TIMOTHY S. BLACK, District Judge.
This is a Social Security disability benefits appeal. At issue is whether the administrative law judge ("ALJ") erred in finding the Plaintiff "not disabled" and therefore not entitled to disability insurance benefits ("DIB") and supplemental security income ("SSI") prior to May 3, 2012. (See Administrative Transcript at Doc.6-2 (PageID 68-82) (ALJ's decision)).
Plaintiff filed applications for DIB and SSI on July 22, 2009, alleging that she became unable to work on January 27, 2006
Plaintiff appealed the ALJ's decision, claiming that she was "totally disabled and unable to perform substantial gainful work activity due to a combination of impairments." (PageID 66-67). The ALJ's decision became final and appealable on March 26, 2013, when the Appeals Council denied Plaintiff's request for review. (PageID 52-54). Now, Plaintiff seeks judicial review pursuant to section 205(g) of the Act. 42 U.S.C. §§ 405(g), 1383(c)(3).
At the time of the hearing, Plaintiff was a 49-year-old female with two years of college. (PageID 80, 99). Plaintiff has past relevant work experience as a licensed practical nurse, working mainly in nursing homes.
The ALJ's "Findings," which represent the rationale of her decision, were as follows:
(PageID 73-82).
In sum, the ALJ concluded that Plaintiff was not under a disability as defined by the Social Security Regulations, and was therefore not entitled to DIB or SSI prior to May 3, 2012. (PageID 82).
On appeal, Plaintiff argues that the ALJ erred in: (1) failing to give the long-time treating physician's opinion controlling weight; (2) failing to evaluate the long-time treating physician's opinion using the applicable regulatory factors; and (3) failing to properly evaluate Plaintiff's credibility. The Court will address each error in turn.
The Court's inquiry on appeal is to determine whether the ALJ's non-disability finding is supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971). In performing this review, the Court considers the record as a whole. Hephner v. Mathews, 574 F.2d 359, 362 (6th Cir. 1978). If substantial evidence supports the ALJ's denial of benefits, that finding must be affirmed, even if substantial evidence also exists in the record upon which the ALJ could have found plaintiff disabled. As the Sixth Circuit has explained:
Felisky v. Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994).
The claimant bears the ultimate burden to prove by sufficient evidence that she is entitled to disability benefits. 20 C.F.R. § 404.1512(a). That is, she must present sufficient evidence to show that, during the relevant time period, she suffered an impairment, or combination of impairments, expected to last at least twelve months, that left her unable to perform any job in the national economy. 42 U.S.C. § 423(d)(1)(A).
The record reflects that:
Plaintiff has a genetically inherited, degenerative disease called Myotonic Dystrophy, a form of Muscular Dystrophy. (PageID 887). It was initially diagnosed in 1991, when Plaintiff was 29 years old. (PageID 769). Despite the progressive disease, Plaintiff was able to work until early 2006. (PageID 309, 887). In January 2006, Plaintiff's long-standing back pain and fatigue worsened. (PageID 471-473, 887). A February 2006 sleep study ruled out sleep apnea as the cause. (PageID 572-573). On February 6, 2006, neurologist, Joel Vandersluis, M.D., evaluated Plaintiff. Plaintiff's symptoms included hypersomnolence,
On March 13, 2007, Dolly Boughaba, M.D., a neurologist, examined Plaintiff for Myotonic Dystrophy. (PageID 309-313). Dr. Boughaba noted extreme fatigue, exertional intolerance, hand weakness, occasional chest pain or flutters, difficulty rising from seated position due to weakness, as well as leg and back pain and stiffness. (PageID 309-310). On examination, Plaintiff had droopy eyelids, orbicularis oculi weakness, and right hearing loss. (PageID 310). On muscle strength testing, she had decreased bilateral abductor pollicis brevis-thumb ("APB"), and decreased bilateral interosseous. (PageID 311). The brachio radlalis reflexes were absent (abnormal) bilaterally. (PageID 312). Myotonic Dystrophy with resulting distal weakness and excessive fatigue/sleepiness was diagnosed, and testing was ordered. (PageID 312-313). Cardiac testing, completed on March 20, 2007, indicated sinus bradycardia, and tricuspid and pulmonary regurgitation. (PageID 314, 318).
