nd the Commissioner's regulations phrase the second prong of the inquiry in the negative: an opinion may be given controlling weight only if it is "
not inconsistent with the other substantial evidence" in the record. SSR 96-2p, West's Soc. Sec. Reporting Serv., Rulings 112 (Supp. 2010) (emphasis added); and
20 C.F.R. §§ 404.1527(d)(2),
416.927(d)(2) (emphasis added).
SSR 96-2p, cited by the court in Watkins, explains that the term "substantial evidence" as used in determining whether a treating source opinion is worthy of "controlling weight" is given the same meaning as determined by the Court in Perales, 402 U.S. at 401. SSR 96-2, West's Soc. Sec. Reporting Serv., Rulings 113 (Supp. 2010) ("Giving Controlling Weight to Treating Source Medical Opinions"). As the Ruling explains, evidence is "substantial evidence" precluding the award of "controlling weight," if it is "such relevant evidence as a reasonable mind would accept as adequate to support a conclusion that is contrary to the conclusion expressed in the medical opinion." Id.
If the treating source opinion is not given controlling weight the inquiry does not end. Watkins, 350 F.3d at 1300. A treating source opinion is "still entitled to deference and must be weighed using all of the factors provided in 20 C.F.R. § 404.1527 and 416.927." Id. Those factors are: (1) length of treatment relationship and frequency of examination; (2) the nature and extent of the treatment relationship, including the treatment provided and the kind of examination or testing performed; (3) the degree to which the physician's opinion is supported by relevant evidence; (4) consistency between the opinion and the record as a whole; (5) whether or not the physician is a specialist in the area upon which an opinion is rendered; and (6) other factors brought to the ALJ's attention which tend to support or contradict the opinion. Id. at 1301; 20 C.F.R. §§ 404.1527(d)(2-6), 416.927(d)(2-6); see also Drapeau v. Massanari, 255 F.3d 1211, 1213 (10th Cir. 2001) (citing Goatcher v. Dep't of Health Human Servs., 52 F.3d 288, 290 (10th Cir. 1995)).
After considering these factors, the ALJ must give reasons in the decision for the weight he assigns the treating source opinion. Id. 350 F.3d at 1301. "Finally, if the ALJ rejects the opinion completely, he must then give `specific, legitimate reasons' for doing so." Id. (citing Miller v. Chater, 99 F.3d 972, 976 (10th Cir. 1996) (quoting Frey v. Bowen, 816 F.2d 508, 513 (10th Cir. 1987)).
B. Controlling Weight
Plaintiff argues that Dr. Shaikh's opinion is based on medically acceptable diagnostic techniques because the ALJ never questioned Dr. Shaikh's schizophrenia diagnosis, and although Dr. Shaikh conceded he did not perform any neuropsychological testing, the record contains nothing to indicate Dr. Shaikh's opinion was not based on such diagnostic techniques. (Pl. Br. 7-8). He argues that Dr. Shaikh's opinion is not inconsistent with other substantial evidence in the record because it "does not entirely conflict with Dr. Boll's evaluation," and is not inconsistent with records from other treating sources, and that the GAF score of 35 assigned by Dr. Shaikh is not inconsistent with other scores in the record. (Pl. Br. 8-13). The Commissioner argues that the ALJ properly declined to accord controlling weight to Dr. Shaikh's opinion because the opinion is inconsistent with Dr. Shaikh's treatment notes. (Comm'r Br. 6).
A Global Assessment of Functioning, or GAF, score is a subjective determination which represents "the clinician's judgment of the individual's overall level of functioning." Am. Psychiatric Ass'n, Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) 32 (4th ed. text revision 2000). The GAF Scale ranges from 100 (superior functioning) to 1 (persistent danger of severely hurting self or others, persistent inability to maintain minimal personal hygiene, or serious suicidal act with clear expectation of death). Id. at 34. GAF is a classification system providing objective evidence of a degree of mental impairment. Birnell v. Apfel, 45 F. Supp. 2d 826, 835-36 (D. Kan. 1999) (citing Schmidt v. Callahan, 995 F. Supp. 869, 886, n. 13 (N.D. Ill. 1998)).
