NO T R EC OM M EN DE D F OR P UB LIC AT ION File Na me: 06a0896n.06 Filed: De cembe r 15, 2006 No. 05-6854 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT
Tam m y R . D e Boa r d, P laintif f-App ellant,
v. Com m ission er of Social Security, Defendan t-Appellee. ) ) ) ) ) ) ) ) ) ) ) ON APPEALFROM THE U NI TED STATES DI STRI CT COURT FOR THE EASTERN DI STRI CT OF KENTUCKY

BEF OR E: M e r r it t, Sut to n, a nd G r iffin, C ir c uit Judg e s. MERRITT, Circuit Judge. Plaintiff Tammy DeB oard appea ls the judgme nt of the district court a ffirmingthe denial of her a pplication for suppleme ntal secur ity income bene fits by

the Commi ssioner of Social Sec urity . For the following rea sons, w e aff irm the judgme nt of the district
c ourt
. I. DeB oard w as almost 37 y ear s old at t he ti me s he filed the application at issue here in. She has a hig h school educ ation but r equire d specia l e ducation classes. Her I Q of 68 place s her in the

“ mil dly m e n t a l l y r e t ar d e d ” r an g e . H e r p a s t r e l e v an t w o r k e xp e r i e n c e c o n s i s t s o f w o r k in telecommunications and as a maid and re staurant c ook. DeB oard f irst filed an a

pplication forNo. 05-6854

DeBoard v . Comm. of Soc. Sec

.

The Globa l Assessment Func tioning score rate s “over all psy cholog ical func tioning” on a 1 scale of 0 t o 100, with a score of 100 indicating “super ior functioning .” Ladwi g v. Comm’r of Soc

. Sec., No
. 00 -6 58 5, 20 02 WL 14 91 87 2, a t *4 n. 5 ( 6th Cir . July 11 , 2 00 2) (c iti ngAm e ri c an Ps y c hiatr ic Association Diag nostic and Statistical Manual of Me ntal Disorder s 34 (4th ed. 2000))
. -2- dis a bil ity be ne fi ts on Ap ri l 20, 199 9. Th e a pp lic a tio n wa s den ie d an d she did no t app e a l th a t de nia l. DeB oard f

iled her c urre nt application for supplemental secur ity income bene fits on March 18, 2002, alleg ing disa

bility beg inning on J une 15, 2001, due primar ily to knee pa in, stomach problems, liver damag e fr om Hepatitis C a nd depre ssion. The a

pplication was de nied initially , but on a motion for
rec onsideration the Administrative L aw Judge held two hearing s. The motion for re consideration
w a s d e n ie d

b e c a u s e th e A dmi n is tr a ti v e L aw Ju d g e f o u n d th a t D e B o ar d

r e ta in e d th e r e sidual functional ca p acity , with some restrictions, to perf orm a sig nificant ra

ng e of lig ht and sede ntary work. The Appea ls Council denied DeB oard’ s reque st for re view and a dopted the Administrative L aw Judge ’s decision to deny benef its as t he final decision of the C ommissi oner. DeB oard the n filed a complaint in fe dera l court see king r ever sal of the Commissioner’s de ci s i o n . Both pa rties filed Motions for Summary

J udg ment and the distric t co u rt g rante d summary judgme nt for the Commi ssioner and denied DeB oard’ s motion. DeB oard appea led to this Court, c ontending that the Commi ssioner’s finding that she was not “disabled” under the Social Security Act wa s not supported by substantial e vidence beca use the Administrative L aw Judge (1) de clined to consider additional
me dic a l e vid e nc e su

bmi tte d a ft e r t

he he ari ng s we re c on c lud e d; ( 2) fa ile d to g ive pr op e r w e ig ht t o
an ea rlier Globa l Assessment Func tioning scor e assig ned t o De Bo ard and (3) de nied DeB oard’ s 1 reque st to submi t additional evidence an d q u es tions to a consulting phy sician who e valuated De B oa rd . F or the fo llo wi ngre a so ns , w e a ff ir m th e de c isi on

of the dis tr ic t c ourt
.No. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-3- II. I n order to obtain Supplemental Security Income, De Boa

rd must establish t h at s he wa s

“ d i s a b l e d ” w i t h i nt h e t e r

m s o f t h e S o c i a l S e c u r i t y A c t
. T h e S o c i a l S e c u r i t y A c td e f i n e s “ d i s a b i l i t y” as the inability

