Opinion ID: 57987
Heading Depth: 2
Heading Rank: 1

Heading: Hoffman’s Physical Impairments

Text: Hoffman first argues that the ALJ misunderstood her spinal impairments and the symptoms those impairments would likely cause, and failed to address the correct diagnosis from the April 2003 MRI. She notes that the ALJ never considered the deformity of the thecal sac and the displacement of nerve roots as determined by the MRI. According to Hoffman, this mistake cannot be harmless error because a complete understanding of the diagnosis would have enabled the ALJ to properly assess Hoffman’s credibility. In determining disability, the Commissioner “give[s] more weight to opinions from . . . treating sources, since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of . . . medical impairment(s) and may bring a unique perspective to the medical evidence.” 20 5 C.F.R. § 404.1527(d)(2). Indeed, the ALJ “must specify what weight is given to a treating physician’s opinion and any reason for giving it no weight, and failure to do so is reversible error.” MacGregor v. Bowen, 786 F.2d 1050, 1053 (11th Cir. 1986). The testimony or opinion of a treating physician must be given substantial or considerable weight unless there is “good cause” not to. Lewis, 125 F.3d at 1440. “‘Good cause’ exists where (1) the treating physician’s opinion was not bolstered by the evidence, (2) the evidence supported a contrary finding, or (3) the treating physician’s opinion was conclusory or inconsistent with his own medical records.” Id. “The opinions of nonexamining, reviewing physicians . . . when contrary to those of examining physicians are entitled to little weight in a disability case, and standing alone do not constitute substantial evidence.” Lamb v. Bowen, 847 F.2d 698, 703 (11th Cir. 1988). Additionally, an ALJ “must consider findings of [non-examining] State agency medical and psychological consultants . . . as opinion evidence, except for the ultimate determination about whether [the claimant is] disabled.” 20 C.F.R. § 404.1527(f)(2)(i). The ALJ may reject the opinion of any physician when the evidence supports a contrary conclusion. Bloodsworth v. Heckler, 703 F.2d 1233, 1240 (11th Cir. 1983). The ALJ is required, however, to state with particularity the weight she gives to different medical opinions and the reasons why. Sharfarz v. 6 Bowen, 825 F.2d 278, 279 (11th Cir. 1987). Here, upon review of the record, we conclude that the ALJ properly evaluated Hoffman’s physical limitations. Even if the ALJ misunderstood the significance of the moderate disc degeneration, the record as a whole confirms that the error was harmless. Diorio v. Heckler, 721 F.2d 726, 728 (11th Cir. 1983). The ALJ noted Hoffman’s ability to do some of her own housework activities of daily living, and that she could manage her own affairs. Although the MRI identified moderate degeneration, subsequent physical examinations reported normal motor strength and symmetrical deep tendon reflexes. Doctors prescribed anti-inflammatory medication, Lortab, which is used to treat moderate pain, and physical therapy. From July 2003 through August 2004, Hoffman was treated by Dr. Crayton, who noted mild degenerative disc disease. Test results revealed full range of motion in all joints, with positive trigger points for fibromyalgia. The bone scan taken did not reveal any abnormalities. Trigger point injections brought reduction in Hoffman’s pain. Moreover, Residual Functioning Assessments in 2003 and 2004 established that Hoffman could lift or carry twenty pounds occasionally and ten pounds frequently; she could stand, walk, or sit for six hours in an eight hour day with normal breaks. Hoffman had no manipulative or communicative restrictions. 7 In 2004, Hoffman underwent several consultative examinations at the request of the Commissioner and her attorney. Dr. Alshazly confirmed the diagnosis of fibromyalgia and chronic pain, but found normal motor function in all extremities, strength at 5/5, normal manual dexterity, good coordination, gait, and standing balance, and full range of motion in her lumbar spine, wrists, hands, hips, and knees. In light of the medical evidence presented in this case, any error in the ALJ’s alleged misstatement of the MRI result constituted harmless error. There was substantial evidence to support the ALJ’s conclusion that Hoffman’s physical limitations were not disabling. Moreover, the court properly evaluated the medical opinions. Although the record established a diagnosis of fibromyalgia, the record does not support a finding that Hoffman’s physical condition qualified her for disability benefits. See Moore v. Barnhart, 405 F.3d 1208, 1212 (11th Cir. 2005) (explaining, “[w]hile a treating physician’s testimony can be particularly valuable in fibromyalgia cases, where objective evidence is often absent, the ALJ . . . adequately articulated specific justification for discounting [the treating physician’s] opinion.” Furthermore, Dr. McArthur’s report would not alter this conclusion. McArthur concluded that Hoffman had a poor prognosis and was unable to engage 8 in gainful employment, but his opinion is inconsistent with the other medical evidence and with the opinions of Hoffman’s treating physicians. The Appeals Council properly considered this evidence and determined that it would not change the ALJ’s decision, especially considering the opinion was based on evidence already before the ALJ. And as a consulting examiner, McArthur’s opinion was not entitled to the same weight as the opinion of Hoffman’s treating physicians.