Lee v. Social Security Administration, Commissioner
Filing
10
MEMORANDUM OPINION. Signed by Judge L Scott Coogler on 9/26/12. (KGE, )
FILED
2012 Sep-26 PM 01:36
U.S. DISTRICT COURT
N.D. OF ALABAMA
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
NORTHEASTERN DIVISION
KAREN M. LEE,
Plaintiff,
vs.
MICHAEL J. ASTRUE,
Commissioner,
Social Security Administration,
Defendant.
]
]
]
]
] 5:11-CV-2315-LSC
]
]
]
]
]
]
MEMORANDUM OF OPINION
I.
Introduction.
The plaintiff, Karen M. Lee, appeals from the decision of the Commissioner of
the Social Security Administration (“Commissioner”) denying her application for a
period of disability, Supplemental Security Income (“SSI”) and Disability Insurance
Benefits (“DIB”). Ms. Lee timely pursued and exhausted her administrative
remedies and the decision of the Commissioner is ripe for review pursuant to 42
U.S.C. §§ 405(g), 1383(c)(3).
Page 1 of 22
Ms. Lee was forty years old at the time of the Administrative Law Judge’s
(“ALJ’s”) decision on remand1, and she has a General Equivalency Diploma
(“GED”) and a certificate of completion as a pharmacy technician. (Tr. at 158.) Her
past work experiences include employment as a nurse assistant and scheduling clerk.
(Doc. 7 at 1.) Ms. Lee claims that she became disabled on September 15, 2005, due to
bipolar disorder, depression, and anxiety. (Tr. at 251.)
When evaluating the disability of individuals over the age of eighteen, the
regulations prescribe a five-step sequential evaluation process. See 20 C.F.R. §§
404.1520, 416.920; see also Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). The
first step requires a determination of whether the claimant is “doing substantial
gainful activity.” 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If he or she is, the
claimant is not disabled and the evaluation stops. Id. If he or she is not, the
Commissioner next considers the effect of all of the physical and mental impairments
combined. 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). These impairments
must be severe and must meet the durational requirements before a claimant will be
found to be disabled. Id. The decision depends on the medical evidence in the record.
1
The ALJ denied benefits on January 22, 2009. The Appeals Council remanded the case to
the ALJ, and the ALJ issued his decision upon remand on August 6, 2010. After the Appeals Council
denied Plaintiff’s request for review, Plaintiff appealed to this Court.
Page 2 of 22
See Hart v. Finch, 440 F.2d 1340, 1341 (5th Cir. 1971). If the claimant’s impairments
are not severe, the analysis stops. 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii).
Otherwise, the analysis continues to step three, which is a determination of whether
the claimant’s impairments meet or equal the severity of an impairment listed in 20
C.F.R. pt. 404, Subpart P, Appendix 1.
20 C.F.R. §§ 404.1520(a)(4)(iii),
416.920(a)(4)(iii). If the claimant’s impairments fall within this category, he or she
will be found disabled without further consideration.
Id.
If they do not, a
determination of the claimant’s residual functional capacity (“RFC”) will be made
and the analysis proceeds to the fourth step. 20 C.F.R. § 404.1520(e), 416.920(e).
The fourth step requires a determination of whether the claimant’s
impairments prevent him or her from returning to past relevant work. 20 C.F.R. §§
404.1520(a)(4)(iv), 416.920(a)(4)(iv). If the claimant can still do his or her past
relevant work, the claimant is not disabled and the evaluation stops. Id. If the
claimant cannot do past relevant work, then the analysis proceeds to the fifth step. Id.
Step five requires the court to consider the claimant’s RFC, as well as the claimant’s
age, education, and past work experience in order to determine if he or she can do
other work. 20 C.F.R. §§ 404.1520(a)(4)(v) 416.920(a)(4)(v). If the claimant can do
other work, the claimant is not disabled. Id.
Page 3 of 22
Applying the sequential evaluation process, the ALJ found that Ms. Lee met the
insured status requirements of the Social Security Act through June 30, 2006, but not
thereafter. (Tr. at 21.) He further determined that Ms. Lee has not engaged in
substantial gainful activity since the alleged onset of her disability. (Id. at 22.)
