Source: http://va.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20180103_0000010.EVA.htm/qx
Timestamp: 2018-02-25 11:59:27
Document Index: 753848908

Matched Legal Cases: ['§ 405', '§ 636', 'art, 434', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', 'art 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404', '§ 404']

VALERIE E. HUNTER, Plaintiff,
On October 2, 2014, Ms. Hunter ("Plaintiff) applied for Social Security Disability Benefits ("DIB''), alleging disability due to a depressive disorder, anxiety disorder, myocardial infarction, hypertension and cardiomyopathy, with an alleged onset date of April 10, 2014. The Social Security Administration ("SSA") denied Plaintiffs claims both initially and upon reconsideration. Thereafter, an Administrative Law Judge ("ALJ") denied Plaintiffs claims in a written decision and the Appeals Council denied Plaintiffs request for review, rendering the ALJ's decision as the final decision of the Commissioner.
Plaintiff seeks judicial review of the ALJ's decision pursuant to 42 U.S.C. § 405(g), arguing that the ALJ erred in properly analyzing opinions of Plaintiff s treating physicians and other providers. (Mem. in Support of Pl's Mot. for Summ. J. ("Pl's Mem.") (ECF No. 13) at 2.) Plaintiff further argues that the ALJ failed to properly account for her moderate difficulties in concentration, persistence and pace, and that he erred in assessing Plaintiffs credibility by foiling to acknowledge her work history in his assessment. (Pl's Mem. at 2, 9.) This matter now comes before the Court by consent of the parties pursuant to 28 U.S.C. § 636(c)(1), on the parties' cross-motions for summary judgment, rendering the matter ripe for review.[1] For the reasons that follow, the Court hereby DENIES Plaintiffs Motion for Summary Judgment (ECF No. 12), GRANTS Defendant's Motion for Summary Judgment (ECF No. 14) and AFFIRMS the final decision of the Commissioner.
On October 3, 2014, Plaintiff filed an application for DIB with an alleged onset date of April 10, 2014. (R. at 236-37.) The SSA denied these claims initially on December 15, 2014, and again upon reconsideration on May 7, 2015. (R. at 120-30, 133-44.) At Plaintiffs written request, the ALJ held a hearing on September 14, 2016. (R. at 34-69.) On September 27, 2016, the ALJ issued a written opinion, denying Plaintiffs claims and concluding that Plaintiff did not qualify as disabled under the Act, because Plaintiff could perform work as a laundry sorter, clerical assistant or packager. (R. at 19-29.) On December 12, 2016, the Appeals Council denied Plaintiffs request for review, rendering the ALJ's decision as the final decision of the Commissioner subject to review by this Court. (R. at 1-4.)
In reviewing the Commissioner's decision to deny benefits, a court "will affirm the Social Security Administration's disability determination 'when an ALJ has applied correct legal standards and the ALJ's factual findings are supported by substantial evidence.'" Mascio v. Colvin, 780 F.3d 632, 634 (4th Cir. 2015) (quoting Bird v. Comm 'r of Soc. Sec. Admin., 699 F.3d 337, 340 (4th Cir. 2012)). Substantial evidence requires more than a scintilla but less than a preponderance, and includes the kind of relevant evidence that a reasonable mind could accept as adequate to support a conclusion. Hancock v. Astrue, 667 F.3d 470, 472 (4th Cir. 2012); Craig v. Chafer, 76 F.3d 585, 589 (4th Cir. 1996). Indeed, "the substantial evidence standard 'presupposes ... a zone of choice within which the decision makers can go either way, without interference by the courts. An administrative decision is not subject to reversal merely because substantial evidence would have supported an opposite decision."' Dunn v. Colvin, 607 Fed.Appx.. 264, 274 (4th Cir. 2015) (quoting Clarke v. Bowen, 843 F.2d 271, 272-73 (8th Cir. 1988)). To determine whether substantial evidence exists, the court must examine the record as a whole, but may not "undertake to re-weigh conflicting evidence, make credibility determinations, or substitute [its] judgment for that of the [ALJ]." Hancock, 667 F.3d at 472 (quoting Johnson v. Barnhart, 434 F.3d 650, 653 (4th Cir. 2005)). In considering the decision of the Commissioner based on the record as a whole, the court must "take into account whatever in the record fairly detracts from its weight." Breeden v. Weinberger, 493 F.2d 1002, 1007 (4th Cir. 1974) (quoting Universal Camera Corp. v. N.L.R.B., 340 U.S. 474, 488 (1951)). The Commissioner's findings as to any fact, if substantial evidence in the record supports the findings, bind the reviewing court to affirm regardless of whether the court disagrees with such findings. Hancock, 667 F.3d at 477. If substantial evidence in the record does not support the ALJ's determination or if the ALJ has made an error of law, the court must reverse the decision. Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir. 1987).
