Opinion
CIV-23-789-PRW
03-28-2024
RACHEL CELESTE LINAM, Plaintiff, v. MARTIN O'MALLEY, Commissioner of Social Security, Defendant.
REPORT AND RECOMMENDATION
SUZANNE MITCHELL UNITED STATES MAGISTRATE JUDGE
Rachel Celeste Linam (Plaintiff) brings this action for judicial review of the Commissioner of Social Security's final decision that she was not “disabled” under the Social Security Act. See 42 U.S.C. § 405(g). United States District Judge Patrick R. Wyrick referred this matter to the undersigned Magistrate Judge for initial proceedings consistent with 28 U.S.C. § 636(b)(1)(B), (C). Doc. 14.
Citations to the parties' pleadings and attached exhibits will refer to this Court's CM/ECF pagination. Citations to the Administrative Record (AR) will refer to its original pagination.
Plaintiff asks this Court to reverse the Commissioner's decision and remand the case for further proceedings, arguing the Administrative Law Judge (ALJ) erred by failing to order a mental and physical consultative examination before issuing a decision. Doc. 17, at 4-16. After careful review of the record, the parties' briefs, and the relevant authority, the undersigned recommends the Court affirm the Commissioner's decision. See 42 U.S.C. § 405(g).
I. Administrative determination.
A. Disability standard.
The Social Security Act defines a disabled individual as a person who is unable “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 [twelve] months.” 42 U.S.C. § 423(d)(1)(A). “This twelve-month duration requirement applies to the claimant's inability to engage in any substantial gainful activity, and not just [the claimant's] underlying impairment.” Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (citing Barnhart v. Walton, 535 U.S. 212, 218-19 (2002)).
B. Burden of proof.
Plaintiff “bears the burden of establishing a disability” and of “ma[king] a prima facie showing that [s]he can no longer engage in h[er] prior work activity.” Turner v. Heckler, 754 F.2d 326, 328 (10th Cir. 1985). If Plaintiff makes that prima facie showing, the burden of proof then shifts to the Commissioner to show Plaintiff “retains the capacity to perform an alternative work activity and that this specific type of job exists in the national economy.” Id. (quoting Channel v. Heckler, 747 F.2d 577, 579 (10th Cir. 1984)).
C. Relevant findings.
1. ALJ's findings.
The ALJ assigned to Plaintiff's case applied the standard regulatory analysis to decide whether Plaintiff was disabled during the relevant timeframe. AR 17-27; see 20 C.F.R. § 404.1520(a)(4); see also Wall v. Astrue, 561 F.3d 1048, 1052 (10th Cir. 2009) (describing the five-step process). The ALJ found that Plaintiff:
(1) had not engaged in substantial gainful activity since August 13, 2019, the alleged onset date;
(2) had the following severe physical impairments: hypertension, adjustment disorder with mixed anxiety and depression, bipolar disorder, panic disorder with agoraphobia, major depressive disorder, post-traumatic stress disorder, and generalized anxiety disorder;
(3) had no impairment or combination of impairments that met or medically equaled the severity of a listed impairment;
(4) had the residual functional capacity(RFC) to perform medium work with the following non-exertional limitations: she could
understand, remember, and carry out only simple, routine, and repetitive tasks; she could relate to supervisors and co-workers only on a superficial work basis; she could have only occasional contact with the public; and she could adapt to a work setting but only with occasional changes in work processes and environment;
(5) was unable to perform past relevant work;
(6) could perform jobs that exist in significant numbers in the national economy, including Dictionary of Occupational Titles (DICOT) 317.687-010, cook helper; DICOT 222.387-030, linen room attendant; and DICOT 381.687-018, industrial cleaner; and so,
(7) had not been under a disability from August 13, 2019 through May 3, 2023.See AR 19-27.
Residual functional capacity “is the most [a claimant] can still do despite [her] limitations.” 20 C.F.R. § 404.1545(a)(1).
