Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alsd-1_15-cv-00626/USCOURTS-alsd-1_15-cv-00626-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION

MARIE G. BOSARGE, :

Plaintiff, :

vs. : CA 15-0626-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), seeking judicial review 

of a final decision of the Commissioner of Social Security denying her claim for a period 

of disability and disability insurance benefits. 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. 18 & 19 (“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 and the parties’ briefs,

1 it is determined that the 

Commissioner’s decision denying benefits should be affirmed.

2

 

 1 At the behest of the Court, given the age of this case, the parties in this matter 

waived oral argument.

2 Any appeal taken from this memorandum opinion and order and judgment shall 

be made to the Eleventh Circuit Court of Appeals. (See Docs. 18 & 19 (“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 1:15-cv-00626-C Document 21 Filed 12/22/16 Page 1 of 15
2

Plaintiff alleges disability due to chronic obstructive pulmonary disease, 

hypertension, migraines, obesity, and degenerative disk disorder. The Administrative 

Law Judge (ALJ) made the following relevant findings:

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

Security Act through June 30, 2016.

2. The claimant has not engaged in substantial gainful activity since 

April 30, 2011, the alleged onset date (20 CFR 404.1571 et seq.).

3. The claimant has the following severe impairments: chronic 

obstructive pulmonary disease (COPD), hypertension, migraines, 

obesity, and degenerative disc disease (20 CFR 404.1520(c)).

. . .

4. The claimant does not have an impairment or combination of 

impairments that meets or medically equals the severity of one of the 

listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 

404.1520(d), 404.1525 and 404.1526).

. . .

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

finds that the claimant has the residual functional capacity to perform

the full range of medium work as defined in 20 CFR 404.1567(c).

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 CFR 404.1529 and SSRs 96-4p and 96-7p. The 

undersigned has also considered opinion evidence in accordance with the 

requirements of 20 CFR 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 

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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 alleges that due to her pain, nausea, dizziness, and breathing 

problems, she is disabled. After careful consideration of the evidence, the 

undersigned finds that the claimant’s medically determinable 

impairments could reasonably be expected to cause the alleged symptoms; 

however, the claimant’s statements concerning the intensity, persistence 

and limiting effects of these symptoms are not entirely credible for the 

reasons explained in this decision.

In terms of the claimant’s alleged physical impairments, she has received 

generally conservative treatment and has been medically non-compliant 

with her medications. The claimant’s treatment records from Bayou La 

Batre Area Health show that the claimant received generally conservative 

treatment for her impairments. Treatment notes from January 2011 show 

that upon examination her back had unremarkable findings and her chest 

was clear as well. A cervical spine view from January 2011 showed 

moderate degenerative disc disease of the cervical spine with some 

spurring with similar changes in her thoracic and lumbar spine. At this 

visit, her COPD was assessed to be stable although her blood pressure 

was elevated. Specifically, treatment notes from April 2011 showed that 

upon examination her chest was clear. Her blood pressure was still high 

so she was prescribed Lisinopril along with Coreg.

In November 2012, Henrietta Kovacs, M.D. examined the claimant. 

Despite her COPD, the claimant continued to smoke tobacco and was 

assessed with tobacco abuse. She reported only getting headaches once a 

month. Upon examination, her lungs were clear to percussion and to 

auscultation and she had no wheezing or rales. She had no murmur or 

gallop. He back was symmetric and there was no flank tenderness. She 

had no edema. She had a mild limitation of the range of motion of the 

dorsolumbar spine on flexion and the left shoulder in abduction and 

forward elevation, but no limitation of range of motion in the other joints. 

She had a negative straight leg raise and was able to heel and toe walk 

and tandem [walk] without any problems. Her gait was normal as well. 

She was assessed with COPD, long history, long history of migraine 

headaches, chronic lower back pain with referred pain and numbness in 

her left upper arm, and hypertension.

Treatment records from the Mostellar Medical Center show that the 

claimant was medically non-compliant. Specifically, the claimant was 

assessed to have been out of her medication for a while despite her denials 

as of a visit in January 2014. She was recommended to take medications, 

including Coreg, but refused. In addition, these treatment notes stated 

that the claimant[] complained of back pain despite previously normal Xrays. Upon examination, her lungs were clear, she had no murmur or 

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gallop, her neck was non-tender, she had full motor strength in all her 

extremities, and no acute abnormalities were note[d] from a lumbar spine 

film. She was assessed with back pain, COPD, hypertension, tobacco 

abuse and medical noncompliance. The claimant was advised of the risk 

of uncontrolled hypertension in light of her medical non-compliance. She 

was prescribed Coreg and Lisinopril. As for her obesity, the claimant’s 

reported height and weight of 5 feet 1 inch and weight of 168 pounds 

calculates to a body mass index of 31.7, which is a BMI indicating obesity 

and the undersigned has considered this impairment as well. 

