Opinion ID: 2975852
Heading Depth: 3
Heading Rank: 4

Heading: Use of a limb; or

Text: e. Movement and its control (e.g., coordination disturbance, psychogenic seizures, akinesia, dyskinesia); or f. Sensation (e.g., diminished or heightened). 3) Unrealistic interpretation of physical signs or sensations associated with the preoccupation or belief that one has a serious injury; AND B. Resulting in at least two of the following: 1) Marked restriction of activities of daily living; or 2) Marked difficulties in maintaining social functioning; or 3) Marked difficulties in maintaining concentration, persistence, or pace; or 4) Repeated episodes of decompensation each of extended duration. 20 C.F.R. Part 404, Subpart P, Appx. 1, § 12.07 (2006). In this case, the ALJ determined that Cruse’s residual functional capacity does not preclude her from performing her past relevant work as a cashier and greeter, and that she is not suffering from a severe impairment that meets or equals a listed impairment. Therefore, the burden of proof is on Cruse to show that she is disabled. See Jones v. Comm’r of Soc. Sec., 336 F.3d 469, 474 (6th Cir. 2003) (“Through step four, the claimant bears the burden of proving the existence and severity of limitations caused by her impairments and the fact that she is precluded from performing her past relevant work.”). We review the Commissioner’s application of this framework under a deferential substantial-evidence standard. A. ALJ’s Treatment of the Medical Opinion Evidence Cruse contends that in finding her capable of performing her past relevant work, the ALJ erred “in fail[ing] to give controlling weight to the opinions of [her] treating sources,” Dr. Gordon and nurse practitioner Hasselle. First, Cruse points to the ALJ’s statement that “the extreme limitations expressed by Dr. Gordon are not supported by the documented available record, and are, therefore, afforded little weight.” Cruse insists that the ALJ did not provide any support for this finding. In general, we have held that the opinions of treating physicians are entitled to controlling weight. See Walters v. Comm’r of Soc. Sec., 127 F.3d 525, 529-30 (6th Cir. 1997) (citing 20 C.F.R. § 404.1527(d)(2) (1997)). “A physician qualifies as a treating source if the claimant sees her ‘with a frequency consistent with accepted medical practice for the type of treatment and/or evaluation required for [the] medical condition.’” Smith v. Comm’r of Soc. Sec., 482 F.3d 873, 876 (6th Cir. 2007) (alteration in original) (quoting 20 C.F.R. § 404.1502). The record shows that Dr. Gordon performed a “New Patient Evaluation” for Cruse on December 26, 2002, and saw Cruse twice more No. 06-5772 Cruse v. Comm’r of Soc. Sec. Page 8 thereafter, on January 11 and June 3, 2003. The record also shows that Cruse was treated to a similar extent by other doctors, including Dr. Mahajan, Dr. Natarajan, and Dr. Curwen, and had similar initial assessments performed by other doctors, including Dr. Blair and Dr. Kennon. From this evidence, we cannot say that the ALJ erred by not giving Dr. Gordon’s initial assessment, performed on January 11, 2003, controlling weight over the opinions, some more recent than Dr. Gordon’s, of the number of other doctors who were as much treating physicians as was Dr. Gordon. Cruse also suggests that the ALJ improperly discounted the opinion of nurse practitioner Hasselle. Hasselle indicated both in her June 13, 2002 evaluation of Cruse, as well as through a letter dated October 15, 2002, that Cruse was unable to work. While the ALJ summarized Hasselle’s findings, he did not give Hasselle’s opinion significant weight or explain his reasons for discounting Hasselle’s findings. As a nurse practitioner, Hasselle is listed under “other [non-medical] sources.” See 20 C.F.R. § 404.1513 (1997). We have previously held that an ALJ has discretion to determine the proper weight to accord opinions from “other sources” such as nurse practitioners. See, e.g., Walters, 127 F.3d at 530. However, at oral argument, Cruse suggested that a recent Social Security Ruling controls our analysis. SSR 06-03P was issued effective August 9, 2006, and clarifies how the Commissioner is to consider opinions and other evidence from sources who are not “acceptable medical sources.” SSR 06-03P, 2006 WL 2329939 (S.S.A.). While the ruling notes that information from “other sources” cannot establish the existence of a medically determinable impairment, the information “may provide insight into the severity of the impairment(s) and how it affects the individual’s ability to function.” Id. at . The ruling goes on to note that: With the growth of managed health care in recent years and