JAMES G. CARR, Sr. District Judge.
This is a Social Security case in which the plaintiff, Rita Brogan, appeals from the Commissioner's decision denying her application for benefits.
An administrative law judge found that Brogan suffered from multiple severe impairments, including depressive disorder and bipolar disorder. (Doc. 12 at 612). But the ALJ determined that Brogan had the residual functional capacity to perform light work, as defined in 20 C.F.R. §§ 404.1567(c) and 416.967(b), and thus was not disabled. (Id. at 614-23).
Pending is Magistrate Judge Knepp's Report and Recommendation (Doc. 21), which recommends that I affirm the Commissioner's decision. As is relevant here, the Magistrate Judge ruled that the ALJ gave good reasons for affording only "little weight" to the opinion of Brogan's treating psychiatrist, Satwant Gill. (Id. at 16-18).
Dr. Gill, who treated Brogan for two years beginning in August, 2008 (Doc. 17 at 7), opined in a July 23, 2010, medical statement that Brogan's "moderate limitations" — in maintaining concentration, working at a reasonable pace, being punctual, and withstanding the stresses of simple, unskilled work — "seriously interfere[d] with [and] . . . may preclude [her] ability to [work] on a regular basis." (Doc. 12 at 516-17).
The ALJ discredited this opinion on the ground that it conflicted with two contemporaneous treatment notes:
(Id. at 623).
Magistrate Judge Knepp determined that this was a good reason for discounting Dr. Gill's opinion:
(Doc. 21 at 17-18).
Brogan has objected to the R&R. (Doc. 22). She argues that the ALJ's reliance on "isolated treatment notes" to discount Dr. Gill's opinion "flies in the face of Social Security's own regulations." (Id. at 4). Brogan also contends the ALJ erred by not mentioning "the factors that must be considered where an opinion [from a treating source] cannot be given controlling weight[.]" (Id. at 5).
On de novo review, see Thomas v. Comm'r of Soc. Sec., 2017 WL 773586, *1 (N.D. Ohio), I will overrule Brogan's objections, adopt the R&R as the order of the court, and affirm the denial of benefits.
It is well-settled, as the Magistrate Judge explained, that inconsistencies within a treating source's opinion, or between that opinion and other record evidence, provide a basis for discounting the opinion. E.g., Price v. Comm'r of Soc. Sec., 342 F. App'x 172, 177 (6th Cir. 2009); Jackson v. Comm'r of Soc. Sec., 2016 WL 1211425, *6 (W.D. Mich.).
Such inconsistencies were present here. While Dr. Gill opined in July, 2010, that Brogan's moderate limitations all but precluded her from working, the contemporaneous notes do not bear that opinion out. To the contrary, the June, 2010 and December, 2010 treatment notes suggested that Brogan's medication regimen was helping to control Brogan's symptoms, such that she was alert, displayed "sufficient" concentration, and was cooperative and organized. They suggested, in other words, that Brogan's mental impairments did not limit her to the extent that Dr. Gill maintained.
To be sure, an ALJ must not cherry-pick evidence to support his opinion, but must instead view the evidence in the record as a whole. Selzer v. Colvin, 2017 WL 405246, *1 (N.D. Ohio). But there is no merit to Brogan's contention that the ALJ improperly viewed the two treatment notes just discussed "in isolation."
Given the substantial limitations that, according to Dr. Gill, existed as of July, 2010, it was reasonable for the ALJ to consult the contemporaneous medical record in search of evidence to support that opinion. Having found none — and, indeed, having found quite the opposite — it was likewise reasonable for the ALJ to rely on the inconsistent reports to discredit Dr. Gill's opinion. (Notably Brogan's objections do not cite any contemporaneous evidence that supports Gill's opinion).
Finally, I reject Brogan's argument that I should vacate the Commissioner's decision because the ALJ did not conduct a detailed analysis of the five factors governing how much non-controlling weight he assigned to Dr. Gill's opinion. See 20 C.F.R. § 404.1527(d)(2) (listing factors).
