UNITED STATES COURT OF APPEALS
FOR THE TENTH CIRCUIT

________________ _________________ DIANE MARTINEZ, Plaintiff - Appellant,

v. COMMISSIONER, SSA, Defendant - Appellee. No. 18-1218 (D.C. No. 1:16-CV-2938-CMA) (D. Colo.)

________________ _________________ ORDER AND JUDGMENT *

________________ _________________ Before BRISCOE , McKAY , and LUCERO , Circuit Judges.

________________ _________________ Diane Martinez appeals from the district court’s order denying her application for Social Security disability b enefits and supplemental securi ty income benefits. Exercising jurisdiction under 28 U.S.C. § 1291 and 42 U.S.C. § 405(g), we affirm.
I. BACKGROUND Ms. Martinez applied for disabilit y insurance benefits and supp lemental security income asserting that s he was disabled due to a wrist injury, elbow and shoulder problems, back pain, bo ils, abdominal pain, insomnia, anxiety, and

* After examining the briefs and appellate record, this panel ha s determined unanimously to honor 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 ther efore submitted without oral argument. T his order and judgment is no t binding precedent, except under the doctrines of la w of the case, res judicata, an d collateral estoppel. It may be cited, however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1. FILED United States Court of Appeals Tenth Circuit 

### June 28, 2019
Elisabeth A. Shumaker Clerk of Court2 depression. After her claims we re denied initially and on reco nsideration, an administrative law judge (ALJ) c onsidered her claims and issued a decision finding Ms. Martinez was not disabled at t he fifth and final step of th e sequential evaluation used to assess social s ecurity disab ility claims. See 20 C.F.R. § 404.1520(a)(4) (describing five-step process). 1
The ALJ determined that Ms. Martin ez had a number of medically determinable severe impairments, including two severe physical impairments— lumbar degenerative di sc disease and history of right wrist fra cture—and two severe mental impairments—affective di sorder and anxiety disorder. Th e ALJ further found that Ms. Martinez’s severe physi cal and mental impairments did not, individually or in combination, meet or equal th e conclusively disabling impair ments in the Listing of Impairments found at 20 C.F. R. Part 404, Subpart P, Appendix I. As required by the sequential process, the ALJ t hen defined Ms. Martinez’s res idual functional capacity (RFC), finding that she could “perform light work . . . except that [she] can only occasionally bend, squat a nd kneel, cannot climb ladders/s caffolds, and can frequently handle/finger” and “re quires unskilled work that inv olves no complex tasks . . . and cannot deal with the general public.” Aplt. Ap p., Vol. I at 22. Based on the testimony of a voca tional expert, the ALJ found th at Ms. Martinez could not perform herpast relevant work, but stil l retained the ability

