UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

James Fredderick Chamberlain

v. Civil No. 17-cv-520-JD Opinion No.

Nancy A. Berryhill, Acting Commissioner, Social Security Administration

O R D E R

James Fredderick Chamberlain seeks judicial review,

pursuant to

(g), of the decision of the Acting

Commissioner of the Social Security Administration, denying his

application for social security disability benefits.

Chamberlain contends that the Administrative Law Judge (“ALJ”)

erred in weighing the medical opinions in the record and

inadequately assessed Chamberlain’s mental impairments. The

Acting Commissioner moves to affirm.

Standard of Review

In reviewing the final decision of the Acting Commissioner

in a social security case, the court “is limited to determining

whether the ALJ deployed the proper legal standards and found

facts upon the proper quantum of evidence.” Nguyen v. Chater,

(1st Cir. 1999); accord Seavey v. Barnhart,

(1st Cir. 2001). The court defers to the ALJ’s

factual findings as long as they are supported by substantial evidence. § 405(g). Substantial evidence is “more than a

scintilla of evidence” but less than a preponderance. Purdy v.

Berryhill,

(1st Cir. 2018). The court must

affirm the ALJ’s findings, even if the record could support a

different conclusion, as long as “a reasonable mind, reviewing

the evidence in the record as a whole, could accept it as

adequate to support [the ALJ’s] conclusion.” Irlanda Ortiz v.

Sec’y of Health & Human Servs.,

(1st Cir.

1991) (internal quotation marks omitted); accord Purdy,

.

Background

Chamberlain previously applied for social security

benefits, and his application was denied in 2014. He then filed

a second application, alleging an onset date of January 14,

2014, when he was fifty-one years old. His last insured date

was December 31, 2014.

When he was working, Chamberlain was employed as an

equipment operator and a janitor. He states that he stopped

working in 2009 and alleges impairments due to neck and back

pain with sciatica, arthritis, Barrett’s esophagus, depression,

anxiety, migraine headaches, foot pain, and difficulty sleeping.

Chamberlain completed the eighth grade, was single, did not have

children, and lived alone.

2 Medical records show that Chamberlain was treated at

Concord Orthopedics for back pain beginning in 2008, although he

also had a back injury in 1999. He sought medical care for

depression in 2009 but declined medication and therapy at that

time. He also received treatment for reflux disorder. Medical

records through 2013 document back pain and treatment.

Chamberlain continued care at Willowbend Family Practice

with Tracey Bottazzi, APRN. She noted in March of 2014 that

Chamberlain had chronic pain in his neck but no new symptoms and

that he did not take medication daily because of Barrett’s

esophagus. Nurse Bottazzi also noted that Chamberlain’s

depression was stable on Cymbalta.

In April of 2014, Nurse Bottazzi completed a Physical

Residual Functional Capacity Questionnaire in which she noted

her own diagnoses of Chamberlain’s pain due to spinal issues,

his treatment, and his limited functional capacity. Also in

April of 2014, Chamberlain had consultative examinations done by

Juliana Read, Ph.D., a psychologist, and Dr. Peter Loeser, an

orthopedist. Non-examining state agency psychologist, Dr. Laura

Landerman, and state agency physician, Dr. Burton Nault, also

provided opinions about Chamberlain’s functional capacity.

A hearing was held before an ALJ on May 17, 2016.

Chamberlain was represented during the process before the ALJ by

3 a non-attorney representative.1 During the hearing, Dr. John

Hackman, a neurological surgeon, and Dr. Delano Bolter, a

psychiatrist, testified by telephone. A vocational expert also

testified.

The ALJ issued her decision on June 13, 2016, concluding

that Chamberlain was not disabled. In support, the ALJ found

that Chamberlain had severe impairments due to degenerative

changes in the cervical and lumbar spine and degenerative joint

disease in his shoulders. The ALJ found that Chamberlain

retained the capacity to do light work without climbing or

crawling and with only occasional reaching. She found that

Chamberlain could do uncomplicated tasks and could maintain

concentration, persistence, and pace for two-hour blocks through

an eight-hour work day. Based on that functional capacity, the

ALJ found that Chamberlain could not return to his past work but

could do work identified by the vocational expert.

Chamberlain appealed that decision to the Appeals Council,

and his representative submitted new evidence in support of the

appeal. The Appeals Council denied his request for review and

1 Chamberlain emphasizes that he had a non-attorney representative before the ALJ but does not explain what significance that circumstance has for purposes of judicial review. Cf. Torres-Pagan v. Berryhill, --- F.3d ---,

, at *4-*5 (1st Cir. Aug. 10, 2018) (remanding for development of the record where claimant was proceeding pro se and was undergoing psychiatric treatment).

