Johns v. SSA

Filing 12

MEMORANDUM OPINION AND ORDER: (1) Pla's 10 Motion for Summary Judgment is DENIED. (2) Commissioner's 11 Motion for Summary Judgment is GRANTED. The decision of the Commissioner is AFFIRMED pursuant to sentence four of 42 USC 405(g) as it was supported by substantial evidence and was decided b proper legal standards. (4) A judgment consistent with this MOO will be entered contemporaneously. Signed by Judge Karen K. Caldwell on September 28, 2015. (AWD) cc: COR

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF KENTUCKY
CENTRAL DIVISION -- LEXINGTON
JAMES T. JOHNS,

CIVIL ACTION NO. 5:14-cv-237-KKC

Plaintiff,
MEMORANDUM
OPINION AND ORDER

V.
CAROLYN W. COLVIN, ACTING
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.

This matter is before the Court for consideration of cross-motions for summary
judgment. (DE 10; DE 11). The plaintiff, James Johns, brought this action pursuant to 42
U.S.C. § 405(g) to obtain judicial relief of an administrative decision of the Commissioner of
Social Security denying his claim for Social Security Disability Insurance Benefits (“DIB”)
and Supplemental Security Income (“SSI”). The Court, having reviewed the record, will
affirm the Commissioner’s decision as it is supported by substantial evidence and was
decided by the proper legal standards.
I.

OVERVIEW OF THE PROCESS
The Social Security Act and corresponding regulations provide that the

administrative law judge (“ALJ”) must follow a five-step sequential process in determining
whether a claimant has a compensable disability. 20 C.F.R. § 404.1520(a)(4); see also
Rabbers v. Comm’r Soc. Sec. Admin., 582 F.3d 647, 652 (6th Cir. 2009) (describing the
administrative process). The five steps, in summary, are as follows:
1) If the claimant is doing substantial gainful activity, the
claimant is not disabled.
2) If the claimant does not have a severe medically
determinable physical or mental impairment—i.e., an
impairment that significantly limits his or her physical or

mental ability to do basic work activities—the claimant is
not disabled.
3) If the claimant has a severe impairment(s) that meets or
equals one of the listings in Appendix 1 to Subpart P of the
regulations and meets the duration requirement, the
claimant is disabled.
4) If the claimant’s impairment does not prevent him or her
from doing his or her past relevant work, the claimant is
not disabled.
5) If the claimant can make an adjustment to other work, the
claimant is not disabled. If the claimant cannot make an
adjustment to other work, the claimant is disabled.
Rabbers, 582 F.3d at 652 (citing 20 C.F.R. §§ 404.1520(a)(4)(i)–(v), 404.1520(b)–(g)). If, at
any step in the process, the ALJ concludes that the claimant is or is not disabled, the ALJ
can then complete the “determination or decision and [the ALJ] do[es] not go on to the next
step.” 20 C.F.R. § 404.1520(a)(4).
Through the first four steps of the analysis, the burden of proof is on the claimant to
show that he is disabled; if the ALJ reaches step five without finding that the claimant is
disabled, the burden of proof shifts to the Commissioner. Johnson v. Comm’r of Soc. Sec.,
652 F.3d 646, 651 (6th Cir. 2011). In order for the claimant to satisfy his burden of proof, he
must provide sufficient facts to find in his favor. Wright-Hines v. Comm’r of Soc. Sec., 597
F.3d 392, 396 (6th Cir. 2010).
II.

PROCEDURAL BACKGROUND AND THE ADMINISTRATIVE DECISION
Johns filed his claim for SSI and DIB on April 14, 2011, alleging an onset date of

March 30, 2011. (Tr. at 160, 162.) The agency denied his application initially and on
reconsideration. (Tr. at 65, 73, 89, 102.) Johns requested review by an ALJ, and the ALJ
held a hearing on March 15, 2013. (Tr. at 26–56.) The ALJ subsequently issued an
unfavorable decision on March 28, 2013. (Tr. at 11–19.)

