Melissa Loomis v. Michael J. Astrue, No. 5:2010cv01521 - Document 17 (C.D. Cal. 2011)
Court Description: MEMORANDUM OPINION AND ORDER by Magistrate Judge Victor B. Kenton, The decision of the ALJ will be affirmed. The Complaint will be dismissed with prejudice. (SEE ORDER FOR FURTHER DETAILS) (lmh)
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1 2 3 4 5 6 UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA WESTERN DIVISION 7 8 9 10 11 MELISSA LOOMIS, 12 13 14 15 Plaintiff, v. MICHAEL J. ASTRUE, Commissioner of Social Security, 16 Defendant. ) ) ) ) ) ) ) ) ) ) ) ) No. ED CV 10-01521-VBK MEMORANDUM OPINION AND ORDER (Social Security Case) 17 18 This matter is before the Court for review of the decision by the 19 Commissioner of Social Security denying Plaintiff s application for 20 disability benefits. 21 consented that the case may be handled by the Magistrate Judge. 22 action arises under 42 U.S.C. §405(g), which authorizes the Court to 23 enter judgment upon the pleadings and transcript of the record before 24 the Commissioner. 25 ( JS ), and the Commissioner has filed the certified Administrative 26 Record ( AR ). Pursuant to 28 U.S.C. §636(c), the parties have The The parties have filed the Joint Stipulation 27 Plaintiff raises the following issues: 28 1. Whether the Administrative Law Judge ( ALJ ) properly 1 2 considered the treating psychiatrist s opinion; 2. 3 4 the ALJ provided a complete assessment of Plaintiff s residual functional capacity; and 3. 5 6 Whether Whether the ALJ posed a complete hypothetical question to the vocational expert. (JS at 2.) 7 8 9 10 This Memorandum Opinion will constitute the Court s findings of fact and conclusions of law. After reviewing the matter, the Court concludes that the decision of the Commissioner must be affirmed. 11 12 I 13 THE ALJ CORRECTLY ASSESSED PLAINTIFF S 14 MENTAL RESIDUAL FUNCTIONAL CAPACITY 15 Plaintiff raises three issues in this litigation, each of which 16 relates to the asserted error committed by the ALJ in failing to 17 properly assess the opinion of her treating psychiatrist, Dr. Leonard. 18 This question is posed as Issue No. 1. 19 assertion that the ALJ failed to provide a complete assessment of her 20 mental residual functional capacity (Issue Two), and the third issue 21 is that in failing to properly consider Dr. Leonard s diagnosis, the 22 ALJ posed an incomplete hypothetical question to the vocational expert 23 ( VE ). 24 Related to that is Plaintiff s The Court will address each of these issues in this section. 25 26 27 28 A. Applicable Law. 1. Mental Impairment. In evaluating mental impairments, 20 C.F.R. §404.1520a(c)(3)(4) 2 1 and §416.920a(c)(3)(4) mandate that consideration be given, among 2 other 3 functioning; concentration, persistence, or pace; and episodes of 4 decompensation. These factors are generally analyzed in a Psychiatric 5 Review Technique Form ( PRTF ). 6 sequential evaluation to determine if a claimant is disabled under the 7 Listing of Impairments; however, the same data must be considered at 8 subsequent steps unless the mental impairment is found to be not 9 severe at Step Two. 10 things, 20 C.F.R. to activities of daily living ( ADLs ), social The PRTF is used at Step Three of the See SSR 85-16. §§404.1520a(c)(1) and 416.920a(c)(1) require 11 consideration of all relevant and available clinical signs and 12 laboratory findings, the effects of your symptoms, and how your 13 functioning may be affected by factors including, but not limited to, 14 chronic mental disorders, structured settings, medication and other 15 treatment. 1 16 SSR 85-16 suggests the following as relevant evidence: 17 History, findings, and observations from medical 18 sources (including psychological test results), regarding 19 the presence, frequency, and intensity of hallucinations, 20 delusions or paranoid tendencies; depression or elation; 21 confusion or disorientation; conversion symptoms or phobias; 22 psycho-physiological 23 behavior; anxiety or tension. symptoms, withdrawn or bizarre Reports of the individual s 24 25 26 27 28 1 20 C.F.R. §404.1545(c) and §416.945(c) also require consideration of residual functional capacity for work activity on a regular and continuing basis and a limited ability to carry out certain mental activities, such as limitations in understanding, remembering, and carrying out instructions, and in responding appropriately to supervision, co-workers, and work pressures in a work setting. 3 1 activities of daily living and work activity, as well as 2 testimony 3 performance and behavior. 