Treating Psychiatrist's Opinion Must Be Given Proper Weight
PUNZIO v. ASTRUE (January 21, 2011)
Patricia Punzio's life has been difficult -- alcoholic parents, sexual abuse, attempted suicide, dyslexia, depression, and alcohol abuse all by the time she was 26. Although she stopped drinking at that time, she still had few job skills and had trouble maintaining employment. In 1998, at the age of 40, she sought psychiatric treatment. For the next several years, she participated in treatment and took medication. She was diagnosed with depression and bipolar disorder. Her condition and symptoms improved at times and, at other times, regressed. Her therapist, who saw her in weekly sessions in 2005 and 2006, concluded that she was incapable of holding down a job as a result of her mental illness. Punzio applied for disability benefits in 2005. At an ALJ hearing in 2007, she testified that her condition had improved with treatment but that she still had days when she could not leave the house, that she was still troubled by dyslexia and poor memory, that she mixes up numbers, that she has trouble remembering directions, and that she spends most of her time at home. In response to a question from the ALJ proposing certain limitations on Punzio's capacity to work, a vocational expert testified that Punzio could return to her prior work and would also be able to do factory work. Punzio's lawyer added additional restrictions to the question, including an inability to stay on task and to understand instructions and a likelihood to miss work three days a month. The vocational expert testified that any of those restrictions would eliminate any potential employment. The ALJ commented that the record did not support those added restrictions and asked for supplemental evidence. Punzio solicited an opinion from her treating psychiatrist. The psychiatrist submitted a report that supported the conditions suggested by Punzio's lawyer. The ALJ denied benefits, assigning no weight to the psychiatrist assessment because it was solicited by her attorney for purposes of the hearing and because it was inconsistent with other treatment notes. He also rejected the therapist’s opinion and Punzio's own testimony (as "not entirely credible"). Judge Darrah (N.D. Ill.) affirmed. Punzio appeals.
In their opinion, Judges Posner, Rovner, and Tinder reversed and remanded for the award of benefits. The Court first noted that the ALJ's failure to give any reason whatsoever for the belief that Punzio's testimony was not credible was grounds for reversal itself. The Court has commented several times recently on this unacceptable but frequent practice. (See Martinez, Spiva, and Parker). But another, more serious problem attracted the Court's attention. A treating physician's opinion is entitled to "controlling weight" if it is supported by competent evidence and not inconsistent with other evidence. Here, the ALJ rejected the treating physician's opinion, citing both that it contradicted her treatment notes and that it was solicited by her lawyer. The Court rejected both reasons. It found no contradiction between her diagnosis and her notes, when viewed as a whole, and criticized the ALJ’s “cherry-picking” the record to find an arguable, fleeting contradiction. As for the opinion being requested by the lawyer, the Court noted that the practice was endorsed by the agency's regulations and even encouraged on the agency's website. The Court recognized that sometimes treating physicians are not objective, but noted that the concern is addressed by the regulations. Given the treating physician's opinion and supporting evidence and the vocational expert's testimony that no jobs are available to someone with Punzio's mental condition, the Court concluded that a remand for further consideration was unnecessary. Instead, it remanded for an award of benefits.
Anita Martinez and her five children live in her mother's basement. Martinez suffers from depression, bipolar disorder, and severe arthritis. She is on medication for both her mental and physical complaints. An ALJ denied her claim for disability benefits. Francis Rider is 61 years old, extremely obese, has severe arthritis in her right knee, and suffers from back pain. An ALJ denied her request for disability benefits. Christine Pound is 60 years old and suffers from coronary artery disease, cartoid artery disease, back pain, and restless leg syndrome. But Pound only had Social Security coverage through the end of 2003. At that time, her conditions were under control and she used only mild medication to treat her pain. An ALJ denied her request for disability benefits. Martinez, Rider, and Pound appeal.
David Spiva had a very unfortunate childhood. His father was shot to death, his mother beat him, he attempted suicide in his teens, he served time in prison, and he experienced urges to hurt himself and others. At the age of 28, he was working as a stock shelver at a 
Jacklin Jones was injured in a car accident in 2001. Over the course of the next several years, she sought medical treatment as her condition worsened. She complained of lower back pain and numbness in her hands. The objective medical evidence, including the results of multiple MRIs, identified the principal problem as a mild, lower- back disc bulge. Her orthopedic surgeon advised her to discontinue the strong pain medication and instead to lose weight and begin physical therapy. She quit her job in November of 2003 because of her pain. She continued to see the orthopedic surgeon, who continued to tell her to lose weight and get into better condition. Jones sought disability benefits. At her hearing, she testified that she was in substantial pain, that she could not sit or stand for long periods, that her pain medication made her drowsy and nauseous, and that she had trouble holding onto objects. A vocational expert, responding to the ALJ's hypotheticals, testified that there were over 3000 jobs available for a person with Jones' conditions. The ALJ concluded that Jones was not disabled, finding that she could perform simple, routine, sedentary work. In reaching that conclusion, the ALJ found Jones' testimony about the intensity of her pain not credible. Judge Randa (E.D. Wis.) concluded that substantial evidence supported the decision and affirmed. Jones appeals.
Lynn Larson has been suffering from anxiety and depression for years. Her already fragile condition worsened in early 2004 when she was raped and suffered several additional physical injuries. Her psychiatrist continued to describe and adjust dosages of several medications throughout this time. Larson applied for Social Security benefits in June of 2004. Her troubles continued -- she was drinking, she had a "nervous breakdown," the nephew she had been raising was taken from her home, and she was arrested for driving under the influence. Her application for benefits was denied in 2004, and again on reconsideration in 2005. Her psychiatrist submitted a new questionnaire with a diagnosis of "severe, recurrent depression." A hearing was held before an ALJ in 2007. Larson testified about her employment history -- that she quit her part-time job at a gas station because she had to hide in the bathroom, she was fired from her bus driver job after a breakdown, and that she worked two hours a week at a restaurant owned by a friend. A psychologist testified that Larson met the "A criteria" but not the "B criteria." Her psychiatrist testified that Larson met all criteria. The ALJ denied the claim. Larson appeals.