# Fulks

> District Court, M.D. Florida · September 9, 2026

URL: https://www.frixlaw.com/law-library/cases/11438710

## Case

- **Full name:** Amanda Fulks v. Commissioner of Social Security
- **Court:** District Court, M.D. Florida
- **Decided:** September 9, 2026
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
OCALA DIVISION

AMANDA FULKS,

Plaintiff,

v. Case No: 5:25-cv-414-PRL

COMMISSIONER OF SOCIAL
SECURITY,

Defendant.

ORDER
Plaintiff appeals the administrative decision denying her applications for disability
insurance benefits (“DIB”) and supplemental security income (“SSI”). Upon a review of the
record, the memoranda, and the applicable law, the Commissioner’s decision is due to be
AFFIRMED.
I. Background
For the sake of convenience, the administrative history, which is not in dispute, is
copied from the Defendant’s brief:
In March 2018, Plaintiff protectively applied for DIB and SSI
alleging disability beginning December 7, 2017 (Tr. 547-88).
After denials at the initial and reconsideration levels, Plaintiff
requested an administrative hearing (Tr. 103-48, 191-233).
Following a hearing, an administrative law judge (ALJ) issued
an unfavorable decision in June 2021 (Tr. 68-102, 149-76). In
April 2022, the Appeals Council granted Plaintiff’s request for
review, vacated the ALJ’s June 2021 decision, and remanded
this matter for further administrative proceedings (Tr. 177-82).
The ALJ held another hearing in March 2023 and issued an
unfavorable decision in April 2023 (Tr. 7-67). The Appeals
Council denied Plaintiff’s request for further administrative
review, and Plaintiff sought judicial review (Case No. 5:23-cv-
637-PRL) (Tr. 1-6, 1942-45). In accordance with this Court’s
February 2024 Judgment, the Appeals Council vacated the
ALJ’s March 2023 decision, and remanded this case for further
administrative proceedings (Tr. 1944-52).
After holding another hearing, the ALJ issued an unfavorable
decision in April 2025 (Tr. 1879-1941). The ALJ’s April 2025
decision became final on June 8, 2025, because Plaintiff did not
file written exceptions, and the Appeals Council did not review
the decision on its own (Tr. 1880). Therefore, the ALJ’s April
2025 decision stands as the Commissioner’s final decision
subject to judicial review, and this Court has jurisdiction over
this action pursuant to § 205(g) of the Social Security Act, 42
U.S.C. § 405(g).
(Doc. 14 at 1-2).1
Plaintiff was 38 years old on the date of the ALJ’s decision. Plaintiff has a high school
education and no past relevant work experience. (Tr. 623, 1892, 1914). Based on a review of
the record, the ALJ found that Plaintiff has the severe impairments of obesity, fibromyalgia,
carpal tunnel syndrome, chronic obstructive pulmonary disease, endocarditis and
nonischemic cardiomyopathy, status post placement of an implantable cardioverter-
defibrillator (ICD), degenerative disc disease of the lumbar and cervical spine, bipolar
disorder with depressive disorder, anxiety disorder with panic disorder, and substance use
disorder (heroin). (Tr. 1885).
The ALJ found that the Plaintiff had the residual functional capacity (“RFC”) to
perform a range of sedentary work, with the following limitations:

1 For claims filed on or after March 27, 2017, the Social Security Administration has issued
new revised regulations regarding the evaluation of medical evidence, including medical source
opinions. See Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844-
01 (Jan. 18, 2017) (final rules) (“We are revising our rules to ensure that they reflect modern healthcare
delivery and are easier to understand and use. We expect that these changes will help us continue to
ensure a high level of accuracy in our determinations and decisions.”).
she can never climb ladders, ropes, or scaffolds; she can
occasionally climb ramps and stairs; she can occasionally stoop,
kneel, crouch, and crawl; she can frequently reach and handle;
she can occasionally tolerate exposure to temperatures under
forty degrees Fahrenheit and over ninety degrees Fahrenheit; she
have no exposure to unprotected heights or with dangerous
moving machinery; she can never operate a motor vehicle as part
of her job duties; she is limited to simple work tasks; she can
tolerate occasional interaction with the public.
(Tr. 1888).

