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Miller v. Berryhill

United States District Court, M.D. Pennsylvania, Scranton

July 22, 2019

RUTH NADINE MILLER, now Ruth Nadine Nemeth, Plaintiff,
v.
NANCY A. BERRYHILL, Deputy Commissioner for Operations, performing the duties and functions not reserved to the Commissioner of Social Security, Defendant.

          REPORT AND RECOMMENDATION TO DENY PLAINTIFF'S APPEAL

          GERALD B. COHN, UNITED STATES MAGISTRATE JUDGE

         This matter is before the undersigned United States Magistrate Judge for a report and recommendation. Ruth Nadine Miller, now Ruth Nadine Nemeth, (“Plaintiff”) seeks judicial review of the Commissioner of the Social Security Administration's decision finding of not disabled. As set forth below, the undersigned recommends to DENY Plaintiff's appeal and AFFIRM the Commissioner's decision in this case.

         I. STANDARD OF REVIEW

         To receive disability or supplemental security benefits under the Social Security Act (“Act”), a claimant bears the burden to demonstrate an “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or 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); accord 42 U.S.C. § 1382c(a)(3)(A).

         The Act further provides that an individual:

shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.

42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B). Plaintiff must demonstrate the physical or mental impairment “by medically acceptable clinical and laboratory diagnostic techniques.” 42 U.S.C. §§ 423(d)(3), 1382c(a)(3)(D).

         Social Security regulations implement a five-step sequential process to evaluate a disability claim. 20 C.F.R. §§ 404.1520, 416.920. The process requires an Administrative Law Judge (“ALJ”) to decide whether an applicant (1) is engaged in “substantial gainful activity;” (2) suffers from a “severe medically determinable physical or mental impairment;” (3) suffers from “an impairment(s) that meets or equals one” listed in the regulation's appendix; (4) has a residual functional capacity (“RFC”) allowing for performance of “past relevant work;” and (5) can “make an adjustment to other work.” Rutherford v. Barnhart, 399 F.3d 546, 551 (3d Cir. 2005).

         If at any of the steps a determination exists that a plaintiff is or is not disabled, evaluation under a subsequent step is not necessary. 20 C.F.R. § 404.1520(a)(4). The claimant bears the burden of proof at steps one through four. See Rutherford, 399 F.3d at 551. If the claimant satisfies this burden, then the Commissioner must show at step five that jobs exist in the national economy that a person with the claimant's abilities, age, education, and work experience can perform. Id.

         In reviewing a decision of the Commissioner, the Court is limited to determining whether the Commissioner has applied the correct legal standards and whether the decision is supported by substantial evidence. See e.g., 42 U.S.C. § 405(g) (“Court shall review only the question of conformity with such regulations and the validity of such regulations”). Substantial evidence is a deferential standard of review. See Jones v. Barnhart, 364 F.3d 501, 503 (3d Cir. 2004). Substantial evidence “does not mean a large or considerable amount of evidence, but rather ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” Pierce v. Underwood, 487 U.S. 552, 565 (1988) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)); see also Johnson v. Commissioner of Social Sec., 529 F.3d 198, 200 (3d Cir. 2008). Substantial evidence is “less than a preponderance” and “more than a mere scintilla.” Jesurum v. Sec'y of U.S. Dep't of Health & Human Servs., 48 F.3d 114, 117 (3d Cir. 1995) (citing Richardson v. Perales, 402 U.S. 389, 401 (1971)).

         The Court may neither re-weigh the evidence nor substitute its judgment for that of the fact-finder. Rutherford, 399 F.3d at 552. The Court will not set the Commissioner's decision aside if it is supported by substantial evidence, even if the Court would have decided the factual inquiry differently. Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir.1999) (citing 42 U.S.C. § 405(g)).

