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Holloway v. Saul

United States District Court, E.D. Pennsylvania

December 30, 2019

JOSLYN D. HOLLOWAY, Plaintiff,
v.
ANDREW SAUL, [1] Commissioner of Social Security, Defendant.

          MEMORANDUM OPINION

          MARILYN HEFFLEY UNITED STATES MAGISTRATE JUDGE

         Joslyn D. Holloway (“Holloway” or “Plaintiff”) seeks review, pursuant to 42 U.S.C. § 405(g), of the Commissioner of Social Security's (“Commissioner”) decision denying her claims for disability insurance benefits (“DIB”) pursuant to Title II of the Social Security Act (the “Act”) and for Supplemental Security Income (“SSI”) pursuant to Title XVI of the Act.[2]For the reasons discussed below, I recommend that her Request for Review be denied.

         I. FACTUAL AND PROCEDURAL BACKGROUND

         Holloway was born on June 5, 1988. R. at 208.[3] She has a high school education, id. at 212, and is able to speak, read and understand English, id. at 210. Holloway's past relevant work experience was as a home healthcare aide and as a housekeeping cleaner. Id. at 213. She applied for DIB and SSI on September 29, 2015, id. at 14, alleging that she became disabled on July 28, 2015 due to the following conditions: “obesity, bipolar disorder, memory loss, acute post[-]stress disorders, acute post[-]traumatic headaches, major depression, dysthymic disorders, obsessions-worry, withdrawn, hostile, ” id. at 211. At the time of her applications, Holloway was approximately 27 years old. Id. at 27. Holloway's applications were initially denied on May 27, 2016. Id. at 77-89, 90-102. She filed a written request for a hearing, id. at 119-20, and an ALJ held a hearing on her claim on February 27, 2018, id. at 36-76. On May 30, 2018, the ALJ issued an opinion denying Holloway's claim. Id. at 14-28. Holloway filed an appeal with the Appeals Council, which it denied on December 17, 2018, thereby affirming the decision of the ALJ as the final decision of the Commissioner. Id. at 1-7. Holloway then commenced this action in federal court.

         II. THE ALJ'S DECISION

         In her decision, the ALJ found that Holloway suffered from severe impairments due to: lumbar spine degenerative disc disease, left knee joint disease, diabetes mellitus, obesity, bipolar disorder, depression, intellectual impairment and cannabis use disorder. Id. at 16. The ALJ determined that none of Holloway's impairments, nor the combination of her impairments, met or medically equaled a listed impairment. Id. at 17-21. The ALJ found that Holloway had the residual functional capacity (“RFC”) to perform:

Sedentary work as defined in 20 CFR 404.1567(a) and 416.967(a), meaning she can lift and carry ten pounds occasionally, lift and carry less than ten pounds frequently, sit for six hours, and stand and walk for two hours in and eight-hour workday. However, she can only frequently operate foot controls bilaterally. She can occasionally climb ramps and stairs, balance, and stoop but never kneel, crouch, crawl, or climb ladders, ropes, or scaffolds. The claimant has no reaching, handling, fingering, feeling, visual or communicative limitations. Additionally, she can never work at unprotected heights and have only occasional exposure to moving mechanical parts, humidity, wetness, extreme cold and heat, and vibration. The claimant is also limited to simple routine tasks, and simple work-related decisions. She can occasionally interact with the public, supervisors, and coworkers.

Id. at 21. Relying on the testimony of the vocational expert (“VE”) who appeared at the hearing, the ALJ determined that Holloway was capable of performing the following occupations: type-copy examiner, final assembler and table worker. Id. at 27. Accordingly, the ALJ found that Holloway was not disabled and denied her claim. Id. at 28.

         III. HOLLOWAY'S REQUEST FOR REVIEW

         In her Request for Review, Holloway asserts that the ALJ erred in: (1) failing to give controlling weight to the opinion of her treating orthopedist; (2) failing to give controlling weight to the opinion of her treating mental health providers; and (3) failing to properly analyze the limitations imposed by her obesity. In addition, Holloway argues that the Appeals Council erred in deciding that the additional evidence she submitted after the ALJ had issued her opinion did not warrant a remand to the ALJ for further consideration.

