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

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FILED 

United States Court of Appeals 

Tenth Circuit 

UNITED STATES COURT OF APPEALS 

FOR THE TENTH CIRCUIT 

APR 25 2005 

PATRICK FISHER 

Clerk 

KAREN S. WISE, 

Plain ti ff-Appellant, 

V. 

JO ANNE B. BARNHART, 

Commissioner, Social Security 

Administration, 

Defendant-Appellee. 

No. 04-7035 

(D.C. No. 02-CV-484-P) 

(E.D. Okla.) 

ORDER AND JUDGMENT* 

Before HARTZ, and BALDOCK, Circuit Judges, and BRIMMER, .. District 

Judge. 

After examining the briefs and appellate record, this panel has determined 

unanimously to grant the parties' request for a decision on the briefs without oral 

argument. See Fed. R. App. P. 34(f); 10th Cir. R. 34.1 (G). The case is therefore 

ordered submitted without oral argument. 

This order and judgment is not binding precedent, except under the 

doctrines of law of the case, res judicata, and collateral estoppel. The court 

generally disfavors the citation of orders and judgments; nevertheless, an order 

and judgment may be cited under the terms and conditions of I 0th Cir. R. 36.3. 

•• The Honorable Clarence A. Brimmer, District Judge, United States District 

Court for the District of Wyoming, sitting by designation. 

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Karen Wise appeals from an order of the district court affirming the 

Commissioner's decision denying her application for Social Security benefits. 

Ms. Wise filed applications for disability insurance benefits and supplemental 

security income payments on September 29, 2000. 1 She alleged disability based 

on anxiety, depression, asthma, and multiple injuries to her body from an 

automobile accident. The agency denied her application initially and on 

reconsideration. 

On February 7, 2002, Ms. Wise received a de novo hearing before an 

administrative law judge (ALJ). The ALJ determined that Ms. Wise had the 

residual functional capacity (RFC) to perform a significant range of sedentary 

work. The ALJ denied Ms. Wise's application for benefits, concluding that she 

was not disabled at step five of the analysis because she could perform a 

significant number of jobs in the national economy. See Williams v. Bowen, 844 

F .2d 748, 750-52 (10th Cir. 1988) ( explaining five-step process for evaluating 

claims for disability benefits). The Appeals Council denied review, making the 

ALJ's decision the Commissioner's final decision. 

Ms. Wise previously filed applications for disability insurance benefits and 

social security income payments. The ALJ issued a decision on February 26, 

1999 finding Ms. Wise disabled under a closed period from August 29, 1997 to 

November 17, 1998, but not thereafter. Ms. Wise alleges an onset date of 

August 29, 1997, but due to the finality of the prior ALJ decision, the relevant 

time period for these applications begins on February 27, 1999. 

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We review the Commissioner's decision to determine whether the factual 

findings are supported by substantial evidence in the record and whether the 

correct legal standards were applied. Winfrey v. Chater, 92 F.3d 1017, 1019 (10th 

Cir. 1996). On appeal, Ms. Wise contends that the ALJ erred by failing to 

properly consider her treating physicians' opinions. We affirm in part and reverse 

in part. 

A treating source opinion is to be given controlling weight only if it is 

"well supported by medically acceptable clinical and laboratory diagnostic 

techniques and is not inconsistent with the other substantial evidence in [the] 

record .... " 20 C.F.R. § 404.1527(d)(2); see also Watkins v. Barnhart, 350 F.3d 

1297, 1300 (10th Cir. 2003) (outlining framework for ALJ's controlling weight 

determination). In considering Ms. Wise's treating physicians, the ALJ lumped 

together the opinions of Dr. Carpenter and Dr. Houston and rejected them both 

stating: 

I find Dr. 's Houston and Carpenter's medical source statements and 

medical consultant review, respectively, to be deficient and without 

supportive medical documentation. Their pessimistic conclusions 

were not supported by the objective medical evidence. They 

provided no clinical signs in support of their conclusion, because 

none existed. Despite exhaustive diagnostic testing, there is simply 

no support for functional limitations to the extent alleged and found 

by these two physicians. The preponderance of the evidence shows 

that their conclusions are based solely on [claimant's] subjective 

complaints, which I do not find to be fully credible. As such, I 

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decline to give their medical conclusions controlling weight as they 

are inconsistent with the credible evidence of record. 

