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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT ________________________
No. 18-14611 Non-Argument Calendar ________________________
D.C. Docket No. 4:17-cv-00378-AKK
KIMBERLY YVETTE NANCE,
Plaintiff-Appellant,
versus
SOCIAL SECURITY ADMINISTRATION, COMMISSIONER, Andrew Saul, Commissioner,
Defendant-Appellee.
________________________
Appeal from the United States District Court for the Northern District of Alabama ________________________
(July 18, 2019)
Before WILLIAM PRYOR, BRANCH, and GRANT, Circuit Judges.
PER CURIAM: Case: 18-14611 Date Filed: 07/18/2019 Page: 2 of 19
Kimberly Yvette Nance appeals the district court’s order affirming the
denial of her claim for Social Security disability benefits. She argues that the
Administrative Law Judge erred by giving little weight to the opinions of her
treating physician. Because we conclude that substantial evidence supported the
decision of the ALJ, we affirm.
I. BACKGROUND
A. Procedural Background
In October 2013, when she was 41 years old, Nance applied for disability
insurance benefits for a period of disability beginning on September 17, 2013. Her
disability claim was based on a failed lumbar disc repair, osteoarthritis,
fibromyalgia, and depression. Before September 2013, Nance worked as a certified
nursing assistant. After a hearing, an ALJ denied Nance’s application on August
18, 2015. The Appeals Council denied her request for review on January 9, 2017,
making the ALJ’s decision the final decision of the Social Security Commissioner.
Nance then sought review of the Commissioner’s decision in the district court. The
district court affirmed the Commissioner’s decision, finding that the ALJ’s
decision was supported by substantial evidence.
B. The Evidence Before the ALJ
Nance completed a function report in which she described her daily
activities. She explained that she generally ate cereal, sandwiches, and fast food
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that someone bought her, and she may cook one meal a month. She stated that she
can drive and ride in a car but that she prefers for someone else to drive because of
her pain. According to the report, she goes to the doctor once a week, shops once a
month for 30 minutes, shops once every other week for 10 to 15 minutes, and visits
her father. She does one load of laundry a day though it takes her all day because
she takes breaks to rest.
On September 17, 2013, Nance saw Dr. Ronnie Lewis at Rapid Care Family
Medical Clinic for anxiety and depression. Dr. Lewis diagnosed situational
depression, myalgia, myositis, and chronic back pain. Dr. Lewis referred Nance to
Rheumatology Associates of North Alabama for fibromyalgia, where she was seen
by Dr. Christie Thomas. Dr. Thomas did not diagnose fibromyalgia and was
“unable to elucidate any type of rheumatologic condition at this time,” but noted
that she would follow-up closely on Nance’s labs. On September 18, 2013, Dr.
Grant Huntzinger performed an MRI of Nance’s lumbar spine. He noted that
Nance had mild lower lumbar spondylosis, most severe at the L4–L5 level, as well
as moderate L4–L5 and severe L5–S1 level facet arthropathy.
On October 10, 2013, Nance saw Dr. Anthony Sims at Henagar Family
Medicine. Nance reported moderate, aching, generalized pain. Associated
symptoms included “chronic myofascial pain, but not depression, joint pain
(multiple sites), leg cramps, morning stiffness in joints, muscle spasms, or
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numbness in arm.” Dr. Sims’s examination showed no clubbing, cyanosis, or
edema, and normal range of motion and strength. Dr. Sims diagnosed low back
pain, fibromyalgia, and hypothyroidism. Dr. Sims recommended that Nance
engage in “[r]egular, low-impact exercises three times a week,” such as “walking,
swimming, water aerobics, & biking.”
Nance then saw Dr. Anjaneyulu Alapati of HH Neurological Associates on
November 5, 2013, complaining of left side facial numbness. Upon examination,
Nance had 5/5 motor strength in all extremities, normal coordination, and normal
gait. Dr. Alapati assessed left side facial numbness for which he scheduled a brain
MRI, and fibromyalgia for which he recommended Nance continue her
medication. That same day, Nance also saw Dr. Mark G. Freeman at the
Orthopaedic Institute of Chattanooga. Dr. Freeman diagnosed osteoarthritis of the
hip and lumbar radiculopathy. Dr. Freeman noted that an x-ray of Nance’s right hip
showed mild degenerative joint space narrowing and that she had “very minimal”
osteoarthritis in her right hip. Dr. Freeman observed that Nance walked with an
antalgic gait but found that her range of motion and strength in her hips were
normal.
