CAROLYN K. DELANEY, Magistrate Judge.
Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner") denying plaintiff's application for Supplemental Security Income ("SSI") under Title XVI of the Social Security Act ("Act"). For the reasons discussed below, the court will deny plaintiff's motion for summary judgment and grant the Commissioner's cross-motion for summary judgment.
Plaintiff, born September 19, 1977, applied for SSI benefits on October 31, 2012, alleging disability beginning September 14, 2009. Administrative Transcript ("AT") 65, 165-85. Plaintiff alleged she was unable to work due to anxiety, posttraumatic stress disorder, depression, nightmares, and back pain. AT 166. In a decision dated March 28, 2014, the ALJ determined that plaintiff was not disabled.
AT 12-20.
Plaintiff argues that the ALJ committed the following errors in finding plaintiff not disabled: (1) improperly assessed plaintiff's mental residual functional capacity ("RFC"); (2) improperly assessed plaintiff's physical RFC; (3) improperly determined that plaintiff's testimony was less than fully credible; (4) failed to properly consider and weigh the lay witness testimony of plaintiff's father; and (5) improperly found plaintiff not disabled at step five based on an erroneous RFC determination.
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 record as a whole must be considered,
Plaintiff first argues that the ALJ erred in his assessment of plaintiff's mental impairments when determining plaintiff's RFC because he failed to fully and properly consider the effects of plaintiff's posttraumatic stress disorder ("PTSD") and anxiety, and improperly rejected portions of the opinion of Dr. Kalman, an examining psychiatrist.
Plaintiff contends that the ALJ failed to properly consider and fully account for the impact of plaintiff's diagnosed anxiety and PTSD in his RFC decision. A review of the ALJ's decision demonstrates that this argument is without merit. Indeed, the ALJ specifically discussed and thoroughly considered the evidence in the record regarding plaintiff's anxiety and PTSD in determining plaintiff's RFC, which included evidence of medical diagnosis of both conditions, medical opinion evidence regarding the impact of all of plaintiff's mental impairments, plaintiff's and her father's statements regarding the impact of those impairments, and the treatment she was prescribed for those conditions. AT 13-19. As discussed in further detail below, the ALJ properly considered and weighed this evidence in reaching his RFC decision. Accordingly, the ALJ did not err in considering plaintiff's anxiety and PTSD.
Plaintiff also argues that the ALJ improperly assessed the impact of plaintiff's mental impairments because he failed to properly consider and weigh the opinion of Dr. Kalman, an examining psychiatrist.
To evaluate whether an ALJ properly 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.
Here, Dr. Kalman conducted a mental consultative examination of plaintiff on January 17, 2014. AT 485-95. Based on the results of this examination, Dr. Kalman prepared a medial source statement for plaintiff regarding the impact plaintiff's mental impairments had on her workplace functioning. AT 490-93. In that statement, Dr. Kalman opined that plaintiff's mental impairments imposed mild limitations, meaning performance would be precluded for 5 to 9 percent of an 8-hour workday, on her ability to: remember locations and work-like procedures; understand and remember very short and simple repetitive instructions or tasks; carry out very short and simple instructions or tasks; perform activities within a schedule or maintain regular attendance; make simple work-related decisions; ask simple questions; respond appropriately to changes in the work setting; and travel in unfamiliar places using public transportation. AT 490-92. He opined further that plaintiff had marked limitations, meaning performance would be precluded for 15 to 49 percent of an 8-hour workday, in the ability to: understand, remember, and carry out detailed instructions; maintain attention and concentration for extended periods such as 2 hour segments; work in coordination with others; complete a normal workday without interruptions from psychologically based symptoms and perform at a consistent pace with an unreasonable number and length of breaks; interact appropriately with the general public; and get along with coworkers. AT 490-91. Dr. Kalman also opined that plaintiff had extreme limitations, meaning performance would be precluded for 50 percent or more of an 8-hour workday, in the ability to accept instructions and respond appropriately to criticism from supervisors. AT 491. He noted further that unruly or demanding customers, production demands or quotas, demand for precision, and the need to make quick and accurate independent decisions on a consistent basis would exacerbate the symptoms of plaintiff's mental impairments. AT 492. However, he also noted that plaintiff would not be a person likely to have exacerbation from a "routine, repetitive, simple, entry-level job."
As an initial matter, the ALJ agreed with and adopted Dr. Kalman's opinion that plaintiff was only capable of work involving simple and repetitive tasks given her limitations regarding that aspect of mental functioning because that opinion was consistent with the other medical opinions and objective medical evidence in the record. AT 18. However, the ALJ rejected the marked-to-extreme limitations Dr. Kalman opined with regard to all other aspects of plaintiff's mental functioning. The ALJ discounted those portions of Dr. Kalman's opinion based on the following rationale:
AT 18. These were specific and legitimate reasons for discounting Dr. Kalman's opinion that were supported by substantial evidence from the record.
