# Plier v. Social Security Administration, Commissioner

> District Court, N.D. Alabama · March 23, 2022

URL: https://www.frixlaw.com/law-library/cases/9990998

## Case

- **Court:** District Court, N.D. Alabama
- **Decided:** March 23, 2022
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/9990998

## How later opinions describe it (automated extraction)

- holding that “good cause” existed where the opinion was contradicted by other notations in the physician’s own record
- holding that the ALJ’s failure to articulate adequate reasons for only partially crediting the plaintiff’s complaints of pain resulted in reversal

## Opinion text

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
MIDDLE DIVISION

TIMOTHY PLIER, )
)
Plaintiff, )
)
v. ) Case No.: 4:20-cv-01627-AMM
)
SOCIAL SECURITY )
ADMINISTRATION, )
Commissioner, )
)
Defendant. )

MEMORANDUM OF DECISION
Plaintiff Timothy Plier brings this action pursuant to the Social Security Act
(the “Act”), seeking review of the decision of the Commissioner of Social Security
(“Commissioner”) denying his claim for a period of disability and disability
insurance benefits (“benefits”). See 42 U.S.C. § 405(g). Based on the court’s review
of the record, the court AFFIRMS the decision of the Commissioner.
I. Introduction
On February 11, 2016, Mr. Plier protectively filed an application for benefits
under Title II of the Act, alleging disability as of January 20, 2016. R. 102–03, 122,
284–85. Mr. Plier alleges disability due to high blood pressure, beginning stages of
COPD, tremors, anxiety, and venous insufficiency peripheral disease. R. 102–03.
He has a limited education, is able to communicate in English, and has past relevant
work experience as a mixing machine operator. R. 31–32.

The Social Security Administration (“SSA”) initially denied Mr. Plier’s
application on May 4, 2016. R. 116, 122, 147–52. On May 31, 2016, Mr. Plier filed
a request for a hearing before an Administrative Law Judge (“ALJ”). R. 122, 155–

56. That request was granted. R. 157–59. Mr. Plier received a hearing before ALJ
Michael Brownfield on December 1, 2017 and a supplemental hearing on May 11,
2018, after he was assessed by a cardiologist for a consultative examination. R. 66–
101, 122. On July 31, 2018, ALJ Brownfield issued a decision, finding that Mr. Plier

was not disabled from January 20, 2016 through his date of last insured, March 31,
2018. R. 119–37. Mr. Plier appealed to the Appeals Council, which granted his
request for review on May 17, 2019. R. 142–45. On remand from the Appeals

Council, ALJ Cynthia W. Brown considered (1) the entire period under review
because the date of last insured changed and (2) the opinion of treating source
Munish K. Goyal, M.D. R. 16. Mr. Plier received a hearing before ALJ Brown on
December 3, 2019. R. 16, 40–65. On February 18, 2020, ALJ Brown issued a

decision, finding that Mr. Plier was not disabled from January 20, 2016 through his
date of last insured, December 31, 2019. R. 13–34. Mr. Plier was forty-three years
old at the time of the ALJ decision. R. 32, 34.
Mr. Plier appealed to the Appeals Council, which denied his request for
review on August 14, 2020. R. 1–3. After the Appeals Council denied Mr. Plier’s

request for review, R. 1–3, the ALJ’s decision became the final decision of the
Commissioner and subject to district court review. On October 16, 2020, Mr. Plier
sought this court’s review of the ALJ’s decision. See Doc. 1.

II. The ALJ’s Decision
The Act establishes a five-step test for the ALJ to determine disability. 20
C.F.R. § 404.1520. First, the ALJ must determine whether the claimant is engaging
in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). “Substantial work

activity is work activity that involves doing significant physical or mental activities.”
20 C.F.R. § 404.1572(a). “Gainful work activity” is work that is done for pay or
profit. 20 C.F.R. § 404.1572(b). If the ALJ finds that the claimant engages in

substantial gainful activity, then the claimant cannot claim disability. 20 C.F.R. §
404.1520(b). Second, the ALJ must determine whether the claimant has a medically
determinable impairment or a combination of medical impairments that significantly
limits the claimant’s ability to perform basic work activities. 20 C.F.R. §§

404.1520(a)(4)(ii), (c). Absent such impairment, the claimant may not claim
disability. Id. Third, the ALJ must determine whether the claimant’s impairment
meets or medically equals the criteria of an impairment listed in 20 C.F.R. § 404,

Subpart P, Appendix 1. See 20 C.F.R. §§ 404.1520(d), 404.1525, and 404.1526. If
such criteria are met, the claimant is declared disabled. 20 C.F.R. §
404.1520(a)(4)(iii).

