Opinion
Case No. 98 C 6561
August 22, 2000
MEMORANDUM OPINION AND ORDER
Plaintiff, Alyce Ashpaugh, seeks judicial review of the final decision of the Commissioner of Social Security ("Commissioner") that she was not entitled to Disability Insurance Benefits ("DIB") or Supplemental Security Income ("SSI"). 42 U.S.C. § 423(d)(2), 1383(a)(3). Both parties have moved for summary judgment seeking a favorable decision, and have consented to have this Court conduct any and all proceedings, including the entry of final judgment. See 28 U.S.C. § 636(c). For the reasons below, this Court affirms the Commissioner's final decision and grants its motion for summary judgment.
Plaintiff filed a motion for summary judgment pro se.
I. Procedural History
Plaintiff applied for DIB and SSI in January and July of 1993, and again in March of 1995, alleging disability due to orthopedic and mental impairments as of March of 1992. (R. at 93-96, 123-25, 165-68). These applications were denied initially and on reconsideration. (R. at 97-106, 126-48, 179-83, 198-99.) Plaintiff then filed a request for a hearing before an Administrative Law Judge ("ALJ"), which was held on January 15, 1997. (R. at 200-01.) Plaintiff appeared at the hearing with counsel, and she, her roommate, a vocational expert, and a medical expert testified. On January 31, 1997, the ALJ issued a written decision concluding that Plaintiff was not disabled. (R. at 49, 27-40A.) Plaintiff then timely requested a review of the ALJ's decision by the Appeals Council, (R. at 23-25), which denied the request, (R. at 10-12), making the ALJ's decision the final decision of the Commissioner. See 20 C.F.R. § 404.955, 404.951 416.1455, 416.1481. Plaintiff now seeks judicial review of that decision. 42 U.S.C. § 405(g).
The applications for SSI do not appear in the record.
The regulations pertaining to DIB and SSI benefits are divided into two different sections which are substaintiallly similar. Thus, for convenience, where the two sections do not substantially differ, only one of them will be cited.
II. Facts and Medical History
At the time of the hearing, Ms. Ashpaugh was 31-years old. She graduated from high school, and attended a community college for one-and-a-half years, earning a 4.0 grade-point average, before joining the United States Army Reserves. (R. at 34, 38, 65, 93, 70, 156, 380, 406.) She was discharged after about six months because she had a problem with one of the females in her barrack. (R. at 71, 381, 406.) She has a nine-year old daughter who lives with her father in Texas. (R at 70.) From 1990 to about 1995, Ms. Asphaugh worked various odd jobs as a security guard, prep cook, dishwasher, cashier, carpet layer, and clerk. (R. at 71, 112, 119, 156, 206, 320, 380, 406.)
By her own account, Ms. Ashpaugh, a self-described "pagan homosexual," did not have a healthy upbringing. (R. at 249, 302, 317, 327.) She has repeatedly reported verbal, emotional, alcohol, physical, and sexual abuse as a young child by her father and mother's boyfriends, substance abuse as a teenager (cocaine, marijuana, tobacco, and alcohol), and unorthodox sexual activity as a young adult. (R. at 247-48, 254-92, 298-300, 302, 305, 319, 327, 351, 380, 405.) She claimed that she ran away from home at age 14 to escape physical abuse by her parents, and remained in foster care until about age 17. (R. at 75, 319-20, 327, 405.) Ms. Ashpaugh stated that her parents and her step-father were alcoholics. (R. at 248, 298, 406.)
Ms. Asphaugh suffered from both physical and mental impairments. On appeal, Ms. Asphaugh does not contest the Commissioner's decision that she can work despite her physical impairments. (Pl.'s Mem., at 14-17.)
The earliest documentation of Ms. Ashpaugh's mental problems was made in 1989 or 1990 when she attended counseling sessions at a mental health clinic in Arizona called Terros. In 1992, Ms. Asphaugh was diagnosed with Bipolar Disorder, posttraumatic stress disorder ("PTSD"), and Borderline Personality Disorder. (R. at 296.) In September of 1993, Dr. Gardner performed a psychological examination, and diagnosed probable PTSD and Borderline Personality Disorder. (R. at 317-21.)
