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

Heading: Agency Doctor’s Opinion

Text: Ms. Kearns also faults the ALJ for giving significant weight to the “stale” opinion of an agency doctor without analyzing it in the context of the entire medical evidence, which shows a decline in mental health in 2012. We deduce that she critiques the ALJ’s reliance on the Psychiatric Review Technique (PRT) and Mental Residual Functional Capacity Assessment (MRFCA) performed by Joan Holloway, Ph.D., a non-examining state-agency psychologist.3 Here too we discern no error. The ALJ followed the mandate in Keyes-Zachary: “It is the ALJ’s duty to give consideration to all the medical opinions in the record. He must also discuss the weight he assigns to such opinions.” 3 In Section I of the MRFCA (“Summary Conclusions”), Dr. Holloway checked boxes indicating that Ms. Kearns was “[m]arkedly [l]imited” in “[t]he ability to understand and remember detailed instructions,” “[t]he ability to carry out detailed instructions,” and “[t]he ability to interact appropriately with the general public.” Aplt. App., Vol. II at 392–93. She found no significant limitations in the remaining categories. In Section III (“Functional Capacity Assessment”), Dr. Holloway explained that Ms. Kearns “can perform simple tasks with routine supervision,” “can relate to supervisors and peers on a superficial work basis,” “cannot relate to the general public,” and “can adapt to a work situation.” Id. at 394. A second non-examining state-agency psychologist, Sharon Taber, Ph.D., affirmed the findings and assessments in the MRFCA, as well as the PRT, on reconsideration. 8 695 F.3d at 1161 (citing 20 C.F.R. §§ 404.1527(c), (e)(2)(ii), 416.927(c), (e)(2)(ii)). In addition to the opinion by Dr. Holloway, which was affirmed by Dr. Taber on reconsideration, the ALJ considered:  a March 23, 2011, case analysis by a state-agency physician, Janet G. Rodgers, M.D., finding no evidence of severe physical impairments, which was affirmed in an August 15, 2011, case analysis by a second state-agency physician, Luther Woodcock, M.D. (which the ALJ gave “strong weight and consideration”), Aplt. App., Vol. I at 44;  three unidentified checklist forms dated July 13, 2010, November 5, 2010, and February 17, 2011, which were completed in connection with an application for social services from the Seminole Nation of Oklahoma (which the ALJ gave “minimal weight or consideration”), id. at 44–45;  an April 14, 2011, letter from Don Bruce Chesler, M.D., which Ms. Kearns procured to defend against felony-assault charges for striking a police officer (which the ALJ gave “minimal weight or consideration”), id. at 45; and  a September 13, 2010, “third party adult function report” completed by Ms. Kearns’s father, which the ALJ deemed to be of questionable accuracy and “simply not consistent with the preponderance of the opinions and observations by medical doctors in this case,” id. The ALJ’s discussion of this opinion evidence was preceded by a thorough recitation of the medical evidence, including records documenting panic attacks in 2010; the examination by Dr. Al-Botros on January 31, 2011; regular visits to Public Indian Health Clinics in 2011; outpatient care with Mental Health Services of Southern Oklahoma in 2011; emergency treatment and inpatient care at Carl Albert in April and May 2012; and inpatient care at Griffin Memorial Hospital in June and July 2012. See id. at 40–43. 9 Not only did the ALJ examine the medical opinions in the context of Ms. Kearns’s medical history, he also devoted extensive attention to the 2012 incidents—when Ms. Kearns was admitted to Carl Albert after taking too many pills within a short period and to Griffin Memorial Hospital following an overdose. In particular, he outlined the progress she made during treatment. When Ms. Kearns left Carl Albert, for instance, she “was stabilized on medications with reported improvement”; she had “attended and interacted well in her group sessions”; she “was alert and oriented with intact memory, normal concentration, and intact judgment” upon discharge; “she was sleeping well with good appetite [and] compliant upon her medications without any side effects”; and “she was utilizing effective coping skills.” Id. at 42. Similarly, at Griffin Memorial Hospital, she “stabilized and improved upon her modified medications” and was “discharged as stable” with a mental health treatment plan. Id. The ALJ carefully considered all of the medical evidence in formulating an RFC that addressed Ms. Kearns’s mental impairments. Just because his assessment was similar to the medical opinions of Drs. Holloway and Taber does not mean that it was based solely on stale evidence. Substantial evidence supports the ALJ’s decision.