Ali v. Colvin

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
______________________________
)
KHALANI IESHA ALI, )
)
Plaintiff, )
)
v. ) Case No. 14-cv-230 (EGS)
)
CAROLYN W. COLVIN, )
Acting Commissioner )
of Social Security, )
)
Defendant. )
)
)
______________________________)
MEMORANDUM OPINION
Plaintiff Khalani Iesha Ali (“Ms. Ali”) brings this action
for judicial review of the final decision of the Commissioner of
the Social Security Administration (“the Commissioner”) denying
in part her claims for Social Security Disability Benefits and
Supplemental Security Income Benefits. Pending before the Court
are Ms. Ali’s Motion for Judgment of Reversal and the
Commissioner's Motion for Judgment of Affirmance. ECF Nos. 10,
13. Upon consideration of the parties' submissions, the
administrative record, the governing statutory and case law, and
for the following reasons, Ms. Ali’s Motion is DENIED and the
Commissioner's Motion is GRANTED.
1
I. BACKGROUND
A. Factual Background
Khalani Iesha Ali, born August 25, 1968, is a former retail
manager seeking Social Security Disability Benefits (“SSD”) and
Supplemental Security Income (“SSI”) under Title II and Title
XVI of the Social Security Act, 42 U.S.C. §§ 301 et. seq. (“the
Act”). In November 2000, Ms. Ali suffered a gunshot wound to her
shoulder following a burglary of her home. AR at 333. In
December 2008, Ms. Ali began receiving treatment for anxiety and
migraines, among other ailments. Id. at 339. By January 2009,
Ms. Ali had reported to her doctor that she experienced constant
anxiety which interfered with her life and prevented her from
interviewing for new jobs. Id. at 329. In March 2009, Ms. Ali
was evaluated for depression and hypomania and diagnosed with
bipolar II disorder. Id. at 333. During this time, Ms. Ali
became increasingly paranoid that someone would break into her
apartment and hurt her again. Id. Ms. Ali periodically suffered
from racing thoughts, uncontrollable crying, poor attention and
concentration, and frequent angry outbursts. Id. By April 2009,
Ms. Ali had returned to work as a store manager. Id. at 335. In
April 2010, however, Ms. Ali received a letter from the Victims
Against Violent Crimes Program informing her that her assailant
would be released from prison in 2015. Ms. Ali stopped working
on April 15, 2010 as she became increasingly confused and unable
2
to handle stress at her job. Id. at 323. In March 2012, Ms. Ali
began seeing a psychologist and a psychiatrist. Id. Ms. Ali’s
reports of crying spells and insomnia prompted her psychologist
to diagnose her with generalized anxiety disorder and post-
traumatic stress disorder. Id. at 499.
Ms. Ali’s mental condition continued to decline. A March 6,
2012 mental status examination revealed that Ms. Ali experienced
hypervigilant behavior, a sad, weeping, and labile affect,
preoccupation with her attacker’s return, poor concentration,
poor social judgment, and poor insight. Id. at 327-28. On April
3, 2012, Ms. Ali was evaluated by a psychiatrist who also
diagnosed Ms. Ali with post-traumatic stress disorder and
bipolar affective disorder. Id. at 672-76. Throughout 2012 and
2013, Ms. Ali reported to her physicians that she was “reliving
the shooting from 2000” and suffering from insomnia because she
saw the gun when she closed her eyes. Id. at 588. On April 17,
2012, Ms. Ali’s treating psychologist, Dr. Ruth Graves, stated
in a letter that Ms. Ali suffered an “emotional setback” in
April 2010 after receiving the letter about her assailant’s
release date and that Ms. Ali has been unable to work due to
psychological symptoms. Id. at 383. Dr. Graves recommended that
Ms. Ali not return to work for at least one year until the
symptoms abated. Id. On April 24, 2012, Ms. Ali’s treating
psychiatrist, Dr. Tanya Alim, drafted a letter in support of Dr.
3
Graves’ opinion, also recommending that Ms. Ali not return to
work for one year. Id. at 385. On October 10, 2012, Ms. Ali’s
treating physician, Dr. Billie Downing, opined that Ms. Ali
required “at least 1 year in intensive services” that would
prohibit her from working during that time. AR at 468. In May
and July 2013, Ms. Ali’s physicians diagnosed her with severe
post-traumatic stress disorder and severe bipolar disorder. Id.
at 678.
