Nardelli v. Commissioner of Social Security

UNITED STATES DISTRICT COURT

MIDDLE DISTRICT OF FLORIDA

TAMPA DIVISION

ANAMARIE NARDELLI,

Plaintiff,

v. Case No. 8:22-cv-132-MAP

COMMISSIONER OF SOCIAL SECURITY

Defendant.

/

ORDER

Plaintiff seeks judicial review of the denial of her claim for Supplemental

Security Income (SSI).1 Plaintiff argues that the Administrative Law Judge (ALJ)

committed reversible error by substituting his opinion for all the medical opinion

evidence and by mechanically applying the Medical-Vocational Guidelines, often

referred to as “the Grids.” 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 1971, claimed disability beginning May 7, 2012 (Tr.

233). She was 41 years old on the alleged onset date. Plaintiff obtained a high school

education, and her past relevant work experience included work as a telephone sales

representative and a residence leasing agent (Tr. 258, 262-77). Plaintiff alleged

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

disability due to diabetes, high blood pressure, borderline personality disorder,

depression, and anxiety (Tr. 257).

Given her alleged disability, Plaintiff filed an application for SSI (Tr. 233-42).

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

upon reconsideration (Tr. 90-129, 134-56). Plaintiff then requested an administrative

hearing (Tr. 157-59). Per Plaintiff’s request, the ALJ held a telephonic hearing at

which Plaintiff appeared and testified (Tr. 32-57). Following the hearing, the ALJ

issued an unfavorable decision finding Plaintiff not disabled and accordingly denied

Plaintiff’s claims for benefits (Tr. 12-31).

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

not engaged in substantial gainful activity since June 11, 2020, the application date

(Tr. 18). After conducting a hearing and reviewing the evidence of record, the ALJ

determined that Plaintiff had the following severe impairments: diabetes mellitus,

hypertension, hypothyroidism, and obesity (Tr. 18). 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. 21). The ALJ then

concluded that Plaintiff retained a residual functional capacity (RFC) to perform the

full range of light work (Tr. 21). 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. 22).

Considering Plaintiff’s noted impairments, the ALJ determined that Plaintiff

could perform her past relevant work as a telephone sales representative and a

residence leasing agent, as such work did not require the performance of work-related

activities precluded by Plaintiff’s RFC (Tr. 25). In addition to her past relevant work,

the ALJ alternatively concluded that other jobs existed in significant numbers in the

national economy that Plaintiff could perform based on Plaintiff’s age, education,

work experience, and RFC (Tr. 26). In reaching that conclusion, the ALJ relied upon

Medical-Vocational Rules 202.21 and 202.14 (Tr. 27). Accordingly, based on his

findings, the ALJ found Plaintiff not disabled (Tr. 27). Given the ALJ’s decision,

Plaintiff requested review from the Appeals Council, which the Appeals Council

denied (Tr. 1-11, 226-28). 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), 1383(c)(3).

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. § 1382c(a)(3)(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. § 1382c(a)(3)(D).

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. § 416.920. If an

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

unnecessary. 20 C.F.R. § 416.920(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. § 416.920(a)(4)(i)-(iv). 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. § 416.920(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. § 416.920(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), 1383(c)(3). “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 that the ALJ erred by improperly substituting his judgment for

that of the medical opinions of record. In short, Plaintiff contends that the ALJ was

not qualified to interpret raw medical data in functional terms, and no medical opinion

supported the ALJ’s RFC determination. According to Plaintiff, the ALJ

impermissibly relied upon his own interpretation of the medical data of record and

improperly substituted his interpretation in place of the opinions of state agency

medical consultants as to Plaintiff’s mental impairments and limitations. Mainly,

Plaintiff contends that, because both of the state agency medical consultants opined

that Plaintiff experienced moderate limitations in interacting with others and in

concentration, persistence, and pace and because a prior ALJ issued a decision – which

Plaintiff concedes is not binding on the ALJ in this matter – finding that Plaintiff’s

depression, anxiety, and PTSD were severe impairments and thus limiting Plaintiff to

unskilled work with no fast-paced production or quota-driven work and occasional

interaction with the public, coworkers, and supervisors (Tr. 64-65), this ALJ

improperly rejected the medical opinions based on the ALJ’s interpretation of medical

evidence, which the ALJ is not qualified to do.2 To the extent that the ALJ held any

2 The prior unfavorable administrative decision covered a period of disability from May 7,

2012, to January 10, 2020 (the alleged onset date to the date of the prior administrative

decision), finding that Plaintiff was not disabled during that period. Plaintiff argues that

“[a]lthough this decision is not binding on the Administrative Law Judge in the current case,

it should not be ignored[,] and some weight should be given to that finding” (Doc. 20, at 8).

