COLEMAN V. COLVIN
Filing
15
MEMORANDUM OPINION AND RECOMMENDATION OF UNITED STATES MAGISTRATE JUDGE signed by MAG/JUDGE JOE L. WEBSTER on 8/9/2016; RECOMMENDS that Plaintiff's Motion for Summary Judgment (Docket Entry 11 ) be DENIED, Defendant's Motion for Judgment on the Pleadings (Docket Entry 13 ) be GRANTED, and the final decision of the Commissioner be upheld. (Sheets, Jamie)
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF NORTH CAROLINA
GARY RAY COLEMAN,
Plaintiff,
v
CAROLYN W. COLVIN,
Acting Commissioner of Social
Security,
Defendant.
)
)
)
)
)
)
)
)
)
)
)
)
t15CV751
MEMORANDUM OPINION AND RECOMMENDATION
OF UNITED STATES MAGISTRATE JUDGE
Plaintiff, Gary Ray Coleman, brought this action pursuant to Section 205(9) of the
Social Security Â,ct (the "Act"), as amended (42 U.S.C. S 405(Ð), to obtain review of a ftnal
decision of the Commissioner of Social Security denying his claims for a Period of Disability
("POD") and Disability Insurance Benefits ("DIB") under Title II of the r\ct. The Court
has
before it the certified administrative record and cross-motions for judgment.
I.
PROCEDURAL HISTORY
Plaintiff filed an application for a POD and DIB in August of 20'12 alleging
a
disabilìty
onset date of March 18, 20L0,later amended to March 29, 201,1,. Qr.34, 152-58.)1 The
'Iranscript citations refer to the Administrative Transcript of Record filed manually with the
Commissioner's r{.nswer. (Docket Entry 8.)
1
application was denied initially and again upon reconsideration.
(d.
Plaintiff then requested a hearing before an ,{.dministrative Law Judge
107.) At the May 1,2,
("VE"). (ld. at30.)
^t
'11,-24.) On Augus
201,4 heanng were
at 69-92, 96-'104.)
(',\LJ").
(Id. at 1,05-
Plaintiff, her attorney, and a vocational expert
The ALJ determined that Plaintiff was not disabled under the
t
Act.
(Id.
25, 201,5 the -Appeals Council denied PlaintifFs request for review,
making the ALJ's determination the Commissioner's fìnal decision for purposes of review.
(d. at 1,-5.)
rr.
r¡òtunr nncrcnouNo
Plaintiff was 56 years old onJune 30,2013, the date last insured. (fd. at13,23.)
FIe
had at least a high school education, was able to communicate in English, and his past relevant
work was
as a
conractor and floor
III.
layer (Id. at23.)
STANDARD FOR REVIEW
The Commissioner held that Plaintiff was not under a disability within the meaning
the
,{,ct. Under 42 U.S.C.
$ 405(9), the scope
of
of judicial review of the Commissioner's final
decision is specifìc and narrow. Smith u. Schweiker,795y.2d343,345 (4th Cir. 1986). T'his
Court's review of that decision is limited to determining whether there is substantial evidence
in the record to support the Commissioner's decision. 42 U.S.C.
$ a05(g); Hanter u. Salliuan,
993 tr.2d 31, 34 (4th Cir. 1992); Hayt u. Salliuan, 907 F.2d 1453, 1.456 (4th Cir. 1990).
Substantial evidence is "such televant evidence as a reasonable mind might accept as adequate
to support
a
conclusion." Hanter,gg3F.2dat34 (ciingMchardson
2
u. Pera/e4402
U.S. 389,401
(1,971)).
It
"consists
of mote than a mere scintilla" "but may be somewhat less than
preponderànce." 1/. (quotingl,aws
u. Celebreq7g,368tr.2d
The Cc¡mmissionet must make findings
of
.fchweiker,
795 tr.2d
^t
345. In
640,642 (4th Cir. 1,966)).
fact and resolve conflicts in the evidence.
