Court Opinion

ID: 9953978
Source: CourtListenerOpinion
Date Created: 2024-03-25 14:00:43.404071+00
Date Added: 2024-06-11T08:12:57.696507
License: Public Domain

USCA11 Case: 23-11883    Document: 25-1      Date Filed: 03/25/2024   Page: 1 of 11

                                                   [DO NOT PUBLISH]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

                           ____________________

                                 No. 23-11883
                           Non-Argument Calendar
                           ____________________

        CARA LECROY,
                                                       Plaintiﬀ-Appellant,
        versus
        COMMISSIONER OF SOCIAL SECURITY,

                                                     Defendant-Appellee.

                           ____________________

                  Appeal from the United States District Court
                      for the Middle District of Georgia
                   D.C. Docket No. 3:22-cv-00059-TES-MSH
                           ____________________
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        2                      Opinion of the Court                23-11883

        Before LAGOA, BRASHER, and ABUDU, Circuit Judges.
        PER CURIAM:
               Cara LeCroy challenges the Commissioner of the Social Se-
        curity Administration’s (“Commissioner”) denial of her application
        for disability insurance benefits (“DIB”) and supplemental security
        income (“SSI”). LeCroy argues that the administrative law judge
        (“ALJ”) erroneously assessed the medical opinions in the record.
        Specifically, LeCroy says the ALJ erred in finding that the opinions
        from LeCroy’s treating sources were unpersuasive and the opin-
        ions from a consultative examiner and reviewer were persuasive.
        She also argues that the ALJ erroneously failed to consider her post-
        traumatic stress disorder (“PTSD”), social phobia, and panic disor-
        der; her and her friend’s subjective reports about her mental health;
        and her absenteeism due to receiving mental health treatment. For
        the reasons discussed below, we affirm.
                                          I.
               When the ALJ denies beneﬁts and the Appeals Council de-
        nies review, we review the ALJ’s decision as the ﬁnal administrative
        decision. Viverette v. Comm’r of Soc. Sec., 13 F.4th 1309, 1313 (11th
        Cir. 2021). Our “review of the Commissioner’s decision is limited
        to an inquiry into whether there is substantial evidence to support
        the ﬁndings of the Commissioner, and whether the correct legal
        standards were applied.” Wilson v. Barnhart, 284 F.3d 1219, 1221
        (11th Cir. 2002); see 42 U.S.C. §§ 405(g), 1383(c)(3). Whether the
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        23-11883               Opinion of the Court                          3

        ALJ applied the proper legal standards is reviewed de novo. Wash-
        ington v. Comm’r of Soc. Sec., 906 F.3d 1353, 1358 (11th Cir. 2018).
               Substantial evidence means “more than a scintilla and is such
        relevant evidence as a reasonable person would accept as adequate
        to support a conclusion.” Crawford v. Comm’r of Soc. Sec., 363 F.3d
        1155, 1158 (11th Cir. 2004) (quotation marks omitted). The sub-
        stantial-evidence threshold “is not high.” Biestek v. Berryhill, 139 S.
        Ct. 1148, 1154 (2019). Under this deferential standard, we do not
        “decide the facts anew, reweigh the evidence, or substitute our
        judgment for that of the Commissioner.” Mitchell v. Comm’r, Soc.
        Sec. Admin., 771 F.3d 780, 782 (11th Cir. 2014) (quotation marks
        omitted). To determine whether a decision was supported by sub-
        stantial evidence, the reviewing court must look at the record as a
        whole, considering evidence that is favorable as well as unfavorable
        to the decision. Foote v. Chater, 67 F.3d 1553, 1560 (11th Cir. 1995).
        Indeed, even if a preponderance of the evidence weighs against the
        Commissioner’s decision, we will aﬃrm so long as substantial evi-
        dence supports it. Buckwalter v. Acting Comm’r of Soc. Sec., 5 F.4th
        1315, 1320 (11th Cir. 2021). But we will not “aﬃrm simply because
        some rationale might have supported the ALJ’s conclusion.” Id.
        (quotation marks omitted).
               To determine whether a claimant is disabled, the ALJ con-
        siders, among other evidence, medical opinions, which are “state-
        ment[s] from a medical source about what [the claimant] can still
        do despite [her] impairment(s),” and prior administrative medical
        ﬁndings, which are “ﬁnding[s], other than the ultimate
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        4                          Opinion of the Court                        23-11883

