Lawson v. Colvin

Filing 13

MEMORANDUM OPINION. Signed by Magistrate Judge Pamela Meade Sargent on 02/24/2016. (Bordwine, Robin)

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF VIRGINIA
BIG STONE GAP DIVISION
PETER JOE LAWSON,
Plaintiff
v.
CAROLYN W. COLVIN,
Acting Commissioner of
Social Security,
Defendant

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Civil Action No. 2:14cv00030
MEMORANDUM OPINION
BY: PAMELA MEADE SARGENT
United States Magistrate Judge

I. Background and Standard of Review
Plaintiff, Peter Joe Lawson, (“Lawson”), filed this action challenging the
final decision of the Commissioner of Social Security, (“Commissioner”),
determining that he was not eligible for disability insurance benefits, (“DIB”),
under the Social Security Act, as amended, (“Act”), 42 U.S.C.A. § 423 (West
2011). Jurisdiction of this court is pursuant to 42 U.S.C. § 405(g). This case is
before the undersigned magistrate judge by transfer based on consent of the parties
pursuant to 28 U.S.C. § 636(c)(1).
The court’s review in this case is limited to determining if the factual
findings of the Commissioner are supported by substantial evidence and were
reached through application of the correct legal standards. See Coffman v. Bowen,
829 F.2d 514, 517 (4th Cir. 1987). Substantial evidence has been defined as
“evidence which a reasoning mind would accept as sufficient to support a
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particular conclusion. It consists of more than a mere scintilla of evidence but may
be somewhat less than a preponderance.” Laws v. Celebrezze, 368 F.2d 640, 642
(4th Cir. 1966). ‘“If there is evidence to justify a refusal to direct a verdict were the
case before a jury, then there is “substantial evidence.’”” Hays v. Sullivan, 907
F.2d 1453, 1456 (4th Cir. 1990) (quoting Laws, 368 F.2d at 642).
The record shows that Lawson protectively filed his application for DIB on
December 3, 2010, alleging disability as of August 27, 2010, due to a back injury,
depression, anxiety, bipolar disorder, memory problems, panic attacks, arthritis and
severe pain in the knees and legs. (Record, (“R.”), at 180, 192, 196, 223-24.) The
claim was denied initially and on reconsideration. (R. at 100-04, 106, 108-10.)
Lawson then requested a hearing before an administrative law judge, (“ALJ”), (R.
at 115), and a hearing was held on December 11, 2012, at which Lawson was
represented by counsel. (R. at 28-55.)
By decision dated December 21, 2012, the ALJ denied Lawson’s claim. (R.
at 15-27.) The ALJ found that Lawson met the nondisability insured status
requirements of the Act for DIB purposes through December 31, 2014.1 (R. at 17.)
The ALJ also found that Lawson had not engaged in substantial gainful activity
since August 27, 2010, his alleged onset date. (R. at 17.) The ALJ found that the
medical evidence established that Lawson suffered from severe impairments,
namely lumbar spine degenerative disc disease; degenerative joint disease of the
bilateral knees; hyperlipidemia; bipolar disorder; generalized anxiety disorder; and
1

In order to be eligible for disability benefits, Lawson must prove disability between
August 27, 2010, the alleged onset date, and December 21, 2012, the date of the ALJ’s decision.

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major depressive disorder, but he found that Lawson did not have an impairment or
combination of impairments listed at or medically equal to one listed at 20 C.F.R.
Part 404, Subpart P, Appendix 1. (R. at 17-19.) The ALJ found that Lawson had
the residual functional capacity to perform a range of simple, routine and repetitive
sedentary work 2 in a low-stress environment, which was defined as involving only
occasional decision making or changes in the work setting, and which allowed for
a sit/stand option every 30 minutes, which did not require him to crawl or to climb
ladders, ropes or scaffolds, which did not require more than occasional balancing,
stooping, kneeling, crouching or climbing of ramps and stairs, which did not
require concentrated exposure to hazardous or moving machinery and unprotected
heights, which did not require more than occasional interaction with the public and
co-workers, and which would accommodate him being off-task about 10 percent of
a normal workday. (R. at 19.) Therefore, the ALJ found that Lawson was unable to
perform his past relevant work as a coal miner and cutting machine operator. (R. at
25.) Based on Lawson’s age, education, work history and residual functional
capacity and the testimony of a vocational expert, the ALJ found that jobs existed
in significant numbers in the national economy that Lawson could perform,
including jobs as an assembler, a packer and a gate guard. (R. at 25-26.) Thus, the
ALJ found that Lawson was not under a disability as defined by the Act and was
not eligible for DIB benefits through the date of the decision. (R. at 27.) See 20
C.F.R. § 404.1520(g) (2015).
2

Sedentary work involves lifting items weighing no more than 10 pounds at a time and
occasionally lifting or carrying articles like docket files, ledgers and small tools. Although a
sedentary job is defined as one which involves sitting, a certain amount of walking and standing
is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are
required occasionally and other sedentary criteria are met. See 20 C.F.R. § 404.1567(a) (2015).

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After the ALJ issued his decision, Lawson pursued his administrative
appeals, (R. at 10-11), but the Appeals Council denied his request for review. (R. at
1-4.) Lawson then filed this action seeking review of the ALJ’s unfavorable
decision, which now stands as the Commissioner’s final decision. See 20 C.F.R.
§ 404.981 (2015). The case is before this court on Lawson’s motion for summary
judgment filed January 30, 2015, and the Commissioner’s motion for summary
judgment filed March 4, 2015.
II. Facts 3
Lawson was born in 1970, (R. at 180), which, at the time of the ALJ’s
decision, classified him as a “younger person” under 20 C.F.R. § 404.1563(c). He
has an eleventh-grade education and certification in underground mining. (R. at 3132, 197.) Lawson has past relevant work experience as a coal miner. (R. at 198.)
Lawson testified at his hearing that he had difficulty concentrating due to his
anxiety and depression. (R. at 33.) He also stated that he had five to six panic
attacks monthly, each lasting for the better part of a day, and which had no specific
triggers. (R. at 34-35.) Lawson testified that he took medication for these panic
attacks, and when he had one, he would try to read a book and “get [his] mind
reeled back in.” (R. at 35.) He stated that he spent most of his time at home, noting
that he was afraid to be around people and became very nervous in public, which
he defined as 15 or more strangers. (R. at 36, 41.) He stated that he could go into
3

Lawson’s arguments on appeal are focused solely on his mental impairments and
associated limitations. Thus, this court will limit its discussion of the medical records to those
pertaining to the same.

