McKenzie v. Commissioner of Social Security

UNITED STATES DISTRICT COURT

MIDDLE DISTRICT OF FLORIDA

FORT MYERS DIVISION

COLLEEN MCKENZIE,

Plaintiff,

v. Case No.: 2:22-cv-763-KCD

KILOLO KIJAKAZI, ACTING

COMMISSIONER OF SOCIAL

SECURITY,

Defendant.

/

ORDER

Plaintiff Colleen McKenzie sues under 42 U.S.C. § 405(g) to challenge

the Commissioner of Social Security’s decision denying her application for

disability insurance benefits. (See Doc. 1.)1 For the reasons below, the

Commissioner’s decision is affirmed.

I. Background

The procedural history, administrative record, and law are summarized

in the parties’ briefs (Docs. 20 22, 23) and not fully repeated here. McKenzie

filed for benefits in 2020, claiming she could no longer work because of various

medical conditions. (Tr. 11.) Her application was denied initially and again

1 Unless otherwise indicated, all internal quotation marks, citations, and alterations have

been omitted in this and later citations.

upon reconsideration. She then requested further review before an

administrative law judge (“ALJ”).

Following a hearing, the ALJ found that McKenzie had severe

impairments of left knee degenerative joint disease, status post partial

replacement, headaches, right shoulder degenerative joint disease, and chronic

pain syndrome. (Tr. 15.) McKenzie also had right wrist/hand pain and

attention deficit hyperactivity disorder, which the ALJ determined were non-

severe impairments. (Tr. 16-17.) Even with those conditions, the ALJ found

McKenzie had the residual functioning capacity (“RFC”) to:

lift 10 pounds occasionally; sit for six hours in an eight-hour work day;

stand and/or walk for two hours in an eight-hour workday, with normal

breaks; never climb ladders, ropes or scaffolds; occasionally climb ramps

or stairs; occasionally balance, kneel, crouch or crawl; frequently stoop;

occasionally bilaterally reach overhead; frequently bilaterally reaching

forward and to the side; frequently bilaterally push or pull; no

limitations regarding handling or fingering up to the external

limitations of sedentary work; never be exposed to extreme

temperatures; occasional exposure to moderate wetness or humidity;

moderate exposure to noise; occasional exposure to moderate levels of

vibration or environmental irritants; avoid all exposure to unprotected

moving mechanical parts or unprotected heights; no exposure to strobe

or bright lights.

(Tr. 22.)2

2 An individual claiming disability benefits must prove she is disabled. Moore v. Barnhart,

405 F.3d 1208, 1211 (11th Cir. 2005). “The Social Security Regulations outline a five-step,

sequential evaluation process used to determine whether a claimant is disabled: (1) whether

the claimant is currently engaged in substantial gainful activity; (2) whether the claimant

has a severe impairment or combination of impairments; (3) whether the impairment meets

or equals the severity of the specified impairments in the Listing of Impairments; (4) based

on a residual functional capacity assessment, whether the claimant can perform any of his

or her past relevant work despite the impairment; and (5) whether there are significant

numbers of jobs in the national economy that the claimant can perform given the claimant’s

After considering the RFC and testimony from a vocational expert

(“VE”), the ALJ determined that McKenzie could perform her past relevant

work as a patient scheduler. (Tr. 31-32.) Because McKenzie could perform her

past relevant work, the ALJ found her not disabled as that term is defined in

this context. (Tr. 32.) McKenzie then exhausted her administrative remedies,

and this lawsuit timely followed. (Doc. 1.)

II. Legal Standard

Review of the Commissioner’s (and, by extension, the ALJ’s) decision

denying benefits is limited to whether substantial evidence supports the

factual findings and whether the correct legal standards were applied. 42

U.S.C. § 405(g); see also Wilson v. Barnhart, 284 F.3d 1219, 1221 (11th Cir.

