Opinion ID: 3055001
Heading Depth: 2
Heading Rank: 2

Heading: Opinions of Drs. Barber and Kirmani

Text: Here, the ALJ adequately explained the weight she gave to the opinions of Dr. Barber and Dr. Kirmani. The ALJ reviewed each doctor’s examination related symptoms. See 20 C.F.R. §§ 404.1545(a), 416.945(a). RFC includes physical abilities, such as standing, sitting, or walking, and mental abilities, such as understanding, carrying out instructions, or responding appropriately to supervision, co-workers, or work pressure. Id. §§ 404.1545(b)-(c), 416.945(b)-(c). 17 Case: 12-16166 Date Filed: 07/09/2013 Page: 18 of 24 findings and then stated that she had “accorded great weight” to their medical opinions because they “are consistent with the medical evidence of record and are supported by the record as a whole” and also because the doctors had “personally examine[d]” Timmons. The ALJ’s explanation of its treatment of these two doctors’ opinions is sufficient to allow for meaningful review. Timmons argues that Dr. Barber’s opinion was too imprecise or tentative to support the ALJ’s RFC findings as to Timmons’s exertional limitations, such as Timmons’s ability to walk, sit, lift and carry. However, the ALJ was not limited to Dr. Barber’s opinion or his clinical findings in making her RFC assessment. Rather, the ALJ considers all the relevant evidence in making an RFC assessment. See 20 C.F.R. §§ 404.1520(e), 416.920(e). Other evidence in the record, including the treatment notes from Timmons’s physical therapy and Timmons’s own statements and hearing testimony as to his daily activities and physical abilities, provided additional information about Timmons’s ability to walk, stand, sit, lift, and carry, and the ALJ was not required to specifically reference each piece of evidence in the decision. See Dyer, 395 F.3d at 1211. For example, Timmons testified that he could sit and stand for about an hour and that he could walk for about a half an hour. In 2007, he reported that he could walk for about 30 minutes, stand for about 30 minutes, sit for two or three hours and could lift 15 to 20 pounds. Similarly, during Dr. Barber’s 2008 examination, 18 Case: 12-16166 Date Filed: 07/09/2013 Page: 19 of 24 Timmons told Dr. Barber he could walk for 20 minutes, stand for 30 minutes, sit for two or three hours, and could lift 10 to 20 pounds. The physical therapy treatment notes stated, inter alia, that Timmons pain was reduced from eight out of ten to zero out of ten, he was able to conduct his usual activities with no pain, and he could sit, stand, and walk. Timmons’s physical abilities, expressed in his own statements and in the treatment notes, are consistent with the ability to perform light work with a sit/stand option. See 20 C.F.R. §§ 404.1567(b), 416.967(b). Timmons also claims that the ALJ’s failure to account for Dr. Barber’s finding that Timmons could not squat is reversible error. Although the IJ noted Dr. Barber’s finding that Timmons could not squat in her decision and gave Dr. Barber’s opinion great weight, the IJ did not include a squatting limitation in her RFC assessment. The problem for Timmons is that squatting (also referred to as crouching) is not required for any of the jobs the ALJ found Timmons could perform. See Dictionary of Occupational Titles, 529.687-138, 1991 WL 674769 (leaf tier), 559.687-014, 1991 WL 683782 (ampoule sealer), 729.687-010, 1991 WL 679733 (assembler of electrical accessories). Accordingly, the omission of a squatting restriction from the RFC assessment was harmless error. Nor did the ALJ err in failing to discuss Dr. Barber’s finding that Timmons’s obesity might exacerbate his symptoms. As already discussed, the ALJ considered the medical evidence and Timmons’s own reports of his daily activities 19 Case: 12-16166 Date Filed: 07/09/2013 Page: 20 of 24 and physical abilities. This evidence supported a finding that Timmons could perform light work with a sit/stand option despite any effect his obesity had on his symptoms. Finally, Timmons takes issue with the ALJ’s decision to give great weight to Dr. Kirmani’s opinion that Timmons was able to make personal and social adjustments and to understand, remember, and carry out instructions. Timmons contends that Dr. Kirmani’s opinion is inconsistent with other evidence in the record that Timmons had significant mental problems despite continuing treatment. Substantial evidence supports the ALJ’s decision to give Dr. Kirmani’s opinion great weight. Although the record contains evidence of Timmons’s difficulties with social functioning, Timmons himself reported to Dr. Kirmani that he got along with family, friends, neighbors, store clerks, and doctors. At the hearing, Timmons testified that he helped his parents with housework and yard work, that he mowed several neighbors’ lawns for money, and that he could do a simple job if he had transportation. The treatment notes from Act Corporation and from Dr. Barber’s examination indicated that Timmons