Large v. Social Security Administration, Commissioner of
MEMORANDUM AND ORDER: The Court concludes that the Decision is well supported by substantial evidence and mustbe affirmed. Based upon the foregoing, it is hereby ORDERED that the Plaintiffs Motion forJudgment on the Pleadings [Doc. 11] be DENIED, and the Commissioners Motion for SummaryJudgment [Doc. 13] be GRANTED. The Clerk of Court will be directed to CLOSE this case.A SEPARATE JUDGMENT WILL ENTER.Signed by District Judge Harry S Mattice, Jr on 9/6/2017. (DJH, )
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF TENNESSEE
KEITH WADE LARGE,
NANCY A. BERRYHILL,1
Acting Commissioner of Social Security,
MEMORANDUM AND ORDER
Now before the Court is the Plaintiff’s Motion for Judgment on the Pleadings and
Memorandum in Support [Docs. 11 & 12] and the Defendant’s Motion for Summary Judgment
and Memorandum in Support [Docs. 13 & 14]. Keith Wade Large (“Large”) seeks judicial review
of the decision of the Administrative Law Judge (“the ALJ”), the final decision of the Defendant
Nancy A. Berryhill, Acting Commissioner of Social Security (“the Commissioner”).
In August 2012, Plaintiff applied for disability insurance benefits and supplemental
security income (Tr. 175-82). He first applied for these benefits in March 2011, alleging disability
as of April 2008, but in a July 2012 decision, the Administrative Law Judge (ALJ) found that
Plaintiff was not “disabled” under the Act (Tr. 10, 53-65). In his current claim, Plaintiff alleges
disability as of July 28, 2012, due to limitations from anxiety, depression, and post-traumatic stress
disorder (PTSD) (Tr. 175, 177, 193-204). Plaintiff’s claims were denied initially (Tr. 137-40), and
During the pendency of this case, Nancy A. Berryhill replaced Acting Commissioner Carolyn
W. Colvin. Pursuant to Federal Rule of Civil Procedure 25(d), Nancy A. Berryhill is substituted
as the Defendant in this case.
on reconsideration (Tr. 142-45).
In April 2014, an ALJ conducted a hearing, and on December 2014, the ALJ rendered his
decision (“the Decision”) (Tr. 10-23). In the Decision, the ALJ found that there was no new and
material evidence to warrant a different conclusion as to ALJ’s previous findings regarding
Plaintiff’s past relevant work, date of birth, education, and residual functional capacity (RFC) (Tr.
19-22). Therefore, he adopted the ALJ’s previous finding that Plaintiff retained the RFC to
perform light work as defined in the regulations with additional postural and mental restrictions
(Tr. 15, 60). The Decision also adopted the prior step four finding that Plaintiff could not perform
his past relevant work as a paramedic, and his step five finding that there was “other work” that
Plaintiff could perform, including the representative occupations of housekeeping cleaner, laundry
folder, and folder (Tr. 21-22). Consequently, the ALJ found that Plaintiff was not “disabled” under
the Act from July 28, 2012 through December 5, 2014 (Tr. 23). In March 2016, the agency’s
Appeals Council denied Plaintiff’s request for review (Tr. 1-4). Thus, the Decision stands as the
“final decision” of the Commissioner subject to judicial review.
Large was 44 years of age when the ALJ issued the Decision in this case (Tr. 32). He
completed two years of college, as well as paramedic school. Large worked as a paramedic from
1994 to 2008 (Tr. 195). He claims disability beginning in July 2008 based on “anxiety, depression,
and PTSD” (Tr. 194).
At the hearing before the ALJ, the Plaintiff testified that his work as a paramedic (“EMT”)
ended – not because of his disability – but because he was fired for stealing medications (Tr. 35).
He then did not take the steps necessary to keep his license to work as a paramedic (Tr. 35):
Q. (by the ALJ): And are you eligible to get your [paramedic] license back if you
A. It was sent to the State to where I’d have to do like a rehab, and I couldn’t be
away from my autistic son, so I never went through the rehab, so I let my license
He also testified that his disability is based on mental and emotional problems, and some
days anxiety, depression, and PTSD (Tr. 36):
Q. (by the ALJ): So are you claiming that you’re disabled due to any physical
problems or mainly emotional?
A. Mainly mental.
As for mental issues, the Plaintiff testified that he loses his temper, has concentration
problems, and headaches (Tr. 39). Finally, Large testified that his son receives disability benefits,
and that Large’s parents help take care of him (Tr. 32, 36).
The Court has considered the medical evidence in the record, the testimony at the hearings,
and all other evidence in the record. The medical history of the Plaintiff and the content of the
ALJ’s Decision are not in dispute, and need not be repeated here.
