Opinion
3:20-cv-00493
06-17-2022
ANGELA LADIKA, Plaintiff, v. KILOLO KIJAKAZI,[1]Acting Commissioner of Social Security, Defendant.
BRANN,C.J.
REPORT AND RECOMMENDATION
JOSEPH F. SAPORITO, JR. UNITED STATES MAGISTRATE JUDGE
This is an action brought under 42 U.S.C. § 405(g), seeking judicial review of the Commissioner of Social Security's final decision denying Angela Ladika's claim for disability insurance benefits under Title II of the Social Security Act. This matter has been referred to the undersigned United States magistrate judge for the preparation of the report and recommended disposition pursuant to the provisions of 28 U.S.C. § 636(b) and Rule 72(b) of the Federal Rules of Civil Procedure.
For the reasons stated herein, we respectfully recommend that the decision of the Commissioner be AFFIRMED.
I. Procedural Background
On September 11, 2017, Ladika protectively filed an application for benefits under Title II of the Social Security Act alleging disability as of September 11, 2017. In her application, Ladika alleged that the following impairments prevent her from engaging in any work: fractured ribs/osteoarthritis, calf blood clots (current and previous), lupus, heart arrythmia disorder, chronic pain, spinal, neck, tailbone, hip, and rib arthritis, deep vein thrombosis and pulmonary embolism, post-traumatic stress disorder (“PTSD”), anxiety, and Raynaud's syndrome. (Tr. 62-63).
Ladika's claim was initially denied on October 31, 2017. Thereafter, on November 21, 2017, Ladika filed a timely request for an administrative hearing. Her request was granted. Ladika appeared and testified before Administrative Law Judge (“ALJ”) Richard E. Guida on November 19, 2018, in Harrisburg, Pennsylvania. Ladika was represented by counsel, Michelle A. Rhizor, Esquire, throughout the proceeding. An impartial vocational expert (the “VE”), Sheryl Bustin, also appeared and testified at the administrative hearing. (Tr. 35).
On January 18, 2019, the ALJ denied Ladika's application for benefits in a written decision. On March 5, 2019, Ladika sought further review of her claim by the Appeals Council, but her request was denied on March 2, 2020. This makes the ALJ's January 2019, decision the final decision subject to judicial review by this Court.
Ladika filed a timely complaint in this Court on March 26, 2020. (Doc. 1). In her complaint, Ladika alleges that the final decision of the Commissioner is not supported by substantial evidence and is not in accordance with the law. (Doc. 1, at 3). On September 9, 2020, the Commissioner filed her answer, in which she maintains that the ALJ's decision was made in accordance with the law and is supported by substantial evidence. (Doc. 13).
II. Factual Background
Ladika is an adult individual born April 28, 1974. She was forty-three years old at the time of the alleged onset of disability-September 11, 2017. (Tr. 19). Ladika's age at the onset date makes her a “younger person” under the Commissioner's regulations whose age generally does not affect her ability to adjust to other work. See 20 C.F.R. § 404.1563.
At the time of the administrative hearing, Ladika was forty-four years old and resided with her husband in Hershey, Pennsylvania, which is in the Middle District of Pennsylvania. Ladika's past work included: office clerk, assistant manager, and office assistant. (Tr. 72-73).
Ladika testified that she believes she cannot work due to her medical issues. She testified that she is in constant pain which, on a scale from one to ten, never goes below five. She stated she has pain in her entire body, although her hands, arms, spine, ribs, legs, and both feet are the worst. (Tr. 39).
Ladika testified that she wakes up in the morning around 4:00 a.m., has a cup of coffee, and takes all of her medications. From there it takes her about an hour to an hour and fifteen minutes until she can freely move from the stiffness, then she gets dressed. During the day she listens to audiobooks and watches television with her feet elevated. (Tr. 41). She stated that she naps two to four hours daily. (Tr. 47)
Ladika testified that she possesses a driver's license, but that she rarely drives. She stated that she is able to shower by herself with a shower chair, and dress herself, but there are times when her husband assists her getting dressed. (Tr. 43).