         IV. SOCIAL SECURITY STANDARD OF REVIEW

         The role of the court in reviewing an administrative decision denying benefits in a Social Security matter is to uphold any factual determination made by the ALJ that is supported by “substantial evidence.” 42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389, 401 (1971); Doak v. Heckler, 790 F.2d 26, 28 (3d Cir. 1986); Newhouse v. Heckler, 753 F.2d 283, 285 (3d Cir. 1985). A reviewing court may not undertake a de novo review of the Commissioner's decision in order to reweigh the evidence. Monsour Med. Ctr. v. Heckler, 806 F.2d 1185, 1190 (3d Cir. 1986). The court's scope of review is “limited to determining whether the Commissioner applied the correct legal standards and whether the record, as a whole, contains substantial evidence to support the Commissioner's finding of fact.” Schwartz v. Halter, 134 F.Supp.2d 640, 647 (E.D. Pa. 2001).

         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.” Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999) (quoting Pierce v. Underwood, 487 U.S. 552, 564-65 (1988)); Kangas v. Bowen, 823 F.2d 775, 777 (3d Cir. 1987). It is “more than a mere scintilla but may be somewhat less than a preponderance of the evidence.” Rutherford v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005). The court's review is plenary as to the ALJ's application of legal standards. Krysztoforski v. Chater, 55 F.3d 857, 858 (3d Cir. 1995).

         To prove disability, a claimant must demonstrate some medically determinable basis for a physical or mental impairment that prevents him or her from engaging in any substantial gainful activity for a 12-month period. 42 U.S.C. § 1382c(a)(3)(A); accord id. § 423(d)(1). As explained in the applicable agency regulation, each case is evaluated by the Commissioner according to a five-step sequential analysis:

(i) At the first step, we consider your work activity, if any. If you are doing substantial gainful activity, we will find that you are not disabled. (ii) At the second step, we consider the medical severity of your impairment(s). If you do not have a severe medically determinable physical or mental impairment that meets the duration requirements in § 416.909, or a combination of impairments that is severe and meets the duration requirement, we will find that you are not disabled. (iii) At the third step, we also consider the medical severity of your impairment(s). If you have an impairment(s) that meets or equals one of our listings in appendix 1 of this subpart and meets the duration requirement, we will find that you are disabled. (iv) At the fourth step, we consider our assessment of your residual functional capacity and your past relevant work. If you can still do your past relevant work, we will find that you are not disabled. (v) At the fifth and last step, we consider our assessment of your residual functional capacity and your age, education and work experience to see if you can make an adjustment to other work. If you can make an adjustment to other work, we will find that you are not disabled. If you cannot make an adjustment to other work, we will find that you are disabled.

20 C.F.R. § 416.920 (references to other regulations omitted).

         V. DISCUSSION

         A. The Standard for Review of Opinions of Treating Physicians

         Holloway focuses her attacks on the ALJ's decision, regarding both her physical RFC and mental RFC, on her contention that the ALJ was required to afford the opinions of her treating physicians controlling weight. See Pl.'s Br. (Doc. No. 11) at 2. However, the rules in effect at the relevant time, [4] which afforded additional weight to the opinions of treating physicians, were not as categorical as Holloway portrays them to be. Applying the pre-2017 rules, the medical opinions of a treating physician “are entitled to substantial and at times even controlling weight.” Fargnoli v. Massanari, 247 F.3d 34, 43 (3d Cir. 2001) (citing 20 C.F.R. § 404.1527[(c)](2)). A treating physician's opinion on the nature and severity of a claimant's impairment will be given controlling weight if the opinion is “well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record.” 20 C.F.R. § 416.927(c)(2). In rejecting a treating physician's assessment, an ALJ may not make “speculative inferences from medical reports” and may not reject a treating physician's opinion “due to his or her own credibility judgments, speculation or lay opinion.” Morales v. Apfel, 225 F.3d 310, 317-18 (3d Cir. 2000) (internal quotation marks omitted). Furthermore, the ALJ must explain on the record his or her reasons for disregarding a treating physician's opinion. Brewster v. Heckler, 786 F.2d 581, 585 (3d Cir. 1986). It cannot be for “no reason or for the wrong reason.” Morales, 225 F.3d at 317 (internal quotations marks omitted).

