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Santiago v. Colvin

United States District Court, D. Massachusetts

February 18, 2015

LUIS A. SANTIAGO, SR., Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security Administration, Defendant.



This is an action for judicial review of a final decision by the Commissioner of the Social Security Administration ("Commissioner") regarding Luis A. Santiago, Sr.'s ("Plaintiff") entitlement to Supplemental Security Income ("SSI") and Social Security Disability Insurance benefits ("SSDI") pursuant to 42 U.S.C. §§ 1383(c)(3) and 405(g). Plaintiff contends that the Commissioner's decision denying him such benefits - memorialized in a February 21, 2013 decision of an administrative law judge ("ALJ") - is in error. He has filed a motion for judgment on the pleadings seeking to remand the decision, while the Commissioner has moved to affirm.

The parties have consented to this court's jurisdiction. See 28 U.S.C. § 636(c); Fed.R.Civ.P. 73. For the reasons that follow, the court will deny Plaintiff's motion for judgment on the pleadings and grant the Commissioner's motion to affirm.


The parties are well aware of the factual and procedural history of this case, the standard of review, and the applicable five-step sequential analysis. In essence, Plaintiff argues that the ALJ erred in failing to consider certain mental health limitations discussed in the opinions of a clinician and registered nurse from River Valley Counseling Center, as well as the opinion of a consultative psychiatrist, when making his residual functional capacity ("RFC") determination. Plaintiff also contends that the ALJ further erred when discounting, or ignoring, those sources' opinions by providing only vague references to the record and failing sufficiently to explain his reasoning. The Commissioner responds that the ALJ's decision is not predicated on any error and is based on substantial evidence. The court agrees.

A. Opinions of Clinician and Registered Nurse

As stated above, Plaintiff argues that the ALJ improperly ignored the opinions of clinician Cheryl Przezdziecki ("Ms. Przezdziecki") and registered nurse Kathryn Proulx ("Ms. Proulx") of River Valley Counseling Center ("River Valley") when making his RFC determination.[1] More specifically, Plaintiff contends that the ALJ erred in failing to (1) assess additional mental limitations discussed in the River Valley medical records and a mental impairment questionnaire completed by Ms. Przezdziecki and (2) explain his rationale for not assessing such additional limitations. In response, the Commissioner asserts that the ALJ appropriately discounted the opinions of Ms. Przezdziecki and Ms. Proulx, both non-"acceptable medical sources, " because their opinions were not supported by their own treatment notes and were inconsistent with other record evidence. The Commissioner, in the court's view, has the better argument.

As an initial matter, the Commissioner's regulations preclude an administrative law judge from giving controlling weight to opinions from those who are not "acceptable medical sources." See Social Security Ruling ("SSR") 06-03p, 2006 WL 2329939, at *2 (Aug. 9, 2006) ("[O]nly acceptable medical sources' can be considered treating sources, as defined in 20 CFR 404.1502 and 416.902, whose medical opinions may be entitled to controlling weight"). Because Ms. Przezdziecki and Ms. Proulx, respectively, a clinician and a registered nurse, are not "acceptable medical sources" under the Commissioner's regulations, their opinions are not entitled to controlling weight. See 20 C.F.R. §§ 404.1513(d), 416.913(d) (defining "other sources"); see also, e.g., Hustead v. Astrue, No. 08-30119-KPN, 2009 WL 1259132, *4 (D. Mass. May 6, 2009) (nurse's opinion not entitled to controlling weight because she was not an "acceptable medical source"); Hardin v. Barnhart, 468 F.Supp.2d 238, 250 (D. Mass. 2006) (same). Still, Ms. Przezdziecki and Ms. Proulx are both "other sources, " whose opinions must be appropriately weighed.

As this court has explained, an administrative law judge may not "ignore other medical sources' or fail to adequately explain the weight given to such evidence." Taylor v. Astrue, 899 F.Supp.2d 83, 88 (D. Mass. 2012). "Thus, although other medical sources' are not entitled to controlling weight and an administrative law judge is not required to provide good reasons' for the weight assigned to such opinions nor consult the factors listed in 20 C.F.R. §§ 416.927(c)(2)-(6) [or 404.1527(c)(2)-(6)], " the administrative law judge "still must adequately explain his [or her] treatment of the opinion so that a reviewer can determine if the decision is supported by substantial evidence." Id. at 88-89; see Simumba v. Colvin, No. 12-30180-DJC, 2014 WL 1032609, at *8-9 (D. Mass. Mar. 17, 2014) (reviewing administrative law judge's evaluation of opinion from an "other source"); see also SSR 06-03P, 2006 WL 2329939, at *3 (acknowledging that Commissioner's regulations "do not explicitly address how to consider relevant opinions and other evidence from other sources'" and offering some guidance on how judges may evaluate an opinion from an "other source").

