TERRY I. ADELMAN, Magistrate Judge.
This cause is on appeal from an adverse ruling of the Social Security Administration. The suit involves Applications for Disability Insurance Benefits under Title II of the Social Security Act and for Supplemental Security Income under Title XVI of the Act. Claimant has filed a Brief in Support of his Complaint, and the Commissioner has filed a Brief in Support of her Answer. The parties consented to the jurisdiction of the undersigned pursuant to 28 U.S.C. § 636(c).
On July 11, 2011, Claimant Indiana S. Rice filed Applications for Disability Insurance Benefits under Title II of the Act, 42 U.S.C. §§ 401
At the hearing on August 7, 2012, Claimant testified in response to questions posed by the ALJ and counsel. (Tr. 32-75). At the time of the hearing, Claimant was twenty-six years of age, and his date of birth is April 7, 1986. (Tr. 39). Claimant stands at five feet ten inches and weighs 145 pounds. (Tr. 39). He is right-handed. (Tr. 40). Claimant is single without children and lives with two friends. He takes care of fourteen dogs and a dozen cats. (Tr. 40). Claimant receives food stamps and Medicaid, and he helps around the house in lieu of paying rent. (Tr. 41-42). He takes care of the animals and does yard work. (Tr. 42). Claimant completed the eleventh grade and then received his GED. (Tr. 42). He received computer training at the Job Corps. (Tr. 43). Claimant has a computer, a cell phone, an email address, and a Facebook page. (Tr. 43).
Claimant testified that on June 30, 2011, he was experiencing extreme depression and having suicidal thoughts and presented at a hospital for admission. (Tr. 44). He testified that his stress and anxiety prevent him from performing a sit-down job. (Tr. 44). He last worked as a janitor in a health center from August, 2009 through February 15, 2010 cleaning rooms in a nursing home. (Tr. 44-45). Claimant was fired, because the other employees were bothered by his talking to himself on the job. (Tr. 45). He mopped floors and lifted trash. Claimant testified that he could not perform the janitorial job, because he has problems being around groups of people. Prior to working as a janitor, he worked as a crew member at Arby's for two to three months in 2009. (Tr.45). Claimant prepared sandwiches, worked the drive-through window, and worked the cash register. (Tr. 46). He quit after his car broke down, and he lacked transportation to get to work. He attended the Job Corps in 2007-2008 and was trained in computer repair and received some payment. (Tr. 46). He performed dock-loading work for one month at a potato products manufacturing company, but family issues forced him to leave the job and move back to Missouri. (Tr. 47). He worked for two to three months on an assembly line at a shoe factory sorting shoe soles based on color and size, but he quit when he no longer wanted the job. Claimant worked at McDonald's for nine months, but he quit when his hours were cut. (Tr. 48). Since June 30, 2011, he has not worked, but he has applied for jobs every couple of months. (Tr. 49). Claimant testified that he has applied for stocking jobs at a grocery stores, because the jobs require little interaction with people. When he applies for a job, he goes to the store and asks if the store is hiring. (Tr. 49).
After waking up around 9:00 a.m., Claimant cleans the house and helps Ms. Wood, one of his roommates, lift and carry things and complete daily activities. (Tr. 50). He plays video games and completes his online school work. (Tr. 51). He is enrolled in ITT Tech and is working on a two-year associate degree in Web design technology. Claimant testified that he receives the assignments at the beginning of the week and completes them when he has time. (Tr. 52). He taken out student loans and applied for grants. He explained the purpose of getting an associate's degree would be to further his education and be able to obtain employment he could perform from home. He plays video puzzle games on the computer and watches television. (Tr. 52). If he enjoys a particular game, he can play the game for four to six hours. (Tr. 53). Claimant does yard work and mows the lawn and helps take care of the outside animals. (Tr. 54). He goes grocery shopping or dog food shopping once a week for an hour or two. (Tr. 56). Claimant helps wash the dishes, makes his bed, vacuums, and dusts. (Tr. 57).
Although Claimant has a driver's license, he has not driven after June 30, 2011, because he does not own a vehicle. (Tr. 57). He has no driving limitations and would drive if he owned a vehicle. (Tr. 58). He smokes a package of cigarettes each day, and Ms. Wood purchases the cigarettes for him. (Tr. 59).