In relation to an earlier application, Damian M. Danopulos, M.D., examined Plaintiff on April 24, 2007. (PageID 857-866). On examination, her spine was painful with motion and with pressure at the lower cervical, lower dorsal, and lumbosacral areas. Deep tendon reflexes and bilateral grip strength were reduced. (PageID 862). Dr. Danopulos thought Plaintiff "gave a reliable history." (PageID 858). On October 14, 2008, Dr. Danopulos re-examined Plaintiff. (PageID 874-886). Plaintiff reported increasing weakness, severe fatigue, muscular and joint aches/pains, low back pain, chest pains, and secondary depression. (PageID 874-886). Plaintiff also reported that she had good and bad days. (Id.) On examination, Plaintiff's upper extremities, lower extremities, and dorsal through lumbosacral spine were painful to palpation. (Id.) Plaintiff's hip and lumbar range of motion were painful, bilateral straight leg raises positive, and she was unable to toe and heel walk. (PageID 880-882). Again, Dr. Danopulos thought Plaintiff "gave a reliable history." (PageID 876).
In July 2007, Plaintiff was hospitalized for chest pains and shortness of breath. (PageID 640-659). Cardiac catheterization revealed that her right coronary artery was 99% obstructed and a balloon angioplasty stent placement was performed. (Id.) On July 31, 2008, she again had increased chest pain and shortness of breath. (PageID 669-672). An emergency cardiac catheterization revealed a 40%-50% restenosis of the right coronary artery, and balloon angioplasty with re-stenting was performed. (Id.) Plaintiff saw cardiologist, Thomas G. Thornton, on an outpatient basis. (PageID 341-371). After a brief recurrence in March and April 2009, Plaintiff remained stable; she saw her treating cardiologist, Dr. Thornton, regularly; and took all of her cardiac medications for atherosclerotic heart disease as prescribed. (See generally, PageID 346-47, 715-23, 813-23).
On September 9, 2008, Plaintiff had genetic testing and counseling for Myotonic Dystrophy. Plaintiff reported chronic fatigue, myotonia of her hands,
In August 2009, Dr. Randall sent Plaintiff to physical therapy for back, leg, and hip pain secondary to Myotonic Dystrophy. (PageID 402-406). A September 2009 examination revealed decreased lower extremity reflexes, and lumbar and thoracic spine tenderness. (PageID 405, 707). On October 7, 2009, physical therapist, Connie Bain, noted Plaintiff had thoracic scoliosis with her head "notably" bent forward, spotty numbness throughout, particularly abdomen, mid-back and legs, and decreased range of motion of the trunk, hamstrings and hips. (PageID 403). After three-and a-half minutes of recumbent biking, Plaintiff became short of breath. (Id.) On October 16, 2009, Ms. Bain noted Plaintiff's "very limited functional strength," and that she completed physical therapy sessions with variable benefit. (PageID 685-707).
In March 2010, Dr. Randall referred Plaintiff to an orthopedist, L. Joseph Rubino, M.D., for left knee pain and swelling. (PageID 464). On examination, Dr. Rubino noted hypersensitivity to palpation along her outer knee, "painful patellofemoral crepitus and patellofemoral grind," and left quadriceps weakness. (PageID 460). Dr. Rubino diagnosed "likely" patellofemoral syndrome,
Genetic specialist, Heather Workman, and State agency examining physician, Dr. Danopulos, noted that ophthalmologic complications are often associated with Myotonic Dystrophy. (PageID 810, 881). Plaintiff had bilateral cataracts removed in 2003 and 2004. (PageID 626-39). Between January 2008 and December 2008, Plaintiff was treated for bilateral cataracts, left eye cysts (removed January 2008), left eye papillomas, right eye epiretinal membrane (abnormal tissue on the retina), and chronic bilateral blepharitis (eyelid infection). Her second left-side cataract surgery was done in February 2008 and her right-side was done in May 2008. (PageID 321-340).
Over time, Plaintiff's physical limitations caused psychological distress. In October 2008, Dr. Randall noted that secondary depression and anxiety worsened Plaintiff's condition. (PageID 677-78). In August 2009, Dr. Randall referred Plaintiff for counseling sessions for dysthymia and anxiety.
On February 20, 2010, psychologist, Stephen W. Halmi, Psy.D., evaluated Plaintiff for the State agency. (PageID 408-416). Dr. Halmi noted that Plaintiff had depression related symptoms including feeling sad, down, decreased concentration, and decreased interest. (PageID 413). Plaintiff reported that she performs some household chores but explained, "it takes me a great deal of effort to do any chores." (PageID 412). She was "frustrated about constant fatigue and weakness" and because she could not do what she wanted. (PageID 413). During her mental status examination, Plaintiff's face was strained and appeared uncomfortable, as she changed positions frequently. (Id.) However, Plaintiff did not appear to exaggerate psychological symptoms or exhibit "excessive pain behavior." (Id.) Plaintiff's affect was flat, and exhibited anxiety from her tense posture and restlessness. (PageID 413-15). Dr. Halmi diagnosed Dysthymic Disorder and found that Plaintiff's ability to handle stress associated with regular work activity was moderately impaired. (PageID 414, 416).
