Guy v. Social Security Administration, Commissioner
Filing
10
MEMORANDUM OPINION. Signed by Judge L Scott Coogler on 9/27/2016. (KAM, )
FILED
2016 Sep-27 PM 12:17
U.S. DISTRICT COURT
N.D. OF ALABAMA
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
WESTERN DIVISION
JACQUELINE GUY,
Plaintiff,
vs.
CAROLYN W. COLVIN,
Commissioner of Social Security,
Defendant.
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7:15-cv-00539-LSC
MEMORANDUM OF OPINION
I.
Introduction
The plaintiff, Jacqueline Guy, appeals from the decision of the
Commissioner of the Social Security Administration (“Commissioner”) denying
her application for a period of disability, Disability Insurance Benefits (“DIB”) and
Supplemental Security Income (“SSI”). Ms. Guy 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).
Ms. Guy was forty-eight years old at the time of the Administrative Law
Judge’s (“ALJ’s”) decision. (Tr. at 58, 173.) She has a high school education and
no past relevant work experience. (Tr. at 51, 85, 174.) Ms. Guy claims that she
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became disabled on December 15, 2010, due to depression and anxiety. (Tr. at 173,
199.)
The Social Security Administration has established a five-step sequential
evaluation process for determining whether an individual is disabled and thus
eligible for DIB or SSI. See 20 C.F.R. §§ 404.1520, 416.920; see also Doughty v.
Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). The evaluator will follow the steps in
order until making a finding of either disabled or not disabled; if no finding is made,
the analysis will proceed to the next step. See 20 C.F.R. §§ 404.1520(a)(4),
416.920(a)(4). The first step requires the evaluator to determine whether the
plaintiff is engaged in substantial gainful activity (“SGA”).
See id. §§
404.1520(a)(4)(i), 416.920(a)(4)(i). If the plaintiff is not engaged in SGA, the
evaluator moves on to the next step.
The second step requires the evaluator to consider the combined severity of
the plaintiff’s medically determinable physical and mental impairments. See id. §§
404.1520(a)(4)(ii), 416.920(a)(4)(ii). An individual impairment or combination of
impairments that is not classified as “severe” and does not satisfy the durational
requirements set forth in 20 C.F.R. §§ 404.1509 and 416.909 will result in a finding
of not disabled. See 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). The
decision depends on the medical evidence contained in the record. See Hart v.
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Finch, 440 F.2d 1340, 1341 (5th Cir. 1971) (concluding that “substantial medical
evidence in the record” adequately supported the finding that plaintiff was not
disabled).
Similarly, the third step requires the evaluator to consider whether the
plaintiff’s impairment or combination of impairments meets or is medically equal
to the criteria of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix
1. See 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If the criteria of a listed
impairment and the durational requirements set forth in 20 C.F.R. §§ 404.1509
and 416.909 are satisfied, the evaluator will make a finding of disabled. 20 C.F.R.
§§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).
If the plaintiff’s impairment or combination of impairments does not meet or
medically equal a listed impairment, the evaluator must determine the plaintiff’s
residual functional capacity (“RFC”) before proceeding to the fourth step. See id.
§§ 404.1520(e), 416.920(e). The fourth step requires the evaluator to determine
whether the plaintiff has the RFC to perform the requirements of her past relevant
work.
See id. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv).
If the plaintiff’s
impairment or combination of impairments does not prevent her from performing
her past relevant work, the evaluator will make a finding of not disabled. See id.
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The fifth and final step requires the evaluator to consider the plaintiff’s
RFC, age, education, and work experience in order to determine whether the
plaintiff can make an adjustment to other work. See id. §§ 404.1520(a)(4)(v),
416.920(a)(4)(v). If the plaintiff can perform other work, the evaluator will find her
not disabled. Id.; see also 20 C.F.R. §§ 404.1520(g), 416.920(g). If the plaintiff
cannot perform other work, the evaluator will find her disabled. 20 C.F.R. §§
404.1520(a)(4)(v), 404.1520(g), 416.920(a)(4)(v), 416.920(g).