First, the ALJ properly cited to the fact that Dr. Kalman's opinion was inconsistent with the generally unremarkable objective medical findings contained in plaintiff's mental treatment notes and the other medical opinion evidence in the record.
The ALJ's resolution of the conflict between these two physicians' opinions was reasonable, especially in light of the other medical evidence in the record. For instance, Dr. Rahman, a treating psychiatrist, filled out a mental disorder questionnaire form on January 31, 2013, wherein she noted that plaintiff did not need assistance with activities of daily living and had no deficits in social functioning, basic task completion, and concentration. AT 414-18. Similarly, plaintiff's treating mental health records generally reflect more moderate symptoms that were either stabilized or improved with medications.
Furthermore, as the ALJ noted in his decision, plaintiff's statements to Dr. Kalman regarding the impact her mental impairments had on her daily activities varied greatly from the statements she made to Dr. Torrez and her other examining and treating physicians. AT 18. Plaintiff reported to Dr. Kalman that she had no friends, experienced hallucinations and delusions, and socially isolated herself except for her attendance at Narcotics Anonymous meetings. AT 485-88. However, she reported to Dr. Torrez and her other mental health physicians that she attended meetings and sought social support, spent time with family, attended her cousin's wedding, and had two good friends with whom she went out to lunch, attended bible study, talked on the phone, and went on walks. AT 457, 478, 480. Accordingly, it was reasonable for the ALJ to determine that Dr. Torrez's opinion, which was based in part on plaintiff's statements to her that were consistent with plaintiff's statements to other physicians in the record, was entitled to greater weight than the opinion of Dr. Kalman, which was based in part on statements that were only made to Dr. Kalman, conflicted with what plaintiff told her other physicians, and indicated that plaintiff was more impaired than what the other evidence in the record suggests.
In sum, the ALJ provided multiple specific and legitimate reasons supported by substantial evidence in support of his decision to discount the aspects of Dr. Kalman's opinion he specified in his decision.
Second, plaintiff argues that the ALJ erred in his RFC determination that plaintiff could perform the exertional demands of medium work and lift and carry 50 pounds occasionally and 25 pounds frequently given the evidence in the record indicating that plaintiff suffered from a severe lumbar strain/sprain with degenerative changes. This argument is without merit.
Dr. Schwartz, who provided the sole opinion in the record based on an examination of plaintiff's physical impairments, opined that plaintiff had no exertional or non-exertional physical limitations beyond a single limitation to frequent stooping. AT 449. Similarly, Dr. Pan and Dr. Sohn, two non-examining physicians who provided the only other opinions in the record regarding plaintiff's physical impairments, opined that plaintiff had no severe physical impairment and no physical functional limitations. AT 73, 87. In short, all of the medical opinions in the record regarding the impact of plaintiff's physical impairments indicate that plaintiff's physical impairments imposed few if any limitations on plaintiff's physical workplace functioning. Despite this substantial medical opinion evidence, it appears that the ALJ gave plaintiff the benefit of the doubt in finding that she was limited to work at a medium exertional level with some additional exertional and non-exertional limitations as a result of her physical impairments. AT 13.
Nevertheless, plaintiff argues that the physical limitations contained in the ALJ's RFC determination were not sufficiently severe in light of the objective medical findings in the record indicating that plaintiff suffered from a degenerative spinal condition and chronic back pain. However, a review of the objective medical evidence in the record regarding plaintiff's physical impairments belies plaintiff's argument. X-rays of plaintiff's spine from 2011 and 2013 show that while plaintiff had degenerative disc space narrowing between her discs at L4 and L5, that condition was only "moderate" in nature and did not significantly worsen during the period between those two x-rays. AT 347, 537. Similarly, while the record shows that plaintiff suffered back pain, it also demonstrates that her treating physicians provided only conservative treatment for that condition in the form of medication and recommendations to engage in home exercise.
Accordingly, the ALJ's RFC determination that plaintiff's physical impairments caused her moderate exertional and non-exertional limitations was reasonable in light of the medical opinion evidence, objective medical findings, and plaintiff's statements to her treating physicians.
Third, plaintiff argues that the ALJ erred in finding plaintiff's pain and symptom testimony less than fully credible because he failed to provide clear and convincing reasons in support of that adverse credibility determination.
The ALJ determines whether a disability applicant is credible, and the court defers to the ALJ's discretion if the ALJ used the proper process and provided proper reasons.
In evaluating whether subjective complaints are credible, the ALJ should first consider objective medical evidence and then consider other factors.
