Smith v. Commissioner of Social Security

UNITED STATES DISTRICT COURT

MIDDLE DISTRICT OF FLORIDA

JACKSONVILLE DIVISION

SAMMIE ELAINE SMITH,

Plaintiff,

v. Case No. 3:21-cv-881-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 failing to properly consider the medical evidence and opinions of

record regarding Plaintiff’s subjective complaints in setting forth Plaintiff’s RFC and

by failing to properly consider Plaintiff’s vocational limitations in determining that

Plaintiff could perform other work. 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 1977, claimed disability beginning June 1, 2019 (Tr.

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

140).2 She was 42 years old on the alleged onset date. Plaintiff completed two years

of college, and her past relevant work experience included work as a recreation aide

and teacher’s aide (Tr. 27-28, 47, 158). Plaintiff alleged disability due to

hypothyroidism and fibromyalgia (Tr. 157).

Given her alleged disability, Plaintiff filed an application for DIB (Tr. 140-46).

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

upon reconsideration (Tr. 54-86). Plaintiff then requested an administrative hearing

(Tr. 92-93). Per Plaintiff’s request, the ALJ held a telephonic hearing at which Plaintiff

appeared and testified (Tr. 34-53). Following the hearing, the ALJ issued an

unfavorable decision finding Plaintiff not disabled and accordingly denied Plaintiff’s

claims for benefits (Tr. 17-33).

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

the insured status requirements through June 30, 2020, and had not engaged in

substantial gainful activity from her alleged onset date of June 1, 2019 through her

date last insured of June 30, 2020 (Tr. 22). After conducting a hearing and reviewing

the evidence of record, the ALJ determined that Plaintiff had the following severe

impairments: obesity, fibromyalgia, generalized anxiety disorder, hypothyroidism,

and obsessive-compulsive disorder (OCD) (Tr. 22). Notwithstanding the noted

impairments, the ALJ determined that Plaintiff did not have an impairment or

2 In her application, Plaintiff alleged that she became disabled as of July 1, 2019 (Tr. 140).

The ALJ identified June 1, 2019, as the alleged onset date (Tr. 20, 22), and Plaintiff does not

argue that she was prejudiced by the error, rendering such error harmless.

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. 22). The ALJ then

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

work with the following exceptions: occasional climbing, balancing, stooping,

kneeling, crouching, and crawling; should have no concentrated exposure to

vibrations, work around moving mechanical parts, or work unprotected heights; was

limited to performing work that needed little to no judgment to do simple duties that

could be learned on the job in a short time (up to and including 30 days); was able to

deal with changes in a routine work setting and was limited to work settings that did

not require production-paced work; and was able to relate adequately to supervisors

with occasional coworker and general public contact (Tr. 24). 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. 25).

Considering Plaintiff’s noted impairments and the assessment of a vocational

expert (VE), the ALJ determined that Plaintiff could not perform her past relevant

work (Tr. 27-28). Given Plaintiff’s background and RFC, the VE testified that Plaintiff

could perform other jobs existing in significant numbers in the national economy, such

as a marker-pricer, a folder, and a bagger (Tr. 28-29). Accordingly, based on Plaintiff’s

age, education, work experience, RFC, and the testimony of the VE, the ALJ found

Plaintiff not disabled (Tr. 29). Given the ALJ’s finding, Plaintiff requested review

from the Appeals Council, which the Appeals Council denied (Tr. 1-6, 136-39).

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’s argument here is twofold: (1) the ALJ failed to properly consider the

medical evidence and opinions of record regarding Plaintiff’s physical and mental

subjective complaints in determining Plaintiff’s RFC, and (2) as a result, the ALJ failed

to properly consider and incorporate all of Plaintiff’s vocational limitations in

concluding that Plaintiff could perform other work. More specifically, Plaintiff

contends that the ALJ failed to properly evaluate evidence and opinions from Dale

Intihar, M.D., regarding Plaintiff’s physical limitations and from Frank G. Stanley,

Ph.D., regarding Plaintiff’s mental limitations as well as the opinions from the state

agency medical consultants regarding Plaintiff’s limitations. Given such failure,

Plaintiff asserts that the ALJ failed to properly incorporate all of Plaintiff’s limitations

into the RFC and the hypotheticals to the VE. Since the RFC and hypotheticals to the

VE did not account for all of Plaintiff’s physical and mental limitations, Plaintiff argues

that the VE’s testimony cannot constitute substantial evidence in support of the ALJ’s

finding that Plaintiff could perform other work. As the decision reflects, however, the

ALJ properly considered the evidence of record, including the medical opinion

evidence, regarding Plaintiff’s physical and mental limitations and incorporated the

limitations supported by the record in determining Plaintiff’s RFC and posing

hypotheticals to the VE.

