UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Cynthia M. Dore
v. Case No. 18-cv-950-PB Opinion No. 2019 DNH 154 Andrew Saul, Commissioner Social Security Administration
MEMORANDUM AND ORDER
Cynthia Dore challenges the denial of her applications for
disability insurance benefits and supplemental security income
pursuant to 42 U.S.C. § 405(g). She contends that the
Administrative Law Judge (“ALJ”) improperly evaluated medical
opinions in her record. The Commissioner, in turn, moves for an
order affirming the ALJ’s decision. I deny Dore’s motion and
affirm the Commissioner’s decision.
I. BACKGROUND
A. Procedural Facts
Dore is a 64-year-old woman with 11th grade education. She
worked a variety of jobs in the retail industry, including as a
retail manager and a convenience store cashier. She alleged
disability as of November 2014, due to degenerative disc disease
of the spine, anxiety disorder, and depressive disorder.
Dore’s applications were initially denied in October 2015,
and on reconsideration in February 2016. On November 2, 2017,
she testified at a hearing before ALJ Paul Martin, who ultimately denied Dore’s claims. See Tr. 18-32. The Appeals
Council denied her request for review in August 2018, rendering
the ALJ’s decision the final decision of the Commissioner. See
Tr. 7-9. Dore now appeals.
B. Medical Opinion Evidence
In September 2015, Dr. Robert Phelps, an orthopedic
surgeon, performed a consultative examination of Dore. She
exhibited impaired ability to perform postural changes, abnormal
posture with elevation of the left shoulder and the left pelvis,
limited range of motion of the lumbosacral spine, increased left
leg pain with lumbar flexion, left thigh pain with strength
testing on the left, sensory impairment of the left foot,
impaired sharp-dull discrimination of the right foot, and
increased low-back pain with straight leg raising on the left.
Dr. Phelps diagnosed her with neck pain, left upper extremity
weakness, ruptured discs in the lower back, mobility impairment
with degenerative disc disease, and a right thoracic left lumbar
scoliosis. He opined that Dore had markedly limited abilities
to lift and carry even occasionally, stand, walk, and push or
pull at the left lower extremity, as well as markedly to
severely limited abilities to bend, climb, balance, stoop,
kneel, crouch, and crawl. Tr. 342.
The following month, Dr. Donald Trumbull, a state agency
physician, reviewed Dore’s record, including Dr. Phelps’ report.
2 He opined that Dore’s degenerative disc disease was a severe
impairment, but that she retained the residual functional
capacity (“RFC”) to perform the requirements of light work.
Specifically, she could lift 20 pounds occasionally and 10
pounds frequently, stand or walk for 6 hours, and sit for 6
hours in an 8-hour workday. Dr. Trumbull also indicated that
Dore was limited to frequent stooping and climbing of ramps or
stairs and occasional kneeling, crouching, crawling, and
climbing of ladders, ropes, or scaffolds. Tr. 44-46.
In February 2016, another state agency physician, Dr.
Sharon Hogan, reviewed the medical record and likewise opined
that Dore could perform light work. According to Dr. Hogan,
Dore was limited to occasional balancing, stooping, kneeling,
crouching, crawling, and climbing of ramps, stairs, ladders,
ropes, or scaffolds. Tr. 69-71.
Orthopedic surgeon Dr. Frank Graf examined Dore and
reviewed her medical records in July 2017. He diagnosed her
with chronic lumbosacral musculoskeletal pain with left lower
extremity radiculopathy in an L5 dermatomal pattern, as well as
sensory and motor system disorder with abnormal cranial nerve
examination and abnormal reflex activity. Dore reported
frequent falls due to loss of coordination and balance. Dr.
Graf opined that her pain symptoms would constantly interfere
with the attention and concentration needed to perform even
3 simple work tasks. According to Dr. Graf, Dore was limited to
less than 2 hours of sitting, standing, or walking in an 8-hour
workday, could stand only for 5 minutes and sit for 10 minutes
at a time, would require the ability to shift positions at will
and frequent unscheduled breaks, was advised to use a cane, was
not capable of lifting more than 10 pounds, and was likely to
miss more than 4 days of work every month. Tr. 739-47.