A GAF score in the range from 31 to 40 indicates "Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school)." DSM-IV-TR at 34 (emphasis in original).
The ALJ explained why he did not accord controlling weight to Dr. Shaikh's opinion, and stated two reasons for the determination: "[(1)] Dr. Shaikh's opinion is not supported by his objective treatment notes. [(2)] The GAF of 35 is much more restrictive than the GAF reflected in his treatment notes. Therefore, Dr. Shaikh's opinion has not been given controlling weight." (R. 36) (numbering added). The threshold for denying controlling weight is low. Cook v. Astrue, 554 F. Supp. 2d 1241, 1245 (D. Kan. 2008); Fritzson v. Astrue, No. 07-4137-JAR, 2009 WL 801796, *7 (D. Kan. Mar. 25, 2009); Cann v. Astrue, No. 08-4018-SAC, 2009 WL 536565, *10 (D. Kan. Mar. 3, 2009). The ALJ need only point to evidence which is "such relevant evidence as a reasonable mind would accept as adequate to support a conclusion that is contrary to the conclusion expressed in the [treating source's] medical opinion." SSR 96-2p, West's Soc. Sec. Reporting Serv., Rulings 113 (Supp. 2010). This standard is met here, as the ALJ found, at least because Dr. Shaikh's treatment notes reflect a GAF score which is inconsistent with the GAF score of 35 reflected in Dr. Shaikh's opinion. The ALJ specifically noted that Dr. Shaikh assigned a GAF score of 45 on January 17, 2007 when Plaintiff began seeing him. (R. 35); see also (R. 325). This is relevant evidence which might support a conclusion that Plaintiff's condition is not as severe as a GAF score of 35 would suggest. As such, the determination not to accord controlling weight is justified.
A GAF score in the range of 41-50 indicates "Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job)." DSM-IV-TR at 34.
Plaintiff's argument "that the GAF score of 35 represents a steady decline in Weber's mental functioning during his treatment with Dr. Shaikh and the other psychiatrists at ComCare" (Pl. Br. 12), does not compel a different finding. Plaintiff points to record evidence in support of this argument, and presents a view of the evidence in which he asserts that Plaintiff's GAF score steadily declined from 52 during intake at ComCare to 40 at his last visit with Dr. Shaikh. Id. at 12-13. He concludes, "Ultimately, Dr. Shaikh further decreased Weber's GAF score to 35 just before the hearing." Id. at 13. However, neither Dr. Shaikh nor the other providers at ComCare stated that Plaintiff's mental function was in a steady decline. Dr. Shaikh explained his mental RFC assessment, but did not mention a steady decline in Plaintiff's functioning. (R. 477).
Plaintiff's argument forgets the standard upon which judicial review is based. The court may not reweigh the evidence or substitute its judgment for that of the Commissioner. Frantz v. Astrue, 509 F.3d 1299, 1300 (10th Cir. 2007); Hackett, 395 F.3d at 1172; White, 287 F.3d at 905. The starting point in the court's review however, is the rationale presented in the Commissioner's decision and not what another party, or even the court, might view as a "proper" weighing of the evidence. 42 U.S.C. § 405(g). The mere fact that there is evidence which might support a finding contrary to that of the ALJ will not establish error in the ALJ's determination. "The possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's findings from being supported by substantial evidence. We may not displace the agency's choice between two fairly conflicting views, even though the court would justifiably have made a different choice had the matter been before it de novo." Lax, 489 F.3d at 1084 (citations, quotations, and bracket omitted); accord, Cruse v. Bowen, 867 F.2d 1183, 1184 (8th Cir. 1989) (citing Consolo v. Fed. Maritime Comm'n, 383 U.S. 607, 620 (1966)). The ALJ's reason (2) is supported by substantial evidence in the record as a whole, and the record evidence does not compel a different finding. Plaintiff should focus on pointing out error in the Commissioner's analysis, not on explaining what in his view a "proper" analysis would reveal.
