P. BRADLEY MURRAY, Magistrate Judge.
Plaintiff Dejario L. King brings this action, pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3), seeking judicial review of a final decision of the Commissioner of Social Security denying her claims for a period of disability, disability insurance benefits, and supplemental security income. The parties have consented to the exercise of jurisdiction by the Magistrate Judge, pursuant to 28 U.S.C. § 636(c), for all proceedings in this Court. (Docs. 18 & 19 ("In accordance with provisions of 28 U.S.C. §636(c) and Fed.R.Civ.P. 73, the parties in this case consent to have a United States magistrate judge conduct any and all proceedings in this case, . . . order the entry of a final judgment, and conduct all post-judgment proceedings.")). Upon consideration of the administrative record, Plaintiff's brief, the Commissioner's brief, and the parties' arguments at the May 20, 2019 hearing before the undersigned, the Court concludes that the Commissioner's decision denying benefits should be affirmed.
Plaintiff protectively filed applications for a period of disability and disability insurance benefits, as well as for supplemental security income benefits, on or about June 17, 2016, alleging disability beginning on October 28, 2015. (See Tr. 190-99.) King's claims were initially denied on August 26, 2016 (Tr. 107-11) and, following Plaintiff's September 12, 2016 written request for a hearing before an Administrative Law Judge ("ALJ") (see Tr. 114-15), a hearing was conducted before an ALJ on December 20, 2017 (Tr. 36-53). On May 15, 2018, the ALJ issued a decision finding that the claimant was not disabled and, therefore, not entitled to benefits. (Tr. 10-22.) More specifically, the ALJ determined that King retains the residual functional capacity to perform sedentary work as defined in 20 C.F.R. § 404.1567(a) and 416.967(a), with certain identified mental limitations, and can perform those sedentary jobs identified by the vocational expert ("VE") during the administrative hearing (compare id. at 15 & 21-22 with Tr. 50 & 51). And, ultimately, the Appeals Council denied Plaintiff's request for review on August 28, 2018 (Tr. 1-3). Thus, the hearing decision became the final decision of the Commissioner of Social Security.
Plaintiff alleges disability due to sarcoidosis, fibromyalgia, degenerative joint disease, obesity, affective disorder, and anxiety disorder. The Administrative Law Judge (ALJ) made the following relevant findings:
(Tr. 13, 15, 21 & 22 (emphasis in original)).
In all Social Security cases, an ALJ utilizes a five-step sequential evaluation
Watkins v. Commissioner of Social Sec., 457 Fed. Appx. 868, 870 (11th Cir. Feb. 9, 2012)
The task for the Magistrate Judge is to determine whether the Commissioner's decision to deny claimant benefits, on the basis that she can those perform those sedentary jobs identified by the VE during the administrative hearing, 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, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971). "In determining whether substantial evidence exists, we 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).
On appeal to this Court, King asserts but one reason the Commissioner's decision denying her benefits is in error (i.e., not supported by substantial evidence), namely, the ALJ's RFC determination is not supported by substantial evidence. In particular, Plaintiff contends that the ALJ's RFC determination is not supported by substantial evidence because the ALJ gave little weight to the opinions of consultative examiner Dr. Stephen Chromiak and treating physician Dr. Eyston Hunte, physicians who actually physically examined her and, instead, the ALJ "cherry picked" from the medical evidence to develop an RFC assessment.
The responsibility for making the residual functional capacity determination rests with the ALJ. Compare 20 C.F.R. § 404.1546(c) ("If your case is at the administrative law judge hearing level . . ., the administrative law judge . . . is responsible for assessing your residual functional capacity.") with, e.g., Packer v. Commissioner, Social Security Admin., 542 Fed. Appx. 890, 891-892 (11th Cir. Oct. 29, 2013) (per curiam) ("An RFC determination is an assessment, based on all relevant evidence, of a claimant's remaining ability to do work despite her impairments. There is no rigid requirement that the ALJ specifically refer to every piece of evidence, so long as the ALJ's decision is not a broad rejection, i.e., where the ALJ does not provide enough reasoning for a reviewing court to conclude that the ALJ considered the claimant's medical condition as a whole." (internal citation omitted)). A plaintiff's RFC—which "includes physical abilities, such as sitting, standing or walking, and mental abilities, such as the ability to understand, remember and carry out instructions or to respond appropriately to supervision, co-workers and work pressure[]"—"is a[n] [] assessment of what the claimant can do in a work setting despite any mental, physical or environmental limitations caused by the claimant's impairments and related symptoms." Watkins v. Commissioner of Social Security, 457 Fed. Appx. 868, 870 n.5 (11th Cir. Feb. 9, 2012) (citing 20 C.F.R. §§ 404.1545(a)-(c), 416.945(a)-(c)); see also Davison, supra, 370 Fed.Appx. at 996 ("An ALJ makes an RFC determination by considering the claimant's ability to sit, stand, walk, lift, carry, push, pull, stoop, crouch, and reach."); 20 C.F.R. § 404.1545(a)(3) (in assessing RFC, the Commissioner is required to consider "descriptions and observations of [the claimant's] limitations from [] impairments, including limitations that result from [] symptoms, such as pain, provided by [the claimant]. . . .").