Based upon the RFC, and considering the testimony of the vocational expert, the ALJ
found that Plaintiff could perform jobs that exist in significant numbers in the national
economy, such as the positions of circuit board layout taper, lampshade assembler, and table
worker. (Tr. 1893). Consequently, the ALJ found that Plaintiff was not disabled. (Tr. 1894).
II. Standard of Review
A claimant is entitled to disability benefits when he or she is unable to engage in any
substantial gainful activity by reason of any medically determinable physical or mental
impairment which can be expected to either result in death or last for a continuous period of
not less than twelve months. 42 U.S.C. §§416(i)(1), 423(d)(1)(A); 20 C.F.R. §404.1505(a).
The Commissioner has established a five-step sequential analysis for evaluating a
claim of disability, which is by now well-known and otherwise set forth in the ALJ’s decision.
See 20 CFR §§ 404.1520(a), 416.920(a); see also Doughty v. Apfel, 245 F.3d 1274, 1278 (11th
Cir. 2001). The claimant, of course, bears the burden of persuasion through step four and, at
step five, the burden shifts to the Commissioner. Bowen v. Yuckert, 482 U.S. 137, 146 n. 5
(1987).
The scope of this Court’s review is limited to a determination of whether the ALJ
applied the correct legal standards and whether the findings are supported by substantial
evidence. McRoberts v. Bowen, 841 F.2d 1077, 1080 (11th Cir. 1988)(citing Richardson v. Perales,
402 U.S. 389, 390 (1971)). Indeed, the Commissioner’s findings of fact are conclusive if
supported by substantial evidence. 42 U.S.C. §405(g). Substantial evidence is more than a
scintilla – i.e., the evidence must do more than merely create a suspicion of the existence of a

fact, and must include such relevant evidence as a reasonable person would accept as
adequate to support the conclusion. Foote v. Chater, 67 F.3d 1553, 1560 (11th Cir. 1995) (citing
Walden v. Schweiker, 672 F.2d 835, 838 (11th Cir. 1982) and Richardson v. Perales, 402 U.S. 389,
401 (1971)); accord Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991). Where the
Commissioner’s decision is supported by substantial evidence, the District Court will affirm,
even if the reviewer would have reached a contrary result as finder of fact, and even if the
reviewer finds that the evidence preponderates against the Commissioner’s decision. Edwards,
937 F.2d at 584 n.3; Barnes v. Sullivan, 932 F.2d 1356, 1358 (11th Cir. 1991). This is clearly a
deferential standard.

III. Discussion
The issue raised by Plaintiff on appeal is whether the ALJ applied the correct legal
standards to various medical opinions from Plaintiff’s physical and mental health providers.
(Doc. 13 at 5). Plaintiff argues that the ALJ erred in finding unpersuasive the opinions of
Seher Shaikh, PA, a physician assistant who provided psychiatric treatment, Dr. Kristal
Khan, who performed a psychiatric examination, and Dr. Michael Barnum, Plaintiff’s
orthopedic surgeon. Plaintiff contends that, in evaluating these opinions, the ALJ failed to
satisfy the requirements of the regulations in explaining the supportability and consistency
factors. Plaintiff thus contends that the ALJ’s decision was not supported by substantial
evidence.
a. Seher Shaikh, PA
Plaintiff first argues that the ALJ erred by failing to properly consider opinions offered
by physician assistant Seher Shaikh. Plaintiff’s argument relates to two opinions in March
2020 and April 2021. (Tr. 1183-85, 1489-90).
Plaintiff argues that both opinions found multiple limitations, including that Plaintiff

had a poor ability to follow work rules, relate to co-workers, deal with the public, use
judgment, interact with supervisors, deal with work stress, function independently, and main
attention or concentration. The ALJ found, in part, that those opinions were not supported
by treatment notes, not consistent with other evidence, and that Plaintiff’s activities
contradicted the opinions. (Tr. 1890). Plaintiff argues, however, that the ALJ’s findings fail
to properly consider the supportability factor and mischaracterize evidence for the consistency
factor.
Plaintiff argues that the ALJ “largely failed to explain” the supportability factor in that
the ALJ only cited one treatment note regarding Plaintiff being stable with medication and in

an unremarkable condition. (Doc. 13 at 8). Plaintiff then argues that the ALJ “largely
ignored” evidence that supported more severe limitations and cites a litany of examples from
the record. (Doc. 13 at 8-10). Plaintiff also contends that the ALJ failed to explain the
consistency factor, and erred in finding that “no other source has identified these specific
restrictions.” (Doc. 13 at 10, Tr. 1890). Plaintiff argues that the ALJ offered nothing more
than a conclusory statement that the Plaintiff’s activities were inconsistent with the limitations
in the opinion.
As a preliminary matter, Plaintiff acknowledges that her claim is subject to an updated
regulatory framework for evaluating medical opinions. For claims filed on or after March 27,
2017, the Social Security Administration has issued revised regulations regarding the
evaluation of medical evidence, including medical source opinions. See Revisions to Rules
Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844-01 (Jan. 18, 2017) (final
rules) (“We are revising our rules to ensure that they reflect modern healthcare delivery and

