Barron v. Commissioner of Social Security
Filing
17
MEMORANDUM OPINION and ORDER: The final decision of the Commissioner is affirmed: Judgment shall enter against Plaintiff Barron and in favor of the Defendant Commissioner of Social Security: See text of order for further information. Signed by Judge Leonard T Strand on 02/22/16. (kfs)
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF IOWA
WESTERN DIVISION
SUZANNE CATHERINE BARRON,
Plaintiff,
No. C15-4028-LTS
vs.
CAROLYN W. COLVIN, Acting
Commissioner of Social Security,
MEMORANDUM OPINION
AND ORDER
Defendant.
____________________
Plaintiff Suzanne Catherine Barron seeks judicial review of a final decision of the
Commissioner of Social Security (the Commissioner) denying her application for
Supplemental Security Income benefits (SSI) under Title XVI of the Social Security Act,
42 U.S.C. § 401 et seq. (Act). Barron contends that the administrative record (AR) does
not contain substantial evidence to support the Commissioner’s decision that she was not
disabled during the relevant period. For the reasons that follow, the Commissioner’s
decision will be affirmed.
I.
BACKGROUND
Barron was born in 1965. She completed high school and two years of college.
AR 436-40. On March 19, 2009, Barron applied for SSI.1 Her claim was denied initially
and on reconsideration. AR 191, 195, 201, 205. At Barron’s request, an administrative
hearing was held on October 18, 2011. AR 92-147. The Administrative Law Judge (ALJ),
Ronald D. Lahners, denied Barron’s claim on December 8, 2011. AR 170-79. Barron
Barron also filed an application for disability insurance benefits (DIB) under Title II of the Act.
Both parties agree, however, that the DIB claim is not before the court because Barron’s amended
alleged disability onset date of March 19, 2009. See Doc. No. 13 at 2; AR 15, 436.
1
then appealed the denial to the Appeals Council, which remanded the case to the ALJ for
further proceedings on March 12, 2013. AR 185-89.
The ALJ held a supplemental administrative hearing on August 20, 2013. AR 4091. The ALJ denied Barron’s claim again on September 16, 2013. AR 15-32. The ALJ
found that Barron had not performed substantial gainful activity after her amended alleged
disability onset date of March 19, 2009. AR 19. The ALJ next found that Barron’s severe
impairments included various mental health conditions, and physical conditions concerning
her cervical spine and shoulders. AR 19.
The ALJ determined that for the period between April 1, 2011, and July 30, 2012,
Barron’s impairments met the per se disabled criteria of section 12.04 of the Appendix 1
Listing of Impairments (Listings). AR 25. The ALJ found that Barron’s condition
medically improved beginning July 31, 2012, such that she no longer met the criteria of
section 12.04. AR 26. The ALJ found that between March 19, 2009 and March 31, 2011,
and between August 1, 2012 and September 16, 2013, Barron did not have an impairment
or combination of impairments listed in or medically equal to one contained in the Listings.
AR 20.
The ALJ determined that between March 19, 2009, and March 31, 2011, and
between August 1, 2012, and September 16, 2013, Barron retained the RFC to perform
light work with the following nonexertional limitations: stooping, climbing, kneeling, and
crawling could be performed only half of normal; reaching above the shoulder should only
be performed on an occasional basis; interaction with the public, supervisors, and peers
should be minimized or not occur; and any work should have minimal change and be
repetitive in nature without the need to concentrate or change from one task to another.
AR 20-21, 27-28. The ALJ determined that prior to April 1, 2011, and after July 30,
2012, Barron could not perform her past relevant work, but she had the RFC to perform
the representative sample of unskilled occupations the Vocational Expert (VE) identified
2
at the hearing (production assembler, machine packager, and housekeeper cleaner). AR
25, 31.
Consequently, the ALJ determined that Barron was entitled to SSI benefits for the
closed period of disability between April 1, 2011, and July 31, 2012, but that she was not
entitled to SSI benefits for the adjudicated periods between (a) March 31, 2009, and March
31, 2011, and (b) August 1, 2012, and September 16, 2013, because her impairments did
not prevent her from performing other work in the economy during those periods of time.
AR 32. The Appeals Council denied Barron’s request for review on February 9, 2015.
AR 1-4.
As such, the ALJ’s second decision stands as the final decision of the
Commissioner. AR 1.
On March 30, 2015, Barron filed a complaint (Doc. No. 3) in this court seeking
review of the Commissioner’s decision.2 The parties have briefed the issues and the matter
is now fully submitted.
II.