Bipolar Disorder is a mood disorder characterized by wild mood swings from mania to depression. See DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, at 317 (4th ed. 1994)("DSM-IV")
Borderline Personality Disorder is characterized by marked impulsivity and unpredictable actions, poor self-image, mood instability, and unstable interpersonal relationships. During their 30s and 40s, a majority of individuals with this disorder attain greater stability in their relationships. DSM-IV, at 650, 653; see also R. at 56.
From July 1993 to February 1994, Ms. Ashpaugh was treated at the Idaho Mental Health Services for Bipolar Disorder and PTSD. (R. at 322-29.) At intake, her Global Assessment of Functioning ("GAF") rating was 60, which indicates a moderate limitation of general functioning. Her condition upon release was "substantially improved" and she was "not in further need of [treatment]." (R. at 322.)
The GAF scale indicates an individual's overall level of functioning in a single measure. DSM-IV, at 30. A GAF score reflects only psychological, social, and occupational functioning, with no consideration of functional impairments due to physical or environmental limitations. DSM-III-R, at 12. A GAP of 51-60 indicates "moderate" symptoms or functional limitations. Id.
In March of 1995, Ms. Asphaugh was diagnosed by Ms. Kay Side, a consultative psychological examiner with unknown credentials, with PTSD, Dysthymia, Borderline Personality Disorder with Histrionic Features, and Possible Dissociative Disorder Not Otherwise Specified ("NOS")( i.e., possible multiple personality disorder NOS). (R. at 345, 401.) Ms. Side rated many elements of Ms. Ashpaugh's mental impairments as moderately or markedly severe. (R. at 345-46, 401-02.) In particular, one of those elements, depressed mood, was of "marked" severity according to Ms. Side, but Ms. Side's ultimate diagnosis was Dysthymia, a "mild" form of depression. Ms. Side also opined that Ms. Ashpaugh's ability to interact appropriately with public contacts was markedly limited. (R. at 401.)
Dysthymia is a very mild form of depression, characterized by a chronic depressed mood. DSM-IV, at 345-46. Afflicted individuals describe themselves as sad or "down in the dumps." Id.
Ms. Ashpaugh was admitted to Spokane Community Mental Health Center ("Spokane") in Washington State in March of 1995 for treatment of Borderline Personality Disorder. CR. at 348-77, 349, 366.) The intake form indicated that PTSD and Agoraphobia (fear of open places) needed to be ruled out, and also indicated possible further diagnoses of Panic Disorder, Dissociative Disorder, and Borderline Personality Disorder NOS. (R. at 349.) All diagnoses except for Personality Disorder were eventually ruled out. (R. at 366.) The social workers at Spokane evaluated Ms. Ashpaugh's overall ability to maintain herself in the community as average to good. (R. at 441.) Treatment was discontinued when Ms. Ashpaugh failed to return. (R. at 440-41.)
In May of 1995, Dr. Lawless made a diagnosis of Personality Disorder NOS. (R. at 383.) He noted her GAF score was 75, reflecting a significant ability to function in almost any environment. (R. at 57, 383.) Dr. Lawless did not diagnose any depressive disorder. (R. at 378-84.)
A GAF score of 71-80 indicates "no more than slight" symptoms or functional limitations. DSM-IV, at 32.
In September of 1995, Ms. Ashpaugh received emergency-room treatment for a migraine headache. (R. at 385-89.)
In March and June of 1996, Ms. Ashpaugh saw Dr. Pollack who performed a consultative psychological examination at the suggestion of Ms. Ashpaugh's attorney. (R. at 405.) Contrary to Dr. Lawless who saw no evidence of a depressive disorder, Dr. Pollack's diagnosed Dysthymia. (R. at 410.) He also diagnosed Personality Disorder with Antisocial and Aggressive Features. ( Id.) Dr. Pollack completed a Mental Residual Functional Capacity Assessment Form, on which he indicated that Ms. Ashpaugh's abilities to perform activities within a schedule, maintain regular attendance, and be punctual within customary tolerances were "markedly limited." CR. at 412.)
