Opinion ID: 6076390
Heading Depth: 2
Heading Rank: 2

Heading: Medical-Opinion Evidence

Text: Prill also contends the ALJ erred in weighing medical opinions regarding Prill’s limitations. Opinions of Drs. Bodeau and Chan. According to Prill, the ALJ should have given controlling weight—or at least more weight than she gave—to the opinion of Prill’s treating physician, Dr. Bodeau. To Prill, this court should consider remanding the case for consideration of an updated medical opinion. See Lambert v. Berryhill, 896 F.3d 768, 774 (7th Cir. 2018); Moreno v. Berryhill, 882 F.3d 722, 728–29 (7th Cir. 2018). The Commissioner counters that an ALJ may give less weight to the opinion of even a treating physician if that opinion is inconsistent with other evidence in the record, including No. 21-1381 19 objective medical evidence and the consulting doctor’s report. See Zoch v. Saul, 981 F.3d 597, 602 (7th Cir. 2020); Loveless, 810 F.3d at 507 (citations omitted). The ALJ adequately explained why she discounted Dr. Bodeau’s opinion. His own treatment notes contradict his assessment of Prill’s limitations (occasional lifting of only up to 25 pounds and rare kneeling, squatting, and crouching). In February and April 2015, Dr. Bodeau indicated that Prill was available for unrestricted activity. Additionally, as the ALJ noted, Prill performed physical and aquatic therapy, and she had a normal gait. Prill also gardened, which involves several movements that Dr. Bodeau wrote ought to be restricted. As the ALJ found, Dr. Bodeau did not provide objective exams or diagnostic testing to support the limitations he believed were necessary. Thus, Dr. Bodeau’s opinion as to Prill’s limitations was internally inconsistent—as well as inconsistent with objective medical evidence in the record—so the ALJ was entitled to give his opinion less weight. See 20 C.F.R. § 404.1527(c)(4); Ketelboeter v. Astrue, 550 F.3d 620, 625 (7th Cir. 2008); Zoch, 981 F.3d at 602; Denton, 596 F.3d at 425; Loveless, 810 F.3d at 507. Similarly, Prill contends the ALJ erred in affording great weight to the opinion of Dr. Chan, a state-agency consultant. To Prill, the ALJ’s reliance on Dr. Chan’s opinion was erroneous because he assessed limitations only related to the knee, and not to the back, even though the ALJ found Prill’s cervical and lumbar disc issues severe. But Prill has not shown that the ALJ’s decision to afford significant weight to Dr. Chan’s opinion was unsupported. Prill focuses on his failure to assess limitations related to the cervical and lumbar 20 No. 21-1381 spine, yet she declines to challenge the ALJ’s consideration of Dr. Chan’s opinion as to knee restrictions. Moreover, Dr. Chan had before him the medical evidence regarding Prill’s cervical spine and lumbar issues when reviewing and analyzing Prill’s medical records. In reaching his conclusions, Dr. Chan relied on the treatment notes showing that Prill’s spine had a normal alignment and that she ambulated with a steady gait. That was a reasonable interpretation of the treatment notes from Prill’s medical examinations. Dr. Chan, an expert in Social Security disability evaluation, was entitled to reach the conclusion that Prill’s cervical spine and lumbar issues did not merit the assessment of additional functional limitations beyond those that he assessed. And the ALJ was permitted to afford great weight to Dr. Chan’s opinion as a consulting physician, particularly because the ALJ determined that his opinion was consistent with the objective medical evidence. See Zoch, 981 F.3d at 602; Ketelboeter, 550 F.3d at 625. Dr. Marozava’s proposed limitations. Prill also argues the ALJ gave too little weight to Dr. Marozava’s opinion. Among other things, Dr. Marozava incorporated into Prill’s proposed functional restrictions that she lift no more than two “cases of pop” as well as Prill’s statement that she did not feel safe driving long distances because of pain in her lower back and neck. Dr. Marozava wrote that Prill had moderate deficits in sitting and standing, opining that she could sit or stand only for approximately 20 minutes before having to change position. Defending the ALJ’s decision to discount Dr. Marozava’s opinions, the Commissioner submits that she based her opinions on Prill’s subjective allegations, which were not consistent with the objective evidence in the record. No. 21-1381 21 The Commissioner is correct that when a physician’s opinion is based primarily upon a patient’s subjective complaints, the ALJ may discount that opinion. See Ketelboeter, 550 F.3d at 625; Zoch, 981 F.3d at 