Story Bates v. Colvin

Filing 23

MEMORANDUM re: 16 SOCIAL SECURITY BRIEF filed by Plaintiff Melissa Story Bates ; For the reasons set forth above, the decision of the Commissioner of Social Security is affirmed. An appropriate Judgment Order is issued herewith.. Signed by Magistrate Judge David D. Noce on 9/9/14. (KKS)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
NORTHERN DIVISION

MELISSA STORY BATES,
Plaintiff,
v.
CAROLYN W. COLVIN,
Acting Commissioner of Social Security,
Defendant.

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No. 2:13 CV 99 DDN

MEMORANDUM
This action is before the court for judicial review of the final decision of the
defendant Commissioner of Social Security denying the application of plaintiff Melissa
Anne Story Bates for disability insurance benefits under Title II of the Social Security
Act, 42 U.S.C. § 401, et seq., and supplemental security income under Title XVI of that
Act, 42 U.S.C. § 1381, et seq. For the reasons set forth below, the decision of the
Administrative Law Judge (ALJ) is affirmed.

I. BACKGROUND
Plaintiff was born on August 28, 1976. (Tr. 127.) She filed her applications on
October 21, 2009, alleging an onset date of June 1, 2007 and alleging disability due to
bipolar disorder and acid reflux.

(Tr. 127, 134, 171-72.) Her applications were denied

initially, and she requested a hearing before an ALJ. (Tr. 11, 68-77.)
On August 14, 2012, following a hearing, the ALJ issued an unfavorable decision.
(Tr. 11-22.) The Appeals Council denied her request for review.
decision of the ALJ stands as the final decision of the Commissioner.

(Tr. 1.) Thus, the

II. MEDICAL AND OTHER HISTORY
On July 19, 2007, plaintiff was admitted to Hannibal Regional Hospital for a
psychotic episode at which time she had been hallucinating about her deceased
grandparents. She had also recently attempted to run in front of a car and was stopped by
family members. She had recently experienced the deaths of two family members and had
a controlling husband. She was taking Zoloft, an antidepressant, and it was discontinued.
She was started on Carbatrol, used to treat bipolar disorder. She was diagnosed with
bipolar disorder, depressed, with psychotic features. She was significantly improved upon
discharge on July 24, 2007. (Tr. 223-34.)
Plaintiff was seen at the Arthur Center in Mexico, Missouri, from December 2007
to February 19, 2010 for outpatient treatment for her bipolar disorder. During that period
she had many situational stressors and was frequently depressed. She was treated with
Depakote, for bipolar disorder, and Lexapro, an antidepressant. (Tr. 243-61.)
On March 18, 2010, plaintiff began treatment with Robert A. Parsonson, D.O., a
family practitioner, at Preferred Family Healthcare (Preferred Family) in Hannibal,
Missouri. A Psychosocial History/Diagnostic Assessment reported that she wanted her
medication adjusted because she could not be around her family or go out and do things.
She reported being on edge a lot, wanting to “blow up,” and being very angry. She
sometimes had hallucinations of her grandparents’ voices.

She was diagnosed with

Schizoaffective, Bipolar Type Disorder. Dr. Parsonson wanted to rule out Borderline
Personality Disorder.

She was having moderate to severe family, relationship, and

budgeting problems at the time. Her GAF score was 50, indicating “serious” symptoms.
(Tr. 333-40.)
Plaintiff saw Dr. Parsonson on March 30, 2010 with complaints of depression,
anxiety, irritability, racing thoughts, and hypersomnia. She reported sleeping sixteen
hours per day and smoking a pack of cigarettes per day.

