Howell v. Commissioner of Social Security
Filing
22
ORDER re 1 Complaint filed by Shanna M. Howell. 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 6/14/2017. (SMC)
UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
TAMPA DIVISION
SHANNA M. HOWELL,
Plaintiff,
v.
Case No: 8:16-cv-745-T-JSS
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
___________________________________/
ORDER
Plaintiff, Shanna M. Howell, seeks judicial review of the denial of her claim for a period
of disability and disability insurance benefits. 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 an application for a period of disability and disability insurance benefits on
July 18, 2012. (Tr. 185.) The Commissioner denied Plaintiff’s claims both initially and upon
reconsideration. (Tr. 77, 95.) Plaintiff then requested an administrative hearing. (Tr. 107.) Upon
Plaintiff’s request, the ALJ held a hearing at which Plaintiff appeared and testified. (Tr. 37–65.)
Following the hearing, the ALJ issued an unfavorable decision finding Plaintiff not disabled and
accordingly denied Plaintiff’s claims for benefits. (Tr. 19–30.) Subsequently, Plaintiff requested
review from the Appeals Council, which the Appeals Council denied. (Tr. 1–4.) 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 42 U.S.C. § 1383(c)(3).
B.
Factual Background and the ALJ’s Decision
Plaintiff, who was born in 1971, claimed disability beginning on March 14, 2012. (Tr.
185.) Plaintiff has a limited education. (Tr. 190.) Plaintiff’s past relevant work experience
included work as a lab technician and a phlebotomist. (Tr. 29.) Plaintiff alleged disability due to
dyslexia, anxiety, depression, fibromyalgia, body pain, left heel pain, left knee pain, feet pain, neck
pain, lower back pain, weight gain, sleep apnea, Epstein-Barr, and chronic fatigue. (Tr. 189.)
In rendering the decision, the ALJ concluded that Plaintiff has not performed substantial
gainful activity since March 14, 2012, the alleged onset date. (Tr. 24.) After conducting a hearing
and reviewing the evidence of record, the ALJ determined that Plaintiff had the following severe
impairments: degenerative disc/joint disease, fibromyalgia, diabetes mellitus, sleep apnea, obesity,
anxiety disorder, major depressive disorder, history of learning disorder, and personality disorder.
(Tr. 24.) 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. (Tr. 24.) The ALJ then concluded that
Plaintiff retained a residual functional capacity (“RFC”) to perform sedentary work. (Tr. 26.) The
ALJ further restricted Plaintiff’s RFC, finding that Plaintiff has the mental limitation that allows
her to retain the ability to get to work and remember work procedures and is able to perform jobs
that require no more than one month to learn. The ALJ further found that Plaintiff is able to
maintain attention and concentration for two hours at a time, show up on time, work within a
schedule, and attend work regularly. The ALJ also concluded that Plaintiff is able to ask a
supervisor or fellow workers for assistance and retains the ability to adhere to basic standards of
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neatness and cleanliness and to use public transportation and travel to unfamiliar places. (Tr. 26.)
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 her symptoms were not fully credible. (Tr. 27.)
Considering Plaintiff’s noted impairments and the assessment of a vocational expert
(“VE”), however, the ALJ determined that Plaintiff could not perform her past relevant work. (Tr.
29.) 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 a telephone order clerk, a
call out operator, and a clerical assistant. (Tr. 30.) Accordingly, based on Plaintiff’s age,
education, work experience, RFC, and the testimony of the VE, the ALJ found Plaintiff not
disabled. (Tr. 30.)
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
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individual is found disabled at any point in the sequential review, further inquiry is unnecessary.
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 20
C.F.R. Part 404, Subpart P, Appendix 1; 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
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court sufficient reasoning for determining that he or she has conducted the proper legal analysis,
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) the ALJ failed to
adopt the opinion of consulting physician Dr. Daniel Van Ingen; (2) the ALJ failed to account for
Plaintiff’s social functioning limitations in the RFC assessment; and (3) the ALJ failed to properly
weigh the opinion of treating physician Dr. Frederic Monosiet. For the reasons that follow, none
of these contentions warrant reversal.
