MADELINE COX ARLEO, District Judge.
The Court has jurisdiction to review the Commissioner's decision under 42 U.S.C. § 405(g). The Court must affirm the Commissioner's decision if there exists substantial evidence to support the decision. 42 U.S.C. § 405(g);
"[T]he substantial evidence standard is a deferential standard of review."
In determining whether there is substantial evidence to support the Commissioner's decision, the Court must consider: "(1) the objective medical facts; (2) the diagnoses of expert opinions of treating and examining physicians on subsidiary questions of fact; (3) subjective evidence of pain testified to by the claimant and corroborated by family and neighbors; and (4) the claimant's educational background, work history, and present age."
To determine a claimant's disability, the Commissioner must apply a five-step test. 20 C.F.R. § 404.1520(a)(4). Step one is to determine whether the claimant is currently engaging in "substantial gainful activity." 20 C.F.R. § 404.1520(a)(4)(i). "Substantial gainful activity" is defined as work activity, both physical and mental, that is typically performed for either profit or pay. 20 C.F.R. § 404.1572. If the claimant is found to be engaged in substantial gainful activity, then he or she is not disabled and the inquiry ends.
At the third step, the Commissioner must determine whether there is sufficient evidence showing that the claimant suffers from a listed impairment. 20 C.F.R. § 404.1520(a)(4)(iii). If so, a disability is conclusively established and the claimant is entitled to benefits.
On July 30, 2009, Plaintiff Kim Davis filed an application for supplemental security income. The application was initially denied on January 20, 2010, and denied again on reconsideration on June 26, 2010. Tr. 68-72, Tr. 74-75. On July 20, 2010, Plaintiff filed a written request for hearings, which were held on July 26, 2011 and February 28, 2012, in Newark, New Jersey. Tr. 21-63. The ALJ determined that Plaintiff was not disabled under section 1614(a)(3)(A) of the Social Security Act, and Plaintiff's application for benefits was denied on March 15, 2012. Tr. 8-20. On June 19, 2014, pursuant to a District Court remand order, the Appeals Council sent the case to be heard by a new ALJ. Tr. 457-462. Plaintiff, a medical examiner, and a vocational expert testified at the new hearing on November 13, 2014. Tr 412-456. Plaintiff was represented by counsel at this time.
Plaintiff is a 53-year-old woman. She has a 10th grade education, and has no past relevant work. Tr. 404, 431. Plaintiff claims she stopped working due to a spinal disorder, left hand post trauma degenerative changes, alcoholism, and depression. Tr. 13.
On July 30, 2009, when Plaintiff was 45 years old, she filed an SSI application, alleging disability due to spinal pain, a left hand impairment, alcoholism, and depressive disorder. Tr. 13. According to Plaintiff, a car accident in April 2000 caused her severe neck and back pain. Tr. 28. Plaintiff wears a neck brace at night and has a transcutaneous electrical nerve stimulation (TENS) unit. Tr. 16. She also has a cane, which she claims was prescribed by her treating physician, Dr. Mahmood.
Plaintiff also claimed to have left handed post traumatic degenerative changes. Tr. 13 Plaintiff is right hand dominant and experiences no limitations with that hand.
Plaintiff claims to suffer from depression over the loss of custody of her son. Tr. 17. She is not under any mental health care, nor is she prescribed any psychotropic medication.
Plaintiff underwent an organicity evaluation with Dr. Figurelli in September 2011. Tr. 376-379. Dr. Figurelli reported that the Plaintiff manifested no evidence of active psychotic disturbances or formal thought disorder. Tr. 377. Plaintiff was found to have intelligible speech, and no difficulty comprehending verbal interactions with the examiner. Dr. Figurelli conducted the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) assessment, in which Plaintiff obtained a full-scale IQ score of 64, placing her within the mild mentally retarded range of intellectual functioning in her age group. Tr. 378. Dr. Figurelli diagnosed Plaintiff memory and concentration deficits consistent with low level cognitive functioning, mild mental retardation upon formal testing, lack of employability skills, and a GAF score of 50. Tr. 379.
Plaintiff has a history of alcoholism. Tr. 17. Plaintiff testified that she had been in a weekly outpatient program to treat her alcoholism from October until December of 2009. Tr. 39. Plaintiff testified that three or four months prior to her hearing she went to AA meetings four times a week.
Plaintiff relies on a family friend for support. Tr. 34. She testified that she is able to perform household chores. Tr. 181. Plaintiff is able to prepare meals for herself daily, as well as shop for groceries three to four times a week. Tr. 180-182. Plaintiff enjoys reading and doing word puzzles. Tr. 183. She spends time with friends and family a "couple times a week," and attends church "sometimes."
