JOHN W. LUNGSTRUM, District Judge.
Plaintiff seeks review of a decision of the Commissioner of Social Security (hereinafter Commissioner) denying Supplemental Security Income (SSI) benefits under sections 1602, and 1614(a)(3)(A) of the Social Security Act. 42 U.S.C. §§ 1381a, and 1382c(a)(3)(A) (hereinafter the Act). Finding no error, the court ORDERS that judgment shall be entered pursuant to the fourth sentence of 42 U.S.C. § 405(g) AFFIRMING the Commissioner's decision.
Plaintiff applied for SSI, alleging disability beginning January 1, 2008. (R. 11, 136-39). Plaintiff exhausted proceedings before the Commissioner, and now seeks judicial review of the final decision denying benefits. Plaintiff presents two formal arguments, in which she alleges the Administrative Law Judge (ALJ) erred in his credibility analysis and in evaluating and relying upon the vocational expert's (hereinafter VE) testimony. Although Plaintiff's Brief presents only two argument sections, both the Commissioner and the court recognize another allegation of error imbedded within her credibility arguments—that the ALJ erred in evaluating the medical opinion of a non-treating physician, Dr. Kass, by ignoring or misrepresenting his medical diagnosis and by failing to specify the weight accorded to his opinion.
The court's review is guided by the Act.
The court may "neither reweigh the evidence nor substitute [its] judgment for that of the agency."
The Commissioner uses the familiar five-step sequential process to evaluate a claim for disability. 20 C.F.R. §§ 404.1520, 416.920;
The Commissioner next evaluates steps four and five of the sequential process— determining at step four whether, in light of the RFC assessed, claimant can perform her past relevant work; and at step five whether, when also considering the vocational factors of age, education, and work experience, claimant is able to perform other work in the economy. Wilson, 602 F.3d at 1139 (quoting Lax, 489 F.3d at 1084). In steps one through four the burden is on Plaintiff to prove a disability that prevents performance of past relevant work.
The court finds no error in the decision, and after addressing one matter involving the conduct of Plaintiff's counsel, addresses each issue in the order presented in Plaintiff's Brief.
In reading Plaintiff's briefs, it soon becomes apparent that counsel believes that the ALJ who handled this case has a predisposition to deny disability claims, and is biased against Plaintiff because she has abused substances in the past. Counsel projects ill motives on the ALJ in this case, and casts unseemly aspersions on his handling of the case. As but one example of this type of argument, the court quotes from the third page of counsel's credibility argument:
(Pl. Br. 19).
Counsel states that the ALJ ignored every contrary bit of relevant and substantial evidence, but he cites to no record evidence which was ignored and which would preclude the findings of the ALJ. In fact, in this instance, he admits that Plaintiff stated that her knee pain was a level of 2-3 on a scale of 1-10.
Counsel notes that in the hearing the ALJ asked Plaintiff if alcohol and drug use ever got her into legal trouble, and that Plaintiff responded that it had not. He then states, "Plaintiff is confident that if there were any existing legal issues ALJ Harty certainly would have proudly heralded them before the Hearing [sic] or most certainly in the final opinion." (Pl. Br. 23). This type of argument continued in counsel's reply brief, wherein he stated, "ALJ Harty relies on the naked assumption that since [Plaintiff] had formerly abused methamphetamine, she certainly must be a contemporaneous liar and that nothing she says may be accepted or properly and completely incorporated into an assessment of residual functional capacity." (Reply, 2-3). It is true that the ALJ found Plaintiff's allegations of symptoms are not credible, and therefore did not credit many of her allegations. It is also true that the ALJ asked Plaintiff if her alcohol and drug use had caused legal problems, and he noted in the decision that Plaintiff "testified that she has not been in legal trouble based on alcohol use." (R.17). But, it will be demonstrated herein when discussing the ALJ's credibility determination that the ALJ did not even rely upon Plaintiff's alcohol or drug use as a basis to discount her credibility.
Counsel assumes that because the ALJ asked the question and because he included statements regarding alcohol and drug abuse in the decision, that he found Plaintiff not credible, or at least implied that she was not credible because of that abuse. However, the decision does not reveal such reliance, and it is necessary for an ALJ to question a claimant regarding, and summarize evidence of, drug addiction and alcoholism because the regulations require that if the Social Security Administration finds "that you are disabled and ha[s] medical evidence of your drug addiction or alcoholism, [it] must determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability." 20 C.F.R. § 416.935(a). Plaintiff admits to an "extensive substance abuse history and condition" (Pl. Br. 3), and it is that history which is recorded in the medical evidence, and which requires the ALJ to pursue the issue of drug addiction and alcoholism at the hearing and in the decision.
