Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-05-02873/USCOURTS-ca8-05-02873-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 

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The Honorable Andrew W. Bogue, United States District Judge for the District

of South Dakota, sitting by designation.

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The Honorable Edward J. McManus, United States District Judge for the

Northern District of Iowa.

United States Court of Appeals

FOR THE EIGHTH CIRCUIT

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No. 05-2873

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Starla K. Tindell,

Appellant,

v.

Jo Anne B. Barnhart,

Commissioner, Social Security

Administration,

Appellee.

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Appeal from the United States

District Court for the

Northern District of Iowa.

 [PUBLISHED]

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Submitted: January 12, 2006

 Filed: April 19, 2006

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Before SMITH and HANSEN, Circuit Judges, and BOGUE,1

 District Judge. 

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HANSEN, Circuit Judge.

Starla K. Tindell appeals the district court's2

 order affirming the denial of her

claim for supplemental security income benefits. We affirm.

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Starla Tindell filed a supplemental security income (SSI) application claiming

disability due to depression, severe anxiety, migraine headaches, pain, and

fibromyalgia, with an onset date of January 1, 1998. An administrative law judge

(ALJ) initially denied benefits on January 25, 2002, and on May 2, 2002, the Appeals

Council remanded to the ALJ for "further consideration [of Tindell's] treating source

opinion," (Appellant's App. at 113), rendered by James R. Cline, who is Tindell's

licensed social worker, and an explanation of the weight given to the treating source's

opinion. On remand, another hearing was held on February 12, 2003, and the ALJ

once again denied benefits on August 22, 2003.

Tindell was 43 at the time of her second hearing and complained of severe

anxiety and panic attacks, depression, migraine headaches, back pain, and

fibromyalgia. The ALJ found on remand that Tindell had impairments that prevented

her from performing her prior work, but he discounted her credibility. The ALJ

considered evidence from Mr. Cline, a licensed social worker who counseled Tindell

on a fairly regular basis. The evidence from Mr. Cline included a questionnaire that

he completed in October 2001 regarding Tindell's mental impairments. The ALJ also

considered the medical opinions of Dr. Lorne Johnson, a licensed psychologist, who

tested and evaluated Tindell on August 13, 2002 (after the Appeals Council remand

and before the second hearing), and who had previously evaluated Tindell in 2000,

prior to the first hearing. Dr. Johnson opined that Tindell had continuing problems

with recurrent depression, had a panic disorder, and had a posttraumatic stress

disorder. Phillip A. Ascheman, Ph.D., a clinical psychologist, testified at the second

hearing as a consultant based on the medical records and the testimony provided at the

second hearing, but he never personally examined Tindell. Dr. Ascheman opined that

the record supported a diagnosis of some type of affective disorder and anxiety-related

disorder, and he agreed with many of the limitations noted by Mr. Cline and Dr.

Johnson. Dr. Ascheman disagreed with the level of some of the limitations noted by

Mr. Cline and with Dr. Johnson's diagnosis of major depression and posttraumatic

stress disorder.

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The ALJ gave greater weight to Dr. Ascheman's opinion than to the opinions

of Mr. Cline and Dr. Johnson. The ALJ determined that although Mr. Cline treated

Tindell, he was not an acceptable medical source under 20 C.F.R. § 416.913(a), but

could be considered as an other source under § 416.913(d). He further found that Mr.

Cline's opinions were inconsistent with other substantial evidence, specifically Dr.

Ascheman's testimony. Thus, Mr. Cline's opinions could be considered but were not

controlling. The ALJ did not consider Dr. Johnson's opinions as controlling because

Dr. Johnson was not a treating source. The ALJ found Ms. Tindell's subjective

complaints to be not credible because they were inconsistent with her activities of

daily living. 

Based on the evidence and the weight accorded the various opinions of the

psychologists and therapists involved, the ALJ determined that Tindell had a severe

affective disorder, a generalized anxiety-related disorder, and a substance abuse

disorder (Tindell testified at the hearing that she drank up to ten beers a night to help

her sleep). From the ALJ's resulting residual functional capacity (RFC) assessment,

he determined that Tindell could not perform her prior work but could do other jobs

within the range of light work available in the economy as testified to by G. Brian

Paprocki, a qualified vocational expert (VE). The Appeals Council affirmed the ALJ's

decision, which was in turn affirmed on appeal to the district court. Tindell now

appeals to this court. 

