United States District Court, M.D. Florida, Orlando Division
E. MENDOZA, UNITED STATES DISTRICT JUDGE
CAUSE is before the Court on the Complaint (Doc. 1) filed by
Plaintiff James Jackson pursuant to 42 U.S.C. §§
405(g) and 1383(c)(3), which seeks judicial review of the
Commissioner of the Social Security Administration's
(“Commissioner”) decision denying Plaintiff's
applications for social security disability benefits. On July
20, 2017, United States Magistrate Judge Karla R. Spaulding
issued a Report and Recommendation (“R&R, ”
Doc. 20), where she recommends that the Commissioner's
final decision be reversed and remanded for further
proceedings. The Commissioner filed an objection to the
R&R (“Objection, ” Doc. 21), to which
Plaintiff filed a response (“Response, ” Doc.
to 28 U.S.C. § 636(b)(1), when a party makes a timely
objection, the Court shall review de novo any
portions of a magistrate judge's report and
recommendation concerning specific proposed findings or
recommendations to which an objection is made. See
also Fed. R. Civ. P. 72(b)(3). De novo review
“require[s] independent consideration of factual issues
based on the record.” Jeffrey S. v. State Bd. of
Educ. of State of Ga., 896 F.2d 507, 513 (11th Cir.
1990) (per curiam). The district court “may accept,
reject, or modify, in whole or in part, the findings or
recommendations made by the magistrate judge.” 28
U.S.C. § 636(b)(1).
Opinions of Dr. Youssef Guergues
referral, Judge Spaulding determined that the ALJ did not
provide a sufficient explanation for her according
“little weight” to the functional capacity
assessments of Plaintiff's treating physician, Dr.
Youssef Guergues. (Doc. 20 at 14-15); see also Lamb v.
Bowen, 847 F.2d 698, 703 (11th Cir. 1988) (“Absent
a showing of good cause to the contrary, the opinions of
treating physicians must be accorded substantial or
considerable weight.”). Specifically, Judge Spaulding
found that the ALJ's reliance on two excerpts from Dr.
Guergues's treatment notes, while seemingly disregarding
the rest of Dr. Guergues's extensive notes, was
insufficient to provide good cause for giving Dr.
Guergues's functional capacity assessment little weight.
(Doc. 20 at 14-15). In the Objection, the Commissioner argues
that “ALJs are not required to discuss in detail every
piece of evidence and each sentence within a particular piece
of evidence.” (Doc. 21 at 2). The Commissioner further
argues that, “the R&R ignores the fact that the ALJ
also noted Dr. Guergues's opinion was repudiated by the
testimony of a medical expert, orthopedic surgeon Frank
Barnes, M.D., who reviewed the record and opined Plaintiff
was not as limited as Dr. Guergues opined.”
(Id.). The Court rejects these arguments.
the ALJ is not required to discuss in detail every piece of
evidence, the ALJ is also not at liberty to “focus
upon one aspect of the evidence and ignor[e] other parts of
the record.” McCruter v. Bowen, 791 F.2d 1544,
1548 (11th Cir. 1986). But, this is precisely what the ALJ
did. Before assigning “little weight” to Dr.
Guergues's opinions, the ALJ did not discuss all of the
elements contemplated by 20 C.F.R. § 416.927(c)(2)-(6),
such as length of the treatment, the extent of the treatment
relationship, or Dr. Guergues's specialty. In fact, the
ALJ failed to discuss the nature of Plaintiff's treatment
Judge Spaulding points out, Dr. Guergues is a board certified
anesthesiologist, whose expertise includes the treatment of
pain. Plaintiff has presented to Dr. Guergues for treatment
of chronic back pain for several years and has undergone
multiple steroid injections after unsuccessful attempts at
full relief with simple modalities, such as nonsteroidal
medications, opiates, muscle relaxants, and therapy. (Doc.
10-16 at 124). During that time, Dr. Guergues's treatment
notes reflect that Plaintiff has suffered from numbness,
paresthesia, decreased range of motion, spasms, severe
tenderness on palpitation, and positive straight-leg test.
(See, e.g., id. at 4, 43, 47, 50, 109-10,
112). The treatment notes also indicate that Plaintiff
consistently suffered from “chronic” or
“severe” back pain in 2014 and 2015. (See,
e.g., id. at 38, 40, 42, 48, 113). Dr. Guergues
appears to link Plaintiff's pain and physical
limitations, stating: “[Plaintiff] suffer[s] from
chronic disabling pain which has caused psychological, social
and physical impairment.” (Id. at 107
(emphasis added)). Because the ALJ failed to discuss much of
this evidence, it appears that the ALJ selectively chose to
highlight only certain aspects of Dr. Guergues's
treatment notes, while neglecting to address evidence that
could have a significant bearing on Plaintiff's ability
Court recognizes that the ALJ relied on Dr. Barnes opinion as
another basis for giving little weight to Dr. Guergues's
opinion. However, a contradictory opinion by a non-examining,
reviewing physician is insufficient to establish the
“good cause” necessary to accord “little
weight” to a treating physician's opinion.
Lamb, 847 F.2d at 703; Sharfarz v. Bowen,
825 F.2d 278, 280 (11th Cir. 1987) (“The opinions of
nonexamining, reviewing physicians . . . when contrary to
those of examining physicians, are entitled to little weight,
and standing alone do not constitute substantial
evidence.”). Accordingly, remand is necessary to allow
the ALJ to explain her reasons for discounting Dr.
Opinions of Dr. Kollmer and Dr. Malik
Spaulding also found that the ALJ erred by failing to state
the weight given to the opinions of Charles E. Kollmer, M.D.
and Vinod Malik, M.D. because the “Appeals Council
explicitly directed the ALJ to state the weight given to all
opinions and explain the weight given to such opinion
evidence.” (Doc. 20 at 16 (quotation omitted)). In
response, the Commissioner argues that the ALJ's failure
to state what weight she gave to the opinions of Dr. Kollmer
and Dr. Malik was harmless error. (Doc. 21 at 3). The Court
some courts have found an ALJ's failure to adhere
strictly to an Appeals Council's remand order can
constitute a harmless error when substantial evidence
supports the ALJ's decision, see, e.g.,
Rogers v. Astrue, No. 06-cv-01258-TAG, 2008 WL
850131, at *16 (E.D. Cal. Mar. 28, 2008), the ALJ's
failure to state with particularity the weight given to Dr.
Kollmer and Dr. Malik is not a harmless error because that
omission makes it impossible for the Court to determine
whether her decision is rational and supported by substantial
evidence, see Winschel v. Commn'r of Soc. Sec.,
631 F.3d 1176, 1179 (11th Cir. 2011). This is especially true
given that the ALJ also failed to sufficiently explain why
she accorded little weight to the opinion of Dr. Guergues.