[DO NOT PUBLISH]

In the

United States Court of Appeals

For the Eleventh Circuit

____________________

No. 22-10198

Non-Argument Calendar

____________________

VICKIE LEMONS, 

Plaintiff-Appellant,

versus

COMMISSIONER, SOCIAL SECURITY ADMINISTRATION, 

Defendant-Appellee.

____________________

Appeal from the United States District Court

for the Northern District of Alabama

D.C. Docket No. 4:20-cv-01267-RDP

____________________

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2 Opinion of the Court 22-10198

Before GRANT, LUCK, and LAGOA, Circuit Judges.

PER CURIAM:

Vickie Lemons appeals the district court’s order affirming 

the Commissioner of the Social Security Administration’s denial of 

her application for disability benefits. After a thorough review of 

the briefing and the relevant records, we affirm.

I. 

Lemons alleges she became disabled on May 1, 2016. She 

applied for a period of disability and disability insurance benefits 

one year later, in May 2017. Lemons stated that her medical 

conditions were anxiety, depression, degenerative bone disease, 

and fibromyalgia. After a hearing, the administrative law judge 

(ALJ) issued an unfavorable decision dated August 12, 2019. 

The ALJ considered several sources of evidence, including

claim documents, work history, and functional reports from 

Lemons and a friend, Jean Langley. These submissions stated that 

Lemons worked part-time at a fast-food restaurant, cared for her 

three grandchildren, and drove, cooked, and cleaned. In doing 

these tasks, however, she had pain in her back and had trouble 

moving, concentrating, and getting along with others. She needed 

pain medication and frequent breaks. 

The ALJ also received medical evidence Lemons submitted 

from several visits with her treating physician, Dr. Tummala. Dr. 

Tummala’s records reflect that Lemons had normal ambulation, 

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22-10198 Opinion of the Court 3

gait, and strength at all examinations, but that during three visits

she had a limited range of motion in her right shoulder. In March 

2019, Dr. Tummala filled out a physical capacities form, concluding

that Lemons could sit upright for only two hours at a time, stand 

for one, would need to be off-task half of every workday, and 

would miss twelve workdays every thirty. 

The ALJ also received medical records and opinions from 

several other doctors about Lemons’s condition. Evidence varied. 

For example, a January 2019 physical capacities form by physician 

assistant Elizabeth Giles showed far more sitting, standing, and 

working capacity than Dr. Tummala’s report. As for Lemons’s 

shoulder, records showed normal strength in September 2017 but 

weak strength in October 2018. After a 2018 surgery, she attended 

physical therapy, and the therapist noted good progress for the

shoulder. The ALJ also received various medical test reports, 

including several MRIs showing mild broad-based bulging in 

Lemons’s back but no herniation. 

Finally, the ALJ also heard testimony from, and posed 

questions to, a vocational expert. In one question, the ALJ asked 

about the capability of a hypothetical individual who, among other 

limitations, was limited to light exertion, alternating sitting and 

standing every twenty to thirty minutes, and had no ability to leave 

the workstation. The vocational expert’s response was that this 

individual could not perform Lemons’s prior work, but could 

perform other work in the national economy, including as a booth 

cashier, office helper, or bench assembler. 

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4 Opinion of the Court 22-10198

Following the five-step process outlined by Social Security 

regulations, the ALJ concluded that Lemons was not disabled from 

May 1, 2016 through August 2019. See Winschel v. Comm'r of Soc. 

Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). For step one, the ALJ 

decided that Lemons had not engaged in substantial gainful activity 

since May 1, 2016—her alleged disability onset date—which made 

her eligible for disability payments from that date. At steps two 

and three, the ALJ concluded that Lemons was not automatically 

disabled by her impairments: although she had degenerative disc 

disease and osteoporosis, these did not meet or equal the severity 

of the impairments listed in 20 C.F.R. § 404, Subpart P, Appendix 

1. At steps four and five, the ALJ determined that Lemons had a 

light work residual capacity with limits; she could not perform her 

past work, but could perform jobs available in the national 

economy. 

Lemons disagreed. After the Appeals Council denied 

additional review, she sued in district court. The district court 

affirmed the Commissioner’s decision. 

II. 

We review the ALJ’s application of legal principles de novo, 

but we are limited to assessing whether the resulting decision “is 

supported by substantial evidence.” Henry v. Comm’r of Soc. Sec., 

802 F.3d 1264, 1266–67 (11th Cir. 2015); 42 U.S.C. § 405(g). 

Substantial evidence is “more than a scintilla, but less than a 

preponderance.” Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 

1990).

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22-10198 Opinion of the Court 5

 III. 

Lemons challenges four aspects of the ALJ’s decision. 

First, she argues that the ALJ gave improper weight to the 

opinions of her treating physician, Dr. Tummala. Her argument 

relies in part on precedents from this Court applying the now 

defunct treating-physician rule. See, e.g., Phillips v. Barnhart, 357 

F.3d 1232 (11th Cir. 2003). Our recent precedent makes clear, 

however, that the Commissioner eliminated the treating physician 

rule for claims filed after March 27, 2017. Harner v. Soc. Sec. 

Admin., Comm'r, 38 F.4th 892, 897 (11th Cir. 2022). Instead of 

requiring special deference to a treating physician, the new 

regulation provides several factors for determining the weight to 

give a claimant’s medical opinions, including their supportability, 

consistency with other evidence, and other relevant information. 

