Wimberly v. Commissioner of Social Security

UNITED STATES DISTRICT COURT

MIDDLE DISTRICT OF FLORIDA :

TAMPA DIVISION

JUDY MARA WIMBERLY,

Plaintiff,

V. CASE No. 8:20-cv-902-TGW

KILOLO KIJAKAZI, .

Acting Commissioner of Social Security,!

Defendant.

ORDER

The plaintiff in this case seeks judicial review of the denial of

her claim for supplemental security income payments.? Because the

decision of the Commissioner of Social Security is supported by substantial

evidence and does not contain any reversible error, the decision will be

affirmed. : □

I. .

The plaintiff, who was fifty-two years old at the time of the

most recent administrative hearing and who has a limited education, has

—_——

' Kilolo Kijakazi became the Commissioner of Social Security on July 9,,2021, and

should be substituted as the defendant. See Fed. R. Civ. P. 25(d).

The parties have consented in this case to the exercise of jurisdiction by a United

States Magistrate Judge (Doc. 23). .

worked as a dining room attendant and cleaner, housekeeper (Tr. 658, 695).

She filed a claim for supplemental security income payments, alleging that

she became disabled due to hepatitis C, arthritis and scoliosis of the back,

stenosis, spine degenerative disc disease, rheumatoid arthritis, a hemiated

disc, titanium plate in neck, depression, and anxiety (Tr. 805-06). The

claim was denied initially and upon reconsideration.

At her request, the plaintiff received a de novo hearing before

an administrative law judge. The law judge found that the plaintiff

severe impairments that reduced her residual functional capacity, but that

they were not disabling (Tr. 62, 70). The district court subsequently

reversed the decision of the Commissioner of Social Security for failure to

consider adequately the opinions of treating physician Dr. John Amann (Tr.

683). The Order of the Appeals Council remanded the case for further

proceedings consistent with the district court’s Order (Tr. 673).3 □

A different law judge conducted a hearing. He found that the

plaintiff had severe impairments of degenerative disc disease and

3The Appeals Council also ordered the consolidation of this case with the

plaintiffs claim for supplemental security income filed on February 9, 2015 (Tr. 673).

(Tr. 649). The law judge concluded that, despite the plaintiff S

impairments, she

has the residual functional capacity to perform ~~

light work as defined in 20 CFR 416.967(b). The

claimant can lift and/or carry twenty pounds

occasionally and ten pounds frequently; stand

and/or walk four hours in an eight-hour day and sit. .

six hours in an eight-hour workday, with anoption

to sit/stand every thirty minutes without leaving

the workstation. The claimant can push/pull to

the weights previously given. The claimant can

occasionally climb, balance, kneel, stoop, crouch - . :

and crawl, but never climb ladders, ropes or

scaffolds. The claimant must avoid concentrated

exposure to hazardous machinery and unprotected

heights. .

(Tr. 651).

The law judge found that the plaintiff was unable to perform

any past relevant work (Tr. 658). However, based on the testimony of a

vocational expert, the law judge determined that there are jobs that exist in

significant numbers in the national economy that the claimant can perform,

such as customer service clerk, cashier II, ticket seller, and office helper (Tr.

659). Consequently, the law judge decided that the plaintiff was not

disabled from April 4, 2011, through April 4, 2018, the date of the decision

(Tr. 660). The Appeals Council denied review, so that the law judge’s

decision became the final decision of the Commissioner.

I.

In order to be entitled to supplemental security income, a

claimant must be unable “to engage in any substantial gainful activity by

reason of any medically determinable physical or mental impairment which

... has lasted or can be expected to last for a continuous period of not less

than twelve months.” 42 U.S.C. 1382c(a)(3)(A). A “physical or mental

impairment,” under the terms of the Social Security Act, is one “that results

from anatomical, physiological, or psychological abnormalities which are

demonstrable by medically acceptable clinical and laboratory diagnostic

techniques.” 42 U.S.C. 1382c(a)(3)(D).

A determination by the Commissioner that a claimant is not

disabled must be upheld if it is supported by substantial evidence. 42

U.S.C. 405(g). Substantial evidence is “such relevant evidence as a

reasonable mind might accept as adequate to support a conclusion.”

Richardson v. Perales, 402 U.S. 389, 401 (1971), quoting Conolidated

Edison Co. v. NLRB, 305 U.S. 197, 229 (1938). Under the substantial

evidence test, “findings of fact made by administrative agencies ... may be

reversed ... only when the record compels a reversal; the mere fact that the

record may support a contrary conclusion is not enough to justify a reversal

of the administrative findings.” Adefemi v. Ashcroft, 386 F.3d 1022, 1027

(11th Cir. 2004) (en banc).

