United States District Court, D. Kansas
MEMORANDUM AND ORDER
ERIC F. MELGREN, District Judge.
Plaintiff Leigh Ann Billings seeks review of a final decision by Defendant Carolyn Colvin, the Commissioner of Social Security, denying her applications for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act, respectively, and award of attorney's fees and costs. Billings alleges that the Commissioner's decision should be reversed and remanded because the Administrative Law Judge ("ALJ") failed to follow administrative guidelines and regulations for obtaining and weighing medical expert opinions. Specifically, Billings opposes the ALJ's decision to reject her treating psychiatrist's opinion. The result, according to Billings, is more error-an improper determination of Billings' mental impairments, her residual functioning capacity, and her ability to obtain gainful employment. Upon review, the Court finds that the ALJ properly evaluated the medical opinion of Billings' treating psychiatrist and supported his determinations with substantial evidence. As such, the decision of the Commissioner is affirmed.
I. Factual and Procedural Background
Leigh Ann Billings was born February 15, 1980. Billings alleges that her disability began December 7, 2007. The agency denied Billings' application initially and on reconsideration. Billings then asked for a hearing before an administrative law judge.
The ALJ held a hearing on December 20, 2011. At that hearing, Billings testified about her medical conditions, including diagnoses for bipolar disorder, borderline personality disorder, and anxiety disorder. A vocational expert also testified as to Billings' employment prospects. Under the conditions described by the ALJ to hypothetically represent the limitations of Billings' disability, Billings would be able to perform the requirements of sedentary, unskilled work. The ALJ's hypothetical disregarded the limitations opined by Billings' treating psychiatrist that would "preclude all work in the national economy."
The ALJ issued his written opinion on May 22, 2012. At step one of the evaluation process, he found that Billings had not engaged in substantial gainful activity since her alleged disability onset date. At step two, he determined that Billings' severe impairments include: obesity, lower back pain, asthma, rectovaginal fistula, borderline personality disorder, anxiety, and alcohol abuse. But he excluded Billings' diagnosis for bipolar disorder. He concluded that "the weight of the evidence" supported a nonexamining medical expert's opinion that Billings' medical records do not justify a diagnosis of bipolar disorder. At step three, he found that Billings' impairments do not meet or medically equal the disability impairment criteria. Specifically, he determined that Billings did not suffer the marked limitation in activities of daily living; social functioning; concentration, persistence, or pace; or the repeated episodes of decompensation necessary to establish disability. At steps four and five, he determined that, despite impairments that preclude Billings from returning to her previous work, she possesses sufficient residual functional capacity to engage in sedentary work that is "limited to simple, unskilled work with no contact with the general public and only occasional interaction with coworkers and supervisors. In addition, she should have no more than moderate exposure to pulmonary irritants and normal access to restroom facilities." The ALJ therefore concluded that Billings had not been under a disability since December 7, 2007, through the date of his decision.
The Social Security Administration's Appeals Council denied Billings' request for review in July 2013. Billings timely requested judicial review. Because Billings exhausted all administrative remedies available to her, the Commissioner's decision denying Billings' application for benefits is now final and this Court has jurisdiction to review the decision.
II. Legal Standard
Judicial review of the Commissioner's decision is guided by the Social Security Act (the "Act"). The Act provides, in part, that the "findings of the Commissioner as to any fact, if supported by substantial evidence, shall be conclusive." The court must therefore determine whether the factual findings of the Commissioner are supported by substantial evidence in the record and whether the ALJ applied the correct legal standard. "Substantial evidence is more than a scintilla, but less than a preponderance; in short, it is such evidence as a reasonable mind might accept to support the conclusion." The court may "neither reweigh the evidence nor substitute [its] judgment for that of the [Commissioner]."
An individual is under a disability only if she can "establish that she has a physical or mental impairment which prevents her from engaging in substantial gainful activity and is expected to result in death or to last for a continuous period of at least twelve months." This impairment "must be severe enough that she is unable to perform her past relevant work, and further cannot engage in other substantial gainful work existing in the national economy, considering [her] age, education, and work experience."
Pursuant to the Act, the Social Security Administration has established a five-step sequential evaluation process for determining whether an individual is disabled. The steps are designed to be followed in order. If it is determined, at any step of the evaluation process, that the claimant is or is not disabled, further evaluation under a subsequent step is unnecessary.
The first three steps of the sequential evaluation require the Commissioner to assess: (1) whether the claimant has engaged in substantial gainful activity since the onset of the alleged disability; (2) whether the claimant has a severe, or combination of severe, impairments; and (3) whether the severity of those severe impairments meets or equals a designated list of impairments. If the impairment does not meet or equal one of these designated impairments, the ALJ must then determine the claimant's residual functional capacity, which is the claimant's ability "to do physical and mental work activities on a sustained basis despite limitations from her impairments."
Upon assessing the claimant's residual functioning capacity, the Commissioner moves on to steps four and five. These steps required the Commissioner to determine whether the claimant can either perform her past relevant work or whether she can generally perform other work that exists in the national economy, respectively. The claimant bears the burden in steps one through four to prove a disability that prevents performance of his past relevant work. The burden then shifts to the Commissioner at step five to show that, despite his alleged impairments, the claimant can perform other gainful work in the national economy.
Billings asserts error resulting from the substantive consequences of two procedural deficiencies. First, Billings claims that the ALJ failed to follow administrative guidelines for obtaining medical expert testimony. Second, Billings claims that the ALJ ignored the regulatory procedure for weighing a treating source opinion. These procedural errors, according to Billings, produced determinations of her residual functional capacity and her ability to obtain gainful employment that lack the support of substantial evidence in the record. The Commissioner contends that the ALJ properly obtained and considered the medical opinion evidence and that the ALJ's resulting conclusions are properly supported by substantial evidence in the record.
A. Administrative Guidelines
Billings' first allegation of procedure-based error suggests a failure to observe two provisions of the Hearings, Appeals, and Litigation Law Manual ("HALLEX"). The first provision directs the ALJ to provide a medical expert with "relevant evidence that will assist" him in providing his opinion. Billings argues that the ALJ failed to provide medical expert Dr. Mark Scher with certain medical records and a statement from one of her former employers. The second provision instructs the ALJ to discuss certain matters on the record before a medical expert testifies at a hearing. These matters-which Billings claims the ALJ omitted from the hearing involving Dr. Scher-include a summary of "the opening statement or relevant testimony on the record if the [medical expert] was not present" and colloquy to "ensure on the record that the [medical expert] has examined all medical and other evidence of record." The Commissioner counters that Dr. Scher's interrogatory response and the references to that response in the ALJ's decision demonstrate the ALJ's compliance.
The Court need not decide this issue of the ALJ's compliance with HALLEX. As Billings points out in her brief, this Court has determined HALLEX generally to be non-binding. Billings argues, however, that the ALJ's "responsibility to develop an adequate record" obligated him to satisfy the demands of HALLEX's provisions for obtaining medical expert testimony. The Court disagrees. HALLEX provisions are enforceable only to the extent that they restate an administrative regulation. Here, the provisions "go beyond the regulations, " providing mere "guidance for processing and adjudicating claims." As such, the Court concludes that ...