ANDREW J. WISTRICH, Magistrate Judge.
Plaintiff seeks reversal of the decision of defendant, the Acting Commissioner of Social Security (the "Commissioner"), denying plaintiff's applications for supplemental security income and disability insurance benefits. The parties have filed a Joint Stipulation ("JS") setting forth their respective contentions.
The procedural facts are undisputed and are summarized in the Joint Stipulation. [
The Commissioner's denial of benefits should be disturbed only if it is not supported by substantial evidence or is based on legal error.
Plaintiff contends that the ALJ impermissibly rejected the controverted opinion of examining psychologist Lance Portnoff, Ph.D. [JS 3].
In general, "[t]he opinions of treating doctors should be given more weight than the opinions of doctors who do not treat the claimant."
The opinion of a non-examining physician normally is entitled to less deference than that of an examining and treating physician precisely because the non-examining physician does not have the opportunity to conduct an independent examination and does not have a treatment relationship with the claimant.
The ALJ found that plaintiff had no severe physical impairments and severe mental impairments consisting of bipolar disorder, borderline intellectual functioning, and a history of substance abuse. [AR 13]. The ALJ determined that plaintiff retained the RFC to perform a full range of work at all exertional levels, but that he was limited to simple, routine tasks and occasional contact with the public and coworkers. [AR 16]. In assessing plaintiff's RFC, the ALJ said that he gave "substantial weight" to Dr. Portnoff's opinion, "greatest weight" to the opinion of consultative psychiatrist Elmo Lee, M.D., and "significant" weight to the opinions of the nonexamining state agency consultants, A. Franco, Psy. D., and Andres Kerns, Ph.D. [AR 17-19]. Plaintiff contends that the ALJ improperly rejected Dr. Portnoff's opinion.
On March 5, 2011, Dr. Portnoff performed a comprehensive psychological evaluation at the Commissioner's request. Dr. Portnoff elicited a history, conducted a mental status examination, and administered psychological tests to measure comprehension, processing speed, memory, and perceptual reasoning, among other things. [
Dr. Portnoff diagnosed bipolar II disorder and cognitive disorder not otherwise specified ("NOS"). Dr. Portnoff opined that plaintiff had moderate limitations in the ability to perform detailed and complex tasks, accept instructions from supervisors, interact with coworkers and the public, complete a normal workday or workweek without interruptions from a psychiatric condition, and deal with the stress encountered in a competitive work environment. [AR 253-254]. Plaintiff was mildly impaired "in his ability to work on a consistent basis without special or additional instruction due to problems with concentration." [AR 254]. Dr. Portnoff concluded that plaintiff retained the ability to perform simple, repetitive tasks and to manage his own money. [AR 253-254].
On July 8, 2012, Dr. Lee conducted a comprehensive psychiatric examination at the Commissioner's request. Dr. Lee elicited a history and conducted a mental status examination. [AR 280-281]. Among other things, plaintiff reported that he had been participating in a dual-diagnosis residential sober-living program since February 2012. [AR 177-179]. Dr. Lee's diagnoses were alcohol abuse, cannabis abuse, substance induced mood disorder, and bipolar disorder by history. He opined that plaintiff's "psychiatric symptoms are directly related to his substance abuse history." [AR 281]. He stated that plaintiff was not capable of managing his funds as a result of "his significant substance abuse issues." [AR 281]. Dr. Lee opined that plaintiff could perform simple and repetitive tasks as well as detailed and complex tasks, and that plaintiff could work without special or additional instructions. Dr. Lee opined that plaintiff was not limited in the following work-related functional abilities and would remain so provided "he remains sober and continues with his current psychiatric treatment": accepting instructions from supervisors, interacting with coworkers and the public, maintaining regular attendance, and completing a normal workday and work week without interruption due to his psychiatric condition. [AR 281-282].
