Brock v. Commissioner of Social Security

United States District Court

Middle District of Florida

Tampa Division

KADIN BROCK,

Plaintiff,

v. NO. 8:24-cv-2256-PDB

COMMISSIONER OF SOCIAL SECURITY,

Defendant.

Order

Kadin Brock challenges the Commissioner of Social Security’s decision

denying her application for supplemental security income. Doc. 1. The

procedural history, administrative record, and general law are summarized in

the ALJ’s decision, Tr. 17–43, and the parties’ briefs, Docs. 15, 20, and not fully

repeated here.

A court’s review of a decision by the Commissioner is limited to whether

substantial evidence supports the factual findings and whether the correct

legal standards were applied. 42 U.S.C. §§ 405(g), 1383(c); Wilson v. Barnhart,

284 F.3d 1219, 1221 (11th Cir. 2002). Substantial evidence is “such relevant

evidence as a reasonable mind might accept as adequate to support a

conclusion.” Biestek v. Berryhill, 587 U.S. 97, 103 (2019) (quoted authority

omitted). The threshold is “not high,” and courts generally defer to the ALJ,

who has “seen the hearing up close.” Id. at 103, 108.

Brock argues that the ALJ failed to properly account for the severity,

frequency, and duration of her migraines because, despite finding that they are

severe impairments, the residual functional capacity (RFC) fails to include

limitations to accommodate them other than restricting her exposure to

excessive noise and vibration. Doc. 15 at 3. The Commissioner argues that

Brock improperly asks the court to reweigh the evidence. Doc. 6–9.

An RFC is the most a claimant can do despite her limitations. 20 C.F.R.

§ 416.945(a)(1). An ALJ assesses the RFC based on all relevant record

evidence. Id. An ALJ need not refer to all evidence in the decision, as long as

the decision makes clear that the ALJ considered the claimant’s “medical

condition as a whole.” Dyer v. Barnhart, 395 F.3d 1206, 1211 (11th Cir. 2005).

An ALJ must consider a claimant’s symptoms and the extent to which

the symptoms can reasonably be accepted as consistent with the objective

medical and other evidence. Id. § 416.929(a). Factors for consideration include:

(i) [the claimant’s] daily activities;

(ii) [t]he location, duration, frequency, and intensity of … pain or

other symptoms;

(iii) [p]recipitating and aggravating factors;

(iv) [t]he type, dosage, effectiveness, and side effects of any

medication [that the claimant] take[s] or ha[s] taken to

alleviate … pain or other symptoms;

(v) [t]reatment, other than medication, [that the claimant]

receive[s] or ha[s] received for relief of … pain or other

symptoms; [and]

(vi) [a]ny measures [the claimant] use[s] or ha[s] used to

relieve … pain or other symptoms[.]

Id. § 416.929(c)(3)(i)–(vi). An ALJ will consider the claimant’s “statements

about the intensity, persistence, and limiting effects of … symptoms” and

evaluate the statements “in relation to the objective medical evidence and

other evidence.” Id. § 416.929(c)(4). An ALJ “will consider whether there are

any inconsistencies in the evidence and the extent to which there are any

conflicts” between the claimant’s statements and the other evidence. Id.

In a report, Brock alleged that she has “sever [sic] light sensitivity”

because of migraines, making “sitting at a computer for long

periods … impossible.” Tr. 277. She alleged that her memory problems make

retaining new information difficult. Tr. 277. She alleged that migraines cause

her nausea, vomiting, and light-sensitivity, and that she must “isolate herself

in a dark, quiet room.” Tr. 252. She alleged that, to calm her anxiety, she

meditates, practices yoga, and plays video games. Tr. 245.

In a questionnaire, Brock reported having daily headaches caused by

“[l]oud noises, bright or flashing lights[,] some pitches in music, [and] smells.”

Tr. 290. She alleged that her migraines last four to five days and her daily

headaches “never go[] completely away.” Tr. 291. She explained that she must

“lay in [a] dark room [with] ice packs on [her] head and neck.” Tr. 291. She

reported being “very sensitive to noise and light.” Tr. 291.

At an April 2024 administrative hearing, Brock, then age 27, gave this

testimony. She last worked in February 2018. Tr. 65. She drives, but not at

night or in the rain because of “severe stigmatism [sic] from … migraines and

[she] can’t really see well.” Tr. 64. She cannot take the trash out, and she needs

help watering her plants. Tr. 64. Transferring laundry from the washing

machine to the dryer causes her shoulders to dislocate. Tr. 64. She experiences

daily headaches lasting twenty minutes to two or more weeks. Tr. 65. She had

been receiving Botox injections. Tr. 65. She has “severe[,] chronic pain

from … chronic migraines and headaches,” which sometimes hinders her

ability to communicate and understand. Tr. 65. She cannot go outside without

wearing special sunglasses because her eyes are sensitive to light. Tr. 66. She

must use special filters on her phone and, when she goes into stores, must wear

special glasses so that she does not get a migraine. Tr. 66. She must wear

special glasses at home, “otherwise [she] will probably end up with a migraine

within the next three days.” Tr. 67. The ALJ questioned Brock’s statements

that she had migraines or headaches daily compared to her statements about

preventative measures. Tr. 68. Brock testified:

I always have a headache, 24/7. Sometimes it’s not very intense.

Sometimes it’s so intense I can’t open my eyes or move. But my head

always hurts. Migraines are different. The pain is much more

intense. And I can’t really talk or function. A headache I can still like,

function with but it depends on the severity of it.

