[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
FILED
________________________ U.S. COURT OF APPEALS
ELEVENTH CIRCUIT
November 3, 2005
No. 05-12597
THOMAS K. KAHN
Non-Argument Calendar CLERK
________________________
D. C. Docket No. 03-01428-CV-HS-W
WALTER A. WRIGHT,
Plaintiff-Appellant,
versus
JO ANNE B. BARNHART,
Commissioner of Social Security Administration,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Northern District of Alabama
_________________________
(November 3, 2005)
Before CARNES, HULL and WILSON, Circuit Judges.
PER CURIAM:
Walter Wright appeals the district court’s order affirming the Social Security
Administration Commissioner’s denial of disability insurance benefits, 42 U.S.C. §
405(g), and supplemental security income, 42 U.S.C. § 1383(c)(3). First, Wright
argues that the Commissioner erred in denying him benefits for the following
reasons: (1) the Administrative Law Judge’s (ALJ) decision is not supported by
substantial evidence, and (2) because the ALJ did not give sufficient weight to the
opinions of several of Wright’s physicians. Second, Wright contends that the
district court erred when it inadequately reviewed the evidence concerning his
alleged disability.
I.
Wright applied for benefits claiming to be disabled as a result of chronic
pain in his back and knees. His alleged disability onset date is January 31, 1997.
After the regional commissioner twice denied Wright’s claim, the ALJ conducted a
hearing, denying Wright benefits on December 28, 1998. Wright appealed to the
district court, but because the claim file was lost, the district court remanded the
case back to the Appeals Council (AC). The AC vacated the ALJ’s decision due to
the lost transcript of the hearing, and the AC remanded the case to the ALJ for a de
novo hearing, which was held on January 29, 2002. After the second hearing, the
ALJ issued a decision denying benefits for the second time on April 5, 2002. That
decision is the subject of this appeal. Because Wright appeals on the basis that
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substantial evidence does not support the ALJ findings, a review of the facts and
medical history is necessary.
II.
Wright testified that he suffers from pain in his back and knees, as well as
depression. Wright takes four pain medications, but he stated that the medications
do not alleviate the pain resulting from sacroiliitis (inflammation of the joints in
the back), tendinitis (inflammation, irritation, and swelling of a tendon), and a
bulging disc. Wright claims that his painkillers cause him to be drowsy to the
point of unconsciousness, although Wright’s medical reports state that he
experienced no significant side effects from his medication—a contradiction
Wright could not explain. Although his doctors prescribed physical therapy,
Wright stopped going due to the expense, but nonetheless claimed he completed
physical therapy in 2000. Wright testified that physical therapy only relieved his
pain temporarily. Because Wright is unable to remain in any one position,
including sitting or standing, for more than 15 minutes to 1 hour, Wright’s medical
condition allegedly renders him unable to drive a car or do any work during an
eight hour day.
In February 1996 Wright hurt his back while working, and a Duty Status
Report from the U.S. Department of Labor (status report) shows that Wright was
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unable to perform regular work at that time and was limited to carrying two
pounds. A second status report also shows strains in both of Wright’s knees. In
March 1996 Dr. Chester Boston treated Wright, finding him to have an abnormal
gait and restricted range of motion from strained muscles and ligaments. Despite
the fact that X-rays of Wright’s spine came back normal, Boston recommended
physical therapy and found that Wright was unable to resume his work. Status
reports in March and early April stated that Wright could not resume work and
recommended sedentary work.
By mid-April, however, things should have started looking up for Wright.
Boston concluded on April 8, 1996 that Wright’s MRI showed narrowing of the
lumbar spinal canal and a bulging disc but no nerve root impairment. X-rays dated
April 9, 1996 showed no radiographic abnormality in the spine or erosive disease
but did show some joint problems. An X-ray of Wright’s knees from April 9, 1996
showed no abnormalities. A status report from that same day showed that Wright
was able to return to work, but he could only perform sedentary work and lift a
maximum of five pounds. An April 29, 1996 report stated the same conclusion.
On May 3, 1996, Boston noted that a lumbar MRI appeared to be within normal
limits and that he could not explain Wright’s continued pain. Boston
recommended that Wright return to regular work. A status report dated May 22,
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1996 also concluded Wright was able to perform regular work.
