Humphreys v. Comm Social Security ( 2005 )

Opinions of the United
2005 Decisions States Court of Appeals
for the Third Circuit
4-4-2005
Humphreys v. Comm Social Security
Precedential or Non-Precedential: Non-Precedential
Docket No. 04-2644
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NOT PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
No: 04-2644
EILEEN M. HUMPHREYS,
an adult individual,
v.
Appellant
JOANNE BARNHART,
COMMISSIONER OF SOCIAL SECURITY
Appeal from the United States District Court
for the Western District of Pennsylvania
(Civ. No. 03-cv-00158)
Trial Judge: Ila Jeanne Sensenich, Magistrate Judge
Submitted under Third Circuit LAR 34.1(a)
March 8, 2005
Before: NYGAARD, McKEE and RENDELL,
Circuit Judges
(Opinion filed: April 4, 2005)
OPINION
McKEE, Circuit Judge.
Eileen M. Humphreys appeals the district court's decision affirming the final
decision of the Commissioner of Social Security denying her application for Disability
Insurance Benefits ("DIB") under Title II of the Social Security Act. 42 U.S.C. §§
401-433. For the reasons that follow, we will affirm.
I.
Humphreys protectively filed an application for DIB on January 8, 2002,
alleging that she had been disabled since February 1, 2001, due to a heart condition,
depression, anxiety and hypertension. The state agency denied her application and
she requested an administrative hearing. The ALJ denied Humphreys' application,
finding that she was not disabled because she could perform a significant number of
jobs in the national economy. The ALJ's decision became the final agency decision
subject to judicial review when the Appeals Council denied Humphreys' request for
review. 20 C.F.R. § 404.981.
Having exhausted her administrative remedies, Humphreys filed a civil
action in the district court. On cross-motions for summary judgment, the
magistrate judge held that the ALJ's decision was supported by substantial
evidence. This appeal followed.
II.
Our scope of review is limited to determining if the Commissioner's
decision is supported by substantial evidence. 42 U.S.C. §§ 405(g), 1383(c)(3);
Monsour Medical Ctr. v. Heckler, 806 F.2d 1185, 1190 (3d Cir. 1986). The ALJ's
decision is the final decision of the Commissioner when the Appeals Council
denies a request for review. Sims v. Apfel, 530 U.S. 103, 107 (2000). Substantial
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evidence refers to that evidence that "a reasonable mind might accept as adequate
to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971)(quoting
Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). It is "more than a
mere scintilla but may be somewhat less than a preponderance of the evidence."
Ginsberg v. Richardson, 436 F.2d 1146, 1148 (3d Cir. 1971).
III.
Because we write only for the parties, we will discuss only briefly state the
facts relevant to our disposition of this appeal. On February 6, 2001, Humphreys
began reporting heart palpitations to her treating primary care physician, Christine
Pascual, D.O. In late February, when the symptoms failed to resolve, Humphreys
was hospitalized for triple bypass surgery. She was discharged four days later.
Dr. Pascual’s office notes from February 16, 2000 through December 1, 2001
show that Humphreys complained repeatedly of fatigue as well as stress and
depression. On two separate occasions Dr. Pascual assessed Humphreys's ability to
work by completing forms that were provided by Humphrey’s private disability
insurance carrier. On the form dated November 8, 2001, Dr. Pascual indicated that
Humphreys could work a total of four hours a day beginning November 21, 2001,
and that Humphreys was limited to carrying up to 10 pounds frequently, and eleven
to twenty pounds occasionally. On March 15, 2002, Dr. Pascual informed the
insurance carrier that Humphreys was unable to work and that she was permanently
disabled due to weakness, fatigue, and depression and because she had a marked
limitation in her ability to engage in stress situations or in interpersonal
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relationships.
On January 10, 2003, Humphreys's new treating physician, Zane H. Gates,
M.D., assessed Humprheys’ ability to work at the request of Humphreys's private
insurance carrier. Dr. Gates confirmed Dr. Pascual’s opinion. He opined that
Humphreys could not stand or walk and could sit only one hour per day; that she
could not cope with stressful situations or interpersonal relationships; and that she
had markedly limited cardiac functioning. He thus concluded that she was totally
disabled.
