Janssen v. Colvin
Filing
25
ORDER denying 16 Motion for Summary Judgment; granting 18 Motion for Summary Judgment(Written Opinion) Signed by Magistrate Judge Franklin L. Noel on 3/22/2018. (TMA)
UNITED STATES DISTRICT COURT
DISTRICT OF MINNESOTA
Gerald Janssen, o/b/o Jill
Janssen (deceased),
Civil No. 16-3338 (FLN)
Plaintiff,
v.
ORDER
Nancy A. Berryhill ,
Acting Commissioner of Social Security,
Defendant.
______________________________________________________________
Karl E. Osterhout and Edward C. Olson, for Plaintiff.
Gregory G. Booker, Assistant United States Attorney, for Defendant.
______________________________________________________________
Plaintiff Gerald Janssen seeks judicial review of the final decision of the Acting
Commissioner (“Commissioner”) of the Social Security Administration (“SSA”), who denied Jill
Janssen, his now deceased wife’s, application for supplemental security income under Title XVI of
the Social Security Act. This Court has jurisdiction over the claim pursuant to 42 U.S.C. §§ 405(g)
and 1383(c)(3), 28 U.S.C. § 636(c), and Rule 73 of the Federal Rules of Civil Procedure. The parties
have submitted cross-motions for summary judgment. See ECF Nos. 16 and 18. For the reasons set
forth below, the Commissioner’s decision is AFFIRMED and the case is DISMISSED WITH
PREJUDICE.
I. INTRODUCTION
On June 24, 2013, Janssen filed an application for supplemental security income (“SSI”).
Administrative Record [hereinafter “AR”] 81, ECF No. 14. Janssen alleged that she became disabled
on June 1, 2013. AR 189. Janssen application was denied initially and again on reconsideration. AR
10–23, 1–5. On April 28, 2015, an administrative hearing was held before Administrative Law Judge
(“ALJ”) Michael D. Quayle. AR 40–61. On February 2, 2012, the ALJ denied Janssen’s applications
for SSI. AR 62–72. On January 9, 2013, the SSA Appeals Council denied Janssen’s request for
review, rendering the ALJ’s decision final for purposes of judicial review. AR 78–80, 5; see 20
C.F.R. § 404.981. On October 3, 2016, Janssen commenced this civil action, seeking a remand for
further proceedings pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). Compl., ECF No. 1.
II. STATEMENT OF FACTS
A. Background
Janssen was 51 years old when she filed her applications for SSI. AR 81. Janssen claimed
that the following severe impairments prevented her from securing and maintaining competitive
employment: depression, anxiety, back problems, and kidney problems. AR 81–82, 187. Janssen did
not have any past relevant work experience, and only identified previously working as a funeral
home telemarketer. AR 90, 188, 204. Janssen had a kidney transplant in 2004. See AR 187. On
October 18, 2016, Jannsen passed away and a motion for substitution of Plaintiff was granted by this
Court on November 4, 2016. See ECF Nos. 7, 10.
B. Medical Evidence
1. Physical Impairments
On June 11, 2013, Janssen met her primary care physician Steven Sumey, M.D. complaining
of low back pain after slipping in the kitchen. AR 303. During her visit, Dr. Sumey advised Janssen
to apply topical heat and do physical therapy at home. Id. Janssen visited podiatrist Richard Erbest,
DPM, on August 20, 2013, complaining of bilateral painful toes. AR 261. Dr. Erbes diagnosed
Janssen with bilateral hammertoes and severe osteoporosis, and told her to obtain a follow-up after
getting a bone density scan. AR 263.
2
Between January and May of 2014, Janssen received treatment for bilateral shoulder pain.
AR 519–25. On January 9, 2014, Janssen visited Dr. Sumey at the SMART Clinic for a refill of her
pain medication. AR 519. It was noted during her visit that, other than her bilateral shoulder pain,
Janssen had no new problems, and was generally feeling well. Id. Janssen visited Dr. Sumey again
on February 6, 2014, and March 6, 2014, complaining of shoulder pain. AR 521–23. During each
visit, Dr. Sumey refilled Janssen’s medication, and noted that she was generally feeling well. Id.
