The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF TEXAS
LUBBOCK DIVISION
JAMES KEITH WARD, §
§
Plaintiff, §
§
v. § Civil Action No. 5:24-cv-00153-BP
§
COMMISSIONER OF SOCIAL §
SECURITY, §
§
Defendant. §
MEMORANDUM OPINION AND ORDER
James Keith Ward (“Ward”) applied for Title II Disability Insurance Benefits (“DIB”)
under the Social Security Act (“SSA”). The Commissioner denied his application, deciding that
he was not disabled. Ward appealed, but the Social Security Appeals Council (“AC”) rejected his
request for review. There is no reversible error in the legal standard that the Administrative Law
Judge (“ALJ”) applied, and substantial evidence supports her determination that Ward was not
disabled. Accordingly, the Court AFFIRMS the Commissioner’s decision and DISMISSES the
case with prejudice.
I. BACKGROUND
Ward applied for DIB on November 22, 2021. Soc. Sec. Admin. R. (hereinafter “Tr.”) ECF
No. 6-1 at 229-30. He alleged disability beginning on December 31, 2020, due to the combined
effects of fluid in his lungs, retaining fluid in his body, difficulty breathing, minimal change
disease, high blood pressure, high cholesterol, and thyroid problems. Id. at 266. The Commissioner
denied his application initially on March 25, 2022, and upon reconsideration on November 14,
2022. Tr. 136-37, 149-50.
Ward challenged the Commissioner’s denial in a hearing before an ALJ, who affirmed the
Commissioner’s decision on December 22, 2023. Id. at 16-34. Ward appealed the decision to the
AC, which denied review on May 1, 2024. Id. at 1-4. “[T]he Commissioner’s decision does not
become final until after the [AC] makes its decision denying the claimant’s request for review.”
Higginbotham v. Barnhart, 405 F.3d 332, 337 (5th Cir. 2005). Ward then filed this civil action
seeking judicial review of the Commissioner’s decision under 42 U.S.C. §§ 405(g), 1383(c)(3).
ECF No. 1.
II. STANDARD OF REVIEW
Title II of the SSA, 42 U.S.C. §§ 401-434, governs the disability insurance program. A
person is disabled if he is 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 12 months.” Id.
§ 423(d)(1)(A). To determine whether a claimant is disabled and thus entitled to DIB, the
Commissioner employs a sequential five-step evaluation process. 20 C.F.R. § 404.1520.
First, the claimant must not be presently doing any substantial gainful activity. Id. §
404.1520(a)(4)(i). “Substantial gainful activity” (“SGA”) is work that “involves doing significant
physical or mental activities” for pay or profit. Id. § 404.1572. Second, the claimant must have a
severe impairment or combination of impairments. Id. § 404.1520(a)(4)(ii). Third, disability exists
if the impairment or combination of impairments meets or equals an impairment in the federal
regulatory list. See id. § 404.1520(a)(4)(iii) (referencing 20 C.F.R. pt. 404, subpt. P, app. 1). Before
proceeding to steps four and five, the Commissioner assesses the claimant’s residual functional
capacity (“RFC”) and considers his past relevant work (“PRW”). See id. § 404.1520(a)(4), (e)-(f).
RFC means “the most [a claimant] can still do despite [his] limitations.” Id. § 404.1545(a)(1).
Previously, PRW meant work the claimant performed “within the past 15 years, that was
substantial gainful activity, and that lasted long enough for [the claimant] to learn to do it.” Id. §
404.1560(b)(1). The definition has since changed, and as of June 22, 2024, PRW means the “work
that you have done within the past five years that was substantial gainful activity and that lasted
long enough for you to learn to do it.” 20 C.F.R. § 404.1560(b)(2). The Commissioner and AC
made their decisions regarding Ward’s application prior to June 22, 2024, so the previous
definition is proper in this case. See Tr. 136-37, 1-4.
