Williams v. Commissioner of Social Security

Filing 18

MEMORANDUM OPINION AND ORDER Accepting 15 Report and Recommendation which recommends that the Commissioner's determination that Williams was not disabled. Judgment shall enter against Williams and in favor of the Commissioner. Signed by Chief Judge Leonard T Strand on 8/16/2017. (src)

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF IOWA
CEDAR RAPIDS DIVISION
TAMMY WILLIAMS,
No. 16-cv-0128-LTS
Plaintiff,
vs.
NANCY A. BERRYHILL, Acting
Commissioner of Social Security,

MEMORANDUM OPINION AND
ORDER ON REPORT AND
RECOMMENDATION

Defendant.
___________________________
I.

INTRODUCTION

This case is before me on a Report and Recommendation (R&R) by the Honorable
Kelly K.E. Mahoney, United States Magistrate Judge. See Doc. No. 15. Judge Mahoney
recommends that I affirm the decision of the Commissioner of Social Security (the
Commissioner) denying plaintiff Tammy Williams’ application for Social Security
disability insurance benefits (DIB) and supplemental security income (SSI) under Titles
II and XVI of the Social Security Act, 42 U.S.C. § 401 et seq. (Act).
Williams filed timely objections (Doc. No. 16) to the R&R. The Commissioner
filed a response. Doc. No. 17. The procedural history and relevant facts are set forth
in the R&R and are repeated herein only to the extent necessary.
II.
A.

APPLICABLE STANDARDS

Judicial Review of the Commissioner’s Decision
The Commissioner’s decision must be affirmed “if it is supported by substantial

evidence on the record as a whole.” Pelkey v. Barnhart, 433 F.3d 575, 577 (8th Cir.
2006); see 42 U.S.C. § 405(g) (“The findings of the Commissioner of Social Security as

to any fact, if supported by substantial evidence, shall be conclusive . . . .”).
“Substantial evidence is less than a preponderance, but enough that a reasonable mind
might accept as adequate to support a conclusion.” Lewis v. Barnhart, 353 F.3d 642,
645 (8th Cir. 2003). The Eighth Circuit explains the standard as “something less than
the weight of the evidence and [that] allows for the possibility of drawing two inconsistent
conclusions, thus it embodies a zone of choice within which the [Commissioner] may
decide to grant or deny benefits without being subject to reversal on appeal.” Culbertson
v. Shalala, 30 F.3d 934, 939 (8th Cir. 1994).
In determining whether the Commissioner’s decision meets this standard, the court
considers “all of the evidence that was before the ALJ, but it [does] not re-weigh the
evidence.” Vester v. Barnhart, 416 F.3d 886, 889 (8th Cir. 2005). The court considers
both evidence which supports the Commissioner’s decision and evidence that detracts
from it. Kluesner v. Astrue, 607 F.3d 533, 536 (8th Cir. 2010). The court must “search
the record for evidence contradicting the [Commissioner’s] decision and give that
evidence appropriate weight when determining whether the overall evidence in support
is substantial.” Baldwin v. Barnhart, 349 F.3d 549, 555 (8th Cir. 2003) (citing Cline v.
Sullivan, 939 F.2d 560, 564 (8th Cir. 1991)).
In evaluating the evidence in an appeal of a denial of benefits, the court must apply
a balancing test to assess any contradictory evidence. Sobania v. Sec’y of Health &
Human Servs., 879 F.2d 441, 444 (8th Cir. 1989). The court, however, does not
“reweigh the evidence presented to the ALJ,” Baldwin, 349 F.3d at 555 (citing Bates v.
Chater, 54 F.3d 529, 532 (8th Cir. 1995)), or “review the factual record de novo.” Roe
v. Chater, 92 F.3d 672, 675 (8th Cir. 1996) (citing Naber v. Shalala, 22 F.3d 186, 188
(8th Cir. 1994)). Instead, if, after reviewing the evidence, the court finds it “possible to
draw two inconsistent positions from the evidence and one of those positions represents
the Commissioner’s findings, [the court] must affirm the [Commissioner’s] denial of
benefits.” Kluesner, 607 F.3d at 536 (quoting Finch v. Astrue, 547 F.3d 933, 935 (8th
2

Cir. 2008)). This is true even if the court “might have weighed the evidence differently.”
Culbertson, 30 F.3d at 939 (quoting Browning v. Sullivan, 958 F.2d 817, 822 (8th Cir.
1992)).

