McCain v. Social Security Administration, Commissioner

UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ALABAMA

MIDDLE DIVISION

NANCY MERIE MCCAIN, )

)

Plaintiff, )

)

v. )

) Case No.: 4:18-cv-01558-SGC

SOCIAL SECURITY )

ADMINISTRATION, Commissioner, )

)

Defendant. )

MEMORANDUM OPINION1

The plaintiff, Nancy Merie McCain, appeals from the decision of the

Commissioner of the Social Security Administration (the “Commissioner”) denying

her applications for Disability Insurance Benefits (“DIB”) and Supplemental

Security Income (“SSI”). McCain timely pursued and exhausted her administrative

remedies, and the Commissioner’s decision is ripe for review pursuant to 42 U.S.C

§§ 405(g) and 1383(c)(3). For the reasons discussed below, the Commissioner’s

decision is due to be affirmed.

I. Procedural History

McCain has a high school education. (Tr. at 15). She attended college but

did not obtain a college degree. (Id.). She has previously been employed as a

1 The parties have consented to the exercise of full dispositive jurisdiction by a magistrate judge

pursuant to 28 U.S.C. § 636(c). (Doc. 12).

certified nurse aide, assistant retail manager, and food server. (Id. at 20). In her

applications for DIB and SSI, McCain alleged she became disabled on June 1, 2013,

due to bipolar disorder and “manic depressive borderline personality.” (Id. at 147,

157). After her claims were denied, McCain requested a hearing before an

administrative law judge (“ALJ”). (Id. at 11). Following a hearing and a

supplemental hearing, the ALJ denied McCain’s claims. (Id. at 11-22). McCain

was thirty years old when the ALJ issued his decision. (Id. at 20, 22). After the

Appeals Council denied review of the decision (id. at 1-3), that decision became the

final decision of the Commissioner, see Frye v. Massanari, 209 F. Supp. 2d 1246,

1251 (N.D. Ala. 2001) (citing Falge v. Apfel, 150 F.3d 1320, 1322 (11th Cir. 1998)).

Thereafter, McCain commenced this action. (Doc. 1).

II. Statutory and Regulatory Framework

To establish eligibility for disability benefits, a claimant must show “the

inability 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

twelve months.” 42 U.S.C. §§ 416(i)(1)(A), 423(d)(1)(A), 1382c(a)(3)(A); 20

C.F.R. §§ 404.1505(a), 416.905(a). Furthermore, a claimant must show she was

disabled between her alleged initial onset date and her date last insured. Mason v.

Comm’r of Soc. Sec., 430 F. App’x 830, 831 (11th Cir. 2011) (citing Moore v.

Barnhart, 405 F.3d 1209, 1211 (11th Cir. 2005); Demandre v. Califano, 591 F.2d

1088, 1090 (5th Cir. 1979)). The Social Security Administration (“SSA”) employs

a five-step sequential analysis to determine an individual’s eligibility for disability

benefits. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).

First, the Commissioner must determine whether the claimant is engaged in

“substantial gainful activity.” Id. at §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If the

claimant is engaged in substantial gainful activity, the Commissioner will find the

claimant is not disabled. Id. at §§ 404.1520(a)(4)(i) and (b), 416.920(a)(4)(i) and

(b). At the first step, the ALJ determined McCain met the SSA’s insured status

requirements through September 30, 2017, and has not engaged in substantial

gainful activity since June 1, 2013. (Tr. at 14).

If the claimant is not engaged in substantial gainful activity, the

Commissioner must next determine whether the claimant suffers from a severe

physical or mental impairment or combination of impairments that has lasted or is

expected to last for a continuous period of at least twelve months. 20 C.F.R. §§

404.1520(a)(4)(ii), 416.920(a)(4)(ii). If the claimant does not have a severe

impairment or combination of impairments, the Commissioner will find the claimant

is not disabled. Id. at §§ 404.1520(a)(4)(ii) and (c), 416.920(a)(4)(ii) and (c). At the

second step, the ALJ determined McCain has the following severe impairments:

polysubstance abuse, affective disorders, and anxiety-related disorders. (Id. at 14).

