Bobbie Brown appeals the district court’s 2 affirmance of the administrative law judge’s (ALJ) denial of Brown’s application for disability insurance benefits (DIB) under Title II of the Social Security Act. Brown contends that the ALJ’s determination that she is not disabled is not supported by substantial evidence on the record as a whole and is inconsistent with the medical evidence and the opinion of Brown’s treating physician. We affirm.
I. Background
A. General Background
Brown claimed disability based on, inter alia, “anxiety problems.”
3
At the time
According to Louis Brown (“Louis”), Brown’s husband, Brown is unable to work eight hours a day, five days a week. He stated that her nerves caused her trouble at work. On one occasion, when Louis returned home from work, Brown did not recognize him and was walking through the house talking to herself.
Latasha Anthony, Brown’s daughter, reported that “[ejven when treatment is effective, persistent consequences of the illness[,] lost opportunities, stigma, residual symptoms and medication side [e]ffect[s] may be very troubling.” According to Anthony, Brown often appears confused and “sometimes cannot concentrate on one thought for very long and may be easily distracted or unable to focus her attention.” Anthony stated that, at times, Brown withdraws socially, avoiding contact with others and not speaking.
B. Medical Evidence
Dr. George Conner, Brown’s primary care physician, has treated Brown since the end of 2001. On March 22, 2002, Brown saw Dr. Conner with complaints of an inability to control her emotions, moodiness, and an inability to sleep. Dr. Conner diagnosed depression with anxiety and prescribed Effexor. Then, in January 2003, Dr. Conner prescribed Ativan to Brown after she complained of difficulty sleeping and nerves in response to the recent death of her sister. During a follow-up examination on February 12, 2003, Dr. Conner treated Brown for, inter alia, anxiety and dysphoria. During the visit, Brown stated that “Ativan helps” and “prayer helps” but that she did not “feel able to face [her] responsibilities [at] work.”
On March 4, 2003, Dr. Conner opined that Brown had, inter alia, “resolving anxiety/depression” and was “doing better [with her] mood,” “[b]etter able to concentrate,” and “less anxious.” On August 27, 2003, Dr. Conner treated Brown for, inter alia, anxiety and prescribed Ativan.
During Brown’s visits to Dr. Conner for various ailments in March and June 2004, Dr. Conner noted Brown as having normal mood, memory, judgment, and insight. But on August 2, 2004, Brown complained to Dr. Conner of stress, and Dr. Conner prescribed Lexapro and recommended that she remain off work for two weeks. During a follow-up appointment on August 20, 2004, Brown reported that she was “feeling better but still [was] not always sleeping at night [because] sometimes [her] mind seem[e]d to keep running when she [was] tired.” Dr. Conner diagnosed stress, instructed Brown to continue Lexapro, and continued her work release until September 7, 2004. On September 3, 2004, Brown again saw Dr. Conner, reporting that she was “feeling less depressed [and] still forgetful but [was] improving with less stress and resting better.” Brown indicated that she thought she
On February 15, 2005, Brown applied for DIB. She alleged disability since July 28, 2004, primarily due to anxiety. During an appointment with Dr. Conner on February 23, 2005, Brown complained of problems sleeping and forgetting things, and Dr. Conner prescribed Paxil for anxiety and recommended counseling. Thereafter, on April 26, 2005, Brown underwent a mental status evaluation by Charles Spell-man, Ph.D. Brown reported going to a mental health center for anxiety and depression when she was in her 20’s but stated that she had not been back for mental health services since that time. Brown told Dr. Spellman that she was depressed and anxious and that her mind wandered, causing her to lose her attention. In his report, Dr. Spellman noted that Brown “was coherent and relevant throughout the evaluation” and that she “was a pleasant woman who talked too much.” He said that she “talks constantly, punctuating her sentences with smiles and casting about of her big eyes. She talked about being abused, her depression, her anxiety, and other bad things all the while casting smiles. It was as if she was talking about bad things but enjoying talking about them.” He reported that she was animated and never cried or appeared to be in distress; in fact, he said that she was quite relaxed.
