NO T REC OM M EN DE D F OR P UB LIC AT ION File Na me: 10a0144n.06 No. 09-5673 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT
RUT H A . B RO CK, P laintif f-App ellant,
v. COMMISSIO N E R OF SOCIAL SECURITY, Defendan t-Appellee. ) ) ) ) ) ) ) ) ) ) ) ) ON AP P EAL FROM THE U NI TED STATES DI STRI CT COURT FOR THE EASTERN DI STRI CT OF KENTUCKY

BEFORE: MERRITT, COOK, and KETHLE DG E, Circuit Judges
. MERRITT, Circuit Judge. Ruth B ro c k a pp e a ls f ro m th e Di st ri ct Co ur

t’ s d e c isi on

to uphold the Commi ssioner of Social Security ’s denial of her a pplication for disability

insurance and supplemental sec urity

income benefits. Br ock claims that the admini strative law judge revie wing her a pp lic a tio n f

a ile d to pr op e rl y

we ig h h e r t

re a tin g phy sic ian’ s o pin ion and fa ile d to a de qu a te ly repr esent her m ental li mitations to the vocational expert. After r eviewingthe re cord, w e find that the ad min istrativ e law j ud g e g ave pr op e r w e ig ht t o th e tr e a tin g phy sic ian’ s o pin ion and that hi s denial of be nefits was ba sed on substantial evidence. We, there fore , AFF I RM the decision of the District Court. I. F actual and Proc edural HistoryNo. 09-5673

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-2- OnF e b r u ar y 2 0 , 2 0 0 4 , B r o c k

p r o te c ti v e ly

f il e d ana p p li c a ti o nf

o r d is a b il it y in s u r ance be ne fi ts, and

on De c e mbe r 5 , 2 00 3, sh e pr ote c tiv e ly fi le d an a pp lic a tio n fo r S up ple me nta l Se c ur ity Inc ome . Sh e a lle g e s a

dis a bil ity be g inn ingin O c tob e r 2 00 3, du e to a c omb inatio n o f a ilm e nts inc lud inghy

pe rt e ns ion , c or on ary

arte ry dis e a se , hy

po thy ro idi sm, fi br omy

a lg ia , d e g e ne rativ e dis c disease, c hronic lowe r bac k pain, morbid obesity , anxiety and depr ession. Br ock’s a pplications were denied initially and ag ain upon re consideration. At Broc k’s reque st, an ad m i n i s t rative la w hea ringwas he ld on Aug ust 25, 2006. During the hea ring , the adminis t ra t i v e law judge hear d testimony from B rock a

nd vocational e x pert Anne Thomas. The judge made f

indings pursua

nt to the gove rningfive-ste p sequential a naly sis. See 2 0 C.F.R. § 416.920. At step one, he found t hat Brock had not eng ag ed in substantial g ainful employ ment since the alleg ed ons et d at e o f d isability . At steps two and thre e, the a dminist rative la w judg e found Br ock’s medic ally

deter minable impairments we re s evere, but dete rmined that none of them met the lis tin g fo un d in

Ap pe nd ix 1 of

the re g ulatio ns . At st ep f our, the jud g e de te rm ine d th a t w hil e Br ock could pe rfor

m a limited rang e of lig ht wo rk , s h e wo uld be unable to pe rfor m past releva

nt
wo rk . F ina lly , a t ste p fi ve , he fo un d that the re we re signif ic ant j ob s in

the e c on omy

tha t B ro c k c ou ld perf orm. Consequentl y , the administrative law judg e found that she was not disabled a nd not entitled to disabilit y insurance benef its. The Appea ls Council declined to revie w the dec ision, and B ro c k s ou g ht j ud ic ia l r e vie w. Th e Di st ri ct Co urt be low a ff ir me d th e de c isi on , a

nd B ro c k ti me ly
a pp e a ls. II. Ana lys isNo. 09-5673

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-3- B ro c k r a ise s thre e argume nts on a pp e a l: (1 ) t

he a dmi nis tr a tiv e law j ud g e did no t pr op e rl y
we ig h th e op ini on

of he r t re a tin g phy sic ian, Dr
. Cha rl e s Mo or e ; (2 ) the a dmi nis tr a tiv e law j ud g e did not provide an a dequate rationale for r ejec ti n g t h e opinion of Dr. Moore ; and (3) the hy pothetical qu e s ti o n th a t th e a dmi n is tr a ti v e la w ju d g e p o s e d to th e v o c a ti o n a l e xp e rt s h o u ld h ave inc luded mental limit ations assessed by consultative examiners Drs. Pamela Starkley and Ke vin Eg g erma

n. Be cause the first two ar g uments have significant ove rlap, we will address them tog ether
. This Court’s reviewis lim ited to determiningwhether the Commiss ioner’s decision was supported by

substantial evidence and wa s made accor ding to proper leg al s tandar ds. 42 U.S.C. § 40 5( g ); Rogers v. Comm’r of Soc. Sec

