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Krol v. Berryhill

United States District Court, D. Massachusetts

March 30, 2017

KAREN KROL, Plaintiff,
v.
NANCY A. BERRYHILL, [1]Defendant.

          OPINION AND ORDER

          GEORGE A. O'TOOLE, JR. UNITED STATES DISTRICT JUDGE

         The plaintiff, Karen Krol, appeals the denial of her application for Social Security Disability Benefits (“DIB”) and Supplemental Security Income (“SSI”) by the Commissioner of Social Security (“Commissioner”). Before the Court are Krol's Motion for Order Reversing the Commissioner's Decision (dkt. no. 11) and the Commissioner's Motion to Affirm the Commissioner's Decision (dkt. no. 14). After consideration of the administrative record and the parties' memoranda, the Court now affirms the Commissioner's decision because there is substantial evidence in the administrative record to support the decision and no error of law was made.

         I. Procedural History

         Krol applied for DIB on June 14, 2012 and applied for SSI on July 31, 2012. Both applications alleged disability beginning January 13, 2012. (Administrative Tr. at 120-26, 159, 750-60 [hereinafter R.]).[2] Her application for DIB was denied initially on December 21, 2012 (id. at 64-66), and again upon reconsideration on August 7, 2013, (id. at 68-70). Krol's application for SSI was denied on August 15, 2012, (id. at 761-69), and was then “escalated to the hearing level” and associated with the application for DIB, (id. at 119A). Krol requested a hearing, (id. at 71-72), which was held before Administrative Law Judge Stephen C. Fulton on May 1, 2014, (id. at 789-829). The ALJ subsequently issued an unfavorable decision, finding that Krol could perform her past relevant work as a medical records clerk based on her residual function capacity (“RFC”). (Id. at 15-33.) Accordingly, the ALJ found that Krol was “not disabled” pursuant to the Social Security Act. (Id. at 33.) On August 11, 2015, the Appeals Council denied Krol's request for review. (Id. at 9-11.) This denial rendered the ALJ's decision the final decision of the Commissioner, and made the case suitable for review by this Court pursuant to 42 U.S.C. § 405(g).

         II. Discussion

         This Court's review of a denial of social security disability benefits is limited to an evaluation as to whether the “ALJ used the proper legal standards and found facts upon the proper quantum of evidence.” Ward v. Comm'r of Soc. Sec., 211 F.3d 652, 655 (1st Cir. 2000). The Commissioner's findings of fact are conclusive if supported by substantial evidence. 42 U.S.C. § 405(g); accord Manso-Pizarro v. Sec'y of Health & Human Servs., 76 F.3d 15, 16 (1st Cir. 1996). The evidence is considered substantial when it is “more than a mere scintilla, ” Richardson v. Perales, 402 U.S. 389, 401 (1971), and an ALJ's determination supported by substantial evidence must be upheld “even if the record arguably could justify a different conclusion, ” Rodriguez Pagan v. Sec'y of Health & Human Servs., 819 F.2d 1, 3 (1st Cir. 1987). Further, deciding issues of credibility is the “prime responsibility” of the ALJ. Rodriguez v. Celebrezze, 349 F.2d 494, 496 (1st Cir. 1965).

         On appeal, Krol argues that the ALJ's decision should be overturned both for legal error and for lack of substantial evidence in the record to support the decision. Specifically, Krol argues that the ALJ erred by: (1) inadequately considering the opinions of certain of Krol's therapists and nurse practitioners; (2) finding that none of Krol's mental impairments were severe;[3] (3) failing to consider Krol's testimony regarding pain; (4) inaccurately citing the record regarding Krol's activities of daily living (“ADLs”); (5) citing evidence in a biased manner; and (6) finding that Krol could do light work.

         There is no reason to outline the details of Krol's medical history or of the DIB and SSI application process here except as is necessary to discuss the specific objections made to the Commissioner's decision.

