United States District Court, D. Maryland
Koretta A. Harris, Plaintiff, represented by Victoria Regina
Robinson, Legal Aid Bureau Inc.
Commissioner, Social Security Administration, Defendant,
represented by Kavita Sahai, Social Security Administration.
REPORT AND RECOMMENDATIONS
STEPHANIE A. GALLAGHER, Magistrate Judge.
to Standing Order 2014-01, the above-captioned case has been
referred to me to review the parties' dispositive motions
and to make recommendations pursuant to 28 U.S.C. Â§
636(b)(1)(B) and Local Rule 301.5(b)(ix). I have considered
the parties' cross-motions for summary judgment. [ECF
Nos. 18, 19]. I find that no hearing is necessary.
See Loc. R. 105.6 (D. Md. 2016). This Court must
uphold the decision of the Agency if it is supported by
substantial evidence and if the Agency employed proper legal
standards. 42 U.S.C. Â§Â§ 405(g), 1383(c)(3); Craig v.
Chater, 76 F.3d 585, 589 (4th Cir. 1996); Coffman v.
Bowen, 829 F.2d 514, 517 (4th Cir. 1987). For the
reasons set forth below, I recommend that Ms. Harris's
motion be denied, that the Commissioner's motion be
granted, and that the Commissioner's judgment be affirmed
pursuant to sentence four of 42 U.S.C. Â§ 405(g).
Harris filed applications for Disability Insurance Benefits
("DIB") and Supplemental Security Income
("SSI") on October 13, 2011, alleging that her
disability began on June 21, 2011. (Tr. 227-30, 231-36). Her
applications were denied initially on March 12, 2012, and on
reconsideration on July 23, 2012. (Tr. 140-44, 151-54). An
Administrative Law Judge ("ALJ") held a hearing on
April 3, 2014, at which Ms. Harris testified and was
represented by counsel. (Tr. 33-81). Following the hearing,
the ALJ determined that Ms. Harris was not disabled within
the meaning of the Social Security Act during the relevant
time frame. (Tr. 10-32). The Appeals Council denied Ms.
Harris's request for review, (Tr. 1-7), so the ALJ's
decision constitutes the final, reviewable decision of the
found that Ms. Harris suffered from the severe impairments of
obesity; hypertension; coronary artery disease (CAD);
status-post myocardial infarction (MI); status-post cardiac
stent placement; diabetes; keratoconus; astigmatism; major
depressive disorder; anxiety disorder; and bipolar disorder.
(Tr. 15). Despite these impairments, the ALJ determined that
Ms. Harris retained the residual functional capacity
perform sedentary work as defined in 20 CFR 404.1567(a) and
416.967(a) except she can only occasionally operate foot
controls; can only occasionally climb stairs and ramps,
balance, stoop, knee, crouch and crawl; and never climb
ladders, ropes or scaffolds. Further, [Ms. Harris] would need
to avoid concentrated exposure to extreme cold as well as
concentrated exposure to extreme heat, as well as
concentrated exposure to excessive vibration, as well as
concentrated exposure to hazardous moving machinery and
unprotected heights. She is limited to occupations requiring
only frequent near acuity, far acuity and depth perception.
She also can only perform simple, routine, repetitive tasks
in a low stress environment defined as one with no strict
production quotas. Finally, Claimant can only occasionally
interact with the public, coworkers and supervisors.
(Tr. 18). After considering the testimony of a vocational
expert ("VE"), the ALJ determined that Ms. Harris
could perform jobs existing in significant numbers in the
national economy and that, therefore, she was not disabled.
Harris disagrees. She raises two primary arguments in support
of her appeal: (1) that the ALJ assigned insufficient weight
to the opinions of her treating physicians; and (2) that the
ALJ, as a result, presented an incomplete hypothetical to the
VE. Each of Ms. Harris's arguments
lacks merit and is addressed below.
Ms. Harris argues that the ALJ assigned insufficient weight
to the opinions of her treating physicians. Pl. Mot. 9-11. A
treating physician's opinion is given controlling weight
when two conditions are met: 1) it is well-supported by
medically acceptable clinical laboratory diagnostic
techniques; and 2) it is consistent with other substantial
evidence in the record. See Craig, 76 F.3d
585; see also 20 C.F.R. Â§Â§ 404.1527(d)(2),
416.927(d)(2). However, where a treating source's opinion
is not supported by clinical evidence or is inconsistent with
other substantial evidence, it should be accorded
significantly less weight. Craig, 76 F.3d at 590. If
the ALJ does not give a treating source's opinion
controlling weight, the ALJ will assign weight after applying
several factors, such as, the length and nature of the
treatment relationship, the degree to which the opinion is
supported by the record as a whole, and any other factors
that support or contradict the opinion. 20 C.F.R. Â§Â§
404.1527(c)(1)-(6), 416.927(c)(1)-(6). The Commissioner must
also consider, and is entitled to rely on, opinions from
non-treating doctors. See SSR 96-6p, at *3 ("In
appropriate circumstances, opinions from State agency medical
and psychological consultants and other program physicians
and psychologists may be entitled to greater weight than the
opinions of treating or examining sources.").
instant case, the ALJ assigned the opinion of Dr. Warren
Israel, Ms. Harris's treating cardiologist, "modest
weight" because it was not supported by clinical
evidence and was inconsistent with the medical record. (Tr.