. , 486 F.3d 234, 241 ( 6th Cir. 2007). A. Treat m ent of Dr. Moor e’s Opinion Br ock argues that the administrative law judge failed to g ive the opinion of h ert reating phy sician the prope r we ight a nd failed to provide an ade quate just ification for reje cting Dr. Moore ’s opinion. The controlling regulations instruct t h e administrative law judg e to g ive the tre ating phy sician' s opinion subst antial weig ht if: (1) it is “well-supporte d by medically

acc eptable c linical and labor atory

diag nostic techniques” an d (2 ) it is “not inconsist ent with the other substantial evidenc e” in the c ase r ecor d. 20 C.F.R. § 404.1527(d)( 2). The r egulations also pro v i d e that the administrative law judg e will gi v e “go od rea sons” for the weig ht give n to a treating phy sician’s opinion. Id. ; see also Shelman v . Hec kler , 821 F.2d 316, 321 ( 6th Cir. 1987)

. Fur ther, if the opinion of a treating phy sician i s not g iven controlli ng weig ht, the admini strative law judge must consider specific fac tors in determiningwhat we ight the tr eating phy sician’s opini on should be g iven. W ilson v. Comm’r of Soc . Sec. , 378 F.3d 541, 544- 46 (6th Cir. 2004). Those fa ctors include: “ the leng th,No. 09-5673

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-4- fre quency , nature , and extent of the treatment relationship; the supportability and consistenc y

of the phy sician' s conclusions; [and] the spec ialization of the phy sician.” Roge rs , 486 F.3d at 240. In W ilson , this Court found err or when an administrative law judge did not give g ood rea sons for f ailing to g ive weig ht to a treating phy sician’s opinion. 378 F.3d at 544-46. This Court noted that the purpose for g iving “g ood rea sons” is so a claimant can understand the outcome of he r ca se. Id . at 544. This is e specia lly important when a claimant knows that he r phy sician cla ssified her a s disabled and, the ref

ore, “ might be espec ially bewilder ed when told by an administrative bur eauc rac y that she is not, unless some rea son for the a g ency ’s dec ision is s upplied.” Id
. I t is uncontested that Dr. Moor e wa s Br ock’s tre ating phy sician. In J une 2006, in addition to h is p re vi ou s d ia g no se s li ste d a bo ve , D r. Mo or e op ine d th a t B ro c k c ou ld o nly c on tin uo us ly sit , sta nd , o r w a lk f

or on e ho ur e a c h d ur ingan eight- ho ur wo rk da y and that sh e c ou ld o nly

oc c a sio na lly lift or car ry up to five pounds. Admi nistrative R ecor d (“A R”) at 439. When addr essing the opinions
and dia g no se s o f D r. Mo or e , th e a dmi nis tr a tiv e law j ud g e fo un d th e fo llo wi ng : As for the opinion evidence , the undersig ned is f ully cog nizant of the usual defe renc e aff orded tre ating medical source opinions. Howe ver, D r. Moore ’s opinion that the claimant is “100% disa

bled” is unsupported by

his essentially benig n clinical data
. Moreove r, the de terminati on of disability is an issue ultimately

deter mined by the Commi s s io n e r

o f So c ia l S e c ur it

y . A d d it io n a ll y , D r . M o o r e c it e d d ia g n o s e s of “De g ener ative disc disease, i ncluding the knees, ankles and wrist” and f ibromy alg ia, all without benefit of diagnostic or ra diologica l studies. The undersig ned also notes Dr . M on de re wi c z’s state me nt t hat th e c la ima

nt “ a ppeared to h ave te nd e r p oints consistent with the diag nosis [ fibromy alg ia].” Howeve r, he did not re commend further investigative measure s. Reg ardle ss, the undersig ned has c are fully considere d the doctor’ s overa ll opinion in the determination of the c laimant’s re sidual functional c a p a c i ty. AR at 25. (interna l citations omit ted).No. 09-5673

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-5- Her e, the a dminist rative la w judg e’s d ec i s i o n to rejec t the opinion of Dr. Moore was supported by

substantial evidence in the record a nd provided “ g ood rea sons” to inform B rock of why Dr. Moore ’s opinion was not beingcre dited. As an initial matter, he c orre ctly disregar d ed Dr. Moore’ s statement that B rock w as “100% disabled,” a s the regu l ati ons rese rve this deter mination for the Socia l Security Secre tary
. 20 C.F.R. § 404.1527(e) (1). Subsec tion (e)( 3) fur ther states that no “spec ial signific ance ” will be g iven to opinions of disabilit y , ev en t h o se made by the treating phy sician. 20 C.F.R § 404.1527(e )(3)
. Additionally , the administrative law judg e’s f indings c halleng e the supporta bility and consistency of Dr. Moore’ s diag noses wit h the ot her evidence in the record in an indi rec t but clear way , as wa s the ca se in Ne lso n v. Com mi ssi on e r of Soc ial