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At the time the ALJ rendered his decision, Johns was forty-eight years old. (Tr. at
29.) He has a high school education and previously worked as a lab technician, line
operator, and grocery store worker. (Tr. at 17, 30.) He alleges disability due to “[p]roblems
with breathing, left foot, left shoulder, [and] degenerative disc disease.” (Tr. at 59, 67.)
Johns meets the insured status requirements of the Social Security Act through September
30, 2015. (Tr. at 13.)
At the first step, the ALJ found that John has not engaged in any substantial
gainful activity since the alleged onset date of March 30, 2011. (Tr. at 13.) At the second
step, the ALJ concluded that Johns has the following severe impairments: “degenerative
disc disease of the lumbar spine with possible spinal stenosis; chronic obstructive
pulmonary disease; degenerative joint disease of the left foot and shoulder.” (Tr. at 13.) At
the third step, the ALJ found that Johns does not have an impairment or combination of
impairments that meets or medically equals in severity any of the listed impairments. (Tr.
at 14.)
After completing step three, the ALJ reviewed the record to determine Johns’s
residual functional capacity (“RFC”). RFC assesses a claimant’s maximum remaining
capacity to perform work-related activities despite the physical and mental limitations
caused by the claimant’s disability. 20 C.F.R. §§ 404.1545(a)(1), 416.945(a)(1). In finding
Johns’s RFC, the ALJ considered all symptoms in light of the objective medical evidence
and other relevant evidence, including the following: (1) daily activities; (2) location,
duration, frequency, and intensity of symptoms; (3) precipitating and aggravating factors;
(4) type, dosage, effectiveness, and side effects of any medication; (5) additional treatment;
(6) additional measures used to relieve symptoms; and (7) other factors concerning
functional limitations and restrictions due to symptoms. 20 C.F.R. §§ 404.1529, 416.929;
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SSR 96-4p, 1996 WL 374187 (July 2, 1996); SSR 96-7p, 1996 WL 374186 (July 2, 1996).
The ALJ also considered the relationship between Johns and the doctors providing medical
opinions; the supportability and consistency of the medical opinions with the entirety of
evidence on the record; medical specialization; and other opinion evidence.

20 C.F.R.

§§ 404.1527, 416.927; SSR 06-3p, 2006 WL 2329939 (Aug. 9, 2006); SSR 96-2p, 1996 WL
374188 (July 2, 1996); SSR 96-5p, 1996 WL 374183 (July 2, 1996); SSR 96-6p, 1996 WL
374180 (July 2, 1996).
The ALJ determined that, based on the medically determinable evidence, Johns has
the RFC to perform less than the full range of sedentary work. (Tr. at 14.) The ALJ noted
that Johns has the following exertional and non-exertional limitations:
He is able to occasionally lift or carry 20 pounds and frequently
lift or carry 10 pounds; he is able to stand and/or walk for 2
hours in an 8-hour period; he is able to sit for 6 hours in an 8hour period; he can frequently climb ramps or stairs; balance,
stoop, and kneel. He can occasionally climb ladders, ropes and
scaffolds and occasionally crouch and kneel. He needs to avoid
concentrated exposure to vibration, fumes, odors, dusts, gases,
poor ventilation and hazards.
(Tr. at 14.)
The ALJ continued to the fourth step and asked the vocational expert (“VE”)
whether a hypothetical individual with Johns’s age, education, work experience, and RFC
could perform any of Johns’s prior jobs. (Tr. at 51–52.) The VE testified that this
hypothetical individual could not perform any of Johns’s previous work. (Tr. at 52.) The
ALJ moved to the fifth step and asked the VE whether this hypothetical individual could
perform any work in the regional or national economy. (Tr. at 52.) The VE stated that this
hypothetical individual could perform the following jobs under the Dictionary of
Occupational Titles (“DOT”): information clerk, factory helper, and hand packager. (Tr. at
52–53.) The ALJ, therefore, found Johns not disabled. (Tr. at 18–19.)
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The ALJ’s decision that John was not disabled from March 30, 2011 through March
28, 2013 became the final decision of the Commissioner when the Appeals Commission
subsequently denied Johns’s request for review on May 21, 2014. (Tr. at 1–3.) Johns has
exhausted his administrative remedies and filed a timely action in this Court. This case is
now ripe for review under 42 U.S.C. § 405(g).
III.