Dr. Parsonson diagnosed

schizoaffective disorder, bipolar type, and gastroesophageal reflux disorder (GERD). He
prescribed Lithium, for bipolar disorder, Mellaril, an antipsychotic, and Ranitidine, for
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GERD. He opined her prognosis was guarded. He assigned a GAF score of 50, and
instructed her to return in in one week. (Tr. 347-48.)
In April 2010, a detailed Individual Treatment and Rehabilitation Plan was
prepared for plaintiff at Preferred Family. She was assigned a GAF score of 50. (Tr. 34145.)
On July 21, 2010, plaintiff saw her primary care physician for abdominal pain at
which time her husband reported that she had not been taking her psychiatric medication
for several weeks. (Tr. 293.)
On May 17, 2010, state agency medical consultant Mark Altomari, Ph.D.,
completed a Psychiatric Review Technique form following review of plaintiff’s medical
records. He found, among other things, that plaintiff had moderate limitations in social
functioning. Based on these limitations, plaintiff retained the ability to perform short and
simple instructions, relate appropriately to coworkers and supervisors in small numbers
and for brief periods, adapt to most usual changes common to competitive work, and make
simple work-related decisions. (Tr. 266-79.)
By September 23, 2010, plaintiff was compliant with her Lithium. During that
time, she tried other medications for schizophrenia, including Zyprexa, Seroquel, and
Invega, as well as Fluoxetine, an antidepressant.
On March 23, 2011, plaintiff underwent an annual evaluation at Preferred Family.
She reported taking her medications as prescribed although a report stated she had been
noncompliant with caseworker meetings. The evaluation stated she displayed “personality
disorder traits, including antisocial, borderline, dependent and histrionic tendencies, but
appears more immature than actually personality disordered” and that the “hallucinations
she reported years ago were likely related to bereavement.” (Tr. 456.) The report stated
she “avoids employment although appears capable and has worked within the past year
with a boyfriend “junking.” (Id.) She was assigned a current GAF score of 58, and 59 for
the past year, indicating “moderate” symptoms. The evaluation concluded she remained
eligible for services due to anxious and impulsive symptoms and the need for psychiatric
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and supportive care.

The five professionals who signed the evaluation stated Dr.

Parsonson’s diagnosis of schizoaffective disorder was an “eligible” diagnosis. (Tr. 45359.)
On September 14, 2011, Dr. Parsonson wrote on a prescription pad: “[Plaintiff] is
in my care for bipolar disorder. Some days she is so depressed she can’t get out of bed.
Other days she is irritable and should not be around other people.” (Tr. 352.) On April 3,
2012, he wrote on a prescription pad: “[Plaintiff] is in my care for bipolar disorder and
should be considered permanently disabled.” (Tr. 471.)
On April 2, 2012, plaintiff was seen at Preferred Family for her annual evaluation.
The Center had been unable to contact her to schedule her evaluation. She was diagnosed
with Schizoaffective disorder, bipolar type and borderline personality. Her current GAF
score was 52. (Tr. 499-522.)
On April 25, 2012, Dr. Parsonson completed a Mental Medical Source Statement
(MSS). He opined that plaintiff had “moderate” limitations in her ability to understand
and remember simple instructions; to make judgments on simple work-related decisions;
to understand and remember complex instructions, and to carry out simple instructions.
She had “marked” limitations in her ability to carry out simple instructions and her ability
to make judgments on complex work-related decisions. Dr. Parsonson opined that she had
“moderate” limitations in her ability to interact socially with the public, coworkers, and
responded appropriately to usual work situations and to changes in routines work settings.
She had “moderate” limitation in her ability to interact appropriately with supervisors. He
based his statement on plaintiff’s subjective report. (Tr. 487-89.)
On May 30, 2012, plaintiff underwent a psychiatric evaluation under Lyle A. Clark,
M.D. She reported not doing very well, sleeping a lot, and feeling depressed and agitated.
She weighed 264 pounds. She did not think her medications, Zyprexa, Prozac, and
Lithium, were working well. She reported having diarrhea from Lithium and feeling
sedated since starting Zyprexa.

She had psychotic symptoms, including an altered

perception of reality with auditory and visual hallucinations. Dr. Clark believed she
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described symptoms of Major Depressive Episode. She was assigned a GAF score of 40,
indicating major impairment in several areas.

Dr. Clark diagnosed severe bipolar I

disorder, depressed, with psychotic features; panic disorder with agoraphobia, generalized
social phobia, GERD, and IBS. She was to reduce her taking Lithium and Zyprexa, and to
start Carbatrol. She was also instructed to return in three weeks. (Tr. 527-30.)