The court may not reverse the Commissioner’s decision “merely because

substantial evidence would have supported an opposite decision.” Baker v. Heckler, 730
F.2d 1147, 1150 (8th Cir. 1984); see also Goff v. Barnhart, 421 F.3d 785, 789 (8th Cir.
2005) (“[A]n administrative decision is not subject to reversal simply because some
evidence may support the opposite conclusion.”).
B.

Review of Report and Recommendation
A district judge must review a magistrate judge’s R&R under the following

standards:
Within fourteen days after being served with a copy, any party may serve
and file written objections to such proposed findings and recommendations
as provided by rules of court. A judge of the court shall make a de novo
determination of those portions of the report or specified proposed findings
or recommendations to which objection is made. A judge of the court may
accept, reject, or modify, in whole or in part, the findings or
recommendations made by the magistrate judge. The judge may also
receive further evidence or recommit the matter to the magistrate judge with
instructions.
28 U.S.C. § 636(b)(1); see also Fed. R. Civ. P. 72(b). Thus, when a party objects to
any portion of an R&R, the district judge must undertake a de novo review of that portion.
Any portions of an R&R to which no objections have been made must be reviewed
under at least a “clearly erroneous” standard. See, e.g., Grinder v. Gammon, 73 F.3d
793, 795 (8th Cir. 1996) (noting that when no objections are filed “[the district court
judge] would only have to review the findings of the magistrate judge for clear error”).
As the Supreme Court has explained, “[a] finding is ‘clearly erroneous’ when although
there is evidence to support it, the reviewing court on the entire evidence is left with the
definite and firm conviction that a mistake has been committed.” Anderson v. City of
3

Bessemer City, 470 U.S. 564, 573 (1985) (quoting United States v. U.S. Gypsum Co.,
333 U.S. 364, 395 (1948)). However, a district judge may elect to review an R&R under
a more-exacting standard even if no objections are filed:
Any party that desires plenary consideration by the Article III judge of any
issue need only ask. Moreover, while the statute does not require the judge
to review an issue de novo if no objections are filed, it does not preclude
further review by the district judge, sua sponte or at the request of a party,
under a de novo or any other standard.
Thomas v. Arn, 474 U.S. 140, 150 (1985).
III.

THE R&R

Williams alleged disability due to problems with her vocal cords, back, and mental
health. Doc. No. 15 at 2-4. In support of her claim, Williams submitted three residual
functional capacity (RFC) opinions drafted by her treating physician, Gina Perri, M.D.
At issue are the ALJ’s evaluation of Dr. Perri’s medical opinions, and whether the ALJ’s
findings as to Williams’ residual functional capacity (RFC) are supported by substantial
medical evidence. After setting forth the relevant facts, Judge Mahoney summarized the
ALJ’s assessment of Dr. Perri’s opinion as follows:
The ALJ gave several reasons for affording Dr. Perri’s opinions little
weight. Most importantly, the ALJ found that Dr. Perri’s opinions were
inconsistent with the record as a whole and “rel[y] on complete acceptance
of the claimant’s . . . self-serving symptoms and functional limitations,”
which the ALJ found unreliable. AR 27-28. Williams contests this factfinding, arguing that Dr. Perri relied on the medical evidence and her
objective observations when forming her opinion, not Williams’ subjective
statements. Some of Dr. Perri’s limitations may be based on her objective
observations of Williams standing with a “stooped” posture and moving
around constantly during her monthly check-ups. AR 877, 881, 1568,
1570. But the ALJ noted that Williams presented in this manner only when
being treated for back pain and seeking drugs to help her pain. AR 23.
Doctors who treated Williams’ vocal cords and mental health indicated that
she had a normal gait and stance. AR 825, 1012, 1125, 1128. Even Dr.
Perri’s own treatment notes indicate that Williams could walk normally
4

