Case Name in Social Security Case - Unavailable

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IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF NORTH CAROLINA
ASHEVILLE DIVISION
1:24-cv-00276-MOC-WCM
APRIL SPRINGSTON, )
)
Plaintiff, ) MEMORANDUM AND
) RECOMMENDATION
v. )
)
COMMISSIONER OF THE SOCIAL )
SECURITY ADMINISTRATION, )
)
Defendant. )
_______________________________ )
This matter has been referred to the undersigned pursuant to 28 U.S.C.
§ 636 for the entry of a recommendation.
I. Procedural Background
On September 14, 2021, April Springston (“Plaintiff”) filed an application
for disability insurance benefits. Transcript of the Administrative Record
(“AR”) 269-276. Plaintiff alleges disability beginning August 31, 2018. Id.
On April 15, 2024, following an administrative hearing at which Plaintiff
appeared and testified, an Administrative Law Judge (“ALJ”) issued an
unfavorable decision. AR 11-23. That decision is the Commissioner’s final
decision for purposes of this action.
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II. The ALJ’s Decision
The ALJ found that Plaintiff had the severe impairments of carpal
tunnel syndrome, obesity, bipolar disorder, depression, and anxiety. AR 16.
After determining that Plaintiff’s impairments did not meet or medically equal
any of the listed impairments, the ALJ found that Plaintiff had the residual
functional capacity (“RFC”):
to perform medium work… except the claimant can
perform frequent bilateral handling and fingering;
work is limited to simple, routine, and repetitive tasks,
performed in a work environment free of fast-paced
production requirements (no assembly line work),
involving only simple, work-related decisions, and
with few, if any, work place changes; the claimant is
capable of learning simple vocational tasks and
completing them at an adequate pace with persistence
in a vocational setting; the individual can perform
simple tasks for two hour blocks of time with normal
rest breaks during an eight hour work day; with only
occasional interaction with the public and coworkers.
AR 18.
Applying this RFC, the ALJ found that Plaintiff could perform other jobs
that exist in significant numbers in the national economy such that Plaintiff
was not disabled. AR 22-23.
III. Plaintiff’s Allegation of Error
Plaintiff contends that when developing the RFC, the ALJ erred in his
consideration of the opinions of Dr. Todd L. Morton, a licensed psychologist
who completed a Comprehensive Clinical Psychological Evaluation of Plaintiff,
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and Dr. Joseph Malancharuvil, a Board Certified Clinical Psychologist who
provided live testimony during the administrative hearing.
IV. Standard of Review
A claimant has the burden of proving that he or she suffers from a
disability, which is defined as a medically determinable physical or mental
impairment lasting at least 12 months that prevents the claimant from
engaging in substantial gainful activity. 20 C.F.R. §§ 404.1505(a); 416.905(a).
The regulations require the Commissioner to evaluate each claim for benefits
using a five-step sequential analysis. 20 C.F.R. §§ 404.1520; 416.920. The
burden rests on the claimant through the first four steps to prove disability.
Monroe v. Colvin, 826 F.3d 176, 179 (4th Cir. 2016). If the claimant is
successful at these steps, then the burden shifts to the Commissioner to prove
at step five that the claimant can perform other work. Mascio v. Colvin, 780
F.3d 632, 635 (4th Cir. 2015); Monroe, 826 F.3d at 180.
Under 42 U.S.C. § 405(g), judicial review of a final decision of the
Commissioner denying disability benefits is limited to whether substantial
evidence exists in the record as a whole to support the Commissioner’s
findings, and whether the Commissioner’s final decision applies the proper
legal standards. Hines v. Barnhart, 453 F.3d 559, 561 (4th Cir. 2006). When a
federal district court reviews the Commissioner’s decision, it does not “re-weigh
conflicting evidence, make credibility determinations, or substitute [its]
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judgment for that of the [Commissioner].” Craig v. Chater, 76 F.3d 585, 589
(4th Cir. 1996). Accordingly, the issue before the Court is not whether Plaintiff
is disabled but, rather, whether the Commissioner’s decision that she is not
disabled is supported by substantial evidence in the record and based on the
correct application of the law. Id.
V. Discussion
An ALJ is required to consider and articulate how persuasive he or she
finds each medical opinion to be, and, in doing so, to consider numerous factors
including “supportability” and “consistency.” See 20 C.F.R. §§ 404.1520c(a) &
(c); 416.920c(a) & (c). “Supportability is the degree to which a provider supports
their opinion with relevant, objective medical evidence and explanation, and
consistency is the degree to which a provider's opinion is consistent with the
evidence of other medical and non-medical sources in the record.” Oakes v.
