Opinion ID: 3161540
Heading Depth: 3
Heading Rank: 2

Heading: GAF Scores

Text: We turn next to Ms. Kearns’s argument that the ALJ did not discuss or weigh certain low GAF scores in his RFC assessment, and that these scores are at odds with the final determination on Ms. Kearns’s ability to work:  a score of 50 during outpatient treatment at Mental Health Services of Southern Oklahoma on April 6, 2011, Aplt. App., Vol. III at 507;  a score of 25 upon admission to Carl Albert Mental Health Center on April 12, 2012, and a past score of 45 noted on the admission form, id. at 554; and  a score of 30 upon admission to Griffin Memorial Hospital on June 5, 2012, id. at 568. Ms. Kearns does not mention two other GAF scores she received: (1) a score of 75-80 during a consultative examination by psychiatrist Adonis Al-Botros, M.D., on January 31, 2011, see id., Vol. II at 376, which is recounted in the ALJ’s analysis, see id., Vol. I at 41; and (2) a score of 52 upon release from Griffin Memorial Hospital on July 24, 2012 (up from 30 at intake), see id., Vol. III at 571. Our analysis necessarily begins with a brief explanation of GAF scores and what they signify. “The GAF is a 100-point scale divided into ten numerical ranges, which permits clinicians to assign a single ranged score to a person’s psychological, social, and occupational functioning.” Keyes-Zachary v. Astrue, 695 F.3d 1156, 1162 n.1 (10th Cir. 2012). Its purpose is to allow clinicians to plan treatment, measure its 6 impact, and predict the outcome. Am. Psychiatric Ass’n, Diagnostic & Statistical Manual of Mental Disorders 32 (4th ed. Text Revision 2000).2 It is true that the ALJ did not expressly recite or reconcile Ms. Kearns’s lower GAF scores, but that omission does not constitute error or take away from the substantial evidence supporting the ALJ’s decision. While “[t]he record must demonstrate that the ALJ considered all of the evidence, . . . an ALJ is not required to discuss every piece of evidence.” Mays v. Colvin, 739 F.3d 569, 576 (10th Cir. 2014) (internal quotation marks omitted). An ALJ’s failure to conduct a comparative analysis and weigh conflicting GAF evidence does not mandate reversal. Keyes-Zachary, 695 F.3d at 1164. “While a GAF score may be of considerable help to the ALJ in formulating the RFC, it is not essential to the RFC’s accuracy.” Howard v. Comm’r of Soc. Sec., 276 F.3d 235, 241 (6th Cir. 2002). In any event, it is obvious the ALJ considered the medical records that contained the GAF scores. At step four, he provided details on Ms. Kearns’s outpatient treatment at Mental Health Services of Southern Oklahoma in 2011, as well as her inpatient care at Carl Albert and at Griffin Memorial Hospital in 2012— details that paraphrased those treatment records. See Aplt. App., Vol. I at 41–42. The GAF scores were only one component of those records, and the ALJ’s discussion 2 In the most recent edition of the manual, the American Psychiatric Association dropped the GAF scale “for several reasons, including its conceptual lack of clarity (i.e., including symptoms, suicide risk, and disabilities in its descriptors) and questionable psychometrics in routine practice.” Am. Psychiatric Ass’n, Diagnostic & Statistical Manual of Mental Disorders 16 (5th ed. 2013). 7 of the records accurately described the overarching evidence of Ms. Kearns’s improved mental state when she was compliant with her prescribed medications, her stable condition upon release from treatment, and the “positive future projection” for her mental health, id. at 42. Substantial evidence supports the ALJ’s decision, and his failure to specifically discuss all of the GAF scores was not fatal.