RONALD L. BUCKWALTER, District Judge.
Currently pending before the Court are Plaintiff Richard K. McCall's Objections to the Report and Recommendation of United States Magistrate Judge Marilyn Heffley. For the following reasons, the Objections are overruled.
On February 18, 2010, Plaintiff Richard McCall, then forty-five years old, filed applications for Disability Insurance Benefits ("DIB") pursuant to Title II of the Social Security Act, 42 U.S.C. § 401,
Plaintiff initiated the present civil action in this Court on August 19, 2013. His Request for Review set forth three alleged errors as follows: (1) the ALJ erred in evaluating the opinions of Plaintiff's treating physician and the consultative examiner; (2) Plaintiff's bipolar disorder met Listing 12.04 at step three of the sequential evaluation process; and (3) the residual functional capacity ("RFC") assessment is not supported by substantial evidence. On April 22, 2015, United States Magistrate Judge Marilyn Heffley issued a Report and Recommendation ("R&R") recommending that Plaintiff's Request for Review be denied.
Plaintiff filed Objections to the R&R on May 6, 2015,
It is well-established that judicial review of the Commissioner's decision is limited to determining whether "substantial evidence" supports the decision.
Where a party makes a timely and specific objection to a portion of a report and recommendation by a United States Magistrate Judge, the district court is obliged to engage in de novo review of only those issues raised on objection. 28 U.S.C. § 636(b)(1);
Under applicable regulations and controlling case law, "opinions of a claimant's treating physician are entitled to substantial and at times even controlling weight."
In choosing to reject the treating physician's assessment, an ALJ may not make "speculative inferences from medical reports" and may not reject a treating physician's opinion "due to his or her own credibility judgments, speculation or lay opinion."
Plaintiff now contends that the ALJ failed to give appropriate weight to both the opinion of his treating physician Dr. Covaci and the consultative examiner, Dr. Philip Taylor. The Court addresses each individually.
The ALJ discussed Dr. Covaci's opinion as follows:
(R. 18-19.)
Upon review of this decision, the Magistrate Judge found that the ALJ's evaluation of Dr. Covaci's opinion was legally sound and supported by substantial evidence. (R&R 4.) The Magistrate Judge remarked that the ALJ's decision to accord significant weight to Dr. Covaci's opinion to the extent it agreed with the RFC, but not give weight to the portions of the opinion that were inconsistent with the RFC, was proper. She observed that the ALJ cited to evidence of record that supported his RFC analysis, including GAF scores, treatment notes, evaluation observations, and the opinions of the state agency psychiatric consultant, Dr. Charles Lawrence.
Plaintiff now contends that both the ALJ's decision, and the Magistrate Judge's affirmation of that decision, are improper for five reasons. First, Plaintiff suggests that the ALJ's reasoning was improperly conclusory and involved "cherry picking" of Dr. Covaci's opinion, contrary to the "cardinal principle" that the ALJ must view the record as a whole. While an ALJ is bound to consider the entire record, Plaintiff's application of this principle is legally incorrect. So long as the ALJ considers the entirety of a record, the ALJ remains free to accept portions of medical opinions that are supported by substantial evidence of record, while disregarding those that are unsupported by the evidence of record.
Second, Plaintiff asserts that the Magistrate "tried to justify the ALJ's unsubstantiated evaluation of Dr. Covaci's opinion by arguing that `McCall reported that his symptoms are improved with psychotropic mediation.'" (Pl.'s Objections 3 (citing R&R 8).) He goes on to assert that "this somewhat vague logic does not automatically indicate that McCall lacks mental health symptoms or resultant limitations." (Pl.'s Objections 3.) Notably, however, an ALJ may properly discount a treating source's opinion on the basis of claimant's improvement while medicated.
Third, Plaintiff challenges the Magistrate Judge's reference to Plaintiff's GAF scores of between 55 and 65 to support the weight the ALJ assigned to Dr. Covaci's opinion. He contends that the American Psychiatric Association has recommended that the GAF score be dropped from the Diagnostic and Statistical Manual of Mental Disorders ("DSM-5") due to "questionable psychometrics in routine practice." DSM-5 at 16.
"While the significance and use of GAF scores has been debated since the GAF scale was eliminated from the Diagnostic and Statistical Manual of Mental Disorders, an ALJ is not precluded from considering GAF scores as evidence."
No. Civ.A.13-2699, 2015 WL 1608741, at *9 n.2 (M.D. Pa. Apr. 10, 2015). In this case, the ALJ gave the GAF scores assigned by Dr. Corvaci significant, but not controlling weight, based on the fact that they were provided by Plaintiff's examining psychiatric practitioners and were otherwise consistent with the evidence of record. Plaintiff identifies no jurisprudence that would preclude the ALJ from relying on the GAF scores in the manner in which he did.
