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Burgos v. Acting Commissioner of Social Security Administration

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

May 7, 2018


          Honorable Roy B. Dalton, Jr. United States District Judge



         THIS CAUSE is before the Court on Plaintiff's appeal of an administrative decision denying her applications for a period of disability, Disability Insurance Benefits (“DIB”), and Supplemental Security Income (“SSI”) payments. On April 22, 2013, Plaintiff applied for DIB and SSI payments alleging that she became disabled on April 3, 2013. (Tr. 213-22.) Plaintiff's claims were denied initially and on reconsideration. A hearing was held before the assigned Administrative Law Judge (“ALJ”) on July 14, 2015, at which Plaintiff was represented by an attorney. (Tr. 43-71.) At the hearing, Plaintiff amended her onset date to February 8, 2012. (Tr. 48-49.) However, on July 23, 2015, almost three (3) months before the ALJ rendered a decision, Plaintiff sent written correspondence to the ALJ rescinding her amended onset date and requesting the ALJ to reinstate her original alleged onset date of April 3, 2013. (Tr. 337.) The ALJ issued an unfavorable decision on November 9, 2015, finding Plaintiff not disabled from February 8, 2012, the amended onset date, through November 9, 2015, the date of the decision. (Tr. 21-37.)

         Plaintiff is appealing the Commissioner's decision that she was not disabled during the relevant time period. 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 undersigned respectfully RECOMMENDS that the Commissioner's decision be 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 argues two general points on appeal. First, Plaintiff argues that the ALJ failed to properly weigh the opinions of Plaintiff's treating physician, Gregory Munson, M.D. Specifically, Plaintiff contends that the ALJ failed to articulate good cause for discounting Dr. Munson's opinions. Second, Plaintiff contends that the ALJ erred by devising a mental residual functional capacity (“RFC”) determination without supporting evidence and without ordering a consultative examination or re-contacting Plaintiff's treating psychiatrist. Defendant argues that the ALJ's evaluation of the medical opinions of record is clearly articulated and supported by substantial evidence. Defendant also argues that the ALJ properly evaluated Plaintiff's mental RFC.

         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), 416.920(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), 416.927(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), 416.927(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).

         “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 Fed.Appx. 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.

         B. The Hearing and ALJ's Decision

         At the beginning of the July 14, 2015 hearing, the ALJ acknowledged Plaintiff's attempt to amend her alleged onset date from April 3, 2013 to February 8, 2012. (Tr. 49 (“Q. Okay. Looking back at the Change of Onset Form, the Claimant has amended the onset date to February 8th, 2012. And this form has been signed by both the Claimant and the Claimant's attorney. Counsel, is that information correct?”).) Later during the hearing, however, the ALJ recognized the lack of clarity as to Plaintiff's earnings history subsequent to her amended onset date. Specifically, Plaintiff testified that she returned to work after knee surgery in February 2012, but that she was also earning short-term disability payments during that time. (Tr. 52-53.) The following colloquy took place:

ALJ: Counsel, the earnings reported for 2012 and 2013- ATTY: Yes.
ALJ: - I need to have that ...

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