Mohr v. Colvin, No. 3:2015cv03010 - Document 22 (D.S.D. 2016)
Court Description: OPINION AND ORDER Affirming Decision of Commissioner. Signed by U.S. District Judge Roberto A. Lange on 9/30/2016. (JLS)
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Mohr v. Colvin Doc. 22 UNITED STATES DISTRICT COURT SEP3fl20I6 DISTRICT OF SOUTH DAKOTA CENTRAL DIVISION 3 15-CV-03010-RAL JENNIFER MOHR, Plamtiff, OPINION AND ORDER AFFIRMING DECISION OF COMMISSIONER vs CAROLYN COLVIN,ACTING COMMISSIONER OF SOCIAL SECURITY, Defendant Plamttff Jennifer Mohr seeks review ofthe denial by the Actmg Commissioner of Social Security (the Commissioner) of her claim for social secunty disability insurance (SSDI) under Title n of the Social Secunty Act (the Act), 42 U S C § 423, and for supplemental secunty income(SSI)under Title XVT ofthe Act,42 U S C § 1382 Docs 1,17,21 The Commissioner argues for affirming the denial of benefits Doc 18 For the reasons set forth herein, this Court affirms the Comnussioner's decision 1 Procedural History Mohr applied for SSI benefits and SSDI benefits m November of 2011 AR* 241—248 Mohr alleged a disabihty onset date of June 10, 2010 AR 32, 241, 283 The Social Secunty Admmistration(SSA)denied Mohr's apphcations on imtial review and on reconsideration AR 79-181 Mohr hired her attorney Michael J Sunpson between the tune of the SSA's uutial This Opmion and Order uses"AR"to refer to the Admmistrative Record,followed by citation to the relevant page number therem Dockets.Justia.com Hftnifll and on reconsideration AR 182-190 After the denials of reconsideration, Mohr requested a tip-anng before an Adrniiustrative Law Judge(AU) AR 191—199 ALJ Chnstel Ainbuehl conducted a video hearing on January 15,2014,in which Mohr,her attorney Siinpson, and vocational expert Wilharn H Weiss participated AR 29—74 The ALJ then issued a dP!P.igif>n detennining Mohr not to be disabled under the Act AR 6—22 Mohr requested review, AR 4--5, and the rqipeals council denied the request for review, AR 1-3 Mohr then commenced this afitinn seekingjudicial review ofthe denial ofher claims for SSI and SSDI Doc 1 Mohr presents three issues to this Court (a) Whether the AU unproperly rejected the opmions of psychologist Christina Hartline,Ph' D (b) Whether the AU improperly rejected Claunant's credibility' (c) Whether this case should be reversed and the government directed to award benejdts' Doc 17 at 2 Although these are three feirly discreet issues, determming vdiether the AU properly discounted the opmion of psychologist Hartline and certam of Mohr's statements requires a broader consideration ofthe AU's decision and the record as a vdiole M Factuall Background A Mohr's Work History Mohr was bom m June of 1966 AR 32, 241 Mohr was 43 at the tune of her alleged disabihty onset of June 10, 2010, and was 47 at the tune of the January 2014 hearmg Mohr completed high school and one year of college AR 34, 284 Mohr had a strong work history before June of 2010, mcluduig domg clencal work for the State of South Dakota, Division of Motor Vehicles at a dnver hcensmg location, packing and supervising the packmg of birdseed at Global Harvest Birdseed, LLC, and vanous other jobs pnor to that mcludmg a tax preparer, office assistant, and cook AR 21, 35-37, 249-268 Mohr's last documented formal employment was with St Mary's Healthcare Center m Pierre, where she earned $851 during a 20-day penod m July of 2011, working m housecleanmg, until she got pneumonia AR 35,249 Besides the bnef employment at St Mary's Healthcare Center m July of 2011, Mohr has not worked smce the disability onset date, although she has taken care of one or two young grandchildren durmg vanous times AR 19,60,1177,1186,1202,1240 B Mohr's Treatment History Mohr's alleged disabihty onset date—June 10, 2010—comcides with a visit to her primary treatmg physician,Dr Thomas Huber AR501~510 On that date, Mohr saw Dr Huber for non-exertional mid-chest pam m the prior week, although she was also havmg some back pam Dr Huber's notes record moderate degenerative disc changes at C5-6 AR510 Because part of the arguments m this case center on the weight to give a psychologist's opmion I concerning Mohr's mental health and its effects on her ability to work, this Court will focus on Mohr's treatment for mftntal health issues, although initially her SSI and SSDI applications were based more on physical—that is, non-mental health—tissues When Mohr saw Dr Huber on June 10,he already had her takmg Zoloft,^ which apparently he had started on May 14,2010,AR 506, but Dr Huber's treatment of Mohr m 2010, 2011, and 2012 pnmanly was for physical issues Dr Huber referred Mohr to Dr Bryan Wellman, a neurosurgeon m Sioux Falls In July of 2010, Dr Wellman performed an antenor cervical discectomy and fusion on Mohr at the levels of C3-4, C4-5, and C5-6 AR 360-65 The cervical fusion surgery seemed to be a ^ Zoloft IS a brand nawift for sertralme