Opinion ID: 1304411
Heading Depth: 1
Heading Rank: 3

Heading: Consideration of Depression

Text: First, Denton argues that the ALJ erred by not considering the symptoms of her depression, and the related factors of her fatigue, sleep difficulties, when formulating her residual functional capacity. When determining a claimant's RFC, the ALJ must consider the combination of all limitations on the ability to work, including those that do not individually rise to the level of a severe impairment. 20 C.F.R. § 404.1523; Terry v. Astrue, 580 F.3d 471, 477 (7th Cir.2009); Villano v. Astrue, 556 F.3d 558, 563 (7th Cir.2009). A failure to fully consider the impact of non-severe impairments requires reversal. Golembiewski v. Barnhart, 322 F.3d 912, 918 (7th Cir.2003). The ALJ did fully consider the impact of her depression and the related symptoms, both in discussing whether her depression was a severe impairment (a point Denton no longer presses) and also in the context of their affect on her fibromyalgia. Specifically, the ALJ noted that Denton did not seek out treatment for depression during the period of purported disability. Further, she never mentioned lack of interest in activities, social isolation, or mood swings to her treating doctors. (Her brief cites only reports of these symptoms on disability applications and not in medical reports.) Denton bears the burden of producing medical records showing her impairment, and if she never sought medical treatment for a condition, then she cannot meet that burden. 20 C.F.R. § 404.1512(c); Scheck v. Barnhart, 357 F.3d 697, 702 (7th Cir.2004). And the other symptoms that Denton did mention to her treating doctorsher trouble sleeping and fatiguewere also addressed by the ALJ in formulating the RFC. Although Denton contended that her fatigue prevented her from working full time during the period of disability, the ALJ concluded that Craddock's evaluation did not support this finding because her evaluation suggested only a limitation on overtime work because of fatigue. Denton next claims that the ALJ gave insufficient weight to Craddock's January 2006 evaluation. She argues that this evaluation shows that her depression left her disabled, unable to perform sedentary work, and likely to miss three days of work monthly. Denton concludes that this opinion should have received controlling weight because Craddock was her treating physician. Denton is incorrect. First, the opinion of a treating physician is entitled to controlling weight only if supported by objective medical evidence. 20 C.F.R. § 404.1527(d)(2). And the ALJ is not required to give controlling weight to the ultimate conclusion of disabilitya finding specifically reserved for the Commissioner. Id. § 404.1527(e)(1); Dixon v. Massanari, 270 F.3d 1171, 1177 (7th Cir.2001). Here, the conclusions about no sedentary work and missing days of work were not based on objective evidence and contradicted two of Craddock's earlier evaluations that were: More than a year earlier, in mid-2004, Craddock reported that Denton could perform non-repetitive office work, and a year later, in September 2005, she concluded that Denton could not work overtime (implying that mere fulltime work was possible). Even though a claimant's condition may worsen, a medical expert is obligated to point to objective medical evidence to explain the worsening prognosis. See Skarbek v. Barnhart, 390 F.3d 500, 504 (7th Cir.2004) (concluding that the ALJ was entitled to discount an opinion when the physician did not identify medical evidence that would support the greater limitation). In this case, Craddock did not do that. She wrote the January 2006 report in the middle of a six-month stretch during which Craddock did not examine Denton, and Craddock cites to no objective medical evidence for her conclusions that Denton could not perform sedentary work or would miss three days of work per month. See, e.g., Haynes v. Barnhart, 416 F.3d 621, 630 (7th Cir.2005) (disregarding contention that claimant would require three days off per month when there was no elaboration or explanation for that conclusion); Dixon v. Massanari, 270 F.3d 1171, 1177 (7th Cir.2001) (disregarding contention that claimant would miss 20 days of work each year without explanation). Beyond this, Denton also ignores that not long after the January 2006 report, Craddock stated again that Denton has indeed been able to work. Craddock commented in August 2006 that, upon examining Denton on multiple earlier occasions, she believed that Denton could return to work. Craddock saw Denton only once after her period of purported disability, so Craddock's comment that she found Denton able to work on multiple occasions includes the period of her claimed disability and is inconsistent with Craddock's clinically unsubstantiated assessment in January 2006 that Denton could not perform sedentary work. Accordingly the ALJ did not err in discounting Craddock's evaluation in January 2006 about no sedentary work and possible missed days of work. See 20 C.F.R. § 404.1527(d)(2); Ketelboeter v. Astrue, 550 F.3d 620, 625 (7th Cir. 2008) (noting that the ALJ may discount treating physician's opinions that are internally inconsistent). [2] The ALJ's view of how depression affected Denton's RFC was also consistent with the opinion of the state agency psychologist, Dr. Boyd. Boyd concluded that although Denton had a depressive disorder, it was in partial remission because she took Lexapro for her fibromyalgia. Despite her remitting depression, Boyd pointed to no limitation on her ability to work, concluding that she could follow moderately complex instructions. The ALJ was entitled to rely on medical experts when no contrary evidence is presented. See Flener ex rel. Flener v. Barnhart, 361 F.3d 442, 448 (7th Cir.2004). Denton also contends that the ALJ erred by refusing to consider Boyd's GAF score of 60. GAF scores, defined in AM. PSYCHIATRIC ASS'N, DIAGNOSTIC & STATISTICAL MANUAL OF MENTAL DISORDERS 32-34 (Text Revision, 4th ed.2000), are useful for planning treatment, and are measures of both severity of symptoms and functional level. Id. at 32. Because the final GAF rating always reflects the worse of the two, id. at 33, the score does not reflect the clinician's opinion of functional capacity. Accordingly, nowhere do the Social Security regulations or case law require an ALJ to determine the extent of an individual's disability based entirely on his GAF score. Wilkins v. Barnhart, 69 Fed.Appx. 775, 780 (7th Cir.2003) (citing Howard v. Comm'r of Soc. Sec., 276 F.3d 235, 241 (6th Cir.2002)). Rather than rely on the unexplained numerical score assigned by Boyd, the ALJ's ultimate finding of no disability was substantially supported by Boyd's narrative finding that Denton had no significant mental impairments. Finally, Denton focuses on her use of Lexapro as establishing the extent of her depression. Although Lexapro is an antidepressant, Denton was prescribed it to treat her fibromyalgia, not depression. And even if Denton had been taking Lexapro for depression, that would not warrant inclusion in her RFC if the prescription controlled her depression, as the evidence suggested. See Prochaska v. Barnhart, 454 F.3d 731, 737 (7th Cir.2006) (concluding that depression was not disabling because it was controlled).