UNITED STATES COURT OF APPEALS
FOR THE TENTH CIRCUIT

________________ _________________ RUBY JEAN BILLS, Plaintiff - Appellant,

v. COMMISSIONER, SSA, Defendant - Appellee. No. 18-1109 (D.C. No. 1:16-CV-03154-STV) (D. Colo.)

________________ _________________ ORDER AND JUDGMENT *

________________ _________________ Before TYMKOVICH , Chief Judge, McKAYand MATHESON , Circuit Judges.

________________ _________________ Ruby Jean Bills appeals the district court’s judgment affirmin g the Commissioner’s denial of her app lications for social security d isability benefits and supplemental security income. E xercising jurisdiction under 42 U.S.C. § 405(g) and 28 U.S.C. § 1291, we affirm.

* After examining the briefs and appellate record, this panel ha s determined unanimously to honor the parties ’ request for a decision on the briefs without oral argument. See Fed. R. App. P. 34(f); 10th Cir . R. 34.1(G). The case is ther efore submitted without oral argument. T his order and judgment is no t binding precedent, except under the doctrines of la w of the case, res judicata, an d collateral estoppel. It may be cited, however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1. FILED United States Court of Appeals Tenth Circuit 

### October 1, 2018
Elisabeth A. Shumaker Clerk of Court2 I. BACKGROUND Ms. Bills filed her benefits appl ications in 2011, alleging she was disabled due to asthma, chronic obstructive pulmonary disorder, anxiety, hip problems, and attention-deficit/hyperactivity d isorder. After a hearing, an administrative law judge (ALJ) denied her applications at steps four and five of the fiv e-step sequential evaluation process set forth in 20 C.F.R. §§ 404.1520(a)(4) and 416.920(a)(4). The Appeals Council affirmed, but t he district court remanded becau se the ALJ failed to explain the weight afforded to the opinion of a consulting exam iner, Dr. Mitchell, that Ms. Bills could stand and wa lk no more than 4 hours per an 8-hour workday and could sit without limitation. On remand, the ALJ found that, although Ms. Bills had several s evere impairments (obesity, scoliosi s, asthma/chronic obstructive pul monary disorder, and gastroesophageal reflux disease) , none met or medically equaled the severity of one of the impairments listed in 20 C.F.R. Pt. 404, Subpart P, Appe ndix 1, commonly referred to as the “Listings,” t hat are so severe as to preclud e employment. The ALJ then found that Ms. Bills had th e residual functional capacity (RFC) to perform work at the light exertional level s ubject to several limitations no t relevant to this appeal. At step four, the ALJ determine d that Ms. Bills could perform h er past relevant work as a cashier II. The ALJ therefo re denied her applications at step four and did not reach step five. Ms. Bills appealed directly to the district c ourt, see 20 C.F.R. § 404.984(a), (d), which affi rmed. This appeal followed.3 II. DISCUSSION Our task is to determi ne whether substantia l evidence supports the agency’s factual findings and whether the agency applied the correct leg al standards. Barnett v. Apfel , 231 F.3d 687, 689 (10th Cir. 2000). “Substantial evidence is such relevant evidence as a reasonable mind mi ght accept as adequate to suppo rt a conclusion.” Id. (internal quotation ma rks omitted). We cannot “reweigh the evi dence” or “substitute our judgment for that of the agency.” Id. (internal quotation marks omitted). We have recognized this is a “defere ntial appellate standard.” Howard v. Barnhart , 379 F.3d 945, 947 (10th Cir. 2004).
A. Light Work and Ms. Bills’s Argument Ms. Bills raises one issue: whet her substantial evidence suppo rts the ALJ’s finding that she was capable of work at the light exertional le vel. “Light” work involves lifting no more than 2 0 pounds at a time with frequent lifting or carrying up to 10 pounds. 20 C.F.R. §§ 404.1567(b), 416 .967(b). It also “requires standing or walking, off and on, for a total of approxim ately 6 hours of an 8-hour w orkday,” with intermittent sitting during the remaining tim e. SSR 83-10, 1983 WL 31251 (1 983), at *6. Ms. Bills claims the record evidence suppo rts that she is limited only to sedentary work, which involves lifting no more than 1 0 pounds at a time and occasiona l walking and standing (no more than two hours total ), 20 C.F.R. §§ 404.1567(a), 416.9 67(a); SSR 83-10 at *5; and if that is the case, then sh e is conclusively disabled unde r the Medical Vocational Guidelines, 20 C.F.R., Part 404, Subpart P, Appendix 2.4 More specifically, Ms . Bills argues that the ALJ gave inadequat e reasons for affording little weight to the opi nions of a consulting examine r, Dr. Mitchell, and of a physician who treated her five times, Dr. Burrows, both of whom identified limitations inconsistent with light work. Instead, the ALJ gav e more weight to the opinion of an agency nonexamini ng medical consultant, Dr. Panek , who identified abilities consistent with light work. Although Ms. Bills may be able t o argue the ALJ’s reasoning was debatable, she has not shown the ALJ was un reasonable. Under the deferent ial substantial-evidence standa rd of review, we affirm.
B. Guidelines for Evalua ting Opinion Evidence The guidelines for evaluating opinion evidence for Ms. Bills’s claims are set out in 20 C.F.R. §§ 404.1527 and 416.927. 1 Opinions from examining sources are generally entitled to more weig ht than opinions from nonexamini ng sources. §§ 404.1527(c)(1), 416.927(c)(1 ). And treating-source opinions —those from sources who have seen a claimant “a numbe r of times and long enough to have obtained a longitudinal picture of [the clai mant’s] impairment[s]”—are gen erally entitled to more weight than opinions based on “individual examinations, su ch as consultative examinations.” §§ 404.1527(c )(2)(i), 416.927(c)(2)(i). An ALJ must give controlling we ight to a treating source’s opin ion on the nature and severity of a claimant ’s impairment if it is “well-s upported by medically

