Kristen L. McKinley v. SSA 13-CV-047-SM 2/26/14 UNITED STATES DISTRICT COURT
DISTRICT OF NEW HAMPSHIRE
Kristen Lee McKinley, Claimant
v. Case No. 13-cv-47-SM Opinion No. 2014 DNH 036 Carolyn W. Colvin, Acting Commissioner, Social Security Administration, Defendant
O R D E R
Pursuant to 42 U.S.C. §§ 405(g) and 1383(c) (3), Claimant,
Kristen McKinley, moves to reverse the Commissioner's decision
denying her application for Social Security Disability Insurance
Benefits under Title II of the Social Security Act (the "Act")
and Supplemental Security Income Benefits under Title XVI of the
Act, 42 U.S.C. §§ 423, 1381, et seg. See document no. 8. The
Commissioner objects and moves for an order affirming his
decision, document no. 11.
Factual Background
I. Procedural History
On August 26, 2010, claimant filed an application for Social
Security Disability Insurance Benefits ("DIB benefits"), and
Supplemental Security Income ("SSI"), alleging disability
beginning August 17, 2010. She asserts eligibility for benefits
based on disabilities due to severe back, neck, arm, shoulder. leg, and hip pain; pain, numbness, and tingling in her lower and
upper extremities; severe headaches and episodes of dizziness and
light headedness; weakness; and anxiety, PTSD, ADHD, bipolar
disorder, and major depression. Her application for benefits was
denied and she reguested an administrative hearing before an
Administrative Law Judge ("ALJ").
On February 8, 2012, claimant (who was then 38 years old),
her attorney, and an impartial vocational expert appeared before
an ALJ. On March 19, 2012, the ALJ issued his written decision,
concluding that claimant was not disabled. The Appeals Council
denied claimant's reguest for review of the ALJ's decision on
December 3, 2012. Accordingly, the ALJ's decision became the
final decision of the Commissioner, subject to judicial review.
Claimant then filed a timely action in this court, appealing
the denial of DIB and SSI benefits. Now pending are claimant's
"Motion for Order Reversing Decision of the Commissioner"
(document no. 8) and the Commissioner's "Motion for Order
Affirming the Decision of the Commissioner" (document no. 11).
II. Stipulated Facts
Pursuant to Local Rule 9.1(d), the parties submitted a Joint
Statement of Material Facts, which is part of the court record
2 (document no. 12), and need not be recounted in detail in this
opinion.
Standard of Review
I. Properly Supported Findings by the ALJ are Entitled to Deference.
Pursuant to 42 U.S.C. § 405(g), the court is empowered "to
enter, upon the pleadings and transcript of the record, a
judgment affirming, modifying, or reversing the decision of the
Commissioner of Social Security, with or without remanding the
cause for a rehearing." Factual findings of the Commissioner are
conclusive if supported by substantial evidence.1 See 42 U.S.C.
§ 4 0 5 (g); Irlanda Ortiz v. Secretary of Health & Human Services,
955 F.2d 765, 769 (1st Cir. 1991). Moreover, provided the ALU's
findings are supported by substantial evidence, the court must
sustain those findings even when there may also be substantial
evidence supporting the contrary position. See Tsarelka v.
Secretary of Health & Human Services, 842 F.2d 529, 535 (1st Cir.
1988) ("[W]e must uphold the [Commissioner's] conclusion, even if
the record arguably could justify a different conclusion, so long
l Substantial evidence is "such relevant evidence as a reasonable mind might accept as adeguate to support a conclusion." Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938). It is something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's finding from being supported by substantial evidence. Consolo v. Federal Maritime Comm'n., 383 U.S. 607, 620 (1966).
3 as it is supported by substantial evidence."). See also
Rodriquez v. Secretary of Health & Human Services, 647 F.2d 218,
222 (1st Cir. 1981) ("We must uphold the [Commissioner's]
findings in this case if a reasonable mind, reviewing the
evidence in the record as a whole, could accept it as adequate to
support his conclusion.").
In making factual findings, the Commissioner must weigh and
resolve conflicts in the evidence. See Burgos Lopez v. Secretary
of Health & Human Services, 747 F.2d 37, 40 (1st Cir. 1984)
(citing Sitar v. Schweiker, 671 F.2d 19, 22 (1st Cir. 1982)). It
is "the responsibility of the [Commissioner] to determine issues
of credibility and to draw inferences from the record evidence.
