Opinion ID: 854868
Heading Depth: 3
Heading Rank: 2

Heading: Weighing medical opinions

Text: The Commissioner’s regulations provide a five-step process for the evaluation of disabilities. See 20 C.F.R. § 404.1520. This court has summarized the five steps as follows: 1. If claimant is doing substantial gainful activity, he is not disabled. 2. If claimant is not doing substantial gainful activity, his impairment must be severe before he can be found to be disabled. 3. If claimant is not doing substantial gainful activity and is suffering from a severe impairment that has lasted or is expected to last for a continuous period of at least twelve months, and his impairment meets or equals a listed impairment, claimant is presumed disabled without further inquiry. 4. If claimant’s impairment does not prevent him from doing his past relevant work, he is not disabled. 5. Even if claimant’s impairment does prevent him from doing his past relevant work, if other work exists in the national economy that accommodates his residual functional capacity and vocational factors (age, education, skills, etc.), he is not disabled. Walters v. Comm’r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997). At step one of this process, the Commissioner does not dispute that Gayheart has had no “substantial gainful activity” since he ceased working in September 2005 on account of his alleged disability. Nor does the Commissioner dispute at step two that Gayheart has the following severe impairments: headaches, an anxiety disorder and depression, borderline intellectual functioning, and alcohol abuse. Rather, this case turns on whether the ALJ appropriately deferred to the opinions of Drs. Buban and Flexman over the opinion of Dr. Onady in: (1) determining at step No. 12-3553 Gayheart v Commissioner of Social Security Page 13 three that the combination of Gayheart’s impairments do not meet or medically equal the criteria of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1; and (2) determining the limitations on Gayheart’s residual functioning capacity (RFC) for use in steps four and five. Had the ALJ found at step three that an impairment listing was met, Gayheart would have been deemed disabled. See 20 C.F.R. § 404.1520(a)(4)(iii). Incorporating additional limitations into the RFC, as Dr. Onady’s opinion called for, would likewise have resulted in a finding that Gayheart was disabled under step five because he would be deemed unable to work. See id. § 404.1520(a)(4)(v).
“The Commissioner has elected to impose certain standards on the treatment of medical source evidence.” Cole, 661 F.3d at 937. These standards, set forth in administrative regulations, describe (1) the various types of evidence that the Commissioner will consider, 20 C.F.R. § 404.1512; (2) who can provide evidence to establish an impairment, 20 C.F.R. § 404.1513; and (3) how that evidence will be evaluated, 20 C.F.R. § 404.1520b. Such evidence may contain medical opinions, which “are statements from physicians and psychologists . . . that reflect judgments about the nature and severity of [a claimant’s] impairment(s), including [] symptoms, diagnosis and prognosis,” physical and mental restrictions, and what the claimant can still do despite his or her impairments. 20 C.F.R. § 404.1527(a)(2). Medical opinions are to be weighed by the process set forth in 20 C.F.R. § 404.1527(c). As a general matter, an opinion from a medical source who has examined a claimant is given more weight than that from a source who has not performed an examination (a “nonexamining source”), id. § 404.1502, 404.1527(c)(1), and an opinion from a medical source who regularly treats the claimant (a “treating source”) is afforded more weight than that from a source who has examined the claimant but does not have an ongoing treatment relationship (a “nontreating source”), id. § 404.1502, 404.1527(c)(2). In other words, “[t]he regulations provide progressively more rigorous tests for weighing opinions as the ties between the source of the opinion and the No. 12-3553 Gayheart v Commissioner of Social Security Page 14 individual become weaker.” Soc. Sec. Rul. No. 96-6p, 1996 WL 374180, at  (Soc. Sec. Admin. July 2, 1996). The source of the opinion therefore dictates the process by which the Commissioner accords it weight. Treating-source opinions must be given “controlling weight” if two conditions are met: (1) the opinion “is well-supported by medically acceptable clinical and laboratory diagnostic techniques”; and (2) the opinion “is not inconsistent with the other substantial evidence in [the] case record.” 20 C.F.R. § 404.1527(c)(2). If the Commissioner does not give a treating-source opinion controlling weight, then the opinion is weighed based on the length, frequency, nature, and extent of the treatment relationship, id., as well as the treating source’s area of specialty and the degree to which the opinion is consistent with the record as a whole and is supported by relevant evidence, id. § 404.1527(c)(2)-(6). The Commissioner is required to provide “good reasons” for discounting the weight given to a treating-source opinion. Id. § 404.1527(c)(2). These reasons must be “supported by the evidence in the case record, and must be sufficiently specific to make clear to any subsequent reviewers the weight the adjudicator gave to the treating source’s medical opinion and the reasons for that weight.” Soc. Sec. Rul. No. 96-2p, 1996 WL 374188, at  (Soc. Sec. Admin. July 2, 1996). This procedural requirement “ensures that the ALJ applies the treating physician rule and permits meaningful review of the ALJ’s application of the rule.” Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004). On the other hand, opinions from nontreating and nonexamining sources are never assessed for “controlling weight.” The Commissioner instead weighs these opinions based on the examining relationship (or lack thereof), specialization, consistency, and supportability, but only if a treating-source opinion is not deemed controlling. 20 C.F.R. § 404.1527(c). Other factors “which tend to support or contradict the opinion” may be considered in assessing any type of medical opinion. Id. § 404.1527(c)(6). No. 12-3553 Gayheart v Commissioner of Social Security Page 15 2. The ALJ failed to weigh the medical opinions according to 20