On August 29, 2014, Janssen visited the FA Fairmont Hospital Emergency Department
complaining of general weakness, and fatigue. AR 401. Janssen was diagnosed with a urinary tract
infection with sepsis and cystitis. AR 406. During her visit, a CT scan revealed large pericardial
effusion, and Janssen was transferred to St. Mary’s Rochester for tertiary care. AR 407. On
September 4, 2014, Janssen visited the FA Fairmont Hospital with dull abdominal pain and
symptoms of nausea and vomiting. AR 418–43. Urinalysis was conducted on Janssen which showed
no signs of infection, and she was discharged with a prescription for potassium. Id. On January 22,
2015 Janssen again visited FA Fairmont Hospital for abdominal pain. AR 453. Janssen was given
pain and nausea medication and discharged on the same day. Id. Janssen returned to the hospital on
January 26, 2015, with moderate abdominal pain which she stated began six days prior. AR 348.
Due to an abnormal EKG, Janssen was transferred to the coronary care unit at Mayo Clinic. AR 386.
On January 29, 2015, however, Janssen was discharged and assessed as asymptomatic. Id.
On February 2, 2015, Janssen visited Courtney Keith, M.D., complaining of her legs jumping
at night causing her difficulty in sleeping. AR 503. Janssen expressed no symptoms of epigastric
pain, shortness of breath, or chest pain. Id. Dr. Keith encouraged Janssen to increase her hydration,
and use of heat and massage for her muscle spasms. AR 504.
3
On February 5, 2015, Dr. Keith diagnosed Janssen with depression, coronary artery disease
with stenting, diabetes, hypertension, hyperlipidemia, and status post kidney transplant. AR 505. Dr.
Keith opined that Janssen’s conditions were lifelong and that she would not be able to perform any
employment in the foreseeable future. Id. Dr. Keith also completed a Medical Source Statement on
March 11, 2015, providing that Janssen was able to lift less than 10 pounds, and stand and walk less
than 2 hours in a 8 hour day, and that Janssen would need to periodically alternate between sitting,
standing, and walking. AR 515. Dr. Keith also opined that Janssen required care for walking, and
could not kneel, crawl, or crouch. AR 517. Janssen would also be absent from work more than three
times a month. Id. According to Dr. Keith, these limitations were due to Janssen’s chronic kidney
disease, status post kidney transplant, hypertension, low back pain (degenerative disc disease),
depression, coronary artery disease, and diabetes. AR 515.
2. Mental Impairments
In her own self-assessment Janssen provided that she suffered from depression and anxiety.
AR 187.
On November 11, 2013, Psychologist, Mark Anderson, P.H.D., completed a Medical Source
Statement for Janssen opining on her residual function capacity. AR 292–95. Dr. Anderson
diagnosed Janssen with major depressive disorder, recurrent, moderate, social isolation and
unemployment. AR 292. Dr. Anderson opined that Janssen’s limitations would likely produce good
and bad days, and that she would be able to manage benefits on her own best interest. AR 295. He
opined that she suffered from extreme limitations in her ability to carry out detailed instructions, as
well as to accept instructions and appropriately respond to criticism. AR 293. Additionally, Dr.
Anderson opined that Janssen had marked limitations in her ability to understand and remember
4
short and simple instructions, maintain attention and concentration, tolerate normal levels of stress,
and complete a normal work day. Id. Dr. Anderson gave Jannsen a Global Assessment of
Functioning overall score of 55. AR 292.
