Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alsd-2_14-cv-00393/USCOURTS-alsd-2_14-cv-00393-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ALABAMA

NORTHERN DIVISION

WILLIE MAE CONNER, :

Plaintiff, :

vs. : CA 14-0393-C

CAROLYN W. COLVIN, :

Acting Commissioner of Social Security,

:

Defendant.

MEMORANDUM OPINION AND ORDER

Plaintiff brings this action, pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3), seeking 

judicial review of a final decision of the Commissioner of Social Security denying her

claim for a period of disability and Supplemental Security Income. The parties have 

consented to the exercise of jurisdiction by the Magistrate Judge, pursuant to 28 U.S.C. § 

636(c), for all proceedings in this Court. (Docs. 20 & 22 (“In accordance with provisions

of 28 U.S.C. 636(c) and Fed.R.Civ.P. 73, the parties in this case consent to have a United 

States Magistrate Judge conduct any and all proceedings in this case, . . . order the entry 

of a final judgment, and conduct all post-judgment proceedings.”).) Upon consideration 

of the administrative record, plaintiff’s brief, the Commissioner’s brief, and the 

arguments of counsel at the June 26, 2015 hearing before the Court, it is determined that 

the Commissioner’s decision denying benefits should be affirmed.

1

 

 1 Any appeal taken from the judgment shall be made to the Eleventh Circuit Court 

of Appeals. (See Docs. 20 & 22 (“An appeal from a judgment entered by a Magistrate Judge shall 

be taken directly to the United States Court of Appeals for this judicial circuit in the same 

manner as an appeal from any other judgment of this district court.”))

Case 2:14-cv-00393-C Document 23 Filed 03/24/16 Page 1 of 22
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Plaintiff alleges disability due to coronary problems, including cardiomyopathy 

and arrhythmia-bradycardia, and hypertension. The Administrative Law Judge (ALJ) 

made the following relevant findings:

1. The Claimant meets the insured status requirements of the Social 

Security Act through December 31, 2012.

2. The Claimant did not engage in substantial gainful activity 

during the period from her alleged onset date of August 11, 2008 

through her date of last insured of December 31, 20012 (20 C.F.R. §

404.1571 et seq.).

3. Through the date last insured, the claimant had the following 

severe impairments: nonischemic cardiomyopathy with chronic heart 

failure, hypertension, and arrhythmia-bradycardia (20 C.F.R. § 

404.1520(c)).

. . .

4. Through the date last insured, the claimant did not have an 

impairment or combination of impairments that met or medically 

equaled the severity of one of the listed impairments in 20 C.F.R. § Part 

404, Subpart P, Appendix 1 (20 C.F.R. § 404.1520(d), 404.1525 and 

404.1526).

. . .

5. After careful consideration of the entire record, the undersigned 

finds that, through the date of last insured, the Claimant had the 

residual functional capacity to perform sedentary work as defined in 20 

C.F.R. § 404.1567(b) except as noted. The Claimant can lift and carry 

twenty pounds occasionally and ten pounds frequently. She can 

stand/walk for two hours during the workday. She can sit for six hours 

during the workday. She can occasionally climb ramps and stairs, 

balance, stoop, kneel, crouch, and crawl. She cannot climb ladders, 

ropes, or scaffolds. She must avoid concentrated exposure to extreme 

temperatures, fumes, odors, dusts, gases, and poor ventilation. She 

must avoid all exposure to hazardous machinery and unprotected 

heights. 

In making this finding, the undersigned has considered all symptoms and 

the extent to which these symptoms can reasonably be accepted as 

consistent with the objective medical evidence and other evidence, based 

on the requirements of 20 C.F.R. § 404.1529 and SSRs 96-4p and 96-7p. The 

undersigned has also considered opinion evidence in accordance with the 

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requirements of 20 C.F.R. § 404.1527 and SSRs 96-2p, 96-5p, 96-6p and 06-

3p.

In considering the Claimant’s symptoms, the undersigned must follow a 

two-step process in which it must first be determined whether there is an 

underlying medically determinable physical or mental impairment(s)—

i.e., an impairment(s) that can be shown by medically acceptable clinical 

and laboratory diagnostic techniques—that could reasonably be expected 

to produce the Claimant’s pain or other symptoms.

Second, once an underlying physical or mental impairment(s) that could 

reasonably be expected to produce the Claimant’s pain or other symptoms 

has been shown, the undersigned must evaluate the intensity, persistence,

and limiting effects of the Claimant’s symptoms to determine the extent to 

which they limit the Claimant’s functioning. For this purpose, whenever 

statements about the intensity, persistence, or functionally limiting effects 

of pain or other symptoms are not substantiated by objective medical 

evidence, the undersigned must make a finding on the credibility of the 

statements based on a consideration of the entire case record.

The Claimant is a forty-five year old woman with a high school education 

who alleges she is disabled due to various heart impairments. She 

testified she regularly has swelling in her legs, which leads her to elevate 

her legs daily. She testified she remains seated or is lying down for most 

of the day. However, she testified she does cook, washes clothes, and 

drives. She testified she continues to have arrhythmia despite medication. 

She testified she is nearly always tired and/or fatigued. She testified she 

could stand for thirty minutes and walk fifty yards, but she previously 

indicated she could walk a quarter of a mile (Ex. 4E). She testified she 

could walk up a flight of stairs, but her legs would hurt. She testified her 

medications make her go to the bathroom more frequently. She wrote she 

can perform her personal care tasks independently (Ex. 4E). She stated

she goes shopping every two weeks. She wrote she attends football 

games every week and goes to church once per month.

The objective evidence shows the Claimant had her heart impairments 

prior to the alleged onset date (Ex. 6F). In 2007, an echocardiogram 

showed the Claimant had significant systolic dysfunction, yet she was 

able to work at substantial gainful activity levels that year (Ex. 17D). 

Additionally, prior to the alleged onset date, a Holter monitor showed the 

Claimant had arrhythmias (Ex. 2F).