Counsel is cautioned that innuendo and ad hominem attacks on a court or other tribunal by a member of the bar are improper and unseemly. If counsel believes the record supports a finding of bias or other impropriety by an ALJ, he should make those charges directly, and support them with evidence. He should not merely imply impropriety as a tactic to seek reversal of an ALJ's decision.
Plaintiff argues that the ALJ improperly relied upon her minimal and sporadic performance of activities of daily living to discount her credibility; erroneously relied upon one report of a low level of pain to discount her other reports of extreme pain; and improperly relied upon evidence of past substance abuse to discount her credibility, without even inquiring as to the issue of abstinence. The Commissioner argues that the ALJ reasonably evaluated the evidence in considering the credibility of Plaintiff's allegations of symptoms. She argues that the ALJ may, and did, properly rely on the inconsistency between Plaintiff's daily activities and her claim of disabling symptoms, and that this inconsistency was but one of many factors the ALJ discussed in his credibility determination. She argues that the ALJ provided several reasons in his decision upon which he relied in discounting Plaintiff's credibility, including conservative treatment, improvement with treatment, inconsistent statements, daily activities, and the medical opinions. (Comm'r Br. 7).
The Tenth Circuit has explained the analysis for considering subjective testimony regarding symptoms.
In evaluating credibility, the court has recognized a non-exhaustive list of factors which should be considered.
The court's review of an ALJ's credibility determination is deferential. An ALJ's credibility determinations are generally treated as binding on review.
The court notes that there is no section of the decision at issue here dealing specifically with the credibility analysis, yet the ALJ began his RFC assessment with a summary of the standard applicable to a credibility determination, (R. 15), and he ended his RFC assessment by concluding that "the claimant's statements concerning the intensity, persistence and limiting effects of [her reported] symptoms
Although there is a section of the decision titled, "Subjective," that section provides only general information about Plaintiff, and contains no analysis by the ALJ suggesting that he discounted Plaintiff's credibility based upon that information. (R. 15-16). The ALJ recognized that Plaintiff testified regarding severe left knee pain, and he found that she has a severe impairment of the left knee. (R. 13). He also noted that Plaintiff "testified that she does not take pain medication for her knee." (R. 16). In the circumstances, the court concludes that the inconsistency between alleging severe knee pain, and testifying that she does not take pain medication for her knee is one basis the ALJ used to discount the credibility of Plaintiff's allegations of disabling symptoms. The ALJ noted that Plaintiff had knee surgery in 2008 and continued to complain of constant pain thereafter. (R. 16). He noted that Plaintiff reported in 2010 that she had exacerbated her knee pain, and that she was "doing okay until that point when her pain became a 2-3 on a pain scale of 1-10 with 10 being the worst possible pain." (R. 16). He then provided another basis to discount the credibility of Plaintiff's allegations: "a pain level of 2-3 is not indicative of disabling pain and maybe [sic] the reason she does not take prescription pain medication currently."
As another reason to discount Plaintiff's allegations, the ALJ noted that Plaintiff complains of being fatigued, but that she has not reported excessive fatigue to medical professionals, and that these "inconsistent statements regarding her fatigue level diminishes the claimant's credibility."
Plaintiff's argument that the ALJ discounted her credibility merely because she had abused methamphetamine and marijuana in the past is not supported by the record. In the decision, the ALJ noted Plaintiff's substance abuse. He stated that Plaintiff "has been a `meth' and marijuana user in the past." (R. 15-16). He noted that Plaintiff "testified that she has not been in legal trouble based on alcohol use." (R. 17). The ALJ noted that Plaintiff had been hospitalized after a planned suicide attempt in 2010, and he stated that "notes from Prairie View show the claimant reported she had used `meth' and stayed up for several days when she thought about suicide (Exhibit F2, p.4). The claimant testified that she quit all of it cold turkey and does not go to `AA' or any other organization."
The ALJ also discussed the opinions of the medical and mental health treatment providers with regard to Plaintiff's drug and alcohol abuse. (R. 19-20). He noted that both a social worker and a registered nurse had diagnosed plaintiff with cannabis abuse and with methamphetamine or amphetamine abuse and he accorded those opinions "substantial weight."