DISABILITY DETERMINATIONS AND THE BURDEN OF PROOF
A disability is defined as the “inability to engage in any substantial gainful activity
by reason of any medically determinable physical or mental impairment which can be
expected to result in death or which has lasted or can be expected to last for a continuous
period of not less than twelve months.” 42 U.S.C. § 1382c(a)(3)(A); 20 C.F.R. §
416.905. A claimant has a disability when the claimant is “not only unable to do his
previous work but cannot, considering his age, education, and work experience, engage
in any other kind of substantial gainful work which exists . . . in significant numbers either
2
This case was initially assigned to United States District Judge Mark W. Bennett and referred
to me, as a United States Magistrate Judge, for the filing of a report and recommended disposition
pursuant to 28 U.S.C. § 636(b)(1)(B). Upon my appointment as a United States District Judge,
the case was reassigned to me. As such, this order constitutes this court’s final disposition of the
case.
3
in the region where such individual lives or in several regions of the country.” 42 U.S.C.
§ 1382c(a)(3)(B).
To determine whether a claimant has a disability within the meaning of the Social
Security Act, the Commissioner follows a five-step sequential evaluation process outlined
in the regulations. 20 C.F.R. § 416.920; see Kirby v. Astrue, 500 F.3d 705, 707 (8th
Cir. 2007). First, the Commissioner will consider a claimant’s work activity. If the
claimant is engaged in substantial gainful activity, then the claimant is not disabled. 20
C.F.R. § 416.920(a)(4)(i).
Second, if the claimant is not engaged in substantial gainful activity, the
Commissioner looks to see “whether the claimant has a severe impairment that
significantly limits the claimant’s physical or mental ability to perform basic work
activities.” Dixon v. Barnhart, 353 F.3d 602, 605 (8th Cir. 2003). “An impairment is
not severe if it amounts only to a slight abnormality that would not significantly limit the
claimant’s physical or mental ability to do basic work activities.” Kirby, 500 F.3d at 707;
see also 20 C.F.R. §§ 416.920(c), 416.921(a).
The ability to do basic work activities is defined as “the abilities and aptitudes
necessary to do most jobs.” 20 C.F.R. § 416.921(b). These abilities and aptitudes include
(1) physical functions such as walking, standing, sitting, lifting, pushing, pulling,
reaching, carrying, or handling; (2) capacities for seeing, hearing, and speaking; (3)
understanding, carrying out, and remembering simple instructions; (4) use of judgment;
(5) responding appropriately to supervision, co-workers, and usual work situations; and
(6) dealing with changes in a routine work setting. Id. § 416.921(b)(1)-(6); see Bowen v.
Yuckert, 482 U.S. 137, 141 (1987). “The sequential evaluation process may be terminated
at step two only when the claimant’s impairment or combination of impairments would
have no more than a minimal impact on her ability to work.” Page v. Astrue, 484 F.3d
1040, 1043 (8th Cir. 2007) (internal quotation marks omitted).
Third, if the claimant has a severe impairment, then the Commissioner will consider
the medical severity of the impairment. If the impairment meets or equals one of the
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presumptively disabling impairments listed in the regulations, then the claimant is
considered disabled, regardless of age, education, and work experience. 20 C.F.R.
§§ 416.920(a)(4)(iii), 416.920(d); Kelley v. Callahan, 133 F.3d 583, 588 (8th Cir. 1998).
Fourth, if the claimant’s impairment is severe, but it does not meet or equal one of
the presumptively disabling impairments, then the Commissioner will assess the claimant’s
residual functional capacity (RFC) to determine the claimant’s “ability to meet the
physical, mental, sensory, and other requirements” of the claimant’s past relevant work.
20 C.F.R. §§ 416.920(a)(4)(iv), 416.945(a)(4). “RFC is a medical question defined
wholly in terms of the claimant’s physical ability to perform exertional tasks or, in other
words, what the claimant can still do despite his or her physical or mental limitations.”
Lewis v. Barnhart, 353 F.3d 642, 646 (8th Cir. 2003) (internal quotation marks omitted);
see also 20 C.F.R. § 416.945(a)(1). The claimant is responsible for providing evidence
the Commissioner will use to make a finding as to the claimant’s RFC, but the
Commissioner is responsible for developing the claimant’s “complete medical history,
including arranging for a consultative examination(s) if necessary, and making every
reasonable effort to help [the claimant] get medical reports from [the claimant’s] own
medical sources.” 20 C.F.R. § 416.945(a)(3). The Commissioner also will consider
certain non-medical evidence and other evidence listed in the regulations. Id. If a claimant
retains the RFC to perform past relevant work, then the claimant is not disabled. Id. §
416.920(a)(4)(iv).
Fifth, if the claimant’s RFC as determined in Step Four will not allow the claimant
to perform past relevant work, then the burden shifts to the Commissioner to show that
there is other work that the claimant can do, given the claimant’s RFC as determined at
Step Four, and his or her age, education, and work experience. See Bladow v. Apfel, 205
F.3d 356, 358-59 n.5 (8th Cir. 2000). The Commissioner must show not only that the
claimant’s RFC will allow the claimant to make an adjustment to other work, but also that
the other work exists in significant numbers in the national economy. Eichelberger v.
