United States District Court, W.D. Pennsylvania
N. Bloch, United States District Judge
NOW, this 27th day of March, 2018, upon consideration of the
parties' cross-motions for summary judgment, the Court,
upon review of the Commissioner of Social Security's
final decision denying Plaintiff's claim for disability
insurance benefits under Subchapter II of the Social Security
Act, 42 U.S.C. § 401 et seq., and denying
Plaintiff's claim for supplemental security income
benefits under Subchapter XVI of the Social Security Act, 42
U.S.C. § 1381, et seq., finds that the
Commissioner's findings are supported by substantial
evidence and, accordingly, affirms. See 42 U.S.C.
§ 405(g); Jesurum v. Secretary of U.S. Department of
Health & Human Services, 48 F.3d 114, 117 (3d Cir.
1995); Williams v. Sullivan, 970 F.2d 1178, 1182 (3d
Cir. 1992), cert. denied sub nom., 507 U.S. 924
(1993); Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir.
1988). See also Berry v. Sullivan, 738 F.Supp. 942,
944 (W.D. Pa. 1990) (if supported by substantial evidence,
the Commissioner's decision must be affirmed, as a
federal court may neither reweigh the evidence, nor reverse,
merely because it would have decided the claim differently)
(citing Cotter v. Harris, 642 F.2d 700, 705 (3d Cir.
IT IS HEREBY ORDERED that Plaintiff's Motion for Summary
Judgment (document No. 9) is DENIED and that Defendant's
Motion for Summary Judgment (document No. 11) is GRANTED.
 The Court finds no merit in
Plaintiff's various arguments that the Administrative Law
Judge (“ALJ”) erred in finding him to be not
disabled, and finds that substantial evidence supports the
Plaintiff's arguments are somewhat intertwined,
but it is clear that he alleges that the ALJ erred by
affording insufficient weight to the opinions of his
consultative examiner, Lindsey Groves, Pys.D., and of two of
his treating physicians, Saghir Ahmad, M.D., and Gowri Arul,
M.D. He argues that these opinions support a finding that he
meets Listings 12.04 and 12.06, 20 C.F.R. pt. 404, subpt. P,
App. 1, and demonstrate that the residual functional capacity
(‘RFC”) and hypothetical question formulated by
the ALJ were insufficient, particularly in regard to
Plaintiff's post traumatic stress disorder. The Court
disagrees and finds that the ALJ adequately explained the
rationale for assigning weight to the opinion evidence as he
did, in finding that Plaintiff did not meet Listings 12.04
and 12.06, and in formulating Plaintiff's RFC.
It is true that when assessing a claimant's
application for benefits, the opinions of the claimant's
treating physicians generally are to be afforded significant
weight. See Fargnoli v. Massanari, 247 F.3d 34, 43
(3d Cir. 2001); Plummer v. Apfel, 186 F.3d 422, 429
(3d Cir. 1999). In fact, the regulations in place at the
relevant time provide that a treating physician's opinion
is to be given “controlling weight” so long as
the opinion is well-supported by medically acceptable
clinical and laboratory diagnostic techniques and not
inconsistent with other substantial evidence in the record.
20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2);
Fargnoli, 247 F.3d at 43; Plummer, 186 F.3d
at 429. (The Court notes that Sections 404.1527 and 416.927,
rather than Sections 404.1520c and 416.920c, apply since
Plaintiff's claims were filed before March 27, 2017.) As
a result, the ALJ may reject a treating physician's
opinion outright only on the basis of contradictory medical
evidence, and not on the basis of the ALJ's own judgment
or speculation, although he may afford a treating
physician's opinion more or less weight depending upon
the extent to which supporting explanations are provided.
See Plummer, 186 F.3d at 429.
It is also important to remember that:
The ALJ -- not treating or examining physicians or
State agency consultants -- must make the ultimate disability
and RFC determinations. Although treating and examining
physician opinions often deserve more weight than the
opinions of doctors who review records, “[t]he law is
clear . . . that the opinion of a treating physician does not
bind the ALJ on the issue of functional capacity[.]”