to eng ag e in: [A] ny substantial ga inful activity by rea son of any medically

deter minable phy sical or mental impairment whic h can be expected to re sult in death o r which has lasted or ca n be expected to last for

a continuous per iod of not less than 12 months . . . . 42 U.S.C. §§ 423(d)(1)( A), 1382c (a) (3)( A). In evaluating whe ther a claimant is d i s abled, the Commi ssione r i s to consider, in a f ive-step se quence , whether the claimant: 1) w orked dur ing the
a lle g e d p e ri od

of dis a bil ity ; 2) ha s a se ve re imp a ir me nt; 3) ha s an im

pa ir me nt t hat me e ts o r e qu a ls the re quirements of an impairment listed in the re g ulations; 4) can r eturn to past re levant wor k; and 5) if not, whethe r he or

she ca n perf orm other work in the national economy . 20 C.F.R. § 416.920; Heston v. Comm’r of Soc. Sec

. , 245 F.3d 528, 534 ( 6th Cir. 2001). Applying the five-ste p sequenc e, the Administrative L aw J udg e found that (1) De Boa rd had not worked dur ing the alleg ed period of disability ; ( 2) she suffe red from “seve re” impairments under the re g ulations; (3) DeB oard’ s impairments, individually or collectively , did not meet or equal any of the lis te d im

pa ir me nts , in c lud ingthe “ a ff

e c tiv e dis or de rs ” sp e c if

ie d in 20 C.F .R. Pt. 40 4, Sub pt. P, App. 1, § 12.04, beca u s e De Bo ar d was not suffic iently functionally

limit ed; (4) she could not return to a ny of her past rele vant work a

nd (5) she reta ined the re sidual functional ca pacity , reduc ed by cer tain exertional and nonexertional limitations , to perfor m a sig nificant ra

n ge o f lig ht orNo. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-4- se de nta ry wo rk in the natio na l e c on omy , a s id e nti fi e d b y the vo c a tio na l e xpe rt . B a se d o n th e se finding s, the Administrative L aw Judge found that Deboa rd was not disabled, a de cision adopted by the Appea ls Council and the district court on summary judgme nt. I n revie wing the dec ision of the district court, we must deter mine whether

the Administrative L aw Judge ’s dec ision was supported by substantial evidence , which is g ener ally define d as such rele v an t e v id e n c e a s a

r e a s o n a b le mi n d mi g h t a c c e p t a s a d e qu a te to s u p p o rt t h e c o n c lusion. See Richardson v. Pe rales , 402 U.S. 389, 401 (1971). Eve n if the evide nce c ould also support another
c o n c l u s i o n , t h e d e c i s i o n o f t h e A dm i n i s t r a t i v e L a w Ju d g e m u s t s t an d i f t h e e v i de nc e c ou ld
rea sonably

support the conc lusion reac hed. See Key v . Callahan , 109 F.3d 270, 273 (6th Cir. 1997). We will now review the issues on appea l. A. Denial of DeBoard’s Request to Consider Additional Medical Evidence DeB oard c laims that the Administrative L aw Judge err ed in re fusing to consider medic al evidenc e submitted after the supplemental he aringon September 22, 2003. This e vidence consisted of (1) rec ords of De Boa

rd’s hospital visits fr o m Oc t o b er 25, 1997, until Februa ry 13, 2002; (2) a le tte r d a te d Se pte mbe r 2 6, 20 03 , f ro m th e B oyd Co un ty Sc ho ol Dis tr ic t sta tin g that De B oa rd ha s a le arn ingdis a

bil ity ; ( 3) re c or ds fr om P a thw ay s, I nc ., a me nta l he a lthfa c ili ty

that tr e a te d D e B oa

rd in 1995, 1997 and 2003; (4) various rec ords from DeB oard’ s hospital stay s in 1999, 2001 and 2002 and (5) a letter dated October 1, 2003, from DeB oard asking Dr. Stuart Cooke, a c onsulting phy sician, to reviewthis additional evidence
. The Administrative L aw Judge found that evidenc e predating the onset of disability on J une 15 , 2 00 1, is i rr e le va

nt a nd e vid e nc e pr e datin g the de nia l of De B oa rd ’s fi rs t a

pp lic a tio n f

or be ne fi tsNo. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-5- o nJ u l y 2 9 , 1 9 9 9 , i s b ar

r e d b y re s ju dic ata b e c a

u s e it w a s c o n s id e r e d

in th e e ar li e r

p r o c e e d in g . We do no t endorse the position t hat all evidenc e or me dical re cords pr edatingthe alleg ed date of the
on se t of dis abi li ty , or

e vid e nc e su

bmi tte d in

su pp or t of an e arl ie r p ro c e e din g , a re ne c e ssa

ri ly i r r e l e v an t o r a

u t o m a t i c a l l y b ar

r e d f r o m c o n s i d e r a t i o nb y res judicata. We rec og nize that evidence prese nted at an ea

rlier he aringor pre dating the onset of disability , when e valuated in combination with l ater ev idence