Ladika stated that she grocery shops with her husband and that she folds the laundry. (Tr. 54, 229). In a daily activities questionnaire dated December 2, 2017, Ladika stated that she helps with dishes, laundry, and she accompanies her husband to the grocery store. She listens to music and the radio daily, she reads the Bible, and she watches the news on her phone. (Tr. 216). She stated that she visits with her daughter, granddaughter, and husband's grandfather daily. (Tr. 217).
In a daily activities questionnaire dated September 25, 2018, Ladika stated that she does dishes and folds laundry. (Tr. 229). Ladika stated that she does not visit family or friends, except her mother-in-law on Christmas. She does not participate in social activities. (Tr. 231-32).
In a Function Report dated September 27, 2017, Ladika stated that she can pay bills, count change, and handle a savings account. (Tr. 197)
III. Standard of Review
When reviewing the denial of disability benefits, the Court's review is limited to determining whether those findings are supported by substantial evidence in the administrative record. See 42 U.S.C. § 405(g) (sentence five); 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 (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). 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 question before the Court, therefore, is not whether the claimant is disabled, but whether the Commissioner's finding that he or 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 [Commissioner]'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 ....”).
To receive disability 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); see also 20 C.F.R. § 404.1505(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); 20 C.F.R. § 404.1505(a).
A “physical or mental impairment” is an impairment resulting from “anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques.” 42 U.S.C. § 423(d)(3).
“Substantial gainful activity” is work that (1) involves performing significant or productive physical or mental duties, and (2) is done (or intended) for pay or profit. 20 C.F.R. § 404.1510.
The Commissioner follows a five-step sequential evaluation process in determining whether a claimant is disabled under the Social Security Act. 20 C.F.R. § 404.1520(a). Under this process, the Commissioner must determine, in sequence: (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 past relevant work, considering his or her residual functional capacity (“RFC”); and (5) whether the claimant is able to do any other work, considering his or her RFC, age, education, and work experience. Id. The claimant bears the initial burden of demonstrating a medically determinable impairment that prevents him or her from doing past relevant work. 42 U.S.C. § 423(d)(5); 20 C.F.R. § 404.1512; Mason, 994 F.2d at 1064. Once the claimant has established at step four that he or she cannot do past relevant work, the burden then shifts to the Commissioner at step five to show that jobs exist in significant numbers in the national economy that the claimant could perform consistent with his or her RFC, age, education, and past work experience. 20 C.F.R. § 404.1512(f); Mason, 994 F.2d at 1064.
An extensive list of impairments that warrant a finding of disability based solely on medical criteria, without considering vocational criteria, is set forth at 20 C.F.R., Part 404, Subpart P, Appendix 1.
“Residual functional capacity” is the most a claimant can do in a work setting despite the physical and mental limitations of his or her impairment(s) and any related symptoms (e.g., pain). 20 C.F.R. § 404.1545(a)(1). In assessing a claimant's RFC, the Commissioner considers all medically determinable impairments, including those that are not severe. Id. § 404.1545(a)(2).
IV. The ALJ's Decision
In his January 18, 2019, decision denying Ladika's claim, the ALJ evaluated Ladika's application for benefits at each step of the sequential process. At step one, the ALJ found that Ladika did not engage in substantial gainful activity since September 11, 2017. (Tr. 21). At step two, the ALJ found the following impairments were medically determinable and severe during the relevant period: atrial tachycardia, inflammatory arthritis, osteoarthritis, neuropathy, anxiety disorder, depressive disorder, and PTSD. (Tr. 15). At step three, the ALJ found that Ladika did not have an impairment or combination of impairments that met or medically equaled the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1, during the relevant period. (Tr. 22).
