Lansford v. Colvin

Filing 21

MEMORANDUM AND ORDER IT IS HEREBY ORDERED that this action is AFFIRMED. A separate Judgment will accompany this Order. Signed by District Judge Ronnie L. White on 3/16/15. (JWJ)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION

TOBY J. LANSFORD,
Plaintiff,
v.
CAROLYN COL VIN,
ACTING COMMISSIONER OF SOCIAL
SECURITY,
Defendant.

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Case No. 4:14-CV-87-RLW

MEMORANDUM AND ORDER
This is an action under 42 U.S.C. § 405(g) for judicial review of the Commissioner of
Social Security's final decision denying Toby J. Lansford's ("Lansford") application for
disability insurance benefits under Title II of the Social Security Act. Lansford alleges disability
due to impairments including bad knees, bad vision in his right eye, limited motion in right arm,
and difficulty breathing through his nose. (Tr. 298).

I.

Background
Lansford allege that he became disabled on June 20, 2008. (Tr. 18). The Social Security

Administration ("SSA") denied Lansford's application for benefits and he filed a timely request
for a hearing before an Administrative Law Judge ("ALJ"). The SSA granted Lansford's request
and a hearing was held on July 3, 2012. (Tr. 35-73) The ALJ issued a written decision on
September 19, 2012, upholding the denial of benefits. (Tr. 16-29.)

Lansford requested an

extension of time to file additional evidence regarding his medical care. (Tr. 12.) Lansford also
requested a review of the ALJ's decision by the Appeals Council. (Tr. 8-11.) The Appeals

Council received a representative brief, which it made part of the record. (Tr. 5.) The Appeals
Council denied Lansford' s request for a review. (Tr. 1-3.) The decision of the ALJ thus stands
as the final decision of the Commissioner.

See Sims v. Apfel, 530 U.S. 103, 107 (2000).

Lansford filed this appeal on January 17, 2014. (ECF No. 1.) The Commissioner filed an
Answer. (ECF No. 5.) Lansford filed a Brief in Support of his Complaint. (ECF No. 13.) The
Commissioner filed a Brief in Support of the Answer. (ECF No. 19.) Lansford filed a reply
brief in support of his Complaint. (ECF No 20).

II.

Decision of the ALJ
The ALJ found that Lansford had severe impairments of depression, alcohol dependence,

blindness in right eye, and arthritis. (Tr. 19-21.) The ALJ determined that Lansford had the
following severe impairments: depression, alcohol dependence, blindness in the right eye, and
arthritis, but that he 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. (Tr. 13.) The ALJ determined that Lansford retained the capacity to perform
medium work in that he can lift and carry fifty pounds occasionally and twenty-five pounds
frequently, stand or walk for six hours out of an eight-hour workday, and sit for six hours out of
an eight-hour workday, except that he must avoid climbing ropes, ladders or scaffolds, and
hazards of heights and machinery. The ALJ noted that Lansford has no vision in his right eye,
but his vision is normal in his left eye. The ALJ found that Lansford is able to understand,
remember, and carry out at least simple instructions and non-detailed tasks. The ALJ stated that
Lansford should not perform work in a setting which requires constant/regular contact with the
general public which includes more than infrequent handling of customer complaints. (Tr. 2127.) The ALJ found that Lansford has the residual functional capacity ("RFC") to perform

2

medium work. The ALJ discerned that Lansford has normal vision in his left eye. The ALJ
found that, based in part upon a GAF of 55, which was found in Dr. Rexroat' s findings, Lansford
has only moderate psychological impairment. The ALJ found that Lansford is unable to perform
any past relevant work. (Tr. 27.) The ALJ determined that jobs exist in significant numbers in
the national economy that Lansford can perform, including housekeeper/cleaner, mail sorter, and
bench assembler. Consequently, the ALJ found Lansford was not disabled, as defined under the
Social Security Act.
Lansford appeals contending that the ALJ (1) improperly failed to take into account
Lansford' s mental impairments, in particularly his repeated GAF scores, (2) the ALJ improperly
failed to take into account Lansford's multiple surgeries to his right eye and the recovery periods,
(3) the ALJ improperly found that Lansford' s vision was normal in his left eye, (4) the ALJ filed
to give proper credit to the report of Lansford ' s treating physician, Dr. Thomas Jackson, (5) the
ALJ improperly determined that Lansford did not meeting listing 12.04, (6) the ALJ filed to take
into account Lansford' s age and training, (7) the ALJ failed to properly take into account all of
Lansford' s impairments in determining his RFC, and (8) there is no substantial evidence that
Lansford can return to his former work and that Lansford can perform other work. (ECF No. 13
at 1-2.)

The Commissioner contends that the ALJ's decision is supported by substantial

evidence on the record as a whole.

III.

Administrative Record
The following is a summary ofrelevant evidence before the ALJ.

A.

Hearing Testimony
1.

Lansford's Testimony

Lansford testified on July 3, 2012 as follows.

3

Lansford lives at home with his parents, and occasionally his son and daughter. (Tr. 38.)
He has a

12th

grade education, plus additional training in construction, specifically brick wor~,

masonry, and plastering. (Tr. 39-42.) He did not participate in vocational rehabilitation as part
of receiving unemployment benefits. (Tr. 45.) He was in prison three times from 2001 to 2003
and then also in 1995 or 1997. (Tr. 45-46.) He has been in jail less than ten times. (Tr. 46-47.)
He has had 7 or 8 DUis and DWis. (Tr. 47.) He has been in rehab for drug and/or alcohol abuse
four times, including most recently about a month ago.

