Court Opinion

ID: 9395526
Source: CourtListenerOpinion
Date Created: 2023-05-18 14:01:31.520777+00
Date Added: 2024-06-11T17:19:09.270618
License: Public Domain

USCA11 Case: 22-13952    Document: 21-1      Date Filed: 05/18/2023   Page: 1 of 11

                                                    [DO NOT PUBLISH]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

                           ____________________

                                 No. 22-13952
                           Non-Argument Calendar
                           ____________________

        GLORIA STURDIVANT,
                                                       Plaintiﬀ-Appellant,
        versus
        SOCIAL SECURITY ADMINISTRATION, COMMISSIONER,

                                                     Defendant-Appellee.

                           ____________________

                  Appeal from the United States District Court
                     for the Southern District of Alabama
                       D.C. Docket No. 2:21-cv-00017-N
                           ____________________
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        2                          Opinion of the Court                        22-13952

        Before WILSON, NEWSOM, and GRANT, Circuit Judges.
        PER CURIAM:
               Gloria Sturdivant appeals the district court’s order affirming
        the decision of the Social Security Administration (SSA) to deny her
        application for supplemental security income (SSI). After careful
        review of the record and the parties’ brief, we affirm.
                                                I.
               Sturdivant applied for SSI, alleging an onset date of Decem-
        ber 31, 2018 for the following disabilities: high blood pressure, dia-
        betes, carpal tunnel in the left hand, lower back problems, acid re-
        flux, and high cholesterol. Disability examiners denied Sturdivant’s
        application initially and on reconsideration. Sturdivant then re-
        quested and received a hearing before an Administrative Law
        Judge (ALJ), who found Sturdivant not disabled.
                The ALJ must follow five steps when evaluating a claim for
        disability. 1 20 C.F.R. § 416.920(a). First, if a claimant is engaged in
        substantial gainful activity, she is not disabled. Id. § 416.920(b).
        Second, if a claimant does not have an impairment or combination
        of impairments that significantly limits her physical or mental abil-
        ity to perform basic work activities, she does not have a severe im-
        pairment and is not disabled. Id. § 416.920(c); see also McDaniel v.
        Bowen, 800 F.2d 1026, 1031 (11th Cir. 1986) (explaining that Step

        1 If the ALJ determines that the claimant is or is not disabled at any step of the
        sequential analysis, the analysis ends. 20 C.F.R. § 416.920(a)(4).
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        22-13952                 Opinion of the Court                             3

        Two acts as a filter, allowing “only claims based on the most trivial
        impairments to be rejected”). Third, if a claimant’s impairments
        meet or equal an impairment listed in a provided appendix (the
        “Listings”), she is disabled. 20 C.F.R. § 416.920(d); 20 C.F.R. pt.
        404, subpt. P, app. 1. Fourth, if a claimant’s impairments do not
        meet or equal an impairment in the Listings, the ALJ must assess
        the claimant’s Residual Functional Capacity (RFC). 20 C.F.R. §
        416.920(e). 2 Fifth, using the claimant’s RFC, the ALJ will deter-
        mine whether the claimant can still perform past relevant work. If
        the claimant can do this type of work, she is not disabled. Id.
        § 416.920(f). Finally, if a claimant’s impairments (considering her
        RFC, age, education, and past work) do not prevent her from per-
        forming other work that exists in the national economy, she is not
        disabled. Id. § 416.920(g).
               Considering Step One, the ALJ here determined Sturdivant
        had not engaged in substantial gainful activity since her alleged on-
        set date. The ALJ found Sturdivant possesses the following severe
        impairments: degenerative disc disease of the lumbar spine,
        chronic pain syndrome, diabetes mellitus, and obesity. 3 But the
        ALJ found Sturdivant’s impairments or combination of impair-
        ments fail to meet or medically equal the severity of an impairment

