Harris v. Commissioner of Social Security

Filing 22

Memorandum Opinion and Order: The Commissioner's decision is AFFIRMED. Magistrate Judge Kathleen B. Burke on 2/26/2016. (D,I)

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF OHIO
EASTERN DIVISION

RAQUIAL A. HARRIS,
Plaintiff,
v.

COMMISSIONER OF SOCIAL
SECURITY ADMINISTRATION,
Defendant.

)
)
)
)
)
)
)
)
)
)
)

CASE NO. 3:15CV927

MAGISTRATE JUDGE
KATHLEEN B. BURKE

MEMORANDUM OPINION & ORDER

Plaintiff Raquial Harris (“Harris”) seeks judicial review of the final decision of
Defendant Commissioner of Social Security (“Commissioner”) denying her application for
Supplemental Security Income (“SSI”). 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. 13.
For the reasons stated below, the Commissioner’s decision is AFFIRMED.
I. Procedural History
On January 19, 2012, Harris protectively filed an application for SSI, alleging a disability
onset date of August 31, 2011. Tr. 14, 171. She alleged disability based on the following:
depression, anxiety, abdomen surgery in 2003 for bowel obstruction, and vision problems seeing
up close: “it hurts to see.” Tr. 202. After denials by the state agency initially (Tr. 68) and on
reconsideration (Tr. 80), Harris requested an administrative hearing. Tr. 96. A hearing was held
before Administrative Law Judge (“ALJ”) Kim L. Bright on November 14, 2013. Tr. 31-56. In
her January 16, 2014, decision (Tr. 14-25), the ALJ determined that there are jobs that exist in
1

significant numbers in the national economy that Harris can perform, i.e., she is not disabled. Tr.
24. Harris requested review of the ALJ’s decision by the Appeals Council (Tr. 8) and, on March
24, 2015, the Appeals Council denied review, making the ALJ’s decision the final decision of the
Commissioner. Tr. 1-3.
II. Evidence
A. Personal and Vocational Evidence
Harris was born in 1972 and was 39 years old on the date her application was filed. Tr.
24. She previously worked as a home health aide and at a fast food restaurant. Tr. 44-45. The
highest grade she completed was seventh grade. Tr. 37.
B. Relevant Medical Evidence1
On March 1, 2011, Harris sought mental health treatment from the Unison Behavioral
Health facility (“Unison”). Tr. 346-354. She reported being depressed and anxious for the past
ten years. Tr. 350-351. She also complained of inattention, sleep problems, psychological
stressors, and alcohol and drug dependency. Tr. 351. Harris was diagnosed with depressive
disorder NOS and assigned a global assessment of functioning (“GAF”)2 score of 55. Tr. 353.
On April 28, 2011, Harris saw Unison psychiatrist Sreekanth Indurti, M.D., for a
psychiatric evaluation. Tr. 334-335. She was tearful and crying and complained of anxiety,
panic attacks, lack of sleep and insomnia. Tr. 334. She also stated she felt sad, hopeless, useless
and worthless, and that she lacked energy, appetite, and interest in doing things. Tr. 334. She
denied any suicidal or homicidal thoughts, but reported occasionally hearing voices. Tr. 334.
1

Harris only challenges the ALJ’s decision with respect to her mental impairments. See Doc. 15. Accordingly,
only the medical evidence relating to Harris’s mental impairments is summarized herein.
2

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 51 and 60 indicates moderate symptoms or
moderate difficulty in social, occupational, or school functioning. Id.
2