If the claimant has a severe impairment or combination of impairments, the

Commissioner must then determine whether the impairment or combination of

impairments meets or equals one of the “Listings” found in 20 C.F.R. Part 404,

Subpart P, Appendix 1. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If the

claimant’s impairment or combination of impairments meets or equals one of the

Listings, the Commissioner will find the claimant is disabled. Id. at §§

404.1520(a)(4)(iii) and (d), 416.920(a)(4)(iii) and (d). At the third step, the ALJ

determined McCain does not have an impairment or combination of impairments

that meets or medically equals the severity of one of the Listings. (Tr. at 14).

If the claimant’s impairment or combination of impairments does not meet or

equal one of the Listings, the Commissioner must determine the claimant’s residual

functional capacity (“RFC”) before proceeding to the fourth step. 20 C.F.R. §§

404.1520(e), 416.920(e). At the fourth step, the Commissioner will compare an

assessment of the claimant’s RFC with the physical and mental demands of the

claimant’s past relevant work. Id. at §§ 404.1520(a)(4)(iv) and (e), 416.920(a)(4)(iv)

and (e). If the claimant is capable of performing her past relevant work, the

Commissioner will find the claimant is not disabled. Id. at §§ 404.1520(a)(4)(iv),

416.920(a)(4)(iv).

Before proceeding to the fourth step, the ALJ determined McCain has the RFC

to perform a full range of work at all exertional levels but with certain non-exertional

limitations. (Tr. at 16). At the fourth step, the ALJ determined McCain is not able

to perform her past relevant work. (Id. at 20).

If the claimant is unable to perform her past relevant work, the Commissioner

must finally determine whether the claimant is capable of performing other work

that exists in substantial numbers in the national economy in light of the claimant’s

RFC, age, education, and work experience. 20 C.F.R. §§ 404.1520(a)(4)(v) and

(g)(1), 416.920(a)(4)(v) and (g)(1). If the claimant is capable of performing other

work, the Commissioner will find the claimant is not disabled. Id. at §§

404.1520(a)(4)(v) and (g)(1), 416.920(a)(4)(v) and (g)(1). If the claimant is not

capable of performing other work, the Commissioner will find the claimant is

disabled. Id. at §§ 404.1520(a)(4)(v) and (g)(1), 416.920(a)(4)(v) and (g)(1).

At the fifth step, considering McCain’s age, education, work experience, and

RFC, the ALJ determined there are jobs existing in significant numbers in the

national economy that McCain can perform, such as those of laundry laborer,

warehouse worker/stubber, and fabrication cutter. (Tr. at 21). Therefore, the ALJ

concluded McCain is not disabled. (Id. at 22).

III. Standard of Review

Review of the Commissioner’s decision is limited to a determination of

whether that decision is supported by substantial evidence and whether the

Commissioner applied correct legal standards. Crawford v. Comm’r of Soc. Sec.,

363 F.3d 1155, 1158 (11th Cir. 2004). A district court must review the

Commissioner’s findings of fact with deference and may not reconsider the facts,

reevaluate the evidence, or substitute its judgment for that of the Commissioner.

Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1260 (11th Cir. 2007); Dyer

v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005). Rather, a district court must

“scrutinize the record as a whole to determine if the decision reached is reasonable

and supported by substantial evidence.” Bloodsworth v. Heckler, 703 F.2d 1233,

1239 (11th Cir. 1983) (internal citations omitted). Substantial evidence is “such

relevant evidence as a reasonable person would accept as adequate to support a

conclusion.” Id. It is “more than a scintilla, but less than a preponderance.” Id. A

district court must uphold factual findings supported by substantial evidence, even

if the preponderance of the evidence is against those findings. Miles v. Chater, 84

F.3d 1397, 1400 (11th Cir. 1996) (citing Martin v. Sullivan, 894 F.2d 1520, 1529

(11th Cir. 1990)).

