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Stone v. Berryhill

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

February 28, 2018

NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          OPINION AND ORDER [1]


         I. Status

         Sharon Jo Stone (“Plaintiff”) is appealing the Commissioner of the Social Security Administration's (“SSA('s)”) final decision denying her claims for disability insurance benefits (“DIB”) and supplemental security income (“SSI”). Plaintiff's alleged inability to work is a result of bipolar disorder, “fusions on the spine, ” arthritis, “back issues, ” and degenerative cervical pain. Transcript of Administrative Proceedings (Doc. No. 12; “Tr.” or “administrative transcript”), filed March 13, 2017, at 86, 96, 108, 122, 234 (emphasis omitted). On February 15, 2013, Plaintiff filed an application for DIB, alleging an onset disability date of June 30, 2012. Tr. at 209.[2] At a later date, Plaintiff filed an application for SSI. See Tr. at 239.[3]Plaintiff's applications were denied initially, see Tr. at 86-95, 106, 140, 141-42 (DIB); Tr. at 96-105, 107, 144, 145-46 (SSI), and upon reconsideration, see Tr. at 108-20, 136, 149, 150-51 (DIB); Tr. at 122-34, 137, 155, 156-57 (SSI).

         On July 15, 2015, an Administrative Law Judge (“ALJ”) held a hearing, during which he heard from Plaintiff, who was represented by counsel, and a vocational expert (“VE”). Tr. at 44-85. At the time of the hearing, Plaintiff was fifty-one years old. Tr. at 47. The ALJ issued a Decision on August 19, 2015, finding Plaintiff not disabled through the date of the Decision. Tr. at 25-38.

         The Appeals Council then received additional evidence in the form of a brief authored by Plaintiff's counsel. Tr. at 5; see Tr. at 299-303 (brief). On October 27, 2016, the Appeals Council denied Plaintiff's request for review, Tr. at 1-3, thereby making the ALJ's Decision the final decision of the Commissioner. On December 28, 2016, Plaintiff commenced this action under 42 U.S.C. §§ 405(g) and 1383(c)(3) by timely filing a Complaint (Doc. No. 1), seeking judicial review of the Commissioner's final decision.

         On appeal, Plaintiff makes the following arguments: 1) “[t]he ALJ's mental residual functional capacity [(“RFC”)] determination is unsupported by substantial evidence as the ALJ improperly subordinated the highly supported examining/treating opinion evidence to that of the non-examining State agency psychological consultants”; and 2) “[t]he ALJ should not have relied on Plaintiff's failure to seek medical treatment as a basis for discounting her credibility.” Plaintiff's Memorandum of Law in Support of a Social Security Appeal (Doc. No. 17; “Pl.'s Mem.”), filed May 12, 2017, at 1, 13, 18 (emphasis omitted). On July 10, 2017, Defendant filed a Memorandum in Support of the Commissioner's Decision (Doc. No. 18; “Def.'s Mem.”) addressing Plaintiff's arguments. After a thorough review of the entire record and consideration of the parties' respective filings, the undersigned finds the Commissioner's final decision is due to be reversed and remanded for further administrative proceedings.

         II. The ALJ's Decision

         When determining whether an individual is disabled, [4] an ALJ must follow the five-step sequential inquiry set forth in the Code of Federal Regulations (“Regulations”), determining as appropriate whether the claimant (1) is currently employed or engaging in substantial gainful activity; (2) has a severe impairment; (3) has an impairment or combination of impairments that meets or medically equals one listed in the Regulations; (4) can perform past relevant work; and (5) retains the ability to perform any work in the national economy. 20 C.F.R. §§ 404.1520, 416.920; see also Phillips v. Barnhart, 357 F.3d 1232, 1237 (11th Cir. 2004). The claimant bears the burden of persuasion through step four and, at step five, the burden shifts to the Commissioner. Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987).

         Here, the ALJ followed the five-step sequential inquiry. See Tr. at 27-37. At step one, the ALJ determined that Plaintiff “has not engaged in substantial gainful activity since June 30, 2012, the alleged onset date.” Tr. at 27 (emphasis and citation omitted). At step two, the ALJ found that Plaintiff “has the following severe impairments: a history of degenerative disc disease of the cervical spine status post two fusions, possible C7 radiculopathy, bipolar disorder and a schizoaffective disorder.” Tr. at 27 (emphasis and citations omitted). At step three, the ALJ ascertained that Plaintiff “does not have an impairment or combination of impairments that meets or medically equals one of the listed impairments in 20 [C.F.R.] Part 404, Subpart P, Appendix 1.” Tr. at 28 (emphasis and citations omitted).

