Stephanie Hill v. Commissioner Of Social Securit

Filing

OPINION filed : AFFIRMED, decision not for publication. Danny J. Boggs, Circuit Judge; Raymond M. Kethledge, Authoring Circuit Judge and Jane A. Restani, International Trade Judge.

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NOT RECOMMENDED FOR FULL-TEXT PUBLICATION
File Name: 14a0233n.06
No. 13-6101
UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT
STEPHANIE M. HILL,

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Plaintiff-Appellant,
v.
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.

FILED
Mar 27, 2014
DEBORAH S. HUNT, Clerk

ON APPEAL FROM THE
UNITED STATES DISTRICT
COURT FOR THE WESTERN
DISTRICT OF KENTUCKY

Before: BOGGS and KETHLEDGE, Circuit Judges; RESTANI, Judge.*
KETHLEDGE, Circuit Judge. Stephanie Hill appeals the district court’s judgment
affirming an administrative law judge’s denial of her application for social-security benefits.
Having reviewed the record, we conclude that substantial evidence supports the ALJ’s findings.
We therefore affirm.
I.
Stephanie Hill previously worked as a waitress and fast-food cook. Hill has not worked
since 2007, when she allegedly became overwhelmed by scoliosis, bipolar disorder, anxiety,
migraine headaches, and pain in her back, neck, knees, and ankles.

In 2010, Hill filed

applications for disability insurance benefits and supplemental security income.

An ALJ

determined that Hill could not perform her past work as a cook or a waitress, but that she was
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The Honorable Jane A. Restani, Judge of the United States Court of International Trade, sitting
by designation.

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capable of performing light work, and therefore was not disabled. The Appeals Council denied
review of the decision, and Hill appealed to federal court. A magistrate judge recommended that
the district court affirm the ALJ’s decision. The district court adopted that recommendation over
Hill’s objections. This appeal followed.
II.
We review only whether the ALJ applied the correct legal standards and reached a
conclusion supported by substantial evidence. See Kyle v. Comm’r of Soc. Sec., 609 F.3d 847,
854 (6th Cir. 2010). Substantial evidence is evidence that “a reasonable mind might accept as
adequate to support a conclusion.” Id (internal quotation marks omitted).
A.
Hill first argues that the ALJ violated the “treating-physician rule” when she rejected Dr.
Yoglesh Malla’s medical opinion. That rule requires an ALJ to give a treating-physician’s
opinion controlling weight if it is “well-supported by medically acceptable clinical and
laboratory diagnostic techniques” and is not “inconsistent with the other substantial evidence” in
the record.

20 C.F.R. § 404.1527(c)(2).

An ALJ must give “good reasons” supported by

evidence in the record if she declines to give controlling weight to that opinion. Wilson v.
Comm’r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004).
As Hill’s treating pain-management specialist, Malla diagnosed Hill with lumbar facet
arthropathy (low-back degenerative arthritis), cervical facet joint arthropathy (neck degenerative
arthritis), and knee osteoarthritis (knee arthritis). He also determined that she could no longer
work. But the ALJ gave several good reasons for declining to give Malla’s opinion controlling
weight. First, Malla’s opinion was not supported by the medical tests that he ordered. The
radiologist who read and interpreted Hill’s CT scan reported that Hill’s arthritis was “mild”;

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Hill’s bilateral-knee x-ray showed “no obvious osteoarthritis” or other acute problems; and
Malla’s post-imaging treatment notes reported the same test results. Yet Malla did not adjust his
diagnosis.
Second, Malla’s treatment notes did not support his opinion that Hill had severe physical
limitations. Malla’s initial-examination notes stated that Hill had normal posture, normal ability
to walk, and no limitations in her motor functioning, grip strength, reflexes, sensations, or
extremity range-of-motion. He also noted that Hill said that she could walk, sit, stand, climb
stairs, dress herself, and drive a car unassisted. Malla’s notes from Hill’s last visit to him said
that she was “doing fine” and that more than 50% of her pain had been relieved by her
medications. The notes therefore undermine his opinions. See Leeman v. Comm’r of Soc. Sec.,
449 F. App’x 496, 497 (6th Cir. 2011).
Third, the ALJ found that Hill’s chiropractic and physical-therapy treatment notes
showed that she had “significantly more physical ability than Dr. Malla has opined.” See
Francis v. Comm’r Soc. Sec. Admin., 414 F. App’x 802, 806 (6th Cir. 2011).
Finally, the ALJ observed that Malla’s opinion was inconsistent with Hill’s own
statements about her daily activities, which included housekeeping and caring for her five-yearold daughter as a single mother. See id. at 805. Thus, the ALJ gave adequate reasons for
rejecting Malla’s opinion.
Hill also contends that the ALJ erred when it credited the opinion of Dr. David Swann (a
non-treating physician) over Malla (her treating physician). As already noted, however, the ALJ
had good reason to give “little to no weight” to Malla’s opinion.