         An ALJ may decide not to credit a treating physician's opinion, however, if he or she provides an adequate explanation. Sherrod v. Barnhart, No. 01-4731, 2002 WL 31429337, at *3 (E.D. Pa. Oct. 29, 2002). For example, an ALJ may reject a treating physician's opinion when it is not supported by sufficient clinical data. Newhouse, 753 F.2d at 286; see also Salles v. Comm'r of Soc. Sec., 229 Fed.Appx. 140, 148 (3d Cir. 2007) (“A lack of evidentiary support in the medical record is a legitimate reason for excluding claimed limitations from the RFC.”). “[T]he United States Court of Appeals for the Third Circuit has also repeatedly held that when a treating physician's notes, analyzed as a whole, contradict the physician's opinion on a claimant's ability to work, an ALJ may properly rely on those notes in determining that the opinion is entitled to little or no weight.” Smith v. Astrue, 961 F.Supp.2d 620, 643 (D. Del. 2013) (citing Dula v. Barnhart, 129 Fed.Appx. 715, 719 (3d Cir. 2005)); accord Humphreys v. Barnhart, 127 Fed.Appx. 73, 76 (3d Cir. 2005); Shelton v. Astrue, No. 11-75J, 2012 WL 3715561, at *3 (W.D. Pa. Aug. 28, 2012); Petrowsky v. Astrue, No. 10-563, 2011 WL 6083117, at *14-15 (D. Del. Dec. 6, 2011). Moreover, an ALJ may reject a treating physician's opinion in favor of that of a non-examining physician if the latter opinion is more consistent with the evidence. Salerno v. Comm'r of Soc. Sec., 152 Fed.Appx. 208, 209 (3d Cir. 2005); Hudson v. Comm'r of Soc. Sec., 93 Fed.Appx. 428, 431 (3d Cir. 2004).

         Furthermore, where a physician fails to provide an explanation supporting his or her opinion, that “by itself would justify the ALJ's decision to accord [it] little weight.” Cunningham v. Comm'r of Soc. Sec., 507 Fed.Appx. 111, 119 (3d Cir. 2012); see also Plummer v. Apfel, 186 F.3d 422, 429 (3d Cir. 1999) (opinion may be given “more or less weight depending upon the extent to which supporting explanations are provided”). This is especially the case when the opinion is provided in a form “which require[s] only that the completing physician ‘check a box or fill in a blank,' rather than provide a substantive basis for the conclusions stated.” Smith, 359 Fed.Appx. at 316 (quoting Mason v. Shalala, 994 F.2d 1058, 1065 (3d Cir. 1993)). Such forms provide “‘weak evidence at best' in the context of a disability analysis.” Id.; see also Wise v. Comm'r of Soc. Sec., 626 Fed.Appx. 357, 360 (3d Cir. 2015) (“[W]e have said that ALJs are not required to give any weight to these fill-in-the-blank and checklist portions of RFC assessments and that their focus instead should be on the narrative portions of the assessments where the medical experts expound on their opinions.”).

         Ultimately, however, determining a claimant's RFC is the province of the ALJ and not of the treating physician. An ALJ is required to conduct an independent analysis of the relevant evidence and to reach his or her own determination regarding the claimant's RFC. Chandler v. Comm'r Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011). As the United States Court of Appeals for the Third Circuit has articulated:

The ALJ-not treating or examining physicians or State agency consultants- must make the ultimate disability and RFC determinations. See 20 C.F.R. §§ 404.1527(e)(1), 404.1546(c). Although treating and examining physician opinions often deserve more weight than the opinions of doctors who review records, see, e.g., 20 C.F.R. § 404.1527(d)(1)-(2), “[t]he law is clear . . . that the opinion of a treating physician does not bind the ALJ on the issue of functional capacity . . . .”

Id. (quoting Brown v. Astrue, 649 F.3d 193, 197 n.2 (3d Cir. 2011)). Thus, the ALJ's role is not merely to choose between the opinions of various medical sources. “There is no legal requirement that a physician have made the particular findings that an ALJ adopts in the course of determining an RFC. Surveying the medical evidence is part of the ALJ's duties.” Titterington v. Barnhart, 174 Fed.Appx. 6, 11 (3d Cir. 2006); see also Chandler, 667 F.3d at 362 (ALJ could extrapolate based on evidence in record because every fact incorporated in an RFC does not need to have been found by a medical expert); Mays v. Barnhart, 78 Fed.Appx. 808, 813 (3d Cir. 2003) (ALJ properly determined that claimant could perform light work based on claimant's treatment records even though the only medical opinion in the case was to the contrary); Kertesz v. Crescent Hills Coal Co., 788 F.2d 158, 163 (3d Cir. 1986) (reaching the same conclusion in a case reviewing an ALJ's determination of eligibility for benefits under the Black Lung Benefits Act).

