Padilla-Irizarry v. Commissioner of Social Security

Filing 22

OPINION AND ORDER affirming the decision of the Commissioner of the Social Security Administration. Signed by US Magistrate Judge Marcos E. Lopez on 1/10/2017.(JMB)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO

MARIA I. PADILLA-IRIZARRY,
Plaintiff,

CIVIL NO: 14-1699 (MEL)

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

OPINION AND ORDER
Pending before the court is María I. Padilla-Irizarry’s (“Plaintiff” or claimant”) appeal
from the decision of the Commissioner of Social Security (“the Commissioner”) denying her
application for disability benefits. Plaintiff—who applied for disability benefits alleging major
depression and back pain—contends that an administrative law judge’s decision to deny her
application was not supported by substantial evidence because the ALJ did not provide good
reasons for disregarding psychiatric opinions on her mental impairment.
I.

PROCEDURAL AND FACTUAL BACKGROUND
On January 23, 2008, Plaintiff filed an application for disability benefits alleging that on

August 14, 2006 (or “the onset date”), she became unable to work because of major depression
and back pain. See Tr. 616; 619; 432.1 Her last date insured under the Social Security Act was
December 31, 2011. Tr. 615. Plaintiff’s application was denied both initially and upon
reconsideration. Thereafter, she filed a request for a hearing before an administrative law judge.

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“Tr.” Refers to the transcript of the record of proceedings.

The administrative law judge held a hearing, and subsequently issued a written decision, finding
that Plaintiff was not disabled from her alleged onset through the date of the decision, March 12,
2010. Tr. 432. On August 2, 2012, the appeals council granted review of the original claim, and
remanded it for hearing before a different administrative law judge (hereafter “the ALJ”).2 On
July 1, 2015, the ALJ issued a written decision finding that Plaintiff was not disabled from
August 14, 2006 to March 12, 2010. On July 19, 2014, the Appeals Council denied Plaintiff’s
request for review, rendering the ALJ’s decision the final decision of the Commissioner of Social
Security, subject to judicial review. Plaintiff filed a complaint seeking review of the
Commissioner’s findings with regard to her mental impairment.3 Both parties have filed
supporting memoranda of law.
II.

LEGAL STANDARD
A. Standard of Review
Once the Commissioner has rendered a final determination on an application for

disability benefits, a district court “shall have the power to enter, upon the pleadings and
transcript of the record, a judgment affirming, modifying, or reversing [that decision], with or
without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). The court’s review is limited
to determining whether the ALJ employed the proper legal standards and whether his factual
findings were founded upon sufficient evidence. Specifically, the court “must examine the
record and uphold a final decision of the Commissioner denying benefits, unless the decision is
based on a faulty legal thesis or factual error.” López-Vargas v. Comm’r of Soc. Sec., 518 F.

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On a subsequent application for disability benefits, Plaintiff was found to be disabled from March 13, 2010. The
appeal pending before the court concerns the period from Plaintiff’s alleged onset on August 14, 2006, to March 12,
2010, the date of the first administrative law judge’s opinion on Plaintiff’s original claim. The decision now on
appeal before the court did not disturb the finding that Plaintiff was disabled since March 13, 2010. Tr. 14.
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Plaintiff’s appeal does not allege the ALJ erred with respect to any findings on her back pain; therefore, the court
declines to address the same in this opinion and order.

