Kalita v. Commissioner of Social Security
6:15-cv-00355
M.D. Fla.Jun 8, 2016Background
- Claimant Michael Kalita applied for DIB and SSI alleging disability from June 27, 2003; administrative proceedings produced mixed results and multiple remands, with the Appeals Council ultimately finding he was not disabled before March 18, 2009 but disabled thereafter.
- Multiple treating/examining physicians (Drs. Mixco, Matuk, Rojas, Vara, Barber, Gayles, Mignogna, Weiss) rendered opinions during the relevant period, several restricting lifting to 10 pounds or otherwise limiting function.
- The ALJ adopted an RFC (later adopted by the Appeals Council for the pre-March 18, 2009 period) allowing up to 40 pounds lifting and forbidding repetitive bending/twisting, pushing/pulling, and ladder/scaffold climbing.
- The ALJ did not discuss or weigh several medical opinions (Mixco, Matuk, Rojas, Vara, Barber); the Appeals Council likewise failed to assign weight to most of those opinions.
- Claimant argued the Appeals Council erred by failing to weigh those medical opinions, by giving little weight to Dr. Gayles, and by omitting limitations from Mignogna’s and Weiss’s opinions; he asked for reversal for benefits or remand.
- The district court reversed and remanded, holding the Appeals Council erred by failing to state with particularity the weight given to the medical opinions and that the error was not harmless because the opinions conflicted with the RFC.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Appeals Council erred by failing to weigh medical opinions from treating/examining physicians | Kalita: Appeals Council did not state weight or reasons for opinions of Drs. Mixco, Matuk, Rojas, Vara, Barber, which conflicts with Winschel requirement | Commissioner: No rigid requirement to discuss every piece of evidence; omission is harmless because it's reasonably clear what weight was given | Court: Reversed — failure to state with particularity the weight assigned violates Winschel and is not harmless because several opinions (e.g., 10-lb lifting limits) conflict with the adopted 40-lb RFC |
| Whether any error was harmless | Kalita: Errors affected RFC and were not harmless | Commissioner: Omission harmless; opinions do not directly contradict ALJ/Appeals Council findings | Court: Not harmless; direct conflicts between medical opinions and the RFC mean error could affect outcome |
| Whether remand should result in an award of benefits | Kalita: Medical-Vocational Guidelines and record support immediate award | Commissioner: Further proceedings appropriate because essential evidence not fully weighed | Court: Denied award of benefits; remand for further proceedings because record not fully considered and disability not established beyond doubt |
| Whether the Appeals Council/ALJ considered retroactive aspects of Dr. Weiss’s opinion | Kalita: Retroactive effect not addressed | Commissioner: Not explicitly argued here | Court: Noted the retroactive aspect was not considered and directed that it be addressed on remand |
Key Cases Cited
- Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176 (11th Cir. 2011) (ALJ must state with particularity the weight given to a medical opinion and reasons)
- Foote v. Chater, 67 F.3d 1553 (11th Cir. 1995) (substantial evidence standard; review must consider whole record)
- Cowart v. Schwieker, 662 F.2d 731 (5th Cir. 1981) (administrative decision must permit meaningful review of rationale)
- Phillips v. Barnhart, 357 F.3d 1232 (11th Cir. 2004) (court may not reweigh evidence on appeal)
- Richardson v. Perales, 402 U.S. 389 (1971) (substantial evidence standard in social security cases)
- Edwards v. Sullivan, 937 F.2d 580 (11th Cir. 1991) (if substantial evidence supports Commissioner, court must affirm)
- Barnes v. Sullivan, 932 F.2d 1356 (11th Cir. 1991) (same)
- Bloodsworth v. Heckler, 703 F.2d 1233 (11th Cir. 1983) (court may not substitute its judgment for the Commissioner)