Opinion ID: 3048416
Heading Depth: 2
Heading Rank: 2

Heading: Medical Source Evidence

Text: The ALJ also properly evaluated the medical opinion evidence in the record in concluding that McMahon’s impairments were not severe. See Sharfarz v. Bowen, 825 F.2d 278, 280-81 (11th Cir. 1987) (explaining that the ALJ is required to indicate and explain the weight assigned to different medical opinions). The ALJ specifically addressed the weight given to each doctor’s medical opinion. Although McMahon contends the ALJ did not give proper weight to her mental health counselor’s 1997 letters and the nurses’ progress notes from McMahon’s 2001 inpatient treatment for alcohol dependence, these documents do not constitute “medical opinions” because they are not statements from physicians or psychologists that reflect judgment about the nature and severity of McMahon’s impairments. See 20 C.F.R. § 404.1527(a)(2).4 Thus, the ALJ was not required to assign and explain the weight given to that evidence. See id.; see also Sharfarz, 825 F.2d at 280-81. Further, while the ALJ must address medical opinions explicitly, the ALJ is not required to address every piece of evidence in the record. 4 In 1995, while in nursing school, McMahon was forced to withdraw from classes due to her drinking problem and, in order to remain in the nursing program, agreed to, among other things, seek counseling. Between 1996 and 1997, Donna Roberts, a licensed mental health counselor and registered nurse, counseled McMahon and also wrote two letters to McMahon’s university. 12 Case: 14-10597 Date Filed: 09/24/2014 Page: 13 of 17 See Dyer v. Barnhart, 395 F.3d 1206, 1211 (11th Cir. 2005) (stating that “there is no rigid requirement that the ALJ specifically refer to every piece of evidence in his decision”); see also Cowart v. Schweiker, 662 F.2d 731, 735 (11th Cir. 1981) (noting that the ALJ should sufficiently explain the weight given to “obviously probative” evidence). As McMahon concedes, the letters and progress notes were not from an “acceptable medical source” for determining whether McMahon had a medically determinable impairment. See 20 C.F.R. § 404.1513(a), (d). The ALJ may still consider evidence from nurses and therapists in determining the severity (rather than the existence) of medically determinable impairments. Id. § 404.1513(d). Here, however, neither the mental health counselor’s letters nor the nurses’ progress notes addressed the severity of McMahon’s other mental impairments, that is, the degree to which those other mental impairments limited her ability to do basic work activities. See id. § 404.1521(a) & (b) (explaining that an impairment is non-severe “if it does not significantly limit [the claimant’s] physical or mental ability to do basic work activities”). The mental health counselor’s letters did not describe any significant limitations on McMahon’s mental ability to do basic work activities, except to say that McMahon found nursing school stressful, that “stress made it difficult for [McMahon] to continue to concentrate on her class work” and that McMahon had 13 Case: 14-10597 Date Filed: 09/24/2014 Page: 14 of 17 “PMS related depression.” The mental health counselor, however, also requested that McMahon’s university permit her to remain a student in good standing and later expressed surprise when McMahon was dismissed from the program. Moreover, the mental health counselor indicated that, although McMahon had failed a drug test, missed a counseling session, and admitted to drinking, McMahon had since put her recovery program back in place and understood her alcoholism. Thus, the mental health counselor’s letters support, rather than undermine, the ALJ’s finding that McMahon’s alcoholism was a contributing material factor to her disability, and, if McMahon stopped using alcohol, her other mental impairments would not cause more than minimal impact on her ability to perform basic work activities during the relevant periods. Likewise, the progress notes for McMahon’s 2001 treatment for alcohol dependence do not contain any evidence of significant limitations caused by McMahon’s other mental impairments. These progress notes indicated, inter alia, that McMahon was sober, sleeping well, and working at a mortgage company and, importantly, that her alcohol dependence was in early remission and her major depression recurrent was in full remission. In short, this evidence supported the ALJ’s finding that, when McMahon was not using alcohol, McMahon’s other mental impairments were not severe.