RIGSBY

v.

COMMISSIONER OF SOCIAL SECURITY

Order Lisa Kimberly Rigsby, claiming disability beginning on November 5, 2013, brings this action under 42 U.S.C. §§ 405(g) and 1383(c) to review a final decision of the Commissioner of Social Security denying her applications for benefits.1 Under review is a decision by an Administrative Law Judge (“ALJ”) dated December 27, 2017. Tr. 10–19. Summaries of the law and the administrative record are in the ALJ’s decision, Tr. 10–19, and the parties’ briefs, Docs. 17, 18, and not fully repeated here. Rigsby argues the ALJ failed to properly evaluate opinions in a “Mental Residual Functional Capacity Questionnaire” completed by her treating psychologist, Natalie Stamey, Psy.D., in December 2015.2 Doc. 17 at 13–22.

1Rigsby filed an application for disability insurance benefits on May 25, 2015. Tr.

49.

The ALJ’s decision states she also filed an application for supplemental security income on November 6, 2017, Tr. 10, shortly before the hearing before the ALJ (November 28, 2017) and the ALJ’s decision (December 27, 2017).

The supplemental-security-income application does not appear to be in the record. The omission is immaterial to this decision, and neither side contends otherwise. 2Rigsby summarily states, “[The ALJ] did not make a finding regarding the opinion of [ARNP Lisa Cordell].” Doc. 17 at 17. The ALJ cited records from ARNP Cordell and stated, “Recent primary care records note various complaints but document no significant abnormal findings on examination.” Tr. 16 (citing Exhibit 16F, Tr. 754–90).

Rigsby does not elaborate and therefore waives any argument concerning ARNP Cordell. A court reviews the Commissioner’s factual findings for substantial evidence. 42 U.S.C. § 405(g).

Substantial evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).

That standard applies only to factual findings. Brown v. Sullivan, 921 F. 2d 1233, 1236 (11th Cir. 1991). “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.” Ingram v. Comm’r of Soc. Sec. Admin., 496 F. 3d 1253, 1260 (11th Cir. 2007) (quoted authority and alterations omitted).

An ALJ must evaluate every medical opinion received. 20 C.F.R. §§ 404.1527(c), 416.927(c).3 A medical opinion is a statement from an acceptable medical source that reflects judgment about the nature and severity of an impairment, including symptoms, diagnosis, prognosis, physical restrictions, mental restrictions, and what someone can do despite the impairment. 20 C.F.R. §§ 404.1527(a)(1), 416.927(a)(1).

An ALJ must state with particularity the weight she gives a medical opinion and the reasons for that weight. Winschel v. Comm’r of Soc. Sec., 631 F. 3d 1176, 1179 (11th Cir. 2011).

Factors to decide the weight include the examining relationship, the treatment relationship, supportability, consistency, and specialization. 20 C.F.R. §§ 404.1527(c), 416.927(c).

An ALJ generally will give more weight to the medical opinions of treating sources because they “are likely to be the medical professionals most able to provide a detailed, longitudinal picture of [a claimant’s] medical impairment and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations.” 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2).

But an ALJ need not give more weight to a

3For claims filed before March 27, 2017, the rules in 20 C.F.R. §§ 404.1527 and 416.927 apply. Because Rigsby filed her claims for benefits before March 27, 2017, those rules apply here. treating source’s medical opinion if there is good cause to do otherwise and substantial evidence supports the good cause. Phillips v. Barnhart, 357 F. 3d 1232, 1240 (11th Cir. 2004).

Good cause exists if the evidence does not bolster the opinion, the evidence supports a contrary finding, or the opinion is conclusory or inconsistent with the treating source’s own medical records. Id. at 1240−41. In Dr. Stamey’s “Mental Residual Functional Capacity Questionnaire,” she explained she had performed a psychological evaluation of Rigsby on April¹⁶, 2015, and Rigsby attended fourteen additional sessions between April and October 2015. Tr.

