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Brought v. Berryhill

United States District Court, M.D. Pennsylvania

April 22, 2019

NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          Judge Munley



         I. Introduction

         Ashley Brought was approximately 19 years old and had no prior work experience when she applied for Social Security disability benefits in 2014. (Tr. 15, 24-5.) According to Brought, she was disabled at the outset of her work life due to the combined effects of psoriatic arthritis, obesity, hammertoes, bone spurs, fibromyalgia, psoriasis, and a bi-polar disorder. (Tr. 17-19.) Following a hearing conducted before an Administrative Law Judge (ALJ), it was determined that Brought could perform a limited range of light work and her claim for disability benefits was denied. (Tr. 21, 25-6.)

         We are very sympathetic to the medical and emotional challenges confronting Ms. Brought as she began her work life. However, given the deferential standard of review that applies to Social Security Appeals, which calls upon us simply to determine whether substantial evidence supports the ALJ's findings, we conclude that substantial evidence exists in this case which justified the ALJ's decision to deny this particular claim. Therefore, for the reasons set forth below, we will affirm the decision of the Commissioner in this case.

         II. Statement of Facts and of the Case

         This is Ashley Brought's second Social Security disability application. On February 27, 2012, Brought applied for child's insurance benefits under the Act. (Tr. 73.) This application was denied by an Administrative Law Judge (ALJ) and the ALJ's decision was affirmed by the Appeals Council. (Tr. 70-1010.)

         Undeterred, on July 8, 2014, Brought applied for benefits as an adult upon reaching her age of majority. (Tr. 15.) Brought's application originally alleged a date of onset of disability in 2011; she later amended this date of onset to December 2013, thus alleging that she was totally disabled at the age of 19. (Tr. 15 and 25.) At the time she applied for these disability benefits Brought had a high school education but no prior relevant work experience. (Tr. 25.) Thus, Brought was asserting a claim of complete disability at the outset of her work life. According to Brought she was disabled due to the combined effects of psoriatic arthritis, obesity, diabetes, fibromyalgia, and bi-polar and affective disorders. (Tr. 17-18.)

         The medical evidence supporting these claimed impairments was often equivocal. For example, treatment records described Brought's psoriatic arthritis as mild, and recommended very conservative treatment for her fibromyalgia, a program of exercise which Brought rejected. (Tr. 276, 901.) Likewise a consultative examination of Brought disclosed that she appeared to be in no acute distress, had a normal stance, had generally normal objective medical findings, and did not reveal the number of trigger points necessary to confirm a diagnosis of fibromyalgia. (Tr. 601-04.) These examination findings largely echoed Brought's treatment records, which reflected that she was an occasionally difficult patient but was not suffering from acute physical impairments. (Tr, 638-51.)

         Brought's mental health history was also fairly unremarkable. Brought received mental health care and counseling from 2012 through 2016. In the course of these frequent clinical encounters, mental health care professionals, including her primary treating source, Dr. Nitin Sheth, made numerous Global Assessment of Functioning, or GAF, evaluations of Brought's mental and emotional state. These GAF scores consistently assessed an overall emotional functioning score to Brought which ranged between 50 and 65.[1]

         These were clinically significant findings since:

A GAF score is a numerical summary of a clinician's judgment of an individual's psychological, social, and occupational functioning on a hypothetical continuum of mental health on a scale of one hundred. See Diagnostic and Statistical Manual of Mental Disorders, 32-34(4th ed. text rev. 2000) (hereinafter ‘DSM-IV'). A score is placed in a particular decile if either symptom severity or the level of functioning falls with that range. Id.

Markoch v. Colvin, No. 3:14-CV-00780, 2015 WL 2374260, at *10 (M.D. Pa. May 18, 2015). Moreover, under the GAF score system: “ ‘GAF scores in the 51-60 range indicate [only] moderate impairment in social or occupational functioning.' Cherry v. Barnhart, 29 Fed.Appx. 898, 900 (3d Cir. 2002). DaVinci v. Astrue, 1:11-CV-1470, 2012 WL 6137324 (M.D. Pa. Sept. 21, 2012) report and recommendation adopted, Davinci v. Astrue, 1:11-CV-1470, 2012 WL 6136846 (M.D. Pa. Dec. 11, 2012).” Jones v. Colvin, No. 1:16-CV-1535, 2017 WL 4277289, at *2 (M.D. Pa. Sept. 25, 2017), report and recommendation adopted sub nom. Jones v. Berryhill, No. 1:16-CV-1535, 2017 WL 4314572 (M.D. Pa. Sept. 27, 2017). Similarly, “a GAF score of 61-70 [simply] indicates transient and expected reactions to psychosocial stressors.” DaVinci v. Astrue, No. 1:11-CV-1470, 2012 WL 6137324, at *2 (M.D. Pa. Sept. 21, 2012), report and recommendation adopted, No. 1:11-CV-1470, 2012 WL 6136846 (M.D. Pa. Dec. 11, 2012).