Although the Claimant has serious heart impairments, the evidence tends 

to indicate they are not as limiting as the Claimant has alleged. Moreover, 

the treatment report shows the Claimant’s condition has improved over

time and with medication (Ex. 16F). In September 2008, a heart 

catheterization showed the Claimant had normal coronary arteries, and 

she had an ejection fraction of 40% (Ex. 2F). An echocardiogram at the 

same time showed she had an enlarged left ventricle and her ejection 

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fraction was only 30% (Id.) A heart catheterization approximately a year 

later in November 2009 showed the Claimant still had unobstructed 

coronary arteries and a 40% ejection fraction (Ex. 11F). By September 

2012, an echocardiogram showed the Claimant’s ejection fraction had 

improved to 45-54% (Ex. 15F). Additionally, that echocardiogram showed 

the Claimant’s left ventricle had returned to a normal size. Additionally, 

an arteriogram from September 2008 showed small irregularities in her 

anterior arteries, but subsequent arteriograms were normal (Exs. 11F and 

12F).

The clinical reports also indicate her symptoms are not as severe as she 

has alleged. The Claimant contends she has near daily swelling; however, 

the treatment reports have consistently shown the Claimant does not have 

significant problems [with] swelling or edema in her extremities (Exs. 2F, 

6F, 11F, 12F, and 15F). Moreover, the treatment reports have shown the 

Claimant has a normal heart rate and rhythm, which indicates the 

treatment to control her arrhythmia has been effective (Id.). The Claimant 

also had a grade II/IV heart murmur (Exs. 11F and 12F). However, by 

August 2011, the treating cardiologist indicated the murmur had gone 

away as he reported then and thereafter that the Claimant did not have a 

murmur (Ex. 12F).

The treatment to control her hypertension also appears to have been 

effective. The Claimant’s highest reported blood pressure reading was in 

May 2009 when it was 152/94 (Ex. 11F). Subsequent readings have been 

within normal range or slightly above 120/80 (Exs. 11F, 12F, and 15F).

The clinical reports also indicate that with the correct treatment her 

symptoms have lessened. Initially, the Claimant was not taking several 

medications [that] were added later and that seemed to have improved 

her symptoms such as Coreg, Lasix, Aspirin, and Zocor (Ex. 15F). By May 

2009, the Claimant’s treating cardiologist wrote the Claimant was doing 

well (Ex. 11F). He echoed that statement February 2010, May 2010, 

November 2010, and October 2012 (Exs. 11F and 12F).

In addition to considering the objective evidence, the undersigned has also 

considered various assessments related to the Claimant’s abilities and 

limitations. The undersigned has afforded significant weight to the 

assessment provided by the medical expert after the hearing in October 

2012 (Ex. 13F). Subsequent to the hearing, the undersigned sent 

interrogatories to the medical expert requesting his assessment of the 

Claimant’s abilities and limitations given the medical records. The 

undersigned sent the records to the same medical expert who testified at 

the first hearing in this matter. Based upon his review of the Claimant’s 

medical records, the medical expert opined the Claimant could perform 

sedentary work. This assessment is well supported by the objective 

evidence. Notably, the Claimant’s treating cardiologist repeatedly wrote 

the Claimant was doing well. Moreover, treatment reports have shown 

that, with proper treatment, the Claimant’s symptoms have been reduced. 

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Additionally, the Claimant activities, helping care for her children, 

driving, shopping, cleaning laundry, and cooking, are consistent with at 

least sedentary work ability. Finally, the medical expert correctly 

observed the inconsistencies between the treating cardiologist’s opinions 

and his treatment reports, which are discussed below.

The assessment provided by the medical consultant from the Disability 

Determination Service has been afforded the most weight (Ex. 5F). 

Although the medical consultant’s assessment was prepared in December 

2008, it has been afforded the most weight because it was affirmed by the 

medical expert’s more general assessment, it is more detailed than the 

medical expert’s assessment, and it is in line with the treatment reports. 

Like the medical expert, the medical consultant believed the claimant 

could only stand/walk for two hours, consistent with a reduction to 

sedentary work. The medical consultant also limited the Claimant to 

occasionally working in various positions. The assessment is also deemed 

valid because the treatment reports show the Claimant’s symptoms were 

worse at the time he made his assessment as compared to after December 

2008. This fact demonstrates the Claimant’s condition did not worsen 

following the assessment meaning that it accurately reflects the Claimant’s 

abilities when her symptoms were at their worse. The evidence also 

demonstrates, and the treating cardiologist confirms, that the Claimant’s 

symptoms have improved with treatment. The Claimant’s heart function 

was also moderately severe in 2008, and it has improved since that time.

The undersigned has also considered the two assessments provided by the 

Claimant’s treating cardiologist (Exs. 10F and 16F). In both assessments

dated August 2008 and October 2012, the cardiologist opined the Claimant 

is totally disabled and unable to work eight hours a day, five days a week 

or an equivalent work schedule. Additionally, he wrote the Claimant 

could not work for two hours at a time. These assessments have been 

afforded little weight even though the assessments were authored by the 

treating cardiologist. As noted by the medical expert, there are several 

inconsistencies between his assessments and his treatment reports. 

Although the representative submitted the latter assessment in the hopes 

of explaining the inconsistencies observed by the medical expert, the 

treating cardiologist’s latter assessment does not address those 

inconsistencies (Ex. 17E). In fact, his latter assessment seems to be 

internally inconsistent in [and] of itself as he wrote the Claimant has 

improved with treatment and that she will continue to respond to 

treatment (Ex. 16F). As discussed above, the cardiologist has stated 

several times since 2009 that the Claimant was doing well and she was 

able to exercise at least two days a week (Ex. 12F). He also observed the 

Claimant did not have side effects from her medication and that she did 

not have swelling as she contends (Ex. 12F). The improvement, as 

demonstrated by her recent echocardiogram results that showed only 

mild ventricular dysfunction, shows at the very least that the Claimant 

would have been much more capable in October 2012 as opposed to 

August 2008. However, the cardiologist believed the Claimant was as

Case 2:14-cv-00393-C Document 23 Filed 03/24/16 Page 5 of 22
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limited in 2012 as she was in 2008 despite the improvement in her 

condition. This inherent inconsistency further indicates the treating 

cardiologist’s assessments are not accurate or valid. Finally, the 

Claimant’s activities also demonstrate the Claimant is far more active than 

what the cardiologist indicated. Accordingly, the treating cardiologist’s 

assessments have been afforded little weight.