2. Appeals Council's findings.
The Social Security Administration's Appeals Council denied Plaintiff's request for review, see id. at 1-4, making the ALJ's decision “the Commissioner's final decision for [judicial] review.” Krauser v. Astrue, 638 F.3d 1324, 1327 (10th Cir. 2011).
II. Judicial review of the Commissioner's decision.
A. Review standard.
The Court reviews the Commissioner's final decision to determine “whether substantial evidence supports the factual findings and whether the ALJ applied the correct legal standards.” Allman v. Colvin, 813 F.3d 1326, 1330 (10th Cir. 2016). Substantial evidence is “more than a scintilla, but less than a preponderance.” Lax, 489 F.3d at 1084; see Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019) (“It means-and means only-‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). The Court “remain[s] mindful that ‘[e]vidence is not substantial if it is overwhelmed by other evidence in the record.'” Wall, 561 F.3d at 1052 (alteration in original) (quoting Grogan v. Barnhart, 399 F.3d 1257, 1261-62 (10th Cir. 2005)).
The Court “consider[s] whether the ALJ followed the ‘specific rules of law that must be followed in weighing particular types of evidence in disability cases,' but [it] will not reweigh the evidence or substitute [its] judgment for the Commissioner's.” Lax, 489 F.3d at 1084 (quoting Hackett v. Barnhart, 395 F.3d 1168, 1172 (10th Cir. 2005)). Thus, “[t]he possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's findings from being supported by substantial evidence.” Id. (quoting Zoltanski v. F.A.A., 372 F.3d 1195, 1200 (10th Cir. 2004)).
“[T]he failure to apply proper legal standards may, under the appropriate circumstances, be sufficient grounds for reversal independent of the substantial evidence analysis.” Hendron v. Colvin, 767 F.3d 951, 954 (10th Cir. 2014) (quoting Glass v. Shalala, 43 F.3d 1392, 1395 (10th Cir. 1994)). But the failure to apply the proper legal standard requires reversal only where the error was harmful. Cf. Shinseki v. Sanders, 556 U.S. 396, 409 (2009) (placing the burden to show harmful error on the party challenging an agency's determination).
B. Medical evidence.
On August 21, 2018, Plaintiff saw her primary care physician, Dr. Miguel R. Sabedra, at Marlow Physicians Clinic (Marlow Clinic) for intermittently elevated blood pressure. AR 421-25. She reported that she had been experiencing stress in her life for less than three months. Id. at 421. Plaintiff described feeling sad, edgy, and anxious. Id. Dr. Sabedra suggested either counseling or medication, and Plaintiff chose the latter. Id. Dr. Sabedra diagnosed Plaintiff with adjustment disorder with mixed anxiety and depressed mood, for which he prescribed bupropion (also known as Wellbutrin), and hypertension, for which he prescribed lisinopril. Id. at 425.
At a follow up appointment on September 12, 2018, Dr. Sabedra increased her dosage of lisinopril. Id. at 416-20. By the next appointment on October 24, 2018, Plaintiff's blood pressure was successfully controlled, and she reported “feeling much better with regards to adjustment disorder symptoms of anxiety and some depression.” Id. at 412. Dr. Sabedra recorded Plaintiff's mood, affect, and thought process as normal. Id. at 414. Additionally, on October 26, 2018, her PHQ-9 and GAD-7 scores were four and five, respectively, showing no depression and mild anxiety. Id. at 408, 411.
During a January 2019 appointment, Plaintiff's blood pressure remained under control. Id. at 405. Dr. Sabedra recorded Plaintiff's mood as mildly depressed with appropriate affect, logical thought content, and good judgment and insight. Id. at 406, 409. While her PHQ-9 had increased to eight, it remained in the mild depression range, and her GAD-7 score had decreased to four, suggesting a lack of measurable anxiety. Id. at 408.