There is no requirement that the ALJ conduct an "exhaustive factor-by-factor analysis." Francis v. Comm'r of Soc. Sec., 414 F. App'x 802, 804 (6th Cir. 2011). Rather, the ALJ simply needs to delineate "good reasons" for not assigning controlling weight to the treating source's opinion. Rabbers v. Comm'r of Soc. Sec., 582 F.3d 647, 660 (6th Cir. 2009). And as the Magistrate Judge correctly explained, that is what the ALJ did here. (Doc. 21 at 15-17).
It is, therefore
ORDERED THAT:
So ordered.
Plaintiff Rita R. Brogan ("Plaintiff") filed a Complaint against the Commissioner of Social Security ("Commissioner") seeking judicial review of the Commissioner's decision to deny disability insurance benefits ("DIB") and supplemental security income ("SSI"). (Doc. 1). The district court has jurisdiction under 42 U.S.C. § 405(g). This matter has been referred to the undersigned for preparation of a report and recommendation pursuant to Local Rule 72.2. (Nondocument entry dated November 25, 2015). For the reasons stated below, the undersigned recommends the decision of the Commissioner be affirmed.
Plaintiff protectively filed for DIB and SSI in April and June 2008, alleging a disability onset date of November 2, 2006.
On October 8, 2013, this Court recommended Plaintiff's case be remanded to determine whether Drummond v. Comm'r of Soc. Sec., 126 F.3d 837, 842 (6th Cir. 1997) was applicable, and for further consideration of the weight given to the opinion of treating psychiatrist, Dr. Satwant Gill. Brogan v. Comm'r of Soc. Sec., 2013 WL 5308717 (N.D. Ohio); (Tr. 707-25). The district court adopted the report and recommendation, and remanded the case. Brogan, 2013 WL 5308717; Case No. 12-CV-2185 (N.D. Ohio) (Doc. 21).
On remand, the Appeals Council vacated the ALJ's decision and remanded for a new hearing and decision. (Tr. 736-40). Plaintiff (represented by counsel) and a VE appeared and testified at a hearing before an ALJ on May 29, 2014. (Tr. 974-93). In a June 18, 2014 written decision, the ALJ found Plaintiff not disabled. (Tr. 603-20). Plaintiff filed exceptions to this decision, Tr. 592-96, but the Appeals Council declined jurisdiction, Tr. 587-90
Plaintiff was 38 years old at her alleged onset date, and 45 years old at the time of the ALJ decision. (Tr. 150, 155). She has a high school education. (Tr. 46, 176).
This Court previously summarized Plaintiff's testimony at her 2010 ALJ hearing:
Brogan, 2013 WL 5308717, at *2.
At the 2014 hearing, Plaintiff testified that her condition had not changed much since the 2010 hearing. (Tr. 979). She lives with her sister, her sister's partner, and Plaintiff's two children (aged 14 and 16). (Tr. 985). Plaintiff's sister has custody of Plaintiff's children, and her sister takes care of them and the household chores. Id.
Plaintiff stated she considers her mental health more limiting in terms of her ability to work than her physical health. Id. Plaintiff testified that being around people while working, and working generally, causes her stress. (Tr. 980). She testified that what is stressful about working is "[h]aving people tell me what to do; and having to keep up with machines; and orders; and stuff like that; and having to do so much at one time; and remembering what to do." Id. She testified to having trouble with motivation and getting out of bed two to three times per month. (Tr. 980-81). She has a hard time talking to people both on the phone and in person. (Tr. 981). She stays at home because being out and around people makes her nervous, stressed, and causes anxiety attacks. Id. She lives with her sister, and only leaves the house with her sister. (Tr. 981-82, 984). When she has an anxiety attack, she cries, gets upset, shaky, and scared. (Tr. 983). When she is nervous, she forgets things, gets slower, and misses things or makes mistakes. (Tr. 984).
Plaintiff described her typical day as getting up, making breakfast, watching television, making lunch, watching television, possibly laying down to rest, and then waiting for her sister to come home. (Tr. 985). Her sister makes supper, and then she goes to bed. Id. Plaintiff also testified that she had remained sober since 2007. (Tr. 986).
