FILED 

 .U.S. COURT OF APPEALS

 ELEVENTH CIRCUIT 

 April 12, 2005 

 THOMAS K. KAHN 

 CLERK

Honorable Jerome Farris, United States Circuit Judge for the Ninth Circuit, sitting by *

designation.

[PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT

________________________

No. 04-13176

________________________

D. C. Docket No. 03-00205-CV-2-CAR-5

CHRISTI L. MOORE,

Plaintiff-Appellant, 

versus 

JO ANNE B. BARNHART,

Defendant-Appellee. 

________________________

Appeal from the United States District Court

for the Middle District of Georgia

_________________________

(April 12, 2005)

Before BARKETT, HILL and FARRIS , Circuit Judges. *

PER CURIAM:

Christi L. Moore appeals the district court’s order affirming the
A varus deformity is defined as a bowing inward of the knee and leg. F.A. Davis,

1

Tarber’s Cyclopedic Medical Dictionary 2064 (18th Ed. 1997). 

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Commissioner of Social Security’s (“Commissioner”) denial of her application for

Disability Insurance Benefit (“DIB”) and Supplemental Security Income (“SSI”)

payments based on a determination that she retained sufficient residual functional

capacity to perform her past relevant work. Specifically, Moore takes issue with:

(i) the ALJ’s failure to credit testimony from her treating physicians; (ii) the ALJ’s

reference to an absence of objective medical evidence; (iii) the ALJ’s ultimate

determination that she remained able to perform the full range of light work; and

(iv) the ALJ’s failure to comply with regulations on the methodology for

evaluating mental impairments. We find the ALJ’s failure to properly evaluate

Moore’s psychological impairments requires remand. 

BACKGROUND

In February 1994, Moore applied for DIB, claiming disability from

fibromyalgia, separation of the right shoulder, a varus deformity of the knee and

leg , asthma, depression, cervical disc disease, and headaches. After hearings 1

before an administrative law judge (“ALJ”), her DIB application was denied in

August 1996. The district court affirmed, but on appeal before this court the Social

Security Administration (“SSA”) requested a “sentence four” remand pursuant to
In order to remand pursuant to the fourth sentence of § 405(g), the court “must either 2

find that the decision is not supported by substantial evidence, or that the Commissioner (or the

ALJ) incorrectly applied the law relevant to the disability claim.” See Jackson v. Chater, 99

F.3d 1086, 1091-92 (11th Cir. 1996).

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42 U.S.C. § 405(g) to allow further consideration of Moore’s fibromyalgia. 

2

Moore subsequently filed her claim for SSI payments in April 1998. After

additional hearings and the presentation of additional evidence, the ALJ

recommended that both claims be denied. Though the ALJ accepted that Moore

both had not engaged in substantial gainful activity and had impairments

qualifying as severe, he determined that Moore’s disabilities did not meet or equal

any of those resulting in a presumption of disability. See Appendix 1, 20 C.F.R. §

404 (2005). The ALJ ultimately found that while Moore was restricted from some

jobs, her impairments did not preclude performance of all of her past relevant

work, including light exertion positions as an office clerk, sales clerk, food

production worker, or waitress. That determination was largely grounded in what

the ALJ perceived as an inconsistency between Moore’s accounts of her daily

activities and her claims of work impairment. The ALJ also made adverse

credibility determinations as to Moore’s claim that she has not kept up with her

prescription drug and treatment regimen due to financial constraints, in light of

Moore’s ability to purchase cigarettes, cocaine, and marijuana. The ALJ further

found Moore’s case weakened by her smoking habit, where medical professionals
4

have repeatedly stated that it exacerbated her asthma and respiratory problems.

After the appeals council denied Moore’s request for review, the

Commissioner adopted the ALJ’s findings as final. Moore appealed to the district

court, which in turn adopted the magistrate’s recommendation to affirm the

Commissioner’s decision. Moore timely appeals.