1 In this order and judgment, we c ite to relevant regulations in 20 C.F.R. Part 404, which apply to claims for di sability insurance benefits. We do not, however, include citations to the parall el provisions published in 20 C. F.R. Part 416, which apply to claims for supplem ental security income.3 to perform other work that exist ed in substantial numbers in th e national economy and was therefore not disabled. The Appeals Council denied rev iew of the ALJ’s decision, and the district court affirmed. This appeal followe d.
II. STANDARD OF REVIEW “We review the Commissioner’s d ecision to determine whether the factual findings are supported by substantial eviden ce in the record an d whether the correct legal standards were applied.” Lax v. Astrue , 489 F.3d 1080, 10 84 (10th Cir. 2007) (internal quotation marks omitted). Substantial evidence is such re levant evidence as a reasonable mind might accept as adequate to support a conclusion. It requires more than a scintilla, but less than a preponderance. W e consider whether the ALJ fol lowed the specific rules of law that must b e followed in weighing particu lar types of evidence in disability cases, but we will not reweigh the evide nce or substitute our judgment for the Commissioner’s.
Id . (citations and internal quotation marks omitted). Moreover, “[t]he possibility of dr awing two inconsistent conclu sions from the evidence does not prevent an admi nistrative agency’s findings f rom being supported by substantial evidence.” Id . (internal quotation mark s omitted). “We may not displace the agency’s choice betw een two fairly conflicting vie ws, even though the court would justifiably have mad e a different choice had the ma tter been before it de novo.” Id . (brackets and internal quotation marks omitted).4 III. ANALYSIS A. Opinion Evidence Ms. Martinez argues that the ALJ’s determination that she was n ot disabled is erroneous because he improperly we ighed several medical opinion s. We disagree. The ALJ was required to considerall the medical source opinion s regarding Ms. Martinez’s claimed impair ments—physical and mental. See 20 C.F.R. § 404.1527(c) (“Regardless of its source, [the ALJ] will evalua te every medical opinion [he] receive[s].”). Under § 404.1527(c)(2), [i]f [the ALJ] find[s] that a treating source’s medical opinion on the issue(s) of the nature and severity of your impairment(s) i s well-supported by medically accep table clinical and laboratory diagnostic techniques a nd is not inconsistentwith the other su bstantial evidence in [the] cas e record, [the ALJ] w ill give it controlli ng weight.
See also Watkins v. Barnhart , 350 F.3d 1297, 1300 (10th Cir. 2003). Conversely, “if the [treating physician’s me dical] opinion is deficient [be cause it is not well-supported or is i nconsistent with other substantial eviden ce in the record], then it is not entitled to c ontrolling weight.” Id. “Unless [the ALJ] give[s] a tr eating source’s medical opinion c ontrolling weight . . . , [the ALJ will] consider [six regulatory] factors in deciding the weight . . . [to] give to any medical opinion,” § 404.15 27(c) (emphasis added), including a treating source’s opi nion. In other words, “resolv ing the controlling weight issue does no t end our review.” Watkins , 350 F.3d at 1300 (i nternal quotation marks omitted). Instead, if the ALJ determines the treating so urce’s opinion is not5 entitled to controlling weight, the ALJ must consider the regul atory factors in § 404.1527(c)(2)-(6) to determine what weight to assign to the opinion. Those factors are: (1) the le ngth of the treatment relationshi p and the frequency of the examination; (2) the nature and extent of the treatment relationship, including the treatment provided and the kind of examination or testing performed; (3) the deg ree to which the physician’s o pinion is supported by relevant evidence; (4) consistency between the opi nion and the record as a whole; (5) wheth er or not the physician is a sp ecialist in the area upon which an opinion is re ndered; and (6) other factors b rought to the ALJ’s attention which tend to s upport or contradict the opinion

. Watkins , 350 F.3d at 1300-01 (internal quotation marks omitted). As an overarching principle, t he ALJ should “[g]enerally . . . give more weight to the medical opinion of a sour ce who has examin ed [the claima nt] than to the medical opinion of a medical sour ce who has not examined [the c laimant].” § 404.1527(c)(1). Nonetheless, “ [a]n opinion found to be an ex amining rather than treating medical-source opinion ma y be dismissed or discounted, ” so long as the ALJ bases the decision “on an evalu ation of all the factors set out in [§ 404.1527(c)] and [he] . . . provide[s] specific, l egitimate reasons for rejectin g it.” Chapo v. Astrue , 682 F.3d 1285, 1291 ( 10th Cir. 2012) (internal quotation marks omitted). B. Physical Impairments 1. Dr. Gregg Dr. Tammy Gregg was Ms. Martinez’ s treating physician. Between August 2011 and April 2015, Dr. Gregg pe riodically filled out check-bo x forms for Ms. Martinez’s participation in a local work program. On these forms, Dr. Gregg consistently indicated, among othe r things, that Ms. Martinez c ould occasionally lift6 ten pounds, but could never lift twenty-five pounds. In Januar y 2015, Dr. Gregg completed a form at the request of Ms. Martinez’s attorney indi cating that Ms. Martinez could lift and carr y five pounds occasionally, sit for four hours per day, and stand for no longer than two hours per day, among other res trictions. The ALJ assigned “very little we ight” to Dr. Gregg’s opinions because they were inconsistent with the record and unsupported by objective findings. But the ALJ’s analysis did not stop th ere. Although the ALJ did not sp ecifically cite § 404.1527(c), he clearly had th e regulatory factors in mind wh en he weighed Dr. Gregg’s statements. Section 404.1527(c)(3) provides: “The more a medical source p resents relevant evidence to support a medical opinion, particularly me dical signs and laboratory findings, the more wei ght [the ALJ] will give that m edical opinion.” Further, “[t]he better an explan ation a source provides for a m edical opinion, the more weight we will give that medical opinion.” Id