Applying the sequential evaluation process, the ALJ found that Ms. Guy
meets the nondisability requirements for a period of disability and DIB and was
insured through the date of the decision. (Tr. at 51.) He further determined that
Ms. Guy has not engaged in SGA since the alleged onset of her disability. (Id.)
According to the ALJ, Plaintiff’s depressive disorder, panic disorder, status post
right ankle fracture, hypertension, and obesity are considered “severe” based on
the requirements set forth in the regulations. (Id. at 52.) However, he found that
these impairments neither meet nor medically equal any of the listed impairments
in 20 C.F.R. Part 404, Subpart P, Appendix 2. (Id. at 53.) The ALJ did not find Ms.
Guy’s allegations to be totally credible, and he determined that she has the
following RFC:
To perform light work as defined in 20 CFR 404.1567(b) and
416.967(b), with the following abilities, limitations and restrictions:
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pushing/pulling and foot control operation on the right side limited to
no more than occasional; climbing ramps and stairs, balancing,
stooping, kneeling, crouching, and crawling are limited to no more
than occasional; no climbing of ladders, ropes or scaffolds; no
exposure to unprotected heights or uneven terrain; avoid any more
than occasional exposure to extreme cold or heat; can understand,
remember and carry out simple instructions with no more than
occasional decision making and changes; no more than occasional
interaction with the public, coworkers and supervisors; and no tandem
tasks required to do the duties of the job.
(Tr. at 54.)
According to the ALJ, Ms. Guy has no past relevant work, she is a “younger
individual age 18-49,” she has a high school education, and she is able to
communicate in English, as those terms are defined by the regulations. (Tr. at 57.)
He determined that “[t]ransferability of job skills is not an issue because the
claimant does not have past relevant work.” (Id.) Because Plaintiff cannot perform
the full range of light work, the ALJ enlisted a vocational expert (“VE”) and used
Medical-Vocational Rule 202.20 as a guideline for finding that there are a
significant number of jobs in the national economy that she is capable of
performing, such as electrical assembler, marker, and food preparer. (Id.) The ALJ
concluded his findings by stating that Plaintiff “has not been under a disability, as
defined in the Social Security Act, From December 15, 2010, through the date of
this decision.” (Id.)
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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 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 Stone
v. Comm’r of Soc. Sec., 544 F. App’x 839, 841 (11th Cir. 2013) (citing Crawford v.
Comm’r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir. 2004)). This Court gives
deference to the factual findings of the Commissioner, provided those findings are
supported by substantial evidence, but applies close scrutiny to the legal
conclusions. See Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996).
Nonetheless, this Court may not decide facts, weigh evidence, or substitute
its judgment for that of the Commissioner. 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)).
“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
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proof preponderates against the Commissioner’s decision, it must affirm if the
decision is supported by substantial evidence. Miles, 84 F.3d at 1400 (citing Martin
v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990)).
However, no decision is automatic, for “despite th[e] deferential standard
[for review of claims], it is imperative that th[is] 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) (citing Arnold v. Heckler, 732 F.2d 881,
883 (11th Cir. 1984)). Moreover, failure to apply the correct legal standards is
grounds for reversal. See Bowen v. Heckler, 748 F.2d 629, 635 (11th Cir. 1984).
III.
Discussion
Ms. Guy alleges that the ALJ’s decision should be reversed and remanded
for several reasons. First, Plaintiff contends that the ALJ did not properly consider
treatment notes from West Alabama Mental Health Center. Second, she believes
that the ALJ did not properly evaluate the opinion of Dr. Donald W. Blanton.
Third, she argues that the ALJ did not sufficiently develop the record. Fourth, she
states that her testimony supports her claims of disabling mental symptoms and
thus implies that the ALJ erred in finding her testimony not entirely credible. Fifth
and finally, she contends the ALJ did not consider or discuss Dr. Blanton’s second
opinion submitted after her administrative hearing.