1 Different guidelines apply to the evaluation of claims filed o n or after March 27, 2017. See 20 C.F.R. §§ 404.1520c, 416.920c.5 acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record.” §§ 404.1 527(c)(2), 416.927(c)(2). Absent an opinion entitled to cont rolling weight, an ALJ must evaluate medical opinions using the following factors drawn fro m §§ 404.1527(c) and 416.927(c): (1) the length of the treatment relationship and the frequency of examination; (2) the nature and extent of the treatment relatio nship, including the treatment provide d and the kind of examination or testing performed; (3) the degree to which the physician’s opin ion is supported by relevant evidence; (4) consistency between the opi nion and the record as a whole; (5) w hether or not the physician is a specialist in the area upon whi ch an opinion is rendered; and ( 6) other factors brought to the ALJ’s attention which tend to supp ort or contradict the opinion. Watkins v. Barnhart , 350 F.3d 1297, 1301 (10th Cir. 2003) (internal quotation mark s omitted); see §§ 404.1527(c), 416.927(c) (explaining that unless a treating-s ource opinion is given cont rolling weight, the agency will consider t hese factors in deciding the weight to give any medical opinion). An ALJ is not require d to discuss all of these factors but must provide “ good reasons” for the weight as signed. Oldham v.
Astrue , 509 F.3d 1254, 1258 (10th Cir . 2007); §§ 404.1527(c)(2), 416. 927(c)(2).
C. The Opinion Evidence
1. Dr. Mitchell’s Opinion The consulting examiner, Dr. Mit chell, saw Ms. Bills in 2010. The ALJ gave multiple reasons for rejecting Dr . Mitchell’s opinion that Ms. Bills could stand or6 walk only about 4 hours in an 8-hour workday. 2 The ALJ found that the opinion was not consistent with Dr. Mitchell’ s own recorded observations du ring the examination, which the ALJ summarized as follo ws: Ms. Bills “had only a mil dly antalgic gait”; “sat comfortably during the exam ination without pain-mitigating movements, did not appear uncomfortable getting on a nd off the examination table o r removing her shoes, and arose spon taneously and unaided from a seated positi on without discernible discomfort”; “could stand on her heels and toes, di d not use an assistive device, and had no discernible discomfort with normal ranges of motion of her cervical and dorsolumbar spine”; and “had full strength in all extremities.” Aplt. App., Vol. 2 at 480–81. The ALJ a lso found that the opinion wa s inconsistent with Ms. Bills’s statement to a sleep consultant in 2013 that she “e ssentially walked everywhere most of the time and she got good exercise,” id. at 481 (discussing id. at 383), and with a 2015 treatmentnote from Dr. Burrows showin g Ms. Bills “walked normally,” id. (discussing Dr. Burrows’s findi ng that she had “normal gait an d station,” id. at 712). Finally, the ALJ noted t hat Dr. Mitchell had examine d Ms. Bills only once and therefore lacked “a longitudinal treatment histor y” with her. Id. Ms. Bills questions only two of these reasons. She first argue s that it was unreasonable for the ALJ to rely on the fact that she could sit comfortably during the