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Supp. 2d 333, 335 (D.P.R. 2007) (citing Manso-Pizarro v. Sec’y of Health & Human Servs., 76
F.3d 15, 16 (1st Cir. 1996) (per curiam)).
Additionally, “[t]he findings of the Commissioner … as to any fact, if supported by
substantial evidence, shall be conclusive.” 42 U.S.C. § 405(g). Substantial evidence is “such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”
Richardson v. Perales, 402 U.S. 389, 401 (1971). The standard requires “‘more than a mere
scintilla of evidence but may be somewhat less than a preponderance’ of the evidence.”
Ginsburg v. Richardson, 436 F.2d 1146, 1148 (3d Cir. 1971) (quoting Laws v. Celebrezze, 368
F.2d 640, 642 (4th Cir. 1966)).
While the Commissioner’s fact findings are conclusive when they are supported by
substantial evidence, they are “not conclusive when derived by ignoring evidence, misapplying
the law, or judging matters entrusted to experts.” Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir.
1999) (per curiam) (citing Da Rosa v. Sec’y of Health & Human Servs., 803 F.2d 24, 26 (1st Cir.
1986) (per curiam); Irlanda Ortiz v. Sec’y of Health & Human Servs., 955 F.2d 765, 769 (1st
Cir. 1991) (per curiam)). Moreover, a determination of substantiality must be made based on the
record as a whole. See Irlanda Ortiz, 955 F.2d at 769 (citing Rodríguez v. Sec’y of Health &
Human Servs., 647 F.2d 218, 222 (1st Cir. 1981)). However, “[i]t is the responsibility of the
[ALJ] to determine issues of credibility and to draw inferences from the record evidence.” Id.
Therefore, the court “must affirm the [Commissioner’s] resolution, even if the record arguably
could justify a different conclusion, so long as it is supported by substantial evidence.”
Rodríguez Pagán v. Sec’y of Health & Human Servs., 819 F.2d 1, 3 (1st Cir. 1987) (per curiam).

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B. Disability Under the Social Security Act
To establish entitlement to disability benefits, the claimant bears the burden of proving
that he or she is disabled within the meaning of the Social Security Act. See Bowen v. Yuckert,
482 U.S. 137, 146 n.5, 146–47 (1987). An individual is deemed to be disabled under the Social
Security Act if he or she is unable “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).
Claims for disability benefits are evaluated according a five-step sequential process. 20
C.F.R. § 404.1520; Barnhart v. Thomas, 540 U.S. 20, 24–25 (2003); Cleveland v. Policy Mgmt.
Sys. Corp., 526 U.S. 795, 804 (1999); Yuckert, 482 U.S. at 140–42. If it is determined that the
claimant is not disabled at any step in the evaluation process, then the analysis will not proceed
to the next step. At step one, it is determined whether the claimant is working and thus engaged
in “substantial gainful activity.” 20 C.F.R. § 404.1520(a)(4)(i). If so, then disability benefits are
denied. 20 C.F.R. § 404.1520(b). Step two requires the ALJ to determine whether the claimant
has “a severe medically determinable physical or mental impairment” or severe combination of
impairments. 20 C.F.R. § 404.1520(a)(4)(ii). If she does, then the ALJ determines at step three
whether the claimant’s impairment or impairments are equivalent to one of the impairments
listed in 20 C.F.R. part 404, subpart P, appendix 1. 20 C.F.R. § 404.1520(a)(4)(iii). If so, then
the claimant is conclusively found to be disabled. 20 C.F.R. § 404.1520(d). If not, then the ALJ
at step four assesses whether the claimant’s impairment or impairments prevent her from doing
the type of work she has done in the past. 20 C.F.R. § 404.1520(a)(4)(iv). In assessing an
individual’s impairments, the ALJ considers all of the relevant evidence in the case record to
determine the most the individual can do in a work setting despite the limitations imposed by her
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mental and physical impairments. 20 C.F.R. § 404.1545(a)(1). This finding is known as the
individual’s residual functional capacity (or “RFC”). Id. If the ALJ concludes that the claimant’s
impairment or impairments do prevent her from performing her past relevant work, the analysis
then proceeds to step five. At this final step, the ALJ evaluates whether the claimant’s residual
functional capacity, combined with her age, education, and work experience, allows her to
perform any other work that is available in the national economy. 20 C.F.R. § 404.1520(a)(4)(v).
If the ALJ determines that there is work in the national economy that the claimant can perform,
then disability benefits are denied. 20 C.F.R. § 404.1520(g).
III.

