Veatta O. Carter v. Commissioner of Social Security

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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 17-14046
Non-Argument Calendar
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D.C. Docket No. 5:16-cv-00501-WTH-PRL
VEATTA O. CARTER,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Middle District of Florida
________________________
(March 12, 2018)
Before MARCUS, JULIES CARNES and HULL, Circuit Judges.
PER CURIAM:
Veatta Carter appeals the affirmance of the decision of the Commissioner of
the Social Security Administration (“Commissioner”) denying her applications for
a period of disability and disability insurance benefits (“DIB”), and supplemental
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security income (“SSI”), 42 U.S.C. §§ 405(g), 1383(c)(3). Carter argues that: (1)
based on the substantial evidence, the ALJ committed error in determining that she
had the residual functional capacity (“RFC”) to perform sedentary work; (2) the
ALJ failed to consider the vocational expert (“VE”) testimony as to her need to
elevate her legs and her cognitive abilities; and (3) the ALJ improperly gave little
weight to two forms by Dr. K. N. Reddy and Nurse Baker, where they opined that
she could not work. After thorough review, we affirm.
We review the ALJ’s decision for substantial evidence, but the ALJ’s
application of legal principles de novo. Moore v. Barnhart, 405 F.3d 1208, 1211
(11th Cir. 2005). Substantial evidence is relevant evidence that a reasonable
person would accept as adequate to support a conclusion. We may not decide the
facts anew, make credibility determinations, or re-weigh the evidence. Id.
The social security regulations outline a five-step, sequential evaluation
process to decide whether a claimant is disabled. See 20 C.F.R. § 404.1520(a)(4).
The ALJ must evaluate whether: (1) the claimant is engaged in substantial gainful
activity; (2) the claimant has a severe impairment; (3) the severe impairment meets
or equals an impairment in the Listing of Impairments; (4) the claimant has the
RFC to perform past relevant work; and (5) in light of the claimant’s RFC, age,
education, and work experience, there are other jobs the claimant can perform.
Phillips v. Barnhart, 357 F.3d 1232, 1237 (11th Cir. 2004); 20 C.F.R. §§
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404.1520(a)(4), 416.920(a)(4). A claimant’s RFC is the most she can still do
despite her limitations and is based on an evaluation of all the relevant evidence.
See 20 C.F.R. §§ 404.1520(e), 404.1545(a)(1), (a)(3), 416.920(e), 416.945(a)(1),
(a)(3). If the ALJ determines that the claimant is not disabled at any step of the
evaluation process, the inquiry ends. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).
If a claimant alleges several impairments, the Commissioner must consider
the impairments in combination to decide whether the combined impairments
render her disabled. Jones v. Dep’t of Health & Human Servs., 941 F.2d 1529,
1533 (11th Cir. 1991). This duty applies even when the impairments considered
separately are not severe. Hudson v. Heckler, 755 F.2d 781, 785 n.2 (11th Cir.
1985). An ALJ’s statement that the claimant did not have an impairment or
combination of impairments that rendered her disabled constitutes evidence that he
considered the combined effects of her impairments. Wilson v. Barnhart, 284 F.3d
1219, 1224 (11th Cir. 2002).
In performing the five-step evaluation process, an examiner who concludes
that a claimant is unable to do past relevant work must then proceed to the “final
step of the evaluation process to determine whether in light of ‘[RFC],’ age,
education, and work experience the claimant can perform other work.” Id. at 1227.
The ALJ may determine whether the claimant has the ability to adjust to other
work in the national economy by use of a vocational expert. Winschel v. Comm’r
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of Soc. Sec., 631 F.3d 1176, 1180 (11th Cir. 2011). “[F]or a vocational expert’s
testimony to constitute substantial evidence, the ALJ must pose a hypothetical
question which comprises all of the claimant’s impairments.” Id. (quotations
omitted). “The hypothetical need only include the claimant’s impairments, not
each and every symptom of the claimant.” Ingram v. Comm’r of Soc. Sec., 496
F.3d 1253, 1270 (11th Cir. 2007) (quotation and citation omitted). The ALJ need
not include findings in the hypothetical that the ALJ found to be unsupported.
Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1161 (11th Cir. 2004).
“Medical opinions” are defined as statements from physicians or other
acceptable medical sources “that reflect judgments about the nature and severity of
[a patient’s] impairment(s), including [her] symptoms, diagnosis and prognosis,
what [she] can still do despite impairment(s), and [her] physical or mental
restrictions.” 20 C.F.R. § 404.1527(a)(2). The opinion of a treating physician
must be given substantial or considerable weight unless “good cause” is shown to
the contrary. Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1179 (11th Cir.
2011). We’ve found “good cause” to exist when: (1) the 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.
