The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF ALABAMA
SOUTHERN DIVISION
REBECCA ANN T., )
)
Plaintiff, )
)
v. ) CASE NO. 1:25-cv-460-JTA
)
FRANK BISIGNANO, Commissioner of )
Social Security, )
)
Defendant. )
MEMORANDUM OPINION AND ORDER
Pursuant to 42 U.S.C. § 405(g), Plaintiff Rebecca Ann T. brings this action to review
a final decision by the Commissioner of Social Security (“Commissioner”). (Doc. No. 1.)1
The Commissioner denied Plaintiff’s application for a period of disability and Disability
Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”). The Court
construes Plaintiff’s brief in support of her Complaint (Doc. No. 13) as a motion for
summary judgment and the Commissioner’s brief in opposition to the Complaint as a
motion for summary judgment (Doc. No. 17). The parties have consented to the exercise
of dispositive jurisdiction by a magistrate judge pursuant to 28 U.S.C. § 636(c). (Docs. No.
5, 6.)
After scrutiny of the record and the motions submitted by the parties, the Court finds
that Plaintiff’s motion for summary judgment is due to be DENIED, the Commissioner’s
1 Document numbers as they appear on the docket sheet are designated as “Doc. No.”
motion for summary judgment is due to be GRANTED, and the decision of the
Commissioner is due to be AFFIRMED.
I. PROCEDURAL BACKGROUND AND FACTS2
Plaintiff is an adult female3 with at least a high school education and no past relevant
work. (R. 25–26.) She alleged a disability onset date of January 1, 2020, due to post
traumatic stress disorder (“PTSD”) and a lumbar condition. (R. 190, 227.)
In May 2023, Plaintiff protectively filed an application for SSI and for a period of
disability and DIB under Titles II and XVI of the Social Security Act. Her claim was denied
initially and upon reconsideration. Following an administrative hearing, the Administrative
Law Judge (“ALJ”) issued an unfavorable decision, and the Appeals Council denied
Plaintiff’s request for review. (R. 1-32.) The hearing decision became the final decision of
the Commissioner. See 42 U.S.C. § 405(g).
On June 20, 2025, Plaintiff filed this civil action for judicial review of the
Commissioner’s final decision. (Doc. No. 1.) The parties have briefed their respective
positions. This matter is ripe for review.
II. STANDARD OF REVIEW
Judicial review of disability claims is limited to whether the Commissioner’s
decision is supported by substantial evidence and whether the correct legal standards were
2 Citations to the administrative record are consistent with the transcript of administrative
proceedings filed in this case. (See Doc. No. 10.)
3 Plaintiff was 33 years old on her alleged onset date. (R. 25.)
applied. 42 U.S.C. § 405(g).4 See Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178
(11th Cir. 2011) (“In Social Security appeals, we must determine whether the
Commissioner’s decision is ‘supported by substantial evidence and based on proper legal
standards.’” (quoting Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1158 (11th Cir.
2004))). “Substantial evidence is more than a scintilla and is such relevant evidence as a
reasonable person would accept as adequate to support a conclusion.” Id. (citation
modified). The court “will affirm the Commissioner’s decision if it is supported by
substantial evidence, even if the preponderance of the evidence weighs against it.”
Buckwalter v. Acting Comm’r of Soc. Sec., 5 F.4th 1315, 1320 (11th Cir. 2021).5 However,
the court may not find new facts, reweigh evidence, or substitute its own judgment for that
of the Commissioner. Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983); see
Winschel, 631 F.3d at 1178 (“We may not decide the facts anew, reweigh the evidence, or
substitute our judgment for that of the Commissioner.” (quotation and brackets omitted)).
4 Sentence four of 42 U.S.C. § 405(g) authorizes the district court to “enter, upon the pleadings
and transcript of the record, a judgment affirming, modifying, or reversing the decision of the
Commissioner of Social Security, with or without remanding the cause for a rehearing.” 42 U.S.C.
§ 405(g).
5 The district court may remand a case to the Commissioner for a rehearing if the court finds “either
. . . the decision is not supported by substantial evidence, or . . . the Commissioner (or the ALJ)
incorrectly applied the law relevant to the disability claim.” Jackson v. Chater, 99 F.3d 1086, 1092
(11th Cir. 1996).
III. STANDARD FOR DETERMINING DISABILITY
An individual who files an application for disability must prove that she is
disabled. See 20 C.F.R. §§ 404.1505, 416.920(a)(4).6 The Act defines “disability” as the
“inability to do 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.” 42 U.S.C. §
423(d)(1)(A); 20 C.F.R. § 405.1505(a).