If the claimant does not fulfill the requirements necessary to be declared
disabled under the third step, the ALJ still may find disability under the next two
steps of the analysis. The ALJ must first determine the claimant’s residual functional

capacity, which refers to the claimant’s ability to work despite his impairments. 20
C.F.R. §§ 404.1520(e), 404.1545. In the fourth step, the ALJ determines whether the
claimant has the residual functional capacity to perform past relevant work. 20
C.F.R. § 404.1520(a)(4)(iv). If the ALJ determines that the claimant is capable of

performing past relevant work, then the claimant is deemed not disabled. Id. If the
ALJ finds the claimant unable to perform past relevant work, then the analysis
proceeds to the fifth and final step. 20 C.F.R. § 404.1520(a)(4)(v). In this step, the

ALJ must determine whether the claimant is able to perform any other work
commensurate with his residual functional capacity, age, education, and work
experience. 20 C.F.R. § 404.1520(g)(1). Here, the burden of proof shifts from the
claimant to the Commissioner to prove the existence, in significant numbers, of jobs

in the national economy that the claimant can do given his residual functional
capacity, age, education, and work experience. 20 C.F.R. §§ 404.1520(g)(1),
404.1560(c).
The ALJ determined that Mr. Plier last met the insured status requirements of
the Act on December 31, 2019. R. 18. Next, the ALJ found that Mr. Plier did not

engage in substantial gainful activity from his alleged onset date through his date of
last insured. R. 19. The ALJ determined that Mr. Plier had the following severe
impairments: venous insufficiency, chronic obstructive pulmonary disorder

(“COPD”), hypertension, anxiety, depression, and personality disorder. R. 19. The
ALJ found that Mr. Plier’s hand tremors were “non-severe” because “[n]either his
physical examinations nor the findings during the [consultative physical exam] . . .
reflected any limitations from [Mr. Plier’s] slight tremor[]” and “[t]here is no

evidence the tremors cause more than a minimal effect on the claimant’s ability to
perform basic activities for a continuous period of 12 months.” R. 19. Additionally,
the ALJ found that Mr. Plier’s history of alcohol abuse was “not a severe

impairment” because “there is no evidence that [Mr. Plier] has been instructed to
cease consumption of alcohol, has been terminated from any employment due to
alcohol consumption, or would be prevented from the performance of a full range of
light work.” R. 19. The ALJ also determined that “there is no objective medical

evidence that [Mr. Plier’s] obesity has affected a major weight bearing joint or
resulted in functional limitations upon his ability to perform exertional and/or
postural activities on a regular and sustained basis.” R. 19. Overall, the ALJ

determined that Mr. Plier did not have “an impairment or combination of
impairments that met or medically equaled the severity of one of the listed
impairments” to support a finding of disability. R. 19.

The ALJ found that Mr. Plier’s “statements concerning the intensity,
persistence[,] and limiting effects of these impairments are not consistent with the
objective medical evidence.” R. 24. The ALJ found that Mr. Plier had the “residual

functional capacity to perform light work” with certain limitations. R. 22. The ALJ
determined that Mr. Plier is limited to occasionally climb ramps and stairs. R. 22.
The ALJ determined that Mr. Plier must: not climb ladders, ropes, or scaffolds; avoid
concentrated exposure to extreme cold, heat, fumes, odors, dusts, and other

pulmonary irritants; and avoid any exposure to hazards. R. 22. Further, the ALJ
noted that Mr. Plier can understand, remember, and carry out short, simple
instructions and attend to those for two-hour periods; would need a well-spaced work

environment; can tolerate occasional interaction with the public, co-workers, and
supervisors; and that changes in the work place should be gradual and occur no more
than occasionally. R. 22.
According to the ALJ, Mr. Plier was “unable to perform any past relevant

work,” he was “a younger individual” on the date of last insured, and he has “a
limited education,” as those terms are defined by the regulations. R. 31–32. The ALJ
determined that “[t]ransferability of job skills is not material to the determination of

disability because using the Medical-Vocational Rules as a framework supports a
finding that the claimant is ‘not disabled,’ whether or not the claimant has
transferable job skills.” R. 32. Because Mr. Plier’s “ability to perform all or

substantially all of the requirements of this level of work was impeded by additional
limitations,” the ALJ enlisted a vocational expert to ascertain whether there were a
significant number of jobs in the national economy that Mr. Plier would be capable

of performing. R. 32. That expert testified that there are indeed a significant number
of such jobs in the national economy, such as an electronics worker, inspector, and
hand packager. R. 32–33.
Based on these findings, the ALJ concluded that Mr. Plier did not have a

disability as defined in the Act, from January 20, 2016 through December 31, 2019.
R. 33–34. Mr. Plier now challenges that decision.
III. Factual Record

The medical records included in the transcript begin before the alleged onset
date. However, the period relevant to the Commissioner’s disability determination
is January 20, 2016 through December 31, 2019.
Mr. Plier’s general practitioner, Dr. Michael Swearingen, referred him to

Heart South Cardiovascular Group. See R. 601. Mr. Plier presented to cardiologist
Jeff Segrest at Heart South Cardiovascular Group on June 12, 2015 for “uncontrolled
hypertension.” R. 499. Mr. Plier reported that he has “[n]o chest pain,” but

“experiences occasional dizziness, dyspnea on exertion[,] and has bilateral edema in
his feet with the left one being worse.” R. 499. Dr. Segrest noted that Mr. Plier was
an “every day smoker” and was counseled to quit. R. 500. Dr. Segrest noted that Mr.

