GREGORY J. FOURATT, Magistrate Judge.
THIS MATTER is before the Court upon Plaintiff Norma Jean Garza's "Motion to Reverse or Remand the Administrative Decision" [ECF 19] ("Motion"). The Motion is fully briefed. See ECFs 20 (Plaintiff's Supporting Memorandum), 24 (Commissioner's Response), 25 (Plaintiff's Reply). Having meticulously reviewed the entire record and the parties' briefing, the Court recommends that the Commissioner's final decision be
Plaintiff was born in 1959 and graduated from high school in 1978. Administrative Record (AR) 192, 204. She obtained a commercial driver's license and worked as a bus driver for the city of Albuquerque from January 1999 to February 2015. AR 46. She stopped working when, after asking a drunk man to leave the bus and the man began kicking the tires, she inadvertently ran over his legs—causing them to be amputated. AR 46, 163, 307. Approximately three months later, in May 2015, she applied for social security disability benefits, claiming that she suffered from disabling "Depression and Anxiety (PTSD)." AR 68, 72.
In November 2015, the Social Security Administration (SSA) denied Plaintiff's claim, concluding that, although she had "some limitations," such limitations "would not prevent [her] from performing past relevant work as [a] Bus driver." AR 79. In May 2016, upon her request for reconsideration, the SSA again denied her claims, concluding that she could not perform her past work—but that she could nevertheless "perform work that is less demanding." AR 96, 106. Plaintiff then requested a hearing, which was held in July 2017 before Administrative Law Judge (ALJ) Ann Farris. AR 41, 113. In December 2017, the ALJ concluded that Plaintiff was not disabled. AR 35.
Plaintiff asserts that, as a matter of law, the ALJ should have found her to be disabled. Compl. 2; Mem. 21-22. Specifically, she argues that the ALJ gave too little weight to those medical opinions that could have supported a finding of disability and too much weight to those that did not. Mem. 7-13, 21-22. Plaintiff further contends that the ALJ's factual findings that relied on such weights—i.e., the findings that Plaintiff had no "listed impairments," that she had the capacity to work, and that she was not disabled—were therefore erroneous. Mem. 13-23; AR 19-34.
The Court's review of an ALJ's decision is both legal and factual. See Maes v. Astrue, 522 F.3d 1093, 1096 (10th Cir. 2008) ("The standard of review in a social security appeal is whether the correct legal standards were applied and whether the decision is supported by substantial evidence." (citing Hamilton v. Sec'y of Health & Human Servs., 961 F.2d 1495, 1497-98 (10th Cir. 1992))).
In determining whether the correct legal standards were applied, the Court reviews "whether the ALJ followed the specific rules of law that must be followed in weighing particular types of evidence in disability cases." Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (quoting Hackett v. Barnhart, 395 F.3d 1168, 1172 (10th Cir. 2005)). The Court may reverse and remand if the ALJ failed to "apply correct legal standards" or "show . . . [he or she] has done so." Hamlin v. Barnhart, 365 F.3d 1208, 1214 (10th Cir. 2004) (citing Winfrey v. Chater, 92 F.3d 1017, 1019 (10th Cir. 1996)).
The Commissioner's findings "as to any fact, if supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g) (emphasis added). "Under the substantial-evidence standard, a court looks to an existing administrative record and asks whether it contains `sufficien[t] evidence' to support the agency's factual determinations." Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019) (brackets in original) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). "And . . . the threshold for such evidentiary sufficiency is not high. Substantial evidence, [the Supreme] Court has said, is more than a mere scintilla." Id. (internal quotation marks and citation omitted). "It means—and means only—such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. (internal quotation marks omitted).
Under this standard, a court should still meticulously review the entire record, but it may not "reweigh the evidence nor substitute [its] judgment for that of the agency." Newbold v. Colvin, 718 F.3d 1257, 1262 (10th Cir. 2013) (quoting Branum v. Barnhart, 385 F.3d 1268, 1270 (10th Cir. 2004)); Hamlin, 365 F.3d at 1214. Indeed, a court is to "review only the sufficiency of the evidence, not its weight." Oldham v. Astrue, 509 F.3d 1254, 1257 (10th Cir. 2007) (emphasis in original). Therefore, "[t]he possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's findings from being supported by substantial evidence." Lax, 489 F.3d at 1084 (quoting Zoltanski v. F.A.A., 372 F.3d 1195, 1200 (10th Cir. 2004)). Furthermore, a court "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." Id. (quoting Zoltanski, 372 F.3d at 1200) (brackets omitted).