(Tr. 48.) He went to the Phoenix

Program in Columbia, OCC in Springfield, and treatment in Farmington. (Tr. 48-49.) In 2010,
' he was taken by police for psychological treatment to somewhere in St. Charles. (Tr. 50-51 .) He
last had alcohol three months ago. (Tr. 52.) He did not recall being told not to mix alcohol with
his psychotropic medications. (Tr. 52.) He states that he has been taking his medication as
prescribed for about two months-since his last relapse.

(Tr. 52-53.)

He states that he

previously stopped taking medications when they made him hallucinate or sleep all the time.
(Tr. 53-54.)
He has had problems with his left eye since he was hit with a golf club in 2004 or 2005.
(Tr. 54.) He has tried to work, since then but he keeps getting fired from his employment. (Tr.
55.)
Lansford tries to help around the house but he breaks the dishes and does the laundry
wrong. (Tr. 55.) He tries to cut the grass but misses an entire section of the lawn. (Tr. 56.) He
cannot cook because he burns or undercooks everything, or forgets about it. (Tr. 56.) He walks
about five or six blocks every day to go shopping for groceries, which he pays for with food
stamps. (Tr. 56.) He does not have a driver's license. (Tr. 57.) He wakes up at 5:30 or 6:00 a.m.
and then makes some breakfast, including frying an egg or toast. (Tr. 57-58.) He spends the rest

4

of the day watching TV, sitting in a chair in the yard, or sleeping. (Tr. 58 .) He walks to AA and
NA meeting one to three times per week-approximately 4-6 blocks away. (Tr. 58-59.)
Lansford last had vision in his right eye about two years ago when he had a chemical spill
in his eye. (Tr. 59.) He had six or seven surgeries but he still has no vision in his right eye. (Tr.
60.) He has limited vision in his left eye-he could not read the clock in the hearing room. (Tr.
60.) His eye issues cause him terrible migraine headaches every day, for an hour or an hour and
a half.

(Tr. 61.)

He has been having these headaches for three or four years.

(Tr. 61.)

According to the ALJ, there are no mention of headaches in his records from his family care
doctor. (Tr. 61.)
Lansford has suicidal thoughts every day. (Tr. 62.) He has problems with rage and anger
every day. (Tr. 62.) He acts out by throwing things or hollering at the people he loves. (Tr. 63 .)
He has problems with his personal hygiene. He can go a week without taking a shower. (Tr.
63.)

B.

Medical Records

Lansford' s relevant medical records are summarized as follows:
On June 16, 2006, he repaired the corneal/scleral laceration. (Tr. 468.) On August 17,
2007, Lansford had an implant was placed in the right eye to repair a dislocated lens. (Tr. 41819 .) On August 14, 2007, Dr. Jackson noted that Lansford suffers from anger problems and
mood swings. (Tr. 426.)
On September 5, 2008, Lansford's mother, Violet Lansford, filled out a Function Report
regarding her son. (Tr. 328-36.) She indicated that Lansford doesn't take care of himself. He
only bathes, combs his hair and changes his clothes every two or three days. She stated that he is
very moody and she can' t be around him. During the day, he sleeps, watches TV, eats, goes

5

outside with friends, and looks for work. She said sometimes he sleeps for a long time and other
times he doesn't sleep at all. She said that he goes out a lot and enjoys being in the fresh air. He
doesn't have a license or drive because of his DWI's. She said that he fishes and watches TV for
hobbies. He goes out with friends 2-3 times per week. He is moody and cusses; he "don't care
about anything." She said he doesn't have a social life because no one wants to be around him
due to his drinking, cussing, and moods. He forgets everything and can only pay attention for 5
minutes.
On October 27, 2008, Paul W. Rexroat, Ph.D. performed a psychological evaluation of
Lansford.

(Tr. 429-32.)

Lansford admitted he is an alcoholic.

Dr. Rexroat estimated that

Lansford's IQ was in the low average range. Lansford described symptoms of major depression.
Dr. Rexroat found Lansford had the ability to understand and remember simple instructions.
Lansford said he has a bunch of friends but doesn't see them because he isn't making money or
drinking. He sees his friends about once a week when they drop by. He sees his children for an
hour and a half on Wednesdays. Lansford reported no homicidal ideation or attempts, occasional
suicidal ideation but no attempts, and no paranoia, hallucinations or delusions. Dr. Rexroat
determined that Lansford had a GAF of 49.
On November 19, 2008, Marc Maddox performed a psychiatric review of Lansford's
records. (Tr. 433-47.) Dr. Maddox determined that Lansford suffers from affective disorders
and substance addiction disorders (alcohol dependence). Dr. Maddox determined that Lansford
can perform simple repetitive tasks in an unskilled work setting. He can understand, remember,
and carry out simple instructions; deal with routine work changes; and make simple work-related
decisions.

Dr. Maddox stated Lansford will have difficulty getting along with others and,

therefore, will do best in a setting where social contact is limited and he can complete tasks

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relatively independently.

Dr. Maddox noted, however, that Lansford' s dependability and

reliability would be adversely, impacted when he drinks.
On November 26, 2008, Lisa Buhr performed a mental RFC assessment. (Tr. 448-52.)
She determined that his functional limitations were more limited by his mental condition than his
physical condition. She noted that Lansford prepares meals and completes household chores.
He is unable to drive due to DWI's. He watches TV. Medical records show that Lansford takes
over the counter Advil for plain relief.

