Ruiz-Lopez v. Commissioner of Social Security
Memorandum Opinion and Order affirming the Commissioner's decision (Related document # 1 Complaint). Magistrate Judge Kathleen B. Burke on 12/18/2015. (P,G)
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF OHIO
COMMISSIONER OF SOCIAL
CASE NO. 1:15-cv-00169
KATHLEEN B. BURKE
MEMORANDUM OPINION & ORDER
Plaintiff Yanira Ruiz-Lopez (“Plaintiff” or “Ruiz-Lopez”) seeks judicial review of the
final decision of Defendant Commissioner of Social Security (“Defendant” or “Commissioner”)
denying her applications for social security disability benefits. Doc. 1. This Court has
jurisdiction pursuant to 42 U.S.C. § 405(g). This case is before the undersigned Magistrate
Judge pursuant to the consent of the parties. Doc. 14. As explained more fully below, the Court
AFFIRMS the Commissioner’s decision.
I. Procedural History
Ruiz-Lopez protectively filed applications for Disability Insurance Benefits (“DIB”) and
Supplemental Security Income (“SSI”) on April 21, 2011. 1 Tr. 14, 263-269.
alleged a disability onset date of June 15, 2009. Tr. 14, 263. She alleged disability due to
diabetes, hirsutism, bipolar disorder, mental retardation, ADHD, high blood pressure, depression,
and amenorrhea. Tr. 101, 113, 127, 139, 154, 159, 167, 173, 282. Ruiz-Lopez’s application
was denied initially and upon reconsideration by the state agency. Tr. 153-161, 166-175.
The Social Security Administration explains that “protective filing date” is “The date you first contact us about
filing for benefits. It may be used to establish an earlier application date than when we receive your signed
application.” http://www.socialsecurity.gov/agency/glossary/ (last visited 12/15/2015).
Thereafter, she requested an administrative hearing. Tr. 181-182. On July 9, 2013,
Administrative Law Judge Eric Westley (“ALJ”) conducted an administrative hearing. Tr. 3796.
In his November 1, 2013, decision, the ALJ determined that Ruiz-Lopez had not been
under a disability at any time between the June 15, 2009, alleged onset date and the date of his
decision. Tr. 8-31. Ruiz-Lopez requested review of the ALJ’s decision by the Appeals Council.
Tr. 6-7. On November 28, 2014, the Appeals Council denied Ruiz-Lopez’s request for review,
making the ALJ’s decision the final decision of the Commissioner. Tr. 1-5.
Personal, vocational and educational evidence
Ruiz-Lopez was born in 1985. Tr. 53. She was born in Puerto Rico and moved to Ohio
around 2010-2011. Tr. 56-57. At the time of the hearing, Ruiz-Lopez was residing with a
friend of her mother’s. Tr. 55. Ruiz-Lopez’s mother lived nearby and Ruiz-Lopez saw her
mother daily. Tr. 56-57. During high school, Ruiz-Lopez was in special education classes. Tr.
53. She graduated high school and, after attending cooking school for one year, obtained a
cooking certification. Tr. 53-54. Ruiz-Lopez speaks Spanish. Tr. 1362. She does not speak or
read English. 2 Tr. 54. While in Puerto Rico, Ruiz-Lopez worked with her mother cleaning
homes. Tr. 56. Ruiz-Lopez stopped working because there was no more work for her and
because of her health condition. Tr. 59.
An interpreter was present at the hearing. Tr. 39, 40.
On April 25, 2012, Ruiz-Lopez saw Patricia Grippi, MSN, APRN-B, of Signature Health,
for a psychiatric evaluation. Tr. 1288-1290. Ruiz-Lopez’s case manager, Olga Cardenas, BA,
and Ruiz-Lopez’s mother accompanied her to the evaluation. Tr. 1288. Ruiz-Lopez reported
having severe depression, anger, aggression and some intermittent suicidal ideation. Tr. 1288.
Ruiz-Lopez reported that some of her family remained in Puerto Rico and it was her wish that
the whole family could be together. Tr. 1288. She reported having had suicidal and homicidal
thoughts. Tr. 1288. She stated that “[s]he can hear people mumbling in her ear and at night
sometimes sees a big black face coming at her.” Tr. 1288. At times, Ruiz-Lopez becomes so
angry and aggressive that she has thrown and broken things at home. Tr. 1288. Ruiz-Lopez has
a past history of anorexia between the ages of 15 and 18. Tr. 1288. At the time of the
evaluation, she was obese, weighing 202 pounds. Tr. 1288. Ruiz-Lopez has hirsutism, which
has resulted in a masculine appearance and facial hair. Tr. 1288. Ruiz-Lopez sees an ugly man
when she looks in the mirror which was very upsetting to her. Tr. 1288. She also suffers from
severe diabetes. Tr. 1288. Ruiz-Lopez indicated that she had never been hospitalized
psychiatrically but she had received outpatient treatment on and off since she was 15 years old.
On mental status examination, Ms. Grippi indicated that Ruiz-Lopez was neat and clean;
obese; showed a very constricted demeanor and frightened affect; insisted on sitting next to her
mother and holding on to her for the entire evaluation; spoke no English and understood very
little English; eye contact was fleeting; speech was spontaneous, coherent and relevant as she
provided answers to the interpreter; her thought process was logical; she reported paranoia and
auditory and visual hallucination; and she denied any current suicidal or homicidal ideation, plan
or behaviors. Tr. 1289. Ms. Grippi’s diagnoses included mood disorder, NOS; intermittent
explosive disorder; and mild mental retardation. Tr. 1289. Ms. Grippi assessed a GAF score of
50. 3 Tr. 1290. Ms. Grippi prescribed Seroquel to treat Ruiz-Lopez’s psychosis and difficulty
sleeping. Tr. 1290.
Ruiz-Lopez saw Ms. Grippi on June 6, 2012, for medication management. Tr. 12911292. Ruiz-Lopez attended the visit with her mother who translated for her. Tr. 1291. The
Seroquel was helping Ruiz-Lopez fall asleep but she was not sleeping through the night and
woke up in a bad mood. Tr. 1291. Ruiz-Lopez indicated she had a great amount of anger and
anxiety. Tr. 1291. She was bothered by other people and wanted to hurt them. Tr. 1291. She
was having thoughts of jumping off a balcony. Tr. 1291. Ms. Grippi asked Ruiz-Lopez about a
report that indicated that, while she was in Puerto Rico, she had been taking Risperdal and
Depakote. Tr. 1291. Ruiz-Lopez indicated that she remembered the Depakote helping her with
her anger. Tr. 1291. Ms. Grippi observed that Ruiz-Lopez was calm, pleasant and cooperative
with her. Tr. 1291. She did not exhibit any high anxiety or anger. Tr. 1291. Her eye contact
going back and forth between Ms. Grippi and her mother was fair. Tr. 1291. Ruiz-Lopez
understood some English but spoke in Spanish to her mother. Tr. 1291. Her speech was
spontaneous, coherent and relevant and her thought process appeared logical. Tr. 1291. RuizLopez was able to answer questions clearly. Tr. 1291. She knew her blood sugar numbers and
that her primary care physician had increased her insulin. Tr. 1291. Ruiz-Lopez reported
continued paranoia, believing that people were watching her. Tr. 1291. Her auditory
GAF (Global Assessment of Functioning) considers psychological, social and occupational functioning on a
hypothetical continuum of mental health illnesses. See American Psychiatric Association: Diagnostic & Statistical
Manual of Mental Health Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric
Association, 2000 (“DSM-IV-TR”), at 34. A GAF score between 41 and 50 indicates “serious symptoms (e.g.,
suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in social, occupational,
or school functioning (e.g., few friends, unable to keep a job).” Id. The GAF was removed from DSM-5. See
American Psychiatric Association: Diagnostic & Statistical Manual of Mental Health Disorders, Fifth Edition.