The undersigned has also considered the Claimant’s allegations and 

testimony in determining her residual functional capacity. Because her 

allegations and testimony are only partially credible, they have been 

afforded only partial weight.

The records show several inconsistencies between the Claimant’s 

statements and the objective evidence. For example, the Claimant testified 

she has adverse side effects to her medication, yet the treatment reports 

show she denied having side effects. The Claimant also testified she could 

only walk 50 yards, but in November 2008 she stated she could walk one 

quarter of a mile, 400 yards. This inconsistency is interesting because the 

Claimant stated she was more capable when her symptoms were worse as 

compared to her recent testimony in which she stated she was more 

limited when her symptoms were improved. These puzzling statements 

undermine the believability of the Claimant’s statements. The Claimant’s 

allegation regarding daily swelling is also not supported by the objective 

evidence. The treatment reports have consistently stated the Claimant 

does not have any swelling or edema in her extremities. The Claimant’s 

daily activities also indicate the Claimant is more capable than what the 

Claimant has alleged. The fact the Claimant was able to work for more 

than a year (2007) with symptoms worse than what she has had for the 

past several years also indicates the Claimant’s testimony is not accurate.

6. Through the date last insured, the Claimant was unable to 

perform any past relevant work (20 CFR § 404.1565).

The Claimant had past relevant work as a lumbar (sic) grader (DOT 

669.687-030, light, semi-skilled). The vocational expert testified a person 

with the Claimant’s vocational profile and residual functional capacity 

would not be able to perform the Claimant’s past relevant work. 

Accordingly, the Claimant was unable to perform past relevant work.

. . .

10. Through the date last insured, considering the Claimant’s age, 

education, work experience, and residual functional capacity, there were 

jobs that existed in significant numbers in the national economy that 

the Claimant could have performed (20 C.F.R. § 404.1569 and 

404.1569(a)).

In determining whether a successful adjustment to other work can be 

made, the undersigned must consider the Claimant’s residual functional 

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capacity, age, education, and work experience in conjunction with the 

Medical-Vocational Guidelines, 20 C.F.R. § Part 404, Subpart P, Appendix 

2. If the Claimant can perform all or substantially all of the exertional 

demands at a given level of exertion, the medical-vocational rules direct a 

conclusion of either “disabled” or “not disabled” depending upon the 

Claimant’s specific vocational profile (SSR 83-11). When the Claimant 

cannot perform substantially all of the exertional demands of work at a 

given level of exertion and/or has nonexertional limitations, the medicalvocational rules are used as a framework for decisionmaking unless there 

is a rule that directs a conclusion of “disabled” without considering the 

additional exertional and/or nonexertional limitations (SSRs 83-12 and 83-

14). If the Claimant has solely nonexertional limitations, section 204.00 in 

the Medical Vocational Guidelines provides a framework for 

decisionmaking (SSR 85-15).

Through the date last insured, if the Claimant had the residual functional 

capacity to perform the full range of light 2 work, a finding of “not 

disabled” would be directed by Medical-Vocational Rule 201.21. 

However, the Claimant’s ability to perform all or substantially all of the 

requirements of this level of work was impeded by additional limitations. 

To determine the extent to which these limitations erode the unskilled 

light occupational base, through the date last insured, the Administrative 

Law Judge asked the vocational expert whether jobs existed in the 

national economy for an individual with the Claimant’s age, education, 

work experience, and residual functional capacity. The vocational expert 

testified that given all of these factors the individual would have been able 

to perform the requirement of representative occupations such as 

production assembler (DOT 723.684-010, light, unskilled) of which there 

are 250,000 jobs nationally and 11,000 jobs regionally, folder (DOT 

685.687-014, sedentary, unskilled) of which there are 174,000 jobs 

nationwide and 1,400 jobs statewide, ticket seller (DOT 211.467-030, light 

unskilled) of which there are 25,000 jobs in the United States and 1,200 

jobs in Alabama.

Pursuant to SSR 00-4p, the undersigned has determined that the 

vocational expert’s testimony is consistent with the information contained 

in the Dictionary of Occupational Titles.

Based on the testimony of the vocational expert, the undersigned 

concludes that, through the date last insured, considering the Claimant’s 

age, education, work experience, and residual functional capacity, the 

Claimant was capable of making a successful adjustment to other work 

that existed in significant numbers in the national economy. A finding of 

“not disabled” is therefore appropriate under the framework of the abovecited rule.

 2 This reference to light work appears to be a mistake in the opinion since the ALJ and the 

Appeals Council both determined that the Plaintiff would only be able to perform a limited 

range of sedentary work. 

Case 2:14-cv-00393-C Document 23 Filed 03/24/16 Page 7 of 22
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11. The Claimant has not been under a disability, as defined in the 

Social Security Act, at any time from August 11, 2008, the alleged onset 

date, through December 31 2012, the date last insured (20 CFR 

404.1520(g)). 

 

(Tr. 16-22 (internal citations omitted; emphasis in original).) 

The claimant asked the Appeals Council to review the ALJ’s decision, which was 

granted. After consideration of the entire record and comments received after the 

Appeals Council notified the claimant that it had granted the request for a review, it 

affirmed the ALJ’s decision after making the following findings:

1. The claimant met the special earnings requirements of the Act on 

August 11, 2008, the date the claimant stated she became unable to 

work, and met them through December 13, 2013.