when instructed to do so and that her presentation was “rather dramatic”
and “quite extraordinary compared to the numerous patients [Dr. Perri]
treat[s] with chronic back pain.” AR 877, 881. Substantial evidence
supports the ALJ’s determination that Williams exaggerated her back
problems around Dr. Perri, which affected Dr. Perri’s evaluation of
Williams’ ability to sit, stand, and walk. Moreover, other objective
evidence does not support limitations as great as those imposed by Dr.
Perri: Magnetic Resonance Imaging (MRI) results from October 2011
showed mild disc bulging in Williams’ spine, an August 2013 MRI was
“essentially negative,” and other tests (e.g., straight leg raises, range of
motion) mostly show no or mild restrictions. AR 726, 743, 845, 849-50,
863, 870, 1467. In addition, Dr. Perri’s opinions and treatment notes
explicitly state that many of the imposed limitations—including lifting,
walking, sitting, bending, stooping, and twisting restrictions—are based on
Williams’ complaints of back pain. AR 1263, 1295, 1385, 1568, 1570.
Substantial evidence supports the ALJ’s determination that Dr. Perri’s RFC
opinions relied heavily on Williams’ discredited subjective complaints,
which is a “good reason” for an ALJ to discount the opinion of a treating
source. See Finch v. Astrue, 547 F.3d 933, 936-37 (8th Cir. 2008) (“Given
that the ALJ found [claimant’s] subjective reports of pain not entirely
credible, a [treating source’s RFC] assessment based on those reports was
appropriately not given substantial weight.”); see also Reece, 834 F.3d at
909; Julin v. Colvin, 826 F.3d 1082, 1085, 1089 (8th Cir. 2016); Cline v.
Colvin, 771 F.3d 1098, 1104 (8th Cir. 2014); but see Papesh, 786 F.3d at
1132-33 (holding that “the ALJ offered no basis to give the [treating
physician’s RFC] opinion non-substantial weight” when the ALJ found it
“based on the claimant’s subjective assertions of pain”).
Another “good reason” given by the ALJ is that some of the
limitations imposed by Dr. Perri are inconsistent with the record as a whole.
See Papesh, 786 F.3d at 1132 (holding that the ALJ may give a treating
source’s RFC opinion non-substantial weight if it is “inconsistent with the
record”). In addition to the previously noted inconsistencies, the ALJ found
that Dr. Perri’s lifting restrictions were inconsistent with Williams’ ability
to throw a door into a neighbor’s dumpster, which she did in November
2011 (and which resulted in her being charged with illegal dumping). AR
21, 823. The ALJ also pointed to Dr. Perri’s August 2012 treatment note
in which she found that Williams’ pain was stable on Lortab and that
Williams reported being “pretty functional.” AR 1387-89.
5

The ALJ found that Dr. Perri’s RFC opinion of October 17, 2013,
was inconsistent with her RFC opinion from a few months earlier. AR 28.
In June 2013, Dr. Perri opined that Williams could never lift more than ten
pounds and that she could not repetitively lift ten pounds or less; in October
2013, Dr. Perri opined that she could never lift ten pounds or more and that
she could rarely lift less than ten pounds (a very minor inconsistency). AR
1295, 1570. She also opined in June 2013 that Williams could engage in
“no repetitive lifting, stooping, bending, twisting, [or] climbing.” AR
1295. In August 2013, she found that Williams could rarely twist, “stoop
(bend),” or climb stairs, and never climb ladders, which is perhaps
inconsistent with her June 2013 opinion. AR 1571. Although the
inconsistencies between Dr. Perri’s opinions are slight, the ALJ could
properly consider them (along with other factors). See Goff v. Barnhart,
421 F.3d 785, 790 (8th Cir. 2005) (“An ALJ may ‘discount or even
disregard the opinion of a treating physician . . . where a treating physician
renders inconsistent opinions that undermine the credibility of such
opinions.’” (quoting Prosch v. Apfel, 201 F.3d 1010, 1013 (8th Cir.
2000))).
With regard to Dr. Perri’s findings that Williams is unable to work
and that she is thus disabled, the ALJ correctly noted that she need not
“adopt the opinion of a physician on the ultimate issue of a claimant’s ability
to engage in substantial gainful employment.” See Wagner, 499 F.3d at
849 (quoting Qualls v. Apfel, 158 F.3d 425, 428 (8th Cir. 1998)); see also
20 C.F.R. §§ 404.1527(d), 416.927(d); 82 Fed. Reg. at 5869, 5881.
Doc. No. 15 at 7-10. Judge Mahoney determined that the ALJ gave good reasons,
supported by substantial evidence, for affording little weight to Dr. Perri’s
medical. Id. at 10.
Turning to the evaluation of the medical evidence, Judge Mahoney outlined
the ALJ's opinion as follows:
The ALJ gave “some weight” to the RFC opinion of Mr. Engelstad,
incorporating many of Mr. Engelstad’s opined limitations. AR 21, 821-26.
Mr. Engelstad found that Williams could understand, remember, and carry
out “basic and repetitive instructions.” AR 826. Similarly, the ALJ found
that Williams “can perform simple tasks.” AR 18. Mr. Engelstad opined
that Williams could not have much interaction with others and that she
would “struggle to interact effectively with supervisors and coworkers.”
6