At the hearing held in January of 1997, Dr. McKnight, a licensed psychologist, testified as a medical expert. (R. at 52.) He opined that Plaintiff had a Personality Disorder with Borderline Features. (R. at 54.) In his opinion, Ms. Ashpaugh had some anti-social features, but they were attributable to an adolescent history of conduct disorder. ( Id.) He noted significant disagreement in the record as to whether Ms. Ashpaugh had a free-standing depressive disorder. (Id.) He concluded that Ms. Ashpaugh's depression was secondary to her Personality Disorder, and was therefore not a free-standing problem. (R. at 58.)
Dr. McKnight testified that Ms. Ashpaugh had only slight restriction in activities of daily living, slight difficulties in maintaining social functioning, and seldom deficiencies of concentration, persistence, and pace. (R. at 58-59.) Dr. McKnight also testified that Ms. Ashpaugh would experience only infrequent episodes of deterioration and "minor" decompensation in work or work-like settings. (R. at 60.) He attributed her emergency room visits to the "rather dramatic " anxiety demonstrations typical with people afflicted with Borderline Personality Disorder. (R. at 60-61.)
Dr. McKnight disagreed with Dr. Pollack's assessment of Ms. Ashpaugh's ability to meet deadlines and appointments and interact with coworkers. Whereas Dr. Pollack thought that Ms. Ashpaugh was markedly limited in these areas, Dr. McKnight testified that Ms. Ashpaugh was only mildly limited in her abilities to perform activities within a schedule, maintain regular attendance, and be punctual, to complete a normal workday, and to respond appropriately to supervisors and coworkers. (R. at 61-63.) Dr. McKnight gave several reasons for why his assessment differed from that of Dr. Pollack. First, Dr. McKnight stated that Dr. Pollack did not have the option of checking a box marked "mildly limited." Second, Dr. Pollack apparently did not have access to records describing Ms. Ashpaugh's participation in martial arts events and other activities. Third, other evidence in the record such as Ms. Ashpaugh's daily living activities indicated that Ms. Ashpaugh could meet deadlines and keep appointments and interact with the other people in general and in a work setting. (R. at 64-65.)
Dr. Pollack did, however, have the option of checking "moderately limited" or "not significantly limited." (R. at 412.)
Like Dr. Pollack, Dr. McKnight completed a Mental Residual Functional Capacity Assessment Form. (R. at 470-71.) Unlike the form that Dr. Pollack used, Dr. McKnight's form included a severity rating of "mildly limited." ( Id.) Dr. McKnight found that most of Ms. Ashpaugh's impairments relating to her understanding and memory, sustained concentration and persistence, and social interaction were not significantly limited. ( Id.) He only rated as "mildly limited" Ms. Ashpaugh's ability to perform activities within a schedule, maintain regular attendance, and be punctual, her ability to complete a normal workweek without distractions and at a consistent pace without an unreasonable number of breaks, and her ability to get along with coworkers and supervisors. ( Id.)
After Dr. McKnight testified, Ms. Asphaugh testified that she hurt her left knee during a martial arts competition in September of 1996. (R. at 72.) She claimed that she could barely walk, could climb stairs very slowly, and that she could not put any weight on her left knee. (R. at 74.) She testified that her back pain prevented her from lifting more than a two gallon bottle of milk, but she admitted that her back condition did not prevent her from participating in martial arts. (R. at 74-75.) She stated that she could no longer bend over because of her back pain. (R. at 81.)
Ms. Ashpaugh testified that she is terrified to leave her house by herself, suffers from sleeplessness, and has "very severe" headaches that can last up to four days. (R. at 79-81.) She drove infrequently because she claimed that traffic gave her headaches. (R. at 82.)
