Teresa D. Hughes v. Commissioner of the Social Security Administration

Case: 11-16021 Date Filed: 08/02/2012 Page: 1 of 11
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 11-16021
Non-Argument Calendar
________________________
D.C. Docket No. 1:10-cv-00154-MP-GRJ
TERESA D. HUGHES,
llllllllllllllllllllllllllllllllllllllll Plaintiff-Appellant,
versus
COMMISSIONER OF THE SOCIAL
SECURITY ADMINISTRATION,
llllllllllllllllllllllllllllllllllllllll Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Northern District of Florida
________________________
(August 2, 2012)
Before MARCUS, FAY, and EDMONDSON, Circuit Judges.
PER CURIAM:
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Teresa D. Hughes appeals from the district court’s order affirming the
Administrative Law Judge’s (“ALJ”) denial of disability insurance benefits (“DIB”),
pursuant to 42 U.S.C. § 405(g). On appeal, Hughes argues that: (1) after the second
remand by the district court, the ALJ erred in discounting Hughes’s treating
physicians’ opinions that she is incapable of full-time work; (2) the ALJ violated the
credibility pain standard established by this Court when the ALJ disregarded
Hughes’s testimony regarding pain to the extent that her testimony was inconsistent
with the ALJ’s determination of Hughes’s residual functional capacity; and (3) the
ALJ erred by not properly considering Hughes’s receipt of Florida State Disability
Retirement benefits. After thorough review, we affirm.
We review a Social Security decision to determine if it is supported by
substantial evidence and based on proper legal standards. Crawford v. Comm’r, 363
F.3d 1155, 1158 (11th Cir. 2004). Substantial evidence consists of “such relevant
evidence as a reasonable person would accept as adequate to support a conclusion.”
Id. (quotation omitted). The burden rests with the claimant to prove that she is
disabled and entitled to Social Security benefits. See 20 C.F.R. § 404.1512(a).
An individual claiming Social Security disability benefits must prove that she
is disabled, see Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir. 1999), and for DIB ,
must demonstrate she was disabled on or before her date last insured, see Moore v.
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Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). “The Social Security regulations
provide a five-step sequential evaluation process for determining if a claimant has
proven that she is disabled.” Jones, 190 F.3d at 1228. A claimant must show that:
(1) she is not performing substantial gainful activity;
(2) she has a severe impairment;
(3) the impairment or combination of impairments meets or equals an
impairment listed in the regulations;
(4) she cannot return to past work;
(5) she cannot perform other work based on her age, education, and
experience.
Phillips v. Barnhart, 357 F.3d 1232, 1237 (11th Cir. 2004); 20 C.F.R. § 404.1520; 20
C.F.R. § 416.920. Specifically, at Step Five, a claimant must show that she does not
retain the residual functional capacity (“RFC”) to perform other work based on her
age, education, and experience. 20 C.F.R. § 404.1520(a)(4)(v).
In order to qualify for DIB, an individual must prove that her disability existed
prior to the end of her insured status period, and, after insured status is lost, a claim
will be denied despite her disability. See Demandre v. Califano, 591 F.2d 1088,
1090-91 (5th Cir. 1979);1 42 U.S.C. §§ 416(i), 423(c)(1); 20 C.F.R. § 404.130.
1
In Bonner v. City of Prichard, 661 F.2d 1206, 1209 (11th Cir. 1981) (en banc), we
adopted as binding precedent all decisions of the former Fifth Circuit handed down before
October 1, 1981.
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“[T]here is no rigid requirement that the ALJ specifically refer to every piece
of evidence in his decision, so long as the ALJ’s decision . . . is not a broad rejection
which is ‘not enough to enable [us] to conclude that [the ALJ] considered her medical
condition as a whole.’” Dyer v. Barnhart, 395 F.3d 1206, 1211 (11th Cir. 2005)
(quoting Foote v. Chater, 67 F.3d 1553, 1561 (11th Cir. 1995)).
“[T]he opinion of a treating physician is entitled to substantial weight unless
good cause exists for not heeding the treating physician’s diagnosis.” Edwards v.
Sullivan, 937 F.2d 580, 583 (11th Cir. 1991); see 20 C.F.R. § 404.1527(c) (stating
that, generally, more weight is given to opinions from treating sources). However,
we have found “good cause” to afford less weight to a treating physician’s opinion
where the opinion was conclusory or inconsistent with the physician’s own medical
records or where the evidence supported a contrary finding. See Lewis v. Callahan,
125 F.3d 1436, 1440 (11th Cir. 1997). Furthermore, the ALJ “is free to reject the
opinion of any physician when the evidence supports a contrary conclusion.” Sryock
v. Heckler, 764 F.2d 834, 835 (11th Cir. 1985) (quotation omitted).
