Court Opinion

ID: 9398457
Source: CourtListenerOpinion
Date Created: 2023-05-31 15:02:17.451999+00
Date Added: 2024-06-11T17:19:33.802050
License: Public Domain

USCA11 Case: 22-11647    Document: 21-1     Date Filed: 05/31/2023   Page: 1 of 9

                                                  [DO NOT PUBLISH]
                                   In the
                United States Court of Appeals
                        For the Eleventh Circuit

                          ____________________

                                No. 22-11647
                          Non-Argument Calendar
                          ____________________

       RAHEEM ELLIS,
                                                     Plaintiﬀ-Appellant,
       versus
       ACTING COMMISSIONER OF SOCIAL SECURITY,

                                                   Defendant-Appellee.

                          ____________________

                 Appeal from the United States District Court
                    for the Northern District of Georgia
                     D.C. Docket No. 1:20-cv-02868-AJB
                          ____________________
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       2                          Opinion of the Court                       22-11647

       Before JORDAN, BRANCH, and TJOFLAT, Circuit Judges.
       PER CURIAM:
               Raheem Ellis appeals from the District Court’s order affirm-
       ing the Commissioner of the Social Security Administration’s (the
       “Commissioner”) denial of his application for disability insurance
       benefits (“DIB”), pursuant to 42 U.S.C. § 405(g). 1
               On appeal, Ellis argues that substantial evidence does not
       support the Administrative Law Judge’s (the “ALJ”) decision to
       give little weight to the opinions of treating psychiatrists, Dr.
       Lantie Quinones and Dr. Linda Welkovich; non-treating psycholo-
       gist, Dr. Roger Raftery; and non-treating Social Security Admin-
       istration (“SSA”) medical expert, Dr. Sridhar Yaratha. He also as-
       serts that, because Dr. Yaratha was a medical expert brought in at
       the ALJ’s behest, the ALJ should have recontacted Dr. Yaratha to
       clarify her opinion as needed before discounting it. He states that,
       by failing to do so, the ALJ abdicated her duty to develop a full and
       fair record.
               Because the Appeals Council declined to review the ALJ’s
       decision, we review it as the Commissioner’s final decision.
       Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). We review

       1 According to 42 U.S.C. § 405(g), “[a]ny individual, after any final decision of
       the Commissioner of Social Security made after a hearing to which he was a
       party, irrespective of the amount in controversy, may obtain a review of such
       decision by a civil action commenced within sixty days after the mailing to
       him of notice of such decision or within such further time as the Commis-
       sioner of Social Security may allow.”
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       22-11647                  Opinion of the Court                              3

       whether the Commissioner’s DIB decisions are supported by sub-
       stantial evidence and review de novo whether the correct legal
       standards were applied. See Moore v. Barnhart, 405 F.3d 1208, 1211
       (11th Cir. 2005). Substantial evidence is any relevant evidence,
       greater than a scintilla, that a reasonable person would accept as
       adequate to support a conclusion. Lewis v. Callahan, 125 F.3d 1436,
       1440 (11th Cir. 1997). “[T]he threshold for such evidentiary suffi-
       ciency is not high.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
               If, considering the record as a whole, substantial evidence
       supports the Commissioner’s decision, we will not disturb it.
       Lewis, 125 F.3d at 1439. Even if the evidence preponderates against
       the Commissioner’s decision, we must affirm if substantial evi-
       dence supports the disability determination. Dyer v. Barnhart, 395
       F.3d 1206, 1210 (11th Cir. 2005) (per curiam). Under this standard
       of review, we will not decide the facts anew, make credibility de-
       terminations, or reweigh the evidence. Winschel v. Comm’r of Soc.
       Sec., 631 F.3d 1176, 1178 (11th Cir. 2011).
               An individual claiming DIB bears the burden of proving that
       he is disabled, and, consequently, he is responsible for producing
       evidence in support of his claim. Ellison v. Barnhart, 355 F.3d 1272,
       1276 (11th Cir. 2003) (per curiam); 20 C.F.R. § 416.912(a). The ALJ
       uses a five-step, sequential evaluation process to determine
       whether a claimant is disabled. 2 Winschel, 631 F.3d at 1178. If an

       2This five-step, sequential evaluation requires the ALJ to determine “(1)
       whether the claimant is currently engaged in substantial gainful activity; (2)
       whether the claimant has a severe impairment or combination of impair-
       ments; (3) whether the impairment meets or equals the severity of the
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       4                        Opinion of the Court                     22-11647

