Opinion ID: 62183
Heading Depth: 3
Heading Rank: 1

Heading: Physician Opinions of Record

Text: Hernandez argues that the Commissioner failed to properly consider the treating and examining physicians’ opinions in determining his residual functional capacity. As an initial matter, he contends that the Commissioner erred in finding that “the medical record provides little or no evidence as to the claimant’s treatment for his impairments from 1999 forward” in light of Dr. Molnar’s 2004 report, which explains that Hernandez sought treatment in Mexico during the interim because he was unaware that he could obtain further past relevant work; and (5) whether the impairment prevents the claimant from performing any other substantial gainful activity. 20 C.F.R. §§ 404.1520(a), 416.920(a). 5 No. 07-51160 workers’ compensation treatment in the United States. As the district court noted, however, Dr. Molnar’s report indicates that the only record of this treatment in Mexico is a physician’s letter given to him by Hernandez, which is not included in the record. In addition, the district court correctly observed that even considering Dr. Molnar’s report and Hernandez’s testimony regarding the alleged treatment in Mexico, the record is bereft of any specific facts regarding any medical treatment or diagnosis between Hernandez’s last treatment by Dr. Molnar in October 1998 and the end of his insured period in December 2001. As a result, the Commissioner did not err in finding a lack of reliable evidence of medical treatment after 1999. Hernandez further argues that the Commissioner erred in discounting Dr. Molnar’s and Dr. Arizmendez’s opinions in their 2004 reports regarding the extent of his disability.2 Dr. Molnar’s opinion is that “it is very reasonable . . . that [Hernandez’s] pain . . . is due to his old injury and his old surgical procedure,” and that “[Hernandez] is probably going to have a difficult time finding employment, either sitting or standing, or bending or twisting. He simply cannot do these activities.” Dr. Arizmendez’s opinion is that Hernandez “is unable to lift more than half a gallon of milk and . . . is developing gout in his hands,” and that “[h]is return to work . . . will likely be confounded by the lifting restrictions, the need for frequent changes in position . . . and limitations with activities . . . given his development of gout.” It is well settled that although the “opinions, diagnoses, and medical evidence of a treating physician who is familiar with the claimant’s injuries, treatments, and responses should be accorded considerable weight in determining disability,” such evidence is not conclusive; rather, the ALJ bears 2 Hernandez also points to a pre-surgery 1997 report of his treating physician, Dr. George Tipton, wherein Dr. Tipton states that he discussed Hernandez’s upcoming surgery and told him that “the more sedentary his occupation the more likely it would be to have long-term relief of symptoms.” This opinion, however, directly supports the residual functional capacity finding for a significant range of sedentary work. 6 No. 07-51160 “the sole responsibility for determining the claimant’s disability status.” Greenspan, 38 F.3d at 237 (internal quotation marks and citations omitted). As this court has explained: [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. Scott [v. Heckler, 770 F.2d 482, 485 (5th Cir. 1985)]. In sum, the ALJ “is entitled to determine the credibility of medical experts as well as lay witnesses and weigh their opinions accordingly.” Id.; see also 20 C.F.R. § 404.1527(c)(2) (“If any of the evidence in your case record, including any medical opinion(s), is inconsistent with other evidence or is internally inconsistent, we will weigh all the other evidence and see whether we can decide whether you are disabled based on the evidence we have.”). Greenspan, 38 F.3d at 237; see also 20 C.F.R. § 404.1527(d) (stating that in weighing medical opinions, the ALJ should consider the examining relationship, the treatment relationship, supportability, consistency with the record, and specialization). Here, as noted by the district court, Dr. Molnar’s and Dr. Arizmendez’s 2004 reports, conducted almost three years after the expiration of Hernandez’s insured period, are relevant only insofar as they bear on his condition between 1997, the alleged onset date of the disability, and 2001, the date on which his benefits ended. See Anthony, 954 F.2d at 295 (explaining that to prove entitlement to disability benefits under Title II, the claimant must prove not only that he is disabled, but also that he became disabled before the end of the insured period). In addition, while both Dr. Molnar and Dr. Arizmendez opined that Hernandez’s physical symptoms would severely restrict his ability to work, the ALJ was entitled to disregard these conclusory statements and to rely instead on the more specific medical diagnosis in Dr. Arizmendez’s report that 7 No. 07-51160 Hernandez suffers from chronic pain syndrome and failed back syndrome.3 Contrary to Hernandez’s argument, moreover, the ALJ did not “reject” Dr. Arizmendez’s opinion but afforded it “the greatest weight,” incorporating most of the limitations outlined in her evaluation in his residual functional capacity finding. Although Dr. Arizmendez limited Hernandez to working only four hours a day, the ALJ was nonetheless justified in finding that Hernandez had the capacity to work eight hours a day, particularly in light of Dr. Arizmendez’s statement elsewhere in her report that he could sit for a total of six to eight hours a day and of the treatment records closer in time to the insured period. Also contrary to Hernandez’s argument, as a consultative examiner instead of a treating physician, Dr. Molnar’s opinion is not accorded the controlling weight given to treating physicians.4 In addition, as the district court emphasized, the record contains several assessments made by him during Hernandez’s insured period that note “contradictions between the Claimant’s efforts and the results of the examinations.” Accordingly, the Commissioner properly considered the physician opinions of record, incorporated the limitations he found consistent with the weight of the evidence as a whole, and made a residual functional capacity finding that is supported by substantial evidence.