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Lyons v. Berryhill

United States District Court, W.D. Pennsylvania

August 29, 2019

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


          Alan N. Bloch United States District Judge.

         AND NOW, this 29th day of August, 2019, 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., 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. 1981)).[1]

         Therefore, IT IS HEREBY ORDERED that Plaintiff's Motion for Summary Judgment (document No. 7) is DENIED and that Defendant's Motion for Summary Judgment (document No. 14) is GRANTED.



[1] Plaintiff argues that the Administrative Law Judge (“ALJ”) erred in formulating her residual functional capacity (“RFC”) because he failed to properly evaluate the medical opinion evidence in this matter. In the alternative, Plaintiff argues that the case should be remanded to the Commissioner on the basis of new evidence pursuant to sentence six of 42 U.S.C. § 405(g). The Court disagrees and finds that substantial evidence supports the ALJ's decision that Plaintiff is not disabled and that remand is not warranted on the basis of the proffered new evidence.

Plaintiff first asserts that the ALJ erred in not giving sufficient weight to the opinions of her treating physician, Uma Purighalla, M.D. (R. 342, 344, 476-78, 480-83, 504, 512, 519-20, 533-34) in formulating her RFC. Plaintiff is, of course, correct that when assessing a claimant's application for benefits, the opinion of the claimant's treating physician generally is 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 provide that for claims, such as this one, filed before March 27, 2017, 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); Fargnoli, 247 F.3d at 43; Plummer, 186 F.3d at 429. 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. However, 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, Plaintiff argues that the ALJ erred in not adopting the limitations to which Dr. Purighalla opined at various points in the record, which were substantially more restrictive than those included in the RFC. However, the ALJ discussed Dr. Purighalla's opinions in substantial detail and provided a sufficient basis for giving the opinions little weight. Specifically, he discussed Dr. Purighalla's lack of expertise, inconsistencies between Dr. Purighalla's opinions and the medical record, internal inconsistencies among the opinions, and the fact that Dr. Purighalla had included a number of serious restrictions that had no record support whatsoever. (R. 36-37). The ALJ also pointed out that Dr Purighalla's opinions were inconsistent with those of Dr. Alexander Kandabarow (R. 780) and Paul Fox, M.D. (R. 91-103, 104-16), the state reviewing agent. In fact, the ALJ assigned only partial weight to these opinions, finding Plaintiff to be more limited than opined by Drs. Kandabarow and Fox. (R. 36-37). In essence, then, the ALJ did precisely what he was supposed to do - weigh and consider the various opinions, in light of the evidence, in determining Plaintiff's RFC. The Court notes that the ALJ also discussed Plaintiff's inconsistent treatment, her lack of compliance with treatment, and her activities of daily living, supporting his findings with citations to the record. (R. 36-37). In light of all of this, the Court finds the ALJ's consideration of the medical opinions and his formulation of the RFC to be supported by substantial evidence.

As noted, Plaintiff alternatively argues that the case should be remanded to the Commissioner for further consideration in light of new evidence - specifically a Functional Capacity Evaluation completed by NovaCare on May 8, 2018. (R. 7-20). The Appeals Council declined to consider this evidence in reviewing the ALJ's decision (R. 2), which Plaintiff contends was in error.

It is well-established that evidence that was not before the ALJ cannot be considered by a district court in its determination of whether or not the ALJ's decision was supported by substantial evidence. See Matthews v. Apfel, 239 F.3d 589, 594 (3d Cir. 2001); Chandler v. Commissioner of Soc. Sec., 667 F.3d 356, 360 (3d Cir. 2011). Accordingly, the Court cannot rely on any records not submitted to the ALJ in making its determination here. As discussed herein, based on the record before the ALJ at the time he issued his decision, substantial evidence supported his finding that Plaintiff was not disabled.

However, a district court can remand a case on the basis of new evidence under sentence six of 42 U.S.C. § 405(g). Section 405(g) provides, in relevant part:

[The court] may at any time order additional evidence to be taken before the Commissioner of Social Security, but only upon a showing that there is new evidence which is material and that there is good cause for failure to incorporate such ...

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