UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Jennifer Edwards Case No. 19-cv-510-PB v. Opinion No.

Andrew Saul, 1 Commissioner, Social Security Administration

MEMORANDUM AND ORDER

Jennifer Edwards challenges the denial of her claims for

Disability Insurance Benefits (“DIB”) and Supplemental Security

Income (“SSI”) pursuant to

(g) and 1383(c)(3),

respectively. She contends that the Administrative Law Judge

(“ALJ”) erred by (1) failing to give proper weight to the

opinion of an examining physician; (2) failing to give proper

weight to the opinion of Edwards’s treating physician; and (3)

failing to properly consider whether Edwards’s impairments met

or equaled Listing 1.02 or 1.04. 20 C.F.R. Pt. 404, Subpt. P,

App. 1. The Commissioner, in turn, moves for an order affirming

1 On June 17, 2019, Andrew Saul was sworn in as Commissioner of Social Security. Pursuant to Fed. R. Civ. P. 25(d), he automatically replaces the nominal defendant, Nancy A. Berryhill, who had been Acting Commissioner of Social Security. the ALJ’s decision. For the following reasons, I deny Edwards’s

motion and affirm the decision of the Commissioner.

I. BACKGROUND

The parties have submitted statements of material facts as

required by Local Rule 9.1(b). Many of the relevant facts are

set out in a previous decision by this court, Edwards v.

Berryhill, No. 17-cv-232-AJ,

(D.N.H. Mar. 7,

2018). I decline to repeat them here in detail. Rather, I focus

on facts relevant to this appeal, including facts developed

after the previous decision was issued.

A. Procedural Facts

Edwards filed her current claim for DIB and SSI in February

2012, alleging a disability onset date of May 6, 2009. Tr. at

150. After an initial denial in May 2012, Edwards’s claim was

heard before ALJ Ruth Kleinfeld in July 2013. Tr. at 173. The

ALJ issued an unfavorable decision that November, Tr. at 173–82,

which Edwards appealed to the Appeals Council. Tr. at 187. The

Appeals Council remanded Edwards’s case and another hearing was

conducted on November 10, 2015 before ALJ Dory Sutker. Tr. at

1209–77. ALJ Sutker addressed the issues raised by the Appeals

Council but ultimately issued another unfavorable decision on

December 16, 2015, Tr. at 1111–35.

2 Edwards’s second request for review by the Appeals Council

was denied, so she appealed to this court. Tr. at 1141–46.

Edwards raised several issues with the ALJ’s opinion, including

that the ALJ’s decision to discount the opinion of examining

physician Dr. Frank Graf was not supported by substantial

evidence. The ALJ had discounted Dr. Graf’s opinion because she

found that the responses on Dr. Graf’s medical source statement

were contradictory, that Dr. Graf’s opinions were not supported

by the report he prepared, and that Dr. Graf’s opinion on

Edwards’s capacity for sitting was not consistent with Edwards’s

own testimony. Edwards,

, at *7.

On March 7, 2018, Magistrate Judge Johnstone remanded

Edwards’s case to the Commissioner on the grounds that none of

these reasons was sufficient for discounting Dr. Graf’s opinion.

First, she found that the apparently contradictory responses

in Dr. Graf’s statement were most logically explained as an

inadvertent transposing of two answers. Id. at *6. Next, she

determined that the ALJ’s assertion that Dr. Graf’s opinions

were not supported by evidence was conclusory and that Dr. Graf

had, in fact, provided examination findings to back up his

conclusions. Id. Finally, she concluded that, while the ALJ had

found that Dr. Graf’s opinion that Edwards should be limited to

one hour of sitting was inconsistent with Edwards’s testimony

about how she spent her days, Magistrate Judge Johnstone

3 determined that there was no inconsistency because Edwards had

stated that she spent most of her time reclining, and reclining

is distinct from sitting. Id. at *7.

Magistrate Judge Johnstone also identified several issues

for the Commissioner to address on remand. Id. Specifically,

Magistrate Judge Johnstone noted instances where the ALJ

misstated Edwards’s history of hospitalization, misidentified a

non-medical SSA employee as a “medical physician,” improperly

afforded weight to the fact that Dr. Graf was the only physician

who noted an issue with Edwards’s right ankle reflexes, and

provided insufficient justification for giving “greatest weight”

to the opinion of expert medical witness Dr. John Kwock. Id. at

*8–9.

On remand, ALJ Sutker conducted a third hearing on November

20, 2018, Tr. at 894–975, and issued an unfavorable decision on

February 26, 2019, Tr. at 870–87. The Appeals Council denied

review, and Edwards appealed to this court.

B. Medical Evidence

Edwards’s disability claim is principally based upon failed

back surgeries (in July 2009 and January 2014) and a failed knee

replacement (in August 2013). Tr. at 900–01. Edwards has also

been diagnosed with mental impairments, such as bipolar

disorder, depression, and anxiety. Tr. at 619, 625, 627. In

addition to surgical intervention, Edwards has been treated with

4 numerous prescription medications. See Pl.’s Statement of

Material Facts, Doc. No. 8-1 at 1 (listing medications). She

also claims to suffer some side effects of these medications

related to her memory and motor function. Tr. at 377.