, may help establish disability . This is particularly true whe n the disabling condition is progr essive. See G roves v . Apfel , 148 F.3d 809, 810- 11 (7th Cir. 1998). Ho we ve r, in t

his c a se , a ny fa ilure by the Ad min ist rativ e L aw Jud g e to c on sid e r t he se re c or ds , even if err or, is harmless be cause the re cords a re la rg ely duplicative of doc uments or in fo rm at i on considere d in deciding DeB oard’ s second a pplication. For

example, a hospi tal rec ord fr om King’ s Daug hter Medic al Center that DeB oard w anted the A dminist rative L aw Judge to consider summarizes DeB oard’ s visits to that hospital, but adds nothing to the information the Administrative L aw Judge alre ady

had conc erningDeB oard’ s various ailm ents. Moreove r, t he re cords, a ll of which predate the hea

ring , wer e not provided until both hear ings had been completed and De Boa rd off ers no explanation for the tar diness of the s u b m i s s i o n . There fore , althoug h we c annot say that eac h
rec ord De Boa

rd soug ht to admit was duplicative of e videnc e in the re cord, the lateness of the submissi on combined with its simi larity to evidence alre ady in the rec ord lea ds us to conclude that the Administrative L aw J udg e did not err in r efusing to c onsider the evidenc e. More over, D eB oard has not shown how the Administrative L aw Judge ’s fa ilure to consider tardy and mostly duplicative evidenc e pre

judiced De Boa

rd.No. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-6- B. F ailure of the Ad mi n i s tr a ti v e Law Ju dge P roperly t o Weigh or Refer ence D eBoard’s P revious G lobal Assessme nt F unctioni ng Score I n 2003, DeB oard scored a 55 on a Global Assessment Functioning exam administ ere d by Dr
. Co ok e , th e c on su lti ngph y sic ian, ind ic a tin g mod e rate sy mpt oms and

mod e rate dif

fi c ult y in social, occupational or school functioning
. DeB oard a rg ues that the Administrative L aw Judge err ed in not giving t h e p ro per w eig ht to an ear lier Global Asse ssment Functioning score of 50 that De B oa rd re c e ive d w he n the te st wa s adm ini ste re d by Pa thw ay s, I nc ., a me dic a l he a lthc are fa c ili ty that trea t ed De Bo ard in the 1990s. A sc ore of 50 indicates “ [s] erious sy mptoms (e.g ., suicidal ide a tio n, s e v e r e o b s e s s i v e r i tu a l s , f r e qu e n ts h o p l i f

t i n g ) O R an y s e r i o u s i mp a i r

m e n ti ns o c i a l, occupational or school functioning (e.g ., no friends, una ble to keep a

job).” Pasco v. Comm’r of Soc. Sec. , No
. 0 3 -4 3 5 8 , 2 0 0 5 W L1 5 0 6 3 4 3 , at * 1 0 n . 1 5 (6 t h C i r. J u n e 23 , 2 0 0 5 ) ( qu o t i n g Diagnostic and Sta tis tic al M

an ua l of Me nta l D iso rd

e rs 30 (4th ed. 1994))
.

“ Th e [Glo ba l A sse ssm e nt F un c tio nin g ] score is a su bje c tiv e de te rm inatio n th a t r e pr e se nts ‘the c linician’s judg ment of the individual’s over all level of f unctioning.’ ” W

esley v. Comm’r of

Soc. Sec. , No
. 9 9 -1 2 2 6 , 2 0 0 0 W L1 9 1 6 6 4 , at * 3 (6 t h C i r . Fe b
. 1 1 , 2 0 0 0 ) ( qu o t i n g Diagnostic and Sta tis tic al Ma nu al of M

e nta l D iso rd

e rs 30 (4th ed. 1994)) . We have pr eviously held that the fa ilure to r e fe re nc e a

