JACKSON L. KISER, Senior District Judge.
On February 10, 2011, Plaintiff filed an application for a period of disability insurance benefits pursuant to Title II of the Social Security Act ("the Act"), and supplemental security income pursuant to Title XVI.
On July 25, 2012, Plaintiff appeared with her attorney before Administrative Law Judge Drew A. Swank ("the ALJ"). (R. 25.) Only Plaintiff testified at the hearing. (R. 27-43.) In a written decision dated August 13, 2012, the ALJ determined that Plaintiff was not disabled within the meaning of the Act. (
After consideration of the entire Record, the ALJ concluded that Plaintiff has the residual functional capacity ("RFC") to perform light work as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b), with some limitations. (R. 14-15.) Specifically, the ALJ determined that Plaintiff "cannot perform repetitive gripping, grasping, pushing, pulling or overhead work with the left upper extremity, can only occasionally climb and kneel but must avoid crawling, and must avoid heights and hazards." (R. 15). The ALJ determined that Plaintiff was capable of performing past relevant work as a retail manager, nanny, and store clerk, and that those positions did not implicate any of the work-related limitations of Plaintiff's RFC. (R. 19-20 (citing 20 C.F.R. §§ 404.1565, 416.965.) Accordingly, he concluded that Plaintiff was not disabled within the meaning of the Act. (R. 20.) The Appeals Council denied Plaintiff's request for review, and the decision of the ALJ became the final decision of the Commissioner on September 25, 2013. (R. 1-3.)
On November 18, 2013, Plaintiff filed suit in this Court to challenge the final decision of the Commissioner. (Compl. [ECF No. 1].) Pursuant to 28 U.S.C. § 636(b)(1)(B), I referred the case to the United States Magistrate Judge for consideration. Plaintiff and the Commissioner filed cross-motions for summary judgment. (Pl.'s Mot. Summ. J., Aug. 8, 2014 [ECF No. 16]; Def.'s Mot. Summ. J., Oct. 1, 2014 [ECF No. 20].) On February 9, 2015, Judge Hoppe filed his Report and Recommendation, recommending that I affirm the final decision of the Commissioner. (R&R, Feb. 9, 2015 [ECF No. 24].) On February 26, 2015, Plaintiff filed objections to the R&R. (Pl.'s Obj., Feb. 26, 2015 [ECF No. 25] [hereinafter "Pl.'s Obj."].) The Commissioner did not respond, and the matter is now ripe for review.
Congress has limited the judicial review I may exercise over decisions of the Social Security Commissioner. I am required to uphold the decision where: (1) the Commissioner's factual findings are supported by substantial evidence; and (2) the Commissioner applied the proper legal standard.
The Commissioner is charged with evaluating the medical evidence and assessing symptoms, signs, and findings to determine the functional capacity of the claimant. 20 C.F.R. §§ 404.1527-404.1545 (2014);
Plaintiff's first objection goes to the extent of the ALJ's consideration of the state agency physicians' opinion that Plaintiff can "only reach in front and to the side with her left arm. ..." (Pl.'s Obj. pg. 1.) Plaintiff contends that the ALJ failed to consider these opinions and, therefore, there is no basis in the Record to reject them. Additionally, she contends that the Magistrate, in concluding that the ALJ did consider this opinion, created a "logical bridge" that the ALJ omitted. (
I certainly agree with Plaintiff that it is not this Court's province to perform functions the ALJ failed to do.
(R. 18 (citing R. 324-27).) By his own words, the ALJ considered the opinions of the state agency's physicians regarding Plaintiff's "postural maneuvers," but rejected them because, with the exception of one occasion, Plaintiff never complained of having the problems identified by the state agency physicians.
"[A] point-by-point articulation of each inconsistency [between the treatment notes and a treating physician's opinion as to a claimant's functional capacity] is not required for the court to understand the ALJ's reasons for weight given the opinion."
Plaintiff next takes issue with the Judge Hoppe's conclusion that the ALJ properly considered and rejected Nurse Lange's opinion. First, Plaintiff asserts that Nurse Lange is a "clearly a treating source and the correct analysis is whether or not she is an acceptable or non-acceptable medical source under the regulations." (Pl.'s Obj. Pg. 4.) As a matter of first principles, "only `acceptable medical sources' can be considered treating sources as defined in 20 C.F.R. 404.1502 and 416.902, whose medical opinions may be entitled to controlling weight." SSR 06-03P, 2006 WL 2329939, at *2 (Aug. 9, 2006) (citing 20 C.F.R. §§ 404.1527(d), 416.927(d)). "Acceptable medical sources are ... licensed physicians ... licensed or certified psychologists ... licensed optometrists ... licensed podiatrists ... and qualified speech-language pathologists. ..." 20 C.F.R. § 404.1513(a). Thus, it is clear that Nurse Lange is not an "acceptable medical source," and therefore she cannot be considered a "treating source."
Regardless of the labels given to Nurse Lange, "the ALJ is required to at least consider the opinion of a non-acceptable medical source ... especially when ... the non-acceptable medical source had a lengthy relationship with the claimant and can present relevant evidence as to the claimant's impairment or ability to work."
Plaintiff objects to Judge Hoppe's conclusion that a "gap in treatment and the completion of the medical source statement was a proper basis for the ALJ to reject Nurse Lange's opinions." (Pl.'s Obj. pg. 4.) It is important to note that Nurse Lange treated Plaintiff for nearly two years, but over a year passed
Plaintiff contends that the ALJ "simply rejected Nurse Lange's opinions based on the gap without properly considering all the other factors to be considered when weighing a medical source's opinion." (Pl.'s Obj. pg. 4.) The factors to be considered when weighing a medical opinion are: examining relationship; treatment relationship; length of the treatment relationship and the frequency of examination; mature and extent of the treatment relationship; supportability; specialization; and other factors.
