KAREN E. SCOTT, Magistrate Judge.
Plaintiff Oscar Garcia Lopez ("Plaintiff") appeals the final decision of the Administrative Law Judge ("ALJ") denying his application for Social Security Disability Insurance benefits ("DIB") and Supplemental Security Income ("SSI"). For the reasons discussed below, the ALJ's decision is AFFIRMED.
Plaintiff applied for DIB and SSI on March 4, 2013, alleging the onset of disability on December 1, 2007, when he was 31 years old. Administrative Record ("AR") 194-99, 200-06. He later withdrew his SSI claim and alleged the application filing date as the date of onset. AR 30.
On January 29, 2015, an ALJ conducted a hearing, at which Plaintiff, who was represented by counsel, appeared and testified. AR 27-58. On March 13, 2015, the ALJ issued a written decision denying Plaintiff's request for benefits. AR 7-26.
The ALJ found that Plaintiff had the severe impairments of "obesity, depression, diabetes, and right knee degenerative disc disease." AR 13. The ALJ did not find that Plaintiff has any severe mental impairments other than depression.
The ALJ also found that Plaintiff "does not have a medically determinable organic brain disorder, intellectual disability, borderline intellectual functioning ("BIF") disorder, or other cognitive disorder. . . ." AR 13. The ALJ acknowledged that while Drs. Unwalla and Larson had diagnosed Plaintiff with BIF and cognitive disorder, the ALJ found those diagnoses unreliable to the extent they were based on Plaintiff's self-reported symptoms and tests administered by the doctors, because Plaintiff "is not a reliable historian or test taker."
Notwithstanding his impairments, the ALJ concluded that Plaintiff had the residual functional capacity ("RFC") to perform a reduced range of light work. AR 15-16. In addition to exertional limitations, the ALJ determined that Plaintiff is "capable of semi-skilled work that can be learned through demonstration; and no fast-paced work." AR 16. The ALJ based this determination on the fact that Plaintiff admitted he had previously performed semi-skilled work as a machine operator and that he learned that work through direct demonstration. AR 31-32, 41-42.
Based on this RFC and the testimony of a vocational expert ("VE"), the ALJ found that Plaintiff would be able to perform the unskilled jobs of electronics worker, shoe packer, and sewing machine operator. AR 22. The ALJ therefore concluded that Plaintiff is not disabled.
Plaintiff raises only one issue: whether the ALJ properly considered the opinions of two examining doctors, Khushro Unwalla, M.D. (a psychiatrist) and Douglas W. Larson, Ph.D. (a psychologist), concerning the disabling effects of Plaintiff's mental impairments.
In determining a claimant's RFC, the ALJ must consider limitations imposed by all of the claimant's impairments, even those that are not severe, and evaluate "all of the relevant medical and other evidence," including the claimant's testimony. SSR 96-8p, 1996 SSR LEXIS 5. However, if a claimant makes "no allegation of a physical or mental limitation or restriction of a specific functional capacity, and [there is] no information in the case record that there is such a limitation or restriction, the adjudicator must consider the individual to have no limitation or restriction with respect to that functional capacity."
In determining the limitations imposed by a claimant's impairments, the ALJ must consider the medical evidence and resolve conflicts. If the record contains evidence "susceptible to more than one rational interpretation, we must uphold the [Commissioner's] findings if they are supported by inferences reasonably drawn from the record."
In deciding how to resolve conflicts between medical opinions, the ALJ must consider that there are three types of physicians who may offer opinions in Social Security cases: (1) those who directly treated the plaintiff, (2) those who examined but did not treat the plaintiff, and (3) those who did not treat or examine the plaintiff.
If the treating physician's opinion is uncontroverted by another doctor, it may be rejected only for "clear and convincing" reasons.
In determining a claimant's RFC, the ALJ should consider those limitations for which there is support in the record, but need not consider properly rejected evidence.
Dr. Unwalla conducted a psychiatric examination of Plaintiff on May 18, 2013. AR 392-98. Dr. Unwalla took a medical history and performed a mental status examination. AR 392-94. Plaintiff reported to Dr. Unwalla that he was "kicked out of school" due to behavioral problems in the eighth grade and never learned to read or write. AR 392. Plaintiff further reported that he lived with his parents and his three children.
