ERIN L. SETSER, Magistrate Judge.
Plaintiff, Gary S. Riener, brings this action pursuant to 42 U.S.C. §405(g), seeking judicial review of a decision of the Commissioner of the Social Security Administration (Commissioner) denying his claims for a period of disability and disability insurance benefits (DIB) and supplemental security income (SSI) under the provisions of Titles II and XVI of the Social Security Act (Act). In this judicial review, the Court must determine whether there is substantial evidence in the administrative record to support the Commissioner's decision.
Plaintiff filed his current applications for SSI and DIB on March 15, 2012, alleging an inability to work since January 21, 2010, due to bipolar disorder, social phobia, anxiety disorder, personality disorder, depression, arthritis, and back injury. (Tr. 127-134, 178, 182). An administrative hearing was held on May 29, 2013, at which Plaintiff appeared with counsel, and he and his mother testified. (Tr. 23-59).
By written decision dated August 16, 2013, the ALJ found that during the relevant time period, Plaintiff had an impairment or combination of impairments that were severe — social phobia; personality disorder; depression; bipolar disorder; and anxiety disorder. (Tr. 11). However, after reviewing all of the evidence presented, the ALJ determined that Plaintiff's impairments did not meet or equal the level of severity of any impairment listed in the Listing of Impairments found in Appendix I, Subpart P, Regulation No. 4. (Tr. 11). The ALJ found Plaintiff retained the residual functional capacity (RFC) to:
(Tr. 13). With the help of the vocational expert (VE), the ALJ determined that during the relevant time period, Plaintiff would not be able to return to his past relevant work, but there were other jobs that Plaintiff would be able to perform, such as warehouse worker (laborer); conveyor feeder/offbearer; and hand packager. (Tr. 16-17).
Plaintiff then requested a review of the hearing decision by the Appeals Council, which denied that request on September 26, 2014. (Tr. 1-5). Subsequently, Plaintiff filed this action. (Doc. 1). This case is before the undersigned pursuant to the consent of the parties. (Doc.6). Both parties have filed appeal briefs, and the case is now ready for decision. (Docs. 9, 10).
This Court's role is to determine whether the Commissioner's findings are supported by substantial evidence on the record as a whole.
It is well established that a claimant for Social Security disability benefits has the burden of proving his disability by establishing a physical or mental disability that has lasted at least one year and that prevents him from engaging in any substantial gainful activity.
The Commissioner's regulations require him to apply a five-step sequential evaluation process to each claim for disability benefits: (1) whether the claimant had engaged in substantial gainful activity since filing his claim; (2) whether the claimant had a severe physical and/or mental impairment or combination of impairments; (3) whether the impairment(s) met or equaled an impairment in the listings; (4) whether the impairment(s) prevented the claimant from doing past relevant work; and (5) whether the claimant was able to perform other work in the national economy given his age, education, and experience.
Plaintiff basically challenges the ALJ's RFC determination, arguing that the ALJ wrongly disregarded the opinion of Plaintiff's treating physician, Dr. Rolland Lee Bailey, and the opinion of Dr. Robert L. Hudson, Ph.D., and that he failed to address Plaintiff's GAF scores. (Doc. 9).
RFC is the most a person can do despite that person's limitations. 20 C.F.R. § 404.1545(a)(1). It is assessed using all relevant evidence in the record.
With respect to weight given to the opinions of treating physicians, "[a] claimant's treating physician's opinion will generally be given controlling weight, but it must be supported by medically acceptable clinical and diagnostic techniques, and must be consistent with other substantial evidence in the record."
The ALJ discussed in detail the medical evidence documenting Plaintiff's mental impairments, and noted that Plaintiff had not received the type of medical treatment one would expect for a totally disabled individual. (Tr. 14). Nancy Bunting, Ph.D., evaluated Plaintiff on January 18, 2011, and reported that at that time, Plaintiff was not taking any medications and had not taken any since January 2010. (Tr. 253).
On April 1, 2011, Plaintiff was referred to Health Resources of Arkansas (HRA) by Baxter County Drug Court. (Tr. 311). Plaintiff received counselling there through October 31, 2011. At his first visit, Plaintiff expressed no intention of stopping the use of THC, did not want any medications, and declined therapy services. (Tr. 315). It is noteworthy that the May 27, 2011 office visit notes indicate that Plaintiff was there because he was required to be, so he was not interested in learning or getting better. (Tr. 319). Plaintiff was diagnosed at HRA with cannabis dependence and social phobia, and was initially given a GAF score of 45. (Tr. 315).
While receiving treatment at HRA, Plaintiff indicated that he could not afford to see a physician and was therefore referred to the Christian Clinic. (Tr. 311). At his next visit to HRA, Plaintiff reported that he received paperwork for the Christian Clinic, but it "was too much paperwork and they ask too much personal information." (Tr. 317). Although economic justifications for lack of treatment can be relevant to a disability determination, lack of interest in completing the paperwork is not, in the Court's opinion, economic justification. There is no record of any indication that Plaintiff was denied treatment due to the lack of funds.
