Grisales v. Commissioner of Social Security

UNITED STATES DISTRICT COURT

MIDDLE DISTRICT OF FLORIDA

TAMPA DIVISION

REGINA GRISALES,

Plaintiff,

v. Case No. 8:22-cv-112-MAP

COMMISSIONER OF SOCIAL SECURITY

Defendant.

/

ORDER

Plaintiff seeks judicial review of the denial of her claim for disability insurance

benefits (DIB).1 Plaintiff argues that the Administrative Law Judge (ALJ) committed

reversible error by concluding that Plaintiff’s mental health impairments were non-

severe impairments. As the ALJ’s decision was based on substantial evidence and

employed proper legal standards, the Commissioner’s decision is affirmed.

I. Background

Plaintiff, who was born in 1965, claimed disability beginning January 25, 2016,

which she later amended to November 11, 2019 (Tr. 36, 211). She was 53 years old

on the amended alleged onset date. Plaintiff completed four or more years of college,

earning a bachelor’s degree and a master’s degree, and her past relevant work

experience included work as a brand manager in marketing, a director of admissions,

1 The parties have consented to my jurisdiction. See 28 U.S.C. § 636(c).

and a vice president of marketing (Tr. 37-38, 58-59, 232). Plaintiff alleged disability

due to major depressive disorder; anxiety; post-traumatic stress disorder (PTSD);

difficulty with absorbing new information, concentrating, gathering thoughts, and

remembering information; suicidal thoughts; back problems; scoliosis pain;

degenerative disc disease; arthrosis in her joints; bone density loss; and an inability to

cope with stress and obligations (Tr. 231).

Given her alleged disability, Plaintiff filed an application for DIB (Tr. 211-14).

The Social Security Administration (SSA) denied Plaintiff’s claims both initially and

upon reconsideration (Tr. 65-110, 120-39). Plaintiff then requested an administrative

hearing (Tr. 145-48). Per Plaintiff’s request, the ALJ held a telephonic hearing at

which Plaintiff appeared and testified (Tr. 31-64). Following the hearing, the ALJ

issued an unfavorable decision finding Plaintiff not disabled and accordingly denied

Plaintiff’s claims for benefits (Tr. 7-25).

In rendering the administrative decision, the ALJ concluded that Plaintiff met

the insured status requirements through December 31, 2021, and had not engaged in

substantial gainful activity since January 25, 2016, the original alleged onset date (Tr.

12).2 After conducting a hearing and reviewing the evidence of record, the ALJ

determined that Plaintiff had the following severe impairments: cervical and lumbar

spine disorders and generalized osteoarthritis (Tr. 12). Notably, the ALJ also

2 Although the ALJ acknowledged that Plaintiff amended her alleged onset date to November

11, 2019 (Tr. 10), the ALJ used the original alleged onset date in the analysis (Tr. 12). Neither

party takes issue with the ALJ’s finding in the decision, however.

considered Plaintiff’s mental impairments of depressive disorder, anxiety disorder, and

trauma and stressor related disorder, finding that the mental impairments, considered

singly or in combination, did not cause more than minimal limitation in Plaintiff’s

ability to perform basic mental work activities and thus were non-severe impairments

(Tr. 13). Notwithstanding the noted impairments, the ALJ determined that Plaintiff

did not have an impairment or combination of impairments that met or medically

equaled one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1

(Tr. 14).

The ALJ then concluded that Plaintiff retained a residual functional capacity

(RFC) to perform light work, except that Plaintiff could only occasionally climb or

stoop; could frequently balance, kneel, crouch, or crawl; could frequently handle and

finger bilaterally; and should avoid concentrated exposure to vibration and hazards

(Tr. 16). In formulating Plaintiff’s RFC, the ALJ considered Plaintiff’s subjective

complaints and determined that, although the evidence established the presence of

underlying impairments that reasonably could be expected to produce the symptoms

alleged, Plaintiff’s statements as to the intensity, persistence, and limiting effects of her

symptoms were not entirely consistent with the medical evidence and other evidence

