Case: 19-14070 Date Filed: 07/21/2020 Page: 1 of 7
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT ________________________
No. 19-14070 Non-Argument Calendar ________________________
D.C. Docket No. 1:18-cv-22027-RNS
MILEIDY FIGUERA,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
________________________
Appeal from the United States District Court for the Southern District of Florida ________________________
(July 21, 2020)
Before WILLIAM PRYOR, Chief Judge, WILSON and BLACK, Circuit Judges.
PER CURIAM: Case: 19-14070 Date Filed: 07/21/2020 Page: 2 of 7
Mileidy Figuera, who has bipolar disorder, appeals the district court’s order
affirming the Commissioner’s denial of her application for disability insurance
benefits (DIB) and supplemental security income (SSI) benefits. An individual
claiming DIB must prove that she is disabled. See Moore v. Barnhart, 405 F.3d
1208, 1211 (11th Cir. 2005). The Administrative Law Judge (ALJ) uses a five-
step, sequential evaluation process to determine whether a claimant is disabled.
Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). 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). At step four of the
sequential analysis, the ALJ must assess and determine a claimant’s residual
functional capacity (RFC) by considering all relevant medical and other evidence.
20 C.F.R. §§ 404.1520(e), 404.1527(e), 404.1546(c); see also Phillips v. Barnhart,
357 F.3d 1232, 1238 (11th Cir. 2004).
On appeal, Figuera argues that: (1) the ALJ did not properly assess the
opinion evidence because he did not articulate the weight accorded to notes
prepared by Dr. Hernandez and two advanced registered nurse practitioners
(ARNP) and gave no weight to a disability exception report prepared by her
treating physician, Dr. Piniella; and (2) the ALJ’s RFC determination was not
2 Case: 19-14070 Date Filed: 07/21/2020 Page: 3 of 7
based on substantial evidence of record because it did not account for mental
limitations documented by State agency consultants.1 After review, 2 we affirm.
I. OPINION EVIDENCE
As a preliminary matter, we note that Figuera has not argued on appeal that
the ALJ committed reversible error by not considering Dr. Hernandez a treating
physician and disregarding his opinion without good cause. Instead, her argument
is that the ALJ should have stated with particularity the weight he gave to the
specific statements by Dr. Hernandez and certain ARNPs regarding the debilitating
nature of her mental illness. She also challenges the ALJ’s decision to give no
weight to a disability exception report prepared by Dr. Piniella. We conclude the
district court committed no reversible error in its consideration of opinion
evidence.
1 Figuera also argues the ALJ failed to properly assess her credibility by not considering all the factors in SSR 96-7p and C.F.R. §§ 404.1257, 416.927(c). However, Figuera did not adequately raise this issue in her brief before the district court. She raised the issue only summarily, without any citations to the record or authority. See Sapuppo v. Allstate Floridian Ins. Co., 739 F.3d 678, 681 (11th Cir. 2014) (noting that a party “abandons a claim when he either makes only passing references to it or raises it in a perfunctory manner without supporting arguments and authority”). As a result, we do not address the sufficiency of the ALJ’s credibility finding. See Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1161 (11th Cir. 2004). 2 We review a Social Security case to determine whether the Commissioner’s decision is supported by substantial evidence and review de novo whether the correct legal standards were applied. See Moore, 405 F.3d at 1211. Substantial evidence is any relevant evidence, greater than a scintilla, that a reasonable person would accept as adequate to support a conclusion. Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997). If, in light of the record as a whole, substantial evidence supports the Commissioner’s decision, we will not disturb it. Id. at 1439. 3 Case: 19-14070 Date Filed: 07/21/2020 Page: 4 of 7
First, the ALJ did not err by failing to state with particularity the weight
given to the notes prepared by the ARNPs. The ALJ had no obligation to discuss
the ARNPs’ notes. While the ALJ must state with particularity the weight given to
different medical opinions and the supporting reasons, Winschel, 631 F.3d at 1179,
nurse practitioners and licensed clinical social workers are not “acceptable medical
sources” under the regulations. See 20 C.F.R. §§ 404.1513(a), 416.913(a). As
“other sources,” they cannot establish the existence of a medically determinable
impairment, produce medical opinions, or be considered treating sources. SSR 06-
3p, 71 Fed. Reg. 45,593-03 (Aug. 9, 2006).3 The ALJ “may” consider evidence
from other sources to show the severity of an individual’s impairments and how
those impairments affect the individual’s ability to function, but he is not required
to do so. Id. Thus, the ALJ’s failure to specifically state the weight he gave to the
ARNPs’ notes was not reversible error. In any case, the ALJ was not required to
discuss every piece of evidence because his decision considered Figuera’s medical
condition as a whole and did not broadly reject her claim. Dyer v. Barnhart, 395
F.3d 1206, 1211 (11th Cir. 2005).
