recognizing that the ALJ is not “obligated to seek independent, additional expert medical testimony” when the record is sufficient to support the ALJ’s decision
How later courts described this case
- recognizing that the ALJ is not “obligated to seek independent, additional expert medical testimony” when the record is sufficient to support the ALJ’s decision
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
MIDDLE DIVISION
ALAN PYRON, )
)
)
Plaintiff,
)
v.
)
)
COMMISSIONER, SOCIAL
) Case No.: 4:22-cv-556-AMM
SECURITY
)
ADMINISTRATION,
)
)
Defendant.
)
MEMORANDUM OF DECISION
Plaintiff Alan Pyron 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”) and supplemental security income. See 42 U.S.C. §§
405(g), 1383(c)(3). Based on the court’s review of the record, the court AFFIRMS
the decision of the Commissioner.
I. Introduction
On September 30, 2019, Mr. Pyron protectively filed an application for
benefits under Title II of the Act, alleging disability as of September 26, 2012. R.
16, 113–21. Also on September 30, 2019, Mr. Pyron protectively filed an application
for supplemental security income under Title XVI of the Act, alleging disability as
of September 26, 2012. R. 16, 97–110. Mr. Pyron alleges disability due to bipolar
disorder, ADHD, agoraphobia, extreme anxiety, right knee problems, and
depression. R. 97, 113. He has at least a high school education and has past relevant
work experience as a landscaper, a painter, a senior auditor, and an attorney. R. 27.
The Social Security Administration (“SSA”) initially denied Mr. Pyron’s
applications on December 26, 2019, and again denied them upon reconsideration on
June 2, 2020. R. 16, 97–110, 113–44. On June 10, 2020, Mr. Pyron filed a request
for a hearing before an Administrative Law Judge (“ALJ”). R. 16, 170–73. That
request was granted. R. 174–76, 243–47. Mr. Pyron received an online video hearing
before ALJ Cynthia W. Brown on June 15, 2021. R. 36–69. On July 15, 2021, ALJ
Brown issued a decision, finding that Mr. Pyron was not disabled from September
26, 2012 through the date of her decision. R. 13–29. Mr. Pyron was fifty-four years
old at the time of the ALJ decision. R. 27.
Mr. Pyron appealed to the Appeals Council, which denied his request for
review on March 22, 2022. R. 2–4. After the Appeals Council denied Mr. Pyron’s
request for review, R. 2–4, the ALJ’s decision became the final decision of the
Commissioner and subject to district court review. On May 3, 2022, Mr. Pyron
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, 416.920. First, the ALJ must determine whether the claimant
is engaging in substantial gainful activity. 20 C.F.R. §§ 404.1520(a)(4)(i),
416.920(a)(4)(i). “Substantial work activity is work activity that involves doing
significant physical or mental activities.” 20 C.F.R. §§ 404.1572(a), 416.972(a).
“Gainful work activity” is work that is done for pay or profit. 20 C.F.R. §§
404.1572(b), 416.972(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),
416.920(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), 416.920(a)(4)(ii), (c). Absent such impairment, the claimant
may not claim disability. 20 C.F.R. §§ 404.1520(a)(4)(ii), (c), 416.920(a)(4)(ii), (c).
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, 404.1526, 416.920(d),
416.925, 416.926. If such criteria are met, the claimant is declared disabled. 20
C.F.R. §§ 404.1520(a)(4)(iii), 416.920(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, 416.920(e), 416.945. 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), 416.920(a)(4)(iv). If the ALJ
determines that the claimant is capable of performing past relevant work, then the
claimant is deemed not disabled. 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv).
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), 416.920(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), 416.920(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), 416.920(g)(1), 416.960(c).
The ALJ determined that Mr. Pyron meets the insured status requirements of
the Act through September 30, 2012. R. 16, 18. Next, the ALJ found that Mr. Pyron
had not engaged in substantial gainful activity since his alleged onset date. R. 18.
The ALJ decided that Mr. Pyron had the following severe impairment: degenerative
disc disease, arthritis of the right shoulder and right knee, chronic obstructive
pulmonary disease, mood disorder, anxiety disorder, and personality disorder. R. 18.