She stated that she had been “depressed for a long time” but that she was never in treatment. Tr.
334. Upon examination, Dr. Indurti observed that Harris was cooperative, made fair eye contact,
had average intelligence, was oriented to time, place, and person, had normal memory, and had
adequate attention, concentration, insight, and judgment. Tr. 334. He diagnosed her with
schizoaffective disorder, current episode depressed; assigned her a GAF score of 45 to 50;3 and
prescribed medication, including Abilify, Lexapro, Buspar and Trazodone. Tr. 335.
On October 10, 2011, Harris told Dr. Indurti that her medications were helping her. Tr.
326. She denied medication side effects and related that she was out of one of her medications.
Tr. 326. Her depression was better and she was not hearing voices that threatened her, although
she did have occasional panic attacks. Tr. 326. Upon exam, Harris was cooperative, made fair
eye contact, had an appropriate affect and normal thought processes and content, was oriented to
time, place, and person, had normal memory and adequate attention, concentration, insight and
judgment. Tr. 326. Dr. Indurti continued her medication regimen. Tr. 326.
On November 7, 2011, Harris told Dr. Indurti that she was doing well and denied any
hallucinations or delusions. Tr. 327. Her medications were helping her. Tr. 327. Dr. Indurti’s
findings remained unchanged from Harris’ prior visit and he continued her medication regimen.
Tr. 327.
On January 18, 2012, Harris saw Dr. Indurti and reported that she was feeling depressed,
sad and tearful. Tr. 328. Dr. Indurti observed that her mood was sad and depressed. Tr. 330.
Otherwise, she was cooperative, made fair eye contact, had an appropriate affect, normal thought
processes, was oriented to time, place, and person, had normal memory and adequate attention,

3

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).” DSM-IV-TR, at 34.
3

concentration, insight and judgment. Tr. 330. Dr. Indurti continued her medications and added
Viibryd. Tr. 329.
On February 16, 2012, Harris reported “having a lot of auditory hallucinations which are
mean to her.” Tr. 332. Upon examination, she was mostly normal except for a dysphoric mood
and affect. Tr. 332. Dr. Indurti started Harris on Fanapt. Tr. 331. On February 23, 2012, Harris
complained of physical side effects from the Fanapt, which she then stopped taking. Tr. 333.
She denied hallucinations, her depression was better, and “she is able to maintain herself.” Tr.
333. Upon examination, Harris was cooperative, made fair eye contact, appeared to be
euthymic, had an appropriate affect, normal thought processes and content, was oriented to time,
place, and person, had normal memory and adequate attention, concentration, insight and
judgment. Tr. 333.
On March 27, 2012, Harris denied any hallucinations or delusions; she also reported that
she heard voices and felt depressed when she woke up but that she got better as the day
progressed and was able to maintain herself well. Tr. 344. Dr. Indurti’s examination findings
were unchanged from the prior month. Tr. 333.
On April 16, 2012, Harris saw a Unison nurse for a mental health follow-up. Tr. 412.
She advised that her anxiety medication was working “really well” and her antidepressant helped
her sleep 7-8 hours. Tr. 412. Upon examination, Harris had a stable mood, appropriate affect,
organized thought process, was oriented in all spheres, and was cooperative. Tr. 412. She was
tearful but calmed easily. Tr. 412.
On May 23, 2012, Harris saw Dr. Indurti for a medical management visit. Tr. 357.
Examination findings revealed no abnormalities and Dr. Indurti assigned Harris a GAF score of

4

52. Tr. 357. He also changed Plaintiff’s diagnoses to depressive disorder NOS, generalized
anxiety disorder, and unspecified cocaine and alcohol dependence. Tr. 357.
On June 20, 2012, Harris reported to a nurse at Unison that her favorite uncle had died
that day and that she felt more depressed, anxious and paranoid. Tr. 414-415. She stated that
she did not like to leave her house. Tr. 414. Upon examination, she was pleasant, relaxed and
cooperative and had good eye contact. Tr. 414. She denied hallucinations. Tr. 414. On July 18,
2012, Harris told the nurse that she was “talking to herself more and more. ‘I can’t help not
answering the voices back. I don’t like people telling me I’m crazy. I can’t be around people.’”
Tr. 416. She was crying during her appointment. Her mood was depressed, she was anxious and
irritable, and her thought content was racing. Tr. 414. Her hygiene was good and she was wellgroomed and dressed appropriately. Tr. 414. Her memory was intact and she was oriented to
time, place, person, and events. Tr. 416. She was easily distracted. Tr. 416. The nurse added
Latuda to her medications. Tr. 416.
On August 22, 2012, Harris saw Dr. Indurti for a medication management visit. Tr. 358.
She denied delusions and hallucinations and had normal examination findings. Tr. 358. Dr.
Indurti assigned her a GAF score of 52. Tr. 358. On September 20, 2012, Harris returned to Dr.
Indurti for a medication management visit. Tr. 418. She denied hallucinations and her
examination findings were again normal, except that her mood was sad. Tr. 418. Dr. Indurti
changed her diagnosis to schizoaffective disorder bipolar type/depressive type, and assigned her
a GAF score of 43. Tr. 418.
On October 15, 2012, Harris saw a Unison nurse and reported that she was feeling down,
isolating more, and had increased depression. Tr. 419. She also requested to see a therapist. Tr.
419. Upon examination, Harris had a stable mood, appropriate affect and organized thought