Fourth, if the claimant’s medical status alone does not constitute a disability, the
impairment or impairments must prevent the claimant from returning to his PRW considering his
RFC. Id. § 404.1520(a)(4)(iv). Fifth, the impairment must prevent the claimant from doing any
other relevant work, considering the claimant’s RFC, age, work experience, and education. Id. §
404.1520(a)(4)(v); Crowley v. Apfel, 197 F.3d 194, 197-98 (5th Cir. 1999). “A finding that a
claimant is disabled or is not disabled at any point in the five-step review is conclusive and
terminates the analysis.” Lovelace v. Bowen, 813 F.2d 55, 58 (5th Cir. 1987). “The claimant bears
the burden of showing [he] is disabled through the first four steps of the analysis; on the fifth, the
Commissioner must show that there is other substantial work in the national economy that the
claimant can perform.” Audler v. Astrue, 501 F.3d 446, 448 (5th Cir. 2007).
Judicial review is limited to determining whether the Commissioner applied correct legal
standards and whether substantial evidence in the record supports the Commissioner’s decision.
Leggett v. Chater, 67 F.3d 558, 564 (5th Cir. 1995); Hollis v. Bowen, 837 F.2d 1378, 1382 (5th
Cir. 1988). “Substantial evidence is such relevant evidence as a reasonable mind might accept to
support a conclusion.” Ripley v. Chater, 67 F.3d 552, 555 (5th Cir. 1995) (quoting Greenspan v.
Shalala, 38 F.3d 232, 236 (5th Cir. 1994)). “It is more than a mere scintilla and less than a
preponderance.” Boyd v. Apfel, 239 F.3d 698, 704 (5th Cir. 2001) (quoting Harris v. Apfel, 209
F.3d 413, 417 (5th Cir. 2000)).
“A finding of no substantial evidence is appropriate only if no credible evidentiary choices
or medical findings support the decision.” Id. (quoting same). The Court may neither reweigh
evidence in the record nor substitute its judgment for the Commissioner’s, but it will carefully
scrutinize the record to determine if substantial evidence is present. Harris, 209 F.3d at 417; Hollis,
837 F.2d at 1383. “Conflicts in the evidence are for the [Commissioner] and not the courts to
resolve.” Brown v. Apfel, 192 F.3d 492, 496 (5th Cir. 1999) (alteration in original) (quoting Selders
v. Sullivan, 914 F.2d 614, 617 (5th Cir. 1990)).
III. ANALYSIS
The Commissioner, acting through the ALJ, completed the five-step evaluation process in
this case. Tr. 21-34. First, the ALJ found that Ward had not engaged in SGA since his alleged
disability onset date of December 31, 2020. Id. at 21. Second, she found five severe impairments:
“hypertension, chronic kidney disease, morbid obesity, lumbar degenerative disc disease, and
chronic obstructive pulmonary disease (COPD).” Id. at 21. She also found that Ward had non-
severe impairments, such as the “medically determinable mental impairment of adjustment
disorder.” Id. at 22. She determined that this impairment “does not cause more than minimal
limitation in the claimant’s ability to perform basic mental work activities and is therefore
nonsevere.” Id.
Third, the ALJ identified no impairment or combination of impairments that qualified
under the federal regulatory list. Tr. 23. The ALJ then assessed Ward’s RFC, concluding:
that [Ward] has the [RFC] to perform medium work as defined in 20
CFR 404.1567(c) except he can occasionally climb ramps or stairs.
He can never climb ladders, ropes, or scaffolds. He can frequently
balance, stoop, kneel, crouch, and crawl. He can have frequent
concentrated exposure to environmental irritants such as dust, odors,
gases, and fumes.
Tr. 24.
At step four, the ALJ determined that Ward could perform PRW as an electrical assembler
and pest control commercial as these jobs are generally performed in the national economy. Id. at
32. The ALJ found that both jobs were “performed within the past fifteen (15) years, were of long
enough duration to allow the claimant to fully learn all duties of the job, and were performed at
the level of [SGA], the [ALJ] finds that they qualify as past relevant work.” Id.
