Opinion
CIV 15-0455-PHX-MHB
09-26-2016
Michael Troy Kelly, Plaintiff, v. Carolyn W. Colvin, Commissioner of the Social Security Administration, Defendant.
ORDER
Pending before the Court is Plaintiff Michael Troy Kelly's appeal from the Social Security Administration's final decision to deny his claim for disability insurance benefits. After reviewing the administrative record and the arguments of the parties, the Court now issues the following ruling.
I. PROCEDURAL HISTORY
Plaintiff filed an application for disability insurance benefits alleging disability beginning April 1, 2010. (Transcript of Administrative Record ("Tr.") at 16, 179-87.) His application was denied initially and on reconsideration. (Tr. at 16, 64-91.) Thereafter, Plaintiff requested a hearing before an administrative law judge, and a hearing was held on May 9, 2013. (Tr. at 16, 32-63.) On June 28, 2013, the ALJ issued a decision finding that Plaintiff was not disabled. (Tr. at 13-31.) The Appeals Council denied Plaintiff's request for review (Tr. at 1-7), making the ALJ's decision the final decision of the Commissioner. Plaintiff then sought judicial review of the ALJ's decision pursuant to 42 U.S.C. § 405(g). \\\
II. STANDARD OF REVIEW
The Court must affirm the ALJ's findings if the findings are supported by substantial evidence and are free from reversible legal error. See Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 1998); Marcia v. Sullivan, 900 F.2d 172, 174 (9th Cir. 1990). Substantial evidence means "more than a mere scintilla" and "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971); see Reddick, 157 F.3d at 720.
In determining whether substantial evidence supports a decision, the Court considers the administrative record as a whole, weighing both the evidence that supports and the evidence that detracts from the ALJ's conclusion. See Reddick, 157 F.3d at 720. "The ALJ is responsible for determining credibility, resolving conflicts in medical testimony, and for resolving ambiguities." Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995); see Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989). "If the evidence can reasonably support either affirming or reversing the [Commissioner's] conclusion, the court may not substitute its judgment for that of the [Commissioner]." Reddick, 157 F.3d at 720-21.
III. THE ALJ'S FINDINGS
In order to be eligible for disability or social security benefits, 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). An ALJ determines a claimant's eligibility for benefits by following a five-step sequential evaluation:
(1) determine whether the applicant is engaged in "substantial gainful activity";
(2) determine whether the applicant has a medically severe impairment or combination of impairments;
(3) determine whether the applicant's impairment equals one of a number of listed impairments that the Commissioner acknowledges as so severe as to preclude the applicant from engaging in substantial gainful activity;
(4) if the applicant's impairment does not equal one of the listed impairments, determine whether the applicant is capable of performing his or her past relevant work;See Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987) (citing 20 C.F.R. §§ 404.1520, 416.920). At the fifth stage, the burden of proof shifts to the Commissioner to show that the claimant can perform other substantial gainful work. See Penny v. Sullivan, 2 F.3d 953, 956 (9th Cir. 1993).
(5) if the applicant is not capable of performing his or her past relevant work, determine whether the applicant is able to perform other work in the national economy in view of his age, education, and work experience.
At step one, the ALJ determined that Plaintiff had not engaged in substantial gainful activity since April 1, 2010 - the alleged onset date - through his date last insured of December 31, 2012. (Tr. at 18.) At step two, she found that Plaintiff had the following severe impairments: lumbar degenerative disc disease, herniated disc, spondylosis and radiculopathy, history of diverticulitis, colostomy and takedown, hernia repair, a major depressive disorder, and anxiety disorder. (Tr. at 18.) At step three, the ALJ stated that Plaintiff did not have an impairment or combination of impairments that met or medically equaled an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 of the Commissioner's regulations. (Tr. at 19-20.) After consideration of the entire record, the ALJ found that, through the date last insured, Plaintiff retained "the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) except that the claimant is limited to performing the mental demands of simple work tasks." (Tr. at 20-24.) The ALJ determined that Plaintiff was unable to perform past relevant work, but through the date last insured, considering Plaintiff's age, education, work experience, and residual functional capacity, there were jobs that existed in significant numbers in the national economy that Plaintiff could have performed. (Tr. at 24-25.) Therefore, the ALJ concluded that Plaintiff was not under a disability from April 1, 2010, through December 31, 2012, the date last insured. (Tr. at 25.)
