Buchanan v. Colvin

Filing 22

MEMORANDUM AND ORDER..IT IS HEREBY ORDERED that the decision of the Commissioner is AFFIRMED and this case is DISMISSED. A separate Judgment in accordance with Memorandum and Order is entered herewith. Signed by Magistrate Judge Abbie Crites-Leoni on 3/27/15. (MRS)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
TAYLOR E. BUCHANAN,
Plaintiff,
v.
CAROLYN W. COLVIN, Acting
Commissioner of Social Security,
Defendant.

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No. 4:14CV501 ACL

MEMORANDUM AND ORDER
Plaintiff Taylor E. Buchanan brings this action pursuant to 42 U.S.C. §
405(g), seeking judicial review of the Social Security Administration (SSA)
Commissioner’s (Commissioner) denial of her disability claim. Buchanan had
previously been found disabled as a child, but was found not to be disabled as an
adult upon turning eighteen years old. Buchanan requests that the matter be
reversed and remanded to the Commissioner for an award of benefits, or for further
proceedings.
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. Factual and Procedural Background
When Buchanan was four months old, she was awarded child supplemental
security income (SSI) based on the SSA finding that she was disabled as of
November 1, 1993. The disability finding was based on the fact that Buchanan
was diagnosed with hereditary spherocytosis.1 The rules applicable to SSA
determinations of disability require that when a child attains the age of eighteen, a
redetermination of eligibility for disability benefits must be conducted. 20 C.F.R.
§ 416.987.
A few months after Buchanan’s eighteenth birthday, in a letter dated
November 14, 2011, the SSA notified Buchanan that it had determined that she
was no longer qualified for SSI benefits as of November 1, 2011, under the
definition of disability for adults. (Tr. 60-68.) Buchanan requested
reconsideration of that decision and the matter was presented to a Disability
Hearing Officer who reviewed the evidence and issued a written decision on
February 16, 2012, finding that Buchanan was no longer eligible for payments.
(Tr. 75-83.)