Plier complained of: “lightheadedness/dizzy, shortness of breath with exertion,
swelling of hands or feet;” “wheezing, shortness of breath, excessive snoring,
chronic cough;” “numbness”; “anxiety”; and “abnormal bruising.” R. 500. Mr. Plier

underwent an ECG on June 12, 2015, which was “within normal limits.” R. 497. Dr.
Segest prescribed carvedilol for hypertension, recommended a low sodium diet, and
recommended a follow-up appointment in one month. R. 502.
Mr. Plier underwent a stress test on June 15, 2015. R. 476. Dr. Goyal noted

that Mr. Plier “had no chest pain during the stress phase and review of the EKG
demonstrated no ischemic changes.” R. 476. Additionally, the test demonstrated
“normal perfusion.” R. 476. Mr. Plier underwent a transthoracic echocardiogram on

June 17, 2015. R. 477. The impressions as noted by Dr. Goyal were: “1. Normal
biventricular systolic ejection fraction. 2. Trace aortic insufficiency. 3. No obvious
intracardiac or pericardial masses or effusions seen.” R. 477.
Mr. Plier followed up with Dr. Goyal at Heart South Cardiovascular Group

on July 22, 2015. R. 509. Mr. Plier complained of “edema in both legs” which was
“worse as the day goes on” and painful swelling in his left leg. R. 509. Dr. Goyal
noted that Mr. Plier’s hypertension was “doing much better, but still elevated,” and
that he would be changing medication. R. 511. Dr. Goyal also noted that he may
refer Mr. Plier to the vein clinic if his edema did not improve. R. 511.

Mr. Plier followed up with Dr. Clifton Vance at Heart South Cardiovascular
Group on August 3, 2015, complaining of chest pain and continued dizzy spells. R.
517. An “[e]cho and stress were obtained and were within normal limits.” R. 518.

Dr. Vance added a mediation for hypertension and advised Mr. Plier to follow up in
one month. R. 520.
A carotid exam was conducted on August 25, 2015 because of Mr. Plier’s
dizziness. R. 496. “No significant obstructive stenosis” was seen in either the right

or left extracranial system. R. 496. Mr. Plier followed up with Dr. Goyal on August
26, 2015. R. 526. At that visit, he denied chest pain and reported that his dizziness
was better. R. 526. Dr. Goyal changed Mr. Plier’s hypertension medication, referred

him to the vein clinic, and instructed Mr. Plier to follow up in six weeks. R. 528.
Mr. Plier followed up with Dr. David Fieno at Heart South Cardiovascular
Group on September 15, 2015. R. 521. Mr. Plier reported “heavy restless feeling
with discoloration around [his] ankles.” R. 521. Mr. Plier denied “wearing stockings

or elevating legs daily.” R. 521. Dr. Fieno assessed Mr. Plier for venous
insufficiency and stated that ablation may be an option. R. 524. Dr. Fieno noted that
Mr. Plier “would like to try conservation therapy,” and he recommended “elevation,

salt restriction, leg exercises[,] and stockings with follow up.” R. 524. Dr. Fierno
ordered a venous ultrasound and advised Mr. Plier to follow up in ninety days. R.
525. The venous ultrasound found that Mr. Plier’s right and left “great saphenous

vein is incompetent,” the right and left “small saphenous vein is competent,” the
right and left “anterior accessory saphenous vein is absent,” the right and left
“posterior accessory saphenous vein is absent,” the right and left “common femoral

vein . . . was negative for DVT,” and the “popliteal vein was negative for DVT.” R.
535–36.
On September 30, 2015, Mr. Plier followed up with Dr. Goyal. R. 537. Dr.
Goyal noted that Mr. Plier’s hypertension was “[w]ell controlled with current

therapy.” R. 539. Dr. Goyal also noted that Mr. Plier was using compression
stockings for venous insufficiency, but was still experiencing symptoms and would
try elevation and follow up with Dr. Fieno for a likely ablation. R. 539. Dr. Goyal

instructed Mr. Plier to follow up in six months. R. 540.
After an episode of syncope and severe cough, a December 9, 2015 chest x-
ray showed a “cardiac silhouette . . . within normal limits,” “stable mild hilar
prominence,” and “minimal right apical scarring.” R. 480, 487–88.

Mr. Plier followed up with Dr. Fieno on January 12, 2016, “to evaluate
compression therapy for the past 90 days.” R. 559. The visit notes reflect that Mr.
Plier “has had some improvement in his leg symptoms since his last visit[,] but [he]

is interested in other treatment options that are available.” R. 559. Dr. Fieno noted
that Mr. Plier’s venous insufficiency had deteriorated and recommended ablation.
R. 562.

Mr. Plier followed up with Dr. Goyal on March 16, 2016, and complained of
high blood pressure, dizziness, and passing out spells. R. 601. Dr. Goyal diagnosed
him with syncope and hypertension. R. 725. Dr. Goyal prescribed an event monitor,

referred Mr. Plier to neurology, and increased his hypertension medication. R. 604.
The event monitor demonstrated “normal sinus rhythm.” R. 674.
Dr. Robert Storjohann completed a psychological evaluation on April 22,
2016, upon referral of the Social Security Administration. R. 606. During this

evaluation, Mr. Plier “described experiencing brief periods of heightened anxiety,
but no clear panic attacks” and “indicated that he has not had any psychiatric
treatment.” R. 607. Mr. Plier also reported disturbed sleep, “periods of low energy,”

fatigue, social withdrawal and isolation, irritability and frustration, and poor
attention and concentration. R. 607. Dr. Storjohann estimated Mr. Plier’s intellectual
functioning to be “in the borderline range,” and considered Mr. Plier’s prognosis to
be “poor given his reported health problems, his personality dysfunction, his specific

phobia, and his apparent intellectual limitations.” R. 609.
Mr. Plier saw Dr. Goyal on May 4, 2016. R. 716. Dr. Goyal reported that there
were no new cardiac concerns other than high blood pressure, but diagnosed Mr.

