KENDALL J. NEWMAN, Magistrate Judge.
Plaintiff seeks judicial review of a final decision by the Commissioner of Social Security ("Commissioner") denying plaintiff's application for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act ("Act").
For the reasons discussed below, the court DENIES plaintiff's motion for summary judgment, GRANTS the Commissioner's cross-motion for summary judgment, and enters judgment for the Commissioner.
Plaintiff was born on February 1, 1964; she has a high school education; her previous occupation was a certified court reporter; and she last worked on August 13, 2004.
Plaintiff raises the following issues: (1) whether the ALJ improperly assessed plaintiff's residual functional capacity ("RFC") by improperly weighing the medical opinion evidence in the record; (2) whether the ALJ relied upon inadequate testimony from the vocational expert; and (3) whether the ALJ improperly discounted plaintiff's testimony regarding the intensity, persistence, and limited effects of her symptoms.
The court reviews the Commissioner's decision to determine whether (1) it is based on proper legal standards pursuant to 42 U.S.C. § 405(g), and (2) substantial evidence in the record as a whole supports it.
The ALJ evaluated plaintiff's entitlement to disability benefits pursuant to the Commissioner's standard five-step analytical framework.
Before proceeding to step four, the ALJ assessed plaintiff's RFC as follows:
(AT 21.)
At step four, the ALJ found that plaintiff was unable to perform any past relevant work through the date last insured. (AT 24.) However, at step five, the ALJ found that considering plaintiff's age, education, work experience, and RFC, there were jobs that existed in significant numbers in the national economy that the claimant could have performed through the date last insured. (
Accordingly, the ALJ concluded that the plaintiff had not been under a disability from August 13, 2014, the alleged onset date, through March 31, 2008, the date last insured. (AT 28.)
First, plaintiff argues that the ALJ erred in considering and weighing the medical opinions of Dr. Duffy, Dr. Kimble, Dr. Champlin, Dr. Jaojoco, and Nurse Practitioner Mullen.
The weight given to medical opinions depends in part on whether they are proffered by treating, examining, or non-examining professionals.
To evaluate whether an ALJ property rejected a medical opinion, in addition to considering its source, the court considers whether (1) contradictory opinions are in the record; and (2) clinical findings support the opinions. An ALJ may reject an uncontradicted opinion of a treating or examining medical professional only for "clear and convincing" reasons.
Plaintiff argues that the ALJ erred by failing to properly incorporate into his RFC determination or otherwise reconcile the limitations opined by Dr. Duffy and Dr. Kimble despite giving those physicians' opinions significant and considerable weight, respectively. For the reasons discussed below, the undersigned finds no error in the ALJ's consideration of Dr. Duffy's and Dr. Kimble's opinions.
After completing an MRI scan of plaintiff on September 9, 2003, which found plaintiff had "reversed lordosis and mild annular bulges at C4-5, C5-6, and C6-7," Dr. Duffy completed an attending physician's statement ("APS") dated October 28, 2003. (AT 305-09.) Dr. Duffy indicated that the current and planned treatment would be conservative, and restricted plaintiff from performing repetitive motions in the neck and upper extremities and prolonged reading, noting that plaintiff's headaches made work and concentration difficult. (AT 305-06.) Dr. Duffy opined that plaintiff could not work in another occupation due to her pain and headaches. (AT 306.) On June 11, 2004, Dr. Duffy opined that plaintiff could work part-time. (AT 300.) In a second APS dated December 7, 2004, Dr. Duffy found that plaintiff could not perform her work as a court reporter as of August 1, 2004, basing his determination on plaintiff's "inability to transcribe" as a result of her impairments. (AT 298-99.) He opined further that plaintiff would continue to be unable to work until March 1, 2005. (AT 298.) The ALJ assigned "significant weight" to Dr. Duffy's opinion because it was "based upon a significant treatment history." (AT 22.)