The Social Security Administration regulations set forth a five-step process that the agency employs to determine whether disability exists. 20 C.F.R. § 404.1520(a)(4); see Mascio, 780 F.3d at 634-35 (describing the ALJ's five-step sequential evaluation). To summarize, at step one, the ALJ looks at the claimant's current work activity. § 404.1520(a)(4)(i). At step two, the ALJ asks whether the claimant's medical impairments meet the regulations' severity and duration requirements. § 404.1520(a)(4)(ii). Step three requires the ALJ to determine whether the medical impairments meet or equal an impairment listed in the regulations. § 404.1520(a)(4)(iii). Between steps three and four, the ALJ must assess the claimant's residual functional capacity ("RFC"), accounting for the most that the claimant can do despite her physical and mental limitations. § 404.1545(a). At step four, the ALJ assesses whether the claimant can perform her past work given her RFC. § 404.1520(a)(4)(iv). Finally, at step five, the ALJ determines whether the claimant can perform any work existing in the national economy. § 404.1520(a)(4)(v).
On September 14, 2016, the ALJ held a hearing during which Plaintiff (represented by counsel) and a vocational expert ("VE") testified. (R. at 34-69.) On September 27, 2016, the ALJ issued a written opinion, finding that Plaintiff did not qualify as disabled under the Act. (R. at 19-29.) The ALJ followed the five-step evaluation process established by the Social Security Act in analyzing Plaintiffs disability claim. (R. at 19-21.) At step one, the ALJ found that Plaintiff had not engaged in substantial gainful activity since August 13, 2016, more than two years after the alleged onset date. (R. at 21.) At step two, the ALJ found that Plaintiff exhibited the following severe impairments: (1) depressive disorder; (2) anxiety disorder; (3) myocardial infarction; (4) hypertension; and, (5) cardiomyopathy. (R. at 21-22.) At step three, the ALJ found that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. §§ 404.1520(d), 404.1525, 404.1526). (R. at 22-23.)
In assessing Plaintiffs RFC, the ALJ found that Plaintiff could perform light work with the following non-exertional limitations: (1) she must avoid any and all concentrated exposure to hazards such as dust, fumes and pulmonary irritants, as well as unprotected heights and moving mechanical parts; (2) she can only perform simple, routine tasks, not at production rate; (3) she has no more than occasional changes in routine work settings; (4) she has no more than occasional contact with supervisors and co-workers; and, (5) she has no interaction with the public. (R. at 23-28.) At step four, the ALJ found that Plaintiff cannot perform any past relevant work. (R. at 28.) At step five, the ALJ determined that Plaintiff could perform jobs existing in significant numbers in the national economy, including as a laundry sorter, clerical assistant or packager. (R. at 28-29.) Therefore, Plaintiff did not qualify as disabled under the Act. (R. at 29.)
Plaintiff, forty-eight years old at the time of this Report and Recommendation, previously worked as a customer service representative and a home health care companion. (R. at 28, 120, 261-63.) She applied for Social Security Benefits, alleging disability due to a heart attack, depression and anxiety, with an alleged onset date of April 10, 2014. (R. at 270.) Plaintiffs appeal to this Court alleges that the ALJ erred in rejecting Andrew D. Cook, M.D.'s opinion, awarding partial weight to the opinions of Tonjanika Boyd, PMHNP-BC, Rashika Wallace, LCSW and Prakash Ettigi, M.D., and giving significant weight to the state agency expert psychologists' opinions. (Pl's Mem. at 3-7.) Plaintiff also alleges that the ALJ erred by failing to account for her moderate difficulties in concentration, persistence or pace. (Pl's Mem. at 9.) Lastly, Plaintiff argues that the ALJ lacked substantial evidence in evaluating Plaintiffs credibility. (Pl's Mem. at 16-19.) For the reasons set forth below, the ALJ did not err in his decision.