21-22). Notably, Dr. Israel opined that Ms. Harris was
"limited to lifting five pounds occasionally, sitting
for eight hours and standing and walking for zero hours in an
eight-hour period." (Tr. 22, 552). Dr. Israel further
stated that Ms. Harris demonstrated a "marked limitation
of activity, " was required to "elevate her legs,
" and "would miss more than four days a month"
due to her limitations. (Tr. 21, 22). The ALJ found, however,
that Dr. Israel's opinion was inconsistent with the
objective medical record and unsupported by clinical
evidence. (Tr. 21-22). For example, the ALJ noted that Dr.
Israel "does not refer to possible motor findings in the
evidence of record to support his lifting limitation, "
and failed to "cite any clinical evidence to support the
standing and walking limitation[.]" (Tr. 22). In
addition, the ALJ noted that the finding of a marked
limitation of activity was "inconsistent with the
claimant's LVEF, " while the leg elevation
requirement was unsubstantiated by clinical support and
contradicted by Ms. Harris's "concession that she
can walk continuously for 15 minutes and jump rope up to 10
minutes." (Tr. 21). Accordingly, the ALJ properly
evaluated Dr. Israel's medical opinion and supported his
assignment of weight with substantial evidence.
found Dr. Elosha Dixon's opinion similarly deficient and
assigned it "no weight." (Tr. 22). Dr. Dixon, Ms.
Harris's primary care physician, opined that she
"was limited to never standing/walking, and lifting less
than 10 pounds[.]" (Tr. 22). As noted above, the
objective medical evidence, as well as Ms. Harris's own
admissions, point to the contrary. (Tr. 22, 476, 547).
Indeed, the ALJ noted that Ms. Harris "has no difficulty
with ambulation and aside from finding obesity and an
elevated blood pressure, Dr. Dixon's physical
examinations of [Ms. Harris] were normal." (Tr. 22,
501-14). Moreover, the ALJ found that Dr. Dixon's opinion
was also inconsistent with other opinion evidence. For
example, the ALJ assigned substantial weight to the opinion
of examining physician, Dr. Joyce Evans, who "opined
that three years post MI did not translate to a condition
where [Ms. Harris] would be disabled from any work[.]"
(Tr. 22, 540-44). The ALJ also assigned moderate weight to
the State medical consultants, who "assessed, in 2012,
that [Ms. Harris] [was] capable of light exertional
work." These inconsistencies, in addition to the
objective medical record and other opinion evidence, provide
sufficient justification for the ALJ's assignment of
weight to Dr. Dixon's opinion.
Harris further argues that the ALJ failed to consider the
factors outlined in 20 C.F.R. Â§Â§ 404.1527(c)(1)-(6),
416.927(1)-(6), when assigning weight to the medical opinion
evidence. The regulations require an ALJ to assess several
factors when determining what weight to assign to the medical
opinions presented. 20 CFR 404.1527(d), 416.927(d). These
factors include: the examining relationship between the
physician and the claimant; the treatment relationship
between the physician and the claimant; the specialization of
the physician; the consistency of a medical opinion with the
record as a whole; and the extent to which a medical opinion
is supported by evidence. 20 CFR Â§Â§ 404.1527(d)(1)-(5),
416.927(d)(1)-(5). Upon review of the record, I find that the
ALJ's analysis was proper under the regulations. For
example, the ALJ acknowledged that Dr. Israel was Ms.
Harris's treating physician and had examined Mr. Harris
on multiple occasions between 2011 and 2012. (Tr. 21-22). The
ALJ also adduced Dr. Israel's opinion and cited his
medical records, which contain Dr. Israel's original
notes and denote his cardiac specialization. (Tr. 21-22,
320-51). The ALJ then held that Dr. Israel's opinion was
inconsistent with the objective medical record and
unsupported by clinical evidence. (Tr. 21-22). The ALJ
performed similar analyses for Ms. Harris's other
treating, examining, and consultative physicians. (Tr.
21-23). Considering the entirety of the ALJ's RFC
analysis, I find that the ALJ properly applied the
regulations in assigning weight to the medical opinion
evidence, and that his findings are supported by substantial
evidence. Therefore, remand is unwarranted.
Ms. Harris contends that the ALJ erred in disregarding
testimony by the VE that she was not eligible for jobs
existing in the national economy because of her limitations.
As an initial matter, an ALJ is afforded "great latitude
in posing hypothetical questions, " Koonce v.
Apfel, 1999 WL 7864, at *5 (4th Cir. Jan. 11, 1999), and
need only pose those that are based on substantial evidence
and accurately reflect a claimant's limitations.
SeeCopeland v. Bowen,861 F.2d 536, 540-41
(9th Cir. 1988). Likewise, a hypothetical question is