SANDRA S. BECKWITH, Senior District Judge.
This matter is before the Court on Magistrate Judge Bowman's Report and Recommendation of March 12, 2014 (Doc. No. 16) and Plaintiff Keli Shay Ziggas's objections to the Report and Recommendation. Doc. No. 27. In her Report and Recommendation, Judge Bowman concluded that the Administrative Law Judge's ("ALJ") determination that Plaintiff is not disabled under the Social Security regulations because she has the residual functional capacity ("RFC") to perform a limited range of jobs at the light level of exertion was supported by substantial evidence. Judge Bowman, therefore, recommended that the ALJ's decision be affirmed and this case be closed on the docket of the Court. As is particularly relevant here, Plaintiff contends that the ALJ erred by rejecting disabling physical and mental health RFC opinions submitted by, respectively, her treating physician and her treating mental health therapist, who is a licensed social worker. In her report, however, Judge Bowman concluded that the ALJ's decision not to give controlling or even significant weight to these disabling opinions was supported by substantial evidence. Finding no error in Judge Bowman's analysis of the ALJ's decision, Plaintiff's objections to the Report and Recommendation are not well-taken and are
Plaintiff Keli Shay Ziggas filed a claim for disability insurance benefits based on both physical and mental impairments. The Social Security Administration denied her claim initially and upon reconsideration. Plaintiff requested and received an evidentiary hearing before an ALJ, which took place in April 2011. In July 2011, the ALJ issued a written decision finding that Plaintiff is not disabled under the Social Security regulations.
Proceeding through the five-step sequence for analyzing disability claims, the ALJ determined that Plaintiff has not engaged in any substantial gainful activity since June 2007. The ALJ next found that Plaintiff has severe impairments of lumbar and cervical spine degenerative disc disease, diabetes mellitus, irritable bowel syndrome, fibromyalgia, headaches, chronic obstructive pulmonary disease (COPD), major depressive disorder, and generalized anxiety disorder, but that none of these impairments, individually or in combination, meets a listed impairment which would direct a finding of disability.
The ALJ then determined that Plaintiff has the physical RFC to perform light work with some additional limitations, specifically, that she can never climb ropes, ladders or scaffolds, she can never crawl, she can occasionally climb ramps or stairs, balance, stoop, kneel or crouch, she can reach overhead occasionally, and she can perform bilateral manipulation involving gross manipulation and fine manipulation on a frequent basis. The ALJ determined that Plaintiff has the mental RFC to perform jobs with routine and repetitive tasks that involve only simple work-related decisions, she can interact with the public but cannot perform transactional work such as sales or negotiations, and she can perform only low stress work involving only occasional changes in the work setting. Finally, the ALJ found that Plaintiff needs a job with a sit/stand option once every 60 minutes for approximately one minute.
The ALJ then concluded that this RFC would not permit Plaintiff to perform her past relevant work as a lab technician. Based on the testimony of the vocational expert, however, the ALJ found that this RFC would allow Plaintiff to perform several jobs that exist in significant numbers in the national economy, such as bench assembler, hand packer, and inspector. Based on her determination that Plaintiff has the RFC to perform these jobs, the ALJ concluded that Plaintiff is not disabled under the Social Security regulations.
In developing Plaintiff's physical and mental RFC, the ALJ gave little weight to an RFC opinion submitted by Plaintiff's treating physician, Dr. Heather Owens, and little weight to the RFC opinion submitted by Plaintiff's mental health therapist, Susan Ullman, a licensed social worker.
Dr. Owens completed a Physical Residual Functional Capacity Questionnaire in March 2010 which was, in the words of the ALJ, "very limiting." Tr. 33. According to Dr. Owens's report, Plaintiff has lumbar degenerative disc disease, hypothyroidism, endometriosis, Type II diabetes, a cervical herniated disc, fibromyalgia, and asthma. Tr. 722. These conditions cause pain, fatigue and shortness of breath. Dr. Owens indicated further that Plaintiff's cervical and lumbar pain is exacerbated by pushing, pulling, standing, bending, standing, walking and prolonged sitting.