Aplt. App. at 25-26 (internal citations omitted). 

Dr. Carpenter 

Dr. Carpenter has been Ms. Wise's treating physician since 1978. She 

completed two medical source statements relating to Ms. Wise's physical 

impairments. In the first medical source statement completed on December 27, 

2000, Dr. Carpenter reported that Ms. Wise was unable to frequently lift and/or 

carry any amount of weight and that she was occasionally only able to lift and/or 

carry five pounds. Aplt. App. at 504. In addition, Dr. Carpenter reported that in 

a typical eight hour work day, Ms. Wise could only stand and/or walk for one 

hour; stand and/or walk continuously for fifteen minutes; sit for one hour and sit 

continuously for fifteen minutes. Id. Dr. Carpenter also stated that Ms. Wise is 

required to lie down during the normal work day to manage pain or other 

symptoms. Id. at 505. 

Dr. Carpenter's second source statement was essentially the same, with a 

few exceptions. Dr. Carpenter reported that Ms. Wise was now able to frequently 

lift and/or carry 5 pounds, but she was only able to stand less than one hour a day 

and only five minutes continuously. Id. at 624. Ms. Wise was now able to sit for 

two hours and to sit continuously for thirty minutes. Id. Based on these medical 

source statements, Ms. Wise would be unable to perform even the most basic 

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sedentary work. The record, however, does not support the limitations found by 

Dr. Carpenter. 

Dr. Carpenter's treatment notes do not indicate that she performed any 

objective testing; they focus instead on Ms. Wise's subjective complaints. See, 

e.g., Aplt. App. at 412-413; 566-567. In addition, the diagnostic testing actually 

ordered by Dr. Carpenter does not support the limitations in her medical source 

statements. See, e.g., Aplt. App. at 622 (diagnostic imaging of ankle shows no 

evidence of hardware failure or acute fracture); id. at 614 ( diagnostic imaging of 

left foot shows no joint or osseous abnormalities); id. at 605-06 (diagnostic 

imaging of left knee shows no acute fracture, dislocation or joint effusion). 

Other evidence in the record is also inconsistent with Dr. Carpenter's 

opinion. Ms. Wise was examined at University Health Partners Orthopedic 

Surgery Resident Clinic as a follow-up to the injuries she sustained in her 

automobile accident. The examination revealed that her humerus and tibia 

fractures were healed. Aplt. App. at 396. The progress notes state also that 

although Ms. Wise cannot return to her previous manual labor job, "[s]he would 

... be able to remain sitting at a desk type job such as computer work or other 

sedentary type jobs." Id. at 396-97 (emphasis added). 

Ms. Wise was also seen by Dr. Howard for a consultative examination. 

Dr. Howard performed a range of motion evaluation. Id. at 575-78. Dr. Howard 

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determined that Ms. Wise had full range of motion in her upper extremities 

( shoulders, elbows, wrists, and hands) and full range of motion in her lower 

extremities (hips, knees, ankles and feet), with the exception that she could not 

flex her knee more than about 100 degrees. Id. at 573, 575-578. Dr. Howard also 

noted that Ms. Wise walked with "a good stable solid gait" and that "she had a 

very slight limp requiring no assistive device." Id. at 57 4. 

Although Ms. Wise contends that "[t]he file as a whole," supports 

Dr. Carpenter's opinion, she does not point to any specific record evidence that 

would justify this assertion. Aplt. Br. at 11. In fact, Ms. Wise barely mentions 

Dr. Carpenter in the argument section of her brief. See id. at 14-18. 