According to the ALJ, Plaintiff’s bipolar disorder, depression, generalized anxiety
disorder, personality disorder, nicotine addiction, history of alcohol and marijuana
abuse in remission, panic disorder with agoraphobia, mixed obsessive compulsive
disorder, and insomnia are considered “severe” based on the requirements set forth
in the regulations. (Id. at 22.) However, he found that these impairments neither
meet nor medically equal any of the listed impairments in Appendix 1, Subpart P,
Regulations No. 4. (Id.) The ALJ did not find Ms. Lee’s allegations to be totally
credible. (Id. at 25.) He determined that she has the residual functional capacity to
perform a full range of work at all exertional levels but with the following
nonexertional limitations:
[S]he is restricted to jobs that are low-stress, defined by SVP-2 or less
involving only simple work-related decisions; with normal breaks, she
can concentrate for two-hour periods across an eight-hour workday; she
is restricted from production pace work; she should have no contact with
the general public and only occasional contact with coworkers and
supervisors; she is capable of working independently with others; and
work should be performed in an isolated workstation.
Page 4 of 22
(Id. at 23.)
According to the ALJ, Ms. Lee is unable to perform any of her past relevant
work, she is a “younger individual,” and she has a “at least a high school education,”
as those terms are defined by the regulations. (Tr. at 31.) He determined that
transferability of job skills is not material to the determination of disability. (Id.) The
ALJ noted that Plaintiff’s ability to perform work at all exertional levels has been
compromised by her nonexertional limitations. (Id.) As such, a vocational expert
testified that a hypothetical individual with Plaintiff’s age, education, work
experience, and RFC would be able to perform unskilled employment at light levels.
(Id. at 32.) The ALJ then used Medical-Vocation Rule 204.00 as a guideline for
finding that there is a significant number of jobs in the national economy that Plaintiff
is capable of performing, such as machine tender, hand packager, and garment folder.
(Id.) The ALJ concluded his findings by stating that Plaintiff “has not been under a
‘disability,’ as defined in the Social Security Act, from the date of September, 17,
2005, through the date of this decision.” (Id.)
II. Standard of Review.
This Court’s role in reviewing claims brought under the Social Security Act is
a narrow one. The scope of its review is limited to determining (1) whether there is
Page 5 of 22
substantial evidence in the record as a whole to support the findings of the
Commissioner, and (2) whether the correct legal standards were applied. See
Richardson v. Perales, 402 U.S. 389, 390, 401 (1971); Wilson v. Barnhart, 284 F.3d
1219, 1221 (11th Cir. 2002). The Court approaches the factual findings of the
Commissioner with deference, but applies close scrutiny to the legal conclusions. See
Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996). The Court may not decide facts,
weigh evidence, or substitute its judgment for that of the Commissioner. Id. “The
substantial evidence standard permits administrative decision makers to act with
considerable latitude, and ‘the possibility of drawing two inconsistent conclusions
from the evidence does not prevent an administrative agency’s finding from being
supported by substantial evidence.’” Parker v. Bowen, 793 F.2d 1177, 1181 (11th Cir.
1986) (Gibson, J., dissenting) (quoting Consolo v. Fed. Mar. Comm’n, 383 U.S. 607,
620 (1966)). Indeed, even if this Court finds that the evidence preponderates against
the Commissioner’s decision, the Court must affirm if the decision is supported by
substantial evidence. Miles, 84 F.3d at 1400. No decision is automatic, however, for
“despite this deferential standard [for review of claims] it is imperative that the Court
scrutinize the record in its entirety to determine the reasonableness of the decision
reached.” Bridges v. Bowen, 815 F.2d 622, 624 (11th Cir. 1987). Moreover, failure to
Page 6 of 22
apply the correct legal standards is grounds for reversal. See Bowen v. Heckler, 748
F.2d 629, 635 (11th Cir. 1984).
III.
Discussion.
Plaintiff alleges that the ALJ’s decision should be reversed and remanded for
two reasons. First, she believes that the ALJ failed to give substantial weight to the
opinions of her treating physicians, basing his decision on personal opinion and
presumptive subjective judgments rather than substantial evidence. (Doc. 7 at 7.)
Second, Plaintiff contends that the ALJ incorrectly found that her impairments did not
meet or equal Listing 12.08, 20 C.F. R. § 404, Subpart P, Appendix 1. (Id. at 18.)
A.
Treating Physicians’ Diagnoses.
