JEAN ROSENBLUTH, Magistrate Judge.
Plaintiff seeks review of the Commissioner's final decision denying her applications for Social Security disability insurance benefits ("DIB") and supplemental security income benefits ("SSI"). The parties consented to the jurisdiction of a U.S. Magistrate Judge under 28 U.S.C. § 636(c). The matter is before the Court on the parties' Joint Stipulation, filed March 31, 2017, which the Court has taken under submission without oral argument. For the reasons stated below, the Commissioner's decision is affirmed.
Plaintiff was born in 1971. (Administrative Record ("AR") 51.) She completed high school and "some" college (AR 51, 387) and worked as a caregiver and sales associate (AR 37, 52).
On October 3, 2011, Plaintiff filed for DIB and SSI, alleging that she had been unable to work since April 14, 2011 (AR 339, 346), because of migraines (AR 386). After her applications were denied initially and on reconsideration, she requested a hearing before an Administrative Law Judge. (AR 119-25, 126-32, 149-58, 159-68, 207-08.) A hearing was held on April 23, 2013, at which Plaintiff testified, as did a vocational expert and medical expert.
A second hearing was held before a different ALJ on December 2, 2014, at which Plaintiff, who was represented by counsel, and a different medical expert and VE testified. (AR 81-111.) On January 22, 2015, the ALJ issued a written decision finding Plaintiff not disabled. (AR 20-45.) On February 6, 2015, Plaintiff requested review of that decision. (AR 29.) On April 8, 2016, the Appeals Council denied review. (AR 1-4.) This action followed.
Under 42 U.S.C. § 405(g), a district court may review the Commissioner's decision to deny benefits. The ALJ's findings and decision should be upheld if they are free of legal error and supported by substantial evidence based on the record as a whole.
People are "disabled" for purposes of receiving Social Security benefits if they are unable to engage in any substantial gainful activity owing to a physical or mental impairment that is expected to result in death or has lasted, or is expected to last, for a continuous period of at least 12 months. 42 U.S.C. § 423(d)(1)(A);
The ALJ follows a five-step sequential evaluation process to assess whether a claimant is disabled. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4);
If the claimant is not engaged in substantial gainful activity, the second step requires the Commissioner to determine whether the claimant has a "severe" impairment or combination of impairments significantly limiting her ability to do basic work activities; if not, the claimant is not disabled and the claim must be denied. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii).
If the claimant has a "severe" impairment or combination of impairments, the third step requires the Commissioner to determine whether the impairment or combination of impairments meets or equals an impairment in the Listing of Impairments ("Listing") set forth at 20 C.F.R. part 404, subpart P, appendix 1; if so, disability is conclusively presumed. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).
If the claimant's impairment or combination of impairments does not meet or equal an impairment in the Listing, the fourth step requires the Commissioner to determine whether the claimant has sufficient RFC to perform her past work; if so, she is not disabled and the claim must be denied. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv). The claimant has the burden of proving she is unable to perform past relevant work.
At step one, the ALJ found that Plaintiff had not engaged in substantial gainful activity since April 14, 2011, the alleged onset date. (AR 25.) At step two, he concluded that she had severe impairments of "atypical migraines, asthma, cervical degenerative disc disease, lumbar degenerative disc disease, obesity status post gastric bypass surgery, torn right medial meniscus[,] and status post arthroscopic surgery of the left knee." (AR 26.) At step three, he determined that her impairments did not meet or equal a listing. (
At step four, the ALJ found that Plaintiff had the RFC
(AR 26-27.) The ALJ concluded that Plaintiff could not perform her past relevant work as a care provider or sales associate. (AR 37.) Based on the VE's testimony, he found that Plaintiff could perform jobs existing in significant numbers in the national economy. (AR 37-39.) Accordingly, he found her not disabled. (AR 39.)
Plaintiff alleges that the ALJ erred by (1) rejecting the opinion of treating doctor Muhammad Sohel,
Plaintiff argues that the ALJ failed to properly assess a probative medical-source opinion; specifically, he erred in rejecting the opinion of Dr. Sohel, one of her treating doctors, that she would "miss work more than 3 times per month due to the combination of her impairments." (
If a treating physician's opinion is well supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in the record, it should be given controlling weight. §§ 404.1527(c)(2), 416.927(c)(2).