"Residual functional capacity" is defined as the most a claimant can do after considering the effects of physical and/or mental limitations that affect the ability to perform work-related tasks.
IV. DISCUSSION
In his brief, Plaintiff contends that the ALJ erred by: (1) failing to properly weigh medical source opinion evidence; (2) failing to properly consider his subjective complaints; and (3) failing to properly consider lay witness or third-party statements. Plaintiff requests that the Court remand for determination of benefits.
A. Medical Source Opinion Evidence
Plaintiff contends that the ALJ erred by failing to properly weigh medical source opinion evidence. Specifically, Plaintiff argues that the ALJ improperly rejected the opinion of treating physician Dale Ratcliffe, D.O., relying instead upon the opinions of the state agency reviewing physicians and other objective medical evidence to discount Dr. Ratcliffe's opinion.
"The ALJ is responsible for resolving conflicts in the medical record." Carmickle v. Comm'r, Soc. Sec. Admin., 533 F.3d at 1164. Such conflicts may arise between a treating physician's medical opinion and other evidence in the claimant's record. In weighing medical source opinions in Social Security cases, the Ninth Circuit distinguishes among three types of physicians: (1) treating physicians, who actually treat the claimant; (2) examining physicians, who examine but do not treat the claimant; and (3) non-examining physicians, who neither treat nor examine the claimant. See Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). The Ninth Circuit has held that a treating physician's opinion is entitled to "substantial weight." Bray v. Comm'r, Soc. Sec. Admin., 554 F.3d 1219, 1228 (9th Cir. 2009) (quoting Embrey v. Bowen, 849 F.2d 418, 422 (9th Cir. 1988)). A treating physician's opinion is given controlling weight when it is "well-supported by medically accepted clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the claimant's] case record." 20 C.F.R. § 404.1527(d)(2). On the other hand, if a treating physician's opinion "is not well-supported" or "is inconsistent with other substantial evidence in the record," then it should not be given controlling weight. Orn v. Astrue, 495 F.3d 624, 631 (9th Cir. 2007).
If a treating physician's opinion is not contradicted by the opinion of another physician, then the ALJ may discount the treating physician's opinion only for "clear and convincing" reasons. See Carmickle, 533 F.3d at 1164 (quoting Lester, 81 F.3d at 830). If a treating physician's opinion is contradicted by another physician's opinion, then the ALJ may reject the treating physician's opinion if there are "specific and legitimate reasons that are supported by substantial evidence in the record." Id. (quoting Lester, 81 F.3d at 830).
Since the opinion of Dr. Ratcliffe was contradicted by the state agency reviewing physicians, as well as, other objective medical evidence in the record, the specific and legitimate standard applies.
Historically, the courts have recognized the following as specific, legitimate reasons for disregarding a treating or examining physician's opinion: conflicting medical evidence; the absence of regular medical treatment during the alleged period of disability; the lack of medical support for doctors' reports based substantially on a claimant's subjective complaints of pain; and medical opinions that are brief, conclusory, and inadequately supported by medical evidence. See, e.g., Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005); Flaten v. Secretary of Health and Human Servs., 44 F.3d 1453, 1463-64 (9th Cir. 1995); Fair v. Bowen, 885 F.2d 597, 604 (9th Cir. 1989).