It is, moreover, the function of the Commissioner, and not the

courts, to resolve conflicts in the evidence and to assess the credibility of the

witnesses. Grant v. Richardson, 445 F.2d 656 (Sth Cir. 1971). Similarly,

it is the responsibility of the Commissioner to draw inferences from the

evidence, and those inferences are not to be overturned if they are supported

by substantial evidence. Celebrezze v. O’Brient, 323 F.2d 989, 990 (Sth

Cir. 1963).

Therefore, in determining whether the Commissioner’s

decision is supported by substantial evidence, the court is not to reweigh the

evidence, but is limited to determining whether the record as a whole

contains sufficient evidence to permit a reasonable mind to conclude that the

claimant is not disabled. However, the court, in its review, must satisfy

itself that the proper legal standards were applied and legal requirements

were met. Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988). .

HI.

The plaintiffs sole argument is that the law judge failed to give

controlling weight to the opinions of her treating neurologist, Dr. John

5

Amann (Doc. 24), The contention is baseless because the law judge stated

good cause for discounting those opinions.

Under the regulations applicable to this case, opinions from

treating physicians are entitled to substantial or considerable weight =

there is good cause for not according them such weight. Phillips v.

Barnhart, 357 F.3d 1232, 1240 (11th Cir. 2004). Good cause exists

the treating physician’s opinion is not bolstered by the widened the

evidence supports a contrary finding, or the opinion is sonctusly or

inconsistent with the physician’s own medical records. Lewis «Catlnan

125 F.3d 1436, 1440 (11th Cir. 1997). The court “will not second Jess

the ALJ about the weight the treating physician's opinion deserves so long

as he articulates a specific justification for it.” Hunter v. Social Security

Administration, Commissioner, 808 F.3d 818, 823 (1 1th Cir. 2015).

In January 2012, and January 2013, Dr. Amann com leted

Residual Functional Capacity Questionnaires in which he essentially i

that the plaintiff is disabled from working (“Questionnaires”) (Tr. 7s

619-20). The Questionnaires are in a conclusory format, .so that most of

Dr. Amann’s opinions are indicated by marks in boxes that correspon with

the opined degree of limitation for each physical function.

Dr. Amann opined in the January 2012 Questionnaire that, due

to cervical disc disease and cervical radiculopathy, the plaintiff could not sit

for more than three hours in an eight-hour workday, she needs a five-minute

break every 15 minutes, can never lift 10 or more pounds, and would be

absent from work more than four times per month (Tr. 537-38). He opined

that the plaintiff's ability to reach and manipulate objects was reduced, but

did not quantify that limitation (Tr. 538). Dr. Amann did not respond to

questions regarding the plaintiff's prognosis or the length of time the plaintiff

could stand/walk (Tr. 537).

The law judge acknowledged Dr. Amann’s opinion of the

plaintiff's functioning and stated (Tr. 655-56):

Pursuant to the Appeal Council’s directive, the

undersigned gave great consideration to the

opinions of Dr. Amann. The undersigned affords 2

moderate weight to Dr. Amann’s assessment dated

January 2012 (Exh.B12F). Dr.Amannsupposed | □

that the claimant could sit for up to thirty minutes =|

at a time for about three hours in an eight-hour day.

He did not indicate how long the claimant could

stand or walk. He indicated that it was “hard to

quantify” how long the claimant could use her *©- |

hands, fingers and arms. He supposed that the

claimant could occasionally lift and carry less than

ten pounds. Dr. Amann is a treating specialist.

However, this assessment is of limited value since

it does not address the claimant’s ability to stand, □

walk, reach or perform fine and_ gross :

manipulations. He did not offer a prognosis and

did not provide a supporting narrative. Dr. ‘

Amann issued this opinion only eight weeks after

the claimant’s cervical fusion. Thus, this

assessment reasonably reflects a very time-limited

set of restrictions. This opinion is not consistent . .

with clinical findings around the date of the □□

assessment. In September 2011, Dr. Varas found

no significant limitations. After the claimant’s

cervical surgery, treatment records in December

2011 and January 2012 indicate that the claimant - -

was recovering well from her surgery. In March . |

2012, Dr. Amann noted that the claimant had

continued pain, but she declined a cervical

epidural injection. She did not seek treatment .

again until October 2012. At this appointment, the ~~

claimant complained only of numbness, not neck

pain. She reported some tenderness in her

cervical spine, but her range of motion in her neck

was full.

The law judge’s reasoning states good cause for eye Dr.

Amann’s opinion of disabling limitations in the 2012 Questionnaire, and it

is supported by substantial evidence.

Thus, the law judge correctly states that Dr. Amann | not

provide a meaningful explanation for his opinion of extreme Hnlttons

which, in itself, is a recognized basis for discounting the opinions the

Questionnaire. See 20 C.F.R. 416.927(c)(3) (“The better an explanation a

source provides for an opinion, the more weight we will give that opinion.”