Plier with a cough and “tachycardia and wheezing.” R. 716, 719. Dr. Goyal
recommended that Mr. Plier go to the emergency room. R. 719. Mr. Plier presented
to the Emergency Department at the Coosa Valley Medical Center on May 4, 2016

complaining of chest congestion with “chest pain, [shortness of breath], slightly
elevated d-dimer, tachycardia.” R. 614, 620. A chest x-ray indicated that his lungs
were clear with “[n]o acute chest disease.” R. 616. Mr. Plier was discharged with

instructions to take medication and follow up with his primary care physician. R.
626.
Mr. Plier presented to the Emergency Department at the Coosa Valley
Medical Center on May 21, 2016 complaining of dyspnea for two hours. R. 634. A

chest x-ray indicated that his lungs were clear with “[n]o acute chest disease.” R.
650. Mr. Plier was discharged with instructions to follow up with his primary care
physician. R. 635.

Mr. Plier followed up with Dr. Goyal on June 1, 2016, due to elevated blood
pressure and swelling. R. 705. Dr. Goyal changed Mr. Plier’s hypertension
medications and directed him to follow up in eight weeks. R. 708. Dr. Goyal also
completed a Physical Capacities Evaluation on June 1, 2016. R. 611. Dr. Goyal did

not complete Sections I–VII of the report, regarding Mr. Plier’s specific physical
limitations. R. 611. Dr. Goyal did complete Section VII, wherein he opined that Mr.
Plier would likely to be absent from work as a result of his impairments or treatment

“[m]ore than four days per month.” R. 611.
On September 14, 2016, Mr. Plier saw Dr. Swearingen to follow up on his
anxiety and COPD. R. 741. Mr. Plier complained of episodes of shortness of breath.

R. 741. Dr. Swearingen prescribed medications, including inhalers, and directed Mr.
Plier to follow up in six months. R. 743.
Mr. Plier saw primary care physician Dr. Swearingen on April 13, 2017 for

his six-month checkup for anxiety and depression medication. R. 677.
Mr. Plier followed up with Dr. Goyal on October 12, 2017. R. 680. The visit
notes indicate that Mr. Plier’s blood pressure was “doing much better with his
current regime.” R. 682. Mr. Plier reported the following symptoms: fatigue;

seasonal allergies; dizziness; passing out; chronic cough; wheezing; heartburn;
anxiety; and easy bruising. R. 682. Dr. Goyal increased Mr. Plier’s hypertension
medication and ordered an EKG. R. 685.Mr. Plier’s EKG results were within normal

limits. R. 680. Dr. Goyal instructed Mr. Plier to follow up in twelve months. R. 685.
Mr. Plier saw Dr. Swearingen on December 14, 2017 to follow up on
medication for anxiety and tremor. R. 808. Mr. Plier reported that while his blood
pressure was doing better, his Prozac was not working as long as it had been working

before. R. 808. Dr. Swearingen directed Mr. Plier to follow up in six months. R. 810.
Mr. Plier saw Dr. Ivan Slavich at Advanced Cardiovascular Care on January
4, 2018 for a disability determination. R. 746–47. Mr. Plier reported that he had

“several syncopal episodes,” dizziness, tremors, and anxiety. R. 746. Dr. Slavich
concluded that “[b]ased on [his] medical findings objectively, [Mr. Plier] doesn’t
have significant impairments that would preclude him from doing work related

activities.” R. 747.
Mr. Plier presented to the Coosa Valley Medical Center Emergency
Department on March 10, 2018 complaining of syncope. R. 758. Mr. Plier stated

that he was cooking when he had a coughing spell and a syncopal episode and fell
and hit his head. R. 758. The emergency room doctor, ordered an EKG, CT of the
brain, and chest x-ray, which showed “[n]o acute . . . abnormality” and “[n]o acute
chest disease[,]” and discharged Mr. Plier. R. 760, 767, 772–73.

Mr. Plier presented to Dr. Swearingen on August 7, 2018 to follow up on his
medication. R. 811. Dr. Swearingen prescribed medications and directed Mr. Plier
to return in six months. R. 813.

Mr. Plier presented to Dr. Goyal on November 13, 2018 for a follow-up visit.
R. 840. Dr. Goyal noted that Mr. Plier was “doing well from a [cardiovascular
standpoint]. [Blood pressure] has been doing good for the most part – will have
occasional spikes. No palpitations. No orthopnea, PND, palpitations or syncope.” R.

840. Dr. Goyal ordered an EKG of Mr. Plier on November 13, 2018. R. 838. The
EKG showed sinus tachycardia “within normal limits.” R. 838. Dr. Goyal advised
Mr. Plier to follow up in twelve months. R. 843.
Mr. Plier returned to Dr. Swearingen on March 18, 2019 to follow up on his
anxiety medication. R. 814. He reported that he was “doing well with blood

pressure.” R. 814. Dr. Swearingen prescribed medications and directed Mr. Plier to
return in six months. R. 815.
On June 3, 2019 Mr. Plier presented to Dr. Fieno complaining of “tiredness

and heaviness, swelling, aching and throbbing [in his] bilateral legs.” R. 833. Dr.
Fieno completed a bilateral lower extremity venous ultrasound with Doppler
interrogation. R. 845. It showed “no evidence of acute deep vein thrombosis in the
lower extremities bilaterally,” but “[s]ustained superficial venous valvular

incompetency in the left greater saphenous vein in its entirety.” R. 845. On July 9,
2019, Mr. Plier underwent an endovenous radio frequency ablation of both the right
and left great saphenous veins. R. 831. A venous ultrasound follow-up report dated