B. Procedural History
On January 23, 2012, Ms. Ali filed applications for Social
Security Disability Benefits (“SSD”) and Supplemental Security
Income Benefits (“SSI”) alleging a disability onset date of
April 15, 2010 – i.e., the date on which she stopped working. AR
at 54, 64, 174-208. Ms. Ali’s claims were denied after initial
review and again upon reconsideration because the Commission
determined that her condition was not so severe as to prevent
Ms. Ali from working. Id. at 102-105, 108-114. On September 19,
2013, an administrative law judge (“ALJ”) issued a partially
favorable decision finding that Ms. Ali was disabled beginning
on March 1, 2012 but not before. Id. at 13-31. Id. The ALJ based
his decision on a consideration of Ms. Ali’s medical records,
the opinions of her treating physicians, the evaluations of
State Agency consultants, and the testimony of a vocational
expert who opined that prior to March 1, 2012, Ms. Ali could
4
have found a job as an assembly worker, a packaging worker, a
quality control worker, or a small parts inserter. Id. at 17-25.
Due to the ALJ’s decision, Ms. Ali has been receiving disability
insurance since March 1, 2012. On November 29, 2013, Ms. Ali
sought review from the Appeals Council of the portion of the
ALJ’s decision that found her not disabled between April 2010
and March 2012. On December 20, 2013, the Appeals Council denied
review, which decision is the subject of this action for
judicial review. Id. at 1-5.
II. LEGAL FRAMEWORK
A. Standard of Review
Section 405(g) of the Social Security Act provides for
judicial review of “final decisions” of the Commissioner of
Social Security. 42 U.S.C. § 405(g). On review, the court must
uphold the Commissioner's determination where it is “supported
by substantial evidence” and “not tainted by an error of law.”
Porter v. Colvin, 951 F. Supp. 2d 125, 129 (D.D.C. 2013) (citing
Smith v. Bowen, 826 F.2d 1120, 1121 (D.C. Cir. 1987)).
Substantial evidence is “such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.” Brown v.
Bowen, 794 F.2d 703, 705 (D.C. Cir. 1986) (quoting Richardson v.
Perales, 402 U.S. 389, 401 (1971)). The substantial evidence
test “requires more than a scintilla, but can be satisfied by
something less than a preponderance of the evidence.” Butler v.
5
Barnhart, 353 F.3d 992, 999 (D.C. Cir. 2004) (quoting Florida
Mun. Power Agency v. F.E.R.C., 315 F.3d 362, 366 (D.C. Cir.
2003)). This standard “entails a degree of deference to the
Commissioner’s decision.” Jackson v. Barnhart, 271 F. Supp. 2d
30, 33 (D.D.C. 2002).
“Even if supported by substantial evidence, however, the
court will not uphold the Commissioner's findings if the
Commissioner reached them by applying an erroneous legal
standard.” Id.; see also Coffman v. Bowen, 829 F.2d 514, 517
(4th Cir. 1987) (“A factual finding by the ALJ is not binding if
it was reached by means of an improper standard or
misapplication of the law.”). To determine whether the
Commissioner's decision is free from legal error and supported
by substantial evidence, the court must “carefully scrutinize
the entire record,” but “may not reweigh the evidence and
replace the [Commissioner's] judgment regarding the weight of
the evidence with its own.” Jackson, 271 F. Supp. 2d at 34
(citing Davis v. Heckler, 566 F. Supp. 1193, 1195 (D.D.C.
1983)). If supported by substantial evidence, the Commissioner's
finding must be sustained “even where substantial evidence may
support the plaintiff's position and despite that the court's
independent analysis of the evidence may differ from the
[Commissioner's].” Rosado v. Sullivan, 805 F. Supp. 147, 153
(S.D.N.Y. 1992).
