JUDITH GAIL DEIN, Magistrate Judge.
The plaintiff, Brenda L. Morrison ("Morrison"), has brought this action pursuant to sections 205(g) and 1631(c)(3) of the Social Security Act, 42 U.S.C. §§ 405(g) and 1383(c)(3), in order to challenge the final decision of the Commissioner of the Social Security Administration ("Commissioner") denying her claims for Social Security Disability Insurance ("SSDI") and Supplemental Security Income ("SSI") benefits. The matter is before the court on the "Plaintiff's Motion for an Order Reversing or Remanding the Decision of the Commissioner" (Docket No. 14), by which the plaintiff requests that the court reverse the decision to deny her claims for benefits or, alternatively, remand the matter to the Social Security Administration for further administrative proceedings. It is also before the court on the "Motion to Affirm the Commissioner's Decision" (Docket No. 16), by which the Commissioner is seeking an order upholding her determination that Morrison is not disabled within the meaning of the Social Security Act, and is therefore not entitled to SSI or SSDI benefits. At issue is whether the Administrative Law Judge ("ALJ"), in reaching his decision that Morrison was not disabled, erred by failing to give controlling weight to the opinions of Morrison's primary care physician, Sofia Chu, M.D., regarding the limiting effects of the plaintiff's physical impairments. Also at issue is whether the ALJ's findings regarding the plaintiff's residual functional capacity, and in particular his assessment of Morrison's credibility, are supported by substantial evidence. As detailed below, this court finds that the ALJ committed no error, and that his decision must be upheld on appeal. Therefore, and for all the reasons described herein, the plaintiff's motion to reverse or remand is DENIED, and the Commissioner's motion to affirm is ALLOWED.
Morrison was born on April 6, 1961, and was 51 years old at the time she applied for Social Security benefits. (Tr. 146, 153). She has a bachelor's degree in psychology, which she received in 1984, and a long work history as both an artist and an office worker. (Tr. 31, 179). Specifically, during the time period from January 1993 to August 2012, Morrison was selfemployed as a glass artist, and ran a business with her husband creating and selling jewelry and various household goods. (Tr. 32-33, 179). Additionally, during the time period from April 1993 to December 2006, Morrison worked as a bookkeeper and office manager for a printing company, where she was responsible for supervising a staff of 20 people and was earning an annual salary of $30,000. (Tr. 33, 179, 196).
The record reveals that Morrison stopped working on August 10, 2012, when she was admitted to the Quincy Medical Center after complaining of shortness of breath. (Tr. 247, 587, 618-22). She was diagnosed with bilateral pulmonary emboli and severe anemia, and remained hospitalized until August 20, 2012. (Tr. 588-89). During her hospitalization, Morrison received blood transfusions and iron to treat her anemia. (Tr. 34, 588). She also was given anticoagulation therapy and an inferior vena cava filter to treat her pulmonary emboli. (Tr. 34-35, 588). Although Morrison's anemia has resolved, she is expected to remain on coumadin for the remainder of her life in order to address her pulmonary condition. (Tr. 346, 353).
In addition to anemia and pulmonary emboli, the plaintiff has a history of morbid obesity, edema, GERD and obstructive sleep apnea. (Tr. 582, 719). Moreover, in November 2013, Morrison was referred to a rheumatologist, Michael York, M.D., due to her ongoing complaints of fatigue and diffuse pain. (Tr. 745-48). Dr. York conducted laboratory testing, and gave Morrison a working diagnosis of fibromyalgia complicated by obstructive sleep apnea and benign joint hypermobility syndrome. (Tr. 732-52). However, there is no indication that this diagnosis has ever been confirmed. The plaintiff claims that her persistent fatigue, chest pain and shortness of breath, combined with poor concentration and the inability to perform tasks on a consistent basis, preclude her from carrying out any type of gainful work activity. (Tr. 181-82, 248-49).
On December 17, 2012 and January 3, 2013, Morrison completed applications for SSDI and SSI, claiming that she had been unable to work since August 10, 2012 due to pulmonary emboli, extreme anemia, shortness of breath, chest pain and persistent weakness. (Tr. 146-63, 178). Her applications were denied initially on April 3, 2013, and upon reconsideration on August 7, 2013. (Tr. 61-62, 87-88). Morrison then requested and was granted a hearing before an ALJ, which took place on July 16, 2014 in Boston, Massachusetts. (Tr. 26-48, 106-07, 120-25). The plaintiff, who was represented by counsel, appeared and testified at the hearing. (Tr. 31-44). The ALJ also obtained testimony from a vocational expert ("VE"), who described Morrison's vocational background based on her past work experience, and responded to hypothetical questions that were designed to determine whether jobs exist in the national and regional economies for an individual with the same age, educational background, work experience and residual functional capacity ("RFC") as the plaintiff. (
Subsequently, Morrison filed a request for review of the ALJ's decision by the Social Security Appeals Council. (Tr. 6). On September 30, 2015, the Appeals Council denied the plaintiff's request, thereby making the ALJ's decision the final decision of the Commissioner for purposes of review. (Tr. 1-3). Accordingly, the plaintiff has exhausted all of her administrative remedies and the case is ripe for judicial review pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3).