As to Brown’s stream of mental activity, Dr. Spellman opined that she was spontaneous and that her thought processes “were logical and well organized. Her speech was not pressured so much as it was that she seemed to just like to talk a lot.” He surmised that Brown controls social situations by being facile with words. As to her thought control, he said that Brown’s “contact with reality appeared good” and that “[t]here was no evidence of hallucinations, delusions, obsessions and unusual powers.” When Dr. Spellman asked Brown what she was depressed about, Brown replied that she did not know/ As to her anxiety, she said, “I will tell you the truth, I don’t know what that means. I just feel funny. My head tingles like your skin does when it is numb. Sometimes I just burst out in sweats.” Dr. Spellman opined that Brown “has heard the word ‘depression’ paired up with anxiety so she always included them together. Although, she did not know the definition of anxiety. She didn’t describe symptoms, which were necessarily anxiety generated.” Brown reported “flashbacks” of emotional, mental, and physical abuse during her first marriage, and Dr. Spell-man indicated that this abuse explained her depression.
Dr. Spellman opined that Brown was in contact with reality and had appropriate orientation with respect to “time, person, place.” He estimated her IQ to be 71 to 79. He observed that although Brown complained of memory problems, they “did not seem significant enough to warrant a diagnosis at this time.” He rated her communication skills as “good in all areas.” Socially, he believed that Brown got along fine with others, and he saw no evidence of “unusual passivity, dependency, aggression, impulsiveness, or withdrawal.” He noted that Brown
fixes complete meals, goes shopping for groceries, drives a vehicle, and attends church regularly. She pays bills. She manages the family money. She has friends.... She is involved in her daughter’s school activities.... A typical day might include visiting her mother, doing housework, checking on her daughter at school ... Her plans are that, perhaps, she would like to travel in the future but not [too] far at one time.
On May 4, 2005, Dr. Kathyrn M. Gale, an agency reviewing physician, examined Brown’s files and concluded that Brown had mild restriction of activities of daily living, mild difficulties in maintaining social functioning, moderate difficulties in maintaining concentration, persistence, or pace, and no episodes of decompensation. Dr. Gale, who relied in part on Dr. Spell-man’s evaluation, stated that Brown’s functioning was not markedly limited and that she could do semi-skilled work. Regarding Brown’s ability to function mentally, Dr. Gale concluded that Brown had no significant limitations in 18 of 20 areas, including Brown’s ability to understand and remember simple and detailed instructions and her ability to work in coordination or proximity to others without being distracted by them. Dr. Gale found that Brown had moderate limitations in two areas: the ability to maintain attention and concentration for extended periods and the ability to complete a normal work day without interruptions from psychologically based symptoms. Despite these limitations, Dr. Gale opined that
[Brown] is able to perform work where interpersonal contact is routine but superficial, e.g.[,] grocery checker; complexity of tasks is learned by experience, several variables, uses judgment with limits; supervision required is little for routine but detailed for non-routine.
Jerry Henderson, Ph.D., a psychologist, agreed with Dr. Gale’s assessments.
Following her examination by Dr. Gale, Brown reported to Dr. Conner on August 17, 2005, that she was experiencing episodes of fear and worry but could not identify any particular stress. According to Brown, she was feeling anxious and not tolerating family stress well; additionally, traveling in a car made her very nervous. Dr. Conner diagnosed anxiety and possible hypertension and prescribed Ativan and Zoloft. During September 2005, Brown complained of feeling anxious and an inability to work. She reported that Zoloft was not helping her anxiety, and Dr. Conner prescribed Paxil and Lorazepam. In October 2005, Dr. Conner diagnosed Brown with improved generalized anxiety disorder. According to Dr. Conner’s notes, Brown’s mood and anxiety seemed better. Dr. Conner prescribed, inter alia, Paxil and Lorazepam.
In January 2006, Brown complained to Dr. Conner that she was “under a lot of stress at home” and “not resting well.” He again diagnosed her with anxiety and prescribed, inter alia, Lorazepam. Two months later, he prescribed Ambien. On April 4, 2006, Brown reported to Dr. Conner that she was unable to sleep, was stressed a lot, and felt “jumpy.” Dr. Conner indicated in his notes that Brown “doesn’t like to take meds.” He assessed Brown with insomnia, stress, and headaches and prescribed Zoloft. A few days later, Dr. Conner replaced Zoloft with Lorazepam. On April 17, 2006, Brown reported that she was still stressed a lot, was not sleeping well, and was experiencing occasional headaches. Dr. Conner diagnosed insomnia, headaches, and depression/stress and prescribed Ambien and Lexapro.
