Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Lara v. Acting Commissioner of Social Security Administration

United States District Court, M.D. Florida, Jacksonville Division

September 19, 2017

TAMMY LARA, Plaintiff,



         THIS CAUSE is before the Court on Plaintiff's appeal of an administrative decision denying her application for a period of disability and disability insurance benefits (“DIB”). Plaintiff claims that she became disabled on December 22, 2008. (Tr. 4.) The first administrative law judge held a hearing on September 27, 2012 (Tr. 10-34), and subsequently issued a decision on October 26, 2012, finding Plaintiff not disabled. (Tr. 50-57.) On November 25, 2012, Plaintiff requested that the Appeals Council review her decision. (Tr. 181-85.) The Appeals Council rendered an unfavorable decision on April 4, 2014. (Tr. 1-7.)

         Having exhausted her administrative remedies, Plaintiff then filed a civil action in the United States District Court for the Middle District of Florida, arguing that the ALJ failed to articulate good cause, supported by substantial evidence, to discount the medical opinions offered by Russell Sachs, M.D., Plaintiff's treating pain management physician. On January 27, 2015, Judge Toomey entered an order reversing the decision of the ALJ and remanding Plaintiff's claim for further proceedings. (Tr. 735-39.) Judge Toomey agreed with Plaintiff that the ALJ's reasons for discrediting Dr. Sachs's opinions - that the opinions were “retrospective” and not supported by the treatment notes, which showed essentially conservative treatment - were not supported by substantial evidence. (Id.) Specifically, Judge Toomey noted that Dr. Sachs treated Plaintiff extensively during the relevant period and the fact that Dr. Sachs rendered his opinions after such period did not support affording “little weight” to the opinions. (Tr. 737.) Judge Toomey also stated that the ALJ's second reason for discounting the opinions was vague and that the record supported more than “conservative treatment.” (Tr. 738.) On remand, the ALJ was instructed to re-evaluate Dr. Sachs's opinions and, if discrediting such opinions, to articulate good cause supported by substantial evidence for doing so. (Id.)

         Plaintiff was provided a new hearing in front of a second administrative law judge (“ALJ”) and the hearing was held on July 28, 2015. (Tr. 675-709.) The ALJ rendered a decision on August 21, 2015, finding Plaintiff not disabled from December 22, 2008, the alleged onset date, through March 31, 2009, the date last insured.[2]

         Plaintiff is appealing the Commissioner's decision that she was not disabled from December 22, 2008 through March 31, 2009. Plaintiff has exhausted her available administrative remedies and the case is properly before the Court. The Court has reviewed the record, the briefs, and the applicable law. For the reasons stated herein, the Commissioner's decision is REVERSED AND REMANDED.

         I. Standard

         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).

         II. Discussion

         Plaintiff argues two general points on appeal. First, Plaintiff argues that the second ALJ also improperly rejected the opinions of her treating physician, Dr. Sachs. Plaintiff contends that the ALJ failed to articulate good cause for discounting his opinions. Second, Plaintiff argues that the ALJ erred by affording significant weight to the non-examining physician, Shakra Junejo, M.D. The Commissioner argues that the ALJ's evaluation of the medical opinions of record is clearly articulated and supported by substantial evidence.

         A. Standard for Evaluating Opinion Evidence

         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). 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).

         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), “[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, No. 8:06-cv-1863-T-27TGW, 2008 WL 649244, at *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., No. 06-15638, 2007 WL 708971, at *2 (11th Cir. Mar. 9, 2007) (per curiam); see also Sryock v. Heckler, 764 F.2d 834, 835 (11th Cir. 1985) (per curiam) (same).

         Evidence from other sources, e.g., not acceptable medical sources such as nurse-practitioners, may be used to show the severity of a claimant's impairments and how it affects the claimant's ability to work. 20 C.F.R. § 404.1513(d); SSR 06-03p. “Since there is a requirement to consider all relevant evidence in an individual's case record, the case record should reflect the consideration of opinions from medical sources who are not ‘acceptable medical sources' and from ‘non-medical sources' who have seen the claimant in their professional capacity.” SSR 06-03p.

The weight to which such evidence may be entitled will vary according to the particular facts of the case, the source of the opinion, including that source's qualifications, the issue(s) that the opinion is about, and many other factors . . . . However, depending on the particular facts in a case, and after applying the factors for weighing opinion evidence, an opinion from a medical source who is not an “acceptable medical source” may outweigh ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.