Opinion
Civil Action 20-1622
02-25-2021
LORI LYNN LAPENTA, Plaintiff, v. ANDREW SAUL, ACTING COMMISSIONER OF SOCIAL SECURITY, Defendant.
MEMORANDUM OPINION
MARILYN HEFFLEY, UNITED STATES MAGISTRATE JUDGE
Lori Lynn Lapenta (“Lapenta” or “Plaintiff”) seeks review, pursuant to 42 U.S.C. § 405(g), of the Commissioner of Social Security's (“Commissioner”) decision denying her claim for Disability Insurance Benefits (“DIB”) pursuant to Title II of the Social Security Act.For the reasons that follow, Lapenta's Request for Review will be denied.
In accordance with 28 U.S.C. § 636(c), the parties voluntarily consented to have the undersigned United States Magistrate Judge conduct proceedings in this case, including the entry of final judgment. See Doc. Nos. 2, 6.
I. FACTUAL AND PROCEDURAL BACKGROUND
Lapenta was born on May 20, 1967. R. at 181. She is able to speak, read, understand, and write in English. Id. at 219. Lapenta completed four or more years of college, id. at 221, has a master's degree in business, and is a certified public accountant, id. at 48. Her past relevant work experience was as an accounting manager, compliance accountant, financial analyst, operations manager, and trust operations manager. Id. at 222. Lapenta applied for DIB benefits on August 17, 2016, id. at 24, 181-82, alleging that she became disabled on May 5, 2016, id. at 181, due to bipolar disorder, anxiety disorder, and depression, id. at 220. Her application was initially denied on November 1, 2016, id. at 106-10, and again denied upon reconsideration on February 27, 2017, id. at 24, 114-18. Lapenta then filed a written request for a hearing on March 13, 2017, id. at 119-20, and an Administrate Law Judge (“ALJ”) held a hearing on her claim on October 11, 2018, id. at 40-72. On November 7, 2018, the ALJ issued an opinion denying Lapenta's claim. Id. at 21-39. Lapenta filed an appeal with the Appeals Council, which the Appeals Council denied on December 13, 2019, thereby affirming the decision of the ALJ as the final decision of the Commissioner. Id. at 11-16. On February 4, 2020, Lapenta requested an extension to seek judicial review, id. at 6-10, which was granted on March 6, 2020. Id. at 6-10. Lapenta then commenced this action in federal court.
Citations to the administrative record will be indicated by “R.” followed by the page number.
II. THE ALJ'S DECISION
In his decision, the ALJ found that Lapenta has not engaged in substantial gainful activity since May 5, 2016, the alleged onset date. Id. at 26. The ALJ determined that Lapenta suffered from the severe impairments of bipolar disorder, anxiety disorder, and depression, and the non-severe impairments of amblyopia of the right eye, visual field defect, and ocular hypertension. Id. at 27. The ALJ concluded that neither Lapenta's individual impairments, nor the combination of her impairments, met or medically equaled a listed impairment. Id. at 27-29. The ALJ found that, during the relevant period, Lapenta had the residual functional capacity (“RFC”) to perform:
a full range of work at all exertional levels but with the following nonexertional limitations: she cannot be exposed to hazards like climbing ropes, ladders, or scaffolds, working at unprotected heights, or working with moving machinery.... [she] can perform simple, routine, and repetitive work, but not at a production pace.... [she] cannot interact with the general public, she can occasionally interact with supervisors and co-workers, but cannot perform work that would require her to work in tandem with coworkers to complete job tasks. She can make simple work[-]related decisions in a stable work environment, defined as very little change in work process or work setting.Id. at 29. Based on this RFC determination, and relying on the vocational expert (“VE”) who appeared at the hearing, the ALJ found that there were jobs that existed in significant numbers in the national economy that Lapenta could perform, such as marker, router, or non-postal mail clerk. Id. at 34-35. Accordingly, the ALJ concluded that Lapenta was not disabled. Id. at 35.
III. LAPENTA'S REQUEST FOR REVIEW
In her Request for Review, Lapenta contends that the ALJ erred by: (1) assigning little weight to the opinion of her treating psychiatrist; (2) finding that her testimony was not entirely consistent with the evidence; and (3) failing to present all of her limitations in the hypothetical posed to the VE.
IV. SOCIAL SECURITY STANDARD OF REVIEW
The role of the court in reviewing an administrative decision denying benefits in a Social Security matter is to uphold any factual determination made by the ALJ that is supported by “substantial evidence.” 42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389, 401 (1971); Doak v. Heckler, 790 F.2d 26, 28 (3d Cir. 1986); Newhouse v. Heckler, 753 F.2d 283, 285 (3d Cir. 1985). A reviewing court may not undertake a de novo review of the Commissioner's decision in order to reweigh the evidence. Monsour Med. Ctr. v. Heckler, 806 F.2d 1185, 1190 (3d Cir. 1986). The court's scope of review is “limited to determining whether the Commissioner applied the correct legal standards and whether the record, as a whole, contains substantial evidence to support the Commissioner's finding of fact.” Schwartz v. Halter, 134 F.Supp.2d 640, 647 (E.D. Pa. 2001).
Substantial evidence is a deferential standard of review. See Jones v. Barnhart, 364 F.3d 501, 503 (3d Cir. 2004). “Substantial evidence ‘does not mean a large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999) (quoting Pierce v. Underwood, 487 U.S. 552, 564-65 (1988)); see also Kangas v. Bowen, 823 F.2d 775, 777 (3d Cir. 1987). It is “more than a mere scintilla but may be somewhat less than a preponderance of the evidence.” Rutherford v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005). The court's review is plenary as to the ALJ's application of legal standards. Krysztoforski v. Chater, 55 F.3d 857, 858 (3d Cir. 1995).
