United States District Court, D. Maryland
STEPHANIE A. GALLAGHER UNITED STATES MAGISTRATE JUDGE.
28, 2016, Plaintiff Eugene Tanzymore petitioned this Court to
review the Social Security Administration's final
decision to deny his claims for Disability Insurance Benefits
and Supplemental Security Income. (ECF No. 1). I have
considered the parties' cross-motions for summary
judgment. (ECF Nos. 14, 15). 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. See 42 U.S.C. §§
405(g), 1383(c)(3); Craig v. Chater, 76 F.3d 585,
589 (4th Cir. 1996). Under that standard, I will deny
Plaintiff's motion, grant the Commissioner's motion,
and affirm the Commissioner's judgment pursuant to
sentence four of 42 U.S.C. § 405. This letter explains
Tanzymore filed claims for Disability Insurance Benefits
(“DIB”) and Supplemental Security Income
(“SSI”) on September 28, 2012, and October 1,
2012, respectively. (Tr. 225-32). His claims were denied
initially and on reconsideration. (Tr. 120-24, 130-33). A
hearing was held on January 5, 2015, before an Administrative
Law Judge (“ALJ”). (Tr. 42-67). Following the
hearing, the ALJ determined that Mr. Tanzymore was not
disabled within the meaning of the Social Security Act during
the relevant time frame. (Tr. 15-41). The Appeals Council
denied Mr. Tanzymore's request for review, (Tr. 1-5), so
the ALJ's decision constitutes the final, reviewable
decision of the Agency.
found that Mr. Tanzymore suffered from the severe impairments
of “obesity, asthma, depressive disorder, bipolar
disorder and a personality disorder.” (Tr. 21). Despite
these impairments, the ALJ determined that Mr. Tanzymore
retained the residual functional capacity (“RFC”)
perform sedentary work as defined in 20 CFR §§
404.1567(a) and 416.967(a) except he can never climb ladders,
ropes, scaffolds, ramps or stairs, kneel, crouch or crawl and
can occasionally balance and stoop. The claimant would
require the use of a cane at all times to stand and walk, and
must avoid concentrated exposure to extreme cold, extreme
heat, humidity and air pollutants such as fumes. The claimant
can understand, remember and carryout [sic] simple
instructions, cannot perform pace work and can have
occasional contact with supervisors and coworkers.
(Tr. 26). After considering the testimony of a vocational
expert (“VE”), the ALJ determined that Mr.
Tanzymore could perform jobs existing in significant numbers
in the national economy and that, therefore, he was not
disabled. (Tr. 35-36).
Tanzymore raises three primary arguments on appeal: (1) that
the ALJ failed to find Mr. Tanzymore's alleged
“bilateral knee osteoarthritis and lumbar pain”
to be severe impairments; (2) that the ALJ's RFC
assessment is not supported by substantial evidence; and (3)
that the ALJ's holding runs afoul of the 4th
Circuit's decision in Mascio v. Colvin, 780 F.3d
632, 638 (4th Cir. 2015). Pl. Mot. 11-18. Each argument lacks
merit and is addressed below.
Mr. Tanzymore contends that the ALJ erred by not determining
that his “bilateral knee osteoarthritis and lumbar
pain” constitutes severe impairments. Pl. Mot. 11-14.
At Step Two, the ALJ must determine whether the claimant has
a severe impairment. See 20 C.F.R. §
404.1520(c); 20 C.F.R. § 416.920(a)(4)(ii). An
impairment is considered “severe” if it
significantly limits the claimant's ability to work.
See 20 C.F.R. § 404.1521(a). The claimant bears
the burden of proving that his impairment is severe. See
Johnson v. Astrue, 2012 WL 203397, at *2 (D. Md. Jan.
23, 2012) (citing Pass v. Chater, 65 F.3d 1200, 1203
(4th Cir. 1995)). Here, the ALJ thoroughly considered Mr.
