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Fooks v. Berryhill
Citation: 284 F. Supp. 3d 305Docket: No. 16–CV–7127 (JFB)
Court: District Court, E.D. New York; January 16, 2018; Federal District Court
Treina Fooks initiated a legal action under 42 U.S.C. § 405(g) of the Social Security Act, contesting the Commissioner of Social Security’s denial of her disability benefits application. An Administrative Law Judge (ALJ) concluded that Fooks had the residual functional capacity for "sedentary work" with limitations to unskilled tasks in low-stress environments. The ALJ found sufficient job availability in the national economy aligned with her capabilities, leading to the determination that she was not disabled. The Appeals Council declined to review the case. Fooks subsequently filed for judgment on the pleadings, which the Acting Commissioner opposed and cross-moved for judgment as well. The factual background outlines that Fooks, born in 1970, was 42 years old when her disability began on October 16, 2012. She possessed a high school diploma and a year of college education. Her work history included roles in elder care, customer service, teaching assistance, and nursing assistance. Fooks ceased working due to a fall that allegedly resulted in injuries to her foot, ankle, and lower back. During her ALJ hearing, she indicated that she lived with her daughter and engaged in various daily activities post-injury, such as personal care, laundry, and limited cleaning. She was capable of shopping, bill-paying, and socializing twice monthly, and had no issues with interpersonal relationships or following instructions. Her medication regimen included Latuda, Setrasaline, Lodapine, and Lumigan. The court ultimately denied Fooks' motion and granted the Acting Commissioner’s cross-motion. Plaintiff was admitted to Southside Hospital on October 16, 2012, due to a left ankle injury from a recent fall, presenting with swelling and pain. Her medical history included only hypertension. Initial assessments showed normal respiratory function, alertness, and a full range of motion in her lower leg, with pain rated at six out of ten. A psychological evaluation indicated no suicidal thoughts or attempts. She was discharged with an ankle stirrup splint and advised to follow up in two to three days. A radiology report noted possible widening indicative of a Lisfranc fracture but found no fractures, with other structures intact. On October 18, Dr. Jhansi Rao examined her, reporting moderate pain (four to six out of ten) and normal respiratory functions, advising ice, rest, compression, and elevation for treatment. On November 5, Dr. Paul Dicpinigaitis examined the plaintiff, who reported severe pain (nine out of ten) and difficulty walking. X-rays revealed no fractures or dislocations, but she exhibited bilateral leg numbness and an antalgic gait. Physical examination indicated limited range of motion in the ankle due to pain and swelling, though stability under stress was noted. Dicpinigaitis prescribed Motrin and Percocet for pain and recommended physical therapy. On November 12, Dr. Rao's follow-up indicated the plaintiff's pain had increased to eight to nine out of ten, and she also reported a history of asthmatic bronchitis and asthma. On December 26, 2012, Dr. Dicpinigaitis assessed the plaintiff, who continued to report left ankle pain and exhibited a mild antalgic gait. The plaintiff was prescribed a CAM walker/fracture boot and advised to persist with physical therapy. During a follow-up on January 7, 2013, an MRI revealed a chronic achy FL tear in the ankle and lower lumbar spondylosis with a left-sided foraminal disc protrusion at L4-5 affecting the left L4 nerve root. The plaintiff received a lidocaine/steroid injection for the ankle and continued physical therapy for both the ankle and back. An independent medical examiner, Dr. Robert Moriarty, evaluated the plaintiff on January 8, 2013, noting no deformities in the left foot but tenderness, mild weakness in ankle dorsiflexion, and normal strength in plantar flexion. He concluded that the plaintiff was temporarily moderately partially disabled (50%). In a follow-up on March 11, 2013, Dr. Dicpinigaitis noted the plaintiff experienced some initial symptom improvement from a cortisone injection but still reported pain levels reaching eight to nine out of ten. He suggested either accepting her symptoms or considering surgery. On March 26, 2013, Dr. Daniel Brandenstein assessed the plaintiff, whose primary complaint was worsening lumbago. She reported significant pain with no alleviating factors. Examination revealed strong leg motor strength and maintained range of motion, with an MRI showing degenerative changes at L4-5 and L5-S1. By July 2, 2013, during another follow-up with Dr. Brandenstein, the plaintiff exhibited signs of depression related to her chronic pain and was prescribed Cymbalta, with a referral for psychiatric evaluation. On July 29, 2013, Dr. Elaine Schaefer documented the plaintiff's ongoing ankle and back pain, her struggles with depression, lack of motivation, and concentration difficulties, along with a reported loss of interest in activities. Plaintiff reported no suicidal or homicidal thoughts and expressed interest in resuming medication, feeling optimistic about her future. In a psychiatric evaluation by Dr. Schaefer, it was noted that the plaintiff was oriented to person, place, and time, with intact insight and judgment. Dr. Schaefer observed no physical complaints and prescribed Zoloft for depression. During a follow-up on October 4, 2013, the plaintiff reported improvement on Zoloft and requested a refill, corroborated by her daughter’s