Second, as for Dr. Hernandez’s statements indicating that Figuera’s
condition was “chronic” and “debilitating,” while the ALJ may have erred by
3 While SSR 06-3p was rescinded by 82 Fed. Reg. 15,263 (Mar. 27, 2017), both parties acknowledge that it was in effect during Figuera’s administrative proceedings and is relevant to her appeal. 4 Case: 19-14070 Date Filed: 07/21/2020 Page: 5 of 7
failing to state with particularity the weight given to Dr. Hernandez’s opinion, see
Winschel, 631 F.3d at 1179, any error was harmless, see Diorio v. Heckler, 721
F.2d 726, 728 (11th Cir. 1983) (noting that even if an ALJ commits an error, the
error is harmless if it did not affect his ultimate determination). Dr. Hernandez’s
conclusion that Figuera’s mental condition was “debilitating” goes to the
determination of disability, an administrative issue reserved for the Commissioner.
See 20 C.F.R. §§ 404.1527(d), 416.927(d). Moreover, as discussed below, the
ALJ’s RFC determination was supported by substantial evidence. See Lewis v.
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Case: 19-14070 Date Filed: 07/21/2020 Page: 1 of 7
[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT ________________________
No. 19-14070 Non-Argument Calendar ________________________
D.C. Docket No. 1:18-cv-22027-RNS
MILEIDY FIGUERA,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
________________________
Appeal from the United States District Court for the Southern District of Florida ________________________
(July 21, 2020)
Before WILLIAM PRYOR, Chief Judge, WILSON and BLACK, Circuit Judges.
PER CURIAM: Case: 19-14070 Date Filed: 07/21/2020 Page: 2 of 7
Mileidy Figuera, who has bipolar disorder, appeals the district court’s order
affirming the Commissioner’s denial of her application for disability insurance
benefits (DIB) and supplemental security income (SSI) benefits. An individual
claiming DIB must prove that she is disabled. See Moore v. Barnhart, 405 F.3d
1208, 1211 (11th Cir. 2005). The Administrative Law Judge (ALJ) uses a five-
step, sequential evaluation process to determine whether a claimant is disabled.
Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). 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). At step four of the
sequential analysis, the ALJ must assess and determine a claimant’s residual
functional capacity (RFC) by considering all relevant medical and other evidence.
20 C.F.R. §§ 404.1520(e), 404.1527(e), 404.1546(c); see also Phillips v. Barnhart,
357 F.3d 1232, 1238 (11th Cir. 2004).
On appeal, Figuera argues that: (1) the ALJ did not properly assess the
opinion evidence because he did not articulate the weight accorded to notes
prepared by Dr. Hernandez and two advanced registered nurse practitioners
(ARNP) and gave no weight to a disability exception report prepared by her
treating physician, Dr. Piniella; and (2) the ALJ’s RFC determination was not
2 Case: 19-14070 Date Filed: 07/21/2020 Page: 3 of 7
based on substantial evidence of record because it did not account for mental
limitations documented by State agency consultants.1 After review, 2 we affirm.
I. OPINION EVIDENCE
As a preliminary matter, we note that Figuera has not argued on appeal that
the ALJ committed reversible error by not considering Dr. Hernandez a treating
physician and disregarding his opinion without good cause. Instead, her argument
is that the ALJ should have stated with particularity the weight he gave to the
specific statements by Dr. Hernandez and certain ARNPs regarding the debilitating
nature of her mental illness. She also challenges the ALJ’s decision to give no
weight to a disability exception report prepared by Dr. Piniella. We conclude the
district court committed no reversible error in its consideration of opinion
evidence.
1 Figuera also argues the ALJ failed to properly assess her credibility by not considering all the factors in SSR 96-7p and C.F.R. §§ 404.1257, 416.927(c). However, Figuera did not adequately raise this issue in her brief before the district court. She raised the issue only summarily, without any citations to the record or authority. See Sapuppo v. Allstate Floridian Ins. Co., 739 F.3d 678, 681 (11th Cir. 2014) (noting that a party “abandons a claim when he either makes only passing references to it or raises it in a perfunctory manner without supporting arguments and authority”). As a result, we do not address the sufficiency of the ALJ’s credibility finding. See Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1161 (11th Cir. 2004). 2 We review a Social Security case to determine whether the Commissioner’s decision is supported by substantial evidence and review de novo whether the correct legal standards were applied. See Moore, 405 F.3d at 1211. Substantial evidence is any relevant evidence, greater than a scintilla, that a reasonable person would accept as adequate to support a conclusion. Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997). If, in light of the record as a whole, substantial evidence supports the Commissioner’s decision, we will not disturb it. Id. at 1439. 3 Case: 19-14070 Date Filed: 07/21/2020 Page: 4 of 7
First, the ALJ did not err by failing to state with particularity the weight
given to the notes prepared by the ARNPs. The ALJ had no obligation to discuss
the ARNPs’ notes. While the ALJ must state with particularity the weight given to
different medical opinions and the supporting reasons, Winschel, 631 F.3d at 1179,
nurse practitioners and licensed clinical social workers are not “acceptable medical
sources” under the regulations. See 20 C.F.R. §§ 404.1513(a), 416.913(a). As
“other sources,” they cannot establish the existence of a medically determinable
impairment, produce medical opinions, or be considered treating sources. SSR 06-
3p, 71 Fed. Reg. 45,593-03 (Aug. 9, 2006).3 The ALJ “may” consider evidence
from other sources to show the severity of an individual’s impairments and how
those impairments affect the individual’s ability to function, but he is not required
to do so. Id. Thus, the ALJ’s failure to specifically state the weight he gave to the
ARNPs’ notes was not reversible error. In any case, the ALJ was not required to
discuss every piece of evidence because his decision considered Figuera’s medical
condition as a whole and did not broadly reject her claim. Dyer v. Barnhart, 395
F.3d 1206, 1211 (11th Cir. 2005).
