Opinion ID: 2978672
Heading Depth: 3
Heading Rank: 2

Heading: Discretion in ordering testing

Text: An ALJ has discretion to determine whether further evidence, such as additional testing, is necessary. 20 C.F.R. § 404.1517; id. § 416.917 (“If your medical sources cannot or will not give us sufficient medical evidence about your impairment for us to determine whether you are disabled or blind, we may ask you to have one or more physical or mental examinations or tests.”); see also -5- No. 09-5409 Lisa D. Hayes v. Commissioner of Social Security Landsaw v. Sec’y of Health & Human Servs., 803 F.2d 211, 214 (6th Cir. 1986) (“[T]he regulations do not require an ALJ to refer a claimant to a consultative specialist, but simply grant him the authority to do so if the existing medical sources do not contain sufficient evidence to make a determination.”). Thus, we apply an abuse-of-discretion standard to the ALJ’s refusal to order testing. In Foster v. Halter, this Court considered a request for consultative intelligence testing. The claimant in Foster had a full scale IQ of 69, but the record did not demonstrate that she had adaptiveskills limitations or onset before age twenty-two. 279 F.3d at 355. The Court, therefore, affirmed the ALJ’s finding that her impairment did not meet or equal Listing 12.05 and rejected her request for additional testing: “Given that there was already sufficient testing on Foster’s impairments in the record for the ALJ to evaluate her mental condition . . . , the ALJ did not abuse his discretion in denying Foster’s requests for additional testing or expert testimony.” Id. at 356. It is important to note that Foster’s IQ of 69 was not sufficient by itself to satisfy Listing 12.05. Id.; see also Blanton v. Soc. Sec. Admin., 118 F. App’x 3, 7 (6th Cir. 2004) (“[T]wo IQ scores of 70, without more, does not satisfy the requirements of Listing 12.05(C).”). Thus, even if additional testing measured Hayes’s IQ below 70, that result, standing alone, would not equal listing 12.05––she must still satisfy the three-prong definition of mental retardation and criteria (C).
Hayes argues that her poor academic record demonstrates that she has subaverage intellectually functioning. Hayes’s school records, on which she relies, however, do not necessarily show that she had intellectual deficiencies. Instead, the records support the conclusion that she had -6- No. 09-5409 Lisa D. Hayes v. Commissioner of Social Security poor school attendance and a troubled home life. Hayes was absent and missed a great deal of school during the years when she did not pass. In contrast, when she attended class, she achieved passing marks. For example, she was retained in the first grade after attending only thirty-three days of school but earned grades of B, C, and D in the eighth grade when she attended 177 days of school. Further, Hayes has admitted to past drug abuse, which, as the ALJ acknowledged, might have undermined her academic performance. Finally, none of her school records mention mental retardation or intellectual deficiencies. Hayes also argues that her work history shows that she has subaverage intellectual functioning, but the record is mixed on this point. First, her own responses and explanations for why she left past employment are inconsistent. For example, in agency forms, she indicated that she stopped working because of her poor physical health and because she needed to care for her husband. Before the ALJ, however, she testified that she stopped working because of her poor health but also testified that she was fired from her last job as a cashier because she did not stock the shelves correctly, could not run the cash register without mistakes, and was too slow. Moreover, no evidence, beyond her own testimony, supports her assertion that she could not succeed at these jobs due to mental impairment. Additionally, the ALJ considered Hayes’s employment record, which includes cashier positions, and concluded that she has had mentally challenging jobs. Hayes responds by claiming that her work history is consistent with “mild mental retardation” because “individuals with mild mental retardation ‘usually achieve social and vocational skills adequate for minimum self-support, but may need supervision, guidance, and assistance . . . [and] appropriate supports.”’ (Hayes Br. 12-13 (quoting Am. Psychiatric Ass’n, Diagnostic and Statistical -7- No. 09-5409 Lisa D. Hayes v. Commissioner of Social Security Manual of Mental Disorders Text Revision, § 317 (4th ed. 2000) (“DSM-IV-TR”)).) But Hayes has offered no evidence that she needed “supervision, guidance, and assistance,” or “appropriate supports.” Finally, therapists and psychologists have been treating Hayes for depression for nearly a decade, and at no point have they indicated that Hayes has limited intellectual functioning. Cf. Cooper v. Comm’r of Soc. Sec., 217 F. App’x 450, 452 (6th Cir. 2007) (“It is undisputed that no psychologist has diagnosed [claimant] with mental retardation.”). Hayes responds that her treatment center, the Helen Ross McNabb Center, does not perform IQ testing. But that misses the point. Her mental health records undermine her argument that she has intellectual deficiencies because the psychiatric evaluations demonstrate that she has clear, logical thinking. In sum, the record to support her claim that she might suffer subaverage intellectual functioning is slight and, without more, Hayes cannot show that the ALJ abused his discretion.
Hayes also relies on her school records to argue that her poor academic record demonstrates that she had intellectual deficits during her developmental years. For the reasons explained above, her school records prove little. Additionally, this Court has never held that poor academic performance, in and of itself, is sufficient to warrant a finding of onset of subaverage intellectual functioning before age twenty-two. Cf. Foster, 279 F.3d at 355 (“The only evidence in the record pertaining to this issue is that Foster left school after completing ninth grade, but why Foster did not continue her studies is unclear.”). Hayes offers no other evidence to establish onset before age twenty-two, and, without establishing this prong, she cannot equal Listing 12.05. See West v. -8- No. 09-5409 Lisa D. Hayes v. Commissioner of Social Security Comm’r of Soc. Sec., 240 F. App’x 692, 698 (6th Cir. 2007) (affirming, in part, because claimant offered no evidence of onset before age twenty-two).
The adaptive skills prong evaluates a claimant’s effectiveness in areas such as social skills, communication skills, and daily-living skills. Heller v. Doe, 509 U.S. 312, 329 (1993) (quoting Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, 28-29 (3d rev. ed. 1987) (“DSM-III”)). To determine the definition of mental retardation under the SSA, it is appropriate to consult leading professional organizations’ definitions. See 67 Fed. Reg. 20022 (2002). The American Psychiatric Association defines adaptive-skills limitations as “[c]oncurrent deficits or impairments . . . in at least two of the following areas: communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health, and safety.” DSM-IV-TR at 49. No part of the record indicates that Hayes has adaptive-skills limitations. To the contrary, the record shows that Hayes’s adaptive skills are not deficient. She cares for herself and her husband; cooks meals, does laundry, and shops; manages her finances; and takes public transportation. All of these daily living skills indicate that, even with further testing, she would not be able to establish this necessary prong. Thus, it was not an abuse of discretion for the ALJ to deny her request for consultative intelligence testing.