observations of positive changes. She indicated better eating and sleeping habits, improved concentration, and a more active demeanor, again stating no suicidal or homicidal ideations. On October 23, 2013, plaintiff underwent a psychiatric evaluation by Dr. Herman, who noted her departure from work in 2012 was due to medical issues, not psychiatric ones. He documented her psychiatric history, including the recent prescription of sertraline, and identified current challenges like sleep apnea, fluctuating appetite, and occasional tearfulness related to life stressors. Dr. Herman found her thought processes coherent with no signs of severe psychiatric symptoms and noted no significant issues with daily living activities. However, he identified moderate limitations in her ability to handle complex tasks and stress. Ultimately, Dr. Herman concluded that her psychiatric issues did not significantly impede her daily functioning. Plaintiff was examined by Dr. Saadia Wasty on November 18, 2013, reporting severe lower back pain (8-9/10) and moderate ankle pain (7-8/10), with relief from rest and elevation. She had a history of asthma since 1987, managed with an inhaler, and experienced shortness of breath during heavy exertion. Additionally, she had experienced depression since 1987 but had no hospitalizations or suicidal ideations. She was diagnosed with glaucoma in 2004 and reported intermittent right eye pain rated at 5-7/10, aggravated by reading. Dr. Wasty noted a normal gait, difficulty walking on heels or toes, and full range of motion in major joints. However, lumbar spine flexion was 80 degrees, with restricted extension (10 degrees) and lateral flexion (30 degrees bilaterally). Dr. Wasty assessed moderate to marked limitations in squatting, kneeling, and moderate limitations in sitting, standing, walking, bending, and heavy lifting. She recommended avoidance of heavy exertion and respiratory irritants and suggested a psychological evaluation. On January 13, 2014, Dr. Robert Hecht observed tenderness and restricted range of motion in the lumbar spine and left ankle, diagnosing a lumbosacral sprain-strain and left ankle derangement from a work injury on October 16, 2012. Follow-up on January 27 revealed an MRI diagnosis of a chronic anterior talofibular ligament tear and lumbar disc protrusion at L4-L5 affecting the L5 nerve root. Dr. Schaefer evaluated the plaintiff on February 14, 2014, noting improvement on Zoloft, including better social interactions, concentration, and attitude, without suicidal ideations. On April 14, 2014, Dr. Hecht continued to find tenderness and restricted motion in the lumbar spine and left ankle, injecting the plaintiff with Depo-Medrol and Lidocaine, while noting her disinterest in physical therapy or further pain management. On April 21, 2014, plaintiff was re-evaluated by Dr. Schaefer, reporting limited effectiveness from previous injections by Dr. Hecht and no improvement from physical therapy. Despite a history of depression, the plaintiff expressed positive feelings about her Zoloft prescription, noting increased energy, better mood, and improved eating and sleeping patterns. A psychiatric assessment indicated normal mood, intact judgment, and minimal depression with a severity index of 2. Dr. Schaefer renewed her Zoloft prescription. On June 23, 2014, Dr. Hecht noted persistent tenderness and restricted motion in the plaintiff's lumbar spine and left ankle during a follow-up visit. He administered another injection of Depo-Medrol and Lidocaine into her ankle and recommended lumbar and ankle orthoses for pain management. During a visit on July 21, 2014, the plaintiff reported relief from the June ankle injection and requested a similar treatment for her back. Dr. Hecht administered the injection to her lower lumbar area, which was well tolerated. On August 6, 2014, Dr. Hanna Ehab conducted a depression screening, where the plaintiff scored 9, indicating mild depression. She reported symptoms including lack of interest, sleep disturbances, fatigue, poor appetite, and negative self-perception, along with thoughts of self-harm. The plaintiff admitted to running out of psychiatric medication and not following up with her psychiatrist. Dr. Ehab refilled her sertraline prescription and referred her to a psychiatrist for further evaluation. Dr. Moriarty evaluated the plaintiff on September 2, 2014, noting complaints of pain and stiffness in the left ankle, instability during long walks, and lower back pain radiating to the left leg, accompanied by tingling in the left calf, ankle, and outer foot. Examination revealed tenderness in the lateral ankle, mild restrictions in ankle motion, and slight weakness in dorsiflexion, with the plaintiff walking with a slight limp. Dr. Moriarty diagnosed a left ankle sprain/strain with chronic symptoms, recommending a self-directed exercise program, weight loss, and an ankle brace. He assessed a 20% scheduled loss of use of the left foot, indicating the plaintiff had reached maximal medical improvement. On September 19, 2014, the plaintiff was admitted to Catholic Charities Mental Health Services, where she was assessed by various professionals, including nurse practitioner Anastasia Blanchard and licensed clinical social worker Krista Ann Hoefling. Follow-up with Dr. Hecht on October 13, 2014, revealed ongoing tenderness and restricted motion in the lumbar spine and left ankle, prompting a recommendation for physical therapy and the use of a cane. The plaintiff declined further injections. On October 20, 2014, during a mental health evaluation, the plaintiff reported increased depression since her ex-husband's death, poor appetite, excessive sleep, lack