Smith v. Colvin

Filing 27

MEMORANDUM AND ORDER. IT IS HEREBY ORDERED that the final decision of the Commissioner denying social security benefits is AFFIRMED. A separate Judgment in accordance with this Memorandum and Order is entered this same date.. Signed by District Judge Ronnie L. White on 3/1/16. (MRS)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
SOUTHEASTERN DIVISION
KENNETH L. SMITH, JR.,

Plaintiff,
v.

CAROLYN W. COLVIN,
Acting Commissioner of Social Security,
Defendant.

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No. 1:14CV140 RLW

MEMORANDUM AND ORDER
This is an action under 42 U.S.C. § 405(g) for judicial review of Defendant's final
decision denying Plaintiffs application for Disability Insurance Benefits ("DIB") under Title II
of the Social Security Act. For the reasons set forth below, the Court affirms the decision of the
Commissioner.

I. Procedural History
On September 13, 2012, Plaintiff filed an application for DIB alleging disability
beginning August 10, 2012 due to severe insomnia, severe social anxiety disorder, and borderline
intellectual functioning. (Tr. 13, 55-56, 98-99) The application was denied, and Plaintiff filed a
request for a hearing before an Administrative Law Judge ("ALJ''). (Tr. 43-62) On February 19,
2014, Plaintiff testified at a hearing before the ALJ. (Tr. 26-42) On April 4, 2014, the ALJ
determined that Plaintiff had not been under a disability from August 10, 2012 through the date
of the decision. (Tr. 13-22) Plaintiff then filed a request for review, and on August 14, 2014, the
Appeals Council denied Plaintiff's request. (Tr. 1-3) Thus, the decision of the ALJ stands as the
final decision of the Commissioner.

II. Evidence Before the ALJ
At the February 19, 2014 hearing before the ALJ, Plaintiff appeared without an attorney.
Plaintiff acknowledged his right to obtain counsel but stated his desire to go forward with the
hearing unrepresented. Plaintiff testified that he was 30 years old. He finished the ninth grade
and took special education classes. He took the test for his GED but did not pass. Plaintiff was
able to read and write at a basic level. He was divorced and did not have children. He lived
alone. Plaintiff did not have a driver's license and testified that he walked everywhere. He was
previously in the Merchant Marines, and his last job was as a deck hand. Plaintiff testified that
he stopped working because he had a nervous breakdown due to the stress of the job. He was
unable to sleep. Plaintiff stated that he was still messed up and saw a psychologist twice a
month. (Tr. 28-33)
Plaintiff testified that he was able to take care of his housework. He usually went out to
eat, but he was able to cook. He had a computer but had problems understanding. He did not
use any social networks. Plaintiff was able to shop for food and clothes. Plaintiff stated that he
was unable to work because of his lack of social skills. He previously witnessed a murder and
had been through a lot emotionally. When he was stressed at work, he felt as though the world
was coming down on him. He became agitated and shaky, and he just wanted to be alone.
Plaintiff further testified that he had been in and out of the ER and the psychiatric ward over the
last several years. Plaintiff had friends but did not do much socializing with them. Plaintiffs
doctor told him that he was narcissistic, which Plaintiff thought explained his difficulty being
around certain people. Plaintiff did not date, but he had a supportive family. Plaintiff used to get
along with co-workers but was more agitated around them after his breakdown. He had a decent
relationship with his boss but thought his boss and co-workers were careful around him because

