Brandon E. Hacia v. Commissioner of Social Security

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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
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No. 14-13504
Non-Argument Calendar
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D.C. Docket No. 8:13-cv-01257-VMC-MCR
BRANDON E. HACIA,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
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Appeal from the United States District Court
for the Middle District of Florida
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(February 2, 2015)
Before TJOFLAT, HULL, and ROSENBAUM, Circuit Judges.
PER CURIAM:
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Brandon Hacia appeals the judgment of the District Court affirming the
Commissioner of Social Security’s denial of his application for disability insurance
benefits, pursuant to 42 U.S.C. § 405(g), and supplemental security income,
pursuant to 42 U.S.C. § 1383(c)(3). The Administrative Law Judge (the “ALJ”)
who adjudicated Hacia’s claim found that he had two severe impairments: primary
generalized epilepsy and a cognitive disorder. The ALJ concluded that Hacia was
not disabled within the meaning of the Social Security Act (the “Act”), however,
and thus was not entitled to benefits under the Act because there were a significant
number of jobs that he could perform despite his impairments. Hacia requested
administrative review of the ALJ’s decision but the Appeals Council denied his
request. On judicial review, the Magistrate Judge recommended that the
Commissioner’s decision denying benefits be affirmed. The District Court adopted
the recommendation and affirmed the Commissioner’s decision.
On appeal, Hacia argues that the ALJ failed to give sufficient weight to (1)
the opinion of his treating physician that he was unable to support himself due to
his condition, and (2) the Department of Defense’s (the “DOD”) determination that
he was entitled to medical coverage as an incapacitated adult child of a retired
service member.
In reviewing the Commissioner’s decision to deny social security benefits in
a particular case, the district court’s inquiry in the first instance, and ours on
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appellate review, is limited to determining whether the Commissioner’s findings
are supported by substantial evidence and whether the Commissioner applied the
correct legal standards. See 42 U.S.C. § 405(g); Lamb v. Bowen, 847 F.2d 698,
701 (11th Cir. 1988). “Substantial evidence is such relevant evidence as a
reasonable person would accept as adequate to support a conclusion.” Hale v.
Bowen, 831 F.2d 1007, 1011 (11th Cir. 1987). “It is more than a scintilla, but less
than a preponderance.” Id. “We may not decide the facts anew, reweigh the
evidence, or substitute our judgment for that of the Commissioner.” Phillips v.
Barnhart, 357 F.3d 1232, 1240 & n.8 (11th Cir. 2004) (quotation marks and
alterations omitted).
To be eligible for disability insurance benefits and supplemental security
income under the Act, a claimant must be disabled. 42 U.S.C. §§ 423(a)(1),
1382(a)(1)–(2). Disability is defined for the purposes of the Act as the inability to
engage in any substantial gainful activity by reason of any medically determinable
physical or mental impairment that can be expected to result in death, or that has
lasted or can be expected to last for a continuous period of not less than 12 months.
42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A person will be found disabled only
if his physical or mental impairments are so severe that he cannot engage in any
kind of substantial gainful work which exists in the national economy. 42 U.S.C.
§§ 423(d)(2)(A), 1382c(a)(3)(B). The claimant bears the burden of proving that he
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is disabled, and thus it is his responsibility to produce evidence in support of his
claim. Ellison v. Barnhart, 355 F.3d 1272, 1276 (11th Cir. 2003).
In evaluating the evidence put forward by the claimant, the ALJ must give a
treating physician’s opinion substantial weight—unless good cause is shown to
disregard the opinion. Edwards v. Sullivan, 937 F.2d 580, 583 (11th Cir. 1991).