Brown v. Astrue, 649 F.3d 193, 197 n. 2 (3d
Cir.2011). State agent opinions merit significant
consideration as well.
Chandler v. Comm'r of Soc. Sec., 667 F.3d
356, 361 (3d Cir. 2011) (internal citations omitted in part).
Here, the ALJ included in his decision a substantial
discussion as to why he gave the weight that he did to the
various medical opinions. Substantial evidence supports his
findings in determining that Plaintiff did not meet Listings
12.04 and 12.06 and in formulating the RFC and hypothetical
question to the vocational expert (“VE”).
Plaintiff asserts that Dr. Groves, on February 19,
2016, opined that he satisfied the criteria to meet Listings
12.04 and 12.06 at Step Three of the sequential analysis,
specifically that he had marked restrictions in maintaining
social functioning and that he had four or more episodes of
decompensation, each of extended duration. (R. 513). (The
Court notes that Listings 12.04 and 12.06 were revised
significantly effective January 17, 2017. See
Revised Medical Criteria for Evaluating Mental Disorders, 81
F.R. 66138-01, 2016 WL 5341732 (Sept. 26, 2016). However,
this Court will review the ALJ's decision using the rules
in effect at the time the decision was issued. See
id. at 66138 n.1.) As the ALJ explained in his analysis
of this issue, in order to satisfy these listings as they
existed at the relevant time, Plaintiff's impairments
have to have resulted in at least two of four of the
following limitations: marked restriction of activities of
daily living; marked difficulties in maintaining social
functioning; marked difficulties in maintaining
concentration, persistence, or pace; or repeated episodes of
decompensation, each of extended duration. (R. 22).
See 20 C.F.R. pt. 404, subpt. P, App. 1,
§§ 12.04, 12.06 (2016). The ALJ further explained
that repeated episodes of decompensation, each of extended
duration, means three episodes within 1 year, or an average
of once every 4 months, each lasting for at least 2 weeks.
(R. 22-23). See 20 C.F.R. pt. 404, subpt. P, App. 1,
§ 12.00.C.4 (2016). While Dr. Groves does contend that
Plaintiff meets two of the four criteria, the ALJ thoroughly
discussed why he rejected both of these findings by Dr.
Groves, pointing out that such limitations are inconsistent
with Dr. Groves' own clinical findings, with her finding
that Plaintiff had a Global Assessment of Functioning
(“GAF”) score of 58, and with the records of Dr.
Ahmad and Jeffrey Turgeon, PA-C. (R. 23).
Indeed, even assuming the ALJ should have accepted Dr.
Groves finding of marked limitations in maintaining social
functioning, Dr. Groves' opinion regarding episodes of
decompensation simply does not line up with the requirements
of Listings 12.04 and 12.06. As the ALJ explained, to meet
the fourth criterion of these listings, there must be
evidence of three or more episodes of decompensation
in a single year, or an average of
once every four months, each lasting for at least two weeks.
(R. 22-23). The ALJ correctly pointed out at the hearing
that, Dr. Groves' opinion notwithstanding, the record
simply does not establish any such episodes, let alone four.
(R. 79-80). He asked for clarification from Dr. Groves as to
what she meant in regard to the opined episodes of
decompensation, and she indicated that she
“assumed” that such episodes had occurred, and
showed no awareness of the requirement for the episodes to
have occurred within a twelve-month period. (R. 520).
Therefore, Dr. Groves' opinion, and the other record
evidence, simply does not support that Plaintiff satisfied
this criterion and that he therefore met Listings 12.04 and
As to the impact of the opinion of Dr. Groves on the
formulation of the RFC and hypothetical question to the VE,
the ALJ likewise adequately explained the basis for factoring
Dr. Groves' opinion the way he did. As discussed above,
the ALJ remarked that Dr. Groves' opinion was
inconsistent with her own clinical findings, with her finding
that Plaintiff had a GAF score of 58, and with the other
objective medical record evidence. (R. 23, 33). He also noted
that Dr. Groves did not have a sustained treatment
relationship with Plaintiff, but rather performed a one-time
consultative examination at Plaintiff's counsel's
request. (R. 32). Despite all ...