2002). Substantial evidence means “such relevant evidence as a reasonable

mind might accept as adequate to support a conclusion.” Biestek v. Berryhill,

139 S. Ct. 1148, 1154 (2019). It is more than a mere scintilla but less than a

preponderance. Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005). The

Supreme Court recently explained, “whatever the meaning of substantial in

other contexts, the threshold for such evidentiary sufficiency is not high.”

Biestek, 139 S. Ct. at 1154.

RFC, age, education, and work experience.” Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176,

1178 (11th Cir. 2011).

When determining whether the ALJ’s decision is supported by

substantial evidence, the court must view the record as a whole, considering

evidence favorable and unfavorable to the Commissioner. Foote v. Chater, 67

F.3d 1553, 1560 (11th Cir. 1995). But the court may not reweigh the evidence

or substitute its judgment for that of the Commissioner. And even if the

evidence preponderates against the Commissioner’s decision, the reviewing

court must affirm if the decision is supported by substantial evidence.

Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983). Finally, “[u]nder

a substantial evidence standard of review, [the claimant] must do more than

point to evidence in the record that supports [her] position; [she] must show

the absence of substantial evidence supporting the ALJ’s conclusion.” Sims v.

Comm’r of Soc. Sec., 706 F. App’x 595, 604 (11th Cir. 2017).

III. Discussion

McKenzie argues six issues on appeal. First, she claims the ALJ erred in

failing to properly identify her past relevant work. (Doc. 20 at 14-18.) Second,

she claims given her advanced age and the lack of transferable skills, she

would be disabled if found unable to do her past relevant work. (Doc. 20 at 18-

20.) Third, McKenzie claims the ALJ erred in failing to find her mental

impairments severe, and regardless of the severity, in failing to include the

relevant limitations in the RFC. (Doc. 20 at 20-27.) Fourth, the ALJ erred in

finding that she had no limitations in fingering or handling. (Doc. 20 at 27-33.)

Fifth, the ALJ erred in evaluating a physical therapy examination and its

opinions. (Doc. 20 at 33-36.) Sixth, the ALJ erred in failing to find her vision

impairment severe, and in failing to properly reflect the vision impairment in

her RFC. (Doc. 20 at 36-41.) The Court addresses each issue in turn.

A. Past Relevant Work

McKenzie first claims the ALJ erred in identifying her past relevant

work as a patient scheduler, which she refers to as a hospital admitting clerk.

She asserts that the tasks she performed in her past work are inconsistent

with the job description of a hospital admitting clerk and instead more closely

align with the job description of an appointment clerk. Compare DOT §

205.362-018 (hospital admitting clerk) with DOT § 237.367-010 (appointment

clerk).

McKenzie did not challenge the VE’s alleged misclassification of her past

work as a patient scheduler during the hearing. This effectively waived her

argument. See Vickery v. Comm’r of Soc. Sec., No. 5:21-CV-122-PRL, 2022 WL

16555990, at *3 (M.D. Fla. Sept. 23, 2022); see also New v. Comm’r of Soc. Sec.,

No. 5:12-CV-211-OC-18PRL, 2013 WL 3804846, at *3 (M.D. Fla. July 8, 2013)

(“As an initial matter, the Commissioner correctly notes that the Plaintiff did

not raise this issue to the ALJ, nor did her attorney object to the VE’s testimony

identifying Plaintiff’s prior work as a housekeeper as past relevant work.