GENERAL STANDARD OF REVIEW
The decision of the Commissioner must be affirmed unless the ALJ applied the

incorrect legal standards or the ALJ’s findings are not supported by substantial evidence.
Lindsley v. Comm’r of Soc. Sec., 560 F.3d 601, 604 (6th Cir. 2009). Substantial evidence is
“such relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.” Id. (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)) (internal
quotations omitted). When reviewing the decision of the Commissioner, courts are not to
conduct a de novo review, resolve conflicts in the evidence, or make credibility
determinations. See Lindsley, 560 F.3d at 604–05. Courts must look at the entire record,
and “may not focus [its] decision entirely on a single piece of evidence, and disregard other
pertinent evidence.” Sias v. Sec’y of H.H.S., 861 F.2d 475, 479 n.1 (6th Cir. 1988) (quoting
Hephner v. Mathews, 574 F.2d 359, 362 (6th Cir. 1978)). The court must affirm the
Commissioner’s decision so long as it is supported by substantial evidence, even if the court
might have decided the case differently. See Her v. Comm’r of Soc. Sec., 203 F.3d 388, 389–
90 (6th Cir. 1999).
IV.

ANALYSIS
On appeal, Johns presents the following issues for review: (1) whether the ALJ erred

in analyzing examining physician Dr. Jared Madden’s medical opinion report; (2) whether
the ALJ properly evaluated Johns’s MRI results; and (3) whether the ALJ should have
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credited the medical opinion report from Dr. Barry Burchett more than Dr. Madden. (DE 10
Pl.’s Mot. for Summ. J. at 4–10.) All three of these issues challenge the ALJ’s analysis
pursuant to the guidelines in 20 C.F.R. § 404.1527.
Section 404.1527 outlines the requirements for evaluating medical opinion evidence.
Subsection C notes that the ALJ will evaluate every medical opinion and prescribes
guidelines for determining the amount of weight any opinion should receive. 20 C.F.R.
§ 404.1527(c). Factors relevant to the weight of an opinion include: (1) whether the
physician examined the claimant (“examining physician”); (2) whether the physician
regularly treats the claimant and has an ongoing treatment relationship (“treating
physician”);

(3)

