Proctor v. Commissioner of Social Security
Filing
23
ORDER re 1 Complaint filed by James Wesley Proctor. The decision of the Commissioner is AFFIRMED. The Clerk of Court is directed to enter final judgment in favor of the Commissioner and close the case. Signed by Magistrate Judge Julie S. Sneed on 8/25/2016. (LBL)
UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
TAMPA DIVISION
JAMES WESLEY PROCTOR,
Plaintiff,
v.
Case No: 8:15-cv-1228-T-JSS
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
___________________________________/
ORDER
Plaintiff, James Wesley Proctor, seeks judicial review of the denial of his claim for
disability insurance benefits and supplemental security income. As the Administrative Law
Judge’s (“ALJ”) decision was based on substantial evidence and employed proper legal standards,
the decision is affirmed.
BACKGROUND
A.
Procedural Background
Plaintiff filed applications for disability insurance benefits and supplemental security
income on June 2, 2011. (Tr. 235–248.) The Commissioner denied Plaintiff’s claims both initially
and upon reconsideration. (Tr. 66–111.) Plaintiff then requested an administrative hearing. (Tr.
7.) Upon Plaintiff’s request, the ALJ held a hearing at which Plaintiff appeared and testified. (Tr.
45–65.) After the hearing, Plaintiff underwent psychological consultative examinations. (Tr. 486–
494, 510–521.) Thereafter, a supplemental hearing was held before the ALJ. (Tr. 28–44.)
Following the supplemental hearing, the ALJ issued an unfavorable decision finding
Plaintiff not disabled and, accordingly, denied Plaintiff’s claims for benefits.
(Tr. 8–27.)
Subsequently, Plaintiff requested review from the Appeals Council, which the Appeals Council
denied. (Tr. 1–6.) Plaintiff then timely filed a complaint with this Court. (Dkt. 1.) The case is
now ripe for review under 42 U.S.C. §§ 405(g) and 1383(c)(3).
B.
Factual Background and the ALJ’s Decision
Plaintiff, who was born in 1965, claimed disability beginning on May 1, 2011. (Tr. 235,
242.) Plaintiff has a twelfth grade education. (Tr. 48, 280.) Plaintiff’s past relevant work
experience included work as a short order cook and kitchen helper. (Tr. 19.) Plaintiff alleged
disability due to lumbar disc problems and pain, depression, and suicidal tendencies. (Tr. 280.)
In rendering the decision, the ALJ concluded that Plaintiff had not performed substantial
gainful activity since May 1, 2011, the alleged onset date. (Tr. 13.) The ALJ determined that
Plaintiff had the following severe impairments: depressive disorder, degenerative disc disease,
panic disorder, post-traumatic stress disorder, pain disorder, cognitive disorder, and borderline
intellectual functioning. (Tr. 13.) Notwithstanding the noted impairments, the ALJ determined
that Plaintiff did not have an impairment or combination of impairments that met or medically
equaled one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (“Listings”),
specifically Listings 1.04, 12.04, 12.05, or 12.06. (Tr. 14–15.) The ALJ then concluded that
Plaintiff retained the following residual functional capacity (“RFC”):
[T]o perform light work, as defined in 20 CFR 404.1567(b) and 416.967(b), with
the following limitations: he can lift and/or carry 20 pounds occasionally, 10
pounds frequently; stand and/or walk for 6 hours in an 8-hour day; and sit for 6
hours in an 8-hour day. He can occasionally climb ramps and stairs, balance, stoop,
kneel, crouch and crawl; however, he must avoid climbing ladders, ropes or
scaffolds. He is able to perform simple, routine, repetitive tasks; and he can
understand, remember and carry out simple instructions. He is able to adapt to
infrequent changes in the work setting. He is limited to work that requires
occasional interaction with coworkers. He is limited to work that requires
occasional supervision.
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(Tr. 15.) In formulating Plaintiff’s RFC, the ALJ considered Plaintiff’s subjective complaints and
determined that, although the evidence established the presence of underlying impairments that
reasonably could be expected to produce the symptoms alleged, Plaintiff’s statements as to the
intensity, persistence, and limiting effects of his symptoms were not fully credible. (Tr. 18.)
Considering Plaintiff’s noted impairments and the assessment of a vocational expert
(“VE”), the ALJ determined that Plaintiff could not perform his past relevant work. (Tr. 19.)
Given Plaintiff’s background and RFC, the VE testified that Plaintiff could perform other jobs
existing in significant numbers in the national economy, such as an electric equipment assembler,
hand packer, shoe packer, and packing line worker. (Tr. 20.) Accordingly, based on Plaintiff’s
age, education, work experience, RFC, and the testimony of the VE, the ALJ found Plaintiff not
disabled. (Tr. 20.)
APPLICABLE STANDARDS
To be entitled to benefits, a claimant must be disabled, meaning that the claimant must be
unable to engage in any substantial gainful activity by reason of any medically determinable
physical or mental impairment that can be expected to result in death or that has lasted or can be
expected to last for a continuous period of not less than twelve months. 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 that are demonstrable by medically acceptable
clinical and laboratory diagnostic techniques. 42 U.S.C. §§ 423(d)(3), 1382c(a)(3)(D).
