Court Opinion

ID: 9401930
Source: CourtListenerOpinion
Date Created: 2023-06-14 18:00:35.250409+00
Date Added: 2024-06-11T17:19:56.291753
License: Public Domain

Case: 22-20609        Document: 00516786292             Page: 1      Date Filed: 06/14/2023

             United States Court of Appeals
                  for the Fifth Circuit                                         United States Court of Appeals
                                                                                         Fifth Circuit

                                     ____________                                      FILED
                                                                                     June 14, 2023
                                      No. 22-20609                                   Lyle W. Cayce
                                     ____________                                         Clerk

   Linda Jeanette Wills,

                                                                    Plaintiff—Appellant,

                                            versus

   Kilolo Kijakazi, Acting Commissioner of Social Security,

                                               Defendant—Appellee.
                     ______________________________

                     Appeal from the United States District Court
                         for the Southern District of Texas
                               USDC No. 4:21-CV-1391
                     ______________________________

   Before Wiener, Southwick, and Duncan, Circuit Judges.
   Per Curiam: *
         The district court affirmed the Social Security Commissioner’s
   decision denying disability benefits to Linda Wills. Wills contends the
   Administrative Law Judge failed to develop the record in assessing her
   Residual Functional Capacity and, therefore, the denial of benefits is not
   supported by substantial evidence. We disagree. AFFIRMED.

         _____________________
         *
             This opinion is not designated for publication. See 5th Cir. R. 47.5.
Case: 22-20609      Document: 00516786292          Page: 2     Date Filed: 06/14/2023

                                    No. 22-20609

                FACTUAL AND PROCEDURAL BACKGROUND
          On December 28, 2018, Linda Jeanette Wills applied for Title II Social
   Security disability benefits. She alleged her disability began December 16,
   2017, due to physical impairments, vision problems, depression, asthma, and
   migraines.
          On initial review, a State Agency Medical Consultant (“SAMC”)
   determined on March 5, 2019, that Wills had no exertional limitations and
   was not disabled.      The SAMC nonetheless recommended she avoid
   concentrated exposure to extreme temperatures, wetness, humidity, and
   pulmonary irritants, and avoid all exposure to hazards.
          Wills asked for reconsideration. In a decision of May 28, 2019, a
   different SAMC assessed Wills as having limited left near and far acuity,
   limited depth perception, and limited field of vision.             The SAMC
   recommended she avoid concentrated exposure to hazards and working with
   moving objects, scaffolds, and heights. She was again, though, found not to
   be disabled.
          In the reconsideration decision, Wills was informed she could request
   a hearing before an Administrative Law Judge (“ALJ”). She made that
   request, and a telephonic hearing was conducted on August 13, 2020. Wills
   was represented by counsel.
          Wills and a vocational expert testified at the hearing. Wills stated that,
   prior to surgery in November 2019, she “was crawling around [her] house,
   [because she] couldn’t stand or walk.” Since the surgery, her condition had
   improved. Still, she had been experiencing pain and stiffness in her back and
   neck. Additionally, looking down caused headaches and numbness in her
   face and neck. All of this, she claimed, made walking and sitting painful. She
   explained that she could walk to her mailbox — though with pain — before
   having to rest, and that on her “good days” she could walk to the corner of

