Opinion
Case No. 3:13-cv-155
04-29-2014
ROBIN RARDAIN Plaintiff, v. COMMISSIONER OF SOCIAL SECURITY, Defendant.
Judge Timothy S. Black
ORDER THAT: (1) THE ALJ'S NON-DISABILITY FINDING IS SUPPORTED
BY SUBSTANTIAL EVIDENCE, AND AFFIRMED;
AND (2) THIS CASE IS CLOSED
This is a Social Security disability benefits appeal. At issue is whether the administrative law judge ("ALJ") erred in finding the Plaintiff "not disabled" and therefore not entitled to disability insurance benefits ("DIB") and supplemental security income ("SSI") prior to May 3, 2012. (See Administrative Transcript at Doc.6-2 (PageID 68-82) (ALJ's decision)).
I.
Plaintiff filed applications for DIB and SSI on July 22, 2009, alleging that she became unable to work on January 27, 2006 due to myotonic dystrophy, coronary artery disease post stenting and balloon angioplasty, obesity, and diabetes mellitus. (PageID 71). Her claim was denied initially and on reconsideration. (Id.) In February 2012, the ALJ held a hearing on Plaintiff's claims, during which Plaintiff was represented by an attorney. (Id.) The ALJ rendered a partially favorable decision on May 16, 2012, finding that Plaintiff was disabled as of her fiftieth birthday, May 3, 2012. (PageID 82). Prior to May 3, 2012, the ALJ found that Plaintiff had the residual functional capacity ("RFC") to perform sedentary work with some restrictions. (PageID 76-80).
Plaintiff filed for benefits four previous times. All of the applications were denied at the initial level in March 2006, July 2006, May 2007, and November 2008. PageID 238-241.
Mytonic dystrophy is part of a group of inherited disorders called muscular dystrophies. It is characterized by progressive muscle wasting and weakness. People with this disorder often have prolonged muscle contractions and are not able to relax certain muscles after use.
The Medical-Vocational Guidelines provides directives to an ALJ in determining disability. Specifically, the Guideline states that "where the findings of fact made with respect to a particular individual's vocational factors [age, education, and work experience] and residual functional capacity coincide with all of the criteria of a particular rule, the rule directs a conclusion as to whether the individual is or is not disabled." 20 C.F.R. Pt. 404, Subpt. P, App. 2 § 200(a) (this process is known as "gridding out"). Section 201(g) directs that an individual approaching advanced age (50-54) who has been limited to sedentary work, and "can no longer perform vocationally relevant past work and have no transferable skills" will ordinarily be found disabled. Table One, which applies to workers limited to sedentary work, directs that based on Plaintiff's vocational factors, she became disabled on her fiftieth birthday. Id. at § 201.14.
A claimant's residual functional capacity ("RFC") is an assessment of "the most [she] can still do despite [her] limitations." 20 C.F.R. § 416.945(a)(1).
"Sedentary work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required occasionally and other sedentary criteria are met." 20 C.F.R. § 404.1567(a).
Plaintiff appealed the ALJ's decision, claiming that she was "totally disabled and unable to perform substantial gainful work activity due to a combination of impairments." (PageID 66-67). The ALJ's decision became final and appealable on March 26, 2013, when the Appeals Council denied Plaintiff's request for review. (PageID 52-54). Now, Plaintiff seeks judicial review pursuant to section 205(g) of the Act. 42 U.S.C. §§ 405(g), 1383(c)(3).
At the time of the hearing, Plaintiff was a 49-year-old female with two years of college. (PageID 80, 99). Plaintiff has past relevant work experience as a licensed practical nurse, working mainly in nursing homes. (PageID 99-101).
Past relevant work is defined as "work that [an individual] has done within the past 15 years, that was substantial gainful activity, and that lasted long enough for the individual to learn to do it." 20 C.F.R. §404.1560(b)(1).
The ALJ's "Findings," which represent the rationale of her decision, were as follows:
1. The claimant meets the insured status requirements of the Social Security Act through June 30, 2011.(PageID 73-82).
2. The claimant has not engaged in substantial gainful activity since the alleged onset date (20 CFR §§ 404.1571 et seq., and 416.971 et seq.).
