JAMES R. KLINDT, Magistrate Judge.
Diane Simons ("Plaintiff") is appealing the Commissioner of the Social Security Administration's final decision denying her claim for disability insurance benefits ("DIB"). Her alleged inability to work is based on her "[a]nxiety, memory loss, lack of concentration, [and] lack of staying on task," and based on her bi-polar disorder and manic depressive disorder.
When determining whether an individual is disabled,
In addition, the Social Security Act "preclude[s] the award of benefits when alcoholism or drug addiction is determined to be a contributing factor material to the determination that a claimant is disabled."
Here, the ALJ followed the five-step sequential inquiry.
The second five-step sequential inquiry was performed as "[i]f [Plaintiff] stopped all substance use." Tr. at 22. At step two, the ALJ determined that Plaintiff's "remaining impairments would cause more than a minimal impact on [her] ability to perform basic work activities; therefore, [Plaintiff] would continue to have a severe impairment or combination of impairments." Tr. at 22 (emphasis omitted). At step three, the ALJ found that Plaintiff "would not have an impairment or combination or impairments that meets or medically equals the criteria of any impairment listed in 20 CFR Part 404, Subpart P, Appendix 1." Tr. at 22 (emphasis and citation omitted).
The ALJ determined Plaintiff's residual functional capacity ("RFC") as follows:
Tr. at 23 (emphasis omitted). At step four, the ALJ found that "[Plaintiff] would be unable to perform her past relevant work," as a "practical nurse." Tr. at 24 (emphasis and citation omitted from first quotation). At step five, after "[c]onsidering [Plaintiff's] age, education, work experience, and [RFC]," the ALJ found that "there would be a significant number of jobs in the national economy that [Plaintiff] could perform," including housekeeper, mail clerk, and office helper. Tr. at 24-25 (emphasis and citation omitted). The ALJ determined that Plaintiff's "substance use disorder is a contributing factor material to the determination of disability, because she would no longer be disabled if she stopped all substance use." Tr. at 25 (emphasis omitted). Therefore, concluded the ALJ, "[Plaintiff] has not been disabled. . . at any time from the alleged onset date through the date of th[e D]ecision." Tr. at 25 (emphasis omitted).
This Court reviews the Commissioner's final decision as to disability pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). Although no deference is given to the ALJ's conclusions of law, findings of fact "are conclusive if . . . supported by `substantial evidence'. . . ."
Plaintiff alleges three (3) specific points of error: 1) "[t]he ALJ improperly determined that substance abuse was a material factor contributing to [Plaintiff's] disability"; 2) "[t]he ALJ improperly determined [Plaintiff] was capable of light work"; and 3) "[t]he ALJ failed to give special weight to [Plaintiff's] treating physicians as required by law." Memorandum in Support of Complaint (Doc. No. 18; "Pl.'s Mem."), filed November 30, 2012, at 2. Although Plaintiff delineates these points of error as three (3) separate issues, Plaintiff relies solely on the opinion of one treating physician, James Moore, M.D. ("Dr. Moore"), to support her contentions.
On May 27, 2011, Dr. Moore completed a "Physician Questionnaire," Tr. at 461-65, in which he opined that Plaintiff is "[u]nable to meet competitive standards" in the categories listed under mental abilities and aptitudes needed to do unskilled, semi-skilled, and skilled work, as well as in the categories listed under mental abilities and aptitude needed to do particular types of jobs, Tr. at 463-64. Dr. Moore noted that prior to completing the questionnaire, he saw Plaintiff four (4) times beginning in October 2010. Tr. at 461. He listed Plaintiff's medications as seroquel, abilify, and xanax, and he indicated that Plaintiff has short term memory loss as a side effect of one or more of those medications. Tr. at 461. In response to the question that asks the physician to "[d]escribe the clinical findings including results of mental status examination that demonstrate the severity of your patient's mental impairment and symptoms," Dr. Moore wrote "see office notes." Tr. at 461. He opined that Plaintiff's prognosis is "guarded." Tr. at 461. He further opined that Plaintiff would miss more than four (4) days per month of work. Tr. at 465.
Of particular importance to this Court's analysis, Dr. Moore indicated that Plaintiff has signs and symptoms of "intermittent" substance dependence, Tr. at 462, and that Plaintiff's alcohol or substance abuse contributes to her limitations, Tr. at 465. Dr. Moore left blank the space provided to list the limitations affected by Plaintiff's alcohol or substance abuse and the space provided to explain the changes he would make to his description of Plaintiff's limitations if she were totally abstinent from alcohol or substance abuse. Tr. at 465.
Dr. Moore's treatment notes reflect the following. On August 17, 2010, Dr. Moore saw Plaintiff, who was accompanied by her husband. Tr. at 405. He noted that Plaintiff's last hospitalization was April 1, 2010 and "[i]t was alcohol related." Tr. at 405. After a discussion with Plaintiff and her husband, including a discussion of the "dangers of combining Xanax with alcohol," Dr. Moore noted his belief that Plaintiff "has rapid cycling/mixed state." Tr. at 405. Dr. Moore's September 14, 2010 treatment note reflects, in total, that Plaintiff "stopped the Lamictal because she thought it was really messing up her memory. Memory has improved some. She still has racing thoughts." Tr. at 407.
