F I L E D
United States Court of Appeals
Tenth Circuit
UNITED STATES COURT OF APPEALS
NOV 29 2000
FOR THE TENTH CIRCUIT
PATRICK FISHER
Clerk
ROBERT M. DANIELS,
Plaintiff-Appellant,
v. No. 00-5009
(D.C. No. 98-CV-897-M)
KENNETH S. APFEL, Commissioner, (N.D. Okla.)
Social Security Administration,
Defendant-Appellee.
ORDER AND JUDGMENT *
Before BRORBY , KELLY , and LUCERO , Circuit Judges.
After examining the briefs and appellate record, this panel has determined
unanimously to grant the parties’ request for a decision on the briefs without oral
argument. See Fed. R. App. P. 34(f); 10th Cir. R. 34.1(G). The case is therefore
ordered submitted without oral argument.
*
This order and judgment is not binding precedent, except under the
doctrines of law of the case, res judicata, and collateral estoppel. The court
generally disfavors the citation of orders and judgments; nevertheless, an order
and judgment may be cited under the terms and conditions of 10th Cir. R. 36.3.
Plaintiff-appellant Robert M. Daniels appeals from an order of the district
court affirming the Commissioner’s decision denying his application for Social
Security disability benefits. Appellant filed for these benefits in August 1995.
He alleged disability commencing January 2, 1992, based on carpal tunnel
syndrome, high blood pressure, ulcers and mental problems. The agency denied
his applications initially and on reconsideration.
On November 14, 1996, appellant received a de novo hearing before an
administrative law judge (ALJ). The ALJ determined that appellant retained the
residual functional capacity (RFC) to perform light work, with the following
restrictions: no repetitive pushing or pulling of arm controls, marked temperature
extremes, vibration, repetitive hand motions with his left hand, or more than
occasional driving. After receiving testimony from a vocational expert (VE), the
ALJ found that appellant could not return to his past relevant work, but that there
were a significant number of other jobs that he could perform in the national or
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regional economy. 1 The Appeals Council denied review, making the ALJ’s
decision the Commissioner’s final decision.
We review the Commissioner’s decision to determine whether the factual
findings are supported by substantial evidence in the record and whether the
correct legal standards were applied. Andrade v. Sec’y of Health & Human
Servs., 985 F.2d 1045, 1047 (10th Cir. 1993). Substantial evidence is “such
relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.” Fowler v. Bowen, 876 F.2d 1451, 1453 (10th Cir. 1989) (quotations
omitted).
I. Severity of mental impairment
Appellant argues that the ALJ’s conclusions concerning the severity of his
mental impairment were not supported by substantial evidence. The ALJ
concluded that appellant’s bipolar disorder was no more than mild and was well
controlled with medication, and that it would not more than minimally affect
1
The Commissioner follows a five-step sequential evaluation process
to determine whether a claimant is disabled. Williams v. Bowen, 844 F.2d 748,
750-52 (10th Cir. 1988). The claimant bears the burden of establishing
a prima facie case of disability at steps one through four. Id. at 751 n.2. If the
claimant successfully meets this burden, the burden of proof shifts to the
Commissioner at step five to show that the claimant retains sufficient RFC to
perform work in the national economy, given his age, education and work
experience. See id. at 751. The ALJ decided this case at step five.
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appellant’s ability to engage in work-related activities. The record supports these
conclusions.
Dr. Louis Hoogewind signed assessment forms concerning appellant’s
condition at the time of appellant’s admission to Parkside Hospital in August
1995. The forms noted that appellant’s speech was “angry” and that his mood
was “angry” and “depressed.” Appellant’s App., Vol. II at 334. Appellant’s
insight and judgment were rated as “poor.” Id. He was able to remember only
two of three objects after five minutes, had homicidal ideation, and could
remember only two previous presidents of the United States. Dr. Hoogewind
noted diagnoses of “Bipolar NOS” and “cocaine abuse” and assigned appellant a
functional level of 46. Id.
Dr. Hoogewind saw appellant, however, before medication had been
prescribed for his bipolar disorder. Subsequent to Dr. Hoogewind’s evaluation,
appellant began taking prescribed medications including lithium and mellaril.