To find that an ALJ's RFC determination is supported by substantial evidence, it must be shown that the ALJ has "`provide[d] a sufficient rationale to link'" substantial record evidence "`to the legal conclusions reached.'" Ricks v. Astrue, 2012 WL 1020428, *9 (M.D. Fla. Mar. 27, 2012) (quoting Russ v. Barnhart, 363 F.Supp.2d 1345, 1347 (M.D. Fla. 2005)); compare id. with Packer v. Astrue, 2013 WL 593497, *4 (S.D. Ala. Feb. 14, 2013) ("`[T]he ALJ must link the RFC assessment to specific evidence in the record bearing upon the claimant's ability to perform the physical, mental, sensory, and other requirements of work.'"), aff'd, 542 Fed. Appx. 890 (11th Cir. Oct. 29, 2013); see also Hanna v. Astrue, 395 Fed. Appx. 634, 636 (11th Cir. Sept. 9, 2010) (per curiam) ("The ALJ must state the grounds for his decision with clarity to enable us to conduct meaningful review. . . . Absent such explanation, it is unclear whether substantial evidence supported the ALJ's findings; and the decision does not provide a meaningful basis upon which we can review [a plaintiff's] case." (internal citation omitted)).
In this case, the Court finds that the ALJ linked her RFC assessment—that is, sedentary work with some mental limitations—to specific evidence in the record bearing upon King's ability to perform the physical, mental, sensory and other requirements of work. (Compare Tr. 15-21 with generally Tr. 317-25, 333-38, 352-82, 386-91 & 399-467.) In particular, even though the Plaintiff argues that the ALJ erred in failing to accord appropriate weight to the opinions of her treating physician, Dr. Eyston Hunte, and consultative examiner Dr. Stephen Chromiak, and, instead, improperly cherry-picked from the evidence of record to "reach" her RFC assessment, this Court does not agree and finds the ALJ's RFC assessment supported by substantial evidence.
Before addressing the Plaintiff's specific arguments, the undersigned notes that "[w]eighing the opinions and findings of treating, examining, and non-examining physicians is an integral part of the process for determining disability." Kahle v. Commissioner of Social Security, 845 F.Supp.2d 1262, 1271 (M.D. Fla. 2012). In general, "the opinions of examining physicians are given more weight than those of non-examining physicians, treating physicians are given more weight than those of physicians who examine but do not treat, and the opinions of specialists are given more weight on issues within the area of expertise than those of non-specialists." McNamee v. Social Sec. Admin., 164 Fed.Appx. 919, 923 (11th Cir. Jan. 31, 2006). Indeed, "the ALJ must give the opinion of the treating physician `substantial or considerable weight unless "good cause" is shown to the contrary.'" Williams v. Astrue, 2014 WL 185258, *6 (N.D. Ala. Jan. 15, 2014), quoting Phillips, supra, 357 F.3d at 1240 (other citation omitted); see Nyberg v. Commissioner of Social Security, 179 Fed.Appx. 589, 591 (11th Cir. May 2, 2006) (citing to same language from Crawford v. Commissioner of Social Security, 363 F.3d 1155, 1159 (11th Cir. 2004)).
Gilabert v. Commissioner of Social Sec., 396 Fed.Appx. 652, 655 (11th Cir. Sept. 21, 2010) (per curiam).
Dr. Eyston Hunte, a physician who has treated King since November 15, 2010 (see Tr. 415), completed a Physical Capacities Evaluation form on November 21, 2016 on which he indicated that Plaintiff can sit for 4 hours at one time and for a total of 4 hours during an 8-hour workday, can stand/walk a total of 1 hour at a time and 1 hour total during an 8-hour workday, can lift a total of 5 pounds for 4 hours during an 8-hour workday and carry 5 pounds for 2 hours out of an 8-hour workday, etc. (Tr. 416). In addition, Dr. Hunte also noted that King suffers from back and knee pain and that these symptoms increase with physical activity (such as walking, standing, bending, stooping, etc.) to such an extent that bed rest is necessary. (Tr. 415). Some three months earlier, on August 19, 2016, King was examined by Dr. Stephen Chromiak, who opined that King "is so dependent for ADL's & IADL's that she
The ALJ accorded little weight to Dr. Hunte's medical source statements and the findings of Dr. Chromiak (Tr. 19-20).
