Opinion ID: 2791033
Heading Depth: 3
Heading Rank: 2

Heading: Medical Source Opinions

Text: Ms. Duncan next argues that the ALJ failed to properly evaluate the medical opinions of Kenneth Trinidad, D.O., and Carl DePaula, M.D. We find no error.
Dr. Trinidad is an examining physician who evaluated Ms. Duncan in connection with her worker’s compensation claim in March 2010 and again in April 2011. Ms. Duncan first asserts that the ALJ “ignored or rejected medical findings without explanation” and ignored those portions of Dr. Trinidad’s reports that were favorable to her claim. Aplt. Opening Br. at 24. Specifically, she states the ALJ “failed to note” the following findings from the March 2010 report: positive Tinel’s sign over the median nerves bilaterally, crepitance in the wrists with range of motion (‘ROM’) testing, weakness in flexion and extension of the wrists to resistance testing, loss of fine motor movement in the 4 Ms. Duncan also points out that although the ALJ agreed at the March 2011 hearing to additional testing for Tinel’s Sign and Phalen’s Sign, there is no indication that this was done. See Aplt. Opening Br. at 20. Although it appears Ms. Duncan is correct, the record already contained medical evidence from October 2010 of positive Tinel’s Sign and Phalen’s Sign testing, which is indicative of carpal tunnel syndrome. Accordingly, we perceive no error. -8- digits, decreased sensation in the first three digits of the right hand, dyesthesias in the first four digits of the left hand, decreased sensation in the little finger of the left hand, tenderness over the medial epicondyles bilaterally, crepitance in the elbows with movement, positive Tinel’s sign over the ulnar nerves at the elbows, decreased sensation in an ulnar distribution into the forearms, and weakness in forearm strength in supination and pronation to resistance testing bilaterally. Id. at 23-24. But despite Ms. Duncan’s claim of error, while “[t]he record must demonstrate that the ALJ considered all of the evidence,” there is no requirement that an ALJ “discuss every piece of evidence.” Mays v. Colvin, 739 F.3d 569, 576 (10th Cir. 2014). The ALJ did not need to expressly discuss these specific findings of Dr. Trinidad as they did not involve “uncontroverted evidence” that the ALJ was choosing not to rely on, nor did they involve “significantly probative evidence” that he was rejecting, see Clifton v. Chater, 79 F.3d 1007, 1010 (10th Cir. 1996). The record confirms this. In connection with the worker’s compensation claim, Dr. Trinidad concluded that Ms. Duncan had work-related trauma injuries in the form of bilateral carpal tunnel syndrome. The ALJ’s decision states that “a review of the medical record indicates” a history of carpal tunnel syndrome and bilateral carpal tunnel syndrome surgery. Aplt. App., Vol. II at 17. It further reflects that Dr. Trinidad’s March 2010 report was considered in the ALJ’s discussion of the medical evidence. See id. at 18. And the ALJ found that the medical evidence in the record supported a diagnosis of -9- carpal tunnel syndrome as he found mild carpal tunnel syndrome bilaterally as a severe impairment. We perceive no error in the ALJ’s failure to expressly discuss the foregoing findings of Dr. Trinidad. Ms. Duncan also argues that the ALJ failed to adequately explain why he gave Dr. Trinidad’s opinions provided in the worker’s compensation claim “only some weight.” Aplt. Opening Br. at 26. We disagree. Dr. Trinidad opined that Ms. Duncan was temporarily totally disabled. He also opined that “[w]ith her current impairment [Ms. Duncan] is unable to return to her former position and, in my opinion, will require vocational training to place her in a light duty job that does not require repetitive work with her hands and arms.” Aplt. App., Vol. III at 533. The ALJ explained that such statements, made in the context of a worker’s compensation claim, are not dispositive of a social security claim. The ALJ also correctly observed that certain opinions by medical providers, including opinions that a claimant is disabled or opinions concerning residual functional capacity, are not medical opinions but, instead, opinions on issues reserved to the Commissioner because they are administrative findings. See 20 C.F.R. § 404.1527(d). Such opinions, even when offered by a treating source, are never entitled to controlling weight or given special significance. Soc. Sec. Ruling (SSR) 96-5p, 1996 WL 374183, at , ,  (July 2, 1996). But Ms. Duncan takes further issue with the ALJ’s handling of Dr. Trinidad’s opinion that Ms. Duncan is limited to jobs that do not require repetitive use of the - 10 - hands and arms. The record shows that Ms. Duncan specifically questioned the VE regarding the vocational impact of a limitation to sedentary, unskilled