Less than three weeks later, treating physician Dr. Sue Storts reported that
appellant’s bipolar disorder was well-controlled with his medications. Id. at 320.
Dr. Goodman, a consulting psychiatrist, saw appellant in August 1996, one
year after his admission to Parkside. Dr. Goodman stated, after examining
appellant: “At this time [appellant] admits that his psychological problems do not
prevent him from working. I tend to agree with him.” Id. at 398. He further
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stated that so long as appellant remained in treatment and abstained from using
alcohol or drugs, “I see no reason why [appellant] cannot return to the same level
of work that he has always done.” Id. at 399.
Appellant raises several arguments in opposition to the ALJ’s conclusions
about the effect of his bipolar disorder on his ability to work. We consider each
of these in turn.
1. ALJ’s (alleged) conclusion that appellant did not have bipolar disorder
In his report, Dr. Goodman cast doubt on appellant’s diagnosis of bipolar
disorder. Among other things, he stated that the previous diagnosis had been
made “by a Bachelor’s level assistant counselor without any verification of his
psychiatric diagnoses.” Id. at 397. The ALJ mentioned this statement in his
decision. Appellant argues from this that the ALJ incorrectly concluded, based on
Dr. Goodman’s report, that he did not have bipolar disorder. As noted, however,
the ALJ accepted the diagnosis of bipolar disorder after reviewing all the
evidence, but concluded that the condition was not severe. This issue therefore
lacks merit.
2. ALJ’s failure to discuss Dr. Hoogewind’s findings
Appellant next complains that the ALJ erred by failing to discuss
Dr. Hoogewind’s diagnosis and findings in his decision. Appellant characterizes
Dr. Hoogewind as a treating physician whose evidence and opinion could not be
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disregarded without adequate explanation. Washington v. Shalala, 37 F.3d 1437,
1440 (10th Cir. 1994); see also 20 C.F.R. § 404.1527(d)(2) (requiring that
controlling weight be given to treating physician’s opinion regarding the nature
and severity of a claimant’s condition, if well-supported and not inconsistent with
the other evidence). Although the assessment forms he signed indicate that he
diagnosed appellant and prescribed medication for him, there is no evidence Dr.
Hoogewind provided ongoing care for appellant. It is doubtful, therefore, that he
is a “treating source” within the meaning of the regulations. 20 C.F.R.
§ 404.1502.
In any event, we do not agree that the ALJ’s failure to discuss
Dr. Hoogewind’s assessment was reversible error. As mentioned, Dr. Hoogewind
saw appellant before he began to take medication for his bipolar disorder. The
report of Dr. Hoogewind’s observations, prior to the time appellant began taking
his medications, does not in any way undermine, nor is it “significantly probative
evidence” in opposition to, the ALJ’s ultimate conclusions concerning the
seriousness of appellant’s bipolar disorder as controlled by medication. Clifton v.
Chater, 79 F.3d 1007, 1010 (10th Cir. 1996) (stating that ALJ must discuss
“significantly probative evidence he rejects”). The ALJ expressly stated that he
reached these conclusions after considering all the evidence in the record.
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An ALJ is required to take into account the effects of treatment when
assessing a claimant’s RFC. SSR 96-8p, 1996 WL 374184, at *5. Given all the
medical evidence, nothing in Dr. Hoogewind’s reports is inconsistent with the
ALJ’s conclusions. Any error the ALJ committed by failing to discuss the reports
therefore cannot form the basis for reversal.
3. ALJ’s PRT form lacking in substantial evidence
Both Dr. Goodman and the ALJ completed psychiatric review technique
(PRT) forms concerning appellant. The ALJ reached conclusions on his PRT
form that were slightly less favorable to appellant than those reached by
Dr. Goodman. Appellant contends that the ALJ should have followed
Dr. Goodman’s conclusions.
Dr. Goodman stated on the PRT form he completed that appellant “Often”
had “Deficiencies of Concentration, Persistence or Pace Resulting in Failure to
Complete Tasks in a Timely Manner” Appellant’s App., Vol. II at 412. The
ALJ’s PRT form, by contrast, indicated that appellant “Seldom” had such
deficiencies. Id. at 26. In other respects, the ALJ’s rating of the severity criteria
on his PRT form was nearly identical to that of Dr. Goodman. 2
2
Dr. Goodman rated appellant’s “Difficulties in Maintaining Social
Function” at “Slight,” while the ALJ rated this factor at “None.” Appellant’s
App., Vol. II at 26, 412. Appellant does not make any argument concerning this
discrepancy.
