Philip Theil v. Commissioner, Social Security Administration

Court of Appeals for the Eleventh Circuit·Decided March 5, 2025·No. 24-11615·Unpublished

Opinion

[DO NOT PUBLISH]

In the

United States Court of Appeals For the Eleventh Circuit

No. 24-11615

Non-Argument Calendar

PHILIP THEIL, Plaintiff-Appellant,

versus COMMISSIONER, SOCIAL SECURITY ADMINISTRATION,

Defendant-Appellee.

Appeal from the United States District Court for the Northern District of Alabama D.C. Docket No. 4:22-cv-00673-RDP

2 Opinion of the Court 24-11615

Before JORDAN, LUCK, and ANDERSON, Circuit Judges. PER CURIAM:

Philip Theil appeals the district court’s order affirming the Commissioner of the Social Security Administration’s (“Commissioner ”) denial of his application for disability insurance benefits (“DIB”) and supplemental security income (“SSI”). Theil argues that the Administrative Law Judge’s (“ALJ”) residual functional capacity (“RFC”) finding failed to properly address and explain Dr. Williams’s medical opinion about Theil’s supervisor and feedback -based limitations.

We review the ALJ’s decision as the Commissioner’s final decision when the ALJ denies benefits and the Appeals Council denies review of the ALJ’s decision. Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). We review Social Security cases to determine whether the Commissioner’s decision was supported by substantial evidence and whether the correct legal standards were applied . Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). The Commissioner’s factual findings must be supported by substantial evidence, meaning “more than a scintilla” and “such relevant evidence as a reasonable person would accept as adequate to support a conclusion.” Id. (quotation marks omitted). However, we review de novo the legal principles applied by the Commissioner . Raper v. Comm’r of Soc. Sec., 89 F.4th 1261, 1268 (11th Cir. 2024).

USCA11 Case: 24-11615 Document: 23-1 Date Filed: 03/05/2025 Page: 3 of 10

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An individual claiming Social Security disability benefits must prove that he is disabled. Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). The Social Security regulations outline a fivestep sequential evaluation process for determining whether a claimant is disabled. See 20 C.F.R. § 404.1520(a)(4)(i)-(v), (b)-(g). 1 First, if a claimant is engaged in substantial gainful activity, they are not disabled. Id. § 404.1520(a)(4)(i), (b). Second, if the claimant has no impairment or combination of impairments that significantly limits their ability to work, they are not disabled. Id. § 404.1520(a)(4)(ii), (c). Third, if the claimant’s impairment meets or equals the severity of one of the Social Security regulations’ listed impairments, they are considered categorically disabled. Id. § 404.1520(a)(4)(iii), (d). Fourth, based on an RFC assessment, if a claimant can still do their past work, they are not disabled. Id. § 404.1520(a)(4)(iv), (e)-(f). Fifth, in light of their RFC, age, education level, and work experience, if a claimant cannot do their past work but can make an adjustment to other work, they are not disabled . Id. § 404.1520(a)(4)(v), (g).

At step four, the ALJ must ascertain the claimant’s RFC, which is “an assessment, based upon all of the relevant evidence, of a claimant’s remaining ability to do work despite his impairments .” Schink v. Comm’r of Soc. Sec., 935 F.3d 1245, 1268 (11th Cir.

1 Separate regulations govern eligibility for DIB and SSI. Compare 20 C.F.R. pt.

404 (DIB), with 20 C.F.R. pt. 416 (SSI). However, “[t]he regulations for both programs are essentially the same.” Bowen v. City of New York, 476 U.S. 467, 470 (1986); see 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4) (providing same fivestep sequential evaluation process).

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2019); 20 C.F.R. § 404.1545(a)(1). The RFC is determined by the ALJ’s consideration of the claimant’s physical, mental, and other abilities affected by their impairment(s). Schink, 935 F.3d at 1268; see 20 C.F.R. § 404.1545(b)-(d). In formulating the RFC, the ALJ must account for all relevant medical evidence and other evidence. Buckwalter v. Acting Comm’r of Soc. Sec., 5 F.4th 1315, 1320 (11th Cir. 2021); 20 C.F.R. § 404.1545(a)(1). The ALJ “must state with particularity the weight given to different medical opinions and the reasons therefor.” Buckwalter, 5 F.4th at 1320-21 (quotation marks omitted).

For claims filed on or after March 27, 2017, a medical opinion “is a statement from a medical source about what [the claimant ] can still do despite [the claimant’s] impairment(s) and whether [the claimant has] one or more impairment-related limitations or restrictions in the following abilities . . . .” 20 C.F.R. § 404.1513(a)(2). Such abilities include the “ability to perform mental demands of work activities, such as understanding; remembering ; maintaining concentration, persistence, or pace; carrying out instructions; or responding appropriately to supervision, co-workers , or work pressures in a work setting”; the “ability to perform other demands of work, such as seeing, hearing, or using other senses”; and the “ability to adapt to environmental conditions, such as temperature extremes or fumes.” Id. § 404.1513(a)(2).

For claims filed on or after March 27, 2017, an ALJ must “not defer or give any specific evidentiary weight, including controlling weight, to any medical opinion(s) or prior administrative medical

24-11615 Opinion of the Court 5

finding(s).” Id. § 404.1520c(a). Instead, an ALJ must consider any submitted medical opinion or prior administrative medical finding using five enumerated factors: (1) supportability, (2) consistency, (3) relationship with claimant, (4) specialization, and (5) other factors . Id. § 404.1520c(a), (c). Because the “most important” factors for evaluating the persuasiveness of a medical opinion are supportability and consistency, the ALJ must explain how it considered those two factors. Id. § 404.1520c(b)(2). “Supportability” refers to the principle that “[t]he more relevant the objective medical evidence and supporting explanations presented by a medical source are to support his or her medical opinion(s) or prior administrative medical finding(s), the more persuasive the medical opinions or prior administrative medical finding(s) will be.” Id. § 404.1520c(c)(1). “Consistency,” in turn, means that “[t]he more consistent a medical opinion(s) or prior administrative medical finding(s) is with the evidence from other medical sources and nonmedical sources in the claim, the more persuasive the medical opinion (s) or prior administrative medical finding(s) will be.” Id. § 404.1520c(c)(2). The ALJ “will articulate how [sh]e considered the medical opinions and prior administrative medical findings in [the claimant’s] claim according to paragraph (b).” Id. § 404.1520c(a).

The ALJ has a duty to develop a full and fair record. Henry v. Comm’r of Soc. Sec., 802 F.3d 1264, 1267 (11th Cir. 2015). The ALJ must “scrupulously and conscientiously probe into, inquire of, and explore for all relevant facts.” Id. (quotation marks omitted). The ALJ must consider the evidence as a whole when determining

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whether a claimant is disabled. Id. Further, “[s]o long as the ALJ’s decision demonstrates to the reviewing court that it considered the claimant’s medical condition as a whole, the ALJ is not required to cite every piece of evidence in the record.” Buckwalter, 5 F.4th at 1326. In determining whether it is necessary to remand a case for development of the record, we consider “whether the record reveals evidentiary gaps which result in unfairness or clear prejudice .” Brown v. Shalala, 44 F.3d 931, 935 (11th Cir. 1995) (quotation marks omitted). Accordingly, “there must be a showing of prejudice before we will find that the claimant’s right to due process has been violated to such a degree that the case must be remanded to the [ALJ] for further development of the record.” Id.

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