STANDARD OF REVIEW

In Social Security appeals, we review de novo the legal principles upon

which the Commissioner’s decision is based. Chester v. Bowen, 792 F.2d 129, 131

(11th Cir. 1986). However, we review the resulting decision only to determine

whether it is supported by substantial evidence. Crawford v. Comm’r of Soc. Sec.,

363 F.3d 1155, 1158-59 (11th Cir. 2004). Substantial evidence is less than a

preponderance, but rather such relevant evidence as a reasonable person would

accept as adequate to support a conclusion. Id. This limited review precludes

deciding the facts anew, making credibility determinations, or re-weighing the

evidence. Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983).

DISCUSSION

An individual claiming Social Security disability benefits must prove that

she is disabled. Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir. 1999). For SSI

claims, a claimant becomes eligible in the first month where she is both disabled
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and has an SSI application on file. 20 C.F.R. § 416.202-03 (2005). For DIB

claims, a claimant is eligible for benefits where she demonstrates disability on or

before the last date for which she were insured. 42 U.S.C. § 423(a)(1)(A) (2005). 

Because Moore’s last insured date was December 31, 1997, her DIB appeal

requires a showing of disability on or before that date. Conversely, as Moore

applied for SSI payments in April 15, 1998, her SSI appeal requires a showing of

disability between that date and the date of the ALJ’s decision, on February 23,

2001. 

The social security regulations establish a five-step evaluation process,

which is used to determine disability for both SSI and DIB claims. McDaniel v.

Bowen, 800 F.2d 1026, 1030-31 (11th Cir. 1986); 20 C.F.R. § 416.912 (2005)

(five-step determination for SSI); 20 C.F.R. § 404.1520 (2005) (five-step

determination for DIB). These regulations place a very heavy burden on the

claimant to demonstrate both a qualifying disability and an inability to perform

past relevant work. Spencer v. Heckler, 765 F.2d 1090, 1093 (11th Cir. 1985). 

Moore’s appeal focuses on step four in the evaluation process: her capacity to

perform her past relevant work.

First, Moore contends that the ALJ erred in failing to properly consider her

symptoms of pain and fibromyalgia. Specifically, Moore contends that the ALJ’s
Unpublished decisions of this court are not binding precedent. See 11th Cir. R. 36-2. 3

However, Moore specifically relies on our unpublished decision in Stewart, and we address it for

this reason.

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decision improperly focused on the absence of objective findings to corroborate

her claims of impairment, and conflicts with our unpublished decision in Stewart v.

Apfel, No. 99-6132, 2000 U.S. App. LEXIS 33214 (11th Cir. Dec. 20, 2000). In 3

Stewart, we reviewed medical research on fibromyalgia, which often lacks medical

or laboratory signs, and is generally diagnosed mostly on a individual’s described

symptoms. Because the impairment’s hallmark is thus a lack of objective

evidence, we reversed an ALJ’s determination that a fibromyalgia claimant’s

testimony was incredible based on the lack of objective evidence documenting the

impairment. Id. at *9, n.4. 

While in this case the ALJ did note that Moore’s treating sources

documented a “lack of corroborative objective findings of impairment,” this

absence of laboratory evidence was not the basis for the ALJ’s own negative

credibility determination. Unlike the situation in Stewart, where the lack of

objective findings formed the basis for the adverse credibility determination, the

ALJ here relied on the inconsistencies between Moore’s descriptions of her diverse

daily activities and her claims of infirmity. More specifically, the ALJ questioned

Moore’s contentions that she could not maintain consciousness or perform light
While Moore argues in passing that the ALJ’s decsion runs afoul of this Circuit’s 4

precedent requiring explicit articulation of the reasons justifying a decision to discredit a

claimant’s subjective pain testimony (e.g., Cannon v. Bowen, 858 F.2d 1541, 1545 (11th Cir.

1988)), the ALJ’s findings and rationale satisfy this standard.

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work, in light of her ability to drive, provide childcare, bathe and care for herself,

exercise, and perform housework. 

We recognize that credibility determinations are the province of the ALJ. 