The claimant has not engaged in substantial gainful activity since 

August 11, 2008.

2. The claimant has the following severe impairments: non-ischemic 

cardiomyopathy with chronic heart failure, hypertension, and 

arrhythmia-bradycardia, but does not have an impairment or 

combination of impairments which is listed in, or which is 

medically equal to an impairment listed in 20 CFR Part 404, 

Subpart P, Appendix 1.

3. The claimant has the residual functional capacity to perform a 

reduced range of work at the sedentary exertional level (Finding 5

of the Administrative Law Judge’s decision).

4. The claimant is unable to perform past relevant work.

5. The claimant was 45 years old on the date of the Administrative 

Law Judge’s decision, which is defined as a younger individual, 

and has a high school education. The claimant’s past relevant work 

is semiskilled or skilled.

6. If the claimant had the capacity to perform the full range of the 

sedentary exertional level, 20 CFR 404.1569 and Rule 201.21, Table 

No. 1 of 20 CFR Part 404, Subpart P, Appendix 2, would direct a 

conclusion of not disabled. Although the claimant’s exertional and 

non-exertional impairments do not allow her to perform the full 

range of the sedentary exertional level, using the above-cited Rule 

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as a framework for the decision making, there are a significant 

number of jobs in the national economy which she could perform.

7. The claimant was not disabled, as defined in the Social Security 

Act, at any time from August 11, 2008 through January 22, 2013, the 

date of the Administrative Law Judge’s decision.

Decision of the Appeals Council, Tr. 4-6. Thus, the Appeals Council, by adoption 

of portions of the ALJ’s decision coupled with findings of its own, determined 

that “the claimant is not entitled to a period of disability or disability insurance

benefits under sections 216(i) and 223, respectively, of the Social Security Act.” 

(Id. at 6).

DISCUSSION

In all Social Security cases, an ALJ utilizes a five-step sequential evaluation 

to determine whether the claimant is disabled, which considers: (1)

whether the claimant is engaged in substantial gainful activity; (2) if not, 

whether the claimant has a severe impairment; (3) if so, whether the 

severe impairment meets or equals an impairment in the Listing of 

Impairments in the regulations; (4) if not, whether the claimant has the 

RFC to perform her past relevant work; and (5) if not, whether, in light of 

the claimant’s RFC, age, education and work experience, there are other 

jobs the claimant can perform.

Watkins v. Commissioner of Soc. Sec., 457 Fed. Appx. 868, 870 (11th Cir. Feb. 9, 2012)3 (per 

curiam) (citing 20 C.F.R. §§ 404.1520(a)(4), (c)-(f), 416.920(a)(4), (c)-(f); Phillips v. 

Barnhart, 357 F.3d 1232, 1237 (11th Cir. 2004)) (footnote omitted). The claimant bears the 

burden, at the fourth step, of proving that she is unable to perform her previous work. 

Jones v. Bowen, 810 F.2d 1001 (11th Cir. 1986). In evaluating whether the claimant has 

met this burden, the examiner must consider the following four factors: (1) objective 

medical facts and clinical findings; (2) diagnoses of examining physicians; (3) evidence 

of pain; and (4) the claimant’s age, education and work history. Id. at 1005. Although “a 

 3 “Unpublished opinions are not considered binding precedent, but they may be cited as 

persuasive authority.” 11th Cir.R. 36-2.

Case 2:14-cv-00393-C Document 23 Filed 03/24/16 Page 9 of 22
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claimant bears the burden of demonstrating an inability to return to h[er] past relevant 

work, the [Commissioner of Social Security] has an obligation to develop a full and fair 

record.” Schnorr v. Bowen, 816 F.2d 578, 581 (11th Cir. 1987) (citations omitted). If a 

plaintiff proves that she cannot do her past relevant work, it then becomes the 

Commissioner’s burden—at the fifth step—to prove that the plaintiff is capable—given 

her age, education, and work history—of engaging in another kind of substantial 

gainful employment that exists in the national economy. Phillips, supra, 357 F.3d at 1237; 

Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir. 1999), cert. denied, 529 U.S. 1089, 120 S.Ct. 

1723, 146 L.Ed.2d 644 (2000); Sryock v. Heckler, 764 F.2d 834, 836 (11th Cir. 1985). 

The task for the Magistrate Judge is to determine whether the Commissioner’s

decision to deny claimant benefits, on the basis that she can perform a limited range of 

sedentary work, is supported by substantial evidence. Substantial evidence is defined as 

more than a scintilla and means such relevant evidence as a reasonable mind might 

accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 91 S.Ct. 

1420, 28 L.Ed.2d 842 (1971). “In determining whether substantial evidence exists, we 

must view the record as a whole, taking into account evidence favorable as well as

unfavorable to the Commissioner’s] decision.” Chester v. Bowen, 792 F.2d 129, 131 (11th 

Cir. 1986). 4 Courts are precluded, however, from “deciding the facts anew or reweighing the evidence.” Davison v. Astrue, 370 Fed. Appx. 995, 996 (11th Cir. Apr. 1, 

2010) (per curiam) (citing Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005)). And, 

“’[e]ven if the evidence preponderates against the Commissioner’s findings, [a court] 

must affirm if the decision reached is supported by substantial evidence.’” Id. (quoting 

Crawford v. Commissioner of Social Security, 363 F.3d 1155, 1158-1159 (11th Cir. 2004)).

 4 This Court’s review of the Commissioner’s application of legal principles, however, is 

plenary. Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987).

Case 2:14-cv-00393-C Document 23 Filed 03/24/16 Page 10 of 22
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On appeal to this Court, Conner asserts three reasons why the Commissioner’s 

decision to deny her benefits is in error (i.e., not supported by substantial evidence): (1) 

the Appeals Council and the ALJ erred in giving little weight to the opinion of the 

treating cardiologist, Dr. John A. Mantle, MD ; (2) the ALJ erred in giving significant 

weight to the opinion of a medical expert consulted after the hearing who did not hear 

any testimony; and (3) the ALJ erred in giving the most weight to the opinion of the 

DDS consultant, who provided an opinion in 2008 and was without access to most of 

the evidence of record. The Court will address each issue in turn, combining the 

analysis of the last two issues.