Each of these instances is supported by the record evidence, and Plaintiff does not argue otherwise. Each instance is a low-key, factual presentation, and in none of them does the ALJ suggest it as a basis to discount the credibility of Plaintiff's allegations. Moreover, as discussed above, when the medical evidence suggests drug addiction or alcoholism as it does here, the ALJ is required to consider that evidence and determine whether drug addiction or alcoholism is a contributing factor material to the determination of disability. The court finds no error in the ALJ's consideration of the record evidence regarding drug and alcohol abuse, and does not find that it was relied upon by the ALJ to discount Plaintiff's credibility. Plaintiff is correct that the minimal and sporadic performance of activities of daily living are generally insufficient to support a negative credibility finding. (Pl. Brief 17) (citing
Finally, Plaintiff argues that is was error for the ALJ to rely upon a single instance wherein Plaintiff reported a low level of pain to discount all of her other reports of extreme pain. Plaintiff acknowledges that she told Dr. Kass
The remainder of Plaintiff's argument that the credibility determination is erroneous relies primarily on her reports or her testimony. The very purpose of the credibility determination is to determine whether Plaintiff's reports and testimony is to be fully believed, and Plaintiff has not shown evidence that precludes the ALJ's finding in this regard. Giving the credibility determination due deference, the court finds no error.
Plaintiff claims the ALJ erred in weighing the medial opinion of a non-treating physician, Dr. Kass, both by ignoring or misrepresenting his medical diagnosis and by failing to specify the weight accorded to his opinion. The Commissioner argues that the ALJ's consideration of Dr. Kass's opinion was sufficient to make clear to the court his evaluation. She argues that the ALJ discussed Dr. Kass's findings favorably, that it is clear that he considered all of the opinion, and that even though he did not use Dr. Kass's words to describe Plaintiff's knee impairment, he accepted that opinion and relied upon it in finding that Plaintiff's knee impairment is severe.
Plaintiff argues that Dr. Kass diagnosed Plaintiff with "patellofemoral degeneration with patellofemoral pain syndrome," but that the ALJ ignored this diagnosis although he "embraced" Dr. Kass's report that Plaintiff stated her knee pain was 2-3 out of ten. (Pl. Br. 19-20). She argues that because the ALJ did not list Dr. Kass's diagnosis among Plaintiff's severe medically determinable impairments at step two of the decision, "it is impossible to know whether or not the entirety of Dr. Kass' [sic] opinion has been properly recognized." (Pl. Br. 20). She argues that because the ALJ did not state the weight accorded to Dr. Kass's diagnosis, the decision is not clear in that regard. In her reply brief, Plaintiff acknowledges that the ALJ included "degenerative joint disease of the left knee" in his list of Plaintiff's severe impairments at step two, but she argues that the ALJ emphasized and relied upon this "generic and marginalized description" of Plaintiff's impairment and ignored Dr. Kass's diagnosis (or diagnostic terminology), and therefore, the court is unable to know the weight accorded to Dr. Kass's diagnosis. (Reply 1-2).
The court does not agree. As Plaintiff points out, an ALJ may not ignore any medical opinion, 20 C.F.R. § 416.927(c), and the "ALJ's decision [must] be `sufficiently specific to make clear to any subsequent reviewers the weight the adjudicator gave to the treating source's medical opinion and the reasons for that weight.'"
The evidence regarding Plaintiff's physical condition, and more specifically her left knee is rather sparse, but the ALJ accurately summarized that record. He noted that she had left knee surgery in February 2008, and that she continued to complain of pain in October, 2008. (R. 16) (citing Ex. 1F, p.6 (R. 284)). He noted that Plaintiff exacerbated her pain in October 2010 and that she reported a pain level of 2-3 at that time.
(R. 17).
From this record evidence as cited by the ALJ, there can be no doubt that it was Dr. Kass's diagnosis of "patellofemoral degeneration with patellofemoral pain syndrome" that lead the ALJ to find degenerative joint disease of the left knee as a severe impairment. Plaintiff asserts that the difference between the two diagnoses is so significant that it was error for the ALJ to use his own terminology rather than that of Dr. Kass. Yet, Plaintiff points to no record evidence suggesting that Dr. Kass's terminology cannot be included within the terminology used by the ALJ. And, she cites no admissible authority—medical, legal, vocational, or otherwise—suggesting such a significance. Moreover, and perhaps most importantly, at the hearing the ALJ listed his findings regarding medical diagnoses, including a "disorder of the left knee," but not including "patellofemoral degeneration with patellofemoral pain syndrome," and he asked, "Have I missed any diagnoses?" (R. 29-30). Plaintiff's counsel responded, "No, sir."
Plaintiff claims the VE ignored Plaintiff's numerous environmental restrictions when she testified regarding jobs available to Plaintiff "because such matters are not encountered in the
As the Commissioner points out, the hypothetical question presented to the VE at the hearing is identical to the RFC assessed for Plaintiff in finding number four in the decision.
The fact that the