[DO NOT PUBLISH]

In the

United States Court of Appeals

For the Eleventh Circuit

____________________

No. 23-11777

Non-Argument Calendar

____________________

JOHN ESCO, JR., 

Plaintiff-Appellant,

versus

COMMISSIONER OF SOCIAL SECURITY, 

Defendant- Appellee.

____________________

Appeal from the United States District Court

for the Middle District of Alabama

D.C. Docket No. 2:21-cv-00119-CWB

____________________

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2 Opinion of the Court 23-11777

Before BRASHER, ABUDU and DUBINA, Circuit Judges.

PER CURIAM:

Appellant John Esco, Jr., appeals the district court’s order 

affirming the Social Security Administration’s (“SSA”) denial of his 

claim for disability insurance benefits (“DIB”).1 He argues that the 

administrative law judge (“ALJ”) erred in finding (1) Esco’s

subjective complaints of pain were “not entirely consistent” with 

the record, (2) Esco did not meet Listing 1.04(A), and (3) Dr. 

Carter’s and Dr. Hayden’s opinions were not persuasive. Having 

read the parties’ briefs and reviewed the record, we affirm the 

district court’s order denying Esco’s claim for DIB.

I.

In a social security disability case in which the Appeal 

Council has denied 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). We review the ALJ’s decision 

for substantial evidence and his application of legal principles de 

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

reviewing for substantial evidence, “we may not decide the facts 

anew, reweigh the evidence, or substitute our judgment for” the 

ALJ’s. Viverette, 13 F.4th at 1314 (quotation marks omitted). 

1 The parties consented to have this case disposed of by a magistrate judge 

pursuant to 28 U.S.C. § 636(c).

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23-11777 Opinion of the Court 3

Substantial evidence is any relevant evidence, less than a 

preponderance, that a reasonable person would accept as adequate 

to support a conclusion. Moore v. Barnhart, 405 F.3d at 1211. 

A claimant must be disabled to be eligible for DIB, 42 U.S.C. 

§ 423(a)(1)(E), and he bears the burden of proving that he is 

disabled. Moore, 405 F.3d at 1211. A claimant is disabled if he 

cannot engage in substantial gainful activity by reason of a 

medically determinable impairment that can be expected to result 

in death “or which has lasted or can be expected to last for a 

continuous period of not less than 12 months.” 42 U.S.C. 

§ 423(d)(1)(A). 

After considering a claimant’s complaints of pain, the ALJ 

may reject them as not credible, which finding we will review for 

substantial evidence. Marbury v. Sullivan, 957 F.2d 837, 839 (11th 

Cir. 1992). The ALJ must explicitly and adequately articulate his

reasons if he discredits subjective testimony. Id. The credibility 

determination does not need to cite “particular phrases or 

formulations”, but it cannot merely be a broad rejection that does 

not allow us to conclude that the ALJ considered a claimant’s 

medical condition in its entirety. Dyer v. Barnhart, 395 F.3d 1206, 

1210 (11th Cir. 2005) (quotation marks omitted).

A claimant’s subjective complaints are insufficient alone to 

establish a disability. 20 C.F.R. § 404.1529(a); see Edwards v. 

Sullivan, 937 F.2d 580, 584 (11th Cir. 1991). A claimant’s subjective 

testimony of pain and other symptoms can establish a finding of 

disability if the medical evidence supports it. Holt v. Sullivan, 921 

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F.2d 1221, 1223 (11th Cir. 1991). The claimant must show evidence 

of an underlying medical condition and either objective medical 

evidence confirming the severity of the alleged symptoms or

evidence that the objectively determined medical condition is 

severe enough that it could reasonably be expected to give rise to 

the alleged pain. Id. 

Once this is established, the ALJ then evaluates the intensity 

and persistence of a claimant’s alleged symptoms and their effect 

on his ability to work. 20 C.F.R. § 404.1529(c). When evaluating 

the extent to which a claimant’s symptoms affect his capacity to 

perform basic work activities, the ALJ considers the daily activities; 

the location, duration, frequency, and intensity of the symptoms; 

precipitating and aggravating factors; the type, dosage, 

effectiveness, and side effects of medication taken to alleviate 

symptoms; treatment other than medication; any measures used to 

relieve symptoms; other factors concerning functional limitations 

and restrictions due to symptoms; and inconsistencies between the 

evidence and subjective statements. Id. § 404.1529(c)(3), (4).

