Spuhler v. Social Security, Commissioner of

Filing 18

ORDER Denying 10 Motion for Summary Judgment; Granting 12 Motion for Summary Judgment; Adopting in part 14 Report and Recommendation; and Dismissing Case. Signed by District Judge Stephen J. Murphy, III. (CCoh)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MICHIGAN
SOUTHERN DIVISION
DAWN N. SPUHLER,
Plaintiff,

Case No. 2:13-cv-12272

v.

HONORABLE STEPHEN J. MURPHY, III

CAROLYN W. COLVIN, Commissioner
of Social Security,
Defendant.
/
ORDER DENYING SPUHLER’S SUMMARY JUDGMENT MOTION
(document no. 10), GRANTING THE COMMISSIONER'S SUMMARY
JUDGMENT MOTION (document no. 12), ADOPTING MAGISTRATE'S REPORT AND
RECOMMENDATION IN PART(document no. 14), AND DISMISSING CASE
Dawn Spuhler filed a claim for social security insurance benefits under Title II of the
Social Security Act. 42 U.S.C. § 401 et seq. (2014). The Administrative Law Judge denied
her petition. Spuhler's administrative appeal was also denied, making the agency’s
determination final. Spuhler appealed the entire decision to the district court under 42
U.S.C. § 405(g), and both parties filed motions for summary judgment. The Court referred
the case to a magistrate judge. The magistrate judge issued a Report and
Recommendation recommending that Spuhler’s case be dismissed. Spuhler filed several
objections. The Court has studied the magistrate’s report, read the briefs, and will dismiss
the case.
BACKGROUND
I.

Underlying Facts About Spuhler's Depression And Anxiety
Dawn Spuhler was a forty five year old woman at the time of the last administrative

hearing. She worked for the United States Postal Service for nearly 25 years. She is
married and has three children. Starting in 2006, Dr. Junaid Ghadai began treating Spuhler

for depression and anxiety. He saw her once every other week through 2011. Tr., ECF No.
7, at 264–68, 344–65. His medical notes consistently state that she was depressed and
anxious. And he placed her on an extensive list of medications, including Celexa, Requip,
Panax, Effexor XR, Lexapro, Ambien, Restoril, Rozerem, and Seroquel. Id. at 305.
In May of 2010 her psychological situation deteriorated. At work her boss berated her
and, eventually, the Postal Service eliminated her part-time position, stating that it could
not accommodate her physical limitations.1 Id. at 41. The next day, she told Dr. Ghadai that
she wanted to commit suicide. Id. at 269. He put her into an inpatient treatment program
at Oakwood Heritage Hospital, where she stayed for almost two weeks.
She left the hospital once insurance would no longer pay for her stay. Id. at 44. After
leaving the hospital, she rarely left her house, sometimes staying inside four to five days
per week. Id. at 55. Normally, she would sleep until eleven o'clock and nap throughout the
day. Id. at 51–52. She also testified that she would have panic attacks around people,
sometimes as often as three times per week. Id. at 56. Spuhler then applied for disability
benefits.
II.

The Administrative Law Judge's Determination
The ALJ issued a written opinion denying Spuhler's application for disability benefits.

He applied the five step sequential analysis required by Social Security Administration
regulations. See 20 C.F.R. § 416.905(a). First, he found that she was not currently
engaging in substantial gainful employment. Second, he determined that she had several

1

In addition to suffering from depression and anxiety, Spuhler had foot and hip pain that
limited the amount and type of work that she could do at the Post Office. The ALJ's findings
regarding her physical limitations were not appealed.
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severe impairments, including obesity, anxiety, and depression. Third, he found that none
of her limitations qualified as a listed impairment.
Before moving on to step four, he determined her residual functional capacity ("RFC"),
an assessment of her remaining capacity for work once her limitations have been taken into
account. Howard v. Comm. of Soc. Sec., 276 F.3d 235, 239 (6th Cir. 2002). The ALJ began
by noting that Dr. Ghadai had submitted a psychiatric narrative report detailing Spuhler's
treatment history. The report stated that he was treating her for depression and anxiety.
She complained of feelings "of depression, worthlessness, helplessness, and
hopelessness." Tr., ECF No. 7, at 28, 305. According to Dr. Ghadai, she "experiences
excessive worries, lack of interest and lack of energy, and inability to concentrate." Id. at
305. He also assigned her a current Global Assessment of Function (GAF) score of 35,
which indicates major impairment in areas such as work, school, family relations, judgment,
thinking, or mood. Id. at 306.
The ALJ gave the GAF score little weight. He noted that Dr. Ghadai's treatment notes
stated that she "was cooperative, had good eye contact, was oriented times three, fair
insight, and grossly intact memory." Id. at 28. Furthermore, Dr. Ghadai's psychiatric
narrative stated that she was sleeping well and that she thought her medications were
working. Id. at 28, 305. Furthermore, she had neither suicidal nor manic tendencies. Id. He
also stated that her "daily living activities and level of social functioning do not support the
low GAF assessment." Id. He noted that while she has problems around people, "she
spends time with her family, goes to the casino, grocery shops, and goes to the
amusement park or zoo." Id. at 29, 178. Finally, he stated that Spuhler "had improvement
in her mental health symptoms through psychotherapy and medication management." Id.
3

