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Carroll v. Saul

United States District Court, W.D. Kentucky, Bowling Green Division

July 23, 2019

ANDREW SAUL, Commissioner of Social Security DEFENDANT


          Lanny King, Judge

         This matter is before the Court on Plaintiff's complaint seeking judicial review, pursuant to 42 U.S.C. § 405(g), of the final decision of the Commissioner denying his claim for Social Security Disability benefits. The fact and law summaries of Plaintiff and Defendant are at Dockets # 15 and 16. The parties have consented to the jurisdiction of the undersigned Magistrate Judge to determine this case, with any appeal lying before the Sixth Circuit Court of Appeals. (Docket # 11.)

         Plaintiff identifies several imperfections in the ALJ's written decision. However, “[n]o principle of administrative law or common sense requires us to remand a case in quest of a perfect opinion unless there is reason to believe that remand might lead to a different result.” Kornecky v. Comm'r of Soc. Sec., 167 Fed.Appx. 496, 507 (6th Cir. 2006) (quoting Fisher v. Sec'y of Health & Human Servs., 869 F.2d 1055, 1057 (7th Cir. 1989)). The Court will AFFIRM the Commissioner's final decision and DISMISS Plaintiff's complaint because the Administrative Law Judge's (ALJ's) decision is supported by substantial evidence, and Plaintiff's arguments show, at worst, harmless error.

         The ALJ's rejection of Dr. Nathoo's disabling findings did not rise to the level of reversible error.

         The ALJ found that Plaintiff suffers from the following severe, or vocationally significant impairments: degenerative disc disease, osteoporosis, mild carpal tunnel syndrome/neuropathy, headaches, and cervical osteoarthritis. (Administrative Record (AR) at 44.) Plaintiff received treatment for these impairments at Medical Center Neuroscience Services in Bowling Green, Kentucky, where neurosurgeon Narendra Nathoo and advanced practice registered nurse (APRN) Kim Haynes work.[1] APRN Haynes described Plaintiff as a “patient of Dr. Nathoo.” (AR at 606.)

         On February 14, 2018, apparently at Plaintiffs request, APRN Haynes completed the Physical Medical Source Statement form. (AR at 844-47.) On March 7, 2018, Dr. Nathoo endorsed APRN Haynes' findings. (AR at 872.)[2]

         Dr. Nathoo made five findings, any one of which, if accepted, would be intolerable to most employers and would render Plaintiff disabled. Specifically, Dr. Nathoo found that Plaintiff would likely: 1) Be able to sit for a maximum of less than 2 hours total in an 8-hour working day and stand/walk for less than 2 hours total in an 8-hour working day; 2) Need to take unscheduled rest breaks during a working day every 15 to 20 minutes, which would last (on average) for 15 to 30 minutes; 3) Be “off task” (due to effects of symptoms on attention and concentration to perform even simple work tasks) 25 percent of the workday; 4) Be incapable of even “low stress” work; and 5) Be absent from work as a result of impairments or treatment more than 4 days per month. (AR at 869-72.)

         The ALJ gave “minimal weight” to Dr Nathoo's disabling findings because 1) they “are inconsistent with the record as a whole, ” 2) APRN Haynes' “own examination findings fail to reveal the type of significant clinical and laboratory abnormalities one would expect if [Plaintiff] were in fact significantly limited and disabled, and she did not specifically address this weakness, ” and 3) the findings contrast “sharply with and [are] without substantial support from the other evidence of record, which renders [them] less persuasive.” (AR at 49-50.) Additionally, the form asked APRN Haynes to “[a]ttach relevant treatment notes, radiologist reports, laboratory and test results as appropriate, ” and APRN Haynes attached the results of MRIs of Plaintiff's lumbar and cervical spine from August 2017. (AR at 858.) The ALJ noted that the lumbar MRI showed only “mild degenerative changes at the L/S1 level without evidence of direct neural impingement” and “mild narrowing of the left neural foramen at the L5/S1 level.” (AR at 47 quoting AR at 858.) MRIs showing “mostly mild-to-moderate findings and no significant degeneration” are generally consistent with an ability to perform light work. Downs v. Comm'r, 634 Fed.Appx. 551, 553 (6th Cir. 2016).

         A treating physician's (e.g., Dr. Nathoo's) opinion is entitled to controlling weight if it is “well- supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in your case record.” 20 C.F.R. § 404.1527(c)(2). Dr. Nathoo's disabling findings were not entitled to controlling weight because they were not “well-supported.” Where (as here) the ALJ did not give the treating physician's opinion controlling weight, the ALJ must give “good reasons” for the weight given the opinion in light of the factors at Section 404.1527(c)(1) - (6). There is no allegation or evidence that the ALJ abused his discretion in discounting Dr. Nathoo's disabling findings in light of these factors. Additionally, the ALJ was justified in discounting Dr. Nathoo's disabling findings because they were given on a “check-off form of functional limitation that did not cite [supporting] clinical test results, observations, or other objective findings.” Ellars v. Comm'r, 647 Fed App'x 563, 566 (6th Cir. 2016). ALJs “may properly give little weight” to such findings. Id.[3]

         The ALJ's giving “some weight” to Dr. Reed's findings did not rise to the level of reversible error.

         In September 2015, the Commissioner's state-agency program physician, Jack Reed, reviewed the available medical evidence and opined that Plaintiff retains the ability to perform a limited range of medium work. (AR at 128-29.) The ALJ, in support of his finding that Plaintiff can perform a limited range of light work, gave “some weight” to Dr. Reed's opinion. (AR at 49.) Plaintiff argues that “there is concern that substantial evidence may not support” Dr. Reed's opinion because Dr. Reed could not have been aware of the medical evidence after September 2015, including the August 2017 MRI evidence discussed above. (Docket # 15 at 5.)

         The argument is unpersuasive because the ALJ's written decision considered the subsequent medical evidence and acknowledged that it supported greater limitations than found by Dr. Reed (i.e., Plaintiff is limited to light as opposed to medium work). See McGrew v. Comm'r, 343 Fed.Appx. 26, 32 (6th Cir. 2009) (rejecting argument that ALJ erred in relying on program physician's opinion that was based on an incomplete record where the ALJ took into account the subsequent medical evidence).

         The ALJ's evaluation of Plaintiff's cane use did not rise to the level of reversible error.

         Dr. Nathoo found, among other things, that Plaintiff's impairments require that he use a cane or other hand-held assistive device when “standing/walking” due to imbalance and weakness and that he “has to have [an] ambulatory device to help with balance.” (AR at 871-72.) The ALJ found that Plaintiff “requires a hand-held assistive device for uneven surfaces and prolonged ambulation.” (AR at 45.) In so finding, the ALJ ...

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