On August 25, 2014, Brandon Scott Dugan, Pys.D., also completed a Medical Source
Statement opinion on Janssen’s residual function capacity. AR 307–10. Dr. Dugan’s prognosis of
Janssen was guaraded. Id. at 307. He opined that the physical impairments or medical conditions that
were contributing to or causing Janssen’s mental health limitations were: obesity, kidney
failure/transplant, and chronic pain. Id. Specifically, Dr. Dugan opined that Janssen had little or no
limitation in remembering location, understanding simple instruction, carrying out detailed
instructions, sustaining an ordinary routine without special provisions, making simple work-related
decisions, interacting appropriately with the general public, asking simple questions or requesting
assistance, being aware of normal hazards, and taking appropriate precautions. AR 308. Dr. Dugan
found that Janssen had moderate limitation in maintaining attention and concentration for more than
two-hour segments, working in coordination with others, getting along with coworkers, accepting
instruction, maintaining socially appropriate behavior, responding appropriately to change in the
work setting, traveling to unfamiliar places or using public transporation, and setting realistic goals.
Id. Dr. Dugan opined that Janssen had serious limitations in performing routine activities,
maintaining a regular schedule, completing a work day without interruption, and tolerating normal
levels of stress. Id.
Russel J. Ludeke, Ph. D., L.P., and Ray M. Conroe, Ph. D., L.P., non-examining state-agency
psychological consultants, also opined on Janssen’s residual functional capacity. See AR 87–90,
102–105. Dr. Ludeke opined that Janssen had no significant limitation in her ability to remember
5
locations and work-like procedures, understand and remember short and simple instructions, carry
out detailed instructions, maintain a schedule and be punctual, work in proximity with others, make
simple work-related decisions, ask simple questions, get along with co-workers, maintain socially
appropriate behavior, travel in unfamiliar places, and set realistic goals. AR 87–89. Dr. Ludeke
found that Janssen had only moderate limitation in being able to understand and remember detailed
instructions, interact appropriately with the general public, and respond appropriately to changes in
a work-setting. Id. Dr. Ludeke further opined that Janssen retained sufficient mental capacity to
concentrate on, understand, and remember routine instructions, but that her ability to deal with coworkers on an ongoing basis and handle stress and pressure at work was reduced. AR 89–90.
Dr. Conroe opined that Janssen was not significantly limited in her ability to remember
locations and work-like procedures, understand and remember short and simple instructions, carry
out detailed instructions, maintain a schedule and be punctual, sustain an ordinary schedule, work
in coordination with others, make simple work-related decisions, ask simple questions, accept
instructions and respond appropriately to criticism from supervisors, get along with coworkers,
maintain socially appropriate behavior, be aware of normal hazards and take appropriate
precautions, travel in unfamiliar places, and set realistic goals. AR 103–104. Dr. Conroe found that
Janssen was moderately limited in her ability to understand and remember detailed instructions,
maintain attention and concentrate for extended periods, complete a normal workday without
interruptions, and interact appropriately with the general public. Id. Dr. Conroe opined that while
Janssen had retained sufficient mental capacity to concentrate on, understand, and remember routine
repetitive instruction and carry out routine step tasks, her ability to deal with coworkers, and handle
stress and pressure was reduced. AR 104.
6
C. The Commissioner’s Decision
On May 26, 2015, the ALJ issued a decision denying Janssen’s request for benefits. AR
10–23. In his determination that Janssen was not disabled, the ALJ followed the five-step sequential
process established by the Social Security Administration (“SSA”), outlined in 20 C.F.R. §§
404.1520 and 416.920(a).
The first step in the sequential evaluation is to consider the claimant’s work history to
determine whether she has engaged in substantial gainful activity. See 20 C.F.R. §§ 404.1520(b),
416.920(b). If the claimant has performed substantial gainful activity, she is not disabled. Id. At step
one, the ALJ found that Janssen had not engaged in substantial gainful activity during the period of
her alleged disability. AR 10–12.
The second step in the sequential evaluation is to determine whether the claimant has a
severe impairment that significantly limits her physical or mental ability to do basic work activities.