Fourth, Plaintiff asserts, in cursory fashion, that "if the ALJ was unsure as to the basis of Dr. Covaci's opinion, he had the option to recontact him for clarification in accordance with SSR 96-5p." (Pl.'s Objections 4.) Social Security Ruling 96-5p, however, only provides that, "[b]ecause treating source evidence (including opinion evidence) is important, if the evidence does not support a treating source's opinion on any issue reserved to the Commissioner and the adjudicator cannot ascertain the basis of the opinion from the case record, the adjudicator must make `every reasonable effort' to recontact the source for clarification of the reasons for the opinion." Social Security Ruling 96-5, 1996 WL 374183, at *6 (S.S.A. July 2, 2006). Under these standards, nothing in the record before the Court triggered the ALJ's duty to recontact Dr. Covaci. "[T]he regulation makes clear that the ALJ only need re-contact the medical source when the evidence received from the medical source is inadequate to determine whether or not the claimant is disabled," not because the ALJ finds the doctor's opinion inconsistent with the claimant's medical records.
Finally, Plaintiff remarks simply that Dr. Covaci's opinions in the medical source statement were supported by the finding of the consultative examiner. It is crucial, however, that the ALJ gave significant weight to the majority of Dr. Covaci's opinion, some of which did not correspond to that of the consultative examiner. To the extent the ALJ discounted the portion of Dr. Covaci's opinion that imposed marked restrictions on Plaintiff's ability to respond appropriately to work situations and to changes in a routine work setting, the ALJ appropriately found that the other substantial evidence of record — including treatment notes, examination observations, GAF scores, and the state agency consultant's opinion — undermined the validity of Dr. Covaci's assessment. As such, the mere fact that some evidence supported Dr. Covaci's opinion did not dictate that the ALJ ignore the other contradictory evidence in the record.
In short, the Court finds no error in the ALJ's assessment of Dr. Corvaci. As such, this portion of Plaintiff's first Objection is overruled.
With respect to Dr. Taylor, the ALJ remarked:
(R. 19.) The ALJ found this conclusion to be well supported by substantial evidence in light of the fact that (a) Dr. Taylor assessed claimant's GAF score at 55, which is indicative of no more than a moderate impairment; (b) Dr. Taylor's opinion was based, in part, upon the subjective history provided by the Plaintiff, which the ALJ found to be not entirely credible; and (c) there were objective clinical findings in the record contrary to Dr. Taylor's opinion. Plaintiff now challenges this decision on multiple grounds.
First, Plaintiff again asserts that the ALJ's reliance on the GAF scores was misplaced given the fact that they have been dropped from the DSM-V. As explained in detail above, however, an ALJ may still properly rely on GAF scores as evidence of a claimant's mental functioning.
Second, Plaintiff contends that the Magistrate Judge failed to identify any other inconsistencies in the record, aside from the GAF scores, to support her conclusion. Notably, however, the ALJ — whose decision is under review — specifically noted that Dr. Covaci's psychiatric evaluation showed that Plaintiff's affect was only slightly restricted, that Plaintiff's symptoms were improved with medication, and that Plaintiff was alert and oriented. Moreover, treatment notes revealed that Plaintiff reported doing "pretty well" and abruptly stopped attending therapy sessions. (R. 18.) In addition, the ALJ found that Dr. Taylor's report was based substantially on Plaintiff's own reporting, which the ALJ deemed not entirely reliable. Lastly, the ALJ referenced the opinion of the state agency psychiatric consultant — who opined that Plaintiff had only mild difficulties in many areas of mental functioning — but nonetheless found that Plaintiff's impairments were more severe and limiting.
Finally, Plaintiff avers that Dr. Taylor's opinion that Plaintiff had marked limitations in his ability to respond to work pressures in a routine work setting was supported by the opinion of Dr. Covaci, who imposed the same limitation. As explained in detail above, however, the ALJ properly accorded little weight to this portion of Dr. Covaci's assessment based on the otherwise contrary evidence in the record.
In short, the Court thus finds no error in the ALJ's disregard of Dr. Taylor's opinion to the extent it imposed marked limitations on Plaintiff's functioning. This portion of Plaintiff's Objections is therefore overruled.
Plaintiff's next Objection concerns the ALJ's finding at step three of the sequential evaluation, wherein the ALJ opined that Plaintiff did not meet or medically equal the criteria of Listing 12.04. Listing 12.04 provides the listing criteria for affective disorders. A claimant will meet the listing only when the requirements of both "paragraph A" and "paragraph B" are satisfied, or when the requirements in "paragraph C" are satisfied. 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.04. A claimant will satisfy the "paragraph A" criteria through medically documented persistence of depressive syndrome, manic syndrome, or bipolar syndrome, each of which is characterized by its own list of symptoms. 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.04A. To meet the "paragraph B" criteria of Listing 12.04, a claimant must prove two of the following: marked restriction in activities of daily living; marked difficulties in maintaining social functioning; marked difficulties in maintaining concentration, persistence and pace; or repeated episodes of decompensation, each of extended duration. 20 C.F.R., pt. 404, subpt. P, app. 1, § 12.04(B).