Since at least 2009, Dr. Melissa Hanrahan has treated

Edwards for these and other ailments. Tr. at 409. In addition to

years of treatment records, Dr. Hanrahan provided two medical

opinions relevant to this appeal. First, in June 2013, she

completed a form that rated Edwards’s limitations in various

categories from “Mild or None” to “Extreme.” Tr. at 688–89. On

this form, Dr. Hanrahan further concluded that Edwards could not

sustain an average eight-hour workday because her “severe

anxiety [and] panic limits her ability to focus at work.” Tr. at

689. Second, in October 2015, Dr. Hanrahan provided a letter

that stated that Edwards “could not work a full day due to

fatigue, chronic pain and needing to change positions

frequently.” Tr. at 864.

Dr. Graf performed a consultative examination of Edwards in

April 2015. Tr. at 792–801. He identified substantial

impairments in Edwards’s ability to bend, stoop, lift, and

carry, with diminished tolerance for walking. Tr. at 793.

Specifically, Dr. Graf opined that Edwards could never lift more

than twenty pounds or carry more than ten pounds. Tr. at 795.

Additionally, he found that she could only spend one hour

5 sitting, thirty minutes standing, and twenty minutes walking in

an eight-hour workday, with the remainder of her time to be

spent reclining. Tr. at 796.

At the hearing, ALJ Sutker heard testimony from Dr. Darius

Ghazi, an orthopedic surgeon who had reviewed Edwards’s medical

records. Tr. at 920–21. After recounting some of Edwards’s

treatment history, Dr. Ghazi opined that Edwards met the

criteria for Listing 1.02A and 1.04C. Tr. at 923. When asked

which objective medical evidence in the record supported a

finding that Edwards could not ambulate effectively, as is

required by 1.02A, Dr. Ghazi stated only that he believed that

anyone with a knee replacement has an inability to ambulate

effectively. Tr. at 925. When asked which objective medical

evidence in the record documented pseudo-claudication, as

required by Listing 1.04C, Dr. Ghazi replied that he “didn’t see

anything.” Tr. at 926.

Dr. Ghazi opined that Edwards could lift five pounds

frequently and ten pounds occasionally. Tr. at 927. He believed

she could stand and/or walk for two hours at a time for a total

of about four hours in an eight-hour workday, sit for six hours,

and occasionally require a cane to walk. Tr. at 928. Dr. Ghazi

disagreed with several of Dr. Graf’s findings. Specifically, Dr.

Ghazi believed that Dr. Graf had overstated Edwards’s capacity

for carrying, Tr. at 933, and thought that there was no

6 objective medical evidence to support Dr. Graf’s restrictions on

Edwards’s use of her arms and her capacity for sitting, Tr. at

936–37.

Edwards had two consultative examinations for her mental

impairments: one in May 2012 by Dr. Michael Evans, Tr. at 584–

87, and one in May 2015 by Dr. Trina Jackson, Tr. at 782–91.

While these two doctors noted that Edwards had had psychological

issues in the past, they both found her to have mild to no

mental impairments at present. Tr. at 586–87 (listing normal or

mildly limited levels of functioning in all categories and a

“good” psychiatric prognosis), 785 (noting “good” social skills,

“intact” memory and cognition, “good” concentration and

persistence, and “mild difficulty with stress tolerance”).

C. The ALJ’s Decision

At step one of the five-step disability evaluation process,

ALJ Sutker found that Edwards had not engaged in substantial

gainful activity since May 6, 2009, her alleged disability onset

date. Tr. at 875. At step two, she found that Edwards had

several severe impairments: “chondromalacia and osteoarthritis

of the left knee, status post total knee replacement;

degenerative disc disease of the lumbar spine; obesity; bipolar

disorder; anxiety[;] and depression.” Tr. at 875.

Relevant to this appeal, at step three, the ALJ considered

whether Edwards’s impairments met or equaled Listing 1.02 or

7 1.04. 2 Tr. at 876. The ALJ recounted the criteria of Listing 1.02

and found that there was “no evidence” to support a finding that

Edwards met them. Tr. at 876. The ALJ then recounted the

criteria of Listing 1.04 and found that the evidence did not

demonstrate that it was “met or medically equaled in this case.”

Tr. at 876.

After finding that Edwards did not meet or equal any listed

impairment, the ALJ formulated her Residual Functional Capacity

(“RFC”). Tr. at 878. Specifically, the ALJ determined that

Edwards had the RFC to perform sedentary work, subject to

several additional restrictions. Relevant to this appeal, she

determined that Edwards could “lift and carry ten pounds

occasionally and five pounds frequently; sit for a total of six

hours and stand and/or walk for four hours total out of an

eight-hour workday with normal breaks” Tr. at 878. The ALJ also

found that Edwards would need to use a cane at her discretion

when ambulating and that, although her “pace is somewhat

variable, . . . she is able to stay on task at least 90% of the

workday.” Tr. at 878.

2 The ALJ also discussed whether Edwards met the criteria for disability based upon obesity pursuant to SSR 02-01, or listing 12.04 or 12.06, two mental impairments. Tr. at 876. Because Edwards has not challenged the ALJ’s determinations on these listings, I decline to discuss them in greater detail.