3. Since the alleged onset date of disability, January 27, 2006, the claimant has had the following severe impairments: myotonic dystrophy, coronary artery disease post stenting and balloon angioplasty, obesity and diabetes mellitus. (20 CFR §§ 404.1520(c) and 416.920(c)).
4. Because the claimant's medically determinable mental impairments cause no more than "mild" limitation in any of the first three functional areas and "no" episodes of decompensation which have been of extended duration in the fourth area, they are nonsevere (20 CFR §§ 404.1520a(d)(1) and 416.920a(d)(1)).
5. Since the alleged onset date of disability, January 27, 2006, the claimant has not had any impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR §§ 404.1520(d), 404.1525, 404.1526, 416.925 and 416.926).
6. After careful consideration of the entire record, I find that since January 27, 2006, the claimant has the residual functional capacity to perform sedentary work as defined in 20 CFR §§ 404.1567(a) and 416.967(a). She must be allowed to sit or stand alternatively at will twice per hour. The claimant cannot climb ladders, ropes or scaffolds and can only occasionally climb ramps or stairs, balance, stoop, crawl, crouch or kneel. The claimant must avoid
concentrated exposure to extreme temperatures and unprotected heights. Lastly, her work is limited to 1-4 step tasks.
7. Since January 27, 2006, the claimant has been unable to perform any past relevant work (20 CFR §§404.1565 and 416.965). The demands of claimant's past relevant work exceed the residual functional capacity.
8. Prior to the established disability onset date, the claimant was a younger individual age 45-49. On May 3, 2012, the claimant's age category changed to an individual closely approaching advanced age (20 CFR§§ 404.1563 and 416.963).
9. The claimant has at least a high school education and is able to communicate in English (20 CFR §§ 404.1564 and 416.964).
10. Prior to May 3, 2012, transferability of job skills is not material to the determination of disability because using the Medical-Vocational Rules as a framework supports a finding that the claimant is "not disabled," whether or not the claimant has transferable job skills. Beginning on May 3, 2012, the claimant has not been able to transfer job skills to other occupations (See SSR 82-41 and 20 CFR Part 404, Subpart P, Appendix 2).
11. Prior to May 3, 2012, the date claimant's age category changed, considering the claimant's age, education, work experience, and residual functional capacity, there were jobs that existed in significant numbers in the national economy that the claimant could have performed (20 CFR §§ 404.1569, 404.1569(a), 416.969, and 416.969(a)).
12. Beginning on May 3, 2012, the date of the claimant's age category changed, considering the claimant's age, education, work experience, and residual functional capacity, there are no jobs that exist in significant numbers in the national economy that the claimant could perform (20 CFR 404.1560(c), 404.1566, 416.960(c), and 416.966). A finding of "disabled" is reached by direct application of Medical-Vocational Rule 201.14.
13. The claimant was not disabled prior to May 3, 2012, but became disabled on that date and has continued to be disabled through the date of this decision (20 CFR 404.1520(g) and 416.920(g)).
In sum, the ALJ concluded that Plaintiff was not under a disability as defined by the Social Security Regulations, and was therefore not entitled to DIB or SSI prior to May 3, 2012. (PageID 82).
On appeal, Plaintiff argues that the ALJ erred in: (1) failing to give the long-time treating physician's opinion controlling weight; (2) failing to evaluate the long-time treating physician's opinion using the applicable regulatory factors; and (3) failing to properly evaluate Plaintiff's credibility. The Court will address each error in turn.
II.
The Court's inquiry on appeal is to determine whether the ALJ's non-disability finding is supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971). In performing this review, the Court considers the record as a whole. Hephner v. Mathews, 574 F.2d 359, 362 (6th Cir. 1978). If substantial evidence supports the ALJ's denial of benefits, that finding must be affirmed, even if substantial evidence also exists in the record upon which the ALJ could have found plaintiff disabled. As the Sixth Circuit has explained:
The Commissioner's findings are not subject to reversal merely because substantial evidence exists in the record to support a different conclusion. The substantial evidence standard presupposes that there is a "zone of choice" within which the Commissioner may proceed without interference from the courts. If the Commissioner's decision is supported by substantial evidence, a reviewing court must affirm.Felisky v. Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994).