Dr. Kimble completed an APS on January 18, 2007, opining that plaintiff would be restricted to no repetitive use of her upper extremities, no sustained neck flexion, and no lifting of more than 10 pounds. (AT 414.) Dr. Kimble opined that these restrictions would likely last plaintiff's lifetime. (
Plaintiff argues that the limitations opined by Dr. Duffy and Dr. Kimble were not adequately incorporated into the RFC. The Ninth Circuit Court of Appeals has noted that an ALJ may synthesize and translate assessed limitations into an RFC assessment without repeating each functional limitation verbatim in the RFC assessment.
Furthermore, insofar as Dr. Duffy's notes contain cursory conclusions that plaintiff cannot perform work as a court reporter or any other occupation, those are opinions on issues reserved for the Commissioner. (AT 306, 415.)
Plaintiff argues that the ALJ erred by failing to address the medical findings and opinions in the record provided by Dr. Champlin and Dr. Jaojoco. For the reasons discussed below, the undersigned finds that the ALJ did not commit prejudicial error by not explicitly discussing and assigning weight to the medical records produced by Dr. Champlin and Dr. Jaojoco.
Dr. Champlin completed an APS on at least four different occasions. (AT 313-15, 318-20, 326-27, 341-42.) In each, Dr. Champlin restricted plaintiff's ability to work for as little as one week to up to three months. (
Dr. Jaojoco examined plaintiff on five occasions and filled out an APS. (AT 420-33.) On January 13, 2006, Dr. Jaojoco found plaintiff had the following range of motion: "flexion 40 degrees, extension 40 degrees, lateral rotation and lateral flexion, with normal limits bilaterally . . . full active range of motion of both upper extremities and the lumbar spine." (AT 430.) She expressed similar findings in her notes for the other examinations. (AT 422-28, 432-33.) Dr. Jaojoco did not in any of her notes comment on plaintiff's ability to perform work-related functions, though she did on several occasions note that plaintiff was well-nourished, well-developed, alert and oriented, and in no acute distress. (AT 422-23, 425, 427, 430.)
As an initial matter, contrary to plaintiff's argument, the record does not contain an opinion from Dr. Jaojoco regarding the functional limitations caused by plaintiff's impairments. Title 20 C.F.R. § 404.1527(c) mandates that the Commissioner consider every medical source opinion by promising claimants that the administration "will evaluate every medical opinion we receive."
With respect to Dr. Champlin, the ALJ's failure to discuss his opinions amounts to harmless error, and thus does not warrant remand.
In addition, to the extent plaintiff argues that the ALJ failed to consider the treatment notes issued by Dr. Champlin and Dr. Jaojoco more generally when developing plaintiff's RFC, that argument is without merit. The ALJ made his RFC determination "[a]fter careful consideration of the entire record," which includes the medical records of those two physicians. (AT 21, 31-32.) Absent any indication that the ALJ purposefully ignored the records provided by these two physicians, it is presumed that he took them into consideration when determining plaintiff's functional limitations. The ALJ carefully considered the record in its entirety and, even in light of the records by Dr. Champlin and Dr. Jaojoco, rendered an RFC determination based on substantial evidence.
Plaintiff argues the ALJ erred in giving little weight to Dr. Manuselis's opinion based on reasoning that Dr. Manuselis did not examine plaintiff until November 2008, seven months after plaintiff's date last insured.
On October 18, 2011, Dr. Manuselis completed a medical source statement and opined the following limitations on plaintiff's physical abilities: can occasionally lift/carry less than 10 pounds; can seldom lift/carry 10 pounds; can never lift/carry 20 pounds or more; can sit, stand or walk for 2 hours in an 8-hour day with periodic alternation between sitting and standing or walking every 30 minutes; can use her feet to operate leg controls frequently; can never elevate her legs; can occasionally push and/or pull and reach; can frequently handle things with her hands; can continually grasp, finger, and feel; can occasionally bend, climb, balance, stoop, kneel, crouch, crawl, extend arms, and squat; and can seldom reach overhead. (AT 659-61.) Dr. Manuselis indicated that the above-described limitations were present since at least July 15, 2004, and cited an x-ray and physical examination in support. (AT 661.) The ALJ gave Dr. Manuselis's opinion "little weight," stating,
Generally, 20 C.F.R. 404.1527(d) and 416.927(d) indicate that treating source opinions are to be afforded controlling weight. However, these regulations also state that in some instances, such opinions may be given little weight if not well supported. In this case, Dr. Manuselis's opinion is unpersuasive because they [sic] claimant did not establish care with the doctor until November 2008, well after the date last insured [citation omitted]. Therefore, as Dr. Manuselis did not examine the claimant during the period at issue, his opinion is obviously less persuasive. Thus, Dr. Manuselis's opinion is given little weight.