Plaintiff did not return to Marlow Clinic until July 31, 2019. Id. at 396-401. While her blood pressure remained under control with medication, she reported that her symptoms of anxiety and depression had worsened. Id. at 396. Her PHQ-9 and GAD-7 scores were sixteen and ten respectively, reflecting moderately severe depression and anxiety. Id. at 398-99. Dr. Sabedra recorded Plaintiff's mood and affect as anxious and sad, but with normal thought process and content. Id. at 399. He reiterated her diagnosis of hypertension, diagnosed moderate recurrent major depression, lowered her lisinopril dosage, and increased her bupropion. Id. at 400.
At Plaintiff's next appointment on September 10, 2019, Plaintiff's blood pressure remained under control, and she reported that her depression and anxiety were improved. Id. at 390. Plaintiff's PHQ-9 and GAD-7 scores were seven and eight, respectively, reflecting mild depression and anxiety. Id. at 392-93. Dr. Sabedra recorded Plaintiff's mood as mildly anxious and sad with normal thought process and content. Id. at 393.
On December 11, 2019, Plaintiff's blood pressure remained under control, and she reported doing well “[a]ll and all” with her anxiety and depression. Id. at 385. Plaintiff explained that she had experienced a “little bit of decreased pleasure” and interest, with some periodic trouble concentrating, but was “able to consistently get things done.” Id. Plaintiff's PHQ-9 and GAD-7 scores were eight and five, respectively, suggesting mild depression and anxiety. Id. at 387. Dr. Sabedra recorded Plaintiff's mood and affect as mildly anxious and sad, with normal thought process and content, and good judgment. Id. at 388.
Plaintiff returned to Dr. Sabedra on June 11, 2020. Id. at 373-78. Plaintiff's blood pressure remained under control, but she reported that her anxiety and depression symptoms had increased. Id. at 373-74. Dr. Sabedra recorded Plaintiff's mood, affect, and thought process and content as normal. Id. at 376. He added a prescription for Paxil to Plaintiff's medication regimen. Id. at 377. On July 22, 2020, Plaintiff reported that Paxil had improved her symptoms, that she was not experiencing any side effects, and that she wanted to continue. Id. at 367-68.
On January 25, 2021, Plaintiff reported that her depression and anxiety symptoms had worsened. Id. at 360-61. Her PHQ-9 and GAD-7 scores were each twelve, suggesting moderately severe depression and anxiety. Id. at 363-64. Plaintiff also noted that her anxiety symptoms had recently increased during a vacation. Id. at 366.
Plaintiff returned to Dr. Sabedra on June 2, 2021. Id. at 351-56. Her blood pressure remained under control, but she reported that her anxiety and depression symptoms had again worsened, and she did not think Paxil was beneficial. Id. at 353-54. Dr. Sabedra prescribed Cymbalta (also known as duloxetine) and discontinued Paxil and bupropion. Id. at 354. Dr. Sabedra recorded Plaintiff's affect as moderately anxious and depressed, but with normal thought content and process and good judgment. Id. at 355.
Three weeks later, Plaintiff reported that she was not experiencing any significant side effects from the Cymbalta and that her symptoms were a “little bit better.” Id. at 347. Dr. Sabedra recorded her affect as mildly anxious and depressed. Id. at 350. Two months later, in late August 2021, Plaintiff reported that her anxiety and depression had improved with Cymbalta. Id. at 342. Dr. Sabedra also noted that her blood pressure remained under control. Id. at 343.
On October 25, 2021, Plaintiff sought mental health treatment at Life Stance Health, Inc. (Life Stance), where she saw a psychiatric mental health nurse practitioner. Id. at 433-55. She reported that she was seeking treatment for depression, anxiety, inability to sleep, lack of concentration, lack of comprehension, and loss of time. Id. at 450. She explained her medication history and that she did not feel like Cymbalta was working to decrease her symptoms. Id. She also reported that she did not like to leave the house or get out of bed, cried for no apparent reason, experienced panic attacks when she went to the store, felt like everything closed in when she went to a big store, and had quit her job because she felt trapped. Id. She also stated that she had tried to kill herself with her husband's shotgun in 2020 but failed because she fell and broke her arm. Id. at 451. Plaintiff screened as positive for depression, anxiety, and PTSD. Id. at 450. The nurse prescribed Wellbutrin and Seroquel, and increased her Cymbalta dosage. Id. at 454-55.