Gl ob a l A sse ssm e nt F un c tio ning sco re i s n ot, sta nd inga lon e , s uf

fi c ie nt g ro un d to
reve rse a disability deter mination. Howard v. Comm’r of Soc. Se c. , 276 F.3d 235, 241 (6t h C ir. 2002) (While a Global A s s essm ent Func tioning scor e may be of “ considera

ble help,” it is not

“ e sse nti a l” to d e te rm ini ngan in div idu a l’ s r e sid ua l f un c tio na l c a

pa c ity .) ; see also K

o r n eck y v.No. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-7- Comm’r of Soc. Se c. , No. 04-2171, 20 0 6 W L 3 0 5 6 48, at *13-*14 (6th Cir. F eb. 9, 2006) (“[A]ccordingto the [Diagnostic and Statist ical Manual’s] explanation of the [Global Assessment Func tioning] scale, a

score may

have little or no be aringon the subject’s soc ial and occ upational functioning . . . . [W ]e are not a war e of a ny statutory , regulatory , or other a uthority requiring the AL J to put stock in a [Global Assessment Functioning ] score in the first plac e.”) M o re o v er , t h e C o m m i s s i o n er “h as d ec l i n edt o en d o rs e t h e [ Gl o b al As s es s m en tFu n ct i o n i n g]
score for ‘ use in the Social Security and [S upplemental Security I ncome] disability prog rams,’ a nd ha s in dic a te d th a t [Gl ob a l A sse ssm e nt F un c tio nin g ] sc or e s have no ‘d ir e c t c or re latio n to the se ve ri ty
r e qu ir e me n ts o f th e me n ta l d is o r d e r s li s ti n g s . ’ ” W in d v. Ba rn ha rt , N o . 0 4
- 1 6 3 7 1 , 2 0 0 5 WL 1317040, at *6 n.5 (11th C ir. J une 2, 2005) ( quoting 65 F ed. Reg . 50746, 50764-65 (Aug . 21, 2000)). Acc ording ly , we have aff irmed denials of disability benef its whe re applicants had Global Assessment Func tioning score s of 50 or lower
. See, e .g., Smith v. Comm’r of Soc. Se c. , No. 02-1653, 2003 WL 22025046 (6th Cir. Aug . 27, 2003) (Global Assessment Func tioning score o f 48); Nierzwick v. Comm’r of Soc . Sec. , No. 00-1575, 2001 WL303522 (6th Cir. Mar. 19, 2001) ( Global Assessment Func tioning scor e of 35) ; Thurman v. Apfel , No. 99-3587, 2000 WL491673 (6th Cir. Apr. 20, 2000) ( Global Assessment F unctioning sc ore of 50). DeB oard’ s argument that the Global Assessment F unctioning sc ore of 50 she re ceive d when she was tested by Pathway s, I nc., should ha ve re ceive d more we ight f rom the Administrative L aw J udg e than the sc ore of

55 she re ceive d when teste d by Dr. Cooke, a consulting phy sician, is based on DeB oard’ s identifying Pathwa y s, I nc., as a

“tre ating source .” Ge nera lly , the medica l opinion of
a cl ai m an t ’s t re at i n g p h y s i ci an i s en t i t l edt o m o re we i gh tt h an t h at o f an o n -t re at i n g, o r c o n s u l t i n g,No. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-8- phy sician. W

ilson v. Comm’r of Soc. Sec

. , 378 F.3d 541, 544 (6th Cir. 2004). Whether the sourc e of a me dical opinion is a “tre ating source ” re quires a f act- specific inquiry
. There is a question as to whe the r P a thw ay s, I nc ., wo uld qu a lif y a s a “ tr e a tin g so ur c e ” in t

his c a se . Ge ne ra lly , w e loo k to how many

times the source treated claimant ove r a c erta in period o f time and how ma ny other
source s were treating c laimant during the same pe riod for the same c ondition. There is no set
numbe r o f t ime s a

pa tie nt m us t be se e n by a sin g le ph y sic ian or fa c ili ty fo r that doc tor or fa c ili ty to be considered a “tre ating source .” Her e, DeBoa rd receive d treatment by

Pathway s, I nc., four

times betwee n November

1995 and F ebrua

ry 2003, a per iod of over se ven y ear s, during which time she
rec eived e x tensive treatment at other fa cilities and by other phy sicians. We will assume that the Administrative L aw Judge viewed Path way s, I nc. as a treating
source for De Boa

rd’s de pression and othe r psy chiatric co n d i t i ons. There is no indication in the opinion th a t th e A dmi n is tr a ti v e L aw Ju d g e d id n o t g iv e w e ig h t to Pathw ay s ’ d ia g n o s e s . For example, he mentioned that the f indings by