Plaintiff filed the current SSI application in June 2020, approximately six months after the

prior ALJ rendered a decision, and she alleges no worsening of her condition from the date

of the prior decision. In considering the current claim for the period of disability post the

prior administrative decision, “the SSA considers the issue of disability with respect to the

unadjudicated period to be a new issue that prevents the application of administrative res

judicata.” Spence v. Comm’r of Soc. Sec., No. 21-12909, 2022 WL 1415888, at *2 (11th Cir. May

4, 2022) (citation omitted; emphasis in original). As such, the SSA considers the facts and

issues in the subsequent disability claim for the unadjudicated period de novo and will not

adopt findings from the prior decision in determining whether the claimant is disabled as to

the unadjudicated period. Id. Accordingly, as the prior ALJ’s decision had no preclusive

effect on the ALJ’s determination of the unadjudicated period at issue in this matter, the ALJ

did not need to rely upon or provide any deference to the prior ALJ’s findings, other than to

accept as res judicata that Plaintiff was not disabled prior to January 10, 2020, the date of the

prior administrative decision.

reservations regarding the state agency medical opinions, Plaintiff asserts that the ALJ

should have employed the services of a medical expert.

At step four of the sequential evaluation process, the ALJ assesses the claimant’s

RFC and ability to perform past relevant work. See 20 C.F.R. §§ 416.920(a)(4)(iv),

416.945. To determine a claimant’s RFC, an ALJ makes an assessment based on all

the relevant evidence of record as to what a claimant can do in a work setting despite

any physical or mental limitations caused by the claimant’s impairments and related

symptoms. 20 C.F.R. § 416.945(a)(1). In rendering the RFC, therefore, the ALJ must

consider the medical opinions in conjunction with all the other evidence of record and

will consider all the medically determinable impairments, including impairments that

are not severe, and the total limiting effects of each. 20 C.F.R. §§ 416.920(e),

416.945(a)(2) & (e); see Schink v. Comm’r of Soc. Sec., 935 F.3d 1245, 1268 (11th Cir.

2019) (per curiam) (“Consideration of all impairments, severe and non-severe, is

required when assessing a claimant’s RFC”); see Jamison v. Bowen, 814 F.2d 585, 588

(11th Cir. 1987) (stating that the “ALJ must consider the applicant’s medical condition

taken as a whole”).

Under the regulations, an ALJ will not defer or give any specific evidentiary

weight, including controlling weight, to any medical opinion or prior administrative

finding, including from a claimant’s medical source. 20 C.F.R. § 416.920c(a). Rather,

in assessing a medical opinion, an ALJ considers a variety of factors, including but not

limited to whether an opinion is well-supported, whether an opinion is consistent with

the record, the treatment relationship between the medical source and the claimant,

and the area of the medical source’s specialization. 20 C.F.R. § 416.920c(1)-(4). The

primary factors an ALJ will consider when evaluating the persuasiveness of a medical

opinion are supportability and consistency. 20 C.F.R. § 416.920c(a) & (b)(2).