On November 2, 2017, Dr. John Kwock, an orthopedic surgeon,
testified at the administrative hearing after reviewing Dore’s
medical file, including all the opinion evidence. Dr. Kwock
opined that Dore had degenerative disc disease of the cervical,
lumbar, and thoracic spine, but that these impairments did not
meet or equal the criteria of any listed impairment. According
to Dr. Kwock, Dore retained the capacity to perform light work,
that is, she could lift and carry 20 pounds occasionally and 10
pounds frequently, sit for 6 hours, and stand or walk for 6
hours in an 8-hour workday. He further testified that she could
frequently balance and kneel, occasionally stoop, crouch, and
climb stairs or ramps, and could never crawl or climb ladders or
scaffolds. Tr. 897-900.
Dr. Kwock dismissed greater restrictions to Dore’s RFC as
based on subjective reporting that was not consistent with
imaging results and other objective medical evidence.
Specifically, he disagreed with Dr. Graf’s opinion because the
4 imaging studies in the record, including cervical and lumbar
spine X-rays done in June and August 2014 and MRIs done in May
2015 and August 2017, indicated that Dore’s degenerative changes
remained generally mild. Although the 2017 MRI included a
finding of chronic severe degenerative disc disease at L5-S1,
Dr. Kwock explained that there was no significant spinal
stenosis and no significant disc herniation. Dr. Kwock
acknowledged that there were positive examination findings in
the record, such as reduced range of motion, slow gait, positive
straight leg raise, decreased sensation, muscle weakness, and
hyperactive reflexes. But he noted that those findings were not
consistent from one exam to the next and that the record also
reflected many negative findings in those same areas. Finally,
Dr. Kwock testified that Dore’s use of a cane was not medically
necessary given general findings of no significant motor
weakness in her upper or lower extremities. Tr. 901-11.
C. The ALJ’s Decision
The ALJ assessed Dore’s claim under the five-step,
sequential analysis required by 20 C.F.R. §§ 404.1520 and
416.920. At step one, he found that Dore had not engaged in
substantial gainful activity since November 26, 2014, her
alleged disability onset date. Tr. 21. At step two, the ALJ
found that Dore’s degenerative disc disease of the spine was a
severe impairment, but that her anxiety disorder and depressive
5 disorder were not severe. Tr. 21-23. At step three, the ALJ
determined that none of Dore’s impairments, considered
individually or in combination, qualified for any impairment
listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. Tr. 23-24.
The ALJ then found that Dore had the RFC to perform light
work as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b),
except that she was limited to simple, unskilled work. In
addition, she could sit for 6 hours, stand or walk for 6 hours,
climb ramps and stairs occasionally, crouch and stoop
occasionally, balance and kneel frequently, and could never
crawl or climb ropes or scaffolding. Tr. 24.
The ALJ gave “great weight” to Dr. Kwock’s reviewing
opinion, finding it well reasoned and consistent with the
medical record, including imaging studies and normal motor
strength findings. Tr. 27-28. He likewise gave “great weight”
to the opinions of non-examining state agency consultants Drs.
Trumbull and Hogan. According to the ALJ, their opinions were
consistent with the record as a whole, and subsequent treatment
notes did not show a worsening of Dore’s condition. Tr. 28-29.
The ALJ assigned “little weight” to Dr. Graf’s opinion,
finding that the limitations he identified were “not fully
consistent with the medical evidence of record” and
“inconsistent with the claimant’s stated activities of daily
living and her treatment plan.” Tr. 29-30. The ALJ also noted
6 that he was satisfied with Dr. Kwock’s explanation as to why Dr.
Graf’s opinion was not well supported by the objective testing.
Tr. 28. Lastly, the ALJ gave “little weight” to Dr. Phelps’
opinion, finding that it was “inconsistent with the results of
the physical examination he performed,” which identified “few
motor strength abnormalities.” Tr. 30-31.
Relying on the testimony of a vocational expert, the ALJ
then found at step four that Dore could perform her past
relevant work as a cashier. Tr. 31-32. Accordingly, the ALJ
concluded that Dore had not been disabled from the alleged
disability onset date through the date of his decision. Tr. 32.