Claimant takes Chlordiazep for anxiety and testified the medication helps him. (Tr. 59). He takes Pristiq for depression, and he testified the medication is working better than Celexa. (Tr. 60). Dr. Gowda changed his medication one month earlier. (Tr. 60). Dr. Gowda treats his depression, and Claimant testified that Dr. Gowda has helped him. (Tr. 62). He has not been hospitalized recently for depression. (Tr. 63). He has difficulty putting his thoughts into words. He last experienced a panic attack two months earlier, and he blanked out and was nonresponsive. He testified how loud noises triggers his anxiety. (Tr. 63). Petting an animal or playing a video game calms him down. (Tr. 64). He was last hospitalized in June 2011 for treatment of depression and anxiety. He received treatment in the emergency room two months earlier. (Tr. 64).
Claimant testified that he does not have any problems concentrating or paying attention. (Tr. 65). He testified that gets along fine with people except he can be shy around a new person. He has no problems understanding instructions. (Tr. 65). He has some anxiety being in public in general. (Tr. 67).
Vocational Expert Julie Bose testified in response to the ALJ's questions. (Tr. 69-75). Ms. Bose summarized his last job as a janitor, light exertional level as described in his testimony and unskilled. (Tr. 70).
The ALJ asked Ms. Bose to assume
(Tr. 71). Ms. Bose responded yes, based on the hypothetical, such individual could perform work as a janitor as normally performed and as performed by Claimant. (Tr. 71). She further opined such individual could perform other work including medium, unskilled positions such as a laundry worker, with 4,100 jobs in Missouri and 280,489 available nationally; hand packer with 2,600 jobs in Missouri and 89,029 available nationally; and a cleaner II with 3,100 jobs in Missouri and 110,133 available nationally. (Tr. 72-73).
Next, the ALJ asked Ms. Bose to assume
(Tr. 72). Ms. Bose responded there would be no change in the numbers and all the previous jobs she cited could be performed. (Tr. 72-73).
Claimant's counsel asked Ms. Bose to assume
(Tr. 73-74). Ms. Bose responded such individual could perform work altogether including his past relevant work. (Tr. 74).
In the Disability Report — Adult, Claimant reported he stopped working on February 15, 2010, because he was fired. (Tr. 190). He completed the GED in 2005 and completed computer repair training through Job Corps in 2008. (Tr. 191).
In the Disability Report — Appeal, Claimant reported his anxiety makes it difficult to be around large groups of people for extended amounts of time. (Tr. 209-13).
In the Statement of Claimant or Other Person, he certified that he has not used any illegal drugs since January 2011. (Tr. 238).
To obtain disability insurance benefits, Claimant must establish that he was disabled within the meaning of the Social Security Act not later than the date his insured status expired — March 31, 2012.
On May 9, 2010, Claimant sought treatment in the emergency room at Wishard Health Services after being struck by a vehicle during a suicide attempt. (Tr. 246). He reported intentionally jumping in front of a moving vehicle and not taking any medications. (Tr. 247). THC, Meth, and Oxycontin are listed as his current substance abuse, and he reported being clean for six months. (Tr. 248, 263). He reported not liking how his life is going. (Tr. 248). He was admitted as mentally ill and dangerous. (Tr. 245-80). Claimant reported moving to Indianapolis four months earlier after losing his job and moving in with a former girlfriend who has since remarried. (Tr. 261). He helps out by babysitting her daughter and completing daily household tasks. (Tr. 261, 263). After fighting with her, he became very angry and stormed out and then jumped in front of a vehicle. (Tr. 261). He reported mood swings, inappropriate anger, poor sense of self, and several attempts to avoid abandonment. He developed dependence on Oxycontin when treated for chronic back pain. He had daily meth, THC and Oxycontin use in the past. (Tr. 261).
Dr. Patibandia found Claimant to have polysubstance dependence in full remission, borderline personality traits, relationship stressors, and lack of social support system, housing, financial. (Tr. 261, 264). Dr. Patibandia noted Claimant to be suffering from depression, and his suicide attempt may have been motivated to prevent being abandoned or to gain sympathy of his ex-girlfriend. (Tr. 262). Dr. Patibandia opined if the girlfriend is willing to take Claimant back, his suicide ideation would resolve and, if not, he may need to be admitted to arrange a suitable crisis plan. (Tr. 262). Claimant was released medically after x-rays showed no broken bones. (Tr. 263). On May 11, 2010, Claimant reported feeling less depressed and receiving help with his anger management. (Tr. 277). After being prescribed Zoloft, Claimant noted he had taken Zoloft in the past, and he was glad to be prescribed the anti-depressant again. (Tr. 273). Upon discharge, he would return to Missouri escorted by his ex-girlfriend to live with his mother. (Tr. 267). At the time of discharge, he denied any suicidal ideations, had a bright affect, and looked forward to returning home. (Tr. 280).