Next, Ms. Paula Elaine Trudell, Ms. Ashpaugh's roommate of over four years, testified that she has observed four different personalities in Ms. Ashpaugh: so-called "regular" Alyce; "Kevin," who can disappear as quickly as he appears in the course of a conversation; a little girl who rocks back and forth on the floor and repeats that she will be good; and "wolf," characterized by growling and guarding food. (R. at 83-85.) Ms. Trudell stated that Ms. Ashpaugh did not like to leave the house, but when Ms. Ashpaugh did leave, she placed a "death grip" on Ms. Trudell's arm. (R. at 85.)
Finally, the ALJ elicited testimony from a vocational expert, Mr. Tom Moreland. (R. at 85-92.) The ALJ asked the expert to assume a younger individual capable of performing light work with the mental functional limitations as indicated by Dr. McKnight. (R. at 87-88, 470-71.) The expert testified that such an individual could perform many jobs in the local and national economy. (R. at 88-89.) When asked to accept as true Dr. Pollack's and Ms. Side's limitations, the expert stated that there were no jobs in the national economy a person with those limitations could perform. (R. at 89-92.)
According to Ms. Ashpaugh, she engaged in numerous social activities. She was a member of the Society for Creative Anachronism ("SCA"), which is a group dedicated to researching and recreating the European Middle Ages in the present. (R. at 66, 162, 231, 238.) As a member, she attended fight practice about once a week, and periodically engaged in mock battles using a wooden sword and wearing Medieval-like armor. (R. at 231-32.) She stopped fighting because she was afraid that she might hurt people. (R. at 233.) The SCA also provided Medieval dance lessons, and Ms. Ashpaugh attended these about once every week, where, for about two hours, she would "socialize with others" and "maybe try a dance or two." (R. at 231.) Ms. Ashpaugh also took martial arts lessons, and participated in martial arts tournaments. (R. at 72, 78.) She reported in April of 1995 that she would "visit friends maybe 2-3 times during [the] week [and] sometimes [on] weekends." (R. at 231.) Sometimes she just hung out with friends and drank coffee. (R. at 66, 238.) About once a week, Ms. Ashpaugh played a role-playing card game called Magic the Gathering with friends. (R. at 231.) In August of 1993, Ms. Ashpaugh reported that she got out of her house about twice a week. (R. at 162.)
III. ALJ's Findings
The ALJ made the following findings:
1. The claimant met the disability insured status requirements of the Act on March 27, 1992, the date the claimant stated she became unable to work, and continued to meet them through June 30, 1996, but not thereafter.
2. The claimant has not engaged in substantial gainful activity since March 27, 1992.
3 The medical evidence establishes that the claimant has severe low back pain and a personality disorder with borderline features, but that she does not have an impairment or combination of impairments listed in, or medically equal to one listed in Appendix 1, Subpart P, Regulations No. 4.
4. The claimant's allegations of total inability to work were not supported by the evidence of record and are not considered to be credible.
5. The claimant has the residual functional capacity to perform the physical exertion and nonexertional requirements of a broad range of light exertional work ( 20 C.F.R. § 404.1545 and 416.945)
6.The claimant is unable to perform her past relevant work as security guard, dishwasher and prep cook.
7. The claimant's residual functional capacity for the full range of light work is reduced by her additional nonexertional (mental) limitations, as analyzed in the body of the decision.
8. The claimant is 31 years old, which is defined as a younger person ( 20 C.F.R. § 404.1563 and 416.963)
9. The claimant has 13 years of education ( 20 C.F.R. § 404.1564 and 416.964)
10. The claimant does not have any acquired work skills, which are transferable to the skilled or semi-skilled work functions of other work ( 20 C.F.R. § 404.1568 and 416.968)
11. Based on an exertional capacity for light work and the claimant's age, education, and work experience, section 404.1569 of Regulations No. 4 and section 416.969 of Regulations No. 16 and Rule 202.21, Table No. 2, of Appendix 2, Subpart P, Regulations No. 4 would direct a conclusion of "not disabled."