The Social Security Administration, in order to regularize the adjudicative process,
promulgated the detailed regulations currently in effect. These regulations establish a “sequential
evaluation process” to determine whether a claimant is disabled. 20 C.F.R. § 416.920. If an
individual is found disabled at any point in the sequential review, further inquiry is unnecessary.
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20 C.F.R. § 416.920(a). Under this process, the ALJ 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, i.e., one that significantly limits the ability to perform workrelated functions; (3) whether the severe impairment meets or equals the medical criteria of a
Listing; and, (4) whether the claimant can perform his or her past relevant work. If the claimant
cannot perform the tasks required of his or her prior work, step five of the evaluation requires the
ALJ to decide if the claimant can do other work in the national economy in view of the claimant’s
age, education, and work experience. 20 C.F.R. § 416.920(a). A claimant is entitled to benefits
only if unable to perform other work. Bowen v. Yuckert, 482 U.S. 137, 140–42 (1987); 20 C.F.R.
§ 416.920(g).
A determination by the Commissioner that a claimant is not disabled must be upheld if it
is supported by substantial evidence and comports with applicable legal standards. See 42 U.S.C.
§ 405(g). Substantial evidence is “such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting
Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)); Miles v. Chater, 84 F.3d 1397, 1400
(11th Cir. 1996). While the court reviews the Commissioner’s decision with deference to the
factual findings, no such deference is given to the legal conclusions. Keeton v. Dep’t of Health &
Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994).
In reviewing the Commissioner’s decision, the court may not decide the facts anew, reweigh the evidence, or substitute its own judgment for that of the ALJ, even if it finds that the
evidence preponderates against the ALJ’s decision. Bloodsworth v. Heckler, 703 F.2d 1233, 1239
(11th Cir. 1983). The Commissioner’s failure to apply the correct law, or to give the reviewing
court sufficient reasoning for determining that he or she has conducted the proper legal analysis,
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mandates reversal. Keeton, 21 F.3d at 1066. The scope of review is thus limited to determining
whether the findings of the Commissioner are supported by substantial evidence and whether the
correct legal standards were applied. 42 U.S.C. § 405(g); Wilson v. Barnhart, 284 F.3d 1219, 1221
(11th Cir. 2002).
ANALYSIS
Plaintiff challenges the ALJ’s decision on the following grounds: (1) at step three of the
sequential process, the ALJ erred in his findings as to whether Plaintiff’s impairments met or
equaled Listing 12.05C; (2) the ALJ failed to articulate good cause for discounting a treating
physician’s opinions; and (3) the ALJ’s assessment of Plaintiff’s RFC failed to incorporate the
severity of limitations opined by consultative examining physicians regarding Plaintiff’s ability to
interact with co-workers and supervisors. For the reasons that follow, these contentions do not
warrant reversal.
A.
Step Three of the Sequential Process
Plaintiff contends that the ALJ erred at step three of the sequential process in his finding
that Plaintiff’s impairments did not meet or equal Listing 12.05C. (Dkt. 16 at 5–17.) The ALJ
concluded that Plaintiff had the following severe impairments: depressive disorder, degenerative
disc disease, panic disorder, post-traumatic stress disorder, pain disorder, cognitive disorder, and
borderline intellectual functioning. (Tr. 13.) However, the ALJ determined that, individually or
in combination, Plaintiff’s mental impairments did “not meet or medically equal the criteria” of
Listing 12.05C because Plaintiff “does not have a valid verbal, performance, or full scale IQ of 60
through 70 and a physical or other mental impairment imposing an additional and significant workrelated limitation of function.” (Tr. 14–15.)
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Plaintiff concedes that his IQ score of 71 is too high to meet Listing 12.05C. (Dkt. 16 at
7.) However, Plaintiff contends that the ALJ erred by ending his analysis of whether Plaintiff met
12.05C “after the ALJ [found] that [Plaintiff’s] IQ score does not ‘meet’ the listing” without
making findings as to the other elements of Listing 12.05C. (Dkt. 16 at 9.) Specifically, Plaintiff
contends that the ALJ erred by not making findings as to whether Plaintiff has “a physical or other
mental impairment imposing an additional and significant work-related limitation of function” or
deficits in adaptive functioning prior to reaching age twenty-two. (Dkt. 16 at 8–9.) Plaintiff
contends that he met the physical or mental impairments prong because the ALJ found that Plaintiff
has severe impairments and that the evidence shows Plaintiff’s adaptive functioning deficits. (Dkt.
16 at 8, 9–13.)
Plaintiff’s “main assignment of error” (Dkt. 22 at 1), however, is that the ALJ erred by
failing to consider whether his intellectual impairment is “medically equivalent” to Listing 12.05C.
(Dkt. 16 at 6; Dkt. 22 at 1–2.) Plaintiff contends that the ALJ was required to consider whether
Plaintiff’s impairments medically equaled the severity of Listing 12.05C even though Plaintiff did
not meet Listing 12.05C. (Dkt. 22 at 1.) Remand is appropriate, Plaintiff argues, for the ALJ to
make findings as to whether Plaintiff met the other elements of Listing 12.05C and as to whether
Plaintiff’s impairments equaled Listing 12.05C. (Dkt. 22 at 1–2.)