Unfortunately for Plaintiff, because she failed to raise this issue to the ALJ or

even object to the VE’s testimony, the ALJ was not obligated to specifically

address the concerns—or rather, arguments—that Plaintiff now raises.”);

Whittemore v. Comm’r of Soc. Sec., No. 3:09-CV-1242-J-MCR, 2011 WL 722966,

at *5 (M.D. Fla. Feb. 23, 2011) (finding that where the plaintiff did not raise

the issue to the ALJ as to whether her prior job as a real estate agent qualified

as substantial gainful activity and did not object to the VE’s “past relevant

work summary,” which included the job of real estate agent, that the ALJ was

not required to specifically discuss his reasons for concluding that the

plaintiff’s past work as a real estate agent qualified as substantial gainful

activity). Thus, without an objection or other reason to doubt his credibility,

the VE’s expertise provides substantial evidence to support reliance on his

testimony that McKenzie could do her past relevant work as she actually

performed it. Curcio v. Comm’r of Soc. Sec., 386 F. App’x 924, 926 (11th Cir.

2010).

B. Medical Vocational Rule 201.06

The analysis above likewise disposes of McKenzie’s second argument.

She claims that because she is of advanced age and she could not perform her

past relevant work as a patient scheduler, and no transferable skills were

identified, the ALJ erred in not concluding she was disabled pursuant to

Medical Vocational Guidelines (grids) Rule 201.06.

McKenzie waived her argument that the ALJ misclassified her past

relevant work as a patient scheduler, and the VE’s expertise provides

substantial evidence to support the ALJ’s reliance on his testimony. Although

McKenzie argues that she is disabled pursuant to the Medical Vocational

Guidelines used in step five of the sequential evaluation process, “those

guidelines apply only if the administrative law judge determines that a

claimant is incapable of performing [her] past relevant work at step four of the

evaluation.” Delmonte v. Comm’r, Soc. Sec. Admin., 585 F. App’x 774, 776 (11th

Cir. 2014). Thus, because the ALJ properly determined that McKenzie could

return to her past relevant work at step four of the sequential evaluation

process, the ALJ did not err in failing to find McKenzie disabled pursuant to

the Medical Vocational Guidelines. See Macia v. Bowen, 829 F.2d 1009, 1012

(11th Cir. 1987) (finding claimant’s argument that the ALJ should have

applied the grids fails because the grids are only applied if the claimant is

unable to perform his or her vocationally relevant past work).

C. Mental Impairments

Next up, McKenzie argues the ALJ erred in failing to find her mental

impairments severe at step two of the sequential evaluation process. She

further claims that, regardless of the severity of her mental impairments, the

ALJ erred in failing to include the relevant limitations in the RFC at step four.

1. Step Two

At step two, an ALJ considers the severity of a claimant’s impairments.

20 C.F.R. § 404.1520(a)(4)(ii). When, as here, the claimant alleges a mental

impairment “the ALJ makes determinations as to the claimant’s abilities in

four broad functional areas known as ‘Paragraph B’ criteria. The four areas

consider the claimant’s ability to (1) understand, remember, or apply

information; (2) interact with others; (3) concentrate, persist, or maintain pace;

and (4) adapt or manage herself.” Buckwalter v. Acting Comm’r of Soc. Sec., 5

F.4th 1315, 1324-25 (11th Cir. 2021) (citing 20 C.F.R. § 404.1520a(c)(3)). The

ALJ rates the claimant’s limitations in each area as none, mild, moderate,

marked, or extreme and must explain why. Id. at 1325. Ultimately, “to find the

presence of a [severe] mental impairment, the ALJ must find that a claimant

has an ‘extreme’ limitation in one of the four functional areas or a ‘marked’

limitation in two.” Id.

Finally, important for present purposes, an ALJ need not identify every

severe impairment to satisfy step two. Tuggerson-Brown v. Comm’r of Soc.

Sec., 572 F. App’x 949, 951 (11th Cir. 2014); Heatly v. Comm’r of Soc. Sec., 382

F. App’x 823, 825 (11th Cir. 2010) (“Nothing requires that the ALJ must

identify, at step two, all of the impairments that should be considered severe.”).

“[S]tep two of the sequential evaluation acts as a ‘screening’ or ‘filter’ to

eliminate groundless claims. Accordingly, we have recognized that step two

requires only a finding of ‘at least one’ severe impairment to continue on to the

later steps.” Tuggerson-Brown, 572 F. App’x at 951. In other words, so long as

the ALJ identifies any severe impairment at step two, there is no reversible

error because that is enough for the claimant “to continue on to the later steps.”

