GARY R. JONES, Magistrate Judge.
Plaintiff appeals to this Court from a final decision of the Acting Commissioner of Social Security (the "Commissioner") denying her applications for Period of Disability and Disability Insurance Benefits under Title II of the Social Security Act ("the Act") and for Supplemental Security Income under Title XVI of the Act. (ECF No. 1.) The Commissioner has answered, ECF No. 13, and both parties have filed briefs outlining their respective positions. (ECF Nos. 18, 19.) For the reasons discussed below, it is recommended that the Commissioner's decision be affirmed.
Plaintiff filed her Title II and Title XVI applications on February 16, 2011, alleging a disability onset date of January 20, 2011. (R. 12, 129-30, 136-39, 1094-97.) Plaintiff alleged that she could no longer work due to neck pain, back pain, chest pain, and migraines. (R. 12, 730-46.) Her application was denied initially and upon reconsideration. (R. 35-45, 98-109.) Plaintiff amended the alleged onset date to April 1, 2011. (R. 12, 772-80.) After a hearing, an administrative law judge ("ALJ") issued a decision unfavorable to Plaintiff on November 20, 2012. (R. 556-73.)
The Appeals Council remanded for further consideration. (R. 574-77.) The ALJ then held another hearing on January 26, 2016, and again found on April 8, 2016, that Plaintiff was not disabled. (R. 9D-28.) After this opinion the Appeals Council denied Plaintiff's request for review on February 17, 2017. (R. 9A-9C.) Plaintiff then filed the instant appeal. (ECF No. 1.)
The Commissioner's findings of fact are conclusive if supported by substantial evidence. See 42 U.S.C. § 405(g) (2012). Substantial evidence is more than a scintilla, i.e., the evidence must do more than merely create a suspicion of the existence of a fact, and must include such relevant evidence as a reasonable person would accept as adequate to support the conclusion. Foote v. Chater, 67 F.3d 1553, 1560 (11th Cir. 1995) (citing Walden v. Schweiker, 672 F.2d 835, 838 (11th Cir. 1982), Richardson v. Perales, 402 U.S. 389, 401 (1971)); accord Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991).
Where the Commissioner's decision is supported by substantial evidence, the district court will affirm, even if the reviewer would have reached a contrary result as finder of fact, and even if the reviewer finds that the evidence preponderates against the Commissioner's decision. Edwards, 937 F.2d at 584 n.3; Barnes v. Sullivan, 932 F.2d 1356, 1358 (11th Cir. 1991). The district court must view the evidence as a whole, taking into account evidence favorable as well as unfavorable to the decision. Foote, 67 F.3d at 1560; accord Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992) (holding that the court must scrutinize the entire record to determine reasonableness of factual findings); Parker v. Bowen, 793 F.2d 1177 (11th Cir. 1986) (finding that the court must also consider evidence detracting from evidence on which the Commissioner relied). However, the district court will reverse the Commissioner's decision on plenary review if the decision applies incorrect law, or if the decision fails to provide the district court with sufficient reasoning to determine that the Commissioner properly applied the law. Keeton v. Dep't Health & Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994).
The law defines disability as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death, or has lasted or can be expected to last for a continuous period of not less than twelve months. 42 U.S.C. §§ 416(I), 423(d)(1) (2012); 20 C.F.R. §§ 404.1505, 416.905 (2015).
The ALJ must follow five steps in evaluating a claim of disability. 20 C.F.R. §§ 404.1520, 416.920. The claimant has the burden of proving the existence of a disability as defined by the Social Security Act. Carnes v. Sullivan, 936 F.2d 1215, 1218 (11th Cir. 1991). First, if a claimant is working at a substantial gainful activity, she is not disabled. §§ 404.1520(b), 416.920(b). Second, if a claimant does not have any impairment or combination of impairments which significantly limit her physical or mental ability to do basic work activities, then she does not have a severe impairment and is not disabled. §§ 404.1520(c), 416.920(c). Third, if a claimant's impairments meet or equal an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1, she is disabled. §§ 404.1520(d), 416.920(d). Fourth, if a claimant's impairments do not prevent her from doing past relevant work, she is not disabled. §§ 404.1520(e)-(f), 416.920(e)-(f). Fifth, if a claimant's impairments (considering her residual functional capacity ("RFC"), age, education, and past work) prevent her from doing other work that exists in the national economy, then she is disabled. §§ 404.1520(g), 416.920(g).