Barnhart, 390 F.3d 584, 591 (8th Cir. 2004); 20 C.F.R. § 416.920(a)(4)(v). If the
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claimant can make an adjustment to other work that exists in significant numbers in the
national economy, then the Commissioner will find the claimant is not disabled. If the
claimant cannot make an adjustment to other work, then the Commissioner will find that
the claimant is disabled. 20 C.F.R. § 416.920(a)(4)(v). At Step Five, even though the
burden of production shifts to the Commissioner, the burden of persuasion to prove
disability remains on the claimant. Stormo v. Barnhart, 377 F.3d 801, 806 (8th Cir.
2004).
III.
THE ALJ’S FINDINGS
The ALJ made the following findings:
1.
The claimant met the insured status requirements of the Social
Security Act through September 30, 2006 and is not eligible for Title II
benefits as of the amended alleged onset date.
2.
The claimant has not engaged in substantial gainful activity
since the alleged onset date.
3.
Since the alleged onset date of disability, March 19, 2009, the
claimant has had the following severe impairments: schizoaffective
disorder, bipolar disorder, a history of obsessive-compulsive disorder, a
history of post-traumatic stress disorder, amphetamine dependence in full
remission, disorders of the cervical spine, a history of fatty liver disease,
bilateral shoulder tendinitis, and history of migraine headaches.
4.
Prior to April 1, 2011, the date the claimant became disabled,
and after July 30, 2012, the claimant did not have an impairment or
combination of impairments that meets or medically equals the severity of
one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix
1.
5.
Prior to April 1, 2011, the date the claimant became disabled,
the claimant had the residual functional capacity to perform light work as
defined in 20 C.F.R. 404.1567(b) and 416.967(b) except the claimant could
lift 30 pounds occasionally and 20 pounds frequently. The claimant could sit
for six hours or stand for six hour in an eight-hour day. The claimant has
unlimited use of the extremities. Stooping, climbing, kneeling and crawling
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could be performed only half of normal. Reaching above the shoulder should
only be performed on an occasional basis. The claimant would not have any
problems remembering or carrying out instructions. She would have
difficulty interacting with the public, supervisors and peers and that such
interaction should be minimized or not occur. Any such work should have
minimal changing and any such work should be repetitive in nature without
the need to concentrate or change from one thing to another.
6.
Since March 19, 2009, the claimant has been unable to
perform any past relevant work.
7.
Prior to the established disability onset date, the claimant was
a younger individual age 18-49.
8.
The claimant has at least a high school education and is able to
communicate in English.
9.
Prior to April 1, 2011, transferability of job skills is not
material to the determination of disability because using the MedicalVocational Rules as a framework supports a finding that the claimant is “not
disabled,” whether or not the claimant has transferable job.
10. Prior to April 1, 2011, considering the claimant’s age,
education, work experience and residual functional capacity, there are jobs
that exist in significant numbers in the national economy that the claimant
could have performed.
11. Beginning on April 1, 2011, the severity of the claimant’s
impairments has met the criteria of section 12.04 of 20 C.F.R. Part 404,
Subpart P, Appendix 1.
12. The claimant was not disabled prior to April 1, 2011, but
became disabled on that date and continued to be disabled through July 30,
2012.
13. The claimant has not developed any new impairment or
impairments since July 31, 2012, the date the claimant’s disability ended.
Thus, the claimant’s current severe impairments are the same as that present
from March 19, 2009 through July 30, 2012.
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14. Beginning July 31, 2012, the claimant has not had an
impairment or combination of impairments that meets or medically equals
the severity of one of the impairments listed in 20 C.F.R. Part 404, Subpart
P, Appendix 1.
15. Medical improvement occurred as of July 31, 2012, the date
the claimant’s disability ended.
16. The medical improvement that has occurred is related to the
ability to work because the claimant no longer has an impairment or
combination of impairments that meets or medically equals the severity of a
listing.
17. Beginning July 31, 2012, the claimant has had the residual
functional capacity to perform light work as defined in 20 C.F.R.
404.1567(b) and 416.967(b) except the claimant could lift 30 pounds
occasionally and 20 pounds frequently. The claimant could sit for six hours
or stand for six hours in an eight-hour day. The claimant has unlimited use
of the extremities. Stooping, climbing, kneeling and crawling could be
performed only half of normal. Reaching above the shoulder should only be
performed on an occasional basis. The claimant would not have any
problems remembering or carrying out instructions. She would have
difficulty interacting with the public, supervisors and peers and that such
interaction should be minimized or not occur. Any such work should have
minimal changing and any such work should be repetitive in nature without
the need to concentrate or change from one thing to another.
18.
The claimant is unable to perform any past relevant work.
19. Since July 31, 2012, the claimant has been a younger
individual age 18-49.