Dr. C ooke we re “ consistent” with DeB oard’ s history of t reatment at P athway s. AL J Dec ision at 3. He a lso noted the limit ations in DeB oard’ s mental residual f unctional ca

pacity took into account her

treatment at Pathway s. Id. at 4-5. This and othe r ref ere nces to Pathwa

y s in the opinion de monstrate that the opinions a nd diag noses of Pathway s were taken into consider ation in rea ching the dec ision
. Any failure to refe renc e Global Asse ssment Func tioning score s or to c ompare differ ent score s attributed to the same subjec t, without more, does not require reve rsal. C. De nia l of D e Boa r d’ s R e que stto Subm itQue st ion s a nd A ddit ion al E vid e nc e to Dr . C oo ke De B oa rd a lso argue s th a t th e Ad

min ist rativ e L aw Jud g e e rr e d in deny in g h e r r e qu e st t oNo. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-9- submit questions and additional evide nce to Dr
. Cooke afte r the hea ring s. DeB oard’ s questions and additional medical e viden ce we re m o stly aimed at a

n eff ort to asce rtain Dr. Cooke ’s rationale for
a ssi g nin g De B oa

rd a hig he r G lob a l A sse ssm e nt F un c tio nin g sc or e tha n th a t a ssi g ne d b y

Pa thw ay s, I nc. Ge nera lly , an Administrative L aw Judge need r econta ct a medic al s ource only if the evide nce
rec eived f

rom that source is “inadequate” f or a disabili t y d et er mination. See 20 C.F.R. § 40 4. 15 12 (e ); Pe rse ll v . S

e c ’y of H e alt h &Hu ma n S

e rv s. , N o. 93 -1 75 9, 19 94 WL52 08 59 , at *4 (6 th Cir. Sept. 21, 1994). A disag ree ment betwee n two medical pr ofessional s d o es not rende r the opinion of one “inade quate” under the regulations. Dr. Cooke revie wed the rec ords from Pathwa y s and conduc ted his o w ne xam an d

ar r i v e d a ta s c o r e d i f f e r e n tf r o m t h a ta s s i g n e d

b y P a t h w ay s . D e B o ar d

s ub mit s nothing to de monstrate that the score assig ned by Dr. Cooke on the Global Assessment F unctioning exam was inadequate except that it did no t m at ch t h e score she re ceive d from Pathway s. The Ad min istrativ e L aw Jud g e state d th a t he re vie we d th e wh ole me dic a l r e c or d a nd he ma de sp e c if

ic ref ere nces in the opinion to the trea tment rec eived by

DeB oard at Pathway s. DeB oard ha s not s hown how re manding the ca se to include Dr . Cooke’s opinion on the differ ence betwee n the Global Assessment Func tioning score s would alter the Administrative L aw J udg e’s de cision. A single Global Assessment F unctioning sc ore is u n l i k ely to chang e the Administrative L aw Judge ’s dec ision when he provide d many other re asons for

f in d in g that DeB oard
wa s n ot d isa

ble d a nd DeBoar d di d not d e mon str a te any ba sis fo r b e lie vin g that D r. Coo ke wo uld chang e his position on the score he g ave to De Boa rd.No. 05-6854

DeBoard v . Comm. of Soc. Sec

.

-10- Fur thermore , as pointed out by the district court, the Social Sec urity Administration does not rely on Gl obal Assessment F unctioning sc ores f or “use in the Social Security and Supplemental Security I ncome disability

prog rams” a

nd has indicate d that the score s have “no di rec t corre lation to the sever ity require ment of the menta l disorders listings.” W ind v . B ar nh ar t , No. 04-16371, 2005 WL 1317040, at *6 n.5 (11th Cir. J une 2, 2005). Conclusion Substantial evidence supports the Administrative L aw Judge ’s findi ng that DeB oard was not disabled duringthe re levant per iod, and his ref usal to consider additional medical recor ds or to allow qu e sti on ingof Dr . Cook e a bo ut De B oa

rd ’s Gl ob a l Asse ssm e nt F un c tio nin g sc or e fr om P a thw ay s, I nc. do not constitute reve rsible er ror. Ba sed on the for eg oing, w e af firm the district cour

t’s judgme nt that substa ntial evidence
su pp or te d th e Com mis sio ne r’ s d e c isi on no t to awa

rd De B oa rd dis a bil ity be ne fi ts.