was cooperative and communicated well. Another consulting psychologist, Dr. Michael Zelenka, reviewed the record and opined that Timmons was not significantly limited in his ability to, inter alia: (1) understand, remember, and follow simple and detailed instructions; (2) accept instructions and respond appropriately to criticism from 20 Case: 12-16166 Date Filed: 07/09/2013 Page: 21 of 24 supervisors; and (3) get along with coworkers or peers without distracting them or exhibiting behavioral extremes. Dr. Zelenka opined that “given some allowances for occasional prob[lem]s with [attention] and [concentration] and for occasional psychol[ogical] problems affecting productivity, and given limited public contact, [claimant] retains adequate mental ability to carry out instr[uctions] and to relate adequately to others in a routine work setting.” In other words, as the ALJ explained, Dr. Kirmani’s opinion that Timmons could make personal and social adjustments and could understand, remember, and follow instructions is consistent with other evidence in the record. Thus, substantial evidence supports the ALJ’s decision to give great weight to Dr. Kirmani’s opinion. IV. LIMITATIONS IN CONCENTRATION, PERSISTENCE, AND PACE Timmons contends that the ALJ failed to adequately reflect Timmons’s limitations in maintaining concentration, persistence, and pace in her RFC assessment and in the hypothetical question she posed to the vocational expert. At the fifth step, the Commissioner bears the burden to show that, in light of the claimant’s RFC and other factors, there exist in the national economy a significant number of jobs the claimant can perform. Winschel, 631 F.3d at 1180; 20 C.F.R. §§ 404.1520(a)(4)(V), 416.920(a)(4)(V). If such jobs exist, then the claimant is not disabled. 20 C.F.R. §§ 404.1520(a), 416.920(a). An ALJ may 21 Case: 12-16166 Date Filed: 07/09/2013 Page: 22 of 24 make this determination by posing hypothetical questions to the VE. See Winschel, 631 F.3d at 1180. For the VE’s testimony to constitute substantial evidence, the ALJ’s hypothetical question need not include “each and every symptom of the claimant,” but must include “all of the claimant’s impairments.” Ingram, 496 F.3d at 1270. An ALJ’s hypothetical question restricting the claimant to simple and routine tasks adequately accounts for restrictions related to concentration, persistence, and pace where the medical evidence demonstrates that the claimant retains the ability to perform the tasks despite limitations in concentration, persistence, and pace. See Winschel, 631 F.3d at 1180 (“[W]hen medical evidence demonstrates that a claimant can engage in simple, routine tasks or unskilled work despite limitations in concentration, persistence, and pace, courts have concluded that limiting the hypothetical to include only unskilled work sufficiently accounts for such limitations.”). In this case, the ALJ’s hypothetical question adequately accounted for Timmons’s moderate limitations in concentration, persistence, and pace. The ALJ asked the VE to assume the individual had the ability to do light work with a sit/stand option, but that the “job should be simple, one-two step task, there should be only occasional contact with the public, coworkers, and supervisors.” The VE identified the three jobs of leaf tier, ampoule sealer, and electronic parts assembler. 22 Case: 12-16166 Date Filed: 07/09/2013 Page: 23 of 24 In response to follow-up questions, the VE explained that these three jobs were not assembly line jobs on a conveyor belt, but instead could be performed at a work station. Notably, both non-examining, consulting psychologists, Dr. Zelenka and Dr. Lauriann Sandrik, concluded that despite moderate limitations in maintaining concentration, persistence, and pace, Timmons could: (1) understand, remember and carry out both short and simple and detailed instructions; (2) perform activities within a schedule, maintain regular attendance, and be punctual within customary tolerances; (3) sustain an ordinary routine without special supervision; (4) work in coordination with or in proximity to others without being distracted by them; and (5) make simple work-related decisions. Dr. Sandrik further stated that Timmons “appears mentally capable of completing simple and complex tasks within an appropriate time frame.” Similarly, Dr. Zelenka stated that, with allowances for occasional problems with concentration and attention and occasional psychological problems affecting productivity, Timmons had the mental ability to carry out instructions in a routine work setting. Dr. Kirmani, who examined Timmons, likewise found that Timmons could understand, remember, and carry out instructions. In light of this supporting medical evidence, the ALJ’s restriction to simple, one- and two-step instructions in 23 Case: 12-16166 Date Filed: 07/09/2013 Page: 24 of 24 her hypothetical question sufficiently accounted for Timmons’s limitations in concentration, persistence, and pace.