Plaintiff's objection ignores a detailed justification for rejecting Nurse Lange's opinion. The ALJ stated that Nurse Lange's opinion was not entitled to controlling weight for a variety of reasons. First, Nurse Lange's opinion was rejected because "the diagnostic and physical examinations have not revealed any disabling findings." (R. 19.) Second, the ALJ stated that Plaintiff's "history of treatment and lack of any ongoing treatment by a physician who specializes in musculoskeletal impairments in addition to lack of any therapy or surgery since allegedly becoming disabled is inconsistent with an individual experiencing disabling symptoms." (
Rather, Plaintiff argues that, during the one-year gap in treatment, Nurse Lange had access to Plaintiff's treatment records "with these other providers" and was therefore "well aware of [P]laintiff's impairments and resulting limitations. ..." (Pl.'s Obj. pg. 5.) Even if that is true (and there is no evidence in the Record that Nurse Lange maintained control over Plaintiff' medical records with other physicians), the Record does not support the severe functional limitations Nurse Lange imposed on Plaintiff. Nurse Smith referred Plaintiff to Dr. Robert Cassidy, an orthopedic surgeon, during the one-year gap in treatment. (
Plaintiff contends that the ALJ ignored or improperly rejected findings and diagnostic results in the Record. She contends that the ALJ ignored diagnostic findings of osteoarthritis, spondylosis, and multilevel degenerative disc disease. (Pl.'s Obj. pg. 5.) This argument is meritless, since the ALJ held that Plaintiff suffered from osteoarthritis and degenerative disc disease of the cervical and lumbar spine. (R. 11.) He also concluded that these disorders "are not slight and have more than a de minimis effect on the claimant's ability to perform basic work activities." (R. 12.) Thus, the Record is not only clear that the ALJ considered Plaintiff's osteoarthritis and multilevel degenerative disc disease, but that he found Plaintiff actually suffered from these impairments.
Plaintiff next asserts the a 2009 bone scan and MRI revealed degenerative changes that supported Nurse Lange's ultimate opinion on Plaintiff's functional limitations. It is clear that the ALJ considered these tests. He expressly referenced both tests, but found that subsequent self-reporting and diagnostic testing indicated that the degenerative changes shown in these tests were minor. (
Plaintiff next objects to the ALJ's conclusion that "non-narcotic medication, muscle relaxers, heat, and exercise prescribed by Nurse Lange to treat [P]laintiff's impairments was `routine and conservative' and properly provided a basis for the ALJ to reject Nurse Lange's opinions." (Pl.'s Obj. pg. 6.) "There exists no bright-line rule between what constitutes `conservative' versus `radical' treatment."
Again, Plaintiff objects to the ALJ's conclusion, not his methodology. The ALJ considered and discussed Plaintiff's medication and treatment regime (
Moreover, Plaintiff is simply wrong that "Plaintiff's degenerative conditions and muscle spasms are not impairments to be treated with surgery as noted by orthopedic surgeon Dr. Robert Cassidy." (Pl.'s Obj. pgs. 6-7.) Dr. Cassidy does not state in any fashion that Plaintiff's impairments, regardless of their severity, cannot be treated by surgery. (
Plaintiff also disagrees with the ALJ's conclusion that Plaintiff's self-reported activities of daily living are inconsistent with Nurse Lange's functional limitations and therefore justifies rejecting Nurse Lange's opinion. She also contends that the ALJ "erred in equating the ability to perform a few household chores sporadically during the week with working on a sustained basis eight hours per day and five days per week." (Pl.'s Obj. pg. 7.) It is well-settled that an ALJ may discount any medical opinion of a claimant's functional limitations when that opinion is inconsistent with the claimant's daily activities.
When I consider the Record as a whole, none of Plaintiff's objections relating to Nurse Lange's opinions carries the day. Therefore, Plaintiff's objections regarding the ALJ's treatment of Nurse Lange's opinions will be overruled.
Plaintiff next objects to Judge Hoppe's conclusion that substantial evidence supports the ALJ's credibility finding. The ALJ concluded that Plaintiff's activities of daily living belie her claim that she is totally disabled, and that the medical evidence does not support the limitations she claims. In seeking to overturn those decisions, Plaintiff repackages her objection from earlier regarding her activities of daily living and the objective medical evidence. As stated above, however, there is substantial evidence in the Record to support the ALJ's decision on those two points. Plaintiff will not prevail by simply repurposing her arguments regarding Nurse Lange and applying them against the ALJ's decision as a whole. The objection will be overruled.
Finally, Plaintiff objects to the ALJ's reliance on Vocational Expert ("VE") testimony from a prior claim filed by Plaintiff. She asserts that the ALJ relies on the VE's testimony from her prior appeal in order to conclude that Plaintiff's RFC did not preclude her from gainful employment. Because, as stated above, the ALJ's RFC determination was supported by substantial evidence, and because the ALJ's RFC in this case was the "same exact" RFC as determined in the prior appeal, reliance on the VE's testimony from the prior appeal was proper. The hypothetical encompassing Plaintiff's limitations listed the same limitations as ALJ Swank determined in the present case. Nothing precludes the ALJ from relying on evidence from Plaintiff's prior appeal.
Because substantial evidence support the ALJ's decision with regards to Plaintiff's RFC, Nurse Lange's opinion, Plaintiff's credibility, and the prior testimony of a VE, Plaintiff's objections will be overruled. I have reviewed the remainder of the Record for clear error and, finding none, will adopt the Report and Recommendation in its entirety and grant the Commissioner's motion for summary judgment.
The Clerk is directed to send a copy of this Memorandum Opinion and the accompanying Order to all counsel of record as well as to Magistrate Judge Hoppe.