Arlington, VA, American Psychiatric Association, 2013 (“DSM-5”), at 16.
hallucinations had lessened since taking Seroquel. Tr. 1291. Although she continued to see a
big black face coming at her, it was less frequent and less intensive. Tr. 1291. Ms. Grippi’s
diagnoses again included mood disorder, NOS; intermittent explosive disorder; and mild mental
retardation. Tr. 1291. Ms. Grippi increased Ruiz-Lopez’s Seroquel dose and ordered Depakote.
Tr. 1291. Ms. Grippi indicated that, although Ruiz-Lopez was having feelings of anger, she
believed that Ruiz-Lopez was at low risk for suicide or homicide. Tr. 1291.
With her mother present, Ruiz-Lopez saw Ms. Grippi again on July 10, 2012, for
medication management. Tr. 1293-1294. Ruiz-Lopez reported having some abdominal pain.
Tr. 1293. She continued to be restless and was not sleeping for long periods of time but her
anger and anxiety had decreased. Tr. 1293. She was less annoyed by other people and had no
desire to hurt them. Tr. 1293. Ruiz-Lopez and her mother were planning a trip to Puerto Rico
because her brother had been in a car accident. Tr. 1293. Ruiz-Lopez admitted that she was not
compliant with taking her medication. Tr. 1293. Ms. Grippi noted that Ruiz-Lopez was very
calm, pleasant and cooperative and there was no anger or anxiety. Tr. 1293. Ruiz-Lopez smiled
often and was proud of her ability to understand a lot of what Ms. Grippi was saying. Tr. 1293.
Ruiz-Lopez’s eye contact was good. Tr. 1293. She reported less paranoia. Tr. 1293. She did
not believe that people were watching her as much as before. Tr. 1293. Her auditory
hallucinations were almost none and her visual hallucinations had abated. Tr. 1293. Ms. Grippi
again assessed mood disorder, NOS; intermittent explosive disorder; and mild mental
retardation. Tr. 1293-1294. Ms. Grippi indicated that Ruiz-Lopez’s acute and chronic risk of
harm to herself and others was low to moderate and noted that Ruiz-Lopez had improved her
ability to control her temper and decrease her psychotic thinking. Tr. 1294. Ruiz-Lopez was
hopeful about the possibility of more improvement. Tr. 1294. Ms. Grippi increased Ruiz-
Lopez’s Seroquel because she was responding well to the medication. Tr. 1294. Ms. Grippi
recommended discontinuing the Depakote because of the potential that it could cause increased
liver function tests. Tr. 1293-1294.
Following their trip to Puerto Rico, Ruiz-Luiz, with her mother, saw Ms. Grippi on
August 23, 2012. Tr. 1295-1296. Ruiz-Lopez’s mother reported that Ruiz-Lopez had a very
difficult time while in Puerto Rico. Tr. 1295. Ruiz-Lopez had decided not to take her
medication with her so she could see how she would do. Tr. 1295. Ruiz-Lopez’s mood was
terrible and she was fighting with everyone. Tr. 1295. The situation helped Ruiz-Lopez decide
that she really needed her medications. Tr. 1295. Ruiz-Lopez was sleeping well at night with
the Seroquel but her mother indicated that she thought there was a problem because Ruiz-Lopez
did not want to wake up in the morning, which was a problem because Ruiz-Lopez’s primary
care physician wanted Ruiz-Lopez to wake early in the morning to have breakfast and take her
insulin. Tr. 1295. Ruiz-Lopez admitted getting mad and yelling. Tr. 1295. However, she
denied any paranoia; auditory or visual hallucinations; or suicidal or homicidal ideations. Tr.
1295. Ms. Grippi’s diagnoses remained mood disorder, NOS; intermittent explosive disorder;
and mild mental retardation. Tr. 1295. Ms. Grippi assessed Ruiz-Lopez’s acute and chronic risk
of harm to self or others as moderate. Tr. 1295. Ruiz-Lopez was willing to listen to Ms. Grippi
and talk about various ideas for improving her situation. Tr. 1296. Ms. Grippi increased RuizLopez’s Seroquel dose, with the hope that the increased dose would decrease Ruiz-Lopez’s anger
and verbal aggressiveness toward others. Tr. 1296.
In October and November of 2012, Ruiz-Lopez attended therapy sessions with her case
manager, Ms. Cardenas. Tr. 1003-1012. Ms. Cardenas urged Ruiz-Lopez to take more
responsibility and practice independent skills. Tr. 1012. Ruiz-Lopez also met with Mattie
Dramis, M.Ed., LSW, PCC-SUPV, in November 2012 for individual counseling. Tr. 1013.
Ruiz-Lopez indicated that she was hoping to move into her own place at Metro Housing or
Ashtabula Tower. Tr. 1013. At times she felt like she was a bother to the person she was living
with. Tr. 1013. Ruiz-Lopez reported that she was having a hard time with her symptoms. Tr.
1013. She reported that sometimes she was forgetting to take her medication or refusing to take
it because it was too much of a bother. Tr. 1013. Ruiz-Lopez relayed to Ms. Dramis that she felt
that her case manager was pushing her to become more independent but she did not like the
pressure. Tr. 1013. Ruiz-Lopez reported that, when she goes shopping, she is happy and there
are no symptoms. Tr. 1013. Ms. Dramis informed Ruiz-Lopez that keeping busy and doing
things that she liked was a great way to stop dwelling on her symptoms and find relief. Tr. 1013.
Evelyn T. Rivera, Ph.D.
On July 11, 2011, psychologist Evelyn T. Rivera, Ph.D., met with Ruiz-Lopez for the
purpose of conducting a consultative psychological evaluation. Tr. 774-778. The interview was
conducted in Ruiz-Lopez’s native language (Spanish). Tr. 774. Ruiz-Lopez’s mother and a
friend of the family who was a case manager at a mental health agency in Ashtabula, Ohio and
who had been assisting Ruiz-Lopez with obtaining services were present at the evaluation. 4 Tr.