and is used to treat depression, pamc attacks, obsessive compulsive disorder, posttraumatic stress disorder, and social anxiety disorder Sertralme is a selective s^tonm reuptake inhibitor, which mcreases levels ofserotonm m the bram success, in that Mohr's prunary complaints of pam to Dr Wellman after the surgery concerned her lower back,rather than her cervical spme AR 437--40,823-28 To attempt to remedy Mohr's low back pam, Dr Wellman performed an L5-S1 antenor lumbar mterbody fusion with bullet cages, an infused bone graft, and bilateral L5-S1 pedicle screw placement on December 10,2010 AR 419-20,432-34 Mohr's recovery from the L5-S1 ftision surgery was not as successful as fiom the cervical fusion surgery Mohr was treated for baflfj hip, and leg issues m 2011 and into 2012 AR 374—75,412, 673—74,692—98, 755—778, 779-822,877-893,930-33,1147 There is nothing m the Admmistrative Record later than May 29, 2013 concemmg Mohr's treatment for ongomg lumbar pam, although she was certainly treated through that date and reported ongoing issues with pam m her testimony to the AU AR 1147, see AR 37-38 Records later than May of 2013 ftom Mohr's psychological and psychiatric treatment m 2013 reference those issues as well AR 1186—87,1221,1235 Mohr's application for SSI and SSDI mNovember of2011 and almost all of her medical records and other submissions for the subsequent 18 months focused on physical issues For inQtanriP. the fiincti"n report that Mohr completed on December 5, 2011, detailed hftmg restrictions of 20 to 30 pounds, abihty to sit for only oiie hour and stand for no more than 30 TTiinntftg^ and an inability to do certam past hobbies because of physical issues AR 292-299 In 2012, Mohr's treatment for back pam mcluded a neurological consultation with Dr Robert Tngrabamj AR 692-98, pam management consultation with Dr D R Rasmussen, AR 701-704, 765-67, 771, physical therapy, AR 882-93, a lumbar fecet jomt mjection, AR 772-73, and a visit to annthPT suTgeon Dr Gonzalo Sanchez, AR 930—32, vdio did not consider her a candidate for further surgery but suggested more physical therapy In tenns of cognitive or mental health issues, Mohr, m December of2011, disclosed that she fimshes what she starts, can follow written instructions, and gets along well with authonty figures, that is, Mohr's December of 2011 function report appeared not to list Imutahons based on psychological issues AR 297-98 The only fimction report subnutted by any other individual, completed by Mohr's fiancé at the tune, David Salathe, similarly focused on Mohr's physical issues including fibromyalgia AR 316-23 Dr Huber appeared to be the only one during this tune treating Mohr for depression, but his medical records contam only a very occasional reference to depression AR 443^86 Dr Huber mentions Mohr bemg worse m July of2012 due to her pain, medications, and financial stress AR 798 However, as late as October of2012,Dr Huber descnbed her linutations as bemg "only due to the pam" AR689 Two nontreating professionals opined that Mohr's dqiression issues were not severe AR 84,114-15 The complexion of Mohr's case appeared to change m April of 2013, when Mohr was referred by Dr Huber to Capital Area Counseling for depression AR 1081-82 On April 19, 2013, Mohr began a course of treatment with Chnstuie Harthne, Ph D (psychologist Hartlme) Mohr presented with a depressed mood,although she was not smcidal Mohr met the cntena for "major depressive disorder, recurrent, moderate, generalized anxiety disorder, and PTSD" AR 1081 Psychologist Hartlme recorded that the posttraumatic stress disorder and depression issues began v^dien she was a teenager, with anxiety onset when she was m her thirties AR 1083 Mohr sadly had been abused as a child and m a previous marriage Psychologist Harthne recorded that Dr Huber was switching Mohr finm Zoloft to Cymbalta^ Mohr's Global Assessment ofFunctionmg(GAF/ score at the tune was 45 AR1085 Mohr underwent weekly counseling with psychologist Harthne m April, May, and June Mohr's treatment covered relationship issues with her fiancé, her childhood trauma, and other topics, mcludmg her pam and economic problems In mid-June of 2013, psychologist Harthne gave Mohr chapter one of a workbook on bipolar disorder Psychologist Harthne recorded "Although it IS unclear at this pomt whether she meets full cntena for this disorder, the workbook contains many usefiil skills for affective mstabihty m general" AR 1179—80 Psychologist Harthne provided Mohr chapter two of the workbook m early July of 2014 AR 1183-84 On July 16, 2013, Mohr underwent a psychiatric evaluation with Dr Uhses Pesce, a psychiatnst AR 1185 Dr Pesce detailed the Apnl of 2013 referral fixim Dr Huber to Capital Area Counseling at a tune when Mohr was veiy depressed and unhappy, and described her past personal history including the episodes of abuse AR 1185—86 Dr Pesce recorded that Mohr takes care of her