Specifically, the more a medical source presents objective medical evidence and

supporting explanations to support the opinion, the more persuasive the medical

opinion will be. 20 C.F.R. § 416.920c(c)(1). Further, the more consistent the medical

opinion is with the evidence from other medical sources and nonmedical sources, the

more persuasive the medical opinion will be. 20 C.F.R. § 416.920c(c)(2). And, in

assessing the supportability and consistency of a medical opinion, the regulations

provide that the ALJ need only explain the consideration of these factors on a source-

by-source basis – the regulations do not require the ALJ to explain the consideration

of each opinion from the same source. See 20 C.F.R. § 416.920c(b)(1). Beyond

supportability and consistency, an ALJ may also consider the medical source’s

specialization and the relationship the medical source maintains with the claimant,

including the length of the treatment relationship, the frequency of examinations, the

purpose of the treatment relationship, the extent of the treatment relationship, and

whether the medical source examined the claimant, in addition to other factors. 20

C.F.R. § 416.920c(c)(3)(i)-(v), (4) & (5). While the ALJ must explain how he or she

considered the supportability and consistency factors, the ALJ need not explain how

he or she considered the other factors.3 20 C.F.R. § 416.920c(b)(2).

3 The exception is when the record contains differing but equally persuasive medical opinions

or prior administrative medical findings about the same issue. See 20 C.F.R. § 416.920c(b)(3).

Notably, a physician’s opinion as to what a claimant can still do despite his or

her impairments differs from an ALJ’s assessment of a claimant’s RFC. See 20 C.F.R.

§§ 416.913(a), 416.945, 416.946; Social Security Ruling (SSR) 96-5p, 1996 WL 374183

(July 2, 1996). Indeed, SSR 96-5p explains:

Even though the adjudicator’s RFC assessment may adopt the opinions

in a medical source statement, they are not the same thing: A medical

source statement is evidence that is submitted to SSA by an individual’s

medical source reflecting the source’s opinion based on his or her own

knowledge, while an RFC assessment is the adjudicator’s ultimate

finding based on a consideration of this opinion and all the other

evidence in the case record about what an individual can do despite his

or her impairment(s).

***

A medical source’s statement about what an individual can still do is

medical opinion evidence that an adjudicator must consider together

with all of the other relevant evidence (including other medical source

statements that may be in the case record) when assessing an individual’s

RFC. Although an adjudicator may decide to adopt all of the opinions

expressed in a medical source statement, a medical source statement

must not be equated with the administrative finding known as the RFC

assessment.

SSR 96-5p, 1996 WL 374183, at *4 & *5. The task of determining a claimant’s RFC

and ability to work thus rests with the ALJ, not a medical source. See Moore v. Soc. Sec.

Admin., Comm’r, 649 F. App’x 941, 945 (11th Cir. 2016);4 Castle v. Colvin, 557 F. App’x

849, 853 (11th Cir. 2014) (“Contrary to the district court’s reasoning, the ALJ did not

‘play doctor’ in assessing Mr. Castle’s RFC, but instead properly carried out his

regulatory role as an adjudicator responsible for assessing Mr. Castle’s RFC … Indeed,

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

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

the pertinent regulations state that the ALJ has the responsibility for determining a

claimant’s RFC.”); Robinson v. Astrue, 365 F. App’x 993, 999 (11th Cir. 2010) (“We

note that the task of determining a claimant’s residual functional capacity and ability

to work is within the province of the ALJ, not of doctors.”). To reiterate, though an

ALJ may not take on the role of doctor, the final responsibility for determining the

RFC remains with the Commissioner, not a physician. See Leslie v. Comm’r of Soc. Sec.,

No. 22-10676, 2022 WL 4476661, at *4 (11th Cir. Sept. 27, 2022).

Here, the ALJ provided a detailed discussion of Plaintiff’s mental impairments

at step two of the sequential analysis, including a discussion of the medical opinions

(Tr. 18-21). Initially, the ALJ found that Plaintiff’s bipolar disorder, cannabis use

disorder, alcohol use disorder in sustained full remission, and cocaine use disorder in

sustained full remission all constituted non-severe impairments because, considered

singly and in combination, they did not cause more than minimal limitation in

Plaintiff’s ability to perform basic mental work activities (Tr. 18). The ALJ also

discussed Plaintiff’s allegations of disability due to borderline personality disorder,

depression, and anxiety (Tr. 18-19). The ALJ acknowledged Plaintiff’s complaints

that she primarily experienced anxiety in public, around people and strangers, and in

crowded or closed spaces and that she had trouble concentrating, completing tasks,

remembering, understanding, following instructions, getting along with others, and

managing stress and changes (Tr. 18). Nevertheless, the ALJ found Plaintiff’s

subjective complaints at odds with her reported ability to perform a wide range of

activities of daily living, her limited treatment without any medication treatment, and

lay observations from field office personnel regarding no perceptible difficulties in

understanding, being coherent, concentrating, talking, and answering (Tr. 18-19). The

