### FILED U.S. COURT OF APPEALS ELEVENTH CIRCUIT March 26,

2004 THOMAS K. KAHN CLERK [PUBLISH]

IN THE UNITED STATES COURT OF APPEALS FOR THE EL EVENTH C IRCUIT

_________________

_______ No. 03-15 270 Non-Argument Calendar

_________________

_______ D.C. Docket No. 02-00937-CV-T -MSS BILLY D. CRAWFORD, Plaintiff -Appella nt,

versus COMMISSIONER OF SOCIAL SECURITY, Defendant-Appellee.

_________________

_________ Appeal f rom t he United States D istrict C ourt for th e Middle Di strict of

Florida

_________________

________ (March26, 2004) Before C ARNES , HUL L and FA Y, Circuit Judges. PER CURIAM: Billy D. Cra

wford ap peals the d

istrict c ourt’s o rder af

firming the Comm issioner’ s denial of

his applica

tions for di sability

insurance

benefits a

nd2

supplem ental soci al securi ty inco me, 42 U.S. C. §§ 405(g ), 1383(c ). On a ppeal, Crawfo rd argues that the A dminis trative L aw Judge ( “AL J”) erred by (1) discrediting the opinions of hi s treating physic ians and chi

ropracto r, and (2) failing to consider consultative psychologist Tracy Hartig’ s opinion that Crawford had “m

arked” psychological limitations. For the re asons set forth more full y below, we affi rm the di stric t cou rt’s or der aff irming the Co mmission er’s decision. Crawford, a 53-ye ar-old male with a m inisterial college education, applied for supplem

ental soci al securi ty inco me a nd disability

insurance

benefits, alleging an onset dat e of Marc h 1, 1999, d ue to bilateral spondy

lolysis , a poster

ior m idline annular tear, and degenerative disc disease. Crawford’ s applications were denied initially and on rec onsiderati on. Craw ford then r equested a

nd receiv ed a hear

ing before an ALJ. Subsequent to the hearing, the ALJ made findings in a decision that included the relevan t medical evide nce and witn ess testi mony. The ALJ discredit ed the opinio ns of chiro practor M abbett Re ckord and tr eating phy sicians Drs. Stanley Z emankiewicz, P edro Ruiz, and Nicholas Blavatsky, all of w hom had classifie d Crawf

ord as “ disabled” o r cited f unctional limitat

ions that w ould preclude even seden

tary work. T

he ALJ f ound that the

restric tions cited

by thes e3

physicians “waver

ed constantly” and were “ contradictory to their other conclusions.” The ALJ further found that these physicians’ notes were inconsi stent and detailed o nly “short-lived problems.” Addit ionally, the ALJ discounted consultative psychologist Tracy Hartig’s opinion that Crawford wa s markedly lim

ited in certain areas, finding that (1) she was not a “tr eating source” because she had examined Crawford only once, (2) she was not a me dical doctor, (3) her findings were based on Crawford’s self-intere sted assertions, and (4) her opinion was inconsisten

t with tre ating psy chiatrist J. K. M ehta’s findings. The AL J found that Crawfo rd suffer ed from the severe impa

irme nts of spinal dege nerativejoint dise ase and re active de pression an d that he co nsequently lacked the

residual f

unctional c apacity

(“R FC”) to perform

any of his past re levant work. T he ALJ f urther fo und, howe ver, tha t Crawf ord retained the RF C to perform “ a significant range of light work,” including work that involved “simple, repetitiv e, routin e, low s tress, sa fe, light work in cl ean surro undings, w ith a sit/stand option, and no overhead reaching.” Relying on the m edical ev idence, and testimony from

a vocational expert (“VE” ) and Crawford, the ALJ found that Crawford was not disabled as defined by the Act beca use he was able to perform other work t hat exist ed in sig nificant n umbers in the n ational ec onomy.4

The Appeals Council denied review of the ALJ’s dec ision. On judicial review, the m agistrate

judge issu ed a repor

t recom mending that the Commissioner’s decision denying benefits be affirm ed. Thereafter, the district court entered an ord er affirming the Com missio ner’s d ecision. On appea l, Craw ford argu es that the ALJ er red by discredit ing the opinio ns of chiropractor Reckord and Drs. Ruiz, Blavatsky , and Zemankiewic z. Crawford maint ains that th e opinions of his treating physi cians we re based o n a lengthy treatment history

and supporte d by the

medic al evidenc e, wher

eas the opinion of consulting phy sician Dr . Jam es Melton, upon which t he ALJ pl aced gre at weight , was “against the great weight of all the evidence. ” Additionally, Crawford ar gues that, alt hough a chir

opractor ’s opinion

generall y is not entitled to controllin g weight, the ALJ

should have a fforded d eferenc e to Recko rd’s opinion becaus e he had treat ed Craw ford for several y ears and h ad refer

red him to special ists for consultatio ns. “W e review

the Com missio ner’s d ecision to d eterm ine if it is supported by substantial evidence and based on proper legal standards.” Lewis v. Callahan , 125 F.3d 1436, 1439 (11th Cir. 1997). “Sub stantial e vidence is more than a scin

tilla and is such r

elevant e vidence a s a reason able pers on would ac cept as ad equate to support a conclusion.” Id. “Ev en if the e vidence preponderat es against the5