Second, as for Dr. Hernandez’s statements indicating that Figuera’s
condition was “chronic” and “debilitating,” while the ALJ may have erred by
3 While SSR 06-3p was rescinded by 82 Fed. Reg. 15,263 (Mar. 27, 2017), both parties acknowledge that it was in effect during Figuera’s administrative proceedings and is relevant to her appeal. 4 Case: 19-14070 Date Filed: 07/21/2020 Page: 5 of 7
failing to state with particularity the weight given to Dr. Hernandez’s opinion, see
Winschel, 631 F.3d at 1179, any error was harmless, see Diorio v. Heckler, 721
F.2d 726, 728 (11th Cir. 1983) (noting that even if an ALJ commits an error, the
error is harmless if it did not affect his ultimate determination). Dr. Hernandez’s
conclusion that Figuera’s mental condition was “debilitating” goes to the
determination of disability, an administrative issue reserved for the Commissioner.
See 20 C.F.R. §§ 404.1527(d), 416.927(d). Moreover, as discussed below, the
ALJ’s RFC determination was supported by substantial evidence. See Lewis v.
Callahan, 125 F.3d 1436, 1439 (11th Cir. 1997) (holding that this Court will not
disturb the Commissioner’s decision if supported by substantial evidence).
Lastly, the ALJ did not commit reversible error by according no weight to
the disability exception report prepared by Dr. Piniella because the ALJ articulated
specific reasons for doing so. See Moore, 405 F.3d at 1212. Specifically, the ALJ
noted that Dr. Piniella had not signed the form and that it was inconsistent with the
benign mental status evaluation Dr. Piniella conducted later. We decline to
“reweigh the evidence, or substitute our judgment for that of the [Commissioner].”
See Winschel, 631 F.3d at 1178 (alteration in original).
Accordingly, we perceive no reversible error concerning the ALJ’s weighing
of opinion evidence and now turn to whether the ALJ’s RFC determination was
based on substantial evidence of record.
5 Case: 19-14070 Date Filed: 07/21/2020 Page: 6 of 7
II. RFC DETERMINATION
Figuera argues that the ALJ’s RFC was not based on the substantial
evidence of record because it does not account for mental limitations documented
by State agency consultants. In formulating an RFC at the fourth sequential step,
the ALJ considers a claimant’s “ability to meet the physical, mental, sensory, and
other requirements of work.” 20 C.F.R. § 404.1545(a)(4). The ALJ examines all
relevant medical and other evidence, including “any statements about what [the
claimant] can still do that have been provided by medical sources” and
“descriptions and observations” by the claimant, her family, her neighbors, her
friends, or others, of her limitations, including limitations resulting from pain. Id.
§ 404.1545(a)(3). State agency medical or psychological consultants are
considered “experts in Social Security disability evaluation,” and the ALJ must
consider and assign weight to their opinions in the same manner as any other
medical source. See id. §§ 404.1527(f)(2), 416.927(f)(2).
We will not disturb the ALJ’s RFC determination here because a review of
the entire record shows that the RFC is supported by substantial evidence and
sufficiently accounted for the limitations of Figuera’s bipolar disorder that were
reflected in the record. The record reflects that Figuera’s bipolar disorder
primarily limited her ability to interact with others without fear or anxiety and
concentrate on and complete complex tasks. The State agency consultants found
6 Case: 19-14070 Date Filed: 07/21/2020 Page: 7 of 7
that her limitations were, at most, moderate, and those expert findings were
qualified with the circumstances under which Figuera could work with and interact
with others. Accordingly, the ALJ’s RFC determination limiting Figuera to
occasional contact with supervisors, occasional interactions with other coworkers
and the public, simple instructions, and simple work-related decisions sufficiently
accounted for the limitations caused by Figuera’s bipolar disorder that were
reflected in the record.
While the ALJ did not discuss every portion of the State agency consultants’
opinions, he was under no obligation to do so. See Dyer, 395 F.3d at 1211.
Additionally, Figuera’s focus on the restrictive aspects of the State agency
consultants’ opinions ignores that her RFC is the most she can do despite her
impairments, not the least. See SSR 96-8p, 61 Fed. Reg. 34,474-01 (July 2, 1996).
III. CONCLUSION
For the reasons discussed above, we affirm the Commissioner’s denial of
Figuera’s application for DIB and SSI.
AFFIRMED.