stating that “we have upheld an ALJ’s decision to discount or even disregard the opinion of a treating physician where other medical assessments are supported by better or more thorough medical evidence or where a treating physician renders inconsistent opinions that undermine the credibility of such opinions” (internal citation and quotation marks omitted)
How later courts described this case
- stating that “we have upheld an ALJ’s decision to discount or even disregard the opinion of a treating physician where other medical assessments are supported by better or more thorough medical evidence or where a treating physician renders inconsistent opinions that undermine the credibility of such opinions” (internal citation and quotation marks omitted)
- stating that “[a] treating physician’s opinion regarding an applicant’s impairment will be granted ‘controlling weight,’ provided that the opinion is ‘well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] record’” (citing 20 C.F.R. § 404.1527 (c)(2))
- explaining how an opinion by the treating physician that the claimant had been disabled since 1990 was “suspect,” given that the same physician had, on the basis of the same information, concluded three weeks earlier that the claimant had been disabled since 1976
- stating that "we have upheld an ALJ's decision to discount or even disregard the opinion of a treating physician . . . where a treating physician renders inconsistent opinions that undermine the credibility of such opinions"
Written by the judges who cited it.
The opinion
LAY, Circuit Judge,
dissenting.
I must respectfully dissent.
In all due respect, I believe justice would be better served in this case by granting benefits or, at the very least, by requiring a re-evaluation of the claimant’s condition under the Administration’s existing rules and regulations. The majority opinion discredits the testimony of Prosch’s treating physician, Dr. Crowe. It does so because Proseh performed substantial gainful activity during a time period that Dr. Crowe opined him to be “totally disabled.” However, Dr. Crowe’s opinion simply observed that, due to an earlier injury, claimant had been disabled since 1976. In order to evaluate whether a physician is being honest in giving a medical opinion, administrative law judges, magistrate judges and Article III judges are required to acknowledge the full record. Upon review of the record, there is no question Dr. Crowe was cognizant that the claimant had worked since 1976. It defies common sense for the ALJ to discredit Dr. Crowe’s statement when the latter was fully aware of Prosch’s attempt to perform lighter work. 3
Furthermore, a claim for benefits should not be denied simply because an injured claimant previously tried to do light work and avoid a premature award of disability benefits. Social security claims must necessarily be proven by hearsay reports by physicians. See Richardson v. Perales, 402 U.S. 389, 402 , 91 S.Ct. 1420 , 28 L.Ed.2d 842 (1971). However, the inability of physicians to fully explicate their medical findings and opinions should not penalize laypersons who seek benefits because of their pain and deficient residual functional capacities.
The majority opinion further allots the opinions of nonspecialists to override the expert opinion of treating orthopedic specialists. While I do not dispute the holdings in Cruze and Rogers, I feel that the ALJ and the majority have failed to consider the language in Social Security Ruling 96-2p, which provides:
Adjudicators must remember that a finding that a treating source medical opinion is not well-supported by medically acceptable clinical and laboratory diagnostic techniques or is inconsistent with the other substantial evidence in the case record means only. that the opinion is not entitled to “controlling *1016 weight,” not that the opinion should be rejected. Treating source medical opinions are still entitled to deference and must be weighed using all of the factors provided in 20 CFR 404.1527 and 416.927. In many cases, a treating source’s medical opinion will be entitled to the greatest weight and should be adopted, even if it does not meet the test for controlling weight.
SSR 96-2p, 1996 WL 374188 , at *4 (Social Security Administration, July 2,1996).
The five factors to be considered under 20 C.F.R. 404.1527(d) are: (1) the length of the treatment relationship; (2) the nature and extent of the treatment relationship; (3) the quantity of evidence in support of the opinion; (4) the consistency of the opinion with the record as a whole; and (5) whether the treating physician is also a specialist. The ALJ failed to consider factors (1), (2) and (5).
I also dissent from the majority’s treatment of the hypothetical posed to the vocational expert. The ALJ did not acknowledge Prosch’s four-hour sitting limitation as a factor in his residual functional capacity assessment. This is the most important factor in the overall evaluation of the claimant’s case. Social Security Ruling 96-8p states:
RFC is an assessment of an individual’s ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis. A “regular and continuing basis” means 8 hours a day, for 5 days a week, or an equivalent work schedule.
SSR 96-8p, 1996 WL 374184 , at *1 (Social Security Administration, July 2,1996) (emphasis added).
The ALJ made no reference to Prosch’s limited ability to sit for given amounts of time. The ALJ simply found that Prosch required a sit-stand option in any future employment, and he was limited to two hours of standing each day. The majority excuses this oversight by finding that since Dr. Crowe opined that Prosch had a four-hour sitting limitation and his opinion was properly discounted, the ALJ was correct in ignoring the limitation. However, neither the ALJ nor the majority point to any other evidence in the record specifically rejecting that opinion. I have trouble understanding how the ALJ could reject Dr. Crowe’s sitting limitation when it is not directly challenged in the record. This is especially important when one considers that the Vocational Expert specifically testified that none of the other jobs for which he found Prosch qualified would be available to an individual with a four-hour sitting limitation. (Tr. 61-62.) Under the circumstances, it is difficult to deny benefits outright without further evaluation; thus, I would remand the case.
. Dr. Crowe reviewed the medical records of his colleague, Dr. Salovich, who was claimant’s orthopedic surgeon since 1978. Proseh had a serious accident at work in 1976 and injured his back. Subsequently, he felt compelled to go to school and train himself for light jobs, during which he continued to see Dr. Salovich. Dr. Crowe was privy to all of Dr. Salovich s reports which repeatedly recite Prosch's engagement in light work. Dr. Crowe was obviously aware of Dr. Salovich’s observations that Prosch's disability, throughout this period of time, was increasing in severity notwithstanding his attempt to carry on lighter jobs. Thus, Dr. Crowe was fully aware that Proseh continued to do light work during that time, testing his pain and endurance without filing for benefits.