         B. The ALJ's RFC Findings Regarding Holloway's Physical Limitations Were Supported by Substantial Evidence

         Holloway contends that the ALJ erred in not giving controlling weight or, at the least, great weight, to the physical limitations stated in the opinion of her orthopedist, Dr. Corey Ruth. Pl.'s Br. at 2, 20-21. Holloway sought treatment from Dr. Ruth after she was injured in a collision that occurred while she was riding on a bus in July 2015. R. at 544. Dr. Ruth submitted responses to interrogatories posed to him by the ALJ. Id. at 730-32. In his responses, Dr. Ruth identified Holloway's course of treatment as including injections, Naprosyn (Naproxen) and Flexeril as well as physical therapy. Id. He did not prescribe narcotic painkillers. Id.; see also id. at 542-56 (Dr. Ruth's treatment records). He further indicated that Holloway was not a candidate for surgery at the time. Id. at 730. Dr. Ruth stated that Holloway was obese and answered affirmatively to a question asking whether “the pain the patient suffered on weightbearing activities such as standing or walking or lifting and carrying [was] exacerbated by her weight.” Id. at 731. He opined that, in an eight-hour workday, Holloway could only stand for a total of one hour and could only sit in a regular straight-back chair for a total of two hours. Id. He further indicated that the most that she could “lift and carry on an occasional basis (a couple of times an hour)” was 10 pounds. Id. Dr. Ruth also answered affirmatively to an interrogatory asking whether Holloway had been precluded for the period from July 2015 to the time of his interrogatory responses on May 24, 2017, from performing unskilled work requiring her to travel to and from the worksite, sit for a total of six hours in a regular straight-back chair, stand for up to two hours and carry up to 10 pounds in weight for up to two hours.[5] Id. at 732. He also stated that Holloway would be off-task for 40 percent of an eight-hour workday. Id.

         Dr. Ruth's treatment records and opinion are problematic for several reasons. His treatment notes were recorded on a form that does not appear to have been fully updated from visit to visit. Thus, each of Dr. Ruth's notes on each of his physical examinations of Holloway state as to his clinical findings the following vague, generic description: “tenderness to palpitation of over [sic] spinous processes, PSIS, sacroiliac joints, or par spinal [sic] musculature, ” and “[p]atient reports slight pain w/ R.O.M., ” and those findings are repeated verbatim for each examination, including the typographical errors. Id. at 545, 547, 550, 552, 555, 795, 798, 801, 804, 807. Dr. Ruth included the language regarding only slight pain with range of movement and slight muscle weakness in Holloway's leg even at times when Holloway reported her pain as high as 8-9 on a 10-point scale. Id. at 547, 550, 555, 795, 798. His interrogatory responses contain no explanation of the basis for his opinions. See id. at 730-32. Dr. Ruth stated on a number of occasions that he intended to “continue conservative care and home exercises.” Id. at 549, 554, 794, 797, 806. Accordingly, he treated Holloway with monthly trigger-point injections and prescribed only Flexeril, a muscle relaxant, and Naproxen. Id. at 730. When Holloway found her medications to be ineffective, he instructed her to take Extra Strength Tylenol instead. Id. at 48, 807-08.

         Similarly, Dr. Ruth's form used for each of Holloway's examinations included the following legend at the bottom: “Plan: home exercises, ice, elevation, and rest, analgesics return for f/u in 4-6 weeks.” Id. at 545, 547, 550, 553, 555, 795-96, 799, 802, 805, 808.[6] He gave no indication of the frequency with which he believed Holloway should elevate her legs, although the fact he recommended exercises and the fact he sent her to physical therapy, see, e.g., id. at 546, indicate that he did not require her to elevate them all of the time. Moreover, even when Dr. Ruth had additional plans specific to Holloway, he added those plans as a separate entry under a separate legend for “Plan” immediately preceding the standard “Plan” legend, but did not alter the standard form language that appeared at the bottom of each treatment note or combine it with his additional “Plan[s].” See id. at 545, 552-53, 807-08.

