Opinion
Civil 1:21-CV-14
05-26-2022
YOLANDA CARADINE, Plaintiff v. KILOLO KIJAKAZI, Acting Commissioner of Social Security[1], Defendant
Mariani, Judge.
REPORT AND RECOMMENDATION
Martin C. Carlson, United States Magistrate Judge.
I. Introduction
The Supreme Court has underscored for us the limited scope of our substantive review when considering Social Security appeals, noting that:
The phrase “substantial evidence” is a “term of art” used throughout administrative law to describe how courts are to review agency factfinding. T-Mobile South, LLC v. Roswell, 574 U.S.--,----, 135 S.Ct. 808, 815, 190 L.Ed.2d 679 (2015). Under the substantial-evidence standard, a court looks to an existing administrative record and asks whether it contains “sufficien[t] evidence” to support the agency's factual determinations. Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) (emphasis deleted). And whatever the meaning of “substantial” in other contexts, the threshold for such evidentiary sufficiency is not high. Substantial evidence, this Court has said, is “more than a mere scintilla.” Ibid.;
see, e.g., Perales, 402 U.S. at 401, 91 S.Ct. 1420 (internal quotation marks omitted). It means-and means only-“such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Consolidated Edison, 305 U.S. at 229, 59 S.Ct. 206. See Dickinson v. Zurko, 527 U.S. 150, 153, 119 S.Ct. 1816, 144 L.Ed.2d 143 (1999) (comparing the substantial-evidence standard to the deferential clearly-erroneous standard).Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019).
Yolanda Caradine filed an application for disability and disability insurance benefits and for supplemental security income under Titles II and XVI of the Social Security Act on July 23, 2018. A hearing was held before an Administrative Law Judge (“ALJ”), and the ALJ found that Caradine was not disabled as of the amended onset date of disability of June 24, 2018 and denied her application for benefits.
Caradine now appeals this decision, arguing that the ALJ's decision is not supported by substantial evidence. However, after a review of the record, and mindful of the fact that substantial evidence “means only-‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion,'” Biestek, 139 S.Ct. at 1154, we find that substantial evidence supported the ALJ's findings in this case. Therefore, for the reasons set forth below, we recommend that the district court affirm the decision of the Commissioner denying this claim.
II. Statement of Facts and of the Case
Yolanda Caradine filed for disability and supplemental security benefits, alleging disability due to lupus, Raynaud's, fibromyalgia, rheumatoid arthritis, sciatica, carpal tunnel in both hands, a torn meniscus, and her right arm rotator cuff. (Tr. 276). She alleged an onset date of disability of February 5, 2016, but amended her onset date to June 24, 2018, at the administrative hearing. (Tr. 15). Caradine had a high school education and past work as a warehouse worker, front desk attendant, packer, and server. (Tr. 277).
Caradine treated for her back pain at the Orthopedic Institute of Pennsylvania in March of 2018. (Tr. 701). It was noted that she had been diagnosed with sciatica, and that she was being treated with medication for lupus. (Id.) On examination, she had a slow gait secondary to back and knee pain. (Id.) Treatment notes indicate that Caradine had an MRI of her lumbar spine which did not show any significant pathology. (Id.) She was sent for an MRI of her right knee to evaluate a possible meniscus tear. (Id.) The MRI revealed a minimal meniscal tear, which was conservatively treated with a corticosteroid injection. (Tr. 703).
Caradine received physical therapy treatment for her pain. In April of 2018, it was noted that her sciatica was worsening, and she had been experiencing severe pain for 3 to 4 weeks. (Tr. 891). Caradine rated her pain as a 7 out of 10. (Tr. 896). At a visit on April 30, 2018, Caradine reported feeling better, and she was able to take her grandchildren to the park and walk around the track. (Tr. 899). On May 11, 2018, she reported some back pain but rated her pain as a 2/3 out of 10. (Tr. 903). However, while improvement was noted in the month she was receiving physical therapy, she stopped attending this therapy and was discharged. (Tr. 905).
In June of 2018, Caradine was seen at the Orthopedic Institute for numbness and tingling in her hands. (Tr. 705). She reported wearing a splint on her left wrist in years prior but had not been wearing it at that time. (Id.) An examination revealed no significant swelling or deformity, full range of motion without pain, and a slight decreased sensation to light touch. (Id.) Given her conservative treatment in the past and worsening symptoms, Caradine opted for carpal tunnel release surgery in both hands. (Id.) At this time, just prior to the amended onset date, it was noted that Caradine had returned to work. (Id.)
Caradine treated for shoulder pain in July of 2018. (Tr. 707). It was noted that she had cortisone injections in the past which helped her pain. (Id.) Examination showed no swelling or deformities, no tenderness to palpation, and 5/5 motor strength in the hand and wrist bilaterally. (Id.) X-rays were within normal limits, and Caradine was given an injection in each shoulder to ease her pain. (Tr. 707-08). In September, it was noted that the injection did not give Caradine any relief in her right shoulder. (Tr. 709).
Caradine also treated at Sadler Health Center. In November 2018, at an appointment for laboratory work, it was noted that Caradine was being treated at the Orthopedic Institute for her low back pain and knee pain. (Tr. 833). The treatment notes stated that Caradine's most recent MRI was unremarkable, and that she was being seen by Rheumatology. (Id.)
Caradine was also seen by Dr. Ahmed Kniefati for an internal medicine examination in November of 2018. (Tr. 738-52). It was noted that Caradine had fibromyalgia, rheumatoid arthritis, Raynaud's disease, pain in her lumbar spine, a torn rotator cuff, and a history of lupus. (Tr. 738-39). On examination, Caradine had a normal gait and was able to stand and walk on her toes and heels. (Tr. 740). She did not use any assistive devices. (Id.) She had positive straight leg raise testing, but no evident joint deformity or abnormality in the thoracic spine. (Tr. 740-41). Dr. Kniefati opined that Caradine could lift and carry up to 20 pounds occasionally and up to 10 pounds frequently; could sit for 4 hours, stand for 3 hours, and walk for 2 hours in an 8-hour workday; could never reach overhead; could occasionally climb stairs, ramps, ladders, and scaffolds, stoop, and kneel and could frequently crouch and crawl. (Tr. 743-46).
Caradine also underwent a mental status evaluation with Dr. John Tardibuono in November of 2018. (Tr. 726-35). Dr. Tardibuono reported that Caradine had not provided any records for his review, although he noted a voluntary commitment to the Pennsylvania Psychiatric Institute in April of 2016 due to depression and suicidal ideation. (Tr. 728). On examination, Caradine was mildly anxious but cooperative. (Tr. 730). She exhibited fluent speech, coherent and goal-directed thought processes, full range of affect, intact concentration and attention, and fair insight and judgment. (Tr. 730-31). With respect to her activities of daily living, Dr. Tardibuono indicated that Caradine took care of her hygiene, completed routine household chores with intermittent breaks due to her pain, and was able to shop and manage money. (Tr. 731). Dr. Tardibuono opined that Caradine had a mild limitation in understanding and remembering complex instructions; a mild to moderate limitation in carrying out complex instructions; a mild limitation in her ability to make judgments on complex work-related decisions; and a mild to moderate limitation in responding appropriately to usual work situations and changes in a routine work setting. (Tr. 733-34).