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A.
Consideration of Treatment Notes from West Alabama Mental
Health Center
As the ALJ noted, Plaintiff began receiving services in October 2011 at West
Alabama Mental Health Center for a diagnosed depressive disorder. (Tr. at 52.) In
November 2011, treatment notes showed a Global Assessment of Functioning
(“GAF”) score of 45, which indicates serious symptoms. (Tr. at 238.) On January
5, 2012, while Plaintiff reported doing okay she also noted mood swings, ongoing
depressive moods, increased stress, feeling that “she’s just sitting on earth and not
really accomplishing anything,” questioning her purpose, feeling that nothing
excites her, problems focusing, and relational problems. (Tr. at 255). However, in
February 2012, while she cited some of the same problems, she also reported doing
okay, and exhibited normal affect, proper orientation, calm motor activity, good
sleep and appetite, and no suicidal or homicidal ideation. (Tr. at 254-55.) By March
2012, treatment notes showed a GAF of 55, which indicates only moderate
symptoms. (Tr. at 235.) On March 27, 2012, a psychiatrist at the center prescribed
Paxil and Vistaril. (Tr. at 237.) By May 2012, she reported sleeping better and
feeling okay. (Tr. at 232.) She denied hearing voices or having homicidal thoughts
or suicidal thoughts. (Id.) Later in May 2012, treatment notes show Plaintiff
complied with her medication regime, but that she experienced increased
depressive moods. (Tr. at 231.) The notes further explain that her moods were
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manageable, except for crying episodes. (Id.) In May 2012, the psychiatrist refilled
her prescriptions for Paxil and Vistaril. (Tr. at 232.) In August 2012, while she
reported lack of interest in forming friendships and constant worrying, she also
reported no suicidal or homicidal thoughts and that she was generally doing okay.
(Tr. at 335.) In September 2012, she reported again that she was doing okay but
that she had some depression. (Tr. at 334.) The next month, she reported doing
okay and complying with her medication regime. (Tr. at 333.) At that time, she
showed normal affect and proper orientation to person, place, time, and situation.
(Id.) Later that month she again reported doing “good.” (Tr. at 342.) However,
she also reported that she was having relationship issues and stated that she
believes that others think she is “stupid.” (Tr. at 333). On November 19, 2012, she
noted that she was doing okay and feeling better “because others haven’t been
critical.” (Tr. at 355). On January 2, 2013, she again said she was doing okay but
felt uncomfortable around others. (Tr. at 332). On February 22, 2013, she reported
doing okay but that her mood was depressed and she was frustrated. (Tr. at 348).
By April 2013, she was still doing okay and exhibited normal affect, no
hallucinations, and showed proper orientation. (Tr. at 344.) On May 24, 2013, she
stated that she was doing okay but also noted some panic attacks, daily stressors,
daily depressive moods and social isolation. (Tr. at 369). Throughout her monthly
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visits until September 2013, she continued to report that she was doing okay but
that she still suffered from some of the same problems such as poor sleep and
depressed mood.
The ALJ considered the above-referenced treatment notes in evaluating
whether Plaintiff had any severe impairment. He found it important that her GAF
score quickly improved from a 45 in November 2011 to a 55 in March 2012,
apparently due to medication and counseling. (Tr. at 52.) He further stated that
while the records showed “some waxing and waning of symptoms, . . . generally the
claimant was reported to be compliant with medication an doing ‘ok.’” (Id.)
Plaintiff argues that these records suggest that her condition deteriorated,
rather than improved, from 2011 to 2013. However, the Court cannot say that
substantial evidence does not support the ALJ’s analysis of these treatment
records. See Dyer, 395 F.3d at 1212 (noting that even if the court disagrees with the
ALJ’s resolution of the factual issues and would resolve those disputed factual
issues differently, his decision must be affirmed where it is supported by substantial
evidence in the record as a whole).
B.