         II. BACKGROUND

         A. Procedural History

         Plaintiff filed an application for Disability Insurance Benefits (“DIB”) pursuant to Title II of the Act and an application for Supplemental Security Income (“SSI”) pursuant to Title XVI of the Act in 2014, alleging disability since June 8, 2014. (Tr. 140-48). A hearing was held on September 29, 2016, in Wilkes-Barre, Pennsylvania before an ALJ. Plaintiff, her fiancé at the time, and a vocational expert (“VE”) testified at the hearing. (Tr. 59-92). On November 22, 2016, the ALJ issued a decision finding Plaintiff not disabled. (Tr. 7-31). In July 2017, the Appeals Council denied Plaintiff's request for review (Tr. 1-6), making the ALJ's decision the Commissioner's final decision for purposes of judicial review. See 20 C.F.R. §§ 416.1481; 422.210(a). This action followed.

         III. ISSUES AND ANALYSIS

         On appeal, Plaintiff alleges three errors: (1) whether the ALJ erred in finding Plaintiff has the RFC to perform light work; (2) whether Plaintiff has an impairment or combination of impairments that meets or medically equals one of the listed impairments under 20 C.F.R. Part 404, Subpart P, Appendix 1; and (3) whether the ALJ erred when she determined Plaintiff could perform work in the national economy. (Pl. Br. at 3) (Doc. 8).

         A. RFC to Perform Light Work

         Plaintiff contends the ALJ erred in finding Plaintiff had the RFC to perform light work. (Pl. Br. at 3-5). In the decision, the ALJ found Plaintiff had the following severe impairments prior to crafting the RFC: “The claimant has the following severe impairments: cervical and lumbar degenerative disc disease, polyneuropathy, migraines, anxiety-related disorders, affective disorders, hepatitis C, and degenerative joint disease of the knees ...” (Tr. 12). Following a review of the medical evidence and testimony, the ALJ found Plaintiff had the RFC to perform: “light work ... that is unskilled in nature, does not involve detailed instructions, and is confined to routine and repetitive work with no more than occasional contact with the public and supervisors.” (Tr. 15). Plaintiff contends the ALJ erred by finding an RFC to perform light work, when these physical and mental impairments render her unable to perform competitive full-time work on a continued and sustained basis in any exertional category. (Pl. Br. at 4).

         1. Medical Evidence of Record

         Plaintiff contends the ALJ erred in evaluating the medical evidence of record. (Pl. Br. at 3-5). In the decision, the ALJ made the following observations regarding the medical evidence of record:

The record contains medical evidence from before June 8, 2014, which the [ALJ] considered in determining what the claimant's limitations were as of the alleged disability onset date. The claimant was referred to WellSpan Health by her primary care physician for a psychiatric evaluation in February 2008. The claimant reported experiencing a longstanding history of anxiety, occasional panic, and intermittent explosiveness, and Gary Zimberg, M.D. prescribed Lexapro. The claimant followed up with Dr. Zimberg through March 2009. Dr. Zimberg noted that the claimant was doing “significantly better” in April 2008, and the claimant stated in May 2008 that she no longer felt out of control with treatment …The claimant visited the Reading Hospital emergency room in November 2009 and received treatment with medication for her reports of anxiety, panic attacks, depression, back pain, and migraines after she ran out of medication for a month. Over three years later, the claimant visited the Schuylkill Medical Center emergency room in August 2012 and reported experiencing chronic back pain. An x-ray of the claimant's lumbar spine showed no fracture with grade 2 spondylolistheses L5 on S1. The claimant was assessed with chronic low back pain and received prescriptions for Vicodin. The claimant returned to Schuylkill Medical center in October 2012 and reported experiencing back and pelvic pain. The claimant exhibited pain with palpitation over her lumbar area as well as negative straight leg raising, intact sensation, and muscle strength at a level of five out of five. Ngan Nguyen, PA-C noted that the claimant was a “very vague historian, ” assessed the claimant with chronic back pain, and prescribed ibuprofen as needed for pain. Nine months later, the claimant visited Cornerstone Coordinated Health Care in July 2013 and reported experiencing back and neck pain as well anxiety, panic attacks, and headaches. James Greenfield, D.O., prescribed … meloxicam … tramadol … and … Zoloft. Dr. Greenfield adjusted the claimant's medications to acetaminophen-hydrocodone, Prozac, and Ultram in October 2013, and the claimant reported that her medications were working well in November 2013, her mood was good, and she was doing well overall … The claimant reported experiencing back pain and headaches when she returned in May 2014, her physical examination findings were normal, and Dr. Greenfield refilled the claimant's medications and referred her for pain management treatment and to a neurologist for evaluation of migraines. The claimant's examination findings were normal in a follow-up appointment later in May 2014.
When the claimant returned to Cornerstone Coordinate health care on June 18, 2014, she reported that her car had broken down, she had just lost her job, she was under a lot of stress, she was “really depressed, ” and she had had two outbursts. The claimant was in no acute distress upon examination and exhibited a flat affect. Dr. Greenfield prescribed Prozac, Ultram, acetaminophen-hydrocodone, and Xanax. The claimant requested help with filling out disability forms in a follow-up appointment five days later on June 25, 2014. The claimant's mood was good, she was in no distress, and her physical examination findings were normal.
The claimant visited Uchenna Uzoukwu, M.D. on July 9, 2014 for a psychiatric evaluation. The claimant reported experiencing depression and anxiety and stated that she was sleeping a lot and was having a hard time talking to people and expressing her emotions … Dr. Uzoukwu assessed the claimant with major depressive disorder and post-traumatic stress disorder. Dr. Greenfield renewed the claimant's prescriptions for Ultram, Mobic, Prozac, Xanax, and acetaminophen-hydrocodone on July 17, 2014. Dr. Uzoukwu noted that the claimant was “doing much better” on [the medication] Geodon, was sleeping better at night, was much less depressed and anxious …
Mark Lentz, M.D. noted that the claimant's mental health issues were “well-controlled” and recommended using hydrocodone … in combination with physical therapy as well as sumatriptan for her migraine headaches. When the claimant returned in September 2014, she reported that sumatriptan had been very effective for her migraines, her generalized anxiety disorder was well-controlled, and her bipolar affective disorder was stable. The claimant also reported experiencing a panic attack while at the races with her boyfriend, though Michelle Kwiec, LSW, noted that the claimant had forgotten to take her Geodon that day, and the claimant's symptoms were consistent with symptoms of withdrawal from Geodon.
The claimant returned to the Geisinger Health Clinic again on October 13, 2014, and reported that her pain had improved … she experienced about seven migraines over the previous month, and her migraines were not as intense and did not last as long as they did in the past. The claimant also reported feeling anxious and restless during the day and requested and adjustment in her medication. Dr. Lentz prescribed … Buspar … to treat the claimant's anxiety further. Two days later, the claimant reported to Dr. Uzoukwu that she was feeling “much better” with Buspar, was no longer having frequent anxiety attacks, and denied any depressive symptoms or disturbance of sleep or appetite …
The claimant underwent physical therapy at Schuylkill Rehabilitation Center from October 22, 2014 to February 25, 2015 for cervical and lumbar degenerative disc disease and bilateral knee osteoarthritis. The claimant visited Dr. Lentz in November 2014 and reported experiencing increased pain after tripping over a space heater in her home … Dr. Lentz … urged her to seek counseling for her anxiety.
The claimant visited Michael Haak, M.D. at the Geisinger Medical Center Orthopedic Spine Surgery Clinic on November 24, 2014. The claimant reported experiencing chronic neck pain, mid-back pain, and lower back pain. Upon examination, the claimant was in no apparent distress, her gait was normal, and she exhibited diffuse spinal tenderness with reduced range of motion. An MRI of the claimant's spine showed chronic bilateral L5 pars defects with grade 2 anterolisthesis of L5 on S1 with associated severe disc space disorder; moderate disc disorder at ¶ 4-L5; and moderate to severe disc space disorder at ¶ 4-C5 with moderate disc space disorder at ¶ 3-C4 and C5-C6. Dr. Haak assessed the claimant with cervicalgia, cervical degenerative disc disease, lumbago, lumbar degenerative disc disease, lumbar spondylosis, and lumbar spondylolisthesis. Dr. Haak explained that while surgical treatment was available, it would have “minimal impact” on the claimant's overall pain complaints. Dr. Haak advised the claimant that she would need to quit smoking to have “any kind of chance of success” from surgery and that she could return after quitting smoking.