The record here demonstrates that substantial evidence 

supports the ALJ’s finding that Esco’s medically determinable 

impairments reasonably could be expected to cause some of his 

alleged symptoms but that his statements regarding the intensity, 

persistence, and limiting effects of those symptoms were “not 

entirely consistent” with the evidence. In making the credibility 

determination, the ALJ referenced Esco’s medical records and 

Esco’s hearing testimony, which both indicated that his treatments 

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improved his functioning. The ALJ also considered both function 

reports submitted to the SSA and Esco’s hearing testimony, which 

showed that he was able to perform the activities of daily life, such 

as washing clothes, cooking basic microwave meals, driving, going 

shopping, dressing, and caring for his pets. While Esco did 

complain of pain and limitations associated with his impairments, 

subjective complaints alone are not sufficient to establish disability 

and evidence showed that his treatments were helping with his 

pain. Furthermore, those treatments and the information in the 

function reports showing daily activity are inconsistent with his 

subjective testimony. We conclude that the ALJ’s assessment 

satisfied the substantial evidence standard, and we affirm in this 

respect.

II.

The ALJ uses a five-step, sequential evaluation process to 

determine whether a claimant is disabled. Winschel v. Comm’r of 

Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). Specifically, the ALJ 

must evaluate: (1) whether the claimant engaged in substantial 

gainful work; (2) whether the claimant has a severe impairment; 

(3) whether the severe impairment meets or equals an impairment 

in the Listings of Impairments; (4) whether the claimant has the 

RFC to perform his past relevant work; and (5) whether, in the light 

of the claimant’s RFC, age, education, and work experience, there 

exist other jobs in the national economy that the claimant can 

perform. 20 C.F.R. § 404.1520(a)(4)(i)-(v).

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Step three considers whether the claimant has shown that 

he has an impairment that “meets or equals a disability described 

in the Listing of Impairments [in Appendix 1 to Subpart P of Part 

404 of the Social Security regulations], which describes 

impairments that are considered severe enough to prevent a 

person from doing any gainful activity.” Davis v. Shalala, 985 F.2d 

528, 532 (11th Cir. 1993); 20 C.F.R. § 404.1520(a)(4)(iii). “To ‘meet’ 

a Listing, a claimant must have a diagnosis included in the Listings 

and must provide medical reports documenting that the conditions 

meet the specific criteria of the Listings and the duration 

requirement.” Wilson v. Barnhart, 284 F.3d 1219, 1224 (11th Cir. 

2002). The duration requirement is satisfied if the impairment has 

lasted or is expected to last for a continuous period of at least 12 

months. 20 C.F.R. § 404.1509. “If a claimant’s condition meets or 

equals the listed impairments, he is conclusively presumed to be 

disabled and entitled to benefits.” Bowen v. City of New York, 476 

U.S. 467, 471, 106 S. Ct. 2022, 2025 (1986). Only if a claimant does 

not meet a listing does the analysis proceed to step four. Id.

Listing 1.04(A) in effect at the time the ALJ made his decision 

provided in part:

Disorders of the spine (e.g., herniated nucleus 

pulposus, spinal arachnoiditis, spinal stenosis, 

osteoarthritis, degenerative disc disease, facet 

arthritis, vertebral fracture), resulting in compromise 

of a nerve root (including cauda equina) or the spinal 

cord. With:

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A. Evidence of nerve root compression characterized 

by neuro‐anatomic distribution of pain, limitation 

of motion of the spine, motor loss (atrophy with 

associated muscle weakness or muscle weakness) 

accompanied by sensory or reflect loss and, if 

there is involvement of the lower back, positive 

straight-leg raising test (sitting and supine).

20 C.F.R. § Pt. 404, Subpt. P, App. 1, § 1.04(A) (effective through 

April 1, 2021).