602. Here, Dr. Marozava’s lifting and driving restrictions rested solely on Prill’s own subjective statements. The ALJ thus did not err in rejecting these proposed limitations. Prill contends the ALJ should have given Dr. Marozava’s opinion on her standing and sitting limitations great weight because it is based on medical imaging, her past medical history, and a physical examination. But Prill equates Dr. Marozava’s opinion with that of Dr. Bodeau. As concluded above, Dr. Bodeau’s opinion is inconsistent with his own treatment notes and with several medical professionals’ objective observations of Prill, including that Prill exhibited a normal gait, normal heel-to-toe and tandem walking, and a lack of unsteadiness. Just as the ALJ did not commit reversible error in rejecting the permanent restrictions that Dr. Bodeau proposed as unsupported by the record, neither did the ALJ contravene the substantial evidence in rejecting the sitting and standing limitations that Dr. Marozava posited. IMEs by Drs. Kulwicki and Monacci. According to Prill, the ALJ failed to sufficiently account for the IMEs by Dr. Kulwicki and Dr. Monacci. Prill points to the IME after which Dr. Kulwicki reported medial joint line tenderness in her right knee and positive tests for a tear in the meniscus. Prill also notes that after her IME with Dr. Monacci, he wrote that Prill had “diffuse, mild paraspinal tenderness” in the cervical spine and diminished sensory examination. Dr. Monacci also reviewed additional records and reported that his findings were unchanged. 22 No. 21-1381 The Commissioner responds that the ALJ gave great weight to the opinions of these two physicians. Following the recommendation laid out in Dr. Kulwicki’s assessment, the ALJ precluded Prill from repetitive bending, squatting, stooping, or kneeling with her right knee. Per the Commissioner, Dr. Monacci’s opinion also supported the ALJ’s RFC determination because Dr. Monacci concluded Prill had no permanent cervical or lumbar restrictions. We conclude that the ALJ appropriately accounted for the findings Drs. Kulwicki and Monacci made after examining Prill. The ALJ found that Prill was restricted to occasional stooping, kneeling, and crouching but not crawling. She thus accounted for Dr. Kulwicki’s findings of right-knee tenderness. And Dr. Monacci’s opinion—in which he concluded nothing warranted permanent restrictions as to Prill’s back—supports the ALJ’s decision not to include any such restrictions in the RFC determination. The ALJ’s RFC assessment was closely tied to her view of the evidence. She laid out her reasoning for the weight she gave to the opinions offered by different medical professionals. Medication improved Prill’s symptoms. Finally, Prill argues the ALJ improperly analyzed her use of the pain medication hydrocodone, which she took simply to function and which did not enable her to perform medium work as outlined in the RFC assessment. Instead, though, the applicable question is whether the pain medications controlled Prill’s symptoms. If they did so such that Prill could perform the tasks necessary to work during the relevant time period, the ALJ correctly concluded that she was not disabled. See Denton, 596 F.3d at 425; Prochaska v. Barnhart, 454 F.3d 731, 737 (7th Cir. 2006). No. 21-1381 23 The evidence on which the ALJ relied established that Prill’s pain medications achieved good results with no side effects, and doctors observed that she achieved normal functioning. For instance, in May 2017 Prill saw Dr. Schuldt, who wrote that “overall her pain seems to be doing fairly well. She is happy with the current regimen she is on.” Dr. Schuldt indicated that she would continue Prill on Tramadol and hydrocodone. As of January 2018, Prill continued to take the same pain medications, which Dr. Schuldt reported did not cause her “any problems.” Thus, substantial evidence supports the ALJ’s finding that pain medications adequately controlled Prill’s symptoms so she could perform medium work, subject to the restrictions detailed in the RFC assessment. The ALJ did not err in analyzing the effect of Prill’s use of hydrocodone on her ability to work. Prill has not shown that the ALJ’s decision was unsupported by substantial evidence. The ALJ adequately explained why she discounted the opinions of Drs. Bodeau and Marozava. Additionally, the ALJ’s RFC assessment was consistent with the opinions of state-agency consultant Dr. Chan and those of Drs. Kulwicki and Monacci, both of whom examined Prill and wrote comprehensive reports. And the ALJ properly analyzed Prill’s use of pain medications.