A. Opinions of Plaintiff’s Treating Physician, Dr. John A. Mantle. Conner 

initially contends that the ALJ erred in failing to accord substantial weight to the 

opinions of her treating cardiologist, Dr. John A. Mantle. On August 21, 2008, Mantle

completed a Certification of Health Care Provider5 (“CHCP”) and then completed a 

medical source statement (that is, a “PCE”) on October 9, 2012. (See Tr. 582, 587 & 669). 

In the CHCP, Mantle indicated that plaintiff suffered from chronic “cardiac 

related problems” that would require periodic visits to his office so that her condition 

could be monitored. His opinion was that she was incapable of engaging in work 

activities for an indefinite period of time. He also provided that her onset date was 

August 11, 2008, the day of her visit to his office. Mantle described her treatment 

regimen as the taking of prescription drugs, evaluation and treatment as needed. (See 

Tr. 582-583). His assessment on October 9, 2012 was that she “could not perform 

sustained work on a regular and continuing basis, i.e., 8 hours a day, for 5 days a week, 

or an equivalent work schedule[.]” Her treatment for “noncoronary cardiomyopathy” 

 5 Dr. Mantle completed a form established by the U.S. Department of Labor for use in gathering 

information relevant to the provisions of the Family and Medical Leave Act of 1993.

Case 2:14-cv-00393-C Document 23 Filed 03/24/16 Page 11 of 22
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at that time was the taking of prescribed medication combined with lifestyle changes 

that appeared to be working since he added that although her condition remained 

chronic, “she has shown some improvement ... [and] should continue to respond to 

ongoing medical Rx[.]” (Tr. at 669). 

The law in this Circuit is clear that an ALJ “’must specify what weight is given to 

a treating physician’s opinion and any reason for giving it no weight, and failure to do 

so is reversible error.’” Nyberg v. Commissioner of Social Security, 179 Fed.Appx. 589, 590-

591 (11th Cir. May 2, 2006) (unpublished), quoting MacGregor v. Bowen, 786 F.2d 1050, 

1053 (11th Cir. 1986) (other citations omitted). In other words, “the ALJ must give the 

opinion of the treating physician ‘substantial or considerable weight unless “good 

cause” is shown to the contrary.’” Williams v. Astrue, 2014 WL 185258, *6 (N.D. Ala. Jan. 

15, 2014), quoting Phillips v. Barnhart, 357 F.3d 1232, 1240 (11th Cir. 2004) (other citation 

omitted); see Nyberg, supra, 179 Fed.Appx. at 591 (citing to same language from Crawford 

v. Commissioner of Social Security, 363 F.3d 1155, 1159 (11th Cir. 2004)). 

Good cause is shown when the: “(1) treating physician’s opinion 

was not bolstered by the evidence; (2) evidence supported a 

contrary finding; or (3) treating physician’s opinion was conclusory 

or inconsistent with the doctor’s own medical records.” Phillips v. 

Barnhart, 357 F.3d 1232, 1241 (11th Cir. 2004). Where the ALJ 

articulate[s] specific reasons for failing to give the opinion of a 

treating physician controlling weight, and those reasons are 

supported by substantial evidence, there is no reversible error. 

Moore [v. Barnhart], 405 F.3d [1208,] 1212 [(11th Cir. 2005)].

Gilabert v. Commissioner of Soc. Sec., 396 Fed.Appx. 652, 655 (11th Cir. Sept. 21, 2010) (per

curiam). Most relevant to this case, an ALJ’s articulation of reasons for rejecting a 

treating source’s PCE must be supported by substantial evidence. See id. (“Where the 

ALJ articulated specific reasons for failing to give the opinion of a treating physician 

controlling weight, and those reasons are supported by substantial evidence, there is no 

reversible error. In this case, therefore, the critical question is whether substantial 

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evidence supports the ALJ’s articulated reasons for rejecting Thebaud’s RFC.”) (citing 

Moore v. Barnhart, 405 F.3d 1208, 1212 (11th Cir. 2005)); D’Andrea v. Commissioner of Social 

Security Admin., 389 Fed.Appx. 944, 947-948 (11th Cir. Jul. 28, 2010) (per curiam) (same).

In this case, the ALJ specifically determined that “little” weight was due to be 

afforded Mantle’s assessments because they were inconsistent with the objective 

evidence, including plaintiffs listed activities, and his own treatment notes. 

Additionally, he determined that the PCE of 2012 was internally inconsistent. (Tr. 19-

20.)

The undersigned has also considered the two assessments provided by the 

Claimant’s treating cardiologist (Exs. 10F and 16F). In both assessments 

dated August 2008 and October 2012, the cardiologist opined the Claimant 

is totally disabled and unable to work eight hours a day, five days a week 

or an equivalent work schedule. Additionally, he wrote the Claimant 

could not work for two hours at a time. These assessments have been 

afforded little weight even though the assessments were authored by the 

treating cardiologist. As noted by the medical expert, there are several 

inconsistencies between his assessments and his treatment reports. 