Id.; see also Jamison v. Bowen, 814 F.2d 585, 588 (11th Cir. 1987) (“[T]he

finding of any severe impairment, whether or not it qualifies as a disability ...

[,] is enough to satisfy the requirement of step two.”).

Here, the ALJ found that McKenzie had several severe physical

impairments. (Tr. 15.) As for her alleged mental impairments, the ALJ found

that McKenzie’s claims of anxiety were unsupported as a medically

determinable impairment during the relevant timeframe. (Tr. 17.) The ALJ

further found McKenzie’s attention deficit hyperactivity disorder was a

medically determinable impairment that did not rise to the “severe” level

because it did not cause more than a minimal limitation on McKenzie’s ability

to perform basic mental work activities. (Tr. 17.) And finally, the ALJ found

that McKenzie had mild limitations in three of four areas of the Paragraph B

mental functioning. (Tr. 17-18.)

To support these findings, the ALJ first cited function reports and pain

questionnaires completed by McKenzie in which she conceded that she could

prepare light meals, complete light house cleaning, take care of her personal

needs, drive, shop, and participate in social activities. (Tr. 272-273, 276, 279,

292-93.) McKenzie reported that she follows instructions well, got along with

authority figures, could pay bills, and handle her savings account. (Tr. 280-81,

305, 307.) The ALJ is clearly authorized to consider the plaintiff’s activities of

daily living in evaluating allegations of disability. See Macia v. Bowen, 829

F.2d 1009, 1012 (11th Cir. 1987); 20 C.F.R. § 404.1529(c)(3)(i).

The ALJ further cited to medical records that show essentially normal

psychiatric findings. For instance, Dr. Voci’s notes indicate that McKenzie

denied having any issues with depression and anxiety and that she had normal

attention and concentration. (Tr. 1331-32, 1344-45.) Dr. Alrais found no overt

psychiatric disease, major depression, cognitive impairment, or memory, and

noted that McKenzie reported improvement of her symptoms with Adderall.

(Tr. 1353, 1360.) Dr Barclay-Shell’s examination found normal findings. (Tr.

1439-43.) Dr. Maniar found that McKenzie did not have anxiety, and her

memory and attention were intact. (Tr. 1472-73.) He further found no

limitations in McKenzie’s ability to follow, carry out, remember, and

understand simple instructions, use judgment, respond to work situations, and

deal with changes in a work setting. (Tr. 1580, 1603.) Dr. Mahaney similarly

reported normal findings regarding McKenzie’s mental status and noted that

she could function well. (Tr. 1478, 1482.) Finally, Dr. Sachs specifically found

no depression or anxiety and determined that McKenzie’s insight and

judgment were good. (Tr. 1527, 1536, 1542.)

Considering the above, the ALJ had substantial evidence to support his

findings and his conclusion that McKenzie’s mental impairments were non-

severe at step two. And regardless, any step-two error would be harmless, as

the ALJ deemed several of claimant’s other medical impairments to be severe

and proceeded through the sequential process. See, e.g., Tippenhaver v.

Kijakazi, No. 20-CV-62555, 2022 WL 3344625, at *4 (S.D. Fla. Aug. 12, 2022)

(upholding ALJ’s decision that failed to address the claimant’s shoulder

impairment at step two because “he found [the claimant] to have at least one

severe impairment and, consequently, proceeded to the next step of the

sequential evaluation”).

2. Step Four

At step four, the ALJ assesses a claimant’s RFC and ability to do past

relevant work. See 20 C.F.R. § 404.1520(a)(4)(iv). The RFC, defined as the most

the claimant can still do despite her limitations, is based on an evaluation of

all the relevant evidence in the record. See id. §§ 404.1520(e), 404.1545(a)(1)

and (a)(3); Social Security Ruling (“SSR”) 96-8p, 1996 WL 374184 (July 2,

1996). Put simply, the ALJ is “required to consider all impairments, regardless

of severity, in conjunction with one another” when building the RFC.

