MICHELLE H. BURNS, District Judge.
Pending before the Court is Plaintiff Kenny Renteria's appeal from the Social Security Administration's final decision to deny his claim for disability insurance benefits and supplemental security income. After reviewing the administrative record and the arguments of the parties, the Court now issues the following ruling.
On May 7, 2009, Plaintiff filed applications for disability insurance benefits and supplemental security income pursuant to Titles II and XVI of the Social Security Act, alleging disability beginning December 22, 2006. (Transcript of Administrative Record ("Tr.") at 135-44, 13.) His applications were denied initially and on reconsideration. (Tr. at 67-74, 77-83.) On May 28, 2010, he requested a hearing before an Administrative Law Judge ("ALJ"). (Tr. at 84-85, 13.) A hearing was held on October 19, 2011. (Tr. at 31-62.) On October 24, 2011, the ALJ issued a decision in which he found that Plaintiff was not disabled. (Tr. at 10-30.) Thereafter, Plaintiff requested review of the ALJ's decision. (Tr. at 7-9.)
The Appeals Council denied Plaintiff's request, (Tr. at 1-6), thereby rendering the ALJ's decision the final decision of the Commissioner. Plaintiff then sought judicial review of the ALJ's decision pursuant to 42 U.S.C. § 405(g).
The Court must affirm the ALJ's findings if the findings are supported by substantial evidence and are free from reversible legal error.
In determining whether substantial evidence supports a decision, the Court considers the administrative record as a whole, weighing both the evidence that supports and the evidence that detracts from the ALJ's conclusion.
In order to be eligible for disability or social security benefits, a claimant must demonstrate an "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." 42 U.S.C. § 423(d)(1)(A). An ALJ determines a claimant's eligibility for benefits by following a five-step sequential evaluation:
At step one, the ALJ determined that Plaintiff had not engaged in substantial gainful activity since December 22, 2006 — the alleged onset date. (Tr. at 15.) At step two, he found that Plaintiff had the following severe impairments: arthritis; obesity; degenerative disc disease; tobacco abuse; narcotic abuse; abdominal pain; and torn meniscus with bilateral knee pain. (Tr. at 15-18.) At step three, the ALJ stated that Plaintiff did not have an impairment or combination of impairments that met or medically equaled an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 of the Commissioner's regulations. (Tr. at 18.) After consideration of the entire record, the ALJ found that Plaintiff retained "the residual functional capacity to perform light work ... except for the following limitations: the claimant is capable of occasionally climbing ramps and stairs, balancing, stooping, crouching, crawling, and kneeling; but is precluded from climbing ladders, ropes, and/or scaffolds. The claimant is to avoid concentrated use of moving machinery; and avoid concentrated exposure to unprotected heights. He is capable of simple, unskilled work."
In his brief, Plaintiff contends that the ALJ erred by: (1) failing to find him illiterate; (2) failing to properly consider his subjective complaints; and (3) failing to properly weigh medical source opinion evidence. Plaintiff requests that the Court remand for determination of benefits.
Plaintiff argues that the ALJ erred by failing to find him illiterate. Specifically, Plaintiff contends that "[t]he ALJ ignor[ed] the evidence demonstrating illiteracy resulting in a mischaracterization of evidence and legal error." Plaintiff alleges that a finding of functional illiteracy is supported by his own testimony; the findings of consultative examiner Joanna Woods, Psy.D.; and the testimony of vocational expert Nathan Dean. Plaintiff states that a determination of disabled is mandatory pursuant to GRID Rule 202.09.
In evaluating a claimant's education, the Social Security Administration uses the following categories:
20 C.F.R. §§ 404.1564(b)(1)-(4), 416.964(b)(1)-(4). The Administration also emphasizes that the numerical grade level that the claimant completed in school may not represent his actual educational abilities — these may be higher or lower.