This Court previously summarized the medical evidence from March 2003 through July 2010:
On April 26, 2008, Dr. Salvi completed a Mental Functional Capacity Assessment. (Tr. 307-08). Dr. Salvi found Plaintiff was not significantly limited in her abilities to understand, remember, and carry out very short and simple instructions; sustain an ordinary routine without interruption; make simple workrelated decisions; interact appropriately with the general public; ask simple questions or request assistance; get along with co-workers without distracting them or exhibiting behavioral extremes; respond appropriately to changes in the work setting; and be aware of normal hazards and take appropriate precautions. (Tr. 307). He found she had moderate limitations in her ability to understand, remember, and carry out detailed instructions; maintain attention and concentration for extended periods; and accept instructions and respond appropriately to criticism from supervisors. (Tr. 307). Dr. Salvi specifically noted Plaintiff's grooming was appropriate, her thought process was well organized, her intelligence appeared to be average, her general knowledge was adequate, and her concentration, abstract thinking, insight, and judgment appeared to be fair. (Tr. 308). Dr. Salvi expected these limitations to last nine to eleven months. (Tr. 307).
Brogan, 2013 WL 5308717, at *2-6 (footnotes omitted).
In August 2010, a progress note from Unison stated Plaintiff reported "doing well". (Tr. 887). She had sufficient concentration, appropriate speech, stable and controlled mood, organized thought process, and was pleasant and cooperative. Id. The nurse noted she was not a danger to herself or others, and was accepting of intervention. Id.
Plaintiff met with Dr. Gill again in September 2010, December 2010, and January 2011. (Tr. 888-89, 891-92, 893-94). Plaintiff reported a stable mood (Tr. 888) and that she was doing well (Tr. 888, 891, 893). Dr. Gill noted on examination that Plaintiff's mood and affect were stable, no lability of mood was noted, she was not in any acute distress, and she did not appear to be a danger to herself or others. (Tr. 888, 891, 893). In September 2010, Dr. Gill's treatment notes state that Plaintiff's "grandma had passed away within the last couple of weeks, but her family was all together, so she handled it well." (Tr. 888).
Plaintiff continued to be seen at Unison through 2014. (Tr. 884-949). In April 2014, K. Roger Johnson, M.Ed., performed a psychological evaluation at the request of the state agency. (Tr. 970-74). Finally, in May 2014, Dr. Gill wrote a letter stating Plaintiff is `"unable to work or engage in any meaningful earning activities due to her symptoms from her psychiatric illness. (Mood lability, depression, irritability, and anxiety)." (Tr. 973).
The ALJ asked the VE to assume a hypothetical person with Plaintiff's age, education, and vocational background. (Tr. 988). He asked the VE to assume this person "[h]as the residual functional capacity for work at the light exertional level; except that the hypothetical individual were best in an environment without closely regimented pace; or production; or without close supervisory scrutiny." Id. The VE testified such an individual could work as a folder, production inspector, or cleaner. (Tr. 988-89).
In a second hypothetical, the ALJ then added restrictions of:
(Tr. 989). The VE testified the three jobs previously listed would still be available. Id.
Finally, in a third hypothetical the ALJ added restrictions of
(Tr. 990). The VE again testified that the three jobs previously listed would still be available. Id.
Plaintiff's counsel asked the VE to consider treating physician Dr. Gill's opinion that Plaintiff would be moderately limited in five areas of functioning (with "moderately limited" described as "an impairment which seriously interferes with, and then in combination with one or more restrictions, may preclude the individual's ability to perform the designated activity"). (Tr. 991). The VE testified such a restriction would eliminate employment. (Tr. 992).
