Staggs v. Commissioner of Social
MEMORANDUM OPINION AND ORDER -- The Court has reviewed the medical evidence of record, the transcript of the administrative hearing, the decision of the ALJ, and the pleadings and briefs of the parties. Based on the forgoing analysis, the Court AFFIRMS the Commissioner's decision. Signed by Magistrate Judge Shon T. Erwin on 9/25/17. (mc)
IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF OKLAHOMA
NANCY A. BERRYHILL, Acting
Commissioner of the Social Security
Case No. CIV-16-1441-STE
MEMORANDUM OPINION AND ORDER
Plaintiff brings this action pursuant to 42 U.S.C. § 405(g) for judicial review of the
final decision of the Commissioner of the Social Security Administration denying Plaintiff’s
applications for benefits under the Social Security Act. The Commissioner has answered
and filed a transcript of the administrative record (hereinafter TR. ____). The parties have
consented to jurisdiction over this matter by a United States magistrate judge pursuant
to 28 U.S.C. § 636(c).
The parties have briefed their positions, and the matter is now at issue. Based on
the Court’s review of the record and the issues presented, the Court AFFIRMS the
The Social Security Administration denied Plaintiff’s applications initially and on
reconsideration. Following an administrative hearing, an Administrative Law Judge (ALJ)
issued an unfavorable decision. (TR. 12-23). The Appeals Council denied Plaintiff’s
request for review. (TR. 1-3). Thus, the decision of the ALJ became the final decision of
THE ADMINISTRATIVE DECISION
The ALJ followed the five-step sequential evaluation process required by agency
regulations. See Fischer-Ross v. Barnhart, 431 F.3d 729, 731 (10th Cir. 2005); 20 C.F.R.
§§ 404.1520 & 416.920. At step one, the ALJ determined that Plaintiff had not engaged
in substantial gainful activity since April 26, 2012, the alleged disability onset date. (TR.
14). At step two, the ALJ determined Ms. Staggs had the following severe impairments:
peripheral arterial disease; major depressive disorder, severe with psychotic features;
and rule out learning disorder, NOS. (TR. 14). At step three, the ALJ found that Plaintiff’s
impairments did not meet or medically equal any of the presumptively disabling
impairments listed at 20 C.F.R. Part 404, Subpart P, Appendix 1 (TR. 16-17).
At step four, the ALJ found that Plaintiff was capable of performing her past
relevant work as a telemarketer. (TR. 21). The ALJ further concluded that this job would
not require the performance of any work-related abilities precluded by her residual
functional capacity (RFC) to:
[P]erform sedentary work as defined in 20 C.F.R. 404.1567(a) and
416.967(a). The claimant could occasionally lift/carry/push/pull 10 pounds
and frequently lift/carry/push/pull less than 10 pounds. She can sit for 6
hours in an 8-hour workday and stand/walk 2 hours in an 8-hour workday.
The claimant cannot climb ladders/ropes/scaffolds or balance. The claimant
can perform simple and some complex tasks with routine supervision;
interact appropriately with supervisors and co-workers on a superficial work
basis; and adapt to work situations.
Even though the ALJ concluded that Ms. Staggs was capable of performing her
past relevant work, she made additional findings at step five. There, the ALJ presented
several limitations to a vocational expert (VE) to determine whether there were other
jobs in the national economy that Plaintiff could perform. (TR. 62). Given the limitations,
the VE identified two jobs from the Dictionary of Occupational Titles (DOT). (TR. 63). The
ALJ adopted the testimony of the VE and concluded that Ms. Staggs was not disabled
based on her ability to perform the identified jobs. (TR. 22-23).
On appeal, Plaintiff alleges the ALJ erred in the evaluation of evidence from Drs.
Fatema Haque and J. Ronald Cruse. In particular, Plaintiff challenges the evaluation of
her Global Assessment of Functioning (GAF) scores.
STANDARD OF REVIEW
This Court reviews the Commissioner’s final “decision to determin[e] whether the
factual findings are supported by substantial evidence in the record and whether the
correct legal standards were applied.” Wilson v. Astrue, 602 F.3d 1136, 1140 (10th Cir.
2010). “Substantial evidence is such relevant evidence as a reasonable mind might accept
as adequate to support a conclusion.” Id. (quotation omitted).
While the court considers whether the ALJ followed the applicable rules of law in
weighing particular types of evidence in disability cases, the court will “neither reweigh
the evidence nor substitute [its] judgment for that of the agency.” Vigil v. Colvin, 805
F.3d 1199, 1201 (10th Cir. 2015) (internal quotation marks omitted).
