UNITED STATES COURT OF APPEALS 

FOR THE TENTH CIRCUIT 

 

TERESA A. RUSSELL, 

 Plaintiff-Appellant, 

v. 

MICHAEL J. ASTRUE, Commissioner 

of the Social Security Administration, 

 Defendant-Appellee. 

No. 11-6320 

(D.C. No. 5:10-CV-00848-R) 

(W.D. Okla.)

 

ORDER AND JUDGMENT*

 

Before TYMKOVICH, HOLLOWAY, and MATHESON, Circuit Judges. 

 

 Teresa A. Russell appeals from the district court’s order upholding the denial 

of her application for Social Security Disability Insurance benefits. We have 

jurisdiction under 42 U.S.C. § 405(g) and 28 U.S.C. § 1291, and we affirm. 

 An administrative law judge (ALJ) found that Ms. Russell suffers from 

autoimmune deficiency disorder, chronic fatigue syndrome, rheumatoid arthritis, and 

 

*

 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. 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 

December 28, 2012

Elisabeth A. Shumaker 

Clerk of Court
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Sjogren’s syndrome. But based on the medical evidence in the record, and testimony 

from Ms. Russell and a vocational expert, the ALJ concluded that Ms. Russell had 

the residual functional capacity to perform light work and, thus, was able to return to 

her past work as claims processor. See Wilson v. Astrue, 602 F.3d 1136, 1139 

(10th Cir. 2010) (describing five-step-evaluation process). The Appeals Council 

denied review, and the district court affirmed. 

On appeal, Ms. Russell argues that the ALJ failed to properly weigh the 

evidence from her treating physician, Dr. Leslie. He opined in 2008 that Ms. Russell 

had “features of mixed connective tissue disease” that met the criteria to be 

considered presumptively disabled under Listing § 14.06, which addresses 

undifferentiated connective tissue disease. See 20 C.F.R. Pt. 404, Subpt. P, App. 1, 

14.00(D)(5)(a) (Listing § 14.06) (“This listing includes syndromes with clinical and 

immunologic features of several autoimmune disorders, but that do not satisfy the 

criteria for any of the [autoimmune] disorders described [in the preceding listings].”). 

Ms. Russell also argues that the ALJ was obligated to ask Dr. Leslie to provide 

additional information about her condition before according his opinion less than 

controlling weight. 

 A treating physician’s opinion that a claimant is disabled is not dispositive 

because that is the ultimate issue for the ALJ to decide. See Castellano v. Sec’y of 

Health & Human Servs., 26 F.3d 1027, 1029 (10th Cir. 1994). Further, an ALJ is not 

required to give controlling weight to the opinion of a claimant’s treating physician if 
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it is “not well-supported by medically acceptable clinical and laboratory diagnostic 

techniques or if it is inconsistent with the other substantial evidence in the case 

record.” Watkins v. Barnhart, 350 F.3d 1297, 1300 (10th Cir. 2003) (internal 

quotation marks omitted). 

That is what the ALJ concluded here. The ALJ explained that he considered 

Dr. Leslie’s opinion probative, but not controlling, because it was not substantiated 

by clinical findings and was inconsistent with other evidence in the record. The ALJ 

gave specific reasons for this conclusion, as he is required to do. See id. at 1301. 

The ALJ noted that Dr. Leslie’s report, which was written more than two years after 

the date Ms. Russell was last insured for disability, provided only minimal 

examination findings and did not reference medical signs, symptoms, or findings for 

the time period in when Ms. Russell was insured. The ALJ noted that during the time 

Dr. Leslie treated Ms. Russell prior to the date she was last insured, his treatment 

notes state that the medication he prescribed for her symptoms was effective. 