20. The claimant has at least a high school education and is able to
communicate in English.
21. Beginning July 31, 2012, transferability of job skills is not
material to the determination of disability because using the MedicalVocational Rules as a framework supports a finding that the claimant is “not
disabled,” whether or not the claimant has transferable job skills.
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22. Beginning July 31, 2012, considering the claimant’s age,
education, work experience and residual functional capacity, there are jobs
that exist in significant numbers in the national economy that the claimant
could have performed.
23. The claimant’s disability began April 1, 2011 and ended July 31,
2012.
24. The claimant was not under a disability within the meaning of
the Social Security Act at any time through September 30, 2006, the date
last insured. The Title II request for hearing is dismissed.
AR 20-33.
IV.
THE SUBSTANTIAL EVIDENCE STANDARD
The Commissioner’s decision must be affirmed “if it is supported by substantial
evidence on the record as a whole.” Pelkey v. Barnhart, 433 F.3d 575, 577 (8th Cir.
2006); see 42 U.S.C. § 405(g) (“The findings of the Commissioner of Social Security as
to any fact, if supported by substantial evidence, shall be conclusive. . . .”). “Substantial
evidence is less than a preponderance, but enough that a reasonable mind might accept as
adequate to support a conclusion.” Lewis, 353 F.3d at 645. The Eighth Circuit explains
the standard as “something less than the weight of the evidence and [that] allows for the
possibility of drawing two inconsistent conclusions, thus it embodies a zone of choice
within which the [Commissioner] may decide to grant or deny benefits without being
subject to reversal on appeal.” Culbertson v. Shalala, 30 F.3d 934, 939 (8th Cir. 1994).
In determining whether the Commissioner’s decision meets this standard, the court
considers “all of the evidence that was before the ALJ, but it [does] not re-weigh the
evidence.” Wester v. Barnhart, 416 F.3d 886, 889 (8th Cir. 2005). The court considers
both evidence which supports the Commissioner’s decision and evidence that detracts from
it. Kluesner v. Astrue, 607 F.3d 533, 536 (8th Cir. 2010). The court must “search the
record for evidence contradicting the [Commissioner’s] decision and give that evidence
appropriate weight when determining whether the overall evidence in support is
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substantial.” Baldwin v. Barnhart, 349 F.3d 549, 555 (8th Cir. 2003) (citing Cline v.
Sullivan, 939 F.2d 560, 564 (8th Cir. 1991)).
In evaluating the evidence in an appeal of a denial of benefits, the court must apply
a balancing test to assess any contradictory evidence. Sobania v. Sec’y of Health & Human
Servs., 879 F.2d 441, 444 (8th Cir. 1989). The court, however, does not “reweigh the
evidence presented to the ALJ,” Baldwin, 349 F.3d at 555 (citing Bates v. Chater, 54
F.3d 529, 532 (8th Cir. 1995)), or “review the factual record de novo.” Roe v. Chater,
92 F.3d 672, 675 (8th Cir. 1996) (citing Naber v. Shalala, 22 F.3d 186, 188 (8th Cir.
1994)). Instead, if, after reviewing the evidence, the court finds it “possible to draw two
inconsistent positions from the evidence and one of those positions represents the
Commissioner’s findings, [the court] must affirm the [Commissioner’s] denial of
benefits.” Kluesner, 607 F.3d at 536 (quoting Finch v. Astrue, 547 F.3d 933, 935 (8th
Cir. 2008)). This is true even in cases where the court “might have weighed the evidence
differently.” Culbertson, 30 F.3d at 939 (quoting Browning v. Sullivan, 958 F.2d 817,
822 (8th Cir. 1992)). The court may not reverse the Commissioner’s decision “merely
because substantial evidence would have supported an opposite decision.” Baker v.
Heckler, 730 F.2d 1147, 1150 (8th Cir. 1984); see Goff v. Barnhart, 421 F.3d 785, 789
(8th Cir. 2005) (“[A]n administrative decision is not subject to reversal simply because
some evidence may support the opposite conclusion.”).
V.
DISCUSSION
Barron argues the ALJ’s decision is flawed for three reasons:
1.
Substantial evidence does not support the ALJ’s RFC findings
before or after the closed period.
2.
The ALJ failed to give proper weight to expert medical
opinions.
3.
The ALJ failed to follow the order of the Appeals Council on
remand.
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I will address these arguments separately below.
A.
