Opinion
Civil Action No. SA-04-CA-0281 RF (NN).
June 7, 2005
MEMORANDUM AND RECOMMENDATION OF THE UNITED STATES MAGISTRATE JUDGE
TO: Hon. W. Royal Furgeson United States District Judge
I. Introduction
Plaintiff Goldie Washington seeks review and reversal of the administrative denial of her application for Disability Insurance Benefits ("DIB") by the Administrative Law Judge ("ALJ") on January 12, 2004. Plaintiff contends that ALJ Peter Belli's conclusion that plaintiff retained the residual functional capacity ("RFC") to perform her past work is not supported by the substantial evidence of the record. For this reason, plaintiff requests that the court reverse, remand and order the entry of a finding of disability, or, in the alternative, remand the case for proper development.
Docket Entries 1, 12, 16. See also Administrative Transcript ("Transcript"), at 23-55.
After considering plaintiff's brief in support of her complaint, defendant's brief in support of the Commissioner's decision, plaintiff's reply brief, the transcript of the Social Security Administration (hereinafter "SSA") proceedings, the pleadings on file, the applicable case authority and relevant statutory and regulatory provisions, and the entire record in this matter, it is my recommendation that plaintiff's request for relief be DENIED.
Docket Entry 12.
Docket Entry 15.
Docket Entry 16.
I have jurisdiction to enter this Memorandum and Recommendation under 28 U.S.C. § 636(b) and the District Court's Order referring all pretrial matters in this proceeding to me for disposition by order, or to aid in their disposition by recommendation where my authority as a Magistrate Judge is statutorily constrained.
II. Jurisdiction
The court has jurisdiction under 42 U.S.C. § 405(g).
III. Administrative Proceedings
According to the record in this case, plaintiff fully exhausted her administrative remedies prior to filing this action in federal court. Plaintiff filed an application for DIB on February 21, 2002, alleging a disability beginning February 16, 2002. The SSA denied plaintiff's application both initially, on May 8, 2002, and on reconsideration, June 27, 2002.
Transcript, at 14, 81-86.
Transcript, at 58-62.
Transcript, at 64-66.
On July 3, 2002, plaintiff requested a hearing before an ALJ. The hearing was held on September 14, 2003. Plaintiff was represented by counsel at the hearing. Plaintiff's attorney was able to examine and question plaintiff, as well as the vocational expert, Jesus Duarte, during the hearing.
Transcript, at 68.
Transcript, at 23-55.
The plaintiff, who was fifty seven (57) years old at the September 2003 hearing, testified that she lived in a house with her husband. Plaintiff told ALJ Belli that she had a tenth grade education and had not obtained a GED. Plaintiff further testified that she had work experience as a home health aide in private homes, nursing homes and hospitals, and that she successfully complete schooling to obtain a certificate for the same. Plaintiff also stated she had work experience as a home health companion.
Transcript, at 29.
Transcript, at 29.
Transcript, at 31.
Transcript, at 33.
When asked why she was unable to work, plaintiff told the ALJ that she was unable to perform work activities because she had severe pain and was incapable of bending, stooping or bathing patients. Plaintiff testified that she had pain in her back, knees, legs, upper arms and wrists. She further stated that she had diabetes, hypertension, high cholesterol, and took medications for the diabetes and hypertension, as well as anxiety and depression. Plaintiff told ALJ Belli that she had never been hospitalized or had surgery for any of her medical conditions. Plaintiff also testified that she was not under the care of a psychologist or a psychiatrist.
Transcript, at 33, 34.
Transcript, at 35.
Transcript, at 41, 44.
Transcript, at 36.
Transcript, at 42.
When asked about her daily and routine activities, plaintiff testified that she was able to do some limited exercises, as well as laundry, vacuuming, cooking, and reading. Plaintiff told ALJ Belli that she was able to drive and to do her own grocery shopping. Plaintiff stated that she walked with the assistance of a cane.
Transcript, at 39.
Transcript, at 37, 38.
Transcript, at 51.
ALJ Belli also heard testimony from vocational expert Jesus Duarte at the administrative hearing. VE Duarte classified plaintiff's past work as a home health aide as either medium or heavy semi-skilled work, and her work as a home health companion as light, semi-skilled work. Mr. Duarte testified that the skills required of a home health aide were transferable to work as a home health companion. Plaintiff's attorney, though offered the opportunity to ask VE Duarte questions, declined to do the same.
Transcript, at 53-55.
Transcript, at 54.