ALJ Hearing
On April 23, 2012, plaintiff appeared and testified to the following at a hearing
before an ALJ. She is 35 years old. She is 5 feet 6 inches tall and weighs 260 pounds.
She remarried one year ago, and she and her new husband live in a house with her three
children, ages 9, 12, and 16, and small dogs. Her husband drove her to the hearing; her
license was revoked for failing to register her vehicle and driving without insurance. Her
sole source of income is child support and her husband’s disability check. She is on
Medicaid. (TR. 35-38.)
She graduated from high school and earned a certificate in child care after
attending two years of vocational technical school. Her certificate allows her to operate
her own daycare although she is not sure if it is still valid. She began working as a CNA
before her oldest daughter was born. As a CNA, she was required to wake, feed, bathe,
and shave residents. She was required to lift the residents, sometimes with the assistance
of another. She quit her CNA positions. (Tr. 35-43.)
She last worked in 2006 when she worked for two or three months as a cashier at a
Fast Stop gas station. She has done temporary work assembling baskets and other things
for Bath and Body Works during the 2004 and 2005 holiday seasons. Other than that, she
has not been employed. Her job at the gas station ended because her “drawer didn’t come
out right” as she is not good at math. (Tr. 35-43.)
She has not sought work recently because her doctor, Dr. Parsonson, said she is not
fit for work. She has also seen Kristy Willing for counseling on a weekly or monthly
basis for the past two years. (Tr. 43-45.)
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On a typical day, she gets up and takes her medicine. She gets her medications
filled at Wal-Mart, and Medicaid helps pay for it. On a good day, she will clean and do
crafts. She is currently making bouquets and table settings for an upcoming wedding.
She attends a table at craft shows with her mother but has had little success with sales.
She is able to take care of her children. She goes “junking” with her boyfriend twice a
week or more by going into dumpsters and removing metal and aluminum for resale. She
has been “junking” for sixteen or seventeen years. The amount of money they make
varies, although they made two hundred dollars the previous week. She also likes to
spend time with her family. She does not watch television. She cooks, makes the beds,
does the laundry, grocery shops, and sometimes works in their flower and vegetable
garden. (Tr. 45-49.)
She does not smoke or drink. She takes Lithium twice a day, as well as Zyprexa,
Prozac, and Seroquel, and Ranitidine for acid reflux. Her medications help but are not
100% effective. Dr. Parsonson prescribes her medications. She does not have any side
effects from her medications. (Tr. 49-52.)
She cannot work because she is scared she is going to be rude or hurt someone
due to her mood swings. She does not think she is stable enough to work because her
medication is not 100% effective.

Even on medication, she gets in a mood where she

does not care and remains in her room and does not talk to anyone. This occurs twice a
week and lasts all day. Her condition improves by keeping to herself. Otherwise she gets
angry, uses profanity, and gets violent. (Tr. 53-54.)
Even on her medications, plaintiff hears the voices of her deceased relatives talking
to her. She sees them once or twice a week when she is in her room and they tell her to
come and be with them. On bad days, plaintiff remains in her room, sleeps all day, and
cries. She does not take care of her personal hygiene, and cannot do housework, cook, go
“junking,” or attend craft shows. On good days, she is happy-go-lucky, capable around
the house, and able to take care of herself. (Tr. 55-58.)

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She is not good with money because she cannot perform basic math or make
correct change. She inherited approximately $40,000 from her grandfather and blew it in
one month on “stupid stuff.” She is able to drive. She was in special education while in
school. On a good day she gets out of bed at 7:00 a.m. She goes to bed between 8:00
and 10:00 p.m. and is able to sleep through the night. (Tr. 57-59.)
Barbara Myers, vocational expert (VE), testified to the following at the hearing.
Plaintiff’s past relevant work (PRW) is categorized as (1) cashier, light and unskilled; (2)
nurse aide, medium, semi-skilled; and (3) packager medium, unskilled. (Tr. 60.)
The ALJ presented the VE with a hypothetical individual who had the same
vocational factors as plaintiff, with no exertional limitations, who was limited to simple,
routine tasks. The individual had only occasional decision-making, occasional changes in
the work setting, and occasional interaction with the public or coworkers.

