Opinion
22-3008
08-05-2024
RAINNA J. LANGLEY, Plaintiff-Appellant, v. MARTIN J. O'MALLEY, Commissioner of Social Security, Defendant-Appellee.
NONPRECEDENTIAL DISPOSITION
Argued September 20, 2023
Appeal from the United States District Court for the Southern District of Indiana, Terre Haute Division. No. 2:21-cv-00248 James R. Sweeney II, Judge.
Before Kenneth F. Ripple, Circuit Judge Candace Jackson-Akiwumi, Circuit Judge John Z. Lee, Circuit Judge
ORDER
Rainna Langley appeals the denial of her application for supplemental social security benefits. After considering multiple psychiatric opinions and Langley's own testimony, an Administrative Law Judge (ALJ) found that Langley was not disabled and denied her application. Langley sought review in the district court, which affirmed the ALJ's conclusion. Because the ALJ's decision was supported by substantial evidence, we affirm the judgment of the district court.
Langley's travails began in April 2019, when her anxiety and panic attacks forced her to leave her job. Over the following year, Langley's psychiatric symptoms caused her to undergo six hospitalizations and multiple emergency room visits. Langley filed an application for supplemental security income on December 30, 2019, asserting that her anxiety, depression, and panic attacks precluded her from working. The Social Security Administration initially denied her claim in June 2020, and again on reconsideration in August 2020. Langley requested reconsideration and received a hearing before an ALJ.
At the hearing, Langley testified that she was experiencing "severe panic attacks daily" and felt "very overwhelmed with panic and anxiety." While she noted some improvement with treatment, she still had between five and six panic attacks per week. Langley explained that these symptoms made simple tasks such as basic grooming and grocery shopping difficult, and that she struggled to make decisions of any kind.
The ALJ also considered the assessments of multiple agency doctors. Clinical Psychologist Dr. Melissa Sprinkle conducted a consultive exam on Langley in June 2020, diagnosing her with Panic Disorder, Major Depressive Disorder, and Generalized Anxiety Disorder. Even with these diagnoses, Dr. Sprinkle found that Langley had the capacity to complete basic tasks and suggested that a structured work environment could alleviate some of her depressive symptoms.
But Dr. Sprinkle also recognized that Langley's anxiety and depression would hinder her motivation to look for a job. And even if Langley did secure employment, Dr. Sprinkle wrote that Langley would struggle to "maintain her focus and attention to complete assigned work activities." Dr. Sprinkle concluded that Langley's "psychological symptoms would have a significant impact on her ability to establish and maintain gainful employment."
The ALJ also considered the reports of two additional agency doctors, Ken Lovko and William Shipley, who reviewed Langley's medical background without conducting independent examinations. After an initial review, Dr. Lovko prepared a report, finding that Langley was moderately limited in three categories of mental functioning: understanding, remembering, and applying information; interacting with others; and adapting or managing oneself. See 20 C.F.R. § 404.1520a(c)(3). He also found that Langley was markedly limited in concentrating, persisting, or maintaining pace. Id. After reviewing an expanded record on reconsideration, Dr. Shipley found that Langley was only moderately limited in all of the aforementioned categories.
The narrative portion of Dr. Lovko's report, which was adopted by Dr. Shipley ("Lovko/Shipley report" or "the report"), described Langley as able to perform simple work-related tasks with some limitations. The Lovko/Shipley report reiterated Dr. Sprinkle's finding that employment could be beneficial for Langley, but that she would struggle to apply for a job due to her symptoms. The report concluded that Langley would "appear to work best alone, in semi-isolation from others or as part of a small group."
In a written decision, the ALJ considered this and other evidence, applied the required five-step analysis, see 20 C.F.R. § 416.920(a), and concluded that Langley was not disabled. The ALJ determined that while Langley suffered from multiple mental health impairments, her symptoms were not sufficient to give rise to a presumption of eligibility for benefits. See Id. § 416.920(d). The ALJ also found that Langley could perform a full range of work, subject to certain limitations. These constraints included limiting Langley to "simple, routine, repetitive tasks" with no more than "occasional, brief interaction with the general public, coworkers, and supervisors." Based on this, the ALJ then found that Langley was unable to perform her prior jobs, but "capable of making a successful adjustment to other work that exists in significant numbers in the national economy." As such, the ALJ concluded that Langley was not disabled and denied her application for benefits.
Langley appealed this decision to the Social Security Appeals Council, which declined to rehear her case. She then sought review in the district court, which affirmed the ALJ's decision. Langley now appeals.
