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noting the ALJ properly “discussed the medical opinion evidence offered by four medical professionals, including the opinion offered by [a licensed mental health counselor]”
Summary of this case from Barbara S. v. KijakaziOpinion
6:19-CV-06786 EAW
2021-01-26
JACQUELINE L., Plaintiff, v. COMMISSIONER OF SOCIAL SECURITY, Defendant.
Kelly Elizabeth Laga-Sciandra, Kenneth R. Hiller, Law Offices of Kenneth Hiller, PPLC, Amherst, NY, for Plaintiff. Anne M. Zeigler, Shruti Kumar Tejwani, Office of the General Counsel Social Security Administration, Kansas City, MO, Kathryn L. Smith, U.S. Attorney's Office, Rochester, NY, for Defendant.
Kelly Elizabeth Laga-Sciandra, Kenneth R. Hiller, Law Offices of Kenneth Hiller, PPLC, Amherst, NY, for Plaintiff.
Anne M. Zeigler, Shruti Kumar Tejwani, Office of the General Counsel Social Security Administration, Kansas City, MO, Kathryn L. Smith, U.S. Attorney's Office, Rochester, NY, for Defendant.
DECISION AND ORDER
ELIZABETH A. WOLFORD, United States District Judge
INTRODUCTION
Represented by counsel, Plaintiff Jacqueline L. ("Plaintiff") brings this action pursuant to Titles II and XVI of the Social Security Act (the "Act"), seeking review of the final decision of the Commissioner of Social Security (the "Commissioner," or "Defendant") denying her applications for child disability benefits and supplemental security income ("SSI"). (Dkt. 1). This Court has jurisdiction over the matter pursuant to 42 U.S.C. § 405(g). Presently before the Court are the parties’ cross-motions for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure (Dkt. 8; Dkt. 10), and Plaintiff's reply (Dkt. 13). For the reasons discussed below, the Commissioner's motion (Dkt. 10) is granted and Plaintiff's motion (Dkt. 8) is denied.
BACKGROUND
Plaintiff protectively filed her applications for child disability benefits and SSI on March 18, 2018. (Dkt. 5 at 19, 100-02). In her applications, Plaintiff alleged disability beginning November 9, 1995, due to anxiety, depression, and panic disorder. (Id. at 19, 70-71, 80-81, 90-91). Plaintiff's applications were initially denied on July 13, 2018. (Id. at 19, 103-24). At Plaintiff's request, a hearing was held before administrative law judge ("ALJ") John P. Costello in Rochester, New York, on April 22, 2019. (Id. at 19, 35-69). On July 2, 2019, the ALJ issued an unfavorable decision. (Id. at 16-30). Plaintiff requested Appeals Council review; her request was denied on August 27, 2019, making the ALJ's determination the Commissioner's final decision. (Id. at 5-7). This action followed.
When referencing the page number(s) of docket citations in this Decision and Order, the Court will cite to the CM/ECF-generated page numbers that appear in the upper righthand corner of each document.
LEGAL STANDARD
I. District Court Review
"In reviewing a final decision of the [Social Security Administration ("SSA")], this Court is limited to determining whether the SSA's conclusions were supported by substantial evidence in the record and were based on a correct legal standard." Talavera v. Astrue , 697 F.3d 145, 151 (2d Cir. 2012) (quotation omitted); see also 42 U.S.C. § 405(g). The Act holds that a decision by the Commissioner is "conclusive" if it is supported by substantial evidence. 42 U.S.C. § 405(g). "Substantial evidence means more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Moran v. Astrue , 569 F.3d 108, 112 (2d Cir. 2009) (quotation omitted). It is not the Court's function to "determine de novo whether [the claimant] is disabled." Schaal v. Apfel , 134 F.3d 496, 501 (2d Cir. 1998) (quotation omitted); see also Wagner v. Sec'y of Health & Human Servs. , 906 F.2d 856, 860 (2d Cir. 1990) (holding that review of the Secretary's decision is not de novo and that the Secretary's findings are conclusive if supported by substantial evidence). However, "[t]he deferential standard of review for substantial evidence does not apply to the Commissioner's conclusions of law." Byam v. Barnhart , 336 F.3d 172, 179 (2d Cir. 2003) (citing Townley v. Heckler , 748 F.2d 109, 112 (2d Cir. 1984) ).