After examining the record, the ALJ found that she had the mental capacity to do
"simple, routine, and repetitive tasks" in "a work environment free of fast paced production
requirements" that involved only simple decisions and few workplace changes. Id. at 25.
It further found that she should "have no interaction with the public" and "only occasional
interaction with coworkers, but no tandem tasks." Id. He stated that the RFC was consistent
with many of her described limitations.
Having found that she had the capacity to do only simple, routine tasks in a low stress
environment, the ALJ determined that she could not continue with her previous work at the
post office. Id. at 29. Nonetheless, he found that there were a substantial number of jobs
in the national economy that she was capable of performing. He therefore denied her
application.
STANDARD OF REVIEW
A claimant may appeal a Social Security Administration decision to a United States
district court. 42 U.S.C. § 405(g). The district court's review, however, "is limited to
determining whether the Commissioner's decision is supported by substantial evidence and
was made pursuant to proper legal standards." Grayheart v. Comm. of Soc. Sec., 710 F.3d
365, 374 (6th Cir. 2013) (citations omitted). Substantial evidence is "such relevant evidence
as a reasonable mind might accept as adequate to support a conclusion." Id. (citations
omitted). A reviewing court will affirm the Commissioner's decision "if it is based on
substantial evidence, even if substantial evidence would also have supported the opposite
conclusion. Id. (citations omitted). Nonetheless, an "ALJ's failure to follow agency rules and
regulations denotes a lack of substantial evidence, even where the conclusion of the ALJ
may be justified based on the record." Id. (citations omitted).
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DISCUSSION
This case presents two questions. First, did the ALJ appropriately evaluate Dr.
Ghadai’s narrative report, and especially the GAF score? Second, if the ALJ appropriately
devalued the GAF score, was there other substantial evidence justifying his RFC
determination?
The Court finds the ALJ correctly evaluated the narrative report. In particular, the GAF
score, standing alone, does not constitute a treating source opinion. Thus, it does not fall
within the treating source rule. Furthermore, other substantial evidence in the record
supported the RFC decision. Accordingly, the Court will dismiss the case.
I.

The Treating Source Rule Does Not Apply Because
The GAF Score Is Not An Opinion Entitled To Deference
Spuhler argues that the ALJ failed to properly apply the treating source rule. Social

Security regulations state that when "a treating source's opinion on the issue(s) of the
nature and severity of [the claimant's] impairment(s) is well-supported by medically
acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the
other substantial evidence in [the claimant's] case record, [the Commissioner] will give it
controlling weight." 20 C.F.R. § 404.1527(c)(2).
The Commissioner argues that Dr. Ghadai never submitted an actual opinion. The
Court agrees that Dr. Ghadai's narrative report is short on concrete limitations. It states that
Spuhler has depression and anxiety. But the closest thing the narrative report contains to
a limitation is the assertion that Spuhler has an "inability to concentrate." Tr., ECF No. 7,
at 305. Moreover, it is not clear if this is Dr. Ghadai's conclusion or merely a report of
Spuhler's complaints.

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The narrative report also gives her a GAF score of 35. But a GAF score is a
generalized assessment that notes some major impairment in work, school, family
relations, judgment, thinking, or mood. Without more, it does not help the ALJ articulate
specific limitations on her ability to work. As both the magistrate and the Commissioner
point out, courts consistently devalue GAF scores that are inconsistent with other evidence.
See Report, ECF No. 14, at 29; Def.'s Resp., ECF No. 16, at 4. The Sixth Circuit has
concluded that a "GAF score is not particularly helpful by itself." Oliver v. Comm. of Soc.
Sec., 415 F. App'x 681, 684 (6th Cir. 2011). Similarly, the Regulations put little weight on
the score. See 65 C.F.R. 50746, 50764–65 ("[GAF Score] does not have a direct
correlation to the severity requirements in our mental disorders listing."). Indeed, the Court
has been unable to locate a single case stating that a GAF score, by itself, constitutes a
treating source opinion entitled to deference.
Furthermore, an “ALJ is not bound by conclusory statements of doctors, particularly
where they are unsupported by detailed objective criteria.” Buxton v. Halter, 246 F.3d 762,
773 (6th Cir. 2001) (citations omitted). The Sixth Circuit has criticized GAF scores for being
a "subjective determination." Oliver, 415 F. App'x at 684. That critique is especially
pertinent when, as here, the doctor did not provide any objective criteria justifying the low
score. Indeed, Dr. Ghadai gave Spuhler a GAF score of 35, yet he did not explain why that
score was appropriate, or how that score might translate into specific limitations. Instead,
it is unsupported. And generalized, unsubstantiated evidence is not an opinion entitled to
controlling weight.

II.