5

process. Tr. 419. She was oriented in all spheres, cooperative, appropriately dressed, and she
had good eye contact, hygiene, and intact memory. Tr. 419. She was easily distracted. Tr. 419.
Tremors were observed in her hands. Tr. 419. The nurse referred her to a therapist. Tr. 419.
On October 25, 2012, Harris reported to a Unison nurse that she liked her medication
regimen and that sometimes she just had bad days. Tr. 421. Upon examination, Harris had good
hygiene, was dressed appropriately, and was alert and oriented in all spheres. Tr. 421.
On December 18, 2012, Harris saw Unison therapist Kenneth Teitlebaum, M.A. Tr. 408.
She reported being more stable on her medications but that they make her sleepy. Tr. 408. She
complained of auditory hallucinations. Tr. 408.
At a medication visit with a Unison nurse on January 24, 2013, Harris reported that she
had been out of medication for four weeks and complained of depressive symptoms, insomnia,
crying spells, high anxiety, and paranoia. Tr. 426. She denied hallucinations. Tr. 426. Harris
saw Teitlebaum on January 28, 2013, and reported that she was sleeping too much. Tr. 409. She
was alert and pleasant, and had a normal mood and appropriate affect. Tr. 409. She stated that
she was interested in taking parenting classes and that she had learned similar skills when she
trained her dog. Tr. 409. Teitlebaum located parenting classes and provided Harris with a phone
number to call. Tr. 409.
On January 30, 2013, Harris saw Dr. Indurti for a medication management visit. Tr. 428.
Upon examination, Harris was alert, oriented, and cooperative; had normal psychomotor activity;
exhibited an “okay” mood; had a congruent, full range affect; had intact memory, attention,
concentration; linear thought; no delusions or hallucinations; and fair insight and judgment. Tr.
428. He assigned her a GAF score of 43. Tr. 428.

6

On February 27, 2013, Harris saw a Unison nurse and reported that she was taking her
medications as prescribed and that they were helping and that she was sleeping well. Tr. 429.
She reported hearing non-commanding voices that were pleasant and not stressful or degrading.
Tr. 429. Upon examination, Harris’s mood was depressed but controlled. Tr. 429.
On March 5, 2013, at a visit with Teitlebaum, Harris’s mood was despondent; she
reported feeling guilty for not stopping her friend from drinking himself to death. Tr. 410. She
reported that she did sign up for parenting classes and that she was taking care of children. Tr.
410. She was isolating but was still able to do household chores like changing her bed linen and
doing laundry. Tr. 410. Teitlebaum “challenged her thinking that she had to lay in bed all day
because she wasn’t motivated to get up. She can motivate herself if she wants to.” Tr. 410. He
encouraged her to do normal activities. Tr. 410.
On May 3, 2013, Harris reported to a Unison nurse that she had experienced some
thoughts of harming herself “without intentions” the previous day. Tr. 433. She denied current
thoughts of harming herself. Tr. 433. Upon examination, Harris was mostly normal and
presented with good hygiene and denied hallucinations, although she was easily distracted and
had poor eye contact. Tr. 433. She spoke about planning to go to church that upcoming Sunday.
Tr. 433.
On May 6, 2012, Harris saw a Unison nurse, who noted that Harris was tearful and felt
hopeless about her future. Tr. 390. On May 20, 2013, she complained of still feeling down but
sleeping better. Tr. 392. She heard voices at night. Tr. 392. Upon examination, Harris’s mood
was stable and other mental status findings were mostly normal. Tr. 392. The nurse referred
Harris to the Genesis facility for additional therapy. Tr. 392.