are easier to understand and use. We expect that these changes will help us continue to ensure
a high level of accuracy in our determinations and decisions.”).
The new regulations impact agency policy in several important respects and contain
several significant changes to prior medical evidence rules. See 81 Fed. Reg. at 62,560. To
begin, the revised regulations redefine how evidence is categorized. Under the revised
regulations, there are five categories of evidence: (1) objective medical evidence; (2) medical
opinions; (3) other medical evidence, (4) evidence from nonmedical sources; and (5) prior
administrative medical findings. See 20 C.F.R. § 416.913(a)(2017).
Second, the definition of “medical opinion” has been considerably revised. For claims
filed by adults on or after March 27, 2017, the regulations provide:

A medical opinion is a statement from a medical source about
what you can still do despite your impairment(s) and whether
you have one or more impairment-related limitations or
restrictions in the following abilities: . . .
Your 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);
Your 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;
Your ability to perform other demands of work, such as seeing,
hearing, or using other senses; and
Your ability to adapt to environmental conditions, such as
temperature extremes or fumes.
20 C.F.R. § 416.913(a)(2) (2017).

Third, for claims filed on or after March 27, 2017, the regulations change how the
agency considers medical opinions and prior administrative medical findings. See 20 C.F.R.
§ 416.920c (2017). Notably, the regulations no longer use the term “treating source,” but refer
to “your medical source(s).” 20 C.F.R. § 416.920c (2017). The Commissioner intentionally
chose not to retain the “treating source rule” that previously required deference to treating
source opinion evidence. See 82 Fed. Reg. at 5883. Rather, the agency “will not defer or give
any specific evidentiary weight, including controlling weight, to any medical opinion(s) or
prior administrative medical findings(s), including those from [the claimant’s own] medical
sources.” 20 C.F.R. § 416.920c(a) (2017). The ALJ will, instead, consider all medical opinions
through the following factors: (1) supportability; (2) consistency; (3) relationship with the
claimant including length of the treatment relationship, frequency of examination, purpose of
the treatment relationship, extent of the treatment relationship, and examining relationship;
(4) specialization; and (5) other factors. Id. § 416.920c(c)(1)-(5).
Here, Defendant contends that the ALJ’s opinion was supported by substantial
evidence and that the ALJ considered physician assistant Shaikh’s opinions in view of the
relevant factors, including supportability and consistency. The ALJ found that PA Shaikh’s

opinion was not persuasive because it was not supported by his own treatment notes or
consistent with other evidence. (Tr. 1889-90). Defendant also points out that the ALJ noted
that the record only contained relevant treatment notes from the brief period of January 2021
through March 2021.
As Defendant notes, PA Shaikh’s January and February 2021 mental status
examinations showed that Plaintiff was alert and cooperative with intact cognition,
appropriate thought content, and fair insight and judgment. (Tr. 1482, 1484, 1887, 1889-90).
Shaikh repeatedly described Plaintiff’s capacity for activities of daily living as fair. (Tr. 1480,

1482, 1484, 1889-90). In February 2021, Plaintiff reported more stable moods, not feeling in
a state of high stress, and better controlled and more manageable anxiety. (Tr. 1481, 1889-
90). Indeed, the ALJ accurately observed that the treatment notes did not support Shaikh’s
opinion regarding more extreme mental limitations.
Simply put, Plaintiff's arguments are not persuasive. This Court's review is limited to
determining whether substantial evidence supports the Commissioner's findings and whether
the Commissioner applied the correct legal standards. McRoberts v. Bowen, 841 F.2d 1077,
1080 (11th Cir. 1988). Plaintiff's argument amounts to little more than an invitation to the
Court to improperly reweigh the evidence and credit the evidence favored by Plaintiff. As
already explained, the ALJ carefully considered the entire record, including all of Plaintiff's

impairments, the medical record as a whole, and medical opinions. Upon review, I submit
that substantial evidence supports the ALJ's decision and the RFC determination.
While Plaintiff has identified aspects of the medical record that she believes support
her argument that the RFC should have contained more limitations, the ALJ considered the
entire medical record in light of the relevant factors, including supportability and consistency.
Further, a review of the record reveals that substantial evidence supports the ALJ’s
conclusions regarding PA Shaikh’s opinions. Notably, the ALJ compared Shaikh’s opinion
to other evidence of record, including Plaintiff’s own reported activities. The ALJ also found
that PA Shaikh’s opinions were not consistent with other evidence, that no other source
identified those specific restrictions, and that Plaintiff’s activity level contradicts the degree of
limitation opined by Shaikh. Indeed, the ALJ’s decision also relied upon other medical
evidence (including records from Community Health Centers) demonstrating that Plaintiff’s
mental status was frequently found to be relatively unremarkable, that she reported that she