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. §§ 404.1520(a)(4)(iv),

404.1545. 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. § 404.1545(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. §§ 404.1520(e),

404.1545(a)(2) & (e); 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”). In

doing so, the ALJ considers evidence such as 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).

As indicated, in addition to the objective evidence of record, the Commissioner

must consider all the claimant’s symptoms,3 including pain, and the extent to which

these symptoms can reasonably be accepted as consistent with the objective evidence

and other evidence. See 20 C.F.R. § 404.1529; SSR 16-3p, 2017 WL 5180304, at *2.

A claimant’s statement as to pain or other symptoms shall not alone be conclusive

evidence of disability. 42 U.S.C. § 423(d)(5)(A). Rather, to establish a disability based

on testimony of pain and other symptoms, the claimant must establish evidence of an

underlying medical condition and either (1) objective medical evidence confirming the

severity of the alleged pain or (2) that the objectively determined medical condition

can reasonably be expected to give rise to the claimed pain. Wilson, 284 F.3d at 1225.

Consideration of a claimant’s symptoms therefore involves a two-step process,

wherein the SSA first considers whether an underlying medically determinable

physical or mental impairment exists that could reasonably be expected to produce the

claimant’s symptoms, such as pain. 20 C.F.R. § 404.1529(b); SSR 16-3p, 2017 WL

5180304, at *3-9. If the SSA determines that an underlying physical or mental

impairment could reasonably be expected to produce the claimant’s symptoms, the

SSA evaluates the intensity and persistence of those symptoms to determine the extent

3 The regulations define “symptoms” as a claimant’s own description of his or her physical

or mental impairment. 20 C.F.R. §§ 404.1502(i), 416.902(n).

to which the symptoms limit the claimant’s ability to perform work-related activities.

20 C.F.R. § 404.1529(c); SSR 16-3p, 2017 WL 5180304, at *3-9. When the ALJ does

not find the claimant’s subjective testimony supported by the record, the ALJ must

articulate explicit and adequate reasons for doing so. Wilson, 284 F.3d at 1225 (citation

omitted). A reviewing court will not disturb a clearly articulated finding regarding a

claimant’s subjective complaints supported by substantial evidence in the record.

Mitchell, 771 F.3d at 782.

Here, the ALJ found that Plaintiff’s obesity, fibromyalgia, generalized anxiety

disorder, hypothyroidism, and OCD constituted severe impairments (Tr. 22).

Considering Plaintiff’s impairments and the limitations stemming therefrom, the ALJ

determined that Plaintiff retained the RFC to perform a reduced range of light work,

as set forth more fully above, and that, although Plaintiff’s impairments could

reasonably be expected to cause Plaintiff’s alleged symptoms, Plaintiff’s statements

about the intensity, persistence, and limiting effects of her symptoms were not entirely

consistent with the medical evidence or other evidence (Tr. 24-26). In doing so, the

ALJ discussed Plaintiff’s subjective complaints and the medical evidence relating to

Plaintiff’s physical and mental impairments along with the medical opinions from Dr.

Intihar and Dr. Stanley and the medical opinions from the following state agency

medical consultants: Shakra Junejo, M.D.; Steve Arkin, M.D.; George Grubbs,

Psy.D.; and Jeffrey Pickett Psy.D. (Tr. 24-27).

As to Plaintiff’s physical impairments, the ALJ discussed treatment records

from Florida Healthcare Plan, Inc., and Dr. Intihar that showed, as of March 2019,

two months prior to the alleged onset date, Plaintiff presented for medication review

and refills, after not having been seen in approximately 10 months, and demonstrated

normal findings upon examination except for edema of both legs (Tr. 25, 324-26).

Thereafter, in June 2019, Plaintiff underwent an ultrasound of her thyroid, which

yielded normal results (Tr. 25, 322-23). Later, in November 2019, Dr. Intihar saw

Plaintiff at a follow-up appointment for preventive medicine and health management

(Tr. 25, 298-309). Despite normal findings upon examination, including no edema,

normal gait, and a full range of motion of all extremities, Dr. Intihar assessed Plaintiff

with abnormal weight gain, hypothyroidism, adjustment disorder with depressed

mood, vitamin D deficiency disease, hyperparathyroidism, and chest discomfort and

noted that Plaintiff’s additional active problems included abnormal weight gain, acute

bacterial sinusitis, anxiety, dry cough, eczema, edema of both legs, fatigue, feeling

weak, fibromyalgia, hormone imbalance, pain in joint, polyarthropathy or

polyarthritis of multiple sites, stress at work, thyroid illness, urinary tract infection,

and visit for screening mammogram (Tr. 25, 301, 308). As the ALJ pointed out, Dr.

