Brown v. Astrue
Filing
23
MEMORANDUM OPINION. Signed by Magistrate Judge Timothy J. Sullivan on 9/12/13. (jnls, Deputy Clerk)
UNITED STATES DISTRICT COURT
DISTRICT OF MARYLAND
CHAMBERS OF
TIMOTHY J. SULLIVAN
UNITED STATES MAGISTRATE JUDGE
101 WEST LOMBARD STREET
BALTIMORE, MARYLAND 21201
(410) 962-4560
Fax (410) 962-3630
September 12, 2013
LETTER TO COUNSEL:
RE:
Monica R. Brown v. Commissioner of Social Security
Civil No. TJS-12-3073
Dear Counsel:
This matter is before me by the parties’ consent. ECF Nos. 3 & 7. On October 18, 2012,
Plaintiff Monica Brown (“Ms. Brown”) petitioned this Court to review the Social Security
Administration’s final decision to deny her claim for Supplemental Security Income (“SSI”) and
Disability Insurance Benefits (“DIB”). ECF No. 1. I have considered Ms. Brown’s Motion for
Summary Judgment (ECF No. 15) and the Commissioner’s Motion for Summary Judgment
(ECF No. 22). I find that no hearing is necessary. Loc. R. 105.6. This Court must uphold the
decision of the agency if it is supported by substantial evidence and if the agency employed the
proper legal standards. See 42 U.S.C. §§ 405(g), 1383(c)(3); Craig v. Chater, 76 F.3d 585, 589
(4th Cir. 1996). For the reasons that follow, I will grant the Commissioner’s motion and deny the
Plaintiff’s motion. This letter explains my rationale.
On September 9, 2009, Ms. Brown filed applications for SSI and DIB benefits alleging
disability commencing June 1, 2008. (Tr. 165-75). Ms. Brown’s claims were denied initially on
November 23, 2009 (Tr. 57-64), and upon reconsideration on June 30, 2010 (Tr. 78-81). A
hearing was held on April 7, 2011 before an Administrative Law Judge (“ALJ”). (Tr. 26-52).
Following the hearing, on April 20, 2011, the ALJ determined that Ms. Brown was not disabled
within the meaning of the Social Security Act during the relevant time frame. (Tr. 7-25). The
Appeals Council denied Ms. Brown request for further review of the ALJ’s decision. (Tr. 1-6).
The ALJ’s decision dated April 20, 2011 constitutes the final, reviewable decision of the agency.
The ALJ evaluated Ms. Brown’s claim for benefits using the five-step sequential
evaluation process set forth in 20 C.F.R. §§ 404.1520, 416.920. At step one, the ALJ found that
Ms. Brown was not engaged in substantial gainful activity, and had not been engaged in
substantial gainful activity since June 1, 2008. (Tr. 12). At step two, the ALJ found that Ms.
Brown suffered from the severe impairments of “affective disorders, diagnosed as bipolar
disorder, and adjustment disorder, and a personality disorder; inflammatory pelvic disease statuspost surgical intervention in 2006; Hepatitis B, and active substance abuse disorders (marijuana
and alcohol abuse).” (Tr. 12). At step three, the ALJ found that Ms. Brown’s impairments,
separately and in combination, failed to meet or equal in severity any listed impairment. (Tr. 13).
The ALJ then determined that, despite Ms. Brown’s severe impairments, she retained the
residual functional capacity (“RFC”) to:
perform medium work as defined in 20 CFR 404.1567(c) and 416.967(c), except
the claimant is limited to unskilled, routine and repetitive tasks. The claimant is
limited to occasional interaction with the public and co-workers.
(Tr. 21).
At step four, the ALJ determined that Ms. Brown has no past relevant work. (Tr. 24). At
step five, however, the ALJ determined that considering Ms. Brown’s “age, education, work
experience and residual functional capacity, there are jobs that exist in significant numbers that
[she] can perform.” (Tr. 26). As a result of this determination, the ALJ found that Ms. Brown
was not disabled during the relevant time frame.