Plaintiff's next argument, that Dr. Boll's opinion is "not entirely inconsistent" with Dr. Shaikh's opinion, recognizes that the two opinions are at least somewhat inconsistent, and thereby supports the ALJ's decision not to accord Dr. Shaikh's opinion controlling weight. By arguing that Dr. Boll's opinion is "notentirely inconsistent" with Dr. Shaikh's opinion, Plaintiff admits that the opinions are inconsistent. Therefore, Dr. Shaikh's opinion fails to meet the requirement that it be "not inconsistent" with the other substantial evidence in the case record if it is to be accorded controlling weight. Plaintiff does not, and cannot, argue that Dr. Boll's opinion is not substantial evidence — that it is not "such relevant evidence as a reasonable mind would accept as adequate to support a conclusion." Perales, 402 U.S. at 401. More is not required to refuse controlling weight. The ALJ properly declined to accord controlling weight to Dr. Shaikh's opinion.
C. Less-Than-Substantial Weight
Plaintiff argues that "the ALJ failed to provide specific reasons for disregarding Dr. Shaikh's opinion." (Pl. Br. 13). He goes on to explain that the ALJ "failed to provide good reasons for his determination that Dr. Shaikh's opinion is worthy of less than substantial weight," because he never identified the specific inconsistencies upon which he relied in discounting Dr. Shaikh's opinion. (Pl. Br. 14). The Commissioner argues, "To the contrary, the ALJ provided good, legitimate reasons for not giving Dr. Shaikh's opinions substantial weight." (Comm'r Br. 7). The Commissioner points to record evidence which supports the ALJ's determination. Id. at 7-12.
The ALJ considered what less-than-controlling weight Dr. Shaikh's opinion should be accorded, and he stated eight reasons for giving the opinion less-than-substantial weight, in addition to the two reasons previously given for not according the opinion controlling weight.
Since it cannot be entitled to controlling weight, Dr. Shaikh's opinion must be analyzed to determine the appropriate weight that it can be given. [(3)] Dr. Shaikh is a psychiatrist [(4)] who had treated the claimant [(5)] once a month [(6)] for 5 months prior to the issuance of this opinion. [(7)] He did not provide therapy, but [(8)] only saw the claimant for 30 minute medication management sessions. Not only is his opinion [(1)] inconsistent with his documented findings, but it is [(9)] contradicted by the findings of other treating and [(10)] examining mental health sources. Therefore, it has not been given substantial weight.
(R. 36) (numbering added). The decision reveals that, contrary to Plaintiff's argument, the ALJ gave ten specific reasons for discounting Dr. Shaikh's opinion. (1) The opinion is not supported by Dr. Shaikh's treatment notes. (2) The GAF score assigned in Dr. Shaikh's opinion (35) is more restrictive than the GAF reflected in his treatment notes (45). (3-6) Dr. Shaikh is a treating psychiatrist who treated Plaintiff once a month but only for five months before forming the opinions at issue. (7-8) Dr. Shaikh only provided medication management, and no therapy for Plaintiff. And, (9-10) Dr. Shaikh's opinion is inconsistent with the findings of both treating and examining mental healthcare providers. As discussed in the previous section of this opinion, reason (2) is supported by substantial evidence. Reasons (3-8) reflect the ALJ's consideration of the regulatory factors for weighing medical opinions, and are supported by Dr. Shaikh's treatment notes as cited by the ALJ. (R. 36) (citing Ex. 13F/1-14) (R. 312-25). Therefore, seven of the ALJ's reasons for discounting Dr. Shaikh's opinion are without question supported by substantial evidence in the record as specifically cited by the ALJ in the same portion of the decision in which he explained those reasons.