The claimant visited Nicole Purcell, D.O. at the Schuylkill Medical Group Neurology Clinic on December 4, 2014. The claimant reported experiencing headaches since she was 13 years old, stated that her pain was worsening, and described associated symptoms of flashing lights, photophobia, dizziness, and nausea. The claimant stated that her headaches last approximately three days without medication and stated that Excedrin and Imitrex worked equally well, though her headaches returned after her medication wore off, and she stated that her headaches were severe enough to warrant daily prophylactic treatment. Dr. Purcell examined the claimant and observed … muscle strength was at a level of five out of five in her upper and lower extremities … Dr. Purcell assessed the claimant with migraine headaches, prescribed Depakote for migraine prophylaxis, and advised her to quit smoking tobacco.
The claimant reported that … her medication was making her worse during her December 10, 2014 visit with Dr. Uzoukwu … [the doctor] stopped her prescription for Geodon, and continued her on Prozac and Depakote. The claimant reported feeling “much calmer” when she returned later in December 2014 was unremarkable …
The claimant underwent a psychiatric evaluation with Samuel Garloff, D.O. later in March 2015 … Dr. Garloff assessed the claimant with bipolar disorder, rule out PTSD. Dr. Garloff prescribed low dose … (Risperdal) for the claimant.
The claimant underwent a consultative EMG and nerve conduction study on March 20, 2015. The claimant ambulated with a single point cane in her left hand and exhibited negative straight leg raising bilaterally … the study showed left L5 radiculopathy with limited acute and chronic neurogenic changes … The claimant visited Moin Mallhi, M.D. at Columbia Pain Management in April 2015 and reported experiencing pain in her back, upper and lower extremities, and neck as well as headaches. The claimant reported that she … had applied for Social Security disability, and reported that her main goals in seeking treatment were to eliminate or reduce her pain, reduce her medication use, feel less depressed, learn to relax better, and “get disability payments.” The claimant reported that her pain was at a level of nine to ten out of ten in severity. However, the claimant entered the examination room walking normally, moved about normally, and appeared to be in “mild to moderate pain” upon examination. The claimant's muscle mass was well built and equal on both sides, her heel walking and toe walking were normal, and straight leg raising was negative … Dr. Mallhi prescribed oxycodone, advised the claimant to stop using hydrocodone, and prescribed Neurotine to control the neuropathic component of the claimant's pain … The claimant reported that her lower back and sacral area pain felt significantly better in May 2015 follow up appointments, and Dr. Mallhi continued her medications. In June 2015, the claimant reported that her overall pain level had “significantly improved, ” she had been able to perform her routine activities in “much less pain, ” and she was happy with the result of her treatment …
The claimant visited Dr. Garloff in July 2015 and reported having positive results from risperidone. Dr. Garloff noted that the claimant's mental status examination was essentially within normal limits. The claimant continued to report significant improvement in her pain with medication later in July 2015 when she met with Dr. Mallhi. Dr. Garloff noted that the claimant continued to do well with normal mental status examination findings in August 2015. The claimant reported an increased in her pain in August and October 2015 visits with Dr. Mallhi. Dr. Mallhi prescribed oxycodone, Neurontin, Soma, and Xanax, and the claimant reported in November 2015 that her overall pain was adequately controlled with some episodic worsening and she was able to perform her daily routine activities with better pain control. Dr. Garloff also noted in late November 2015 that the claimant's presentation and mental status was “entirely within normal limits, ” and he continued her prescriptions …
The claimant continued to follow up with Dr. Mallhi in 2016 for pain management. The claimant underwent physical therapy from June 2016 to August 2016 after reporting an increased in her lumbar pain. However, the claimant reported improvement in her symptoms with physical therapy, and she reported in March, April, and June 2016 visits with Dr. Mallhi that her pain was adequately controlled and she was able to perform her daily routine activities …
A September 2016 lumbar MRI showed Grade I approaching Grade II spondylolisthesis of L5 on S1 with associated posterior and bilateral lateral disc herniation leading to moderate severity bilateral neural foraminal stenosis with the disc material abutting the exiting L5 nerve roots. The lumbar MRI also showed degenerative endplate osteophytes and posterior and right lateral disc bulging / protrusion leading to mild to moderate severity right-sided neural foraminal stenosis with the disc material likely abutting the exiting right L4 nerve root …
Turning to the opinion evidence, the [ALJ] gives significant weight to the September 2014 opinion of State Agency medical consultant John Gavazzi, Psy.D. Dr. Gavazzi opined that the claimant has no restriction of activities of daily living, moderate difficulties in maintaining social functioning and concentration, persistence, or pace, and no repeated episodes of decompensation of extended duration. Dr. Gavazzi further opined that the claimant can understand, retain, and follow simple job instructions, can perform simple, routine, repetitive tasks in a stable environment, can make decisions, can maintain regular attendance and be punctual, can carry out very short and simple instructions, can maintain socially appropriate behavior, and can perform the personal care functions needed to maintain an acceptable level of personal hygiene. Dr. Gavazzi is a non-treating, non-examining medical source who based his opinion upon a thorough review of the available medical records and a comprehensive understanding of agency rules and regulations. The [ALJ] finds that his opinion is internally consistent and well supported by a reasonable explanation. The available evidence, which demonstrates that the claimant's mental impairments respond favorably to treatment and her mental status examination findings were good without evidence of memory impairment in her recent treatment records, also supports his opinion. As such, the [ALJ] affords this opinion significant weight …
The [ALJ] gives little weight to the restrictions in the claimant's functioning from 2005, including Albert Cecchini, D.O.'s November 2005 opinion limiting the claimant to sedentary work. These restrictions precede the claimant's requested disability onset date by almost ten years, are remote in time from the current application, and are inconsistent with the claimant's treatment records within the relevant period. Therefore, they receive little weight.

