MICHELLE H. BURNS, Magistrate Judge.
Pending before the Court is Plaintiff Sally Ann Johnson's appeal from the Social Security Administration's final decision to deny her claim for disability insurance benefits. After reviewing the administrative record and the arguments of the parties, the Court now issues the following ruling.
Plaintiff filed an application for disability insurance benefits in March 2011, alleging disability beginning August 17, 2010. (Transcript of Administrative Record ("Tr.") at 21, 151-52.) Her application was denied initially and on reconsideration. (Tr. at 92-94, 100-02.) Thereafter, Plaintiff requested a hearing before an administrative law judge, and a hearing was held on September 25, 2012. (Tr. at 35-66.) On November 30, 2012, the ALJ issued a decision finding that Plaintiff was not disabled. (Tr. at 18-34.) The Appeals Council denied Plaintiff's request for review (Tr. at 1-6), making 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 August 17, 2010 — the alleged onset date. (Tr. at 23.) At step two, she found that Plaintiff had the following severe impairments: a major depressive disorder, generalized anxiety disorder, panic disorder without agoraphobia, and attention-deficit hyperactivity disorder. (Tr. at 23.) 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 23-24.) After consideration of the entire record, the ALJ found that Plaintiff retained "the residual functional capacity to perform a full range of work at all exertional levels but with the following nonexertional limitations: the claimant can understand, remember and carry out simple and detailed work tasks. She should not work in a team. She can work objects or data."
Therefore, the ALJ concluded that Plaintiff "has not been under a disability ... from August 17, 2010, through the date of [her] decision." (Tr. at 29.)
In her brief, Plaintiff contends that the ALJ erred by: (1) failing to properly consider her subjective complaints; (2) failing to properly weigh medical source opinion evidence; (3) failing to fully develop the record by declining to subpoena a state agency reviewing psychological consultant; (4) failing to properly consider lay witness testimony; and (5) failing to properly consider whether Plaintiff could perform a significant number of jobs in the national economy. Plaintiff requests that the Court remand for determination of benefits.
Plaintiff argues that the ALJ erred in rejecting her 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."
Plaintiff suffers from panic attacks. She explained she did not know what a panic attack was until after she had a severe one and was unable to return to work. She now has panic attacks four or five times each day, and feels as if she will pass out. (Tr. at 42.) Plaintiff's panic attacks last about 15 minutes, and she will isolate herself until it passes. Stress increases panic, and sometimes Plaintiff will break out in hives. (Tr. at 43.) During a typical day, Plaintiff experiences racing thoughts and depression. She does not like to be around other people and avoids going out in public. She has good and bad days. On bad days she will cry a lot and does not want to see anyone. This happens about 6 days each week. (Tr. at 44.) Plaintiff has canceled a few medical appointments because she was having a bad day and could not leave the house. She has a roommate who does most of the grocery shopping. Plaintiff has walked out of the grocery store and left her items because of panic. (Tr. at 45.)
Plaintiff discussed her erratic sleep patterns. She takes a one hour nap a couple of times each week. She has difficulty concentrating and tends to start tasks and not finish them. (Tr. at 46.) Dyslexia makes it difficult for Plaintiff to read, and she almost missed an appointment because she read the numbers for the address backwards. (Tr. at 47.) Plaintiff has had to change mental health doctors because of insurance and financial problems. (Tr. at 48-49.) She is not entirely sure how often she had panic attacks in the past because she did not know what panic attacks were until later. (Tr. at 52.) When Plaintiff changed doctors, she also had to change medication. She has yet to find a combination of mediation that works as well as the ones prescribed by her doctor. (Tr. at 53.)
Having reviewed the record along with the ALJ's credibility analysis, the Court finds that the ALJ made sufficient credibility findings and identified several clear and convincing reasons supported by the record for discounting Plaintiff's statements regarding her pain and limitations. Although the ALJ recognized that Plaintiff's medically determinable impairments could reasonably be expected to cause the alleged symptoms, she also found that Plaintiff's statements concerning the intensity, persistence, and limiting effects of the symptoms were not fully credible. (Tr. at 25-27.)