The ALJ also made a step five finding in the alternative, explaining that “in addition to
[PRW], there are other jobs that exist in significant numbers in the national economy that the
claimant also can perform, considering the claimant’s age, education, work experience, and
[RFC].” Id. The ALJ explained that if Ward could perform the full range of medium work, this
would lead to a finding of “not disabled.” Id. at 33. But the ALJ then explained that even though
Ward’s ability to perform the full range of medium work was “impeded by additional limitations,”
the vocational expert had testified that there were still jobs existing in significant numbers in the
national economy that Ward could perform, namely, the jobs of machine packer, laundry worker,
and sweeper/cleaner. Id.
Ward argues that “[t]he ALJ erred by failing to properly evaluate the medical opinion
evidence consistent with SSA authority and Fifth Circuit precedent.” ECF No. 8 at 3. Specifically,
he asserts that the ALJ “never addressed the consistency factor when evaluating the opinion of Dr.
Garrett.” Id. Ward argues that “the record is consistent with and supports the opinion of Dr.
Garrett,” and that “the ALJ did not find to the contrary.” Id. at 8.
In response, the Commissioner argues that the ALJ “properly evaluated the opinion
evidence in accordance with the requirements of 20 C.F.R. § 404.1520c.” ECF No. 16 at 4. The
Commissioner further asserts that “after the ALJ discussed [Ward’s] subjective allegations and
treatment history, she specifically stated that [Ward’s] allegations are not supported by and were
inconsistent with the medical evidence.” Id. 9-10. Finally, the Commissioner states that “despite
[Ward’s] argument to the contrary, the ALJ properly considered whether Dr. Garrett’s opinion was
consistent with the medical evidence as a whole.” Id. at 10.
A. Substantial evidence supports the ALJ’s determination of Ward’s RFC.
“Because a determination [of] whether an impairment[ ] is severe requires an assessment
of the functionally limiting effects of an impairment[ ], [all] symptom-related limitations and
restrictions must be considered at this step.” Martinez v. Kijakazi, No. 3:20-cv-3282-BH, 2022
WL 4590577, at *11 (N.D. Tex. Sept. 29, 2022) (quoting Social Security Ruling 96-3P, 1996 WL
374181, at *2 (S.S.A. July 2, 1996)). Ultimately, a severity determination may not be “made
without regard to the individual's ability to perform [SGA].” Stone v. Heckler, 752 F.2d 1099, 1104
(5th Cir. 1985).
Although a claimant's step-two burden is quite low, it remains exceedingly difficult to show
that substantial evidence does not support an ALJ's opinion, in whole or in part. Evidence is
substantial if it “is more than a mere scintilla,” but it need not be greater than a preponderance.
Boyd, 239 F.3d at 704. It is the bare minimum needed for “a reasonable mind [to] accept to support
a conclusion.” Ripley, 67 F.3d at 555 (quoting Greenspan, 38 F.3d at 236). A finding of no
substantial evidence is only appropriate where a reasonable mind could not support the ALJ's
conclusion based on the evidence under consideration. See Id.
Substantial evidence did not support the ALJ’s RFC determination in Ripley, thus
warranting remand, because the record “d[id] not clearly establish…the effect [the claimant’s]
condition had on his ability to work.” Id. at 557. The ALJ found Ripley not disabled because he
could perform sedentary work. Id. Even though the record included “a vast amount of medical
evidence,” including “reports discussing the extent of Ripley’s injuries,” no reports from “qualified
medical experts” showed how Ripley’s condition affected his ability to perform sedentary work.
Id. at 557 & n.27.