of motivation, low self-esteem, isolation, and passive suicidal thoughts. She disclosed a history of various forms of abuse and a previous suicide attempt at age 12. On November 10, 2014, Dr. Hecht noted the same physical symptoms and administered another injection to the left ankle while prescribing Mobic. A psychiatric evaluation on November 12, 2014, reiterated her struggles with depression, appetite, motivation, isolation, and suicidal thoughts. Plaintiff reported a history of sexual, physical, and verbal abuse, including instances involving family members and friends. She experienced depression throughout her life, attempted suicide at age 12, and struggled with hallucinations and manic moods. Additionally, plaintiff faced a bed-wetting issue from age five to thirty and had ongoing comprehension difficulties. On a mood disorder questionnaire, she scored 100%, indicating significant issues. Although she expressed passive suicidal ideation, she had no current plan and focused on her children. Plaintiff was evaluated by Dr. Jalil Anwar on December 12, 2014, for sleep problems and was diagnosed with severe obstructive sleep apnea, leading to a prescription for a CPAP machine. She visited Dr. Hecht on December 22, 2014, reporting slight improvement from an injection for ankle pain but ongoing tenderness and restricted motion in her lumbar spine and ankle. On January 23, 2015, Dr. Gary Kelman assessed her pain, which she rated as eight out of ten, noting she could walk half a city block with difficulty and sit for only ten to fifteen minutes. Kelman's examination revealed a mild limp and restricted range of motion in her lumbar spine and left ankle. He diagnosed her with back pain and a left ankle/foot sprain/strain, recommending work restrictions against prolonged standing or walking, excessive stair climbing, and lifting over 40 lbs. Dr. Hecht's follow-up on February 16, 2015, indicated some relief from a previous injection, while further examinations continued to show the same issues in her lumbar spine and ankle. A follow-up visit occurred on March 30, 2015. Dr. Hecht observed tenderness and limited motion in the lumbar spine and left ankle during a follow-up visit, administering the same injection to the left ankle as in previous treatments. He recommended physical therapy, prescribed Flexeril 10mg to be taken three times daily as needed (with a caution against driving or working if drowsy), and Ibuprofen 800mg three times daily as needed. Dr. Tolentino completed a mental impairment questionnaire on July 9, 2015, noting that he had been seeing the plaintiff for individual therapy twice monthly since October 20, 2014, despite her having canceled nine appointments. Clinical findings indicated depression, clear speech, logical thought processes, normal perception, and admission of auditory hallucinations. Symptoms reported included anhedonia, appetite changes, decreased energy, suicidal thoughts, mood disturbances, concentration difficulties, emotional withdrawal, bipolar syndrome, hallucinations, emotional lability, mania, and sleep disturbances. Regarding work-related abilities, Dr. Tolentino assessed that the plaintiff had very good abilities to remember procedures, work near others without distraction, and be aware of hazards. However, she was unable to meet competitive standards in various areas, including understanding and carrying out simple instructions, maintaining attention, sustaining routine without supervision, making decisions, and managing work stress. For semiskilled and skilled work, she could not meet competitive standards for understanding or carrying out detailed instructions, setting goals independently, or dealing with work-related stress. Nonetheless, she demonstrated good abilities to interact with the public and maintain appropriate behavior. Dr. Tolentino confirmed that the plaintiff did not exhibit low IQ or reduced intellectual functioning. Dr. Tolentino evaluated the plaintiff's functional limitations due to mental impairments, identifying marked restrictions in daily activities, social functioning, and concentration. She anticipated the plaintiff would miss over four workdays per month due to these impairments. Additionally, Dr. Tolentino noted that the plaintiff experiences auditory hallucinations that hinder her functioning. During a June 16, 2015, administrative hearing, the plaintiff testified about a fall on October 16, 2012, which resulted in injuries to her foot, ankle, and lower back, with no significant improvement since their onset. Symptoms related to her left foot and ankle included numbness, stiffness, constant pain, and swelling, which occurred without apparent cause. She rated her pain as eight or nine out of ten, with temporary relief from injections. The plaintiff described her back pain as a dull numbing sensation, which worsened with specific activities such as bending and sitting. She also reported having high blood pressure, glaucoma, and asthma, for which she was receiving treatment. Her glaucoma symptoms included spots in her vision and occasional blackouts, while her asthma caused shortness of breath and infrequent losses of consciousness, managed with an inhaler. The plaintiff is under psychiatric care at Catholic Charities, diagnosed with depression and bipolar disorder by Dr. Tolentino. She reported persistent auditory hallucinations, particularly worsening after her fall and her ex-husband's death. Although prescribed medication has provided some relief, it has not eliminated the hallucinations or fully addressed her depressive symptoms, which include frequent tearfulness and lack of motivation. Plaintiff described a significant impact of her