Stewart v. Social Security Administration Commissioner

Filing 13

MEMORANDUM OPINION Signed by Honorable James R. Marschewski on January 23, 2013. (sh)

IN THE UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF ARKANSAS
FORT SMITH DIVISION
MISTY D. STEWART
o/b/o J.L.M, a minor
v.

PLAINTIFF
Civil No. 2:11-cv-02203-JRM

MICHAEL J. ASTRUE, Commissioner
Social Security Administration

DEFENDANT

MEMORANDUM OPINION
I.

Factual and Procedural Background
Plaintiff, Misty D. Stewart, brings this action on behalf of her son, J.L.M., seeking judicial

review, pursuant to 42 U.S.C. § 405(g), of a decision of the Commissioner of the Social Security
Administration (Commissioner) denying his application for child supplemental security income
(“SSI”) benefits under Title XVI of the Social Security Act (the “Act”).
Plaintiff protectively filed an application for SSI on March 22, 2007, alleging a disability
onset date of March 1, 2007, due to learning disorder, attention-deficit/hyperactivity disorder
(“ADHD”), anxiety, and speech and language delay. Tr. 10, 13, 238. At the time of filing, Plaintiff
was a preschooler, and subsequently became a school-age child. Tr. 13. Plaintiff’s application was
denied at the initial and reconsideration levels. Tr. 126-128, 130-133. An administrative hearing
was held on November 6, 2008. Tr. 41-77. Plaintiff was present at the hearing and represented by
council. The ALJ issued an unfavorable decision on June 23, 2009, finding that Plaintiff was not
disabled within the meaning of the Act. Tr. 107-122.
In a remand order dated March 24, 2010, the Appeals Council directed the ALJ to obtain
additional evidence concerning Plaintiff’s anxiety, further evaluate the treating source opinion, take
any further action needed to complete the administrative record, and issue a new decision. Tr. 123-

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125. A supplemental hearing was held on November 2, 2010. Tr. 78-104. In a written decision
dated February 3, 2011, the ALJ determined Plaintiff was not disabled within the meaning of the
Act. Tr. 7-24. On September 29, 2011, the Appeals Council declined to review the ALJ’s decision,
thus making the ALJ’s decision the final decision of the Commissioner. Tr. 1-6. Plaintiff now seeks
judicial review of that decision.
II.

Applicable Law
The court’s role on review is to determine whether the Commissioner’s findings are

supported by substantial evidence in the record as a whole. Ramirez v. Barnhart, 292 F.3d 576, 583
(8th Cir. 2003). “Substantial evidence is less than a preponderance, but enough so that a reasonable
mind might accept it as adequate to support a conclusion.” Estes v. Barnhart, 275 F.3d 722, 724 (8th
Cir. 2002) (quoting Johnson v. Apfel, 240 F.3d 1145, 1147 (8th Cir. 2001)). In determining whether
evidence is substantial, the court considers both evidence that detracts from the Commissioner’s
decision as well as evidence that supports it. Craig v. Apfel, 212 F.3d 433, 435-36 (8th Cir. 2000)
(citing Prosch v. Apfel, 201 F.3d 1010, 1012 (8th Cir. 2000)). If, after conducting this review, “it
is possible to draw two inconsistent positions from the evidence and one of those positions
represents the [Secretary’s] findings,” then the decision must be affirmed. Cox v. Astrue, 495 F.3d
614, 617 (8th Cir. 2007) (quoting Siemers v. Shalala, 47 F.3d 299, 301 (8th Cir. 1995)).
To be disabled under the Act, a child must prove that he “has a medically determinable
physical or mental impairment, which results in marked and severe functional limitations,” and
which has lasted or can be expected to last for at least twelve months. 42 U.S.C. § 1382c(a)(3)(C)(i);
20 C.F.R. § 416.906. In determining whether a claimant under the age of eighteen is disabled, the
ALJ undertakes a sequential three-step evaluation. Moore ex rel. Moore v. Barnhart, 413 F.3d 718
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(8th Cir. 2005); 20 C.F.R. § 416.924(a). The ALJ first determines whether the child is engaged in
substantial gainful activity. 20 C.F.R. § 416.924(b). If the child is so engaged, he will not be
awarded SSI benefits. Id. At the second step, the ALJ determines whether the child has an
impairment or combination of impairments that is “severe.” 20 C.F.R. § 416.924(c). To be deemed
severe, an impairment must be more than “a slight abnormality . . . that causes no more than minimal
functional limitations." Id. At the final step, the ALJ determines whether the child has an
impairment or impairments that meet, medically equal, or functionally equal a listed impairment.
20 C.F.R. § 416.924(d).
III.