STANDARD OF REVIEW
When reviewing the Commissioner’s determination of whether an individual is disabled
pursuant to 42 U.S.C. § 405(g), the Court is limited to determining “whether the ALJ applied the
correct legal standards and whether the findings of the ALJ are supported by substantial evidence.”
Blakley v. Comm’r of Soc. Sec., 581 F.3d 399, 405 (6th Cir. 2009) (citing Key v. Callahan, 109
F.3d 270, 273 (6th Cir. 1997)). If the ALJ applied the correct legal standards and his findings are
supported by substantial evidence in the record, his decision is conclusive and must be affirmed.
42 U.S.C. § 405(g); Warner v. Comm’r of Soc. Sec., 375 F.3d 387, 390 (6th Cir. 2004). Substantial
evidence is “more than a scintilla of evidence but less than a preponderance; it is such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion.” Cutlip v. Sec’y
of Health & Human Servs., 25 F.3d 284, 286 (6th Cir. 1994) (citing Kirk v. Secretary of Health &
Human Servs., 667 F.2d 524, 535 (6th Cir. 1981)) (internal citations omitted).
It is immaterial whether the record may also possess substantial evidence to support a
different conclusion from that reached by the ALJ, or whether the reviewing judge may have
decided the case differently. Crisp v. Sec’y of Health & Human Servs., 790 F.2d 450, 453 n.4 (6th
Cir. 1986). The substantial evidence standard is intended to create a “‘zone of choice’ within
which the Commissioner can act, without the fear of court interference.” Buxton v. Halter, 246
F.3d 762, 773 (6th Cir. 2001) (quoting Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986)).
Therefore, the Court will not “try the case de novo, nor resolve conflicts in the evidence, nor decide
questions of credibility.” Garner v. Heckler, 745 F.2d 383, 387 (6th Cir. 1984) (citing Myers v.
Richardson, 471 F.2d 1265 (6th Cir. 1972)).
In addition to reviewing the ALJ’s findings to determine whether they were supported by
substantial evidence, the Court also reviews the ALJ’s decision to determine whether it was
reached through application of the correct legal standards and in accordance with the procedure
mandated by the regulations and rulings promulgated by the Commissioner. See Wilson v.
Comm’r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004).
On review, the plaintiff “bears the burden of proving his entitlement to benefits.” Boyes
v. Sec’y. of Health & Human Servs., 46 F.3d 510, 512 (6th Cir. 1994) (citing Halsey v. Richardson,
441 F.2d 1230 (6th Cir. 1971)).
Large’s claim before this Court is that the ALJ erred by giving little weight to the opinions
of two psychiatrists and a psychologist, all of whom stated that Large was unable to handle the
kind of stress one might encounter in an ordinary work environment. In this regard, Large argues
that the ALJ did not follow the treating source rule. Specifically, Plaintiff argues that the ALJ
erred in evaluating the opinions of his treating sources Shirley Tretham, M.D., R. Jeffrey Munson,
Ph.D., and Catherine Gyurik, M.D. These sources all offered opinions on the restrictions from
Plaintiff’s mental impairments (Tr. 600-01, 634-36, 645-48, 650-51, 654-55).
The Court agrees with the Plaintiff that the ALJ will give controlling weight to a treating
source’s opinion in most cases. However, this deference is only afforded when the opinion is
“well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not
inconsistent with the other substantial evidence in [the] record.” See 20 C.F.R. § 404.1527; SSR
96-2p. If the ALJ does not give the opinion controlling weight, the ALJ determines the appropriate
weight to afford the opinion by evaluating the following factors: length of treatment, frequency
of examination, nature and extent of the treatment relationship, amount of relevant evidence that
supports the opinion, the opinion’s consistency with the record as a whole, the specialization of
the source, and other factors which tend to support or contradict the opinion. See Wilson v. Comm’r
of Soc. Sec., 378 F.3d 541, 544-45 (6th Cir. 2004) (citing 20 C.F.R. § 404.1527). The regulations
state that the agency “will always give good reasons. . . for the weight we give your treating
source’s opinion.” 20 C.F.R. § 404.1527(c)(2); Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365,
376 (6th Cir. 2013) (the Commissioner is required to provide “good reasons” for discounting the
weight given to a treating source opinion). “These reasons must be ‘supported by the evidence in
the case record, and must be sufficiently specific to make clear to any subsequent reviewers the
weight the adjudicator gave to the treating source’s medical opinion and the reasons for that
weight.’” Gayheart, 710 F.3d at 376 (quoting SSR 96-2p). “This procedural requirement ‘ensures
that the ALJ applies the treating physician rule and permits meaningful review of the ALJ’s
application of the rule.’” Id. (quoting Wilson, 378 F.3d at 544).
