United States District Court, M.D. Florida, Fort Myers Division
OPINION AND ORDER
MIRANDO UNITED STATES MAGISTRATE JUDGE.
Nicole Anna Jordan seeks judicial review of the denial of her
claim for a period of disability and disability insurance
benefits (“DIB”) by the Commissioner of the
Social Security Administration (“Commissioner”).
The Court has reviewed the record, the briefs and the
applicable law. For the reasons discussed herein, the
decision of the Commissioner is
Issues on Appeal
raises three issues on appeal: (1) whether the Administrative
Law Judge (“ALJ”) properly evaluated the severity
of Plaintiff's physical impairments at step two and
considered them in assessing Plaintiff's ability to work;
(2) whether the ALJ properly evaluated the opinions of the
consultative and treating physicians in determining
Plaintiff's residual functional capacity
(“RFC”); and (3) whether substantial evidence
supports the ALJ's determination at step five.
Summary of the ALJ's Decision
a high school graduate and age 38 at the time of the
decision, filed her application for DIB on May 9, 2012,
alleging her disability began September 28, 2010 due to
Graves' disease, brain anomaly, severe anxiety,
depression, rapid pulse and high blood pressure. Tr. 83, 151,
249-57, 404. Plaintiff's claim was denied initially on
October 23, 2012. Tr. 158-63. Plaintiff requested and
received a hearing before ALJ Gregory Hamel on February 12,
2015. Tr. 60, 92-131. Plaintiff, who was represented by
counsel, and vocational expert (“VE”) Dawn
Bergren testified by video-teleconference. Tr. 92-131. On
August 10, 2015, the ALJ issued a decision finding Plaintiff
not disabled from September 28, 2010 through December 31,
2014, the date last insured. Tr. 64-85. In his decision, at
step two of the sequential process,  the ALJ found that Plaintiff
had the severe impairments of major depressive disorder,
anxiety disorder and panic disorder without agoraphobia. Tr.
68. At step three, the ALJ found Plaintiff did not have an
impairment or combination of impairments that met or
medically equaled a listing. Tr. 68-70. Prior to step four,
the ALJ then determined that during the relevant period
Plaintiff had the RFC to perform a full range of work at all
exertional levels, but with the following non-exertional
[Plaintiff] has been able to carry out only routine and
repetitive tasks that do not require more than occasional
public contact or more than occasional interactions with
co-workers. [Plaintiff] can carry out these functions
consistently over the course of the work day and work week.
Tr. 74. Next, at step four, the ALJ found that Plaintiff is
unable to perform her past relevant work as a claims adjuster
or teacher's aide, because these occupations are skilled
and semi-skilled and exceed Plaintiff's RFC, which limits
her to the performance of routine and repetitive tasks. Tr.
83. Relying on the testimony of the VE, the ALJ determined
Plaintiff could perform the requirements of unskilled
representative occupations such as automobile cleaner, floor
worker, housekeeper and small parts assembler. Tr. 84. As a
result, he found Plaintiff was not disabled. Tr. 85.
Standard of Review
scope of this Court's review is limited to determining
whether the ALJ applied the correct legal standards and
whether the findings are supported by substantial evidence.
Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176,
1178 (11th Cir. 2011) (internal citations omitted). The
Commissioner's findings of fact are conclusive if
supported by substantial evidence. 42 U.S.C. §
405(g). Substantial evidence is “more than a
scintilla, i.e., evidence that must do more than
create a suspicion of the existence of the fact to be
established, and such relevant evidence as a reasonable
person would accept as adequate to support the
conclusion.” Foote v. Chater, 67 F.3d 1553,
1560 (11th Cir. 1995) (internal citations omitted).
Eleventh Circuit has restated that “[i]n determining
whether substantial evidence supports a decision, we give
great deference to the ALJ's fact findings.”
Hunter v. Soc. Sec. Admin., Comm'r, 808 F.3d
818, 822 (11th Cir. 2015) (citation omitted). 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 or found that the preponderance of the evidence is
against the Commissioner's decision. Edwards v. Su
livan, 937 F.2d 580, 584 n.3 (11th Cir.
1991); Barnes v. Su livan, 932 F.2d
1356, 1358 (11th Cir. 1991); cf. 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 factual findings). The Court reviews the
Commissioner's conclusions of law under a de
novo standard of review. Ingram v. Comm'r of
Soc. Sec. Admin., 496 F.3d 1253, 1260 (11th Cir. 2007)
(citing Martin v. Sullivan, 894 F.2d 1520, 1529
(11th Cir. 1990)).