At an appointment at Sadler in December 2018, Caradine expressed that she was stressed about her living situation. (Tr. 831). Treatment notes stated that Caradine had been out of work for a few months due to her carpal tunnel surgery, but that she was taking care of her three grandchildren. (Id.) On examination, she was orientated, had appropriate affect, normal thought processes, good memory, and intact judgment and insight. (Id.) It was recommended that she practice setting boundaries with her daughter, and that she practice breathing and healthy coping techniques. (Tr. 832). Caradine also saw Dr. Miller, her primary physician, for her pain at this time. (Tr. 828). At this visit in December 2018, it was stated that Caradine had dyslipidemia, and it was recommended that she exercise vigorously for 30 to 40 minutes three to four days per week. (Id.)
In December 2018, state agency examiner Dr. Karen Plowman opined on the plaintiff's mental functioning limitations. (Tr. 99-102). Dr. Plowman found that Caradine's depression and anxiety disorders were nonsevere. (Tr. 101). Dr. Plowman opined that Caradine had only mild limitations in understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; and adapting or managing oneself. (Id.) Dr. Plowman reviewed Dr. Tardibuono's mental status evaluation and found it to be internally inconsistent, in that he noted no impairments in several areas during his evaluation but endorsed a “moderate” impairment in these areas on another form. (Tr. 102).
A state agency examiner also opined on Caradine's physical limitations at this time. (Tr. 103-06). Dr. Carl Ritner found that Caradine could occasionally lift and carry 20 pounds and frequently lift and carry 10 pounds; stand, sit, or walk 6 hours in an 8-hour workday; could occasionally climb ramps, stairs, ladders, ropes, and scaffolds, balance, stoop, kneel, crouch, and crawl; and that she was limited in her ability to reach overhead with her right arm, and limited with both extremities in handling/gross manipulation. (Tr. 104-05). He also opined that Caradine should avoid concentrated exposure to extreme cold, vibration, and hazards. (Tr. 105-06).
Caradine presented to the emergency room in January of 2019 with muscle spasms. (Tr. 757). It was observed that she had no back or neck pain at that time and had normal range of motion. (Tr. 759-60). She was given a dose of Valium and discharged with marked improvement in her symptoms. (Tr. 939). She followed up with Dr. Miller at Sadler the following day, who prescribed her Flexeril for her muscle spasms. (Tr. 824). At a follow up appointment on January 7, 2019, it was noted that her issues had been resolved. (Tr. 822). Notes from a March 19, 2019 visit to UPMC Pinnacle indicated that Caradine was experiencing pain in her knees and feet, and it was recommended that she start doing specific exercises for her shoulder, back, and knees. (Tr. 754-55).
Caradine saw Dr. Miller in April of 2019, and it was stated that she was having increased problems with her left sciatica. (Tr. 819). Dr. Miller noted she was having increased discomfort and slightly decreased range of motion. (Id.) It was recommended that she follow up with Orthopedics for her sciatica, and Dr. Miller noted that she was taking Cymbalta and Flexeril as needed. (Tr. 820). In June of 2019, Caradine experienced a fall and presented to the emergency room with pain in her left hip and pelvis area. (Tr. 762). It was reported that she drove herself to the hospital and was not experiencing any other extremity injury, pain, or discomfort. (Id.) At this time, an examination revealed no tenderness, no deformity, and normal range of motion, and she had a normal mood and affect and was oriented to person, place, and time. (Tr. 764).
In September of 2019, Caradine was seen at the Orthopedic Institute complaining of right shoulder pain and spasms in her neck. (Tr. 797). It was noted that she began experiencing this pain shortly after cleaning and playing with her grandson. (Id.) It was recommended that Caradine seek treatment at physical therapy. (Id.) She returned to UPMC Carlisle in October 2019 complaining of hip pain after following up with Rheumatology. (Tr. 766). At this visit, she denied any history of depression. (Tr. 769). On physical examination, Caradine had right hip pain with mild swelling but full range of motion, and no edema or cyanosis. (Id.)
Caradine followed up with Dr. Miller at Sadler, where it was observed that the MRI of her hip taken at the hospital was unremarkable, and she planned to follow up with Rheumatology. (Tr. 811-12). Caradine also followed up at Sadler for her generalized depression and anxiety, and it was noted that she was getting frustrated when she was unable to do things around the house. (Tr. 809).
Caradine also began treating with physical therapy again in October 2019. (Tr. 908). Caradine was experiencing pain in her neck and right arm, and it was noted that she believed her pain to stem from her cleaning job that she was working at that time. (Id.) It was further stated that the pain medication she was taking for her lupus helped with this pain as well. (Id.) In December of 2019, it was noted that Caradine had not returned for physical therapy, as she had received injections for her hip and it was causing numbness. (Tr. 915). Around this same time, progress notes from Rheumatology reported that Caradine had been working in a warehouse in November. (Tr. 927-28). It was suggested that Caradine continue the exercises she had learned in physical therapy for her shoulder, back, and knees. (Tr. 932).
Caradine presented at the emergency room again in December 2019. (Tr. 954). She complained of left leg pain which was worse with movement and ambulation. (Id.) On examination, Caradine had a negative straight leg raise and full range of motion in her bilateral upper and lower extremities. (Tr. 957). It was noted that Caradine had mild sciatica. (Id.)
It was against the backdrop of this medical opinion and clinical evidence that an ALJ conducted a hearing on Caradine's disability application on February 11, 2020. (Tr. 34-78). Caradine and a Vocational Expert both appeared and testified at this hearing. (Id.) Following this hearing, on July 10, 2020, the ALJ issued a decision denying Caradine' application for disability benefits. (Tr. 12-33). In this decision, the ALJ first concluded that Caradine had not engaged in substantial gainful activity since the date of her alleged onset of disability. (Tr. 17). The ALJ then found at Step 2 of the sequential analysis which governs disability claims that Caradine suffered from the following severe impairments: degenerative disc disease of the lumbar spine, degenerative joint disease of the right upper extremity, degenerative joint disease of the right knee, rheumatoid arthritis, and lupus. (Tr. 18). At this step, the ALJ considered Caradine's depressive disorder and anxiety, but determined that these impairments were nonsevere, as Caradine had only mild limitations in several areas of mental functioning. (Tr. 19-20). At Step 3, the ALJ concluded that none of Caradine's severe impairments met or equaled the severity of a listed impairment under the Commissioner's regulations. (Tr. 20-21).