         In his clinical encounters with Brought, Dr. Sheth frequently observed that she was friendly, communicative, and fully oriented; had logical thinking, appropriate thought content, and normal speech; had intact cognitive functioning and short and long term memory; and had the ability to abstract and do arithmetic calculations. (Tr. 547, 551, 555, 560, 564, 568, 573, 577, 582, 587, 592, 596, 675, 678-79, 682-83, 686, 690-91, 698, 701, 705, 709, 713, 728, 755, 788-89, 792-93, 801.) These observations were echoed by other health care providers who also noted throughout the relevant period that Brought was alert and oriented, and had an appropriate mood and affect. (Tr. 280, 285, 289, 292, 297, 302, 306, 314, 316, 344, 437, 603-04, 838.)

         Given these relatively benign clinical records and findings, the state agency experts who assessed Brought's disability claim concluded that she possessed the residual physical and emotional capacity to perform a range of light work despite her impairments. (Tr. 102-116.) In stark contrast to his body of clinical and opinion evidence was a single treating source opinion from Dr. David Tanner, who opined that Brought's physical and emotional impairments were totally disabling. (Tr. 886- 896.) While Dr. Tanner proffered these opinions as a treating source, it appeared that the doctor only saw Brought infrequently, made minimal treatment notes, and never conducted clinical testing of her physical or mental limitations (Tr. 627-37, 962-70). Indeed, it appeared that Dr. Tanner had only a handful of clinical encounters with Brought between 2013 and 2016. (Tr. 627-37, 962-63.)

         It was against this medical and factual backdrop that the ALJ conducted a hearing considering Brought's disability application on October 7, 2016. (Tr. 31-68.) At this hearing Ms. Brought and a vocational expert appeared and testified. (Id.) In her testimony Brought described the degree of her impairment in terms which appeared to exceed the objective medical record. For example, Brought claimed to experience 20 bad days each month, during which she was totally confined to her bed. (Tr. 58.) Brought also professed that she was unable to cook, clean, shop, or engage in many tasks of basic personal hygiene. (Tr. 51-8.)

         Following this hearing, on February 17, 2017, the ALJ issued a decision denying Brought's application for disability benefits. (Tr. 12-26.) In this decision, the ALJ first found that Brought had not engaged in any substantial gainful activity since the alleged onset date of her disability, December 2013. (Tr. 17.) At Step 2 of the five-step sequential analysis process that applies to Social Security disability claims the ALJ concluded that Brought had the following severe impairments: psoriatic arthritis, obesity, hammertoes and a left calcaneal spur. (Tr. 17.)

         In reaching this conclusion, the ALJ carefully considered and analyzed Brought's emotional conditions before concluding that they were not severe impairments. (Tr. 18-20.) The ALJ noted that Brought's treatment records consistently documented only a moderate to mild degree of impairment due to her depression, anxiety and bi-polar conditions. The ALJ further observed that the state agency expert found that Brought could satisfactorily perform in the four broad areas of mental functioning: understanding, remembering and applying information; interacting with others; concentration, persistence and pace; and adapting and managing. (Tr. 19-20.) Yet, while the ALJ ultimately concluded after an extensive consideration that Brought's emotional conditions were not severe impairments, the ALJ expressly factored these emotional impairments into the residual functional capacity analysis in this case and considered these impairments throughout the evaluation of Brought's case, limiting Brought to simple tasks that entail only occasional exposure to others. (Tr. 21.)

         At Step 3 of this sequential analysis the ALJ concluded that none of Brought's conditions met the exacting standards of a listing that would define her as per se disabled. (Tr.17-21.) The ALJ then found that Brought retained the residual functional capacity to perform a range of light work. (Tr. 21.) In reaching this conclusion, the ALJ assessed the medical opinion of Dr. Tanner, but gave that opinion little weight, finding that Dr. Tanner's opinion was inconsistent with both Brought's treatment records and with the opinions of state agency experts which were far more congruent with the medical record as a whole. (Tr. 23-4.) The ALJ also concluded that Brought's description of the totally disabling impact of her medical conditions was not fully credible since that descriptions conflicted with other medical opinions of state agency experts and with Brought's treatment records. (Id.)

         Having made these findings the ALJ concluded that Brought had no prior relevant work history but possessed the ability to perform jobs that existed in significant numbers in the regional and national economies. (Tr. 25.) On the basis of these findings, the ALJ concluded that Brought had not met the stringent standard for disability prescribed by the Social Security Act and denied her claim. (Id.)

         This appeal followed. (Doc. 1.) On appeal, Brought argues that the ALJ erred: (1) in failing to rate her emotional impairments as severe; (2) in affording little weight to Dr. Tanner's medical opinion; and (3) in finding Brought's claims of total disability to be only partially credible. The case is fully briefed and is, therefore, ripe for resolution. For the reasons set forth below, we conclude, under the deferential standard of review which applies to Social Security appeals, that substantial evidence supports the findings of the ALJ. Therefore, we will affirm those findings.

         III. ...

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