Intihar provided no further treatment to Plaintiff in 2020 prior to her date last insured

on June 30, 2020 (Tr. 26, 383-426).

Instead, Plaintiff did not meet with Dr. Intihar again until December 2020,

initially complaining about tiredness, fatigue, and hyperlipidemia but presenting with

primarily unremarkable findings except for non-healing wounds on her legs (Tr. 26,

388-96). Later that month, Plaintiff presented to Dr. Intihar for an initial evaluation

for disability papers and demonstrated unremarkable findings upon examination,

including no edema, a full range of motion of all extremities, normal gait, and no

wounds on her legs or otherwise (Tr. 26, 385-87). Notwithstanding, Dr. Intihar

submitted a medical opinion the same day regarding Plaintiff’s ability to do work

activities, opining that Plaintiff could occasionally lift and carry less than 10 pounds;

could frequently lift and carry less than 10 pounds; could stand and walk less than two

hours with normal breaks during an eight-hour workday; could sit less than two hours

with normal breaks during an eight-hour workday; could sit for five minutes before

needing to change position; could stand for five minutes before needing to change

positions; would need to walk around every five minutes for a period of five minutes;

would need the opportunity to shift at will from sitting or standing/walking; would

need to lie down at unpredictable intervals during a work shift; could occasionally

twist, stoop (bend), or climb stairs; could never crouch or climb ladders; was limited

in her ability to reach, handle, finger, feel, push, and pull; must avoid concentrated

exposure to wetness and hazards (machinery, heights, etc.); must avoid even moderate

exposure to extreme cold, extreme heat, humidity, noise, or fumes, odors, dusts, gases,

poor ventilation, etc.; and would need to be absent from work more than three times

per month due to her impairments or treatment (Tr. 26, 368-70).

As the ALJ discussed, between Plaintiff’s November 2019 and December 2020

appointments with Dr. Intihar, Plaintiff met with James Shoemaker, D.O., in January

2020 for a consultative examination at the request of the SSA (Tr. 25, 333-36). Dr.

Shoemaker noted that Plaintiff was claiming disability due to hypothyroidism,

fibromyalgia, and anxiety with symptoms of anxiety, depression, weight gain, fatigue,

muscle aches, neck pain, back pain, and leg pain (Tr. 25, 333). Upon examination,

Dr. Shoemaker reported unremarkable findings except that Plaintiff appeared anxious

and showed some paraspinal muscle tightness and tenderness in her cervical spine and

trace nonpitting edema of her bilateral lower extremities (Tr. 25, 334-35). Dr.

Shoemaker diagnosed Plaintiff with anxiety, hypothyroidism, hypertension, and

attributed diagnoses of fibromyalgia and hypodontia to statements from Plaintiff (Tr.

335-36).

The ALJ also discussed Plaintiff’s treatment regarding her mental impairments

and limitations (Tr. 25-26). As the ALJ noted, Plaintiff presented to Diane Ramirez,

Ph.D., for a consultative psychological examination at the request of the SSA in March

2020 (Tr. 25-26, 343-46). Dr. Ramirez noted that the records she reviewed, primarily

the notes of Dr. Shoemaker, indicated that Plaintiff suffered from anxiety and

depression, was taking Xanax, had difficulty coping with daily activities, did not feel

like getting out of bed sometimes, and had panic attacks and that Plaintiff indicated

she was planning to admit herself to a psychiatric facility for two months for treatment

(Tr. 343). Dr. Ramirez observed that Plaintiff arrived on time and alone; drove to the

appointment alone; provided all the information; dressed casually and was adequately

groomed with adequate hygiene; was cooperative and had a positive attitude; was able

to answer all questions with no difficulty; showed no speech or articulation deficits;

rate of speech was normal; speech was loquacious; eye contact was adequate;

psychomotor activity was normal; did not evidence difficulty with ambulation or gross

motor skills; and showed no fine motor skills deficits, shaking, or weakness (Tr. 26,

343). Mental status examination revealed that Plaintiff had a good mood; her affect

was congruent with her mood; she was oriented to time, place, situation, and person;

she showed adequate insight; her judgment was good; she had good immediate

memory; she was able to recall 4 out of 4 words presented immediately; she had

adequate recent memory; she was able to recall 3 out of 4 words a few minutes after

presentation; she had good remote memory; her cognition appeared unimpaired; her

receptive language appeared good; her expressive language appeared good; her written

language appeared good; her attention and concentration were good; her intelligence

was judged to be average; her thought process was clear, organized, and coherent; her

thought content was relevant to the current topic; and her hand/eye coordination was

adequate (Tr. 26, 345-46). After conducting the mental status examination, Dr.