The RFC Determination
The RFC is an administrative assessment that the ALJ determines upon
consideration of all evidence in the record. See 20 C.F.R. § 416.927(e)(2); Social Security
Ruling (SSR) 96-5p, 1996 WL 374183, at *5; SSR 96-8p, 1996 WL 374184, at *2. A
claimant’s RFC is “what [the claimant] can still do” despite his or her “physical or mental
limitations.” 20 C.F.R. § 416.945(a)(1). This “is a medical question,” Lauer v. Apfel,
245 F.3d 700, 704 (8th Cir. 2001), and must be supported by “some medical evidence.”
Dykes v. Apfel, 223 F.3d 865, 867 (8th Cir. 2000) (per curiam). The medical evidence
should address the claimant’s “ability to function in the workplace.” Lewis, 353 F.3d at
646. At Step Four, the claimant has the burden to prove his RFC and the ALJ determines
the RFC based on all relevant evidence. See Harris v. Barnhart, 356 F.3d 926, 930 (8th
Cir. 2004).
The ALJ is not required to mechanically list and reject every possible limitation.
McCoy v. Astrue, 648 F.3d 605, 615 (8th Cir. 2011). Furthermore, “[a]n ALJ’s failure
to cite specific evidence does not indicate that such evidence was not considered.”
Wildman v. Astrue, 596 F.3d 959, 966 (8th Cir. 2010) (quoting Black v. Apfel, 143 F.3d
383, 386 (8th Cir. 1998)). “[T]he ALJ may reject the conclusions of any medical expert,
whether hired by a claimant or by the government, if inconsistent with the medical record
as a whole.” Bentley v. Shalala, 52 F.3d 784, 787 (8th Cir. 1995). The RFC must only
include those impairments which are substantially supported by the record as a whole.
Goose v. Apfel, 238 F.3d 981, 985 (8th Cir. 2001); see also Forte v. Barnhart, 377 F.3d
892, 897 (8th Cir. 2004).
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1.
Physical RFC
Barron notes that in his first decision, the ALJ found that she could lift 20 pounds
occasionally and 10 pounds frequently, but in his subsequent decision he found she could
lift 30 pounds occasionally and 20 pounds frequently. Doc. No. 13 at 10-12; AR 27, 174.
Barron contends that the ALJ failed to explain this change and that the second finding
is not supported by the record. This argument does not merit reversal.
First, because the Appeals Council vacated the ALJ’s initial decision, AR 186, it is
not binding on either party. 20 C.F.R. § 416.1455(c). On remand, the ALJ was entitled
to take any additional action that was not inconsistent with the Appeals Council’s remand
order. 20 C.F.R. § 416.1477(b). The Appeals Council informed the ALJ that he should
give further consideration to Barron’s maximum RFC. AR 188. He did. The ALJ acted
within his authority by revisiting Barron’s physical RFC.
Second, both of the ALJ’s RFC determinations included a finding that Barron had the
RFC to perform light work. AR 20, 27. The jobs the VE identified involve only light
exertional work. AR 25, 31, 86. The VE provided Dictionary of Occupational Titles
(DOT) codes for the identified jobs and noted that he was only considering the light
exertional category of jobs. AR 86-87. The DOT defines a production assembler, machine
packager and housekeeper/cleaner occupations as light exertion jobs. See DOT Nos.
706.687-010, 920.685-078, and 323.687-014, respectively. By definition, such jobs
would not require Barron to lift more than 10 pounds frequently and 20 pounds
occasionally in these jobs. See 20 C.F.R. § 416.967(b). Those jobs thus fell within the
ALJ’s first, more-restrictive physical RFC finding. Barron has not shown that the
ALJ’s alleged error with regard to the second RFC finding had any potential impact on
the disposition of this case. Shinseki v. Sanders, 556 U.S. 396, 409-410 (2009); Barnett
v. Apfel, 231 F.3d 687, 689 (10th Cir. 2000).
Finally, at the time of the second hearing the ALJ had the benefit of new evidence in
the form of findings made by Douglas Martin, M.D., after a comprehensive consultative
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examination on April 16, 2013. AR 907-11. Dr. Martin found that Barron could lift and
carry up to 30-35 pounds occasionally and up to 20 pounds frequently. AR 910. Thus,
the medical evidence of record supports the ALJ’s finding, in the second RFC, that
Barron could lift 30 pounds occasionally and 10 pounds frequently beginning July 31, 2012.
AR 27.
2.
Mental RFC
Barron contends that substantial evidence does not support the ALJ’s mental RFC
because the opinion of Michael Baker, Ph.D., is vague, and Scott Shafer, Ph.D., erred in
stating Barron was noncompliant with her medication treatment. Doc. No. 13 at 13-15.
The Commissioner disagrees.
Dr. Baker conducted a one-time consultative examination on August 17, 2009. AR
539-40. The ALJ acknowledged that he included some of Dr. Baker’s limitations in
formulating Barron’s mental RFC. AR 22. Specifically, the ALJ incorporated Dr. Baker’s
limitations of (a) jobs that involve no more than minimal interaction with the public,
coworkers and supervisors, (b) the need for repetitive work and (c) jobs that do not require
significant concentration or judgment. AR 22, 539. The ALJ noted, “There is no basis
in the record to support a conclusion that Dr. Baker’s opinion should be interpreted as
suggesting greater limitations before April 1, 2011.” AR 22. Dr. Baker explicitly stated
the abilities and limitations he believed Barron possessed. AR 539-40.