In his decision, the ALJ said that he credited both doctors' opinions, giving "substantial weight" to Dr. Portnoff's report and "greatest weight" to Dr. Lee's report. The ALJ said that he gave more weight to Dr. Lee's findings "the record as a whole amply supports this opinion." [AR 20]. The ALJ concluded that Dr. Portnoff's opinion "is supportive of" Dr. Lee's opinion, and that Dr. Lee's report was entitled to the most weight because he examined plaintiff most recently and "had more of the medical evidence of record available to him." [AR 20].
While Dr. Lee examined plaintiff sixteen months after Dr. Portnoff, Dr. Lee said he had "only the list of allegations" from plaintiff's record, so the ALJ wrongly concluded that Dr. Lee's opinion was based on a more complete medical record. [AR 277]. Nonetheless, the ALJ reasonably concluded that Dr. Lee's opinion was supported by the record as a whole. The record does not include a treating source opinion regarding plaintiff's ability to perform work-related functional activities. Both Dr. Portnoff and Dr. Lee were one-time examining physicians who based their opinions on independent clinical findings. Although Dr. Lee did not administer psychological tests, he had the benefit of a more accurate and complete history, especially plaintiff's history of substance abuse, which Dr. Lee opined was "directly related" to plaintiff's psychiatric symptoms. That aspect of Dr. Lee's opinion is broadly consistent with Dr. Portnoff's observation that plaintiff's testing profile was "more than what would be expected from the neuropsychology of bipolar/depressive disorder alone," and that in the absence of a specific history of "an alcohol/drug encephalopathy" or learning disabilities, a diagnosis of generic cognitive disorder NOS was warranted. [AR 253].
Furthermore, Dr. Portnoff and Dr. Lee agreed that plaintiff could perform at least simple, repetitive tasks and had no more than mild limitations in his ability to work without special or additional instructions. While only Dr. Portnoff assessed the additional "moderate" functional limitations in accepting instructions from supervisors, interacting with coworkers and the public, completing a normal workday or work week without interruptions from a psychiatric condition, and dealing with the stress of a competitive work environment, the ALJ adequately captured some of those limitations by adopting the state agency medical consultants' opinion that plaintiff was limited to only occasional interaction with coworkers and the public.
As for the remaining moderate functional limitations endorsed by Dr. Portnoff, the ALJ was entitled to resolve the conflict between the consultative examining source opinions by rejecting those limitations.
Plaintiff's contention that the ALJ improperly disregarded or gave too little weight to Global Assessment of Function ("GAF") scores lacks merit. "A GAF score is a rough estimate of an individual's psychological, social, and occupational functioning used to reflect the individual's need for treatment."
As plaintiff notes, Dr. Portnoff gave plaintiff a GAF score of 58, indicating moderate symptoms or moderate difficulty in social, occupational, or school functioning. Dr. Lee, on the other hand, gave plaintiff a GAF score of 65, indicating mild symptoms or mild functional difficulties. The ALJ did not err in failing to mention Dr. Portnoff's GAF score because he discussed Dr. Portnoff's narrative opinion, including the moderate mental functional limitations Dr. Portnoff assessed. For the reasons described above, the ALJ permissibly adopted some, but not all, of those limitations, so a separate discussion of the GAF score was not required and would not have been useful. Other providers gave plaintiff GAF scores between 50 and 60, with one assigning a GAF score of 48. As plaintiff notes, however, those "GAF scores were not accompanied by an analysis" or by any medical opinion regarding plaintiff's ability to work, so the ALJ did not err in failing to discuss those scores. [JS 6-8;
For all of these reasons, the ALJ did not err in evaluating the medical opinion evidence.
Plaintiff contends that the ALJ erred in evaluating the credibility of his subjective symptoms. [JS 3].
Once a disability claimant produces evidence of an underlying physical or mental impairment that could reasonably be expected to produce the pain or other subjective symptoms alleged, the adjudicator is required to consider all subjective testimony as to the severity of the symptoms.
The ALJ partially credited plaintiff's subjective allegations about his depression, anxiety, and social difficulties by restricting him to simple, routine tasks with occasional contact with the public and coworkers.
In addition, the ALJ remarked that no treating source opined that plaintiff was disabled or assessed functional limitations, while Dr. Lee and the state agency medical consultants opined that plaintiff could work.