On June 30, 2011, Claimant presented at Saint Luke's Medical complaining of depression and suicidal thoughts over the past several months. (Tr. 287). He reported he had been looking for a job, but he has trouble dealing with people and cannot function in crowded places. He reported being hospitalized three times but after leaving the hospital, he did not continue taking his medications and has been off medications for almost one year. He was admitted for treatment, and Dr. Niewald started him on Celexa. Dr. Niewald found him to be stabilized on medication as he denied any suicidal ideation. (Tr. 287). In a consultation for medical management, Dr. Niewald noted how Claimant reported being diagnosed with bipolar disorder in the past, but he has not been on any medication for quite sometime. (Tr. 293). Dr. Niewald agreed with his admission to the inpatient facility for further psychiatric evaluation and treatment. (Tr. 297).
In the Psychiatric Review Technique completed on August 23, 2011 by Dr. Mark Altomari, he found there was insufficient evidence to assess the degree of functional limitation without having current functional information. (Tr. 308-18). Dr. Altomari noted how Claimant failed to return ADLs despite multiple attempts to contact him. (Tr. 318).
In the September 28, 2011 initial intake assessment at Pathways on referral by Dr. Barbin, His presenting issues were high anxiety and feelings of depression. (Tr. 470). Claimant reported he wanted to learn how to manage his depression, anxiety, and get disability approved or find work. (Tr. 475). In the Diagnostic Review Form, Mary Tatkenhorst, a community support specialist, listed major depression and post traumatic stress disorder as his clinical disorders, and economic, occupational, and problems relating to social environment as his psychosocial problems. (Tr. 468).
In the Program Authorization, he reported his mother has had many relationships with men, and he has been physically abused by his step fathers. (Tr. 466). His biological father died from suicide when he was three years old. (Tr. 466). In the October 13, 2011 Individual Progress Note, he reported a lot of anxiety and depression, and he has anxiety while filling out job applications and trouble in social situations. (Tr. 464).
On September 20, 2011, Claimant presented at Sullivan Medical to establish care and receive treatment for anxiety. (Tr. 331). He reported having difficulty working or meeting social obligations and experiencing anxiety. He reported doing better since being discharged from St. Luke's psychiatric unit last July and taking Celexa. (Tr. 331). Examination showed his affect to be flat, and he is not anxious. (Tr. 333). Dr. Jennifer Barbin found his insight, judgment, concentration, and attention span to be normal. (Tr. 333). In follow-up treatment on October 19, he reported feet pain. (Tr. 328-30). On December 14, he presented with back pain. (Tr. 325). Examination showed no cervical or lumbar spine tenderness. (Tr. 326).
In the September 28, 2011 Diagnostic Review Form, major depression and posttraumatic stress disorder are listed as his clinical disorders. (Tr. 468). Economic problems, occupational problems, other psych/environmental, and problems relating to social environment are listed as his psychosocial and environmental problems. (Tr. 468). In the Initial Intake Assessment, he reported having high anxiety, problems being around groups of people, and becoming stressed when completing paperwork. (Tr. 470-76).
In the initial meeting with Rebecca Lewis of Community Support Services ("CSS") on October 13, 2011, Claimant reported having a lot of anxiety and depression problems. (Tr. 464). He reported experiencing anxiety while filling out job applications, and he has trouble in social situations. (Tr. 464). He indicated that he wanted to learn how to manage his depression and anxiety and get disability approved or find work. (Tr. 466).