Plaintiff contends that the ALJ improperly evaluated her treating physicians’
opinions. (Doc. 7 at 7.) A treating physician’s testimony is entitled to “substantial
or considerable weight unless ‘good cause’ is shown to the contrary.” Crawford v.
Commissioner of Social Security, 363 F.3d 1155, 1159 (11th Cir. 2004) (quoting Lewis v.
Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997)) (internal quotations omitted). The
weight to be afforded a medical opinion regarding the nature and severity of a
claimant’s impairments depends, among other things, upon the examining and
treating relationship the medical source had with the claimant, the evidence the
Page 7 of 22
medical source presents to support the opinion, how consistent the opinion is with the
record as a whole, and the specialty of the medical source. See 20 C.F.R. §§
404.1527(d), 416.927(d). Furthermore, “good cause” exists for an ALJ to not give a
treating physician’s opinion substantial weight 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, 1241 (11th Cir. 2004)
(citing Lewis, 125 F.3d at 1440); see also Edwards v. Sullivan, 937 F.2d 580, 583-84 (11th
Cir. 1991) (holding that “good cause” existed where the opinion was contradicted by
other notations in the physician’s own record).
The Court must also be aware of the fact that opinions such as whether a
claimant is disabled, the claimant’s residual functional capacity, and the application
of vocational factors “are not medical opinions, . . . but are, instead, opinions on issues
reserved to the Commissioner because they are administrative findings that are
dispositive of a case; i.e., that would direct the determination or decision of
disability.” 20 C.F.R. §§ 404.1527(e), 416.927(d). The Court is interested in the
doctors’ evaluations of the claimant’s “condition and the medical consequences
thereof, not their opinions of the legal consequences of his [or her] condition.” Lewis,
Page 8 of 22
125 F.3d at 1440. Such statements by a physician are relevant to the ALJ’s findings,
but they are not determinative, as it is the ALJ who bears the responsibility for
assessing a claimant’s residual functional capacity. See, e.g., 20 C.F.R. § 404.1546(c).
Plaintiff saw several health care professionals between September 29, 2005, and
the date of the ALJ’s decision. (Doc. 7 at 7-18.) Of those professionals, Plaintiff refers
to Drs. Lindsey, Doody, and Yedla as her “treating psychiatrist[s].” (Id. at 13, 17.)
She refers to Dr. Vargas as a “non-treating physician.” (Id. at 13.) The ALJ did not
give great weight to Dr. Lindsey’s opinions, and he gave no weight to Dr. Yedla’s
opinions. (Tr. at 28-30.) He gave substantial weight, however, to the opinions of Drs.
Doody and Vargas. (Id. at 165.)
Dr. Trevor Lindsey, a psychiatrist who began treating Plaintiff in December
2008, completed a global assessment functioning (“GAF”) test of Plaintiff on
September 29, 2005, indicating that Plaintiff had a GAF score of 50.2 (Tr. at 29.) On
March 4, 2009, Dr. Lindsey completed a Request for Medical Information form used
by the State of Alabama Department of Human Resources Food Stamp Program
indicating that Plaintiff became permanently disabled and could not work due to the
2
A GAF score of 50 indicates serious symptoms or any serious impairment in social,
occupational, or school functioning. See Diagnostic and Statistical Manual of Mental Disorders, 4th
ed.
Page 9 of 22
September 2005 onset of bipolar disorder, obsessive compulsive disorder, panic
disorder with agoraphobia, generalized anxiety disorder, and insomnia. (Tr. at 28.)
