Opinion
CIVIL ACTION NO. 06-332-JBC.
March 24, 2008
MEMORANDUM OPINION AND ORDER
This matter is before the court upon cross-motions for summary judgment on the plaintiff's appeal of the Commissioner's denial of his application for Disability Insurance Benefits and Supplemental Security Income (DE 5, 6). The court, having reviewed the record and being otherwise sufficiently advised, will deny the plaintiff's motion and grant the defendant's motion.
I. Overview of the Process
Judicial review of the ALJ's decision to deny disability benefits is limited to determining whether there is substantial evidence to support the denial decision and whether the Secretary properly applied relevant legal standards. Brainard v. Sec'y of Health Human Servs., 889 F.2d 679, 681 (6th Cir. 1989) (citing Richardson v. Perales, 402 U.S. 389 (1971)). "Substantial evidence" is "more than a scintilla of evidence, but less than a preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Cutlip v. Sec'y of Health Human Servs., 25 F.3d 284, 286 (6th Cir. 1994). The court does not try the case de novo or resolve conflicts in the evidence; it also does not decide questions of credibility. See id. Rather, the ALJ's decision must be affirmed if it is supported by substantial evidence, even though the court might have decided the case differently. See Her v. Comm'r of Soc. Sec., 203 F.3d 388, 389-90 (6th Cir. 1999).
The ALJ, in determining disability, conducts a five-step analysis. At Step 1, the ALJ considers whether the claimant is performing substantial gainful activity; at Step 2, the ALJ determines whether one or more of the claimant's impairments are "severe"; at Step 3, the ALJ analyzes whether the claimant's impairments, singly or in combination, meet or equal a listing in the Listing of Impairments; at Step 4, the ALJ determines whether the claimant can perform past relevant work; and, finally, at Step 5 — the step at which the burden of proof shifts to the Commissioner — the ALJ determines, once it is established that the claimant cannot perform past relevant work, whether significant numbers of other jobs exist in the national economy which the claimant can perform. See Preslar v. Sec'y of Health Human Servs., 14 F.3d 1107, 1110 (6th Cir. 1994); 20 C.F.R. § 404.1520.
II. The ALJ's Determination
The plaintiff is a forty-year-old male with a high-school-equivalent education and past relevant work ("PRW") as a warehouse worker, machine shipper and parts distributor, contract laborer, and farm laborer. AR 20, 66, 71. He alleges disability beginning on June 29, 2003, as a result of degenerative disc disease of the lumbar spine, spinal stenosis, back and leg pain, and depression. AR 20, 65. The plaintiff filed a claim for Supplemental Security Income ("SSI") on January 30, 2004, and an application for Disability Insurance Benefits ("DIB") on February 18, 2004, which were denied initially and on reconsideration. AR 19. After a hearing held on December 28, 2005, Administrative Law Judge ("ALJ") Don C. Paris determined that the plaintiff did not suffer from a disability as defined by the Social Security Act. At Step 1, the ALJ determined that the plaintiff had not engaged in substantial gainful activity. At Step 2, the ALJ found that the plaintiff's degenerative disc disease of the lumbar spine with chronic low back pain, status-post fracture of the left tibia requiring open reduction internal fixation, and deformity of the left shoulder with decreased range of motion were severe impairments. The ALJ then determined that the plaintiff's impairments did not meet or equal a listing in the Listing of Impairments at Step 3. At Step 4, the ALJ found that the plaintiff was unable to perform his PRW. The ALJ concluded at Step 5, however, that the plaintiff could perform a significant number of other jobs in the national economy at the sedentary exertional level. AR 25-26. On September 8, 2006, the Appeals Council denied the plaintiff's request for review of the ALJ's decision, see AR 10, and the plaintiff then commenced this action.
III. Legal Analysis
The plaintiff objects to the ALJ's determination for the following reasons: (1) the ALJ failed to consider the plaintiff's impairments in combination; (2) the ALJ failed to give appropriate weight to the opinion of the plaintiff's treating physician; and (3) the ALJ erred in his determination of the plaintiff's credibility. The court will consider these arguments in turn.
The claimant appears to argue also that the ALJ erred in determining that his "impairments were not severe enough to meet the impairments listed." DE 5, at 5. However, the court will not analyze this argument further because the claimant does not allege the presence of any specific listed impairment, and the ALJ considered all of the claimant's impairments in determining that his ailments did not equal a listed impairment.