        2 A claimant’s RFC is the level of physical and mental work she can consist-
        ently perform despite her limitations. Id. § 416.945(a).
        3 The ALJ also found that Sturdivant had the following non-severe impair-
        ments: essential hypertension, hyperlipidemia, carpal tunnel syndrome, ulcer
        disease, reflux, allergic rhinitis, dysthymia, and anxiety.
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        4                        Opinion of the Court                     22-13952

        in the Listings. The ALJ then found Sturdivant has an RFC to per-
        form medium work4 with the following caveats: Sturdivant can
        frequently balance, stoop, kneel, crouch, crawl, and climb ramps
        and stairs, but she can never climb ladders, ropes, or scaffolds and
        must avoid all exposure to hazards.
               Based on these findings, the ALJ determined Sturdivant can
        perform her past relevant work as companion. The ALJ also deter-
        mined Sturdivant can perform other jobs existing in significant
        numbers in the national economy, specifically jobs for hand pack-
        ers; sorters/samplers/weighers; and hand packers/packagers. As
        a result, the ALJ found Sturdivant not disabled.
               Sturdivant then requested the Appeals Council review the
        ALJ’s decision. The Appeals Council denied Sturdivant’s request
        for review, making the ALJ’s decision the final decision of the Com-
        missioner. Sturdivant appealed to the district court, which af-
        firmed the ALJ’s denial of Sturdivant’s SSI. Sturdivant timely ap-
        pealed.
                                             II.
               When “an ALJ denies beneﬁts and the Appeals Council de-
        nies review, we review the ALJ’s decision as the Commissioner’s
        ﬁnal decision.” Viverette v. Comm’r of Soc. Sec., 13 F.4th 1309, 1313–

        4 “Medium work involves lifting no more than 50 pounds at a time with fre-
        quent lifting or carrying of objects weighing up to 25 pounds. If someone can
        do medium work, [the SSA can] determine that he or she can also do sedentary
        and light work.” 20 C.F.R. § 416.967(c).
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        22-13952               Opinion of the Court                         5

        14 (11th Cir. 2021) (alteration adopted) (internal quotation marks
        omitted). We review a social security disability case to determine
        whether the Commissioner’s decision is supported by substantial
        evidence and review de novo whether the ALJ applied the correct
        legal standards. Id. “Our review is ‘the same as that of the district
        court,’ meaning we neither defer to nor consider errors in the dis-
        trict court’s opinion.” Henry v. Comm’r of Soc. Sec., 802 F.3d 1264,
        1267 (11th Cir. 2015) (per curiam) (quoting Doughty v. Apfel, 245 F.3d
        1274, 1278 (11th Cir. 2001)).
               Substantial evidence is relevant evidence, less than a prepon-
        derance but greater than a scintilla, that “a reasonable person
        would accept as adequate to support a conclusion.” Viverette, 13
        F.4th at 1314. In reviewing for substantial evidence, we “may not
        decide the facts anew, reweigh the evidence, or substitute our judg-
        ment for that of the ALJ.” Id. (alteration adopted). But a decision
        is not based on substantial evidence if it focuses on one aspect of
        the evidence while disregarding contrary evidence. McCruter v.
        Bowen, 791 F.2d 1544, 1548 (11th Cir. 1986). The ALJ need not refer
        to every piece of evidence in his decision, so long as a reviewing
        court can conclude that the ALJ considered the claimant’s medical
        condition as a whole. Mitchell v. Comm’r, Soc. Sec. Admin., 771 F.3d
        780, 782 (11th Cir. 2014). We will not aﬃrm merely because some
        rationale might support the ALJ’s conclusion if he “fails to state
        with at least some measure of clarity the grounds for his decision.”
        Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1179 (11th Cir. 2011)
        (internal quotation marks omitted).
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        6                         Opinion of the Court                       22-13952