Transcript, at 55.
Transcript, at 55.
On January 12, 2004, the ALJ issued his decision in which he concluded that plaintiff was not under a "disability," as defined by the Social Security Act ("the Act"), at any time through the date of the decision — that is, from the date plaintiff submitted her application through the date of the ALJ's decision. Specifically, ALJ Belli found that plaintiff retained the RFC to perform her past work.
Transcript, at 11-21.
After receiving the ALJ's unfavorable decision dated January 12, 2004, plaintiff requested review of the hearing and decision on February 5, 2004. On March 13, 2004, the Appeals Council concluded that there was no basis upon which it could grant plaintiff's request for review, thereby denying plaintiff's request. Plaintiff commenced the instant action in this court on April 1, 2004.
Transcript, at 4-7.
Transcript, at 3-6.
Docket Entry 1.
IV. Issue Presented
Whether the ALJ's decision is supported by substantial evidence and comports with relevant legal standards?V. Analysis
A. Standard of Review
In reviewing the Commissioner's decision denying disability insurance benefits, I am limited to a determination of whether substantial evidence supports the decision and whether the Commissioner applied the proper legal standards in evaluating the evidence. "Substantial evidence is more than a scintilla, less than a preponderance, and is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Substantial evidence "must do more than create a suspicion of the existence of the fact to be established, but `no substantial evidence' will be found only where there is a `conspicuous absence of credible choices' or `no contrary medical evidence."'
Martinez v. Chater, 64 F.3d 172, 173 (5th Cir. 1995); 42 U.S.C. §§ 405(g), 1383(c)(3) (2002).
Villa v. Sullivan, 895 F.2d 1019, 1021 (5th Cir. 1990) (quoting Hames v. Heckler, 707 F.2d 162, 164 (5th Cir. 1983)).
Abshire v. Bowen, 848 F.2d 638, 640 (5th Cir. 1988) (quoting Hames, 707 F.2d at 164).
If the Commissioner's findings are supported by substantial evidence, then they are conclusive and must be affirmed. In my review of the Commissioner's findings, I must carefully examine the entire record, but refrain from re-weighing the evidence or substituting my judgment for that of the Commissioner. Conflicts in the evidence and credibility assessments are for the Commissioner and not for the courts to resolve. Four elements of proof are weighed by the courts in determining if substantial evidence supports the Commissioner's determination: (1) objective medical facts, (2) diagnoses and opinions of treating and examining physicians, (3) the claimant's subjective evidence of pain and disability, and (4) the claimant's age, education and work experience.
Martinez, 64 F.3d at 173.
Ripley v. Chater, 67 F.3d 552, 555 (5th Cir. 1995); Villa, 895 F.2d at 1021 ("The court is not to reweigh the evidence, try the issues de novo, or substitute its judgment for that of the Commissioner.").
Martinez, 64 F.3d at 174.
Id.
1. Entitlement to Benefits
Every individual who is insured for disability insurance benefits, has not reached retirement age, has filed an application for benefits, and is under a disability is entitled to receive disability insurance benefits. The term "disabled" or "disability" means the 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 twelve months." A claimant shall be determined to be disabled only if his physical or mental impairment or impairments are so severe that he is unable to not only do his previous work, but cannot, considering his age, education, and work experience, participate in any other kind of substantial gainful work which exists in significant numbers in the national economy, regardless of whether such work exists in the area in which he lives, whether a specific job vacancy exists, or whether he would be hired if he applied for work.
Id. § 1382c(a)(3)(A).
Id. § 1382c(a)(3)(B).
2. Evaluation Process and Burden of Proof
Regulations set forth by the Commissioner prescribe that disability claims are to be evaluated according to a five-step process. A finding that a claimant is disabled or not disabled at any point in the process is conclusive and terminates the Commissioner's analysis.
20 C.F.R. §§ 404.1520 and 416.920 (2002).
Leggett v. Chater, 67 F.3d 558, 564 (5th Cir. 1995).