Tuggerson-Brown, 572 F. App’x at 951. Thus, when an ALJ finds mild mental

limitations at step two, he must have a “real discussion of how the mental

condition affected [the claimant’s] RFC.” Schink v. Comm’r of Soc. Sec., 935

F.3d 1245, 1269 (11th Cir. 2019). “If an ALJ fails to address the degree of

impairment caused by the combination of physical and mental medical

problems, the decision that the claimant is not disabled cannot be upheld.” Id.

According to McKenzie, the ALJ was required to include mental

functional limitations in the RFC since there were findings of “mild”

limitations in the Paragraph B criteria. (See Doc. 20 at 26-27.) Not so. It

appears that McKenzie conflates (1) limitations in the Paragraph B criteria,

with (2) limitations in a claimant’s RFC. The limitations in the Paragraph B

criteria help the ALJ determine the severity of a claimant’s mental

impairments or whether a claimant meets a listing, while limitations in the

RFC help the ALJ determine the level of work that a claimant can perform.

Compare 20 C.F.R. § 404.1520a, with 20 C.F.R. § 404.1545. While some

precedent suggests that a finding of a moderate limitation or severe

impairment at steps two or three may require an ALJ to include such

limitations in the RFC, or at least explain the decision to not include the

limitations, here, the ALJ never found McKenzie’s mental impairments caused

work-related limitations. For example, in Winschel, the Eleventh Circuit

reasoned:

[T]he ALJ determined at step two that Winschel’s mental

impairments caused a moderate limitation in maintaining

concentration, persistence, and pace. But the ALJ did not indicate

that medical evidence suggested Winschel’s ability to work was

unaffected by this limitation, nor did he otherwise implicitly

account for the limitation in the hypothetical.

Winschel, 631 F.3d at 1181. Along the same lines, the Eleventh Circuit

determined an ALJ’s hypothetical question to a VE was improper where the

ALJ found a claimant’s bipolar disease was a severe impairment that caused

significant limitations in the claimant’s ability to perform work activities but

included no limitations associated with that illness. Samuels v. Acting Comm’r

of Soc. Sec., 959 F.3d 1042, 1047 (11th Cir. 2020).

Those decisions are distinguishable from this case. Here, the ALJ found

only mild impairments. As such, he was not required to include any mental

limitations in the RFC. See Williams v. Soc. Sec. Admin., 661 F. App’x 977,

979-80 (11th Cir. 2016); Mielbeck v. Comm’r of Soc. Sec., No. 2:20-cv-987-JLB-

MRM, 2022 WL 4285873, at *4 (M.D. Fla. Sept. 16, 2022) (finding the ALJ did

not err in failing to include mental limitations in the RFC where there were no

more than mild limitations in the ability to perform mental work activities).

Moreover, the Court is satisfied that substantial evidence supports the

ALJ’s determination that McKenzie’s mental health impairments did not cause

any work-related limitations. At step four, the ALJ considered and found

persuasive the State agency consultants’ opinions that McKenzie’s mental

impairments were non-severe and that she only exhibited mild limitations in

the paragraph B criteria. (Tr. 28 (citing Tr. 111-28, 130-138.)) The ALJ found

these opinions to be consistent with the essentially normal objective findings

of Drs. Voci and Maniar and ARNP Kaiser, who all indicated essentially

normal psychiatric findings. (Id. (citing Tr. 1315-46, 1454-66, 1467-77, 1492-

1501, 1557-83, 1592-1601.)) He further found the opinions to be generally

consistent with the normal objective psychiatric findings of Dr. Mahaney and

McKenzie’s primary care providers. (Id. (citing Tr. 1439-43, 1478-87, 1523-45.))