She stated Lansford had no medically determinable

impairment for a knee condition, arm condition, or breathing condition.
On April 1, 2009, Lansford underwent an MRI of the right knee, which indicated he
suffered from osteoarthritis that is moderately severe with a minis cal tear. (Tr. 520.) The MRI
of the left knee indicated mild osteoarthritis with small joint effusion. (Tr. 521.)
On August 29, 2010, Lansford was seen at Mercy hospital for facial swelling and
shoulder pain after being in a fist altercation 4 days prior. (Tr. 873-85 .)
On August 31 , 2010, Lansford was evaluated by Dr. Praveeen Nimmagadda for a DSMIV Diagnostic Report. (Tr. 542-43.) Lansford was assigned a GAF score of 55.
On October 2, 2010, Lansford was seen at Mercy hospital for pain to his right eye. (Tr.
888-93.)
On October 18, 2010, Lansford was seen again by Dr. Rexroat for a psychological
examination. (Tr. 622-25.) He was estimated to be at the low average level of intelligence. Dr.
Rexroat found Lansford was able to understand and remember simple instructions. He could
sustain concentration and persistence with simple tasks. He had marked limitations in his ability
to interact socially. He could adapt to his environment. He was diagnosed with alcohol-induced
mood disorder and a personality disorder. He was assigned a GAF score of 45.

7

In October 2010, Lansford suffered a chemical injury to the right eye and his cornea was
opaque as a result.

(Tr. 468.)

On January 10, 2011, Lansford received an ocular surface

reconstruction with lateral tarsorrhaphy to the right eye. (Tr. 732.) Despite these surgeries,
Lansford lost use of his right eye. (Tr. 627, 1099 (indicating that Lansford ' s vision in his right
eye was "extremely poor with only light perception behavior")) As of September 6, 2012, Dr.
Korenfeld indicated that Lansford had a retinal hole in his left (good) eye. (Tr. 1099.) Dr.
Korenfeld also stated that Lansford had 20/20 vision in his left eye. (Id.) On May 18, 2011,
Lansford was seen by Dr. Jackson with complaints of headache throughout his entire head and
mood disorder.

(Tr. 569-71.) He experienced anxiety, compulsive thoughts, fatigue, manic

episodes, poor concentration, indecisiveness, and sleep disturbance, but no feelings of
worthlessness, hallucinations, panic attacks, or thoughts of suicide. He was prescribed Vicodin
and Zyprexa. On June 1, 2011, Lansford was seen by Dr. Steven Couch regarding migraine pain
behind his right eye. (Tr. 632.) On June 3, 2011 , Lansford was seen at Mercy hospital for
chronic eye and back pain. (Tr. 894-98.)
On June 6, 2011, Lansford was assigned a GAF of 30 by Jeanne Niehaus, Clinical Nurse
Specialist.

(Tr. 533-35.)

Lansford was found to have behavior that was "considerably

influenced by delusions or hallucinations or serious impairment in communication or judgment
or inability to function independently in almost all areas." He was in "[ sJome danger of hurting
self or others."

The police were contacted and affidavits were written to seek involuntary

hospitalization. He stated that he stopped medications because they knocked him out and he
could not work.
On June 10, 2011, Dr. Jackson completed a Medical Source Statement (Physical). (Tr.
456-61.)

Dr. Jackson indicated that Lansford is unable to avoid ordinary hazards in the

8

workplace, such as boxes on the floors, doors ajar, or approaching people or vehicles. Dr.
Jackson also stated that Lansford has "no right eye [vision] and his peripheral vision is
impaired." Dr. Jackson found that Lansford "has severe mood disorder impairing his ability to
concentrate and work."
On June 15, 2011 , Lansford was seen by Dr. Philip Custer for pain behind his right eye.
(Tr. 627.) Dr. Custer noted that Lansford had " [v]isual acuity without correction is bare light
perception in the right eye and 20/60 pinholing to 20/30 in the left eye." (Id.) Dr. Custer said
that he would perform surgery on the eye to relieve the pain. On July 18, 2011 , Lansford was
seen by Dr. Jackson for chronic pain in his eye and for his mood disorder. (Tr. 564-66.) He
complained of lack of sleep, depressed mood, poor concentration, indecisiveness, and
restlessness or sluggishness, but no manic thoughts or hallucinations.

He was prescribed

Zyprexa and Vicodin.
On November 7, 2011 , Lansford was assessed by the Family Support Division, which
indicated that Lansford was manic depressive, suffered from chronic pain in the right eye, and
was unable to work due to worsening vision and trouble concentrating. (Tr. 463-64.)
On January 31 , 2012, Lansford was seen by Dr. Jackson for a headache and a mood
disorder. (Tr. 550-52.) He complained of anxiety, fearful thoughts, compulsive thoughts and
behaviors and fatigue but no feelings of worthlessness, hallucinations or manic episodes. He was
prescribed valproic acid for his headache, and to continue his Ativan and Zyprexa.
IV.