Still, Wright alleged his back and knee pain continued, and as a result he
was incapable of working. On September 3, 1996, Dr. Joseph Fritz diagnosed
Wright with possible degenerative arthritis of the knees, but X-rays from
September 5 indicated no arthritic changes, no fracture, and no definite
abnormality. On November 26, 1996, Dr. Bobby Hill diagnosed Wright with
chronic knee pain syndrome, and on December 3, 1996, Dr. Lucy King found
Wright had symptoms of patella tendinitis but no signs of effusion (accumulation
of fluid), instability, or cartilage wear, and found that surgery was unnecessary.
On December 16, 1996, Wright returned to Fritz who noted that both the X-rays
and the MRI came back normal.
On January 23, 1997, Wright alleged he injured his back while getting up off
the couch, but on January 28, 1997 a status report indicated that Wright was able to
return to work, although some restrictions were noted. On February 4, 1997, Fritz
diagnosed Wright with chronic pain in his back and knees, but his examination
showed a normal range of motion in both knees. February 10, 1997 radiology
reports show moderate cartilage loss, but no other abnormalities in the knees. And
a February 11, 1997 radiology report showed a normal lumbar spine with no
evidence of fractures, dislocation, or degenerative change. However, a February
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16, 1997 status report showed that Wright was unable to work at all due to a
lumbar strain and knee problems.
Despite his normal test results, Wright’s alleged pain continued. On
February 18, 1997, Dr. Alexander Todorov found that Wright suffered from
lumbar pain, but felt there was a “significant overstatement of symptoms.”
Wright’s electromyography and nerve conduction velocity studies (EMG/NCV)
both came back normal. On February 25, 1997, an MRI administered by King
came back normal. On March 3, 1997, Wright saw Boston, who remarked that the
X-rays of Wright’s lumbar spine showed some hypertrophy, but were otherwise
“unremarkable.” Likewise, an X-ray of Wright’s knees on that same date was also
unremarkable.
An April 8, 1997 residual functional capacity assessment came back with
exertional limits of occasionally lifting 50 pounds, frequently lifting 25 pounds,
limits of 6 hours of standing or walking and 6 hours of sitting in an 8 hour
workday. However, on April 28, 1997, King indicated that Wright was capable of
sitting and standing no more than 2 hours in an 8 hour workday. On June 12,
1997, a capabilities test performed by Dr. William Lawrence produced the same
results as the April 8 test, contradicting King’s April 28, 1997 analysis.
Despite his allegedly disabling pain, on February 6, 1998, Wright
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complained to King that his pain was causing him “difficulties with sports.” King
recommended continued physical therapy but found surgery unnecessary. In
February 1998, two visits to Dr. T.S. Shivashankara revealed chronic pain but no
objective cause for the pain because all the tests results, including an MRI, X-rays,
and EMG/NCV came back normal. On April 10, 1998, Fritz wrote a letter stating
that because Wright had a 10 year history of pain, “it is reasonable to assume that
he will be having pain a year from now or for that matter two years from now.”
And in May 1998, Dr. Steven Hahn identified Wright as suffering from an
inflammatory arthritic condition, exacerbated by lifting, twisting, and stair
climbing, and consequently, Hahn stated that Wright’s physical activity should be
limited.
On January 26, 1999, a CT scan of Wright’s head showed no abnormalities,
and X-rays of his knees and lumbar spine on February 12, 1999, revealed no
fractures or significant abnormalities. However, on June 7, 1999, Dr. Ramesh
Kumar stated that Wright was diagnosed with spondyloarthropathy and that he was
unable to work because of the limitation of movement in his spine. On December
8, 1999, X-rays revealed no bone or joint abnormalities, no recent trauma, no
degenerative change, and no fusion, and on March 8, 2000, and June 23, 2000,
Kumar found a full range of motion in Wright’s knees and recommended physical
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therapy. X-rays of Wright’s spine on September 7, 2000, showed no injury, but
showed minimal lateral spurring, and the knee X-rays on that date came back
relatively normal. Finally, on January 24, 2001, Dr. Marcin Gornisiewicz
diagnosed Wright with spondyloarthropathy, noting that the condition was stable
and that Wright tolerated medication without significant side effects.
