United States District Court, D. Maryland
REPORT AND RECOMMENDATIONS
STEPHANIE A. GALLAGHER UNITED STATES 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. §
636(b)(1)(B) and Local Rule 301.5(b)(ix). [ECF No. 4]. I have
considered the parties' cross-motions for summary
judgment. [ECF Nos. 10, 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);
Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996).
Under that standard, I recommend that Plaintiff's motion
be denied, the Commissioner's motion be granted, and the
Commissioner's judgment be affirmed pursuant to sentence
four of 42 U.S.C. § 405(g).
Vick protectively filed a claim for Disability Insurance
Benefits (“DIB”) on November 15, 2012, alleging a
disability onset date of October 18, 2012. (Tr. 243-50). Her
claim was denied initially and on reconsideration. (Tr.
83-93, 95-110). A hearing was held on September 22, 2015,
before an Administrative Law Judge (“ALJ”). (Tr.
62-82). Following the hearing, the ALJ determined that Ms.
Vick was not disabled within the meaning of the Social
Security Act during the relevant time frame. (Tr. 35-48). The
Appeals Council (“AC”) denied Ms. Vick's
request for review, (Tr. 1-7), so the ALJ's decision
constitutes the final, reviewable decision of the Agency.
found that Ms. Vick suffered from the severe impairments of
“arthralgia, cervical degenerative disc disease
status-post fusion, cervical radiculopathy, cervical
spondylosis, chondromalacia patella, chronic pain syndrome,
fibromyalgia, gastroesophageal reflux disease, insomnia, left
scapular dyskinesia, status-post arthroscopy, major
depressive disorder with anxiety, myofascial pain syndrome,
right lateral epicondylitis, right rotator cuff tendinopathy,
and rotator cuff tear, status-post arthroscopy.” (Tr.
38). Despite these impairments, the ALJ determined that Ms.
Vick retained the residual functional capacity
perform sedentary work as defined in 20 CFR 404.1567(a)
except she is limited to skilled work, allowing her to
alternate between sitting and standing positions, provided
that she is not off task more than 10 percent of the workday.
The claimant could occasionally use her non-dominant left
hand to reach, handle, feel, push, and pull. She could
frequently perform reaching[, ] handling, feeling,
pushing/pulling with the right upper extremity. The claimant
could frequently use judgment in making work related
decisions that are detailed. She could work in an environment
not requiring satisfaction of production pace. She could
frequently interact with supervisors and coworkers and
occasionally could interact with the general public.
(Tr. 40). After considering the testimony of a vocational
expert (“VE”), the ALJ determined that Ms. Vick
could perform jobs existing in significant numbers in the
national economy and therefore was not disabled. (Tr. 47-48).
appeal, Ms. Vick raises two primary arguments: (1) that the
ALJ failed to properly weigh the medical opinion evidence;
and (2) that the ALJ failed to properly evaluate Ms.
Vick's credibility. Each argument lacks merit and is
Ms. Vick contends that the ALJ failed to properly weigh the
medical opinion evidence. Specifically, Ms. Vicks argues that
the ALJ erred by: (1) assigning “little” weight
to her treating physiatrist, Dr. Theresa Carlini; (2)
assigning “modest weight” to the medical opinions
of her treating internist, Dr. Philip Wistosky; and (3)
assigning “little” weight to her treating
psychologist, Dr. David Hiland. Pl. Mot. Summ. J. 20. A
treating physician's opinion is given controlling weight,
unless it is not supported by clinical evidence or is
inconsistent with other substantial evidence. See
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, including
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). The
Commissioner must also consider, and is entitled to rely on,
opinions from non-treating doctors. See SSR 96-6p,
1996 WL 374180, at *3 (S.S.A. July 2, 1996) (“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.”).
the ALJ provided substantial evidence to support his
assignments of “little” and “modest”
weight to Ms. Vick's treating physicians. In his
decision, the ALJ observed that “[t]he opinions of [Ms.