Because the issues on appeal relate primarily to the ALJ's treatment of the opinion evidence, including Dr. Thompson's and Dr. Warchya's opinions, and the ALJ's Residual Functional Capacity ("RFC") assessment, the relevant portions of the medical record, the opinion evidence, the hearing testimony, and the ALJ's findings are summarized below.
Throughout 2010 and to March 2011 Plaintiff visited Gainesville Primary Care Physicians.
In May and August 2010 Plaintiff underwent consultations regarding her migraine headaches. Her physical exam findings were normal, and she did not complain of other pain. The impression was chronic daily headaches with strong migrainous features. But the recommended treatment involved only increasing her pain medications. (R. 160-65.)
From May 2010 to February 2011 Plaintiff also visited North Florida Regional Medical Center due to her migraine headaches. She had no other complaints other than associated nausea, her physical exam was normal (other than an abnormal ear exam on one occasion), her CT scan findings were stable and showed no acute intracranial findings, and her treatment involved IV and prescription medications. Notably, during each visit she improved after medication. (R. 167-98, 206-14, 330-66.)
Plaintiff also visited Richard Johansen Physical Therapy from December 2010 to May 2011. By the end of January, it was noted that her migraine headaches were reduced and that her right arm symptoms were gone. Additionally, her range of motion and mobility improved after each visit. Overall, Plaintiff's right upper extremity symptoms resolved well but that she continued to experience migraine headaches, neck pain, and occasional back pain. (R. 512-41, 543-44.)
Plaintiff also visited Florida Pain and Rehabilitation Center from February to June 2011 to address her headaches and neck pain radiating to the right shoulder and arm.
With regard to procedures and diagnostic testing, Plaintiff underwent a greater occipital nerve block in February 2011, cervical epidural steroid injections in February and March 2011, which offered her some pain relief, and a facet medial branch block in April 2011. She also had an MRI of her cervical spine done in February 2011, which revealed small broad-based central disc protrusion at C4-C5, C5-C6, and C6-C7. There was no cord compression, but there was mild bilateral neural foraminal narrowing at C5-C6.
In May 2011 Plaintiff visited the Orthopaedic Institute regarding neck pain and right shoulder and arm pain. Her physical exam findings were normal other than moderate paraspinous muscle spasms, some slight weakness in her right biceps and triceps, and reduced sensory in the right C6-7 distribution. Upon radiographic imaging, the impression was cervical spondylosis causing cervicalgia and intermittent cervical radiculopathy. The recommended treatment plan involved considering anterior cervical diskectomy and fusion at C4-5, C5-6, and C6-7. (R. 296-97, 435-36, 438-39.)
Plaintiff visited Primary Care Physicians of Gainesville from August 2011 to May 2012. Her physical exams revealed overall normal findings, but at times a mildly tender neck with decreased range of motion due to pain as well as lumbar tenderness. Her diagnoses included neck pain, headache/migraine, hypertension, low back pain, muscle spasm, generalized abdominal pain, hematuria, UTI, otalgia, post-gastric surgery syndromes, exposure to communicable disease, and insomnia. The course of treatment involved medication. (R. 415-34.)
Plaintiff returned to Florida Pain and Rehabilitation Center from June 2011 and throughout 2012, and she experienced some relief from the course of treatment during this time. Plaintiff underwent trigger point injections in March and May 2012, and she experienced 50% pain relief. In October 2012 Plaintiff underwent a facet medial branch block of the cervical and thoracic spine, which resulted in 100% pain relief. She also underwent lumbar epidural steroid injections in November 2012. The notes also reflect that her medication and physical therapy were helping some. (R. 367-91, 410-11, 464-90, 492-93, 499-500, 1000-08.)
Plaintiff continued at the Florida Pain and Rehabilitation Center in 2013 and 2014. She stated that her medication was helping some and that she was not experiencing any side effects. Her treatment continued to involve medication only, which provided adequate relief, and she declined procedures and surgical consults. She did, however, undergo a trigger point injection in October 2013 to address her occipital neuralgia. But in February 2014 Plaintiff was permanently discharged from the clinic due to violating the narcotic contract. (R. 903-04, 1009-25.)
Plaintiff returned to Primary Care Physicians of Gainesville in January 2014. Her physical exam findings were normal other than tenderness over the cervical and thoracic spine. Her assessments included insomnia, anxiety, migraine headaches, and neck pain. But her treatment involved medication only. (R. 899-902.)