See 20 C.F.R. §§ 404.1520(c), 416.920(c). For the purpose of satisfying the regulations, “severe”
impairments are those that significantly limit an individual’s ability to perform basic work activities.
20 C.F.R. § 404.1509. At step two, the ALJ found that Janssen had the following severe
impairments: major depressive disorder, recurrent, moderate, and posttraumatic stress disorder.1 AR
12. In making this determination, the ALJ considered the opinions of Charles T. Grant, M.D., and
Gregory H. Salmi, M.D., the non-examining state agency medical consultants, Janssen’s treating
physicians Brandon Scott Dugary, P.H.D. and Keith Courtney M.D., as well as Janssen’s treating
1
Janssen does not allege any error regarding the ALJ’s determination of these disabilities.
Therefore, the Court adopts the ALJ’s factual findings as to these impairments and does not
reiterate them in its statement of facts.
7
medical records and evidence. AR 12–15. The ALJ found that while Janssen had a urinary tract
infection and received treatment for a bilateral shoulder pain, that neither condition caused her morethan-minimal limitations for a continuous period of at least 12 months. AR 13. Additionally, the ALJ
accorded little evidentiary weight to Dr. Keith’s opinions regarding Janssen’s back pain, diabetes
mellitus, hypertension, and hyperlipidemia, finding that these opinions were not consistent with the
evidence taken as a whole. AR 14–15.
The third step in the sequential evaluation requires the ALJ to determine whether the
claimant has an impairment that meets or equals one of the listings in 20 C.F.R. Part 404, Subpart
P, Appendix 1. 20 C.F.R. §§ 404.1520(d), .1525, .1526; 416.920(d), .925, .926. At step three, the
ALJ determined that Janssen did not have an impairment or combination of impairments that met
or medically equaled one of the listed impairments in Appendix 1. AR 15–16.
Where the ALJ determines that a claimant’s impairments do not meet or equal one of the
listings in Appendix 1, then the ALJ must make an assessment of the claimant’s residual functional
capacity (“RFC”). An individual’s RFC is her ability to do physical and mental work activities on
a sustained basis despite limitations from her impairments. Here, the ALJ concluded that Janssen
had an RFC to:
[P]erform a range of work at all exertional levels, albeit with all of the following
non-exertional limitations: she can concentrate on, understand and remember routine
and repetitive instructions; she can carry out routine and repetitive 3- and 4-step
tasks with adequate persistence and pace; she can handle superficial contact with
coworkers, not sustained, close contact with coworkers; and she can handle stress
associated with 3- and 4-step limited detail work, not multi-detailed or complex
work.
AR 16–17. In making this determination, the ALJ “considered all symptoms and the extent to which
these symptoms can reasonably be accepted as consistent with the objective medical evidence and
8
other evidence” as well as opinion evidence. AR 17. The ALJ found “although [Janssen]’s medically
determinable impairments reasonably could be expected to cause the alleged symptoms, [Janssen]’s
representations, concerning the intensity, persistence, and functionally limiting effects of the
symptoms alleged, are not credible because they are not generally consistent with evidence overall.”
AR 18. The ALJ specifically found that Dr. Ludeke and Dr. Conroe found that Janssen “had a
mental residual functional capacity to concentrate on, understand, remember, and carry out routine
and repetitive 3-to-4 step instructions and tasks, handle supervision contact with coworkers, and
tolerate the routine stressors of a routine and repetitive 3-4 step limited detail work setting.” Id.
Further, the ALJ found that their opinions were generally consistent with the evidence overall,
including Janssen’s adult function reports, as well as her treating medical records. Id.