whether

medical

evidence

supports

the

physician’s

opinion

(“supportability”); (4) whether the physician has provided consistent opinions concerning a
claimant’s alleged disabilities (“consistency”); (5) whether the physician is a specialist in the
field related to the claimant’s alleged disabilities (“specialization”); and (6) other factors
evident in the medical records (“other factors”). Id. Importantly, the ALJ must evaluate the
record as a whole in connection with “other sources” including testimonial and anecdotal
evidence. Engebrecht v. Comm’r of Soc. Sec., 572 F. App’x 392, 397–98 (6th Cir. 2014) (citing
20 C.F.R. § 404.1513). It is not necessary, however, for the ALJ to use to word “weight” in
his or her analysis of the relevant factors.
1. The ALJ did not err in analyzing Dr. Madden’s medical opinion report.
Johns asserts that the ALJ did not properly review Dr. Madden’s medical report for
several reasons. (DE 10 Pl.’s Mot. for Summ. J. at 5–9.) Johns argues that the ALJ should
have given more weight to Dr. Madden’s determination of Johns’s RFC. (DE 10 Pl.’s Mot.
for Summ. J. at 5–9.) Johns also contends that the ALJ did not properly credit Dr.
Madden’s interpretation of Johns’s MRI. (DE 10 Pl.’s Mot. for Summ. J. at 7.) Finally, he
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claims that the ALJ wrongly interpreted Dr. Madden’s reference to “somatic dysfunction.”
(DE 10 Pl.’s Mot. for Summ. J. at 8.) These alleged errors, however, do not establish that
the ALJ’s decision is based upon an incorrect legal standard or a lack of substantial
evidence. See Lindsley, 560 F.3d at 604.
First, Dr. Madden’s RFC determination is not automatically entitled to significant
weight. Dr. Madden is an examining physician, not a treating physician. Therefore, Dr.
Madden’s opinion is not entitled to the “treating physician rule.” See Gentry v. Comm’r of
Soc. Sec., 741 F.3d 708, 723 (6th Cir. 2014). The ALJ also detailed Dr. Madden’s findings
(Tr. at 6), concluded that Dr. Madden’s findings deserved “[l]ittle weight” (Tr. at 7), and
explained why he gave greater weight to other medical opinion evidence (Tr. at 7). Notably,
the ALJ determined that the “supportability” and “consistency” factors identified in 20
C.F.R. § 404.1527(c) did not substantiate Dr. Madden’s findings. (Tr. at 7.) And the ALJ did
not need to credit Dr. Madden’s determination of Johns’s RFC because RFC is an
administrative finding of an individual’s ability to perform work-related activities that is
explicitly reserved for the Commissioner. See 20 C.F.R. § 404.1545(a); SSR 96-5p, 1996 WL
374183, at *5 (July 2, 1996); see also Howard v. Comm’r of Soc. Sec., 276 F.3d 235, 240 (6th
Cir. 2002) (holding that RFC is not meant to describe physical maladies, but residual
abilities). Therefore, the ALJ did not err in assigning little weight to Dr. Madden’s
determination of Johns’s RFC.
Second, Dr. Madden’s interpretation of Johns’s MRI is not the only medical opinion
evidence in the record. Dr. Richard Scalf prepared an MRI report that detailed the findings
and impression of Johns’s MRI results. (Tr. at 283.) The ALJ did not err in giving more
weight to Dr. Scalf’s findings than Dr. Madden’s findings, especially because the ALJ
concluded that Dr. Madden did not perform the MRI, is not Johns’s treating physician, and
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did not provide a conclusion of Johns’s abilities that is supported by, or consistent with, the
medical record evidence. See 20 C.F.R. § 404.1527(c).
Finally, Dr. Madden’s usage of the term “somatic dysfunction” does not
automatically entitle Johns to a disability determination. Although “somatic dysfunction”
means “an impaired or altered function of the somatic bodywork system including skeletal
system” (DE 10 Pl.’s Mot. for Summ. J. at 8), the ALJ may still properly discount any and
all medical opinion evidence that does not meet the relevant factors pursuant to 20 C.F.R.
§ 404.1527(c). The ALJ properly analyzed how much weight to give to Dr. Madden’s
opinion, id.; and Dr. Madden’s usage of a specific term of art does not mean that his medical
opinion suddenly warrants greater weight.
2. The ALJ properly analyzed Johns’s MRI results.
Johns properly notes that an ALJ is not authorized to independently interpret the