The claimant bears the ultimate burden to prove by sufficient evidence that she is entitled to disability benefits. 20 C.F.R. § 404.1512(a). That is, she must present sufficient evidence to show that, during the relevant time period, she suffered an impairment, or combination of impairments, expected to last at least twelve months, that left her unable to perform any job in the national economy. 42 U.S.C. § 423(d)(1)(A).
A.
The record reflects that:
1. Medical Evidence
Plaintiff has a genetically inherited, degenerative disease called Myotonic Dystrophy, a form of Muscular Dystrophy. (PageID 887). It was initially diagnosed in 1991, when Plaintiff was 29 years old. (PageID 769). Despite the progressive disease, Plaintiff was able to work until early 2006. (PageID 309, 887). In January 2006, Plaintiff's long-standing back pain and fatigue worsened. (PageID 471-473, 887). A February 2006 sleep study ruled out sleep apnea as the cause. (PageID 572-573). On February 6, 2006, neurologist, Joel Vandersluis, M.D., evaluated Plaintiff. Plaintiff's symptoms included hypersomnolence, upper and lower extremity weakness, left hand numbness, and decreased balance. (PageID 536-537). On examination, Plaintiff had the "facies typical of Myotonic Dystrophy with slight inversion of the 'fish mouth' and early somewhat male pattern balding," decreased grip strength, "somewhat diminished" reflexes, and decreased sensation around the thoracic spine. (ld.) Dr. Vandersluis suggested cardiac and diabetic screenings. (PageID 537).
Hypersomnolence is a sleeping disorder characterized by excessive sleeping or sleepiness.
On March 13, 2007, Dolly Boughaba, M.D., a neurologist, examined Plaintiff for Myotonic Dystrophy. (PageID 309-313). Dr. Boughaba noted extreme fatigue, exertional intolerance, hand weakness, occasional chest pain or flutters, difficulty rising from seated position due to weakness, as well as leg and back pain and stiffness. (PageID 309-310). On examination, Plaintiff had droopy eyelids, orbicularis oculi weakness, and right hearing loss. (PageID 310). On muscle strength testing, she had decreased bilateral abductor pollicis brevis-thumb ("APB"), and decreased bilateral interosseous. (PageID 311). The brachio radlalis reflexes were absent (abnormal) bilaterally. (PageID 312). Myotonic Dystrophy with resulting distal weakness and excessive fatigue/sleepiness was diagnosed, and testing was ordered. (PageID 312-313). Cardiac testing, completed on March 20, 2007, indicated sinus bradycardia, and tricuspid and pulmonary regurgitation. (PageID 314, 318).
In relation to an earlier application, Damian M. Danopulos, M.D., examined Plaintiff on April 24, 2007. (PageID 857-866). On examination, her spine was painful with motion and with pressure at the lower cervical, lower dorsal, and lumbosacral areas. Deep tendon reflexes and bilateral grip strength were reduced. (PageID 862). Dr. Danopulos thought Plaintiff "gave a reliable history." (PageID 858). On October 14, 2008, Dr. Danopulos re-examined Plaintiff. (PageID 874-886). Plaintiff reported increasing weakness, severe fatigue, muscular and joint aches/pains, low back pain, chest pains, and secondary depression. (PageID 874-886). Plaintiff also reported that she had good and bad days. (Id.) On examination, Plaintiff's upper extremities, lower extremities, and dorsal through lumbosacral spine were painful to palpation. (Id.) Plaintiff's hip and lumbar range of motion were painful, bilateral straight leg raises positive, and she was unable to toe and heel walk. (PageID 880-882). Again, Dr. Danopulos thought Plaintiff "gave a reliable history." (PageID 876).