12. Although the claimant's additional nonexertional limitations do not allow her to perform the full range of light work, using the above-cited rule as a framework for decision-making, there are a significant number of jobs in the national economy which she could perform. Examples of such jobs are: cleaner/housekeeper (24,000 jobs in the northwest region and 726,000 jobs in the nation), electrical/electronic assembly (19,000 jobs in the northwest region and 1,200,000 jobs in the nation) and laundry worker (6,768 jobs in the northwest region and 330,000 jobs in the nation).
13. The claimant was not under a "disability," as defined in the Social Security Act, at any time through the date of this decision ( 20 C.F.R. § 404.1520(f) and 416.920(f)).
CR. at 37-38.)
IV. Discussion
To be eligible for Disability Insurance Benefits (or Supplemental Security Income), a claimant must be under a disability. Disability is defined as:
the inability to do 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. To meet this definition, [Claimant] must have a severe impairment which makes [her] unable to do previous work or any other substantial gainful activity which exists in the national economy. To determine whether [she] is able to do any other work, we consider [her] residual functional capacity, age, education, and work experience.20 C.F.R. § 416.905(a). Determining whether a claimant is is a five-step process, which includes the following that must be resolved in sequence:
Substantial gainful activity means work that:
(a) Involves doing significant and productive physical or mental duties; and (b) Is done (or intended) for pay or profit.20 C.F.R. § 416.910.
A disabling impairment is defined as:
an impairment (or combination of impairments) which, of itself, is so severe that it meets or equals a set of criteria in the Listing of Impairments in Appendix 1 of this subpart or which, when considered with [Claimant's] age, education, and work experience, would result in a finding that [Claimant is] disabled under § 416.994 . . . .20 C.F.R. § 416.911(a)(1).
A claimant's residual functional capacity ("RFC") represents the most a claimant can still do despite his or her limitations. See 20 C.F.R. § 416.945(a); see also SSR 96-8p.
Step 1: Is the Claimant presently employed? If so, the claim is disallowed; if not, the inquiry proceeds to step two.
Step 2: Is the Claimant's impairment "severe," and expected to last at least 12 months? If not, the claim is disallowed; if so, the inquiry proceeds to step three.
Step 3: Does the impairment meet or exceed one of a list of specific impairments? If so, the Claimant is automatically disabled; if not, the inquiry proceeds to step four.
Step 4: Is the Claimant able to perform her past relevant work experience? If so, the claim is denied; if not, the inquiry proceeds to step five where the burden shifts to the Commissioner.
Step 5: Is the Claimant able to perform any other work [within her residual functional capacity] in the national economy? If so, the claim is denied; if not, the Claimant is disabled.See 20 C.F.R. § 416.920; see also, e.g., Butera v. Apfel, 173 F.3d 1049, 1054 (7th Cir. 1999)
Section 405(g) of the Social Security Act grants federal courts the authority to review final decisions with the power to affirm, modify, or reverse with or without remand to the Commissioner for a rehearing. See 42 U.S.C. § 405(g). However, the scope of judicial review is quite limited; the court must affirm the Commissioner's decision if it is supported by substantial evidence in the record. See Estok v. Apfel, 152 F.3d 636, 638 (7th. Cir. 1998); Herron v. Shalala, 19 F.3d 329, 333 (7th Cir. 1994)
In determining whether substantial evidence supports the decision, the court must review all the evidence of record to ascertain whether it contains "such relevant evidence as a reasonable mind might accept as adequate to support [the] conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971). The ALJ's findings must be supported by more than a mere scintilla of evidence; however, they may be supported by less than the weight of the evidence. See, e.g., Id.; Young v. Secretary of Health and Human Svces, 957 F.2d 386, 389 (7th Cir. 1992). Although the reviewing court must consider all the evidence of record, "we do not substitute our judgment for that of the Commissioner by reconsidering facts, reweighing evidence, resolving conflicts in evidence, or deciding questions of credibility." Maggard v. Apfel, 167 F.3d 376, 379 (7th Cir. 1999) (internal quotations omitted); see also Nelson v. Apfel, 131 F.3d 1228, 1234 (7th Cir. 1997). Therefore, the critical question is not whether the claimant is actually disabled, but rather whether substantial evidence supports the ALJ's conclusion that the claimant is not disabled. See Cass v. Shalala, 8 F.3d 552, 555 (7th Cir. 1993)