Ha1s,907 F.2d at 1456 (ciang King u. Califàno, 599 F.2d
does not conduct a de nouo review
597
,
599 (4th
Cir. 1979)). The Court
of the evidence nor of the Commissioner's
reviewing
for
a
findings.
substantial evidence, the Court does not
undertake to re-weigh conflicting eviclence, to make credibility determinations, or to substitute
its judgment for that of the Commissioner. Craig u. Chater, 7 6 F.3d 585, 589 (4th Cir. 1,996)
(citing Hay,907 F.2d at 'i456). "Where conflicting evidence allows reasonable minds to
differ as to whethet a claimant is disabled, the responsibility for that decision falls on the
fCommissioner] (or the [Commissioner's] designate, the,{,LJ)." C*tg,76tr.3d at 589 (quoung
ll/alker u. Bowen,834 F.2d 635,640 (7th Cir. 1987)). The denial of benefits will be reversed
only if no reasonable mind could accept the record as adequate to support the determination.
See
Nchardson u. Pera/es,402 U.S. 389,401, (1,971).
'fhe issue before the Court, therefore, is not
if Plaintiff is disabled, but whether the Commissioner's finding that Plaintiff is not
disabled is
supported by substantial evidence and was reached based upon a correct application of the
televant
law.
See
id,; Cofman u. Bowen,829 F.2d 51,4, 517 (4th Cir. 1,987).
IV.
THE ALJ'S DISCUSSION
The Social Security ltegulations define "disability" for the purpose of obtaining
disability benefits as the "inability to do any substantial gainful activity by reason of any
J
medically determinable physical
ot mental impairment2 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." 20 C.F.R. S 404.1505(a);
definition, a claimant must have
a severe
al¡o 42 U.S.C. S 423(d)(1XA).
see
To meet this
impairment which makes it impossible to do previous
work or any other substantial gainful activity3 that exists in the national economy. 20 C.F'.lì.
S
404.1505(a);
see
al¡o 42 U.S.C. S 423(dX2X,\).
A. The Five-Step Sequential
Analysis
The Commissioner follows a five-step sequential analysis to ascertain whethet the claimant
is disabled, which is set forth in 20 C.F.R.
S
404.1520.
Sæ
Albright
u. Comm'r oJ'Soc. Sec.
Admin.,
't74 F.3d 473,475 n.2 (4th Cir. 1999). The ALJ must determine in sequence:
(1)
Whether the claimant is engaged in substanttal gainful activity
claimant is working).
Q)
If
(2.e.,
whether the
so, the claimant is not disabled and the inquiry ends.
Whether the claimant has a severe impairment.
If not, then the claimant
is not
disabled and the inquiry ends.
(3)
Whether the impairment meets ot equals to medical criteria of 20 C.F.ll., Part
404, Subpart P, Appendix 1, which sets forth a list of impairments thatwarcant a
' A
"physical
or
mental impairment"
is an rmpairment
resulting ftom "^fiatomical,
physiological, or psychological abnotmalities which are clemonstrable by medically acceptable clinical
and labotatory diagnostic techniques." 42 U.S.C. $ 423 (dX3).
3
"substantial gainful activiq" is work that (1) involves performing sþifìcant or productive
physical or mental duties, and (2) is done (or intended) for pay or profìt. 20 C.F.R. $ 404.1510.
4
fìnding of disability without considering vocational criteria.
If
so, the claimant
i¡
disabled and the inquiry is halted.
(4)
Whether the impairment prevents the claimant from performing past relevant
'
work. If not, the claimant
(5)
Whether the claimant is able to perform any other work considering both his
is not disabled and the inquiry is halted.
residual functional capacity ("ltFC") and his vocational abilities.
If
so, the
claimant is not disabled.
20 c.tr.Iì. s 404.1520.
Here, the ,A,LJ first determined that Plaintiff had not engaged in substantial gainful
activity since his amended alleged oriset date of March 29,201,1 through his date last insured
on June 30, 2013. (Tr. at 13.) 'I'he A.LJ next found in step two that PlaintifPs history
pulmonary emboli and history
of
atrial fibrillation were severe impairments.
(Itf.) At
of
step
three, the,A,LJ found that Plaintiff did not have an impairment or combination of impairments
listed in, ot medically equal to, one listed in Appendix
B.
1.
(d. at 19.)
Residual Functional Capacity Determination
The ÂLJ next determined Plaintiffls RFC based on an evaluation of the evidence,
including PlaintifPs testimony and the fìndings
providers. (d. at19-22.)
of
treating and examining health care
Based on the evidence as a whole, the -A.LJ determined that
Plaintiff
retained the lìFC to perform medium work, except that he should also avoid concentrated
exposure to hazardous machinery and heights. (d. at
5
1,9.)
