JOHN E. McDERMOTT, Magistrate Judge.
On October 5, 2012, Lucia Jimenez ("Plaintiff" or "Claimant") filed a complaint seeking review of the decision by the Commissioner of Social Security ("Commissioner") denying Plaintiff's applications for Social Security Disability Insurance benefits and Supplemental Security Income benefits. The Commissioner filed an Answer on January 24, 2013. On June 10, 2013, the parties filed a Joint Stipulation ("JS"). The matter is now ready for decision.
Pursuant to 28 U.S.C. § 636(c), both parties consented to proceed before this Magistrate Judge. After reviewing the pleadings, transcripts, and administrative record ("AR"), the Court concludes that the Commissioner's decision must be affirmed and this case dismissed with prejudice.
Plaintiff is a 56-year-old female who applied for Social Security Disability Insurance benefits and Supplemental Security Income benefits on January 6, 2011, alleging disability beginning October 14, 2009. (AR 11.) The ALJ determined that Plaintiff had not engaged in substantial gainful activity since October 14, 2009. (AR 13.)
Plaintiff's claims were denied initially on August 12, 2011, and on reconsideration on October 21, 2011. (AR 11.) Plaintiff filed a timely request for hearing, which was held before Administrative Law Judge ("ALJ") Joseph D. Schloss, on April 3, 2012, in Moreno Valley, California. (AR 11.) Plaintiff appeared and testified at the hearing and was represented by counsel. (AR 11.) Medical expert ("ME") Glenn E. Griffin, M.D. and vocational expert ("VE") Sandra M. Fioretti also appeared and testified at the hearing. (AR 11.)
The ALJ issued an unfavorable decision on April 10, 2012. (AR 11-22.) The Appeals Council denied review on August 20, 2012. (AR 1-6.)
As reflected in the Joint Stipulation, Plaintiff only raises the following disputed issue as a ground for reversal and remand:
Under 42 U.S.C. § 405(g), this Court reviews the ALJ's decision to determine whether the ALJ's findings are supported by substantial evidence and free of legal error.
Substantial evidence means "`more than a mere scintilla,' but less than a preponderance."
This Court must review the record as a whole and consider adverse as well as supporting evidence.
The Social Security Act defines disability 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 . . . can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). The Commissioner has established a five-step sequential process to determine whether a claimant is disabled. 20 C.F.R. §§ 404.1520, 416.920.
The first step is to determine whether the claimant is presently engaging in substantial gainful activity.
Before making the step four determination, the ALJ first must determine the claimant's residual functional capacity ("RFC"). 20 C.F.R. § 416.920(e). Residual functional capacity ("RFC") is "the most [one] can still do despite [his or her] limitations" and represents an assessment "based on all the relevant evidence." 20 C.F.R. §§ 404.1545(a)(1), 416.945(a)(1). The RFC must consider all of the claimant's impairments, including those that are not severe. 20 C.F.R. §§ 416.920(e), 416.945(a)(2); Social Security Ruling ("SSR") 96-8p.
If the claimant cannot perform his or her past relevant work or has no past relevant work, the ALJ proceeds to the fifth step and must determine whether the impairment prevents the claimant from performing any other substantial gainful activity.
In this case, the ALJ determined at step one of the sequential process that Plaintiff has not engaged in substantial gainful activity since October 14, 2009, the alleged onset date. (AR 13.)
At step two, the ALJ determined that Plaintiff has the following combination of medically determinable severe impairments: neck pain and history of impingement syndrome of the right shoulder with partial tear of the right rotator cuff. (AR 13-16.)
At step three, the ALJ determined that Plaintiff does not have an impairment or combination of impairments that meets or medically equals one of the listed impairments. (AR 17.)
The ALJ then found that Plaintiff has the RFC to perform the full range of medium work as defined in 20 CFR §§ 404.1567(c) and 416.967(c). (AR 17-21.) In determining this RFC, the ALJ made an adverse credibility determination (AR 17-19) which Plaintiff does not challenge here.
At step four, the ALJ found that Plaintiff is able to perform her past relevant work as a sandwich maker and security guard. (AR 21.)
Consequently, the ALJ found Claimant not disabled within the meaning of the Social Security Act at any time from the alleged onset date through the date of the ALJ's decision. (AR 21.)
The ALJ decision must be affirmed. The ALJ properly rejected the treating physician opinion of Dr. Ibrahim Sumaril for specific, legitimate reasons supported by substantial evidence. The ALJ's RFC is supported by substantial evidence. The ALJ's non-disability determination is supported by substantial evidence and free of legal error.