The first step involves determining whether the claimant is currently engaged in substantial gainful activity. If so, the claimant will be found not disabled regardless of his medical condition or his age, education, or work experience. The second step involves determining whether the claimant's impairment is severe. If it is not severe, the claimant is deemed not disabled. In the third step, the Commissioner compares the severe impairment with those on a list of specific impairments. If it meets or equals a listed impairment, the claimant is deemed disabled without considering his age, education, or work experience. If the impairment is not on the list, the Commissioner, in the fourth step, reviews the claimant's RFC and the demands of his past work. If he is still able to do his past work, he is not disabled. If he cannot perform his past work, the Commissioner moves to the fifth and final step of evaluating the claimant's ability, given his residual capacities, age, education, and work experience, to do other work. If he cannot do other work, he will be found disabled. The claimant bears the burden of proof at the first four steps of the sequential analysis. Once he has shown that he is unable to perform his previous work, the burden shifts to the Commissioner to show that there is other substantial gainful employment available that the claimant is not only physically able to perform, but also, taking into account his exertional and non-exertional limitations, able to maintain for a significant period of time. If the Commissioner adequately points to potential alternative employment, the burden shifts back to the claimant to prove that he is unable to perform the alternative work.
20 C.F.R. §§ 404.1520 and 416.920.
Id.
Id.
Id.
20 C.F.R. §§ 404.1520 and 416.920.
Id.
Id.
Id.
Id.
Leggett, 67 F.3d at 564.
Watson v. Barnhart, 288 F.3d 212, 217 (5th Cir. 2002).
Anderson v. Sullivan, 887 F.2d 630, 632-33 (5th Cir. 1989).
In the instant case, the ALJ reached his decision at step four of the evaluation process. At step one, the ALJ concluded that plaintiff had not engaged in substantial gainful employment since the date of her application for DIB. ALJ Belli then concluded at steps two and three that plaintiff had an impairment or combination of impairments (diabetes mellitus, degenerative disc disease, and diabetic neuropathy) which were severe, but did not meet or medically equal a listed impairment as of the date the plaintiff was last insured. At step four, the ALJ found that plaintiff retained the residual functional capacity to perform her past relevant work as a home health aide and as a home health companion. Based on the foregoing, ALJ Belli concluded that plaintiff was not under a disability. B. Is the ALJ's January 12, 2004 Decision Supported by Substantial Evidence?
Transcript, at 15; ¶ 1, at 20.
Transcript, at 17; ¶ 3, at 21.
Transcript, at 17; ¶ 4, at 21.
Transcript, at 19, 20; ¶¶ 6-8, at 21.
Transcript, at 14, 20; ¶ 9, at 21.
Plaintiff challenges the ALJ's decision, asserting that the ALJ: (1) erroneously concluded that plaintiff was not a credible witness; and (2) improperly rejected the opinions of plaintiff's treating physicians in favor of the opinions of the State Agency Medical Consultants (SAMCs). Plaintiff argues that these mistakes constitute reversible error and that substantial evidence does not support the ALJ's decision. In my opinion, plaintiff's grounds for reversal are not meritorious. For that reason, I recommend that plaintiff's request for relief be DENIED.
Docket Entries 12, 16.
1. Did the ALJ erroneously conclude that plaintiff was not a credible witness?
In her first point of error, plaintiff argues that the ALJ improperly concluded that she was not a credible witness based on her ability to perform certain household and daily activities. Plaintiff asserts that her ability to do limited cooking, driving and grocery shopping does not mean that she is capable of performing work activities. Plaintiff contends:
the ALJ failed to explain how the performance of activities such as some cooking, rare driving, or the ability to take care of herself with difficulty, made her able to perform the daily requirements of a job and failed to explore the pace and exertion level at which these activities are performed.
Docket Entry 12, at 8-9.
Social Security Ruling 96-7p was written to clarify the procedure to be used in assessing the credibility of a Social Security claimant's statements about symptoms and pain. The Ruling requires the ALJ to engage in a two-step process. In the first step,
Policy Interpretation Ruling Titles II and XVI: Evaluation of Symptoms in Disability Claims — Assessing the Credibility of an Individual's Statements, SSR 96-7p, at * 1.
the adjudicator must consider whether there is an underlying medically determinable physical or mental impairment(s) . . . that could reasonably be expected to produce the individual's pain or other symptoms.
Policy Interpretation Ruling Titles II and XVI: Evaluation of Symptoms in Disability Claims — Assessing the Credibility of an Individual's Statements, SSR 96-7p, at * 2.
If an underlying physical or mental impairment that could reasonably be expected to produce the individual's pain has been established, the adjudicator
must evaluate the intensity, persistence, and limiting effects of the individual's symptoms to determine the extent to which the symptoms limit the individual's ability to do basic work activities.
Id.