granddaughter "qmte often, mostly last three months" AR 1186 Dr Pesce detailed Mohr's physical issues, her pam medications, and her switch fiom the antidepressant Zoloft to Cymbalta AR 1186 Dr Pesce's diagnosis was major depressive disorder, recurrent. ^ Cymbalta is a brand name for duloxetme, which is used to treat depression and anxiety, as well as arthritis, chrome back pain, and fibromyalgia It is a serotonm-norepm^hnne reuptake inhibitor, which mcreases serotomn and norepmephrme m the bram * GAF IS a numeric scale used by mental health providers to rate the social, occupational, and psychological functioning of an individual on a scale of 1 to 100 Mohr's imtial GAF score of 45 IS m the "senous symptoms" range, while her later scores of60 and 65 are m the "moderate symptoms" and "some mdd symptoms" ranges respectively relational problems, and posttraumatic stress disorder AR 1187 Mohr's GAF score at the timft was 60 AR 1187 Dr Pesce started Mohr on Abihfy ^ When Mohr returned to see psychologist Harthne on July 19,2013, she was"domg quite well" and "fiequentlyjoked throughout session and laughed" AR 1192 However,the next tune that Mohr saw psychologist Hartlme, she was noticeably upset as her fiancé had ruined the day over his womes about money AR 1193 Mohr's moods appeared to stabilize through the weekly psychology appomtments m August, although she expressed the behef that Ability was makmg her more imtable AR1197 Dr Pesce evaluated Mohr on August 16, 2013 AR 1199 On that date, Mohr was able to ambulate without difficulties, had a thought process that showed no disorganization, had good insight and judgment, had an mtact memory for recent and remote events, and had good attention and concentration AR 1200 Her GAF score was 60 AR 1200 Dr Pesce's diagnnsis of Mohr remained the same, but he mcreased her dose of Abilify fixim five milhgrams to ten imlligrams daily AR 1200 Mohr contmued to visit psychologist Hartlme m August and September of 2013 AR 1202-09 On September 23, 2013, Dr Pesce agam evaluated Mohr His assessment about Mohr's abilities was the same as m August of2013 AR 1210 Mohr had a depressed mood, but it was unproved finm the past, and Dr Pesce beheved that the mcreased dosage of Abilify had helped her AR1211 Mohr's GAF score was 65,and her diagnosis remamed the same AR1211 Mohr contmued to see psychologist Harthne m October of2013 Mohr had been gaming weight and questioned whether the Abihfy was the cause AR 1208,1213-19 Mohr talked with ^ Abilify IS the brand name for anpiprazole, which is considered an "atypical antipsychotic" drug used to treat such things as major depression, schizophrenia, bipol^ disorder and obsessive compulsive disorder ^ psychologist Hartline about having hosted ajeweliy party and dealing with relational issues with her fiancé AR1213-19 Mohr saw Dr Pesce agam on October 22, 2013 Dr Pesce made the same findmgs m terms of Mohr's cogmtive abihties, but noted that she was walking with a cane at that tune AR 1221 Dr Pesce believed Mohr's depression to be improved although still present, had the same diagnosis, and recommended no changes m her medication AR 1221 Mohr was finstrated with this as she beheved her weight gam was finm Abilify AR 1226 Mohr saw psychologist Hartlme twice m November and then on December 3, 2013 AR 1224-30, 1238 On December 3, 2013, psychologist Hartlme completed a medical source statement of abihty to do work for the SSA AR 1228-30 Psychologist Hartlme recorded that "Jennifer has reported difficulties with decision-makmg, paying attention, concentrating, and memory" AR 1228 Psychologist Hartlme also recorded "Jennifer struggles with imtabihty and verbally lashing out at others when distressed" AR 1229 Psychologist Hartlme expressed the opmion that Mohr's depression and posttraumatic stress syndrome mterfered with her completing tasks and work AR 1229 P^chologist Hartlme's counseling records for December 3,2013 state We reviewed the packet of papers she had me complete finm Social Secunty Admmistration regarding her ability to do work-related activities She stated she was comfortable with my responses, and I told her I would send it m AR1238 One week pnor to psychologist Harthne's submission to SSA, Dr Pesce had agam seen Mohr on November 26, 2013 Dr Pesce recorded that Mohr ambulated without a cane, had clear, well-articulated and modulated speech, had mtact thought processes, had no evidence of psychosis, delusions, or hallucinations, had good judgment and insight, had no memory deficits 8 for recent or remote events, had good attention and concentration, and had an mtact fund of knowledge AR 1236 Dr Pesce's diagnosis remained major depressive disorder, recurrent, / " relational problem, and posttraumatic stress disorder AR 1236 Mohr's GAP score at the tune was 65 AR 1236 In December of 2013, Dr Huber evidently stopped both the Abilify and Hydrocodone prescnptions, leavmg Mohr on no