On March 18, 2011, Dr. Moore again saw Plaintiff. Tr. at 466-67. His notes reflect that she was "seen at her request with her husband." Tr. at 467. At that time, her medications were abilify and xanax. Tr. at 467. She reported to Dr. Moore that "[s]he currently uses alcohol" and that "[s]he consumes varuabke [sic] alcoholic beverages per week." Tr. at 466. Dr. Moore, Plaintiff, and Plaintiff's husband "spent over 30 minutes discussing [Dr. Moore's] assessment that the main problem is [Plaintiff's] borderline personality disorder and [Plaintiff and her husband's] interpersonal difficulties and the[ ] significant danger of xanax, especially in conjunction with alcohol." Tr. at 467. Dr. Moore diagnosed Plaintiff with "borderline personality," "nondependent alcohol abuse," and "bipolar affective mixed mod [sic]." Tr. at 467 (capitalization omitted).
Plaintiff reported to Dr. Moore on May 11, 2011 that "seroquel has caused great improvement" in that "she is less moody." Tr. at 468. Plaintiff also reported some family situations that were causing her angst. Tr. at 468. Dr. Moore's diagnoses generally remained the same as they were on March 18, 2011: "bipolar affective mixed mild," "nondependent alcohol abuse," and "borderline personality." Tr. at 468 (capitalization omitted). Plaintiff was to return to see Dr. Moore in three (3) months. Tr. at 469.
On May 27, 2011, Plaintiff returned to see Dr. Moore "primarily to review [her] application for disability." Tr. at 471. Plaintiff told Dr. Moore that "[s]he feels [her] memory impairment is [the] main factor preventing her from being able to work, also [her] anxiety." Tr. at 471.
On July 7, 2011, Plaintiff reported that she felt "so so," and she explained to Dr. Moore that she and her husband had an argument. Tr. at 476. Apparently, either after that argument or a different argument, Plaintiff "went to spend the night with her parents, [she] started drinking, [her parents] threw her out, she returned home, made some suicidal com[m]ents, [and] consider[ed] [going] to the hospital[ but] did not." Tr. at 476.
The Regulations instruct ALJs how to weigh the medical opinions
If an ALJ concludes the medical opinion of a treating physician should be given less than substantial or considerable weight, he or she must clearly articulate reasons showing "good cause" for discounting it.
Generally, a non-examining physician's opinion is given less weight than that of a treating or examining physician. 20 C.F.R. § 404.1527(d)(1). Nevertheless, every medical opinion should be considered in making the disability determination. 20 C.F.R. § 404.1527(d). The same factors are relevant in determining the weight to be given to a non-examining physician's opinion as are relevant in determining the weight to be given to a treating physician's opinion: (1) the "[l]ength of the treatment relationship and the frequency of examination"; (2) the "[n]ature and extent of [any] treatment relationship";
(3) "[s]upportability"; (4) "[c]onsistency" with other medical evidence in the record; and (5) "[s]pecialization." 20 C.F.R. §§ 404.1527(d)(2)-(5), 416.927(d)(2)-(5);
In the ALJ's Decision, he discussed the totality of the medical evidence, including Dr. Moore's treatment notes. Tr. at 20-21. Pertinent to the instant dispute, the ALJ summarized Dr. Moore's May 2011 opinion (memorialized on the Physician Questionnaire form). Tr. at 21. The ALJ found that Dr. Moore's opinion was deserving of "little weight" because 1) "Dr. Moore offered no analysis or rationale to support his opinions, which appear inconsistent with his stated global assessment of functioning (GAF) of 50"; and 2) "Dr. Moore failed to address the significance of [Plaintiff's] ongoing alcohol dependency in his assessment of her mental and social functioning." Tr. at 21.
The ALJ assigned "great weight" to the opinions of the non-examining State agency consultants who "opined that [Plaintiff] was capable of performing a limited range of light work, restricted to relatively simple tasks with limited social interaction" because those opinions "were consistent with the medical record." Tr. at 24 (citing Tr. at 392-95, 423-30, 449-51). The ALJ also assigned "considerable weight" to the opinion of Carlos Kronberger, Ph.D., a psychological expert who testified at the December 6, 2011 hearing, finding that Dr. Kronberger's opinion was "consistent with the medical evidence." Tr. at 24;
After reviewing the ALJ's Decision and the evidence in the record, the undersigned finds that the ALJ's Decision is supported by substantial evidence. Plaintiff argues that "[t]he ALJ improperly determined that substance abuse was a material factor contributing to [Plaintiff's] disability." Pl.'s Mem. at 6 (emphasis and capitalization omitted). Plaintiff contends that Dr. Moore's opinion that Plaintiff has "intermittent" dependence on alcohol and that her alcohol abuse contributes to her limitations adequately addresses the issue.
Plaintiff further argues that the ALJ failed to fully and fairly develop the record. Pl.'s Mem. at 6-7. While the ALJ has a duty to develop the record, the burden remains on Plaintiff to prove that she is disabled and that her alcohol abuse is not a contributing factor material to her disability.
Moreover, as explained by the ALJ, there exists substantial evidence in the record to support his Decision. While a non-examining physician's opinion is typically given less weight than that of a treating or examining physician, any opinion can be rejected if "the evidence supports a contrary conclusion."
In sum, Plaintiff has selected one (1) opinion from the record (Dr. Moore's opinion) and seeks to have only that opinion form the basis of a finding of disability. Considering the totality of the evidence, however, including the other medical opinions in the record and the testimony of Plaintiff, the ALJ reasonably found that Plaintiff's alcohol abuse is a contributing factor material to her disability and but for Plaintiff's continued alcohol abuse, she would not be disabled. These findings are supported by substantial evidence.
Upon review, the undersigned finds that the ALJ properly assessed Dr. Moore's opinion, and the ALJ did not err in assigning that opinion little weight. The ALJ's Decision is supported by substantial evidence. Accordingly, it is
1. The Clerk of Court is directed to enter judgment pursuant to sentence four of 42 U.S.C. § 405(g)
2. The Clerk is further directed to close the file.