United States District Court, D. Maryland
January 4, 2017, Ms. Kristi Pough petitioned this Court to
review the Social Security Administration's final
decision to deny her claims for Disability Insurance Benefits
and Supplemental Security Income. (ECF No. 1). I have
considered the parties' cross-motions for summary
judgment. (ECF Nos. 15, 18). I find that no hearing is
necessary. Loc. R. 105.6 (D. Md. 2016). This Court must
uphold the decision of the Agency if it is supported by
substantial evidence and correct legal standards were
employed. 42 U.S.C. § 405(g); see Craig v.
Chater, 76 F.3d 585, 589 (4th Cir. 1996). Under that
standard, I will deny Ms. Pough's Motion, grant the
Government's motion, and affirm the Social Security
Administration's judgment pursuant to sentence four of 42
U.S.C. § 405(g). This letter explains my rationale.
Pough filed a claim for benefits on August 8, 2012, and
subsequently amended her alleged onset date of disability to
July 11, 2012. (Tr. 232-40; 252). Her claim was denied
initially and on reconsideration following appeal. (Tr.
59-68; 96-108). Administrative Law Judge (“ALJ”)
Anthony J. Johnson, Jr. held a hearing on June 24, 2015. (Tr.
29-57). Following that hearing, on July 28, 2015, the ALJ
determined that Ms. Pough was not disabled during the
relevant time frame. (Tr. 13-23). The Appeals Council denied
Ms. Pough's request for review on November 4, 2016,
making the ALJ's decision the final, reviewable decision
of the Agency. (Tr. 1-4).
arriving at his decision to deny Ms. Pough's claim, the
ALJ followed the five-step sequential evaluation of
disability set forth in the Secretary's regulations. 20
C.F.R. § 416.920. “To summarize, the ALJ asks at
step one whether the claimant has been working; at step two,
whether the claimant's medical impairments meet the
regulations' severity and duration requirements; at step
three, whether the medical impairments meet or equal an
impairment listed in the regulations; at step four, whether
the claimant can perform her past work given the limitations
caused by her medical impairments; and at step five, whether
the claimant can perform other work.” Mascio v.
Colvin, 780 F.3d 632, 634-35 (4th Cir. 2015). If the
first three steps do not yield a conclusive determination,
the ALJ then assesses the claimant's residual functional
capacity (“RFC”), “which is ‘the
most' the claimant ‘can still do despite'
physical and mental limitations that affect her ability to
work, ” by considering all of the claimant's
medically determinable impairments regardless of severity.
Id. at 635 (quoting 20 C.F.R. § 416.945(a)(1)).
The claimant bears the burden of proof through the first four
steps of the sequential evaluation. If she makes the
requisite showing, the burden shifts to the Social Security
Administration at step five to prove “that the claimant
can perform other work that ‘exists in significant
numbers in the national economy, ' considering the
claimant's residual functional capacity, age, education,
and work experience.” Lewis v. Berryhill, 858
F.3d 858, 862 (4th Cir. 2017) (internal citations omitted).
case, at step one, the ALJ found that Ms. Pough had not
engaged in “substantial gainful activity” since
July 11, 2012, the amended alleged onset date. (Tr. 16). At
step two, the ALJ determined that Ms. Pough's attention
deficit hyperactivity disorder (ADHD), bipolar disorder,
anxiety disorder, panic disorder, and history of cocaine
abuse constitute severe impairments under the relevant
regulations. Id. At step three, the ALJ found that
Ms. Pough does not have an impairment or combination of
impairments that meet or medically equal the severity of any
of the listed impairments set forth in 20 C.F.R. Part 404,
Subpart P, Appendix 1. Id. Then, “[a]fter
careful consideration of the entire record, ” the ALJ
determined that Ms. Pough has the RFC to perform “a
full range of work at all exertional levels but with the
following nonexertional limitations: she can understand,
remember, and carry out simple and routine work-related
instructions; she can concentrate for periods of two hours on
work-related tasks before requiring a break; and she can
occasionally work with the public, coworkers, and
supervisors.” (Tr. 17). At step four, the ALJ explained
that Ms. Pough has no past relevant work. (Tr. 22). Finally,
after considering the testimony of a vocational expert, the
ALJ determined that Ms. Pough can perform work existing in
significant numbers in the national economy and that she was
therefore not disabled during the relevant time frame.
Court reviews an ALJ's decision to ensure that the
ALJ's findings are supported by substantial evidence and
were reached through application of correct legal standards.
Hancock v. Astrue, 667 F.3d 470, 472 (4th Cir.
2012). “Substantial evidence means such relevant
evidence as a reasonable mind might accept as adequate to
support a conclusion, ” which “consists of more
than a mere scintilla of evidence but may be less than a
preponderance.” Id. (internal citations and
quotations omitted). In accordance with this standard, the
Court does not “undertake to reweigh conflicting
evidence, make credibility determinations, or substitute
[its] judgment for that of the ALJ.” Johnson v.
Barnhart, 434 F.3d 650, 653 (4th Cir. 2005) (internal
citations and quotations omitted). Instead, “[w]here
conflicting evidence allows reasonable minds to differ as to
whether a claimant is disabled, the responsibility for that
decision falls on the ALJ.” Id.
appeal, Ms. Pough argues that: (1) the ALJ failed to set
forth a narrative discussion to support his findings
regarding her RFC; (2) the ALJ's limitation of Ms. Pough
to the performance of simple and routine work-related
instructions is inappropriate under Mascio v.
Colvin, 780 F.3d 632 (4th Cir. 2015); (3) the ALJ failed
to evaluate the opinions of Dr. Smith, Ms. Pough's
treating physician; and (4) the ALJ failed to properly
evaluate the opinion of a state agency physician. Ms.