         A. The ALJ's Decision Properly Weighed the Evidence of Krol's Treating Therapist and Nurses

         Krol first contends that the ALJ failed to properly weigh the medical evidence when he gave “less weight” to the opinions of Krol's treating therapist, Helen Ekmekchi, a licensed social worker, and nurse practitioners Kathryn Kieran and Michele Adam. (R. at 23.)

         Under the relevant regulations, therapists and nurse practitioners are not among the recognized “acceptable medical sources.” 20 C.F.R. §§ 404.1513(a), 416.913(a). Their opinions therefore are not afforded “controlling weight” under the treating physician's rule. See id. § 404.1513(c). The ALJ must nevertheless evaluate every medical opinion received. Id. § 404.1527(c). When a treating source is not given “controlling weight, ” the weight attributed to the opinions is to be determined by the ALJ based on the application of the following factors: (1) the examining and/or treatment history between the treating source and the claimant; (2) the length and frequency of that relationship; (3) the nature and extent of the relationship; (4) the strength and sufficiency of the evidence forming the basis for the opinion; (5) the consistency of the opinion with the record as a whole; (6) the specialty, if any, of the source; and (7) any other factors the claimant brings to the ALJ's attention. See id., § 416.927(c). Ultimately, in determining how much weight to give a therapist's opinion, “an ALJ is only constrained by the duty to reach a conclusion supported by substantial evidence in the record.” Gagnon v. Astrue, Civil Action No. 11-CV-10381-PBS, 2012 WL 1065837, at *5 (D. Mass. Mar. 27, 2012) (citation omitted).

         Here, the ALJ considered therapist Ekmekchi's opinion as required by § 404.1527(c), and the ALJ's treatment of that opinion is supported by substantial evidence. In her March 31, 2014, opinion, Ms. Ekmekchi concluded that Krol exhibited symptoms of anxiety, difficulty being around people, moderate difficulty in maintaining social functioning, and a marked deficiency of concentration. (R. at 681-87.) The ALJ gave the opinion “less weight” because it was inconsistent with the overall weight of the record, including the claimant's treatment history, her daily activities, and her own statements. (Id. at 23.)

         The claimant's treatment history demonstrates that many of her mental impairments have been treated effectively with medication. For example, the claimant herself stated in the hearing before the ALJ that the medication she takes to combat her Attention Deficit Hyperactivity Disorder (“ADHD”), which impacts her ability to concentrate, is “a miracle thing” that helps reduce her symptoms. (Id. at 812-13.) She also noted in her function report that with medications she can pay attention “pretty well” and “usually” finishes what she starts. (Id. at 188.) The claimant's medical records also contains evidence that Krol's anxiety was reduced with medication. (See, e.g., id. at 612, 629.) Furthermore, the record indicates that the claimant is able to carry out daily tasks such as making quick meals, doing laundry, and shopping for groceries with assistance from her brother. (Id. at 185-86.) The ALJ therefore did not err in his decision to give Ms. Ekmekchi's opinion “less weight” in light of the inconsistencies in the opinion with other information and assessments in the record as a whole.

         Similarly, the ALJ's consideration of the treatment records of nurse practitioners Kieran and Adams satisfied the requirement that the ALJ reach a conclusion supported by substantial evidence in the record. See Gagnon, 2012 WL 1065837, at *5. These nurse practitioners' findings include that Krol suffered from anxiety, trouble concentrating, insomnia, and depression. As discussed, the record provides ample evidence that the claimant's symptoms were controlled and improved with medication. (See, e.g., R. at 401, 603, 612, 659.) Furthermore, ALJs are permitted “to piece together the relevant medical facts from the findings and opinions of multiple physicians.” Evangelista v. Sec'y of Health & Human Servs., 826 F.2d 136, 144 (1st Cir. 1987). It is an ALJ's responsibility, and was therefore within his discretion, to consider the evidence as a whole, including evidence ...


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