AR 826. Like Mr. Engelstad, the ALJ limited Williams’ interactions with
other people, noting that she can never work with the public and that her
work with coworkers and supervisors must be “incidental.” AR 18. Mr.
Engelstad found that Williams needed to work in “an environment that is
not stressful.” AR 826. In an effort to be more precise, the ALJ found
that Williams could not perform fast-paced work or work with the public,
as such “factors often lead[] to a stressful work environment.” AR 18, 29.
Unlike the ALJ, however, Mr. Engelstad found Williams capable of
handling money. AR 18, 826. Mr. Engelstad also found that Williams
lacked good judgment and would struggle to adjust to workplace change,
which the ALJ did not include in her RFC assessment. Id.
The ALJ gave “significant weight” to the RFC opinions of the state
agency medical consultants. AR 29. Dr. Rene Staudacher and Dr. Marlene
Gernes evaluated the effect of Williams’ degenerative disc disease on her
physical RFC. AR 131-35, 152-54. Dr. Gernes also considered Williams’
June 2012 vocal cord surgery and disorder but found it did not change Dr.
Staudacher’s previous RFC assessment. AR 154. Drs. Staudacher and
Gernes opined that Williams can occasionally balance, crouch, stoop,
kneel, crawl, climb ladders, and climb stairs. AR 134, 152. They found
that she can occasionally lift twenty pounds and frequently lift ten pounds.
AR 133, 152. They determined that in an eight-hour workday, Williams
could sit for six hours and stand for six hours. Id.
Dr. Aaron Quinn and Dr. Scott Shafer evaluated the effect of
Williams’ anxiety, depression, and history of alcohol abuse on her ability
to function mentally and opined that Williams suffered from no marked or
severe limitations. AR 132, 135-37, 151, 154-57. They found her
moderately limited in the following areas: understanding, remembering,
and carrying out detailed instructions; maintaining attention and
concentration for extended periods; completing a normal workday and
workweek without interruptions from psychologically based symptoms;
performing at a consistent pace without an unreasonable number and length
of rest periods; interacting appropriately with the public; getting along with
coworkers without distracting them; responding appropriately to workplace
change; and setting goals and making plans independently of others. AR
135-36, 154-56. Drs. Quinn and Shafer ultimately concluded that Williams
would be able to perform simple, repetitive tasks. AR 137, 157. The state
agency medical consultants evaluated the effects of the impairments that the
ALJ found severe, and their RFC assessments are almost identical to the
7