Plaintiff, who was 51-years-old at the time of the hearing, testified to the following regarding his education and ability to read and write:
(Tr. at 38, 41-42.) Based on this testimony, Plaintiff's attorney examined the vocational expert Nathan Dean stating, in pertinent part:
(Tr. at 59.)
On September 26, 2009, Joanna Woods, Psy.D., performed a consultative examination. (Tr. at 16, 522-28.) As set forth in the ALJ's decision, Dr. Woods concluded "there is no evidence to indicate that Mr. Renteria is unable to work based solely on Axis I or Axis II diagnosis. He does not currently meet criteria for major depression disorder nor does he meet any criteria for posttraumatic stress disorder at this time. He does not demonstrate impairments in memory or concentration that would preclude him from work. He is able to interact in a socially appropriate way. He has demonstrated ability in the area of adaptation as he has been participating in activities at a local gym." (Tr. at 16, 526.) Dr. Woods further determined that Plaintiff "is able to remember and understand instructions, locations and work like procedures." He "has the ability to maintain attention and concentration ..., carry out instructions and sustain a normal routine without special supervision ..., interact with others ..., [and] respond appropriately to changes in a work setting and to be aware of hazards and take appropriate action." (Tr. at 16, 527.) As to his education, Dr. Woods noted that "Mr. Renteria states that he dropped out of high school because he could not read or write. He states he learned to read at the age of 34. He took one college course. He was in special education for `literacy.'" (Tr. at 21, 523.) Dr. Woods also documented that during testing Plaintiff "was not able to spell the word WORLD forward or backwards but was able to spell the word CAT forward and backwards." She indicated that "[t]his is likely based on his history of poor literacy." (Tr. at 525.) Lastly, she stated that "[w]hen asked to write a sentence that makes sense, his spelling was wrong, it was a run on sentence with poor grammar. He is suspected to have a below average IQ." (Tr. at 525.)
After considering the evidence set forth in the record regarding Plaintiff's ability to read and write, the ALJ found that Plaintiff has a limited education and is able to communicate in English. (Tr. at 24.) The ALJ stated, in pertinent part:
(Tr. at 21.)
The Commissioner, not this Court, is charged with the duty to weigh the evidence, resolve material conflicts in the evidence, and determine the case accordingly. Reviewing courts must consider the evidence that supports as well as detracts from the examiner's conclusion.
The Court finds that the ALJ did not err in finding that Plaintiff is able to read and write. Although Plaintiff testified that he could not read or write very well (Tr. at 41-42), there is evidence in the record that conflicts with a finding that Plaintiff is "illiterate" under the regulations. First, Plaintiff had an eighth-grade education (Tr. at 38, 157) and a history of skilled work (Tr. at 56), which are consistent with the regulatory definitions of "limited" or "marginal" education, rather than "illiteracy."
Second, as the ALJ indicated in his decision, except for the allegations set forth in the hearing testimony, the record is absent of, and Plaintiff fails to direct the Court to, any evidence demonstrating illiteracy. Rather, the record — including Plaintiff's applications, disability reports, daily activities, as well as, the objective medical evidence — indicates that he can read and write in English. And, although Dr. Woods (who Plaintiff relies upon in an effort to demonstrate illiteracy) notes a "history of poor literacy," she never states that Plaintiff is, in fact, illiterate. Instead, she reports that Plaintiff learned to read at the age of 34 and took one college course. (Tr. at 21, 523.)
Finally, as the Court has noted, Grid Rule 202.09 applies to an individual with unskilled, or no work experience. Here, Plaintiff has a history of skilled work experience (Tr. 56), thus, Grid Rule 202.09 does not apply.
In sum, Plaintiff's assertion of illiteracy is unpersuasive. The ALJ's finding that he was not illiterate is supported by substantial evidence of record.
Plaintiff argues that the ALJ erred in rejecting his subjective complaints in the absence of clear and convincing reasons for doing so.