Following a July 26, 2011 hearing, the ALJ denied Plaintiff's SSI claims. Tr. 22, 72. In a March 15, 2011 decision, the ALJ found that Plaintiff had not engaged in substantial gainful activity since July 30, 2009, the benefits application date. Tr. 13. The ALJ determined that Plaintiff has the following severe impairments: spinal disorder, left hand post trauma degenerative changes, alcoholism, and depressive disorder.
The ALJ considered Plaintiff's subjective complaints in assessing her residual functional capacity, but found that her statements concerning the intensity, persistence, and limiting effects of the alleged symptoms were not entirely credible to the extent they were inconsistent with the RFC. Tr. 16. The ALJ found that Plaintiff has no past relevant work, and concluded that jobs exist in significant numbers in the national economy that Plaintiff can perform. Tr. 19. In reaching this finding, the ALJ relied on the testimony of a vocational expert.
Plaintiff alleges that: (1) the Plaintiff has established disability through substantial evidence in the administrative record, Pl.'s Br. at 26-28, "ECF" No. 11; and (2) the decisional RFC is not based on substantial evidence, Pl.'s Br. at 18-26. None of these arguments prevails because the ALJ appropriately assessed Plaintiff's impairments under applicable law and the ALJ's findings are supported by substantial evidence.
Plaintiff primarily argues that she established disability through substantial evidence in the administrative record. Pl's. Br. at 10. Plaintiff argues that the ALJ erred when he: (i) afforded less weight to the medical experts' opinions that she was disabled, Pl.'s Br. at 10-18; and (ii) disregarded Plaintiff's cognitive impairment, Pl's Br. at 15-18. The Court disagrees.
The Plaintiff claims that the ALJ erred by crediting his lay opinion over the medical experts' opinions regarding medical equivalence and disability. Pl's. Br. at 13-15. Plaintiff argues that the examinations done by Dr. Candela and Dr. Figurelli show that the Plaintiff met or equaled a listing at § 12.05, and that the ALJ erred by rejecting the findings of those examinations. Pl's. Br. at 14. Plaintiff argues that the ALJ's conclusion that the Plaintiff's mild mental retardation did not meet 12.05
According to the Commissioner's regulations, a statement by a medical source alleging disability or inability to work does not necessitate a determination of disability. 20 C.F.R. § 416.927(d)(1). While a medical expert's opinion is helpful in assisting the finder of fact in determining eligibility for claimants, opinions as to disability are ultimately reserved for the Commissioner.
In the instant case, the ALJ considered the results of Dr. Figurelli's intelligence testing, and found that Plaintiff's low mental functioning had not manifested before the age of 22, as required by § 12.05. The ALJ reasoned that Plaintiff had consistently reported completing 10th grade in regular education classes and was capable of independently handling her own personal care and daily living activities. Tr. 14. Additionally, both Dr. Candela and Dr. Figurelli reported Plaintiff to have an "average fund of knowledge," with clear and goal-oriented thoughts, and to be fully alert and attentive. Tr. 236, 377. In fact, Dr. Figurelli reported that Plaintiff did not have any significant difficulty in adequately comprehending verbal interaction and verbal instruction. Tr. 18. The ALJ also found that Plaintiff's chronic history of alcoholism may have affected her functioning after the developmental period, resulting in a lower IQ score during the intelligence testing. Tr. 401. The ALJ found that these facts contradicted the medical experts' opinions that Plaintiff was disabled, and therefore appropriately afforded the opinions of the medical experts less weight.
Plaintiff alleges that substantial evidence in the record establishes that her alleged impairments meet or equal the listing requirements for disability. Pl.'s Br. at 10-18. Plaintiff argues that the ALJ erred when he failed to acknowledge Plaintiff's alleged cognitive impairments. Pl's Br. at 15-18, ECF. No. 11. The Court disagrees.
An ALJ's failure to cite specific evidence does not indicate that it was not considered.
Plaintiff claims to have demonstrated a cognitive impairment on two separate occasions; first, during a mental status examination conducted by the Commissioner's psychologist, Dr. Candela, on November 19, 2009, and again on September 22, 2009 during another mental status examination conducted by Dr. Figurelli. Tr. 234-237, Tr. 376-380. The test results concluded that Plaintiff's full scale IQ was in the range of 64, which is evidence of mild mental retardation. Tr. 376-379. The ALJ found the results from these tests to be inconsistent with evidence of record, and determined that Plaintiff did not meet the medical listing requirements for § 12.05. According to the ALJ, it was "clear that this level of mental functioning was not manifested during her developmental period i.e. before the age 22 as required in section 12.05." Tr. 14. Additionally, the Plaintiff reported that she has never been psychiatrically hospitalized, and that she was never in special education classes. Tr. 235, 431. The ALJ did determine that Plaintiff had a history of alcoholism, but the ALJ found no evidence of any mental health disorder related to alcoholism. Tr. 14. Further, as mentioned above, the ALJ found that Plaintiff's history of alcoholism after age 22 could have contributed to her low IQ score. Tr. 401.
