SUZANNE H. SEGAL, Magistrate Judge.
Jessica Olive ("Plaintiff") brings this action seeking to overturn the decision of the Acting Commissioner of Social Security (the "Commissioner" or "Agency") denying her application for Disability Insurance Benefits. The parties consented, pursuant to 28 U.S.C. § 636(c), to the jurisdiction of the undersigned United States Magistrate Judge. (Dkt. Nos. 11-13). For the reasons stated below, the Court AFFIRMS the Commissioner's decision.
On June 17, 2014, Plaintiff filed an application for Disability Insurance Benefits, pursuant to Title II of the Social Security Act ("Act"), alleging a disability onset date of September 9, 2013. (AR 85, 141-44). The Commissioner denied Plaintiff's application initially and on reconsideration. (AR 76-95). Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"), which took place on September 29, 2015.
Plaintiff was born on February 27, 1984. (AR 141). She was thirty-one (31) years old when she appeared before the ALJ on July 26, 2016. (AR 39). Plaintiff is a high-school graduate and has an associate's degree. (AR 40). She is single and lives with her parents. (AR 61, 169, 183). Plaintiff last worked in September 2013 as a receptionist. (AR 65, 161). She alleges disability due to anxiety, panic attacks, and severe depression. (AR 160).
On June 28, 2014, Plaintiff submitted an Adult Function Report. (AR 169-77). She asserted that she is unable to work due to severe panic attacks that cause extreme dizziness, shaking, nausea, diarrhea, inability to focus, anxiety, paranoia, and sleep disturbances. (AR 169-70). Plaintiff also asserted that her mental impairments affect her vision and her ability to memorize and concentrate. (AR 174). Plaintiff is able to exercise, read, write, listen to music, and go outside. (AR 170). She has no problems with personal care, including dressing, bathing, taking her medications, and feeding herself. (AR 170-71). Plaintiff is able to prepare meals, do house and yard work, and care for her dog. (AR 170-71). She occasionally drives and shops in stores. (AR 172). Plaintiff's hobbies and interests include occasional reading, writing, watching television, blogging, photography and playing baseball. (AR 173). She regularly socializes with friends and family, with no problems getting along with others. (AR 173-74).
In an August 2014 Disability Report, Plaintiff asserted that her panic attacks prevent her from doing everyday activities. (AR 223). The stresses of work created issues where she could not breathe or think, would get dizzy and nauseous, and would have severe diarrhea. (AR 223). She has severe problems talking on the phone and going outside and interacting with people because of her panic attacks and anxiety. (AR 223).
At Plaintiff's hearing, she testified that she is unable to work because of symptoms related to anxiety, depression, and PTSD. (AR 57). Social functions, being on the phone, and looking for work exacerbate her panic attacks. (AR 57). She suffers from significant anxiety, which causes diarrhea, shaking, and an inability to think. (AR 57). She has made some progress with her recent therapist. (AR 53-55). While Prozac and Zyprexa have helped her depression significantly, they affect her memory and cause headaches. (AR 56-58). Plaintiff testified that she tries to help out around the house when her anxiety is under control. (AR 61-62).
Plaintiff sought treatment with Kaiser in Salem, Oregon, since July 2013. (AR 264). On July 11, 2013, Plaintiff complained of increase anxiety associated with job stressors. (AR 264). She reported trying to find a new job. (AR 284). She reported being overly tearful, difficulty breathing, and nausea. (AR 264). She was diagnosed with an adjustment disorder with mixed anxiety and depression and prescribed Prozac. (AR 264-65). On July 18, Plaintiff reported worsening anxiety and stress, with eye twitching and intermittent chest tightness. (AR 266). On September 19, Plaintiff reported that her depression was improving, but anxiety was still present. (AR 267). She was diagnosed with panic disorder without agoraphobia and major depressive disorder. (AR 263).
On September 10, 2013, Barbara Hoover, D.O., Plaintiff's primary care doctor, diagnosed generalized anxiety disorder and prescribed Ativan to relieve Plaintiff's panic symptoms at work. (AR 277). On September 19, Plaintiff reported her depression as improving but anxiety is still present. (AR 277). She reported being on short-term disability due to her panic attacks. (AR 277). Dr. Hoover recommended that she continue off work until her depression and anxiety stabilized. (AR 277). On October 3, Plaintiff reported a decrease in panic attacks. (AR 276).
On September 12, 2013, Plaintiff began treating with New Perspectives Center for individual psychotherapy. (AR 297). She reported high anxiety, panic attacks, and depression. (AR 298). Recurrent panic attacks cause extreme distress and have impaired her ability to work. (AR 298). Although Plaintiff reported recent suicidal thoughts, she denied any plans or intent. (AR 298). Her anxiety and depression symptoms include nightmares, sleep disturbance, exaggerated startle response, depressed mood, weight loss/gain, anhedonia, severe psychomotor agitation, feelings of worthlessness, low self-esteem, poor appetite, muscle tension, irritability, fatigue, panic attacks, excessive worry, difficulty concentrating, and difficulty sustaining attention. (AR 300-01). Plaintiff was diagnosed with panic disorder without agoraphobia and major depressive disorder and assigned a Global Assessment of Functioning ("GAF") score of 45.
