Becker v. Colvin
MEMORANDUM AND ORDER re: 19 SOCIAL SECURITY CROSS BRIEF re 14 SOCIAL SECURITY BRIEF filed by Defendant Carolyn W. Colvin, 14 SOCIAL SECURITY BRIEF filed by Plaintiff Jean Becker. Judgment to follow.. Signed by Magistrate Judge Abbie Crites-Leoni on 3/31/15. (CSG)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
JEAN D. BECKER,
CAROLYN W. COLVIN,
Acting Commissioner of Social Security,
) Case No. 2:13CV00095 ACL
Plaintiff Jean D. Becker brings this action pursuant to 42 U.S.C. ' 405(g),
seeking judicial review of the Social Security Administration Commissioner’s
denial of her application for Disability Insurance Benefits under Title II of the Social
Security Act and Supplemental Security Income under Title XVI of the Act.
An Administrative Law Judge (ALJ) found that Becker had multiple severe
impairments, including several physical impairments, as well as mental impairments
and a history of cocaine abuse. Notwithstanding Becker’s severe physical and
mental impairments, the ALJ found that Becker was not disabled as she had the
residual functional capacity to perform the requirements of occupations such as
housekeeper, small product assembler, and electronics assembly, which exist in
significant number in the national economy.
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This matter is pending before the undersigned United States Magistrate
Judge, with consent of the parties, pursuant to 28 U.S.C. § 636(c). A summary of
the entire record is presented in the parties’ briefs and is repeated here only to the
extent necessary. Because substantial evidence supports the ALJ’s opinion, the
Commissioner’s decision denying benefits is AFFIRMED.
I. Procedural History
On October 22, 2010, Becker filed applications for Disability Insurance
Benefits (DIB) and Supplemental Security Income (SSI), claiming that she became
unable to work due to her disabling condition on May 8, 2004. (Tr. 146-59.)
Becker’s claims were denied initially. (Tr. 78-85.) Following an administrative
hearing, Becker=s claims were denied in a written opinion by an ALJ, dated
September 5, 2012. (Tr. 13-32.) Becker then filed a request for review of the
ALJ=s decision with the Appeals Council of the Social Security Administration
(SSA), which was denied on September 23, 2013. (Tr. 1-5.) Thus, the decision of
the ALJ stands as the final decision of the Commissioner. See 20 C.F.R. ''
In the instant action, Becker claims that the “ALJ erred by failing to provide
controlling weight to the treating physician, Dr. Curry, as required by SSR 96-2p”
(Doc. 14 at 7) and that the “ALJ did not provide a proper RFC determination as
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required by SSR 96-8p because the ALJ failed to explain how the evidence
supported his conclusions,” id. at 13.
II. Applicable Law
II.A. Standard of Review
The decision of the Commissioner must be affirmed if it is supported by
substantial evidence on the record as a whole. 42 U.S.C. § 405(g); Richardson v.
Perales, 402 U.S. 389, 401 (1971); Estes v. Barnhart, 275 F.3d 722, 724 (8th Cir.
2002). Substantial evidence is less than a preponderance of the evidence, but
enough that a reasonable person would find it adequate to support the conclusion.
Johnson v. Apfel, 240 F.3d 1145, 1147 (8th Cir. 2001). This “substantial evidence
test,” however, is “more than a mere search of the record for evidence supporting the
Commissioner’s findings.” Coleman v. Astrue, 498 F.3d 767, 770 (8th Cir. 2007)
(internal quotation marks and citation omitted). “Substantial evidence on the
record as a whole . . . requires a more scrutinizing analysis.” Id. (internal quotation
marks and citations omitted).
To determine whether the Commissioner's decision is supported by
substantial evidence on the record as a whole, the Court must review the entire
administrative record and consider:
The credibility findings made by the ALJ.
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The plaintiff's vocational factors.
The medical evidence from treating and consulting physicians.
The plaintiff's subjective complaints relating to exertional and
non-exertional activities and impairments.
Any corroboration by third parties of the plaintiff's
The testimony of vocational experts when required which is
based upon a proper hypothetical question which sets forth the
Stewart v. Secretary of Health & Human Servs., 957 F.2d 581, 585-86 (8th Cir.
1992) (internal citations omitted). The Court must also consider any evidence
which fairly detracts from the Commissioner’s decision. Coleman, 498 F.3d at
770; Warburton v. Apfel, 188 F.3d 1047, 1050 (8th Cir. 1999). However, even
though two inconsistent conclusions may be drawn from the evidence, the
Commissioner's findings may still be supported by substantial evidence on the
record as a whole. Pearsall v. Massanari, 274 F.3d 1211, 1217 (8th Cir. 2001)
(citing Young v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000)). “[I]f there is
substantial evidence on the record as a whole, we must affirm the administrative
decision, even if the record could also have supported an opposite decision.”