The VE

testified that such an individual would be able to do the past work of packager, as well as
laundry worker, cleaner, and kitchen helper. (Tr. 61.)
Under a second hypothetical, the VE testified that no jobs would be available if the
claimant was unable to sustain full-time work eight hours a day on a regular and
consistent basis , because more than two unexcused or unscheduled absences a month is
unacceptable to an employer. (Tr. 62.)

III. DECISION OF THE ALJ
On August 14, 2012, the ALJ issued a decision finding that plaintiff was not
disabled. The ALJ found that plaintiff had the severe impairments of bipolar disorder,
generalized anxiety disorder, and borderline personality disorder. (Tr. 13.) However, the
ALJ found plaintiff did not have an impairment or combination of impairments listed in or
medically equal to one contained in the listings, 20 C.F.R. part 404, subpart P, appendix 1.
(Tr. 14-15.) The ALJ determined that plaintiff had the RFC to perform a range of simple
work with limited interaction with others. She could perform work at all exertional levels,
but was limited to simple, routine tasks. She could occasionally make decisions and adapt
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to changes in the work setting and could have occasional interaction with co-workers and
the public. (Tr. 15.) The ALJ concluded that plaintiff’s impairments would not preclude
her from performing her past work as a packager. Accordingly, the ALJ found plaintiff
not disabled under the Act. (Tr. 21-22.)

IV. GENERAL LEGAL PRINCIPLES
The court’s role on judicial review of the Commissioner’s decision is to determine
whether the Commissioner’s findings comply with the relevant legal requirements and are
supported by substantial evidence in the record as a whole. Pate-Fires v. Astrue, 564 F.3d
935, 942 (8th Cir. 2009). “Substantial evidence is less than a preponderance, but is
enough that a reasonable mind would find it adequate to support the Commissioner’s
conclusion.” Id. In determining whether the evidence is substantial, the court considers
evidence that both supports and detracts from the Commissioner's decision. Id. As long
as substantial evidence supports the decision, the court may not reverse it merely because
substantial evidence exists in the record that would support a contrary outcome or because
the court would have decided the case differently. See Krogmeier v. Barnhart, 294 F.3d
1019, 1022 (8th Cir. 2002).
To be entitled to disability benefits, a claimant must prove she is unable to perform
any substantial gainful activity due to a medically determinable physical or mental
impairment that would either result in death or which has lasted or could be expected to
last for at least twelve continuous months.

42 U.S.C. §§ 423(a)(1)(D), (d)(1)(A),

1382c(a)(3)(A); Pate-Fires, 564 F.3d at 942. A five-step regulatory framework is used to
determine whether an individual is disabled. 20 C.F.R. § 416.920(a)(4); see also Bowen
v. Yuckert, 482 U.S. 137, 140-42 (1987) (describing five-step process); Pate-Fires, 564
F.3d at 942 (same).
Steps One through Three require the claimant to prove (1) she is not currently
engaged in substantial gainful activity, (2) she suffers from a severe impairment, and (3)
his condition meets or equals a listed impairment. 20 C.F.R. § 416.920(a)(4)(i)-(iii). If
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the claimant does not suffer from a listed impairment or its equivalent, the
Commissioner’s analysis proceeds to Steps Four and Five.

Step Four requires the

Commissioner to consider whether the claimant retains the RFC to perform PRW. Id. §
416.920(a)(4)(iv). The claimant bears the burden of demonstrating she is no longer able
to return to her PRW. Pate-Fires, 564 F.3d at 942. If the Commissioner determines the
claimant cannot return to PRW, the burden shifts to the Commissioner at Step Five to
show the claimant retains the RFC to perform other work that exists in significant
numbers in the national economy. Id.; 20 C.F.R. § 416.920(a)(4)(v).

V. DISCUSSION
Plaintiff argues that the ALJ erred in not according controlling weight to the
opinion of her treating physician, Dr. Parsonson. She also argues the ALJ erred in
ignoring the amended alleged onset date (AOD) of October 21, 2009 and relying on
evidence that pre-dates the amended date. This court disagrees.

1.