Indeed, the resolution of conflicts in the evidence is for the
[Commissioner], not the courts." Irlanda Ortiz, 955 F.2d at 769
(citation omitted). Accordingly, the court will give deference
to the ALJ's credibility determinations, particularly when those
determinations are supported by specific findings. See
Frustaqlia v. Secretary of Health & Human Services, 829 F.2d 192,
195 (1st Cir. 1987) (citing Da Rosa v. Secretary of Health &
Human Services, 803 F.2d 24, 26 (1st Cir. 1986)).
4 II. The Parties' Respective Burdens
An individual seeking Social Security disability benefits is
disabled under the Act if he or she is unable "to engage in any
substantial gainful activity by reason of any medically
determinable physical or mental impairment which can be expected
to result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months." 42 U.S.C.
§ 423(d)(1)(A). The Act places a heavy initial burden on
claimant to establish the existence of a disabling impairment.
See Bowen v. Yuckert, 482 U.S. 137, 146-47 (1987); Santiago v.
Secretary of Health & Human Services, 944 F.2d 1, 5 (1st Cir.
1991) . To satisfy that burden, claimant must prove that her
impairment prevents her from performing her former type of work.
See Gray v. Heckler, 760 F.2d 369, 371 (1st Cir. 1985) (citing
Goodermote v. Secretary of Health & Human Services, 690 F.2d 5, 7
(1st Cir. 1982)). Nevertheless, claimant is not reguired to
establish a doubt-free claim. The initial burden is satisfied by
the usual civil standard: a "preponderance of the evidence." See
Paone v. Schweiker, 530 F. Supp. 808, 810-11 (D. Mass. 1982).
If claimant demonstrates an inability to perform her
previous work, the burden shifts to the Commissioner to show that
there are other jobs in the national economy that she can
perform. See Vazguez v. Secretary of Health & Human Services,
5 683 F.2d 1, 2 (1st Cir. 1982). See also 20 C.F.R. §§
404.1512(g). If the Commissioner shows the existence of other
jobs that claimant can perform, then the overall burden to
demonstrate disability remains with claimant. See Hernandez v.
Weinberger, 493 F.2d 1120, 1123 (1st Cir. 1974); Benko v.
Schweiker, 551 F. Supp. 698, 701 (D.N.H. 1982).
In assessing a disability claim, the Commissioner considers
both objective and subjective factors, including: (1) objective
medical facts; (2) claimant's subjective claims of pain and
disability, as supported by the testimony of claimant or other
witnesses; and (3) claimant's educational background, age, and
work experience. See, e.g., Avery v. Secretary of Health & Human
Services, 797 F.2d 19, 23 (1st Cir. 1986); Goodermote, 690 F.2d
at 6. When determining whether a claimant is disabled, the ALJ
is also reguired to make the following five inguiries:
(1) whether claimant is engaged in substantial gainful activity;
(2) whether claimant has a severe impairment;
(3) whether the impairment meets or eguals a listed impairment;
(4) whether the impairment prevents claimant from performing past relevant work; and
(5) whether the impairment prevents claimant from doing any other work.
6 20 C.F.R. § 404.1520. Ultimately, a claimant is disabled only if
his :
physical or mental impairment or impairments are of such severity that [s]he is not only unable to do [her] previous work but cannot, considering [her] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which [s]he lives, or whether a specific job vacancy exists for [her], or whether [s]he would be hired if [s]he applied for work.
42 U.S.C. § 423(d)(2)(A).
With those principles in mind, the court reviews claimant's
motion to reverse and the Commissioner's motion to affirm her
decision.
Discussion
I. Background - The ALJ's Findings
In concluding that McKinley was not disabled within the
meaning of the Act, the ALJ properly employed the mandatory five-
step seguential evaluation process described in 20 C.F.R.