The ALJ declined to give substantial weight to Dr. Lindsey’s opinions. He first
determined that the GAF score is a “one-time” assessment and did not reflect
longitudinal evidence. (Tr. at 29.) He also noted that the GAF score of 50 reflected
Plaintiff’s noncompliance with recommended treatment and substance abuse issues,
because Plaintiff had been hospitalized earlier within the same month related to
substance abuse and received a GAF score of 52, which is indicative of no more than
moderate limitations, and she had thereafter failed to seek treatment and tested
positive for marijuana and benzodiazepine. (Id.) Further, the food stamp form failed
to persuade the ALJ for at least five reasons. First, when Dr. Lindsey completed the
food stamp form in March 2009, Plaintiff was unmedicated and had seen Dr. Lindsey
only twice in over three years. (Id.) Plaintiff also had been repeatedly noncompliant
with medications and for months had been noncompliant with therapy. (Id.) Second,
Dr. Lindsey’s diagnoses of Plaintiff did not address actual functional limitations or
symptoms. (Id.) Third, Dr. Lindsey offered no clinical or objective findings to support
his opinions, which were inconsistent with his own previous and subsequent treatment
records concerning Plaintiff. (Tr. at 667-68, 713-14.) For example, during Plaintiff’s
Page 10 of 22
March 2009 visit, Dr. Lindsey noted that Plaintiff’s “sensorium appeared clear” and
that “she spoke rationally and cohesively.” (Tr. at 617.) Fourth, the ALJ suggested
that Dr. Lindsey may have provided the disabling form to avoid unnecessary doctorpatient tension, since it “depart[s] substantially from the rest of the evidence of
record.” (Tr. at 30.) Fifth, the ALJ noted that food stamp forms are “clearly not used
to fully evaluate an individual’s medical condition.” (Id.)
Plaintiff argues that the ALJ should have given substantial weight to Dr.
Lindsey’s opinions. According to Plaintiff, the opinions that Dr. Lindsey provided on
the food stamp form prove that she has permanently been unable to work since
September 2005. (Doc. 7 at 18.) Plaintiff also challenges the ALJ’s criticism that she
had only seen Dr. Lindsey twice in the three years leading up to his completion of the
food stamp form. (Id. at 18.) According to Plaintiff, such criticism does not coincide
with the ALJ’s decision to give substantial weight to the opinions that Drs. Doody and
Vargas gave after seeing Plaintiff only once. (Id.)
Substantial evidence supports the ALJ’s clearly-articulated decision not to give
great weight to Dr. Lindsey’s opinions. The ALJ correctly drew a distinction between
Dr. Lindsey’s opinions concerning the legal consequences of Plaintiff’s condition and
his opinions concerning the medical consequences of Plaintiff’s condition. See Lewis,
Page 11 of 22
125 F.3d at 1440 (“[W]e . . . are concerned here with the doctors’ evaluations of [the
plaintiff’s] condition and the medical consequences thereof, not their opinions of the
legal consequences of [the plaintiff’s] condition.”) Because Dr. Lindsey provided his
opinions in the context of a food stamp application, the ALJ reasonably interpreted
them as concerning the legal consequences of Plaintiff’s condition. Dr. Lindsey’s
opinion also failed to indicate functional limitations and lacked support from clinical
or objective findings, further suggesting that it concerned legal rather than medical
consequences of Plaintiff’s condition. (Tr. at 29.) Finally, Dr. Lindsey’s infrequent
visits with Plaintiff undermined his opinions, especially since Plaintiff remained
noncompliant leading up to those visits. (Id.)
Dr. Anapuma Yedla, a psychiatrist, completed a Medical Source Opinion
(Mental) form on May 27, 2008, indicating that Plaintiff had “extreme” and
“marked” functional limitations resulting from irritability, severe depression, and
suicidal ideation. (Tr. at 525.) The ALJ gave no weight to Dr. Yedla’s opinions on this
form for at least three reasons. First, the form “sharply contrast[ed]” with her own
treatment records concerning Plaintiff, including records dating from the same month.
(Tr. at 165.) For example, Plaintiff showed entirely normal mental status in Dr.
Yedla’s mental status examinations in November 2007, May 2008, and August 2008.
Page 12 of 22
(Tr. at 166.) During those visits, Plaintiff repeatedly denied suicidal ideations, and the
evaluations found no irritability or disturbed mood. (Id.) Second, the ALJ noted that
Dr. Yedla’s assessment of Plaintiff’s functional limitations as “marked” and
“extreme” does not comport with her opinion that Plaintiff is capable of managing her
benefits in her own best interest. (Id.) Third, the ALJ suggested that Dr. Yedla may
have provided the medical source opinion to avoid unnecessary doctor-patient
tension, since it “depart[s] substantially from the rest of the evidence of record.” (Id.)
Plaintiff argues that the ALJ should have given substantial weight to Dr. Yedla’s
opinion. According to Plaintiff, Dr. Yedla’s opinion did coincide with her own
treatment notes. (Doc. 7 at 14-17.) Plaintiff also challenges the ALJ’s skepticism
concerning Dr. Yedla’s motives, suggesting that the ALJ failed to meet an affirmative
duty to verify the bases for Dr. Yedla’s opinion. (Id. at 17.)
