ARTHUR J. TARNOW, Senior District Judge.
Plaintiff seeks review of Defendant's denial of her application for disability benefits. Plaintiff filed a Motion for Summary Judgment [12] on August 26, 2014. Defendant filed a Motion for Summary Judgment [16] on November 17, 2014. On March 9, 2015, the Magistrate Judge filed a Report and Recommendation (R&R) [17] recommending that the Court deny Defendant's motion, grant Plaintiff's motion, and remand for further proceedings. Defendant filed Objections to the Report and Recommendation [18] on March 19, 2015. Plaintiff filed a Response to Defendant's Objections [19] on March 26, 2015.
For the reasons stated below, the Court
The Court adopts the following description of this case's factual background from the R&R:
Plaintiff requested review of the ALJ's decision. The Appeals Council denied Plaintiff's request for review on November 19, 2013. Plaintiff filed the instant suit for judicial review on January 22, 2014.
The R&R concluded that remand is necessary because the ALJ relied on an RFC finding unsupported by substantial evidence. Specifically, the R&R concluded that in omitting any mental limitation from the RFC, the ALJ improperly "disregarded" Dr. Balunas's opinion on Plaintiff's mental limitations and "substituted her own medical opinion against the weight of the evidence." In its Objections[18], Defendant argues that the R&R misinterpreted Sixth Circuit precedent on "disregarding" consulting opinions. Defendant argues that, while the ALJ may not ignore consulting opinions favorable to the claimant, the ALJ is free to reject any such opinion in fulfilling the ALJ's duty to independently determine a claimant's RFC. Defendant further argues that the ALJ properly rejected Dr. Balunas's opinion because it was apparently based on Ms. Bonanno's opinion, which in turn was poorly supported.
The Court agrees with Defendant that it was not per se error for the ALJ to reject Dr. Balunas's characterization of Plaintiff's mental RFC, even though it was the only such characterization by a medical professional in the record. See 20 C.F.R. § 404.1527(d)(2) ("Although we consider opinions from medical sources on issues such as ... your residual functional capacity ... the final responsibility for deciding these issues is reserved to the Commissioner."); id. § 404.1527(e)(2)(i) ("Administrative law judges are not bound by any findings made by State agency medical or psychological consultants ...."). Moreover, since Dr. Balunas never examined Plaintiff and Ms. Bonnano examined her only once, neither was a treating physician. See Ealy v. Comm'r of Soc. Sec., 594 F.3d 504, 514 (6th Cir. 2010) (citing Smith v. Comm'r of Soc. Sec., 482 F.3d 873, 875 (6th Cir. 2007)). Since they were not treating physicians, the ALJ was not strictly required to articulate good reasons for rejecting their opinions. Ealy, 594 F.3d at 514 (citing Smith, 482 F.3d at 876).
However, the opinions of Dr. Balunas and Ms. Bonnano were not the only evidence supporting Plaintiff's claimed mental limitations; Plaintiff's own testimony also supported her claim. The ALJ summarized some of Plaintiff's testimony as follows:
The ALJ found that Plaintiff's "statements concerning the intensity, persistence and limiting effects of [her] symptoms are not entirely credible ...." The Court must review whether the ALJ's "explanations for partially discrediting [Plaintiff's testimony] are reasonable and supported by substantial evidence in the record." Jones v. Comm'r of Soc. Sec., 336 F.3d 469, 476 (6th Cir. 2003); see also Rogers v. Comm'r of Soc. Sec., 486 F.3d 234, 248 (6th Cir. 2007) ("[B]lanket assertions that the claimant is not believable will not pass muster, nor will explanations as to credibility which are not consistent with the entire record and the weight of the relevant evidence.") The Court concludes that they are not.
The ALJ did not identify any way in which the psychological opinions or other medical evidence of record undermined Plaintiff's testimony concerning her mental limitations. In fact, the ALJ identified only one source of evidence that arguably undermined Plaintiff's testimony: the observation of Plaintiff by unidentified field office employees. Specifically, the ALJ stated the following:
An ALJ's assessment of a claimant's credibility is owed deference in part because the ALJ has an opportunity to observe the claimant's demeanor. Jones, 336 F.3d at 476. Here, however, the ALJ's opinion makes no mention of the ALJ's observation of Plaintiff. The Court does not owe deference to the ALJ's credibility assessment to the extent it is based on the reported observation of Plaintiff by unidentified field office employees.
The ALJ's failure to identify persuasive evidence undermining Plaintiff's testimony is especially troubling given that her testimony is supported in several respects by the opinions of Dr. Balunas and Ms. Bonnano. Though the ALJ provided reasons for discrediting their opinions, the ALJ's stated reasoning is flawed. In support of the ALJ's rejection of Dr. Balunas's opinion, Defendant states only that "Dr. Balunas apparently based his opinion entirely on Ms. Bonnano's [opinion]," which in turn was poorly supported. This was not the reason given by the ALJ for rejecting Dr. Balunas's opinion. When setting forth the reasoning for her RFC finding, the ALJ addressed Dr. Balunas's opinion as follows:
The ALJ only articulated a reason for rejecting one limitation identified by Dr. Balunas: Plaintiff's limitation to simple one- and two-step tasks. However, Dr. Balunas identified other limitations. As recounted in the R&R, Dr. Balunas "found plaintiff to be moderately limited in her ability ... to maintain attention and concentration for extended periods, to interact appropriately with the general public, and to respond appropriately to changes in the work setting." These findings support Plaintiff's testimony concerning her mental limitations.