(Tr. 17). Considering Plaintiff’s noted impairments and the assessment of a vocational

expert (VE), the ALJ determined that Plaintiff could perform all her past relevant

work, as generally performed, as the work did not require the performance of work-

related activities precluded by Plaintiff’s RFC (Tr. 19, 59-63). Accordingly, based on

Plaintiff’s age, education, work experience, RFC, and the testimony of the VE, the

ALJ found Plaintiff not disabled (Tr. 20). Given the ALJ’s finding, Plaintiff requested

review from the Appeals Council, which the Appeals Council denied (Tr. 1-6, 202-07).

Plaintiff then timely filed a complaint with this Court (Doc. 1). The case is now ripe

for review under 42 U.S.C. § 405(g).

II. Standard of Review

To be entitled to benefits, a claimant must be disabled, meaning the claimant

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

medically determinable physical or mental impairment which can be expected to result

in death or which has lasted or can be expected to last for a continuous period of not

less than twelve months.” 42 U.S.C. § 423(d)(1)(A). A “physical or mental

impairment” is an “impairment that results from anatomical, physiological, or

psychological abnormalities, which are demonstrable by medically acceptable clinical

and laboratory diagnostic techniques.” 42 U.S.C. § 423(d)(3).

To regularize the adjudicative process, the SSA promulgated the detailed

regulations currently in effect. These regulations establish a “sequential evaluation

process” to determine whether a claimant is disabled. 20 C.F.R. § 404.1520. If an

individual is found disabled at any point in the sequential review, further inquiry is

unnecessary. 20 C.F.R. § 404.1520(a). Under this process, the ALJ must determine,

in sequence, the following: whether the claimant is currently engaged in substantial

gainful activity; whether the claimant has a severe impairment, i.e., one that

significantly limits the ability to perform work-related functions; whether the severe

impairment meets or equals the medical criteria of 20 C.F.R. Part 404, Subpart P,

Appendix 1; and whether the claimant can perform his or her past relevant work. 20

C.F.R. § 404.1520(a)(4). If the claimant cannot perform the tasks required of his or

her prior work, step five of the evaluation requires the ALJ to decide if the claimant

can do other work in the national economy in view of his or her age, education, and

work experience. 20 C.F.R. § 404.1520(a)(4)(v). A claimant is entitled to benefits only

if unable to perform other work. Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987); 20

C.F.R. § 404.1520(g)(1).

A determination by the Commissioner that a claimant is not disabled must be

upheld if it is supported by substantial evidence and comports with applicable legal

standards. See 42 U.S.C. § 405(g). “Substantial evidence is more than a scintilla and

is such relevant evidence as a reasonable person would accept as adequate to support

a conclusion.” Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011)

(citation and internal quotation marks omitted). While the court reviews the

Commissioner’s decision with deference to the factual findings, no such deference is

given to the legal conclusions. Ingram v. Comm’r of Soc. Sec., 496 F.3d 1253, 1260 (11th

Cir. 2007) (citations omitted).

In reviewing the Commissioner’s decision, the court may not reweigh the

evidence or substitute its own judgment for that of the ALJ, even if it finds that the

evidence preponderates against the ALJ’s decision. Mitchell v. Comm’r of Soc. Sec., 771

F.3d 780, 782 (11th Cir. 2014); Winschel, 631 F.3d at 1178 (citations omitted);

Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983). The Commissioner’s

failure to apply the correct law, or to give the reviewing court sufficient reasoning for

determining that he or she has conducted the proper legal analysis, mandates reversal.

Ingram, 496 F.3d at 1260 (citation omitted). The scope of review is thus limited to

determining whether the findings of the Commissioner are supported by substantial

evidence and whether the correct legal standards were applied. 42 U.S.C. § 405(g);

Wilson v. Barnhart, 284 F.3d 1219, 1221 (11th Cir. 2002) (per curiam) (citations omitted).

