NO T R EC OM M EN DE D F OR F UL L- TEX T P UB LIC AT ION F ile Nam e: 11a0151n.06 No. 09-6263 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT DA RRE L LC. F RA

NC I S, Pla int if f- Ap pe lla nt, v. COMMI SSI ONER S OC I AL S E C URI TY ADMI NI STRATI ON, Def endant- Appellee . ) ) ) ) ) ) ) ) ) ) ON APPEALFROM THE U NI TED STATES DI ST R I CT COURT FOR THE EASTERN DI STRI CT OF TEN NESSEE

B e fo re : K EI TH , KEN

NE DY , a nd CO OK , Ci rc uit

Judg e s. COOK, Circuit J udg e. Da rre ll Fra ncis asks us t o re v i ew the district court’s judg ment up ho l d i n g t h e d e c i s i o n

o f ana dm i n i s t r a t i v e l aw j u d g e ( “ A L J” ) t h a td e n i e d h i md i s a b i l i t y b e n e f its under the Social Security Act. See 42 U. S.C. §§ 41 6( i) , 4 23 (d ), 13 82 c . We a ff ir m. I. Whil e wo rkingin mai nt enan ce fo r t he U ni vers it y of T enn ess ee, Fra nci s b egan to e xpe ri e nc e pa in throug hout his body . Thoug h he manag ed thi s pain for se vera l y ear s, a work- related fa ll from a ladde r alleg edly rende red it so intolerable that he found himself una ble to continue wor

king. F ranc is applied for Social Sec urity

disability benef its, and the ag ency

g rante d him a hear ing.No. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 2 - At the heari n g , anA L J r e v ie w e d F r an c is ’ s me d ic a l a

n d f u n c ti o n a l h is to r

y to d e te r mi n e the sever ity of his impairments. Diag nostic test s demonstrated that Fra ncis suffe red f

rom deg ener ative ailments, a limited r ang e of spinal motion, and pain; but the tests did not support acute disc he rniations or sig nif ic ant n e ur olo g ic a l or mot or de fi c its . Tr e a tme nt r e c or ds dis c los e d th a t, a ft e r h is a c c ide nt, his ph y sic ians pr ima

ri ly pr e sc ri be d p a i n

r e l i e ve rs and

ph y sic a l th e ra

py . A nd te sti mony

c on c e rn inghis da ily a c tiv iti e s r e ve a le d th a t he rou ti ne ly sh op pe d, c oo ke d f

or him se lf , a nd pe rf or me d h ou se ho ld c ho re s, including making be ds, washingdishes, and vac uuming. As ag ency

regulations require , the AL J also consider ed the opinions of F ranc is’s phy sicians on his functional ca

pacity . Dr. Pinzon, a treatingorthopedic sur g eon, opined that F ranc is could per form aver ag e-e x ertion work, liftingsix ty pounds occa sionally or thirty pounds fre quently . Dr. Ke nnedy , an examining orthopedic surg eon, believe d t h at Fr ancis could lift twenty pounds occa sionally

or ten pounds fre quently , and that he should a lternate as n ecessary betwee n sitti ng and standing . But Dr . Wakham, a tre ating family osteopath, assi gn ed g reater seve rity to Fra ncis’s condition. He a

ppraised F ra nc is’ s li ft inga

bil ity a t te n p ou

nd s o c c a sio na lly

and fi ve po un ds fr e qu e ntl y , a nd ma int a ine d th a t, i f F ra nc is w e re to w or

k, he wo uld

mis s f our d ay s p e r m on th d

ue to h is c on dit ion , a

nd his pa in w ou ld c a

us e l a p s e s i nh i s c o n c e n t r a t i o nf o r s e v e r a l h o u r s e a c hd ay. The AL J assessed the medical e vidence , Fr ancis’s te stimony , and the opinions of F ranc is’s phy sicians, and f

o u n d t h at Fr ancis possesse d functional limitations in l ine with Dr. Ke nnedy ’s assessment. I n coming to this conclusion, the AL J noted that he a ssigne d no weig ht to Dr. Wakham’sNo. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 3 - opinion b e c a u s e it c o n f li c te d w it hth e o th e r

me d ic a l o p in io n s , th e me d ic a l e v id e n c e , F r an c is’ s c on se rv a tiv e tr e a tme nt, and his da ily a c tiv iti e s. W e i g h i n g F r an c i s ’ s f

u n c t i o n a l c a

p a c i t y a l o n g w i t hh i s a g e , e d

u c a t i o n , an d e x p e r i e n c e , t h e A LJ then deter mined, with the help of a