Ramirez concluded that Plaintiff appeared to meet the criteria for Generalized Anxiety

Disorder and Obsessive-Compulsive Disorder, as the presented symptom picture was

consistent with the reported conditions (Tr. 26, 346). Dr. Ramirez concluded that

Plaintiff’s prognosis was fair; the severity of Plaintiff’s symptoms appeared to be mild,

based on observation and client report; and should any benefits be determined,

Plaintiff could manage her benefits (Tr. 346).

The only other mental health evidence provided was a neuropsychological

evaluation conducted by Frank Stanley, Ph.D., at the request of Plaintiff’s

representative, notably after the date last insured (Tr. 26, 373-81). Indeed, the dates of

examination were identified as December 17, 2020, and January 13, 2021 (Tr. 373).

Dr. Stanley administered several tests of Plaintiff’s functionality, finding that Plaintiff

performed more poorly than expected on several measures of her neuropsychological

functioning (Tr. 26, 373-80). Following clinical interviews, a review of records, and

the administration of several neuropsychological tests, Dr. Stanley opined:

The clinical information and observations together with psychological

testing suggest that [Plaintiff’s] problems are psychological in nature.

Her psychological problems might have begun with childhood sexual

abuse which has resulted in a post-traumatic stress disorder. Personality

testing suggesting a borderline personality disorder might be more

reflective of her psychologically untreated post-traumatic stress disorder.

The information for personality testing that indicates a schizoid

personality disorder could be related to her social withdrawal due to her

physical and emotional problems. Affective testing supports her

complaints of high levels of generalized anxiety and depression. The

testing also supports a diagnosis of post-traumatic stress disorder. She

recently has been experiencing severe levels of generalized anxiety and

depression which have not resolved with antianxiety and antidepressant

medications. Her poor performance in several areas of the

neuropsychological testing might be related to her sleep problems and

chronic pain or more to a developing underlying psychotic process due

to ineffectively treated depression. She could consult with a psychiatrist

who reviews the present psychological evaluation and also addresses

concerns about an underlying psychotic thought process secondary to

depression and trauma. She also should actively participate in treatment

with a clinical psychologist or a psychotherapist with special training in

sexual trauma resolution. At the present time, she is severely impaired

in her social functioning and in her neurocognitive and affective

functioning. [Plaintiff] clearly cannot work an eight[-]hour day without

interruptions from her fatigue, chronic pain, and psychological problems.

She also likely will be absent several days when her symptoms increase

or are exacerbated and to attend psychiatric and psychological

appointments.

(Tr. 26, 381).

As the ALJ concluded, therefore, the evidence of record during the relevant

period did not establish that Plaintiff’s impairments prevented her from performing

work in accordance with the limitations set forth in the RFC (Tr. 26-27). Indeed, the

ALJ appropriately highlighted Plaintiff’s limited and conservative treatment with Dr.

Intihar during the applicable period of adjudication as well as the largely normal

physical examinations conducted by Dr. Intihar and Dr. Shoemaker (Tr. 27).

Likewise, the ALJ correctly noted the lack of psychiatric treatment during the relevant

period and the unremarkable findings set forth by Dr. Ramirez upon psychological

examination (Tr. 27). The ALJ thus provided substantial evidence in support of his

finding that Plaintiff’s subjective complaints were not as significant as alleged and did

not rise to the level of disabling.

Beyond that, after discussing the medical evidence of record, the ALJ addressed

the medical opinions, providing further support for his findings (Tr. 27). 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. § 404.1520c(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. § 404.1520c(c)(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. § 404.1520c(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. § 404.1520c(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. § 404.1520c(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. § 404.1520c(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. § 404.1520c(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.4 20 C.F.R. § 404.1520c(b)(2).

The ALJ first addressed the opinions from Dr. Junejo and Dr. Arkin, the state

agency medical consultants considering Plaintiff’s physical impairments and

limitations (Tr. 27, 54-60, 70-74). The ALJ found Dr. Junejo’s opinion that Plaintiff

had no severe physical impairments not persuasive considering the consultative

examination performed by Dr. Shoemaker, reconsideration level opinion (issued after

4 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. §

404.1520c(b)(3).