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grocery stores or other large stores for short periods of time, he participated in
some church activities and tried to hunt and fish “a little bit to try to get some
exercise and easement of the mind.” (R. at 41-42.) Lawson estimated that he had
gone hunting only three or four times that year behind his house and for
approximately two hours at most. (R. at 42.) He testified that he had a driver’s
license and drove once or twice weekly for less than 10 miles to pick up a few
groceries. (R. at 43.) Lawson stated that his wife took care of the household chores
and paid the bills, and his 23-year-old son took care of most of the yard work. (R.
at 38-39.)
Martin Kranitz, a vocational expert, also was present and testified at
Lawson’s hearing. (R. at 45-53.) Kranitz characterized Lawson’s past work as a
cutting machine operator in an underground coal mine as medium 4 work, but more
likely heavy 5 work as it was performed by Lawson. (R. at 45-46.) When asked to
consider a hypothetical individual of Lawson’s age, limited education and past
work experience, who could perform simple, routine, repetitive medium work that
required no more than occasional climbing of ladders, ropes or scaffolds and no
more than occasional stooping, kneeling, crouching and crawling, that did not
require concentrated exposure to hazards like moving machinery and heights, and
4

Medium work involves lifting items weighing up to 50 pounds at a time with frequent
lifting or carrying of objects weighing up to 25 pounds. If someone can perform medium work,
he also can perform light and sedentary work. See 20 C.F.R. §404.1567(c) (2015).
5

Heavy work involves items weighing up to 100 pounds at a time with frequent lifting or
carrying of objects weighing up to 50 pounds. If someone can do heavy work, he also can do
medium, light and sedentary work. See 20 C.F.R. § 404.1567(d) (2015).

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that required no more than occasional interaction with the public or with coworkers, Kranitz testified that such an individual could not perform Lawson’s past
work as an underground coal miner, but could perform other jobs existing in
significant numbers in the national economy, including jobs as a stock selector, a
machine feeder and a bus person in a restaurant. (R. at 46-47.) When Kranitz was
asked to consider a hypothetical individual who could perform simple, routine,
repetitive light 6 work in a low-stress environment, which was defined as involving
only occasional decision making or changes in the work setting, but who could
never climb ladders, ropes or scaffolds and never crawl, who could occasionally
climb ramps or stairs and occasionally balance, stoop, kneel and crouch, who could
occasionally interact with the public or with co-workers, who would be off-task
about 10 percent of the workday to deal with the effects of both pain and mental
limitations and who must avoid concentrated exposure to hazards like moving
machinery and heights, Kranitz testified that such an individual could perform the
jobs of an assembler, a gate guard and a packer. (R. at 47-48.) Kranitz next was
asked to consider the same hypothetical individual, but who could stand or walk
for just two hours out of an eight-hour day and sit for up to six hours and who
would need a sit/stand option at 30-minute intervals. (R. at 49.) Kranitz testified
that such an individual could perform the light jobs enumerated, but in lower
numbers. (R. at 49.) Kranitz next was asked to consider the same hypothetical
individual, but who likely would be off-task about 20 to 25 percent of the workday,
who likely would be absent from work at least twice monthly and who would need
6

Light work involves lifting items weighing up to 20 pounds at a time with frequent
lifting or carrying of objects weighing up to 10 pounds. If someone can do light work, he also
can do sedentary work. See 20 C.F.R. § 404.1567(b) (2015).

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additional breaks each workday to deal with the effects of pain and mental
limitations. (R. at 50.) Kranitz testified that such an individual could not perform
any jobs. (R. at 50.) Kranitz next testified that, if an individual had no ability to
behave in an emotionally stable manner, employment would be precluded if the
individual acted in an unstable way during the course of the workday. (R. at 51.)
Likewise, Kranitz testified that an individual with no ability to maintain attention
or concentration could not work. (R. at 51-52.) Lastly, Kranitz testified that an
individual who missed two days or more of work per month would be precluded
from employment. (R. at 53.)
In rendering his decision, the ALJ reviewed medical records from Lee
County Public Schools; Lee County Community Hospital; Stone Mountain Health
Services; Pain Medicine Associates; Holston Medical Group; Dr. James Louthan,
M.D.; Indian Path Medical Center; Blue Ridge Internal Medicine; Dr. Uzma
Ehtesham, M.D., a psychiatrist; Mountain States Medical Group; Lee Regional
Medical Center; East Kentucky Psychological Services; Dr. Kevin Blackwell,
D.O.; Robert S. Spangler, Ed.D., a licensed psychologist; Jeanne Buyck, Ph.D., a
state agency psychologist; Dr. Michael Hartman, M.D., a state agency physician;
Louis Perrott, Ph.D., a state agency psychologist; and Dr. Richard Surrusco, M.D.,
a state agency physician.
The record reveals that Lawson saw Dr. Kelly McQueen, D.O., his treating
physician, on November 23, 2009, with complaints of depression. (R. at 415-17,
422-24, 538-40.) He requested to restart Cymbalta, stating that he had responded
well to it in the past. (R. at 415, 423, 539.) Lawson denied any suicidal, homicidal
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or bizarre thoughts. (R. at 416, 423, 539.) He complained of decreased appetite and
sleep, depression, decreased motivation, less enjoyment, crying spells and
anxiousness, but no panic attacks. (R. at 416, 423, 539.) Lawson requested a
referral to a Christian counselor. (R. at 416, 423, 539.) On physical examination,
Lawson’s attitude was normal and cooperative with appropriate behavior. (R. at
416, 423, 539.) He was alert, awake and oriented with a depressed mood, but
without evidence of anxiety, schizophrenia, personality disorder or other
psychiatric disorders. (R. at 416, 423, 539.) There was no evidence of suicidal,
homicidal or harmful behavior, judgment was appropriate, and insight was clear
with a good understanding of his condition. (R. at 416, 423, 539.) Dr. McQueen
diagnosed chronic major depression, and she restarted Cymbalta. (R. at 417, 424,
540.) The referral specialist provided information regarding a Christian counselor,
but there is no evidence in the record that Lawson followed through with
counseling. (R. at 411, 428, 530.) Lawson returned to Dr. McQueen on June 23,
2010, reporting the recent death of a sister. (R. at 409, 429, 521.) He also reported
stopping the Cymbalta, stating that it did not always help him. (R. at 409, 429,
521.) Lawson reported continued highs and lows, but denied suicidal thoughts or
plans. (R. at 409, 429, 521.) He reported both anxiety and depressive symptoms.
(R. at 409, 429, 521.) Lawson was fully oriented, but tearful, his attitude was
normal, and he had no suicidal tendencies or homicidal ideation. (R. at 410, 430,
522.) Dr. McQueen diagnosed chronic major depression and prescribed Cymbalta.
(R. at 410, 430, 522.) She discussed the need for Lawson to see a psychiatrist due
to his never having benefitted from any medication and her opinion that he might
have bipolar disorder. (R. at 410, 430, 522.) She referred him to Dr. Somiah. (R. at
410, 430, 522.)
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On September 1, 2010, Lawson reported not doing well and that he had not
seen the psychiatrist because he did not take insurance. (R. at 404, 431, 515.) He
was fully oriented with a blunted, flat, sad, tearful and worried affect. (R. at 405,
432, 516.) His attitude was normal, and he had no suicidal tendencies or homicidal
ideations. (R. at 405, 432, 516.) Dr. McQueen diagnosed bipolar disorder, she
discontinued Cymbalta and prescribed Symbyax. (R. at 404-05, 431-32, 515-16.)
She discussed the urgent need for Lawson to see a psychiatrist. (R. at 406, 433,
517.) On September 10, 2010, Lawson reported continued depression. (R. at 396,
438, 505.) He reported going to Dr. Somiah’s office, but again was told they did
not take his insurance. (R. at 396, 438, 505.) Lawson’s attitude was normal, and his
affect was blunted, flat and tearful, but he had no suicidal tendencies or homicidal
ideation. (R. at 397, 439, 506.) Dr. McQueen diagnosed chronic major depression
and prescribed Cymbalta. (R. at 397, 439, 506.) She again urged Lawson to see a
psychiatrist for treatment of possible bipolar disorder. (R. at 397, 439, 506.) On
September 14, 2010, Dr. McQueen requested a psychiatry consult. (R. at 394, 443,
502.) On September 27, 2010, Lawson noted slight improvement in his depression.
(R. at 388, 445, 496.) He was fully oriented with a sad, tearful and worried affect,
but he had a normal attitude with no suicidal tendencies or homicidal ideation. (R.
at 390, 447, 498.) Dr. McQueen diagnosed bipolar disorder and again requested a
psychiatry consult. (R. at 390, 447, 498.)
The record reveals that Lawson saw Dr. Uzma Ehtesham, M.D., a
psychiatrist, on a monthly basis for approximately two years, from November 15,
2010, to December 10, 2012. On November 15, 2010, he complained of depression
and mood swings, excessive worry, sadness, low self-esteem, hopelessness,
agitation, racing thoughts, decreased sleep, impulsivity, paranoia and visual
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hallucinations. (R. at 570.) He reported that his depression started “a while ago”
and had worsened. (R. at 570-71.) Lawson reported that he had seen a counselor
and had taken Symbyax, Cymbalta, Zoloft and Paxil. (R. at 571.) On mental status
examination, Lawson’s hygiene and grooming were good, he maintained eye
contact, his speech was normal, and he exhibited normal motor activity. (R. at
573.) His affect was flat, anxious, agitated and irritable with congruent mood and
thoughts. (R. at 573.) He exhibited excessive worry and anticipatory anxiety, but
he denied suicidal or homicidal ideations. (R. at 573.) No delusions were elicited,
there was no evidence of mania, and Lawson did not appear to be responding to
internal stimuli. (R. at 573.) Lawson reported hallucinations, but he was fully
oriented, his thought processes were goal-oriented, his insight was good, and his
judgment was intact. (R. at 573.) Dr. Ehtesham diagnosed Lawson with severe,
recurrent major depressive disorder with psychotic behavior, and she assessed his
then-current Global Assessment of Functioning, (“GAF”), 7 score at 56. 8 (R. at
575.) She decreased his dosage of Symbyax and prescribed Lithium. (R. at 575.)
On November 29, 2010, he reported less anger and less mind racing. (R. at 568.)
His anxiety was rated as a three on a 10-point scale. (R. at 568.) He denied
hallucinations, and no attention symptoms were noted. (R. at 568.) Eye contact was
intermittent, and speech was spontaneous. (R. at 568.) Lawson’s affect was
anxious and agitated with congruent mood. (R. at 568.) He denied suicidal or
homicidal ideation, no delusions were elicited, and there was no evidence of

