KATHERINE P. NELSON, Magistrate Judge.
Plaintiff Michelle Robinson 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 her applications for a period of disability and disability insurance benefits ("DIB") under Title II of the Social Security Act, 42 U.S.C. § 401, et seq., and for 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. 26, 27).
Upon consideration of the parties' briefs (Docs. 15, 16, 23) and those portions of the administrative record (Doc. 14) (hereinafter cited as "(R. [page number(s) in lower-right corner of transcript])") relevant to the issues raised,
On March 27, 2012, Robinson filed applications for a period of disability, DIB, and SSI with the Social Security Administration ("SSA"), alleging disability beginning November 15, 2011.
On June 19, 2015, the Appeals Council for the Office of Disability Adjudication and Review vacated the ALJ's initial unfavorable decision and remanded Robinson's case to the ALJ for resolution of certain issues. (R. 183-187). On remand, the ALJ held another hearing on October 15, 2015. On December 9, 2015, the ALJ issued a second unfavorable decision on Robinson's applications. (R. 17-37). The Commissioner's decision on Robinson's applications became final when the Appeals Council denied Robinson's request for review of the ALJ's second unfavorable decision on July 27, 2016. (R. 1-5). Robinson subsequently filed this action under §§ 405(g) and 1383(c)(3) for judicial review of the Commissioner's final decision. See (Doc. 1); 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."); 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."); 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].'" Id. (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, [the Court] 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).
However, the "substantial evidence" "standard of review applies only to findings of fact. No similar presumption of validity attaches to the [Commissioner]'s conclusions of law, including determination of the proper standards to be applied in reviewing claims." MacGregor v. Bowen, 786 F.2d 1050, 1053 (11th Cir. 1986) (quotation omitted). Accord, e.g., Wiggins v. Schweiker, 679 F.2d 1387, 1389 (11th Cir. 1982) ("Our standard of review for appeals from the administrative denials of Social Security benefits dictates that `(t)he findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive. . . .' 42 U.S.C.A. s 405(g) . . . As is plain from the statutory language, this deferential standard of review is applicable only to findings of fact made by the Secretary, and it is well established that no similar presumption of validity attaches to the Secretary's conclusions of law, including determination of the proper standards to be applied in reviewing claims." (some quotation marks omitted)). This Court "conduct[s] `an exacting examination' of these factors." Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996) (per curiam) (quoting Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990)). "`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)). Accord Keeton v. Dep't of Health & Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994).
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).").
Thornton v. Comm'r, Soc. Sec. Admin., 597 F. App'x 604, 609 (11th Cir. 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, 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). See also Ellison v. Barnhart, 355 F.3d 1272, 1276 (11th Cir. 2003) (per curiam) ("It is well-established that the ALJ has a basic duty to develop a full and fair record. Nevertheless, the claimant bears the burden of proving that he is disabled, and, consequently, he is responsible for producing evidence in support of his claim." (citations omitted)). "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. Because the Appeals Council vacated the ALJ's initial unfavorable decision, the Court reviews the ALJ's second unfavorable decision issued December 9, 2015, as the Commissioner's final decision. "[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.
At Step One, the ALJ determined that Robinson had not engaged in substantial gainful activity since the alleged disability onset date, November 15, 2011. (R. 23). At Step Two, the ALJ determined that Robinson had the following severe impairments: diabetes mellitus with neuropathy, obesity, osteoarthritis of the left knee, degenerative disc disease of the lumbar spine, obstructive sleep apnea, borderline intellectual functioning ("BIF"), and adjustment disorder with depression. (R. 23-24). At Step Three, the ALJ found that Robinson 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. 25-28).
At Step Four,
Phillips, 357 F.3d at 1238-39 (footnote omitted).
The ALJ determined that Robinson had the RFC "to perform medium work as defined in 20 CFR 404.1567(c) and 416.967(c)[
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. 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. 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." E.g., Bloodsworth, 703 F.2d at 1240. 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. 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)). An ALJ's failure to clearly articulate the reasons for giving less weight to the opinion of a treating physician is reversible error. Lewis v. Callahan, 125 F.3d at 1440 (citing MacGregor, 786 F.2d at 1053).
Robinson's sole claim of reversible error is that the ALJ erred at Step Four in assigning less than substantial or considerable weight to the medical opinion of her treating physician, Dr. Perry Timberlake.
(R. 33-34). The ALJ weighed Dr. Timberlake's opinions in these forms as follows:
(R. 36).
The ALJ found good cause to assign little weight to Dr. Timberlake's opinions because they were inconsistent with the doctor's own medical records, Winschel, 631 F.3d at 1179, and substantial evidence supports that decision. The ALJ summarized Dr. Timberlake's records as follows:
(R. 30, 32-34). Robinson takes no issue with the ALJ's view of Dr. Timberlake's records as discussed above, and the undersigned finds that it substantially supports the ALJ's determination.