In March 2014 Plaintiff underwent diagnostic cervical facet joint injections at C4/C5, C5/C6, and C6/C7 at the Laser Spine Institute. After the procedure, Plaintiff reported 100% improvement. Her cervical MRI/CT scans revealed degenerative disc disease, bulging disc, foraminal stenonosis, facet degen/hypertrophy, and osteophytes at the C4/C5, C5/C6, and C6/C7 levels. Additionally, spinal stenosis in cervical region, displacement of cervical intervertebral disc without myelopathy, cervical spondylosis without myelopathy, and degeneration of the cervical intervertebral disc were noted. Then in June 2014 Plaintiff underwent a radiofrequency denervation to the dorsomedial nerves located at C4, C5, C6, and C7 areas at North Florida Surgical Pavilion. (R. 827-44, 850-51, 860-65, 919-44, 985-87.)
Plaintiff also visited Southeastern Rehabilitation Medicine in 2014 and 2015 regarding pain management for cervical pain, low back pain, and migraine headaches. In 2014 her physical exam findings revealed tenderness over the cervical and thoracolumbar spine as well as restricted cervical spine range of motion, but a note in the findings stated she exhibited "pain behaviors of overreaction, superficial tenderness and severe guarding." In 2015 her physical exam findings revealed tenderness of the neck and neck pain with motion as well as lumbosacral tenderness, but all other findings were normal. Her assessments included backache, cervical spondylosis (C4-C5), chronic common migraine, cervicalgia, depression, anxiety disorder, and chronic pain syndrome. Her treatment, however, included medication and home exercise as tolerated. (R. 858-59, 867-83, 908-12, 945-84, 987-98, 1029-59, 1068-72, 1074-86.)
Plaintiff also visited Southeastern Health Psychology in 2014. Her diagnostic classification included bipolar disorder, posttraumatic stress disorder, and pain disorder associated with both psychological factors and general medical condition. Due to the complexity of her medical and psychiatric problems, Plaintiff was referred to Shands Vista outpatient services. (R. 1065-67.)
Dr. Bancks, a medical consultant, completed a physical RFC assessment on July 14, 2011. He found that Plaintiff could lift 20 pounds occasionally and 10 pounds frequently, and she could sit, stand, and/or walk for about 6 hours in an 8-hour workday. Plaintiff also had limited push and/or pull in her upper extremities, and she could only occasionally climb, balance, stoop, kneel, crouch, and crawl. She also needed to avoid concentrated exposure to hazards, such as machinery and heights. Dr. Bancks also specifically noted that there was no objective basis to limit Plaintiff to sedentary work. (R.322-29.)
Dr. Warycha signed a physical medical source statement in July 2012. Her diagnoses included neck pain, cervical radiculopathy with HNP, occipital neuralgia, carpal tunnel syndrome, lower back pain, and headaches. Her symptoms included neck pain, lower back pain, bilaterla knee pain, and migraine type headaches. The objective evidence included tenderness over the cervical and lumbar spine as well as the straight leg raising test. (R. 502-03.)
Regarding Plaintiff's functional limitations, Dr. Warycha found that Plaintiff could walk 50 feet without rest or severe pain, sit for 1 hour and 20 minutes at one time, and stand for 1 hour and 15 minutes at one time. In a total 8-hour workday, Plaintiff could sit and stand/walk for less than 2 hours. It was noted that she would need a job that permits shifting positions and that she would need to walk for 5 minutes every 20 minutes. She would also need to take a 30-minute break every 30 to 60 minutes, lie down 4 or 5 times a day for 20 to 30 minutes, and elevate her legs 50% of the day. The need for these breaks was attributed to muscle weakness, chronic fatigue, pain/paresthesias, numbness, and adverse effects of medication (drowsiness). (R. 503.)
With regard to other limitations, Plaintiff could only rarely lift less than 10 pounds and only rarely twist and stoop. Additionally, she could never crouch/squat, climb stairs, or climb ladders. It was also noted that Plaintiff would be off task 25% or more of the workday because her symptoms would be severe enough to interfere with her attention and concentration. She would also be absent more than four days per month. (R. 504-05.)
During the hearing held on January 26, 2016, an orthopedic medical expert, Dr. Robert Thompson, testified. He stated that the objective musculoskeletal evidence appears to meet 1.04 paragraph A from April 2011 to January 2012, which is not a 12-month period. He further testified that Plaintiff could lift and carry 10 pounds occasionally, but not frequently and nothing heavier than 10 pounds. Plaintiff could sit, stand, and walk at one time a maximum of one hour at one time. In an eight-hour workday, Plaintiff could sit for four hours and stand and walk for three hours. He said that he limited Plaintiff's ability to sit, stand, and walk due to her pain in the neck and knees as well as actual neurological abnormalities. (R. 1184-98.)