§ 404.1520. He first determined that McKinley had not been
engaged in substantial gainful employment since her alleged onset
of disability. Next, he concluded that she has the severe
impairments of adjustment disorder with mixed features of anxiety
and depression, lumbar degenerative disc disease, left shoulder
tendonitis, bursitis in hips, and obesity. Administrative Record
7 ("Admin. Rec.") at 17-18. Nevertheless, the ALJ determined that
those impairments, regardless of whether they were considered
alone or in combination, did not meet or equal one of the
impairments listed in Part 404, Subpart P, Appendix 1. I_d. at
19.
Next, the ALJ concluded that McKinley retained the residual
functional capacity to perform light work, "except [that] she is
limited to occasional balancing, stooping, kneeling and
crawling." I_d. at 20. He also found that she "can occasionally
climb ramps and stairs" and that she is "limited to frequent
pushing, pulling and overhead reaching with the left upper
extremity . . . [and] frequent bilateral foot operation." The
ALJ found that McKinley "must avoid all unprotected heights and
exposure to hazardous machinery," and that "she is limited to
simple, routine and repetitive tasks and only occasional
interaction with the public and with co-workers because of her
mental impairment." iId. The ALJ concluded, therefore, that
McKinley is capable of performing her past relevant work as a
cashier and housekeeper, and also other jobs in the national
economy. Id., at 26-28. Consequently, the ALJ concluded that McKinley was not
disabled from August 17, 2010, through the date of his decision.
Id. at 2 8.
II. Claimant's Arguments
On appeal, McKinley argues that the ALJ's RFC finding is not
supported by substantial evidence. Specifically, she says the
ALJ arrived at his RFC finding by (1) improperly evaluating the
opinion evidence; (2) improperly assess[ing] her credibility; (3)
"unfairly constru[ing]" her daily activities; and (4) ignoring
certain provider notes.2
A. Opinion Evidence
McKinley challenges the ALJ's assessment of the opinion
evidence in two respects. She says that the ALJ improperly
discounted the opinion of her treating therapist, Rachel Wizer, a
licensed clinical social worker, regarding the extent of
functional limitations caused by her mental impairments, and
further, that he impermissibly rejected her treating physician's
2 Claimant also argues that the ALJ did not properly rely on the vocational expert's testimony with respect to the alternative hypothetical. Because the court finds that the ALJ properly rejected the severe limitations contained in the hypothetical, the ALJ was not required to adopt the VE's testimony in that regard. opinion that her physical impairments rendered her unable to
"return to work." Admin. Rec. at 25, 206.
With regard to McKinley's mental impairment, the ALJ found
that it limited her to work involving "simple, routine, and
repetitive tasks and only occasional interaction with the public
and with co-workers." iId. at 20. In making that finding, the
ALJ gave the "greatest weight" to the opinion of the consultative
psychological examiner, Stephanie Griffin, Ph.D. I_d. at 26. Dr.
Griffin reviewed the available record and opined that McKinley's
mental impairments "did not have a significant adverse impact on
[her] work related functions." iId. She concluded that McKinley
could adhere to a schedule, interact with others, and make
decisions, and that "continued psychiatric medication management
and counseling would assist [her] in coping with situational
stressors." Id.
In further support of his mental RFC finding, the ALJ noted
that McKinley generally scored in the normal range on mental
status examinations and that, over the years, she "received only
minimal health care for her mental impairment." iId. at 24. He
discounted the opinion of McKinley's treating therapist, Ms.
Wizer, who had concluded that McKinley had severe limitations in
key work-related functions, and "no useful ability" to deal with
10 work stress and even simple instructions. Admin. Rec. at 25;
1128-31.
McKinley faults the ALJ for giving "little weight" to Ms.
Wizer's opinion. McKinley's briefing on the point is
undeveloped, and on this ground, alone, her argument should be
rejected. But even on the merits the argument fails. See e.g.
O'Neill-Beal v. Colvin, 2013 WL 5941070, at *5 (D. Me. Nov. 5,
2013) (claimant's "latter argument is undeveloped and thus
waived, but neither argument could prevail in any event."). The
ALJ stated that he put little value on Ms. Wizer's opinion
because it was based on a "brief treatment history" of three
months. Admin. Rec. at 26. He also determined that Ms. Wizer's
opinion was inconsistent with the "substantial clinical or
diagnostic findings" in the record, with "the testimony presented
at the hearing," and "with the record as a whole." The ALJ
"note[d] that Ms. Wizer is not an acceptable medical source"
under the regulations. Id.