        determination about whether [the claimant is] disabled, about a
        medical issue made by [the SSA’s] Federal and State agency medical
        and psychological consultants at a prior level of review.” 20 C.F.R.
        § 416.913(a)(2), (5). 1 For claims ﬁled on or after March 27, 2017, the
        ALJ will not defer or give any speciﬁc evidentiary weight to any
        medical opinion or prior administrative ﬁnding. Id. § 416.920c(a).
        Instead, the ALJ must determine the persuasiveness of medical
        opinions and prior administrative medical ﬁndings by considering
        ﬁve factors: (1) supportability; (2) consistency; (3) the provider’s
        “[r]elationship with the claimant”; (4) specialization; and (5) “other
        factors” including, but not limited to, the provider’s familiarity with
        other evidence in the claim and the provider’s understanding of
        SSA program policies. Id. § 416.920c(c)(1)-(5). Supportability and
        consistency are the “most important” factors. Id. § 416.920c(b)(2).
        The ALJ is required to articulate how it considered the supportabil-
        ity and consistency factors, but not the remaining factors. Id. As
        to supportability, the more relevant the objective medical evidence
        and explanations are to the medical opinions, the more persuasive
        the opinion is. Id. § 416.920c(c)(1). As to consistency, the more

        1 Separate regulations govern eligibility for DIB and SSI. Compare 20 C.F.R. pt.

        404 (DIB), with 20 C.F.R. pt. 416 (SSI). However, “[t]he regulations for both
        programs are essentially the same.” Bowen v. City of New York, 476 U.S. 467,
        470 (1986); see, e.g., 20 C.F.R. §§ 404.1520, 416.920 (setting out identical five-
        step sequential evaluation processes for evaluation of disability of adults); 20
        C.F.R. §§ 404.1520c, 416.920c (setting out identical regulations for how the
        SSA considers medical opinions).
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        23-11883              Opinion of the Court                        5

        consistent a medical opinion is with evidence from other sources,
        the more persuasive the opinion is. Id. § 416.920c(c)(2).
               Here, the ALJ properly considered the medical opinions of
        the treating and non-treating sources. The ALJ complied with the
        applicable regulation by articulating how he considered the sup-
        portability and consistency of the medical opinions and prior ad-
        ministrative medical findings, and substantial evidence supports
        the ALJ’s weighing of their relative persuasiveness.
                In particular, the ALJ considered the opinions of LeCroy’s
        treating therapist, Janet Beasley, LPC, and concluded that Beasley’s
        opinions were not persuasive because they were inconsistent with
        each other, her treatment notes, and the consultative examination
        findings. Beasley opined that LeCroy has abnormal recent and re-
        mote memory; abnormal insight, judgment, and impulse control;
        and abnormal ability to understand, remember, and carry out sim-
        ple instructions. The ALJ rejected these contentions because they
        were not consistent with Beasley’s treatment notes, the consulta-
        tive examination findings, or Beasley’s later opinion. Beasley’s
        treatment notes reported that LeCroy appeared neat, clean, and
        well-groomed at her appointments, and other record evidence
        showed that LeCroy’s memory and concentration abilities are in-
        tact and that she is able to comprehend and answer questions and
        follow instructions. The ALJ further found Beasley’s opinion un-
        persuasive because Beasley stated she was not aware of LeCroy’s
        ability to follow instructions or otherwise function in work situa-
        tions, and that LeCroy has only a ”fair” ability to maintain her
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        6                     Opinion of the Court                23-11883

        personal appearance and behave in an emotionally stable way—but
        other evidence showed that LeCroy’s memory and concentration
        abilities are intact and that she demonstrates appropriate mood and
        affect. These latter observations are inconsistent with Beasley’s
        opinion that LeCroy has only a fair ability to behave in an emotion-
        ally stable manner.
               Similarly, the ALJ considered opinions from LeCroy’s treat-
        ing mental health provider, Dr. Ann Kesser, and found her unper-
        suasive. Dr. Kesser opined that LeCroy has a fair-to-poor ability to
        function in work situations and only a fair ability to follow simple
        instructions, maintain personal appearance, and behave in an emo-
        tionally stable manner. The ALJ found these opinions unpersua-
        sive because LeCroy’s mental health treatment notes do not sup-
        port such limitations and, instead, indicate that LeCroy maintains
        a neat, clean, well-groomed appearance, and that her memory and
        concentration abilities are intact. The ALJ also noted that LeCroy’s
        mental health treatment appeared effective, since she had not re-
        quired mental health hospitalization “for many years.”
               On the other hand, the ALJ adequately explained why he
        found that Dr. John Grace, Dr. Robbie Ronin, and Dr. S. Kyle’s
        opinions were all more persuasive. Dr. Grace, an independent con-
        sultative examiner, opined that LeCroy understands basic rules of
        social convention, can take and follow instructions, can respond
        adaptively to appropriate workplace criticism, and can make sim-
        ple workplace decisions. He found LeCroy to be mildly impaired
        in her ability to concentrate and remain attentive throughout a
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        23-11883              Opinion of the Court                        7

