KATHERINE P. NELSON, Magistrate Judge.
Social Security Claimant/Plaintiff Michael D. Braggs 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. By the consent of the parties (see Doc. 18), 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. 19).
Upon consideration of the parties' briefs (Docs. 14, 15) and the administrative record (Doc. 13) (hereinafter cited as "(R. [page number(s)])"),
On September 20, 2011, Braggs filed applications for DIB and SSI with the Social Security Administration ("SSA"),
"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).
When, as here, "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 . . ." Ingram, 496 F.3d at 1262.
(Doc. 14 at 1-2).
At Step One, the ALJ determined that Braggs had "not engaged in substantial gainful activity since January 8, 2011, the alleged onset date . . ." (R. 23). At Step Two, the ALJ determined that Braggs had the following severe impairments: panic disorder, Lortab and Xanax dependence, obesity, arthritis of the hands and wrist, headache disorder, asthma, degenerative disc disease of the lumbar spine and degenerative joint disease, left wrist osteoarthritis, right hemi-diaphragm elevation, bronchitis, and "status post gunshot wounds." (R. 23). At Step Three, the ALJ found that Braggs did not have an impairment or combination of impairments that meets or equals the severity of the specified impairments in the Listing of Impairments. (R. 24).
At Step Four,
Phillips, 357 F.3d at 1238-39 (footnote omitted).
The ALJ determined that Braggs had the RFC "to perform light work as defined in 20 CFR 404.1567(b) and 20 CFR 416.967(b),"
Braggs contends that the ALJ erred in assigning less than substantial weight to the opinions of treating physician Dr. Otis Harrison. "`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)). "[T]he ALJ must state with particularity the weight given to different medical opinions and the reasons therefor." Winschel, 631 F.3d at 1179 (citing Sharfarz v. Bowen, 825 F.2d 278, 279 (11th Cir. 1987) (per curiam)). However, 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).
"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). "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." Id. (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)).
At Step Four, the ALJ summarized Dr. Harrison's treatment notes and opinions as follows:
(R. 29). Fulfilling the requirement that he "state with particularity the weight given to [Dr. Harrison's] medical opinions and the reasons therefor[,]" Winschel, 631 F.3d at 1179, the ALJ found that Dr. Harrison's opinion in the Medical Source Statement (R. 509) "merits no substantial weight" because it "is not consistent with the treatment or examination evidence." (R. 29). As noted previously, good cause exists to discount a treating physician's opinion when it is not bolstered by the evidence and is inconsistent with the physician's own medical records. Winschel, 631 F.3d at 1179. The Eleventh Circuit has recently re-emphasized that courts "will not second guess the ALJ about the weight the treating physician's opinion deserves so long as he articulates a specific justification for it." Hunter v. Soc. Sec. Admin., Comm'r, 808 F.3d 818, 823 (11th Cir. 2015) (citing Moore, 405 F.3d at 1212).
Moreover, substantial evidence supports the ALJ's decision to assign little weight to Dr. Harrison's opinions. As the ALJ noted with emphasis, Dr. Harrison's opinions — that Braggs's lower back and wrist pain and hypertension precluded him from gainful employment and would be so exacerbated by physical activity so as to necessitate bed rest — were inconsistent with his treatment notes from an examination conducted a mere four days prior, in which he noted "no acute distress," unremarkable respiratory examination, lungs clear to auscultation bilaterally,
Dr. Harrison's opinions were also inconsistent with treatment notes concerning Braggs's physical impairments from several examining, non-treating physicians. (R. 27-29). Dr. Edward Simms examined Braggs on July 24, 2010, at Springhill Medical Center's emergency room for complaints of pain radiating from Braggs's right flank, noting "no acute distress," no acute disease process based on a portable chest x-ray, a normal sinus rhythm based on an EKG, lungs "clear to auscultation bilaterally," and normal extremities with no obvious deformity. Dr. Simms administered a Toradol IV, after which Braggs reported he was "feeling much better," and discharged Braggs that same day with a diagnosis of "back pain" and "muscle spasm." (R. 27-28, 345-347). Dr. Simms again examined Braggs on January 6, 2011, when he returned to the emergency room with complaints of left sided chest pain. Dr. Simms noted "no acute distress'" clear lungs with "no acute respiratory distress;" nontender extremities with normal range of motion and no gross deformities; no joint swelling or instability; and normal blood tests and x-rays. Braggs was discharged the same day with "chest wall pain." (R. 28, 348-352). Braggs again returned to Springhill Medical Center's emergency room on February 5, and March 10, 2011,
On March 28, 2012, Braggs visited Dr. Henrietta Kovacs for a consultative physical examination. Dr. Kovacs noted that Braggs complained of arthritis of the wrist, lower back pain, and difficulty breathing; that his "back and extremities examinations were normal;" that he could "do heel and toe walking and squatting in both phases;" and that other musculoskeletal examination was largely unremarkable, with some limitation in straight leg raising. Dr. Kovacs opined that Braggs could lift thirty pounds and carry it a short distance; that he could push and pull a grocery cart; that he could not bend but could stoop and squat; that he could reach and kneel; that he could climb stairs but get out of breath; and that he can crawl but not run or jog." (R. 28-29, 401-410). The ALJ assigned "great weight" to Dr. Kovacs's opinions, finding that they "demonstrate that the claimant's physical impairments are not disabling." (R. 29).