results of an MRI. (See DE 10 Pl.’s Mot. for Summ. J. at 7–8.) “The ALJ must not substitute
his own judgment for a doctor’s conclusion without relying on other medical evidence or
authority in the record.” Booth v. Comm’r of Soc. Sec., No. 1:06-CV-122, 2008 WL 744 230,
at *13 (S.D. Ohio Mar. 19, 2008) (citing Clifford v. Apfel, 227 F.3d 863, 870 (7th Cir. 2000)).
But here, the ALJ did not independently evaluate Johns’s MRI. Both Dr. Madden and Dr.
Scalf interpreted Johns’s MRI results. (Tr. at 283, 321–26.) Therefore, the guidelines
pursuant to 20 C.F.R. § 404.1527(c) provide guidance for which medical opinion the ALJ
should credit. Both Dr. Madden and Dr. Scalf examined Johns; neither Dr. Madden nor Dr.
Scalf is Johns’s treating physician; Dr. Madden is an osteopathic physician and Dr. Scalf is
a diagnostic radiologist; Dr. Madden’s conclusion was not supported by other credible
medical evidence in the record but Dr. Scalf’s findings were supported by other credible
medical evidence in the record. 20 C.F.R. § 404.1527(c). Therefore, the ALJ’s conclusion to
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give Dr. Madden’s analysis of Johns’s MRI results little weight is based upon a correct legal
standard and is supported by substantial evidence. See Lindsley, 560 F.3d at 604.
3. The ALJ did not err in giving greater weight to Dr. Burchett’s medical opinion
than to Dr. Madden’s medical opinion.
Johns contends that the ALJ should not have given greater weight to Dr. Burchett’s
medical opinion than to Dr. Madden’s medical opinion. (DE 10 Pl.’s Mot. for Summ. J. at 5–
9.) Notably, Johns claims that the ALJ’s failure to use the word “weight” when analyzing
Dr. Burchett’s medical opinion is “a significant error in this decision and requires remand of
the matter.” (DE 10 Pl.’s Mot. for Summ. J. at 7.)
Here, the ALJ detailed the findings of both Dr. Burchett’s and Dr. Madden’s
examination of Johns. (Tr. at 16–17.) The ALJ also identified the other medical evidence in
the record relevant to determining the amount of weight to give the medical opinion
evidence. (Tr. at 14–17.) Then, the ALJ weighed the medical opinion evidence. (Tr. at 17.)
The ALJ determined that Dr. Madden’s opinion should be given “[l]ittle weight” and gave
weight to Dr. Burchett’s opinion because the ALJ used Dr. Burchett’s opinion to formulate
Johns’s RFC and Johns’s RFC limitation. (Tr. at 14–17.)
Johns is correct that the ALJ did not use the word “weight” when analyzing Dr.
Burchett’s opinion; however, failure to use the word “weight” does not require remand. The
regulations require an ALJ to “weigh” medical opinions. 20 C.F.R. § 404.1527(c). The
regulations also provide guidance for the proper methodology to weigh a medical opinion.
Id. The regulations, however, do not require a particular vocabulary. See id. Although the
ALJ did not use the word “weight,” it is clear that the ALJ weighed Dr. Burchett’s medical
opinion evidence. The ALJ determined the examining relationship, the supportability of Dr.
Burchett’s conclusions, and the consistency of Dr. Burchett’s medical opinion with the
record as a whole. (Tr. at 16–17.) The ALJ then used Dr. Burchett’s medical opinion to
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formulate Johns’s RFC. (Tr. at 14–17.) Clearly the ALJ weighed Dr. Burchett’s medical
opinion according to the guidance provided under the regulations. See 20 C.F.R. § 404.1527.
Therefore, the ALJ’s determination to give Dr. Burchett’s medical opinion evidence more
weight than Dr. Madden’s medical opinion evidence is based upon a correct legal standard
and is supported by substantial evidence. See Lindsley, 560 F.3d at 604.
V. CONCLUSION
For the reasons set forth above, the Court hereby ORDERS as follows:
1. Plaintiff’s motion for summary judgment (DE 10) is DENIED;
2. The Commissioner’s motion for summary judgment (DE 11) is GRANTED;
3. The decision of the Commissioner is AFFIRMED pursuant to sentence four of 42
U.S.C. § 405(g) as it was supported by substantial evidence and was decided by proper legal
standards; and
4. A judgment consistent with this Memorandum Opinion and Order will be
entered contemporaneously.
Dated September 28, 2015.

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