Legal Standard

Under the Social Security Act, the Commissioner has established a five-step process for
determining whether a person is disabled. 20 C.F.R. §§ 416.920, 404.1529. "'If a claimant fails
to meet the criteria at any step in the evaluation of disability, the process ends and the claimant is

9

determined to be not disabled."' Goff v. Barnhart, 421 F.3d 785, 790 (8th Cir. 2005)

(qu~ting

Eichelberger v. Barnha'r t, 390 F.3d 584, 590-91 (8th Cir. 2004)). In this sequential analysis, the

claimant first cannot be engaged in "substantial gainful activity" to qualify for disability benefits.
20 C.F.R. §§ 416.920(b), 404.1520(b). Second, the claimant must have a severe impairment. 20
C.F.R. §§ 416.920(c), 404.1520(c). The Social Security Act defines "severe impairment" as
"any impairment or combination of impairments which significantly limits [claimant's] physical
or mental ability to do basic work activities .... " Id. "The sequential evaluation process may be
terminated at step two only when the claimant's impairment or combination of impairments
would have no more than a minimal impact on [his or] her ability to work." Page v. Astrue, 484
F.3d 1040, 1043 (8th Cir. 2007) (quoting Caviness v. Massanari, 250 F.3d 603, 605 (8th Cir.
2001).
Third, the ALJ must determine whether the claimant has an impairment which meets or
equals one of the impairments listed in the Regulations. 20 C.F.R. §§ 416.920(d), 404.1520(d);
Part 404, Subpart P, Appendix 1. If the claimant has one of, or the medical equivalent of, these
impairments, then the claimant is per se disabled without consideration of the claimant's age,
education, or work history. Id.
Fourth, the impairment must prevent claimant from doing past relevant work. 1 20 C.F.R.
§§ 416.920(e), 404.1520(e). At this step, the burden rests with the claimant to establish his RFC.

Steed v. Astrue, 524 F.3d .872, 874 n.3 (8th Cir. 2008); see also Eichelberger, 390 F.3d at 590-

91 ; Masterson v. Barnhart, 363 F.3d 731, 737 (8th Cir. 2004). RFC is

defi~ed

as what the

claimant .can do despite his or her limitations, 20 C.F.R. § 404.1545(a), and includes an
1

"Past relevant work is work that [the claim.ant] has done within the. past 15 years, that was
substantial gainful activity, and that lasted long enough for [the claimant] to learn how to do it."
Mueller v. Astrue, 561 F.3d 837, 841 (8th Cir. 2009) (citing 20 C.F.R. § 404.1560(b)(l)).

10

assessment of physical abilities and mental impairments. 20 C.F.R. § 404.1545(b)-(e). The ALJ
will review a claimant's RFC and the physical and mental demands of the work the claimant has
done in the past. 20 C.F.R. § 404.1520(±). If it is found that the claimant can still perform past
relevant work, the claimant will not be found to be disabled. Id.; 20 C.F.R. § 416.920(a)(4)(iv).
If the claimant cannot perform past relevant work, the analysis proceeds to Step 5.

At the fifth and last step, the ALJ considers the claimant' s RFC, age, education, and work
experience to see if the claimant can make an adjustment to other work.

20 C.F.R.

§ 416.920(a)(4)(v). If it is found that the claimant cannot make an adjustment to other work, the
claimant will be found to be disabled. Id.; see also 20 C.F.R. § 416.920(g). At this step, the
Commissioner bears the burden to "prove, first that the claimant retains the RFC to perform
other kinds of work, and, second that other work exists in substantial numbers in the national
economy that the claimant is able to perform." Goff, 421 F.3d at 790; Nevland v. Apfel, 204 F.3d
853 , 857 (8th Cir. 2000). The Commissioner must prove this by substantial evidence. Warner v.
Heckler, 722 F.2d 428, 431 (8th Cir. 1983).
If the claimant satisfies all of the criteria of the five-step sequential evaluation process,

the ALJ will find the claimant to be disabled. "The ultimate burden of persuasion to prove
disability, however, remains with the claimant." Id. ; see also Harris v. Barnhart, 356 F .3d 926,
931 n.2 (8th Cir. 2004) (citing 68 Fed. Reg. 51153 , 51155 (Aug. 26, 2003)).
This court reviews the decision of the ALJ to determine whether the decision is supported
by "substantial evidence" in the record as a whole. See Smith v. Shala/a, 31 F.3d 715 , 717 (8th
Cir. 1994). "Substantial evidence is less than a preponderance but is enough that a reasonable
mind would find it adequate to support the Commissioner's conclusion."

Krogmeier v.

Barnhart, 294 F.3d 1019, 1022 (8th Cir. 2002); see also Cox v. Astrue, 495 F.3d 614, 617 (8th

11

Cir. 2007). Therefore, even if a court finds that there is a preponderance of the evidence against
the ALJ's decision, the ALJ's decision must be affirmed if it is supported by substantial
evidence. Clark v. Heckler, 733 F.2d 65 , 68 (8th Cir. 1984). In Bland v. Bowen, 861 F.2d 533 ,
535 (8th Cir. 1988), the Eighth Circuit Court of Appeals held:
[t]he concept of substantial evidence is something less than the weight of the
evidence and it allows for the possibility of drawing two inconsistent conclusions,
thus it embodies a zone of choice within which the Secretary may decide to grant
or deny benefits without being subject to reversal on appeal.
As such, " [the reviewing court] may not reverse merely because substantial evidence exists for
the opposite decision." Lacroix v. Barnhart, 465 F.3d 881, 885 (8th Cir. 2006) (quoting Johnson

v. Chater, 87 F.3d 1015, 1017 (8th Cir. 1996)). Similarly, the ALJ decision may not be reversed
because the reviewing court would have decided the case differently. Krogmeier, 294 F.3d at
1022.

V.