Weikert v. Sullivan, 977 F.2d 1249, 1252 (8th Cir. 1992) (internal quotation marks
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and citation omitted); see also Jones ex rel. Morris v. Barnhart, 315 F.3d 974, 977
(8th Cir. 2003).
II.B. Determination of Disability
To be eligible for DIB and SSI under the Social Security Act, plaintiff must
prove that she is disabled. Pearsall v. Massanari, 274 F.3d at 1217; Baker v.
Secretary of Health & Human Servs., 955 F.2d 552, 555 (8th Cir. 1992). The
Social Security Act defines disability 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 12 months." 42 U.S.C. §§
423(d)(1)(A), 1382c(a)(3)(A). An individual will be declared disabled "only if
h[er] physical or mental impairment or impairments are of such severity that [s]he is
not only unable to do h[er] previous work but cannot, considering h[er] age,
education, and work experience, engage in any other kind of substantial gainful
work which exists in the national economy." 42 U.S.C. §§ 423(d)(2)(A),
The SSA Commissioner has established a five-step process for determining
whether a person is disabled. See 20 C.F.R. '' 404.1520, 416.920; Bowen v.
Yuckert, 482 U.S. 137, 141-42 (1987); Fines v. Apfel, 149 F.3d 893, 894-95
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(8th Cir. 1998). First, it is determined whether the claimant is currently engaged in
Asubstantial gainful employment.@ If the claimant is, disability benefits must be
denied. See 20 C.F.R. '' 404.1520, 416.920 (b). Step two requires a
determination of whether the claimant suffers from a medically severe impairment
or combination of impairments. See 20 C.F.R '' 404.1520 (c), 416.920 (c). To
qualify as severe, the impairment must significantly limit the claimant=s mental or
physical ability to do Abasic work activities.@ Id. Age, education and work
experience of a claimant are not considered in making the Aseverity@ determination.
If the impairment is severe, the next issue is whether the impairment is
equivalent to one of the listed impairments that the Commissioner accepts as
sufficiently severe to preclude substantial gainful employment. See 20 C.F.R. ''
404.1520 (d), 416.920 (d). This listing is found in Appendix One to 20 C.F.R. 404.
20 C.F.R. pt. 404, subpt. P, App. 1. If the impairment meets or equals one of the
listed impairments, the claimant is conclusively presumed to be impaired. See 20
C.F.R. '' 404.1520 (d), 416.920 (d). If it does not, however, the evaluation
proceeds to the next step which requires an inquiry regarding whether the
impairment prevents the claimant from performing his or her past work. See 20
C.F.R. ' 404.1520 (e), 416.920 (e). If the claimant is able to perform the previous
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work, in consideration of the claimant=s residual functional capacity (RFC) and the
physical and mental demands of the past work, the claimant is not disabled. See id.
If the claimant cannot perform his or her previous work, the final step involves a
determination of whether the claimant is able to perform other work in the national
economy taking into consideration the claimant=s residual functional capacity, age,
education and work experience. See 20 C.F.R. '' 404.1520 (f), 416.920 (f). The
claimant is entitled to disability benefits only if s/he is not able to perform any other
work. See id. Throughout this process, the burden remains upon the claimant until
s/he adequately demonstrates an inability to perform previous work, at which time
the burden shifts to the Commissioner to demonstrate the claimant=s ability to
perform other work. See Beckley v. Apfel, 152 F.3d 1056, 1059 (8th Cir. 1998).
The evaluation process for mental impairments is set forth in 20 C.F.R. ''
404.1520a, 416.920a. The first step requires the Commissioner to Arecord the
pertinent signs, symptoms, findings, functional limitations, and effects of treatment@
in the case record to assist in the determination of whether a mental impairment
exists. See 20 C.F.R. '' 404.1520a (b) (1), 416.920a (b) (1). If it is determined
that a mental impairment exists, the Commissioner must indicate whether medical
findings Aespecially relevant to the ability to work are present or absent.@ 20 C.F.R.
'' 404.1520a (b) (2), 416.920a (b) (2). The Commissioner must then rate the
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degree of functional loss resulting from the impairments in four areas deemed
essential to work: activities of daily living, social functioning, concentration, and
persistence or pace. See 20 C.F.R. '' 404.1520a (b) (3), 416.920a (b) (3).
Functional loss is rated on a scale that ranges from no limitation to a level of severity
which is incompatible with the ability to perform work-related activities. See id.
