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Thomas v. Berryhill

United States Court of Appeals, Eighth Circuit

February 5, 2018

Amy Thomas Plaintiff- Appellant
Nancy A. Berryhill, Acting Commissioner of Social Security Defendant-Appellee

          Submitted: December 13, 2017

         Appeal from United States District Court for the Eastern District of Arkansas - Jonesboro

          Before SMITH, Chief Judge, ARNOLD and KELLY, Circuit Judges.

          ARNOLD, Circuit Judge.

         Amy Thomas was thirty-four years old, the mother of a four-year-old son, and in the process of divorcing her second husband. A high-school graduate, she lived on her own, cared for herself and her indoor dog and cat, tended her home, managed her finances, and led a more-or-less independent life. She had custody of her son every other week and would care and provide for him as well, from preparing his breakfast to putting him to sleep. She had a driver's license and could drive if need be, but grew anxious behind the wheel and preferred to have someone else take her on her weekly errands, which she handled herself. To pass the time, she enjoyed painting, television, and light reading. She was also morbidly obese, suffered from osteoarthritis, scored a full-scale IQ of seventy, experienced depression and anxiety, and said that she often relied on a parent to help her with chores that she could not do on her own. Thomas had also never held a job, going onto disability benefits at age eighteen and coming off them only when her husband's income rendered her ineligible. With her divorce looming on the horizon, she applied again for supplemental security income on the basis of disability, claiming that she could not work.

         The Commissioner of Social Security denied Thomas's application, and an administrative law judge upheld the denial, finding that Thomas was not disabled since her impairments did not preclude her from performing substantial gainful work. See 42 U.S.C. § 1382c(a)(3)(B). The Appeals Council declined Thomas's request for further review, making the ALJ's decision the Commissioner's final one. See Combs v. Berryhill, 878 F.3d 642, 645 (8th Cir. 2017). Thomas sought judicial review of that decision, and the district court affirmed it in a conscientious opinion and order. She appeals from the judgment entered on that order, and we reverse and remand.

         We review the district court's judgment de novo and will affirm if substantial evidence on the record as a whole supports the Commissioner's decision. Vance v. Berryhill, 860 F.3d 1114, 1117 (8th Cir. 2017); see also 42 U.S.C. § 405(g).

         The ALJ used the Social Security Administration's five-step evaluation process to find that Thomas was not "disabled." See 20 C.F.R. § 416.920(a)(4). Thomas does not contest the ALJ's findings at the first three steps: that she has not engaged in substantial gainful work, that she has severe impairments that significantly limit her ability to perform basic work activities, and that her impairments do not render her per se disabled. She assigns error only to the ALJ's findings at the fourth and fifth steps, where he expressly gave "little weight" to her treating physician's medical opinion in determining her residual functional capacity (RFC) and based his finding that she could perform a significant number of jobs in the national economy on a vocational expert's testimony that her RFC qualified her for two jobs in particular.

         "The opinion of a treating physician is accorded special deference under the social security regulations" and "normally entitled to great weight." Vossen v. Astrue, 612 F.3d 1011, 1017 (8th Cir. 2010). "However, the Commissioner may discount or even disregard the opinion of a treating physician where other medical assessments are supported by better or more thorough medical evidence." Fentress v. Berryhill, 854 F.3d 1016, 1020 (8th Cir. 2017). The Commissioner may also assign "little weight" to a treating physician's opinion when it is either internally inconsistent or conclusory. Chesser v. Berryhill, 858 F.3d 1161, 1164-65 (8th Cir. 2017).

         Thomas calls Dr. Roland Hollis her treating physician. At the hearing, she told the ALJ that she has visited Dr. Hollis, a primary-care doctor, every other month since 2005. But at the end of January 2013 when Dr. Hollis disclosed Thomas's patient file from January 2012 onwards, the file showed that she had seen him only twice: in July 2012 and January 2013. Only eleven other office visits appear in the record, all of which took place after Thomas had filed her new social-security application in late January 2013. The record supports a conclusion that Thomas exaggerated her pre-application relationship with Dr. Hollis and thus his ability to provide "a detailed, longitudinal picture" of her impairments-the primary reason that the social-security regulations accord treating physicians deference. See 20 C.F.R. § 404.1527(c)(2).