Although the representative submitted the latter assessment in the hopes 

of explaining the inconsistencies observed by the medical expert, the 

treating cardiologist’s latter assessment does not address those 

inconsistencies (Ex. 17E). In fact, his latter assessment seems to be 

internally inconsistent in [and] of itself as he wrote the Claimant has 

improved with treatment and that she will continue to respond to 

treatment (Ex. 16F). As discussed above, the cardiologist has stated 

several times since 2009 that the Claimant was doing well and she was 

able to exercise at least two days a week (Ex. 12F). He also observed the 

Claimant did not have side effects from her medication and that she did 

not have swelling as she contends (Ex. 12F). The improvement, as 

demonstrated by her recent echocardiogram results that showed only 

mild ventricular dysfunction, shows at the very least that the Claimant 

would have been much more capable in October 2012 as opposed to 

August 2008. However, the cardiologist believed the Claimant was as 

limited in 2012 as she was in 2008 despite the improvement in her 

condition. This inherent inconsistency further indicates the treating 

cardiologist’s assessments are not accurate or valid. Finally, the 

Claimant’s activities also demonstrate the Claimant is far more active than 

what the cardiologist indicated. Accordingly, the treating cardiologist’s 

assessments have been afforded little weight.

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(Id.) The undersigned construes the ALJ’s comments as an implicit (if not explicit) 

finding that Dr. Mantle’s opinions were conclusory and inconsistent with the doctor’s 

own medical records, as well as not bolstered by the other evidence of record. (See id.)

A review of the transcript reflects that Dr. Mantle has treated plaintiff since May 

14, 2007. (See, e.g., Tr. 494-495 (first record of visit reflects a referral for arrhythmiabradycardia and bundle branch block-left with a possible murmur).) Mantle ordered an 

echocardiogram on June 11, 2007 that confirmed his diagnosis and he prescribed the 

appropriate medications. (Tr. 490-491). He saw her again on August 27, 2007 to adjust 

her medications based on her complaints of edema in the hands and feet. He noted that 

she would “work as tolerated” and was encouraged to avoid overexertion or becoming 

overheated. (Tr. 483-484).

Approximately ten months later, Plaintiff returned to Mantle with complaints of 

an irregular heartbeat and was considered to have symptoms of atrial fibrillation. A 

Holter monitor was worn and the readings suggested atrial fibrillation. (Tr. 473). This 

information led to the administration of a stress test on August 8, 2008. Based on risk 

factors, the changing symptoms she reported and the abnormal stress test, it was 

suggested that she proceed with arteriographic studies to exclude coronary artery 

disease. (Tr. 459). On September 9, 2008, Dr. George P. Hemstreet, performed a left 

heart catheterization, selective coronary angiography and left ventriculogram. The 

findings revealed normal coronary arteries with an ejection fraction of about 40%. (Tr. 

454-457). Mantle adjusted her medication because of Plaintiff’s described symptoms 

and set her for a visit in six months. (Id. at 454). 

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Plaintiff’s follow-up visits from May 10, 2010 through February 28, 2012 are 

consistent with the original diagnosis and show improvement because she followed the 

regimen suggested by Mantle. On May 10, 2010, it was noted that she was doing well 

overall and prior anteriograms had been normal with no new or changing complaints. 

(Tr. 641). In November 2010, it was determined that “[s]he [had] stabilized on the 

current program, without problems with either chest pain, palpitations or shortness of 

breath, although she still has some discomfort at times.” (Tr. 638). On her next visit, 

May 9, 2011, on complaints of shortness of breath, described as mild, edema and heart 

racing, she was instructed to continue her activities as tolerated, change her dose of 

Coreg, continue with other medications as prescribed, reduce her risk factors, seek 

regular care and return for a follow-up visit in one month. (Tr. 633-636). The June 13, 

2011 visit reveals similar recommendations: her medications were altered and she was 

given similar instructions to those that were given in May and scheduled for a followup in three months. (Tr. 629-632). 

The follow-up visit on August 22, 2011 was a positive visit. Mantle’s records 

reveal that Plaintiff was stabilized and did not have problems with chest pain, 

palpitations or shortness of breath although she reported some discomfort at times. 

Mantle noted that she was “doing better on the increased dosage” of Coreg. (Tr. 625). 

Six months later, February 28, 2011, Plaintiff went for her follow-up with complaints of 

shortness of breath and some chest pain. She was instructed to continue her activities 

as tolerated, take her medications as prescribed, seek regular care and return in six 

months. (Tr. 621-624).

After the visit on August 27, 2012, Plaintiff was scheduled for an echocardiogram 

and a renal duplex. (Tr. 648). The notes from October 3, 2011 record that she did not 

have chest pain at the time and the renal duplex completed on September 25, 2011 did 

Case 2:14-cv-00393-C Document 23 Filed 03/24/16 Page 15 of 22
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not show evidence of renal artery stenosis. The echocardiogram performed on the same 

date indicated a “mildly reduced ejection fraction” that had improved since the 2008 

test. He recommended a change in diet, continued activities as tolerated, same

medications and a return visit in six months. (Tr. 657-658). 

In addition to the clinical reports, the ALJ considered the assessments Dr. James 

Anderson (Ex. 14F) and Dr. Robert M. Little (Ex. 5F). Interrogatories were sent to 

Anderson after the hearing and based on his review of the record; he formed the 

opinion that Plaintiff could perform sedentary work. (Tr. 649-652 ). He also determined 

that Dr. Mantle’s opinion that the claimant was unable to perform work activities in 

August 2008 was in conflict with his treatment notes that allowed her to continue with 

her activities and did not reveal an objective basis for precluding sedentary work. (Id. 

at 651). 

Little’s assessment was prepared early in the process, December 2008, but the 

ALJ afforded the most weight to his findings as is reflected in the ultimate RFC. His 

findings were considered most influential because the treatment notes reflect that the 

claimant’s symptoms and conditions were at their worst stage in her treatment history 

and did not worsen but improved with the treatment regimen prescribed by her 

cardiologist. Her condition was considered moderately severe in 2008 and had 

improved by the date of the hearing. Specifically, Little’s findings were that Plaintiff

could lift twenty pounds occasionally, ten pounds frequently, stand and/or walk for at 

least two hours in a workday, sit at least six hours in a workday and push and pull with 

her hands and feet on an unlimited basis. He thought her ability to climb ramps and 

stairs, balance, stoop, kneel, crouch, and crawl were only occasionally limited. He did 

not believe that she should ever climb ladders, ropes or scaffolds. Little did not believe 

she had any manipulative, visual or communicative limitations but did find that she 

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should avoid concentrated exposure to extreme heat and cold and any fumes, odors, 

dusts, gases, poor ventilation. Finally, it was his opinion that she should avoid all 

exposure to environmental hazards such as machinery and heights. (Tr. 498-505).6

Upon further review by the Appeals Council, that body also noted that Dr. 