The ALJ, however, gave little weight to Dr. Owens's opinion on the grounds that "it is not found to be consistent with the overall medical evidence of record, including her own treatment notes" and because "it appears to be based largely on the claimant's subjective report of her symptoms and limitations." Tr. 34. Instead, the ALJ gave significant weight to the opinions of the state agency physicians in determining that Plaintiff has the physical RFC to perform a limited range of light work.
Plaintiff's mental health therapist, Susan Ullman, a licensed social worker who was treating Plaintiff for depression, gave an extremely limiting mental RFC opinion. Ms. Ullman indicated that Plaintiff is seriously limited in her abilities to remember worklike procedures, understand, remember and carry out very short and simple instructions, and respond appropriately to changes in a routine work setting. Tr. 1010. Ms. Ullman stated that Plaintiff is limited but can satisfactorily ask simple questions or ask for assistance and interact appropriately with co-workers.
Instead, in arriving at Plaintiff's mental RFC, the ALJ "generally accepted" the opinions of the state agency psychologists except that she concluded that Plaintiff is moderately limited in social functioning and moderately limited in concentration, persistence and pace, and she could have only limited contact with the public for transactional work. Tr. 35. In contrast, for instance, Dr. Chiappone indicated that Plaintiff is only mildly impaired in her ability to interact with co-workers, supervisors, and the general public. Tr. 635.
As stated above, the ALJ determined that Plaintiff is not disabled under the Social Security regulations because the RFC she adopted indicates that Plaintiff can perform several jobs that exist in significant numbers in the national economy. After the Commissioner denied Plaintiff's request for review of the ALJ's decision, Plaintiff filed a timely complaint for judicial review of that decision.
In two assignments of error, Plaintiff contends that the ALJ failed to give good reasons for giving less than significant weight to the opinions of Dr. Owens and Ms. Ullman. Plaintiff argues further that the ALJ violated the Sixth Circuit's opinion in
Magistrate Judge Bowman's report found that both the weight the ALJ gave to the medical opinions and the ALJ's credibility determinations were supported by substantial evidence. Supporting the weight, or lack thereof, the ALJ gave to Dr. Owens's opinion, Judge Bowman noted the contrary opinions of the state agency physicians, reports that Plaintiff's diabetes is stable, normal chest and head CT scans, MRI's showing no nerve root compression or cervical radiculopathy, normal neurological and musculoskeletal examinations, and an absence of complaints from Plaintiff in treatment notes concerning fibromyalgia. Judge Bowman also determined that the ALJ did not violate
Judge Bowman next determined that Ms. Ullman is not a treating source under the Social Security regulations and that, therefore, the ALJ did not have to give her opinion any deference, although she did have to consider it. Judge Bowman found that the ALJ's decision to give little weight to Ms. Ullman's opinion was supported by substantial evidence, pointing out for instance, inconsistencies between the finding that Plaintiff has an extremely impaired memory and the absence of complaints or findings of an impaired memory in Plaintiff's initial assessment. Finally, Judge Bowman found that the ALJ's credibility determination was supported by substantial evidence. In rejecting Plaintiff's complaints of disabling pain, Judge Bowman pointed out the ALJ's reliance on Plaintiff's normal physical examinations on at least several occasions and her findings that Plaintiff's activities are only mildly impaired. Accordingly, Judge Bowman recommended affirming the ALJ's decision.
Plaintiff filed timely objections to Judge Bowman's report which are ready for disposition.
The relevant statute provides the standard of review to be applied by this Court in reviewing decisions by the ALJ.
Plaintiff's argument that the ALJ erred in the weight she gave to Dr. Owens's opinion implicates the treating physician rule.
Under the "treating physician rule," the opinion of a claimant's treating physician is accorded controlling weight if it is "well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with other substantial evidence in [the] case record[.]"
With the above standards in mind, the Court concurs with Judge Bowman's assessment that the ALJ's decision to give little weight to Dr. Owens's extreme disabling opinion was supported by substantial evidence.
First, as the ALJ noted, Dr. Owens's opinion was inconsistent with much of the medical evidence, including her own treatment notes as well as the treatment notes of other doctors in her practice group. An ALJ is entitled to reject the opinion of a treating physician when it is inconsistent with his or her treatment notes.