8 In reaching this conclusion, the ALJ determined that Dr.

Hanrahan’s checklist-style form had “little to no probative

value because it is not supported by any objective evidence.”

Tr. at 884. Specifically, the ALJ found that Edwards’s daily

activities, such as “babysitting, preparing simple meals[,] and

performing light household chores” were inconsistent with the

Edwards’s “allegations of disabling functional limitations.” Tr.

at 884. With regard to Dr. Hanrahan’s 2015 opinion that Edwards

“could not work a full day due to fatigue [and] chronic pain and

needed to change positions frequently,” the ALJ noted that she

was “not persuaded” because the opinion was “conclusory in

nature, fails to give disabling limitations[,] and is an

assessment of [Edwards’s] ability to engage in basic work[-]like

activities, which is an opinion reserved to the Commissioner.”

Tr. at 885. Although the ALJ did not assign Dr. Hanrahan’s

opinion “the controlling weight ordinarily assigned to a

treating physician[’]s report commenting on the claimant’s

abilities,” she did not ignore Dr. Hanrahan’s observations and

findings and “carefully considered [them] in providing insight

as to functional ability and how they affect [Edwards’s] ability

to work.” Tr. at 885.

The ALJ gave “some weight” to Dr. Graf’s 2015 opinion. Tr.

at 884. After summarizing Dr. Graf’s findings, the ALJ gave Dr.

Graf’s opinion less weight than would ordinarily be assigned to

9 an examining physician because “more contemporaneous treatment

notes do not support [Dr. Graf’s] restrictions in standing and

walking. Specifically, physical examinations recently showed no

gait abnormalities and described [Edwards] as active in

performing daily activities and household chores.” Tr. at 884.

The ALJ also noted that Dr. Ghazi had disagreed with some

aspects of Dr. Graf’s report. Tr. at 883. Specifically, Dr.

Ghazi could find no evidence to support Dr. Graf’s restrictions

on Edwards’s standing and walking other than her history of

reconstructive surgery, and he was unable to find any support in

the record at all for Dr. Graf’s opined limitations on Edwards’s

sitting and use of her upper extremities. Tr. at 883.

Overall, the ALJ gave “great weight” to the opinion of Dr.

Ghazi, based upon an evaluation several factors, including

“supportability, including the degree of explanation and support

by objective evidence; consistency with the record as a whole;

[and] degree of specialization in the area of medicine

involved.” Tr. at 883. The ALJ noted that “Dr. Ghazi is an

orthopedic surgeon, he has an awareness of all the evidence in

the record, and he has an understanding of social security

disability programs and evidentiary requirements.” Tr. at 883.

“Most importantly, his opinion regarding [Edwards’s] functional

limitations is highly persuasive because it is well-supported by

the objective medical evidence.” Tr. at 883–84.

10 The ALJ gave “some weight” to the 2012 opinion of Dr. Evans

because “more recent treatment notes showed relatively normal

mental status examination and good control of depression and

anxiety with prescribed medication.” Tr. at 881. She also gave

“great weight” to the opinion of Dr. Jackson because she was an

examining physician who “had an opportunity to observe

[Edwards].” Tr. at 881–82. However, while Dr. Jackson had opined

no limitations in Edwards’s ability to stay on task during the

workday, the ALJ determined that her “persistence and pace is

somewhat variable” so she could only be “on task at least 90% of

the workday. Tr. at 882.

Having formulated Edwards’s RFC, the ALJ determined that

Edwards could not perform any of her past work. Tr. at 885.

Then, considering Edwards’s “age, education, work experience,

and residual functional capacity,” the ALJ found that there were

“jobs that exist in significant numbers in the national economy

that [Edwards] can perform.” Tr. at 886. This led her to the

conclusion that Edwards was not disabled. Tr. at 887.

II. STANDARD OF REVIEW

I am authorized to review the pleadings submitted by the

parties and the administrative record and enter a judgment

affirming, modifying, or reversing the Commissioner’s final

decision. See

(g). That review “is limited to

11 determining whether the ALJ used the proper legal standards and

found facts [based] upon the proper quantum of evidence.” Ward

v. Comm’r of Soc. Sec.,

(1st Cir. 2000). I

“defer to the Commissioner’s findings of fact, so long as they

are supported by substantial evidence.”

(citing Nguyen v.

Chater,

(1st Cir. 1999) (per curiam)).

“[W]hatever the meaning of ‘substantial’ in other contexts, the

threshold for such evidentiary sufficiency is not high.” Biestek

v. Berryhill, ___ U.S. ___,

,

(2019). It means only “such relevant evidence as a

reasonable mind might accept as adequate to support a

conclusion.”

(quoting Consolidated Edison Co. v. NLRB,

,

,

(1938)).

If the Commissioner’s factual findings are supported by

substantial evidence, they are conclusive, even where the record

“arguably could support a different conclusion . . . .” Irlanda

Ortiz v. Sec’y of Health & Human Servs.,

(1st

Cir. 1991) (per curiam). The Commissioner’s findings “are not

conclusive when derived by ignoring evidence, misapplying the

law, or judging matters entrusted to experts.” Nguyen,

. “Issues of credibility and the drawing of permissible

inference from evidentiary facts are the prime responsibility of

the Commissioner, and the resolution of conflicts in the

evidence and the determination of the ultimate question of

12 disability is for [him], not for the doctors or for the courts.”