. In this regard, the ALJ explaine d that there was no objective e vidence to support Dr. Gregg’s statements. For example, the ALJ noted tha t Dr. Gregg’s check-box forms were not suppor ted by objective findings and la cked detail. Further, the ALJ found that Dr. Gregg base d her “extreme assessed limita tions . . . on a thoracic sprain but she failed to cite any objective findings.” Aplt. App., Vol. 1 at 24. Moreover, the ALJ noted that Ms. Martinez had only “mil d restriction” in her activities of d aily living. Id . at 22.7 Section 404.1527(c)(4) provides: “Generally, the more consiste nt a medical opinion is with the record as a w hole, the more weight we will give to that medical opinion.” Relevant here, the ALJ noted that Dr. Gregg’s severe restrictions did not jibe with the medical evidence because, am ong other things, “im aging of the thoracic spine and cervical spine have been normal or unremarkable,” and Ms. Martinez’s “back symptoms have been stable , with no radiation of pain.” A plt. App., Vol. 1 at 24. We also disagr ee with Ms. Martinez that the ALJ did not adequately explain how the record—as a whole—was in consistent with Dr. Gregg’s pro posed restrictions. To the contrary, t he ALJ detailed the medical no tes and testing concerning Ms. Martinez’s wrist and back problems and specifica lly found that Dr. Gregg’s proposed restrictions “are not consistent with the record as [a] whole and are not supported by objective evidence.” Id . (emphasis added). Instead, the ALJ found that “[l]ongitudinally , the medical record supports a limitation to light work with occasional bending, s quatting and kneeling, and frequ ent handling/fingering.” Id

. We conclude that the ALJ’s re asons for affording Dr. Gregg’s o pinions “very little weight” are supported by substantial evidence.
2. Dr. Susman A State agency consulting physicia n, Dr. Morris Susman, complet ed a Residual Functional Capacity Asse ssment, which was based on his review of the medical record. Dr. Susman conc luded that Ms. Martinez could s tand or walk for six hours and sit for six hours in a normal eight-hour workday, cou ld perform postural8 activities at least occasionally , and did not have limitations of her fine manipulation skills. The ALJ gave Dr. Susma n’s opinion “some weight,” becau se it “is generally consistent with [the ALJ’s asse ssment of Ms. Mar tinez’s] residu al functional capacity.” Id . at 23. First, Ms. Martinez argues that the ALJ formulated Ms. Martinez ’s RFC and only then did he search the record for evidence to support it. See 20 C.F.R. § 404.1545(a)(3) (“We will asse ss your residual functional capa city based on all of the relevant medical and other evidence.”). We d isagree. The ALJ discussed several pieces of evidence, including Dr . Susman’s opinion, and formula ted Ms. Martinez’s RFC. While the wording is unart ful, we are convinced there was no error. Second, we agree with Ms. Martin ez that the ALJ failed to speci fically state the reasons for assigning more w eight to Dr. Susman’s opinion t han to Dr. Gregg’s opinions, or otherwise explain th e weight he gave Dr. Susman’s opinion. Nonetheless, we agree with the C ommissioner that this omission does not require us

to reverse. State agency medical consultant s are highly qualified experts i n Social Security evaluation. See § 404.1513a(b)(1). Moreove r, “an ALJ’s failure to weigh a medical opinion involves harmle ss error if there is no inconsis tency between the opinion and the ALJ’s assessment of residual functional capacit y.” Mays v. Colvin , 739 F.3d 569, 578-79 (10th Ci r. 2014) (emphasis added). See also Keyes-Zachary v.
Astrue , 695 F.3d 1156, 1163 (10th Cir . 2012) (same). Here, the ALJ’s RFC finding9 is consistent with Dr. Susman’s opinion, with the exception of a limitation favorable to Ms. Martinez that Dr. Susman did not propose in his opinion. C. Mental Impairments 1. Dr. Wesley Dr. Immaculate Wesley, a consulta tive psychologist, examined Ms . Martinez on one occasion. In her report, s he noted her observations and results from several tests, and concluded that Ms. M artinez’s “[s]ocial interaction is extremely impaired,” and her “abilities as related to basic work activities appear i mpaired and most likely precluded due to the severity of her depression.” Aplt. App., Vol. 2 at 480. The ALJ gave “no weight” to Dr. Wesley’s opinion, id . Vol. 1 at 24, however, because: (1) there was no eviden ce of psychiatric treatment ormedications; (2) the body of Dr. Wesley’s report did not support the level of impair ment she suggested; (3) Dr. Irwin Matus, a State ag ency consultant, discounted Dr. Wesley’s report because it was based on Ms. Mar tinez’s self-reports and inconsi stent with how she presented herself at the exami nation; and (4) Dr. Matus found o nly limited impairments. Regarding the inconsis tencies between Dr. W esley’s report and h ow Ms. Martinez presented herself, t he ALJ noted that even though Ms. Martinez “cried throughout the exami nation[,] . . . her spe ech was of normal ra te, rhythm and volume; thought processes were logical and coherent; thought content wa s free of delusions; and there were no disorders of perception exhibited.” Id . at 25. “Additionally, [Ms. Martinez] was well oriented to all spheres, could name bot h the current and past10 Presidents correctly, and was ab le to spell the word ‘world’ ba ckward correctly.” Id