ALJ’s Determination
At step one, the ALJ determined Plaintiff had not engaged in substantial gainful activity since

March 22, 2007, the application date. Tr. 13. At step two, he found Plaintiff suffers from learning
disorder and speech and language delay, which were considered severe impairments under the Act.
At step three, the ALJ determined Plaintiff did not have an impairment or combination of
impairments that met or medically equaled a listed impairment in 20 C.F.R. Pt. 404, Subpt. P, App.
1. Tr. 13. Additionally, the ALJ determined Plaintiff did not have an impairment or combination
of impairments that functionally equaled a listing, as Plaintiff had no limitation or less than marked
limitation in each of the six domains of functioning. Tr. 13-24. Accordingly, the ALJ determined
Plaintiff was not disabled from March 22, 2007, the application date, through February 3, 2011, the
date of the administrative decision. Tr. 24.
IV.

Discussion
Plaintiff contends that the Commissioner's decision is not supported by substantial evidence.

Specifically, Plaintiff raises the following issues: (A) whether the ALJ erred in his functional
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equivalence analysis; and (B) whether the ALJ erred in evaluating the opinion evidence. See Pl.’s
Br. 7-13. The Commissioner contends that substantial evidence supports the ALJ’s decision. See
Def.’s Br. 10-17.
The records show that on January 26, 2007, Nanette Barnett, a speech-language pathologist,
conducted a Psychoeducational Evaluation of Plaintiff. Tr. 294-310. On the Wechsler Intelligence
Scale for Children IV, Plaintiff received a verbal comprehension score of 69 and a full-scale score
of 73. Tr. 294, 298. Plaintiff’s verbal comprehension score was extremely low and his full-scale
score was borderline. Tr. 298. Ms. Barnett determined Plaintiff had a specific learning disability
involving basic reading and mathematical calculation. Tr. 301-302. She noted that Plaintiff had
adequate behaviors during the evaluation, normal vision and hearing, and adequate oral structures
for communication. Tr. 309. Plaintiff’s receptive and expressive language scores fell below the
average range and he exhibited a moderate articulation disorder characterized by substitution and
omission of sounds. Tr. 309. However, his voice and fluency appeared adequate. Tr. 309. Ms.
Barnett recommended that Plaintiff undergo sixty minutes of speech-language therapy weekly. Tr.
309. The Arkansas Severity Rating Assignment for Speech/Language Impairment rated Plaintiff’s
limitations as moderate for articulation, moderate for language, normal for fluency, and normal for
voice. Tr. 310-311.
Plaintiff was also evaluated by Sandra J. Sanders, a school psychology specialist. Tr. 394403. Test results indicated a specific learning disability in the areas of basic reading and math
calculation. Tr. 401-402. Ms. Sanders recommended that Plaintiff participate in small group and
individualized instruction in the areas of basic reading and math calculation. Tr. 403.