On November 25, 2013, Dr. Robert Estock, a state agency psychological
consultant, reviewed the record and stated that Nance had moderate restrictions in
activities of daily living, moderate difficulties in maintaining social functioning,
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and moderate difficulties in maintaining concentration, persistence, or pace. Dr.
Estock also stated: “[Nance] can fix light meals and does laundry. She can drive,
shop and pay bills. She is credible but she does not have listing level functional
limitations.”
On December 6, 2013, Nance saw Noel N. Lawson, FNP, for follow-up after
a therapeutic lumbar facet injection. Nance reported that her pain had not
decreased since the injection and described it as constant achy, sharp, and stabbing
pain in the lower lumbar spine on both sides. Nance also stated that standing,
prolonged sitting, bending, and movement made the pain worse. Lawson advised
Nance to avoid bed rest lasting four days or longer, resume normal activities,
continue with water aerobics, and remain off work until her next appointment.
Nance saw Lawson again on January 22, 2014, when Nance stated that she was
60% better than her last office visit. Lawson advised Nance to resume normal
activities and continue with conservative measures but did not discuss a work
restriction.
Nance returned to Dr. Sims on April 8, 2014, and April 29, 2014. At both
visits, Nance described her pain as aching, generalized, chronic, and moderate. Dr.
Sims noted that her range of motion and strength were normal. Dr. Sims at both
visits recommended “[r]egular, low-impact exercises three times a week” and
“[l]ow-stress exercises such as walking, swimming, water aerobics, & biking.” On
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April 29, 2014, Dr. Sims provided an Attending Physician’s Statement in which he
stated that Nance was restricted from sitting for more than one hour, standing for
more than 30 minutes, and lifting any amount of weight. Dr. Sims also completed a
physician’s certification dated May 18, 2014, that stated that Nance could not
engage in substantial gainful activity due to fibromyalgia but could perform
activities of daily living even though they took her longer to complete.
On May 28, 2014, Nance reported to Dr. Sims with generalized, moderate
edema. Dr. Sims recommended that Nance reduce sodium intake, avoid stressful
activities, and exercise regularly. Nance saw Dr. Sims again on October 6, 2014.
She described her back pain as moderate and said that it improved with anti-
inflammatory use but worsened with activities of daily life. On examination, Nance
had normal range of motion and strength. Dr. Sims recommended that Nance use
over-the-counter pain medications; avoid manipulation of the spine, extensive
extension or flexion of the spine, and twisting; “[e]xercise three to four times a
week, once or twice a day as tolerated for 20–40 minutes each time;” and apply
heat to the affected area as needed.
On October 13, 2014, Nance saw Dr. Franklin C. Sammons with The
Orthopaedic Center because she had increased pain in her hip and leg from a fall
on September 3, 2014. An MRI scan showed facet arthropathy that read as mild,
but that Dr. Sammons believed was moderate, with a significant amount of
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additional bone formation on the right side. Dr. Sammons recommended a lumbar
fusion surgery. The surgery was performed on November 7, 2014, by Dr.
Sammons. At a follow-up visit on January 1, 2015, Nance told Dr. Sammons that
she was still having pain (though she did not describe the level of pain) and was
having side effects from some of her medications. X-rays showed that the
hardware in her back was in a good position. Dr. Sammons changed her
medications to ameliorate the side effects and recommended physical therapy.
Nance told Dr. Sammons that she was walking about 2.5 miles a day, and Dr.
Sammons recommended that she decrease the distance to one mile a day. Nance
received physical therapy three times in January and February of 2015. The
physical therapist noted that Nance’s prognosis was “good” though she had
limitations in home management, leisure activities, and work activities.
In a letter dated March 4, 2015, Dr. Sims opined that Nance’s surgery had
been a failed lumbar intervertebral disc repair and that she could not be gainfully
employed because of her physical ailments and the mental demands of a work
environment. On March 31, 2015, Nance saw Dr. John Roberts at Tennessee
Valley Pain Consultants for dull aching pain in her lower back. Dr. Roberts
recommended physical therapy, pool therapy, daily stretches, and weight loss. An
April 6, 2015, CT scan ordered by Dr. Sammons showed that the hardware from
her surgery was in “good position.” It also showed a vertebral body hemangioma
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but noted that the spinal canal was well maintained in the area of Nance’s fusion.
No significant disc abnormality, or spinal canal or neural foraminal stenosis was
found.
