MAGISTRATE JUDGE KRISTEN L. MIX.
This matter is before the Court
Plaintiff alleges that he became disabled at the age of thirty-three on September 9, 2011, due to anxiety and diabetes. Tr. 172, 176.
The ALJ determined that Plaintiff met the insured status requirements of the Act through December 31, 2013, and that Plaintiff had not engaged in substantial gainful activity ("SGA") since September 9, 2011, the alleged onset date. Tr. 12. The ALJ found that Plaintiff suffers from one severe impairment, i.e., anxiety disorder. Tr. 12. However, the ALJ also found that Plaintiff does not have an impairment or combination of impairments which meet or medically equals "the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925 and 416.926)." Tr. 13. The ALJ next concluded that Plaintiff has the residual functional capacity ("RFC") to perform the full range of work at all exertional levels with one nonexertional limitation, i.e., that Plaintiff "should not have any interaction with the general public." Tr. 15. Based on the RFC and the testimony of an impartial vocational expert ("VE"), the ALJ found that Plaintiff was unable to perform any past relevant work, but found that there are jobs which exist in significant numbers in the national economy which Plaintiff can perform, including the representative occupations of silver wrapper, price marker, and short order cook. Tr. 20-21. She therefore found Plaintiff not disabled at step five of the sequential evaluation. Tr. 21. The ALJ's decision has become the final decision of the Commissioner for purposes of judicial review. 20 C.F.R. §§ 404.981, 416.1481.
Pursuant to the Act:
"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 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 Court reviews a final decision by the Commissioner by examining the administrative record and determining "whether the [ALJ's] factual findings are supported by substantial evidence in the record and whether the correct legal standards were applied." Wilson v. Astrue, 602 F.3d 1136, 1140 (10th Cir.2010). However, the Court "may neither reweigh the evidence nor substitute [its] judgment for that of the agency." Harper v. Colvin, 528 Fed.Appx. 887, 890 (10th Cir.2013) (quoting Barnett v. Apfel, 231 F.3d 687, 689 (10th Cir.2000)). In other words, the Court does not reexamine the issues de novo. Sisco v. U.S. Dep't of Health & Human Servs., 10 F.3d 739, 741 (10th Cir.1993). Thus, even when some evidence could support contrary findings, the Court "may not displace the agency's choice between two fairly conflicting views," even if the Court may have "made a different choice had the matter been before it de novo." Oldham v. Astrue, 509 F.3d 1254, 1257-58 (10th Cir. 2007).
The Social Security Administration uses a five-step framework to determine whether a claimant meets the necessary conditions to receive Social Security benefits. See 20 C.F.R. §§ 404.1520, 416.920. The claimant bears the burden of proof at steps one through four, and if the claimant fails at any of these steps, consideration of any subsequent step or steps is unnecessary. Williams v. Bowen, 844 F.2d 748, 750 (10th Cir.1988) ("If a determination can be made at any of the steps that a claimant is or is not disabled, evaluation under a subsequent step is not necessary."). The Commissioner bears the burden of proof at step five. Bowen v. Yuckert, 482 U.S. 137, 146 n. 5, 107 S.Ct. 2287, 96 L.Ed.2d 119 (1987).
Step one requires the ALJ to determine whether a claimant is "presently engaged in substantial gainful activity." Wall, 561 F.3d at 1052 (quoting Allen v. Barnhart, 357 F.3d 1140, 1142 (10th Cir.2004)). If not, the ALJ considers at step two whether a claimant has "a medically severe impairment or impairments." Id. "An impairment
An ALJ must consider all evidence and explain why he or she finds a claimant not disabled. Clifton v. Chater, 79 F.3d 1007, 1009 (10th Cir.1996). However, the ALJ need not specifically "reference everything in the administrative record." Wilson, 602 F.3d at 1148. "Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. at 1140 (internal quotation marks omitted). "It requires more than a scintilla, but less than a preponderance." Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir.2007). A decision by the ALJ is not based on substantial evidence "if it is overwhelmed by other evidence in the record...." Grogan v. Barnhart, 399 F.3d 1257, 1261-62 (10th Cir.2005). In other words, the Court's determination of whether the ALJ has supported his or her ruling with substantial evidence "must be based upon the record taken as a whole." Washington v. Shalala, 37 F.3d 1437, 1439 (10th Cir.1994). Further, evidence is not substantial if it "constitutes mere conclusion." Musgrave v. Sullivan, 966 F.2d 1371, 1374 (10th Cir.1992). In addition, "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).