At the end of April 2006, Brown went to Baptist Memorial Hospital in Memphis, Tennessee (“Baptist”), with complaints of nervousness and atypical chest pain. Her
On May 20, 2006, Brown was treated at the Forrest City Medical Center Triage (“Forrest City”) for difficulty sleeping. She was diagnosed with non-specific depression and anxiety, given an injection, and prescribed Ambien. The next day, Brown returned to Baptist, reporting that she was unable to sleep. She was diagnosed with insomnia and anxiety and prescribed Xanax. Then, on May 27, 2006, Brown was treated at the Forrest City emergency room for heart fluttering and nerves. She was diagnosed with anxiety and prescribed Ambien for sleep. Shortly thereafter, on June 1, 2006, Brown again went to Baptist, where she was treated for sleep disturbance. She was diagnosed with acute adjustment reaction and psychosocial dysfunction, anxiety state, and insomnia. She was prescribed Ativan, in addition to the Prozac and Ambien that she was already taking. That same day, Brown was seen at Lakeside Behavioral Health System (“Lakeside”), where she was given a provisional diagnosis of possible depression and anxiety and a Global Assessment Functioning (GAF) of 45. Medical personnel recorded that Brown had no previous treatment for a psychiatric disorder and that she exhibited normal speech and thought processes and fair judgment, insight, and memory.
On June 30, 2006, Brown was admitted to the Baptist emergency room and diagnosed with psychosis. She received injections of Haldol and Ativan. Brown’s family agreed to commit her for treatment. A “Certificate of Need for Emergency Admission” to a psychiatric facility was completed, in which Dr. Steven Creasy certified that Brown “has a mental illness or serious emotional disturbance” as evidenced by her “sudden onset of delusional, hallucinatory behavior.” According to Dr. Creasy, this was “the first episode she has exhibited.”
Brown was transferred on July 1, 2006, to Lakeside for inpatient care. A psychological assessment indicated that when Brown’s husband returned home from work, Brown was “talking out of her head about religious things” and kept chanting, “Bible, Bible, drugs are sin, drugs are sin.” Brown admitted problems in major life areas, including her lack of employment, loss of energy, social withdrawal, and ability to parent. She was delusional and appeared to be responding to internal stimuli. She could not respond normally to questions and had a vacant look in her eyes. Brown was given a provisional diagnosis of psychotic disorder and a GAF of 25. At the time of her admission, she was only taking Buspar. During her hospitalization, she was placed on Ambien for sleep and Haldol injections twice a day for acute exacerbation of psychotic symptomatology. A psychiatric progress note from Dr. Radwan Khuri on July 7, 2006, indicated that Brown’s general appearance, affect, mood, speech, language, thought process, and thought content were within normal limits.
During her hospitalization, Brown told a doctor that about two weeks of poor sleep preceded her delusional episode. She de
On July 17, 2006, Brown was admitted to Counseling Consultants, Inc. as an outpatient for treatment of generalized anxiety disorder, psychosis, and possible bipolar disorder with psychotic features. She was prescribed Abilify, and the Cogentin and Sonata were discontinued. During a medication management appointment in late July, Brown was assigned a GAF of 48.
On July 28, 2006, at Lakeside’s direction, Brown saw Dr. Conner for a follow-up appointment for her psychosis. His notes indicate that Brown was feeling much better and sleeping much better. He stated that Brown had “no significant anxiety” and “no obvious psychotic behavior.” He found her “much improved.” He increased her dosage of Abilify. A review of the administrative record reveals that although Brown continued seeing Dr. Conner on occasion from August to November 2006, she was seeing Dr. Conner for medical conditions unrelated to anxiety, depression, or psychosis. 4
In August 2006, Brown saw Dr. Robert W. Schriner for insomnia. Brown had quit taking Abilify because it made her too sleepy to function during the day and instead was taking Xanax. He diagnosed insomnia related to underlying anxiety and referred her to Dr. Jack Morgan, a psychiatrist.