The ALJ also was entitled to rely in part on inconsistent statements plaintiff made about the nature and extent of his alcohol and drug use. The ALJ pointed to several such statements, not merely one as plaintiff contends. [
The ALJ articulated clear and convincing reasons, supported by substantial evidence in the record, for his partial rejection of plaintiff's subjective complaints.
Plaintiff contends that the ALJ did not adequately support his decision to give little weight to the third-party function report prepared by Heather Hopmans, plaintiff's live-in girlfriend and the mother of one of his children. [AR 208-216].
"[F]riends and family members in a position to observe a claimant's symptoms and daily activities are competent to testify as to [the claimant's] condition."
The ALJ said that he gave "little weight" to Ms. Hopmans's lay testimony because her status as his live-in girlfriend and the mother of his child gave her a financial interest in helping plaintiff obtain benefits, and because her statements "essentially are the same" as plaintiff's subjective allegations, which the ALJ discredited. [AR 19].
The ALJ erred in rejecting Ms. Hopmans's lay testimony because she was plaintiff's girlfriend and lived with him. "[T]he fact that a lay witness is a family member cannot be a ground for rejecting his or her testimony. To the contrary, testimony from lay witnesses who see the claimant everyday is of particular value; such lay witnesses will often be family members."
The ALJ's error was harmless, however, because he articulated a second, germane reason for not finding Ms. Hopmans' fully credible, namely, the similarity between her statements in the function report and plaintiff's subjective allegations.
The statements made by plaintiff's girlfriend in her function report were similar to plaintiff's description of his subjective symptoms. Plaintiff was living in the sober-living facility at the time the reports were completed. [AR 208, 216]. Ms. Hopmans said that she saw plaintiff daily for meals and for walks. [AR 208]. Both Ms. Hopmans and plaintiff said that he exhibits a lot of anxiety and a sense of impending doom. [AR 209, 214, 222]. Ms. Hopmans said that plaintiff "loses patience quickly" while preparing a meal, while plaintiff wrote he "just gets frustrated" when he makes food for himself. [AR 210, 218]. Ms. Hopmans described plaintiff as "often irritable and very impatient" when dealing with other people. [AR 213]. She asserted that plaintiff "needs things to be explained in detail, more than once. [He] can't concentrate easily, is impatient with most people." [AR 213]. She added that he had past problems getting along with coworkers and had trouble handling stress. [AR 214]. Plaintiff said that he did not "like people and they make me paranoid. . . . I can't always get along with others . . . ." [AR 221]. He also said that he did not handle stress well. [AR 222]. Ms. Hopmans and plaintiff described his activities of daily living as including attending group meetings, counseling, and appointments; going on walks; making meals a few days a week; washing dishes; going outside daily; food shopping one to three times weekly; paying bills, using a check book, and handling a bank account; watching television daily; and spending time with others on a daily basis talking and smoking cigarettes. [AR 208-223].
In limiting plaintiff to simple, routine work with only occasional contact with the public and coworkers, the ALJ gave some weight to the testimony from plaintiff and his girlfriend regarding his difficulty in social functioning and his problems with impatience, frustration, and difficulty understanding, concentrating on, and completing tasks. As the ALJ noted, however, plaintiff's subjective complaints of disabling social difficulties was undermined by his ability to live in a dual-diagnosis sober-living facility for two years, successfully complete that residential program, and attend twelve-step group meetings and therapy during and after completing that two-year program. Plaintiff's ability to perform a variety of daily activities, the absence from the record of any treating source disability opinion, and the opinions of Dr. Lee and the state agency medical consultants, including the evidence on which they relied, all tended to undermine the credibility of the testimony from plaintiff and Ms. Hopmans.
Since the ALJ articulated a germane reason for not fully crediting plaintiff's girlfriend's lay witness testimony, any error resulting from his reliance on a second, defective reason was harmless.
For the reasons stated above, the Commissioner's decision is based on substantial evidence and is free of reversible legal error. Accordingly, the Commissioner's decision is