As for other limitations, Plaintiff could not reach overhead, but she could do other reaching and handling as well as pushing and pulling occasionally. She could finger and feel frequently, but only occasionally use stairs and ramps. Plaintiff could not use ladders or scaffolds, crawl, occasional stoop, kneel, or crouch. Plaintiff also must avoid heavy vibration and only occasionally be exposed to extreme heat. (R. 1196-97
Dr. Thompson, however, testified that Plaintiff can work an eight-hour workday, but that she needs increased periods of breaks and some rest time. Specifically, he said that Plaintiff would need to lie down for an hour a day based on neck pain and her neck condition. (R. 1197-99.)
Plaintiff also testified at the hearing. With regard to her work history, Plaintiff testified that she worked doing janitorial work as well as acted as a supervisor for housekeeping at the Red Roof Inn in 2002 and then at different locations from 2005 to 2011. Plaintiff said that she has not attempted to return to work since 2011 when she was terminated for having frequent migraines. (R. 1200-12.)
Plaintiff also stated that she started having migraines after a car accident five or six years prior to the hearing because neck pain from the accident would trigger migraines. During that time, she was also experiencing back pain, right shoulder pain, and right hand pain. She testified that she saw pain management regarding this injuries, and her treatment included injections in her neck and back as well as pain medication. She also underwent massage therapy, but she never had surgery. Plaintiff said that the injections and medication offered her some relief from the pain. (R. 1213-24, 1235-38.)
With regard to her physical limitations, Plaintiff testified that she can only stand and sit for about 45 minutes to an hour before needing to take a stretch or change positions. She also said that she could walk for about a half of a block before needing to take a rest due to lower-back pain and that walking that distance would take her about 15 minutes. Additionally, Plaintiff can carry things so long as they do not weigh more than 10 pounds. Plaintiff also stated that when she was working she would have to lie down every morning and then at least every three days for two hours. (R. 1225-31, 1238.)
Plaintiff also testified as to her daily activities. She said that she is able to prepare meals, wash dishes, do laundry, and make the bed, but it takes her a long time. She stated, however, that she does not do things like vacuuming because it would cause her pain. (R. 1231-35.)
The ALJ found that Plaintiff has not engaged in substantial gainful activity since April 1, 2011, the amended alleged onset date. The ALJ also found that she has the following severe impairments: a history of cervical spine pain secondary to degenerative joint disease and facet changes at C-4 to C-7, history of migraines, history of obesity, and some insomnia. However, none of these impairments, or a combination thereof, meets or medically equals the severity of one of the listed impairments. (R. 14-15.)
Based on the entire record, the ALJ concluded that through the date last insured, Plaintiff had the following residual functional capacity ("RFC"):
(R. 16.)
The ALJ then found that Plaintiff was not capable of performing any past relevant work. However, the ALJ found that there were jobs that existed in significant numbers in the national economy that Plaintiff could have performed. Accordingly, the ALJ concluded that Plaintiff has not been under a disability from April 1, 2011, through the date of the ALJ's decision, April 8, 2016. (R. 26-28.)
Rather than identifying the precise nature of her argument on appeal Plaintiff instead describes her argument as follows:
(ECF No. 18 at 34.) In support of this run-on argument Plaintiff provided only one citation to the record in her entire argument section, a four-page citation to a physical medical source statement signed by Dr. Warycha. (R. 502-05.)
Plaintiff elaborated on this argument only briefly. Plaintiff argued that "it was . . . impermissible for ALJ Thompson to substitute his judgment for that of the medical expert." She also asserted that "ALJ Thompson also violated the treating physician rule by rejecting the opinions of Plaintiff's treating physicians." (ECF No. 18 at 35-36.)
Rather than focusing her argument on an identifiable issue and rather than discussing the ALJ's decision, the Court is left with the task of attempting to identify the arguments Plaintiff is attempting to advance in this case. Liberally construing Plaintiff's conclusory arguments, the Court construes Plaintiff's argument to be a challenge to the ALJ's treatment of the opinion evidence in the record, specifically the opinions of Dr. Thompson, the medical expert at the hearing, and Dr. Warycha, one of Plaintiff's treating physicians. Also, Plaintiff makes the more general argument (without evidentiary support) that substantial evidence does not support the ALJ's decision.