On December 8, 2006, Dr. Morgan diagnosed Brown with depressive disorder, probable bipolar disorder, with the most recent episode being a psychotic mania, and anxiety disorder. He reported that Brown “continues to feel significantly better than at the time I first saw her.” He stated that Brown had difficulty getting to sleep and staying asleep the previous evening but that Brown said she had “nothing particular ... on her mind.” According to Dr. Morgan, Brown indicated that she “get[s] a little worked up at times” when family members discuss their problems with her because “she feels there is nothing she can do.” Brown informed Dr. Morgan that she had a family Christmas dinner at her home the prior evening, which may have affected her sleep, as the family ate later than usual for her. Dr. Morgan noted that Brown was working out on a regular basis and that her “[m]ood seems to be stable. At present, there isn’t any overt psychotic symptomatology, delusional thinking, grandiosity!,] etc. Thought processing integrated.” He assigned Brown a GAF of 70.
On January 19, 2007, Dr. Morgan reported that Brown “says that she’s been feeling reasonably well, in terms of mood, level of energy[,] and interest. Brown informed Dr. Morgan that she was sleeping better, her appetite was good, and she was better able “to relax more than I normally
On March 2, 2007, Dr. Morgan indicated that Brown “feels that she’s getting good benefit from her medication” and that Brown generally felt that she was “more relaxed and ‘calmed down.’ ” His impression was the same as December 8 and January 19, but he added that Brown “is spending more time taking care of herself’ and that her “[d]ealing with stress is improved.” He assigned her a GAF of 70. A few days later, Brown called Dr. Morgan to report that she was not sleeping; in response, Dr. Morgan increased the dosage of Seroquel.
On April 25, 2007, the day of Brown’s administrative hearing, Dr. Conner wrote a letter on Brown’s behalf, stating:
I have been a primary care provider for Bobb[ie] A. Brown since December of 2001. I have seen her for a variety of complaints and problems. I have seen no evidence of malingering or deceptive behavior. She has suffered from anxiety and anxiety-related illness during the years I have seen her.
Last year she suffered with an episode which caused psychosis and required her hospitalization. Since that time her emotional state would not allow employment. I have been concerned since that time she would not be able to return to full time employment. She has been in relatively stable condition over the past few months but because of the continued problems she has with stress and anxiety in normal daily activity, she is not able to tolerate full time employment. In my opinion, she is not able to return to work now or in the future.
Thereafter, on May 31, 2007, Dr. Morgan reported that Brown “has generally been doing fairly well” but that there were “occasions, such as the recent graduation and subsequent graduation party of her grandson where the task of going about, making preparations etc. caused some feeling of tension or emotional distress.” But he noted that this emotional distress was “nothing severe.” He also observed that Brown had experienced no recurrence of psychotic or manic symptoms. His impression was that although Brown “had a severe episode of illness, it seems that she is reasonably stable.” He noted that Brown was unclear as to “who evaluated her for disability” and “whether it was an application for SSDI.” According to Dr. Morgan,
[i]t seems that the “agenda” may in part be related to the disability question. For the first time in a while, her husband and daughter are both here with her, with various “questions” about what I think of the issue, whether any company would hire a person who might have to occasionally be off work due to illness[,] etc.
Dr. Morgan assigned Brown a GAF of 65 and recommended that she see a counselor in addition to taking her medications.
C. Administrative Hearing and ALJ’s Decision
At the administrative hearing, a vocational expert (VE) testified that Brown’s past relevant work as an assembly worker was light and unskilled, her past relevant work as a cashier was light and semiskilled, and her past relevant work as a substitute teacher was light and skilled. The ALJ then presented the following hypothetical to the VE:
Let’s assume that we have an individual that’s early 50s. They have a high school equivalency education, two years of college. They[’ve] got the same work history as you’ve just described. They really don’t have any physical restrictions, but they do have some nonexertional limitations. But ... this hypothetical individual should be able to perform work [where] interpersonal contact is routine, but superficial. Complexity of the tasks is learned by experience. Several variables. They can use judgment with limits. The supervision required is little for routine, but detailed for non-routine.