II. Disability Determination
An ALJ follows a five-step sequential evaluation to determine whether a claimant is disabled within the meaning of the Act. See Bowen v. City of New York , 476 U.S. 467, 470-71, 106 S.Ct. 2022, 90 L.Ed.2d 462 (1986). At step one, the ALJ determines whether the claimant is engaged in substantial gainful work activity. See 20 C.F.R. §§ 404.1520(b), 416.920(b). If so, the claimant is not disabled. If not, the ALJ proceeds to step two and determines whether the claimant has an impairment, or combination of impairments, that is "severe" within the meaning of the Act, in that it imposes significant restrictions on the claimant's ability to perform basic work activities. Id. §§ 404.1520(c), 416.920(c). If the claimant does not have a severe impairment or combination of impairments, the analysis concludes with a finding of "not disabled." If the claimant does have at least one severe impairment, the ALJ continues to step three. At step three, the ALJ examines whether a claimant's impairment meets or medically equals the criteria of a listed impairment in Appendix 1 of Subpart P of Regulation No. 4 (the "Listings"). Id. §§ 404.1520(d), 416.920(d). If the impairment meets or medically equals the criteria of a Listing and meets the durational requirement (id. §§ 404.1509, 416.909), the claimant is disabled. If not, the ALJ determines the claimant's residual functional capacity ("RFC"), which is the ability to perform physical or mental work activities on a sustained basis, notwithstanding limitations for the collective impairments. See id. §§ 404.1520(e), 416.920(e).
The ALJ then proceeds to step four and determines whether the claimant's RFC permits the claimant to perform the requirements of his or her past relevant work. Id. §§ 404.1520(f), 416.920(f). If the claimant can perform such requirements, then he or she is not disabled. If he or she cannot, the analysis proceeds to the fifth and final step, wherein the burden shifts to the Commissioner to show that the claimant is not disabled. Id. §§ 404.1520(g), 416.920(g). To do so, the Commissioner must present evidence to demonstrate that the claimant "retains a residual functional capacity to perform alternative substantial gainful work which exists in the national economy" in light of the claimant's age, education, and work experience. Rosa v. Callahan , 168 F.3d 72, 77 (2d Cir. 1999) (quotation omitted).
DISCUSSION
I. The ALJ's Decision
In determining whether Plaintiff was disabled, the ALJ applied the five-step sequential evaluation set forth in 20 C.F.R. §§ 404.1520 and 416.920. Initially, the ALJ determined that Plaintiff, who was born on November 9, 1995, had not attained the age of 22 as of November 9, 1995, the alleged onset date. (Dkt. 5 at 21). At step one, the ALJ determined that Plaintiff had not engaged in substantial gainful work activity since November 9, 1995, the alleged onset date. (Id. at 22).
At step two, the ALJ found that Plaintiff suffered from the severe impairments of: "anxiety and depression, with a panic disorder and possible attention deficit disorder ; history of left wrist fracture with surgical correction." (Id. ). The ALJ further found that Plaintiff's medically determinable impairments of migraine headaches and respiratory impairment were non-severe. (Id. ).
At step three, the ALJ found that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of any Listing. (Id. at 22). The ALJ particularly considered the criteria of Listings 1.02, 1.03, 12.02, 12.04, and 12.06 in reaching his conclusion. (Id. at 22-24).