work with no repetitive use of the arms or hands as expressed in Dr. Trinidad’s report. The VE testified that no repetitive use equated vocationally to constant use under the Dictionary of Occupational Titles, but that frequent and occasional use was still available. The ALJ noted this testimony in his decision. But Ms. Duncan now contends that there is no evidence that Dr. Trinidad defines “repetitive” in the same way as the VE and the ALJ therefore should have recontacted Dr. Trinidad. We find Ms. Duncan’s argument unavailing. Assuming, without deciding this is a substantial issue, Ms. Duncan did not further question the VE regarding the meaning of repetitive use or challenge the VE’s interpretation of Dr. Trinidad’s use of the term such that she raised it as an issue for the ALJ to resolve. See Wall v. Astrue, 561 F.3d 1048, 1063 (10th Cir. 2009) (observing that claimant must raise any substantial issue she seeks to develop). Nor did the ALJ deem Dr. Trinidad’s evidence inadequate for him to determine whether Ms. Duncan was disabled. See White v. Barnhart, 287 F.3d 903, 908 (10th Cir. 2001); see also Robinson v. Barnhart, 366 F.3d 1078, 1084 (10th Cir. 2004) (noting ALJ’s duty to seek additional evidence or clarification from treating source when evidence contains conflict or ambiguity). In sum, we conclude the ALJ sufficiently explained the weight he gave to Dr. Trinidad’s opinions and properly considered his opinions. - 11 -
Dr. DePaula is Ms. Duncan’s treating orthopedic surgeon. Ms. Duncan argues that the ALJ was “silent” as to the weight accorded Dr. DePaula’s opinions and failed to follow the sequential two-step inquiry in determining the weight assigned to a treating source’s medical opinion. Aplt. Opening Br. at 27-28; see also Krauser v. Astrue, 638 F.3d 1324, 1330 (10th Cir. 2011) (discussing two-step analytical framework for dealing with treating medical source opinions). In support, Ms. Duncan states that Dr. DePaula found that she had peripheral neuropathy with numbness at the wrist, bilateral carpal tunnel syndrome, diabetic neuropathy, and cervical disc disease but that the ALJ “gave no credit to these assessments and objective findings.” Aplt. Opening Br. at 28. Ms. Duncan is mistaken. The findings of Dr. DePaula identified by Ms. Duncan constitute the medical opinion of Dr. DePaula regarding medical diagnoses, which the ALJ properly considered and did not reject. See 20 C.F.R. § 404.1527(a)(2) (providing that medical opinions are statements from physicians that reflect judgments concerning a claimant’s symptoms and diagnosis). Indeed, the ALJ found diabetes with diabetic neuropathy, mild carpal tunnel syndrome bilaterally, and degenerative disc disease of the cervical spine to be severe impairments. Ms. Duncan does not point to medical opinions of Dr. DePaula regarding work-related limitations attributed to the impairments he diagnosed or the placement of any significant exertional restrictions. See, e.g., Watkins, 350 F.3d at 1299 - 12 - (assessing treating source medical opinion concerning nature and severity of impairment that rendered claimant “unable to work an eight-hour day doing anything, sitting or standing” (internal quotation marks omitted)); Krauser, 638 F.3d at 1330 (assessing treating source’s opinion regarding exertional restrictions); 20 C.F.R. § 404.1527(a)(2) (providing that physician’s medical opinion may include opinion on what claimant can still do despite impairments and physical or mental restrictions). Given that the ALJ did not reject the medical impairments found by Dr. DePaula and there were no medical opinions regarding Ms. Duncan’s work-related functional limitations, there was no opinion on such matters by Dr. DePaula for the ALJ to weigh. Cf. Watkins, 350 F.3d at 1300-01 (reversing judgment of the district court where ALJ failed to perform analysis regarding weight to assign treating source’s opinion that claimant could not do anything sitting or standing in eight-hour workday). Ms. Duncan further faults the ALJ for failing to credit a parking placard application in which Dr. DePaula indicated the basis for the application was Ms. Duncan’s severely limited ability to walk due to her diabetic peripheral neuropathy. Dr. DePaula did not, however, identify a similar work-related restriction in his medical notes. In any event, the ALJ’s RFC limited Ms. Duncan to sedentary work and standing and/or walking to two hours in an eight-hour workday. Finally, Ms. Duncan’s claim of error regarding Dr. DePaula’s opinion that Ms. Duncan is disabled and should get vocational rehabilitation is meritless. As the ALJ explained, - 13 - that is an opinion on an issue reserved to the Commissioner and, therefore, is not entitled to controlling weight or special significance. See 20 C.F.R. § 404.1527(d)(3).