Plaintiff does not challenge the ALJ's finding that her physical impairments were not disabling. Rather, Plaintiff attacks the ALJ's residual functional capacity ("RFC") assessment that Plaintiff's mental impairments did not prevent her from working. In that regard, Plaintiff argues that the opinion of Dr. McKnight, who was a non-examining, non-treating physician, does not constitute substantial evidence, and therefore it was error for the ALJ to rely on the opinion in assessing Plaintiff's RPC. Rather, Plaintiff urges, the ALJ should have given the opinions of Plaintiff's treating and examining sources ( i.e., Dr. Pollack and Ms. Side) conclusive weight, who indicated that Plaintiff had moderate to marked limitations in her ability to perform work-related activities. Plaintiff also suggests that the ALJ's credibility determination regarding Plaintiff's testimony was patently wrong. Next, Plaintiff contends that the ALJ failed to consider Plaintiff's non-exertional impairments, such as pain. Finally, Plaintiff suggests that the ALJ should have elicited the opinion of a vocational expert as to the effect of Plaintiff's non-exertional impairments on her ability to work. Each of these contentions is addressed in turn below.
Plaintiff states in her brief, "Plaintiff further contends that there is no substantial evidence which would rebut her own testimony, as well as the testimony of the lay witness and the opinions of her treating physicians that she is unable to work." (Pl.'s Mem., at 15.)
First, Plaintiff argues that the opinion of a non-examining, non-treating physician can never constitute substantial evidence, citing Wilder v. Chater, 64 F.3d 335 (7th Cir. 1995) [hereafter Wilder I], and Wilder v. Apfel, 153 F.3d 799 (7th Cir. 1998) [hereafter Wilder II]. Neither case supports that contention. In Wilder I, the court criticized the ALJ for rejecting a non-examining expert's uncontradicted opinion, stating that "the uncontradicted evidence of the only disinterested expert to opine upon [the claimant's illness] is entitled to considerable weight." Wilder I, 64 F.3d at 337 (emphasis added). In Wilder II, which involved the same claimant, two disinterested experts came to opposite conclusions regarding the claimant's disability status. One agency-appointed expert opined that the claimant was totally disabled, and another expert opined that she was not. The court gave the second expert's opinion no weight, calling it "hopelessly inconclusive as well as contaminated by legal confusion." Wilder II, 153 F.3d at 803. But it gave the first non-treating, disinterested expert's opinion conclusive weight and awarded the claimant disability benefits. Id. at 804. Thus, both cases actually support the opposite of what Plaintiff argues, i.e., a disinterested expert's opinion can constitute substantial evidence. See also 29 C.F.R. § 404.1527(d) 404.1527(f); DeFrancesco v. Bowen, 867 F.2d 1040, 1043 (7th Cir. 1989) (the ALJ is entitled "to give substantial weight to the testimony of a medical advisor even though the advisor has not examined the claimant personally."). Therefore, Plaintiff's contention that Dr. McKnight's opinion is entitled to no weight has no merit.
Indeed, Dr. McKnight's opinion was neither "hopelessly inconclusive" nor "contaminated by legal confusion," and the ALJ properly considered it. Dr. McKnight's diagnosis of Borderline Personality Disorder was consistent with many physicians' opinions, and his rejection of a free-standing depressive disorder was based on a careful explanation of the contradictory medical evidence regarding such disorder. Dr. McKnight did believe Plaintiff suffered from a depressive disorder, but he concluded that the disorder was secondary to her personality disorder, and was attributable to her troubled child and adolescent experiences. He noted that although other disorders had been suggested, most had been ruled out and other physicians had not diagnosed them. He downplayed the significance of the emergency room visits, testifying that such dramatic anxiety demonstrations were typical of someone afflicted with a personality disorder. Thus, unlike the rejected opinions in Wilder II, Dr. McKnight's opinion is consistent with other findings in the record and not conclusory.