A district court reviews the Commissioner’s legal conclusions de novo. Davis

v. Shalala, 985 F.2d 528, 531 (11th Cir. 1993). “The [Commissioner’s] failure to

apply the correct law or to provide the reviewing court with sufficient reasoning for

determining that the proper legal analysis has been conducted mandates reversal.”

Cornelius v. Sullivan, 936 F.2d 1143, 1145-46 (11th Cir. 1991).

IV. Discussion

On appeal, McCain argues the ALJ failed to properly weigh the opinions of

(1) Dr. Adam J. Pruett; (2) Julie Lowman, a social worker; (3) Dr. Frederic Feist; (4)

Dr. Christopher S. Randolph; and (5) Dr. Alfred Jonas. (Doc. 13).2

“ ‘Medical opinions are statements from physicians and psychologists or other

acceptable medical sources that reflect judgments about the nature and severity of

[the claimant’s] impairment(s), including [the claimant’s] symptoms, diagnosis and

prognosis, what [the claimant] can still do despite impairment(s), and [the

claimant’s] physical or mental restrictions.’” Winschel v. Comm’r of Soc. Sec., 631

F.3d 1176, 1178-79 (11th Cir. 2011) (quoting 20 C.F.R. §§ 404.1527(a)(2),

416.927(a)(2)). “[T]he ALJ must state with particularity the weight given to

different medical opinions and the reasons therefor.” Id. at 1179 (citing Sharfarz v.

Bowen, 825 F.2d 278, 279 (11th Cir. 1987)). “ ‘In the absence of such a statement,

it is impossible for a reviewing court to determine whether the ultimate decision on

the merits of the claim is rational and supported by substantial evidence.’” Id.

(quoting Cowart v. Schweiker, 662 F.2d 731, 735 (11th Cir. 1981)). “Therefore,

2 The undersigned notes that in addition to her primary arguments, McCain also contends the ALJ

assigned to her case is “skeptical against claimants.” (Doc. 13 at 3). The sole basis of this claim

is the allegation the ALJ approved only 35% of claims that came before him in 2017, as compared

to the 50% of claims approved by other ALJs in Alabama. (Id.). To demonstrate bias, a claimant

must overcome a presumption of honesty and integrity in the ALJ by presenting evidence beyond

statistics alone. Wells v. Soc. Sec. Admin., Comm’r, 777 F. App’x 429, 433 (11th Cir. 2019).

McCain has failed to carry this burden.

when the ALJ fails to ‘state with at least some measure of clarity the grounds for his

decision,’ we will decline to affirm ‘simply because some other rationale might have

supported the ALJ’s conclusion.’” Id. (quoting Owens v. Heckler, 748 F.2d 1511,

1516 (11th Cir. 1984)).

“The ALJ may consider many factors when weighing medical evidence,

including the claimant’s relationship with the examining or treating physician,

whether a medical opinion is well supported, whether a medical opinion is consistent

with the claimant’s records, and a doctor’s specialization.” Wilcox v. Comm’r, Soc.

Sec. Admin., 442 F. App’x 438, 439 (11th Cir. 2011); see also 20 C.F.R. §§

404.1527(c) (identifying factors relevant to assigning weight to medical opinions),

416.927(c) (same). “An ALJ may reject any medical opinion if the evidence

supports a contrary finding.” Arnold v. Soc. Sec. Admin., Comm’r, 724 F. App’x

772, 779 (11th Cir. 2018) (citing Sryock v. Heckler, 764 F.2d 834, 835 (11th Cir.

1985)).

However, “[a]bsent ‘good cause,’ an AJL is to give the medical opinions of

treating physicians ‘substantial or considerable weight.’” Winschel, 631 F.3d at

1179 (quoting Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997)). “Good

cause exists ‘when the: (1) treating physician’s opinion was not bolstered by the

evidence; (2) evidence supported a contrary finding; or (3) treating physician’s

opinion was conclusory or inconsistent with the doctor’s own medical records.’” Id.