(AT 22.)
Generally, medical reports should not be disregarded solely because they are rendered retrospectively, and may be relevant to a prior period of disability.
As the ALJ stated, Dr. Manuselis did not start treating plaintiff until November 2008, roughly seven months after the end of the relevant period, and issued his opinion regarding plaintiff's functional limitations on October 18, 2011, roughly three and a half years after that period. (AT 454, 661.) The ALJ was permitted to rely on these facts in support of his determination that Dr. Manuselis's opinion was entitled to reduced weight with regard to determining plaintiff's RFC.
Moreover, the ALJ also discounted Dr. Manuselis's opinion, which consisted primarily of a check-the-box form, because it was not well supported. (AT 22.) While Dr. Manuselis acted as plaintiff's treating physician after the relevant period, the opinion was conclusory in nature and was not well supported by the other medical evidence in the record.
Plaintiff argues the ALJ erred in his consideration of Nurse Practitioner Mullin's opinion that plaintiff was restricted from working as a court reporter or in any other profession for one year. The ALJ gave Nurse Practitioner Mullin's opinion little weight, stating: "Mr. Mullin's opinion is unpersuasive because he is not a physician, and therefore cannot be an acceptable medical source pursuant to 06-3p." (AT 22.)
As an initial matter, the ALJ erred in his reasoning for giving Nurse Practitioner Mullin's opinion little weight because the Code of Federal Regulations clearly includes a nurse practitioner as an acceptable "other medical source" to be used as evidence to show the severity of a claimant's impairments. 20 C.F.R. § 404.1513(d)(1). The ALJ is not permitted to reject an opinion from such a medical source merely because it is not from an "acceptable medical source" as that term is defined in the applicable regulations. Nevertheless, the undersigned finds the error to be harmless because Nurse Practitioner Mullen's opinion gave only a conclusory determination that plaintiff was unable to work without providing any specific clinical findings regarding plaintiff's functional capacity. (AT 406-08.) As discussed above, cursory conclusions that plaintiff cannot work as a court reporter or in any other profession constitute an opinion on issues reserved for the Commissioner.
An ALJ may pose a range of hypothetical questions to a vocational expert, based on alternate interpretations of the evidence. However, the hypothetical that ultimately serves as the basis for the ALJ's determination, i.e., the hypothetical that is predicated on the ALJ's final RFC determination, must account for all of the limitations and restrictions of the particular claimant that are supported by substantial evidence in the record as a whole.
Here, plaintiff argues that the ALJ erred in rendering his step five determination based on the testimony provided by the vocational expert ("VE") because the ALJ's hypotheticals based on plaintiff's RFC determination failed to fully encompass all of plaintiff's limitations supported by the evidence in the record, therefore meaning that the VE's testimony did not constitute substantial evidence. Specifically, plaintiff contends that the ALJ's hypotheticals based on his RFC determination failed to incorporate a limitation that plaintiff was limited to sitting, standing or walking for 2 hours in an 8-hour workday, occasionally lifting less than 10 pounds, and seldom lifting 10 pounds, as stated in Dr. Manuselis's opinion. (AT 659-61.) However, as discussed above, the ALJ properly discounted Dr. Manuselis's opinion. Accordingly, the ALJ was not required to adopt the limitations opined by that physician that were more extreme than what was included in the ALJ's RFC determination.