The regulations "do[] not expressly reguire that
administrative law judges provide 'good reasons' for discounting
the opinion of a source who is not an 'acceptable medical
source.'" King v. Astrue, 2010 WL 4457447, at *4 (D. Me. Oct.
31, 2010) (Rich, M.J.) (guoting and citing SSR 06-03p, 2006 WL
11 2329939, at *2 (2006)), aff'd 2010 WL 4823921, at *1 (D. Me. Nov.
22, 2010). Nevertheless, the ALJ, here, did provide good reasons
for assessing "little weight" to Ms. Wizer's opinion, and his
assessment is supported by substantial evidence.
With regard to McKinley's physical impairments, the ALJ
found that they limited her to light work with some additional
limitations. Admin. Rec. at 20. In making that finding, the ALJ
gave "great weight" to the opinion of McKinley's treating
physician. Dr. Minh Tran. I_d. at 25. Dr. Tran, a physical
medicine and rehabilitation specialist, opined that "claimant was
at only 15% whole person impairment," id., and he agreed with a
functional capacity evaluation that indicated McKinley was able
to work an eight-hour day. iId. at 324. The ALJ acknowledged
that the opinion predated claimant's alleged date of disability,
but also noted that the record documented improvement, not
deterioration, in her condition since that time. iId. at 21-22.
The ALJ also assigned varying weight to the opinions of Dr.
S. J. Holman. I_d. at 25. Dr. Holman, a pain specialist,
"completed a Worker's Compensation evaluation and assessed that
the claimant could occasionally bend, kneel, sguat, climb, stand,
walk, sit, and reach," and that claimant "had no restrictions in
her ability to drive." iId. Dr. Holman also checked "no" to the
12 question of whether McKinley can "return to work," but opined
that she had not reached maximum medical improvement. iId. at
206.
The ALJ accepted Dr. Holman's opinion that McKinley could
occasionally bend, kneel, etc., and found the opinion to be
consistent with his RFC finding that McKinley could do light work
with some restrictions. He rejected Dr. Holman's opinion,
however, that claimant could not return to work. Noting that it
was "not clear that the doctor was familiar with the definition
of 'disability' contained in the Social Security Act and
regulations," the ALJ reasoned that "it is possible that Dr.
Holman was referring solely to claimant's inability to perform
her past relevant work as a convenience store manager, which is
consistent with the conclusions reached in this decision." Id.
at 25 .
McKinley argues that the ALJ improperly rejected Dr.
Holman's opinion that she could not "return to work." The
argument is without merit. For one thing, the opinion does not
constitute a "medical opinion" under the Commissioner's
regulations, but rather, is an opinion on an issue reserved to
the Commissioner. See SSR 96-5p, 1996 WL 374183, at *3. In
addition, the ALJ reasonably inferred, as he was entitled to do.
13 that Dr. Holman believed he was answering the question whether
McKinley could return to her work as a convenience store manager.
See Irlanda Ortiz, 955 F.2d at 769 (the ALJ is entitled to draw
reasonable "inferences from the record evidence").3
For all of these reasons, the court finds that the ALJ
properly assessed the opinion evidence.
B. Claimant's Credibility
When a claimant demonstrates that her impairment could
reasonably be expected to produce the symptoms she alleges, the
ALJ is required to determine the intensity, persistence, and
limiting effects of those symptoms. 20 C.F.R. § 404.1529(c). In
making that determination, the ALJ must evaluate the claimant's
"statements about the effects of her symptoms ... in light of the
medical evidence and other evidence such as precipitating and
aggravating factors, medications and treatment, and how the
symptoms affect the applicant's daily living." Syms v. Astrue,
2011 WL 2972122, at *4 (D.N.H. July 21, 2011) (DiClerico, J.)
(citing 20 C.F.R. § 404.1529(c)(3)).