depression and physical limitations on her daily life and work capabilities. She expressed a desire to remain in bed and isolate herself, having spent prolonged periods (up to a month) doing so, with the most recent episode occurring just days prior. On average, she experiences 20 to 25 "bad days" monthly, during which her mental state severely affects her ability to function. In 2013, while in a work-study program, she missed several days due to her conditions and often felt mentally absent at work. She reported severe physical limitations, being unable to sit for more than 20 minutes due to pain, stand for more than one or two minutes, or walk even ten steps without stopping. She also struggles with bending, lifting, and carrying, unable to lift more than ten pounds or lift objects overhead without discomfort. Plaintiff's previous job in telephone sales, which required prolonged sitting, became untenable after her injury in 2012. She stated that any potential job would need to allow her to work at her own pace. Her current medication regimen includes Latuda, setrasaline, lodapine, and Lumigan. Between October 2013 and May 2014, she worked part-time, about ten hours a week, performing tasks such as answering phones and filing. An impartial vocational expert, Esperanza DeStefano, provided testimony during the administrative hearing, responding to a hypothetical scenario presented by the ALJ. This scenario outlined a light exertional limitation for an individual with similar characteristics to the plaintiff, detailing specific physical capabilities and restrictions, including limitations on exposure to irritants and the requirement for a low-stress work environment characterized by minimal decision-making and infrequent changes. Ms. DeStefano testified that the plaintiff's past work experience was deemed unsuitable due to specific limitations. She identified three jobs that the hypothetical individual could perform: mail clerk (2,181 positions nationally), office helper (3,588 positions nationally), and electrical equipment assembler (5,208 positions nationally). The ALJ later provided a modified set of limitations classified as "sedentary exertional," allowing for occasional lifting of up to ten pounds, standing or walking for about six hours, and sitting for approximately six hours per day. Under these conditions, Ms. DeStefano cited additional jobs: table worker (2,721 positions nationally), document preparer (45,835 positions nationally), and addresser (7,338 positions nationally). She noted that most employers would permit up to two absences per month. The plaintiff argued that medical evidence indicated an inability to remain on task due to psychiatric and chronic pain issues, along with asthma, suggesting that absences would exceed allowable limits. Procedurally, the plaintiff applied for disability benefits on June 24, 2013, claiming disability since October 16, 2012. The initial application was denied on November 25, 2013. Following a hearing on June 16, 2015, where Ms. DeStefano testified, ALJ Patrick Kilgannon ruled on July 31, 2015, that the plaintiff was not disabled under the Social Security Act. The plaintiff's request for review by the Appeals Council was denied on November 9, 2016, finalizing the ALJ's decision. The plaintiff subsequently filed this lawsuit on December 28, 2016, and sought judgment on the pleadings on March 30, 2017. On June 1, 2017, the Commissioner filed a cross-motion for judgment on the pleadings, to which the plaintiff responded on June 22, 2017. The Court reviewed all submissions. The standard of review allows a district court to overturn a Commissioner's determination only if there is legal error or lack of substantial evidence supporting the factual findings. "Substantial evidence" is defined as more than a mere scintilla and what a reasonable mind might accept as adequate for a conclusion. The agency is responsible for weighing conflicting evidence, and if substantial evidence exists, the Commissioner’s decision must be upheld, even if a court might have reached a different conclusion upon de novo review. To qualify for disability benefits, a claimant must demonstrate an inability to engage in substantial gainful activity due to a medically determinable impairment expected to last at least twelve months. An impairment is not considered disabling unless it prevents the individual from doing past work or any other substantial gainful work available in the national economy. The Commissioner follows a five-step procedure for evaluating disability claims, which includes assessing current employment status, identifying severe impairments, checking for listed impairments, evaluating residual functional capacity for past work, and determining the ability to perform other work if necessary. The claimant bears the burden of proof for the initial four steps in the benefits determination process, while the Commissioner is responsible for proving the final step. The Commissioner evaluates a claimant's entitlement to benefits based on: 1) objective medical facts, 2) medical diagnoses or opinions derived from these facts, 3) subjective evidence of pain or disability from the claimant or witnesses, and 4) the claimant's educational background, age, and work experience. In the case at hand, the Administrative Law Judge (ALJ) established that the plaintiff met the insured status requirements through December 31, 2016. The ALJ determined that the plaintiff had not engaged in substantial gainful activity since the alleged onset of disability on October 16, 2012, despite some work activity post-onset that did not qualify as substantial. The ALJ identified severe impairments including left