Her v. Berryhill, 0:16-cv-04389

Background

Plaintiff Sai Her, age 58, applied for DIB and SSI (onset March 14, 2008) alleging cervical pain, headaches, major depressive disorder, and PTSD; applications denied initially and on reconsideration.
ALJ Virginia Kuhn held a hearing (with translator) and denied benefits, finding severe impairments but RFC for medium work with mental limitations; Appeals Council denied review and ALJ decision became final.
Primary dispute concerns the weight given to two treating providers’ post-denial mental-impairment questionnaires: Dr. Maradeth Searle (psychologist) and Carol Thersleff (nurse practitioner), each opining claimant unable to perform full-time work.
ALJ gave those questionnaires little weight, relying on treatment notes showing mostly mild-to-moderate symptoms, normal mental-status exams, effective medication management, activities inconsistent with total disability, and lack of objective support or explanation for extreme questionnaire ratings.
District Court applied the substantial-evidence standard, upheld the ALJ’s evaluation of the opinions (including treatment of GAF scores), and affirmed the Commissioner’s denial of benefits.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether ALJ improperly discounted treating psychologist Dr. Searle’s opinion	Searle was a treating, acceptable medical source; ALJ failed to give proper weight, ignored low GAFs, and substituted own judgment	ALJ reasonably discounted the questionnaire because Searle’s treatment notes lacked specificity, relied on subjective reports, showed only mild/moderate symptoms, and lacked supporting objective findings	ALJ’s evaluation of Searle’s opinion supported by substantial evidence; no remand required
Whether ALJ erred in weighing nurse practitioner Thersleff’s opinion	Thersleff’s extreme limitations are consistent with Searle and should be credited	Thersleff’s own treatment notes show improvement, normal mental-status exams, and medication stabilization; questionnaire inconsistent with record	ALJ permissibly discounted Thersleff’s questionnaire as inconsistent with her treatment notes and the record
Whether ALJ failed to consider consistency between providers’ opinions	ALJ should have explicitly weighed the agreement between Searle and Thersleff	Weight is determined by consistency with the whole record; ALJ need not compare every opinion against each other	Court: ALJ not required to analyze internal consistency between every opinion; substantial-evidence review supports decision
Whether ALJ improperly discounted GAF scores	Low GAFs demonstrate greater limitations and require more weight	GAF is a single-point, subjective measure and may be given less weight than the overall medical evidence	Court upheld ALJ’s approach to GAFs: permissible to give less weight to GAFs when inconsistent with broader record

Key Cases Cited

Kelley v. Barnhart, 372 F.3d 958 (8th Cir. 2004) (describing deferential review standard for ALJ findings)
Clark v. Chater, 75 F.3d 414 (8th Cir. 1996) (review limited to whether ALJ’s findings are supported by substantial evidence and free of legal error)
Blackburn v. Colvin, 761 F.3d 853 (8th Cir. 2014) (definition of substantial evidence)
Kirby v. Astrue, 500 F.3d 705 (8th Cir. 2007) (ALJ may discount opinion based largely on claimant’s subjective complaints)
Jones v. Astrue, 619 F.3d 963 (8th Cir. 2010) (ALJ may afford greater weight to medical evidence over GAF scores)
Johnson v. Apfel, 240 F.3d 1145 (8th Cir. 2001) (a drafting imprecision in an ALJ opinion does not require remand when supported by substantial evidence)