774. The evaluation consisted of a partial clinical interview with the Ruiz-Lopez as well as
interviews with her mother and Ms. Sanchez. Tr. 774. Dr. Rivera indicated that Ruiz-Lopez did
not appear to understand many of her questions so Ruiz-Lopez’s mother and Ms. Sanchez
provided most of the information for the evaluation. Tr. 774. Ruiz-Lopez did not know and
could not explain why she was applying for social security disability. Tr. 774. She did not know
what day of the week it was or where she lived. Tr. 774. Ruiz-Lopez demonstrated a short
The family friend referenced was Ana Sanchez. Tr. 70.
attention span; she had an irritable mood throughout the interview; and she was unable to sit for
more than five minutes. Tr. 774. Her behavior was disruptive and she threatened to hit her
mother during the evaluation. Tr. 774. Ruiz-Lopez reported that she cried all the time and could
not sleep. Tr. 774. Due to Ruiz-Lopez’s disruptive behavior during the interview and her threats
to her mother, Dr. Rivera had to ask Ms. Sanchez to take her outside so that Dr. Rivera could
complete her interview with Ruiz-Lopez’s mother. Tr. 775. Dr. Rivera noted that Ruiz-Lopez’s
mother appeared to be scared of her daughter. Tr. 775. Ruiz-Lopez’s mother had left her
daughter when her daughter was 22 because of her daughter’s aggression. Tr. 776. However,
Ruiz-Lopez was not doing well in Puerto Rico and later came to live with her mother in Ohio.
Ruiz-Lopez’s mother and Ms. Sanchez reported that Ruiz-Lopez had mental health
problems, including ADHA, explosive/aggressive behavior, and bipolar disorder. Tr. 744, 775.
They also indicated that Ruiz-Lopez had been diagnosed with MRDD in first grade. Tr. 774,
775. Dr. Rivera indicated that medical records that were provided showed that Ruiz-Lopez had
been diagnosed with generalized anxiety disorder and borderline intellectual functioning in
November 2004 and major depressive disorder in 2009. Tr. 775. Ruiz-Lopez’s mother reported
that her daughter had not been on medication and had not seen a psychiatrist since moving to
Geneva, Ohio, in September 2010. Tr. 775. Dr. Rivera noted that no psychological testing was
requested or performed during the July 11, 2011, evaluation. Tr. 777.
Dr. Rivera’s mental health diagnoses included explosive intermittent disorder; major
depressive disorder, recurrent, no psychotic features; rule or ADHD; rule out bipolar disorder;
borderline intellectual functioning (previously diagnosed); and rule out mild MRDD. Tr. 777.
Dr. Rivera assessed an overall GAF score of 20. 5 Tr. 777.
Dr. Rivera indicated that Ruiz-Lopez was unable to provide coherent or reliable
information. Tr. 777. Dr. Rivera indicated that both Ruiz-Lopez’s mother and Ms. Sanchez
provided consistent descriptions of Ruiz-Lopez’s behavior when they were interviewed
separately by Dr. Rivera. Tr. 777. Based on her observations and reports from Ruiz-Lopez’s
mother and Ms. Sanchez, Dr. Rivera found that Ruiz-Lopez appeared to demonstrate impulse
control problems; aggressive behavior towards her mother; unprovoked yelling at neighbors and
strangers on the street; and inappropriate sexual touching and language in public. Tr. 777. Dr.
Rivera also found that Ruiz-Lopez appeared to have some serious cognitive limitations, possibly
related to borderline intellectual functioning or mild MRDD and some significant depressive
symptoms (insomnia, transient suicidal ideation, and irritability) indicative of major depressive
disorder. Tr. 777. Ruiz-Lopez was not receiving any psychiatric treatment at the time. Tr. 777.
Dr. Rivera’s functional assessment included her conclusions that (1) Ruiz-Lopez would
be expected to understand and apply instructions in a work setting consistent with borderline to
mild MRDD intellectual functioning, noting that Ruiz-Lopez’s English was limited and at times
her language was incoherent and illogical; (2) Ruiz-Lopez’s mood and behavior would
negatively impact her ability to perform work-related tasks; (3) Ruiz-Lopez would have
difficulty working well with co-workers and supervisors; and (4) Ruiz-Lopez’s cognitive
limitations, disruptive and aggressive behavior, sexually inappropriate language and behavior in
A GAF between 11 and 20 indicates “some danger of hurting self or others (e.g., suicide attempts without clear
expectation of death; frequently violent; manic excitement) or occasionally fails to maintain minimum hygiene (e.g.,
smears feces) or gross impairment in communication (e.g. largely incoherent or mute).” DSM-IV-TR at 34.
public, irritable mood, and inability to control her volatile mood and impulsive behavior would
make it difficult for her to respond appropriately to work pressures in a work setting. Tr. 778.
James Cozy, M.A.
On November 7, 2011, psychologist James Cozy, M.A., 6 completed an Ohio Job &
Family Services’ Mental Functional Capacity Assessment. Tr. 800-801. Mr. Cozy offered his
opinion as to Ruiz-Lopez’s functional abilities in 20 categories, with available rating choices of
“not significantly limited,” “moderately limited,” “markedly limited,” and “not rated.” Tr. 800.
In 2 categories – ability to carry out very short and simple instructions and ability to carry out
detailed instructions – Mr. Cozy rated Ruiz-Lopez moderately limited. Tr. 800. In 3 categories
– ability to ask simple questions or request assistance, ability to respond appropriately to changes
in the work setting, and ability to set realistic goals or make plans independently of others – Mr.
Cozy rated Ruiz-Lopez not significantly limited. Tr. 800. In the remaining 15 categories, Mr.
Cozy rated Ruiz-Lopez markedly limited. Tr. 800. As part of the Mental Functional Capacity
Assessment, a narrative statement was included indicating that Ruiz-Lopez had not been
employed since 2009 because of lack of employment; she demonstrated difficulty interacting
with others and being responsible for being at work on time; and she had poor social skills and
poor memory. Tr. 801.
David V. House, Ph.D.
After the administrative hearing, per the ALJ’s request, on September 12, 2013,
psychologist David V. House, Ph.D., met with Ruiz-Lopez for the purpose of conducting a
consultative psychological evaluation. Tr. 1362-1368. Ruiz-Lopez’s mother accompanied her to
The record is not clear as to the extent of the treatment relationship between Mr. Cozy and Plaintiff.
the evaluation. Tr. 1262. The evaluation was conducted with the assistance of a Spanish
translator. Tr. 1262. Dr. House’s summary and conclusions were as follows:
Based on the information gathered during testing and interview session, it is my
opinion, with reasonable scientific certainty, that Yanira Ruiz Lopez would suffer
from a diagnosis of Autistic Spectrum Disorder. She may be demonstrating some
Asperger’s function. She seems highly limited and is highly socially limited and
has some difficulties with verbal appropriateness. Her condition appears chronic.
