[DO NOT PUBLISH]

IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT

________________________ No. 19

- 11928 Non

- Argument Calendar

________________________ D.C. Docket No. 8:17

- cv - 02461

- CEH

- AEP

WENDY L. MEADE, Plaintiff

– Appellant,

versus COMMISSIONER OF SOCIAL SECURI TY, Defendant

– Appellee.

________________________ Appeal from the United States District Court for the Middle District of Florida

________________________ (March 23, 2020) Before MARTIN , ROSENBAUM and BLACK , Circuit Judges.
PER CURIAM:

Case: 19-11928 Date Filed: 03/23/2020 Page: 1 of 142 Wendy Meade appeals the district court’s affirmance of the Social Security Administration Commissioner’s decision denying her application for disability insurance benefits (DIB). Mea de a sserts Arline Colon, the administrative law judge (ALJ) who presided over her proceedings , erred in failing to recuse herself on remand from the Appeals Council , despite evidence stemming from Meade’s administrative proceedings that indicated ALJ Colon was biased or prejudiced against her

. Meade also contends ALJ Colon committed reversible error because ALJ Colon’s decision was not supported by substantial evidence, insofar as she : failed to consider the episodic nature of Meade’s panic disorde r ; improperly required eyewitness accounts of Meade’s panic attacks by medical professionals; improperly required corroborating testimony from Meade’s former coworkers and employers regarding her panic disorder’s effect on her ability to work; and discounted the medical opinions of three physicians who treat ed or evaluated Meade without good cause for doing so

. After review, we affirm in part, and reverse and remand in part.
I. DISCUSSION A. Bias of ALJ Colon A presumption exists that judicial and quasi

- judicial officers such as ALJs are unbiased. Schweiker v. McClure , 456 U.S. 188, 195 (1982 ). That presumption can be rebutted by showing a conflict of interest or some other specific reason

Case: 19-11928 Date Filed: 03/23/2020 Page: 2 of 143 warranting the ALJ’s disqualification. Id. The party asserting a disqualifying interest bears the burden of establishing its existence. Id. at 196. Bias is shown where an objective, fully

- informed lay person would have significant doubt about a judge’s impartiality. In re Walker , 532 F.3d 1304 , 1310 (11th Cir. 2008). Generally, bias sufficient to disqualify a judge must stem from an extrajudicial source, except where a judge’s remarks in a judicial context show such pervasive bias and prejudice that it constitutes bias against a party. Id. at 1310

– 11. Judicial rulings, routine administrative efforts, and ordinary admonishments (whether or not legally supportable) to counsel and witnesses that occur during the course of judicial proceedings that neither rely upon knowledge acquired outside of such proceedings nor display a deep

- seated and unequivocal antagonism rendering fair judgment impossible are inadequate grounds for recusal. Liteky v. United States , 510 U.S. 540, 556 (1994). The record does not support Meade’s claim that ALJ Colon was biased or prejudiced against her. Although Meade argues ALJ Colon’s bias was shown by her refusal to provide an evidentiary hearing in 2014, as ordered by the Appeals Council on remand, Meade offers no evidence in support of her claim that ALJ Colon willf ully misread § I

- 3

- 7

- 40(E) of the Hearings, Appeals, and Litigation and Law Manual. To the extent Meade asserts ALJ Colon’s 2017 decision is indicative of bias based on her discussion and interpretation of the evidence, an unfavorable

Case: 19-11928 Date Filed: 03/23/2020 Page: 3 of 144 judicial decision is not indicative of bias without other evidence of bias. Liteky , 510 U.S. at 556. Similarly, Meade’s SSA Office of Disability Adjudication and Review’s Division of Quality Service complaint about ALJ Colon, which arose out of Meade’s administrative procee dings, was an inadequate basis for recusal absen t extrajudicial sources of bias or other evidence of antagonism. Id. ; In re Walker , 532 F.3d at 1310. Meade has not cited any overt, pervasive statements by ALJ Colon indicating she was biased against Meade, nor has Meade offere d an extrajudicial reason for ALJ Colon’s alleged bias or prejudice against her. Accordingly, because Meade cannot show an obje ctive, fully

- informed lay person would have significant doubt about ALJ Colon’s impartiality in the absence of such evidence , we affirm the district court’s denial of Meade’s bias claim

. B. Substantial Evidence We review the Commissioner’s conclusions of law and the district court’s judgment de novo

. Washington v. Comm’r of Soc. Sec. , 906 F.3d 1353, 1358 (11th Cir. 2018). The Commissioner’s factual findings are conclusive if they are supported by substantial evidence, which is relevant evidence that a reasonable person would accept as adequate to support a conclusion. Id. Even wher e the evidence preponderates against the Commissioner’s factual findings, we must affirm if the decision is supported by substantial evidence. Parks ex rel. D.P. v. Comm’r, Soc. Sec. Admin. , 783 F.3d 847, 850 (11th Cir. 2015). Under this

