# Dixon v. Commissioner of Social Security

> District Court, W.D. North Carolina · March 9, 2023

URL: https://www.frixlaw.com/law-library/cases/10259627

## Case

- **Court:** District Court, W.D. North Carolina
- **Decided:** March 9, 2023
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF NORTH CAROLINA
CHARLOTTE DIVISION
3:21-cv-00525-RJC

DARCEL DENISE DIXON, )
)
Plaintiff, )
v. )
)
COMMISSIONER OF SOCIAL SECURITY, ) Order
)
Defendant. )

THIS MATTER comes before the Court on the Parties’ Cross Motions for Summary
Judgment. (Doc. Nos. 12, 14). Having fully considered the written arguments, administrative
record, and applicable authority, the Court grants Plaintiff’s Motion for Summary Judgment and
remands this matter for further proceedings consistent with this Order.
I. BACKGROUND
Plaintiff Darcel Dixon (“Dixon”) seeks judicial review of the Commissioner of Social
Security’s (“Defendant” or “Commissioner”) denial of her social security claim. Dixon filed her
applications for disability insurance benefits and supplemental security income on July 9, 2014,
with an alleged onset date of January 1, 2011. (Tr.1 54).
In denying Dixon’s social security claim, the ALJ held a hearing on Dixon’s claim and
conducted a five-step sequential evaluation, ultimately finding Dixon was capable of performing
past relevant work and other jobs that existed in significant numbers in the national economy. (Id.
at 54-64). After exhausting her administrative remedies, Dixon appealed to this Court and the
Honorable Graham C. Mullen remanded her case to the Commissioner for the ALJ to consider

1 Citations to “Tr.” throughout the order refer to the administrative record at Doc. No. 10.
new medical opinion and treatment records from Dixon’s treating physician, Dr. Pugh. (Id. at 621-
627).
On remand, the same ALJ held another hearing on Dixon’s claim for disability benefits.
(Id. at 503-504). The ALJ again conducted a five-step sequential evaluation. (Id. at 506-518). At
step one, the ALJ found that Dixon had not engaged in substantial gainful activity since January

1, 2011, the alleged onset date. (Id. at 506). At step two, the ALJ found that Dixon had the
following severe impairment: generalized seizure disorder. (Id. at 507-508). At step three, the
ALJ found that none of the impairments, or combinations of impairments, met or equaled the
severity of a listed impairment. (Id. at 508). Before moving to step four, the ALJ found that Dixon
had the residual functional capacity (“RFC”) as follows:
to perform a full range of work at all exertional levels but with the following
nonexertional limitations: frequent not constant exposure to workplace hazards,
such as unprotected heights and dangerous machinery.

(Id. at 508-515). At step four, the ALJ found that Dixon is capable of performing past relevant
work as a home attendant, child monitor, teacher aide II, and security guard. (Id. at 515-518).
Alternatively, at step five, the ALJ found that Dixon could perform other jobs that existed in
significant numbers in the national economy. (Id.).
After exhausting her administrative remedies, Dixon brought the instant action for review
of Defendant’s decision. (Doc. No. 1).
II. STANDARD OF REVIEW
The Social Security Act, 42 U.S.C. § 405(g) and § 1383(c)(3), limits this Court’s review
of a final decision of the Commissioner to: (1) whether substantial evidence supports the
Commissioner’s decision, Richardson v. Perales, 402 U.S. 389, 390, 401 (1971); and (2) whether
the Commissioner applied the correct legal standards. Hays v. Sullivan, 907 F.2d 1453, 1456 (4th
Cir. 1990); see also Hunter v. Sullivan, 993 F.2d 31, 34 (4th Cir. 1992) (per curiam). The District
Court does not review a final decision of the Commissioner de novo. Smith v. Schweiker, 795 F.2d
343, 345 (4th Cir. 1986); King v. Califano, 599 F.2d 597, 599 (4th Cir. 1979); Blalock v.
Richardson, 483 F.2d 773, 775 (4th Cir. 1972).
As the Social Security Act provides, “[t]he findings of the [Commissioner] as to any fact,

if supported by substantial evidence, shall be conclusive.” 42 U.S.C. § 405(g). In Smith v. Heckler,
782 F.2d 1176, 1179 (4th Cir. 1986) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)),
the Fourth Circuit defined “substantial evidence” as:
Substantial evidence has been defined as being “more than a scintilla and do[ing]
more than creat[ing] a suspicion of the existence of a fact to be established. It
means such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.”

See also Seacrist v. Weinberger, 538 F.2d 1054, 1056–57 (4th Cir. 1976) (“We note that it is the
responsibility of the [Commissioner] and not the courts to reconcile inconsistencies in the medical
evidence.”).
The Fourth Circuit has long emphasized that it is not for a reviewing court to weigh the
evidence again, nor to substitute its judgment for that of the Commissioner, assuming the
Commissioner’s final decision is supported by substantial evidence. Hays v. Sullivan, 907 F.2d at
1456; see also Smith v. Schweiker, 795 F.2d at 345; and Blalock v. Richardson, 483 F.2d at 775.
Indeed, this is true even if the reviewing court disagrees with the outcome—so long as there is
“substantial evidence” in the record to support the final decision below. Lester v. Schweiker, 683
F.2d 838, 841 (4th Cir. 1982).
III. DISCUSSION OF CLAIM
Dixon argues remand is warranted for two reasons: (1) the ALJ did not properly explain
why she discounted the opinion of Dixon’s treating physician Dr. Pugh; and (2) the ALJ was
unconstitutionally appointed. Remand is warranted based on Plaintiff’s first challenge.
For claims filed before March 27, 2017, the regulations require ALJs to “always consider
the medical opinions in your case” and to “evaluate every medical opinion” received. 20 C.F.R.