750. For a “DSM-IV Multiaxial Evaluation,” she wrote “Axis I: F44.5 Conversion D/O with Attacks or Seizures”; “Axis II: none”; “Axis III: see medical record”; “Axis IV: finances, health, housing, conflicting relationship with husband and in[-]laws”; and “Axis V: Current [Global Assessment of Functioning (‘GAF’) rating]: 45.” Tr.

750. She wrote that Rigsby’s highest GAF rating in the last year was 50. Tr.

750. She drew an arrow pointing to “husband and in[-]laws” and wrote, “primary problem.” Tr.

750. Under “Identify your patient’s signs and symptoms,” Dr. Stamey checked anhedonia or pervasive loss of interest in almost all activities; decreased energy; feelings of guilt or worthlessness; impairment in impulse control; mood disturbance; difficulty thinking or concentrating; recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress; persistent disturbances of mood or affect; persistent, nonorganic disturbance of vision, speech, hearing, use of a limb, movement and its control, or sensation; apprehensive expectation; intense and unstable interpersonal relationships and impulsive and damaging behavior; disorientation to time and place; motor tension; emotional lability; flight of ideas; deeply ingrained, maladaptive patterns of behavior; pressures of speech; easy distractibility; incoherence (adding, “with attacks only”); emotional withdrawal or isolation; autonomic hyperactivity; memory impairment—short, intermediate, or long term; and sleep disturbance. Tr. 750–51. The form directs the provider to explain the patient’s ability “to do workrelated activities on a day-to-day basis in a regular work setting” on a scale of 1 to 5. Tr.

751. A rating of 4 means the person can “perform designated task or function, but has or will have noticeable difficulty (distracted from job activity) more than 20 [percent] of the workday or workweek (i.e. more than one hour and up to two hours per day or more than one half day to one day per week).” Tr. 751 (emphasis in original). A rating of 5 means the person cannot “perform the designated task or function on a regular, reliable and sustained basis.” Tr.

751. Under “Mental Abilities and Aptitudes Needed to do Unskilled Work,” Dr. Stamey checked “5” for Rigsby’s ability to remember work-like procedures; understand and remember very short and simple instructions; carry out very short and simple instructions; maintain attention for a two-hour segment; maintain regular attendance and be punctual within customary, usually strict tolerances; sustain an ordinary routine without special supervision; work in coordination with or proximity to others without being unduly distracted; make simple work-related decisions; complete a normal workday and workweek without interruptions from psychologically based symptoms; perform at a consistent pace without an unreasonable number and length of rest periods; ask simple questions or request assistance; accept instructions and respond appropriately to criticism from supervisors; get along with co-workers or peers without unduly distracting them or exhibiting behavioral extremes; respond appropriately to changes in a routine work setting; deal with normal work stress; and be aware of normal hazards and take appropriate precautions. Tr.

752. Under “Mental Abilities and Aptitudes Needed to do Semiskilled and Skilled Work,” Dr. Stamey checked “5” for Rigsby’s ability to understand and remember detailed instructions, carry out detailed instructions, set realistic goals or make plans independently of others, and deal with the stress of semiskilled and skilled work. Tr.

752. Under “Mental Abilities and Aptitude Needed to do Particular Types of Jobs,” Dr. Stamey checked “4” for Rigsby’s ability to interact appropriately with the general public, maintain socially appropriate behavior, and adhere to basic standards of neatness and cleanliness. Tr.

752. Dr. Stamey checked “5” for Rigsby’s ability to travel in unfamiliar places and use public transportation. Tr.

752. Under “Has your patient’s impairment lasted or can it be expected to last at least twelve months,” Dr. Stamey checked, “Yes.” Tr.

753. Next to “Is your patient a malingerer,” she checked, “No.” Tr.

753. Next to, “Are your patient’s impairments reasonably consistent with the symptoms and functional limitations described in this evaluation,” she checked, “Yes.” Tr.

