USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 1 of 10
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 20-14237
Non-Argument Calendar
________________________
D.C. Docket No. 1:19-cv-24147-MGC
MAURA PROENZA,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Southern District of Florida
________________________
(July 21, 2021)
Before MARTIN, BRANCH, and BRASHER, Circuit Judges.
PER CURIAM:
Maura Proenza appeals the district court’s order affirming the
Commissioner’s denial of her application for a period of disability, disability
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 2 of 10
insurance benefits, and supplemental security income. First, she argues that the
administrative law judge failed to properly weigh the medical opinion evidence in
the record. Second, she argues that the ALJ’s assessment of her residual functional
capacity (“RFC”) is not supported by substantial evidence. Third, she argues that the
ALJ failed to properly assess her subjective complaints regarding her symptoms.
After careful review, we affirm.
I.
We review the ALJ’s application of legal principles de novo. Moore v.
Barnhart,
405 F.3d 1208, 1211 (11th Cir. 2005). We ask whether the ALJ’s resulting
decision “was supported by substantial evidence in the record.” Washington v.
Comm’r of Soc. Sec.,
906 F.3d 1353, 1358 (11th Cir. 2018). Substantial evidence is
any relevant evidence, greater than a scintilla, that a reasonable person would accept
as adequate to support a conclusion.
Id. Under this standard, we may affirm the
ALJ’s decision even if the evidence preponderates against it. Crawford v. Comm’r
of Soc. Sec.,
363 F.3d 1155, 1158–59 (11th Cir. 2004). We will not decide the facts
anew, make credibility determinations, or re-weigh the evidence. Winschel
v. Comm’r of Soc. Sec.,
631 F.3d 1176, 1178 (11th Cir. 2011).
The claimant bears the burden of proving that she is disabled. Moore,
405
F.3d at 1211. The ALJ follows a five-step analysis to determine whether a claimant
is disabled, asking: (1) whether she is engaged in substantial gainful activity; (2) if
2
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 3 of 10
not, whether she has a severe impairment or combination of impairments; (3) if so,
whether that impairment, or combination of impairments, meets or equals the listings
in the regulations; (4) if not, whether she can perform her past relevant work in light
of her RFC; and (5) if not, whether, based on her age, education, and work
experience, she can perform other work found in the national economy. 20 C.F.R.
§ 404.1520(a)(4); see also Winschel,
631 F.3d at 1178. “These regulations place a
very heavy burden on the claimant to demonstrate both a qualifying disability and
an inability to perform past relevant work.” Moore,
405 F.3d at 1211. The same
analysis is used to determine whether a claimant qualifies for a period of disability,
DIB, or SSI. Sullivan v. Zebley,
493 U.S. 521, 525 (1990).
II.
Proenza argues that the ALJ failed to properly assess the medical opinion
evidence in the record. Specifically, Proenza argues that the ALJ erred by: (1)
granting “little weight” to the opinion of Dr. Lermo, her treating physician; (2)
granting “some weight” to the opinion of Dr. Rocha, a consultative examiner; and
(3) by granting “significant weight” to the opinion of Dr. Giardina, a psychological
consultant. We disagree.
The ALJ must “state with particularity the weight given to different medical
opinions and the reasons therefor.” Winschel,
631 F.3d at 1179. The ALJ must give
a treating physician’s opinion substantial or considerable weight unless there is good
3
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 4 of 10
cause not to do so. Schink v. Comm’r of Soc. Sec.,
935 F.3d 1245, 1259 (11th Cir.
2019). Good cause exists when (1) the treating physician’s opinion was not bolstered
by the evidence, (2) the evidence supported a contrary finding, or (3) the opinion
was conclusory or inconsistent with the doctor’s own medical records.
Id. We will
not second guess the weight given a treating physician’s opinion so long as the ALJ
articulates a specific justification for it. Hunter v. Soc. Sec. Admin., Comm’r,
808
F.3d 818, 823 (11th Cir. 2015).
Here the ALJ identified good cause for giving Dr. Lermo’s opinion little
weight. To begin, the ALJ found that Dr. Lermo’s opinion was not bolstered by the
evidence. In her March 2018 assessment, Dr. Lermo checked boxes on the
assessment form rating Proenza’s ability to do work-related activities as “poor” or
“none” in every category. But she left blank all questions asking her to describe the
findings that supported her assessment of Proenza’s limitations. In her July 2018
assessment, Dr. Lermo again rated Proenza’s abilities as “poor” or “none” across-
the-board. But she left blank a question asking her to describe the findings
supporting her assessment of Proenza’s ability to make occupational adjustments.