Plaintiff requests judicial review of the ALJ's decision denying him disability insurance benefits and supplemental security income. Brief [# 13] at 2-3. Specifically, Plaintiff argues that: (1) the ALJ erred by failing to have valid reasons for rejecting most of the opinion of Jose Vega, Ph.D. ("Dr. Vega"); (2) the ALJ erred by failing to provide valid reasons for crediting the opinion of Brett Valette, Ph.D. ("Dr. Valette") over the opinion of Dr. Vega; (3) the ALJ failed to properly assess the opinion of Rona Knudsen, M.D. ("Dr. Knudsen"); and (4) the ALJ's RFC finding is not supported by the evidence, and so the ALJ should have developed the record concerning Plaintiff's mental limitations. Id. at 4.
Citing to SSR 96-5p, 1996 WL 374193, at *5 (July 2, 1996), Plaintiff argues that the ALJ erred by failing to properly assess Dr. Knudsen's opinion that Plaintiff was totally disabled for a period of six-to-twelve months. Brief [# 13] at 29 (citing Tr. 19-20). In relevant part, SSR 96-5p provides:
1996 WL 374193, at *5 (emphasis added). Plaintiff asserts that the italicized sentence above means that the ALJ erred in her assessment.
In relevant part, the ALJ stated with respect to Dr. Knudsen's opinion:
Tr. 19-20 (internal citations omitted) (emphasis in original).
The Med-9 form discussed by the ALJ was accompanied by two pages of notes from Dr. Knudsen. Tr. 267-68. The ALJ addressed the content of these additional pages in the Decision. See Tr. 16-17. Notably, Plaintiff does not clearly articulate an argument that the ALJ erred by failing to weigh the medical portion of Dr. Knudsen's opinion, as found in these two additional pages. See Brief [# 13] at 29-30; Reply [# 15] at 10-11. Rather, the sole focus of Plaintiff's argument appears to be that the ALJ improperly rejected the portion of Dr. Knudsen's opinion regarding Plaintiff's ability to work. See id. To the extent Plaintiff makes this argument, though, he is incorrect. As noted above, SSR 96-5p merely states that opinions regarding an individual's ability to work must not be totally disregarded. See 1996 WL 374193, at *5. SSR 96-5p also states that "even when offered by a treating source, they can never be entitled to controlling weight or given special significance." Id. Here, after discussing Dr. Knudsen's opinion regarding Plaintiff's ability to work, the ALJ stated that her "opinion is noted, but not binding in this case." Tr. 20. Thus, the ALJ did not disregard the opinion but also did not give it special significance. Therefore, the ALJ
Plaintiff next argues that the ALJ provided improper reasons for giving only "little weight" to the opinion of Dr. Vega and failed to properly explain why she gave more weight to Dr. Valette's opinion than she did to Dr. Vega's opinion. Brief [# 13] at 22-28; Reply [# 15] at 4-9. In large part, Plaintiff premises this argument on the holding in Quintero v. Colvin, 567 Fed.Appx. 616 (10th Cir.2014), which was issued after the ALJ's July 23, 2013 decision in this case. See, e.g., Brief [# 13] at 26, 28.
In part, the ALJ discussed Dr. Vega's opinion as follows:
Tr. 19 (internal citations omitted). An ALJ's decision to assign little weight to an opinion "operate[s] as the equivalent of a rejection of the opinion." Quintero, 567 Fed.Appx. at 620 n. 6 (citing Chapo v. Astrue, 682 F.3d 1285, 1291 (10th Cir. 2012)). In short, the ALJ provided three reasons for discounting Dr. Vega's opinion: (1) "Dr. Vega does not have a treating relationship with the claimant;" (2) Dr. Vega "apparently relied quite heavily on the subjective report of symptoms and limitations provided by" Plaintiff; (3) Plaintiff "underwent the examination ... in connection with an effort to generate evidence for the current appeal." Tr. 19. The ALJ tempered this last reason by stating: "Although such evidence is certainly legitimate and deserves due consideration, the context in which it was produced cannot be entirely ignored." Tr. 19.