1

Hereditary spherocytosis is a condition affecting red blood cells. People with the condition
typically experience anemia, jaundice, and an enlarged spleen. Hereditary spherocytosis,
Genetics Home Reference (published Feb. 15, 2015), available at <http://ghr.nlm.nih.gov/
condition/hereditary-spherocytosis>. In a letter dated August 2012, Dr. Cheng, Buchanan’s
pediatrician, reported that Buchanan experienced no major effects from this condition since
having her spleen removed in 2003. (Tr. 436.)
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Next, Buchanan requested a hearing before an Administrative Law Judge
(ALJ). That hearing was held on December 20, 2012. Buchanan and a vocational
expert testified. (Tr. 27-49.) The ALJ issued a decision on February 8, 2013,
finding that Buchanan’s disability ended on November 15, 2011, and that she had
not become disabled since that time. (Tr. 7-21.) Additionally, the ALJ found that
Buchanan had several severe impairments, including: ADHD, learning disorder,
and bipolar disorder. The ALJ also found that although Buchanan did not have any
past relevant work, she had the residual functional capacity (RFC) to perform work
as a hand packer, laundry worker, and janitor/housekeeper, which exist in
significant numbers in the national economy.
On January 31, 2014, the Appeals Council denied Buchanan’s request for
review of the ALJ’s decision. (Tr. 1-3.) The ALJ’s determination thus stands as
the final decision of the Commissioner. 42 U.S.C. § 405(g).
In the instant action for judicial review, Buchanan claims that the ALJ’s
decision is not supported by substantial evidence on the record as a whole, because
the ALJ failed to accord proper weight to the opinion evidence of record.
Specifically, Buchanan argues that her treating psychiatrist’s (Dr. Bhuyan) opinion
was entitled to “substantial/significant if not controlling weight.” (Doc. 16 at 12,
14) Buchanan alleges that the ALJ’s failure to weigh Dr. Bhuyan’s opinion more
heavily was based on the ALJ’s improper consideration of the opinions from Dr.
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Cheng, Dr. Buffkins, and an SSA interviewer, A. Duvall, as well as Buchanan’s
refusal to recognize, or lack of insight into her limitations. Id. at 8-14.
II. Applicable Law and Standard of Review
When a claimant who was awarded disability benefits as a child turns
eighteen years old the SSA re-determines the claimant’s eligibility for disability
benefits. 20 C.F.R. § 416.987. The rules used for “age-18 redeterminations” are
those applicable to adult claimants who file new applications for benefits, that is,
the rules set out in 20 C.F.R. § 416.920(c)-(h). See 20 C.F.R. § 416.987(b).
Accordingly, the framework used by the Commissioner in age-18 redeterminations
is the familiar five-step sequential analysis for reviewing new adult applications for
disability, except that whether the claimant is engaged in substantial gainful
activity is not considered. Id.
In age-18 redeterminations, the Commissioner first determines whether the
claimant has a “severe” impairment or combination of impairments, meaning that
which significantly limits her ability to do basic work activities. If the claimant's
impairment(s) is not severe, then she is not disabled. The Commissioner then
determines whether claimant's impairment(s) meets or equals one of the
impairments listed in 20 C.F.R., Part 404, Subpart P, Appendix 1. If claimant's
impairment(s) is equivalent to one of the listed impairments, she is conclusively
disabled. At the next step, the Commissioner establishes whether the claimant can
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perform her past relevant work. If so, the claimant is not disabled. If the claimant
cannot perform past relevant work, the Commissioner evaluates various factors to
determine whether she is capable of performing any other work in the economy. If
not, the claimant is declared disabled and becomes entitled to disability benefits.
20 C.F.R. § 416.920(c)-(g). Throughout all steps of the process, the claimant
retains the burden of demonstrating that she is disabled. Pearsall v. Massanari,
274 F.3d 1211, 1217 (8th Cir. 2001); Baker v. Secretary of Health & Human
Servs., 955 F.2d 552, 555 (8th Cir. 1992). With age-18 redeterminations, the
Commissioner may find a claimant not to be disabled even though there was a
previous finding of disability as a child. 20 C.F.R. § 416.987(a)(2).
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
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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:
1.

The credibility findings made by the ALJ.

2.

The plaintiff's vocational factors.

3.

The medical evidence from treating and consulting physicians.

4.

The plaintiff's subjective complaints relating to exertional and
non-exertional activities and impairments.

5.

Any corroboration by third parties of the plaintiff's
impairments.

6.

The testimony of vocational experts when required which is
based upon a proper hypothetical question which sets forth the
claimant's impairment.