Citing to treatment records from Lincoln Wellness and Family Care (Tr. at 404-52), the ALJ first noted that magnetic resonance imaging of Plaintiff's lumbar spine taken in June 2011 demonstrated no acute lumbar spine fracture (Tr. at 21). The records indicated no moderate or severe canal stenosis, but noted a small posterior annular tear at L3-L4 and L5-Sl, and a desiccated disc at L3-L4, L4-L5 and L5-S1 with varying degrees of neural foramina narrowing. The ALJ additionally found that according to records from John C. Lincoln Hospital, Advanced Pain Management, and Desert Pain and Rehabilitation (Tr. at 370-96, 779-85, 792-835), Plaintiff reported good benefit from steroid injections and some relief from epidural injections, and noted pain improvement with medication (Tr. at 21). Plaintiff was observed to be able to sit, stand, and walk without difficulty.
The ALJ found that when examined in February 2013 at John C. Lincoln - Your Family Medicine (Tr. at 1166-78), Plaintiff's spine was of normal contour with no deformity or swelling (Tr. at 22). There was no neurological or motor defect detected; straight leg raising was negative; and Plaintiff walked with a normal gait. Further, records from Desert Pain and Rehabilitation failed to indicate any abdominal pain (Tr. at 792-835, 1078-1156).
The ALJ concluded that the objective and clinical findings do not indicate disabling impairments. (Tr. at 21-22.) Specifically, Plaintiff exhibited good musculoskeletal abilities, good range of motion of the spines and joint, no atrophy and no gait abnormalities during multiple examinations.
Dr. Ratcliffe submitted three opinions stating that Plaintiff was unable to sustain competitive employment. (Tr. at 23-24, 1051-52, 1205-06, 1210.) In May 2012, Dr. Ratcliffe stated that Plaintiff was unable to work eight hours a day, five days a week on a regular and consistent basis due to lumbar degenerative disc disease, lumbar spondylosis, and pain syndrome. (Tr. at 23-24, 1051-52.) In April 2013, Dr. Ratcliffe submitted another statement that was substantially similar to the 2012 opinion, and he added wrist pain and abdominal wall pain syndrome to his assessment. (Tr. at 1205-06.) In July 2012, Dr. Ratcliffe submitted a statement that Plaintiff would benefit from disability because "return to work at this time is not possible." (Tr. at 1210.)
Finding that Dr. Ratcliffe's opinions were not supported by the objective medical evidence of record, the ALJ did not assign his opinions any significant weight. (Tr. at 23-24.) Specifically, although Dr. Ratcliffe reported that Plaintiff suffers from moderately severe pain which prevents him from performing work related activity, the ALJ found that the medical evidence demonstrated that Plaintiff's pain responded well to medications and other treatment. Further, the ALJ found that objective medical imaging did not indicate disabling impairment.
Lastly, the ALJ addressed the conclusions reached by the state agency reviewing physicians supporting a finding of not disabled. (Tr. at 24.) The ALJ stated that "[a]lthough these physicians were non-examining, and therefore their opinions do not as a general matter deserve as much weight as those of examining or treating physicians, those opinions do deserve significant weight, particularly in a case like this in which there exists a number of other reasons to reach similar conclusions."
The Court finds that the ALJ properly weighed the medical source opinion evidence, and gave specific and legitimate reasons, based on substantial evidence in the record, for discounting Dr. Ratcliffe's opinions. The ALJ properly discredited the medical opinions due to inconsistencies with Plaintiff's treatment record and the medical evidence as a whole. See 20 C.F.R. § 404.1527(c)(4) (stating an ALJ must consider whether an opinion is consistent with the record as a whole); Batson v. Comm'r of Soc. Sec., 359 F.3d 1190, 1195 (9th Cir. 2004) (ALJ may discredit treating physicians' opinions that are conclusory, brief, and unsupported by the record as a whole, or by objective medical findings). And, the opinions of the state agency reviewing physicians were consistent with the other objective medical evidence of record. See Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002) ("The opinions of non treating or non examining physicians may also serve as substantial evidence when the opinions are consistent with independent clinical findings or other evidence in the record."). Therefore, the Court finds no error.
B. Plaintiff's Subjective Complaints
Plaintiff argues that the ALJ erred in rejecting his subjective complaints in the absence of clear and convincing reasons for doing so.
