MONTE C. RICHARDSON, Magistrate Judge.
The scope of this Court's review is limited to determining whether the Commissioner applied the correct legal standards, McRoberts v. Bowen, 841 F.2d 1077, 1080 (11th Cir. 1988), and whether the Commissioner's findings are supported by substantial evidence, Richardson v. Perales, 402 U.S. 389, 390 (1971). "Substantial evidence is more than a scintilla and is such relevant evidence as a reasonable person would accept as adequate to support a conclusion." Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir. 2004). 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 v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991); 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 v. Chater, 67 F.3d 1553, 1560 (11th Cir. 1995); accord Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992) (stating the court must scrutinize the entire record to determine the reasonableness of the Commissioner's factual findings).
Plaintiff raises two issues on appeal: (1) that the ALJ erred in giving "only some weight" to the opinions of her treating physician, Todd Gates, D.O.,
The ALJ is required to consider all the evidence in the record when making a disability determination. See 20 C.F.R. §§ 404.1520(a)(3), 416.920(a)(3). With regard to medical opinion evidence, "the ALJ must state with particularity the weight given to different medical opinions and the reasons therefor." Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 2011). Substantial weight must be given to a treating physician's opinion unless there is good cause to do otherwise. See Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997).
"`[G]ood 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." Phillips v. Barnhart, 357 F.3d 1232, 1240-41 (11th Cir. 2004). When a treating physician's opinion does not warrant controlling weight, the ALJ must nevertheless weigh the medical opinion based on: (1) the length of the treatment relationship and the frequency of examination, (2) the nature and extent of the treatment relationship, (3) the medical evidence supporting the opinion, (4) consistency of the medical opinion with the record as a whole, (5) specialization in the medical issues at issue, and (6) any other factors that tend to support or contradict the opinion. 20 C.F.R. §§ 404.1527(c)(2)-(6), 416.927(c)(2)-(6).
Although a treating physician's opinion is generally entitled to more weight than a consulting physician's opinion, see Wilson v. Heckler, 734 F.2d 513, 518 (11th Cir. 1984) (per curiam); 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2), "[t]he opinions of state agency physicians" can outweigh the contrary opinion of a treating physician if "that opinion has been properly discounted," Cooper v. Astrue, 2008 WL 649244, *3 (M.D. Fla. Mar. 10, 2008). Further, "the ALJ may reject any medical opinion if the evidence supports a contrary finding." Wainwright v. Comm'r of Soc. Sec. Admin., 2007 WL 708971, *2 (11th Cir. Mar. 9, 2007) (per curiam). See also Sryock v. Heckler, 764 F.2d 834, 835 (11th Cir. 1985) (per curiam) (same).
"The ALJ is required to consider the opinions of non-examining state agency medical and psychological consultants because they `are highly qualified physicians and psychologists, who are also experts in Social Security disability evaluation.'" Milner v. Barnhart, 275 F. App'x 947, 948 (11th Cir. May 2, 2008) (per curiam). See also SSR 96-6p (stating that the ALJ must treat the findings of State agency medical consultants as expert opinion evidence of non-examining sources). While the ALJ is not bound by the findings of non-examining physicians, the ALJ may not ignore these opinions and must explain the weight given to them in his decision. SSR 96-6p.
Here, at step two of the five-step sequential evaluation process, the ALJ found that Plaintiff's borderline intellectual functioning, among others, was a severe impairment. (Tr. 22.) Then, after considering the medical evidence and opinions of treating, examining, and non-examining sources, the testimony at the hearing, and other relevant evidence in the record, the ALJ found that Plaintiff retained the residual functional capacity ("RFC") to perform a reduced range of light work. (Tr. 25.) The ALJ's RFC assessment included the following mental limitations: "The claimant can understand, remember, and carry out simple instructions. The claimant has the ability to make simple, work related decisions." (Id.)
As part of his RFC determination, the ALJ addressed Dr. Gates's opinions as follows:
(Tr. 29.)
The ALJ also addressed Dr. Jasinski's opinions:
(Tr. 27-28.)
Plaintiff argues that the ALJ's RFC assessment is not supported by substantial evidence because it fails to take into account Dr. Gates's opinions. Importantly, as Plaintiff notes in her brief, Dr. Gates issued opinions regarding Plaintiff's ability to perform work-related activities on two occasions.