Dr. House’s functional assessment included his conclusions that: (1) Ruiz-Lopez was
unable to follow instructions with any real effectiveness; (2) Ruiz-Lopez would be unable to
follow multi-step directions, at least not on a consistent basis; (3) Ruiz-Lopez would be unable to
effectively conduct relationships with a fairly broad range of people, even coworkers or
supervisors; and (4) Ruiz-Lopez seemed to have significant difficulties functioning even in dayto-day activities. Tr. 1367. Dr. House’s diagnosis was autistic spectrum disorder and he
assessed a GAF score of 25. 7 Tr. 1367. He opined that Ruiz-Lopez’s prognosis was poor and
her condition appeared chronic. Tr. 1367.
Also, on September 18, 2013, Dr. House completed a Medical Source Statement of
Ability to Do Work-Related Activities (Mental) (“MSS”). Tr. 1359-1361. In the MSS, Dr.
House rated Ruiz-Lopez’s ability to understand, remember, and carry out instructions and ability
to interact appropriately with supervision, co-workers, and the public as well as respond to
changes in the routine work setting. Tr. 1359-1360. In all areas rated, Dr. House opined that
Ruiz-Lopez was markedly limited. Tr. 1359-1360. In the MSS, Dr. House opined that RuizLopez’s autistic spectrum disorder supported his assessments. Tr. 1359-1360. Dr. House also
A GAF score between 21 and 30 indicates “behavior is considerably influenced by delusions or hallucinations or
serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal
preoccupation) or inability to function in almost all areas (e.g. stays in bed all day; no job, home, or friends).”
DSM-IV-TR at 34.
opined that Ruiz-Lopez’s condition would impact her ability to perform activities of daily living.
Cooperative Disability Investigations Unit evidence 8
On July 14, 2011, during review of Ruiz-Lopez’s claim, Ohio Disability Determination
Service (DDS) discovered areas of conflict in the medical evidence as compared to Ruiz-Lopez’s
statements regarding her alleged limitations. Tr. 105-106, 782. As a result, DDS referred RuizLopez’s case to the Cleveland Cooperative Disability Investigations (CDI) Unit for an
investigation. Tr. 782. The matter was opened for investigation on August 18, 2011. Tr. 782.
On September 21, 2011, Special Agent Muniz and Detective Ted Sloan met with and
interviewed Ruiz-Lopez at her residence. Tr. 785. In the CDI report submitted by Special
Agent/CDI Unit Team Leader Kelly Clark 9 in October 2011, it is reported that, during their
interview with Ruiz-Lopez, Special Agent Muniz and Detective Sloan noted and/or observed that
Ruiz-Lopez did not appear unkempt; she had heavy facial hair; she was dressed in sleepwear; she
did not appear to be anxious or depressed; she spoke clearly and concisely in Spanish; she
answered all questions and asked her own; she seemed comfortable talking with the investigators
as they discussed an unrelated law enforcement matter; she exhibited no problems with
recollection of dates; her memory of events was good; she did not appear nervous, afraid, or
delusional; she required no simplification of questions during the interview; she confirmed that
she attended high school and culinary school in Puerto Rico; and at the time of the interview,
Ruiz-Lopez was caring for several children. Tr. 780-788.
During the hearing, Ruiz-Lopez’s counsel questioned the reliability and admissibility of the CDI report 44-50. The
ALJ indicated that he was not going to exclude the report. Tr. 50.
The CDI report was “submitted” by Kelly Clark and “approved” by Elias Papoulias, Assistant Special Agent in
Charge or Resident Agent in Charge. Tr. 786.
Following its review, DDS concluded that there was reason to believe that Ruiz-Lopez
knowingly concealed and incorrectly provided information regarding the extent of her
impairments. Tr. 106-108, 159-160. Therefore, DDS disregarded information that Ruiz-Lopez
reported concerning her impairments, including the July 11, 2011, consultative examining
psychologist report. Tr. 108, 159-160.
Ashtabula County Board of Developmental Disabilities
To qualify for services through the Ashtabula County Board of Developmental
Disabilities, an applicant must have at least three substantial limitations in seven life areas that
are assessed by the Ohio Eligibility Determination Instrument (OEDI). Tr. 803. The seven life
areas evaluated were mobility; self-care; self-direction; capacity for independent living; learning;
economic self-sufficiency; and receptive and expressive language. Tr. 824. A November 11,
2011, evaluation resulted in a finding that Ruiz-Lopez had a substantial limitation in only one
area – self-direction. Tr. 803, 812-814, 824. Since Ruiz-Lopez did not demonstrate at least
three areas of substantial limitations, on November 16, 2011, Ashtabula County Board of
Developmental Disabilities notified Ruiz-Lopez that she was not eligible for services through the
Ashtabula County Board of Developmental Disabilities. Tr. 803.
Ruiz-Lopez was represented at and testified at the hearing with the assistance of an
interpreter. Tr. 52-68. Ruiz-Lopez stated that she was not working. Tr. 54. She stated that
sometimes there are children at the home where she is residing but indicated that she does not
take care of children. Tr. 54-55. She indicated that she worked a while ago in Puerto Rico with
her mother because she could not work alone. Tr. 56. She was unable to work alone because she
would forget everything. Tr. 56. Ruiz-Lopez also indicated that she had difficulties in the past
working eight hours a day, five days a week because she would get tired a lot and her sugar
levels would rise or drop. Tr. 58. She stated that she stopped working because there was no
work for her and because of her health condition. Tr. 59.
Ruiz-Lopez indicated that she depends upon her mother a lot but she also fights with her
mother a lot. Tr. 57. Ruiz-Lopez stated that she is almost always angry. Tr. 59. She suffers
from bipolar disorder and has mood swings. Tr. 67. She takes medication prescribed through
Signature Health but she indicated that it was not helping that much. Tr. 60. She stated that her
medication makes her tired. Tr. 60, 67. She stated that she fills her days watching television or
listening to music. Tr. 61. She does not shower every day. Tr. 65. Sometimes her mother has
to remind her to take a shower. Tr. 65. She usually stays in her pajamas all the time. Tr. 65.
She stated that she was wearing her pajamas at the hearing. Tr. 65. She shops at the grocery
store with her mother because she does not know how to do anything for herself. Tr. 61. She
stated that she does not count change very well and so her mother pays for things at the store.
Tr. 62. Ruiz-Lopez receives a food stamp card. Tr. 63. Her mother takes the card with them to
the store. Tr. 63.
Ruiz-Lopez does not drive. Tr. 61. She took a driver’s test once but was not able to pass
the test. Tr. 61. Ruiz-Lopez’s mother takes her to her doctor’s appointments and reminds RuizLopez to take her medication. Tr. 63-64.
Ana Sanchez, Ruiz-Lopez’s case manager at Signature Health, helped Ruiz-Lopez
complete her social security disability forms because she did not understand the forms mentally
and because the forms were in English. Tr. 59, 67. Before Ms. Sanchez was assigned as RuizLopez’s case manager, Ruiz-Lopez’s case manager was Olga. Tr. 67.