At the third step of the sequential process, the ALJ considers “the medical severity” of the
claimant’s impairments and the claimant is disabled if the ALJ finds the impairments meet or equal
a Listing. 20 C.F.R. § 416.920(a)(4)(iii). Thus, “[a] claimant may prove that he is disabled by
either (1) meeting the listings or (2) equaling the listings.” Wilkinson on Behalf of Wilkinson v.
Bowen, 847 F.2d 660, 662 (11th Cir. 1987) (emphasis in original). “The Secretary explicitly has
set the medical criteria defining the listed impairments at a higher level of severity than the
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statutory standard” and a finding that a claimant meets or equals a Listing is a finding that the
claimant is unable of “performing any gainful activity, not just ‘substantial gainful activity.’”
Sullivan v. Zebley, 493 U.S. 521, 532 (1990) (emphasis in original).
To meet a Listing, the claimant must “(1) have a diagnosed condition that is included in
the listings and (2) provide objective medical reports documenting that this condition meets the
specific criteria of the applicable listing and the duration requirement.” Wilkinson, 847 F.2d at
662. Thus, “[f]or a claimant to show that his impairment matches a listing, it must meet all of the
specified medical criteria” and “[a]n impairment that manifests only some of those criteria, no
matter how severely, does not qualify.” Sullivan, 493 U.S. at 530 (emphasis in original).
To meet Listing 12.05C, a claimant’s impairment must first satisfy “the diagnostic
description in the introductory paragraph,” to Listing 12.05, which requires that a claimant
demonstrate significantly subaverage general intellectual functioning with deficits in adaptive
functioning initially manifested before age twenty-two. 20 C.F.R., Pt. 404, Subpt. P, App. 1, §§
12.00A, 12.05. In addition to meeting the diagnostic threshold, a claimant must show evidence of
(1) a valid IQ score of 60 through 70 and (2) “a physical or other mental impairment imposing an
additional and significant work-related limitation of function.” Id. § 12.05C; Frame v. Comm’r,
Soc. Sec. Admin., 596 F. App’x 908, 910–911 (11th Cir. 2015). Therefore, Listing 12.05C requires
that a “claimant meet[] the diagnostic criteria of Listing 12.05, including deficits in adaptive
functioning; a qualifying IQ score; onset before age 22; and the requisite deficits in work-related
functioning.” Perkins v. Comm’r, Soc. Sec. Admin., 553 F. App’x 870, 873 (11th Cir. 2014).
To equal a Listing, the claimant “must present medical findings equal in severity to all the
criteria for the one most similar listed impairment.” Sullivan, 493 U.S. at 531 (emphasis in
original). “A claimant cannot qualify for benefits under the ‘equivalence’ step by showing that
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the overall functional impact of his unlisted impairment or combination of impairments is as severe
as that of a listed impairment.” Id. “If a claimant has more than one impairment, and none meets
or equals a listed impairment, the Commissioner reviews the impairments’ symptoms, signs, and
laboratory findings to determine whether the combination is medically equal to any listed
impairment.”
Wilson, 284 F.3d at 1224.
The Social Security Administration’s Program
Operations Manual System (“POMS”) describes the criteria for equaling Listing 12.05C:
Listing 12.05C is based on a combination of an IQ score with an additional and
significant mental or physical impairment. The criteria for this paragraph are such
that a medical equivalence determination would very rarely be required. However,
slightly higher IQ’s (e.g., 70-75) in the presence of other physical or mental
disorders that impose additional and significant work-related limitation of function
may support an equivalence determination. It should be noted that generally the
higher the IQ, the less likely medical equivalence in combination with another
physical or mental impairment(s) can be found.
Soc. Sec. Admin., Program Operations Manual System, DI 24515.056 (2016).1
The burden is on the claimant to show that he meets or equals a Listing. Wilkinson, 847
F.2d at 662. To meet a Listing, the claimant must “present specific medical findings that meet the
various tests listed under the description of the applicable impairment.” Id. To equal a Listing,
the claimant “must present evidence which describes how the impairment has such an
equivalency.” Id.
The reviewing Court must determine whether substantial evidence supports the ALJ’s
determination regarding whether a claimant meets or equals a Listing. Hutchison v. Bowen, 787
F.2d 1461, 1463 (11th Cir. 1986) (discussing the ALJ’s finding as to whether claimant met a
Listing and holding that “[t]he proper standard in reviewing the Secretary’s findings of fact is
whether there is substantial evidence to support those findings and inferences”); See Dunlop v.
Comm’r of Soc. Sec., 518 F. App’x 691, 693 (11th Cir. 2013) (affirming the ALJ’s decision
1
The POMS is available at https://secure.ssa.gov/poms.nsf/lnx/0424515056.
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because “[r]egardless of the evidence that might suggest that [claimant’s] impairments were more
severe than the ALJ concluded, the record as a whole contains sufficient evidence for a reasonable
person to accept the ALJ’s conclusion that [claimant’s] impairments did not meet, medically equal,
or functionally equal a listed impairment”); McMillian, on Behalf of A.T.F. v. Comm’r of Soc. Sec.,
521 F. App’x 801, 803 (11th Cir. 2013) (“Substantial evidence supported the ALJ’s determination
that [claimant’s] impairments did not medically equal a Listing”); Turberville ex rel. Rowell v.