At the administrative hearing the vocational expert (VE) testified that given
Wright’s skills and physical limitations, several jobs existed in the national
economy that he could still perform. These include administrative assistant,
general entry-level office jobs, payroll and timekeeping clerk, production
assembler, telephone operator, and order taker.
Based on all of this, the ALJ determined that Wright was not disabled.
After the ALJ rendered his decision, Wright saw Dr. Hisham Hakim on
March 29, 2002. Hakim stated that Wright suffered from several conditions, and
as a result, Wright was totally disabled. He felt that Wright could lift 10 pounds
occasionally and could sit for 2 hours and stand or walk for 1 hour during an 8
hour day. He also said that Wright suffered severe drug side effects.
Wright submitted Hakim’s findings to the AC, but on April 17, 2003, the
AC denied review. The AC found that because Hakim had not treated Wright prior
to March 2002, and because his clinical findings did not support his “circle-the-
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answer” opinions, evidence supporting Hakim’s opinion was not sufficient to
require the AC to remand the case back to the ALJ for consideration of Hakim’s
report. The district court affirmed the ALJ’s decision.
III.
We review a social security case to determine whether the ALJ applied the
correct legal standards and whether the ALJ’s decision is supported by “substantial
evidence.” See Lewis v. Callahan, 125 F.3d 1436, 1439 (11th Cir. 1997).
First, the ALJ clearly applied the correct legal standards. In order to qualify
for disability benefits, a claimant must meet the Social Security Act’s definition of
disabled: suffering from the “inability to engage in any substantial gainful activity
by reason of any medically determinable physical or mental impairment which can
be expected to result in death or which has lasted or can be expected to last for a
continuous period of not less than twelve months.” 42 U.S.C. § 423(d)(1)(A); 42
U.S.C. § 416(I). A “physical or mental impariment” under the Act is “an
impairment that results from anatomical, physiological, or psychological
abnormalities which are demonstrable by medically acceptable clinical and
laboratory diagnostic techniques.” 42 U.S.C. § 423(d)(3).
The Act requires that the ALJ must follow a five-step sequence in
determining whether a claimant is entitled to supplemental security income (SSI)
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and disability:
(1) Is the claimant presently unemployed?
(2) Is the claimant's impairment severe?
(3) Does the claimant's impairment meet or equal one of the specific
impairments set forth in 20 C.F.R. Pt. 404, Subpt. P, App. 1?
(4) Is the claimant unable to perform his or her former occupation?
(5) Is the claimant unable to perform any other work within the
economy?
McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986). “An affirmative
answer to any of the above questions leads either to the next question, or, on steps
three and five, to a finding of disability. A negative answer to any question, other
than step three, leads to a determination of ‘not disabled.’” Id.; 20 C.F.R. §
416.920(a)-(f).
Here, the ALJ followed this sequence correctly, concluding: (1) Wright is
currently unemployed; (2) Wright suffers from a severe impairment; (3) Wright’s
impairment does not meet or equal one of the specific impairments outlined in the
regulations; (4) Wright is unable to perform any of his past relevant work; but (5)
Wright is able to perform a full range of sedentary work available in significant
numbers in the national economy, and, therefore, Wright is not disabled under the
Act.
Next, we turn to whether substantial evidence supports the ALJ’s findings.
“Substantial evidence is more than a scintilla and is such relevant evidence as a
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reasonable person would accept as adequate to support a conclusion.” Id. at 1440.
The ALJ’s findings are conclusive if supported by substantial evidence. Wilson v.
Barnhart, 284 F.3d 1219, 1221 (11th Cir. 2002). Our role as a reviewing court is
limited in that we may not find facts “anew,” reweigh evidence, or substitute our
own judgment for that of the ALJ, even if we find the evidence preponderates
against the ALJ’s decision. Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir.
1990). The question is not whether we would make the same decision as the ALJ,
but whether “the record as a whole” shows the ALJ’s decision is “reasonable and
supported by substantial evidence.” Bloodsworth v. Heckler, 703 F.2d 1233, 1239
(11th Cir. 1983).
In this case, contrary to Wright’s contention, substantial evidence clearly
supports the ALJ’s decision. The record reveals evidence that would lead a
“reasonable person” to agree with the ALJ’s conclusion. Lewis, 125 F.3d at 1439.