On October 14, 2011, Dr. Bhaskar Gowda completed the initial psych evaluation of Claimant. (Tr. 460). Claimant reported not having worked for two years and having applied for disability. (Tr. 460). He reported feelings of hopeless, helpless, and worthless as he cannot get or hold a job and feeling increasingly guilty for his dependency situations. He constantly worries about finances, his future, and the relationship with his parents. (Tr. 460). He denied symptoms of PTSD. (Tr. 461). Claimant reported ten suicide attempts with ten prior hospitalizations. (Tr. 461). He last worked as a computer repair person, and he lives with his mother who supports him. (Tr. 462). Dr. Gowda observed Claimant to have normal speech, his flow of thoughts to be goal directed, and no paranoia in his thought content. He denied any visual hallucinations. Dr. Gowda observed Claimant to be alert and oriented to time, place and person, his intelligence to be above average, and his immediate recall and recent and remote memory appeared to be good. (Tr. 462). Dr. Gowda found Claimant to have a GAF of 50 and found him to have bipolar disorder Type 1 depressed type, generalized anxiety disorder, panic disorder with agoraphobia, and borderline personality disorder. (Tr. 453). In the progress note, Ms. Lewis noted his mood was good and affect was congruent. (Tr. 459). In follow-up session on October 17, Claimant reported his anxiety is alright, and his depression is not really bad. (Tr. 458). He reported his depression to be under control, and his anxiety is under control so long as he is not in social situations. He explained how he wanted to find a job fixing computers since he is certified in that area. (Tr. 458).
In the October 18, 2011 progress note, Claimant reported his anxiety prevents him from entering stores, and he stays in bed when depressed. (Tr. 455). Ms. Tatkenhorst noted how his case had been assigned to Ms. Lewis. (Tr. 457).
In follow-up treatment on October 28, 2011, he reported becoming irritable and impulsive, his energy and motivation to be poor, and his anxiety/panic attacks to be worse. (Tr. 452). Dr. Gowda continued his medication regimen. (Tr. 453). On November 23, Dr. Gowda continued his medication regimen in follow-up treatment. (Tr. 450-51). Claimant reported doing a lot better and working for someone and in return, her housekeeper helps him. (Tr. 449). He is waiting for his SSI. (Tr. 449). Ms. Lewis observed Claimant to be agitated. He moved to Cuba and helps around the house doing maintenance, yard work, and taking care of the animals. (tr. 447). He reported being unable to work, because he cannot stand being around people for too long. (Tr. 447).
On November 30, 2011, he had his weekly meeting with Ms. Lewis. (Tr. 446). Ms. Lewis observed his mood to be good and his affect to be congruent. He reported not being upset lately and now has motivation to do every day things like shower. (Tr. 446). On December 21, Claimant appeared for a doctor's appointment, but the appointment had been changed. (Tr. 44). On December 27, Dr. Gowda observed insight and judgment appeared to be good. (Tr. 442). He reported feeling better and helping his family take care of dogs and other animals. (Tr. 441). His energy and motivation are good, but his anxiety attacks are worse. (Tr. 441). Dr. Gowda continued his medication regimen. (Tr. 442).
During his weekly meetings on January 3 and 9, 2012, Claimant reported being depressed lately. (Tr. 438, 440). He has looked into schools, because he wanted to be recertified on computers. (Tr. 438).
Ms. Lewis met with Claimant to help him get to the Pathway's office for his appointment with Dr. Gowda. (Tr. 433). Ms. Lewis observed his mood to be good and his affect to be congruent. (Tr. 433). He reported being excited about the possibility of attending school online and has completed some financial aide applications. (Tr. 434). He has handled the application process well without any anxiety. Claimant reported not having any anxiety since his medication was changed from Buspar to Limigdal. He discussed more job opportunities and the possibility of going further in school. (Tr. 434). During treatment on January 24, 2012, Dr. Gowda increased his Celexa dosage and stopped his Buspar prescription. (Tr. 436). Claimant reported doing a "lot better now" and helping his landlord clean her trailers. (Tr. 435). His mood has improved, and "[h]e has been trying to get a job now as he gets bored quickly." He reported his motivation and energy are good, but his anxiety/panic attacks are worse. (Tr. 435).
Ms. Lewis met with Claimant to help him get to the Pathway's office for his appointment with Dr. Gowda on February 22, 2102. (Tr. 428). Ms. Lewis observed his mood to be good and his affect to be congruent. He reported having little anxiety but being depressed due to Valentine's Day. To keep busy, he has been taking care of the animals and cleaning the house. (Tr. 433). Dr. Gowda observed his thoughts to be goal directed and no paranoia in his thought content. (Tr. 431). Dr. Gowda noted he is alert and oriented to time, place, and person; his immediate recall, recent and remote memory appeared to be good; and his insight and judgment appeared to be good. (Tr. 431).