In July 2007, Plaintiff was hospitalized for chest pains and shortness of breath. (PageID 640-659). Cardiac catheterization revealed that her right coronary artery was 99% obstructed and a balloon angioplasty stent placement was performed. (Id.) On July 31, 2008, she again had increased chest pain and shortness of breath. (PageID 669-672). An emergency cardiac catheterization revealed a 40%-50% re-stenosis of the right coronary artery, and balloon angioplasty with re-stenting was performed. (Id.) Plaintiff saw cardiologist, Thomas G. Thornton, on an outpatient basis. (PageID 341-371). After a brief recurrence in March and April 2009, Plaintiff remained stable; she saw her treating cardiologist, Dr. Thornton, regularly; and took all of her cardiac medications for atherosclerotic heart disease as prescribed. (See generally, PageID 346-47, 715-23, 813-23).
On September 9, 2008, Plaintiff had genetic testing and counseling for Myotonic Dystrophy. Plaintiff reported chronic fatigue, myotonia of her hands, progressive lethargy, drowsiness, and "extreme fatigue related" to muscle weakness. (PageID 809-10). Plaintiff's genetic testing was "consistent with the clinical diagnosis of Myotonic Dystrophy" and recommendations included neurologic, eye, cardiac, and cognitive evaluations. (PageID 810).
Myotonia is a condition that makes it difficult for an individual to relax his/her grip.
In August 2009, Dr. Randall sent Plaintiff to physical therapy for back, leg, and hip pain secondary to Myotonic Dystrophy. (PageID 402-406). A September 2009 examination revealed decreased lower extremity reflexes, and lumbar and thoracic spine tenderness. (PageID 405, 707). On October 7, 2009, physical therapist, Connie Bain, noted Plaintiff had thoracic scoliosis with her head "notably" bent forward, spotty numbness throughout, particularly abdomen, mid-back and legs, and decreased range of motion of the trunk, hamstrings and hips. (PageID 403). After three-and a-half minutes of recumbent biking, Plaintiff became short of breath. (Id.) On October 16, 2009, Ms. Bain noted Plaintiff's "very limited functional strength," and that she completed physical therapy sessions with variable benefit. (PageID 685-707).
In March 2010, Dr. Randall referred Plaintiff to an orthopedist, L. Joseph Rubino, M.D., for left knee pain and swelling. (PageID 464). On examination, Dr. Rubino noted hypersensitivity to palpation along her outer knee, "painful patellofemoral crepitus and patellofemoral grind," and left quadriceps weakness. (PageID 460). Dr. Rubino diagnosed "likely" patellofemoral syndrome, injected her knee, and prescribed physical therapy. (PagelD 458-60). In May 2010, physical therapy examination showed tenderness to palpation, decreased left leg range of motion, decreased hamstring flexibility, and knee laxity with possible meniscal irritation. (PageID 611).
Patellofemoral syndrome is pain in the front of the knee.
Genetic specialist, Heather Workman, and State agency examining physician, Dr. Danopulos, noted that ophthalmologic complications are often associated with Myotonic Dystrophy. (PageID 810, 881). Plaintiff had bilateral cataracts removed in 2003 and 2004. (PageID 626-39). Between January 2008 and December 2008, Plaintiff was treated for bilateral cataracts, left eye cysts (removed January 2008), left eye papillomas, right eye epiretinal membrane (abnormal tissue on the retina), and chronic bilateral blepharitis (eyelid infection). Her second left-side cataract surgery was done in February 2008 and her right-side was done in May 2008. (PageID 321-340).
2. Psychological Evidence
Over time, Plaintiff's physical limitations caused psychological distress. In October 2008, Dr. Randall noted that secondary depression and anxiety worsened Plaintiff's condition. (PageID 677-78). In August 2009, Dr. Randall referred Plaintiff for counseling sessions for dysthymia and anxiety. (PageID 372-78, 411). Giovanni M. Bonds, Ph.D., evaluated Plaintiff on October 13, 2008 for the state agency. (PageID 867-874). Plaintiff explained that she felt frustrated that she could no longer do what she wanted. (PageID 869). Her primary physical symptoms included significant fatigue, weakness, and back, leg, and shoulder pain. (PageID 868-869).
