Lauren J. Horowitz v. Commissioner of Social Security
688 F. App'x 855
11th Cir.2017Background
- Horowitz applied for Social Security disability benefits alleging physical (fibromyalgia, chronic pain, leg injury from an abduction) and mental impairments (PTSD, mood disorder, anxiety); ALJ hearing included her testimony of severe functional limits (e.g., cane use, limited sitting/standing, mostly bedridden).
- Medical evidence included consultative exams (Dr. Daryace, Dr. Kanner) showing largely normal gait, intact strength, and ability to perform activities; rheumatologist Dr. Busch treated her briefly with conservative therapy and ordered tests; mental-health care consisted mostly of short (15-minute) medication-management visits with Dr. Sultana.
- Dr. Sultana completed a Treating Source Mental Status Report opining Horowitz could not sustain an 8-hour workday and had impaired memory/concentration but provided no objective behavioral data to support those conclusions.
- ALJ found Horowitz had severe impairments but retained RFC to sit/stand 6 hours each, lift 20/10 pounds, perform simple tasks with limited social contact; ALJ gave little weight to Dr. Sultana’s opinion and found Horowitz’s symptom testimony not fully credible.
- Appeals Council refused to consider two post-decision questionnaires from Dr. Busch because they were not chronologically relevant (issued after the ALJ decision and not shown to relate back to the ALJ period).
- District court affirmed the Commissioner; Eleventh Circuit affirmed, holding (1) ALJ gave adequate reasons supported by substantial evidence for discounting the treating psychiatrist’s opinion and Horowitz’s credibility, and (2) Appeals Council properly declined to consider Dr. Busch’s post-decision opinions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Weight given to treating psychiatrist’s opinion | Dr. Sultana’s opinion that Horowitz is unable to work should receive controlling/substantial weight | ALJ had good cause: opinions inconsistent with record, conclusory, and contradicted by objective evidence and conservative treatment | Affirmed: ALJ permissibly gave little weight; reasons supported by substantial evidence |
| Credibility of Horowitz’s symptom testimony | ALJ improperly discounted pain/fibromyalgia-related testimony because fibromyalgia often lacks objective signs | ALJ relied on lack of objective findings for specific alleged injuries, conservative treatment, and medical records showing better functioning | Affirmed: ALJ’s credibility findings supported by substantial evidence given medical record and treatment history |
| Appeals Council refusal to consider Dr. Busch’s post-ALJ questionnaires | Dr. Busch’s opinions relate back to pre-decision treatment and are chronologically relevant | Questionnaires were issued after the ALJ decision and do not indicate they rely on pre-decision records or examinations | Affirmed: Appeals Council properly declined to consider the evidence as not chronologically relevant |
| Sufficiency of ALJ’s reasons re: treating source weight | ALJ failed to state whether substantial or little weight was given to Dr. Sultana, requiring remand | Court can discern from the ALJ’s opinion that little weight was given and the reasons are explicit | Affirmed: no remand required because the ALJ’s reasons are ascertainable and supported by the record |
Key Cases Cited
- Moore v. Barnhart, 405 F.3d 1208 (11th Cir. 2005) (standard for substantial evidence review and fibromyalgia guidance)
- Phillips v. Barnhart, 357 F.3d 1232 (11th Cir. 2004) (treating-physician weight and good-cause standard)
- Lewis v. Callahan, 125 F.3d 1436 (11th Cir. 1997) (ALJ must articulate reasons for discounting treating-source opinion)
- Washington v. Soc. Sec. Admin., Comm’r, 806 F.3d 1317 (11th Cir. 2015) (Appeals Council must consider chronologically relevant new evidence that relates back to the ALJ period)
- Wolfe v. Chater, 86 F.3d 1072 (11th Cir. 1996) (conservative treatment may undermine a disability claim)
- Barnes v. Sullivan, 932 F.2d 1356 (11th Cir. 1991) (substantial evidence standard explained)
- Henry v. Comm’r of Soc. Sec., 802 F.3d 1264 (11th Cir. 2015) (ALJ must consider claimant’s reasons for lack of treatment before drawing adverse inferences)
- Ellison v. Barnhart, 355 F.3d 1272 (11th Cir. 2003) (consideration of a claimant’s ability to obtain treatment when evaluating noncompliance)
- Wiggins v. Schweiker, 679 F.2d 1387 (11th Cir. 1982) (remand required if court cannot determine weight given to treating-source evidence)