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On May 4, 2007, Becky Evans, Plaintiff’s first grade teacher, completed a Teacher
Questionnaire, in which she stated Plaintiff was able to function well in most areas, although he had
a very serious problem with expressing ideas in written form and needed extra support in written
communication. Tr. 266-273. She found that Plaintiff’s speech, written communication, and
handwriting were all serious problems, and noted that Plaintiff received resource support for his
speech. Tr. 273. However, Ms. Evans opined that Plaintiff was a normal functioning child who held
his own in reading, with a “B” average, and had good comprehension. Tr. 273. She added that he
was responsible, polite, and obedient, and did not require behavior modification strategies. Tr. 269,
273.
On May 29, 2007, Holly Layes, a speech-language pathologist, found that Plaintiff’s speech
was 50 percent intelligible on the first attempt and 70-75 percent intelligible with repetition. Tr. 284.
Ms. Layes noted that Plaintiff’s misarticulations consisted of substitutions and a few omissions. Tr.
284. On that same date, Stephen A.Whaley, M.D., a state agency physician, completed a Childhood
Disability Evaluation Form in which he opined that Plaintiff had less than marked limitations in the
domains of acquiring and using information and interacting and relating with others, and no
limitations in the domains of attending and completing tasks, moving about and manipulating
objects, caring for yourself, and health and physical well-being. Tr. 421-426.
On September 11, 2007, Jennifer Jernigan, Plaintiff’s second grade teacher, completed a
Teacher-Educator Domain Performance Assessment, in which she found Plaintiff had extreme
limitations in the domains of maintaining attention and concentration for extended periods. Tr. 245.
Ms. Jernigan also determined Plaintiff had marked limitations in the domains of acquiring and using