Here, the ALJ gave "little" weight to the opinions of Ms. Przezdziecki and Ms. Proulx because, generally, their findings were "not supported by the totality of the evidence." (Administrative Record ("A.R.") 612.) The ALJ explained that the administrative record contained minimal medication treatment records from Ms. Proulx in support of her conclusions, and similarly no counseling records of Ms. Przezdziecki other than an intake evaluation in support of her conclusions. (Id.) Further, the ALJ explained that their findings were neither internally nor externally consistent. (Id.) Prior to making these findings, the ALJ discussed the following: Plaintiff's intake evaluation where, according to Ms. Przezdziecki, he presented with severe panic and anxiety with extreme difficulty in social situations; Plaintiff's incarceration records, which did not reflect any of the severe symptoms noted by Ms. Przezdziecki or Ms. Proulx; and Plaintiff's improvements in managing his impairments, which were reflected in the River Valley treatment records and a report to another nurse practitioner. (A.R. 602, 608, 603, 612).

As the ALJ indicated, the administrative record only contains Plaintiff's intake evaluation with Ms. Przezdziecki, three medication consultations with Ms. Proulx, and the mental impairment questionnaire Ms. Przezdziecki completed on July 18, 2012. (A.R. 957-998.) During intake on October 6, 2011, Ms. Przezdziecki found Plaintiff "present[ed] with severe panic and anxiety" and observed that he was hyperactive, had "tremors/tics, " and his affect was tearful, sad, anxious, and inappropriate. (A.R. 960, 964.) She found that he had "moderate" depressive symptoms and moderately impaired judgment. She also observed that he was casually groomed, cooperative, and well-oriented with normal speech, intact thought processes, and no memory problems. Plaintiff reported panic attacks and suicide attempts and that he was afraid to the leave the house and had difficulty in social situations and with sleeping. (A.R. 960.) Ms. Przezdziecki diagnosed panic disorder with agoraphobia and depressive disorder. (A.R. 957.) She treated Plaintiff from October 2011 to February 2012.

With respect to the July 2012 questionnaire, Ms. Przezdziecki stated that Plaintiff exhibited signs of severe anxiety, panic, and paranoia that caused significant impairment in functioning and judgment. (A.R. 995-996.) She assessed marked restriction of activities of daily living, extreme difficulties in maintaining social functioning, and moderate difficulties in concentration, persistence, or pace, as well as three episodes of decompensation within twelve months. (A.R. 997-998.) She also stated that Plaintiff had "debilitating" panic and agoraphobic symptoms. (A.R. 998.)

Those limitations set forth in the questionnaire are inconsistent with the records from Plaintiff's incarceration. Although Ms. Przezdziecki was unaware of the fact that Plaintiff ceased treatment at River Valley due to his incarceration, and while consistent with a diagnosis of depressive disorder and generalized anxiety disorder, records from his incarceration do not reveal any such extreme or debilitating symptoms. (A.R. 611.) Rather, as the ALJ noted, on April 18, 2012, Plaintiff "presented no overt signs of depression, mania, anxiety, or psychosis." (A.R. 608, 1002). Moreover, other medical providers found Plaintiff with moderate, and at times mild, limitations in social functioning, concentration, persistence, and pace. (A.R. 611.)

Plaintiff first saw Ms. Proulx on December 1, 2011 for medication management. (A.R. 989.) She assessed Plaintiff with depression and identified post traumatic stress disorder, schizoaffective disorder, and bipolar disorder as possible diagnoses. (A.R. 988.) After three weeks on medication, however, Ms. Proulx found Plaintiff's appearance, speech, and thought processes normal, his eye contact and rapport good, and his affect appropriate. (A.R. 985.) Plaintiff reported mild depressive symptoms, moderate anxiety symptoms with panic attacks, and paranoid thinking. (Id.) Ms. Proulx adjusted his medications accordingly. (A.R. 986.) On January 18, 2012, Plaintiff's third and final appointment with Ms. Proulx, she again found Plaintiff with normal appearance, speech, and thought processes and appropriate affect. (A.R. 983.) At that time, Plaintiff denied symptoms of depression or anxiety. (A.R. 983-984.) In weighing these pieces of ...

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