In a written decision dated June 18, 2014, the ALJ found Plaintiff: 1) meets the insured status requirements of the Social Security Act through March 31, 2010; 2) has not engaged in substantial gainful activity since November 2, 2006, the alleged onset date; 3) has severe impairments of depressive disorder, bipolar disorder, mild degenerative disc disease of lumbar spine, minimal degenerative joint disease bilateral knees, and obesity; 4) does not have an impairment or combination of impairments that meets or medically equals the severity of the listings; and 5) retains the residual functional capacity to perform light work except:
(Tr. 605-09). The ALJ concluded Plaintiff was unable to perform any past relevant work; and considering Plaintiff's age, education, work experience, and residual functional capacity, there were jobs that existed in significant numbers in the national economy that she could perform. (Tr. 618-19)
In declining to exercise jurisdiction, the Appeals Council stated:
In reviewing the denial of Social Security benefits, the Court "must affirm the Commissioner's conclusions absent a determination that the Commissioner has failed to apply the correct legal standards or has made findings of fact unsupported by substantial evidence in the record." Walters v. Comm'r of Soc. Sec., 127 F.3d 525, 528 (6th Cir. 1997). "Substantial evidence is more than a scintilla of evidence but less than a preponderance and is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Besaw v. Sec'y of Health & Human Servs., 966 F.2d 1028, 1030 (6th Cir. 1992). The Commissioner's findings "as to any fact if supported by substantial evidence shall be conclusive." McClanahan v. Comm'r of Soc. Sec., 474 F.3d 830, 833 (6th Cir. 2006) (citing 42 U.S.C. § 405(g)). Even if substantial evidence or indeed a preponderance of the evidence supports a claimant's position, the court cannot overturn "so long as substantial evidence also supports the conclusion reached by the ALJ." Jones v. Comm'r of Soc. Sec., 336 F.3d 469, 477 (6th Cir. 2003).
Eligibility for benefits is predicated on the existence of a disability. 42 U.S.C. §§ 423(a), 1382(a). "Disability" is defined as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 20 C.F.R. § 416.905(a); see also 42 U.S.C. § 1382c(a)(3)(A). The Commissioner follows a five-step evaluation process—found at 20 C.F.R. § 404.1520—to determine if a claimant is disabled:
Under this five-step sequential analysis, the claimant has the burden of proof in Steps One through Four. Walters, 127 F.3d at 529. The burden shifts to the Commissioner at Step Five to establish whether the claimant has the residual functional capacity to perform available work in the national economy. Id. The court considers the claimant's residual functional capacity, age, education, and past work experience to determine if the claimant could perform other work. Id. Only if a claimant satisfies each element of the analysis, including inability to do other work, and meets the duration requirements, is she determined to be disabled. 20 C.F.R. §§ 404.1520(b)-(f); see also Walters, 127 F.3d at 529.
Plaintiff's first argument implicates the well-known treating physician rule. Generally, the medical opinions of treating physicians are afforded greater deference than those of nontreating physicians. Rogers v. Comm'r of Soc. Sec., 486 F.3d 234, 242 (6th Cir. 2007); see also SSR 96-2p, 1996 WL 374188. "Because treating physicians are `the medical professionals most able to provide a detailed, longitudinal picture of [a plaintiff's] medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone,' their opinions are generally accorded more weight than those of nontreating physicians." Rogers, 486 F.3d at 242 (quoting 20 C.F.R. § 416.927(d)(2)).
A treating physician's opinion is given "controlling weight" if it is supported by (1) medically acceptable clinical and laboratory diagnostic techniques; and (2) is not inconsistent with other substantial evidence in the case record. Wilson v. Comm'r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004). The requirement to give controlling weight to a treating source is presumptive; if the ALJ decides not to do so, he must provide evidentiary support for such a finding. Id. at 546; Gayheart v. Comm'r of Soc. Sec., 710 F.3d 365, 376-77 (6th Cir. 2013). When the physician's medical opinion is not granted controlling weight, the ALJ must give "good reasons" for the weight given to the opinion. Rogers, 486 F.3d at 242 (quoting 20 C.F.R. § 416.927(d)(2)). "Good reasons" are reasons "sufficiently specific to make clear to any subsequent reviewers the weight given to the treating physician's opinion and the reasons for that weight." Wilson, 378 F.3d at 544.