2 Although the ALJ said she gave “limited weight” to Dr. Mitchel l’s opinion, Aplt. App., Vol. 2 at 480, she app ears to have rejected the opi nion with respect to Ms. Bills’s ability to stand or w alk, which was inconsistent wi th the ALJ’s RFC finding. What “limited weight” th e ALJ afforded Dr. Mitchell’s opinion appears to concern Ms. Bills’s ability to bend, squat, crouch, and stoop o nly occasionally, all of which was made part of the ALJ’s RFC.7 examination because Dr. Mitchell’ s opinion was that she could s it for an unlimited amount of time. We agree that t his was not a good reason for d iscounting Dr. Mitchell’s opinion regarding Ms. Bills’s ability to stand a nd walk. This misstep, however, is not dispositive becaus e substantial evidence still supports the ALJ’s rejection of Dr. Mitchell’s opi nion of Ms. Bills’s standing and walking abilities. Ms. Bills’s other contention is t hat the ALJ’s reliance on the lack of a longitudinal treatment relations hip to discount Dr. Mitchell’s opinion was inconsistent with the ALJ’s attri buting greater weight to the o pinion of the nonexamining consultant, Dr. Pan ek, who never saw Ms. Bills and therefore similarly lacked a longitudinal relationshi p with her. As noted, the len gth of the relationship between a medical source and a cl aimant is only one legitimate factor to consider in evaluating medical-source opini on evidence. §§ 404.1527(c)(2)( i), 416.927(c)(2)(i). It was reasonable here for the A LJ to rely on the fact that Dr. Mitchell saw Ms. Bills only once. Moreover, that encoun ter occurred in 2011, very ear ly in the relevant time period, which stretched from the amended onset date in 201 0 to the date of the ALJ’s decision in 2016. In cont rast, Dr. Panek reviewed medica l evidence from 2010 and 2011, see id. at 369–71, which, although also c overing an early part of the time frame, presented at least a par tial longitudinal picture of Ms. Bills’s functional capacity. Ms. Bills does not challenge any of the other reasons the ALJ g ave for rejecting Dr. Mitchell’s opinion regarding her ability to stand and walk other than to contend that the opini on was consistent wit h three of Dr. Mitch ell’s examination8 findings: a “mildly antalgic ga it,” “mild scoliosis,” and “the absence or reduction of all [Ms. Bills’s] reflexes.” Aplt. Opening Br. at 39. But ass uming those findings, which the ALJ noted, are consis tent with Dr. Mitchell’s opinion that Ms. Bills could stand or walk only 4 hours in a n 8-hour workday, the ALJ identi fied evidence that was not consistent with that deg ree of limitation—Dr. Mitchell’ s other findings at the consultative exam, the later ev idence that Ms. Bills “had norma l station and gait,” Aplt. App., Vol. 2 at 712, and her statement that she walked mo st “everywhere” and “got good exercise,” id. at 383. Under the substantial evidence standard, “we may not displace the agency’s choice between two fairly conflicting views,” Oldham , 509 F.3d at 1258 (brackets and in ternal quotation marks omitted ). The ALJ’s rejection of Dr. Mitchell’s opi nion that Ms. Bills could stand or walk only 4 hours in an 8-hour workday withstands her challenge on appeal.
2. Dr. Burrows’s Opinion Dr. Burrows, who saw Ms. Bills f our times in la te 2015 and once in April 2016 for complaints of es ophageal burning, completed a gastritis med ical assessment form in July 2016. The ALJ gave Dr. Burrows’s opinion “partial weig ht.” Aplt. App., Vol. 2 at 480. The ALJ (1) rejec ted Dr. Burrows’s opinion that she could lift and carry 10 pounds rarely and neve r more than 10 pounds, could onl y walk two blocks, and needed to alternate sitting and standing and lie down afterstanding, id. at 837, 839—all of which is inconsistent with light work—but (2) accept ed Dr. Burrows’s opinion that she could stand a nd walk at least 6 hours in an 8- hour workday, id. at 837—which is consiste nt with light work.9 Ms. Bills claims that the ALJ err ed in relying on a lack of a l ongitudinal treatment history in rejecting part of Dr. Burrows’s opinion be cause he examined her on five occasions. Five visits over eight months would typical ly be sufficient to establish a longitudinal relati onship such that Dr. Burrows cou ld be considered a treating physician. And his opi nions would therefore be entitl ed to controlling weight if they were “well-support ed by medically acceptable cli nical and laboratory diagnostic techniques” and were “ not inconsistent with the othe r substantial evidence in [the] case record.” §§ 404. 