the emphasis on containing medical costs, medical sources who are not “acceptable medical sources,” such as nurse practitioners . . . have increasingly assumed a greater percentage of the treatment and evaluation functions handled primarily by physicians and psychologists. Opinions from these medical sources who are not technically deemed “acceptable medical sources,” under our rules, are important and should be evaluated on key issues such as impairment severity and functional effects, along with the other evidence in the file. Id. at . Further, the ruling explains that opinions from non-medical sources who have seen the claimant in their professional capacity should be evaluated by using the applicable factors, including how long the source has known the individual, how consistent the opinion is with other evidence, and how well the source explains the opinion. Martin v. Barnhart, 470 F. Supp. 2d 1324, 1328-29 (D. Utah 2006) (citing SSR 06-03P, 2006 WL 2329939 at -6). Finally, the ruling states that: [a]lthough there is a distinction between what an adjudicator must consider and what the adjudicator must explain in the disability determination or decision, the adjudicator generally should explain the weight given to opinions for these “other sources,” or otherwise ensure that the discussion of the evidence in the determination or decision allows a claimant or subsequent reviewer to follow the adjudicator’s reasoning, when such opinions may have an effect on the outcome of the case. SSR 06-03P, 2006 WL 2329939 at . In his decision denying Cruse disability insurance and SSI benefits, the ALJ stated the findings of nurse practitioner Hasselle, including her letter advising that “[Cruse] was unable to return to work.” The ALJ’s only explanation for discounting Hasselle’s opinion was that “Hasselle is neither a medical doctor nor a vocational expert, and thus lacks the credentials for making such a determination.” As it stands, the ALJ’s decision was devoid of any degree of specific consideration of nurse practitioner Hasselle’s functional assessments. Following SSR 06-03P, the ALJ should have discussed the factors relating to his treatment of Hasselle’s assessment, so as to No. 06-5772 Cruse v. Comm’r of Soc. Sec. Page 9 have provided some basis for why he was rejecting the opinion. However, SSR 06-03P was not implemented until August 9, 2006, after the Administration had issued its December 4, 2004 final decision through the Appeals Council. We are not aware of any constitutional or statutory requirement that the Administration apply its policy interpretation rulings to appeals then-pending in the federal courts, absent, of course, ex post facto or due process concerns not present here. Neither in the text of SSR 06-03P nor elsewhere can we identify any intent on the part of the Administration to apply SSR 06-03P to appeals pending in the federal courts as of August 9, 2006, and we therefore decline to require that it be applied in this case.4 See Landgraf v. USI Film Products, 511 U.S. 244, 275 n.29 (1994) (“[T]he mere fact that a new rule is procedural does not mean that it applies to every pending case. A new rule concerning the filing of complaints would not govern an action in which the complaint had already been properly filed under the old regime, and the promulgation of a new rule of evidence would not require an appellate remand for a new trial. Our orders approving amendments to federal procedural rules reflect the commonsense notion that the applicability of such provisions ordinarily depends on the posture of the particular case.”). B. Substantial Evidence Supports the ALJ’s Credibility Assessment of Cruse Cruse also argues that the ALJ erred in finding that her claimed limitations were not supported by the medical evidence and were less than fully credible. “There is no question that subjective complaints of a claimant can support a claim for disability, if there is also evidence of an underlying medical condition in the record.” Jones, 336 F.3d at 475 (citing Young v. Sec’y of Health & Human Servs., 925 F.2d 146, 150-51 (6th Cir. 1990)). Here, it is uncontested that doctors diagnosed Cruse with illnesses including conversion disorder and asthma, treated her for those disorders, and have “therefore supplied the requisite objective medical condition to support” Cruse’s claim. Id. However, “an ALJ is not required to accept a claimant’s subjective complaints and may . . . consider the credibility of a claimant when making a determination of disability.” Id. at 476 (citing Walters, 127 F.3d at 531). Notably, an ALJ’s credibility determinations about the claimant are to be given great weight, “particularly since