MARY S. SCRIVEN, District Judge.
In the Eleventh Circuit, a district judge may accept, reject, or modify a magistrate judge's report and recommendation after conducting a careful and complete review of the findings and recommendations. 28 U.S.C. § 636(b)(1);
In the initial brief on appeal, Plaintiff raises four challenges to the Commissioner's decision. In particular, Plaintiff argues that: (1) the ALJ's finding that Plaintiff did not meet or equal Listing 1.04A was not based on substantial evidence; (2) the ALJ did not articulate good cause for rejecting opinions from two treating physicians; and (3) the hypothetical question posed to the vocational expert was not based on substantial evidence. In a thorough and well-reasoned analysis, the Magistrate Judge rejected each of these arguments. Plaintiff now raises six objections to the R&R, which are addressed below.
The ALJ determined that, through the date last insured, Plaintiff did not have an impairment or combination of impairments that met or equaled a listed impairment. (T. 29) In reaching that conclusion, the ALJ noted that the State agency medical consultant, Clarence Louis, M.D., also determined that no listing was met or equaled. The ALJ further observed that no new evidence had been introduced to rebut that finding. (Id.) On appeal, Plaintiff argues that this finding was not supported by substantial evidence because Plaintiff did, in fact, meet or equal Listing 1.04A. Alternatively, Plaintiff requests that the case be remanded in order for the ALJ to obtain and consider an updated medical expert opinion on this issue.
The Magistrate Judge concluded that the ALJ's decision was supported by substantial evidence. In the objections to the R&R, Plaintiff maintains that the Magistrate Judge did not address whether the ALJ erred by failing to obtain an updated medical expert opinion, and erroneously characterized Dr. Louis's opinion as irrelevant to the ALJ's decision.
Upon de novo review, and assuming that the argument was properly raised before the administrative agency,
Here, the medical evidence does not demonstrate that Plaintiff's back impairment met or equaled Listing 1.04A during the relevant period. Listing 1.04A requires Plaintiff to show that he has a disorder of the spine resulting in compromise of a nerve root or spinal cord with:
The Regulations further provide that, "[b]ecause abnormal physical findings may be intermittent, their presence over a period of time must be established by a record of ongoing management and evaluation."
As the ALJ found, the Plaintiff did have a disorder of the spine: degenerative disc disease of the lumbar spine with two herniated discs. (T. 25) However, Plaintiff has not identified evidence that this disorder resulted in nerve root compression, as the Magistrate Judge explained. (Dkt. 24, pp. 11-13). For instance, the most recent lumbar MRI results, from March 2004, stated that there was no evidence of nerve root impingement. (T. 32, 248) With respect to the other clinical signs required by Listing 1.04A, Plaintiff points to only isolated exam findings (
Accordingly, the Court finds that the ALJ did not err in failing to obtain an updated medical expert opinion, and that the ALJ's determination that Plaintiff did not meet or equal Listing 1.04A was based on substantial evidence. Additionally, although Plaintiff maintains that the ALJ improperly relied on the opinion of Dr. Louis, the State agency medical consultant, the Court agrees with the Magistrate Judge that the ALJ's decision was based on the ALJ's own independent review of the medical evidence. (
On appeal, Plaintiff also argues that the ALJ failed to articulate good cause for rejecting the opinions of two treating physicians: Howard Goldman, M.D., a psychiatrist, and Taras Kochno, M.D., a physical medicine and rehabilitation specialist. The Magistrate Judge determined that these contentions were without merit. In the objections, Plaintiff maintains that the Magistrate Judge mischaracterized case law and erroneously determined that the ALJ committed harmless error by misstating the chronology of Plaintiff's mental health treatment.
The ALJ is "required to state with particularity the weight he gave the different medical opinions and the reasons therefor," particularly treating physicians' opinions.
In the R&R, the Magistrate Judge correctly stated the law pertaining to evaluation of treating source opinions. (Dkt. 24, pp. 14) The Magistrate Judge also correctly observed that evidence of a diagnosis, by itself, is not sufficient to demonstrate functional limitations. (
Specifically, with respect to Dr. Goldman's opinion, the ALJ found that the opinion was not supported by Dr. Goldman's own records. In particular, the ALJ observed that Plaintiff's course of treatment was not of the consistency one would expect if, in fact, the Plaintiff had marked limitations. Plaintiff's course of treatment was limited, running from July to October 2009, with a gap in treatment until July 2010. The ALJ further noted that Plaintiff's self-reported mental symptoms were moderate, that Plaintiff did not fill his prescription for Zoloft, that Plaintiff asserted that his appetite, energy level, and libido were fine, and that there was no reported memory issue. Ultimately, the ALJ concluded that, despite Dr. Goldman's opinion, the record was more consistent with the opinion of the consultative psychologist, who concluded that Plaintiff did not meet the criteria for any specific mental health disorder. That determination was based, in part, on Plaintiff's essentially unremarkable mental status examination and Plaintiff's own report that he did not have any significant mental health problems. (T. 34-37)
Although the ALJ stated that Plaintiff's mental health treatment did not begin until July 2009 (T. 37), the Magistrate Judge properly concluded that this statement does not constitute reversible error. Earlier in the opinion, the ALJ specifically considered the prior mental health records in weighing Dr. Goldman's opinion, as follows:
The ALJ also discussed the prior mental health treatment notes at a number of other points in the decision. (T. 28, 29, 32)
With respect to Dr. Kochno's opinion, the ALJ observed that the opinion did not correlate with treatment notes concerning Plaintiff's back disorder. In particular, the record indicated that, after prior treatment with Dr. Kochno in August 2003, Plaintiff's symptoms reportedly subsided. Plaintiff returned to Dr. Kochno in May 2009, and Dr. Kochno issued his opinion that same month, after a very limited period of treatment. Moreover, Dr. Kochno opined that Plaintiff suffered from functional limitations as of June 2001, even though Plaintiff himself did not allege disability until April 2004. The ALJ also reviewed in detail other relevant evidence, including diagnostic imaging, electrodiagnostic testing, and physical examinations, which showed largely normal or mild findings. The ALJ further noted that Plaintiff sought only sporadic care for his back impairment, he reported improvement on medication or declined medication, and he engaged in a range of daily activities. (T. 26, 32-36) The ALJ thus articulated good cause for assigning little weight to Dr. Kochno's opinion, and that finding was based on substantial evidence.
In his final argument on appeal, Plaintiff argues that the ALJ erred by failing to include in the hypothetical to the vocational expert: (1) limitations from Dr. Goldman's and Dr. Kochno's opinions; and (2) a limitation accounting for the ALJ's own finding that Plaintiff had moderate limitations in concentration, persistence, and pace. In the R&R, the Magistrate Judge determined that the hypothetical was adequate and that Plaintiff's proper challenge would be to the ALJ's residual functional capacity assessment. The Magistrate Judge further determined that, assuming Plaintiff had not forfeited this challenge, it would be meritless. In the objections, Plaintiff maintains that the Magistrate Judge erred in both determinations.
An ALJ is not required to include functional limitations in a hypothetical if the ALJ has found the limitations to be unsupported.
Upon consideration of the Report and Recommendation, and in conjunction with an independent examination of the file, including a de novo review of Plaintiff's objections, it is hereby