On March 7, 2012, Claimant returned to Sullivan Medical for treatment of joint and back pain and abdominal discomfort. (Tr. 322). Examination showed tenderness of thoracic and lumbar spine and a full range of motion of both. (Tr. 323). The March 14, 2012 x-rays showed negative results. (Tr. 336-38). The March 14, 2012 of his right foot showed an old healed fracture deformity of the proximal fifth metatarsal. (Tr. 339). In follow-up on April 11, he presented with clearance for foot surgery. (Tr. 319).
Ms. Lewis met with Claimant to help him get to the Pathway's office for his appointment with Dr. Gowda on March 20, 2012. (Tr. 423). Ms. Lewis observed his mood to be good and his affect to be congruent. Claimant reported starting school the previous day, and he has already completed a homework assignment. His anxiety has been fine, but he has had a little depression. (Tr. 423). Claimant reported having a hard time going out due to financial reasons, and he is waiting on disability. (Tr. 425). Dr. Gowda continued his medication regimen. (Tr. 427).
While receiving treatment of equinus right foot, Dixie Fox observed Claimant to be alert and oriented, and his mood affect to be normal. (Tr. 501)
On April 17, 2012, Claimant reported he has been feeling anxious as he is cutting down his smoking. (Tr. 419). Dr. Gowda observed his thoughts to be goal directed and no paranoia in his thought content. (Tr. 420). Dr. Gowda noted he is alert and oriented to time, place, and person; his immediate recall, recent and remote memory appeared to be good; and his insight and judgment appeared to be good. Dr. Gowda continued his medication regimen. (Tr. 420).
On April 26, 2012, Claimant met Gregory Hutchison of CSS. (Tr. 417). He reported being in a good mood lately and feeling well. He has been taking his medications, and the medications seem to be working well. Claimant reported his online classes are going well, and he might look into getting a part time job. (Tr. 417).
Claimant met with Mr. Hutchison on May 2, 2012, to assess his behavior and review medication management. (Tr. 415). Claimant reported feeling pretty well lately, and his online classes are going well. He continues to help with the household chores and take care of several animals. (Tr. 415). On May 9, Claimant reported taking his medications, and his medications are working well. (Tr. 413). He had to contact the IT Department to help him get his internet working again. (Tr. 413). On May 14, he reported doing well with his school work and using his computer and playing video games. (Tr. 411).
On May 6, 2012, Claimant presented at Missouri Baptist Sullivan Hospital accompanied by his sister who stated her brother has PTSD and the fighting between his mother and his step father set him off. (Tr. 345). Dr. Otha Rains ordered a saline lock and lithium. (Tr. 346). A urine test showed positive for Benzo. (Tr. 352).
On May 22, 2012, Mr. Hutchison accompanied him to his visit with Dr. Gowda. (Tr. 406). He reported being slightly depressed, because he could not do much after his foot surgery. (Tr. 407). He is busy with his online course work. Claimant told Dr. Gowda that he was having difficulty sleeping. Dr. Gowda adjusted his medications to try to help him have more energy and sleep better. (Tr. 407, 409). He reported feeling depressed after undergoing surgery on his ankle. (Tr. 408). His energy and motivation are good, and he helps take care of the dogs and other animals. (Tr. 408).
Claimant met with Mr. Hutchison on May 31, 2012, and reported sleeping better and finishing one of his classes. (Tr. 404). On June 6, Claimant reported feeling better each day, and his medication seemed to be working well. (Tr. 402). His anxiety has been under control. He has been studying for a final exam, and he starts more classes on June 18. (Tr. 402). In the June 12 meeting, he reported feeling slightly depressed and having some suicidal ideation. (Tr. 400). He completed two classes and will start two new classes on June 18. He did well in his classes. Claimant reported being able to do a few more household chores. (Tr. 400). On June 21 during his meeting with Mr. Hutchison, he reported starting his new classes, Math 1 and Web Programming, and having attended a barbeque for his grandmother. (Tr. 398). He became a little nervous with all of the people, but he is becoming bored sitting around the house. (Tr. 398).