III. Discussion

Plaintiff argues solely that the ALJ erred by failing to find that Plaintiff’s mental

impairments constituted severe impairments. The claimant bears the burden of

demonstrating the existence of a severe impairment or combination of impairments.

Turner v. Comm’r of Soc. Sec., 182 F. App’x 946, 948 (11th Cir. 2006) (per curiam) (citing

Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir. 1999)).3 The ALJ considers the medical

severity of a claimant’s impairments at step two of the sequential analysis. 20 C.F.R.

§ 404.1520(a)(4)(ii). Step two operates as a threshold inquiry. McDaniel v. Bowen, 800

F.2d 1026, 1031 (11th Cir. 1986); see Gray v. Comm’r of Soc. Sec., 550 F. App’x 850, 853

(11th Cir. 2013) (per curiam). At step two, a claimant must show that he or she suffers

from an impairment or combination of impairments that significantly limits his or her

physical or mental ability to do basic work activities. See 20 C.F.R. §§

404.1520(a)(4)(ii), 404.1521, 404.1522(a). Basic mental work activities include

activities such as understanding, carrying out, and remembering simple instructions;

using judgment; responding appropriately to supervision, coworkers, and usual work

3 Unpublished opinions are not considered binding precedent but may be cited as persuasive

authority. 11th Cir. R. 36-2.

situations; and dealing with changes in a routine work setting. 20 C.F.R. §

404.1522(b)(3)-(6). “An impairment is not severe only if the abnormality is so slight

and its effect so minimal that it would clearly not be expected to interfere with the

individual’s ability to work, irrespective of age, education or work experience.”

McDaniel, 800 F.2d at 1031; Brady v. Heckler, 724 F.2d 914, 920 (11th Cir. 1984) (per

curiam). “[T]he ‘severity’ of a medically ascertained disability must be measured in

terms of its effect upon ability to work, and not simply in terms of deviation from

purely medical standards of bodily perfection or normality.” McCruter v. Bowen, 791

F.2d 1544, 1547 (11th Cir. 1986). In other words, an impairment or combination of

impairments is not considered severe where it does not significantly limit the

claimant’s physical or mental ability to perform basic work activities. Turner, 182 F.

App’x at 948 (citations omitted); 20 C.F.R. § 404.1521.

Notably, however, the finding of any severe impairment, whether or not it

results from a single severe impairment or a combination or impairments that together

qualify as severe, is enough to satisfy step two. Jamison v. Bowen, 814 F.2d 585, 588

(11th Cir. 1987) (citations omitted); see Packer v. Comm’r, Soc. Sec. Admin., 542 F. App’x

890, 892 (11th Cir. 2013) (per curiam) (“[T]he ALJ determined at step two that at least

one severe impairment existed; the threshold inquiry at step two therefore was

satisfied.”); see Heatly v. Comm’r of Soc. Sec., 382 F. App’x 823, 824-25 (11th Cir. 2010)

(per curiam) (noting that an ALJ’s failure to identify an impairment as severe, where

the ALJ found that the plaintiff suffered from at least one severe impairment,

constituted harmless error and was, in fact, sufficient to meet the requirements of step

two, and additionally noting that nothing requires the ALJ to identify, at step two, all

of the impairments that could be considered severe). Here, the ALJ determined that

Plaintiff’s cervical and lumbar spine disorders and generalized osteoarthritis

constituted severe impairments (Tr. 12). Accordingly, since the ALJ determined that

Plaintiff suffered from severe impairments at step two, and thus proceeded beyond step

two in the sequential analysis, any error in failing to find that Plaintiff suffered from

other severe impairments is rendered harmless. Gray, 550 F. App’x at 853-54; Packer,

542 F. App’x at 892; Heatly, 382 F. App’x at 824-25.

Further, in considering the severity of Plaintiff’s mental impairments, the ALJ

complied with the regulations and provided substantial evidence in support of the

assessment (Tr. 13-14). Agency regulations require a “special technique” be used by

the ALJ when evaluating mental impairments, often referred to as the psychiatric

review technique. Moore v. Barnhart, 405 F.3d 1208, 1213 (11th Cir. 2005); 20 C.F.R.