ANALYSIS
All of Plaintiff’s arguments on appeal challenge the ALJ’s RFC findings on her mental

limitations. The ALJ determined, in pertinent part, that Plaintiff had an RFC “limited to the
performance of unskilled, simple, and repetitive tasks not requiring attending [to the] public. . . .”
Tr. 18. The ALJ presented these limitations to a vocational expert, who testified that although an
individual with that RFC could not perform Plaintiff’s past work, she could perform
representative occupations such as Table Worker, Surgical Instruments Inspector, and Plastic
Hospital Products Assembler. Tr. 42-44. Accordingly, the ALJ found that Plaintiff was not
disabled because there is work in the national economy she could perform. Plaintiff contends that
she had greater limitations than assessed in the RFC; therefore, subsequent analysis was flawed
to the extent it relied on a mistaken view of her limitations.
In determining Plaintiff’s RFC, the ALJ considered Plaintiff’s treatment record (Tr. 2022) as well as the opinions of two treating psychiatrists and a State Agency psychiatrist who

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assessed Plaintiff for her disability determination. The ALJ gave “less weight”4 to the State
Agency psychiatrist, Dr. Carmen Piñeiro (Tr. 22), who assessed depressive disorder but opined
that Plaintiff’s mental impairments are not severe. Tr. 746 and 747. The ALJ found that Plaintiff
did have a severe mental impairment, although not enough as to prevent work-related activities.
The ALJ gave “limited” weight to Dr. Alberto Rodríguez and Dr. Carmen Cotto, two
psychiatrists who had treated Plaintiff through the State Insurance Fund. Dr. Cotto assessed
major depression with anxiety and relatively minor limitations, while Dr. Rodríguez assessed
severe major depression with psychosis and much more severe limitations. Plaintiff contends the
ALJ’s RFC finding was in error because the ALJ did not provide good reasons for
“disregarding” the opinion of Dr. Rodríguez.
The disability determination process generally accords “more weight to opinions from [a
claimant’s] treating sources, since these sources are likely to be the medical professionals most
able to provide a detailed, longitudinal picture of [the claimant’s] medical impairment(s) and
may bring a unique perspective to the medical evidence that cannot be obtained from the
objective medical findings alone or from reports of individual examinations, such as consultative
examinations or brief hospitalizations.”5 20 C.F.R. § 404.1527(c)(2). As such, “a treating
source’s opinion on the question of the severity of an impairment will be given controlling
weight so long as it ‘is well-supported by medically acceptable clinical and laboratory diagnostic
techniques and is not inconsistent with the other substantial evidence in [the] record.’” PolancoQuiñones v. Astrue, 477 F. App’x 745, 746 (1st Cir. 2012) (quoting 20 C.F.R. § 404.1527(c)(2)).

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Within the context of the ALJ’s opinion, the phrase “less weight” seems to mean “some weight, but not as much as
‘great weight and credibility.’” See Tr. 22 ¶ 5 and 6.
The ALJ gave “great weight” to an internal medicine specialist’s opinion on Plaintiff’s back pain. Within the context
of the ALJ’s opinion, the phrase “less weight” seems to mean some weight but not as much as “great weight.”
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Similarly, the Commissioner should “give more weight to the opinion of a source who has examined [the claimant]
than to the opinion of a source who has not examined [the claimant].” 20 C.F.R. § 404.1527(c)(1).

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To this end, “an ALJ must give ‘good reasons' for the weight accorded to a treating source's
opinion.” Id. (quoting 20 C.F.R. § 404.1527(c)(2)) (emphasis in original).
In this case, the ALJ recognized that both Dr. Rodríguez and Dr. Cotto performed
comprehensive evaluations of Plaintiff; however, he afforded their opinions “limited weight”
because of their discrepancies. He noted there have been ups and downs in Plaintiff’s
symptomatology and discrepancies in diagnoses.
On November 15, 2006, Dr. Cotto evaluated Plaintiff’s psychiatric condition for
treatment. She diagnosed major depressive disorder with anxiety and prescribed Cymbalta and
Klonopin, as well as follow up treatment. Tr. 287-291. After having “not improved much” as of
her second psychiatric session (Tr. 285), Plaintiff reported feeling better as of February 16, 2007.
Tr. 273. On April 10, Dr. Cotto discharged Plaintiff after five sessions of treatment. Based on
Dr. Cotto’s observations, Plaintiff was assessed a 10% psychiatric disability on April 23, 2007.
Tr. 161. In the same report, the reviewing doctor notes a mild level of pathology in thought,
affect, and behavior, and normal intellectual functioning, perception, and judgment. Id.
On August 20, 2007, Plaintiff was admitted into a mental health center for deterioration
of depressive symptoms. She experienced partial hospitalization and intensive outpatient
treatment, which she received 2-3 times a week. At the time of discharge on November 27,
2007, she was diagnosed with psychotic disorder not otherwise specified and delusional disorder.
Tr. 168. Her discharge form notes that “[d]uring therapeutic treatment the patient improved her
mood, interpersonal skills, and relations with family members. The medications were decreased
and we observed group integration.” Tr. 167 and 168. On her discharge she was referred to
another health center for further monitoring. Roughly ten days later she reported to her follow up