Kijakazi, 70 F.4th 207, 212 (4th Cir. 2023) (citation omitted); see also Bright v.
Saul, No. 1:19CV504, 2020 WL 4483008, at *3 (M.D.N.C. Aug. 4, 2020)
(“Supportability is an internal check that references objective medical evidence
and supporting explanations that come from the source itself. Consistency is
an external check that references evidence from other medical and nonmedical
sources”).
Here, Dr. Morton completed a Comprehensive Clinical Psychological
Evaluation of Plaintiff on May 3, 2023 and also submitted a Medical Source
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Statement (“MSS”). AR 804-811. Dr. Morton indicated that Plaintiff had
marked limitations in her ability to make judgments regarding simple and
complex work-related decisions, understand and remember complex
instructions, carry out complex instructions, interact appropriately with
supervisors and coworkers, and respond to usual work situations and changes
in a routine work setting. AR 804-805. Dr. Morton also indicated that Plaintiff
had an extreme limitation in her ability to interact with the public. AR 805.
Dr. Morton concluded that Plaintiff would have “severe impairment in her
ability to maintain her attention on a simple repetitive task for an extended
period of time” and “moderate to severe impairment in her ability to maintain
a pace of work that most employers require.” AR 811. Finally, Dr. Morton
stated that Plaintiff had “poor coping skills due to bipolar disorder and
therefore…the day-to-day stress of a full-time work week would result in
significant increases in her symptoms of anxiety, mania, and paranoia.” Id.
In contrast, during the administrative hearing, Dr. Malancharuvil
testified that while Plaintiff had a diagnosis of bipolar disorder and
posttraumatic stress disorder, Plaintiff would have “none to mild” impairment
when processing information, performing activities of daily living, or following
simple instructions. AR 37. Additionally, Dr. Malancharuvil opined that
Plaintiff would have mild to moderate limitations in social functioning;
concentrating, persisting, or maintaining pace; and adapting to work or a
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work-like setting. Id. When asked about Dr. Morton’s opinion, Dr.
Malancharuvil testified that he did not believe the limitations identified by Dr.
Morton were consistent with Plaintiff’s mental status or the “overall picture of
the claimant’s mental functions.” AR 38. In support of that view, Dr.
Malancharuvil referenced specific treatment records which he characterized as
reflecting Plaintiff’s “essentially functional” and “essentially intact” mental
status. AR 40.
The ALJ found that Dr. Morton’s opinion was “not persuasive at all with
the totality of the evidence” and stated:
As [Dr. Malancharuvil] discussed, the claimant’s
mental status examinations throughout most of the
record [have] shown normal mental status
examinations. [Dr. Malancharuvil] found Dr.
Morton’s conclusions not to be warranted by the
overall medical evidence; [Dr. Morton] gave [Plaintiff]
marked limitations which are not warranted in social
interaction. [Plaintiff] has a functional mental status
per Exhibit 1F/4). [Plaintiff] also has intact mental
functioning at Exhibit 2F/5 and 3F/7. [Plaintiff] was
manic and sleepless for 3 days when she said she had
mania; however, she tested positive for PCP at the
time and marijuana. [Plaintiff] has also shown
functional mental capacity at 7F/6 and was mentally
intact at 8F/8. (Testimony).
AR 21.
Significantly, in discussing the persuasiveness of Dr. Morton’s opinions,
the ALJ cited the same medical records that Dr. Malancharuvil cited during
the administrative hearing, and it appears that the ALJ discounted Dr.
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Morton’s opinions based primarily (if not completely) on Dr. Malancharuvil’s
testimony, which the ALJ found to be “overall persuasive” and “consistent with
the totality of the medical evidence.” AR 21.
However, although the records cited by Dr. Malancharuvil include some
normal findings with respect to Plaintiff’s mental status, those same records
also include abnormal findings. See e.g., AR 39, AR 492-494 (December 17,
2018 treatment note listing Plaintiff’s “total depression screen score” as
“critical” and recording Plaintiff’s mood as “dysthymic, anxious,” her affect as
“constricted” and nearly tearful, and indicating that Plaintiff was
“distractible”); AR 610 (September 13, 2021 treatment note indicating that
Plaintiff was oriented to situation, time, place, and person; exhibited normal
attention and concentrating ability; and was alert with intact memory; also
reflecting Plaintiff’s apathetic mood and constricted affect); see also AR 641,
644, 653, 669 (treatment notes reflecting Plaintiff’s apathetic or labile mood
and constricted, flat, or sullen affect); AR 773 (January 4, 2022 treatment note
indicating that Plaintiff’s speech, affect, and thought context were
unremarkable, and that she was oriented to person and place with normal
memory and normal judgment and insight but that her thought progression
was disorganized).