When the adjudicator needs additional information to assess the plaintiff's credibility, he should assess the following kinds of factors:
1. The individual's daily activities;
2. The location, duration, frequency, and intensity of the individual's pain or other symptoms;
3. Factors that precipitate and aggravate the symptoms;
4. The type, dosage, effectiveness, and side effects of any medication the individual takes or has taken to alleviate pain or other symptoms;
5. Treatment, other than medication, the individual receives or has received for relief of pain or other symptoms;
6. Any measures other than treatment the individual uses or has used to relieve pain or other symptoms (e.g., lying flat on his or her back, standing for 15 to 20 minutes every hour, or sleeping on a board); and
7. Any other factors concerning the individual's functional limitations and restrictions due to pain or other symptoms.
Policy Interpretation Ruling Titles II and XVI: Evaluation of Symptoms in Disability Claims — Assessing the Credibility of an Individual's Statements, SSR 96-7p, at * 3.
In the instant case, plaintiff criticizes the ALJ's analysis of her credibility. Plaintiff takes particular exception to the ALJ's finding that plaintiff's ability to perform household and personal chores meant that plaintiff was also able to perform work activities. Similarly, plaintiff challenges the ALJ's finding that plaintiff was working in March 2003 and deceiving the SSA.
After reviewing the medical evidence of record in the decision, the ALJ documented plaintiff's testimony regarding her daily activities. The ALJ wrote:
The claimant appeared and testified that she can cook, do laundry, vacuum, and bathe and dress herself, but does need help with putting on her socks. The claimant stated that she can watch television but can sit for only 15 to 30 minutes before changing positions, but can drive a motor vehicle and operate the pedals, steering wheel, and back up. The claimant also testified that she went to therapy about 2 to 3 months ago for exercise, she has had no emergency room visits in the last 12 months, has had no surgeries in the last 10 years and no surgery is scheduled. The claimant also testified that she has no problems with any of her medications, has never received treatment from a psychiatrist or psychologist and has never been hospitalized for any mental problems. The claimant also testified that she uses a cane because she loses her balance, and that she fell 4 months ago.
Transcript, at 18.
Later in the decision, the ALJ concluded that plaintiff's subjective allegations of pain were inconsistent with the substantial evidence of the record:
The claimant's subjective allegations concerning her impairment related symptoms and limitations are inconsistent with the objective evidence of record, her treatment history, her activities of daily living, and the medical source opinion evidence. In addition, the claimant testified at the hearing that she last worked February 16, 2002. However, when the claimant was seen by Dr. Carry on March 17, 2002, the doctor noted that the claimant was working and disability did not know (Ex R3). Therefore, for all the foregoing reasons, the Administrative Law Judge finds the claimant's subjective allegations concerning her impairment related symptoms and limitations are credible only to the extent that they are consistent with the rationale and findings herein.
Transcript, at 18.
The ALJ's assessment of plaintiff's credibility comports with the legal standards outlined in Ruling 96-7p. The ALJ reviewed plaintiff's daily activities, plaintiff's treatment protocols and medications, as well as her functional limitations. The ALJ gave sufficient explanation for the basis of his decision.
See Policy Interpretation Ruling Titles II and XVI: Evaluation of Symptoms in Disability Claims — Assessing the Credibility of an Individual's Statements, SSR 96-7p, at * 3. Importantly, the ALJ is not required to assess each and every factor delineated in SSR 96-7p. Rather, SSR 96-7p merely provides guidance as to the kinds of criteria the ALJ should assess in determining a plaintiff's credibility.
Moreover, the ALJ adequately reviewed plaintiff's own account of her daily activities. See Transcript, at 37-39, 47.
Moreover, the ALJ's reliance on plaintiff's ability to perform daily activities was not misplaced. Plaintiff relies on, inter alia, the Eback v. Chater decision for the proposition that a claimant's ability to perform household chores does not mean that she is capable of performing work activities. However, Eback did not solely stand for that proposition and is importantly factually distinguishable from the instant case. In Eback, the claimant had never worked, had such severe asthma that she required the use of a nebulizer four times per day, had severely diminished math and reading skills, and had severe anxiety. In the context of plaintiff Eback's impairments, limitations, vocational and educational background, the Eighth Circuit held that her ability to take care of her personal needs, share responsibility with her husband for the care of her toddler child, perform some cooking and cleaning, and attend bingo did not support the conclusion that plaintiff could perform full-time work activities. In the instant case, plaintiff was able to work for quite a long time and her impairments do not rise to the level of severity of those in the Eback case. Thus, the ALJ did not commit prejudicial, i.e. reversible, error in relying on evidence of plaintiff's daily activities to support his conclusions on disability. Rather, the ALJ complied with the analysis set forth in SSR 96-7p.