         Dr. Ruth was similarly sparse in his responses to the ALJ's interrogatories. Despite the extreme limitations that he assigned to Holloway, which would have precluded her from performing even sedentary work, he provided no explanation of the basis for his assigned limitations other than a diagnosis of “L3-S1 herniated disc and sciatica.” Id. at 730-32. That failure “by itself” justified the ALJ's decision to afford Dr. Ruth's opinion little weight. Cunningham, 507 Fed.Appx. at 119; see also Wise, 626 Fed.Appx. at 360 (directing reviewing courts to focus on the sufficiency of the “narrative portion of [physicians'] assessments where the medical experts expound on their opinions”).

         Moreover, the ALJ also had before her the report and opinion of a consultative examiner, Dr. Joel Marmar. R. at 417-26. Dr. Marmar examined Holloway on March 16, 2016. Id. She reported to him that, despite receiving injections and physical therapy, her low-back pain continued to cause her pain daily, ranging in intensity from a five to a nine on a 10-point scale. Id. at 417. She further reported that she had to ascend 23 steps from the sidewalk to reach her bedroom, she could walk one block, and she took public transportation but did not drive. Id. Holloway also reported that she could cook, clean, shower and dress herself, but she needed help with shopping and laundry because they put strain on her back. Id. at 418. As to his clinical examination of Holloway, Dr. Marmar noted that she “appear[ed] to be in no acute distress, ” her gait was normal, she could stand on heels and toes and could perform 40 percent of a full squat. Id. He further noted that she did not need an assistive device to walk, needed no help in changing for the examination or getting on and off the examination table and was able to rise from a chair without difficulty. Id. Dr. Marmar found as to her musculoskeletal system that she had “[n]o scoliosis, kyphosis, or abnormality in the thoracic spine” and that seated leg-raise testing was negative bilaterally. Id. at 419. Holloway's joints had no deformity or tenderness or any redness, heat or effusion. Id. Her extremities had no cyanosis, clubbing or edema, her reflexes were physiological and equal in her upper and lower extremities and her strength was “5/5” in both. Id. Dr. Marmar opined that Holloway could lift and carry up to 20 pounds frequently but could never lift more than 20 pounds. Id. at 421. He further indicated that she could sit or stand for up to four hours at a time each, but that she could only walk continuously for one hour. He stated that, in an eight-hour workday, she could sit or stand for up to seven hours each but could only walk for a total of two hours. Id. at 422.

         Before reaching her decision, the ALJ extensively examined Holloway's treatment records and her subjective allegations regarding her back problems. See id. at 21-24. In analyzing Holloway's physical limitations, the ALJ accepted Dr. Ruth's opinions as to Holloway's limitations on standing and walking because she found them consistent with Holloway's treatment records, “which document consistent back pain despite treatment.” Id. at 24. Although she did not specifically address Dr. Ruth's opinion that Holloway could not sit for a total of more than two hours in a day in the portion of her decision discussing Dr. Ruth's findings, she did address Holloway's physical limitations again later in her decision. Id. at 26. In summarizing her findings regarding Holloway's physical limitations, the ALJ acknowledged that Holloway had undergone consistent treatment since her injury during the accident in July 2015. Id. She noted, however, that Holloway's records reflected that her treatment was limited to medication, physical therapy and lumbar injections and that she had not required surgery. Id. In other words, as Dr. Ruth had stated repeatedly, her treatment remained conservative. Id. at 549, 554, 794, 797, 806. The ALJ also noted that, even when Holloway experienced an exacerbation of her back pain in November 2015, her range of motion remained full, her gait remained normal, and physical examination revealed only moderate tenderness. Id. at 22. Indeed, the record is devoid of evidence of Holloway ever needing the use of an assistive device in walking or of developing an abnormal gait. Nevertheless, taking into account Holloway's subjective allegations regarding her symptoms, even though she found them to be “not entirely consistent with the medical evidence” and with Holloway's daily activities, id., the ALJ determined that Holloway should be limited to sedentary work, id. at 26. By definition, that exertion level would require Holloway to be able to sit for six hours in a day. SSR 83-10, 1983 WL 31251, at *5 (Jan. 1, 1983). The ALJ reasoned that the “clinical findings in evidence document[ed] that she maintained a normal gait and the diagnostic imaging revealed only mild to moderate issues.”[7] R. at 24

         The ALJ's view that the clinical findings were inconsistent with greater limitations than those that apply to sedentary work is supported by Dr. Ruth's repeated findings on physical examination that Holloway had only “tenderness to palpitation of over [sic] spinous processes, PSIS, sacroiliac joints, or par spinal [sic] musculature.” Id. at 545, 547, 550, 552, 555, 795, 798, 801, 804, 807. Insufficient clinical findings to support an opinion regarding a claimant's limitations justifies an ALJ's rejection of a treating physician's opinion. Newhouse, 753 F.2d at 286. The ALJ also noted that, even when Holloway experienced an exacerbation of her back pain in November 2015, her range of motion remained full and her gait remained normal, and physical examination revealed only moderate tenderness. R. at 22. Indeed, the record is devoid of evidence of Holloway ever needing the use of an assistive device in walking or of developing an abnormal gait.