Dr. Carpenter's medical source statements indicate that Ms. Wise is unable to 

perform even sedentary work. The objective tests ordered by Dr. Carpenter, 

however, indicate that Ms. Wise's injuries from her automobile accident have 

healed. In addition, Dr. Howard's range of motion testing demonstrates that 

Ms. Wise has a full range of motion in her upper and lower extremities, with the 

exception of a slightly decreased range of motion in her left knee. And, the 

medical records from the doctors who examined Ms. Wise for the follow-up to her 

accident state that her injuries are healed and that she can perform sedentary 

work. Based on our review of the record, we conclude that there is substantial 

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evidence to support the ALJ's conclusion that Dr. Carpenter's opinion was not 

entitled to controlling weight and that it should be rejected. 

Dr. Houston 

Dr. Houston treated Ms. Wise from August 30, 2000 through January 2001. 

The record shows that Dr. Houston diagnosed Ms. Wise with bipolar disorder and 

that she prescribed three medications for Ms. Wise, including Prozac. See Aplt. 

App. at 507-508, 511. There are also three mental status examination forms from 

August 30, September 6 and September 12, id. at 515-517, and treatment notes 

from September 13 and October 11, id at 511-512. Dr. Houston completed a 

mental medical source statement on January 10, 2001 in which she reported that 

Ms. Wise is markedly limited in her ability to: remember locations and work-like 

procedures; understand and remember detailed instructions; carry out detailed 

instructions; maintain attention and concentration for extended periods; sustain an 

ordinary routine without special supervision; work in coordination with or 

proximity to others without being distracted by them; complete a normal work day 

and workweek without interruptions from psychologically based symptoms and 

perform at a consistent pace without an unreasonable number and length of rest 

periods; accept instructions and respond appropriately to supervisors; respond 

appropriately to changes in the work setting; and set realistic goals or make plans 

independently of others. Id. at 5 I 8-19. Dr. Houston also filled out a mental 

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status form on January 24, in which she gave a more detailed report of her 

observations of Ms. Wise. For example, she noted that: 

Client has difficulty assimilating information. I must repeat things at 

times, more than once, for clarification to client .... [s]he has 

difficulty thinking and making decisions. She can reason thoughts 

out if given appropriate time frame; she does respond after her 

complete understanding . . . . Karen has difficulty remembering, but 

writes things down. She can carry out simple instructions, if stated 

in step by step terms. Complete instructions appear to be a problem 

due to client's ability to concentrate and remember. 

Id. at 509. Dr. Houston concluded that Ms. Wise's prognosis was guarded and 

that there was "little hope of improvement." Id. 

Since Dr. Carpenter mainly treated Ms. Wise for her physical conditions 

and Dr. Houston treated Ms. Wise solely for her mental conditions, the ALJ's 

combined treatment of these opinions has made our review more difficult. 

As discussed above, the ALJ's reasons for rejecting Dr. Carpenter's opinion are 

supported by the record. In contrast, however, applying these same reasons to 

rejecting Dr. Houston's opinion about Ms. Wise's medical condition does not 

make sense. The ALJ talks about a lack of "objective medical evidence" and 

"diagnostic testing." Aplt. App. at 25. But a psychological opinion does not need 

to be based on "tests;" those findings can be based on "observed signs and 

symptoms." Robinson v. Barnhart, 366 F.3d 1078, 1083 (10th Cir. 2004) ( citing 

20 C.F.R. subpart P, App. I § 12.00(B)). Dr. Houston's observations of Ms. Wise 

do constitute specific medical findings. 