Astrue, 316 F. App’x 891, 893 (11th Cir. 2009) (concluding that although “the ALJ did not
explicitly discuss why [claimant] did not actually meet Listing 112.05—substantial record
evidence supports that [claimant’s] condition did not actually or functionally meet Listing 112.05
and, therefore, supports the ALJ’s ultimate conclusion that [claimant] was not disabled.”). Thus,
while the ALJ is required to consider whether the claimant’s impairments meet or equal a Listing,
the ALJ is not required to “mechanically recite the evidence leading to her determination” and
even an implicit finding that a claimant does not meet a Listing is upheld if supported by substantial
evidence. Hutchison, 787 F.2d at 1463.
In this case, the ALJ concluded that Plaintiff does “meet or medically equal the criteria of”
Listing 12.05C “because the claimant does not have a valid verbal, performance, or full scale IQ
of 60 through 70 and a physical or other mental impairment imposing an additional and significant
work-related limitation of function (14F).” (Tr. 14–15.) The ALJ’s finding that Plaintiff did not
have a valid IQ score between 60 and 70 is supported by substantial evidence. Specifically, the
ALJ cited to and accorded “great weight” (Tr. 15, 17) to a March 2013 psychological report
prepared by consultative examining physician Dr. Cecilia Yocum based on Dr. Yocum’s March
18, 2013 evaluation of Plaintiff. (Tr. 486–494.) During the evaluation, Dr. Yocum administered
the Wechsler Adult Intelligence Scale-Fourth Edition and Plaintiff obtained a full scale IQ score
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of 71, a verbal comprehension score of 74, a perceptual reasoning score of 75, a working memory
score of 71, and a processing speed score of 65. (Tr. 488.) Dr. Yocum noted that these scores
“indicate borderline intellectual functioning.”2 (Tr. 488.) Thus, the ALJ’s finding as to Plaintiff’s
IQ score is supported by Dr. Yocum’s report. Plaintiff must show that he meets “all of the
specified medical criteria” of Listing 12.05C. See Sullivan, 493 U.S. at 530 (emphasis in original).
Because Plaintiff could not meet the IQ requirement of Listing 12.05C, the ALJ’s finding that
Plaintiff does not meet Listing 12.05C was proper.
Plaintiff argues that, even though he could not meet Listing 12.05C because of his IQ score,
the ALJ should have made findings as whether Plaintiff met the other elements of 12.05C and
whether Plaintiff’s impairments were the medical equivalent of Listing 12.05. (Dkt. 16 at 8–13.)
However, the ALJ was not required to “mechanically recite the evidence leading to [his]
determination” and the decision will be upheld if it is supported by substantial evidence.
Hutchison, 787 F.2d at 1463. Upon review of the evidence, the Court finds that the ALJ’s finding
that Plaintiff did not meet or equal Listing 12.05 is supported by substantial evidence.
Specifically, the ALJ considered Plaintiff’s testimony regarding his ability to work part
time and his daily activities. Plaintiff testified that, at the time of Plaintiff’s hearings before the
ALJ, he was working as a cook and dishwasher three days a week. (Tr. 16, 18, 48–49.) The ALJ
also considered Plaintiff’s testimony that he is able to read “simple sentences” and add “on [his]
fingers.” (Tr. 18, 34.) As to his ability to do chores, Plaintiff testified that he vacuums, washes
the dishes, and does laundry. (Tr. 55.) The ALJ considered this testimony and accordingly limited
Plaintiff’s RFC to “performing simple, routine, repetitive tasks,” understanding, remembering, and
2
It should be noted that Dr. Yocum’s finding that Plaintiff’s IQ score indicates “borderline intellectual functioning”
further supports the ALJ’s determination that Plaintiff did not meet Listing 12.05C because a diagnosis of “ borderline
intellectual functioning . . . is mutually exclusive of [intellectual disability]. Jordan v. Comm’r of Soc. Sec. Admin.,
470 F. App’x 766, 768 (11th Cir. 2012).
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carrying out simple instructions, adapting to “infrequent changes in the work setting” interacting
occasionally with co-workers, and being occasionally supervised. (Tr. 18.) The ALJ also
considered the findings of the Disability Determination Service, in its denial of Plaintiff’s claims
initially and upon reconsideration, that Plaintiff had no severe mental impairments, but concluded
that Plaintiff does have severe, but not totally disabling, mental impairments. (Tr. 19, 70, 79, 93,
103.)
Next, the ALJ gave “great weight” to Dr. Yocum’s opinions. (Tr. 17.) In the narrative
portion of her report, Dr. Yocum found Plaintiff’s speech to be “fairly clear, coherent, logical, and
rational but a little stilted.” (Tr. 488.) Dr. Yocum found that Plaintiff had limited concentration
and trouble interpreting a “simple proverb,” although Plaintiff had fair “[j]udgment into
hypothetical social situations.” (Tr. 488.) As far as Plaintiff’s adaptive functioning, Dr. Yocum
found that Plaintiff can tend to his self-care, tell time, do some household chores, including
cleaning his room, doing dishes, using the microwave, and doing laundry, buy groceries and
clothes, manage his money, drive a scooter, and talk on the phone. (Tr. 488.) Plaintiff did,
however, report difficulty reading, “although he can read signs,” and getting along with others.
(Tr. 488.)