2

they were afraid he would snap. Plaintiffs co-workers did not typically complain about his
work; however, when they did, his stress would build up. Plaintiff testified that he went to the
hospital after an argument with his girlfriend. He had also been in the hospital a month ago. (Tr.
33-38)
A vocational expert ("VE") also testified at the hearing. The ALJ asked the VE to
assume an individual the same age, educational background, and work history of the Plaintiff.
He had exertional limitations limited to jobs consisting of simple, routine, and repetitive tasks.
In addition, while he could work in close proximity to others, he was limited to jobs that did not
require close cooperation and interaction with co-workers. He could have only occasional
interaction and cooperation with the general public. Further, the individual retained the ability to
maintain attention and concentration for a minimum of two hour periods at a time, as well as
adapt to changes at the workplace on a basic level instead of supervision. Given this
hypothetical, the VE testified that the individual could perform Plaintiffs past work as hanger.
In addition, he could work as a tumbler operator, boring machine tender, and finisher operator.
These jobs were medium unskilled occupations. If the ALJ added that the individual was unable
to consistently interact and cooperate with co-workers and supervisors, he would be unable to
perform those or any other jobs. (Tr. 38-41 )
In a Function Report - Adult dated September 25, 2012, Plaintiff stated that he could not
be around other people. He was able to care for his personal needs but did not cook. He went
outside all the time. Plaintiff walked but did not drive due to a DWI. He did not like to shop,
and he did not spend time with others. He reported that he had problems getting along with
family, friends, and others and that they hated being with him. Plaintiffs conditions affected his
ability to understand, follow instructions, and get along with others. He was unable to pay

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attention at all. He could not follow written instructions, and he did not follow spoken
instructions very well. Plaintiff was fired from his job at Tyson Tools because he had problems
getting along with others. He could not handle stress or changes in routine. Plaintiff stated that
he wished he could work, but he was unable to take the stress. (Tr. 141-51)

III. Medical Evidence
In 1999, when Plaintiff was in eighth grade, he underwent intellectual testing through the
Poplar Bluff school district. His verbal IQ was 70; his performance IQ was 65; and his full scale
IQ was 65. The evaluation indicated that he was functioning at the intellectually deficient range.
School records showed that problems academically, he did not exhibit social or behavioral
problems. (Tr. 207-95)
On September 23 , 2006, Paul W. Rexroat, Ph.D., performed a consultative psychological
examination of Plaintiff. Dr. Rexroat noted that Plaintiff presented an adequate appearance, with
appropriate dress and general well-grooming. Plaintiff was socially confident and comfortable in
his interactions with Dr. Rexroat. He generally understood instructions. He exhibited an
appropriate attitude towards the evaluation and maintained good interest and effort. Dr. Rexroat
assessed a verbal scale IQ of 72, performance scale IQ of 59, and full scale IQ of 64, which fell
within the extremely low (mild mental retardation) range of intellectual abilities. Dr. Rexroat
opined that Plaintiff could understand and remember simple instructions and sustain
concentration and persistence with simple tasks. He had marked limitations in his ability to
interact socially and moderate limitations in his ability to perform basic activities of daily living.
Further, Dr. Rexroat did not believe Plaintiff could manage his own money because of his low
level of intelligence. Dr. Rexroat diagnosed panic disorder without agoraphobia; mild mental
retardation; occupational, financial, and educational problems; and a Global Assessment

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Functioning ("GAF") score of 54. 1 Plaintiffs motivation was good, and his prognosis was
guarded. (Tr. 299-303)
On October 9, 2012, Ben Lanpher, Ph.D., a licensed psychologist, performed a
psychological evaluation at the request of Disability Determinations. Plaintiff reported that he
had not received mental health counseling but had been prescribed psychotropic medications in
the past. His current symptoms included generalized anxiety and social isolation. He described
being shaky and panicky when around other people. He experienced episodes of anger and
irritability, which had increased over the past year and a half. Plaintiff also reported symptoms
of depression, including sleep problems and feelings of inadequacy. Dr. Lanpher noted that
Plaintiff appeared to be functioning within the borderline range of intellectual ability. However,
past records revealed an IQ score in the range of mild mental retardation. Plaintiff appeared to
have a severe learning disability in written expression. He also exhibited symptoms of social
anxiety and depression. Dr. Lanpher assessed social phobia; depressive disorder, NOS;