Next, the Commissioner must determine the severity of the impairment based on
those ratings. See 20 C.F.R. '' 404.1520a (c), 416.920a (c). If the impairment is
severe, the Commissioner must determine if it meets or equals a listed mental
disorder. See 20 C.F.R. '' 404.1520a(c)(2), 416.920a(c)(2). This is completed by
comparing the presence of medical findings and the rating of functional loss against
the paragraph A and B criteria of the Listing of the appropriate mental disorders.
See id. If there is a severe impairment, but the impairment does not meet or equal
the listings, then the Commissioner must prepare a residual functional capacity
(RFC) assessment. See 20 C.F.R. '' 404.1520a (c)(3), 416.920a (c)(3).
II.C. Residual Functional Capacity (RFC)
RFC is the most a person can do despite that person’s limitations. 20 C.F.R.
' 404.1545(a)(1). It is assessed using all relevant evidence in the record. Id.
This includes medical records, observations of treating physicians and others, and
the claimant’s own descriptions of her limitations. Guilliams v. Barnhart, 393 F.3d
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798, 801 (8th Cir. 2005); Eichelberger v. Barnhart, 390 F.3d 584, 591 (8th Cir. 2004).
Limitations resulting from symptoms such as pain are also factored into the
assessment. 20 C.F.R. ' 404.1545(a)(3). The Eighth Circuit has held that a
“claimant’s residual functional capacity is a medical question.” Lauer v. Apfel, 245
F.3d 700, 704 (8th Cir. 2001). Therefore, an ALJ’s determination concerning the
claimant’s RFC must be supported by medical evidence that addresses the
claimant’s ability to function in the workplace. Lewis v. Barnhart, 353 F.3d 642,
646 (8th Cir. 2003). “[T]he ALJ is [also] required to set forth specifically a
claimant’s limitations and to determine how those limitations affect his RFC.” Id.
II.D. Opinion Evidence
In evaluating opinion evidence, the Regulations require the ALJ to explain in
the decision the weight given to any opinions from treating sources, non-treating
sources, and non-examining sources. See 20 C.F.R. §§ 404.1527(e)(2)(ii),
416.927(e)(2)(ii). The Regulations require that more weight be given to the
opinions of treating physicians than other sources. 20 C.F.R. §§ 404.1527(c)(2),
416.927(c)(2). A treating physician's assessment of the nature and severity of a
claimant's impairments should be given controlling weight if the opinion is well
supported by medically acceptable clinical and laboratory diagnostic techniques and
is not inconsistent with other substantial evidence in the record. 20 C.F.R. §§
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404.1527(c)(2), 416.927(c)(2); see also Forehand v. Barnhart, 364 F.3d 984, 986
(8th Cir. 2004). This is so because a treating physician has the best opportunity to
observe and evaluate a claimant's condition,
since these sources are likely to be the medical professionals most able
to provide a detailed, longitudinal picture of [a claimant's] medical
impairment(s) and may bring a unique perspective to the medical
evidence that cannot be obtained from the objective medical findings
alone or from reports of individual examinations, such as consultative
examinations or brief hospitalizations.
20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2). However, a medical source’s opinion
that an applicant is unable to work involves an issue reserved for the Commissioner
and is not the type of opinion which the Commissioner must credit. Ellis v.
Barnhart, 392 F.3d 988, 994-95 (8th Cir. 2005).
When a treating physician's opinion is not given controlling weight, the
Commissioner must look to various factors in determining what weight to accord the
opinion, including the length of the treatment relationship and the frequency of
examination, the nature and extent of the treatment relationship, whether the treating
physician provides support for his findings, whether other evidence in the record is
consistent with the treating physician's findings, and the treating physician's area of
specialty. 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2). The Regulations further
provide that the Commissioner “will always give good reasons in [the] notice of
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determination or decision for the weight [given to the] treating source's opinion.”
20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2).
II.E. Credibility Findings
An ALJ is required to consider all the evidence relating to a claimant’s
subjective complaints, including: (1) the claimant’s daily activities; (2) the duration,
frequency, and intensity of her pain; (3) precipitating and aggravating factors; (4)
dosage, effectiveness, and side effects of her medication; and (5) functional
restrictions. Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984). The
claimant’s work history and the absence of objective medical evidence to support
the claimant’s complaints are also relevant. Wheeler v. Apfel, 224 F.3d 891, 895
(8th Cir. 2000). The ALJ does not need to discuss each factor as long as he or she
acknowledges and considers the factors before discrediting the claimant’s subjective
complaints. Goff v. Barnhart, 421 F.3d 785, 791 (8th Cir. 2005). “An ALJ who
rejects [subjective] complaints must make an express credibility determination
explaining the reasons for discrediting the complaints.” Singh v. Apfel, 222 F.3d
448, 452 (8th Cir. 2000). This Court must defer to the ALJ’s determinations
regarding the credibility of testimony, so long as they are supported by good reasons
and substantial evidence. Guilliams, 393 F.3d at 801.