psycbiatnc medication AR 1244 This was ofconcern to Dr Pesce when seemg Mohr on December 23, 2013 AR 1244 E)r Pesce's evaluation of Mohr's abilities and psycbiatnc condition lemamed the same as m the past AR 1245 However, Dr Pesce was concerned about Mohr's mood not bemg stable and was suspicious of possible bipolar disorder Dr Pesce prescnbed hthium^ to help moderate Mohr's moods AR 1245 Mohr's OAF score at the tune was 60 AR 1245 C Admmiistrative Hearing and AU Decision The AU conducted a hearing on January 15,2014, at which Mohr and vocational expert Weiss testified AR 29-74 Mohr testified that she hved m Harrold m a house with her boyfiiend and had three adult children AR 33 Mohr testified about her past work expenence AR 34-36 Mohr descnbed constant pam as a reason she could not work, including low back and hip pam and fibromyalgia AR 37-39 Mohr descnbed that she had depression, posttraumatic stress disorder, and bipolar disorder,^ and did not socialize well AR 40 Mohr testified that she was taking hthium prescnbed by Dr Pesce and seemg psychologist Hartlme AR 42 Dr Huber remained her primary treating physician AR 43 Mohr testified to sleeping ^ The element lithium is used as a mood stabilizing psycbiatnc medication to treat major depressive disorder and bipolar disorder ^ No healthcare provider had diagnosed Mohr with bipolar disorder, as the discussion above indicated However, a psychologist had given her a workbook on bipolar disorder and the final visit to Dr Pesce caused bun to ponder if she rmght have bipolar disorder during the day, and to limitations on walking, standing, and sitting, which were limitations well beyond what had appeared previous m the record AR 47-48 Mohr testified that she had no memory of conversations once they occur, cannot remember appomtments, and cannot concentrate through a fiill television program AR 49-50 Mohr testified that she struggled to make decisions, did not socialize, and was too traumatized to mteract with the pubhc AR 51—52 Mohr testified to activities of daily hvmg, mcludmg cookmg, vacuuming, sweeping and moppmg fioors, as well as preparmg meals and canng for her cats and dog, but Mohr said that it I pained her to engage m such activities AR 54^60 When prompted by questioning fijom the \ AU, Mohr acknowledged playing darts weekly, hosting a jewelry party, and babysitting her granddaughter for a couple of months AR 58-61 Mohr watched her granddaughter who was three and a half years old and watched a second granddaughter who was of a similar age during the day for some tune AR 61-62 Vocational expert Weiss testified based on hypotheticals that a person with Mohr's f limitations could not do her pnor relevant work AR 66 However, Weiss proffered three jobs that a person with Mohr's limitations could perform, even with certam restrictions AR 66-68 A person could not do those jobs, however,ifthey needed to he down three to four hours during the workday, AR 68, which Mohr at one pomt testified that she had to do, AR 48 On February 14, 2014, the AU issued a decision denying Mohr's apphcations for SSI and SSDI AR 9-22 In doing so,the AU employed the sequential five-step evaluation process m 20 C F R §§ 404 1520(a)and 416 920(a) Under "the fiimihar five-step process" to determine whether an mdividual is disabled, Martisev Astrue. 641 F 3d 909,921 (8th Cir 2011),the AU considers whether "(1) the claimant was employed,(2) she was severely unpaired,(3) her impairment was, or was comparable to, a hsted impairment,(4) she could perform past relevant 10 work, and if not,(5)whether she could perform any other kmH ofwork" Id.(quoting Halverson V Astnie. 600 F 3d 922, 929(8th Cir 2010)), see also 20 C F R § 416 920 (detaihng the fivestep process) At the first step, the ALJ determmed that Mohr had not engaged m substantial gainfiil employment smce June 10, 2010 AR 11 The AU determined at step two that Mohr suffered finm severe impairments— cervical degenerative disc disease, degenerative disc disease of lumbar spine, degenerative disc disease of thoracic spme, fihromyalgia, major depressive disorder, posttraumahc stress disorder, and obesity AR 12 At step three, the AU determmed that Mohr did not have an impairment or combination of impairments that met or medically equaled a hsted impairment AR12 Between step three and step four, the AU is to determine an individual's residual filnctional capacity(RFC) The AU did so m determining that Mohr had the RFC [T]o perform less than a fiill range of sedentary work as defined m 20 C F R 404 lS67(a)and 416 967(a) She can lift and/or carry 10 pounds occasionally and less than 10 pounds fi%quently, sit(with normal bre^)for 6 hours m an 8 hour work day, stand and/or walk (with normal breaks) for 2 hours m an 8 hour workday She is lirmted to occasional foot controls with the nght foot She can occasionally climb ramps and stairs, never climb ladders/ropes/scaffelds She can occasionally