Thus, the ALJ had a “real discussion” of McKenzie’s mental functioning as

required under Eleventh Circuit precedent.

Given the record outlined above, substantial evidence supports the ALJ’s

decision not to incorporate mental limitations in the RFC. See Faircloth v.

Comm’r of Soc. Sec., No. 6:21-cv-782-EJK, 2022 WL 2901218, at *2 (M.D. Fla.

July 22, 2022) (“[A]n ALJ is not required to include mental limitations in the

RFC finding merely because he identified mild mental limitations in the PRT

criteria.”).

D. Fingering and Handling

Turning to her physical impairments, McKenzie claims the ALJ erred in

finding that she had no limitations with fingering and handling despite her

complaints to Drs. Sachs and Mahaney and the limitations identified by Dr.

Maniar.3 The ALJ further erred, according to McKenzie, by failing to reflect

her fingering and handling limitations in the RFC.

Starting with Dr. Sachs, the ALJ noted that she diagnosed McKenzie

with right wrist pain in February 2021, but discontinued the diagnosis by June

2021. (Tr.16.) In fact, Dr. Sachs noted in December 2021 that McKenzie’s wrist

pain was better. (Tr. 1537.) The ALJ therefore found that the injury was acute,

not chronic, and did not substantiate a finding of any limitations lasting more

than one year. (Tr. 16.)

As for Drs. Mahaney and Maniar, McKenzie fails to acknowledge that

the ALJ considered their opinions regarding fingering and handling

limitations and rejected them, finding them to be inconsistent with the

objective evidence of record, including their own examinations of McKenzie,

which were essentially normal, as well as examinations by Drs. Voci, Alrais,

Barclay-Shell, Sachs, and ARNP Kaiser. (Tr. 29-30 (citing Tr. 1342-46, 1355-

59, 1439-43, 1458-64, 1470-75, 1478-87, 1493-1501, 1523-45, 1577-83, 1586-

1605, 1605-08.)) The ALJ’s decision, read as a whole, supports this conclusion.

See Rice v. Barnhart, 384 F.3d 363, 370 n.5 (7th Cir. 2004) (“[I]t is proper to

read the ALJ’s decision a whole[.]”); Jones v. Barnhart, 364 F.3d 501, 505 (3d

3 McKenzie also refers to the physical therapy examination/functional capacity evaluation.

(Doc. 20 at 29.) For reasons explained later in this report, the ALJ’s rejection of the physical

therapist’s opinion is supported by substantial evidence.

Cir. 2004) (holding that the ALJ’s decision contained a sufficient explanation

for the step three finding because the ALJ is not required to “use particular

language or adhere to a particular format”). Among other evidence, the ALJ

discussed the treatment records of ARNP Kaiser showing that McKenzie

reported having a previously unremarkable EMT and that, upon objective

examination, she had 5/5 motor strength in her bilateral upper and normal

musculoskeletal range of motion. (Tr. 24, 1461-62.) Also of note, the ALJ

discussed Dr. Maniar’s objective findings of 5/5 muscle strength in all

extremities, intact coordination, and normal range of motion, as well the same

findings upon follow up several months later. (Tr. 24-25, 1473-74, 1498-99,

1580-81, 1596.) The ALJ noted Dr. Mahaney’s findings upon examination of

her upper extremities including 5/5 muscle strength, normal reflexes and

intact sensations. (Tr. 25, 1478-80.) He also noted Dr. Sach’s finding of normal

motor strength. (Tr. 26, 1533, 1536-37, 1542-53.) Physical examinations

repeatedly showed McKenzie’s grip strength, wrist strength and flexion, and

finger flexors strength was 5/5 with normal muscle tone. (Tr. 1319, 1327, 1332,

1479, 1596.) Finally, the ALJ’s findings are also supported by the opinions of

the state agency medical consultants, who imposed no manipulative

limitations on McKenzie as to handling, fingering, or feeling. (Tr. 122, 135.)