The ALJ instead gave

“considerable weight” to the opinion of Swann, who reviewed Hill’s record and assessed that she
could perform medium-exertional work. Hill responds that the ALJ should not have credited

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Swann’s opinion because he signed off on a form that was prepared by the state-agency decision
maker. See Johnson v. Comm’r Soc. Sec. Admin., 652 F.3d 646, 650-51 (6th Cir. 2011).
Whereas Malla’s opinion was undermined by substantial evidence, that same substantial
evidence supported Swann’s opinion. The ALJ did not err in crediting Swann’s opinion. See id.
at 652.
B.
Hill also challenges the ALJ’s evaluation of her mental limitations. Hill first argues that
the ALJ improperly weighed the opinion of her therapist, Charles Cox. Hill concedes that Cox, a
licensed marriage and family therapist, is not an “acceptable medical source” under 20 C.F.R
§ 404.1513(a)(2), and thus that his opinion could not be given controlling weight. Instead, Hill
argues that the ALJ failed to properly consider Cox’s opinion as an “other source.” SSR 06-03p
at 6.
An ALJ must consider other-source opinions and “generally should explain the weight
given to opinions for these ‘other sources[.]’” Id. But other-source opinions are not entitled to
any special deference. See id. Here, the ALJ “thoroughly considered” Cox’s opinion before
assigning it “little to no weight.” The ALJ found that the allegedly severe mental limitations that
Cox identified were not supported by the objective record and were inconsistent with other
substantial evidence. For example, Cox found that Hill was extremely limited in her ability to
relate to co-workers, interact with supervisors, and behave in an emotionally stable manner. He
also found that she was seriously limited in her ability to maintain her personal appearance and
relate predictably in social settings. But Cox’s own treatment notes repeatedly described Hill as
cooperative, polite, readily engaging, displaying neat appearance, coherent speech, good eyecontact, and verbal skills. See Leeman, 449 F. App’x at 497. In addition, Cox’s opinions that

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Hill was extremely limited in her ability to maintain attention and concentration, be reliable, and
that she was seriously limited in her ability to function independently were all undermined by
Hill’s own testimony that she was the sole caretaker for her daughter and that she managed her
home and finances. See Francis, 414 F. App’x at 805. Thus, the ALJ properly considered the
Cox’s opinion as an “other source” and explained her reasons for giving it “little to no weight.”
Hill further asserts that the ALJ erred when it assessed Cox’s medical source statement,
which was submitted after the hearing.

Hill contends that Cox’s statement identified

impairments that were not addressed by other mental health experts at the ALJ hearing, and
therefore that the ALJ should have deferred to Cox’s assessment or referred his opinion to a
medical expert for further consideration. For the reasons above, however, the ALJ found Cox’s
opinions incredible and therefore had no reason to seek a follow-up assessment based upon them.
Hill also argues that the ALJ erred by assigning “controlling weight” to the assessment of
Dr. Tom Wagner, an impartial psychological expert who testified at the hearing. An ALJ must
weigh all medical opinions presented. 20 C.F.R. § 404.1527(c). Here, the ALJ said that “great
and controlling weight” was given to Wagner’s assessment, which is technically wrong because
“controlling weight” is a level of deference reserved for treating sources, and Wagner did not
treat Hill. Id.; Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365, 376 (6th Cir. 2013). When
viewed as a whole, however, the ALJ’s decision shows that she indeed weighed all of the
mental-health opinions presented to her. See id. She considered opinions from Wagner, Bruce
Amble, Ph.D., a psychological consultative examiner, Larry Freudenberger, Psy.D, a Kentucky
state-agency psychologist, and Cox, Hill’s therapist.