Disability under the Act is determined under a five-step sequential evaluation
process. The ALJ must determine (1) whether Plaintiff is currently performing substantial
gainful activity; (2) whether Plaintiff has a severe impairment or combination of
impairments; (3) whether the severe impairment meets or exceeds an impairment in the
Listings of Impairments; (4) whether the Plaintiff can perform her past relevant work
despite the impairment; and (5) whether Plaintiff can perform other jobs that exist in the
national economy7 given her residual functional capacity (“RFC”), age, education, and
work experience. Simon v. Comm’r, Soc. Sec. Admin., 7 F.4th 1094, 1101–02 (11th Cir.
2021).8 Plaintiff has the burden of proof on the first four steps and the Commissioner
6 Although DIB and SSI are separate programs, the standards for determining disability are
identical. See Patterson v. Bowen, 799 F.2d 1455, 1456 n.1 (11th Cir. 1986); Miles v. Soc. Sec.
Admin., Comm’r, 469 F. App’x 743, 744 (11th Cir. 2012).
7 To determine the existence of other jobs which the claimant can perform, the ALJ may rely on
the testimony of a vocational expert (“VE”). Winschel, 631 F.3d at 1180.
8 Simon was superseded on other grounds by 2017 regulations abrogating the treating physician
rule. See Harner v. Soc. Sec. Admin., Comm’r, 38 F.4th 892, 894 (11th Cir. 2022).
carries the burden on the fifth step. Goode v. Comm’r of Soc. Sec., 966 F.3d 1277, 1279
(11th Cir. 2020). If the Commissioner carries the burden at the fifth step, the burden shifts
back to Plaintiff to prove she is unable to perform the jobs suggested. Id.
IV. ADMINISTRATIVE DECISION
Within the structure of the sequential evaluation process, the ALJ found that
Plaintiff met the insured status requirements of the Social Security Act through December
31, 2023, but had not engaged in substantial gainful activity since September 1, 2022. (R.
19–20.)9 The ALJ determined Plaintiff suffers from the following severe impairments that
significantly limit her ability to perform basic work activities: PTSD, generalized anxiety
disorder, unspecified depressive disorder, obesity, lumbar spine facet changes, and
lumbago. (R. 20.) The ALJ also determined Plaintiff had the non-severe impairment of
lumbar radiculopathy. (Id.)
The ALJ concluded that Plaintiff’s impairments do not meet or medically equal the
severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (R.
20.) The ALJ also concluded that Plaintiff retains the RFC to perform light work as defined
in 20 C.F.R. §§ 404.1567(b) and 416.967(b),10 with certain restrictions:
[Plaintiff can] occasionally lift twenty pounds; frequently lift ten pounds;
frequently climb; unlimited balancing; occasionally stoop; frequently kneel
9 Because Plaintiff had previously filed Title II and Title XVI applications that were denied on
August 31, 2022, the relevant time period was amended to begin on September 1, 2022. (R. 17.)
10 “Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying
of objects weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in
this category when it requires a good deal of walking or standing, or when it involves sitting most
of the time with some pushing and pulling of an arm or leg controls.” 20 C.F.R. §§ 404.1567(b)
and 416.967(b).
and crouch; [and] occasionally crawl. [Plaintiff] is limited to understand,
remember, and carry out simple instructions. [She] can have occasional
interaction with [the] general public, co-workers, and supervisors. [Plaintiff]
can perform no production pace work and is limited to work with no more
than occasional changes in work setting.
(R. 22.)
Based upon the testimony of a VE, the ALJ determined that an individual with
Plaintiff’s age, education, work experience, and RFC could work as a price marker, mail
clerk, or office helper. (R. 26.) The ALJ found that based upon Plaintiff’s age, education,
work experience and RFC, Plaintiff can make a successful adjustment to other work that
exists in significant numbers in the national economy. (R. 26–27.) Based on the foregoing,
the ALJ concluded Plaintiff had not been disabled from the alleged onset date through the
date of the hearing decision and was not disabled under the Social Security Act. (R. 27.)
V. DISCUSSION
Plaintiff presents two issues in this appeal. First, Plaintiff argues the RFC is
unsupported by substantial evidence because the ALJ did not properly evaluate her
psychiatric symptoms. (Doc. No. 13 at 2.) Second, Plaintiff argues the ALJ failed to
properly analyze whether good cause existed for her noncompliance with treatment. (Id. at
3.) The Court addresses each issue in turn.
A. Evaluation of Psychiatric Symptoms
Plaintiff argues the ALJ erred when crafting her RFC because he improperly focused
on when she was noncompliant with her medications “instead of analyzing her mental
health symptoms as a whole[.]” (Doc. No. 13 at 8.) The Commissioner responds substantial
evidence supports the ALJ’s RFC determination. (Doc. No. 17 at 5.)