(Id. (internal citations omitted)).
The Court begins its analysis by observing that the ALJ's finding that Dr. Hunte's medical source statements are "not well supported by his own findings or other substantial evidence" (Tr. 20), if accurate, constitutes a valid reason (or reasons) for failing to accord those statements more than little weight. See Gilabert, supra, 396 Fed.Appx. at 655 (recognizing that good cause for rejecting a treating physician's opinion include that the opinion is inconsistent with the doctor's own medical records, the opinion is not bolstered by the evidence, and that the evidence supports a contrary finding). In this case, the undersigned disagrees with Plaintiff's view of the evidence and finds that the ALJ's decision to accord Dr. Hunte's medical source statements little weight is supported by substantial evidence of record. First, Dr. Hunte's own treatment records and objective findings do not support the limitations reflected on the November 21, 2016 PCE form or his comment about Plaintiff's pain,
In addition, the vast majority of the remaining medical evidence of record is consistent with Dr. Hunte's innocuous examination findings, as opposed to the opinions reflected on the treating physician's PCE (and pain comment), and likewise serve as a proper basis for the ALJ to accord less than controlling weight to the treating physician's medical source statements. For instance, the radiographic evidence is unremarkable or only reflects mild findings (see Tr. 408, 441 & 448), including some posterior calcaneal spurring near the Achilles insertion (on the left) but no fracture or dislocation (Tr. 442; see also Tr. 446 (bilateral posterior calcaneal spurs)). On August 24, 2016, office notes from Franklin Primary reveal some tenderness of the left Achilles tendon with mild swelling and decreased range of motion of the left ankle but, otherwise, that King was in no acute distress. (Tr. 403-05.) An examination conducted on September 9, 2016, contains a notation of Plaintiff's use of a cane and some left ankle swelling and pain, along with notation 10 out of 18 soft tissue tender points; however, there was no other extremity edema and neurological examination was grossly normal. (Tr. 399-401.) A rheumatology evaluation on October 14, 2016, detected some pain in the knees but no extremity edema and neurological exam was grossly normal; overall, the doctor's assessment was that Plaintiff's sarcoidosis was improving. (Tr. 435-38.) Another rheumatology evaluation on January 13, 2017 revealed only some 8 of 18 soft tissue tender points but no other positive objective examination findings; indeed, there was no extremity edema and a normal neurological examination. (Tr. 429-32.) An examination by Dr. James L. West on January 12, 2017, revealed some tenderness in the cervical and lumbar spine and a decreased range of motion but a normal neurological examination (Tr. 447) and an examination by Dr. Mark Perry on January 17, 2017, revealed bilateral Achilles tightness and tenderness over the mid-substance of the Achilles but there was no evidence of neuropathy and sensation was intact to light touch in all nerve distributions of the feet (Tr. 445). Finally, by September 13, 2017, the examination of Dr. Christopher Jones revealed that King was in no acute distress and presented with a normal gait, without assistive device, and a normal station. (Tr. 450.) The foregoing radiological and examination findings are consistent with the examination findings of Dr. Hunte (compare Tr. 399-401, 403-05, 408, 429-32, 435-38, 441-42 & 445-48 with Tr. 364, 366-68, 370-76, 411, 413, 417, 419, 421, 451 & 453) and fully supportive of the RFC determination of the ALJ (compare id. with Tr. 15); as a consequence, these medical findings substantially support the ALJ's decision to accord little weight to Dr. Hunte's medical source statements. See Gilabert, supra, 396 Fed.Appx. at 655.
