Opinion ID: 2982946
Heading Depth: 4
Heading Rank: 1

Heading: State Agency Evaluations

Text: On March 5, 2009, prior to beginning her psychological treatment, Winn was examined by psychologist Mary Ann Jones at the request of the Bureau of Disability Determination. State agency psychologist Kristen Haskins reviewed the record on March 24, 2009 and evaluated Winn’s mental functioning capabilities. 1 The GAF scale rates an individual’s “overall psychological functioning” from 0 to 100 at a given moment in time. This scale is meant to reflect an individual’s “psychological, social, and occupational functioning on a hypothetical continuum of mental health-illness.” Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision at 34. An individual with a score of 51-60 is classified as having “moderate symptoms . . . or moderate difficulty in social, occupational, or school functioning.” Id. 4 No. 14-3499 Dr. Jones determined that Winn suffers from dysthymic disorder, generalized anxiety disorder, and psychological factors affecting her physical condition. She assigned Winn a GAF score of 55 and determined that: Ms. Winn’s mental ability to relate to others, including fellow workers and supervisors, is moderately impaired by her depression, anxiety, and her preoccupation with her medical limitations. She would be unable to relate sufficiently to coworkers and supervisors on any sustained basis (for two or more hours at a time), even to perform simple, repetitive tasks . . . . Ms. Winn’s mental ability to understand, remember, and follow instructions is moderately impaired, and this is more so by her overall psychological condition than any cognitive limitations . . . . Her mental ability to withstand the stress and pressures associated with day-to-day work activity is judged as moderately impaired. Ms. Winn shows moderate mental limitations in the areas of relating and comprehension because of her depression, anxiety, and preoccupation with her medical limitations. (R. 6, Certified Administrative Record, Page ID # 477.) Dr. Haskins reviewed Winn’s record and completed a mental residual functional capacity assessment. Dr. Haskins found that Winn was “markedly limited” in her “ability to interact appropriately with the general public.” (Id. at 500.) She determined that Winn was “moderately limited” in her “ability to complete a normal workday and workweek without interruptions from psychologically based symptoms and to perform at a consistent pace without an unreasonable number and length of rest periods.” (Id.) She also found Winn to be “moderately limited” in her: (1) “ability to respond appropriately to changes in the work setting,” (2) “ability to understand and remember detailed instructions;” (3) “ability to carry out detailed instructions;” (4) “ability to maintain attention and concentration for extended periods;” and (5) “ability to work in coordination with or proximity to others without being distracted by them.” (Id. at 499500.) 5 No. 14-3499 Following her review of the record, Dr. Haskins concluded that Winn “would be able to perform [simple repetitive tasks and] follow 1-2 step instructions in a static and non-public environment and [without] strict production or time demands.” (Id. at 501.) She also found that “[Winn] would be able to interact [with] others minimally and superficially.” (Id.) On September 15, 2009, state agency psychologist Alice Chambly reviewed the record and affirmed Dr. Haskins’ findings.