Discussion
A. Listing 12.04

Lansford argues that he meets Listing 12.04 for affective disorders. (ECF No. 13 at 7-8.)
Lansford stated, without citation to the record, that there was testimony in support of a finding of
depressive

syndrome, including sleep

disturbance, cycle motor agitation, difficulties

concentrating or thinking, thoughts of suicide and hallucinations. Lansford also argued, without
citation to the record, that he had manic syndrome, characterized by at least three of the
following: hyperactivity, flight of ideas, decreased need for sleep, easily distractible and
involvement in activities that have a high probability of painful consequences and hallucinations.
In response, the government argues that the substantial evidence supports· the ALJ' s finding
that Lansford did not meet or equal Listing 12.04 for affective disorders. (Tr. 20.) To meet
listing 12.04, Lansford must show either that (1) he suffers from a condition or symptom listed in
12

Paragraph A which results in at least two of the four criteria listed in Paragraph B, or (2) he has a
documented chronic affective disorder resulting in one of three criteria listed in Paragraph C. 20
C.F.R. Pt. 404, subpt. P, app. 1 § 12.04; Blackburn v. Colvin, 761 F.3d 853 , 858 (8th Cir. 2014).
To meet Paragraph B of the listing, Lansford required a showing that a condition has resulted in
two of the following four criteria: " (1) Marked restriction of activities of daily living; or .(2)
Marked difficulties in maintaining social functioning; or (3) Marked difficulties in maintaining
concentration, persistence, or pace; or (4) Repeated episodes of decompensation, each of
extended duration." Id. at § 12.04(B). The government notes that Lansford focused in his brief
on the Paragraph A criteria, but he cited no evidence from the record to support his argument.
(ECF No.

19 at 4.)

The government contends that the evidence supported a finding that

Lansford had normal psychomotor activity. (Tr. 527, 529, 531, 623.) In addition, except on a
few occasions, Lansford generally denied to his providers that he hallucinated. (Tr. 527, 529,
531 , 550, 555, 573 , 577, 582.) The government further contends that Lansford is largely relying
on his own subjective statements, which the ALJ found not credible. (ECF No. 19 at 4-5.)
In addition, the government argues that Lansford has not shown that he meets the criteria for
Paragraph B.

The ALJ determined that Lansford did not have any marked restrictions or

repeated episodes of decompensation. (Tr. 20.) Likewise, the ALJ found that Plaintiff had no restrictions in activities of daily living, based upon his ability to care of his children and dogs,
cook meals, leave the house daily, mow the lawn, handle his own finances, handle his personal
care, do household chores, watch television, play basketball, fish and hunt. (Tr. 20, 305 , 310-13 ,
430, 624, 643.) The ALJ also found Lansford was mildly limited in social functioning. (Tr. 20.)
Lansford did not have history of violence during the relevant period and interacted well with his
doctors. (Tr. 20, 401 , 415 , 430-31 , 527, 529, 531 , 623, 876, 890, 896.) He also displayed

13

adequate social skills during a consultative examination. (Tr. 430.) He further demonstrated the
ability to adequately function socially because he attends AA and NA meetings, shopped, and
occasionally went to church. (Tr. 20, 58, 312.) With respect to concentration, persistence or
pace, the ALJ found that Lansford had moderate difficulties. (Tr. 20.) Lansford was generally
alert and orientated at his examinations. (Tr. 20, 431 , 551 , 557, 562, 571 , 588, 591, 594, 639,
651 , 876, 878, 890.) A consultative examiner found that Lansford could sustain concentration,
persistence or pace with simple tasks.

(Tr. 20, 432.)

And, Lansford suffered no repeated

episodes of decompensation of extended duration. (Tr. 20.) Finally, Dr. Maddox opined that
Lansford did not have any marked limitations or episodes of decompensation. (Tr. 441.)
The Court holds that the substantial evidence supports a finding that Lansford did not meet
the 12.04 Listing. As detailed by the government, Lansford did not cite to any evidence in the
record to support a finding of disability under Paragraph A, and the record indicates, for
example, that he had normal psychomotor activity and did not hallucinate. Likewise, Lansford
did not meet the criteria of Paragraph B. Evidence in the record supports a finding that he did
not have any marked restrictions or repeated

~pisodes

of decompensation. There was ample

evidence in the record, including repeated statements by Lansford, that he was not restricted in
the activities of daily living and that any restrictions, such as driving, were due to his drinking
problem. Also, there is evidence in the record to support the ALJ's finding that Lansford was
mildly limited in social functioning. He regularly attended AA and NA meetings, shopped, went
to church, and interacted with friends frequently without incident. Evidence also supported
moderate difficulties in concentration, persistence, or pace, particularly based upon the findings
of a consultative examiner. (Tr. 20, 432.) Dr. Maddox also found that Lansford did not have
any marked limitations or episodes of decompensation. (Tr. 44.) Thus, the Court holds that the

14

ALJ's determination that Lansford did not meet the criteria of 12.04 was based upon substantial
evidence.
B. ALJ's RFC Assessment
Lansford contends that the ALJ failed to properly consider and evaluate his vanous
limitations when determining his RFC.
1. GAF Score
First, Lansford asserts the ALJ improperly used Lansford ' s GAF score of 55 to determine
that he had only moderate psychological impairment. (ECF No. 13 at 6.) Lansford notes that all
of his other GAF scores, 49, 30, and 45, were below 50, which indicates serious symptoms or
serious impairment in social or occupational functioning . (Id.) Lansford argues it was improper
for the ALJ to pick out one GAF score of 55 ; he argues that the ALJ should have evaluated the
other scores and evaluated them all, along with Lansford' s other impairments to properly
determine his RFC. (ECF No. 20 at 2.) Lansford acknowledges that one GAF score alone
cannot be the basis of a determination of disability but contends that it was improper for the ALJ
to choose only the highest score without referencing the lower scores. (ECF No. 13 at 6.)
In response, the government argues that Lansford overemphasizes the importance of a GAF
score.