        typical workday. The ALJ determined that these opinions were
        persuasive because they were consistent with the consultative ex-
        amination findings and LeCroy’s other records. Similarly, Dr. Ro-
        nin, a state agency psychologist, found that LeCroy has the ability
        to learn and remember locations and workplace procedures and to
        understand and remember detailed instructions. The ALJ was like-
        wise persuaded by Dr. Ronin’s opinions because LeCroy’s mental
        health treatment notes and the consultative examiner's opinions
        supported Ronin’s conclusions regarding LeCroy’s ability to per-
        form daily activities with no more than moderate limitations. And
        so too for Dr. Kyle’s opinions. Dr. Kyle, a state agency psycholo-
        gist, found that LeCroy could remember locations and workplace
        procedures, carry out simple instructions, and handle detailed,
        complex tasks. He further found that LeCroy would be able to ad-
        here to a schedule, maintain regular attendance, and sustain an or-
        dinary routine without special supervision and without becoming
        distracted by others around her. The ALJ found these opinions
        persuasive because Dr. Kyle’s conclusions were supported by, and
        consistent with, LeCroy’s mental health treatment notes, records
        regarding her ability to perform activities of daily living, and the
        opinions of the consultative examiner.
               Substantial evidence supports the ALJ’s finding that Dr.
        Kyle, Dr. Grace, and Dr. Ronin were persuasive, and that Beasley
        and Dr. Kesser were not. The former three opinions were con-
        sistent with each other, as they all agreed that LeCroy could per-
        form daily activities despite her limitations and these conclusions
        were supported by LeCroy’s medical records and the consultative
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        8                       Opinion of the Court                  23-11883

        examination. And, as the ALJ explained, the latter two opinions
        were not persuasive because Beasley’s opinions were inconsistent
        and neither Beasley’s nor Dr. Kesser’s opinions were supported by
        the records. We, therefore, reject LeCroy’s contention that the
        ALJ failed to properly assess the persuasiveness of her providers’
        medical opinions.
                                           II.
                An individual claiming Social Security disability beneﬁts
        must prove that she is disabled. Moore v. Barnhart, 405 F.3d 1208,
        1211 (11th Cir. 2005). The Social Security regulations establish a
        ﬁve-step sequential evaluation process to determine whether a
        claimant is disabled for both SSI and DIB claims. Id. First, if a
        claimant is working at a substantial gainful activity, she is not disa-
        bled. 20 C.F.R. § 416.920(a)(4)(i). Second, if a claimant has no im-
        pairment or combination of impairments that signiﬁcantly limit
        her physical or mental ability to do basic work activities, then she
        is not disabled. Id. § 416.920(a)(4)(ii). Third, if a claimant’s impair-
        ments meet or equal an impairment listed in the Listing of Impair-
        ments, she is disabled. Id. § 416.920(a)(4)(iii). Fourth, if a claim-
        ant’s impairments do not prevent her from doing past relevant
        work, she is not disabled. Id. § 416.920(a)(4)(iv). Fifth, if a claim-
        ant’s impairments—considering her residual functional capacity
        (“RFC”), age, education, and past work—prevent her from doing
        other work that exists in the national economy, then the claimant
        is disabled. Id. § 416.920(a)(4)(v).
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        23-11883               Opinion of the Court                         9