Further, some of these same records include recommendations for more
intense mental health treatment. See AR 610 (September 13, 2021 treatment
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note that includes the assessment that Plaintiff was “[s]trongly encouraged to
consider hospitalization and talk to her husband about it, [due to] poor self
care, prolonged severe depression”); AR 774-775 (January 4, 2022 treatment
note recommending that Plaintiff meet with mobile crisis to assist with
transfer to in-patient hospitalization).
It is not apparent that either Dr. Malancharuvil or the ALJ considered
information contained in the treatment notes cited by Dr. Malancharuvil that
is arguably inconsistent with Dr. Malancharuvil’s opinion (and in turn the
ALJ’s opinion) that Plaintiff’s mental status was essentially functional or
intact.
Additionally, as Plaintiff points out, other medical records indicate that
Plaintiff exhibited abnormalities on mental status exams. See e.g., Doc. 5 at 9
(citing,	
inter alia, AR 503 (December 12, 2018 treatment note reflecting
Plaintiff’s mood as depressed and anxious and affect as “tearful, at other times,
incongruent, laughs at times,” and that Plaintiff was distractible and that her
memory was impaired); AR 534-535 (October 26, 2018 treatment note
reflecting that Plaintiff exhibited rapid speech, a “depressed, mixed,
hypomanic, labile, anxious” mood, that her affect was tearful, anxious, and
“laughing at other times,” that her thought process was highly circumstantial,
and that she had an impaired memory, lack of insight, and moderate
impairment in her judgment)).
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“[T]he substantial evidence standard ‘presupposes ... a zone of choice
within which the decisionmakers can go either way, without interference by
the courts. An administrative decision is not subject to reversal merely because
substantial evidence would have supported an opposite decision.’” Dunn v.
Colvin, 607 F. App’x 264, 274 (4th Cir. 2015) (quoting Clarke v. Bowen, 843
F.2d 271, 272-73 (8th Cir. 1988)). At the same time, “[a]n ALJ has the
obligation to consider all relevant medical evidence and cannot simply
cherrypick facts that support a finding of nondisability while ignoring evidence
that points to a disability finding.” Lewis v. Berryhill, 858 F.3d 858, 869-70
(4th Cir. 2017) (remand appropriate because the same medical records that
contained the “normal” findings relied upon by the ALJ also included notations
that plaintiff presented with constant pain and was given a steroid injection);
see also Arakas v. Comm’r, Social Security Admin., 983 F.3d 83, 99 (4th Cir.
2020) (vacating ALJ's decision where ALJ cherry picked certain facts and
misstated and mischaracterized other material facts). In sum, when weighing
the evidence, the ALJ cannot ignore material evidence that is contrary to his
or her decision.
Here, the ALJ cited evidence that supported his conclusion, but did not
acknowledge or discuss seemingly contrary information, even though such
information appeared in some of the treatment records upon which the ALJ
relied. See Jennifer B. v. O'Malley, No. 2:23-CV-00503, 2024 WL 4248782, at
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*9 (S.D.W. Va. Aug. 27, 2024), report and recommendation adopted sub nom.,
Baisden v. O'Malley, No. 2:23-CV-00503, 2024 WL 4245445 (S.D.W. Va. Sept.
19, 2024) (“the ALJ's selective reliance upon periodically ‘normal’ examination
findings without a fulsome discussion of conflicting evidence is particularly
concerning because it arises in the context of mental-health impairments—
including a diagnosis of recurring depressive episodes. The Fourth Circuit has
expressly stated that mental impairments tend to be characterized by waxing
and waning symptoms—and an ALJ is obligated to consider the effect of a
claimant's mental-health impairments over time in a sustained, full-time work
environment.”) (citing Testamark v. Berryhill, 736 F. App'x 395, 398 (4th Cir.
2018)).
VI. Recommendation
The undersigned therefore RESPECTFULLY RECOMMENDS that the
Commissioner’s decision be VACATED, and that this matter be REMANDED
for further administrative proceedings.
Signed: February 20, 2026
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Time for Objections
The parties are hereby advised that, pursuant to Title 28, United States
Code, Section 636, and Federal Rule of Civil Procedure 72(b)(2), written
objections to the findings of fact, conclusions of law, and recommendation
contained herein must be filed within fourteen (14) days of service of same.
Responses to the objections must be filed within fourteen (14) days of service
of the objections. Failure to file objections to this Memorandum and
Recommendation with the presiding District Judge will preclude the parties
from raising such objections on appeal. See Thomas v. Arn, 474 U.S. 140, 140
(1985); United States v. Schronce, 727 F.2d 91, 94 (4th Cir. 1984).
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