C.
Adiustment to Other Work
T'he claimant bears the initial burden of proving the existence
S
423(dX5); 20 C.F.ll.
S
of a disability. 42 U.S.C.
404.1512; Smirh u. Califàn0,592F.2d 1235,'1236 (4th Cn. 1,979). Once
the claimant has established at step four that he cannot do any work he has done in the past
because
of his severe impairments, the burden shifts to the Commissioner at step fìve to show
that jobs exist
in significant
numbers
in the national economy which the claimant
perform consistent with his RFC, age, education, and past work experience
.
could
Hanter, gg3 F.2d
at 35; I'Vil¡on u. Califano, 617 F.2d 1050, 1053 (4th Cir. 1980).
Flere, the A,LJ found that based on Plaintifls age, education, work experience, and
IìFC, there were jobs that existed in signifìcant numbers in the national economy that he could
perform such as a cleaner of laboratory equipmefit, a counter supply worker, and a porter
bagger.
(k.
at 23-24.) The ALJ then concluded that that Plaintiff was not disabled from
March 29,201.1, the amended alleged onset date, throughJune 30,201.3, the date last insured.
(d. at23-24.)
V.
ANALYSIS
Plaintiff taises two ovedapping contentions.4 First, he contends that the ALJ erred in
concluding that he has the lìFC to perform medium
work.
(Docket Entry
1,2
at3.)
Second,
Plaintiff contends the ALJ failed to give the appropriate weight to the medical opinion of
nurse ptactitionet.
(Id.) Taken together, the gtavamen of
a Because
a
these objections are that the
Plaintiffs claims ovedap, the Court has addressed them in the most logical fashion
for ease of refetence.
6
decision of the ALJ is unsupported by substantial evidence, in large part because the ALJ failed
to appropriately evaluate the medical opinion of a particular nurse practitioner. (d. at 4-9.)
I
The ALJ's Finding that Plaintiff Can Perform Medium Work with
Environmental Limitations Is Supported bv Substantial Evidence.
Plaintiff contends that the ALJ erred in concluding that he can perform medium, rather
than sedentaly,
work.
(Id.
at7.)
This argument is not persuasive.
A claimant's lìFC is the most a claimant can do in a work setting despite the physical
and mental limitations of his impairment and any related symptom (e.¿.,
pain).
See
20 C.F.R.
S404.1545(uXl);¡eeal¡ol-line¡ul)arnltart,453F.3d559,562(4thCir.2006).'l'helìFCincludes
both a "physical exertional or stength limitation" that
sedentalry,
assesses
the claimant's "ability to clo
light, meclium, heavy, or very heavy work," as well as "nonexertional limitations
(mental, sensory or skin impairments)." I-lall u. Ilarri¡,658 F.2d 260, 265 (4th Cir. 1981).
Medium wotk is defìned as "lifting no more than 50 pounds at a time with frequent lifting or
carrying of objects weighing up to 25 pounds." 20 C.F'.R. $ a0a.1567(c). Sedentary work, in
tutn, is defined as "lifting no more than 10 pounds at a time and occasionally lifting or carrying
articles like docket fìles, ledgers, and small
tools. Although a sedentary job is defìned
as one
which involves sitting, a cefiain amount of walking and standing is often necessary in carrying
out job duties." Id. S 404J1567 (a).
Here, in assessing Plaintifls RFC, the ALJ reviewed the medical record.
It
showed
that Plaintiffs impairments responded to treatment and showed further that clinical findings
were generally unremarkable.
(fr.
^t
13-22.) More specifìcally, the ALJ
Plaintifls history of pulmonary emboli and arrial fibrillarion (Id.
7
^t
considered
20-21,.) The ALJ
correctly indicated that Plaintiff experienced bilateral pulmonary emboli in March
of
201.0,
prior to the relevant period. (d. at 20,31,0-11,.) During aMarch 2010 hospitahzaaon for
chest pain, Plaintiff was treated with anticoagulation agents (Coumadin and Lovenox) and
after his chest pain and shortness of breath resolved, Plaintiff reported "feeling
31,0-11,
well."