To determine whether a claimant's testimony regarding subjective pain or symptoms is credible, the ALJ must engage in a two-step analysis. "First, the ALJ must determine whether the claimant has presented objective medical evidence of an underlying impairment `which could reasonably be expected to produce the pain or other symptoms alleged.' The claimant, however, `need not show that her impairment could reasonably be expected to cause the severity of the symptom she has alleged; she need only show that it could reasonably have caused some degree of the symptom.'"
In weighing a claimant's credibility, the ALJ may consider many factors, including, "(1) ordinary techniques of credibility evaluation, such as the claimant's reputation for lying, prior inconsistent statements concerning the symptoms, and other testimony by the claimant that appears less than candid; (2) unexplained or inadequately explained failure to seek treatment or to follow a prescribed course of treatment; and (3) the claimant's daily activities."
At the administrative hearing, Plaintiff testified that he lived by himself in an apartment, that he is 5' 8" tall and weighs 205 pounds, and that he attended school through the eighth grade. (Tr. at 38.) He stated that he has not worked since December of 2006, after being stabbed in the abdomen, small intestines, large intestines, and spine. (Tr. at 40, 42.) After the stabbing, Plaintiff underwent immediate surgery with complications of an infection that ran throughout his body and affected his kidneys and lungs. (Tr. at 42.) Two months following the stabbing and surgery, Plaintiff underwent additional surgery as there was incomplete removal of stool from the intestines. (Tr. at 42.) In total, Plaintiff underwent "four or five" surgeries and allegedly suffers ongoing abdominal pain with functional limitation. (Tr. at 43.) When lifting, moving the wrong way, or getting up from a seated position, Plaintiff experiences pain in the abdominal area that requires him to sit in a fetal position. (Tr. at 43.) He stated that he could lift 15 pounds at a time, but did not think he could do it on a regular basis. (Tr. at 44.) He stated that current treatment for his abdominal pain consisted of prescription medication, and also indicated that he was subject to back and knee pain that was treated with prescription medication and home exercises. (Tr. at 45.) Plaintiff stated that he could stand one-and-a-half to two hours at a time, and sit for two hours at a time. (Tr. at 46.) He also said that he has difficulty sleeping due to muscle cramps. (Tr. at 47.) Plaintiff indicated that he drinks a six-pack to a twelve-pack of beer a week. (Tr. at 48.) Plaintiff testified that during the day he does volunteer work at a youth program (boxing) he has developed, and that he does a lot of stretching, focus ball work, light weights, and Chi. (Tr. at 49-51.)
Having reviewed the record along with the ALJ's credibility analysis, the Court finds that the ALJ made extensive credibility findings and identified several clear and convincing reasons supported by the record for discounting Plaintiff's statements regarding his pain and limitations. Although the ALJ recognized that Plaintiff's medically determinable impairments could reasonably be expected to cause the alleged symptoms, he also found that Plaintiff's statements concerning the intensity, persistence, and limiting effects of the symptoms were not fully credible. (Tr. at 19-22.)
In his evaluation of Plaintiff's testimony, the ALJ first referenced the objective medical evidence finding that said evidence did not support pain and limitations of the degree alleged. (Tr. at 19-21);
The ALJ then analyzed Plaintiff's pain management regimen citing multiple sources within the medical record to discount Plaintiff's subjective complaints,
(Tr. at 20.) From 2007 through 2009, the ALJ, citing medical records from The Pain Center of Arizona, documented multiple instances wherein Plaintiff reported that his medication was "effective," that Plaintiff was noted to be improving and "doing well," and that Plaintiff's pain was again reported as "moderate" or "current" stability. (Tr. at 20, 413-93.) Plaintiff was consistently discharged from The Pain Center "without the use of any support equipment," and, according to the records, was "able to learn how to tolerate physical pain he is in with a minimal amount of pain medications." (Tr. at 20, 413-93, 698-707, 695.)