Ultimately, if the correct legal standards were applied and substantial evidence supports the ALJ's findings, the Commissioner's decision stands and Plaintiff is not entitled to relief. Langley v. Barnhart, 373 F.3d 1116, 1118 (10th Cir. 2004); Hamlin, 365 F.3d at 1214.
To qualify for disability benefits, a claimant must establish that he or she is unable to "engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A) (emphasis added).
The SSA has devised a five-step sequential evaluation process to determine disability. See 20 C.F.R. § 404.1520(a)(4); Barnhart v. Thomas, 540 U.S. 20, 24-25 (2003). The claimant bears the burden of proof at steps one through four. See Bowen v. Yuckert, 482 U.S. 137, 146 & n.5 (1987); Grogan v. Barnhart, 399 F.3d 1257, 1261 (10th Cir. 2005); Williams v. Bowen, 844 F.2d 748, 750-51, 751 n.2 (10th Cir. 1988). In the first four steps, the claimant must show (1) that she "is not presently engaged in substantial gainful activity," (2) that she "has a medically severe impairment or combination of impairments," and either (3) that the impairment is equivalent to a listed impairment
If the claimant has advanced through step four, the burden of proof then shifts to the Commissioner to show that the claimant nonetheless retains sufficient capacity "to perform other work in the national economy in view of [her] age, education, and work experience." Yuckert, 482 U.S. at 142, 146, n.5.
In her December 2017 written decision, the ALJ affirmed that she carefully considered "all the evidence" and "the entire record." AR 15, 17, 24.
At step one, the ALJ found that Plaintiff had not engaged in "substantial gainful activity" since February 2015, the alleged onset date of her disability. AR 17-18.
Before performing the step four analysis, in which the ALJ considers whether a claimant can perform past work, the ALJ must first determine the claimant's "residual functional capacity" (RFC).
AR 24. In discussing the evidence and reasoning that led to this RFC finding, the ALJ began by reviewing Plaintiff's allegations that her "anxiety, PTSD, and depression" prevent her from working. AR 25-26, 49. As set forth below, however, the ALJ found that Plaintiff's "statements concerning the intensity, persistence and limiting effects of [her] symptoms [were] not entirely consistent with the medical evidence and other evidence in the record." AR 26.
The ALJ observed that "[t]he medical evidence of record show[ed] that [Plaintiff] was diagnosed with these conditions [i.e., depression and anxiety (PTSD)], and evidence[d] her treatment." AR 26. The evidence, however, "also show[ed] that [Plaintiff] was interested in leaving her position as a bus driver prior to the alleged [disability] onset date, and for different reasons." AR 26-27 (citing Plaintiff's diagnoses, on separate occasions around mid-2014, of vertigo, "non-cardiac chest pain," and hypothyroidism and Plaintiff's representation to a nurse that her job "[would] not find her light duty," along with that nurse's (unelaborated) notation that Plaintiff "[was] not able to work as a bus driver"). The ALJ also noted that, in August 2014, "her depression was reported as `much better.'" AR 27.
The ALJ also observed that, on the day of Plaintiff's alleged disability onset date in February 2015, she was "assessed with anxiety related to work, and the plan was no work for two weeks." Id. The medical notes from two weeks later stated that she was still "scared of driving" and recommended "no work till seen by psych." Id. The psychiatrist, Parvaneh Bakhtiar, M.D., saw Plaintiff in early April 2015 and completed a leave application form, noting that Plaintiff's "period of incapacity [would] last only two to three months." Id. Approximately one month later, Dr. Bakhtiar also "completed what appear[ed] to be [a private] application for disability benefits . . ., stating that [Plaintiff] was `totally disabled' from April 1, 2015 through `ongoing.'" Id. (emphasis added). The ALJ, however, gave no weight to this "medical opinion" because "it [was] not sufficiently well-explained, contain[ed] no factual support for its assertions, contradict[ed] without explanation [Dr. Bakhtiar's previous] statements which estimated two to three months of incapacity and [was] based on three stated dates of treatment." Id.
