Opinion
CASE NO. 8:02CV402
August 19, 2003
MEMORANDUM AND ORDER
This matter comes before the Court on the denial, initially and on reconsideration, of the Plaintiff's disability insurance ("disability") benefits under the Social Security Act ("Act"), 42 U.S.C. § 401-433, and supplemental security income ("SSI") benefits under Title XVI of the Act, 42 U.S.C. § 1381-1383. The Court has carefully considered the record and the parties' briefs.
PROCEDURAL BACKGROUND
The Plaintiff, Maria Antoinette Randolph, filed her initial applications for disability and SSI benefits on November 3, 1999. (Tr. 34-36, 188-200.) The claims were denied. (Tr. 23-28, 201.) An administrative hearing was held before Administrative Law Judge ("ALJ") Donald R. Colpitts of New Orleans, Louisiana, on March 8, 2001. (Tr. 203-21.) On May 23, 2001, the ALJ issued a decision finding that Randolph was not "disabled" within the meaning of the Act and therefore is not eligible for either disability or SSI benefits. (Tr. 19, 21.) On July 5, 2002, the Appeals Council denied Randolph's request for review. (Tr. 5-6.) Randolph now seeks judicial review of the ALJ's determination as the final decision of the Defendant, the Commissioner of the Social Security Administration ("SSA"). (Filing No. 1.)
Randolph claims that the ALJ's decision was incorrect because the ALJ failed to: 1) appropriately weigh the opinion of Randolph's treating physician, Melanie Vega, M.D.; and 2) find that Randolph's testimony was credible.
Upon careful review of the record, the parties' briefs and the law, the Court concludes that the ALJ's decision denying benefits is supported by substantial evidence on the record as a whole. Therefore, the Court affirms the Commissioner's decision.
FACTUAL BACKGROUND
Randolph was forty-two years old at the time of the hearing. She earned her General Equivalency Degree and studied further to obtain a license to work as a nursing assistant. (Tr. 206.) Randolph's occupational experience includes work as a nursing assistant, sales associate, hotel room attendant and telemarketer. (Tr. 40, 56.) Since October of 1999, Randolph has not engaged in any substantial gainful employment. (Tr. 208-09.)
Randolph alleges disability due to chest pain, difficulty breathing, problems with walking, and being overweight. (Tr. 39.) Randolph's application for disability benefits and disability report do not mention mental or emotional problems. (Tr. 34-47.) Likewise, Randolph's application for SSI benefits listed only shortness of breath, chest pains, and being overweight and no mental or emotional difficulties. (Tr. 189.)
Randolph's Testimony
At the hearing, Randolph testified to her work history. She worked as a telemarketer off and on for a couple of years. (Tr. 207.) Randolph testified that her main difficulty at work was an inability to focus. (Tr. 209.)
Randolph stated that she continued to receive mental health treatment at the Central City Mental Health Clinic. Randolph testified that she began her mental health treatment when she experienced suicidal thoughts, feelings of loneliness, and a desire to remain isolated and sleep a lot. (Tr. 209-10.) At the time of the hearing, Randolph stated that she weighed 360 pounds and had been gaining weight rapidly. (Tr. 210.) She stated that in October 1999, her weight was 282 pounds. (Tr. 211.) She testified that she was being treated for a thyroid condition and gastric reflux disease. (Tr. 210.) Randolph testified that she could not stand for any period of time. She stated that she could sit for thirty minutes before having to lie down and that she could walk one block. She could not bend, crawl or stoop. (Tr. 211.) She does not drive due to effects of her medication, Trazodone. She stated that she had been hospitalized the week prior to the hearing after experiencing breathing problems. (Tr. 212.)
Randolph testified that she used to live with her husband, but that she began residing with her sister one month prior to the hearing. (Tr. 213.) Randolph stated that, at the time of the hearing, her husband was "out of the picture." (Tr. 216.) She stated that she washed dishes and cooked while with her husband, but that he did all other chores due to her inability to remember things and concentrate. Her husband did the shopping. She testified that she slept all day while living with her husband. (Tr. 214.) Randolph stated that she only left her downstairs apartment to go to her medical appointments. (Tr. 213, 214.)
Randolph rode the bus alone and without assistance to the hearing, despite problems getting on and off the bus. (Tr. 215.)