was stable and doing well, and that her mental health symptoms had improved with
treatment. (Tr. 1889, 1891, 2429). The ALJ acknowledged that Plaintiff’s reported activities
included caring for her child, grocery shopping, driving, going outside, and using Facebook.
(Tr. 1891-92).
The record reflects that the ALJ properly considered Shaikh’s opinion in light of the
relevant factors, including supportability and consistency. Under the revised regulations, the
ALJ was not required to give deference to the opinion. See Matos v. Comm'r of Soc. Sec., No.
21-11764, 2022 WL 97144, at *4 (11th Cir. Jan. 10, 2022) (“This new regulatory scheme no
longer requires the ALJ to either assign more weight to medical opinions from a claimant's
treating source or explain why good cause exists to disregard the treating source's opinion.”).

Substantial evidence supports the ALJ’s decision to find the opinions unpersuasive and to
give greater weight to the other evidence credited by the ALJ.
The regulations explain that the “supportability” factor involves considering whether
the medical source presented relevant objective evidence and supporting explanations to
support his opinion. See 20 C.F.R. §§ 404.1520c(c)(1), 416.920c(c)(1). The ALJ expressly
found that Shaikh’s own treatment notes did not support his opinion, stating “Mr. Shaikh’s
opinion is not entirely supported by his own treatment notes.” (Tr. 1889-90). The ALJ
followed this statement by examples from the treatment notes of Plaintiff reporting greater
stability with medication, reporting that she was not in a state of high stress, and that the
mental status examination was “largely unremarkable.” (Tr. 1890).
As Defendant points out, consistency “relates to the relationship between a medical
source’s opinion and other evidence within the record.” Frye v. Comm’r of Soc. Sec., 6:21-cv-

741-DCI, at *2 (M.D. Fla. Apr. 7, 2022). The Eleventh Circuit has explained that ALJ
decisions “should be read as a whole and need not repeat a discussion of facts that establish
inconsistency, merely to place it near the conclusion that an opinion is inconsistent with the
medical evidence.” Adams v. Soc. Sec. Comm’r, No. 23-11233, 2024 WL 2846726, at *3 (11th
Cir. June 5, 2024) (citing Raper v. Comm’r of Soc. Sec., 89 F.4th 1261, 1275-76 (11th Cir. 2024).
In this case, the ALJ’s decision includes a sufficient analysis of consistency. The ALJ
specifically stated that Shaikh’s opinion was not consistent with other evidence and provided
examples throughout the opinion to support that conclusion, including the examples
mentioned above and Plaintiff’s “activity level.” (Tr. 1890).

Accordingly, the ALJ did not err in considering the opinion of physician assistant
Shaikh.
b. Dr. Kristal Khan
Next, Plaintiff argues that the ALJ erred in considering the opinion of Dr. Kristal
Khan, Plaintiff’s psychiatrist. Following an examination in November 2024, Dr. Khan opined
that Plaintiff had various mental limitations, including that Plaintiff was unable to meet
competitive standards in maintaining attention and concentration for two-hour segments, that
Plaintiff was unable to sustain an ordinary routine without special supervision, that Plaintiff
was not capable of working in coordination with or proximity to others without being unduly
distracted, and other limitations. (Tr. 2219-20).
The ALJ expressly found that Dr. Khan’s opinion statements were “conclusory and
are not explained by examination notes or objective findings. Her opinion is not well
supported.” (Tr. 1891). The ALJ also found that the extreme limitations found by Dr. Khan
were not reflected in other assessments or supported by Plaintiff’s “numerous unremarkable

examinations,” and the limitations were also inconsistent with Plaintiff’s generally
conservative treatment. Accordingly, the ALJ found Dr. Khan’s opinion to be not persuasive.
(Tr. 1891).
Plaintiff argues that the ALJ erred in considering the supportability and consistency
factors regarding Dr. Khan’s opinion. Plaintiff contends that the ALJ “failed to provide any
explanation how it was not supported outside this conclusory statement.” (Doc. 13 at 15).
Plaintiff’s argument is unavailing and fails to acknowledge the ALJ’s explicit explanation of
supportability, including the ALJ’s noting that the opinions related to a single examination
and that the findings were not supported in the examination notes or by objective findings.
As to consistency, Plaintiff takes issue with the ALJ’s analysis and argues that the ALJ