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 that
fairly detracts from the Commissioner’s decision. Coleman, 498 F.3d at 770;
Warburton v. Apfel, 188 F.3d 1047, 1050 (8th Cir. 1999). “If, after reviewing the
entire record, it is possible to draw two inconsistent positions, and the
Commissioner has adopted one of those positions,” the Commissioner’s decision
must be affirmed. Anderson v. Astrue, 696 F.3d 790, 793 (8th Cir. 2012). The
decision may not be reversed merely because substantial evidence could also
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support a contrary outcome. Young v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000).
III. The ALJ's Decision
The ALJ found that Buchanan attained eighteen years of age on July 19,
2011, and was eligible for receipt of supplemental security income as a child for
the month prior to the month of her eighteenth birthday.
The ALJ considered substantial records from various treating and consulting
professionals. One of the treating professionals was Buchanan’s treating
psychiatrist, Dr. Elly Bhuyan. The ALJ gave “little evidentiary weight to the
findings of limitations and opinions” of Dr. Bhuyan. (Tr. 17.) The ALJ’s
consideration of the records from Dr. Bhuyan was thorough, and included
treatment records dated July 2, 2010 through November 6, 2012, and a recognition
of the fact that Buchanan had been a patient since January 31, 2000. In
determining to give little weight to Dr. Bhuyan’s opinion, the ALJ discussed the
supportability and consistency of Dr. Bhuyan’s opinions or lack of supportability
and consistency, within the record of the case as a whole. The ALJ wrote:
Treatment records. . .document complaints of social anxiety, suicidal
thoughts, and low mood. It was noted that [Buchanan] was socially
behind and immature. . .[and] that [her] current Global Assessment of
Functioning (GAF) scores were 66-69, which is consistent with only
mild limitations of functioning. . .the treatment records contain subjective reports and very little if any objective medical findings of significant deficiencies in cognition, mood, affect, thought process, speech,
or psychomotor activity. Although the claimant reported having social
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problems, it was noted she had a boyfriend and she reported she was not
fighting with her mother. In December 2011, [Buchanan] reported she
was working one day per week. . .[on other days, Buchanan] reported[:]
she was in a good mood and that she had applied for Social Security
disability. . .she got good grades last semester and she was going on a
trip to New York with her music class. . .[she] was working in a movie
theater. . .she graduated from high school and was getting vocational
rehabilitation services. . .On August 12, 2012,. . .she was frustrated
that she did not get Social Security disability. . .
On September 12, 2012, Dr. Bhuyan completed a Mental Residual
Functional Capacity Questionnaire [MRFCQ]. . .indicating many moderate to marked limitations of functioning. Specifically,. . .claimant
was markedly limited in her abilities to: get along with coworkers or
peers with distracting them or exhibiting behavioral extremes; respond
appropriately to changes in the work setting; deal with normal work
stress; be aware of hazards and take necessary precautions; maintain
regular attendance; or sustain an ordinary routine without special
supervision. . .Dr. Bhuyan noted moderate limitations in carrying out
very short and simple instructions; maintaining attention for two-hour
segments; making simple work-related decisions; and asking simple
questions or requesting assistance. . .[Buchanan] was an emotionally
fragile individual and. . .did not have the capacity to hold a meaningful
job on her own to support her. . .[Buchanan] was tolerating her medications. . . .[she] was assigned current. . .GAF scores of 64 to 70, which is
consistent with only mild limitations of functioning and grossly inconsistent with the findings of marked or even moderate limitations noted
by Dr. Bhuyan in the [MRFCQ]. Moreover, the findings of limitations
are also inconsistent with the findings in the school records that the
claimant’s strengths included her ability to participate in class, complete
tasks, and ask questions when she needed help.
(Tr. 16-17; emphasis added.)
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After thorough consideration of the other documents and opinions within the
record, the ALJ found that Buchanan was determined to no longer be disabled as of
November 15, 2011, based on a redetermination of disability under the rules for
adults filing new applications. The ALJ found that since November 15, 2011,
Buchanan’s ADHD, learning disorder, and bipolar disorder were severe
impairments, but that they did not meet or medically equal an impairment listed in
20 C.F.R. Part 404, Subpart P, Appendix 1. (Tr. 12.) Additionally, the ALJ found
that, since November 15, 2011, Buchanan had the RFC to perform work at all
exertional levels, except that she was
limited to occupations that involve only simple, routine, and repetitive
tasks. She is limited to occupations that do not require addition,
subtraction, multiplication, or division. In a low stress job that is
defined as having only occasional changes in the work setting and
only occasional judgment required on the job. Furthermore, the
claimant is limited to only occasional interaction with the public, and
only occasional interaction with coworkers, but contact with
coworkers can occur as long as said contact is casual and infrequent.
Lastly, the claimant requires isolated work defined as supervisory
contact concerning work duties, when work duties are being
performed up to expectations, occurs no more than four times per
workday.
(Tr. 13-14.) The ALJ determined that Buchanan did not have any past relevant
work. Considering Buchanan’s age, education, work experience, and RFC, the
ALJ determined that vocational expert testimony supported a finding that
Buchanan could perform work as it exists in significant numbers in the national
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economy, specifically, as a hand packer, laundry worker, and janitor/housekeeper.
The ALJ concluded that Buchanan’s disability ended on November 15, 2011, and
that she had not become disabled since that date. (Tr. 19-20.)
IV. Discussion
Buchanan’s overarching argument is that the ALJ erred by not attributing
significant weight to her treating psychiatrist, Dr. Bhuyan. According to
Buchanan, the ALJ should have accorded Dr. Bhuyan’s opinion “substantial if not
controlling weight.” (Doc. 16 at 12, 14.) To support her argument, Buchanan
claims that the reasons offered by the ALJ to discredit Dr. Bhuyan’s opinion were
not good reasons, specifically, noting that “the ALJ failed to explain how being
emotionally fragile was inconsistent with tolerating medications” and “[t]he ALJ
should have afforded greater weight to the medical and educational evidence than
to a GAF score.” Id. at 9. Buchanan also argued that Dr. Bhuyan’s opinion
should have been afforded greater weight as it was consistent with Dr. Cheng’s
opinion letter dated August 28, 2012, which stated although Buchanan is capable
of “manual light labor,” it would be difficult for her to sustain regular employment
based on “her inability to stay focused on tasks for a substantial period,” id. at 1112; and the ALJ erred by not identifying the weight given to the opinion of Dr.
Buffkins, id. at 14, a consultative examiner.
For the following reasons, the Court disagrees.
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IV.A. Opinion Evidence
When evaluating opinion evidence, the ALJ is required by the Regulations
to explain in the decision the weight given to any opinions from treating sources,
non-treating sources, and non-examining sources. 20 C.F.R. § 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. § 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. Id.; 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.
Id. However, a treating physician’s opinion is not automatically controlling.
Grable v. Colvin, 770 F.3d 1196, 1201 (8th Cir. 2014). “An ALJ may ‘discount or
disregard a treating physician’s opinion where other medical assessments are
supported by better or more thorough medical evidence, or where a treating
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physician renders inconsistent opinions that undermine the credibility of such
opinions.’” Id. (quoting Smith v. Colvin, 756 F.3d 621, 625-26 (8th Cir. 2014)).
In addition, 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 that 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 her 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. § 416.927(c). The Regulations further
provide that the Commissioner “will always give good reasons in [the] notice of
determination or decision for the weight [given to the] treating source's opinion.”
20 C.F.R. § 416.927(c)(2). Inconsistency with other substantial evidence alone is
sufficient to discount a treating physician’s opinion. Goff v. Barnhart, 421 F.3d
785, 790-91 (8th Cir. 2005) (emphasis added).
For the following reasons, the ALJ’s decision to “give[] little evidentiary
weight to the findings of limitation and the opinions by Dr. Bhuyan” (Tr. 16) is
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supported by substantial evidence on the record as a whole.
IV.A.1.