Tanzymore's “bilateral knee osteoarthritis and
lumbar pain” at Step Two. (Tr. 21-22). Specifically, in
a detailed analysis, the ALJ noted that Mr. Tanzymore
“displayed a normal gait, normal alignment and mobility
of his spine and normal range of motion and strength in all
four extremities during…examinations.” (Tr. 21).
In addition, the ALJ noted that Mr. Tanzymore “denied
any pain, ” “tingling[, ] or numbness in his
extremities, ” and “admitted that he was not
taking any medication for his pain.” Id.
Moreover, the ALJ noted objective medical testing of Mr.
Tanzymore's knees revealed only “mild”
osteoarthritis and effusion. Id. Accordingly, the
ALJ fairly concluded that the impairments had no more than a
de minimis effect on his ability to work.
Id. Moreover, even if the ALJ had erred in her
evaluation of Mr. Tanzymore's “bilateral knee
osteoarthritis and lumbar pain” at Step Two, such error
would be harmless. Because Mr. Tanzymore made the threshold
showing that his obesity, asthma, depressive disorder,
bipolar disorder, and personality disorder constituted severe
impairments, the ALJ continued with the sequential evaluation
process and properly considered all of the impairments, both
severe and non-severe, that significantly impacted Mr.
Tanzymore's ability to work. See 20 C.F.R.
§§ 404.1523, 416.923. In particular, Mr.
Tanzymore's knee and back pain were addressed in the RFC
analysis. (Tr. 34). Any Step Two error, then, does not
Mr. Tanzymore contends that the ALJ failed to properly assign
weight to several medical opinions. Pl. Mot. at 14-16.
Specifically, he contends that the ALJ erred in evaluating
the opinion of his treating psychiatrist, the opinion of his
nurse practitioner, and his GAF scores. Beginning with his
treating psychiatrist, Mr. Tanzymore contends that the ALJ
failed to properly evaluate Dr. Stagg's opinion. Pl. Mot.
16-17. 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 (4th Cir. 1996); see also 20 C.F.R.
§§ 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. §§ 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.”).
case, although the ALJ assigned Dr. Stagg's opinion
“great” evidentiary weight, Mr. Tanzymore
contends that the ALJ erred in rejecting Dr. Stagg's
assessment that “[he] has some grooming
impairment.” (Tr. 33). However, contrary to Mr.
Tanzymore's assertion, the ALJ properly evaluated Dr.
Stagg's opinion. The ALJ noted that “there is no
support for Dr. Stagg's assessment that [Mr. Tanzymore]
has some grooming impairment.” Id. The ALJ
also noted that Dr. Stagg's assertion “is vague and
is not consistent with the record as a whole, which largely
indicated that [Mr. Tanzymore] displayed appropriate dress
and was well groomed.” Id. Although the ALJ
acknowledged that “[Mr. Tanzymore] was poorly kept at
times, ” the ALJ also noted that “it seemed to
coincide with when he was residing on the street.”
Id. Moreover, substantial evidence elsewhere in the
record belies Dr. Stagg's assertion, including the fact
that Mr. Tanzymore “is independent in his personal
care, ” “go[es] outside alone, ”
“perform[s] light cooking and cleaning, ” and
“appeared well groomed and appropriately dressed”
on examination. (Tr. 28). These inconsistencies, in
addition to others cited by the ALJ, provide sufficient
justification for the ALJ's decision to reject Dr.
Stagg's assertion regarding Mr. Tanzymore's alleged
Mr. Tanzymore argues that the ALJ assigned inadequate weight
to the opinion of his treating nurse practitioner, Ms.
Sampson. Pl. Mot. 17. As an initial matter, Ms. Sampson, a
certified registered nurse practitioner, is not an acceptable
medical source. Pl. Mot. 9. Because a CRNP is not an
“acceptable medical source, ” Ms. Sampson cannot
give a “medical opinion” or be considered a
treating source. Social Security Ruling (“SSR”)
06-3P. Whether a source is an “acceptable medical
source” or not is a factor that may be considered in
assigning weight to that source's opinion. Id.
