JOEL H. SLOMSKY, District Judge.
Before the Court are the Objections of Plaintiff Heather Vargas ("Plaintiff") to the Report and Recommendation ("R&R") of United States Magistrate Judge Timothy R. Rice. (Doc. No. 17.) On March 15, 2018, Plaintiff initiated this action by filing a Motion for Leave to Proceed in
On January 30, 2019, Magistrate Judge Rice issued the R&R, recommending that Plaintiff's request for review be denied. (Doc. No. 17.) On February 13, 2019, Plaintiff timely filed Objections to the R&R. (Doc. No. 18.) On February 27, 2019, Defendant filed a Response to Plaintiff's Objections. (Doc. No. 20.)
Pursuant to 28 U.S.C. § 636(b)(1), the Court has conducted a
Plaintiff Heather Vargas, a forty-three year old woman, was born on September 26, 1976. (Administrative Record ("R.") at 98.) She has a high school education and past relevant work as a nursing assistant, a delivery food driver, and a personal care assistant. (R. at 34-35.) She currently lives with her husband, father, and brother. (R. at 972.)
In October 2013, Plaintiff filed an application for disability benefits, claiming she had mental impairments including manic depression and social anxiety. (R. at 47-48.) On October 18, 2013, Plaintiff filed an application for SSI. (R. at 15.) On October 21, 2013, Plaintiff also filed an application for DIB. (R. at 98-100.) In her applications, she claimed that, as of her amended onset date,
On June 8, 2016, ALJ Richard E. Guida held a hearing. (R. at 15.) Plaintiff, who was represented by counsel, testified at the hearing that she had reoccurring suicidal thoughts, often harmed herself, had trouble attending social events, had trouble sustaining meaningful work, had low motivation, and had experienced numerous panic attacks each month. (R. at 961-67.) Additionally, the Vocational Expert testified that there was work Plaintiff could do in the national economy if she was limited to simple, routine tasks involving only simple work-related decisions with few, if any, workplace changes and only occasional interaction with supervisors, coworkers, and the public.
On August 11, 2016, the ALJ issued a decision, finding that Plaintiff was not disabled within the meaning of the Social Security Act and that she was not entitled to DIB or SSI. (R. at 22.) Soon thereafter, Plaintiff appealed the ALJ's findings to the Appeals Council. On January 18, 2018, the Appeals Council denied Plaintiff's request for review, making the ALJ's decision the final decision of the Social Security Commissioner. (R. at 6-8.)
To prove a "disability", a claimant must demonstrate "the inability to do 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. § 404.1505(a). The claimant has the burden of proving the existence of a disability and can satisfy this burden by showing an inability to return to former work.
When evaluating a disability, the Social Security Administration uses a five-step process, which is followed in a set order:
20 C.F.R. § 404.1520(a)(4)(i)-(v).
At the third step, the ALJ evaluates whether the claimant's impairment is so severe that it meets or medically equals the criteria of an impairment listed in 20 C.F.R. Part 404, Subpart P, App. 1 (2015). In making this finding, the ALJ must consider whether the "Paragraph B" criteria are satisfied. To satisfy the Paragraph B criteria, the mental impairments must result in at least two of the following: (1) marked restriction of activities of daily living; (2) marked difficulties in maintaining social functioning; (3) marked difficulties in concentration, persistence, or pace; or (4) repeated episodes of decompensation, each of extended duration.
Between the third and fourth steps, the Social Security Administration assesses a claimant's residual functional capacity ("RFC"), which is the "most [a claimant] can do despite [her] limitations." § 404.1545(a)(1). The Administration uses the RFC assessment to determine at the fourth step whether the claimant is able to do her "past relevant work." § 404.1545(a)(5)(i).
When determining RFC, the Administration considers "all the relevant evidence in the case record . . . including [a claimant's] medically determinable impairment that are not `severe.'" § 404.1545(a)(1-2). According to the regulations, the Administration "will consider whether [a claimant's] statements and the statements from third parties are consistent with the medical and other evidence . . . ." 20 C.F.R. Part 404, Subpart P, App. 1 § 12(C)(3).
In a decision issued on August 11, 2016, the ALJ applied the Social Security Administration's five-step evaluation and determined that Plaintiff was not disabled as defined by the Social Security Act. (R. at 17-22.) The ALJ made the following findings:
(R. at 17-22.) As a result, the ALJ found that Plaintiff was not entitled to DIB or SSI.