With regard to opinion evidence generally, "the ALJ must state with particularity the weight given to different medical opinions and the reasons therefor." Winschel v. Commissioner of Social Security, 631 F.3d 1176, 1179 (11th Cir. 2011) (citing Sharfarz v. Bowen, 825 F.2d 278, 279 (11th Cir. 1987) (per curiam)). This information and explanation allows "a reviewing court to determine whether the ultimate decision on the merits of the claim is rational and supported by substantial evidence." Id. at 1178-79 (quoting Cowart v. Schweiker, 662 F.2d 731, 735 (11th Cir. 1981)).
This does not mean, however, that an ALJ must adopt every medical opinion in the record. To the contrary, an ALJ may reject a medical opinion if the evidence supports a contrary finding. McCloud v. Barnhart, 166 F. App'x 410, 418-19 (11th Cir. 2006). Additionally, the opinions of examining physicians are typically entitled to more weight than the opinions of non-examining physicians. Broughton v. Heckler, 776 F.2d 960, 961-62 (11th Cir. 1985).
With regard to a treating physician's opinion, the ALJ must give that opinion controlling weight if the opinion is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is consistent with the other substantial evidence in the record. 20 C.F.R. § 416.927(d)(2). But the ALJ may discount the treating physician's opinion if good cause exists to do so. Hillsman v. Bowen, 804 F.2d 1179, 1181 (11th Cir. 1986).
If an ALJ rejects a treating physician's opinion, he must give explicit, adequate reasons for so doing, and failure to do so results in the opinion being deemed accepted as true as a matter of law. MacGregor v. Bowen, 786 F.2d 1050, 1053 (11th Cir. 1986); Marbury v. Sullivan, 957 F.2d 837, 841 (11th Cir. 1992). The Commissioner's reasons for refusing to credit a treating physician's opinion must be supported by substantial evidence. MacGregor, 786 F.2d at 1054.
In this case the Court concludes that the ALJ did not err in his treatment of the opinion evidence, including the opinions of Dr. Thompson and Dr. Warycha. In Plaintiff's brief she completely ignores any reference to the ALJ's lengthy, detailed discussion of the weight the ALJ gave to each opinion in the record. Instead, Plaintiff appears to insist that the ALJ was required to adopt all of the limitations included in the various opinions.
Turning first to the opinion of Dr. Thompson—the medical expert who testified at the supplemental hearing in January 2016— Dr. Thompson testified about the physical limitations Plaintiff experienced as a result of her alleged impairments. Dr. Thompson concluded that Plaintiff could lift and carry 10 pounds occasionally; sit, stand, and walk for one hour at one time; and sit for four hours and stand and walk for three hours in and eight-hour workday. He limited Plaintiff's ability to sit, stand, and walk due to her pain in the neck and knees as well as actual neurological abnormalities. (R. 1184-98.)
As for other limitations, Dr. Thompson concluded that Plaintiff could never reach overhead; occasionally do other reaching, handling, pushing, and pulling; frequently finger and feel; occasionally use stairs and ramps; and never use ladders or scaffolds, crawl, occasional stoop, kneel, or crouch. He also testified that Plaintiff must avoid heavy industrial vibration and only occasionally be exposed to extreme heat. Many of these limitations were based on cervical spine issues. (R. 1196-97
Dr. Thompson concluded that Plaintiff can work an eight-hour workday, but that she needs increased periods of breaks and some rest time. Specifically, he said that Plaintiff would need to lie down for an hour a day based on neck pain and her neck condition. (R. 1197-99.)
In discussing the weight given to Dr. Thompson's opinion, the ALJ wrote:
(R. 25.)
Thus, the ALJ stated with particularity the weight given to various portions of Dr. Thompson's opinion as well as the reasons for assigning only partial weight to certain limitations. More specifically, as the ALJ explained, he discounted the portions of Dr. Thompson's opinion that were unsupported by the evidence in the record, an appropriate reason to dsicount an opinion.
The second opinion specifically at issue is the medical source statement from July 2012 signed by Dr. Warycha, one of Plaintiff's pain management treating physicians.
The source statement also lists Plaintiff's functional limitations. The source statement notes that Plaintiff could walk 50 feet without rest or severe pain; sit for 1 hour and 20 minutes at one time; stand for 1 hour and 15 minutes at one time; and sit and stand/walk for less than 2 hours in an 8-hour workday. Further, it reflect that she would need a job that permits shifting positions; would need to walk for 5 minutes every 20 minute; would need to take a 30-minute break every 30 to 60 minutes; would need to lie down 4 or 5 times a day for 20 to 30 minutes; and would need to elevate her legs 50% of the day. These breaks would be necessary due to muscle weakness, chronic fatigue, pain/paresthesias, numbness, and adverse effects of medication (drowsiness). (R. 503.)