Barron complains that the ALJ should have interpreted Dr. Baker’s opinion as being
more restrictive in light of the fact that Dr. Baker assigned a Global Assessment of
Functioning (GAF) score of 50.3 However, the Commissioner has declined to endorse
3
A GAF score represents a clinician's judgment of an individual's overall ability to function in
social, school or occupational settings, not including impairments due to physical or
environmental limitations. See American Psychiatric Ass'n, Diagnostic & Statistical Manual of
Mental Disorders 34 (4th ed. 1994) (DSM–IV). GAF scores between 41 and 50 indicate that the
individual has serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent
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GAF scores in disability analysis and has determined that GAF scores have no “direct
correlation” to disability adjudications. 65 Fed. Reg. 50746, 50764-65 (Aug. 21, 2000);
accord Jones v. Astrue, 619 F.3d 963, 973-74 (8th Cir. 2010). Indeed, the latest version
of the Diagnostic and Statistical Manual of Mental Disorders has discontinued the use of
GAF scores because of “its conceptual lack of clarity . . . and questionable psychometrics
in routine practice.” American Psychiatric Ass’n, Diagnostic & Statistical Manual of
Mental Disorders 16 (5th ed. 2013) (DSM-V). Moreover, the Commissioner’s regulations
and rulings define the term “medical opinion” as including statements that discuss the
particular activities an individual can still do in terms of walking, lifting, seeing, and
remembering instructions. See 20 C.F.R. § 416.927(a)(2); SSR 96-5p, at *4. Thus, a
GAF score does not qualify as an opinion. I find no error in the ALJ’s failure to give
weight to the fact that Dr. Baker assigned a GAF score of 50.
The ALJ also discussed Dr. Shafer’s opinion that Barron “might only be able to
interact with the public, coworkers and supervisors on a superficial level.” AR 22, 557.
The ALJ noted that Dr. Shafer was impressed with Barron’s good response to her
medication regimen but noted that she was not fully compliant. Id. Barron argues that
Dr. Shafer was mistaken about her compliance. Doc. No. 13 at 14-15. However, records
from the Iowa Bureau of Prisons indicate Barron was noncompliant with medications on
two separate occasions and she did not take lithium medication that her doctor had
prescribed three weeks earlier. AR 520. Records from February 2009 specifically note
that Barron’s symptoms “definitely stabilized” and she “has done very well on
medications.” AR 509. Thus, the point of Dr. Shafer’s remark was that the records
showed Barron’s medications helped control her mental functioning when she took them.
Impairments that treatment or medication can control are not disabling. Buckner v. Astrue,
shoplifting) or a serious impairment in social, occupational or school functioning (e.g., no friends,
unable to keep a job). Id.
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646 F.3d 549, 557 (8th Cir. 2011); Gates v. Astrue, 627 F.3d 1080, 1082 (8th Cir. 2010);
Schultz v. Astrue, 479 F.3d 979, 983 (8th Cir. 2007).
For all of these reasons, I find that there is substantial evidence in the record to
support the ALJ’s RFC assessments, both physical and mental.
B.
The ALJ Properly Considered the Medical Opinions
The medical experts gave opinions that cut both ways. The ALJ analyzed those
opinions and considered the record as a whole to determine the weight to afford to each.
I find that in arriving at his RFC finding, the ALJ properly considered and weighed the
opinions of Thomas England, Ph.D., Dr. Baker, Dr. Shafer, Advanced Practice
Registered Nurse (APRN) Carla Mundt, Licensed Independent Social Worker (LISW)
Joann Martin, Ronald Brinck, M.D., Bushra Nauman, M.D., and Denise Marandola,
Ph.D. AR 22-30.
An ALJ is free to reject medical opinions, or parts of medical opinions, that are
inconsistent with the author’s own treatment notes or other evidence of record. Hacker,
459 F.3d at 937; 20 C.F.R. § 416.927(d)(2). Also, when medical providers base their
opinions on a claimant’s subjective statements rather than clinical findings, the opinions
are not binding on the ALJ. See SSR 96-2p, 1996 WL 374188, at *1; Rankin v. Apfel,
195 F.3d 427, 430 (8th Cir. 1999); Gaddis v. Chater, 76 F.3d 893, 895 (8th Cir. 1996)
(physician’s opinion properly discounted as being based on plaintiff’s complaints and not
physician’s findings). The ALJ is not required to give any weight to opinions that the
medical provider does not link to clinical evidence with any reasoning or analysis.
Edwards v. Barnhart, 314 F.3d 964, 967 (8th Cir. 2003); Haggard v. Apfel, 175 F.3d
591, 595 (8th Cir. 1999). The lack of supportability in an opinion is a factor that justifies
according it less than controlling weight. See 20 C.F.R. § 416.927(c)(3).
