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Heffner v. Berryhill

United States District Court, D. Oregon

March 1, 2018

JONA B. HEFFNER, Plaintiff,
NANCY A. BERRYHILL, Commissioner of the Social Security Administration, Defendant.


          Michael McShane United States District Judge.

         Plaintiff Jona Bernae Heffner brings this action for judicial review of the Commissioner's decision denying her application for disability insurance benefits (“DIB”). This court has jurisdiction under 42 U.S.C. §§ 405(g).

         On December 13, 2012, Heffner protectively filed a Title II application for DIB, alleging disability as of June 13, 2012. Tr. 9.[1] During the hearing before the administrative law judge (“ALJ”), Heffner amended her alleged onset date to January 1, 2014. Tr. 9. After the ALJ concluded Heffner was not disabled, Hefner filed this appeal.

         Heffner argues the ALJ erred in rejecting the opinion of her treating physician, her subjective complaints of symptoms and limitations, and the opinion of her partner. Because the Commissioner's decision is based on proper legal standards and supported by substantial evidence, the Commissioner's decision is AFFIRMED.


         A reviewing court shall affirm the decision of the Commissioner of Social Security if her decision is based on proper legal standards and the legal findings are supported by substantial evidence in the record. 42 U.S.C. § 405(g); Batson v. Comm'r Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004). “Substantial evidence is ‘more than a mere scintilla but less than a preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” Hill v. Astrue, 698 F.3d 1153, 1159 (9th Cir. 2012) (quoting Sandgathe v. Chater, 108 F.3d 978, 980 (9th Cir. 1997)). To determine whether substantial evidence exists, the district court must review the administrative record as a whole, weighing both the evidence that supports and detracts from the ALJ's decision. Davis v. Heckler, 868 F.2d 323, 326 (9th Cir. 1989).


         The Social Security Administration utilizes a five-step sequential evaluation to determine whether a claimant is disabled. 20 C.F.R. §§ 404.1520 & 416.920 (2012). The initial burden of proof rests upon the claimant to meet the first four steps. If the claimant satisfies his burden with respect to the first four steps, the burden shifts to the Commissioner for step five. 20 C.F.R. § 404.1520. At step five, the Commissioner must show that the claimant is capable of making an adjustment to other work after considering the claimant's residual functional capacity (“RFC”), age, education, and work experience. Id. If the Commissioner fails to meet this burden, then the claimant is disabled. 20 C.F.R. §§ 404.1520(a)(4)(v); 416.920(a)(4)(v). If, however, the Commissioner proves that the claimant is able to perform other work existing in significant numbers in the national economy, the claimant is not disabled. Bustamante v. Massanari, 262 F.3d 949, 953-54 (9th Cir. 2001).

         At step two, the ALJ found that Heffner had the following severe impairments: orthostatic hypotension; vertigo with no evidence of labyrinthine disorder; moderate cervical degenerative disc disease and degenerative joint disease; anxiety; and depression. Tr. 11. In formulating Heffner's RFC, the ALJ concluded that Heffner could perform sedentary work with the following limitations: she is unable to use a computer screen or video monitor; and she can carry out only simple instructions in a setting with no public contact and no team assignments. Tr. 14. Based on the vocational expert's (“VE”) testimony, a person with Heffner's RFC could perform the jobs of addressor, sorter, or electronic inspector. Tr. 21, 58. As noted, Heffner makes several assignments of error.

         I. Weight Assigned to the Opinion of Dr. Cullen.

         I turn first to Heffner's argument that the ALJ improperly rejected the medical opinion of her treating physician, Dr. Clark Cullen. The ALJ is responsible for resolving conflicts in the medical record, including conflicts among physicians' opinions. Carmickle v. Comm'r, 533 F.3d 1155, 1164 (9th Cir. 2008). Generally, a treating doctor's opinion is entitled to more weight than an examining doctor's opinion, which in turn is entitled to more weight than a reviewing doctor's opinion. Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir. 2014). When a treating physician's opinion is contradicted by another medical opinion, the ALJ may reject the treating physician's opinion only by providing “specific and legitimate reasons supported by substantial evidence in the record.” Orn v. Astrue, 495 F.3d 625, 632 (9th Cir. 2007).

         Dr. Cullen has been Heffner's primary care physician since February 2013. Tr. 391. On March 4, 2015, Dr. Cullen completed a “Dizziness Medical Source Statement” (“DMMS”) outlining his opinion on Heffner's functional limitations. Tr. 391-95. Dr. Cullen opined that Heffner's was incapable of low-stress work because, “as a consequence of relentless dizziness and incapacity her mental state is fragile.” Tr. 393. Dr. Cullen described Heffner's dizziness episodes as “24/7 constant.” Tr. 391. He noted Heffner used a walker to prevent falls. Tr. 391-92. Heffner suffered visual disturbances and mood changes, exhaustion, mental confusion, and severe headaches. Tr. 391. These symptoms were “incapacitating” and lasted all day, every day. Tr. 391-92. According to Dr. Cullen, Heffner had “no good days.”

         The ALJ gave little weight to Dr. Cullen's opinion because it conflicted with his own treatment notes. Tr. 18. A “discrepancy” between a doctor's examination notes and his medical opinion “is a clear and convincing reason for not relying on the doctor's opinion.” Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005). An examination of Dr. Cullen's treatment notes against his opinions in the DMMS supports the ALJ's conclusion to assign little weight to Dr. Cullen's opinion.

         The same day Dr. Cullen filled out the DMMS, he examined Heffner and reported that she had normal gait and ambulation, normal coordination, and normal movement in all extremities. Tr. 18, 453. Dr. Cullen described Heffner as “healthy-appearing, ” having “normal mood and affect, ” and presenting with “good judgment.” Tr. 18, 453. Dr. Cullen recorded the above objective findings upon physical examination despite Heffner's report that day of “no change in incapacitating dizziness.” Tr. 453. At a November 2014 examination-Heffner's last appointment with Dr. Cullen before Dr. Cullen filled out the DMMS-Dr. Cullen noted Heffner's report that although she still felt as if she was “on a boat on an ocean, ” her “severe vertigo episodes have subsided.” Tr. 397. At that appointment, Heffner was fully oriented, ambulated normally with normal movement of all extremities, and had no ataxia. Tr. 397. The objective findings Dr. Cullen reported on the two appointments closest in time to the DMMS mirrored those reported by Dr. Cullen during earlier appointments. See Tr. 16, 265 (describing “normal” mental status and ambulation); 275 (reporting “no ataxia” and normal Romberg sign); 278 (stating that Heffner was “ambulating ...

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