With regard to other limitations, the source statement reflects that Plaintiff could rarely lift less than 10 pounds; rarely twist and stoop; and never crouch/squat, climb stairs, or climb ladders. She should avoid extreme temperatures and environments posing hazards. Additionally, Plaintiff would be off task 25% or more of the workday and would be absent more than four days per month.
In evaluating the weight the ALJ assigned to this opinion, the ALJ provided an exceptionally thorough and detailed explanation supporting his reasons for not give the treating physician's opinion controlling weight. The ALJ explained:
(R. 24.)
Thus, as evidenced in the ALJ written decision the ALJ discounted Dr. Warycha's opinion for at least the following reasons. First, the ALJ noted that Dr. Warycha extreme limitations are not unsupported by and in many instances are contradicted by the medical and opinion evidence in the record, including Dr. Warycha's own treatment notes and diagnostic opinion where the opinion is inconsistent with the doctor's own medical records and is not supported by clinical data. Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997) (finding good cause where the evidence "supports a contrary finding," the opinion is "conclusory," the opinion is "inconsistent with [the treating physician's] own medical records," and the statement "contains no [supporting] clinical data or information").
Plaintiff offers no specifics addressing how the ALJ violated the treating physician's rule or how the ALJ's detailed reasoning for rejecting the opinion was improper. The Court declines to speculate as to what Plaintiff could have or should have argued in this regard. Instead, because the ALJ had good cause for giving little weight to the opinion of Dr. Warycha and because the ALJ provided adequate, explicit reasons for doing so that were supported by substantial evidence, the Court concludes that the ALJ did not err in his assessment of Dr. Warycha's opinion. See MacGregor, 786 F.2d at 1054.
Although Plaintiff makes no specific reference to opinion evidence from anyone other than the medical expert and Dr. Warycha, the Court, nonetheless, will briefly discuss the ALJ's treatment of the other opinion evidence in the record. This other opinion evidence included opinions from Dr. Subramanian, Dr. Kendrick, and the State agency physicians.
With regard to each of these opinions, the ALJ discussed with particularity the weight he gave to reach opinion and the reasons therefor. The reasons the ALJ offered for discrediting the opinions were all proper, including the fact that they were unsupported by Plaintiff's objective medical findings and her conservative course of treatment. Additionally, where the ALJ assigned greater weight to an opinion, he did so appropriately based on the consistency of the opinion with the rest of the record evidence. (R. 23-25.) Accordingly, the Court concludes that the ALJ did not err in his treatment of any of the opinion evidence in the record.
Lastly, in a conclusory fashion—and with little or no discussion of the record— Plaintiff argues that substantial evidence does not support the ALJ's findings in this case. But other than a reference to Dr. Thompson's opinion that Plaintiff would need to lie down for one hour each day and a reference to Dr. Warycha's opinion that Plaintiff would be absent more than four days per month, Plaintiff provides no citation to or any discussion of other evidence in the record that would constitute substantial evidence to support a finding of disability.
In stark contrast to Plaintiff's unsupported allegation that she is disabled, the ALJ's detailed decision concluding that Plaintiff is capable of light work with limitations is supported by substantial evidence. The ALJ's decision includes a thorough discussion of all of the evidence in the record. With regard to the medical evidence, the ALJ's decision summarizes Plaintiff's treatment records and findings related to Plaintiff's musculoskeletal impairments, insomnia, and migraine headaches as well as references to Plaintiff's overall conservative course of treatment. The ALJ's decision also summarizes Plaintiff's testimony regarding her functional limitations and daily activities.
Based upon all of the evidence in the record, the ALJ found that Plaintiff was not disabled. (R. 18-26.)
Having considered all of the evidence, the ALJ found that the record supports a finding that Plaintiff had severe impairments from a history of cervical spine pain with degenerative joint disease and facet changes, a history of migraines, obesity, and some insomnia. But the ALJ found that the record does not support the degree of functional limitation Plaintiff alleges or the preclusion of all work activity.
Accordingly, the Court concludes that the ALJ properly considered and discussed all the opinion evidence in the record and that substantial evidence supports the ALJ's RFC determination and finding that Plaintiff is not disabled.
In view of the foregoing, it is respectfully
(R. 25.)