Upon administering a mental status exam, Dr. Unwalla observed that Plaintiff had "some thought blocking," "poverty of thought content," could not do serial threes, had "poor" insight and judgment, and a "poor" fund of knowledge. AR 394. He also noted slowed and soft speech, blunted affect, and diminished concentration.
Dr. Unwalla noted "no specific mental health issues except intellectual deficits."
AR 395.
Dr. Larson conducted a psychological examination on June 27, 2013. AR 399-407. Dr. Larson took a medical history, performed a mental status examination, and conducted several memory and intelligence tests. AR 399-403. Dr. Larson described Plaintiff as "generally pleasant and cooperative" but "slow." AR 401. Dr. Larson noted "somewhat slowed" speech, "somewhat impaired" thought process, mild poverty of thought content, "reduced" memory and concentration, and "limited" insight and judgment.
Plaintiff reported to Dr. Larson that he had a driver's license, but had not driven in three months.
AR 403.
The ALJ agreed that Plaintiff has "moderate" impairments with regard to concentration, persistence, and pace. AR 15. The ALJ, however, found that Plaintiff's limitations in the areas of daily living and social functioning were only "mild." AR 14. With regard to his activities of daily living, the ALJ cited the fact that Plaintiff was "able to do his own grocery shopping without assistance" citing Ex. 2F p. 83
The ALJ expressly found a "lack of evidence" that Plaintiff's depression more than mildly impairs his social functioning. AR 20. The ALJ cited the fact that Plaintiff reported his family relationships as "good"
In discussing Dr. Unwalla's opinions, the ALJ noted that they were based, in part, on limitations reported by Plaintiff which the ALJ found not credible due to inconsistencies. For example, Dr. Unwalla noted that Plaintiff never learned to read, yet Plaintiff testified at the hearing that he had passed the written driver's license test and could "more or less" read. AR 19, citing AR 34, 392. When the ALJ asked if he could read instructions "on the side of a box on how to prepare something in a microwave," Plaintiff answered, "No — maybe, yes." AR 34. Dr. Unwalla noted that Plaintiff said he does not do any shopping, but Plaintiff told his Kaiser doctors that he could "do shopping without assistance." AR 19, citing AR 359, 393.
The ALJ also reasoned that Dr. Unwalla's findings were not corroborated by objective evidence outside of the tests he administered which could be manipulated by Plaintiff. AR 19, 20. The ALJ concluded that Plaintiff had likely manipulated the test results for a number of reasons. First, the ALJ cited inconsistencies in Plaintiff's statements concerning the severity of his impairments. AR 17. Second, the ALJ cited the fact that Plaintiff had performed semi-skilled work in the past, which is inconsistent with him suffering from disabling cognitive impairments. AR 19, citing Plaintiff's hearing testimony at AR 39-42. Third, the ALJ cited Plaintiff's "poor work history," suggesting that Plaintiff was capable of working but unmotivated to maintain employment.
The ALJ discounted Dr. Larson's opinions for the same reasons that he discounted Dr. Unwalla's opinions. AR 20. The ALJ repeated that Plaintiff "is not a reliable historian or test taker."
First, Plaintiff focuses on the opinion of Dr. Unwalla that Plaintiff would have "moderate limitations completing a normal workday or workweek due to [his] mental condition" and the opinion of Dr. Larson that Plaintiff is moderately impaired "in the ability to comply with job rules such as safety and attendance." JS at 8, citing AR 395, 403. Plaintiff argues that the "ability to maintain work activity on a consistent basis without excessive absenteeism is the hallmark of substantial gainful work activity," and the ALJ did not give sufficient reasons for discounting the attendance-related opinions of Drs. Unwalla or Larson.