Mantle’s opinion was conclusory and not supported in the record. (Tr. 5). In addition, 

the Appeals Counsel rejected the argument, as interpreted by the undersigned,

currently presented by the claimant:

The claimant’s representative argues that it is improper to credit 

only part of Dr. Mantle’s statement (that the claimant is improving) while 

ignoring the rest (that the claimant cannot sustain work). To the contrary, 

the statement that the claimant is improving is well supported by the 

record, including Dr. Mantle’s contemporaneous October 3, 2012 progress 

note; Dr. Mantle’s opinion that the claimant cannot sustain work, on the 

other hand, is conclusory and not well supported by the record, so it does 

not merit significant weight.

(Tr. 5).

Based on the foregoing, the Court finds that the ALJ was correct in giving little 

weight to that portion of Dr. Mantle’s assessments of August 8, 2008 and October 9, 

2012 that Plaintiff was incapable of gainful employment because his findings are 

inconsistent with the objective medical evidence, including his own examination notes. 

In other words, Dr. Mantle’s objective clinical findings are inconsistent with the limited 

vocational findings he made and therefore, the Court finds the ALJ’s articulated reasons 

for giving little weight to his findings are supported by substantial evidence. Although 

counsel argues that the notations of claimant’s improvement do not translate into 

vocational abilities, there is no dispute that when her condition was first diagnosed, she 

was capable of performing her past relevant work. In addition, the evidence does 

 6 At the time Little composed his RFC assessment, there were no statements from Dr. Mantle in 

the record for him to consider.

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support improvement in her conditions and the continued ability to perform her daily 

activities as tolerated. When you couple that evidence with the assessments provided 

by Drs. Anderson, Little and the vocational expert, the record evidence clearly supports 

the conclusion that she was capable of engaging in a limited range of sedentary work 

activities. Accordingly, the undersigned discerns no error in the ALJ affording little

weight to Mantle’s opinions of Plaintiff’s abilities to engage in gainful employment.

B. The ALJ Erred in Giving Weight to the Opinions of Consulting Doctors. In

her brief, Plaintiff contends that the ALJ’s decision to give significant weight to the 

opinion of Dr. Anderson, a medical expert who testified by the means of post-hearing 

interrogatories, requires remand of this action. First, he attacks the credibility of 

Anderson because he obviously failed to remember that he had previously served as a 

medical expert during a hearing held on February 3, 2010, involving the same plaintiff. 

It is unclear, however, how this mistake would somehow diminish his opinions formed 

after a review of the records in this case. The undersigned does not agree that 

Anderson’s credibility in this action is undermined by his response to Interrogatory No. 

4. (See Ex. 14F, Tr. 650).

Secondly, plaintiff argues that Anderson’s opinions are expressed on a form and 

do not contain sufficient information to allow any weight to be given them. Specifically, 

it is argued that he did not address the symptoms of shortness of breath, palpitations 

and chest discomfort. Additionally, it is argued that he did not provide a rationale for 

his disagreement with Dr. Mantle’s 2008 assessment. This position requires little 

discussion since it is clear from a review of the form completed by Anderson and the 

analysis of the ALJ, that he did provide his rationale for discounting the vocational 

assessments of Mantle and clearly referenced treatment notes where the symptoms 

listed were successfully treated with medication and regular checkups.

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Plaintiff also argues that it was error for the ALJ to give “the most weight” to the 

assessment provided by a medical consultant from the Disability Determination Service 

dated in December 2008. (Ex. 5F). 

With regard to Plaintiff’s argument that the assessment of Dr. Anderson was 

weighted to heavily by the ALJ, the only citation presented in support of her position is 

to Swindle v. Sullivan, 914 F.2d 222, 226 n. 3 (11th Cir. 1990), apparently for the 

proposition that the “opinion of a non-examining reviewing physician is entitled to 

little weight and taken alone, does not constitute substantial evidence to support an 

administrative decision.” (Doc. 13 at 6). The entirety of the footnote is:

The ALJ's finding regarding Ms. Swindle's residual functional 

capacity mirrors the conclusions reached by Dr. Hibbett, the consulting 

doctor who reviewed the medical evidence after the hearing. Although 

Dr. Hibbett opined that Ms. Swindle was capable of a full range of 

sedentary work, with the restriction that she avoid exposure to the sun, 

his opinion neither took into account nor refuted Ms. Swindle's nonexertional symptoms of pain and dizziness. Because Dr. Hibbett did not 

examine Ms. Swindle, his opinion is entitled to little weight and taken 

alone does not constitute substantial evidence to support an 

administrative decision. Broughton v. Heckler, 776 F.2d 960, 962 (11th 

Cir.1985).

Swindle v. Sullivan, 914 F.2d 222, 226 n. 3 (11th Cir. 1990). Plaintiff then references 

Spencer ex rel. Spencer v. Heckler, 765 F.2d 1090 (11th Cir. 1985), Johns v. Bowen, 821 F.2d 

551 (11th Cir. 1987), Sharfarz v. Bowen, 825 F.2d 551 (11th Cir. 278 (11th Cir. 1987) and Lamb 

v. Bowen, 847 F2d 698 (11th Cir. 1988) for the general propositions that “reports of 

reviewing nonexamining physicians do not constitute substantial evidence on which to 

base an administrative decision[;] the good cause requirement in affording little weight 

is not provided by the report of a nonexamining physician where it contradicts the 

report of the treating physician; and opinions of nonexamining physicians are entitled 

to little weight when contrary to those of an examining physician and standing alone do 

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not constitute substantial evidence. While the Court does not take issue with these 

general propositions, it is not entirely clear as to how they apply in this case.