Before proceeding to step four, the ALJ determined that Plaintiff retained the RFC to perform a full range of work at all exertional levels, with the following non-exertional limitations:
[Plaintiff] is limited to occasional interaction with supervisors, coworkers and the general public; she is limited to low stress work, defined as work involving occasional decisionmaking; she is limited to occasional handling, fingering and pushing/pulling with the left upper extremity.
(Id. at 24). At step four, the ALJ found that Plaintiff had no past relevant work. (Id. at 28).
At step five, the ALJ relied on the testimony of a vocational expert ("VE") to conclude that, considering Plaintiff's age, education, work experience, and RFC, there were jobs that exist in significant numbers in the national economy that Plaintiff could perform, including the representative occupations of addresser and photo copy machine operator. (Id. at 29). Accordingly, the ALJ found that Plaintiff was not disabled as defined in the Act. (Id. at 29-30).
II. The Commissioner's Determination is Supported by Substantial Evidence and Free from Legal Error
Plaintiff asks the Court to reverse or, in the alternative, remand this matter to the Commissioner, arguing that (1) the ALJ did not properly evaluate the medical opinions in the record, including the opinions offered by Melinda Tellier, FNP and Kelly Quinn, LMHC, and his use of the term "persuasive" does not adequately assess the weight and application to the RFC, and (2) the ALJ did not properly consider and evaluate Plaintiff's ability to manage stress. (Dkt. 8-1 at 15-26). The Court has considered each of these arguments and, for the reasons discussed below, finds them without merit.
A. Weighing of Medical Opinion Evidence
1. New Regulations Regarding Evaluation of Medical Opinion Evidence
"Previously, the SSA followed the ‘treating physician rule,’ which required the agency to give controlling weight to a treating source's opinion, so long as it was ‘well-supported by medically acceptable clinical and laboratory diagnostic techniques’ and not ‘inconsistent with the other substantial evidence’ in the record." Soto v. Comm'r of Soc. Sec. , No. 19-CV-4631 (PKC), 2020 WL 5820566, at *3 (E.D.N.Y. Sept. 30, 2020) (quoting 20 C.F.R. § 416.927(c)(2) ). However, the regulations relating to the evaluation of medical evidence were amended for disability claims filed after March 27, 2017. Revisions to Rules Regarding the Evaluation of Medical Evidence , 2017 WL 168819, 82 Fed. Reg. 5844-01, at *5844 (Jan. 18, 2017). Because Plaintiff's claim was filed on March 18, 2018, the new regulations, codified at 20 C.F.R. §§ 404.1520c and 416.920c, apply.
Pursuant to the new regulations, the Commissioner "will not defer or give any specific evidentiary weight, including controlling weight, to any medical opinion(s) or prior administrative medical finding(s), including those from [the claimant's] medical sources." 20 C.F.R. §§ 404.1520c(a), 416.920c(a). Further, when a medical source provides one or more medical opinions, the Commissioner will consider those medical opinions from that medical source together using the factors listed in paragraphs (c)(1) through (c)(5) of this section. Id. Those factors include: (1) supportability; (2) consistency; (3) relationship with the claimant, including the length of the treatment relationship, the frequency of examinations, purpose and extent of the treatment relationship, and the examining relationship; (4) specialization; and (5) any other factors that "tend to support or contradict a medical opinion or prior administrative medical finding." Id. at §§ 404.1520c(c), 416.920c(c).
When evaluating the persuasiveness of a medical opinion, the most important factors are supportability and consistency. Id. at §§ 404.1520c(a), 416.920c(a). With respect to "supportability," the new regulations provide that "[t]he more relevant the objective medical evidence and supporting explanations presented by a medical source are to support his or her medical opinion(s) or prior administrative medical finding(s), the more persuasive the medical opinions or prior administrative medical finding(s) will be." Id. at §§ 404.1520c(c)(1), 416.920c(c)(1). With respect to "consistency," the new regulations prove that "[t]he more consistent a medical opinion(s) or prior administrative medical finding(s) is with the evidence from other medical sources and nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior administrative medical finding(s) will be." Id. at §§ 404.1520c(c)(2), 416.920c(c)(2).