Lewis v. Callahan, supra, 125 F.3d at 1440; Johns v. Bowen, 821 F.2d 551,

555 (11th Cir. 1987); see, e.g., Brown v. Commissioner of Social Security,

442 Fed. Appx. 507, 512 (11th Cir. 2011) (The law judge stated good ase

to not give controlling weight to the treating physician’s opinions oe in

forms which did not reference his treatment records or adequately explain

his opinions.); Burgin v. Commissioner of Social Security, 420 Fed. | oe

901, 903 (11th Cir. 2011).

As indicated, Dr. Amann’s opinions consist primarily of marks

in boxes. Although Dr. Amann identifies two diagnoses, they do not sect

Dr. Amann’s opined extreme limitations because “[t]he mere existence|of an

impairment does not reveal the extent to which it limits a claimant's ility

to work ....” Robinson v. Astrue, 365 Fed. Appx. 993, 995 (11th Cir.

2010), citing Moore v. Barnhart, 405 F.3d 1208, 1213 n.6 (11th Cir. sos)

see also McCruter v. Bowen, 791 F.2d 1544, 1547 (11th Cir. 1986)|(The

physician needs to translate how abnormal clinical findings affect work

functioning.). Thus, cervical disc disease and cervical radiculopathy can

vary greatly in degree, and are not necessarily disabling. Consequently the

law judge did not err in discounting the 2012 Questionnaire vecdiusl it is

conclusory.

9

Furthermore, the law judge reviewed the objective medical

evidence and could reasonably conclude that, while the plaintifP’s

impairments cause substantial functional limitations, they do not support Dr.

Amann’s opinions of disabling physical dysfunction. See 20 C.F.R.

416.929(c)(2) (“Objective medical evidence ... is a useful indicator to assist

us in making reasonable conclusions about the intensity and persistence of

symptoms and the effect those symptoms ... may have on [a plaintiff's]

ability to work ....”); Barclay v. Commissioner of Social Security

Administration, 274 Fed. Appx. 738, 741 (11th Cir. 2008) (lack of

supporting medical records may be considered in rejecting the treating

physician’s opinion); see, e.g., Grant v. Social Security Administration

Commissioner, 710 Fed. Appx. 426 (11th Cir. 2018) (noting normal clinical

findings, such as normal gait, range of motion and muscle strength, were

inconsistent with an opinion of disabling functional limitations). —

Thus, the law judge found that the 2012 Questionnaire

responses are “not consistent with clinical findings around the date of this

assessment” (Tr. 656). Specifically, the law judge discussed that

consultative examiner Dr. Ricardo Varas, who conducted a detailed physical

examination of the plaintiff in September 2011, did not identify any

10

significant limitations (id.). The law judge summarized Dr. Varas’s

findings (Tr. 653):

The claimant was able to get on and off the table

and in and out of a chair with no apparent

difficulty. The claimant was also able to tie and

untie her shoes with no problems. Her gait and

extremities were normal. She had normal range

of motion in her elbows, forearms, wrists

shoulders. Her cervical spine was within normal

limits. Her lumbar examination was normal with

the exception of some mild paraspinal muscle |

tenderness. The claimant’s hips, knees and

ankle[s] appeared normal. She had negative :

straight leg raise tests. She was able to walk on

her heels and able to squat. Neurological

findings were completely within normal limits... .

Although Dr. Varas formed a final impression of !

chronic lower back pain with scoliosis with

radiculopathy, he simultaneously noted that the

claimant’s musculoskeletal exam was only mildly

abnormal on her lower back with some decreased .

monofilament perception on her feet.

Furthermore, the law judge noted, after the plaintiff had cervical

surgery in November 2011, Dr. Amann stated that the plaintiff was

recovering well from her surgery (Tr. 656). Specifically, Dr. Amann

reported in December 2011 that the plaintiff was

making reasonable recovery from cervical !

surgery. Her arm symptoms have resolved.

She has stiffness in the neck but no severe pain. ... 2

She is ready to begin some range of motion °-

exercises ...

11

.

(Tr. 546). Additionally, during a physical examination in a, the

plaintiff's neurological and extremities systems were normal (Tr. 635).

Moreover, the law judge noted, despite Dr. Amann’s highly-restrictive

assessment of Plaintiffs cervical symptoms, several months passed before

the plaintiff followed up with Dr. Amann, at which time the plaintiff reported

some tenderness in her cervical spine, but she did not complain of rieck pain

and she had a full range of motion in her neck (Tr. 656). The law judge

elaborated (Tr. 653):

the claimant’s gait appeared normal. There were

no signs of atrophy. The claimant had some

decreased sensation in her fingers, hand and foot.