Two weeks later, Plaintiff reported that her symptoms had improved. Id. at 460. She explained that she had gone to Walmart for the first time in years. Id. She also reported that she had taken a trip to Las Vegas and was able to enjoy herself. Id. She no longer cried daily and was able to be in crowds. Id. The next month, Plaintiff reported that she was still doing okay and not crying daily, but still became “very anxious” when she left the house or went places. Id. at 465. Despite her relatively positive reports, Plaintiff's scores on the PHQ-9 and GAD-7 were fifteen and twelve, respectively, indicating moderately severe depression and moderate anxiety. Id. at 469-70.
Similarly, in January 2022, Plaintiff reported that she was feeling better and that her husband also thought she had greatly improved. Id. at 478. She noted that she still got anxious outside the house when around a lot of people. Id. Her PHQ-9 score was twenty-three, showing severe depression, and her GAD-7 score remained twelve, suggesting moderate anxiety. Id. at 480. On March 2, 2022, Plaintiff reported that her mood was “all over the place.” Id. at 483. She reported that she was irritable, cried when she was angry, had bursts of energy for days, and then crashed into depression with feelings of worthlessness and inability to get anything done. Id. at 483. The nurse added a mood stabilizer to Plaintiff's medication regimen. Id. at 483, 485. Plaintiff's PHQ-9 and GAD-7 scores were nineteen and thirteen, respectively, reflecting moderately severe depression and moderate anxiety. Id. at 485-89.
At the end of March 2022, Plaintiff reported that her sleep had improved; she was not manic, though her mood was still up and down; she did not go many places, but her anxiety had greatly improved. Id. at 496. Her PHQ-9 score was twenty-one, reflecting severe depression, and her GAD-7 score was thirteen, pointing to moderate anxiety. Id. at 498. In late April, Plaintiff reported that she was feeling much better, had fewer crying spells, was not experiencing rage, still had some social anxiety, but had not experienced mania and was sleeping better. Id. at 501. She also reported that she was having trouble concentrating and focusing. Id. The nurse added a prescription for Strattera to her medication regimen. Id. at 501, 504. Plaintiff's PHQ-9 and GAD-7 scores were thirteen and ten, respectively, reflecting moderate depression and anxiety. Id.
On June 24, 2022, Plaintiff reported that she was struggling with fatigue and felt wiped out after completing a task but that overall her mood was better. Id. at 507. The nurse practitioner increased Plaintiff's Strattera dosage. Id. at 507, 511. Plaintiff's PHQ-9 and GAD-7 scores were both fourteen, reflecting moderately severe depression and anxiety. Id. at 512-15.
In September 2022, the nurse recorded Plaintiff as displaying a full and appropriate affect, an organized thought process, intact memory and attention span, and fair insight. Id. at 556. Plaintiff's PHQ-9 and GAD-7 scores were fourteen and ten, respectively, reflecting moderately severe depression and anxiety. Id. The next month, the nurse recorded the same observations except that she also stated Plaintiff's mood was irritable and anxious. Id. at 562. Her PHQ-9 and GAD-7 scores were eighteen and fifteen, respectively, suggesting moderately severe depression and severe anxiety. Id. at 563.
By November, the nurse's observations of Plaintiff's mood had improved to euthymic. Id. at 568. Her PHQ-9 and GAD-7 scores were ten and seventeen, respectively, reflecting moderately severe depression and severe anxiety. Id. at 569. Finally, in December 2022, the nurse observed Plaintiff had an organized thought process, intact memory and attention span, and fair insight. Id. at 576. Her PHQ-9 and GAD-7 scores were seventeen and ten, respectively, suggesting moderately severe depression and anxiety. Id. at 576.