Between Steps 3 and 4, the ALJ then concluded that Caradine:
[H]a[d] the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) except that she may frequently handle with her bilateral upper extremities and occasionally balance, stoop, kneel, crouch, crawl, climb ramps, stairs, ladders, ropes, or scaffolds, and reach overhead with her bilateral upper extremities. The claimant may never be exposed to extreme cold, vibration, unprotected heights, or moving machinery and parts.(Tr. 21).
In reaching this result, the ALJ considered the medical record as detailed above, as well as medical opinion evidence and Caradine's reported symptoms. With respect to the medical opinion evidence, the ALJ considered the opinion of Dr. Carl Ritner, D.O., a state agency examiner. (Tr. 24-25). Dr. Ritner found that Caradine could perform a range of light work with some postural limitations, and that she should not be exposed to environmental hazards. (Id.) The ALJ found Dr. Ritner's opinion persuasive, as it was consistent with the overall medical record showing that Caradine generally retained full range of motion and normal strength and sensation, although at times she experienced tenderness, reduced range of motion, and pain on palpation during examinations. (Id.)
The ALJ also considered the opinion of Dr. Ahmed Kniefati, M.D., and found this opinion to be partially persuasive. (Tr. 25). Dr. Kniefati found that Caradine could sit for 4 hours, stand for 3 hours, and walk for 2 hours in an 8-hour workday, and that she was limited to never reaching over her head. (Id.) The ALJ found Dr. Kneifati's opinion to be partially consistent with the medical record, in that he found occasional postural limitations and the ability to perform a range of light work, but found that Dr. Kneifati's limitations on sitting, standing, and walking were more restrictive than the record supported. (Id.) The ALJ reasoned that Dr. Kniefati's sitting, standing, walking, and reaching limitations were based more on the plaintiff's subjective complaints of pain rather than the objective medical evidence. (Id.)
With respect to Caradine's mental functioning, the ALJ considered the opinions of Dr. Karen Plowman and Dr. John Tardibuono. (Tr. 25-26). Dr. Plowman opined that Caradine had only mild limitations in her ability to understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and care for herself. (Tr. 25). The ALJ found this opinion persuasive, as it was consistent with the medical record which showed nonsevere impairments, conservative treatment, and no significant mental status examination findings. (Id.) The ALJ found Dr. Tardibuono's opinion, which found more moderate mental functioning limitations, to be unpersuasive and inconsistent with the medical record. (Tr. 25-26).
The ALJ also considered Caradine's statements regarding her impairments. Caradine filled out a function report, in which she asserted that she had a problem taking care of herself, including her personal hygiene. (Tr. 301). She stated she was unable to cook, and that she needed help washing dishes and sweeping. (Tr. 30203). She indicated that she had trouble sleeping because of her pain, and that she could not bend, twist, turn, jump, run, lift more than five pounds, or write or type. (Tr. 300). The ALJ found Caradine's statements to be inconsistent with the medical evidence of record, and that her impairments were not as debilitating as she had alleged. (Tr. 24). The ALJ reasoned that Caradine's treatment for her impairments was conservative, including physical therapy and oral medications. (Id.) The ALJ further found that the medical record indicated Caradine was able to provide for her personal care needs, engage in household chores, and go outside alone and shop at stores. (Id.) Significantly, the ALJ noted that Caradine actually took on some employment during the alleged disability period, which involved working 8-hour days at times. (Id.)
Having made these findings, the ALJ found that Caradine could perform her past work as a warehouse worker and cleaner housekeeper, and further concluded at Step 5 that there were a significant number of jobs in the national economy that Caradine could perform, such as cashier II, ticket taker, and office helper. (Tr. 2728). Accordingly, the ALJ found that Caradine had not met the stringent standard prescribed for disability insurance benefits and denied her claim. (Tr. 28).
This appeal followed. On appeal, Caradine presents three issues. First, she argues that the ALJ erred in omitting her mild mental functioning limitations from the hypothetical posed to the Vocational Expert. She then asserts that the ALJ erred in his assessment of the medical opinion evidence, and in his consideration of her subjective complaints. This case is fully briefed and is therefore ripe for resolution. For the reasons set forth below, under the deferential standard of review that applies here, we recommend that the court affirm the decision of the Commissioner.
III. Discussion
A. Substantial Evidence Review - the Role of this Court
When reviewing the Commissioner's final decision denying a claimant's application for benefits, this Court's review is limited to the question of whether the findings of the final decision-maker are supported by substantial evidence in the record. See 42 U.S.C. § 405(g); Johnson v. Comm'r of Soc. Sec., 529 F.3d 198, 200 (3d Cir. 2008); Ficca v. Astrue, 901 F.Supp.2d 533, 536 (M.D. Pa. 2012). 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.” Pierce v. Underwood, 487 U.S. 552, 565 (1988). Substantial evidence is less than a preponderance of the evidence but more than a mere scintilla. Richardson v. Perales, 402 U.S. 389, 401 (1971). A single piece of evidence is not substantial evidence if the ALJ ignores countervailing evidence or fails to resolve a conflict created by the evidence. Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993). But in an adequately developed factual record, substantial evidence may be “something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent [the ALJ's decision] from being supported by substantial evidence.” Consolo v. Fed. Maritime Comm'n, 383 U.S. 607, 620 (1966). “In determining if the Commissioner's decision is supported by substantial evidence the court must scrutinize the record as a whole.” Leslie v. Barnhart, 304 F.Supp.2d 623, 627 (M.D. Pa. 2003).
The Supreme Court has recently underscored for us the limited scope of our review in this field, noting that:
The phrase “substantial evidence” is a “term of art” used throughout administrative law to describe how courts are to review agency factfinding. T-Mobile South, LLC v. Roswell, 574 U.S.--,----, 135 S.Ct. 808, 815, 190 L.Ed.2d 679 (2015). Under the substantial-evidence standard, a court looks to an existing administrative record and asks whether it contains “sufficien[t] evidence” to support the agency's factual determinations. Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) (emphasis deleted). And whatever the meaning of “substantial” in other contexts, the threshold for such evidentiary sufficiency is not high. Substantial evidence, this Court has said, is “more than a mere scintilla.” Ibid.; see, e.g., Perales, 402 U.S. at 401, 91 S.Ct. 1420 (internal quotation marks omitted). It means-and means only-“such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Consolidated Edison, 305 U.S. at 229, 59 S.Ct. 206. See Dickinson v. Zurko, 527 U.S. 150, 153, 119 S.Ct. 1816, 144 L.Ed.2d 143 (1999)
(comparing the substantial-evidence standard to the deferential clearly-erroneous standard).Biestek, 139 S.Ct. at 1154.