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III. The ALJ=s Determination
The ALJ found that Becker meets the insured status requirements of the
Social Security Act through March 31, 2012. (Tr. 18.) He also found that she has
not engaged in substantial gainful activity since May 8, 2004, the alleged onset date
(20 CFR 404.1571 et seq., and 416.971 et seq.).1 Id.
In addition the ALJ concluded that Becker had several severe impairments,
including: posttraumatic degenerative joint and disc disease in the lumbar spine with
mild spondylolisthesis, right rotator cuff strain, status post left foot/ankle surgery,
obesity, posttraumatic stress disorder, bipolar disorder, personality disorder, and
history of cocaine abuse (20 CFR 404.1520(c) and 416.920(c)), however, she did not
have an impairment or combination of impairments that meets or medically equals
the severity of one of the listed impairments in 20 CFR Part 404, Subpart P,
Appendix 1 (20 CFR 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925 and
416.926). (Tr. 18-19.)
As to Becker’s RFC, the ALJ stated:
After careful consideration of the entire record, the undersigned finds
that the claimant has the residual functional capacity to perform light
work as defined in 20 CFR 404.1567(b) and 416.967(b) except the
1 The ALJ made this finding while at the same time noting that Becker was employed at
Walgreens as a photography technician in 2006 and performing SGA. (Tr. 3.) The record also
indicates that Becker’s employment at Walgreens resulted in her earning more than the monthly
SGA amount from 2004 through the end of 2005 and likely through part of 2006. (Tr. 188.)
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claimant can frequently balance and stoop. She can occasionally
kneel, crawl, and climb ramps and stairs. She can never crouch or
climb ladders, ropes, or scaffolds. In addition, the claimant is limited
to no more than occasional overhead reaching with her non-dominant
right upper extremity. The claimant can have only occasional interaction with coworkers, supervisors, and the public. She can understand,
remember, and carry out simple instructions.
In formulating Becker’s RFC, the ALJ considered the opinions of doctors
who evaluated the degree of limitation posed by Becker’s mental impairments. The
ALJ conducted a thorough review (Tr. 26-28) of Becker’s treating psychiatrist’s (Dr.
Denise Curry of Pathways) treatment notes for the eleven times she met with Becker
(540-70), as well as the Medical Source Statement that Dr. Curry completed (Tr.
573-74) regarding the impact of Becker’s mental condition on her ability to work.
The ALJ gave Dr. Curry’s conclusion that Becker had marked to extreme limitations
in all four categories described on the Medical Source Statement (i.e.,
Understanding and Memory; Sustained Concentration and Persistence, Social
Interactions, and Adapt[ability]) little weight, because the degree of limitation
assessed by Dr. Curry:
is not consistent with [ Becker]’s treatment records indicating
improvement and not consistent with [Becker]’s wide range of activeities of daily living including being the primary caregiver for her
3-year old child, providing some in-home care for a man named
Paul Williams, and going to school online. Moreover, other records
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indicate [ Becker] has previously engaged in activities such as working as a tow truck driver and has reported being a caregiver for her parents
(8F, p. 3; 9F; 12F, p. 5).
The ALJ also noted that “[t]he record does not show the claimant’s mental
impairments limited her to a greater extent than provided in the above residual
functional capacity.” Id. In addition, the ALJ gave partial weight to the findings
by the State agency psychologist/psychiatrists (Dr. Mades, Tr. 26; Dr. DeVore, Tr.
30) that “claimant only had mild restriction in activities of daily living.” (Tr. 26,
29-30.) The ALJ found that Dr. Mades’ opinions were consistent with the record
up to the point of her evaluation of Becker in February of 2011, but acknowledged
that the subsequent records support “some moderate limitations.” (Tr. 26.) The
ALJ concluded that Becker “was more limited in social functioning and with regard
to concentration, persistence, and pace than found by the State agency.” (Tr. 30.)
In doing so, although the ALJ characterized the weight he accorded Dr. Curry’s
opinion as “little,” the ALJ did in fact consider her opinion. The ALJ stated that his
RFC assessment “reflect[ed] the degree of limitation [he. . .] found in the ‘paragraph
B’ mental function analysis” (Tr. 20), which he examined in detail in his written
decision, see Tr. 19-20. He also noted that “[t]he record does not show [Becker]’s
mental impairments limited her to a greater extent than provided in the above
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[RFC].” (Tr. 28.)