       ALJ finds a claimant disabled or not disabled at any given step, the
       ALJ does not proceed to the next step. 20 C.F.R. § 404.1520(a)(4).
       At the fourth sequential step, the ALJ determines a claimant’s re-
       sidual function capacity (“RFC”) by considering his or her “ability
       to meet the physical, mental, sensory, and other requirements of
       work.” 20 C.F.R. § 404.1545(a)(4). The RFC is the most a claimant
       can do despite his restrictions. Id. § 404.1545(a)(1). The ALJ exam-
       ines all relevant medical and other evidence, including any state-
       ments about what the claimant can still do provided by medical
       sources and descriptions and observations by the claimant, her
       family, her neighbors, her friends, or others, of her limitations, in-
       cluding limitations resulting from pain. Id. § 404.1545(a)(3).
               For claims filed before March 27, 2017, the opinions of treat-
       ing physicians and non-treating physicians are treated differently.
       See Gibson v. Heckler, 779 F.2d 619, 623 (11th Cir. 1986) (citing Fruge
       v. Harris, 631 F.2d 1244, 1246 (5th Cir.1980)); see also 20 C.F.R.
       § 404.1520c(a) (forbidding ALJs from deferring or giving any spe-
       cific evidentiary weight to any medical opinions for claims filed on
       or after March 27, 2017). A non-treating physician’s opinion based
       on a single examination is “not entitled to great weight.” Crawford
       v. Comm’r of Soc. Sec., 363 F.3d 1155, 1160 (11th Cir. 2004) (per

       specified impairments in the Listing of Impairments; (4) based on a residual
       functional capacity (“RFC”) assessment, whether the claimant can perform
       any of his or her past relevant work despite the impairment; and (5) whether
       there are significant numbers of jobs in the national economy that the claim-
       ant can perform given the claimant's RFC, age, education, and work experi-
       ence.” Winschel, 631 F.3d at 1178.
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       22-11647                Opinion of the Court                          5

       curiam). However, a treating physician’s opinion “must be given
       substantial or considerable weight unless ‘good cause’ is shown to
       the contrary.” Lewis, 125 F.3d at 1440 (quoting MacGregor v. Bowen,
       786 F.2d 1050, 1053 (11th Cir. 1986)).
               In determining the weight to give a medical opinion, the ALJ
       considers several factors, including: (1) the examining relationship;
       (2) the treatment relationship, including the length and nature of
       the relationship; (3) the supportability of the opinion; and (4) the
       consistency of the opinion with other evidence. 20 C.F.R.
       § 404.1527(c)(1)–(4). Good cause for discounting the opinion of a
       treating physician exists when: (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 conclu-
       sory or inconsistent with her own medical records. Winschel, 631
       F.3d at 1179. When good cause exists, the ALJ may disregard a
       treating physician’s opinion but must clearly articulate the reasons
       for doing so. Id.
               In rejecting a treating physician’s opinion because it is incon-
       sistent with the source’s own medical records, an ALJ must identify
       a “genuine” inconsistency. Schink v. Comm’r of Soc. Sec., 935 F.3d
       1245, 1262 (11th Cir. 2019) (per curiam). A failure to do so is re-
       versible error. Lewis, 125 F.3d at 1440. In the context of mental
       and emotional disorders, we have explained that it is not enough
       for the ALJ to merely point to “positive or neutral observations that
       create, at most, a trivial and indirect tension with the treating phy-
       sician’s opinion by proving no more than that the claimant’s im-
       pairments are not all-encompassing.” Simon v. Comm’r, Soc. Sec.
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       6                       Opinion of the Court                  22-11647

       Admin., 7 F.4th 1094, 1107 (11th Cir. 2021) (quoting Lewis, 125 F.3d
       at 1440). We have also observed that when evaluating a claimant’s
       medical records, an ALJ must consider the fundamental differences
       between the relaxed, controlled setting of a medical clinic and the
       more stressful environment of a workplace. Id.
               The ALJ has a basic duty to develop a full and fair record.
       See 20 C.F.R. § 416.912(b); Graham v. Apfel, 129 F.3d 1420, 1422
       (11th Cir. 1997) (“Because a hearing before an ALJ is not an adver-
       sary proceeding, the ALJ has a basic obligation to develop a full and
       fair record.”). As such, when the evidence received from a medical
       source is inadequate to determine whether the claimant is disabled,
       the ALJ should take steps to resolve the inadequacy—including re-
       contacting the medical source, requesting additional evidence from
       the claimant, or asking the claimant to undergo a consultative ex-
       amination. 20 C.F.R. §§ 404.1520b(b)(2). However, an ALJ has no
       obligation to further develop the record when the available evi-
       dence is sufficient to make a disability determination. See Kelley v.
       Heckler, 761 F.2d 1538, 1540 (11th Cir. 1985) (per curiam) (explain-
       ing that a showing of prejudice, or a showing that the ALJ did not
       have all of the relevant evidence before him in the record or did
       not consider all of the evidence in the record, must be made before
       requiring remand); Wilson v. Apfel, 179 F.3d 1276, 1278 (11th Cir.
       1999) (per curiam) (holding that the record, “which included the
       opinions of several physicians . . . , was sufficient for a decision and
       additional expert testimony was unnecessary.”).
               In evaluating whether sufficient prejudice exists to warrant
       remand, we are guided by “whether the record reveals evidentiary
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       22-11647                 Opinion of the Court                             7