Substantial evidence supports the ALJ’s decision to give no weight to Dr.
Yedla’s opinion. While Dr. Yedla supported her May 2008 opinion by stating that
Plaintiff had significant problems including suicidal ideations, her treatment notes
from November 2007, May 2008, and August 2008 indicate that Plaintiff denied
suicidal ideations. (Tr. at 579, 583, 587.) Indeed, Plaintiff reported in November 2007
that she was “doing well,” and in May 2008 that she was “generally doing well.”
Page 13 of 22
(Tr. at 48, 120.) Additionally, Dr. Yedla’s statement that Plaintiff could manage her
own benefits could reasonably be seen as inconsistent with her diagnosis of Plaintiff
as having “marked” limitations. (Id. at 17.) Some evidence, such as Plaintiff’s
overdose in February 2008, may coincide with Dr. Yedla’s medical source opinion.
(Doc. 7 at 16.) Still, substantial evidence supports the ALJ’s decision to give no weight
to Dr. Yedla’s opinions, as they were inconsistent with her own treatment records.
Plaintiff also incorrectly asserts that the ALJ had a duty to contact Dr. Yedla to
verify the basis for her opinion. (Id. at 17.) Indeed, the ALJ may not “arbitrarily
substitute his own hunch or intuition for the diagnosis of a medical professional,”
Marbury v. Sullivan, 957 F.2d 837, 840-41 (11th Cir. 1992), and there are situations
wherein an ALJ should request clarification from a physician. However, the ALJ is
not required to do so when the record contains sufficient evidence to make an
informed decision. Reeves v. Heckler, 734 F.2d 519, 522 n.1 (11th Cir. 1984) (citing Ford
v. Secretary of Health & Human Servs., 659 F.2d 66, 69 (5th Cir. 1981) (Unit B)). The
ALJ here neither acted arbitrarily nor substituted his own opinions for those of Dr.
Yedla. The ALJ merely provided a reasoned explanation for giving no weight to Dr.
Yedla’s opinion and opted to rely instead upon the opinions of other medical
professionals such as Drs. Doody and Vargas.
Page 14 of 22
Dr. Regina Doody, one of Plaintiff’s treating psychiatrists, completed a GAF
test of Plaintiff on September 26, 2006, indicating that Plaintiff had a GAF score of
55. (Tr. 165.) Her findings concerning Plaintiff’s memory, attention, concentration,
normal thought processes, normal speech, and normal affect indicated no more than
moderate functional limitations. (Id.) The ALJ gave substantial weight to Dr. Doody’s
opinions for at least two reasons. First, Dr. Doody used mental status examination
findings and other objective evidence to support her assessment of Plaintiff’s GAF
score of 55. (Id.) Second, the ALJ noted Dr. Doody’s thorough evaluation of both the
Plaintiff and her medical history, highlighting Dr. Doody’s access to Huntsville
Hospital’s records regarding its contact with Plaintiff. (Id.)
Plaintiff argues that the ALJ gave too much weight to Dr. Doody’s opinions,
emphasizing that Dr. Doody had never treated her prior to the 2006 assessment. (Doc.
7 at 13.) Plaintiff further suggests that Dr. Doody lacked medical records concerning
Plaintiff’s later hospitalizations for psychiatric services. (Id. at 14.)
Substantial evidence supports the ALJ’s decision to give substantial weight to
Dr. Doody’s opinions. Although Plaintiff later underwent hospitalizations for
psychiatric services, Dr. Doody nonetheless conducted a thorough examination of
Plaintiff that was consistent with treatment notes from a later period, particularly from
Page 15 of 22
Plaintiff’s visits to the hospital from December 2008 through January 2010. (Tr. at
26.) The consistency of Dr. Doody’s September 2006 opinions with subsequent
treatment notes concerning Plaintiff constitutes substantial evidence supporting the
ALJ’s decision to give great weight to Dr. Doody’s opinions.
