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Bates v. Berryhill

United States District Court, E.D. Missouri, Eastern Division

March 28, 2018

MELISSA A. BATES, Plaintiff,
NANCY A. BERRYHILL[1], Deputy Commissioner for Operations, Defendant.



         This is an action under 42 U.S.C. § 405(g) for judicial review of the Commissioner of Social Security's final decision denying Melissa Bates' application for supplemental security income under the Social Security Act, 42 U.S.C. § 416 et seq. Bates alleged disability due to a back condition. (Tr. 148.) The parties have consented to the exercise of authority by the undersigned United States Magistrate Judge pursuant to 28 U.S.C. § 636(c). [Doc. 26.]

         Although Bates' application was made based on her physical impairments, the medical record also revealed severe mental impairments, which are the subject of this appeal. The record contains two medical opinions regarding Bates' mental health impairments. Dr. Kirmach Natani, a Social Security consulting psychologist, examined Bates and provided a written medical opinion on September 9, 2013. (Tr. 250-253.) A non-examining agency psychologist, Dr. Robert Cottone, examined Bates' medical records and provided an opinion on October 9, 2013. (Tr. 58-60.) The administrative law judge (ALJ) gave significant weight specifically to the global assessment functioning (GAF) score assessed by Dr. Natani, but did not comment on the weight given to the opinion as a whole. The ALJ also gave Dr. Cottone's opinion significant weight. A substantial portion of Bates' medical treatment regarding her mental impairments occurred after the doctors' opinions were written.

         Bates asserts that the administrative law judge (ALJ) failed to properly weigh and consider the medical opinion evidence. Specifically, Bates states the ALJ erred by not weighing Dr. Natani's opinion and giving significant weight to Dr. Cottone's opinion. The Commissioner contends that the ALJ's decision is supported by substantial evidence in the record as a whole. For the following reasons, the Court will affirm the ALJ's decision.

         I. Standard of Review

         The Social Security Act defines disability as an “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 416(i)(1)(A). The standard of review is narrow. Pearsall v. Massanari, 274 F.3d 1211, 1217 (8th Cir. 2001). This Court reviews the decision of the ALJ to determine whether the decision is supported by substantial evidence in the record as a whole. 42 U.S.C. § 405(g). Substantial evidence is less than a preponderance, but enough that a reasonable mind would find adequate support for the ALJ's decision. Smith v. Shalala, 31 F.3d 715, 717 (8th Cir. 1994). The Court determines whether evidence is substantial by considering evidence that detracts from the Commissioner's decision as well as evidence that supports it. Cox v. Barnhart, 471 F.3d 902, 906 (8th Cir. 2006). The Court may not reverse just because substantial evidence exists that would support a contrary outcome or because the Court would have decided the case differently. Id. If, after reviewing the record as a whole, the Court finds it possible to draw two inconsistent positions from the evidence and one of those positions represents the Commissioner's finding, the Commissioner's decision must be affirmed. Masterson v. Barnhart, 363 F.3d 731, 736 (8th Cir. 2004). The Court must affirm the Commissioner's decision so long as it conforms to the law and is supported by substantial evidence on the record as a whole. Collins ex rel. Williams v. Barnhart, 335 F.3d 726, 729 (8th Cir. 2003).

         II. Discussion

         The ALJ found that Bates had the severe impairments of degenerative disc disease of the cervical and lumbar spine, obesity, anxiety disorder, depression, and polysubstance abuse. (Tr. 12.) The RFC is defined as what the claimant can do despite his or her limitations, and includes an assessment of physical abilities and mental impairments. 20 C.F.R. § 416.945(a). The RFC is a function-by-function assessment of an individual's ability to do work related activities on a regular and continuing basis.[2] SSR 96-8p, 1996 WL 374184, at *1 (July 2, 1996). It is the ALJ's responsibility to determine the claimant's RFC based on all relevant evidence, including medical records, observations of treating physicians, and the claimant's own descriptions of his limitations. Pearsall, 274 F.3d at 1217. A RFC determination made by an ALJ will be upheld if it is supported by substantial evidence in the record. See Cox, 471 F.3d at 907.

         In addressing Bates' severe mental impairments, the ALJ found that Bates had the RFC to perform sedentary work with the following limitations: (1) simple, routine tasks in an environment where there are only occasional workplace changes and (2) occasional contact with supervisors, co-workers, or the general public. (Tr. 13.) The ALJ referenced Dr. Natani and Dr. Cottone's medical opinions in support of the RFC determination. (Tr. 18.)

         Medical opinions are statements from physicians and psychologists or other acceptable medical sources that reflect judgments about the nature and severity of a claimant's impairments, including symptoms, diagnosis and prognosis, and what the claimant can still do despite impairments and physical or mental restrictions. 20 C.F.R. § 416.927(a)(2)[3]. All medical opinions, regardless of the source, are weighed based on (1) whether the provider examined the claimant; (2) whether the provider is a treating source; (3) length of treatment relationship and frequency of examination, including nature and extent of the treatment relationship; (4) supportability of opinion with medical signs, laboratory findings, and explanation; (5) consistency with the record as a whole; (6) specialization; and (7) other factors which tend to support or contradict the opinion. 20 C.F.R. § 416.927(c). Now the Court will address each doctor's opinion in turn.

         A. Dr. Kirmach Natani

         Dr. Natani prepared a written psychological evaluation of Bates on September 19, 2013. (Tr. 250-53.) The mental status examination demonstrated that Bates was alert and oriented to time, place, and person. (Tr. 251.) Her appearance was adequate with good eye contact. (Tr. 251.) She was cooperative with speech within normal limits. (Tr. 251.) Dr. Natani described Bates as “preoccupied with being a homeless person at age 41 years and very upset about her current circumstances.” (Tr. 251.) He described her mood as depressed with an anxious affect. (Tr. 251.) He also observed that her thoughts were logical, coherent, and relevant. (Tr. 251.) Dr. Natani noted that she had limited insight and fair judgment. (Tr. 252.)

         Dr. Natani diagnosed Bates with posttraumatic stress disorder (PTSD); dysthymic disorder, late onset, recurrent with anger and irritable features; a history of self-medication with alcohol, cannabis, and tobacco; anxiety disorder due to a general medical condition; parent-child relational problem with her mother and her child, alcohol related disorder, and cannabis-related disorder. (Tr. 252-53.) Dr. Natani opined that Bates had a GAF score of 60, which indicates moderate limitations related to her anxiety and depression. (Tr. 253.) The ALJ gave significant weight to the GAF score, asserting that “Dr. Natani thoroughly reviewed the claimant's psychiatric history and conducted a detailed clinical interview before offering his conclusion.” (Tr. 18.)

         Plaintiff asserts that the ALJ's failure to give weight to Dr. Natani's entire opinion and reliance solely on Dr. Natani's GAF score was reversible error. The Commissioner asserts that the ALJ was not required to assign a particular weight to Dr. Natani's clinical findings, only to a medical opinion and the only portion of Dr. Natani's evaluation that constituted a medical opinion was the GAF ...

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