Opinion ID: 1266110
Heading Depth: 3
Heading Rank: 3

Heading: The ALJ Failed to Properly Evaluate Blakley's Treating Physicians

Text: The ALJ has placed nothing on the record indicating that she considered the opinion of Dr. Kiefer as a treating physician. Classifying a medical source requires us to interpret the definitions in [20 C.F.R.] § 404.1502, a question of law we review de novo. Smith v. Comm'r of Soc. Sec., 482 F.3d 873, 876 (6th Cir.2007). We accord substantial deference to any factual finding by the ALJ that bears on the question, however. Id. Here, the ALJ did not make any findings on the record with respect to Dr. Kiefer, so we do not defer to the ALJ's decision. A physician is a treating source if he has provided medical treatment or evaluation and has had an ongoing treatment relationship with the claimant ... with a frequency consistent with accepted medical practice for the type of treatment and/or evaluation [that is] typical for the [treated condition(s)]. 20 C.F.R. § 404.1502. Dr. Kiefer treated Blakley's neck injury and performed the discectomy. As such, Dr. Kiefer developed an extensive treatment relationship, spanning over one year, and qualifies as one of Blakley's treating physicians. In addition to performing Blakley's discectomy in July 2004, Dr. Kiefer provided ongoing medical notes for Blakley from April 2004 through April 2005. Dr. Kiefer also continued to send Blakley for MRIs, CT scans, and x-rays based on Blakley's complaints of pain. And those studies revealed objective findings of degenerative disc disease in the cervical and thoracic spine. Dr. Kiefer expressed concern that the degenerative disc disease in Blakley's thoracic spine may require aggressive treatment. Dr. Kiefer also made Blakley's diagnosis of carpal tunnel syndrome. Therefore, as a treating physician, any opinions Dr. Kiefer made should have been given controlling weight absent justifiable reasons-made on the record-for discounting those opinions. Soc. Sec. Rul. 96-2p, 1996 WL 374188, at -5. However, Dr. Kiefer is not mentioned anywhere in the ALJ's opinion.
Dr. Kibler performed two surgeries on Blakley, a rotator cuff repair in October 2004 and AC joint repair in May 2005, and provided notes on Blakley from February 2004 through February 2006. The ALJ rejected Dr. Kibler's assessment as follows: Although a treating physician [i.e., Dr. Kibler] indicated [Blakley] should not do more than 20 pounds lifting to his waist and no overhead lifting on a repetitive basis, the possibility always exists that a doctor may express an opinion in an effort to assist a patient with whom he or she sympathizes for one reason or another. Another reality which should be mentioned is that patients can be quite insistent and demanding in seeking supportive notes or reports from their physicians, who might provide such a note in order to satisfy their patient's requests and avoid unnecessary doctor/patient tension. While it is difficult to confirm the presence of such motives, they are more likely in situations where the opinion in question departs substantially from the rest of the evidence of record, as in the current case. Even assuming arguendo that the ALJ correctly reached her determination that Dr. Kibler should be discredited, the ALJ's summary rejection of Dr. Kibler without explaining the weight given his opinions falls short of the Agency's own procedural requirements: [A] finding that a treating source medical opinion ... is inconsistent with the other substantial evidence in the case record means only that the opinion is not entitled to `controlling weight,' not that the opinion should be rejected. Soc. Sec. Rul. 96-2p, 1996 WL 374188, at . Treating 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.
Dr. Raza began his relationship with Blakley as a consulting psychiatrist in 2004. That relationship expanded to include treatment at the Cumberland River Comprehensive Care Center in 2005. Though the ALJ summarizes Blakley's time at Cumberland, which is Dr. Raza's place of practice, the ALJ does not explain in her decision whether she weighed Dr. Raza as an expert, a treater, or both. Here again, the ALJ failed to account for Dr. Raza's opinions as a treating physician in disregard of 20 C.F.R. § 404.1527.