United States District Court, D. New Hampshire
ORDER ON APPEAL
JOSEPH N. LaPLANTE, District Judge.
Holly Couture has appealed the Social Security Administration's ("SSA") denial of her application for a period of disability and disability insurance benefits. An administrative law judge ("ALJ") ruled that, despite Couture's severe impairments (fibromyalgia and asthma), she retains the residual functional capacity ("RFC") to perform jobs that exist in significant numbers in the national economy, and, as a result, is not disabled. See 20 C.F.R. § 404.1505(a). The Appeals Council later denied Couture's request for review, see id. § 404.968(a), with the result that the ALJ's decision became the final decision on Couture's application, see id. § 404.981. Couture then appealed the decision to this court, which has jurisdiction under 42 U.S.C. § 405(g) (Social Security).
Couture has filed a motion to reverse the decision. See L.R. 9.1(b)(1). Couture argues that the ALJ erred at step four of the process by improperly evaluating the medical opinion evidence bearing on his RFC determination in a manner that failed to properly account for evidence of Couture's fibromyalgia and, as a result, erroneously found in step five that Couture can perform jobs that exist in the national economy. The Acting Commissioner of the Social Security Administration has crossmoved for an order affirming the ALJ's decision, see L.R. 9.1(d), defending the ALJ's RFC determination as supported by substantial evidence. As explained fully below, the court agrees with the Acting Commissioner, and therefore grants her motion to affirm (and denies Couture's motion to reverse) the decision.
I. Applicable legal standard
The court limits its review of a final decision of the SSA "to determining whether the ALJ used the proper legal standards and found facts upon the proper quantum of evidence." Ward v. Comm'r of Soc. Sec., 211 F.3d 652, 655 (1st Cir. 2000). The court will uphold the ALJ's decision if it is supported by "such evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971) (quotations omitted). Though the evidence in the record may support multiple conclusions, the court will still uphold the ALJ's findings "if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support his conclusion." Irlanda Ortiz v. Sec'y of Heath & Human Servs., 955 F.2d 765, 769 (1st Cir. 1991).
In assessing Couture's request for disability benefits, the ALJ engaged in the requisite five-step process. See 20 C.F.R. § 416.920. He first concluded that Couture had not engaged in substantial gainful activity since the alleged onset of her disability on March 15, 2011. At the second step, he determined that Couture suffers from two severe impairments: fibromyalgia and asthma. The ALJ then found that Couture's impairments did not meet or "medically equal" the severity of one of the impairments listed in the Social Security regulations. See 20 C.F.R. §§ 416.920(d), 416.925, and 416.926. At the fourth step, the ALJ concluded that Couture retained the RFC to "perform light work as defined in 20 C.F.R. § 404.1567(b) except she can occasionally climb, stoop, crouch, crawl and kneel, " and "[s]he must avoid concentrated exposure to respiratory irritants, such as fumes, dusts and gasses." Admin. R. at 17. After finding that Couture could not perform her past relevant work as a baker, day care worker, and child monitor, see 20 C.F.R. § 404.1565, the ALJ continued to step five, at which the SSA bears the burden of showing that a claimant can perform other jobs that exist in significant numbers in the economy. Freeman v. Barnhart, 274 F.3d 606, 608 (1st Cir. 2001). Relying on the testimony of a vocational expert, the ALJ concluded that Couture could perform such jobs as companion, telemarketer, appointment clerk, and final assembler. Therefore, the ALJ found, Couture was not disabled within the meaning of the Social Security Act.
At issue in this appeal is whether the ALJ's RFC assessment is supported by substantial evidence in the record. In evaluating Couture's RFC as related to her fibromyalgia, the ALJ had three medical opinions at his disposal: those of Dr. Nicole Orzechowski, Couture's treating rheumatologist; Dr. Matthew Masewic, a consultative examiner; and Dr. John MacEachran, a state agency medical consultant. Couture maintains that the ALJ erred by affording "less weight" to the opinion of Dr. Orzechowski and only "some weight" to the opinion of Dr. MacEachran. Couture then argues that the ALJ ultimately and impermissibly relied on his own lay interpretation of the medical evidence in determining her RFC after affording "great weight" to the opinion of Dr. Masewic, because that opinion did not include a function-by-function capacity analysis. The court disagrees.
A. Medical opinion evidence
1. Dr. Orzechowski
The argument that undergirds Couture's appeal is her contention that the ALJ erred by affording "limited weight"- instead of controlling or greater weight-to the opinion of Couture's treating physician, Dr. Orzechowski. Couture predictably invokes the SSA's rule that more weight should generally be accorded to treating sources than non-treating sources. 20 C.F.R. § 404.1527(c)(1). The opinion of a treating physician must be given controlling weight if it is well supported by medically acceptable diagnostic techniques and not inconsistent with other evidence on the record. Id . § 404.1527(c)(2). If controlling weight is not afforded the opinion of a treating source, the ALJ must "give good reasons" for the weight afforded that source. Id . § 404.1527(c)(2). Where, as here, an ALJ relies on inconsistencies between a source's opinion and the record to discount that opinion, "the claimed inconsistencies must be adequately supported by the record as well." Beck v. Astrue, 2011 DNH 146, 14. Here, the ALJ's stated reasons for discounting Dr. Orzechowski's opinion find substantial support in the record.
Dr. Orzechowski opined only that Couture "would be best served by working part time, " that is, "for four hours per shift, preferably during the day, " and that she "should be allowed to sit periodically, perhaps 15 minutes during a 4 hour shift." Admin. R. at 355. In discounting Dr. Orzechowski's opinion, the ALJ provided a thorough review of the record evidence provided by Couture and her mother, as well as the other medical opinions in evidence.
The ALJ relied primarily on Couture's level of activity during her alleged period of disability, which conflicted with Dr. Orzechowski's conclusion that Couture could only work four hours out of the day. Yet Couture herself reported that she had no difficulty sitting, standing, or walking; that she attended the gym regularly, and walked, hiked, and danced for exercise; that she performed caretaking services for her parents for up to seven hours a day; and that she performed all of her own household chores, including cooking meals. As the ALJ further observed, Couture's mother validated the reports of ...