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information, attending and completing tasks, interacting and relating with others, and moving about
and manipulating objects. Tr. 244-248.
Area Health Educational Center (“AHEC”) clinic notes from August 6, 2007, through
October 3, 2007, reveal that Plaintiff’s mother reported that Plaintiff had been hyperactive for years
but was unable to give any specific examples. Tr. 451. She stated that Plaintiff made “Bs” and “Cs”
in school and would sit down and do his homework if she could get him to calm down. Tr. 451.
Audra Jackson, M.D., noted that Plaintiff was jumping around the room, interrupting her
conversation with Plaintiff’s mother, and fighting with his brother. Tr. 451. She noted that Plaintiff
did not answer questions directed at him. Tr. 451. On October 3, 2007, Dr. Jackson noted that
completed teacher/school forms showed no sign of ADHD and forms Plaintiff’s mother completed
showed mild hyperactivity but no inattention. Tr. 450.
On November 7, 2007, Plaintiff presented to Perspectives Behavioral Health Management
for a diagnostic evaluation. Tr. 472-489. Plaintiff’s mother reported problems with behavior and
hyperactivity, but noted that Plaintiff received “As,” “Bs,” and “Cs” in school. Tr. 472-473.
Plaintiff’s therapist noted that Plaintiff’s speech was difficult to understand and he sucked on his
fingers between appointments. Tr. 472-473. Plaintiff was diagnosed with anxiety disorder not
otherwise specified and given a Global Assessment of Functioning (“GAF”) score of 48. Tr. 470,
488. Brent Witherington, M.D., prescribed Sertraline and Focalin. Tr. 456, 470.
On June 12, 2008, Plaintiff’s mother reported that Plaintiff was doing “a lot better.” Tr. 455.
Treatment notes indicate some noncompliance with therapy sessions. Tr. 458. On July 31, 2008,
Dr. Witherington examined Plaintiff and noted that Plaintiff’s condition was improving, although
he had visited a therapist only once during the current review period. Tr. 458. On August 12, 2008,
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Dr. Witherington completed a Psychiatric Documentation Form for Children, in which he determined
Plaintiff met the Listing for anxiety-related disorder. Tr. 443-449. Dr. Witherington noted that
Plaintiff had marked impairment in age appropriate/cognitive communicative function, social
functioning, and personal/behavior function, as well as deficiencies of concentration, persistence,
or pace resulting in frequent failure to complete tasks in a timely manner. Tr. 449.
On September 9, 2008, Plaintiff’s mother reported that Plaintiff was doing worse and had
been getting in trouble at school and on the bus. Tr. 453. However, Plaintiff’s mother denied
receiving any feedback from Plaintiff’s teachers or school. Tr. 453. Dr. Witherington noted that
Plaintiff’s condition was “stable” and estimated his GAF score at 50. Tr. 453.
On February 21, 2008, an Individualized Education Program (“IEP”) assessment stated that
Plaintiff’s language skills were below grade level, his word reading, numerical operations, and
speaking scores were at expectancy level, and his reading comprehension, mathematical reasoning,
spelling, listening, and learning process scores were above expectancy level. Tr. 317. The
examiners noted that Plaintiff did not need behavioral interventions, accommodations, special
communication, or assistive technology. Tr. 318. Plaintiff followed discipline and attendance
policies, and a progress goal report found that Plaintiff’s goals either had been met or would be met
by the end of the year. Tr. 318-319. A third grade report card shows that Plaintiff received grades
of “A,” “B,” “C,” outstanding, and satisfactory. Tr. 330.
On September 14, 2009, Plaintiff visited University of Arkansas for Medical Science
(“UAMS”) Centers for Children due to concerns of a pervasive development disorder. Tr. 586. On
the Wechsler Intelligence Scale for Children IV, Plaintiff received a verbal comprehension score of
79 and a full-scale IQ score of 83, indicating functioning within the low average to borderline range.
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Tr. 589. Examiners noted that Plaintiff did not meet the diagnostic criteria for a diagnosis of
pervasive developmental disorder, but did demonstrate delays in socialization skills. Tr. 593.
Plaintiff was diagnosed with anxiety disorder not otherwise specified, ADHD, inattentive type,
mixed expressive-receptive language disorder, phonological disorder, and obsessive-compulsive
symptoms. Tr. 592.
On September 21, 2009, Plaintiff underwent a Psychoeducational Reevaluation. Tr. 342.
Examiners noted that Plaintiff spoke in a quiet tone with adequate articulation and maintained good
eye contact, and his visual and auditory acuity appeared to be adequate for testing purposes. Tr. 342.
Plaintiff’s fine motor skills were within normal limits, he had a legible handwriting, and he used his
fingers for counting or calculating mathematical problems. Tr. 342. Ms. Sanders opined that test
results did not indicate a disability. Tr. 345.
Plaintiff underwent a Speech and Language Reevaluation on September 28, 2009. Tr. 346354. During the evaluation, Plaintiff was fretful, needed frequent repetition of information, and
exhibited impulsive, fidgety behavior. Tr. 347. He often had to be reminded to take his shirt collar
or fingers out of his mouth. Tr. 347. Plaintiff’s articulation scores were within the normal range,
but his receptive language scores fell below the average range and his expressive language scores
fell significantly below the average range. Tr. 354. Ms. Layes recommended sixty minutes of
speech-language therapy weekly. Tr. 354.
On March 17, 2010, Dr. Witherington saw Plaintiff for evaluation of ADHD and anxiety
disorder. Tr. 491. He noted Plaintiff’s history of noncompliance with multiple medications and
therapy treatment, with subsequent discharge in December 2009. Tr. 491. He noted that Plaintiff’s
mother felt that the combination of Sertraline and Strattera had been effective. Tr. 491. Plaintiff’s
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mother reported that Plaintiff’s grades were dropping and he had been to detention on two occasions
for “acting out.” Tr. 491. However, she also stated that Plaintiff had been out of medication for
several months. Tr. 491. Dr. Witherington diagnosed Plaintiff with ADHD, predominantly
inattentive, anxiety disorder not