Purdy v. Berryhill,

(1st Cir. 2018) (internal

quotation marks and brackets omitted) (quoting Rodriguez v.

Sec’y of Health & Human Servs.,

(1st Cir.

1981)).

III. ANALYSIS

Edwards alleges that the ALJ committed reversible error by

(1) failing to give proper weight to the opinion of examining

physician Dr. Graf; (2) failing to give proper weight to the

opinion of Edwards’s treating physician, Dr. Hanrahan; and (3)

failing to properly consider whether Edwards’s impairments met

or equaled Listing 1.02 or 1.04. Pl.’s Mem. of Law, Doc. No. 8-2

at 1. As explained below, none of Edwards’s arguments provides

grounds for remand.

A. Weight Given to Opinion of Examining Physician Dr. Graf

The ALJ is required to evaluate every medical opinion that

she receives. See

(c), 416.927(c). Among

those opinions, the Social Security regulations establish a

hierarchy that generally gives greatest weight to opinions of

treating sources, lesser weight to opinions from examining

sources, and least weight to opinions from sources who have

neither examined nor treated a claimant. See

404.1527(c)(1)–(2), 416.927(c)(1)–(2). 3 In weighing any medical

opinion, the ALJ should consider: (1) the length of the medical

source’s treatment relationship with the claimant and the

frequency of the source’s examination of the claimant; (2) the

nature and extent of the claimant’s treatment relationship with

the medical source; (3) the opinion’s supportability; (4) the

opinion’s consistency with the record as a whole; (5) the

specialization of the medical source who provided the opinion;

and (6) other factors. See

(c)(2)–(6),

416.927(c)(2)–(6). “[J]ust as an ALJ may properly decline to

give controlling weight to the opinion of a treating source, an

ALJ may also discount the weight given to the opinion of an

examining source in favor of the opinion of a non[-]examining

source.” Wall v. Berryhill, No. 18-cv-277-PB,

,

at *4 (D.N.H. June 27, 2019) (internal quotation marks omitted).

As noted above, in her prior ruling, the ALJ discounted Dr.

Graf’s opinion on three grounds, all of which were rejected as

insufficient by this court. Edwards,

, at *6.

Notably, the magistrate judge considered the rejection of these

grounds to be “perhaps a close call.” Id. at *5. On remand, the

3 For applications filed on or after March 27, 2017, a new set of regulations governs the evaluation of medical opinions. See

.1520c, 416.920c. Because Edwards filed her application for DIB and SSI benefits in February 2012, Tr. at 150, the previous regulations govern.

14 ALJ complied with the magistrate judge’s order requiring her not

to base her decision on any of the grounds deemed insufficient.

In the ALJ’s current ruling, she gave Dr. Graf’s opinion

“some weight,” noting that “Dr. Graf’s observations and findings

are not ignored and have been carefully considered in providing

insight as to functional ability and how they affect the

claimant’s ability to work.” Tr. at 884. The ALJ noted that

“more contemporaneous treatment notes do not support [Dr.

Graf’s] restrictions in standing and walking. Specifically,

physical examinations recently showed no gait abnormalities and

described the claimant as active in performing daily activities

and household chores.” Tr. at 884. Edwards challenges the

sufficiency of these two reasons for discounting Dr. Graf’s

opinion and adds that, because Dr. Graf’s opinion is consistent

with the testimony of Dr. Ghazi, the ALJ should have afforded it

greater weight. None of these arguments is persuasive.

1. Lack of Gait Abnormalities

As an initial matter, Edwards claims that “[t]he ALJ

provides no explanation how treatment records provided three

years after the first hearing could, in any way, inform her

determination that [Dr. Graf’s] opinion was inconsistent with

the record.” Doc. No. 8-2 at 7. This argument fails for at least

three reasons.

15 First, it does not accurately describe the ALJ’s ruling,

which cites to treatment notes of normal gait both preceding Dr.

Graf’s opinion, Tr. at 880 (citing August 14, 2014 treatment

note at 805), and approximately 16 months thereafter, Tr. at 880

(citing September 16, 2016 treatment note at 1366). 4 Second,

Edwards has never alleged any change in her condition between

the time of Dr. Graf’s opinion and the ALJ’s opinion at issue

here. To the contrary, at her hearing, Edwards testified that

her condition was unchanged. Tr. at 915. Finally, and perhaps

most important, the regulations require that the ALJ evaluate

the consistency of each medical opinion “with the record as a

whole.”

(c)(4), 416.927(c)(4). The ALJ was,

therefore, required to determine whether Dr. Graf’s opinion was

consistent with later treatment records.

Turning to Edwards’s argument that a lack of gait

abnormalities was an improper reason for the ALJ to afford Dr.

Graf’s opinion only “some weight,” I again find no reason to

4 Edwards faults the ALJ for not appending these citations to her conclusion sentence, where she states that Dr. Graf’s opinion is inconsistent with treatment records showing no gait abnormalities. To be sure, remand is appropriate if the ALJ fails to provide specific citations to the record such that meaningful review is not possible. See, e.g., Jenness v. Colvin, No. 15-cv–005-LM,

, at *7 (D.N.H. Aug. 27, 2015). But the ALJ did provide such specific citations here, and in the same RFC section no less. That the ALJ did not repeat these citations in her conclusion is no impediment to meaningful review of her decision.

