Fancher v. Social Security Administration, Commissioner
Filing
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MEMORANDUM OPINION Signed by Judge William M Acker, Jr on 2/3/15. (SAC )
FILED
2015 Feb-03 PM 04:24
U.S. DISTRICT COURT
N.D. OF ALABAMA
IN THE UNITED STAT1ES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
CASSANDRA B. FANCHER,
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Plaintiff,
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v.
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CAROLYN W. COLVIN,
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Acting Commissioner of Social }
Security,
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}
Defendant.
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CIVIL ACTION NO.
2:13-CV-2122-WMA
MEMORANDUM OPINION
Claimant, Cassandra B. Fancher, upon exhaustion of her
administrative remedies, brings this action pursuant to 42 U.S.C.
§ 405(g) for judicial review of the final agency decision denying
her application for disability insurance and supplemental
security income benefits. (R. at 76-77). While both parties agree
that Fancher has severe impairments,1 Fancher challenges the
agency’s final determination that she has the residual functional
capacity to perform a range of light work (R. at 28-32) and is
therefore not “disabled” under regulation. 20 C.F.R. §§ 404.1529
and 416.929.
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The administrative law judge (“ALJ”) found that Fancher
suffers from bipolar disorder, anxiety, obsessive compulsive
disorder, morbid obesity, hypertension postpartum, degenerative
joint disease of the bilateral knees, and migraines. (R. at 26).
Fancher does not challenge the ALJ’s finding that these
impairments do not meet the severity of those listed in agency
regulation. (Doc. 10 at 2, 8). To be “disabled,” Fancher must
lack the residual functional capacity to perform the requirements
of any past relevant work. (R. at 27-28).
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Fancher challenges the ALJ’s decision on two grounds: (1)
that the ALJ failed to apply proper legal standards or to state
adequate reasons for rejecting the opinion of Dr. Lucas,
Fancher’s treating physician (Doc. 10 at 12); and (2) that the
ALJ erred in giving “significant weight” to the opinions of
nonexamining physicians Dr. Estock and Dr. Dobbs. (Doc. 10 at
12).
For the following reasons, the final agency decision denying
Fancher disability and supplemental security income benefits will
be affirmed.
As a product of the administrative adjudicative process,
federal courts “may not decide the facts anew, reweigh the
evidence, or substitute [its] judgment for that of the
Commissioner.” Mitchell v. Comm'r, Soc. Sec. Admin., 771 F.3d
780, 782 (11th Cir. 2014)(quotation omitted). “If the
Commissioner's decision is supported by substantial evidence,
this Court must affirm, even if the proof preponderates against
it.” Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005)
(quoting Phillips v. Barnhart, 357 F.3d 1232, 1240 n. 8 (11th
Cir. 2004)); see 42 U.S.C. § 405(g) (“The findings of the
Commissioner of Social Security as to any fact, if supported by
substantial evidence, shall be conclusive.”). “Substantial
evidence is more than a scintilla and is such relevant evidence
as a reasonable person would accept as adequate to support a
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conclusion.” Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1178
(11th Cir. 2011).
“In contrast to the deferential review accorded to the
Secretary's findings of fact, the Secretary's conclusions of law,
including applicable review standards, are not presumed valid.”
Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990).
However, where the organic statute is ambiguous, “[courts] must
accord proper deference to the interpretation adopted by the
agency to which Congress has delegated the administration of the
statute.” Stroup v. Barnhart, 327 F.3d 1258, 1260 (11th Cir.
2003) (citing Chevron U.S.A., Inc. v. Natural Resources Defense
Council, Inc., 467 U.S. 837 (1984)). In particular, deference is
owed to regulations promulgated by the Social Security
Administration interpreting the ambiguous statutory definition of
“disability.” Barnhart v. Walton, 535 U.S. 212, 217-18 (2002).
I. Treating physician
Pursuant to agency regulation, a treating source’s opinion
is given controlling weight where it “is well-supported by
medically acceptable clinical and laboratory diagnostic
techniques and is not inconsistent with the other substantial
evidence in [the] case record.” 20 C.F.R. § 404.1527. In accord
with this regulation, the Eleventh Circuit generally upholds an
ALJ decision that gives little weight to the opinion of a
treating physician of the ALJ has clearly articulated “good
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cause” by showing either the “(1)treating physician’s opinion was
not bolstered by 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).
In this case, the ALJ clearly articulated that “Dr. Lucas’
opinion while considered is thus, inconsistent with the record as
a whole and afforded little weight.” (R. at 30); Winschel v.
Commissioner of Social Security, 631 F.3d 1176, 1179 (11th Cir.
2011) (“the ALJ must state with particularity the weight given to
different medical opinions and the reasons therefor”). While
Fancher alleges Dr. Lucas’ opinion was entitled to “controlling
weight” (Doc. 10 at 8-15), there is substantial evidence in the
record to support the ALJ’s contrary conclusion.