otherwise specified,

phonological disorder, mixed

expressive/receptive language disorder, and noncompliance with treatment. Tr. 497. He estimated
Plaintiff’s GAF score at 45. Tr. 497. He prescribed Strattera and recommended individual and
family therapy. Tr. 498. Dr. Witherington noted that the public school system would continue to
treat Plaintiff’s learning disorders. Tr. 502.
In April 2010, Plaintiff’s mother reported that Plaintiff was doing “better” and his grades had
improved. Tr. 536. In June 2010, however, Plaintiff’s mother reported that he was doing worse
overall and had been playing with lighters and acting out. Tr. 534. Dr. Witherington prescribed
Tenex for impulsivity. Tr. 535. On August 23, 2010, Dr. Witherington noted that Plaintiff was
doing better overall with his medication, “did what he was supposed to do,” and did not“lash out like
he did before.” Tr. 532. Treatment notes dated September 10, 2010, reveal that Plaintiff had missed
all his therapy sessions for the past review cycle. Tr. 539-540.
On his fifth grade report card, Plaintiff received grades of “B,” “C,” and satisfactory. Tr. 393.
An IEP report dated October 22, 2010, indicates that Plaintiff received sixty minutes of speechlanguage therapy per week and 600 minutes of special education instruction. Tr. 381-390. Plaintiff
could comprehend reading on a 3.5 grade level and spell words on a 5.0 grade level with 80 percent
accuracy. Tr. 382. He could perform grade level math that was reduced and given in a small group
setting. Tr. 382.