         The ALJ's decision not to fully adopt Dr. Ruth's opinion also is consistent with Dr. Ruth's decision to give Holloway only conservative treatment. “The extent of treatment prescribed is a factor that the applicable regulations instruct ALJ's to consider in evaluating claimants' subjective testimony regarding the extent of their symptoms.” Gladden o/b/o Hyman-Self v. Berryhill, No. 17-1832, 2018 WL 1123763, at *8 (E.D. Pa. Feb. 28, 2018) (citing 20 C.F.R. § 404.1529); Proper v. Astrue, No. 10-238 ERIE, 2011 WL 5360296, at *10 (W.D. Pa. Nov. 7, 2011).

         In addition, although the ALJ did not accept the findings of the consultative examiner, Dr. Marmar, that Holloway could sit for up to seven hours in a workday, his opinion provided medical evidence contrary to Dr. Ruth's opinion and provided additional evidentiary support for the ALJ's decision not to fully credit Dr. Ruth's opinion. Northington v. Berryhill, No. 17-2922, 2018 WL 2159923, at *1 n.1 (E.D Pa. May 10, 2018); see also Lewis v. Berryhill, No. CV 17-2270, 2018 WL 3447177, at *4 (E.D. Pa. July 17, 2018) (finding that an ALJ's RFC determination was supported by “an opinion which, if fully accepted, supported a less restrictive RFC than that assessed by the ALJ”); Armbruster v. Colvin, No. 14-CV-3026, 2016 WL 5930913, at *7 (E.D. Pa. Oct. 12, 2016) (same). An ALJ is not required to adopt or reject each of the specific limitations a physician deems necessary regardless of the weight he or she gives to the physician's opinion as a whole. See Wilkinson v. Comm'r of Soc. Sec., 558 Fed.Appx. 254, 256 (3d Cir. 2014); (“[N]o rule or regulation compels an ALJ to incorporate into an RFC every finding made by a medical source simply because the ALJ gives the source's opinion as a whole ‘significant' weight.”); accord Pascarello v. Berryhill, No. 18-3406, 2019 WL 2288233, at *8 (E.D. Pa. May 28, 2019); Northington, 2018 WL 2159923, at *1 n.1; Lucas v. Berryhill, No. 17-3005, 2018 WL 6737376, at *3 (E.D. Pa. Nov. 20, 2018).

         The ALJ's determination that Dr. Ruth's opinion was not supported by Holloway's activities of daily living, see R. at 24, also is supported by the record. Her finding that Holloway's ability to care for her eight-year-old daughter was not consistent with Dr. Ruth's opinion that she was incapable of performing even sedentary work was reasonable, notwithstanding the fact she received assistance from her mother, who lived with her. Id. Other activities that the ALJ noted included Holloway's ability to regularly travel to medical appointments and physical therapy by public transportation without accompaniment or assistance. Id. Moreover, although the ALJ did not further elucidate the daily activities that she found inconsistent with the extreme limitations set out in Dr. Ruth's opinion, the record contains additional evidence regarding Holloway's daily activities that supports her finding. For example, there were 23 steps between Holloway's bedroom and the sidewalk, id. at 417, but she reported that she still left her home daily, id. at 233. Furthermore, the treatment notes of her psychotherapist, April Morgan, recorded statements by Holloway that she took “brisk walks” around a local track as a “coping strategy used to manage her mood-stated [sic].” Id. at 643; see also id. at 635 (Holloway reporting that she used long walks in her neighborhood as a means of managing her stress and emotions); id. at 675 (same). The therapist's records also reflect numerous instances of her complimenting Holloway for using walking as a stress-reliever and urging her to continue to do so. See id. at 635, 639, 643, 645, 655, 665, 667, 685, 691, 853. It is well established that an ALJ may properly discount a treating physician's opinion if he ...


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