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Wood v. Berryhill

United States District Court, N.D. Alabama, Middle Division

March 31, 2017

NANCY A. BERRYHILL, Acting Commissioner, Social Security Administration, Defendant.


          L. Scott Coogler, United States District Judge

         I. Introduction

         The plaintiff, Christopher Wood, appeals from the decision of the Commissioner of the Social Security Administration (“Commissioner”) denying his application for Supplemental Security Income (“SSI”). Mr. Wood timely pursued and exhausted his administrative remedies and the decision of the Commissioner is ripe for review pursuant to 42 U.S.C. §§ 405(g), 1383(c)(3).

         Mr. Wood was twenty-one years old at the time of the Administrative Law Judge's (“ALJ”) decision, and he has an eighth grade education without prior work experience. (Tr. at 28.) Mr. Wood claims that he became disabled on September 21, 2011, due to being a slow learner, having foot problems, attention deficit hyperactivity disorder (“ADHD”), inability to move his left foot, diabetes, and anxiety. (Tr. at 193.)

         The Social Security Administration has established a five-step sequential evaluation process for determining whether an individual is disabled and thus eligible for 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. 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 his 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 him from performing his past relevant work, the evaluator will make a finding of not disabled. See id.

         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 him 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 him 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 Mr. Wood has not engaged in SGA since the application date, September 26, 2011. (Tr. at 25.) According to the ALJ, Plaintiff's diabetes mellitus, history of ADHD, impulse control disorder, borderline intellectual functioning, learning disability, and mood disorder are considered “severe” based on the requirements set forth in the regulations. (Id.) However, she found that these impairments neither meet nor medically equal any of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Id.) The ALJ did not find Mr. Wood's allegations to be totally credible, and she determined that he has the following RFC: he can perform light work except that he can only occasionally climb ramps and stairs, but never climb ladders, ropes, and scaffolds; can frequently balance, stoop, kneel, crouch, and crawl; has no limitation in reaching, handling, fingering, and feeling; should never work in environments with concentrated exposure to extreme heat, extreme cold, humidity, or wetness; should avoid hazardous conditions such as unprotected heights and moving machinery; can understand, remember, and carry out simple, but not detailed or complex instructions; work place changes should be infrequent and introduced gradually; can perform work that needs little or no judgment and make simple, work-related decision; can never work at a production rate pace, but can perform goal-oriented work; can never interact with the general public, but can occasionally interact with co-workers and supervisors, meaning that he can be around them throughout the workday, but would have only occasional conversations and personal interaction, and overall would be better dealing with things rather than people; and is capable of sustaining concentration and attention for at least two hour blocks of time with normal breaks throughout an eight-hour day. (Tr. at 27.)

         According to the ALJ, Mr. Wood has no past relevant work, he is a “younger individual, ” he has a “limited education, ” and he is able to communicate in English, as the regulations define those terms. (Tr. at 33.) She determined that transferability of skills is not an issue because Plaintiff has no past relevant work. (Id.) At the final step, the ALJ used Medical-Vocational Rule 202.17 as a guideline for finding that there are a significant number of jobs in the national economy that Plaintiff is capable of performing, such as an entry level assembler, a sorter, and a cleaner/housekeeper. (Tr. at 33.) The ALJ concluded her findings by stating that Plaintiff was not under a disability, as defined in the Social Security Act, since September 26, 2011, the date the application was filed. (Tr. at 34.)

         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 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

         Mr. Wood alleges that the ALJ's decision should be reversed and remanded for eight reasons. First, he takes issue with the ALJ's decision to give little weight to the opinion of a two-time examining medical source. Second, he contends that the ALJ erroneously relied on the opinion of the State agency non-examining psychological consultant. Third, he argues that the ALJ should have considered additional impairments severe at step two. Fourth, he believes that the ALJ failed to consider his impairments in combination. Fifth, he contends that the ALJ failed to state adequate reasons for finding him not entirely credible. With regard to the credibility issue Plaintiff raises, he has also filed a motion asking this Court to remand this case so that the ALJ can conduct a new credibility determination pursuant to a new Social Security Ruling (“SSR”) that was enacted in March 2016, SSR 16-3p. (Doc. 12). The Commissioner has responded in opposition to that motion. (Doc. 13). Sixth, the plaintiff takes issue with several aspects of the ALJ's RFC assessment. Seventh, he contends that the ALJ improperly drew adverse inferences from his noncompliance with medical treatment. Eighth, he argues that the ALJ improperly engaged in “sit and squirm” jurisprudence.

         A. Weight Given to Two-Time Examining Medical Source

         At Plaintiff's attorney's request, Dr. David R. Wilson, Ph.D., examined Plaintiff twice, first on May 24, 2011, for a consultative psychological evaluation (“CPE”) and again over two years later, on July 9, 2013, for a follow up CPE.[1] He concluded at the first evaluation that

[Plaintiff] is diabetic and he has a mood disorder, with mood swings and he does have a history of acting out. His behavior is likely to be too unstable and unpredictable for him to maintain a job. The combination of all of these problems makes it unlikely that he will be able to maintain employment. He would definitely have problems with the problem solving and the interpersonal aspects of such settings.

(Tr. at 529.) After the second evaluation two years later, Dr. Wilson concluded:

If anything, his mood disturbance appears to have gotten worse, and this may relate in part to him not being able to afford the appropriate medication he needs for his diabetes. He has had an increase in his moodiness and his irritability, and these would cause him major problems in any work environment. He would definitely have difficulty with the interpersonal and task aspects of any job. He is not capable of managing benefits.

(Id.) At both evaluations, Dr. Wilson completed a Mental Medical Source Statement, opining that Plaintiff had marked limitations due to the mood disorder (not the ADHD), including in his ability to maintain socially appropriate behavior and to adhere to basic standards of neatness and cleanliness, as well as marked limitations in his ability to maintain concentration and adaption. (Tr. at 530-31.) Dr. Wilson diagnosed Plaintiff with bipolar disorder, history of ADHD, and borderline intelligence. (Id.) He assessed Plaintiff's Global Assessment of Function (“GAF”) score to be 48, which is a serious impairment of functioning. (Id.) The ALJ ultimately gave little weight to Dr. Wilson's opinion because it was not consistent with his own notes or the medical record as a whole, including the other medical opinions of record.

         The weight to be afforded a medical opinion regarding the nature and severity of a claimant's impairments depends, among other things, upon the examining and treating relationship the medical source had with the claimant, the evidence the medical source presents to support the opinion, how consistent the opinion is with the record as a whole, and the specialty of the medical source. See 20 C.F.R. §§ 404.1527(d), 416.927(d). A treating doctor's opinion generally is entitled to more weight, and an ALJ must give good reasons for discounting a treating doctor's opinion. See 20 C.F.R. § 416.927(c)(2); Winschel v. Comm'r of Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 2011). However, the opinions of one-time examiners, i.e., non-treating doctors, are not entitled to deference or special consideration. See Crawford, 363 F.3d at 1160; McSwain v. Bowen, 814 F.2d 617, 619 (11th Cir. 1987). Dr. Wilson did not have an ongoing treating relationship with Plaintiff and was, therefore, an examining physician, not a treating doctor. See 20 C.F.R. §§ 416.902, 416.927(c)(1), (c)(2). Thus, his opinions were not entitled to any special deference. See id. Moreover, an ALJ may discount any doctor's opinion when the opinion is conclusory, the doctor fails to provide objective medical evidence to support his or her opinion, the opinion is inconsistent with the record as a whole, or the evidence otherwise supports a contrary finding. See 20 C.F.R. ยง 416.927(c). A doctor's ...

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