Dysthymia is a common psychological disorder characterized by a chronic but mild depressive state that has been present in an individual for more than two years.
On February 20, 2010, psychologist, Stephen W. Halmi, Psy.D., evaluated Plaintiff for the State agency. (PageID 408-416). Dr. Halmi noted that Plaintiff had depression related symptoms including feeling sad, down, decreased concentration, and decreased interest. (PageID 413). Plaintiff reported that she performs some household chores but explained, "it takes me a great deal of effort to do any chores." (PageID 412). She was "frustrated about constant fatigue and weakness" and because she could not do what she wanted. (PageID 413). During her mental status examination, Plaintiff's face was strained and appeared uncomfortable, as she changed positions frequently. (Id.) However, Plaintiff did not appear to exaggerate psychological symptoms or exhibit "excessive pain behavior." (Id.) Plaintiff's affect was flat, and exhibited anxiety from her tense posture and restlessness. (PageID 413-15). Dr. Halmi diagnosed Dysthymic Disorder and found that Plaintiff's ability to handle stress associated with regular work activity was moderately impaired. (PageID 414, 416).
3. Medical Source Opinion Evidence
In his February 2007 and August 2008 reports for the state agency, Plaintiff's physician, Dr. Randall, noted that Plaintiff "had progressive difficulties" with Myotonic Dystrophy-related symptoms including weakness, muscular strength, and pain. (PageID 563, 769). Plaintiff also had a "progressive decline" in physical ability, as well as examination findings that included decreased reflexes, range of motion and overall strength. (Id.) In February 2007 and October 2008, Dr. Randall noted that Plaintiff has Myotonic Dystrophy, a "profound progressive disease." (PageID 677-678, 680-681). Examinations revealed Plaintiff had decreased range of motion of the spine and joints, and positive neurological findings. (Id.) Dr. Randall opined that Plaintiff was unemployable for at least twelve months. (Id.) In the June 2007 and October 2008 ability to work forms, Dr. Randall noted that Plaintiff's prognosis was "poor," her ability to stand/walk and sit were significantly limited, she could not use her hands for repetitive grasping pushing/pulling, or fine manipulation, and was not able to perform full-time work. (PageID 679, 682).
On March 1, 2010, Jerry McCloud, M.D., reviewed the record for the state agency. (PageID 422-429). Dr. McCloud opined that Plaintiff could perform a reduced range of light work. (PageID 423-424). On August 20, 2010, Willa Caldwell, M.D., reviewed the record and agreed that Plaintiff could perform a reduced range of light work. (PageID 614-17).
Alice Chambly, Psy.D., reviewed the psychological evidence of record on March 26, 2010 for the state agency. (PageID 430-47). Dr. Chambly opined that Plaintiff had a severe psychological impairment, and her ability to maintain concentration, persistence, or pace was moderately impaired; however, she could still perform simple and moderately complex tasks. (PageID 433, 444).
In February 2012, Dr. Randall completed two physical capacity evaluations. (PageID 829-830, 892-893). He noted that Plaintiff's standing, walking, sitting, lifting, bending, and crawling all continued to be significantly restricted. (Id.) Dr. Randall also opined that Plaintiff did not have the residual functional ability to perform even sedentary work on a sustained basis. (Id.) In February 2012, Dr. Randall also completed two supplemental questionnaires. (PageID 825-28, 888-91). He opined that Plaintiff had a moderately-severe impairment in her ability to perform daily activities and maintain production standards. (PageID 825, 888). Additionally, Dr. Randall found that Plaintiff had a moderately-severe to severe impairment in her ability to complete a normal workday or workweek without symptoms interfering. (PageID 827, 890). Plaintiff's prognosis was "poor"as she had a "progressive, deteriorating condition." (PageID 827-828, 890).
In a March 21, 2012 letter, Dr. Randall explained:
Myotonic Dystrophy is a form of Muscular Dystrophy with progressive deterioration of muscle function that occurs over a patient's lifetime. Ms. Rardain [Plaintiff] has been able to work for the early portions of her life, but on or about the beginning of 2006, it is my determination that Plaintiff has become physically disabled and unable to perform either sedentary or physically active work.(PageID 887). Dr. Randall added that Plaintiff is physically unable to perform sedentary work because progressive weakness and fatigue interferes with Plaintiff's concentration and focus. (Id.)