Se c ur ity , 195 F. App’ x 462 (6th Cir. 2006) (whe n administ ra t i v e law judg e attac ks the supportability and consistenc y

of treating phy sician’s opinion describingits faults, then treatingphy sician’s opini on may not be consistent with the rec ord
as a whole and, ther efor e, not entitled to controlling w eig ht). The a dminist rative la w judg e noted that Dr. Moore ’s finding s did not have the suppor t of clinical data. AR at 25. Dr. Moor e’s diagnoses for de g ener ative disc disea se or f ibromy alg ia we re not confirmed by diag nostic or ra diologica l studies. Id . Additionally , the j udg e considered evaluations by other e x amining doc tors. He noted that c ard iol og ist

Dr . M ic he lle F ri da

y fo un d in O c tob e r o f 2 00 3 th a t B ro c k h a d n or ma l art e ri e s w ith only minimal plaquing and nor mal left ventric ular func tion. AR at 18. The judg e found that in May 2004, Dr. Jules Bar efoot pe rfor med a c onsultive ex am finding“no sig nificant motor, s en s ory , or ref lex deficits and no evidenc e of any disorder.” Id . He f

urther a ddresse d a consultive e valuation perf ormed in October of 2005 by Dr. Monder ewicz. Dr. Monde rew icz stated that Br ock had te nderNo. 09-5673

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-6- points consistent with Dr. Moore’s d i agnosis of fibromyalg ia but did not recommend a ny further testing. A R at 19, 25. The judg e also found that Broc k’s pain appea red to be adequately

controlled by the medication prescr ibed by Dr. Moore . AR at 24. All of the pre cedingfac tual fin d ings a re supported by

the re cord e vidence
. Fi n all y , the administrative law judg e also c onsidered B rock’ s demea nor and testimony during the hear ing when e valuatingher c laims of disability
. Se e As hwo rth v. Sullivan , 9 5 1 F
. 2 d

3 4 8 ( 6 th Ci r . 1 9 9 1 ) ( ta

b le ) ( n o ti n g th a t c la im an t’ s d e me an o r a t t h e h e ar ing belied her doctor’s c onclusions of disability). He f ound that she did not exhi bit the behavior of an individual in “prolong ed or se vere pain or a ny other de bilitating sy

mptomatology .” AR at 24. In sum, the administrative law jud g e addr essed in-de pth the finding s of Dr. Moor e’s
e xami na tio ns , in c lud inge va luatio ns in F e br ua ry 20 05 and June 20 06 . A R at 18 -1 9. He e xplic itl y stated that he w as aw are of the usual defe renc e g iven to a treating phy sician’s opinion and that he
c o n s i d e r e d

D r . M o o r e ’ s o v e r a l l f

i n d i n g s w h e nd e t e r

m i n i n g B r o c k ’ s r e s i d

u a l f un c t i o n i n g c a

p a c i ty. AR at 25. Ho w e v e r , a s n o te d a b o v e , h e d id

n o t b e li e v e D r . M o o r e ’ s f in d in g s w e r e s u

p p o rte d by clinical data
. Id . Be cause there is substantial evidence in the record to support the a dminist rative law judg e’s de termination, we find that he af forde d the prope r we ight to the opinion of Dr . Moore and that he pr ovided g ood rea sons for the we ight he was a ffor ding.

C. Hypothetical Question Pose d to Vocational Expert Br ock conte nds t h at the hy pothetical question posed to the voc ational expert did not
acc urate ly

descr ibe her

mental limitations . In order for the Commissioner t o rely upon the vocational expert’s testimony

to meet his burden, “ the testimony must be g iven in response to a hy pothetical qu e sti on that a c c ur a te ly

de sc ri be s th e pla int if

f i n a ll sig nif

ic ant, re le va

nt r e sp e c ts; fo r a

re sp on se toNo. 09-5673

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-7- a hy po the tic a l qu e sti on

to c on sti tut e su

bs tanti a l e vid e nc e , e a c h e le me nt o f t he h y po the tic a l mu st
ac cu ra t ely

descr ibe the cla imant.” Felisky v . Bowen , 3 5 F
. 3 d 1 0 2 7 , 1 0 3 6 ( 6 th