4 noted that the new evidence did not related to the period at

issue for his benefits application. The ALJ’s decision then

became the decision of the Acting Commissioner.

Discussion

Chamberlain contends that the ALJ erred in relying on the

opinions of the non-examining medical experts, a neurological

surgeon and a psychiatrist, who testified at the hearing, and

should instead have given greater weight to other opinions in

the record. Chamberlain also contends that the ALJ failed to

adequately assess his mental impairments in combination with all

of his impairments. The Acting Commissioner moves to affirm,

arguing that the ALJ properly assessed the medical opinion

evidence and considered and assessed Chamberlain’s mental

impairments.

A. Medical Opinion Evidence

“Medical opinions are statements from acceptable medical

sources that reflect judgments about the nature and severity of

your impairment(s), including your symptoms, diagnosis and

prognosis, what you can still do despite impairment(s), and your

physical or mental restrictions.”

(a)(1).

Acceptable medical sources include licensed physicians and

5 certain other licensed medical providers but not nurse

practitioners.

(a); Arseneau v. Berryhill,

, at *8 (D.N.H. Aug. 14, 2018). Opinions provided by

non-acceptable sources may be considered, but only “‘to show the

severity of the [claimant’s] impairment(s) and how it affects

the [claimant’s] ability to function.’” Ledoux v. Berryhill,

, at *5 (D.N.H. June 12, 2018) (quoting SSR 06-

3p, at *2).

Medical opinions are evaluated based upon the nature of the

medical source’s relationship with the claimant, the extent to

which the source provides evidence to support the opinion, the

extent the opinion is consistent with other evidence in the

record, the specialization of the medical source, and other

factors including the understanding the source has of the social

security system. § 404.1527(c). An ALJ may rely on the

opinions of state agency consultant medical sources based on the

same factors used to evaluate other medical opinions. Ledoux,

, at *4. If a consultant’s opinion is not based

on a complete record, however, it will not support the ALJ’s

functional capacity assessment when other evidence supports the

claimant’s limitations.

6 1. Dr. Hackman

Dr. Hackman, a board certified neurological surgeon,

testified by telephone at the hearing.2 Dr. Hackman stated that

Chamberlain could lift twenty pounds occasionally and ten pounds

frequently. He testified that Chamberlain had no limitations in

his ability to sit, stand, or walk. He said that Chamberlain’s

spinal problems would not cause restrictions in reaching but did

not give an opinion on whether Chamberlain’s degenerative

shoulder condition would limit his ability to reach, which he

said was an issue for an orthopedist. He also found no

limitations in handling, fingering, or manipulative activities,

and no limitations in postural activities other than climbing

ladders or scaffolding.

The ALJ gave great weight to Dr. Hackman’s opinion, noting

that he was an impartial medical expert and a board certified

neurosurgeon. The ALJ also noted that Dr. Hackman had the

complete medical record and the hearing testimony, that he had

explained his assessment and cited evidence in support, and that

he had discussed other opinions and why he did not find them

supported by the record. Chamberlain contends that assessment

2 Chamberlain notes that there were technical difficulties during the hearing so that Dr. Hackman could not hear Chamberlain’s testimony. The ALJ summarized the testimony, and Chamberlain agreed with the summary. It appears that the hearing issue was addressed when it arose, and Chamberlain does not show that Dr. Hackman missed any testimony.

7 was wrong because Dr. Hackman did not consider Chamberlain’s

complaints of pain and relied on only objective medical

evidence.

Chamberlain cites no legal support for his theory that Dr.

Hackman’s opinion was invalid because he did not consider

Chamberlain’s complaints of pain and his mental health issues.

To the extent he argues that Dr. Hackman should have credited

the findings made by Dr. Loeser and Nurse Bottazzi, Dr. Hackman

adequately explained why he did not rely on those opinions.

Chamberlain also cites no authority to show that Dr. Hackman was

required to provide opinions on areas outside the area of his

medical expertise.

Chamberlain has not shown that the ALJ erred in relying on

Dr. Hackman’s opinion. That opinion provides substantial

evidence to support the ALJ’s residual functional capacity

assessment.

2. Dr. Delano Bolter

Dr. Bolter, a psychiatrist, also testified at the hearing

by telephone. Dr. Bolter noted other limitations shown in

Chamberlain’s records but found no psychological functional

limitations beyond a mild degree. The ALJ gave Dr. Bolter’s

opinion great weight and did not find any psychological

impairment to be severe. Although not entirely clear, it

8 appears that Chamberlain challenges that assessment because Dr.