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On April 7, 2011, Plaintiff’s mother reported that Plaintiff was doing better overall and had
been more focused. Tr. 597. Dr. Witherington discontinued Strattera, continued Tenex, and added
Vyvanse. Tr. 597. He estimated Plaintiff’s GAF score at 47. Tr. 606.
A. Functional Equivalency
Plaintiff argues that his impairments functionally equal a listing. Specifically, Plaintiff
argues that he has marked limitations in the domains of attending and completing tasks and
interacting and relating with others. See Pl.’s Br. 7-9.
To determine whether an impairment functionally equals a disability included in the Listings,
the ALJ must assess the child's developmental capacity in six specified domains. 20 C.F.R. §
416.926a(b)(1). The six domains are: (1) acquiring and using information; (2) attending and
completing tasks; (3) interacting and relating with others; (4) moving about and manipulating
objects; (5) caring for yourself; and, (6) health and physical well-being. 20 C.F.R. § 416.926a(b)(1);
see also Moore ex rel. Moore v. Barnhart, 413 F.3d 718, 722 n. 4 (8th Cir. 2005). To functionally
equal a listing, an impairment must result in “marked” limitations in two domains of functioning or
an “extreme” limitation in one domain. 20 C.F.R. § 416.926a(a).
A marked limitation is an impairment that seriously interferes with the child’s ability to
independently initiate, sustain, or complete activities. 20 C.F.R. § 416.926a(e)(2)(i). It is “more
than moderate" but "less than extreme." Id. An extreme limitation is defined as “more than
marked,” and exists when a child’s impairment(s) interferes very seriously with his ability to
independently initiate, sustain, or complete activities. 20 C.F.R. § 416.926a(e)(3)(i). Day-to-day
functioning may be very seriously limited when an impairment(s) limits only one activity or when
the interactive and cumulative effects of the impairment(s) limit several activities. Id.
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The ALJ concluded that Plaintiff’s impairments do not functionally equal a listed
impairment, as he found less than marked limitation in the domains of acquiring and using
information, attending and completing tasks, and interacting and relating with others, and no
limitation in the domains of moving about and manipulating objects, caring for yourself, or health
and physical well-being. Tr. 17-24.
1. Attending and Completing Tasks
This domain considers how well a child is able to focus and maintain attention, and how well
he is able to begin, carry through, and finish activities, including the pace at which he performs
activities and the ease of changing activities. 20 C.F.R. 416.926a(h). The ALJ found that Plaintiff
has less than marked limitation in attending and completing tasks. Tr. 19-20. Specifically, he found
that although Plaintiff has some difficulty in this domain, medication and therapy have been helpful
in treating symptoms of inattention and distractability. Tr. 20.
Substantial evidence supports the ALJ’s determination that Plaintiff has less than marked
impairment in the domain of attending and completing tasks. Although Plaintiff had some initial
difficulty in this domain, his ADHD symptoms significantly improved when he was compliant with
medication and treatment. In April 2010, Plaintiff’s mother reported that Plaintiff was doing “better”
and his grades had improved while on Strattera. Tr. 536. On August 23, 2010, Plaintiff was doing
better overall with his medication and “did what he was supposed to do.” Tr. 532. On April 7, 2011,
Plaintiff’s mother reported that he had been more focused. Tr. 597. At the administrative hearing,
Plaintiff’s mother testified that Plaintiff was doing well and had not gotten into trouble recently at
school. Tr. 73. Plaintiff was making “As,” “Bs,” and “Cs” on his report card and was “all right”
while on medication, but hyperactive without it. Tr. 97-98. See Estes v. Barnhart, 275 F.3d 722,
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725 (8th Cir. 2002) (an impairment that can be controlled by treatment or medication is not
considered disabling).
Ms. Evans, Plaintiff’s first grade teacher, noted that Plaintiff was a normal functioning child
who held his own in reading, with a “B” average, and had good comprehension. Tr. 273. She added
that he was responsible, polite, and obedient, and did not require behavior modification strategies.
Tr. 269, 273. Jennifer Jernigan, Plaintiff’s second grade teacher at Bonneville, completed a TeacherEducator Domain Performance Assessment, in which she found Plaintiff had extreme limitations in
the domain of maintaining attention and concentration for extended periods. Tr. 245. However,
Plaintiff’s mother testified that Plaintiff was at Bonneville for less than a month before being
transferred to another school. Tr. 72-73. Thus, Ms. Jernigan was only able to observe Plaintiff for
a very short period of time, whereas Ms. Evans taught Plaintiff for an entire year.
IEP notes from February 21, 2008, indicate that Plaintiff did not need behavioral
interventions, accommodations, special communication, or assistive technology. Tr. 318. Plaintiff
followed discipline and attendance policies, and a progress goal report found that Plaintiff’s goals
either had been met or would be met by the end of the year. Tr. 318-319. A third grade report card
shows that Plaintiff received grades of “A,” “B,” “C,” outstanding, and satisfactory. Tr. 330.
Morever, Plaintiff had never been retained in school. Tr. 330, 338. For these reasons, substantial
evidence supports the ALJ’s determination that Plaintiff has less than marked limitation in the
domain of attending and completing tasks.
2. Interacting and Relating with Others
In assessing a claimant’s limitations in the domain of interacting and relating with others, the
ALJ considers how well the child initiates and sustains emotional connections with others, develops
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and uses the language of the community, cooperates with others, complies with rules, responses to
criticism, and respects and takes care of the possessions of others. 20 C.F.R. § 416.926a(i); Garrett
ex rel. Moore v. Barnhart, 366 F.3d 643, 654 (8th Cir. 2004). With regard to this domain of
functioning, the ALJ found that Plaintiff has less than marked limitation.
The records show that Plaintiff exhibited a moderate articulation disorder characterized by
substitution and omission of sounds, for which he received sixty minutes of speech-language therapy
weekly. Tr. 309. The Arkansas Severity Rating Assignment for Speech/Language Impairment rated
Plaintiff’s limitations as moderate for articulation, moderate for language, normal for fluency, and
normal for voice. Tr. 310-311. On May 29, 2007, Ms. Layes found that Plaintiff’s speech was 50
percent intelligible on the first attempt and 70-75 percent intelligible with repetition. Tr. 284.
Ms. Evans, Plaintiff’s first grade teacher, found that Plaintiff was responsible, polite, and
obedient, and did not require behavior modification strategies. Tr. 269, 273. An IEP assessment
dated February 21, 2008, stated that Plaintiff’s language skills were below grade level, his word
reading, numerical operations, and speaking scores were at expectancy level, and his reading
comprehension, mathematical reasoning, spelling, listening, and learning process scores were above
expectancy level. Tr. 317. Plaintiff did not need behavioral interventions, accommodations, special
communication, or assistive technology. Tr. 318. Plaintiff followed discipline and attendance
policies, and a progress goal report found that Plaintiff’s goals either had been met or would be met
by the end of the year. Tr. 318-319.
On September 14, 2009, UAMS evaluators noted that Plaintiff did not meet the diagnostic
criteria for a diagnosis of pervasive developmental disorder, but did demonstrate delays in
socialization skills. Tr. 593. Plaintiff underwent a Speech and Language Reevaluation on
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September 28, 2009. Tr. 346-354. Plaintiff’s articulation scores were within the normal range, but
his receptive language scores fell below the average range and his expressive language scores fell
significantly below the average range. Tr. 354. However, Plaintiff’s adaptive behavior skills were
within the average range. Tr. 338.
Although the evidence of record demonstrates moderate impairment in Plaintiff’s ability to
effectively communicate with others, the undersigned cannot conclude that Plaintiff’s impairment
seriously interferes with the his ability to independently initiate, sustain, or complete activities. For
these reasons, the undersigned finds that substantial evidence supports the ALJ’s determination that
Plaintiff has less than marked limitation in the domain of interacting and relating with others.
B. Opinion Evidence
Plaintiff argues that the ALJ failed to attach proper weight to Dr. Witherington’s opinion.
See Pl.’s Br. 9-13. A treating physician’s opinion is given controlling weight if it “is well-supported
by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with
the other substantial evidence” in a clamant’s record. Tilley v. Astrue, 580 F.3d 675, 679 (8th Cir.
2009); 20 C.F.R. § 404.1527(d)(2). The record must be evaluated as a whole to determine whether
the treating physician’s opinion should be controlling. Reed v. Barnhart, 399 F.3d 917, 920 (8th Cir.
2005). A treating physician’s evaluation may be disregarded where other medical assessments “are
supported by better or more thorough medical evidence, or where a treating physician renders
inconsistent opinions that undermine the credibility of such opinions.” Id. at 920-21 (quoting
Prosch, 201 F.3d at 1013). In any case, an ALJ must always “give good reasons” for the weight
afforded to the treating physician’s opinion. 20 C.F.R. § 404.1527(d)(2).