ALJ likewise found such complaints at odds with the medical evidence of record,

which confirmed that Plaintiff possessed essentially unremarkable function on

longitudinal mental status examinations during both psychological and physical

examinations (Tr. 19). Given the relatively benign medical findings, the ALJ

concluded that Plaintiff experience no limitation in understanding, remembering, or

applying information; mild limitation in interacting with others; mild limitation in

concentrating, persisting, or maintaining pace; and no limitation in her ability to adapt

or manage herself (Tr. 19).5 As the ALJ found that Plaintiff’s mental impairments

caused no more than mild restrictions in any functional area, the ALJ properly

concluded that Plaintiff’s mental impairments were not severe. See 20 C.F.R. §

416.920a(d)(1).

Thereafter, the ALJ discussed the medical opinions of record pertaining to

Plaintiff’s mental impairments and limitations, including the opinions of the state

5 Agency regulations require a “special technique” be used by the ALJ when evaluating

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

416.920a. 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. § 416.920a(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. § 416.920a(c)(4). 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. §

416.920a(e)(4). Here, the ALJ did so.

agency psychological consultants (Tr. 20). Under the regulations, an ALJ need not

adopt any prior administrative medical findings but must consider medical evidence

from federal and state agency medical consultants, as such “consultants are highly

qualified and experts in Social Security disability evaluation.” 20 C.F.R. §

416.913a(b)(1). Though state agency medical consultants are considered highly

qualified and experts, nothing in the revised regulations requires an ALJ to find

opinions from state agency medical consultants persuasive or more persuasive than a

treating or an examining medical source. See 20 C.F.R. §§ 416.913, 416.920c. Here,

in considering the medical opinions, the ALJ stated:

First, I am not persuaded by the assessments of the State agency

psychological consultants that the claimant is limited to simple routine

work tasks with limited social interaction. Although the consultants

internally support these assessments with references to the evidence,

these assessments are not consistent with the evidence as a whole. This

is because the assessments largely refer to the claimant’s subjective

reports throughout the record, rather than any objective medical

evidence. To that end, the claimant subjectively reported psychological

symptoms, but did not demonstrate any corresponding objective

abnormalities or deficits on examinations. To the contrary, the claimant

generally demonstrated entirely benign mental status and cognitive

function on mental status examinations both before and during the

relevant period at issue, with only some rare and modest abnormalities,

like reduced insight and judgment. Otherwise, she consistently

demonstrated adequate social functioning, attention, and concentration,

which is highly inconsistent with the state agency consultants’ opinions.

Thus, these assessments are clearly inconsistent with the objective

medical evidence[] and are not persuasive.

To the extent that it is an opinion, I am also not persuaded by the

statement of the psychological consultative examiner in October 2020

that the claimant’s mental health symptoms appeared to be “severely”

impacting the claimant’s activities of daily living, vocational

performance, and interpersonal interactions. This statement also appears

to be based entirely upon the claimant’s subjective characterization of her

symptoms rather than any objective medical evidence. To that end, this

statement is significantly unsupported by, and inconsistent with, the

evaluator’s own findings during the mental status examination which

showed that the claimant possessed essentially normal mental status and

cognitive function. For example, the consultative examiner found

“good” mood, intact memory, adequate concentration and attention,

appropriate social interaction, and adequate insight and judgment.

Moreover, this statement is inconsistent with the other medical evidence

of record, including a prior psychological consultative evaluation

confirming normal mental status findings with the exception of poor

insight and judgment, and subsequent primary care treatment notes

confirming the claimant’s denial of psychological symptoms and normal

performance on neuropsychiatric examination. Accordingly, I am not

persuaded that the claimant’s mental health symptoms “severely impact”

her functioning.

(Tr. 20) (internal citations omitted).