         The ALJ determined that Plaintiff has the following RFC:

[Plaintiff can] perform a range of light work as defined in 20 [C.F.R. §§] 404.1567(b) and 416.967(b) with limitations. Specifically, [Plaintiff] can sit, stand or walk for up to six hours each during an eight-hour workday. She can lift/carry [twenty] pounds occasionally and [ten] pounds or less more frequently. She can push or pull arm, hand or foot pedal controls occasionally. She also can climb ramps or stairs occasionally, but she must never climb ladders, ropes or scaffolds. In addition, [Plaintiff] can occasionally balance, kneel, stoop, crouch or crawl. She also should avoid use of her neck for extreme twisting maneuvers but she can reach in all directions, except overhead, frequently. There are no restrictions in her ability to handle, finger and feel within the above weight limits. However, [Plaintiff] must avoid overhead reaching and she must avoid working at unprotected heights, work around dangerous moving machinery and work in proximity to heavy industrial vibrations. [Plaintiff] also must . . . avoid extremely cold temperatures and she is further limited to performing simple, rote and repetitive tasks in a work environment that does not change from one day to the next. Furthermore, [Plaintiff] must avoid interaction with the general public and she is limited to no more than occasional interaction with coworkers or supervisors. [Plaintiff] also must avoid work that requires that she meet a strict production goal or quota such as assembly line work or pay-by-piece type work. [Plaintiff] will work better with things as opposed to people.

Tr. at 30 (emphasis omitted). At step four, the ALJ relied on the testimony of the VE and found Plaintiff “is capable of performing her past relevant work as a wire preparation worker.” Tr. at 36 (emphasis omitted).

         The ALJ then proceeded to make alternative findings regarding the fifth and final step of the sequential inquiry. Tr. at 36-37. At step five, after considering Plaintiff's age (“48 years old . . . on the alleged disability onset date”), education (“a limited education”), work experience, and RFC, the ALJ again relied on the testimony of the VE and found “there are other unskilled jobs that exist in significant numbers in the national economy that [Plaintiff] also can perform, ” Tr. at 36, including “Marker, ” “Routing Clerk, ” and “Collator Operator, ” Tr. at 37. The ALJ concluded that Plaintiff “has not been under a disability . . . from June 30, 2012 through the date of th[e D]ecision.” Tr. at 37 (emphasis and citation omitted).

         III. Standard of Review

         This Court reviews the Commissioner's final decision as to disability pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). Although no deference is given to the ALJ's conclusions of law, findings of fact “are conclusive if . . . supported by ‘substantial evidence' . . . .” Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001) (citing Falge v. Apfel, 150 F.3d 1320, 1322 (11th Cir. 1998)). “Substantial evidence is something ‘more than a mere scintilla, but less than a preponderance.'” Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005) (quoting Hale v. Bowen, 831 F.2d 1007, 1011 (11th Cir. 1987)). The substantial evidence standard is met when there is “‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” Falge, 150 F.3d at 1322 (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). It is not for this Court to reweigh the evidence; rather, the entire record is reviewed to determine whether “the decision reached is reasonable and supported by substantial evidence.” Cornelius v. Sullivan, 936 F.2d 1143, 1145 (11th Cir. 1991) (internal quotation and citations omitted); see also McRoberts v. Bowen, 841 F.2d 1077, 1080 (11th Cir. 1988); Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987). The decision reached by the Commissioner must be affirmed if it is supported by substantial evidence-even if the evidence preponderates against the Commissioner's findings. Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1158-59 (11th Cir. 2004) (per curiam).

         IV. Discussion

         As noted above, Plaintiff makes two arguments. First, she argues the ALJ erred when he “subordinated” the “treating/examining opinion evidence” to that of the non-examining consultants. Pl.'s Mem. at 1, 13 (emphasis omitted). Specifically, she contends that “[t]he ALJ committed reversible error in rejecting the supported opinions of Dr. [Raena] Baptiste-Boles and Dr. [J.] Gaines.” Id. Second, Plaintiff asserts that the ALJ, in making his credibility finding, erred in relying on Plaintiff's failure to seek treatment because, according to Plaintiff, this failure was “due to lack of funds.” Id. at 18-19. Further, argues Plaintiff, “the ALJ never took into account [that] Plaintiff's mental illness may have led her to avoid treatment.” Id. at 19. These arguments, and the law applicable to each, are addressed in turn.