Id.

The ALJ assigned “considerable

weight” to Dr. Amble’s and Dr. Freudenberger’s opinions, “little to no weight” to Cox’s opinion,
and after considering the “totality of the evidence,” the ALJ determined that Wagner provided

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the “most accurate and detailed assessment” of Hill’s abilities and limitations. Thus, the ALJ’s
error in labeling the weight she gave to Wagner’s opinion as “controlling” was harmless because
the ALJ’s opinion on a whole was consistent with the regulations. See also Bass v. McMahon,
499 F.3d 506, 510 (6th Cir. 2007).
In summary, substantial evidence—including the objective record of treatment and Dr.
Wagner’s impartial expert opinion—supported the ALJ’s determination of Hill’s mental-health
limitations. See Atterberry v. Sec’y of Health & Human Servs., 871 F.2d 567, 570 (6th Cir.
1989).
C.
Hill next argues that the ALJ failed to consider the combined effects of all of her
impairments. Specifically, she says that the ALJ failed to consider whether her bipolar disorder
and obesity exacerbate her neck, back, and knee pain. But “[a]n ALJ’s individual discussion of
multiple impairments does not imply that [s]he failed to consider the effect of the impairments in
combination, where the ALJ specifically refers to a ‘combination of impairments’ in finding that
the plaintiff does not meet” a listed impairment. Loy v. Sec’y of Health & Human Servs.,
901 F.2d 1306, 1310 (6th Cir. 1990).

And here, the ALJ found that Hill did not have a

“combination of impairments that meets or medically equals one of the listed impairments[.]”
Thus, Hill’s combined-effects argument is meritless.
Hill also contends briefly that the ALJ failed to recognize her post-traumatic stress
disorder as a severe impairment. But disability is determined by the functional limitations
imposed by a condition, not the mere diagnosis of it. See Higgs v. Bowen, 880 F.2d 860, 863
(6th Cir. 1988). And Hill cites no evidence or authority to show that inclusion of PTSD as a
severe impairment would have changed the ALJ’s assessment of her functional limitations.

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Thus, Hill’s cursory argument that the ALJ failed to denote PTSD as a severe limitation is
waived. See Rice v. Comm’r of Soc. Sec., 169 F. App’x 452, 454 (6th Cir. 2006).
D.
Hill next argues that the ALJ erred in the last step of the disability analysis set out in
20 C.F.R. § 404.1520. For this step, the burden of proof shifts to the government to show “by
substantial evidence that [Hill] has the vocational qualifications to perform specific jobs.” Ealy
v. Comm’r of Soc. Sec., 594 F.3d 504, 512 (6th Cir. 2010) (internal quotation marks omitted).
“[S]ubstantial evidence may be produced through reliance on the testimony of a vocational
expert [] in response to a hypothetical question, but only if the question accurately portrays [the
claimant’s] individual physical and mental impairments.” Id. at 512-13 (internal quotation marks
omitted). Here, Hill contends that the hypothetical question that the ALJ posed to the vocational
expert did not accurately portray her mental impairments because it did not include a limitation
identified by Dr. Freudenberger: that she could only sustain concentration for “2 hour segments
over an 8 hour workday.” But a hypothetical is inaccurate when it fails to include a specific
limitation found by the ALJ. See id. at 516-17. And here the ALJ posed hypotheticals based on
someone who had “the mental health limitations as per Dr. Wagner in his testimony today.” The
hypothetical therefore accurately portrayed the mental impairments that the ALJ found to be
supported by “the objective record of treatment and the opinion of impartial psychological expert
Dr. Tom Wagner.” Thus, the vocational expert’s testimony provided substantial evidence for the
ALJ to determine that there were jobs that existed in significant numbers in the national
economy that Hill could perform.
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The district court’s judgment is affirmed.

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