6
B. The Social Security Act
To qualify for disability benefits under Title II, the
Commissioner must find that the applicant has a “disability” as
defined in the Act. See 20 C.F.R. § 404.315. The Act defines
“disability” as the “inability to engage in any substantial
gainful activity by reason of any medically determinable
physical or mental impairment which...has lasted or can be
expected to last for a continuous period of not less than 12
months.” 42 U.S.C. § 423(d)(1)(A); 20 C.F.R. § 404.1505. The
same definition of “disability” is used to determine eligibility
for SSI benefits under Title XVI. See 42 U.S.C. § 1382(a)(3)(A);
20 C.F.R. § 416.905.
The Commissioner has established a five-step sequential
evaluation process for assessing a claimant's alleged
disability. See 20 C.F.R. § 416.920. The claimant bears the
burden of proof during the first four steps. Id. First, the
claimant must demonstrate that she is not presently engaged in
“substantial gainful work.” 20 C.F.R. § 416.920(b). Second, a
claimant must show that she has a “severe impairment” that
“significantly limits [her] physical or mental ability to do
basic activities.” 20 C.F.R. § 416.920(c). Third, if the
claimant suffers from an impairment that meets or equals an
impairment listed in Appendix 1 to the Commissioner's
7
regulations, she is deemed disabled, and the inquiry ends. 20
C.F.R. § 416.920(d).
If the impairment is not one the regulations presumed to be
disabling, however, then the evaluation continues to a fourth
step, which requires the claimant to show that she is incapable
of performing work that she has done in the past. 20 C.F.R. §
416.920(e). Once the claimant has carried her burden on the
first four steps, the burden shifts to the Commissioner on step
five to demonstrate that the claimant is able to perform “other
work” based on a consideration of her “residual functional
capacity” (“RFC”), age, education and past work experience. 20
C.F.R. § 416.920(f); see also Brown, 794 F.2d at 706; Davis v.
Astrue, 602 F. Supp. 2d 214, 217 (D.D.C. 2009).
III. DISCUSSION
A. The Commissioner’s Decision
In this case, the Commissioner, through the ALJ, applied
the five-step analysis and determined, first that Ms. Ali had
not engaged in substantial gainful activity since her alleged
onset date of April 15, 2010. AR at 19. At step two, the ALJ
found, based on the objective medical evidence, that Ms. Ali’s
anxiety disorder and affective disorder were severe impairments.
Id. At step three, the ALJ found that Ms. Ali’s impairments did
not meet or equal any of the impairments listed in 20 C.F.R.
Part 404, Subpart P Appendix 1, specifically considering the
8
mental disorder listings. Id. at 20. At step four, the ALJ
determined that prior to March 1, 2012, Ms. Ali had the residual
functional capacity “to perform a full range of work at all
exertional levels, but [was] limited to performing tasks with
simple instructions (no complex tasks) with occasional contact
with co-workers, supervisors, and the public[.]” Id. Due to Ms.
Ali’s concentration and focus problems, the ALJ found that Ms.
Ali “would be off task 5% of the workday.” Id. The vocational
expert determined that Ms. Ali would be able to work as an
assembly worker, a packaging worker, a quality control worker,
and a small parts inserter. Id. at 24. The expert testified that
approximately 700 assembly worker, 600 packaging worker, 500
quality control worker, and 400 small parts inserter jobs were
available in Ms. Ali’s area. Id. Based on a consideration of the
objective medical evidence and the information provided by the
vocational expert, the ALJ determined that prior to March 1,
2012, Ms. Ali could have successfully adjusted to work that
existed in significant numbers in the national economy, and that
therefore she was not “disabled” under the Act. Id. at 24-25.
Here, Ms. Ali does not challenge the ALJ’s determination
that she was disabled as of March 1, 2012. However, Ms. Ali
argues that the ALJ should have relied on the opinions of her
treating physicians to determine that her disability onset date
was two years earlier — i.e., on April 15, 2010. Pl.’s Mot., ECF
9
No. 10 at 13-14. According to Ms. Ali, the ALJ failed to give
the opinions of her treating physicians controlling weight and,
as a result, improperly determined Ms. Ali’s disability onset
date. Id.
Ms. Ali also contends that the ALJ improperly evaluated her
credibility because the ALJ focused his credibility assessment
on two facts: 1) that prior to March 1, 2012, Ms. Ali did not
obtain treatment with a specialist; and 2) that Ms. Ali was, at
times, non-compliant with her prescribed psychotropic
medications. Id. at 20. The ALJ overlooked, Ms. Ali argues, the
fact that non-compliance with mental health treatment is often a
symptom of a psychiatric condition rather than an indication of
the severity of the impairments. Id. The Commissioner refutes
both claims, arguing that the ALJ properly weighed the opinions
of Ms. Ali’s treating physicians and evaluated Ms. Ali’s
credibility. Opp., ECF No. 13 at 12-19. The Court will examine
each of Ms. Ali’s claims in turn.