She had full strength in her upper extremity,

except for in the interossei. She had a positive

Phalen’s test. She had no sensory loss and no

motor weakness. Her coordination was intact.

Her fine motor skills were normal. .

In sum, substantial evidence supports the law judge's finding

that, while the plaintiff's impairments impose some functional limitations,

the medical records fail to reveal the type of significant abnormalities one

would expect if the claimant were in fact disabled. See Barclay Vv.

Commissioner of Social Security Administration, supra, 274 Fed. Appx. at

740.

12

The plaintiff argues that the “reasoning used by the ALJ not □

giving more weight to Dr. Amann’s opinions was ... not supported by the

evidence” (Doc. 24, p. 18). The arguments are meritless.

The plaintiff objects to the law judge’s finding that the 2012

Questionnaire was of “limited value” (id., p. 19). She argues that, “just

because Dr. Amann did not opine limitations for all work function, debe not

mean that the limitations he did opine could be ignored” (id.). .

Initially, the plaintiff fails to acknowledge that the law judge

also stated that the 2012 Questionnaire was of limited value because Dr.

Amann did not state the plaintiff's prognosis and that he failed to. provide a

supporting narrative for his opinion of extreme limitations. The law pes

could reasonably find that these circumstances undermine the probative

value of the 2012 Questionnaire.

Furthermore, the plaintiff's contention that the law

“ignored” the 2012 Questionnaire is frivolous (see Tr. 655-56). ‘The law

judge not only stated that he gave it “great consideration,” it is ore that

the law judge considered the 2012 Questionnaire on its merits, as he

explained that the extreme limitations therein were inconsistent wit the

13

clinical findings during that time period, and cited examples of such clinical

findings (Tr. 656). 7.

In fact, the plaintiff quibbles with the law judge’s citation to

some of those normal examination findings (Doc. 24, pp. 19-20).

Specifically, the plaintiff objects to the law judge mentioning consultative

examiner Dr. Varas’ normal examination findings, arguing that “Dr. Amann

and others did find significant limitations during that same time period” (id.,

p. 19). In this regard, the plaintiff recounts clinical abnormalities, such as

spinal tenderness and reduced range of motion, and identifies MRI and X-

ray abnormalities (id., pp. 19-21).

The plaintiff's argument misapprehends the standard of judicial

review, which is very deferential to the law judge. Thus, the court is not to

reweigh the evidence, but is limited to determining whether the record as a

whole contains sufficient evidence to permit a reasonable mind to conclude

that the claimant is not disabled. Bloodsworth v. Heckler, 703 F.2d 1233,

1239 (11th Cir. 1983); Lawton v. Commissioner of Social Security, 43 Fed.

Appx. 830, 833 (11th Cir. 2011) (“While the record does contain some

evidence that is contrary to the ALJ’s determination, we are not permitted to

reweigh the importance attributed to the medical evidence.”). Therefore,

14

upon judicial review, it is insufficient to identify evidence that is consistent

with, or supports, disability; the evidence must compel that conclusion.

See Adefemi v. Ashcroft, supra, 386 F.3d at 1027 (“findings of fact ... may

be reversed ... only when the record compels a reversal”).

Here, the law judge acknowledged the plaintiff's clinical and

imaging abnormalities (Tr. 652-656). However, he disagreed that,

considering the evidence in its totality, the objective findings supported

disabling limitations (see Tr. 655). That determination is supported by

substantial evidence, as the law judge identifies numerous clinical findings

that were normal or near normal (see Tr. 652-656). The law judge noted,

for example, that the claimant consistently displayed normal motor strength,

balance, gait and fine motor skills, and that records from her primary care

physician (Jay Care) indicate generally normal examinations, with

unremarkable extremities and no neurological deficits (Tr. 654-55): See,

e.g., Lustgarten v. Commissioner of Social Security, 794 Fed. Appx, 843,

846 (11th Cir. 2019) (the law judge reasonably considered in rejecting the

treating physician’s opinion of disabling limitations that the plaintiff had a

normal range of motion in her arms and legs, normal motor strength and

sensory responses, walked with a steady gait, and had no swelling in the feet

15 .

and lower legs).

Under these circumstances, the plaintiff's identification of

some evidence that could support a finding of disability is insufi ent

Adefemi v. Ashcroft, supra, 386 F.3d at 1027 (“[T]he mere fact L the

record may support a contrary conclusion is not enough to justify a sve

of the administrative findings.”). Thus, the plaintiff's disagreeme | with

the law judge essentially is a difference of opinion as to the wi to be

given to certain circumstances. The law judge, however, is given the

responsibility to assess those circumstances so that the plaintiff's di ren

opinion must yield. Graham v. Bowen, 790 F.2d 1572, 1575 (11th cn

(“The weighing of evidence is a function of the factfinder, not of the pe □

court.”); Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005) ee

is given to the law judge’s decision if it is supported by substantial evidence

even though the evidence may preponderate against it).