In her medical source statement, Dr. Yocum found that Plaintiff had no difficulties
understanding, remembering, or carrying out simple instructions or making simple work-related
decisions, moderate difficulties with complex work-related decisions, and marked difficulties with
understanding, remembering, or carrying out complex instructions. (Tr. 491.) As far as his ability
to interact with others, Dr. Yocum found that Plaintiff has mild difficulties with interacting
appropriately with the public, moderate difficulties responding appropriately to “usual work
situations and to changes in a routine work setting,” and marked difficulties with interacting
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appropriately with supervisors and co-workers. (Tr. 492.) Dr. Yocum stated that these findings
were based on Plaintiff’s reports of his “difficulties getting along with coworkers and supervisors
due to anger problems and poor work performance.” (Tr. 491.)
The ALJ afforded “significant weight” to a consultative psychological examination
performed by Dr. Jeremy Zehr in July 2011. (Tr. 16, 410–413.) In his disability evaluation, Dr.
Zehr noted that, at the time of the evaluation, Plaintiff worked twenty-five hours per week. (Tr.
410.) Dr. Zehr noted that Plaintiff worked full time for the majority of the past twenty-five years
and that he began working part time due to back pain. (Tr. 411.) Plaintiff “reported good
relationships with coworkers and supervisors,” but reported receiving verbal reprimands from
managers based on his work performance. (Tr. 411.) Dr. Zehr found that Plaintiff has a driver’s
license, drives a scooter, and is able to use public transportation independently. (Tr. 411–412.)
Further, Dr. Zehr found Plaintiff to be “appropriately dressed and groomed, with good basic
functioning and hygiene,” “alert and well oriented,” logical, coherent, and exhibiting appropriate
affect. (Tr. 412.) Overall, Dr. Zehr diagnosed Plaintiff with depressive disorder, but found his
prognosis to be “fair.” (Tr. 412–413.)
Finally, the ALJ considered a June 2013 psychological consultative examination
performed by Dr. Gerald Hodan. (Tr. 17–18, 510–521.) Plaintiff reported that his daily activities
included watching television, “trying to get some exercise” by walking, shopping at Walmart,
making small meals, and working. (Tr. 512.) Plaintiff reported working four days a week for
about five to six hours a day. (Tr. 512.) Dr. Hodan found that Plaintiff’s ability to independently
set realistic goals and make plans was “unlimited or very good,” but that Plaintiff is unable to
“meet competitive standards” as far as understanding, remembering, and carrying out “detailed”
instructions. (Tr. 520.) Further, he found Plaintiff’s adherence to basic cleanliness and neatness
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standards “unlimited or very good,” and his ability to interact with the general public “limited but
satisfactory.” (Tr. 520.) Dr. Hodan found that Plaintiff would need to be absent from work for
about four days per month. (Tr. 521.) The ALJ found that Plaintiff’s ability to work on a parttime basis “contradicts” Dr. Hodan’s opinions, although the ALJ did incorporate some of Dr.
Hodan’s opinions as to Plaintiff’s limitations in the ALJ’s analysis of whether Plaintiff met
different subsections of Listing 12.05. (Tr. 14–15, 18.)
The Court finds that the ALJ’s decision that Plaintiff does not meet or equal Listing 12.05C
is supported by substantial evidence. As set forth above, Plaintiff testified that he works part time
as a cook and dishwasher, which he has done for twenty-five years, and can attend to his daily
needs. The ALJ’s reliance on evidence of Plaintiff’s daily activities and ability to work was proper
and the evidence supports the ALJ’s conclusions. O’Neal v. Comm’r of Soc. Sec., 614 F. App’x
456, 459–60 (11th Cir. 2015) (determining that the ALJ’s conclusion that claimant did not meet
the adaptive functioning deficit requirement of Listing 12.05 was supported by substantial
evidence because claimant worked, at least part time, for many years, drove, and tended to his
home, personal care, and children independently); Harris v. Comm’r of Soc. Sec., 330 F. App’x
813, 815 (11th Cir. 2009) (finding that substantial evidence supported the ALJ’s determination
that claimant did not meet Listing 12.05 because he did well in his special education classes, held
jobs, and could tend to his personal care and money management). The ALJ’s decision is further
buttressed by the opinions of Dr. Yocum and Dr. Zehr. Accordingly, Plaintiff’s contention does
not warrant reversal.
B.
Weight Accorded to Treating Physician’s Opinions
Next, Plaintiff argues that the ALJ erred by failing to articulate good cause for discounting
the opinions of Plaintiff’s treating physician, Dr. Manjul Derasari.
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(Dkt. 16 at 19–23.)
Specifically, Plaintiff contends that if the ALJ had afforded Dr. Derasari’s opinion that Plaintiff
was not capable of performing full-time work, then Plaintiff would be entitled to benefits. (Dkt.
16 at 19–20.)
Medical opinions, which include physician statements regarding the nature and severity of
the claimant’s impairments, may support the ALJ’s determination of whether a claimant suffers
from a severe impairment. 20 C.F.R. § 404.1527(a)(2). When assessing the medical evidence, the
ALJ must state with particularity the weight afforded to different medical opinions and the reasons
therefor. Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 2011). In determining
the weight to afford a medical opinion, the ALJ considers the following factors: the examining and
treatment relationship between the claimant and doctor, the length of the treatment and the
frequency of the examination, the nature and extent of the treatment relationship, the supportability
and consistency of the evidence, the specialization of the doctor, and other factors that tend to
support or contradict the opinion. Hearn v. Comm’r, Soc. Sec. Admin., 619 F. App’x 892, 895
(11th Cir. 2015).