ALJ’s RFC assessment. The ALJ also adopted most of the limitations found
by Mr. Engelstad and conducted an independent review of the medical
evidence. Accordingly, some medical evidence supports the ALJ’s RFC
opinion. See Kamann v. Colvin, 721 F.3d 945, 948-51 (8th Cir. 2013)
(rejecting claimant’s argument that the ALJ “formulated his own medical
opinion” when the ALJ rejected the RFC opinion of the one-time examining
psychologist and instead relied on a “thorough[] review[] [of] years of
medical evidence on record” to formulate an opinion “consistent with the
views of . . . the reviewing agency psychologist”); Krogmeier v. Barnhart,
294 F.3d 1019, 1023-24 (8th Cir. 2002) (holding that some medical
evidence supported the ALJ’s RFC determination when he rejected the
treating source’s RFC opinion and relied on the opinion of a consulting
physician and an independent review of the medical evidence); see also
Stormo v. Barnhart, 377 F.3d 801, 806-807 (8th Cir. 2004) (finding some
medical evidence supported the ALJ’s physical RFC determination when it
was consistent with the state agency medical consultants’ opinions, and at
least one treating physician’s physical RFC opinion was in the record but
assigned non-controlling weight).
Doc. No. 15 at 11-13. Judge Mahoney found that the ALJ properly weighed and
considered the medical opinions of Drs. Perri, Staudacher, Gernes, Quinn, and Shafer,
as well as Mr. Englestad, a certified school psychiatrist who examined Williams once.
Id. at 13. Judge Mahoney noted that the state agency medical consultants evaluated each
of the impairments that the ALJ found severe, and that their RFC assessments were
consistent with the ALJ’s. Id. at 12. Additionally, Judge Mahoney observed that the
ALJ adopted most of the limitations recommended by Mr. Engelstad and that the ALJ
conducted an independent review of the medical evidence. Id. Judge Mahoney found
that substantial medical evidence in the record as a whole supported the ALJ's findings.
Id. at 13.

8

IV.
A.

DISCUSSION

Williams’ Objections
Williams objects to Judge Mahoney’s findings that (1) the ALJ properly weighed

the medical opinions of Dr. Perri and (2) the ALJ's RFC is supported by substantial
medical evidence.
B.

I review those issues de novo.

Dr. Perri’s Medical Opinions
Williams argues that the ALJ failed to give proper weight to Dr. Perri’s medical

opinions regarding Williams’ RFC. Williams argues that Dr. Perri’s opinions were
materially different from those of the state agency consultants and consistent with the
medical record as a whole. Doc. No. 12 at 10-13. An opinion by a treating physician
must be given “controlling weight” if it “is well-supported by medically acceptable
clinical and laboratory diagnostic techniques and is not inconsistent with the other
substantial evidence.” Papesh v. Colvin, 786 F.3d 1126, 1132 (8th Cir. 2015) (quoting
Wagner v. Astrue, 499 F.3d 842, 848-49 (8th Cir. 2007)); see also 20 C.F.R. §§
404.1527(c)(2), 416.927(c)(2); 82 Fed. Reg. at 5869-70, 5880-81. The ALJ must give
“good reasons . . . for the weight [the ALJ gives a] treating source’s medical opinion.”
20 C.F.R. § 404.1527(c)(2); see also Singh v. Apfel, 222 F.3d 448, 452 (8th Cir. 2000).
Based on my de novo review, I find no error.
Dr. Perri provided three medical opinions regarding Williams’ RFC. In a letter
dated August 30, 2012, Dr. Perri opined that “Williams suffers from multiple medical
problems and . . . [will not] be able to return to the workforce.” AR at 1263. Dr. Perri
went on to describe Williams’ diagnoses, symptoms, and limitations:
She has chronic low back pain and has undergone a thorough
evaluation for that. She is really not suited to bend, stoop, kneel, or crawl.
She can only walk about half a block and then she has to stop because of
pain and shortness of breath . . . . She sees a psychiatrist for chronic anxiety
and is limited in what she can handle in terms of stress. She cannot work
in any stressful environments including dust, fumes, temperature hazards
9

due to her asthma. She has moderately severe problems in speaking with
chronic hoarse voice and has undergone surgery on her vocal cord nodules,
speech therapy, and has a permanent, pretty significant hoarse voice . . . .
Given this patient’s mental conditions and limited education, severe
anxiety, chronic pain and medications used to treat chronic pain is not really
able to follow instructions all that well. Throughout her life she has made
poor decisions. I do not think she is going to be able to interact in the
workplace gainfully with the public whatsoever or her coworkers. She does
not demonstrate good judgment though I think she could give an attempt to
deal with her own finances, although that may be even questionable
somewhat as well.
On today’s exam she is constantly moving about the room, voice is
hoarse, stands up bent over, thoughts are scattered, etc.
AR at 1263-64. In forms dated June 10, 2013, and October 17, 2013, Dr. Perri provided
the ALJ with substantially similar information.