With respect to the paragraph B criteria, the ALJ, in this case, found that Plaintiff had a mild restriction in activities of daily living, moderate difficulties in both social functioning and concentration, persistence, or pace, and no episodes of decompensation which have been of extended duration. The Magistrate Judge found this decision to be well supported by substantial evidence. Plaintiff now contends that the moderate limitations in both social functioning and concentration, persistence, or pace are undermined by the record.
As to social functioning, Plaintiff asserts that his Adult Function Report revealed that he rarely speaks to anyone on the phone, does not attend church, community centers, or sporting events, and does not participate in any social groups. (R. 227.) Further, Plaintiff indicated that he has a quick temper, which gets in the way of his building relationships and has resulted in him getting fired by past employers. (
As noted by the Report and Recommendation, however, the ALJ properly observed that Plaintiff reported spending time talking with family members, attending summer parties at his sister's home, and speaking to his neighbors. (R&R 12.) Moreover, the ALJ appropriately discounted Dr. Taylor's assessment as unsupported by the remainder of the evidence of record. Finally, Dr. Corvaci expressly opined that Plaintiff had only a moderate limitation in his ability to interact with supervisors and co-workers — an opinion to which the Court gave weight in light of the doctor's ability to observe functional limitations caused by Plaintiff's mental impairments. (R. 19.) Accordingly, the Court finds the ALJ's decision in this area to be supported by substantial evidence.
As to the limitation on concentration, persistence, and pace, the ALJ found only moderate difficulties, as follows:
(R. 16.) Plaintiff, however, asserts that this reasoning is flawed on several grounds. First, at the hearing, Plaintiff testified both that he maintained a stamp collection only before he became disabled and not during his disability, and that his mother helped him do research on the internet. Second, Plaintiff testified that he suffered from racing thoughts, panic attacks, hearing voices, and visual hallucinations. Third, both Dr. Taylor and Dr. Covaci opined that Plaintiff had marked limitations in this area. Finally, Plaintiff contends that both the ALJ and the Magistrate failed to cite any medical source that supports only a moderate limitation in concentration, persistence, and pace.
Again, however, Plaintiff's arguments are unfounded. As properly noted by the R&R, Plaintiff expressly testified at his hearing that he spends time working on his stamp collection "a lot, . . . moving stuff around and working on my displays." (R. 45.) His mother went on to note that "once he starts working on it he might spend the whole afternoon on it and then maybe he won't work on it again for a while, you know, or look at them" — testimony that undermines a marked impairment in concentration. (R. 62-63.) Moreover, contrary to his current argument, Plaintiff never testified that he needed his mother's help to use the internet. Further, although Plaintiff complained of racing thoughts, panic attacks, and hallucinations, the ALJ properly explained why he did not give full credence to Plaintiff's statements. In addition, as throughly discussed above, the ALJ appropriately rejected the marked limitations imposed by Drs. Covaci and Taylor. Finally, and again contrary to Plaintiff's argument, the ALJ properly cited to evidence to support a no more than moderate limitation on concentration, persistence, and pace, including treatment notes showing limited symptoms, lack of continued treatment, moderate GAF scores, the opinion of the state agency consultant, and Plaintiff's own testimony. While the ALJ could have properly concluded that a more restrictive limitation was appropriate, the ALJ's decision is supported by enough relevant evidence as a reasonable mind might accept as adequate to support his conclusion.
In any event, even if Plaintiff could have proven a marked limitation in this area, the record clearly provides substantial evidence for the ALJ's ruling that Plaintiff did not have marked limitations in two of the Paragraph B areas of functioning for Listing 12.04. Therefore, Plaintiff's Objection on this ground is overruled.
Plaintiff's final objection asserts that the ALJ failed to account for Plaintiff's moderate difficulty in concentration, persistence, or pace. The ALJ's RFC limited Plaintiff to performing routine, repetitive tasks. Yet, according to Plaintiff, courts in the Third Circuit have refused to uphold an ALJ's ruling where a claimant either "often" had deficiencies or had "moderate" deficiencies in concentration, persistence, or pace, and where the the ALJ only limited the claimant to non-detailed, simple and routine and/or low stress work. Plaintiff's argument is meritless.
While Plaintiff is correct that Third Circuit precedent requires an ALJ to include restrictions specific to nonexertional limitations, including concentration, persistence, and pace,
Giving weight to the credible portions of Dr. Covaci's opinion and other portions of the record, the ALJ, in this case, indicated that Plaintiff was limited to performing routine, repetitive tasks and was restricted from both contact with the public and close cooperation with co-workers to achieve job tasks. Under the wealth of jurisprudence, the Court finds no error in such an RFC and, thus, overrules Plaintiff's Objection on this issue.
As noted above, this Court's review of the ALJ's decision is limited to determining whether "substantial evidence" supports the decision.
An appropriate Order follows.
Plaintiff also cites