The ALJ may disregard a treating physician's opinion whether or not that opinion is contradicted.
On March 14, 2013, Dr. Sohel, who evaluated and treated Plaintiff from April 2011 to March 2013, completed a "Multiple Impairment Questionnaire" for her Social Security case. (AR 827-34.) The handwritten questionnaire is largely illegible, but Dr. Sohel clearly opined that Plaintiff could sit for only one hour and stand or walk for one hour or less in an eight-hour workday (AR 829); could not sit continuously and would have to "get up and move around" every 15 minutes for "15-30" minutes at a time (AR 829-30); could not stand or walk continuously (AR 830); would have to take unscheduled breaks, lasting between 30 and 60 minutes each, more than 10 times a day (AR 832); would have "good days" and "bad days" (AR 833); and would likely be absent from work as a result of her impairments or treatment "[m]ore than three times a month" (
At the April 23, 2013 hearing, Plaintiff testified that she suffered from migraines "[o]nce or twice a week," each lasting "for about a day and a half." (AR 56.) Even after taking prescribed medication, her migraines would cause her to sleep for "almost four hours" during the day, vomit, and become sensitive to light and noise. (AR 56-57.) She testified that she had no difficulty taking care of her two children, then aged five and seven years, but that they were "kind of — almost, like, independent." (AR 64-65.) She attended church "every Sunday," sitting for "two hours" without difficulty "with the support of [a] pillow." (AR 68.)
Dr. Gerald Weingarten, a specialist in internal medicine who testified as a medical expert at Plaintiff's 2013 hearing, opined that Plaintiff "might be off work from time to time because of her headaches." (AR 74-76, 250.) When asked by the ALJ whether an individual who "can sit six hours in an eight-hour day; can occasionally lift 50 pounds, frequently lift 25 pounds; [and] can occasionally climb ladders, scaffolds, and ropes" would be able to do Plaintiff's past relevant work, the VE testified, "yes." (AR 77.) When asked whether such an individual with the additional limitation of having to "miss three or more days per month from work" could perform "any jobs in the labor market," the VE testified that such an individual "cannot go back to any type of work." (AR 77-78.)
In July 2013, Plaintiff started receiving Botox injections for her migraines. (AR 865.) She continued to receive a course of Botox injections every one or two months, although she missed some appointments. (AR 859-64.) In July 2014, she reported that the frequency of her headaches had reduced to one or two migraines a week, but she continued to have "significant headaches" even with the Botox. (AR 859-60.)
At her second hearing, on December 2, 2014, Plaintiff testified that she last attempted to work in 2013. (AR 89.) She worked for one week at a telemarketer job; during that week she missed three days of work because of her migraines. (
When asked by Plaintiff's counsel whether she would have "any limitations with regard to the ability to maintain attendance [or] be at work every day as a result of the migraines," Dr. Arnold Ostrow, a specialist in internal medicine who testified as a medical expert at the 2014 hearing, opined that she would. (AR 88.) Dr. Ostrow testified that he could not "quantify" that limitation, but he agreed with counsel's statement that "it would be expected of someone that has migraines that they would potentially either have to leave late, leave early, or miss work on occasion." (
As an initial matter, Plaintiff does not contest the ALJ's assessment of any medical opinion — other than Dr. Sohel's opinion about her absenteeism — or her RFC. She also does not contest the ALJ's finding that her subjective complaints were "less than fully credible." (AR 37.) The ALJ found that "[t]he credibility of [Plaintiff's] allegations regarding the severity of her symptoms and limitations is diminished because those allegations are greater than expected in light of the objective evidence of record," some of her activities of daily living were "inconsistent" with "an incapacitating or debilitating condition," and she had "not generally received the type of medical treatment one would expect for a totally disabled individual." (AR 29.) In finding that her subjective symptom allegations lacked credibility, the ALJ extensively discussed Plaintiff's descriptions of disabling headaches: he noted the allegations she made in a Headache Questionnaire (
As explained herein, Dr. Sohel's opinion that Plaintiff would be absent from work "[m]ore than three times a month" because of her "impairments or treatment" (AR 833) was inconsistent with other evidence in the record, including Plaintiff's alleged daily activities. But even though Dr. Ostrow specifically said that he could not "quantify" Plaintiff's absenteeism (AR 88), Dr. Sohel's opinion was not directly contradicted by another doctor's. Thus, the ALJ was likely required to give a clear and convincing reason for rejecting it.