AR at 1294-96, 1568-71.

Judge

Mahoney found minor inconsistencies between the specific limitations imposed by Dr.
Perri (Doc. No. 15 at 9-10), but none of these are significant to the determination. In
addition to these opinions, the ALJ reviewed extensive medical records regarding
Williams’ treatment in Dr. Perri’s office dating back to January 2011. AR at 729-819,
872-1007, 1196-1252, 1262-64, 1294-96, 1320-1446, 1460-68, 1501-03, 1565-71. The
ALJ reviewed these records in the context of the record as a whole. AR at 27-28.
The ALJ afforded Dr. Perri’s opinions “little weight,” finding the medical record
does not support the work limitations she endorsed. AR at 27-28. Specifically, the ALJ
stated that Dr. Perri’s opinions were inconsistent with the record as a whole, and “rel[y]
on complete acceptance of the claimant’s . . . self-serving symptoms and functional
limitations,” which the ALJ also found to be unreliable. Id. Like Judge Mahoney, I find
that substantial evidence supports the ALJ’s finding that Dr. Perri relied heavily on
Williams’ subjective behaviors over other, objective evidence as to the extent of
Williams’ disability. Moreover, like Judge Mahoney, I find that Dr. Perri’s reliance on
10

Williams’ discredited subjective complaints is a “good reason” for an ALJ to discount
the opinion of a treating source. See Finch, 547 F.3d at 936-37, Reece v. Colvin, 834
F.3d 904, 909 (8th Cir. 2016); Julin v. Colvin, 826 F.3d 1082, 1085, 1089 (8th Cir.
2016); Cline v. Colvin, 771 F.3d 1098, 1104 (8th Cir. 2014). But see Papesh, 786 F.3d
at 1132-33 (ALJ erred in discounting treating doctor’s opinions because they were based
on plaintiff’s subjective behaviors, where ALJ did not find that the treating doctor’s
opinions were inconsistent with the record as a whole).
Although there is some medical evidence to support Dr. Perri’s diagnoses, the
limitations drawn from these diagnoses are inconsistent with the objective findings by
Williams’ other treating physicians and the state agency medical consultant. AR at 13135, 152-54. Ultimately, claimant bears the burden to demonstrate her disability. See
Eichelberger v. Barnhart, 390 F.3d 584, 591 (8th Cir. 2004). The record as a whole
indicates that Williams was not a reliable source of information for her own limitations.
Her subjective presentation of her symptoms was described as “rather dramatic” and
“quite extraordinary compared to the numerous patients I treat with chronic back pain.”
AR at 881. Dr. Perri observed Williams “twitching with spasms a fair amount,” but
stated that it was “[h]ard to say whether [the twitching] is volitional or not” and that the
twitching was “somewhat dramatic.” AR at 885.
When seeking pain medication, Williams constantly and restlessly paced the room,
“bent over,” yet she could stand and walk straight when instructed to do so. AR at 877,
881. Doctors did not observe these problems when Williams was seeking treatment for
her vocal cord or mental health issues. AR at 825, 10012, 1125, 1128. Williams objects
that the silence of her physicians on this behavior is not dispositive. See Taylor v. Chater,
118 F.3d 1274, 1278 (8th Cir. 1997) (ALJ may not find inconsistencies in the record
based solely on physicians’ silence, where physicians were not treating claimant’s back
pain); Howard v. Astrue, No. 4:10 CV 1389 JCH, 2011 WL 4007936 at *7 (E.D. Mo.
Sept. 8, 2011) (ALJ may not base functional determination “solely on the silence of
11

claimant’s physicians”); Freeman v. Astrue, Civ. No. 10-2094, 2011 WL 2600636 at *3
(W.D. Ark. June 30, 2011) (ALJ may not consider “a treating doctor's silence on the
claimant's work capacity” as substantial evidence where “the doctor was not asked to
express an opinion on the matter and did not do so.”). However, the silence of Williams’
other physicians is not the only factor that the ALJ considered in discounting Dr. Perri’s
opinions.