Residual Functional Capacity and Credibility
Because it bears indirectly on the issue of the ALJ’s consideration of treating

physician Dr. Parsonson’s opinion, the court will first discuss the ALJ’s RFC
determination and her credibility finding. RFC is a medical question and the ALJ’s
determination of RFC must be supported by substantial evidence in the record. Hutsell v.
Massanari, 259 F.3d 707, 711 (8th Cir. 2001); Lauer v. Apfel, 245 F.3d 700, 704 (8th Cir.
2001); Singh v. Apfel, 222 F.3d 448, 451 (8th Cir. 2000). RFC is what a claimant can do
despite her limitations, and it must be determined on the basis of all relevant evidence,
including medical records, physician’s opinions, and a claimant’s description of his
limitations. Donahoo v. Apfel, 241 F.3d 1033, 1039 (8th Cir. 2001); 20 C.F.R. §§
404.1545, 416.945(a). While the ALJ is not restricted to medical evidence alone in
evaluating RFC, the ALJ is required to consider at least some evidence from a medical
professional. Lauer, 245 F.3d at 704. An “RFC assessment must include a narrative
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discussion describing how the evidence supports each conclusion, citing specific medical
facts (e.g., laboratory findings) and nonmedical evidence (e.g., daily activities,
observations).” SSR 96-8p, 1996 WL 374184, at *7 (1996).
In this case the ALJ determined that plaintiff retained the RFC to perform a range
of simple work with limited interaction with others. She could perform work at all
exertional levels, but was limited to simple, routine tasks. She could occasionally make
decisions and adapt to changes in the work setting and could have occasional interaction
with co-workers and the public. (Tr. 15.)
In finding plaintiff capable of a range of simple work with limited interaction with
others, the ALJ considered the record as a whole, including plaintiff’s subjective
complaints. The ALJ properly found plaintiff’s allegations inconsistent with the record as
a whole, including her medical record evidence, daily activities, work history, and the
medical opinions.

The ALJ’s consideration of the subjective aspects of plaintiff’s

complaints comported with the regulations at 20 C.F.R. §§ 404.1529, 416.929 (2013), and
the framework set forth in Polaski v. Heckler, 739 F.2d 1320 (8th Cir. 1984).
The record evidence supported the ALJ’s determination that plaintiff was not fully
credible. In evaluating plaintiff’s credibility, the ALJ considered her medical treatment.
The ALJ noted that plaintiff’s medications helped her condition. (Tr. 16, 19, 53, 220-23,
254-58, 291, 454, 458, 477, 520.) See Renstrom v. Astrue, 680 F.3d 1057, 1066 (8th Cir.
2012) (impairment cannot be considered disabling if it can be controlled by treatment or
medication). However, plaintiff was frequently not compliant with her medications. (Tr.
293.) See Guilliams v. Barnhart, 393 F.3d 798, 802 (8th Cir. 2005) (failure to follow
recommended course of treatment weighs against claimant’s credibility).

Plaintiff also

did not comply with other medical recommendations; she avoided counseling and
received no treatment between March 2010 and March 2011. (Tr. 19, 347, 453-56, 500,
504.) The ALJ also noted that plaintiff’s treatment frequently revolved around situational
stressors, specifically her family relationships, that are not a basis for disability. (Tr. 245,
250-51, 254-55, 290, 455.) Cf. Gates v. Astrue, 627 F.3d 1080, 1082 (8th Cir. 2010)
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(medical record supports conclusion that any depression was situational in nature, related
to marital issues, and improved with medication and counseling). Plaintiff’s limited
medical treatment does not support the extent of her allegations. (Tr. 16, 19.)
Furthermore, to the extent plaintiff is suggesting that her impairment prevented her
from complying with prescribed treatment or seeking more regular treatment, this
argument fails. While a mental impairment can prevent an individual from complying
with treatment, there is no record evidence to support the assertion that plaintiff’s
noncompliance was caused by her mental impairment. Cf. Wildman v. Astrue, 596 F.3d
959, 966 (8th Cir. 2010) (there is little or no evidence expressly linking claimant’s mental
limitations to repeated noncompliance). Plaintiff also failed to identify record evidence
demonstrating that her mental impairment precluded her from being compliant with her
medication, returning phone calls, and seeking treatment. As such, the ALJ properly
considered plaintiff’s noncompliance and limited medical treatment. (Tr. 16, 19.)
Consistent with Polaski, the ALJ also found plaintiff’s allegations of disabling
symptoms not supported by the medical evidence. Plaintiff alleged disability, in part,
based on bipolar disorder.