Tr. 68. Brock continued with this testimony. When she has a migraine, which

happens “three and upwards of six times” a month, she is unable to do anything

and lies in bed and tries to sleep. Tr. 68–69. She has trouble focusing on one

thing for more than 20 minutes, finishing what she starts, and getting along

with other people. Tr. 73.

The ALJ found that Brock has the RFC to perform medium work, with

additional limitations:

[Brock] can frequently balance, crouch, kneel, and stoop. She can

occasionally climb ramps and stairs, but should never crawl or climb

ladders, ropes, and scaffolds. She must avoid even moderate

exposure to extreme cold, excessive noise, and vibration. [Brock] can

perform simple tasks. She can have no interaction with the public

and occasional interaction with coworkers and supervisors. She

cannot participate in tandem tasks. She must have low stress jobs

defined as having occasional decision making required and having

occasional changes in the work setting.

Tr. 23.

The ALJ summarized Brock’s allegations and testimony, including about

light-sensitivity, severe pain, communication difficulties, and confusion. See

Tr. 24. The ALJ found that Brock’s “medically determinable impairments could

reasonably be expected to cause the alleged symptoms,” but her “statements

concerning the intensity, persistence and limiting effects of these symptoms

are not entirely consistent with the medical evidence and other evidence in the

record” and “are not supported by the record as a whole.” Tr. 24–25. The ALJ

explained, “The evidence demonstrates [that Brock] has the retained ability to

perform work at the medium level with additional postural limitations to

accommodate reduced capabilities caused by migraines and cardiac

arrythmias. Migraines and headaches are a constant complaint throughout the

records and [Brock] receives care from a neurologist with medications and

Botox injections. (Exhibits B2F, B11F, B14F, B18F, B20F).” Tr. 25.

The ALJ observed that Brock’s most prominent complaint appears to be

migraines, for which Brock has seen multiple specialists, including a

neurologist, an ENT, an allergist, an ophthalmologist, and a pain manager. Tr.

25. The ALJ observed that Brock “complains of persistent headaches and

migraines, but she has normal neurological findings.” Tr. 25. The ALJ

summarized notes from Brock’s treatment with the specialists. Tr. 26–37. The

ALJ observed that Brock reported to her pain manager 100% relief of

headaches with Botox in February 2024. Tr. 37 (citing B29F/7). The ALJ

observed that Brock’s therapist noted exaggeration by Brock on multiple

occasions. Tr. 26, Tr. 30 (citing B12F/91), Tr. 31 (citing B12F/103, 121), Tr. 32

(citing B12F/145, 151; B26F/16), Tr. 33 (citing B26F/19).

The ALJ found that Brock’s “allegations of disability are not consistent

with the overall evidence [primarily because] the objective medical and mental

health records do not establish conditions that produced disabling limitations.”

Tr. 37. The ALJ explained that the “record reflects no limitations in [Brock’s]

activities of daily living greater than those as reflected in the [RFC].” Tr. 37.

The ALJ observed that Brock described her typical day to include meditating,

practicing yoga, or playing video games to lessen her anxiety, Tr. 37; Brock

stated that she could drive a car and go out alone if she was very familiar with

the place, Tr. 37; Brock indicated that she spends time online playing games

with friends and enjoys researching and reading about herbal plants, Tr. 38;

Brock stated that she checks her plants outside unless it is too hot; and Brock

stated that she medicates with cannabis and delta 8 THC, Tr. 38.

The ALJ considered the location, duration, frequency, and intensity of

Brock’s pain:

The record documents complaints of migraines, headaches, and a

variety of mental health symptoms and that [Brock] has sought

treatment for her symptoms. However, the frequency and intensity

of her symptoms as shown in the evidence do not support the need

for greater limitations. Further, the aggravating factors were

considered and accommodated in the [RFC]. [Brock] is limited to

medium work with additional postural and environmental

limitations in order to avoid exacerbation of her migraines,

headaches, or other pain symptoms. She also has limited interactions

with others and is limited to low stress jobs to accommodate her

mental health impairments.

Tr. 39. The ALJ also considered Brock’s medications and found that her “use

of medications does not suggest the presence of an impairment that is more

limiting than found in this decision.” Tr. 39. The ALJ concluded, “Viewing all

of the evidence together, the undersigned finds that [Brock]’s subjective

allegations of disability cannot reasonably be accepted as consistent with the

objective medical evidence and other evidence in this case record.” Tr. 39.

A state agency medical consultant at the reconsideration level opined

that Brock could perform work at the medium exertion level and attributed to

Brock’s migraines postural and environmental limitations consistent with

those included in the ALJ’s ultimate RFC. Tr. 100. The ALJ found that the

consultant’s explanation supported the limitations and that the limitations

were “consistent with the overall evidence showing persistent complaints of

migraines with some improvement with treatment.” Tr. 39–40 (citing B2F,

B11F, B14F, B18F, B20F).

Contrary to Brock’s argument, the ALJ adequately accounted for her

migraines in the RFC, and substantial evidence supports the decision. The ALJ

acknowledged Brock’s complaints of severe, chronic pain from migraines,

causing light sensitivity and difficulty functioning. Tr. 24. The ALJ recounted

Brock’s medical history and complaints and found that the evidence did not

support her assertions on the intensity, persistence, and limiting effects of her

migraines. Tr. 24. The ALJ noted that although Brock complained of persistent

headaches and migraines, she had normal neurological findings, Tr. 25, and

she reported 100% relief after a Botox injection in early 2024. Tr. 34. The ALJ

noted that Brock’s therapist repeatedly reported that Brock exaggerated her

symptoms. Tr. 26. The ALJ found that the record shows Brock has no

limitation to her activities of daily living greater than those included in the

RFC. Tr. 37. The ALJ considered aggravating factors and accounted for them,

to the extent they were supported by the record, by limiting Brock to jobs that

avoid even moderate exposure to extreme cold, excessive noise, and vibration.

