United States District Court, District of Colorado
RUTH A. TRUJILLO, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.
OPINION AND ORDER
MICHAEL J. WATANABE United States Magistrate Judge
The government determined that Ruth Trujillo is not disabled for purposes of Social Security Disability Insurance and Supplement Security Income. Trujillo has asked this Court either to reverse that decision or to remand for further hearing.
The Court has jurisdiction under 42 U.S.C. § 405(g) and 42 U.S.C. § 1383(c)(3). Both parties have agreed to have this case decided by a U.S. Magistrate Judge under 28 U.S.C. § 636(c). The Court AFFIRMS the government’s determination.
The Court reviews the ALJ’s decision to determine whether the factual findings are supported by substantial evidence and whether the correct legal standards were applied. See Pisciotta v. Astrue, 500 F.3d 1074, 1075 (10th Cir. 2007). “Substantial evidence is such evidence as a reasonable mind might accept as adequate to support a conclusion. It requires more than a scintilla, but less than a preponderance.” Raymond v. Astrue, 621 F.3d 1269, 1271–72 (10th Cir. 2009) (internal quotation marks omitted). The Court “should, indeed must, exercise common sense” and “cannot insist on technical perfection.” Keyes-Zachary v. Astrue, 695 F.3d 1156, 1166 (10th Cir. 2012). The Court cannot reweigh the evidence or its credibility. Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007).
All of Trujillo’s arguments pertain to the proper weighing of medical opinions. By law, an ALJ must discuss the weight given each medical opinion in the record. 20 C.F.R. § 404.1527(c). “Medical opinion” is a term of art:
Medical opinions are statements from physicians and psychologists or other acceptable medical sources that reflect judgments about the nature and severity of your impairment(s), including your symptoms, diagnosis and prognosis, what you can still do despite impairment(s), and your physical or mental restrictions.
20 C.F.R. § 404.1527(a)(2). Medical opinions come in a few varieties, with the most important category being the opinions of “treating sources.” See 20 C.F.R. § 404.1502. If the medical opinion of a treating source is in the record, and it passes a specific legal test, the ALJ must give it controlling weight. 20 C.F.R. § 404.1527(c)(2). That test is (1) whether the opinion is “well-supported by medically acceptable clinical and laboratory diagnostic techniques” and (2) whether the opinion is “not inconsistent with the other substantial evidence in [the] case record.” Id. If it does not pass this test, the ALJ must give “good reasons” for not assigning it controlling weight and must still weigh it along with the other medical opinions. Id. See also Krauser v. Astrue, 638 F.3d 1324, 1330– 32 (10th Cir. 2011) (describing the foregoing analysis as a two-step inquiry).
If no opinion is given controlling weight, the ALJ must consider all of the medical opinions in the record. 20 C.F.R. § 404.1527(b). The ALJ must weigh those opinions according to certain factors: (1) whether the source of the opinion actually examined the claimant; (2) whether and to what extent the source of the opinion had a treatment relationship with the claimant; (3) whether the source’s opinion is supported by evidence and explanation; (4) whether the opinion is consistent with the record as a whole; (5) whether the source of the opinion is a specialist; and (6) whether any other factors tend to support or contradict the opinion. 20 C.F.R. § 404.1527(c). The ALJ need not address each and every factor, nor even explicitly reference the factors; rather, the ALJ need only be “sufficiently specific to make clear to any subsequent reviewers the weight the adjudicator gave to the treating source’s medical opinion and the reasons for that weight.” Oldham v. Astrue, 509 F.3d 1254, 1258 (10th Cir. 2007). Finally, in almost every case, the record will contain opinions and findings from consultants employed by a state disability agency; these are weighed according to the same rules as medical opinions. 20 C.F.R. § 404.1527(e)(2).
A. Dr. Riley
Trujillo’s first argument is that the government’s administrative law judge (“ALJ”) and the Appeals Council failed to properly evaluate the opinions of Dr. Dana Riley. Dr. Riley is Trujillo’s primary care provider, and she completed two questionnaires expressing a very restrictive assessment of Trujillo’s physical limitations. (AR 404–10.) The ALJ mentioned Dr. Riley’s treatment records but failed to mention Dr. Riley’s medical opinions. The Appeals Council, however, noted that the opinions (1) were inconsistent with each other, (2) failed to provide any rationale supporting the opined limitations, and (2) were inconsistent with Dr. Riley’s treatment notes. (AR 5–6.) From there, the Appeals Council adopted the ALJ’s conclusions. (Id.) The Appeals Council did not discuss whether Dr. Riley was a treating source, did not assess whether her opinions should be given controlling weight, and did not explicitly assign a weight of any sort to her opinions. In briefing before this Court, the government concedes that Dr. Riley’s questionnaires are medical opinions from a treating source. (See Docket No. 18, pp. 9–11.)
Trujillo argues that the Appeals Council’s failure to follow a formal two-step analysis requires remand, citing Krauser. But despite the strength of the Tenth Circuit’s language in Krauser, the Tenth Circuit routinely declines to remand cases for formalistic errors, so long as the Commissioner’s reasoning is evident, legally sound, and substantially supported by the record. See, e.g., Mays v. Colvin, 739 F.3d 569, 575 (10th Cir. 2014). It is error for the Commissioner to stop after the first step- determining that the opinion is not entitled to controlling weight-and fail to address the second question of whether it’s entitled to any weight at all. But where the Commissioner makes that ultimate determination of the appropriate weight due the opinion, it is not necessarily error to have collapsed the inquiry into one step. Tarpley v. Colvin, __ F. App’x __, 2015 WL 451237, at *2 (10th Cir. Feb. 4, 2015); see also Dunn v. Colvin, No. 14-cv-00759-KLM, 2015 WL 1756126, at *4 (D. Colo. Apr. 15, 2015) (“Here the ALJ collapsed the two-step inquiry into a single point, stating only that she ‘gives this opinion little weight’ because ‘[t]he opinion is not supported by the objective findings’ and ‘is inconsistent with the claimant’s own testimony.’ The ALJ’s decision does not explicitly mention the issue of controlling weight at all. However, the ALJ is not required to expressly state that she denied controlling weight to a treating physician’s opinion when it is implicitly clear from the ALJ’s analysis that she declined to give the opinion controlling weight.”).
Here, the Appeals Council quite clearly gave Dr. Riley’s opinions little weight- and it is therefore quite clear that it did not give Dr. Riley’s opinions controlling weight. The non-conclusory reasons given by the Appeals Council satisfy the test for not giving a treating source’s opinion controlling weight, and also satisfy the test for giving any opinion limited weight. These non-conclusory reasons are also supported by the ...