Here, Barron complains that the ALJ failed to give proper weight to the opinions
from LISW Martin in July 2011, Dr. Brinck in February 2012, and Dr. Nauman in July
15
2012. See Doc. No. 13 at 20-22. However, these opinions concern Barron’s condition
during the period of time the ALJ found her to be disabled. In fact, the ALJ specifically
noted the opinions from Dr. Brinck and Dr. Nauman while explaining his decision to
award a closed period of disability in this case. AR 26.
The ALJ pointed out that Dr.
Brinck opined that Barron could not maintain gainful employment and noted that in early
July 2012, Dr. Nauman reported that she was responding “very well” to treatments for
cervical facet pain syndrome, but not completely. Id. Barron has not shown reversible
error in the ALJ’s consideration of the evidence from Drs. Brinck and Nauman.
Further, the ALJ properly considered the September 2010 conclusory opinion from
LISW Martin at Siouxland Mental Health Center (SMHC). AR 22-23. After a brief
description of Barron’s diagnoses and medication, Martin stated: “At this time, I do not
believe she is capable of competitive employment.” AR 623.
The ALJ determined that
the opinion was entitled to no weight because it was out of proportion with the objective
evidence and LISW Martin’s own treatment notes, she relied quite heavily on Barron’s
subjective statements over the objective evidence, and it was conclusory with very little
explanation of the evidence relied upon. AR 23. As noted, these are legitimate reasons
for discounting an opinion.
For example, the clinical findings on the same date as Martin’s September 2010
opinion indicate that Barron’s mood was euthymic with a congruent affect, appearance
was casually dressed and clean, speech was normal in rate and tone, motor skills had no
apparent abnormalities, judgment was good, insight was fair, and concentration and
memory had no problems. AR 752. 4
In light of the normal clinical findings in the
4
Examination of Martin’s and her SMHC co-workers’ treatment notes show that Barron’s mental
status examinations repeatedly showed she was casually dressed and groomed, her speech was at
a normal rate and tone, there were no apparent motor activity abnormalities, she had good
concentration, memory, and judgment, and her thoughts were linear, logical and goal directed.
AR 564-566, 568, 570, 572, 574, 576, 578, 581, 584, 729, 732, 734, 736, 738, 740, 743, 745,
747, 752, 755, 757, 760, 763, 766, 770, 772, 775, 779, 783, 788, 793, 799, 804, 808, 811, 814,
818, 820, 823, 827, 829, 833, 838, 1106, 1121, 1132, 1136, 1144, 1146, 1149, 1151, 1156,
1158, 1161, 1165, 1168, 1176, 1180, 1182, 1184, 1186, 1188.
16
treatment records, the ALJ was entitled to conclude that Martin inappropriately relied on
Barron’s subjective complaints over the clinical findings. Also, an opinion stating that a
claimant is “disabled,” “unable to work,” or the like is not a medical opinion. See, e.g.,
Renstrom v. Astrue, 680 F.3d 1057, 1065 (8th Cir. 2012) (opinion that claimant was
“totally disabled” gets no deference because it invades the province of the Commissioner
to make the ultimate disability determination); Ellis v. Barnhart, 392 F.3d 988, 994 (8th
Cir. 2005) (a medical source opinion that an applicant is “disabled” or “unable to work”
involves an issue reserved to the Commissioner and therefore is not the type of “medical
opinion” to which the Commissioner gives controlling weight); 20 C.F.R. § 416.927(e);
SSR 96-5p, at *5.
Barron also references the one-time examination and opinion of APRN Mundt from
Catholic Charities Omaha. See Doc. No. 13 at 20. On April 6, 2009 (about two weeks
after Barron’s alleged disability onset date), Mundt stated: “I urged her to apply for
disability since she will never be able to obtain gainful employment.” AR 532. Again,
this statement is not a “medical opinion” and is entitled to no deference.
Mundt also wrote that Barron was fully oriented, made direct eye contact, was
casually dressed, had a full affect, and her mood was only somewhat depressed. Id. She
reported that Barron’s speech had average spontaneity and productivity, with good fluency
and no pressure, and thought process was organized with no obsessions, tangentially, loss
of associations, flight of ideas, or racing thoughts. Id. Mundt found Barron to be alert,
to have above-average intelligence and fund of knowledge, and to have some insight
into her problems and past behaviors. Id. Nonetheless, Mundt wrote a letter stating
that Barron had racing thoughts, auditory hallucinations, dissociative episodes and
general problems with concentration and focus, which, when added to her obsessivecompulsive disorder, “would make it nearly impossible to stay on task in any type of
work setting.” AR 533. The ALJ was entitled to find, as he did, that Mundt’s opinions
were inconsistent with her own clinical findings.
