Opinion ID: 2979143
Heading Depth: 2
Heading Rank: 1

Heading: ALJ’s Finding Regarding Medium Work

Text: Tilley first claims on appeal that the ALJ’s determination that he could perform the exertional demands of medium work is supported neither by the opinion of Dr. Boals nor by other medical evidence in the record. Tilley cites the Commissioner’s definition of the full range of medium work, emphasizing its language that “being on one’s feet for most of the workday is critical.” Specifically, Tilley cites to Dr. Boals’s opinion that Tilley “should avoid . . . prolonged walking, standing, stooping, squatting, bending, climbing and excessive No. 09-6081 9 flexion, extension or rotation of the back,” and asserts that this opinion would not allow an individual to perform medium work. As defendant points out, however, the ALJ did not determine that Tilley could generally perform medium work; rather, he limited Tilley to sitting and standing as needed. In doing so, the ALJ adopted Dr. Lovell’s 50-pound lifting restriction, with which Dr. Boals agreed, as well as Dr. Boals’s restriction on sitting or standing for prolonged periods. Concerning the other medical evidence in the record, Tilley points to Dr. Keown’s statement that he was limited to “frequent lifting of 10 to 15 pounds, occasional lifting of 25 to 30 pounds.” Tilley asserts that the ALJ failed to explain how he resolved this “inconsistency” in the record. However, as specifically noted by the ALJ, Dr. Keown “found little in the way of positive objective findings,” and performed her exam of Tilley two months prior to his surgery. This is a sufficient explanation for not fully adopting Dr. Keown’s presurgical restrictions. Tilley also asserts that the opinions of treating physician Dr. Srivastava and Dr. Harnisch are inconsistent with the ALJ’s decision. The ALJ thoroughly examined the records pertaining to Tilley’s visits to both doctors, and explained why he weighed their opinions as he did. The ALJ referenced Dr. Srivastava’s opinion that Tilley was “incapable of performing even sedentary work,” but noted that in fact Dr. Srivastava’s treatment focus was on Tilley’s blood sugar and diabetes. The ALJ considered the occasions, reflected in Dr. Srivastava’s notes, where Tilley complained of back pain, and noted that the examinations were within normal limits. Furthermore, the ALJ fully explained why he considered the No. 09-6081 10 “most compelling” evidence to be that of Tilley’s surgeon Dr. Lovell, rather than Dr. Srivastava. Concerning Dr. Harnisch’s opinion, the ALJ pointed out that the largely indecipherable notes reflected just one visit, and primarily reiterated Tilley’s subjective complaints. The ALJ pointed out that while Dr. Harnisch completed a Medical Source Statement recommending limitations on Tilley’s “handling, fingering and feeling,” there were no objective findings, and that the limitations represented a “gross exaggeration” on the part of Dr. Harnisch, one that led the ALJ to discredit Dr. Harnisch’s opinion generally. While Tilley asserts that Dr. Harnisch’s report is “replete with medical findings,” we concur with the ALJ’s assessment, reiterated by the district court, that “Dr. Harnisch found few objective findings on his examination and generally recited Plaintiff’s subjective complaints.” 1 We find the ALJ’s determination that the “objective findings do not support the extreme degree of limitation imposed by this physician” to be supported by substantial evidence. B. Residual Functional Capacity to Return to Past Relevant Work Tilley next claims that the ALJ improperly determined that he could return to his past relevant work as a machine operator/utility man. Tilley argues that he did not indicate that his past work as a machine operator involved any sitting at all. Tilley cites to his own report 1 Tilley makes the additional argument that the ALJ improperly found he had no mental impairment, because Dr. Harnisch found limitations on Tilley’s mental status examination. As refuted by defendant, however, Dr. Harnisch’s specialty is family medicine, Dr. Harnisch made no recommendation for mental treatment for Tilley, and no other evidence of record indicated any issue with, or treatment for, Tilley’s mental health. No. 09-6081 11 that his past relevant work required, on a daily basis, 3 hours of walking, 3 hours of standing, .25 hours of climbing, 3 hours of stooping, 3 hours of crouching, 6 hours of handling, grabbing, or grasping big objects, and 2 hours of reaching. We note that the accuracy of such a report is questionable, given that the time spent on the tasks listed by Tilley add up to more hours than the 8-hour workday he reported on the previous page. Moreover, as defendant asserts, plaintiff stated in a different report in the record that the job of Machine Operator involved sitting for two hours. This is sufficient