In the fourth and fifth steps of the sequential evaluation process, the ALJ must determine
whether the claimant has the RFC to perform either her past relevant work or any other jobs that
exist in significant numbers in the national economy. See 20 C.F.R. §§ 404.1520(f)–(g), .1560(b),
.1565; 416.920(f)–(g), .960(b), .965. If the ALJ determines that the claimant can still perform her
past relevant work, the ALJ will find that the claimant is not disabled. If the claimant cannot perform
her past relevant work, then the “burden of proof to the Commissioner to prove, first, that the
claimant retains the [RFC] to perform other kinds of work, and, second, that other such work exists
in substantial numbers in the national economy.” Nevland v. Apfel, 204 F.3d 853, 856 (8th Cir.
2000).
At step four, the ALJ found that Janssen had no past relevant work. AR 21. The ALJ,
however, at step five, determined that there were jobs that exist in significant numbers in the
regional economy that a person with Janssen’s RFC could perform. AR 22. Specifically, Janssen was
9
able to perform work such as a laundry folder, agricultural produce sorter, and hand bander. Id. This
was based on the VE’s testimony, which the ALJ found consistent with the information contained
in the Dictionary of Occupational Titles (“DOT”). Id. Based on the ALJ’s findings at step five that
there were other adequate jobs available to Janssen, the ALJ denied Janssen’s application for SSI,
and found that Janssen was not under a disability at any time from her alleged onset date through
the date of the hearing. AR 22–23.
III. STANDARD OF REVIEW
Congress has prescribed the standards by which Social Security disability benefits may be
awarded. “Disability” under the Social Security Act means the “inability 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). “An individual shall be
determined to be under a disability only if his physical or mental impairment or impairments are of
such severity that he is not only unable to do his previous work but cannot, considering his age,
education, and work experience, engage in any other kind of substantial gainful work which exists
in the national economy.” Id. § 423(d)(2)(A).
Judicial review of the final decision of the Commissioner is restricted to a determination of
whether the decision is supported by substantial evidence in the record as a whole. See 42 U.S.C.
§ 405(g); see also Qualls v. Apfel, 158 F.3d 425, 427 (8th Cir. 1998); Gallus v. Callahan, 117 F.3d
1061, 1063 (8th Cir. 1997); Wilson v. Sullivan, 886 F.2d 172, 175 (8th Cir. 1989). Substantial
evidence means more than a mere scintilla; it means “such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971)
10
(quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 220 (1938) (quotations omitted)). In
determining whether evidence is substantial, a court must also consider whatever is in the record that
fairly detracts from its weight. See Warburton v. Apfel, 188 F.3d 1047, 1050 (8th Cir. 1999); see also
Cruse v. Bowen, 867 F.2d 1183, 1184 (8th Cir. 1989) (citing Universal Camera Corp. v. NLRB., 340
U.S. 474, 488 (1951)).
A court, however, may not reverse merely because substantial evidence would have
supported an opposite decision. See Roberts v. Apfel, 222 F.3d 466, 468 (8th Cir. 2000); see also
Gaddis v. Chater, 76 F.3d 893, 895 (8th Cir. 1996). “As long as substantial evidence in the record
supports the Commissioner’s decision, we may not reverse it because substantial evidence exists in
the record that would have supported a contrary outcome . . . or because we would have decided the
case differently.” Roberts, 222 F.3d at 468 (citing Craig v. Apfel, 212 F.3d 433, 436 (8th Cir. 2000);
Woolf v. Shalala, 3 F.3d 1210, 1213 (8th Cir. 1993)). “Substantial evidence is less than a
preponderance, but is enough that a reasonable mind would find it adequate to support the
Commissioner’s conclusion.” Id. Therefore, this Court’s review of the ALJ’s factual determinations
is deferential, and we neither re-weigh the evidence, nor review the factual record de novo. See
Flynn v. Chater, 107 F.3d 617, 620 (8th Cir. 1997); Roe v. Chater, 92 F.3d 672, 675 (8th Cir. 1996).