Dr. Haque treated Plaintiff at North Rock Medication Clinic and Dr. Cruse performed
a one-time consultative examination which had been ordered by the SSA. (TR. 298-302
(Dr. Cruse); TR. 331, 335, 341, 375, 398, 400, 405, 455, 461, 465, 479, 487, 494, 498,
503, 523, 528, 533, 538 (Dr. Haque)). Each of these physicians rated Ms. Stagg’s GAF by
means of assigning a rating to Ms. Staggs based on the particular examination. Plaintiff
raises two separate, yet related, arguments regarding the ALJ’s treatment of the evidence
from these physicians. First, Plaintiff takes issue with the ALJ’s failure to mention or
discuss any of the GAF scores. (ECF No. 20:2-7). Second, Plaintiff alleges error in the
ALJ’s failure to discuss the weight she accorded certain evidence from both physicians.
(ECF No. 20:2-7). The Court rejects both arguments.
“The GAF is a 100–point scale divided into ten numerical ranges, which permits
clinicians to assign a single ranged score to a person’s psychological, social, and
occupational functioning.” Keyes–Zachary v. Astrue, 695 F.3d 1156, 1162 n. 1 (10th Cir.
2012) “A GAF score of 41–50 indicates ‘[s]erious symptoms . . . [or] serious impairment
in social, occupational, or school functioning,’ such as inability to keep a job.” Langley v.
Barnhart, 373 F.3d 1116, 1122, n.3 (10th Cir. 2004). A GAF score of 31–40 indicates
“[s]ome impairment in reality testing or communication ... OR major impairment in
several areas, such as work, school, family relations, judgment, thinking or mood.”
Cainglit v. Barnhart, 85 F. App’x 71, 75 (10th Cir. 2003).
The GAF ratings at issue involve scores of 32 (rated twice), 40 (rated six times),
42 (rated five times), 45 (rated five times), 48 (rated once), and 49 (rated once). Of the
twenty scores, seventeen were made as part of a summary of findings with no
accompanying explanations. (TR. 302, 375, 398, 400, 405, 455, 461, 465, 479, 487, 494,
498, 503, 523, 528, 533, 538). The remaining three scores were authored as part of a
one-page check sheet which Dr. Haque completed as part of examining Ms. Staggs. (TR.
331, 335, 341). On the check sheet, Dr. Haque also noted that Ms. Staggs:
suffered from social and familial problems, and
complained of auditory hallucinations.
(TR. 331, 335). Even so, Dr. Haque did not link the GAF scores or the other findings to
specific work-related limitations. (TR. 331, 335, 341).
In the decision, the ALJ gave a detailed summary of Plaintiff’s mental health
records, including the records from Drs. Haque and Cruse, although admittedly, the ALJ
failed to specifically mention the GAF scores. (TR. 14-16). Ms. Staggs maintains that the
ALJ should have discussed the scores because they indicated an inability to work, contrary
to the ALJ’s findings. (ECF No. 20:2-7). The Court disagrees for three reasons.
First, Ms. Staggs has failed to show that the ALJ ignored the GAF scores. The
record must demonstrate that the ALJ considered all of the evidence, but an ALJ is not
required to discuss every piece of evidence.” Clifton v. Chater, 79 F.3d 1007, 1009–1010
(10th Cir. 1996). The ALJ discussed the findings from Drs. Haque and Cruse,1 and error
does not exist based on an ALJ’s failure to explicitly mention each piece of evidence
contained in their reports. Moreover, the ALJ stated that she considered the entire
record,2 and the Court must take the ALJ at her word. See Wall v. Astrue, 561 F.3d 1948,
1970 (10th Cir. 2009).
Second, the GAF scores were not significantly probative. A low GAF score, standing
alone, is insufficient to prove disability. “[T]he Social Security Administration does not
consider GAF scores to have a direct correlation to the severity requirements in [the]
mental disorders listings, and the [ ] Diagnostic and Statistical Manual of Mental Disorders
has discontinued its use because of “its conceptual lack of clarity . . . and questionable
psychometrics in routine practice.” Rose v. Colvin, 634 F. App’x. 632, 636 (10th Cir. 2015)
(internal quotation marks and citations omitted).
Third, the records contained no explanation regarding how the GAF scores had
been calculated, nor did any medical professional link the scores to any particular workrelated limitations. See TR. 302, 331, 335, 341, 375, 398, 400, 405, 455, 461, 465, 479,
487, 494, 498, 503, 523, 528, 533, 538. Although Plaintiff maintains that the scores “were
in conflict with the ALJ’s finding of the ability to work,”3 Ms. Stagg’s theory is not entirely
self-evident. See Butler v. Astrue, 412 F. App’x 144, 147 (10th Cir. 2011) (noting that
GAF scores that are not linked to any work-related limitations are not particularly helpful
and cannot alone determine disability); Eden v. Barnhart, 109 F. App’x. 311, 314 (10th
Cir. 2004) (noting that because a GAF of 50 “may not relate to [Plaintiff’s] ability to work,
the score, standing alone, without further explanation, does not establish an impairment
(ECF No. 20:2-3).