As the ALJ discussed, the medical findings simply did not support the state

agency psychological consultants’ opinions that Plaintiff would experience moderate

limitations in interacting with others and in concentration, persistence, and pace (Tr.

20, 95-100, 113-25). For example, in April 2019, Plaintiff presented for a physical

consultative evaluation with Abraham Khan, M.D., reporting a history of depression,

PTSD, and borderline personality disorder and some related symptoms (Tr. 369-73).

Upon examination, however, Plaintiff appeared her stated age, was in no acute

distress, was alert with good eye contact and fluent speech, had an appropriate mood,

had clear thought processes, showed normal memory and good concentration, and

was oriented to time, place, person, and situation (Tr. 19, 371-72).

Around the same time, Plaintiff reported for a psychological consultative

evaluation with Steven N. Kanakis, Psy.D., indicating she was applying for disability

benefits due to PTSD, panic attacks, bipolar disorder, alcoholism, and drug addiction

(Tr. 19, 378-80). Dr. Kanakis indicated that Plaintiff appeared to be about her stated

age, her appearance was neat with good personal hygiene, she related in an appropriate

manner and was accessible, her facial expression was normal and responsive with

good eye contact, she displayed no signs of distress during the interview, her mood

was calm, she displayed a full range of affect, her energy level appeared normal, her

speech was normal and spontaneous, her thought processes were logical and coherent,

no evidence of a thought disorder appeared at the time of the evaluation, she admitted

a history of suicidal ideations but denied any current suicidal ideations or plans, her

intelligence appeared to fall within the average range, her general fund of knowledge

was good, her ability to solve simple arithmetic problems was good, she had intact

recent and remote memory, her attention was good, her concentration was fair, and

she was oriented in all spheres, although her insight and judgment were believed to be

fair to poor (Tr. 379-80). Dr. Kanakis assessed Plaintiff with cannabis use disorder,

alcohol use disorder in sustained full remission, and cocaine use disorder in sustained

full remission and concluded that Plaintiff would benefit from involvement with

Alcoholics Anonymous/Narcotics Anonymous and outpatient substance abuse

counseling, with any underlying psychological disorders being evaluated once Plaintiff

reached some level of sobriety (Tr. 380). According to Dr. Kanakis, Plaintiff’s

prognosis was guarded, but he opined that she could manage her own finances, as

demonstrated by her ability to perform simple arithmetic problems and her reports of

managing her own finances at that time, and she was not at risk of suffering

decompensation in a work-like setting (Tr. 380).

Similarly, as the ALJ discussed, at a second psychological consultative

evaluation in October 2020 with Nicholas Gehle, Psy.D., Plaintiff reported that she

was seeking disability based on physical impairments and anxiety, depression, and

borderline personality disorder (Tr. 19, 339-42). During the evaluation, Plaintiff was

able to answer all questions presented and to provide specific information and dates

without difficulty, so she appeared reliable and accurate, and additionally showed

good eye contact, displayed a positive attitude, showed positive and appropriate

cooperation and effort, showed normal affect, and demonstrated unremarkable

behavior (Tr. 339-40). Plaintiff reported that she was currently undergoing mental

health treatment that she believed had been helpful (Tr. 340). Based on Plaintiff’s

account of present mental health conditions, Dr. Gehle characterized Plaintiff’s

current level of mental health symptoms as severe (Tr. 340). Notwithstanding, Dr.

Gehle documented a wide range of reported daily activities that Plaintiff could

perform, including cooking, cleaning, watching television, bathing independently,

dressing independently, toileting independently, moving around without assistance,

driving independently without difficulty, preparing food without assistance,

completing basic household chores without assistance, managing money, paying the

bills, and completing the grocery shopping independently (Tr. 340). Dr. Gehle also

noted that Plaintiff was alert, oriented to person, place, situation, and time; did not

display any significant problems with motor functioning; displayed unremarkable rate

and quality of speech; speech was relevant, coherent, and logical; showed adequate

attention and concentration, attending to the evaluator’s questions throughout the

interview without distraction and was able to complete tasks of alphabetic and numeric

reiteration without errors; mental flexibility was adequate; no significant difficulties in

processing speed occurred; receptive and expressive language appeared adequate;