Ms. Brown presents a number of arguments on appeal, which the Court has reorganized
as follows: (1) the ALJ misinterpreted a medical source’s opinion concerning Ms. Brown’s
mental limitations; (2) the ALJ improperly considered reports of consultative examiners where
no medical source statements were provided; and (3) the ALJ improperly considered Ms.
Brown’s Global Assessment of Functioning scores. I will address each argument in turn.
First, Ms. Brown argues that the ALJ failed to properly “consider every medical opinion
in the record.” ECF No. 15-1 at 7. In his written opinion, the ALJ stated:
I further note that Dr. Willis’ mental limitations on the claimant were only
moderate, not extreme like Dr. Joseph’s assessment. Dr. Willis’[ ] assessment of
the claimant’s mental limitations more closely approximates the State Agency’s
assessment and is more consistent with the totality of the evidence than Dr.
Joseph’s extreme opinion. I note that the claimant has been able to attend school
and cosmetology classes, which is completely inconsistent with an assessment
that the claimant has extreme limitations in mental functioning.
(Tr. 22). Ms. Brown notes that Dr. Ashley Willis’ Medical Report Form 402B dated September
10, 2010 (Tr. 558-563) states an opinion that Ms. Brown experiences difficulties in maintaining
concentration, persistence or pace “often.” (Tr. 561). The form Dr. Willis used to render this
opinion provides five checkboxes, labeled “none; seldom; often; frequent; constant,” for the
source to rate Ms. Brown’s degree of limitation with respect to maintaining concentration,
persistence or pace. (Tr. 561). Two of the other functional limitations set forth on the form
(restriction of activities of daily living and difficulties in maintaining social functioning), each
provide five checkboxes, labeled “none; mild; moderate; marked; extreme.” (Tr. 561). Ms.
Brown contends that by checking the option “often” rather than “seldom,” Dr. Willis meant to
convey her opinion that Ms. Brown’s difficulties with respect to maintaining concentration,
persistence or pace are more limited than “moderate.” ECF No. 15-1 at 7. This argument has no
merit. Unlike the options for “moderate,” “marked,” and “extreme,” the form Dr. Willis used did
not provide a definition for “often.” On the form, the checkbox for “often” is listed in the middle
of the choices and situated below the “moderate” choice for the other functional limitations.
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Ms. Brown suggests that the ALJ’s statement that “Dr. Willis’s assessment of the
claimant’s mental limitations more closely approximates the State Agency’s assessment” is a
“mis-categorization” (ECF No. 15-1 at 7) of Dr. Willis’s opinion. Id. Rather than rating Ms.
Brown’s limitations with respect to maintaining concentration, persistence or pace as “often”
(Dr. Willis’ opinion), the State Agency’s assessment was that her limitations are “moderate.”
(Tr. 550). For the same reasons stated above, I am not persuaded that there is any difference
between limitations that occur “often” and limitations that are “moderate,” given the nature of
the forms. The words used on the two forms are different, but the meanings appear to be
interchangeable upon examination of the forms.
Ms. Brown also argues that Dr. Willis “had more than an adequate basis for asserting that
[Ms. Brown] would often be deficient in concentration and pace.” ECF No. 15-1 at 7. This
argument, however, only supports the ALJ’s conclusion that Dr. Willis’ opinion concerning Ms.
Brown’s moderate mental limitations is “consistent with the totality of the evidence.” (Tr. 22).
Ms. Brown’s interpretation of the term “often” as being more limited than a “moderate” rating is
at the root of this argument. The ALJ did not reject Dr. Willis’ opinion with regard to this issue,
but instead interpreted Dr. Willis’ opinion differently than Ms. Brown. For the reasons stated
above, this argument is not persuasive.