§ 404.1520a. Essentially, this technique requires an assessment regarding how the

claimant’s mental impairments impact four broad functional areas: (1) understanding,

remembering, or applying information; (2) interacting with others; (3) concentrating,

persisting, or maintaining pace; and (4) adapting or managing oneself. 20 C.F.R. §

404.1520a(c)(3). In rating the degree of limitation, the SSA employs a five-point scale

in the functional areas: none, mild, moderate, marked, and extreme. 20 C.F.R. §

404.1520a(c)(4). Rating the degrees of limitation as “none” or “mild” generally results

in a conclusion that the mental impairment(s) is not severe unless the evidence

otherwise indicates that the impairment(s) causes more than a minimal limitation in

the claimant’s ability to perform basic work activities. 20 C.F.R. § 404.1520a(d)(1).

When considering a claimant’s mental impairments, the ALJ must incorporate into

the written decision the pertinent findings and conclusions based on the technique and

must make a specific finding as to the degree of limitation for each of the functional

areas. Moore, 405 F.3d at 1213-14; 20 C.F.R. § 404.1520a(e)(4).

As noted, the ALJ considered Plaintiff’s mental impairments of depressive

disorder, anxiety disorder, and trauma and stressor related disorder and concluded

that, whether considered singly or in combination, the impairments did not cause more

than minimal limitation in Plaintiff’s ability to perform basic mental work activities

and thus found the impairments non-severe (Tr. 13). In doing so, the ALJ found that

Plaintiff experienced no limitations in her ability to understand, remember, or apply

information; mild limitation in her ability to interact with others; mild limitation in

her ability to concentrate, persist, or maintain pace; and mild limitation in her ability

to adapt or manage herself (Tr. 13-14). Because the ALJ found no more than mild

limitations in any of the broad areas of functioning, the ALJ correctly determined that

Plaintiff’s mental impairments, taken either singly or in combination, did not

constitute severe impairments. See 20 C.F.R. § 404.1520a(d)(1).

In making that determination, the ALJ relied upon substantial evidence in the

record. As to Plaintiff’s ability to understand, remember, or apply information, the

ALJ acknowledged Plaintiff’s testimony regarding her anxiety causing difficulty

understanding, concentrating, and remembering but found that Plaintiff’s mental

status examinations generally showed no deficits in this area, and, despite reporting

that she had not taken any medications for her mental conditions in more than two

years, Plaintiff appeared at a consultative examination with Michelle Ayala-Feliciano,

Psy.D. alert and oriented; her expressive and receptive language was adequate; her

conversational speech was spontaneous; her thought process was logical and goal-

directed, although her thought content was characterized by cognitive distortions; her

attention and concentration were adequate with good mental flexibility, immediate

memory, recent memory, and remote memory; and her overall fund of knowledge was

adequate (Tr. 13, 414-17, 516-20, 536-56). As to Plaintiff’s ability to interact with

others, the ALJ found only a mild limitation based on Plaintiff’s statements that she

had difficulty controlling her emotions and had feelings of irritability and anxiety,

which Plaintiff indicated led to screaming, crying, and getting palpitations (Tr. 13). In

addition to those statements, however, the ALJ pointed to Plaintiff’s statements that

she generally got along with other people and the mental status examinations generally

showing no deficit in that area of functioning (Tr. 13, 414-17, 516-20, 536-56). For

example, at the consultative examination with Dr. Ayala-Feliciano, Plaintiff was alert,

oriented, and cooperative; maintained sustained eye contact and developed rapport

easily; and demonstrated adequate social skills with good abstract reasoning and

insight with fair judgment despite a sad and anxious mood with nervous affect (Tr. 13,

414-17).