To prove disability, a claimant must demonstrate some medically determinable basis for a physical or mental impairment that prevents him or her from engaging in any substantial gainful activity for a 12-month period. 42 U.S.C. § 1382c(a)(3)(A); accord id. § 423(d)(1). As explained in the applicable agency regulation, each case is evaluated by the Commissioner according to a five-step sequential analysis:
(i) At the first step, we consider your work activity, if any. If you are doing substantial gainful activity, we will find that you are not disabled. (ii) At the second step, we consider the medical severity of your impairment(s). If you do not have a severe medically determinable physical or mental impairment that meets the duration requirements in § 404.1509, or a combination of impairments that is severe and meets the duration requirement, we will find that you are not disabled. (iii) At the third step, we also consider the medical severity of your impairment(s). If you have an impairment(s) that meets or equals one of our listings in appendix 1 of this subpart and meets the duration requirement, we will find that you are disabled. (iv) At the fourth step, we consider our assessment of your residual functional capacity and your past relevant work. If you can still do your past relevant work, we will find that you are not disabled. (v) At the fifth and last step, we consider our assessment of your residual functional capacity and your age, education and work experience to see if you can make an adjustment to other work. If you can make an adjustment to other work, we will find that you are not disabled. If you cannot make an adjustment to other work, we will find that you are disabled.20 C.F.R. §§ 404.1520(a)(4)(i)-(v) (references to other regulations omitted).
V. DISCUSSION
A. Substantial Evidence Supports the ALJ's Decision to Assign Little Weight to the Opinion of Lapenta's Treating Psychiatrist
Lapenta contends that the ALJ's RFC assessment was not supported by substantial evidence because the ALJ did not properly evaluate the opinion of her treating psychiatrist, Sandeep Gupta, M.D. Pl.'s Br. (Doc. No. 13) at 6-17. This argument lacks merit.
Under applicable regulations and controlling case law, “opinions of a claimant's treating physician are entitled to substantial and at times even controlling weight.” Fargnoli v. Massanari, 247 F.3d 34, 43 (3d Cir. 2001) (citing 20 C.F.R. § 404.1527(d)(2)); accord 20 C.F.R. § 404.1527(c)(2). A treating physician's opinion on the nature and severity of a claimant's impairment will be given controlling weight if the opinion is “well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record.” 20 C.F.R. § 404.1527(c)(2). If an ALJ does not afford a treating physician's opinion controlling weight, he or she may instead give it “more or less weight depending upon the extent to which supporting explanations are provided.” Plummer v. Apfel, 186 F.3d 422, 429 (3d Cir. 1999). Factors to be considered by the ALJ in assigning appropriate weight to a medical opinion include the following: the length of the treating relationship and frequency of examination; the nature and extent of the treating relationship; supportability; consistency; specialization; and other relevant factors. 20 C.F.R. § 404.1527(c)(1)-(6).
The Commissioner made “sweeping changes” to the rules regarding the evaluation of medical opinion evidence that became effective on March 17, 2017. Lepperd v. Berryhill, No. 16-02501, 2018 WL 1571954, at *6 n.10 (M.D. Pa. Feb. 20, 2018) (citing Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844-01 (Jan. 18, 2017)), report and recommendation adopted, No. 16-2501, 2018 WL 1566662 (M.D. Pa. Mar. 30, 2018).
In rejecting a physician's assessment, however, 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.” Morales v. Apfel, 225 F.3d 310, 317-18 (3d Cir. 2000) (internal quotation marks omitted). An ALJ must explain on the record his or her reasons for disregarding a physician's opinion. Brewster v. Heckler, 786 F.2d 581, 585 (3d Cir. 1986). While it is essential that an ALJ set forth reasons for his or her decision, an ALJ is not required to use particular language or adhere to a specific formula or format in conducting the analysis. Jones, 364 F.3d at 505. The ALJ need only provide a “‘discussion of the evidence' and an ‘explanation of reasoning' for his [or her] conclusion sufficient to enable meaningful judicial review.” Diaz v. Comm'r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009) (quoting Burnett v. Comm'r of Soc. Sec., 220 F.3d 112, 120 (3d Cir. 2000)).
Dr. Gupta, a psychiatrist at Serene Minds, LLC, began treating Lapenta on November 14, 2016 for bipolar disorder, anxiety disorder, and depression. R. at 388. On December 15, 2016, after only two appointments with Lapenta, Dr. Gupta completed a Mental Residual Functional Capacity Questionnaire in which he evaluated her ability to do work-related activities on a dayto-day basis in a regular work setting. Id. at 388-92. With respect to her mental abilities and aptitude to do semiskilled and skilled work, Dr. Gupta opined that she was “[l]imited but satisfactory” in all four categories, namely: “[u]nderstand and remember detailed instructions;” “[c]arry out detailed instructions;” “[s]et realistic goals or make plans independently of others;” and “[d]eal with stress of semiskilled work and skilled work.” Id. at 391. Dr. Gupta also found that she was “[l]imited but satisfactory” in all categories related to her mental abilities and aptitude to do particular types of jobs, including: “[i]nteract appropriately with the general public;” “[m]aintain socially appropriate behavior;” “[a]dhere to basic standards of neatness and cleanliness;” “[t]ravel in unfamiliar place;” and “[u]se public transportation.” Id.
Lapenta's first appointment with Dr. Gupta was on November 14, 2016, R. at 394, and her second appointment was on December 2, 2016, id. at 399.