July 16, 2019 showed “no evidence of acute deep vein thrombosis in the lower
extremities bilaterally,” and “Bilateral GSV’s are ablated = / > 2 cm distal to their
SFJ’s.” R. 847.
Mr. Plier underwent a lower extremity PVR with stress report on September

10, 2019. R. 848. It showed that “[i]n the bilateral lower extremities the PVR
waveforms are pulsatile to the level of the metatarsals. The ankle brachial index is
normal bilaterally. There is no evidence of significant arterial occlusive disease at

rest.” R. 848.
Mr. Plier returned to Dr. Swearingen on September 16, 2019 to follow up on
medication for tremor and nerves. R. 816. He reported that he was “doing better with

his blood pressure.” R. 816. Dr. Swearingen prescribed medications and directed
Mr. Plier to return in six months. R. 818.
Mr. Plier presented to Dr. Fieno for “pain and tingling in his right leg” and

underwent a venous ultrasound on October 28, 2019. R. 819–20. Dr. Fieno noted
that Mr. Plier’s venous insufficiency and leg pain were improved and his venous
stasis dermatitis and body mass index were unchanged. R. 823. A venous ultrasound
with Doppler interrogation was performed. R. 850. It concluded “R distal GSV is

still patent and refluxing over 500ms.” R. 850. On that same day, Mr. Plier presented
to Dr. Goyal for an eleven-month follow-up. R. 825. Dr. Goyal noted that Mr. Plier
was “[d]oing well” from a cardiovascular standpoint; his blood pressure has “finally

come down”; and there was “[n]o orthopnea, PND, palpitations[,] or syncope.” R.
825. To treat Mr. Plier’s hypertension and non-sustained ventricular tachycardia, Dr.
Goyal continued medications, advised a follow up in twelve months, and counseled
Mr. Plier on exercise, smoking cessation, and appropriate diet. R. 828. Dr. Goyal

also ordered an EKG, which was “within normal limits.” R. 830.
On November 4, 2019, Dr. Fieno completed an “[u]ltrasound guided
sclerotherapy of the right distal great saphenous vein.” R. 853.

IV. Standard of Review
This court’s role in reviewing claims brought under the Act is a narrow one.
The only issues before this court are whether the record reveals substantial evidence

to sustain the ALJ’s decision, see 42 U.S.C. § 405(g); Walden v. Schweiker, 672 F.2d
835, 838 (11th Cir. 1982), and whether the correct legal standards were applied, see
Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988); Chester v. Bowen, 792 F.2d

129, 131 (11th Cir. 1986). The Act mandates that the Commissioner’s findings are
conclusive if supported by “substantial evidence.” Martin v. Sullivan, 894 F.2d 1520,
1529 (11th Cir. 1990); see 42 U.S.C. § 405(g). This court may not reconsider the
facts, reevaluate the evidence, or substitute its judgment for that of the

Commissioner; instead, it must review the record as a whole and determine if the
decision is reasonable and supported by substantial evidence. See Martin, 894 F.2d
at 1529 (citing Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)).

Substantial evidence falls somewhere between a scintilla and a preponderance
of evidence; “[i]t is such relevant evidence as a reasonable person would accept as
adequate to support a conclusion.” Martin, 894 F.2d at 1529 (quoting Bloodsworth,
703 F.2d at 1239). If the Commissioner’s factual findings are supported by

substantial evidence, they must be affirmed even if the preponderance of the
evidence is against the Commissioner’s findings. See Martin, 894 F.2d at 1529. No
decision is automatic, for “[d]espite th[e] deferential standard [for review of claims],

it is imperative that th[is] Court scrutinize the record in its entirety to determine the
reasonableness of the decision reached.” Bridges v. Bowen, 815 F.2d 622, 624 (11th
Cir. 1987) (citing Arnold v. Heckler, 732 F.2d 881, 883 (11th Cir. 1984)). Failure to

apply the correct legal standards is grounds for reversal. See Bowen v. Heckler, 748
F.2d 629, 635 (11th Cir. 1984).
V. Discussion

Mr. Plier alleges that the ALJ’s decision should be reversed and remanded
because the ALJ: “failed to respond to the order of the Appeals Council requiring
consideration of the opinion evidence of [Mr. Plier’s] treating cardiologist”; “erred
in holding that [Mr. Plier’s] daily activities diminish the persuasiveness of his

allegations”; and “improperly drew Adverse Inferences from Lack of Medical
Treatment.” Doc. 11 at 2.
A. The ALJ’s Evaluation of Dr. Munish Goyal’s Medical Opinion

Mr. Plier first argues that the ALJ erred by “fail[ing] to respond to the order
of the Appeals Council requiring consideration of the opinion evidence of [Mr.
Plier’s] treating cardiologist, Dr. Munish Goyal.” Id. at 24. Mr. Plier argues that the
ALJ failed to address Dr. Goyal’s opinion evidence. Id. at 25.

Under the regulations applicable to Mr. Plier’s application for benefits, the
ALJ must articulate the weight given to different medical opinions in the record and
the reasons therefore. See Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1179

(11th Cir. 2011). The weight afforded to a medical opinion regarding the nature and
severity of a claimant’s impairments depends upon the examining and treating
relationship the medical source had with the claimant, the evidence the medical

source presents to support the opinion, whether the opinion is consistent with the
record as a whole, and the specialty of the medical source. See 20 C.F.R. §
404.1527(c).

