Opinion
CIVIL ACTION No. 02-2085-GTV
January 21, 2003
MEMORANDUM AND ORDER
Plaintiff Gregory Arnett brings this action pursuant to 42 U.S.C. § 405(g) and D. Kan. Rule 83.7, seeking judicial review of the decision of the Commissioner of Social Security ("Commissioner") to deny his application for a period of disability and disability insurance benefits under Title II of the Social Security Act. Plaintiff is a college-educated fifty-year-old who has been diagnosed with Chronic Fatigue Syndrome. His past work experience includes employment as a business manager and a computer programmer/analyst. Plaintiff contends that the Commissioner improperly disregarded the opinion of his treating physician, inadequately addressed his residual functional capacity, and incorrectly evaluated his credibility. For the reasons set forth below, the court reverses the Commissioner's decision based on Plaintiff's first argument, and having done so, concludes that it need not address the other two arguments. The Commissioner is ordered to make an immediate award of benefits.
I. Procedural Background
On December 14, 1999, Plaintiff filed his application for a period of disability and disability insurance benefits, claiming disability since March 26, 1999 due to chronic fatigue, depression, and high stress levels. The application was denied both initially and upon reconsideration. At Plaintiff's request, an administrative law judge ("ALJ") held a hearing on October 17, 2001, at which Plaintiff and his counsel were present. On November 20, 2001, the ALJ rendered a decision in which he determined that Plaintiff was not under a "disability" as defined by the Social Security Act. After the ALJ's unfavorable decision, Plaintiff requested review by the Appeals Council. The Appeals Council denied Plaintiff's request for review on February 2, 2002, rendering the ALJ's decision the final decision of the Commissioner.
II. Standard of Review
The Commissioner's findings are binding on this court if supported by substantial evidence. 42 U.S.C. § 405(g); Dixon v. Heckler, 811 F.2d 506, 508 (10th Cir. 1987). The court's review is limited to determining whether the Commissioner's decision is supported by substantial evidence in the record and whether the Commissioner properly applied relevant legal standards. Marshall v. Chater, 75 F.3d 1421, 1425 (10th Cir. 1996) (citing Castellano v. Sec'y of Health Human Servs., 26 F.3d 1027, 1028 (10th Cir. 1994)). "Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Castellano, 26 F.3d at 1028 (citations and internal quotation marks omitted). The court may not reweigh the evidence or substitute its judgment for that of the Commissioner. Hamilton v. Sec'y of Health Human Servs., 961 F.2d 1495, 1500 (10th Cir. 1992).
III. ALJ's Findings
In his November 20, 2001 decision, the ALJ made the following findings:
• Claimant meets the nondisability requirements for a period of disability and Disability Insurance Benefits set forth in Section 216(i) of the Social Security Act and is insured for benefits through the date of this decision.
• Claimant has not engaged in substantial gainful activity since the alleged onset of disability.
• Claimant has an impairment or a combination of impairments considered "severe" based on the requirements in the Regulations ( 20 C.F.R. § 404.1520(b)).
• These medically determinable impairments do not meet or medically equal one of the listed impairments in Appendix 1, Subpart P, Regulation No. 4.
• The undersigned finds claimant's allegations regarding his limitations are not totally credible for the reasons set forth in the body of the decision.
• The undersigned has carefully considered all of the medical opinions in the record regarding the severity of claimant's impairments ( 20 C.F.R. § 404.1527).
• Claimant has the following residual functional capacity: light work with no significant restrictions in functioning due to mental and emotional impairments.
• Claimant's past relevant work as a business manager and computer programmer/analyst do not require the performance of work-related activities precluded by his residual functional capacity ( 20 C.F.R. § 404.1565).
• Claimant's medically determinable depression and chronic fatigue syndrome do not prevent claimant from performing his past relevant work or a wide range of other light work.
• Claimant was not under a "disability" as defined in the Social Security Act, at any time through the date of the decision ( 20 C.F.R. § 404.1520(e)).
IV. Discussion
Plaintiff claims that the ALJ improperly ignored the opinion of Plaintiff's treating psychiatrist, Dr. D. Geenens, that Plaintiff was disabled."A treating physician's opinion must be given substantial weight unless good cause is shown to disregard it. When a treating physician's opinion is inconsistent with other medical evidence, the ALJ's task is to examine the other physicians' reports to see if they outweigh the treating physician's report, not the other way around." Goatcher v. United States Dep't of Health Human Servs., 52 F.3d 288, 289-90 (10th Cir. 1995) (citation and internal quotation marks omitted). In weighing any medical opinion, the ALJ must consider the following factors: (1) how long and often the physician has been treating the plaintiff; (2) the treatment relationship's nature and extent; (3) the amount of relevant evidence supporting the physician's opinion; (4) how consistent that opinion is with the rest of the record; (5) whether the physician is a specialist; and (6) other factors tending to support or contradict the opinion. 20 C.F.R. § 404.1527(d)(2)-(6). The ALJ cannot disregard a treating physician's opinion that a claimant is disabled without giving legitimate and specific reasons for doing so. Goatcher, 52 F.3d at 290 (citing Frey, 816 F.2d at 513).