(Tr. 16-24). The ALJ reviewed the medical evidence to evaluate the RFC. In summary, the ALJ noted in November 2009, Plaintiff went to the emergency room and received treatment with medication for her reports of anxiety, panic attacks, depression, back pain, and migraines after she ran out of medication for a month. (Tr. 17). Over three years later, in August 2012, Plaintiff returned to the emergency room and reported experiencing chronic back pain. Id. Plaintiff was assessed with chronic low back pain and received prescriptions for Vicodin. Id. In October and November 2013, Plaintiff reported her medications were working well, her mood was good, and she was doing well overall. Id. In May 2014, Plaintiff reported back pain and headaches when she returned, but her physical examination findings were normal. Id. In July 2014, Plaintiff had a psychiatric evaluation with Dr. Uzoukwu, who assessed Plaintiff with major depressive disorder and post-traumatic stress disorder. (Tr. 17-18). Dr. Uzoukwu noted Plaintiff was “doing much better” on the medication, was sleeping better at night, was much less depressed and anxious. (Tr. 18). In September 2014, Mark Lentz, M.D. noted Plaintiff reported sumatriptan had been very effective for her migraines, her generalized anxiety disorder was well-controlled, and her bipolar affective disorder was stable. Id. In November 2014, following an MRI of Plaintiff's spine, Dr. Haak assessed Plaintiff with cervicalgia, cervical degenerative disc disease, lumbago, lumbar degenerative disc disease, lumbar spondylosis, and lumbar spondylolisthesis. (Tr. 19). Dr. Haak explained while surgical treatment was available, it would have “minimal impact” on Plaintiff's overall pain complaints. Id. On March 20, 2015, Plaintiff ambulated with a single point cane in her left hand and exhibited negative straight leg raising bilaterally and underwent a consultative EMG and nerve conduction study, which showed left L5 radiculopathy with limited acute and chronic neurogenic changes. (Tr. 20). In April 2015, Plaintiff reported to Dr. Mallhi she had applied for Social Security disability, and her main goals in seeking treatment were to eliminate or reduce her pain, reduce her medication use, feel less depressed, learn to relax better, and “get disability payments.” Id. Plaintiff reported the pain in her back, upper and lower extremities, and neck as well as headaches were a level of nine to ten out of ten in severity. Id. However, Dr. Mallhi noted Plaintiff entered the examination room walking normally, moved about normally, and appeared to be in “mild to moderate pain” upon examination. Id. Plaintiff's muscle mass was well built and equal on both sides, her heel walking and toe walking were normal, and straight leg raising was negative. Id. In June 2015, Plaintiff reported to Dr. Mallhi her overall pain level had “significantly improved, ” she had been able to perform her routine activities in “much less pain, ” and she was happy with the result of her treatment. (Tr. 21). In November 2015, Plaintiff reported to Dr. Mallhi her overall pain was adequately controlled with some episodic worsening and she was able to perform her daily routine activities with better pain control. Id. In late November 2015, Dr. Garloff also noted Plaintiff's presentation and mental status was “entirely within normal limits.” Id. From June 2016 to August 2016, Plaintiff underwent physical therapy after reporting an increased in her lumbar pain. Id. In the March, April, and June 2016 visits with Dr. Mallhi, Plaintiff reported improvement in her symptoms with physical therapy and her pain was adequately controlled and she was able to perform her daily routine activities. Id.