4. Hearing Testimony
In 1991, when Plaintiff was initially diagnosed with Myotonic Dystrophy, she was still able to work full-time; however, over the years, her symptoms increased until she was no longer able to work. (PageID 116). Symptoms included "constant" back, leg and hip pain, decreased grip strength and fine motor handling, generalized weakness, and "tremendous, constant fatigue." (PageID l02). Plaintiff testified that she has good days one-to-two times a week. On those days she can stand 10-15 minutes, walk (with an ambulatory aid) 15-20 minutes, sit 15-20 minutes, and lift 10-15 pounds, at a time. Plaintiff estimated that she could lift 1-2 pounds. (PageID 112-115). Her ability to perform daily activities is severely limited. (Id.) Plaintiff lives with a disabled 20-year-old daughter and her elderly mother. (Id.) She testified that it is essentially a team effort to complete household chores. (Id.) For example, her daughter may get a few items out of the refrigerator for Plaintiff to make a sandwich. Additionally, Plaintiff testified that she must use a shower chair; she has trouble with buttons; her handwriting has "deteriorated;" and she uses a large mouse for computer work. (PageID 109-113, 119). Plaintiff summarized:
I have a hard time living day to day, let alone trying to carry on a job at the same time. And due to the pain and the fatigue, I cannot do it.(PageID 120). Over the past two years, Plaintiff testified that she has felt depressed and frustrated "not being able to do anything, not being able to go anywhere." (PageID 117).
5. ALJ Decision
In the ALJ's decision, she found that Plaintiff's myotonic dystrophy, coronary artery disease post stenting and balloon angioplasty, obesity, and diabetes mellitus were "severe" impairments. (PageID 73). However, the ALJ found that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of any listed impairments, including impairments found in Listing 11.13 and 4.04 since January 2006. (PageID 75-76). The ALJ found that Plaintiff had the residual functional capacity to perform sedentary work prior to May 3, 2012, but that she became disabled on that date (her fiftieth birthday), because the Medical - Vocational guidelines directed a finding of disability. (PageID 76, 80-81). Thus, the ALJ denied Plaintiff's claims for benefits prior to May 3, 2012. (PageID 81).
20 C.F.R. § 404.1520(d) directs the ALJ decision when an individual's impairment(s) meets or equals a listed impairment in appendix 1. Section 1520(d) dictates that "if you have an impairment(s) that meets the duration requirement and is listed in appendix 1 or is equal to a listed impairment(s), we will find you disabled without considering your age, education, and work experience." Listing 11.13 lists "muscular dystrophy with disorganization of motor function," defined as "significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station."
Listing 4.04 lists "Ischemic heart disease with symptoms due to myocardial ischemia, as described in 4.00E3-4.00E7, while on a regimen of prescribed treatment" as an impairment. Ischemic heart disease is a disease characterized by reduced blood supply to the heart caused by a blockage in the coronary arteries.
B.
First, Plaintiff alleges that the ALJ erred in failing to give Dr. Randall's opinion controlling weight when determining her RFC. Plaintiff asserts that Dr. Randall's clinical findings as to her disabling conditions were well supported by his office evaluations and the examinations of several other doctors over a number of years.
If an ALJ rejects the opinion of a treating physician, s/he must clearly articulate "good reasons" for doing so. Wilson v. Comm'r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004). In order to be "good," those reasons must be "supported by the evidence in the case record, and must be sufficiently specific to make clear to any subsequent reviewers the weight the adjudicator gave to the treating source's medical opinion and the reasons for that weight." SSR 96-2p. In Rogers v. Comm'r of Soc. Sec., the Sixth Circuit held that the ALJ's "failure to follow the procedural requirement of identifying the reasons for discounting the opinions, and for explaining precisely how those reasons affected the weight...denotes a lack of substantial evidence, even where the conclusion of the ALJ may be justified based upon the record." 486 F.3d 234, 243 (6th Cir. 2007).