The Court must “defer heavily to the findings and conclusions of the SSA.” Howard v. Massanari,
255 F.3d 577, 581 (8th Cir. 2001).
IV. CONCLUSIONS OF LAW
In challenging the ALJ’s decision, Janssen argues that the ALJ erred by: (1) finding that
Janssen’s physical impairments did not meet the Agency’s step 2 “severe” standard; and (2) failed
11
to consider the medical opinions of Drs. Anderson and Dugan consistent with regulations, Agency
policy, and Eighth Circuit precedent. See, e.g., ECF No. 17.
A.
Substantial evidence supports the ALJ’s determination that Janssen’s physical
impairments were non-severe.
As discussed above, the ALJ must determine at step two of the sequential evaluation process
“whether the claimant has an impairment or combination of impairments that significantly limits the
claimant’s ability to perform basic work activities.” Page v. Astrue, 484 F.3d 1040, 1043 (8th Cir.
2007); accord 20 C.F.R. §§ 404.1520(a)(4)(ii), 404.1521, 416.920(a)(4)(ii). The claimant bears the
burden of demonstrating that her impairment is severe. See Kirby v. Astrue, 500 F.3d 705, 707 (8th
Cir. 2007). Here, the ALJ concluded that Janssen suffered from the following severe impairments:
major depressive disorder, recurrent, moderate, and post-traumatic stress disorder. AR 12. Plaintiff
argues that the ALJ erred in finding that Janssen’s physical impairments did not meet the de minimis
threshold standard at step two. See ECF No. 17 at 5–9. Specifically, Plaintiff asserts that the
Agency’s consultants did not have access to Janssen’s full medical records, which includes the
opinions of Janssen’s treating physician, who diagnosed her with chronic kidney disease,
hypertension, low back pain (degenerative disc disease), and type II diabetes. Id. at 12. Plaintiff
further argues that the ALJ failed to account for all of Janssen’s impairments in the RFC finding
leading to a failure to present any physical limitations to the vocational expert and resulting in
Janssen being denied benefits. Id. at 13–15. The Commissioner argues that the ALJ properly
concluded that Janssen’s physical impairments were non-severe, and assuming an error was made,
the error was harmless. See, e.g., ECF No. 20.
In making his determination, the ALJ considered Janssen’s documented physical
impairments, which included osteoporosis in her feet, hammertoes, acute lumbar sprain, bilateral
12
shoulder pain associated with bursitis, urinary tract infection, and her past medical history associated
with her renal transplant. AR 12–15. The ALJ found that these physical impairments considered
together or in combination, did not cause her more-than-minimal limitations in basic work-related
functioning for a continuous period of at least 12 months. AR 12. Plaintiff does not dispute the
Agency’s non-examining medical consultants’ findings, but instead argues that their opinions should
be discounted because they did not have access to Janssen’s full medical records. ECF No. 17 at
11–15. According to Plaintiff, Dr. Keith’s opinions demonstrate that Janssen’s physical impairments
were severe as to meet the de minimis threshold at step two. Id. at 14. Plaintiff, however, fails to cite
to any physical impairments in Janssen’s medical records, not considered by the ALJ or the agency’s
non-examining medical consultants, whereby it was concluded that the impairment singularly, or
in combination with others, would have more-than-minimally limited Janssen’s basic work-related
functions. To the contrary, the Court finds that substantial evidence existed in the record to support
the ALJ’s determination that Janssen’s physical impairments were not severe.
Further, even if we were to assume that the ALJ erred in his determination that Janssen’s
physical impairments were non-severe, the error is harmless. Had the ALJ denied Janssen’s claim
for benefits at step two, the ALJ’s impairment determination could be reviewed. However, at step
two, the ALJ found at least one severe impairment, and proceeded to step three. See AR 12–15.
In addition, the Court notes that the ALJ considered the entirety of the record in fashioning
Janssen’s RFC. AR 10–23 ; see also 20 C.F.R. §§ 404.1520(e), 404.1545, 416.920(e), 416.945.
