JOHN W. LUNGSTRUM, District Judge.
Plaintiff seeks review of a decision of the Acting Commissioner of Social Security (hereinafter Commissioner) denying Disability Insurance benefits (DIB) under sections 216(i) and 223 of the Social Security Act. 42 U.S.C. §§ 416(i) and 423 (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 DIB, alleging disability beginning March 1, 2010. (R. 12, 136-42). Plaintiff exhausted proceedings before the Commissioner, and now seeks judicial review of the final decision denying benefits. Plaintiff argues that the Administrative Law Judge's (ALJ) residual functional capacity (RFC) assessment is erroneous in numerous respects, and that he erred in evaluating the opinion of a chiropractor who treated Plaintiff.
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;
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.
The court finds no error in the decision below. The court is mindful that each of the errors alleged by Plaintiff (including the evaluation of Plaintiff's chiropractor's opinion) factors into the ALJ's consideration of Plaintiff's RFC. Nevertheless, it addresses each error in the order presented in Plaintiff's brief.
RFC is an assessment of the most a claimant can do on a regular and continuing basis despite his limitations. 20 C.F.R. § 404.1545(a);
Although an ALJ is not an acceptable medical source qualified to render a medical opinion, "the ALJ, not a physician, is charged with determining a claimant's RFC from the medical record."
The Commissioner issued SSR 96-8p "[t]o state the Social Security Administration's policies and policy interpretations regarding the assessment of residual functional capacity (RFC) in initial claims for disability benefits." West's Soc. Sec. Reporting Serv., Rulings 143 (Supp. 2014). The ruling includes narrative discussion requirements for the RFC assessment.
Plaintiff first argues that because the state agency physician, Dr. Parsons, determined at step two of the sequential process that Plaintiff had no severe physical impairments, whereas the ALJ determined this case alternatively at step four and step five, "the ALJ's assertion that Dr. Parsons's non-assessment of RFC supported his own RFC finding was incorrect." (Pl. Br. 7). Plaintiff's argument is without a basis in the decision at issue. Contrary to Plaintiff's argument, the ALJ did not assert that Dr. Parsons's opinion supported the ALJ's RFC assessment. Rather, the ALJ stated that he only assigned "some weight" to Dr. Parsons's opinion because it was inconsistent with Plaintiff's employers' reports, and he concluded, contrary to Dr. Parsons's opinion, that Plaintiff's "migraines, Crohn's disease, and obesity are at least minimally severe based on additional evidence received at the hearing level." (R. 20). Plaintiff does not argue that the ALJ erred in finding that migraines, Crohn's disease, and obesity are severe impairments despite Dr. Parsons's contrary finding.
With regard to the ALJ's credibility argument, Plaintiff asserts that she assumes for the sake of argument that the credibility finding is based on substantial evidence, but she argues that the credibility finding is not based on all relevant evidence. (Pl. Br. 7-8). She argues that although the ALJ discussed the employers' statements regarding Plaintiff's abilities and limitations, his consideration of the statements was unclear. She argues that because the ALJ relied upon the employers' statements to discount Dr. Parsons's opinion, he must have accepted the statements, yet he did not include any RFC limitations suggested by the statements, and this failure is error.
Plaintiff's argument misunderstands the standard for the Commissioner's disability determinations. It is Plaintiff's burden to show that she is disabled, not the Commissioner's burden to show that she is not. In the Tenth Circuit, an ALJ must consider all third-party opinion evidence, and as Plaintiff admits, the ALJ did so here. The fact that the ALJ discounted Dr. Parsons's opinion because it was inconsistent with the statements of Plaintiff's employers does not establish that the ALJ accepted each of the employers' opinions at face value. If Plaintiff believes the evidence requires greater functional limitations than assessed by the ALJ, she must state what those limitations are, point to the record evidence which requires those limitations, and explain based upon the record evidence why the lesser limitations assessed by the ALJ cannot be accepted. She has not done so here. Rather, in essence she has asked that court to reweigh the employers' statements, and substitute its judgment for that of the agency in assigning weight to those statements. As noted above, the court may not do so.
Moreover, if as Plaintiff assumes for the sake of argument substantial evidence supports the ALJ's credibility determination (and it does), the fact that the record evidence might also support a contrary conclusion is irrelevant to this court's review. "The possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's findings from being supported by substantial evidence. We may not displace the agency's choice between two fairly conflicting views, even though the court would justifiably have made a different choice had the matter been before it de novo."