Vocational Expert's Testimony
Testimony was also heard from a vocational expert ("VE"), Nancy Favalora, under contract with the SSA. (Tr. 216-20.) The ALJ presented the VE with the following hypothetical:
Let's take a 42 year old lady with a GED, high school GED and let's say she's capable of medium work, been ordered to avoid any stressful situations. Also avoid any interactions with the public. Let's limit any extended standing or walking. Extended, that doesn't mean she can't do it. Okay, with those limitations, are there positions that you think she could — well, could she go back and do any of her past work?
(Tr. 217.)
The VE answered that, assuming that the condition that Randolph avoid contact with the public did not preclude such telephone contact, that Randolph could perform her past relevant work as a telemarketer. (Tr 217.) In answer to the ALJ's question whether other positions exist that Randolph could perform with the stated restrictions, the VE stated that Randolph could perform the following medium jobs: food preparer; hand packager; assembler; and sewing machine operator. (Tr. 217-18.)
Documentary Evidence Before the ALJ
In addition to oral testimony, the ALJ considered medical evidence. The medical evidence shows that Randolph began treatment on December 8, 1999, at Central City Mental Health Clinic. (Tr. 166.) Randolph reported that she was always sad, and that she experienced difficulty with concentration and memory. She stated that her sleep and appetite were poor, and that she had crying spells (Tr. 164). Randolph reported on January 5, 2000, that she was still depressed, but "`doing fine.'" (Tr. 163.)
Randolph was seen by Sheldon Hersh, M.D., on December 29, 1999, for complaints of shortness of breath and nerves. (Tr. 114-15.) Dr. Hersh noted that Randolph's chest x-rays and echocardiogram were normal, as was a pulmonary function study conducted in November 1999. (Tr. 114.) Randolph reported that her sleep and appetite were poor, as well as her memory and concentration. At this time, Randolph was five feet three inches tall and weighed 288 pounds. (Tr. 115.) A full examination revealed no abnormalities other than obesity, and a "mildly abnormal," yet nonspecific, electrocardiogram. (Tr. 115-16.) Randolph got on and off the examining table without any complaints of pain or assistance. Randolph had no tenderness or spasm in her back, and her gait was normal. (Tr. 116.) Dr. Hersh noted specifically that Randolph had no significant cardiac or pulmonary problems. He stated that Randolph was significantly depressed, and that she had a "constriction" on her activities of daily living. Dr. Hersh opined that work in a stressful environment would be difficult. He recommended continued psychiatric treatment. (Tr. 117.)
On January 19, 2000, Melanie Vega, M.D., noted that Randolph's thoughts were logical and goal-directed. (Tr. 161.) On January 31, 2000, Dr. Vega opined that Randolph demonstrated the following symptoms: anhedonia, or pervasive loss of interest in almost all activities; appetite disturbance with change in weight; sleep disturbance; psychomotor agitation or retardation; decreased energy; feelings of guilt or worthlessness; difficulty concentrating or thinking; suicidal thoughts; and hallucinations, delusions, or paranoid thinking. Dr. Vega indicated the applicability of the following: extreme restriction of daily activities; extreme difficulties in maintaining social functioning; constant deficiencies of concentration, persistence or pace resulting in frequent failure to complete tasks in a timely manner in work or other settings; and continued episodes of deterioration or decompensation in work or work-like settings which caused Randolph to withdraw from the situation or to experience exacerbation of signs and symptoms. (Tr. 153.) Dr. Vega opined that Randolph demonstrated: a substantial loss of ability to understand, carry out, or remember simple instructions; respond appropriately to supervision, coworkers, or usual work situations; and deal with changes in routine work settings. Dr. Vega commented that Randolph was "very easily irritated" and documented a demonstrated episode showing Randolph's inappropriate treatment of others. (Tr. 154.)
On February 11, 2000, Randolph saw Alvin Cohen, M.D., for a psychiatric examination. Randolph reported that she was able to travel alone using public transportation. (Tr. 121.) She stated that she performs a few household chores, but she indicated that she stopped due to shortness of breath and poor memory. (Tr. 122.) A mental status examination showed that Randolph was alert, responsive and appropriate. She was cooperative, and her thought content revealed no gross abnormalities. Randolph's mood was depressed and anxious. Dr. Cohen found: adequate memory for recent and past events; intact ability to pay attention; clinically adequate concentration; an adequate fund of general information; and an adequate intellectual capacity. Dr. Cohen further noted: no marked impairment in Randolph's ability to perform usual daily activities; limited, but not markedly impaired social functioning; and sufficient concentration to timely perform tasks and daily household routines. Dr. Cohen noted evidence that Randolph would not adapt to stressful circumstances and would withdraw from such situations. He diagnosed: 1) major depression with psychotic features, by history, in remission, by history; and 2) personality disorder. Dr. Cohen noted that Randolph's prognosis was guarded, and that she was competent to manage funds but preferred not to do so. (Tr. 123.)
