CONROY

v.

COMMISSIONER OF SOCIAL SECURITY

The Plaintiff seeks judicial review of the Commissioner’s denial of his claims for Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI) payments. For the reasons discussed below, the Commissioner’s decision is affirmed.

I.

The Plaintiff was born in 1981, is high school educated, and has no past relevant work experience. (R. 28, 39, 228). In December 2014 and January 2015, the Plaintiff applied for DIB and SSI, respectively, alleging disability as of January 5, 2014,

In a decision dated July 26, 2017, the ALJ found that the Plaintiff: (1) had not engaged in substantial gainful activity since his alleged onset date of January 5, 2014; (2) had the severe impairments of paranoid schizophrenia, post-traumatic stress disorder (PTSD), and schizoaffective disorder bipolar type; (3) did not, however, have an impairment or combination of impairments that met or medically equaled the severity of any of the listed impairments; (4) had the residual functional capacity (RFC) to perform a full range of work at all exertional levels, subject to certain nonexertional limitations; and (5) based on the VE’s testimony, was capable of making a successful adjustment to work that exists in significant numbers in the national economy. (R. 16-35). In light of these findings, the ALJ concluded that the Plaintiff was not disabled. (R. 30). The Appeals Council denied the Plaintiff’s request for review. (R. 1-6). Accordingly, the ALJ’s decision became the final decision of the Commissioner. II. The Social Security Act (the Act) defines disability as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment . . . 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); 20 C.F.R. §§ 404.1505(a), 416.905(a).² A physical or mental impairment under the Act “results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques.” 42 U.S.C. §§ 423(d)(3), 1382c(a)(3)(D). To determine whether a claimant is disabled, the Social Security Regulations (Regulations) prescribe “a five-step, sequential evaluation process.” Carter v. Comm’r of Soc. Sec., 726 F. App’x 737, 739 (11th Cir. 2018) (citing 20 C.F.R. § 404.1520(a)(4)); 20 C.F.R. § 416.920(a)(4).3 Under this process, an ALJ must determine whether the claimant: (1) is performing substantial gainful activity; (2) has a severe impairment; (3) has a severe impairment that meets or equals an impairment specifically listed in 20 C.F.R. Part 404, Subpart P, Appendix¹; (4) has the RFC to engage in past relevant work; and (5) can perform other work in the national economy given his RFC, age, education, and work experience. Id. (citing Phillips v. Barnhart, 357 F. 3d 1232, 1237 (11th Cir. 2004); 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4)). While the claimant has

245 F. 3d 1274, 1280 (11th Cir. 2001)). A claimant who does not prevail at the administrative level may seek judicial review in federal court provided that the Commissioner has issued a final decision on the matter after a hearing. 42 U.S.C. § 405(g). Judicial review is limited to determining whether the Commissioner’s decision is supported by substantial evidence and whether he applied the correct legal standards. Id.; Hargress v. Soc. Sec. Admin., Comm’r, 883 F. 3d 1302, 1305 n.2 (11th Cir. 2018) (citation omitted). “Substantial evidence is more than a scintilla and is such relevant evidence as a reasonable person would accept as adequate to support a conclusion.” Hargress, 883

F. 3d at 1305 n.2 (quoting Crawford v. Comm’r of Soc. Sec., 363 F. 3d 1155, 1158 (11th Cir. 2004)). In evaluating whether substantial evidence supports the Commissioner’s decision, the Court “may not decide the facts anew, make credibility determinations, or re-weigh the evidence.” Carter, 726 F. App’x at 739 (citing Moore v. Barnhart, 405 F. 3d 1208, 1211 (11th Cir. 2005)). While the court accords deference to the Commissioner’s factual findings, “no such deference is given to [his] legal conclusions.” Keel-Desensi v. Berryhill, 2019 WL 1417326, at *2 (M.D. Fla. Mar. 29, 2019) (citations omitted).

III.