Between steps three and four, the ALJ assessed Ladika's RFC. After evaluating the relevant evidence of record, the ALJ found that Ladika had the RFC to perform light work as defined in 20 C.F.R. § 404.1567(b), except for the following:
[S]he can never crawl or climb ladders, ropes, or scaffolds; can only occasionally perform all other postural activities; must avoid concentrated exposure to temperature extremes, wetness, humidity, and hazards; and is limited to the performance of simple, routine, tasks involving only simple work-related decisions with few, if any, workplace changes.(Tr. 24).
In making this finding, the ALJ considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements of 20 C.F.R. § 404.1529 and Social Security Ruling 16-3. In addition, the ALJ considered the medical opinions(s) and prior administrative medical findings(s) in accordance with the requirements of 20 C.F.R. § 404.1520c. The ALJ's conclusions at steps four and five of the sequential evaluation process was based on this RFC assessment and the testimony of the vocational expert.
At step four, the ALJ found that Ladika was unable to perform any of her past relevant work as an administrative clerk and retail salesclerk. (Tr. 28).
At step five, the ALJ found that Ladika could perform other jobs that exist in significant numbers in the national economy. Specifically, the ALJ relied on testimony by the vocational expert about whether there were jobs for a hypothetical individual with Ladika's age, education, work experience, and RFC. The vocational expert testified that Ladika could perform the occupations of carding machine operator, DOT #681.685-030, with 20,000 positions available nationally; optical goods final assembler, DOT #713.687-018, with 40,000 positions available nationally; or dowel inspector, DOT # 669.687-014, with 16,000 positions available nationally. (Tr. 29)
V. Discussion
Ladika contends the decision of the Commissioner contains multiple errors. Ladika's specifically argues that: (1) the ALJ erred with symptom evaluation, and (2) the ALJ failed to properly weigh the opinion of her treating physician, Carol A. Baase, M.D.
A. The ALJ's symptom evaluation.
The plaintiff contends that the ALJ's decision is not supported by substantial evidence because the ALJ erred in his evaluation of Ladika's symptoms, including her subjective complaints of pain in particular. See generally 20 C.F.R. § 404.1502(i) (“Symptoms means your own description of your physical or mental impairment.”).
Standing alone, a claimant's allegation of pain or other symptoms is not enough to establish an impairment or disability. 20 C.F.R. § 404.1529(a); Prokopick v. Comm'r of Soc. Sec., 272 Fed. App'x 196, 199 (3d Cir. 2008) (“Under the regulations, an ALJ may not base a finding of disability solely on a claimant's statements about disabling pain ....”). “An ALJ is permitted to reject a claimant's subjective testimony as long as he or she provides sufficient reasons for doing so.” Prokopick, 272 Fed. App'x at 199 (citing Schaudeck v. Comm'r of Soc. Sec., 181 F.3d 429, 433 (3d Cir. 1999)).
When evaluating a claimant's subjective allegations of pain or other symptoms, an ALJ utilizes a two-step process. Soc. Sec. Ruling 16-3p, 2017 WL 5180304, at *2 (revised Oct. 25, 2017). First, the ALJ must determine whether there is a medically determinable impairment that could reasonably be expected to produce the symptoms alleged. Id., at *3; see also 20 C.F.R. § 404.1529(b). A claimant cannot be found to be “disabled based on alleged symptoms alone.” Soc. Sec. Ruling 16-3p, 2017 WL 5180304, at *4.
Once the ALJ has found that a medically determinable impairment has been established, the ALJ must then evaluate the claimant's allegations about the intensity, persistence, or functionally limiting effects of his or her symptoms against the evidence of record. Id. This evaluation requires the ALJ to consider “the entire case record, including the objective medical evidence; an individual's statements about the intensity, persistence, and limiting effects of symptoms; statements and other information provided by medical sources and other persons; and any other relevant evidence in the individual's case record.” Id.