In follow-up treatment with Dr. Gowda on June 26, 2012, Claimant reported feeling depressed from time to time and having mood fluctuations on a regular basis. (Tr. 395). He has suicidal thoughts on a daily basis, but he has not been acting on the thoughts. He is taking online classes and working towards a degree in web design technology. A friend helps him with housing and food stamps. (Tr. 395). Dr. Gowda observed his thoughts to be goal directed and no paranoia in his thought content. (Tr. 396). Dr. Gowda noted he is alert and oriented to time, place, and person; his immediate recall, recent and remote memory appeared to be good; and his insight and judgment appeared to be fair. Dr. Gowda changed his medication regimen. (Tr. 396). Dr. Gowda encouraged him to continue working towards his degree and requested his counsel "fax any documents that the client needed to have filled out for the hearing" on August 7. (Tr. 393).
On July 5, 2012, Claimant reported feeling better lately and sleeping better. (Tr. 391). The Pristiq was giving him more energy, and he seemed to be feeling better. His online classes were going well, and he shared a few of his web programming projects with Mr. Hutchison. Claimant stated that he would "want Dr. Gowda to assist him with his disability process by writing a letter or filling out paperwork." (Tr. 391).
During treatment on July 11, 2012, Claimant reported his mood being more even. (Tr. 388). He denied having any suicidal thoughts. His friend helps him with housing and food stamps, and he has been taking online classes. (Tr. 388). Dr. Gowda observed his thoughts to be goal directed and no paranoia in his thought content. (Tr. 389). Dr. Gowda noted he is alert and oriented to time, place, and person; his immediate recall, recent and remote memory appeared to be good; and his insight and judgment appeared to be fair. Dr. Gowda continued his medication regimen. (Tr. 389).
On July 24, 2012, Dr. Gowda completed an Assessment for Social Security Disability Claim wherein he opined that Claimant's mental impairments would prevent him from engaging in any kind of sustained full-time competitive employment, and his impairments would have prevented him from working on or before March 31, 2012. (Tr. 478). In the Residual Functional Capacity Assessment, Dr. Gowda found Claimant to have marked limitations in his ability to remember and carry out detailed instructions and maintain adequate attention and moderate limitations in his ability to maintain a work schedule, understand and carry out simple instructions, to make appropriate work related decisions, and to complete a normal work week. (Tr. 480). Dr. Gowda further found Claimant to have marked limitations in social interactions including his ability to interact appropriately with the general public or customers and adaptation. (Tr. 480).
The ALJ found that Claimant meets the insured status requirements of the Social Security Act through March 31, 2012. (Tr. 18). Claimant has not engaged in substantial gainful activity since June 30, 2011, the amended alleged onset date. (Tr. 18). The ALJ found that the medical evidence establishes that Claimant has the severe impairments of bipolar disorder I, depressed type, generalized anxiety disorder, panic disorder with agoraphobia, and borderline personality disorder, but no impairment or combination of impairments listed in, or medically equal to one listed in Appendix 1, Subpart P, Regulations No. 4. (Tr. 18-20). The ALJ found that Claimant has the residual functional capacity to perform the full range of work at all exertional levels but with the following restrictions: he is limited to work with only occasional interaction with coworkers, supervisors, and the general public; and he must avoid even moderate exposure to very loud noises. (Tr. 21). He is able to perform past relevant work as a janitor. (Tr. 25). In the alternative, the ALJ found there are other jobs existing in the national economy he is also able to perform. Considering his age, education, work experience, and residual functional capacity, the ALJ found there are jobs that exist in significant numbers in the national economy that Claimant can perform such as laundry worker, hand packer, and cleaner II, . (Tr. 26). The ALJ concluded that Claimant has not been under a disability from June 30, 2011, through the date of the decision. (Tr. 27).
In a disability insurance benefits case, the burden is on the claimant to prove that he or she has a disability.
The Commissioner has promulgated regulations outlining a five-step process to guide an ALJ in determining whether an individual is disabled. First, the ALJ must determine whether the individual is engaged in "substantial gainful activity." If she is, then she is not eligible for disability benefits. 20 C.F.R. § 404. 1520(b). If she is not, the ALJ must consider step two which asks whether the individual has a "severe impairment" that "significantly limits [the claimant's] physical or mental ability to do basic work activities." 20 C.F.R. § 404.1520(c). If the claimant is not found to have a severe impairment, she is not eligible for disability benefits. If the claimant is found to have a severe impairment the ALJ proceeds to step three in which he must determine whether the impairment meets or is equal to one determined by the Commissioner to be conclusively disabling. If the impairment is specifically listed or is equal to a listed impairment, the claimant will be found disabled. 20 C.F.R. § 404.1520(d). If the impairment is not listed or is not the equivalent of a listed impairment, the ALJ moves on to step four which asks whether the claimant is capable of doing past relevant work. If the claimant can still perform past work, she is not disabled. 20 C.F.R. § 404.1520(e). If the claimant cannot perform past work, the ALJ proceeds to step five in which the ALJ determines whether the claimant is capable of performing other work in the national economy. In step five, the ALJ must consider the claimant's "age, education, and past work experience." Only if a claimant is found incapable of performing other work in the national economy will she be found disabled. 20 C.F.R. § 404.1520(f);
Court review of an ALJ's disability determination is narrow; the ALJ's findings will be affirmed if they are supported by "substantial evidence on the record as a whole."