cited only generally to normal examinations and noted conservative treatment. First,
Plaintiff’s argument is not compelling because the record evidence regarding normal
examinations and conservative treatment represents substantial evidence on which the ALJ
could rely. Moreover, Plaintiff’s argument fails to acknowledge that the ALJ’s statements
regarding Dr. Khan’s opinions were made within the context of numerous references to
record evidence regarding Plaintiff’s generally unremarkable mental condition, such as
described above. The undersigned finds that the ALJ did not err in considering Dr. Khan’s
opinion.
c. Dr. Michael Barnum
Finally, Plaintiff argues that the ALJ erred in considering the opinion of Dr. Michael
Barnum, Plaintiff’s orthopedic surgeon. Dr. Barnum opinions included that Plaintiff could
only sit for one hour total and at a time in the workday, and that Plaintiff could stand/walk
for one hour total and at a time in the workday. (Tr. 2110). Dr. Barnum also opined that

Plaintiff could occasionally lift or carry up to five pounds and not more, and that Plaintiff
could not bend, squat, crawl, or climb and could occasionally reach. (Tr. 2110-11). The ALJ
found that the opinions were not persuasive, and that Dr. Barnum did not explain these
limitations or reference objective findings. (Tr. 1890).
Plaintiff contends that the ALJ erred when analyzing supportability because the ALJ
failed to credit numerous treatment notes reflecting abnormalities. Plaintiff again cites a litany
of record evidence that she contends supports more severe limitations. Plaintiff also contends
that the ALJ erred in considering consistency because the ALJ merely noted that no other
provider found the same limitations and that the limitations were inconsistent with Plaintiff’s

activities.
Once again, Plaintiff’s argument appears to be an invitation to the Court to improperly
reweigh evidence and credit the evidence favored by the Plaintiff. The Court's review,
however, remains limited to determining whether substantial evidence supports the
Commissioner's findings and whether the Commissioner applied the correct legal standards.
See McRoberts, 841 F.2d at 1080.
The ALJ expressly found, “Dr. Barnum has not adequately explained these limitations
or referenced objective findings. The opinion is, therefore, not well supported.” (Tr. 1890).
The ALJ further stated, “[i]t is noted that no other source has identified this extreme degree
of limitation. The opinion is, therefore, not consistent with other evidence.” (Tr. 1890). The
ALJ then proceeded to explain his findings further, stating that Dr. Barnum’s assessments
were not supported by explanatory statements, that they were not consistent with other
evidence, that no other source identified those specific limitations, that the record contained

mostly normal examinations, that Plaintiff’s activity level was inconsistent with the opinions,
and that Plaintiff’s primary care physician’s notes indicated that Plaintiff was able to care for
young children, walk, and ride a stationary bike. (Tr. 1890).
As Defendant points out, the ALJ reviewed the record as a whole, and specifically
cited substantial evidence supporting the RFC. For example, the ALJ cited records reflecting
normal examination findings, including a normal range of motion, no tenderness in Plaintiff’s
back, and no focal neurological deficits. (Tr. 848, 1889). The evidence cited by the ALJ also
included a November 2018 examination showing normal musculoskeletal and neurological
findings, including normal range of motion, normal strength, and no focal deficits (Tr. 851,
1889-90), and an August 2024 examination with similar normal findings, including normal

range of motion and no edema (Tr. 1889-90, 2124). These are examples of the substantial
evidence supporting the ALJ’s findings, including the finding that Dr. Barnum’s opinions
were unsupported and inconsistent with other evidence and therefore not persuasive.
The ALJ’s decision should be affirmed because substantial evidence supports the
ALJ’s evaluation of Plaintiff’s condition and the determination regarding her alleged
impairments. See Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996) (“If the Commissioner's
decision is supported by substantial evidence we must affirm, even if the proof preponderates
against it.”).
IV. Conclusion
For the reasons stated above, the ALJ’S decision is AFFIRMED under sentence four
of 42 U.S.C. § 405(g). The Clerk is directed to enter judgment accordingly, terminate any
pending motions, and close the file. For the reasons stated above, the ALJ’S decision is
AFFIRMED under sentence four of 42 U.S.C. § 405(g). The Clerk is directed to enter
judgment accordingly, terminate any pending motions, and close the file.
DONE and ORDERED in Ocala, Florida on September 9, 2026.

Per
PHILIP R. LAMMENS
United States Magistrate Judge
Copies furnished to:
Counsel of Record
Unrepresented Parties

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/11438710. Public record. Not legal advice.