B. The ALJ did not err in weighing the medical opinions
from Ms. Ali’s treating physicians.
Ms. Ali contends that the ALJ erroneously failed to give
sufficient weight to the opinions from her treating
psychologist, Dr. Graves, and treating psychiatrist, Dr. Alim,
in determining her disability onset date. See Pl.’s Mot., ECF
No. 10 at 13. According to Ms. Ali, the ALJ should have given
the opinions of Drs. Graves, Downing and Alim “controlling
10
weight” because they are treating sources. Id. at 13-15. Ms. Ali
also argues that the ALJ failed to properly consider the
retrospective opinions from these treating sources. Id. at 15-
16. Ms. Ali emphasizes that Drs. Alim and Downing specifically
indicated that her disabling psychiatric impairments began prior
to March 1, 2012, and contends that evidence from before March
1, 2012 is consistent with the abnormalities identified by these
doctors. Id. at 16. Ms. Ali claims that the opinions of Drs.
Graves, Alim, and Downing are well-supported, and that adverse
findings from non-examining consultants alone are not sufficient
to override the opinions from her treating sources. Id. at 18.
The Commissioner counters that the objective medical
evidence in the record fails to demonstrate that Ms. Ali became
disabled before March 1, 2012. Opp., ECF No. 13 at 16. In
support of this claim, the Commissioner notes that the medical
findings prior to March 2012 demonstrate that Ms. Ali was doing
well, did not consistently seek treatment or take medication,
and sought a new job. Id. Further, the Commissioner emphasizes
that by January 2011, Ms. Ali had stopped seeing her
psychiatrist and treated her symptoms with meditation. Id.
Finally, the Commissioner argues that Ms. Ali failed to carry
her burden to overcome the objective medical evidence suggesting
that Ms. Ali’s impairments did not become disabling until March
1, 2012. Id.
11
Under the applicable regulations, a treating physician’s
medical opinion is entitled to “controlling weight” if it is
well-supported by medically acceptable clinical and laboratory
diagnostic techniques and not inconsistent with other
substantial record evidence. 20 C.F.R. §§ 404.1527(c)(2),
416.927(c)(2); see also Butler, 353 F.3d at 1003 (“Because a
claimant’s treating physicians have great familiarity with her
condition, their reports must be accorded substantial weight.”);
id. (“A treating physician’s [opinion] is binding on the fact-
finder unless contradicted by substantial evidence.”). The
opinion of a treating physician is not afforded controlling
weight where the physician issues an opinion that is not
consistent with other substantial evidence in the record.
Halloran v. Barnhart, 362 F.3d 28, 31 (2nd Cir. 2002). An ALJ
must provide “good reasons” for the weight it gives to a
treating source’s opinion. 20 C.F.R. §§ 404.1527(c)(2),
416.927(c)(2); Social Security Ruling (“SSR”) 96–2p, 1996 WL
374188, *5 (July 2, 1996). If the ALJ “rejects the opinion of a
treating physician [he must] explain his reasons for doing so.”
Butler, 353 F.3d at 1003. (citation omitted). The ALJ’s reasons
must be “sufficiently specific to make clear to [the court]” why
the ALJ gave it that weight. SSR 96–2, 1996 WL 374188 at *5.
Here, the ALJ provided a clear explanation for the weight
he gave to the medical opinions of Ms. Ali’s treating
12
physicians. The ALJ granted “great weight” to the opinions of
Ms. Ali’s treating physicians for the period during which they
treated Ms. Ali because they “c[ame] from a treating source[.]”
AR at 22-23. As a practical matter, the ALJ effectively granted
controlling weight to the treating physicians’ opinions for this
period as the ALJ ultimately determined that Ms. Ali was
disabled once treatment began. Id. During the period before Ms.
Ali began treatment, the ALJ gave the treating physicians’
opinions “some weight because they originated from treating
sources.” Id. at 22. The ALJ specifically explained that he did
not grant controlling weight to the portions of the medical
opinions addressing Ms. Ali’s condition before treatment began
because they “d[id] not correspond to the treatment record.” Id.Instead, for Ms. Ali’s pre-treatment period, the ALJ assessed
the entire record, including the treating physicians’ opinions,
the opinions of State Agency consultants, and Ms. Ali’s medical
records. See id. at 17-25.
