Blackburn, District Judge.
The matter before me is plaintiff's
Plaintiff alleges that she is disabled as a result of degenerative disc disease, chronic back pain, and depression. After her application for supplemental security income benefits was denied, plaintiff requested a
The ALJ found that plaintiff was not disabled and therefore not entitled to supplemental security income benefits. Although the evidence established that plaintiff suffered from severe impairments, the judge concluded that the severity of those impairments did not meet or equal any impairment listed in the social security regulations. Other impairments were found to be non-severe. The ALJ found that plaintiff had the residual functional capacity to perform a wide range of light work which required simple, routine, repetitive tasks, only occasional public contact, and the ability to communicate only in basic, simple English. Although this finding precluded plaintiff's past relevant work, the ALJ concluded that there were jobs existing in significant numbers in the national and local economies that she could perform. The ALJ therefore found plaintiff not disabled at step 5 of the sequential evaluation. Plaintiff appealed this decision to the Appeals Council. The Council affirmed. Plaintiff then filed this action in federal court.
A person is disabled within the meaning of the Social Security Act only if her physical and/or mental impairments preclude her from performing both her previous work and any other "substantial gainful work which exists in the national economy." 42 U.S.C. § 423(d)(2). "When a claimant has one or more severe impairments the Social Security [Act] requires the [Commissioner] to consider the combined effects of the impairments in making a disability determination." Campbell v. Bowen, 822 F.2d 1518, 1521 (10th Cir.1987) (citing 42 U.S.C. § 423(d)(2)(c). However, the mere existence of a severe impairment or combination of impairments does not require a finding that an individual is disabled within the meaning of the Social Security Act. To be disabling, the claimant's condition must be so functionally limiting as to preclude any substantial gainful activity for at least twelve consecutive months. See Kelley v. Chater, 62 F.3d 335, 338 (10th Cir.1995).
The Commissioner has established a quinquepartite sequential evaluation process for determining whether a claimant is disabled:
20 C.F.R. § 416.920(a)(4)(i)-(v). See also Williams v. Bowen, 844 F.2d 748, 750-52 (10th Cir.1988). The claimant has the initial burden of establishing a disability in the first four steps of this analysis. Bowen v. Yuckert, 482 U.S. 137, 146 n. 5, 107 S.Ct. 2287, 2294 n. 5, 96 L.Ed.2d 119 (1987). The burden then shifts to the Commissioner to show that the claimant is capable of performing work in the national economy. Id. A finding that the claimant is disabled or not disabled at any point in the five-step review is conclusive and terminates the analysis. Casias v. Secretary of Health & Human Services, 933 F.2d 799, 801 (10th Cir.1991).
Review of the Commissioner's disability decision is limited to determining whether the ALJ applied the correct legal standard and whether the decision is supported by substantial evidence. Hamilton v. Secretary of Health and Human Services, 961 F.2d 1495, 1497-98 (10th Cir. 1992); Brown v. Sullivan, 912 F.2d 1194, 1196 (10th Cir.1990). Substantial evidence is evidence a reasonable mind would accept as adequate to support a conclusion. Brown, 912 F.2d at 1196. It requires more than a scintilla but less than a preponderance of the evidence. Hedstrom v. Sullivan, 783 F.Supp. 553, 556 (D.Colo. 1992). "Evidence is not substantial if it is overwhelmed by other evidence in the record or constitutes mere conclusion." Musgrave v. Sullivan, 966 F.2d 1371, 1374 (10th Cir.1992). Further, "if the ALJ failed to apply the correct legal test, there is a ground for reversal apart from a lack of substantial evidence." Thompson v. Sullivan, 987 F.2d 1482, 1487 (10th Cir. 1993). Although a reviewing court should meticulously examine the record, it may not reweigh the evidence or substitute its discretion for that of the Commissioner. Id.
Plaintiff claims the ALJ erred in weighing the various medical source opinions of record and in finding that the alternative jobs identified at step 5 of the sequential evaluation were within plaintiff's residual functional capacity. Finding no such reversible error in the ALJ's decision, I affirm.
Plaintiff's first argument challenges the relative weights assigned to the opinions of plaintiff's treating psychiatrist, Dr. John Martens, and the non-examining state agency psychologist, Dr. Douglas Hanze. While Dr. Martens opined that plaintiff had marked limitations in numerous areas of work-related mental functioning (see Tr. 304-305), Dr. Hanze found her to have only mild to moderate limitations (Tr. 70). The ALJ assigned "reduced" weight to Dr. Martens's opinion, while affording Dr. Hanze's opinion "significant" weight. (Tr. 29.)
The opinion of a treating source is generally entitled to controlling weight so long as it is "well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with other substantial evidence in the case record." 20 C.F.R. § 416.927(c)(2); see also Watkins v. Barnhart, 350 F.3d 1297, 1300 (10th Cir.2003). Good cause may be found where the treating source's opinion is brief, conclusory, or unsupported by the medical evidence. Frey v. Bowen, 816 F.2d 508, 513 (10th Cir.1987). Even if a treating source opinion is not given controlling weight, it is still entitled to deference "and must be weighed using all of the factors provided in 20 C.F.R. 404.1527 and 416.927."
The ALJ found Dr. Martens's opinion "overly restrictive" in light of the treatment record, and therefore gave it "reduced weight." In this regard, he noted that the opinion, rendered after Dr. Martens had been treating plaintiff less than a year, was based on "minimal and only initial positive objective findings." He pointed also to the "extremely conservative" nature of plaintiff's treatment, which he characterized as having been principally "rendered over the phone." (Tr. 29.)