The ALJ found that Mr. Pyron’s history of hypertension and polysubstance abuse
were “non-severe” because “the medical evidence of record does not show that these
impairments have persistently caused more than minimal symptoms and does not
show any persistent significant limitations of function arising from these
impairments.” R. 19. Overall, the ALJ determined that Mr. Pyron did not have “an
impairment or combination of impairments that meets or medically equals the
severity of one of the listed impairments” to support a finding of disability. R. 19.
The ALJ found that Mr. Pyron’s “statements concerning the intensity,
persistence[,] and limiting effects of these symptoms are not entirely consistent with
the medical evidence and other evidence in the record.” R. 23. The ALJ found that
Mr. Pyron had the “residual functional capacity to perform light work” with certain
limitations. R. 22. The ALJ determined that Mr. Pyron may: frequently climb ramps
and stairs; frequently balance; occasionally stoop, kneel, crouch, and crawl. R. 22.
The ALJ also determined that Mr. Pyron must not: climb ladders, ropes, or scaffolds;
reach overhead bilaterally; experience concentrated exposure to extreme
temperatures, fumes, odors, and other pulmonary irritants; or be exposed to any
hazards. R. 22. The ALJ also determined that Mr. Pyron: can understand, remember,
and carry out simple instructions; can maintain attention for at least two-hour
periods; would function best with his own work area without close proximity to
others; would benefit from a familiar, repetitive work routine; should avoid quick
decision making and rapid changes; could tolerate occasional interaction with the
general public and coworkers; and experience workplace changes that are gradually
introduced and occur no more than occasionally. R. 22–23.
According to the ALJ, Mr. Pyron was “unable to perform any past relevant
work” as a landscaper, a painter, a senior auditor, and an attorney. R. 27. According
to the ALJ, Mr. Pyron was “a younger individual . . . on the alleged disability onset
date,” but “subsequently changed age categories to an individual closely
approaching advanced age,” as those terms are defined by the regulations. R. 27.
The ALJ determined that he has “at least a high school education.” R. 27. 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 [he] has transferable job
skills.” R. 27. Because Mr. Pyron’s “ability to perform all or substantially all of the
requirements of this level of work has been impeded by additional limitations,” the
ALJ enlisted a vocational expert to ascertain “the extent to which these limitations
erode the unskilled light occupational base.” R. 27–28. That expert testified that such
individual “would be able to perform the requirements of representative occupations
such as a price marker[,] . . . a mailroom clerk[,] . . . and an assembler.” R. 28, 67.
Based on these findings, the ALJ concluded that Mr. Pyron did not have a
disability as defined in the Act, from September 26, 2012 through the date of the
decision, July 15, 2021. R. 28–29. Mr. Pyron now challenges that decision.
III. 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), 1383(c)(3); 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),
1383(c)(3). 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).
IV. Discussion
Mr. Pyron alleges that the ALJ’s decision should be reversed because the ALJ
failed “to fully and fairly develop the record” regarding Mr. Pyron’s agoraphobia
impairment. Doc. 10 at 22. In the alternative, Mr. Pyron alleges that the ALJ’s
decision “is not supported by substantial evidence considering the effect of [his] total
impairments singly or in combination.” Id.
A. Duty to Develop the Record
A disability is defined as an “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 12 months.” 42 U.S.C. § 423(d)(1)(A).
An individual claiming benefits must prove that he is disabled. Moore v. Barnhart,
405 F.3d 1208, 1211 (11th Cir. 2005). The burden is on the claimant to introduce
evidence in support of his application for benefits. Ellison v. Barnhart, 355 F.3d
1272, 1276 (11th Cir. 2003).
The Commissioner is not required to hire an expert medical source when
determining whether a claimant is disabled. 20 C.F.R. §§ 404.1513a(b)(2),
404.1517, 416.917, 416.919a(b); Klawinski v. Comm’r of Soc. Sec., 391 F. App’x
772, 776 (11th Cir. 2010); Wilson v. Apfel, 179 F.3d 1276, 1278 (11th Cir. 1999)
(recognizing that the ALJ is not “obligated to seek independent, additional expert
medical testimony” when the record is sufficient to support the ALJ’s decision).
Instead, “the ALJ has a basic obligation to develop a full and fair record.” Graham
v. Apfel, 129 F.3d 1420, 1422 (11th Cir. 1997). “The court should be guided by
whether the record reveals evidentiary gaps which result in unfairness or ‘clear
prejudice.’” Id. at 1423.