When evaluating Lapenta's mental abilities and aptitude to do unskilled work, Dr. Gupta opined that she was “[l]imited but satisfactory” in her ability to “[a]sk simple questions or request assistance, ” and “[s]eriously limited but not precluded” from “[m]ak[ing] simple work-related decisions.” Id. at 390. He also found that Lapenta was “[u]nable to meet competitive standards” in the following categories: “[m]aintain regular attendance and be punctual within customary, usually strict tolerances;” “[s]ustain an ordinary routine without special supervision;” “[w]ork in coordination with or proximity to others without being unduly distracted;” “[c]omplete a normal workday and workweek without interruptions from psychologically based symptoms;” “[p]erform at a consistent pace without an unreasonable number and length of rest periods;” “[r]espond appropriately to changes in a routine work setting;” and “[b]e aware of normal hazards and take appropriate precautions.” Id. Dr. Gupta further reported that Lapenta had “[n]o useful ability to function” in her ability to “[m]aintain attention for two[-]hour segment;” “[a]ccept instructions and respond appropriately to criticism from supervisors;” “[g]et along with co-workers or peers without unduly distracting them or exhibiting behavioral extremes;” and “[d]eal with normal work stress.” Id. When asked to provide an explanation for these limitations, Dr. Gupta simply stated “see attachment indicated ‘8Q, '” which contained treatment notes and Lapenta's personal log of her prior jobs, including the issues she had at each workplace and the reasons for her terminations. Id. at 393-02.
As defined by the questionnaire: “Seriously limited, but not precluded means ability to function in this area is seriously limited and less than satisfactory, but not precluded in all circumstances.” R. at 390 (emphasis in original).
As defined by the questionnaire: “Unable to meet competitive standards means your patient cannot satisfactorily perform this activity independently, appropriately, effectively and on a sustained basis in a regular work setting.” R. at 390 (emphasis in original).
As defined by the questionnaire: “No useful ability to function, an extreme limitation, means your patient cannot perform this activity in a regular work setting.” R. at 390 (emphasis in original).
The ALJ determined that Dr. Gupta's opinion should be given “little weight” because the opinion was “overly extreme and the degree of his limitations is not supported by the overall medical evidence.” Id. at 32. Substantial evidence supports this decision.
In evaluating Dr. Gupta's opinion, the ALJ explained that “Dr. Gupta indicated he started seeing [] [Lapenta] on November 14, 2016, and he offered his opinion after only 2 sessions with” her. Id. (internal citations to the record omitted). Treating-physician opinions are afforded a level of deference because they are “most able to provide a detailed, longitudinal picture of [a claimant's] medical impairment(s) and may bring a unique perspective to the medical evidence.” 20 C.F.R. § 404.1527(c)(2); see also id. § 404.1527(c)(2)(i) (“Generally, the longer a treating source has treated you and the more times you have been seen by a treating source, the more weight we will give to the source's medical opinion. When the treating source has seen you a number of times and long enough to have obtained a longitudinal picture of your impairment, we will give the medical source's medical opinion more weight than we would give it if it were from a nontreating source.”). Here, Lapenta has failed to establish that, at the time Dr. Gupta issued his opinion, he had sufficient interaction with her to qualify for such deference. See, e.g., Morris v. Barnhart, 78 Fed.Appx. 820, 823 (3d Cir. 2003) (holding that opinion of physician who saw claimant on only three or four occasions over two or three months was not entitled to greater weight than other medical opinions); Galbreath v. Colvin, No. 13-2157, 2014 WL 4923233, at *12 (M.D. Pa. Sept. 30, 2014) (physician who saw claimant only four times over a period of several months did not qualify as treating physician); Stoyer v. Colvin, No. 13-2481, 2014 WL 4272764, at *15-16 (M.D. Pa. Aug. 28, 2014) (doctors who saw claimant five times over eight months and six times over three months, respectively, did not qualify as treating physicians).
Further supporting the ALJ's decision to afford Dr. Gupta's opinion little weight is that Lapenta's more recent treatment records with Dr. Gupta showed her “symptoms improving with ongoing treatment, and better control of her symptoms with medication regimen.” R. at 32. For example, Lapenta presented to Dr. Gupta on February 2, 2018 after a three-weekday treatment program at Rockford Center, id. at 441, where she received “[t]reatment [for] mood instability related to bipolar disorder, ” id. at 601. During this appointment, Lapenta indicated that the Rockford Center “continued [her] on [her] current combination of medications and [added] Risperdal 0.5 mg twice per day [] for impulsivity” Id. at 441. According to Dr. Gupta, Lapenta “[r]eport[ed] improvement in impulsivity and mood symptoms with additional Risperdal.” Id.
On examination, Dr. Gupta observed that Lapenta was neatly dressed, made direct eye contact, had a normal rate and volume of speech, had coherent language, and was cooperative. Id. at 441-42. She was alert and her attention span and concentration, orientation to time, place, and person, recent and remote memory, and fund of knowledge were all within normal limits. Id. at 442. Her mood was “anxious, ” and her affect was “stable and full range, anxious.” Id. Lapenta's judgement and insight were within normal limits; her thoughts processes, including rate, abstract reasoning, and associations, were intact; and her thought content was “clear and logical.” Id. Dr. Gupta also noted that “no psychotic symptoms [were] reported” but that “excessive worries and anxiety [were] present.” Id. He also stated that Lapenta “[d]enie[d] any thoughts of self-harm” and that she was “[h]opeful and future oriented.” Id. At the conclusion of his examination, Dr. Gupta determined that Lapenta “appear[ed] to be [exhibiting] mild depressive symptoms which could be situational and in nature” and that “[i]t appear[ed] [Lapenta] had [a] mild hypomanic episode last month.” Id. at 444. He observed that “[c]urrently she [was] not exhibiting any manic symptoms” and he decided to “continue her on [her] current combination of medications.” Id. With respect to her generalized anxiety “related to finances and work, ” Dr. Gupta opined that “[n]o medication change [was] needed, ” that Lapenta “has done well on Lexapro 10mg dose, ” and that she would “[c]ontinue Lexapro.” Id.