Pursuant to the Regulations, a treating source's opinion as to the nature and severity of a claimant's impairment will be given controlling weight, if it 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). The treating source's opinion is given greater weight because the treating source may provide a more detailed picture of the claimant's medical impairments and can give "a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone, or from reports of individual examinations, such as consultative examinations or brief hospitalizations." (Id.)
Both parties' briefs cite 20 C.F.R. § 404.1527(d)(2) to support this contention. However, 20 C.F.R. § 404.1527(d)(2) is inapplicable because it states that determining issues regarding the severity of a disability is reserved to the Commissioner. 20 C.F.R. § 404.1527(c)(2) states that a treating source's opinion should be given controlling weight if well supported.
In February of 2007, Dr. Randall, who had treated Plaintiff for many years (PageID 887), completed a Basic Medical questionnaire, which included a Physical Function Capacity Assessment (PageID 681-684). Dr. Randall opined that Plaintiff was unable to do any fine manipulation, repetitive pushing, pulling, and grasping. (PageID 681). In February 2012, Dr. Randall provided a Supplemental Questionnaire where he noted that Plaintiff could stand and/or walk about two hours in an eight-hour workday; could sit and/or alternate positions for about four hours in an eight-hour work day; and could use her hands for repetitive fine motor skills. (PageID 829). Dr. Randall also noted that the Plaintiff could occasionally lift up to ten pounds but she could not bend, squat, crawl or climb, nor did she have the RFC to perform sedentary work on a sustained basis in an eight-hour day. (PageID 830). Dr. Randall answered the question as to what clinical or objective findings supported his opinions by noting, "this is a [sic] inherited disease thru [sic] her family." (PageID 827).
The ALJ provided good reasons for giving little weight to the medical opinions of a number of the doctors, including Dr. Randall. Three private doctors examined Plaintiff over a period of two years; only one, Dr. Vandersluis, limited Plaintiff to carrying no more than three pounds and restricted her from driving. (PageID 77). The ALJ gave little weight to Dr. Vandersluis's opinion, because it was contradicted by Plaintiff's own testimony that she can lift 10-15 pounds and that she drives her car on her own. (Id., PageID 98, 114). Additionally, Plaintiff was also examined by two agency doctors, Drs. McCloud and Caldwell, who opined that Plaintiff could perform light work. (PageID 422-429, 613-620). The ALJ gave little weight to these opinions because they failed to take into consideration documentation of Plaintiff's fatigue and deconditioning. (PageID 80).
Two of the doctors, Dr. Danopulos and Dr. Boughaba, only noted that Plaintiff's symptoms were consistent with a diagnosis of Mytonic Dystrophy. (PageID 77). Neither of these doctors offered any opinion as to the consistency of any of Plaintiff's impairments or their subsequent impact on Plaintiff's ability to work.
As to Dr. Randall, the ALJ stated her reasons for giving his opinion "little weight." Specifically, the ALJ points out that Dr. Randall's opinion conflicted with the other medical examinations in the record; conflicted with Plaintiff's own testimony as to her manipulative abilities; and his opinions relied solely on Plaintiff's self-reported limitations. Accordingly, the ALJ articulated good reasons for giving little weight to Dr. Randall's opinion, and therefore, her decision is supported by substantial evidence.
C.
Next, Plaintiff claims that the ALJ erred by not evaluating Dr. Randall's opinion using the applicable regulatory factors. Plaintiff asserts that the ALJ did not defer to Dr. Randall's opinion or apply the relevant factors as required by SSR 96-2p.
If the ALJ does not accord the opinion of the treating source controlling weight, it must apply certain factors in determining what weight to give the opinion. These factors include the length of the treatment relationship and the frequency of examination, the nature and extent of the treatment relationship, the supportability of the opinion, the consistency of the opinion with the record as a whole, and the specialization of the treating source.Rabbers v. Comm'r Soc. Sec. Admin., 582 F.3d 647, 660 (6th Cir. 2009) (discussing 20 C.F.R. §§ 404.1527(d)(2)(i)-(ii), (d)(3)-(6)). Although the regulations call for the application of these factors, the Commissioner can comply with the regulation by attacking the consistency of the medical opinions. Hall v. Comm'r of Soc. Sec., 148 Fed. Appx. 456, 464 (6th Cir. 2005) (holding that the ALJ provided good reasons in either his analysis of the treating doctor, or his analysis of the claimant's impairments).