Again, citing from the various medical sources and records listed previously, the ALJ additionally found that Plaintiff's physical examinations were "largely `normal,' `within normal limits,' and `unremarkable.'" (Tr. at 20.) He stated that the findings "repeatedly included `good' muscle strength, bulk and tone; `normal' gait; `normal' range of motion, flexion and extension; `unremarkable' sensory results; and `normal' deep tendon reflexes." (Tr. at 20.) He discussed the diagnostic studies performed on Plaintiff from January of 2009 through August of 2011 noting that in "June 2009 lumbar MRI results demonstrated `mild' facet hypertrophy at the L4-L5 and L5-S1 levels, with `otherwise unremarkable' findings"; in "September 2009 lumbosacral MRI imaging revealed `negative' results" and "upper and lower extremity nerve conduction study data demonstrated `mild' bilateral radiculopathy at the S-1 level, with all other results normal"; in "October 2010 lumbar MRI results demonstrated `mild' spondylosis with `no focal herniated nucleus pulpous, canal stentosis or foraminal compromise'"; and in "August 2011 lumbar MRI images demonstrated `minimal' facet arthrosis at L4-L5 and L5-S1, with `no canal or foraminal compromise.'" (Tr. at 21, 499-500, 520-21, 266, 718-19.)
In addition to the objective medical evidence used to support his credibility analysis, the ALJ also found that evidence of Plaintiff's daily activities, as well as, inconsistencies in the record "somewhat diminished" Plaintiff's credibility. (Tr. at 21-22.) "[I]f the claimant engages in numerous daily activities involving skills that could be transferred to the workplace, an adjudicator may discredit the claimant's allegations upon making specific findings relating to the claimant's daily activities."
Regarding the inconsistencies in the record detracting from Plaintiff's credibility, the ALJ addressed Dr. Woods' September 26, 2009 psychiatric consultation wherein Plaintiff stated that he has been looking for work, but that no one will hire him with all the medications he is taking. (Tr. at 21, 524.) As previously demonstrated, the ALJ found multiple instances wherein Plaintiff reported that his medication was "effective," that he was noted to be improving and "doing well," and that his pain was reported as "moderate" or "current" stability. (Tr. at 20, 413-93.) Indeed, by June of 2009, Plaintiff was "able to learn how to tolerate physical pain he is in with a minimal amount of pain medications." (Tr. at 20, 695.) Moreover, the ALJ found Plaintiff's allegation of illiteracy (previously addressed by this Court at 4-9) inconsistent with the evidence set forth in the record.
As to Plaintiff's daily activities, the ALJ stated, "the claimant has described daily activities which are not limited to the extent one would expect, given the complaints of disabling symptoms and limitations." (Tr. at 21.) According the records provided from Dr. Woods' consultation and The Pain Center of Arizona, the ALJ found that Plaintiff "teaches and volunteers and works with children to keep himself active." (Tr. at 21, 522-28.) Plaintiff alleges no limitations with his activities of daily living, and no problems with his personal care. Plaintiff reported going for daily walks, visiting his son and granddaughter daily, teaching children how to box, spending "five hours per day" at the gym, being "able to do his chores at his home," shopping for groceries, and doing laundry. (Tr. at 21, 522-28.) At the hearing, Plaintiff testified that he is capable of standing for "two hours," and the record indicates that Plaintiff socializes "daily," and states that he is "writing his own book." (Tr. at 22, 46, 522-28.) While not alone conclusive on the issue of disability, an ALJ can reasonably consider a claimant's daily activities in evaluating the credibility of his subjective complaints.
In summary, the Court finds that the ALJ provided a sufficient basis to find Plaintiff's allegations not entirely credible. While perhaps the individual factors, viewed in isolation, are not sufficient to uphold the ALJ's decision to discredit Plaintiff's allegations, each factor is relevant to the ALJ's overall analysis, and it was the cumulative effect of all the factors that led to the ALJ's decision. The Court concludes that the ALJ has supported his decision to discredit Plaintiff's allegations with specific, clear and convincing reasons and, therefore, the Court finds no error.