A.
Adoption of Dr. Van Ingen’s Opinions
Plaintiff first argues that although the ALJ afforded consulting physician Dr. Van Ingen’s
opinion significant weight, the ALJ failed to adopt Dr. Van Ingen’s opinion. Specifically, Plaintiff
contends that the ALJ failed to adopt portions of Dr. Van Ingen’s opinion supporting disability
into Plaintiff’s RFC. (Dkt. 18 at 15.) Plaintiff asserts that although the ALJ assigned moderate
limitations in social functioning and concentration, persistence and pace, the only mental
functioning limitation in Plaintiff’s RFC is that Plaintiff can perform jobs that require no more
than one month to learn. (Dkt. 18 at 12.) Plaintiff further argues that the ALJ failed to account
for Dr. Van Ingen’s opinion that Plaintiff’s mental impairment would impact her ability to maintain
attention and concentration and her ability to get along with others, as well as cause significant
difficulties in Plaintiff’s ability to deal with stress. (Dkt. 18 at 16.)
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Dr. Van Ingen performed a consultative examination on Plaintiff on October 23, 2012. In
his mental status examination report, Dr. Van Ingen noted that Plaintiff’s demeanor and
responsiveness to questions were cooperative, and her manner of relating, social skills, and overall
presentation were adequate. (Tr. 531.) Specifically, Plaintiff’s thought process was coherent and
goal directed with no evidence of delusions, hallucinations, or disordered thinking. Her mood was
depressed and anxious, but her intelligibility was fluent. (Tr. 531.) Plaintiff’s attention and
concentration were noted as limited. Her recent and remote memory skills appeared to be impaired
due to distress secondary to her anxiety disorder. (Tr. 531.) Plaintiff’s cognitive functioning was
in the average range and her insight and judgment were fair to good. (Tr. 532.)
In his medical source statement, Dr. Van Ingen opined that vocationally, Plaintiff appears
to be capable of understanding and following simple instructions and directions. (Tr. 532.)
Plaintiff appeared capable of performing simple tasks independently. Dr. Van Ingen noted that
while she may have difficulty maintaining attention and concentration due to symptoms of her
anxiety disorder, she is capable of maintaining a regular schedule and learning new tasks. (Tr.
532.) Further, Plaintiff has a “fair capability for relating adequately with others, but appears to be
affected by her anxiety and mood symptoms.” She appeared to have a fair capability for making
appropriate decisions, but had significant difficulty coping with “stressors.” (Tr. 532.) In Dr. Van
Ingen’s diagnosis, Plaintiff was diagnosed with posttraumatic stress disorder, major depressive
disorder, methamphetamine abuse, learning disorder, personality disorder, and assigned a GAF
score of 45. (Tr. 532–533.)
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
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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).
Here, Dr. Van Ingen is a consultative examiner and, as such, his opinions are not entitled
to the deference normally given treating sources. 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 one-time 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 obtained from the objective medical findings alone or from reports of individual examinations,
such as consultative examinations or brief hospitalizations”). Dr. Van Ingen is not Plaintiff’s
treating physician, rather he examined Plaintiff to provide opinions as to Plaintiff’s social security
applications. Thus, although the ALJ accorded Dr. Van Ingen’s significant weight, the opinion
was not entitled to significant weight.
In assessing Plaintiff’s RFC, the ALJ noted that overall, Dr. Van Ingen opined that Plaintiff
retains the ability to perform work that is simple in nature and consistent with the RFC as outlined
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in the ALJ’s opinion. (Tr. 28.) The ALJ specifically addressed the portions of Dr. Van Ingen’s
opinion regarding Plaintiff’s limited attention and concentration and impaired memory, but also
noted that Plaintiff is independent with her personal care and household chores and reported
engaging in activities such as going to church with her family and spending time with friends. (Tr.