In this case, the ALJ concluded at step three that Ladika's “statements concerning the intensity, persistence, and limiting effects of [her] symptoms are not entirely consistent with the medical evidence and other evidence in the record.” (Tr. 24). Ladika's claim alleges disability due to osteoarthritis, rheumatoid arthritis, deep vein thrombosis, lupus, cardiac arrhythmia, and mental health impairments including anxiety and PTSD. Ladika stated that she has difficulty lifting, squatting, bending, standing, reaching, walking, sitting, kneeling, talking, climbing stairs, seeing, remembering information, completing tasks, concentrating, understanding, following instructions, and using her hands. She stated she has difficulty lifting a gallon of milk, she is unable to sit, stand, or walk for prolonged periods, and she is unable to work due to constant pain and fatigue. She reported she has difficulty dressing herself and performing other personal care activities. She alleges she is unable to perform household chores. (Tr. 161, 194-200).
In his decision, the ALJ points to statements submitted by Ladika and her husband wherein they admit that she is capable of preparing her own meals, driving a car, traveling independently, shopping in stores, and managing money. (Tr. 185-86, 196-97). The ALJ noted that in Ladika's questionnaires from December 2017 and September 2018, she stated that she assists with washing dishes and laundering clothes. (Tr. 215, 229). Here, the ALJ found that Ladika's activities demonstrate that she retains a greater capacity for cognitive and adaptive tasks then alleged, to wit: the fact that Ladika can prepare meals suggests that she is capable of following simple instruction, consistent with a recipe or package directions; the fact that Ladika can shop in stores suggests that she is capable of identifying purchase needs, making a list, selecting food items, managing money, and interacting appropriately with checkout personnel; the fact that she is capable of performing household activities, such as laundering clothes and washing dishes, suggests that she is capable of sustaining attention and concentration necessary to perform and complete simple activities and remains capable of utilizing simple machinery safely; the fact that she is able to travel independently and drive a car suggests that she is capable of making a travel plan, adapting to changes in the situation including other drivers on the road, road closures, or changed travel schedules. The ALJ found that all of these activities suggest that Ladika retains a greater capacity for cognitive and adaptive skills then alleged in connection with her disability application and appeal. The ALJ found that these activities do not suggest a degree of impairment consistent with a finding of disability, and that they support the above assessment of Ladika's RFC. (Tr. 25).
As to the medical records, the ALJ noted that Ladika suffered from osteoarthritis. The record showed that Ladika suffers from a history of inflammatory arthritis and a newer diagnosis of small fiber neuropathy confirmed on biopsy. (Tr. 320, 327,377, 408, 417, 548, 549, 562). Due to these conditions, Ladika reported multiple joint pain, joint swelling, hand numbness, and fatigue for which she received opioid medications, neuropathic pain medications, non-steroidal anti-inflammatory drugs, steroidal treatments and anti-rheumatic medications. (Tr. 310-431, 547632). The ALJ noted that despite her complaints, Ladika's longitudinal treatment records showed that she had demonstrated little more than minimal joint tenderness, minimal strength loss, and minimal loss of bilateral hand range of motion on repeated examinations. (Tr. 310-431, 547-632, 755-56). Her physician reported eliciting no real swelling in her upper extremities and no more than trace edema in her lower extremities. (Tr. 310-431). Dr. Baase noted that, despite her pain and loss of range of motion, she remains capable of lifting up to 10-15 pounds and walking unaided with a normal gait. (Tr. 548, 561). The ALJ pointed to a medical record where Dr. Baase had noted that Ladika had not used any of her prescribed medications other than her pain pills, and that she had not used her prescribed muscle relaxant or the increased dose of steroid medication. (Tr. 336).