However, the medical records demonstrate that plaintiff

generally appeared alert and oriented with normal speech, intact memory, and a logical
thought process. (Tr. 17-18, 220, 222, 224, 244-46, 248-52, 254, 257, 259, 301, 307, 319,
335, 357, 362, 380-81, 391, 405, 419, 436, 454). See Halverson v. Astrue, 600 F.3d 922,
933 (8th Cir. 2010) (inconsistent with a claimant’s allegations of disability, the claimant
appeared alert and oriented with normal speech and thought processes).

Plaintiff’s

assertion that she had difficulty interacting with others was also inconsistent with the
record evidence demonstrating that she generally remained very pleasant, cooperative, and
calm.

(Tr. 220, 222, 224, 244-46, 248-50, 252, 254-55, 335, 380, 391, 405, 419, 443,

477, 479, 482, 485.) Thus, the ALJ properly concluded that the medical evidence did not
support plaintiff’s alleged limitations. (Tr. 17-18.)
The ALJ also considered plaintiff’s daily activities in assessing her credibility.
Plaintiff retained the ability to maintain her personal care and care for her children and
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pets. She could prepare meals, clean, wash dishes, do laundry, shop, and drive. She could
ride ATVs, perform yard work, work on crafts, and decorate for parties. (Tr. 45-46, 4849, 184-88, 206, 336-37, 374, 378, 453, 458, 506, 510-11, 517.) Cf. McCoy, 648 F.3d at
614, (cooking, vacuuming, washing dishes, doing laundry, shopping, driving, and
walking, are inconsistent with subjective complaints of disabling pain).

Plaintiff’s

assertion that she had difficulty getting along with others was inconsistent with her ability
to spend time with others, shop, and attend craft shows. She also performed part-time
work--including after her AOD--by “junking” or collecting scrap metal and other items for
resale. (Tr. 19-20, 334, 337, 453, 456, 458, 513, 520). The ALJ properly considered the
inconsistencies between plaintiff’s subjective allegations and the record as a whole in
evaluating her credibility.
Finally, the ALJ properly considered plaintiff’s work history. Plaintiff’s highest
earnings were $12,000 in 2000. She had no earnings in 1996, 2003, and 2005. (Tr. 155).
Therefore, plaintiff’s work history did not support her credibility. See Buckner v. Astrue,
646 F.3d 549, 558 (8th Cir. 2011) (poor work history distracts from claimant’s
credibility).
This court concludes that the ALJ properly evaluated plaintiff’s credibility and
found her allegations of disability not credible. Substantial evidence supports the ALJ’s
finding that plaintiff could perform a range of simple work with limited interaction with
others.

2.

Opinion of Robert A. Parsonson, D.O.
The ALJ also properly considered the opinion of Dr. Parsonson. Opinions from

medical sources who have treated a claimant typically receive more weight than opinions
from one-time examiners or non-examining sources. See 20 C.F.R. § 416.927(c)(1)-(2).
However, the rule is not absolute; a treating physician’s opinion may be disregarded in
favor of other opinions if it does not find support in the record. See Casey v. Astrue, 503
F.3d 687, 692 (8th Cir. 2007).

Likewise, an ALJ may appropriately rely on non- 12 -

examining opinions as part of his RFC analysis. See Hacker v. Barnhart, 459 F.3d 934,
935, 939 (8th Cir. 2006) (ALJ’s RFC assessment was supported by substantial evidence,
including the opinions from non-examining doctors). Ultimately, it is up to the ALJ to
determine the weight each medical opinion is due. Id., 459 F.3d at 936 (ALJ’s task is to
resolve conflicts in the evidence).

In this case, the ALJ properly considered Dr.