Between 1997 and 2001, Wright’s objective clinical test results were
generally interpreted as normal or within the normal range. Specifically, X-rays on
February 10, 11, and March 3, 1997, March 24, 1998, February 12 and December
8, 1999, and September 6 and September 7, 2000, all performed after the alleged
onset date, show an absence of injuries or abnormalities to Wright’s lumbar region
and knees. Likewise, MRIs on February 19, February 25, March 3, April 8, 1997,
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and on February 12, February 24, and December 12, 1998, do not suggest a cause
for Wright’s pain. These MRI results were completely normal or showed “mild”
findings of abnormality. EMG/NCV tests on February 19, 1997 and February 24,
1998 were normal, as were CT scans on March 10, 1997 and January 26, 1999. In
addition to these normal tests results, the ALJ could have relied on Todorov’s
belief that Wright’s alleged pain involved “a significant overstatement of
symptoms.” Furthermore, the evidence showed that Wright, who allegedly
suffered from a disability that rendered him incapable of working even a sedentary
job, went to King’s office complaining of knee pain that caused him “difficulties
playing sports.”
The ALJ did not err in according less weight to the opinions of treating
physicians King and Kumar. Testimony or an opinion of a treating physician must
be given substantial or considerable weight unless “good cause” is shown to the
contrary. Lewis, 125 F.3d at 1440. We have found “good cause” to exist where:
(1) the opinion was not bolstered by the evidence; (2) the evidence supported a
contrary finding; or (3) the opinion was conclusory or inconsistent with the
doctor’s own medical records. Id. (internal citations omitted). The ALJ must
clearly articulate the reasons for giving less weight to the opinion of a treating
physician, and the failure to do so is reversible error. Id. However, when an
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incorrect application of the regulations results in harmless error because the correct
application would not contradict the ALJ’s ultimate findings, the ALJ’s decision
will stand. See Diorio v. Heckler, 721 F.2d 726, 728 (11th Cir. 1983).
In this case, contradictory opinions from two other treating physicians,
Boston and Todorov, along with the objective tests, constitute substantial evidence
for a reasonable person to agree with the ALJ. The ALJ rejected King’s and
Kumar’s findings that Wright was unable to work because King’s and Kumar’s
opinions were inconsistent with their own clinical findings, objective tests, and the
examinations they performed. Thus, the ALJ afforded the opinions of King and
Kumar little weight for “good cause.” Lewis, 125 F.3d at 1440.
Although the ALJ did not explicitly state what weight he afforded the
opinions of Hahn, Fritz, Shivashankara, and Gornisiewicz, none of their opinions
directly contradicted the ALJ’s findings, and, therefore, any error regarding their
opinions is harmless. See Dioro, 721 F.2d at 728. That is, while each of these
doctors found that Wright suffered from chronic pain or conditions associated with
chronic pain, not one of these doctors indicated that Wright is unable to perform
sedentary work as a result of that pain.
Wright improperly relies on opinions of Hakim that were not presented to
the ALJ and to which the AC denied review. We have held that “when the
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[Appeals Council] has denied review, we will look only to the evidence actually
presented to the ALJ in determining whether the ALJ's decision is supported by
substantial evidence.” Falge v. Apfel, 150 F.3d 1320, 1323 (11th Cir. 1998). Any
opinion of Hakim reported after the ALJ’s final decision, and not presented to the
ALJ, may not be considered in assessing whether substantial evidence supported
the ALJ’s determination. Id.
Finally, Wright’s argument that the district court did not adequately review
the record has no merit. 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). Thus, our limited review in this case is whether
substantial evidence supports the findings of the ALJ, not the district court.
Graham v. Bowen, 790 F.2d 1572, 1575 (11th Cir. 1986). Because the findings of
the district court do not bind or even guide our de novo review of the ALJ decision,
Wright’s allegation that the district court erred by inadequately reviewing the
evidence is irrelevant.
As an aside, however, we note that the district court order shows a
painstaking and thorough review of the facts, recognizing the arguments for and
against Wright’s position before determining that the record as a whole revealed
substantial evidence for the ALJ decision.
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IV.
Upon careful review of the record on appeal and consideration of the parties’
briefs, we discern no reversible error. Because the ALJ applied correct legal
standards and substantial evidence supports the ALJ’s decision, we affirm.
AFFIRMED.
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