7

On July 8, 2013, Harris told Teitlebaum that, through Genesis, she discovered how she
was made to dislike herself and how to counter this. Tr. 387. She was “much happier without
anyone in her life and is focusing on self[-]care now.” Tr. 387. Her cousin was staying in her
apartment with her at night. Tr. 387. On August 14, 2013, Harris reported that she was isolating
and hated her apartment. Tr. 388. After receiving upsetting news, she attempted to overdose on
her medication; she slept for two days but “woke up OK” and stated that she would not do it
again. Tr. 388. On September 25, 2013, Harris was depressed and anxious. Tr. 389. She was
also pleasant, oriented, had good thought content and eye contact, was well-groomed, and had
good hygiene. Tr. 389.
C. Medical Opinion Evidence
1. Treating Source Opinion
In September 2012, Dr. Indurti completed a check-box mental functional capacity
assessment on behalf of Harris. Tr. 360. He opined that Harris was markedly limited in all areas
assessed, including the following abilities: understand, remember, and carry out very short and
simple instructions; maintain attention and concentration for extended periods; work in
coordination with or proximity to others without being distracted by them; make simple work
related decisions; complete a normal workday and workweek without interruptions from
psychologically based symptoms; perform at a consistent pace without an unreasonable number
and length of rest periods; interact appropriately with general public; maintain socially
appropriate behavior; and adhere to basic standards of neatness and cleanliness. Tr. 360.
Dr. Indurti indicated that Harris was unemployable and that the limitations were expected to last
twelve months or more. Tr. 360.

8

On May 6, 2013, Dr. Indurti completed a medical source statement on behalf of Harris.
Tr. 435-437. Dr. Indurti opined that, for two-thirds of an eight-hour workday, Harris could
remember, understand, and follow directions and maintain attention and concentration; she
would be more than twenty-five percent less productive than an unimpaired worker in her ability
to perform work at a reasonable pace; she is unable to consistently interact appropriately with the
public and would be distracted by or distract coworkers more than one third of the time; she
would be absent, late, or leave work early more than three times a month; and she would have
emotional outbursts directed at coworkers or supervisors more than once every other month. Tr.
435-436. She could not withstand the stress and pressures of routine, simple, unskilled work
because such work would likely cause her to decompensate and she would likely be successful
only in a sheltered environment. Tr. 437. In his only comment provided, Dr. Indurti stated that
Harris had hallucinations and delusions of persecution. Tr. 437.
2. State Agency Reviewers
On March 19, 2012, state agency psychologist Mel Zwissler, Ph.D., reviewed Harris’s
record. Tr. 62-65. Regarding Harris’s mental residual functional capacity (“RFC”), Dr. Zwissler
opined that Harris’s symptoms from her diagnosis of schizophrenic, paranoid, and other
psychotic disorders resulted in moderate limitations in her abilities to complete a normal
workday and workweek and to perform at a consistent pace without an unreasonable number of
rest periods. Tr. 62-64. As a result, Harris could perform tasks that do not have strict time or
production requirements. Tr. 64. Dr. Zwissler found Harris to be moderately limited in her
ability to get along with coworkers or peers without distracting them and that she could perform
tasks that require occasional, superficial interaction with others. Tr. 64-65. She was moderately