The ALJ must articulate his consideration of the medical opinion evidence, including how persuasive he finds the medical opinions in the case record. Id. at §§ 404.1520c(b), 416.920c(b). "Although the new regulations eliminate the perceived hierarchy of medical sources, deference to specific medical opinions, and assigning ‘weight’ to a medical opinion, the ALJ must still articulate how [he or she] considered the medical opinions and how persuasive [he or she] find[s] all of the medical opinions." Andrew G. v. Comm'r of Soc. Sec. , No. 3:19-CV-0942 (ML), 2020 WL 5848776, at *5 (N.D.N.Y. Oct. 1, 2020) (quotations and citation omitted). Specifically, the ALJ must explain how he considered the "supportability" and "consistency" factors for a medical source's opinion. 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2). The ALJ may—but is not required to—explain how he considered the remaining factors. Id. However, when the opinions offered by two or more medical sources about the same issue are "both equally well-supported ... and consistent with the record ... but are not exactly the same," the ALJ will articulate how he considered the remaining factors in evaluating the opinions. Id. at §§ 404.1520c(b)(3), 416.920c(b)(3). "Even though ALJs are no longer directed to afford controlling weight to treating source opinions—no matter how well supported and consistent with the record they may be—the regulations still recognize the ‘foundational nature’ of the observations of treating sources, and ‘consistency with those observations is a factor in determining the value of any [treating source's] opinion.’ " Shawn H. v. Comm'r of Soc. Sec. , No. 2:19-CV-113, 2020 WL 3969879, at *6 (D. Vt. July 14, 2020) (alteration in original) (quoting Barrett v. Berryhill , 906 F.3d 340, 343 (5th Cir. 2018) ).
2. The ALJ's Assessment of Opinion Evidence
To the extent Plaintiff argues that the ALJ erred by failing to identify the weight afforded to the medical opinions in the record (see Dkt. 8-1 at 15), any such argument is misplaced. The new regulations do not require the ALJ to give specific weight to any particular medical opinion; rather, they require that the ALJ articulate how he considered the medical opinions and how persuasive he finds the opinions. See Andrew G. , 2020 WL 5848776, at *5 (explaining that the new regulations eliminate assigning "weight" to a medical opinion, but rather require the ALJ to evaluate their persuasiveness). Accordingly, the ALJ's failure to assess the specific weight afforded to each medical opinion, standing alone, is not a basis for remand.
The ALJ discussed the medical opinion evidence offered by four medical professionals, including the opinions offered by Todd Deneen, Psy.D. and Harbinder Toor, M.D., independent medical examiners; FNP Tellier, one of Plaintiff's mental health care providers; and LMHC Quinn, Plaintiff's therapist. (Dkt. 5 at 26-28). Plaintiff does not challenge the ALJ's assessment of Dr. Toor's opinion relating to Plaintiff's physical limitations; accordingly, the Court will focus the analysis on the ALJ's assessment of the opinions offered by Dr. Deneen, FNP Tellier, and LMHC Quinn.
Under the new regulations, FNP Tellier is considered an "acceptable medical source." See 20 C.F.R. § 416.902(a)(7) (defining "acceptable medical source" to include a "Licensed Advanced Practice Registered Nurse, or other licensed advanced practice nurse with another title, for impairments within his or her licensed scope of practice").