The ALJ's RFC limits Plaintiff to medium work. (AR 17.) The ALJ also made an adverse credibility finding. (AR 17-19.) Significantly, Plaintiff does not challenge this finding. Plaintiff's only argument is that the ALJ improperly rejected the treating physician opinion of Dr. Ibrahim Sumaril. There is no merit to Plaintiff's contention. The ALJ rejected Dr. Sumaril's opinion for specific legitimate reasons supported by substantial evidence.
In evaluating medical opinions, the case law and regulations distinguish among the opinions of three types of physicians: (1) those who treat the claimant (treating physicians); (2) those who examine but do not treat the claimant (examining physicians); and (3) those who neither examine nor treat the claimant (non-examining, or consulting, physicians).
Where a treating doctor's opinion is not contradicted by another doctor, it may be rejected only for "clear and convincing" reasons.
In a February 2, 2011, Medical Source Statement, Dr. Sumaril of the Palm Springs Family Care Center provided an RFC inconsistent with the ALJ's RFC. (AR 550-554.) He diagnosed moderate shoulder pain with "rotator cuff abnormalities" and reduced range of motion. (AR 550.) He opined that Ms. Jimenez can lift up to 20 pounds occasionally and 10 pounds frequently, sit for 6 hours in an 8-hour work day and stand/walk 2 hours. (AR 551-553.) Dr. Sumaril described Ms. Jimenez as limited to occasional right hand reaching. (AR 553.) He opined Ms. Jimenez would miss work two days a month. (AR 554.)
An ALJ "may disregard a treating physician's opinion whether or not that opinion is contradicted."
Plaintiff cites to treatment records purporting to show Ms. Jimenez had an irreparable rotator cuff tear, as supporting Dr. Sumaril's opinion. Dr. Sumaril, however, did not cite these records and only diagnosed "rotator cuff abnormalities," not an irreparable tear. (AR 550.) Plaintiff offers no rebuttal to the ALJ's finding that Dr. Sumaril failed to explain how her impairments could cause the exertional and postural limitations assessed. Nor is there any explanation why Plaintiff would miss work two days a month. The ALJ's finding that Dr. Sumaril's Medical Source Statements offers conclusions without explanation is reasonable, not adequately addressed or rebutted by Plaintiff, and supported by substantial evidence.
Second, the ALJ rejected Dr. Sumaril's opinion because it was based on Plaintiff's subjective report of symptoms which Dr. Sumaril accepted uncritically. (AR 20.) The ALJ also made an adverse credibility determination that Plaintiff does not challenge (AR 19), which severely undermines Dr. Sumaril's opinion. An ALJ may reject a physician's opinion based on discredited subjective symptoms.
The ALJ, for example, found that Plaintiff's pain symptoms were "well controlled with Tramadol . . . without complaints of ineffectiveness." (AR 18.) Impairments that can be controlled effectively with medication are not disabling.
The ALJ also found that treatment for Plaintiff's alleged impairment "has been essentially routine and conservative," consisting of Tramadol and over-the-counter Motrin. (AR 19.) The ALJ observed that Plaintiff never sought follow-up treatment or surgical intervention. (AR 19-20.) Infrequent, conservative treatment is not indicative of a disabling impairment. Conservative treatment is a valid factor in assessing crediblity.
Most importantly, the ALJ discounted Plaintiff's subjective symptoms and Dr. Sumaril's opinion because the objective medical evidence does not substantiate Claimant's subjective symptoms. (AR 18, 19, 21.) An ALJ is entitled to consider whether there is a lack of medical evidence to corroborate a claimant's alleged pain symptoms so long as it is not the only reason for discounting a claimant's credibility.
Plaintiff argues that the ALJ imposes no right upper extremity limitation at all. This is not true. Based on Dr. Bilezkjan's report, the ALJ limited Plaintiff to medium work. Plaintiff's argument that Bilezkjan's opinion is not substantial evidence is plainly meritless.
Plaintiff argues that an examining doctor who makes the same diagnoses as a treating physician, differing only in conclusions, cannot be substantial evidence, citing
Plaintiff may disagree with the ALJ's evaluation of the evidence but it is the ALJ who is responsible for resolving conflicts in the medical evidence and ambiguities in the record.
The ALJ properly rejected Dr. Sumaril's opinion for specific, legitimate reasons supported by substantial evidence. The ALJ's non-disability determination is supported by substantial evidence and free of legal error.
IT IS HEREBY ORDERED that Judgment be entered affirming the decision of the Commissioner of Social Security and dismissing this case with prejudice.