A treating physician’s opinion is “given substantial or considerable weight unless good
cause is shown to the contrary.” MacGregor v. Bowen, 786 F.2d 1050, 1053 (11th Cir. 1986). An
ALJ’s failure “to clearly articulate the reasons for giving less weight to the opinion of a treating
physician” is reversible error. Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997). Good
cause for giving a treating physician’s opinion less weight “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, 1240–1241 (11th Cir. 2004). Ultimately, the ALJ
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may reject the opinion of any physician if the evidence supports a contrary conclusion. Sryock v.
Heckler, 764 F.2d 834, 835 (11th Cir. 1985).
In assessing Plaintiff’s RFC, the ALJ examined Dr. Derasari’s treatment notes and opinions
set forth in Dr. Derasari’s physical RFC questionnaire. (Tr. 16–17.) In his physical RFC
questionnaire, Dr. Derasari opined that Plaintiff’s back pain frequently interferes with Plaintiff’s
attention and concentration. (Tr. 482.) He opined that Plaintiff is able to walk one to two blocks
without rest or severe pain, sit for two and a half hours and stand for two hours and forty-five
minutes before switching positions, and sit and “stand/walk” for two hours out of an eight hour
workday. (Tr. 482–483.) Further, he found that Plaintiff would need to take one, one-hour
unscheduled break per work day and would be absent from work about two days per month. (Tr.
483, 484.) Plaintiff could occasionally lift and carry twenty pounds, but never fifty pounds. (Tr.
483.) The ALJ did not accord Dr. Derasari’s opinions significant weight because they were not
“supported by the record as a whole” and were inconsistent with Dr. Derasari’s treatment notes
and Plaintiff’s testimony that he is able to work eight-hour days on a part-time basis. (Tr. 17.)
The Court finds that the ALJ articulated good cause for discounting Dr. Derasari’s opinions
because they were inconsistent with Dr. Derasari’s own treatment notes and were not bolstered by
the evidence. Upon review of the evidence, the ALJ’s determination is supported by substantial
evidence. Although Dr. Derasari’s treatment notes show that he treated Plaintiff’s back pain, they
reveal that Dr. Derasari found Plaintiff’s pain to be managed with medication, which enabled
Plaintiff to work, and could be improved with diet and exercise. Specifically, in January 2010
treatment notes, Dr. Derasari stated that “[f]rom the pain perspective, [Plaintiff] is doing good”
and stated that he would refill Plaintiff’s pain medications. (Tr. 395.) In April 2010 treatment
notes, Dr. Derasari stated that Plaintiff “continues to work and this [pain] medication is allowing
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him to remain functional.” (Tr. 394.) He noted that Plaintiff had been in an accident while on his
motor bike since his last visit and that his main injury was to his right shoulder. (Tr. 394.) At the
time of his accident, an x-ray was performed, which had normal results. (Tr. 394.) In July 2010
treatment notes, Dr. Derasari stated that Plaintiff’s use of a back brace “seems to be working and
helping him during his work.” (Tr. 393.)
In October 2010 treatment notes, Dr. Derasari stated that he intended to continue Plaintiff’s
pain medication regime because “the medicine is allowing him to remain functional and gainfully
employed.” (Tr. 392.) Dr. Derasari noted, in January 2011 treatment notes, that he was refilling
Plaintiff’s prescriptions because of pain due to standing in one position for long hours. (Tr. 391.)
In April 2011 treatment notes, Dr. Derasari stated that he recommended Plaintiff continue to do
stretching to relieve Plaintiff’s pain and maintain his fitness. (Tr. 390.) Dr. Derasari noted that
Plaintiff reported that he “is not able to fulfill the long hours and the physical demand of his work,”
and therefore was considering “cutting down the work and applying for the social security
disability.” (Tr. 390.) In July 2011 treatment notes, Dr. Derasari noted that he advised Plaintiff
to lose weight because that could help his back pain. (Tr. 428.) Plaintiff reported, at an August
2011 examination, that his pain worsened and Dr. Derasari recommended that Plaintiff “should
start developing core body strength” to help his back pain. (Tr. 427.) In October 2011 treatment
notes, Dr. Derasari noted that Plaintiff was walking for exercise, but Dr. Derasari recommended
that he lose weight and continue exercising to remain strong. (Tr. 426.) In July 2012 treatment
notes, Dr. Derasari noted that Plaintiff’s medications were working well and that Plaintiff was
working part time. (Tr. 464.) Thus, Dr. Derasari’s own treatment notes undermine the extent of
limitations he found in his physical RFC evaluation because his treatment notes demonstrate that
Plaintiff’s back pain was managed with medications, which enabled him to work.