Dr. Bhuyan

Elly Bhuyan is a Medical Doctor and Distinguished Life Fellow of the
American Psychiatric Association. She has been Buchanan’s treating psychiatrist
since Buchanan was six years old. In September 2012, Dr. Bhuyan completed a
Mental RFC Questionnaire in which she rendered opinions that Buchanan
experienced numerous limitations so significant that she would essentially be
unable to function effectively in the workplace. The ALJ found these opined
limitations to be inconsistent with Dr. Bhuyan’s own assignment of GAF scores
that indicated only mild limitations; and, further, to be inconsistent with other
evidence of record, including Buchanan’s school records. (Tr. 17.)
In August 2011, Dr. Bhuyan informed disability determinations that
Buchanan’s GAF score was 66-69, indicating mild limitations of functioning. In
her September 2012 RFC Questionnaire, Dr. Bhuyan again reported Buchanan’s
GAF score to be consistent with mild limitations, stating the score to currently be
64-70 with Buchanan’s highest score in the previous year to be 70.2 As noted by
the ALJ, these GAF scores, as assigned by Dr. Bhuyan, are inconsistent with her
opinion that Buchanan suffers from limitations that effectively preclude her from
Notably, consulting psychologist Dr. Buffkins assigned a consistent GAF score of 66-69
during her October 2011 evaluation of Buchanan.