See infra n. 14. The applicable regulation is 20 C.F.R. 404.1527(c)(2)(i)-(ii), (c)(3)-(6)).
The purpose of the regulation is to review whether the ALJ's decision provided sufficient reasons for rejecting the treating doctors' opinions. As detailed above, the ALJ articulated sufficient reasons for why she did not give deferential weight to Dr. Randall's opinions.
D.
Lastly, Plaintiff claims that the ALJ erred in assessing her credibility. Plaintiff asserts that the ALJ did not offer any meaningful analysis of the factors in determining her credibility.
The standard for evaluating subjective complaints of pain is articulated in Duncan v. Sec'y. of Health & Human. Servs., 801 F.2d 847 (6th Cir. 1986):
First, we examine whether there is objective medical evidence of an underlying medical condition. If there is, we then examine: (1) whether objective medical evidence confirms the severity of the alleged pain arising from the condition; or (2) whether the objectively established medical condition is of such a severity that it can reasonably be expected to produce the alleged disabling pain.
An ALJ's finding regarding a claimant's credibility is entitled to deference because the ALJ had the unique opportunity to observe the claimant at the hearing and judge her subjective complaints. (Id.)
In the instant case, the ALJ's credibility finding deserves deference. The ALJ's opinion is based on both her assessment of Plaintiff and the inconsistencies between Plaintiff's account and the evidence in the record. The ALJ summarized the evidence and sufficiently articulated her reasoning to satisfy the Regulations. Bailey v. Comm'r of Soc. Sec., 623 F.Supp.2d 889, 901 (W.D. Mich. 2009) (holding that reversal is inappropriate in the face of the substantial evidence supporting the ALJ's conclusion and stated reasoning, when the only purpose of the reversal is to get a more thorough discussion of the evidence bearing on claimant's credibility). Accordingly, the ALJ's finding as to credibility is supported by substantial evidence.
For example, Plaintiff alleged that she suffered swelling, but a majority of the examinations either did not mention swelling or stated that swelling was not present. (PageID 78). Additionally, Plaintiff reported difficulty gripping and using her hands, but the medical evidence did not show this as a continuous impairment. Plaintiff also claimed that her daily living activities were significantly limited (PageID 916), but she reported that she can take care of herself, her elderly mother, and her disabled daughter. (PageID 79, 98, 108-112). Plaintiff also told her primary care doctor that she was "staying active," and her cardiologist reported that she was doing well. (PageID 79).
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The Court's duty on appeal is not to re-weigh the evidence, but to determine if the decision below is supported by substantial evidence. Raisor v. Schweiker, 540 F. Supp. 686 (S.D. Ohio 1982). Although there might be substantial evidence that supports the Plaintiff's claim to disability from January 27, 2006 to May 2, 2012, the issue to be decided by this Court is whether the ALJ's decision is supported by substantial evidence. Casey v. Sec'y of Health & Human Servs., 987 F.2d 1230, 1233 (6th Cir. 1993). This Court finds that substantial evidence supports the ALJ's finding that Plaintiff could perform sedentary work prior to May 3, 2012, and therefore Plaintiff was not disabled before that date.
III.
For the foregoing reasons, Plaintiff's assignments of error are unavailing. The ALJ's decision is supported by substantial evidence and is affirmed.
IT IS THEREFORE ORDERED THAT the decision of the Commissioner, that Robin Rardain was not entitled to disability insurance benefits and supplemental security income before May 3, 2012 is found SUPPORTED BY SUBSTANTIAL EVIDENCE, and AFFIRMED; the Clerk shall enter judgment accordingly; and, as no further matters remain pending for the Court's review, this case is CLOSED.
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Timothy S. Black
United States District Judge