Finally, Dr. Sherlee Vargas, a consultative examining psychologist, performed
an evaluation of Plaintiff on January 5, 2007, at the request of the Disability
Determination Service in Birmingham, Alabama, indicating that Plaintiff had the
ability to function independently and had an unimpaired ability to understand,
remember, and carry out simple instructions and only a mildly-to-moderatelyimpaired ability to respond to supervision and coworkers in a work setting. (Id. at 165,
340, 460.) The ALJ gave substantial weight to Dr. Vargas’s opinions for at least two
reasons. First, Dr. Vargas’s opinions indicated that she had reviewed Plaintiff’s
medical treatment history and conducted a thorough mental status interview and
examination of Plaintiff. (Id. at 165.) Second, the ALJ noted that Dr. Vargas’s opinions
corresponded with other objective evidence of record. For example, like Dr. Vargas,
both Dr. Doody and Dr. Rankart, a consulting physician at the State agency, found in
September 2006 and January 2007, respectively, that Plaintiff’s mental illness resulted
in no more than mild-to-moderate functional limitations. (Id. at 165.)
Page 16 of 22
Plaintiff argues that the ALJ gave too much weight to Dr. Vargas’s opinions.
According to Plaintiff, Dr. Vargas only treated her once and was not one of her
treating physicians. (Doc. 7 at 18.) Plaintiff also suggests that Dr. Vargas lacked
medical records concerning Plaintiff’s later hospitalizations for psychiatric services.
(Id. at 14.)
Substantial evidence supports the ALJ’s decision to give substantial weight to
Dr. Vargas’s opinions. Although Plaintiff underwent later hospitalizations for
psychiatric services, Dr. Vargas nonetheless conducted a thorough examination of
Plaintiff that was consistent with treatment notes from later in the record, particularly
from Plaintiff’s visits to the hospital from December 2008 through January 2010. (Tr.
26.) The consistency of Dr. Vargas’s 2007 opinions with subsequent treatment notes
concerning Plaintiff constitutes substantial evidence. In sum, although Dr. Doody and
Dr. Vargas’s evaluations occurred earlier in the time period at issue, because
treatment notes from both before and after those evaluations are consistent with those
evaluations, it was appropriate for the ALJ to rely on them.
Plaintiff also incorrectly asserts that the ALJ gave too much weight to Dr.
Vargas’s opinions because Dr. Vargas was a non-treating physician. (Doc. 7 at 15.)
Within the classification of acceptable medical sources are the following different
Page 17 of 22
types of sources which are entitled to different weights of opinion: 1) a treating source,
which is defined in the regulations as “your physician, psychologist, or other
acceptable medical source who provides you, or has provided you, with medical
treatment or evaluation and who has, or has had, an ongoing treatment relationship
with you;” 2) a non-treating source, which is defined as “a physician, psychologist,
or other acceptable medical source who has examined you but does not have, or did
not have, an ongoing treatment relationship with you;” and 3) a non-examining
source, which is a “a physician, psychologist, or other acceptable medical source who
has not examined you but provides a medical or other opinion in your case . . .
includ[ing] State agency medical and psychological consultants . . .” 20 C.F.R. §
404.1502. The regulations and case law indeed set forth a general preference for
treating sources’ opinions over those of non-treating sources, and non-treating
sources over non-examining sources. See 20 C.F.R. § 404.1527(d)(2); Ryan v. Heckler,
762 F.2d 939, 942 (11th Cir. 1985). However, as explained previously, good cause
existed for the ALJ to give less weight to the opinions of two of Plaintiff’s treating
psychiatrists, Drs. Lindsey and Yelda. The ALJ determined that those psychiatrists’
opinions were inconsistent with their own treatment records, not bolstered by the
evidence, and that the evidence supported a contrary finding. It was thus not
Page 18 of 22
inappropriate for the ALJ to give greater weight to the opinion of a non-treating
physician, Dr. Vargas, especially when she conducted a thorough interview and
examination of Plaintiff and had reviewed her medical history. See Fries v. Comm’r of
Soc. Sec., 196 F. App’x 827, 833 (11 th Cir. 2006) (the ALJ properly relied on an
opinion from a one-time examiner and found good cause to discount a treating source
opinion because it was inconsistent with the other evidence); Forrester v. Comm’r of
Soc. Sec., 455 F. App’x 899, 902-03 (11th Cir. 2012) (“The evidence supported a
contrary conclusion to [the treating physician’s] opinion, and the ALJ was not
prohibited from reaching that conclusion simply because non-treating physicians also
reached it.”).
