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Haynes v. Commissioner of Social Security

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

November 12, 2019

CLEF D. HAYNES, SR., Plaintiff,



         This is an appeal of the administrative denial of supplemental security income (SSI) and disability insurance benefits (DIB). See 42 U.S.C. §§ 405(g), 1383(c)(3). Plaintiff argues the Administrative Law Judge (ALJ) erred in formulating Plaintiff's residual functional capacity (RFC) and should have either re-contacted his treating physician or ordered a consultative examination. After considering Plaintiff's arguments, Defendant's response, and the administrative record, I find the ALJ applied the proper standards, and the decision that Plaintiff is not disabled is supported by substantial evidence (docs. 16, 17). I affirm the ALJ's decision.

         A. Background

         Plaintiff Clef Haynes was born on July 9, 1958. He was 56 years old on his alleged disability onset date of September 14, 2014, with a high school education and a year and a half of community college. Plaintiff's 42-year work history includes past jobs as a shipping supervisor (from 1995 to 2001) and an inventory supervisor (from 2002 through 2014). (R. 35) At the time of the hearing, Plaintiff was living at home with his mother. As he explained, “[s]he's 88 years old, and I initially moved in with her before my diagnosis. I was working out of Texas and she had a stroke and there was nobody in the house so I moved in with her and to take care of her. And now it's almost reversed, she's taking care of me. So she does the bulk of the cooking, only when she wants to.” (R. 41)

         Plaintiff alleges disability due to diabetes and hypertension and testified these impairments cause him back pain, neck pain, neuropathy in his feet and hands, blurred vision, and fatigue. After a hearing, the ALJ found Plaintiff suffers from a more extensive list of severe impairments: “diabetes mellitus; cervical degenerative disc disease with radiculopathy; narrowing at the C5-6 level with anterior spondylosis; minimal loss of vertebral height at the L1 and L2 levels; hypertension; cardiomyopathy; peripheral vascular disease with occlusion of the mid through distal right superficial femoral artery; and obesity.” (R. 12) Aided by the testimony of a vocational expert (VE), the ALJ determined Plaintiff is not disabled as he has the RFC to perform light work:

He can lift up to 20 pounds occasionally and lift or carry 10 pounds frequently. He can stand or walk for approximately 6 hours and sit for approximately 6 hours, in an 8-hour workday with normal breaks. He can frequently climb ladders, ropes, scaffolds, ramps or stairs, balance, stoop, crouch, kneel or crawl.

(R. 13) The ALJ found that, with this RFC, Plaintiff could perform his past relevant work as a stock control supervisor as that job is performed in the national economy (but not as Plaintiff actually performed it). (R. 18) The Appeals Council denied review. Plaintiff, who has exhausted his administrative remedies, filed this action.

         B. Standard of Review

         To be entitled to DIB and/or SSI, a claimant must be unable to engage “in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” See 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A “‘physical or mental impairment' is an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques.” See 42 U.S.C. §§ 423(d)(3), 1382c(a)(3)(D).

         The Social Security Administration, to regularize the adjudicative process, promulgated detailed regulations that are currently in effect. These regulations establish a “sequential evaluation process” to determine whether a claimant is disabled. See 20 C.F.R. §§ 404.1520, 416.920. If an individual is found disabled at any point in the sequential review, further inquiry is unnecessary. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). Under this process, the Commissioner must determine, in sequence, the following: (1) whether the claimant is currently engaged in substantial gainful activity; (2) whether the claimant has a severe impairment(s) (i.e., one that significantly limits his ability to perform work-related functions); (3) whether the severe impairment meets or equals the medical criteria of Appendix 1, 20 C.F.R. Part 404, Subpart P; (4) considering the Commissioner's determination of claimant's RFC, whether the claimant can perform his past relevant work; and (5) if the claimant cannot perform the tasks required of his prior work, the ALJ must decide if the claimant can do other work in the national economy in view of his RFC, age, education, and work experience. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). A claimant is entitled to benefits only if unable to perform other work. See Bowen v. Yuckert, 482 U.S. 137, 142 (1987); 20 C.F.R. § 404.1520(f), (g); 20 C.F.R. § 416.920(f), (g).

         In reviewing the ALJ's findings, this Court must ask if substantial evidence supports those findings. See 42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389, 390 (1971). The ALJ's factual findings are conclusive if “substantial evidence consisting of relevant evidence as a reasonable person would accept as adequate to support a conclusion exists.” Keeton v. Dep't of Health and Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994) (citation and quotations omitted). The Court may not reweigh the evidence or substitute its own judgment for that of the ALJ even if it finds the evidence preponderates against the ALJ's decision. See Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983). The Commissioner's “failure to apply the correct law or to provide the reviewing court with sufficient reasoning for determining the proper legal analysis has been conducted mandates reversal.” Keeton, 21 F.3d at 1066 (citations omitted).

         C. Discussion

         Plaintiff argues the ALJ's RFC is not supported by substantial evidence, because the ALJ relied on an outdated opinion from a non-examining state agency physician. According to Plaintiff, the ALJ should have re-contacted one of his treating physicians for a more recent opinion or ordered an updated consultative examination. The Commissioner objects, stating there is no need for additional medical opinions because substantial evidence supports the ALJ's determination that Plaintiff retains the RFC for light work.

         A claimant's RFC is the most work he can do despite any limitations caused by his impairments. 20 C.F.R. §§ 404.1545(a)(1); 416.945(a)(1). In formulating a claimant's RFC, the ALJ must consider all impairments and the extent to which the impairments are consistent with medical evidence. 20 C.F.R. §§ 404.1545(a)(2), (e); 416.945(a)(2), (e). This includes both severe and non-severe impairments when determining if the claimant can “meet the physical, mental, sensory, and other requirements of work.” 20 C.F.R. §§ 404.1545(a)(4); 416.945(a)(4). An ALJ may not arbitrarily reject or ignore uncontroverted medical evidence. McCruter v. Bowen, 791 F.2d 1544, 1548 (11th Cir. 1986) (administrative review must be of the entire record; accordingly, ALJ cannot point to evidence that supports the decision but disregard other contrary evidence). Ultimately, under the statutory and regulatory scheme, a claimant's RFC is a formulation reserved for the ALJ, who must support his findings with substantial evidence. See 20 C.F.R. §§ 404.1546(c); 416.946(c).

         On December 30, 2015, Suzanne Johnson, D.O. - a non-examining state agency physician - opined at the reconsideration level that Plaintiff retained the RFC for light work. (R. 75-76) She based her RFC assessment on her review of all the record medical evidence as of December 30, 2015, including the new evidence Plaintiff submitted at the reconsideration level: a cervical spine X-ray taken at Rose Radiology just a week earlier and August 2015 records from the Family Care Center. (R. 73) Dr. Johnson noted that Plaintiff suffers from diabetes, hypertension, and spine disorders. (Id.) And due to Plaintiff's “mildly reduced [e]ection ...

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