Second, the ALJ's determination that Dr. Owens's opinion was inconsistent with the overall medical record was supported by substantial evidence. The ALJ noted normal physical examination findings on numerous occasions, consistent observations that Plaintiff appeared in no acute distress and had normal strength, muscle tone, and gait, absence of current complaints concerning fibromyalgia symptoms, and an MRI showing only mild to moderate degenerative disc disease and degenerative facet changes. Tr. 796-797.
Third, the ALJ did not run afoul of
Next, and relatedly, Plaintiff is incorrect that the ALJ erred by not stating how much weight she gave to the opinion of Dr. Chiappone, the state agency psychologist. Plaintiff is further incorrect that Dr. Chiappone's opinion that Plaintiff is moderately impaired in the ability to carry out simple instructions precludes her ability to work. As to the first argument, the ALJ specifically stated that "the opinions of the state agency reviewing psychologists are generally accepted," Tr. 35, a statement which indicates that the ALJ gave Dr. Chiappone's opinion significant weight. Moreover, is not clear that Dr. Chiappone actually stated that Plaintiff is moderately impaired in her ability to carry out simple instructions. Dr. Chiappone stated that Plaintiff is not impaired in her ability to remember simple instructions, that she is moderately impaired in remembering simple instructions, and moderately impaired "in her ability to carry out and persist over time due to depression and anxiety." Tr. 635.
Plaintiff notably does not provide any authority to support her contention that a moderate limitation in carrying out simple instructions precludes the claimant's ability to work. In any event, courts generally agree that although the Social Security regulations do not define a "moderate limitation" it is commonly defined on agency forms "as meaning that the individual is still able to function satisfactorily."
Finally, the state agency reviewing psychologist, whose opinions the ALJ also "generally accepted," indicated that Plaintiff is not significantly limited in her ability to carry out simple instructions. Tr. 653. Therefore, the ALJ's determination that Plaintiff's mental impairments do not limit her ability to carry out simply instructions is supported by substantial evidence in the record. In other words, even though the ALJ "generally accepted" Dr. Chiappone's opinion, his opinion does not necessarily trump the opinion of the other state agency psychologist and mandate a finding that Plaintiff's ability to carry out simple instructions is impaired.
Continuing further, the ALJ did not err in the weight she gave to the opinions of Ms. Ullman, the social worker. Social workers are not acceptable medical sources under the applicable regulations and their opinions are not entitled to be given any weight or deference by the ALJ.
Finally, the ALJ did not err in assessing Plaintiff's credibility. Plaintiff complains that the activities of daily living she can perform do not support the ALJ `s determination that she can work on a sustained basis. Assessing the claimant's credibility, however, involves more than just evaluating the claimant's activities of daily living; it requires consideration of the whole medical record, including "medical signs and lab findings, the claimant's own complaints of symptoms, any information provided by the treating physicians and others, as well as any other relevant evidence contained in the record."
Here, the ALJ cited more than just Plaintiff's activities of daily living in discounting her subjective complaints about the severity of her symptoms. In particular, the ALJ observed that Plaintiff's Lyme titres are normal, her CT scans were normal and there were no current complaints of migraines, Plaintiff's diabetes was reported as stable and there was no evidence of neuropathy or end organ damage, Plaintiff had no nerve root compression, and normal motor strength and reflexes and a well-coordinated gate. Tr. 32-33. The ALJ also noted the absence of current complaints about fibromyalgia and the fact that treating doctors consistently noted that Plaintiff did not appear to be in acute distress despite complaining of high levels of pain. Tr. 33-34. The ALJ also observed that Plaintiff appeared to be able to tolerate sitting through hour-long counseling sessions without discomfort or losing her concentration. Tr. 34. Finally, the ALJ cited findings that Plaintiff is able to interact appropriately with others and improvement in her mental status after starting Trazadone and Zoloft. Tr. 34. These findings all support the ALJ's decision to discount Plaintiff's credibility.
In conclusion, Plaintiff's objections to Magistrate Judge Bowman's Report and Recommendation are