Case: 19-11928 Date Filed: 03/23/2020 Page: 4 of 145 standard of revi ew, we will not decide the facts anew, make credibility determinations, or re

- weigh the evidence. Winschel v. Comm’r of Soc. Sec. , 631 F.3d 1176, 1178 (11th Cir. 2011). However, we will not “merely rubber

- stamp a decision . . . [but] must scrutinize the record as a whole to determine if the decision reached is reasonable and supported by substantial evidence.” Schink v. Comm’r of Soc. Sec. , 935 F.3d 1245, 1257 (11th Cir. 2019) (quotation marks omitted). Remand is appropriate for further factual developm ent before the ALJ where the record reveals evidentiary gaps that result in unfairness or clear prejudice. Washington , 906 F.3d at 1358.

“ An individual claiming Social Security disability benefits must prove that she is disabled. ” Moore v. Barnhart , 40 5 F.3d 1208, 1211 (11th Cir. 2005)

. The ALJ uses a five

- step, sequential evaluation process to determine whether a claimant is disabled. Winschel , 631 F.3d at 1178. This process includes an analysis of whether the claimant: (1) is unable to engage in substantial gainful activity; (2) has a severe and medically

- determinable impairment; (3) has an impairment, or combination thereof, that meets or equals a Listing, and meets the duration requirement; (4) can perform past relevant work, in light of her RFC ; and (5) can make an adjustment to other work, in light of h er RFC, age, education, and work experience. See id. ; 20 C.F.R. § 404.1520(a)(4).

Case: 19-11928 Date Filed: 03/23/2020 Page: 5 of 146 An ALJ considers many factors when weighing medical opinion evidence, including the examining relationship, th e treatment relationship, whether an opinion is well

- supported, and whether an opinion is consistent with the record.
20 C.F.R. § 404.1527(c). The ALJ may discount any medical opinion when the opinion is conclusory or inconsistent with the record, or whe n the evidence supports a contrary finding. Id. Physicians’ opinions about a claimant’s abilities and restrictions constitute relevant evidence but are not determinative, because the ALJ has the responsibility of assessing the claimant’s RFC. Id. § 404. 1527(d). An ALJ must give a treating physician’s opinion “substantial or considerable weight” unless there is “good cause” not to do so. Schink , 935 F.3d at 1259. “Good cause exists when (1) the treating physician’s opinion was not bolstered by the evid ence, (2) the evidence supported a contrary finding, or (3) the treating physician’s opinion was conclusory or inconsistent with his or her own medical records.” Id. The ALJ must clearly articulate her reasons for giving less weight to a treating physici an's opinion. Id.
In Schink , we vacated the ALJ’s denial of disability benefits, holding, in relevant part, that the ALJ failed to give good cause for discounting the opinion of the claimant’s two treating physicians while giving substantial weight to the opinion of two evaluative physicians who had never treated the claimant. Id.
at 1256, 1260. As part of the ALJ’s finding the treating physicians’ opinions were

Case: 19-11928 Date Filed: 03/23/2020 Page: 6 of 147 due little weight, the ALJ found their treatment notes indicated only mild limitations during the claimant’s mental

- status examinations. Id. at 1262. We noted the ALJ did not clearly articulate the basis for that conclusion but stated it was unclear how the record could support such a conclusion. Id. We stated some of the claimant’s mental

- status examinations were better than others with respect to vari ous metrics, but nevertheless held the alleged inconsistencies within those medical records were insufficient to discount the treating physicians’ opinions because “[i]t is not enough merely to point to positive or neutral observations that create, at most , a trivial and indirect tension with the treating physician’s opinion by proving no more than that the claimant’s impairments are not all

- encompassing.” Id. at 1262

– 63. We also noted the fact the claimant could remain on topic during a conversation on e xamination was not inconsistent with a finding the claimant suffered from a highly disruptive mood disorder that rendered him incapable of working. Id. at 1263. Finally, we stated the ALJ’s reliance on the claimant’s ability to engage in solitary activit ies, such as watching television or walking the dog, was not a basis to discount the treating physicians’ opinions, particularly with regard to their opinions regarding the claimant’s ability to interact with others. Id. at 1264.
ALJ Colon’s decision wa s not supported by substantial evidence because her denial of Meade’s DIB claim relied primarily on alleged inconsistencies or

Case: 19-11928 Date Filed: 03/23/2020 Page: 7 of 148 interpretations of the medical opinions of physicians who treated or evaluated Meade that are not adequately supported by the record. See id. at 1257. In evaluating Meade’s claim, ALJ Colon stated that, although Meade’s pattern of work from the late 1990s onward might have tended to support her disability claim, that evidence was equivo cal because it was not supported by corroborating evidence from Meade’s former coworkers or employers, or medical evidence