After considering the medical evidence of record, the undersigned finds 

that the claimant’s hypertension, obesity, COPD, migraines, degenerative 

disc disease, and arising symptoms are accommodated by the limitation to 

medium work and preclusion of heavy or very heavy work.

. . .

In regards to the claimant’s credibility, after evaluation of the medical 

evidence and the claimant’s statements, the undersigned finds that the 

claimant’s allegations regarding her limitations and being disabled are not 

wholly credible. The undersigned has considered the objective medical 

evidence (sign and laboratory findings); medical treatment history; 

medical opinions and observations; opinions of non-examining medical 

sources; the claimant’s daily activities; the location, duration, frequency, 

and intensity of her symptoms; precipitating and aggravating factors; 

type, dosage, effectiveness and side effects of medication; treatment other 

than medication; other measures; consistency of statements; observations 

of non-medical persons; and the claimant’s work history in assessing the 

claimant’s credibility (SSR 96-7p).

The claimant’s alleged disability is not wholly credible because overall her 

examination findings show findings within generally normal limits, 

particularly in light of clear lungs upon examination, X-ray evidence 

showing findings within normal limits despite her pain complaints, and 

normal gait, normal tandem walk, and normal heel to toe walk. She is not 

medically compliant with her blood pressure medication as prescribed by 

her doctor, and she uses tobacco despite her COPD. Moreover, she ran out 

of her COPD medication and was therefore non-compliant with taking her 

COPD medication. Her activities of daily living belie her allegations of 

disable[ity] as to her physical limitations in that she is generally able to 

perform personal care, wash dishes, do laundry, cook simple meals, spend 

time with her grandchildren, and drive. She has not received aggressive 

treatment for any of her impairments. The medical evidence does not 

establish headaches, nausea, fatigue, swelling, shortness of breath, or pain 

of the level and severity that would result in debilitating limitations, and 

her medical non-compliance suggests that her symptoms are not severe as 

well. Her activities of daily living are self-restricted, as no treating source 

has advised her to stay home all day, lie down during the day, or to 

restrict her activities of daily living in any manner, and instead she has 

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been encouraged to exercise. She has not been advised to refrain from 

performing all gainful work activity. She has not required recurrent 

emergency room visits, recent surgery for her back, prolonged physical 

therapy, or chronic pain management treatment.

In sum, the above residual functional capacity assessment is supported by 

the claimant’s musculoskeletal findings generally within normal limits; 

generally clear lungs upon examination; X-ray evidence showing 

generally findings within normal limits; examination findings of normal 

gait, normal tandem walk, and heel and to[e] walk; the lack of consistent 

medical treatment for any of her impairments; the lack of any need for 

hospitalizations o[r] emergency room treatment for her[] severe 

impairments; medical non-compliance; and in the light of the variety of 

her activities of daily living and ability to generally perform personal care 

and drive.

6. The claimant is capable of performing past relevant work as a 

screen printer. This work does not require the performance of workrelated activities precluded by the claimant’s residual functional 

capacity (20 CFR 404.1565).

The claimant has past relevant work as a screen printer. The term “past 

relevant work” means work performed (either as the claimant actually 

performed it or as it is generally performed in the national economy) 

within the last 15 years or 15 years prior to the date that disability must be 

established. In addition, the work must have lasted long enough for the 

claimant to learn to do the job and have been SGA (20 CFR 404.1560(b) 

and 404.1565).

The claimant worked as a screen printer from 1994 to 2000, which was 

within the last 15 years. At her job in 1994 to 2000, she earned $10.00 per 

hour and worked 8 hours per day, 40 hours a week, which calculates to 

approximately $1600.00 per month. In addition, her earnings from 1999 

was $17,755.00, which divided by twelve approximates to $1479.58 per 

month. Thus, her earnings for 1999 and while working in 2000 was over 

the SGA amount of at least $500 prior to July 1999, and then $700 from 

July 1999 through December 2000. She performed this work for more than 

6 months; thus, she performed this job long enough for her to learn to do 

the job. 