vocational ex pert, that the national ec onomy included a sig nificant number of jobs he could per form. Bec ause this evaluation supported the notion that Fr ancis could find suitable employ

ment, the AL J conclude d that Fr ancis did not suffe r from a “disability ” under the Social Se c ur ity Ac t and de nie d h is c la im. F ra nc is s ou g ht r e vie w o f t

his de c isi on

fr om t he Ap pe a ls C ou nci l. Th e Counc il d e nie d h is reque st and adopted the AL J ’s dec ision. Franc is then filed this action in the district court, which g rante d summary

judgme nt to the Comm issioner. II. We reviewthe district cour t ’s d ec i s ion de novo, askingonly whether the AL J ’s dec ision (a) confor ms to prope r leg al standards and (b) finds support in substantial e vidence . Rogers v. Comm’r of Soc. Sec
. , 486 F.3d 234, 241 ( 6th Cir. 2007). Fra ncis contends that it does ne ither. A.No. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 4 - F ra nc is i nit ia lly

argue s th a t th e AL J’s d e c isi on c omm its pr oc e dura l e rr or —a nd thu s f a ils to c on fo rm to p ro pe r l e g a l st and ard s— by ins uf fi c ie ntl y a c c ounti ngfo r c e rt a in m e dic a l op ini on s f ro m hi s treating phy sicians. We disag ree . Ag e nc y re g ulatio ns ins tr

uc t an A L J to th or ou g hly

c on sid e r me dic a l op ini on s f ro m a dis a bil ity claimant’s tre ating phy sicians. Such opinions rece ive “c ontrolling we ight” unless the AL J finds them un s u p p o rte d o r “ ‘ in c o n s is te n t w it h th e o th e r s u

b s ta n ti a l e v id e n c e in [th e ] c a s e r e c o r d . ’” W ilson v. Comm’r of Soc. Se c. , 378 F. 3 d 5 41, 544 (6th Cir. 2004) (a lteration in orig inal) (quoting20 C.F.R. § 4 0 4 . 1 5 2 7 ( d ) ( 2 ) ( 2 0 0 4 ) ) . W h e na t r e a t i n g - s o u r c e o p i n i o nd o e s n o td e s e r v e “ c o n t r o l l i n g w e i g h t , ” t

h e A LJ s ti ll c o n s id e r s th e o p in io n in a c c o r d an c e w it h c e rta in f

a c tor s. S ee 2 0 C . F . R . § 4 0 4 . 1 5 2 7 ( d ) ( 2 ) . A LJ written dec isions mus t ultim ately contain “g ood rea sons . . . for the weig ht [they ] give” the opinion, id. , and their e x planation “must be suff iciently specific t o m ak e clea

r to any subsequent re viewer s the weight [given] to the treatingsource ’s medica l opinion and the rea sons for that we ight,” SSR96-2p, 1996 WL 374188, at *5 (July 2, 1996). I f an AL J ’s decision flouts these proc edura l rules, we a ffirm only if we f ind the err or har

mless. See, e .g. , W

ilson , 378 F.3d at 546–47. Fr ancis be g ins his procedura l argument by contendingthat, in determining his functional capa city , the AL J ’s dec ision gave short shrift to his phy sicians’ opinions reg ardinghis pain. He notes that Dr. Wakham de scribed his pa in a s “intrac table,” “seve re,” and “e x treme” ; Dr. Ke nnedy opined that he su ff e rs fr om a “ pa inf ull y dis a bli ngc on dit ion ” ; and

Dr . K ill e fe r ( a

tr e a tin g surg e on ) c a lle d h is p a inNo. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 5 - “ pe rs ist e nt” and

“ fa ir ly se ve re .” Th e se state me nts c ount as ind e pe nd e nt me dic a l opin ion s, he argue s, y et went unmentioned in the A L J ’s dec ision. W e do not view them quite this way . The pa in-related opinions of Drs. Wakham and K ennedy underpinne d the doctors’ capa city -towork opinions, which the AL J expressly considere d. Dr. W akham, in his repor t on Fra ncis’s func tional capa city , noted both Fr ancis’s pain and his phy sical impairments; and Dr . Kenne dy , in his independent medical e valuation, desc ribed F ranc is’s pain, conc luded that he had a 10% phy sical impairment, and then deter mined his functional limitations . Dr . K il lef er’s pa in- re late d s tate me nt, on the oth e r h and , is no t a