       gaps which result in unfairness or clear prejudice.” Brown v.
       Shalala, 44 F.3d 931, 935–36 (11th Cir. 1995) (per curiam) (deter-
       mining that prejudice existed where the ALJ failed to obtain rec-
       ords which were the subject of testimony, to acquire a report
       which he stated he would review, and to question an available wit-
       ness when the claimant herself was unable to explain how her dis-
       abilities prevented her from working).
               In this case, the ALJ’s decision to discount the opinions of
       Dr. Quinones, Dr. Welkovich, Dr. Raftery, and Dr. Yaratha was
       clearly articulated and supported by substantial evidence, and we
       affirm. We briefly address each opinion in turn, keeping in mind
       (1) that the ALJ only needed to find more “than a scintilla” of evi-
       dence to satisfy the substantial evidence standard; and (2) if the ALJ
       met that standard, we will not reweigh the evidence, engage in fact-
       finding, or make our own credibility determinations.
               As to Dr. Quinones’s opinion, substantial evidence supports
       the ALJ’s decision to discount the opinion because it was conclu-
       sory and contradicted by Dr. Quinones’s own treatment notes. 3
       Notably, the ALJ pointed to three main inconsistencies in Dr. Qui-
       nones’s opinion: (1) Dr. Quinones indicated that she saw Ellis
       every three months for three years, but the record indicated she
       had seen him more sporadically than that; (2) Dr. Quinones incor-
       rectly reported her own GAF scores for Ellis, as well as the GAF

       3 Because this was a sufficient basis for discounting the opinion, we do not
       reach the ALJ’s additional rationale for her decision—that Dr. Quinones’s
       opinion was inconsistent with other evidence in the record.
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       8                      Opinion of the Court                 22-11647

       scores of other providers; and (3) Dr. Quinones described Ellis as
       having side effects from Citalopram and Clonazepam such as seda-
       tion, nausea, and cognitive dulling, but Ellis only reported sedation
       as a side effect regarding those two drugs—he attributed the other
       side effects he reported (roughly a year later) to a new antidepres-
       sant medication, which Dr. Quinones stopped prescribing him.
       The ALJ also found that Dr. Quinones did not cite any clinical find-
       ings demonstrating the severity of symptoms, choosing instead to
       base her findings on Ellis’s uncorroborated reports. These discrep-
       ancies are enough to constitute “good cause” for discounting Dr.
       Quinones’s opinion.
               Similarly, as to Dr. Welkovich’s opinion, substantial evi-
       dence supports the ALJ’s decision to discount that opinion because
       her opinion was unsupported by her notes and objective clinical
       findings. Dr. Welkovich’s examinations never showed any of the
       deficits she noted in her statement and opinion about Ellis’s ability
       to work, nor did her exams support the extreme impairment she
       claimed Ellis had.
               Lastly, the ALJ did not err in discounting Dr. Raftery and Dr.
       Yaratha’s opinions as both were entitled to little weight as opinions
       from non-treating medical sources. Dr. Raftery had only seen Ellis
       once; Dr. Yaratha had never seen Ellis. Both opinions suffered
       from issues with supportability. Dr. Yaratha, specifically, failed to
       properly support her findings, despite explicit and repeated instruc-
       tions to do so.
               Ellis also argues that we must remand the case because the
       ALJ did not comply with its duty to develop a full or fair record,
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       22-11647              Opinion of the Court                       9

       and the ALJ should have recontacted Dr. Yaratha prior to denying
       his DIB request. But Ellis has not pointed to any gaps in the evi-
       dentiary record, and nothing suggests that the record, which in-
       cluded the opinions of several medical professionals, was insuffi-
       cient. See Apfel, 179 F.3d at 1278. Thus, the ALJ’s duty to develop
       a full and fair record did not compel her to recontact Dr. Yara-
       tha. Accordingly, we affirm.
              AFFIRMED