9

limited in her ability to respond appropriately to changes in the work setting and would do best
in an environment that was relatively static with few changes. Tr. 65.
On August 27, 2012, state agency psychologist Karla Voyten, Ph.D., reviewed Harris’s
record and affirmed Dr. Zwissler’s findings. Tr. 73-76.
D. Testimonial Evidence
1. Harris’s Testimony
Harris was represented by counsel and testified at the administrative hearing. Tr. 32-51.
She is single and lives alone in an apartment. Tr. 36-37. She has a car and a driver’s license and
drives four or five times a week when she needs to go to the store or do laundry. Tr. 37. She
does not drive at night because she gets nervous and because of her vision. Tr. 37. She walked
to the hearing; it took her about twenty minutes. Tr. 37. She has gained thirty pounds in the last
year because she began to eat better and is getting more sleep. Tr. 36.
After Harris dropped out of school, she attended Job Corps and attempted to train for a
trade but she could not keep up and had to drop out. Tr. 38. She went to nursing school and “the
lady, she let me pass anyway” but she was unable to get her STNA (State Tested Nursing
Assistant) certification despite three attempts. Tr. 39. She worked as a home health aide for
about eight months and then she was laid off when “they found some reliable workers.” Tr. 40.
She then quit because they would not give her any more hours. Tr. 40. She also worked in fast
food for a short time but quit when she could not keep up. Tr. 40-41.
In a typical day, Harris gets up around 10 or 11 o’clock and gets something to eat. Tr.
41. She takes her medication, which makes her tired, and then she goes back to sleep. Tr. 41.
When she gets up again she “might straighten up a little bit.” Tr. 41. She does not leave the
house much because she does not have any friends. Tr. 41. She goes to doctor appointments and

10

a family member might come over to take her somewhere or visit with her. Tr. 41. Her sister
has children and she sometimes goes out with them; sometimes her brother-in-law will pick her
up and take her to their house. Tr. 41. Sometimes she does not get dressed or comb her hair and
stays in bed all day. Tr. 42. She does this anywhere from two to five days a month. Tr. 37. She
does not watch television; she explained that she is tired and not motivated to do much. Tr. 42.
She stated, “Since I don’t have any children, I guess I don’t feel motivated to do anything.” Tr.
47. She also explained that her medications make her sleepy. Tr. 44.
Harris testified that she is unable to work because, in every job she has had, people have
told her that she cannot pay attention and that they do not have time to stand with her and show
her what to do. Tr. 44. She described how she worked seasonally one year as a cashier at Sears.
Tr. 46. Her cousin, a manager there, got her the job and no one knew she was having a hard time
because her cousin helped her. Tr. 46-47. She stated that, when she learned new tasks at work,
she understood when people first gave her instructions but that, as soon as they left, she would
forget “one or two things” and have to find another person to ask. Tr. 50. Soon, all the people at
work would comment that they had just shown her what to do and she would be told that she
could not keep up. Tr. 50. People also complained that she was in her own world and not nice
enough. Tr. 44. One person suggested she needed a job dealing only with one person. Tr. 44.
When she worked as a home health aide for the elderly, the patients told her boss that they did
not want Harris to come back; that they did not like her; and that she had an attitude. Tr. 44.
Harris explained that she did not know she had an attitude and stated that she has tried to work
but it keeps getting harder and harder the older she gets. Tr. 44-45. People have also told her
she has “anger issues.” Tr. 47.

11

Harris stated that her medications are “really good this time,” including that her side
effects are diminished. Tr. 48. She is not having mood swings as often on the Seroquel. Tr. 48.
She gets upset “every once in a while” because she does not like being around people. Tr. 48.
She does not get upset a lot like she used to when she was working. Tr. 48. She stated that her
medication makes her feel a lot better than she did when she was trying to work and was not
taking medication. Tr. 48. She also stated that she gets more sleep: “I used to—all my life, I feel
like I only got two or three hours of sleep; now I get seven hours of sleep.” Tr. 49. She can
wake up after eight hours of sleep and go right back to sleep for another six hours, “if I want to,
because that’s what the medication does.” Tr. 49. She has been hearing voices since she was a
little girl, but they are eliminated when she takes her medication. Tr. 49.
2. Vocational Expert’s Testimony
Vocational Expert Joe Thompson (“VE”) testified at the hearing. Tr. 51-56. The ALJ
asked the VE to determine whether a hypothetical individual of Harris’s age, education and work
experience could perform unskilled work if the individual had the following characteristics: can
perform work at all exertional levels, can perform simple, routine tasks consistent with unskilled
work in a static environment with few changes; can make simple work-related decisions with no
strict production requirements; and can have occasional interaction with coworkers, supervisors,
and the public. Tr. 53. The VE answered that such an individual could perform work as a
dishwasher (10,000 Ohio jobs; 300,000 national jobs), janitor (20,000 Ohio jobs; 800,000
national jobs), and laundry worker (5,000 Ohio jobs; 200,000 national jobs). Tr. 53-54.
The ALJ asked the VE how long a typical worker would be expected to be on-task during
a workday. Tr. 54. The VE replied that, in his experience, a typical worker would get two 15minute scheduled breaks in the morning and afternoon, a 30-minute lunch break, and one or two