The Plaintiff raises two challenges on appeal: (1) the ALJ failed to appropriately evaluate certain opinion evidence; and (2) the ALJ neglected to account for all of the Plaintiff’s limitations in his RFC determination. (Doc. 22 at 13-22, 33-36). The Commissioner counters that the ALJ supplied sufficient reasons for discounting the medical source opinions at issue, and that the ALJ’s RFC determination is supported by substantial evidence. Id. at 22-33, 36-38. After careful consideration of the record and the parties’ submissions, the Court finds no basis for reversal or remand.

A. Evaluation of Opinion Evidence

In support of his first claim of error, the Plaintiff contends that the ALJ improperly discounted the opinions of a Nurse Practitioner (NP), Don Davis, who treated the Plaintiff, as well as the medical source statement of Dr. Jamie H. Barron, a one-time examining psychologist. Id. at 13-22. Neither contention has merit. The Regulations governing an ALJ’s evaluation of opinion evidence offered by medical sources draw a distinction between “acceptable medical sources” and “other medical sources.” Social Security Ruling (SSR) 06-03p, 2006 WL 2329939, at *1-4 (S.S.A. Aug. 9, 2006) (explaining how the SSA assesses opinions from different types of evidentiary sources);⁴ 20 C.F.R. §§ 404.1513, 416.913. Acceptable medical sources include licensed physicians and licensed or certified psychologists, while “other sources” include physicians’ assistants and nurse practitioners. Id. at §§ 404.1513, 416.913. Under the Regulations, “only evidence from ‘acceptable medical sources’ can establish the existence of a medically determinable impairment, and only ‘acceptable medical sources’ can give medical opinions or be considered treating sources,5 whose medical opinions may be entitled to controlling weight.” Anteau v. Comm’r of Soc. Sec., 708 F. App’x 611, 613 (11th Cir. 2017) (per curiam) (citing SSR 06-03p, 2006 WL 2329939, at *2); see also Graham v. Berryhill, 2018 WL 4520342, at *4 (M.D. Fla. Sept. 21, 2018) (citing SSR 06-03p). When an opinion is offered by an “acceptable medical source,” an ALJ “must state with particularity” the weight accorded that opinion and the reasons therefor. Winschel v. Comm’r of Soc. Sec., 631 F. 3d 1176, 1178-79 (11th Cir. 2011) (citation omitted). In rendering this determination, the Regulations require that the ALJ consider the following five factors: (1) whether the doctor has examined the claimant;

(2) the length, nature, and extent of the doctor’s relationship with the claimant; (3) the

“acceptable medical source,” he nevertheless “fully considered” his opinions in determining the severity of the Plaintiff’s impairments and their effects on the Plaintiff’s functional abilities. (R. 27-28). The ALJ also highlighted that the Plaintiff was able to engage in certain activities of daily living despite his mental impairments and that his mental health status largely appeared intact on examination in January 2017, which undermined the functional restrictions NP Davis offered. (R. 28). Together, these statements satisfy the Court that the ALJ met his duty to consider NP

Davis’s opinions with the record as a whole and to generally explain his decision to discount them. Contrary to the Plaintiff’s contention (Doc. 17 at 17-18), the ALJ was under no obligation to deem NP Davis a “treating source” whose opinions may be entitled to controlling weight under the Regulations. As explained above, nurse practitioners cannot be considered “treating sources” because they are not “acceptable medical sources.” 20 C.F.R. §§ 404.1527(a), 416.927(a); Medina v. Soc. Sec. Admin., 636 F. App’x 490, 493 (11th Cir. 2016) (citations omitted). The ALJ’s evaluation of Dr. Barron’s medical source statement likewise accords with the applicable regulations and is supported by substantial evidence. Dr. Barron opined that, with respect to the Plaintiff’s adaptation abilities (which appears to be the focus of the Plaintiff’s challenge here),⁶ the Plaintiff had “marked” restrictions in his ability to “respond appropriately to usual work situations and changes in a

B.