The question before this Court, therefore, is not whether the claimant is disabled, but rather whether the Commissioner's finding that she is not disabled is supported by substantial evidence and was reached based upon a correct application of the relevant law. See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D. Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ's errors of law denote a lack of substantial evidence”) (alterations omitted); Burton v. Schweiker, 512 F.Supp. 913, 914 (W.D. Pa. 1981) (“The Secretary's determination as to the status of a claim requires the correct application of the law to the facts”); see also Wright v. Sullivan, 900 F.2d 675, 678 (3d Cir. 1990) (noting that the scope of review on legal matters is plenary); Ficca, 901 F.Supp.2d at 536 (“[T]he court has plenary review of all legal issues ”).
Several fundamental legal propositions flow from this deferential standard of review. First, when conducting this review, “we are mindful that we must not substitute our own judgment for that of the fact finder.” Zirnsak v. Colvin, 777 F.3d 607, 611 (3d Cir. 2014) (citing Rutherford, 399 F.3d at 552). Thus, we are enjoined to refrain from trying to re-weigh the evidence. Rather, our task is to simply determine whether substantial evidence supported the ALJ's findings. However, we must also ascertain whether the ALJ's decision meets the burden of articulation demanded by the courts to enable informed judicial review. Simply put, “this Court requires the ALJ to set forth the reasons for his decision.” Burnett v. Comm'r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000). As the Court of Appeals has noted on this score:
In Burnett, we held that an ALJ must clearly set forth the reasons for his decision. 220 F.3d at 119. Conclusory statements ... are insufficient. The ALJ must provide a “discussion of the evidence” and an “explanation of reasoning” for his conclusion sufficient to enable meaningful judicial review. Id. at 120; see Jones v. Barnhart, 364 F.3d 501, 505 & n. 3 (3d Cir. 2004). The ALJ, of course, need not employ particular “magic” words: “Burnett does not require the ALJ to use particular language or adhere to a particular format in conducting his analysis.” Jones, 364 F.3d at 505.Diaz v. Comm'r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009).
Thus, in practice, ours is a twofold task. We must evaluate the substance of the ALJ's decision under a deferential standard of review, but we must also give that decision careful scrutiny to ensure that the rationale for the ALJ's actions is sufficiently articulated to permit meaningful judicial review.
B. Initial Burdens of Proof, Persuasion, and Articulation for the ALJ
To receive benefits under the Social Security Act by reason of disability, a claimant must demonstrate an inability to “engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. §423(d)(1)(A); 42 U.S.C. §1382c(a)(3)(A); see also 20 C.F.R. §§404.1505(a), 416.905(a). To satisfy this requirement, a claimant must have a severe physical or mental impairment that makes it impossible to do his or her previous work or any other substantial gainful activity that exists in the national economy. 42 U.S.C. §423(d)(2)(A); 42 U.S.C. §1382c(a)(3)(B); 20 C.F.R. §§404.1505(a), 416.905(a). The definition of a disability for a child age 18 or older is the same definition used to determine a disability for purposes of SSI or disability insurance benefits. See 42 U.S.C. § 402(d)(1)(B); 42 U.S.C. § 423(d).
In making this determination at the administrative level, the ALJ follows a five-step sequential evaluation process. 20 C.F.R. §§404.1520(a), 416.920(a). Under this process, the ALJ must sequentially determine: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals a listed impairment; (4) whether the claimant is able to do his or her past relevant work; and (5) whether the claimant is able to do any other work, considering his or her age, education, work experience and residual functional capacity (“RFC”). 20 C.F.R. §§404.1520(a)(4), 416.920(a)(4).
Between Steps 3 and 4, the ALJ must also assess a claimant's residual functional capacity (RFC). RFC is defined as “that which an individual is still able to do despite the limitations caused by his or her impairment(s).” Burnett v. Comm'r of Soc. Sec., 220 F.3d 112, 121 (3d Cir. 2000) (citations omitted); see also 20 C.F.R. §§404.1520(e), 404.1545(a)(1), 416.920(e), 416.945(a)(1). In making this assessment, the ALJ considers all of the claimant's medically determinable impairments, including any non-severe impairments identified by the ALJ at step two of his or her analysis. 20 C.F.R. §§404.1545(a)(2), 416.945(a)(2).
There is an undeniable medical aspect to an RFC determination, since that determination entails an assessment of what work the claimant can do given the physical limitations that the claimant experiences. Yet, when considering the role and necessity of medical opinion evidence in making this determination, courts have followed several different paths. Some courts emphasize the importance of medical opinion support for an RFC determination and have suggested that “[r]arely can a decision be made regarding a claimant's residual functional capacity without an assessment from a physician regarding the functional abilities of the claimant.” Biller v. Acting Comm'r of Soc. Sec., 962 F.Supp.2d 761, 778-79 (W.D. Pa. 2013) (quoting Gormont v. Astrue, Civ. No. 11-2145, 2013 WL 791455 at *7 (M.D. Pa. Mar. 4, 2013)). In other instances, it has been held that: “There is no legal requirement that a physician have made the particular findings that an ALJ adopts in the course of determining an RFC.” Titterington v. Barnhart, 174 Fed.Appx. 6, 11 (3d Cir. 2006). Further, courts have held in cases where there is no evidence of any credible medical opinion supporting a claimant's allegations of disability that “the proposition that an ALJ must always base his RFC on a medical opinion from a physician is misguided.” Cummings v. Colvin, 129 F.Supp.3d 209, 214-15 (W.D. Pa. 2015).
These seemingly discordant legal propositions can be reconciled by evaluation of the factual context of these decisions. Those cases which emphasize the importance of medical opinion support for an RFC assessment typically arise in the factual setting where a well-supported medical source has opined regarding limitations which would support a disability claim, but an ALJ has rejected the medical opinion which supported a disability determination based upon a lay assessment of other evidence. In this setting, these cases simply restate the commonplace idea that medical opinions are entitled to careful consideration when making a disability determination, particularly when those opinions support a finding of disability. In contrast, when an ALJ is relying upon other evidence, such as contrasting clinical or opinion evidence or testimony regarding the claimant's activities of daily living to fashion an RFC, courts have adopted a more pragmatic view and have sustained the ALJ's exercise of independent judgment based upon all of the facts and evidence. See Titterington v. Barnhart, 174 Fed.Appx. 6, 11 (3d Cir. 2006); Cummings, 129 F.Supp.3d at 214-15. In either event, once the ALJ has made this determination, our review of the ALJ's assessment of the plaintiff's RFC is deferential, and that RFC assessment will not be set aside if it is supported by substantial evidence. Burns v. Barnhart, 312 F.3d 113, 129 (3d Cir. 2002); see also Metzger v. Berryhill, No. 3:16-CV-1929, 2017 WL 1483328, at *5 (M.D. Pa. Mar. 29, 2017), report and recommendation adopted sub nom. Metzgar v. Colvin, No. 3:16-CV-1929, 2017 WL 1479426 (M.D. Pa. Apr. 21, 2017); Rathbun v. Berryhill, No. 3:17-CV-00301, 2018 WL 1514383, at *6 (M.D. Pa. Mar. 12, 2018), report and recommendation adopted, No. 3:17-CV-301, 2018 WL 1479366 (M.D. Pa. Mar. 27, 2018).