(ECF No. 19 at 9); see also Kelly v. Colvin, No. 13-0609-CV-W-ODS, 2014 WL

2004467, at *4 (W.D. Mo. May 16, 2014)("Plaintiff also seems to suggest the ALJ was required
to include greater limitations in the RFC based simply on the GAF score Dr. Parks assigned. This
is incorrect."). "The GAF scale is used by clinicians to report an individual's overall level of
functioning ." Quaife v. Barnhart, 312 F. Supp. 2d 1195, 1200 (E.D. Mo. 2004)(citing American
Psychiatric Assoc., Diagnostic and Statistical Manual of Mental Disorders 32 (Text Revision 4th
ed.2000)). " [T]he [GAF] score, standing alone, does not establish an impairment seriously

15

interfering with plaintiffs ability to perform basic work activities." Quaife v. Barnhart, 312 F.
Supp. 2d 1195, 1200 (E.D. Mo. 2004); cf Howard v. Comm'r of Soc. Sec., 276 F.3d 235, 241
(6th Cir.2002) ("While a GAF score may be of considerable help to the ALJ in formulating the
RFC, it is not essential to the RFC's accuracy.").
In addition, the government contends that the ALJ did not ignore Lansford's lower GAF
scores simply because they are not cited in her decision. The governrrient notes that an ALJ does
not need to discuss every piece of evidence submitted and failure to discuss every piece of
evidence does not mean that it was ignored.

See Black v. Apfel, 143 F.3d 383, 386 (8th

Cir.1998). The GAF score, standing alone does not reflect an opinion about an individual's
ability to work or necessarily correlate to any specific work-related limitations. Lansford's GAF
scores reflecting serious symptoms do not necessarily undermine the ALJ's analysis of
Lansford's work-related limitations, particuiarly if those limitations are reflected in the medical
records or in Lansford's daily activities. In any event, the government maintains that the ALJ's
opinion reflects that she was aware of Lansford's lower GAF scores. For example, the ALJ
notes that Lansford's medical records show that "deterioration of his mental status is generally
correlated with the times he stops taking medication, and he quickly recovers." Thus, according
to the government, the ALJ properly found that Lansford's periods of increased symptoms did
not reflect his level of functioning when he took his medications. (Tr. 26; Tr. 533-34 (at the time
that Lansford was assigned a 30 GAF score, he stated that "he stopped medications because they
knock him out & he could not work"); see Juszczyk v. Astrue, 542 F.3d 626, 632 (8th Cir.
2008)(ALJ properly determined Dr. Stanley's GAF assessment could not be relied on). "If an
impairment can be controlled by treatment or medication, it cannot be considered disabling."
Brace v. Astrue, 578 F.3d 882, 885 (8th Cir.2009); Brown v. Astrue, 611 F.3d 941, 955 (8th Cir.

16

2010). Further, the other two, lower GAF scores were assigned by Dr. Rexroat, a consultative
examiner (Tr. 432, 625), whose findings the ALJ specifically referenced in her opinion. (ECF
No. 19 at 11.) For example, Dr. Rexroat believed that Lansford could sustain concentration,
persistence and paced with simple tasks, and the ALJ incorporated this restriction into Lansford's
RFC. (Tr. 21, 25-26, 432, 624.) The government states that because a GAF score does not
necessarily reflect an opinion about an individual ' s ability to work, it was proper for the ALJ to
place more emphasis on the actual work-related restrictions contained in Dr. Rexroat' s opinions
than the GAF scores he assigned. (ECF No. 19 at 11.) Finally, the government asserts that
Lansford has mischaracterized the ALJ's decision by stating that the ALJ used Lansford's GAF
score of 55 to find that he had only moderate impairment. (ECF No. 19 at 11 (citing ECF No. 13
at 6)). The government argues, instead, that the ALJ's decision reflects her consideration of the
entire record to form Lansford' s mental RFC, including the results of his mental-status
examinations, his described daily activities and the opinions of Dr. Rexroat and Dr. Maddox
concerning Lansford's actual work-related limitatfons. (Tr. 20, 22-26, 432, 445-47, 624.) The
government contends the ALJ was entitled to rely on this evidence instead of isolated GAF
scores. (ECF No. 19 at 11 ).
The Court agrees that the ALJ properly considered Lansford's GAF scores when determining
his mental RFC. The record indicates that the ALJ discounted Lansford's lowest GAF score
because it occurred while he was not on his medication, which was needed to regulate his mental
status. In addition, the ALJ referenced the reports of Dr. Rexroat which contained the other GAF
scores so she must have also considered those scores as well. Most importantly, the ALJ's
opinion demonstrates that she considered Lansford' s entire mental health record in ,determining
his mental RFC. The ALJ discussed and evaluated the results of his mental-status examinations,