The ALJ must of course consider all medical opinions in the record and discuss the weight assigned to each opinion. See 20 C.F.R. §§ 404.1527(c), 404.1527(e)(2)(ii), 416.927(c), 416.927(e)(2)(ii). The Court can quickly dispose of two of the ALJ's reasons for discounting Dr. Vega's opinion.
Regarding the ALJ's third reason, she stated that Dr. Vega "apparently relied quite heavily on the subjective report of symptoms and limitations provided by the claimant, and seemed to uncritically accept as true most, if not all, of what the claimant reported. Yet, as explained elsewhere in this decision, there exist good reasons for questioning the reliability of the claimant's subjective complaints." Tr. 19. The consistency of Dr. Vega's opinion with the record as a whole is a legitimate factor to be considered in evaluating the opinion. See Quintero, 567 Fed.Appx. at 620 (citing 20 C.F.R. §§ 404.1527(c)(4), 416.927(c)(4)). The Tenth Circuit Court of Appeals has stated that, "[t]he ALJ cannot reject [a physician's] opinion solely for the reason that it was based on [the claimant's] responses because such rejection impermissibly substitutes her judgment for that of [the physician]." Thomas v. Barnhart, 147 Fed.Appx. 755, 759-60 (10th Cir.2005) (stating that "[t]he practice of psychology is necessarily dependent, at least in part, on a patient's subjective statements"). Plaintiff argues that because the other reasons for discounting Dr. Vega's opinion were improper, the ALJ erred by discounting Dr. Vega's opinion solely because of an allegedly heavy reliance on subjective statements made by Plaintiff during his examination.
However, the ALJ did not in fact discount Dr. Vega's opinion solely for that reason but, rather, rejected the opinion because elsewhere in her decision, the ALJ called into question the credibility of Plaintiff's statements.
Tr. 18 (emphasis added). Thus, the ALJ explicitly stated why she found troublesome Plaintiff's statements to Dr. Vega during the single examination they had together, i.e., there was no explanation in the record regarding why Plaintiff's functional abilities had apparently rapidly declined in the previous year.
In addition, the Court rejects Plaintiff's argument that "[t]here is simply no evidence to support the ALJ's conclusion that Dr. Vega's opinion is based on plaintiff's misleading subjective statements." Reply [# 15] at 6. Even a cursory review of the "Mental Status Examination" and "Summary" portions of Dr. Vega's report demonstrates that Dr. Vega relied on Plaintiff's statements. See Tr. 312-14. Thus, although the ALJ could have been more explicit when discussing this aspect of her decision, the Court is able to follow the ALJ's reasoning without resorting to post hoc rationalization. See Carpenter v. Astrue, 537 F.3d 1264, 1267 (10th Cir. 2008); see Keyes-Zachary v. Astrue, 695 F.3d 1156, 1166 (10th Cir.2012). No more is required.
Tr. 19 (internal citations omitted). Plaintiff argues that the ALJ provided no reason for giving more weight to Dr. Valette's opinion than she did to Dr. Vega's. See, e.g., Reply [# 15] at 7-9. "The opinion of an examining physician is generally entitled to less weight than that of a treating physician, and the opinion of an agency physician who has never seen the claimant is entitled to the least weight of all." Robinson v. Barnhart, 366 F.3d 1078, 1084 (10th Cir.2004) (citing 20 C.F.R. § 404.1527(d)(1), (2); 20 C.F.R. § 416.927(1), (2); SSR 96-6p, 1996 WL 374180, at *2). Here, however, both Dr. Vega and Dr. Valette are examining physicians, and thus their opinions are generally entitled to about the same weight, in the absence of any other considerations. Tr. 16, 17, 19.
