Opinion ID: 3160729
Heading Depth: 2
Heading Rank: 1

Heading: Dr. Wisdom’s Opinion

Text: On appeal, Lawson first contends that the ALJ erred in finding she was not disabled because the ALJ “failed to discuss, review or give any weight to the actual opinions” of her primary treating psychiatrist, Dr. Wisdom. The government counters that there are only seven treatment notes from Dr. Wisdom in the record, and those seven notes describe fifteen-minute appointments that were focused on adjusting Lawson’s medications.2 Dr. Wisdom also did not provide any opinion, the government argues, as to Lawson’s prognosis or limitations. After our review of the record and the parties’ briefs, we conclude the ALJ did not err in discussing, reviewing, or giving less weight to Dr. Wisdom’s opinion. As this Court has explained elsewhere, “An ALJ may discount or disregard a treating physician’s opinion ‘where other medical assessments are supported by better or more thorough medical evidence, or where a treating physician renders inconsistent opinions that undermine the credibility of such opinions.’” Turpin v. Colvin, 750 F.3d 989, 993 (8th Cir. 2014) (quoting Prosch v. Apfel, 201 F.3d 1010, 1013 (8th Cir. 2000)) (internal quotation marks omitted). In addition, “[a]n ALJ may give less weight to a conclusory or inconsistent opinion by a treating physician.” Id. “In considering how much weight to give a treating physician’s opinion, an ALJ must also consider the length of the treatment relationship and the frequency of examinations.” Casey v. Astrue, 503 F.3d 687, 692 (8th Cir. 2007). 2 We reviewed Dr. Wisdom’s seven treatment notes dated May 20, 2010; July 8, 2010; September 2, 2010; October 14, 2010; November 11, 2010; December 16, 2010; and February 17, 2011. The first appointment was for thirty minutes and the rest of the appointments were for fifteen minutes. -4- In this case, the ALJ referenced and then gave little weight to Dr. Wisdom’s testimony for good reasons. The ALJ noted that Dr. Wisdom assigned a low GAF score, which was inconsistent with the totality of the medical evidence and not supported by Lawson’s demonstrated level of functioning.3 See also Jones, 619 F.3d at 973 (“The [Global Assessment Functioning] score is a subjective determination that represents the clinician’s judgment of the individual’s overall level of functioning.”) (alteration in original) (internal quotation marks and citations omitted)). Dr. Wisdom saw Lawson seven times between May 20, 2010 and February 17, 2011. Dr. Wisdom’s evaluation indicates Lawson was doing “fairly well” in November 2010. Contrary to Lawson’s assertions, the ALJ also recognized that Dr. Wisdom noted Lawson “appears to be doing quite well” and found “[n]o problems with her medications” at their last meeting in February 2011. The ALJ also mentioned Dr. Wisdom’s assertion in February 2011 that “[s]ince [Lawson’s] dismissal from the hospital, [she] had done ‘very well.’” At the same appointment, Dr. Wisdom saw “no reason for making any changes,” and he stated his belief that Lawson’s medications were “working well.” Overall, Dr. Wisdom’s progress notes in the record reflect that Lawson met with Dr. Wisdom for six fifteen-minute appointments and one thirty-minute appointment to adjust her medications. The notes also indicate her mental conditions improved with the proper medications. See 3 Lawson argues Dr. Wisdom did not assign any GAF score. The government counters that Lawson’s counsel represented at the ALJ’s supplemental hearing that Dr. Wisdom assigned Lawson a GAF score of approximately 38. The government concedes that it appears Dr. Wisdom never assigned a GAF score in his treatment notes. However, because the Master Treatment Plan, which includes a GAF score of 38, lists Dr. Wisdom as Lawson’s provider, the government argues it is unclear whether Dr. Wisdom or Mr. Leach assigned that GAF score. Putting the parties’ disagreements aside, even if the ALJ wrongly attributed a GAF score to Dr. Wisdom, such a GAF score is inconsistent with the evidence in the record and conflicts with Dr. Wisdom’s treatment notes as discussed above. -5- Wildman v. Astrue, 596 F.3d 959, 965 (8th Cir. 2010) (“If an impairment can be controlled by treatment or medication, it cannot be considered disabling.” (quoting Brown v. Barnhart, 390 F.3d 535, 540 (8th Cir. 2004))). Thus, Dr. Wisdom’s opinions do not support a finding of disability. Assuming, for the sake of argument, Dr. Wisdom gave a low GAF assessment for Lawson, the ALJ did not err in giving less weight to Dr. Wisdom’s assessment. As the ALJ rightly noted, a low GAF score is inconsistent with the totality of the medical evidence and not supported by Lawson’s demonstrated level of functioning. Regarding Lawson’s medical record, as the ALJ explained, Dr. Jonas opined that Lawson had no impairment in her daily living and her subjective complaints of a mental impairment did not reflect her actual functional abilities. Nor does Lawson have any limitations in concentration, persistence, or pace, according to Dr. Jonas. When Dr. Jonas was asked about Lawson’s low GAF scores, he responded he “did not give much credence to GAF scores, because, based on his medical experience, they were unreliable.” In addition, Mr. John Keough, a licensed psychologist, performed a consultative psychological examination of Lawson on August 26, 2009. Lawson told Mr. Keough that her general attitude was “good” while she was on her medications. Mr. Keough also reported that Lawson “had no difficulty interacting” with him and she “was overemphasizing” her symptoms. See Jones, 619 F.3d at 973 (“The ALJ was entitled to draw conclusions about [the claimant’s] credibility based on [the psychiatrist’s observation] indicating that [the claimant] was exaggerating symptoms . . .” (quoting Baker v. Barnhart, 457 F.3d 882, 892 (8th Cir. 2006))). “[Lawson’s] ability to sustain concentration, be persistent in tasks and maintain an adequate pace in productive activity, necessary to be gainfully employed, working 40 hours a week, in a mainstream work-related environment, for a duration of at least 12 months, with regard to psychological issues,” Mr. Keough wrote, “would be adequate up to a complex or demanding setting.” -6- The ALJ also considered Lawson’s daily activities as a stay-at-home mother. For example, Lawson testified to “perform[ing] household chores, including cleaning and laundry” and “watching television and writing her thoughts in a daily journal.” Lawson also reported no problems taking care of her personal needs, such as bathing, grooming, dressing, etc., and she drives, shops for groceries, walks a lot, fishes and camps with her family, and cares for her two children, one of whom has mild cerebral palsy, “all the time.” See Brown, 390 F.3d at 541 (finding the ALJ permissibly discounted appellant’s subjective complaints of disabling pain, which were inconsistent with her testimony that she “acted as the primary caregiver of her daughter with cerebral palsy.”). There is evidence in the record that Lawson cooked, helped mow her yard, washed dishes, vacuumed, and wiped tables and counters. The record indicates that Lawson is able to manage her finances. Lawson reported her social activities consist of visiting with others “maybe once a week.” In sum, the ALJ did not err by giving less weight to a low GAF rating for Lawson, which is not supported by Lawson’s daily activities and inconsistent with her medical record.