After Ripley, the Court found that reversible error lies where the “record does not clearly
establish” how an applicant’s condition affects his ability to work. Bowles v. Comm'r of Soc. Sec.,
No. 7:20-cv-00112-O-BP, 2021 WL 7451148, at *3 (N.D. Tex. Oct. 19, 2021), rec. adopted, 2022
WL 768546 (N.D. Tex. Mar. 14, 2022); Fitzpatrick v. Colvin, No. 3:15-cv-3202-D, 2016 WL
1258477, at *7-8 (N.D. Tex. Mar. 31, 2016); Thornhill v. Colvin, No. 3:14-cv-335-M, 2015 WL
232844, at *10 (N.D. Tex. Dec. 15, 2014), rec. adopted, 2015 WL 232844 (N.D. Tex. Jan. 16,
2015).
Ward asserts that his treating provider, James Garrett, M.D., found that he was “limited to
lifting/carrying 25 pounds; sitting and standing/walking less than 2 hours each during an 8-hour
workday,” and that his legs should be elevated twelve inches with prolonged sitting, “he would be
off task 20% of the time; required unscheduled breaks during the workday; and would likely be
absent from work greater than 3 days per month.” ECF No. 8 at 6; See also Tr. 651-51. Ward
argues that “Dr. Garrett’s opinion patently describes greater limitations than the ALJ’s RFC.” Id.
Ward asserts that the ALJ’s analysis of Dr. Garrett’s opinion was “defective.” Id. at 10.
However, the record reflects that the analyzed Dr. Garrett’s opinions in depth and
adequately explained why she found them to be unpersuasive. Regarding Dr. Garrett’s April 2021
opinion that Ward could not work until his follow-up appointments with nephrology and
pulmonary specialists, the ALJ found that “[t]his opinion … Garrett offers no function-by-function
analysis on the impact of [Ward’s] impairments on his ability to perform basic work activities”
and thus was not persuasive. Tr. 30. In July 2021, Dr. Garrett expressed concerns about Ward
going back to work in a hot environment, and the ALJ found that the opinion was unpersuasive
because it did not concern “[Ward’s] ability to do other work generally; therefore this is not an
opinion about functional ability.” Id. at 30-31.
Finally, in January 2023 Dr. Garrett performed a “Physical Medical Inquiry on behalf of
[Ward]” that to determine Ward’s work capabilities. Id. The ALJ considered this finding, but also
the fact that two days before this inquiry, “[Ward] presented to Dr. Garrett’s office and had a form
to complete to give to his disability advisor.” Id. The ALJ found that “Dr. Garrett apparently relied
quite heavily on the subjective report of symptoms and limitations provided by [Ward,] and
seemed to uncritically accept as true most, if not all, of what [Ward] reported.” Id. Ultimately the
ALJ found this opinion to be unpersuasive because “[Ward’s] physical examination is relatively
normal and does not support the limitations assessed by Dr. Garrett.” Tr. 31.
Contrary to Ward’s assertion, the ALJ’s opinion directly addresses the lack of consistency
between Dr. Garrett’s opinions and his physical examination of Ward, thus leading to his findings.
Id. Further, Ward asserts that consistency requires consideration of whether the opinion is
consistent with “the entire record.” ECF No. 17 at 2. However, throughout the ALJ’s report she
references many factors that led to her conclusion that Dr. Garrett’s opinions were not consistent
with the record as a whole and that Ward is not disabled. The ALJ dedicated seven pages of her
opinion to an analysis of the entire record, including Ward’s testimony at the hearing, his previous
treatment and examinations from health care professionals, his reported daily activities, medical
opinions, and prior administrative medical findings. Tr. 24-31.
The Fifth Circuit has held that “ALJs are no longer required to give controlling weight to
a treating physician’s opinion…” Webster v. Kijakazi, 19 F.4th 715, 719-720 (5th Cir. 2021). To
that end, the ALJ here properly exercised her responsibility as fact finder to weigh the evidence
and incorporate limitations in her RFC assessment that the record supported. Audler, 501 F.3d at
447. Accordingly, she did not commit reversible error on this point.
B. The ALJ properly considered Dr. Garrett’s opinion.
Ward asserts that the ALJ’s criticisms of Dr. Garrett generally are defective and not
sufficient to support her conclusion that he was not disabled. ECF No. 8 at 10. However, an ALJ
is free to reject any medical opinion when the evidence supports a contrary conclusion. Qualls v.