(td. at
329.) T'heteafter, Plaintiff was maintained on Coumadin. (d. at 276-77.) His
hematologist, Alfred Newman, M.D., documented that PlaintifFs international normalized
rat7o, an indication
of clotting
tendency
of the blood, was mildly sub-therapeutic, and
accordingly, Dr. Newman advised Plaintiff
to stop binge drinking (which could alter the
metabolism of Coumadin) and adjusted his Coumadin dosage. (Id. at20,331-37.)
'l'hereafter, PlaintifFs clinical findings on examination were generally normal. For
example, Plaintiff appeared to be
in no acute distress; his respiratory examination findings
were normal showing notmal respiratory rhythm and effort, clear bteath sounds, and good air
exchange; his cardiovascular examination fìndings were normal
with normal heafi rate and
rhythm, no murmurs or gallops, normal attertalpulses, and no peripheral edema; and his lower
extremity examinations were normal with intact range of motion and no edema. (Id. at 276-
77,279-89,331-36,394.) Plaintiff routinely denied chest pain, shortness of breath, lower
extremiry pain, and swelling.
(d. at 277, 279-80, 281-82, 283-84, 286, 289, 331-36.) A
computed tomography pulmonary angiogram in late 2010 showed no evidence for residual or
recurrent pulmonary emboli. (d. at 20,336,338,397.) Accordingly, pulmonologist Jason
Spiers, M.D., assessed that Plaintiff was "doing well"
I
in connection with this history of
pulmonary emboli and had no underlying cardiopulmonary issues.s (ld. at 394.)
The ALJ also considered Plaintiff
s
history of atrial
fibrillation. In November of 201,0,
prior to the relevant period, Plaintiff developed proximal atrial fìbrillation during an exercise
te
st, which did not require catdioversion and was stabilized
with medication.
Qd.
^t
20,404.)
Theteafter, PlaintifÎs cardiac examinations were normal, and his atial fibrillation was assessed
as stable on
medication. (d. at289,529,533-34.) He appeared fot periodic, routine follow-
up appointments in 2011 (the beginning of the relevant period) and 201.2. Plaintiff denied
shortness
of
breath and chest pain, and his treating sources documented unremarkable
examination fìndings. (d. at 283-290.)
'fhe ALJ also considered the effectiveness of PlaintifFs conservative treatment course
5
The,{,LJ also took into consideration two accidents PlaintifFs had. Ql14,20,22) First,
prior to the relevant time period, in July of 201,0, Plaintiff fell off a lawn ttactor and sustained a lower
extremity hematoma and cellulitis, but diagnostic testing showed no evidence of fracture or cleep vein
thrombosis. (Id. at 14,365-66.) During hospitahzation, PlaintifFs hematoma was aspirated. (d. at
366.) His left lower extremity pain and swelling improved, and he was discharged. (Id, at366.) The
following month, in August of 201,0, l)laintrff reported "feeling pretty good" and denied lower
extremity pain and swelling. (Id. at 335.) ,{t subsequent medical appointments, Plaintiffs lower
extremities were normal with full range of motion and no edema. Qd. at 283-87.) Second, in
F-ebruary of 201,3, Plaintiff was involved in an automobile accident. (Id. at 1,6, 292.) Plaintiff
reported mental symptoms such as lack of concentration and impaired sensation in his left foot. Qd.
at 292-93.),4. computed tomography evaluation of Plaintiffs head was unremarkable, and he was
assessed with post-concussive syndrome. (Id. at 293,306.) A left leg arterial ultrasound showed no
peripheral vascular disease. (Id. at 308.) At follow-up appointments in F'ebruary, Plaintiff had no
swelling in his lower extremities; he had intact sensation in his feet and could discern light touch
although he could not discern blunt or sharp sensations; he had intact deep tendon reflexes and normal
motor strength; and he walked with a normalgait. (Id. at293,296,299.) In March of 2013, Plaintiff
reported that his leg pain was better. (d. at 303.) In June 201 3, Plaintiff had normal range of motion
in his lower extremities, no edema, and intact sensation to light touch þut could not discern blunt
and sharp sensations). (Id. at 533-34.) In July of 201.3, Plaintiff reported being "90o/o back to
normâI," and Nurse Practitionet l7ilson documented a normal physical examination including full
range of motion in his lower extremities, no edema, normal sensation and motor sftength, and intact
deep tendon reflexes and pulses. (d. at 1,6,529.)