Initially, I reject plaintiff's suggestion that the ALJ's use of the term "reduced weight" is overly vague as an indicator of the weight he assigned to Dr. Martens's opinion. In context, it is clear that the term was meant to convey the ALJ's assessment that Dr. Martens's opinion was not entitled to controlling weight. Nevertheless, the ALJ plainly afforded the opinion some weight, as he expressly incorporated a restriction on public contact into plaintiff's residual functional capacity to account for Dr. Martens's indication that plaintiff had difficulties in appropriate social interaction. (See Tr. 29-30.) The ALJ's opinion thus was "sufficiently specific to make clear to any subsequent reviewers the weight [he] gave to the treating source's medical opinion and the reason for that weight." Langley v. Barnhart, 373 F.3d 1116, 1120 (10th Cir.2004).
As for the reasons cited by the ALJ in support of his decision to afford less than controlling weight to Dr. Martens's opinion, all are legitimate and find adequate support in the record. At the outset, the ALJ noted the limited duration of plaintiff's treatment with Dr. Martens prior to the issuance of his opinion. (Tr. 29.) Indeed, plaintiff had visited Dr. Martens only three times over a period of six months at the time he authored his opinion in February 2011. The limited nature of a treating source's involvement with a claimant's care is a valid reason for assigning lesser weight to his opinion. See 20 C.F.R. § 416.927(c)(2)(i) ("Generally, the longer a treating source has treated you and the more times you have been seen by a treating source, the more weight we will give to the source's medical opinion."); 20 C.F.R. § 416.902 (treating source is one with whom claimant has "ongoing treatment relationship"). See also Megginson v. Astrue, 2011 WL 4382570 at *3 n. 3 (D.Colo. Sept. 20, 2011), aff'd, 489 Fed. Appx. 260 (10th Cir.2012).
Moreover, the ALJ noted that Dr. Martens's treatment notes showed "minimal and only initial positive objective findings" that were inconsistent with the significant restrictions he suggested.
Nor do I perceive any reversible error in the ALJ's conclusion that plaintiff's treatment with Dr. Martens was conservative and rendered largely over the phone. (Tr. 29.) The ALJ elsewhere characterized plaintiff's treatment for her physical impairments as "very conservative, consisting entirely of medication" (Tr. 30), which adequately demonstrates how he understood and used the term "conservative" in referring to plaintiff's psychological treatment. Moreover, the record fully supports the conclusion that plaintiff's mental health treatment in fact was largely limited to medication management. After an initial series of visits from August 2010 to April 2011,
I therefore find and conclude that the ALJ gave legitimate, sufficiently specific reasons for his decision to afford less than controlling weight to the opinion of Dr. Martens. Based on similar reasons—evidence of "conservative" (i.e., limited to medication) mental health treatment, evidence of non-compliance with recommendations for therapy and several unexplained failures to keep appointments, and minimal clinical findings in the record—the ALJ gave greater credence the opinion of Dr. Hanze. (Tr. 29.) "State agency medical and psychological consultants are highly qualified physicians and psychologists who are experts in the evaluation of the medical issues in disability claims under the Act."
Plaintiff also complains of the weight afforded the physical capacity assessment of the consultative examiner, Dr. Tista Ghosh. (Tr. 293-297.) Following her examination, Dr. Ghosh suggested that, due to a positive straight leg test, plaintiff had a maximum capacity to sit, stand, and walk of up to two hours and was restricted to lifting no more than ten pounds. (Tr. 296.)
Nevertheless, the second observation—that the test is unique in the context of the larger medical record—does constitute good cause to reject a medical source opinion. See 20 C.F.R. § 416.927(c)(4); Pisciotta v. Astrue, 500 F.3d 1074, 1078 (10th Cir.2007). Moreover, the ALJ noted
Although plaintiff positions her second point of error as going to whether the Commissioner met her burden at step 5
It does strike this court that the ALJ could have done more to develop the record regarding whether plaintiff in fact was illiterate, vel non, or at least better articulate the bases for his conclusion that she was not. Nevertheless, if there was error in this regard and plaintiff is in fact illiterate, she has not shown that such a conclusion warrants remand in this case.
Plaintiff argues that illiteracy is incompatible with the jobs identified at step 5 because the Language Development level of the General Educational Development ("GED") component of these jobs as set forth in the Dictionary of Occupational Titles contemplates the ability to read and write to a far greater degree.
Id. Plaintiff argues that someone who is illiterate has none of these skills, and thus that the Commissioner has failed to meet her burden at step 5.
I am not persuaded. For one thing, "GED does not describe specific mental or skill requirements of a particular job, but rather describes the general educational background that makes an individual suitable for the job[.]" Anderson v. Colvin, 514 Fed.Appx. 756, 764 (10th Cir.2013). Moreover, accepting plaintiff's argument would make illiteracy itself a substitute for disability, which is contrary to both common sense and the Commissioner's regulations:
20 CFR Pt. 404, Subpt. P, App. 2, § 202.00(g). See also Charles v. Astrue, 291 Fed.Appx. 552, 555 (5th Cir.2008) ("[P]ersons who are functionally illiterate in English can still perform a significant number of unskilled jobs in the national economy[.]") Finally, it appears that the jobs plaintiff performed in the past had GED Language Development levels of as high as 2, demonstrating that such requirements in themselves do not preclude plaintiff from working, even if she is illiterate. (See Tr. 56-57.)
Given the lack of a firm consensus on this issue, the court will continue its own practice of using numerals in referring to the steps of the sequential evaluation to achieve a modicum of internal consistency with its numeric description of the quinquepartite, sequential evaluation at 1160-61, supra.