The RFC assesses the claimant’s remaining ability to do work despite her
impairments and any related symptoms. 20 C.F.R. § 404.1545(a)(1). When assessing a
claimant’s RFC, the ALJ must consider “all impairments, severe and non-severe.” Schink
v. Comm’r of Soc. Sec., 935 F.3d 1245, 1268 (11th Cir. 2019) (citing Bowen v. Heckler, 748
F.2d 629, 634–35 (11th Cir. 1984)). The ALJ determines RFC “based on all of the relevant
medical and other evidence.” 20 C.F.R. § 404.1545(a)(3). Although the ALJ does not need
to discuss every piece of evidence, he must consider the claimant’s “medical condition as
a whole.” Dyer v. Barnhart, 395 F.3d 1206, 1211 (11th Cir. 2005); see also 20 C.F.R. §
404.1523(c) and Social Security Ruling 96-8p.
Here, substantial evidence supports the ALJ’s RFC determination. The ALJ noted
that Plaintiff’s medical record includes multiple mental status examinations that were
generally normal. (R. 23, 651, 704, 779–80, 801–02, 814.) Additionally, the ALJ
recognized that while her treatment regimen “does not eliminate all of her symptoms, the
stability of these conditions is dependent on proper management[.]” (R. 23.) While the ALJ
did note Plaintiff was noncompliant with her medications for months, it was to show that
that the noncompliance resulted in a decrease in her mental abilities and that once she
resumed taking her medications, her condition improved. (R. 23.) The ALJ cited to specific
medical records to support these conclusions. (R. 23, 778–79.) Additionally, the ALJ
supported Plaintiff’s mental RFC determination with Dr. David Ghostly’s consultative
psychological examination. (R. 23–24, 674–75.) As the ALJ noted, Dr. Ghostly found
Plaintiff’s ability to function independently and to manage finances is unimpaired; her
ability to reliably understand, remember, and carry out instructions is mildly to moderately
impaired; and her ability to respond appropriately to supervisors, coworkers, and work
pressures in a work setting is moderately impaired. (R. 24, 675.) The ALJ also considered
the prior administrative medical findings at the initial and reconsideration levels. (R. 25,
51–63, 83–84.) The state agency psychological consultants found Plaintiff was mildly to
moderately limited by her mental impairments. (R. 55, 86–88.)11 The ALJ reasoned the
mental RFC restrictions addressed Plaintiff’s limitations caused by her anxiety and
depressive symptoms; her adaptive limitations; and her limitations in interactional
functions. (R. 24.)
Plaintiff points to the Eleventh Circuit’s decisions in Simon and Cabrera to support
her argument that the ALJ failed to properly evaluate her psychiatric symptoms, but both
are distinguishable. (Doc. No. 13 at 6–7 (citing Cabrera v. Comm’r of Soc. Sec., No. 22-
13053, 2023 WL 5768387, at *8 (11th Cir. Sept. 7, 2023); Simon, 7 F.4th at 1106). In both
cases, the Eleventh Circuit reversed and remanded because the ALJ failed to state good
cause for discounting the opinions of the plaintiffs’ treating psychiatrists. See Simon, 7
F.4th at 1108; Cabrera, 2023 WL 5768387, at *8.12 The Eleventh Circuit held the ALJ erred
11 At the initial and reconsideration levels, the state agency psychologists found Plaintiff
moderately limited in her abilities to understand and remember detailed instructions; carry out
detailed instruction; maintain attention and concentration for extended periods; interact
appropriately with the general public; accept instructions and respond appropriately to criticism
from supervisors; and respond appropriately to changes in the work setting. (R. 59–60, 87–88.) At
the initial level, the state agency psychologist also found Plaintiff moderately limited in her ability
to complete a normal workday without interruptions from her psychologically based symptoms
and to perform at a consistent pace. (R. 60.)
12 These cases were decided under the treating physician rule, which only applies to claims filed
before March 27, 2017. See Simon, 7 F.4th at 1104 n.4; Cabrera, 2023 WL 5768387, at *6
(recognizing the treating physician rule only applies to claims filed before March 27, 2017).
when using generalized findings to show inconsistency and discount a treating physician’s
opinion. See Simon, 7 F.4th at 1106 (concluding that “isolated entries in [the treating
physician’s] notes indicating that [the plaintiff] was at times stable on his meds, without
more, cannot constitute or contribute to good cause to reject [the treating physician’s]
opinions”); Cabrera, 2023 WL 5768387, at *8 (stating that if an ALJ seeks to discount a
treating physician’s opinion “the ALJ must rely on the full range of evidence . . . rather
than cherry picking records from single days or treatments to support a conclusion”).