The medical record shows repeated “normal” or “negative” objective

observations related to Williams’ back pain and back and extremity strength. AR at 583,
587, 595, 608, 641, 652, 684, 702, 709, 713, 743, 751, 756, 766, 859, 896, 1001, 1328.
Williams’ drug-seeking behavior is also well-documented.

On multiple occasions,

Williams went to the emergency room asking for specific pain-killers, telling the
emergency room staff that her doctor was out of town or otherwise unavailable, in spite
of signing a pain contract agreeing to seek pain relief only from Dr. Perri. AR at 70506, 774, 844-48, 870, 887-91, 1081.
Objective imaging of Williams’ spine shows only “[m]ild disk bulging at L4-L5
and to a lesser at L3-L4. Otherwise unremarkable MR lumbar spine.” AR at 726.
Williams’ described limitations are inconsistent with the fact that she threw a door into a
neighbor’s dumpster. AR at 823. Each of these inconsistencies—the negative objective
findings, the drug-seeking behavior, and the disparity between the severity of Williams’
degenerative disc disease, alleged limitations, and actions—distinguish Williams’ case
from Taylor. In Taylor, the silent records were not inconsistent because the physicians
“made no attempt to catalog [the claimant’s] every pain and her behavior resulting from
the pain.” 118 F.3d at 1278. Contrary to Taylor, Williams’ physicians’ reports ranged
from silent to negative to careful attempts to catalogue Williams’ pain, out of fear that
she was seeking addictive narcotics.
The state agency doctors whose opinions the ALJ gave greater weight took all of
this information into account, including the limited positive findings of degenerative disc
disease, and reached RFC opinions inconsistent with Dr. Perri’s. AR at 131-35, 152-54.
12

In light of these inconsistencies, the ALJ did not err in discounting Dr. Perri’s medical
opinions and finding that Williams had a greater RFC than reported by Dr. Perri. I find
no error with the ALJ's finding. Williams’ objection is overruled.
C.

The RFC Assessment
Williams also argues that the ALJ's RFC assessment is not supported by

substantial medical evidence. Williams contends the RFC is flawed because it is not
supported by any treating or examining source, suggesting that the ALJ failed to fully
develop the record. I disagree.
The ALJ found that Williams had the RFC to perform a range of light work as
defined in 20 C.F.R. § 404.1567(b) and § 416.967(b). Specifically:
The claimant can lift and/or carry and push and/or pull twenty pounds
occasionally, ten pounds frequently. She can stand and/or walk, with
normal breaks, for a total of six hours in a workday. She can sit, with
normal break, for a total of six hours in a workday. The claimant can
balance, crouch, stoop, kneel, crawl, and climb occasionally. The
claimant can perform simple tasks. She can work with co-workers and
supervisors on an incidental basis. She cannot work with the public. She
cannot perform fast-paced work. The claimant is not able to do telephone
work. She should not manage money or drive.
AR at 18. In reaching this conclusion, the ALJ considered all medical opinions
according to 20 C.F.R. § 404.1527 and § 416.927, in addition to Social Security Ruling
96-2p, Ruling 96-5p, Ruling 96-6p, and Ruling 06-3p. Id. The ALJ weighed the
nature and length of each treating relationship, their areas of specialty, and the findings
supporting their opinions. Id. Ultimately, the matter of a claimant’s RFC is an issue
reserved for the ALJ. Wagner, 499 F.3d at 849 see also 20 C.F.R. §§ 404.1527(d),
416.927(d). The ALJ’s RFC determination must be supported by substantial evidence,
which includes medical evidence, that is to say the ALJ may not ordinarily make an
RFC determination without the benefit of opinion evidence from a treating source.
13

