Opinion
Case No. 1:20-cv-185-SMD
2021-07-15
Louise Delilla DYE, Plaintiff, v. Kilolo KIJAKAZI, Acting Commissioner of Social Security, Defendant.
Walter Allen Blakeney, Brock & Stout LLC, Enterprise, AL, for Plaintiff. James Joseph DuBois, U.S. Attorney's Office, Montgomery, AL, Rebecca Ringham, Office of the General Counsel, Region IV, Atlanta, GA, for Defendant.
Walter Allen Blakeney, Brock & Stout LLC, Enterprise, AL, for Plaintiff.
James Joseph DuBois, U.S. Attorney's Office, Montgomery, AL, Rebecca Ringham, Office of the General Counsel, Region IV, Atlanta, GA, for Defendant.
ORDER
Stephen M. Doyle, CHIEF U.S. MAGISTRATE JUDGE
Louise Delilla Dye ("Dye") appeals the denial of her application for Social Security benefits under 42 U.S.C. § 405(g). Compl. (Doc. 1) p. 1. Dye contends that the Commissioner's decision denying her application is not supported by substantial evidence. Id. For the following reasons, the Court reverses the decision below and remands this case to the Commissioner for further administrative proceedings consistent with this order.
Under 28 U.S.C. § 636(c), the parties have consented to the undersigned conducting all proceedings and entering final judgment in this case. Comm'r Consent (Doc. 8) p. 1; Dye Consent (Doc. 9) p. 1.
I. STATUTORY FRAMEWORK & STANDARD OF REVIEW
The Social Security Act provides the framework for determining who is eligible to receive Social Security benefits. Martin v. Sullivan , 894 F.2d 1520, 1530 (11th Cir. 1990). Under the Act, an administrative law judge ("ALJ") must evaluate an application for a period of disability and/or disability insurance benefits pursuant to a five-step inquiry:
(1) Is the person presently unemployed?
(2) Is the person's impairment severe?
(3) Does the person's impairment meet or medically equal one of the specific impairments set forth in 20 C.F.R. Pt. 404, Subpt. P, App. 1 ?
(4) Is the person unable to perform his or her former occupation?
(5) Is the person unable to perform any other work within the economy?
20 C.F.R. § 404.1520(a). An ALJ reaches step four only if a claimant is unemployed (step 1), has a severe impairment (step 2), and does not have an impairment that meets or medically equals an impairment listed in 20 C.F.R. Pt. 404, Subt. P, App. 1. McDaniel v. Bowen , 800 F.2d 1026, 1030 (11th Cir. 1986).
An ALJ applies the same inquiry when reviewing applications for supplemental security income under 20 C.F.R. § 416.920(a). Smith v. Comm'r of Soc. Sec. , 486 F. App'x 874, 875 n.* (11th Cir. 2012) (per curiam) ("The definition of disability and the test used to determine whether a person has a disability is the same for claims seeking disability insurance benefits or supplemental security income.").
A claimant bears the burden of proof through step four; the Commissioner bears the burden of proof at step five. See Wolfe v. Chater , 86 F.3d 1072, 1077 (11th Cir. 1996).
To evaluate whether a claimant is able to perform her former occupation (step 4) and, if not, able to perform other work within the economy (step 5), an ALJ must first determine the claimant's residual function capacity ("RFC"). Phillips v. Barnhart , 357 F.3d 1232, 1238 (11th Cir. 2004). A claimant's RFC is defined as that which the claimant can do despite her impairments considering the record as a whole. 20 C.F.R. § 404.1545(a). An ALJ must conclude that a claimant is disabled if she can perform neither her former occupation nor any other work within the economy. McDaniel , 800 F.2d at 1030.
By contrast, an ALJ must conclude that a claimant is not disabled if she can perform her former occupation or any other work within the economy. Id. A claimant may seek review of an ALJ's unfavorable decision before the Social Security Appeals Council. 20 C.F.R. § 416.1468. Should the Appeals Council deny a claimant's request for review, the ALJ's decision becomes a final administrative decision of the Commissioner. 20 C.F.R. § 416.1481. A claimant may then seek judicial review of the Commissioner's decision in federal court. 42 U.S.C. § 405(g).
A federal court, however, is limited in its review of a final decision by the Commissioner. MacGregor v. Bowen , 786 F.2d 1050, 1053 (11th Cir. 1986). A reviewing court will not disturb the Commissioner's factual findings if they are supported by substantial evidence. Cornelius v. Sullivan , 936 F.2d 1143, 1145 (11th Cir. 1991). Substantial evidence is more than a scintilla, but less than a preponderance; it is that which a reasonable person would accept as adequate to support a conclusion. Moore v. Barnhart , 405 F.3d 1208, 1211 (11th Cir. 2005) (per curiam); Crawford v. Comm'r Of Soc. Sec. , 363 F.3d 1155, 1158 (11th Cir. 2004) (per curiam). An ALJ's failure to provide a "reviewing court with sufficient reasoning for determining that the proper legal analysis has been conducted mandates reversal." Cornelius , 936 F.2d 1143, 1145–46.
