FILED

United States Court of Appeals

Tenth Circuit

February 7, 2012

Elisabeth A. Shumaker

Clerk of Court

UNITED STATES COURT OF APPEALS

FOR THE TENTH CIRCUIT

WILLIAM O. MAYBERRY,

Plaintiff-Appellant,

v.

MICHAEL J. ASTRUE, Commissioner

of Social Security Administration,

Defendant-Appellee.

No. 11-5058

(D.C. No. 4:09-CV-00533-TLW)

(N.D. Okla.)

ORDER AND JUDGMENT*

Before TYMKOVICH, Circuit Judge, BRORBY, Senior Circuit Judge, and

EBEL, Circuit Judge.

William O. Mayberry appeals from the order entered by the district court

affirming the Social Security Commissioner’s decision denying his applications

for disability insurance benefits and supplement security income benefits under

the Social Security Act. Exercising jurisdiction under 42 U.S.C. § 405(g) and

28 U.S.C. § 1291, we affirm.

* 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. 
I.

Plaintiff applied for social security benefits based on various physical and

mental infirmities. His applications were denied initially and on reconsideration,

and a de novo hearing was held before an administrative law judge (ALJ). 

The ALJ also denied plaintiff’s applications at step five of the five-step

sequential evaluation process for determining disability. See Fischer-Ross v.

Barnhart, 431 F.3d 729, 731 (10th Cir. 2005) (describing five steps). 

Specifically, the ALJ found that: (1) plaintiff has not engaged in substantial

gainful activity since February 21, 2002; (2) plaintiff suffers from the severe

medical impairments of obesity, diabetes mellitus, depression, and a pain

disorder; (3) plaintiff’s impairments do not meet or equal any listed impairment

under the controlling regulations; (4) plaintiff has the residual functional capacity

to perform sedentary work, but he cannot perform more than “simple, repetitive

tasks,” Aplt. App., Vol. 2 at 18; (5) plaintiff is not able to perform his past

relevant work as a groundskeeper since he performed that work at the medium

level of exertion; but (6) considering plaintiff’s age, education, work experience,

and residual functional capacity, there are other jobs that exist in significant

numbers in the national economy that plaintiff can perform such as bench

assembler, machine operator, and order clerk. 

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The Appeals Council denied plaintiff’s request for review of the ALJ’s

decision. He then filed a complaint in the district court. A magistrate judge

affirmed, and this appeal followed.

Because the Appeals Council denied review, the ALJ’s decision is the

Commissioner’s final decision for purposes of this appeal. See Doyal v.

Barnhart, 331 F.3d 758, 759 (10th Cir. 2003). In reviewing the ALJ’s decision,

“we neither reweigh the evidence nor substitute our judgment for that of the

agency.” Casias v. Sec’y of Health & Human Servs., 933 F.2d 799, 800 

(10th Cir. 1991). Instead, we review the ALJ’s decision only “to determine

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

and whether the correct legal standards were applied.” Doyal, 331 F.3d at 760. 

Substantial evidence is “more than a scintilla, but less than a preponderance.” 

Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007). It “is such relevant

evidence as a reasonable mind might accept as adequate to support a conclusion.” 

Id. (internal quotation marks omitted). A decision is not based on substantial

evidence “if it is overwhelmed by other evidence in the record.” Wall v. Astrue,

561 F.3d 1048, 1052 (10th Cir. 2009) (internal quotation marks omitted).

II.

Plaintiff claims that: (1) the ALJ failed to perform a proper evaluation of

the opinions of his treating physician, Dr. LaFromboise; (2) the ALJ’s finding

that plaintiff’s statements about his impairments were not entirely credible is not

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supported by substantial evidence; and (3) the ALJ’s determination of plaintiff’s

residual functional capacity is flawed because it did not include all of his relevant

impairments. 

Before addressing these issues, we note that plaintiff’s medical history is

summarized in detail in the ALJ’s decision and the parties’ briefs on appeal, and

we will not repeat that history here. In addition, because we are convinced that

the ALJ’s denial of social security benefits is supported by substantial evidence in

the administrative record and free of any legal error, we do not deem it necessary

to separately address each of the multiple sub-arguments that plaintiff has

advanced in support of his three general propositions of error. Instead, we will

limit our analysis to the points discussed below. 