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Dr. Deneen examined Plaintiff on May 15, 2018. (Id. at 438). Plaintiff reported that she obtained her GED in 2016 and had one year of college education. (Id. ). While Plaintiff reported anxiety leaving her house and driving, she stated that she could drive her boyfriend to work and go out to dinner with him. (Id. at 439). Plaintiff Dr. Deneen found that Plaintiff's demeanor was immature, her social skills were poor, her thought processes were coherent and goal-directed, her mood was anxious, and her attention and concentration were "mildly impaired" due to anxiety in the examination setting. (Id. at 439-40). Plaintiff's recent and remote memory skills were intact, with average intellectual functioning. (Id. at 440). Her insight was poor, and her judgment was good. (Id. ). Dr. Deneen offered the following medical source statement:
The claimant will have no limitation with the following: Understand, remember, or apply simple directions and instructions; sustain an ordinary routine and regular attendance at work; maintain personal hygiene and appropriate attire; and awareness of normal hazards and taking appropriate precautions. She will have a mild limitation with the following: Understand, remember, or apply complex directions and instructions; use reason and judgment to make work-related decisions; and sustain concentration and perform a task at a consistent pace. She will have a moderate limitation with the following: Interact adequately with supervisors, co-workers, and the public and regulate emotions, control behavior, and maintain well-being.
The claimant's difficulties are caused by her lack of motivation, anxiety, and depression.
The results of the examination appear to be consistent with psychiatric problems, but in itself, this does not appear to be significant enough to interfere with the claimant's ability to function on a daily basis.
(Id. at 441). The ALJ found that Dr. Deneen's opinion was "fairly persuasive," because it was consistent with his own observations and with the medical and clinical examinations in the record. (Id. at 28). The RFC, which limits Plaintiff to occasional interaction with supervisors, coworkers, and the general public, as well as low-stress work (defined as occasional decision making), is supported by Dr. Deneen's opinion that Plaintiff has a mild limitation using reason and judgment to make work-related decisions and a moderate limitation interacting with others.
FNP Tellier completed a "Medical Assessment of Ability to do Work-Related Activities (Mental)" on April 23, 2019. (Id. at 560). FNP Tellier began treating Plaintiff in 2016 and saw her every three to six months. (Id. ). Plaintiff was diagnosed with depression, anxiety, ADD, and allergies, which were treated with medications and counseling, with some improvement. (Id. ). FNP Tellier stated that Plaintiff was "stable" at her last appointment, and while she did not suffer from a "panic disorder," she experienced panic attacks and had disproportionate fear and anxiety in certain situations. (Id. at 560-61). FNP Tellier found that Plaintiff was moderately limited (defined as "[p]atient's ability to function in this area independently, appropriately, effectively, and on a sustained basis is fair") in interacting with others and adapting and managing herself, and was markedly limited (defined as "[p]atient's ability to function in this area independently, appropriately, effectively, and on a sustained basis is seriously limited") in concentrating, persisting, or maintaining pace. (Id. at 561-62). Plaintiff had a "fair" ability to perform the following tasks: follow work rules; relate to co-workers; deal with the public; use judgment; interact with supervisors; deal with work stress; and function independently. (Id. at 562). Plaintiff's ability to maintain attention and concentration was "poor." (Id. ). FNP Tellier noted that Plaintiff was easily overwhelmed and emotional when faced with adversity. (Id. at 563). Plaintiff had a "fair" ability to understand, remember, and carry out complex and detailed job instructions, and "good" ability to understand, remember, and carry out simple job instructions. (Id. ). Plaintiff had a "good" ability to maintain personal appearance; a "fair" ability to demonstrate reliability and to handle stressful situations that arise in employment settings; and a "poor" ability to behave in an emotionally stable manner and relate predictably in social situations. (Id. ). According to FNP Tellier, the frequency of Plaintiff's panic attacks would increase if she was to attempt to perform fulltime employment, and she would be off-task more than 16 percent of the workday if she was to return to unskilled work. (Id. at 563-54). On average, Plaintiff would be absent from work three or more days per month. (Id. at 564).