Upon reviewing Plaintiff's medical records, the state reviewing psychologists concluded that she was capable of doing medium work with some non-exertional limitations. Id. at 81-87, 96-100. They concluded,
[Claimant] is able to understand, recall and perform simple and detailed but not complex tasks, and make related judgments. Unable to perform tasks that involve in-depth multilayer decisionmaking or supervisory tasks. [Claimant] is able to focus for two hour periods with routine breaks and pace and persist for 8 hour work day and 40 hour work week despite psychological symptoms. [Claimant] is able to interact with coworkers and supervisors to learn tasks and accept criticism but can only tolerate incidental/occasional public contact. [Claimant] is able to adapt to work setting and some changes in the work setting.Id. at 86, 100.
During the administrative hearing, Plaintiff testified that her blood pressure remained under control with medication and that high blood pressure was not, by itself, the reason for her disability claim. Id. at 51-52. She explained that she first went to the doctor for high blood pressure and was then diagnosed “with the anxiety and everything to go along with it.” Id. at 52.
Plaintiff added that since her disability onset date, she had taken four vacations. Id. at 44-46. In mid-2020, she rode with her family to Fort Walton, Florida and spent four to five days in a condominium for her son's senior trip. Id. at 45-47, 49. In late January 2021, as her children's Christmas present, she rode with her family to Gatlinburg, Tennessee and stayed in a cabin. Id. at 45-47. Plaintiff flew to Las Vegas, Nevada in late 2021 and stayed for three days. Id. at 44-47. Finally, in November 2022, she flew for a vacation in Cancun, Mexico. Id. at 46-47. Plaintiff testified that she was able to go on these trips because she was in a manic phase during each. Id. at 47-50. For example, although she reported to Life Stance in late 2021 that she had recently enjoyed herself on a vacation to Las Vegas, she testified at the administrative hearing that she had stayed awake the entire three days and walked around the hotel each night. Id. at 47-48.
C. Analysis.
Plaintiff contends the ALJ failed to properly develop the record by denying her requests for physical and mental consultative examinations. She made these requests both prior to and during the administrative hearing. Id. at 37-38, 337. In his decision, the ALJ explained that he declined Plaintiff's request “because sufficient evidence of record exists in the matter to render a decision.” Id. at 17.
An ALJ “has broad latitude” in determining whether to order a consultative examination or tests. Jazvin v. Colvin, 659 Fed.Appx. 487, 489 (10th Cir. 2016). “A consultative examination may be required if there is a direct conflict in the medical evidence, the medical evidence is inconclusive, or additional tests are required to explain a diagnosis.” Id. (internal quotations omitted). That said, “there is no need for a consultative examination when the ALJ has enough information to make a disability determination.” Id.
1. The ALJ did not err in denying Plaintiff's request for a physical consultative examination.
In her opening brief, Plaintiff only briefly addresses the alleged need for a physical consultative examination in relation to hypertension. She states that the record shows she “received treatment from her hypertension only from her primary care physician . . . but [he] did not provide any opinions regarding her limitations.” Doc. 17, at 7-8. She then essentially states that because the ALJ concluded her hypertension was a severe impairment, a consultative examination was necessary. Id. at 8.
By Plaintiff's own acknowledgment, factors including a direct conflict in the medical evidence, inconclusive medical evidence, or a diagnosis needing further explanation are generally required to warrant a consultative examination. Id. at 5 (first citing 20 C.F.R. § 404.1591a(b); then citing Miller v. Barnhart, 175 Fed.Appx. 952, 957 (10th Cir. 2006)). None of those factors apply to Plaintiff's hypertension. Dr. Sabedra diagnosed Plaintiff with hypertension in 2018, and it has been controlled with medication since that time. AR 343, 348, 352, 360, 373, 385, 396, 405, 412 (noting satisfactory blood pressure control); see also id. at 420-21, 425 (noting unsatisfactory blood pressure control and medication). Plaintiff confirmed during the administrative hearing that her hypertension was controlled with medication. Id. at 51-52.