When reviewing a final decision of the Commissioner of Social Security, the Court must determine whether the record demonstrates substantial evidence to support the Commissioner's decision. 42 U.S.C. §§ 405(g), 1383(c)(3). Substantial evidence is "more than a mere scintilla . . . [and includes] such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
Because the Commissioner adopts an ALJ's decision as his findings of fact, the ALJ must set out a specific factual basis for each finding.
Plaintiff makes two Objections to Magistrate Judge Rice's R&R. (Doc. No. 18.) First, Plaintiff objects to the Magistrate Judge's finding that substantial evidence supports the ALJ's decision to grant "limited weight" to the medical opinions of Dr. Ann Dall, Plaintiff's outpatient psychiatrist. (
In her first Objection, Plaintiff argues that the Magistrate Judge erred in finding that substantial evidence supports the ALJ's decision to grant "limited weight" to the opinions of Dr. Dall. (
The ALJ assigned "limited weight" to Dr. Dall's medical opinion because he found it to be inconsistent with the Plaintiff's treatment records. (
As the factfinder, the ALJ is specifically charged with the duty to evaluate all medical evidence in a disability insurance benefits case.
First, the ALJ assigned limited weight to some of Dr. Dall's opinions (R. at 217-22) because he found them to be inconsistent with the other evidence in the record, including the opinion of Dr. Thomas Fink, a psychological consultant who does work for the Social Security Administration. (R. at 20.) For example, Dr. Dall opined that Plaintiff had marked restriction on activities of daily living, marked difficulties in maintaining social functioning, marked difficulties in maintaining concentration, persistence, or pace, and three episodes of decompensation within 12 months, each of which lasted at least two weeks.
Additionally, Dr. Dall found that Plaintiff was unable to work outside the home because Plaintiff's impairments would cause her to be absent from work more than four days per month.
Ultimately, the ALJ determined that the record showed significantly less mental health issues than Plaintiff's treatment records and progress notes which, as a whole, were suggestive of only "moderate mental health symptoms and limitations." (R. at 20.) The Court agrees with the Magistrate Judge that the ALJ accurately summarized the medical records and found that, while Plaintiff continued to experience the symptoms set out in her Objections, "her mental status examinations were largely normal." (Doc. No. 17 at 12). As such, the Court is persuaded that to the extent that the ALJ granted limited weight to Dr. Dall's opinions, it was properly based on their inconsistencies with the record.
Next, Plaintiff contends that to the extent that the ALJ determined Dr. Dall's opinions were inconsistent with the record, he should have requested further clarification from Dr. Dall. (Doc. No. 18 at 2.) Again, the Court disagrees.
The Third Circuit has made clear that the ALJ is only required to request clarification when "the evidence we receive from your treating physician or psychologist or other medical source is inadequate for us to determine whether you are disabled."
As properly outlined in the R&R, there was substantial evidence which enabled the ALJ to make a disability determination in this case. (Doc. No. 17 at 16.) As noted prior, Plaintiff had GAF scores generally in the range of 54-56. (
The ALJ determined that Plaintiff was exaggerating the frequency and severity of her symptoms and that she actually had a greater capacity for social interaction.
Based on the above, the ALJ had ample evidence to make a determination in Plaintiff's case. The ALJ was "under no obligation to re-contact" Dr. Dall.
Plaintiff argues that the ALJ erred in relying on Plaintiff's GAF scores in her disability assessment. (Doc. No. 18 at 2.) Plaintiff argues that because the GAF scale was erased from the latest edition of the Diagnostic and Statistical Manual of Mental Disorders ("DSM-5"),
Plaintiff is correct that the GAF scale was erased from DSM-5 in 2013. In light of the publication of DSM-5, the Social Security Administration released an Administrative Message ("AM") addressing how GAF scores were to be considered. (Admin. Message 13066, Global Assessment of Functioning (GAF) Evidence in Disability Adjudication) (Soc. Sec. Admin. July 22, 2013.) "Critically, the AM notes that even though DSM-5 eliminated the GAF scale, the [Administration] `will continue to receive and consider GAF in medical evidence.'"
The present action, having been filed with the Administration in 2013, allowed for the ALJ to consider Plaintiff's GAF scores as part of the relevant medical evidence. The ALJ did not give these scores controlling weight; rather, they were reviewed in the context of Dr. Dall's records. Ultimately, the ALJ determined that the scores were consistent with Plaintiff's "stable" condition and largely normal mental status examination results. (Doc. No. 17 at 16-17 n.12);
As previously mentioned, these GAF scores were consistent with the balance of Plaintiff's medical record and Dr. Fink's opinions. Accordingly, the ALJ and the Magistrate Judge properly considered Plaintiff's GAF scores. As such, the Court will overrule Plaintiff's first Objection.