Carter focuses her appeal on problems with her veins and legs, her cognitive
abilities, and her IQ. On the record before us, however, substantial evidence
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supports the ALJ’s RFC finding for a reduced range of sedentary work and the
ultimate finding that in spite of her alleged difficulties, she was not disabled. As
for her vein and leg problems, the record reveals that her leg pain and swelling had
improved after receiving several vein ablation treatments. Doctors repeatedly told
her to exercise, walk, lose weight, and wear compression stockings or hose, which
were conservative treatments. Overall, her exams were normal, showing some
edema in the legs, but the ability to walk. The doctors’ advice to exercise
contradicted her arguments that she cannot walk or stand while at a job. Her
reported activities of daily living contradicted her arguments as well, since she said
that she cared for her children, did chores, cared for herself, and went to the gym.
Moreover, nothing in the record suggests that her IQ or cognitive
functioning is so low that she cannot perform any job, even though the record
reflects that she has learning disabilities. The doctor who evaluated her in 2006
did not note that she could not work, only that it may be difficult for her to pass a
test that would allow her to continue working in childcare. As for Carter’s
argument that her illiteracy prevents her from doing any work, she testified during
the ALJ hearing that she read the Bible, which contradicts this argument. Illiteracy
“means the inability to read or write,” and an individual is considered illiterate if
she “cannot read or write a simple message such as instructions or inventory lists
even though the person can sign . . . her name[.]” 20 C.F.R. §§ 404.1564(b)(1),
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416.964(b)(1). The records of her learning disability and IQ testing do not reflect
that she was illiterate, but rather show that she had difficulties reading and writing,
as well as borderline intellectual functioning. Thus, contrary to Carter’s argument,
the record does not compel the conclusion that she was illiterate or unable to
perform the educational requirements of the jobs.
The ALJ also demonstrated he had considered all of Carter’s impairments,
by expressly finding she did not have an “impairment or combination of
impairments” that met or equaled the severity of a listed impairment. The ALJ
added that he considered her impairments in combination, the “entire record,” and
“all symptoms” in evaluating her RFC, and he discussed her subjective statements
and the relevant medical evidence. On this record, substantial evidence supported
the ALJ’s determination of the RFC for a reduced range of sedentary work.
The ALJ also articulated good reasons, supported by substantial evidence,
for his assessment of the weight due to the medical opinion evidence of her
treating physicians, Dr. K.N. Reddy and Nurse Baker. As the ALJ explained,
opinions that Carter could simply not work were conclusory, and neither specified
any reason for why she could not work. In addition, they were inconsistent with
the record as a whole, since doctors repeatedly told Carter to exercise and use
conservative treatments. For instance, while Dr. Nagender Reddy recommended
leg elevation in combination with other conservative treatment, such as
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compression stockings or hose, he did not order that she keep her legs elevated
during the day; notably, he never said that Carter had to elevate her legs in order to
function nor that she had to refrain from sitting or standing unless she periodically
elevated her legs. Dr. K. N. Reddy and Nurse Baker’s opinions were also
inconsistent with Dr. K. N. Reddy’s own treatment notes, especially where he
recommended that Carter walk, exercise, and continue with vein treatments. Thus,
we reject Carter’s arguments that the ALJ improperly gave little weight to two
forms by Dr. K. N. Reddy and Nurse Baker.
Finally, we are unpersuaded by Carter’s claim that the ALJ improperly
relied on the VE’s testimony. Carter says that the ALJ failed to consider the VE
testimony about her need to elevate her legs, but the record does not support her
alleged need to keep her feet elevated during the day. It is true that the VE
testified that, if a claimant had to elevate her feet with the feet extended while at
work, that “no work” would be available. But the only pieces of evidence that
mentioned elevating her feet were the functional reports by either Dr. K. N. Reddy
or Nurse Baker -- and as we already observed, those opinions, where Dr. K. N.
Reddy and/or Nurse Baker opined that Carter could never work, were conclusory
and did not indicate why she was unable to work. Nor has Carter explained how
the ALJ’s hypothetical question failed to accommodate her moderate limitations in
concentration, persistence, or pace or even alleged that the ALJ’s hypothetical did
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not include all her non-exertional limitations. Thus, the ALJ’s hypothetical
question sufficed to accommodate Carter’s limitations in concentration,
persistence, or pace.
As for Carter’s argument on appeal that the VE’s testimony about her
cognitive abilities did not comport with the Dictionary of Occupational Titles
(“DOT”), it is not supported by any evidence. The VE did not say that any of the
example jobs required a certain IQ or reading level, and the ALJ found that the
VE’s testimony was consistent with the DOT. Furthermore, the ALJ asked the VE
about simple and unskilled or low semiskilled work, and the VE explained that
there were jobs available for that level of skill with Carter’s other physical
limitations. Thus, the VE’s testimony provided substantial evidence to support the
ALJ’s conclusion that Carter could perform other work and was not disabled.
In short, because there was relevant evidence that a reasonable person would
accept as adequate to support the conclusions that Carter’s difficulties with her
legs, veins, IQ and cognitive abilities were not disabling, and that she had an RFC
to perform sedentary work, we can find no error in the ALJ’s decision. See Moore,
405 F.3d at 1211. Accordingly, we affirm the Commissioner’s decision denying
DIB and SSI.
AFFIRMED.
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