The ALJ concluded that from August 10, 2012 through the date of his decision on August 20, 2014, Morrison "ha[d] not been under a disability, as defined in the Social Security Act," which defines "disability" as "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment or combination of impairments that can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than 12 months." (Dec. 1 and Finding #7; Tr. 10, 19).
The first inquiry in the five-step evaluation process is whether the claimant is "engaged in substantial gainful work activity[.]"
The second inquiry is whether the claimant has a "severe impairment," meaning an "impairment or combination of impairments which significantly limits [her] physical or mental ability to do basic work activities[.]" 20 C.F.R. §§ 404.1520(c), 416.920(c). If not, the claimant is deemed not to be disabled and the application for benefits is denied.
The third inquiry is whether the claimant has an impairment equivalent to a specific list of impairments contained in Appendix 1 of the Social Security regulations, in which case the claimant would automatically be found disabled.
The fourth inquiry asks whether "the applicant's `residual functional capacity' is such that he or she can still perform past relevant work[.]"
(Dec. Finding #5; Tr. 16-17). Morrison challenges this finding, and contends that it was not based on substantial evidence.
In reaching his conclusion regarding the plaintiff's RFC, the ALJ followed well established procedures. He first considered all of Morrison's symptoms and the extent to which those symptoms were consistent with the objective medical evidence and other evidence in the record. (Dec. 8; Tr. 17). Accordingly, the ALJ reviewed the plaintiff's medical records, which consisted of records covering the time period from August 2012 through May 2014. (
After explaining the basis for his RFC determination, the ALJ compared Morrison's RFC to the physical and mental demands of her past work as a glass artist, office manager and bookkeeper, and considered the VE's testimony that an individual with Morrison's age, education, work history and RFC would be capable of returning to each of these positions. (Dec. 10; Tr. 19). The ALJ determined that each of the plaintiff's past jobs, as actually performed, "does not require the performance of work-related activities precluded by the claimant's [RFC]." (Dec. Finding #6; Tr. 19). Accordingly, he concluded that Morrison was capable of performing her past relevant work. (
If the ALJ finds that the claimant has the RFC to perform her past relevant work, the claimant is deemed not to be disabled, and there is no need for the ALJ to proceed to step five.
In this action, Morrison is seeking judicial review of the Commissioner's "final decision" pursuant to the Social Security Act § 205(g), 42 U.S.C. § 405(g) (the "Act"). The Act provides in relevant part as follows:
42 U.S.C. § 405(g) (emphasis added). The Supreme Court has defined "substantial evidence" to mean "more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
As the First Circuit has explained:
"Even in the presence of substantial evidence, however, the Court may review conclusions of law, and invalidate findings of fact that are `derived by ignoring evidence, misapplying the law, or judging matters entrusted to experts.'"
The plaintiff's principal challenge to the ALJ's decision concerns his treatment of the available opinion evidence in connection with his finding that the plaintiff retained the physical RFC to perform a limited range of sedentary work. Specifically, Morrison contends that the ALJ committed error by crediting the opinions of a State agency physician, Swaran Goswami, M.D., over those of her treating physician, Dr. Chu, and by "substitut[ing] his own judgment about the outcome of Plaintiff's treatment for her pulmonary emboli, sleep apnea, chest pain and tightness, and shortness of breath rather than rely on medically supported opinion of the [plaintiff's] treating physician." (Pl. Mem. (Docket No. 15) at 7-9). For the reasons that follow, this court finds that there was substantial support for the ALJ's treatment of the available opinion evidence, and that his decision on that matter must be upheld.