Moreover, The ALJ articulated specific reasons for rejecting the opinions of Drs. Pollack and Lawless. The ALJ noted that Drs. Pollock and Lawless did not have access to later records from Spokane Community Mental Health Center which indicated that Plaintiff's behavior was under control and that she had discontinued treatment. In addition, Dr. Pollack apparently did not see records which documented Plaintiff's ability to participate in martial arts and other social activities. Finally, the ALJ noted that Dr. Pollack's findings were inconsistent those of Dr. McKnight and with the record. In short, the ALJ was faced with conflicting medical opinions, and had to choose among them. Obviously, Plaintiff disagrees with his selection, but since substantial evidence supports the ALJ's reliance on Dr. McKnight's opinions, there is no reason to disturb the Commissioner's decision.
When an ALJ is confronted with conflicting medical reports, "it is up to the ALJ to decide which doctor to believe . . . subject only to the requirement that the ALJ's decision be supported by substantial evidence." Books v. Chater, 91 F.3d 972, 980 (7th Cir. 1996). Medical evidence may be discounted if it is internally inconsistent or inconsistent with other evidence. See 20 C.F.R. § 404.1527(c)(2); 404.1527(d)(4); see also Knight v. Chater, 55 F.3d 309, 314 (7th Cir. 1995). In every case, however, an ALJ is required to give a minimum articulation of his reasoning and evaluation of all the evidence. See Pope, 998 F.2d at 481. He must "sufficiently articulate his assessment of the evidence to "assure us that the ALJ considered the important evidence . . . [and to enable] us to trace the path of the ALJ's reasoning.'" Rohan v. Chater, 98 F.3d 966, 971 (7th Cir. 1996)
The ALJ's decision to believe Dr. McKnight is supported by substantial evidence. First of all, Dr. McKnight diagnosed Borderline Personality Disorder, which many other physicians had also diagnosed. Dr. McKnight also convincingly discounted all the conflicting evidence in the record. For example, one doctor, Dr. Lawless, did not believe Plaintiff suffered from any depressive disorder, but Dr. Pollack did, and diagnosed dysthymia, a mild depressive disorder. Ms. Side also diagnosed dysthymia, but in the same breath reported that Plaintiff had "marked" limitations in areas of functioning dealing with social interaction, a finding that is "quite impossible" with a diagnosis of dysthymia, according to Dr. McKnight. (R. at 54.) A marked limitation should have triggered a diagnosis of Major Depressive Disorder, not the milder form of dysthymia. ( Id.) A marked limitation also suggests an individual who is unable to meet any deadlines, but Plaintiff was able to attend martial arts events, regularly meet friends for coffee, attend SCA dance lessons, and attend classes at a college where she earned a 4.0 grade point average, activities which suggest a substantial ability to maintain schedules and meet deadlines and appointments.
The ALJ also did not give much weight to the opinions of Ms. Side, whose credentials are unknown and is not a mental-health specialist. Dr. McKnight found Ms. Side's diagnosis internally inconsistent. Ms. Side opined that Plaintiff's ability to interact or relate to coworkers was markedly limited, but Plaintiff had worked for a full year and there is no evidence of any problems with coworkers in any work records. Ms. Side also thought Plaintiff's ability to interact with the public in a social context was markedly limited, but Dr. McKnight pointed to Plaintiff's frequent contacts with the public through her various daily activities. Finally, Dr. McKnight was simply baffled by Ms. Side's rating of a markedly severe depressed mood and her contemporaneous diagnosis of dysthymia, a mild but not marked form of depression. Accordingly, the ALJ properly accepted Dr. McKnight's criticisms of Ms. Side's report, and properly gave it the weight it deserved.