Tr. 23, 39. The ALJ explained that the environmental limitations were

included “to avoid exacerbation of [Brock’s] migraines, headaches, or other

pain symptoms.” Tr. 39. The decision makes clear that the ALJ considered the

severe impairment in light of the entire record and included limitations that

he found the record supported.

Brock complains, “There is no accommodation for light sensitivity at all

in the ALJ’s RFC and no explanation for this.” Doc. 15 at 4. Brock is correct

that the ALJ did not specifically address why the RFC includes no limitation

concerning light sensitivity. But the decision makes clear that the ALJ did not

include such a limitation based on his consideration of the entire record, which

includes evidence that Brock was able to adjust her activities of daily living for

her light sensitivity. For example, she wears sunglasses to go outside and drive

during the day, Tr. 66, 247, 250, 283; uses special glasses to filter light at home

and in stores, Tr. 66–67; and uses special filters on her TV and phone to play

video games, watch TV, and watch videos on her phone, Tr. 67, 245, 248, 297.

Brock argues that the limitations of simple work, low-stress jobs, and

medium work do not account for her migraines. Doc. 15 at 4. She contends the

postural and environmental limitations fail to address her migraines, Doc. 15

at 4; and she cites evidence that she contends supports “greater functional

limitations such as absenteeism, [the] inability to be around bright light, [the]

need[ for] additional breaks[,] and [the] inability to sustain concentration that

would not exceed off[-]task behavior allowances in a work setting.” Doc. 15 at

4–7. Brock fails to show the absence of substantial evidence supporting the

ALJ’s findings. Although the ALJ did not discuss in the same detail the

evidence that Brock does, the ALJ provided enough detail to make clear that

he considered the record as a whole, and substantial evidence supports the

decision.

Brock points out that in Raduc v. Commissioner of Social Security, 380

F. App’x 896, 898 (11th Cir. 2010), the Eleventh Circuit reversed because the

ALJ failed to discuss how the claimant’s irritable bowel syndrome might affect

her ability to perform her job duties. Doc. 15 at 78. Brock also cites these cases

for the proposition that courts in this district “have remanded when migraines

are found to be a severe impairment by the ALJ, but the ALJ fails to account

for them in the RFC finding”: Reis ex rel. Reis v. Astrue, No. 8:11-cv-2027-TGW,

2012 WL 3231092, at *4 (M.D. Fla. Dec. 5, 2012); Battles v. Colvin, No. 8:15-

cv-339-VMC-TGW, 2016 WL 3360428, at *1 (M.D. Fla. May 20, 2016), report

and recommendation adopted sub nom. Battles v. Commissioner of Social

Security, 2016 WL 3258423, at *3 (M.D. Fla. June 14, 2016); Gurske v.

Commissioner of Social Security, No. 6:17-cv-2050-DNF, 2019 WL 643722, at

*3 (M.D. Fla. Feb. 15, 2019); Hill v. Saul, No 8:19-cv-121-TGW, 2020 WL

1430917, at *4 (M.D. Fla. Mar. 24, 2020); Nance v. Commissioner of Social

Security, No. 8:20-cv-507-NPM, 2021 WL 4305093, at *4–5 (M.D. Fla. Sept. 22,

2021). Doc. 15 at 8. These non-binding and factually unique cases do not help

Brock. Unlike the ALJ in Raduc and the other cases, the ALJ here discussed

the effects of Brock’s migraines and accounted for them in the RFC. See Tr. 23,

39.

Brock also argues that the ALJ failed to properly consider the

persuasiveness of the medical opinions of Kathryn Bliss, L.M.H.C. (her

therapist) and Kyle Cieply, Ph.D. (an examining psychologist). Doc. 15 at 9.

The Commissioner disagrees and responds that the ALJ adequately explained

his persuasiveness finding considering the most important factors of

supportability and consistency. Doc. 20 at 9.

In 2017, the Social Security Administration revised its medical evidence

rules. See Revisions to Rules Regarding the Evaluation of Medical Evidence,

82 Fed. Reg. 5844-01, 2017 WL 168819 (Jan. 18, 2017). The revisions include

redefining terms related to evidence; revising how the agency considers

medical opinions and prior administrative medical findings; and revising rules

about treating sources. Id. The revised rules apply to claims filed on or after

March 27, 2017. Id.

Under the revised rules, “[o]bjective medical evidence” is “medical signs,

laboratory findings, or both[.]” 20 C.F.R. § 416.913(a)(1). A “medical opinion”

is “a statement from a medical source about what [a claimant] can still do

despite … impairment(s) and whether [the claimant has] one or more

impairment-related limitations or restrictions” in:

(A) [the] ability to perform physical demands of work activities, such

as sitting, standing, walking, lifting, carrying, pushing, pulling, or

other physical functions (including manipulative or postural

functions, such as reaching, handling, stooping, or crouching);

(B) [the] ability to perform mental demands of work activities, such

as understanding; remembering; maintaining concentration,

persistence, or pace; carrying out instructions; or responding

appropriately to supervision, co-workers, or work pressures in a work

setting;

(C) [the] ability to perform other demands of work, such as seeing,

hearing, or using other senses; and

(D) [the] ability to adapt to environmental conditions, such as

temperature extremes or fumes.