Several weeks later, at her March 20, 2018 appointment, Lapenta told Dr. Gupta that “overall she is doing fairly well on [her] current combination of medications.” Id. at 437. She indicated that “overall her mood is stable, ” she is “[a]ble to sleep without any problems, ” her “[a]ppetite is good, ” her “[e]nery level is fair, ” and she “[d]enie[d] any thoughts of self-harm.” Id. Notwithstanding her improvement, Lapenta also indicated that she was “currently not working, ” that “[s]he has difficulty keeping a job because of her behavior, ” and that she “[b]ecome[s] suspicious of people she works with.” Id. The findings from Dr. Gupta's mentalstatus examination were identical to his February 2, 2018 findings. Id. at 438-39. Dr. Gupta concluded that Lapenta's “[b]ipolar disorder . . . appears to be s[t]able.” Id. at 440. He also noted: “Bipolar disorder, in full remis.” Id. at 439. With respect to her generalized anxiety, he reported that “[n]o medication change [was] needed, ” that Lapenta “has done well on Lexapro 10mg dose, ” and that she would “[c]ontinue Lexapro.” Id. at 440. Despite finding that her bipolar disorder was stable and that she had done well on Lexapro, Dr. Gupta determined that Lapenta was “unable to function due to history of mood swings and paranoia.” Id.
Dr. Gupta's mental-status examination findings on February 16, 2017, R. at 457-58, May 8, 2017, id. at 453-54, August 7, 2017, id. at 450-51, and November 10, 2017, id. at 446-47, were also virtually identical to Lapenta's February 2, 2018 and March 20, 2018 examination findings. The sole difference was that at her February 16, 2017 appointment, her mood was “[o]kay, ” id. at 458, instead of “anxious, ” id. at 438, 442, and her affect was “stable and full range, ” id. at 458, instead of “stable and full range, anxious, ” id. at 438, 442.
This was not the first time that Dr. Gupta opined that Lapenta's bipolar disorder appeared to be stable. On February 16, 2017, Dr. Gupta stated: Lapenta “appears to be relatively stable. She is exhibiting mild symptoms of anxiety and a[ ] bipolar depression. I will continue her on current medication combinations.” R. at 459. At both her May 8, 2017 and August 7, 2017 appointments, Dr. Gupta opined that “as far as bipolar disorder is concerned, [Lapenta] is stable.” Id. at 452, 456. Moreover, on November 10, 2017, Dr. Gupta stated: “bipolar disorder: [Lapenta] appears to be doing fairly well on current combination of medication.” Id. at 448.
On May 8, 2017, Dr. Gupta prescribed Lapenta a “low dosage of Lexapro” for her generalized anxiety. R. at 456. At her August 7, 2017 visit, Dr. Gupta “increase[d] [her] dose of Lexapro to 10mg for anxiety.” Id. at 452. Thereafter, at her November 10, 2017 visit, as well as her two most recent visits discussed supra, Dr. Gupta opined that “[s]he has done well on Lexapro 10mg dose” and that she should “[c]ontinue Lexapro.” Id. at 448; see also id. at 440, 444. Notably, both her psychiatric evaluation dated December 27, 2017 and discharge summary dated January 18, 2018 from the Rockford Center state the following: “She started with her current psychiatrist, Dr. Sandeep Gupta about a year ago, feels that this has been very effective to manage her anxiety and feels her anxiety at this point [is] completely under control.” Id. at 601, 699.
To the extent Dr. Gupta opined that Lapenta was disabled, the ALJ was under no obligation to give his opinion special weight because a finding of disability is an issue reserved to the Commissioner. See 20 C.F.R. § 404.1527(d)(1), (3) (“We are responsible for making the determination or decision about whether you meet the statutory definition of disability. In so doing, we review all of the medical findings and other evidence that support a medical source's statement that you are disabled. A statement by a medical source that you are ‘disabled' or ‘unable to work' does not mean that we will determine that you are disabled.”); SSR 96-5p, 1996 WL 374183, at *2 (July 2, 1996) (“[T]reating source opinions on issues that are reserved to the Commissioner are never entitled to controlling weight or special significance.”).
The ALJ's decision to afford Dr. Gupta's opinion little weight was also supported by the other medical evidence of record. In particular, the ALJ assigned “some weight” to the opinion of Norman Broudy, M.D. & Associates, LLC (the “Broudy Opinion”), dated October 18, 2016, id. at 369-72, which indicated that: “[w]ith age, it is getting harder to manage [Lapenta's] mood, occupation, social relationships, [and] cognition. She cannot function in her usual capacity.
As the ALJ noted in his decision, the opinion of Norman Broudy, M.D. & Associates, LLC “appears to be from Peta Clarkson, M.D., but is unclear in this regard, as the signature is illegible.” R. at 32. Dr. Clarkson is Lapenta's former psychiatrist.
Guarded, ” Id. at 372. The ALJ found that this opinion was “consistent with the treatment records that indicate[d] that [Lapenta] should be limited to unskilled work without much contact with others.” Id. at 32. Indeed, Dr. Gupta's treatment notes document Lapenta's frequent complaints regarding anxiety, stress, and troubles at work, particularly with respect to her employers. Id. at 437, 441, 445, 449. Dr. Gupta noted, however, that “some of [Lapenta's] anxiety is situational, ” id. at 452, and when Lapenta “[a]ppear[ed] to be exhibiting mild depressive symptoms” that her symptoms “could be situational and in nature, ” id. at 444. The Broudy Opinion is also consistent with Dr. Clarkson's treatment notes from September 2016 and October 2016. For example, at Lapenta's September 20, 2016 visit, Dr. Clarkson observed:
To the extent that Lapenta argues that the ALJ failed to cite, consider, or rely on Dr. Clarkson's treatment notes, Pl.'s Reply Br. (Doc. No. 15) at 4-5, “[t]here is no requirement that the ALJ discuss in [his or her] opinion every tidbit of evidence included in the record.” Hur v. Barnhart, 94 Fed.Appx. 130, 133 (3d Cir. 2004). Nor does “the ALJ's mere failure to cite specific evidence . . . establish that the ALJ failed to consider it.” Phillips v. Barnhart, 91 Fed.Appx. 775, 780 n.7 (3d Cir. 2004) (citations omitted). Here, the ALJ fully discussed Lapenta's medical care and summarized her treatment history before affording Dr. Gupta's opinion little weight. R. at 29-33.