ankle posttraumatic synovitis, lumbar disc protrusion, morbid obesity, asthma, bipolar affective disorder, and depression, but found that the plaintiff failed to prove that hypertension, glaucoma, and sleep apnea constituted severe impairments. Although the plaintiff had a history of these conditions, the ALJ noted that they did not result in more than minimal functional limitations, supported by treatment records indicating controlled blood pressure and the absence of significant symptoms related to glaucoma or sleep apnea. At the third step, the ALJ concluded that the plaintiff's impairments did not meet or medically equal the severity of any listed impairments in 20 CFR Part 404, Subpart P, Appendix 1, specifically noting that the ankle impairment did not meet the criteria for listings 1.02 or 1.06 due to a lack of evidence showing an inability to ambulate effectively. The ALJ determined that the plaintiff's spinal impairment did not meet the criteria for listing 1.04, as there was evidence of nerve root compromise but no accompanying motor loss, sensory or reflex loss, or positive straight-leg raising test. Additionally, the plaintiff's asthma was found not to meet listing 3.03 due to a lack of chronic asthmatic bronchitis or the required number of physician-intervention attacks within the specified timeframe. Regarding mental impairments, the ALJ assessed the "paragraph B" criteria, which require at least two marked restrictions in daily living activities, social functioning, concentration, persistence, or pace, or repeated episodes of decompensation lasting at least two weeks. The ALJ found that the plaintiff had mild restrictions in daily activities and social functioning, moderate difficulties in concentration, persistence, or pace, and no episodes of extended decompensation. Consequently, the "paragraph B" criteria were not met. The ALJ also evaluated the "paragraph C" criteria and concluded that there was no evidence of a chronic affective disorder lasting at least two years that caused more than minimal limitations in basic work activities, especially when considering treatment effects. Before proceeding to step four of the evaluation process, the ALJ assessed the plaintiff's residual functional capacity, concluding that she could perform sedentary work with specific limitations: no climbing of ladders, only occasional climbing of ramps or stairs, and restrictions on balancing, stooping, kneeling, crouching, or crawling. The plaintiff must avoid hazards such as moving machinery and unprotected heights, as well as concentrated irritants. She is also limited to unskilled tasks in low-stress environments, defined by occasional decision-making and changes in work settings. The ALJ employed a two-step analysis to assess the plaintiff's symptoms. First, the ALJ confirmed the presence of medically determinable physical or mental impairments that could reasonably produce the plaintiff's alleged symptoms. Second, the ALJ evaluated the intensity, persistence, and functional limitations of these symptoms, ultimately finding the plaintiff's claims regarding their severity to be "not entirely credible" due to a lack of objective medical evidence. The ALJ determined that the plaintiff was limited to sedentary work with specific postural restrictions, based on medical evidence related to a left ankle sprain and posttraumatic synovitis, which caused residual swelling and limited motion. The ALJ referenced medical records from various doctors, including treatment notes and progress notes, to support this conclusion. Additionally, the ALJ identified a left-sided foraminal disc protrusion at L4-5 affecting the left L4 nerve root, leading to tenderness and restricted lumbar spine motion, which further constrained the plaintiff's ability to lift and carry up to ten pounds. The plaintiff's asthma and decreased lung capacity necessitated avoidance of environmental irritants. The ALJ also recognized the plaintiff's mental impairments, including depression and bipolar disorder, which warranted limitations to unskilled, low-stress work. The ruling noted the plaintiff's diagnosis of morbid obesity and acknowledged that functional limitations arising from obesity were considered in the residual functional capacity assessment. The ALJ considered the plaintiff's obesity in assessing her limitations on lifting, carrying, standing, and walking but found insufficient grounds for further limitations. The ALJ noted that medical evidence did not support the plaintiff's claims of severe difficulties with sitting, standing, and walking. Specifically, the plaintiff was discharged in stable condition from Southside Hospital the same day as her accident. Two months post-accident, Dr. Dicpinigaitis observed that she walked with a mild antalgic gait at a normal speed and that her ankle was stable with no fractures detected on X-ray. In an October 2013 follow-up, Dr. Dicpinigaitis again noted an antalgic gait but found the ankle stable and motor strength normal. Additionally, Dr. Brandenstein reported in 2013 that the plaintiff's spinal range of motion was well maintained. At a late 2013 examination by Dr. Wasty, the plaintiff exhibited a normal gait and full range of motion in her ankle. The ALJ found no medical support for the plaintiff's claims of constant shortness of breath; Dr. Schaefer's records indicated she consistently denied such symptoms, and her lungs were clear on examination. Although pulmonary function tests showed decreased DLCO, flow and volume remained normal. The ALJ also determined that the plaintiff's psychiatric claims, including auditory hallucinations and inability to leave home, were unsupported by medical