To determine whether a claimant's testimony regarding subjective pain or symptoms is credible, the ALJ must engage in a two-step analysis. "First, the ALJ must determine whether the claimant has presented objective medical evidence of an underlying impairment 'which could reasonably be expected to produce the pain or other symptoms alleged.' The claimant, however, 'need not show that her impairment could reasonably be expected to cause the severity of the symptom she has alleged; she need only show that it could reasonably have caused some degree of the symptom.'" Lingenfelter v. Astrue, 504 F.3d 1028, 1036-37 (9th Cir. 2007) (citations omitted). "Second, if the claimant meets this first test, and there is no evidence of malingering, 'the ALJ can reject the claimant's testimony about the severity of her symptoms only by offering specific, clear and convincing reasons for doing so.'" Id. at 1037 (citations omitted). General assertions that the claimant's testimony is not credible are insufficient. See Parra v. Astrue, 481 F.3d 742, 750 (9th Cir. 2007). The ALJ must identify "what testimony is not credible and what evidence undermines the claimant's complaints." Id. (quoting Lester, 81 F.3d at 834).
In weighing a claimant's credibility, the ALJ may consider many factors, including, "(1) ordinary techniques of credibility evaluation, such as the claimant's reputation for lying, prior inconsistent statements concerning the symptoms, and other testimony by the claimant that appears less than candid; (2) unexplained or inadequately explained failure to seek treatment or to follow a prescribed course of treatment; and (3) the claimant's daily activities." Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996); see Orn, 495 F.3d at 637-39. The ALJ also considers "the claimant's work record and observations of treating and examining physicians and other third parties regarding, among other matters, the nature, onset, duration, and frequency of the claimant's symptom; precipitating and aggravating factors; [and] functional restrictions caused by the symptoms ... ." Smolen, 80 F.3d at 1284 (citation omitted).
With respect to the claimant's daily activities, the ALJ may reject a claimant's symptom testimony if the claimant is able to spend a substantial part of her day performing household chores or other activities that are transferable to a work setting. See Fair, 885 F.2d at 603. The Social Security Act, however, does not require that claimants be utterly incapacitated to be eligible for benefits, and many home activities may not be easily transferable to a work environment where it might be impossible to rest periodically or take medication. See id. --------
At the hearing, Plaintiff testified that he has been unable to work due to back and leg pain, exacerbated by sitting, standing, walking, and lifting. (Tr. at 40.) Plaintiff explained that he has tried all forms of treatment, including medication, injections, and a back brace, but prescribed treatment modalities have been largely ineffective. (Tr. at 41-42, 44.) During the day, Plaintiff follows prescribed care and lies down.
Plaintiff described low back pain with pain and numbness that radiates down the legs. The radiating pain is sharp, and goes into the toes. (Tr. at 41.) Injections and a TENS unit provided only temporary, if any, relief. (Tr. at 42.) Pain severity will fluctuate between a 5 and 7, on a 10 point scale. (Tr. at 43.) On average, Plaintiff can sit for 20-45 minutes at a time, before needing to rise. (Tr. at 45.) He can stand 15 minutes at a time, or walk one-half of a block, and then needs to rest. Lifting is limited 10 pounds. (Tr. at 46.)
Plaintiff also discussed his secondary depression as well as anxiety and emotional lability. (Tr. at 49-50.) Relevant symptoms of depression and anxiety include shortness of breath, and a feeling like he is having a heart attack. The severe anxiety symptoms can last 5-25 minutes, and they occur 2-3 times daily. Plaintiff has tried marijuana for symptom relief, but it was ineffective. (Tr. at 51.)