In comparing the claimant’s residual functional capacity with the physical 

and mental demands of this work, the undersigned finds that the claimant 

is able to perform it as generally performed.

This work was classified as medium semi-skilled work with no 

transferable skills by the vocational expert. In addition, the undersigned 

notes that the Dictionary of Occupational Titles (DOT) designates screen 

printer helper as medium unskilled work (DOT 979.687-022) and screen 

printer as light semi-skilled work (DOT 979.684-034). Nevertheless, under 

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the vocational expert’s classification accepted under SSR 00-4p, and/or in 

the alternative under both the DOT’s classifications, the claimant would 

be able to return to her past relevant work as a screen printer under the 

above residual functional capacity of a full range of medium work.

7. The claimant has not been under a disability, as defined in the 

Social Security Act, from April 30, 2011, through the date of this 

decision (20 CFR 404.1520(f)). 

 

(Tr. 50, 52, 53-55 & 55-56 (internal citations omitted; emphasis in original).) The 

Appeals Council affirmed the ALJ’s decision (Tr. 1-4) and thus, the hearing decision 

became the final decision of the Commissioner of Social Security.

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 1:15-cv-00626-C Document 21 Filed 12/22/16 Page 6 of 15
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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 her past relevant 

work as a screen printer, 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] 

 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).

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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)).

On appeal to this Court, Bosarge asserts two reasons why the Commissioner’s 

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

the ALJ’s residual functional capacity (RFC) assessment (for the full range of medium 

work) is not supported by substantial evidence of record because the only opinion in 

the file that supports such a finding is an opinion rendered by a Single Decision Maker 

(SDM); and (2) the ALJ failed to comply with SSR 96-7p in discrediting plaintiff for her 

failure to obtain treatment without first considering her explanations for lack of 

treatment. The Court will address each issue in turn.

A. Is the ALJ’s RFC Determination Supported by Substantial Evidence of 

Record? In her brief, plaintiff contends that the ALJ’s RFC assessment is not supported 

by substantial evidence because the only opinion in the record supporting the ALJ’s 

finding is that of a Single Decision Maker (Doc. 12, at 1; see also id. at 2-3).

Initially, the Court notes that the responsibility for making the residual 

functional capacity determination rests with the ALJ. Compare 20 C.F.R. § 404.1546(c)

(“If your case is at the administrative law judge hearing level . . ., the administrative law 

judge . . . is responsible for assessing your residual functional capacity.”) with, e.g., 

Packer v. Commissioner, Social Security Admin., 542 Fed. Appx. 890, 891-892 (11th Cir. Oct. 

29, 2013) (per curiam) (“An RFC determination is an assessment, based on all relevant 

evidence, of a claimant’s remaining ability to do work despite her impairments. There is 

no rigid requirement that the ALJ specifically refer to every piece of evidence, so long as 

the ALJ’s decision is not a broad rejection, i.e., where the ALJ does not provide enough 

reasoning for a reviewing court to conclude that the ALJ considered the claimant’s 

medical condition as a whole.” (internal citation omitted)). A plaintiff’s RFC—which 

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“includes physical abilities, such as sitting, standing or walking, and mental abilities, 

such as the ability to understand, remember and carry out instructions or to respond 

appropriately to supervision, co-workers and work pressure[]”—“is a[n] [] assessment 

of what the claimant can do in a work setting despite any mental, physical or 

environmental limitations caused by the claimant’s impairments and related 

symptoms.” Watkins, supra, 457 Fed. Appx. at 870 n.5 (citing 20 C.F.R. §§ 404.1545(a)-(c), 

416.945(a)-(c)). Here, the ALJ’s RFC assessment consisted of the following: “After

careful consideration of the entire record, the undersigned finds that the claimant has 

the residual functional capacity to perform the full range of medium work as defined 

in 20 CFR 404.1567(c).” (Tr. 53 (emphasis in original).)

To find that an ALJ’s RFC determination is supported by substantial evidence, it 

must be shown that the ALJ has “’provide[d] a sufficient rationale to link’” substantial 

record evidence “’to the legal conclusions reached.’” Ricks v. Astrue, 2012 WL 1020428, 

*9 (M.D. Fla. Mar. 27, 2012) (quoting Russ v. Barnhart, 363 F. Supp. 2d 1345, 1347 (M.D. 