An ALJ who refuses to accord controlling weight to the
medical opinion of a treating physician must consider a number
of factors to determine how much weight to give the opinion,
including: 1) the length of the treatment relationship and the
frequency of examination; 2) the nature and extent of the
treatment relationship; 3) the evidence that supports the
treating physician’s report; 4) how consistent the treating
13
source’s opinion is with the record as a whole; 5) the
specialization of the source in contrast to the condition being
treated; and 6) any other significant factors. 20 C.F.R. §§
404.1527(d)(2), 416.927(d)(2). In refusing to give controlling
weight to the medical opinions of Ms. Ali’s treating physicians
regarding the period during which they did not treat Ms. Ali,
the ALJ clearly considered these factors. See AR at 21-22. For
instance, when assessing the length, nature and extent of the
treatment relationship, the ALJ explained that Drs. Grave and
Alim did not treat Ms. Ali before March 1, 2012. Id. When
examining the evidence that supports the physicians’ report and
assessing how consistent the medical opinions are with the
entire record, the ALJ identified specific portions of Ms. Ali’s
medical records that were inconsistent with the treating
sources’ opinions. Id. While Drs. Grave and Alim indicated that
Ms. Ali experienced an “emotional setback” in April 2010 after
receiving a letter informing Ms. Ali of her assailant’s
anticipated release date, Ms. Ali’s medical records during this
period indicate that she was not taking any psychological
medications, had not reported a mood disorder, had not visited a
psychiatrist, and had declared “life is good”. Id. Further
evidence in the record supports the ALJ’s determination. For
example, the Residual Functional Capacity report notes that on
January 4, 2011, Ms. Ali exhibited “[n]o depression and no
14
insomnia.” Id. at 61, 66, 71, 85. The Court is thus satisfied
that substantial evidence exists to support the ALJ’s
determination. See Butler, 353 F.3d at 999 (recognizing that the
substantial evidence test “requires more than a scintilla, but
can be satisfied by something less than a preponderance of the
evidence”). Moreover, the ALJ clearly explained his reasons for
declining to grant controlling weight to the pre-treatment
portions of the treating physicians’ opinions, detailing the
contradictory evidence in the record. Id. at 1003 (reasoning
that if the ALJ “rejects the opinion of a treating physician [he
must] explain his reasons for doing so”).
Contrary to Ms. Ali’s assertion, the ALJ did not fail to
consider the retrospective opinions from Ms. Ali’s treating
sources. See Pl.’s Mot., ECF No. 10 at 16. While courts have
recognized that a treating physician may properly offer a
retrospective opinion on the past extent of an impairment, see,
e.g., Wooldridge v. Bowen, 816 F.2d 157, 160 (4th Cir. 1987),
greater weight is given to such opinions when there is no
contradictory expert or medical evidence. Wilkins v. Sec'y,
Dep't of Health & Human Servs., 953 F.2d 93, 96 (4th Cir. 1991);
Dousewicz v. Harris, 646 F.2d 771, 774 (2d Cir. 1981) (reasoning
that retrospective diagnoses must be “considered in light of the
entire record”). As described above, in not giving controlling
weight to the letters of Drs. Graves and Alim — which indicated
15
that Ms. Ali experienced an emotional setback in April 2010 —
the ALJ analyzed Ms. Ali’s medical records and the opinions of
State Agency consultants which contradicted the physicians’
retroactive assessments. To be clear, the ALJ did not disregard
the physicians’ assessments, but granted them “some weight” as
opposed to controlling weight. Because of the contradictory
evidence in the record concerning the period before Drs. Alim
and Graves began treating Ms. Ali, the Court finds that the ALJ
did not err in weighing the evidence accordingly. See Plummer v.
Apfel, 186 F.3d 422 (3d Cir. 1999) (reasoning that where there
is contradictory medical evidence, an ALJ “may reject a treating
physician’s opinion outright” or “may afford [that] opinion more
or less weight depending upon the extent to which supporting
explanations are provided.”).