Id. § 416.913(a)(2)(i). “Other medical evidence” is “evidence from a medical

source that is not objective medical evidence or a medical opinion, including

judgments about the nature and severity of [the claimant’s] impairments, [the

claimant’s] medical history, clinical findings, diagnosis, treatment prescribed

with response, or prognosis.” Id. § 416.913(a)(3).

The old rules required an ALJ to “give more weight” to a treating

physician’s medical opinion absent good cause to the contrary. Id.

§ 416.927(c)(2); Harner v. Soc. Sec. Admin., Comm’r, 38 F.4th 892, 896 (11th

Cir. 2022). The revised rules abrogate Eleventh Circuit precedent applying the

treating-physician rule, see Harner, 38 F.4th at 896, and no longer use the term

“treating source,” compare 20 C.F.R. § 416.913, with id. § 416.927.

Under the revised rules, an ALJ “will not defer or give any specific

evidentiary weight, including controlling weight, to any medical opinion(s) or

prior administrative medical finding(s), including those from [a claimant’s]

medical sources.” 20 C.F.R. § 416.920c(a). Instead, the ALJ will consider

supportability, consistency, the relationship with the claimant, any

specialization, and “other factors,” including evidence that a medical source is

familiar with the other evidence in the claim or understands the disability

program’s policies and evidentiary requirements. Id. § 416.920c(c)(1)–(5).

The most important factors are supportability and consistency, and the

ALJ must explain how he considered them. Id. § 416.920c(a), (b)(2).

Supportability concerns the support provided by the source issuing the opinion:

“The more relevant the objective medical evidence and supporting

explanations presented by a medical source are to support his or her medical

opinion(s) or prior administrative medical finding(s), the more persuasive the

medical opinions or prior administrative medical finding(s) will be.” Id.

§ 416.920c(c)(1). Consistency concerns a comparison with other items in the

record: “The more consistent a medical opinion(s) or prior administrative

medical finding(s) is with the evidence from other medical sources and

nonmedical sources in the claim, the more persuasive the medical opinion(s) or

prior administrative medical finding(s) will be.” Id. § 416.920c(c)(2).

In June 2021, Dr. Cieply conducted a neuropsychological evaluation of

Brock and administered tests. Tr. 621–32. He stated, “[Brock] has normal

results on cognitive measures, though most self-report measures suggest a

level of over-report invalidating her findings.” Tr. 626. He observed that, based

on a rating scale, Brock’s responses to a symptom checklist related to attention

deficit hyperactivity disorder fell “in the ‘Marked’ range for symptoms of the

disorder” and indicated “severe inattention and hyperactivity-impulsivity.” Tr.

628. He explained the results of cognitive testing:

[Brock]’s cognitive test results are likely an accurate representation

of her current functional status, though self-report likely over-

estimate[s] the extent and severity of psychiatric problems as most

standardized measures suggest possible validity concerns based on

the level of over-reporting.

…

Emotionally, there is evidence of a severe number of symptoms of

depression and anxiety. There are also evident problems managing

past traumas and history of panic attacks. There are concerns about

the level of suicidal ideation and indications of

hopelessness. … [Brock] is at risk for significant behavioral and

social difficulties.

Tr. 630–31.

Dr. Cieply provided these clinical impressions:

Overall, there is limited evidence of cognitive impairment[,] and the

results are consistent with pre-morbid expectations based on age,

acquired education, and previous occupations. Any variability

amongst individual test results during the evaluation is the result of

the severity of psychiatric illness evident on every self-report

measure. These apparent psychiatric factors could lower the

efficiency of her cognitive functioning and raise her awareness of

many functional problems not actually evident during the testing

session. In addition, some functional problems could also occur

secondary [Brock]’s reported history of reading[-]based learning

disability (i.e., dyslexia) and medical ailments (including chronic

pain) resulting in a disabled status.

The findings suggest levels of depression (with exceptionally low

self-esteem and vague suicidal ideation) and anxiety (with panic

attacks) more consistent with hospitalized psychiatric patients.

Some evident problems managing stress are likely the result of

[Post-Traumatic Stress Disorder (PTSD)] secondary multiple

traumas as an adolescent. Bipolar II Disorder is a future possibility

with further monitoring by her health care professionals[,] as the

current results provide more evidence of Borderline Personality

Disorder. Ultimately, [Brock] is in a very overwhelmed state and in

need of supportive treatment through her mental health

professionals responsible for her care. On the other hand, the results

provide limited evidence of O[bsessive-]C[ompulsive ]D[isorder].

Although there are some subtle tendencies evident, these symptoms

are more consistent with the severity of anxiety on testing. There is

also limited evidence of Attention-Deficit/Hyperactivity Disorder.

Tr. 631.

Dr. Cieply provided this recommendation:

Psychiatric symptoms are very concerning at this time. As such,

[Brock] should continue ongoing outpatient psychiatric follow-up as

a means of managing psychopharmacological means of treating

symptoms at the discretion of her treatment provider[,] with regular

psychosocial counseling as a means of improving her coping

mechanisms and addressing behavioral / social issues evident on

testing. … .

Tr. 632.