II. STANDARD OF REVIEW
I am authorized to review the pleadings submitted by the
parties and the administrative record and enter a judgment
affirming, modifying, or reversing the “final decision” of the
Commissioner. See 42 U.S.C. § 405(g). That review is limited,
however, “to determining whether the [Commissioner] used the
proper legal standards and found facts [based] upon the proper
quantum of evidence.” Ward v. Comm’r of Soc. Sec., 211 F.3d
652, 655 (1st Cir. 2000). I defer to the Commissioner’s
findings of fact, so long as those findings are supported by
substantial evidence. Id. Substantial evidence exists “if a
reasonable mind, reviewing the evidence in the record as a
whole, could accept it as adequate to support his conclusion.”
7 Irlanda Ortiz v. Sec’y of Health & Human Servs., 955 F.2d 765,
769 (1st Cir. 1991) (per curiam) (quoting Rodriguez v. Sec’y of
Health & Human Servs., 647 F.2d 218, 222 (1st Cir. 1981)).
If the Commissioner’s factual findings are supported by
substantial evidence, they are conclusive, even where the record
“arguably could support a different conclusion.” Id. at 770.
The Commissioner’s findings are not conclusive, however, “when
derived by ignoring evidence, misapplying the law, or judging
matters entrusted to experts.” Nguyen v. Chater, 172 F.3d 31,
35 (1st Cir. 1999) (per curiam). “Issues of credibility and the
drawing of permissible inference from evidentiary facts are the
prime responsibility of the Commissioner, and the resolution of
conflicts in the evidence and the determination of the ultimate
question of disability is for [him], not for the doctors or for
the courts.” Purdy v. Berryhill, 887 F.3d 7, 13 (1st Cir. 2018)
(internal quotation marks and brackets omitted).
III. ANALYSIS
Dore challenges the ALJ’s decision on the ground that the
ALJ improperly weighed the medical opinion evidence. Because
substantial evidence supports the ALJ’s evaluation of those
opinions, Dore cannot sustain her burden of establishing that
remand is necessary.
An ALJ must consider “medical opinions” provided by both
treating and nontreating “acceptable medical sources,” “together
8 with the rest of the relevant evidence.” 20 C.F.R.
§§ 404.1527(a)-(b), 416.927(a)-(b); see Social Security Ruling
(“SSR”) 96-8p, 1996 WL 374184, at *7 (July 2, 1996). In
addition, the ALJ must address each medical opinion and – if it
conflicts with the RFC finding – must explain why it was not
adopted. SSR 96-8p, 1996 WL 374184, at *7.
The regulations define “medical opinions” as “statements
from acceptable medical sources that reflect judgments about the
nature and severity of [a claimant’s] impairment(s), including
[her] symptoms, diagnosis and prognosis, what [she] can still do
despite impairment(s), and [her] physical or mental
restrictions.” 20 C.F.R. §§ 404.1527(a)(1), 416.927(a)(1).
When weighing a medical opinion, an ALJ must consider, inter
alia, the nature of the relationship between the medical source
and the claimant, the supportability of the opinion, the
consistency of the opinion with the record as a whole, and
whether the source of the opinion is a specialist. See id.
§§ 404.1527(c), 416.927(c).
An ALJ is generally required to give more weight to the
opinion of a source who has examined a claimant than to the
opinion of a nonexamining source. Id. §§ 404.1527(c)(1),
416.927(c)(1). “However, just as an ALJ may properly decline to
give controlling weight to the opinion of a treating source, an
ALJ may also discount the weight given to the opinion of an
9 examining source in favor of the opinion of a nonexamining
source.” Wall v. Berryhill, 2019 DNH 103, 2019 WL 2723887, at
*4 (D.N.H. June 27, 2019) (internal quotation marks omitted).
Here, the ALJ gave “great weight” to the reviewing opinions
Drs. Kwock, Trumbull, and Hogan, and “little weight” to the
opinions of one-time examining consultants Drs. Graf and Phelps.
I address each in turn.
1. Dr. Kwock’s Opinion
Dr. Kwock testified at the administrative hearing after
reviewing Dore’s medical file. The ALJ gave “great weight” to
Dr. Kwock’s opinion that Dore could perform light work, with
some postural limitations that the ALJ incorporated into the RFC
finding. The ALJ’s assessment is supported by evidence that is
“adequate” to persuade “a reasonable mind.” See Irlanda Ortiz,
955 F.2d at 769 (internal quotation marks omitted).
The ALJ reasoned that Dr. Kwock is a specialist in
orthopedic surgery who reviewed the full evidence of record and
whose opinion was consistent with that record. Those are
permissible reasons for assigning great weight to the opinion.