2

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engaging in any sustained work-related activity. Contrary to Buchanan’s assertion,
an ALJ is permitted to consider GAF scores and their consistency with other
evidence of record. Where, as here, a treating physician renders an opinion that a
claimant suffers from extreme limitations, the ALJ is not compelled to give
controlling weight to that opinion when that same physician also assigned GAF
scores indicating that claimant experienced only moderate to mild symptoms. See
Halverson v. Astrue, 600 F.3d 922, 930 (8th Cir. 2010); Goff v. Barnhart, 421 F.3d
785, 791 (8th Cir. 2005).
Although Buchanan argues that the ALJ improperly relied on only the GAF
scores to discredit Dr. Bhuyan’s opinion and did not consider other substantial
medical and other evidence of record, a review of the ALJ’s decision shows this
claim to be without merit. The ALJ thoroughly reviewed all of the evidence of
record, including treatment notes and opinion evidence from Buchanan’s treating
physicians, reports from consultative evaluations, Buchanan’s school records, and
Buchanan’s subjective claims. While the ALJ considered Buchanan’s GAF scores
when weighing Dr. Bhuyan’s opinion, he also specifically noted that her opinion
regarding Buchanan’s limitations were inconsistent with observations made in
Buchanan’s school records that demonstrated Buchanan’s ability to participate in
class, complete tasks, and ask questions. As detailed in the next section, a review
of the record in toto shows there to be substantial evidence that Buchanan was not
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as limited as opined by Dr. Bhuyan. The ALJ did not err in according little weight
to her opinion.
That being said, a review of the ALJ's RFC assessment shows it to contain
significant functional limitations, including the limitation to simple, routine, and
repetitive work with no math computations required; low stress work with only
occasional changes in work setting and only occasional judgment required; only
occasional interaction with the public and coworkers; and isolated work with no
more than four contacts with supervisors per day. Such limitations are consistent
with many of the limitations described by Dr. Bhuyan. It cannot be said, therefore,
that the ALJ wholly failed to consider Dr. Bhuyan’s opinion or that the RFC
assessment is not supported by some medical evidence. See Martise v. Astrue, 641
F.3d 909, 926 (8th Cir.2011); Ellis, 392 F.3d at 994. An ALJ is “not required to
rely entirely on a particular physician's opinion or choose between the opinions
[of] any of the claimant's physicians.” Martise, 641 F.3d at 927 (internal quotation
marks and citation omitted). Instead, the ALJ must determine a claimant's RFC
based on his review of the record as a whole. The ALJ did so here.
IV.A.2.