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The ALJ attached little weight to the report completed by Dr. Witherington, noting that his
findings were inconsistent with his own progress notes and were based to some extent on the
subjective representations of Plaintiff’s mother. Tr. 17.
After reviewing the evidence of record, the undersigned concludes that substantial evidence
supports the ALJ’s evaluation of the opinion evidence. Dr. Witherington’s overly restrictive findings
conflict with his own treatment notes, which reveal that Plaintiff’s symptoms improved with
medication and treatment. Tr. 455, 458, 491, 532, 636, 597. See Wagner v. Astrue, 499 F.3d 842,
849 (8th Cir. 2007) (ALJ may credit other medical evaluations over treating physician when other
assessments are supported by better medical evidence or where treating physician renders
inconsistent opinions); Haggard v. Apfel, 175 F.3d 591, 595 (8th Cir. 1999) (treating physician’s
opinion was not supported by his own findings or the diagnostic data).
Additionally, Plaintiff argues that his GAF scores alone warrant a finding of disability. GAF
scores cover only a snapshot in time and are very subjective in nature. See Jones v. Astrue, 619 F.3d
963, 973 (8th Cir. 2010). While the GAF system provides insight into a claimant’s overall level of
functioning, it is by no means dispositive on the issue of disability and must be considered in
conjunction with other medical evidence. Here, the ALJ considered the medical evidence of record,
including Plaintiff’s GAF scores, but determined he was not disabled. Substantial evidence supports
this determination.
Finally, the undersigned notes that the ALJ properly considered Plaintiff’s teacher’s
evaluations in conjunction with the regulations regarding “other source” opinions. 20 C.F.R. §
416.913(d)(1). Thus, after considering the evidence of record, the Court concludes that substantial
evidence supports the ALJ’s determination.
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V.

Conclusion
Having carefully reviewed the record, the undersigned finds that substantial evidence

supports the ALJ's determinations at each step of the disability evaluation process, and thus the
decision should be affirmed. Accordingly, Plaintiff’s Complaint is dismissed with prejudice.
IT IS SO ORDERED this 23rd day of January 2013.

/s/ J. Marschewski
HONORABLE JAMES R. MARSCHEWSKI
CHIEF UNITED STATES MAGISTRATE JUDGE

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