Based on this hypothetical, the ALJ asked the VE whether this “hypothetical individual” would be able to work as a cashier, substitute teacher, or assembly line worker. The VE responded that this individual would be able to work as a cashier and assembly line worker but not as a substitute teacher.
The ALJ evaluated Brown’s disability claim according to the five-step process outlined by the Social Security regulations. See 20 C.F.R. § 404.1520(a)-(f). In his decision, the ALJ concluded that Brown had not engaged in substantial gainful activity since the onset of her alleged disability on July 28, 2004, although she had worked part-time as a substitute teacher. He also found that the medical evidence established that Brown suffers from a depressive disorder and an anxiety disorder but that Brown did not have an impairment that met the requirements of any listed impairments. He also found that Brown’s subjective allegations were “not borne out by the overall record” and concluded that such allegations were “not to be fully credible to the extent alleged.” According to the ALJ, Brown had the residual functional capacity (RFC) to perform work-related activities at the semiskilled level with no exertional limitations. The ALJ determined, based on the VE’s testimony, that Brown could perform her past relevant work as an assembly worker and cashier because both jobs were categorized as light and either unskilled or semiskilled. The ALJ’s ultimate conclusion was that Brown was not “disabled” under the Social Security Act.
In reaching his decision, the ALJ rejected Dr. Conner’s opinion that Brown was “not able to return to work now or in the future.” Although he acknowledged that “great weight must be given to this opinion by reason of the position as the claimant’s primary care physician,” he noted that “opinions or conclusions by a treating or examining physician that a claimant is ‘unable to work’ or ‘disabled’ are not binding” because “whether a given claimant meets the definition of disability rests by law with the [ALJ] who is charged with the duty of conducting an independent evaluation of the signs and symptoms which led the doctor to his conclusion.” Additionally, the ALJ rejected Dr. Conner’s opinion because “he is the claimant’s primary care physician and has not had specialized training in treating and diagnosing mental impairments like Dr. Morgan, the claimant’s treating psychiatrist.” Furthermore, the ALJ found that Dr. Conner’s opinion was contrary to Dr. Morgan’s opinion.
Brown filed a request for review, which the Appeals Council denied. Thereafter, Brown sought judicial review of the ALJ’s decision in district court. The district court concluded that the ALJ’s decision was supported by substantial evidence and affirmed the ALJ’s decision.
II. Discussion
On appeal, Brown argues that she is unable to work due to her long history of mental illness. She notes that she has been hospitalized on several occasions because of her illness, including a psychotic episode in June 2006 during which she
In response, the government argues that the ALJ’s finding that Brown was not disabled was within the purview of the Act and consistent with regulatory criteria. The ALJ found that Brown had the severe impairments of a depressive disorder and an anxiety disorder but that her impairments did not render her disabled. According to the government, substantial evidence supports the ALJ’s determination of Brown’s RFC; additionally, the ALJ correctly weighed the medical evidence, including the medical records and opinions from Brown’s treating physician, Dr. Conner, and Brown’s treating psychiatrist, Dr. Morgan. The government argues that the ALJ properly rejected Dr. Conner’s statement that Brown could not work because Dr. Conner opined in an area reserved for the Commissioner of the Social Security Administration. And, the government contends that Dr. Conner’s opinion conflicted with Dr. Morgan’s treatment notes, Dr. Conner’s, own treatment notes, and with Brown’s account of her wide-range of activities.
We review de novo a district court’s decision affirming the denial of social security benefits. We will affirm if the Commissioner’s decision is supported by the substantial evidence on the record as a whole. Substantial evidence means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. We consider both evidence that detracts from and evidence that supports the Commissioner’s decision. If substantial evidence supports the decision, then we may not reverse, even if inconsistent conclusions may be drawn from the evidence, and even if we may have reached a different outcome.
McNamara v. Astrue,
We recognize that “a treating physician’s opinion is generally entitled to substantial weight”; however, such an “opinion does not automatically control in the face of other credible evidence on the record that detracts from that opinion.”