Dr. Blanton’s Opinion
On May 30, 2012, Dr. Blanton conducted a mental evaluation of Ms. Guy at
the request of the State Agency Disability Determination Service. (Tr. at 256-60.)
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As the ALJ noted, his examination showed signs for diagnosed depressive disorder
and panic disorder without agoraphobia. (Tr. at 260.) He assessed a GAF score of
50. (Id.) In evaluating his opinion, the ALJ noted that he is a Licensed Professional
Counselor and not a Licensed Clinical Psychologist. (Tr. at 56.) The Social
Security administrative regulations explain that licensed therapists are not
“acceptable medical sources.” See 20 C.F.R. §§ 404.1513(a), 416.913(a),
(identifying acceptable medical sources). Rather, therapists are “other sources”
from which the Commissioner may use evidence. See 20 C.F.R. §§ 404.1513(d)(1),
416.913(d)(1). Accordingly, Dr. Blanton’s opinion was not entitled to any special
significance or consideration. See 20 C.F.R. §§ 404.1527(a)(2), 416.927(a)(2)
(defining medial opinions as “statements from physicians and psychologists or
other acceptable medical sources that reflect judgments about the nature and
severity of [the claimant’s] impairment(s), . . . .”) (emphasis added); see also Social
Security Rule (“SSR”) 06-03p, 2006 WL 2263437, at *2 (S.S.A) (only acceptable
medical sources can provide medical opinions and a licensed clinical social worker
is a medical “other source,” not an acceptable medical source).
Plaintiff argues that because the Social Security Disability Determination
Service ordered the evaluation from Dr. Blanton, the Commissioner should not
now be able to say that his opinion is entitled to no special weight because he was
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merely a therapist. That may be true, but regardless, the ALJ still considered Dr.
Blanton’s findings, consistent with the regulations, with respect to the severity of
Plaintiff’s impairments and the effect of her impairments on her functioning. (Tr.
at 52, 56). See 20 C.F.R. §§ 404.1513(a), (d)(1), 416.913(a), (d)(1); SSR 06-03p,
2006 WL 2263437, at *2. The ALJ emphasized that while Dr. Blanton reported a
GAF score, he did not offer an opinion on any of Plaintiff’s functional limitations.
As the ALJ noted, GAF scores may be helpful in formulating an RFC, but a low
GAF score, standing alone, does not evidence an impairment seriously interfering
with a claimant’s ability to work. (Tr. at 55.) In Wind v. Barnhart, the Eleventh
Circuit noted that the Social Security Administration has declined to endorse GAF
scores for “use in the Social Security and SSI disability programs,” and has
indicated that GAF scores have no “direct correlation to the severity requirements
of the mental disorders listings.” 133 F. App’x 684, 692 n.5 (11th Cir. 2005) (per
curiam) (citing 65 Fed. Reg. 50746, 50764–65 (Aug. 21, 2000)). Therefore, even if
Dr. Blanton’s opinion had been entitled to the weight given to acceptable medical
sources, the ALJ still applied the proper standards in evaluating Dr. Blanton’s
opinion and substantial evidence supports his evaluation.
C.
Failure to Develop the Record
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Plaintiff asserts that the ALJ needed to have ordered a mental health
evaluation in order to properly evaluate her claim, either from Dr. Blanton or from
another medical source he would deem acceptable. The ALJ has a duty to develop
the facts fully and fairly and to probe conscientiously for all of the relevant
information. Ware v. Schwieker, 651 F.2d 408, 414 (5th Cir. 1981). However, in all
social security disability cases, the claimant bears the ultimate burden of proving
disability and is responsible for furnishing or identifying medical and other
evidence regarding her impairments. See Bowen v. Yuckert, 482 U.S. 137, 146 n.5
(1987); 42 U.S.C. § 423(d)(5). Further, Plaintiff was represented at the
administrative level. (Tr. at 63-90.) As such, the ALJ did not have any sort of
heightened duty to develop the record on Plaintiff’s behalf. See Leiter v. Comm’r of
Soc. Sec., 377 F. App’x 944, 949 (11th Cir. 2010). Where the ALJ’s findings are
supported by evidence sufficient for a decision, the ALJ is not obligated to seek
additional medical testimony. See Wilson v. Apfel, 179 F.3d 1276, 1278 (11th Cir.