At Steps 1 through 4, the claimant bears the initial burden of demonstrating the existence of a medically determinable impairment that prevents him or her from engaging in any of his or her past relevant work. Mason, 994 F.2d at 1064. Once this burden has been met by the claimant, it shifts to the Commissioner at Step 5 to show that jobs exist in significant numbers in the national economy that the claimant could perform that are consistent with the claimant's age, education, work, experience, and RFC. 20 C.F.R. §§404.1512(f), 416.912(f); Mason, 994 F.2d at 1064.
The ALJ's disability determination must also meet certain basic substantive requisites. Most significant among these legal benchmarks is a requirement that the ALJ adequately explain the legal and factual basis for this disability determination. Thus, in order to facilitate review of the decision under the substantial evidence standard, the ALJ's decision must be accompanied by “a clear and satisfactory explication of the basis on which it rests.” Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981). Conflicts in the evidence must be resolved and the ALJ must indicate which evidence was accepted, which evidence was rejected, and the reasons for rejecting certain evidence. Id. at 706-707. In addition, “[t]he ALJ must indicate in his decision which evidence he has rejected and which he is relying on as the basis for his finding.” Schaudeck v. Comm'r of Soc. Sec., 181 F.3d 429, 433 (3d Cir. 1999).
C. Legal Benchmarks for the ALJ's Assessment of Medical Opinions
The plaintiff filed this disability application in July of 2018 after a paradigm shift in the manner in which medical opinions were evaluated when assessing Social Security claims. Prior to March 2017, ALJs were required to follow regulations which defined medical opinions narrowly and created a hierarchy of medical source opinions with treating sources at the apex of this hierarchy. However, in March 0f 2017, the Commissioner's regulations governing medical opinions changed in a number of fundamental ways. The range of opinions that ALJs were enjoined to consider were broadened substantially and the approach to evaluating opinions was changed from a hierarchical form of review to a more holistic analysis. As one court as aptly observed:
The regulations regarding the evaluation of medical evidence have been amended for claims filed after March 27, 2017, and several of the prior Social Security Rulings, including SSR 96-2p, have been rescinded. According to the new regulations, the Commissioner “will no longer give any specific evidentiary weight to medical opinions; this includes giving controlling weight to any medical opinion.” Revisions to Rules Regarding the Evaluation of Medical Evidence (“Revisions to Rules”), 2017 WL 168819, 82 Fed.Reg. 5844, at 5867-68 (Jan. 18, 2017), see 20 C.F.R. §§ 404.1520c(a), 416.920c(a). Instead, the Commissioner must consider all medical opinions and “evaluate their persuasiveness” based on the following five factors: supportability; consistency; relationship with the claimant; specialization; and “other factors.” 20 C.F.R. §§ 404.1520c(a)-(c), 416.920c(a)-(c).
Although the new regulations eliminate the perceived hierarchy of medical sources, deference to specific medical opinions, and assigning “weight” to a medical opinion, the ALJ must still “articulate how [he or she] considered the medical opinions” and “how persuasive [he or she] find[s] all of the medical opinions.” Id. at §§ 404.1520c(a) and (b)(1), 416.920c(a) and (b)(1). The two “most important factors for determining the persuasiveness of medical opinions are consistency and supportability,” which are the “same factors” that formed the foundation of the treating source rule. Revisions to Rules, 82 Fed.Reg. 5844-01 at 5853.
An ALJ is specifically required to “explain how [he or she] considered the supportability and consistency factors” for a medical opinion. 20 C.F.R. §§ 404.1520c (b)(2), 416.920c(b)(2). With respect to “supportability,” the new regulations provide that “[t]he more relevant the objective medical evidence and supporting explanations presented
by a medical source are to support his or her medical opinion(s) or prior administrative medical finding(s), the more persuasive the medical opinions or prior administrative medical finding(s) will be.” Id. at §§ 404.1520c(c)(1), 416.920c(c)(1). The regulations provide that with respect to “consistency,” “[t]he more consistent a medical opinion(s) or prior administrative medical finding(s) is with the evidence from other medical sources and nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior administrative medical finding(s) will be.” Id. at §§ 404.1520c(c)(2), 416.920c(c)(2).
Under the new regulations an ALJ must consider, but need not explicitly discuss, the three remaining factors in determining the persuasiveness of a medical source's opinion. Id. at §§ 404.1520c(b)(2), 416.920c(b)(2). However, where the ALJ has found two or more medical opinions to be equally well supported and consistent with the record, but not exactly the same, the ALJ must articulate how he or she considered those factors contained in paragraphs (c)(3) through (c)(5). Id. at §§ 404.1520c(b)(3), 416.920c(b)(3).Andrew G. v. Comm'r of Soc. Sec., No. 3:19-CV-0942 (ML), 2020 WL 5848776, at *5 (N.D.N.Y. Oct. 1, 2020).
Oftentimes, an ALJ must evaluate various medical opinions. Judicial review of this aspect of ALJ decision-making is still guided by several settled legal tenets. First, when presented with a disputed factual record, it is well-established that “[t]he ALJ - not treating or examining physicians or State agency consultants - must make the ultimate disability and RFC determinations.” Chandler v. Comm'r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011). Thus, when evaluating medical opinions “ the ALJ may choose whom to credit but ‘cannot reject evidence for no reason or for the wrong reason.'” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000) (quoting Mason, 994 F.2d at 1066). Therefore, provided that the decision is accompanied by an adequate, articulated rationale, it is the province and the duty of the ALJ to choose which medical opinions and evidence deserve greater weight.
Further, in making this assessment of medical evidence:
An ALJ is [also] entitled generally to credit parts of an opinion without crediting the entire opinion. See Thackara v. Colvin, No. 1:14-CV-00158-GBC, 2015 WL 1295956, at *5 (M.D. Pa. Mar. 23, 2015); Turner v. Colvin, 964 F.Supp.2d 21, 29 (D.D.C. 2013) (agreeing that “SSR 96-2p does not prohibit the ALJ from crediting some parts of a treating source's opinion and rejecting other portions”); Connors v. Astrue, No. 10-CV-197-PB, 2011 WL 2359055, at *9 (D.N.H. June 10, 2011). It follows that an ALJ can give partial credit to all medical opinions and can formulate an RFC based on different parts from the different medical opinions. See e.g., Thackara v. Colvin, No. 1:14-CV-00158-GBC, 2015 WL 1295956, at *5 (M.D. Pa. Mar. 23, 2015).Durden v. Colvin, 191 F.Supp.3d 429, 455 (M.D. Pa. 2016). Finally, where there is no evidence of any credible medical opinion supporting a claimant's allegations of disability “the proposition that an ALJ must always base his RFC on a medical opinion from a physician is misguided.” Cummings, 129 F.Supp.3d at 214-15.