“ me dic a l op ini on ” a t a ll— it mere ly regurg itates Fr ancis’s se lf-desc ribed sy mptoms. See 20 C.F .R. § 4 04 .1 52 7( a )( 2) . A nd e ve n if thi s w e re a

me dic a l op ini on , w e wo uld de e m it s o mis sio n f

ro m th e AL J’s d e c isi on

ha rm le ss b e c a

us e the AL J never

theless “ma[de] findings consistent with the opinion.” W ilson , 378 F.3d at 547. I n the very same doc ument to which Franc is points, Dr. Killefer notes that Fr ancis wa s “tolerating this [pain] and wo rk ing .” I f w e c an f

a ir ly a sc ri be any

“ op ini on ” to t

his re po rt , it

is that F ra

nc is s uf fe rs fr om p a in but can still work—an “ opinion” consistent with the AL J ’s ultimate deter mination. Ap art fr om his pa in- re late d ar g ume nts , F ra nc is c omp la ins that th e AL J neg le c te d tw o 2 0 C. F .R. § 4 04 .1 52 7( d) (2 ) f

a c tor s in we ig hin g Dr . Wakh am’ s o pin ion : th e “ [l]en g th o f t he tr e a tme nt r e latio ns hip and the f reque ncy of examination” and the “ [n] ature and extent of the treatment relationship” betwe en F r an c i s an d D r . W akh am . 2 0 C . F . R . § 4 0 4 . 1 5 2 7 ( d ) ( 2 ) ( i )
- ( i i ) . A l t h o u g ht h e r e g u l a t i o n s i n s t r u c tanA LJNo. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 6 - to c on sid e r t

he se fa c tor s, the y

e xpre ssl y

re qu ir e on ly

that the AL J’s d e c isi on

inc lud e “ g oo d r e a so ns . . . for the w eig ht . . . give [n] [t o the] treating source ’s opinion”—not an exhaustive fac tor-by -fa ctor analy sis. Id. § 404.1527(d)( 2). He re, the AL J acknow ledg ed Dr . Wakham’s role a s Fra ncis’s “tre ating fa mil y os te op a th. ” I n ass ig nin g no we ig ht to his opi nio n, the AL J c ite d the op ini on ’s inc on sis te nc y wi th th e o bjective medic al evidenc e, F ranc is’s conser vative tre atment and da ily activities, and the assessments of F ranc is’s other phy sicians. Proce durally , the re g ulations require no more. Nor would it matter, in this case , i f t h ey d i d . Be ca u se the tre ating -sourc e rule is not “a procr ustean bed, requiring an ar bitrary confor mity at all times,” Friend v. Comm’r of Soc. Sec
. , 3 75 F. App’x 543, 551 (6th Cir. 2010) (per curiam), we excuse a dec ision’s noncompliance w ith its provisions “whe re [the dec ision] has met the g oal of § 1527(d)( 2)—the provision of the proc edura l safeguard of rea sons—even thoug h [i t] has not complied with the terms of the regulation,” W ilson , 378 F.3d at 547. So long as the decision “pe rmits the claimant and a revie wing court a clea

r under standing of the re asons for the weig ht g iven a treating phy sician’s opini on,” we look past such proc edura l error s. Friend , 375 F. App’ x at 551. Both we and F ranc is possess a “c l ea r u n d er s tanding ” of why the AL J reje cted Dr . Wakham’s opinion. Noting Dr. Wakham’s relationship with Fr ancis, the AL J outlined the my riad wa y s in which the doctor’ s opinion conflicted with evidenc e in the re cord. The AL J gav e Fr an ci s his procedur al sa fe g ua rd of re a so ns —me e tin g the g oa l of the re g ulatio n— and the on ly tr ue dis a g re e me nt l ie s w ith in the me ri ts o f t

he re a so ns the mse lve s. We t hu s f ind any pr oc e dura l e rr or

ha rm le ss.No. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 7 - B. I n addition to his purely

proce dural a

rguments, Fra

ncis cha lleng es the mer its of the AL J ’s “g ood rea sons” for r ejec ting Dr . Wakham’s medica l opinion, deem i n g them unsupported by substantial evidenc e. Th e a g ency ’s tre a tin g -s ourc e ru le pe rm its an A L J to r e je c t a tr e a tin g so ur c e ’s op ini on if substantial evidence in the rec ord contra dicts it. 20 C.F.R. § 404.1527(d)( 2). Substantial evidence