II. FACTS & PROCEDURAL HISTORY
In July 2015, Dye applied for a period of disability, disability insurance benefits, and supplemental security income. Admin. Ct. Tr. at 256, 263. In August 2019, an ALJ entered an opinion evaluating Dye's case pursuant to the five-step inquiry outlined in the Social Security Act. Id. at 12–27. At steps 1 and 2 respectively, the ALJ found that Dye had been unemployed since her disability allegedly began and that she suffers from several severe impairments. Id. at 15. The ALJ then moved to step 3 and concluded that none of Dye's impairments meet or medically equal an impairment listed in 20 C.F.R. Pt. 404, Subpt. P, App. 1. Id. at 17.
"Admin. Ct. Tr. " consists of a consecutively paginated record of the administrative proceedings below and spans from ECF Doc. 15-1 to ECF Doc. 15-9. For clarity and consistency with the parties' briefs, the Court cites to the consecutive pagination instead of the ECF pagination.
Dye's disability allegedly began on September 30, 2014. Admin. Ct. Tr. at 12. The ALJ found that Dye suffers from the following severe impairments: fibromyalgia, bilateral carpal tunnel syndrome, vertigo, and a history of diverticulitis. Id. at 15.
Before proceeding to step 4, the ALJ determined that Dye has an RFC "to perform light work"—as defined in 20 C.F.R. §§ 404.1576(b), 416.967(b) —such that she "can lift and carry 10 pounds frequently and 20 pounds occasionally; sit for a total of 6 hours during an 8 hour workday; [and] stand and walk for a total of 6 hours during an 8 hour workday." Id. at 19. The ALJ also determined that Dye can frequently balance, stoop, kneel, crouch, crawl, reach, handle, finger, feel, and climb ramps and stairs. Id. Dye cannot, the ALJ further found, drive automotive equipment; work in extreme temperatures; work around unprotected heights or dangerous machinery; or climb ladders, ropes, or scaffolds. Id.
Under 20 C.F.R. §§ 404.1567(b), 416.967(b), light work is defined as "lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds." A job is considered "light work" if it requires "a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls." 20 C.F.R. §§ 404.1567(b), 416.967(b).
In determining Dye's RFC, the ALJ gave no weight to a medical evaluation completed by Dye's treating physician, Dr. Joseph Sewell, in August 2018. Id. at 25. In his evaluation, Dr. Sewell opined that Dye can occasionally push, pull, grasp, twist, and handle objects; bend and stoop; and operate motor vehicles. Id. at 587. Dr. Sewell also opined that Dye can sit for two hours and stand/walk for less than an hour in any given workday, but that she can never climb stairs or ladders or work around dangerous machinery. Id. He further noted that, due to her impairments, Dye would likely miss more than four workdays per month and would need bed rest and/or pain medication if she engaged in certain physical activities. Id. at 587–88.
The ALJ, however, discredited Dr. Sewell's evaluation in its entirety based solely on an emergency room report indicating that, in February 2016, Dye injured her back while helping "get a boat ‘unstuck.’ " Id. at 25. After discrediting Dr. Sewell's evaluation and determining Dye's RFC, the ALJ found that Dye can perform her former occupation as a cashier and, in the alternative, other work within the economy. Id. at 25–27. Accordingly, the ALJ concluded that Dye is not disabled for purposes of the Social Security Act. Id. at 27. Dye requested review of the ALJ's decision before the Social Security Appeals Council, but the Council denied her request. Id. at 1. In response, Dye filed the instant action under 42 U.S.C. § 405(g). Compl. (Doc. 1) p. 1.
III. DISCUSSION
Dye argues that the ALJ improperly discredited Dr. Sewell's medical evaluation. Dye Br. (Doc. 13) p. 6. An "ALJ must state with particularity the weight given to different medical opinions and the reasons therefor." Winschel v. Comm'r of Soc. Sec. , 631 F.3d 1176, 1179 (11th Cir. 2011). The Social Security Act defines "medical opinions" as "statements from acceptable medical sources that reflect judgments about the nature and severity of [a claimant's] impairment(s)," including the claimant's symptoms, the claimant's physical and mental restrictions, and what the claimant can do despite her impairment(s). 20 C.F.R. § 404.1527(a)(1).