The ALJ did not explicitly state why she gave more weight to Dr. Valette's opinion than she did to Dr. Vega's opinion when she was analyzing the opinions of these two providers. Tr. 19. However, elsewhere in her decision, the ALJ explained the difference in weight by discussing the statements provided to Dr. Valette in June 2012 and the statements provided to Dr. Vega in June 2013 and by stating that there was no explanation in the record for why Plaintiff's condition had deteriorated between June 2012 and June 2013 to the extent he alleged. Tr. 18. "The ALJ must give good reasons for the weight she assigns to [a medical] opinion, and specific, legitimate reasons if she rejects the opinion entirely." Jones v. Colvin, 610 Fed. Appx. 755, 758 (10th Cir.2015) (citing Watkins v. Barnhart, 350 F.3d 1297, 1301 (10th Cir.2003)). Here, the ALJ stated why Dr. Valette's opinion was given greater weight than Dr. Vega's, i.e., the difference was based on the ALJ's earlier assessment of Plaintiff's credibility and the ALJ's determination that Dr. Valette's opinion was generally supported by the facts in the record as a whole.
Accordingly, the Court finds no reversible error with respect to the ALJ's conclusions about Dr. Vega's and Dr. Valette's opinions.
Plaintiff argues that the ALJ should have more fully developed the record because substantial evidence does not support her RFC finding. See Brief [# 13] at 31-34; Reply [# 15] at 12-15.
The claimant in a social security disability matter has the burden of establishing her disability. Rose v. Colvin, 634 Fed.Appx. 632, 636-37, 2015 WL 8593444, at *3 (10th Cir. Dec. 14, 2015) (citing Wall v. Astrue, 561 F.3d 1048, 1062 (10th Cir. 2009)). The procedure for determining disability is nonadversarial and, as Plaintiff argues, "the ALJ has a duty to ensure than an adequate record is developed during the disability hearing consistent with the issues raised." Rose, 634 Fex.Appx. at 637, 2015 WL 8593444, at *3 (quoting Wall, 561 F.3d at 1062-63). However, this duty "is not unqualified." Rose, 634 Fed. Appx. at 637, 2015 WL 8593444, at *3 (quoting Wall, 561 F.3d at 1063) (emphasis in original). "The ALJ's duty to further develop the record is triggered by conflicts, inconsistencies or inconclusive findings in the medical record requiring further investigation." Maestas v. Colvin, 618 Fed.Appx. 358, 361 (10th Cir.2015) (citing Hawkins v. Chater, 113 F.3d 1162, 1166-67, 1169 (10th Cir.1997) (stating that an ALJ's determination whether to order a consultative examination is given broad latitude, but may be required "where there is a direct conflict in the medical evidence," "where the medical evidence in the record is inconclusive," and "where additional tests are required to explain a diagnosis already contained in the record").
Plaintiff argues that the ALJ rejected one medical opinion (Dr. Vega's) and accepted, without weighing, Dr. Valette's opinion that Plaintiff has no mental limitations. See, e.g., Reply [# 15] at 13. The Court has already rejected Plaintiff's contention that the ALJ failed to weigh Dr. Valette's opinion. Plaintiff suggests that the Court should construe the ALJ's statements about Dr. Valette's opinion as meaning that this opinion was unreliable. See, e.g., id. However, the ALJ accepted Dr. Valette's opinion, giving it "some weight," except to the extent that it conflicted with the one part of Plaintiff's testimony that the ALJ did find credible, i.e., that Plaintiff needed to avoid contact with the general public because of his anxiety. See Tr. 15, 19. Thus, Dr. Valette's opinion was not "useless, non-reliable, or rejected," despite Plaintiff's argument to the contrary. See Reply [# 15] at 14. The parties agree that the ALJ's RFC finding need not perfectly mirror the limitations suggested by a physician or psychologist in the record. See Response [# 14] at 5-6]; Reply [# 15] at 14. The ALJ's use of Dr. Valette's opinion demonstrates that the record was not devoid of a reliable opinion (as assessed by the ALJ), and, having resolved the conflict between Dr. Vega's opinion and Dr. Valette's opinion, the ALJ was under no obligation to further develop the record. See Maestas, 618 Fed.Appx. at 361.
Based on the foregoing, the Court rejects Plaintiff's contention that the ALJ was left without sufficient evidence in the record to assess Plaintiff's mental impairments and create an RFC, and finds no reversible error with respect to this issue.
For the foregoing reasons,
IT IS HEREBY
IT IS FURTHER