We review the district court's affirmance of the Commissioner's denial of

benefits de novo, "consider[ing] whether the ALJ's determination is supported by

substantial evidence on the record as a whole." Vandenboom v. Barnhart, 421 F.3d

745, 749 (8th Cir. 2005) (internal marks omitted). We review the ALJ's interpretation

of Social Security regulations de novo, and we give substantial deference to the

Commissioner's interpretation of the Social Security Act. Reutter ex rel. Reutter v.

Barnhart, 372 F.3d 946, 950 (8th Cir. 2004).

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Tindell argues that the ALJ misconstrued the regulations when he refused to

give treating source weight to Mr. Cline's opinion about the severity of her

impairments. The parties agree that as a licensed therapist Mr. Cline is not an

"acceptable medical source[]," see 20 C.F.R. § 416.913(a) (listing acceptable medical

sources); § 416.913(d) (including therapists in the list of "other sources"), but they

disagree about the ramifications of that fact. 

Medical opinions are but one type of medical evidence used to evaluate a

disability claim. The social security regulations provide a detailed explanation of how

the Commissioner will evaluate opinion evidence. If a treating source's medical

opinion about the nature and severity of the claimant's impairments is well-supported

by medical evidence and is not inconsistent with other substantial evidence in the

case, the treating source opinion is entitled to controlling weight. § 416.927(d)(2). 

The regulations define "medical opinions" as "statements from physicians and

psychologists or other acceptable medical sources that reflect judgments about the

nature and severity of [the claimant's] impairments." § 416.927(a)(2). "Treating

source" is defined as the claimant's "own physician, psychologist, or other acceptable

medical source" who provides the claimant with medical treatment or evaluation on

an ongoing basis. § 416.902. By definition then, the controlling weight afforded to

a "treating source" "medical opinion" is reserved for the medical opinions of the

claimant's own physician, psychologist, and other acceptable medical source. Mr.

Cline was not a treating source as defined in the regulations, nor was he associated

with a physician, psychologist, or other acceptable medical source that could

potentially give him treating source status. See Shontos v. Barnhart, 328 F.3d 418,

426 (8th Cir. 2003) (giving treating source status to the group of medical

professionals, including therapists and nurse practitioners who worked with claimant's

psychologist, where the treatment center used a team approach); Benton ex rel. Benton

v. Barnhart, 331 F.3d 1030, 1037 (9th Cir. 2003) (noting that "the use of a team

approach by medical providers [wa]s analytically significant" in Shontos's application

of the treating source regulations). Thus, in considering the evidence, including

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opinion evidence, from Mr. Cline as an "other source," the ALJ was not bound by the

treating source regulations but had "more discretion" and was "permitted to consider

any inconsistencies found within the record." Raney v. Barnhart, 396 F.3d 1007, 1010

(8th Cir. 2005) (evaluating therapist's assessment as "other medical evidence" rather

than as a treating source opinion). 

Even though Mr. Cline's opinion was not entitled to treating source weight, his

opinion was entitled to consideration as other medical evidence in the record. As for

Dr. Johnson's medical opinions, his status as an evaluating source would generally

entitle his opinion to greater weight than that of Dr. Ascheman, who never met with

Tindell. See § 416.927(d)(1). "It is the ALJ's function to resolve conflicts among the

various treating and examining physicians." Vandenboom, 421 F.3d at 749-50

(internal marks omitted). The ALJ did not discredit Mr. Cline's or Dr. Johnson's

opinions in total. Dr. Ascheman, as the consulting psychologist, agreed with Mr.

Cline and Dr. Johnson that Tindell suffered from some sort of depression and anxiety

but disagreed that the medical record supported a diagnosis of major depression. Dr.

Ascheman found the lack of symptoms noted in Mr. Cline's records inconsistent with

the over-endorsement of symptoms noted by Dr. Johnson, and both inconsistent with

a diagnosis of major depression. He agreed with both Mr. Cline and Dr. Johnson,

however, that Tindell's depression and anxiety created moderate limitations for

activities involving detailed complex situations. 