balance, stoop, kneel, crouch and crawl She should not be exposed to unprotected heights or moving mechamcal parts From a mental standpomt,the claimant is able to understand, remember, and carry out simple tasks and would be limited to simple work related decisions She can have occasional mteraction with coworkers, supervisors and the public AR 15 Based on this RFC,the AU determmed at step four that Mohr could not perform past relevant work AR 20-21 In the fifth and final step,the AU considered Mohr's age, education, work expenence and RFC,as well as the testimony ofthe vocational expert, and determined that Mohr was "capable of making a successful adjustment to other work that exists m sigmficjint numbers m the national economy" AR 22 The AU thus concluded that Mohr was "not disabled" under apphcable standards AR22 11 Mohr does not take issue with the bulk of the AU's findings or with the apphcation of any part of the five-step analysis Rather, Mohr asserts that the AU inappropriately discounted the opmions of Mohr's treating psychologist Hartline and Mohr's own testimony concerning her limitations Particular portions of the AU's reasoning m doing so will be discussed below m analyzmg Mohr's challenge to the AU's decision M Standard of Review "When considermg whether the AU properly demed social secunty benefits, we determme whether the decision is based on legal error, and whether the findings of fiict are supported by substantial evidence m the record as a whole" rnllms v Astrue. 648 F 3d 869, 871 (8th Cir 2011)(quoting Lowe v Anfel. 226 F 3d 969, 971 (8th Cu: 2000)) "Legal error may be an error of procedure, the use of erroneous legal standards, or an mcorrect apphcation of the law," id.(mtemal citations omitted), and such errors are reviewed de novo, i^ (quoting Juszczvkv Astrue.542 F 3d 626,633(8th Cir 2008)) The Comnussioner's decision must be "supported by substantial evidence on the record as a whole" Rvansv Sbalala. 21 F 3d 832, 833 (8th Cn 1994) "Substantial evidence is more than a mere scmtdla," Consol Edison Co ofN Y v NLRE ^ 305 US 197,229(1938), but "less than a preponderance," Maresh v Ramhart 438 F3d 897, 898 (8th Cir 2006) (quoting McKinnev v Anfel. 228 F 3d 860, 863 (8th Cn 2008)) It is that vduch a "reasonable mmd would find adequate to support the Commissioner's cone usion" Miller v Colvin. 784 F 3d 472, 477 (8th Cir.2015)(quoting Blackbum v Colvm. 761 F3d 853, 858 (8th Cir 2014)), accord Burress v Anfel. 141 F 3d 875, 878 (8th Cir 1998), Jones v Chater. 86 F 3d 823, 826 (8th Cir 1996) "P^he 'substantial evidence m the record as a vdiole' standard is not synonymous with the less ngorous 'substantial evidence' standard" Burress. 141 F 3d at 878 12 "'Substantial evidence on the record as a whole' requires a more scrutmizmg analysis" Gavmv Heckler. 811F2dll95, 1199(8th Cir 1987)(quoting Smith v Heckler. 735 F 2d 312, 315(8thCir 1984)) A reviewmg court therefore must "consider evidence that supports the [Commissioner's] decision along with evidence that detracts from it" Siemers v Shalala 47 F 3d 299, 301 (8th Cir 1995) In doing so, the court may not make its own findings of &ct, but must treat the Commissioner's findings that are supported by substantial evidence as conclusive 42 U S C § 405(g), see also Renskm v Bowen. 830 F 2d 878, 882(8th Cir 1987)(noting that reviewing courts are "governed by the general principle that questions of &ct,includmg the credibihty of a claimant's subjective testimony, are primarily for the [Commissioner] to decide, not the courts") "If, after undertakmg this review, [the court] detennine[s] that 'it is possible to draw two inconsistent positions fiom the evidence and one of those positions represents the [Commissioner's] findings, [the court] must affirm the decision' of the [Commissioner]" Siemers.47 F 3d at 301 (quoting Robinson v Sullivan. 956 F 2d 836,838(8th Cir 1992)) The court "may not reverse simply because [it] would have reached a different conclusion than the AU or because substantial evidence supports a contrary conclusion" Miller. 784 F 3d at 477 IV Discussion Mohr raises three issues with the AU's determination (1)the AO's discounting of the opimon of psychologist Harthne, (2) the AO's credibility determination regarding some of Mohr's testimony, and (3) whether the case should be reversed with a directive to award benefits Doc 17 at 2 These issues are addressed m turn A Discounting ofPsychologist Harthne's Opmions 13 Mohr contends that the AU's decision to discount Psychologist Harthne's opinions was improper—and m particular takes issue with five aspects of the ALJ's reasoning (1) that psychologist Harthne's opmions were "mconsistent with the Claimant's abihty to go to dart league, commumcate appropriately with her healthcare providers, care for her grandchildren and hold jewelry parties," Doc 17 at 40, AR 20,(2) that Psychologist Harthne's opmions were "mconsistent with