1527(c)(2), 416.927(c)(2). But the ALJ found that Dr. Burrows’s opinions were inconsis tent with (1) his August 2015 t reatment notes showing that Ms. Bills “walked normally, had normal motor stren gth and tone, did not have musculoskeletal tendern ess, and had normal movement in all extremities,” Aplt. App., Vol. 2 at 480 (discussing id. at 712), and (2) his April 2016 treatment notes in which “he noted limite d objective findings and suggest ed dietary changes, fluid consumption, and using Pepto-Bismol periodically,” id. (discussing id. at 705–06). Ms. Bills has not challenged thes e reasons or any of the other reasons the ALJ gave for rejecting Dr. Burrows’s lifting and sit/stand limitati ons. The ALJ also noted that Dr. Burrows treat ed Ms. Bills for gas troesophageal reflux disease and did not indicate whether this disease cau sed the limitations he recomme nded (abdominal pain was the only symptom Dr. Burrows attributed to the disease, id. at 836). And the ALJ doubted Dr. Burrows’s lifti ng and sit/stand limitations bec ause (1) his opinion that Ms. Bills would need nine re stroom breaks a day lacked sup port, and (2) there10 was a discrepancy between Dr. Bu rrows’s notation that he began seeing Ms. Bills once a year in 2013 and the record showing he first saw her in August 2015 and then four more times over the ensuing eight months. The ALJ gave “specific, legitima te reasons” for rejecting Dr. B urrows’s lifting and sit/stand limitations, Watkins , 350 F.3d at 1301 (internal quotation marks omitted), based on the regulator y factors concerning the treatm ent provided, the lack of evidentiary support, and incons istency with other record evi dence. Ms. Bills has not shown the ALJ’s rejection of those limitations lacks a subs tantial-evidence basis.
3. Dr. Panek’s Opinions Dr. Panek, the agency nonexamini ng medical consultant, reviewed all of the medical records in 2012. Consiste nt with light work, Dr. Panek said Ms. Bills could occasionally lift or carry 20 po unds, frequently lift or carry 10 pounds, stand and/or walk about 6 hours in an 8-hour w orkday, and sit about 6 hours in an 8-hour workday. See Aplt. App., Vol. 1 at 99–101; id. , Vol. 2 at 369–71. The ALJ gave “great weight” to these opinions because they were “consistent with the record as a whole,” including Dr. Burrows’s August 2015 treatment note. Id. , Vol. 2 at 481. Ms. Bills does not challenge these reasons other than to argue that the opinions of Drs. Mitchell and Burrows regar ding her abilities to stand, walk, lift, and carry were entitled to more weight. B ut we have upheld the ALJ’s rej ection of those opinions under the deferential su bstantial evidence standard, w hich does not allow us to reweigh the evidence or substitu te our judgment for the ALJ’ s. Accordingly, it was permissible for the ALJ to rely on Dr. Panek’s opinion. See SSR 96-6P,11 1996 WL 374180 (July 2, 1996), a t *3 (“In appropriate circumsta nces, opinions from State agency medical and psycho logical consultants and other pr ogram physicians and psychologists may be entitled to greater weight than the op inions of treating or examining sources.”). Lacking any argument from Ms. Bills ques tioning the ALJ’s reliance on Dr. Panek’s opinion, w e conclude that substantial e vidence supports the ALJ’s RFC for light work.
III. CONCLUSION The district court’s judgment is affirmed.

Entered for the Court

Scott M. Matheson, Jr. Circuit Judge