severely interfering with an ability to perform basic work activities.”); Cainglit v. Barnhart,
85 F. App’x 71, 75 (10th Cir. 2003) (“In the absence of any evidence indicating that [the
physicians] assigned these GAF scores [ranging from 39-45] because they perceived an
impairment in [the plaintiff’s] ability to work, the scores, standing alone, do not establish
an impairment seriously interfering with [the plaintiff’s] ability to perform basic work
Indeed, the three “check sheet” scores also included findings that Plaintiff had
reported several social and familial problems, which could have explained the scores. See
Lee v. Barnhart, 117 F. App’x. 674, 678 (10th Cir. 2004) (noting that an unexplained GAF
score might indicate an impairment “solely within the social, rather than the occupational,
sphere”); Cainglit v. Barnhart, 85 F. App'x 71, 75 (10th Cir. 2003) (noting that “A GAF
score of 39–45 thus may indicate problems that do not necessarily relate to one’s ability
Because the GAF scores were not significantly probative and the ALJ stated that
she considered all of the evidence in the record, the Court rejects Plaintiff’s argument
regarding error in the ALJ’s consideration of GAF scores.
Evidence from Drs. Haque and Cruse
In a related argument, Plaintiff challenges the ALJ’s overall treatment of certain
evidence from Drs. Haque and Cruse. (ECF No. 20:2, 4-7). Specifically, Ms. Staggs states,
“The ALJ did not discuss the weight given to treating Dr. Haque or Dr. Cruse the CE.”
(ECF No. 20:2). In support, Plaintiff states:
The evidence shows that Ms. Staggs suffers from severe mental
impairments causing psychotic limitations to the point she believes there is
a time machine in the attic and a city below her home. These impairments
have been severe and have left Ms. Staggs struggling to accomplish basic
household tasks or even get herself to her doctor by herself without her
sister for memory purposes. Her sister notes she sits on the porch and talks
back to the voices in her head. How can a person like this work?
(ECF No. 20:4-5). Ms. Stagg’s attorney clearly believes that Plaintiff’s delusions and other
struggles render her unable to work. But the ALJ considered this evidence and concluded
otherwise. See TR. 16, 19, 20 (ALJ’s consideration of Plaintiff’s testimony regarding the
city below her home, a time machine in her attic, and her ability to perform household
tasks). The Court cannot reweigh the evidence and reach a different conclusion based on
counsel’s speculation that Ms. Staggs cannot work. See Vigil v. Colvin, 805 F.3d 1199,
1201 (10th Cir. 2015) (internal quotation marks omitted) (the court will “neither reweigh
the evidence nor substitute [its] judgment for that of the agency.”).
According to Plaintiff, the ALJ violated the “treating physician rule” because she
“never determined the weight to be granted to the treating physician or the CE, both of
who’s [sic] opinions conflict with the ALJ’s finding.” (ECF No. 20:5). But Plaintiff’s
argument suffers from a fatal flaw in that she neglects to identify what opinion the ALJ
failed to evaluate. Outside of the specific GAF scores, which the Court has already
addressed, Plaintiff only cites “many, many references to disturbing mental health
behaviors to the point of suicide” and “numerous references to her serious mental health
problems which would prevent work . . .” (ECF No. 20:5).
Under the treating physician rule, an ALJ must assign weight to a treating
physician’s opinion regarding a claimant’s limitations. Allman v. Colvin, 813 F.3d 1326,
1331 (10th Cir. 2016). Plaintiff generally cites her suicidal behavior, but does not cite to
a single treating physician opinion in the record that the ALJ allegedly ignored. And the
Court will not search the medical record looking for such an opinion. See Keyes–Zachary
v. Astrue, 695 F.3d 1156, 1161 (10th Cir. 2012) (“We will consider and discuss only those
contentions that have been adequately briefed for review.”); Effinger v. Callahan, 1997
WL 446724, at *2 (10th Cir. 1997) (holding that the Court “will not comb through the
record where counsel has not provided specific references tied to an argument”); Mueller
v. Colvin, No. CIV-13-805-M, 2014 WL 3419313, at *3 (W.D. Okla. July 11, 2014)
(“Plaintiff does not cite to a single treating physician opinion in the record—much less to
one that the ALJ ignored—and the undersigned will not comb the medical record looking
for such an opinion.”).
The ALJ did not err in failing to discuss the GAF scores, as they were not linked to
any specific work-related limitations and standing alone, they were not significantly
probative on the issue of disability. Likewise, the Court rejects Plaintiff’s allegation of error
regarding the ALJ’s treatment of evidence from Drs. Haque and Cruse, as Plaintiff has
failed to fully develop this argument by explaining which opinion evidence the ALJ had
allegedly failed to consider.
The Court has reviewed the medical evidence of record, the transcript of the
administrative hearing, the decision of the ALJ, and the pleadings and briefs of the parties.
Based on the forgoing analysis, the Court AFFIRMS the Commissioner’s decision
ENTERED on September 25, 2017.
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