A. Treating Physician 

Plaintiff first contends the ALJ erred by giving only “limited weight” to 

Dr. LaFromboise’s opinions. See Aplt. App., Vol. 2 at 24. Over two years after

plaintiff filed his social security applications, Dr. LaFromboise treated him for

depression, back pain, hypertension, and other ailments. Id. at 193-200. 

Dr. LaFromboise’s opinions are set forth in a letter dated March 27, 2008, in

which she stated the following:

Since 01/17/08, William Mayberry has received outpatient

services at Associated Centers for Therapy (ACT).

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As the primary provider, it is my professional opinion that

William is unable to perform the duties required of a job due to a

combination of mental and physical health issues. . . . 

William is easily confused and has poor ability to concentrate

on conversation of any depth. His current state is of permanent

disability.

Id. at 202. 

Under the controlling regulations, the final responsibility for deciding the

ultimate issue of whether a social security claimant is “disabled” or “unable to

work” is reserved to the Commissioner. 20 C.F.R. §§ 404.1527(e)(1) and

416.927(e)(1) (internal quotation marks omitted). Consequently, an ALJ is not

bound by a treating physician’s opinion on the ultimate issue of disability, id.,

and such an opinion is never entitled to controlling weight or special significance,

see Soc. Sec. Ruling (SSR) 96-5p, 1996 WL 374183, at *1, *2, *5 (July 2, 1996).

However, opinions from any medical source on issues reserved

to the Commissioner must never be ignored. The adjudicator is

required to evaluate all evidence in the case record that may have a

bearing on the determination or decision of disability, including

opinions from medical sources about issues reserved to the

Commissioner. If the case record contains an opinion from a medical

source on an issue reserved to the Commissioner, the adjudicator

must evaluate all the evidence in the case record to determine the

extent to which the opinion is supported by the record.

Id. at *3; see also id. at *1 (stating that a social security decision “must explain

the consideration given to a treating source’s opinion(s)” on an issue reserved to

the Commissioner).

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Given this framework, Dr. LaFromboise’s opinions that plaintiff is “unable

to perform the duties required of a job” and is “permanent[ly] disabled” are “not

medical opinions, . . . but are, instead, opinions on issues reserved to the

Commissioner.” 20 C.F.R. §§ 404.1527(e) and 417.927(e). While a physician’s

opinions on issues reserved to the Commissioner are not entitled to controlling

weight or any special significance, the ALJ was still required to provide an

evaluation of the opinions and explain his reasons for either rejecting or accepting

them. 

We conclude that the ALJ sufficiently explained his decision to give “little

weight” to Dr. LaFromboise’s opinions. First, the ALJ correctly noted that “it is

not clear that the doctor was familiar with the definition of ‘disability’ contained

in the Social Security Act and regulations.” Aplt. App., Vol. 2 at 24. Second, the

ALJ stated that “[t]he course of treatment pursued by the doctor has not been

consistent with what one would expect if the claimant were truly disabled, as the

doctor has reported.”1

 Id. Although the latter statement borders on improper

1 We note that the ALJ also gave two additional reasons for discounting 

Dr. LaFromboise’s opinions. First, the ALJ stated that Dr. LaFromboise

“apparently relied quite heavily on the subjective reports of symptoms and

limitations provided by the claimant, and seemed to uncritically accept as true

most, if not all, of what the claimant reported.” Aplt. App., Vol. 2 at 24. Second,

the ALJ pointed out that, “[w]hile [Dr. LaFromboise] does have a treating

relationship with the claimant, the treatment history is quite brief, when

considering the claimant’s alleged onset date of February 2, 2002.” Id. These are

insufficient reasons for discounting Dr. LaFromboise’s opinions. The first reason

(continued...)

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boilerplate language, we believe it is better construed as properly relying on

inconsistencies between Dr. LaFromboise’s opinions and her treatment records.