         On appeal, Thomas does not assert that Dr. Hollis's file on her paints a detailed, longitudinal portrait of her impairments, nor does she contend that the file as a whole supports her claim of disability: She faults the ALJ only for assigning little weight to Dr. Hollis's medical opinions in the "two residual functional capacity assessments [he completed]-one in March 2013 and the other in March 2014." Those assessments, however, consist of nothing more than vague, conclusory statements-checked boxes, circled answers, and brief fill-in-the-blank responses. They cite no medical evidence and provide little to no elaboration, and so they possess "little evidentiary value." See Toland v. Colvin, 761 F.3d 931, 937 (8th Cir. 2014). On that basis alone, the ALJ did not err in giving Dr. Hollis's RFC assessments little weight and relying more heavily on other opinions in the record. See id. at 935, 937.

         As the district court noted, moreover, Dr. Hollis's earlier assessment of Thomas is inconsistent with his later one. In March 2013, Dr. Hollis found that Thomas could use her fingers to manipulate objects for an entire eight-hour workday, use her hands to grasp and twist objects for half of the workday, sit for sixty minutes in a row, and stand/walk for five minutes at a time. But one year later, he declared, without any explanation for the change, that Thomas could use her fingers and hands only for one-fifth of a workday, sit for ten minutes at a time, and stand/walk for no length of time. Dr. Hollis's clinical notes from Thomas's intervening office visits do not reflect that kind of escalation in the severity of her impairments: There is no mention of a difficulty with her hands or fingers or any indication she had acquired a problem with sitting, and the only specialist he recommended was a dietician to place her on a low-calorie diet. Since Dr. Hollis's more recent assessment was inconsistent with the trend line in his notes and his own earlier assessment, the ALJ did not err in rejecting those medical opinions. See Boyd v. Colvin, 831 F.3d 1015, 1021 (8th Cir. 2016).

         The ALJ did not err in finding that Dr. Hollis's opinions were also inconsistent with the record as a whole. Dr. Hollis, as we already observed, stated in his March 2014 assessment that Thomas could not stand/walk for any length of time and could use her hands and fingers for only one-fifth of a workday. He asserted further that Thomas's impairments interfered constantly with the attention and concentration required for simple work-related tasks. Those core assessments were contradicted by the medical findings of multiple examining physicians. For example, Dr. Joseph Patterson found that Thomas had a perfectly normal grip in both hands, could hold a pen and write, could touch fingertips to palm, could oppose thumbs to fingers, could pick up a coin, and could stand/walk without assistive devices. He confirmed that Thomas had osteoarthritis in her knees, but detected no joint deformity or instability and no muscle weakness or atrophy. Dr. Anita Gail Wells found "no evidence" that Thomas was unable "to cope with typical mental/cognitive demands of basic worklike tasks" and concluded that "[o]ther than being morbidly obese and [exhibiting a] slow gait, " Thomas appeared able "to complete work related tasks in an acceptable timeframe." Thomas's own psychiatrist, Dr. W. Robert VanScoy, corroborated Dr. Wells's findings, remarking in multiple progress notes that Thomas's concentration, judgment, and insight were "good" and that her memory was "completely intact." The ALJ did not err in relying instead on those more thorough, detailed opinions. See Fentress, 854 F.3d at 1020.

         Thomas's self-reported activities of daily living provided additional reasons for the ALJ to discredit Dr. Hollis's pessimistic views of her abilities. Thomas's activities-caring for her young son, preparing his meals, doing housework, shopping for groceries, handling money, watching television, and driving a car when necessary, among other things-showed that she could work. See Roberson v. Astrue, 481 F.3d 1020, 1025 (8th Cir. 2007); see also Hacker v. Barnhart, 459 F.3d 934, 937-38 (8th Cir. 2006); Ellis v. Barnhart, 392 F.3d 988, 995 (8th Cir. 2005). No one disputes that Thomas faces severe impairments and may regularly need assistance in her life. But it is implicit in the Commissioner's disability-evaluation ...

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