Second, Plaintiff argues that the ALJ did not adequately account for Plaintiff's moderate difficulties with concentration, persistence, and pace. Plaintiff contends that someone with moderate difficulties in this area will need regular reminders to stay on task. JS at 8-9. During the hearing, the ALJ asked the VE whether a hypothetical worker with Plaintiff's RFC who also needed "regular reminders on how to perform their job and reminders to stay on task" would be able to perform the jobs of electronics worker, shoe packer, and sewing machine operator. AR 57. The VE responded that he would not.
Third, Plaintiff argues that the ALJ may not discount the opinions of mental health professionals for the same reasons that the ALJ discounted Plaintiff's testimony concerning the severity of his symptoms (i.e., that Plaintiff is not a reliable historian or test taker). According to Plaintiff, if Drs. Unwalla and Larson deemed Plaintiff's answers to mental status exam questions sufficiently reliable to provide a basis for their opinions, then the ALJ cannot second-guess those answers. JS at 10, citing
Respondent argues that the ALJ's failure to credit some of the "moderate" limitations found by Drs. Larson and Unwalla is, at worst, harmless error. JS at 16. Respondent points out that mental impairments causing only moderate limitations in the ability to maintain regular attendance and stay on-task while at work need not be accommodated through limitations in the RFC.
First, the ALJ properly discounted the opinions of Drs. Unwalla and Larson as inconsistent with Plaintiff's known history of performing semi-skilled work. Plaintiff testified that he was a "machine operator" for Tree Island Wire. AR 31. He operated a machine that fabricated "the wire that goes outside of a house before . . . the stucco."
The VE testified that this was semi-skilled work with a reasoning level of 3. AR 41. The Dictionary of Occupational Titles ("DOT") specifies the "reasoning level" required for each listed job using six defined levels. Reasoning Level 1 requires the ability to "carry out simple one- or two-step instructions," whereas Reasoning Level 6 requires the application of "principles of logical or scientific thinking to a wide range of intellectual and practical problems."
Dr. Unwalla's opinion that Plaintiff suffers from "borderline intellectual functioning" and would have moderate difficulty performing even simple, repetitive tasks (AR 395) is inconsistent with Plaintiff's history of working a job requiring Reasoning Level 3 and only leaving that job when its exertional demands (i.e., standing all day) diminished his output, causing his employer to let him go. So too Dr. Larson's opinions that Plaintiff is "moderately" impaired in interacting with others, complying with job site rules, and responding to changes in a "normal" workplace setting (AR 403) are inconsistent with Plaintiff's having worked as a machine operator for eight months until the job's exertional demands became too difficult. Thus, the inconsistency identified by the ALJ is supported by substantial evidence in the record.
Second, an ALJ may discount medical opinions that rely on the claimant's subjective complaints where the ALJ has properly discounted the claimant's credibility.
The ALJ's determination that Plaintiff was unreliable was, in turn, supported by substantial evidence in the record. As noted above, Plaintiff made inconsistent statements about his ability to shop unassisted (
Third, the ALJ rejected the opinions of Dr. Unwalla and Larson that Plaintiff has "moderate" difficulty interacting with others based on "lack of evidence." AR 20. Indeed, the record shows that Plaintiff reported (1) his family relationships were "good" (AR 394), (2) he got along "well" with authority figures (AR 258-59), (3) he sometimes attended church (AR 48, 257), and (4) he never received treatment for depression, social anxiety, or any similar mental disorder that would impair his social interactions (AR 391, 426). Thus, the ALJ properly concluded that the opinions of Drs. Unwalla and Larson concerning Plaintiff's social functioning were inconsistent with the record as a whole.
"A decision of the ALJ will not be reversed for errors that are harmless."
Here, the ALJ accounted for Plaintiff's moderate difficulties in maintaining concentration, persistence, and pace by limiting him to jobs that do not require fast-paced work and that can be learned by demonstration. The ALJ properly discredited the opinions of Drs. Unwalla and Larson that Plaintiff has moderate difficulty in the area of social functioning. The other "moderate" limitations found by Drs. Unwalla and Larson (i.e., moderate difficulties with attendance, completing a normal workday, working without special supervision, and responding to change) are comparable to the limitations discussed in
Based on the foregoing, IT IS ORDERED THAT judgment shall be entered AFFIRMING the decision of the Commissioner denying benefits.