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Gruber v. Acting Commissioner of Social Security Administration

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

March 26, 2018

LORRIE GAIL GRUBER, Plaintiff,
v.
ACTING COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION, Defendant.

          MEMORANDUM OPINION AND ORDER [1]

          MONTE C. RICHARDSON UNITED STATES MAGISTRATE JUDGE

          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 alleges she became disabled on October 29, 2008. (Tr. 387.) A hearing was held before the assigned Administrative Law Judge (“ALJ”) on November 13, 2012, at which Plaintiff was represented by a non-attorney representative. (Tr. 96-123.) The ALJ found Plaintiff not disabled from October 29, 2008 through January 11, 2013, the date of the decision. (Tr. 176-89.) On September 13, 2014, the Appeals Council vacated the ALJ's January 11, 2013 decision and remanded the case to the ALJ for further proceedings.[2] (Tr. 197-98.) In accordance with the remand order, the ALJ held additional hearings on April 14, 2015 and November 17, 2015. (Tr. 124-45, 60-95.) On December 16, 2015, the ALJ issued a second decision finding Plaintiff not disabled from October 29, 2008 through December 31, 2013, the date last insured.[3] (Tr. 30-51.)

         Plaintiff is appealing the Commissioner's decision that she was not disabled from October 29, 2008 through December 31, 2013. Plaintiff has exhausted her available administrative remedies and the case is properly before the Court. The undersigned 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 of Review

         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 raises three issues on appeal. First, Plaintiff argues that the ALJ failed to reconcile the opinions of the non-examining medical expert and orthopedic surgeon, Dr. Kwock, who testified at the most recent hearing before the ALJ, regarding the severity of Plaintiff's cervical and lumbar spine conditions with the opinions of the treating neurosurgeon, Dr. Spatola, and the treating orthopedic surgeon, Dr. Ero, and also with Dr. Ero's lumbar spine surgical report from November 21, 2013. Second, Plaintiff argues that the ALJ erred in failing to articulate good cause for not crediting the opinions of Plaintiff's long-time treating pain physician, Dr. Florete. Finally, Plaintiff argues that the ALJ failed to properly analyze Plaintiff's pain and credibility. Defendant responds that the ALJ properly evaluated the medical opinions of record and Plaintiff's subjective complaints, and her RFC assessment is supported by substantial evidence.

         A. Standard for Evaluating Opinion Evidence and Subjective Complaints

          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, 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.

         When a claimant seeks to establish disability through her own testimony of pain or other subjective symptoms, the Eleventh Circuit's three-part “pain standard” applies. Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991) (per curiam). “If the ALJ decides not to credit such testimony, he must articulate explicit and adequate reasons for doing so.” Id.

The pain standard requires (1) evidence of an underlying medical condition and either (2) objective medical evidence that confirms the severity of the alleged pain arising from that condition or (3) that the objectively determined medical condition is of such a severity that it can be reasonably expected to give rise to the alleged pain.

Id.

         Once a claimant establishes that her “pain is disabling through objective medical evidence that an underlying medical condition exists that could reasonably be expected to produce the pain, ” pursuant to 20 C.F.R. § 404.1529, “all evidence about the intensity, persistence, and functionally limiting effects of pain or other symptoms must be considered in addition to the medical signs and laboratory findings in deciding the issue of disability.” Foote, 67 F.3d at 1561; see also SSR 96-7p (stating that after the ALJ finds a medically determinable impairment exists, the ALJ must analyze “the intensity, persistence, and limiting effects of the individual's symptoms to determine the extent to which the symptoms limit the individual's ability to do basic work activities”).

         When a claimant's “statements about the intensity, persistence, or functionally limiting effects of pain or other symptoms are not substantiated by objective medical evidence, ” the ALJ “must make a finding on the credibility of the individual's statements based on a consideration of the entire case record.” SSR 96-7p.

When evaluating the credibility of an individual's statements, the adjudicator must consider the entire case record and give specific reasons for the weight given to the individual's statements. . . . The reasons for the credibility finding must be grounded in the evidence and articulated in the determination or decision. It is not sufficient to make a conclusory statement that “the individual's allegations have been considered” or that “the allegations are (or are not) credible.” It is also not enough for the adjudicator simply to recite the factors that are described in the regulations for evaluating symptoms.[4] The determination or decision must contain specific reasons for the finding on credibility, supported by the evidence in the case record, and must be sufficiently specific to make clear to the individual and to any subsequent reviewers the weight the adjudicator gave to the individual's statements and the reasons for that weight.

Id.

         “[C]redibility determinations are the province of the ALJ, ” Moore v. Barnhart, 405 F.3d 1208, 1212 (11th Cir. 2005), and “[a] clearly articulated credibility finding with substantial supporting evidence in the record will not be disturbed by a reviewing court, ” Foote, 67 F.3d at 1562.

         B. The ALJ's December 16, 2015 Decision

         The ALJ found that Plaintiff had severe impairments, including “history of spinal fusion [at] C4-7, lumbar degenerative disc disease, osteoarthritis, hypertension, and obesity.” (Tr. 33.) The ALJ also found that through the date last insured, Plaintiff had the residual functional capacity (“RFC”) to perform light work with the following additional restrictions:

[T]he claimant has the ability to lift and/or carry ten pounds frequently, and twenty pounds occasionally. She can sit for a total of seven hours during an eight-hour day. The claimant can stand [a] total of six hours, and walk a total of four hours, during an eight-hour day. The claimant can continuously use her upper extremities in reaching from her waist to chest. She can frequently reach above her shoulders, and continuously handle, finger, and feel. She can occasionally climb stairs and ramps, but never climb ladders, ropes or scaffolds. She can never crawl, but can occasionally ...

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