17

his described daily activities and the opinions of Dr. Rexroat and Dr. Maddox, not simply his
GAF scores. The Court

find~

that the ALJ correctly did not credit the other GAF scores when

developing Lansford ' s RFC and instead relied on the other medical evidence. Thus, the Court
finds that the record as a whole supports the ALJ' s mental RFC determination. See Kornecky v.
Cornrn'r of Soc. Sec., 167 F. App'x 496, 511 (6th Cir. 2006)("If other substantial evidence (such

as the extent of the claimant's daily activities) supports the conclusion that she is not disabled,
the court may not disturb the denial of benefits to a claimant whose GAF score is as low as [the
claimant' s] or even lower.").
2. Right-Eye Pain Complaints
Lansford argues that the ALJ failed to take into consideration Lansford' s subjective
complaints of pain as a result of the surgery, which is improper. (ECF No. 13 at 6.) Lansford
contends that there is substantial medical evidence to support his eye and head pain but the ALJ
filed to take his pain into consideration. (Id.)
The government maintains that substantial evidence supported a finding that Lansford' s eye
pain and recovery periods did not result in any additional work-related limitations or were so
severe as to be disabling. (ECF No. 19 at 7.) For example, in January 2012; Dr. Jackson noted
that Lansford' s eye pain was stable on medication (Tr. 1086), which is corroborated by other
treatment records. (Tr. 564.) See Brown v. Astrue , 611 F.3d 941 , 955 (8th Cir. 2010); Brace v.
Astrue, 578 F.3d 882, 885 (8th Cir. 2009)("1f an impairment can be controlled by treatment or

medication, it cannot be considered disabling."). Lansford was also never in any acute distress
during his appointments, which undermines his claim of disabling pain. (Tr. 551 , 562, 565, 571 ,
574, 578, 583 , 588, 591 , 594, 876, 878, 892, 1087, 1092.) See McCoy v. Astrue, 648 F.3d 605,
614 (8th Cir. 2011)("complaints of disabling pain are inconsistent with repeated observations

18

from treating and consultative physicians that McCoy was not in acute pam or distress").
Lansford extensive list of daily activities (caring for children, shopping, attending meetings,
mowing grass) were also not indicative of disabling pain. See Steed v. Astrue, 524 F.3d 872, 876
(8th Cir. 2008)(ALJ did not err in discounting claimant' s credibility where there was "substantial
evidence for the ALJ's observation that [claimant's] reported daily activities were inconsistent
with her self-reported limitations"). Further, in a medical source statement, Dr. Jackson did not
indicate any limitations due to Lansford ' s eye pain or otherwise mention his eye pain. (Tr. 45661.) Lansford also does not explain what symptoms he experienced during his recovery periods
that the ALJ did not account for. (ECF No. 19 at 8 (citing ECF No. 13 at 7)). In sum, although
Lansford sought some treatment for eye pain, the government asserts that the evidence does not
support of a finding that it resulted in greater work-related limitations than the ALJ assigned or
that it was so severe as to be disabling.
The Court holds that substantial evidence supported a finding that Lansford ' s eye pain and
recovery periods did not result in any additional work-related limitations or were so severe as to
be disabling. The Court agrees that the evidence in the record does not indicate that Lansford
reported disabling pain at the time of his appointments with his physicians.

Likewise, his

extensive daily activities belie his claim that his eye pain was disabling. His treating physician
also did not find his alleged pain to be credible or intensive enough to include in his medical
source statement. (Tr. 456-61.) The Court also cannot speculate as to what symptoms Lansford
experienced during his periods of recovery from surgery but those ailments do not appear from
the record to be disabling. Therefore, the Court fmds that Lansford ' s eye pain was not disabling
as a matter of law based upon the record .
3. Left Eye

19

Lansford also asserts the ALJ improperly found that Lansford' s vision was normal in his left
eye, despite the testimony of Lansford and Dr. Korenfeld who indicated there was a retinal hole
in his left eye. (ECF No. 13 at 7; Tr. 21 , 23.)
The government disagrees based upon Dr. Korenfeld's determination that Lansford had

20120 corrected vision in his left eye, despite having a retinal hole. (ECF No. 19 at 14 (citing Tr.
1099.))
The Court finds that credible evidence, namely the opinion of Dr. Korenfeld, supported a
finding that Lansford's vision was normal in his left eye, despite having a retinal hole.
4. Opinions of Dr. Jackson, Lansford ' s Treating Physician
Finally, Lansford maintains that the ALJ improperly gave no weight to the opm10ns of
Lansford's treating physician, Dr. Jackson. Dr. Jackson indicated that Lansford had no right eye
vision and his peripheral vision was impaired; Lansford suffered from severe mood disorder
impairing his ability to concentrate and work; and suffered from mood and personality disorders,
including bi-polar personality disorder. (ECF No. 13 at 7.)

In particular, Lansford cites to the

Social Security Regulations which state that a treating physician' s opinion on the nature and
severity of an impairment should be given controlling weight if it is consistent with the other
substantial evidence in the record.
In response, the government maintains that the ALJ properly gave Dr. Jackson's opinion only
limited weight because there was no evidence that Lansford had ever injured himself due to
ordinary hazards. (ECF No. 19 at 12 (citing Tr. 23.)) The government states that "[a]lthough Dr.
Jackson opined that Plaintiff could not avoid ordinary hazards in the workplace, his treatment
notes contain no indication that Plaintiff had injured himself because of ordinary items, such as
boxes or open doors, or had complained of difficulty avoiding such items." (ECF No. 19 at 13

20

(citing Tr. 23 , 259.)) The government maintains that it was reasonable for the ALJ to believe
that Lansford would have injured himself or at least complained of some difficulty avoiding
ordinary hazards if he were truly as limited as Dr. Jackson opined. (ECF No. 19 at 13 .) In
addition, Lansford has admitted that his daily activities include caring for his two children and
dogs, cooking meals, going outside by himself, shopping, moving the law, doing household
chores, playing basketball, fishing, and hunting.