In the present case, the Court finds that the ALJ reasonably evaluated the opinions of Drs.
Trentham, Munson, and Gyurik, and gave “good reasons” for the weight afforded to their opinions.
The ALJ gave Dr. Trentham’s assessment little weight, because the ALJ found it to be too
restrictive based on her own treatment notes (Tr. 20). He discussed that her records indicated
Large was generally doing well with treatment, with occasional changes and adjustment in his
medications from July 2012 through November 2013 (Tr. 20, 577-84, 657-75, 684, 687, 689-92,
694-97). The ALJ considered the opinions of Dr. Munson and Dr. Gyurik and found that they
were generally consistent with the RFC, which included significant limitations related to moderate
restrictions in mental functioning (Tr. 21). However, the ALJ found that their opinions that Large
had marked or extreme limitations were not consistent with treatment records that indicated Large
was generally doing well on medications (Tr. 21, 577-84, 657-75, 684, 687, 689-92, 694-97).
Overall, the ALJ did give their opinions weight, as they were somewhat consistent with the RFC
Plaintiff argues that the ALJ’s only reason for discounting the treating source opinions was
that they were inconsistent with the treatment notes. The Court finds, however, that the ALJ
reasonably considered that the opinions were inconsistent with the treatment records. The ALJ
discussed Plaintiff’s treatment for depression and anxiety since November 2007, and his diagnosis
of PTSD in January 2012 (Tr. 18). The ALJ noted that treatment records from Helen Ross McNabb
Center revealed that Large did well on his medications from February through July 2012 (Tr. 18,
404-22, 585-93). The ALJ discussed specific subjective reports and mental status examination
findings from Plaintiff’s October 2012, January 2013, April 2013, July 2013, September 2013,
November 2013, December 2013, January 2014, March 2014 and April 2014 examinations (Tr.
18-19, 577-84, 657-75, 684, 687, 689-92, 694-97). The ALJ accurately summarized Plaintiff’s
mental health treatment notes and recognized that Large had limitations from his mental
impairments (Tr. 19). The Court finds that the treatment records did not support the marked and
extreme limitations opined by Dr. Trentham, Dr. Munson, and Dr. Gyurik (Tr. 20-21).
The Court further finds that the ALJ explained that he gave “little weight” to Dr.
Trentham’s opinion and “great weight” to the opinions of Dr. Munson and Dr. Gyurik (Tr. 20-21).
Moreover, additional substantial evidence supports this conclusion. The Plaintiff managed his
basic activities of daily living and took care of his autistic son (Tr. 19). Large’s daily activities,
including his responsibility as a caregiver for his autistic son, were additional inconsistencies that
the ALJ could point to as “good reasons” for discrediting a treating source’s opinion. See Miller
v. Comm’r of Soc. Sec., 524 F. App’x 191, 194 (6th Cir. 2013) (holding that the treating source’s
opinion that the claimant had marked limitations in mental functioning was inconsistent with the
treatment records, evidence of the claimant’s daily activities, and the claimant’s part-time
The Sixth Circuit, in a recent opinion, affirmed this analysis in a similar case. In Mueller
v. Comm’r of Soc. Sec., No. 16-6527, 2017 WL 1065550 (6th Cir. March 21, 2017), the plaintiff
argued that the ALJ failed to give good reasons for affording little weight to the medical opinion
of plaintiff’s treating psychiatrist, Dr. Maitra. Dr. Maitra opined that the plaintiff’s mental
impairments were so severe that the plaintiff would miss work frequently and be unable to perform
any work on a consistent basis. The ALJ, however, gave little weight to Dr. Maitra’s opinion,
because the opinion was inconsistent with Dr. Maitra’s treatment notes from the relevant period
which showed that the plaintiff “responded well to her medications.” And moreover, as in the
present case, Dr. Maitra’s opinion was contradicted by the evidence of the plaintiff’s daily
activities. The Sixth Circuit concluded that the evidence that the ALJ relied on in discounting Dr.
Maitra’s opinion also constitutes substantial evidence to support the RFC and the finding of not
The Court concludes that the Decision is well supported by substantial evidence and must
be affirmed. Based upon the foregoing, it is hereby ORDERED that the Plaintiff’s Motion for
Judgment on the Pleadings [Doc. 11] be DENIED, and the Commissioner’s Motion for Summary
Judgment [Doc. 13] be GRANTED. The Clerk of Court will be directed to CLOSE this case.
A SEPARATE JUDGMENT WILL ENTER.
/s/ Harry S. Mattice, Jr._______
HARRY S. MATTICE, JR.
UNITED STATES DISTRICT JUDGE
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