In reviewing the Commissioner's decision, the Court must review the entire administrative record and consider:
The ALJ's decision whether a person is disabled under the standards set forth above is conclusive upon this Court "if it is supported by substantial evidence on the record as a whole."
Claimant contends that the ALJ's decision is not supported by substantial evidence on the record as a whole, because the ALJ failed to accord appropriate weight to his treating physician. Claimant also contends that the ALJ's decision is not supported by substantial evidence on the record as a whole, because the ALJ failed to properly assess his credibility.
The undersigned finds that the ALJ considered Dr. Gowda's assessments and gave little weight to his opinions in his written opinion as follows:
(Tr. 24-25) (internal citations omitted).
"A treating physician's opinion is 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 [a claimant's] case record.'"
A treating physician's opinion may be, but is not automatically, entitled to controlling weight. 20 C.F.R. § 404.1527(d)(2). Controlling weight may not be given unless the opinion is well-supported by medically acceptable clinical and laboratory diagnostic techniques. SSR 96-2P, 1996 WL 374188 (July 2, 1996). Even a well-supported medical opinion will not be given controlling weight if it is inconsistent with other substantial evidence in the record.
Additionally, Social Security Ruling 96-2p states in its "Explanation of Terms" that it "is an error to give an opinion controlling weight simply because it is the opinion of a treating source if it is not well-supported by medically acceptable clinical and laboratory diagnostic techniques or if it is inconsistent with other substantial evidence in the case record." 1996 WL 374188, at *2 (S.S.A. July 2, 1996). SSR 96-2 clarifies that 20 C.F.R. §§ 404.1527 and 416.927 require the ALJ to provide "good reasons in the notice of the determination or decision for the weight given to a treating source's medical opinion(s)."
On July 24, 2012, Dr. Gowda completed an Assessment for Social Security Disability Claim wherein he opined that Claimant's mental impairments would prevent him from engaging in any kind of sustained full-time competitive employment. In the Residual Functional Capacity Assessment, Dr. Gowda found Claimant to have marked limitations in his ability to remember and carry out detailed instructions and maintain adequate attention and moderate limitations in his ability to maintain a work schedule, understand and carry out simple instructions, to make appropriate work related decisions, and to complete a normal work week. Dr. Gowda further found Claimant to have marked limitations in social interactions including his ability to interact appropriately with the general public or customers and adaptation.
Although a treating physician's opinion is often given "controlling weight," such deference is not appropriate when the opinion is "inconsistent with other substantial evidence."
First, to the extent Dr. Gowda opined that Claimant is disabled and incapable of performing any competitive employment, a treating physician's opinion that a claimant is not able to work "involves an issue reserved for the Commissioner and therefore is not the type of `medical opinion' to which the Commissioner gives controlling weight."
Dr. Gowda treated Claimant two weeks before completing the function assessment in addition to meeting with Mr. Hutchison, but he did not report the conditions and symptoms that he claims render him totally disabled. Dr. Gowda noted Claimant to be alert and oriented to time, place, and person; his immediate recall, recent and remote memory appeared to be good; and his insight and judgment appeared to be fair. Indeed, he reported the Pristiq giving him more energy, and he seemed to be feeling better. His online classes were going well, and he shared a few of his web programming projects with Mr. Hutchison. Claimant stated that he would "want Dr. Gowda to assist him with his disability process by writing a letter or filling out paperwork."
The ALJ acknowledged that Dr. Gowda was a treating source, but that his opinions were not entitled to controlling weight, because they were inconsistent with the objective medical records. The undersigned notes no examination notes accompanied the July 24 assessments. Opinions of treating doctors are not conclusive in determining disability status and must be supported by medically acceptable clinical or diagnostic data.
