Ignacio Ybarra v. Commissioner of Social Security
658 F. App'x 538
| 11th Cir. | 2016Background
- Ignacio Ybarra applied for Title II and XVI benefits, claiming disability due to back pain, right-shoulder problems, hypertension, and depression; his claims were denied and an ALJ held a hearing.
- The ALJ found Ybarra’s impairments severe at step two but not meeting or equaling a listing at step three, assessed an RFC for unskilled medium work with limitations, and concluded he could not do past relevant work but could perform other jobs (e.g., kitchen helper) per a vocational expert.
- The Appeals Council denied review and the district court affirmed; Ybarra appealed to the Eleventh Circuit.
- Ybarra challenged: (1) the ALJ’s adverse credibility finding; (2) the discounting of treating physician Dr. Hassan’s opinion; (3) the RFC and the hypothetical to the VE; (4) failure to order a consultative exam; and (5) alleged impermissible medical fact‑finding by the ALJ.
- The Eleventh Circuit reviewed de novo legal issues and for substantial evidence the ALJ’s factual findings, and affirmed—concluding the ALJ’s credibility, weighting of medical opinions, RFC, and step‑five findings were supported by substantial evidence and the record was sufficient without a consultative exam.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Credibility of claimant | Ybarra: ALJ improperly discounted his testimony about pain, work stoppage, and treatment effects | Commissioner: ALJ cited inconsistencies between testimony and medical/employment records supporting adverse credibility | Held: ALJ’s credibility finding supported by substantial evidence despite one improper inference about deferring injections without considering affordability |
| Weight given to treating physician (Dr. Hassan) | Ybarra: ALJ erred in discounting treating physician’s opinion without good cause | Commissioner: ALJ cited inconsistencies between Dr. Hassan’s opinion, his own treatment notes, and other record evidence | Held: Discounting was supported by substantial evidence due to inconsistencies and other evidence |
| RFC and hypothetical to VE | Ybarra: RFC failed to incorporate step‑two/step‑three findings (shoulder and moderate mental limits); VE hypothetical thus defective | Commissioner: RFC limited to medium work with specific mental and social restrictions mirroring medical opinions (including Dr. Rowley); hypothetical matched RFC | Held: RFC and VE hypothetical adequately accounted for limitations and were supported by substantial evidence |
| Duty to develop record / consultative exam | Ybarra: ALJ should have ordered a consultative exam to better evaluate impairments | Commissioner: Record contained sufficient evidence; consultative exam not required | Held: No duty to order exam because substantial evidence in record supported ALJ’s findings |
Key Cases Cited
- Wilson v. Barnhart, 284 F.3d 1219 (11th Cir. 2002) (standard for reviewing ALJ factual findings and VE hypotheticals)
- Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176 (11th Cir. 2011) (ALJ must include claimant’s limitations in hypothetical to VE)
- Moore v. Barnhart, 405 F.3d 1208 (11th Cir. 2005) (credibility determinations are for the ALJ; scope of review)
- Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155 (11th Cir. 2004) (treating physician may be discounted for inconsistency with record)
- Dyer v. Barnhart, 395 F.3d 1206 (11th Cir. 2005) (substantial-evidence review prohibits reweighing evidence)
- Phillips v. Barnhart, 357 F.3d 1232 (11th Cir. 2004) (treating physician may be discounted when inconsistent with treatment notes and record)
- Bloodsworth v. Heckler, 703 F.2d 1233 (11th Cir. 1983) (definition of substantial evidence)
- Henry v. Comm’r of Soc. Sec., 802 F.3d 1264 (11th Cir. 2015) (ALJ must consider whether claimant’s failure to obtain treatment was due to lack of funds)
- Wolfe v. Chater, 86 F.3d 1072 (11th Cir. 1996) (Commissioner bears burden at step five to prove jobs exist)
- Marbury v. Sullivan, 957 F.2d 837 (11th Cir. 1992) (ALJ may not play physician but must resolve conflicting medical opinions)
- Watson v. Heckler, 738 F.2d 1169 (11th Cir. 1984) (ALJ’s responsibility to weigh medical evidence)