Here, the ALJ found plaintiff's testimony less than fully credible for the following reasons: (1) plaintiff's treatment records show her pain medications had been eliminated over time, which conflicted with her claims regarding the limitations stemming from her physical impairments; (2) plaintiff's reported daily activities conflicted with her claims of disabling symptoms; (3) plaintiff made conflicting statements to her health care providers regarding the last time she used illicit drugs; and (4) the medical evidence in the record does not generally support the severity, intensity, or frequency of the symptoms she alleged. These were clear and convincing reasons for discounting plaintiff's testimony that were supported by substantial evidence in the record.
First, the ALJ properly noted that while plaintiff listed pain medication in her disability report, in recent medication lists, pain medications had been eliminated, which "suggests that her treating doctors did not find sufficient correlation between symptoms and objective findings to justify continued prescription of pain medications." AT 15. The fact that plaintiff's physicians determined it unnecessary for plaintiff to continue on pain medications undermined her claims that her physical impairments caused her substantial physical limitations.
Second, the ALJ cited to the fact that plaintiff's reported daily activities conflicted with her claims of disabling symptoms. "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."
Here, the ALJ noted that plaintiff able to cook, shop, do household chores, manage her own transportation, and care for her own personal hygiene without assistance. AT 17, 457, 487. Plaintiff also reported that she regularly attended Narcotics Anonymous meetings, sought social support, spent time with family, rode horses, attended her cousin's wedding, and had two good friends with whom she went out to lunch, attended bible study, talked on the phone, and went on walks. AT 236, 457, 478, 480. The ALJ properly cited to these activities to support his determination that plaintiff's claims regarding the extent of her symptoms were not fully credible.
Third, the ALJ appropriately determined that plaintiff's conflicting statements to her physicians regarding when she last used illicit drugs undermined her overall credibility.
Finally, the ALJ also determined that plaintiff's claims of disabling symptoms conflicted with the weight of the objective medical evidence in the record. The record contains substantial evidence for this assertion as the credible medical opinion evidence indicates that plaintiff had limitations far less severe than what she alleged.
Because the ALJ provided multiple clear and convincing reasons to support his adverse credibility determination, each of which was supported by substantial evidence from the record, that determination was not made in error.
Fourth, plaintiff argues that the ALJ improperly discounted the lay witness testimony of her father without providing germane reasons for doing so that were specific to that witness. "[L]ay witness testimony as to a claimant's symptoms or how an impairment affects ability to work is competent evidence, and therefore cannot be disregarded without comment."
When the ALJ provides clear and convincing reasons for discounting a claimant's testimony and the third-party lay witness's testimony is similar to the claimant's testimony, the ALJ's reasons for discounting the claimant's testimony may also constitute germane reasons for rejecting the third-party lay witness's testimony.
Here, the ALJ summarized the third-party statement plaintiff's father in detail, clearly indicating that he considered the information. AT 14, 19. Moreover, plaintiff's father's report essentially echoed plaintiff's own testimony and, as discussed above, the ALJ already provided specific, clear and convincing reasons for discounting plaintiff's testimony, which are equally germane to this third-party testimony. As such, any error in not explicitly restating or incorporating by reference the reasons given for discounting plaintiff's testimony with respect to this third party statement was harmless and remand is not warranted.
Finally, plaintiff argues that the ALJ erred at step five by relying on vocational expert ("VE") testimony that lacked evidentiary value because it was based on improper hypothetical questions that failed to include all of plaintiff's functional limitations.
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.
Plaintiff asserts that because the ALJ failed to properly evaluate the medical evidence and find plaintiff's and her father's testimony credible, the hypotheticals the ALJ posed to the VE based on the limitations contained in his RFC determination were improper as they did not reflect all of plaintiff's functional limitations. This argument, however, lacks merit because, for the reasons stated above, the ALJ properly evaluated the medical evidence, both opinion evidence and objective findings, and gave proper reasons for finding plaintiff's and her father's testimony regarding the impact of her impairments not fully credible. Because the ALJ found plaintiff not credible, he was not required to include any of plaintiff's alleged limitations beyond those already included in the RFC determination. Furthermore, the ALJ posed hypotheticals to the VE that were based on the limitations outlined in the ALJ's RFC determination, which were supported by substantial evidence from the record. Therefore, plaintiff's argument is without merit.
For the reasons stated herein, IT IS HEREBY ORDERED that:
1. Plaintiff's motion for summary judgment (ECF No. 13) is denied;
2. The Commissioner's cross-motion for summary judgment (ECF No. 14) is granted; and
3. Judgment is entered for the Commissioner.
The claimant bears the burden of proof in the first four steps of the sequential evaluation process.