A. Combination of Impairments
The plaintiff asserts that the ALJ failed to consider the cumulative effect of his impairments. An examination of the ALJ's written opinion refutes this allegation. The ALJ considered the plaintiff's impairments as a whole in assessing the plaintiff's claims. AR 21-23. In determining whether the plaintiff's impairments were severe, the ALJ considered each of the plaintiff's complaints and then considered their combined effect on the plaintiff. AR 20-22. The ALJ found some of the plaintiff's impairments severe within the meaning of the Regulations. AR 22. The ALJ considered not only the severe physical impairments, but also the effects of the claimed mental impairments and other non-severe limitations, when determining the plaintiff's residual functional capacity ("RFC"). Id. In making the RFC assessment, the ALJ considered "all symptoms, including pain, and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence. . . ." Id. The court finds that the ALJ properly considered the plaintiff's impairments singly and in combination. See Loy v. Sec'y of Health and Human Servs., 901 F.2d 1306, 1310 (6th Cir. 1990).
The ALJ found the following to be severe impairments: degenerative disc disease of the lumbar spine with chronic lower back pain; status-post fracture of the left tibia requiring open reduction internal fixation; and deformity of the left shoulder with decreased range of motion. AR 22. The ALJ discussed the plaintiff's symptoms of depression, anxiety, and pain disorder, but found that these mental impairments constituted only mild limitations on the plaintiff's activities, and therefore were non-severe impairments. Id. The plaintiff's reported activities and testimony and the medical reports of treating and examining sources were considered by the ALJ. Id. The plaintiff was found to experience only mild limitations in his activities of daily living, social functioning, and in concentration, persistence, and pace. Id.
B. Treating Physician
The plaintiff also claims that the ALJ improperly rejected the opinion of his treating physician, Dr. Phillip Tibbs, who opines that the plaintiff is disabled and unable to work due to his incapacitation. AR 136-45, 264-68. The opinions of a treating physician are entitled to significant deference. See, e.g., Wilson v. Comm'r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004); Farris v. Sec. of Health and Human Servs., 773 F.2d 85, 90 (6th Cir. 1985). If the opinion of a treating physician is not contradicted, it is entitled to complete deference. Walker v. Sec. of Health and Human Servs., 980 F.2d 1066, 1070 (6th Cir. 1992). If the opinion of a treating source is not accorded controlling weight, the ALJ must consider factors such as the length of the treatment relationship and 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 source's specialization, in determining the weight to give the opinion. Wilson, 378 F.3d at 544. An ALJ may, however, reject the opinion of a treating physician when that opinion is not sufficiently supported by medical findings. Walter v. Comm'r, 127 F.3d 525, 530 (6th Cir. 1997); Cutlip v. Sec'y of Health and Human Servs., 25 F.3d 284, 287 (6th Cir. 1994) (When substantial medical evidence exists to the contrary, the ALJ is not bound by the treating physician's opinion.); Bogle v. Sullivan, 998 F.2d 342, 347-48 (6th Cir. 1993).
While a treating physician's medical opinions can have controlling weight, medical opinions "are statements from physicians . . . that reflect judgments about the nature and severity of [the claimant's] impairment(s), including [his] symptoms, diagnosis and prognosis, what [he] can still do despite impairment(s), and [his] physical or mental restrictions." 20 C.F.R. § 404.1527(a)(2). Thus, other issues are reserved to the Commissioner, such as the decision of whether the plaintiff meets the statutory definition of disability. The ALJ is not bound by a treating physician's statement that a claimant is "disabled" or "unable to work." 20 C.F.R. § 404.1527(e)(1); King v. Heckler, 742 F.2d 968, 973 (6th Cir. 1984).
The ALJ considered the medical opinions of all acceptable medical sources, including their judgments about the nature and severity of the claimant's impairments and resulting limitations. AR 22. In his hypothetical question to the Vocational Expert, the ALJ carefully considered the opinions of the claimant's treating physician, Dr. Tibbs, and essentially adopted his recommendations as to the claimant's limitations. AR 307. The ALJ did not adopt Dr. Tibbs's finding that the claimant is limited to sitting for two hours in an eight-hour workday, and instead found, based on the record, that he can sit for six hours. AR 23. Some of the claimant's doctors and physical therapists recommend that the claimant gradually increase his activity level. AR 134, 236. Dr. Tibbs, in his evaluation of the claimant, noted that he has normal knee and ankle reflexes and normal strength. AR 136. The claimant saw a doctor regarding some of his same impairments prior to his alleged onset date, and yet he continued to work. AR 159-63; see Blacha v. Sec'y of Health and Human Servs., 927 F.2d 228, 231 (6th Cir. 1990) (finding that a claimant's continuing to work after being injured is significant evidence). The ALJ evaluated how the claimant's symptoms affected him based on all the evidence in the record and found that the claimant can perform sedentary work. AR 23. Thus, the record as a whole supports the ALJ's finding that the claimant is capable of performing a limited range of sedentary work. See 20 C.F.R. § 404.967(a). Though a treating physician's opinions are ordinarily given significant deference, the court finds that the ALJ did not err in not fully accepting Dr. Tibb's medical assessment, as it was inconsistent with some of the physician's own findings and with the remainder of the evidence in the record.