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Additionally, the ALJ’s decision to discount Dr. Derasari’s opinions is supported by other
record evidence. Specifically, the ALJ noted that Plaintiff testified that, at the time of his hearings,
Plaintiff was working eight-hour days, albeit on a part-time basis. (Tr. 18, 31, 49.) Further,
treatment notes from Plaintiff’s visits to the emergency room in November 2012 and June 2013
show that Plaintiff’s back was “normal” and “nontender” and Plaintiff had a normal range of
motion, strength, and no tenderness or swelling. (Tr. 450, 525.) Finally, the ALJ considered the
opinions of Dr. Eniola Owi, a consultative examining physician. (Tr. 16–17.) Dr. Owi examined
Plaintiff in August 2011 and noted that Plaintiff reported that he works for three days a week and
exercises by walking and doing push-ups. (Tr. 414.) Dr. Owi noted that Plaintiff’s gait was normal
and that he did not require an assistive device and that Plaintiff was able to “do tandem gait, onelegged stance without difficulty” and that his “heel and toe gait” was normal, although a “little
unsteady.” (Tr. 416.) Although Plaintiff reported tenderness and palpitation in the lumbar spine,
Dr. Owi found no spasm. (Tr. 417.)
Therefore, the ALJ adequately articulated good cause for discounting Dr. Derasari’s
opinions because the ALJ explained that Dr. Derasari’s opinions were contradicted by Dr.
Derasari’s treatment notes and other record evidence showing that Plaintiff’s limitations were not
as limiting as opined by Dr. Derasari. The ALJ’s reasons are supported by substantial evidence
and, therefore, Plaintiff’s contention does not warrant reversal.
C.
The ALJ’s Assessment of Plaintiff’s RFC
Finally, Plaintiff contends that, in his assessment of Plaintiff’s RFC, the ALJ failed to
account for limitations opined by consulting physicians regarding Plaintiff’s ability to interact with
co-workers and supervisors. (Dkt. 16 at 23–25.) The ALJ found that Plaintiff retained the RFC
to do work that requires occasional interaction with co-workers and supervision. (Tr. 15.) Plaintiff
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argues, however, that Dr. Yocum found that Plaintiff had “marked” impairments in interacting
with supervisors and co-workers and that Dr. Hodan found that Plaintiff was “unable to meet
competitive standards” with respect to interacting with co-workers and supervisors. (Dkt. 16 at
23–24.) Further, Plaintiff cites the VE’s testimony that if the hypothetical claimant were limited
to “less than occasional interaction” with co-workers and supervisors, he would be unable to
perform the jobs listed by the VE. (Tr. 43.)
In Dr. Yocum’s medical source statement, Dr. Yocum opined that Plaintiff has “marked”
restrictions in interacting appropriately with supervisors and co-workers. (Tr. 492.) Dr. Yocum
was required to specify the “factors (e.g., the particular medical signs, laboratory findings, or other
factors described above)” supporting her assessment. (Tr. 492.) Dr. Yocum stated that Plaintiff
“reported he had difficulty getting along with coworkers and supervisors due to anger problems
and poor work performance.” (Tr. 492.) In the background portion of her medical source
statement, Dr. Yocum stated that Plaintiff reported that he “encountered problems with co-workers
and ‘people in general,’” had problems with management because “they are not satisfied with how
he works,” and has been “written up” for anger problems, but not fired. (Tr. 487.) Further, in her
findings as to Plaintiff’s adaptive functioning, Dr. Yocum noted that Plaintiff “reported problems
getting along with other people and has a very low tolerance for dealing with stress with others.”
(Tr. 488.)
In Dr. Hodan’s psychological evaluation, Dr. Hodan stated that Plaintiff reported that he
had “problems with his managers,” has been written up, and experienced anger when his managers
“tell him he is not working fast enough” or “is not doing something right.” (Tr. 512.) Further,
Plaintiff reported to Dr. Hodan that “when he is experiencing a high level of pain . . . he knows he
can be impatient, easily irritated, overreact to stressors with anger, and is intolerant of crowds and
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noise causing him to be quite socially withdrawn and isolated.” (Tr. 513.) After a one-hour
examination, Dr. Hodan completed a mental RFC questionnaire in which he opined that Plaintiff
would be “unable to meet competitive standards” with regard to “sustain[ing] an ordinary routine
without special supervision” and “work[ing] in coordination with or proximity to others without
being unduly distracted.” (Tr. 519.) The RFC questionnaire defined “unable to meet competitive
standards” as meaning that “your patient cannot satisfactorily perform this activity independently,
appropriately, effectively and on a sustained basis in a regular work setting.” (Tr. 519.) However,
Dr. Hodan found that Plaintiff’s ability to “get along with co-workers or peers without unduly
distracting them or exhibiting behavioral extremes” and “interact appropriately with the general
public” was “limited but satisfactory.” (Tr. 519, 520.) Further, Dr. Hodan found that Plaintiff was
“seriously limited, but not precluded,” meaning that his abilities were “seriously limited and less
than satisfactory, but not precluded in all circumstances” with regard to “accept[ing] instructions
and respond[ing] appropriately to criticism from supervisors,” “respond[ing] appropriately to
changes in a routine work setting,” and “deal[ing] with normal work stress.” (Tr. 519.)