In a letter dated March 20, 2000, Dr. Vega stated that Randolph's symptoms were consistent with "Major Depressive disorder, severe, with psychotic features." (Tr. 157.) Dr. Vega stated that Randolph's depression was compounded by her cardiac disease, obesity, and hypothyroidism. (Tr. 157.) Dr. Vega opined:
I do not believe that Mrs. Randolph is able to work at the present time. Her mental condition makes it difficult for her to deal appropriately with other people, causes poor judgment and unpredictable behavior, causes poor endurance and difficulty in finishing tasks and following directions, interferes with her ability to think clearly and rationally, and would be exacerbated by any stressful situation.
(Tr. 157.)
Dr. Vega's progress notes dated only four days after her letter state that, despite continued depression, Randolph was sleeping and eating well. (Tr. 156.)
Randolph saw Christina Scott, Ph.D., on June 19, 2000, for a psychological evaluation. (Tr. 183-85.) Visual-motor functioning was normal, and intelligence testing placed her at the low end of the average range. Randolph's response pattern on intellectual testing suggested that her depressive symptoms interfered with her concentration. Dr. Scott diagnosed major depressive disorder with psychotic features. (Tr. 184.)
THE ALJ'S DECISION
The ALJ found that Randolph was not "disabled" pursuant to her November 3, 1999, application for disability or SSI benefits. (Tr. 15.) The ALJ framed the issues as: (1) whether Randolph was entitled to disability and SSI benefits under the Act; and (2) whether Randolph was "disabled." (Tr. 15.)
The ALJ followed the sequential evaluation process set out in 20 C.F.R. § 404.1520 and 416.920. Following this analysis, the ALJ found that Randolph is not disabled. Specifically, at step one the ALJ found that Randolph has not performed any substantial gainful work activity since October 1999. At step two, the ALJ found that Randolph has depression, a medically determinable impairment that is considered "severe" within the meaning of the SSA's regulations. At step three, the ALJ found that Randolph's medically determinable impairment did not meet section 12.04 or any other section of Appendix 1 to Subpart P of the Social Security Administration's Regulations No. 4, known as the "listings." (Tr. 16.) At step four, the ALJ determined that, despite Randolph's medically determinable impairments, she possessed the residual functional capacity to perform her past relevant work as a telemarketer. (Tr. 27.)
Section 404.1520 relates to disability benefits, and identical § 416.920 relates to SSI benefits. For simplicity, further references will only be to § 404.1520.
Finally, at step five the ALJ found that Randolph has the residual functional capacity to perform certain medium jobs, limited to avoid: stressful situations; interaction with the public; and extended standing or walking. The specific available jobs that fit this category include: food preparer; hand packager; assembler; and sewing machine operator. In so deciding, the ALJ weighed Randolph's testimony, finding the testimony not credible. (Tr. 19.) The ALJ also carefully considered the medical records submitted by treating physician Dr. Vega at the mental health center (Tr. 18), the opinion of consultative physicians Drs. Hersh and Cohen (Tr. 17), and the psychological evaluation performed by Dr. Scott (Tr. 18).
STANDARD OF REVIEW
In reviewing a decision to deny disability benefits, a district court does not reweigh evidence or the credibility of witnesses or revisit issues de novo. Bates v. Chater, 54 F.3d 529, 532 (8th Cir. 1995); Harris v. Shalala, 45 F.3d 1190, 1193 (8th Cir. 1995). Rather, the district court's role under 42 U.S.C. § 405(g) is limited to determining whether substantial evidence in the record as a whole supports the Commissioner's decision and, if so, to affirming that decision. Harris, 45 F.3d at 1193.
