holding “a diagnosis or a mere showing of a deviation from purely medical standards of bodily perfection or normality is insufficient; instead, the claimant must show the effect of the impairment on her ability to work”
How later courts described this case
- holding “a diagnosis or a mere showing of a deviation from purely medical standards of bodily perfection or normality is insufficient; instead, the claimant must show the effect of the impairment on her ability to work”
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
TAMPA DIVISION
LINDA GIBSON,
Plaintiff,
v. Case No.: 8:23-cv-1349-KCD
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
/
ORDER
Plaintiff Linda Gibson sues under 42 U.S.C. § 405(g) to challenge the
Commissioner of Social Security’s decision denying her application for
disability benefits. (Doc. 1.)1 For the reasons below, the Commission’s decision
is affirmed.
I. Background
The procedural history, administrative record, and law are summarized
in the parties’ briefs (Docs. 25, 27) and not fully repeated here. In short, Gibson
filed for benefits claiming she could not work because of vision problems,
neuropathy, sciatica, scoliosis, tachycardia, depression, and anxiety. (Tr. 72.)
1 Unless otherwise indicated, all internal quotation marks, citations, and alterations have
been omitted in this and later citations.
After her application was denied, Gibson sought review by an administrative
law judge (“ALJ”). (Tr. 128.)
Following a hearing, the ALJ agreed that Gibson was not disabled.
(Tr. 17-41.) To make that determination, the ALJ used the multi-step
evaluation process established by the Commissioner. See 20 C.F.R. §
404.1520(a).2 The ALJ found that although Gibson had severe impairments of
degenerative disc disease, hypertension, panuveitis,3 immune deficiency
disorder, peripheral neuropathy, visual impairment, cardiac dysrhythmias,
muscle/ligament/fascia disorder, depression, and anxiety, she retained the
residual functional capacity (“RFC”) to engage in some work with certain non-
exertional limitations:
After careful consideration of the entire record, the undersigned finds
that, through the date last insured, the claimant had the residual
functional capacity to perform light work as defined in 20 CFR
404.1567(b) with exceptions. The claimant can lift twenty pounds
occasionally and ten pounds frequently. She can stand/walk six hours
2 An individual claiming Social Security disability benefits must prove that 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 RFC, age, education, and work experience.” Winschel v. Comm’r of Soc.
Sec., 631 F.3d 1176, 1178 (11th Cir. 2011).
3 “Panuveitis involves inflammation inside the eye that similarly affects the front, middle
and back of the eye.” Johns Hopkins Medicine, Uveitis, available at
https://www.hopkinsmedicine.org/health/conditions-and-diseases/uveitis (last visited May 2,
2024).
per day and sit six hours per day. The claimant can never climb ladders,
ropes, and scaffolds; and occasionally climb ramps and stairs, balance,
stoop, kneel, crouch, and crawl. She can frequently reach, handle, finger
and feel. The claimant must be able to use eyeglasses. She must avoid
vibration, hazardous machinery, and heights. She can understand,
remember, and carry out routine and repetitive instructions and tasks.
The claimant cannot perform work requiring a specific production rate
or pace, such as assembly lines. She can maintain attention and
concentration for two hours at a time, but does require the standard
morning, lunch, and afternoon breaks.
(Tr. 24.)
After considering the RFC and other evidence, including vocational
expert testimony, the ALJ ultimately concluded that Gibson could not perform
her past relevant work but could perform other work in the national economy.
(Tr. 40.) Thus, Gibson was not disabled as that term is defined in this context.
(Tr. 40-41.) Gibson further exhausted her administrative remedies, and this
lawsuit followed. (Doc. 1.)
II. Standard of Review
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.
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). 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, 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. Analysis
Gibson argues the ALJ erred in just one way—by failing to properly
account for her vision impairment in the RFC. (Doc. 25 at 3.) In step four of the
analytical process, 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 v. Comm’r of Soc. Sec., 572 F. App’x 949, 951 (11th Cir.
2014).
Error arises only when the ALJ rejects medical evidence from the RFC
“without (at least) providing a good reason for doing so.” Sneed v. Comm’r of
Soc. Sec., No. 6:13-CV-1453-ORL-TBS, 2015 WL 1268257, at *7 (M.D. Fla. Mar.
19, 2015); see also Marbury v. Sullivan, 957 F.2d 837, 840 (11th Cir. 1992)
(Johnson, J., concurring) (“Although the ALJ could have legitimately
discounted the diagnoses, he could have done so only if he had clearly
articulated his reasons for such action[.]”); Whisby v. Colvin, No. 5:13-CV-360
MTT, 2015 WL 150188, at *3-5 (M.D. Ga. Jan. 12, 2015) (finding error when
the ALJ made an arbitrary determination).
At step two, the ALJ found that Gibson’s panuveitis and visual
impairment constituted severe impairments. (Tr. 20.) But, according to Gibson,
the only limitation in the RFC that touches on these impairments—that she
“must be able to use eyeglasses”—does not account for her diagnosis of
panuveitis and the “resulting symptoms of pain, blurred vision, seeing floaters,
redness, itchiness, and eye strain when looking at anything for thirty minutes
or longer as [she] testified to.” (Doc. 25 at 3, citing Tr. 57, 61-62.)
Contrary to Gibson’s claim, the ALJ did not err in this respect. In the
RFC assessment, the ALJ specifically considered Gibson’s vision-related
conditions. Her treatment records and her reported activities support a
conclusion that she failed to prove her allegations of any greater limitations
than those in the RFC.