28.) The ALJ further noted that Plaintiff was cooperative with adequate social skills and
presentation, appropriate grooming, normal thought process, full orientation, intact cognitive
functioning and average intelligence despite her reported history of learning disorders. (Tr. 28.)
Plaintiff argues that the ALJ only “selectively credited” Dr. Van Ingen’s opinion. (Dkt. 18
at 13.) However, there is no requirement that the ALJ specifically refer to every piece of evidence
from Plaintiff’s medical records in her decision. Dyer v. Barnhart, 395 F.3d 1206, 1211 (11th Cir.
2005). Rather, the district court must review the ALJ’s decision and determine whether the ALJ
considered the plaintiff’s medical condition as a whole and also determine whether the ALJ’s
conclusion, as a whole, was supported by substantial evidence in the record. Id. (quoting Foote v.
Charter, 67 F.3d 1553, 1561 (11th Cir. 1995)). Substantial evidence is something “more than a
mere scintilla, but less than a preponderance.” Hale v. Bowen, 831 F.2d 1007, 1011 (11th Cir.
1987).
Moreover, despite Plaintiff’s argument that the only mental limitation contained in
Plaintiff’s RFC was a limitation to jobs requiring no more than one month to learn, the ALJ
included multiple limitations that take into account Plaintiff’s mental health. As the Commissioner
argues, the ALJ’s RFC assessment reflects the work Plaintiff is able to do despite her mental
limitations. (Dkt. 21 at 6.) Notably, the ALJ included a limitation for Plaintiff’s ability to maintain
attention and concentration for only two hours at a time. (Tr. 26.) The ALJ further included that
Plaintiff has “the mental limitation that allows her to retain the ability to get to the work place and
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remember work procedures,” is able to get to work on time, work within a schedule, attend work
regularly, adhere to basic standards of neatness and cleanliness, use public transportation, and
travel to unfamiliar places. (Tr. 26.) With regard to Plaintiff’s social functioning, the ALJ
specified that Plaintiff is able to ask a supervisor or fellow worker for assistance. (Tr. 26.) Thus,
the ALJ included multiple mental limitations in Plaintiff’s RFC, including those for Plaintiff’s
ability to maintain attention and concentration and to get along with others.
Plaintiff next argues that the ALJ failed to mention that Dr. Van Ingen assigned Plaintiff a
GAF score of 45, a score that indicates Plaintiff is unable to carry out the basic duties of regular
employment. (Dkt. 18 at 15.) Plaintiff believes that the GAF score is evidence that Dr. Van Ingen
would not have agreed with the ALJ’s impression of his opinion. Plaintiff further states that the
GAF score is evidence that the ALJ misinterpreted Dr. Ingen’s opinion as the opinion is far more
limiting than Plaintiff’s RFC, an inconsistency which the ALJ never explained. (Dkt. 18 at 15.)
The Commissioner argues that the GAF score does not have a direct correlation to the
severity requirements in mental disorder listings. (Dkt. 21 at 6.) The Commissioner has declined
to endorse the GAF scale for use in disability programs. Revised Medical Criteria for Evaluating
Mental Disorders and Traumatic Brain Injury, 65 FR 50746-01; see Luterman v. Comm’r of Soc.
Sec., 518 F. App’x. 683, 690 (11th Cir. 2013). Further, absent evidence that an examiner assigned
a GAF score based on an opinion regarding the claimant’s ability to work, an ALJ’s failure to
mention and specifically weigh a GAF score does not warrant reversal. See McGregor v. Astrue,
No. 8:08-cv-2361-T-TGW, 2010 WL 138808, at *3 (M.D. Fla. Jan. 12, 2010) Bruner v. Comm’r
of Soc. Sec., No. 8:08-cv-1744-T-27GJK, 2009 WL 3052291 (M.D. Fla. Sept. 23, 2009). As noted
by the Commissioner, Dr. Van Ingen did not explain why he assessed a GAF score of 45 and,
instead, gave a narrative opinion on Plaintiff’s vocational abilities. The ALJ addressed Dr. Van
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Ingen’s opinion and included it within the RFC assessment. (Dkt. 21 at 8.) Consequently, the
Plaintiff’s argument does not warrant reversal.