Pough's arguments lack merit and will be addressed in
Pough first argues that, in his RFC determination, the ALJ
failed to set forth a narrative discussion to support his
findings. Specifically, Ms. Pough asserts that the ALJ
“provided no explanation to support his findings”
that she could “understand, remember, and carry out
simple and routine work-related instructions, could
concentrate for periods of two hours, and could occasionally
work with the public, coworkers, and supervisors.” (ECF
No. 15-1 at 6). Social Security regulations require an ALJ to
include a “narrative discussion of the claimant's
symptoms and medical source opinions” to support the
RFC determination. White v. Commissioner,
Civ. No. SAG-16-2428, 2017 WL 1373236, at *1 (D. Md. Apr. 13,
2017) (internal citation and quotations omitted).
Specifically, an ALJ's “RFC assessment is
sufficient if it includes a narrative discussion of the
claimant's symptoms and medical source opinions.”
Bowers v. Commissioner, Civ. No. SAG- 11-1445, 2013
WL 150023, at *2 (D. Md. Jan. 11, 2013) (quoting Taylor
v. Astrue, Civ. No. BPG-11-0032, 2012 WL 294532, at *6
(D. Md. Jan. 31, 2012)). Here, the ALJ provided a four-page
narrative on Ms. Pough's RFC, in which he summarized Ms.
Pough's hearing testimony, her symptoms, and the relevant
medical evidence. (Tr. 17-22). The ALJ discussed the reports
from Dr. Miller and Dr. Estwick, and noted that he considered
the opinions of state agency medical and psychological
consultants as well as an assessment from a licensed clinical
social worker. (Tr. 18-21). The ALJ also cited “the
claimant's poor treatment compliance, and the fact that
she was able to go significant time periods without regular
treatment beyond medication.” (Tr. 20). Accordingly,
the ALJ set forth a sufficient narrative discussion of Ms.
Pough's symptoms and the medical source opinions. Ms.
Pough's first argument fails.
and Routine Work-Related Instructions
Pough's second argument relies on the Fourth
Circuit's holding in Mascio v. Colvin, 780 F.3d
632 (4th Cir. 2015), and asserts that the ALJ failed to
explain how a limitation to simple and routine work-related
instructions within the RFC determination properly accounts
for Ms. Pough's limitations in concentration,
persistence, or pace. In Mascio, the ALJ did not
include any mental limitations in the RFC assessment other
than “unskilled work, despite the fact that, at step
three of the sequential evaluation, the ALJ determined that
the claimant had moderate difficulties in maintaining
concentration, persistence, or pace.” Roxin v.
Commissioner, Civ. No. SAG-14-2311, 2015 WL 3616889, at
*2 (D. Md. June 5, 2015) (citing Mascio, 780 F.3d at
637-38). In its holding, the Fourth Circuit “emphasized
the distinction between the ability to perform simple tasks
and the ability to stay on task, stating that ‘[o]nly
the latter limitation would account for a claimant's
limitation in concentration, persistence, or
at step three, the ALJ determined that Ms. Pough has moderate
difficulties in concentration, persistence, or pace. (Tr.
17). However, unlike in Mascio, where the ALJ merely
limited the claimant to “simple, routine tasks”
or “unskilled work, ” the ALJ here explained Ms.
Pough's nonexertional limitations in greater detail:
“she can understand, remember, and carry out simple and
routine work-related instructions; she can concentrate for
periods of two hours on work-related tasks before requiring a
break; and she can occasionally work with the public,
coworkers, and supervisors.” (Tr. 17). Although Ms.
Pough asserts that the ALJ only limited her to “simple
and routine work-related instructions, ” in actuality,
the ALJ included specific limitations to account for her
mental impairments, including the two-hour concentration
period and only occasional work with others. These additional
limitations that the ALJ included in the RFC assessment
certainly account for Ms. Pough's limitations in
concentration, persistence, or pace with regard to her
ability to stay on task, as opposed to her ability to perform
simple tasks, as the Fourth Circuit required in
Mascio. Ms. Pough's second argument is therefore
of Physician Opinions
final two arguments, Ms. Pough claims that the ALJ failed to
evaluate the opinions of Dr. Smith, her treating physician,
and a state agency physician. First, Ms. Pough argues that
the ALJ confused the evidence and analyzed a 2013
questionnaire completed by Dr. Smith under the false
assumption that the questionnaire was completed by Dr.
Miller, a consultative examiner, instead. (Tr. 21, 386). The
Government admits that the ALJ did mistakenly interpret Dr.
Smith's report as being authored by Dr. Miller and
analyzed the report as if it had been submitted by Dr. Miller
instead of Dr. Smith, but argues that such error is harmless
because the fact that Dr. Miller is a consultative examiner
and not a treating physician was only a small part of the
ALJ's analysis of the report and Ms. Pough failed to show
that Dr. Smith's opinion was entitled to greater weight.
According to the “treating physician rule, ”
“the ALJ must generally give more weight to a treating
physician's opinion, . . . but where a treating
physician's opinion is not supported by clinical evidence
or is inconsistent with other substantial evidence, it should
be afforded significantly less weight.” Rivers v.
Colvin, Civ. No. TMD-12-3265, 2013 WL 5797344, at *2 (D.
Md. Oct. 25, 2013) (citing 20 C.F.R. §§
404.1527(d)(2), 416.927(d)(2) and Craig v. Chaters,
76 F.3d 585, 585, 590 (4th Cir. 1996)). ALJs must consider
various factors when determining the amount of weight to give
treating physicians' findings: (i) the “length of
the treatment relationship and the frequency of
examination;” (ii) the ...