Plaintiff argues Drs. Anderson and Dugan established a far greater, and more detailed limitation,
than are accounted for in the ALJ’s mental RFC findings, and satisfies Janssen’s burden of proof in
demonstrating that she is disabled. ECF No. 17 at 20. An ALJ’s RFC determination should be based
13
on all of the evidence in the record, including “the medical records, observations of treating
physicians and others, and an individual’s own description of his limitations.” Krogmeier v.
Barnhart, 294 F.3d 1019, 1024 (8th Cir. 2002). An ALJ “bears the primary responsibility for
assessing a claimant’s [RFC] based on all the relevant evidence[,] . . . [but] a claimant’s [RFC] is
a medical question” that requires “[s]ome medical evidence” in support. Lauer v. Apfel, 245 F.3d
700, 703 (8th Cir. 2001). Here, the record shows that the ALJ’s RFC determination included, at
minimum, some medical evidence. This Court’s review of the ALJ’s factual determination is
deferential, and it neither re-weighs the evidence, reviews the factual record de novo, see Flynn v.
Chater, 107 F.3d 617, 620 (8th Cir. 1997), nor reverses when an ALJ’s decision falls within a
reasonable “zone of choice.” Hacker v. Barnhart, 459 F.3d 934, 936 (8th Cir. 2006). If the ALJ’s
decision is supported by substantial evidence on the record, this Court cannot reverse simply
“because substantial evidence exists in the record that would have supported a contrary outcome
. . . or because we would have decided the case differently.” Roberts, 222 F.3d at 468. Because the
ALJ’s RFC determination relied on a sufficient examination of the record, the Court concludes that
substantial evidence exists to support the ALJ’s RFC determination. See id.
B.
The ALJ provided good reasons for giving limited weight to Dr. Anderson’s and Dr.
Dugan’s opinions.
Generally, a “treating physician's opinion is entitled to controlling weight,” so long as it is
“supported by medically acceptable techniques and is not inconsistent with substantial evidence in
the record.” Julin v. Colvin, 826 F.3d 1082, 1088 (8th Cir. 2016) (citing Hamilton v. Astrue, 518
F.3d 607, 610 (8th Cir. 2008)). If, however, the treating physician’s opinion “is not given controlling
weight, then the ALJ must review various factors to determine how much weight is appropriate.”
Id. (citing 20 C.F.R. § 416.927(c)). These factors include (i) the examining relationship, (ii)
14
treatment relationship, (iii) supportability, (iv) consistency, (v) specialization, and (vi) other factors.
See 20 C.F.R. § 416.927(c). Opinions of treating physicians . . . may be given limited weight if they
are . . . inconsistent with the record.” Id. (citing Papesh v. Colvin, 786 F.3d 1126, 1132 (8th Cir.
2015)). Additionally, “a treating physician’s opinion does not deserve controlling weight when it
is nothing more than a conclusory statement.” Hamilton, 518 F.3d at 610 (citing Piepgras v. Chater,
76 F.3d 233, 236 (8th Cir.1996)).
Plaintiff argues that the ALJ erred by failing to properly analyze the medical opinions of Drs.
Anderson and Dugan. See ECF No. 9–22. A treating physician’s opinion is generally entitled to
greater or controlling weight in an RFC assessment. See 20 C.F.R. § 404.1527(c)(2). The rationale
is that a physician who regularly interacts with a patient tends to have a more complete and thorough
understanding of the patient’s medical condition, than would a consulting or examining physician.
See Thomas v. Sullivan, 928 F.2d 255, 259 (8th Cir. 1991). However, that entitlement is not
absolute. See Bentley v. Shalala, 52 F.3d 784, 785–86 (8th Cir. 1995). “A treating physician’s
opinion regarding an applicant’s impairment will be granted controlling weight, provided the
opinion is well-supported by medically acceptable clinical and laboratory diagnostic techniques and
is not inconsistent with other substantial evidence on the record.” Hamilton, 518 F.3d at 610.
Here, the ALJ provided sufficient reasons for assigning little evidentiary weight to Drs.
