Opinion ID: 772880
Heading Depth: 4
Heading Rank: 2

Heading: Reviewing Physicians

Text: 35 The record also contains the reports of three reviewing physicians, those of Drs. Burdan, Hansell, and Hsieh. Doctors Burdan and Hansell simply checked boxes on form reports and gave no significant supporting explanation for their conclusions. Dr. Hansell's report, dated August 12, 1996, simply states conclusorily that Holohan has no severe impairments. In contrast, in a report dated February 23, 1995, Dr. Burdan found Holohan severely impaired, but he indicated that he did not have enough information to determine whether Holohan met two of the four category B criteria in Appendix 1. 9 Dr. Burdan's report is, therefore, neutral on the question of whether Holohan qualified as disabled at step three of the five step inquiry. 36 Unlike Drs. Burdan and Hansell, Dr. Hsieh wrote a letter explaining her opinions concerning Holohan. At the time she wrote on Holohan's behalf, Dr. Hsieh had just recently taken over as Holohan's primary care physician. She explained that she had taken over Holohan's case from Dr. Kristen Shaeffer, with whom Holohan had a long, close relationship. 10 Based on a review of Holohan's file, in a letter dated July 9, 1997, Dr. Hsieh stated that her 37 impression is that Mrs. Holohan has had, and continuesto have, illness of great severity. In addition to beinga victim of domestic abuse, Mrs. Holohan has diseasesthat include depression, insomnia, severe anxietydisorder and panic attacks that were described as quitedebilitating by a psychologist in 7/96 .... Theimplication from all reports is that Mrs. Holohancontinues to suffer from severe psychiatric diseasewhich would hinder her from maintaining a job. 38 The ALJ rejected Dr. Hsieh's opinion because Dr. Hsieh admitted that he [sic, she] did not have first hand knowledge of [Holohan's] impairments and limitations and because the weight of the most recent evidence of record indicates improvement in her mental condition and panic attacks, particularly when separated from her unfortunate marital environment, and the record clearly does not contraindicate performance of work activity. 39 We conclude that the ALJ's specific reason for rejecting Dr. Hsieh's medical opinion is not supported by substantial evidence. In concluding that the most recent medical evidence indicates that Holohan was improving, the ALJ selectively relied on some entries in Holohan's records from San Francisco General Hospital and ignored the many others that indicated continued, severe impairment. 11 In addition, the ALJ relied on the medical opinions of examining and reviewing physicians (besides that of Dr. Hsieh) to the exclusion of Dr. Oh's more recent opinion that Holohan's impairments are quite severe. The only medical opinions in the record that conflict with Dr. Oh's are those of Dr. Flach, who stated that Holohan had only mild anxiety and depression, and Dr. Hansell, who conclusorily indicated that Holohan had no severe impairments. However, these opinions--of an examining physician who examined Holohan only once and a reviewing physician who merely checked boxes without giving supporting explanations--are insufficient to outweigh the opinion of a treating physician who cared for Holohan over a period of time and who provided an opinion supported by explanation and treatment records. See 20 C.F.R. 404.1527(d)(2), (3). When Dr. Oh's opinion is given appropriate consideration, it cannot be said that the weight of the most recent evidence of record indicates improvement in her mental condition and panic attacks. Therefore, there was not substantial evidence to support the ALJ's reason for rejecting Dr. Hsieh's opinion.