In April 2024, L.M.H.C. Bliss completed a mental capacity source

statement form and listed these diagnoses: “Major Depressive Disorder,

recurrent, moderate”; “[P]ost[-]Traumatic Stress Disorder”;

“Attention-Deficit/Hyperactivity Disorder, Combined Presentation”; and

“Borderline Personality Disorder.” Tr. 1752–54. Through a checklist, she

opined that Brock had “marked” limitations in these areas of mental

work-related functioning:

 [t]he ability to maintain attention and concentration [f]or extended

periods;

 [t]he ability to perform activities within a schedule, [m]aintain regular

attendance, and be punctual [w]ithin customary limits;

 [t]he ability to sustain an ordinary routine without [s]pecial supervision;

 [t]he ability to complete a normal workday [w]ithout interruptions from

psychological [b]ased symptoms; and

 [t]he ability to interact appropriately with the [g]eneral public.

Tr. 1752–53. Through a checklist, she opined that Brock had “extreme”

limitations in these areas of mental work-related functioning:

 [t]he ability to carry out detailed instructions;

 [t]he ability to work in coordination with or in [p]roximity to others

without being distracted [b]y them;

 [t]he ability to complete a [n]ormal workweek without interruptions

from psychologically based symptoms;

 [t]he ability to perform as a consistent pace with a one hour lunch break

and two 15 minutes rest periods;

 [t]he ability to get along with coworkers or [p]eers without distracting

them or exhibiting [b]ehavioral extremes; and

 [t]he ability to travel in unfamiliar places or [u]se public transportation.

Tr. 1752–53. The form defines “marked” as: “The individual has limitations

functioning in this area, two thirds of an eight hour work day.” Tr. 1752. The

form defines “extreme” as: “There is major limitation in this area. There is no

useful ability to function in this area.” Tr. 1752. Under the instruction,

“Describe the medical/[c]linical findings that support this assessment,”

L.M.H.C. Bliss includes no description. Tr. 1753. Through a checklist, she

states that her opinion was based on direct observation/treatment, patient

report, psychological/psychiatric evaluations, and counseling/therapy records.

Tr. 1754.

The ALJ evaluated Dr. Cieply’s report:

The opinion of the examining psychologist, Kyle R. Cieply, Ph.D., is

not persuasive (Exhibit B4F). Dr. Cieply did not provide an opinion

of functioning, noted a suggestion of over-reporting, and pointed out

inconsistencies between the severity of symptoms reported and the

findings of the evaluation. Moreover, the other evidence of record

does not support the statement of [Brock] being “in a very

overwhelmed state.” The overall evidence is consistent with mental

impairments causing moderate limitations, but is not consistent with

symptoms showing greater deficits tha[n] accommodated herein. The

mental health records note exaggeration on the part of [Brock]. Her

therapist documented exaggeration on numerous occasions with

times when [Brock] would fail to cease the behavior (Exhibits B4F;

B12F/91, 103, 121, 140, 151; B26F/16, 19, 58, 60; B30F/8). Moreover,

the evidence shows she has the ability to interact with those she

knows and is characterized as comfortable during appointments

(Exhibits B2F/15–16; B3F/5; B4F/12; B9F/3, 22; B10F/32–37, 40–44;

B11F/31; B17F/61; B25F; B37F/12). She is also characterized as

pleasant and cooperative (Exhibits B1F/149–150, 209–210; B4F/6;

B10F/18–21, 32–37; B12F/2; B21F/25; B27F/5; B37F/12).

Furthermore, [Brock] was able to interact appropriately with both

consultative examiners and was cooperative during both

appointments (Exhibit B22F, B23F). In addition, she told her

therapist she was assisting her mother care for a sick friend for over

a year (Exhibit B26F/2, 16, 92). Lastly, the evidence shows [Brock]

has adapted her daily activities to accommodate her limitations

suggesting she has the ability to adapt to change. (Exhibits B5E,

B6E, B10E, B12E).

Tr. 40.

The ALJ evaluated these opinions, including the opinions of L.M.H.C.

Bliss:

The opinions of Jeanne Utterback, [Brock]’s physical therapist, dated

April 1, 2024, opinion of [her] therapist, Kathryn Bliss, LMHC, and

the opinion of Abraham Fura, M.D., [her] pain management

provider, are not persuasive (Exhibits B33F, B34F, B35F, B36F). The

treating opinions are not supported by adequate explanation and

also are not consistent with [Brock’s] testimony and information in

her function reports and physical therapy records. For example, Ms.

Utterback noted findings of joint hypermobility, which is not

documented elsewhere in objective findings. She also noted

instability of the spine, which is also not show[n] in the numerous

physical examinations in the evidence documenting normal

musculoskeletal and normal neurological findings (Exhibits B2F/1–

3, 7–8, 10–11, 15–16; B3F/5; B4F/12; B9F/3, 22; B10F/40–44;

B11F/10, 25; B17F/53, 61; B21F/25). If [Brock] were as bad as stated

by the treating providers, [she] could not drive. Moreover, [Brock]

testified she could lift ten pounds, which [is] inconsistent with

portions of the treating opinions. The information in the mental

health treatment records do not support marked and extreme

limitation in functioning and Ms. Bliss did not provide information

to explain the rating of marked and extreme difficulty. For example,

there is no evidence to support marked difficulty getting along [with]

the general public. [Brock] was shown to interact appropriate[ly]

with the consultative examiners and was noted throughout the

records as very pleasant and cooperative (Exhibits B1F/149–150,

209–210; B4F/6; B10F/18–21, 32–37; B12F/2; B21F/25; B22F; B23F;

B27F/5; B37F/12). In addition, she told her therapist she was

assisting her mother care for a sick friend for over a year (Exhibit

B26F/2, 16, 92). Furthermore, the evidence shows [Brock] has the

ability to interact with those she knows and is characterized as

comfortable during appointments (Exhibits B2F/15–16; B3F/5;

B4F/12; B9F/3, 22; B10F/32–37, 40–44; B11F/31; B17F/61; B25F;

B37F/12). The opinion of Dr. Fura is not consistent with the pain

management records. While there are findings of reduced and

painful range of motion of the cervical spine[,] and cervical facet

maneuvers were positive bilaterally[,] there is also reporting of

improvement with treatment (Exhibits B21F, B27F, B29F).