12

additional unscheduled 10-15 minute breaks; if a worker is off-task 20 percent of the time or
more, there would be no jobs the worker could perform. Tr. 54. Next, the ALJ asked the VE
how the individual’s ability to sustain competitive employment would be affected if the
individual required re-direction performing tasks. Tr. 54. The VE explained that, typically in
unskilled positions, there would be occasional supervision provided but, if the individual
required re-direction more frequently than that to the point where there would be consistent redirection, there would be no jobs the individual could perform. Tr. 54. The ALJ asked what
“occasional” meant and the VE answered that “occasional” meant up to one-third, or 30%, of the
workday. Tr. 54. Lastly, the ALJ asked the VE what the standard in the workplace is regarding
absences and the VE stated that, in his experience, if a person is consistently absent one to two
days per month all employment would be eliminated. Tr. 55.
Next, Harris’s attorney asked the VE whether the hypothetical individual previously
described would be affected in her ability to sustain work if the individual was also 25% less
productive than an unimpaired worker. Tr. 55. The VE answered that, for the positions
mentioned, there would be no set criteria for productivity. Tr. 55. However, if the limitation
posed was akin to off-task time, the VE stated that it would be over 20% and, therefore, preclude
all employment. Tr. 55.
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:

13

[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 economy . . . .
42 U.S.C. § 423(d)(2).
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:
1.

If claimant is doing substantial gainful activity, he is not disabled.

2.

If claimant is not doing substantial gainful activity, his impairment must
be severe before he can be found to be disabled.

3.

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, claimant is presumed disabled without further inquiry.

4.

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.

5.

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
national economy.

20 C.F.R. §§ 404.1520, 416.920;4 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

4

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).

14

Commissioner at Step Five to establish whether the claimant has the vocational factors to
perform work available in the national economy. Id.
IV. The ALJ’s Decision
In her January 16, 2014, decision, the ALJ made the following findings:
1.

The claimant has not engaged in substantial gainful activity since January
19, 2012, the application date. Tr. 16.

2.

The claimant has the following severe impairments: depression, anxiety,
and schizoaffective disorder. Tr. 16.

3.

The claimant does not have an impairment or combination of
impairments that meets or medically equals the severity of one of the
listed impairments in 20 CFR Part 404, Subpart P, Appendix 1. Tr. 16.

4.

The claimant has the residual functional capacity to perform a full range
of work at all exertional levels but with the following non-exertional
limitations: the claimant retains the ability to perform simple, routine
tasks consistent with unskilled work in a static environment with few
changes; able to make simple work related decisions; and only superficial
interaction with others. Tr. 18.

5.

The claimant was born on September 28, 1972 and was 39 years old,
which is defined as a younger individual age 18-49, on the date the
application was filed. Tr. 24.

6.

The claimant has a limited education and is able to communicate in
English. Tr. 24.

7.

Transferability of job skills is not an issue because the claimant does not
have past relevant work. Tr. 24.

8.

Considering the claimant’s age, education, work experience, and residual
functional capacity, there are jobs that exist in significant numbers in the
national economy that the claimant can perform. Tr. 24.

9.

The claimant has not been under a disability, as defined in the Social
Security Act, since January 19, 2012, the date the application was filed.
Tr. 25.
V. Parties’ Arguments

15

Harris objects to the ALJ’s decision on two grounds. She argues that the ALJ erred with
respect to the medical opinion evidence because she failed to give good reasons when assigning
“less weight” to the opinions of Harris’s treating physician, Dr. Indurti, and she failed to properly
evaluate the state agency opinions. Doc. 15, pp. 9-15. In response, the Commissioner submits
that the ALJ followed the proper procedure and that substantial evidence supports her evaluation
of the medical opinion evidence. Doc. 19, pp. 9-16.
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 and Human Servs., 889 F.2d 679, 681
(6th Cir. 1989) (per curiam) (citations omitted)). 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).
A. The ALJ gave good reasons for the weight she assigned to Dr. Indurti’s opinions
The ALJ did not assign controlling weight to the opinions of Dr. Indurti, Harris’s treating
psychiatrist. Harris does not challenge this finding by the ALJ. Instead, Harris argues that,
having found Dr. Indurti’s opinions not entitled to controlling weight, the ALJ was required to
provide good reasons for not assigning “significant” weight to the opinions and this she did not
do. Doc. 15, p. 9.