See id.; 20 C.F.R. § 404.1520c(a).

Here, the ALJ applied the correct legal standard. Lemons 

filed her claim in May 2017, and so the new regulations apply. 

Consistent with these new regulations, the ALJ examined the 

supportability of Dr. Tummala’s opinions and those of the other 

doctors by scrutinizing their conclusions given the objective 

medical evidence. Moreover, the ALJ analyzed the consistency of 

the doctors’ opinions with each other, as well as with the medical 

records. The ALJ also reasoned that Dr. Tummala’s opinions 

about Lemons’s limitations extended earlier than could be 

supported by his records. This detailed analysis amply complies 

with 20 C.F.R. § 404.1520c(a). 

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6 Opinion of the Court 22-10198

Lemons insists that Dr. Tummala’s opinions are supported

by evidence in the record. But because her brief fails to describe

this evidence with specificity or connect the decisions she cites to a 

conclusion about substantiality, she forfeits this claim. See Harner,

38 F.4th at 899. Even if she had not, the ALJ supported his 

discounting of Dr. Tummala’s opinions, pointing to specific 

reasons. And under the substantial evidence standard, an ALJ need 

not refer to every piece of contrary evidence in its decision. See 

Mitchell v. Comm'r, Soc. Sec. Admin., 771 F.3d 780, 782 (11th Cir. 

2014). 

Second, Lemons argues that the ALJ erred by stating that her

daily activities diminish the persuasiveness of her disability 

allegations. To begin, we note that the ALJ appropriately 

patterned his analysis of Lemons’s subjective testimony on the

three-part pain standard of this Circuit, which Lemons does not 

appear to dispute. See Holt v. Sullivan, 921 F.2d 1221, 1222–23

(11th Cir. 1991). Instead, the question is whether substantial 

evidence supports the ALJ’s evaluation, mindful that an ALJ must 

“articulate explicit and adequate reasons.” Dyer v. Barnhart, 395 

F.3d 1206, 1210 (11th Cir. 2005) (quotation omitted).

Here, the ALJ’s analysis holds up. An ALJ may discredit a 

claimant’s subjective complaints based, at least in part, on daily 

activities. See Dyer, 395 F.3d at 1210–12. That is what happened 

here. The ALJ did not rely “heavily” on Lemons’s activities, as she 

claims, but discredited her complaints based on the conservative 

nature of her treatment and the objective medical evidence 

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22-10198 Opinion of the Court 7

showing improvement of her condition. See 20 C.F.R. § 

404.1529(c)(3)–(4). We cannot conclude that the ALJ erred. 

Third, Lemons advanced a two-part claim related to the 

ALJ’s determination that she could perform limited light work: 

(1) the ALJ erred by violating Social Security Ruling 96-8p and 

(2) this finding was not supported by substantial evidence. 

As distinct from her second argument, Lemons’s first is

essentially procedural. Under SSR 96-8p, an ALJ must first identify 

an individual’s functional limitations, next assess work-related 

abilities, and only then express them in terms of exertional levels. 

See 61 Fed. Reg. 34474-0 (July 2, 1996). Along the way, an ALJ must 

include a narrative discussion connecting relevant evidence to its 

conclusions for each step. Id. at 34478.

The ALJ’s decision here is not a model of step-by-step 

analysis. Still, it complies with SSR 96-8p. The analysis of residual 

functional capacity first acknowledged that it was pointed at 

Lemons’s “ability to do work-related activities.” Throughout the 

analysis, the ALJ broke down Lemons’s functional limitations 

anatomically, separately considering her right shoulder, back, hips, 

and mental concentration. He noted Lemons’s statements about 

her difficulty lifting, bending, standing, walking, sitting, 

concentrating, and handling stress—all work-related limitations. 

In the penultimate paragraph of the section on residual functional 

capacity, the ALJ included an assessment of Lemons’s “ambulation, 

gait, strength, movement of all extremities, and cardiovascular and 

respiratory systems.” And in the summary heading, the ALJ 

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8 Opinion of the Court 22-10198

attached the label of “light work” and included additional 

limitations tailored to Lemons’s abilities. Altogether, the ALJ met 

the procedural requirements of SSR 96-8p.

Lemons’s substantive argument—that the residual 

functional capacity finding was not supported by substantial 

evidence—fails for reasons we have already discussed. Lemons 

failed to develop this claim in her counseled brief and presents 

nothing to counter the ALJ’s extensive evidentiary analysis. 

Fourth and finally, Lemons argues that the ALJ erred by 

considering the vocational expert testimony as substantial evidence 

and neglecting to question the vocational expert about her pain. In 

general, an ALJ is “not required to include findings in the 

hypothetical that the ALJ had properly rejected as unsupported.” 

Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155, 1161 (11th Cir. 

2004). That means the ALJ was not required to include a pain 

impairment nor any alternate residual functional capacities in his

hypothetical questions to the vocational expert—he had resolved 

these issues earlier in a well-supported analysis. As we have held

above, all the ALJ’s analytical steps were supported by substantial 

evidence, and it follows that his overall disability determination 

was as well. 

* * *

Because the ALJ’s decision applied the correct legal 

standards and was supported by substantial evidence, the order of 

the district court is AFFIRMED.

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