the ALJ is charged with observing the claimant’s demeanor and credibility.” However, they must also be supported by substantial evidence. Walters, 127 F.3d at 531 (citations omitted). Here, the ALJ specifically set forth his reasons for discrediting Cruse’s subjective complaints based on the medical evidence and inconsistencies in her testimony. Namely, the ALJ noted that Cruse’s testimony regarding her activities was “hardly reflective of any totally disabling disorder.” During her September 2003 evaluation by Dr. Kennon, Cruse indicated that her daily activities included washing dishes, light cooking, and doing the laundry. Cruse also reported to the Pathways intake physician that she was able to shop, read, and spend time with friends without any problems. During the hearing, Cruse reported being able to bathe herself, attend church, visit friends, go to the mall, and travel to a national park. See id. at 532 (“An ALJ may also consider household and social activities engaged in by the claimant in evaluating the claimant’s assertion of pain or ailments.”) (citing Blacha v. Sec’y of Health & Human Servs., 927 F.2d 228, 231 (6th Cir. 1990)). Additionally, the record is replete with medical evidence that Cruse’s symptoms were not as severe as she suggested. As noted by the ALJ, Cruse claimed that she could not walk without her walker despite the fact that she had told Dr. Curwen that she did not always need the walker and hoped to be free of it within weeks. During Cruse’s April 2003 hospitalization for physical therapy, Dr. Curwen noted that she was able to tolerate all scheduled therapies and that her functional limitations were improving. Cruse also indicated that her condition had improved during a May 15, 4 Should Cruse bring another claim before the Administration, the ALJ would be bound by SSR 06-03P. No. 06-5772 Cruse v. Comm’r of Soc. Sec. Page 10 2003 outpatient visit with Dr. Curwen. Thereafter, Dr. Curwen noted that Cruse was independent in all aspects of self-care and opined that she would be “totally independent” in six to eight weeks. Moreover, at the time of the hearing, Cruse stated that her therapy doctor advised her to move around as much as she could, and that he had not placed her on any specific restrictions. There are also inconsistencies regarding Cruse’s testimony about her concentration. While Cruse stated that she was incapable of managing her own funds, Dr. Kennon opined that she was capable of this function. Despite Cruse’s assertion that she was plagued by an inability to concentrate, Dr. Blair found that Cruse demonstrated adequate recall of both recent and remote events, while displaying a relevant and organized train of thought. Moreover, Dr. Kennon indicated that Cruse’s stream of thought was logical, clear and coherent. Therefore, substantial evidence supports the ALJ’s decision to treat Cruse’s testimony as less than credible. See Walters, 127 F.3d at 531 (“Discounting credibility to a certain degree is appropriate where an ALJ finds contradictions among medical reports, claimant’s testimony, and other evidence.”) (citing Bradley v. Sec’y of Health & Human Servs., 862 F.2d 1224, 1227 (6th Cir. 1988)). C. Substantial Evidence Supports the ALJ’s Finding that Cruse’s Impairments Do Not Preclude Her from Performing Her Past Relevant Work Cruse also contends that substantial evidence does not support the ALJ’s conclusion that she can return to her past relevant work as a cashier or greeter.5 The ALJ agreed that Cruse suffered from a conversion disorder and asthma, but determined that the impairments were not severe enough to meet or medically equal the requirements for any listing in Appendix 1 to Subpart P of the Regulations. Specifically, the ALJ found that Cruse suffered from a conversion disorder and, therefore, satisfied Part A of § 12.07. However, the ALJ determined that Cruse had: 1) no difficulty tending to her activities of daily living; 2) no difficulty in maintaining proper social functioning; 3) only moderate difficulties in sustaining concentration, persistence and pace; and 4) no evidence of episodes of decompensation. Therefore, Cruse failed to satisfy Part B of § 12.07. Substantial evidence supports the ALJ’s conclusion that Cruse did not have a listed impairment. Cruse is able to do a variety of daily activities. She takes care of her personal needs and does the dishes and light cooking, talks on the telephone, shops for food and clothes, and occasionally goes to church. While Cruse stated that she is unable to drive or take public transportation, the ALJ is permitted to treat these assertions as less than credible. The ALJ also properly discounted Dr. Gordon’s opinion about Cruse’s inability to function independently. Therefore, the ALJ’s finding that Cruse has no difficulty attending to her activities of daily living is amply supported by the evidence. See Young, 925 F.2d at150 (finding that claimant failed to show marked restriction in activities of daily living where the evidence of record exemplified that claimant was able to perform “a variety of daily activities”). Social functioning refers to an individual’s capacity to interact appropriately and communicate effectively with others, including family members, friends, and merchants. 