For instance, the citation to Swindle is not particularly helpful. As explained by 

Magistrate Judge Nelson, when the weight given to the opinion of a non-examining 

physician comes under attack by a plaintiff, the analysis is more complicated than 

suggested by the Plaintiff in this case:

Swindle remains good law in this Circuit, but, under certain 

circumstances, “substantial evidence supports [an] ALJ's decision to 

assign great weight to” the opinion of a state agency physician. Ogranaja,

186 Fed. App'x at 850. In Ogranaja, the court cited Swindle, but then noted 

that, there,

[t]he ALJ arrived at his decision after considering the 

record in its entirety and did not rely solely on the opinion of the 

state agency physicians. The ALJ found that, unlike [the treating 

physician's] opinions, the expert opinions of the non-examining 

state agency physicians were supported by and consistent with 

the record as a whole.

Id. at 851 (emphasis added). Further, as explained by the court in Hogan v. 

Astrue, Civil Action No. 2:11cv237–CSC, 2012 WL 3155570 (M.D.Ala. Aug. 

3, 2012),

[i]n isolation, Swindle seems to suggest that the opinion of a 

nonexamining physician cannot be substantial evidence under 

any circumstances. Swindle cites Broughton as authority, but that 

case “held that the opinion of a nonexamining physician is 

entitled to little weight if it is contrary to the opinion of the 

claimant's treating physician.” Broughton, 776 F.2d at 962 

(emphasis added). That formulation of the law is consistent with 

Lamb v. Bowen, 847 F.2d 698 (11th Cir.1988) and Sharfarz v. Bowen,

825 F.2d 278 (11th Cir.1987). Thus, the court concludes that the 

opinion of a non-examining physician who has reviewed medical 

records may be substantial evidence if it is consistent with the 

well-supported opinions of examining physicians or other medical 

evidence in the record.

Id. at *5 (citations modified and second emphasis added). In Hogan, the 

court ultimately affirmed the ALJ's decision, concluding “[a]fter a careful 

review of all the medical records, ... that the ALJ's residual functional 

capacity [was] consistent with the medical evidence as a whole as well as 

Hogan's testimony about her abilities.” Id. at *6 (emphasis added).

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Similarly, here, the ALJ “agreed with ... the findings of the State agency 

[Dr. Jackson] with respect to [Alexander's] mental capacities” after noting 

that the medical expert called to testify at the hearing, Dr. Davis, agreed 

with those findings. (R. 48.) The ALJ then “incorporated” the findings as 

to Alexander's mental capacities into his RFC determination, which the 

ALJ also noted was “supported by the medical history of record, the 

minimal abnormal test and examination findings of record, the sporadic 

nature of [Alexander's] treatment, ... and by [Dr. Davis's] testimony.” (R. 

48–49.)

Alexander v. Colvin, No. CIV.A. 2:12-00607-N, 2013 WL 5176355, at *6 (S.D. Ala. Sept. 13, 

2013)(emphasis supplied).

In his action, the ALJ discounted the opinion of Dr. Mantle that the Plaintiff was 

unable to engage in employment after a thorough discussion of the records and the 

inconsistencies noted above, a decision with which the undersigned is in complete 

agreement. He also discredited the testimony of the Plaintiff to the degree that her 

impairments rendered her unable to engage in a limited range of sedentary work. 

Instead, the ALJ “afforded the most weight” to Dr. Little’s assessment. (Tr. 19; Ex. 5F). 

Although his assessment had been prepared in 2008, “it was affirmed by [Dr. 

Anderson’s] more general assessment” and “is in line with the treatment reports.” (Tr. 

19). Both believed Plaintiff could engage in sedentary work but Dr. Little, consistent 

with record as a whole, placed more limitations on the full range of sedentary work. 

Based on the entire record, the Court cannot say that the decision to heavily rely 

on the opinions of Dr. Little and Dr. Anderson is not based on substantial evidence. See 

Wilkinson v. Commissioner of Soc. Sec. Admin., 289 Fed. App'x. 384, 386 (11th Cir. Aug. 20, 

2008) (per curiam) (“The ALJ did not give undue weight to the opinion of the nonexamining state agency physician because he did not rely solely on that opinion. The 

ALJ considered the opinions of other treating, examining, and non-examining 

physicians; rehabilitation discharge notes indicating improvement; and Wilkinson's 

own disability reports and testimony.” (citing Broughton, 776 F.2d at 962)); cf. Davis v. 

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Astrue, Civil Action No. 2:08CV631–SRW, 2010 WL 1381004, at *5 (M.D.Ala. Mar. 31, 

2010) (holding that “the ALJ properly assigned ‘great weight’ “ to the opinion a nonexamining physician because that opinion was “supported by and consistent with the 

record as a whole[,] unlike the opinion of plaintiff's treating sources.... The opinion of a 

non-examining physician alone does not constitute substantial evidence. Swindle v. 

Sullivan, 914 F.2d 222, 226 n. 3 (11th Cir.1990). However, where the ALJ has discounted 

the opinion of an examining source properly, the ALJ may rely on the contrary opinions 

of non-examining sources.” (emphasis added and some citations omitted)).

Based on the law in this Circuit, the Court must conclude that the ALJ properly 

relied on the opinions of Drs. Little and Anderson and that these opinions provide the 

necessary linkage regarding the plaintiff's ability to perform the requirements of a 

limited range of sedentary work. Therefore, the ALJ's decision provides this Court with 

a sufficient rationale to review his conclusions and conclude that the decision is 

supported by substantial evidence.

CONCLUSION

In light of the foregoing, it is ORDERED that the decision of the Commissioner 

of Social Security denying plaintiff benefits be affirmed.

DONE and ORDERED this the 23rd day of March, 2016.

s/WILLIAM E. CASSADY

UNITED STATES MAGISTRATE JUDGE

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