When determining weight and articulating good reasons, the ALJ "must apply certain factors" to the opinion. Rabbers v. Comm'r Soc. Sec. Admin., 582 F.3d 647, 660 (6th Cir. 2009) (citing 20 C.F.R. § 404.1527(d)(2)). These factors include the length of treatment relationship, the frequency of examination, the nature and extent of the treatment relationship, the supportability of the opinion, the consistency of the opinion with the record as a whole, and the specialization of the treating source. Id. While an ALJ is required to delineate good reasons, he is not required to enter into an in-depth or "exhaustive factor-by-factor analysis" to satisfy the requirement. See Francis v. Comm'r of Soc. Sec. Admin., 414 F. App'x 802, 804-05 (6th Cir. 2011); Allen v. Comm'r of Soc. Sec., 561 F.3d 646, 651 (6th Cir. 2009). The Sixth Circuit has held that an ALJ may also give "good reasons" by challenging the supportability and consistency of the treating physician's opinion in an "indirect but clear way", Brock v. Comm'r of Soc. Sec., 368 F. App'x 622, 625 (6th Cir. 2010), or "implicitly provid[ing] sufficient reasons for not giving those opinions controlling weight, and indeed for giving them little to no weight overall", Nelson v. Comm'r of Soc. Sec., 195 F. App'x 462, 472 (6th Cir. 2006). Addressing an opinion's supportability and consistency with the record as a whole is sufficient. See Henke v. Astrue, 498 F. App'x 636, 640, n.3 (7th Cir. 2012); Benneman v. Comm'r of Soc. Sec., 2012 WL 5384974, at *1 (N.D. Ohio).
Plaintiff specifically objects to the ALJ's analysis of Dr. Gill's July 2010 opinion. In that opinion, Dr. Gill noted Plaintiff would be "moderately limited" in her abilities to: 1) maintain attention and concentration for two hour periods of time; 2) perform work activities at a moderate pace; 3) keep a regular work schedule and maintain punctual attendance; 4) withstand the stresses and pressures of routine simple unskilled work; and 5) make judgments that are commensurate with the functions of unskilled work, i.e., make simple work-related decisions. (Tr. 510-11). The form opinion defined "moderate limitation" as "[a]n impairment which seriously interferes with, and in combination with one or more other restrictions assessed, may preclude the individual's ability to perform the designated activity on a regular and sustained basis." (Tr. 510).
The ALJ summarized Dr. Gill's findings and then addressed them as follows:
(Tr. 617). Plaintiff contends that the "reference to two treatment notes is not `good reason' for rejecting the opinion of the long-term treating psychiatrist." (Doc. 17, at 11). The Commissioner responds that Dr. Gill's opinion "lacked support and was inconsistent with the record as a whole" including being "directly at odds with his own treatment notes and observations during mental status examinations." (Doc. 20, at 11). The undersigned agrees with the Commissioner and finds the ALJ satisfied the reason-giving requirement.
Although the ALJ cited only two treatment notes, those notes are from the time period surrounding Dr. Gill's July 2010 opinion—one before (June 2010), and one after (December 2010). Discounting a treating physician's opinion based on inconsistent contemporaneous treatment notes is reasonable. See Price v. Comm'r of Soc. Sec., 342 F. App'x 172, 177 (6th Cir. 2009) (finding treating physician rule not violated in part where: "the record also supports the ALJ's conclusion that [the treating physician's] opinion was inconsistent with his own prior assessments and treatment notes"); Jackson v. Comm'r of Soc. Sec., 2016 WL 1211425, *6 (W.D. Mich.) ("This statement was inconsistent with . . . contemporaneous treatment notes that stated Plaintiff was `doing very well' and was `alert, cooperative, and oriented' with satisfactory memory.").