16

Under the treating physician rule, “[a]n ALJ must give the opinion of a treating source
controlling weight if he finds the opinion well supported by medically acceptable clinical and
laboratory diagnostic techniques and not inconsistent with the other substantial evidence in the
case record.” Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004); 20 C.F.R. §
404.1527(c)(2). If an ALJ decides to give a treating source’s opinion less than controlling
weight, she must give “good reasons” for doing so that are sufficiently specific to make clear to
any subsequent reviewers the weight given to the treating physician’s opinion and the reasons for
that weight. Wilson, 378 F.3d at 544. In deciding the weight given, the ALJ must consider
factors such as the length, nature, and extent of the treatment relationship; specialization of the
physician; the supportability of the opinion; and the consistency of the opinion with the record as
a whole. See 20 C.F.R. § 416.927(c); Bowen v. Comm’r of Soc. Sec., 478 F.3d 742, 747 (6th Cir.
2007).
Here, the ALJ gave Dr. Indurti’s opinions “less weight” vis a vis the “great weight” she
assigned to the opinions of the state agency reviewers. Tr. 22. Harris argues that the ALJ
committed error because, when assigning weight to Dr. Indurti’s opinions, she did not consider
all the factors contained in 20 C.F.R. § 416.927(c). Doc. 15, p. 12. She argues that the ALJ only
considered the consistency of Dr. Indurti’s opinions with the record as a whole and the
supportability of his opinions5 but did not discuss the length, nature, and extent of the treatment
relationship. Id.
An ALJ is not required to discuss every factor in 20 C.F.R. § 416.927(c). Francis v.
Comm’r of Soc. Sec., 414 Fed. App’x 802, 804 (6th Cir. March 16, 2011) (“Although the
5

Again, Harris does not dispute that the ALJ provided sufficient explanation as to how Dr. Indurti’s opinions were
inconsistent with the record as a whole and were unsupported. See Tr. pp. 22-23 (ALJ’s decision explaining how
Dr. Indurti’s opinions are inconsistent with the record as a whole and not supported by his own treatment notes or
his two check-box form opinions, which contained only one handwritten comment between them); 20 C.F.R. §
416.927(c) (the ALJ considers the consistency of the opinion with the record as a whole and the supportability of the
opinion when discussing good reasons for assigning weight to an opinion).
17

regulations instruct an ALJ to consider [the length, nature, and extent of the treatment
relationship], they expressly require only that the ALJ’s decision include ‘good reasons . . . for
the weight . . . give[n] [to the] treating source’s opinion’—not an exhaustive factor-by-factor
analysis.”). Even assuming the ALJ was required to consider all the factors, her failure to follow
this procedural rule is harmless error when, as here, the Court can engage in meaningful review
of the ALJ’s decision. See Blakley v. Comm’r of Soc. Sec., 581 F.3d 399, 408 (6th Cir. 2009) (an
ALJ’s failure to give good reasons for assigning less weight to a treating source opinion is
harmless error where the court can engage in meaningful review of the ALJ’s decision).
Moreover, the Court disagrees that the ALJ did not discuss all the factors found in 20
C.F.R. § 416.927(c). The only factors the ALJ did not expressly discuss in the paragraph of her
decision assigning weight to Dr. Indurti’s opinions were Dr. Indurti’s specialization and the
length, nature, and extent of his treatment relationship with Harris. However, elsewhere in her
decision, the ALJ made clear that she considered those factors. In detailing Harris’s treatment
history in exhaustive detail, the ALJ described Dr. Indurti as a psychiatrist. Tr. 20 (“In April
2011, Psychiatrist Sreekanth Indurti, M.D., diagnosed the claimant...”). She also outlined
Harris’s treatment history in chronological order. She begins in March 2011 when Harris
presented, for the first time, for mental health treatment and notes that, one month later, she
began treatment with Dr. Indurti. Tr. 20. She states that Harris saw Dr. Indurti in October and
November 2011 and discusses his treatment notes. Tr. 20. She observes that Harris continued to
treat with Dr. Indurti “throughout 2012, meeting with him approximately one time each month
for 30 minutes.” Tr. 20. She goes on to discuss Dr. Indurti’s treatment notes (and identifies
them as Dr. Indurti’s treatment notes) from March, April, May, August, and September 2012 and
January 2013. Tr. 21. And the ALJ accurately dated Dr. Indurti’s two opinions. Tr. 22