"Substantial evidence is less than a preponderance, but enough that a reasonable mind might accept it as adequate to support a decision." Holmstrom v. Massanari, 270 F.3d 715, 720 (8th Cir. 2001). The Court must consider evidence that both detracts from, as well as supports, the Commissioner's decision. Id.; Morse v. Shalala, 16 F.3d 865, 870 (8th Cir. 1994). As long as substantial evidence supports the Commissioner's decision, that decision may not be reversed merely because substantial evidence would also support a different conclusion or because a district court would decide the case differently. McKinney v. Apfel, 228 F.3d 860, 863 (8th Cir. 2000); Harris, 45 F.3d at 1193.
DISCUSSION "Disability" Defined
An individual is considered to be disabled if he is unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to . . . last for a continuous period of not less than twelve months." 42 U.S.C. § 423(d)(1)(A). The physical or mental impairment must be of such severity that the claimant is "not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy." 42 U.S.C. § 423(d)(2)(A). If the claimant argues that he has multiple impairments, the Act requires the Commissioner to "consider the combined effect of all of the individual's impairments without regard to whether any such impairment, if considered separately, would be of such severity." 42 U.S.C. § 423(d)(2)(B).
Sequential Evaluation
In determining disability, the Act follows a sequential evaluation process. See 20 C.F.R. § 416.920. In engaging in the five-step process, the ALJ considers whether: 1) the claimant is gainfully employed; 2) the claimant has a severe impairment; 3) the impairment meets the criteria of the "listings"; 4) the impairment prevents the claimant from performing past relevant work; and 5) the impairment necessarily prevents the claimant from doing any other work. Id. If a claimant cannot meet the criteria at any step in the evaluation, the process ends and the determination is one of no disability. Id.
In this case, the ALJ completed all five steps in the evaluation process, concluding: 1) Randolph has not performed substantial gainful work activity since November 3, 1999; 2) Randolph has a medically determinable impairment, i.e., depression, that is considered "severe" within the meaning of the SSA's regulations; 3) Randolph's medically determinable impairment does not meet the "listings"; 4) despite Randolph's medically determinable impairment, she possesses the residual functional capacity to perform her past relevant work as a telemarketer; and 5) Randolph has the residual functional capacity to perform medium work, which includes the following jobs: food preparer; hand packager; assembler; and sewing machine operator, all jobs that exist in significant numbers in the national economy. Such work must be limited to avoid: stressful situations; interaction with the public; and extended standing or walking.
Pain Analysis Credibility of Randolph's Testimony
Randolph argues that the ALJ did not properly apply the correct standard in evaluating Randolph's subjective complaints of pain. Randolph argues that the ALJ improperly discounted her complaints of pain only because the ALJ found the complaints inconsistent with the medical evidence.
The ALJ found that Randolph's testimony was not totally credible in light of the criteria set forth in 20 C.F.R. § 404.1529 and 416.929 and Social Security Ruling 96-7p. Specifically, the ALJ found that Randolph's complaints relating to her symptoms, pain, functional limitations and restrictions in daily activities are exaggerated, lack corroboration in the medical evidence, inconsistent in light of the medical evidence and testimony, and result from a lack of adherence to suggested medication or treatment plans. (Tr. 19.)
The credibility of Randolph's testimony in its entirety is crucial because, in determining the fourth and fifth factors relating to a claimant's residual functional capacity to perform past relevant work and a range of work activities in spite of her impairments, the ALJ must evaluate the credibility of a claimant's testimony regarding subjective pain complaints. The underlying issue is the severity of the pain. Black v. Apfel, 143 F.3d 383, 386-87 (8th Cir. 1998). The ALJ is allowed to determine the "authenticity of a claimant's subjective pain complaints." Ramirez v. Barnhart, 292 F.3d 576, 582 (8th Cir. 2002). An "`ALJ may discount subjective complaints of pain if inconsistencies are apparent in the evidence as a whole.'" Haley v. Massanari, 258 F.3d 742, 748 (8th Cir. 2001) (stating the issue as whether the record as a whole reflected inconsistencies that discredited the plaintiff's complaints of pain) (quoting Gray v. Apfel, 192 F.3d 799, 803 (8th Cir. 1999)).
Also, an ALJ may resolve conflicts among various treating and examining physicians, assigning weight to the opinions as appropriate. Pearsall v. Massanari, 274 F.3d 1211, 1219 (8th Cir. 2001).
The Polaski standard is the guide for credibility determinations:
While the claimant has the burden of proving that the disability results from a medically determinable physical or mental impairment, direct medical evidence of the cause and effect relationship between the impairment and the degree of claimant's subjective complaints need not be produced. The adjudicator may not disregard a claimant's subjective complaints solely because the objective medical evidence does not fully support them.