The ALJ further found that Becker is unable to perform any past relevant
work (20 CFR 404.1565 and 416.965); she was born on September 2, 1969 and was
34 years old, which is defined as a younger individual age 18-49, on the alleged
disability onset date (20 CFR 404.1563 and 416.963). (Tr. 30.) He also concluded
that 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 can perform (20 CFR 404.1569, 404.1569(a), 416.969,
and 416.969(a)). Id.
As to the manner in which the ALJ assessed the credibility of Becker’s
statements, the ALJ reviewed the Polaski factors and other considerations that are
required under the law. (Tr. 28-29.) Overall, the ALJ found that Becker’s
“allegations were not wholly credible.” (Tr. 29.) To support his conclusion, the
ALJ examined: Becker’s statements regarding her activities of daily living; the fact
that although she claimed a lack of health insurance negatively impacted her ability
to seek medical treatment, her history of treatment was “historically sporadic and
conservative”; emergency department records indicated drug-seeking behavior; Dr.
Mades’ discovery that Becker was an “[un]reliable informant” regarding her
substance abuse in that she made inconsistent reports to two separate medical
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providers regarding her prior substance abuse on the same day; and indication that
Becker was involved in more work activity than she admitted to during the hearing
as paper record included evidence she had been a tow truck driver and caregiver for
her parents. Id.
Utlimately, the ALJ found:
After careful consideration of the evidence, the undersigned finds that
the claimant’s medically determinable impairments could reasonably
be expected to cause the alleged symptoms; however, [Becker]’s statements concerning the intensity, persistence, and limiting effects of these
symptoms are not credible to the extent they are inconsistent with the
above residual functional capacity assessment.
Id. The ALJ further noted that his RFC assessment was “supported by a
longitudinal examination of the evidence.” (Tr. 30.)
The ALJ=s final decision reads as follows:
Based on the application for a period of disability and disability
insurance benefits filed on October 20, 2010, the claimant is not
disabled under sections 216(i) and 223(d) of the Social Security Act.
Based on the application for supplemental security income filed on
October 22, 2010, the claimant is not disabled under section
1614(a)(3)(A) of the Social Security Act.
In this action for judicial review, Becker first claims that the ALJ’s decision to
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assign little weight to the opinion of her treating psychiatrist, Dr. Curry, was not
supported by substantial evidence, or good reasons. Becker’s second claim is that
the ALJ failed to adequately explain his determination of her RFC. For the
following reasons, the undersigned disagrees.
IV.A. The treating psychiatrist’s opinion
At the time of the administrative hearing, Dr. Curry had been Becker’s
treating psychiatrist for a period of ten months between August 2011and May 2012;
Becker visited with Dr. Curry a total of eleven times. During Becker’s first visit
with Dr. Curry in August 2011, Becker disclosed that she: was appealing the denial
of her disability claim, completed high school and two associate degrees (culinary
arts and computer skills), and had hopes to complete a Bachelor degree in Criminal
Justice. (Tr. 541-42.) Dr. Curry diagnosed Becker with bipolar disorder and
PTSD, and assessed a GAF score of either 48 or 502 for every visit. (Tr. 542, 545,
548, 551, 554, 557, 559, 561, 564, 567, 570.) Dr. Curry’s treatment notes for all of
Becker’s visits reflected a “severe” Axis IV3 impression regarding Becker’s
response to “chronic illness, marital, separation from child, and legal issues.” Id.
2 A GAF score of 41-50 is indicative of “[s]erious symptoms (e.g., suicidal ideation, severe
obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or
school functioning (e.g., no friends, unable to keep a job).” See American Psychiatric Ass’n.,
Diagnostic and Statistical Manual of Mental Disorders 34 (Text Revision 4th ed. 2000).
3 Axis IV is for reporting psychosocial and environmental problems that may affect the
diagnosis, treatment, and prognosis of mental disorders (Axes I and II). Id. at 29. A
psychosocial and environmental problem may be a negative life event, an environmental difficulty
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The ALJ gave little weight to the GAF scores assigned by Dr. Curry. Id. at
27, 28. The ALJ remarked that
Dr. Curry continued to assess [Becker] with GAF scores in the serious
symptoms range, even when progress notes showed her symptoms improved. Additionally, Dr. Curry continued to indicate that [Becker]’s
legal issues were considered (Exhibit 13F).
(Tr. 28.) The ALJ noted earlier in his decision that Dr. Curry’s consideration of
“[Becker]’s limitations included marital problems, separation from her child, and
legal issues, which do not necessarily reflect [Becker]’s ability to work.” (Tr. 27.)