(quoting Phillips v. Barnhart, 357 F.3d 1232, 1241 (11th Cir. 2004)). “With good

cause, an ALJ may disregard a treating physician’s opinion, but he ‘must clearly

articulate [the] reasons’ for doing so.” Id. at 1179 (quoting Phillips, 357 F.3d at

1240-41).

An opinion as to whether a claimant is able to work is not a medical opinion,

even if offered by a treating source, but rather a dispositive finding for the ALJ to

make. 20 C.F.R. §§ 404.1527(d)(1), 416.927(d)(1); Kelly v. Comm’r of Soc. Sec.,

401 F. App’x 403, 407 (11th Cir. 2010). It is entitled to no special significance. 20

C.F.R. §§ 404.1527(d)(1) and (3), 416.927(d)(1) and (3); Kelly, 401 F. App’x at 407.

A. Opinions of Dr. Pruett

McCain was hospitalized four times between May 2013 and October 2014.

(Tr. at 508-44).3 Records from each hospitalization include diagnoses of bipolar

disorder. (Id. at 508, 514, 521, 536). McCain reported smoking Spice,4 abusing

Adderall, and using another unknown substance prior to her May 2013 admission

and tested positive for amphetamines and opiates during her October 2014

admission. (Id. at 510, 514). Records from these hospitalizations include the

additional diagnoses of amphetamine abuse with respect to the May 2013

3 McCain was hospitalized again in May 2017 after threatening to commit suicide upon returning

home from a reported month-long drug binge. (Tr. at 725-43).

4 Spice is a brand of synthetic cannabinoid. See

https://www.drugabuse.gov/publications/drugfacts/synthetic-cannabinoids-k2spice (last visited

February 18, 2020).

hospitalization and amphetamine and opiate dependence with respect to the October

2014 hospitalization. (Id. at 508, 514).

Dr. Pruett treated McCain during all four hospitalizations, each of which

lasted approximately one week. (Id. at 508-44). In the discharge summary for

McCain’s October 2014 hospitalization, Dr. Pruett stated, “[McCain] continues to

apply for disability in spite of being well stabilized. The patient has severe

symptoms of bipolar disorder in my opinion, preclud[ing] her from doing work and

I support her applying for disability and have filled out paperwork in [] support.”

(Id. at 508). The paperwork to which Dr. Pruett referred was a form mental RFC

assessment on which he indicated McCain has marked limitations in the areas of

understanding and memory and sustained concentration and persistence. (Id. at

586).

The ALJ assigned little weight to Dr. Pruett’s opinions McCain is not able to

work and has marked limitations in the areas of understanding and memory and

sustained concentration and persistence on the grounds (1) the opinions are not

consistent with Dr. Pruett’s contemporaneous treatment records or other evidence of

record and (2) whether McCain is disabled is an issue reserved to the Commissioner.

(Id. at 19-20). These grounds constitute good cause for discounting Dr. Pruett’s

opinions. See Kelly, 401 F. App’x at 407-08 (holding ALJ did not err in discounting

treating physician’s opinion because that opinion was not supported by other

evidence of record); Flowers v. Comm’r of Soc. Sec., 441 F. App’x 735, 741-43

(11th Cir. 2011) (holding ALJ did not err in discounting opinions of treating and

examining physicians because those opinions were not supported by the physicians’

own clinical findings); Heppell-Libsansky v. Comm’r of Soc. Sec., 170 F. App’x 693,

698 (11th Cir. 2006) (holding ALJ did not err by declining to accord controlling

weight to treating physician’s statement he doubted claimant would ever be able to

return to gainful employment because such statement is a dispositive finding left to

ALJ, not a medical opinion).