Therefore, the point of Plaintiff's argument (that the ALJ did not identify the specific inconsistencies upon which he relied in discounting Dr. Shaikh's opinion), is that the ALJ did not identify specific record evidence to support his reasons (1), (9), and (10) — that Dr. Shaikh's opinion is not supported by his own treatment notes, and is contradicted by other treating and examining mental healthcare sources. Plaintiff argues that the Commissioner's decision must be evaluated based only upon the rationale provided in the decision, and that the court may not support the ALJ's findings by citing evidence not specifically cited by the ALJ because such action usurps the agency's function of "weighing and balancing" the evidence and constitutes improperpost hoc rationalization of the decision. (Pl. Br. 14-15) (citingSEC v. Chenery Corp., 318 U.S. 80 (1943); Carpenter v. Astrue, 527 F.3d 1264, 1267 (10th Cir. 2008); Grogan v. Barnhart, 399 F.3d 1257, 1263 (10th Cir. 2005); Robinson v. Barnhart, 366 F.3d 1078, 1084 (10th Cir. 2004); and Youngblood v. Astrue, Civ. A. No. 08-2607-KHV-GBC, WL 4611459, *4-5 (D. Kan. Dec. 4, 2009)). Plaintiff concludes his argument, "Here, the ALJ forces this Court to speculate which inconsistencies, if any, exist between Dr. Shaikh's opinion and the record. But this Court may not reweigh the evidence or speculate as to the ALJ's rationale. As a result, reversal and remand are necessary for a proper explanation of the ALJ's rationale." (Pl. Br. 15) (citation omitted). Nonetheless, the court finds substantial evidence in the record as a whole supports the ALJ's determination to accord less-than-substantial weight to Dr. Shaikh's opinion.
The court agrees with plaintiff that it may "neither reweigh the evidence nor substitute [its] judgment for that of the agency." Bowman, 511 F.3d at 1272 (quoting Casias, 933 F.2d at 800); accord, Hackett, 395 F.3d at 1172. Moreover, it may not properly weigh the evidence in the first instance. Neil v. Apfel, No. 97-7134, 1998 WL 568300 at *3 (10th Cir. Sept. 1, 1998). And, as Plaintiff suggests, an ALJ's decision should be evaluated based solely on the rationale presented in the decision.Robinson, 366 F.3d at 1084. A reviewing court may not create post-hoc rationalizations to explain the Commissioner's treatment of evidence when that treatment is not apparent from the Commissioner's decision. Grogan, 399 F.3d at 1263. By considering legal or evidentiary matters not considered by the ALJ, a court risks violating the general rule against post hoc justification of administrative action recognized in Chenery. Allen v. Barnhart, 357 F.3d 1140, 1145 (10th Cir. 2004). Nonetheless, when the ALJ has, in fact, considered the legal and evidentiary matters and has stated his rationale in his decision, the court is required to determine whether substantial evidence on the record as a whole supports the ALJ's consideration and the rationale provided. E.g., Frantz, 509 F.3d at 1300 (quotingCastellano v. Sec'y of Health Human Servs., 26 F.3d 1027, 1028 (10th Cir. 1994)); Howard v. Barnhart, 379 F.3d 945, 947 (10th Cir. 2004); Haddock, 196 F.3d at 1087; Fowler v. Bowen, 876 F.2d 1451, 1453 (10th Cir 1989).
As Plaintiff's argument implies, the ALJ did not state each reason for discounting Dr. Shaikh's opinion and then list all the evidentiary bases supporting that reason. However, an ALJ need not cite record evidence supporting every assertion made in the decision. What he must do is provide a rationale for his decision which is reviewable by the court. Fischer-Ross v. Barnhart, 431 F.3d 729, 734 (10th Cir. 2005). Here, the ALJ's rationale is apparent from the decision, and it is not a post hoc rationalization for the court to acknowledge record evidence supporting the ALJ's stated rationale, even if a particular piece of evidence was not cited by the ALJ. Grogan, 399 F.3d at 1263 (reviewing court may not create post-hoc rationalizations to explain the Commissioner's treatment of evidence when that treatment is not apparent from the Commissioner's decision).