immediate and remote memory were adequate; mental computation was adequate;

social skills were fair; abstract reasoning was adequate; judgment related to self-care

social problem-solving was adequate; insight was adequate; overall intelligence was

average; general thought processes were coherent, logical, and goal directed; thought

form and content were age appropriate and unremarkable; had two suicide attempts,

most recently at 18, but no suicidal or homicidal ideations at the time of evaluation;

had hallucinations in the past but had not experienced them in 23 years; and denied

experiencing delusions presently or in the past (Tr. 341). Despite the unremarkable

findings on examination and Plaintiff’s reports of extensive daily activities, Dr. Gehle

diagnosed Plaintiff with unspecified bipolar and related disorder, with moderate

anxious distress, and concluded that Plaintiff’s mental health symptoms based on

report and clinical observations appeared to severely impact Plaintiff’s activities of

daily living, vocational performance, and interpersonal interactions (Tr. 342). Dr.

Gehle found Plaintiff’s prognosis poor but believed she could manage benefits and

financial decisions (Tr. 342).

Beyond that, the ALJ also discussed Plaintiff’s other treatment notes that

supported his findings that Plaintiff did not suffer from a severe mental impairment

and that the medical opinions were not persuasive, including a primary care treatment

note from June 2021 indicating that, though Plaintiff indicated no psychological

symptoms except the loss of pleasure from usual activities, Plaintiff presented with

entirely normal findings upon examination (Tr. 19, 366-67). Given the ALJ’s

thorough discussion of the mental health evidence and the substantial evidence cited

by the ALJ in support of his findings, the ALJ did not err in his consideration of the

medical opinions nor improperly found Plaintiff’s mental health impairments non-

severe. As the Commissioner asserts, Plaintiff bore the burden of proving the existence

of a disability as defined by the Social Security Act. Carnes v. Sullivan, 936 F.2d 1215,

1218 (11th Cir. 1991).

To prove the existence of such disability, Plaintiff had to furnish medical and

other evidence rather than simply relying on conclusory statements of pain or other

symptoms or upon diagnoses alone. 42 U.S.C. §§ 423(d)(5)(A), 1382c(a)(3)(D) &

(H)(i); see 20 C.F.R. § 416.929(b) (“Your symptoms, such as pain, fatigue, shortness of

breath, weakness, or nervousness, will not be found to affect your ability to do basic

work activities unless medical signs or laboratory findings show that a medically

determinable impairment(s) is present.”). Indeed, “[d]iagnosis of a listed impairment

is not alone sufficient; the record must contain corroborative medical evidence

supported by clinical and laboratory findings.” Carnes, 936 F.2d at 1218 (citations

omitted). “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). Moreover, the receipt of mental

health treatment and medication prescribed for mental impairments does not lead to a

finding that an individual is limited by his or her mental impairments in the 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). Instead, the severity of a medically

ascertained impairment is measured in terms of in terms of its effect upon ability to

work not by deviation from purely medical standards of bodily perfection or normality.

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

In this instance, Plaintiff failed to meet her burden of providing evidence of

disabling mental impairments. Rather, the ALJ correctly found that, although

Plaintiff was diagnosed with mental impairments and received some treatment for

those impairments, neither the medical evidence of record nor the medical opinions

supported a finding of disability. As the ALJ properly considered Plaintiff’s mental

impairments and the medical opinions of record, applied the appropriate legal

standards, and provided substantial evidence in support of his findings, remand is

unwarranted.6

6 Remand is also unwarranted as to Plaintiff’s second argument. Essentially, Plaintiff asserts

that, because the ALJ improperly failed to include non-exertional limitations in the RFC, the

ALJ erred by mechanically applying the Grids. Plaintiff therefore predicates her argument as

to the misapplication of the Grids upon her argument that the ALJ improperly omitted non-

exertional limitations in setting forth Plaintiff’s RFC. Since the ALJ at step four properly

considered the medical opinions and Plaintiff’s mental impairments and limitations in

determining that Plaintiff could perform her past relevant work, the ALJ did not need to make

this alternative finding at step five. As her first argument fails, so too does her second

argument.

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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