The absence of an objective medical basis which supports the degree of severity of subjective complaints alleged is just one factor to be considered in evaluating the credibility of the testimony and complaints. The adjudicator must give full consideration to all of the evidence presented relating to subjective complaints, including the claimant's prior work record, and observations by third parties and treating and examining physicians relating to such matters as:
1. the claimant's daily activities; 2. the duration, frequency and intensity of the pain; 3. precipitating and aggravating factors; 4. dosage, effectiveness and side effects of medication; 5. functional restrictions.
The adjudicator is not free to accept or reject the claimant's subjective complaints solely on the basis of personal observations. Subjective complaints may be discounted if there are inconsistencies in the evidence as a whole.Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1986).
Interpreting the Polaski standard, §§ 404.1529 and 416.929 discuss the framework for determining the credibility of subjective complaints, e.g., pain.
An ALJ is required to make an "express credibility determination" when discrediting a social security claimant's subjective complaints. Lowe v. Apfel, 226 F.3d 969, 971-72 (8th Cir. 2000). This duty is fulfilled when an ALJ acknowledges the Polaski factors, and the ALJ has clearly examined the factors before discounting the claimant's testimony. An ALJ is "not required to discuss methodically each Polaski consideration." Id. at 972.
The federal regulations provide that the ALJ must consider all symptoms, "including pain, and the extent to which symptoms can reasonably be accepted as consistent with the objective medical evidence," defined as "medical signs and laboratory findings." 20 C.F.R. § 416.929. Medical "signs" are defined as:
anatomical, physiological, or psychological abnormalities which can be observed, apart from your statements (symptoms). Signs must be shown by medically acceptable clinical diagnostic techniques. Psychiatric signs are medically demonstrable phenomena that indicate specific psychological abnormalities, e.g., abnormalities of behavior, mood, thought, memory, orientation, development, or perception. They must also be shown by observable facts that can be medically described and evaluated.20 C.F.R. § 416.928(b) (2001).
"Laboratory findings" are defined as: "anatomical, physiological, or psychological phenomena which can be shown by the use of medically acceptable laboratory diagnostic techniques. Some of these diagnostic techniques include chemical tests, electrophysiological studies (electrocardiogram, electroencephalogram, etc.), roentgenological studies (X-rays), and psychological tests."20 C.F.R. § 416.928(c) (2001).
Social Security Ruling 96-7p provides that a "strong indication" of the credibility of a claimant's statements is the consistency of the claimant's various statements and the consistency between the statements and the other evidence in the record. Ruling 96-7p provides that the ALJ must consider such factors as:
* The degree to which the individual's statements are consistent with the medical signs and laboratory findings and other information provided by medical sources, including information about medical history and treatment.
* The consistency of the individual's own statements. The adjudicator must compare statements made by the individual in connection with his or her claim for disability benefits with statements he or she made under other circumstances, when such information is in the case record. Especially important are statements made to treating or examining medical sources and to the "other sources" defined in 20 C.F.R. § 404.1513(e) and 416.913(e). However, the lack of consistency between an individual's statements and other statements that he or she has made at other times does not necessarily mean that the individual's statements are not credible. Symptoms may vary in their intensity, persistence, and functional effects, or may worsen or improve with time, and this may explain why the individual does not always allege the same intensity, persistence, or functional effects of his or her symptoms. Therefore, the adjudicator will need to review the case record to determine whether there are any explanations for any variations in the individual's statements about symptoms and their effects.
* The consistency of the individual's statements with other information in the case record, including reports and observations by other persons concerning the individual's daily activities, behavior, and efforts to work. This includes any observations recorded by SSA employees in interviews and observations recorded by the adjudicator in administrative proceedings.
SSR 96-7p, 1996 WL 374186 (S.S.A.) at *5 (July 2, 1996).
Social Security Ruling 96-7p is entitled: "Policy Interpretation Ruling Titles II and XVI: Evaluation of Symptoms in Disability Claims: Assessing the Credibility of an Individual's Statements.
Deference is generally granted to an ALJ's determination regarding the credibility of a claimant's testimony and, in particular, subjective complaints of pain. Dunahoo v. Apfel, 241 F.3d 1033, 1038 (8th Cir. 2001) (stating that if an ALJ provides a "good reason" for discrediting claimant's credibility, deference is given to the ALJ's opinion, although every factor may not have been discussed).