         As for opinions in the record, the ALJ gave significant weight to the September 2014 opinion of State Agency medical consultant John Gavazzi, Psy.D. (Tr. 23). Dr. Gavazzi opined Plaintiff has no restriction of activities of daily living, moderate difficulties in maintaining social functioning and concentration, persistence, or pace, and no repeated episodes of decompensation of extended duration. Id. Dr. Gavazzi further opined Plaintiff can understand, retain, and follow simple job instructions, can perform simple, routine, repetitive tasks in a stable environment, can make decisions, can maintain regular attendance and be punctual, can carry out very short and simple instructions, and can maintain socially appropriate behavior. Id. See 20 C.F.R. § 404.1527(e)(2)(i) 20 C.F.R. § 416.927(e)(2)(i) (state agency medical consultants “are highly qualified physicians, psychologists, and other medical specialists who are also experts in Social Security disability evaluation); § 404.1527(e)(2)(ii) (ALJ should evaluate a state agency medical consultant's opinion using the factors set forth in 20 C.F.R. § 404.1527(a)-(d)); § 404.1527(c)(4) (ALJ must consider whether an opinion is consistent with the record as a whole); and § 404.1527(c)(3) (opinions receive weight based on their supportability). “Furthermore, the ALJ relied upon the state agency expert opinions in making this disability determination, a course of action that is authorized by law particularly when that state opinion draws significant support from the clinical record, as did the opinion of [the State Agency doctor] in this case.” Michael v. Berryhill, No. 3:16-CV-00658, 2018 WL 279095, at *7 (M.D. Pa. Jan. 3, 2018) (citing Chandler v. Comm'r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).