At bottom, McKenzie fails to show that the ALJ erred in finding that her

wrist impairment was not severe and in failing to include fingering and

handling limitations in the RFC.

E. Physical Therapy RFC Rejection

McKenzie next argues the ALJ did not properly consider the physical

therapy examination and corresponding RFC evaluation that limited her

significantly more than the ALJ found.

Thomas Hafer, a licensed physical therapist, found McKenzie has very

limited functioning. For instance, he found that she was unable to stand more

than five to eight minutes, walk more than three minutes, and sit more than

twenty minutes due to pain. (Tr. 1502, 1584.) He noted that McKenzie had left

arm pain that increased with activity. (Id.) Hafer also opined that “[b]alance

issues makes patient vulnerable for falls, especially with carrying objects.” (Tr.

1503, 1585.) He ultimately concluded that McKenzie was unable to work unless

it was an extremely light duty sitting job that allows for breaks every twenty

minutes. (Tr. 1502-03, 1584-85.)

The ALJ recognized the extremely limited physical therapy examination

findings, which seemed to be based on McKenzie’s subjective complaints, and

found that the “essentially normal objective findings by her treating providers

during the relevant period” eliminated the persuasiveness of Hafer’s opinions.

(Tr. 27 (citing Tr. 1342-46, 1355-59, 1439-43, 1458-64, 1470-75, 1478-87, 1493,

1523-44, 1577-85, 1592-1601.)) The ALJ later discussed the evaluation from

the physical therapist in more detail:

The undersigned does not find persuasive the opinion of the

physical therapist, Thomas Hafer, in which he opined that

the claimant was unable to work at this time unless an

extremely light-duty sitting job that allows breaks every 20

minutes and that the claimant has balance issues that

makes her vulnerable for falls, especially with carrying

objects. (Exhibits 12F/1-2, 16F/1-2). His opinion is not

phrased in vocational relevant terms. Moreover, his

opinion is internally inconsistent with his own objective

findings in which he found that the claimant had a Tineeti

[sic] test of 25/28 which is inconsistent with the claimant

being more than a low risk for falls. (Exhibits 12F/1-2,

16F/1-2). His opinion is also generally inconsistent with the

generally essentially normal objective findings by

claimant’s treating primary care providers, Dr. Alrais, Dr.

Barclay-Shell, and Dr. Sachs, as above. (Exhibits 5F/9-13;

6F/5-9; 14F/1-22). Finally, his opinion is generally

inconsistent with the essentially normal objective findings

by Dr. Mahaney, as above, and even inconsistent with Dr.

Mahaney’s prescribing narcotic medication and his

diagnoses. (Exhibit 9F/1-10). Accordingly, the undersigned

does not find this opinion persuasive.

(Tr. 30.)

The ALJ’s explanation is sufficient. A physical therapist is not an

acceptable medical source and, therefore, their opinions are not entitled to any

special significance. Garcia v. Comm’r of Soc. Sec., No. 2:19-CV-877-FTM-

MRM, 2021 WL 1037856, at *10 (M.D. Fla. Mar. 18, 2021). But even setting

that aside, the Court is satisfied the ALJ properly considered and rejected the

opinions. See Matthew J. S. v. Comm’r of Soc. Sec., No. 6:20-CV-1606 (GLS),

2022 WL 957974, at *3 (N.D.N.Y. Mar. 30, 2022) (explaining the ALJ “was

required to articulate how persuasive he found [a physical therapist’s] opinion,

specifically noting the supportability and consistency”).