Second, Dr. Gowda's opinions are inconsistent with his clinical treatment notes.
Further, no examining physician in any treatment notes stated that Claimant was disabled or unable to work or imposed mental limitations on Claimant's capacity for work.
The undersigned finds that the ALJ's determination is supported by substantial evidence on the record as a whole. "It is not the role of [the reviewing] court to reweigh the evidence presented to the ALJ or to try the issue in this case de novo."
For the foregoing reasons, the ALJ's decision is supported by substantial evidence on the record as a whole. Inasmuch as there is substantial evidence to support the ALJ's decision, this Court may not reverse the decision merely because substantial evidence exists in the record that would have supported a contrary outcome or because another court could have decided the case differently.
Claimant contends that the ALJ's decision is not supported by substantial evidence on the record as a whole, because the ALJ failed to properly assess his credibility.
The undersigned will begin with a review of the ALJ's credibility determination.
The Eighth Circuit has recognized that, due to the subjective nature of physical symptoms, and the absence of any reliable technique for their measurement, it is difficult to prove, disprove or quantify their existence and/or overall effect.
A claimant's complaints of pain or symptoms "shall not alone be conclusive evidence of disability . . . there must be medical signs and findings, established by medically acceptable clinical or laboratory diagnostic techniques."
In evaluating Claimant's credibility, the ALJ determined that he was not fully credible, in part because his testimony at the hearing was not consistent with what he reported to physicians, the observations by third parties and treating and examining physicians, his activities of daily living, his searching for jobs, his earnings record, and the lack of objective medical evidence supporting the degree of severity of subjective complaints alleged. In her decision the ALJ thoroughly discussed the medical evidence of record and inconsistencies in the record.
The ALJ properly considered the inconsistencies between Claimant's allegations of total disability and his daily activities.
The ALJ noted how Claimant testified at the hearing and reported during treatment that he was looking for work and found "[t]his evidence suggests that he believes he is capable of performing this type of work, despite his mental limitations." (Tr. 24). A Claimant's search for employment during a claimed period of disability is a factor the ALJ can properly consider in determining credibility.
Furthermore, as noted by the ALJ, treatment has controlled Claimant's impairments:
The lack of medical evidence supporting Claimant's complaints was a proper consideration when evaluating his credibility,
Specifically, the ALJ noted that no treating physician in any treatment notes stated that Claimant was disabled or unable to work or imposed mental limitations on Claimant's capacity for work.
Finally, the ALJ cited Claimant's work history and poor earnings record as additional factors detracting from his credibility regarding the severity of his impairments alleged and his overall motivation to work versus motivation for benefits inasmuch as his record documents poor and overall inconsistent earnings. The ALJ noted that "[t]he work record shows that the claimant has a very sporadic work history consisting of low wages. The claimant's work record itself draws into question his motivation to work and his credibility as a witness herein." (Tr. 24). A poor work history lessens a Claimant's credibility.
The undersigned notes how the medical record shows a one-year gap in treatment from May 2010 until June 2011 undermines Claimant's credibility concerning his disabling impairments.
After engaging in a proper credibility analysis, the ALJ incorporated into Claimant's RFC those impairments and restrictions found to be credible.
As demonstrated above, a review of the ALJ's decision shows the ALJ not to have denied relief solely on the lack of objective medical evidence to support her finding that Claimant is not disabled. Instead, the ALJ considered all the evidence relating to Claimant's subjective complaints, including the various factors as required by
The undersigned finds that the ALJ considered Claimant's subjective complaints on the basis of the entire record before her and set out the inconsistencies detracting from Claimant's credibility. The ALJ may disbelieve subjective complaints where there are inconsistencies on the record as a whole.
The undersigned finds that the ALJ's determination is supported by substantial evidence on the record as a whole. "It is not the role of [the reviewing] court to reweigh the evidence presented to the ALJ or to try the issue in this case de novo."
For the foregoing reasons, the ALJ's decision is supported by substantial evidence on the record as a whole. Inasmuch as there is substantial evidence to support the ALJ's decision, this Court may not reverse the decision merely because substantial evidence exists in the record that would have supported a contrary outcome or because another court could have decided the case differently.
Therefore, for all the foregoing reasons,
Judgment shall be entered accordingly.