                                          2
Case: 22-20609         Document: 00516786292               Page: 3       Date Filed: 06/14/2023

                                           No. 22-20609

   her street. Moreover, she could sit for approximately 15 to 20 minutes before
   having to change positions, and she could stand for approximately 20
   minutes, provided she was able to move around. She further stated that she
   could not reach upward without becoming dizzy.
           The ALJ determined Wills had not engaged in substantial gainful
   activity since her alleged disability date and was significantly limited by her
   physical, but not her mental, impairments. Additionally, her impairments
   did not meet the severity of any of the enumerated conditions in the
   applicable regulation.         Further, the ALJ found that although Wills’s
   “impairments could reasonably be expected to cause the alleged symptoms,”
   she was not as limited as she claimed.
           The ALJ determined Wills had the Residual Functional Capacity
   (“RFC”) to perform “sedentary work with an option to alternate sitting and
   standing.” 1 In addition, the ALJ provided that Wills’s ability to work would
   be further restricted by a host of physical limitations due to her cervical
   degenerative disc disease, vertigo, arthritis, impaired vision, and asthma.
           The ALJ also found, based on the vocational expert’s testimony, that
   even though Wills’s RFC made her unable to perform any past relevant work,
   she had acquired skills from her work experience which were transferable to
   other occupations existing in significant numbers without vocational
   adjustment. Therefore, the ALJ concluded she was not disabled during the
   alleged disability period and denied her application.

           _____________________
           1
             “Sedentary work involves lifting no more than 10 pounds at a time and
   occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although
   a sedentary job is defined as one which involves sitting, a certain amount of walking and
   standing is often necessary in carrying out job duties.” 20 C.F.R. § 404.1567(a).

                                                 3
Case: 22-20609     Document: 00516786292          Page: 4   Date Filed: 06/14/2023

                                   No. 22-20609

          The Appeals Council denied Wills’s request for review, making the
   ALJ’s opinion the Commissioner’s final decision. See Sims v. Apfel, 530 U.S.
   103, 106–07 (2000).
         Wills petitioned for review in district court as permitted by 42 U.S.C.
   § 405(g). The parties consented to proceed before a magistrate judge.
   Summary judgment was granted in favor of the Commissioner, and Wills
   timely appealed.
                                  DISCUSSION
         Our review “is exceedingly deferential and limited to two inquiries:
   whether substantial evidence supports the ALJ’s decision, and whether the
   ALJ applied the proper legal standards when evaluating the evidence.”
   Taylor v. Astrue, 706 F.3d 600, 602 (5th Cir. 2012). “Substantial evidence is
   such relevant evidence as a reasonable mind might accept as adequate to
   support a conclusion.” Perez v. Barnhart, 415 F.3d 457, 461 (5th Cir. 2005)
   (quotation marks and citation omitted).        “A finding of no substantial
   evidence is appropriate only if no credible evidentiary choices or medical
   findings support the decision.” Whitehead v. Colvin, 820 F.3d 776, 779 (5th
   Cir. 2016) (emphasis added) (quotation marks and citation omitted). We
   must “not reweigh the evidence or substitute [our] judgment for the
   Commissioner’s.” Perez, 415 F.3d at 461.
         In making a disability determination, the Commissioner follows a five-
   step approach and considers:
         (1) whether the claimant is engaged in substantial gainful
         activity, (2) the severity and duration of the claimant’s
         impairments, (3) whether the claimant’s impairment meets or
         equals one of the listings in the relevant regulations, (4)
         whether the claimant can still do his past relevant work, and (5)
         whether the impairment prevents the claimant from doing any
         relevant work.

                                        4
Case: 22-20609       Document: 00516786292          Page: 5   Date Filed: 06/14/2023

                                     No. 22-20609

   Webster v. Kijakazi, 19 F.4th 715, 718 (5th Cir. 2021) (quotation marks and
   citation omitted).
          A claimant’s RFC represents the most the claimant can do in a work
   setting with her limitations. 20 C.F.R. § 404.1545(a)(1). The RFC is used at
   steps four and five to determine if she can still perform her past relevant work
   or adjust to other work. Perez, 415 F.3d at 461–62 (citing 20 C.F.R. §
   404.1520(e)).
          Wills argues here, first, that the ALJ failed to develop the record
   adequately before making her RFC determination. That led, second, to the
   ALJ’s impermissibly drawing conclusions from raw medical data based only
   on her lay interpretation.      Finally, those shortcomings mean the RFC
   determination is not supported by substantial evidence. We will separately
   consider each of those arguments.
          I.       Development of the record
          Wills argues the ALJ failed to develop the record, which led to
   applying the incorrect legal standard, for two reasons: (1) the ALJ relied on
   stale medical opinions, and (2) the ALJ should have obtained a consultative
   examination regarding Wills’s ability to work in her deteriorated condition.
          Wills contends the two SAMC opinions were “stale” because they
   were rendered before her lumbar/cervical condition deteriorated and
   additional procedures were performed, particularly her November 2019
   surgery. Wills avers that, by relying on unusable medical opinions, the ALJ
   effectively did not rely on any medical opinion.
          First, the record does not support that the ALJ even relied on the
   SAMC opinions.         The ALJ stated she had “considered both prior
   administrative medical findings; however, both [were] inconsistent with the
   overall record and fail[ed] to consider all impairments.” Wills maintains that