Heino v. Astrue,
Here, the ALJ “rejected” Dr. Conner’s opinion for three reasons: (1) Dr. Conner’s opinion that Brown is unable to work usurps an issue that is exclusively within the ALJ’s determination; (2) Dr. Conner, as the primary care physician, does not have specialized training in treating and diagnosing mental impairments like Dr. Morgan, the treating psychiatrist; and (3) Dr. Conner’s opinion is contrary to Dr. Morgan’s opinion.
1. Dr. Conner’s Opinion That Brown Is Unable To Work
Dr. Conner, Brown’s primary care physician, opined that Brown “is not able to tolerate full time employment” and “is not able to return to work now or in the future.” The ALJ rejected Dr. Conner’s opinion, in part, based on his conclusion that he was not bound by a treating physician’s opinion on the ultimate issue— whether a claimant is “disabled.”
Here, “[t]he ALJ correctly noted ... that the ultimate conclusion of whether [Brown] could sustain gainful employment is a question for the Commissioner.”
Van Vickie v. Astrue,
Nevertheless, Brown argues that the ALJ’s conclusion is at odds with this court’s decisions in
Cox v. Barnhart,
But Cox and Hatcher are distinguishable from the present case because the “larger medical record” does not support Dr. Conner’s conclusory opinion. Here, Dr. Conner opined on August 25, 2007, that Brown was unable to work even though he had not been the primary doctor treating her for her anxiety since her entry into Lakeside in June 2006. Although Dr. Conner did see Brown in July 2006, it was a “follow-up” appointment following her discharge from Lakeside in which Dr. Conner actually denied that Brown had any significant anxiety. Specifically, he noted that Brown had “no significant anxiety” and “no obvious psychotic behavior.” He found her “much improved.” Additionally, even though Brown saw Dr. Conner periodically from August to November 2006, she was seeing him for medical conditions unrelated to anxiety, depression, or psychosis.
2. Dr. Conner’s Lack of Specialization in Treating and Diagnosing Mental Illness
The ALJ’s second reason for discounting Dr. Conner’s opinion was that Dr. Conner “is the claimant’s primary care physician and has not had specialized training in treating and diagnosing mental impairments like Dr. Morgan, the claimant’s treating psychiatrist.”
“Greater weight is generally given to the opinion of a specialist about medical issues in the area of specialty, than to the opinion of a non-specialist.”
Thomas v. Barnhart,
In
Hinchey,
the claimant argued that the ALJ should have given more credit to her family practitioner, who was more familiar with her conditions, instead of giving greater weight to the opinion of a specialist in cardiology.
Given the fact that, at a minimum, [the cardiologist] is at least one of two treating physicians, the court committed no error in giving greater weight to his expertise. The Secretary’s regulations for evaluating medical opinions specify, “We generally give greater weight to the opinion of a specialist about medical issues related to his or her area of specialty than to the opinion of a source who is not a specialist.” 20 C.F.R. § 416.927(d)(5). We conclude that the ALJ committed no error in giving greater weight to the opinions of [the cardiologist] as the treating specialist in this case.
Id.
at 432;
see also Hensley v. Barnhart,
Here, as in Hinchey, the ALJ committed no error in giving greater weight to Dr. Morgan’s expertise, as he is a specialist in mental health and functioned as a treating physician to Brown.
3. Conflicting Opinions of Dr. Conner and Dr. Morgan
The ALJ specifically found that Dr. Conner’s opinion was contrary to Dr. Morgan’s opinion. We now address whether Dr. Morgan’s opinion actually conflicted with that of Dr. Conner.