Ana Sanchez’s testimony 10
Ana Sanchez testified at the hearing regarding her involvement with and observations
regarding Ruiz-Lopez. Tr. 68-85. Ms. Sanchez indicated that she had been one of Ruiz-Lopez’s
assigned case workers at Signature Health and had assisted Ruiz-Lopez with completing the
social security disability forms. Tr. 69, 84. Ms. Sanchez stated that she is an advocate for a lot
of people in the Hispanic community outside her job and was assisting Ruiz-Lopez in that
capacity as well. Tr. 69-70. Ms. Sanchez started working as Ruiz-Lopez’s case manager on
June 13, 2013, because Ruiz-Lopez’s case manager Olga was out on leave. Tr. 84. Before
taking over as Ruiz-Lopez’s case manager, Ms. Sanchez confirmed with her boss that, even
though Ms. Sanchez was already familiar with and had been assisting Ruiz-Lopez, there was no
issue with her acting as Ruiz-Lopez’s case manager. Tr. 84.
Ms. Sanchez attended Ruiz-Lopez’s consultative evaluation at Dr. Rivera’s office on July
11, 2011. Tr. 70. Ms. Sanchez drove Ruiz-Lopez to the evaluation along with Ruiz-Lopez’s
mother and Pedro, the friend that Ruiz-Lopez lived with. Tr. 71. According to Ms. Sanchez,
Ruiz-Lopez was arguing with her mother during the car ride to the evaluation. Tr. 71. At
certain points during the car ride, Ruiz-Lopez wanted to hit her mother. 11 Tr. 71. Ruiz-Lopez
was sitting in the back seat so Ms. Sanchez stopped the car and had Ruiz-Lopez sit in the front
seat so Ms. Sanchez could try to distract her. Tr. 71.
Ruiz-Lopez called Ana Sanchez as a witness at the hearing to assist with filling in gaps since she had assisted
Ruiz-Lopez with completing many social security disability forms and had observed Ruiz-Lopez at the consultative
psychological evaluation. Tr. 46-47. At one point during Ms. Sanchez’s testimony, the ALJ interrupted the
questioning to ask Ruiz-Luiz what she was doing and, following his inquiry, he noted that “it appears that the
claimant is drawing on the table with her finger, and erasing it and drawing it again.” Tr. 75.
Ms. Sanchez has observed Ruiz-Lopez being angry and aggressive with her mother in the past. Tr. 71-72. RuizLopez and her mother live across the street from each other. Tr. 71. Ms. Sanchez indicated they stopped living
together because of their arguments. Tr. 72.
Once they arrived for the evaluation, they had to wait for about an hour for Dr. Rivera,
which caused Ruiz-Lopez to become frustrated. Tr. 73. During Dr. Rivera’s evaluation, RuizLopez became aggressive towards her mother and Ms. Sanchez had to take Ruiz-Lopez outside
to calm down. Tr. 72. While outside, Ms. Sanchez indicated that Ruiz-Lopez acted very
inappropriate by exposing her breasts and trying to pull Ms. Sanchez’s shirt down. Tr. 73. Ms.
Sanchez got Ruiz-Lopez back in the building, got her something to eat, and sat her down and
tried to explain to Ruiz-Lopez why she could not do what she had done outside. Tr. 73. Because
she had seen Ruiz-Lopez act out in the past in a sexually inappropriate manner, Ms. Sanchez did
not believe that Ruiz-Lopez was trying to “play the system” by acting out at the evaluation. Tr.
Ruiz-Lopez’s counsel asked Ms. Sanchez, in her capacity as a case worker, and having
worked with Ruiz-Lopez, whether she had an opinion as to Ruiz-Lopez’s functional limitations
in terms of being able to work competitively, even at a simple job, 8 hours a day, 5 days a week.
Tr. 83-84. Ms. Sanchez indicated that at one point she thought about having her go through
vocational rehabilitation but did not believe that Ruiz-Lopez could work 8 hours a day, 5 days a
week. Tr. 84-85. She thought that Ruiz-Lopez might do okay at first but with too many people
she would become angry and act out. Tr. 85.
Vocational Expert’s testimony
Vocational Expert (“VE”) Carmine Abraham testified at the hearing. Tr. 85-93. The
ALJ indicated that he did not think that there was any past relevant work and proceeded with a
hypothetical. Tr. 86. The ALJ asked the VE to assume a hypothetical individual of RuizLopez’s age and education who could perform work at all exertional levels but would be limited
to simple tasks, could not work at a production pace, but could perform goal oriented work,
interaction with supervisors would be limited to speaking and signaling, could not interact with
the public and generally needed a static work setting but could tolerate a few changes. Tr. 86-87.
The VE indicated that there were jobs in the economy that the described individual could
perform, including (1) packager, a medium, unskilled job with 1,720 positions available in the
region and 20,530 in the state; (2) housekeeper or cleaner, a light, unskilled job with 1,230
positions available in the region and 29,340 in the state; and (3) laundry worker, a light,
unskilled job with 980 positions available in the region and 12,270 in the state. Tr. 87.
Ruiz-Lopez’s counsel asked the VE whether a limitation of no ability to read or speak
English would change her response to the ALJ’s hypothetical. Tr. 88. The VE indicated that the
additional limitation would not change her opinion regarding the availability of the three listed
positions because, in today’s economy, with the types of jobs identified, there are many
employers who hire Spanish speaking individuals. Tr. 89. The VE further explained that the
jobs identified are entry level positions that do not require extensive reading or writing and could
be learned through a short demonstration. Tr. 89-90. The VE clarified that an employer’s hiring
of a Spanish speaking individual did not amount to a special accommodation because the
employer is not really changing the work environment. Tr. 90. Ruiz-Lopez’s counsel asked the
VE whether her opinion was consistent with the DOT which requires a certain amount of English
to be spoken. Tr. 91. The VE indicated that, although the DOT requires English, things change
over time and in today’s economy there is such an influx of people that speak Spanish. Tr. 91.
Thus, the VE indicated that her opinion was consistent with the DOT along with her experience
in working with Spanish speaking individuals in the economy. Tr. 91, 93.
Ruiz-Lopez’s counsel then modified the hypothetical, asking whether there would be jobs
available to an individual with marked limitations in her ability to perform activities within a
schedule, maintain regular attendance, and be punctual within customary tolerances. Tr. 91-92.
The VE stated that, if an individual was off task over 20 percent of the time or if she was unable
to maintain attendance and was missing one to two days a month on a consistent basis, the
person would likely be unemployable. Tr. 92.
Ruiz-Lopez’s counsel then asked whether there would be jobs available to a hypothetical
individual who had marked limitations in her ability to get along with coworkers or peers
without distracting them or exhibiting behavioral extremes. Tr. 92. The VE stated that, if an
individual was unable to work with people even on an occasional basis, said individual would
likely be unable to function in a work environment. Tr. 92.