The ALJ limited the claimant to occasionally lifting ten pounds, even though Dr. Tibbs marked on one report that the claimant could occasionally lift up to fifty pounds. AR 23, 141, 307. In a separate report completed a year later, Dr. Tibbs stated that the claimant can rarely lift and carry less than ten pounds and never lift ten pounds or more, but he does not give any basis for the increased restrictions. AR 267. Where a treating physician gives an opinion that is contrary to a previously expressed opinion by that same treating physician, the ALJ may reject the opinion as long as there is no evidence of the claimant's condition worsening. Hall v. Bowen, 837 F.2d 272, 276 (1988).
This is consistent with the opinion of Dr. John Rawlings, who found the claimant limited to six hours of sitting in an eight-hour workday, and it is consistent with the claimant's daily activities and other evidence in the record. AR 186.
C. The ALJ's Credibility Determination
The claimant argues that the ALJ erred in his determination because he did not consider the claimant's testimony regarding the pain associated with his restrictions. The court construes these allegations as an argument that the ALJ improperly evaluated the claimant's credibility. The Commissioner is required to consider all of a claimant's symptoms, including pain, in determining whether he is disabled. 20 C.F.R. § 404.1529(a). Before these symptoms will lead to a finding of disability, however, medical signs must exist which show the claimant has an impairment which could reasonably be expected to produce the symptoms alleged. 20 C.F.R. § 404.1529(b). When such medical signs are present, the Commissioner must then evaluate how the intensity and persistence of the symptoms affect the claimant's ability to work. 20 C.F.R. § 404.1529(c); see also Felisky v. Bowen, 35 F.3d 1027, 1038-39 (6th Cir. 1994) (citing Duncan v. Sec'y of Health and Human Servs., 801 F.2d 847, 853 (6th Cir. 1986)). In performing this inquiry, the ALJ must consider the objective medical evidence, evidence of the claimant's daily activities, the frequency and intensity of the claimant's pain, any precipitating or aggravating factors, any medications taken to alleviate the pain, and any other measures taken to remedy the claimant's pain. See Felisky, 35 F.3d at 1039-40; 20 C.F.R. § 404.1529(c)(3). Although an ALJ's credibility findings are to be accorded significant deference, an ALJ's assessment of a claimant's credibility must be supported by substantial evidence. Walters v. Comm'r of Soc. Sec., 127 F.3d 525, 531 (6th Cir. 1997).
The ALJ in this case "carefully considered the claimant's allegations of disabling impairments" but did not deem those allegations entirely credible. AR 22. The ALJ notes that the claimant received lumbar epidural steroid injections that provided relief from his symptoms in the past. Id. The claimant is additionally prescribed and completes a home exercise program by his physical therapist. AR 284-85. Noting that it was reasonable for the claimant to experience pain associated with his degenerative disc disease, the ALJ continued that "his daily activities would indicate that he is not totally incapacitated by his impairment." AR 22. The record reveals that the claimant is able to attend his daughter's school activities, including her band concerts. AR 22, 116. He sometimes prepares lunch for his children and drives to the local store to get school supplies. AR 22, 294. His daily activities include reading magazines and watching television. AR 22, 294. Additionally, "[h]e watches the children ride their pony and he visits with neighbors and family members." AR 22, see also AR 85. With the help of prescribed Ambien, the claimant is able to sleep. Id.
"As a matter of law, an ALJ may consider household and social activities in evaluating complaints of disabling pain." Blacha v. Sec'y of Health and Human Services, 927 F.2d 228, 231 (6th Cir. 1990). The ALJ's assessment of the plaintiff's credibility and pain was based on substantial evidence, including the ALJ's assessment of the plaintiff's testimony, his daily activities, and the medical record; therefore, the court will not disturb it.
IV. Conclusion
Accordingly,
IT IS ORDERED that the Commissioner's motion for summary judgment (DE 6) is GRANTED. IT IS FURTHER ORDERED that the plaintiff's motion for summary judgment (DE 5) is DENIED.