In October 2013, Plaintiff began treating with Sarah Dubal, a psychiatric mental health nurse practitioner. (AR 270-72). Plaintiff complained of severe depression and some anxiety. (AR 270). A mental status examination was unremarkable. (AR 270). Dubal diagnosed adjustment disorder with disturbance of mood and anxiety and transitioned Plaintiff from Prozac to Zoloft. (AR 270-71). Three weeks later, Plaintiff complained that she feels worse with Zoloft, except panic attacks are only about every three days. (AR 270). Dubal suggested Plaintiff try 5-HTP as an alternative for her.
In January 2014, Plaintiff began treating with Clarissa J. Shepherd, a licensed professional counselor. (AR 328). Plaintiff reported panic attacks, including unfocused vision, loss of breath, shaking, nausea, uncontrolled crying, and diarrhea. (AR 329). A mental status examination was unremarkable. Plaintiff was fully oriented and her affect, appearance, speech, attention, concentration, memory, mood, thought content, insight, judgment and intellectual functioning were all normal. (AR 329-30). There were no signs of hallucinations or delusions. (AR 330). Shepherd diagnosed major depressive disorder and generalized anxiety disorder and assigned a GAF score of 50. (AR 332). Plaintiff continued with individualized, weekly therapy sessions from January to May 2014. (AR 333-41). In February 2014, Plaintiff reported feeling better and being able to engage in a variety of activities, including walking her dog on a daily basis and enjoying a variety of social interactions. (AR 337-38). Over the course of her treatment, Plaintiff reported that her symptoms of anxiety and depression decreased as she followed through with her treatment plan. (AR 326). On July 18, 2014, Shepherd opined that Plaintiff is unable to perform required workplace duties, such as sustaining concentration or being able to socially interact and adapt to workplace situations and environment. (AR 327).
On July 17, 2014, Sohini P. Parikh, M.D., reviewed the medical record and performed a complete psychiatric evaluation on behalf of the Commissioner. (AR 343-50). Plaintiff was casually dressed and reasonably groomed with a normal posture and gait. (AR 343). Her chief complaints were depression, anxiety, and "medical problems." (AR 343). She reported feeling depressed and frustrated due to the situation at her workplace beginning in July 2013. (AR 344). Plaintiff claimed she was "picked on and given a hard time at work." (AR 344). She reported anxiety attacks with increased heart rate, sweatiness, and dizzy spells. (AR 344). Big crowds "bother her a lot." (AR 344). She denied any psychosis or any suicidal or homicidal ideations. (AR 344). Plaintiff is able to drive, manage funds, and pay bills. (AR 346). She is able to cook, shop, and do housekeeping. (AR 346). Plaintiff cares for herself and her dog. (AR 346). She has close friends, gets along with her family, and has no problems with her neighbors. (AR 346).
Dr. Parikh conducted a mental status examination. (AR 346-48). Plaintiff was alert, attentive, cooperative, and followed simple oral and written instructions. (AR 346). No cognitive problems were noted. (AR 346). Plaintiff's speech was normal, she was fully oriented, with logical form of thought, and normal thought content. (AR 347). Plaintiff's mood was depressed and anxious and her affect was "brighter." (AR 347). She denied any feelings of hopelessness, helplessness, anhedonia, or worthlessness. (AR 347). She denied hallucinations, delusions, phobias, or any preoccupations with suicidal or homicidal ideations. (AR 347). Plaintiff's abstract thinking, judgment, insight, memory, and intellectual functioning were all unremarkable. (AR 347-48).
Dr. Parikh diagnosed anxiety disorder and depressive disorder and assigned a GAF score of 66 to 71.
In July 2014, Plaintiff moved to California to live with her parents but did not begin treatment until January 2015. (AR 326, 356, 393). At her initial intake at Kaiser in Anaheim, California, Plaintiff complained of anxiety and depression. (AR 356). Her reported symptoms included tearfulness, anhedonia, fluctuating weight, insomnia, irritability, fatigue, feeling worthless, reduced concentration and memory, panic, lack of consistent motivation, and conflict with friends. (AR 357-58). She denied psychosis and homicidal or suicidal ideations. (AR 358). A mental status examination was largely unremarkable. (AR 359). Although her mood was depressed and anxious, her appearance, behavior, affect, motor activity, speech, orientation, alertness, memory, insight, judgment, thought form, and thought content were all normal. (AR 359). Plaintiff was diagnosed with major depression and panic disorder and assigned a GAF score of 51 to 60.