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appointment at the new health center, upon which her diagnosis changed. She was diagnosed
with severe major depressive disorder, single episode, without psychotic features. Tr. 169.
On March 13, 2008, Dr. Piñeiro assessed Plaintiff for her disability claim. Dr. Piñeiro
assessed depressive disorder, but opined that Plaintiff’s mental condition is not severe. In her
case analysis report, Dr. Piñeiro found mild restriction of Plaintiff’s activities of daily living;
mild difficulties in maintaining social functioning; no episodes of decompensation of extended
duration; and mild difficulties in maintaining concentration, persistence, or pace. Tr. 757.
On the other hand, Dr. Rodríguez assessed on June 12, 2011, that Plaintiff was unable to
meet competitive standards in any of the assessed areas of mental functioning. See Mental
Residual Functional Capacity Assessment at Tr. 966-970. As the cause of these limitations, he
diagnosed severe major depression with psychosis. Tr. 967. He assessed marked restriction of
activities of daily living, marked difficulties in maintaining social functioning, three episodes of
decompensation within a 12 month period, each of at least two week duration, and marked
deficiencies of concentration, persistence, or pace. Tr. 968. Although Dr. Rodríguez’s report
postdates the relevant period in this case (August 14, 2006 to March 12, 2010), his report states
the earliest day the description of symptoms and limitations applies is May 21, 2009. Tr. 969;
See Tr. 247.
Plaintiff contends that she suffered a deterioration of her mental condition such that the
various reports are not inconsistent but valid opinions for the time period they were issued. The
ALJ, however, found a longitudinal history of Plaintiff’s mental condition could not be
established because treatment was not continuous and raised the question of what happened
during the lapses in treatment. Insofar as Plaintiff had the burden of establishing the severity of
her mental impairment (See Deblois v. Sec'y of Health & Human Servs., 686 F.2d 76, 79 (1st
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Cir. 1982)), this lack of evidence weighed against her disability claim. The Plaintiff has had
episodes of crisis; however, the ALJ noted that she responded to treatment after those episodes
and has reported feeling better on several occasions. Accordingly, the ALJ found “discrepancies”
between Dr. Rodríguez’s opinion and other evidence in the record showing much less severe
limitations and therefore declined to give the opinion of Dr. Rodríguez controlling weight. For
this reason, the ALJ was not required to include in the RFC all of the limitations assessed by
Dr. Rodríguez—i.e. marked difficulties in “concentration, persistence, or pace.”
Ultimately, the ALJ considered three medical opinions on Plaintiff’s mental limitations:
one finding Plaintiff’s impairment was not severe, one finding relatively mild limitations, and a
third finding severe limitations. Although he declined to give any of them controlling weight
because of their discrepancies, the ALJ’s final RFC determination reflected a middle ground
between the three opinions. Plaintiff contends the ALJ “disregarded” the medical opinions and
left himself with no medical evidence on which to base his RFC assessment; however, the ALJ’s
language suggests he gave each opinion some, although not controlling, weight, and concluded
that Plaintiff’s RFC was somewhere in between the three opinions.
Based on the foregoing analysis, the court concludes that the decision of the
Commissioner was based on substantial evidence. Therefore, the Commissioner’s decision is
hereby AFFIRMED.
IT IS SO ORDERED.
In San Juan, Puerto Rico, this 10th day of January, 2017.
s/Marcos E. López
U.S. Magistrate Judge

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