. The ALJ also noted that Dr. Wesl ey assessed Ms. Martinez with “ [a] GAF score of 38,” 2 id . at 24, which Dr. Wesley said d emonstrated “major impairment i n all areas of functioning, including work, fam ily relations, judgment, thinki ng and mood,” id

. Vol. 2 at 479. But the ALJ found that Ms. Martinez “report[ed] no problems getting along with family, friends, neighb ors or others, and she gets a long ‘good’ with authority figures.” Id . Vol. 1 at 22. As the examining psychologist, Dr. Wesle y’s opinion is presumptively e ntitled to more weight than a non- examining medical source. See § 404.1527(c)(1). And although an examining opinion may be dismissed or discounted, t hat determination must be based on an evaluation of the factors in § 404.1527(c)( 2)-(6), and the ALJ “must provide specific, legitimate reasons for rejecting it.” Chapo , 682 F.3d at 1291 (internal quotation ma rks omitted). The ALJ did not specifical ly mention the factors in § 404.1527(c)(2)-(6), but he cl early had them in mind when h e found that Dr. Wesley’s extreme opinion wa s not well-supported, inconsiste nt with the record as a whole, lacked explanation, a nd contradicted by how Ms. Mar tinez presented herself. The parties agree that the ALJ could not ignore Dr. Wesley’s op inion simply because it was based on Ms . Martinez’s self-reports. See Robinson v. Barnhart ,

2 The Global Assessment of Func tioning, or GAF score, “is a subj ective determination based on a scale of 100 to 1 of the clinician’s j udgement of the individual’s overall lev el of functioning.” Langley v. Barnhart , 373 F.3d 1116, 1122 n.3 (10th Cir. 2004) (internal quotation marks omitted).11 366 F.3d 1078, 1083 ( 10th Cir. 2004) (per curiam) (“[A] psychol ogical opinion may rest either on observed signs a nd symptoms or on psychological tests.”). But as explained above, the ALJ gave seve ral other legitimate reasons to discount Dr. Wesley’s report. We conclude that the ALJ’s reas ons for affording Dr. Wesley’s o pinion “no weight” are supported by substantial evidence.
2. Dr. Matus Dr. Matus reviewed Dr. Wesley’s report and the medical record a nd opined that Ms. Martinez’s “[p]sychiat ric condition does not preclude all work tasks. [Claimant] can perform lower end , moderately complex work tasks .” Aplt. App., Vol. 1 at 79. Dr. Matus also di sagreed with Dr. Wesley that Ms . Martinez was extremely impaired as to social interaction. The ALJ gave “som e weight” to Dr. Matus’s opinion. Id . at 24. Although Dr. Matus not ed no limitations in social interaction, the ALJ limited Ms. Martinez “to unskilled work th at involves no dealing with the general public.” Id . at 25. Ms. Martinez argues, and we agree, that the ALJ erred by failin g to address any of the factors under § 404.15 27(c)(2)-(6) in deciding what weight to give Dr. Matus’s opinion. Nonetheless , we agree with t he Commission er that this error was harmless. As a State agency medical consultant, Dr. Matus is a highly qualified expert in Social Security evaluation. See § 404.1513a(b)(1). Moreover, the absence of a specific discussion is harmless if there is no inc onsistency between the opinion and the ALJ’s RFC assessment. See Mays , 739 F.3d at 578-79. See also12 Keyes-Zachary , 695 F.3d at 1163. Here, the ALJ ’s RFC finding is generally consistent with Dr. Matus’s opinion.
IV. CONCLUSION The judgment of the distr ict court is affirmed.

Entered for the Court

Monroe G. McKay Circuit Judge