Dr. Ascheman provided specific reasons for disagreeing with the level of

depression found by Mr. Cline and Dr. Johnson. Dr. Ascheman concluded that Mr.

Cline's diagnosis was supported by minimal symptoms, and he noted that the

limitations Mr. Cline relied upon in his diagnosis for disability purposes were not

included in his findings that were recorded during his therapy sessions. Further, on

the mental impairment questionnaire, Mr. Cline assigned Tindell a Global Assessment

of Functioning (GAF) score of 50 even though he had reported a GAF of 59 in his

treatment notes from the previous day. 

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Dr. Ascheman took issue with Dr. Johnson's report because during Dr.

Johnson's evaluation, Tindell claimed to have all of the symptoms for three different

types of depression. Even Dr. Johnson recognized that the results of the MMPI-II test

(a self-report inventory of symptoms) resulted in a "faking bad" profile that

invalidated the test. Dr. Johnson did not think the "faking bad" profile indicated a

deceptive intent by Tindell, but Dr. Ascheman disagreed, stating that the level

indicated on the MMPI-II test was from an over-endorsement of symptoms, which had

to be intentional. Tindell claimed to have each symptom on the test. The ALJ

provided specific reasons for giving differing weight to the conflicting evidence, and

he was within his authority in resolving the conflicting opinions. We recognize that

generally examining source opinions should be given greater weight than that given

to a psychologist who has never met the claimant and bases his opinion solely on the

record. But the ALJ sufficiently explained the inconsistencies that led him to give

greater weight to the consultative opinion in this case, and we agree with his

assessment of the evidence from the record as a whole. 

Having determined that the ALJ properly weighed the conflicting medical

evidence, we must decide "whether the ALJ's determination is supported by

substantial evidence on the record as a whole." Vandenboom, 421 F.3d at 749

(internal marks omitted). The ALJ considered Tindell's credibility under the factors

outlined in Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984), and determined

that she was not fully credible because her activities of daily living were not consistent

with her alleged extremely limited residual functional capacity, which she described

as "merely surviving." Tindell claimed a disability onset date of January 1, 1998. As

noted by the ALJ, since that time she attended college classes in 1999 and 2000; she

worked ten hours per week in a catering business; and she took care of her young

grandson as recently as August 2002, just a few months before the second hearing.

She took little medication considering the alleged severity of her symptoms, though

we note that financing her medication was often a problem for her. We also note that

the ALJ did not discredit her complaints in total and included many of her subjective

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limitations in his RFC assessment. The ALJ properly considered the Polaski factors

and supported his credibility assessment with detailed findings. He was in a better

position to judge Tindell's credibility, and we find no error in his judgment. See

Strongson v. Barnhart, 361 F.3d 1066, 1072 (8th Cir. 2004).

 

The ALJ determined that Tindell had an affective disorder and an anxiety

disorder, which limited her RFC, such that she could not perform complex work or

work requiring prolonged attention to minute detail or rapid shifts in attention. He

also determined that she could tolerate only short and superficial interaction with

others and could not make significant decisions or exercise significant judgment.

Finally, he determined that she should avoid work that was stressful, performed at a

fast pace, had quotas, or involved emergency situations. Even with these limitations,

the VE determined that she could perform a variety of light, unskilled work positions.

After reviewing the evidence in the record as a whole, we believe that

substantial evidence supports the ALJ's decision that Tindell is not disabled under the

Social Security Act. Little evidence contradicts the ALJ's position as to the severity

of Tindell's depression other than the conclusions by Mr. Cline and Dr. Johnson.

Tindell has never worked full-time but has supported herself with part-time work. She

seems to suffer from situational depression, as noted by Dr. Ascheman and reported

in Mr. Cline's notes about her dissatisfaction with a then-recent move to subsidized

housing and problems with a neighbor. Tindell has little history of medication for her

depression or anxiety, which supports the ALJ's conclusions and discredits Mr. Cline's

and Dr. Johnson's assessments of the effects of her depression on her ability to work.

Many of Mr. Cline's notes indicated that Tindell was continuing therapy on the advice

of counsel in order to document her medical problems for purposes of establishing her

entitlement to disability. The ALJ included all of Tindell's credible limitations in his

RFC assessment, and the ALJ's conclusions are supported by substantial evidence in

the record. 

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The district court's judgment is affirmed.

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