However, the opinion of a non-acceptable medical source, such
as a CRNP, is relevant in determining the severity of an
impairment and its impact on an individual's ability to
function. Id. SSR 06-3P explains that the same
factors that apply to evaluating the opinions of medical
sources apply to evaluating the opinions of other sources.
to Mr. Tanzymore's assertion, the ALJ cited a variety of
those factors as reasons to discount Ms. Sampson's
evaluation of Mr. Tanzymore's physical capacity. (Tr.
19). Ms. Sampson opined that Mr. Tanzymore “can lift 15
pounds occasionally, ten pounds frequently, requires the use
of a cane, can stand/walk and sit for one-hour each, out of
an eight-hour workday, needs frequent breaks, has postural
and environmental limitations and that his ability to
push/pull, feel, reach and handle are affected.” (Tr.
32). However, the ALJ assigned Ms. Sampson's opinion
“little weight” because it was inconsistent with
the medical evidence and unsupported by the objective record.
(Tr. 32-33). Specifically, the ALJ noted that
“[a]lthough Ms. Sampson correctly assessed [Mr.
Tanzymore's] ability to lift/carry, as well as the fact
that he needs a cane, and assigned postural and environmental
limitations, the remainder of her assessment overstates [his]
limitations and are not supported by the record.” (Tr.
32). In addition, the ALJ noted that Ms. Sampson's
assessment was inconsistent with the objective medical
findings, including “largely unremarkable”
physical examinations “revealing a normal gait, normal
spinal alignment and mobility and normal range of motion and
strength in all four extremities.” (Tr. 32-33).
Moreover, the ALJ noted that “Ms. Sampson did not cite
to any treatment or examination notes for her support, which
as discussed above, do not support the majority of her
assessment.” (Tr. 33). Accordingly, the ALJ concluded
that, “[g]iven these largely unremarkable physical
examinations and diagnostic imaging, there is no support for
these strict limitations imposed by Ms. Sampson[.]”
Id. Thus, the ALJ did not simply reject Ms.
Sampson's opinion as an opinion from a non-acceptable
source, but engaged in an appropriate analysis of the merits
of her opinion in light of the other evidence of record.
to the global assessment records, Mr. Tanzymore contends that
the ALJ erred in assigning “no weight” to Mr.
Tanzymore's GAF scores ranging below 50 and
“moderate weight” to his GAF scores ranging from
51 to 65. Pl. Mot. 15. Importantly, my review of the
ALJ's decision is confined to whether substantial
evidence, in the record as it was reviewed by the ALJ,
supports the decision and whether correct legal standards
were applied. Richardson v. Perales, 402 U.S. 389,
390, 404 (1971). Thus, even if there is other evidence that
may support Mr. Tanzymore's position, I am not permitted
to reweigh the evidence or to substitute my own judgment for
that of the ALJ. See Hays v. Sullivan, 907 F.2d
1453, 1456 (4th Cir. 1990). Here, I find that the ALJ
provided substantial evidence in rejecting the GAF scores
below 50. In his discussion of the opinion evidence, the ALJ
stated that, “[n]o weight is afforded to the [GAF]
scores [below 50] assessed throughout the record, as they
overstate [Mr. Tanzymore's] limitations and are not
supported by the record as a whole.” (Tr. 33). To the
contrary, the ALJ found that “the record as a whole
supports a finding of no more than mild restriction in
activities of daily living and moderate difficulties
maintaining social functioning and concentration, persistence
or pace.” Id. However, the ALJ assigned
“moderate weight” to Mr. Tanzymore's GAF
scores above 50 because “they are consistent with the
record as a whole” and “reflect [his] condition
after he received appropriate treatment.” (Tr. 34). As
a result, the ALJ concluded that Mr. Tanzymore's
“mental health improved with treatment, ” and did
not “preclude him from all work activity.”
Id. Furthermore, while nothing prohibits an ALJ from
considering GAF scores as one component of ...