The record also demonstrated that Ladika suffers from episodes of atrial tachycardia for which she has a prescribed medication prior to her onset date. (Tr. 310-431). She reported that she requires 3 to 4 halftablets each week to manage her symptoms. (Tr. 327). However, on October 11, 2018, Ladika admitted that her symptoms quickly abate and remain well-controlled. (Tr. 755). In addition, it was noted that her symptoms occur predominantly in the evening, and the ALJ found that this strongly suggests that her condition is unlikely to significantly interfere with her ability to maintain work activity. (Tr. 26, 755).
The ALJ pointed out that Ladika's use of a cane does not correspond to the objective findings in the record. On August 12, 2018, treating rheumatologist, Nancy Olsen, M.D., noted that Ladika demonstrated “normal gait.” (Tr. 561). The notes of Francis Murphy, Ph.D., the state agency psychological consultant, corresponded with the treatment record. Murphy noted that, despite the presence of her anxiety symptoms, Ladika had been able to manage her symptoms without the use of psychotropic medication until April 2018, when she complained of PTSD symptoms. Ladika began counseling and medication management services, however, and within a few months, she reported that she was no longer suffering nightmares or flashbacks, and that she had experienced a significant decrease in PTSD symptoms. (Tr. 521). By October 11, 2015, Ladika informed Dr. Baase that she no longer required a counselor for her PTSD symptoms. (Tr. 755).
Although Ladika quibbles with the outcome of the ALJ's analysis of the evidence of record, it is clear that the ALJ properly evaluated the claimant's symptoms in accordance with the applicable regulations, and that the ALJ reasonably concluded that, notwithstanding the claimant's subjective complaints of pain and other symptoms, the evidence as a whole did not support physical or mental limitations in excess of those set forth in the ALJ's RFC determination. While this same evidence might have also reasonably supported the adoption of substantially greater limitations, it did not compel such a finding.
Accordingly, we find the ALJ's evaluation of the plaintiff's subjective complaints of pain and other symptoms is supported by substantial evidence and was reached based upon a correct application of the relevant law.
B. The ALJ's evaluation of medical opinion evidence.
The plaintiff contends that the ALJ's decision is not supported by substantial evidence because the ALJ erred in his evaluation of medical opinions and prior administrative findings presented in the administrative proceedings below. As a preface, we note the well-established principle that, in evaluating the medical opinion evidence of record, an “ALJ is not only entitled, but required to choose between” conflicting medical opinions. Cotter v. Harris, 642 F.2d 700, 706 (3d Cir. 1981). “[T]he possibility of drawing two inconsistent conclusions from the evidence does not prevent [an ALJ's decision] from being supported by substantial evidence.” Consolo v. Fed. Maritime Comm'n, 383 U.S. 607, 620 (1966). Moreover, “[i]n the process of reviewing the record for substantial evidence, we may not ‘weigh the evidence or substitute [our own] conclusions for those of the fact-finder.'” Rutherford v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005) (quoting Williams v. Sullivan, 970 F.2d 1178, 1182 (3d Cir. 1992)). Ultimately, to reverse the ALJ's findings and decision, “we must find that the evidence not only supports [a contrary] conclusion, but compels it.” Immigration & Naturalization Serv. v. Elias-Zacarias, 502 U.S. 478, 481 n.1 (1992); see also Smith v. Chater, 99 F.3d 780, 782 & N.3 (6th Cir. 1996) (citing Elias-Zacarias in the context of social security disability benefits); Hert v. Barnhart, 234 F.Supp.2d 832, 837 (N.D. Ill. 2002) (“The court may reverse the Commissioner's decision only if the evidence ‘compels' reversal, not merely because the evidence supports a contrary decision.”) (citing Elias-Zacarias).
Here, the plaintiff originally filed her administrative claim for benefits in September 2017. Thus, a relatively new regulatory framework governing the evaluation of medical opinion evidence applies to this case.