Her dress and grooming are appropriate, she is friendly and communicative, and she appears to be her stated age. Mood is euthymic, mild anxiety. Her speeches mildly pressured.... She denies hallucinations and delusions and there is no apparent thought disorder. Associations are intact, thinking is generally logical, and thought content is appropriate. Her cognitive functioning, based on vocabulary and fund of knowledge, is intact and age appropriate, and she is fully oriented. There are mild signs of anxiety. There are no signs of attentional or hyperactive difficulties. Insight and judgement appear intact.Id. at 373. At her October 13, 2016 visit, Dr. Clarkson noted that Lapenta:
appears wary, attentive, and appears anxious.... Signs of moderate depression are present. Affect is appropriate, full range, and congruent with mood.... Associations are intact, thinking is logical, and thought content appears appropriate.... Vocabulary and fund of knowledge indicate cognitive functioning in the normal range. Insight into problems appears normal. Judgment appears intact. There are signs of anxiety. There are no signs of hyperactive or attentional difficulties.Id. at 375. Finally, at her October 18, 2016 visit, Dr. Clarkson opined that Lapenta:
appears friendly, attentive, but appears anxious. She exhibits speech that is normal in rate, volume, and articulation and is coherent and spontaneous. Language skills are intact. Signs of mild depression are present. Demeanor is mildly sad. Affect is appropriate, full range, and congruent with mood. There are no apparent signs of hallucinations, delusions, bizarre behaviors, or other indicators of psychotic process. Associations are intact, thinking is logical, and thought content appears appropriate.... Cognitive functioning and fund of knowledge are intact and age appropriate.... Insight into problems appears normal. Judgment appears intact. There are signs of anxiety. There are no signs of hyperactive or attentional difficulties.Id. at 377.
In addition to the Broudy Opinion, the ALJ afforded “significant weight” to the State agency reconsideration opinion of Alex Siegel, Ph.D., dated March 3, 2017. Id. at 33; see also id. at 88-105. Dr. Siegel found that Lapenta had no understanding and memory limitations but that she had sustained concentration and persistence limitations and social interaction limitations. Id. at 100-01. With respect to her sustained concentration and persistence limitations, Dr. Siegel opined that she was moderately limited in her “ability to carry out detailed instructions, ” but not significantly limited in any of the other categories. Id. Dr. Siegel further determined that Lapenta “can understand, retain, and follow simple job instructions, i.e., perform one and two steps tasks....can perform simple, routine, repetitive work in a stable environment....[and] can make simple decisions.” Id. at 101. With respect to her social interaction limitations, Dr. Siegal found that she was moderately limited in her “ability to interact appropriately with the general public, ” “to accept instructions and respond appropriately to criticism from supervisors, ” and “to get along with co[-]workers or peers without distracting them or exhibiting behavioral extremes.” Id. She was not significantly limited in her ability “to ask simple questions or request assistance” and “to maintain socially[-]appropriate behavior and to adhere to basic standards of neatness and cleanliness.” Id. When asked to elaborate, Dr. Siegal reported that Lapenta “also says she has difficulty getting along with others, and reports a history of insubordination at work. Her behavior has improved with treatment, but she is likely better suited to jobs that do not require much interaction with other people.” Id. Dr. Siegal further noted that “[f]unctionally, she can manage daily activities independently, and her mental status is intact, but . . . she appears to have residual limitations in social functioning.” Id. at 102. The ALJ determined that this opinion was “more consistent with the totality of the medical evidence, including the more recent updated treatment records, and[] [Lapenta's] history of struggling with more stressful skilled work.” Id. at 33. Here, the ALJ's decision to give significant weight to the State agency opinion was proper. See, e.g., Plummer, 186 F.3d at 429 (holding that where the opinion of a treating physician conflicts with that of a non-treating, non-examining physician, the ALJ may choose whom to credit); see also Salerno v. Comm'r of Soc. Sec., 152 Fed.Appx. 208, 209-10 (3d Cir. 2005) (affirming an ALJ's decision to credit the opinion of the nonexamining State agency reviewing psychologist because his opinion was more supported by the record than the opinions of the treating physician and the consultative examiner); Jones v. Sullivan, 954 F.2d 125, 129 (3d Cir. 1991) (contradictory opinions by State agency physicians provided a sufficient basis for refusing to give a treating physician's conclusory opinion controlling weight).
These categories included the following: (1) “ability to carry out very short and simple instructions;” (2) “ability to maintain attention and concentration for extended periods;” (3) “ability to perform activities within a schedule, maintain regular attendance, and be punctual within customary tolerances;” (4) “ability to sustain an ordinary routine without special supervision;” (5) “ability to work in coordination with or in proximity to others without being distracted by them;” (6) “ability to make simple work-related decisions;” and (6) “ability to complete a normal workday and workweek without interruptions from psychologically[-]based symptoms and to perform at a consistent pace without an unreasonable number and length of rest periods.” R. at 100-01.