Fla. 2005)); compare id. with Packer v. Astrue, 2013 WL 593497, *4 (S.D.Ala. Feb. 14, 2013) 

(“’[T]he ALJ must link the RFC assessment to specific evidence in the record bearing 

upon the claimant’s ability to perform the physical, mental, sensory, and other 

requirements of work.’”), aff’d, 542 Fed. Appx. 890 (11th Cir. Oct. 29, 2013)5; see also 

Hanna v. Astrue, 395 Fed. Appx. 634, 636 (11th Cir. Sept. 9, 2010) (per curiam) (“The ALJ 

must state the grounds for his decision with clarity to enable us to conduct meaningful 

review. . . . Absent such explanation, it is unclear whether substantial evidence 

 5 In affirming the ALJ, the Eleventh Circuit rejected Packer’s substantial evidence 

argument, noting, she “failed to establish that her RFC assessment was not supported by 

substantial evidence[]” in light of the ALJ’s consideration of her credibility and the medical 

evidence. Id. at 892.

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supported the ALJ’s findings; and the decision does not provide a meaningful basis 

upon which we can review [a plaintiff’s] case.” (internal citation omitted)).6

In order to find the ALJ’s RFC assessment supported by substantial evidence, it is 

not necessary for the ALJ’s assessment to be supported by the assessment of an 

examining or treating physician. See, e.g., Packer, supra, 2013 WL 593497, at *3 

(“[N]umerous court have upheld ALJs’ RFC determinations notwithstanding the 

absence of an assessment performed by an examining or treating physician.”); 

McMillian v. Astrue, 2012 WL 1565624, *4 n.5 (S.D. Ala. May 1, 2012) (noting that 

decisions of this Court “in which a matter is remanded to the Commissioner because 

the ALJ’s RFC determination was not supported by substantial and tangible evidence 

still accurately reflect the view of this Court, but not to the extent that such decisions are 

interpreted to require that substantial and tangible evidence must—in all cases—

include an RFC or PCE from a physician” (internal punctuation altered and citation 

omitted)); but cf. Coleman v. Barnhart, 264 F.Supp.2d 1007 (S.D. Ala. 2003). In this case, of 

 6 It is the ALJ’s (or, in some cases, the Appeals Council’s) responsibility, not the 

responsibility of the Commissioner’s counsel on appeal to this Court, to “state with clarity” the 

grounds for an RFC determination. Stated differently, “linkage” may not be manufactured 

speculatively by the Commissioner—using “the record as a whole”—on appeal, but rather, 

must be clearly set forth in the Commissioner’s decision. See, e.g., Durham v. Astrue, 2010 WL 

3825617, *3 (M.D. Ala. Sept. 24, 2010) (rejecting the Commissioner’s request to affirm an ALJ’s 

decision because, according to the Commissioner, overall, the decision was “adequately 

explained and supported by substantial evidence in the record”; holding that affirming that 

decision would require that the court “ignor[e] what the law requires of the ALJ[; t]he court 

‘must reverse [the ALJ’s decision] when the ALJ has failed to provide the reviewing court with 

sufficient reasoning for determining that the proper legal analysis has been conducted’” 

(quoting Hanna, 395 Fed. Appx. at 636 (internal quotation marks omitted))); see also id. at *3 n.4 

(“In his brief, the Commissioner sets forth the evidence on which the ALJ could have relied . . . . 

There may very well be ample reason, supported by the record, for [the ALJ’s ultimate 

conclusion]. However, because the ALJ did not state his reasons, the court cannot evaluate them 

for substantial evidentiary support. Here, the court does not hold that the ALJ’s ultimate 

conclusion is unsupportable on the present record; the court holds only that the ALJ did not 

conduct the analysis that the law requires him to conduct.” (emphasis in original)); Patterson v. 

Bowen, 839 F.2d 221, 225 n.1 (4th Cir. 1988) (“We must . . . affirm the ALJ’s decision only upon 

the reasons he gave.”).

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course, as plaintiff acknowledges (see Doc. 12, at 2), the record contains no RFC 

assessments completed by a treating or examining physician (compare id. with Tr. 222-

233, 235-240, 242-258, 260-267 & 269-283), only an RFC assessment by P.C. Simmons, a 

SDM (see Tr. 95-96). 