Even if this Court might have reached a different
conclusion had it independently balanced the evidence, the Court
recognizes that it “may not reweigh the evidence presented to it
when reviewing a disability claim...nor may it replace the
Secretary's judgment concerning the weight and validity of the
evidence with its own.” Heckler, 566 F. Supp. at 1195. If
supported by substantial evidence, as is the case here, the
Commissioner's finding must be sustained. Smith, 826 F.2d at
1121.
16
C. The ALJ properly evaluated Ms. Ali’s credibility.
The ALJ determined that Ms. Ali’s “medically determinable
impairments could reasonably be expected to cause the alleged
symptoms” but found her statements “concerning the intensity,
persistence, and limiting effects of her symptoms...not entirely
credible prior to March 1, 2012.” AR at 21. Ms. Ali argues that
the ALJ failed to properly evaluate her credibility, asserting
that the ALJ focused his credibility analysis almost entirely on
the fact that prior to March 1 2012, Plaintiff did not obtain
treatment with a specialist and was at times non-compliant with
her prescribed psychotropic medications. Pl.’s Mot., ECF No. 10
at 20. According to Ms. Ali, the ALJ ignored the fact that non-
compliance with mental health treatment can be a symptom of the
psychiatric condition itself rather than an indication of the
severity of the impairments. Id. Ms. Ali insists that her
statement from her medical records that she was “doing well”
before March 1, 2012 does not necessarily mean she was not
disabled. Id. at 21.
The Commissioner argues that the ALJ properly assessed
Plaintiff’s credibility, citing to 20 C.F.R. §§ 404.1529(a),
416.929(a) which require an ALJ to consider the extent to which
a claimant’s symptoms could reasonably be accepted as consistent
with the objective medical evidence. Opp., ECF No. 13 at 17.
17
Under the Social Security Act, a claimant’s “statement as
to pain or other symptoms shall not alone be conclusive evidence
of disability.” 42 U.S.C. § 423(d)(5)(A). Rather, the claimant
must also furnish objective medical evidence of the symptoms
established by medically acceptable clinical or laboratory
techniques. Id. A plaintiff's allegations of pain and functional
limitations are “entitled to great weight where...it is
supported by objective medical evidence.” See Baker v. Comm’r of
Soc. Sec’y, 2015 WL 7574467, *5 (N.D.N.Y. Nov. 3, 2015) (citing
Rockwood v. Astrue, 614 F. Supp. 2d 252, 270 (N.D.N.Y. 2009)).
If an individual's statements about pain or other symptoms are
not substantiated by the objective medical evidence, the
adjudicator must consider all of the evidence in the case
record, including any statements by the individual and other
persons concerning the individual's symptoms. See SSR 96–7p,
1996 WL 374186 (July 2, 1996). 1
ALJs follow a two-step process for evaluating a claimant’s
symptoms. Id.; see also Porter, 951 F. Supp. 2d at 134 (“Non-
compliance with SSR 96–7p[‘s two-step process] warrants reversal
of a decision of the ALJ, even if evidence suggests his
conclusions are ultimately correct.”). First, the ALJ determines
1 Although SSR 96-7p has been superseded by SSR 16-3p, effective March 28,
2016, the Commissioner is not authorized to issue a rule that applies
retroactively to claims filed before the rule's effective date. See Portlock
v. Barnhart, 208 F. Supp. 2d 451 (D. Del. 2002). As a result, 96-7p is still
instructive for the instant case.
18
whether there is objective medical evidence demonstrating the
existence of a medical impairment that could reasonably be
expected to produce the symptoms alleged. SSR 96–7p, 1996 WL
374186, *2. Second, if there is such evidence, the ALJ evaluates
the intensity and persistence of Plaintiff’s symptoms and the
extent to which they affect her ability to work. Id. As part of
the second step, the ALJ must make a detailed credibility
determination as to the claimant’s statements regarding the
intensity, persistence, or functionally limiting effects of the
symptoms. Id. The ALJ must provide specific reasons for his or
her finding on credibility, supported by the evidence in the
case record. Id. In addition to the objective medical evidence,
the ALJ must consider: 1) the individual’s daily activities; 2)
the location, duration, frequency, and intensity of the
individual’s pain or other symptoms; 3) factors that precipitate
and aggravate the symptoms; 4) the type, dosage, effectiveness,
and side effects of any medication the individual takes or has
taken to alleviate pain or other symptoms; 5) treatment, other
than medication, the individual receives or has received for
relief of pain or other symptoms; 6) any measures other than
treatment the individual uses or has used to relieve pain or
other symptoms; and 7) any other factors concerning the
individual’s functional limitations and restrictions due to pain
or other symptoms. Id.; see also 20 C.F.R. §§ 404.1529(a),
19
416.929(a). An ALJ “is not required to accept [a claimant's]
subjective complaints without question; he may exercise
discretion in weighing the credibility of the [claimant's]
testimony in light of the other evidence in the record.” Baker,
2015 WL 7574467, at *5. If an ALJ “discredits [a claimant’s]
subjective testimony, he must articulate explicit and adequate
reasons for doing so.” Wilson v. Barnhart, 284 F.3d 1219, 1225
(11th Cir. 2002).