Plaintiff thereafter began seeing Dr. Bailey, a family physician, on November 28, 2011. (Tr. 333). Plaintiff reported to Dr. Bailey on December 17, 2011, that Xanax helped a lot. (Tr. 332). On January 10, 2012, Dr. Bailey reported that Plaintiff seemed calmer, and was doing better overall. (Tr. 331). On February 14, 2012, Dr. Bailey reported Plaintiff was still depressed with underlying anxiety (Tr. 328), and on March 20, 2012, Plaintiff reported to Dr. Bailey that he could not afford Effexor or other medications, and that he was better. (Tr. 328). On June 17, 2012, Dr. Bailey completed a Medical Source Statement, wherein he indicated, by checkmarking boxes in a form, that Plaintiff had no useful ability to function in the areas of working in coordination with or proximity to others without being unduly distracted and accepting instructions and responding appropriately to criticism from supervisors. (Tr. 380-381). The report also indicated that Plaintiff was unable to meet competitive standards in: maintaining regular attendance and being punctual within customary, usually strict tolerances; sustaining an ordinary routine without special supervision; completing a normal workday and work week without interruptions from psychologically based symptoms; asking simple questions or requesting assistance; getting along with co-workers or peers without unduly distracting them or exhibiting behavioral extremes; and dealing with normal work stress. (Tr. 381). The records reflect Plaintiff saw Dr. Bailey through March 21, 2013, when Dr. Bailey reported that Plaintiff was still down and depressed. (Tr. 397).
On May 4, 2012, Robert L. Hudson, Ph.D., conducted a Mental Diagnostic Evaluation. (Tr. 339). Dr. Hudson noted that Plaintiff was not seeing a mental health provider, but was being seen by his primary care physician for psychotropic medication management. (Tr. 339). Plaintiff was supposed to be taking Effexor, but said he could not afford it. (Tr. 339). Dr. Hudson opined that Plaintiff had probably had extensive mental problems that went untreated, and that it was not clear what adequate psychiatric treatment would be "as he continues to be unmotivated." (Tr. 340). Dr. Hudson noted that Plaintiff was evasive as to his last substance use, and offered up little, if anything, spontaneously. (Tr. 340). Dr. Hudson diagnosed Plaintiff as follows:
(Tr. 341). He further opined that Plaintiff was limited in social interaction, but that there appeared to be no significant limitations in communication ability. (Tr. 341-342). He also found that there did not appear to be any significant mental/cognitive limits on basic work-like tasks. (Tr. 342). Dr. Hudson found Plaintiff exhibited limits on his ability to attend and sustain concentration on basic tasks and on persistence in completing tasks, but had no significant limits on completion of tasks in a timely fashion. (Tr. 342). He did note that initiative was totally lacking. (Tr. 342).
On May 8, 2012, non-examining consultant, Sheri Simon, Ph.D., completed a Psychiatric Review Technique form and Mental RFC Assessment, and concluded that Plaintiff was capable of performing unskilled work. (Tr. 353, 367, 369).
In his decision, the ALJ addressed the reports of Dr. Bunting, HRA, Dr. Bailey, and Dr. Hudson, and concluded that although Plaintiff may have had some problems functioning, the objective evidence did not support any marked impairment in adaptive functioning. (Tr. 15). He therefore concluded that Plaintiff could perform unskilled work. (Tr. 15). The ALJ found that Dr. Bailey's Medical Source Statement was not supported by the record, and was outside his area of expertise. (Tr. 15). The regulations state that more weight is generally given to the opinion of a specialist about medical issues related to the area of specialty than to the opinion of a source who is not a specialist. 20 C.F.R. §404.1527(c)(5). The Court agrees that Dr. Bailey's Medical Source Statement is not supported by the record or his own office records. Finally, the Medical Source Statement consists of a conclusory checkbox form, leading the Court to conclude that the ALJ considered and afforded proper weight to the various opinions of all of the physicians.
In addition, as noted by Defendant, Dr. Hudson's mental consultative evaluation supports the ALJ's RFC Assessment because Dr. Hudson found that Plaintiff had only some limits in attending and sustaining concentration and persistence in completing tasks and could still complete tasks in a timely fashion, and that Plaintiff had no significant limitations in communication or mental cognitive ability to perform basic work tasks. The ALJ's RFC takes Plaintiff's mental limitations into consideration by limiting him to unskilled work.
The Court is of the opinion that after evaluating the record as a whole, there is substantial evidence to support the ALJ's conclusions relating to the opinions of Dr. Bailey and Dr. Hudson, and his RFC determination.
With respect to the GAF scores, Plaintiff argues that the ALJ's RFC determination made no consideration for Plaintiff's consistently low GAF scores. In his decision, the ALJ noted that Dr. Hudson gave Plaintiff a GAF score of 48-52 (indicative of serious to moderate symptoms in social, occupational, or school functioning). (Tr. 14). With respect to the other GAF scores, the record reflects that Plaintiff was given a GAF score of 45 on April 1, 2011 (Tr. 315), thereafter consistently received a GAF score of 50, up until October 31, 2011 (Tr. 320-323), and a received a score of 45 on October 31, 2011 . (Tr. 325). A GAF score is not essential to the RFC's accuracy.
With respect to the ALJ's credibility analysis, the ALJ was required to consider all the evidence relating to Plaintiff's subjective complaints including evidence presented by third parties that relates to: (1) Plaintiff's daily activities; (2) the duration, frequency, and intensity of his pain; (3) precipitating and aggravating factors; (4) dosage, effectiveness, and side effects of his medication; and (5) functional restrictions.
After thoroughly reviewing the hearing transcript along with the entire evidence of record, the Court also finds that the hypothetical questions the ALJ posed to the vocational expert fully set forth the impairments which the ALJ accepted as true and which were supported by the record as a whole.
Accordingly, having carefully reviewed the record, the Court finds substantial evidence supporting the ALJ's decision denying the Plaintiff benefits, and thus the decision is hereby affirmed. The Plaintiff's Complaint should be, and is hereby, dismissed with prejudice.
IT IS SO ORDERED.