7

The GAF scale ranges from zero to 100 and “[c]onsider[s] psychological, social, and
occupational functioning on a hypothetical continuum of mental health-illness.” DIAGNOSTIC
AND STATISTICAL MANUAL OF MENTAL DISORDERS FOURTH EDITION, (“DSM-IV”), 32
(American Psychiatric Association 1994).
8

A GAF score of 51 to 60 indicates “[m]oderate symptoms … OR moderate difficulty in
social, occupational, or school functioning. …” DSM-IV at 32

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mania. (R. at 568.) Lawson’s insight was fair/poor, and his judgment was
intact/improved. (R. at 568.) Dr. Ehtesham prescribed Vistaril, Lithium and
Geodon. (R. at 568-69.)
When Lawson returned to Dr. McQueen on December 8, 2010, she noted
that he had been taking Geodon and Lithium and was more stable and feeling
better, but did “not want to admit it,” as he had filed for disability. (R. at 551, 584.)
It was noted that he “still [had] bad days, but they [were] manageable.” (R. at 551,
584.) On physical examination, Lawson was awake, alert and fully oriented with
an improved mood. (R. at 552, 585.) Dr. McQueen noted that Lawson was actually
smiling and not tearful, and she described his affect as “almost content.” (R. at
552, 585.) She recommended that Lawson continue psychiatric treatment and
medications. (R. at 552, 585.)
Lawson returned to Dr. Ehtesham in December 2010 and January 2011.
During this time, he reported that his depression was improving, he was less sad
and anxious, and he experienced fewer mood swings. (R. at 564, 566.) His
depression was rated as a three and his mania as a three to four. (R. at 564, 566.)
Eye contact was intermittent, and Lawson’s affect was anxious and agitated with
congruent mood. (R. at 564, 566.) No delusions were elicited, and there was no
evidence of mania. (R. at 564, 566.) Lawson’s insight was deemed fair/poor, while
his judgment was intact/improved. (R. at 564, 566.) In January 2011, although
Lawson reported paranoia, his thought processes were goal-oriented. (R. at 564.)
Dr. Ehtesham continued him on Vistaril, Lithium and Geodon during this time. (R.
at 564, 567.)