4 homes, or similar assistive entities. of third parties about the individual s Reports from workshops, group 5 6 It is also required under §404.1520a(c)(2) and §416.920a(c)(2) 7 that the ALJ must consider the extent to which the mental impairment 8 interferes with an ability to function independently, appropriately, 9 effectively, and on a sustained basis including such factors as the 10 quality and level of [] overall functional performance, any episodic 11 limitations 12 require[d]. [and] the amount of supervision or assistance [] 13 Pursuant to the September 2000 amendments to the regulations 14 which modify 20 C.F.R. §404.1520a(e)(2) and §416.920a(e)(2), the ALJ 15 is no longer required to complete and attach a PRTF. 16 regulations identify five discrete categories for the first three of 17 four relevant functional areas: activities of daily living; social 18 functioning; concentration, persistence or pace; and episodes of 19 decomposition. These categories are None, Mild, Moderate, Marked, and 20 Extreme. (§404.1520a(c)(3), (4).) In the decision, the ALJ must 21 incorporate pertinent findings and conclusions based on the PRTF 22 technique. §404.1520a(e)(2) mandates that the ALJ s decision must show 23 the 24 findings, and the functional limitations that were considered in 25 reaching a conclusion about the severity of the mental impairment(s). 26 The decision must include a specific finding as to the degree of 27 limitation in each of the functional areas described in paragraph (c) 28 of this section. significant history, including 4 examination and The revised laboratory 1 The Step Two and Three analyses (see Decision at AR 53-54) are 2 intended to determine, first, whether a claimant has a severe mental 3 impairment (Step Two), and if so, whether it meets or equals any of 4 the Listings (Step Three). It is also required under §404.1520a(c)(2) 5 and §416.920a(c)(2) that the ALJ must consider the extent to which the 6 mental 7 independently, appropriately, effectively, and on a sustained basis 8 including such factors as the quality and level of [] overall 9 functional performance, any episodic limitations [and] the amount of 10 impairment interferes with an ability to function supervision or assistance [] require[d]. 11 12 2. General Assessment of Functioning ( GAF ). 13 The GAF scale is intended to reflect a person s overall level of 14 functioning at or about the time of the examination, not for a period 15 of at least 12 consecutive months, which is required for a finding of 16 impairment or disability. (See 20 C.F.R. §§416.905, 416.920(c)(2006).) 17 GAF scores are intended to be used for clinical diagnosis and 18 treatment, and do not directly correlate to the severity assessment 19 set 20 Criteria for Evaluating Mental Disorders and Traumatic Brain Injury, 21 65 Fed. Reg. 50746, 50764-65 (Aug. 21, 2000), and American Psychiatric 22 Ass n, Diagnostic and Statistical Manual of Mental Disorders, Text 23 Revision 33 (4th Ed. 2000). forth in Social Security regulations. (See Revised Medical 24 25 B. Summary of Facts and ALJ s Decision. 26 As Plaintiff notes, she received an Adult Intake Assessment at 27 the Riverside County Department of Mental Health ( Riverside Mental 28 Health ), on December 7, 2007. (AR 118.) 5 At that time, a GAF of 48 1 was assessed. (Id.) In addition, there was a mental status 2 examination performed as part of that process, in which Plaintiff 3 self-reported that she was having auditory and visual hallucinations, 4 poor insight and judgment, and poor insight control. (AR 122.) 5 On February 4, 2008, Dr. Leonard completed an Initial Psychiatric 6 Assessment, in which she diagnosed Plaintiff with bipolar disorder, 7 Type 8 borderline IQ. II; post-traumatic stress disorder (chronic); ruling out Her GAF was noted to be 45. (AR 147.) 9 Plaintiff does not discuss, however, the chronological treatment 10 notes from Riverside Mental Health noted in the record, which indicate 11 substantial improvement under medication and treatment. (AR 226-227, 12 232, 235, 241-245, 253.) 13 December 11, 2008 (AR 241), reveal appropriate appearance; appropriate 14 mood, although anxious; appropriate affect; appropriate attention and 15 concentration; and appropriate speech. 16 sleep problems, appetite problems, or drug or alcohol abuse are noted. 