The ALJ first addressed the objective medical evidence noting that the "objective medical evidence does not indicate that the claimant's impairments are disabling," particularly as Plaintiff "exhibited good mental status during multiple office visits." (Tr. at 26.) Despite allegations of debilitating panic attacks, depression, and social difficulties, Plaintiff appeared calm, cooperative, and fully oriented during a June 2010 psychiatric treatment visit. (Tr. at 25, 432.) Subsequently, in a February 2011 office visit, Plaintiff did not exhibit any phobias, fears, compulsions, or thought disorder. (Tr. at 25, 272-74.) Three months later, in May 2011, Plaintiff appeared polite and cooperative, with a thought process that was appropriate to content. (Tr. at 26, 283.) A month later, Plaintiff informed her physician she was "doing well." (Tr. at 26, 345.) By September 2011, Plaintiff reported, "I am doing really good. I think that this medication is working." (Tr. at 26, 298.) She explained her mood was good, her concentration was better, and her memory was "fine." (Tr. at 26, 298.) Significantly, she also reported she was not experiencing panic attacks. (Tr. at 26, 298.) On examination, she had satisfactory attention span, intact thought content, and euthymic affect. (Tr. at 298.) As the ALJ discussed in his decision, subsequent treatment reports continued to demonstrate Plaintiff had generally unremarkable mental status findings, including calm and cooperative presentation, affect appropriate to content, and Plaintiff's own reports that she was doing "better." (Tr. at 26, 417, 430.) Further, the ALJ noted that treating mental health clinicians routinely reported Plaintiff had global assessment of functioning (GAF) scores in the 60s and 70s range, "indicating a high degree of functioning." (Tr. at 26.) In June 2010, for example, a clinician assessed Plaintiff with a GAF score of 60. (Tr. at 25, 433.) Thereafter, in September 2011, a clinician reported Plaintiff had a GAF score of 70. (Tr. at 26, 298.) In March 2012, a clinician indicated Plaintiff had a GAF score of 75. (Tr. at 26, 426.) An ALJ may discredit a claimant's allegations if they are inconsistent with the objective medical evidence.
Next, the ALJ discredited Plaintiff's allegations because Plaintiff "was inconsistent regarding the severity of her mental impairments." (Tr. at 26.) "One strong indication of the credibility of an individual's statements is their consistency, both internally and with other information in the case record." Social Security Ruling (SSR) 96-7p, available at 1996 WL 374186, at *5. Accordingly, an ALJ "may engage in ordinary techniques of credibility evaluation, such as considering claimant's reputation for truthfulness and inconsistencies in claimant's testimony."
The ALJ also found that Plaintiff provided inconsistent reports regarding her drug and alcohol use. (Tr. at 27.) In April 2011, Plaintiff informed a treating physician she drank once or twice each week. (Tr. at 27, 269.) However, in a questionnaire completed only one month later, in May 2011, Plaintiff denied using alcohol or drugs. (Tr. at 27, 189.) Thereafter, in November 2011, Plaintiff again provided inconsistent statements when she informed a clinician that she drank alcohol three to four times a week. (Tr. at 27, 387.)
Lastly, in evaluating Plaintiff's credibility, the ALJ analyzed Plaintiff's activities of daily living. "[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."
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 her 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 the medical source opinions of treating physician Marie Gronley, M.D., and examining physician Jacqueline Worsley, Psy.D.
"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.
Since it appears that Drs. Gronley and Worsley's opinions were contradicted by the state agency physicians, as well as, other objective medical evidence of record, 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.
The Court having reviewed the ALJ's evaluation of the objective medical evidence finds that the ALJ failed to provide specific and legitimate reasons for rejecting the opinions of Drs. Gronley and Worsley. (Tr. at 27.) The ALJ rejected Dr. Gronley's opinion stating that the GAF assigned by Dr. Gronley was in conflict with Plaintiff's ability to work at a semi-skilled job the prior year. The ALJ also asserted that objective medical evidence did not support Dr. Gronley's rating of Plaintiff's social abilities. In support, the ALJ cites the lay witness testimony of Ria Rebel who "reported that the claimant gets along okay with authority figures" and the lay witness testimony of Mary Atherton who "reported that she spends time with the claimant once per week by shopping, talking and having lunch." (Tr. at 27.) The ALJ's assertions are improper because Plaintiff's ability to work at a semi-skilled job the year before she became ill has no bearing on Dr. Gronley's opinion as to how the psychiatric impairment effected functioning a year later. Further, in weighing the treating physician's opinion, the ALJ does not explain how lay witness testimony represents "objective medical evidence" conflicting with Dr. Gronley's opinion of Plaintiff's ability to sustain social function in a work setting.
Regarding Dr. Worsley, the ALJ gave "some weight" to her assessment, but found "the claimant is not as limited as Dr. Worsley reports," referring to the "paragraph B" discussion in another part of the decision. (Tr. at 27.) However, the ALJ's "paragraph B" discussion fails to set forth sufficient reasons for discounting Dr. Worsley's opinion.
Thus, the Court finds that the ALJ erred in her evaluation of the objective medical evidence. Moreover, the ALJ's error in this regard does not constitute harmless error.
Therefore, in light of the fact that the Court finds that the ALJ failed to provide specific, legitimate reasons based on substantial evidence in the record for rejecting the opinions of Drs. Gronley and Worsley, and the fact that the ALJ relied upon an erroneous evaluation of the objective medical evidence to derive Plaintiff's residual functional capacity assessment, in part, the Court declines to reach Plaintiff's remaining arguments as they are impacted by the assessment. The Court will order that the decision of the ALJ be vacated and the case be remanded.
"[R]emand for further proceedings is appropriate where there are outstanding issues that must be resolved before a determination can be made, and it is not clear from the record that the ALJ would be required to find claimant disabled if all the evidence were properly evaluated."
For the reasons discussed in this Order, the Commissioner's decision will be vacated and this matter will be remanded for further administrative proceedings consistent with this Order.
Accordingly,