GREGORY J. KELLY, District Judge.
Akan Crapps (the "Claimant") brings this action pursuant to the Social Security Act (the "Act"), as amended, 42 U.S.C. § 405(g), to obtain judicial review of a final decision of the Commissioner of the Social Security Administration (the "Commissioner") denying his applications for disability insurance benefits and Supplemental Security Income. Doc. No. 1. On June 8, 2012, Claimant filed applications for benefits, alleging an onset of disability date of April 17, 2012. R. 270-277. Claimant alleges disability due to symptoms and limitations from the following impairments: neck and back pain, muscle deterioration in the lower back, arthritis, pulmonary fibrosis, and substance abuse issues. R. 186.
Claimant argues that the Administrative Law Judge (the "ALJ") erred by giving significant weight to, and relying solely upon the opinion of a non-examining state agency physician, who authored an opinion without the benefit of significant objective medical evidence. Doc. No. 23 at 12-20. Thus, the Claimant argues that the Commissioner's final decision is not supported by substantial evidence. Id.
Under the authority of the Social Security Act, the Social Security Administration has established a five-step sequential evaluation process for determining whether an individual is disabled. See 20 C.F.R. §§ 404.1520(a), 416.920(a). In Doughty v. Apfel, 245 F.3d 1274 (11th Cir. 2001), the Eleventh Circuit explained the five-step sequential evaluation process as follows:
Id. at 1278 (citations omitted). The steps are followed in order. If it is determined that the claimant is not disabled at a step of the evaluation process, the evaluation will not go on to the next step.
The Commissioner's findings of fact are conclusive if supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is more than a scintilla — i.e., the evidence must do more than merely create a suspicion of the existence of a fact, and must include such relevant evidence as a reasonable person would accept as adequate to support the conclusion. Foote v. Chater, 67 F.3d 1553, 1560 (11th Cir. 1995) (citing Walden v. Schweiker, 672 F.2d 835, 838 (11th Cir. 1982) and Richardson v. Perales, 402 U.S. 389, 401 (1971)); accord Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991).
Where the Commissioner's decision is supported by substantial evidence, the District Court will affirm, even if the reviewer would have reached a contrary result as finder of fact, and even if the reviewer finds that the evidence preponderates against the Commissioner's decision. Edwards, 937 F.2d at 584 n.3; Barnes v. Sullivan, 932 F.2d 1356, 1358 (11th Cir. 1991). The District Court must view the evidence as a whole, taking into account evidence favorable as well as unfavorable to the decision. Foote, 67 F.3d at 1560; accord Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992) (court must scrutinize the entire record to determine reasonableness of factual findings); Parker v. Bowen, 793 F.2d 1177, 1180 (11th Cir. 1986) (court also must consider evidence detracting from evidence on which Commissioner relied). The District Court "`may not decide the facts anew, reweigh the evidence, or substitute [its] judgment for that of the [Commissioner].'" See Phillips v. Barnhart, 357 F.3d 1232, 1240 n.8 (11th Cir. 2004) (quoting Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)).
In the decision, at step-two of the sequential evaluation process, the ALJ determines that Claimant has the following severe impairments: "disorders of the respiratory impairment system and disorders of the spine." R. 22. Ultimately, the ALJ determines that Claimant has the following residual functional capacity assessment (the "RFC"):
R. 24. Thus, the ALJ found that Claimant has the RFC to perform a reduced range of light work. R. 24.
This case presents the unusual situation where the ALJ's decision, with respect to Claimant's neck and back impairments, is not supported by substantial evidence and that error is largely apparent on the face of the decision. R. 24-27. The ALJ's error is illustrated through the ALJ's chronological review of the medical and opinion evidence, which comes directly after the ALJ's above-stated RFC. R. 24-27. As the ALJ notes in the decision, Claimant's alleged onset of disability date is April 17, 2012, the date Claimant was involved in a motor vehicle accident. R. 20, 27 (noting the alleged onset date is based on the date of the accident). See also R. 506 (April 20, 2012 treatment records after motor vehicle accident where Claimant complains of radiating neck pain).