“The new regulations have been described as a ‘paradigm shift' in the way medical opinions are evaluated.” Knittle v. Kijakazi, Civil No. 1:20-CV-00945, 2021 WL 5918706, at *4 (M.D. Pa. Dec. 15, 2021). “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.” Densberger v. Saul, Civil No. 1:20-CV-772, 2021 WL 1172982, at *7 (M.D. Pa. Mar. 29, 2021). Under this prior regulatory scheme, the Social Security Administration “followed the ‘treating physician rule,' which required the agency to give controlling weight to a treating source's opinion, so long as it was ‘well-supported by medically acceptable clinical and laboratory diagnostic techniques' and not ‘inconsistent with the other substantial evidence' in the record.” Michelle K. v. Comm'r of Soc. Sec., 527 F.Supp.3d 476, 481 (W.D. Pa. 2021). However, the regulations governing the evaluation of medical evidence were amended and the treating physician rule was eliminated effective March 27, 2017. See Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed.Reg. 5,844 (Jan. 18, 2017); see also Densberger, 202 WL 1172982, at *7-*8; Michelle K., 527 F.Supp.3d at 481. “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.” Densberger, 2021 WL 1172982, at *7.
Under these new regulations, the agency “will not defer or give any specific evidentiary weight, including controlling weight, to any medical opinion(s) or prior administrative medical finding(s), including those from [the claimant's] medical sources.” 20 C.F.R. § 404.1520(a). “Rather than assigning weight to medical opinions, [an ALJ] will articulate ‘how persuasive' he or she finds the medical opinions.” Knittle, 2021 WL 5918706, at *4; see also 20 C.F.R. § 404.1520. If a medical source provides one or more medical opinions, the agency will consider those medical opinions from that medical source together using the following factors: “(1) supportability; (2) consistency; (3) relationship with the claimant, including the length of the treatment relationship, the frequency of examinations, purpose and extent of the treatment relationship, and the examining relationship; (4) specialization; and (5) any other factors that ‘tend to support or contradict a medical opinion or prior administrative medical finding.'” Michelle K., 527 F.Supp.3d at 481; see also 20 C.F.R. § 404.1520c(a); Densberger, 2021 WL 1172982, at *8. Under the new regulations, “[t]he 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.” Densberger, 2021 WL 1172982, at *8; see also 20 C.F.R. § 404.1520c(b)(2); Michelle K., 527 F.Supp.3d at 481; compare 20 C.F.R. § 404.1520c(c)(1) (supportability), and id. § 404.1520c(c)(2) (consistency), with id. § 404.1527(c)(3) (supportability), and id. § 404.1527(c)(4) (consistency). An ALJ is specifically required to address these two factors in his or her decision. See 20 C.F.R. § 404.1520(c)(b)(2); see also Densberger, 20211172982, at *8; Michelle K., 527 F.Supp.3d at 482. “The ALJ may-but is not required to-explain how he considered the remaining factors.” Michelle K., 527 F.Supp.3d at 482; see also 20 C.F.R. § 404.1520c(b)(2); Densberger, 2021 WL 1172982, at *8. “However, when 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 [the remaining] factors ....” Densberger, 2021 WL 1172982, at *8; see also 20 C.F.R. § 404.1520c(b)(3); Michelle K., 527 F.Supp.3d at 482.
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.” 20 C.F.R. § 404.1520c(c)(1). With respect to consistency, the new regulations provide 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.” Id. § 404.1520c(c)(2).
Under this new regulatory scheme, the plaintiff's contention that Dr. Baase's opinion is entitled to “controlling weight” is clearly meritless because the treating physician rule upon which she relies had been eliminated before she had filed her claim for benefits with the agency. Moreover, in reviewing the ALJ's decision and the administrative record, it is clear that the ALJ considered each of the pertinent factors in evaluating the persuasiveness of Dr. Baase's opinion.