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Appellant argues that the ALJ improperly disregarded Dr. Goodman’s
medical opinion without comment and substituted his own opinion on the PRT
form. He contends that the ALJ’s stated reasons for his conclusions on his own
PRT do not outweigh Dr. Goodman’s opinion, and that the ALJ’s failure to
explain the discrepancy between his PRT form and Dr. Goodman’s requires
reversal.
A. Failure to follow Dr. Goodman’s PRT form
Appellant’s argument on the first point lacks merit, for at least two reasons.
First, the ALJ has sole responsibility for determining appellant’s RFC, including
his mental RFC, based upon the record as a whole. 20 C.F.R. § 404.1527(e)(2);
see also SSR 96-8p, 1996 WL 374184, at *4-5. Second, the PRT form is a
psychiatrist’s opinion, and the ALJ is not bound by conclusions expressed in such
an opinion to the extent those conclusions are inconsistent with the psychiatrist’s
own clinical findings. See 20 C.F.R. § 404.1527(d)(4) (“Generally, the more
consistent an opinion is with the record as a whole, the more weight we will give
to that opinion”); cf. Castellano v. Sec’y of Health & Human Servs., 26 F.3d
1027, 1029 (10th Cir. 1994) (stating even treating physician’s opinion may be
rejected if not supported by specific findings or the evidence).
Dr. Goodman’s underlying findings concerning the lack of effect of
appellant’s bipolar disorder on his ability to work belie his conclusion that
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appellant “often” had deficiencies of concentration, persistence or pace that
would result in his inability to complete tasks in a timely manner. Because of this
inconsistency between Dr. Goodman’s PRT and his clinical findings, the ALJ
permissibly departed from the conclusions reached on Dr. Goodman’s PRT form.
B. Failure to distinguish Dr. Goodman’s PRT results
Even if the ALJ was free to disregard Dr. Goodman’s opinion, however,
appellant argues that he could do so only by providing a reasoned explanation.
Appellant asserts that he failed to provide such an explanation, requiring reversal.
Where an ALJ’s conclusions concerning a claimant’s abilities, expressed on
the PRT form, differ dramatically from those reached by a treating physician, an
explanation is required. See Winfrey v. Chater, 92 F.3d 1017, 1024 (10th Cir.
1996). This is a corollary of the requirement that conclusions reached on the
PRT be supported by substantial evidence. See Washington, 37 F.3d at 1442. Dr.
Goodman was an examining, rather than a treating physician. This suggests that
the duty to explain any discrepancy was less serious in his case than in Winfrey or
Washington.
Here, the ALJ’s conclusions on the PRT form did not differ dramatically
from those reached by Dr. Goodman. Although the ALJ did not state expressly
his reasons for rejecting Dr. Goodman’s conclusions, he did note appellant’s
statement to Dr. Goodman that his psychological problems did not prevent him
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from working. The ALJ also specifically noted three activities appellant was able
to do that were inconsistent with his alleged inability to concentrate: reading,
following television shows, and going to the library.
Appellant argues, however, that the activities mentioned by the ALJ are
substantively insufficient to provide a reason for departing from Dr. Goodman’s
conclusion that he lacks the ability to concentrate. We disagree. First, as noted
above, Dr. Goodman’s conclusion about concentration on the PRT form lacks
support from confirmatory findings. Second, a claimant’s daily activities are
properly considered when evaluating the severity of his alleged nonexertional
impairments. 20 C.F.R. § 404.1529(c)(3)(i). Third, the ALJ stated that he had
considered all the evidence in this case when reaching the conclusions on his PRT
form, and we must presume that such evidence included Dr. Goodman’s
underlying findings concerning the lack of effect of appellant’s bipolar disorder
on his ability to go back to work. We conclude that the ALJ provided sufficient
rationale for departing from Dr. Goodman’s conclusion on the PRT form.