Comm issioner’ s findings, we m ust affir m if t he decision

reached is supporte d by substantial evidence.” Martin v. Sullivan , 894 F.2d 15 20, 1529 (11th Cir. 1 990). It is wel l-establi shed that “ the testim ony of a treating p hysici an mus t be given substa

ntial or co nsiderable

weight unl ess ‘good

cause’ is shown to t

he contrary.” Lewis , 125 F.3d at 1440. A treat ing physi cian’s report “

may be discounted w

hen it is not a ccom

panied by objecti ve me dical evid ence or is wholly conclusory.” Edwards v. Sullivan , 937 F.2 d 580, 583-8 4 (11th Cir . 1991) (g ood cause exi sted wher

e the opinion

was contr

adicted by

other nota

tions in the physician’s own record). Dr. Rui z’s opini on that Cra wford is p erma

nently and totally

disabled is inconsistent with his own treatment notes, unsupported by the me dical evidence, and appear s to be bas ed primarily on Crawfor d’s subjectiv e complaints o f pain. Only three weeks after

concluding that Crawford was unable to work due to lower back pain, Dr. Ruiz noted tha t Crawf ord was “ impro ved” and “ doing well” and that he had

stated “ I’m

doing great .” More over, subs equent to rendering hi s diagnosis of

perm anent and t otal disabi lity, Dr. Ru iz exam ined Craw ford and reported “no acute distress” Further t esting by Dr. Ruiz revealed no

muscu loskeletal

abnorm alities. Additiona lly, medic al tests tha t were c onducted by physic ians to who m Dr . Ruiz ha d refer red Craw ford reve aled “no evidence of6

fracture, dislocation or bony destruction,” norm al soft tissues, and “[n]o evidence of metastatic disease.” Ba sed on the foregoing, and the fact that Crawford repea tedl y had de clin ed medic atio n tha t Dr. Ru iz had presc ribed him, the ALJ’s decision to disco unt Dr. Ruiz’s o pinion was suppo rted by subst antial evi dence. See Dawkins v. Bowen , 848 F.2 d 1211, 1213 ( 11th Cir. 1988) (failure to f ollow prescribed medical treatm ent will preclude a finding of disability). Additionally, substantial evidence supports the ALJ’s determ ination that Dr. Zem ankiewic z’s fin dings did not e stablish tha t Crawf ord was di sabled wi thin the

mean ing of the A ct. The medic al recor

d indicate s that Dr . Zem

ankiewic z found Crawford to be disabled for only a nine-day period. To the extent that Crawford asserts th at Dr. Zem ankiewic z’s fin dings war rant a finding of total and perm anent disability, he is not entitled to relief because such a finding is inconsistent with Dr. Zemankiewicz’ s treatment notes. During his first exam ination of Crawford, Dr. Zemankiewicz pre scribed a “back program for exercise” and prohibited Crawford from lifting m ore than 25 pounds. A subsequent MRI revealed “[v]er y minim al degenera tive disc di sease . . . [n] o bulge or pr otrusion . . . [n] o canal stenosis or

nerve roo t impingeme nt.” Fina lly, Dr. Z eman

kiewicz noted in an a ddendum

that a repeat e xamin ation of the MRI reve aled “no associat ed spondy lolisthesis,7

significant neural foramen narrowing, or spinal stenosis” and “ no canal compromise.” Next, D r. Blava

tsky’ s conclusor

y finding that Cra

wford w as disable d is unsupported b y the m

edical ev idence an d contradic ted by h is own tre atme nt notes, which state that (1) Crawford’s MRI and bone scan were negative, (2) there was “no ev idence of

fiscal in carceration, pr

otrusion, b ony des tructive p rocess, alignm ent, intr

insic or neural abnor

malit y,” (3) x-ra

ys re vealed “

no evidence

of spondylo listhesis”and “ good preser vation of lu

mbar lordosis, ” and (4) “[f

]lexion and extensive views done on this oc casion dem onstrate n o evidence

of spondylo listhesis or

segmental instab ility. ” Addition ally, less than two weeks after m aking a fin ding of disab ility, Dr. Bl avatsky noted that C rawfor

d’s ner ve conduction s tudies we re negative. Base d on the for egoing, the

ALJ’ s decision t o discount Dr. Blavatsky’s opinion was supported by substantial evidence. Next, the ALJ’s decision to discount chiropractor Reckford’s opinion was supported by

substantial

evidencefor two r

easons. F irst, Re ckford is n ot considere d an “ accepta

ble source ” and, thu s, his opini on cannot es tablish the existenc e of an impairment. See20 C.F. R. §§ 404. 1513(a), 416.913(a ) (exclud ing chiropra ctors from the