The regulations and case law establish a general preference for assigning
greater weight to the opinions of treating medical sources than the opinions of non-
treating medical sources, and greater weight to the opinions of non-treating medical
sources than the opinions of non-examining medical sources. See 20 C.F.R. §§

404.1527(c)(1)-(2); Ryan v. Heckler, 762 F.2d 939, 942 (11th Cir. 1985). Thus, a
treating physician’s opinion is entitled to “substantial or considerable weight unless
‘good cause’ is shown to the contrary.” Crawford Comm’r of Soc. Sec., 363 F.3d

1155, 1159 (11th Cir. 2004) (quoting Lewis v. Callahan, 125 F.3d 1436, 1440 (11th
Cir. 1997)).
“Good cause” exists for an ALJ to not give a treating physician’s opinion
substantial weight 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.”
Phillips v. Barnhart, 357 F.3d 1232, 1241 (11th Cir. 2004) (citing Lewis, 125 F.3d

at 1440); see also Edwards v. Sullivan, 937 F.2d 580, 583-84 (11th Cir. 1991)
(holding that “good cause” existed where the opinion was contradicted by other
notations in the physician’s own record). On the other hand, the opinions of a one-

time examiner or of a non-examining medical source are not entitled to the initial
deference afforded to a physician who has an ongoing treating relationship with a
plaintiff. McSwain v. Bowen, 814 F.2d 617, 619 (11th Cir. 1987).

An ALJ “may reject the opinion of any physician when the evidence supports
a contrary conclusion.” McCloud v. Barnhart, 166 F. App’x 410, 418 (11th Cir.
2006) (citing Bloodsworth v. Heckler, 703 F.2d 1233, 1240 (11th Cir. 1983)).
Further, an ALJ does not err when it declines to give a medical opinion controlling

weight, if the ALJ articulates specific and proper reasons for doing so. Moore v.
Barnhart, 405 F.3d 1208, 1212 (11th Cir. 2005); see also Beegle v. Comm’r, 482 F.
App’x 483, 486 (11th Cir. 2012).

Additionally, applicable regulations provide that physicians’ opinions on
issues such as whether a claimant is disabled, the claimant’s residual functional
capacity, and the application of vocational factors “are not medical opinions, . . . but
are, instead, opinions on issues reserved to the Commissioner because they are

administrative findings that are dispositive of a case; i.e., that would direct the
determination or decision of disability.” 20 C.F.R. § 404.1527(d). The court focuses
on the doctors’ evaluations of the claimant’s “condition and the medical

consequences thereof, not their opinions of the legal consequences of his [or her]
condition.” Lewis, 125 F.3d at 1440. Such statements by a physician may be relevant
to the ALJ’s findings, but they may not be determinative, because the ALJ bears the

responsibility for assessing a claimant’s residual functional capacity. See, e.g., 20
C.F.R. § 404.1546(c).
Mr. Plier argues that the ALJ failed to accord proper weight to a June 1, 2016,

opinion—a Physical Capacities Evaluation—by his treating cardiologist, Dr. Goyal.
Doc. 11 at 25. In the Physical Capacities Evaluation, Dr. Goyal completed Section
VIII, where he opined that Mr. Plier would miss more than four days of work per
month Id.; R. 611. Dr. Goyal did not complete sections I–VII of the Physical

Capacities Evaluation, which inquired about Mr. Plier’s ability to sit, stand, walk,
lift, carry, use his hands and feet, stoop, crouch, kneel, crawl, climb, balance, reach,
and work around certain hazards. R. 611.

On remand, the ALJ considered and discussed in her decision Dr. Goyal’s
medical opinion. R. 16, 28. First, the ALJ stated her understanding that the Appeals
Council “directed [her] . . . to further consider the opinion of treating source Munish
K. Goyal, M.D.” R. 16. Second, the ALJ rejected the conclusory opinion of Dr.

Goyal. The ALJ explained her consideration of Dr. Goyal’s opinion:
On June 1, 2016, Dr. Goyal opined [Mr. Plier] would miss
more than four days of work per month. He gave no other
exertional or non-exertional limitations. He did not
provide a basis or explanation of what would warrant such
excessive absences. This is wholly inconsistent with his
treatment notes at the time of the opinion and currently.
Dr. Goyal consistently notes [Mr. Plier] was (and is
currently) doing well on his hypertension medications. His
blood pressure slowly improved over the years, and his
most recent treatment notes document it is well-controlled.
A review of Dr. Goyal’s treatment notes shows that they
do not document any disabling limitations that would
warrant such excessive absences. Arrhythmia monitoring
showed tachycardia, but [Mr. Plier] was asymptomatic. He
was having some syncope, but not at the rate that would
warrant four or more absences in a month. He recently
denied syncope, so this has resolved. [Mr. Plier] is doing
much better. His blood pressure is controlled on his
current treatment regime.