On August 6, 2013, Dr. Goswami reviewed the available medical records and completed an assessment of Morrison's physical RFC in connection with the plaintiff's requests for reconsideration of her claims for SSI and SSDI. (Tr. 70-72, 82-84). Dr. Goswami noted that Morrison was a 52-year old obese female, who suffered from "several pulmonary emboli, blood clots, extreme anemia, shortness of breath, chest pain, chest pressure, [and] persistent weakness." (Tr. 71, 83). She determined that despite these limitations, Morrison retained the capacity to lift 20 pounds occasionally and 10 pounds frequently; to stand and/or walk for about 6 hours in an 8-hour workday; to sit for about 6 hours in an 8-hour workday; and to push and/or pull without limitation. (Tr. 70, 82). In addition, Dr. Goswami opined that Morrison could climb ramps or stairs occasionally, and balance, stoop, kneel, crouch and crawl occasionally, but that she could never climb ladders, ropes or scaffolds. (Tr. 70-71, 82-83). While Dr. Goswami found that the plaintiff had no manipulative, visual or communicative limitations, she recommended that Morrison avoid concentrated exposure to extreme cold, extreme heat, humidity, fumes, odors, dust, gases, poor ventilation and hazards such as machinery and heights. (Tr. 71, 83). Accordingly, Dr. Goswami concluded that Morrison's impairments did not preclude her from performing work at the light level of exertion.
While the record contains no other assessments of Morrison's RFC, it does contain opinion evidence from Dr. Chu, one of the plaintiff's primary care physicians. (
2. Chronic fatigue and muscle pain — working diagnosis is fibromyalgia and mixed connective tissue disease. This makes it difficult to stand for long periods of time because it induces pain in her joints.
3. Anxiety/depression — this is a result of her chronic medical issues that she faces daily, and her financial stressors.
4. Foot pain — gout verses arthritis verses connective tissue disorder, intermittent, but persistent and make it difficult to stand or walk for periods at a time.
(
The ALJ considered Dr. Chu's opinions in connection with his finding regarding Morrison's RFC. (Dec. 9; Tr. 18). He first noted that questions of disability are reserved for the Commissioner. (
(
The ALJ also explained that he had given "some weight" to Dr. Goswami's assessment of the plaintiff's physical RFC. (Dec. 10; Tr. 19). In connection with this decision, the ALJ acknowledged that the State agency physician had no opportunity to examine the plaintiff. (
Although the ALJ relied on Dr. Goswami's assessment, he rejected the State agency physician's opinion that Morrison retained the capacity to perform work at the light exertional level. Instead, he explained that he had reduced the Morrison's exertional level to sedentary based on both the medical evidence and the plaintiff's testimony at the hearing. (
This court finds that the ALJ's findings on these matters were both appropriate and well supported by the evidentiary record. As an initial matter, the ALJ was not required to accept Dr. Chu's opinion that Morrison was "physically disabled" and incapable of working. (
To the extent Morrison contends that the ALJ was otherwise required to give controlling weight to the opinions of Dr. Chu, her argument is unpersuasive. Pursuant to the social security regulations, "[c]ontrolling weight will be given to a treating physician's opinion on the nature and severity of a claimant's impairments if the opinion `is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence' in the record."
"Where controlling weight is not given to a treating source opinion, the ALJ considers an array of factors to determine what weight to grant the opinion[.]"
In this case, the ALJ provided good reasons for his decision to give Dr. Chu's opinions "less weight." As the ALJ explained in his written decision, Dr. Chu suggested that the plaintiff may be suffering from a number of conditions that are not substantiated by the plaintiff's medical records. (Dec. 9; Tr. 18). For example, Dr. Chu stated that Morrison suffers from anxiety and depression. (Tr. 752). However, the record contains no evidence that the plaintiff was ever diagnosed with, or attempted to obtain treatment for, either of these conditions. In fact, the medical records, including records of Dr. Chu's own encounters with the plaintiff, consistently describe Morrison's psychiatric status as normal. (
Dr. Chu also indicated that Morrison may be suffering from fibromyalgia or mixed connective tissue disease. (Tr. 752). However, there is no indication that either of these conditions has been confirmed by any laboratory tests or physical evaluations. (
The ALJ further explained that while Dr. Chu described various limitations resulting from Morrison's physical impairments, she did not specify the degree to which those limitations would impact the plaintiff's ability to perform various tasks. (
To the extent Morrison argues that the opinion of Dr. Goswami, the State agency consultant, cannot outweigh the opinion of a treating physician, this argument too lacks merit. "State agency physicians are qualified as experts in the evaluation of medical issues in disability claims."