Mr. Pyron argues that his “medical records . . . do not contain sufficient
evidence for the ALJ to make an informed decision regarding the severity of [his]
agoraphobia impairment.” Doc. 10 at 21. Mr. Pyron states that there is a lack of
evidence in the record between 2012 and 2019 because he “lacked medical insurance
and could not afford any medical treatment.” Id. at 22 (citing R. 60). Mr. Pyron
argues the decision of the ALJ should be “reversed and remanded for further
development of the record concerning [his] agoraphobia impairment, and another
consultative examination with a psychiatrist.” Id. Mr. Pyron states that “[t]he
psychological evaluation . . . by Dr. Arnold on December 4, 2019, does not indicate
whether she even asked Mr. Pyron about his agoraphobia,” and that “Dr. Bolton
found [Mr. Pyron] to be suffering from agoraphobia.” Id. at 21–22.
The Commissioner argues that “the ALJ sufficiently discussed the evidence
of record in support of her finding” that Mr. Pyron’s “complaints of disabling
agoraphobia . . . were not entirely consistent with the record evidence.” Doc. 11 at
8. The Commissioner also argues that Mr. Pyron “has shown neither a breach of duty
[to develop the record] nor harmful error” because “he has not adequately shown
that there was a gap in the records . . . material to the ALJ’s finding that he was not
disabled.” Id. at 11–12.
Although Mr. Pyron argues that there is a need for further development of the
medical record and a psychiatric consultative examination, the ALJ discussed Mr.
Pyron’s mental impairments throughout her decision. First, she identified mood
disorder, anxiety disorder, and personality disorder as severe impairments and stated
they “limit [Mr. Pyron’s] ability to perform basic work activities.” R. 18–19. With
respect to Mr. Pyron’s mental impairments, the ALJ cited a December 2019
psychological evaluation diagnosing him with “mood disorder, anxiety disorder, and
personality disorder” and his testimony “that he currently takes medications for these
impairments.” R. 19; see also R. 469–71.
Second, in her step three analysis, the ALJ found that “[t]he severity of [Mr.
Pyron’s] mental impairments, considered singly and in combination, does not meet
or medically equal the criteria of listings 12.04, 12.06, and 12.08.” R. 21. The ALJ
went on to consider the “paragraph B” criteria and in that analysis cited: Mr. Pyron’s
function report; Mr. Pyron’s ability “to provide information about his health, follow
instructions from healthcare providers, comply with treatment outside of a doctor’s
office or hospital, and respond to questions from medical providers”; the December
2019 “Report of Psychological Evaluation”; State agency reviewing psychiatrist
reports; and that Mr. Pyron “had a good rapport with providers, was described as
cooperative, had good interactions with non-medical staff, and appeared comfortable
during appointments.” R. 21–22.
Third, the ALJ included in Mr. Pyron’s residual functional capacity
limitations related to his mental impairments. R. 22. In the residual functional
capacity, the ALJ specifically stated Mr. Pyron:
can understand, remember, and carry out simple
instructions, and maintain attention for at least two-hour
periods; would function best with his own work area
without close proximity to others; would benefit from a
familiar, repetitive work routine, but should avoid quick
decision making and rapid changes; could tolerate
occasional interaction with the general public and
coworkers; and changes in the workplace should be
gradually introduced and occur no more than occasionally.
R. 22–23. In forming the residual functional capacity, the ALJ properly described
and applied the Eleventh Circuit’s pain standard. R. 23–26. Under that standard, Mr.
Pyron 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), 416.929(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), 416.929(c); Wilson, 284 F.3d at 1225–26.
With respect to Mr. Pyron’s mental impairments, the ALJ cited his disability
report, function report, and hearing testimony to support his allegations. R. 23. She
stated that she “is cognizant of the substantial overlap in symptomology between
different mental impairments, as well as the inherently subjective nature of mental
diagnoses” and considered Mr. Pyron’s “psychological symptoms and their effect
on his functioning . . . together, instead of separately, regardless of the diagnostic
label attached.” R. 25. After citing the evidence of record, the ALJ concluded that
Mr. Pyron’s “daily activities and reported functioning do not indicate disabling
mental limitations, but he does have some mental limitations as defined in the
residual functional capacity herein.” R. 25. The ALJ clearly articulated her reasons
for finding that Mr. Pyron’s agoraphobia testimony was “not entirely consistent with
the medical evidence and other evidence in the record.” R. 23.