753. Under, “Please describe any additional reasons not covered above why your patient would have difficulty working at a regular job on a sustained basis,” she wrote, “Patient has frequent attacks/episodes that prevent functioning. See explanation below.” Tr.

753. Under, “Can your patient manage benefits in his or her own best interest,” she checked, “Yes.” Tr.

753. At the bottom of the form, Dr. Stamey handwrote: Lisa Rigsby’s biggest stressor is her husband. Stress is manifested in Lisa in terms of symptoms which appear to be neurological in nature[] but are not. They are caused by stress/husband. These episodes present suddenly [and] incapacitate her. She shakes [and] has convulsions which are severe in nature. Sometimes she has the episodes all day long, sometimes more than 10 per day. She is not able to speak during these episodes or recall what has happened. She is literally terrorized by fear of him. This fear, anxiety [and] anger all create physical symptoms in her that she has no control over. The only treatment for this disorder is reducing the stress (husband), antidepressants, and therapy (which she cannot afford).

Her prognosis is poor without these three components. She cannot work at all until these episodes go away. Tr. 753 (emphasis added).

At an administrative hearing, Rigsby’s lawyer asked her whether having been divorced from her husband for two-and-a-half years has affected her symptoms, and she responded she has experienced no improvement, with no change in the number of seizures she is having. Tr.

36. The ALJ asked the vocational expert if breaks taken

at different times and for different durations would be tolerated in the representative jobs the vocational expert identified, and the vocational expert testified no, explaining only customary breaks (15 minutes in the morning, a 30-minute lunch, and¹⁵ minutes in the afternoon) and additional 10-percent of “off-task” behavior would be tolerated. Tr.

45. The ALJ asked the vocational expert, “And absenteeism. Some days are better than others and you need to leave early, or come in late, or call off altogether once a week. Is that too much?” Tr.

45. The vocational expert responded,

“That is too much,” explaining, “Many employers allow 10 unscheduled absences per year.” Tr.

45.

In the decision, the ALJ found Rigsby has severe impairments of “pseudoseizure disorder; headaches; bipolar disorder; gastrointestinal disorders diagnosed as history of microscopic colitis, irritable bowel syndrome (‘IBS’), ulcerative colitis, and gastritis; and degenerative disc disease (‘DDD’) of the cervical spine.” Tr.

12.

The ALJ did not expressly consider Listing 12.07 concerning somatoform disorders but found Rigsby has only moderate limitations in understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; and adapting or managing oneself. Tr.

13. The ALJ

explained: The claimant is able to read, shop, cook, clean, attend to her personal needs, handle finances, take her medications, attend appointments, interact with medical personnel and her family, etc., despite her allegations of episodes and impaired memory, suggesting no more than moderate limitations of functioning in th[ese] domain[s]. Tr.

13.

The ALJ found Rigsby has the residual functional capacity (“RFC”) to perform work at all exertional levels with limitations: no climbing, exposure to hazards, or exposure to concentrated temperature extremes; only simple, routine tasks that require no exposure to the public to prevent unknown variables; and a work environment with only occasional changes. Tr.

14.

The ALJ summarized Rigsby’s allegations: Tabhdeo cmlaiinmala npta ianll eagneds ddaisilayb ivloitmy idtiuneg t ao sg awsetlrlo ains ttewsteinntayl itsos utheisr ttyh apts ceauudsoeseizures per week. She testified that she cannot work because she is not reliable given her inability to drive, daily vomiting and unpredictable pseudo-seizures as well as memory loss. She testified that none of her treating providers have given her lifting restrictions and she is able to help with household chores, prepare simple meals and frozen dinners, though she testified that she “basically lives on baby food, Jell-O, and bananas.” She lives with her mother and stepfather, moving in with them after her divorce. She no longer drives so she sold her car to pay for medical expenses. She frequents a psychiatrist and doctors’ offices for follow-up evaluations and medication refills. She takes antidepressants but is no longer able to afford therapy even though she stated that it helped her. Tr.