Vick's] physicians often appear to repeat the subjective
claims [Ms. Vick] sets forth with little objective support
for the severity of limitations that they assigned her in
their medical source statements.” (Tr. 45). Moreover,
the ALJ noted that the treating physicians' opinions were
“inconsistent with the consultative examiner's
opinion and the state agency medical consultant's
opinions, ” and that “[t]he severity of
limitations reported by [Ms. Vick's] physician varies
significantly based on the physician providing the opinion
and  are also at odds with the physical findings throughout
the doctor's records.” Id. The ALJ
thoroughly evaluated and cited to objective medical evidence
and testimony that were inconsistent with Ms. Vick's
treating physicians' opinions. I will address the
ALJ's evaluations of Ms. Vick's treating physicians
with the medical opinions of Ms. Vick's treating
physiatrist, Dr. Carlini opined that Ms. Vick “must
spend four hours in a supine position, could stand and walk
for less than an hour[, ] and [could] sit for less than
two.” (Tr. 45); see (Tr. 622). The ALJ
concluded that Dr. Carlini's “opinions on these
areas of function are inconsistent with the various physical
examinations and imaging studies in the record.” (Tr.
45). The ALJ, for example, observed that Ms. Vick's
“imaging studies since [her fusion] procedure have
shown generally stable, post-surgical findings, with no
abnormality of the hardware placement.” (Tr. 42).
Moreover, the ALJ noted that Ms. Vick's “physical
examinations have shown consistent findings regarding
strength, generally measuring 5/5.” Id. The
ALJ also cited Dr. Carlini's treatment notes, which
“indicated that [Ms. Vick] should exercise, engage in
activity and that her neurological and muscle strength and
tone appears intact.” (Tr. 43). These inconsistencies,
in addition to others cited by the ALJ, provide sufficient
justification for the ALJ's decision to accord
“little” weight to Dr. Carlini's opinions.
next to Ms. Vick's treating internist, Dr. Wistosky
opined that Ms. Vick was restricted “to standing,
sitting, walking for less than an hour, with movement every
five or ten minutes[.]” (Tr. 45); see (Tr.
1994-99). The ALJ assigned “only modest weight”
to Dr. Wistosky's opinions after finding that they were
“inconsistent with the objective medical evidence,
” id., and that there was “little
support for the extensive restrictions Dr. Wistostky [sic]
assigned [Ms. Vick] with regard to manipulative functioning,
” (Tr. 45-46). In addition to the above-cited treatment
records, the ALJ noted that Ms. Vick indicated that she
“remains able to drive a vehicle, use a computer, watch
television four hours daily, care for a dog[, ]  does not
require an assistive device to ambulate or stand[, ] . . .
cooks a meal once weekly, performs light cleaning[, ] and
grocery shops.” (Tr. 42); see (Tr. 68-70).
Accordingly, the ALJ found that Dr. Wistosky's opinions
were undermined by Ms. Vick's admitted activities, which
indicate that she can perform at least a limited range of
sedentary work. See (Tr. 42-43). In light of the
evidence on the record, the ALJ properly supported his
assignment of “modest” weight to Dr.
Wistosky's opinions with substantial evidence.
Ms. Vick's treating psychologist, Dr. Hiland, opined that
Ms. Vick has “‘marked' limitations due to her
mental health symptoms.” (Tr. 46); see (Tr.
936-40). As an initial matter, Dr. Hiland issued this opinion
about three months after he began treating Ms. Vick.
See (Tr. 936-40). Moreover, at the time of the
Mental Impairment Questionnaire's completion, Dr. Hiland
had only treated Ms. Vick during a nine-day period. See
Id. (indicating that the “Date of first
treatment” was July 8, 2014, and that the “Date
of most recent exam” was July 16, 2014). As a result,
his treatment relationship supports an assignment of lesser
weight, since he lacks the type of longitudinal relationship
warranting greater deference. Lang v. Astrue, Civ.
No. TJS-11-1909, 2013 WL 425064, at *3 (D. Md. Feb. 1, 2013)
(characterizing a five-month treating relationship as
“short-term” and “far from
substantial”). Additionally, Dr. Hiland's Mental
Impairment Questionnaire and treatment notes consist of a
brief “checkbox form opinion[s]” that provide
limited opportunity for narrative assessment or citation to
the medical record. (Tr. 936-40, 941, 943). See Brown ex
rel. A.W. v. Comm'r of Soc. Sec., No. CIV.