See 20 C.F.R. §§ 404.1527(c)(4), 416.927(c)(4) (“Generally, the
more consistent a medical opinion is with the record as a whole,
the more weight we will give to that medical opinion.”); id.
§§ 404.1527(c)(5), 416.927(c)(5) (“We generally give more weight
to the medical opinion of a specialist about medical issues
10 related to his or her area of specialty than to the medical
opinion of a source who is not a specialist.”); id.
§§ 404.1527(c)(6), 416.927(c)(6) (“the extent to which a medical
source is familiar with the other information in [a claimant’s]
case record [is a] relevant factor[] that we will consider”).
Dr. Kwock also presented relevant evidence to support his
medical opinion that Dore could perform modified light work.
Cf. id. §§ 404.1527(c)(3), 416.927(c)(3) (“The more a medical
source presents relevant evidence to support a medical opinion,
particularly medical signs and laboratory findings, the more
weight we will give that medical opinion.”). He explained that
the imaging studies, including the 2015 lumbar MRI and the 2017
lumbar MRI, indicated only a mild to moderate degenerative disc
disease. As a result, Dr. Kwock believed that Dore’s subjective
complaints could not be attributed to “anatomical changes or
physiological changes.” Tr. 904.
Further, as both Dr. Kwock and the ALJ recognized, although
there are positive examination findings in the record, such as
reduced range of motion, slow gait, positive straight leg raise,
decreased sensation, muscle weakness, and hyperactive reflexes,
those findings were not consistent from one exam to the next.
The record contains many intact findings, including full range
of motion of all joints, normal sensation, normal reflexes,
normal muscle strength, negative straight leg raise test, and
11 normal gait. See Tr. 26, 28, 30 (citing record sources). The
inconsistency in the examination findings and the mild
degenerative disc changes shown in the imaging studies support
the ALJ’s decision to credit Dr. Kwock’s opinion that Dore could
perform light work. Cf. Irlanda Ortiz, 955 F.2d at 769
(conflicts in the evidence are for the ALJ to resolve).
Dore criticizes the ALJ’s assessment because Dr. Kwock
based his opinion primarily on objective imaging and discounted
her subjective complaints. But the regulations do not require a
medical source to consider a claimant’s subjective symptoms.
Rather, it is the ALJ who has the responsibility to assess a
claimant’s RFC based on the entire record, including any
subjective complaints. See SSR 16-3p, 2016 WL 1119029, at *3
(Mar. 16, 2016); Coskery v. Berryhill, 892 F.3d 1, 4 (1st Cir.
2018). The ALJ cannot disregard the claimant’s statements about
her symptoms solely because they are unsubstantiated by
objective medical evidence. See SSR 16-3p, 2016 WL 1119029, at
*5. Rather, an inconsistency between subjective complaints and
objective medical evidence is just “one of the many factors” to
consider in weighing the claimant’s statements. Id. Other
factors the ALJ must consider, known as the “Avery factors” in
the First Circuit, include (1) the claimant’s daily activities;
(2) the location, duration, frequency, and intensity of the pain
or symptom; (3) any precipitating and aggravating factors; (4)
12 the effectiveness of any medication currently or previously
taken; (5) the effectiveness of non-medicinal treatment; (6) any
other self-directed measures used to relieve pain; and (7) any
other factors concerning functional limitations or restrictions.
Avery v. Sec’y of Health & Human Servs., 797 F.2d 19, 29 (1st
Cir. 1986); see 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3). But
the ALJ is not required to address every Avery factor in his
written decision for his evaluation to be supported by
substantial evidence. Deoliveira v. Berryhill, 2019 DNH 001,
2019 WL 92684, at *5 (D.N.H. Jan. 2, 2019). Instead, the
decision need only “contain specific reasons for the weight
given to the individual’s symptoms, be consistent with and
supported by the evidence, and be clearly articulated so the
individual and any subsequent reviewer can assess how the
adjudicator evaluated the individual’s symptoms.” SSR 16-3p,
2016 WL 1119029, at *9.
Here, the ALJ gave sufficiently specific reasons for
discounting Dore’s subjective complaints. First, the ALJ cited
the inconsistency between her complaints and the objective
medical evidence, discussed above. Cf. id. at *4 (“objective
medical evidence is a useful indicator to help make reasonable
conclusions about the intensity and persistence of symptoms”).
