Summary
finding that ALJ committed no error in interpreting claimant's Waddell's signs as malingering given the medical reports of multiple positive signs and poor effort on testing
Summary of this case from Haywood v. Soc. Sec. Admin.Opinion
No. SA-04-CA-0212-RF.
February 23, 2005
ORDER ADOPTING REPORT AND RECOMMENDATION OF UNITED STATES MAGISTRATE JUDGE
BEFORE THE COURT is the Report and Recommendation of the United States Magistrate Judge Pamela A. Mathy, entered on September 28, 2004. (Docket No. 15). The Magistrate Judge recommends that the decision of the Commissioner denying Plaintiff's applications for disability insurance benefits be affirm ed. Plaintiff filed his objections to the Magistrate Judge's Report and Recommendation on October 1, 2004. After due consideration, the Court is of the opinion that the Magistrate Judge's Report and Recommendation should be ADOPTED IN ITS ENTIRETY.
BACKGROUND
On July 17, 2001, Santana Rodriguez, Plaintiff, filed his application for Disability Insurance Benefits with the Social Security Administration, alleging headaches, back and right shoulder problems, and carpal tunnel syndrome. The Social Security Administration denied Plaintiff's application both initially and upon reconsideration. An Administrative Law Judge ("ALJ") held a hearing on May 19, 2003, at which time Plaintiff was represented by counsel. On August 25, 2003, the ALJ determined that Plaintiff was in fact not disabled. At the time of the decision, Plaintiff was fifty-one years old with a tenth grade education and a past work experience as a truck driver. According to the ALJ, Plaintiff alleged his disabilities began as early as January 17, 2001. The ALJ found, however, that Plaintiff had engaged in substantial gainful employment from the alleged onset date up until December 28, 2001. Furthermore, the ALJ found that Plaintiff had not engaged in substantial gainful employment on or after December 29, 2001. After analyzing Plaintiff's condition through a multi-step process, weighing several doctors' diagnoses, and assessing Plaintiff's residual functional capacity ("RFC") and vocational expert's opinion, the ALJ determined the Plaintiff was capable of performing a full range of light work. The Appeals Council denied Plaintiff's request for review on February 27, 2004, making the ALJ's determination the final decision of the Commissioner. Plaintiff now appeals from that determination. Magistrate Judge Pamela Mathy reviewed the Commissioner's decision denying Plaintiff's disability benefits and recommends that it be affirmed .
This Court adopts the "ALJ's FINDINGS AND PLAINTIFF'S CONTENTIONS" as they appear in the Magistrate Judge's Report and Recommendation, p. 4-22.
STANDARD OF REVIEW
The Court reviews de novo a Magistrate Judge's Report and Recommendation if a party files specific objections within ten days of service. The Court need not consider objections that are frivolous, conclusive, or general in nature. If there are no specific objections to a Magistrate Judge's Memorandum and Recommendation, the District Court is to review for it for findings and conclusions that are either clearly erroneous or contrary to law. In the present case, Plaintiff timely filed specific objections to the Magistrate Judge's Report and Recommendation, thus warranting de novo review by the Court.
Battle v. United States Parole Comm'n, 834 F.2d 419, 421 (5th Cir. 1987).
United States v. Wilson, 864 F.2d 1219, 1221 (5th Cir. 1989).
STANDARD OF REVIEW IN SOCIAL SECURITY APPEALS
The Court's review of the Commissioner's denial of disability benefits is limited to deciding whether the finding is supported by substantial evidence in the record and whether the proper legal standards were followed in evaluating the evidence. Here, substantial means more than a scintilla, but less than a preponderance of the evidence that a reasonable person might accept as adequate to support a conclusion. A finding of no substantial evidence is appropriate only if no credible evidentiary choices or medical findings exist to support the Commissioner's decision.
Boyd v. Apfel, 239 F.3d 698, 704 (5th Cir. 2001); 42 U.S.C. §§ 405(g), 1383(c)(3) (2002).
Boyd, 239 F.3d at 704.
Johnson v. Bowen, 864 F.2d 340, 343-44 (5th Cir. 1993).
The Commissioner's findings must be affirmed if they are supported by substantial evidence. In applying the substantial evidence standard, this Court reviews the entire record but may not re-weigh the evidence, nor substitute its judgment for that of the Commissioner. Four elements are weighed by the Court to determine whether the Commissioner's determination is supported by substantial evidence: (1) objective medical facts, (2) diagnoses and opinions of treating and examining physicians, (3) the claimant's subjective evidence of pain and disability, and (4) the claimant's age, education and work experience.
Masterson v. Barnhart, 309 F.3d 267, 272 (5th Cir. 2002).
Johnson, 864 F.2d at 343-44.
Martinez v. Chater, 64 F.3d 172, 174 (5th Cir. 1995).