The ALJ’s Determination Is Supported By Substantial Evidence
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The ALJ determined that Spuhler had the mental capacity to do "simple, routine, and
repetitive tasks" in "a work environment free of fast paced production requirements" that
involved only simple decisions and few workplace changes. Tr. ECF No. 7, at 25. It further
found that she should "have no interaction with the public" and "only occasional interaction
with coworkers, but no tandem tasks." Id. As the ALJ explained, these limitations account
for many of Spuhler’s symptoms of depression and anxiety. The question is whether the
ALJ articulated sufficient reasons justifying that residual functional capacity.
Dr. Ghadai’s narrative report provided evidence supporting the ALJ’s determination.
Dr. Ghadai stated that Spuhler “did not have suicidal or homicidal ideas.” Id. at 305. Nor
did she have “symptoms suggestive of mania, hypomania, or psychosis.” Id. Her sleep has
improved due to medication, and she “believes that the meds she is on are helping her.”
Id. The ALJ noted each of these findings in it opinion. Id. at 28.
Furthermore, his RFC determination accounted for Spuhler's own description of her
limitations. She stated that she had difficulty remembering things, and that she became
anxious around people she did not know. She was able to cook for her family, do light
chores, and shop each week. Id. at 175–77. To be sure, these statements are consistent
with a person that has severe limitations. Yet, the ALJ stated that he took the “claimant’s
alleged symptoms into consideration and limited the claimant to simply work, with no
interaction with the public; only occasional interaction with coworkers, and no tandem
tasks." Id. at 29. Thus, his RFC determination accounted for many of Spuhler’s
psychological limitations.2

2

While the magistrate judge makes some reliance on Dr. Ghadai's handwritten notes
about eye contact and other matters, the Court is not prepared to second-guess Dr.
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Spuhler contends that, in the absence of any medical opinion on the record, the ALJ
could not determine her RFC. Social Security Regulations provide that “[i]f any of the
evidence in your case record, including any medical opinion(s), is inconsistent, we will
weigh the relevant evidence and see whether we can determine whether you are disable
based on the evidence we have.” 20 C.F.R. § 416.920b(b). This regulation allows the ALJ
to weigh all of the evidence when no medical opinion is given controlling weight.
For example, in Her v. Comm. of Soc. Sec., 203 F.3d 388 (6th Cir. 1999), the plaintiff
complained of depression and hallucinations. In support, she proffered the opinion of one
doctor that stated she was depressed and suffered from a GAF score of 25–30. Id. at 390.
The ALJ determined that the opinion was not credible, and that Her could perform light
unskilled work. On appeal, Her argued that once the ALJ discarded the only medical
opinion, he could not determine Her's residual functional capacity. The Court rejected this
argument, stating "it is not unfair to require the claimant to prove the extent of his
impairments." Id. at 391. It therefore "reject[ed] plaintiff's contention that once the burden
of proof shifts to the Commissioner at step five, the Commissioner is then required to prove
a claimant's Residual Functional Capacity." Id. The Court concluded by finding that the ALJ
had substantial evidence to support his determination.

Ghadai's determination merely because Spuhler made good eye contact or spoke in
coherent sentences. The Court does not know whether if it is inconsistent for a person with
depression to make eye contact with their psychologist, and the issue is one example of
why the regulations put stock in the competence of medical professionals. But, as
demonstrated infra, even ignoring the treatment notes, there is substantial evidence
supporting the ALJ’s residual functional capacity determination.
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The same principles apply here. Spuhler had the burden to demonstrate what she
was capable or not capable of doing. Yet, the record lacks any psychological opinion
detailing her limitations. As in Her, the ALJ was justified in examining all of the evidence
and determining Spuhler's capacity, notwithstanding the absence of a conclusive medical
opinion.
Finally, Spuhler argues the ALJ should have ordered a psychiatric evaluation. The
Regulations provide discretion for an ALJ to order additional tests if, "after weighing the
evidence we determine we cannot reach a conclusion about whether you are disabled." 20
C.F.R. § 416.920b(c). There is no mandate, however, that the ALJ order additional testing
if the evidence is sufficient to make a disability determination. As explained above, the
ALJ's determination that Spuhler could work in a setting with little stimulation or
interpersonal contact was supported by the evidence. Thus, no additional testing was
required.
CONCLUSION
The Court determines that the GAF score, standing alone, was not an "opinion"
sufficient to trigger the treating source rule. The Court further finds the capacity
determination to be supported by substantial evidence in the record.

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ORDER
WHEREFORE, it is hereby ORDERED that the Commissioner's Summary Judgment
Motion (document no. 12) is GRANTED and the case DISMISSED.
IT IS FURTHER ORDERED that Spuhler's summary judgment motion (document no.
10) is DENIED.
IT IS FURTHER ORDERED that the Court ADOPTS IN PART the magistrate's report
and recommendation (document no. 14).
SO ORDERED.

s/Stephen J. Murphy, III
STEPHEN J. MURPHY, III
United States District Judge
Dated: September 30, 2014
I hereby certify that a copy of the foregoing document was served upon the parties and/or
counsel of record on September 30, 2014, by electronic and/or ordinary mail.
s/Carol Cohron
Case Manager

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