Read examined Chamberlain and provided a different opinion, and

because Dr. Bolter focused on psychological impairments rather

than Chamberlain’s physical pain and the impact of his

depression on his physical impairments.

The ALJ explained that he gave great weight to Dr. Bolter’s

opinion because he was an impartial medical expert and a

psychiatrist and he had considered all of the medical records

and Chamberlain’s testimony. The ALJ noted Dr. Bolter’s

familiarity with the social security regulations. The ALJ also

noted that Dr. Bolter explained his opinions and cited evidence

in support. The ALJ explained that he gave less weight to the

opinions of Dr. Read, an examining psychological consultant,

because Dr. Bolter reviewed the entire record. Chamberlain has

not shown error in that assessment.

3. Other Opinions

To the extent Chamberlain also argues that the ALJ erred in

failing to give great weight or controlling weight to the

opinions of Dr. Loeser, Dr. Read, Dr. Landerman, Nurse Bottazzi,

Physical Therapist Shannon Gile, he has not shown that error

occurred. The ALJ properly gave appropriate reasons for the

weight given to those opinions. While Chamberlain correctly

notes that those sources provided opinions that would support

9 additional limitations, Chamberlain has not shown that the ALJ

was required to accept and give weight to the opinions.

Chamberlain has not shown that the ALJ’s assessments were done

erroneously.

B. Mental Impairments

Chamberlain contends that despite Dr. Bolter’s opinion the

ALJ should have found severe mental impairments at Step Two and

that the ALJ erred in failing to assess mental impairments at

Steps Four and Five. Chamberlain, however, makes no developed

argument that the severity assessment at Step Two was wrong,

cites no standard, and focuses on the analysis at Steps Four and

Five. Therefore, Chamberlain has not shown any error at Step

Two.

In challenging the analysis at Steps Four and Five,

Chamberlain argues that the ALJ did not consider the combined

effect of his mental and physical impairments. He contends that

the ALJ did not adequately consider his mental impairments at

Steps Four and Five and did not consider their effect on the

occupational base of work he could do. The Acting Commissioner

acknowledges the requirement that the ALJ consider the combined

effects of severe and nonsevere impairments and argues that the

ALJ satisfied that requirement. Alternatively, the Acting

10 Commissioner argues that Chamberlain has not shown that any

prejudice resulted from the ALJ’s analysis.

In assessing a claimant’s residual functional capacity, an

ALJ must consider all of his impairments, even those that are

not severe. McDonald v. Sec’y of Health & Human Servs.,

(1st Cir. 1986). That is because impairments

taken separately may not be disabling but when considered

together they may significantly limit the ability to work.

Policy Interpretation Ruling Titles II and XVI: Assessing

Residual Functional Capacity in Initial Claims, SSR 96-8p, 1996

WL374184, at *5 (July 2, 1996). The required consideration of

the combined effect of impairments may be satisfied at any stage

of the sequential analysis, and once considered, the ALJ need

not provide a detailed separate discussion of the medical

evidence. Tellier V. Acting Comm’r, U.S. Social Security

Admin.,

,

, at *4 (D.N.H. July 10,

2018).

In this case, the ALJ properly considered all of

Chamberlains impairments, including his mental impairments. The

ALJ noted that Chamberlain had received treatment for symptoms

of depression and anxiety and was diagnosed with a major

depressive disorder and a mild adjustment disorder with anxiety.

The ALJ relied on Dr. Bolter’s opinion, however, that those

11 issues would have no more than a minimal effect on Chamberlain’s

ability to work.

The ALJ then reviewed other opinion evidence related to

Chamberlain’s mental impairments and found no severe

limitations. The ALJ also stated that she considered all of

Chamberlain’s impairments, severe and nonsevere, including his

“mental health related symptoms in conjunction with his ongoing

pain symptoms,” and found that those impairments limited

Chamberlain’s ability to maintain focus and concentration to the

extent that he was restricted to uncomplicated tasks. Admin.

Rec. at 32. The ALJ then included that limitation in her

residual functional capacity assessment. Therefore, the ALJ met

the requirement for considering Chamberlain’s impairments in

combination.3

Conclusion

For the foregoing reasons, the claimant’s motion to reverse

(document no. 11) is denied.

The Acting Commissioner’s motion to affirm (document no.

16) is granted.

3 Chamberlain contends that the restriction to uncomplicated tasks was intended to account for his lack of education. That is not what the ALJ explained in her decision.

12 The clerk of court shall enter judgment accordingly and

close the case.

SO ORDERED.

______________________________ Judge Joseph A. DiClerico, Jr. United States District Judge

August 22, 2018

cc: Sarah E. Choi, Esq. Janine Gawryl, Esq. Robert J. Rabuck, Esq.

13