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When Lawson returned to Dr. McQueen on January 19, 2011, she noted that
he was seeing a psychiatrist for treatment of bipolar disorder. (R. at 549, 580, 724.)
He was awake, alert and fully oriented at that time. (R. at 550, 581.)
On January 31, 2011, Dr. Ehtesham completed a Mental Status Evaluation
Form of Lawson, stating that he experienced mood swings and anger problems and
that he isolated himself. (R. at 559-63.) She described him as cooperative, fully
oriented and sad with fair memory and illogical thought content, confusion at
times, decreased concentration, persistence and task completion, a concrete thinker
with poor judgment and becoming irritable under stress. (R. at 561-62.) Dr.
Ehtesham did not offer any diagnosis. (R. at 559.) Lawson continued to treat with
Dr. Ehtesham from February through April 2011. Over this time, he reported
improvement in his depression, mood swings and anger, but a decreased ability to
focus. (R. at 606, 608, 610, 612.) His depression was rated from a four to a six
during this time, his anxiety a three to an eight and his mania a five. (R. at 606,
608, 610, 612.) On February 21, 2011, Lawson endorsed auditory hallucinations
and racing thoughts. (R. at 612.) However, by March and April 2011, he denied
hallucinations, and no attention symptoms were noted. (R. at 606, 610.) Lawson’s
affect was consistently described as anxious with congruent mood. (R. at 606, 608,
610, 612.) Lawson also consistently denied suicidal or homicidal ideation, he
exhibited intermittent eye contact and spontaneous speech, his insight was
fair/poor, and his judgment was intact/improved. (R. at 606, 608, 610, 612.) Dr.
Ehtesham continued to treat Lawson with medications during this time, including
Lithium, Vistaril, Geodon, Klonopin and Lamictal. (R. at 606-13.)
When Lawson saw Dr. McQueen on April 18, 2011, she noted that he was
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awake, alert, fully oriented, pleasant and cooperative. (R. at 578-79.)
Lawson continued treating with Dr. Ehtesham in May and June 2011. On
May 3, 2011, he reported that his anger, depression and anxiety all were
decreasing, and his anxiety was rated a five. (R. at 604.) By May 19, 2011, he
reported increased depression and continued mind racing, and his anxiety was
rated an eight and his depression a four. (R. at 602.) On June 17, 2011, Lawson
reported improving depression, and his anxiety was rated a five and his depression
a three. (R. at 600.) During this time, Lawson denied hallucinations, he denied
suicidal or homicidal ideations, he displayed intermittent eye contact and
spontaneous speech, and no attention symptoms were noted. (R. at 600, 602, 604.)
Lawson’s insight was deemed to be fair/poor and his judgment intact/improved.
(R. at 600, 602, 604.) Dr. Ehtesham continued to describe Lawson’s affect as
anxious with congruent mood, and she continued to treat him with medications.
(R. at 600-05.)
On June 16, 2011, Dr. Ehtesham completed a Mental Status Evaluation
Form of Lawson for the period covering November 15, 2010, through June 16,
2011. (R. at 595-99.) She noted that Lawson had depression and mood swings with
a tendency toward anger. (R. at 595-96.) Dr. Ehtesham described Lawson as
cooperative and fully oriented with an irritable mood and affect, decreased
memory, illogical thought content and organization, confusion, decreased
concentration, decreased judgment and limited fund of information. (R. at 597-98.)
She noted that Lawson became angry when under stress. (R. at 598.) Dr. Ehteshem
diagnosed Lawson with severe, recurrent major depressive disorder with psychotic
behavior. (R. at 595.)
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Lawson returned to Dr. Ehtesham in July and August 2011, reporting severe
and intensifying depression, paranoia and becoming nervous more easily. (R. at
639, 641, 643.) However, on July 15, 2011, he reported the recent death of his
father. (R. at 643.) His anxiety was rated a five and his depression an eight. (R. at
643.) On August 3, 2011, Lawson’s depression was rated an eight, and on August
29, 2011, his anxiety was rated a five and his depression a three. (R. at 639, 641.)
Over this time, Dr. Ehtesham noted that Lawson had intermittent eye contact,
spontaneous speech and no attention symptoms. (R. at 639, 641, 643.) He denied
suicidal or homicidal ideation, no delusions were elicited, and there was no
evidence of mania. (R. at 639, 641, 643.) On August 3 and August 29, 2011,
Lawson specifically denied hallucinations. (R. at 639, 641.) His affect was
consistently anxious with congruent mood, his insight was fair/poor, and judgment
was intact/improved. (R. at 639, 641, 643.) During this time, Dr. Ehtesham
prescribed Haldol and Celexa, increased Lawson’s Lithium dosage and continued
him on Klonopin and Lamictal. (R. at 639-44.)
When Lawson returned to Dr. McQueen on August 18, 2011, she noted that
Lawson was seeing a psychiatrist and feeling better. (R. at 713.) His “active
problem” list included bipolar disorder, most recent episode, depressed, mild. (R.
at 714.) Lawson was alert and fully oriented at that time. (R. at 714-15.) He again
saw Dr. McQueen on October 4, 2011, at which time Lawson continued to be alert
and fully oriented. (R. at 711.) Dr. McQueen noted his diagnosis of bipolar
disorder, most recent episode depressed, mild. (R. at 710.)
Lawson continued treating with Dr. Ehtesham in September and October
2011. During this time, Lawson reported severe depression, anxiety, panic, mania
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and feeling more nervous throughout the day. (R. at 637, 669.) On September 28,
2011, Dr. Ehtesham rated Lawson’s anxiety as an eight. (R. at 637.) However,
Lawson reported he had run out of Haldol. (R. at 637.) At that time, he also
endorsed agitation, paranoia and auditory and visual hallucinations. (R. at 637.)
Eye contact was intermittent, and no attention symptoms were noted. (R. at 637.)
By October 19, 2011, Lawson maintained eye contact, and he denied delusions or
hallucinations. (R. at 669, 672.) Lawson’s insight was good, judgment was intact,
thought processes were goal-oriented, and he was fully oriented. (R. at 672.) Dr.
Ehtesham diagnosed Lawson with severe, recurrent major depressive disorder with
psychotic behavior, and she assessed his then-current GAF score as 58. (R. at 674.)
Over this time, Lawson denied suicidal and homicidal ideation, no delusions were
elicited, and there was no evidence of mania. (R. at 637, 672.) His affect was
anxious with congruent mood. (R. at 637, 672.) Dr. Ehtesham continued Lawson
on medication. (R. at 637-38, 674.)
On October 28, 2011, Dr. Ehtesham completed a work-related mental
assessment, finding that Lawson had a seriously limited ability to follow work
rules and to understand, remember and carry out complex job instructions. (R. at
645-47.) She found that Lawson had no useful ability to relate to co-workers, to
deal with the public, to use judgment, to interact with supervisors, to deal with
work stresses, to function independently, to maintain attention and concentration,
to understand, remember and carry out both simple and detailed job instructions, to
maintain personal appearance, to behave in an emotionally stable manner, to relate
predictably in social situations and to demonstrate reliability. (R. at 645-46.) Dr.
Ehtesham based these findings on Lawson’s severe psychosis with bipolar disorder
and severe panic attacks. (R. at 645-46.) She opined that Lawson would miss more
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than two days of work monthly due to his impairments or treatment. (R. at 647.)
Lawson continued treating with Dr. Ehtesham from November 18, 2011, to
January 17, 2012. Over this time, Lawson’s condition remained fairly consistent,
with less depression and no panic symptoms. (R. at 663, 667.) His anxiety was
rated between a three and a five, and his depression was rated a four. (R. at 663,
665, 667.) Lawson reported sadness, agitation and paranoia, but he denied
hallucinations and attentions symptoms, eye contact was intermittent, and speech
was spontaneous. (R. at 663, 665, 667.) He denied suicidal or homicidal ideation,
no delusions were elicited, and no mania was noted. (R. at 663, 665, 667.) Dr.
Ehtesham described Lawson’s affect as anxious with congruent mood, his insight
was fair/poor, and his judgment was intact/improved. (R. at 665, 667.) She
continued him on Lithium, Celexa, Lamictal and Haldol. (R. at 663, 668.)
On December 15, 2011, Lawson returned to Dr. McQueen with no
complaints of anxiety or depression. (R. at 707.) He was alert and fully oriented.
(R. at 708-09.) Dr. McQueen described Lawson’s mood as improved since seeing
the psychiatrist, but she noted that he had a flat affect. (R. at 709.)
Lawson continued to treat with Dr. Ehtesham from February 15 through
April 12, 2012. In February and March 2012, Lawson reported less depression, but
increased anger and some confusion. (R. at 659, 661.) His anxiety was rated
between a five and an eight. (R. at 659, 661.) Lawson reported sadness, agitation
and paranoia, but he denied panic symptoms, delusions, hallucinations and
attention symptoms. (R. at 659, 661.) He denied suicidal or homicidal ideation, no
delusions were elicited, and there was no evidence of mania. (R. at 659, 661.)
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Lawson exhibited intermittent eye contact and spontaneous speech. (R. at 659,
661.) Dr. Ehtesham described his affect as anxious with congruent mood, and he
had fair/poor insight and intact/improved judgment. (R. at 659, 661.) By April 12,
2012, Lawson reported both increased anger and depression. (R. at 657.) His
anxiety was rated an eight and his depression a three. (R. at 657.) Lawson reported
panic symptoms, including trembling, chest pain and nausea, as well as sadness,
agitation and paranoia. (R. at 657.) He denied hallucinations and attention
symptoms, eye contact was intermittent, and speech was spontaneous. (R. at 657.)
Lawson had no suicidal or homicidal ideation, and no delusions were elicited. (R.
at 657.) Insight was fair/poor, judgment was intact/improved, and thought
processes were goal-oriented. (R. at 657.) Over this time, Dr. Ehtesham continued
Lawson on medications. (R. at 657-61.)
On April 24, 2012, Lawson reported no anxiety or depression to Dr.
McQueen. (R. at 704.)
Dr. Ehtesham continued to treat Lawson from June 13 to August 14, 2012.
In June 2012, he reported less depression, while in August 2012, he reported
worsened depression. (R. at 648, 654.) During this time, Lawson’s anxiety was
rated between a three and a four, his depression a five and his bipolar symptoms a
two. (R. at 648-49, 654.) Lawson endorsed excessive worry, agitation, poor
concentration, heart palpitations, irritability, restlessness, trembling, chest pain,
nausea, sadness, excessive guilt, paranoia, fatigue and hopelessness. (R. at 648-49,
654.) He denied hallucinations and attention symptoms, as well as suicidal or
homicidal ideations. (R. at 649, 654.) No delusions were elicited, and there was no
evidence of mania. (R. at 649, 654.) In June 2012, eye contact was intermittent, but
-17-