First, we find no merit to Hughes’s claim that the ALJ erred in discounting the
opinions of Hughes’s treating family physician, Dr. May Montrichard, concerning
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Hughes’s ability to work.2 Although on at least seven occasions between 2002 and
2009 Dr. Montrichard expressed the opinion that Hughes was completely disabled
and incapable of employment, none of these opinions cited to specific objective
medical evidence or test results or referenced any specific information regarding the
results of physical or mental evaluations in support of those opinions. Thus, the basis
for Dr. Montrichard’s opinions remains unclear. Further, three of Dr. Montrichard’s
opinions -- the January 27, 2005 letter to the Florida Retirement System, the June 7,
2005 residual functional capacity assessment, and the February 9, 2009 assessment
for the Florida Retirement System -- do not appear to be based upon Hughes’s mental
and physical conditions within the time period at issue in the instant case, July 20,
1999, to December 31, 2004, the date that Hughes was last insured. Thus, these
opinions were not particularly relevant to whether Hughes was disabled for purposes
of DIB. See Demandre, 591 F.2d at 1090-91.
Moreover, substantial evidence supports the ALJ’s determination that Dr.
Montrichard’s opinions regarding Hughes’s ability to work were contradicted by
2
As an initial matter, although Hughes mentions that the ALJ erred by rejecting her
treating physicians’ medical opinions that she was not capable of full-time work, Hughes only
presents argument regarding the medical opinions of Dr. Montrichard. Thus, Hughes has
abandoned any challenge to the ALJ’s decision to give less weight to opinions of Hughes’s other
treating physicians. See Greenbriar, Ltd. v. City of Alabaster, 881 F.2d 1570, 1573 n.6 (11th
Cir.1989) (stating that passing references are insufficient to raise issues for appeal and such
issues are deemed abandoned).
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other medical evidence, including Dr. Montrichard’s own statements and those of
other treating physicians. For example, in the October 28, 2004 form, Dr.
Montrichard opined that Hughes could lift no more than 20 pounds, but in the
December 14, 2009 residual functional capacity assessment provided to counsel for
the time period of November 11, 1999, to December 31, 2004, Dr. Montrichard
opined that Hughes was unable to lift more than 2 pounds. On numerous occasions,
Dr. Phillip K. Springer, Hughes’s treating psychiatrist and pain management
specialist, opined that Hughes’s overall mental health showed improvement, often
significant, from previous sessions. Other treating physicians, Dr. James Atchison
and Dr. Andrew Cordista, noted after September 2001 physical examinations that
Hughes had a normal gait, negative straight leg raise on both sides, and no deformity,
laxity, or weakness in her cervical or lumbar spine or extremities.
Dr. Montrichard further opined that Hughes’s pain was so incapacitating that
Hughes was unable to perform most activities of daily living and could not work a
normal eight-hour workday, she had extreme limitations in her ability to maintain
attention and concentration for extended periods of time, and had marked restrictions
in her ability to interact appropriately with the general public, but these opinions were
also contradicted by substantial evidence, including by Hughes herself. Hughes
consistently reported to doctors and testified at hearings that she was able to take care
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of her personal needs, cook simple meals, do laundry, wash dishes, go shopping when
necessary, handle her own finances, and drive herself to go shopping or to doctor’s
appointments.
Assessments by consulting physicians, psychiatrists, and psychologists also
contradicted Dr. Montrichard’s opinions regarding Hughes’s capabilities to work
full-time. For example, on March 27, 2003, Dr. Lance Chodosh determined that,
although Hughes’s neck had moderate decrease in range of motion, all joints in
extremities had full range of motion; her range of motion for her cervical and lumbar
spine were within the normal range; there was no deformity, tenderness, or paraspinal
muscular spasm of her back; straight leg raises were negative bilaterally; she had
normal gross motor function in all extremities, normal manual dexterity, and good
coordination; she had a normal gain, with heel to toe walk; and she was able to squat
and rise.
In addition, results of medical tests provided substantial evidence to support
the ALJ’s determination to give less weight to Dr. Montrichard’s opinions. The
results of x-rays taken of Hughes’s cervical spine on July 12, 2001, showed that her
cervical spine was normal, with a mild decrease in disc space at the L4-5 level and
narrowing at the L5-S1 which was unchanged from July 27, 1999 MRI results.