Despite the substantial evidence supporting the ALJ's decision, Lapenta argues that the ALJ improperly substituted his own lay opinion when he rejected Dr. Gupta's opinions. Pl.'s Br. at 15-16. This assertion is baseless. Determining a claimant's RFC is an administrative task to be performed by the ALJ. See Chandler v. Comm'r Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011). As the Chandler court explained:
The ALJ-not treating or examining physicians or State agency consultants-must make the ultimate disability and RFC determinations. See 20 C.F.R. §§ 404.1527(e)(1), 404.1546(c). Although treating and examining physician opinions often deserve more weight than the opinions of doctors who review records, see, e.g., 20 C.F.R. § 404.1527(d)(1)-(2), “[t]he law is clear . . . that the opinion of a treating physician does not bind the ALJ on the issue of functional capacity.”667 F.3d at 361 (quoting Brown v. Astrue, 649 F.3d 193, 197 n.2 (3d Cir. 2011)). Thus, an ALJ is not bound by the specific functional ratings set by a physician in a medical source form. See id. at 362 (ALJ could extrapolate RFC from medical evidence in the record); Titterington v. Barnhart, 174 Fed.Appx. 6, 11 (3d Cir. 2006) (ALJ may adopt RFC findings that have not been stated by physician). “Surveying the medical evidence to craft an RFC is part of the ALJ's duties.” Titterington, 174 Fed.Appx. at 11. In this matter, the ALJ's determination that the opinion of Dr. Gupta was entitled to little weight and that the limitations found by him should not be incorporated into Lapenta's RFC was supported by substantial evidence.
B. Substantial Evidence Supports the ALJ's Decision to Discount Lapenta's Testimony
Lapenta contends that the ALJ erred in finding that her testimony was not entirely consistent with the evidence. Pl.'s Br. at 17-20. This contention is meritless.
As part of an RFC analysis, an ALJ must determine the credibility of the claimant's subjective complaints by evaluating the intensity and persistence of the symptoms to determine the extent to which those symptoms limit the individual's ability to work. 20 C.F.R. § 404.1529(c). “This obviously requires the ALJ to determine the extent to which a claimant is accurately stating the degree of pain or the extent to which he or she is disabled by it.” Hartranft, 181 F.3d at 362. In reaching a determination, the ALJ must consider “objective medical evidence, the individual's own statements about symptoms, statements and other information provided by treating or examining physicians or psychologists and other persons about the symptoms and how they affect the individual, and any other relevant evidence in the case record.” SSR 96-7p, 1996 WL 374186, at *1 (July 2, 1996). “Credibility determinations by an ALJ need only be supported by substantial evidence on the record as a whole, and when the ALJ weighs the credibility of the claimant's testimony against other evidence in the record as seems to be the circumstances here, the Court must defer to the factfinder.” Thompson v. Barnhart, No. 05-395, 2006 WL 709795, at *17 n.9 (E.D. Pa. Mar. 15, 2006) (citations omitted); accord Roman ex rel. K.M.J. v. Barnhart, No. 04-4628, 2006 WL 516769, at *5 n.3 (E.D. Pa. Feb. 28, 2006); Wilson v. Apfel, No. 98-6511, 1999 WL 993723, at *4 (E.D. Pa. Oct. 29, 1999).
As the ALJ summarized, Lapenta testified at the hearing that she cannot work because she struggles with relationships and anger. R. at 30. She reported that stress quickly escalates her anger, leading to impaired judgment and verbal attacks directed at coworkers and supervisors. Id. at 30-31. Lapenta further testified that she cycles between manic and depressive moods because of her bipolar disorder. Id. at 31. During a manic episode, she is initially productive but ultimately destructive, leading her to verbal expressions of inappropriate anger. Id. During a depressive episode, which Lapenta testified occurs at least twice per year and lasts for up to two months, she experiences overwhelming fatigue and struggles with getting out of bed, performing normal chores, maintaining personal hygiene, and communicating with others. Id. She also reported that her bipolar disorder causes her to sleep less, slows her speech, and causes bursts of energy. Id. Because of her moods, Lapenta testified, she has been terminated from employment and has difficulty with personal relationships. Id. Lapenta testified that she feels guilty because of her behavior. Id. With respect to her daily activities, Lapenta testified that she cares for two animals, cleans her house, does laundry, and occasionally visits a friend or neighbor. Id. She stated that she can grocery shop and attend appointments, but that she has had trouble driving because her symptoms cause her to experience road rage. Id. She also reported that when she reads, she becomes disinterested and has trouble focusing. Id. Lapenta also has difficulty staying organized and presenting herself professionally. Id.
Here, the ALJ found that Lapenta'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.” Id. This determination was supported by substantial evidence.
With respect to the objective medical evidence, the ALJ found that it “does not support a finding that [] [Lapenta's] impairments would preclude any sustained work activity.” Id. at 32. In making this determination, the ALJ explained that, “[a]lthough [] [Lapenta] has received treatment for her allegedly disabling impairments, that treatment is not suggestive of a level of severity that would preclude the ability to perform sustained work activity.” Id. For example, at her February 16, 2017, May 8, 2017, August 7, 2017, November 10, 2017, and March 20, 2018 visits, Dr. Gupta opined that Lapenta's bipolar disorder appeared stable. Id. at 440, 448, 452, 456, 459. Dr. Gupta continued Lapenta on her current combination of medications at her February 16, 2017, May 8, 2017, August 7, 2017, November 10, 2017, and February 2, 2018 visits. Id. at 444, 448, 452, 456, 459. At her March 20, 2018 visit, however, Dr. Gupta did “lower the dosage of Risperdal to 0.5 mg at bedtime” due do Lapenta's complaints of constipation. Id. at 437, 440. With respect to her generalized anxiety, Dr. Gupta prescribed Lapenta a “low dosage of Lexapro” at her May 8, 2017 visit. Id. at 456. At her August 7, 2017 visit, Dr. Gupta “increase[d] dose of Lexapro to 10mg for anxiety” and noted that “some of [Lapenta's] anxiety is situational.” Id. at 452. Thereafter, at her November 10, 2017, February 2, 2018, and March 20, 2018 visits, Dr. Gupta opined that “[s]he has done well on Lexapro 10 mg dose” and that she should “[c]ontinue Lexapro.” Id. at 440, 444, 448. Notably, both her psychiatric evaluation dated December 27, 2017 and discharge summary dated January 18, 2018 from the Rockford Center state the following: “She started with her current psychiatrist, Dr. Sandeep Gupta about a year ago, feels that this has been very effective to manage her anxiety and feels her anxiety at this point [is] completely under control.” Id. at 601, 699.
