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Layton v. Berryhill

United States District Court, M.D. Pennsylvania

November 9, 2017

NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.



         I. Introduction

         Social Security Administrative Law Judges face a singularly demanding task. They are required to make a series of legal, medical and factual judgments in the course of adjudicating disability claims. They perform this task against the backdrop of a five-step sequential analytical paradigm. Once they complete this task, courts are called upon in some instances to evaluate the outcome of these agency proceedings, reviewing the ALJ's decisions using what is generally considered to be a deferential standard of review. Oftentimes, the ALJ's task is complicated by the fact that a claimant submits only sparse and sporadic medical records in support of a disability claim, or relies upon medical opinions which draw scant support from the actual medical record.

         So it is in this case. In the instant case we are called upon to review a decision by a Social Security Administrative Law Judge (ALJ) that found that the plaintiff, Valentina Layton, could perform a limited scope of light work, and concluded that she was not disabled. Layton now challenges this determination arguing that the ALJ erred in failing to more fully credit the opinion of a doctor who had only treated Layton sporadically, who had never seen Layton to address disability issues prior to being asked to opine on those questions, and who stated that it was unknown whether she was a malingerer. (Tr. 455.) Layton also asserts that the ALJ erred in failing to give greater credence to her claims of on-going disabling impairments, even though the medical records only demonstrated that Layton had sought occasional, episodic treatment over the years when she claimed to be wholly disabled. Finally, Layton argues that the ALJ erred in formulating a residual functional capacity in her case based upon the fragmentary information which she presented to that ALJ.

         Given the deferential standard of review that applies to Social Security Appeals, which calls upon us simply to determine whether substantial evidence supports the ALJ's findings, we conclude that substantial evidence exists in this case which justified the ALJ's decisions that led to the denial of this particular claim. Therefore, for the reasons set forth below, we recommend that the district court affirm the decision of the Commissioner in this case.

         II. Statement of Facts and of the Case

         Valentina Layton applied for disability insurance benefits on October 11, 2012, and for supplemental security income on June 12, 2013, (Tr. 191, 198), alleging an onset of disability on or about October 1, 2012. (Tr. 50, 191). According to Layton she was totally disabled due to the combined effects of fibromyalgia, arthritis, obesity, and a lumbar spinal condition. (Tr. 29.) Layton, who was approximately 47 years old at the time of this alleged onset of her disability, had graduated high school; she had completed specialized training in early childhood education and nursing assistance; and she held an associate's degree in medical billing and coding. (Tr. 223.) Despite her training and education in multiple work disciplines, Layton had a sporadic work history and a minimal history of reported earnings. (Tr. 205.)

         While Layton claimed to experience “constant” back pain, “24/7” most days, (Tr. 89), the medical record in this case presented a different, and far more equivocal picture concerning the frequency and severity of her medical conditions. As the ALJ noted, Layton's medical records were sporadic and often presented mixed findings that were not consistent with wholly disabling medical conditions. Thus, her “medical records contain[ed] notable normal clinical findings.” (Tr. 29.) Furthermore, “there [we]re vast periods of time for which [Layton] has not sought treatment for these conditions.” (Tr. 34.) Moreover, “despite her purported fatigue, she was noted to be alert on multiple occasions.” (Id.) Finally, “the entirety of [Layton's] medical records indicates that [Layton's] treatment has been conservative, infrequent, and routine in nature, apparently confined to acute exacerbations only and has been managed solely with medication as she has not been referred for pain management services or received any physical therapy.” (Tr. 34-5.)

         These findings were confirmed by the records of Layton's primary care physician, which indicated that Layton sought treatment on an episodic and irregular basis, occasionally allowing many months to pass between clinical encounters. (Tr. 456-560.) As her primary care physician reported in June of 2014, Layton had “not seen anyone consistently in the past couple of years.” (Tr. 478.) Thus, at the very time that Layton alleged that she was experiencing wholly disabling impairment, her medical treatment records were isolated, sporadic and episodic, a medical history which made it “challenging” for her physicians to make any informed comments regarding her longstanding disability. (Id.) Moreover, the apparently episodic nature of her impairments was underscored by Layton's self- reported description of her condition to her care-givers at various times. For example, when she was seen by physicians in October of 2012, at the time of the alleged onset of her total disability, Layton complained of back pain but described the onset of these symptoms as “occasional.” (Tr. 371.)