evidence. Notably, psychiatric symptoms were not documented until July 2013, post-onset date. Dr. Schaefer's notes reflected issues like frequent crying and poor concentration but did not mention hallucinations. The plaintiff was reported as alert and oriented, with intact insight and judgment. After being prescribed Zoloft, she reported feeling better, being more active, and having improved concentration. Dr. Schaefer observed that the plaintiff exhibited a normal mood, was alert and oriented, and displayed intact insight and judgment. A PHQ depression screening indicated "minimal depression." Dr. Herman's October 23, 2013 report confirmed the absence of hallucinations, noting the plaintiff was cooperative with coherent and goal-directed thought processes, and no signs of delusions or paranoia. In August 2014, Dr. Ehab noted the plaintiff had negative thoughts when out of medication, yet found her in a "good mood" during examination. By February 2015, Dr. Ehab again reported the plaintiff was in a "good mood." The ALJ emphasized the need to consider factors beyond objective medical evidence when assessing the credibility of the plaintiff's reported symptoms, as outlined in 20 CFR 404.1529(c). These factors included daily activities, pain characteristics, medication effects, non-medication treatments, and other functional limitations. The ALJ observed that the plaintiff's reported daily activities were not as limited as expected given her disability claims. A function report from August 6, 2013, revealed the plaintiff had no personal care issues, could perform light household tasks, and was capable of independent travel for shopping and bill payments. Additionally, she reported good relationships with others and the ability to follow instructions. The plaintiff also testified to attending classes and working up to ten hours a week in a work-study program after her 2014 injury. The ALJ concluded that the treatment for her physical and mental impairments had been relatively conservative. The ALJ noted that the plaintiff's ankle and back pain were managed through localized injections and physical therapy, while her mental impairments were primarily treated with medication from a primary care physician. The ALJ found the plaintiff's claim of a disabling mental impairment questionable, as she did not report such an impairment when filing her application, stating she had not sought treatment for psychiatric symptoms until after applying for disability benefits. Although Dr. Dicpinigaitis reported a "100% temporary impairment" preventing the plaintiff from returning to work, the ALJ did not weigh this conclusion in assessing residual functional capacity due to its lack of long-term evaluation. Dr. Hecht also reported total disability and a "100% temporary impairment" on several occasions, but the ALJ assigned little weight to these assessments, emphasizing that they pertained to the plaintiff's ability to perform her previous job, which does not equate to disability under the Social Security Act. Additionally, the ALJ disregarded Dr. Hecht's use of "disabled," as it lacked a defined meaning. Dr. Moriarty's assessment indicated that the plaintiff could work under modified duties with restrictions on prolonged standing, walking, and lifting over 15 pounds. The ALJ assigned "good" weight to this assessment, as it aligned with Dr. Moriarty's earlier findings. However, because Dr. Moriarty did not examine the plaintiff's spine and considering her testimony about weight-lifting difficulties, the ALJ adjusted the lifting restrictions downward. Subsequently, Dr. Moriarty assessed a 20% scheduled loss of use of the left foot due to chronic ankle issues; the ALJ gave this opinion no weight, stating it was irrelevant under the Social Security Act. Dr. Kelman, who examined the plaintiff for Workers' Compensation, also determined she could return to work with specific restrictions. The ALJ assigned "good" overall weight to Dr. Kelman's opinion, which indicated that the plaintiff should avoid prolonged walking/standing, excessive stair climbing, vertical ladders, squatting, repetitive bending, and lifting over 40 lbs. The ALJ noted the plaintiff's spinal impairment and obesity warranted further restrictions beyond Dr. Kelman's assessment. Dr. Wasty identified moderate to marked limitations in squatting and kneeling, and moderate limitations in prolonged sitting, standing, walking, bending forward, and heavy lifting, advising avoidance of heavy exertion and environments with respiratory irritants due to asthma. The ALJ gave Dr. Wasty's opinion "partial" weight, citing inconsistencies regarding knee pain and the plaintiff's conservative treatment approach, which included her engagement in four college courses. Dr. Herman's evaluation indicated no significant limitations in the plaintiff's ability to follow simple directions, perform tasks, maintain focus, learn new tasks, make decisions, or relate to others. Dr. Herman found no moderate limitations regarding complex tasks and stress management. The ALJ assigned "great" weight to this opinion, as it aligned with the plaintiff's social skills, mental state, and positive response to Zoloft. The ALJ gave "little" weight to the state agency psychiatrist's opinion, which suggested the plaintiff had a non-severe mental impairment, as it conflicted with Dr. Herman's findings. The ALJ reviewed Dr. Tolentino's report, which stated that the plaintiff was "unable to meet competitive standards" in most employment areas. However, the ALJ noted that Dr. Tolentino's agency records showed only two appointments with the plaintiff, which included evaluations by a social worker and a nurse practitioner. Dr. Tolentino, listed