USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 1 of 9

[DO NOT PUBLISH] In the United States Court of Appeals For the Eleventh Circuit ____________________ No. 24-12496 Non-Argument Calendar ____________________ DAVID A. BALL, Plaintiff-Appellant, versus SOCIAL SECURITY ADMINISTRATION, COMMISSIONER,

Defendant-Appellee.

____________________ Appeal from the United States District Court for the Northern District of Alabama D.C. Docket No. 2:22-cv-01456-LSC ____________________ USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 2 of 9

2 Opinion of the Court 24-12496

Before JORDAN, LUCK, and WILSON, Circuit Judges.

PER CURIAM: Plaintiff-Appellant David Ball appeals the district court’s or- der affirming the Commissioner of the Social Security Administra- tion’s (Commissioner) denial of his application for supplemental security income (SSI). Ball argues that the Administrative Law Judge (ALJ) failed to provide any rationale for her rejection of the functional limitations documented by Nurse Practitioner (NP) Cherie Keahey and neglected to state her consideration of the “sup- portability” of Dr. June Nichols’s opinion. After careful review, we affirm.

I.

Ball filed an SSI application on June 9, 2020, alleging a disa- bility onset date of June 9, 2020. His disability report stated that the bulging discs in his spine limited his ability to work. Ball’s disability benefits claim was denied initially and on reconsideration. Ball then requested and received a hearing before an ALJ.

The Social Security regulations outline a “five-step sequen- tial evaluation process” for determining whether a claimant is dis- abled. See 20 C.F.R. § 416.920(a)(4)(i)–(v). If the ALJ determines that the claimant is or is not disabled at any step of the sequential analysis, the analysis ends. 20 C.F.R. § 404.1520(a)(4). First, if a claimant performs “substantial gainful activity,” he is not disabled. Id. § 416.920(a)(4)(i), (b). Second, if the claimant has no impairment or combination of impairments that significantly limits his ability USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 3 of 9

24-12496 Opinion of the Court 3 to work, he is not disabled. Id. § 416.920(a)(4)(ii). Third, if the claimant’s impairment meets or equals the severity of one of the Social Security regulations’ listed impairments, he is considered categorically disabled. Id. § 416.920(a)(4)(iii). Fourth, based on a re- sidual functional capacity (RFC) assessment, if a claimant can still do their past work, they are not disabled. Id. § 416.920(a)(4)(iv).

Fifth, considering their RFC, age, education level, and work expe- rience, if a claimant cannot do his past work but can make an ad- justment to other work, he is not disabled. Id. § 416.920(a)(4)(v).

The ALJ issued a written decision on November 22, 2021. At step one of the sequential evaluation, the ALJ found that Ball had not engaged in substantial gainful activity since the alleged onset date of June 9, 2020. At step two, the ALJ found that Ball’s severe impairments of degenerative disc disease, depression, and obesity limited his ability to work. At step three, the ALJ concluded that none of Ball’s impairments met the severity threshold of any of those listed in the applicable regulations.

At step four, based on the entire record, the ALJ determined that Ball had the RFC to perform light work as defined in 20 C.F.R. § 416.967(b), with various exceptions based on his mental and phys- ical capabilities. Regarding Ball’s back pain, the ALJ reviewed ob- jective evidence and provided written explanations for the medical opinions and prior administrative medical findings in the record.

But the ALJ did not directly address statements from NP Cherie Keahey based on Ball’s visits with her in November and December 2019. During the November 2019 visit, NP Keahey documented a USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 4 of 9

4 Opinion of the Court 24-12496 plan for Ball’s back pain, which involved adopting a low-sodium and low-fat diet, walking daily for twenty to thirty minutes, “no lifting, pushing, or pulling” anything greater than ten pounds, tak- ing the prescribed medication, and going to receive x-rays on his lumbar back within three weeks. The ALJ only referenced Ball’s visits with NP Keahey when discussing the onset of his symptoms, stating that records indicated that he reported intermittent back pain that ranked a seven out of ten and moderate depression symp- toms prior to his disability onset date.

Regarding Ball’s mental health, the ALJ considered medical record evidence from state psychological consultants, a licensed so- cial worker, a psychiatrist, and a clinical psychologist, Dr. June Nichols. As relevant here, the ALJ found that Dr. Nichols’s opinion that Ball had severe limitations due to his psychological symptoms was unpersuasive because the opined limitations were very severe considering Dr. Nichols’s findings that Ball had adequate general knowledge; good judgment and insight; could understand, remem- ber, or carry out short simple instructions; and maintained socially appropriate behavior.

At step five, the ALJ relied on testimony by a vocational ex- pert that an individual with Ball’s RFC, age, education, and experi- ence could work as a filters assembler, poly packer and heat sealer, and final inspector, jobs which existed in significant numbers in the national economy. Accordingly, the ALJ found Ball not disabled.

Ball then requested that the Appeals Council review the ALJ’s decision. The Appeals Council denied Ball’s request, making USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 5 of 9

24-12496 Opinion of the Court 5 the ALJ’s decision the final decision of the Commissioner. Ball then filed a complaint for judicial review in the district court, and the district court affirmed the ALJ’s decision. Ball timely appealed.

II.

We review the ALJ’s decision as the Commissioner’s final decision when the ALJ denies benefits and the Appeals Council de- nies review of the ALJ’s decision. Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001). We review Social Security appeals to deter- mine whether the Commissioner’s decision was supported by sub- stantial evidence and based on correct legal standards. Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). To be sup- ported by substantial evidence, there must be “more than a scin- tilla” and “such relevant evidence as a reasonable person would ac- cept as adequate to support a conclusion.” Id. (quotation marks omitted). 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).