In determining that Plaintiff experienced a mild limitation in her ability to

concentrate, persist, and maintain pace, the ALJ pointed to Plaintiff’s testimony that

she could not perform her past relevant work because, among other reasons, she had

difficulty concentrating and had anxiety that caused difficulty understanding and

concentrating, collecting her emotions, and remembering and because she lacked

motivation and just wanted to stay home (Tr. 13-14). The ALJ again noted that the

mental status examinations generally noted no deficit in this area of functioning,

including showing only mildly impaired attention at times and, during the consultative

examination, demonstrating adequate attention and concentration with good mental

flexibility, immediate memory, recent memory, and remote memory (Tr. 14, 414-17,

516-20, 536-56). Last, regarding Plaintiff’s ability to adapt or manage herself, the ALJ

concluded that Plaintiff experienced a mild limitation, considering Plaintiff’s

statements that she lived with her husband, could drive no longer than 20 minutes due

to drowsiness and low back pain, did laundry once per month, and, on a typical day,

would meditate, cook simple meals, watch television, help her elderly mother, and

walk for about 20 minutes (Tr. 14). As the ALJ noted, Plaintiff’s doctors suggested

that she make lifestyle changes to improve her symptoms, she was generally non-

compliant with medications, and, at the consultative examination, she was alert and

oriented, well-groomed, casually dressed, her language was adequate, her speech was

spontaneous, her overall fund of knowledge was adequate, and she had good abstract

reasoning and insight with fair judgment despite reporting that she had not taken any

medications for her mental conditions in more than two years (Tr. 14, 375-77, 414-17,

536-56). Given the ALJ’s proper application of the psychiatric review technique and

the substantial evidence she relied upon in concluding that Plaintiff did not suffer from

a severe mental impairment, the ALJ did not err at steps two and three of the sequential

analysis.

Notwithstanding, Plaintiff argues that the ALJ should not have considered

Plaintiff’s activities of daily living and non-compliance with medication as factors in

determining that Plaintiff’s mental impairment was non-severe. In determining a

Plaintiff’s RFC, the ALJ may consider evidence of the claimant’s medical history;

medical signs and laboratory findings; medical source statements; daily activities;

evidence from attempts to work; lay evidence; recorded observations; the location,

duration, frequency, and intensity of the claimant’s pain or other symptoms; the type,

dosage, effectiveness, and side effects of any medication or other treatment the

claimant takes or has taken to alleviate pain or other symptoms; treatment, other than

medication, the claimant receives or has received for relief of pain or other symptoms;

any measures the claimant uses or has used to relieve pain or symptoms; and any other

factors concerning the claimant’s functional limitations and restrictions. 20 C.F.R. §§

404.1529(c)(3)(i)-(vii), 404.1545(a)(3); Social Security Ruling (SSR) 96-8p, 1996 WL

374184 (July 2, 1996); SSR 16-3p, 2017 WL 5180304 (Oct. 25, 2017). In evaluating

and discrediting a claimant’s complaints, therefore, the ALJ may consider the

claimant’s daily activities along with several other factors. 20 C.F.R. §

404.1529(c)(3)(i); Conner v. Astrue, 415 F. App’x 992, 995 (11th Cir. 2011) (“A

claimant’s daily activities may be considered in evaluating and discrediting a

claimant’s subjective complaints”) (citation omitted); cf. Dyer v. Barnhart, 395 F.3d

1206, 1212 (“In sum, the ALJ considered Dyer’s activities of daily living, the frequency

of his symptoms, and the types and dosages of his medications, and concluded that

Dyer’s subjective complaints were inconsistent with his testimony and the medical

record. The ALJ thus adequately explained his reasons and it was reversible error for

the district court to hold otherwise.”). As Plaintiff notes, participation in everyday

activities of short duration, such as housework, will not necessarily disqualify a

claimant from disability. See Simon v. Comm’r, Soc. Sec. Admin., 7 F.4th 1094, 1108

(11th Cir. 2021) (“In our view, it goes almost without saying that many people living

with severe mental illness are capable of eating, putting on clothes in the morning, and

purchasing basic necessities. None of those activities, however, say much about

whether a person can function in a work environment—with all its pressures and

obligations—on a sustained basis.”). Notwithstanding, an ALJ is not precluded from

considering a claimant’s daily activities at all in determining disability. 20 C.F.R. §

404.1529(c)(3); Hoffman v. Astrue, 259 F. App’x 213, 219 (11th Cir. 2007) (per curiam).