16 disturb the ALJ’s conclusion. The ALJ determined that Dr. Graf’s

opinions on Edwards’s ability to stand and walk 5 was inconsistent

with records of Edwards’s treatment record both preceding and

following Dr. Graf’s opinion. Tr. at 884. The Commissioner has

further identified treatment notes, too numerous to recite in

full here, showing no gait abnormalities. These notes are

consistent with each other but not with Dr. Graf’s opinion. See,

e.g., Tr. at 811 (October 6, 2014 treatment note identifying no

gait abnormalities), 1425 (March 11, 2016 note stating that

Edwards denied gait abnormalities), 1397 (January 6, 2017

treatment note reciting generally normal physical exam results

of Edwards’s knees and back), 1405 (January 26, 2018 treatment

note stating that Edwards denied gait abnormalities).

Edwards correctly points out that there are aspects of the

record that are consistent with Dr. Graf’s assessment. Doc. No.

8-2 at 8. But I must uphold an ALJ’s opinion supported by

5 In an undeveloped argument, Edwards faults the ALJ for not supporting her decision to afford less weight to Dr. Graf’s opinion on Edwards’s capacity for sitting. The ALJ, however, did address this issue when she discussed Dr. Ghazi’s evaluation of Dr. Graf’s opinion. Tr. at 883. The ALJ noted that Dr. Ghazi was unable to identify any “persuasive objective evidence” in the record that supported Dr. Graf’s limitation, Tr. at 883. Edwards has likewise identified none. This complete lack of support for Dr. Graf’s opined limitation is sufficient grounds to reject it. See

(c)(3), 416.927(c)(3) (“The more a medical source presents relevant evidence to support a medical opinion, particularly medical signs and laboratory findings, the more weight we will give that medical opinion.”).

17 substantial evidence even if there is also substantial evidence

to support a different conclusion. Irlanda Ortiz,

. The ALJ properly relied upon inconsistencies between the

medical record and Dr. Graf’s opinion on Edward’s ability to

stand and walk to discount the weight she gave to that opinion.

I decline to overturn her decision on these grounds.

2. Performance of Daily Activities

Edwards also challenges the ALJ’s determination that Dr.

Graf’s opinion was inconsistent with Edwards’s reported

performance of daily activities and household chores. Doc. No.

8-2 at 9. 6 Evidence of daily activities inconsistent with a

medical source’s opinion can constitute “good reasons” for

discounting that opinion. See Dimambro v. U.S. Soc. Sec. Admin.,

Acting Comm’r, No. 16-cv-486-PB,

, at *12 (D.N.H.

Jan. 5, 2018) (citing Reece v. Colvin,

(8th

Cir. 2016)). In concluding that Edwards’s daily activities were

inconsistent with Dr. Graf’s opined limitations, the ALJ cited

to instances in the record where Edwards reported “prepar[ing]

simple meals and complet[ing] light household chores,” Tr. at

6 Here again, Edwards faults the ALJ for not appending citations to her conclusion sentence on this issue. Because the ALJ did include the relevant citations earlier in the RFC section, I conclude for the reasons already stated that this has not impeded meaningful review and is, therefore, not a basis to reject the ALJ’s conclusion.

18 879 (citing Tr. at 372); being able “to stand and walk for

longer periods and complete daily chores,” Tr. at 880 (citing

Tr. at 1451); and being “able to do daily chores and shopping

and remain very active,” Tr. at 880 (internal quotations

omitted) (citing Tr. at 1410, 1425, 1435). Such activities

provide substantial evidence for discounting Dr. Graf’s opinion

that Edwards could walk for no more than twenty minutes and

stand for no more than thirty minutes in a day.

In support of her position, Edwards cites to Sanford v.

Berryhill, No. 17-cv-246-JL,

(D.N.H. Sept. 12,

2018), a case where the court rejected the ALJ’s decision to

give less weight to a medical source because, the ALJ said, the

source’s opinions were inconsistent with the claimant’s daily

activities. Sanford,

, at *7. Edwards’s argument,

however, is unavailing because her situation is unlike the

claimant’s in Sanford. Like Edwards, the Sanford claimant could

cook meals that did not require excessive preparation, but

unlike Edwards, the Sanford claimant could not clean, could only

shop for a few items at a time once a month, and could no longer

engage in any of his former activities.

In Sanford, the

claimant’s daily activities were entirely consistent with the

rejected medical source’s opined limitations, so it was improper

for the ALJ to discount the opinion on those grounds.

In

this case, Edwards’s cleaning, shopping, and other chores are

19 subject to some limitations, but they are not as limited as the

Sanford claimant’s. Edwards is able, for example, to load

groceries into her car at the store and put away everything

except for the groceries that require her to stoop to low

shelves. Tr. at 911–12. The ALJ could reasonably find that her

activities are inconsistent with the rather extreme limitations

opined by Dr. Graf.