The ALJ noted that Hafer examined McKenzie on a single occasion and

for only sixty minutes. (Tr. 25-26.) He explained that Hafer’s finding that

McKenzie was at a high risk for falls was internally inconsistent and not

supported by the objective findings of the Tinetti balance test that put her at a

low risk. (Tr. 30 (citing Tr. 1502-03, 1584-85.)) The ALJ then thoroughly

summarized McKenzie’s medical history, noting the objective findings of ARNP

Kaiser, Drs. Maniar, Mahaney, Alrais, Barclay-Shell, and Sachs, including

normal gait, balance, stance, range of motion, motor strength, and muscle

strength. (Tr. 24-26, 1440-41, 1461-62, 1473-74, 1478-81, 1498-99, 1527, 1536,

1542-43, 1580-81 1596.) The ALJ’s discussion thus addressed the required

factors (supportability and consistency) and was based on substantial

evidence. See Thaxton v. Kijakazi, No. 1:20-CV-00616-SRW, 2022 WL 983156,

at *8 (M.D. Ala. Mar. 30, 2022) (“[T]he ALJ need not use any magic words in

discussing whether a medical opinion is supported by evidence from the

medical source himself and whether the opinion is consistent with other

evidence of record.”). Accordingly, because substantial evidence supports the

ALJ’s finding that Hafer’s evaluation of McKenzie was not persuasive, she fails

to show error.

F. Vision Impairment

Last, McKenzie argues the ALJ erred by not finding her vision

impairment severe and in failing to include her vision limitations in the RFC.

At step two, the ALJ found that McKenzie’s alleged loss of visual acuity

was not established by objective medical evidence. (Tr. 19.) The ALJ noted the

lack of medical signs or laboratory findings showing the existence of the alleged

impairment. (Tr. 19.) Then, at step four, the ALJ acknowledged ARNP Kaiser’s

finding of fully intact visual field on the right eye with some diminishment on

the left. (Tr. 24, 1461.) Further, the ALJ noted Dr. Maniar’s finding that

McKenzie had some diminished visual field on the left eye, specifically

difficulty seeing out of the left side, which was unchanged since cyst removal

surgery in 2006. (Tr. 24-25, 1470, 1473.) The ALJ ultimately concluded that,

although it was not established by any objective testing such as a Humphrey’s

visual field test, McKenzie’s diminished left visual field did not create more

than a minimal limitation on her ability to perform work related activities.

Substantial evidence supports the ALJ’s treatment of McKenzie’s vision

issues. McKenzie testified that she was able to use an iPad, did not wear

glasses, and was told she did not need to do so. (Tr. 91, 98.) She reported that

she could drive and read for enjoyment about 90 minutes a day. (Tr. 278-79,

293-94, 305-06.) As indicated by the ALJ, absent from the medical history are

any records specifically for vision treatment. Meanwhile, records from

McKenzie’s physicians who treated her for other ailments refer to her vision as

unremarkable. Dr. Alrais found no focal deficits, and Dr. Barclay-Shell

specifically reported no loss or diminished vision. (Tr. 1358, 1440.) On several

occasions, Dr. Maniar reported McKenzie’s eyes were negative for visual

disturbance or diplopia. (Tr. 1460-61, 1472-73, 1595.) Dr. Sachs reported she

had no vision changes with no limitations in her eyes. (Tr. 1527, 1535-36,

1542.) The ALJ’s findings are also supported by the findings of the state agency

medical consultants, who found no visual limitations regarding McKenzie’s

RFC. (Tr. 122, 135.)

Considering the evidence above, the ALJ did not err by treating

McKenzie’s visual impairment as non-severe. It also follows that McKenzie has

not demonstrated that the ALJ erred by failing to including any visual

limitations in the RFC.

IV. Conclusion

Substantial evidence supports the ALJ’s findings, and McKenzie has

failed to show error. Accordingly, the Court AFFIRMS the Commissioner’s

decision and directs the Clerk to enter judgment for the Commissioner and

against Colleen McKenzie and close the file.

ORDERED in Fort Myers, Florida on October 2, 20238.

Lal Sud

0K eC. Dudek A

21 United States Magistrate Judge