Ms. Brown’s second argument is that the ALJ improperly gave significant weight to
consultative examination reports where the reports were not accompanied by any medical source
statement. ECF No. 15-1 at 8. Ms. Brown concedes that “the lack of a medical source statement
or residual functional capacity assessment does not invalidate a consultative examination,” but
contends that the consultative examinations are a “tremendous waste of money” without medical
source statements. ECF No. 15-1 at 8.
The regulations provide that
[a]lthough we will ordinarily request, as part of the consultative examination
process, a medical source statement about what you can still do despite your
impairment(s), the absence of such a statement in a consultative examination
report will not make the report incomplete.
20 C.F.R. § 404.1519n(c)(6); see also 20 C.F.R. § 416.919n(c)(6). Because the regulations
specifically indicate that the absence of a medical source statement does not make a consultative
examiner’s report incomplete, Ms. Brown’s argument is without merit. The ALJ properly
weighed the State Agency medical consultants’ assessments and consultative examination
reports, found that they were entitled to significant weight, and adequately explained his
reasoning. (Tr. 23).
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Ms. Brown also argues that the “ALJ tried to make something of the Axis V GAF[1] . . .
scores but the GAF scale does not have a direct correlation to the severity requirements in the
agency’s mental disorder listings.” ECF No. 15-1 at 8 (internal quotation omitted). Ms. Brown
is correct that “the Commissioner has declined to endorse the GAF scale for ‘use in the Social
Security and SSI disability programs,’ and has indicated that GAF scores have no ‘direct
correlation to the severity requirements of the mental disorders listings.’” Wind v. Barnhart, 133
F. App’x 684, 692 n.5, 2005 WL 1317040 (11th Cir. June 2, 2005) (quoting 65 Fed. Reg. 50746,
50764-65 (Aug. 21, 2000)) An ALJ, however, is not precluded from considering a claimant’s
GAF scores, together with other evidence of record, in evaluating a claimant’s mental
impairments and limitations. See Rios v. Comm'r of Soc. Sec., 444 F. App'x. 532, 535 (3d Cir.
2011) (finding that “[GAF scores] are only medical evidence that informs the Commissioner's
judgment of whether an individual is disabled”); Howard v. Comm'r of Soc. Sec., 276 F .3d 235,
241 (6th Cir. 2002) (stating that while a GAF score may be of “considerable help,” it is not
“essential” to determining an individual's residual functional capacity). Here, the ALJ properly
considered Ms. Brown’s GAF scores in combination with the other evidence of record. For
example, the ALJ noted that when Ms. Brown’s GAF scores rose from 45 to 50 in two weeks,
she had also resumed therapy and reported “already feeling better” and “that she was having
good days . . . and that she was enrolled in school and felt good about it.” (Tr. 23). Ms. Brown’s
argument that the ALJ improperly considered her GAF scores is without merit.
For the reasons set forth herein, Ms. Brown’s Motion for Summary Judgment (ECF No.
15) will be DENIED, and the Commissioner’s Motion for Summary Judgment (ECF No. 22) will
be GRANTED. The clerk is directed to CLOSE this case.
Despite the informal nature of this letter, it should be flagged as an opinion. An
implementing Order follows.
Sincerely yours,
/s/
Timothy J. Sullivan
United States Magistrate Judge
1
The Global Assessment of Functioning (“GAF”) scale is a method of considering
psychological, social, and occupational function on a hypothetical continuum of mental health.
Johnson v. Astrue, No. TMD-10-947, 2011 WL 5149574 at *2 (D. Md. Oct. 27, 2011) (citing
Diagnostic and Statistical Manual of Mental Disorders, Fourth Ed.). A GAF score is a
subjective determination that represents the clinician’s judgment of the
individual’s overall level of functioning. It ranges from 100 (superior functioning)
to 1 (persistent danger of severely hurting self or others, persistent inability to
maintain minimal personal hygiene, or serious suicidal act with clear expectation
of death).
White v. Comm’r of Social Sec., 572 F.3d 272, 276 (6th Cir. 2009) (citing Edwards v. Barnhart,
383 F. Supp. 2d 920, 924 n.1 (E.D. Mich. 2005))
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