Dr. Cheng

Dr. Cheng was Buchanan’s treating pediatrician since 1999. The ALJ
accorded little weight to the opinions (Tr. 16) expressed in Dr. Cheng’s August
2012 Physical RFC Questionnaire, id. at 437-41, and accompanying letter, id. at
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436. The ALJ noted that the opined physical limitations in the Questionnaire were
inconsistent with Dr. Cheng’s treatment notes that yielded normal medical findings
(“aside from intermittent findings of congestion, the medical findings were
normal,” Tr. 16; no major issues related to anemia after splenectomy in 2003, id.).
Additionally, even Dr. Cheng noted that “[o]verall, this Questionnaire is not
appropriate for assessing [Buchanan]’s functional capacity, as much of it asks
about physical disabilities which [Buchanan] does not suffer from.” (Tr. 436.) Dr.
Cheng further suggested, “I do not prescribe [Buchanan’s psychotropic]
medications,. . .I strongly suggest you have her psychiatrist provide you a list of
those medications and provide you a more comprehensive analysis of her ability to
work.” Id.
Where limitations in a treating physician’s opinion were never mentioned in
the physician’s treatment records, nor are supported by any objective testing or
reasoning, the ALJ does not err in discounting that physician’s opinion. Cline v.
Colvin, 771 F.3d 1098, 1103-04 (8th Cir. 2014). Nor does the ALJ err in
according little weight to a treating physician’s opinion when it contains internal
inconsistencies. Anderson v. Barnhart, 344 F.3d 809, 813 (8th Cir. 2003). See
also Bernard v. Colvin, 774 F.3d 482, 487 (8th Cir. 2014) (ALJ may give less
weight to inconsistent opinion by treating physician); Wagner v. Astrue, 499 F.3d
842, 849-50 (8th Cir. 2007) (and cases cited therein) (physician opinions that are
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internally inconsistent are entitled to less deference).
With respect to the opined behavioral limitations due to Buchanan’s mental
impairments, the ALJ noted that Dr. Cheng never treated Buchanan for any
psychological impairment. An ALJ properly discounts a treating physician’s
opinion when it is based on an area outside of the physician’s expertise. See
Brosnahan v. Barnhart, 336 F.3d 671, 676 (8th Cir. 2003). In addition, the ALJ
noted that at the time Dr. Cheng rendered his opinions, he had admittedly not seen
Buchanan for over one year. Indeed, the record shows that Buchanan last visited
Dr. Cheng in May 2011, which was two months prior to her attaining eighteen
years of age, six months prior to the SSA’s determination that she was not disabled
under the rules governing adult disability, and fifteen months prior to rendering his
opinions as to Buchanan’s RFC. Given that Dr. Cheng’s opinions were based on
remote medical evidence outside the relevant period, the ALJ did not err in
discounting such opinions. Cf. Rogers v. Chater, 118 F.3d 600, 602 (8th Cir.
1997) (proper for ALJ to accord greater weight to opinions of physicians who
rendered treatment during relevant time and who gave opinions close to the time
she was actually treated); Frankl v. Shalala, 47 F.3d 935, 939 (8th Cir. 1995) (error
to rely on remote medical evidence to determine RFC; RFC must reflect claimant’s
functional abilities at time of hearing).
Substantial evidence supports the ALJ’s reasons to accord little weight to
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Dr. Cheng’s opinions regarding Buchanan’s physical and mental limitations. The
ALJ did not err in according such weight.
IV.A.3.