III.

Ball advances two arguments on appeal. First, he argues that NP Keahey’s functional limitation that Ball could lift, push, or pull no more than ten pounds was a medical opinion, and the ALJ erred by failing to address it. Second, Ball argues that the ALJ erred in failing to address the “supportability” of Dr. Nichols’s opinion. We address each in turn.

Both claims involve step four of the sequential evaluation.

At this step, the ALJ must ascertain the claimant’s RFC, which is USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 6 of 9

6 Opinion of the Court 24-12496 “an assessment, based upon all of the relevant evidence, of a claim- ant’s remaining ability to do work despite his impairments.” Schink v. Comm’r of Soc. Sec., 935 F.3d 1245, 1268 (11th Cir. 2019) (per cu- riam) (quotation marks omitted); see also 20 C.F.R. § 416.945(a)(1).

The ALJ must account for “all relevant medical and other evi- dence” and “state with particularity the weight given to different medical opinions and the reasons therefor.” Buckwalter v. Acting Comm’r of Soc. Sec., 5 F.4th 1315, 1320–21 (11th Cir. 2021) (quota- tion marks omitted); see also 20 C.F.R. § 416.945(a)(1).

A “medical opinion” is “a statement from a medical source about what [the claimant] can still do despite [the claimant’s] im- pairment(s) and whether [the claimant has] one or more impair- ment-related limitations or restrictions” in certain abilities to per- form the physical and mental demands of work provided in the reg- ulations. 20 C.F.R. § 416.913(a)(2). In contrast, “other medical evi- dence” is “evidence from a medical source that is not objective medical evidence or a medical opinion, including judgments about the nature and severity of [the claimant’s] impairments, [the claimaint’s] medical history, clinical findings, diagnosis, treatment prescribed with response, or prognosis.” Id. § 416.913(a)(3).

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. § 416.920c(a), (c). But the regulations do not require the same for other medical evidence.

Id. The “most important” factors for evaluating the persuasiveness USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 7 of 9

24-12496 Opinion of the Court 7 of a medical opinion are supportability and consistency, so the ALJ must explain how she considered those two factors. Id. § 416.920c(b)(2).

Applicable here, “supportability” refers to the principle that “[t]he more relevant the objective medical evidence and support- ing explanations presented by a medical source are to support his or her medical opinion(s) or prior administrative medical find- ing(s), the more persuasive the medical opinions or prior adminis- trative medical finding(s) will be.” Id. § 416.920c(c)(1). The ALJ “will articulate how [the ALJ] considered the medical opinions and prior administrative medical findings in [the claimant’s] claim . . . .”

Id. § 416.920c(a). But “there are no magic words” that the ALJ must use to state the weight given to medical opinions or the reasons for discounting them. Raper, 89 F.4th at 1276 n.14.

First, the ALJ did not err by not analyzing the persuasiveness of NP Keahey’s November and December 2019 treatment notes because they were not “medical opinions” under 20 C.F.R. § 416.913(a)(2). The lifting, pushing, and pulling limitations were not “medical opinions” because they did not address Ball’s ability to perform demands of work “despite [his] impairment(s).” See id. They addressed activities Ball should not engage in at all, not what he could still do in a work context. And the lifting, pushing, and pulling limitations were just one of many treatment-plan recom- mendations for Ball’s back pain, which also included taking the pre- scribed pain medication and muscle relaxant, receiving imaging of his lumbar back, and returning for a follow-up appointment after USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 8 of 9

8 Opinion of the Court 24-12496 imaging was complete. As NP Keahey’s treatment notes are “other medical evidence,” not a “medical opinion” as defined in the regu- lations, the ALJ did not have to evaluate their persuasiveness. See 20 C.F.R. § 416.920c.

Next, the ALJ properly considered the supportability of Dr. Nichols’s opinion. The ALJ explained that Dr. Nichols’s own find- ings of Ball’s mental functioning did not support her medical opin- ion of severe mental limitations, thereby addressing the supporta- bility. Specifically, the ALJ explained that Dr. Nichols’s findings, in- cluding that Ball presented with an adequate fund of knowledge, appeared to have good judgment and insight, and could under- stand, remember, and carry out very short and simple instructions, maintain socially appropriate behavior, and adhere to basic stand- ards of neatness and cleanliness, did not support her opinion that Ball had such severe mental limitations that he could not maintain attention, concentration, or pace for periods of at least two hours, sustain an ordinary routine with special supervision, or interact with supervisors or coworkers. Although the ALJ never used the words “support” or “supportability” in her analysis, these “magic words” are not required. See Raper, 89 F.4th at 1276 n.14. The ALJ properly considered and articulated Dr. Nichols’s opinion as the regulation required, and substantial evidence supports her deci- sion.

IV.

In sum, the ALJ did not err by not analyzing the persuasive- ness of NP Keahey’s November and December 2019 treatment USCA11 Case: 24-12496 Document: 27-1 Date Filed: 04/04/2025 Page: 9 of 9

24-12496 Opinion of the Court 9 notes because they were not medical opinions as defined by the regulations. And the ALJ properly considered the supportability of Dr. Nichols’s opinions by explaining that Dr. Nichols’s own find- ings about Ball’s mental functioning did not support her medical opinion of his severe mental limitations.

AFFIRMED.