9
(Id. at'16-17,21.) For example, PlaintifPs hypertension and hyperlipidemia wete controlled
with medication. (Id. at 276,279,281,283,285,288, 533.) Likewise, PlaintifFs history of
atrial fìbrillation and pulmonary emboli were stable on medication with no reoccurrence of
either, including duting the relevant period for this disability
claim. (Id. at 289,338,
534.)
In addition to Plaintiffs treatment records, the consultative examiner's findings
and
the opinions of the state agency experts offered further support for the ALJ's RFC assessment.
(d. at 2'l-22.) Consultative examiner Vincent Flillman, M.D., whose opinion the ALJ
gave
"great weight," did not document any disabling functional limitations during his evaluation.
(d. at 2'1, 424-27.) llather, Dr. Hillman found that Plaintiff was able to sit, stand, and
ambulate without diffìculty, and found further Plaintiff had, a normal
gait.
(Id. at 426.)
Further, the opinions of the state agency experts, which were given "substantial weight" and
were consistent with the evidence
of record, offered further support for the .{LJ's
assessment that Plaintìff could perform meclium work with environmental
^t22,71-78,80-90.)
See
RFC
limitations.
(Id.
20 C.tr.R. S 404.1,527 (e)(Z)(i) (explaining that state agency physicians
and psychologists are highly qualifìed and experts in Social Security disability evaluation)
T'he ALJ also considered Plaintiffs activities of daily
living. Fot example, the record
indicated that while he was allegedly disabled, Plaintiff went to his tile installation business and
checked e-mails and took care of business.
(fr.
18-21,35, 41,4.) In addition, Plaintiff went
outside when there was nice weather; he took "walk[s] around and work[ecl] out a little bit";
he prepated meals; he washed laundry; he mowed his lawn with a riding mower; he left his
house once to twice a day; he drove
^
c t; he shopped in stores; he ran etrands; and he went
l0
out to e^t at restaurants
.
(f d.
^t
18-20,228-32, 4'14.) ,All of this ptovides substantial evidence
for the AIJ's RFC determination that Plaintiff could perform
medium work with
environmental limitations
II.
The ALT's Decision to Give No Weisht to Nurse Practitioner Wilson Is
Legally Correct and Supponed by Substantial Evidence.
Plaintiff also contends that the r\LJ's llFC assessment was flawed because he did not
give greater weight to the opinions of I(ristina Wilson, a nurse practitioner. (Docket Entty
12 at
5-9.) This contention also lacks metit.
'I'he treating source rule requires an ALJ to give controlling weight to the opinion of
treating source regarding the nature and severity
404.1,527 (cX2) (
a
of a claimant's impairment. 20 C.F.R. S
"[T]reating sources . . . provide a detailed, longitudinal picture of
[a claimant's]
medical impairment(s) and may bting a unique perspective to the medical evidence that cannot
be obtained from the objective medical fìndings alone or from reports of individual
examinations, such as consultative examinations or brief hospitalizations.").
-I'he
rule also
recognizes, however, that not all treating sources ot treating source opinions merit the same
deference. T'he nature and extent
of
each treatment relationship appteciably tempers the
weight an ALJ affords an opinion.
\'ee
20 C.F.tl.
SS 404.1 527
Moreover, as subsections (2) through (a)
(c)(2)(n).
of the rule describe in
source's opinion, like all medical opinions, deserves deference only
if
detail, a treating
well-supported by
medical signs and laboratory finrlings and consistent with the other substantial evidence in the
case
record.
See
20 C.F.ll.
SS
404.1527
(c)(Z)-(). "[I]f
a
physician's opinion is not supported
by clinical evidence or if it is inconsistent with other substantial evidence, it should be accorded
l1
signifìcantly less
weight." Crai¿,76F.3d
^t
590. As for nurse practitioners in particular, they
do not constitute "acceptable medical sources,"
"other sources,"
¡ee
see
20 C.f,.R. S 404.1513(a)), but rather are
20 C.F.Iì. S 404.1513(d), whose opinions cannot receive controlling
weight, but may be used to "show the severity of . . . impaitment(s) and how [they] affect[]
claimant's] ability to
work."