C. The ALJ’s Decision
On August 18, 2015, the ALJ denied Nance’s application for social security
disability. The ALJ applied the five-step sequential evaluation for determining
whether an individual is disabled. See 20 C.F.R. § 404.1520(a). First, the ALJ
determined that Nance had not been engaged in substantial gainful activity since
September 17, 2013, when her disability was alleged to have started. Second, the
ALJ determined that Nance had the severe impairments of obesity, lumbar
degenerative disc disease, and depression. At step three, the ALJ determined that
none of Nance’s impairments, considered individually or in combination, met or
“medically equal[ed] the severity of one of the impairments included in 20 CFR
Part 404, Subpart P, Appendix 1. . . .” Fourth, the ALJ explained that:
[Nance] has the residual functional capacity to perform light work as defined in 20 C.F.R. § 404.1567(b) except [she], as a part of a job requirement, should not climb ladders, ropes, scaffolds, nor perform around work hazards. [Nance] could occasionally climb ramps or stairs, kneel or crawl; and [she] could frequently stoop or crouch. Additionally, [Nance] could understand and remember simple instructions and carry out those instructions and sustain attention to routine tasks for extended periods. [Nance] could tolerate ordinary work pressure, but should avoid quick decision-making, rapid changes and multiple demands. [Nance] would benefit from regular rest breaks and a slowed pace but can maintain a work pace consistent with the mental demands of competitive level work. Contact with the public 8 Case: 18-14611 Date Filed: 07/18/2019 Page: 9 of 19
should be no more than occasional. [Nance] can accept supportive feedback and can adapt to infrequent, well-explained changes in the work requirements or work process.
In determining Nance’s residual functional capacity, the ALJ considered the
medical records. The ALJ determined that Nance’s “statements concerning the
intensity, persistence and limiting effects of [her] symptoms are not entirely
credible” because they were “not substantiated to the degree alleged by the medical
evidence of record.” The ALJ explained that although Nance had been instructed to
participate in physical therapy regularly, she had failed to do so. The ALJ also
explained that Nance’s “back condition appears to wax and wane, and [she] has
experienced significant improvement with some relatively conservative treatment.”
Further, the ALJ explained that Nance had self-reported her pain as “dull” and that
her “aching” back pain improved with anti-inflammatory use.
The ALJ next turned to the medical opinion evidence. As relevant to
Nance’s appeal, the ALJ decided to give little weight to the opinions expressed in
Dr. Sims’s March 4, 2015, letter for the following reasons. First, the question of
whether a person is disabled is a matter for the Commissioner to decide. The ALJ
also noted that Dr. Sims was a general practitioner and not a specialist, meaning
his opinion was less probative than others. Furthermore, Dr. Sims’s opinions were
inconsistent with his treatment records because there were no post-surgery
treatment records and the pre-surgery records described Nance’s back pain as
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moderate and aching. The ALJ also gave little weight to Dr. Sims’s April 2014
Attending Physician’s Statement regarding Nance’s physical limitations because it
was inconsistent with Nance’s own statement regarding her activities of daily
living. The ALJ gave little weight to Dr. Sims’s opinion expressed in a May 2014
physician’s certification that Nance was unable to engage in any substantial gainful
activity because Dr. Sims’s opinion again concerned an issue reserved to the
Commissioner and was unsupported by his statement that she took longer to
perform activities of daily living.
At the fifth and final step, the ALJ determined that Nance could not perform
her past work as a certified nursing assistant but that, based on the testimony of a
vocational expert, there are jobs that exist in sufficient numbers in the national
economy that she could perform, including laundry worker and marker. The ALJ
also explained that if Nance’s residual functional capacity were reduced to
sedentary level work, there would still be jobs that exist in sufficient numbers that
she could perform, including machine operator feeder or surveillance system
monitor. Accordingly, the ALJ determined Nance was not disabled for the period
between September 17, 2013 through August 18, 2015.
The Appeals Council denied Nance’s request for review on January 9, 2017,
making the ALJ’s decision the final decision of the Commissioner.
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D. The District Court’s Decision
Nance filed a complaint in the district court under 42 U.S.C. § 405(g), seeking
review of the Commissioner’s final decision on March 10, 2017. The district court
determined the ALJ had not erred by finding that Nance’s testimony about her pain
was not credible, that the ALJ had not erred in giving little weight to Dr. Sims’s
opinions, and that the ALJ’s residual functional capacity determination and
conclusion that Nance could perform other work in the national economy were
supported by substantial evidence. The district court thus affirmed the
Commissioner’s final decision on August 31, 2018. Nance filed her notice of
appeal on October 31, 2018—one day after the deadline for filing such notice
pursuant to Rule 4(a)(1)(B)(iii) of the Federal Rules of Appellate Procedure.1
However, the district court allowed Nance to file out of time pursuant to Rule
4(a)(5)(A) of the Federal Rules of Appellate Procedure. 2 Her appeal is thus timely.