Before addressing the medical-opinion evidence, the ALJ specifically stated that he had "considered opinion evidence in accordance with the requirements of 20 CFR 404.1527 and 416.927," which list the factors an ALJ must consider "in deciding the weight . . . give[n] to any medical opinion." (AR 27.) The ALJ summarized Dr. Sohel's Multiple Impairment Questionnaire and noted his opinion that Plaintiff would "miss more than three days of work a month." (AR 33.) He gave "little weight" to Dr. Sohel's opinion overall because "[t]he severity of the limitations assessed by Dr. Sohel are inconsistent with [Plaintiff]'s admitted level of daily activities." (AR 36.) The ALJ noted that Plaintiff
(
Indeed, Plaintiff's ability to sit for two hours during a church service is inconsistent with Dr. Sohel's opinion that she could sit for only one hour, could not sit continuously, and would have to "get up and move around" every 15 minutes for "15-30" minutes at a time. (AR 829-30.) And her ability to care for a one-year-old child — who presumably could not yet walk, talk, use the toilet, prepare food, or do anything independently — for almost eight hours a day every day and take her daughter to school on a regular schedule — both of which she suggested she did without assistance (
Plaintiff argues that the opinion that she would "need to miss work 3 times a month" is not inconsistent with the daily activities listed by the ALJ and thus the ALJ did not reject that portion of Dr. Sohel's opinion. (J. Stip at 6.) But the ALJ need not recite "magic words" to reject an opinion; the court may draw "specific and legitimate inferences" from the ALJ's opinion as a whole.
Further, the record shows that Plaintiff visited Dr. Sohel only seven times in two years, canceled or failed to show up to five other appointments, and didn't see Dr. Sohel at all from March 2012 to March 2013. (
Although Plaintiff testified that her headaches in fact caused her to miss three days of work in one week at her last job (AR 89) and that despite the Botox injections she still had headaches every week as to which she had to do "certain things" to avoid triggering a "full-blown" migraine (AR 92), including "just not [doing] a whole lot of functioning" (AR 97), the ALJ specifically found that her allegations regarding the severity of her symptoms were not credible (AR 29-30), a finding Plaintiff does not contest. Indeed, a treating doctor's reliance on a claimant's incredible subjective complaints is a legally sufficient basis to give that doctor's opinion limited weight.
In its July 24, 2014 order remanding the first ALJ's decision, the Appeals Council found that that ALJ's reason for giving little weight to Dr. Sohel's opinion — that "there [wa]s no objective evidence to support the extremely severe level of impairments and function limitations" — needed further explanation because Dr. Sohel's opinion was "relatively consistent" with the medical evidence and "the only other examining source opinions in the record." (AR 187.) The Appeals Council identified "EMGs/NCVs that demonstrated radiculopathy and neuropathy," "Exhibit 8F . . . [which] notes moderate and severe tenderness and positive straight leg raising on the left," "Exhibit 10F, p. 7-9 . . . [which] notes antalgic gait, sensory deficits, motor deficits, severe tenderness, positive physical exam tests, and positive bilateral straight leg raising," and "Exhibit 15F." (
On remand, the ALJ did not reject Dr. Sohel's opinion outright: rather, he gave "little weight" to it. In his January 22, 2015 decision, the ALJ addressed each of the Appeals Council's concerns. The ALJ "generously considered" Plaintiff's complaints of "decreased strength" and limited her to "less than [a] full range of sedentary work." (AR 35.) He gave "little weight" to the opinion of chiropractor Rink in Exhibit 10F because it was not from an acceptable medical source and was inconsistent with the objective medical evidence. (AR 36.) He gave "some weight" to the opinion of Plaintiff's chiropractor Negin Rameshni in Exhibit 15F because it was "inconsistent with the objective evidence as a whole." (AR 36.) Plaintiff does not contest the ALJ's evaluation of the opinions of chiropractors Rink and Rameshni. The ALJ credited those portions of Dr. Sohel's opinion that were consistent with the record, as identified by the Appeals Council. In doing so, he implicitly rejected those portions of Dr. Sohel's opinion that were inconsistent with the objective medical evidence. Indeed, Plaintiff has not identified, nor does the record reveal, any objective evidence that supports Dr. Sohel's opinion that Plaintiff would be excessively absent from work because of the combination of her conditions or her treatment for them, particularly given the improvement in her headaches since she began Botox.