B.
Listing 12.08 Evaluation.
Plaintiff contends that her medical and psychological profile met or equaled the
requirements of section 12.08 of the Listing of Impairments, 20 C.F.R. § 404, Subpart
P, Appendix 1, 12.08, Personality Disorders. (Doc. 7 at 19.) The Eleventh Circuit has
stated:
To “meet” a Listing, a claimant must have a diagnosis
included in the Listings and must provide medical reports
documenting that the conditions meet the specific criteria
of the Listings and the duration requirement. To “equal”
a Listing, the medical findings must be “at least equal in
severity and duration to the listed findings.”
Page 19 of 22
Wilson v. Barnhart, 284 F.3d 1219, 1224 (11th Cir. 2002). To meet the required level
of severity for these disorders, Plaintiff must meet at least three criteria, one from
“Paragraph A” and two from “Paragraph B.” Paragraph A criteria include deeply
ingrained, maladaptive patterns of behavior, while Paragraph B criteria encompass
results of those behavioral patterns including certain impairments or decompensation.
See 20 C.F.R. § pt. 404, subpt. P, app. 1, § 12.08. More specifically, Paragraph B
requires either two “marked” (i.e., more than moderate) impairments or one such
impairment along with “repeated episodes of decompensation, each of extended
duration” (i.e., at least three episodes within one year, or an average of once every
four months, with each lasting for at least two weeks). 20 C.F.R. § 404, Subpart P,
Appendix 1, 12.00(c)(4). In this case, the ALJ found that Plaintiff fails to satisfy the
Paragraph B criteria because she has no more than moderate impairments and has
experienced only one or two episodes of decompensation of extended duration. (Tr.
at 23.)
Plaintiff argues that the ALJ failed to support with objective evidence his
opinion of her limitations. (Doc. 7 at 19.) To rebut the ALJ’s opinion, Plaintiff recites
a litany of negative results (concerning Paragraph B) stemming from her purported
maladaptive behavioral patterns (concerning Paragraph A). (Id. at 19-22.)
Page 20 of 22
Substantial evidence in the record as a whole supports the ALJ’s decision, so
it must be affirmed. See Wilson, 284 F.3d at 1221. The ALJ first analyzed the medical
opinions and treatment notes in the record and found that Plaintiff was only
moderately limited and thus did not meet or medically equal the criteria of Listing
12.08. (Tr. at 22-23). For example, Plaintiff’s treatment notes indicate that she was
treated repeatedly for abuse of marijuana, alcohol, and Xanax, (tr. at 364-78), that she
enjoyed activity and work and spent time with friends, (tr. at 159, 369), and that she
was repeatedly noncompliant with recommended mental health treatment. (Tr. at
327-332.) Treatment notes also reveal that even though unmedicated, Plaintiff had
normal mood, affect, orientation, and denied suicidal ideations. (Tr. at 439.) As
noted previously, evaluations by Drs. Doody and Vargas also resulted in normal
findings indicative of no more than moderate functional limitations. (Tr. at 165, 464.)
Further, Dr. Yedla’s treatment notes show that Plaintiff had a normal mental status
examination in November 2007 and May 2008. (Tr. at 579-80.) Additionally, Dr.
Lindsey reported in March and November 2009 that Plaintiff was adequately
groomed, calm, and spoke rationally and cognitively. (Tr. at 25, 667-68.) The ALJ
also considered Plaintiff’s stated ability to do certain activities, including washing
clothes and cooking, walking on a treadmill for an hour each day, and interacting
Page 21 of 22
socially with her family, boyfriend, stepson, and other group therapy participants at
a mental health center. (Tr. at 161, 369, 506, 609.) Because the medical evidence of
record supports the ALJ’s finding that Plaintiff had mental impairments, but that she
was no more than moderately limited and did not meet the criteria for Paragraph B of
Listing 12.08, substantial evidence supports the Commissioner’s decision and it is due
to be affirmed.
IV.
Conclusion.
Upon review of the administrative record, and considering all of Ms. Lee’s
arguments, the Court finds the Commissioner’s decision is supported by substantial
evidence and in accord with applicable law. A separate order will be entered.
Done this 26th day of September 2012.
L. Scott Coogler
United States District Judge
[160704]
Page 22 of 22
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?