. However, Meade’s ex

- husband, Steven South, stated Meade began experiencing difficulty at work due to her excessive worrying and fea rs about leaving the house, for which she began taking excessive amounts of medication, which s upports that Meade’s troubled work history was caused by her anxiety disorder. Further, Meade testified that, as of 2006, she was taking Xanax in quantities far exceeding her prescribed dose in an unsuccessful attempt to manage her panic disorder so she could continue to work. At her 200 9 disability hearing, Meade also stated she had previously filed for disability in 2001 and 2005 due to her panic attacks, whic h indicates her condition had worsened to some degree as early as 2001. Thus, while ALJ Colon cited the lack of certain corroborating evidence in concluding Meade’s work history was not supportive of her disability claim, Meade nevertheless provided her o wn supportive testimony and South’s corroborating evidence, and there was no contrary evidence in the record that supported ALJ Colon’s finding that Meade’s work history was not tied to her panic disorder. See id. at 1257.

Case: 19-11928 Date Filed: 03/23/2020 Page: 8 of 149 Next, in assigning little weight to Dr. Karl Jones’ opinion, ALJ Colon cited inconsistencies within his September 2006 testimony. Specifically, ALJ Colon stated Dr. Jones had “paradoxically” stated Meade had made some, albeit insignificant, progress under his care, even though he also s tated her global

assessment

- of

- functioning ( GAF ) score had decreased from 60 to 50 over the same time period. But Dr. Jones’ opinion as Meade’s treating physician was due substantial or considerable weight absent good cause to discount it, and there is no inherent contradiction between the idea Meade h ad made some insignificant progress under Dr. Jones’ care while her overall ability to function simultaneously decreased due to the addition of the stress stemming from her divorce. See id. at 1259. Further, Dr. Jones’ assessment of a GAF score of 50 was in line with the GAF scores of 55 and 65 Meade received from Drs. Lia Nardone and Gerald Hodan that same year, and thus, the other contemporaneous medical

- opinion evidence in the record did not support a finding that Dr. Jones’ opinion was due little weig ht. There is also no inherent inconsistency between Meade’s GAF score of 75 f ro m October 2006

— which represented a 25

- point increase from the month before

— given the fluctuating nature of Meade’s anxiety. See id. at 1262

- 63. And, in any event, Dr. Jones s ubsequently explained Meade’s average GAF score was 60, which he considered to be a large functional impairment, based on his long

term observations of her. Thus, even if ALJ Colon was correct to discount Dr.

Case: 19-11928 Date Filed: 03/23/2020 Page: 9 of 1410 Jones’ October 2006 opinion of Meade’s conditi on, she did not properly consider his opinion as Meade’s treating physician because that one treatment record did not make his overall opinion of Meade inconsistent with the record s uch that his opinion could be given little weight across the board. 20 C. F.R. § 404.1527(c); Schink , 935 F.3d at 1259, 1262

- 63. ALJ Colon similarly erred in giving little weight to Dr. Hodan’s opinion that Meade would have issues with reliability. ALJ Colon stated that Dr. Hodan’s opinion was due little weight because: there was no evidence that Meade was late to, failed to show for, or cancelled any medical appointments due to her condition; it largely relied on Meade’s self

- reported symptoms; Meade had been on a consistent prescription of Xanax for many years; Meade had nev er been hospitalized due to her panic disorder; Meade did not provide any evidence of reliability issues from her former coworkers or employers nor evidence of an actual deterioration of her condition while at work; and no medical professional had witnesse d one of Meade’s attacks. However, as discussed above , Meade provided corroborating evidence indicating her extensive work history was due to her panic disorder, and it is unclear how her ability to consistently show up for medical appointments that occur red monthly or every few mo n ths was indicative of her ability to reliably report to work on a daily or near

- daily basis. Relatedly, it is unclear why ALJ Colon required corroborating evidence that Meade had

Case: 19-11928 Date Filed: 03/23/2020 Page: 10 of 1411 experienced a panic attack while at work, as the record indicates Meade’s disorder affected her reliability by inhibiting her ability to regularly report to work, regardless of whether she also suffered from panic attacks while at work. See Schink , 935 F. 3d at 1263

- 64. ALJ Colon’s reliance on Meade’s consistent Xanax prescription history was also misplaced, since Meade testified that, immediately before she filed for disability, she was taking dosages far exceeding her prescribed
amount to manage her anxi ety, and her September 2007 request for an early Xanax refill suggests she continued to need above