In this instance, the ALJ considered Plaintiff’s testimony regarding her ability

to drive for short periods of time, meditate, cook simple meals, watch television, take

walks of short duration, do laundry monthly, and help with her elderly mother in

finding that Plaintiff experienced no more than mild limitations in the functional area

of adapting or managing herself (Tr. 14, 37, 54-55). The ALJ considered such activities

of daily living in conjunction with the doctors’ recommendations to make lifestyle

changes to improve her symptoms, her noncompliance with medications, and the

observations of Dr. Ayala-Feliciano during the consultative examination (Tr. 14, 375-

76, 379, 417, 548-54). The ALJ thus did not solely rely upon Plaintiff’s activities of

daily living in concluding that Plaintiff experienced only mild limitations in her ability

to adapt or manage herself but rather properly considered Plaintiff’s activities of daily

living along with other factors in appropriately finding that Plaintiff’s limitations in

that area of functioning were mild and that Plaintiff’s mental impairments were non-

severe.

Plaintiff also contends that the ALJ should not have considered her

noncompliance with medication since Plaintiff provided a good reason for such

noncompliance, i.e., that her medication made her drowsy and increased her restless

leg syndrome. Generally, the ALJ may consider noncompliance with treatment in

determining whether a claimant is disabled, as the failure to follow prescribed

treatment without a good reason will preclude a finding of disability. See 20 C.F.R. §

404.1530(a) & (b); Ellison v. Barnhart, 355 F.3d 1272, 1275 (11th Cir. 2003). Here, the

ALJ referred to Plaintiff’s noncompliance with medication but did not rely primarily

or even significantly upon Plaintiff’s noncompliance with medication in determining

that Plaintiff’s mental impairments were non-severe (Tr. 14). Rather, the ALJ

referenced it as one of many factors demonstrating that Plaintiff’s mental impairments

were non-severe. Even so, as the Commissioner highlights, several treatment notes

documented Plaintiff’s noncompliance or non-use of medication, including (1)

statements to Dr. Ayala-Feliciano that Plaintiff’s most recent psychoactive medication

prescribed was for Pristiq but that Plaintiff had not taken any psychoactive

medications in over two years (Tr. 417); (2) statements to Dr. Bich-Ngoc Pham that

Plaintiff had been under psychiatric care four to five years before her May 2020

appointment when she was overwhelmed with work, had been on Pristiq off and on

for the past few years, decided to retire and move, felt like most of her mood issues

were work-related, got off medications and had not had too many symptoms or issues

with any acute depressed or anxious moods and no panic attacks, and only

experienced some mild stressors and recurrent sleep issues (Tr. 379); (3) notations by

Dr. Pham in June 2020 that Plaintiff was aware that she should not be taking her

prescription sleeping pills nightly and that Plaintiff should continue with stress

modification, simplifying her life, organizing, and prioritizing to reduce tension and

anxiety (Tr. 375-76); and (4) received prescriptions for Lexapro and Vistaril in October

2020 but felt neither one was helping so stopped Lexapro in mid-November 2020 with

reported side effects (Tr. 548-49). Further, when Plaintiff reported side effects, her

medication was adjusted (see Tr. 551-54). Accordingly, the ALJ considered Plaintiff’s

noncompliance with medication as one of several factors in determining that Plaintiff’s

mental impairments were non-severe and did not interfere with her ability to perform

work activities. As indicated, therefore, the ALJ properly considered the severity of

Plaintiff’s mental impairments at steps two and three.