Becker did not complain about the ALJ’s determination to give little weight to the
low GAF scores assigned by Dr. Curry. The weight attributed by the ALJ to the
low GAF scores was reasonable in light of the fact that Dr. Curry consistently rated
Becker’s psychosocial and environmental problems as severe even though Becker’s
symptoms and her life stressors improved. For example, even after Becker
regained custody of her son prior to her March 14, 2012 session with Dr. Curry,
Becker’s elimination of this issue/stressor did not result in an improved GAF score.
(Tr. 564, 567, 570.)
In her Medical Source Statement-Mental, Dr. Curry expressed the opinion
that Becker had extreme, marked, and moderate limitations in her ability to perform
or deficiency, a familial or other interpersonal stress, an inadequacy of social support or personal
resources, or other problem relating to the context in which a person’s difficulties have developed.
. . In practice, most psychosocial and environmental problems will be indicated on Axis IV.
However, when a psychosocial or environmental problem is the primary focus of clinical attention,
it should also be recorded on Axis I. . . Id.
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sustained work. (Tr. 573-74) The ALJ accorded “little weight” to Dr. Curry’s
opinions, noting first that Dr. Curry’s opinions were inconsistent with Becker’s
treatment records indicating improvement, activities of daily living, and recent
history of working as a tow truck driver and being a caregiver for her parents.4 (Tr.
28.) Furthermore, the ALJ reasoned that Becker engaged in many of these
activities prior to resuming mental health treatment, and that as a result of her
treatment “it would appear that her ability to perform work-related activities would
increase. . .rather than decrease.” Id.
One of the reasons the ALJ accorded Dr. Curry’s opinions little weight was
that they were incongruent with her own treatment notes, specifically finding that
Becker’s records indicate improvement. (Tr. 28) As an example, a review of Dr.
Curry’s treatment notes reveals that Becker’s ability to concentrate was assessed as
“moderately to severely impaired” between August 2011 and November of 2011,
however, improved to only “moderately impaired” between December 16, 2011 and
May 9, 2012. While Dr. Curry consistently noted psychiatric symptoms on
4 Becker alleges that she wasn’t really a “caregiver” for her parents. (Doc. 14 at 10-11.) It is
true that Becker did not list being a caregiver for her parents in any of the reports submitted to the
SSA regarding her past work experience. Nevertheless, it was not improper for the ALJ to
consider Becker’s characterization of what she did for her parents outside of any proceeding
related to her application for DIB and SSI benefits. During a visit to the Phelps County Regional
Medical Center on March 11, 2012, according to the hospital treatment notes, Becker’s chief
complaint was “back pain” and she self-reported: “Five year history of sciatica. Patient is the
care giver for her parents. She states sha has been lifting lots of laundry lately.” (Tr. 521.)
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examination, Becker was an active participant in the process of identifying which
medications worked best to manage her symptoms.
Additional notations support that Becker’s mental impairment improved with
treatment, include Dr. Curry’s notes for some visits that Becker’s symptoms
improved with medication. For example, in September 2011, Dr. Curry noted that
Becker felt better after starting Trileptal. (Tr. 544.) The next month, Becker
reported worsening depression, irritability, and difficulty completing tasks and the
medications were adjusted. (Tr. 550-51.) As to Becker’s involvement in assisting
Dr. Curry in effectively modifying her prescriptions, the following is representative
of her participation: in February, Becker reported that her medication was no longer
effective, and she was experiencing symptoms of mania, including reduced ability to
sleep, increased agitation, increased irritability, and aggressiveness (Tr. 558); two
weeks later, Becker reported that her anxiety was on the rise (Tr. 560); in March, Dr.
Curry indicated that Becker was less irritable, and her grooming had improved (Tr.
564); the next month, Becker reported that her medication was no longer effective,
she was more apathetic, depressed, and she had decreased energy (Tr. 566); and in
May 2012, the last visit in the record, Becker reported that her medications wore off
as the day went on and she was more easily irritated, slept shorter periods, and her
anxiety was on the rise (Tr. 569).
Becker’s willing and effective communication with Dr. Curry regarding the
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efficacy of the medications she was taking also supports that Becker does have the
ability to understand and remember detailed instructions, as well as the ability to
carry out detailed instructions, and the ability to respond appropriately to changes,
although Dr. Curry’s Medical Source Statement included the opinion that Becker
was markedly limited in such areas. See Tr. 573. Based on Becker’s feedback, Dr.
Curry made adjustments to the medications that were prescribed and each time the
medications were modified Dr. Curry noted that Becker “expressed
understanding—her queries reflected good comprehension of planned
intervention-and agreed to take medications as prescribed.” (Tr. 543, 546, 548,
551, 554, 557, 559, 561, 564, 567, 570.)