RFC Determination

The Plaintiff’s second claim of error is directed at the sufficiency of the ALJ’s RFC determination. Specifically, the Plaintiff contends the ALJ erred by not including limitations related to the Plaintiff’s frequent visual hallucinations, despite the fact that the ALJ characterized the mental impairments giving rise to those hallucinations as severe. (Doc. 22 at 33-36). This argument also does not survive scrutiny.

As alluded to above, an RFC reflects the most a claimant can do despite his limitations and is used at steps four and five to determine whether the claimant is able to perform any past relevant work or adjust to other work. Lacina v. Comm’r, Soc. Sec. Admin., 606 F. App’x 520, 526 (11th Cir. 2015). Because a claimant bears the burden of proof through step four, it falls upon him to show that the ALJ’s RFC determination is deficient. Schmidt v. Comm’r of Soc. Sec., 2018 WL 3805863, at *1 (M.D. Fla. Aug. 10, 2018) (citing Hines-Sharp v. Comm’r of Soc. Sec., 511 F. App’x 913, 915 n.2 (11th Cir. 2013)). In an effort to meet his burden here, the Plaintiff recites his testimony and subjective reports regarding visual hallucinations and submits that the ALJ “acknowledged, without dispute,” certain aspects of this testimony in his decision. (Doc. 22 at 34-35). As the Commissioner points out, however, the ALJ’s acknowledgement of particular evidence does not indicate he credited it. Indeed, the ALJ’s finding that the Plaintiff’s “statements concerning the intensity, persistence[,] and limiting effects of [his] symptoms are not entirely consistent with the medical evidence and other evidence in the record” belies such an assertion. (R. 26).

Nor can the Plaintiff validly argue that the ALJ’s finding discrediting the Plaintiff’s subjective reports is unsupported by the record. While the Plaintiff testified before the ALJ that his medications did not alleviate his frequent hallucinations (R. 40), NP Davis’s report from one month earlier stated that the Plaintiff suffered from no hallucinations or perceptual disturbances while on medications (R. 450). In addition, the progress notes from the facility where the Plaintiff received treatment between January 2015 and August 2016, Baycare Behavioral Health, contained only varying reports of hallucinations. (R. 370-92). The mere fact that the ALJ found the Plaintiff’s paranoid schizophrenia and schizoaffective disorder bipolar type to be severe does not alter the Court’s conclusion. It is well settled that “[s]evere impairments do not necessarily result in specific functional limitations.” Owens v. Colvin, 2015 WL 12856780, at *1 (M.D. Fla. Oct. 15, 2015) (citing Castel v. Comm’r of Soc. Sec., 355 F. App’x 260, 264 (11th Cir. 2019) and

Davis-Grimplin v. Comm’r, Soc. Sec. Admin., 556 F. App’x 858, 863 (11th Cir. 2014)). Accordingly, where, as here, there are “no specific functional limitations from a severe impairment . . . the ALJ need not include a corresponding limitation for that impairment in the RFC.” Id. (citing Castel, 355 F. App’x at 263-64). In sum, the Court discerns no error in the ALJ’s decision not to include limitations in the RFC stemming from the Plaintiff’s alleged visual hallucinations. Millionder v. Colvin, 2014 WL 4792602, at *13 (N.D. Fla. Sept. 25, 2014) (citing McSwain v. Bowen, 814 F. 2d 617, 620 n.1 (11th Cir. 1987) (providing that ALJ need not include in the RFC limitations, restrictions, or opinions he has properly rejected or that lack record support)).

IV.

For the foregoing reasons, it is hereby ORDERED: 1. The Commissioner’s decision is affirmed. 2. The Clerk is directed to enter Judgment in favor of the Defendant and to close the case.

DONE and ORDERED in Tampa, Florida, this 27th day of September 2019.

[hide beca Act.

HONORABLE CHRISTOPHER P. TUITE

United States Magistrate Judge

Copies to: Counsel of record