The ALJ provided a detailed discussion of FNP's Tellier's opinion, finding that it was "not entirely consistent with the record and is not deemed to be significantly persuasive." (Id. at 27). The ALJ discussed specific evidence in the record which was not consistent with FNP Tellier's opinion, including that Plaintiff did not require serious treatment for her panic attacks, performed part-work in 2017, drove her boyfriend to work (as often as on a daily basis), and engaged in fairly routine, less stressful activity. (Id. ). The ALJ also explained that, while Plaintiff reported that she experienced ongoing anxiety in her treatment records, she exhibited no deficits in concentration or attention, memory, or cognitive functioning in general under clinical examination and, as such, FNP Tellier's opinion that Plaintiff would be off-task for much of the workday, would miss work on multiple days, and would experience serious difficulties focusing on even simple, less stressful tasks was not supported by the record. (Id. ).
LMHC Quinn completed the same form on May 6, 2019. (Id. at 642). Plaintiff was admitted to the clinic in November 2018 and attended monthly therapy appointments. (Id. ). Plaintiff was diagnosed with general anxiety disorder and reported some benefit from therapy and medications. (Id. ). LMHC Quinn reported that Plaintiff experienced disproportionate fear or anxiety about certain situations. (Id. at 644). She was moderately limited in her ability to interact with others, and she was mildly to moderately limited in concentrating, persisting, or maintaining pace and adapting and managing herself. (Id. at 644-45). Plaintiff had a "good" ability to follow work rules and use judgment; a "fair" ability to relate to co-workers, deal with the public, interact with supervisors, function independently, and maintain attention/concentration, and a "poor" ability to deal with work stress. (Id. at 645). She had a "good" ability to understand, remember, and carry out simple job instructions, and a "fair" ability to understand, remember, and carry out complex and detailed job instructions. (Id. at 646). Plaintiff had a "good" ability to maintain personal appearance; a "fair" ability to behave in an emotionally stable manner and demonstrate reliability; and a fair to poor ability to relate predictably in social situations and handle stressful situations that arise in employment settings. (Id. ). Plaintiff reported that she had two panic attacks per week when out of the house. (Id. ). LMHC Quinn was unable to assess whether Plaintiff's panic attacks would increase with fulltime work, what percentage of time Plaintiff would be off-task, and how often Plaintiff would be absent from work. (Id. at 646-47).
The ALJ also provided a detailed discussion of LMHC Quinn's opinion in the written determination. The ALJ found that her opinion was "fairly consistent with the evidence and is fairly persuasive." (Id. at 28). Specifically, the ALJ explained that LMHC Quinn's opinion was not entirely inconsistent with the record; although Plaintiff did not exhibit any serious cognitive deficits generally, she did consistently complain of anxiety. (Id. ). However, the ALJ found that LMHC Quinn's opinion did not suggest that Plaintiff would be unable to perform fulltime work, which was less stressful and involved less intense social interaction. (Id. ).
The Court has reviewed the medical evidence in the record, including the aforementioned opinions, as well as the written determination, and finds that the ALJ properly weighed the medical opinion evidence in the record, and his assessment of the RFC based on this evidence is supported by substantial evidence. As required by the new regulations, the ALJ explained his findings regarding the supportability and consistency for each of the opinions, pointing to specific evidence in the record supporting those findings. As is evident from the written determination, the ALJ found that the opinion offered by Dr. Deneen was better supported and more consistent with the evidence than the opinions offered by FNP Tellier and LMHC Quinn. As explained above, the new regulations eliminate the "treating physician rule," and the opinion of a consultative examiner may override the opinion of a treating physician, particularly where the opinion of the consultative examiner is better supported by the record. See Netter v. Astrue , 272 F. App'x 54, 55-56 (2d Cir. 2008). Accordingly, the ALJ's finding in this regard was proper.