Brown argues that Dr. Conner’s opinion is consistent with his own treatment notes, Dr. Morgan’s opinion, and with other medical evidence in the record. In her reply brief, Brown asserts that the ALJ created inconsistencies between the opinions of Dr. Conner and Dr. Morgan by selecting evidence from Brown’s “symptom-free periods,” thereby ignoring this court’s observation that “one characteristic of mental illness is the presence of occasional symptom-free periods,”
Andler v. Chater,
We first address whether inconsistencies appear in Dr. Conner’s own treatment notes. On July 28, 2006, after Brown’s release from Lakeside for her admittedly one-time psychotic episode, Dr. Conner held a “follow-up” consultation with Brown, as Lakeside had directed. During that appointment — held 18 days after her discharge from Lakeside — Brown informed Dr. Conner that she was feeling much better and sleeping much better. Dr. Conner found no obvious psychotic behavior and stated that Brown was “much improved.” Thereafter, Dr. Conner did not see Brown again for any mental conditions, such as anxiety, depression, and psychosis, prior to his April 27, 2007 letter. The record reflects that he was not her treating physician for her mental conditions after July 2006; instead, Dr. Morgan assumed the role of Brown’s treating psychiatrist. Not until July 20, 2007 — after the April 27, 2007 letter — did Brown report to Dr. Conner about her mental condition, stating that her medications were working well. Therefore, at the time that Dr. Conner wrote his opinion letter, he effectively had not treated Brown for her anxiety, depression, or psychosis in eight months. While Dr. Conner admitted in his letter that Brown “had been in relatively stable condition over the past few months,” his conclusion that Brown’s “continued problems she has with stress and anxiety in normal daily activities” meant that she could not “tolerate full time employment” was not based on a recent examination of Brown for her mental illness. This lapse in time, coupled with his July 2006 notes that Brown exhibited “no significant anxiety” and “no obvious psychotic behavior,” detracts from his 2007 conclusion that Brown could not work again.
We must next examine whether inconsistencies exist between the opinions of Dr. Conner and Dr. Morgan. From December 2006 to May 2007, Dr. Morgan consistently opined that Brown’s mood was stable, she showed no signs of psychosis, and her thought processing was integrated. He reported that she was “less vulnerable to day to day stressors” and assigned her a GAF of either 65 or 70. Additionally, Dr. Morgan commented on Brown’s daily activities, stating that she “works out fairly regularly,” had a “family Christmas dinner
It is true that Dr. Morgan acknowledged on May 31, 2007, that Brown “had a severe episode of illness,” just as Dr. Conner’s letter acknowledged Brown’s past psychotic episode. And, just as Dr. Conner recognized that Brown “has been in relatively stable condition over the past few months,” so too did Dr. Morgan recognize that Brown “is reasonably stable.” The opinions are consistent in this regard.
But the difference between the two opinions is that Dr. Conner was willing, despite not treating Brown for mental illness since July 2006, to conclude that because of Brown’s
past
episode, Brown is no longer capable of working. By contrast, while Dr. Morgan did not explicitly state whether Brown was capable of working or identify any limitations on her ability to work, he did consistently assign her a GAF of 65 or 70. “[A] GAF score of 65 [or 70] ... reflects ‘some mild symptoms (e.g. depressed mood or mild insomnia) OR some difficulty in social, occupational, or school functioning ... but generally functioning pretty well, has some meaningful interpersonal relationships.’”
Kohler v. Astrue,
Furthermore, other evidence in the record detracts from Dr. Conner’s opinion that Brown is unable to work. The record reflects that Brown’s medications are effective. “If an impairment can be controlled by treatment or medication, it cannot be considered disabling.”
Brace v. Astrue,
Additionally, Brown’s daily activities, in conjunction with other record evidence, support the ALJ’s finding that Brown is capable of performing light work. “[A]cts which are inconsistent with a claimant’s assertion of disability reflect negatively upon that claimant’s credibility.”
Goff,
III. Conclusion
Because substantial evidence on the record as a whole supports the ALJ’s conclusion that Brown is not disabled, we affirm the judgment of the district court.
Notes
. The Honorable Beth M. Deere, United States Magistrate Judge for the Eastern District of Arkansas, to whom the case was referred for final disposition by consent of the parties pursuant to 28 U.S.C. § 636(c).
. In her application, Brown also claimed disability based on “bladder problems.” Brown has not pursued her claim of disability based on urinary incontinence in her appeal of the ALJ's decision. Therefore, we will only review the ALJ’s determination that Brown’s mental condition did not render her "disabled” under the Act.
. We recognize that after the ALJ's June 27, 2007 decision, Dr. Conner did see Brown on July 10, 2007, to talk about her medications. His notes indicate that the medications were “working well with psychosis.” Brown told Dr. Conner that she was still having trouble with stress but that she had experienced "no psychotic episodes” since being on Seroquel.