The Youngblood case, cited in Plaintiff's brief, does not require a different conclusion. There, the court found that reasons given by the ALJ for discounting the treating source opinion were "merely conclusory findings which the ALJ ha[d] not supported with rationale, example, or evidence." Youngblood, WL 4611459, at *4. Here, although the ALJ did not cite specific evidence in direct relation to every reason given for discounting Dr. Shaikh's opinion, he did provide a complete rationale for his determination which is reviewable by the court. The court is not required to speculate regarding the rationale for the decision. Moreover, the ALJ summarized the record evidence in his decision, and the court is not required to weigh the evidence to determine what the ALJ's rationale was in making his determinations. The court merely has to review the decision and "meticulously examine the record as a whole, including anything that may undercut or detract from the ALJ's findings in order to determine if the substantiality test has been made." Wall, 561 F.3d at 1052 (quoting Flaherty v. Astrue, 515 F.3d 1067, 1070 (10th Cir. 2007)). Plaintiff has not cited, and the court has not found, record evidence overlooked or ignored (and hence not weighed) by the ALJ which would preclude the findings reached by the ALJ in making his determinations.
Reason (1) for discounting Dr. Shaikh's opinion was that it is not supported by Dr. Shaikh's treatment notes. The ALJ summarized Dr. Shaikh's treatment notes beginning on January 17, 2007 when he first saw Plaintiff and assigned a GAF score of 45:
His treatment notes reflect the claimant's alert and cooperative manner, lack of abnormal movements, normal speech and articulation, intermittent anxiety, congruent effect, full orientation, intact memory, attention, and concentration, and logical thought form. The claimant sometimes exhibited slow responses, but denied suicidal and homicidal ideation, paranoid delusions, impulsivity, and obsessions/compulsions. The claimant's cognitive functions appeared to be at baseline and insight and judgment were fair. Cannabis abuse was not shown to be in remission. The claimant reported in February, 2007, during cold weather, that he was nervous at the mission because there were too many unfamiliar people in the mornings. He stated that mood swings and irritability were in control (with mood swing occurring only occasionally), that he was attending groups, and that he no longer had difficulty falling asleep. He stated that he occasionally felt paranoid at the shelter. He denied medication side effects, but admitted not being very compliant with medication.
(R. 35-36) (citing Ex. 13F/1-14 (R. 312-25)). Plaintiff does not, and cannot, contest the ALJ's characterization of Dr. Shaikh's treatment notes. The court finds it is supported by the record evidence.
The ALJ also summarized Dr. Shaikh's opinion, noting his opinion that Plaintiff's "alcohol and marijuana dependence is in full remission and does not exacerbate the claimant's symptoms." (R. 35). The ALJ noted that Dr. Shaikh assigned a GAF score of 35, and found Plaintiff markedly limited in four mental activities "and moderately limited in most other areas." Id. In fact, of twenty mental activities described in the Mental RFC form completed by Dr. Shaikh, the psychiatrist found Plaintiff markedly limited in four, moderately limited in fourteen, and "not significantly limited" in only two activities — "the ability to ask simple questions or request assistance," and "the ability to accept instructions and respond appropriately to criticism from supervisors." (R. 475-76). Even the most cursory review of the record must conclude that Dr. Shaikh's treatment notes do not support the severity presented in his opinion. Substantial evidence in the record supports reason (1) for discounting Dr. Shaikh's opinion.
As reason (9), the ALJ found that Dr. Shaikh's opinion is contradicted by other treating mental healthcare sources. (R. 36). The Commissioner points to the treatment records of Dr. Ludvigson and Dr. Shah as evidence supporting reason (9). The court agrees. Dr. Ludvigson assigned GAF scores of 50 at four visits and 45 at one visit (R. 328, 331, 334, 337, 340), and at two visits the psychiatrist noted that Plaintiff smelled (at one visit Dr. Ludvigson used the term "reeks") of alcohol, but that Plaintiff stated he only drinks an occasional beer. (R. 332, 335). The GAF scores assigned by Dr. Ludvigson are indeed inconsistent with the score of 35 assigned by Dr. Shaikh, and the revelations regarding alcohol are inconsistent with Dr. Shaikh's opinion that Plaintiff's alcohol dependence is in full remission.
