Opinion ID: 222841
Heading Depth: 2
Heading Rank: 2

Heading: Perkins's Claims on Appeal

Text: On appeal, Perkins claims that (1) the ALJ failed to give adequate weight to Perkins's treating physician; (2) the ALJ failed to comply with the Commissioner's policies in evaluating the severity of Perkins's fibromyalgia; (3) the ALJ erred in finding statements not credible and in failing to properly apply the Polaski [3] factors; (4) the ALJ erred when he declined to adopt a finding from the vocational expert; and (5) the ALJ is biased. We will address each of these claims, in turn.
Perkins argues that the ALJ failed to accord adequate weight to the opinions of her treating physician, Dr. Erik Meidl. `[A] treating physician's opinion is given controlling weight if it is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence.' Medhaug, 578 F.3d at 815 (quoting Goff, 421 F.3d at 790). `A treating physician's opinion does not automatically control, since the record must be evaluated as a whole.' Id. (quoting Goff, 421 F.3d at 790). `An ALJ may discount or even disregard the opinion of a treating physician where other medical assessments are supported by better or more thorough medical evidence, or where a treating physician renders inconsistent opinions that undermine the credibility of such opinions.' Id. (quoting Goff, 421 F.3d at 790) (internal quotation marks omitted). First, Perkins argues that the ALJ should have given controlling weight to Dr. Meidl's opinion in his July 7, 2007 treatment notes. In these notes, Dr. Meidl stated, The patient is currently unable to work with her severe psychiatric problems and flare-up of her fibromyalgia and her chronic pain from her prior neck injuries. Appendix at 251. However, [a] treating physician's opinion that a claimant is disabled or cannot be gainfully employed gets no deference because it invades the province of the Commissioner to make the ultimate disability determination. House v. Astrue, 500 F.3d 741, 745 (8th Cir.2007). Thus, the ALJ was not required to give controlling weight to Dr. Meidl's July 7, 2007 opinion. Second, Perkins argues that the ALJ should have given controlling weight to the Medical Source Statement of Ability to do Work-Related Activities (Medical Source Statement) that Dr. Meidl completed on November 30, 2007. The Medical Source Statement is a form checklist that the SSA considers when determining whether a claimant is able to perform specific work-related activities. On the Medical Source Statement, Dr. Meidl indicated that Perkins has numerous limitations, including: (1) lifting less than five pounds frequently and ten pounds occasionally; (2) standing or walking less than two hours in an eight-hour workday; (3) a requirement to periodically alternate sitting and standing to relieve pain or discomfort; (4) limited pushing or pulling with either her upper or lower extremities; (5) never climbing ramps, stairs, ladders, ropes, or scaffolds; (6) never balancing, kneeling, crouching, crawling, or stooping; (7) limited reaching, handling, fingering, and feeling; and (8) certain environmental limitations, including limited exposure to temperature extremes, dust, vibration, hazards such as machinery and heights, and fumes, odors, chemicals or gases. See Appendix at 421-424. The ALJ found that Perkins has the residual functional capacity to work, but the ALJ recognized that she has several limitations, including: (1) an inability to engage in prolonged or frequent standing or walking; (2) an inability to lift or carry objects weighing more than ten pounds; (3) the need to periodically alternate sitting and standing throughout the workday; (4) the need to avoid repetitive reaching, pushing, or pulling with any of her upper or lower extremities; (5) the need to avoid kneeling, crawling, crouching, stooping, or climbing ropes, ladders or scaffolds; and (6) the need to avoid having concentrated or excessive exposure to dust, fumes, chemicals, temperature extremes, high humidity or dampness, and other typical allergens, pollutants and atmospheric irritants. See id. at 22. However, the ALJ declined to give all of Dr. Meidl's opinions in the Medical Source Statement controlling weight, finding that they were inconsistent with the preponderance of the medical evidence in this record, including [Dr. Meidl's] own treatment notes. Id. at 19. The ALJ then discussed evidence in the record that he found to be inconsistent with Dr. Meidl's opinions in the Medical Source Statement. Specifically, the ALJ noted that Dr. Meidl's notes reflected that Perkins's reports of intense pain were infrequent and that neither of the musculoskeletal pain specialists who saw Perkins suggested that her pain was unmanageable. Further, no tests demonstrated that Perkins has extensive arthritic or neurological damage to any spinal or joint area. The ALJ recognized that Perkins has received only conservative treatments, including a brief course of physical therapy in February of 2006, and she does not require any assistive devices to walk. The ALJ found that the medical evidence established no musculoskeletal impairment impeded her ability to ambulate effectively or perform fine and gross movements effectively on a sustained basis. The ALJ also concluded that Perkins's other chronic conditions were well controlled with medication. Due to these inconsistencies, the ALJ did not adopt Dr. Meidl's opinions in the Medical Source Statement that Perkins could not stand for a total of two hours in an eight-hour work day and that Perkins could not lift ten pounds even occasionally. Upon reviewing the ALJ's reasons for discounting some of Dr. Meidl's opinions in the Medical Source Statement, we conclude that the ALJ did not err. See Davidson v. Astrue, 578 F.3d 838, 843 (8th Cir.2009) (It is permissible for an ALJ to discount an opinion of a treating physician that is inconsistent with the physician's clinical treatment notes.). In addition to the reasons the ALJ provided, other evidence in the record supports the ALJ's decision. For example, Dr. Meidl opined that Perkins could never climb stairs, but Perkins's testified that she climbed the stairs in her home and could climb 14 stairs or walk for four or five minutes before becoming out of breath. Upon reviewing the entire record, we conclude that there is substantial evidence to support the ALJ's finding that certain opinions in the Medical Source Statement are inconsistent with Dr. Meidl's own treatment notes and other relevant evidence. Consequently, the ALJ was not required to give controlling weight to those opinions. Cf. Heino v. Astrue, 578 F.3d 873, 879-80 (8th Cir.2009) (declining to give controlling weight to certain opinions of treating physicians).
Perkins maintains that [t]he ALJ failed to comply with the Commissioner's policies in evaluating the severity of [her] fibromyalgia. Blue Br. at 20. Perkins's counsel argues that the ALJ who decided Perkins's case has never granted benefits to any of counsel's firm's clients with fibromyalgia, and that the ALJ substitutes the medical community's recognition of the disease, the Commissioner's position on the disease, and the Eighth Circuit's precedent on the disease with his own feelings that fibromyalgia either does not exist or can never be disabling. Id. at 23-24. Contrary to Perkins's assertions, however, the ALJ recognized that Dr. Meidl raised the possibility of fibromyalgia on June 7, 2007, in his treatment notes. The ALJ also acknowledged that Dr. Luvell Glanton, a pain management specialist, diagnosed Perkins with fibromyalgia on October 26, 2007. The ALJ then held, The medical evidence establishes that [Perkins] has status-post cervical spine fusion at C5-C6, possible fibromyalgia, carpal tunnel syndrome, mild facet artropathy [sic] at L5-S1, possible mild chronic obstructive pulmonary disease, and hypertension, gastroesophageal reflux disease, anxiety, and depression controlled by medication, but no impairment or combination of impairments that meets or equals in severity the requirements of any impairment listed in Appendix 1, Subpart P, Regulations No. 4.