Dr. Geenens diagnosed Plaintiff with Chronic Fatigue Syndrome. Based on his observations during his two-year treatment of Plaintiff, he opined that Plaintiff was disabled. Dr. Geenens indicated that Plaintiff had several limitations in his ability to engage in work-related activities, including an inability to concentrate or pay attention for an extended period of time.
The ALJ decided that the opinion of Dr. Gerald Vanderberg, a medical expert asked by the ALJ to testify at Plaintiff's hearing, outweighed the opinion of Dr. Geenens. Dr. Vanderberg did not examine Plaintiff, but opined that Plaintiff did not appear to be significantly, clinically depressed. The court notes that while Dr. Vanderberg did not think that Plaintiff was depressed, he also did not express an opinion as to whether Plaintiff was limited in any way in his activities or abilities due to Chronic Fatigue Syndrome.
The ALJ explained why he disregarded Dr. Geenen's opinion in favor of Dr. Vanderberg's opinion as follows:
In making this determination, the undersigned has specifically considered the report of claimant's treating psychiatrist, Dr. Geenens, that indicate[s] that claimant is disabled due to mental and emotional impairments. . . . However, the undersigned finds that this opinion is not entitled to significant weight, and Dr. Geenens has not cited any specific reports or evaluations to support this conclusion, which is otherwise inconsistent with Dr. Geenens'[s] treatment notes and other reports, which demonstrate that claimant's condition has waxed and waned in severity and that he was in a good mood and not showing signs of distress during many office visits.
The court is troubled by the ALJ's analysis for several reasons. The ALJ failed to consider many of the factors enumerated in 20 C.F.R. § 404.1527(d)(2)-(6). First, the ALJ failed to consider the fact that Dr. Geenens was the only physician to treat Plaintiff over a significant period of time. Dr. Vanderberg did not treat Plaintiff at all. He merely reviewed the medical records in the case.
Next, the ALJ faulted Dr. Geenens for failing to cite any specific reports or evaluations in support of his opinion, but the court finds substantial support for Dr. Geenens's opinion in his treatment notes and reports. Numerous times, Dr. Geenens noted that Plaintiff's fatigue and depression significantly limited his life activities.
The ALJ also failed to recognize that Dr. Geenens is a psychiatrist, a specialist in mental disorders. Furthermore, although the ALJ stated that Dr. Geenens's conclusion was inconsistent with the rest of the record, the court concludes that the record does not support that statement. Every doctor who evaluated Plaintiff except Dr. Vanderberg found that Plaintiff had some level of difficulty concentrating and paying attention. As noted above, Dr. Vanderberg did not actually opine that Plaintiff was not limited in any way. The ALJ erroneously noted in his decision that Dr. Vanderberg stated that Plaintiff "did not suffer any significant limitations due to depression." This is an inaccurate reflection of the record. Dr. Vanderberg merely stated that Plaintiff did not appear to be "significantly, clinically depressed." He did not speak to Plaintiff's limitations at all.
Dr. Geenens's observations that Plaintiff improved at times or appeared to be in a good mood at times are not inconsistent with his determination that Plaintiff had difficulty concentrating or paying attention. Dr. Geenens explained any possible inconsistency with an observation that Plaintiff appeared to be the classic portrait of someone who was trying to fight off his depression, but could not overcome it.
In sum, the court concludes that the ALJ's decision to discredit Dr. Geenens's opinion is not supported by substantial evidence. The ALJ should have considered the limitations identified by Dr. Geenens and others when determining whether Plaintiff could perform his previous jobs or other jobs in the national economy.
The vocational expert who testified at the hearing stated that if Plaintiff was unable to concentrate or pay attention, he would be incapable of working in his previous jobs or in any jobs in the national economy. As explained above, substantial evidence in the record supports such a hypothetical. An ALJ "may not ask a vocational expert a hypothetical question based on substantial evidence and then ignore unfavorable answers." Campbell v. Bowen, 822 F.2d 1518, 1523 n. 6 (10th Cir. 1987).
The court need not consider Plaintiff's other arguments. Because the vocational expert testified that Plaintiff could not perform his past work or any other work in the national economy given Dr. Geenens's restrictions, and Dr. Geenens's restrictions were improperly discounted, the Commissioner should have awarded Plaintiff benefits. Where the evidence has been fully developed and points to a particular finding, the court may reverse and remand for an immediate award of benefits. Gatson v. Bowen, 838 F.2d 442, 450 (10th Cir. 1988); Biri v. Apfel, 4 F. Supp.2d 1276, 1279-80 (D.Kan. 1998). Here, the evidence has been fully developed and indicates that Plaintiff should have been awarded benefits.
IT IS, THEREFORE, BY THE COURT ORDERED that the Commissioner's decision is reversed. Pursuant to 42 U.S.C. § 405(g), sentence four, the case is remanded for an award of benefits.
Copies of this order shall be transmitted to counsel of record.
The case is closed.