in August 2012, Lawson was able to maintain eye contact. (R. at 649, 654.) His
speech was spontaneous and normal. (R. at 649, 654.) In June 2012, Lawson’s
affect was anxious with congruent mood, and in August 2012, it was anxious, flat,
blunted and hypomanic with congruent mood. (R. at 649, 654.) Nonetheless, in
August 2012, Dr. Ehtesham deemed Lawson’s insight to be good, and she noted
that his thought processes were goal-oriented. (R. at 649.) She described his thencurrent level of functioning as “good,” and she placed his then-current GAF score
at 51-60. (R. at 648, 650.) Dr. Ehtesham diagnosed Lawson with severe, recurrent
major depressive disorder with psychosis and continued him on medications. (R. at
648, 654-55.)
On August 23, 2012, Lawson again reported no anxiety or depression to Dr.
McQueen. (R. at 701.)
Lawson saw Dr. Ehtesham on July 13, 2012, with complaints of increased
mood cycling. (R. at 651.) His reported symptoms included excessive worry,
irritability, sadness, increased anger, increased paranoia and decreased attention
span. (R. at 651-52.) However, Lawson reported no panic, and he denied delusions,
hallucinations, attention symptoms and suicidal or homicidal ideation. (R. at 65152.) Lawson maintained eye contact, and speech was normal. (R. at 652.) His
affect was anxious with congruent mood. (R. at 652.) No delusions were elicited,
and there was no evidence of mania. (R. at 652.) Lawson’s insight was good, and
his thought process was goal-oriented. (R. at 652.) Dr. Ehtesham noted that
Lawson was compliant with treatment, and she deemed his then-current level of
functioning as “good.” (R. at 652-53.) Lawson’s diagnosis and GAF score
remained unchanged, as did his medications. (R. at 651, 653.)
-18-

Dr. Ehtesham completed another work-related mental assessment on
September 13, 2012, finding that Lawson had a seriously limited ability to interact
with supervisors, to understand, remember and carry out detailed job instructions
and to behave in an emotionally stable manner. (R. at 676-78.) In all other areas of
work-related mental functioning, Dr. Ehtesham found that Lawson had no useful
ability. (R. at 676-77.) She based her findings on Lawson’s severe anxiety, severe
psychosis with depression, memory problems and severe panic attacks. (R. at 67677.) Dr. Ehtesham further opined that Lawson had severe anger and mood swings
resulting in no ability to work. (R. at 678.) She opined that he would miss more
than two workdays monthly due to his impairments or treatment. (R. at 678.)
Lawson continued seeing Dr. Ehtesham from October 11 through December
5, 2012. (R. at 679-86.) Over this time, Lawson continued to complain of
depression, anxiety, panic symptoms and bipolar symptoms. His anxiety was
consistently rated as a three, his depression between a three and a four, his bipolar
symptoms as a three and his mania as a five. (R. at 679, 681-82, 684.) In October
2012, Lawson complained of a few days of increased depression, but he denied
hallucinations, and no attention symptoms were noted. (R. at 679.) In November
2012, Lawson complained of anxiety, depression and bipolar symptoms, but
denied panic symptoms. (R. at 681-82.) He denied delusions, hallucinations and
attention symptoms, but reported increased paranoia. (R. at 682.) Over this time,
Lawson’s affect was anxious with congruent mood, and there was no evidence of
mania. (R. at 679, 682.) Eye contact was either intermittent or maintained, and
speech was spontaneous and normal. (R. at 679, 682.) In October 2012, Lawson’s
insight was fair/poor, and his judgment was intact/improved. (R. at 679.) In
November 2012, his insight was deemed “good,” and his thought processes were
-19-

goal-oriented. (R. at 682.) Dr. Ehtesham rated Lawson’s then-current level of
functioning as “good.” (R. at 683.) She diagnosed him with severe, recurrent major
depressive disorder with psychosis, and she placed his then-current GAF score at
51-60. (R. at 681.) Over this time, Dr. Ehtesham continued Lawson on
medications, increasing his Klonopin dosage. (R. at 679-83.) By December 5,
2012, Lawson’s reported symptoms included heart palpitations, trembling and fear
of losing control. (R. at 684.) He denied delusions, hallucinations and attention
symptoms, as well as suicidal or homicidal ideation. (R. at 685.) Despite these
notations, this treatment note proceeds to state that Lawson reported increased
auditory and visual hallucinations, increased paranoia and decreased attention span
and focus. (R. at 685.) Lawson’s affect was anxious with congruent mood. (R. at
685.) There was no evidence of mania, insight was fair, and thought processes
were goal-oriented. (R. at 685.) Lawson’s diagnosis and GAF score remained
unchanged, and Dr. Ehtesham continued him on medications. (R. at 684.)
Dr. Ehtesham completed a third work-related mental assessment of Lawson
on December 10, 2012, finding that he was seriously limited in his ability to deal
with work stresses and to understand, remember and carry out detailed job
instructions. (R. at 697-99.) She further found that Lawson had no useful ability to
follow work rules, to relate to co-workers, to deal with the public, to use judgment,
to interact with supervisors, to function independently, to maintain attention /
concentration, to understand, remember and carry out both simple and complex job
instructions, to maintain personal appearance, to behave in an emotionally stable
manner, to relate predictably in social situations and to demonstrate reliability. (R.
at 697-98.) Dr. Ehtesham based her opinions on Lawson’s severe bipolar disorder
with psychosis, his difficulty finishing work and his severe panic attacks and anger
-20-