Nevland v. Apfel, 204 F.3d 853, 857 (8th Cir. 2000); Fitzgerald Morris v. Colvin, No.
C14-4068-LTS, 2016 WL 3360506 at *8-9 (N.D. Iowa June 16, 2016). However, as
this court has explained, “ordinarily” does not mean “never”: “[I]f other medical
evidence in the record clearly establishes a claimant's RFC to do other work, and to
function in the workplace, the absence of an opinion from examining physicians may
not require remand.” Kruger v. Colvin, No. C13–3036–MWB, 2014 WL 1584411, at
*10 (N.D. Iowa Apr. 21, 2014) (citing Nevland, 204 F.3d at 858; Hattig v. Colvin,
No. C12–4092 MWB, 2013 WL 6511866, at *10 (N.D. Iowa Dec. 12, 2013)). The
question is whether the lack of opinion evidence from a treating or examining source
is overcome by other medical evidence that clearly establishes the claimant’s RFC.
Fitzgerald Morris, 2016 WL 3360506 at *10.
I find that the ALJ’s RFC determination was consistent with, and fully accounted
for, work limitations supported by substantial evidence. See Buford v. Colvin, 824
F.3d 793, 797 (8th Cir. 2016) (finding the ALJ’s residual functional capacity
assessment was supported by substantial evidence, noting that it was consistent with
the limitations identified by the reviewing consultant). Further, regardless of Dr.
Perri’s RFC opinion, this is not a Nevland case in which the ALJ inferred her own
medical opinions without the benefit of an appropriate medical source. Instead, the ALJ
did have the benefit of opinion evidence from a treating source, and relied at least in
part on Dr. Perri’s objective findings, as well as the objective findings of other
physicians in Williams’ medical record. Finally, I find that the lack of a substantially
weighted medical opinion regarding RFC is overcome in this case by other objective
medical evidence that clearly establishes Williams’ mental and physical RFC.
Fitzgerald Morris, 2016 WL 3360506 at *10.
The ALJ’s reliance on the state agency consultants’ opinions provided substantial
evidence for the ALJ’s RFC assessment. See Buford, 824 F.3d at 797 (finding that the
ALJ did not have to obtain “an opinion from a treating or consultative doctor as to
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Buford’s work related limitations” because “medical assessments of state agency
medical consultants as to Buford’s limitations are of record and were expressly
considered by the ALJ.”). An ALJ’s RFC findings do not need to “be supported by a
specific medical opinion.” Hensley v. Colvin, 829 F.3d 926, 932 (8th Cir. 2016).
Here, the ALJ relied upon the reports of Mr. Englestad and Drs. Quinn and Shafer as
to Williams’ mental impairments, and relied on Drs. Staudacher’s and Gernes’
evaluations regarding the effects of Williams’ degenerative disc disease on her physical
RFC. AR at 18, 21, 29. Drs. Staudacher and Gernes gave some weight to Dr. Perri’s
opinions, and relied on the objective findings of back pain and other medical
impairments to determine the extent of Williams’ physical limitations. Indeed, the ALJ
would not have found limitations in lifting, standing, and walking without those
opinions. However, as stated above, the ALJ properly discounted portions of the
medical evidence that went to the extent of Williams’ physical limitations because they
were based on Williams’ unsupported subjective complaints.
Based on my de novo review, I find the RFC is supported by substantial evidence.
Williams’ objection is overruled.
V.

CONCLUSION

For the reasons set forth herein:
1.

Plaintiff Tammy I. Williams’ objections (Doc. No. 16) to the Report and

Recommendation are overruled.
2.

I accept United States Magistrate Judge Kelly K.E. Mahoney’s Report and

Recommendation (Doc. No. 15) without modification. See 28 U.S.C. § 636(b)(1).
3.

Pursuant to Judge Mahoney’s recommendation:
a.

The Commissioner’s determination that Williams was not disabled is

affirmed; and

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b.

Judgment shall enter against Williams and in favor of the

Commissioner.
IT IS SO ORDERED.
DATED this 16th day of August, 2017.

__________________________
Leonard T. Strand, Chief Judge

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