17 Plaintiff was adherent to medication, with no side effects. Plaintiff 18 indicated that the medication Strattera was helping her. (Id.) In the 19 same report, Plaintiff indicated that her financial aid was approved 20 to continue classes in business administration; that her relationships 21 were going well, and that she had noticed a big difference with her 22 medication. As an example, the treatment note from No hallucinations, delusions, 23 Subsequent mental status examinations, such as one conducted in 24 August 2009 by Dr. Leonard, indicated that Plaintiff had judgment and 25 insight within normal limits. (AR 226.) 26 27 28 At no time did Dr. Leonard ever provide an opinion regarding Plaintiff s mental functional capacity. The ALJ took testimony from 6 a medical expert ( ME ), Dr. 1 Glassmire. 2 concluded that Plaintiff could perform simple repetitive tasks with no 3 public interaction; that she could have non-intense interaction with 4 co-workers and supervisors; and she could not perform tasks requiring 5 hyper-vigilance. (AR 269.) 6 Based on Dr. Glassmire s review of the records, he In his decision, the ALJ noted Plaintiff s testimony regarding 7 hearing voices, anger outbursts, irritability, mood swings, and 8 anxiety. (AR 14.) 9 failed to credibly establish functional limitations greater than the Nevertheless, he found that Plaintiff s testimony 10 conclusions he reached in his decision.2 11 testimony that Plaintiff had a bipolar disorder and post-traumatic 12 stress disorder which was secondary to childhood molestation and other 13 traumatic events. 14 times was within normal limits. 15 appeared to be controlled by medication, and thus she would be able to 16 behave appropriately in the workplace. Dr. Glassmire provided He noted that Plaintiff had anger problems but at Her hallucinations as reported 17 The ALJ s assessment of Plaintiff s mental functional abilities 18 (denominated mental residual functional capacity [ MRFC ]) found mild 19 restriction in activities of daily living; moderate difficulties in 20 social 21 persistence or pace; and no experienced episodes of decompensation. 22 (AR 12-13.) functioning; moderate difficulties in concentration, 23 24 C. 25 While 26 Analysis. Plaintiff s complaint is that the ALJ ignored the conclusions of her psychiatrist, Dr. Leonard, which Plaintiff asserts 27 28 2 Plaintiff does not contest the ALJ s credibility assessment. 7 1 demonstrate a more significant level of mental impairment than the ALJ 2 allowed, the Court does not find that the ALJ either ignored Dr. 3 Leonard s reports, or, more importantly, that he disputed them. 4 regard to acknowledging these reports, the decision indicates that he 5 in fact did review them. (See AR at 15.) 6 whether Dr. Leonard in fact diagnosed more substantial restrictions 7 than did the ALJ, the Court s review of Dr. Leonard s treatment notes 8 indicates that this is not the case. 9 formally assessed mental functional limitations. With As to the question of As noted, Dr. Leonard never But in any event, 10 the treatment notes support a longitudinally based conclusion that 11 Plaintiff responded well to medication and treatment, and a diagnosis 12 of her mental condition which is less restrictive than that reflected 13 in the ALJ s conclusions. 14 scores is misplaced. Further, Plaintiff s focus on the GAF 15 Moreover, the Court finds that the testimony of the ME at the 16 hearing is supported by the longitudinal treatment records, and the 17 ALJ was correct in relying on this testimony in assessing Plaintiff s 18 MRFC. (See Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1996).) 19 The determination of this issue controls the result as to the 20 remaining two issues. The second issue questions whether the ALJ 21 provided a complete assessment of Plaintiff s MRFC. 22 Court s analysis under its discussion of the first issue, the ALJ 23 followed the correct procedures in determining Plaintiff s mental 24 capacities. Further, the hypothetical question posed to the VE at the 25 hearing (see AR at 272) adequately and correctly summarized the 26 applicable mental limitations so that the VE could provide a response 27 at Step Five of the sequential evaluation process. (AR 272-273.) 28 this reason, Plaintiff s third issue, which questions the adequacy of 8 As noted in the For 1 2 3 4 the hypothetical question posed to the VE, is without merit. For the foregoing reasons, the decision of the ALJ will be affirmed. The Complaint will be dismissed with prejudice. IT IS SO ORDERED. 5 6 DATED: June 20, 2011 /s/ VICTOR B. KENTON UNITED STATES MAGISTRATE JUDGE 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 9
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