We review the district court's judgment affirming the agency's decision de novo but apply the "substantial evidence" standard when reviewing the ALJ's decision. See Sevec v. Kijakazi, 59 F.4th 293, 297 (7th Cir. 2023). Substantial evidence means "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Butler v. Kijakazi, 4 F.4th 498, 501 (7th Cir. 2021) (cleaned up). "An ALJ need not specifically address every piece of evidence, but must provide a logical bridge between the evidence and his conclusions." O'Connor-Spinner v. Astrue, 627 F.3d 614, 618 (7th Cir. 2010) (internal quotation marks omitted). Our review is deferential, and we will not "reweigh the evidence or substitute our judgment for that of the ALJ." Summers v. Berryhill, 864 F.3d 523, 526 (7th Cir. 2017). As the Supreme Court has explained, "whatever the meaning of 'substantial' in other contexts, the threshold for such evidentiary sufficiency is not high." Biestek v. Berryhill, 587 U.S. 97, 103 (2019).
Under the Social Security Act, an individual must "furnish[] such medical and other evidence" of a disability in order to qualify for benefits. 42 U.S.C. § 423(d)(5)(A). A person is "disabled" if he or she has an "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Id. § 423(d)(1)(a). Social security regulations prescribe a five-step test for determining if a claimant meets this definition. See 20 C.F.R. § 404.1520(a). We have summarized this test as requiring the ALJ to consider whether:
(1) the claimant is presently employed; (2) the claimant has a severe impairment or combination of impairments; (3) the claimant's impairment meets or equals any impairment listed in the regulations as being so severe as to preclude substantial gainful activity; (4) the claimant's residual functional capacity leaves him unable to perform his past relevant work; and (5) the claimant is unable to perform any other work existing in significant numbers in the national economy.Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 351-52 (7th Cir. 2005) (citing 20 C.F.R. §§ 404.1520, 416.920). Between steps three and four of this process, an ALJ determines a claimant's "residual functional capacity" (RFC), which is the most work an individual can perform despite their limitations. See 20 C.F.R. § 416.945(a)(1). The burden of proof is on the claimant at steps one through four, but the burden shifts to the Commissioner at step five. Wilder v. Kijakazi, 22 F.4th 644, 651 (7th Cir. 2022).
On appeal, Langley raises two grounds for remand, both challenging the ALJ's formulation of her RFC. First, Langley contends that the ALJ arrived at an assessment that was less limiting than the opinion of the state agency psychologists, Dr. Lovko and Dr. Shipley, without explaining why. Second, she argues that the ALJ failed to articulate a rationale for rejecting the opinion of the agency's consulting psychologist, Dr. Sprinkle. We address each argument in turn.
Langley first raises two issues with the ALJ's treatment of the Lovko/Shipley report. She claims that the ALJ committed legal error by not explaining why the RFC deviated from the language in the report. And she argues that the ALJ failed to incorporate any concentration limitations in the RFC as suggested by Dr. Lovko and Dr. Shipley. Both arguments are unpersuasive.
We start with Langley's contention that the ALJ erred by deviating from the Lovko/Shipley report without explanation. Langley's argument here is quite narrow. She does not contend that the doctors' evaluations were erroneous, but only argues that the ALJ should have explained why he did not adopt the report's language.
An ALJ has discretion when incorporating a doctor's narrative opinion into an RFC assessment and need not replicate the precise language. See Recha v. Saul, 843 Fed.Appx. 1, 4 (7th Cir. 2021) ("[A]n ALJ has some latitude with the exact wording of an RFC as long as it conveys in some way the restrictions necessary to address a claimant's limitations."). In evaluating prior administrative medical findings, the ALJ must consider criteria such as the supportability and consistency of the medical opinions. See 20 C.F.R. § 416.920c(b)(2). We will reverse only when the ALJ does not rely on substantial evidence, a standard that "does not present a high hurdle." Recha, 843 Fed.Appx. at 4. The ALJ's decision need only include "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Biestek, 587 U.S. at 103 (citation omitted).
The ALJ's incorporation of the Lovko/Shipley report meets this standard. In relevant part, the report states that Langley is "able to respond appropriately to brief supervision and interactions with coworkers and work situations." And while the report also notes that Langley could "manage occasional contact with the public," it also suggests that "sustained, intensive, interpersonal contact would be precluded."
In the RFC, the ALJ wrote that Langley is limited to "no more than occasional, brief interaction with the general public, coworkers, and supervisors." In constructing this RFC, the ALJ copiously recounted the evidence Langley presented and found that she could largely complete basic daily tasks such as controlling her personal care, managing her finances, and taking care of her dog. And the ALJ also considered Langley's history of mental illness and difficulty interacting with other people. Based on this evidence, the ALJ provided an RFC that closely echoed the doctors' suggestion.
Moreover, the ALJ's formulation that limits Langley to no more than occasional interaction with other people is more limiting than the doctors' assessment. As we have noted previously, an RFC that is more limiting than an agency doctor's analysis illustrates that the ALJ gave "reasoned consideration" to the evidence. Burmester v. Berryhill, 920 F.3d 507, 510 (7th Cir. 2019). Because the ALJ has demonstrated such reasoned consideration here, we are satisfied that the ALJ appropriately incorporated Dr. Lovko's and Dr. Shipley's opinions in the RFC.