II. STANDARD OF REVIEW
1 “The notice of appeal may be filed by any party within 60 days after entry of the judgment or order appealed from if one of the parties is: . . . a United States officer or employee sued in an official capacity.” Fed. R. App. P. 4(a)(1)(B)(iii). 2 “The district court may extend the time to file a notice of appeal if: (i) a party so moves no later than 30 days after the time prescribed by this Rule 4(a) expires; and (ii) regardless of whether its motion is filed before or during the 30 days after the time prescribed by this Rule 4(a) expires, that party shows excusable neglect or good cause.” Fed. R. App. P. 4(a)(5)(A). 11 Case: 18-14611 Date Filed: 07/18/2019 Page: 12 of 19
“In Social Security appeals, we review de novo the legal principles on which
the Commissioner’s decision is based,” but “we review the resulting decision only
to determine if it is supported by substantial evidence.” Moore v. Barnhart, 405
F.3d 1208, 1211 (11th Cir. 2005). This Court defines substantial evidence as “less
than a preponderance, but rather such relevant evidence as a reasonable person
would accept as adequate to support a conclusion.” Id. We will not decide the facts
anew, make credibility determinations, or reweigh the evidence. Winschel
v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). “We review de novo
the district court’s decision on whether substantial evidence supports the ALJ’s
decision.” Wilson v. Barnhart, 284 F.3d 1219, 1221 (11th Cir. 2002).
III. DISCUSSION
A. Applicable Statutory and Regulatory Framework.
“An individual claiming Social Security disability benefits must prove that
she is disabled.” Moore, 405 F.3d at 1211. To determine whether a claimant is
disabled, the ALJ uses the five-step, sequential evaluation process outlined by the
Social Security Regulations. Winschel, 631 F.3d at 1178. That process requires the
ALJ to determine whether the claimant: (1) is unable to engage in substantial
gainful activity; (2) has a severe and medically-determinable impairment or
combination of impairments; (3) has an impairment, or combination thereof, that
meets or equals one of the listed impairments included in 20 C.F.R. Part 404,
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Subpart P, Appendix 1, and meets the duration requirement; (4) can perform past
relevant work, in light of his residual functional capacity; and (5) can make an
adjustment to other work, in light of her residual functional capacity, age,
education, and work experience. Id. (citing 20 C.F.R. §§ 404.1520(a)(4)(i)–(v),
416.920(a)(4)(i)–(v)). If an ALJ finds a claimant disabled or not disabled at any
given step, the ALJ does not proceed to the next step. 20 C.F.R. § 404.1520(a)(4).
As Nance’s appeal concerns the determination of her residual functional
capacity in step four of the analysis, we outline the step four requirements in
greater detail. At step four, the ALJ must determine a claimant’s residual
functional capacity “based on all the relevant medical and other evidence.” Phillips
v. Barnhart, 357 F.3d 1232, 1238 (11th Cir. 2004) (quoting 20 C.F.R.
§ 404.1520(e)). “Moreover, the ALJ must state with particularity the weight given
to different medical opinions and the reasons therefor.” Winschel, 631 F.3d at
1179. An ALJ considers many factors when weighing medical opinion evidence,
including the examining relationship, the treatment relationship, whether an
opinion is well-supported, whether an opinion is consistent with the record as a
whole, and whether the source is a specialist. 20 C.F.R. § 404.1527(c). The ALJ
must give a treating physician’s medical opinion substantial or considerable weight
unless the ALJ clearly articulates good cause for discrediting that opinion.
Winschel, 631 F.3d at 1179. “Good cause exists ‘when the: (1) treating physician’s
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opinion was not bolstered by the evidence; (2) evidence supported a contrary
finding; or (3) treating physician’s opinion was conclusory or inconsistent with the
doctor’s own medical records.’” Id. (quoting Phillips, 357 F.3d at 1241). Opinions
by a medical source that a claimant is disabled are not given any special weight—
regardless of the source—because that issue is reserved for the Commissioner’s
determination. 20 C.F.R. § 404.1527(d)(1)–(3).
