Lisa Ambrose McGranahan v. Commissioner of Social Security

[DO NOT PUBLISH]
In the
United States Court of Appeals
For the Eleventh Circuit
____________________
No. 23-11706
Non-Argument Calendar
____________________
LISA AMBROSE MCGRANAHAN,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
____________________
Appeal from the United States District Court
for the Middle District of Florida
D.C. Docket No. 8:22-cv-00795-WFJ-TGW
____________________
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2 Opinion of the Court 23-11706
Before W ILLIAM PRYOR , Chief Judge, and JORDAN and L AGOA, Cir-
cuit Judges.
PER CURIAM:
Lisa McGranahan appeals the denial of her application for
disability insurance benefits and supplemental security income.
42 U.S.C. §§ 405(g), 1383(c)(3). After McGranahan alleged that she
was disabled due to major depression disorder, generalized anxiety
disorder, and social anxiety disorder, the administrative law judge
found that she was not disabled and denied her application.
McGranahan challenges that denial and argues that the administra-
tive law judge failed to evaluate properly the medical opinion evi-
dence from two of her treating mental-health providers, her sub-
jective complaints, and her residual functional capacity. We affirm.
We review the administrative law judge’s application of le-
gal principles de novo and review the resulting decision “to deter-
mine whether it is supported by substantial evidence.” Buckwalter
v. Acting Comm’r of Soc. Sec., 5 F.4th 1315, 1320 (11th Cir. 2021).
“Substantial evidence is more than a scintilla and is such relevant
evidence as a reasonable person would accept as adequate to sup-
port a conclusion.” Id. We will not decide the facts anew, make
credibility determinations, or re-weigh the evidence. Winschel v.
Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). Even if the
preponderance of the evidence weighs against the decision, we will
affirm so long as substantial evidence supports the decision. Buck-
walter, 5 F.4th at 1320.
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23-11706 Opinion of the Court 3
In support of her claim, McGranahan submitted medical
opinions from psychiatric nurse practitioner Emily Reynolds. In
February 2018, about two months after McGranahan’s alleged dis-
ability onset date, Reynolds recorded, during a mental-status exam,
that McGranahan’s thought process was coherent and logical, her
level of intellectual functioning was average, and her memory was
grossly intact. Reynolds recorded that McGranahan stated that she
was mildly depressed and anxious and that her medication was
somewhat effective, and Reynolds adjusted her medication.
Over the next three years, Reynolds completed three psychi-
atric impairment questionnaires. In February 2019, one week after
McGranahan reported tolerating her medication well and re-
quested a medication adjustment, Reynolds opined in a question-
naire co-signed by psychiatrist Dr. Gregory Onderko that
McGranahan would experience marked restrictions in daily living
activities and social functioning and frequent deficiencies of con-
centration, persistence, or pace resulting in failure to complete
tasks in a timely manner and her absence from work about once a
month. In October 2020, despite McGranahan reporting over the
previous ten months that she was busy over the holidays, helped a
family member move, gardened, and planned a trip to the beach,
Reynolds opined in a second questionnaire, co-signed by psychia-
trist Dr. Linda Leffler, that McGranahan had a moderate restriction
of daily living activities and extreme difficulties in social function-
ing but that she could not assess whether McGranahan experienced
deficiencies of concentration, persistence, or pace. Nevertheless,
Reynolds opined that these impairments would cause McGranahan
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4 Opinion of the Court 23-11706
to be absent from work more than twice a month. During that
month, McGranahan reported that her medications were helpful,
denied major mood instability, and reported engaging in healthy
lifestyle behaviors and exercising regularly. In June 2021, after
McGranahan reported four months earlier that she was comforta-
ble with her medications, was exercising, and was engaging in var-
ious projects to stay busy and denied any major mood instability,
Reynolds opined in a third questionnaire, co-signed by Dr. Leffler,
that McGranahan had marked restrictions of daily living activities
and social functioning and would experience frequent deficiencies
of concentration, persistence, and pace and that these impairments
would cause her to be absent from work more than twice a month.
During that month, McGranahan reported that she wanted to con-
tinue her medications because she felt that she had made significant
progress while taking them. And in August 2021, McGranahan re-
ported doing well overall and being more organized and grounded.
McGranahan also presented medical opinion evidence from
Dr. Marisol Valencia-Payne who evaluated McGranahan during a
single telehealth visit in September 2020. Dr. Valencia-Payne
opined that McGranahan had marked limitations in social interac-
tion, adaptation, and concentration and persistence, which would
cause her to be absent from work more than three times a month.