The June 2010 nurse's progress note referenced by the ALJ noted Plaintiff's physical appearance was good; she was oriented to person, place, time, and events; she was alert; her concentration was sufficient; her mood was stable; her thought process was organized; and she was cooperative. (Tr. 884). The December 2010 note from Dr. Gill stated Plaintiff "related she has been doing well on the medicines." (Tr. 891). He noted she was "[a]lert and oriented"; "[c]ooperative"; "[m]ood and affect stable"; "[n]o lability of the mood noted"; "[n]o formal thought disorder noted"; and "[s]he was not seen to be in any acute distress . . . [or] in any immediate danger to herself or others." Id. He recommended Plaintiff continue her current medication regime, follow up with the nurse in five weeks, and follow up with Dr. Gill in nine weeks (or as needed before that). (Tr. 892). Moreover, other treatment notes from Dr. Gill from the time period leading up to his opinion similarly support that Plaintiff was stable and doing well on medication. (Tr. 477 (May 2010), 479 (March 2010), 481 (January 2010), 486 (November 2009), 491 (July 2009), 495 (May 2009), 497 (March 2009)). The same is true for other notes after that time period. (Tr. 888 (September 2010), Tr. 893 (January 2011)). Thus, the undersigned finds it was reasonable for the ALJ to give "little weight" to Dr. Gill's July 2010 opinion that Plaintiff was more severely limited. See Price, 342 F. App'x at 177; Jackson, 2016 WL 1211425, *6. The ALJ's reasons were "sufficiently specific to make clear to any subsequent reviewers the weight given to the treating physician's opinion and the reasons for that weight." Wilson, 378 F.3d at 544. The ALJ's opinion addressed the consistency and supportability of Dr. Gill's opinion. See Henke, 498 F. App'x at 640, n.3; Benneman 2012 WL 5384974, at *1. Although Plaintiff points to contradictory evidence in the record, as noted above, even if substantial evidence or indeed a preponderance of the evidence supports a claimant's position, the court cannot overturn "so long as substantial evidence also supports the conclusion reached by the ALJ." Jones, 336 F.3d at 477.
Similarly, the ALJ did not err in his evaluation of Dr. Salvi's opinion.
Plaintiff's second argument is that the ALJ's RFC determination lacks foundation because it is not based on medical opinion. The Commissioner responds that the ALJ reasonably formulated an RFC based on the various medical opinions in the record. The undersigned finds no error in the ALJ's determination.
A claimant's RFC is an assessment of "the most [she] can still do despite [her] limitations." 20 C.F.R. § 404.1545(a)(1). An ALJ must consider all symptoms and the extent to which those symptoms are consistent with the objective medical evidence. Id. § 404.1529. An ALJ must also consider and weigh medical opinions. Id. § 404.1527. Although "[i]t is well established that the ALJ may not substitute his medical judgment for that of the claimant's physicians", Brown v. Comm'r of Soc. Sec., 2015 WL 1431521, *7 (W.D. Mich.) (citing Meece v. Barnhart, 192 F. App'x 181, 194 (6th Cir. 2009)), "an ALJ does not improperly assume the role of a medical expert by assessing the medical and non-medical evidence before rendering a residual functional capacity finding." Poe v. Comm'r of Soc. Sec., 342 F. App'x 149, 157 (6th Cir. 2009); see also 20 C.F.R. § 404.1527(d)(2) ("Although we consider opinions from medical sources on issues such as [a claimant's RFC] . . . the final responsibility for deciding these issues is reserved to the commissioner").
An RFC determination is not the duty of a claimant's physicians; instead this determination is exclusively within the purview of the Commissioner. Edwards v. Comm'r of Soc. Sec., 97 F. App'x 567, 569 (6th Cir. 2004); see also SSR 96-5p, 1996 WL 374183, *5 ("Although an adjudicator may decide to adopt all of the opinions expressed in a medical source statement, a medical source statement must not be equated with the administrative finding known as the [RFC] assessment."); Rudd v. Comm'r of Soc. Sec., 531 F. App'x 719, 728 (6th Cir. 2013) ("To require the ALJ to base her RFC finding on a physician's opinion, `would, in effect, confer upon the treating source the authority to make the determination or decision about whether an individual is under a disability and thus would be an abdication of the Commissioner's statutory responsibility to determine whether an individual is disabled.'") (quoting SSR 96-5p, 1996 WL 374183, at *2); Henderson v. Comm'r of Soc. Sec., 2010 WL 750222, *2 (N.D. Ohio) ("[T]he ALJ is charged with evaluating several factors in determining the RFC, including the medical evidence (not limited to medical opinion testimony), and the claimant's testimony.").