1999).
Furthermore, before remanding for further development of the record, a
reviewing court must consider “whether the record reveals evidentiary gaps which
result in unfairness or ‘clear prejudice.’” Smith v. Schweiker, 677 F.2d 826, 830
(11th Cir.1982) (quoting Ware, 651 F.2d at 413). “Although the ALJ has a duty to
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develop a full and fair record, there must be a showing of prejudice before [a
reviewing court] will remand for further development of the record.” Robinson v.
Astrue, 365 F. App’x 993, 995 (11th Cir. 2010) (citing Brown v. Shalala, 44 F.3d 931,
935 (11th Cir. 1995)).
Despite Plaintiff’s contentions, the ALJ had sufficient evidence in the record
on which to evaluate Plaintiff’s mental impairments. The ALJ discussed significant
mental health evidence contained in the record that related to the period at issue in
this case. As the ALJ observed, Plaintiff did not seek mental health treatment until
October 2011, and while the treatment notes from West Alabama Mental Health
Center showed some mental “ups and downs,” they also showed general
improvement and that Plaintiff has been relatively stable on medication. (Tr. at
228-55, 333-55, 362-70.)
D.
Credibility
Plaintiff states that her testimony provides insight into her mental functional
limitations, and thus implies that the ALJ erred in making his credibility
determination. In her Function Report on May 3, 2012, Ms. Guy reported she
would eat a bowl of cereal in the morning, take her medications, and watch
television. (Tr. at 203). She did not take care of any other people or any pets; stress
and anxiety woke her up during the night about every two hours; and at times she
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did not want to bathe or care for her hair. (Tr. at 204). She required reminders to
take her medication. The only meals she could prepare were sandwiches or frozen
dinners. She tried to do laundry and housework but did not finish what she started.
(Tr. at 205). She did not like to drive because she got nervous. She could shop for
grocery items, but it would take two and half to three hours because she could not
make up her mind what to purchase. (Tr. at 206). She reported poor memory and
concentration. She had no social activities and liked to stay at home. (Tr. at 207).
She reported problems with anger, mood swings, anxiety, depression, stress,
memory, concentration, understanding, following instructions and getting along
with others. (Tr. at 208). She was easily stressed, angry, frustrated and nervous.
She was afraid of large bodies of water, had a fear of dying, and was afraid of
something happening to her children or grandchildren. (Tr. at 209). At her hearing,
Ms. Guy testified she became unable to work because of anxiety attacks and
depression. (Tr. at 68). She testified her daughter lived next door and did her
household chores and cooking. (Tr. at 75, 78). She testified to crying easily. (Tr. at
76). She testified she had trouble concentrating and focusing and did not like to be
around people. (Tr. at 77). She testified when her daughter was at work she would
get assistance from neighbors or her son. (Tr. at 80).
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The Social Security Administration’s regulations at 20 C.F.R. §§ 404.1529,
416.929 identify how the agency evaluates symptoms, including pain. According to
the regulations, statements about pain and other symptoms will not alone establish
disability; medical signs or laboratory findings must show there is a medical
impairment that could reasonably be expected to produce the pain or other
symptoms alleged. See 20 C.F.R. §§ 404.1529(a), 416.929. If medical signs or
laboratory findings demonstrate the existence of such a medical impairment, then
the agency will consider the subjective allegations of pain and other symptoms
along with all of the other evidence. Id. As part of the analysis, the agency will
evaluate the intensity and persistence of the claimant’s symptoms and the extent to
which the alleged symptoms affect the claimant’s functional limitations. See 20
C.F.R. §§ 404.1529, 416.929.