Moreover, the opinions provided are not consistent with [Brock]’s

reported daily activities, which having included going shopping all

around town with her mother, multiple arts and crafts projects,

tending herb gardens, research of symptoms and other areas of

interest, going to the Tampa Aquarium with family, attending an art

exhibition, and assisting her mother with the care of a sick friend

(Exhibits B1F/173; B12F/55, 61, 67; B26F/2, 16, 19, 22, 92).

Tr. 41. The ALJ provided this summary:

[B]ased on a review of the medical evidence of record, as well as

[Brock]’s testimony at the hearing and the record as a whole, the

undersigned finds the evidence contained in the record does not

support [Brock]’s allegations of totally incapacitating symptoms.

[She] has retained the capacity to perform medium work, with minor

non-exertional limitations, throughout the period under

consideration. [Brock] has not demonstrated that the medical

evidence supports greater limitation than included in the [RFC].

Tr. 41.

Contrary to Brock’s argument, the ALJ properly evaluated Dr. Cieply’s

and L.M.H.C. Bliss’s opinions, and substantial evidence supports the ALJ’s

finding that the opinions were unpersuasive.

The ALJ properly considered the persuasiveness of Dr. Cieply’s opinion.

The ALJ explained that he was not persuaded by Dr. Cieply’s opinion because

Dr. Cieply provided no opinion of functioning, noted a suggestion of

over-reporting, and identified inconsistencies between his evaluation findings

and Brock’s reported severity of symptoms. Tr. 40. The ALJ found that the

record fails to support Dr. Cieply’s statement that Brock is “in a very

overwhelmed state” and contains documented exaggeration on numerous

occasions. Tr. 40 (citing Exhibits B4F; B12F/91, 103, 121, 140, 151; B26F/16,

19, 58, 60; B30F/8). The ALJ found that the evidence shows Brock can interact

with people she knows and was characterized as comfortable, pleasant, and

cooperative, Tr. 40 (citing Exhibits B1F/149–150, 209–210; B2F/15–16; B3F/5;

B4F/6, 12; B9F/3, 22; B10F/18–21, 32–37, 40–44; B11F/31; B12F/2; B17F/61;

B21F/25; B25F; B27F/5; B37F/12); she interacted appropriately with the

consultative examiners and was cooperative during the appointments, Tr. 40

(citing Exhibits B22F, B23F); she helped her mother care for a sick friend for

over a year, Tr. 40 (citing Exhibit B26F/2, 16, 92); and she adapted her daily

activities to accommodate her limitations, suggesting she has the ability to

adapt to change, Tr. 40 (citing Exhibits B5E, B6E, B10E, B12E).

The ALJ properly considered the persuasiveness of L.M.H.C. Bliss’s

opinion. The ALJ explained that he was not persuaded by L.M.H.C. Bliss’s

opinion because he found the “marked” and “extreme” limitations in

functioning were unsupported by the mental health treatment records, and

L.M.H.C. Bliss “did not provide information to explain the ratings of marked

and extreme difficulty.” Tr. 41. The ALJ explained that he found the opinion

was inconsistent with the overall record for reasons similar to those he

provided for Dr. Cieply’s opinion: Brock interacted appropriately with the

consultative examiners and was observed throughout the record as “very

pleasant and cooperative,” Tr. 41 (citing Exhibits B1F/149–50, 209–10; B4F/6;

B10F/18–21, 32–37; B12F/2; B21F/25; B22F; B23F; B27F/5; B37F/12); she

helped her mother care for a sick friend for over a year, Tr. 41 (citing Exhibit

B26F/2, 16, 92); and she was able to interact with people she knows and was

characterized as comfortable during appointments, Tr. 41 (citing Exhibits

B2F/15–16; B3F/5; B4F/12; B9F/3, 22; B10F/32–37, 40–44; B11F/31; B17F/61;

B25F; B37F/12). He also determined that the opinion was inconsistent with

Brock’s reported daily activities of “going shopping all around town with her

mother, multiple arts and crafts projects, tending herb gardens, research of

symptoms and other areas of interest, going to the Tampa Aquarium with

family, [and] attending an art exhibition[.]” Tr. 41 (citing Exhibits B1F/173;

B12F/55, 61, 67; B26F/2, 16, 19, 92).