Because Plaintiff’s claim was filed after the treating physician rule was abrogated, these
cases are distinguishable. All that is required here is that the “ALJ’s decision is not a broad
rejection which is not enough to enable a reviewing court to conclude that the ALJ
considered the claimant’s condition as a whole.” Mitchell v. Comm’r, Soc. Sec. Admin., 771
F.3d 780, 782 (11th Cir. 2014) (citation modified). As described in more detail above, the
ALJ considered Plaintiff’s condition as a whole, including fluctuations in Plaintiff’s
symptoms and the effectiveness of her medications.13
Because the ALJ did not solely rely on Plaintiff’s noncompliance with her
medication, but rather relied on Plaintiff’s medical record, a consultative psychological
examination, and the prior administrative medical findings at both the initial and
13 Plaintiff appears to argue the ALJ disregarded evidence that contradicted his conclusion that
Plaintiff is not disabled. (Doc. No. 13 at 8.) But, as Plaintiff notes, “there is no rigid requirement
that the ALJ specifically refer to every piece of evidence in his decision.” Dyer, 395 F.3d at 1211.
Here, the ALJ acknowledged that Plaintiff’s treatment regimen does not eliminate all of her
symptoms, and noted Plaintiff reported nightmares, anxiety, flashbacks, tiredness from her
medication, and hypervigilance. (R. 22–23.) Although the ALJ did not refer to every piece of
evidence, the ALJ’s decision was not a broad rejection and shows he considered Plaintiff’s
condition as a whole. Mitchell, 771 F.3d at 782.
reconsideration levels, substantial evidence supports the ALJ’s RFC determination. See
Winschel, 631 F.3d at 1178 (“Substantial evidence is more than a scintilla and is such
relevant evidence as a reasonable person would accept as adequate to support a
conclusion.” (citation modified)).
Accordingly, the Court finds no reversible error.
B. Noncompliance with Treatment
Plaintiff also argues the Commissioner’s decision should be reversed because the
ALJ failed to evaluate whether good cause existed for her noncompliance with treatment.
(Doc. No. 13 at 11.) The Commissioner responds that the ALJ properly considered
Plaintiff’s noncompliance in accordance with the regulations. (Doc. No. 17 at 9.)
The Eleventh Circuit has held that “refusal to follow prescribed medical treatment
without a good reason will preclude a finding of disability.” Ellison v. Barnhart, 355 F.3d
1272, 1275 (11th Cir. 2003) (citing Dawkins v. Bowen, 848 F.2d 1211, 1213 (11th Cir.
1988)); see also 20 C.F.R. §§ 404.1530(b), 416.930(b) (“[i]f you do not follow the
prescribed treatment without a good reason, we will not find you disabled”). “[B]efore
denying an application based on a claimant’s failure to comply with prescribed medical
care, the ALJ must consider whether the claimant is able to afford the medical care.” Brown
v. Comm’r of Soc. Sec., 425 F. App’x 813, 817 (11th Cir. 2011) (citing Ellison, 355 F.3d
at 1275). However, the requirement to consider a claimant’s ability to afford medical care
applies when “the ALJ relies on noncompliance as the sole ground for the denial of
disability benefits.” Ellison, 355 F.3d at 1275 (emphasis added).
Here, the ALJ did not rely on Plaintiff’s noncompliance with her medication to deny
her disability benefits. Rather, the ALJ highlighted Plaintiff’s noncompliance to show
medication helped improve her condition. (R. 23 (“once back on her medications the
claimant’s condition improved”)). As the Commissioner notes, an ALJ may consider the
“type, dosage, effectiveness, and side effects of any medication” when evaluating a
claimant’s subjective symptoms. 20 C.F.R. §§ 404.1529(c)(3)(iv); 416.929(c)(3)(iv). That
is exactly what the ALJ did here. Additionally, even if the ALJ did deny Plaintiff benefits
based on her noncompliance with medication, it was not his sole reason for denying
benefits. As explained above, the ALJ relied on Plaintiff’s medical record, a consultative
psychological examination, and the prior administrative medical findings at both the initial
and reconsideration levels when making his decision to deny Plaintiff benefits. Thus, the
ALJ was not required to consider Plaintiff’s ability to afford treatment. See Ellison, 355
F.3d at 1275–76 (affirming the Commissioner’s decision when the ALJ’s determination
that the plaintiff was not disabled “was not significantly based on a finding of
noncompliance”); Brown, 425 F. App’x at 817 (“Because the gap in medical treatment did
not play a major role in the ALJ’s decision, any error in considering that gap in treatment
was harmless.”).
Consequently, the Court finds no reversible error.
VI. CONCLUSION
For the reasons stated, the Court finds the decision of the Commissioner is supported
by substantial evidence and is in accordance with applicable law. Therefore, it is
ORDERED as follows:
1. Plaintiff’s motion for summary judgment (Doc. No. 13) is DENIED.
2. The Commissioner’s motion for summary judgment (Doc. No. 17) is
GRANTED.
3. The decision of the Commissioner is AFFIRMED.
A separate judgment will issue.
DONE this 22nd day of June, 2026.
JERUSHA/T. ADAMS
UNITED/STATES MAGISTRATE JUDGE
12