Substantial evidence supports the administrative law judge’s
finding that McGranahan was not disabled. The administrative law
judge considered both providers’ medical opinions but found that
the opinions were unpersuasive because they were inconsistent
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23-11706 Opinion of the Court 5
with other medical evidence and lacked support in the record. See
20 C.F.R § 404.1520c, 416.920(c) (providing that for claims filed on
or after March 27, 2017, the administrative law judge must articu-
late how persuasive he finds each medical opinion, but providing
that he no longer must assign more weight to a treating source’s
medical opinion or explain why good cause exists to disregard it).
The administrative law judge considered and explained that Reyn-
olds’s opinions that McGranahan experienced severe limitations
were inconsistent with record evidence that McGranahan func-
tioned independently, performed a variety of activities like shop-
ping and driving, did not require hospitalization or intense treat-
ment, and experienced improvement in her symptoms with regu-
lar medication, which she requested no changes to in 2021. The
administrative law judge also considered Dr. Valencia-Payne’s
opinion, which was based on her one-time video examination of
McGranahan, and found that this opinion lacked support in the rec-
ord and appeared to contradict both McGranahan’s reports to
Reynolds regarding her increased activities during that time and
Dr. Valencia-Payne’s notes that McGranahan exhibited a coherent
and goal-directed thought process with intact concentration and at-
tention. See Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1159 (11th
Cir. 2004) (finding that substantial evidence supported the “deci-
sion to discount” a physician’s opinion because it was “inconsistent
with his own treatment notes, unsupported by the medical evi-
dence, and appear[ed] to be based primarily on [the claimant’s] sub-
jective complaints”). And because the administrative law judge
found the opinions equally unpersuasive, the new regulations did
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6 Opinion of the Court 23-11706
not require him to articulate his consideration of the other factors.
See 20 C.F.R. §§ 404.1520c(b)(2)-(3), 416.920c(b)(2)-(3) (“[W]e will
explain how we considered the supportability and consistency fac-
tors for a medical source’s medical opinions . . . . We may, but are
not required to, explain how we considered the [remaining factors]
when we articulate how we consider medical opinions . . . .”).
Substantial evidence also supports the administrative law
judge’s finding that McGranahan’s subjective complaints regarding
the intensity, persistence, and limiting effects of her symptoms
were inconsistent with the medical evidence and her testimony.
The administrative law judge found that despite McGranahan’s al-
legations that she was severely limited, her conditions “required
little medical intervention” and “caused no symptoms that pre-
vented the claimant from performing substantial gainful activity.”
See Wilson v. Barnhart, 284 F.3d 1219, 1226 (11th Cir. 2002). The ad-
ministrative law judge also found it significant that, with treatment
and an effective medication regimen, McGranahan was able to in-
crease her activities and improve her symptoms. The administra-
tive law judge explained that, despite McGranahan self-reporting
on a supplemental questionnaire that she was limited in memory,
completing tasks, concentrating, and getting along with others, he
observed at the hearing that she “paid good attention, was well fo-
cused, understood the questions, and gave relevant and detailed
answers.” See id.
Substantial evidence supports the finding that McGranahan
had the residual functional capacity to perform work with certain
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23-11706 Opinion of the Court 7
non-exertional limitations. The administrative law judge found
that McGranahan could understand and carry out “routine, repeti-
tive, unskilled tasks with the ability to make basic decisions and ad-
just to simple changes in a work setting; as long as interaction with
the public, coworkers and supervisors is no more than frequent.”
In doing so, the administrative law judge properly evaluated the
medical record, the opinions of McGranahan’s mental health pro-
viders, and the symptoms she alleged. And the administrative law
judge also considered but partially rejected the medical opinion of
two state agency psychological consultants, both of whom opined
that McGranahan experienced only mild limitations, because the
administrative law judge found that the medical evidence estab-
lished that McGranahan experienced moderate, not mild, limita-
tions in interacting with others and concentrating, persisting, or
maintaining pace. The administrative law judge properly evaluated
and articulated his consideration of this medical evidence in deter-
mining McGranahan’s non-exertional limitations of performing
routine, unskilled tasks with reduced interactions with others. See
Winschel, 631 F.3d at 1179.
We AFFIRM the denial of McGranahan’s application for
benefits.
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