral instructions involving a few concrete variables in or from standardized situations. She can manage only minimal changes in the work setting and routines. She can be called on to make judgments on only simple, work-related decisions."
Watts argues that the ALJ, in making this determination, erred in discounting the medical opinions of her treating physician, Dr. Cecil L. Parker, Jr., M.D.
(R. 34-36).
Social Security Ruling 96-2p, 1996 WL 374188 (effective July 2, 1996),
Moreover, "a finding that a treating source medical opinion is not well-supported by medically acceptable clinical and laboratory diagnostic techniques or is inconsistent with the other substantial evidence in the case record means only that the opinion is not entitled to `controlling weight,' not that the opinion should be rejected. Treating source medical opinions are still entitled to deference and must be weighed using all of the factors provided in 20 CFR 404.1527 and 416.927. In many cases, a treating source's medical opinion will be entitled to the greatest weight and should be adopted, even if it does not meet the test for controlling weight." Id.
The Eleventh Circuit has held:
Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1178-79 (11th Cir. 2011). The Court will not find reversible error "when the ALJ articulated specific reasons for declining to give the treating physician's opinion controlling weight, and the reasons were supported by substantial evidence." Forrester v. Comm'r of Soc. Sec., 455 F. App'x 899, 902 (11th Cir. 2012) (per curiam) (citing Moore v. Barnhart, 405 F.3d 1208, 1212 (11th Cir. 2005) (per curiam)).
Both parties argue at length why the ALJ correctly or incorrectly discounted Dr. Parker's opinions in both the PCE and the CAP Form. It is difficult to address these arguments as to the CAP Form, however, because, unlike the PCE, the ALJ does not specifically reference or discuss the opinions in the CAP Form or indicate what weight she assigned them. The Court notes that, unlike the PCE, the CAP Form does not indicate that its findings apply before Watts's last insured date. (R. 415-16). In fact, in response to Question 9, which asks "How long has the patient's pain been at the level indicated above," Dr. Parker wrote "pain level 8/10 since" but did not specify a date. (R. 416). Moreover, as the Commissioner notes (see Doc. 14 at 8), in support of his determinations in the CAP Form, Dr. Parker cites only to clinical and laboratory findings regarding the fracture of Watts's right tibia and fibula resulting from a May 2012 automobile accident, which occurred after the last insured date. (See R. 30 ("The claimant reported having a fracture of the leg in 2012 secondary to a motor vehicle accident. However, this injury occurred after her date last insured. Therefore, it is found not to be a severe impairment relative to a determination of disability.")).
Like the PCE, Dr. Parker's CAP Form suggests that Watts is burdened by significant impairments, as it opines that she is experiencing "intractable and virtually incapacitating" pain, that physical activity will cause "[i]ncrease of pain to such an extent that bed rest is necessary[,]" and that she "will be totally restricted and thus unable to function at a Productive level of work" due to her level of pain. (R. 415-16). While it is entirely possible that the ALJ discounted the CAP Form for the same reasons she rejected the PCE, or because there was no indication Dr. Parker's opinions therein applied on or prior to Watts's date last insured, the ALJ's complete failure to reference this opinion of a treating physician is reversible error. As noted above, while the opinion of a treating physician may be disregarded for good cause, the ALJ "must clearly articulate his reasons for doing so." Lawton v. Comm'r of Soc. Sec., 431 F. App'x 830, 834 (11th Cir. 2011) (per curiam) (citing Phillips, 357 F.3d at 1240-41).
Winschel, 631 F.3d at 1179. See also Davis v. Comm'r of Soc. Sec., 449 F. App'x 828, 833 (11th Cir. 2011) (per curiam) ("The ALJ must clearly articulate his reasons for disregarding a treating physician's opinion. Moreover, his explanation must include good reasons. We will not affirm an ALJ's decision without adequate explanation because, without such an explanation, 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." (internal citations and quotations omitted)).
Because the ALJ failed to expressly consider and assign weight to the medical opinion of a treating physician, it is impossible for the Court to determine whether the ultimate decision on the merits of Watts's claim is rational and supported by substantial evidence.
Therefore, the Commissioner's final decision in this action is due to be
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.