the Claimant's GAP scores, which have consistently heen 60 or 65 smce she' started therapy," Doc 17 at 40, AR 20,(3)"there is also evidence that Claimant had input mto Dr Harthne's opimon, or at least had the opportumty to eiqiress whether she was 'comfortable' with the responses," Doc 17 at 40, AR 20,(4)"The marked restrictions are mconsistent with the fiict that 'the Claimant is very close to her mother and siblmgs,'" Doc 17 at 40, AR 13, and (5) Mohr's fimction report fix>m 2011 did not indicate social limitations at the tune. Doc 17 at 40 t "A treatmg physician's opmion is generally given controllmg weight if it is 'well- supported by medically accqitable chmcal and laboratory diagnostic techniques and is not mconsistent with the other substantial evidence'm the record" Tea^uev Astme. 638 F 3d 611, 615 (8th Cir 2011)(quoting 20 CFR § 404 1527(c)(2)) However, a treatmg physician's opmion "does not automatically control, since the record must be evaluated as a whole" Prosch V Apfel. 201 F 3d 1010, 1013 (8th Cir 2000)(citation and mtemal marks oimtted) "An ALT may discount or even disregard the opmion of a treating physician where other medical assessments are supported by better or more thorough medical evidence, or where a treating physician renders inconsistent opmions that undermine the credibility ofsuch opmions" Perkins V Astrue. 648 F 3d 892, 897—98 (8th Cir 2011)(citation omitted) "Whether the AT J grants a treating physician's opmion substantial or httle weight,the regulations provide that the ATJ must 14 'always give good reasons' for the particiilar weight given to a treating physician's evaluation" Prosch. 201 F 3d at 1013(quotmg 20 C F R § 404 1527(c)(2)) When the AU does not give the treating physician's opmion controlling weight, the opinion is weighed considering the fiictors set forth m 20 C F R § 404 1527(c) See Shontos v Ramhart. 328 F 3d 418, 426 (8th Cir 2003) The &ctors under 20 C F R § 404 1527(c)include 1)the examining relationship, 2)the treatment relationship, mcludmg length of treatment, frequency of examination, and the nature and extent of the treatment relationship, 3) supportabihty, 4)consistency, 5)specialization, and 6)any other factors brought to the AU's attention tending to support or contradict the opimon The AU's decision regarding Mohr's psychological condition and psychologist Harthne's opmions did not mvolve a complete rejection of psychologist Hartlme's impressions, but was more nuanced The AU correctly observed "From a mental perspective, the claimant has major depressive disorder and posttraumatic stress disorder The record is nearly silent as to these impairments until the claimant reported a worsening of her psychologically based symptoms m late 2012 and early 2013" AR 18 The AU then noted that Mohr had mild restnctions m her activities of daily hvmg, as the AU had explamed earher m the opmion as well AR 13, 18 functionmg AR 13 The AU concluded that Mohr had "moderate difficulties" m social However, the AU accurately stated that Mohr's "[m]ental status examinations reveal mtact memory, good attention/concentration and good insight and judgment" AR 14,see AR 1200,1211,1222,1236,1245 The AU noted that Mohr had a GAF as low as 45 at the start of counseling, but that GAF improved after Mohr started ther^y to i 60-65 AR 18, ^AR 1187,1200,1211,1236 The AU did not put undue weight on the GAF, and indeed reasoned, "although GAF scores are only one consideration, the claimant's GAF scores are not mdicative of disabling psychologically based symptoms 15 They receive some weight" AR 18 The AU then reasoned "When the claimant's GAF scores are considered with her activities of daily hving, they suggest a higher level offunctioning than alleged by the claimant at hearing" AR 18 The AU referenced the state agency consultants—^Dr Kevm Whittle and Dr George Enckson—who had concluded that Plaintiff could perform "a relatively full range of hght work," albeit sedentary work AR 20 The AU also referenced the two consultmg professionals on psychological issues—Doug Soule, Ph D, and George Richards, M D —who both opmed m 2012 that the psychological conditions of Mohr were non-severe AR 20, s^ AR 84, 114—15 The AU concluded that psychologist Harthne's opmions were inconsistent with Mohr's abilities and noted, with support fiom the record, that "there is also evidence the claimant [Mohr] had mput mto Dr Harthne's opmion, or at least had the opportumly to express whether she was'comfortable' with the responses" AR 20,see AR 1238 The AU did not eiqilicitly discuss the six &ctors under 20 C F R § 404 1527(c) m evaluatmg the weight to give psychologist Hartlme's opmion The AU's decision, however, reflects an understanding of the exammmg and treatment relationship between Mohr and psychologist Hartlme, as well as psychologist Harthne's specialization The AU's discussion of Mohr's psychological wellbeing and psychologist Hartlme's