         As for the November 2005 opinion from Albert Cecchini, D.O., the ALJ gave little weight to the restrictions limiting Plaintiff to sedentary work. (Tr. 23-24). The ALJ noted these restrictions preceded Plaintiff's requested disability onset date by almost ten years, were remote in time from the current application, and were inconsistent with Plaintiff's treatment records within the relevant period. Id. Moreover, Plaintiff did not argue in her brief the ALJ erred in rejecting Dr. Cecchini's opinion from November 2005. (See generally Pl. Br. 3-7). In September 2017, the Middle District of Pennsylvania summarized Plaintiff's burden to present evidence of disability:

The Act and controlling regulations make clear that while an ALJ has a duty to develop the record, the burden is always on Plaintiff to present evidence of her disability. 42 U.S.C. § 423(d)(5)(A); 20 C.F.R. §§ 404.1512(a), 416.912(a)). It is the plaintiff's responsibility to provide medical and other evidence upon which the Commissioner can base a decision. See, e.g., Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987). The ALJ has the duty to develop the record sufficiently to make a determination of disability, Ventura v. Shalala, 55 F.3d 900 (3d Cir. 1995); 20 C.F.R. § 416.912(d), but the duty does not come into play where the record contains adequate evidence to make a determination. While an ALJ must undertake this duty “with special care” in situations where the claimant is unrepresented, Dobrowolsky v. Califano, 606 F.2d 403, 407 (3d Cir. 1979), district courts have concluded that “[w]hen an applicant for social security benefits is represented by counsel the administrative law judge is entitled to assume that the applicant is making his strongest case for benefits.” Yoder v. Colvin, No. 13-cv-107, 2001 WL 2770045, *3 (W.D. Pa. June 18, 2014) (citing Lofland v. Astrue, No. 12-624, 2013 WL 3929795, at *17 (D. Del. July 24, 2013)).

Jacobs v. Berryhill, No. 3:17-CV-271, 2017 WL 4284385, at *6 (M.D. Pa. Sept. 27, 2017). In this case, Plaintiff has been represented by counsel, and thus, Plaintiff has the burden to present evidence of disability.

         Plaintiff argues her treating psychiatrist, Dr. Uchenna Uzoukwu, M.D. diagnosed her with major depressive disorder, recurrent, severe, PTSD, polysubstance abuse r/o dependence, polyneuropathy, chronic pain, chronic sinusitis, arthritis, and unemployment with a GAF of 45-50. (Pl. Br. at 5) (citing Tr. 273-77). The ALJ made the following observations regarding the GAF scores in the record:

The [ALJ] gives little weight to the GAF scores assigned to the claimant. Dr. Zimberg assigned the claimant a GAF score of 55 in February 2008, indicating moderate symptoms or moderate difficulty in functional. Dr. Garloff assigned the claimant a GAF score of 50 to 55 in April 2015, indicating serious to moderate symptoms or difficulty in functioning. A GAF score is a mere snapshot of the claimant's ability to function at the particular time of the assessment that includes factors such as legal, housing, or financial problems that are not properly part of the disability analysis under the Social Security Act. Therefore, these GAF scores receive little weight.

(Tr. 24). Moreover, the ALJ accounted for Plaintiff's mental limitations; as the ALJ limited Plaintiff to work “that is unskilled in nature, does not involve detailed instructions, and is confined to routine and repetitive work with no more than occasional contact with the public and supervisors.” (Tr. 15). The ALJ based the RFC on Plaintiff's limitations established in the record. “[T]he ALJ need only include those limitations that are supported by evidence of record.” Moody v. Barnhart, 114 Fed.Appx. 495, 502 (3d Cir. 2004) (citing Chrupcala v. Heckler, 829 F.2d 1269, 1276 (3d Cir. 1987). Substantial evidence supports the ALJ's decision.

         2.Plaintiff's Testimony

         Plaintiff contends the ALJ erred in not considering her testimony. (Pl. Br. at 2-3). In the decision, the ALJ made the following ...


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