Opinion ID: 2982351
Heading Depth: 2
Heading Rank: 1

Heading: Weight Given Dr. Dunaway’s Opinion

Text: Dyer’s appeal focuses mainly on the discrepancies between the opinion of one of her treating physicians, Dr. Dunaway, and the findings of the administrative law judge as to Dyer’s physical limitations. When according weight to the opinion of a treating physician, the opinion must be given controlling weight if it is “well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record.” 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2); Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004). However, the treating physician’s opinion can be properly discounted if there is substantial medical evidence to the contrary or the physician provided a “conclusory opinion that claimant is unable to work.” Tate v. Comm’r of Soc. Sec., 467 F. App’x -4- No. 13-6024, Dyer v. Soc. Sec. Admin. 431, 433 (6th Cir. 2012). For example, in Tate we affirmed an administrative law judge’s decision not to give controlling weight to a treating physician’s opinion where that opinion was inconsistent with other evidence in the record or the assessment relied on subjective symptoms without support of objective findings. Id. The administrative law judge must give “good reasons” for the weight—or lack of weight—given a treating physician’s opinion. 20 C.F.R. § 404.1527(c)(2). The administrative law judge must consider specific factors to determine what weight the treating physician’s opinion will be given, and the judge’s “good reasons” must be supported by the evidence in the record. Wilson, 378 F.3d at 544-46. Dr. Dunaway opined, based on Dyer’s cervical spine MRI, that Dyer could lift less than 10 pounds, stand and walk less than two hours, and sit about two hours. Dr. Dunaway stated that Dyer must change positions every 10-15 minutes when sitting and 5-10 minutes when standing. He opined that Dyer would need to shift at will from sitting or standing and that she would need to lie down twice in a normal work day of 8 hours. In contrast, the administrative law judge found that she could carry 10 pounds frequently and 20 pounds occasionally, and sit or stand and walk, depending on the job, for 6 hours out of an 8-hour workday. Dyer argues that the administrative law judge failed to give Dr. Dunaway’s opinion proper weight in determining her residual functional capacity. In support of the decision to give little weight to Dr. Dunaway’s opinion, the administrative law judge acknowledged that the opinions of Dyer’s treating physicians are entitled to “great weight unless there is persuasive contradictory evidence. . . . [but little] weight is accorded the opinions of these physicians inasmuch as they are inconsistent with the weight of the medical evidence of record and her activities of daily living.” ALJ Decision at 13-14. The -5- No. 13-6024, Dyer v. Soc. Sec. Admin. administrative law judge went on to detail the reasons why he did not give much weight to Dr. Dunaway’s opinion and to explain why he gave other opinions more weight. The administrative law judge gave considerable weight to nontreating, consultative examiner Dr. Beard in regard to Dyer’s residual functional capacity assessment. See Carrelli v. Comm’r of Soc. Sec., 390 F. App’x 429, 436-38 (6th Cir. 2010) (administrative law judge gave considerable weight to a nontreating physician’s assessment that was consistent with objective medical evidence such as MRIs and with the claimant’s self-reported daily activities). Dr. Beard found no evidence of hypertensive or diabetic retinopathy and no organ damage due to diabetes mellitus. Dr. Beard also found her chronic obstructive pulmonary disease, restrictive pulmonary disease and dyspnea after exertion to be “mild” or “very mild.” He found mild tenderness or mild pain in the cervical spine and the shoulder joint. He found her wrists nontender and nonswollen. Her grip strength was only “mildly diminished” and she was able to make a fist, pick up a button and coins with either hand, write with her dominant hand with no difficulty and had no intrinsic hand atrophy or sensory loss from carpal tunnel syndrome. She could stand on one leg at a time with no difficulty and was able to walk on heels and toes. Dr. Beard noted that Dyer is limited in terms of repetitious or prolonged use of the hands, repetitive bending and heavy lifting or carrying. ALJ Decision at 12-13. Dyer’s cardiac and vascular system testing likewise show full revascularization after angioplasty and a stenting procedure, a normal EKG and blood pressure within an acceptable range with medication. The administrative law judge also did not give controlling weight to Dr. Dunaway’s opinion because it was inconsistent with the evidence about her activities of daily living. He related at length in his decision the “wide range of varied activities of daily living” engaged in by -6- No. 13-6024, Dyer v. Soc. Sec. Admin. Dyer according to her own testimony, citing Dyer’s ability to take care of her personal hygiene and grooming, cooking, cleaning, laundry, driving, shopping, visiting with friends and family, caring for her ill mother, and taking care of her pet bird. ALJ Decision at 13. He found that Dyer is trying to make her symptoms sound significantly more severe than they actually are. The . . . symptoms alleged by the claimant [are] significantly greater than that which can be reasonably anticipated based upon the objective physical findings. The medical evidence simply fails to establish the presence of . . . impairment that could reasonably be expected to cause symptoms of the great degree alleged. Id. at 12. The judge concluded that “[i]t appears that the claimant has exaggerated her physical limitations.” Id. Dyer counters that undertaking these activities causes her to experience “days of pain” and further restriction of movement and that there are times when her sister must help her wash her hair. She also relates that family members help her with “most” household chores. Appellant’s Br. at 21. We have affirmed findings in similar situations, holding that daily activities such as those reported by Dyer herself can constitute substantial evidence in support of a finding that a claimant is not disabled. See Tyra v. Sec’y of Health & Human Servs., 896 F.2d 1024, 1030 (6th Cir. 1990). Dyer also challenges the administrative law judge’s findings of her mental status and capabilities, particularly her ability to remember instructions. While one examining physician, Dr. Lima, noted that Dyer would have difficulty remembering simple instructions, there is substantial evidence in the record from other mental health professionals that Dyer could remember simple instructions requiring brief learning periods and instructions that were repetitive in day-to-day situations. -7- No. 13-6024, Dyer v. Soc. Sec. Admin. The administrative law judge carefully summarized the results of all of Dyer’s medical records. He explained why each of her stated impairments—back, neck and shoulder pain, neurologic damage from degenerative disc disease, pulmonary disease, coronary artery disease, diabetes, carpal tunnel syndrome and mental impairments, including depression—do not meet, alone or in combination, a listed impairment and why Dr. Dunaway’s opinion is inconsistent with these findings. The reasons given are well supported on the record. The objective medical evidence simply fails to support Dr. Dunaway’s opinion. Dr. Dunaway’s own treatment records do not support the extremely restrictive limitations on Dyer’s work-related activities he gave in his opinion. For example, after diagnosing Dyer with cervical stenosis in 2007, later examinations noted full range of motion in her shoulders, fairly strong and symmetric grip strength with normal sensation and back flexibility and bending near normal. These findings are similar to those made by Dr. Beard, the consultative physician to whose opinion the administrative law judge gave considerable weight. An administrative law judge may give more weight to the opinions of examining or consultative sources where the treating physician’s opinion is not well-supported by the objective medical records. See, e.g., Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365, 376, 379-80 (6th Cir. 2013). Substantial evidence supports the administrative law judge’s finding that Dr. Dunaway’s proposed severe limitations were inconsistent with the evidence in the record and the treating physician rule was not violated.