opmions reflect a consideration of the supportability, consistency, and other &ctors brought to the AU's attention tending to support or contradict the opmion The AU's determination of the weight to give psychologist Hartlme's opmions is not mconsistent with 20 C F R § 404 1527(c) There is no inherent problem m the AU considering, among other things, Mohr's weekly participation m a dart league, commumcating appropriately with healthcare providers, and abihty to care for her grandchildren and hold a jewelry party m evaluatmg whether Mohr's activity levels were consistent with psychologist Harthne's December 3, 2013 opmion See Toland v 16 ColvuL 761 F 3d 931, 936 (8th Cir 2014)(discounting treating phsrsician's opinion based on activites), Gallus v Callahan. 117 F 3d 1061, 1064 (8th Cir 1997)(discrediting mental health work limitations suggested by medical professionals vdien contradicted by claimant's daily activities) Likewise, psychologist Harthne did not place inappropriate emphasis on GAF scores Surely, GAF scores can be misleadmg and tend to be a subjective evaluation couched m a numeral score as if an objective measurement Sto Hallv Colvm. 18 F Supp 3d 144, 153(D RI 2014V Rmench v Colvin.90 F Supp 3d 480,492(M D N C 2015) Although GAF scores may not have a direct correlation to seventy of mental health issues, they nonetheless may be considered by an AU and m reviewmg an AU's determination Sm Mversv Colvm. 721 F 3d 521, 525 (8th Cir 2013), Goffv Bamhart. 421 F 3d 785, 791 (8th Cir 2005) The AU was cautious m using the GAF scores, and indeed noted that they are only one consideration and not indicative of disabling symptoms, but rather "receive some weight" AR 18 The AU's reference to the GAF scores m this manner,alongside consideration ofother relevant information on Mohr's mental wellbemg, was not m error The AU's observation that psychologist Harthne gave Mohr the opportumty to express vdiether she was "comfortable" witii psychologist Hartlme's submission to SSA pnor to sendmg It IS supported by the record AR 1238 Mohr argues that there was nothing mappropnate m psychologist Harthne doing so, and that indeed may be true However,there likewise is nothing m^ropnate m the AU noting that psychologist Hartline vetted her opmions with Mohr before submitting them to SSA After all, an AU may find a physician's opimon less credible when it IS prepared for benefit purposes,rather than m the course oftreatment Hurdv Astrue.621 F 3d 734, 739 (8th Cn 2010) Moreover, the AU did not expressly reject the opmions simply 17 because they were vetted with Mohr ahead of time, but for vanous reasons expressed m the ALT'sopmion See AR 9-22 The next phallenge Mohr makes is to the ALJ's reference that she "is very close with her mother and siblmgs" AR 13 This reference actually is not m tiie section where the ALT was Hisraigsing why she chose not to credit to a greater extent psychologist Hartlme's opmions The record contains ample information that Mohr is close to her mother, but the reference to "sibhngs" IS an error, as Mohr has just one surviving siblmg who, during at least the relevant tune, lived m Chicago AR 1084,1193 Regardless, the AU did not rely on a relationship with the siblmg for discountmg either psychologist Harthne's opmions or Mohr's own testimony Finally, the absence of social limitations reflected m the 2011 function report is a feu readmg of the report AR 292-99 That report was done before Mohr's course of treatment lip-gan at Capital Area Counseling The AU's decision reflects an understanding that there was a worsening of Mohr psychologically m late 2012 and early 2013 AR 18 The ALJ's analj^is reflects a consideration of a wide range of information, mcluding but not lumted to the 2011 function report, m evaluating the senousness of Mohr's psychological condition There is nothing wrong with the AU's approach m that regard or generally m how the AU looked at a imiltitiiHft of information and fectors m determmmg vdiat weight to accord psychologist Hartlme's opmions B The ALJ's Evaluation of Mohr's Credibnhty Mohr argues that the AU improperly discounted Mohr's own statements about her limitatinng Doc 17 at 47-^8 The Comimssioner responds that the AU appropnately evaluated Mohr's credibihty Doc 18 at 13-16 18 When analyzing a claimant's subjective complamts of pam and liimtations, an AU under Eighth Cncmt precedent must consider the objective medical evidence, the claimant's work history, and the "Pnlasln fuitors," which include "(1) the claimant's daily activities, (2) the duration, frequency and mtensity of the pam, (3) precipitatmg and aggravating factors, (4) dosage, effectiveness and side effects of medications, and(5)functional restrictions" Perkins v Astrue. 648 F 3d 892, 900 (8th Cir 2011)(mtemal quotation marks omitted)(hstmg frictors articulated m Polaski v Heckler. 