as the supervisor of the nurse practitioner, did not personally examine the plaintiff, and his opinion was given little weight due to discrepancies with other medical evidence. The ALJ highlighted that the plaintiff's reported symptoms at Catholic Charities, including manic episodes and auditory hallucinations, significantly differed from her accounts to Drs. Schaefer, Hanna, and Herman, who documented minimal depression with a good response to medication. At step four of the evaluation process, the ALJ determined that the plaintiff could not perform her past work as a certified nursing assistant, directory assistance operator, or order filler, with vocational expert testimony affirming that her residual functional capacity precluded her from these roles. At step five, the ALJ concluded that, considering the plaintiff's age, education, work experience, and residual functional capacity, there were jobs available in significant numbers in the national economy that she could perform. The ALJ applied the Medical-Vocational Guidelines, noting that if the plaintiff could meet the exertional demands of sedentary work, Rule 201.28 would indicate a finding of "not disabled." The Administrative Law Judge (ALJ) found that the plaintiff's ability to work was limited by certain restrictions. To assess how these limitations affected the plaintiff's capacity for unskilled sedentary work, the ALJ consulted a vocational expert regarding available jobs in the national economy that matched the plaintiff's age, education, work experience, and residual functional capacity. The expert identified three representative sedentary occupations: Table Worker (2,721 jobs), Document Preparer (45,835 jobs), and Addresser (7,338 jobs), all classified as SVP 2. The ALJ concluded that the vocational expert's testimony was consistent with the Dictionary of Occupational Titles and determined that the plaintiff could adjust to other work available in significant numbers. Consequently, the ALJ ruled the plaintiff as "not disabled" under Medical-Vocational Rule 201.28, stating that the plaintiff had not been under a disability as defined by the Social Security Act from October 16, 2012, through the date of the decision, based on the application filed on June 24, 2013. The plaintiff challenged the ALJ’s conclusion regarding her residual functional capacity to perform sedentary work, claiming insufficient weight was given to her psychiatrist Dr. Tolentino's opinion and that her credibility was improperly assessed. The legal standard, known as the treating physician rule, mandates that a treating physician's medical opinion should be given controlling weight if it is well-supported by medical evidence and consistent with the overall record. The regulations emphasize the importance of treating sources in providing a comprehensive view of a claimant's medical impairments. However, the ultimate determination of disability rests with the Commissioner, who evaluates the medical data provided by physicians to reach a conclusion on disability status. If the treating physician's opinion regarding an impairment's nature and severity is not given controlling weight by the Administrative Law Judge (ALJ), the ALJ must consider several factors to determine the appropriate weight to assign the opinion. These factors include: the frequency and extent of the treatment relationship; supporting evidence for the opinion; consistency with the overall record; whether the opinion is from a specialist; and other relevant considerations as outlined in 20 C.F.R. §§ 404.1527(d)(2), 416.927(d)(2). The ALJ is required to provide good reasons in the notice of determination for the weight assigned to the treating physician's opinion. Even if the opinion does not qualify for controlling weight, it should still be given significant weight due to the treating physician's familiarity with the claimant's condition. If the ALJ fails to provide adequate reasons for not crediting the treating physician's opinion, it can be grounds for remand. In this case, the ALJ appropriately weighed the opinions of the plaintiff's treating physicians, providing "good weight" to some opinions while articulating valid reasons for giving little weight to others, notably the opinion of Dr. Tolentino from Catholic Charities. The ALJ highlighted the limited interaction (only two appointments) between the plaintiff and Dr. Tolentino, the lack of personal examination by her, and the numerous canceled appointments by the plaintiff. As a result, the ALJ assigned little weight to Dr. Tolentino's findings regarding the plaintiff's ability to meet employment standards. The ruling emphasizes that reliance on consultative physicians' findings after a single examination is discouraged, as seen in case law that warrants remand for inadequate reasoning. Consulting physician opinions, such as Dr. Tolentino's, are generally given limited weight due to the brief nature of consultative exams and the lack of comprehensive medical history review. In this case, Dr. Tolentino had minimal contact with the plaintiff, with no documented personal examination, leading the ALJ to conclude that he was not entitled to deference as a treating physician. The ALJ noted discrepancies between the plaintiff's symptom reports during Catholic Charities examinations and her accounts to more frequently consulted doctors, Drs. Schaefer, Hanna, and Herman, who reported only minimal depression and a positive response to Zoloft, without noting any manic episodes or hallucinations. The plaintiff argued that the ALJ failed to conduct a required "function-by-function" analysis of her residual functional capacity, but the Second Circuit has