Robinson's own summary of the treatment notes of Dr. Timberlake and others simply point out various diagnoses made. (See Doc. 16 at 3-5). She also claims that Dr. Timberlake's opinions are not inconsistent with his treatment records because those records "show he administered injections and prescribed medications[,]" declaring "[i]t is inconceivable that a physician would administer injections and prescribe medications for a condition that did not warrant such treatment." (Id. at 6). However, "[t]he mere existence of [] impairments does not reveal the extent to which they limit [Robinson's] ability to work or undermine the ALJ's determination in that regard." Moore, 405 F.3d at 1213 n.6. See also Higgs v. Bowen, 880 F.2d 860, 863 (6th Cir. 1988) (per curiam) ("The mere diagnosis of arthritis, of course, says nothing about the severity of the condition."). Similarly, it does not follow that Robinson must be found disabled merely because she is receiving medical treatment. Moreover, Robinson cites only one instance in which Dr. Timberlake "administered pain medication by injection and prescribed Tylenol #3[,]" (Doc. 16 at 4 (citing R. 674-676)), indicating that whatever impairments required such treatment were largely controlled by it. Cf. Dawkins v. Bowen, 848 F.2d 1211, 1213 (11th Cir. 1988) ("a remediable or controllable medical condition is generally not disabling"). At the very least, substantial evidence supports the ALJ's articulated "good cause" to reject Dr. Timberlake's opinion.
Robinson also argues the ALJ erred by assigning "great weight" to the opinion of nonexamining physician Dr. Mani, "who affirmed the findings of" another nonexamining physician, Dr. Gragg, after find finding the opinions were "consistent with the evidentiary record as a whole. . ." (R. 36). In rejecting Dr. Timberlake's opinion, the ALJ noted that the opinion was "directly contradict[ed]" by "Dr. Mani's findings. . ." (R. 36). It is true that "[t]he good cause required before the treating physicians' opinions may be accorded little weight is not provided by the report of a nonexamining physician where it contradicts the report of the treating physician." Lamb v. Bowen, 847 F.2d 698, 703 (11th Cir. 1988) (citing Johns v. Bowen, 821 F.2d 551 (11th Cir. 1987) (per curiam)). However, any reference to Dr. Mani's opinion in rejecting Dr. Timberlake's is harmless because the ALJ articulated other grounds showing "good cause," and those grounds are supported by substantial evidence, see supra.
It is also true that "[t]he reports of reviewing nonexamining physicians do not constitute substantial evidence on which to base an administrative decision[,]" id. (citing Spencer on Behalf of Spencer v. Heckler, 765 F.2d 1090 (11th Cir. 1985) (per curiam), and Strickland v. Harris, 615 F.2d 1103 (5th Cir. 1980)), and that the "`opinions of nonexamining, reviewing physicians, . . . when contrary to those of examining physicians are entitled to little weight in a disability case, and standing alone do not constitute substantial evidence.'" Id. (quoting Sharfarz v. Bowen, 825 F.2d 278, 280 (11th Cir. 1987) (per curiam)). However, the ALJ did not rely solely on the opinions of the nonexamining physicians in formulating the RFC, instead also relying on the extensive objective medical evidence of record, including the treatment records of Dr. Timberlake and the findings of consultative examining physician Dr. Chu
Accordingly, the Court
In accordance with the foregoing analysis, it is
"For DIB claims, a claimant is eligible for benefits where she demonstrates disability on or before the last date for which she were insured. 42 U.S.C. § 423(a)(1)(A) (2005). For SSI claims, a claimant becomes eligible in the first month where she is both disabled and has an SSI application on file. 20 C.F.R. § 416.202-03 (2005)." Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005) (per curiam).
Here, Robinson's claim of reversible error focuses solely on whether the ALJ showed good cause to reject Dr. Timberlake's opinion, which the undersigned has answered in the affirmative. While Dr. Mani's opinion alone would not be substantial evidence to support the ALJ's decision, the ALJ also relied on objective medical records in determining that Robinson could perform past work, and Robinson does not attempt to explain how these records are insufficient to support this finding. Cf. Johnson, 138 F. App'x at 271 ("Johnson's past work as a cashier required standing for about four and a half hours a day, walking about one hour, siting for about thirty minutes, and minimal lifting. Her job as a security guard required walking for five hours, sitting for one hour, standing for one hour, and minimal lifting. Although the vocational analysis indicated that the security guard position was light exertional work, which Johnson was capable of doing, the medical records are inconsistent with this analysis, as the records show that she continued to experience pain in her back and legs and she walked with a cane. Even if her level of pain was not credible, as discussed above, the medical records do not support a finding that she was able to return to her past work.").