Plaintiff objects to the Magistrate Judge's conclusion that substantial evidence supports the ALJ's mental RFC finding. (Doc. No. 18 at 3.) As discussed below, the Court agrees with the Magistrate Judge that the ALJ properly determined Plaintiff's RFC.
As noted above, step two of the Social Security Administration's five-step analysis involves considering the severity of the claimant's impairments. An impairment is considered severe if it significantly limits an individual's ability to perform basic work activities. (R. at 16.) Conversely, an impairment is not severe when evidence establishes only a slight abnormality that has no more than a minimal effect on an individual's ability to work. 20 C.F.R. § 404.1521. If the impairment is not sufficiently severe under the Administration's regulations, the claimant is not considered disabled. 20 C.F.R. § 404.1520(a)(4)(ii). If the claimant's impairment is deemed severe, the analysis proceeds to the third step.
Here, the ALJ concluded that Plaintiff "has the following severe impairments: an anxiety disorder, bipolar disorder, depression, and PTSD" and found that these impairments cause "more than a minimal effect on the claimant's ability to work." (R. at 17.) As such, the ALJ proceeded to the third step.
At the third step, the ALJ evaluates whether the claimant's impairment is so severe that it meets or medically equals the criteria of an impairment listed in 20 C.F.R. Part 404, Subpart P, App. 1. In making this finding, the ALJ must consider whether the "Paragraph B" criteria are satisfied. To satisfy the Paragraph B criteria, the mental impairments must result in at least two of the following: (1) marked
After examining the credible, objective evidence in the record, the ALJ concluded that Plaintiff's mental impairments did not satisfy the "Paragraph B" criteria because Plaintiff did not have marked restrictions or limitations in a single category, nor did she have any episodes of decompensation. (R. at 17A.) Notably, the ALJ found that Plaintiff had only moderate difficulties maintaining concentration, persistence, or pace. (R. at 17A.) More specifically, the ALJ determined that Plaintiff had "some trouble concentrating and dealing with stress." (R. at 17A.) Because the ALJ determined that Plaintiff's impairments did not satisfy the "Paragraph B" criteria, he proceeded to step four.
As noted prior, between steps three and four of the five-step evaluation process, the Administration assesses a claimant's residual functional capacity, which is the "most [a claimant] can do despite [her] limitations."
In the present case, after considering Plaintiff's limitations as described in steps two and three, the ALJ found that Plaintiff's impairments could reasonably be expected to cause her symptoms of sleep disturbances, changes in energy, panic attacks, tearfulness, a depressed mood, nightmares, and anxiety. (R. at 18-19.) However, the ALJ also determined that Plaintiff's statements regarding the intensity, persistence, and limiting effects of these symptoms were not entirely consistent with the medical evidence and other evidence in the record. (R. at 18.) As a result, the ALJ concluded that Plaintiff has the RFC to perform a full range of work at all exertional levels but with the following non-exertional limitations: (1) she is limited to simple and routine tasks, with few, if any work place changes; (2) she is limited to occasional interaction with supervisors, co-workers, and the public. (R. at 18.)
Plaintiff objects to the ALJ's RFC assessment arguing that it failed to account for Plaintiff's moderate difficulties in maintaining concentration, persistence, or pace. (Doc. No. 18 at 3.) This argument is unavailing.
The ALJ accounted for Plaintiff's moderate difficulties maintaining concentration, persistence, or pace when making his RFC assessment. The ALJ specifically stated that "[d]ue to [Plaintiff's] alleged problems concentrating, the claimant is limited to specific, routine tasks involving simple work related decisions and few, if any work place changes." (R. at 20.)
Plaintiff contends that the ALJ's assessment does not accurately reflect her moderate restrictions in concentration, pace, and persistence. As such, the Court finds that the additional limitations involving simple work related decisions and few, if any, workplace changes adequately encompasses Plaintiff's moderate difficulties maintaining concentration.
Having independently reviewed the ALJ's decision, the Court is satisfied that the ALJ properly considered Plaintiff's mental impairments when evaluating the RFC. Further, substantial evidence in the record supports the ALJ's ultimate RFC assessment. For that reason, Plaintiff's second objection will be overruled.
For the foregoing reasons, Plaintiff's Objections to the R&R (Doc. No. 18) will be overruled. The Report and Recommendation (Doc. No. 17) will be approved and adopted in its entirety. An appropriate Order follows.