Ci r . 1 9 9 4). Consequently , we must deter mine whether

the information conta ined in the hy pothetical question
was a ccur ate. The re cord r efle cts that two consultative m ental eva luations were perf ormed on B rock, one i nM ay 2 0 0 4 an d

an o th e r i n O c t o b e r 2 0 0 5 , b y P s yc h o l o g i s t S t ar k l e y an d D r . E g g e r m an , r e s p e c t i v e l y. In Ma y 20 04 , Stark le y de te rm ine d that B ro c k wa s lik e ly to have mil d dif fi c ulty wi th si mpl e instructions, moderate dif ficultly with skill s neede d for completing tasks in wor k settings a

nd household routines, and mode rate difficulty with the normal pressures of a work setting. AR at 186. Fur ther, Starkley

conclude d that Br ock’s a bility to relate t o people was mildly impaired. Id . When Dr . E g g e rm an e va luate d B ro c k in Oc tob e r 2 005, hi s con c lus ion s w e re no t a s r e str ic tiv e a s th os e deter mined by Dr. Starkley more than a y ear befor e. F or instance , Eg g erma n found that B rock w as not limi ted in her a

bility to reme mber sim ple i nstructions. AR at 331-32. He also deter mined that sh e wa s o nly

mil dly lim ite d in

he r a bil ity to c omp le te de ta ile d in str ucti on s, mak e sim

ple work-r elated judg ments, and intera ct appr opriately with co-w orker s and super visors. Id
. F i n a l l y,
so me wh a t si mil arl y

to D r. Stark le y , he de te rm ine d that sh e wo uld have mil d to mod e ra te dif fi c ult ly respondingto work re lated pre ssures. Id . at 332. Using these c onsultations, the a d mi n is tr a ti v e law judg e made the followingfinding reg arding B ro c k’ s me nta l c a

pa bil iti e s: [T] he under signe d ag ree s with the opinio n s o f Psy cholog ist S tarkley and Dr
. Eg g erma n, who found the c laimant reta ins the capa city to understand, r emember and car ry out at lea s t s h o rt , simple instructions. Moreover, a fter the more re centNo. 09-5673

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-8- e va luatio n b y

Dr . E g g e rm an, it was de te rm ine d th e c la ima nt r e ta ine d a de qu a te capa city to understand, r emember , and ca rry out even de tailed instructions; interact a pp ro pr iate ly

wi th the pu

bli c , sup e rv iso rs , an d co wo rk e rs ; and re sp on d a pp ro pr iate ly to chang es in a routine w ork setting
. AR a t 25 . T he a dmi nis tr a tiv e law j ud g e a sk e d th e vo c a tio na l e xpe rt to a ssume that Bro ck cou ld “eng ag e in occ asional and supe rficia l contact with cowor kers, supervisors a

nd the g ener al public.” AR at 519. B r o c k

c la im s th a t b e c a

u s e th e qu e s ti o nf

a il e d to in c lu d e h e r

a b il it y to to le r a te w ork pressure s, maintain attention, maintain attendanc e and othe r var ious restrictions, then the vocational expert' s testimony

is unreliable. Contr ary to B ro c k’ s su g g e sti on , th e a dmi nis tr a tiv e law j ud g e a g re e d w iththe f i nd ing s o f b oth mental hea lth professionals. But the f indings re flec t that he foc used more on the rec ent assessment compl eted by

Dr. Eg g erma

n, who found that B rock’ s mental limit ations were less restric tive than those found by Dr. Starkley
. The administrative law judge ’s question acc urate ly ref lected the fi nd ing s o f D r. Eg g e rm an, a s D r. Eg g e rm an b e lieved th at Brock wa s o nly mil dly lim ite d in

a ll assessments with the exception of re spondin g t o work related pr essure s. Furthe r, a hy pothetical question may

be incomplete, yet still accuratel y p o rt ra y a cla imant’s limit ations. See , e.g. , Infantadao v. Astrue , 263 F. App’ x 469, 4 7 7 (6 t h C i r. 2008). Such is the c ase he re. While the hy pothetical question could have conta ined more r estrictions, it contained an accurate portra y al of Br ock’s menta l limi tations. Conse qu e n tl y , th e v o c a ti o n a l e xp e rt’ s o p in io nc o n s ti tute s s u b s ta n ti a l e v id e n c e . T he vocat i o n al ex p ert identified jobs that Broc k could complete g iven her mental limitations , and the administrative law judge appropr iately relied on this opinion. The Commi ssioner m et h i s b urdenNo. 09-5673

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-9- of p r o v i n g th e e xi s t e n c e o f a l t e r n a t i v e w o r

k f o r B r o c k , an d th e D i s tr i c t C o urt ’ s o p ini on is AFF I RMED.