The ALJ also reviewed two subsequent opinions from Dr. Bakhtiar, from June 2015 and July 2016, that were completed to use as part of Plaintiff's SSA disability application. AR 31-32. These opinions consisted of a "questionnaire" form and a "mental residual functional capacity assessment" form and were "loosely based on outdated or misstated social security listing information." AR 31, 351-57, 391-97. Dr. Bakhtiar checked boxes (or circled answers) on these forms that classified Plaintiff as having, inter alia, (1) a "complete inability to function outside the area of [her] home," (2) "marked" limitations in all four "areas of mental functioning" ("understanding and memory," social functioning, "concentration, persistence or pace," and ability to adapt or manage herself), and (3) "three [qualifying] episodes of deterioration or decompensation in work or work like settings." AR 19-22, 31, 354-57, 394-97 (emphasis added).
Although the ALJ acknowledged that Dr. Bakhtiar was a "treating acceptable medical source," she nevertheless gave her opinions "little weight" because they were inconsistent with the evidence and contained "inadequate factual support:"
AR 31-32 (citing Plaintiff's testimony).
The ALJ also reviewed three opinions, expressed on similar "questionnaire" forms, from a "non-acceptable medical source," Kevin Heiskala, a licensed clinical social worker. AR 19, 30-31. Mr. Heiskala's first opinion, from June 2016, classified Plaintiff as having, inter alia, "marked" limitations in two out of four areas of mental functioning (i.e., social functioning and "concentration, persistence or pace"). AR 30, 387-89. Mr. Heiskala's second opinion, from May 2017, classified Plaintiff has having no "marked" limitations in the four areas of mental functioning
AR 30-31 (emphasis added). Consequently, the ALJ gave "no weight" to Mr. Heiskala's opinions and explained her reasoning as follows:
AR 31 (emphasis added).
The ALJ reviewed the opinion of a consultative psychologist, Louis Wynne, Ph.D., from October 2015. AR 28-29. After interviewing Plaintiff and performing a mental status examination, Dr. Wynne opined that Plaintiff had some mental limitations:
AR 367. The ALJ gave this opinion "moderate" weight and provided a number of reasons for doing so:
AR 29.
The ALJ also reviewed the opinion of state agency psychological consultant Sheri L. Simon, Ph.D., who examined the record at the initial disability determination level. AR 29-30, 74-78. At the reconsideration level, state agency psychological consultant Hillel Raclaw, Ph.D., reviewed this opinion and adopted it. AR 30, 90-94. These opinions reviewed Plaintiff's potential limitations within four general areas of mental functioning. AR 74-78, 90-94. In the first area, "understanding and memory," these doctors found moderate limitations in one out of three subcategories.
AR 30.
At step four, given the RFC described above, the ALJ found that Plaintiff was unable to perform her past relevant work as a bus driver "because it involves working with the public." AR 33. At step five, however, the ALJ found that Plaintiff was able to successfully adjust to "other work that exists in significant numbers in the national economy." AR 33-34.
Plaintiff argues that the ALJ erred by giving too little weight to opinions from three sources (i.e., the treating physician, Dr. Bakhtiar; the "non-acceptable" medical source, Mr. Heiskala; and the examining psychologist, Dr. Wynne) and too much weight to medical opinions from two sources (i.e., the non-examining state agency doctors, Drs. Simon and Raclaw). Mem. 7-13, 21-22. As explained below, this Court disagrees.
The weight that an ALJ gives to a medical opinion "will vary according to the relationship between the disability claimant and the medical professional." Hamlin, 365 F.3d at 1215 (citing 20 C.F.R. § 404.1527(c)). For example, "[t]he ALJ is required to give controlling weight to the opinion of a treating physician"—but only if certain conditions are met. Id.
"[I]n determining what weight to give any medical opinion," the ALJ must "consider a series of [six] specific factors." Hamlin, 365 F.3d at 1215 (emphasis added) (citation omitted).
Plaintiff argues that—because she met with her treating psychiatrist, Dr. Bakhtiar, "on a monthly basis for over one year" and because Dr. Bakhtiar's treatment notes "support[]" her opinion—Dr. Bakhtiar's opinion "was entitled to controlling weight." Mem. 8-9 (citing C.F.R. §404.1527). This Court disagrees.
