HOWES v. SOCIAL SECURITY ADMINISTRATION COMMISSIONER

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UNITED STATES DISTRICT COURT
DISTRICT OF MAINE
KAITLYNN H., 	)
)
Plaintiff 	)
)
v. 	) 	No. 1:23-cv-00429-SDN
)
MARTIN O’MALLEY, 	)
Commissioner of Social Security, 	)
)
Defendant 	)
REPORT AND RECOMMENDED DECISION
The Plaintiff in this Social Security Disability and Supplemental Security
Income appeal contends that the Administrative Law Judge (ALJ) erred in her
evaluation of medical opinion evidence. 	See Plaintiff’s Brief (ECF No. 13) at 1.
I discern no error and recommend that the Court affirm the Commissioner’s decision.
I. Background
The Plaintiff applied for benefits in August 2021, alleging a disability onset
date of February 28, 2020,1 based upon limitations caused by attention deficit
hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, and
borderline personality disorder. 	See Record at 208-24, 241. 	After her claims were
denied at the initial and reconsideration levels, the Plaintiff requested a hearing
before an ALJ. 	See id. at 80-115, 142-44. That hearing took place on February 24,
2023, see id. at 35-58, following which the ALJ issued a written decision finding that
1 Although at hearing the Plaintiff amended her alleged onset date to February 2, 2020, see id. at 39,
the ALJ based her decision on the original alleged onset date of February 28, 2020, see id. at 18.
This discrepancy does not alter my analysis or recommendation.
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the Plaintiff suffered from the severe impairments of personality disorder, mood
disorder, 	anxiety 	disorder, 	ADHD, 	and 	post-traumatic 	stress 	disorder 	(PTSD),
see id. at 20. 	Considering those impairments, the ALJ found that the Plaintiff had
the residual functional capacity (RFC) “to perform a full range of work at all
exertional levels but with the following nonexertional limitations: she can understand
and remember simple instructions and perform simple tasks; she cannot work with
the public; and she can adapt to simple changes in the work environment.” Id. at 22.
The ALJ concluded that the Plaintiff could not return to her past relevant work but
that she could perform other jobs existing in significant numbers in the national
economy and was therefore not disabled. 	See id. at 27-29. 	The Appeals Council
denied the Plaintiff’s request to review the ALJ’s decision, see id. at 1-3, making that
decision the Commissioner’s final determination, see 20 C.F.R. §§ 404.981, 416.1481.
II. Standard of Review
A final decision of the Commissioner is subject to judicial review to determine
whether it is based on the correct legal standards and supported by substantial
evidence. 	See 42 U.S.C. 	§§ 405(g), 	1383(c)(3); 	Seavey 	v. 	Barnhart,
276 F.3d 1, 9 (1st Cir. 2001). Substantial evidence in this context means evidence in
the administrative record that a reasonable mind could accept as adequate to support
an ALJ’s findings. 	See Biestek v. Berryhill, 587 U.S. 97, 103 (2019). 	If an ALJ’s
findings are supported by substantial evidence, they are conclusive even if the record
could arguably support a different result. See Irlanda Ortiz v. Sec’y of Health & Hum.
Servs., 955 F.2d 765, 769 (1st Cir. 1991). 	But an ALJ’s findings “are not conclusive
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when 	derived 	by 	ignoring 	evidence, 	misapplying 	the 	law, 	or 	judging 	matters
entrusted to experts.” Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999).
III. Discussion
The Plaintiff contends that the ALJ erroneously evaluated the opinions of
mental health provider Vicky Packard, PMHNP-BC, as well as agency psychological
consultants Brian Stahl, Ph.D., and Leigh Haskell, Ph.D. 	See Plaintiff’s Brief at 8.
Specifically, the Plaintiff asserts that the ALJ’s findings regarding those opinions
were unsupported by substantial evidence and she failed to adequately evaluate their
supportability and consistency. See id; 20 C.F.R. §§ 404.1520c(a)-(c), 416.920c(a)-(c).
The ALJ found NP Packard’s opinion unpersuasive because it “overstate[d] the
[Plaintiff’s] limitations” and indicated a “level of impairment . . . not supported by the
evidence, including [NP] Packard’s own records reflecting generally benign mental
status 	examinations 	and 	reports 	of 	improved 	symptoms 	with 	treatment.”
Record at 26. The ALJ further noted that the Plaintiff’s “mental status examinations
demonstrate[d] largely unremarkable findings;” she “report[ed] improved symptoms
with medication;” and she could “travel, maintain relationships with others, live
independently, take care of pets, and perform on stage.” Id.
Correspondingly, the ALJ found Dr. Stahl’s and Dr. Haskell’s less restrictive
mental assessments persuasive because they were “supported by the [Plaintiff’s]
mental status examinations overall,” which showed that she “consistently present[ed]
as alert, pleasant, and cooperative, and her memory, concentration, and judgment
[were] all within normal limits”; her impairments “responded well to medication and
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therapy and ha[d] not required advanced care”; and finally, she “retaine[d] sufficient
functioning to complete her activities of daily living, maintain relationships with
family and friends, participate in Dungeons and Dragons events, and perform on
stage.” Id.
