Opinion ID: 4161529
Heading Depth: 2
Heading Rank: 2

Heading: Hantzis’s Claim

Text: Here, in his May 1995 treatment notes, Dr. Ho listed functional impairments of “[r]estricted bending, lifting and twisting,” and stated that Hantzis “remains unable to work due to her chronic symptomatology.” In August 1995, Dr. Brennan opined that Hantzis needed vocational rehabilitation and had the following work restrictions: (1) lifting no more than 20 pounds; (2) no frequent bending and twisting at the back; and (3) short rest periods of less than a minute to perform exercises when her symptoms significantly increase. In July 1997, Dr. Brennan 5 Case: 14-14311 Date Filed: 04/19/2017 Page: 6 of 9 noted an additional “functional loss of being unable to tolerate prolonged sitting or standing activities.” In determining Hantzis’s RFC, the ALJ declined to give controlling weight to the opinions of Drs. Ho and Brennan about Hantzis’s functional limitations. Instead, the ALJ gave “significant weight” to Dr. Brennan’s lifting restriction of 20 pounds, but “little weight” to the doctors’ other restrictions on Hantzis’s ability to sit, stand, bend, and twist. By way of explanation, the ALJ stated: In determining the amount of weight to accord these opinions, the undersigned had considered various factors including, the examining relationship, the treating relationship, supportability, consistency, and specialization. The undersigned notes that these opinions are not supported by the doctors’ own internal notes whereby improvement is documented in the claimant’s condition with continued conservative management. The undersigned finds these limitations are inconsistent with the record when considered in its entirety. Furthermore, the undersigned notes that the ultimate issue of disability is a finding of fact reserved to the Commissioner. The ALJ concluded that his RFC assessment—the ability to perform a full range of light work—was “supported by the longitudinal treatment record and the effectiveness of [Hantzis’s] conservative treatment, physical therapy, and medication regimen.” We conclude that the ALJ applied the correct legal standards when evaluating Drs. Brennan’s and Ho’s opinions, and that substantial evidence supports the ALJ’s decision to grant little weight to Drs. Brennan’s and Ho’s opinions regarding Hantzis’s ability to sit, stand, bend, and twist. The ALJ 6 Case: 14-14311 Date Filed: 04/19/2017 Page: 7 of 9 provided good cause for discounting these opinions when he explained that they were unsupported by the doctors’ own internal notes and inconsistent with the entire record. See Winschel, 631 F.3d at 1179. Furthermore, substantial evidence supports the ALJ’s conclusion that these opinions were not supported by Drs. Brennan’s and Ho’s notes or the rest of the record. Medical records showed that Hantzis experienced improvement with medication and therapies, such as physical therapy and strengthening exercise. Though Hantzis’s subjective report of her pain did not consistently or greatly improve, she showed gains in flexibility and strength. For example, at examinations, Dr. Brennan generally noted only a mild to moderate amount of splinting and tenderness. Also, in February 1995, Dr. Brennan noted Hantzis could flex forward to a position where her hands were approximately three feet from the floor, but the distance had decreased to two feet in March, April and June 1995, and to one foot in August 1995. In April and June 1995, Dr. Brennan described Hantzis’s L5 radiculopathy as “gradually resolving.” Many objective diagnostic tests results, such as x-rays, CT scans, electromyography, and nerve conduction studies were normal. For these reasons, the ALJ provided good cause for according little weight to Drs. Brennan’s and Ho’s functional limitations in sitting, standing, bending, and twisting, and substantial evidence supports the ALJ’s determination. 7 Case: 14-14311 Date Filed: 04/19/2017 Page: 8 of 9 Hantzis suggests that the ALJ improperly discounted the opinions of Drs. Brennan and Ho based on the opinion of another treating physician, Dr. Jerrilyn Wetzel. Hantzis stresses that Drs. Brennan and Ho treated her chronic back pain for years, while Dr. Wetzel saw her only three times. In March and June 1997, Dr. Wetzel treated Hantzis for episodes of vertigo, facial numbness, chest pain, and shortness of breath. In her June treatment notes, Dr. Wetzel noted, among other things, that (1) Hantzis kept trying to get Dr. Wetzel to relate all of her current symptoms back to a 1989 fall; (2) except for a passing reference to a steroid injection, Hantzis had not disclosed her fall or her history of chronic low back pain at her earlier visit in March 1997; and (3) Hantzis was difficult to follow when describing her history of complaints and contradicted herself while describing her symptoms. Dr. Wetzel made clear to Hantzis that she thought Hantzis’s current complaints of dizziness and loss of consciousness were unrelated to her 1989 back injury or her chronic low back pain. Dr. Wetzel explained to Hantzis that her current symptoms might be related to heart disease and would need to be worked up separately, and Dr. Wertzel advised Hantzis to continue therapy for her chronic back pain with Drs. Brennan and Ho. Dr. Wetzel expressed no opinion about Hantzis’s ability to sit, stand, twist or bend. Contrary to Hantzis’s argument, the record does not reflect that the ALJ discounted Drs. Brennan’s and Ho’s opinions of Hantzis’s functional limitations 8 Case: 14-14311 Date Filed: 04/19/2017 Page: 9 of 9 based on Dr. Wetzel’s statements in her treatment notes or based on any misunderstanding about whether Hantzis’s chronic back and leg pain dated back to her 1989 falls. Indeed, the ALJ found that the medical evidence established that Hantzis sustained two falls in 1989 that were the genesis of her complaints of chronic back pain, leg pain, and headaches. In reviewing the medical evidence, the ALJ noted Dr. Wetzel’s statements in her treatment notes, but the ALJ did not express that these statements carried more weight with him than other parts of the record documenting the effectiveness of Hantzis’s physical therapy and medication regimens, which the ALJ discussed at length. Nor did the ALJ point to Dr. Wetzel’s statements in explaining his decision to discount the opinions of Drs. Brennan and Ho. In sum, substantial evidence supports the ALJ’s articulated reasons for assigning little weight to the opinions of Drs. Brennan and Ho about Hantzis’s sitting, standing, bending and twisting restrictions. For this reason, we affirm the ALJ’s denial of Hantzis’s application for DIB benefits. AFFIRMED. 9