Plaintiff argues that although the "ALJ dismissed [Dr. Gibbons's] opinion on the basis of consideration of factors in 20 C.F.R. § 404.1527, his finding was incapable of meaningful review because his reasoning was minimal." (Pl. Br. 11). Plaintiff acknowledges that the ALJ discounted Dr. Gibbons's opinion because it was inconsistent with the findings on Dr. Heincker's examination, but argues that the ALJ's decision was unclear how "Dr. Heincker's one-time findings undermined those of Ms. [sic] Gibbons." (Pl. Br. 12). She argues this is so because Dr. Gibbons had treated Plaintiff nine times before she provided her opinion, and because in Plaintiff's view Dr. Gibbons's opinion was supported by substantial evidence. Plaintiff concludes her argument, "[w]hile the ALJ may have believed that Ms. [sic] Gibbons's opinion was not entitled to weight on the basis of his consideration of 20 C.F.R. § 404.1527, he should have presented evidence that was capable of meaningful review to support such a proposition."
As Plaintiff admits, a chiropractor such as Dr. Gibbons is not an "acceptable medical source," and her opinion is not technically a medical opinion. Nonetheless, the Commissioner has provided a means for evaluating the opinions of such healthcare providers. In accordance with the regulations, an "acceptable medical source" includes only certain named classes of professionals: licensed physicians, licensed or certified psychologists, licensed optometrists, licensed podiatrists, and qualified speech-language pathologists. 20 C.F.R. § 404.1513. Chiropractors are among another group of healthcare providers called "other" medical sources from whom the Commissioner will accept and use evidence showing the severity of a claimant's impairment(s) and how the impairment(s) affects claimant's ability to work.
Applying these regulations, a chiropractor is an "other" medical source, not an "acceptable medical source" or a "treating source."
Recognizing the reality that an increasing number of claimants have their medical care provided by healthcare providers who are not "acceptable medical sources"—nurse-practitioners, physician's assistants, social workers, and therapists, the Commissioner promulgated SSR 06-3p. West's Soc. Sec. Reporting Serv., Rulings 327-34 (Supp. 2014). In that ruling, the Commissioner noted:
SSR 06-3p explains that where a treating source opinion is not given controlling weight, opinions of chiropractors will be evaluated using the regulatory factors for evaluating medical opinions.
In this case, the ALJ followed the dictates of SSR 06-3p, applied the regulatory factors to consider Dr. Gibbons's opinion, and explained the weight accorded to Dr. Gibbons's opinion:
(R. 20). From this discussion, it is clear that the ALJ considered Dr. Gibbons's opinion in accordance with the regulatory factors for weighing medical opinions, and discounted her opinion because she is not an acceptable medical source and because her opinion is inconsistent with the findings of Dr. Heincker's examination of Plaintiff. Dr. Heincker is a medical doctor, and consequently an acceptable medical source.
Plaintiff does not argue that these reasons are erroneous. Rather, she argues that even though Dr. Gibbons cannot be considered a treating source, and her opinion does not qualify as a medical opinion, "the frequency and extent of [Dr. Gibbons's] treatment relationship with Miller was still a valid consideration, and one that indicated a greater awareness of Miller's condition than that of one-time examiner Dr. Heincker" (Pl. Br. 13). Plaintiff's argument would be a valid argument if Dr. Gibbons were an acceptable medical source, if her opinion were a "medical opinion," or if she were a "treating source." But none of those conditions is true. In the hierarchy of healthcare providers and their opinions, Dr. Heincker is an acceptable medical source and his opinion is a medical opinion, Dr. Gibbons is an "other" medical source and her opinion is not a medical opinion. In essence, Plaintiff is arguing that there is no difference between an "acceptable medical source" and an "other" medical source. The regulations provide that there is a difference, and if Plaintiff believes the regulations should be changed she should address that concern to the Commissioner or the Congress. Plaintiff points to no specific error in the ALJ's weighing of Dr. Gibbons's opinion, she merely asks the court to reweigh the opinion, and assign it greater weight because the chiropractor saw her more than did the medical doctor. As noted above, the court may not do so. Plaintiff has shown no error in the decision of the Commissioner.