In his February 2007 and August 2008 reports for the state agency, Plaintiff's physician, Dr. Randall, noted that Plaintiff "had progressive difficulties" with Myotonic Dystrophy-related symptoms including weakness, muscular strength, and pain. (PageID 563, 769). Plaintiff also had a "progressive decline" in physical ability, as well as examination findings that included decreased reflexes, range of motion and overall strength. (Id.) In February 2007 and October 2008, Dr. Randall noted that Plaintiff has Myotonic Dystrophy, a "profound progressive disease." (PageID 677-678, 680-681). Examinations revealed Plaintiff had decreased range of motion of the spine and joints, and positive neurological findings. (Id.) Dr. Randall opined that Plaintiff was unemployable for at least twelve months. (Id.) In the June 2007 and October 2008 ability to work forms, Dr. Randall noted that Plaintiff's prognosis was "poor," her ability to stand/walk and sit were significantly limited, she could not use her hands for repetitive grasping pushing/pulling, or fine manipulation, and was not able to perform full-time work. (PageID 679, 682).
On March 1, 2010, Jerry McCloud, M.D., reviewed the record for the state agency. (PageID 422-429). Dr. McCloud opined that Plaintiff could perform a reduced range of light work. (PageID 423-424). On August 20, 2010, Willa Caldwell, M.D., reviewed the record and agreed that Plaintiff could perform a reduced range of light work. (PageID 614-17).
Alice Chambly, Psy.D., reviewed the psychological evidence of record on March 26, 2010 for the state agency. (PageID 430-47). Dr. Chambly opined that Plaintiff had a severe psychological impairment, and her ability to maintain concentration, persistence, or pace was moderately impaired; however, she could still perform simple and moderately complex tasks. (PageID 433, 444).
In February 2012, Dr. Randall completed two physical capacity evaluations. (PageID 829-830, 892-893). He noted that Plaintiff's standing, walking, sitting, lifting, bending, and crawling all continued to be significantly restricted. (Id.) Dr. Randall also opined that Plaintiff did not have the residual functional ability to perform even sedentary work on a sustained basis. (Id.) In February 2012, Dr. Randall also completed two supplemental questionnaires. (PageID 825-28, 888-91). He opined that Plaintiff had a moderately-severe impairment in her ability to perform daily activities and maintain production standards. (PageID 825, 888). Additionally, Dr. Randall found that Plaintiff had a moderately-severe to severe impairment in her ability to complete a normal workday or workweek without symptoms interfering. (PageID 827, 890). Plaintiff's prognosis was "poor" as she had a "progressive, deteriorating condition." (PageID 827-828, 890).
In a March 21, 2012 letter, Dr. Randall explained:
(PageID 887). Dr. Randall added that Plaintiff is physically unable to perform sedentary work because progressive weakness and fatigue interferes with Plaintiff's concentration and focus. (Id.)
In 1991, when Plaintiff was initially diagnosed with Myotonic Dystrophy, she was still able to work full-time; however, over the years, her symptoms increased until she was no longer able to work. (PageID 116). Symptoms included "constant" back, leg and hip pain, decreased grip strength and fine motor handling, generalized weakness, and "tremendous, constant fatigue." (PageID 102). Plaintiff testified that she has good days one-to-two times a week. On those days she can stand 10-15 minutes, walk (with an ambulatory aid) 15-20 minutes, sit 15-20 minutes, and lift 10-15 pounds, at a time. Plaintiff estimated that she could lift 1-2 pounds. (PageID 112-115). Her ability to perform daily activities is severely limited. (Id.) Plaintiff lives with a disabled 20-year-old daughter and her elderly mother. (Id.) She testified that it is essentially a team effort to complete household chores. (Id.) For example, her daughter may get a few items out of the refrigerator for Plaintiff to make a sandwich. Additionally, Plaintiff testified that she must use a shower chair; she has trouble with buttons; her handwriting has "deteriorated;" and she uses a large mouse for computer work. (PageID 109-113, 119). Plaintiff summarized:
(PageID 120). Over the past two years, Plaintiff testified that she has felt depressed and frustrated "not being able to do anything, not being able to go anywhere." (PageID 117).
In the ALJ's decision, she found that Plaintiff's myotonic dystrophy, coronary artery disease post stenting and balloon angioplasty, obesity, and diabetes mellitus were "severe" impairments. (PageID 73). However, the ALJ found that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of any listed impairments, including impairments found in Listing 11.13
First, Plaintiff alleges that the ALJ erred in failing to give Dr. Randall's opinion controlling weight when determining her RFC. Plaintiff asserts that Dr. Randall's clinical findings as to her disabling conditions were well supported by his office evaluations and the examinations of several other doctors over a number of years.