The ALJ was not required to give controlling weight to any of Dr. Bakhtiar's opinions. Plaintiff, for example, cites to no "medically acceptable clinical and laboratory diagnostic techniques," Hamlin, 365 F.3d at 1215, that support Dr. Bakhtiar's April 2015 opinion that she was "totally disabled" or Dr. Bakhtiar's subsequent opinions that she had a "complete inability to function" outside the home, "marked" limitations in all four "areas of mental functioning," or "three [qualifying] episodes of deterioration or decompensation." See Mem. 8-9; Reply 2-3. And after meticulously reviewing the record, this Court is aware of no such evidence. See AR 311-425 (medical records). In addition, Plaintiff provides no explanation for how such opinions "[are] not inconsistent with other substantial evidence in the record," Hamlin, 365 F.3d at 1215. See Mem. 8-9; Reply 2-3. As explained in Section V(B) below, there is substantial evidence that Plaintiff is not as limited as Dr. Bakhtiar's opinions portray.
Furthermore, the ALJ gave "good reasons," Oldham, 509 F.3d at 1258, for giving "no weight" to Dr. Bakhtiar's April 2015 opinion that she was "totally disabled." See supra Section IV(B)(1) (quoting AR 27) (ALJ noting that the opinion was not well-explained, lacked factual support, was based on three dates of treatment, and inexplicably contradicted the doctor's previous estimates of two to three months of incapacity). The ALJ likewise gave good reasons for assigning "little weight" to Dr. Bakhtiar's subsequent opinions from June 2015 and July 2016. See id. (quoting AR 31-32) (ALJ noting that these opinions were inconsistent with the medical evidence, inconsistent with Plaintiff's testimony about her own abilities, and lacked factual support). Consequently, "[n]othing more was required." Oldham, 509 F.3d at 1258.
Plaintiff argues that the opinion of the "non-acceptable" medical source, Mr. Heiskala, was "consistent with other evidence in the record" and therefore "should have been accorded significant weight." Mem. 9-11 (citing Social Security Ruling (SSR) 06-03p, 71 Fed. Reg. 45593 (Aug. 9, 2006)
To begin, the assertion that—because some other piece of evidence could support a "non-acceptable" medical source's opinion—such an opinion "warrants significant weight" is incorrect. Mem. 9-10; see SSR 06-03p (reviewing the six factors that the ALJ generally considers and noting that "[t]he evaluation of an opinion from a medical source who is not an `acceptable medical source' depends on the particular facts in each case"); supra note 16 (list of the six specific factors). Instead, the question is whether the ALJ provided "good reasons," Oldham, 509 F.3d at 1258, for the weight she gave to these opinions. And the ALJ gave "good reasons" for assigning Mr. Heiskala's significantly inconsistent opinions "no weight." See Section IV(B)(2) (quoting AR 30-31) (ALJ explaining that Mr. Heiskala's opinions were (1) internally inconsistent, (2) inconsistent with each other, (3) inconsistent with the medical evidence, (4) inconsistent with Plaintiff's own testimony, (5) not well-explained, and (6) lacked factual support). Consequently, "[n]othing more was required." Oldham, 509 F.3d at 1258.
Plaintiff argues that the ALJ erroneously failed to (1) give the opinion of the examining psychologist, Dr. Wynne, more than "moderate weight" or (2) apply that opinion to her RFC findings. Mem. 11-13; Reply 5. This Court disagrees.
To begin, the ALJ had "good reasons," Oldham, 509 F.3d at 1258, for assigning only "moderate weight" to Dr. Wynne's opinion that Plaintiff's "concentration and ability to persist . . . [were] at least moderately impaired," that she could "interact with the general public" (but would have difficulty with coworkers or supervisors), and that she "might have difficulty adapting to changes in the workplace." AR 367. Although the ALJ noted that Dr. Wynne's opinion was "generally consistent with the medical record" and supported with his observations, he did not give it greater weight because he (1) examined Plaintiff only once, see Robinson, 366 F.3d at 1084 (observing that "[t]he opinion of an examining physician is generally entitled to less weight than that of a treating physician"), (2) did not examine all of the medical and other records, (3) based his opinion primarily on Plaintiff's subjective reports, and (4) failed to provide "detail[s] as to the basis for his opinion." AR 29.