R. 28 (citations omitted). The ALJ “considered opinion evidence in accordance with
the requirements of 20 CFR 404.1527.” R. 23.
Mr. Plier argues that “[t]he ALJ failed to address the opinion evidence of” Dr.
Goyal, “failed to respond to the order of the Appeals Council in a meaningful
manner,” and “disregarded the opinion of a treating physician without stating good
cause.” Doc. 11 at 25; Doc. 13 at 4.
The ALJ properly discounted Dr. Goyal’s opinion in the Physical Capacities
Evaluation because it was conclusory and unexplained. R. 28, 611. Additionally, Dr.
Goyal’s conclusion was inconsistent with his own treatment record, which the ALJ
discussed. R. 28, 476–77, 509–11, 526–28, 537–40, 601, 604, 674, 682, 685, 705–
08, 716, 719, 725, 840–43. Additionally, other evidence from the record supports a
conclusion contrary to Dr. Goyal’s opinion. See discussion supra Part II.
Because Dr. Goyal’s opinion was conclusory and unexplained and not
supported by his own treatment or Mr. Plier or the record as a whole, the ALJ could

properly reject his opinion. Additionally, the ALJ stated the reasons why she
discounted the opinion, thus satisfying the “good cause” requirement. R. 28.
Substantial evidence supports the ALJ’s decision.

B. The ALJ’s Evaluation of Daily Activities
Mr. Plier next argues that the ALJ erred in holding that his daily activities
diminish the persuasiveness of his allegations. Doc. 11 at 25.
A claimant’s subjective complaints are insufficient to establish a disability.

See 20 C.F.R. § 404.1529(a); Edwards v. Sullivan, 937 F.2d 580, 584 (11th Cir.
1991). Subjective testimony of pain and other symptoms may establish the presence
of a disabling impairment if it is supported by medical evidence. See Foote v. Chater,

67 F.3d 1553, 1561 (11th Cir. 1995). The Eleventh Circuit applies a two-part pain
standard when a claimant claims disability due to pain or other subjective symptoms.
The claimant must show evidence of an underlying medical condition and either (1)
objective medical evidence that confirms the severity of the alleged symptoms

arising from the condition, or (2) that the objectively determined medical condition
is of such severity that it can reasonably be expected to give rise to the alleged
symptoms. See 20 C.F.R. § 404.1529(a), (b); Social Security Ruling 16-3p, 2017
WL 5180304, at *3-*4 (Oct. 25, 2017) (“SSR 16-3p”); Wilson v. Barnhart, 284 F.3d
1219, 1225 (11th Cir. 2002).

If the first part of the pain standard is satisfied, the ALJ then evaluates the
intensity and persistence of a claimant’s alleged symptoms and their effect on his
ability to work. See 20 C.F.R. § 404.1529(c); Wilson, 284 F.3d at 1225-26. In

evaluating the extent to which a claimant’s symptoms affect his capacity to perform
basic work activities, the ALJ will consider (1) objective medical evidence, (2) the
nature of a claimant’s symptoms, (3) the claimant’s daily activities, (4) precipitating
and aggravating factors, (5) the effectiveness of medication, (6) treatment sought for

relief of symptoms, (7) any measures the claimant takes to relieve symptoms, and
(8) any conflicts between a claimant’s statements and the rest of the evidence. See
20 C.F.R. § 404.1529(c)(3), (4); SSR 16-3p at *4, *7-*8. To discredit a claimant’s

statements, the ALJ must clearly “articulate explicit and adequate reasons.” See
Dyer, 395 F.3d at 1210.
An ALJ’s review “must take into account and evaluate the record as a whole.”
McCruter v. Bowen, 791 F.2d 1544, 1548 (11th Cir. 1986). There is no rigid

requirement that the ALJ specifically refer to every piece of evidence in his decision.
Jacobus v. Comm’r of Soc. Sec., 664 F. App’x 774, 776 (11th Cir. 2016). Instead,
the ALJ must consider the medical evidence as a whole and not broadly reject the

evidence in the record. Id.
A credibility determination is a question of fact subject only to limited review
in the courts to ensure the finding is supported by substantial evidence. Mitchell v.

Comm’r, Soc. Sec. Admin., 771 F.3d 780, 782 (11th Cir. 2014); see Hand v. Heckler,
761 F.2d 1545, 1548-49 (11th Cir. 1985), vacated for rehearing en banc, 774 F.2d
428 (11th Cir. 1985), reinstated sub nom., Hand v. Bowen, 793 F.2d 275 (11th Cir.

1986). However, a reversal is warranted if the decision contains no indication of the
proper application of the pain standard. See Ortega v. Chater, 933 F. Supp. 1071,
1076 (S.D.F.L. 1996) (holding that the ALJ’s failure to articulate adequate reasons
for only partially crediting the plaintiff’s complaints of pain resulted in reversal).

“The question is not . . . whether [the] ALJ could have reasonably credited
[claimant’s] testimony, but whether the ALJ was clearly wrong to discredit it.”
Werner v. Comm’r of Soc. Sec., 421 F. App’x 935, 939 (11th Cir. 2011).

Mr. Plier argues that the ALJ erred when she found that his “activities of daily
living further diminish the persuasiveness of his allegations.” Doc. 11 at 26; R. 28.
After delineating the pain standard, the ALJ noted that the regulations include
“daily activities” as a factor relevant to the claimant’s symptoms. R. 23. When

describing Mr. Plier’s symptoms, the ALJ wrote:
[Mr. Plier] alleges an inability to work due to leg pain,
high blood pressure, and dizziness. He alleges these
restrict his ability to stand (one hour), walk (100 yards),
and sit (45–60 minutes). He alleges his legs get heavy
when he walks. He also alleges anxiety. He alleges he gets
nervous in vehicles. He alleges numbness, tingling, and
swelling in his legs. He alleges he bandages his legs and
feet and props his legs up three to four hours a day to keep
the swelling down. He alleges he passes out due to
dizziness. He alleges breathing difficulty. He alleges he
cannot catch his breath. He alleges when it is hot outside,
he has difficulty breathing. He alleges he is unable to get
off the couch about 3–4 days a month.

