[DO NOT PUBLISH]

In the

United States Court of Appeals

For the Eleventh Circuit

____________________

No. 23-11944

Non-Argument Calendar

____________________

KAREN COLES, 

Plaintiff-Appellant,

versus

COMMISSIONER, SOCIAL SECURITY ADMINISTRATION, 

Defendant-Appellee.

____________________

Appeal from the United States District Court

for the Northern District of Florida

D.C. Docket No. 1:22-cv-00199-AW-CAS

____________________

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2 Opinion of the Court 23-11944

Before JORDAN, LAGOA, and BLACK, Circuit Judges.

PER CURIAM:

Karen Coles appeals the district court’s order affirming the 

decision of the Commissioner of the Social Security Administration 

to deny her disability insurance benefits (DIB). Coles asserts the 

administrative law judge (ALJ) did not properly weigh and consider 

the impact of her fibromyalgia diagnosis in assessing her residual 

functional capacity (RFC) as required by Social Security Ruling 

(SSR) 12-2p, did not sufficiently consider the opinion of her treating 

physician regarding her ability to work, and improperly assigned 

weight to a flawed examination administered by a consultative disability examiner. After review,1 we affirm. 

Individuals claiming disability benefits must prove they are 

disabled. Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). 

The Social Security regulations establish a five-step sequential evaluation process the ALJ must follow to determine whether the 

claimant is disabled. Id. As relevant here, at step four, the ALJ must 

1 “Where an ALJ denies benefits and the Appeals Council denies review, we 

review the ALJ’s decision as the Commissioner’s final decision.” Viverette v. 

Comm’r of Soc. Sec., 13 F.4th 1309, 1313 (11th Cir. 2021) (quotation marks and 

brackets omitted). Our review of the Commissioner’s decision “is limited to 

an inquiry into whether there is substantial evidence to support the findings 

of the Commissioner, and whether the correct legal standards were applied.” 

Wilson v. Barnhart, 284 F.3d 1219, 1221 (11th Cir. 2002). We review de novo

whether the Commissioner’s decision applied the proper legal standards. 

Washington v. Comm’r of Soc. Sec., 906 F.3d 1353, 1358 (11th Cir. 2018).

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23-11944 Opinion of the Court 3

ascertain the claimant’s RFC, which is “an assessment, based upon 

all of the relevant evidence, of a claimant’s remaining ability to do 

work despite [her] impairments.” Schink v. Comm’r of Soc. Sec., 935 

F.3d 1245, 1268 (11th Cir. 2019); 20 C.F.R. § 404.1545(a)(1). The 

RFC is determined by the ALJ’s consideration of the claimant’s 

physical, mental, and other abilities affected by her impairments. 

Schink, 935 F.3d at 1268; see 20 C.F.R. § 404.1545(b)-(d). In formulating the RFC, the ALJ must account for all relevant medical evidence and other evidence. Buckwalter v. Acting Comm’r of Soc. Sec., 

5 F.4th 1315, 1320-21 (11th Cir. 2021); 20 C.F.R. § 404.1545(a)(1). 

The ALJ “must state with particularity the weight given to different 

medical opinions and the reasons therefor.” Buckwalter ̧ 5 F.4th at 

1320-21 (quotation marks omitted).

For claims filed on or after March 27, 2017, the ALJ must not 

defer or give any specific evidentiary weight to any medical opinion or prior administrative finding. 20 C.F.R. § 404.1520c(a). Instead, the ALJ must determine the persuasiveness of a medical 

opinion and/or prior administrative medical finding by considering 

five factors: (1) supportability; (2) consistency; (3) relationship with 

the claimant; (4) specialization; and (5) other factors. Id.

§ 404.1520c(c)(1)-(5). Supportability and consistency are the “most 

important” factors. Id. § 404.1520c(b)(2). The ALJ is required to 

articulate how he considered the supportability and consistency 

factors, but not the remaining factors. Id. As to supportability, the 

more relevant the objective medical evidence and explanations are 

to the medical opinion, the more persuasive the opinion is. Id.

§ 404.1520c(c)(1). As to consistency, the more consistent a medical 

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4 Opinion of the Court 23-11944

opinion is with evidence from other sources, the more persuasive 

the opinion is. Id. § 404.1520c(c)(2).

SSR 12-2p provides guidance on the establishment of fibromyalgia as a medically determinable impairment (MDI) and articulates how an ALJ should evaluate fibromyalgia in claims for 

DIB. 77 Fed. Reg. 43,640-01, 43,643 (July 25, 2012) (providing once 

fibromyalgia has been established as an MDI, the ALJ should “evaluate the intensity and persistence of the [claimant’s] pain or any 

other symptoms and determine the extent to which the symptoms 

limit the [claimant’s] capacity for work”). SSR 12-2p states the ALJ 

may find a claimant has an MDI of fibromyalgia if all of the following are present: (1) a history of widespread pain in all quadrants of 

the claimant’s body; (2) on physical examination, at least 11 positive tender points on both the left and right sides of the claimant’s 

body and which exist both above and below the claimant’s waist; 

and (3) other disorders that could cause the symptoms or signs experienced by the claimant having been ruled out by examinations 

and laboratory testing. Id. at 43,641-42. In ascertaining the claimant’s RFC, SSR 12-2p states the ALJ should “consider a longitudinal 

record whenever possible because the symptoms of [fibromyalgia] 

can wax and wane so that [the claimant] may have ‘bad days and 

good days.’” Id.