Plaintiff contends that the ALJ erred by failing to properly weigh medical source opinion evidence. Specifically, Plaintiff argues that the ALJ failed to consider the opinions of John Prieve, D.O., who performed a consultative examination on September 1, 2009, and Plaintiff's treating physician, Brock Merritt, D.O.
"The ALJ is responsible for resolving conflicts in the medical record."
If a treating physician's opinion is not contradicted by the opinion of another physician, then the ALJ may discount the treating physician's opinion only for "clear and convincing" reasons.
Plaintiff contends that the ALJ erred in rejecting Dr. Prieve's opinion "based on the allegation that Dr. Prieve was not properly licensed at the time of the examination and was not a qualified medical source." Plaintiff alleges that Dr. Prieve was properly licensed at the time the examination was conducted, and asserts that "because the Defendant has not established specific and legitimate reasons set forth by the ALJ for rejecting the medical opinion of Dr. Prieve, said opinion should now be credited as true."
According to the record, Dr. Prieve performed a consultative examination on September 1, 2009. (Tr. at 511-19.) The parties briefly discussed Dr. Prieve's evaluation at the October 19, 2011 hearing before the ALJ stating:
(Tr. at 35.)
In his decision, addressed Dr. Prieve's findings and opinion as follows:
(Tr. at 22-23.)
In support of his argument that Dr. Prieve was licensed to practice medicine in Arizona at the time of the examination, Plaintiff directs the Court to the Official Website of the Arizona Medical Board, www.azmd.gov. Under the heading entitled "General Information," Dr. Prieve is currently listed as having an "Active" license, with a license issue date of January 15, 2003. Under the heading entitled "Board Actions," however, Dr. Prieve is listed as having been under probation pursuant to a Consent Agreement beginning February 1, 2007 through August 8, 2011. According to the information provided in the Consent Agreement, Dr. Prieve's license to practice medicine was suspended by the Massachusetts Board of Registration in Medicine as a result of disciplinary action taken in the State of Massachusetts related to alcohol and chemical dependency issues.
Having reviewed the record as well as the submissions provided by Plaintiff, the Court finds no error in the ALJ's decision not to rely on Dr. Prieve's findings. Although it appears that Dr. Prieve's Arizona license had not been revoked or suspended during the time frame in question, he was, in fact, on probation for 5 years. Further, the Massachusetts Board of Registration in Medicine did suspend Plaintiff's license to practice medicine in the Commonwealth indefinitely — which ultimately led to Plaintiff's probationary status in Arizona. Thus, according to 20 C.F.R. § 404.1503a, any reliance on Dr. Prieve's opinion would have been error. 20 C.F.R. § 404.1503a provides that the Social Security Administration will not use in its program "any individual or entity ... whose license to provide health care services is currently revoked or suspended by any State licensing authority ...." Therefore, the Court will not disturb the ALJ's conclusion as to Dr. Prieve.
Plaintiff argues that the ALJ erred in giving greater weight to a non-treating, non-examining source over the opinion of Dr. Merritt who recommended on February 11, 2010, that Plaintiff not work for one year. Since the opinion of Dr. Merritt, Plaintiff's treating physician, was contradicted by State agency medical consultants, as well as, other objective medical evidence, the specific and legitimate standard applies.
Historically, the courts have recognized the following as specific, legitimate reasons for disregarding a treating or examining physician's opinion: conflicting medical evidence; the absence of regular medical treatment during the alleged period of disability; the lack of medical support for doctors' reports based substantially on a claimant's subjective complaints of pain; and medical opinions that are brief, conclusory, and inadequately supported by medical evidence.