Absent good cause to conclude otherwise, an ALJ must give considerable or substantial weight to a treating physician's medical opinion. Lewis v. Callahan , 125 F.3d 1436, 1440 (11th Cir. 1997). Good cause exists when: (1) a treating physician's opinion is conclusory or inconsistent with the physician's own medical records, (2) the treating physician's opinion is not supported by the evidence, or (3) the evidence supports a finding contrary to the treating physician's opinion. Phillips , 357 F.3d at 1241. An ALJ must clearly articulate a specific reason for discrediting a treating physician's medical opinion; otherwise, the ALJ commits reversable error. See, e.g., Lewis , 125 F.3d at 1440 ; MacGregor , 786 F.2d at 1053.
A treating physician is someone who provides (or has provided) a claimant with medical treatment and has (or has had) an ongoing treatment relationship with the claimant. 20 C.F.R. § 404.1527(a)(2).
For example, evidence of a claimant's daily activities constitutes good cause for discrediting a treating physician's medical opinion if the claimant's alleged activities contradict the physician's opinion. Compare Jarrett v. Comm'r of Soc. Sec. , 422 F. App'x 869, 873 (11th Cir. 2011) (per curiam) (holding that evidence that a claimant volunteered at a hospital for eight hours per week and performed household chores constitutes good cause for discrediting a treating physician's opinion that the claimant could not work on a sustained basis), with Schink v. Comm'r of Soc. Sec. , 935 F.3d 1245, 1264 (11th Cir. 2019) (per curiam) (holding that evidence that a claimant watched television, walked the dog, and cooked is insufficient to discredit a treating physician's opinion that the claimant suffered from mental health conditions that substantively impaired his ability to work).
In this case, the ALJ failed to articulate good cause for discrediting each of the medical opinions contained in Dr. Sewell's evaluation. The ALJ discredited Dr. Sewell's evaluation in its entirety on the grounds that it is inconsistent with the evidence that Dye helped get a boat unstuck. Admin. Ct. Tr. at 25. But many of the medical opinions contained in Dr. Sewell's evaluation appear consistent with that evidence. For instance, Dr. Sewell opined that Dye can occasionally push, pull, grasp, twist, and handle objects; bend and stoop; and operate motor vehicles. Id. at 587. He also noted that Dye would need bed rest and/or pain medication if she engaged in certain physical activities. Id. at 588. Indeed, the record shows that, after she allegedly helped get a boat unstuck, Dye "couldn't get out of [her] bed" and went to the emergency room to receive treatment. Id. at 500.
The record reflects that Dr. Sewell had an ongoing treatment relationship with Dye and provided her medical treatment on several occasions between 2015 and 2019. Admin. Ct. Tr. at 487–96, 586–88, 641–53, 721–90. Thus, the Court has no trouble concluding—and the parties do not dispute—that Dr. Sewell constitutes a "treating physician" under the Social Security Act. See supra note 8.
Additionally, some of Dr. Sewell's opinions do not appear relevant to whether Dye helped get a boat unstuck. Dr. Sewell, for example, opined that Dye can sit for two hours and stand/walk for less than an hour in any given workday and that she would likely miss more than four workdays per month due to her impairments. Id. at 587. Dr. Sewell further noted that Dye can never climb stairs or ladders, or work around dangerous machinery. Id. Evidence that Dye helped get a boat unstuck does not appear to undermine or discredit these medical opinions.
With that said, the Court is cognizant that some of Dr. Sewell's opinions appear inconsistent with the evidence that Dye helped get a boat unstuck. For instance, Dr. Sewell opined that Dye can occasionally lift five pounds and frequently lift one pound. Id. Evidence that Dye helped get a boat unstuck arguably undermines that opinion, but the ALJ failed to clearly articulate good cause for discrediting that opinion—or any other opinion contained in Dr. Sewell's medical evaluation.
As a result, the Court cannot determine whether the ALJ's decision to wholly discredit Dr. Sewell's evaluation is rational and supported by substantial evidence. See Cowart v. Schweiker , 662 F.2d 731, 735 (11th Cir. 1981) (explaining that "it is impossible for a reviewing court to determine whether [an ALJ's] ultimate decision ... is rational and supported by substantial evidence" if the ALJ fails to specifically explain why he discredited medical evidence). Because the ALJ failed to clearly articulate good cause for discrediting each of the medical opinions contained in Dr. Sewell's evaluation, the Court finds that the ALJ erred in discrediting the evaluation in its entirety.
Moreover, this error is not harmless because the ALJ's ultimate RFC determination included less restrictive limitations than those included in Dr. Sewell's evaluation. Cf. Wright v. Barnhart , 153 F. App'x 678, 684 (11th Cir. 2005) (per curiam) (explaining that an ALJ's failure to apply the correct legal standards is harmless error where the correct application does not "contradict the ALJ's ultimate findings").
IV. CONCLUSION
The Court therefore REVERSES the decision below and REMANDS this case to the Commissioner for further administrative proceedings consistent with this order. The Court will enter a final judgment separately.
DONE this 15th day of July, 2021.