Plaintiff also argues that other than finding it to be a severe impairment, the ALJ failed to
discuss Plaintiff’s dyslexia, which Dr. Van Ingen identified in her report. (Dkt. 18 at 16.)
However, the ALJ considered Plaintiff’s allegations and noted that although she has a history of
learning disorder, Plaintiff exhibited average intelligence. (Tr. 24–25, 28.) Moreover, Plaintiff
has not identified any work-related limitations related to her dyslexia. Plaintiff bears the burden
of showing that she has a severe impairment or combination of impairments that may qualify as a
disability. Hutchinson v. Astrue, 408 F. App’x. 324, 326 (11th Cir. 2011) (citing McDaniel v.
Bowen, 800 F.2d 1026, 1031 (11th Cir. 1986)). “[T]he ‘severity’ of a medically ascertained
disability must be measured in terms of its effect upon ability to work, not simply in terms of
deviation from purely medical standards of bodily perfection or normality.” McCruter v. Bowen,
791 F.2d 1544, 1547 (11th Cir. 1986). Proof of the mere existence of an impairment does not
prove the extent to which the impairment may limit Plaintiff’s ability to work. Hutchinson, 408
F. App’x. at 326. Here, Plaintiff points to no medical evidence indicating that Plaintiff’s dyslexia
affected her ability to work.
Plaintiff next argues that the ALJ failed to include any specific findings regarding
Plaintiff’s ability to cope with stress in Plaintiff’s RFC. (Dkt. 18 at 17.) According to Plaintiff,
this is significant because Dr. Van Ingen opined that Plaintiff would have difficulties dealing with
stress and the definition of unskilled work does not contain a limitation to low stress work. Plaintiff
argues that the ALJ was required to make an explicit determination regarding the effect of this
limitation on Plaintiff’s range of employment. (Dkt. 18 at 17.) The Commissioner argues, and the
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Court agrees, that according to Social Security Ruling 85-15, “stress” is defined as “the demands
of work” and can result in limitations on the ability to meet the various demands of work:
The reaction to the demands of work (stress) is highly
individualized, and mental illness is characterized by adverse
responses to seemingly trivial circumstances. The mentally impaired
may cease to function effectively when facing such demands as
getting to work regularly, having their performance supervised, and
remaining in the workplace for a full day. A person may become
panicked and develop palpitations, shortness of breath, or feel faint
while riding in an elevator; another may experience terror and begin
to hallucinate when approached by a stranger asking a question.
Thus, the mentally impaired may have difficulty meeting the
requirements of even so-called ‘low-stress’ jobs.
Because response to the demands of work is highly individualized,
the skill level of a position is not necessarily related to the difficulty
an individual will have in meeting the demands of the job. A
claimant’s condition may make performance of an unskilled job as
difficult as an objectively more demanding job. For example, a
busboy need only clear dishes from tables. But an individual with a
severe mental disorder may find unmanageable the demands of
making sure that he removes all the dishes, does not drop them, and
gets the table cleared promptly for the waiter or waitress. Similarly,
an individual who cannot tolerate being supervised may not be able
to work even in the absence of close supervision; the knowledge that
one’s work is being judged and evaluated, even when the
supervision is remote or indirect, can be intolerable for some
mentally impaired persons. Any impairment-related limitations
created by an individual’s response to demands of work, however,
must be reflected in the RFC assessment.
SSR 85-15 (S.S.A. 1985). Here, the ALJ specifically addressed Plaintiff’s ability to cope with the
demands of work in the RFC assessment, including that Plaintiff is able to get to work, show up
on time, work within a schedule, attend work regularly, and ask a supervisor for assistance. (Tr.
26.) Therefore, Plaintiff’s argument does not warrant reversal.