Moreover, substantial evidence supports the ALJ’s finding Dr. Pruett’s

opinions are not consistent with his contemporaneous treatment records. At the

same time he offered opinions regarding McCain’s inability to work and functional

limitations, Dr. Pruett noted in the discharge summary for McCain’s October 2014

hospitalization that McCain had “improved dramatically” during the course of her

admission, demonstrating better concentration, more logical thoughts, and increased

insight into a pattern whereby she ceases taking her medication and then begins using

drugs and becoming more manic. (Tr. at 508). Additionally, it is difficult to

reconcile Dr. Pruett’s assertion McCain is not able to work and has marked

limitations in certain areas of mental functioning with his statement she “continues

to apply for disability in spite of being well stabilized.” (Id. at 508) (emphasis

added). The phrase “in spite of” is typically used to express a contrast between two

things – in this case, an individual’s decision to continue pursuing disability benefits

on the one hand, and that individual’s achievement of mental stability on the other.

In other words, Dr. Pruett’s latter statement suggests that notwithstanding his

avowed support for McCain’s disability application, he may have harbored some

doubt as to its necessity.

Substantial evidence also supports the ALJ’s finding Dr. Pruett’s opinions are

not consistent with other evidence of record. As noted by the ALJ, McCain was able

to read, understand, and complete forms describing her impairments, physical and

mental limitations, work history, and medication regimen for purposes of her

disability applications. (Id. at 349-64, 391-92). Moreover, records from treatment

McCain received at Cherokee-Etowah-Dekalb Mental Health Center (“CED Mental

Health Center”), discussed below, are not consistent with disabling functional

limitations. Accordingly, the ALJ did not err by assigning little weight to Dr.

Pruett’s opinions.

B. Opinions of Ms. Lowman and Dr. Feist

During the relevant period, McCain also received outpatient care at CED

Mental Health Center in the form of therapy and the prescription and administration

of medication. (Id. at 546-85, 702-05, 708-20, 745-48). Records from CED Mental

Health Center reflect a diagnosis of bipolar disorder for McCain and also indicate

she was being treated for the use of cannabis and amphetamines. (Id. at 546, 744).

In July 2017, Ms. Lowman and Dr. Feist, both of whom treated McCain at CED

Mental Health Center, each completed a form titled “Mental Health Source

Statement.” (Id. at 747-48). Their answers to the questions presented on the form

were identical, with one exception. Both indicated McCain could not understand,

remember, or carry out very short and simple instructions; maintain attention,

concentration, and/or pace for periods of at least two hours; sustain an ordinary

routine without special supervision; or adjust to routine and infrequent work

changes. (Id. at 747-48). While Ms. Lowman indicated McCain could likely interact

with co-workers, Dr. Feist indicated it was not likely McCain could interact with co-

workers. (Id. at 747-48).

The ALJ did not describe the weight afforded the opinions reflected in the

“Mental Health Source Statement” forms completed by Ms. Lowman and Dr. Feist

with the phrase “little weight” or the phrase “no weight.” However, he did state the

opinions are not entirely consistent with contemporaneous treatment records from

CED Mental Health Center. (Id. at 20). This statement, together with the ALJ’s

discussion of the contents of the “Mental Health Source Statement” forms and

treatment records from CED Mental Health Center (id. at 18), make it sufficiently

clear both that the ALJ considered and rejected the opinions and why he did so. See

Brito v. Comm’r, Soc. Sec. Admin., 687 F. App’x 801, 804 (11th Cir. 2017) (holding

that while ALJ did not assign specific weight to doctor’s treatment notes or mental

status report, his discussion of the same was stated with sufficient clarity to review

grounds for decision).

Moreover, the grounds articulated by the ALJ for rejecting the opinions

constitute good cause for doing so, see Flowers, 441 F. App’x at 741-43 (holding

ALJ did not err in discounting opinions of treating and examining physicians

because those opinions were not supported by the physicians’ own clinical findings),

and they are supported by substantial evidence. With relatively few aberrations,

mental status examinations performed at CED Mental Health Center between June

2013 and September 2016 found McCain’s thought process to be logical, her thought

content within normal limits, her attention and concentration adequate, and her

energy and motivation fair. (Id. at 550-53, 708, 713, 718).5 Moreover, when

McCain presented to CED Mental Health Center for monthly injections of Abilify

Maintena6 between November 2015 and August 2016 she routinely reported she was

doing well and denied experiencing psychiatric symptoms or medication side

effects, apart from complaining of weight gain and, once, of difficulty sleeping. (Id.