Defendant argues that the ALJ identified a reasoned basis for giving Ms. Bonnano's opinion no weight, and that these reasons sufficed to discredit Dr. Balunas's opinion as well because Dr. Balunas "apparently based his opinion on Ms. Bonnano's [opinion]." However, the ALJ's stated reasons for rejecting Ms. Bonnano's opinion were flawed. For instance, the ALJ stated that Ms. Bonnano "did not appear to critically and objectively assess [Plaintiff's] statements." In support of this critique, the ALJ mentioned that Ms. Bonnano described her impression of Plaintiff as "slightly guarded." Ms. Bonnano was neither accepting nor rejecting any statement made by Plaintiff when she recorded this description, and it thus appears irrelevant to the issue of whether Ms. Bonnano appropriately assessed Plaintiff's statements. The ALJ proceeded to state the following:
The ALJ thus identified an inconsistency between Plaintiff's statements to Ms. Bonnano and her prior statements to other medical professionals. However, as the ALJ herself explained, Ms. Bonnano acknowledged this inconsistency. This suggests that she did "question the reliability" of Plaintiff's statements.
The ALJ proceeded to fault Ms. Bonnano for neglecting another inconsistency—where none, in fact, existed. The ALJ stated the following:
In other words, in April 2007 Plaintiff reported to Easter Seals that her substance abuse problem had been in remission since October 2006, and in May 2011 she reported to Ms. Bonnano that the problem had been in remission since July 2007. These statements are not, as the ALJ suggested, inconsistent. The ALJ thus failed to explain why Ms. Bonnano's failure to "consider" this information detracted from the weight of her opinion.
Though it is unclear from the ALJ's opinion, the ALJ may have discredited Plaintiff's testimony in part due to her failure to seek mental health treatment. Social Security Ruling 96-7p states that a claimant's testimony "may be less credible if the level or frequency of treatment is inconsistent with the level of complaints, or if the medical reports or records show that the individual is not following the treatment as prescribed and there are no good reasons for this failure." 1996 WL 374186, at *7 (1996). However, Ruling 96-7p also provides that an ALJ "must not draw any inferences about an individual's symptoms and their functional effects from a failure to seek or pursue regular medical treatment without first considering any explanations that the individual may provide, or other information in the case record, that may explain infrequent or irregular medical visits or failure to seek medical treatment." Id. (emphasis added). The ruling lists examples of sound explanations for noncompliance, recognizing, for instance, that a claimant's poverty may interfere with her ability to obtain or adhere to treatment. Id. at *8 ("The individual may be unable to afford treatment and may not have access to free or low-cost medical services."). Further, the Sixth Circuit has joined other federal courts in recognizing that for a claimant suffering from mental illness, noncompliance with treatment may be a symptom of her condition, rather than evidence that her condition is not disabling. See White v. Comm'r of Soc. Sec., 572 F.3d 272, 283 (6th Cir. 2009) (citing Pate-Fires v. Astrue, 564 F.3d 935, 945 (8th Cir. 2009)).
Here, during his opening statement at the hearing, Plaintiff's attorney opined that Plaintiff has not been receiving the mental health medication she should be receiving. When the ALJ asked why Plaintiff is not receiving the medication, Plaintiff's attorney responded that she "has no funds and she has no access to the medication through community health." When he added that Plaintiff's current physicians have focused on other symptoms, the ALJ wondered whether her physicians do not consider her mental condition "bad enough." Plaintiff's counsel responded that Plaintiff's medical records consistently reflect a diagnosis of bipolar affective disorder. Later, Plaintiff disclosed that she receives treatment at "St. Joe's Hospital" and treatment for fibromyalgia from Dr. Densley at CBM Medical. The ALJ did not ask any questions about the availability of mental health treatment from these sources or their evaluations of Plaintiff's mental health. In her written opinion, however, the ALJ noted Plaintiff's claim to be unable to afford mental health treatment and suggested that her claim was discredited by her treatment at "St. Joe's" and at CBM Medical.
These facts are insufficient to support an inference that Plaintiff is not receiving mental health treatment because her symptoms are less severe than she claims. The ALJ failed to confirm the extent to which Plaintiff's low-income health program provides free or affordable mental health treatment. In fact, the ALJ exhibited little interest in Plaintiff's treatment aside from her repeated criticism of Dr. Densley's prescription of Vicodin to treat fibromyalgia.
In sum, the ALJ's explanation for discrediting Plaintiff's testimony concerning her mental limitations was not "reasonable and supported by substantial evidence in the record." Jones, 336 F.3d at 476. The Court therefore adopts the R&R to the extent that it recommends remand. On remand, the ALJ should reassess Plaintiff's credibility in a manner that corrects the deficiencies identified in this Order, including the ALJ's failure to adequately assess the extent to which Plaintiff's credibility is supported by the medical opinion evidence.
For the reasons stated above,