list of “ accepta

ble me dical sources” who se opinions m ay be

cons idere d in d etermin ing t he exi sten ce of an impairmen t). Sec ond, R eckfo rd’s8

findings of disability

are incon sistent wi th his own tr eatm ent notes a

nd unsupported by the medical evidence. Rec kford’s finding that Crawford was unable to return to his past rele vant work as a truc k driver w as based sol ely on Crawfo rd’s subj ective co mplaints of pain. Additiona lly, approximately two wee ks after m aking his finding, Rec kford rep orted “ an imm ediate 50%reduction in the amount of pain, s pasm a

nd limi ted mo tion” and not ed that Crawford “ alway s feels better w ith com

pletion of c hiroprac tic trea tment .” Fina lly, approximately five weeks af ter indica ting that Cr

awford c ould perfor

m no ca rrying, liftin g, standing , sitting, climbing, balancing, stooping, crouching, kneeling, or crawling, Reckford reported that Crawford baby-sits his grandchildren and helps his wife and children around th e house. Additional ly, C rawfor

d’s contention that D r. Melto n’s opinio n was “ against the great weight of all the evidence” lacks merit. Dr. Melton’s opinion that Crawfo rd should not r

eturn to w ork that inv olves lifting more than 20 to 2 5pounds, or frequent lifting in excess of 15 pounds, is consistent with the abovementioned medical e vidence and comports with Dr. Zemankiewicz’ s finding that Crawfo rd should be r

estricte d from

lifting m ore than 25 pounds. Final ly, Crawfo rd arg ues t hat th e ALJ err ed by fai ling to con side r Harti g’s opinion that he had “marked” psy chological limitations. Crawford maintains that9

the ALJ had no basis f

or reje cting Har

tig’s opin ion and, thu s, erre d by failing to include her

findings in t

he hypot hetical qu estion to the

VE. C rawfor

d additional ly contends tha

t the distri ct court e rred by “failing to ju stify the ALJ’ s impli cit rejection of the ‘marked’ limitations noted [by Dr. Hartig]. ” Crawfo rd’s co ntention tha t the AL J ignored H artig’ s findings is belied by the record. The ALJ expressly considered Hartig’s opinion that Crawford was markedly lim

ited in terms of his ability to cope with change or stress. However, the ALJ found that H artig’ s opinion wa s not entitle d to control ling weight and that, based on treating psychiatrist Dr. Mehta’ s reports, Crawford could perform “limited, simple, low-stress, routine work r equiring moderate concentration.” The AL J correc tly fo und that, be cause Ha rtig exam ined Craw ford on only one occasi on, her opi nion was n ot entitl ed to great weight. See McSwain v. Bowen , 814 F.2 d 617, 619 (1 1th Cir. 1 987) (stat ing that a do ctor who e xamin es a claimant on on ly one occasio n is not co nsidered a “treating physici an”). Moreover, the ALJ’s findings regarding Crawfor d’s mental capacity

were supported by the findings of Dr. Mehta, the psychiatrist w ho had examined Crawford on two occasions and reported that Crawford was “ cooperative . . . clear, spontaneous, but without any ev idence of loose assoc iations, f

lights of ide as, or pressure of speech.” Additionally, Dr . Mehta stated that Crawford had described10

his moo d as “ feeling be tter” and that he shou ld attend voc ational rehabilitati on to ascertain whethe r he can l earn skill s that wil l enable hi m to pe rform gainful emplo ym ent. Ba sed on the f oregoing, Crawf

ord is not en

titled to r elief on th is cla im. Additional ly, C rawfor d’s contention that the

district c ourt faile d to addres s the ALJ’ s impli cit rej ection of H artig’ s opinion is be lied by the recor d. The district court expressly found that the ALJ had properly considered Ha rtig and Dr. Mehta’s reports and that the ALJ’s decision on the issue of Crawford’ s mental limit ations wa s supported b y substa ntial evide nce. Mor

eover, C rawfor

d cannot show t hat h e was pr ejudi ced by th e cour t’s all eged e rror b ecaus e the AL J’s decision was suppo rted by subst antial evi dence, as di scussed a bove. Final ly, we nee d not addre ss Cra wford ’s cont enti on th at the ALJ’s hypothe tical ques tion to the VE was in adequate because C rawfor d failed to raise this iss ue in the d istrict co urt. See Stewart v. Dept. of He alth and Human Services , 26 F.3d 115, 115-16 (11th Cir. 1994 ) (statin g that “ [a]s a general p rinciple, this Court will not addres s an argument th at has not been raised in the dis trict cour t”). In any event, the ALJ w as not required to include findings in the hypothetical that the ALJ had proper

ly re jected as unsupport ed.11

Accord ingl y, we conc lude that s ubst anti al evi dence supp orts the ALJ ’s decision to discredit

the opinions o f Craw ford’s treating p hysici ans and chiro pract or. We fu rther concl ude t hat s ubst anti al evi dence supp orts the ALJ ’s fin di ng s re gar di ng Cra wfo rd’ s men tal RFC . We, th ere for e, a ffi rm. AFFIRMED.