702-05, 709-10, 712, 714-16, 719). In January 2017, McCain reported to a therapist

at CED Mental Health Center that her current medication was working very well and

5 Her judgement and insight were more variable during this period of time. (See Tr. at 550-53,

708, 713, 718).

6 Abilify Maintena is used to treat schizophrenia and bipolar I disorder. See

https://www.abilifymaintena.com/ (last visited February 18, 2020).

she felt stable. (Id. at 746). In May 2017, she denied psychiatric symptoms other

than problems sleeping due to racing thoughts, and her therapy provider noted she

had made good progress in maintaining stability. (Id. at 746). Finally, in January,

March, April, and June 2016, McCain reported to CED Mental Health Center staff

that she was working. (Id. at 712, 715-16, 720). The relative stability reflected in

treatment records from CED Mental Health Center is at odds with the debilitating

functional limitations to which Ms. Lowman and Dr. Feist opined in the “Mental

Health Source Statement” forms. Accordingly, the ALJ did not err by rejecting the

opinions.7

C. Opinions of Dr. Randolph

Dr. Randolph performed a consultative psychiatric examination of McCain in

July 2016. (Id. at 591-98). Dr. Randolph noted McCain had applied makeup in the

office lobby prior to the examination and observed “[t]his was done in a rather garish

manner to one side of her face only.” (Id. at 594). He further noted McCain was

“markedly delusional” during the examination, “demonstrate[ed] flight of ideas with

pressured, disorganized speech,” and “was incapable of focusing on [the

7 Moreover, because a social worker is not an “acceptable medical source,” the ALJ was not

required to give Ms. Lowman’s opinions any special consideration. See Levie v. Berryhill, 757 F.

App’x 834, 836-37 (11th Cir. 2018) (noting a social work is not an “acceptable medical source”)

(citing 20 C.F.R. § 404.1502(a)); Farnsworth v. Soc. Sec. Admin., 636 F. App’x 776, 784 (11th

Cir. 2016) (holding that while ALJ was required to consider mental health counselors’ opinions as

“other medical sources,” ALJ was not required to give their opinions controlling weight over

opinions of “acceptable medical sources”).

examination] and frequently derailed into psychotic ideas, such as [the] experience

of seeing a bird and getting a signal from this bird who then followed her.” (Id.).

McCain told Dr. Randolph she experiences flashbacks of sexual abuse by her

grandfather. (Id. at 594-95). As part of the examination, Dr. Randolph asked

McCain to draw a clock face. (Id. at 595, 597-98). McCain clustered the hour

markers on one side of the clock face, added a brand name, and drew a wristband.

(Id. at 595, 597-98). Upon completing the examination, Dr. Randolph concluded as

follows:

In light of severity of impaired reality testing and longevity of psychotic

thought content as well as poor symptom management with current

medications, I do not see how this young lady could ever obtain and

manage the stress of a work environment that would not constitute a

danger to self or others. During this [examination] she was so

disconnected and distracted by psychotic thought content she could not

complete the facial makeup she had started an hour and a half earlier.

In light of extreme impairment in completing the easiest tasks assigned

and impairment in judgment and previous history of substance abuse, I

do not feel she should handle her finances.

(Id. at 596). Dr. Randolph also completed a form titled “Medical Source Statement

of Ability To Do Work-Related Activities,” indicating extreme limitations in

McCain’s ability to understand, remember, and carry out even simple instructions;

make judgments on even simple work-related decisions; interact appropriately with

the public, supervisors, and co-workers; and respond appropriately to usual work

situations and changes in a routine work setting. (Id. at 591-93).