Apart from her citation to Sanford, Edwards argues against

the ALJ’s discounting of Dr. Graf’s opinion principally by

reciting a list of several impairments, such as pain and

numbness, difficulty climbing stairs, use of a cane, inability

to lift her grandson, and difficulty putting away groceries.

Doc. No. 8-2 at 10. To the extent that Edwards argues that these

impairments are inconsistent with “the exertional requirements

of sedentary work,” Doc. No. 8-2 at 10, she has confused the

roles of Dr. Graf’s medical opinion with the Commissioner’s role

in determining a claimant’s ultimate ability to perform

sedentary work, see

(d)(2). Dr. Graf did not

give an opinion about Edwards’s ability to perform sedentary

work, nor would I be able to rely on such an opinion on a

determination reserved for the Commissioner.

To the extent Edwards offers these impairments as

substantial evidence supporting a conclusion different from the

conclusion reached by the ALJ, she misunderstands the standard

20 that must be met to warrant remand. Because the ALJ’s opinion is

supported by substantial evidence, I must uphold it, even though

the limitations Edwards lists might support a different

conclusion. See Irlanda Ortiz,

. As already

explained, the ALJ provided good reasons for giving only “some

weight” to Dr. Graf’s opinion, and Edwards has provided me with

no basis to reject those reasons.

3. Consistency with Dr. Ghazi’s Testimony

In what is perhaps her most confusing argument, Edwards

contends that the ALJ should have given greater weight to Dr.

Graf’s opinion because it is consistent with the opinion of Dr.

Ghazi, which the ALJ afforded “great weight.” Doc. No. 8-2 at

12–13. Edwards cites no authority to support the proposition

that an ALJ must give greater weight to a medical opinion if

that opinion is consistent with another opinion that the ALJ has

given great weight.

Even if Edwards had cited authority for her argument,

however, such a case would be inapplicable here because Dr.

Graf’s opinion differed from Dr. Ghazi’s opinion in numerous

respects. In some instances, Dr. Graf opined greater

restrictions than Dr. Ghazi, including greater limitations on

Edwards’s sitting and reaching. Compare Tr. at 796–800 (Dr. Graf

opining a one-hour limitation on Edwards’s sitting and a

complete inability to reach overhead) with Tr. at 936, 928 (Dr.

21 Ghazi opining no sitting restrictions and finding no basis for a

restriction on reaching). In other instances, it was Dr. Ghazi

who opined greater restrictions, including greater limitations

on Edwards’s lifting. Compare Tr. at 795 (Dr. Graf opining that

Edwards could lift no more than twenty pounds) with Tr. at 933

(Dr. Ghazi opining that Dr. Graf had “overstated” Edwards’s

ability to lift twenty pounds). The ALJ adopted Dr. Ghazi’s more

stringent limitations on Edwards’s lifting and carrying, as well

as his less restrictive limitations on her sitting. Tr. at 878.

That the ALJ gave “great weight” to Dr. Ghazi’s opinion is no

basis for me to reject her decision to give Dr. Graf’s opinion

only “some weight.”

In sum, Edwards has provided me with no reason to reject

the ALJ’s decision to give Dr. Graf’s opinion “some weight.” I,

therefore, decline to overturn the ALJ’s decision on that basis.

B. Weight given to Dr. Hanrahan’s opinion

The ALJ must give “controlling weight” to the opinion of a

treating source if the ALJ “find[s] that a treating source’s

medical opinion on the issue(s) of the nature and severity of

[the claimant’s] impairment(s) is well-supported by medically

acceptable clinical and laboratory diagnostic techniques and is

not inconsistent with the other substantial evidence in [the

claimant’s] case record . . . .”

(c)(2),

416.927(c)(2). If the ALJ does not give controlling weight to a

22 treating source’s opinion, she must give “good reasons” for that

decision.

(c)(2), 416.927(c)(2). Good

reasons “offer a rationale that could be accepted by a

reasonable mind,” Levesque v. U.S. Soc. Sec. Comm’n, Acting

Comm’r, No. 18-cv-420-LM,

, at *4 (D.N.H. May 7,

2019) (quoting Dimambro,

, at *10), and “are both

specific . . . and supportable,” Dimambro,

, at

*10 (alternation in original) (citation omitted).

The ALJ discounted the 2013 opinion form submitted by Dr.

Hanrahan, Edwards’s treating physician, because it was a

“checklist-style form” that “includes only conclusions regarding

functional limitations without any rationale for those

conclusions”; it was “not supported by any objective evidence”;

and it was inconsistent with the claimant’s “somewhat normal

level of daily activity and interaction.” Tr. at 884. The ALJ

also declined to give controlling weight Dr. Hanrahan’s 2015

opinion that Edwards “could not work a full day due to fatigue,

chronic pain and need[ing] to change positions frequently”

because, the ALJ reasoned, this opinion was “conclusory in

nature, fails to give disabling limitations and is an assessment

of the claimant’s ability to engage in basic work[-]like

activities, which is an opinion reserved to the Commissioner.”

Tr. at 885. The ALJ noted that she did not ignore Dr. Hanrahan’s

opinion and did incorporate some of Dr. Hanrahan’s limitations

23 (such as Edwards’s sensitivity to cold) into her RFC

determination.

