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Kline v. Saul

United States District Court, M.D. Pennsylvania

September 9, 2019

TONI KLINE, Plaintiff
ANDREW SAUL, Commissioner of Social Security, Defendant

          Conner, Chief Judge


          Martin C. Carlson, United States Magistrate Judge

         I. Introduction

         Toni Kline is a disability claimant, a younger worker who was approximately 33 years old at the time of the alleged onset of her disability. Kline's disabilities were emotional in nature and consisted of bipolar disorder, major depressive disorder, and a generalized anxiety disorder.

         With respect to these impairments, the record before the Administrative Law Judge (ALJ) was marked by contrasting and inconsistent themes. Thus, while several treating sources opined that Kline's impairments were totally disabling, Kline's treatment records described these conditions as episodic and fluctuating in their severity. These treatment records also indicated that there were times when Kline experienced improvement in her mental state and that her emotional declines were related to outside stressors. Further, notwithstanding her emotional impairments, treatment records disclosed that Kline displayed logical thoughts processes, was cooperative with caregivers, and treating sources frequently documented essentially normal clinical findings for Kline. Moreover, with only a few exceptions, global assessment of functioning, or GAF, assessments of Kline made over the span of six years by her treating physicians documented only a moderate degree of emotional impairment. Given this mixed treatment history, a state agency expert opined that Kline could still work notwithstanding her psychiatric state. Finally, Kline described her activities of daily living in terms which were not consistent with a claim that she was totally disabled.

         Presented with this conflicting evidence, the ALJ concluded that Kline could still perform simple tasks despite her emotional impairments. Kline now challenges this decision on appeal, but as the Supreme Court has recently underscored, we employ a limited scope of review when considering Social Security appeals. Our task is simply to determine whether substantial evidence supports the ALJ's decision. On this score:

The phrase “substantial evidence” is a “term of art” used throughout administrative law to describe how courts are to review agency factfinding. T-Mobile South, LLC v. Roswell, 574 U.S. __, __, 135 S.Ct. 808, 815, 190 L.Ed.2d 679 (2015). Under the substantial-evidence standard, a court looks to an existing administrative record and asks whether it contains “sufficien[t] evidence” to support the agency's factual determinations. Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) (emphasis deleted). And whatever the meaning of “substantial” in other contexts, the threshold for such evidentiary sufficiency is not high. Substantial evidence, this Court has said, is “more than a mere scintilla.” Ibid.; see, e.g., Perales, 402 U.S. at 401, 91 S.Ct. 1420 (internal quotation marks omitted). It means-and means only-“such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Consolidated Edison, 305 U.S. at 229, 59 S.Ct. 206. See Dickinson v. Zurko, 527 U.S. 150, 153, 119 S.Ct. 1816, 144 L.Ed.2d 143 (1999) (comparing the substantial-evidence standard to the deferential clearly-erroneous standard).

Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019).

         Mindful of the fact that substantial evidence “means only-‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion,' ” Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019), we find that substantial evidence supported the ALJ's findings in this case. Therefore, for the reasons set forth below, we recommend that the district court affirm the decision of the Commissioner denying this claim.

         II. Statement of Facts and of the Case

         On May 10, 2016, Toni Kline applied for disability and supplemental security income benefits pursuant to Title II and Title XVI of the Social Security Act, alleging that she had become totally disabled beginning in February of 2009 due to depression which she experienced. (Tr. 17.) Kline was 33 years old at the time of the alleged onset of her disability, making her a younger worker under the Commissioner's regulations. She also was a high school graduate and possessed an associate degree in computer science. (Tr. 27, 38.)

         Kline's presenting medical concerns were psychiatric and consisted of bipolar disorder, major depressive disorder, and a generalized anxiety disorder. (Tr. 19.) Kline had been treated for these conditions for the past ten years. As a result, there was a substantial body of treatment records relating to Kline's depression and related emotional impairments available for consideration by the ALJ.

         These records revealed that Kline briefly received in-patient treatment for these conditions in November of 2008. (Tr. 470-90.) At the time of her admission, Kline was severely depressed and was determined to have a Global Assessment of Functioning, or GAF score, of 25.[1] However, upon her discharge Kline's emotional state had improved significantly and her GAF score was rated at 55. (Id.) Over the ensuing decade, Kline was routinely seen by mental health professionals on an outpatient basis and her depression was treated through counseling and medication. (Tr. 262-319, 758-825.) During this span of years these mental health professionals provided multiple GAF evaluations for Kline. With two isolated exceptions, [2] these GAF scores fell within a range of 51 to 60, [3] scores which merely “indicate[d] moderate impairment in social or occupational functioning.” Cherry v. Barnhart, 29 F. App'x. 898, 900 (3d Cir. 2002).

         The treatment narratives which accompanied these clinical encounters also described periods of depression which were episodic, moderate, and marked by fluctuations. In fact, Kline often reported that her medications were helping, and stated that she was doing fairly well or feeling some improvement. (Tr. 398, 415, 436.) Kline also reported on occasion that her mood was stable, and her anxiety was not too bad. (Tr. 443, 452.) In other instances where Kline reported a decline in her emotional state, that decline was tied to some specific stressors such as family conflicts. (Tr. 412, 418.) Thus, Kline's treatment history and records generally described a moderate degree of emotional impairment, which frequently showed signs either of improvement or stabilization with treatment.