As the ALJ found and as the Commissioner argues, Dr. Shah's treatment notes during the relevant period after Plaintiff's alleged onset on June 1, 2000 are also inconsistent with Dr. Shaikh's opinion of significant limitations. Those notes reveal that Dr. Shah assigned a GAF score of 45 (R. 258), that Plaintiff did a lot of walking (R. 247, 249-51), that Plaintiff went to the "drop-in center," and volunteered at "His Helping Hands" (R. 256-57), and that Plaintiff was looking for a job. (R. 254). Again, the GAF score assigned by Dr. Shah is inconsistent with Dr. Shaikh's opinion, and the activities reported are inconsistent with the severe mental limitations opined by Dr. Shaikh. Plaintiff asserts that Dr. Shah's and Dr. Ludvigson's treatment notes are consistent with Dr. Shaikh's opinion, but cites no specific evidence which compels such a finding. Reason (9) is supported by substantial evidence in the record.
Because Dr. Boll is the only non-treating source who opined regarding Plaintiff's limitations, the court must necessarily address Plaintiff's final argument (that the ALJ failed to explain why Dr. Boll's opinion is entitled to substantial weight) when it considers reason (10) for discounting Dr. Shaikh's opinion — that Dr. Shaikh's opinion is inconsistent with that ofexamining mental healthcare sources. Therefore, it considers both issues together in the next section of this opinion.
A psychologist who examined, but did not treat, claimant. 20 C.F.R. § 404.1502.
V. Evaluation of Dr. Boll's Opinion
The ALJ summarized the opinion of Dr. Boll:
Consulting psychological examiner Dr. Boll stated that the claimant appeared able to comprehend and follow simple instructions, perform simple, routine, repetitive tasks, concentrate on appropriate assigned tasks, maintain reasonable work attendance standards, and relate adequately with others in an accepting and supportive environment. Dr. Boll opined that the claimant would have difficulty dealing with a more authoritarian or critical supervisor, but should be able to deal with work pressures in an appropriate and emotionally adaptive way and exercise acceptable judgments concerning work functions as long as he remained on psychotropic medications and assuming there was no interference from substance abuse.
(R. 36). He concluded his analysis by stating two reasons for assigning substantial weight to Dr. Boll's opinion: It is based on medically acceptable diagnostic methods, and it is consistent with the findings of treating mental healthcare sources. Id.
Plaintiff claims this is error because the ALJ failed to consider factors detracting from Dr. Boll's opinion, and never cited record evidence supporting his finding that the opinion is consistent with records of treating mental healthcare sources.
When a treating source opinion is not accorded controlling weight, all medical opinions will be evaluated by the Commissioner in accordance with the regulatory factors discussed above. 20 C.F.R. §§ 404.1527(d), 416.927(d); SSR 96-5p, West's Soc. Sec. Reporting Serv., Rulings 123-24 (Supp. 2010). The opinion of a non-treating source (such as Dr. Boll) "is not entitled to the sort of deferential treatment accorded to a treating physician's opinion." Doyal, 331 F.3d at 763. However, opinions of non-treating sources are generally given more weight than the opinions of non-examining sources who have merely reviewed the medical record. Robinson, 366 F.3d at 1084.
Plaintiff's argument that the ALJ failed to properly consider regulatory factors is without merit. In stating that Dr. Boll was a "Consulting psychological examiner," the ALJ specifically addressed regulatory factors 1 (examining relationship), 2 (treatment relationship), and 5 (specialization). His findings regarding diagnostic methods, and consistency with the notes of treating mental healthcare sources reflect consideration of regulatory factors 3 (supportability) and 4 (consistency). The ten reasons given for discounting Dr. Shaikh's opinion and for not according it controlling weight, supra at 15-24, also reveal that the ALJ weighed the medical opinions in accordance with the regulatory factors. Moreover, the ALJ stated that he had "considered opinion evidence in accordance with the requirements of 20 CFR 404.1527 and 416.927 and SSRs 96-2p, 96-5p, 96-6p, and 06-3p." (R. 33). The ALJ specifically acknowledged that Dr. Boll was a non-treating source who examined Plaintiff only once, and that Dr. Shaikh was a treating source who treated plaintiff five times and provided medication management but not therapy. (R. 35-36). He also noted the course of Plaintiff's mental health treatment, that Plaintiff had a lapse in treatment with Dr. Shah from 1999-2004, that Plaintiff initiated treatment at ComCare in October, 2003, attended therapy in November, 2005, treatment lapsed until March, 2006, and that Dr. Shaikh began as Plaintiff's new psychiatrist in January, 2007 and had monthly visits till May 2007. (R. 29-30, 35-37).