The plaintiff also cites to her subjective complaints to “pecs

that her pain was “incapacitating,” and that she could not hold things in her

hands for more than a few seconds without her hands falling asleep on

24, pp. 20-21). The law judge, however, found that the viatlaer S

subjective complaints were not fully credible (Tr. 652). That wet

determination is unchallenged. Therefore, the law judge was not required

to accept uncritically the plaintiffs complaints of debilitating pain and

limitations in determining the weight given to the 2012 Questionnaire. See,

e.g., Majkut v. Commissioner of Social Security, 394 Fed. Appx: 660, 664

(11th Cir. 2010) (law judge did not have to accept the opinion of a rrhating

physician based upon the plaintiffs subjective complaints when the plaintiff

was not fully credible).

Finally, the plaintiff argues that the “reasoning used by the ALJ

for not giving more weight to Dr. Amann’s opinions [in the 2012

Questionnaire] was ... contrary to this Court’s previous decision” (Doc. 24,

p. 18). This argument focuses on the law judge’s comment. that “Dr.

Amann issued this opinion only eight weeks after the claimant’s cervical

fusion. Thus, this assessment reasonably reflects a very time-linnited set of

restrictions” (Tr. 656).

The plaintiff argues that the court’s Order remanding this case

precludes the law judge from concluding that Dr. Amann’s opined

limitations were temporary on the ground that they were given shortly after

surgery (Doc. 24, p. 18; see Tr. 682-83). The plaintiff takes the court’s

comments out of context.

17

The court stated about the prior law judge’s decision (Tr. 682):

In according this opinion [Dr. Amann’s 2012 -:.

Questionnaire] “little weight,” the ALJ simply =~

stated that Plaintiff had neck surgery in November

2011 and Dr. Amann’s opinion “reflects post-

surgical precautions more than anything.” .

... Dr. Amann’s records show that despite

surgery, Plaintiff continued to have numbness and

pain in her hands and feet, thus undercutting the

ALJ’s speculation that they were limitations .

related to surgery. Accordingly, the ALJ failed — |

. one

to articulate good cause for not fully crediting Dr.

Amann’s January 2012 opinion.

Here, the law judge does not merely speculate that the pone

in the 2012 Questionnaire were temporary solely based on the vapor

connection to the plaintiff's surgery. Rather, the law judge explains that

those limitations are also reasonably considered temporary because Dr.

Amann did not provide a prognosis indicating that they were permanent (nor

did Dr. Amann opine in the Questionnaire that they were permanent

limitations), and the law judge identified post-surgery medical findings and

treatment that are inconsistent with such a conclusion.’ Theréfore, this

argument fails.

4Consequently, even if the temporal proximity factor were excluded, there is no

reason to think that the law judge would have found that the opined limitations were

permanent. See Stultz v. Commissioner of Social Security, 628 Fed. Appx. 665, 669 n.4

(11th Cir. 2015) (error in assessing medical opinion not reversible error when) other

18

.

The plaintiff argues further that the court directed in the prior

decision that the law judge may not conclude that the “clinical findings do

not support Dr. Amann’s opinions” (Doc. 24, pp. 18-19). | It is

unreasonable to suggest that the court would direct the law judge to disregard

medical evidence that is inconsistent with a physician’s opinion, and there is

no comment by the court that remotely suggests that.

In sum, the plaintiff's challenges do not show that the law judge

erred in discounting the weight given to Dr. Amann’s responses in the 2012

Questionnaire.

B. The plaintiff also challenges the law judge’s decision to

discount Dr. Amann’s opinions in the J anuary 2013 Questionnaire (Tr. 619—

20). The 2013 Questionnaire includes extraordinary limitations, that the

plaintiff could sit for no more than five minutes at a time and one hour total

in a workday, and that she could not lift or carry any weight (Tr. 619). Dr.

Amann attributed these limitations due to neuropathy and “possible” cervical

radiculopathy (id.).

reasons are sufficient); Diorio v. Heckler, 721 F.2d 726, 728 (11th Cir. 1983), :

19

The law judge discussed, in detail, his reasons for reducing the

weight given this opinion (Tr. 656):

The undersigned affords some weight to Dr.

Amann[’]s opinion dated January 2013. (Exh.

B17F). Dr. Amann is a treating specialist. .

However, this assessment reveals more extreme : |

limitation[s] than his prior assessment. Dr.

