United States District Court, E.D. Missouri, Eastern Division
MELISSA A. BATES, Plaintiff,
NANCY A. BERRYHILL, Deputy Commissioner for Operations, Defendant.
MEMORANDUM AND ORDER
NANNETTE A. BAKER UNITED STATES MAGISTRATE JUDGE
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.
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.
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.
Standard of Review
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.
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. 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.
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.)
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). 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.
Dr. Kirmach Natani
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.)
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.)
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