Brock argues that the ALJ’s determination that L.M.H.C. Bliss did not

provide information to explain the “marked” and “extreme” ratings is incorrect

because the evaluation form defines the words. Doc. 15 at 12. She complains

about the finding that Bliss’s treatment notes do not support marked and

extreme limitations in functioning based on the absence of evidence to support

marked difficulty getting along with the general public, arguing that Bliss was

“familiar enough with [her] mental limitations to draw this conclusion due to

the lengthy and consistent treatment.” Doc. 15 at 12. The arguments are

unpersuasive. Even with the form’s definitions, why L.M.H.C. Bliss chose the

ratings is unexplained. See Tr. 1752–53. Moreover, as the Commissioner

observes, through the RFC, the ALJ accounted for Brock’s problems with

getting along with the general public by limiting her to jobs involving no

interaction with the public. Doc. 20 at 11; see Tr. 23.

Brock argues that the ALJ’s reasons for finding Dr. Cieply’s report

unpersuasive are inaccurate or insufficient. Doc. 15 at 16. She contends that

Dr. Cieply assigned functional limitations in his evaluation because he

“indicate[d] ‘marked’ and ‘severe’ symptoms related to her depression and

anxiety” and he “assigned social limitations describing anger when

overwhelmed or acting out, or when something goes wrong.” Doc. 15 at 16

(citing Tr. 630–32). This argument is also unpersuasive. Dr. Cieply assigned

no functional limitation in the evaluation. See Tr. 621–32. Using “marked” and

“severe” to describe Brock’s symptoms relating to an attention deficit

hyperactivity disorder test, see Tr. 628, is not the same as providing an opinion

about necessary limitations. Nor is the statement that Brock “is at risk for

social difficulties based on possible angry cognitions, moods, behaviors, or

fantasies, usually intrusive and occurring at unwanted times,” or his

description of Brock’s anger when overwhelmed or acting out. See Tr. 630–32.

Moreover, as the Commissioner observes, the ALJ acknowledged Brock’s social

difficulties and accounted for them in the RFC by limiting her to jobs involving

no interaction with the public, no more than occasional interaction with

supervisors and coworkers, and no participation in tandem tasks. See Doc. 20

at 11 (citing Tr. 23).

Brock argues that the ALJ’s decision suggests her over-reporting and

exaggeration of symptoms was malingering when it is actually a symptom of

her personality disorder. Doc. 15 at 17–18. As the Commissioner persuasively

responds, “[T]he ALJ acknowledged [Brock]’s mental impairments, finding

that her severe impairments included a personality disorder, depression,

anxiety, and PTSD (Tr. 19). The ALJ did not find that [Brock] was malingering;

he simply found that [her] description of the intensity, persistence, and

limiting effects of her symptoms was undermined by her much-remarked-upon

tendency to exaggerate (Tr. 23).” Doc. 20 at 11.

Brock argues that the fact that she “was able to behave appropriately

while in doctors’ offices does not translate to a finding that she could respond

appropriately when in a work environment, interacting with co-workers,

supervisors and the public.” Doc. 15 at 13. This argument overlooks that the

RFC limits Brock to “no interaction with the public” and only “occasional

interaction with coworkers and supervisors.” See Tr. 23. In any event, a finding

that behaving appropriately in doctors’ offices suggests some ability to behave

appropriately in other contexts is supported by substantial evidence.

Brock argues that her ability to interact appropriately at her providers’

offices and with the consultative examiners, and the fact that she “happened

to be oriented with normal memory and appropriate mood and effect,” are not

evidence that undermines a treating or non-treating physician’s opinion or any

other source opinion. Doc. 15 at 17. She relies on Simon v. Commissioner,

Social Security Administration, 7 F.4th 1094, 1103 (11th Cir. 2021), and Richey

v. Social Security Administration, Commissioner, No. 22-11595, 2023 WL

4013525, at *3 (11th Cir. June 15, 2023). The Eleventh Circuit decided each

case under the pre-revision guidelines that required an ALJ to consider opinion

evidence under the treating-physician rule. See Simon, 7 F.4th at 1104 n.4 &

1107 (applying the treating-physician rule); Richey, 2023 WL 4013525 at *2

n.2 & *3 (explaining the treating physician rule; “[T]he ALJ’s decision is not

supported by substantial evidence as to Dr. Boxley because he did not identify

good cause to discount her opinions.” (citing Simon, 7 F.4th at 1105–06)). In

any event, the ALJ did not reversibly err in considering Brock’s interactions in

determining the persuasiveness of opinions. Moreover, in addition to those

interactions, the ALJ considered how Brock appeared at the administrative

hearing, when the ALJ could personally observe Brock’s social and

communication skills. Tr. 22.

Brock complains that the ALJ’s statements about her activities of daily

living mischaracterize the extent to which she did those things. Doc. 15 at 18.

She cites other evidence to support her complaint. See Doc. 15 at 18. A review

of the exhibits to which the ALJ cites (“Exhibits B1F/173; B12F/55, 61, 67;

B26F/2, 16, 19, 22, 92”) shows no mischaracterization:

 B1F/173 (Tr. 525) L.M.H.C. Bliss’s 9/15/2020 progress note: “[Brock]

presented as bright, showing off handmade crafts and artwork that

she has been doing.”

 B12F/55 (Tr. 973) L.M.H.C. Bliss’s 3/23/2022 progress note: “[Brock]

keeps busy with her many art projects and plants.”

 B12F/61 (Tr. 979) L.M.H.C. Bliss’s 3/30/2022 progress note: “[Brock]

processed events from her week today, including attending a

spectacular art exhibition.”

 B12F/67 (Tr. 985) L.M.H.C. Bliss’s 4/6/2022 progress note: “[Brock]

reported [she] remains active with art[s], crafts[,] and gardening.”