Subsequent to being stabbed in the abdomen, Plaintiff received treatment from Dr. Merritt beginning as a new patient in March of 2008. (Tr. at 248-249.) Dr. Merritt's treatment notes show that he treated Plaintiff for abdominal and low back pain post abdominal surgery. (Tr. at 235-36, 238-39, 241-42, 245-46, 248-49, 571, 575, 578-79, 581-82, 587-88.) In February of 2010, the record indicates that Plaintiff saw Dr. Merritt for "stuffy nose, headaches, sinus pressure, and follow-up on disability" as his "chief complaint." (Tr. at 587-88.) As to his "history of present illness," Dr. Merritt stated that Plaintiff "has still been unable to work and having a lot of pain in his low back." (Tr. at 587.) Dr. Merritt recommended "no work for the next year." (Tr. at 588.)
On October 6, 2009, state agency medical consultant, Charles Fina, M.D., reviewed the medical record and completed a Physical Residual Functional Capacity Assessment. (Tr. at 529-36.) Dr. Fina opined that Plaintiff could lift and/or carry 20 pounds occasionally and 10 pounds frequently; stand and/or walk about six hours in an 8-hour workday; sit about six hours in an 8-hour workday; frequently climb ramps/stairs, balance, stoop, kneel, crouch and crawl; and occasionally climb ladders/ropes/scaffolds. He found that Plaintiff did not have manipulative, visual, and communicative limitations but should avoid concentrated exposure to hazards (machinery, heights, etc.). Dr. Fina specifically noted that Plaintiff's "allegations outweigh the facts," that "there are no positive neuro findings and the x-rays of the back are NORMAL," and that "the neurosurgeon found nothing objectively wrong with the clmt ...." (emphasis original). (Tr. at 529-36.)
On March 31, 2010, state agency medical consultant, L.A. Woodard, D.O., reviewed the medical record and provided a Case Analysis. (Tr. at 564.) Dr. Woodard stated that "a review of voluminous med. records on file is w/out obj. evid. of a signif. back abnormality." (Tr. at 564.) Specifically, Dr. Woodard determined:
(Tr. at 564.) Dr. Woodard concluded that Plaintiff's condition "is w/out evid. of severity (non-severe) and clt should be able to perform all reasonable activities/maneuvers associated w/SGA." (Tr. at 564.)
In his evaluation of the objective medical evidence, the ALJ first addressed Dr. Fina's medical assessment, noted above, and found that Dr. Fina's conclusions were consistent with the treatment record, objective findings, opinion evidence, and the medical evidence as a whole. (Tr. at 22.) The ALJ gave "great weight" to Dr. Fina's opinion. (Tr. at 22.)
Then, the ALJ discussed Dr. Woodard's findings set forth in her Case Analysis. (Tr. at 22.) The ALJ concluded the "rationale expressed by this consultant and the conclusions reached [were] consistent with the treatment record, objective findings, opinion evidence and the medical evidence as a whole." (Tr. at 22.) The ALJ gave Dr. Woodard's opinion "great weight." (Tr. at 22.)
After discussing and ultimately discounting Dr. Prieve's opinion, the ALJ spent the majority of his discussion of the objective medical evidence examining Dr. Merritt's opinion. (Tr. at 23.) The ALJ found, as follows:
(Tr. at 23.)
The Court finds that the ALJ did not err in his assessment of Dr. Merritt's opinion. Not only did Dr. Merritt give a determination on the ultimate question of disability — which said determination is reserved solely to the Commissioner — but the ALJ found that his conclusions were based primarily on Plaintiff's subjective complaints, and were uncorroborated and inconsistent with the objective medical evidence of record.
Substantial evidence supports the ALJ's decision to deny Plaintiff's claim for disability insurance benefits and supplemental security income in this case. The ALJ's finding that Plaintiff was not illiterate is supported by substantial evidence in the record; the ALJ properly discredited Plaintiff's credibility providing clear and convincing reasons supported by substantial evidence; and the ALJ properly discounted the opinion of Dr. Prieve and also provided specific and legitimate reasons, based on substantial evidence, for discounting the opinion of Dr. Merritt. Consequently, the ALJ's decision is affirmed.
Based upon the foregoing discussion,