First, it must be noted that Dr. Yocum and Dr. Hodan are both consultative examiners and,
as such, their opinions are not entitled to the deference normally given treating sources because
they are not treating physicians. McSwain v. Bowen, 814 F.2d 617, 619 (11th Cir. 1987) (finding
that opinions of consultative examining physicians “are not entitled to deference because as onetime examiners they were not treating physicians”); Crawford v. Comm’r of Soc. Sec., 363 F.3d
1155, 1160–161 (11th Cir. 2004) (“The ALJ correctly found that, because [a consultative
examiner] examined [claimant] on only one occasion, her opinion was not entitled to great
weight.”); 20 C.F.R. § 404.1527(c)(2) (explaining that treating sources are given greater weight
because their opinions “may bring a unique perspective to the medical evidence that cannot be
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obtained from the objective medical findings alone or from reports of individual examinations,
such as consultative examinations or brief hospitalizations”). Dr. Yocum and Dr. Hogan are not
Plaintiff’s treating physicians, rather they examined Plaintiff to provide opinions as to Plaintiff’s
social security applications. Thus, these opinions were not entitled to be accorded significant
weight by the ALJ.
Although Plaintiff concedes that the ALJ is not required to “credit every aspect of a medical
opinion” the ALJ finds entitled to great weight, Plaintiff argues that the ALJ erred by not
explaining why he did not incorporate Dr. Yocum’s and Dr. Hodan’s findings as to Plaintiff’s
ability to interact with co-workers and supervisors in his RFC assessment. (Tr. 25.) Plaintiff’s
contention is belied by the ALJ’s decision, which shows that the ALJ considered both opinions
and incorporated them into his assessment of Plaintiff’s RFC. (Tr. 17–18.)
Specifically, as to Dr. Yocum’s opinions, the ALJ noted that Dr. Yocum found that Plaintiff
mainly had mild or no limitations, and had “marked limitations only in interacting with supervisors
and co-workers.” (Tr. 17.) The ALJ stated that Plaintiff’s “limitations have been accommodated
in the residual capacity determination herein.” (Tr. 17.) To the extent the ALJ did not state
explicitly why he found Plaintiff capable of occasional interaction with co-workers and
supervisors, which is less limited than Dr. Yocum’s finding of a “marked” limitation, this finding
is proper because Dr. Yocum’s opinions were based upon Plaintiff’s subjective reports. As
discussed above, Dr. Yocum stated that her opinions as to Plaintiff’s ability to interact with coworkers and supervisors were based solely on Plaintiff’s reports that “he had difficulty getting
along with coworkers and supervisors due to anger problems and poor work performance.” (Tr.
492.)
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An ALJ may discredit a treating physician’s opinion that is inconsistent with the medical
evidence and is based on the claimant’s subjective complaints. Hoffman v. Astrue, 259 F. App’x
213, 218 (11th Cir. 2007) (finding the ALJ’s discrediting medical opinions proper because the
opinions were based on Plaintiff’s subjective complaints as to her mental impairments and were
inconsistent with the record); Majkut v. Comm’r of Soc. Sec., 394 F. App’x 660, 664 (11th Cir.
2010) (affirming an ALJ’s giving less weight to a treating physician’s opinions where the opinions
were “based on [claimant’s] subjective complaints” of symptoms of mental and psychological
impairments); Soroka v. Astrue, No. 8:08-CV-1423-T-TBM, 2009 WL 2424563, at *5 (M.D. Fla.
Aug. 5, 2009) (affirming the ALJ’s discrediting a physician’s opinions in part because the opinions
relied “‘quite heavily’” on the subjective complaints of the Plaintiff”). Therefore, because Dr.
Yocum’s opinions regarding the extent of Plaintiff’s limitations in interacting with co-workers and
supervisors were based solely on Plaintiff’s subjective reports, the ALJ’s decision to not
incorporate the severity of Dr. Yocum’s opined limitations was supported by substantial evidence.
As to Dr. Hodan’s opinions, the ALJ incorporated some of Dr. Hogan’s opinions into his
decision, but found that Dr. Hodan’s opinions that Plaintiff “could not sustain an ordinary routine
without special supervision” or “work in coordination with or proximity to others without being
unduly distracted,” were inconsistent with Plaintiff’s “continued ability to work three days a week,
8 hours a day.” (Tr. 18.) Thus, contrary to Plaintiff’s contention, the ALJ explained that his reason
for not incorporating Dr. Hodan’s opinions regarding Plaintiff’s ability to interact with co-workers
and supervisors was they were contradicted by Plaintiff’s ability to maintain part-time
employment. The ALJ’s finding is buttressed by Plaintiff’s testimony that he was working part
time (Tr. 31, 48–49) and his work history report, which shows that he has been employed at the
same restaurant since 1986 or 1987 (Tr. 260, 272), demonstrating that, despite Plaintiff’s reports
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of difficulties, he has been able to maintain employment with the same employer for three decades.
The ALJ’s finding is further supported by Dr. Zehr’s findings that Plaintiff “reported good
relationship with coworkers and supervisors,” although he had some difficulties with managers
based on them giving him reprimands because of his work performance. (Tr. 411.) Therefore, the
ALJ’s finding that Plaintiff is capable of occasional interaction with co-workers and supervisors,
despite the opinions of Dr. Yocum and Dr. Hodan finding more pronounced limitations, was
supported by substantial evidence.
Accordingly, Plaintiff’s final contention for reversal is
unwarranted.
CONCLUSION
Accordingly, after due consideration and for the foregoing reasons, it is
ORDERED:
1.
The decision of the Commissioner is AFFIRMED.
2.
The Clerk of Court is directed to enter final judgment in favor of the Commissioner
and close the case.
DONE and ORDERED in Tampa, Florida on August 25, 2016.
Copies furnished to:
Counsel of Record
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