See supra note 9 for a more detailed discussion of Dr. Gupta's opinion regarding the stability of Lapenta's bipolar disorder.
In partially discounting Lapenta's credibility, the ALJ also noted that her “allegations regarding her symptoms and limitations, and her inability to perform sustained work activity, is diminished, because those allegations are greater than expected in light of the objective evidence of record.” Id. at 32. Indeed, as discussed supra in Section V(A) and as noted by the ALJ, “[h]er most recent psychiatric examination reveal[ed] [that] she was neatly dressed, alert and cooperative, with direct eye contact, appropriate attitude, normal speech, oriented in all spheres, normal memory, normal fund of knowledge, stable and full range affect, normal judgment, normal insight, and normal thought processing, but an anxious mood.” Id. Moreover, as the ALJ explained, “[f]ollowing her discharge from the partial hospitalization program, [] [Lapenta] was noted to be doing fairly well on medications, with stable mood, good sleep, good appetite, and fair energy, but she has difficulty keeping a job due to becoming suspicious of others.” Id.
See supra Section V(A) for a detailed discussion of the results of Dr. Gupta's February 2, 2018 examination of Lapenta, and see supra note 8 for a discussion of the results of Dr. Gupta's February 16, 2017, May 8, 2017, August 7, 2017, November 10, 2017, and March 20, 2018 examinations of Lapenta.
These findings are consistent with many of Lapenta's prior reports to Dr. Gupta. For example, on February 16, 2017, Lapenta reported that since the discontinuation of Abilify, “her mood and anxiety are much better” and that “[s]he has also noticed improvement in irritability.” R. at 457. It was further noted that “[s]he is able to sleep well, ” “has good appetite, ” and that her “[e]nergy level is fair.” Id. Lapenta “also talked about [how] not working [has] probably helped her with mood and anxiety” and “[s]tate[d] she sometimes experiences panic attacks but they're manageable.” Id. At her May 8, 2017 visit, Lapenta stated “[o]verall she feels a lot better” and that “even her boyfriend has noticed improvement in mood swings.” Id. at 453. She indicated that “[s]he went back to work [a] couple of weeks ago” and “[s]he is liking her job and decided to give up on disability.” Id. In addition, she reported that she “feels her bipolar disorder is improved, ” and that “[o]verall quality of life is much better, ” and she “denie[d] any trouble with sleep or appetite.” Id. She did, however, “complain[] of anxiety symptoms including panic attacks....[and] of racing thoughts, inability to sit still, unable to relax, racing mind and nervousness.” Id. Lapenta also stated that “she worries obsessively.” Id. On August 7, 2017, Lapenta reported that she had started working but indicated that “work was very stressful and [that her] employer had unrealistic expectations.” Id. at 449. But, “[o]n a positive note, [Lapenta] did not lose control and did not shout or yell [at] her employer.” Id. She did, however, “quit her job last week before he could fire her.” Id. Lapenta also “complain[ed] of anxiety with physical symptoms of diarrhea, nervousness, unable to relax, excessive worries and anxiety” but “no panic symptoms [were] reported.” Id. Further, Lapenta's “[m]ood [was] overall stable” and she was “not endorsing significant depressive symptoms.” Id. Finally, at her November 10, 2017 visit, Lapenta “[s]tate[d] she was doing fairly well on [her] current combination of medications until couple of days ago.” Id. at 445. Lapenta indicated that she “is doing some part-time work and felt anxious because of work-related issues” but “[o]verall she [was] not endorsing any significant depressive or anxiety symptoms.” Id. She also reported that “[s]he [was] hopeful and future oriented, ” “[d]enie[d] any major issues with sleep or appetite, ” and “[d]enie[d] any anxiety symptoms.” Id. Dr. Gupta also noted that there was “[n]o irritability noticed” and “[n]o anxiety or excessive worries reported.” Id.
In partially crediting Lapenta's testimony, the ALJ explained that “what the evidence suggests is that [] [Lapenta's] symptoms . . . may have other mitigating factors against their negative impact on [] [Lapenta's] functional abilities.” Id. The ALJ then provided the following example: “although [] [Lapenta] repeatedly alleges that work results in increased symptoms, her work attempts have included skilled work that involves more interaction with others than would be expected given her past difficulties.” Id. Lapenta's past relevant work was as a financial manager, trust manager, auditor, and project accountant. Id. at 33. All of these positions are skilled in nature, which, by definition, “may require dealing with people.” 20 C.F.R. § 404.1568(c). Therefore, it is hardly surprising that Lapenta, given her limitation in interacting with others, would find it difficult to keep a skilled job. Substantial evidence does, however, support the ALJ's finding that Lapenta would be able to engage in an unskilled job, which “ordinarily involve[s] dealing primarily with objects, rather than with data or people.” SSR 8515, 1985 WL 56857, at *4 (1984); see also 20 C.F.R. pt. 404, subpt. P, app. 2, § 202(g). Indeed, Dr. Siegel, who authored the State agency reconsideration opinion that the ALJ afforded significant weight, opined that Lapenta was “better suited to jobs that do not require much interaction with other people, ” R. at 101, and noted that “TSO is given appropriate weight, and indicates that she should be able to sustain employment in a more solitary job setting, ” id. at 102.