D. Legal Benchmarks for the ALJ's Assessment of a Claimant's Alleged Symptoms
The interplay between the deferential substantive standard of review that governs Social Security appeals, and the requirement that courts carefully assess whether an ALJ has met the standards of articulation required by law, is also illustrated by those cases which consider analysis of a claimant's reported pain.
When evaluating lay testimony regarding a claimant's reported degree of pain and disability, we are reminded that:
[T]he ALJ must necessarily make certain credibility determinations, and this Court defers to the ALJ's assessment of credibility. See Diaz v. Comm'r, 577 F.3d 500, 506 (3d Cir.2009) (“In determining whether there is substantial evidence to support an administrative law judge's decision, we owe deference to his evaluation of the evidence [and] assessment of the credibility of witnesses....”). However, the ALJ must specifically identify and explain what evidence he found not credible and why he found it not credible. Adorno v. Shalala, 40 F.3d 43, 48 (3d Cir.1994) (citing Stewart v. Sec'y of Health, Education and Welfare, 714 F.2d 287, 290 (3d Cir.1983)); see also Stout v. Comm'r, 454 F.3d 1050, 1054 (9th Cir.2006) (stating that an ALJ is required to provide “specific reasons for rejecting lay testimony”). An ALJ cannot reject evidence for an incorrect or unsupported reason. Ray v. Astrue, 649 F.Supp.2d 391, 402 (E.D.Pa.2009) (quoting Mason v. Shalala, 994 F.2d 1058, 1066 (3d Cir.1993)).Zirnsak v. Colvin, 777 F.3d 607, 612-13 (3d Cir. 2014).
Yet, it is also clear that:
Great weight is given to a claimant's subjective testimony only when it is supported by competent medical evidence. Dobrowolsky v. Califano, 606 F.2d 403, 409 (3d Cir. 1979); accord Snedeker v. Comm'r of Soc. Sec., 244 Fed.Appx. 470, 474 (3d Cir. 2007). An ALJ may reject a claimant's subjective testimony that is not found credible so long as there is an explanation for the rejection of the testimony. Social Security Ruling (“SSR”) 96-7p; Schaudeck v. Comm'r of Social Security, 181 F.3d 429, 433 (3d Cir. 1999). Where an ALJ finds that there is an underlying medically determinable physical or mental impairment that could reasonably be expected to produce the individual's pain or other symptoms, however, the severity of which is not substantiated by objective medical evidence, the ALJ must make a finding on the credibility of the individual's statements based on a consideration of the entire case record.McKean v. Colvin, 150 F.Supp.3d 406, 415-16 (M.D. Pa. 2015) (footnotes omitted). Thus, we are instructed to review an ALJ's evaluation of a claimant's subjective reports of pain under a standard of review which is deferential with respect to the ALJ's well-articulated findings but imposes a duty of clear articulation upon the ALJ so that we may conduct meaningful review of the ALJ's conclusions.
In the same fashion that medical opinion evidence is evaluated, the Social Security Rulings and Regulations provide a framework under which the severity of a claimant's reported symptoms are to be considered. 20 C.F.R. §§ 404.1529, 416.929; SSR 16-3p. It is important to note that though the “statements of the individual concerning his or her symptoms must be carefully considered, the ALJ is not required to credit them.” Chandler v. Comm'r of Soc. Sec., 667 F.3d 356, 363 (3d. Cir. 2011) (referencing 20 C.F.R. §404.1529(a) (“statements about your pain or other symptoms will not alone establish that you are disabled”). It is well settled in the Third Circuit that “[a]llegations of pain and other subjective symptoms must be supported by objective medical evidence.” Hantraft v. Apfel, 181 F.3d 358, 362 (3d Cir. 1999) (referring to 20 C.F.R. § 404.1529). When evaluating a claimant's symptoms, the ALJ must follow a two-step process in which the ALJ resolves whether a medically determinable impairment could be the cause of the symptoms alleged by the claimant, and subsequently must evaluate the alleged symptoms in consideration of the record as a whole. SSR 16-3p.
First, symptoms, such as pain or fatigue, will only be considered to affect a claimant's ability to perform work activities if such symptoms result from an underlying physical or mental impairment that has been demonstrated to exist by medical signs or laboratory findings. 20 C.F.R. §§ 404.1529(b), 416.929(b); SSR 16-3p. During the second step of this credibility assessment, the ALJ must determine whether the claimant's statements about the intensity, persistence, or functionally limiting effects of his or her symptoms are substantiated based on the ALJ's evaluation of the entire case record. 20 C.F.R. § 404.1529(c), 416.929(c); SSR 163p. This includes but is not limited to medical signs and laboratory findings, diagnoses, and other medical opinions provided by treating or examining sources, and other medical sources, as well as information concerning the claimant's symptoms and how they affect his or her ability to work. Id. The Social Security Administration has recognized that individuals may experience their symptoms differently and may be limited by their symptoms to a greater or lesser extent than other individuals with the same medical impairments, signs, and laboratory findings. SSR 16-3p.
Thus, to assist in the evaluation of a claimant's subjective symptoms, the Social Security Regulations identify seven factors which may be relevant to the assessment of the severity or limiting effects of a claimant's impairment based on a claimant's symptoms. 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3). These factors include: activities of daily living; the location, duration, frequency, and intensity of the claimant's symptoms; precipitating and aggravating factors; the type, dosage, effectiveness, and side effects of any medication the claimant takes or has taken to alleviate his or her symptoms; treatment, other than medication that a claimant has received for relief; any measures the claimant has used to relieve his or her symptoms; and, any other factors concerning the claimant's functional limitations and restrictions. Id.; see Koppenaver v. Berryhill, No. 3:18-CV-1525, 2019 WL 1995999, at *9 (M.D. Pa. Apr. 8, 2019), report and recommendation adopted sub nom. Koppenhaver v. Berryhill, No. 3:18-CV-1525, 2019 WL 1992130 (M.D. Pa. May 6, 2019); Martinez v. Colvin, No. 3:14-CV-1090, 2015 WL 5781202, at *8-9 (M.D. Pa. Sept. 30, 2015); George v. Colvin, No. 4:13-CV-2803, 2014 WL 5449706, at *4 (M.D. Pa. Oct. 24, 2014).