Importantly, in establishing Bosarge’s RFC for the full range of medium work,

which means determining Bosarge’s “remaining ability to do work despite her

impairments[,]” Packer, 542 Fed.Appx. at 891—keeping a focus on the extent of those 

impairments as documented by the credible record evidence—the ALJ walked through 

all the evidence of record, along with the claimant’s testimony (see Tr. 54-55), and

ultimately concluded that plaintiff’s RFC assessment was properly informed by “the

claimant’s musculoskeletal findings generally within normal limits; generally clear 

lungs upon examination; X-ray evidence showing generally findings within normal 

limits; examination findings of normal gait, normal tandem walk, and heel and to[e] 

walk; the lack of consistent medical treatment for any of her impairments; the lack of 

any need for hospitalizations o[r] emergency room treatment for any of her 

impairments; medical non-compliance; and in light of the variety of her activities of 

daily living and ability to generally perform personal care and drive.” (Tr. 56.) As 

previously noted, an ALJ’s RFC assessment does not have to be supported by the 

assessment of an examining or treating physician, and in this case it was not (see Tr. 53-

56). Moreover, in reaching his RFC assessment in this case, the ALJ made no mention of 

the RFC assessment of the SDM, much less accord it any weight (see id.). Plaintiff’s 

suggestion that the ALJ must have accorded the SDM’s opinion substantial weight, 

since that is the only physical RFC assessment in the record, is fundamentally flawed 

because it ignores clear precedent that the assessment of a claimant’s RFC is solely the 

ALJ’s responsibility and such responsibility can be satisfied without relying upon the 

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RFC assessment completed by a treating or examining physician. In light of this clear 

precedent, see, e.g., Packer, supra, 2013 WL 593497, at *3, it is impossible for this Court to 

agree with plaintiff’s argument that the ALJ must have relied upon the RFC assessment 

of an SDM nowhere mentioned in the ALJ’s decision, particularly in light of the 

plethora of evidence to which the ALJ cited in support of that assessment (compare Tr. 

56 with Tr. 54-55 & Tr. 239-240 (negative radiographs of the cervical spine and lumbar 

spine); Tr. 264, 266-267 (range of motion testing reflected only mild limitation of the 

dorsolumbar spine on flexion and the left shoulder in abduction and forward elevation 

but no limitation in any of the other joints examined); Tr. 281 (physical examination 

revealed 5/5 motor strength in all four extremities, normal sensory exam, and LS-spine 

film showed no acute abnormalities)).

7 In light of the foregoing, the undersigned finds 

that the ALJ’s RFC assessment provides an articulated linkage to the medical evidence 

of record. The linkage requirement is simply another way to say that, in order for this 

Court to find that an RFC determination is supported by substantial evidence, ALJs 

must “show their work” or, said somewhat differently, show how they applied and 

analyzed the evidence to determine a plaintiff’s RFC. See, e.g., Hanna, 395 Fed. Appx. at 

636 (an ALJ’s “decision [must] provide a meaningful basis upon which we can review [a 

plaintiff’s] case”); Ricks, 2012 WL 1020428, at *9 (an ALJ must “explain the basis for his 

decision”); Packer, 542 Fed.Appx. at 891-892 (an ALJ must “provide enough reasoning

for a reviewing court to conclude that the ALJ considered the claimant’s medical 

condition as a whole[]” (emphasis added)). Thus, by “showing his work” (see Tr. 53-56), 

 7 In other words, because the medical evidence of record (see, e.g., Tr. 239-240, 264, 

266-267 & 281) in this case supports the ALJ’s RFC determination, the ALJ obviously had no 

need to rely, explicitly or implicitly, upon the RFC assessment of the SDM.

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the ALJ has provided the required “linkage” between the record evidence and her RFC 

determination necessary to facilitate this Court’s meaningful review of his decision.

B. Did the ALJ fail to comply with SSR 96-7p in Discrediting Plaintiff due 

to Non-compliance with Treatment without Considering her Explanation for Noncompliance? Plaintiff correctly points out that SSR 96-7p provides that an ALJ “must 

not draw any inferences about an individual’s symptoms and their functional effects 

from a failure to seek or pursue regular medical treatment without first considering any 

explanations that the individual may provide, or other evidence in the case record, that 

may explain infrequent or irregular medical visits or failure to seek medical treatment.” 

Id. To this end, the ruling recognizes that an ALJ “may need to recontact the individual 

or question the individual at the administrative proceeding in order to determine 

whether there are good reasons the individual does not seek medical treatment or does 

not pursue treatment in a consistent manner.” Id.8 Bosarge contends that the ALJ ran 

afoul of SSR 96-7p in this case by discrediting her due to her non-compliance in 

obtaining and taking her medications without first taking into consideration her ability 

to pay for her medications. (See Doc. 12, at 3.) 