Having reviewed the record along with the ALJ's credibility analysis, the Court finds that the ALJ made sufficient credibility findings and identified clear and convincing reasons supported by the record for discounting Plaintiff's statements regarding his pain and limitations. Although the ALJ recognized that Plaintiff's medically determinable impairments could reasonably be expected to cause the alleged symptoms, she also found that Plaintiff's statements concerning the intensity, persistence, and limiting effects of the symptoms were not fully credible. (Tr. at 20-21.) "[Q]uestions of credibility and resolutions of conflicts in the testimony are functions solely of the ALJ." Greger v. Barnhart, 464 F.3d 968, 972 (9th Cir. 2006) (citation and internal quotation marks omitted). The court defers to the ALJ's credibility determination "where, as here, the evidence reasonably supports the ALJ's decision." Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1174 (9th Cir. 2008).
Significantly, in addressing Plaintiff's credibility, the ALJ relied on several inconsistencies between Plaintiff's statements and the other evidence of record. (Tr. at 21-23.) See 20 C.F.R. § 404.1529(c)(4) (stating an ALJ must consider whether there are conflicts between a claimant's statements and the rest of the evidence). Initially, as the Court has examined above, the ALJ determined that the objective medical evidence and clinical findings did not support the degree of severity alleged by Plaintiff. See Bray, 554 F.3d at 1227 (upholding credibility determination where ALJ pointed out that claimant's statements at the hearing did not comport with objective evidence in her medical record). The ALJ stated, "the objective medical evidence does not document that the claimant's impairments are disabling. The claimant exhibited good musculoskeletal abilities, good range of motion of the spines and joint, no significant neurological deficits, no atrophy and no gait abnormalities during multiple examinations. As well, he exhibited good mental status on multiple occasions. Objective imaging and clinical findings did not indicate disabling symptoms. While the claimant's impairments might be expected to impose some limitations, those limitations are adequately accommodated in this decision's residual functional capacity. The need to use a restroom every two hours does not require an unreasonable number or length of breaks." (Tr. at 22.) Further, the ALJ found that the medical evidence demonstrated that Plaintiff's symptoms improved with treatment. (Tr. at 20-24.) Again, as noted above, Plaintiff reported that his pain medication reduced his pain without side effects, and that he received "good benefit" from epidural steroid injections.
The ALJ gave other reasons for discounting Plaintiff's credibility. The ALJ analyzed Plaintiff's activities of daily living. (Tr. at 21.) "[I]f the claimant engages in numerous daily activities involving skills that could be transferred to the workplace, an adjudicator may discredit the claimant's allegations upon making specific findings relating to the claimant's daily activities." Bunnell v. Sullivan, 947 F.2d 341, 346 (9th Cir. 1991) (citing Fair, 885 F.2d at 603); see Berry v. Astrue, 622 F.3d 1228, 1234-35 (9th Cir. 2010) (claimant's activities suggested a greater functional capacity than alleged). The ALJ found that although Plaintiff testified that he experiences severe musculoskeletal pain which prevents him from performing many activities of daily living, the record revealed that he "leads a more active lifestyle than what he alleged to during the hearing." (Tr. at 21.) Plaintiff reported that he helps care for his children by preparing meals, helping them with homework and getting them ready for school; he is independent in self-care; he drives and rides in a car; he goes shopping in stores; he watches the children all day until his wife gets home from work; and he prepares meals occasionally during the day.
While not alone conclusive on the issue of disability, an ALJ can reasonably consider a claimant's daily activities in evaluating the credibility of his subjective complaints. See, e.g., Stubbs-Danielson, 539 F.3d at 1175 (upholding ALJ's credibility determination based in part of the claimant's abilities to cook, clean, do laundry, and help her husband with the finances); Burch v. Barnhart, 400 F.3d 676, 680-81 (9th Cir. 2005) (upholding ALJ's credibility determination based in part on the claimant's abilities to cook, clean, shop, and handle finances).
The ALJ identified other reasons, including, that Plaintiff provided inconsistent reports regarding substance abuse, and testimony suggesting that Plaintiff's unemployment may have been unrelated to his medical impairments. (Tr. at 23); see Molina v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012) (in considering the claimant's testimony, the ALJ may use ordinary techniques of credibility evaluation, such as a claimant's reputation for truthfulness).