Edwards faults the ALJ first for discounting Dr. Hanrahan’s

checklist form and, second, for including in Edwards’s RFC a

finding that she could stay on task at least ninety percent of

the workday, although Dr. Hanrahan had opined greater

limitations. Neither argument is persuasive.

1. Dr. Hanrahan’s 2013 Checklist Form

“[A] treating provider’s opinion may be entitled to less

weight when it is in a ‘worksheet’ or checklist format,

unaccompanied by explanation.” Gould v. Astrue, No. 11-cv-485-

SM,

, at *5 (D.N.H. Oct. 31, 2012) (citing

Halloran v. Barnhart,

(2d Cir. 2004)). “When an

opinion is given in a cursory fashion, the ALJ can properly give

it less weight.” McGrath v. Astrue, No. 10-CV-455-JL,

, at *5 n.13 (D.N.H. Mar. 22, 2012) (citing Coggon v.

Barnhart,

(D. Mass. 2005)).

On the form that the ALJ discounted, Dr. Hanrahan checked

thirty-three boxes, including nineteen items that limited

Edwards’s ability to function in a work environment. Tr. at 685–

86. In support of these check boxes, Dr. Hanrahan provided only

a one-sentence explanation: “Severe anxiety [and] panic limits

her ability to focus at work.” Tr. at 686. Even if I were to

believe the somewhat strained proposition that thirty-three

24 conclusions can be adequately supported by a single sentence

devoid of any detail, I would still struggle to connect a number

of Dr. Hanrahan’s specific conclusions with her given

explanation. For example, a limited ability to focus due to

anxiety and panic, standing alone, does not logically explain

why Edwards would require “[p]roximity to a bathroom . . . due

to urgent urinary/bowel problems” or why “[m]edication side

effects would occur and limit work.” Tr. at 686. In short, the

rationale provided by the ALJ is adequate to explain the limited

weight she gave to this form. See Nickerson v. Berryhill, No.

18-CV-559-PB,

, at *7 (D.N.H. June 27, 2019).

Edwards identifies numerous notes in Dr. Hanrahan’s

treatment records that are consistent with the opinions given on

the checklist form. Once again, however, Edwards misapprehends

the standard for overturning the ALJ’s decision. I must uphold

the ALJ’s decision if it is supported by substantial evidence,

even if there is substantial evidence to support a different

conclusion. See Irlanda Ortiz,

. Whatever support

in Dr. Hanrahan’s treatment notes there may have been for the

conclusions she opined on the checklist form, Dr. Hanrahan never

identified those notes or articulated connections between them

and her conclusions. It would have been error for the ALJ to

bridge that gap herself by hunting down and interpreting raw

medical data. See Nguyen,

(noting that “[a]s a

25 lay person . . . the ALJ was simply not qualified to interpret

raw medical data in functional terms”). The ALJ, therefore, gave

adequate support for discounting Dr. Hanrahan’s 2013 checklist

opinion, and I will not overturn her determination to do so.

2. The RFC Determination that Edwards Could Stay on Task

for Ninety Percent of the Workday

As clarified in her Reply, Doc. No. 12, Edwards’s contends

that it was error for the ALJ to determine that she could stay

on task for ninety percent of the workday because the ALJ should

have afforded greater weight to Dr. Hanrahan’s opinion and

crafted a more restrictive RFC. Edwards has not, however,

provided any argument for why the ALJ’s reasons for discounting

Dr. Hanrahan’s opinion on this matter were improper. Rather,

Edwards cites to Dr. Hanrahan’s treatment notes that are

consistent with her opinion.

As the Commissioner points out (and Edwards fails to

challenge), the ALJ articulated valid reasons for discounting

Dr. Hanrahan’s opinion on Edwards’s ability to stay on task.

Namely, she found that it was “conclusory in nature, fails to

give disabling limitations[,] and is an assessment of the

claimant’s ability to engage in basic work[-]like activities,

which is an opinion reserved to the Commissioner.” Tr. at 885.

As already stated above, I must uphold the ALJ’s decision

regarding the weight given to an expert opinion when that

26 decision is supported by substantial evidence, even if there is

substantial evidence that arguably supports another conclusion.

See Irlanda Ortiz,

. Edwards has offered no

argument that the ALJ’s given reasons for discounting Dr.

Hanrahan’s opinion are unsupported. The ALJ’s ruling on this

issue must, therefore, be upheld.

C. Listings 1.02 and 1.04

Finally, Edwards argues that the ALJ erred at step three in

the analysis by failing to properly consider whether her

impairments met or equaled Listings 1.02 and 1.04. Doc. No. 8-2

at 16. Edwards bears the burden of proving, at step three, that

she meets or equals one of the listed impairments in 20 C.F.R.

Pt. 404, Subpt. P, App. 1. See Freeman v. Barnhart,

(1st Cir. 2001). “For a claimant to show that [her]

impairment matches a [L]isting, it must meet all of the

specified medical criteria. An impairment that manifests only

some of those criteria, no matter how severely, does not

qualify.” Sullivan v. Zebley,

,

,

(1990) (emphasis in original) (quoting SSR 83–

19 7). As explained below, she has failed to meet that burden with

respect to either Listing.