Amann indicated that the claimant could sit for no

more than five minutes at a time and no more than

one hour total out of an eight hour day. He °. |

opined that the claimant could never lift any =

weight. He also reported that the claimant had

significant limitation in using her hands, fingers :

and arms. Even the claimant testified that she |

could sit for ten to fifteen minutes before needing

to change positions. The claimant also testified

that she could hold a five pound [bag] of sugar

with at least one hand. Thus, Dr. Amann’s

assessment is more extreme than the claimant’s

own allegations. Dr. Amann’s opinion is also

contrary to his findings upon examinations

surrounding the date of his assessment. In July .

2013, PA Bacheldor, who worked in the same

office as Dr. Amann, noted that the claimant’s © -

physical examination was normal except for

tenderness in her lower lumbar area along with a

straight leg raise. The claimant had normal

balance, no sensory loss, no motor weakness and

normal fine motor © skills. Likewise, —

examinations performed by Dr. Jarquin in January,

February and March 2013 indicated that the

claimant had limited range of motion, but no

muscle weakness and no neurological deficits.

Only a few months prior to this opinion, Dr. Varas

noted that the claimant’s musculoskeletal exam

was only mildly abnormal on her lower back with

20

some decreased monofilament perception on her

feet. Additionally, Dr. Amann failed to offer a

persuasive narrative supporting his conclusions.

While he noted the claimant’s diagnosis, this alone

does not explain the claimant’s supposed

limitations, especially when clinical findings tend :

to negate them. Furthermore, this opinion was :

prior to the claimant’s surgery in October 2013,

which should have alleviated her symptoms to. .

some degree. Finally, Dr. Amann’s assessments

are both contrary to the claimant’s ability to drive,

walk her dogs and shop for groceries.

Specifically, the claimant’s inability to lift any

amount of weight in particular would seem to -.

preclude these activities.

The law judge clearly states ample good cause for discounting

Dr. Amann’s extreme opinions, and those reasons are supported by

substantial evidence. See Lewis v. Callahan, supra, 125 F.3d at 1440.

Initially, it is noted that, similar to the 2012 Questionnaire, Dr.

Amann’s opinions in the 2013 Questionnaire are wholly conclusory. As

indicated, this deficiency itself states good cause for discounting the 2013

Questionnaire. See id. The failure to state a meaningful explanation for

the Questionnaire responses is especially important considering the

extremity of the opined limitations and that Dr. Amann had not treated the

plaintiff for several months before completing that Questionnaire.

21

Furthermore, as the law judge noted, “Dr. Amann’s opinion is

also contrary to his findings upon examinations surrounding the date of his

assessment” (Tr. 656). See 20 C.F.R. 416.929(c)(2); Belle v. Barnhart, 129

Fed, Appx. 558, 560 (11th Cir. 2005) (normal findings on examination are

relevant to whether the plaintiff's allegations of debilitating impairments are

credible). For example, the law judge pointed out that, “[i]n july 2013, PA

Bacheldor, who worked in the same office as Dr. Amann, noted that the

claimant’s physical examination was normal except for waack her

lower lumbar area along with a straight leg raise” (Tr. 656). F urthermore,

the law judge detailed that, at the appointment, the plaintiff demonstrated

normal balance, no sensory loss, no motor weakness and normal fine motor

skills (id.). Similarly, treatment notes from Dr. Amann’s office in August

2013 showed that, although the plaintiff had tenderness in her spine and pain

on bending and twisting, she had normal fine motor skills, no motor

weakness, no sensory loss, intact balance, gait and coordination (Tr. 1155—

56). Therefore, as the defendant argues, “the significant limitations Dr.

Amann indicated in the 2013 RFC questionnaire did not match his

physician’s assistant’s subsequent clinical observations a few months later

and so the ALJ was authorized to assign it only some weight” (Doc. 25, p.

22

16). See, e.g., Scott v. Colvin, 652 Fed. Appx. 778, 780 (11th Cir, 2016)

(good cause to reject physician’s opinions that are inconsistent with own

medical records).

Additionally, the law judge noted that contemporaneous

clinical findings by treating physician Dr. Alvaro Jarquin in

February, and March 2013 are inconsistent with debilitating pions

specifying that, although treatment notes “indicated that [she] had rs

range of motion ... [there was] no muscle weakness and no neurological

deficits” (Tr. 656).

Moreover, the law judge noted that the “significant gaps P [the

plaintiff's] treatment” are inconsistent with Dr. Amann’s Pay n of

disabling limitations. See 20 CFR. 416.927(c)(2)(i) (frequency of

examination is a consideration in determining the weight to give a

physician’s opinion).

The law judge explained (Tr. 655) (emphasis added):

[T]he claimant sought no neurological [treatment] . :

from after her laminectomy in October 2013 until

after her motor vehicle accident in June 2016. She

also had no treatment at all from May 2014 to

December 2015. Given the plethora of records *

before and after these dates, this total absence of

treatment strongly suggests that the claimant was

doing well in this period.