The second time Dr. Gates expressed his opinions was on July 19, 2016, only days before the ALJ's decision, when he responded to questions regarding Dr. Jasinski's May 13, 2016 answers to the ALJ's Medical Interrogatory. In response to the Medical Interrogatory, Dr. Jasinski opined that the level of Plaintiff's intellectual deficit was unclear. (Tr. 514.) Dr. Jasinski stated:
(Tr. 514-15.) Then, Dr. Jasinski opined that Plaintiff had moderate difficulties in maintaining concentration, persistence, or pace, and in the ability to understand, remember, and carry out complex instructions and to make judgments on complex work-related decisions. (Tr. 516, 520.) He concluded that Plaintiff was capable of performing the work she had performed in the past. (Tr. 519.)
Upon receipt of Dr. Jasinski's answers to the ALJ's Medical Interrogatory, on June 27, 2016, Plaintiff's counsel sent a letter to the ALJ with comments on Dr. Jasinski's answers.
On July 19, 2016, Dr. Gates answered the questions from Plaintiff's counsel pertaining to Dr. Jasinski's May 13, 2016 opinions as well as Dr. Gates's earlier opinions. The questions and corresponding answers are as follows:
(Tr. 525-26.)
The ALJ did not mention Dr. Gates's July 19, 2016 opinions in his decision and there is no indication that he considered them. This is significant because in his answers, Dr. Gates reaffirms his earlier opinions and directly responds to Dr. Jasinski's conclusions on which the ALJ relied in formulating the RFC. The Court can only speculate whether the ALJ would have accorded the same weight to the medical opinions of record, including, inter alia, the opinions of Dr. Gates, Dr. Jasinski, Dr. Kurzhals, and Dr. Paulillo, and whether he would have reached the same conclusions as to Plaintiff's RFC and ability to work, if he had actually considered Dr. Gates's more recent opinions.
Although the ALJ is not required to refer to every piece of evidence in his decision, he may not ignore relevant evidence, particularly when it supports Plaintiff's position. See, e.g., Lord v. Apfel, 114 F.Supp.2d 3, 13 (D.N.H. 2000); Meek v. Astrue, No. 3:08-cv-317-J-HTS, 2008 WL 4328227, *1 (M.D. Fla. Sept. 17, 2008) ("Although an ALJ need not discuss all of the evidence in the record, he may not ignore evidence that does not support his decision . . . . Rather, the judge mut explain why significant probative evidence has been rejected.") (internal citations and quotation marks omitted). The evidence at issue supports Plaintiff's position because it reaffirms Dr. Gates's earlier opinions, which the ALJ discounted, and responds to Dr. Jasinski's contrary opinions. The subject evidence, along with the opinions of Dr. Paulillo
Based on the foregoing, the Court is unable to conclude that the ALJ's decision is supported by substantial evidence. See Cowart v. Schweiker, 662 F.2d 731, 735 (11th Cir. 1981) ("Unless the [ALJ] has analyzed all evidence and has sufficiently explained the weight he has given to obviously probative exhibits, to say that his decision is supported by substantial evidence approaches an abdication of the court's `duty to scrutinize the record as a whole to determine whether the conclusions reached are rational.'").
Therefore, this case will be remanded with instructions to the ALJ to conduct the five-step sequential evaluation process in light of all the evidence, including all opinion evidence from Dr. Gates.
Accordingly, it is
1. The Commissioner's decision is
2. The Clerk of Court is directed to enter judgment accordingly, terminate any pending motions, and close the file.
3. In the event that benefits are awarded on remand, any § 406(b) or § 1383(d)(2) fee application shall be filed within the parameters set forth by the Order entered in In re: Procedures for Applying for Attorney's Fees Under 42 U.S.C. §§ 406(b) & 1383(d)(2), Case No.: 6:12-mc-124-Orl-22 (M.D. Fla. Nov. 13, 2012). This Order does not extend the time limits for filing a motion for attorney's fees under the Equal Access to Justice Act, 28 U.S.C. § 2412.
(Tr. 448.)
(Tr. 364.) On February 4, 2014, Dr. Kurzhals administered the Wechsler Adult Intelligence Scale-Fourth Edition ("WAIS-IV"), showing a Full Scale IQ score of 67, placing Plaintiff "within the extremely low range." (Tr. 374.) However, Dr. Kurzhals opined that Plaintiff's "adaptive functioning certainly suggest[ed] at least borderline abilities." (Id.)
(Tr. 15.) The Appeals Council received Dr. Gates's September 1, 2016 letter, but stated that the letter did not relate to the period at issue. (T r. 2.) Of note, Plaintiff had to establish disability on or before September 30, 2016, her date last insured, in order to be entitled to a period of disability and DIB. (Tr. 20.)