Parsonson’s statements and found them entitled to little weight.
As to Dr. Parsonson’s opinion that plaintiff was permanently disabled, the ALJ
properly found his opinion was entitled to little weight because a determination of
disability is an issue reserved for the Commissioner. (Tr. 19, 471.) See House v. Astrue,
500 F.3d 741, 745 (8th Cir. 2007) (treating physician’s opinion that claimant is disabled or
cannot be gainfully employed gets no deference because it invades province of the
Commissioner to make ultimate disability determination); 20 C.F.R. §§ 404.1527(d),
416.927(d) (2013). The ALJ also properly noted that Dr. Parsonson’s statement provided
no basis for his opinion and was inconsistent with his earlier statement that plaintiff
appeared capable of working. (Tr. 19-20, 456, 471.)
The ALJ also properly considered the Mental MSS submitted by Dr. Parsonson.
(Tr. 19, 487-89.) Dr. Parsonson opined that plaintiff could satisfactorily understand and
remember simple instructions, make judgments on simple work-related decisions,
understand and remember complex instructions, carry out complex instructions, and
interact appropriately with supervisors.

However, he opined that plaintiff had a

substantial loss in her ability to function in carrying out simple instructions, making
judgments on complex work-related decisions, interact appropriately with the public and
co-workers, and respond appropriately to usual work situations and to changes in a routine
work setting. (Tr. 487-88.) The ALJ properly found that Dr. Parsonson’s opinion was not
based on objective evidence, but, rather on plaintiff’s subjective report. As discussed
above, the ALJ found plaintiff’s “subjective reports” not credible, and therefore did not err
in giving Dr. Parsonson’s opinion less weight. (Tr. 19). Cf. McCoy, 648 F.3d at 617
(doctor’s evaluation appeared to be based, at least in part, on claimant’s self-reported
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symptoms and, thus, insofar as those reported symptoms were found to be less than
credible, doctor’s report was rendered less credible).
Moreover, to the extent plaintiff is arguing that there is no objective evidence to
evaluate mental impairments, this court disagrees. The regulations provide that objective
evidence for mental impairments includes psychological abnormalities which can be
observed, apart from a claimant’s statements.

See 20 C.F.R. §§ 404.1528, 416.928

(2013). Psychiatric signs are medically demonstrable phenomena that indicate specific
psychological abnormalities, e.g., abnormalities of behavior, mood, thought, memory,
orientation, development, or perception.