problems. (R. at 697-98.) She further opined that Lawson would be absent from
work more than two days monthly due to his impairments or treatment. (R. at 699.)
Lawson was seen at Pain Medicine Associates from October 8, 2010,
through February 24, 2011, for problems associated with his back. (R. at 339-45,
358-60, 482, 576.) However, these notes contain some references to Lawson’s
mental status. On October 8, 2010, Lawson reported that his back impairment had
caused feelings of depression, irritability, anger and thoughts of suicide. (R. at
358.) He endorsed an anxiety disorder, depression, nervous tension and nervous
exhaustion, among other things. (R. at 359.) Over this time, he was described as
fully oriented with clear and articulate speech with an appropriate mood and affect
to the situation. (R. at 341, 344-45, 353, 356, 365, 378, 382, 452, 454, 459, 462,
485, 490, 576.) Lawson was diagnosed with history of anxiety/depression per
patient report and a history of nervous tension and nervous exhaustion per patient
report. (R. at 339, 341-42, 344, 347, 349-50, 352, 354, 366, 368-69, 371-72, 376,
378-79, 381, 383, 455, 457, 459-60, 462, 482-83, 485-86, 488, 491, 576.) On
October 13, 2010, Lawson was described as very pleasant, fully alert and oriented
with clear and articulate speech with an appropriate affect, but becoming tearful
from time to time during the conversation. (R. at 356, 363, 385, 452, 493.)
Jeanne Buyck, Ph.D., a state agency psychologist, completed a Psychiatric
Review Technique form, (“PRTF”), on March 15, 2011, in connection with
Lawson’s initial disability claim. (R. at 65.) She concluded that Lawson was mildly
restricted in his activities of daily living, had moderate difficulties maintaining
social functioning and in maintaining concentration, persistence or pace and had
experienced no repeated episodes of decompensation of extended duration. (R. at
-21-

65.) Buyck also completed a mental residual functional capacity assessment of
Lawson, finding that he was moderately limited in his abilities to understand,
remember and carry out detailed instructions, to maintain attention and
concentration for extended periods, to work in coordination with or in proximity to
others without being distracted by them, to complete a normal workday and
workweek without interruptions from psychologically based symptoms and to
perform at a consistent pace without an unreasonable number and length of rest
periods, to interact appropriately with the general public, to accept instructions and
respond appropriately to criticism from supervisors, to get along with co-workers
or peers without distracting them or exhibiting behavioral extremes, to maintain
socially appropriate behaviors and to adhere to basic standards of neatness and
cleanliness, to respond appropriately to changes in the work setting and to set
realistic goals or make plans independently of others. (R. at 69-71.) Buyck
concluded that Lawson was capable of performing simple, unskilled routine work
with limited contact with the public. (R. at 71.) She noted that when Lawson was
not on his medications for bipolar disorder and anxiety, he began to cycle rapidly
into manic-like episodes and, even when medication-compliant, he remained
symptomatic, but showed overall improvement compared to baseline. (R. at 71.) It
was concluded that, while Lawson had depression, anxiety, panic attacks and
bipolar disorder, the evidence showed that, with proper treatment, his condition
should continue to improve and that he could perform work that did not require a
great deal of contact with other people. (R. at 74.)
Lawson saw Phil Pack, M.S., a licensed psychological practitioner, on July
23, 2011, for a psychological evaluation at the request of Disability Determination
Services. (R. at 622-29.) Pack noted Lawson’s desire to impress upon him the
-22-

severity of his symptoms and difficulties and his reasons for not being able to
continue employment. (R. at 623.) He described recurrent bouts of depression that
had been going on for a number of years, in addition to chronic symptoms of mood
swings, which, at times, included psychotic processes such as auditory perceptual
disturbances. (R. at 623.) Specifically, Lawson recounted incidences of hearing
voices or having unusual obsessive-compulsive type thoughts about injuring
himself or other people and incidences of becoming extremely angry. (R. at 62324.) Lawson reported that medication had been helpful. (R. at 624.) He stated that
he continued to occasionally have perceptual disturbances and occasional
obsessive thoughts and beliefs that he was going to hurt someone. (R. at 624.)
Lawson reported that he drove short distances around home. (R. at 625.) He
also reported attending church, which he felt helped him control his thoughts. (R.
at 625.) Lawson stated that he talked with his mother on the phone daily, and he
was able to keep up with his own mail and appointments, as well as tend to his
own self-care without difficulty. (R. at 626.) Lawson’s speech was clear, and he
maintained appropriate eye contact. (R. at 626.) He was fully oriented, and
sensorium was intact, as were general cognitive and memory functions. (R. at 626.)
Lawson’s mood was generally pleasant, and his affect was described as broadened.
(R. at 626.) Pack diagnosed Lawson with bipolar disorder, not otherwise specified,
with psychotic features; polysubstance dependence, in full sustained remission;
and obsessive-compulsive disorder, (“OCD”); and he assessed his then-current
GAF score at 45.9 (R. at 627.) He indicated that Lawson had stabilized with
treatment, although he continued to present with residual depressive and OCD
9

A GAF score of 41-50 indicates “[s]erious symptoms … OR any serious impairment in
social, occupational, or school functioning. …” DSM-IV at 32.

-23-

behavior. (R. at 628.) Pack opined that Lawson’s general stress tolerance was poor,
and his prognosis was guarded to fair, as long as he maintained long-term
psychiatric treatment for stabilization of his issues. (R. at 628.) Pack concluded
that Lawson’s ability to perform detailed and complex tasks, versus simple and
repetitive tasks, was more than satisfactory, his general cognitive and memory
processes were not limited by a mental impairment, his ability to maintain regular
attendance in the workplace, perform work activities on a consistent basis and
without special or additional supervision was seriously limited, but not precluded,
and his abilities to accept instructions from a supervisor and to deal with coworkers and the general public were seriously limited, but not precluded. (R. at
628.)
On August 1, 2011, Lawson saw Dr. Kevin Blackwell, D.O., for a
consultative physical evaluation at the request of Disability Determination
Services. (R. at 632-35.) During the course of this evaluation, Dr. Blackwell
indicated that Lawson was alert, cooperative and fully oriented with good mental
status. (R. at 633.) His affect, thought content and general fund of knowledge
appeared intact. (R. at 633.)
Louis Perrott, Ph.D., another state agency psychologist, completed a PRTF
on August 22, 2011, in connection with the reconsideration of Lawson’s disability
claim. (R. at 86.) Perrott found that Lawson was mildly restricted in his activities
of daily living, experienced moderate difficulties maintaining social functioning
and in maintaining concentration, persistence or pace and that he had experienced
no repeated episodes of decompensation of extended duration. (R. at 86.) Perrott
also completed a mental residual functional capacity assessment of Lawson,
-24-

finding that Lawson was moderately limited in all of the same areas as
psychologist Buyck had found previously. (R. at 90-92.) Like state agency
psychologist Buyck, Perrott concluded that Lawson was capable of performing
simple, unskilled routine work with limited contact with the public and co-workers.
(R. at 92.) It was concluded that, while Lawson may occasionally feel nervous and
depressed, the evidence indicated that he was able to perform daily activities
without severe limitations, and he had a good ability to perform simple or less
skilled work without significant cognitive impairment. (R. at 95-96.)
Lawson saw Robert S. Spangler, Ed.D., a licensed psychologist, on
December 4, 2012, for a consultative psychological evaluation at the request of his
attorney. (R. at 688-91.) He reported driving locally twice weekly to the store or
other short trips. (R. at 688.) Lawson was cooperative, seemed socially confident,
anxious and depressed during the interview. (R. at 688.) He described classic
depressive symptoms, as well as anxiety. (R. at 688.) Lawson generally understood
the instructions for each task, and he demonstrated good concentration. (R. at 688.)
Lawson appeared to do his best on all tasks, but was slow secondary to pain and
depressive symptoms. (R. at 688.) He was appropriately persistent on the tasks, but
pace was impacted. (R. at 688.) Lawson reported becoming “real nervous in public
if there is a crowd.” (R. at 688.) He reported that he had about five manic episodes
monthly with angry outbursts, and he reported seeing and hearing things. (R. at
689.)
On mental status examination, Lawson was alert with adequate recall of
remote events, but inadequate recall of recent events. (R. at 689.) His mood was
depressed and anxious with congruent affect, he was cooperative, compliant and
-25-