On March 19, 2015, Plaintiff was "feeling a little tired, but pretty good." (AR 434). She reported working on wedding plans for her friend. (AR 434). Other than an anxious and depressed mood, a mental status examination was unremarkable. (AR 423). Dr. Dom discontinued Seroquel due to concerns about cardiac side effects and started Risperdal. (AR 423-24). On March 27, Plaintiff reported side effects of headaches and dizziness. (AR 441). She also reported that anxiety and mood symptoms have worsened significantly since tapering off of Seroquel. (AR 441). On examination, Plaintiff's mood was anxious and depressed and her affect restricted and congruent. (AR 442). Dr. Dom diagnosed bipolar I disorder and panic disorder and assigned a GAF score of 50 to 55. (AR 442). Dr. Dom discontinued Risperdal and started Trileptal. (AR 442). On April 22, Plaintiff reported that Trileptal was ineffective at controlling either her anxiety or her depression. (AR 452). Dr. Dom discontinued Trileptal and started Abilify. (AR 453).
On May 6, 2015, Plaintiff reported anxiety when looking online for jobs. (AR 464). On May 12, Plaintiff reported side effects of occasional hand tremors and restlessness and no significant improvements in mood with Abilify. (AR 471). Plaintiff is making an effort to engage in social activities, including attending church functions. (AR 471). Dr. Dom discontinued Abilify due to the side effects and started Latuda. (AR 472). On May 28, Plaintiff reported that she had stopped Latuda due to side effects of palpitations and chest pressure and was taking herbal medications. (AR 487). Her depression is better but she experiences almost daily panic attacks. (AR 487). Plaintiff is able to engage in social activities and will be going to Utah to help her grandmother move into nursing home for three weeks beginning in June. (AR 487, 502). Other than an anxious mood and a restricted and congruent affect, a mental status examination was unremarkable. (AR 488). On July 17, Plaintiff reported that she has been more stable with herbal medications. (AR 509). She has mood swings but is generally able to control them. (AR 509). Other than an anxious mood and a restricted and congruent affect, a mental status examination was normal. (AR 510). Dr. Dom diagnosed bipolar I disorder and panic disorder, prescribed hydroxyzine, and assigned a GAF score of 55. (AR 510). On September 1, Plaintiff reported that she had stopped hydroxyzine because it caused her to be too sedated the next day. (AR 532). Because her depression has worsened and she was experiencing daily panic attacks, Plaintiff was open to trying psychotropic medications. (AR 532). Other than an anxious and depressed mood and a restricted and congruent affect, a mental status examination was unremarkable. (AR 533). Dr. Dom prescribed Zyprexa and Prozac. (AR 534).
On August 12, 2014, Pamela Hawkins, Ph.D, a state agency consultant, evaluated the mental health records and concluded that Plaintiff's anxiety and depression are nonsevere. (AR 81). She opined that Plaintiff has a mild restriction of activities of daily living, mild difficulties in maintaining social functioning, and mild difficulties in maintaining concentration, persistence or pace. (AR 81). Dr. Hawkins concluded that Plaintiff's mental impairments do not significantly limit her ability to do basic work activities. (AR 82). On September 3, 2014, R.E. Brooks, M.D., concurred with Dr. Hawkins's assessment. (AR 90-92).
To qualify for disability benefits, a claimant must demonstrate a medically determinable physical or mental impairment that prevents the claimant from engaging in substantial gainful activity and that is expected to result in death or to last for a continuous period of at least twelve months.
To decide if a claimant is entitled to benefits, an ALJ conducts a five-step inquiry. 20 C.F.R. §§ 404.1520, 416.920. The steps are:
The claimant has the burden of proof at steps one through four and the Commissioner has the burden of proof at step five.
The ALJ employed the five-step sequential evaluation process and concluded that Plaintiff was not disabled within the meaning of the Social Security Act. (AR 17-25). At step one, the ALJ found that Plaintiff has not engaged in substantial gainful activity since September 9, 2013, her alleged onset date. (AR 19). At step two, the ALJ found that Plaintiff's bipolar disorder, anxiety disorder, and panic disorder are severe impairments.
The ALJ then assessed Plaintiff's RFC and concluded that she can perform a full range of work at all exertional levels but with the following nonexertional limitations: "she is limited to work involving simple[,] repetitive tasks; she is limited to work involving no more than occasional contact with coworkers; and she is limited to work involving no public contact." (AR 21). At step four, the ALJ found that Plaintiff is unable to perform any past relevant work. (AR 23-24). Based on Plaintiff's RFC, age, education, work experience, and the VE's testimony, the ALJ determined at step five that there are jobs that exist in significant numbers in the national economy that Plaintiff can perform, including packager and assembler. (AR 24-25). Accordingly, the ALJ found that Plaintiff was not under a disability, as defined by the Social Security Act, from September 9, 2013, through the date of the decision. (AR 25).