In the decision, the ALJ reviews a November 2, 2011 computerized axial tomography scan ("CT Scan") of the lumbar spine, which "revealed bilateral pars defects with grade 1 anterolisthesis at L5-S1 with moderate bilateral foraminal narrowing [and] [m]oderate right foraminal narrowing at the L4-L5." R. 25 (citing R. 1784-85). The ALJ also reviews a February 26, 2012 magnetic resonance imaging ("MRI") of the lumbar spine, which revealed:
R. 25 (citing R. 550, 1783-84). Thus, prior to Claimant's April 17, 2012, objective medical evidence shows no significant disk herniation or nerve root impingement at any level of Claimant's lumbar spine.
The ALJ also discusses the objective medical evidence post-April 17, 2012. R. 26. The ALJ states:
R. 26 (citing R. 1994-95). Thus, as of September 27, 2012, MRI of the cervical spine revealed disk bulging and herniation at multiple levels. R. 26, 1994-95.
The ALJ reviews a December 26, 2012 MRI of the lumbar spine, showing:
R. 26 (citing R. 1992-93). Thus, as of December 26, 2012, MRI of the lumber spine revealed herniation at multiple levels with mild to marked stenosis; displacement of the S1 nerve roots; and possible impingement of the L5 nerve roots. R. 26, 1992-93.
As part of the ALJ's review of the medical record, the ALJ discusses an October 3, 2012 opinion of a non-examining, state agency physician:
R. 26 (citing R. 177-181). Ultimately, the ALJ gives that opinion "significant weight" because the non-examining physician is a "specially trained source[ ]," who "reviewed records and issued [an] unbiased opinion[ ] that [is] supported by the medical evidence of record." R. 27.
The ALJ's decision is not supported by substantial evidence for two (2) related reasons. First, the non-examining physician's opinion, upon which the ALJ relies so heavily, was authored on October 3, 2012, only a few days after and several months prior to the most significant pieces of objective medical evidence in the record related to Claimant's cervical and lumbar spine impairments — the September 27, 2012 and the December 26, 2012 MRIs. See Doc. No. 26, R. 177-181, 1992-95. The September 27, 2012 MRI was not part of the medical records reviewed by the non-examining physician. R. 177, 179. Thus, it was not considered by the non-examining physician. Id. With respect to the December 26, 2012 MRI, it did not exist when the non-examining physician provided her opinion. Therefore, the ALJ's reason for giving significant weight to or relying on the October 3, 2012 non-examining opinion, i.e., that the pertinent medical evidence was reviewed by the physician, is not supported by substantial evidence. Moreover, in the Eleventh Circuit, the opinion of a non-examining physician standing alone does not constitute substantial evidence upon which to base a decision. See Shafarz v. Bowen, F.3d 278, 279-80 (11th Cir. 1987). In this case, with respect to Claimant's cervical and lumbar spine impairments, including the symptoms and limitations stemming therefrom, the ALJ relied upon the opinion of a non-examining physician, who did not examine the two most significant MRIs in the record. R. 26.
Second, the non-examining opinion the ALJ relied upon was offered at the reconsideration stage in the proceedings. R. 170-181. The administrative form, of which the non-examining physical opinion is but a single part (R. 177-181), also states that a consultative examination is required because: "The evidence as a whole, both medical and non-medical, is not sufficient to support a decision on the claim," and "[a]dditional evidence is required to establish current severity of the individual(s) impairments." R. 174. It does not specify the type of consultative examination that is required before an informed decision may be made. R. 174. The record contains no consultative examination related to Claimant's cervical and lumbar spine. R. 1-2032. In addition, the administrative form provides that Claimant's medically determination impairments are disorders of the respiratory system, affective disorders, and alcohol, substance addiction disorders. R. 175. Thus, the administrative form, which contains the non-examining physician's opinion does not even acknowledge that Claimant has severe impairments of the cervical and lumbar spine. R. 175. The Court essentially agrees with what is stated on the administrative form (R. 174), and finds that without a consultative examination of Claimant's cervical and lumbar spine, accompanied by an opinion with respect to Claimant's limitations, the final decision is not supported by substantial evidence. See Reeves v. Heckler, 734 F.2d 519, 522 n.1 (11th Cir. 1984) (reversible error for ALJ not to order consultative examination when such an evaluation is necessary to make informed decision); 20 C.F.R. § 416.917 (providing that Commissioner may order consultative examination if necessary to make a decision).
Based on the forgoing, the Court finds that the final decision is not supported by substantial evidence and a remand for further proceedings is necessary.
For the reasons stated above, it is