While the symptomology of Becker’s mental impairment required continued
management, all of Dr. Curry’s treatment notes included the conclusion that
Becker’s insight was either “fair to good,” or “good,” and that Becker had “good
verbal fluency and comprehension coupled with full abstraction capacity indicative
of above average intellectual function.” (Tr. 542, 545, 548, 551, 554, 557, 559,
561, 564, 567, 570.) Dr. Curry’s notes during two of Becker’s last three visits
included the following positive findings regarding Becker’s progress:
Gregarious. Grooming improved. Good eye contact. Psychomotor
activity normal. Speech clear, with normal rate and volume—no push
of speech. Content appropriate to query. Organization: run-on sentences, but not tangential nor with flight of ideas.
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(Tr. 564, 567.) During Becker’s last visit, Dr. Curry noted that although Becker
was irritated with a delay in the appointment time instead of being gregarious,
Becker’s grooming was “good” and her organization was “fully intact.” (Tr. 570.)
In addition, for the last three treatment sessions, Dr. Curry indicated that Becker’s
affect was “moderately intense without lability,” she was “less irritable,” her
attention was “fully intact,” and memory was “grossly intact in all spheres.” (Tr.
564, 567, 570.)
Furthermore, Dr. Curry rated Becker’s capacity to perform sustained work
despite her mental impairments with regard to “Understanding and Memory,”
“Sustained Concentration and Persistence,” “Social Interaction,” and “Adapt[ability]” as “markedly” to “extremely” limited in ten of the twenty rated categories;
Dr. Curry assessed Becker’s ability as “moderately limited” in ten categories. (Tr.
573-74.) Dr. Curry made these assessments more than three months after her last
treatment session with Becker. It is noteworthy that the limitations Dr. Curry
assigned to Becker’s functional abilities for sustained work were much more severe
than any of Dr. Curry’s assessments of Becker’s overall level of functioning during
treatment sessions, as none of Dr. Curry’s treatment session notes described any of
Becker’s limitations as being marked or extreme.
The undersigned recognizes that “[a]lthough the mere existence of
symptom-free periods may negate a finding of disability when a physical
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impairment is alleged, symptom-free intervals do not necessarily compel such a
finding when a mental disorder is the basis of a claim.” Andler v. Chater, 100 F.3d
1389, 1393 (8th Cir. 1996). Additionally, “[s]ymptom-free intervals and brief
remissions are generally of uncertain duration and marked by the impending
possibility of relapse.” Id. Nevertheless, Becker “cites no authority suggesting
that bipolar disorder’s episodic nature is alone enough to reverse an ALJ’s denial of
benefits. If that were the case, an ALJ could never deny benefits to a bipolar
claimant—a result the law does not support.” Sneller v. Colvin, 2014 WL 855618,
*8 (N.D. Iowa 2014, No. C 12-4113-MWB).
The ALJ’s decision to accord little weight to Dr. Curry’s opinions was
supported by substantial evidence in the record as a whole.
IV.A.2. The claimant’s daily activities
The ALJ also indicated that Dr. Curry’s opinions were inconsistent with
Becker’s daily activities. (Tr. 28.) The ALJ pointed out that Becker was the
primary care-giver for her three-year-old child, provided some in-home care for a
man named Paul Williams, and attended school online. Id. The ALJ further noted
that Becker had previously worked as a tow truck driver, and as a caregiver for her
First, with regard to Becker’s care of her three-year-old child, Dr. Curry’s
treatment notes indicate that Becker’s son was in foster care during a portion of the
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time that she was receiving treatment from Dr. Curry. (Tr. 541.) As a result of
Becker’s ability to work with officials at the Division of Family Services (DFS), she
was able to be reunited with her son and successfully regained custody. (Tr. 563.)
This accomplishment required Becker’s persistence, an ability to communicate with
authority figures, as well as the ability to follow directions. It was proper for the
ALJ to consider the fact Becker was the primary caregiver for her son. In fact, the
child attended the hearing before the ALJ with Becker. (Tr. 40-41.)
With respect to Becker’s other activities, Becker testified at the administrative
hearing that she has taken online classes after her alleged onset of disability, but she
dropped out because she had difficulty completing assignments. (Tr. 43.) Dr.
Curry’s treatment notes document Becker’s difficulties performing school work.