“ ‘m e ans su c h r e le va

nt e vid e nc e a s a reas on abl e min d mi g ht a c c e pt a s a de qu a te to s up po rt a conclusion.’” Richardson v. Pe rales , 4 0 2 U. S . 3 8 9 , 4 0 1 (1 9 7 1 ) ( qu o t i n g Consol. Edison Co. v. NLRB , 30 5 U .S. 19 7, 22 9 (19 38 )) . Whe n s ub sta nti a l e vid e nc e su

pp or ts a n A L J’s d e c isi on , w e a ff

ir m e ve n if we would have de cided diff ere ntly , see Kinsella v. Sc hweiker , 708 F.2d 1058, 1059 ( 6th Cir. 1983) (per curiam), and even if substantial e vidence also supports the opposite conc lusion, see M ullen v. Bowen , 800 F.2d 535, 545 ( 6th Cir. 1986) (en ba nc). Th e AL J r e

je c te d Dr . Wakh am’ s o pin ion be c a us e he fo un d th e “ se ve re fu nc tio na l li mit a tio ns ” it a ssigne d to F ranc is inc onsistent with (1) objec tive medical e vidence ; (2) F ranc is’s daily activities; (3) Fr ancis’s tre atment; and (4) the opi nions of ot her phy sicians. Substantial evidenc e supports hi s view. F ir st, the re lativ e ly

be nign n a tur e of F ra

nc is’ s sc ans , x-r ay s, and c lin ic a l e xams c on fl ic te d w ith the limit ations Dr. Wakham descr ibed. Fr ancis’s ba ck tests re veale d no signific ant non-de g ener ative iss ue s, sh ou lde r a

nd kn e e te sti ngwe re no rm a l, a nd ne ur olo g ic a l te sts de mon str a te d no se ve re pr ob le ms.No. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 8 - Th ou g h F ra

nc is m a int a ins tha

t th e AL J ig no re d the pa inf ul natur e of

the se c on dit ion s, the AL J simp ly fo un d th a t F ra

nc is’ s c omp la int s o f s e ve re pa in w e re inc on sis te nt w ithDr . Wakh am’ s li mit a tio ns . Se c on d, the AL J re a so na

bly fo un d th a t an ind ivi du a l with“ se ve re fu nc tio na l li mit a tio ns ” wo uld fi nd it d if fi c ult to e ng a g e in F ra

nc is’ s da ily a c tiv iti e s. Th e AL J e xpla ine d that F ra nc is p re pa

re s me a ls, mana g e s h is f

ina nc e s, and he lps wi th vari ou s c ho re s, inc lud ingva c uumin g . F ra nc is c ounte rs that th e se activities do not “evinc e an ability to perf orm full time work on a reg ular and continuing basis.” But a re a so nable pers on

c ou ld d e e m F ra

nc is’ s a c tiv ity

le ve ls a s mo re c on sis te nt w iththe vie w that he is su ff e ri ngmana geabl e imp a ir

me nts tha n th e vie w that he is e xpe ri e nc ingse ve re lim itatio ns —a nd thi s is a ll tha t th e su bs tanti a l- e vid e nc e sta

nd ard de mand s. Third, the AL J rea sonablely viewed Fr ancis’s limited treatment as inconsistent with Dr. Wak ham’ s opin ion . Whil e F ra nc is h a s b e e n n o s tr ang e r t o a do c tor ’s of

fi c e , a ll o f h is r e c e nt t

re a tme nts we re c on se rv a tiv e and

larg e ly c on fi ne d to pai n medic a tio ns . F ra nc is a rgue s th a t c on sumin g pa in medication is itself evidenc e that he ex perie nces mode rate to severe pain, as Dr . Wakham opined. B ut it i s ju st a s c on sis te nt wi th a fi nd ing that F ra nc is’ s me dic a tio ns a de qu a te ly mana g e his pa in a

nd e na ble him to work full time with som e re strictions. This, ag ain, is all that the substantial-evide nce sta ndard require s. L ast, the AL J rig htly

focu s ed o n the discre pancy betwee n the seve rity

of Dr. Wakham’s assessment and the moderate d i agn o s es of F ranc is’s surg eons. F ranc is reconc iles this conflict byNo. 09-6263

Francis v. Comm’r of Soc. Sec
.

- 9 - maintaining that the surg eons’ f unctional-c apac ity

opinions did not acc ount for his pain, a nd that, if they had, they would alig n with Dr. W akham’ s—a viewpoint we reje cted in our e arlier treatment of the topic. Th e AL J thus c ite d s pe c if ic c on fl ic ts be tw e e n Dr . Wakh am’ s o pin ion and su bs tanti a l me dic a l, lifestyle, and opinion evidenc e. B eca us e substantial evidence supports his decision to rejec t the opinion, we look no fur

ther into its merits. See M ullen , 80 0 F .2 d at 54 5; Kinsella, 708 F.2d at 1059. III . For these re asons, we a ffirm.