Anderson and Dugary’s opinions; finding that they were inconsistent with Janssen’s own function
reports, each other, and the record as a whole. See, e.g., Gaddis, 76 F.3d at 895 (concluding that an
ALJ may assign lower weight to a treating physician’s opinion if the record as a whole is
inconsistent with the treating physician’s findings). For example, the ALJ gave little weight to Dr.
Anderson’s opinion because it was overall inconsistent with Dr. Anderson’s own finding of a GAF
15
score of 55. See AR 16, 292–295. While Dr. Anderson found that Janssen had major limitations in
carrying out detailed instructions, appropriately to criticism from supervisors, and marked
limitations in understanding simple instructions, maintaining attention, and completing a normal
work day, AR 293, as the ALJ noted, a GAF score of 55 is generally consistent with moderate
symptoms or limitations in functioning. AR 16. Further, the ALJ found that Dr. Anderson’s and Dr.
Dugan’s assessments were inconsistent with each other. While Dr. Anderson opined that Janssen
has marked limitations in her ability to understand and follow simple instructions and extreme
limitations in her ability to carry out detailed instructions, AR 293, Dr. Dugan opined that Janssen
had only mild or no limitation in Janssen’s ability to understand and remember detailed instructions,
and no limitations in her ability to carry out detailed instructions. Id. Further, the ALJ found that
their opinions were inconsistent with Janssen’s own function report, which provided that she lived
alone with her husband in an apartment, had no problem dressing, bathing, caring for herself, and
went grocery shopping once a month for two to three hours. AR 217–224. The ALJ found that this
was more consistent with the opinions of the state agency psychologists Drs. Russell Ludeke and
Ray Conroe. Drs. Ludeke and Conroe opined that Janssen had no significant limitations on her
ability to remember locations and understand simple instructions, and only had moderately limited
ability to maintain attention and concentrate for extended periods of time. AR 87– 89.
Even if the Court was to find that the ALJ should have given Drs. Anderson and Dugan’s
opinions controlling weight under the guidelines, any error the ALJ may have made was harmless
as Plaintiff has not presented any evidence that but for this error, the ALJ would have decided
Janssen could not perform sedentary work. See Byes v. Astrue, 687 F.3d 913, 917 (8th Cir. 2012)
(“To show an error was not harmless, [the claimant] must provide some indication that the ALJ
16
would have decided differently if the error had not occurred.”). After reviewing the ALJ’s opinion,
it is clear to the Court that the ALJ found the opinions of Dr. Anderson and Dr. Dugan were
inconsistent with the record as a whole. It is well established in the Eighth Circuit that “an ALJ may
grant less weight to a treating physician’s opinion when that opinion conflicts with other substantial
medical evidence contained within the record.” Prosch v. Apfel, 201 F.3d 1010, 1013–14 (8th Cir.
2000). Plaintiff has not met his burden to show that had the ALJ given Dr. Anderson’s and Dr.
Dugan’s opinions controlling weight, the ALJ would have made a different RFC determination.
V. CONCLUSION AND ORDER
If the ALJ’s decision is supported by substantial evidence on the record, this Court cannot
reverse simply “because substantial evidence exists in the record that would have supported a
contrary outcome . . . or because we would have decided the case differently.” Roberts, 222 F.3d at
468. Here, substantial evidence supports the ALJ’s determination that Janssen was not disabled.
Based upon all of the files, records, and proceedings herein, IT IS HEREBY ORDERED
that:
1. Plaintiff’s Motion for Summary Judgment (ECF No. 16) is DENIED;
2. Defendant’s Motion for Summary Judgment (ECF No. 18) is GRANTED;
3. The Commissioner’s decision is AFFIRMED and the case is DISMISSED WITH
PREJUDICE.
LET JUDGMENT BE ENTERED ACCORDINGLY
DATED: March 22, 2018
s/Franklin L. Noel
FRANKLIN L. NOEL
United States Magistrate Judge
17
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?