Second, the ALJ considered Dore’s daily activities, which
included handling personal care, cleaning, cooking, doing
13 laundry, and playing with her granddaughter. The ALJ
supportably concluded that this level of activity is consistent
with a capacity for light work. Cf. Coskery, 892 F.3d at 7
(permissible for ALJ to infer that claimant could perform light
work based on ability to do activities such as household chores,
personal care, dog care, and grocery shopping). Third, the ALJ
explained that Dore’s treatment plan was generally conservative,
involving physical therapy, home exercise, and pain management,
and that she had failed to follow through on some treatment
recommendations. 1 Cf. Bourque v. Berryhill, 2018 DNH 149, 2018
WL 3536087, at *10 (D.N.H. July 23, 2018) (ALJ permissibly
concluded that “consistent, conservative courses of treatment
prescribed by medical professionals . . . does not conflict with
an RFC of light work”). Accordingly, the ALJ’s decision to
discount Dore’s subjective complaints is entitled to deference.
Because the ALJ properly considered Dore’s symptoms and
gave adequate reasons, supported by the record, for assigning
“great weight” to Dr. Kwock’s opinion, there was no error.
1 The ALJ noted that Dore had discontinued physical therapy in September 2017 after only three sessions. Tr. 27. She argues that the ALJ erroneously considered her noncompliance with treatment without exploring possible reasons for that noncompliance, as required by SSR 16-3p. Dore’s explanation that she stopped physical therapy because her provider told her to do so, however, is not consistent with the record. She was encouraged to switch her therapy to a different provider. Tr. 814. The ALJ was therefore entitled to consider her noncompliance as a factor in discounting her complaints. 14 2. Opinions of Drs. Trumbull and Hogan
Dore next faults the ALJ for giving “great weight” to the
opinions on two state agency reviewing physicians. Drs.
Trumbull and Hogan both opined that Dore could perform light
work, with some postural limitations. The ALJ reasoned that
their opinions were consistent with the record and with Dr.
Kwock’s opinion. Dore’s challenge to the ALJ’s reliance on
these opinions fails.
Dore argues that the ALJ improperly relied on the fact that
the opinions of Drs. Trumbull and Hogan were consistent with Dr.
Kwock’s opinion. But a consistency of a medical opinion with
other record evidence is among the factor that the regulations
expressly recognize as relevant when weighing opinion evidence.
See 20 C.F.R. §§ 404.1527(c)(4), 416.927(c)(4) (“Generally, the
more consistent a medical opinion is with the record as a whole,
the more weight we will give to that opinion.”).
In any event, the ALJ discussed other reasons for the
weight given to those opinions. Drs. Trumbull and Hogan
reviewed the available medical record, including Dore’s 2015 MRI
that showed only mild degenerative disc disease. The ALJ
supportably concluded that subsequent medical evidence,
discussed above, was consistent with the evidence they had
reviewed. See Byron v. Saul, 2019 DNH 131, 2019 WL 3817401, at
*6 (D.N.H. Aug. 14, 2019) (ALJ may rely on medical opinion based
15 on incomplete record “where the medical evidence postdating the
reviewer’s assessment does not establish any greater
limitations, or where the medical reports of claimant’s treating
providers are arguably consistent with, or at least not clearly
inconsistent with, the reviewer’s assessment”) (internal
quotation marks omitted). Finally, the ALJ supportably found
that Dore’s daily activities, discussed above, were consistent
with the opinions finding that she could do light work.
Accordingly, there was no error in the ALJ’s weighing of the
state agency physicians’ opinions.
3. Dr. Graf’s Opinion
Dr. Graf is a one-time examining orthopedic surgeon who
opined that Dore’s postural limitations precluded even sedentary
work and that her pain and other symptoms rendered her incapable
of performing even low-stress jobs. The ALJ assigned “little
weight” to Dr. Graf’s opinion, finding that the limitations he
identified were not consistent with the medical record, Dore’s
daily activities, or her treatment plan. Substantial evidence
supports the ALJ’s assessment.