B. Whether the ALJ Erred by Giving Little Weight to Dr. Sims’s Opinions.
Nance argues that the ALJ failed to properly weigh the opinions of her
treating physician, Dr. Anthony Sims. In particular, there are three statements from
Dr. Sims that Nance argues should have been given greater weight: (1) an April 29,
2014, Attending Physician’s Statement; (2) a physician’s certification dated May
19, 2014; and (3) an opinion letter dated March 4, 2015. For the reasons that
follow, substantial evidence supports the ALJ’s decision to discount each of Dr.
Sims’s opinions.
As a general matter, the ALJ properly granted little weight to Dr. Sims’s
opinions that Nance is disabled and cannot perform her occupational duties
because those are legal determinations reserved for the Commissioner. See 20
C.F.R. § 404.1527(d). Thus, the ALJ did not err by giving them little weight. See
20 C.F.R. § 404.1527(d)(3) (“We will not give any special significance to the
source of an opinion on issues reserved to the Commissioner. . . .”). 14 Case: 18-14611 Date Filed: 07/18/2019 Page: 15 of 19
With respect to Dr. Sims’s April 29, 2014, opinion that Nance is restricted
from performing any of her past occupational duties, including walking, lifting,
bending, moving, or sitting, and that she cannot sit for more than one hour or stand
for more than thirty minutes, the ALJ gave Dr. Sims’s opinion little weight because
it was inconsistent with Nance’s admitted activities of daily living. Although the
ALJ did not expressly state which of Nance’s admitted daily activities are
inconsistent with the Dr. Sims’s opinion, the ALJ cited Nance’s functional report,
which stated that she engaged in activities such as driving, shopping, doing
laundry, and cooking—all of which would involve some sitting, standing, walking,
and lifting. The ALJ thus had sufficient reason for discounting Dr. Sims’s opinion
as inconsistent. See Phillips, 357 F.3d at 1241 (discounting a physician’s opinion
because it conflicted with treatment notes and the claimant’s own testimony
regarding her daily activities). Further, although not discussed by the ALJ, it is
clear from the record that the Dr. Sims’s opinion is contradicted by his own
treatment notes, which state that Nance had normal range of motion, strength, and
gait, and recommended regular exercise. Substantial evidence supports the ALJ’s
decision to discount Dr. Sims’s April 2014 Attending Physician’s Statement.
Substantial evidence also supports the ALJ’s decision to discount Dr. Sims’s
May 19, 2014, opinion that Nance cannot engage in any substantial gainful activity
due to her fibromyalgia. In the same document, Dr. Sims’s stated that Nance can
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perform activities of daily living (though it takes her longer than a well person) and
that her pain worsened with activity and stress. The ALJ gave little weight to Dr.
Sims’s opinion for two reasons: (1) because it concerns a matter reserved to the
Commissioner, 20 C.F.R. § 404.1527(d); and (2) because taking longer to perform
activities of daily living and having some pain with activity and stress is not
inherently disabling. The ALJ was entitled to determine whether Dr. Sims’s
opinion was internally inconsistent, Winschel, 631 F.3d at 1179, and it found that it
was unsupported by relevant evidence, 20 C.F.R. § 416.927(c)(3). As further
support, it is clear from the record that Dr. Sims’s May 2014 opinion that Nance
cannot engage in substantial activity is inconsistent with his treatment notes
concerning Nance’s range of motion, strength, and gait, and recommending
exercise. For those reasons, substantial evidence supports the ALJ’s decision.
Finally, substantial evidence supports the ALJ’s decision to discount Dr.
Sims’s March 4, 2015, letter stating that Nance’s back surgery “is considered a
failed lumbar intervertebral disc repair.” The ALJ gave this opinion little weight
because Dr. Sims is a general practitioner—not a specialist. Whether a physician is
a specialist in the area in which he is giving an opinion is a relevant consideration.
20 C.F.R. § 404.1527(c)(5). It was thus appropriate for the ALJ to give more
weight to the opinion of Dr. Sammons—an orthopedic surgery specialist—who
found that the hardware from Nance’s back surgery was in good position and
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determined that she had no significant disc abnormalities. The ALJ also explained
that Dr. Sims’s opinion was inconsistent with his own treatment records. See
Edwards v. Sullivan, 937 F.2d 580, 583–84 (11th Cir. 1991) (discounting treating
physician’s opinion because it conflicted with treatment records). In particular, the
ALJ noted that there were no post-surgery treatment notes from Dr. Sims in the
record,3 but that his notes prior to surgery reflected that Nance described her back
pain as aching and moderate and as improving with anti-inflammatory use. Finally,
as the ALJ explained, the objective medical records do not support Dr. Sims’s
opinion. See, e.g., Edwards, 937 F.2d at 583 (“The treating physician’s report may
be discounted when it is not accompanied by objective medical evidence. . . .”).