E. The ALJ's Decision in this Case is Supported by Substantial Evidence.
In this setting, we are mindful that we are not free to substitute our independent assessment of the evidence for the ALJ's determinations. Rather, we must simply ascertain whether the ALJ's decision is supported by substantial evidence, a quantum of proof which is less than a preponderance of the evidence but more than a mere scintilla, Richardson v. Perales, 402 U.S. 389, 401 (1971), and “does not mean a large or considerable amount of evidence,” Pierce v. Underwood, 487 U.S. 552, 565 (1988), but rather “means-and means only-‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.' ” Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019). Judged against these deferential standards of review, we find that substantial evidence supported the ALJ's decision that Caradine was not entirely disabled.
Caradine first argues that the ALJ erred when he failed to include mental functioning limitations in his hypothetical questions to the Vocational Expert. At Step Five of the sequential evaluation process, the ALJ considers the claimant's age, education, and work experience to determine whether the claimant can make the adjustment to other work by posing a hypothetical question to the Vocational Expert. Chrupcala v. Heckler, 829 F.2d 1269, 176 (3d Cir. 1987); see also Rutherford, 399 F.3d at 554; Ramirez, 372 F.3d at 552-55; Podedworny v. Harris, 745 F.2d 210, 218 (3d Cir. 1984). On this score, “[a] hypothetical question must reflect all of the claimant's impairments that are supported by the record; otherwise the question is deficient and the [vocational] expert's answer to it cannot be considered substantial evidence.” Chrupcala, 829 F.2d at 1276; see also Rutherford, 399 F.3d at 554; Ramirez, 372 F.3d at 552-55; Podedworny, 745 F.2d at 218. The ALJ, however, is not required to submit to the vocational expert every impairment alleged by a claimant. Rutherford, 399 F.3d at 554. “[S]uch references to ‘all impairments' encompass only those that are medically established.” (Id.) Thus, the question posed to the ALJ must accurately convey to the vocational expert all of a claimant's credibly established limitations. Id. (quoting Plummer, 186 F.3d at 431).
Here, the ALJ did not include any mental functioning limitations in the hypotheticals posed to the Vocational Expert, despite finding that the plaintiff was mildly limited in some areas of mental functioning. The ALJ found that the plaintiff's depressive and anxiety disorders were nonsevere, and that Caradine had only mild limitations in understanding, remembering, and applying information; interacting with others; concentrating, persisting, and maintaining pace; and adapting or managing oneself. These findings are consistent with the overall medical evidence of record showing coherent thought processes, normal mood and affect, intact insight and judgment, and that the plaintiff had the ability to care for herself, go out alone and shop, and perform household tasks. On this score, the ALJ sufficiently considered the mild limitations that the plaintiff had in these areas of mental functioning, but ultimately determined they were nonsevere and did not have more than a minimal limitation on Caradine's ability to do basic work activities. Accordingly, given that the ALJ is only required to include impairments from medically established limitations, we conclude that the ALJ did not err in omitting these mild limitations from his hypothetical to the Vocational Expert. See Holley v. Comm'r of Soc. Sec., 590 Fed.Appx. 167, 169 (3d Cir. 2014) (finding no error in omitting mild limitations from a hypothetical where the evidence regarding the claimant's mental impairments was sparse); Northrup v. Kijakazi, 2022 WL 889968, at *5 (M.D. Pa. March 24, 2022) (Schwab, M.J.) (finding that the ALJ's determination of nonsevere impairments was supported by substantial evidence, and thus there was no error in omitting those impairments from the RFC assessment).
Moreover, any error in omitting these mild limitations from the hypothetical was harmless. Social Security appeals are subject to harmless error analysis. Therefore:
[A]ny evaluation of an administrative agency disability determination must also take into account the fundamental principle that: “‘No principle of administrative law or common sense requires us to remand a case in quest of a perfect opinion unless there is reason to believe that the remand might lead to a different result.'” Moua v. Colvin, 541 Fed.Appx. 794, 798 (10th Cir. 2013) quoting Fisher v. Bowen, 869 F.2d 1055, 1057 (7th Cir. 1989). Thus, ALJ determinations in Social Security appeals are subject to harmless error analysis, Seaman v. Soc. Sec. Admin., 321 Fed.Appx. 134, 135 (3d Cir. 2009) and “the burden of showing that an error is harmful normally falls upon the party attacking the agency's determination.” Shinseki v. Sanders, 556 U.S. 396, 409, 129 S.Ct. 1696, 1706, 173 L.Ed.2d 532 (2009).Metzger v. Berryhill, No. 3:16-CV-1929, 2017 WL 1483328, at *4 (M.D. Pa. Mar. 29, 2017), report and recommendation adopted sub nom. Metzgar v. Colvin, No. 3:16-CV-1929, 2017 WL 1479426 (M.D. Pa. Apr. 21, 2017). In this regard “we apply harmless error analysis cautiously in the administrative review setting.” Fischer-Ross v. Barnhart, 431 F.3d 729, 733 (10th Cir. 2005). However:
In Social Security appeals courts may apply harmless error analysis when assessing the sufficiency of an ALJ's decision. Seaman v. Soc. Sec. Admin., 321 Fed.Appx. 134, 135 (3d Cir. 2009). “Under the harmless error rule, an error warrants remand if it prejudices a party's ‘substantial rights.' An error implicates substantial rights if it likely affects the outcome of the proceeding, or likely affects the ‘perceived fairness, integrity, or public reputation of judicial proceedings.'” Hyer v. Colvin, 72 F.Supp.3d 479, 494 (D. Del. 2014).Harrison v. Berryhill, No. 3:17-CV-618, 2018 WL 2051691, at *5 (M.D. Pa. Apr. 17, 2018), report and recommendation adopted, No. 3:17-CV-0618, 2018 WL 2049924 (M.D. Pa. May 2, 2018).
In Caradine's case, the evidence related to her depression and generalized anxiety disorders was sparse. While there were some records from Sadler that the plaintiff was experiencing some depression and anxiety during the relevant period, treatment notes during this time consistently show that Caradine had normal and goal-directed thought processes, intact insight and judgment, and normal mood and affect. Based on this limited record regarding her depression and anxiety, there is little evidence to support Caradine's assertion that her mental limitations would result in work-related limitations. See e.g., Brumfield v. Saul, 2020 WL 4934315, at 7-8 (E.D. Pa. Aug. 21, 2020). Accordingly, any error in the ALJ's analysis on this score is harmless and does not require a remand.
Next, Caradine contends that the ALJ erred when he found the opinions of Dr. Ritner and Dr. Plowman more persuasive than the opinions of Dr. Kniefati and Dr. Tardibuono. Caradine further asserts that the ALJ erred in his analysis of her subjective complaints, in that the ALJ failed to adequately consider her testimony regarding her mental limitations, as well as her Raynaud's disease, fibromyalgia flare ups, rheumatoid arthritis, knee pain, and shoulder pain.
