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Genereux v. Berryhill

United States District Court, D. Massachusetts

March 31, 2017

NANCY A. BERRYHILL, [1]Defendant.


          George A. O'Toole, Jr. United States District Judge.

         The plaintiff, Maureen S. Genereux, 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 Genereux's Motion for Judgment on the Pleadings (dkt. no. 12) and the Commissioner's Motion to Affirm the Commissioner's Decision (dkt. no. 16). 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.

         I. Procedural History

         The plaintiff filed applications for DIB and SSI on March 7, 2012, and March 16, 2012, respectively, alleging disability beginning February 15, 2012. (Administrative Tr. at 269-75, 276- 84 [hereinafter R.].)[2] On June 15, 2012, Genereux's applications were initially denied, (id. at 191- 92), and were denied again upon reconsideration on December 13, 2012. (Id. at 223-28.) She then requested a hearing, (id. at 229-31), which was held before Administrative Law Judge Henry J. Hogan (the “ALJ”) on January 21, 2014. (Id. at 140-73.) On February 28, 2014, the ALJ issued an unfavorable decision finding that Genereux was not disabled. (Id. at 121-37.) Genereux requested review of the ALJ's decision by the Appeals Council on April 8, 2014, (id. 119-20), but the Appeals Council denied that request on June 26, 2015. (Id. at 1-6.) This denial rendered the ALJ's decision the final decision of the Commissioner, making the case ripe for review by this Court pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3).

         II. Discussion

         An individual may seek judicial review of a final decision by the Commissioner within sixty days of the decision. 42 U.S.C. § 405(g). Judicial review is restricted “to determining 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); accord Seavey v. Barnhart, 276 F.3d 1, 9 (1st Cir. 2001). A court will uphold an ALJ's decision when it is supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence exists where “a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support [the ALJ's] conclusion.” Ortiz v. Sec'y of Health & Human Servs., 955 F.2d 765, 769 (1st Cir. 1991) (citation and internal quotation marks omitted). If supported by substantial evidence, this Court must uphold the Commissioner's decision “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) (citing Lizotte v. Sec'y of Health & Human Servs., 654 F.2d 127, 128 (1st Cir. 1981)), for “factual inferences, credibility determinations, and resolutions of conflicts in the evidence are reserved to the Commissioner.” Conte v. McMahon, 472 F.Supp.2d 39, 46 (D. Mass. 2007) (citing Ortiz, 955 F.2d at 769). Further, the ALJ may rely upon findings and opinions of multiple physicians to determine medical facts. Evangelista v. Sec'y of Health & Human Servs., 826 F.2d 136, 144 (1st Cir. 1987).

         In her Motion for Judgment on the Pleadings, Genereux argues that the ALJ failed to properly weigh the opinions of the medical sources in the record. Specifically, she challenges the ALJ's assessment of Dr. Rachel Gross' opinion, and she also asserts that the ALJ should not have relied on the two opinions of the non-treating state agency medical reviewers. Additionally, Genereux alleges that the ALJ erred in determining that her statements concerning the intensity, persistence, and limiting effects of her symptoms were not credible because they were inconsistent with the residual functional capacity assessment.

         The full and extensive administrative record is filed on the docket in this case, as is the written decision of the ALJ. There is no reason to restate the details of Genereux's medical history or of the application process except as necessary to discuss the specific objections made to the Commissioner's decision.

         A. Weight of the Medical Opinion Evidence

         i. Dr. Gross' Opinion

         Genereux alleges that the ALJ erred when he did not afford the opinion of a treating physician, Dr. Gross, controlling weight. On October 14, 2013, the plaintiff's rheumatologist, Dr. Gross, completed a Lupus Impairment Questionnaire. (R. at 743-49.) In that questionnaire, Dr. Gross stated that Genereux was able to sit for six hours in an eight-hour workday, stand or walk for two hours in an eight-hour workday, frequently lift up to five pounds and occasionally lift and carry up to twenty pounds, but she could not kneel, bend, or stoop. (Id. at 746-48.) Dr. Gross also opined that the plaintiff would sometimes need to take two to three unscheduled breaks lasting between fifteen and thirty minutes during an eight-hour workday. (Id. at 748.) Finally, Dr. Gross stated that Genereux would likely have one unexpected absence from work a month due to flare-ups in her symptoms. (Id.) According to the testimony of the vocational expert, this combination of limits would make Genereux unable to perform her past relevant work as a credit manager, which would support a finding of disability. (See id. at 171.)

         An ALJ is required to give a treating physician's opinion controlling weight only if the opinion is “well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence” in the medical record. 20 C.F.R. § 404.1527(c)(2).[3] If the ALJ determines that a treating physician's opinion is not entitled to controlling weight, the ALJ must consider the following factors in deciding what weight that opinion deserves: (1) the length of the treatment relationship and the frequency of examination; (2) the nature and extent of the treatment relationship; (3) the relevant evidence in support of the medical opinion; (4) the consistency of the medical opinions reflected in the record as a whole; (5) whether the medical provider is a specialist in the area in which she renders her opinions; and (6) any other factors which tend to support or contradict the opinion. Id. at §§ 404.1527(c)(2)(i)-(ii), (c)(3)-(6). As long as the ALJ's decision “makes clear that he considered the factors . . . [he is] not required to expressly mention each factor” when determining how much weight to afford each opinion. McNelley v. Colvin, No. 15-1871, 2016 WL 2941714, at *2 (1st Cir. Apr. 28, 2016). Here, the ALJ's reasoning was sufficiently clear even though he did not specifically discuss every factor referenced in the regulation in his decision.

         The ALJ properly followed the regulatory requirements when he assigned “little weight” to the opinion of Dr. Gross. (See R. at 132.) The ALJ explained that he gave little weight to the opinion of Dr. Gross, instead of controlling weight, because: Dr. Gross relied heavily on the plaintiff's subjective report of symptoms and limitations and uncritically accepted them; Dr. Gross only met with the plaintiff on an infrequent basis; and the opinion contrasts sharply with other evidence in the record. (Id.)

         First, the ALJ determined that Dr. Gross' opinion was primarily based on Genereux's subjective complaints about her symptoms rather than on actual medical findings. In support of this finding, the ALJ referred to inconsistencies between Dr. Gross' treatment records and the opinion submitted by Dr. Gross.[4] The ALJ is entitled to reject a treating source's opinion if he determines that the opinion is based on the claimant's subjective statements about her condition and not objective medical evidence. See Colon v. Astrue, No. 11-30078-GAO, 2012 WL 4106764, at *5 (D. Mass. Sept. 19, 2012).

         Next, the ALJ found that Dr. Gross treated Genereux infrequently. (R. at 132.) The records indicate that Dr. Gross met with Genereux every three to four months from November 19, 2012, to September 16, 2013, for a total of five treatments. (Id. at 701-05, 712-15, 719-22, 761-64, 765-68.) The ALJ was entitled to take into account the number and spacing of visits when assessing Dr. Gross' opinion. See 20 C.F.R. § 404.1527(c)(2)(i) (stating that “[w]hen the treating source has seen you a number of times and long enough to have obtained a longitudinal picture of your impairment, we will give the medical source's medical opinion more weight”). It is also notable that Genereux's treating physician, ...

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