Opinion ID: 164123
Heading Depth: 3
Heading Rank: 1

Heading: Dr. Osborne’s Opinion

Text: In deciding how much weight to give the opinion of a treating physician, an ALJ must first determine whether the opinion is entitled to “controlling weight.” See Watkins v. Barnhart, __ F.3d __, 2003 WL 22855009, at  (10th Cir. Dec. 2, 2003). An ALJ is required to give the opinion of a treating physician controlling weight if it is both: (1) “well-supported by medically acceptable clinical and laboratory diagnostic techniques;” and (2) “consistent with other substantial evidence in the record.” Id. (quotation omitted). “[I]f the opinion is deficient in either of these respects, then it is not entitled to controlling weight.” Id. Even if a treating physician’s opinion is not entitled to controlling weight, “[t]reating source medical opinions are still entitled to deference and must be weighed using all of the factors provided in 20 C.F.R. [§§] 404.1527 and 416.927.” Id. (quotation omitted). And, “[a]fter considering the pertinent factors, the ALJ must give good reasons . . . for the weight he ultimately assigns the opinion.” Id. at  (quotation omitted). Further, “if the ALJ rejects the opinion completely, he must then give specific, legitimate reasons for doing so.” Id. (quotation omitted). We have also held that an ALJ “may reject a treating -7- physician's opinion outright only on the basis of contradictory medical evidence and not due to his or her own credibility judgments, speculation or lay opinion.” McGoffin v. Barnhart, 288 F.3d 1248, 1252 (10th Cir. 2002) (quotation omitted). In October 2001, Dr. Osborne filled out a form entitled “Medical Source Statement - Physical.” See Aplee. Supp. App. at 301-02. With respect to her exertional limitations, the form states: (1) that Mrs. Lamb can stand, walk, or sit for a total of less than one hour during an eight-hour workday; (2) that she is limited in her ability to push or pull; and (3) that she can only occasionally lift less than ten pounds. Id. As noted by the ALJ in his decision, the limitations imposed by Dr. Osborne on standing, walking, and sitting indicate that Mrs. Lamb has “less than sedentary capability.” Id. at 26. This is in conflict with the “Physical Residual Functional Capacity Assessment” forms that were completed by two non-examining medical consultants on behalf of the Commissioner, as both of the non-examining consultants found that Mrs. Lamb’s exertional limitations do not prevent her from performing light work. Id. at 227-34, 235-42. The ALJ characterized Mrs. Lamb’s impairment as “degenerative disc disease,” and he found that it was a severe impairment at step two, but that it did not meet or equal the listing for vertebrogenic disorders of the spine (Listing 1.05C) at step three. Id. at 25. After concluding that “Dr. Osborne’s less than sedentary findings . . . are not supported by the medical record,” id. at 26, the -8- ALJ found at step four that Mrs. Lamb retains the RFC to perform light work for an eight-hour workday, and he concluded that she is not disabled at step five based on the grids, id. at 26-27. The ALJ therefore completely rejected Dr. Osborne’s opinion, and he apparently gave it no weight whatsoever. The ALJ provided two reasons for his conclusion that Dr. Osborne’s opinion is not supported by the medical record. First, he noted that “[m]agnetic resonance imaging did not show stenosis, herniation, damage to the spinal cord, or other developments necessary for Dr. Osborne’s evaluation to be legitimate.” Id. at 26. Second, he noted that “[b]oth [Mrs. Lamb] and her treating surgeon stated in the record that she received significant relief from the permanently implanted spinal cord stimulator.” Id. Although he did not specifically tie his credibility determination to his evaluation of Dr. Osborne’s opinion, the ALJ also found that Mrs. Lamb’s claim that she is in constant pain “is not credible in view of the record’s marking of her progress.” Id. Based on the record before this court, we conclude that these are not legitimate reasons for rejecting Dr. Osborne’s opinion. To begin with, while the ALJ is correct that the record does not contain MRI evidence showing “stenosis, herniation, [or] damage to the spinal cord,” this does not mean that Dr. Osborne’s opinion that Mrs. Lamb cannot perform even sedentary work is unsupported. To the contrary, the ALJ committed reversible error by failing to analyze the specific -9- physical ailments that are documented in Mrs. Lamb’s medical records. Specifically, in order to determine whether Dr. Osborne’s opinion is entitled to controlling weight, the ALJ was required to analyze the physical ailments that are documented in Mrs. Lamb’s medical records ( i.e. , degenerative disc disease and complex or chronic regional pain syndrome 1 and the pain and physical limitations related thereto) and determine, as a threshold matter, whether Dr. Osborne’s opinion that those ailments are disabling is well supported and not inconsistent with other substantial evidence in the record. See Watkins, 2003 WL 22855009, at . Moreover, the fact that Dr. Marshall’s medical records indicate in very general terms that Mrs. Lamb had decreased pain and was functioning better after the spinal cord stimulator was implanted does not provide any specific or useful information regarding the physical limitations caused by her underlying back and neck problems. Consequently, the general references in Dr. Marshall’s medical records do not provide a legitimate basis for rejecting Dr. Osborne’s opinion. Similarly, the ALJ’s conclusory assertion that Mrs. Lamb’s medical records show “progress” is not a legitimate basis for rejecting Dr. Osborne’s 1 With respect to the diagnosis of complex or chronic regional pain syndrome, we note that there is a recent Social Security Ruling specifically addressing how ALJs are to evaluate this syndrome. See SSR 03-2p, Evaluating Cases Involving Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome , 2003 WL 22399117 (Oct. 20, 2003). -10- opinion. Accordingly, because the ALJ failed to provide legitimate reasons for rejecting the opinion of Dr. Osborne, we must remand this case for a reevaluation of Dr. Osborne’s opinion.