The undersigned finds no reversible error in this regard. A review of the 

transcript of the administrative hearing revealed the following exchange between the 

ALJ and Bosarge:

Q Are you able to get your medications regularly and on time 

like you’re supposed to?

A Yes, sir.

 8 Plaintiff also correctly points out that the ruling provides that one valid reason 

for not following treatment is as follows: “The individual may be unable to afford treatment 

and may not have access to free or low-cost medical services.” Id. 

Case 1:15-cv-00626-C Document 21 Filed 12/22/16 Page 13 of 15
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Q Do you take them regularly like you’re supposed to?

A Yes, sir.

Q Do they seem to help you?

A Yes, sir.

(Tr. 72.) With this exchange, the ALJ provided an open door through which plaintiff 

could have walked and explained any inability to afford her prescribed medications; 

however, Bosarge gave no indication that she was unable to obtain her medications 

regularly and on time because of an inability to afford them. Accordingly, this Court 

declines to find that the ALJ in any manner ran afoul of SSR 96-7p in stressing, as one 

basis for finding plaintiff’s testimony not credible, her non-compliance with prescribed 

medications.9

Because plaintiff raises no other issues and, specifically, no argument is raised 

that plaintiff would be unable to perform her past relevant work as a screen printer 

based upon a “substantially supported” RFC determination for the full range of 

medium work,

10 the Commissioner’s fourth-step determination is due to be affirmed.11

 9 However, even assuming error in this regard does not assist plaintiff inasmuch 

as such error would be harmless in light of the numerous other reasons elucidated by the ALJ 

for finding plaintiff’s subjective complaints less than fully credible. (See Tr. 55 (finding plaintiff’s 

allegations of disability not wholly credible not only because of her non-compliance with 

medications but also because of generally normal examination findings, her activities of daily 

living, the conservative nature of treatment, a lack of any indication from a treating or 

examining source that she should refrain from performing work activity, and the lack of 

recurrent visits to the emergency room, prolonged physical therapy, or chronic pain 

management).) 

10 And, as noted above, this Court has already determined that the ALJ’s RFC 

determination (for a full range of medium work) is supported by substantial evidence.

11 Indeed, the vocational expert testified during the administrative hearing that the 

range of motion findings by consultative examiner Dr. Henrietta Kovacs (Tr. 266-267) would be 

consistent with the ability to perform past relevant work as a screen printer (see Tr. 86). 

Case 1:15-cv-00626-C Document 21 Filed 12/22/16 Page 14 of 15
15

Compare Land v. Commissioner of Social Security, 494 Fed.Appx. 47, 49 & 50 (11th Cir. Oct. 

26, 2012) (“[S]tep four assesses the claimant’s RFC to determine whether the claimant is 

capable of performing ‘past relevant work.’ . . . A claimant’s RFC takes into account 

both physical and mental limitations. . . . Because more than a scintilla of evidence 

supported the ALJ’s RFC assessment here, we will not second-guess the 

Commissioner’s determination.”) with Phillips v. Barnhart, 357 F.3d 1232, 1238-1239 (11th 

Cir. 2004) (“At the fourth step, the ALJ must assess: (1) the claimant’s residual 

functional capacity []; and (2) the claimant’s ability to return to [his] past relevant work. 

As for the claimant’s RFC, the regulations define RFC as that which an individual is still 

able to do despite the limitations caused by his or her impairments. Moreover, the ALJ 

will assess and make a finding about the claimant’s residual functional capacity based 

on all the relevant medical and other evidence in the case. Furthermore, the RFC 

determination is used both to determine whether the claimant: (1) can return to [his] 

past relevant work under the fourth step; and (2) can adjust to other work under the 

fifth step . . . . If the claimant can return to [his] past relevant work, the ALJ will 

conclude that the claimant is not disabled. If the claimant cannot return to [his] past 

relevant work, the ALJ moves on to step 5.” (internal citations, quotation marks, and 

brackets omitted; brackets added)).

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 22nd day of December, 2015.

s/WILLIAM E. CASSADY

UNITED STATES MAGISTRATE JUDGE

Case 1:15-cv-00626-C Document 21 Filed 12/22/16 Page 15 of 15