evidence for the finding made by the ALJ that plaintiff’s past relevant work would allow for a sit and stand option, as needed. C. Opinion of Treating Physician We stated in Hensley v. Astrue, 573 F.3d 263 (6th Cir. 2009) that: [i]n social security cases involving a claimant’s disability, the Commissioner’s regulations require that if the opinion of the claimant’s treating physician is “well-supported by medically acceptable clinical and laboratory diagnostic techniques” and [is] “not inconsistent with the other substantial evidence in the case record,” it must be given “controlling weight.” Id. at 266 (quoting Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 548 (6th Cir. 2004)). Tilley asserts that the ALJ improperly accorded “little weight” to Dr. Srivastava’s opinion that Tilley was not able to perform even sedentary work, and argues that the mere existence of a contrary opinion in the record did not give the ALJ a valid basis to reject Dr. Srivastava’s opinion. Tilley contends that the ALJ’s rejection of Dr. Srivastava’s opinion did not comport with the regulations, which list six factors to consider in weighing medical opinions. See 20 C.F.R. § 404.1527(d). No. 09-6081 12 Although treating physicians’ opinions can be entitled to “controlling weight,” it is clear that a treating physician’s opinion that is not “well supported by medically acceptable clinical and laboratory diagnostic techniques,” or is “inconsistent with the other substantial evidence,” is not controlling. 20 C.F.R. § 404.1527(d)(2). While Tilley cites Blakley v. Commissionr of Social Security, 581 F.3d 399, 410 (6th Cir. 2009), in asserting that the ALJ improperly failed to address each of the regulatory factors in evaluating the opinion of the treating physician, Blakely does not support his argument. The Blakely decision, finding that the ALJ had failed to give good reasons for according less than controlling weight to the plaintiff’s treating sources, remanded the case to the Commissioner for further proceedings. Unlike in Blakely, the ALJ’s decision in the instant case fully described the reasoning for discounting Dr. Srivastava’s opinion. The ALJ thoroughly reviewed Dr. Srivastava’s notes and found that his physical exams of Tilley were “essentially normal,” and that the evidence contained “little or no objective findings showing any significant change in [Tilley’s] medical condition since he was released by his surgeon in April 2005.” Furthermore, the ALJ determined that the opinion of Dr. Lovell, Tilley’s neurosurgeon, was entitled to more weight as a specialist and specific treater of Tilley’s back problems, in accordance with 20 C.F.R. § 416.927(d)(5). We do not find that the ALJ’s determination to accord greater weight to the opinion of Dr. Lovell was improper. D. ALJ’s Credibility Determination The ALJ questioned Tilley’s credibility in his decision: [a]fter considering the evidence of record, the undersigned finds that the claimant’s medically determinable impairments could reasonably be expected No. 09-6081 13 to produce the alleged symptoms, but that the claimant’s statements concerning the intensity, persistence and limiting effects of these symptoms are not entirely credible. On review, “we are to accord the ALJ’s determinations of credibility great weight and deference particularly since the ALJ has the opportunity, which we do not, of observing a witness’s demeanor while testifying.” Jones, 336 F.3d at 476. We find that substantial evidence supports the ALJ’s determination concerning Tilley’s credibility. For instance, the ALJ noted that the record contained “little or no” evidence of objective findings showing any change in Tilley’s condition after April 2005. Furthermore, also noted by the ALJ, Tilley did not regularly complain of back pain to Dr. Srivastava and informed him at least once that he was “trying hard for his disability.” The ALJ also noted that record documents from Tilley’s post-surgery period indicated that Tilley “was unmotivated, prompting his post surgical physical therapy to be terminated.” Similarly, the ALJ inspected records from the Tennessee Department of Health, and correctly noted that they showed “essentially normal findings on examinations and only intermittent musculoskeletal complaints.” Whether or not we would have come to the conclusion reached by the ALJ, we find that substantial evidence supports his decision. For the reasons given above, we AFFIRM the decision of the district court.2 2 This claim was resolved essentially as one involving alleged disability from a back injury. To the degree that at oral argument counsel for claimant seemed to suggest that disability should have been found as a result of the totality of plaintiff’s medical conditions, this claim fails since there is a lack of objective medical evidence in the record to support such a claim. No. 09-6081 14