Astrue, 339 F. App'x 461, 466 (5th Cir. 2009) (quoting Bradley v. Bowen, 809 F.2d 1054, 1057
(5th Cir. 1987)); see also Harris, 209 F.3d at 417. An ALJ may even completely disregard the
opinion of a treating physician under certain circumstances. See Brown, 192 F.3d at 500.
Regardless of whether an ALJ accepts or rejects a medical opinion, she must “articulate in
[her] determination or decision how persuasive [she] find[s] all of the medical opinions . . . in [a
claimant's] case record.” 20 C.F.R. § 404.1520c(b); see also Guy v. Comm'r of Soc. Sec., No. 4:20-
cv-01122-O-BP, 2022 WL 1008039, at *3 (N.D. Tex. Mar. 14, 2022), rec. adopted 2022 WL
1004241 (N.D. Tex. Apr. 4, 2022). The articulation requirement is to “allow a subsequent reviewer
or reviewing court to trace the path of an [ALJ]’s reasoning.” 82 Fed. Reg. 5858 (Jan. 18, 2017).
This requirement is obligatory for claims filed on or after March 27, 2017. Id. Ward applied for
DIB on November 22, 2021, and is, therefore, entitled to the explanation. Tr. 229-30.
While ALJs need not exhaustively recount their reasoning, they must “explain how [they
considered the supportability and consistency factors for . . . medical opinions . . . in [a claimant's]
determination or decision.” 20 C.F.R. § 404.1520c(b)(2). Mere evidentiary summaries fall short
of § 404.1520c's requirements, as evidenced in the plain meaning of the regulatory text. Id. ALJs
consider five factors when evaluating medical opinions, and they must explain how they
considered the two “most important factors,” supportability and consistency. Id.
Determining supportability and consistency “involve different analyses and require the
ALJ to explain [her] reasoning for [her] persuasiveness finding with respect to each factor.” Linda
M. v. Comm'r, Soc. Sec. Admin., No. 3:21-cv-210-BK, 2022 WL 4125095, at *3 (N.D. Tex. Sept.
8, 2022) (quoting Kilby v. Kijakazi, No. 4:20-cv-03035, 2022 WL 1797043, at *3 (S.D. Tex. Mar.
15, 2022)). While “supportability” measures the degree of relatedness between a medical
provider's opinion and the medical evidence she provides to support that opinion, “consistency” is
“an all-encompassing inquiry” that focuses on “how well a medical source is supported, or not
supported, by the entire record.” Id. (emphasis removed); See 20 C.F.R. §§ 404.1520c(c)(1), (2).
The ALJ here evaluated Dr. Garrett’s opinion at step four. Tr. 24-31. As discussed
previously, the ALJ stated many reasons why Dr. Garrett’s opinion was unpersuasive and
discussed the entire record in weighing this opinion. Because “[c]onflicts in the evidence are for
the Commissioner and not the courts to resolve,” the Court cannot second guess the ALJ's
determination of the weight to be afforded Dr. Garrett’s opinion compared to the rest of the
evidentiary record. See Brown, 192 F.3d at 496. Considering the clarity of the ALJ's explanation
and the degree to which she supported her conclusion with references to specific evidence in the
record, substantial evidence supports the Commissioner's conclusion, and reversal is not required
on this point.
IV. CONCLUSION
Because the ALJ applied the proper legal standards and substantial evidence supports the
ALJ’s decision, the Court AFFIRMS the Commissioner’s decision and DISMISSES this case
with prejudice.
It is so ORDERED on February 18, 2025.
Hal Ray, Jr.
UNITED STATES MAGISTRATE JUDGE
1]