The medical record, the reviewing state agency physicians' opinions, and Plaintiff's own testimony provided sufficient evidence to decide whether Plaintiff's hypertension resulted in physical limitations. Harlan v. Astrue, 510 Fed.Appx. 708, 712 (10th Cir. 2013) (“Without a statute, regulation, or case requiring an ALJ to rule on a request for a consultative examination or to provide reasons for the ALJ's ruling, the appropriate inquiry continues to be whether the ALJ met his responsibility to ensure the record was sufficiently developed to decide the issues presented at the hearing.”). So the ALJ committed no legal error here.
2. The ALJ did not err in denying Plaintiff's request for a mental consultative examination.
Plaintiff also argues the ALJ erred by denying her request for a mental consultative examination. To establish the factors generally warranting the same, she begins with attempting to establish direct conflict in her medical records. See Jazvin, 659 Fed.Appx. at 489. She contends the fluctuations in her PHQ-9 and GAD-7 scores during treatment at Marlow Clinic and Life Stance constitute an inconsistency in her medical records. Doc. 17 at 8-10, 13-14. But these scores do not illustrate a conflict in the records. Instead, the scores and the overall records from both sources illustrate the waxing and waning nature of Plaintiff's symptoms, including within the treatment periods from each facility. See supra § II.B. Plaintiff has acknowledged this aspect of her symptoms, reporting that she had been experiencing good and bad days, and easier and more difficult phases. AR 47-51, 59-60, 62-63 (Plaintiff's testimony); see also id. at 342, 347, 353-54, 360-61, 373-74, 385, 390, 396, 412, 421, 450, 460, 465, 478, 483, 496, 501, 507 (medical records reflecting variable mental state).
Moving to the third factor, Plaintiff argues that her diagnoses of multiple mental health impairments require further explanation through cognitive testing and advanced psychological assessments that she could obtain during a consultative examination. Doc. 17, at 10-11. She relies on her often-elevated PHQ-9 and GAD-7 scores to argue that a consultative examination is “crucial for the ALJ to make a well-informed determination.” Id. at 11. Plaintiff's assertion is conclusory, at best.
The ALJ reviewed over four years of medical records pertaining to Plaintiff's impairments and medical treatments. AR 341-425, 431-517, 524-78.
He also considered Plaintiff's function report, her husband's and mother's third-party function reports, her testimony during the administrative hearing, and the state reviewing physicians' opinions. Id. at 41-64, 79-87, 95-100, 273-80, 283-90, 291-98. In light of this considerable evidence in the record, Plaintiff fails to explain why additional testing is necessary for the ALJ's determination, as “there is no need for a consultative examination when the ALJ has enough information to make a disability determination.” Jazvin, 659 Fed.Appx. at 489; see also Cowan v. Astrue, 552 F.3d 1182, 1187 (10th Cir. 2008) (finding “there was no need to further develop the record [by ordering a consultative examination] because sufficient information existed for the ALJ to make her disability determination”).
Plaintiff further suggests that the RFC lacks substantial evidentiary support without a consultative examination because it does not line up with a medical expert opinion or specific testing within her treatment records. Doc. 17, at 6-7, 10-11. But the regulations do not require a direct correspondence between an RFC finding and a specific medical opinion. See Valdez v. Kijakazi, 2022 WL 278731, at *6 (D.N.M. Jan. 31, 2022) (“[T]he Tenth Circuit has affirmatively rejected the notion that the components of an RFC lack substantial evidence unless they line up perfectly with an expert medical opinion.” (citing Chapo v. Astrue, 682 F.3d 1285, 1289 (10th Cir. 2012))), adopted, 2022 WL 683024 (D.N.M. Mar. 8, 2022). Further, “the ALJ, not a physician, is charged with determining a claimant's RFC from the medical record.” Watts v. Berryhill, 705 Fed.Appx. 759, 762 (10th Cir. 2017) (citing Howard v. Barnhart, 379 F.3d 945, 949 (10th Cir. 2004)).