Plaintiff's objection to the ALJ's weighing of the medical opinion evidence hinges on her argument that the ALJ should have given greater weight to the opinions offered by FNP Tellier and LMHC Quinn because they are "treating sources." (See Dkt. 8-1 at 18). In explaining why he found FNP Tellier's opinion to be inconsistent with the record and not significantly persuasive, the ALJ pointed to specific evidence contradicting her opinion, including that Plaintiff exhibited no deficits in concentration or attention, memory, or cognitive functioning under clinical examination, and she demonstrated that she could engage in routine, less-stressful activity. (Dkt. 5 at 27). FNP Tellier's opinion was provided on a form, which did not provide an adequate explanation for the significant limitations she assessed. For example, FNP Tellier did not offer any support for her opinion that Plaintiff would be absent for more than three days per month and would be off-task more than 16 percent of the workday, even performing unskilled work. Further, while Plaintiff's treatment notes, including those from FNP Tellier, confirm that she experienced ongoing anxiety (see, e.g. , id. at 400, 402, 405, 408, 494), her mental assessments were largely normal (id. at 400, 402, 403, 406, 409, 411, 413, 489, 492, 494-95). See Pawlak v. Saul , No. 19-CV-165-MJR, 2020 WL 3046204, at *6 (W.D.N.Y. June 8, 2020) (explaining that "[a]lthough the findings from Plaintiff's mental or psychiatric examinations supported some limitations, they did not support disabling restrictions"). In other words, although FNP Tellier found that Plaintiff had a poor ability to maintain attention and concentration and would be frequently off-task and absent from work, Plaintiff's medical records do not support those conclusions. The ALJ incorporated into the RFC other limitations assessed by FNP Tellier which were consistent with evidence in the record, including that Plaintiff was moderately limited in interacting with others and had a "fair" ability to deal with the public, use judgment, interact with supervisors, and deal with work stress.
Plaintiff further contends that the ALJ's statement that Plaintiff could perform part-time work was not a valid reason for discounting FNP Tellier's opinion. (Dkt. 8-1 at 19). As an initial matter, the ALJ discounted FNP Tellier's opinion for several reasons, including that Plaintiff exhibited no deficits during her mental status examinations. In discussing Plaintiff's past work, the ALJ clarified that the work was for only six months on a part-time basis, but nonetheless found that Plaintiff's ability to work for that period of time did not support FNP Tellier's opinion that Plaintiff would be off-task more than 16 percent of the day and would be absent more than three days per week. The ALJ's analysis goes to the consistency of FNP Tellier's opinion with other evidence in the record, including Plaintiff's work history. See Downs v. Colvin , No. 6:15-CV-06644(MAT), 2016 WL 5348755, at *3 (W.D.N.Y. Sept. 26, 2016) (ALJ properly considered that plaintiff's "part-time work, even if not substantial gainful activity, may show a claimant is able to do more than they actually did").
The ALJ also properly assessed the opinion offered by LMHC Quinn, which the ALJ found to be "fairly persuasive." As explained in the written determination, the ALJ found that LMHC Quinn's opinion that Plaintiff had a "fair" to "poor" ability to handle work stress and stressful situations was not supported by the record, nor was it consistent with other evidence in the record, including Plaintiff's largely normal mental status examinations. (See, e.g. , Dkt. 5 at 569-70, 572-73, 579, 583, 589-90, 598, 605-06, 621, 628, 635). Significantly, the RFC accounts for other limitations assessed by LMHC Quinn, including that Plaintiff was moderately limited in interacting with others, had a fair ability to deal with the public and relate with co-workers, and had a "good" ability to use her judgment.
In sum, the ALJ's assessment of the opinion evidence in the record was proper. Further, the ALJ's limiting Plaintiff to occasional interaction with supervisors, coworkers and the general public, as well as low stress work, defined as work involving occasional decision making, is consistent with the medical evidence in the record and is supported by the opinion of Dr. Deneen, who found that Plaintiff would be moderately limited in interacting with others and regulating her emotions, behavior, and well-being. (See Dkt. 5 at 28 (explaining that the RFC "includes significant mental limitations which ... should accommodate [Plaintiff's] ongoing anxiety but which recognize that she did not exhibit any serious cognitive/concentration deficits: work would need to be ‘low stress’, meaning that it should involve only occasional decisionmaking; she would also be limited to only occasional interaction with supervisors, coworkers and the general public, in order to reduce her anxiety levels (again, she is capable of leaving her home when needed, and she seems to be able to interact with others on a reduced basis given her part-time work history and her interactions with treating sources). There is no reasonable indication that additional mental restrictions would be warranted, given the medical evidence of record.")). Accordingly, remand is not required on this basis.