The district court did not err in affirming the ALJ’s decision 

that Coles was not disabled and was therefore not entitled to DIB. 

Substantial evidence supports the ALJ’s determination that Coles 

had sufficient RFC to perform a reduced range of sedentary fullUSCA11 Case: 23-11944 Document: 43-1 Date Filed: 07/05/2024 Page: 4 of 8
23-11944 Opinion of the Court 5

time work. See Goode v. Comm’r of Soc. Sec., 966 F.3d 1277, 1280 

(11th Cir. 2020) (stating substantial evidence means “more than a 

scintilla and is such relevant evidence as a reasonable person would 

accept as adequate to support a conclusion” (quotation marks 

omitted)). In evaluating Coles’ fibromyalgia, the ALJ stated he had 

considered SSR 12-2p and found “[Coles’] fibromyalgia satisfies the 

criteria necessary to establish the condition as a medically determinable impairment.” The ALJ also stated “consideration will be 

given to any functional limitations resulting from the fibromyalgia 

in the [RFC] assessment in addition to any limitations resulting 

from any other physical or mental impairment identified.” Thus, 

Coles’ contention the ALJ did not sufficiently consider either SSR 

12-2p or the nature and severity of her fibromyalgia diagnosis is 

clearly contradicted by the factual record. The ALJ then considered 

Coles’ RFC, and specifically considered whether medical records 

and opinions regarding fibromyalgia supported functional limitations.

First, the ALJ articulated how persuasive he found the medical opinions and prior administrative medical findings on the record, and substantial evidence supports the ALJ’s finding the opinion 

of Dr. Harris was unpersuasive. See Buckwalter, 5 F.4th at 1320-21. 

Dr. Harris opined that there were extreme limitations on Coles’ 

ability to perform work-related physical activities, that Coles was 

only capable of working between four and six hours per day, and

that Coles would miss work two to three times per month due to 

her impairments. However, Dr. Harris’ opinion is inconsistent 

with Coles’ extensive medical records starting in October 2014, all 

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of which revealed no serious physical abnormalities in her musculoskeletal system, nervous system, or cervical and thoracic spine. 

Dr. Harris’ opinion is also inconsistent with the conservative nature 

of her treatment recommendations for Coles, which included massage therapy, physical exercise, and cervical trigger point injections 

rather than opioid-based pain medications or surgical interventions. Accordingly, the ALJ was empowered to accord minimal 

weight to Dr. Harris’ medical opinion regarding Coles’ ability to 

perform work-related tasks and general level of disability. 

Second, the ALJ noted Dr. Adhami’s consultative examination findings that Coles presented with normal gait and no evidence of limited joint movement, inflammation, or swelling—findings which did not support a more limited RFC. To the extent 

Coles argues the ALJ improperly considered Dr. Adhami’s findings 

under the regulations governing consideration of medical opinions, Coles has waived that argument by failing to object to the 

magistrate judge’s finding that Dr. Adhami’s findings and diagnoses 

did not meet the definition of a medical opinion. See 11th Cir. R. 

3-1 (providing a party “failing to object to a magistrate judge’s findings or recommendations” in a R&R “waives the right to challenge 

on appeal the district court’s order based on unobjected-to factual 

and legal conclusions if the party was informed of the time period 

for objecting and the consequences on appeal for failing to object”).

In any event, Coles’ argument the ALJ improperly weighed Dr. Adhami’s consultative exam because he did not ask her questions relating to her subjective pain level or conduct tests of her trigger 

points is an argument for this Court to reweigh the evidence, which 

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we cannot do. See Mitchell v. Comm’r, Soc. Sec. Admin., 771 F.3d 780, 

782 (11th Cir. 2014) (stating under the deferential substantial evidence standard, we do not “decide the facts anew, reweigh the evidence, or substitute our judgment for that of the Commissioner” 

(quotation marks omitted)).

Third, the ALJ acknowledged Coles’ alleged physical impairments—which included fibromyalgia, antalgic gait, diminished 

muscle strength, and residual fatigue—eroded her functional abilities. See Buckwalter, 5 F.4th at 1320-21; Schink, 935 F.3d at 1268. 

While explaining the RFC finding, the ALJ recognized that Coles 

reported suffering from severe impairments and concluded she 

could only “perform physical requirements of work at the sedentary exertional level, with the acknowledged limitations.” Substantial evidence—in the form of Coles’ stable condition throughout 

her medical history and the examination reports of Dr. Craig, Dr. 

Zaremski, and Dr. Adhami—supports the ALJ’s conclusion that 

while Coles suffered from significant impairments, she had sufficient RFC to work as a document preparer, a printed circuit board 

screener, or a table worker.

Thus, there was sufficient relevant evidence in the record 

viewed as a whole, to support the ALJ’s conclusion that Coles was 

not under a disability preventing her from performing any work 

and had sufficient RFC to perform other work that exists in the national economy. See Goode, 966 F.3d at 1280; Foote v. Chater, 67 F.3d 

1553, 1560 (11th Cir. 1995) (explaining to determine whether the 

decision was supported by substantial evidence, we must “view the 

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record as a whole, taking into account evidence favorable as well as 

unfavorable to the decision”); 20 C.F.R. § 416.920(a)(4)(v) (providing, at step five of the sequential evaluation process, that if the 

claimant’s impairments—considering RFC, age, education, and 

past work—do not prevent the claimant from adjusting to other 

work in the national economy, then the claimant is not disabled). 

The ALJ’s finding that Coles was not entitled to DIB was supported 

by substantial evidence. 

AFFIRMED.

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