Wilson v. Heckler, 734 F.2d 513, 517 (11th Cir. 1984). As the ALJ provided a

detailed factual basis for his credibility determination , which did not turn on the 4

lack of objective evidence documenting fibromyalgia, Stewart is unavailing to

Moore. Indeed, the ALJ even cited to our decision in Stewart, making clear that

Moore’s lack of corroborative medical evidence “did not establish the claimant has

no impairment from fibromyalgia.” R. 1182.

Second, Moore suggests that the ALJ improperly discredited the testimony

of her treating chiropractor. Moore cites to decisions of this court requiring that

the ALJ clearly articulate the reasons for giving less weight to the testimony of a

treating physician. MacGregor v. Bowen, 786 F.2d 1050, 1053 (11th Cir. 1986). 

While a treating physician’s testimony can be particularly valuable in fibromyalgia

cases, where objective evidence is often absent, see Stewart, 2000 U.S. App.

LEXIS 33214 at *9, the ALJ here adequately articulated specific justification for

discounting Dr. Pardo’s opinion. Dr. Pardo treated Moore for approximately six
8

months before opining, in February 1997, that Moore was unable to work

indefinitely. The ALJ found this opinion deficient because it failed to account for

Moore’s diverse daily activities, or to give any specific assessment of Moore’s

functional capacity or explanation of how it bore on Dr. Pardo’s conclusion that

Moore could not work. In addition, the ALJ discounted Dr. Pardo’s opinion

because the opinion was prepared on a short form used to support Moore’s food

stamp eligibility. Where our limited review precludes re-weighing the evidence

anew, Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996), and as the ALJ

articulated specific reasons for failing to give Dr. Pardo’s opinion controlling

weight, we find no reversible error.

Third, Moore urges error in the ALJ’s ultimate determination that her

residual functional capacity (“RFC”) enabled her to perform some of her past

work. On this point, the ALJ relied on medical testimony that Moore’s varus

orthopedic problem only “moderately restricted” her gait, did not restrict light duty

employment, and could be treated with high-top shoes and over-the-counter

medications. R. 1185. The ALJ drew on similar medical testimony that Moore’s

psychiatric and depressive impairments resulted in moderate deficiencies in

concentration and attention, but did not affect Moore’s mobility or require
 On this point, the ALJ rejected a state agency’s determination that Moore’s affective 5

disorder was “non-severe”, finding instead that it imposed non-minimal restrictions on her

capacity. R. 1186.

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hospitalization. R. 1184-85. Likewise, Moore’s vertebrogenic disorders resulted 5

in no major functional loss. R. 1183. The ALJ further noted that throughout the

time period under consideration, Moore’s condition remained relatively stable,

with a gain in weight, no diminution in muscle strength, a full range of motion, and

normal muscle tone. R. 1183, 1185. While the ALJ’s RFC decision considered

Moore’s subjective pain, it noted that Moore’s medical history contained notations

of embellished and magnified pain behaviors, as well as drug-seeking manipulative

tendencies. R. 1183, 1185. The ALJ’s RFC determination also drew on findings

of an inconsistency between Moore’s own testimony as to her daily activities and

her claims of impairment.

Based on the foregoing, we find that the ALJ’s determination that Moore

retained sufficient RFC to perform some of her past relevant work was supported

by substantial evidence. See Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir.

1990) (“[e]ven if the evidence preponderates against the Secretary’s factual

findings, we must affirm if the decision reached is supported by substantial

evidence”); cf., Graham v. Apfel, 129 F.3d 1420, 1422 (11th Cir. 1997) (affirming

ALJ determination that claimant’s claims of work impairment could not be squared
To a large extent, Moore questions the ALJ’s RFC determination based solely on the 6

fact that she has varus leg instability and shoulder separation. However, the mere existence of

these impairments does not reveal the extent to which they limit her ability to work or undermine

the ALJ’s determination in that regard. See McCruter v. Bowen, 791 F.2d 1544, 1547 (11th Cir.

1986) (“‘severity’ of a medically ascertained disability must be measured in terms of its effect

upon ability to work”).