The ALJ found that Dr. Leslie’s opinion was inconsistent with other medical 

evidence, and gave as an example the detailed physical examination of Ms. Russell 

by a consulting physician, who stated Ms. Russell had a full range of motion, full 

motor strength in her arms and legs, normal hand grip strength and good use of her 

hands, and a normal, unassisted, stable gait. The ALJ also noted other medical 

evidence that reflected a negative rheumatoid arthritis factor and normal x-rays. 
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The record supports the ALJ’s observations and conclusions with respect to his 

consideration of the factors used to determine the weight of a medical opinion. 

Dr. Leslie’s treatment notes are, as the ALJ found, minimal, his opinion lacked 

objective or laboratory support, and he did not document the symptoms and 

conditions identified by the Commissioner as necessary for a determination of 

disability. See Listing § 14.06 and SSR 99–2p, 1999 WL 271569, at *2 (evaluation 

of cases involving chronic fatigue syndrome). The record also supports the ALJ’s 

conclusion that Dr. Leslie’s report was inconsistent with the other substantial medical 

evidence. 

Ms. Russell argues that Dr. Leslie’s opinion is not supported by clinical 

findings because impairments such as chronic fatigue syndrome do not rely upon 

objective measurements, and that “there is no dipstick laboratory test” for chronic 

fatigue syndrome. Aplt. Opening Br. at 16. To the contrary, under the 

Commissioner’s regulations, an ALJ may only determine that chronic fatigue is a 

disabling condition “when it is accompanied by medical signs or laboratory 

findings.” SSR 99–2p, 1999 WL 271569, at *2. 

We conclude that the ALJ’s decision not to give controlling weight to 

Dr. Leslie’s opinion was adequately explained, is supported by substantial evidence, 

and is free from legal error.1

 See Wilson, 602 F.3d at 1140 (noting that we review the 

 

1

 Ms. Russell concedes that the consultative examination did not support, and 

was not “consistent” with, Dr. Leslie’s opinion, but she argues for the first time on 

(continued) 
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Commissioner’s decision to determine whether the ALJ’s “factual findings are 

supported by substantial evidence in the record and whether the correct legal 

standards were applied”). 

We also reject Ms. Russell’s contention that the ALJ was obligated to 

re-contact Dr. Leslie to get additional information about his 2008 report. See

20 C.F.R. § 404.1512(e)(1) (2008)2

 (requiring ALJ to re-contact a medical source 

“when the report from [a claimant’s] medical source contains a conflict or ambiguity 

that must be resolved, the report does not contain all the necessary information, or 

does not appear to be based on medically acceptable clinical and laboratory 

diagnostic techniques.”). She asserts the ALJ should have re-contacted him before 

inferring that Ms. Russell’s impairments would likely have worsened from 2005 

(when she was last insured) to 2008 (when Dr. Leslie opined on the severity of her 

impairments), and before giving Dr. Leslie’s opinion less weight because it was 

unsupported by clinical evidence. But “it is not the rejection of the treating 

physician’s opinion that triggers the duty to re-contact the physician; rather it is the 

inadequacy of the evidence the ALJ receives from the claimant’s treating physician 

that triggers the duty.” White v. Barnhart, 287 F.3d 903, 908 (10th Cir. 2001) 

 

appeal that it was not “inconsistent” with Dr. Leslie’s opinion. We do not address 

this argument because it was not presented to the district court. See Crow v. Shalala, 

40 F.3d 323, 324 (10th Cir. 1994). 

2

 This provision was amended and recodified, effective February 2012, at 

20 C.F.R. § 404.1520b(c)(1) and (2) 
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(brackets and internal quotation marks omitted). Here, the ALJ did not find 

Dr. Leslie’s evidence incomplete or in need of clarification; he simply found it 

unsupported and inconsistent with the medical evidence viewed in its entirety. Thus, 

the ALJ was not obligated to re-contact Dr. Leslie. See id. 

The judgment of the district court is affirmed. Ms. Russell’s motion to 

proceed in forma pauperis is granted. 

 Entered for the Court 

 William J. Holloway, Jr. 

 Circuit Judge