§ 404.1527(b)–(c). Under these regulations, more weight is generally to be given to medical
opinions from the claimant’s treating sources. Brown v. Comm’r Soc. Sec. Admin., 873 F.3d 251,
268 (4th Cir. 2017) (quoting 20 C.F.R. § 404.1527(c)(2)). “Under the regulation’s treating
physician rule, controlling weight is to be accorded to ‘a treating source’s medical opinion on the
issue(s) of the nature and severity of your impairment(s)’ if that opinion ‘is well-supported by
medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the
other substantial evidence in your case record.’” Brown, 873 F.3d at 256 (quoting 20 C.F.R. §
404.1527(c)(2)). “Thus, by negative implication, if a physician’s opinion is not supported by
clinical evidence or if it is inconsistent with other substantial evidence, it should be accorded

significantly less weight.” Mastro v. Apfel, 270 F.3d 171, 178 (4th Cir. 2001) (internal quotation
marks and brackets omitted). The ALJ must “give good reasons” for the weight given to a treating
source’s opinion. 20 C.F.R. §§ 404.1527(c)(2).
“When a treating source’s medical opinion is not given controlling weight, [six] factors are
utilized to determine what lesser weight should instead be accorded to the opinion.” Brown, 873
F.3d at 256. The six factors that must be considered when determining “the weight the opinion
should be afforded [are]: (1) the ‘[l]ength of the treatment relationship and the frequency of
examination’; (2) the ‘[n]ature and extent of the treatment relationship’; (3) ‘[s]upportability,’ i.e.,
the extent to which the treating physician ‘presents relevant evidence to support [the] medical
opinion’; (4) ‘[c]onsistency,’ i.e., the extent to which the opinion is consistent with the evidence
in the record; (5) the extent to which the treating physician is a specialist opining as to ‘issues
related to his or her area of specialty’; and (6) any other factors raised by the parties ‘which tend
to support or contradict the medical opinion.’” Dowling v. Comm’r of Soc. Sec. Admin., 986 F.3d
377, 384-85 (4th Cir. 2021) (alteration in original) (quoting 20 C.F.R. § 404.1527(c)(2)(i)–(6)).

“While an ALJ is not required to set forth a detailed factor-by-factor analysis in order to discount
a medical opinion from a treating physician, it must be apparent from the ALJ’s decision that [s]he
meaningfully considered each of the factors before deciding how much weight to give the
opinion.” Dowling, 986 F.3d 377, 384-86 (emphasis in original) (remanding for “failing to
acknowledge and apply each of these six factors”); see also Triplett v. Saul, 860 Fed. App’x 855,
865 (4th Cir. June 23, 2021) (remanding under Dowling for failing to properly consider section
404.1527(c)(2) factors).
Here, the ALJ gave Dixon’s treating physician Dr. Pugh’s opinions little or “less” weight.
(Tr. 513-514). When evaluating Dr. Pugh’s opinions, the ALJ considered in detail the

supportability and consistency of Dr. Pugh’s opinions. Specifically, the ALJ explained why she
considered Dr. Pugh’s opinions as inconsistent with his treatment records and with the other
evidence in the record. However, in evaluating Dr. Pugh’s opinion, the ALJ failed to explain how
she considered the length, nature, and extent of Dixon and Dr. Pugh’s relationship. Additionally,
the ALJ failed to explain how she considered whether Dr. Pugh is a specialist opining on issues of
his specialty. True, the ALJ mentioned Dr. Pugh is a neurologist and began treating Dixon in
2015, but that alone is insufficient. Triplett, 860 Fed. App’x at 864-65 (“True, the ALJ mentioned
that Gray had seen Triplett for approximately five years and was her family physician. But the ALJ
failed to explain whether she considered either the length or the nature of the treating relationship,
as she was required to do under § 404.1527(c), before discounting Gray’s opinion. And her analysis
failed even to acknowledge the other three § 404.1527(c) factors.”). Because Dixon’s claim was
filed before March 27, 2017, the ALJ was required to consider all of the 20 C.F.R. § 404.1527(c)
factors before giving little weight to Dr. Pugh’s opinions, and it must be apparent from the ALJ’s
decision that she meaningfully considered each of these factors. Id. The Commissioner argues

the weight the ALJ gave to Dr. Pugh’s opinion is supported by substantial evidence but does little
to explain how the ALJ’s decision demonstrates that the ALJ actually evaluated all of the §
404.1527(c) factors. It is not apparent that the ALJ considered all the § 404.1527(c) factors when
giving little weight to Dr. Pugh’s opinions; therefore, remand is warranted.
By ordering remand, the Court does not forecast a decision on the merits of Plaintiff’s
application for disability benefits. See Patterson, 846 F.3d at 663. “Under § 405(g), ‘each final
decision of the Secretary [is] reviewable by a separate piece of litigation,’ and a sentence-four
remand order ‘terminate[s] the civil action’ seeking judicial review of the Secretary’s final
decision.” Shalala v. Schaefer, 509 U.S. 292, 299 (1993) (quoting Sullivan v. Hudson, 490 U.S.

877, 892 (1989)).
IV. CONCLUSION
IT IS, THEREFORE, ORDERED that:
1. Plaintiff’s Motion for Summary Judgment, (Doc. No. 12), is GRANTED;
2. Defendant’s Motion for Summary Judgment, (Doc. No. 14), is DENIED; and
3. This matter is REMANDED to the Commissioner for further proceedings
consistent with this order.
The Clerk is directed to close this case.
SO ORDERED.

Signed: March 9, 2023

I.
Robert J. Conrad, Jr. hee»
United States District Judge “ev

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10259627. Public record. Not legal advice.