               Additionally, at step four, the ALJ must determine the claim-
        ant’s RFC, which is “an assessment, based upon all of the relevant
        evidence, of a claimant’s remaining ability to do work despite h[er]
        impairments.” Schink v. Comm’r of Soc. Sec., 935 F.3d 1245, 1268
        (11th Cir. 2019); 20 C.F.R. § 416.945(a)(1). In formulating the RFC,
        the ALJ must account for all relevant medical evidence and other
        evidence. Buckwalter, 5 F.4th at 1320; 20 C.F.R. § 416.945(a)(1). In
        an RFC ﬁnding, the ALJ “must state with particularity the weight
        given to diﬀerent medical opinions and the reasons therefor.” Buck-
        walter, 5 F.4th at 1320-21 (quotation marks omitted).
                A claimant’s subjective complaints are insuﬃcient to estab-
        lish a disability on their own. 20 C.F.R. § 416.929(a). Instead, ob-
        jective medical evidence must show that the claimant has a medical
        impairment “which could reasonably be expected to produce the
        pain or other symptoms alleged” and that, when considered with
        all of the other evidence, “including statements about the intensity
        and persistence of [the claimant’s] pain or other symptoms which
        may reasonably be accepted as consistent with the medical signs
        and laboratory ﬁndings,” would lead to a conclusion that the claim-
        ant is disabled. Id. Accordingly, “to establish a disability based on
        testimony of pain and other symptoms, the claimant must satisfy
        two parts of a three-part test showing: (1) evidence of an underly-
        ing medical condition; and (2) either (a) objective medical evidence
        conﬁrming the severity of the alleged pain; or (b) that the objec-
        tively determined medical condition can reasonably be expected to
        give rise to the claimed pain.” Wilson, 284 F.3d at 1225 (11th Cir.
        2002) (citing Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991)).
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        10                     Opinion of the Court                 23-11883

               The ALJ “has a basic obligation to develop a full and fair rec-
        ord. A full and fair record not only ensures that the ALJ has fulﬁlled
        his duty . . . to scrupulously and conscientiously probe into, inquire
        of, and explore for all the relevant facts, but it also enables us on
        appeal to determine whether the ultimate decision on the merits is
        rational and supported by substantial evidence.” Welch v. Bowen,
        854 F.2d 436, 440 (11th Cir. 1988) (internal quotation marks and ci-
        tations omitted). Even still, “there is no rigid requirement that the
        ALJ speciﬁcally refer to every piece of evidence in his decision, so
        long as the ALJ’s decision . . . is not a broad rejection which is not
        enough to enable [the reviewing court] to conclude that the ALJ
        considered her medical condition as a whole.” Dyer v. Barnhart, 395
        F.3d 1206, 1211 (11th Cir. 2005) (alteration adopted, quotation
        marks omitted).
               Here, the ALJ properly considered all of LeCroy’s mental
        health limitations, the subjective reports, and absenteeism. The
        ALJ applied the correct legal standards and substantial evidence
        supports the ALJ’s decision that LeCroy is able to work even with
        her mental health treatment and disorders. At step four, the ALJ
        considered all of LeCroy’s alleged impairments, including PTSD,
        social phobia, and panic disorder. When explaining the RFC find-
        ing, the ALJ described how LeCroy reported suffering from panic
        attacks and that she was bothered by leaving her home, spent most
        of her day in bed, stopped working due to overwhelming social
        anxiety and panic, and had symptoms that were exacerbated by
        grief and trauma. But, as the ALJ explained, substantial evidence—
        including Dr. Grace’s consultative examination, Dr. Ronin’s and
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        23-11883              Opinion of the Court                       11

        Dr. Kyle’s opinions based on record review, and Beasley’s and Dr.
        Kessen’s treatment notes—supported an RFC not further limited
        by LeCroy’s reported PTSD, social phobia, and panic disorder.
        The ALJ did not err in rejecting LeCroy’s subjective reports about
        her own mental health, nor her friend, Antman’s subjective re-
        ports. Those subjective statements were not consistent with the
        medical evidence in the record, as the ALJ explained in some detail.
        Indeed, as the ALJ said, the medical evidence supports a finding
        that LeCroy was cooperative, demonstrated a normal mood, ap-
        peared neat and clean, and was able to perform routine activities of
        daily life. And, while the ALJ acknowledged that LeCroy had been
        hospitalized for mental health concerns in the past, he noted that
        she had not been hospitalized in many years and thus would not
        need such lengthy treatment as to interfere with a work schedule.
               In sum, we conclude that more than a scintilla of evidence
        supports the ALJ’s decision that LeCroy was not under a disability
        that prevented her from performing any work. Crawford, 363 F.3d
        at 1158. Accordingly, we affirm.
              AFFIRMED.