The record demonstrates that substantial evidence supports 

the ALJ’s finding that Esco did not meet Listing 1.04(A) because the 

evidence in the record did not show that his impairments rose to 

the listing level severity. The ALJ noted that Esco’s impairments 

did not rise to the level of severity contemplated by that listing 

because the diagnostic evidence did not show the diagnostic 

findings necessary for the listing and the physical examinations did 

not show the longitudinal or durational requirement of the listing. 

A 2019 MRI did not show evidence of cord or nerve root 

impingement, nor did a nerve conduction study in 2018. Thus,

Esco failed to present evidence of ongoing nerve compression 

sufficient to meet the requirements of Listing 1.04(A), and the 

medical evidence supported the ALJ’s determination. 

Furthermore, as the ALJ noted, Esco failed to meet his burden of 

showing that his impairment satisfied the durational requirement 

of at least 12 months. The sporadic treatment notes Esco 

references are from different points in time (not continuous) when 

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he met the requirements of the listing, and, thus, are insufficient to 

meet his burden. We conclude that the ALJ correctly determined 

that Esco failed to meet Listing 1.04(A), and we affirm in this 

respect. 

III.

For claims filed before March 27, 2017, “[t]he opinion of a 

treating physician” had to be “given substantial or considerable 

weight unless good cause [was] shown to the contrary.” Phillips v. 

Barnhart, 357 F.3d 1232, 1240 (11th Cir. 2004) (quotation marks 

omitted). “For claims filed . . . on or after March 27, 2017,” which 

applies in Esco’s case, an ALJ must “not defer or give any specific 

evidentiary weight, including controlling weight, to any medical 

opinion(s) or prior administrative medical finding(s), including 

those from [a claimant’s] medical sources.” 20 C.F.R. § 

404.1520c(a). Instead, as we noted in Harner v. Soc. Sec. Admin., 

Comm’r, the new regulation “provides several factors for 

determining what weight to give a claimant’s proffered medical 

opinions.” 38 F.4th 892, 897 (11th Cir. 2022). “Those factors 

include the supportability of the medical opinion, its consistency 

with other record evidence, the physician’s relationship with the 

claimant, the physician’s specialty, and other relevant information, 

such as the physician’s familiarity with the other record evidence 

and with making a claim for disability.” Id. (citing 20 C.F.R. 

§ 404.1520c(c)(1)‐(5)).

The most important factors for the ALJ to consider when 

evaluating the persuasiveness of medical opinions are 

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supportability and consistency. 20 C.F.R. § 404.1520c(a). For 

supportability, “[t]he more relevant the objective medical evidence 

and supporting explanations presented by a medical source are to 

support his or her medical opinion(s) . . ., the more persuasive the 

medical opinions . . . will be.” Id. § 404.1520c(c)(1). For 

consistency, “[t]he more consistent a medical opinion(s) . . . is with 

the evidence from other medical sources and nonmedical sources 

in the claim, the more persuasive the medical opinion(s) . . . will 

be.” Id. § 404.1520c(c)(2). The ALJ “will articulate how [he] 

considered the medical opinions and prior administrative medical

findings in [the claimant’s] claim according to paragraph (b).” Id. 

§ 404.1520c(a).

The record demonstrates that substantial evidence supports

the ALJ’s finding that Dr. Carter’s opinion was “not persuasive” 

and Dr. Hayden’s opinion “non persuasive,” because they were not 

entirely consistent with the evidence in the record. The ALJ 

properly considered the relevant factors including supportability 

and consistency in weighing the medical opinion evidence in the 

record. In making its determination, the ALJ cited Esco’s own 

testimony of his daily activities while living independently. The 

ALJ also stated that Dr. Carter’s own records did not support his 

opinion, finding the opinion not persuasive specifically as it related 

to the extensive limitations in walking, sitting, and standing, based 

on the lack of clinical observations or objective testing. The ALJ’s 

opinion highlighted that Dr. Hayden’s opinion was not fully 

consistent with his examination of Esco nor with Esco’s stated daily 

activities. We conclude that the weight the ALJ afforded to the 

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10 Opinion of the Court 23-11777

medical opinions of Dr. Carter and Dr. Hayden was supported by 

substantial evidence, and we affirm in this respect.

Accordingly, based on the aforementioned reasons, we 

affirm the district court’s order affirming the SSA’s denial of Esco’s 

claim for DIB.

AFFIRMED.

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