On appeal, Humphreys argues that the ALJ erred by failing to accord
controlling weight to the opinions of her treating physicians. In particular, she
argues that the ALJ erred because he relied on a Physical Residual Functional
Capacity Assessment ("PRFCA") prepared by John G. DiLeonardo, a state agency
claims adjudicator who is not a physician. That assessment indicated that
Humphreys could do light work. The ALJ therefore concluded that she could
perform light work.
In Morales v. Apfel, 225 F.3d 310 (3d Cir. 2000), we wrote:
A cardinal principle guiding disability eligibility
determinations is that the ALJ accord treating physicians'
reports great weight, especially when their opinions reflect
expert judgment based on a continuing observation of the
patient's condition over a prolonged period of time. Where,
as here, the opinion of a treating physician conflicts with
that of a non-treating, non-examining physician, the ALJ
may choose whom to credit but cannot reject evidence for no
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reason or for the wrong reason. The ALJ must consider the
medical findings that support a treating physician's opinion
that the claimant is disabled.
In choosing to reject the treating physician's
assessment the ALJ may not make speculative inferences
from medical reports and may reject a treating physician's
opinion outright only on the basis of contradictory medical
evidence and not due to his or her own credibility
judgments, speculation or lay opinion.
Id. at 317 (citations and internal quotations omitted). Humphreys argues that
DiLeonardo is not an acceptable medical source to provide evidence of an
impairment as defined by the Social Security Administration, and, therefore, it was
reversible error for the ALJ to rely on the PRFCA.
We agree that DiLeonardo is not an acceptable medical source as defined by
the regulations. See 20 C.F.R. § 404.1513 (Acceptable medical sources include
licensed physicians, licensed or certified psychologists, licensed optometrists,
licensed podiatrists, and qualified speech-language pathologists). However, we
believe that the ALJ's limited reliance on the PRFCA was harmless because it was
not the sole basis for his conclusion. The ALJ also relied upon substantial objective
medical evidence that contradicted the opinions of Drs. Pascual and Gates,
Humphreys' treating physicians.
First, the objective diagnostic findings of record contradicted the treating
physicians' opinions. In particular, Humphreys completed an exercise stress test in
June 2001, performing at a level of at least 10.1 METS. See Guides to the
Evaluation of Permanent Impairments, 170-71 (American Medical Association, ed.
5
4th ed. 1995) (explaining that patients who can exercise from 7 to 16 METS are
classified as having no resulting limitations); see also Moore v. Sullivan, 919 F.2d
901, 904 (5th Cir. 1990) (holding that 10.1 METS is "more than enough" for the
performance of light work). Notably, Humphreys was able to exercise for nine
minutes and twelve seconds on this exercise stress test, and for eight minutes on a
second exercise stress test that she completed in August 2002. She did so without
ischemia, chest pain or other significant abnormalities. Clearly, the results of these
two stress tests support the ALJ's determination that Humphreys retained the ability
to perform light work.
Second, additional diagnostic tests supported the ALJ's finding that the
cardiac limitations described by Drs. Pascual and Gates were not reliable. For
example, a twenty-four hour Holter monitor showed no major episodes of cardiac
abnormality and found no clinical evidence to corroborate Humphreys's claimed
heart palpitations. Moreover, Dr. Gates stated that a carotid artery study was
negative for significant stenosis after surgery.
Third, the examination findings of record contradicted the opinions of the
treating physicians. The treatment notes of Alan C. Ford, M.D., Humphreys'
cardiologist, documented consistently normal cardiac examinations and indicated
that Humphreys was "doing well." Michael L. Humphrey, D.O., an
endocrinologist, reported that she had normal heart rate, rhythm and pulses.
Fourth, Humphreys' treatment history was not consistent with the degree of
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limitation described by Drs. Pascual and Gates. She completed cardiac rehabilitation
in July 2001. After that time, she saw her cardiologist only every four to six months
for routine follow-up evaluations, which were consistently normal.
Fifth, Humphreys had no treatment from a mental health professional for
her claimed disabling depression or anxiety.
Finally, the extreme functional limitations described by Dr. Gates are not
supported by the record evidence. Dr. Gates noted that Humphreys was almost
unable to get out of bed; that she could not stand or walk at all; and that she could sit
for only one hour a day. However, nothing in the record, even Humphreys' own
allegations, provides even minimal support for this extreme level of incapacity.
Overall, the record evidence, even absent reference to the PRFCA, clearly
supports the ALJ's decision to reject the opinions of Humphrey's treating physicians
that she is permanently disabled.
VI.
For all of the above reasons, we will affirm.
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