First, rather than being firmly based on medically
acceptable clinical and laboratory diagnostic techniques, the ALJ
highlights the thin basis for Dr. Lucas’ opinion that Fancher has
“extreme difficulties.” (R. at 30). The sole factor Dr. Lucas
identified in making Fancher’s assessment was “a history of
psychiatric and therapy appointments.” (R. at 30, 680); 20 C.F.R.
§ 404.1527. The ALJ also highlighted the infrequency and scope of
Dr. Lucas’ examinations. Lewis v. Callahan, 125 F.3d 1436, 1440
(11th Cir. 1997). While the ALJ incorrectly stated that Dr. Lucas
had only evaluated Fancher once (R. at 30), the medical reports
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included in the record document four visits with minimal comments
that suggest Fancher was seen by a therapist/nurse where Dr.
Lucas merely reviewed the therapist/nurse’s notes. (R. at 49497). Dyer v. Barnhart, 395 F.3d 1206, 1211 (11th Cir. 2005)
(“there is no rigid requirement the ALJ specifically refer to
every piece of evidence in his decision”). Despite the ALJ’s
error, which was innocuous, the record supports the lessened
weight given that the ALJ gave Dr. Lucas’ opinion given the
infrequency and summary quality of Dr. Lucas’ examinations.
The ALJ further highlighted that Dr. Lucas’ opinion was
inconsistent with the other substantial evidence in the record.
Specifically, Fancher’s global assessment of functioning scores
indicated moderate difficulties inconsistent with Dr. Lucas’
evaluation of “extreme difficulties.” (R. at 30). The ALJ
emphasized that the lack of frequent changes in Fancher’s
medication and degree of psychiatric care were “inconsistent with
extreme and marked limitations as Dr. Lucas identified.” (R. at
30). Unlike a patient with “extreme difficulties,” Fancher
“remained in psychiatric outpatient services with no record of
inpatient treatment and no indication of decompensation requiring
more intensive care.” (R. at 30). These inconsistent facts
provided substantial evidence for giving Dr. Lucas’ opinion
lesser weight.
Further, given both the limited medical foundation for Dr.
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Lucas’ opinion and the inconsistent evidence in the record, the
ALJ’s giving the treating physician’s opinion “little weight” is
consistent with agency regulation and constitutes “good cause.”
Phillips v. Barnhart, 357 F.3d 1232, 1240 (11th Cir. 2004) (where
the ALJ articulates “several legitimate reasons,” the treating
physician’s “opinion should be given little weight [and] is
supported by substantial evidence”).
II. Nonexamining sources
Agency regulation advises that “because nonexamining sources
have no examining or treating relationship with [the claimant],
the weight [the ALJ] will give their opinions will depend on the
degree to which they provide supporting explanations for their
opinions.” 20 C.F.R. §§ 404.1527 and 416.927. Consistent with
these regulations, in the Eleventh Circuit, while “the opinion of
a treating physician is generally entitled to more weight than
that of a non-treating physician,” opinions from nonexamining
physicians may be accepted where the evidence supports a contrary
conclusion. Oldham v. Schweiker, 660 F.2d 1078, 1084 (5th Cir.
1981); see Bonner v. Prichard, 661 F.2d 1206, 1209 (5th Cir.
1981) and Broughton v. Heckler, 776 F.2d 960, 962 (11th Cir.
1985).
In this case, the ALJ gave the opinions of nonexamining
physicians Dr. Estock and Dr. Dobbs “significant weight in
assessing [Fancher’s] abilities, as they were well reasoned and
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consistent with the identified medical evidence and activities
they identified.” (R. at 31-32). The ALJ emphasized that both
physicians’ identified behavior by Fancher that was consistent
with a residual functional capacity to perform a range of light
work. (R. at 28, 31-32). Specifically, Fancher “received visitors
and attended the library,” was able “to grocery shop, attend
church, perform needlework, and other activities requiring
concentration and socialization capacity.” (R. at 31-32). While
Fancher speculates that Dr. Dobbs and Dr. Estock may have drawn
different conclusions had they been aware of Dr. Lucas’
assessment, Fancher points to nothing in the record to support
such speculation. (Doc. 10 at 16). Instead, there is substantial
evidence in the record to support the ALJ’s decision to give
significant weight to the opinions of nonexamining physicians Dr.
Estock and Dr. Dobbs. Furthermore, the ALJ carefully considered
and based his decision on the record in its entirety, not just
the three physician opinions challenged by Fancher. Randolph v.
Astrue, 291 Fed. Appx. 979, 982 (11th Cir. 2008).
CONCLUSION
For the reasons detailed above, the court will by separate
order affirm the final agency decision denying Fancher disability
and supplemental security income benefits.
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DONE this 3rd day of February, 2015.
_____________________________
WILLIAM M. ACKER, JR.
UNITED STATES DISTRICT JUDGE
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