Under 42 U.S.C. § 405(g), a district court may review the Commissioner's decision to deny benefits. The court may set aside the Commissioner's decision when the ALJ's findings are based on legal error or are not supported by substantial evidence in the record as a whole.
"Substantial evidence is more than a scintilla, but less than a preponderance."
Plaintiff asserted that she is unable to work due to severe panic attacks that cause extreme dizziness, shaking, nausea, diarrhea, inability to focus, anxiety, paranoia, and insomnia. (AR 57, 169-70, 223). She also asserted that her mental impairments affect her vision, memory, and concentration. (AR 174). Plaintiff testified that social functions, being on the phone, and looking for work exacerbate her panic attacks. (AR 57).
When assessing a claimant's credibility regarding subjective pain or intensity of symptoms, the ALJ must engage in a two-step analysis.
If the claimant satisfies this first step, and there is no evidence of malingering, the ALJ must provide specific, clear and convincing reasons for rejecting the claimant's testimony about the symptom severity.
In discrediting the claimant's subjective symptom testimony, the ALJ may consider the following:
Further, the ALJ must make a credibility determination with findings that are "sufficiently specific to permit the court to conclude that the ALJ did not arbitrarily discredit claimant's testimony."
The ALJ provided multiple, specific, clear, and convincing reasons, supported by evidence in the record, to find Plaintiff's complaints of disabling anxiety, panic attacks, and mental symptomology only partially credible. (AR 30). These reasons are sufficient to support the Commissioner's decision.
First, the ALJ found that Plaintiff's statements were internally inconsistent. (AR 23). "[T]he ALJ may consider inconsistencies either in the claimant's testimony or between the testimony and the claimant's conduct."
Second, Plaintiff's allegations were inconsistent with her acknowledged activities of daily living. (AR 23). "ALJs must be especially cautious in concluding that daily activities are inconsistent with testimony about pain, because impairments that would unquestionably preclude work and all the pressures of a workplace environment will often be consistent with doing more than merely resting in bed all day."
Plaintiff contends that "[e]vidence that a claimant can participate in basic human function `is not determinative of disability.'" (Dkt. No. 19 at 10) (quoting
Third, the ALJ found that Plaintiff's acknowledged work search contradicts her allegation of disabling panic attacks and other symptoms. (AR 23). Throughout the medical record, Plaintiff reported that she was applying and looking for work. (AR 284, 319, 464). The ALJ properly concluded that Plaintiff's actions were inconsistent with being disabled from all types of employment. (AR 23);
Plaintiff argues that "[a]ll [Plaintiff's job search] demonstrates is that the stress of working or looking for work in hopes of being able to work again one day is consistent with [her] testimony." (Dkt. No. 19 at 13). The ALJ found, however, that Plaintiff's acknowledged job search activities contradict her statements that she is unable to be on the phone and interact with people. (AR 21, 23). Further, as Plaintiff acknowledged in her brief, she "reported in July 2013 that her current job was causing her stress and she was looking for a new job." (Dkt. No. 19 at 12). This is consistent with the ALJ's finding that Plaintiff cannot perform any past relevant work but that there are simple, repetitive jobs, with no more than occasional contact with coworkers and no public contact, in the national economy that she can perform. (AR 21-25).
Fourth, the ALJ found that Plaintiff's allegations of disabling anxiety, chronic panic attacks, and severe depression were inconsistent with the objective medical evidence, which indicated that "[h]er condition waxed and waned with treatment." (AR 21-22). While inconsistencies with the objective medical evidence cannot be the
Plaintiff does not identify any relevant medical evidence overlooked by the ALJ. Instead, she contends that the ALJ's subjective symptom analysis was contrary to law. (Dkt. No. 19 at 7-9). However, as discussed above, the ALJ's analysis was consistent with the law and supported by specific, clear, and convincing reasons for rejecting Plaintiff's testimony. Furthermore, the ALJ did not completely reject Plaintiff's testimony. (AR 21-23). Indeed, partly because of Plaintiff's subjective statements that the ALJ found credible, the ALJ rejected Dr. Parikh's assessments and those of the State agency mental consultants, who found that Plaintiff's mental impairments were nonsevere. (AR 22, 23;
In sum, the ALJ offered clear and convincing reasons, supported by substantial evidence in the record, for his adverse credibility findings. Accordingly, because substantial evidence supports the ALJ's assessment of Plaintiff's credibility, no remand is required.
Consistent with the foregoing, IT IS ORDERED that Judgment be entered AFFIRMING the decision of the Commissioner. The Clerk of the Court shall serve copies of this Order and the Judgment on counsel for both parties.