After eliminating the contradictory and inconsistent reports of Drs. Pollack and Lawless and Ms. Side, the ALJ was left with Dr. McKnight's disinterested and unbiased assessment of Plaintiff's REC, and adopted it with support from substantial evidence in the record. Dr. McKnight's opinion closely resembled that of Dr. Pollack, differing only as to the severity of Plaintiff's impairment. Dr. Pollack believed that Plaintiff was moderately to markedly limited in the areas of maintaining regular and punctual attendance, sustaining a consistent work pace, and dealing with coworkers and supervisors, whereas Dr. McKnight believed Plaintiff was only mildly limited in those areas. As support, Dr. McKnight noted that Plaintiff regularly met friends for coffee, attended weekly dance lessons, met for martial arts practice and competed in martial arts events, regularly attended classes, presumably showed up for exams prepared and on time, as indicated by her 4.0 grade-point average, and there were no complaints in her work records about problems meeting deadlines or attending meetings or conflicts with coworkers or supervisors. For these reasons, the ALJ did not err in giving Dr. McKnight's significant weight in assessing Plaintiff's REC.
Next, Plaintiff appears to argue that the ALJ improperly discredited her testimony regarding her ability to work. For example, Plaintiff states that she has had suicidal thoughts, suffers from severe depression and lack of sleep, and is terrified of going outside of her house alone. She also testified that she suffers from allergies and severe migraines. According to Plaintiff, she has great difficulty doing household chores and difficulty bending over. Her roommate testified that Plaintiff suffers from blackout spells, has difficulty controlling her anger, and has multiple personalities. The roommate also testified that when she and Plaintiff leave the house, Plaintiff places a "death grip" on her arm. (R. at 85.)
The ALJ considered Plaintiff's testimony, CR. at 32-33), and specifically rejected it, a result which we do not find to be "patently wrong." Luna v. Shalala, 22 F.3d 687, 690 (7th Cir. 1994). With regard to her alleged physical limitations, Plaintiff does not challenge the ALJ's RFC assessment of her physical impairments. The ALJ considered Plaintiff's testimony regarding her alleged mental impairments, and found that her testimony was not consistent by Dr. McKnight's well-supported findings. Plaintiff's statement that she was too terrified to go outside alone is belied by her participation in many away — from-home social activities. Plaintiff believes she suffers from severe depression, but no doctor diagnosed severe depression, and of those that did diagnose dysthymia, the ALJ properly relied on Dr. McKnight's opinion that any depressive disorder Plaintiff suffered was secondary to her personality disorder. Dr. McKnight's opinion that Plaintiff was only mildly limited in her ability to maintain a schedule, maintain regular attendance, and interact with coworkers and supervisors was appropriately based upon Plaintiff's daily activities, a rejection of conflicting medical evidence, and the report from Spokane Community that Plaintiff's behavior and symptoms were under control. For these reasons, the ALJ's rejection of Plaintiff's self-serving testimony regarding her mental impairments was not patently wrong in view of the cold record.
Finally, Plaintiff argues that the ALJ should have considered the effects of non-exertional limitations such as pain, allergies, and migraines on her ability to work, and should have elicited testimony from a vocational expert regarding such limitations. But Plaintiff has not identified any evidence which attributed Plaintiff's mental impairments to the effects of pain or migraines. Rather, Dr. McKnight, Ms. Side, and Dr. Pollack all attributed Plaintiff's personality disorder to childhood abuse and a dysfunctional family. Thus, there being no suggestion in the record that Plaintiff's non-exertional impairments affected her mental impairments, the ALJ rightly did not consider her non-exertional impairments as effecting her mental impairments.
No doubt Ms. Ashpaugh will be disappointed by this Court's ruling, but from all appearances, she has a promising future. Despite her description of a wretched and abusive childhood, Ms. Ashpaugh graduated from high school and put herself partway through college, earning a perfect grade-point average, and leads an active social life. She is very articulate and writes well, preparing a legal brief (we assume she wrote it) that rivals some of those prepared by lawyers. All things considered, these are laudable accomplishments. Of course, it is not because of these accomplishments that this Court affirms the Commissioner's decision. But every so often, there is a glimmer of hope, and it is worthwhile to pause and acknowledge it.
V. Conclusion
For the foregoing reasons, this Court affirms the Commissioner's final decision. Accordingly, the Court grants the Commissioner's motion for summary judgment [25-1] and denies Plaintiff's motion for summary judgment [23-1]