ANALYSIS
Plaintiff makes several objections to Magistrate Judge Mathy's Report and Recommendation. His objections first contest the Judge's conclusion that the ALJ's decision provides a thorough and detailed summary of all the medical evidence in the record and that the medical record provides substantial support for the ALJ's determination. Plaintiff further objects to the Report and Recommendation's finding that Dr. Kuwamura's opinion does not contain a discussion of his examination findings. In particular, Plaintiff objects to the ALJ's conclusion that the opinion of Dr. Kuwamura, one of Plaintiff's treating physicians, is inconsistent with other medical reports and opinions found in the record. Plaintiff further argues that the ALJ inaccurately concluded that Dr. Kuwamura did not account for Plaintiff's pain exaggeration found in the doctor's own report. Similarly, Plaintiff objects to the Report and Recommendation's finding that the opinion of Dr. Geibel, another treating physician, was not consistent with his own examination conclusions. He especially objects to the finding that Dr. Geibel's opinion did not reflect whether the doctor knew of Plaintiff's history of pain exaggeration and that Dr. Geibel intruded upon matters reserved for the Social Security Administration. Plaintiff maintains that both doctors agree that Plaintiff's medical conditions are severe and that he should be precluded from work. Plaintiff further asserts that the two treating doctors' opinions are not inconsistent and unsupported, except that their opinions are quite different from the opinions on which the ALJ relied.Plaintiff's arguments concerning the weight afforded to Dr. Kuwamura's and Dr. Geibel's medical opinions do not persuade the Court to set aside Judge Mathy's recommendation because substantial evidence in the record supports the ALJ's finding s. Dr. Kuwamura and Dr. Geibel are only two of seven doctors who saw Plaintiff from October 2001 to May 2003. The five other doctors never diagnosed Plaintiff as being disabled. Additionally, though some evaluations indicated some modest lower extremity sensory and reflex deficits, the ALJ was right to question the accuracy of those findings given that five doctors from October 2001 to February 2003 no ted that Plaintiff exhibited a tendency to exaggerate the amount of pain from which he suffered.
Report and Recommendation of the U.S. Magistrate Judge, at 16-17.
Typically, the opinion and diagnosis of a treating physician should be afforded considerable weight in determining disability. The ALJ, however, has sole responsibility for determining a claimant's status. The ALJ is free to reject a physician's opinion when the evidence supports a contrary conclusion. The treating physician's opinions are not conclusive. With good cause, the ALJ may discount, or even disregard entirely the opinion of the treating physician. In the present case, the ALJ had good cause to disregard the opinions of Dr. Kuwamura and Dr. Geibel because their assessments were unsupported by the record, and the ALJ found that the record as a whole did not support a conclusion that the claim ant is disabled from all work activity.
Newton v. Apfel, 209 F.3d 448, 455 (5th Cir. 2000) ( citing Paul v. Shalala, 29 F.3d 208, 211 (5th Cir. 1994)); Brown v. Apfel, 192 F.3d 492, 500 (5th Cir. 1999).
Newton, 209 F.3d at 455.
Id.
See Brown, 192 F.3d at 500.
Id.
Report and Recommendation of the U.S. Magistrate Judge, at 16.
Contrary to Plaintiff's assertions, evidence in the record reveals inconsistencies between the treating physicians' own opinions and between their opinions and those of other doctors as well. For instance, Dr. Kuwamura diagnosed Plaintiff as disabled on November 11, 2002, but this assessment was not supported by objective medical evidence, which instead showed Plaintiff's neurological functioning remained intact. Furthermore, this assessment contradicted an earlier report indicating that Plaintiff could perform work other than his previous work. Because the Secretary has the authority to determine who qualifies for disability insurance benefits, a treating physician's statement that a claimant is disabled is not conclusive evidence that he is entitled to disability benefits. Moreover, it is not clear whether Dr. Kuwamura's opinion accounted for the multiple reports of Plaintiff's symptom exaggeration.
Dr. Kuwamura felt Plaintiff was disabled and should proceed with SSI consideration, Tr. at 190.
Report and Recommendation of the U.S. Magistrate Judge, at 26-27.
Id. at 8, 27.
Barajas v. Heckler, 738 F.2d 641, 645 (5th Cir. 1984); See 20 C.F.R. § 416.927.
Report and Recommendation of the U.S. Magistrate Judge, at 26-27.
Additionally, Dr. Kuwamura's opinion relating to Plaintiff's "orthopedic concerns" is not consistent with other medical reports and opinions in the record and does not account for Plaintiff's history of pain exaggeration, which is present in his own medical report. Dr. Mulroy examined Plaintiff on July 29, 2002 and reported many non-physiological findings, including multiple Waddell signs. Dr. Mulroy also diagnosed that Plaintiff's multiple musculoskeletal pain complaints were out of proportion with the mechanism of his in jury. Dr. Mulroy further diagnosed that Plaintiff would be capable of engaging in light work.