Severity of Plaintiff's physical impairments
first argues the ALJ erred by determining Plaintiff's
alleged physical impairments - specifically, Graves'
disease, eye symptoms and headaches - were not severe
impairments, and he failed to consider the combined effects
of Plaintiff's alleged physical impairments along with
her mental impairments in determining Plaintiff's RFC.
Doc. 21 at 15-19. The Commissioner responds substantial
evidence supports the ALJ's finding that Plaintiff
physical impairments are not severe, and the ALJ considered
these impairments when assessing Plaintiff's RFC.
Id. at 19-21.
discussed in detail Plaintiff's treatment for her
physical impairments, beginning with her treatment for
papillary thyroid carcinoma, for which she underwent a total
thyroidectomy in November 2005. Tr. 68. The ALJ stated there
was no recurrence of the cancer, and medical tests and
records from soon after the surgery and October 2014, January
2015 and February 2015 showed Plaintiff was completely
asymptomatic. Tr. 68-69, 493-94, 603, 696-97, 714.
Plaintiff's examinations in late 2014 and early 2015
showed Plaintiff was in no distress and had no joint
tenderness or swelling. Tr. 696-97. She had no complaints of
pain, mylalgias or arthralgias, no headaches or bone pain,
and no visual disturbance. Tr. 68, 696-97. The ALJ further
discussed Plaintiff's earlier medical records for
treatment of Graves' disease and headaches:
Earlier medical reports describe treatment for Graves'
disease (with ophthalmopathy noted on CT imaging). Records
from the Endocrine Group show that Ms. Jordan reported less
severe symptoms related to thyroid disease in February 2007,
where earlier reports showed some palpitations and fatigue
(Exhibits 2F and 3F). Mark Yacono, M.D., treating physician,
noted that the condition occasionally affected daily
activities but did not affect quality of sleep (Exhibit 1F).
A thyroid ultrasound showed no residual mass in October 2007
(Exhibit 2F. page 18), and a more recent study in October
2014 likewise revealed no nodule or suspicious mass (Exhibit
It is noteworthy that at the time she was actively treated
for the thyroid disease Ms. Jordan was regularly employed.
Moreover, Dr. Yacono alluded to no ongoing and significant
vocationally relevant limitations associated with thyroid or
Graves' disease, although Ms. Jordan has used Synthroid
(a dosage of 125 mg. is shown in an October 2007 report)
(Exhibit 1F/7). An MRI in May 2005 showed no acute
intracranial abnormality, although there was a prominent
cortical vein seen representing a development venous anomaly
(Exhibit 3F, page 1).
Ms. Jordan complained of headache and neck pain in 2007, and
the possibility of migraine headaches was raised (Exhibit 3F,
pages 13-15). An MRI of the brain in February 2007 showed no
acute abnormality, with sinusitis observed on the right side
(Exhibit 3F). A CT scan of the head conducted in February
2015, shortly after the insured status expired, likewise
revealed no abnormality (Exhibit 27F). In 2007 the claimant
was also treated for pleuritic chest pain with pneumonia
(Exhibit 3F, page 22). However, there has been no recurrent
issues related to this problem or of any reported work
Tr. 68-69. After further discussion of Plaintiff's
treatment for other medical ailments not at issue here, the
ALJ discussed the consultative examination of Joseph Prezio,
M.D., who opined in October 2012 that Plaintiff had no
physical limitations or restrictions. Tr. 69. Summarizing his
reasoning for not finding Plaintiff's alleged physical
limitations to be severe and citing to extensive support in
the record, the ALJ concluded:
Following the birth of [Plaintiff's] third child in March
2010, the physical conditions noted above did not cause her
to be unable to continue working. By contrast, the medical
record shows only an intermittent need for treatment, and
there is nothing in the medical reports to show that
[Plaintiff] stopped work in September due to any specific
physical illness. . . . Moreover, it appears that [Plaintiff]
received unemployment benefits through at least the fourth
quarter of 2012 (Exhibit 7D). While not conclusive on the
issue to be determined, this does tend to suggest that Ms.
Jordan considered herself able to do some level of work . . .
In sum, the need for treatment has been sporadic since
September 2010, and overall clinical findings on examinations
performed by multiple independent medical sources show few
clinical findings showing significant functional deficit.
Despite allegations of severe complaints, the evidence does
not support severe symptoms or functional limitation enduring
12 months despite intermittent need for treatment (Exhibits
16F, page 4; 30F, pages 12, 107, 109-110). Rather clinical
findings, including those established after the October 2012
consultative examination, show few or no deficits in