17
Barron further relies on a statement from Dr. Marandola that her attention and
concentration are poor, she would have difficulty interacting with supervisors, coworkers, and the public, and she had a history of poor judgment and would have difficulty
adjusting to changes in a work environment. See Doc. No. 13 at 22 (citing AR 927-28).
The ALJ acknowledged Dr. Marandola’s opinion and determined that it was entitled to
some weight.
AR 29.
The ALJ accordingly included restrictions in his RFC that
incorporated some of Dr. Marandola’s findings. For example, the ALJ determined that
Barron should only perform jobs where interaction with the public, supervisors, and peers
should be minimized or not occur; and any work should have minimal change and be
repetitive in nature without the need to concentrate or change from one task to another.
AR 20-21, 27-28.
Finally, the ALJ did not err in relying on Dr. England, a medical expert who
testified at Barron’s hearings. Dr. England provided opinions based on his review of
clinical findings. AR 116-37. The ALJ pointed out that Dr. England found no basis for
concentration problems based on Barron’s performances in intelligence and memory tests.
AR 23, 70-71, 122-23. Dr. England also testified about Barron’s mental health history
and how the record did not indicate that she consistently had hallucinations or psychotic
syndromes for the required 12 months. AR 23, 71, 118.
The ALJ noted Dr. England’s testimony that Barron’s obsessive compulsive
disorder and posttraumatic stress disorder were fairly well controlled, but she still had
difficulty being around people. AR 23, 72-73, 119-20, 133. Dr. England testified that
treatment personnel had not consistently diagnosed a personality disorder during the
adjudicated period and that the record did not support a finding that Barron was unable to
perform all work before April 2011. AR 23-24, 73, 120-121. The ALJ was entitled to
find that this testimony was consistent with the objective evidence supporting the denial of
benefits for the adjudicated period before April 2011.
18
The ALJ also relied on Dr. England’s testimony to find that Barron satisfied Listing
12.04 for the period between April 1, 2011 and July 2012, but not before or after. AR
25-26, 76. Dr. England testified that during that period of time there was evidence of
“some pretty fair instability,” AR 76, with evidence that Barron’s functioning significantly
improved after a treatment regimen started in early July 2012. AR 25-26, 77-78. The
ALJ also noted that Dr. England testified that Barron’s mental and physical conditions
improved after July 2012 to the point that while she still had some symptoms, they were
not at the disabling level. AR 30.
Based on his consideration of the record as a whole, the ALJ found that Barron had
some limitations but retained the physical and mental RFC to perform particular jobs, as
identified by the VE. AR 25, 31. This court may not simply reweigh the medical
evidence. Wildman, 596 F.3d at 964; McKinney, 228 F.3d at 863; Loving v. Dep’t of
Health & Human Servs., 16 F.3d 967, 969 (8th Cir. 1994). It is the ALJ’s function to
resolve conflicts among the opinions of various treating and examining physicians.
Wagner v. Astrue, 499 F.3d 842, 848 (8th Cir. 2007). The court must defer to the ALJ’s
resolution of the conflicts in the record. Even if the court would have decided the matter
differently had it been in the ALJ’s position, and even if substantial evidence may have
supported another finding, the Court cannot reverse an ALJ’s decision that is supported by
substantial evidence. Haley v. Massanari, 258 F.3d 742, 747 (8th Cir. 2001). Based on
my review of the record as a whole, I find that to be the case here.
C.
Compliance with the Appeals Council’s Order
The Appeal Council, in remanding the case for additional proceedings, provided
various directions to the ALJ. AR 187-89. Barron contends that the ALJ failed to comply
with those directions, particularly with regard to Dr. England. Doc. No. 13 at 26-29.
The Appeals Council directed the ALJ to “further consider Dr. England’s opinion and
resolve inconsistencies between the opinion and the decision’s findings.” AR 187.
19
As discussed above, the ALJ expressly addressed Dr. England’s testimony on
remand and concluded that his opinions were entitled to significant weight. AR 23-24,
30. I have already found that the ALJ’s findings as to Barron’s physical and mental RFC
are supported by substantial evidence in the record as a whole. I also note that the Appeals
Council had the opportunity to consider whether the ALJ complied with remand directions
but declined to grant Barron’s request for review of the second ALJ decision. AR 1-4.
For these reasons, I find no reversible error.
VI.
CONCLUSION
After a thorough review of the entire record and in accordance with the standard
of review I must follow, I conclude that the ALJ’s determination that Barron was not
disabled within the meaning of the Act is supported by substantial evidence in the record.
Accordingly, the final decision of the Commissioner is affirmed. Judgment shall enter
against Barron and in favor of the Commissioner.
IT IS SO ORDERED.
DATED this 22nd day of February, 2016.
________________________________
LEONARD T. STRAND
UNITED STATES DISTRICT JUDGE
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