Source: http://pa.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20180327_0000439.WPA.htm/qx
Timestamp: 2019-04-25 05:51:17+00:00

Document:
CAROLYN W. COLVIN, ACTING COMMISSIONER OF SOCIAL SECURITY, Defendant.
AND NOW, this 27th day of March, 2018, upon consideration of the parties' cross-motions for summary judgment, the Court, upon review of the Commissioner of Social Security's final decision denying Plaintiff's claim for disability insurance benefits under Subchapter II of the Social Security Act, 42 U.S.C. § 401 et seq., and denying Plaintiff's claim for supplemental security income benefits under Subchapter XVI of the Social Security Act, 42 U.S.C. § 1381, et seq., finds that the Commissioner's findings are supported by substantial evidence and, accordingly, affirms. See 42 U.S.C. § 405(g); Jesurum v. Secretary of U.S. Department of Health & Human Services, 48 F.3d 114, 117 (3d Cir. 1995); Williams v. Sullivan, 970 F.2d 1178, 1182 (3d Cir. 1992), cert. denied sub nom., 507 U.S. 924 (1993); Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir. 1988). See also Berry v. Sullivan, 738 F.Supp. 942, 944 (W.D. Pa. 1990) (if supported by substantial evidence, the Commissioner's decision must be affirmed, as a federal court may neither reweigh the evidence, nor reverse, merely because it would have decided the claim differently) (citing Cotter v. Harris, 642 F.2d 700, 705 (3d Cir. 1981)).
Therefore, IT IS HEREBY ORDERED that Plaintiff's Motion for Summary Judgment (document No. 9) is DENIED and that Defendant's Motion for Summary Judgment (document No. 11) is GRANTED.
 The Court finds no merit in Plaintiff's various arguments that the Administrative Law Judge (“ALJ”) erred in finding him to be not disabled, and finds that substantial evidence supports the ALJ's decision.
Plaintiff's arguments are somewhat intertwined, but it is clear that he alleges that the ALJ erred by affording insufficient weight to the opinions of his consultative examiner, Lindsey Groves, Pys.D., and of two of his treating physicians, Saghir Ahmad, M.D., and Gowri Arul, M.D. He argues that these opinions support a finding that he meets Listings 12.04 and 12.06, 20 C.F.R. pt. 404, subpt. P, App. 1, and demonstrate that the residual functional capacity (‘RFC”) and hypothetical question formulated by the ALJ were insufficient, particularly in regard to Plaintiff's post traumatic stress disorder. The Court disagrees and finds that the ALJ adequately explained the rationale for assigning weight to the opinion evidence as he did, in finding that Plaintiff did not meet Listings 12.04 and 12.06, and in formulating Plaintiff's RFC.
It is true that when assessing a claimant's application for benefits, the opinions of the claimant's treating physicians generally are to be afforded significant weight. See Fargnoli v. Massanari, 247 F.3d 34, 43 (3d Cir. 2001); Plummer v. Apfel, 186 F.3d 422, 429 (3d Cir. 1999). In fact, the regulations in place at the relevant time provide that a treating physician's opinion is to be given “controlling weight” so long as the opinion is well-supported by medically acceptable clinical and laboratory diagnostic techniques and not inconsistent with other substantial evidence in the record. 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2); Fargnoli, 247 F.3d at 43; Plummer, 186 F.3d at 429. (The Court notes that Sections 404.1527 and 416.927, rather than Sections 404.1520c and 416.920c, apply since Plaintiff's claims were filed before March 27, 2017.) As a result, the ALJ may reject a treating physician's opinion outright only on the basis of contradictory medical evidence, and not on the basis of the ALJ's own judgment or speculation, although he may afford a treating physician's opinion more or less weight depending upon the extent to which supporting explanations are provided. See Plummer, 186 F.3d at 429.
The ALJ -- not treating or examining physicians or State agency consultants -- must make the ultimate disability and RFC determinations. Although treating and examining physician opinions often deserve more weight than the opinions of doctors who review records, “[t]he law is clear . . . that the opinion of a treating physician does not bind the ALJ on the issue of functional capacity[.]” Brown v. Astrue, 649 F.3d 193, 197 n. 2 (3d Cir.2011). State agent opinions merit significant consideration as well.
Chandler v. Comm'r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011) (internal citations omitted in part). Here, the ALJ included in his decision a substantial discussion as to why he gave the weight that he did to the various medical opinions. Substantial evidence supports his findings in determining that Plaintiff did not meet Listings 12.04 and 12.06 and in formulating the RFC and hypothetical question to the vocational expert (“VE”).
Plaintiff asserts that Dr. Groves, on February 19, 2016, opined that he satisfied the criteria to meet Listings 12.04 and 12.06 at Step Three of the sequential analysis, specifically that he had marked restrictions in maintaining social functioning and that he had four or more episodes of decompensation, each of extended duration. (R. 513). (The Court notes that Listings 12.04 and 12.06 were revised significantly effective January 17, 2017. See Revised Medical Criteria for Evaluating Mental Disorders, 81 F.R. 66138-01, 2016 WL 5341732 (Sept. 26, 2016). However, this Court will review the ALJ's decision using the rules in effect at the time the decision was issued. See id. at 66138 n.1.) As the ALJ explained in his analysis of this issue, in order to satisfy these listings as they existed at the relevant time, Plaintiff's impairments have to have resulted in at least two of four of the following limitations: marked restriction of activities of daily living; marked difficulties in maintaining social functioning; marked difficulties in maintaining concentration, persistence, or pace; or repeated episodes of decompensation, each of extended duration. (R. 22). See 20 C.F.R. pt. 404, subpt. P, App. 1, §§ 12.04, 12.06 (2016). The ALJ further explained that repeated episodes of decompensation, each of extended duration, means three episodes within 1 year, or an average of once every 4 months, each lasting for at least 2 weeks. (R. 22-23). See 20 C.F.R. pt. 404, subpt. P, App. 1, § 12.00.C.4 (2016). While Dr. Groves does contend that Plaintiff meets two of the four criteria, the ALJ thoroughly discussed why he rejected both of these findings by Dr. Groves, pointing out that such limitations are inconsistent with Dr. Groves' own clinical findings, with her finding that Plaintiff had a Global Assessment of Functioning (“GAF”) score of 58, and with the records of Dr. Ahmad and Jeffrey Turgeon, PA-C. (R. 23).
Indeed, even assuming the ALJ should have accepted Dr. Groves finding of marked limitations in maintaining social functioning, Dr. Groves' opinion regarding episodes of decompensation simply does not line up with the requirements of Listings 12.04 and 12.06. As the ALJ explained, to meet the fourth criterion of these listings, there must be evidence of three or more episodes of decompensation in a single year, or an average of once every four months, each lasting for at least two weeks. (R. 22-23). The ALJ correctly pointed out at the hearing that, Dr. Groves' opinion notwithstanding, the record simply does not establish any such episodes, let alone four. (R. 79-80). He asked for clarification from Dr. Groves as to what she meant in regard to the opined episodes of decompensation, and she indicated that she “assumed” that such episodes had occurred, and showed no awareness of the requirement for the episodes to have occurred within a twelve-month period. (R. 520). Therefore, Dr. Groves' opinion, and the other record evidence, simply does not support that Plaintiff satisfied this criterion and that he therefore met Listings 12.04 and 12.06.

References: § 401
 § 1381
 § 405
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