The Plaintiff first argues that the ALJ’s findings regarding the persuasiveness
of NP Packard’s, Dr. Stahl’s, and Dr. Haskell’s opinions are not supported by
substantial evidence. See Plaintiff’s Brief at 8-11. In an attempt to undermine these
findings, the Plaintiff asserts that the ALJ improperly relied on medical evidence
predating the amended alleged onset date, and points to evidence in NP Packard’s
treatment records and the Plaintiff’s own testimony that, according to her, support
the more restrictive limitations in NP Packard’s opinion.2 Id.
I find these points unavailing. As a threshold matter, the ALJ was required to
evaluate “all evidence in [the] case record,” even if it predated the Plaintiff’s amended
alleged onset date of February 2, 2021. 	20 C.F.R. §§ 404.1520(a)(3), 416.920(a)(3).
NP Packard stated in her opinion that she first treated the Plaintiff in 2015, and the
symptoms 	and 	limitations 	described 	therein 	had 	appeared 	two 	years 	prior;
accordingly, it was entirely proper for the ALJ to consider evidence from that period
2 The Plaintiff also challenges the ALJ’s citation to the treatment records of Michael Dufresne, M.D.,
as 	evidence 	of 	the 	Plaintiff’s 	“generally 	benign 	mental 	status 	examinations” 	with 	“largely
unremarkable findings.” Plaintiff’s Brief at 10. These records, the Plaintiff argues, cannot constitute
substantial evidence to support the ALJ’s evaluation of the opinion evidence because they include no
mental health findings beyond describing the Plaintiff’s psychiatric condition during appointments as
“normal.” Id. This argument fails because the ALJ did not rely exclusively on these records, but cited
them 	as 	one 	of 	several 	factors 	supporting 	her 	findings 	and 	RFC 	determination.
See Record at 26; cf. Coskery v. Berryhill, 892 F.3d 1, 7-8 (1st Cir. 2018) (concluding that an ALJ’s
determination that the plaintiff could perform light work was supported by substantial evidence where
evidence of his “daily activities was only one of several factors that the ALJ considered, and ultimately,
it [was] the entire record . . . that led the ALJ to conclude that [he] [was] not disabled” (cleaned up)).
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in 	her 	evaluation 	of 	the 	relevant 	medical 	opinions. 	See 	Record 	at 	1099;
cf. Nathaniel M. v. Kijakazi, No. 1:22-cv-00237-LEW, 2023 WL 4145043, at *4-5
(D. Me. June 23, 2023) (rec. dec.) (vacating an ALJ’s decision and remanding the case
where the ALJ downplayed a psychological report that predated the alleged disability
onset date, even though the evidence had already been considered in a prior,
administratively final decision, because it was material to the claimant’s mental
function during the relevant period), aff’d, 2023 WL 6390627 (D. Me. Oct. 2, 2023).
Moreover, the Plaintiff cannot undermine the ALJ’s finding that NP Packard’s
opinion was unsupported by her own treatment notes solely by emphasizing excerpts
from 	that 	evidence 	that 	might 	support 	a 	different 	conclusion.
See 	Malaney 	v. 	Berryhill, 	No. 	2:16-cv-00404-GZS, 	2017 	WL 	2537226, 	at 	*2
(D. Me. June 11, 2017) (rec. dec.) (“The mere fact that a claimant can point to evidence
of record supporting a different conclusion does not, in itself, warrant remand.”), aff’d,
2017 WL 2963371 (D. Me. July 11, 2017), aff’d, No. 17-1889, 2019 WL 2222474
(1st 	Cir. 	May 15, 2019). 	This 	is 	especially true 	where 	the Plaintiff 	fails to
meaningfully engage with the ALJ’s extensive discussion of her treatment records
and testimony or the ALJ’s ultimate conclusion that the mental status examinations
of record contained “largely unremarkable” findings overall. 	See Record at 22-27;
see 	also 	West 	v. 	Berryhill, 	No. 	17-1170, 	2017 	WL 	6499834, 	at 	*1
(1st Cir. Dec. 11, 2017) (“[T]he court considers the ALJ’s decision as whole when
determining whether substantial evidence supported the ALJ's findings.”).