In Randolph's case, the record illustrates that the ALJ performed a thorough Polaski analysis in determining the credibility of Randolph's subjective pain complaints. In making the credibility determination, the ALJ considered that Randolph has not performed substantial gainful activity since October 1, 1999. The ALJ considered Randolph's daily activities, which include the ability to take public transportation alone, get on and off a doctor's examination table without assistance, and perform some daily chores at home. The evidence shows that Randolph has such abilities although she does not appear to engage in many daily activities of choice.
The ALJ exhaustively considered all medical opinions, although he excluded the opinion of Dr. Vega, Randolph's treating physician. (Tr. 16-18.) The ALJ also accepted the opinions of Dr. Hersch, an internist who examined Randolph and concluded that work in a stressful environment should be avoided. The ALJ also considered the opinion of Dr. Cohen, a psychiatrist who evaluated Randolph and found no marked impairment in her ability to perform daily living functions, though diagnosing her with major depression and recommending continued therapy. (Tr. 17.) Finally, the ALJ considered the opinion of Dr. Scott, a psychologist who evaluated Randolph and similarly diagnosed major depressive disorder and recommended continued counseling, medical therapy, and social work services. (Tr. 18-19.) The ALJ considered Randolph's essentially normal electrocardiogram and echocardiogram results. (Tr. 16.)
In summary, the ALJ thoroughly considered Randolph's subjective pain complaints, the reports of her treating physician, efforts at continued therapy, reports of consultative and agency physicians, and Randolph's own statements. The ALJ correctly engaged in the Polaski analysis. The ALJ set out the standards stated in §§ 404.1529 and 416.929, and the ALJ acknowledged the Polaski standard as well as applicable regulations and SSR 96-7p. (Tr. 30-31.) The ALJ's conclusion that Randolph`s pain is not severe enough to prevent her from engaging in her past relevant work as a telemarketer was well-founded, and followed an appropriate express credibility determination regarding Randolph's assertion of subjective complaints. The ALJ's credibility decision was well-supported and based on a thorough analysis of treating and consultative medical reports.
Therefore, the ALJ appropriately determined that Randolph's testimony was not credible with respect to the extent of her symptoms and limitations.
Past Relevant Work
The ALJ bears the primary responsibility for assessing Randolph's residual functional capacity based on the relevant evidence. However, Randolph's residual functional capacity is a medical question. Hutsell v. Massanari, 259 F.3d 707, 711 (8th Cir. 2001). The ALJ must resolve any conflict in the medical evidence. Id. However, some medical evidence "`must support the determination of the claimant's [residual functional capacity], and the ALJ should obtain medical evidence that addresses the claimant's ability to function in the workplace.'" Id. at 712 (quoting Lauer v. Apfel, 245 F.3d 700, 704 (8th Cir. 2001)). "To properly determine a claimant's residual functional capacity, an ALJ is therefore `required to consider at least some supporting evidence from a [medical] professional.'" Id. (quoting Lauer, 245 F.3d at 704).
In Randolph's case, the ALJ followed the procedures in determining that Randolph retained the residual functional capacity to return to some of her past relevant work. The ALJ considered the "entire record." (Tr. 19.) Conflicts existed among those opinions, and therefore the ALJ examined additional factors in the record. Taking all of this evidence into consideration, the Court finds that the ALJ properly determined the fourth and fifth steps of the inquiry.
Therefore, this Court agrees that the ALJ properly determined that Randolph could return to her past relevant work as a telemarketer.
Residual Functional Capacity
Residual functional capacity is defined as what Randolph "can still do despite . . . limitations." 20 C.F.R. § 404.1545(a), 416.945(a). Residual functional capacity is an assessment based on all "relevant evidence," id., including a claimant's description of limitations; observations by treating or examining physicians or psychologists, family, and friends; medical records; and the claimant's own description of her limitations. Id. §§ 404.1545(a)-(c), 416.945(a)-(c).