23

In sum, substantial evidence clearly supports the law judge’s

determination that Dr. Amann’s opinion of extreme and marked limitations

in the 2013 Questionnaire is not supported by his treatment notes or the

medical record as a whole and, therefore, the law judge reasonably found the

opinions therein unpersuasive. See Lewis v. Callahan, supra; Barclay v.

Commissioner of Social Security, Supra, 274 Fed. Appx. at 740 cle of

supporting medical records may be considered in rejecting the ‘penne

physician’s opinion); Crawford v. Commissioner of Social Security, 363

F.3d 1155, 1159 (11th Cir. 2004) (treating physician’s report snley be

discounted when it is not accompanied by objective medical video or is

wholly conclusory”).

Finally, the law judge discussed that the plaintiff enga ed in

activities of daily living that were inconsistent with the extreme limitations

in the 2013 Questionnaire, which also states good cause for socolming

those opinions. See Jarrett v. Commissioner of Social Security, a Fed.

Appx. 869, 873 (11th Cir. 2011) (“We have held that an ALJ does need

to give a treating physician’s opinion considerable weight if evidence of the

claimant’s daily activities contradicts the opinion.”); Crow v. commiss one

Social Security Administration, 571 Fed. Appx. 802, 806-07 (11th Cir.

2014) (evidence of the plaintiff's daily activities provided good cause to

discount the treating physician's opinion); Forrester v. Commissioner of

Social Security, 455 Fed. Appx. 899, 902 (11th Cir. 2012) (The law judge

does not need to give a treating physician’s opinion considerable weight if

evidence of the claimant's daily activities contradict the opinion.).

The law judge discussed that, “[a]t various times during the

disability process, the claimant acknowledged that she can drive, prepare

quick meals, perform some housecleaning, walk her dogs, shop for groceries _

... [and] visit with friends...” (Tr. 652; see also Tr. 650, 655). Therefore,

the law judge could reasonably find that the plaintiff's activities are

inconsistent with Dr. Amann’s opinions of extreme functional imittons

The plaintiff argues that the law judge’s reasoning does not

state good cause for discounting the 2013 Questionnaire. The conte ho is

meritless.

The plaintiff asserts that the law judge’s comment that the

plaintiff's laminectomy likely “alleviated her symptoms to some degree” is

“[not] justification for failing to give the treating neurosurgeon’s opinion full

weight” (Doc. 24, p. 22). Specifically, the plaintiff contends that,

[i]f she did improve sometime after her recovery .

from the lumbar surgery in October of 2013, the

25 -

ALJ still needed to assess whether Dr. Amann’s

opinions would need to be given controlling or

great weight for that time period up to the

improvement after the 2013 surgery. Rejecting

Dr. Amann’s opinions outright due to

improvement some two and a half years after the

onset of disability was not appropriate.

(id.). This contention is frivolous. The law judge’s lengthy =_

for discounting the extreme opinions show that he did not reject Dr. Ariens

opinions “outright” due to post-surgical improvement (see Tr. 656). In

fact, the law judge noted many normal clinical findings before shepla tiff’s

laminectomy in explaining why he discounted the extreme limitations iin the

2013 Questionnaire (id.).

The plaintiff also quibbles with the law judge’s finding at she

testified to greater functional capabilities than opined by Dr. Amann (Doc.

24,p.22). Specifically, the plaintiff contends that the differences between

them are slight and, therefore, the “ALJ is trying to make an inconsistency

where none exists” (id.).

The plaintiff is referring to the following discussion by the law

judge (Tr. 656):

Dr. Amann indicated that the claimant could sit for

no more than five minutes at a time and no more

than one hour total out of an eight hour day. He

opined that the claimant could never lift any -.

26

weight. He also reported that the claimant had_ - :

Significant limitation in using her hands, fingers i

and arms. Even the claimant testified that she

could sit for ten to fifteen minutes before needing

to change positions. The claimant also testified

that she could hold a five pound[ bag] of sugar

with at least one hand. Thus, Dr. Amann’s

assessment is more extreme than the claimant’s

own allegations.

The plaintiff argues that her testimony that she would need to

change positions after 10-15 minutes is not significantly different from Dr.

Amann’s opinion that a change would be necessary every 5 minutes.. This

is not an insignificant difference; in all events, the law judge’s point is that

Dr. Amann’s assessment is more extreme than the plaintiffs own

exaggerated allegations, and there is ample record support for that

conclusion. In addition to the examples above, the law judge identifies

several activities of daily living that contradict Dr. Amann’s opinions of the

plaintiff's functional limitations (see Tr. 656) (stating that Dr. Amann’s

“assessments are both contrary to the claimant’s ability to drive; walk her

dogs and shop for groceries. [T]he claimant’s inability to lift any amount

of weight in particular would seem to preclude these activities.”).| See

Magill v. Commissioner of Social Security, 147 Fed. Appx. 92, 94 (1 I Cir.