In summary, the Court finds that citing to the record, the ALJ identified multiple inconsistencies that undermined the veracity of Plaintiff's allegations. While perhaps the individual factors, viewed in isolation, are not sufficient to uphold the ALJ's decision to discredit Plaintiff's allegations, each factor is relevant to the ALJ's overall analysis, and it was the cumulative effect of all the factors that led to the ALJ's decision. The Court concludes that the ALJ has supported her decision to discredit Plaintiff's allegations with specific, clear and convincing reasons and, therefore, the Court finds no error.
C. Lay Witness/Third-Party Statements
Plaintiff contends that the ALJ erred in failing to properly consider the statements of his wife who submitted reports depicting her observations as to Plaintiff's pain and the effect thereof. (Tr. at 245-60, 289-96.) Ms. Kelly noted that her husband has difficulty with prolonged sitting, standing, and walking; and cannot lift much weight. Due to pain, Plaintiff has no consistent daily routine. He needs to periodically rest throughout the day.
In determining whether a claimant is disabled, an ALJ must consider lay witness testimony regarding the claimant's inability to work. See Bruce v. Astrue, 557 F.3d 1113, 1115 (9th Cir. 2009) (citing Stout v. Comm'r, Soc. Sec. Admin., 454 F.3d 1050, 1053 (9th Cir. 2006)). An ALJ cannot disregard lay witness testimony without comment, see Bruce, 557 F.3d at 1115 (citing Nguyen v. Chater, 100 F.3d 1462, 1467 (9th Cir. 1996)), but may do so only upon providing specific reasons that are "germane to each witness." Id. (quoting Nyugen, 100 F.3d at 1467); Stout, 454 F.3d at 1054. When an ALJ errs in failing "to properly discuss competent lay testimony favorable to the claimant, a reviewing court cannot consider the error harmless unless it can confidently conclude that no reasonable ALJ, when fully crediting the testimony, could have reached a different disability determination." Stout, 454 F.3d at 1056.
Here, the ALJ considered the third-party statements and found that the statements were not supported by the objective medical evidence. (Tr. at 24.) The ALJ additionally stated that the statements were not persuasive of additional restrictions in Plaintiff's residual functional capacity. The ALJ recognized that Ms. Kelly was concerned for Plaintiff, but stated that the limits she finds were not supported by the objective medical evidence. Lastly, the ALJ stated that Ms. Kelly is not qualified to make a diagnosis regarding Plaintiff's impairments.
The Court finds that the ALJ properly considered the third-party statements set forth in the record and appropriately disregarded the statement by providing specific reasons "germane to each witness." See Bayliss, 427 F.3d at 1218 (affirming rejection of lay witness testimony that was inconsistent with claimant's daily activities and objective medical evidence); Valentine v. Comm'r Soc. Sec. Admin., 574 F.3d 685, 694 (9th Cir. 2009) (where lay witness testimony was similar to the claimant's own complaints, which the ALJ had discredited for clear and convincing reasons, it followed that the ALJ also gave germane reasons for rejecting the lay testimony).
Even if there was a failure to properly discuss the third-party statements, the Court finds that no reasonable ALJ, even if fully crediting the statement, could have reached a different disability determination. The limitations and symptoms contained in the third-party statement are entirely similar to and consistent with, those which Plaintiff described in his own testimony. As a result, because this Court concludes that the ALJ's decision to discredit Plaintiff's testimony was supported by substantial evidence, and because the third-party statement was consistent with Plaintiff's testimony, it was reasonable for an ALJ to disregard that statement as well.
V. CONCLUSION
Substantial evidence supports the ALJ's decision to deny Plaintiff's claim for disability insurance benefits in this case. Consequently, the ALJ's decision is affirmed.
Based upon the foregoing discussion,
IT IS ORDERED that the decision of the ALJ and the Commissioner of Social Security be affirmed;
IT IS FURTHER ORDERED that the Clerk of the Court shall enter judgment accordingly. The judgment will serve as the mandate of this Court.
DATED this 26th day of September, 2016.
/s/_________
Michelle H. Burns
United States Magistrate Judge