Plaintiff also argues that the ALJ misread Dr. Van Ingen’s opinion. (Dkt. 18 at 15.)
However, substantial evidence supports the ALJ’s interpretation of Dr. Van Ingen’s opinion and
the conclusion that Plaintiff can perform sedentary work with the additional limitations found in
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Plaintiff’s RFC. As noted above, the RFC reflects much of Dr. Van Ingen’s opinion. Further, the
state agency mental experts opined that Plaintiff retains the ability to perform less than a full range
of light work with limitations in social and cognitive functioning. (Tr. 74, 92.) The ALJ assigned
the opinions significant weight and further reduced Plaintiff to sedentary work based on Plaintiff’s
testimony. (Tr. 28.) To the extent that Plaintiff points to other evidence which would undermine
the ALJ's RFC determination, this argument misinterprets the narrowly circumscribed nature of
the court’s appellate review, which precludes us from “re-weigh[ing] the evidence or substitut[ing]
our judgment for that [of the Commissioner]…even if the evidence preponderates against” the
decision. Moore v. Barnhart, 405 F.3d 1208, 1213 (11th Cir. 2005) (quoting Bloodsworth, 703
F.2d at 1239). This court may not reweigh the evidence and decide facts anew and must defer to
the ALJ's decision if it is supported by substantial evidence even if the evidence may preponderate
against it. See Dyer, 395 F.3d at 1210.
B.
The ALJ’s Assessment of Plaintiff’s Social Functioning Limitations
Plaintiff next contends that the ALJ failed to incorporate his findings that Plaintiff has
moderate social functioning limitations in the RFC assessment. (Dkt. 18 at 18.) However, the
ALJ’s finding regarding Plaintiff’s moderate difficulties in social functioning was one of the four
ratings the ALJ made pursuant to the psychiatric review technique form used in assessing mental
impairments. (Tr. 25.) “Agency regulations require the ALJ to use the ‘special technique’ dictated
by the [Psychiatric Review Technique Form] PRTF for evaluating mental impairments.” Moore,
405 F.3d at 1213; 20 C.F.R. § 404.1520a (effective June 13, 2011). Utilization of the special
technique requires separate evaluations concerning how the claimant’s mental impairment impacts
four functional areas: “activities of daily living; social functioning; concentration, persistence, or
pace; and episodes of decompensation.”
Moore, 405 F.3d at 1213–14; 20 C.F.R. §
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404.1520a(c)(3). The PRTF is not an assessment of Plaintiff’s RFC. 20 C.F.R. §§ 404.1520(a)(4),
404.1520a(d); SSR 96-8p.
Here, as the Commissioner notes, the ALJ properly used the PRTF ratings to find at step
two of the sequential process that Plaintiff has severe mental impairments, but does not have an
impairment that meets or equals a listed impairment. (Dkt. 21 at 10.) The ALJ then properly
continued on to step three and assessed Plaintiff’s RFC. (Tr. 26.) Plaintiff contends that the ALJ
did not include findings in the RFC that relate to working with others, supervisors, or the public.
(Dkt. 18 at 20–21.) But, the ALJ specifically addressed Plaintiff’s ability to work with others and
supervisors in the RFC in finding that Plaintiff is able to ask a supervisor or fellow worker for
assistance. (Tr. 26.) Thus, Plaintiff’s contention does not warrant reversal.
C.
Weight Accorded to Dr. Monosiet’s Opinions
Plaintiff’s final argument is that the ALJ improperly assigned the opinion of treating
psychiatrist Dr. Monosiet little weight. According to Plaintiff, the records and medical source
statement from Dr. Monosiet’s treatment were obtained subsequent to the hearing but prior to the
ALJ’s written opinion. (Dkt. 18 at 22.) Plaintiff indicates that additional progress notes were
submitted to the Appeals Council that reveal two more visits with Dr. Monosiet in June 2014.