[a
Id.
Flere, Nurse Practitioner Wilson wrote a letter onJuly 12,2012 stating, "Please excuse
this patient from jury duty for meclical reasons. fPlaintiffl has a history of blood clots [and]
pulmonary embolus. He is tteated with coumadin and therefore should not sit or stay in one
position for any extended period of time. -Iherefore
jury
dury." (I'r.29'1.)
She also
I feel that he is unable to perform on
wtote a short letter on March 20,201,4, stating that Plaintiff
"has been a patient in my practice since 2008. He has numerous medical problems including
atrial fibrillation, anxiety, pulmonary embolism and hypertension. Â.s a result
multiple medical problems, plaintiffl is unable to
work."
of
these
(Id, at 51,6.)
Nutse Ptactitioner Wilson next fìlled out medical source statements on April 22,2014
checking boxes indicating that Plaintiff could only
lift ten pounds, had limitations in sitting
and standing and pushing and pulling, had postural and manipulative limitations, had problems
heating, and had numerous environmental limitations. (d. at 605-608, 617-625,631,-634.)
She also wrote a short letter on May 23,2014, stating
Plaintiff "has multiple medical problems
including a history of fdeep vein thrombosis] in lower extemities. As a result he may need
to use
a
walker to assist with ambulation." (ld. at 635.)
'fhe ALJ accutately recited the applicable regulations for
t2
assessing Nurse Practitioner
\X/ilson's opinions and also discussed these opinions at considerable
22.)
length. (Id. at13-'15,20-
Beyond this, the ,{LJ explained that Nurse Practitioner \ùTilson's opinions were entitled
to no weight because (1) they addressed administrative issues reserved to the Commissioner;
(2) they lacked "supporting evidence or an explanation"; (3) they "rel[yl almost exclusively on
the claimant's subjective reports that are not even consistently documented within her own
treatment notes;" and (4) because they wete "wildly inconsistent with the record as a whole."
(Id.) Fot
the following reasons, these conclusions are supported by substantial evidence.
First, Nurse Practitioner \X/ilson's opinion that Plaintiff is limited to sedentary work
with a number of additional limitations is rendered in a conclusory fashion.
Practitioner \X/ilson provides little-to-no explanation oF the evidence used
Nurse
to form her
opinions, which are set forth either in shott and conclusory letters or in a check box form, and
the record lacks objective medical evidence in support of her conclusory assertions. (d. at
605-608,
61.7
-625, (¡3't-635, 516, 291.)
5.ee
20 C.þ'.11. S 404.1,527 (c)(3) (stating that the better
explanation a source provides for an opinion, the more weight the Commissioner gives that
opinion); Ma¡on u. \'l¡a/a/ø,994 F.2d 1058, 10ó5 (3d Cir. 1993) ("Form reports in which
a
physician's obligation is only to check a box or fìll in a blank are weak evidence at best.").
Instead, as the ALJ noted, Nurse Practitioner Wilson appears to have been relying in large
p^tt, ot perhaps exclusively, on Plaintiffs own self-reporting. (d. zt 13-14.) 20 C.F.R. S
404J,529(a) (claimant's allegations alone are insufficient to establish disability).
Second, Nurse Practitioner Wilson's conclusions are inconsistent with the remainder
of the record, described in detail above, which
l3
indicates that PlaintifPs ailments were
essentiallystableandwell-reated. See llobertsu.Aúraq1:11-cv-00236-MR,201,3WL663306,
*6 flX/.D.N.C. Feb. 22, 201,3) (unpublished) (concluding that "an opinion of a
physician is not entitled to controlling weight
if it
treattng
is unsupported by medically acceptable
clinical and laboratory diagnostic techniques andf or inconsistent with other substantial
evidence of record") (citing 20 C.F'.R. S 404.1527 (.XZ))
Third, Nurse Practitioner Wilson's treatment notes, which the ALJ sctutinized, were
inconsistent with her opinions. Q'r. '13-17 ,20-22.) Specifìcally, Nurse Practitioner \X/ilson's
progress notes documented that Plaintiff's hypertension and hypedipidemia were "doing well"
on medication; his history of alr.tal fibrillation was "stable" on medication; and his pulmonary
emboli was managed on medication. (Id.Ãt 276-80,283-89,533-34.) Moteover, Nurse
Practitioner \X/ilson frequently documented unremarkable physical examinations with normal
respiratory, cardiovascular, and lower extremity findings. (d. at276-80,283-89,533-34,626.)
