Opinion ID: 218138
Heading Depth: 3
Heading Rank: 3

Heading: Dr. Berland's Opinion

Text: Martise contends that the ALJ did not give Dr. Berland's opinion sufficient weight. According to Martise, as both an expert and a treating physician, Dr. Berland's opinion is entitled to more weight. Martise argues that the ALJ erroneously discredited Dr. Berland's opinion for the following reasons: (1) Dr. Berland's treatments of Martise included her children rather than separate sessions with Martise when, in fact, Dr. Berland saw Martise individually on 16 occasions, and (2) issues arising from the ALJ's ex parte letter to Dr. Berland. Martise also asserts that the ALJ cited no specific medical evidence contradicting Dr. Berland. We recognize that a treating physician's opinion is generally entitled to substantial weight; however, such an opinion does not automatically control in the face of other credible evidence on the record that detracts from that opinion. Heino v. Astrue, 578 F.3d 873, 880 (8th Cir.2009) (internal quotations and citation omitted). Moreover, an ALJ may credit other medical evaluations over that of the treating physician when such other assessments are supported by better or more thorough medical evidence. Id. at 879 (internal quotations and citations omitted). When deciding how much weight to give a treating physician's opinion, an ALJ must also consider the length of the treatment relationship and the frequency of examinations. Casey v. Astrue, 503 F.3d 687, 692 (8th Cir.2007). When an ALJ discounts a treating physician's opinion, he should give good reasons for doing so. Davidson v. Astrue, 501 F.3d 987, 990 (8th Cir.2007) (internal quotations and citation omitted). Brown, 611 F.3d at 951-52. An ALJ may justifiably discount a treating physician's opinion when that opinion is inconsistent with the physician's clinical treatment notes. Davidson, 578 F.3d at 843. Thus, [w]hen a treating physician's opinions are inconsistent or contrary to the medical evidence as a whole, they are entitled to less weight. Halverson, 600 F.3d at 929-30 (internal quotation and citation omitted). Here, the ALJ afforded less weight ... to the [MSS] of Dr. Berland, finding that his opinion is not supported by medical evidence. This finding was proper. First, the record supports the ALJ's finding that Martise does not have separate sessions with Dr. Berland. As the district court explained: The ALJ ... noted that, during the hearing, plaintiff testified that she did not have individual treatment sessions with Dr. Berland, but instead took her children with her for group sessions. Plaintiff challenges this finding, stating that it is incorrect because Dr. Berland's reports indicated that he saw plaintiff individually. However, during plaintiff's hearing, she answered no when asked whether she had separate sessions with Dr. Berland. (Tr. 31). Plaintiff then explained [b]ecause when we go in and I take my kids in, and then if I tell him things are happening with my kids and then I tell himstart telling him how it's affecting me and then he helps my children and then he turns around and then he tries helping me at the same time. ( Id. ) The ALJ's observation that plaintiff does not have separate sessions with Dr. Berland is therefore not incorrect, as plaintiff contends, but is instead in accord with plaintiff's own hearing testimony. (Tr. 20). In addition, the ALJ did not say that plaintiff had never had a separate session with Dr. Berland and ... the lack of separate sessions was not the only reason the ALJ gave for his decision to give less weight to Dr. Berland's opinion. Finally, as the Commissioner correctly notes, the ALJ did not completely discredit Dr. Berland; he only decided to give Dr. Berland's opinion less weight in favor of the opinions of Drs. Aisenstat, plaintiff's long-term treating physicians, and Dr. Brown, who treated plaintiff's arm. Second, with regard to Martise's argument that the ALJ erroneously disregarded Dr. Berland's opinion in part because of the issues arising out of the ALJ's ex parte letter to Dr. Berland, as explained supra, there is no indication in the record that Dr. Berland's response letter indicating that he had no further evidence formed the basis for the ALJ's decision. See supra Part II.A. In granting Dr. Berland's opinion less weight, the ALJ merely noted that Dr. Berland reported he had no other documentation regarding claimant. Finally, contrary to Martise's argument, the record supports the ALJ's conclusion that Dr. Berland's treatment notes contain inconsistencies and his opinion lacks medical support. As the district court adequately explained: In his treatment notes, Dr. Berland noted memory problems, but found that plaintiff's concentration appeared intact based on her ability to perform serial threes with no errors, and her ability to spell world correctly forward and backward. In addition, Dr. Berland's records are almost devoid of any medical findings, such as the results of any mental status examinations, to support the extreme limitations he noted in his MSS. When a treating physician's notes are inconsistent with his opinion, the Court may decline to give controlling weight to that opinion. See Hacker [ v. Barnhart, ] 459 F.3d [934,] 937 [(8th Cir.2006)]. In addition, as the Commissioner correctly states, the Regulations and Eighth Circuit precedent clearly require that a medical opinion be well-supported by medical evidence to be entitled to substantial or controlling weight. 20 C.F.R. § 404.1527(d)(3); Hacker, 459 F.3d [at] 937.    [T]he ALJ specifically stated that he was giving Dr. Berland's MSS opinion less weight, in favor of the opinions of Drs. Aisenstat, because, inter alia, Dr. Berland's opinion was unsupported by medical evidence. The ALJ still found that plaintiff could only perform jobs requiring her to understand, remember, and carry out simple instructions and non-detailed tasks; perform in a low-stress environment; and work without public contact. (Tr. 13). As the Commissioner notes, these limitations represent serious functional restrictions, and support the conclusion that the ALJ did not entirely reject Dr. Berland's opinion. Ellis v. Barnhart, 392 F.3d 988, 994 (8th Cir.2005) (The ALJ's finding that plaintiff was limited to sedentary work is itself a significant limitation, and reveals that the ALJ did give some credit to the opinion evidence). Finally, the undersigned notes that it cannot be said that Dr. Berland's MSS opinion is consistent with the balance of the objective medical information in the administrative record. As noted above, the ALJ in this case conducted an exhaustive review of the medical evidence of record, and made specific factual findings regarding all of the objective medical evidence, noting, inter alia, that none of plaintiff's treating physicians indicated that plaintiff had serious functional restrictions. A treating physician's checkmarks on an MSS form are conclusory opinions that may be discounted if contradicted by other objective medical evidence in the record. See Stormo v. Barnhart, 377 F.3d 801, 805-06 (8th Cir.2004); Hogan [ v. Apfel ], 239 F.3d [958,] 961 [(8th Cir.2001)].