The ALJ noted that Dr. Baase completed a statement indicating Ladika: was unable to sit, stand, or walk for more than two hours each during an 8-hour workday; required unscheduled 10 to 15 minute work breaks every 45 to 60 minutes; required the use of a cane and needed to elevate her feet at least 18 inches off the ground for 75 percent of the workday; experienced pain that would constantly preclude her from the attention and concentration necessary to perform even simple work tasks; and was likely to be absent from work more than four days per month. (Tr. 776-79). The ALJ pointed out that this opinion contained material internal consistencies, such as Dr. Baase's claim that Ladika's pain would preclude her from sustaining the attention and concentration necessary to perform even simple work tasks while also acknowledging that Ladika remained capable of performing low stress jobs. (Tr. 777). The ALJ also found Dr. Basse's opinion inconsistent with Ladika's longitudinal treatment records, with Dr. Baase opining that Ladika was unable to lift even 10 pounds on an occasional basis, while her notes recorded only four weeks earlier indicated that Ladika had admitted she could lift up to 15 pounds. (Tr. 548). While Dr. Baase opined that Ladika required the use of a cane, Ladika's rheumatologist, Dr. Olsen, observed on August 12, 2018, that Ladika remained capable of independent and unaided ambulation with a normal gait. (Tr. 561).
The ALJ found Dr. Baase's mental RFC questionnaire responses unpersuasive because many of the limitations stated there were due to Ladika's physical impairments, not the result of any mental health impairment. Dr. Baase noted that she was uncertain of any onset date of Ladika's psychiatric conditions because her physical conditions were the more critical issue. Dr. Baase's completed form indicated that Ladika was currently involved in therapy for her conditions, but Ladika has admitted that she was no longer involved in therapy at that time. Dr. Baase's own treatment notes showed that only two months earlier, Ladika had admitted to having no mental fatigue symptoms, and she had reported that her medications had helped significantly to control her symptoms. (Tr. 569).
The ALJ found the opinion of Francis Murphy, Ph.D., the state agency medical expert, to be persuasive. Murphy had opined that Ladika could perform a range of light, unskilled work. In finding this opinion persuasive, the ALJ had relied upon objective findings in the treatment record and Ladika's longitudinal treatment history. (Tr. 71).
Finally, the plaintiff has also argued that, to the extent the ALJ found Dr. Baase's opinion to be inconsistent, he was obligated to recontact Dr. Baase for clarification. But the ALJ was under no such obligation. Under the agency's regulations, an ALJ may exercise his or her discretion to recontact a medical source if that is the most effective and efficient way to resolve an evidentiary inconsistency or insufficiency that precludes him or her from making a disability determination. See 20 C.F.R. § 404.1520b((b)(2); see also Bryson v. Comm'r Soc. Sec., 639 Fed. App'x 784, 787 n.8 (3d Cir. 2016) (noting that, although a prior iteration of the regulations required an ALJ to recontact a medical source under certain circumstances, the rule was changed in 2012 to make recontacting a medical source discretionary); Ross v. Colvin, Civil No. 1:14-0990, 2015 WL 1636132, at *9 n.4 (M.D. Pa. Apr. 8, 2015). We find no abuse of discretion here as, for the reasons given above, the ALJ had substantial evidence to support a disability determination.
Accordingly, we find the ALJ's evaluation of medical opinions and prior administrative findings is supported by substantial evidence and was reached based upon a correct application of the relevant law.
VI. Conclusion
Based on the foregoing, we conclude that the Commissioner's finding that Ladika was not disabled is supported by substantial evidence and was reached based upon a correct application of the relevant law. Accordingly, we recommend that the Commissioner's decision denying disability benefits should be AFFIRMED and the Clerk be directed to close this case.
NOTICE
NOTICE IS HEREBY GIVEN that the undersigned has entered the foregoing Report and Recommendation dated June 17, 2022. Any party may obtain a review of the Report and Recommendation pursuant to Local Rule 72.3, which provides:
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.
Failure to file timely objections to the foregoing Report and Recommendation may constitute a waiver of any appellate rights.