(Tr. 566.) Those notes also reflect that Becker completed high school and earned
two associate degrees. (Tr. 541.) Becker further testified that she tried working at
an in-home healthcare position, 27.5 hours per week, from the middle of March to
the end of April 2012, but she was terminated from the position. (Tr. 45.) Becker
explained she left the job, because her employer simply said “this is just not going to
work out.” Id. Although Becker had recent failed attempts at completing college
classes online and working part-time, the record does not support that those failures
were caused by Becker’s mental impairments.
On a final note, Becker’s counsel mistakenly suggests that Becker’s mental
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impairment is what prevented Becker from returning to work. (Doc. 14 at 8.)
There is nothing in the record to support that Becker left any of her jobs as a result of
mental health issues since her alleged onset date of May 8, 2004, or any date
thereafter. What the record does support is that Becker was let go from Walgreen’s
in 2006 based on her perceived involvement in an employee theft problem (Tr.
44-45); she left her job at CiCis’ Pizza in 2007 after recovering from a shoulder
injury to presumably work as a tow truck driver--Becker explained that her husband
was the dispatcher and she drove the tow truck (Tr. 323, see also Tr. 542, Becker
advised Dr. Curry that one of her prior jobs involved auto repossessions); and her
work as a tow truck driver apparently ended around Thanksgiving of 2010, because
the tow truck was inoperable (Tr. 444, 453, 455).
The undersigned finds that the bases upon which the ALJ determined to
accord little weight to Dr. Curry’s opinions are supported by substantial evidence on
the record as a whole and constitute good reasons under the Regulations.
IV.B. Residual Functional Capacity
As previously noted, Becker also argues that the ALJ failed to provide a
narrative discussion of the rationale for his mental RFC findings, and that the mental
RFC determination is not supported by the medical evidence. The undersigned
disagrees and further recognizes that Becker finds no fault in the ALJ’s RFC
assessment with regard to her physical limitations, rather only attacks the two
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limitations that were applied to address her mental impairments.
The ALJ found that Becker was limited to only occasional interaction with
coworkers, supervisors, and the public; and can understand, remember, and carry out
simple instructions. (Tr. 20.) In determining Becker’s mental RFC, the ALJ
stated that he had considered and assigned partial weight to the findings by the State
agency (Dr. Mades and Dr. DeVore) that “claimant only had mild restriction in
activities of daily living.” (Tr. 26, 29-30.) The ALJ found that Dr. Mades’
opinions were consistent with the record up to the point of her evaluation in
February of 2011, but acknowledged that the subsequent records support “some
moderate limitations.” (Tr. 26.) The ALJ concluded that Becker “was more
limited in social functioning and with regard to concentration, persistence, and pace
than found by the State agency.” (Tr. 30.) In doing so, the “little weight” the ALJ
accorded Dr. Curry’s opinion was considered in making the RFC determination.
Furthermore, the ALJ stated that his RFC assessment “reflect[ed] the degree of
limitation [he. . .] found in the ‘paragraph B’ mental function analysis.” (Tr. 20.)
The ALJ’s paragraph B findings included that Becker had mild restriction in
activities of daily living; moderate difficulties in social functioning and
concentration, persistence, or pace; as well as no episodes of decompensation for an
extended duration. (Tr. 19-20.)
The ALJ also considered Becker’s own statements, which he found were “not
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wholly credible” for a myriad of reasons. (Tr. 29.) The reasons cited by the ALJ,
included: the fact that the treatment of Becker’s physical and mental impairments
was “historically sporadic and conservative,” evidence of “drug-seeking behavior”
by Becker that made her an “unreliable informant,” which further “weaken[ed] the
credibility of [ Becker]’s statements regarding her symptoms and limitations”; and
evidence that Becker failed to admit all of her prior work activity.5 (Tr. 29.) The
ALJ’s conclusion regarding Becker’s credibility is supported by substantial
evidence in the record as a whole.
In consideration of the record as a whole the ALJ properly considered the
medical records, observations of treating physicians and others, and the claimant’s
own descriptions of her limitations. As a result, the ALJ’s RFC finding is
supported by substantial evidence on the record as a whole.
In sum, the decision of the ALJ finding Becker not disabled is supported by
substantial evidence. As a result, the ALJ’s decision is AFFIRMED.
Dated this 31st day of March, 2015.
UNITED STATES MAGISTRATE JUDGE
5 In this regard, Becker was not forthright regarding her prior work history when she submitted
information to the SSA for consideration of her disability claim. For example, when reporting her
work history on at least three separate forms that were completed on October 22 and 26, 2010, as
well as March 7, 2011 she failed to disclose her work history at Walgreen’s between 2004 and
2006, CiCi’s Pizza in 2007 (Tr. 196, 235), or her work as a tow truck driver between 2007 and
2010 for her husband’s business (Tr. 268).
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