The ALJ assigned little weight to Dr. Randolph’s opinions on the grounds

they are not consistent with the other medical evidence and are overly reliant on

statements made by McCain. (Id. at 19). Because Dr. Randolph was not one of

McCain’s treating physicians, his opinions were not entitled to deference. See

McSwain v. Bowen, 814 F.2d 617, 619 (11th Cir. 1987) (holding opinions of one-

time examiners were not entitled to deference because the examiners were not

treating physicians). Moreover, the ALJ articulated appropriate reasons for

assigning little weight to Dr. Randolph’s opinions, and those reasons are supported

by substantial evidence. See Jarrett v. Comm’r of Soc. Sec., 422 F. App’x 869, 873

(11th Cir. 2011) (“Generally, the more consistent a physician’s opinion is with the

record as a whole, the more weight an ALJ should place on that opinion.”); 20 C.F.R.

§§ 404.1527(stating same proposition), 416.927(same); cf. Crawford, 363 F.3d at

1159 (holding ALJ properly discounted treating physician’s opinion because,

amongst other things, that opinion appeared to be based primarily on claimant’s

subjective complaints of pain).

Substantial evidence supports the ALJ’s finding Dr. Randolph’s opinions are

not consistent with other medical evidence. Most notably, Dr. Randolph’s opinions

McCain has debilitating functional limitations, which he articulated in July 2016,

are at odds with roughly contemporaneous treatment records from CED Mental

Health Center, which as discussed above, reflect relative stability.

Substantial evidence also supports the ALJ’s finding Dr. Randolph’s opinions

are overly reliant on statements made by McCain. Although Dr. Randolph did

appear to rely on mental status examinations he administered to McCain, he also

appears to have placed great weight in McCain’s report to him regarding her

symptoms and medical history. Accordingly, the ALJ did not err by discounting Dr.

Randolph’s opinions.

D. Opinions of Dr. Jonas

Dr. Jonas is a psychiatrist called by the ALJ to offer testimony during the

supplemental hearing. He testified that as a general matter bipolar disorder is

“massively over[-]diagnosed” and there is no correlation between being sexually

abused as a child and later developing bipolar disorder. (Tr. at 46, 49). He also

testified that as a general matter it is hard to diagnose an individual with bipolar

disorder or borderline personality disorder when that person is actively abusing

controlled substances. (Id. at 46-50). With respect to McCain, he testified that his

review of her medical records did not clearly show a period of sobriety that would

make it possible to attribute her symptoms to bipolar disorder and not substance

abuse. (Id. at 46-50). The ALJ assigned significant weight to Dr. Jonas’ opinions

and articulated several reasons for doing so. (Id. at 19-20).

McCain correctly notes some courts have found ALJs to have committed

reversible error by improperly crediting Dr. Jonas’ opinions over those of treating

and examining physicians. See, e.g., Tobler v. Colvin, 2014 WL 4187372, at *3-5

(N.D. Ala. Aug. 20, 2014); Creekmore v. Colvin, 2015 WL 4771947, at *6-7 (D.S.C.

Aug. 12, 2015) (noting a troubling pattern of the Social Security Administration

repeatedly utilizing Dr. Jonas to attack the opinions of claimants’ treating

physicians) (collecting cases); Lydia v. Colvin, 2016 WL 5402857, at *4 (D.S.C.

Sept. 28, 2016) (noting Dr. Jonas’ credibility has been called into question by

numerous courts) (collecting cases); Brown v. Comm’r Soc. Sec. Admin., 873 F.3d

251, 268-69 (4th Cir. 2017). However, these cases do not demonstrate the ALJ’s

reliance on Dr. Jonas’ testimony in this case constitutes reversible error.

McCain also argues Dr. Jonas’ opinions bipolar disorder is over-diagnosed

and unrelated to childhood sexual abuse are scientifically unsound. However, the

validity of these general opinions is not relevant for purposes of the review

conducted by the undersigned. Dr. Jonas did not question whether McCain has

bipolar disorder based solely on these general opinions. He offered the opinion the

record lacked evidence of a sustained period of sobriety from which it could be

determined McCain’s symptoms are attributable to bipolar disorder and not

substance abuse. (Id. at 46-50); see also Springer v. Colvin, 31 F. Supp. 3d 1246,

1255 (E.D. Wash. 2014) (noting substance abuse affects the ability to diagnose

bipolar disorder) (citing Diagnostic and Statistical Manual of Mental Disorders (4th

ed.)).