                                           5
Case: 22-20609       Document: 00516786292           Page: 6    Date Filed: 06/14/2023

                                      No. 22-20609

   the ALJ must have implicitly relied on those administrative findings, at least
   in part, because her ordered limitations incorporate aspects of those findings.
   That is unconvincing speculation, however, in light of the ALJ’s directly
   indicating the contrary. The ordered limitations share some similarities with
   the SAMC opinions, but that does not invalidate them.
            Second, even if the ALJ did partially rely on the SAMC reports, and
   even if those findings were stale, Wills fails to show this would constitute
   error.    That is particularly so here where the ALJ acknowledged the
   shortcomings of the reports and proceeded to incorporate additional
   symptoms in imposing her more restrictive limitations — that is, more
   favorable to Wills — than those previously suggested. Rather, the applicable
   regulations support that the ALJ was entitled to find the administrative
   findings partially persuasive and then use those findings, together with other
   relevant record evidence, in making her RFC determination. See 20 C.F.R.
   § 404.1520c (providing Commissioner will determine “how persuasive” it
   finds medical opinions and prior administrative medical findings); id. §
   404.1545(a)(3) (“We will assess your [RFC] based on all of the relevant
   medical and other evidence.” (emphasis added)).
            Wills additionally argues the ALJ at least should have obtained a
   consultative examination to account for her deteriorated condition. Wills, in
   her opening brief, appears to interpret a series of district court decisions —
   not holdings from this court — as stating a per se rule that the ALJ fails to
   develop the record if: (a) the only medical opinion speaking to the effect of a
   claimant’s impairments on her ability to work is provided prior to a
   significant development in the claimant’s condition; and (b) the ALJ does not
   order a consultative examination to consider that development. We interpret
   her reply brief as arguing a lesser point that, in this case, an additional medical
   opinion was needed.

                                           6
Case: 22-20609      Document: 00516786292          Page: 7    Date Filed: 06/14/2023

                                    No. 22-20609

          We conclude that any per se rule is inappropriate and instead rely on
   the duty of an ALJ “to develop the facts fully and fairly relating to an
   applicant’s claim for disability benefits.” See Boyd v. Apfel, 239 F.3d 698, 708
   (5th Cir. 2001) (quotation marks and citations omitted). “A consultative
   examination is required to develop a full and fair record only if the record
   establishes that such an examination is necessary to enable the ALJ to make
   the disability decision.” Webster, 19 F.4th at 720 (alteration omitted)
   (quotation marks and citations omitted). Indeed, even where the record lacks
   any medical opinions “describing the types of work that the applicant is still
   capable of performing,” “[t]he absence of such a statement . . . does not, in
   itself, make the record incomplete.” Ripley v. Chater, 67 F.3d 552, 557 (5th
   Cir. 1995). Instead, these types of medical opinions are just one of several
   categories of evidence the ALJ considers in making RFC determinations. See
   20 C.F.R. § 404.1513. In fact, “where no medical statement has been
   provided, our inquiry focuses upon whether the decision of the ALJ is
   supported by substantial evidence in the existing record.” Ripley, 67 F.3d at
   557.
          Here, the “record was replete with medical documents that spanned
   years.” See Hardman v. Colvin, 820 F.3d 142, 148 (5th Cir. 2016). There
   were over 1,000 pages of Wills’s medical records which included extensive
   progress notes — prepared by health care professionals directly caring for
   Wills — regarding her impairments, treatment, progress, mobility, and
   symptoms.     Many of those records corresponded to examinations and
   procedures occurring subsequent to the medical consultants’ evaluations.
   An important record was of a November 2019 discectomy and fusion.
          Further, the ALJ heard testimony from Wills regarding her ability to
   conduct daily tasks and from a vocational expert regarding jobs available for
   someone with the RFC being considered.              Although a consultative
   examination may have been helpful, the record does not support that more