The ALJ must determine RFC based on all of the relevant evidence, including the medical records, observations of treating physicians and others, and the claimant's own description of her limitations. McKinney v. Apfel, 228 F.3d 860, 863-64 (8th Cir. 2000). Before determining residual functional capacity, an ALJ first must evaluate the claimant's credibility. In evaluating subjective complaints, the ALJ must consider, in addition to objective medical evidence, any other evidence relating to: a claimant's daily activities; duration, frequency and intensity of pain; dosage and effectiveness of medication; precipitating and aggravating factors; and functional restrictions. See Polaski, 739 F.2d at 1322; see also § 404.1529. Subjective complaints may be discounted if there are inconsistencies in the evidence as a whole. Polaski, 739 F.2d at 1322. A lack of work history may indicate a lack of motivation to work rather than a lack of ability. See Woolf v. Shalala, 3 F.3d 1210, 1214 (8th Cir. 1993) (stating that a claimant's credibility is diminished by a poor work history). The credibility of a claimant's subjective testimony is primarily for the ALJ, not a reviewing court, to decide. Pearsall, 274 F.3d at 1218.
In this case, the ALJ set out the language describing the appropriate standard under Polaski and § 404.1529. (Tr. 22-23.) The ALJ summarized Randolph's testimony and described her daily activities according to the testimony and documentary evidence. The ALJ found Randolph's testimony not credible. (Tr. 16.) The ALJ specifically considered, in addition to Randolph's testimony, documentary evidence including reports of treating and consultative physicians, results of medical tests, and the testimony of Nancy Favalora, a vocational expert under contract with the SSA. The VE opined that Randolph had the residual functional capacity to perform her past relevant work as a telemarketer as well as medium jobs limited to avoid stressful situations, interaction with the public, and extended standing or walking. Examples of such jobs that exist in significant numbers in the national economy are: food preparer; hand packager; assembler; and sewing machine operator. (Tr. 19.)
Opinion of Randolph's Treating Physician
"The [social security] regulations provide that a treating physician's opinion . . . will be granted `controlling weight,' provided the opinion is `well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] record.'" Prosch v. Apfel, 201 F.3d 1010, 1012-13 (8th Cir. 2000) (quoting 20 C.F.R. § 404.1527(d)(2)). An ALJ may discount such an opinion if other medical assessments are supported by superior medical evidence, or if the treating physician has offered an opinion inconsistent with other evidence as a whole. Id. at 1013; Holmstrom, 270 F.3d at 720. "The ALJ's function is to resolve conflicts among `the various treating and examining physicians.'" Estes v. Barnhart, 275 F.3d 722, 725 (8th Cir. 2002) (quoting Bentley v. Shalala, 52 F.3d 784, 785, 787 (8th Cir. 1985)). Whether the weight accorded the treating physician's opinion by the ALJ is great or small, the ALJ must give "good reasons" for that weighting. Holmstrom, 270 F.3d at 720 ; Prosch, 201 F.3d at 1013 (quoting 20 C.F.R. § 404.1527(d)(2)).
Dr. Vega, Randolph's treating physician, opined that Randolph cannot work. The ALJ discounted Dr. Vega's opinion:
While the claimant has been diagnosed with major depression with psychotic features, in January 2000, progress notes from the mental health center indicated the claimant was doing fine on medication. There is no evidence of record that claimant has been placed on a significant mental health treatment plan nor has in-patient hospitalization been recommended. In February 2000, Dr. Alvin Cohen found that claimant's depression was in remission. Dr. Cohen opined that claimant had no marked impairment in her ability to perform the usual activities of daily living. Her social functioning was not markedly impaired but limited. Dr. Cohen indicated that claimant's concentration was sufficiently adequate to handle tasks and daily household routines in a timely manner. However, Dr. Cohen felt, as did Dr. Hersch that claimant would not adapt to stressful situations and would withdraw from such circumstances.
The undersigned finds that the weight of all the objective medical evidence of record, including from the mental health clinic, does not support Dr. Vega's opinion that claimant is unable to work. Thus, such an opinion is not given "controlling" weight.
(Tr. 18.)
This Court has carefully reviewed the record and agrees with the ALJ's summary of Dr. Vega's opinion. The opinion differs significantly from other objective medical evidence and opinions.
The ALJ evaluated Dr. Vega's opinion appropriately. The ALJ's conclusion that the treating physician's opinion was inconsistent with evidence in the record as a whole is supported by substantial evidence. See Dunahoo, 241 F.3d at 1038 (finding that the treating physician's opinion was contradicted by the opinions of four other physicians).
CONCLUSION
For the reasons discussed, the Court concludes that the Commissioner's decision is supported by substantial evidence on the record as a whole and is affirmed.
IT IS ORDERED that the decision of the Commissioner is affirmed, the appeal is denied, and judgment in favor of the Defendant will be entered in a separate document.