In asserting that "the opinion of Dr. Harrison is supported by the medical evidence of record", Braggs largely points to various diagnoses from the notes of the examining physicians discussed above. (See Doc. 14 at 3-4). Tellingly, Braggs offers little discussion of Dr. Harrison's own treatment notes. Indeed, his brief makes no mention of Dr. Harrison's treatment notes from his September 3, 2013 examination (R. 510-511), the only treatment notes from Dr. Harrison specifically discussed by the ALJ in rejecting Dr. Harrison's September 7, 2013 Medical Source Statement. Braggs's only citation to Dr. Harrison's treatment notes are diagnoses of left wrist pain and low back pain at a March 18, 2013 examination (R. 508) and diagnoses of musculoskeletal pain, osteoarthritis of the left wrist, degenerative disc disease of L-5 spine, gastroesophageal reflux disease (GERD), chronic bronchitis, and hypertension at June 17 and July 26, 2013 examinations (R. 504-505). (See Doc. 14 at 4). However, as the ALJ noted, see supra, these diagnoses were accounted for in Dr. Harrison's September 3, 2013 treatment notes, which the ALJ determined did not support Dr. Harrison's opinions.
The records Braggs cites indicate, at most, that Braggs has a history of back and wrist pain. The ALJ did not, however, reject these diagnoses — only Dr. Harrison's opinions as to their limiting effects. The ALJ articulated good cause for rejecting Dr. Harrison's opinions, substantial evidence supports that finding, and Braggs has not cited any record evidence that compels a different conclusion. Accordingly, the Court
At Step Four, the ALJ also determined that "the residual functional capacity in Exhibit 1A and 3A is generally consistent with the treatment and examination evidence and, thus, merits significant weight." (R. 31). Exhibits 1A (R. 69-80) and 3A (R. 82-93) are reports prepared by non-examining state agency physician Dr. Gregory Parker on May 1, 2012, during the initial denial of Braggs's applications. Dr. Parker prepared a proposed RFC in each, finding that Braggs could lift and/or carry 20 pounds occasionally and 10 pounds frequently; could sit, stand and/or walk about 6 hours in an 8-hour workday with normal breaks; could push and/or pull with his left upper extremity only occasionally; could occasionally climb ramps and stairs, balance, stoop, kneel, crouch, and crawl; could never limb ladders, ropes, or scaffolds; and could handle and finger with his left hand only occasionally. (R. 77-78, 90-91).
Braggs asserts the ALJ improperly rejected the opinion of treating physician Dr. Harrison in favor of non-examiner Dr. Parker's opinion. It is well established in this Circuit that "[t]he report of a non-examining doctor. . ., standing alone, cannot constitute substantial evidence." Edwards v. Sullivan, 937 F.2d 580, 584 (11th Cir. 1991) (citing Spencer on behalf of Spencer v. Heckler, 765 F.2d 1090, 1093-94 (11th Cir. 1985) (per curiam)). Accord Lamb v. Bowen, 847 F.2d 698, 703 (11th Cir. 1988). However,
Jarrett v. Comm'r of Soc. Sec., 422 F. App'x 869, 873 (11th Cir. Apr. 11, 2011) (per curiam) (unpublished).
As explained above, the ALJ articulated good cause to assign little weight to the opinions of Dr. Harrison, and substantial evidence supports that decision. Moreover, the ALJ did not base his decision on Dr. Parker's opinions alone. As detailed above, the ALJ considered Dr. Harrison's treatment notes and the notes of several examining physicians. He also assigned "great weight" to the opinions of examining physician Dr. Kovacs. The ALJ expressly found Dr. Parker's opinions to be "generally consistent with the treatment and examination evidence," thus meriting "significant weight," and Braggs has given the Court no reason to question this determination. Thus, the ALJ did not err in assigning more weight to non-examining physician Dr. Parker's opinions than to the opinions of Braggs's treating physician. Accordingly, the Court
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.
As this Court has since noted, "[n]othing in the regulations requires the ALJ to accept at least one medical opinion before rendering a decision—indeed, an ALJ may make a disability determination without any medical opinion in the record." Hale v. Colvin, Civil Action No. 14-00222-CG-N, 2015 WL 3397939, at *11 (S.D. Ala. Apr. 24, 2015) (Nelson, M.J.), report and recommendation adopted, 2015 WL 3397628 (S.D. Ala. May 26, 2015) (Granade, J.). See also 20 C.F.R. §§ 404.1527(a)(2) & 416.927(a)(2) ("Evidence that you submit or that we obtain