Beyond that, the ALJ also considered Plaintiff’s mental impairments in

assessing Plaintiff’s RFC at step four (Tr. 16-19). Indeed, although an ALJ need not

determine whether every alleged impairment is “severe” at step two, the ALJ must

consider all impairments, regardless of severity, in conjunction with one another in

performing the latter steps of the sequential evaluation. 20 C.F.R. § 404.1545; see

Tuggerson-Brown v. Comm’r of Soc. Sec., 572 F. App’x 949, 951 (11th Cir. 2014). To

begin, the ALJ discussed Plaintiff’s testimony regarding issues with her past relevant

work and mental health issues that arose (Tr. 16). As the ALJ recognized, Plaintiff

testified that she worked as a brand manager for three years, but she quit that position

due to anxiety, stress, and suicidal ideation, which led to a voluntary hospitalization

for her suicidal thoughts (Tr. 16, 39-40). Prior to that, Plaintiff worked as an

admissions director, which required a lot of marketing and travel and became too

much for her (Tr. 16, 40). In addition, Plaintiff worked as a marketing director for 11

years but left that position due to internal conflict arising from her purported role as a

whistleblower (Tr. 16, 40-42). According to Plaintiff, she could not perform any of her

past relevant work because she had trouble concentrating, she is insecure, and she

could not sit for longer than 10 minutes, type, or stand for more than 10 minutes (Tr.

16, 42-49).

The ALJ again discussed Plaintiff’s statements regarding her anxiety causing

difficulty understanding, concentrating, controlling emotions, and remembering; her

feelings of irritability and anxiousness, leading to screaming, crying, and palpitations;

her inability to sleep well; her lack of motivation and desire to stay home; and her

ability to generally get along with others (Tr. 16). The ALJ also noted that Plaintiff

was seeing a psychiatrist and taking medications for her mental health conditions and

that Plaintiff tried therapy (Tr. 16). As the ALJ stated, Plaintiff indicated that therapy

did not work for her, and Plaintiff did not feel that her medications worked for her

either and that the medications caused side effects of dryness, headaches,

stomachache, restlessness, and blurry vision (Tr. 16).

After addressing the medical evidence relating to Plaintiff’s physical

impairments, the ALJ addressed the medical opinions and prior administrative

findings relating to both Plaintiff’s mental and physical impairments (Tr. 18-19). As

the ALJ indicated, the state agency medical consultants at the initial and

reconsideration levels considered the evidence of record and found Plaintiff’s mental

impairments of depression and anxiety non-severe and concluded that Plaintiff

experienced no more than mild limitations in any of the mental areas of functioning

(Tr. 18, 65-74, 78-96). The ALJ found the state agency medical consultants’ opinions

persuasive, especially given the consistency of their opinions with the findings in the

records submitted after the issuance of their opinions (Tr. 18-19).

The ALJ also considered the consultative psychological evaluation of Dr.

Ayala-Feliciano (Tr. 414-17). Dr. Ayala-Feliciano assessed Plaintiff with persistent

depressive disorder and generalized anxiety disorder but noted that Plaintiff exhibited

no signs of significant cognitive deficits or impaired judgment and could manage her

financial affairs (Tr. 18, 417). The ALJ found Dr. Ayala-Feliciano’s opinion

persuasive as she based her opinion on a clinical interview with Plaintiff, a mental

status examination, behavioral observations, and a review of available records and

because the opinion was consistent with the other medical evidence (Tr. 19, 415-17).

The ALJ then discussed Plaintiff’s mental health treatment with Nurse

Practitioner Vickie Pose-Kerlin at Florida Behavioral Health (Tr. 19, 536-56). As the

ALJ discussed, NP Pose-Kerlin indicated that Plaintiff was intermittently impaired for

work – although she noted that Plaintiff could care for herself and perform activities

of daily living – but did not explain to what extent Plaintiff would be impaired for work

(Tr. 538, 541, 543). Later treatment notes from Plaintiff’s treatment with Linda

Gottwald, PMHNP, at Florida Behavioral Health, indicated that Plaintiff was not

impaired for work (Tr. 548, 550). Consequently, the ALJ did not find NP Pose-

Kerlin’s opinion persuasive (Tr. 19).

