United States District Court, E.D. Pennsylvania
TIMOTHY R. RICE, U.S. MAGISTRATE JUDGE
Rachel O'Donnell alleges the Administrative Law Judge
(“ALJ”) erred in denying her application for
Disability Insurance Benefits (“DIB”) and
Supplemental Security Income (“SSI”) by
improperly: (1) evaluating her migraine headaches; (2)
discounting the opinion of her treating physician; and (3)
finding her testimony inconsistent with the medical evidence.
Pl. Br. (doc. 12) at 1. I disagree and deny
contends the ALJ misconstrued her medical records by
overlooking July 2016 records showing complaints of daily
migraines and diagnosing migraine with aura, chronic daily
headache, and menstrual migraines. Pl. Br. at 6, Reply (doc.
14) at 1 (citing R. at 964-65). She argues the ALJ
impermissibly substituted his own lay opinion for medical
evidence when he relied on a stable February 2018 MRI to
discount O'Donnell's subjective reports of
functionally debilitating migraines. Pl. Br. at 6-7, Reply at
found O'Donnell's migraines were not disabling based
on her exaggeration of symptoms in the medical record, which
showed her headaches had no serious physiological basis. R.
at 26. He contrasted her testimony, that she had experienced
a headache every day since September 2015, with her report in
December 2015 that she was experiencing one two-to-three-day
headache each week and her April 2016 reports that she was
experiencing two migraines with aura per month and two or
three migraines per month related to her menstrual cycle.
Id. He also noted that the February 2018 MRI showed
her neurological condition was stable, that her cardiac
condition was classified as “level II, which indicated
mild symptoms and only slight limitation during ordinary
activity, ” and that her blood pressure concerns
required aggressive medication management and avoiding only
heavy lifting and straining. Id. The ALJ's
analysis constitutes substantial evidence. See Burkhart
v. Colvin, No. CIV.A. 13-238J, 2015 WL 1507856, at *3
(W.D. Pa. Mar. 31, 2015) (denying claim that ALJ failed to
adequately address migraine headaches that were acknowledged
but found not to cause debilitating functional impairments).
analysis is also supported by other evidence. For example,
the neurologist who diagnosed O'Donnell with multiple
kinds of migraines also attributed her headaches at least in
part to “medication overuse.” R. at 966. Another
physician, Dr. Testa, treated O'Donnell's headaches
beginning in April 2015. Id. at 490. Although there
is evidence that O'Donnell complained of increased
headaches in March 2016, id. at 974, Dr. Testa's
records document a stable treatment regimen since May 2017.
See id. at 1355 (noting in December 2015 that her
non-menstrual migraines were relieved by Aleve); 1294
(“continu[ing]” the previously-prescribed
treatment in May 2017); 1496 (lumping migraine treatment into
the “other” category in August 2017); 1490 (no
longer listing the migraine diagnosis specifically in a
regular September 2017 assessment). In March 2018,
O'Donnell's neurosurgeon described her migraines as
“not intractable.” Id. at 1537.
the ALJ accurately noted the inconsistency between
O'Donnell's testimony and the medical record,
addressed the potential neurological and cardiac bases for
her headaches, and reasonably concluded her migraines did not
cause the debilitating functional limitations O'Donnell
claimed, he cited substantial evidence to justify his
conclusion. Burkhart, 2015 WL 1507856, at *3.
also claims the ALJ failed to provide substantial evidence to
support giving little weight to the opinion of her treating
cardiologist, Dr. David Shipon. Pl. Br. at 8-10. Dr. Shipon
opined in April 2017 that O'Donnell could not lift or
carry any weight; could sit, stand, or walk for less than two
hours in an eight-hour day; was subject to a variety of other
postural limitations; would need frequent breaks; and would
be absent from work more than four days per month. R. at
Shipon's, however, was not the only treating
physician's opinion in the record. O'Donnell's
cardiac surgeon and neurosurgeon both opined O'Donnell
should avoid only heavy lifting due to her Level II, a.k.a
mild, aneurysm. Id. at 1285, 1517. The ALJ concluded
the “extreme limitations” in Dr. Shipon's
opinion were inconsistent with his own “unremarkable
examination results.” Id. at 25. The ALJ cited
records of Dr. Shipon's August and June 2017
appointments, and contrasted Dr. Shipon's opinion with
the surgeons' opinions as well as a finding of normal
muscle strength in November 2017. Id.
accurately summarized Dr. Shipon's findings. Id.
at 1415, 431. He also accurately summarized the contrast
between the Dr. Shipon's opinion and the other
doctors'. Id. at 1285; 1518. Further, he
accurately noted that, despite testifying she was bedbound
90% of the time, O'Donnell retained normal muscle
strength. Id. at 47, 1517.
argues the ALJ erred by not addressing each of the regulatory
factors when discussing Dr. Shipon's opinion. Pl. Br. at
8-9. The ALJ addressed the opinion's supportability and
consistency, but never explicitly noted that Dr. Shipon had
personally examined O'Donnell, maintained a treating
relationship, and was a specialist in cardiology.
See 20 C.F.R. §§ 404.1527(c)(2);
416.927(c)(2). The regulatory factors the ALJ failed to
address, however, would not have weighed in favor of Dr.
Shipon's opinion over the other doctors' opinions
because they also examined O'Donnell, maintained a
treating relationship with her, and were accredited in
relevant specialties. R. at 1285, 1518.
Shipon's opinion as to the nature and severity of an
impairment is not entitled to controlling weight where it is
not “well-supported by medically acceptable clinical
and laboratory diagnostic techniques” or is
“inconsistent with the other substantial evidence in
[the] case record.” 20 C.F.R. §§
404.1527(d)(2), 416.927(d)(2). Thus, the ALJ was required to
address and weigh the conflicting evidence provided by the
other physicians. Id. His failure to specifically
list the factors that would not have helped him do so fails
to justify remand. See Diaz v. Comm'r of Soc.
Sec., 577 F.3d 500, 504 (3d Cir. 2009) (“the ALJ,
of course, need not employ particular ‘magic'
words”); Woodson v. Comm'r Soc. Sec., 661
Fed.Appx. 762, 767 (3d Cir. 2016) (affirming ALJ opinion
despite harmless error). The ALJ supported his treatment of
Dr. Shipon's opinion with substantial evidence. See
Bowser v. Barnhart, 84 Fed.Appx. 241, 244 (3d Cir. 2004)
(confirming ALJ opinion that denied benefits despite treating
physician opinion based on conflicting medical opinions).