Dr. Buffkins

Plaintiff claims that the ALJ failed to explain the weight he gave to Dr.
Buffkins’ opinion and that such failure constituted error requiring remand
inasmuch as the weight accorded to the opinion would have affected the outcome
of the case. (Doc. 16 at 12-14.) For the following reasons, Buchanan’s claim fails.
As noted above, the ALJ must explain in his decision the weight given to
any opinions from treating sources, non-treating sources, and non-examining
sources. See 20 C.F.R. § 416.927(e)(2)(ii). By explaining the weight given to
medical source opinions, an ALJ both complies with the Regulations and assists
the Court in reviewing the decision. See Willcockson v. Astrue, 540 F.3d 878, 880
(8th Cir. 2008). In circumstances where a medical source opinion may affect the
outcome of a case, substantial evidence does not support an ALJ's adverse decision
if it cannot be determined what, if any, weight the ALJ afforded the opinion.
McCadney v. Astrue, 519 F.3d 764, 767 (8th Cir. 2008); see also Woods v. Astrue,
780 F. Supp. 2d 904, 913-14 (E.D. Mo. 2011).
In the instant written decision, the ALJ set out the findings Dr. Buffkins
made during her psychological evaluation of Buchanan, noting specifically that
Buchanan’s mental status examination was essentially normal; that Buchanan
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exhibited an appropriate affect and, at times, a mildly irritable mood; that her
cognition was intact, and her insight and judgment were good; that her
concentration and persistence were adequate during the evaluation, and her pace
slowed at times; and that Dr. Buffkins assigned a GAF score of 65-70, indicating
mild limitations of functioning. (Tr. 18.) Although Dr. Buffkins rendered an
opinion as to Buchanan’s diagnoses (per history) and prognosis, she gave no
opinion as to the severity of Buchanan’s impairments, what Buchanan could still
do despite her impairments, or any physical or mental restrictions. See 20 C.F.R. §
416.927(a)(2) (setting out contents of medical opinions). Nevertheless, the ALJ
noted Dr. Buffkins’ observations during the evaluation to be consistent with other
evidence of record as well as with the RFC assessment as determined by the ALJ.
(See Tr. 18.) As such, when considered in view of the decision in toto, the Court is
able to determine that the ALJ accorded some weight to Dr. Buffkins’ observations
and findings. Accordingly, although the ALJ did not use specific terms to identify
the precise weight he accorded Dr. Buffkins’ limited opinion or her findings, the
failure to do so here does not require his finding of non-disability to be set aside.
See Robinson v. Sullivan, 956 F.2d 836, 841 (8th Cir. 1992) (administrative finding
not required to be set aside when deficiency in opinion-writing technique has no
bearing on outcome).
In addition, a review of the record shows there to be substantial evidence to
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support the ALJ’s determination to accord some weight to Dr. Buffkins’ findings
and opinion. During her evaluation of Buchanan in October 2011, Dr. Buffkins
identified Buchanan’s daily activities to include going to school, working parttime, doing homework, and performing household chores. Buchanan’s social
interactions were noted to include going out for fun activities; getting along with
family, friends, and a boyfriend of nine months; and experiencing some discord
with teachers and some classmates. These observations are consistent with those
of school staff who noted during the relevant period that Buchanan was arguing
less at school, had a more pleasant attitude, and was participating in class.
Buchanan was in the regular classroom at least eighty percent of the time, and she
was earning passing grades. By April 2012, Buchanan was noted to be
communicating effectively with her teachers and to have shown drastic
improvement in her attitude. Although Buchanan demonstrated an intellectual
ability to work competitively, teachers expressed concern regarding the
appropriateness of Buchanan’s behavior as well as her ability to cope with adult
tasks and responsibilities. Notably, Buchanan graduated in June 2012 with a 2.336
GPA and an attendance record of 95.69 %.
Dr. Buffkins’ observations are likewise consistent with those of Buchanan’s
treating psychiatrist, Dr. Bhuyan, whose notes during the relevant period show that
Buchanan engaged in significant daily and social activities, including working
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part-time, planning travel to New York, maintaining a relationship with her
boyfriend, and getting good grades at school. Dr. Bhuyan also observed Buchanan
to have an appropriate affect and normal mood during this period. Although
Buchanan was observed to be defiant, immature, and a “little volatile,” Dr. Bhuyan
consistently assigned GAF scores indicating only mild limitations. Notably, Dr.
Buffkins’ GAF score of 65-70 is consistent with the GAF scores consistently
assigned by Dr. Bhuyan. In addition, there is no indication that Buchanan engaged
in defiant or inappropriate behavior during her evaluation with Dr. Buffkins, and
the record shows any such behavior not to have precluded Buchanan from
succeeding at school or in her social relationships. E.g., Moore v. Astrue, 623 F.3d
599, 603 (8th Cir. 2010).
Where, as here, there are conflicts in the medical opinion evidence, it is the
duty of the Commissioner to resolve such conflicts. Renstrom v. Astrue, 680 F.3d
1057, 1065 (8th Cir. 2012). An ALJ does not err in relying on the findings of a
one-time consulting physician when he couples such consideration with an
independent review of the medical evidence of record. Krogmeier v. Barnhart,
294 F.3d 1019, 1025 (8th Cir. 2002). This is what the ALJ did here. When the
weight of the medical evidence is more in keeping with the findings made by the
consulting physician, an ALJ may accord greater weight to such findings than to
inconsistent and unsupported findings by a treating physician. Hogan v. Apfel, 239
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F.3d 958, 961 (8th Cir. 2001). The ALJ did not err in according some weight to
the findings made by Dr. Buffkins in her October 2011 psychological evaluation of
Buchanan.
A review of the ALJ’s decision shows the ALJ to have evaluated all of the
opinion evidence of record and to have adequately explained his consideration
thereof such that the Court can determine what weight the ALJ afforded the
medical source opinions. For the reasons set out above, substantial evidence on the
record as whole supports the ALJ’s determination as to the weight he accorded the
opinion evidence in this cause.
IV.A.4.