We have found good cause to exist where (1) the physician’s opinion was not
bolstered by the evidence, (2) the evidence supported a contrary finding, or (3) the
physician’s opinion was conclusory or inconsistent with his or her own medical
records. Phillips, 357 F.3d at 1240–41. If an ALJ determines that the opinion of
the treating physician is not entitled to substantial weight, he or she must clearly
articulate the reasons for that conclusion. Id.Here, the ALJ articulated several reasons supporting his decision not to give
substantial weight to the opinion of Dr. Bozorg, Hacia’s treating physician. As the
ALJ noted, the conclusions expressed by Dr. Bozorg in a Residual Function
Capacity (“RFC”) questionnaire were not only internally inconsistent but they
were also unsupported—even contradicted—by Dr. Bozorg’s treating notes in
Hacia’s medical records. For example, the questionnaire states that Hacia was
experiencing an average of one seizure a month without any precipitating factors,
but Dr. Borzog noted in his treating records that Hacia’s seizures were controllable
with medication and opined that the seizures were due to Hacia’s noncompliance
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with his prescribed medication regimen. Upon reviewing the record, we cannot
say that the ALJ’s conclusion that good cause existed to discount Dr. Bozorg’s
opinion lacked substantial support.1
Hacia’s second argument fares little better. A finding of disability by
another agency is not binding on the Commissioner, although we have held that it
should be given great weight. Bloodsworth v. Heckler, 703 F.2d 1233, 1241 (11th
Cir. 1983); see also 20 C.F.R. §§ 404.1504, 416.904 (stating that a determination
of disability by another agency is not binding on the Social Security
Administration). Nor, if the other agency’s standard for determining disability
deviates substantially from the Commissioner’s standard, is it error for the ALJ to
give the agency’s finding less than substantial weight. Cf. Falcon v. Heckler, 732
F.2d 827, 831 (11th Cir. 1984) (finding that an ALJ should have given great weight
to a state agency’s disability standard because it had been construed similarly to
the Commissioner’s disability standard).
Here, the ALJ specifically considered the DOD’s determination that Hacia
was an incapacitated adult child of a retired service member but found, albeit with
little explanation, that the DOD’s standard was “more lenient” than the disability
1
Hacia argues that it is unreasonable to assume that a doctor would make false
statements at his patient’s behest. We note in this regard that within one day of completing the
RFC questionnaire at issue, Dr. Bozorg observed in his treatment notes that Hacia had been
experiencing monthly breakthrough seizures but he and his mother had not been promptly
reporting them to Dr. Bozorg because they were hoping Hacia would qualify for disability and
did not think he would qualify unless he was having regular seizures.
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standard imposed by social security law and thus gave it limited weight. Hacia
appears to contend that the ALJ erred because he did not sufficiently discuss how
the DOD’s standard differed from the Commissioner’s standard or support that
conclusion with substantial evidence.
Hacia fails to cite us to any binding precedent holding that an ALJ must
make detailed findings in support of his conclusion that the relative disability
standards differ. The ALJ’s decision reflects that he considered both standards,
determined that the DOD’s disability standard was lower than that of the
Commissioner, and thus assigned limited weight to the DOD’s determination. This
was not error. See Pearson v. Astrue, 271 F. App’x 979, 981 (11th Cir. 2008) (per
curiam) (affirming denial of benefits despite a finding by the Department of
Veteran’s Affairs that claimant was disabled where ALJ “considered the rating in
his decision and correctly explained that a claimant had to satisfy a more stringent
standard to be found disabled under the [SSA]”).
Moreover, upon reviewing the record, we find substantial support for the
ALJ’s determination that the DOD’s standard was more lenient than the
Commissioner’s standard. Based on the evidence submitted by Hacia, it appears
that to obtain continued insurance coverage as an incapacitated dependent under
DOD regulations, a claimant need only submit a current physician’s statement to
that effect. By comparison, the Commissioner evaluates a disability claim with an
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in-depth five-step sequential process, 20 C.F.R. §§ 404.1520(a), 416.920(a), and
reviews a variety of medical and non-medical evidence in making a final
determination, see 20 C.F.R. §§ 404.1512(a)–(c), 416.912(a)–(c). Notably, a
physician’s statement that an individual is incapacitated or disabled is not
dispositive. 20 C.F.R. §§ 404.1527(d), 416.927(d).
In sum, we find that the ALJ applied the correct legal standards in reaching
his decision that Hacia was not entitled to disability insurance benefits or
supplemental security income and that this conclusion finds substantial support in
the record. Accordingly, we AFFIRM.
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