The ALJ gave clear and convincing reasons for rejecting Dr. Sohel's opinion that Plaintiff would miss work "more than three times per month" because of her impairments or treatment. Thus, remand is not warranted.
Plaintiff contends that the VE's testimony demonstrated that she could not perform any work "consistent with" her RFC. (J. Stip. at 11-13, 16.) She argues that the "sit/stand" option in her RFC (AR 27) should be interpreted to mean that she had "to sit for about half the day and stand for about half the day" (J. Stip. at 11). Because the VE testified that an individual with Plaintiff's RFC who had to sit half the day and stand half the day would not be able to perform sedentary or any other work, Plaintiff argues, the VE's testimony established that she was disabled. (
The ALJ presented to the VE a hypothetical person with Plaintiff's education, training, and work experience with the following limitations:
(AR 104-05.) The VE testified that such a person would not be able to perform Plaintiff's past relevant work; she would be able to perform the jobs of "telephone quotation clerk," DOT 237.367-046, 1991 WL 672194, and "pari-mutuel ticket checker," DOT 219.587-010, 1991 WL 671989, however, which are both unskilled, sedentary-work jobs. (AR 105.) The VE clarified that those jobs "would accommodate [Plaintiff's RFC] as long as the standing or walking part of that optional [sic] doesn't — does not exceed two-hour parameters of sedentary work." (
Plaintiff's representative further presented a hypothetical individual to the VE with the same limitations as those described by the ALJ but who also had to "alternate positions every 20 to 30 minutes — for 20 to 30 minutes at a time, so essentially, they're sitting and standing for half of the day." (
To ascertain the requirements of occupations as generally performed in the national economy, the ALJ may rely on VE testimony or information from the DOT. SSR 00-4P, 2000 WL 1898704, at *2 (Dec. 4, 2000) (at steps four and five, SSA relies "primarily on the DOT . . . for information about the requirements of work in the national economy" and "may also use VEs . . . at these steps to resolve complex vocational issues"); SSR 82-61, 1982 WL 31387, at *2 (Jan. 1, 1982) ("The [DOT] descriptions can be relied upon — for jobs that are listed in the DOT — to define the job as it is
When a VE provides evidence at step four or five about the requirements of a job, the ALJ has a responsibility to ask about "any possible conflict" between that evidence and the DOT.
Social Security Ruling 83-12 discusses a claimant's need to "[a]lternate [s]itting and [s]tanding":
SSR 83-12, 1983 WL 31253, at *4 (1983). The ruling recognizes that "some jobs in the national economy — typically professional and managerial ones" — allow an individual to sit or stand "with a degree of choice"; but "most jobs have ongoing work processes which demand that a worker be in a certain place or posture for at least a certain length of time to accomplish a certain task."
Plaintiff argues that the sit/stand option in her RFC is "an option that the individual would be able to chose [sic] for themselves throughout the day"; in Plaintiff's case, she would allegedly need to stand for "20-30 minute intervals" throughout the day, resulting in her standing for "more than 2 hours a day." (J. Stip. at 11-12.) When asked by Plaintiff's representative whether an individual limited to standing and walking for two hours in an eight-hour day with a sit/stand option requiring her to "sit[] and stand[] for half of the day" could perform any work, the VE testified that such an individual could not. (AR 108.) Plaintiff argues that the VE's testimony thus "established disability." (J. Stip. at 12.)
As an initial matter, Plaintiff does not argue that a conflict existed between the VE's testimony and the DOT; indeed, the ALJ asked the VE whether any conflict existed and the VE confirmed that it did not.
Plaintiff mischaracterizes the nature of her sit/stand option. As Defendant points out, "Plaintiff's attorney asked the VE a confusing question because no sedentary occupation" allows for "standing half the workday," in that "sedentary work, by definition, requires at most occasional standing." (J. Stip. at 15);
Although the ALJ did not quantify in Plaintiff's RFC "how much sitting and standing" the sit/stand option allowed or required (
Consistent with the foregoing and under sentence four of 42 U.S.C. § 405(g),