The ALJ’s thorough analysis of Mr. Pyron’s mental impairments throughout
her decision demonstrates that the record here was neither incomplete nor inadequate
as it related to Mr. Pyron’s agoraphobia. Instead, the record was sufficient for the
ALJ to evaluate Mr. Pyron’s impairments and craft a residual functional capacity
that incorporated his abilities. Although Mr. Pyron alleges that the record is bare
because of his lack of medical insurance, the record contained both reports of the
State agency providers and the December 2019 evaluation, which were discussed in
detail by the ALJ. Although Mr. Pyron questions the December 2019 evaluation
because it “does not indicate” that Mr. Pyron was asked about his agoraphobia, Doc.
10 at 21, the report includes an evaluation of Mr. Pyron’s background, a mental
status exam, and the psychologist’s diagnostic impression of mood disorder, anxiety
disorder, and personality disorder. R. 469–71. Substantial evidence supports the
ALJ’s consideration of Mr. Pyron’s impairments, and Mr. Pyron has failed to
establish that the ALJ had any obligation to further develop the record.
B. Combined Effect of Impairments
The Eleventh Circuit has held that when considering the “total limiting
effects” of impairments, an ALJ must consider “all of a claimant’s medically
determinable impairments, even those not designated as severe.” Ehrisman v. Astrue,
377 F. App’x 917, 919 (11th Cir. 2010); see Davis v. Shalala, 985 F.2d 528, 533
(11th Cir. 1993); 20 C.F.R. § 404.1545(a)(2). “[I]t is certain that mental and
psychological defects can combine with physical impairments to create total
disability to perform gainful employment.” Bowen v. Heckler, 748 F.2d 629, 634
(11th Cir. 1984). A statement that an ALJ “considered all symptoms” is not
sufficient if the content of the ALJ’s decision does not include discussion or findings
as to how “all symptoms” affected the claimant’s residual functional capacity.
Schink v. Comm’r of Soc. Sec., 935 F.3d 1245, 1269 (11th Cir. 2019).
Mr. Pyron argues that the ALJ’s decision fails “to make specific and well-
articulated findings as to the effect of the combination of impairments.” Doc. 10 at
22. The Commissioner argues that “the ALJ also properly considered the
combination of [Mr. Pyron’s] impairments,” “stated in her decision that the
combination of [Mr. Pyron’s] impairments did not meet or equal a listed
impairment,” and considered and accommodated Mr. Pyron’s severe and non-severe
impairments in the residual functional capacity. Doc. 11 at 12.
The ALJ determined that Mr. Pyron “did not have an impairment or
combination of impairments that meets or medically equals the severity of one of
the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1.” R. 19. The
ALJ determined a residual functional capacity that incorporated both exertional and
non-exertional limitations – to account for Mr. Pyron’s degenerative disc disease,
arthritis, chronic obstructive pulmonary disease, mood disorder, anxiety disorder,
and personality disorder. R. 18, 22–23. Specifically, the ALJ stated that she had
“considered all symptoms and the extent to which these symptoms can reasonably
be accepted as consistent with the objective medical evidence and other evidence.”
R. 23. The ALJ remarked that Mr. Pyron’s “treatment records and diagnostic
imaging do not indicate disabling functional limitations arising from his
impairments.” R. 23.
Additionally, the residual functional capacity accommodates Mr. Pyron’s
“degenerative disc disease, arthritis of right shoulder and right knee, as well as his
chronic obstructive pulmonary disease.” R. 24–25. As for Mr. Pyron’s mental
impairments, the ALJ stated that “he does have some mental limitations as defined
in the residual functional capacity herein.” R. 25. The ALJ also noted that she
“limited [Mr. Pyron] to accommodate his impairments, both severe and non-severe.”
R. 26. The ALJ properly considered the combination of impairments and determined
Mr. Pyron’s residual functional capacity accordingly.
V. Conclusion
Upon review of the administrative record, the court finds the Commissioner’s
decision is supported by substantial evidence and in accord with the applicable law.
A separate order will be entered.
DONE and ORDERED this 20th day of September, 2023.
ANNA M. hans.
UNITED STATES DISTRICT JUDGE
16