Next, the ALJ found that Dr. Lermo’s opinion was internally inconsistent. In
her March 2018 assessment, Dr. Lermo stated that Proenza was capable of managing
her benefits in her own best interest, despite rating her ability to make work-related
adjustments “poor” or “none” in every category. Furthermore, Dr. Lermo changed
4
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 5 of 10
her opinion just a few months later, indicating in her July 2018 assessment that
Proenza could not manage her own benefits, though she did not explain why her
opinion had changed. Proenza herself had previously informed the agency that she
was able to pay bills, count change, and handle a savings account on her computer.
The ALJ also found that Dr. Lermo’s opinion was inconsistent with her own
medical records. Dr. Lermo conducted mental status examinations of Proenza over
a three-year period. After most examinations, Dr. Lermo filled out a mental status
report and assigned Proenza a global assessment of functioning score. When her
treatment period began in February 2015, Dr. Lermo assigned Proenza a GAF score
of 55, indicating an impairment of moderate severity. Dr. Lermo’s notes indicated
that Proenza had a clean appearance, was eager to find work, and was oriented to
person, place, and time. Her notes also indicated that Proenza responded well to
medication. The ALJ concluded that these findings were inconsistent with Dr.
Lermo’s assessment of Proenza’s ability to make work-related adjustments as “poor”
or “none” in every category.
Finally, the ALJ found that Dr. Lermo’s opinion was conclusory insofar as
she had opined that Proenza was unable to work. Whether a claimant meets the
statutory definition of disabled is an administrative finding, not a medical opinion.
The ALJ noted that such a finding is reserved to the Commissioner, not a claimant’s
5
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 6 of 10
physician. 20 C.F.R. § 404.1527(d)(1); see also Walker v. Soc. Sec. Admin.,
Comm’r,
987 F.3d 1333, 1339 (11th Cir. 2021).
Second, we cannot say the ALJ erred in giving “some weight” to Dr. Rocha’s
opinion that Proenza’s functioning was affected by “motivational issues.” The
weight given a consulting physician’s opinion depends, among other things, on the
extent to which it is consistent with other evidence. 20 C.F.R. § 404.1527(c)(4); see
also Crawford,
363 F.3d at 1158, 1160. Here, the ALJ determined that Dr. Rocha’s
opinion was entitled to “some weight” for several reasons, including that it (1) was
based on his own observation of Proenza; (2) was consistent with his determination
that Proenza had a GAF score of 72; and (3) was generally consistent with Dr.
Lermo’s reports indicating a clean appearance, clear speech, fair motor behavior,
orientation in three spheres, fair eye contact, fair motivation, and fair reality testing.
Finally, we cannot say that the ALJ erred in giving “significant weight” to Dr.
Giardina’s opinion that Proenza suffered moderate limitations on her RFC. Though
she is not required to adopt them, the ALJ must consider the opinions of
psychological consultants “because our Federal or State agency medical or
psychological consultants are highly qualified and experts in Social Security
disability evaluation.” 20 C.F.R. §§ 404.1513a(b)(1), 416.913a(b)(1). The ALJ may
rely on opinions of non-examining sources when they do not conflict with those of
examining sources. Edwards v. Sullivan,
937 F.2d 580, 584–85 (11th Cir. 1991).
6
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 7 of 10
Here, the ALJ found that Dr. Giardina’s opinion was consistent with other evidence
in the record, including Dr. Lermo’s clinical notes, Proenza’s GAF scores, and Dr.
Rocha’s determination that Proenza’s functioning was affected by motivational
issues.
In sum, the ALJ articulated specific reasons for weighing the medical opinion
evidence as she did. It is not our task to second guess those determinations, see
Hunter, 808 F.3d at 823, or to re-weigh the evidence on appeal, Winschel,
631 F.3d
at 1178. Our inquiry is limited to whether the ALJ gave appropriate reasons for her
determination and supported that decision with substantial evidence. Here, the ALJ
did so.
III.