(Tr. 20, 305, 310-13 , 624, 643.)

The

government asserts that these activities are more extensive than would be expected from
someone who could not avoid ordinary workplace hazards. Also, the credibility of Dr. Jackson' s
opinion is questionable given that he never cautioned Lansford to limit any of his daily activities
or otherwise cautioned him to avoid ordinary hazards. (ECF No. 19 at 13.) See Hogan v. Apfel,
239 F.3d 958, 961 (8th Cir. 2001)(discrediting the ALJ's opinion of the claimant's limitations
where "[n]one of these restrictions appear elsewhere in his treatment records"). Finally, the
government maintains that the ALJ accounted for Lansford' s visual impairments by limiting
Lansford's exposure to hazards, such as machinery and heights, and restricting Lansford to only
occasional climbing. (ECF No. 19 at 14 (citing Tr. 23.))
The government also maintains that Dr. Jackson' s opinion that Lansford suffers from a mood
disorder is consistent with the ALJ's findings.

(ECF No. 19 at 14.) The ALJ found that

Lansford suffers from severe depression (Tr. 19), which limited Lansford' s ability to concentrate
and resulted in work-related limitations. (Tr. 20.) To account for this issue, the ALJ limited
Lansford to work that involved understanding, remembering, and carrying out only simple
instructions, which was consistent with Dr. Rexroat's opinion. (Tr. 20-21.) The government
challenges that nothing in Dr. Jackson' s opinion or treatment notes support greater limitations
than the ALJ assigned. (ECF No. 19 at 14). In fact, Dr. Jackson found that Lansford was alert

21

ap.d orientated, without unusual anxiety or evidence of depression. (ECF No. 19 (citing Tr. 557,
562, 578, 583, 591 , 1088, 1092.))
The Court holds that the ALJ properly accommodated the opinions of Dr. Jackson that were
I

corroborated in the medical record. ALJs are not obliged to defer to treating physician's medical
opinions unless they are "well-supported by medically acceptable clinical and laboratory
diagnostic techniques and [are] not inconsistent with the other substantial evidence in the
record." Ellis v. Barnhart, 392 F.3d 988, 995 (8th Cir.2005) (quotations omitted). The Court
agrees that there is nothing in the record that indicates that Lansford was unable to avoid
ordinary workplace dangers.

Rather, and as demonstrated by Lansford' s extensive daily

activities, he seemed capable of avoiding ordinary workplace hazards. Further, to the extent that
Lansford had any impairment, the ALJ properly accounted for that impairment by limiting
Lansford' s exposure to hazards, such as machinery and heights, and restricting him to only
occasional climbing. In addition, the Court holds that the ALJ properly accounted for Lansford' s
mental impairment as outlined by Dr. Jackson. The ALJ acknowledged that Lansford suffers
from depression and impaired concentration. Therefore, the ALJ limited Lansford ' s work to that
involved understanding, remembering, and carrying out only simple instructions. The Court
finds that these restrictions were properly tailored to Lansford' s limitations as detailed in the
medical records. See Juszczyk, 542 F.3d at 632 ("The ALJ rejected Dr. Stanley's assessment
because it was inconsistent with Dr. Stanley's own treatment notes, with objective testing, and
with other medical evidence in the record. Our review of the record, including reports from Dr.
Pulcher, Dr. King, Dr. Plageman, and the Truman Medical Center confirms · the ALJ's
conclusion.").
C.

Lansford Could Perform Other Jobs in the Economy

22

Finally, Lansford maintains that there is no substantial evidence that Lansford can return
to his former work and that Lansford can perform other work.

(ECF No. 13 at 2).

The

government points out that the ALJ found that Lansford could not perform his past work (Tr. 27)
and, therefore, through examination of a vocational expert, determined that Lansford could
perform other work existing in significant numbers in the national economy. (ECF No. 19 at 15
(citing Tr. 18.)) The vocational expert testified that a hypothetical claimant with Lansford' s RFC
could perform the jobs of housekeeper/cleaner, mail sorter, and bench assembler. (Tr. 28, 7071.) Based upon this testimony, the ALJ concluded that Lansford could perform these jobs and
was not disabled.
The Court holds that the testimony of the vocational expert satisfied the Commissioner' s
burden to show that Lansford could perform other work existing in significant numbers in the
national economy. See Cox v. Astrue , 495 F.3d 614, 621 (8th Cir. 2007)("because the vocational
expert, in response to a hypothetical that captures the consequences of [claimant's] deficiencies,
described readily available occupations in which she could engage, the Commissioner
successfully demonstrated Cox's ability to perform work in the economy"). Therefore, the Court
holds that substantial evidence supported the ALJ' s finding that Lansford could perform other
work.
VI.

Conclusion

Based on the foregoing, the Court finds that the ALJ' s decision was based on substantial
evidence in the record as a whole and should be affirmed.
Accordingly,
IT IS HEREBY ORDERED that this action is AFFIRMED. A separate Judgment will

accompany this Order.

23

Dated this _th day of March, 2015.

~L~
~IEL. WHITE

UNITED STATES DISTRICT JUDGE

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