Ultimately, even if the ALJ erred in crediting Dr. Jonas’ opinion that it is not

clear whether McCain has bipolar disorder over the diagnoses from McCain’s

treating and examining medical providers of bipolar disorder included in the record,

the error does not require reversal and remand to the Commissioner. A diagnosis

does not establish disability. See Davis v. Barnhart, 153 F. App’x 569, 572 (11th

Cir. 2005) (“Disability is determined by the effect an impairment has on the

claimant’s ability to work, rather than the diagnosis of an impairment itself.”).

“[T]he finding of any severe impairment, whether or not it results from a single

impairment or a combination of impairments that together qualify as ‘severe,’ is

enough to satisfy step two.” Hearn v. Comm’r, Soc. Sec. Admin., 619 F. App’x 892,

895 (11th Cir. 2015) (citing Jamison v. Bowen, 814 F.2d 585, 588 (11th Cir. 1987)).

Therefore, an ALJ is not required to identify every severe impairment at step two.

Tuggerson-Brown v. Comm’r of Soc. Sec., 572 F. App’x 949, 951 (11th Cir. 2014).

If an ALJ finds the existence of one severe impairment, the ALJ’s failure to identify

another impairment as severe at step two does not constitute reversible error,

provided the ALJ properly notes he considered the impairment in the later steps. Id.;

Hearn, 619 F. App’x at 895 (citing Jones v. Dep’t of Health & Human Servs., 941

F.2d 1529, 1533 (11th Cir. 1991)); Medina v. Soc. Sec. Admin., 636 F. App’x 490,

492-93 (11th Cir. 2016). An ALJ’s statements he evaluated whether a claimant has

an “impairment or combination of impairments” that meets or medically equals a

Listing and considered “all symptoms” in determining a claimant’s RFC are

sufficient to demonstrate the ALJ considered all necessary evidence, including an

impairment not specifically found to be severe, in reaching a conclusion a claimant

is not disabled. Tuggerson-Brown, 572 F. App’x at 951-52 (citing Wilson v.

Barnhart, 284 F.3d 1219, 1224-25 (11th Cir. 2002)).

The ALJ in this case indicated he evaluated whether McCain has an

“impairment or combination of impairments” that meets or medically equals a

Listing and stated he considered “all symptoms” in determining McCain’s RFC. (Tr.

at 14, 16). Going beyond those statements, he also discussed evidence of McCain’s

alleged bipolar disorder and the alleged limitations it imposed on her functioning.

(Id. at 14-20).8 Ultimately, while the ALJ questioned whether McCain’s alleged

disabling symptoms were attributable to bipolar disorder or substance abuse, he

considered those symptoms in determining McCain’s RFC and concluding McCain

is not disabled. The ALJ’s determination of McCain’s RFC and his conclusion

McCain is not disabled are supported by substantial evidence, including the absence

of frequent hospitalizations since October 2014 and the treatment records from CED

Mental Health Center reflecting relative stability during the relevant period.

For the foregoing reasons, the ALJ did not commit reversible error by

assigning significant weight to Dr. Jonas’ opinions.

8 The undersigned notes this discussion distinguishes the instant case from Tobler, where the ALJ

did not discuss impairments beyond the one he found to be severe based solely on Dr. Jonas’

testimony. See Tobler, 2014 WL 4187372, at *3-6.

V. Conclusion

Having reviewed the administrative record and considered all the arguments

presented by the parties, the undersigned finds the Commissioner’s decision is due

to be AFFIRMED. A separate order will be entered.

DONE this 28th day of February, 2020.

Lita 4. Cryin

STACI G. CORNELIUS

U.S. MAGISTRATE JUDGE

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