In this case, Dr. Goswami's RFC assessment was the only opinion from a medical expert that specifically described what Morrison could do despite her impairments. Additionally, the ALJ determined, following a thorough review of the plaintiff's medical history and consideration of her testimony at the hearing, that Dr. Goswami's "opinion is generally consistent with and supported by the record as a whole." (Dec. 10; Tr. 19;
Finally, there is no merit to the plaintiff's contention that the ALJ "substituted his own judgment about the outcome of Plaintiff's treatment for her pulmonary emboli, sleep apnea, chest pain and tightness, and shortness of breath rather than rely on medically supported opinion of the treating physician." (Pl. Mem. at 8). As described above, the ALJ based his finding of the plaintiff's RFC on a "careful consideration of the entire record," including the medical evidence, the available opinion evidence and the plaintiff's own allegations. (
In connection with his RFC assessment, the ALJ evaluated the credibility of Morrison's claim that the intensity, persistence and limiting effects of the pain and other symptoms she suffers as a result of her impairments render her incapable of working. Although the ALJ found that Morrison's medical conditions "could reasonably be expected to cause the alleged symptoms[,]" he determined that "[h]er alleged limitations are self-imposed restrictions that are not fully supported by the medical evidence and are inconsistent with some of her own actions." (Dec. 8-9; Tr. 17-18). Accordingly, he concluded that her statements regarding the intensity, persistence and limiting effects of her symptoms were "not entirely credible[.]" (Dec. 9; Tr. 18). The plaintiff argues that there is no support for these findings. (
In support of his conclusion regarding Morrison's credibility, the ALJ first described why he found Morrison's claim of disabling symptoms at odds with her own actions. As the ALJ explained in his written decision, "[t]he claimant's ability to carry out activities of daily living remains reasonably intact." (Dec. 8; Tr. 17). Thus, the ALJ found it significant that the plaintiff could prepare some light meals and complete certain household chores, had no difficulty with personal hygiene, was able to drive and go outside on a daily basis, and was able to provide care for her cats such as giving them food and water. (Dec. 7-8; Tr. 16-17). He also noted that Morrison was able to perform shopping on a computer, handle her own finances, interact well with others and act in her own interest. (Dec. 8; Tr. 17). In short, the ALJ determined that Morrison had no more than mild restrictions in her activities of daily living, and no difficulties in social functioning. (Dec. 7; Tr. 16).
The ALJ's findings regarding Morrison's daily activities are supported by substantial evidence in the record. On January 18, 2013, Morrison completed a Function Report at the request of the Social Security Administration. (Tr. 185-93). Therein, Morrison indicated that she has no problems with personal care, goes outside on a daily basis, is able to perform sedentary activities, and has no difficulties managing her finances. (Tr. 187-90). She also stated that she regularly spends time with others, and has no cognitive limitations. (Tr. 190). During the hearing held on July 16, 2014, the plaintiff testified that she is able to shower, dress and prepare simple meals, that she gets up every two hours and moves around, and that she is able to complete simple chores such as making the bed and folding laundry. (Tr. 32, 35, 40). She also stated that she is able to drive and ride in a car, and that she typically spends her day reading, watching television, listening to music, and speaking on the phone with family and friends. (Tr. 32, 37). When asked about her social functioning, Morrison testified that she has no problems interacting with other people. (Tr. 38). She further indicated that she is able to go to the movies or to events such as a wedding, as long as she is dropped off close to the door. (Tr. 43-44). Thus, although Morrison's testimony and written answers to questions reveal that her activities are hindered by her physical limitations, and that she is no longer able to complete tasks that she was able to perform prior to her hospitalization in 2012, there is adequate evidence to support the ALJ's finding that she has no more than mild restrictions in her ability to carry out day-to-day activities and is not as limited as she claims.
The ALJ also relied on the medical records to support his determination that Morrison's complaints of disabling symptoms were not entirely credible and that her impairments, while severe, "are not so limiting that the claimant could not perform at the [RFC] level set forth above." (
As the ALJ stated in his written decision, the records show that "[a]s of December 2012, [Morrison's] acute pulmonary embolus was resolved[.]" (Dec. 9; Tr. 18;
With respect to Morrison's obesity, the ALJ noted that the plaintiff had been evaluated by multiple specialists, and cleared to receive a vertical sleeve gastrectomy. (
Finally, the ALJ's decision to discount Morrison's credibility is supported by Dr. Goswami's opinion that her impairments would not preclude her from performing light work. While the ALJ further reduced Morrison's exertional level to sedentary in order to account for evidence in the medical record and Morrison's own testimony, as described above, he reasonably relied on Dr. Goswami's opinion as further evidence that the plaintiff remained capable of working.
Ordinarily, "[t]he credibility determination by the ALJ, who observed the claimant, evaluated [her] demeanor, and considered how [her] testimony fit in with the rest of the evidence, is entitled to deference, especially when supported by specific findings."
For all the reasons detailed herein, the "Plaintiff's Motion for an Order Reversing or Remanding the Decision of the Commissioner" (Docket No. 14) is DENIED, and the defendant's "Motion to Affirm the Commissioner's Decision" (Docket No. 16) is ALLOWED.