The ALJ was also not required to take the Plaintiff’s testimony at face value,
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and reasonably weighed it against other evidence indicating that she was, in fact,
more functional than alleged. 	See Record at 22-27; 20 C.F.R. §§ 404.1529(c),
416.929(c). 	The ALJ explicitly observed that the Plaintiff’s “statements about the
intensity, persistence, and limiting effects of her symptoms” were “inconsistent with
the evidence of record,” Record at 23, which “show[ed] that she engage[d] in numerous
activities, including Dungeons and Dragons events and talent shows,” id. at 26, and
that she was “able to take care of her dogs and rabbits, attend to her personal care
needs, prepare meals, attend medical appointments, complete household chores,
drive a car, go shopping, manage finances, read, write, play computer games, and
socialize 	with 	friends 	and 	family,” 	id; 	see 	also 	Nicolas 	D. 	v. 	O’Malley,
No. 	2:22-cv-00354-JDL, 	2023 	WL 	8867881, 	at 	*2, 	4 	(D. 	Me. 	Dec. 	22, 	2023)
(rec. dec.) (affirming an agency decision where the claimant merely asserted “that the
ALJ wrongly deemed his activities of daily living inconsistent” with a medical opinion
and “fail[ed] to come to grips with the ALJ’s detailed discussion of his daily activities
and medical records”), aff’d, 2024 WL 729708 (D. Me. Feb. 22, 2024).
The Plaintiff’s second argument—that the ALJ failed to adequately evaluate
the 	supportability 	and 	consistency 	of 	NP 	Packard’s, 	Dr. 	Stahl’s, 	and
Dr. Haskell’s medical opinions—also misses the mark. See Plaintiff’s Brief at 11-12;
20 C.F.R. §§ 404.1520c(a)-(c), 416.920c(a)-(c). The Plaintiff asserts that the ALJ erred
by omitting any specific evaluation of (1) the reasoning NP Packard provided in her
opinion to support the limitations identified therein, or her opinion regarding the
Plaintiff’s likely time off-task and absences, and (2) the explanations Dr. Stahl and
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Dr. Haskell offered in support of their opinions. See Plaintiff’s Brief at 11-12.
However, NP Packard did not offer a specific opinion about the Plaintiff’s likely
time-off task, see Record at 1095-1100, and the ALJ expressly explained in her
decision that NP Packard’s opinion regarding the Plaintiff’s likely absences from
work overstated her limitations and was neither supported by nor consistent with
record 	evidence, 	including 	NP 	Packard’s 	own 	treatment 	notes,
see id. at 26, 1099. 	Moreover, the ALJ was not obligated to provide a detailed
evaluation 	of 	every 	statement 	in 	NP 	Packard’s 	opinion.
See 20 C.F.R. §§ 404.1520c(b)(1) (“[I]t is not administratively feasible . . . to articulate
in each determination or decision how we considered all of the factors for all of the
medical opinions and prior administrative medical findings in [the] case record.”),
416.920c(b)(1) (same); Revisions to Rules Regarding the Evaluation of Medical
Evidence, 82 Fed. Reg. 5844, 5858 	(Jan. 18, 2017) (explaining that the agency
employs a “reasonable articulation standard determinations . . . that does not require
written analysis about how we consider each piece of evidence”).
The 	Plaintiff’s 	challenge 	to 	the 	ALJ’s 	evaluation 	of 	Dr. 	Stahl’s 	and
Dr. Haskell’s opinions fails for the same reasons. In her decision, the ALJ stated that
she found Dr. Stahl’s and Dr. Haskell’s opinions persuasive because they were
supported by the Plaintiff’s largely benign mental status examinations, positive
response to medication and therapy, and ability to “complete her activities of daily
living, maintain relationships with family and friends, participate in Dungeons and
Dragons events, and perform on stage.” Record at 26. The ALJ thoroughly discussed
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the case record, see id. at 23-26, and explained which evidence supported Dr. Stahl’s
and Dr. Haskell’s opinions, id. at 26, “which indicates clearly enough—even if she did
not explicitly use the word ‘consistency’—that she found the opinion[s] []consistent
with the evidence.” 	Kyle K. v. O’Malley, No. 2:23-cv-00044-JAW, 2024 WL 356910,
at *3 (D. Me. Jan. 31, 2024) (rec. dec.), aff’d, 2024 WL 1092998 (D. Me. Mar. 13, 2024).
At bottom, the Plaintiff’s arguments are simply an improper request of the
Court to reweigh the evidence and reach a different conclusion. 	See Becky K. G. v.
Saul, No. 1:20-cv-00089-GZS, 2020 WL 7418974, at *5 (D. Me. Dec. 17, 2020)
(rec. dec.) (“That the record could arguably support a different conclusion does not
entitle the plaintiff to remand; it is for the ALJ, not the court, to draw conclusions
from the evidence and to resolve any conflicts therein.”), aff’d, 2021 WL 66609
(D. Me. Jan. 7, 2021).
IV. Conclusion
Accordingly, I recommend that the Commissioner’s decision be AFFIRMED.
NOTICE
A party may file objections to those specified portions of a Magistrate
Judge’s 	report 	or proposed 	findings 	or 	recommended 	decisions 	entered
pursuant to 28 U.S.C. § 636(b)(1)(B) for which de novo review by the District
Court is sought, together with a supporting memorandum, within fourteen
(14) days after being served with a copy thereof. 	A responsive memorandum
shall be filed within fourteen (14) days after the filing of the objection.
Failure to file a timely objection shall constitute a waiver of the right
to de novo review by the District Court and to appeal the District Court’s
order.
Dated: December 4, 2024
/s/ Karen Frink Wolf
United States Magistrate Judge
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