                                              III.
               Sturdivant pushes back against two ALJ conclusions. First,
        the ALJ found unpersuasive the opinion of Sturdivant’s treating
        doctor that Sturdivant had severe physical limitations, which lim-
        ited her ability to work. Sturdivant argues that this ﬁnding violated
        SSA regulations and was unsupported by substantial evidence. Sec-
        ond, the ALJ found that Sturdivant’s RFC enabled her to perform
        medium work with certain limitations. Sturdivant contends that
        this ﬁnding was similarly unsupported by substantial evidence. We
        will address each argument in turn.
                                              A.
                Sturdivant contends the ALJ erred in two ways when as-
        sessing her treating doctor’s, Dr. Glenton Davis’s, opinion.5 First,
        the ALJ erred by not articulating good cause for his evaluation of
        Dr. Davis’s opinion. Second, the ALJ erred in ﬁnding that Dr. Da-
        vis’s opinion was unpersuasive, notably by misrepresenting the rec-
        ord to ﬁnd the opinion inconsistent and unsupported by the medi-
        cal evidence.
              First, Sturdivant misunderstands how the ALJ must now
        evaluate medical opinions. Because Sturdivant ﬁled her SSI

        5 To determine whether a claimant is disabled, the ALJ considers medical
        opinions from acceptable medical sources, including physicians. 20 C.F.R.
        §§ 416.902(a)(1), 416.913(a)(2). “A medical opinion is a statement from a med-
        ical source about what [a claimant] can still do despite [her] impairment(s) and
        whether [she has] one or more impairment-related limitations or restrictions.”
        Id. § 416.913(a)(2).
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        22-13952               Opinion of the Court                        7

        application on June 18, 2019, the ALJ had to assess Dr. Davis’s opin-
        ion under new regulations, diﬀerent from what Sturdivant appar-
        ently contemplates. For claims ﬁled on or after March 27, 2017, the
        ALJ “will not defer or give any speciﬁc evidentiary weight, includ-
        ing controlling weight, to any medical opinion(s) or prior adminis-
        trative medical ﬁnding(s).” 20 C.F.R. § 416.920c(a). This regulation
        abrogated our earlier precedents applying the treating-physician
        rule, which required good cause to discount a treating physician’s
        opinion. Harner v. Soc. Sec. Admin., Comm’r, 38 F.4th 892, 896 (11th
        Cir. 2022); 20 C.F.R. § 416.927. Thus, the ALJ was not required to
        provide good cause for discounting Dr. Davis’s opinion.
               Rather, under the new regulations, the ALJ must determine
        the persuasiveness of medical opinions and prior administrative
        medical findings by considering supportability, consistency, treat-
        ment relationship, specialization, and other factors. 20 C.F.R.
        § 416.920c(c)(1)–(5). Supportability and consistency are the most
        important factors. Id. § 416.920c(b)(2). The ALJ is required to ar-
        ticulate how it considered the supportability and consistency fac-
        tors, 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 consistent a medical
        opinion is with evidence from other sources, the more persuasive
        the opinion is. Id. § 416.920c(c)(2).
               Here, the ALJ followed the new regulations and explained
        that he found that Dr. Davis’s opinion was both unsupported and
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        8                        Opinion of the Court                    22-13952

        inconsistent with the record. Sturdivant argues that the ALJ’s de-
        termination is not supported by substantial evidence. We disagree.
        Dr. Davis’s opinion was a pre-printed form on which Dr. Davis
        checked certain boxes and circled answers. Despite indicating that
        Sturdivant had significant physical limitations, Dr. Davis did not
        provide any medical basis for that opinion, nor did he reference any
        clinical observations or testing.
                Dr. Davis’s own treatment notes do not reﬂect those serious
        physical limitations. Rather, those treatment notes often found
        Sturdivant’s extremities to be stable. While Dr. Davis discussed
        Sturdivant’s diabetes within his treatment notes, Dr. Davis did not
        indicate that Sturdivant’s diabetes caused signiﬁcant physical limi-
        tations. Dr. Davis’s opinion ﬁnds no support in other treatment
        notes, including Sturdivant’s endocrinologist. Notes from her en-
        docrinologist support Sturdivant’s diabetes as a severe impairment
        but those notes do not show the signiﬁcant physical limitations
        noted in Dr. Davis’s opinion. Sturdivant’s physical exams with her
        endocrinologist reveal nothing out of the ordinary as to physical
        limitations. Sturdivant spills a lot of ink about her diabetes, and to
        be sure, the ﬁndings show that she had high glucose levels and gly-
        cated hemoglobin levels. But again, none of those ﬁndings trans-
        late to observations or testing to support a determination of signif-
        icant physical limitations. 6