18

(referencing Dr. Indurti’s “one handwritten comment” in his opinion, otherwise containing
“check marks on pre-printed forms,” completed in May 2013); Tr. 23 (discussing Dr. Indurti’s
“earlier” opinion, dated September 2012). In contrast to Harris’s assertion (Doc. 21, p. 3), the
ALJ clearly recognized that Harris treated with Dr. Indurti, a psychiatrist, once a month, for
thirty minutes each month, for the better part of two years. The ALJ’s failure to summarize the
aforesaid in her paragraph assigning weight to Dr. Indurti’s opinions does not render her decision
non-compliant with the factors in 20 C.F.R. § 416.927(c).
In an unrelated argument, Harris complains about the ALJ’s assertion that Harris’s
assigned GAF score of 45-50 would not preclude a claimant from having the mental capacity to
hold at least some jobs in the national economy. Tr. 15, p. 13. She argues that the issue is not
whether there are “some jobs” but whether there are “significant jobs.” Id. However, the ALJ,
relying on VE testimony, found that there are a significant number of jobs in the national
economy that Harris can perform. Tr. 24 (listing dishwasher (10,000 Ohio jobs; 300,000
national jobs), janitor (20,000 Ohio jobs; 800,000 national jobs), and laundry worker (5,000 Ohio
jobs; 200,000 national jobs). The ALJ’s failure to use the word “significant” rather than “some”
in a generalized statement about GAF scores is not error. Moreover, Harris concedes that an
ALJ is not required to credit a GAF score. Doc. 21, p. 3.
B. The ALJ did not err when evaluating the state agency reviewers’ opinions
Harris argues that the ALJ erred when she assigned “great weight” to the state agency
reviewers’ opinions because she only listed one reason for doing so—that the “consultants have
specialized knowledge in assessing medical findings within the Social Security standard.” Doc.
15, p. 14 (quoting Tr. 22). The Court disagrees. The ALJ also explained that she found the
severity of the symptoms reported by Harris not entirely credible, “as evidenced by treatment

19

records and reported activities,” and that the record shows that Harris’s mood improved with
medication adjustments; i.e., the state agency reviewers’ opinions were consistent with the
record as a whole. Tr. 22. Harris’s additional argument, that the ALJ improperly gave more
weight to a reviewing source opinion than a treating source opinion, is also without merit. “In
appropriate circumstances, opinions from State agency medical and psychological consultants
and other program physicians and psychologists may be entitled to greater weight than the
opinions of treating or examining sources.” Soc. Sec. R. 96-6p, 1996 WL 374180, at *3 (July 2,
1996); Price v. Comm’r of Soc. Sec., 342 Fed. App’x 172, 177 (August 18, 2009) (“Although the
opinion of a treating physician generally is given more weight, this Court has recognized that
consultative opinions may be credited where they are supported by the record.”).
The ALJ did not run afoul of the regulations when assigning weight to the medical
opinion evidence and her decision is supported by substantial evidence. Accordingly, her
decision must be affirmed. See Jones v. Comm’r of Soc. Sec., 336 F.3d 469, 477 (6th Cir. 2003)
(a court must uphold the ALJ’s decision if it is supported by substantial evidence).
VII. Conclusion
For the reasons set forth herein, the Commissioner’s decision is AFFIRMED.

Dated: February 26, 2016
Kathleen B. Burke
United States Magistrate Judge

20