Docket Entry 12, at 8 discussing Eback v. Chater, 94 F.3d 410 (8th Cir. 1996).
Id. Plaintiff Eback ate her hair as a result of her anxiety disorder. This condition escalated until she was required to have surgery to remove large masses of hair from her stomach and intestines. Id. , 94 F.3d, at 411, n. 1.
Eback, 94 F.3d, at 413.
Notably, the ALJ may have misread the doctor's note which he believed to state that plaintiff was working despite alleging disability to the SSA. ALJ Belli read the note as saying that plaintiff was "was working and disability did not know." However, the note, scribbled in messy handwriting without the benefit of punctuation, can be read in one of two ways: either that plaintiff was working and the SSA did not know she was working, or that plaintiff was working on obtaining disability benefits but did not know if she would receive them. It is impossible to decipher the true meaning of the note. Since the ALJ cited the note as one among many factors in his assessment of plaintiff's credibility, plaintiff has failed to establish that the ALJ committed prejudicial error in relying, at least in part, on the same.
Transcript, at 18, citing Transcript, at 156.
Transcript, at 156.
See Carey v. Apfel, 230 F.3d 131, 142 (5th Cir. 2000), "This Court will not reverse the decision of an ALJ for failure to fully and fairly develop the record unless the claimant shows that he or she was prejudiced by the ALJ's failure . . . To establish prejudice, a claimant must demonstrate that he or she `could and would have adduced evidence that might have altered the result (internal citations omitted).'" Plaintiff's argument that the "error was anything but harmless because it was used as one of the most important, if not the most important, piece of evidence to discredit Plaintiff and her complaints . . ." is without merit. Docket Entry 16. It is clear from the syntax of the decision that the note was one of many pieces of evidence that factored into the ALJ's credibility assessment. ALJ Belli accorded it no superior or special weight. See Transcript, at 18.
Because ALJ Belli utilized the appropriate legal standard in assessing plaintiff's credibility, the only issue is whether his conclusions regarding the same were supported by the substantial evidence of the record. When the alleged defect in the decision centers around the substantiality of the evidence, the decision must be affirmed if it is supported by substantial evidence — even if the evidence preponderates against the ALJ's findings. For the foregoing reasons, the ALJ's assessment of plaintiff's credibility is supported by the substantial evidence of the record. I find that plaintiff's first point of error is unavailing.
See Smith v. Chater, 962 F. Supp. 980, 982 (N.D. Tex. 1997), "Even if the court should determine that the evidence preponderates in the claimant's favor, the court must still affirm the Commissioner's findings if there is substantial evidence to support these findings."
2. Did the ALJ improperly reject the opinions of plaintiff's treating physician in favor of the opinions of the SAMCs?
In her second, and final, point of error, plaintiff asserts that the ALJ failed to provide adequate reasons for dismissing the opinion of plaintiff's treating physician, Dr. Frederick, and improperly accorded more weight to the opinions of the State Agency Medical Consultants (SAMCs).
Docket Entry 12.
When the ALJ assesses the oral and written evidence provided by the various medical professionals, he must ordinarily give "substantial weight . . . to the opinion, diagnosis and medical evidence of the claimant's treating physician." However, the ALJ can "`reject the opinion of any physician if the evidence supports a contrary conclusion'" provided the ALJ has good cause for so doing.
[W]hen good cause is shown, less weight, little weight, or even no weight may be given to the physician's testimony. The good cause exceptions we have recognized include disregarding statements that are brief and conclusory, not supported by medically acceptable clinical laboratory diagnostic techniques, or otherwise unsupported by the evidence.
Dorsey v. Heckler, 702 F.2d 597, 603 (5th Cir. 1983).
Bradley v. Bowen, 809 F.2d 1054, 1057 (5th Cir. 1987), citing Oldham v. Schweiker, 660 F.2d 1078, 1084 (Former 5th Cir. Unit B 1981).
Greenspan v. Shalala, 38 F.3d 232, 237 (5th Cir. 1994).
Greenspan, 38 F.3d, at 237, citing Scott v. Heckler, 770 F.2d 482, 485 (5th Cir. 1985).