A. The ALJ Did Not Err in his Evaluations of the Opinion Evidence.
Plaintiff argues that the ALJ afforded too little weight to the opinions of Plaintiff 's treating sources and too much weight to the state agency expert psychologists. (Pl's Mem. at 3-7.) Defendant responds that substantial evidence supports the ALJ's analysis and he appropriately reconciled conflicting medical opinions. (Mem. in Support of Def.'s Mot. for Summ. J. ("Def.'s Mem.") (ECF No. 14) at 13-16.)
The ALJ based his opinion on whether Plaintiffs medically-determinable combination of severe impairments significantly limited her ability to do basic work activities by analyzing her medical records and medical expert evaluations. 20 C.F.R. §§ 404.1512, 404.1527. When multiple medical opinions exist and prove inconsistent with each other, the ALJ must evaluate the opinions and assign them respective weight to properly analyze the evidence involved. §§ 404.1527(c)(2)-(6), (d). Only an "acceptable medical source" can, but does not have to, offer an opinion entitled to controlling weight. SSR 06-03p.[2] Licensed physicians and licensed or certified psychologists constitute acceptable medical sources. §§ 404.1513(a), 404.1527(a) (2014). The ALJ may also consider evidence from "other sources" - including nurse-practitioners, therapists and social workers - as evidence of the severity of impairment or for the effect that the impairments have on the claimant's ability to work. § 404.1513(d). Regulations and case law require the ALJ to give a treating source's opinion controlling weight contingent upon substantial support obtained through medically acceptable clinical and laboratory diagnostic techniques that prove not inconsistent with other substantial evidence. § 404.1527(c)(2); Lewis v. Berryhill, 858 F.3d 858 (4th Cir. 2017); Craig, 76 F.3d at 589; SSR 96-2p.[3] Notably, the ALJ does not have to accept opinions from a treating source if it opines on the claimant's ultimate disability for employment purposes. § 404.1527(d)(1). Further, the regulations do not require that the ALJ accept an opinion from a treating source which is inconsistent with other evidence or is not well-supported. § 404.l527(c)(3)-(4).
The ALJ must consider the following when evaluating a treating source's opinion: (1) the length of the treating source relationship and frequency of examination; (2) the nature and extent of the treatment relationship; (3) supportability based upon the medical record; (4) consistency between the opinion and the medical record; (5) any specialization on the part of the treating source; and, (6) any other relevant factors. § 404.1527(c). The regulations vest the authority to determine whether a claimant is disabled in the ALJ alone, not in the treating source. § 404.1527(d)(1). These same factors may be applied in evaluating opinion evidence from "other sources." SSR 06-03p.
1. Dr. Cook's Opinion.
Plaintiff argues that given her long treatment history with Dr. Cook, his opinion warrants more weight. (Pl's Mem. at 5.) Defendant argues that the ALJ properly awarded "no weight" to Dr. Cook's letter, because he made a conclusory statement about Plaintiffs ultimate disability - an issue reserved only for the Commissioner - and could not speak specifically about Plaintiffs limitations, deferring instead to Dr. Ettigi. (Def.'s Mem. at 16.)
The ALJ assigned no weight to Dr. Cook's opinion. (R. at 27.) The ALJ reasoned that Dr. Cook wrote a conclusory opinion without offering specific functional limitations, inconsistent with both Plaintiffs treatment records and mental status examination findings. (R. at 27.) Within his letter, Dr. Cook wrote that Plaintiffs "disability . .. has been primarily due to her mental health problems." (R. at 537.) Dr. Cook further opined that Plaintiff "had significant depression after her heart attack [and] due to ... work stress and health problems of family members." (R. at 537.) Dr. Cook concluded that Plaintiffs mental health limited her ability to maintain employment and left her unable to manage her anxiety. (R. at 537.) After making these statements, Dr. Cook deferred to Dr. Prakash Ettigi for "specific limitations." (R. at 537.)