Under the new analytical paradigm prescribed by Social Security regulations, persuasiveness is the touchstone for any medical opinion evaluation. Further, it is well settled that “supportability ... and consistency ... are the most important factors [to] consider when [ ] determine[ing] how persuasive [to] find a medical source's medical opinions ... to be.” 20 C.F.R. § 404.1520c(b)(2). In this context, supportability means that “[t]he more relevant the objective medical evidence and supporting explanations presented by a medical source are to support his or her medical opinion(s) or prior administrative medical finding(s), the more persuasive the medical opinions or prior administrative medical finding(s) will be.”
Consistency, in turn, is defined to mean that: “[t]he more consistent a medical opinion(s) or prior administrative medical finding(s) is with the evidence from other medical sources and nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior administrative medical finding(s) will be.” 20 C.F.R. § 404.1520c(c)(1)-(2).
At the outset, we note that the question of disability is a legal determination and is not wholly dictated by medical opinions. Indeed, it is well settled that “[t]he ALJ-not treating or examining physicians or State agency consultants-must make the ultimate disability and RFC determinations.” Chandler, 667 F.3d at 361. Further, in making this assessment of medical opinion evidence, “[a]n ALJ is [also] entitled generally to credit parts of an opinion without crediting the entire opinion.” Durden, 191 F.Supp.3d at 455. Finally, when there is no evidence of any credible medical opinion supporting a claimant's allegations of disability it is also well settled that “the proposition that an ALJ must always base his RFC on a medical opinion from a physician is misguided.” Cummings, 129 F.Supp.3d at 214-15.
Here, the ALJ explained why he found certain opinions more persuasive than others. With respect to any mental limitations, the ALJ found Dr. Plowman's opinion more persuasive than Dr. Tardibuono's. The ALJ stated that Dr. Plowman's opinion, which found only mild limitations, was consistent with the objective medical evidence showing normal mental status examination findings and no ongoing mental health treatment. The ALJ explained that Dr. Tardibuono's opinion was not consistent with this evidence to the extent he found more than mild limitations in certain areas of mental functioning. With respect to her physical limitations, the ALJ found Dr. Ritner's opinion more persuasive than Dr. Kneifati's. The ALJ reasoned that Dr. Kniefati's opinion overstated the claimant's limitations in walking, standing, and sitting and appeared to be based on her subjective complaints rather than the objective medical evidence showing that she generally maintained normal strength, sensation, and range of motion.
The ALJ also considered Caradine's testimony and examined it in light of the objective medical evidence. The ALJ ultimately concluded that the medical record did not support Caradine's statements regarding the severity of her impairments. Significantly, the ALJ reiterated that Caradine actually sought and obtained employment and worked during the relevant period, sometimes for 8-hour days. Indeed, the ALJ noted that her earnings in the fourth quarter of 2019 exceeded the threshold and constituted substantial gainful activity. The ALJ further noted that the medical record showed that Caradine generally maintained full range of motion and normal strength, that she underwent conservative treatment for her impairments, and that her activities of daily living, which included personal care, household chores, shopping alone, and maintaining some level of employment throughout the disability period, showed that her conditions were not as debilitating as she alleged.
On this score, the ALJ was confronted by several medical opinions, which including varying limitations based on the plaintiff's impairments. The ALJ considered all of these opinions against the objective medical evidence in the record and explained why he found certain opinions partially persuasive and why he found other opinions to be inconsistent with the medical evidence. The ALJ further considered the plaintiff's subjective complaints against the objective medical evidence and concluded that the evidence was not consistent with Caradine's alleged level of limitation. We again note that “[t]he ALJ - not treating or examining physicians or State agency consultants-must make the ultimate disability and RFC determinations.” Chandler, 667 F.3d at 361. Accordingly, we find that the ALJ considered all of the medical evidence and the plaintiff's subjective complaints and adequately explained his reasoning for the persuasiveness afforded to the various medical opinions in this case to determine the range of work Caradine could perform.
At bottom, it appears that the plaintiff is requesting that this court re-weigh the medical and opinion evidence. This we may not do. See Chandler v. Comm'r of Soc. Sec., 667 F.3d 356, 359 (3d Cir. 2011) (citing Richardson v. Perales, 402 U.S. 389, 401 (1971) (“Courts are not permitted to re-weigh the evidence or impose their own factual determinations.”); see also Gonzalez v. Astrue, 537 F.Supp.2d 644, 657 (D. Del. 2008) (“In determining whether substantial evidence supports the Commissioner's findings, the Court may not undertake a de novo review of the Commissioner's decision and may not re-weigh the evidence of the record.”) (internal citations omitted)). Rather, our task is simply to determine whether the ALJ's decision is supported by substantial evidence, a quantum of proof which is less than a preponderance of the evidence but more than a mere scintilla, Richardson, 402 U.S. at 401, and “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.” Pierce, 487 U.S. at 565. Finding that this deferential standard of review is met here, we conclude that a remand is not appropriate for the purpose of further assessing this opinion evidence or re-examining the ALJ's symptom evaluation in Caradine's case.
In sum, on its merits the ALJ's assessment of the evidence in this case complied with the dictates of the law and was supported by substantial evidence. This is all that the law requires, and all that a claimant can demand in a disability proceeding. Thus, notwithstanding the argument that this evidence might have been viewed in a way which would have also supported a different finding, we are obliged to affirm this ruling once we find that it is “supported by substantial evidence, ‘even [where] this court acting de novo might have reached a different conclusion.' ” Monsour Med. Ctr. v. Heckler, 806 F.2d 1185, 1190-91 (3d Cir. 1986) (quoting Hunter Douglas, Inc. v. NLRB, 804 F.2d 808, 812 (3d Cir. 1986)). Accordingly, under the deferential standard of review that applies to appeals of Social Security disability determinations, we find that substantial evidence supported the ALJ's evaluation of this case and recommend that this decision be affirmed.
IV. Recommendation
For the foregoing reasons, IT IS RECOMMENDED that the decision of the Commissioner in this case should be affirmed, and the plaintiff's appeal denied.
The parties are further placed on notice that pursuant to Local Rule 72.3:
Any party may object to a magistrate judge's proposed findings, recommendations or report addressing a motion or matter described in 28 U.S.C. § 636 (b)(1)(B) or making a recommendation for the disposition of a prisoner case or a habeas corpus petition within fourteen (14) days after being served with a copy thereof. Such party shall file with the clerk of court, and serve on the magistrate judge and all parties, written objections which shall specifically identify the portions of the proposed findings, recommendations or report to which objection is made and the basis for such objections. The briefing requirements set forth in Local Rule 72.2 shall apply. A judge shall make a de novo determination of those portions of the report or specified proposed findings or recommendations to which objection is made and may accept, reject, or modify, in whole or in part, the findings or recommendations made by the magistrate judge. The judge, however, need conduct a new hearing only in his or her discretion or where required by law, and may consider the record developed before the magistrate judge, making his or her own determination on the basis of that record. The judge may also receive further evidence, recall
witnesses or recommit the matter to the magistrate judge with instructions.