Despite the weight given to the treating source's opinion, the ALJ must evaluate every medical opinion received. When the ALJ does not give the treating source's opinion controlling weight, he must consider various factors in deciding the weight given to each opinion. Those factors are: (1) the examining relationship (the ALJ should generally give more weight to a source who examined the claimant); (2) the treatment relationship (the ALJ should generally give more weight to a source who treated claimant), including the length, nature and extent of the treatment relationship, as well as the frequency of the examination(s); (3) the supportability of the opinion (the ALJ should give greater weight to the source who provides more relevant evidence to support the opinion); (4) consistency (the ALJ should give greater weight to opinions which are consistent with the record as a whole); (5) specialization (the ALJ should generally give greater weight to the opinion of a specialist); and (6) any other factors which "tend to support or contradict the opinion."
Id.
20 C.F.R. § 404.1527(d) (2(i)-(ii)).
20 C.F.R. § 404.1527(d)(5). See also Moore, 919 F.2d, at 905.
When a medical opinion is incomplete or inconsistent, the ALJ is obligated to resolve the inconsistencies or inadequacies. One of the primary social security rulings on medical source opinions directs the ALJ to re-contact a medical source, when possible, to resolve any inconsistencies in the evidence provided by that source. Specifically, the ruling states
Policy Interpretation Ruling Titles II and XVI: Medical Source Opinions on Issues Reserved to the Commissioner, SSR 96-5p (July 2, 1986).
Because treating source evidence (including opinion evidence) is important, if the evidence does not support a treating source's opinion on any issue reserved to the Commissioner and the adjudicator cannot ascertain the basis of the opinion from the case record, the adjudicator must make `every reasonable effort' to recontact the source for clarification of the reasons for the opinion.
Id., at *6.
Thus, even though the ALJ and SSA retain the "final responsibility for deciding certain issues, such as whether an individual is disabled under the Act," and, similarly, the responsibility for resolving all conflicts in the evidence, the ALJ is still required, at a minimum, to attempt to obtain clarification when the record contains inconsistencies.
Id. , at *1.
Plaintiff asserts that the ALJ failed to provide adequate reason(s) for rejecting the opinion of plaintiff's treating physician Dr. Frederick that plaintiff should be retired because of her disabilities. Plaintiff further argues:
Docket Entry 12, at 10.
the ALJ based his conclusion on Dr. Carry's remark regarding the alleged Ms. Washington's employment ( sic) after the alleged onset date of disability and the State agency's medical and psychological consultants . . . The ALJ did not take into account any of the differing opinions of the treating physicians based on in personam examinations.
Docket Entry 12, at 11.
In this case, the ALJ fully complied with the legal standards set forth in the applicable rulings. After reviewing the medical reports and opinions of treating physician Frederick, examining physician Dr. Jonathan Barnes, Dr. Rodney Carry, plaintiff's Health South physical therapist, and the State Agency Medical Consultants, ALJ Belli concluded that plaintiff's impairments did not preclude her from performing work activities. The ALJ wrote, in pertinent part:
See Transcript, at 16-20.
the Administrative Law Judge notes that the claimant's only work limiting impairment is her diabetes mellitus, degenerative disc disease of the lumbar spine, and diabetic neuropathy, and these impairments would limit the claimant to medium work. Even though the Administrative Law Judge finds the claimant's diabetes mellitus, degenerative disc disease of the lumbar spine, and diabetic neuropathy to be severe, the objective medical evidence from Dr. Barnes, and the balance of the opinions of the medical consultants from the State Agency who evaluated this issue at the initial and reconsideration levels of the administrative process and reached the same conclusion. Additionally, nothing else in the record suggests that the claimant's alleged impairments, which are essentially mild, would preclude her from performing work at the medium exertional level.
Transcript, at 19.
The ALJ then specifically discussed the opinions of Dr. Frederick according to the applicable legal standards. After several paragraphs outlining the applicable standards, ALJ Belli concluded:
The Administrative Law Judge notes that on February 18, 2002, Dr. Frederick completed an To ( sic) Whom It May Concern letter (Ex 1F/1). Dr. Frederick's medical opinion is not supported by medically acceptable clinical and laboratory diagnostic techniques, is not consistent with the other substantial evidence of record, and therefore accorded no substantial weight. Importantly, in reaching his decision to accord less than controlling weight to Dr. Frederick's opinions, the ALJ relied on the totality of the medical evidence of record including not only the opinions of the SAMCs but also, in pertinent part, on the opinions of Dr. Barnes — an examining physician. For all the foregoing reasons, plaintiff has failed to establish that the ALJ's treatment of the treating source opinion was either unsupported by the substantial evidence of the record or made in disregard of the applicable legal standards.
Transcript, at 20.