         This treatment history, however, was interpreted by medical professionals in two very different ways. At the outset, a state agency expert, Dr. Michael Suminski, found, based upon a review of this treatment history, that Kline was moderately impaired in her ability to understand detailed instructions and maintain attention and concentration for extended periods, but concluded that she could make simple decisions and perform simple, repetitive tasks. (Tr. 59-62.) Therefore, Dr. Suminski determined that Kline's emotional impairments were not disabling. (Id.) In contrast, Dr. Johar Shah, one of Kline's treating physicians, drew upon the same body of clinical records to conclude that Kline suffered from marked and extreme emotional impairments which rendered her unable to work. (Tr. 895-903.) In turn, Sharon Hill, a counsellor who had been treating Kline, opined in December of 2017 that Kline's emotional impairments resulted in moderate or marked limitations-a conclusion which was more benign than Dr. Shah's findings but more severe than the conclusions reached by Dr. Suminski, the state agency expert. (Tr. 988-96.)

         The question of the degree to which Kline's emotional impairments were wholly disabling was further clouded by Kline's testimony at the hearing held before the ALJ on January 25, 2018. At that hearing, Kline testified in a fashion which suggested that she retained the ability to perform a range of functions, stating that she was able to dress, shower, cook, shop, do laundry, vacuum, occasionally drive, care for her daughter and grandfather, and attend school functions. (Tr. 39-43.)

         It was against this clinical backdrop that a hearing was held on this disability application on January 25, 2018. (Tr. 34-53.) At this hearing, the plaintiff and a Vocational Expert both testified. (Id.) Following this hearing, on April 11, 2018, the ALJ issued a decision denying this application for benefits. (Tr. 14-33.) In that decision, the ALJ first concluded that Kline met the insured status requirements of the Act through September 2013, and had not engaged in substantial gainful activity since the date of the alleged onset of her disability in 2009. (Tr. 19.) At Step 2 of the sequential analysis that governs Social Security cases, the ALJ found that Kline suffered from the following severe impairments: bipolar disorder, major depressive disorder, and a generalized anxiety disorder. (Tr. 19.) At Step 3, the ALJ determined that Kline faced moderate limitations in terms of concentration, persistence, and maintaining pace at work, but found none of her emotional impairments met or medically equaled the severity of one of the listed impairments. (Tr. 20-22.)

         Between Steps 3 and 4, the ALJ fashioned the following residual functional capacity (“RFC”) assessment for Kline:

[T]he claimant has the residual functional capacity to perform a full range of work at all exertional levels but with the following nonexertional limitations: Work is limited to simple, routine repetitive tasks involving simple work[-]related decisions with few, if any, workplace changes.

(Tr. 22.)

         In making this simple tasks RFC determination, the ALJ extensively discussed and weighed the clinical and opinion evidence. (Tr. 22-26.) At the outset, the ALJ considered Kline's statements regarding the severity of her physical and emotional distress. While the ALJ credited these statements, in part, the ALJ found that the statements concerning the intensity, persistence, and limiting effect of these symptoms were not entirely consistent with the medical record. (Tr. 24.) On this score, the ALJ's review of Kline's treatment history disclosed “multiple notations” which were not consistent with her assertion of totally disabling emotional impairment. (Id.) These notations included Kline's reports of stable moods, as well as periodic reports by Kline that her condition had improved. (Id.) The ALJ also cited Kline's self-reported activities of daily living, which included cooking, cleaning, driving, shopping, caring for others, and performing household tasks, as evidence of her ability to perform some sustained activity. (Tr. 25.)

         The ALJ's decision then considered the competing medical opinions of Dr. Suminski, Dr. Shah, and Counselor Hill. (Tr. 25-26.) At the outset, the ALJ gave significant weight to the judgment of the state agency expert, Dr. Suminski, that Kline did not suffer from completely disabling emotional impairments. (Tr. 25.) The ALJ found this opinion credible because it was rendered by an agency expert and was consistent with Kline's treatment records. (Id.)

         The ALJ afforded less weight to the opinions of Dr. Shah and Counselor Hill, finding that these opinions were inconsistent with Kline's treatment records. (Tr. 26.) Likewise, the ALJ gave less weight to the various GAF scores, noting that the GAF has been abandoned by the medical community as a psychometric benchmark, and only provided a limited picture of Kline's functioning on specific dates in the past. (Id.)

         Having arrived at this residual functional capacity (RFC) assessment based upon an evaluation of these clinical records and various medical opinions, the ALJ found at Step 5 that, while Kline could not return to her prior occupations, there were other simple task jobs in the national economy that she could perform. (Tr. 27-28.) Accordingly, the ALJ concluded that Kline did not meet the stringent standard for disability set by the Act and denied her disability claim. (Id.) This appeal followed. (Doc. 1.)

         On appeal, Kline asserts three claims. First, she argues that the ALJ erred in failing to give greater weight to the opinion of Dr. Shah, Kline's treating physician. Kline then advances a closely related argument, contending that if Dr. Shah's opinion was given greater weight, then at Step 3, Kline should have been found to have been per se disabled. Finally, Kline asserts that the ALJ's limitation of Kline to simple, routine, repetitive tasks involving simple work-related decisions with few, if any, workplace changes as a matter of law did not fully account for the plaintiff's moderate emotional impairments.

         This case is fully briefed and is therefore ripe for resolution. For the reasons set forth below, under the deferential standard of review that applies here, we recommend that the court affirm the decision of the Commissioner.

         III. Discussion

         A. Substantial Evidence Review - the ...

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