The ALJ posed hypotheticals to the VE that incorporated all of the limitations included in the ALJ's RFC determination, to which the VE responded that there existed several jobs within the national economy that plaintiff could perform. (AT 25-28.) The ALJ properly relied on this testimony to support his step five determination that there existed jobs in significant numbers within the national economy that plaintiff could perform given her RFC.
Finally, plaintiff argues that the ALJ erred by improperly discounting her testimony regarding the extent of the pain and limitations stemming from her impairments without providing clear and convincing reasons supported by substantial evidence for doing so.
In
"The ALJ must specifically identify what testimony is credible and what testimony undermines the claimant's complaints."
Here, to the extent that the ALJ discounted plaintiff's testimony regarding her symptoms and functional limitations, the ALJ provided several specific, clear, and convincing reasons for doing so.
First, the ALJ noted that the plaintiff's "allegations of physical impairment are not corroborated by the medical records, which revealed generally benign findings." (AT 23.) Although lack of medical evidence cannot form the sole basis for discounting plaintiff's subjective symptom testimony, it is nevertheless a relevant factor for the ALJ to consider.
Second, the ALJ noted that plaintiff's conditions were well controlled by medication and treatment. (AT 23.) A condition that can be controlled or corrected by medication is not disabling for purposes of determining eligibility for benefits under the Act.
Third, substantial evidence supports the ALJ's finding that plaintiff's daily activities were inconsistent with her allegations of disabling symptoms and limitations. (AT 23.) "While a claimant need not vegetate in a dark room in order to be eligible for benefits, the ALJ may discredit a claimant's testimony when the claimant reports participation in everyday activities indicating capacities that are transferable to a work setting . . . Even where those activities suggest some difficulty functioning, they may be grounds for discrediting the claimant's testimony to the extent that they contradict claims of a totally debilitating impairment."
The ALJ questioned plaintiff on her daily activities during the relevant period, from 2004 to 2008. (AT 88-94.) Plaintiff testified that, between 2004 and 2008, with the help of her daughter, she completed daily household chores and activities, including: changing bed sheets; folding laundry; mopping; cooking; cleaning the bathroom; shopping for groceries; picking vegetables from her garden; potting flowers; and swimming for exercise. (AT 88-93.) She also went camping once between 2004 and 2008. (AT 93.) Treatment records note that plaintiff was also participating in jazzercise, yoga, Pilates, and aerobics for exercise during the relevant period. (AT 454.) Such activities provided substantial support for the ALJ's determination that plaintiff's daily activities undermined plaintiff's claims of debilitating symptoms.
Plaintiff also testified that, because of her pain, she could no longer complete most of these activities, and her daughter does most of the household work, which indicates that plaintiff may have been more impaired than what her daily activities would suggest on their face. (AT 90-91.) However, it is the function of the ALJ to resolve any ambiguities, and the court finds the ALJ's assessment to be reasonable and supported by substantial evidence.
For the above reasons, the undersigned finds no error in the ALJ's credibility assessment of plaintiff's testimony regarding the intensity, persistence, and limiting effects of her impairments.
In sum, the ALJ's decision was free from prejudicial error and supported by substantial evidence in the record as a whole. Accordingly, IT IS HEREBY RECOMMENDED that:
1. Plaintiff's motion for summary judgment (ECF No. 14) be DENIED.
2. The Commissioner's cross-motion for summary judgment (ECF No. 15) be GRANTED.
3. The Commissioner's final decision be AFFIRMED and judgment be entered for the Commissioner.
4. The Clerk of Court be directed to close this case.
These findings and recommendations are submitted to the United States District Judge assigned to the case, pursuant to the provisions of 28 U.S.C. § 636(b)(l). Within fourteen (14) days after being served with these findings and recommendations, any party may file written objections with the court and serve a copy on all parties. Such a document should be captioned "Objections to Magistrate Judge's Findings and Recommendations." Any reply to the objections shall be served on all parties and filed with the court within fourteen (14) days after service of the objections. The parties are advised that failure to file objections within the specified time may waive the right to appeal the District Court's order.
IT IS SO RECOMMENDED.
The claimant bears the burden of proof in the first four steps of the sequential evaluation process.