Furthermore, Langley's supposition that the ALJ must explicitly explain any deviation from the Lovko/Shipley report lacks grounding. We require only that an ALJ "consider the entire record"; they are not obligated to "rely entirely on a particular physician's opinion or choose between the opinions [of] any of the claimant's physicians." Schmidt v. Astrue, 496 F.3d 833, 845 (7th Cir. 2007). In constructing the RFC, the ALJ only minimally departed from the doctors' opinion and, as explained above, this deviation was supported by substantial evidence in the record. This is all we require.
Next, Langley contends that the ALJ failed to incorporate her concentration limitations in the RFC. This too finds no support in the record. Both Dr. Shipley and Dr. Lovko noted that Langley was "moderately limited" in her ability to "maintain attention and concentration for extended periods." Dr. Lovko also indicated that Langley had a "marked" limitation in the ability to "concentrate, persist, or maintain pace." But on reconsideration, Dr. Shipley changed this to only a "moderate" limitation. In the RFC, the ALJ limited Langley's ability to work to "simple, routine, and repetitive tasks .. with little opportunity for diversion or interruption."
Langley rests her argument on Winsted v. Berryhill, 923 F.3d 472 (7th Cir. 2019). There, as here, the ALJ determined that the claimant was limited to "simple, routine, repetitive tasks with few workplace changes." Id. at 476. But, in Winsted, a physician had concluded that the claimant had suffered from moderate difficulties with concentration, persistence, and pace. Given this, we found the ALJ's conclusory statement wanting, noting that "in most cases employing terms like 'simple repetitive tasks' on their own . are insufficient to present the claimant's limitations in this area." Id. at 477 (quoting O'Connor-Spinner, 627 F.3d at 620 (7th Cir. 2010)) (cleaned up).
But, unlike in Winsted, the ALJ in this case provided a more robust analysis of Langley's concentration deficit. He noted that Langley should have "little opportunity for diversion or interruption" and that she is limited to only "occasional, brief interactions with the general public." The ALJ further added that Langley should have no complex decisions, no complex written or verbal communications, and no fast-paced or assembly-line production requirements. This is far more than the bald statement in Winsted and fails to establish legal error.
Langley next argues that the ALJ failed to articulate a rationale for rejecting Dr. Sprinkle's opinion. After reviewing the record, Dr. Sprinkle concluded that Langley's "psychiatric symptoms would have a significant impact on her ability to establish and maintain gainful employment." She noted that the process of applying for and learning a new job would increase the severity of Langley's symptoms, and Langley would struggle to maintain focus to complete work tasks.
The ALJ outlined Dr. Sprinkle's findings and stated that her determination was "not consistent with [Langley's] mental status examination findings and is not supported by the record as a whole and is therefore not persuasive." In Langley's view, this explanation was inadequate and constitutes legal error.
While an ALJ must provide a rationale for discounting a medical opinion, it is well within the ALJ's discretion to assign weight to different opinions based on their consistency with the overall record. See Prill v. Kijakazi, 23 F.4th 738, 751 (7th Cir. 2022). In finding that Langley's symptoms would affect her ability to work, Dr. Sprinkle cites Langley's lack of motivation to find work and her trouble concentrating when given an assigned task. As the ALJ notes, there is record evidence that contradicts both of these conclusions.
The ALJ, for instance, pointed to Langley's own testimony that she can complete household chores, go shopping, and even exercise. And as the ALJ noted, these activities are "consistent with the ability to perform work" subject to certain requirements. Furthermore, Dr. Shipley, Dr. Lovko, and Dr. Sprinkle concluded that Langley's "attention and concentration are [ ... ] adequate" and she can "focus for sustained periods of time." Relying on this evidence, the ALJ provided sufficient reasons to afford Dr. Sprinkle's opinions less weight.
Langley also insists that the ALJ erred in assessing Dr. Sprinkle's determination that Langley's symptoms would "have a significant impact on her ability to establish and maintain gainful employment." The ALJ discounted this determination, finding that it was a question reserved for the Commissioner. Under applicable regulations, whether a claimant is disabled, able to work, or able to perform regular or continuing work, are issues reserved to the Commissioner and an expert's conclusion as to these matters is "inherently neither valuable nor persuasive" to a disability determination. See 20 C.F.R. § 416.920b(c).
But we need not conclusively decide this issue. As we note above, the ALJ's departure from Dr. Sprinkle's report was supported by substantial evidence. So even if the ALJ erred in failing to consider the statement, any differences are supported by the ALJ's extensive discussion of the record and the multiple pieces of evidence that contradict Dr. Sprinkle's assessment.
AFFIRMED