If an ALJ rejects the opinion of a treating physician, s/he must clearly articulate "good reasons" for doing so. Wilson v. Comm'r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004). In order to be "good," those reasons must be "supported by the evidence in the case record, and must be sufficiently specific to make clear to any subsequent reviewers the weight the adjudicator gave to the treating source's medical opinion and the reasons for that weight." SSR 96-2p. In Rogers v. Comm'r of Soc. Sec., the Sixth Circuit held that the ALJ's "failure to follow the procedural requirement of identifying the reasons for discounting the opinions, and for explaining precisely how those reasons affected the weight . . . denotes a lack of substantial evidence, even where the conclusion of the ALJ may be justified based upon the record." 486 F.3d 234, 243 (6th Cir. 2007).
Pursuant to the Regulations, a treating source's opinion as to the nature and severity of a claimant's impairment will be given controlling weight, if it is "well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in the case record." 20 C.F.R. § 404.1527(c)(2).
In February of 2007, Dr. Randall, who had treated Plaintiff for many years (PageID 887), completed a Basic Medical questionnaire, which included a Physical Function Capacity Assessment (PageID 681-684). Dr. Randall opined that Plaintiff was unable to do any fine manipulation, repetitive pushing, pulling, and grasping. (PageID 681). In February 2012, Dr. Randall provided a Supplemental Questionnaire where he noted that Plaintiff could stand and/or walk about two hours in an eight-hour workday; could sit and/or alternate positions for about four hours in an eight-hour work day; and could use her hands for repetitive fine motor skills. (PageID 829). Dr. Randall also noted that the Plaintiff could occasionally lift up to ten pounds but she could not bend, squat, crawl or climb, nor did she have the RFC to perform sedentary work on a sustained basis in an eight-hour day. (PageID 830). Dr. Randall answered the question as to what clinical or objective findings supported his opinions by noting, "this is a [sic] inherited disease thru [sic] her family." (PageID 827).
The ALJ provided good reasons for giving little weight to the medical opinions of a number of the doctors, including Dr. Randall. Three private doctors examined Plaintiff over a period of two years;
As to Dr. Randall, the ALJ stated her reasons for giving his opinion "little weight." Specifically, the ALJ points out that Dr. Randall's opinion conflicted with the other medical examinations in the record; conflicted with Plaintiff's own testimony as to her manipulative abilities; and his opinions relied solely on Plaintiff's self-reported limitations. Accordingly, the ALJ articulated good reasons for giving little weight to Dr. Randall's opinion, and therefore, her decision is supported by substantial evidence.
Next, Plaintiff claims that the ALJ erred by not evaluating Dr. Randall's opinion using the applicable regulatory factors. Plaintiff asserts that the ALJ did not defer to Dr. Randall's opinion or apply the relevant factors as required by SSR 96-2p.
Rabbers v. Comm'r Soc. Sec. Admin., 582 F.3d 647, 660 (6th Cir. 2009) (discussing 20 C.F.R. §§ 404.1527(d)(2)(i)-(ii), (d)(3)-(6)).
The purpose of the regulation is to review whether the ALJ's decision provided sufficient reasons for rejecting the treating doctors' opinions. As detailed above, the ALJ articulated sufficient reasons for why she did not give deferential weight to Dr. Randall's opinions.
Lastly, Plaintiff claims that the ALJ erred in assessing her credibility. Plaintiff asserts that the ALJ did not offer any meaningful analysis of the factors in determining her credibility.
The standard for evaluating subjective complaints of pain is articulated in Duncan v. Sec'y. of Health & Human. Servs., 801 F.2d 847 (6th Cir. 1986):
An ALJ's finding regarding a claimant's credibility is entitled to deference because the ALJ had the unique opportunity to observe the claimant at the hearing and judge her subjective complaints. (Id.)
In the instant case, the ALJ's credibility finding deserves deference. The ALJ's opinion is based on both her assessment of Plaintiff and the inconsistencies between Plaintiff's account and the evidence in the record.
The Court's duty on appeal is not to re-weigh the evidence, but to determine if the decision below is supported by substantial evidence. Raisor v. Schweiker, 540 F.Supp. 686 (S.D. Ohio 1982). Although there might be substantial evidence that supports the Plaintiff's claim to disability from January 27, 2006 to May 2, 2012, the issue to be decided by this Court is whether the ALJ's decision is supported by substantial evidence. Casey v. Sec'y of Health & Human Servs., 987 F.2d 1230, 1233 (6th Cir. 1993). This Court finds that substantial evidence supports the ALJ's finding that Plaintiff could perform sedentary work prior to May 3, 2012, and therefore Plaintiff was not disabled before that date.
For the foregoing reasons, Plaintiff's assignments of error are unavailing. The ALJ's decision is supported by substantial evidence and is affirmed.