- prescribed levels of medication to manage her condition. As for the lack of any eyewitness accounts by medical personnel, Meade explained she scheduled ou tings in such a way that her Xanax would be at full

strength when she needed to leave the house. Further, she provided corroborating statements regarding her frequent panic attacks from S outh, Richard Holland, Thomas Harfst, and Fel i cia Barr, and ALJ Colo n did not explain why an observation by medical personnel would have been more illuminating, since the core problem with Meade’s panic disorder as it related to her ability to work was the fact it frequently prevented her from being able to leave her home. See Schink , 935 F.3d at 1264. In addition, ALJ Colon failed to explain why Dr. Hodan’s opinion was due less weight because it was largely based on Meade’s self

reporting, as one would expect a psychiatric evaluation to largely rely on such

Case: 19-11928 Date Filed: 03/23/2020 Page: 11 of 1412 testimonial ev idence, particularly during an initial evaluation, and Meade’s self

reports are corroborated by the record evidence. Therefore, because Dr. Hodan’s opinion was not contradicted by other record evidence and ALJ Colon’s stated reasons for discounting his op inion are unpersuasive, ALJ Colon erred in giving Dr. Hodan’s opinion little weight. 20 C.F.R. § 404.1527(c). Next, ALJ Colon erred in assigning little weight to Dr. Nardone’s opinion from March 2007 that Meade would be unable to maintain employment due t o her panic disorder because that finding is not supported by substantial evidence. In discounting Dr. Nardone’s opinion, ALJ Colon stated that opinion w a s incon sistent with Dr. Nardone’s treatment notes. First, ALJ Colon stated Dr. Nardone’s
treatment n otes from January and March 2008 indicated Meade was less anxious following the finalization of her divorce, and by January 2009, Meade’s agoraphobia was focused on her fear of bridges. However, there is nothing inconsistent with the idea that Meade was u nable to maintain employment in 2007 due to her panic disorder, and the idea her anxiety was reduced one year later following the fina l ization of her divorce, which was a significant source of stress.
See Schink , 953 F.3d at 1262

- 63. Further, although Me ade reported in January 2009 that she was anxious about having to cross a bridge, nothing in Dr. Nardone’s treatment notes indicate Meade’s agoraphobia was solely focused on that fear. To

Case: 19-11928 Date Filed: 03/23/2020 Page: 12 of 1413 the contrary, Dr. Nardone’s January 2009 treatment notes state Mead e’s fear of bridges was an element of Meade’s panic disorder, not the sole cause thereof. ALJ Colon also cited the fact Dr. Nardone did not opine for how lon g Meade would be unable to maintain employ ment as a basis for giving that opinion little weight. But ALJ Colon did not state why th e lack of a long

- term prognosis justified discounting Dr. Nardone’s opinion . Further, there is nothing within Dr. Nardone’s March 2007 treatment note s that suggests her assessment of Meade’s ability to work durin g a time when Meade reported breakthrough panic attacks despite her Xanax prescription and the stress associated with her divorce was meant to be anything other than an evaluation of Meade’s then

- current situation. And, even if Meade was able to better ma nage her symptoms after the fi nalization of her divorce in 2007, Dr. Nardone’s December 2006 and March 2007 assessments suggest Meade was unable to work while her divorce was pending in 2006 and 2007. ALJ Colon’s reliance on Meade’s normal speech , euthymi c affect, lack of psychosis, linear thought processes, and normal cognitive functions also do not support the assignment of little weight to Dr. Nardone’s opinion because ALJ Colon did not provide any reason why those evaluations were inconsistent with
Mea de’s inability to reliably leave her house or remain at work due to her panic disorder and agoraphobia, which intermittently but consistently incapacitated her.
See Schink , 935 F.3d at 1264. Finally, for the reasons discussed above, Dr.

Case: 19-11928 Date Filed: 03/23/2020 Page: 13 of 1414 Nardone’s opinion is not inconsistent with the opinions of Drs. Jones and Hodan, who also concluded Meade’s panic disorder would inhibit her ability to maintain employment. Thus, because ALJ Colon’s finding that Dr. Nardone’s opinion was due little weight was not based on its conclusory nature or inconsistencies with Dr. Nardone’s treatment records or other record evidence, ALJ Colon did not have good cause to discount Dr. Nardone’s opinion. See id. at 1259. Therefore, ALJ Colon’s findings that the opinions of Drs. Jones, Hodan, and Nardone were due little weight is not supported by substantial evidence, and the district court erred in affirming the denial of Meade’s DIB application. See Washington , 906 F.3d at 1358.
II. CONCLUSION We affirm as to Meade’s claim of bias, and reverse and remand to the district court with instructions to remand Meade’s claim to the Commissioner for proper consideration of the medical

- opinion evidence. AFFIRMED IN PART AND REVERSED AND REMANDED IN
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