First, the ALJ pointed out that a week prior to Dr. Graf’s
examination, Dore had a full physical examination, which showed
normal gait and station, normal mobility in her neck and spine,
intact sensation, and 5/5 strength in the upper and lower
extremities. Tr. 30. Those findings were inconsistent with Dr.
16 Graf’s observations, including that Dore had difficulties
walking and standing, a decreased range of motion in her spine,
hyper-reflexivity, and sensory deficits. Id. The ALJ also
correctly noted that other examinations showed negative findings
in those areas and thus conflicted with Dr. Graf’s opinion. As
to Dr. Graf’s finding of hyper-reflexivity, the ALJ credited Dr.
Kwock’s opinion that such activity is unusual for Dore’s
impairment because degenerative disc disease typically causes
hypo-reflexive activity. Id. Such conflicts in the evidence
are for the ALJ to resolve and constitute permissible reasons to
discount Dr. Graf’s opinion. See Purdy, 887 F.3d at 13.
Next, the ALJ reasoned that Dr. Graf’s opinion was
inconsistent with Dore’s daily activities. See Dimambro v. U.S.
Soc. Sec. Admin., 2018 DNH 004, 2018 WL 301090, at *12 (D.N.H.
Jan. 5, 2018) (inconsistency with daily activities can be a
“good reason” to give an opinion less weight). Dr. Graf opined
that Dore had extreme limitations, including being able to stand
only for 5 minutes and sit only for 10 minutes at a time, but
she reported handling personal care, cleaning, cooking, doing
laundry, and playing with her granddaughter. In addition,
Dore’s treating providers encouraged her to exercise. See,
e.g., Tr. 803. Although Dore reported some restrictions in
those activities due to pain, they remain inconsistent with the
disabling limitations identified by Dr. Graf.
17 The ALJ also found Dr. Graf’s opinion inconsistent with
Dore’s conservative treatment and her non-compliance with
physical therapy. Finally, the ALJ noted that he was satisfied
with Dr. Kwock’s explanation as to why the opinion of Dr. Graf
was not well supported by the objective testing. Tr. 28, 30.
Adjudicators are entitled to rely on such findings to credit
opinion evidence. See 20 C.F.R. §§ 404.1527(c), 416.927(c).
4. Dr. Phelps’ Opinion
Dr. Phelps examined Dore on one occasion and opined that
she had numerous marked limitations, including in her abilities
to stand, walk, lift, and carry. The ALJ assigned “little
weight” to this opinion, reasoning that it was inconsistent with
Dr. Phelps’ own examination findings and with the record as a
whole. The ALJ’s assessment is entitled to deference.
The ALJ permissibly concluded that Dr. Phelps’ examination
findings did not show such extreme impairment. Although Dore
exhibited abnormal posture and reduced lumbar range of motion,
she had good range of motion in the cervical spine, upper
extremities, and lower extremities. In addition, Spurling’s
test was only mildly painful with moderate downward pressure;
her motor strength was generally intact; her reflexes were good;
and straight leg raise was negative on the right and caused back
pain, but no leg pain, on the left. Tr. 340-41. Dore maintains
that the ALJ did not consider all the examination findings and
18 relied too heavily on her intact motor strength. But Drs.
Trumbull, Hogan, and Kwock considered those examination findings
and found, consistent with the ALJ’s RFC, that Dore was not as
limited as Dr. Phelps opined.
The ALJ also permissibly concluded that Dr. Phelps’ opinion
was inconsistent with the record as a whole. As discussed
above, the ALJ thoroughly considered Dore’s record, including
the opinions of Drs. Kwock, Trumbull, and Hogan, the imaging
studies showing mild to moderate disease overall, the treatment
notes indicating many normal or only slightly abnormal findings,
recommendations for conservative treatment and noncompliance;
and Dore’s daily activities. The ALJ’s evaluation of Dr.
Phelps’ opinion is therefore supported by substantial evidence.
IV. CONCLUSION
Pursuant to sentence four of 42 U.S.C. § 405(g), I grant
the Commissioner’s motion to affirm (Doc. No. 9) and deny Dore’s
motion for an order reversing the Commissioner’s decision (Doc.
No. 8). The clerk is directed to enter judgment accordingly and
close the case.
SO ORDERED. /s/ Paul J. Barbadoro Paul J. Barbadoro United States District Judge
September 17, 2019
cc: D. Lance Tillinghast, Esq. Amy C. Bland, Esq.