III. Standard for Disability
Under the Act, 42 U.S.C § 423(a), eligibility for benefit payments depends on the
existence of a disability. “Disability” is defined as 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). Furthermore:
[A]n 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 economy12 . . . .
42 U.S.C. § 423(d)(2)(A).
In making a determination as to disability under this definition, an ALJ is required to
follow a five-step sequential analysis set out in agency regulations. The five steps can be
summarized as follows:
“’[W]ork which exists in the national economy’ means work which exists in significant numbers either in the
region where such individual lives or in several regions of the country.” 42 U.S.C. § 423(d)(2)(A).
If the claimant is doing substantial gainful activity, he is not disabled.
If claimant is not doing substantial gainful activity, his impairment must
be severe before he can be found to be disabled.
If claimant is not doing substantial gainful activity, is suffering from a
severe impairment that has lasted or is expected to last for a continuous
period of at least twelve months, and his impairment meets or equals a
listed impairment, 13 claimant is presumed disabled without further inquiry.
If the impairment does not meet or equal a listed impairment, the ALJ
must assess the claimant’s residual functional capacity and use it to
determine if claimant’s impairment prevents him from doing past relevant
work. If claimant’s impairment does not prevent him from doing his past
relevant work, he is not disabled.
If claimant is unable to perform past relevant work, he is not disabled if,
based on his vocational factors and residual functional capacity, he is
capable of performing other work that exists in significant numbers in the
20 C.F.R. §§ 404.1520, 416.920; 14 see also Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987).
Under this sequential analysis, the claimant has the burden of proof at Steps One through Four.
Walters v. Comm’r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997). The burden shifts to the
Commissioner at Step Five to establish whether the claimant has the RFC and vocational factors
to perform work available in the national economy. Id.
IV. The ALJ’s Decision
In his November 1, 2013, decision, the ALJ made the following findings: 15
The Listing of Impairments (commonly referred to as Listing or Listings) is found in 20 C.F.R. pt. 404, Subpt. P,
App. 1, and describes impairments for each of the major body systems that the Social Security Administration
considers to be severe enough to prevent an individual from doing any gainful activity, regardless of his or her age,
education, or work experience. 20 C.F.R. § 404.1525.
The DIB and SSI regulations cited herein are generally identical. Accordingly, for convenience, further citations
to the DIB and SSI regulations regarding disability determinations will be made to the DIB regulations found at 20
C.F.R. § 404.1501 et seq. The analogous SSI regulations are found at 20 C.F.R. § 416.901 et seq., corresponding to
the last two digits of the DIB cite (i.e., 20 C.F.R. § 404.1520 corresponds to 20 C.F.R. § 416.920).
The ALJ’s findings are summarized.
Ruiz-Lopez was insured for a period of disability and disability insurance
benefits on June 15, 2009, the alleged onset date, and she remained
insured for these benefits through June 30, 2010. Tr. 17.
Ruiz-Lopez had not engaged in substantial gainful activity since the June
15, 2009, alleged onset date. Tr. 17.
Ruiz-Lopez had the following severe impairments: borderline intellectual
functioning and an affective disorder. The following were non-severe
impairments: diabetes mellitus, hypertension, ovarian cysts, pancreatitis,
gastroesophageal reflux disease, a condition causing excess hair,
including on the face; neck, back and knee problems, being overweight,
autism and, autistic spectrum disorder. 16 Tr. 17-21.
Ruiz-Lopez did not have an impairment or combination of impairments
that met or medically equaled the severity of one of the listed
impairments. Tr. 21.
Ruiz-Lopez had the RFC to perform work without any exertional
limitations/restrictions: limited to simple tasks; unable to work at a
production pace but could perform goal oriented work; interactions with
supervisors and coworkers limited to speaking and signaling; unable to
interact with members of the public; and required a generally static work
setting but could tolerate a few changes. Tr. 21-25.
Ruiz-Lopez had no past relevant work. Tr. 25.
Ruiz-Lopez was considered to be a younger individual in the 18-49 age
group since the June 15, 2009, alleged onset date. Tr. 25.
Ruiz-Lopez had a limited education in learning disability classes and was
unable to communicate in English. Tr. 25.
Transferability of job skills was not material to the determination of
disability. Tr. 25.
Considering Ruiz-Lopez’s age, education, work experience and RFC,
there were jobs that existed in significant numbers in the national
economy that Ruiz-Lopez could perform, including packager,
housekeeper, and laundry worker. Tr. 25-26.
The ALJ acknowledged that Dr. House had diagnosed Ruiz-Lopez with autistic spectrum disorder but, since no
other medical source had diagnosed Ruiz-Lopez with autism or autistic spectrum disorder, and since there was no
evidence that Ruiz-Lopez was considered to have such disorders while a student, the ALJ found that there was
insufficient evidence to establish the disorder. Tr. 18. However, the ALJ indicated that, although the evidence did
not establish that autism or autistic spectrum disorder was a severe impairment, he would still consider the
functional evidence. Tr. 18-19.
Based on the foregoing, the ALJ determined that Ruiz-Lopez had not been under a
disability since June 15, 2009, the alleged onset date. Tr. 26.
V. Parties’ Arguments
Ruiz-Lopez argues that the ALJ erred by failing to discuss or weigh the opinion of Ana
Sanchez. Doc. 16, pp. 12-13, Doc. 19, p. 1. She contends that Ms. Sanchez is an “other source”
and therefore, under SSR 06-03p, the ALJ should have considered and generally explained the
weight provided to Ms. Sanchez’s opinion that was offered during the administrative hearing.
Doc. 16, pp. 12-13, Doc. 19, p. 1.
In response, the Commissioner argues that Ruiz-Lopez overstates Ms. Sanchez’s
professional relationship with Ruiz-Lopez. Doc. 18, pp. 9-10. The Commissioner asserts that
Ms. Sanchez was only assigned to act as Ruiz-Lopez’s case manager at Signature Health a few
weeks prior to the July 9, 2013, administrative hearing and therefore, prior to that time, Ms.
Sanchez was not acting in a professional capacity but rather in her capacity as a family friend.
Doc. 18, pp. 9-10. The Commissioner further argues that there was no need for the ALJ to
address Ms. Sanchez’s opinion because Ruiz-Lopez failed to demonstrate that Ms. Sanchez was
an “other source” under the Regulations and because Ms. Sanchez was not the type of objective
source that could provide an opinion because her friendship with Ruiz-Lopez caused a potential
conflict. Doc. 18, pp. 9-10.
Ruiz-Lopez also argues that the ALJ erred in assigning “little weight” to mental health
opinions rendered by Dr. Rivera, Mr. Cozy, and Dr. House. Doc. 16, pp. 13-17, Doc. 19, p. 2.
Ruiz-Lopez argues that the three mental health opinions were consistent with each other and
discounting them based on a CDI Unit report that was of little probative value was error. Doc.
16, pp. 13-17, Doc. 19, p. 2.