Interpreting these regulations, the Eleventh Circuit held that to establish
disability based on testimony of pain and other symptoms, a claimant must satisfy
two parts of a three-part test showing: (1) evidence of an underlying medical
condition; and (2) either (a) objective medical evidence confirming the severity of
the alleged pain; or (b) that the objectively determined medical condition can
reasonably be expected to give rise to the claimed pain. See Wilson v. Barnhart, 284
F.3d 1219, 1225 (11th Cir. 2002) (citing Holt v. Sullivan, 921 F.2d 1221, 1223 (11th
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Cir. 1991)). The regulations contain the same language as the pain standard. See
Wilson, 284 F.3d at 1225. Thus, by citing to §§ 404.1529 and 416.929 in his
decision, “it is clear that the ALJ applied this Circuit’s pain standard.” Wilson, 284
F.3d at 1226. When evidence documents an impairment that could reasonably be
expected to produce the symptoms alleged by a claimant, the Commissioner then
evaluates the intensity and persistence of the symptoms to determine how the
symptoms limit the claimant’s capacity for work. See 20 C.F.R. §§ 404.1529(c)(1),
416.929(c)(1). In making a credibility finding, the ALJ must articulate specific
reasons for questioning Plaintiff’s credibility, and his reasons for rejecting
Plaintiff’s testimony must be supported by substantial evidence. See Dyer, 395 F.3d
at 1210. “A clearly articulated credibility finding with substantial supporting
evidence in the record will not be disturbed by a reviewing court.” Foote v. Chater,
67 F.3d 1553, 1562 (11th Cir. 1995).
In evaluating Plaintiff’s subjective complaints, the ALJ examined the
evidence of record and found it did not support her allegations. For example,
Plaintiff not only testified about her mental impairments but also her physical
condition. She testified that pain in her ankle after a car accident was at an “8” out
of “10,” that she could walk less than a football field, stand up for only 10 minutes
at a time, and sit for only 30 minutes at a time, that she had to lie down for three to
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four hours a day with her leg elevated for ankle swelling and pain, and that although
no doctor prescribed her a cane she purchased one anyway to help her walk. (Tr. at
68-70.) However, the ALJ found these statements less than credible because
treatment records indicate that Plaintiff’s ankle healed and she made no more than
occasional complaints of pain to physicians and was treated conservatively with
Motrin. (Tr. at 317-20). Additionally, while Plaintiff testified that her blood
pressure medicine and Motrin made her drowsy, the ALJ noted that the record
showed no significant medication side effects to corroborate her testimony. (Tr. at
56). As the ALJ observed, none of her treating physicians have indicated that she
was unable to perform work related activities or placed any mental or physical
restrictions on her, and that in fact treatment records show that Plaintiff was
encouraged to increase her activity “without any evidence whatsoever that she
needs to lie down as much as half a day watching television with her feet or legs
propped up.” (Tr. at 56, 323). With specific regard to the ALJ’s rejection of her
testimony regarding her mental impairments, the ALJ noted that Plaintiff had no
mental health treatment until October 2011 and she has improved since that time.
(Tr. at 56.) The ALJ’s discussion shows that he considered the entire record in
evaluating Plaintiff’s subjective complaints.
E.
Consideration of Dr. Blanton’s Second Opinion
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After her hearing, Ms. Guy had a second examination by Dr. Blanton on
October 2, 2013. Dr. Blanton again diagnosed Major Depressive Disorder,
recurrent. He also administered IQ testing, resulting in a full scale IQ score of 74
and a diagnosis of borderline intellectual functioning. (Tr. at 384, 386). Dr.
Blanton’s second report was electronically submitted on October 10, 2013. The
ALJ issued an Unfavorable Decision on October 18, 2013, that did not reference
Dr. Blanton’s second report. Upon inquiry by Plaintiff’s attorney, the report was
located in the “Case Documents” portion of the electronic folder. The electronic
folder indicates the document was received on October 10, 2013.