forthcoming. (R. at 689.) There was no illogical language or loose associations,
and his judgment and insight were consistent with low average intelligence. (R. at
689.) Lawson reported experiencing auditory and visual hallucinations once
weekly, including hearing people whining and seeing faces on the wall. (R. at 690.)
He also admitted anger during manic episodes. (R. at 690.) Delusional thought was
not evident. (R. at 690.) Lawson reported attending church weekly, when possible,
and watching television, but he reported that his mind raced. (R. at 690.) Spangler
deemed Lawson’s social skills adequate, and he related well to him. (R. at 690.)
Spangler found Lawson to be credible. (R. at 690.)
Spangler administered the Wechsler Adult Intelligence Scale – Fourth
Edition, (“WAIS-IV”), the results of which were deemed valid. (R. at 690.)
Lawson’s full-scale IQ score was assessed at 82, placing him in the low average
range of intelligence. (R. at 691.) Spangler also administered the Wide Range
Achievement Test – Fourth Edition, (“WRAT-4”), on which Lawson tested in the
eighth-grade level in word reading, the twelfth-grade level in sentence
comprehension and in the eighth-grade level in arithmetic computation. (R. at
691.) The Bender Visual Motor Gestalt Test did not indicate the presence of
organicity. (R. at 691.) However, Lawson’s pace was inadequate as objectively
tested. (R. at 691.) Spangler diagnosed Lawson with polysubstance dependence in
full remission; bipolar 1 disorder, currently diagnosed, moderate on prescriptions;
general anxiety disorder, moderate on prescriptions; major depressive disorder,
recurrent, severe with psychotic features; cognitive disorder, not otherwise
specified; low average intelligence; and a GAF score of 50. (R. at 691.) Spangler’s
prognosis for Lawson was guarded, and he opined that Lawson needed continued
mental health treatment with Dr. Ehtesham for a period to exceed 12 months. (R. at
-26-

691.)
Spangler also completed a work-related mental assessment on December 4,
2012, finding that Lawson had a limited, but satisfactory, ability to maintain
attention and concentration when taking medications. (R. at 693-95.) He found that
Lawson had a seriously limited ability to follow work rules, to relate to coworkers, to use judgment, to interact with supervisors, to function independently
and to maintain personal appearance. (R. at 693-94.) Spangler found that, on good
days, Lawson had a seriously limited ability to understand, remember and carry out
simple job instructions, to behave in an emotionally stable manner, to relate
predictably in social situations and to demonstrate reliability. (R. at 694.) He found
that Lawson had no useful ability to deal with the public, to deal with work stresses
and to understand, remember and carry out both detailed and complex job
instructions. (R. at 693-94.) Spangler also found that, on bad days, Lawson had no
useful ability to understand, remember and carry out simple job instructions, to
behave in an emotionally stable manner, to relate predictably in social situations
and to demonstrate reliability. (R. at 694.) Spangler based these findings on
Lawson’s low average intelligence; cognitive disorder; limited education; slowed
pace; major depressive disorder, recurrent, severe with psychotic features on
medications; generalized anxiety disorder, moderate on medications; and bipolar 1
disorder, depressed currently, moderate on medications. (R. at 694-95.) He further
opined that Lawson’s severe, recurrent major depressive disorder with psychotic
features impacted all work-related activities significantly, especially the ability to
deal with work stress and reliability. (R. at 695.) Spangler stated that Lawson met
or equaled §12.02, the medical listing for organic mental disorders, if etiology was
clarified. (R. at 695.) He opined that Lawson could not manage benefits in his own
-27-

best interest and that he would be absent from work more than four days monthly
due to his mental impairments or treatment. (R. at 695.)
III. Analysis
The Commissioner uses a five-step process in evaluating DIB claims. See 20
C.F.R. § 404.1520 (2015); see also Heckler v. Campbell, 461 U.S. 458, 460-62
(1983); Hall v. Harris, 658 F.2d 260, 264-65 (4th Cir. 1981). This process requires
the Commissioner to consider, in order, whether a claimant 1) is working; 2) has a
severe impairment; 3) has an impairment that meets or equals the requirements of a
listed impairment; 4) can return to his past relevant work; and 5) if not, whether he
can perform other work. See 20 C.F.R. § 404.1520. If the Commissioner finds
conclusively that a claimant is or is not disabled at any point in this process, review
does not proceed to the next step. See 20 C.F.R. § 404.1520(a) (2015).
As stated above, the court’s function in this case is limited to determining
whether substantial evidence exists in the record to support the ALJ’s findings.
The court must not weigh the evidence, as this court lacks authority to substitute its
judgment for that of the Commissioner, provided her decision is supported by
substantial evidence. See Hays, 907 F.2d at 1456. In determining whether
substantial evidence supports the Commissioner’s decision, the court also must
consider whether the ALJ analyzed all of the relevant evidence and whether the
ALJ sufficiently explained his findings and his rationale in crediting evidence. See
Sterling Smokeless Coal Co. v. Akers, 131 F.3d 438, 439-40 (4th Cir. 1997).
Thus, it is the ALJ’s responsibility to weigh the evidence, including the
-28-

medical evidence, in order to resolve any conflicts which might appear therein.
See Hays, 907 F.2d at 1456; Taylor v. Weinberger, 528 F.2d 1153, 1156 (4th Cir.
1975). Furthermore, while an ALJ may not reject medical evidence for no reason
or for the wrong reason, see King v. Califano, 615 F.2d 1018, 1020 (4th Cir. 1980),
an ALJ may, under the regulations, assign no or little weight to a medical opinion,
even one from a treating source, based on the factors set forth at 20 C.F.R.
§ 404.1527(c), if he sufficiently explains his rationale and if the record supports his
findings.
Lawson argues that the ALJ erred by making incomplete findings at step
three of the sequential evaluation process. (Plaintiff’s Memorandum In Support Of
His Motion For Summary Judgment, (“Plaintiff’s Brief”), at 5-6.) Lawson also
argues that the ALJ erred by improperly determining his mental residual functional
capacity. (Plaintiff’s Brief at 6-8.) The court, sua sponte, raises the issue whether
the ALJ erred in his reliance on the vocational expert’s testimony in finding that a
significant number of jobs exist in the national economy that Lawson can perform,
thereby making him ineligible for disability benefits.
I first find Lawson’s argument that the ALJ erred by making incomplete
findings at step three of the sequential evaluation process unpersuasive.
Specifically, Lawson argues that the ALJ failed to adequately explain the basis for
his finding that the “paragraph B” criteria, necessary for a finding that a claimant’s
mental impairment meets or equals a medical listing, were not met. He argues that
the ALJ is required to provide findings in the decision that are essential to the
sequential evaluation process because, without such, a meaningful review of the
decision is impossible. Lawson does not direct the court to a specific medical
-29-