R. 23–24. Along with her consideration of the record medical evidence, function
reports, and hearing testimony, the ALJ considered Mr. Plier’s daily activities when
making her credibility determination. R. 28. The ALJ described her assessment of
Mr. Plier’s daily activities as follows:
The undersigned also finds that [Mr. Plier’s] activities of
daily living further diminish the persuasiveness of his
allegations. [Mr. Plier] reported that he is able to manage
his personal care, mow the grass, do household repairs,
ride in a car, leave home, manage his finances, spend time
with family and friends, and watch television. At the
psychological consultative examination, [Mr. Plier]
reported that he is able to occasionally prepare simple
meals, do yard work, watch television, and listen to music.
Although the claimant reported that he does not cook,
emergency department record indicates that he reported
passing out while he was cooking. These activities of daily
living are consistent with the ability to perform light work
and are directly contradictory to [Mr. Plier’s] allegation
that he is unable to work in any capacity.

R. 28 (citations omitted).
The controlling regulations specifically list daily activities as a factor to
consider in evaluating a claimant’s credibility regarding his symptoms. 20 CFR §
404.1529(c)(3)(i). Additionally, an ALJ is entitled to consider a claimant’s daily
activities at Step Four, as she did here. See Macia v. Bowen, 829 F.2d 1009, 1012
(11th Cir. 1987).

The ALJ’s finding that Mr. Plier’s daily activities were inconsistent with his
allegations of total disability is supported by substantial evidence. As the ALJ noted,
both the medical evidence and the function reports indicate a level of activity that

reasonably supports the ALJ’s residual functional capacity of light work with further
restrictions. R. 362–65, 608, 758. Additionally, the ALJ did not solely rely on daily
activities in her credibility determination; rather the discussion of daily activities
was one paragraph of a ten-page, thorough analysis under binding precedent and

regulations. R. 22–31. With respect to her credibility determination, the ALJ
concluded that “[a]fter assessing [Mr. Plier’s] subjective allegations in light of the
regulatory factors, as well as the medical evidence, relevant opinions, if any, and

Function Reports, if any, and hearing testimony, the undersigned finds that [Mr.
Plier’s] impairments would reasonably limit him to light work as heavy lifting and
carrying may exacerbate his pain, cardiovascular issue, and breathing issues.” R. 30–
31. She continued by listing the further restrictions she imposed in her residual

functional capacity. R. 31. Substantial evidence supports the ALJ’s credibility
determination, including her discussion of Mr. Plier’s daily activities.
C. The ALJ’s Inference from Lack of Medical Treatment
Mr. Plier next argues that the ALJ “drew adverse inferences from the lack of
medical evidence which resulted in an adverse decision.” Doc. 11 at 28.

The evaluation of symptoms under the pain standard discussed above
prohibits an ALJ from drawing adverse inferences about a claimant’s failure to seek
medical treatment without first considering a claimant’s explanation. “[T]he

adjudicator must not draw any inferences about an individual’s symptoms and their
functional effects from a failure to seek or pursue regular medical treatment without
first considering any explanations that the individual may provide, or other
information in the case record, that may explain infrequent or irregular medical visits

or failure to seek medical treatment.” Social Security Ruling 96-7p, 1996 WL
374186, at *7 (July 2, 1996). However, “[a] conservative treatment plan tends to
negate a claim of disability.” Morales v. Comm’r, 799 F. App’x 672, 676 (11th Cir.

2020) (citing Wolfe v. Chater, 86 F.3d 1072, 1078 (11th Cir. 1996)). Additionally,
the burden is on the claimant to introduce evidence in support of her application for
benefits. Ellison v. Barnhart, 355 F.3d 1272, 1276 (11th Cir. 2003).
Mr. Plier alleges that the ALJ “failed to develop the record on the issue of lack

of medical treatment” and committed error by “draw[ing] an inference from lack of
treatment due to no income.” Doc. 11 at 31; Doc. 13 at 10.
The ALJ discussed Mr. Plier’s mental health treatment in her determination

of residual functional capacity, specifically with respect to her analysis of Mr. Plier’s
psychological consultative exam. R. 29. The ALJ stated that “‘[t]here is no evidence
of mental health treatment other than prescribed medications by his primary care
physician.” R. 29. There is no evidence of noncompliance with a proscribed
treatment regimen, nor is there evidence that Mr. Plier’s inability to afford treatment
prevented him from further medical treatment. Instead, the record shows that Mr.
Plier received medications for his mental health that were prescribed by his primary
care physician, Dr. Swearingen, who treated Mr. Plier every six months. R. 677,
741-43, 808-17. The ALJ did not err by noting Mr. Plier’s conservative treatment
in her assessment of Mr. Plier’s psychological consultative examination.
VI. Conclusion
Upon review of the administrative record, the court finds the Commissioner’s
decision 1s supported by substantial evidence and in accord with the applicable law.
A separate order will be entered.
DONE and ORDERED this 23rd day of March, 2022.

UNITED STATES DISTRICT JUDGE

29

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/9990998. Public record. Not legal advice.