Plaintiff contends that the ALJ did not consider or discuss Dr. Blanton’s
October 2, 2013 opinion when he should have. However, Plaintiff concedes that
this second examination report was submitted after the hearing. Although the
report was submitted before the ALJ rendered his opinion, Plaintiff’s counsel did
not ask the ALJ to hold the record open at the hearing, nor did he inform the ALJ
that he intended to submit additional records. (Tr. at 63-90). In fact, the ALJ asked
Plaintiff’s counsel whether he had anything to add to the record, and Plaintiff’s
counsel responded in the negative. (Tr. at 67).
Although the ALJ did not discuss Dr. Blanton’s second opinion, the Appeals
Council considered the post-hearing evidence, but found that it did not provide a
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basis for changing the ALJ’s decision. (Tr. at 6). The Appeals Council considers
the entire record, including the new, material, and chronologically relevant
evidence, and will review the ALJ’s decision if it finds the ALJ’s action, findings,
or conclusion is contrary to the weight of the evidence currently of record. See
Ingram v. Comm’r, 496 F.3d 1253, 1261 (11th Cir. 2007) (citing 20 C.F.R §
404.970(b)). This Court also considers the entire record, including the evidence
submitted to the Appeals Council, under the substantial evidence standard, to
determine “whether the new evidence renders the denial of benefits erroneous.”
Id. at 1262-63, 1266-67.
The additional evidence Plaintiff submitted does not demonstrate that
substantial evidence did not support the ALJ’s decision the Appeals Council
properly denied review. See 20 C.F.R. §§ 404.970(b), 416.1570(b). Plaintiff
contends that this report deserves additional consideration because Dr. Blanton
offered a functional assessment, which the ALJ had noted was not contained in Dr.
Blanton’s first report. The second time around, the therapist stated that Ms. Guy
had
marked limitations that seriously interfere with her ability to perform
work-related activities on a day-to-day basis in a regular work setting
in the following areas: understand detailed or complex instructions,
use judgment in detailed or complex work-related decisions, respond
[to] customary work pressure, maintain attention and concentration
and pace for a period of at least two hours. It is my opinion that her
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emotional problems have been present at this level for at least one year
and that her low intellect is a lifelong condition. It is also my opinion
that her emotional problems are likely to worsen if she’s placed under
stress especially that of a job.
(Tr. at 385). However, as previously discussed, Dr. Blanton is not a medical source
whose opinion is worthy of deference or special consideration. See 20 C.F.R. §§
404.1513(d)(1), 416.913(d)(1). Even if he was, his treatment notes are not
consistent with his ultimate opinion. See 20 C.F.R. §§ 404.1527(d), 416.927(d) (the
weight to be afforded a medical opinion regarding the nature and severity of a
plaintiff’s impairments depends, among other things, upon the examining and
treating relationship the medical source had with the plaintiff, the evidence the
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) (emphasis added).
During his mental status examination on the day he offered his opinion, Dr.
Blanton noted logical thoughts and conversation. (Tr. at 383). Plaintiff’s
associations remained intact and she showed flat, but appropriate affect. (Tr. at
383). Plaintiff showed no confusion or evidence of hallucination, delusions, or
paranoia. (Tr. at 383). She remained alert and oriented to place, person, and
situation. (Tr. at 383). Additionally, Dr. Blanton found Plaintiff’s judgment
remained fair for work and financial type decisions. (Tr. at 383). He further noted
that Plaintiff could shop and handle her own money. (Tr. at 384). Given the record
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as a whole, including Dr. Blanton’s October 2013 report, substantial evidence
supports the ALJ’s decision.
IV.
Conclusion
Upon review of the administrative record, and considering all of Ms. Guy’s
arguments, the Court finds the Commissioner’s decision is supported by
substantial evidence and in accord with the applicable law. A separate order will be
entered.
DONE and ORDERED on September 27, 2016.
_____________________________
L. Scott Coogler
United States District Judge
160704
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