Dr. Junejo’s opinion), and treatment notes form Dr. Intihar (Tr. 27, 54-60). The ALJ

found Dr. Arkin’s reconsideration opinion that Plaintiff could perform medium work

with frequent postural activities only partially persuasive (Tr. 27, 70-74). Importantly,

the ALJ stated that, though “physical examinations were overwhelmingly normal,”

the ALJ limited Plaintiff “to light work with environmental limitations and greater

postural limitations in an abundance of caution and in viewing the evidence in the

light most favorable to the claimant” (Tr. 27). The ALJ therefore gave Plaintiff the

benefit of the doubt in considering Plaintiff’s physical limitations despite the lack of

support in the record for greater limitations.

Next, the ALJ considered the opinions from Dr. Grubbs and Dr. Prickett, the

state agency medical consultants considering Plaintiff’s mental impairments and

limitations (Tr. 27, 58-59, 63-70). As the ALJ noted, both Dr. Grubbs and Dr. Prickett

opined that Plaintiff had no severe mental impairments (Tr. 27, 58-59, 63-70). While

the ALJ found the opinions generally supported by the consultative psychological

examination conducted by Dr. Ramirez, the ALJ did not find the opinions of Dr.

Grubbs and Dr. Prickett completely persuasive, given Plaintiff’s ongoing complaints

of anxiety (Tr. 27). The record supports the ALJ’s conclusion, and, again, the ALJ

afforded Plaintiff the benefit of the doubt in including limitations related to Plaintiff’s

mental impairments.

After that, the ALJ discussed Dr. Intihar’s opinion, finding it unpersuasive (Tr.

27). The ALJ appropriately determined that Dr. Intihar’s opinion was not supported

by Dr. Intihar’s treatment notes, which, as discussed above, documented normal

examination findings and a conservative course of treatment. In addition, the ALJ

appropriately concluded that Dr. Intihar’s opinion was neither supported by Dr.

Shoemaker’s consultative examination nor by any other records.

Finally, the ALJ discussed Dr. Stanley’s opinion (Tr. 27). As the ALJ indicated,

although Dr. Stanley related his findings back to the period prior to the date last

insured, Dr. Stanley rendered his opinion after the date last insured and based his

opinion upon an examination conducted after the date last insured. To be eligible for

DIB, a claimant must demonstrate disability on or before the last date for which he or

she was insured. Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005) (per curiam);

see 42 U.S.C. §§ 416(i)(3), 423(a) & (c); 20 C.F.R. §§ 404.101, 404.130, 404.131.

“Evidence is irrelevant and immaterial when it relates to a time period after the

eligibility determination at issue.” Carroll v. Soc. Sec. Admin., Comm’r, 453 F. App’x

889, 892 (11th Cir. 2011) (citation omitted); see McClain v. Comm’r, Soc. Sec. Admin.,

676 F. App’x 935, 938 (11th Cir. 2017) (noting that an ALJ did not err by failing to

address evidence that discussed the claimant’s condition outside the time frame that

the claimant would qualify for benefits since the ALJ was tasked with determining

whether the claimant was disabled between the onset date and the date last insured);

Adamo v. Comm’r of Soc. Sec., 365 F. App’x 209, 213 (11th Cir. 2010) (upholding the

ALJ’s decision to reject a physician’s report in its entirety where, among other things,

the opinion relied upon evidence created after the date last insured). The ALJ

therefore did not err in finding Dr. Stanley’s opinion unpersuasive on that ground.

Going further, the ALJ correctly concluded that Dr. Stanley’s opinion was

unpersuasive as it was inconsistent with any evidence prior to the date last insured,

including the consultative psychological examination and lack of mental health

treatment. See Mason v. Comm’r of Soc. Sec., 430 F. App’x 830, 832 (11th Cir. 2011)

(“Where the medical record contained a retrospective diagnosis, that is, a physician’s

post-insured-date opinion that the claimant suffered a disabling condition prior to the

insured date, we affirm only when that opinion was consistent with pre-insured-date

medical evidence.”) (citations omitted).

Against that backdrop, I find that the ALJ properly considered the medical

evidence and medical opinions of record in concluding that Plaintiff’s subjective

complaints were not as limiting as alleged and that Plaintiff maintained the ability to

perform a reduced range of light work with the expressed limitations set forth by the

ALJ in the RFC assessment. The ALJ provided substantial evidence in support of his

findings and applied the correct legal standards. Consequently, Plaintiff’s argument

that the ALJ somehow failed to include any further limitations in the RFC or in the

hypotheticals posed to the VE necessarily fails. Remand is thus not warranted on

either issue.

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 28th day of July, 2023.

MARK A. PIZZO

UNITED STATES MAGISTRATE JUDGE

cc: Counsel of Record

20