clarified that such a procedure is not a strict requirement if the ALJ's determination is supported by substantial evidence and allows for meaningful judicial review. The ALJ's assessment included a thorough evaluation of the plaintiff’s physical and mental impairments, encompassing her chronic pain, asthma, and psychiatric conditions, thereby addressing her ability to remain on task. The ALJ’s detailed analysis of the plaintiff's impairments and the opinions of her treating physicians was deemed sufficient, countering the plaintiff's claim of inadequate consideration of her symptoms. The Court determined that the ALJ's analysis was thorough and supported by substantial evidence, despite not requiring the function-by-function analysis requested by the plaintiff. The plaintiff contended that the ALJ improperly deemed her testimony "not entirely credible" and that the medical evidence did not support her claims. However, the Court emphasized that resolving evidentiary conflicts and assessing witness credibility falls within the Commissioner's purview. The ALJ acknowledged that the plaintiff's medically determinable impairments could reasonably produce her alleged symptoms but found that her statements about the intensity and limitations were not fully credible. In her testimony, the plaintiff described severe pain and significant limitations in her ability to sit, stand, or walk, stating she could only sit for 20 minutes, stand for one to two minutes, and walk for ten steps before needing to stop. She claimed she could lift less than ten pounds and was unable to work due to constant pain. However, the ALJ concluded that objective medical evidence did not corroborate these claims of extreme difficulty. The ALJ cited examinations from several doctors, including Dr. Dicpinigaitis, who observed a mild antalgic gait but noted the plaintiff's ankle was stable and X-rays showed no fractures. Dr. Brandenstein reported relatively well-maintained spinal range of motion and normal motor strength. Dr. Wasty's examination revealed a normal gait and full range of motion in the left ankle. The Court affirmed that substantial evidence supported the ALJ's findings undermining the plaintiff's claims regarding her physical limitations. The ALJ determined that the objective medical evidence did not support the plaintiff's claims of persistent shortness of breath. Dr. Schaefer's notes indicated that the plaintiff consistently denied experiencing shortness of breath, wheezing, or cough, both at rest and during physical exertion. The Court found substantial evidence backing the ALJ's conclusion that the medical records contradicted the plaintiff's assertions regarding her asthma attacks leading to loss of consciousness and constant shortness of breath. Additionally, the ALJ found the medical evidence insufficient to substantiate the plaintiff's claims about her psychiatric impairments, including alleged auditory hallucinations and an inability to leave her home. The ALJ noted that the plaintiff responded positively to psychiatric medication and that there were no documented psychiatric symptoms until July 2013, after the alleged disability onset date. At that appointment, the plaintiff exhibited upset emotions but did not report hallucinations. Dr. Schaefer's evaluation showed the plaintiff was alert, oriented, and had an intact affect, insight, and judgment. Subsequent visits indicated improvements in her mood and concentration, supported by a depression-screening questionnaire revealing minimal depression. Dr. Herman's psychiatric examination corroborated these findings, revealing no reports of hallucinations or manic episodes, and that the plaintiff demonstrated appropriate social skills and coherent thought processes. Treatment notes from Dr. Ehab, the plaintiff's primary care provider, also indicated a good mood and alertness, with no references to hallucinations or manic episodes. The ALJ appropriately evaluated the credibility of the plaintiff's statements according to 20 CFR 404.1529(c), concluding that the plaintiff’s reported daily activities did not align with the extent of her claimed disabling symptoms. A function report from August 2013 indicated she had no issues with personal care and could perform laundry and cleaning tasks that did not require bending or climbing. Plaintiff reported engaging in social activities, traveling independently, shopping, and managing bills, with no issues in relationships with family, friends, or authority figures. She indicated the ability to follow instructions and was enrolled in classes at Suffolk County Community College while working up to ten hours weekly under a work-study program. At the time of her social security disability application, she did not disclose any mental impairments, despite the application requesting information on all conditions affecting her work capability, and she had not sought treatment for psychiatric symptoms until after applying for benefits. The Administrative Law Judge (ALJ) conducted a credibility assessment that was supported by substantial evidence, including objective medical records contradicting the plaintiff's claims. The court upheld the ALJ's credibility determination, concluding that there was no basis for reversal. The plaintiff's motion for judgment was denied, while the Acting Commissioner's motion was granted. The ALJ noted specific limitations on the types of sedentary work the plaintiff could perform and environmental restrictions, emphasizing the need to avoid hazards and irritants. The ALJ's decision followed established procedures, and the Appeals Council declined to review the case, affirming the ALJ's ruling as the final decision.