Given the foregoing, the ALJ provided substantial evidence in support of her

finding that Plaintiff’s mental impairments were non-severe. To be sure, Plaintiff was

diagnosed with mental impairments over the course of her treatment and some

treatment notes reflect complaints of anxiety, depression, poor energy, and difficulty

sleeping, which the ALJ acknowledged. Plaintiff cannot simply rely upon her

diagnoses of mental impairments, however. Rather, as the Commissioner contends,

“[d]iagnosis of a listed impairment is not alone sufficient; the record must contain

corroborative medical evidence supported by clinical and laboratory findings.” Carnes

v. Sullivan, 936 F.2d 1215, 1218 (11th Cir. 1991). “Disability is determined by the

effect an impairment has on the claimant’s ability to work, rather than the diagnosis

of an impairment itself.” Davis v. Barnhart, 153 F. App’x 569, 572 (11th Cir. 2005) (per

curiam). Further, the severity of a medically ascertained impairment is not measured

in terms of deviation from purely medical standards of bodily perfection or normality

but rather in terms of its effect upon ability to work. McCruter, 791 F.2d at 1547.

Moreover, the fact that Plaintiff was diagnosed with anxiety and depression and

periodically prescribed medication for those impairments likewise does not lead to a

finding that Plaintiff is limited by her mental impairments in her ability to work. See

Smith v. Comm’r of Soc. Sec., 501 F. App’x 875, 879 (11th Cir. 2012) (concluding that,

though the record indicated a history of anxiety and depression for which the claimant

was prescribed medication, nothing in the record indicated that the claimant

experienced any effects from the mental impairments that could be expected to

interfere with her ability to work). While the ALJ acknowledged that Plaintiff had

mental impairments and received treatment and medication for those impairments,

the ALJ also provided substantial evidence in support of her finding that Plaintiff’s

mental impairments were non-severe and did not significantly affect Plaintiff’s ability

to work.4

To the extent that Plaintiff asks me to reweigh the evidence or substitute my

opinion for that of the ALJ, I cannot. If the ALJ’s findings are based on the correct

legal standards and are supported by substantial evidence – as they are here – the

Commissioner’s decision must be affirmed even if I would have reached a different

conclusion. See Mitchell, 771 F.3d at 782; Bloodsworth, 703 F.2d at 1239. “And

whatever the meaning of ‘substantial’ in other contexts, the threshold for such

evidentiary sufficiency is not high.” Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019).

To reiterate, I may not reweigh the evidence or substitute my own judgment for that

4 I am cognizant of the Eleventh Circuit’s analysis in Simon discussing the unpredictable

fluctuation of symptoms, including good days and bad days, for individuals with mental

disorders and the directive that “an ALJ must take into account the fundamental differences

between the relaxed, controlled setting of a medical clinic and the more stressful environment

of a workplace” when evaluating a claimant’s medical records. 7 F.4th at 1106-07. Upon

review of the ALJ’s decision and the evidence of record in this case, I am satisfied that the

ALJ fully and properly considered the medical evidence in conjunction with the other

evidence describing Plaintiff’s subjective complaints regarding her mental impairments.

of the ALJ, even if I find the evidence preponderates against the ALJ’s decision. See

Mitchell, 771 F.3d at 782; Bloodsworth, 703 F.2d at 1239.

IV. — Conclusion

For the foregoing reasons, the ALJ applied the correct legal standards, and the

ALJ’s decision is supported by substantial evidence. Accordingly, after consideration,

it is hereby

ORDERED:

1. The decision of the Commissioner is AFFIRMED.

2. The Clerk is directed to enter final judgment in favor of the

Commissioner and close the case.

DONE AND ORDERED in Tampa, Florida, on this 22nd day of March, 2023.

MARK A. PIZZO

UNITED STATES MAGISTRATE JUDGE

cc: Counsel of Record

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