        6Sturdivant argues that the ALJ improperly relied on only a subset of treat-
        ment notes to conclude that her diabetes had improved. True, those treat-
        ment notes do also show that Sturdivant’s glucose level increased, but they
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        22-13952                  Opinion of the Court                                9

               Dr. Davis’s status as a treating physician has no impact on
        his opinion’s persuasiveness under the new regulations. And sub-
        stantial evidence supported the ALJ’s finding that Dr. Davis’s opin-
        ion was unpersuasive, as his opinion was not accompanied by an
        explanation. And, aside from elevated glucose levels, neither Dr.
        Davis’s records nor other medical records showed Sturdivant had
        abnormal symptoms affecting her ability to work.
                                              B.
               Sturdivant argues that the ALJ’s RFC determination is not
        connected to the record and thus not supported by substantial evi-
        dence.
               A claimant’s RFC is the most she can still do despite her lim-
        itations and is based on all the relevant evidence in the case record,
        including her medical history, medical reports, medical source
        statements, and descriptions of limitations from the claimant and
        others. 20 C.F.R. § 416.945. The ALJ must consider all record evi-
        dence about all the claimant’s impairments, including those that
        are not severe. Id. § 416.945(a)(1)–(2). The ALJ must consider state-
        ments about what a claimant can do from medical sources and the
        claimant. Id. § 416.945(a)(3).

        also show that her glycated hemoglobin had decreased. And either way, Stur-
        divant fails to show how those findings about her diabetes impact her physical
        limitations. McCruter, 791 F.2d at 1547 (“[T]he ‘severity’ of a medically ascer-
        tained disability must be measured in terms of its effect upon ability to work,
        and not simply in terms of deviation from purely medical standards of bodily
        perfection or normality.”).
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        10                     Opinion of the Court                  22-13952

                Sturdivant’s argument on the RFC focuses again on Dr. Da-
        vis’s opinion. But as discussed above, the ALJ properly found that
        Dr. Davis’s opinion was unpersuasive because it was unsupported
        by and inconsistent with the record. After making that determina-
        tion, the ALJ considered Sturdivant’s medical evidence and testi-
        mony to determine her RFC. At the hearing, Sturdivant testified
        about her pain from her impairments and how that limited her abil-
        ity to work, but the ALJ found that Sturdivant’s statements were
        not consistent with the medical evidence. For instance, despite tes-
        tifying about her back pain, the medical records showed that Stur-
        divant treated that particular issue with medication and there were
        no significant symptoms. For example, a June 2020 treatment note
        showed normal alignment of the spin, no evidence of fracture, and
        only mild degenerative changes. The ALJ compared that testi-
        mony with Sturdivant’s Function Report where she detailed her
        abilities to cook, take care of others, do chores, and go out to stores
        and church.
               Sturdivant argues that the ALJ was required to link evidence
        to the RFC findings, but our case law only requires that the ALJ
        state with clarity his reasons for his decision. See Winschel, 631 F.3d
        at 1179. Here, the ALJ’s decision carefully addressed the medical
        evidence and explained how he came to the RFC, including finding
        a state medical consultant’s opinion with the same RFC to be sup-
        ported by the medical evidence.
              Substantial evidence supported the ALJ’s RFC finding that
        Sturdivant could do medium work because medical records
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        22-13952              Opinion of the Court                      11

        showed few symptoms, all of which were treated by medication;
        an ability to do many daily activities, and an opinion from a state
        medical consultant recommended that RFC finding. Accordingly,
        we affirm.
              AFFIRMED.