Finally, the ALJ did not reject Lapenta's allegations entirely; rather, he incorporated certain limitations related to Lapenta's complaints in his RFC finding. For example, the ALJ acknowledged that Lapenta struggles with relationships by limiting her to no interactions with the general public, occasional interactions with supervisors and coworkers, and no work that required her to work in tandem with coworkers to complete job tasks. Id. at 29. “Credibility determinations by an ALJ need only be supported by substantial evidence on the record as a whole, and when the ALJ weighs the credibility of the claimant's testimony against other evidence in the record as seems to be the circumstances here, the Court must defer to the factfinder.” Thompson, 2006 WL 709795, at *17 n.9 (citations omitted); accord Roman ex rel. K.M.J., 2006 WL 516769, at *5 n.3; Wilson, 1999 WL 993723, at *4. Here, read as a whole, the ALJ's decision demonstrates that he considered the entire record and that his assessment of Lapenta's credibility was supported by substantial evidence and is entitled to judicial deference. Zaccaria v. Comm'r of Soc. Sec., 267 Fed.Appx. 159, 161 (3d Cir. 2008); Williams v. Barnhart, 87 Fed.Appx. 240, 242 (3d Cir. 2004).
To the extent that Lapenta argues that the ALJ failed to consider all the evidence related to her credibility, Pl.'s Br. at 18-20, “[t]here is no requirement that the ALJ discuss in [his or her] opinion every tidbit of evidence included in the record.” Hur, 94 Fed.Appx. at 13. Nor does “the ALJ's mere failure to cite specific evidence . . . establish that the ALJ failed to consider it.” Phillips, 91 Fed.Appx. at 780 n.7 (citations omitted). In this case, the ALJ fully discussed Lapenta's medical care and summarized her treatment history. R. at 29-33. The ALJ credited some of Lapenta's complaints, determined that the record supported a finding that she retained the RFC to perform light work, and adequately explained the reasoning underlying his determination. See id.
C. Substantial Evidence Supports the ALJ's Hypothetical Question to the VE
Lapenta maintains that the ALJ failed to incorporate all of her limitations in his hypothetical question to the VE because he did not include the limitations assessed by Dr. Gupta. Pl.'s Br. at 20-22. This argument is unpersuasive.
At the hearing, the ALJ asked the VE to consider whether there were any occupations that could be performed by a hypothetical person of the same age, education, and past work history as Lapenta, who:
could perform work at all exertional levels but . . . could not be exposed to hazards like climbing ropes, ladders, or scaffolds, . . . [and] cannot work at unprotected heights or work with moving machinery..... could perform simple, routine, and repetitive work but not any production pace.... would be unable to interact with the general public but could occasionally interact with supervisors and coworkers as long as they did not have to perform work in tandem with coworkers to complete job tasks.... [and] could make simple work[-]related decision in a stable work environment which would be defined as very little change in work process or work setting.R. at 66. In response, the VE identified the following occupations: marker, router, and non postal mail clerk. Id. at 68. Lapenta's counsel then posed additional hypothetical to the VE in which the VE was asked to assume that the hypothetical individual had the restrictions identified in Dr. Gupta's opinion. Id. at 69-71. The VE testified that these restrictions would preclude the person from working in any position. Id.
The VE's testimony, however, “concerning a claimant's ability to perform alternative employment may only be considered for purposes of determining disability if the question accurately portrays the claimant's individual physical and mental impairments.” Podedworny v. Harris, 745 F.2d 210, 218 (3d Cir. 1984). An ALJ is not required to include in a claimant's RFC those impairments that he or she finds are not credibly established by the evidence. Salles v. Comm'r of Soc. Sec., 229 Fed.Appx. 140, 147 (3d Cir. 2007). It was Lapenta's burden to present evidence to establish that she was unable to engage in any substantial gainful activity. Santiago v. Comm'r of Soc. Sec., 273 Fed.Appx. 211, 213 n.1 (3d Cir. 2008) (citing 42 U.S.C. § 1382c(3)(A)). She was required to “prove her medical condition and [the resulting] functional limitations.” Esposito v. Apfel, No. 99-771, 2000 WL 218119, at *4 (E.D. Pa. Feb. 24, 2000) (citing Diaz v. Shalala, 59 F.3d 307, 315 (2d Cir. 1995); Torres v. Schweiker, 682 F.2d 109, 111 (3d Cir. 1982)). The ALJ's hypothetical on which the decision ultimately relied contained all of the limitations found by the ALJ, and substantial evidence supports his findings. Lapenta's counsel, however, proffered additional limitations to the VE, including that the hypothetical person could never interact appropriately with supervisors or coworkers; could never carry out short, simple instructions or deal with normal work stress even in an unskilled work environment; and was likely to be absent from work four days a month on an ongoing basis. R. at 66-71. Here, the ALJ did not find that those additional limitations were credibly established. Cf. Burns v. Barnhart, 312 F.3d 113, 123 (3d Cir. 2002) (“[W]hile the ALJ may proffer a variety of assumptions to the expert, the vocational expert's testimony concerning a claimant's ability to perform alternative employment may only be considered for purposes of determining disability if the question accurately portrays the claimant's individual physical and mental impairments.” (quoting Podedworny, 745 F.2d at 218)). Accordingly, the ALJ's decision not to include the limitations identified in Lapenta's counsel's hypotheticals to the VE was not in error.
VI. CONCLUSION
For the reasons set forth above, I find that the ALJ's decision is supported by substantial evidence. Therefore, Plaintiff's Request for Review will be denied and dismissed. An appropriate order follows.
Those changes abandoned the treating-physician rule. See 20 C.F.R. § 404.1520(c). Although a physician's relationship with the claimant and the length of the treating relationship are still relevant considerations under the revised rules, id. § 404.1520c(c)(2), (3), the rules make the “most important factors” in considering a physician's opinion its supportability and consistency with the evidence, id. § 404.1520c(a). Because Lapenta filed her application for DIB benefits before March 27, 2017, the revised rules are inapplicable to her claim. Therefore, Dr. Gupta's opinion will be evaluated in accordance with the rules set forth in 20 C.F.R. § 404.1527.