The ALJ's decision to afford Dr. Cook's letter no weight finds support from the medical evidence in the record. Plaintiff had a heart attack on April 10, 2014. (R. at 41.) On June 30, 2014, Plaintiff began a series of monthly visits to Dr. Cook after her cardiologist suggested that she see a primary care physician about her depression and stress-related problems. (R. at 554.) Dr. Cook suggested that Plaintiffs depression "could be from a combination of grief from [her] mother's death, recent heart attack and cumulative stress with work and family needs." (R. at 555.) Plaintiff exhibited normal speech, behavior, judgment, thought content, cognition and memory, and a depressed mood. (R. at 555.) Dr. Cook referred Plaintiff to a psychologist for her anxiety and depression. (R. at 555.)
On July 16, 2014, Plaintiffs condition remained largely the same, except that she suffered from an allergic reaction from a tick bite and began a prescription for her allergy medicines. (R. at 556-57.) On July 24, 2014, Plaintiff again exhibited similar conditions, and suffered from lightheadedness possibly due to her anxiety. (R. at 559-60.) During a follow-up visit on August 25, 2014, Plaintiff exhibited similar conditions, reported severe headaches, chest pains and - without medical guidance - she stopped taking her prescribed Zoloft and Mirtazepine. (R. at 562-64).
On October 21, 2014, Plaintiff reported that she suffered from anxiety attacks and headaches about every two days. (R. at 565.) However, she also reported improvements in her anxiety and depression with counseling. (R. at 567.) Dr. Cook suggested to halve or quarter her current dosage of Ativan if it caused Plaintiff too much sleepiness. (R. at 567.)
On November 4, 2014, Plaintiff received osteopathic manipulation treatment. (R. at 569-70.) On January 26, 2015, Plaintiff reported chest pain and headaches, but she appeared otherwise normal upon examination. (R. at 573.) Dr. Cook encouraged Plaintiff to see a specialist for her stress headaches and to consider physical therapy if the pain became chronic. (R. at 575.) Plaintiff received another osteopathic manipulation treatment and reported neck swelling and elbow pain on February 23, 2015. (R. at 577, 579.)
On March 25, 2015, Plaintiff presented with normal speech, behavior, judgment, thought content, cognition and memory, as well as a depressed, anxious mood, and worsening headaches. (R. at 581, 583.) On June 26, 2015, Plaintiff reported that her headaches and elbow pain occurred every other day and lasted one to twelve hours. (R. at 584.) On August 4, 2015, Plaintiff again exhibited similar conditions. (R. at 588-90.) On October 26, 2015, Plaintiffs condition remained unchanged, except that she reported a decreased appetite and insomnia. (R. at 592.)
On March 28, 2016, Plaintiff reported increased anxiety and headaches, but that she also wanted to start working half-days for six weeks. (R. at 601-03.) Despite reporting more frequent anxiety and headaches, Dr. Cook's notations remained largely the same. (R. at 603.) On May 4, 2016, Plaintiff again exhibited normal speech, behavior, judgment, thought content, cognition and memory, and a depressed mood. (R. at 604, 606.) During her final visit on July 18, 2016, Plaintiff reported an infected tooth, problems seeing, depression and breast pain. (R. at 607.) Dr. Cook again noted an unremarkable psychiatric evaluation. (R. at 609.)
Overall, the objective medical evidence in the record supports the ALJ's decision to afford no weight to Dr. Cook's opinion. Dr. Cook offered no specific work-related limitations. (R. at 537.) Instead, he acknowledged that Dr. Ettigi primarily managed Plaintiffs anxiety and depression, and deferred to Dr. Ettigi for a more detailed assessment. (R. at 537.) Moreover, Dr. Cook did not refer to any of his past moderate findings. (R. at 537.) During twelve of her thirteen visits for anxiety and depression, Plaintiff exhibited normal speech, behavior, judgment, thought content, cognition and memory. (R. at 555, 557, 560, 563, 567, 575, 583, 586, 594, 603, 606, 609.) During the one other visit, Plaintiff exhibited a "normal mood and affect" instead of a depressed or anxious mood. (R. at 590.) Although Plaintiff ...