The Commissioner contends that the ALJ properly evaluated and discounted the opinions
of Dr. Rivera, Mr. Cozy, and Dr. House that contain very significant limitations and the record,
when viewed as a whole, demonstrates that Ruiz-Lopez is more engaged than as reported in the
opinions. Doc. 18, pp. 10-12.
VI. Law & Analysis
A reviewing court must affirm the Commissioner’s conclusions absent a determination
that the Commissioner has failed to apply the correct legal standards or has made findings of fact
unsupported by substantial evidence in the record. 42 U.S.C. § 405(g); Wright v. Massanari, 321
F.3d 611, 614 (6th Cir. 2003). “Substantial evidence is more than a scintilla of evidence but less
than a preponderance and is such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Besaw v. Sec’y of Health & Human Servs., 966 F.2d 1028,
1030 (6th Cir. 1992) (quoting Brainard v. Sec’y of Health & Human Servs., 889 F.2d 679, 681
(6th Cir. 1989).
The Commissioner’s findings “as to any fact if supported by substantial evidence shall be
conclusive.” McClanahan v. Comm’r of Soc. Sec., 474 F.3d 830, 833 (6th Cir. 2006) (citing 42
U.S.C. § 405(g)). Even if substantial evidence or indeed a preponderance of the evidence
supports a claimant’s position, a reviewing court cannot overturn the Commissioner’s decision
“so long as substantial evidence also supports the conclusion reached by the ALJ.” Jones v.
Comm’r of Soc. Sec., 336 F.3d 469, 477 (6th Cir. 2003). Accordingly, a court “may not try the
case de novo, nor resolve conflicts in evidence, nor decide questions of credibility.” Garner v.
Heckler, 745 F.2d 383, 387 (6th Cir. 1984).
Reversal and remand is not warranted for further consideration of evidence
presented by Ms. Sanchez
Ruiz-Lopez contends that, contrary to SSR 06-03p, the ALJ did not discuss or weigh Ms.
Sanchez’s opinion and the ALJ’s decision does not allow this reviewing Court the ability to
follow the ALJ’s reasoning with respect to evidence offered by Ms. Sanchez.
Under SSR-06-03p, an ALJ must “consider all relevant evidence in an individual’s case
record.” SSR 06-03p - Considering Opinions and Other Evidence from Sources Who are Not
“Acceptable Medical Sources” in Disability Claims; Considering Decisions on Disability by
Other Governmental and Nongovernmental Agencies, 2006 WL 2329939, *6 (August 9, 2006).
Further, “’[n]on-medical sources’ who have had contact with the individual in their professional
capacity, such as . . . social and welfare agency personnel who are not health care providers, are .
. . valuable sources of evidence for assessing impairment severity and functioning.” Id. at *3. In
addition, “evidence provided by other ‘non-medical sources’ such as . . . friends . . . and
neighbors” is considered. Id. The case record should reflect the consideration of opinions from
. . . ‘non-medical sources’ who have seen the claimant in their professional capacity [and]
[a]lthough there is a distinction between what an adjudicator must consider and what the
adjudicator must explain the disability determination or decision, the adjudicator generally
should explain the weight given to opinions from these ‘other sources,’ or otherwise ensure that
the discussion of the evidence in the determination or decision allows a claimant or subsequent
reviewer to follow the adjudicator’s reasoning.” Id.
The opinion that Ruiz-Lopez contends the ALJ erroneously failed to weigh was provided
by Ms. Sanchez at the hearing in response to questioning from Ruiz-Lopez’s counsel. Tr. 83-84.
In particular, at the hearing, the following exchange occurred:
Q Given your background as a case worker for individuals that have mental health
impairments - - and I realize you are not a psychologist, but in your capacity as a
case worker, do you, in your limited sphere, having worked so closely with
Yanira, do you have an opinion as to whether she would have any functional
A [INAUDIBLE] I’m sorry.
Q In terms of being able to work competitively, even at a simple job, eight hours a
day, five days a week?
A Yes; I don’t believe that she would be able to do a job five or eight hours. At
one point I had thought - - I just received her - - Olga was her other, her case
manager at Signature Health. However, Olga is out on medical leave until August
. . . one though[t] of mine was to take her to the BVR. However I don’t think that
she would do well because at the BVR Mr. Steven Jacobs . . . . usually send[s] his
clients to the Goodwill to do an assignment, work assignment there.
WTN: So that the supervisors there can in return come back and say how they
were doing. There’s too many people. I think that she would get angry. I think
that she would act out. Maybe at first she would be okay. She’s okay sometimes.
I mean she seems she’s okay, sometimes. And then she’ll turn into this different ALJ: Okay.
WTN: Person, I guess.
ALJ: All right.
ATTY: Thank you. I have no further questions.
To the extent that Ms. Sanchez was offering her opinion that Ruiz-Lopez was
unemployable, such an opinion is an issue reserved to the Commissioner. See Bass v. McMahon,
499 F.3d 506, 511 (6th Cir. 2007) (“[T]he conclusion of disability if reserved to the Secretary.”).
Furthermore, contrary to Ruiz-Lopez’s claim, the ALJ considered evidence from Ms. Sanchez
and the ALJ’s discussion of the evidence allows this Court the opportunity to review the ALJ’s
reasoning with respect to the evidence offered by Ms. Sanchez.
Ms. Sanchez testified that she assisted Ruiz-Lopez with completion of various reports,
including reports identified in the record as Exhibits 3E, 4E, and 7E. Tr. 69. Ms. Sanchez
indicated that, at the time she completed the forms, she was aware of Ruiz-Lopez’s mental and
physical limitations based on her own observations, information provided by Ruiz-Lopez’s
mother, and information contained in school and medical records. Tr. 69-70. The ALJ’s
decision reflects the ALJ’s acknowledgement that Ms. Sanchez provided testimony at the
hearing in support of Ruiz-Lopez. Tr. 14. When discussing and weighing the evidence, the ALJ
clearly stated that he was giving “little weight to the allegations/observations” included in reports
prepared by Ms. Sanchez. Tr. 19 (citing among the exhibits, Exhibits 4E and 7E, which, as
noted above, were identified by Ms. Sanchez at the hearing as having been completed by her (Tr.
69). Further, the ALJ stated that he was also giving “little weight . . . to the most extreme
allegations that were made about the claimant’s mental health during her hearing . . .” Tr. 1920. The ALJ’s decision makes clear that he considered and weighed Ms. Sanchez’s testimony.
Tr. 20 (“While the undersigned finds that the claimant and her mother and her advocate have
exaggerated the severity of the claimant’s mental problems . . .) (emphasis supplied).
Based on the foregoing, it is clear that the ALJ considered evidence presented by Ms.