X-rays taken of Hughes’s cervical spine during a June 3, 2001 emergency room visit
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also revealed no acute abnormalities. June 2, 2004 MRIs of Hughes’s lumbar and
cervical spine showed mild narrowing at the L4-5 and L5-S1 levels, but remaining
osseous structures appeared unremarkable and, although the radiologist noted some
mild degenerative changes, there was no evidence of acute body abnormality. For all
of these reasons, the ALJ did not err by discounting Dr. Montrichard’s opinions.
Next, we are unpersuaded by Hughes’s argument that the ALJ violated our
Court’s credibility pain standard. Pursuant to 42 U.S.C. § 423,
An individual’s statement as to pain or other symptoms shall not alone
be conclusive evidence of disability as defined in this section; there
must be medical signs and findings, established by medically acceptable
clinical or laboratory diagnostic techniques, which show the existence
of a medical impairment that results from anatomical, physiological, or
psychological abnormalities which could reasonably be expected to
produce the pain or other symptoms alleged and which, when considered
with all evidence required to be furnished under this paragraph
(including statements of the individual or his physician as to the
intensity and persistence of such pain or other symptoms which may
reasonably be accepted as consistent with the medical signs and
findings), would lead to a conclusion that the individual is under a
disability. Objective medical evidence of pain or other symptoms
established by medically acceptable clinical or laboratory techniques
(for example, deteriorating nerve or muscle tissue) must be considered
in reaching a conclusion as to whether the individual is under a
disability.
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42 U.S.C. § 423(d)(5)(A). See also 20 C.F.R. § 404.1528(a) (stating that a claimant’s
“statements alone are not enough to establish that there is a physical or mental
impairment”).
In a case where a claimant attempts to establish disability through her own
testimony concerning pain or other subjective systems, we apply a three-part “pain
standard.” Holt v. Sullivan, 921 F.2d 1221, 1223 (11th Cir. 1991). “The pain
standard requires (1) evidence of an underlying medical condition and either (2)
objective medical evidence that confirms the severity of the alleged pain arising from
that condition or (3) that the objectively determined medical condition is of such a
severity that it can be reasonably expected to give rise to the alleged pain.” Id. If the
ALJ decides not to credit a claimant’s subjective testimony concerning pain, she
“must articulate explicit and adequate reasons for doing so.” Id.Here, substantial evidence supports the ALJ’s determination that Hughes’s
medically determinable impairments could reasonably be expected to cause her
alleged symptoms. However, substantial evidence also supports the ALJ’s
determination that Hughes’s statements concerning the intensity, persistence, and
limiting effects of those symptoms were not credible to the extent that they were
inconsistent with the ALJ’s functional capacity assessment and the objective evidence
in the record. As we’ve discussed above, the objective medical evidence showed only
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minor degenerative changes and no acute abnormalities, and physical examinations
demonstrated mostly normal results in terms of range of motion, gait, heel and toe
walk, and ability to squat and raise. And, as we’ve also already detailed, Hughes’s
own statements regarding her activities of daily living at least partially contradicted
her claims regarding the limiting effects of her symptoms. What’s more, the ALJ’s
articulated reasons for only partially crediting Hughes’s subjective statements
regarding her symptoms were adequate, as the ALJ articulated specific medical test
results that were not compatible with Hughes’s statements, cited to physical
examinations by Dr. Montrichard and Dr. Chodosh that were relatively normal, and
contrasted Hughes’s statements about her symptoms with her reported activities of
daily living.
Finally, we reject Hughes’s claim that the ALJ erred by not properly
considering Hughes’s receipt of Florida State Disability Retirement benefits.
Generally, “[t]he findings of disability by another agency, although not binding on
the [Commissioner,] are entitled to great weight.” Bloodsworth v. Heckler, 703 F.2d
1233, 1241 (11th Cir. 1983). Even when an agency’s definition of disability differs
from that of social security law, if the agency’s disability definition is construed in
a similar manner as the definition of disability under social security law, it is error for
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the ALJ to not give that agency’s finding of disability great weight. Falcon v.
Heckler, 732 F.2d 827, 831 (11th Cir. 1984).
In this case, substantial evidence supports the ALJ’s decision to give little
weight to the State of Florida’s disability determination. Although Hughes’s
submitted the State of Florida’s March 7, 2005 disability determination, that
document consisted of a single page that stated that Hughes had been approved for
“Regular Disability Retirement” but provided no explanation for the basis of that
determination. As the ALJ noted, Hughes offered no specific or additional evidence
in conjunction with the State’s determination that would lead to a different conclusion
than that reached in the ALJ’s decision.
AFFIRMED.
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