In his decision, the ALJ accurately summarized the treatment that 

Dr. LaFromboise provided to plaintiff as follows:

Treatment records from Associated Centers for Therapy cover

the period from January 17, 2008 through June 26, 2008. Initial

evaluation showed an assessment of rule out post traumatic stress

disorder, which could be a mood disorder secondary to multiple

health problems, rule out diabetes, possible sleep apnea,

hypertension, lower back pain and rectal bleeding. The claimant was

prescribed Rozerem, Provigil, Flexeril and Lisinopril, as well as

laboratory blood tests. The claimant was followed by Dawn

LaFromboise, M.D. for his mental health needs. The claimant

reported that he was still having problems with the medications not

getting him to sleep and the depression medication made him jittery

during the day. The claimant reported the Flexeril worked to help

relieve back pain but tended to make him a little sleepy during the

day. The claimant continued to complain of depression despite

taking the Provigil. [Dr. LaFromboise therefore discontinued the

Provigil and instead prescribed Amitriptyline, an anti-depressant.] 

The claimant’s affect was irritable and mood was described as

“depressed.” Insight was fair and behavior was appropriate. The

diagnostic assessment was mood disorder secondary to multiple

health problems, rule out post traumatic stress disorder, and major

depressive disorder. On April 30, 2008 the claimant reported for his

monthly appointment and reported his blood pressure medication

working and the Amitriptyline helped him to sleep. He also reported

the depression was getting better. The claimant’s mood was

congruent and affect was stressed due to family problems on May 29,

2008. The assessment was major depressive disorder, recurrent and

1

(...continued)

is conclusory and relies on improper boilerplate language, while the second

reason ignores the fact that Dr. LaFromboise saw plaintiff seven times over the

course of a six-month period and prepared detailed treatment records concerning

each visit. 

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possible post traumatic stress disorder. He was to continue taking

the medications of Flexeril 10mg, Lisinopril 20 mg, and

Amitriptyline raised to 100mg. He was scheduled to return in one

month. On June 26, 200[8] the claimant’s behavior was more

sociable and made good eye contact. Dr. LaFromboise reported the

claimant seemed grateful that he was coming to therapy and he

realized his depression was clearing up. The affect was euthymic

and mood was better. 

Id. at 21-22.

With the exception of his consultative examinations in 2005 and 2007, two

mental and two physical, the record indicates that plaintiff received no medical

treatment for any physical or mental impairment between his alleged onset date in

February 2002 and this six-month period in 2008. Further, Dr. LaFromboise’s

treatment records do not document any particular functional limitations associated

with plaintiff’s mental and physical ailments; nor do they contain a single medical

opinion regarding plaintiff’s ability to mentally or physically perform the normal

tasks associated with working. Instead, Dr. LaFromboise’s treatment of

plaintiff’s mental and physical ailments was primarily limited to prescribing

medications. Id. at 193-200. Moreover, Dr. LaFromboise’s records show that, as

a result of her short-term treatment, plaintiff’s depression was “clearing up” and

“getting closer to euthymic”2

 as of June 2008. Id. at 193.

2 “Euthymic” is defined as “[r]elating to, or characterized by, euthymia,” and

“euthymia” means “[m]oderation of mood, not manic or depressed.” Stedman’s

Medical Dictionary 627 (27th ed. 2000).

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In sum, all we have from Dr. LaFromboise is a general conclusion that

plaintiff is “permanently disabled,” without any supporting residual functional

capacity assessments3

 or other specific findings regarding actual functional

limitations.4

 This conclusion provides little guidance because of its uncertain

medical meaning, and extends into an assessment of interrelated medical,

educational, and vocational factors beyond the expertise of most physicians. 

Given these shortcomings, the ALJ did not err in assigning only “limited weight”

to Dr. LaFromboise’s opinions. 

B. Adverse Credibility Determination

The ALJ found that plaintiff was not credible to the extent that his

statements concerning his symptoms were inconsistent with the residual

functional capacity determined by the ALJ. See Aplt. App., Vol. 2 at 20. 

“Credibility determinations are peculiarly the province of the finder of fact, and

we will not upset such determinations when supported by substantial evidence.” 

3 At the hearing before the ALJ, plaintiff’s counsel told the ALJ that he was

“anticipating” that Dr. LaFromboise would provide a mental residual functional

capacity assessment form for plaintiff. See Aplt. App., Vol. 2 at 230-31. As a

result, the ALJ left the administrative record open for ten days following the

hearing “to receive that record.” Id. at 231. However, there is no such record in

the administrative record that is before this court.

4 As noted above, Dr. LaFromboise did state that plaintiff is “easily confused

and has poor ability to concentrate on conversation of any depth.” Aplt. App.,

Vol. 2 at 202. The ALJ took into account the former limitation by limiting

plaintiff’s residual functional capacity to “simple, repetitive tasks,” id. at 18,

while the latter limitation finds no support in Dr. Lafromboise’s treatment records

as the doctor never mentioned any difficulties in maintaining a conversation.