 B12F/133 (Tr. 1051) L.M.H.C. Bliss’s 7/13/2022 progress note:

“[Brock] shared she and her mother had spent the day traveling the

area shopping and having fun.”

 B26F/2 (Tr. 1506) L.M.H.C. Bliss’s 8/24/2022 progress note: “[Brock]

has been helping her mother provide additional care to a friend in an

[assisted living facility (ALF)] by attending to her at the ALF and by

accompanying her to medical appointments.”

 B26F/16 (Tr. 1520) L.M.H.C. Bliss’s 11/2/2022 progress note: “[Brock]

shared a great deal of frustration around her mother’s friend whom

she and her mother are monitoring and helping in an ALF as her

mental and physical abilities decline.”

 B26F/19 (Tr. 1522–23) L.M.H.C. Bliss’s 11/9/2022 progress note:

“[Brock] and her boyfriend will meet family members at the Tampa

Aquarium but will leave if/when they become too stimulated or

overwhelmed. Elements of exaggeration and emphasis on dogmatic

demands were again brought forward but this time client ignored the

information.”

 B26F/22 (Tr. 1526) L.M.H.C. Bliss’s 11/23/2022 progress note:

“[Brock] … had a good time with her boyfriend’s family in Tampa

which had been a worry for her. [She] appears happier when there

are family gatherings that go well. Current family events were

reviewed and [she] developed plans to create positive outcomes for

upcoming get[-]togethers.”

 B26F/92 (Tr. 1596) L.M.H.C. Bliss’s 10/11/23 progress note: “[Brock]

presented as somewhat anxious, scared[,] and upset. She shared the

situation of the declining cognitive processes of her mother’s close

friend who [she] assists with care. [She] stated that she is helping

staff learn to deal with her mother’s friend more appropriately[.]”

Citing other evidence, see Doc. 15 at 18, Brock contends that her

activities of daily living “do[] not translate to being able to perform in a work

setting,” Doc. 15 at 19. But the ALJ is the one who had to evaluate that and

the other evidence to make findings, which this court will uphold as supported

by substantial evidence. See Buckwalter v. Acting Comm’r of Soc. Sec., 5 F.4th

1315, 1320 (11th Cir. 2021) (explaining that a court affirms a decision

supported by substantial evidence and may not reweigh evidence or decide the

facts anew). Brock’s reliance on Simon and Richey is again misplaced. See Doc.

15 at 19. In each case, the Eleventh Circuit applied pre-revision guidelines

when finding that the ALJ failed to explain how the claimant’s activities of

daily living sufficiently discredited a treating physician’s opinion. See Simon,

7 F.4th at 1108; Richey, 2023 WL 4013525, at *3. In Schink, the Eleventh

Circuit found that the ALJ’s conclusion that the claimant had only a “mild”

limitation in his activities of daily living was not substantially supported by

the evidence. 935 F.3d 1245, 1266 (11th Cir. 2019). The Eleventh Circuit stated

that the claimant’s ability “to feed and clothe himself, walk a dog, and watch

television [said] very little about whether he suffered from a severe mental

impairment or about his ability to function in a stressful work setting.” Id.

Here, the ALJ’s finding that Dr. Cieply’s and L.M.H.C. Bliss’s opinions were

inconsistent with Brock’s reported daily activities is supported by substantial

evidence.

Finally, Brock contends that the ALJ erred by reciting the medical

evidence before the persuasiveness analysis and “failing to link those findings”

to the analysis. Doc. 15 at 19–21. She states, “An ALJ has a duty to make clear

the weight accorded to each item of evidence and the reasons for those decisions

to enable a reviewing court to determine whether the ultimate decision is based

on substantial evidence.” Doc. 15 at 19–20 (citing Himes v. Comm’r of Soc. Sec.,

585 F. App’x 758 (11th Cir. 2014)). She states, “Other courts have found error

when the ALJ failed to build an ‘accurate and logical bridge’ between his

findings and the conclusions he reached.” Doc. 15 at 20 (citing, in this order,

Brown v. Comm’ of Soc. Sec., No. 6:20-cv-840-GJK, 2021 WL 2917562, at *4

(M.D. Fla. July 12, 2021); Pierson v. Comm’r of Soc. Sec., No. 6:19-cv-1515-

RBD-DCI, 2020 WL 1957597, at *6 (M.D. Fla. April 8, 2020); Michael v. Saul,

No. 2:20-cv-238, 2021 WL 1811736, at *11 (N.D. Ind. May 6, 2021); Moore v.

Colvin, 743 F.3d 1118, 1112 (7th Cir. 2014); Lanigan v. Berryhill, 865 F.3d 558,

563 (7th Cir. 2017); Lewis v. Berryhill, 858 F.3d 858, 867-68 (4th Cir. 2017);

Owens v. Heckler, 748 F.2d 1511, 1514-16 (11th Cir. 1984); Holt v. Sullivan

921 F.2d 1221, 1223 (11th Cir. 1991); and Strickland v. Comm’ of Soc. Sec.,

516 F. App’x 829, 832 (11th Cir. 20138)). Neither the regulations nor binding

precedent use the term “logical bridge.” As shown by the above excerpts from

the decision, the ALJ considered the record as a whole and adequately

explained his consideration of the opinion evidence.

The Commissioner’s decision is affirmed. The clerk is directed to enter

judgment for the Commissioner of Social Security and against Kadin Brock

and close the file.

Ordered in Jacksonville, Florida, on September 29, 2025.

CE Protea foachbobe

Patricia D. Barksdale

United States Magistrate Judge

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