(Dkt. 18 at 22.) Plaintiff asserts that if credited, the medical source statement would require a
finding of disability. (Dkt. 18 at 22.) At the hearing, Plaintiff testified that she treated with Dr.
Monosiet every three months. (Tr. 49.) Plaintiff argues that the ALJ mischaracterized Dr.
Monosiet’s relationship with Plaintiff and failed to recognize Dr. Monosiet as a treating physician.
(Dkt. 22 at 23.) The Commissioner, in contrast, argues that the ALJ properly considered Dr.
Monosiet’s opinion and had good cause for assigning the opinion little weight as it was conclusory
and not based on any examination findings. (Dkt. 21 at 12.)
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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
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).
Here, the ALJ assigned Dr. Monosiet’s opinion little weight, noting that the extent of the
treatment relationship between Plaintiff and Dr. Monosiet was unclear. (Tr. 28.) The ALJ
indicated that although Dr. Monosiet noted that Plaintiff had various impairments, Plaintiff had
not sought treatment for many of the impairments during the time period relevant to the ALJ’s
decision. (Tr. 28.) The ALJ recognized Dr. Monosiet’s opinion that Plaintiff has marked
limitations in activities of daily living, social functioning, and concentration, persistence, and pace,
but ultimately found the opinion conclusory. The ALJ reasoned that Dr. Monosiet’s opinion does
not reference any examination findings and appeared to be based solely on Plaintiff’s subjective
complaints. (Tr. 28.)
The record in this case reflects that Dr. Monosiet completed a mental status examination
of Plaintiff on March 27, 2014, finding Plaintiff alert, cooperative, and oriented as to time and
place with no evidence of delusions or paranoia. (Tr. 563.) She had difficulty coping at times but
denied an intent toward self-harm or harm towards others. Further, her judgment appeared fair
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and her memory seemed intact. (Tr. 563.) The only other record from Dr. Monosiet before the
ALJ at the time of his decision was a medical source statement dated June 26, 2014. (Tr. 612–
614.) Within the medical source statement, Dr. Monosiet opined that Plaintiff has a marked
restriction in activities of daily living, marked difficulties in maintaining social functioning, and
marked deficiencies of concentration, persistence, or pace. (Tr. 614.) Notably, the section
regarding the frequency and length of contact between the patient and physician and the section
regarding the clinical findings, including results of mental status examination that demonstrate the
severity of the patient’s mental impairments, are left blank. (Tr. 612.) Therefore, the ALJ’s
conclusion that Dr. Monosiet’s opinion is conclusory and his assignment of little weight to the
treating physician’s opinion is supported by the record evidence.
Plaintiff argues that additional progress notes from Dr. Monosiet were submitted to the
Appeals Council, revealing two office visits with Dr. Monosiet in June 2014. (Dkt. 18 at 22.)
Although the June 2014 records are dated before the ALJ’s July 24, 2014, decision, Plaintiff did
not submit the records to the ALJ. (Tr. 616–619.) Rather, the records were submitted after the
ALJ’s decision and were submitted to the Appeals Council as part of Plaintiff’s request to review
the ALJ’s decision. (Tr. 1–6.) On review, the Appeals Council found no reason to review the
ALJ’s decision, finding that the newly submitted evidence did not provide a basis for changing the
ALJ’s decision. (Tr. 2.) See Mitchell v. Comm’r, Soc. Sec. Admin., 771 F.3d 780, 783–85 (11th
Cir. 2014) (providing that the Appeals Council is not required to provide a detailed explanation of
a claimant’s new evidence when it denies a petition for review and that it is sufficient for the
Appeals Council to simply state that it considered the additional evidence but that “the information
did not provide a basis for changing the ALJ’s decision”). Notably, however, Plaintiff does not
challenge the Appeals Council’s decision or raise any argument regarding the Appeals Council’s
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review. Therefore, Plaintiff’s argument that the ALJ failed to assign weight to any opinion that
was not before the ALJ is without merit.
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 June 14, 2017.
Copies furnished to:
Counsel of Record
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