         Likewise, Layton had only sought specialized treatment from her rheumatologist on a sporadic basis. Although she claimed to be disabled since October 1, 2012 due to arthritis, Layton did not visit her rheumatologist until almost two years later, on June 20, 2014. (Tr. 461.) At that time, the doctor reported that Layton had not visited the rheumatology practice in more than three years, [1] but described her condition as one marked by periodic pain in the mornings and evening, symptoms as to which her medications were “mildly to moderately helpful.” (Tr. 461.)

         Given the spotty, incomplete, and episodic nature of Layton's treatment history, it is hardly surprising that her treating doctor found it “challenging” when he was asked to opine regarding whether her condition was disabling. (Tr. 478.) The impairment questionnaire completed by this physician in June of 2014 reflected the challenging nature of this task and contained a series of notations which largely undermined the opinion proffered by the physician. (Tr. 451-55.) In this report, the doctor disclosed that he was opining on medical matters which were entirely new to him, acknowledging that at the time he was asked by Layton to complete this disability report she was being “seen for the first time today by me for these issues.” (Tr. 455.) The treatment notes written by the doctor for the clinical encounter that accompanied the preparation of this questionnaire also explicitly underscored that the physician lacked a credible basis for opining on questions of disability, since her primary care physician reported that Layton had “not seen anyone consistently in the past couple of years, ” and observed that the absence of any treatment history made it “challenging” to provide any informed comments regarding her longstanding disability. (Tr. 478.) Given this lack of any significant clinical history with Layton, the physician also candidly noted that it was “unknown” whether Layton was a malingerer, (Tr. 451), but relying upon the sporadic records he possessed and Layton's self-reported limitations the doctor provided an opinion concerning her limitations in the workplace. (Id.)

         It was against this equivocal medical and factual backdrop that the ALJ conducted a hearing considering Layton's disability application on December 1, 2014. (Tr. 43-105.) At this hearing Layton and a vocational expert appeared and testified. (Id.) In the course of this testimony Layton described her activities of daily living in terms which were largely disabling; the vocational expert, in turn, testified describing a variety of positions available in the regional and national economy for a person who was capable of performing a range of light work. (Id.)

         Following this hearing, on March 3, 2015, the ALJ issued a decision denying Phillips' application for disability benefits. (Tr. 23-38.) In this decision, the ALJ first found that Layton met the insured requirements of the Act, (Tr.29), and then at Step 2 of the five-step sequential analysis process that applies to Social Security disability claims concluded that Layton experienced the following severe impairments: firbomyositis, arthritis, obesity and a lumbar condition. (Tr. 29.) At Steps 3 and 4 of this sequential analysis, the ALJ concluded that none of Layton's impairments met a listing which would define him as per se disabled, (Tr. 30-32), but also found that she could not return to his past employment due to these impairments. (Tr. 36.)

         The ALJ then concluded that Layton retained the residual functional capacity to perform a range of light work. (Tr. 32-36.) Specifically, the ALJ found that Layton could perform light work: “except that she is limited to alternating between sitting and standing as needed. She is limited to occasional overhead reaching, occasional climbing of ramps and stairs, occasional crouching, occasional kneeling, and occasional stooping. She is limited to no ladders, ropes, or scaffolds.” (Tr. 32.) In reaching this conclusion, the ALJ partially discounted Layton's subjective complaints of disabling pain, finding those complaints to be not fully credible given the lack of objective medical and clinical support for Layton's claims concerning the persistence and severity of her symptoms. (Id.) The ALJ also gave only limited weight to the opinions of Layton's treating physician, finding that the sporadic and incomplete nature of Layton's treatment history, a factor which Layton's own treating doctor described as “challenging” in terms of reaching any informed medical opinions on the extent of her impairments, meant that this opinion could only be afforded limited value in making this disability determination. Instead, finding that Layton's medical history, when viewed in its totality, revealed only periodic and episodic medical flare-ups, and conditions which fell short of being totally disabling, the ALJ concluded that there were significant jobs in the national economy which Layton could perform.

         This appeal followed. (Doc. 1.) On appeal, Layton brings several related claims, attacking the ALJ's weighing of this medical opinion evidence; the ALJ's credibility determinations; and the ALJ's decision that Layton retained the residual functional capacity to perform a range of light work. The parties have fully briefed these issues and this case is ripe for resolution. For the reasons set forth below, we find, under the deferential standard of review which applies to Social Security ...

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