3 McKinley's identical argument regarding Dr. Ollar's notation is, likewise, rejected.
14 McKinley alleges that the intensity, persistence, and
limiting effects of her impairments are so severe as to render
her unable to work. In a September 21, 2010, function report,
she stated that she has to "sit down to get dressed; has
difficulty standing in the shower; experiences pain in her left,
dominant hand while brushing her long hair; and has pain while
bending to shave her legs and when standing for too long to
cook." Jt. Stmt., doc. no. 12 at 15. She reported that she must
sit freguently while cooking and that she reguires help to lift
laundry in and out of her car. I_d. McKinley also indicated that
she needs to stop and rest after walking for ten minutes; that
she is "able to pay attention for about 15 minutes"; and that she
"gets overwhelmed very easily . . . and . . . [does] not handle
changes in routine well." iId. at 15-16.
At the administrative hearing, McKinley testified,
consistent with her function report, that she is physically
limited in her daily activities. She reported that she is
"unable to work because she cannot stand for long periods of time
or deal with large groups of people"; "cannot stand for more than
a half hour before needing to sit"; and "freguently has to change
positions while sitting because of low back pain." I_d. at 17.
She added that she has "tendinitis in her left rotator cuff";
"bursitis in her hips, which radiates down her legs and prevents
15 her from standing for long periods of time"; and "problems with
both knees." iId. at 17-18.
McKinley also testified as to the effects of her mental
impairments. Although she described her psychiatric medication
as helpful, she also "report[ed] significant mental health
symptoms including racing thoughts, impaired sleep, decreased
concentration, irritability, mood swings, depression, and
anxiety." Admin. Rec. at 21.
The ALJ found that McKinley's statements "concerning the
intensity, persistence and limiting effects of [her] symptoms"
were not entirely credible. iId. The ALJ reached that conclusion
in light of clinical signs and medical opinion evidence;
McKinley's course of treatment; her "history of non-compliance
with rehabilitative therapy"; and her "high level of activities
of daily living." I_d. at 21-23. He also found McKinley not
entirely credible because she had "stopped working in February
2009 due to a business-related layoff" and amended her disability
onset date "to August 17, 2010, which is the date that the
claimant's unemployment benefits ceased." iId. at 23.
In addition to those reasons, the ALJ cited as "[a]nother
factor influencing" his credibility assessment claimant's
16 "appearance and demeanor while testifying at the hearing." Id.
at 23. He explained:
[T]he claimant shifted in her seat numerous times and explained that she did so in order to alleviate her pain at the start of the hearing. However, the undersigned observed that the claimant stopped alternating positions and shifting mid-way through the hour and twenty minute hearing. Furthermore, the undersigned observed that the claimant appeared bored and not in pain throughout the duration of the hearing.
Id.
McKinley argues that the ALJ's credibility determination is
flawed because the ALJ was not entitled "to assess a Plaintiff's
pain based on limited observation and subjective speculation that
the Plaintiff appears bored during a hearing." Pi. Br., doc. no.
8-1, at 12. The argument is entirely without merit.
"Part of the ALJ's credibility determination necessarily
involves an assessment of a claimant's demeanor, appearance, and
general 'believability.'" Guerin v. Astrue, 2011 WL 2531195, at
*6 (D.N.H. June 24, 2011). In sizing up McKinley's demeanor and
apparent ability to sit without great pain, the ALJ, therefore,
did what he was authorized and expected to do in his role as
factfinder. Moreover, he appropriately assessed that single
piece of information within the context of a larger mix of
evidence, which itself was more than enough to support his
conclusion that McKinley's complaints about the severity,
17 persistence, and limiting effects of her symptoms were not
entirely credible. See Teixeira v. Astrue, 755 F. Supp. 2d 340,
347 (D. Mass. 2010) (ALJ's consideration of claimant's demeanor,
as "one factor . . . among several," was "particularly
appropriate" where claimant alleged disabling pain).
C. Daily Activities
McKinley argues that the ALJ "unfairly construed [her] daily
activities to demonstrate she had residual functional capacity."
Pi. Br., doc. no. 8-1, at 10. In support, she points out that
she testified to disabling limitations in carrying out daily
tasks, including limitations in lifting, dressing, and bathing
her son; washing herself; and doing the dishes and other
household chores. McKinley says that the ALJ glossed over these
limitations, "recount[ing] plaintiff's activities of daily living
to make it sound as if she had an ungualified ability to walk,
cook, take care of her personal hygiene, drive, and attend to her
infant son without limitation." Id.