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with her ability to care for herself and manage daily activities of childcare and

housework). To the extent that Moore points to other evidence which would

undermine the ALJ’s RFC determination , her contentions misinterpret the 6

narrowly circumscribed nature of our appellate review, which precludes us from

“re-weigh[ing] the evidence or substitut[ing] our judgment for that [of the

Commissioner] . . . even if the evidence preponderates against” the decision. 

Bloodsworth, 703 F.2d at 1239. Furthermore, we note that rather than pointing to

medical evidence that conflicts with the ALJ’s RFC determination, Moore argues

inferentially that based on their evaluations, Moore’s physicians would most likely

disagree with the ALJ’s findings. Because Moore bears the burden of

demonstrating that she is unable to perform her past relevant work, see Jones, 190

F.3d at 1228, this sort of extrapolation and conjecture remains insufficient to

disturb the ALJ’s RFC determination, where it is supported by substantial

evidence. 

Fourth and finally, Moore argues that the ALJ erred in his consideration of

her mental impairments. Specifically, Moore points to the ALJ’s failure to
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complete a Psychiatric Review Technique Form (“PRTF”) or comply with the

mode of analysis the form and its accompanying regulations dictate. Agency

regulations require the ALJ to use the “special technique” dicated by the PRTF for

evaluating mental impairments. 20 C.F.R. § 404.1520a-(a). This technique

requires separate evaluations on a four-point scale of how the claimant’s mental

impairment impacts four functional areas: “activities of daily living; social

functioning; concentration, persistence, or pace; and episodes of decompensation.” 

20 C.F.R. § 404.1520a-(c)(3-4). The ALJ is required to incorporate the results of

this technique into the findings and conclusions. 20 C.F.R. § 404.1520a-(e)(2). 

On appeal, the Commissioner concedes (as she must) that the ALJ erred in

not completing the PRTF or complying with its mode of analysis. The

Commissioner argues, however, that remand is unnecessary as it would require no

more than the ALJ’s rote completion of the PRTF. We cannot agree. The ALJ

failed to even analyze or document Moore condition in two of the PRTF’s

functional areas: social functioning and prior episodes of decompensation. 

Because the ALJ’s decision lacks consideration of these factors and their impact on

his ultimate conclusion as to Moore’s RFC, we cannot even evaluate the

Commissioner’s contention that the ALJ’s error was harmless. 

Furthermore, the fact that the ALJ complied with the PRTF method and
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regulations when he first evaluated Moore’s claim in 1996, prior to remand, is not

sufficient to excuse his failure to do so here. Particularly where Moore has

presented non-frivolous evidence suggesting that her mental condition has

deteriorated since the vacated 1996 decision, the ALJ’s prior evaluation is

insufficient to deny Moore another evaluation of her mental impairments’ effect on

her RFC through the date of the ALJ’s 2001 decision. 

We thus join our sister circuits in holding that where a claimant has

presented a colorable claim of mental impairment, the social security regulations

require the ALJ to complete a PRTF and append it to the decision, or incorporate

its mode of analysis into his findings and conclusions. Failure to do so requires

remand. See Gutierrez v. Apfel, 199 F.3d 1048, 1051 (9th Cir. 2000) (Schroeder,

C.J.) (where claimant presents colorable claim of mental impairment, ALJ’s failure

to comply with PRTF regulations requires remand); Stambaugh v. Sullivan, 929

F.2d 292, 296 (7th Cir. 1991) (ALJ’s failure to evaluate claimant’s alleged mental

disorder or to document the procedure on a PRTF required reversal); Hill v.

Sullivan, 924 F.2d 972, 975 (10th Cir. 1991) (same); Montgomerty v. Shalala, 30

F.3d 98, 100 (8th Cir. 1994) (reversing and remanding because ALJ purported to

evaluate mental disorder, but failed to do so according to PRTF and its

regulations).
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The judgment of the district court is reversed and the case is remanded with

instructions to remand the matter to the ALJ for an evaluation of Moore’s mental

impairments that complies with the applicable regulations.

REVERSED AND REMANDED.