II. Commissioner’s Step Five Finding
Appellant next launches a number of attacks on the Commissioner’s finding
at step five that he could perform a significant number of alternative jobs. His
first challenge rests on his assertion that the ALJ erroneously concluded that he
did not have a severe mental impairment. He contends that the ALJ should have
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presented appellant’s mental impairments as part of the hypothetical question to
the vocational expert. As noted above, however, appellant’s attacks on the ALJ’s
conclusions concerning his bipolar disorder lack merit. Therefore, this derivative
attack on the ALJ’s hypothetical question also fails.
Appellant also attacks the ALJ’s RFC finding as unsupported by the
vocational testimony. The VE testified that appellant’s past relevant work was
unskilled, with the exception of his telemarketing experience. She stated that
appellant could not do any unskilled jobs at the sedentary level because of his
hand problems. She identified a number of unskilled jobs at the light level,
however, that appellant could perform. Appellant contends that the VE later
withdrew this testimony in response to further questioning by the ALJ, leaving no
jobs that he could perform.
Appellant’s argument misstates the record. The ALJ’s initial hypothetical
assumed a moderate to severe limitation on ability to grip and finger with the
(non-dominant) left hand, and a mild limitation on ability to grip and finger with
the right hand. Appellant’s App., Vol. II at 84. Given these limitations, the VE
testified that appellant could perform a number of unskilled, light jobs including
food service worker, unskilled production labor, and unskilled office cleaning.
Id. at 86. She also testified that appellant could perform the semi-skilled,
sedentary job of sedentary order clerk. Id. at 85.
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For his second hypothetical, the ALJ added mental restrictions based upon
appellant’s bipolar disorder. Id. at 88. The VE testified that if appellant were
limited in his ability to interact with the general public, he could not do the
sedentary order clerk job. The ALJ then posed a third hypothetical, assuming the
mental limitation but also a moderate, rather than mild, limitation on ability to
finger and grip with the dominant right hand. Id. Under these circumstances, the
VE stated that approximately fifty percent of the light jobs would be eliminated.
Id. at 89. The ALJ then asked the VE whether there were any light or sedentary
jobs that appellant could perform if he couldn’t do much handling of objects at
all. At this point, the VE conceded, in language now cited by appellant, that there
were most likely no jobs that appellant could perform. Id. at 90.
When it came to his decision, however, the ALJ did not accept the
limitations identified in his third and fourth hypotheticals. Rather, he concluded
that appellant had only a moderate limitation in his ability to grip and finger with
his left hand, and a mild limitation in his ability to grip and finger with his right
hand. Id. at 22. These limitations were not inconsistent with the VE’s testimony
that there were light, unskilled jobs that appellant could perform.
The ALJ is not bound by the VE’s responses to hypothetical questions that
include assumed restrictions not ultimately found by the ALJ to be supported by
the record as a whole. See Gay v. Sullivan, 986 F.2d 1336, 1341 (10th Cir.
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1993). The fact that the VE testified (in response to hypothetical questions listing
impairments that the ALJ ultimately rejected) that appellant could not perform
any jobs is irrelevant to the outcome of this case. Appellant fails to show that the
ALJ’s conclusions about his ability to use his hands were lacking in substantial
evidence.
Appellant also argues that the ALJ erred in concluding that he had
transferable skills from his work as a telemarketer. Since the ALJ’s conclusion
that appellant could perform unskilled, light jobs is supported by substantial
evidence, and the ALJ listed a sufficient number of jobs in the national economy
at that skill and exertional level, it is not strictly necessary to determine whether
appellant could perform skilled work. We note, however, that appellant errs in
arguing that he had only one month’s experience as a telemarketer. In fact, it
appears from the record that he had the requisite three to six months’ experience
as a telemarketer to have learned the job, which carries a specific vocational
preparation (SVP) level of 4. Appellant’s App., Vol. II at 44, 83, 154; see
generally United States Dep’t of Labor, Dictionary of Occupational Titles, Vol. II,
App. C (4th ed. Rev. 1991). Therefore, the ALJ did not err in determining that
appellant had transferable skills from his telemarketing work.
The judgment of the United States District Court for the Northern District
of Oklahoma is AFFIRMED.
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Entered for the Court
Wade Brorby
Circuit Judge
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