See 20 C.F.R. §§ 404.1528, 416.928. As

discussed above, the medical record evidence shows that plaintiff frequently appeared
alert and oriented with normal speech, intact memory, and a logical thought process. (Tr.
17-18, 220, 222, 224, 244-46, 248-52, 254, 257, 259, 301, 307, 319, 335, 357, 362, 38081, 391, 405, 419, 436, 454).
Further, Dr. Parsonson’s opinion is internally inconsistent. He opined that plaintiff
could satisfactorily carry out complex instructions, but could not carry out simple
instructions. (Tr. 487.) There is no reasonable explanation for the inconsistency. Cf.
Choate v. Barnhart, 457 F.3d 865, 871 (8th Cir. 2006) (given the inconsistencies between
doctor’s letter and his MSS, as well as lack of supporting objective evidence, the ALJ did
not err in discounting doctor’s opinion). This court concludes that that based on the
record as a whole, the ALJ properly considered Dr. Parsonson’s opinion and found it
entitled to little weight.
Plaintiff also suggests that she had greater limitations based on the GAF scores of
50, citing Pate-Fires v. Astrue in support of her contention that her GAF scores
demonstrate that she is disabled. According to the Diagnostic and Statistical Manual of
Mental Disorders (DSM), the GAF scale is intended for use by practitioners in making
treatment decisions. American Psychiatric Association, Diagnostic and Statistical Manual
of Mental Disorders 32-33 (4th ed.-Text Revision 2000) (DSM-IV). However, the most
recent version of the DSM dropped GAF from inclusion because of its “conceptual lack of
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clarity (i.e., including symptoms, suicide risk, and disabilities in its descriptors) and
questionable psychometrics in routine practice.” DSM-V 16 (5th ed. 2013).
Moreover, neither Social Security regulations nor case law require an ALJ to
determine the extent of an individual’s mental impairment based solely on a GAF score.
In fact, 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.” See 65 Fed. Reg.
50746, 50764-65, 2000 WL 1173632 (August 21, 2000).
While the Commissioner has declined to endorse the GAF scale for use in the
Social Security and SSI disability programs, GAF scores may still be used to assist the
ALJ in assessing the level of a claimant's functioning. See Halverson v. Astrue, 600 F.3d
922, 930-31 (8th Cir. 2010) (GAF score may be of considerable help in formulating RFC,
but is not essential to RFC's accuracy). GAF scores may also be considered by the ALJ
when considering weight to be given treating doctor’s opinion and whether the doctor’s
opinion is inconsistent with treatment record. Myers v. Colvin, 721 F.3d 521, 525 (8th
Cir. 2013).
In Pate-Fires, the Eighth Circuit held that because the claimant’s GAF score was
above 50 only four out of twenty-one times in a six-year period, the history of GAF scores
at 50 and below, taken as a whole, indicated serious symptoms and supported the treating
physician’s opinion that the claimant was not capable of gainful employment. 564 F.3d at
944. In this case plaintiff has not presented a history of GAF scores similar to Pate-Fires.
The ALJ in this case relied heavily on plaintiff’s actual daily activities and other record
evidence in reaching her conclusions. Finally, the Eighth Circuit has since noted that the
court in Pate–Fires did not reference 65 Federal Regulation 50746, 50764–65 (August 21,
2000), in which the Commissioner declined to endorse the GAF scales to evaluate Social
Security claims because the scales do not have a direct correlation to the severity
requirements in mental disorders listings. Jones v. Astrue, 619 F.3d 963, 974 (8th Cir.
2010). Therefore, because there is no direct correlation between plaintiff’s GAF scores
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and a mental impairments' severity, and the ALJ has no obligation to credit or even
consider GAF scores in the disability determination, plaintiff’s reliance on her GAF scores
is without merit.
The ALJ also properly weighed the state agency medical consultant’s opinion.
(Tr. 20, 266-79.) In May 2010, Mark Altomari, Ph.D., reviewed plaintiff’s medical
records and opined that plaintiff had moderate limitations in social functioning. (Tr. 26679.) Based on these limitations, plaintiff retained the ability to perform short and simple
instructions, relate appropriately to co-workers and supervisors in small numbers and for
brief periods, adapt to most usual changes common to competitive work, and make simple
work-related decisions. (Tr. 279.) The ALJ appropriately accommodated the limitations
in the RFC finding. (Tr. 15, 20.) See Kamann v. Colvin, 721 F.3d 945, 951 (8th Cir.
2013) (ALJ reviewed the medical record evidence and issued a finding consistent with the
reviewing agency psychologist).
3.

Amended Alleged Onset Date
Plaintiff next argues that the ALJ improperly considered evidence prior to October

21, 2009, suggesting that an ALJ cannot consider evidence prior to an AOD. However,
the ALJ may consider evidence prior to an AOD in order to evaluate whether the
limitations lasted for 12 continuous months, and plaintiff has not provided authority
holding otherwise. The ALJ must also consider how plaintiff’s impairments have changed
over time. See e.g., Goff v. Barnhart, 421 F.3d 785, 793 (8th Cir. 2005) (ALJ found
claimant’s speech impediment was not as limiting as alleged because claimant effectively
worked as a nurse’s aide with her speech impediment and there is no indication that her
ability to speak had deteriorated since her stroke in 1997).

Also, plaintiff received

minimal medical treatment after October 21, 2009 and received no treatment between
March 2010 and March 2011. As such, it was necessary for the ALJ to rely on earlier
medical records to evaluate plaintiff’s claims.

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Finally, the ALJ did not err in not amending plaintiff’s AOD. Counsel stated at the
administrative hearing that plaintiff’s June 1, 2007 AOD was not supported by the record
and that the appropriate AOD was October 21, 2009. (Tr. 32.) The ALJ requested--and
counsel agreed--to submit the proposed amended AOD in writing. (Tr. 32-33.) Counsel
did not do so. Instead, plaintiff submitted additional evidence restating that the June 1,
2007 AOD. (Tr. 488). Based on all of these facts, the ALJ properly evaluated plaintiff’s
impairments since June 1, 2007. (Tr. 11.)

VI. CONCLUSION
For the reasons set forth above, the decision of the Commissioner of Social
Security is affirmed. An appropriate Judgment Order is issued herewith.

S/ David D. Noce
f
UNITED STATES MAGISTRATE JUDGE
Signed on September 9, 2014.

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