SAG-12-52, 2013 WL 823371, at *2 (D. Md. Mar. 5, 2013)
(noting that “it would be difficult for an ALJ to
assign any meaningful weight to opinions devoid of
evidentiary support”); see also Beitzell v.
Comm'r, Soc. Sec. Admin., No. CIV.
SAG-12-2669, 2013 WL 3155443, at *3 (D. Md. June 18, 2013)
(upholding the ALJ's assignment of weight and noting that
the treating physician's assessment “provided no
narrative explanation for the limitations proposed in the
form”). Regardless, the ALJ noted that Dr. Hiland's
opinion “is not supported by the treatment records that
show mild to moderate symptoms throughout the record.”
(Tr. 46). The ALJ also observed that Ms. Vick's
“presentations at the consultative examination, in her
physical therapy, . . . and at testimony does not [sic]
support ‘marked' level limitation due to her mental
health symptoms.” Id. In particular, the ALJ
noted that Ms. Vick's mental status examinations
“show generally stable thought process, memory, and
good reality contact[, ]” and that “the level of
dysfunction she attribut[ed] to her mental health allegations
appears disproportionate with her treatment regimen of
individual therapy and medication management and the
frequency with which she receiv[ed] such treatment.”
(Tr. 44). Accordingly, the ALJ's assignment of
“little” weight to Dr. Hiland's opinion is
supported by substantial evidence.
Ms. Vick contends that the ALJ failed to properly evaluate
Ms. Vick's credibility. To determine the credibility of
the individual's statements, the ALJ “must consider
the entire case record, including the objective medical
evidence, the individual's own statements about symptoms,
statements and other information provided by treating or
examining physicians . . . and any other relevant evidence in
the case record.” SSR 96-7p, 1996 WL 374186, at *1
(S.S.A. July 2, 1996). Importantly, an ALJ must
“articulate which of a claimant's individual
statements are credible, rather than whether the claimant is
credible as a general matter.” Bostrom v.
Colvin, 134 F.Supp.3d 952, 960 (D. Md. 2015) (quoting
Armani v. Comm'r, Soc. Sec. Admin., No.
JMC-14-CV-976, 2015 WL 2062183, at *1 (D. Md. May 1, 2015));
see also Mascio v. Colvin, 780 F.3d 632, 640 (4th
Cir. 2015) (“Nowhere, however, does the ALJ explain how
he decided which of [the claimant's] statements to
believe and which to discredit, other than the vague (and
circular) boilerplate statement that he did not believe any
claims of limitations beyond what he found when considering
[the claimant's] residual functional capacity.”).
to Ms. Vick's contention, the ALJ properly evaluated her
credibility. First, the ALJ observed that Ms. Vick's
admitted daily activities undermined her subjective
allegations of pain. (Tr. 42). Most notably, Ms. Vick
testified that she was able to “drive to doctor's
appointments,  drive to the pharmacy[, ] . . . do very
limited grocery shopping[, ] . . . cook maybe one -- one meal
a week[, ] . . . [and] may clean the house one to two times
in a month.” (Tr. 68). Second, the ALJ noted that Ms.
Vick “remains non-compliant with [the] recommendations
[of her treating physicians] throughout much of the
record.” (Tr. 43). The ALJ, for example, cited to
treatment records indicating that Ms. Vick “was
resistant to PT recommendations[, ] . . . exhibits some
self-limiting behaviors[, ] . . . [and] “has not
contacted PT in >30 days and is thus discharged from
care.” (Tr. 1707). See also Bettis v. Astrue,
Civil No. SKG-12-826, 2013 WL 1209408, at *11 (D. Md. Mar.
22, 2013) (“[T]he individual's allegations about
the effects of pain or other symptoms may be less credible if
the individual is not following his or her treatment as
prescribed when there are no good reasons for the
noncompliance.”). Ultimately, the ...