The Court is of the opinion that substantial evidence
supports the ALJ's decision to discount the segments of Ms.
Ali’s testimony as they related to the time period prior to
March 1, 2012. During this time period, Ms. Ali complained of
disabling anxiety, confusion, and depression. AR at 21. The ALJ
concluded, however, that Ms. Ali’s complaints were inconsistent
with the objective medical evidence prior to March 1, 2012. As
detailed above, the ALJ cited to specific evidence in the record
that indicated that between April 2010 and March 2012, Ms. Ali
had not visited her psychologist, stopped taking psychological
medications, stated that “life is good”, and when asked
repeatedly, reported no mood disorder. Id. Further, the ALJ
considered the factors set forth in 20 C.F.R. §§ 404.1529(c)(3)
and 416.929(c)(3) to reach his conclusion. Specifically, the ALJ
noted that before March 1, 2012, Ms. Ali’s daily activities
included “personal care, preparing meals, house and yard work,
20
shopping by mail and computer, handling money, watching TV and
reading.” Id. at 20. The ALJ also chronicled the progression of
Ms. Ali’s medical conditions, describing her treatment regimen
and noting that her symptoms were exacerbated in March 2012. Id.
at 20-22. Ms. Ali argues that the ALJ improperly ignored the
fact that non-compliance with mental health treatment may be a
symptom of the psychiatric condition rather than an indication
of the severity of the impairment. See Pl.’s Mot., ECF No. 10 at
20. Ms. Ali, however, fails to allege that she declined
treatment and medication because of her impairment. On balance,
even if Ms. Ali had alleged that to be the case, the Court’s
decision would not change. As explained herein, the ALJ
considered the entire medical record when rendering his decision
— Ms. Ali’s lack of treatment was but one of a number of
factors. See AR at 21 (detailing Ms. Ali’s statement that “life
is good” and repeated reports of no mood disorder).
To be clear, the ALJ did not completely discount Ms. Ali’s
testimony. The ALJ found Ms. Ali’s allegations regarding her
symptoms and limitations beginning on March 1, 2012 to be
generally credible. Id. at 22. The ALJ based this determination
on medical records demonstrating that in March 2012, Ms. Ali
began seeing a psychologist on a weekly basis. Id. Beginning
around the same period, Ms. Ali’s physicians diagnosed her with
a mental disorder with pressured speech, hypervigilance, sad
21
affect, and hallucinations when not on medications. Id. The ALJ
further found that, after March 1, 2012, Ms. Ali’s abilities
were unduly strained due to unresolved issues surrounding her
traumatic experience. Id. Around this time, the ALJ noted, Ms.
Ali’s “insight and prognosis were both poor.” AR at 22. By May
2013, Ms. Ali’s psychiatrist stated that Ms. Ali’s diagnosis was
poor due to chronic relapsing episodes. Id.In sum, the record indicates that the ALJ articulated
specific reasons for the weight he gave to Ms. Ali’s subjective
testimony based upon a consideration of the objective medical
evidence. See Wilson, 284 F.3d at 1225. For these reasons, and
for all of the reasons that the ALJ’s weighing of the medical
opinions from Ms. Ali’s treating physicians is appropriate, the
Court finds the ALJ’s credibility determination to be supported
by substantial evidence.
IV. CONCLUSION
For the foregoing reasons, Ms. Ali’s motion for judgment of
reversal is DENIED. The Commissioner’s motion for judgment of
affirmance is GRANTED. An appropriate Order accompanies this
Memorandum Opinion, filed this same day.
SO ORDERED.
Signed: Emmet G. Sullivan
United States District Judge
February 21, 2017
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