Parra v. Berryhill

Background

Sabrina M. Parra sought judicial review of the Commissioner of Social Security’s final decision denying her application for disability insurance benefits under Title II of the Social Security Act. She alleged disability beginning December 10, 2013. An administrative law judge (ALJ) held a hearing and issued an unfavorable decision on September 29, 2017. The ALJ found severe impairments consisting of obesity, a partial rotator-cuff tear, and lumbar degenerative disc disease.

The ALJ determined that Parra had the residual functional capacity (RFC)—her remaining ability to work despite her impairments—to perform light work with limits. Those limits included lifting and carrying 20 pounds occasionally and 10 pounds frequently; sitting, standing, and walking for six hours each; pushing and pulling up to the lifting and carrying limits; and frequently reaching overhead and in other directions with her right arm. The ALJ concluded that Parra could perform jobs such as copy-machine operator, housekeeping or cleaner, and cafeteria attendant. The Appeals Council denied review.

Parra and the Commissioner filed cross-motions for summary judgment. Parra argued that the ALJ improperly evaluated medical opinions about her ability to reach, improperly assessed her testimony about her symptoms, and relied on vocational-expert testimony that did not include all of her claimed limitations.

Medical-source opinions

Parra challenged the ALJ’s decision to give little weight to treating physician Eduardo Lin’s medical-source statement. Dr. Lin diagnosed a lumbosacral disc injury and a right-shoulder rotator-cuff injury and described substantial physical, postural, reaching, and mental limitations. The court explained that, under the regulations applicable to Parra’s claim, a treating physician’s opinion could receive controlling weight when adequately supported and consistent with the record. If the ALJ gave the opinion less weight, the ALJ had to consider specified factors, such as the treatment relationship, frequency of examination, supportability, consistency, and specialization, and had to provide legally sufficient reasons for discounting it.

The court found that the ALJ did not discuss all of the required regulatory factors, including the length and extent of the treatment relationship, frequency of examination, and specialization. But the court held that the ALJ gave an independent, clear, and convincing reason supported by substantial evidence for discounting Dr. Lin’s opinion: the extreme limitations were not supported by Parra’s diagnoses and were inconsistent with the medical record. The court noted that Dr. Lin’s treatment notes did not document complaints about using Parra’s right hand or fingers or problems with her neck, and included statements that she denied neck pain. The court also upheld the ALJ’s reasons for rejecting Dr. Lin’s mental limitations because Dr. Lin was not a psychologist, his notes did not show a mental-status evaluation, and the record cited by Parra did not support his findings of depression or decreased energy. The court further upheld the ALJ’s reliance on conservative treatment, later records showing no medication for back or shoulder pain, and normal range of motion, strength, and stability in rejecting Dr. Lin’s physical limitations.

Parra also challenged the ALJ’s treatment of consultative examining physician Farah Rana and non-examining state-agency physicians F. Greene and G. Lee. Dr. Rana observed limited motion and tenderness in Parra’s right shoulder and opined that shoulder pain would make overhead work difficult. Drs. Greene and Lee found that Parra was limited to occasional overhead reaching with her right arm. The court held that the ALJ gave clear and convincing reasons supported by substantial evidence for rejecting those reaching limitations, including the lack of consistent follow-up, conservative treatment, and later records showing normal musculoskeletal findings.

Parra’s testimony about her symptoms

The ALJ found that Parra’s statements about the intensity, persistence, and limiting effects of her symptoms were not entirely consistent with the medical and other evidence. The ALJ relied on conservative treatment, a gap in treatment records from September 2014 through July 2015, and later records showing no pain, no pain medication, and normal physical findings.

The court held that the ALJ adequately identified the testimony being discounted and gave clear and convincing reasons for finding it inconsistent with the record. The medical evidence showed mild or moderate degenerative changes, and later treatment records generally documented no back, joint, or neck pain, no joint swelling or muscle weakness, normal motion and strength, and no medication for back or shoulder pain. The court also noted that the ALJ accounted for Parra’s limitations by restricting her to light work with lifting, carrying, reaching, and postural limits.

The court agreed that the ALJ erred by relying on the treatment gap without addressing Parra’s testimony that she could not afford some treatment and that her workers’ compensation case affected whether her doctors would treat her back and shoulder. But the court found that error harmless because the ALJ relied on other evidence, including the later medical records and objective findings, that supported the disability determination.

Vocational-expert testimony and disposition

Parra argued that the ALJ improperly relied on a vocational expert’s response to a hypothetical that did not include all of her limitations. The court rejected the argument because it depended on the same limitations the court had already found the ALJ properly discounted. The court therefore concluded that the vocational expert’s testimony was based on appropriate limitations.

Judge Virginia K. Demarchi denied Parra’s motion for summary judgment and granted the Commissioner’s cross-motion for summary judgment. The clerk was directed to enter judgment accordingly and close the file.