Fourth, as discussed above, Plaintiff performed
^
mnge
of daily activities, including
some wotk activity, walking, exercising, meal ptepatation, yard work, household chores, and
social activities. 'Ihese activities are inconsistent with Nurse Practitioner Wilson's vague and
unsupported conclusions that Plaintiff could only perform a limited range of sedentary work.
Fifth,
as
noted above, opinions by medical practitioners regarding the ultimate issue
of
whether a plaintiff is disabled within the meaning of the Act nevet receive contolling weight
because the decision
on that issue remains for the Commissioner alone. 20 C.F.ll.
404.'1527(d). Nurse Practitioner Wilson states
Plaintiff is "unable to
work."
(See, e,g.,
in the record in a conclusory fashion
Tr.516.) However, thatis
14
$
that
an issue reserved for the
Commissioner and Nurse Practitioner Wilson's opinion on this issue is entitled to no weight.
Last, PlaintifÎs argums¡¡s-v/þich essentially propose alternative ways to view and
weigh the evidence-on this issue are not persuasive. 'fhe fact that plaintiff disagrees with
the ALJ's assessment of Nurse Practitioner Wilson's conclusions does not render the decision
improper. lìor all these reasons, the,A,LJ's decision to give no weight to the medical opinions
of Nurse Practitioner \X/ilson is supported by substannal evidence.
'lo
summarize, Plaintiff has presented no basis for remand. 'Ihe
AIJ
reviewed and
weighed the evidence of record. 'I'he ,A,LJ also determined an RFC that accounted for his
credibly 6 supported functional limitations.
For the reasons explained above, substantial
evidence supports the,\LJ's decision, and accordingly, his decision should be affirmed.
7
VI. CONCLUSION
After a carcful consideration of the evidence of record, the Court ûnds that
the
ó
l'laintiff does not challenge the ALJ's credibility determination directly, and the Court finds
no error regardingit. See Crai¿,76\t,3dar593-96;20 C.F.lì.. $ 40a.1529(a)-(c); Soc. Sec.lì. 96-7p,
1996 NøL 374186, at *1 n. 1,*2 Çuly 2,1996). The ALJ's credibility analysis also provides further
substantial evidence in support of the llFC determination.
t lrlaintiff also atgues that if
the ALJ had given Nurse Practitioner !Øilson's opinions the
weight they deserwed, he would have had no choice but to find Plaintiff disabled. This is because,
Plaintiff reasons, the VE tesufied that a person with the kinds of limitations Nurse Practitioner líilson
attributed to Plaintiff could not work at any exertional level. (Docket Entry 12 at 7 citing '[r, 66)
However, as explained in detail in this llecommendation, the ALJ had many good reasons for giving
Nurse Practitioner \ùTilson's opinions no weight. Consequently, the VE's answer to a hypothetical
adopting Nurse Practitioner \Wilson's limitatrons is immaterial. See e.g., Johnson u. Commissioner oJ'Social
.Çec.,398 F. App'x 727,735 (3rd Cir.2010) (concluding thatALJ's failure to explain why he did not
consider VE's answer to second hypothetical question, which included work restriction of frequent
breaks, dicl not render his finding defìcient because it was obvious the answer was immaterial once
the ALJ made lìFC determination, which did not include need for frequent breaks); Boynlon u. Apfel,
No. 98-1987, L999 nøL 38091, *4 (7th Ciu- Jan.7,1.999) (unpublished) (concluding that ALJ did not
neecl to explicitly acldress second hypothetical because his findings implicitly rejected the basis for it).
l5
Commissioner's decision
is supported by substantial evidence. Accordingly, this Coutt
RECOMMENDS that Plaintiffs Motion for Summary Judgment (Docket Entry 11)
be
DENIED, Defendant's Motion for Judgment on the Pleadings (Docket Ettt"y 13) be
GRANTED, and the final decision of the Commissioner be upheld.
J
August
q
-,
201,6
l6
ebster
States Magisttate Judge
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