         A. ALJ's Evaluation of Medical Opinions

         1. Applicable Law[5]

         The Regulations establish a “hierarchy” among medical opinions[6] that provides a framework for determining the weight afforded each medical opinion: “[g]enerally, the opinions of examining physicians are given more weight than those of non-examining physicians[;] treating physicians[' opinions] are given more weight than [non-treating physicians;] and the opinions of specialists are given more weight on issues within the area of expertise than those of non-specialists.” McNamee v. Soc. Sec. Admin., 164 F. App'x 919, 923 (11th Cir. 2006) (citing 20 C.F.R. § 404.1527(d)(1), (2), (5)). The following factors are relevant in determining the weight to be given to a physician's opinion: (1) the “[l]ength of the treatment relationship and the frequency of examination”; (2) the “[n]ature and extent of [any] treatment relationship”; (3) “[s]upportability”; (4) “[c]onsistency” with other medical evidence in the record; and (5) “[s]pecialization.” 20 C.F.R. §§ 404.1527(d)(2)-(5), 416.927(d)(2)-(5); see also 20 C.F.R. §§ 404.1527(e), 416.927(f).

         With regard to a treating physician, [7] the Regulations instruct ALJs how to properly weigh such a medical opinion. See 20 C.F.R. § 404.1527(c). Because treating physicians “are likely to be the medical professionals most able to provide a detailed, longitudinal picture of [a claimant's] medical impairment(s), ” a treating physician's medical opinion is to be afforded controlling weight if it is “well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence” in the record. Id. When a treating physician's medical opinion is not due controlling weight, the ALJ must determine the appropriate weight it should be given by considering the factors identified above (the length of treatment, the frequency of examination, the nature and extent of the treatment relationship, as well as the supportability of the opinion, its consistency with the other evidence, and the specialization of the physician). Id.

         If an ALJ concludes the medical opinion of a treating physician should be given less than substantial or considerable weight, he or she must clearly articulate reasons showing “good cause” for discounting it. Hargress v. Soc. Sec. Admin., Comm'r, __ F.3d __, No. 17-11683, 2018 WL 1061567 (11th Cir. Feb. 27, 2018); Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997). Good cause exists when (1) the opinion is not bolstered by the evidence; (2) the evidence supports a contrary finding; or (3) the opinion is conclusory or inconsistent with the treating physician's own medical records. Hargress, 2018 WL 1061567; Phillips, 357 F.3d at 1240-41; see also Edwards v. Sullivan, 937 F.2d 580, 583-84 (11th Cir. 1991); Schnorr v. Bowen, 816 F.2d 578, 582 (11th Cir. 1987) (stating that a treating physician's medical opinion may be discounted when it is not accompanied by objective medical evidence).

         An examining physician's opinion, on the other hand, is not entitled to deference. See McSwain v. Bowen, 814 F.2d 617, 619 (11th Cir. 1987) (per curiam) (citing Gibson v. Heckler, 779 F.2d 619, 623 (11th Cir. 1986)); see also Crawford, 363 F.3d at 1160 (citation omitted). Moreover, the opinions of non-examining physicians, taken alone, do not constitute substantial evidence. Broughton v. Heckler, 776 F.2d 960, 962 (11th Cir. 1985) (citing Spencer v. Heckler, 765 F.2d 1090, 1094 (11th Cir. 1985)). However, an ALJ may rely on a non-examining physician's opinion that is consistent with the evidence, while at the same time rejecting the opinion of “any physician” whose opinion is inconsistent with the evidence. Oldham v. Schweiker, 660 F.2d 1078, 1084 (5th Cir. Unit B. 1981) (citation omitted).

         An ALJ is required to consider every medical opinion. See 20 C.F.R. §§ 404.1527(d), 416.927(d) (stating that “[r]egardless of its source, we will evaluate every medical opinion we receive”). While “the ALJ is free to reject the opinion of any physician when the evidence supports a contrary conclusion, ” Oldham, 660 F.2d at 1084 (citation omitted); see also 20 C.F.R. §§ 404.1527(d)(2), 416.927(d)(2), “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) (citing Sharfarz v. Bowen, 825 F.2d 278, 279 (11th Cir.1987)); see also Hargress, 2018 WL 1061567; Moore v. Barnhart, 405 F.3d 1208, 1212 (11th Cir. 2005); Lewis, 125 F.3d at 1440.

         2. Opinions at Issue

         a. Dr. Baptiste-Boles

         Dr. Baptiste-Boles is a licensed psychologist who, at the request of the SSA, conducted a psychological examination of Plaintiff on October 23, 2013. See Tr. at 384-86. According to Dr. Baptiste-Boles's examination notes, Plaintiff reported that her current mental health conditions included “emotional lability, ‘feeling like someone is watching [her], ' ‘feeling paranoid, ' racing thoughts, isolation, difficulty trusting people ‘even [her] kids, ' and sadness/tearfulness.” Tr. at 384. She also reported “feeling as if the TV knows what [she is] doing.” Tr. at 384. She stated her symptoms “often occur daily” but that she tries to “control it.” Tr. at 385. She reported she was feeling nervous at the time of the examination, and Dr. Baptist-Boles noted ...

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