Other points

Finally, the record does not support Buchanan’s suggestions that the ALJ
should have considered the third party opinion of A. Duvall (SSA interviewer) in
determining the credibility and weight to give to Dr. Bhuyan’s opinion (Doc. 16 at
11), or that the ALJ failed to consider “the entire line of evidence regarding
[Buchanan’s] insight into her illness,” id. at 13, based on his finding that
Buchanan’s “symptoms were controlled by medication, which ‘severely
undermine[d Buchanan’s] credibility,’” id. at 12.
First, the interview by Duvall was conducted to simply complete Form SSA3367 (Tr. 202-04), which was used to assist DDS in making a decision regarding
Buchanan’s alleged disability. Id. at 11. There is no suggestion that Duvall had
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any relevant credentials to assess Buchanan’s impairments, nor that Duvall was an
acceptable medical source offering an opinion for consideration by the ALJ. The
fact Buchanan acted inappropriately in a routine interview with an SSA employee,
and that she relied on her mother to answer questions is not required to be
considered by the ALJ.
Next, as far as Buchanan’s alleged lack of insight into her illness and refusal
to accept her limitations, the ALJ recited a substantial history of how Buchanan
has progressed in school and in social relationships. (Tr. 14-15.) During the
hearing before the ALJ, Buchanan explained the fact that she had a history of being
bullied, but reported that since she has been in college “people are nice and she is
not getting bullied.” Id. at 15. She also detailed among other things: routine daily
responsibilities such as helping to take care of her sister and cleaning; a recognition
that she has difficulty with math; achievements at school (graduating from high
school and attending college), as well as a goal to earn a college degree in special
education. Id. at 14-15. In his written decision, the ALJ thoroughly reviewed
Buchanan’s testimony and records regarding how Buchanan interacts with others.
The ALJ recognized that Buchanan expressed embarrassment about others
knowing she was disabled, however, Buchanan achieved the laudable goals of
graduating from high school and attending college. Id. 14-15. Furthermore, an
Individualized Education Program meeting held a few months before Buchanan’s
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eighteenth birthday revealed that Buchanan was “able to advocate for herself” and
that she “was providing good input when she participated in class discussions, she
was able to communicate with teachers and staff members, she did not need as
many breaks, and she had improved her attitude drastically.” Id. at 15.
When considering the evidence in the record as a whole, these two points do
not detract from the substantial evidence that supports the ALJ’s decision.
VI. Conclusion
When reviewing an adverse decision by the Commissioner, the Court’s task
is to determine whether the decision is supported by substantial evidence on the
record as a whole. Davis v. Apfel, 239 F.3d 962, 966 (8th Cir. 2001). “Substantial
evidence is defined to include such relevant evidence as a reasonable mind would
find adequate to support the Commissioner's conclusion.” Id. Where substantial
evidence supports the Commissioner's decision, this Court may not reverse the
decision merely because substantial evidence exists in the record that would have
supported a contrary outcome or because another court could have decided the case
differently. Id.; see also Buckner v. Astrue, 646 F.3d 549, 556 (8th Cir. 2011);
Gowell v. Apfel, 242 F.3d 793, 796 (8th Cir. 2001).
For the reasons set out above on the claims raised by Buchanan on this
appeal, a reasonable mind can find the evidence of record sufficient to support the
ALJ’s determination that Buchanan’s disability ended November 15, 2011, and
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that Buchanan did not become disabled after that date. This Court finds that
substantial evidence on the record as a whole supports the ALJ’s decision,
therefore it must be affirmed. Davis, 239 F.3d at 966. This Court may not reverse
the decision merely because substantial evidence exists that may support a contrary
outcome.
IT IS HEREBY ORDERED that the decision of the Commissioner is
AFFIRMED and this case is DISMISSED.
A separate Judgment in accordance with Memorandum and Order is entered
herewith.
Dated: March 27, 2015
ABBIE CRITES-LEONI
UNITED STATES MAGISTRATE JUDGE

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