Nance’s post-surgery MRI and x-ray results showed that the hardware was in good
position and that Nance had no significant disc abnormalities. Nance’s physical
therapy notes also suggest that her post-surgery prognosis was good.
Although Nance disagrees with the ALJ’s weighing of the evidence, our task
is to determine only whether the ALJ applied the proper legal standards and arrived
at a decision that is supported by substantial evidence. Crawford v. Comm’r of Soc.
Sec., 363 F.3d 1155, 1158 (11th Cir. 2004) (“We review the Commissioner’s
3 Nance submitted to the Appeals Council treatment notes from examinations conducted by Dr. Sims in February and April of 2015. Those notes, however, reflect that Nance’s pain improved with anti-inflammatory use and that Dr. Sims recommended Nance engage in “[r]egular, low-impact exercises three times a week,” including “walking, swimming, water aerobics, & biking.” Thus, as the district court concluded, those notes do not undermine the ALJ’s decision to give little weight to Dr. Sims’s opinion. 17 Case: 18-14611 Date Filed: 07/18/2019 Page: 18 of 19
decision to determine if it is supported by substantial evidence and based on proper
legal standards”) (quoting Lewis v. Callahan, 125 F.3d 1436, 1439 (11th Cir.
1997)). We may not decide facts anew or reweigh the evidence. Winschel, 631
F.3d at 1178. In sum, we conclude that the ALJ’s decision to discount Dr. Sims’s
opinions was supported by substantial evidence.4
C. Whether this Court Should Reverse Because the District Court Engaged in Post Hoc Rationalization.
Nance suggests that we reverse because the district court gave “a long, four
and a half page post hoc rationalization for affirming the ALJ.” Although we
disagree that the district court’s entire discussion of Dr. Sims’s opinions was a post
hoc rationalization, the district court may have ventured beyond the ALJ’s decision
in one respect. It appears the district court determined that all of Dr. Sims’s
opinions were contrary to his treatment notes. In contrast, the ALJ found the March
2015, opinion contrary to the treatment notes but did not discuss that factor with
respect to the other opinions. Agency actions, however, must be upheld on the
4 Nance argues that the ALJ erred in discounting Dr. Sims’s opinions while giving great weight to the opinion of Dr. Estock (a non-examining psychiatrist) that Nance had moderate limitations in her activities of daily living, moderate difficulties in social functioning and in maintaining concentration, persistence, or pace. We acknowledge that “[t]he opinions of nonexamining, reviewing physicians, . . . when contrary to those of examining physicians are entitled to little weight in a disability case, and standing alone do not constitute substantial evidence.” Lamb v. Bowen, 847 F.2d 698, 703 (11th Cir. 1988) (quoting Sharfarz v. Bowen, 825 F.2d 278, 280 (11th Cir. 1987)). But these opinions are not contrary to those of Dr. Sims who did not opine on Nance’s social functioning or on her ability to maintain concentration, persistence, or pace. Further, the only opinion Dr. Sims gave on Nance’s activities of daily living was that she could perform those activities even though they took her longer to complete, which is consistent with Dr. Estock’s finding of moderate limitations. 18 Case: 18-14611 Date Filed: 07/18/2019 Page: 19 of 19
same bases articulated in the agency’s order. See FPC v. Texaco, Inc., 417 U.S.
380, 397 (1974); see also Newton v. Apfel, 209 F.3d 448, 455 (5th Cir. 2000) (“The
ALJ’s decision must stand or fall with the reasons set forth in the ALJ’s
decision.”); Owens v. Heckler, 748 F.2d 1511, 1516 (11th Cir. 1984) (explaining
that this Court will not “affirm simply because some rationale might have
supported the ALJ’s conclusion.”). The discrepancy between the district court and
the ALJ’s decision is nevertheless irrelevant because our review is limited to the
agency’s decision. See Wilson, 284 F.3d at 1221 (“We review de novo the district
court’s decision on whether substantial evidence supports the ALJ’s decision.”);
Owens, 748 F.2d at 1514 (“As we have indicated many times, the scope of our
review is limited to determining whether there is substantial evidence in the record
as a whole to support the Secretary’s findings.”).
Because substantial evidence supports the ALJ’s decision, we affirm.
AFFIRMED.