                                          7
Case: 22-20609      Document: 00516786292          Page: 8   Date Filed: 06/14/2023

                                    No. 22-20609

   information was necessary in order for the ALJ to make the decision about
   disability. See Webster, 19 F.4th at 720.
          We find no error in the development of the record.
          II.    The ALJ did not draw medical conclusions
          Next, Wills maintains that the allegedly undeveloped record led the
   ALJ to engage in impermissible fact-finding by drawing medical conclusions
   from raw medical data based only on her lay interpretation. In other words,
   Wills claims, the ALJ was “playing doctor.” See Frank v. Barnhart, 326 F.3d
   618, 621–22 (5th Cir. 2003). In doing so, Wills relies heavily on imaging
   conducted on her neck and back relating to her November 2019 operation,
   arguing that the ALJ lacked the medical expertise required to interpret that
   data. Our review reveals the ALJ did not merely observe tests conducted on
   Wills and opine on what conditions they presented and their effects. Rather,
   the ALJ examined Wills’s extensive medical history documenting such
   matters as test results, physicians’ interpretations of those tests, diagnoses,
   treatments and procedures, and information regarding her recovery from
   those procedures. Most important was the documentation related to Wills’s
   mobility and reported pain following her November 2019 surgery.
          An ALJ is to assess RFC “based on all the relevant evidence in [the]
   case record.” 20 C.F.R. § 404.1545(a)(1). The record convinces us that the
   ALJ did not improperly draw medical opinions from raw data but properly
   examined the extensive medical documentation.
          III.   The RFC determination is supported by substantial evidence
          Finally, we examine whether the RFC determination is supported by
   substantial evidence.    Once more, the record is “replete with medical
   documents” describing Wills’s conditions, treatment, and recovery. See
   Hardman, 820 F.3d at 148. The ALJ heard Wills’s testimony regarding her

                                          8
Case: 22-20609      Document: 00516786292          Page: 9   Date Filed: 06/14/2023

                                    No. 22-20609

   mobility and symptoms, assessed her credibility against that objective
   medical evidence, and determined her symptoms were legitimate, but not as
   serious as she claimed. “Conflicts in the evidence are for the Commissioner
   and not the courts to resolve.” Newton v. Apfel, 209 F.3d 448, 452 (5th Cir.
   2000) (alterations omitted) (quotation marks and citations omitted). The
   ALJ then correctly stated that the SAMC opinions failed to account for all of
   Wills’s impairments. The ALJ then examined the relevant testimony and
   medical records and gave a sufficient explanation of her analysis.
   “Furthermore, the ALJ appropriately used the RFC when questioning the
   vocational expert, and [claimant’s] counsel had the opportunity to correct
   deficiencies in the ALJ’s question[s] by mentioning or suggesting to the
   vocational expert any purported defects in the hypothetical questions.” See
   Webster, 719 F.4th at 719 (quotation marks and citation omitted).
          We have already acknowledged that a consultative examination
   regarding Wills’s ability to work in her current state might have been helpful,
   but “we cannot say that ‘no credible evidentiary choices or medical findings
   support the [ALJ’s] decision.’” Whitehead, 820 F.3d at 781 (quoting Boyd,
   239 F.3d at 704).
          The decision is supported by substantial evidence.
          AFFIRMED.

                                         9