Finally, because the ALJ properly assigned "moderate weight" to this opinion, there is no requirement that she somehow incorporate the entire opinion (or at least those portions that are most favorable to Plaintiff) into her RFC finding, as Plaintiff seems to imply. See Mem. 12; Reply 3-4.
Plaintiff argues that the "outdated opinions" of the non-examining state agency doctors "should have been given the least weight." Mem. 12-13 (citing 20 C.F.R. § 404.1527(c)). Again, this Court disagrees.
As with the other opinions reviewed above, the ALJ likewise gave "good reasons" for giving the "greatest weight" to the opinions of Drs. Simon and Raclaw that Plaintiff had the capacity to work in unskilled jobs with limited social interaction: (1) they were experts that were familiar the SSA's mental disability standards, (2) they reviewed the medical record, (3) they provided "a more reasonable, consistent and objective overview" of the evidence, (4) their opinions were consistent with the evidence, (5) their opinions were well-explained, (6) their opinions were well-supported factually, and (as illustrated above) (7) most of the other opinions were "internally inconsistent, overstated and inconsistent with [Plaintiff's] testimony and the medical record." AR 30. Although such opinions are generally "entitled to the least weight of all, Robinson v. Barnhart, 366 F.3d at 1084, there is no rule precluding them from receiving greater weight than the opinions of treating or examining sources—particularly when, as here, there are both "good reasons" to give less weight to the opinions of the treating an examining sources, see supra Section V(A)(2)-(4), and "good reasons" to give greater weight to the opinions of these agency physicians. Consequently, given the "good reasons" for the weight given to these opinions, "[n]othing more was required." Oldham, 509 F.3d at 1258.
Given that the ALJ did not improperly weigh the opinion evidence, the remaining issues are easily resolved. See also Reply 5 (Plaintiff, after advocating for greater weight to the opinions from the first three sources discussed above, acknowledging that "all further analysis is dependent on consideration of this [opinion] evidence").
First, the ALJ's finding at step three that Plaintiff had no "listed impairment" was supported by substantial evidence. AR 19-24. At step three, the ALJ relied—not on the opinions of Dr. Bakhtiar or Mr. Heiskala—but on the opinions of Drs. Wynne, Simon, and Raclaw and Plaintiff's own testimony. AR 22-23. As discussed above, the ALJ was not required to give more weight to the opinions of Dr. Bakhtiar or Mr. Heiskala or less weight to the opinions of Drs. Wynne, Simon, and Raclaw—and it is not this Court's role to "reweigh the evidence." Newbold, 718 F.3d at 1262; see also Oldham, 509 F.3d at 1257 (stating that courts may review "only the sufficiency of the evidence, not its weight"). Furthermore, the evidence that the ALJ relied on at step three (i.e., the opinions of Drs. Wynne, Simon, and Raclaw and Plaintiff's testimony) is "more than a mere scintilla" and therefore meets the substantial evidence "threshold for . . . evidentiary sufficiency." Biestek, 139 S. Ct. at 1154.
Second, the ALJ's RFC findings and her ultimate finding of no disability were supported by substantial evidence. The evidence on which the ALJ relied in making her RFC findings— including Plaintiff's testimony, the medical evidence, and the opinions of Drs. Wynne, Simon, and Raclaw—is likewise "more than a mere scintilla"—i.e., "such relevant evidence as a reasonable mind might accept as adequate to support [the ALJ's] conclusion" that Plaintiff could "perform a full range of [medium and unskilled] work" with certain "nonexertional" limitations (e.g., no driving, few workplace changes, and minimal social interaction). Id. (emphasis added). Consequently, in light of this RFC and the vocational expert's testimony at steps four and five, the latter of which was not challenged by Plaintiff,
Finally, the ALJ "consider[ed] all of the evidence," 20 C.F.R. § 404.1520(a)(3), and properly omitted from her RFC finding certain opined functional limitations—limitations that were expressed in the previously discounted opinions of Dr. Bakhtiar, Mr. Heiskala, and Dr. Wynne. Although Plaintiff asserts that the ALJ failed to consider such limitations, See Mem. 16-21,
The ALJ applied the correct legal standards and her findings and decision were supported by substantial evidence.