Proenza argues that the ALJ’s RFC finding is not supported by substantial
evidence in the record. She argues that the ALJ’s assessment of her mental
impairments was “woefully deficient” and led to the erroneous conclusion that she
could perform significant work in the national economy. Again, we disagree.
The RFC is an assessment of a claimant’s ability to do work despite her
impairments. Lewis v. Callahan,
125 F.3d 1436, 1440 (11th Cir. 1997); see also 20
C.F.R. § 404.1545(a). Mental impairments are evaluated based on how they impact
four functional areas: (1) understanding, remembering, or applying information;
(2) interacting with others; (3) concentration, persistence, or maintaining pace; and
7
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 8 of 10
(4) adapting or managing oneself. 20 C.F.R. § 404.1520a(c)(3). The mere existence
of an impairment does not reveal the extent to which it limits a claimant’s ability to
work. Nor does it undermine the ALJ’s determination that she can work. Moore,
405
F.3d at 1213 n.6. The ALJ considers all of the record evidence in determining the
claimant’s RFC. Phillips v. Barnhart,
357 F.3d 1232, 1238 (11th Cir. 2004).
Proenza’s argument fails for two reasons. First, Proenza fails to identify
specific evidence in the record supporting greater functional limitations than those
identified by the ALJ. Nor has she described what functional limitations were
warranted by the record evidence beyond what the ALJ found. For an argument to
be sufficiently briefed on appeal, the argument must include the appellant’s
“contentions and the reasons for them, with citations to the authorities and parts of
the record on which the appellant relies.” Fed. R. App. P. 28(a)(8)(A). Proenza’s
statement that “glaring discrepancies” existed “between the ALJ’s assessment of the
evidence and what the substantial evidence of record actually reveals,” without
more, is not enough to preserve this issue for review. See Sapuppo v. Allstate
Floridian Ins. Co.,
739 F.3d 678, 681 (11th Cir. 2014).
Second, the ALJ’s RFC finding was supported by substantial evidence. The
ALJ relied on Dr. Lermo’s clinical notes which indicated that Proenza had a clean
appearance, fair memory, organized thought process, clear quality of speech, good
eye contact, cooperative attitude, was oriented to person, place, and time, and that
8
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 9 of 10
Proenza responded well to medication. The RFC finding was consistent with the
GAF scores assessed by both Drs. Lermo and Rocha, which indicated at most a
moderate limitation on functioning. Not only was Proenza able to regularly conduct
daily living activities, but she was also able to sustain a part-time job for two years
after her alleged onset date. Accordingly, the ALJ’s finding that Proenza had no
more than moderate limitations in any of the four areas of mental functioning was
supported by substantial evidence.
IV.
Finally, Proenza argues that the ALJ failed to properly assess her subjective
complaints regarding her symptoms and limitations. To establish a disability based
on testimony of pain and other symptoms, the claimant must show: (1) evidence of
an underlying medical condition; and (2) either (a) objective medical evidence
confirming the severity of the alleged symptoms or (b) that the objectively
determined medical condition can reasonably be expected to give rise to the claimed
symptoms. Wilson v. Barnhart,
284 F.3d 1219, 1225–26 (11th Cir. 2002); see also
20 C.F.R. § 404.1529(a). The ALJ must articulate “explicit and adequate” reasons
for discrediting subjective testimony. Wilson,
284 F.3d at 1226.
Here, the ALJ did so. The ALJ explained that although “the claimant’s
medically determinable impairments could reasonably be expected to cause the
alleged symptoms,” Proenza’s statements “concerning the intensity, persistence and
9
USCA11 Case: 20-14237 Date Filed: 07/21/2021 Page: 10 of 10
limiting effects of these symptoms are not entirely consistent with the medical
evidence and other evidence in the record.” To support this finding the ALJ relied
on the fact that Proenza had continued to work for several years after her alleged
onset date. The ALJ also relied on Dr. Lermo’s notes documenting her clean
appearance, clear quality of speech, fair motor behavior, orientation in three spheres,
fair eye contact, fair motivation, and fair reality testing. The ALJ relied on the fact
that the claimant had not been hospitalized over her alleged symptoms, nor had she
experienced any negative side effects from her medications. Accordingly, the ALJ’s
decision to discount Proenza’s testimony regarding the limiting effects of her
symptoms was supported by substantial evidence.
AFFIRMED.
10