7 SSR 83-19 was rescinded as of August 20, 1980 and replaced by SSR 91-7C, which contains identical language.

27 1. Listing 1.02

Edwards specifically contends that the ALJ should have

found that she meets the criteria for 1.02A, 8 which reads in

full:

1.02 Major dysfunction of a joint(s) (due to any cause): Characterized by gross anatomical deformity (e.g., subluxation, contracture, bony or fibrous ankylosis, instability) and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s). With:

A. Involvement of one major peripheral weight-bearing joint (i.e., hip, knee, or ankle), resulting in inability to ambulate effectively, as defined in 1.00B2b;

Subpt. P, App. 1. “Inability to ambulate

effectively means an extreme limitation in the ability to walk”

and is “defined generally as having insufficient lower extremity

functioning . . . to permit independent ambulation without the

use of a hand-held assistive device(s) that limits the

functioning of both upper extremities.” Id. at 1.00B2b(1).

“[E]xamples of ineffective ambulation include . . . the

inability to walk without the use of a walker, two crutches or

8 In her motion, Edwards refers to 1.02B, but the text she quotes and her argument center around 1.0A. I, therefore, assume, as the Commissioner did, that this is a typographical error and evaluate Edwards’s argument as it applies to 1.02A.

28 two canes[; and] the inability to carry out routine ambulatory

activities, such as shopping and banking.” Id. at 1.00B2b(2).

In support of her argument, Edwards cites to numerous

instances in the record of “instability” in her knee, including

instances of falling and balance problems. Doc. No. 8-2 at 17–

18. These facts fall short of providing substantial evidence

that Edwards could not ambulate effectively. To the contrary,

there is substantial evidence in the record that Edwards is able

to ambulate effectively, as defined in 1.00B2b. Edwards

identifies nothing in the record suggesting that she requires

the use of a walker, two crutches, two canes, or any other

apparatus that restricts her use of both of her upper

extremities. She stated, rather, that she only occasionally

needs one cane, Tr. at 99–100, 376, 917; and at least two

medical sources agreed, Tr. at 114 (Dr. Kwock), 928 (Dr. Ghazi).

Moreover, as already discussed, she engages in “routine

ambulatory activities, such as shopping.” 1.00B2B(2).

No one doubts that Edwards’s cannot walk as well as a

person with completely healthy knees, but that is not the

standard for rejecting the ALJ’s decision. The ALJ’s

determination that Edwards’s limitations in her ability to

ambulate fell short of Listing 1.02B is supported by substantial

evidence. I decline to overturn it.

29 2. Listing 1.04

In this section, Edwards primarily argues that the ALJ

should have found that she meets the criteria for Listing 1.04A. 9

That Listing refers to:

Disorders of the spine . . . resulting in compromise of a nerve root . . . or the spinal cord. With . . . [e]vidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine).

Subpt. P, App. 1.

While Edwards has identified record evidence supporting a

compromised nerve root, Doc. No. 8-2 at 18–19, she has not

provided sufficient support for a finding that the other

elements of Listing 1.04A have all been met. She identifies, for

example, no limitation of motion of her spine. While she points

to evidence of decreased sensation, Doc. No. 8-2 at 19, she

provides no evidence that it is accompanied by motor loss or

atrophy. Edwards identifies sporadic positive straight leg

9 Although Edwards develops no argument on the subject, she references an opinion by Dr. Ghazi that she meets Listing 1.04C. Listing 1.04C requires that the claimant be unable to ambulate effectively. As already discussed, there is substantial evidence to support the conclusion that Edwards can ambulate effectively, as defined by 1,00B2b, so Listing 1.04C does not apply. Edwards offers no argument whatsoever to support a determination that she meets Listing 1.04B.

30 raises spread out over the eight-year period. Tr. at 413 (2009);

793 (2015); 1464, 1473 (2017). She fails, however, to provide

evidence that this impairment continued for any twelve-month

period, as is her burden. See Barnhart v. Walton,

,

222–23,

,

(2002) (holding that

the “‘12 month’ duration requirements apply to both the

‘impairment’ and the ‘inability’ to work requirements.”). The

record shows, rather, that these four positive straight leg

tests are interspersed with at least twenty-three negative

straight leg raise tests throughout the same period. Tr. at 433,

435 (2009); 431, 462 (2010); 821 (2014); 847, 1493, 1511, 1520

(2015); 1402, 1417, 1427, 1442, 1448, 1479, 1489, 1506 (2016);

1397, 1412, 1515 (2017); 1402, 1421, 1431 (2018).

There is substantial evidence to support the ALJ’s

conclusion that Edwards’s impairments do not meet Listing 1.04.

I, therefore, decline to overturn the ALJ’s determination.

IV. CONCLUSION

For the foregoing reasons, I grant the Commissioner’s

motion to affirm (Doc. No. 10) and deny Edwards’s motion to

reverse (Doc. No. 8). The clerk of court shall enter judgment in

accordance with this Memorandum and Order and close the case.

31 SO ORDERED.

/s/ Paul J. Barbadoro Paul J. Barbadoro United States District Judge

December 31, 2019

cc: Edward A. Wicklund, Esq. Janine Gawryl, Esq. Hugh Dun Rappaport, Esq.

32