Id. at 27.
The Attorneys Medical Deskbook explains that Waddell signs indicate complaints of pain that are not cause by physical abnormality; Attorneys Medical Deskbook 3d § 11:2 (2003) (Westlaw.com at "MEDDESK").
Report and Recommendation of the U.S. Magistrate Judge, at 28.
Id.
The ALJ also examined reports made by Dr. Tarbox, who examined Plaintiff on February 19, 2003. The ALJ found that these reports reflected that as of late February 2003, Plaintiff's strength and reflex functioning remained largely intact, and that examining physicians, including Dr. Kuwamura, believed Plaintiff was exhibiting signs of pain exaggeration. Therefore, although Dr. Kuwamura believed Plaintiff was no longer capable of working, his reports do not reflect a diagnosis resulting in disability, but rather coincide with the opinions of Dr. Mulroy and Dr. Tarbox, indicating only signs of pain exaggeration by Plaintiff.
Id. at 29.
Id.
In regards to Dr. Geibel's opinion, the ALJ found many inconsistencies within the doctor's own examination findings. For instance, Dr. Geibel reported that Plaintiff "remains totally disabled" and "has difficulty walking or standing," yet he later stated that Plaintiff possesses "good heel/toe walking capacity, full range of motion in the hips, and no focal neurological deficiencies in the upper extremities." Additionally, the ALJ found that Dr. Geibel's opinion did not reflect whether the doctor had any knowledge of Plaintiff's history of pain exaggeration.
Id.
Id.
When there is a presence of pain exaggeration, the ALJ must locate the line between legitimate mental impairments and physical symptoms and symptoms consciously exaggerated in an effort to avoid working and acquire disability benefits where none are due. In the present case, the record indicates a presence of pain exaggeration on the part of the Plaintiff, thus giving the ALJ the discretion to determine the credibility and legitimacy of the Plaintiff's symptoms, especially because conflicting evidence exists. Thus, because substantial evidence supports the ALJ's conclusion that Dr. Kuwamura's and Dr. Geibel's opinion should be afforded little significant weight and because the ALJ supports his findings with an extensive discussion and provides ample reasons for his position, there is no error. The Court upholds the Commissioner's decision and affirms the Magistrate's recommendation.
Brown v. Bowen, 864 F.2d 336, 338 (5th Cir. 1988).
Barajas, 738 F.2d at 645; Jones v. Heckler, 702 F.2d 616, 621 (5th Cir. 1983).
Plaintiff further objects to Judge Mathy's findings regarding the Plaintiff's Waddell signs. In particular, Plaintiff objects to the Magistrate Judge's conclusion that the ALJ's explanation of the Waddell signs is consistent with both the medical expert's testimony and with the Attorneys Medical Deskbook. Plaintiff contends that the evidence suggests that the ALJ did not have a proper understanding of Waddell signs, and thus Judge Mathy's findings regarding this matter are an error.
Plaintiff's Objections to Report and Recommendation of U.S. Magistrate Judge, at 2.
Id. at 2-3.
This Court finds that the ALJ made no error in interpreting Plaintiff's Waddell signs in support of his findings. Plaintiff has failed to provide any legal support for his contention that the ALJ committed error in interpreting Plaintiff's Wad dell sign s. According to the Attorneys Medical Deskbook, the presence of three or more findings is "usually considered sufficient to make a diagnosis of functional disorder or deliberate deception (malingering) and rule out physical abnormality. The record indicates that both Dr. Kuwamura and Dr. Mulroy reported evidence of multiple positive Waddell signs. Furthermore, the ALJ explained that Waddell signs are indicative of non-physiologic responses, suggesting a correlation to the continued symptom exaggeration by Plaintiff. Further evidence of malingering is hinted at by Dr. White who referred to Plaintiff's poor effort during testing. Thus, having considered Plaintiff's objections and having reviewed de novo the controlling law and the specific facts surrounding this case, the Court concurs with the Magistrate Judge's conclusions.
Report and Recommendation of the U.S. Magistrate Judge, at 29-30; Attorneys Medical Deskbook 3d § 11:2 (2003) (Westlaw.com at "MEDDESK").
Report and Recommendation of the U.S. Magistrate Judge, at 31.
Id.
Id.
CONCLUSION
The remainder of the Magistrate Judge's report is neither clearly erroneous nor contrary to law. Accordingly, the Report and Recommendation should be ADOPTED IN ITS ENTIRETY.
It is therefore ORDERED that the Report and Recommendation of the United States Magistrate Judge is ADOPTED IN ITS ENTIRETY.
It is further ORDERED that the Commissioner's Decision is AFFIRMED.