listing, but, in his decision, the ALJ stated that he was considering § 12.04 and
§ 12.06, the medical listings for affective disorders and anxiety-related disorders,
respectively. Under the regulations, to meet the “paragraph B” criteria for such
listings at step three of the sequential process, two of the following requirements
must be met:
1. Marked restriction of activities of daily living; or
2. Marked difficulties in maintaining social functioning; or
3. Marked difficulties in maintaining concentration, persistence, or
pace; or
4. Repeated episodes of decompensation, each of extended duration.
20 C.F.R. Pt. 404, Subpt. P, App. 1, §§ 12.04(B), 12.06(B) (2015). The ALJ found
that the medical evidence established that Lawson had mild restrictions in his
activities of daily living, moderate difficulties in maintaining social functioning
and in maintaining concentration, persistence or pace and that he had experienced
no episodes of decompensation of extended duration. (R. at 18.)
In his decision, the ALJ specifically stated that Lawson participates in some
activities that seem to show that he is capable of more than he claims, including
hunting, fishing, attending church services weekly and occasionally driving to the
store. (R. at 19-20, 23.) The ALJ further stated that Lawson could keep up with his
mail and his medical appointments. (R. at 23.) The ALJ also noted Lawson’s
hearing testimony that he often read. (R. at 19.) Lastly, the ALJ stated in his
decision that Lawson did not attend counseling and had never been psychiatrically
hospitalized. (R. at 23.) I find that such findings by the ALJ adequately explain his
-30-

conclusion that Lawson’s mental impairments did not meet the “paragraph B”
criteria.
Next, Lawson argues that the ALJ erred in his mental residual functional
capacity finding. I agree, but on slightly different grounds than argued by Lawson.
While Lawson simply argues that the ALJ should have given more weight to the
opinions of his treating psychiatrist, Dr. Ehtesham, and consultative psychological
examiners Pack and Spangler, instead of relying on the opinions of state agency
psychologists Buyck and Perrott, I find that the ALJ erred by failing to explicitly
state the weight given to Dr. Ehtesham’s opinions. It is well-settled that “the
[Commissioner] must indicate explicitly that all relevant evidence has been
weighed and its weight.” Stawls v. Califano, 596 F.2d 1209, 1213 (4th Cir. 1979).
“Unless the [Commissioner] has analyzed all evidence and has sufficiently
explained the weight he has given to obviously probative exhibits, to say that his
decision is supported by substantial evidence approaches an abdication of the
court’s ‘duty to scrutinize the record as a whole to determine whether the
conclusions reached are rational.’” Arnold v. Sec’y of Health, Educ. & Welfare,
567 F.2d 258, 259 (4th Cir. 1977) (quoting Oppenheim v. Finch, 495 F.2d 396, 397
(4th Cir. 1974)). In his decision, the ALJ never explicitly stated the weight he was
giving to Dr. Ehtesham’s opinions. He noted that some of her findings were
illogical and that her opinions were inconsistent with her treatment notes.
However, he did not state whether he was giving her opinions no weight, little
weight, some weight or some other designation. In contrast, the ALJ did explicitly
state the weight that he was giving to the other psychological sources contained in
the record. All of this being the case, because the ALJ did not explicitly indicate
the weight given to all relevant evidence, I cannot determine if the findings are
-31-

supported by substantial evidence. See Gordon v. Schweiker, 725 F.2d 231, 235
(4th Cir. 1984).
Lastly, the court raises, sua sponte, as it may, 10 the issue of whether the ALJ
erred in his reliance on the vocational expert’s testimony in finding that a
significant number of jobs exist in the national economy that Lawson could
perform, thereby making him ineligible for disability benefits. I find that he did so
err. Residual functional capacity refers to the “maximum degree to which the
individual retains the capacity for sustained performance of the physical-mental
requirements of jobs.” 20 C.F.R. Pt. 404, Subpt. P, App. 2, § 200.00(c) (2015).
Here, the ALJ concluded that Lawson retained the functional capacity to perform a
range of sedentary work and that he could perform the jobs of an assembler, a
packer and a gate guard, which, in his decision, he represented were classified as
sedentary level work. (R. at 26.) However, at the hearing, the vocational expert had
explicitly clarified that these jobs were classified as light level work upon
questioning by the ALJ. In particular, the following exchange between the ALJ and
the vocational expert, (“VE”), occurred:
ALJ: Let’s take that second hypothetical in its entirety. Let’s just
make one change. And that one change is that the individual could
stand or walk for just 2 hours out of an eight-hour day. He could sit
for up to six hours. And the individual would need a sit/stand option
at 30-minute intervals. …
VE: I believe that the jobs 11 which I’ve mentioned would exist, but
10

In Ricks v. Cmr. of Soc. Sec., 2010 WL 6621693, at *7 (E.D. Va. Dec. 29, 2010), the
court further held that, especially given the nonadversarial nature of social security disability
cases, it could not ignore obvious and prejudicial errors, even if the litigants did not identify and
debate them.
11

The jobs to which the VE is referring are an assembler, a gate guard and a packer. (R.

-32-

in lower numbers.
ALJ: Okay the jobs you gave me in hypo two are light jobs. So these
would be sedentary jobs, then, as an assembler?
VE: No. These would be light jobs that would allow sitting or
standing.
ALJ: Oh, I see. Okay. So that –
VE: So that the only adjustment to the hypothetical was that it was a
stand – it was two, instead of six hours.
ALJ: Oh, that’s right.
VE: [INAUDIBLE] sit/stand option, so –
ALJ: That’s correct.
VE: I’m anticipating that the person could still, theoretically, lift 20
pounds, but may do it from a sitting position if necessary.
(R. at 49-50.)
Furthermore, testimony of a vocational expert constitutes substantial
evidence for purposes of judicial review where his or her opinion is based upon a
consideration of all of the evidence of record and is in response to proper
hypothetical questions which fairly sets out all of a claimant’s impairments. See
Walker v. Bowen, 889 F.2d 47, 50 (4th Cir. 1989). The determination of whether a
hypothetical question fairly sets out all of a claimant’s impairments turns on two
issues: (1) is the ALJ’s finding as to the claimant’s residual functional capacity
supported by substantial evidence; and (2) does the hypothetical fairly set forth the
residual functional capacity as found by the ALJ? The Commissioner may not rely
upon the answer to a hypothetical question if the hypothesis fails to fit the facts.
See Swaim v. Califano, 599 F.2d 1309, 1312 (4th Cir. 1979). This is precisely the
case here, as the ALJ found that Lawson could perform sedentary work with
certain restrictions. However, the vocational expert was never presented with a
at 48.)

-33-

hypothetical question setting forth the residual functional capacity for sedentary
work. Additionally, the jobs that the ALJ found existed in significant numbers in
the national economy that Lawson could perform were actually classified as light
jobs by the vocational expert, not sedentary, as the ALJ represented in his decision.
Given these circumstances, I cannot find that substantial evidence exists to support
the ALJ’s residual functional capacity finding and his ultimate conclusion that
Lawson is not entitled to disability benefits.
Based on the above-stated reasons, I find that substantial evidence does not
support the ALJ’s decision denying benefits. I will deny both motions for summary
judgment, vacate the decision denying benefits and remand Lawson’s claim to the
Commissioner for further development. An appropriate order and judgment will be
entered.
ENTERED: February 24, 2016.
s/

Pamela Meade Sargent

UNITED STATES MAGISTRATE JUDGE

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