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Kepler v. Chater, 68 F.3d 387, 391 (10th Cir. 1995) (internal quotation marks

omitted). But “[f]indings as to credibility should be closely and affirmatively

linked to substantial evidence and not just a conclusion in the guise of findings.” 

Id. (internal quotation marks omitted). 

The ALJ’s main findings in support of his adverse credibility determination

were as follows:

The claimant has described daily activities which are not limited to

the extent one would expect, given the complaints of disabling

symptoms and limitations. At one point or another in the record,

either in forms completed in connection with the application and

appeal, medical records or reports, or in the claimant’s testimony, the

claimant has reported the following activities of caring for his own

personal needs, fixing meals for himself, performing the household

chores for himself, mowing the lawn and visiting with close friends. 

As far as medical care, the claimant has not generally received

the type of medical treatment one would expect for a totally disabled

individual, and the treatment the claimant has received for the

allegedly disabling impairments has been essentially routine and

conservative in nature. With regard to medication side effects,

although the claimant has alleged various side effects from the use of

the medications, the medical records, such as office treatment notes,

do not corroborate those allegations. . . . The record fails to

demonstrate the presence of any pathological clinical signs,

significant medical findings, or any neurological abnormalities which

would establish the existence of a pattern of pain of such severity as

to prevent the claimant from engaging in any work on a sustained

basis. 

Aplt. App., Vol. 2 at 23. 

Because the medical evidence in this case is so sparse, we do not need to

delve into plaintiff’s allegations regarding his activities of daily living or his

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medication side effects to affirm the ALJ’s adverse credibility determination. 

Simply put, there are only two limited periods of time since plaintiff’s onset date

in February 2002 when he has received medical treatment: (1) the treatment he

received from Dr. LaFromboise from January 2008 until June 2008, see

Aplt. App., Vol. 2 at 193-200; and (2) the treatment he received from “OU

Physicians -Tulsa Family Medicine” from September 2008 until January 2009, 

id. at 211-27. None of these medical records document any specific physical or

mental functional limitations that would preclude the sedentary residual

functional capacity, limited to simple, repetitive tasks, found by the ALJ. Rather,

as the ALJ found, plaintiff’s medical treatment “has been essentially routine and

conservative.”5

 Aplt. App., Vol. 2 at 23. Thus, we conclude that substantial

evidence supports the ALJ’s adverse credibility determination. 

5 According to plaintiff, the lack of medical evidence in this case is

attributable to the fact that “he couldn’t afford to go to the doctor.” Aplt.

Opening Br. at 33; see also id. (“The ALJ ignores that affordability may explain

Claimant’s failure to seek a physician’s advice and receive less conservative

treatment.”). This argument is without merit. Plaintiff succeeded in obtaining

extensive medical treatment from Dr. LaFromboise and the OU physicians, and he

has provided no evidence that he “sought to obtain [additional] low-cost medical

treatment” or that he has “been denied medical care because of [his] financial

condition,” Murphy v. Sullivan, 953 F.2d 383, 386-87 (8th Cir. 1992); cf. Threet

v. Barnhart, 353 F.3d 1185, 1191 n.7 (10th Cir. 2003) (indicating “that inability

to pay may provide a justification for [the] claimant’s failure to seek treatment”

when there is evidence that the claimant sought and was refused treatment).

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C. Residual Functional Capacity Determination 

Finally, plaintiff claims the ALJ erred by not including certain additional

impairments in his residual functional capacity determination. See Aplt. Opening

Br. at 20-22 (discussing diminished and painful range of motion of spine, weak

heel/toe walking, weak grip strength, hypertension, history of rectal bleeding, dry

mouth from medications, and headaches). We agree with the Commissioner,

however, that plaintiff “has failed to show that any of the [additional]

impairments impact his ability to perform sedentary work. . . . Nor has [plaintiff]

pointed to medical evidence which would support his allegations of work-related

limitations.” Aplee. Br. at 29-30. Accordingly, we see no error in the ALJ’s

residual functional capacity determination. 

The judgment of the district court is AFFIRMED.

Entered for the Court

Timothy M. Tymkovich

Circuit Judge

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