Sanchez and explained that he was providing little weight to that evidence, which suggested a
disabling impairment. In doing so, the ALJ relied upon the CDI Unit report which presented a
different, less extreme, picture of Ruiz-Lopez’s mental functional abilities. Tr. 19-20. To the
extent that Ruiz-Lopez suggests that the CDI Unit report should not have been considered or
relied upon by the ALJ because it is unreliable or lacks credibility, this Court, in reviewing the
Commissioner’s decision, “may not try the case de novo, nor resolve conflicts in evidence, nor
decide questions of credibility.” Garner, 745 F.2d at 387. Further, the ALJ did not rely solely
on the CDI Unit report in reaching his decision. As indicated in his decision, the ALJ considered
other record evidence, including Ruiz-Lopez’s past mental health treatment which, other than the
consultative examinations, did not reveal significant mental health issues and a report from the
Ashtabula County Board of Developmental Disabilities finding that Ruiz-Lopez was not eligible
for services through that Board. Tr. 20.
Here, the ALJ did not disregard evidence presented by Ms. Sanchez and he sufficiently
explained the reasons for providing little weight to that evidence. Accordingly, reversal and
remand is not warranted for further consideration of evidence presented or offered by Ms.
The ALJ properly considered the medical opinion evidence
Ruiz-Lopez argues that the ALJ erred in his consideration of the opinions of three
consultative examining psychologists Dr. Rivera, Mr. Cozy, and Dr. House. Doc. 16, pp. 13-17,
Doc. 19, p. 2. She asserts that there is a strong consistency among the three opinions, the
opinions were rendered by board-certified psychologists, and the opinions contain acceptable
medical findings. Doc. 16, pp. 14-15. Therefore, she argues that the ALJ should have assigned
considerable weight to the opinions. Doc. 16, pp. 14-15. She also contends that the ALJ’s only
basis for discounting the opinions was the CDI Unit report and asserts that the CDI Unit report
does not provide an adequate basis for discounting the medical opinions. Doc. 16, pp. 15-17,
Doc. 19, p. 2.
The Regulations make clear that a claimant’s RFC is an issue reserved to the
Commissioner and the ALJ assesses a claimant’s RFC “based on all of the relevant evidence” of
record. 20 C.F.R. §§ 404.1545(a); 404.1546(c). It is the responsibility of the ALJ, not a
physician, to assess a claimant’s RFC. See 20 C.F.R. § 404.1546 (c); Poe v. Comm'r of Soc.
Sec., 342 Fed. Appx. 149, 157 (6th Cir.2009). In assessing a claimant’s RFC, “an ALJ does not
improperly assume the role of a medical expert by assessing the medical and nonmedical
evidence before rendering a residual functional capacity finding.” Id.
As one-time examining consultative psychologists, Dr. Rivera, Mr. Cozy, and Dr. House,
did not have an ongoing treatment relationship with Ruiz-Lopez and therefore their opinions
were not entitled to deference or controlling weight under the treating physician rule. See
Kornecky v. Comm’r of Soc. Sec, 167 Fed. Appx. 496, 508 (6th Cir. 2006); Daniels v. Comm’r of
Soc. Sec., 152 Fed. Appx. 485, 490 (6th Cir. 2005). It is the ALJ’s responsibility to evaluate the
opinion evidence using the factors set forth in 20 C.F.R. § 404.1527. See 20 C.F.R. §
404.1527(c). Those factors include (1) the length of the treatment relationship and the frequency
of the examination, (2) the nature and extent of the treatment relationship, (3) the supportability
of the opinion, (4) the consistency of the opinion with the record as a whole, (5) the
specialization of the source, and (6) any other factors that tend to support or contradict the
opinion. Id. However, the ALJ is not obliged to include in his decision an exhaustive factor-byfactor analysis. See Francis v. Comm’r of Soc. Sec., 414 Fed. Appx. 802, 804 (6th Cir. 2011).
Although Dr. Rivera, Mr. Cozy, and Dr. House were not treating source providers, the
ALJ’s decision, consistent with the regulations, the ALJ’s decision makes clear that the ALJ
considered their opinions and explained the weight assigned to their opinions, stating:
In assessing the claimant’s residual functional capacity, the undersigned has also
considered the various medical source opinions that have been offered in this
matter. The residual functional capacity the undersigned has assigned for the
claimant is supported by the report of the above-mentioned investigation that was
conducted in this matter (see 8F), and by the case summaries that were
respectively prepared on July 14, 2011 (see Ex. 5E) and October 25, 2011 (see
Ex. 1A). The undersigned has also considered the opinions offered by the abovementioned consulting psychologist who evaluated the claimant on July 11, 2011
at the request of the Commissioner (see Ex. 7F, pps. 4 and 5); and the opinions
offered by the above-mentioned consulting psychologist who evaluated the
claimant at the undersigned’s request on September 12, 2013 (see Ex. 27F, pp. 1,
2, and 9); and the opinions of a consulting psychologist found in pages five and
six of exhibit 10F. However, to the extent it is argued that the most
extreme/restrictive opinions offered by these sources support a finding that the
claimant’s mental residual functional capacity has been more restricted than the
undersigned is finding, such arguments are rejected on the ground that the
longitudinal record, including the evidence that has already been cited to in this
decision, does not support a more restrictive mental residual functional capacity
over any continuous 12-month period since May 19, 2009.
The foregoing makes clear that the ALJ did not rely solely on the CDI Unit report when
considering and weighing the opinions of Dr. Rivera, Mr. Cozy, and Dr. House. As is clear, the
ALJ considered the supportability of the opinions with the other evidence of record and found
that the bulk of the evidence did not support the extreme/restrictive opinions offered by the onetime consultative psychologists. As set forth in the Regulations, supportability of a medical
opinion and length of treatment relationship are appropriate factors to consider when weighing
an opinion. See 20 C.F.R. § 404.1527(c). To the extent that Ruiz-Lopez claims that the ALJ’s
decision lacked detailed analysis of each separate factor under 20 C.F.R. § 404.1527(c), that
argument is unpersuasive because, even when an opinion being considered was rendered by a
treating physician, which is not the situation in this case, the ALJ is not obliged to include in his
decision an exhaustive factor-by-factor analysis. See Francis, 414 Fed. Appx. at 804.
To the extent that Ruiz-Lopez argues that the ALJ should have excluded or not provided
much weight to the CDI Unit report because it lacks specificity or was based on an investigation
conducted by non-mental health professionals in a different environment than the July 2011
consultative evaluation, which may have resulted in a different presentation by Ruiz-Lopez, her
argument amounts to a request that this Court reweigh evidence already considered by the ALJ,
which this Court may not do. See Garner, 745 F.2d 383, 387 (6th Cir. 1984) (A court “may not
try the case de novo, nor resolve conflicts in evidence, nor decide questions of credibility.”).
Based on the foregoing, the Court finds that the ALJ sufficiently explained the weight
assigned to the opinions of the three one-time consultative psychologists and Ruiz-Lopez has not
shown that the decision is not supported by substantial evidence. Accordingly, reversal and
remand is not warranted for further consideration of the medical opinion evidence.
For the reasons set forth herein, the Court AFFIRMS the Commissioner’s decision.
Dated: December 18, 2015
Kathleen B. Burke
United States Magistrate Judge
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