McKinley's argument is rejected. It is true that an ALJ
errs when he "misconstrue[s]" the evidence of claimant's
activities of daily living, or gives that evidence only "cursory
consideration." Blake v . Apfe1, 2000 WL 1466128, at *6, 8
(D.N.H. Jan. 28, 2000) (Barbadoro, J.). The ALJ, here, made
18 neither of those mistakes. Instead, he thoughtfully assessed the
probative value of McKinley's testimony about her daily
activities and drew supportable conclusions from it.
The ALJ first fully acknowledged that "claimant has
described daily activities, which are fairly limited." Admin.
Rec. at 24. He concluded, however, that McKinley's testimony was
of limited probative value, explaining that "two factors weigh
against considering these allegations to be strong evidence in
favor of finding the claimant disabled." iId. First, the alleged
limitations in claimant's daily activities "cannot be objectively
verified with any reasonable degree of certainty." iId. Second,
"even if the claimant's daily activities are truly as limited as
alleged, it is difficult to attribute that degree of limitation
to the claimant's medical condition, as opposed to other reasons,
in view of the relatively weak medical evidence and other factors
discussed in this decision." Id.
And although he assessed limited probative value to
McKinley's testimony about her daily activities, he supportably
found that, even as she described them, McKinley's daily
activities are "not limited to the extent one would expect, given
the complaints of disabling symptoms and limitations." iId. He
noted, in particular, that McKinley "lives independently";
19 "attend[s] to her personal care needs, drives a car, shop[s] in
stores, prepare[s] meals, go[es] out to eat in restaurants,
do[es] laundry, wash[es] dishes, carets] for her nine-month old
son, and [has] weekend visits with her 14-year old daughter."
Id. He also noted that she is "able to manage her own finances,
maintain friendships, . . . watch movies . . . attend[] religious
services on Sundays, and is able to interact with the servicing
minister." I_d. at 24-25.
At bottom, the ALJ did not improperly assess or misconstrue
McKinley's reports regarding her daily activities.
D. Undiscussed Notes
An ALJ must consider and weigh all relevant evidence. See
Alcantara v. Astrue, 2007 WL 4328148, at *2 (1st Cir. Dec. 12,
2007) (citing 20 C.F.R. §§ 416.920(a) (3), 416.920(a) & (c)). To
demonstrate that the ALJ impermissibly ignored evidence, a
claimant must do more than point to the fact that the ALJ never
mentioned the evidence in his written decision. See Dwyer v.
Astrue, 2012 WL 2319097, at *4 (D.N.H. June 19, 2012) (an ALJ is
not reguired to "to discuss 'every piece of evidence in the
record'") (guoting Shulkin v. Astrue, 2012 WL 79007, at *8
(D.N.H. Jan. 11, 2012) (Barbadoro, J.)). She must also showthat
the evidence is probative of her claim and not cumulative of
20 evidence the ALJ explicitly addressed. Shulkin, 2012 WL 79007,
at *8-9. In other words, claimant must show that the ALJ
essentially "adopted one view of the evidence, ''without
addressing the underlying conflict.'" Id. at *9.
McKinley says that the ALJ failed to consider comments
included in four treatment provider notes and one educational
intake form. All of the notations describe what could be
regarded as disabling symptoms. To that extent, then, they are
probative of McKinley's claim. But because they all represent
the provider's or educator's recitation of McKinley's subjective
complaints, they are cumulative of evidence the ALJ explicitly
addressed in his written decision. The ALJ directly and
thoroughly addressed the underlying conflict between claimant's
subject complaints of disabling limitations and the very
substantial body of evidence suggesting that claimant suffers
only limited functional losses. His failure to discuss those few
cumulative notations does not, therefore, constitute error.
Conclusion
For the foregoing reasons, claimant's motion to reverse the
decision of the Commissioner (document no. 8_) is denied. The
Commissioner's motion to affirm her decision (document no. 11) is
21 granted. The Clerk of Court shall enter judgment in accordance
with this order and close the case.
SO ORDERED
:even J/McAuliffe Jnited States District Judge
February 2 6, 2014
cc: Christine W. Casa, Esq. Robert J. Rabuck, AUSA