At the outset, the Court notes that a diagnosis of panuveitis alone does
not establish work-related limitations. See Moore, 405 F.3d at 1213 n.6
(holding “the mere existence of these impairments does not reveal the extent
to which they limit her ability to work or undermine the ALJ’s determination
in that regard”); Wind v. Barnhart, 133 F. App’x 684, 690 (11th Cir. 2005)
(holding “a diagnosis or a mere showing of a deviation from purely medical
standards of bodily perfection or normality is insufficient; instead, the
claimant must show the effect of the impairment on her ability to work”).
Turning to the record here, the ALJ considered the medical evidence
related to panuveitis when discussing Gibson’s treatment for reduced vision
from inflammation. (Tr. 26, 541-41, 681-704.) The ALJ noted that the
inflammation improved with treatment. (Tr. 26, 695.) The ALJ also considered
multiple eye exams, some irregular, but improvement was seen with
treatment. Noncompliance is discussed throughout the records as well, and
noted in the ALJ’s decision. (Tr. 26, 31, 32, 33.) For example, in December 2021
Gibson reported decreased vision with floaters but was non-compliant with
treatment (no treatment for a year) and had not returned as requested. (Tr.
32, 687.) Once she restarted mediation, the inflammation improved. (Tr. 33,
692.)
Gibson alleges that the only limitation in the RFC (wearing eyeglasses)
fails to account for the symptoms of panuveitis (pain, blurred vision, seeking
floaters, redness itchiness, and eye strain). But wearing eyeglasses was not the
only restriction imposed in the RFC to address such symptoms. The ALJ
stated, “[Gibson’s] reduced vision along with reduced concentration and
awareness caused by pain and neuropathy are also addressed with the
environmental limitations in the residual functional capacity limiting her
exposure to conditions that could pose a danger. In addition, she is limited in
her exposure to conditions that could exacerbate her pain or other symptoms.”
(Tr. 26.) The ALJ further limited her to jobs where a specific production rate
was not required. (Tr. 24.)
The ALJ also considered the opinion of Dr. Anubha Agarwal, M.D., who
completed a “Medical Statement of Ability to Do Work-Related Activities
(Physical).” (Tr. 1668.) Dr. Agarwal found that, due to her visual impairment,
Gibson should avoid ordinary hazards in the workplace and cannot read very
small print, but she could read ordinary newspaper or book print and view a
computer screen. (Tr. 1671.) The ALJ concluded that Dr. Agarwal’s opinion
regarding the vision listing is consistent with the evidence and supported by
the records from Gibson’s eye exams. (Tr. 38.)
The ALJ also considered Gibson’s alleged symptoms, which included
floaters in her eyes and blurriness (Tr. 25, 61-62.) The ALJ determined that
her statements concerning the intensity, persistence, and limiting effects of
those symptoms were not entirely consistent with the evidence. (Tr. 25.)
Although not dispositive, a claimant’s activities may show that her symptoms
are not as limiting as alleged. See 20 C.F.R. § 404.1529(c)(3)(i); SSR 16-3p;
Dyer, 395 F.3d at 1212. As discussed by the ALJ, Gibson testified that she went
“out to dinner and movies,” cooked quick meals, had no problems with personal
care, went grocery shopping, and sometimes ordered on Amazon. (Tr. 25, 36,
64.) She also drove during the daytime, which included to the store about ten
miles from her home. (Tr. 36, 57.)
As the ALJ noted, Gibson completed a function report where she
reported cooking, performing household chores, including cleaning and
laundry. (Tr. 37, 207-08.) She also reported she watched television and engaged
in social activities, including talking on the phone, video chats, texting, and
going to the park, though she alleged she did not pay attention well and had
difficulty following written and spoken instructions. (Tr. 37, 209, 211.) In the
same function report, she reported wearing glasses when “[r]eading, writing,
watching TV, [and] driving.” (Tr. 211.) Similarly, Gibson’s boyfriend completed
a third-party function report, in which he reported that Gibson wore glasses
“when reading.” (Tr. 37, 220.) All this evidence undermines Gibson’s testimony
about her symptoms, and it was enough for the ALJ to reject her claims.
Gibson argues that records dated after the expiration of her insured
status showed a worsening of her vision. (Doc. 25 at 9-10.) But the relevant
question is whether Gibson was disabled by her date last insured (December
31, 2020). See 42 U.S.C. §§ 416(i)(3), 423(a), (c); 20 C.F.R. §§ 404.101, 404.130,
404.131. The ALJ, nevertheless, discussed the evidence post-dating the end of
Gibson’s insured status. (Tr. 32-33.) Thus, Gibson has shown no error in this
regard.
At bottom, there is sufficient evidence to uphold the RFC. Gibson may
believe the record supports more restrictions than imposed by the ALJ, but the
Court may not reweigh the evidence. Bloodsworth, 703 F.2d at 1239. The
question is simply whether there is enough evidence to satisfy a reasonable
mind of the ALJ’s decision. Here, there is.
IV. Conclusion
Considering the record as a whole, substantial evidence supports the
ALJ’s findings. Accordingly, the Court AFFIRMS the Commissioner’s decision
and directs the Clerk to enter judgment for the Commissioner and against
Linda Gibson and close the file.
ORDERED in Fort Myers, Florida on May 3, 2024.
e C. Dudek
United States Magistrate Judge
Copies: All Parties of Record
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