With respect to one-time examiner Dr. Stephen Chromiak, the ALJ gave little weight to his August 19, 2016 findings of cervical spasm, loss of balance, decreased sensation, loss of motor strength due to pain, limitation to walking a few steps with a cane, etc., on the basis that those findings were "at variance with findings from other sources, including treating sources that were generated about the same time." (Tr. 19.) And, indeed, the undersigned agrees with the ALJ that Dr. Chromiak's findings are at odds with her treating physician's examination notes on August 16, 2016 (only three days before Dr. Chromiak's examination) that contain no objective findings relative to King's extremities, joints, neck or back (Tr. 413; see also Tr. 411 (September 29, 2016 examination by treating physician noted only diffuse tenderness in the upper back and legs); Tr. 417, 419, 421, 451 & 453 (examination notes from treating physician dated November 21, 2016, January 31, 2017, March 22, 2017, August 24, 2017, and November 13, 2017, contain no objective findings relative to King's extremities, joints, neck or back)) and, as well, cannot be squared with mild objective evidence produced by other examiners (see, e.g., Tr. 403-05 (on August 24, 2016, office notes revealed some tenderness of the left Achilles tendon with mild swelling and decreased range of motion of the left ankle but, otherwise, the Plaintiff was noted to be in no acute distress); Tr. 399-401 (September 9, 2016 examination revealed only some left ankle swelling and pain but a grossly normal neurological examination, including normal sensation); Tr. 435-38 (on October 14, 2016, neurological examination was grossly normal); Tr. 429-32 (normal neurological examination on January 13, 2017); Tr. 447 (evaluation on January 12, 2017, revealed some tenderness in the cervical and lumbar spine regions, with a decreased range of motion, but a normal neurological examination); & Tr. 445 (bilateral Achilles tightness and tenderness over the mid-substance of the Achilles noted on January 17, 2017, but there was no evidence of neuropathy and sensation was intact to light touch in all nerve distributions of the feet)). Indeed, no doctor in the record, other than one-time examiner Dr. Chromiak, ever noted muscle spasming, a loss of sensation, or the dragging of the left leg and restriction on walking, such that the one-time examiner's findings need be viewed as an aberration as opposed to a true depiction of King's physical condition.
In light of the foregoing, the Court finds that good cause existed for the ALJ to afford little weight to the medical source statements completed by Dr. Hunte on November 21, 2016, see Hunter v. Social Sec. Admin., Commissioner, 808 F.3d 818, 823 (11th Cir. 2015) ("We 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."), cert. denied, 136 S.Ct. 2487, 195 L.Ed.2d 823 (2016), as well as Dr. Chromiak's findings, cf. Gilabert, supra, 396 Fed.Appx. at 655 (recognizing that good cause exists to reject a treating physician's opinion/findings where the evidence supports a contrary finding). Finally, any suggestion by Plaintiff that the ALJ improperly "cherry-picked" from the medical evidence to develop an RFC assessment and, in doing so, improperly substituted her own opinion for that of Drs. Hunte and Chromiak, is belied by the record, a record which establishes good cause for the weight ("little") the ALJ assigned to Dr. Hunte's medical source statements and Dr. Chromiak's findings, while at the same time supplying substantial evidence to support the ALJ's RFC determination
Given that King's overarching assignment of error is properly overruled and Plaintiff does not challenge the VE's identification of sedentary jobs an individual with the residual functional capacity reflected in the decision can perform (compare Doc. 13 with Tr. 15, 21-22 & 50-51), the Commissioner's fifth-step determination is due to be affirmed. See, e.g., Owens v. Commissioner of Social Security, 508 Fed.Appx. 881, 883 (11th Cir. Jan. 28, 2013) ("The final step asks whether there are significant numbers of jobs in the national economy that the claimant can perform, given h[er] RFC, age, education, and work experience. The Commissioner bears the burden at step five to show the existence of such jobs . . . [and one] avenue[] by which the ALJ may determine [that] a claimant has the ability to adjust to other work in the national economy . . . [is] by the use of a VE[.]"(internal citations omitted)); Land v. Commissioner of Social Security, 494 Fed.Appx. 47, 50 (11th Cir. Oct. 26, 2012) ("At step five . . . `the burden shifts to the Commissioner to show the existence of other jobs in the national economy which, given the claimant's impairments, the claimant can perform.' The ALJ may rely solely on the testimony of a VE to meet this burden." (internal citations omitted)). In short, substantial evidence supports the ALJ's determination that King is not disabled.
It is
"Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required occasionally and other sedentary criteria are met." 20 C.F.R. § 404.1567(a). Indeed, "[s]ince being on one's feet is required `occasionally' at the sedentary level of exertion, periods of standing or walking should generally total no more than about 2 hours of an 8-hour workday, and sitting should generally total approximately 6 hours of an 8-hour workday." SSR 83-10. Again, this Court finds that the minimal objective findings set forth in the medical evidence of record provide substantial support for the ALJ's determination that King retains the residual functional capacity to perform sedentary work.