2005), citing Phillips v. Barnhart, 357 F.3d 1232, 1240-41 (11th Cir. 004)

27

(“[A]n ALJ need not give a treating physician’s opinion considerable weight

if the applicant's own testimony regarding her daily activities contradicts that

opinion.”).

Moreover, it is noted that, in F ebruary 2013, one month after

Dr. Amann completed the 2013 Questionnaire, the plaintiff testified before

an administrative law judge in this case that she could sit for 20-30 minutes

at a time; that she uses a computer “[o]ff and on” during the day, ala that

she has no problem driving to her brother’s home 15-20 minutes away (Tr.

99, 102-03). Therefore, this challenge to the law judge’s decision fails.

Finally, the plaintiff argues that injuries she sustained in 2014,

when she fell down a flight of stairs, and in 2016, when she was a pedestrian

hit by a car, “continued to support Dr. Amann’s opinion of her work

limitations” (Doc. 24, p. 24). This contention is also meritless. -

Initially, the plaintiff does not explain how medical findings

related to these accidents show that Dr. Amann’s opinions were supported

by objective medical evidence at the time they were given. Since the

accidents occurred years after Dr. Amann completed the ci

those medical findings could not have been the basis for his opinions (see

also Tr. 655 (the law judge found that the plaintiff was doing well before the

28

accidents)). Therefore, they do not undermine the law judge’s finding that

Dr. Amann did not provide adequate objective medical evidence to

his opinions of extreme limitations. See 20 C.F.R. 416.927 (c)(3) (“The

more a medical source presents relevant evidence to support [his] medical

opinion .... The more weight we will give that opinion.”). Arguably, the

plaintiff's citation to such evidence underscores the lack of objective medical

findings supporting Dr. Amann’s opinions.

Furthermore, there is ample medical evidence generated after

these accidents that is inconsistent with debilitating functional limitations.

Thus, in July 2015, the plaintiff underwent an examination with con sultant

Dr. Edwin Lamm, who found that the plaintiff's cervical spine was i

normal limits,” and that other examination findings were mostly normal (Tr.

1389). Dr. Lamm opined that there is “no evidence of physical limitations

that would prevent her from finding some kind of employment”, (id.).

Notably, the plaintiff told consultative psychologist Maria Jimenez that she

walks without assistance, prepares meals on her own, drives independently,

and is independent in her personal care (Tr. 1393).

On June 25, 2016, the plaintiff was examined at a hospital after

she was hit from behind by a slow-moving vehicle (Tr. 15 16-17, “y

29 !

The plaintiff had been walking home from a friend’s house (Tr. 1828). The

plaintiff exhibited normal ranges of motion in her back and musculoskeletal

systems, and her neurological functioning was normal (Tr. 1674). . She was

discharged that day with diagnoses of lacerations and contusions (Tr. 1673).

The following month, an examination showed that the plaintiff had a normal

gait; normal ranges of motion in the back and musculoskeletal stems and

normal sensation, strength, and pulses in the bilateral extremities (Tr. 1631-

32).

In February 2017, a physical examination showed that the

plaintiff had normal range of motion in her musculoskeletal system, normal

strength, non-tender back, no neck abnormalities, normal motor functioning,

and no focal neurological deficits (Tr. 1576-77). Additionally, in| May

2017, the plaintiff exhibited normal strength, normal gait, normal pulses, full

range of motion of all joints, no focal neurological deficits, and no

extremities abnormalities (Tr. 1896, 1900-01).

In sum, the law judge stated good cause for discounting Dr.

Amann’s opinion of debilitating functional limitations in the 2013

Questionnaire, and that determination is supported by substantial evidence.

Sée Hargress v. Social Security Administration, Commissioner, supra, 883

30

F.3d at 1302, 1305 (11th Cir. 2018); Lewis v. Callahan, supra, 125 F.3d at

1440 (“Substantial evidence is more than a scintilla and is such. relevant

evidence as a reasonable person would accept as adequate to support a

conclusion.”).

While the plaintiff identified some evidence of abnormalities,

they did not compel the law judge to find her disabled, especially considering

the contrary medical evidence. See Adefemi v. Ashcrofi, supa, 386 F.3d

at 1027 (“findings of fact ... may be reversed ... only when the record

compels a reversal”).

It is, therefore, upon consideration,

ORDERED: 4.

That the Commissioner’s decision is hereby AFFIRMED

The Clerk shall enter judgment in accordance with this Order and CLOSE

this case.

DONE and ORDERED at Tampa, Florida, this 1g day of

September, 2021. ;

THOMAS G. WILSON .

UNITED STATES MAGISTRATE JUDGE

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