The ALJ determined that Plaintiff's IQ score was inconsistent with the record and therefore invalid, and thus ruled that the Plaintiff did not meet one of the additional criteria in subsections A through D of listing § 12.05.
Plaintiff argues that the decisional RFC is not based on substantial evidence, and that the ALJ erred when he: (i) disregarded evidence of Plaintiff's alleged left-hand and cognitive impairment, Pl's Br. at 25; and (ii) failed to reflect all of the Plaintiff's alleged impairments in his hypothetical question to the vocational expert. Pl's Br. at 21-25.
Plaintiff contends that the ALJ failed to properly assess her RFC because he disregarded or ignored evidence supporting of her claim for disability. Pl's Br. at 21-25. Plaintiff argues that the manipulative restrictions conveyed by the Commissioner's orthopedic consultant were ignored, that the formal testing by the Commissioner's veteran psychological examiner stating her IQ was in the "deficit functioning range" was disregarded, and that all four of the Commissioner's experts have been ignored and rejected "without a single piece of contradictory medical evidence." Pl's Br. at 25. The Court disagrees.
The ALJ evaluates the credibility of the claimant's subjective complaints and allegations of disability based on the record as a whole, including the objective medical evidence, medical source opinions, and other relevant evidence. C.F.R. § 416.929; SSR 96-97p. The ALJ may make an independent assessment of a claimant's RFC because the ALJ, not treating physicians or state consultants, must make the ultimate disability and RFC determinations.
Here, the ALJ considered all the evidence and found that the statements concerning the intensity, persistence, and limiting effects of the Plaintiff's left-hand impairment were not entirely credible to the extent that they were inconsistent with the RFC assessment. Tr. 16. Dr. Mahmood opined that Plaintiff did not have any limitations in reaching, handling, or feeling. Tr. 274. Dr. Fechner opined that Plaintiff could occasionally reach overhead with both hands, frequently reach anywhere else with both hands, continuously handle, finger, feel, push and pull with her dominant hand, occasionally engage in fine repetitive movements with her left hand, and could frequently engage in gross motor movements with her left hand. Tr. 390. The ALJ determined that while there is evidence of weakness in her left hand, there is no evidence of significant pain or associated symptoms, and that there were no limitations in Plaintiff's dominant hand. Tr. 17. The ALJ also noted that Plaintiff was not currently receiving treatment for her left hand.
Additionally, as discussed above, the ALJ considered all evidence on the record regarding Plaintiff's alleged cognitive impairment and found that Plaintiff did not meet or equal the listing for disability. Tr. 18. The ALJ determined that the majority of physicians found Plaintiff capable of completing simple, routine, repetitive tasks that involve simple work-related decisions and few workplace changes. Tr. 18, 402. The ALJ discounted the intelligence testing results that indicated Plaintiff is in the mild mental retardation range and cited contradictory evidence in the record that supported this decision. Tr. 18. An ALJ is authorized to make such a determination.
The Plaintiff contends that the ALJ failed to construct a hypothetical which reasonably conveyed the extent of Plaintiff's mental limitations, because the hypothetical posed did not include all of Plaintiff's credibly established mental limitations. Pl's Br. at 21-25. Plaintiff argues that the opinions from three psychologists and an orthopedist were improperly substituted for lay opinion and speculation. Pl's Br. at 25-26. This argument is not persuasive.
A hypothetical question is not impeachable if it adequately reflects an RFC for which the ALJ has sufficient evidence.
In the instant case, the ALJ asked a hypothetical question that fairly set forth all of Plaintiff's credibly established limitations. Tr. 440-444. The vocational expert's response establishes considerable evidence in support of the ALJ's determination. Tr. 443-445. As discussed above, the ALJ is not required to consider evidence in the record that is not supported by the record, nor is he bound by the opinions of any consultative examiner or treating physician in making his RFC assessment. The Plaintiff had the burden to establish presumptive disability, and the ALJ found that the Plaintiff failed to meet this burden with regard to her alleged cognitive impairments. Consequently, the ALJ did not reflect evidence of those impairments in his hypothetical question to the vocational expert. Therefore, the ALJ fairly considered the substantial evidence and properly posed the hypothetical question based on that evidence.
Because the Court finds the ALJ's decision is supported by substantial evidence, the Commissioner's denial of disability benefits is