Plaintiff's argument that Dr. Boll did not have the benefit of evaluating Plaintiff's condition when he was receiving regular mental health treatment is essentially a repeat of the argument that Plaintiff's condition was steadily declining from the time he began treatment with ComCare until Dr. Shaikh assigned a GAF score of 35. As the court found above, neither Dr. Shaikh, nor any other medical source stated that opinion. The ALJ stated his findings in this regard, and substantial evidence in the record supports those findings. Neither the court nor Plaintiff may impose his view of the evidence over that of the ALJ absent substantial evidence in the record which precludes the finding made by the ALJ. Lax, 489 F.3d at 1084; Cruse, 867 F.2d at 1184;accord, Consolo v. Fed. Maritime Comm'n, 383 U.S. at 620.
Finally, the court addresses the related reasons given by the ALJ both for according substantial weight to Dr. Boll's opinion (it is consistent with the findings of treating healthcare sources), and for discounting Dr. Shaikh's opinion ((10) it is not supported by examining mental healthcare sources). Dr. Boll's opinion as summarized by the ALJ is consistent with the treatment records of Dr. Ludvigson and Dr. Shah, who were both Plaintiff's treating physicians at times during the period at issue here. This is substantial evidence in the record as a whole supporting the ALJ's determination to accord substantial weight to Dr. Boll's opinion.
Despite Plaintiff's assertion that "Dr. Shaikh's opinion does not entirely conflict with Dr. Boll's evaluation," and that the doctors' reports "are not entirely inconsistent" (Pl. Br. 9), it is abundantly clear from the record evidence discussed herein that Dr. Boll's opinion does not support the significant limitations opined by Dr. Shaikh. Not surprisingly, the reports of the two doctors do contain many similarities. After all, both reports are discussing the mental health condition of the same individual within a three-year time frame. However, Dr. Shaikh found Plaintiff markedly limited in four out of twenty mental activities, and moderately limited in fourteen of the remaining sixteen mental activities. Dr. Boll, found Plaintiff has mental limitations, but on the other hand, he found Plaintiff able to perform simple, routine, repetitive tasks; found no significant problems with concentration; found him able to maintain reasonable attendance standards; found him able to relate adequately with others; and found him able to deal with work pressures in the appropriate circumstances. (R. 226). The court finds that reason (10) given by the ALJ for discounting Dr. Shaikh's opinion is supported by substantial evidence in the record as a whole.
As Plaintiff points out, the opinion of a treating source is worthy of deference, and is generally worthy of greater weight than the opinion of a non-treating source. However, in this case the ALJ weighed the opinions and articulated ten reasons for discounting the opinion of the treating source, Dr. Shaikh. Each of those ten reasons is supported by substantial evidence in the record. The ALJ also considered the opinion of the consultative examiner, Dr. Boll, and provided two reasons supported by substantial evidence in the record for according substantial weight to that opinion. The court finds that the ALJ provided specific, legitimate reasons to discount the opinion of the treating physician, and applied the correct legal standard to evaluating the medical opinions. His decision to accord substantial weight to the opinion of Dr. Boll is also supported by substantial evidence in the record as a whole.
Plaintiff has shown no error in the Commissioner's decision.
IT IS THEREFORE ORDERED that judgment be entered in accordance with the fourth sentence of 42 U.S.C. § 405(g) AFFIRMING the Commissioner's decision.
Dated this 9th day of December 2010, at Kansas City, Kansas.