As required by the regulations, the ALJ here evaluated all the evidence of record in formulating Plaintiff's RFC. See Tr. 609-17. He acknowledged her mental limitations in limiting her to "simple, routine, and repetitive tasks"; no "fast paced production requirements"; "few if any work place changes"; and only "occasional interaction with the general public, coworkers, and supervisors." (Tr. 609). He acknowledged her testimony that she has difficulty handling stress and being around other people, as well as quota or speed demands at work, such as while waitressing. Id. He summarized Plaintiff's medical treatment from 2006 onward. (Tr. 610-17). Specifically, the ALJ evalutated treating psychiatrist Dr. Salvi's opinion. (Tr. 612). Although the ALJ ultimately gave that opinion "some limited weight" (Tr. 613), he thoroughly discussed why he found Plaintiff less limited than opined by Dr. Salvi based on the doctor's own treatment notes (Tr. 612-13).
The ALJ also discussed the two hospitalizations Plaintiff had during the relevant time period. See Tr. 610 (discussing June 2007 hospital admission); 613 (discussing May 2008 admission). During each of these admissions, Plaintiff showed improvement with medication adjustment. See Tr. 512 (discharge note stating "[w]ith adjustments in her medications and medication dose, she has done progressively well . . . . [and] [t]he target symptoms . . . appear to be in total abeyance at the present time"); Tr. 272 (discharge note stating "[d]ose of Seroquel was increased and Wellbutrin SR was added" and Plaintiff's "mood was better"; "[s]he denied any suicidal or homicidal ideations"; and "[t]here was no psychosis."); Tr. 313 (treatment note from Dr. Salvi after May 2008 hospitalization noting Plaintiff was "doing better" on the new medications).
The ALJ also evaluated Plaintiff's testimony and alleged limitations, finding them not fully credible. (Tr. 615-16). Credibility evaluations are within the purview of the ALJ. See Casey v. Sec'y of Health & Human Servs., 987 F.2d 1230, 1234 (6th Cir. 1993).
Additionally, as discussed above, the ALJ gave good reasons for giving Dr. Gill's opinion about Plaintiff's limitations "little weight", notably its inconsistency with Dr. Gill's own records. (Tr. 617).
Finally, the ALJ also reasonably relied on the fact that Plaintiff's mental condition improved when an effective medication regimen was established. See Houston v. Sec'y of Health & Human Servs., 736 F.2d 365, 367 (6th Cir. 1984) ("The medical evidence reflected that appellant's impairments were controlled with medication[.]").
As noted above, the ALJ was not required to rely solely on medical opinion evidence to formulate his RFC. See Rudd, 531 F. App'x at 728; Poe, 342 F. App'x at 157; Henderson, 2010 WL 750222, at *2. Accordingly, having reviewed the entire record, and the ALJ's decision, the undersigned finds the ALJ's RFC determination supported by substantial evidence. Moreover, the Court notes that it reviews the ALJ's RFC assessment not for complete or exact correlation between the evidence and the ALJ's findings, but for legal error or lack of substantial supporting evidence. Finding neither in this case, the undersigned recommends the ALJ's RFC determination be affirmed.
Following review of the arguments presented, the record, and the applicable law, the undersigned recommends the Commissioner's decision be affirmed.
ANY OBJECTIONS to this Report and Recommendation must be filed with the Clerk of Court within fourteen days of service of this notice. Failure to file objections within the specified time WAIVES the right to appeal the Magistrate Judge's recommendation. See Thomas v. Arn, 474 U.S. 140 (1985); United States v. Walters, 638 F.2d 947 (6th Cir. 1981).
(Tr. 588). Plaintiff notes that "[b]ecause the Appeals Council mended the ALJ's error in considering the entire period with a subsequent application, this error will not be addressed on appeal." (Doc. 17, at 4). The Court may only consider evidence that was before the ALJ. See Matthews v. Weber, 423 U.S. 261, 263 (1976). Because the Appeals Council remanded for consideration of the later time period, the undersigned only reviews the ALJ's decision as it related to pre-May 2011, the time period the Appeals Council determined was properly considered by the ALJ.