Plaintiff also relies on 42 U.S.C. § 423(d)(5)(B) to imply the ALJ erred in not ordering a consultative examination because he did not have twelve months of medical records on which to make a determination. Doc. 17, at 12. As established, however, the record contains over four years of medical records regarding Plaintiff's mental impairments. See supra § II.B. Life Stance records alone cover over a one-year period from October 2021 through December 2022. AR 431-517, 524-78.
Also, because Plaintiff's treatment providers often recorded her conditions as being of “high severity,” she challenges the ALJ's rationale by characterizing his decision as concluding Plaintiff's conditions are moderate. Doc. 17, at 13. But Plaintiff misreads the ALJ's decision. The ALJ found that Plaintiff suffered from multiple severe impairments but that the resulting limitations were moderate and could be accommodated through the determined RFC. Cf. Terwilliger v. Comm'r, Soc. Sec. Admin., 801 Fed.Appx. 614, 622 (10th Cir. 2020) (noting plaintiff had “identifie[d] no inconsistency between the RFC for a limited range of light work and [the physician's] diagnoses” because “without any specific functional limitations, there is no obvious impact on the RFC, as the diagnoses alone do not automatically establish he was disabled”).
Plaintiff also criticizes the ALJ's reliance on one state reviewing physician's opinion because it was based on a review of her records rather than a personal examination. Doc. 17, at 14. “The non-examining physician's opinion is an acceptable medical source, which the ALJ was entitled to consider.” Flaherty v. Astrue, 515 F.3d 1067, 1071 (10th Cir. 2008) (citing 20 C.F.R. § 404.1513(a)(1)). Here, the ALJ evaluated the state reviewing physicians' opinions that Plaintiff retained an RFC consistent with medium, semi-skilled work and certain non-exertional limitations. The ALJ then reasonably concluded these opinions were generally persuasive due to their consistency with the record as a whole. AR 24-25. Although, the ALJ did go a step further concluding that limiting Plaintiff to unskilled work was “more consistent with the evidence of record.” Id. at 24.The Court will not reweigh the evidence or overturn the ALJ's reasonable conclusions on appeal. See Lax, 489 F.3d at 1084 (“We consider whether the ALJ followed the ‘specific rules of law that must be followed in weighing particular types of evidence in disability cases,' but we will not reweigh the evidence or substitute our judgment for the Commissioner's.” (quoting Hackett, 395 F.3d at 1172)).
The ALJ also found the reviewing physician's opinion at the reconsideration level only partially persuasive to the extent that he found Plaintiff's hypertension non-severe. AR at 25. The ALJ explained that the record showed Plaintiff had “problems with her hypertension, which required the use of medications.” Id.
While the record did not contain an examining medical opinion on functional limitations, this is not a circumstance where the record contained “[a] direct conflict in the medical evidence, the medical evidence [was] inconclusive, or additional tests [were] required to explain a diagnosis.” Jazvin, 659 Fed.Appx. at 489. So the ALJ had no duty to further develop the record or order a consultative examination regarding Plaintiff's mental impairments. Thus, the ALJ committed no error.
III. Recommendation and notice of right to object.
For the above reasons, the undersigned recommends that the Court affirm the Commissioner's final decision.
The undersigned advises the parties that they may object to this Report and Recommendation with the Clerk of Court on or before April 11, 2024, under 28 U.S.C. § 636(b)(1) and Federal Rule of Civil Procedure 72(b)(2). The undersigned also advises the parties that failure to timely object to this Report and Recommendation waives the right to appellate review of both factual and legal issues contained herein. See Moore v. United States, 950 F.2d 656, 659 (10th Cir. 1991).
This Report and Recommendation disposes of all issues and terminates the referral to the undersigned Magistrate Judge in this matter.