B. Evaluation of Plaintiff's Ability to Manage Stress
Plaintiff's second and final argument is that the ALJ failed to consider and evaluate Plaintiff's ability to manage stress. Contrary to Plaintiff's contention, the ALJ specifically considered Plaintiff's ability to manage stress. (See, e.g. , id. at 27 (discussing Plaintiff's treatment records and FNP Tellier's April 2019 statement, and concluding that "[Plaintiff] seems to be able to tolerate less stressful activity on a fairly routine, sustained basis despite her symptoms"); id. at 28 (discussing opinion offered by LMHC Quinn and concluding that her opinion "does not suggest that the claimant would be unable to perform fulltime work which was less stressful and involved less intense social interaction")). The ALJ also adequately explained that, to the extent LMHC Quinn opined that Plaintiff had a "fair" to "poor" ability to handle work stress/stressful situations and maintain normal social functioning, her opinion was not supported by the record. (Id. at 28).
The RFC limits Plaintiff to occasional interaction with supervisors, coworkers and the general public, and low stress work, defined as work involving occasional decision making. "[C]ourts reviewing an ALJ's evaluation of stress-based limitations do not demand an exhaustive analysis of the issue. So long as the decision reveals that the ALJ considered and accounted for stress limitations—even if not in the most explicit terms—remand is not warranted." Gomez v. Comm'r of Soc. Sec. , No. 18-CV-96-FPG, 2020 WL 1322565, at *4 (W.D.N.Y. Mar. 20, 2020) (internal citation omitted). Here, FNP Tellier opined that Plaintiff had a "fair" ability to deal with work stress and handle stressful situations that arise in employment settings. Similarly, Dr. Deneen opined that Plaintiff had a moderate limitation for interacting adequately with supervisors, co-workers, and the public, regulating her emotions, controlling behavior, and maintaining well-being. Given this evidence, the limitations contained in the RFC adequately account for Plaintiff's limitations for managing stress, particularly because the record supports that Plaintiff's stress and anxiety stemmed, in large part, from interacting with others. (See id. at 25 (discussing Plaintiff's testimony that her daily anxiety worsened with social activities and that she was unable to interact with others due to anxiety)). Accordingly, the Court finds that the ALJ adequately considered and accounted for Plaintiff's stress-based limitations. See Alexandrea R. R. v. Berryhill , No. 18-CV-121, 2019 WL 2269854, at *7 (N.D.N.Y. May 28, 2019) ("The ALJ discharged his duty [to account for stress-based limitations] ... by assessing a number of limitations in [the plaintiff's] ability to perform work-related mental tasks, and by including a number of specific restrictions in recognition of [the] plaintiff's ability to handle work-related stressors."); see also Blocker v. Saul , No. 18-CV-6788F, 2020 WL 1047737, at *6 (W.D.N.Y. Mar. 4, 2020) (although claimant was "markedly limited in appropriately dealing with stress," the ALJ accounted for this by limiting claimant to simple routine tasks, occasional interaction with co-workers and the general public, and low stress work, defined as work involving only occasional decision making). Plaintiff has failed to explain why additional stress-related limitations are required. Because the RFC accounts for Plaintiff's stress-related limitations, she is not entitled to remand on this basis.
CONCLUSION
For the foregoing reasons, the Commissioner's motion for judgment on the pleadings (Dkt. 10) is granted and Plaintiff's motion for judgment on the pleadings (Dkt. 8) is denied. The Clerk of Court is directed to enter judgment and close this case.
SO ORDERED.