20 C.F.R. Part 404, Subpart P, § 12.00(C)(2). There is no indication that Cruse’s social functioning is impaired. She attends church and enjoys visiting with family and friends, occasionally goes to the mall, and has even traveled to a national park with her cousins. Moreover, Dr. Blair found that Cruse was cooperative, pleasant and exhibited appropriate behavior. Furthermore, Dr. Kennon indicated that Cruse was capable of using appropriate judgment with the public. Finally, the ALJ 5 In her brief on appeal, Cruse states as an issue presented that substantial evidence does not support the ALJ’s conclusion at step four that she can return to her past relevant work as a cashier or greeter. However, in the argument section of her brief, Cruse contends that substantial evidence does not support the ALJ’s conclusion at step three that her condition did not meet or equal a listed impairment in Appendix 1 to Subpart P of the Social Security Regulations. Accordingly, we address here Cruse’s argument as she developed it in the argument section of her brief. No. 06-5772 Cruse v. Comm’r of Soc. Sec. Page 11 properly discounted the opinion of Dr. Gordon regarding Cruse’s ability to use judgment with the public. Therefore, substantial evidence supports the ALJ’s finding that Cruse did not have marked difficulties in maintaining social functioning. Concentration, persistence, and pace refers to the “ability to sustain focused attention sufficiently long to permit the timely completion of tasks commonly found in work settings.” 20 C.F.R. Part 404, Subpart P, § 12.00(C)(3). While Cruse reported that she did have difficulty with concentration, the ALJ was free to treat her claims as less than credible. Moreover, the ALJ properly discounted the opinion of Dr. Gordon as to Cruse’s attention and concentration. Dr. Blair determined that Cruse demonstrated adequate recall of both recent and remote events, while displaying a relevant and organized train of thought. Dr. Kennon stated that Cruse could follow simple work rules. Only the Pathways intake clinician found that Cruse suffered from poor attention. Therefore, substantial evidence supports the ALJ’s determination that Cruse suffered only moderate difficulties in maintaining concentration, persistence, or pace. Arguably, the ALJ failed to identify substantial evidence in the record to show that Cruse did not experience repeated instances of deterioration or decompensation in work-like settings, causing her to withdraw from the situation or to experience exacerbation of signs and symptoms. 20 C.F.R. Part 404, Subpart P, § 12.00(C)(4). Namely, Dr. Kennon stated that Cruse may have difficulty sustaining employment due to her somatic complaints and unfounded belief that she has a neurological disorder. Even so, Cruse has only demonstrated that she suffers from one, not the required two, of the four categories under § 12.07(B). Accordingly, Cruse did not meet the listing requirements of § 12.07 and failed to meet her burden of showing that she is unable to perform her past relevant work as a cashier and greeter. See Atterberry, 871 F.2d 569 (noting that burden is on claimant to show she cannot perform past relevant work). D. The ALJ Did Not Err by Failing to Obtain the Testimony of a Qualified Vocational Expert Cruse also suggests that the ALJ committed reversible error by failing to secure the testimony of a vocational expert. This argument lacks merit. As previously discussed, substantial evidence supports the ALJ’s conclusion that Cruse’s limitations did not render her incapable of performing her past relevant work. Therefore, the burden of proof remained with Cruse. See Jones, 336 F.3d at 474 (“Through step four, the claimant bears the burden of proving the existence and severity of limitations caused by her impairments and the fact that she is precluded from performing her past relevant work, but at step five . . . the burden shifts to the Commissioner to identify a significant number of jobs in the economy that accommodate the claimant’s residual functional capacity . . . and vocational profile.”) (citation omitted). AFFIRMED.