739 F 2d 1320, 1322 (8th Cir 1984)) An AU need not exphcitly discuss each Polaski factor, but an AU who rejects subjective complaints "must make an eiqpress credibihty determination explainmg the reasons for discrediting the complamts" Wagner V Astrue. 499 F 3d 842,851 (8th Cir 2007) (quotmg Smehv Anfel. 222 F 3d 448,452 (8th Cir 2000)) Although an AU may not discount a claimant's subjective complamts solely because they are not fully supported by objective medical evidence, a claimant's complamt "may be discounted based on mconsistencies m the record as a whole" FJlis v Rambart, 392 F 3d 988, 996(8th Cir 2005) A court must"defer to the AU's determmations regarding the credibility of V testimony, so long as they are supported by good reasons and substantial evidence" Perks v Astrue.687 F 3d 1086, 1091 (8th Cir 2012)(quotmg Pelkevv Pambart. 432 F 3d 575,578(8th Cn 2006)) The Eighth Cucmt has cautioned judges agamst subshtutmg their opmions for opmions of AUs, who are "m a better position to assess credibihty" Eichelberger v Bamhart. 390 F 3d 584,590(8th Cn 2004) Mo^'s case appears to be one where 'ifaere is no doubt that the claimant is expenencmg pain, the real issue is how severe that pam is" Ctowellv Anfel. 242 F 3d 793,796(8th Cir 2001)(quotmg Wnnlfv Shalala 3 F 3d 1210,1213(8th Cir 1993)) 19 The AU here did not rqect all of what Mohr said about her physical and mental wellbeing or abilities However, the AU did reject Mohr's statements concemmg the mtensity, persistence, and limiting effects of her symptoms AR 16 The AU then discussed Mohr's medical records and reports from phjrsicians, AR 16-17, Mohr's testunony durmg the hearmg, AR 17, and Mohr's medications, AR 17-18 The AU, with support m the record, noted that "with respect to all of Claimant's physical impairments, she has had ongomg treatment, but her treatment was very limited m 2013" AR 18 The AU appropnately observed Specifically, the claimant is able to perform personal care activities without assistance, make lunch and dinner for herself and her significant other, and clean up afterward She can perfiirm some household chores, including laundry, vacuuming, moppmg, and loading/unloading the dishwasher She feeds and waters her cats and dog, and cleans the htterbox She shops for grocenes and other Items The claimant also cares for her young grandchildren She claims she has not dnven smce 2011 because of her medications' However, she has not reported that she is unable to dnve to any of her treatment providers, nor have they restricted her fixim dnvmg All of these activities reflect an ability to perform at least sedentary work AR 18 The AU determined that Mohr had "imld restrictions" m activities of daily hving and "moderate difficulties" m social functioning based on the information of record AR 13 The AU then discussed Mohr's psychological issues, with the medical records being limited as to any psychological impairments until 2013, and situational stressors at that tune AR 18 The AU noted that the mental status examinations revealed attention/concentration, and good insight and judgment AR 14 mtact memory, good Indeed, the repeated evaluations m the second half of 2013 by Dr Pesce of Mohr's abilities conflicted with and * There is evidence m the Admmistrative Record that Mohr drove on her own smce 2011, notwithstanding her testimony m fiont of the AU AR 295 (indicating that she dnves the car, but only when no one can give her a nde), AR 319(third party indicating that she dnves if she has to), AR 1177 (indicating that she was planning to travel to Aberdeen that day to brmg her granddaughter back to see her mother) 20 directly undermined Mohr's testimony in January of 2014 about severe limitations based on her cognitive or mental health issues. Compare AR 49-53, with AR 1200, 1211, 1222, 1236, 1245. Although the ALJ did not specifically enumerate the Polaski factors, consideration of each of those five factors can be found in the ALJ's discussion analyzing Mohr's testimony and reported limitations. "The ALJ is not required to discuss each Polaski factor as long as the analytical framework" for evaluating credibility "is recognized and considered." Tucker v. Bamhart. 363 F.3d 781, 783 (8th Cir. 2004). The ALJ's consideration of the activities of daily living in determining whether to credit Mohr's testimony about her extreme limitations is appropriate. See Wagner v. Astrue, 499 F.3d 842, 852-53 (8th Cir. 2007); Brown v. Bamhart. 390 F.3d 535, 541 (8th Cir. 2004). C. Request for Remand for BeneHts Because this Court has determined that the Commissioner's decision ought to be affirmed, a remand with a directive to award benefits is not appropriate here. V. Conclusion For the reasons explained above, it is hereby ORDERED that the Commissioner's decision is affirmed and that Judgment enter accordingly. DATED this "30^ day of September, 2016. BY THE COURT: ROBERTO A. LANGf UNITED STATES DISTRICT JUDGE 21
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