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The ALJ also concluded that Dr. Houston's opinion was "inconsistent with 

the credible evidence of record," Aplt. App. at 26, but he fails to explain what 

those inconsistencies are. In the case of Dr. Carpenter, the inconsistencies were 

obvious, but with Dr. Houston, the record is not as clear. Ms. Wise was examined 

by Dr. Mynatt, a consulting physician. Dr. Mynatt diagnosed her with major 

depressive disorder and generalized anxiety. He noted that she has "symptoms 

affecting sleep, appetite, memory, concentration and energy." Id. at 538. He 

concluded that "[e]nvironment is a problem in symptom otology as she has 

difficulties interacting with others, and has difficulty in employment, financial 

and other areas." Id. at 539. He rated her level of functioning at 52, which is 

indicative of moderate symptoms or moderate difficulty in social, occupational or 

school functioning, see American Psychiatric Assoc., Diagnostic and Statistical 

Manual of Mental Disorders 34 ( 4th ed. 2000). Dr. Mynatt concluded that 

Ms. Wise's "condition is not expected to improve significantly within the next 12 

months." Id. Without any guidance from the ALJ, this opinion appears in large 

part to be consistent with Dr. Houston's assessment. 

Ms. Wise's records were also reviewed by two agency experts. It does not 

appear that either of these physicians actually evaluated Ms. Wise in person. The 

first doctor concluded that Ms. Wise was not markedly limited in any areas and 

was only moderately limited in three areas. Id. at 534-35. The second doctor 

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concluded that Ms. Wise was markedly limited in her ability to understand and 

remember detailed instructions; carry out detailed instructions and interact 

appropriately with the public. Id. at 595-96. The first doctor's opinion is 

inconsistent with most of the evidence in the record, including the opinion of the 

second agency expert. The second expert's conclusion that Ms. Wise is markedly 

limited in her ability to understand, remember and carry out detailed instructions 

is consistent with Dr. Houston's assessment, although the opinions do differ in 

other respects. The agency expert's conclusions are reported in a mental residual 

functional capacity assessment, which is a standard form with boxes checked to 

indicate conclusions. "Such evaluation forms, standing alone, unaccompanied by 

thorough written reports or persuasive testimony, are not substantial evidence." 

Williams, 844 F.3d at 757 (quotation omitted). In addition, the ALJ is generally 

required to give more weight to the opinion of a treating physician than to an 

agency physician who has never seen the claimant. Id. ("[T]he opinions of 

physicians who have seen claimant over a period of time for purposes of 

treatment are given more weight over ... those who only review the medical 

records and never examine the claimant."). 

Finally, the ALJ determined in his RFC that Ms. Wise could perform 

sedentary work with the additional limitation of performing simple, routine tasks; 

however, Dr. Houston's mental RFC assessment included other more restrictive 

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limitations that could impact Ms. Wise's ability to hold a job. For example, Dr. 

Houston determined that Ms. Wise was markedly limited in her ability to sustain 

an ordinary routine without special supervision; to complete a normal work day 

and workweek without interruptions from psychologically based symptoms and to 

perform at a consistent pace without an unreasonable number and length of rest 

periods. 

Because the ALJ failed to explain his reasons for rejecting Dr. Houston's 

additional restrictions, failed to distinguish the types of medical evidence 

presented by Dr. Houston from that of Dr. Carpenter, and failed to explain or 

identify what the inconsistencies were between Dr. Houston's opinion and the 

other substantial evidence in the record, the ALJ's reasons for rejecting Dr. 

Houston's opinion are not "sufficiently specific" to enable this court to 

meaningfully review his findings. Langley v. Barnhart, 373 F.3d 1116, 1123 

(10th Cir. 2004). We conclude that the ALJ's rejection of Dr. Houston's opinion 

is not supported by substantial evidence and we must remand for further findings. 

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Accordingly, we AFFIRM the ALJ's determination with respect to 

Dr. Carpenter, but we REVERSE and REMAND the ALJ's determination with 

respect to Dr. Houston. 

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Entered for the Court 

Clarence A. Brimmer 

District Judge 

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