The Court notes that the Diagnostic and Statistical Manual of Mental Disorders
("DSM")-V was released in 2013 and replaced the DSM-IV. The DSM-V "no longer uses GAF
scores to rate an individual' s level of functioning because of 'its conceptual lack of clarity' and
' questionable psychometrics in routine practice."' Alcott v. Colvin, No. 4:13-CV-01074-NKL,
2014 WL 4660364, at *6 (W.D. Mo. Sept. 17, 2014) (citing Rayford v. Shinseki, 2013 WL
3153981 , at *1 n.2 (Vet. App. 2013) (quoting the DSM-V)). However, because the DSM-IV
"was in use when the medical entries were made and the [ALJ' s] decision was issued in this
matter, the Global Assessment of Functioning scores remain relevant for consideration in this
appeal." Rayford, 2013 WL 3153981 , at *1 n.2.
Under the Diagnostic and Statistical Manual of Mental Disorders, a GAF score of 31 to
40 indicates "some impairment in reality testing or communication ... OR major impairment in
several areas such as work or school, family relations, judgment, thinking, or mood . ... "
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) 34 (4th ed. 2000). A GAF
of 41 to 50 indicates "serious symptoms ... OR any serious impairment in social, occupational,
or school functioning (e.g. , few friends, unable to keep a job)." Id. A GAF score of 51 to 60
indicates "moderate symptoms . . . OR moderate difficulty in social, occupational, or school
functioning," and a GAF score of 61 to 70 indicates "some mild symptoms . . . OR some
difficulty in social, occupational, or school functioning ... but generally functioning pretty well,
has some meaningful interpersonal relationships." Id.

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borderline intellectual functioning, rule out mild mental retardation; borderline hypertension and
high cholesterol; possible heart problem; problems in social network, severe; and a GAF of 47.
Dr. Lanpher opined that Plaintiff was moderately to markedly impaired in his ability to
understand instructions; mildly to moderately impaired in his ability to remember instructions;
moderately to markedly impaired in his ability to sustain concentration; markedly impaired in his
ability to interact socially; moderately to markedly impaired in his ability to adapt to his
environment and persist in tasks; and capable of managing his finances . (Tr. 322-25)
Charles W. Watson, Psy. D., the non-examining medical consultant, evaluated Plaintiffs
claim on November 15, 2012 and determined that the Dr. Lanpher' s opinion was entitled to some
weight but not significant weight. Dr. Watson noted inconsistencies between the stated abilities
and the objective data provided by Dr. Lanpher. Further, the opinion was inconsistent with
Plaintiffs recent work history. Dr. Watson noted that Plaintiffs adaptive function was
inconsistent with mild mental retardation and that he was able to work despite his anxiety. In
addition, Plaintiff had not pursued treatment for anxiety. Dr. Watson opined that Plaintiffs
impairments did not meet the listings criterion for mental retardation, anxiety, or substance
addiction disorders. Dr. Watson concluded that Plaintiff retained the capacity to acquire and
retain simple instructions and sustain concentration and persistence with simple, repetitive tasks.
Further, Plaintiff appeared to have the capacity to adapt to changes in settings that did not require
frequent contact with the public or very close interactions with others in the workplace. (Tr. 4354)
On November 20, 2012, Plaintiff presented to the ER complaining that he believed
someone drugged him at a bar. Plaintiff appeared anxious and requested diazepam to calm him
down. He reported using street drugs and cocaine on occasion. His mood was cooperative. Lab

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results were negative, and Plaintiff was discharged in stable condition and encouraged to seek
outpatient help from a family practitioner. (Tr. 402-07) Plaintiff returned to the ER on
November 23 , 2012 seeking alcohol detoxification. He was discharged the same day with a
diagnosis of anxiety and alcoholism. Plaintiff was referred to an outpatient drug and alcohol
rehabilitation facility. (Tr. 397-401) On December 25, 2012, the police brought Plaintiff to the
ER for alcohol intoxication and homicidal ideation. (Tr. 388-91 )
Plaintiff was admitted to the hospital on May 8, 2013 after presenting to the ER feeling
suicidal and mildly homicidal. He stated that he argued with his mother and became enraged at
her and his stepfather. Diagnoses upon admission were cyclothymic disorder, major depression,
generalized anxiety, and a GAF of 35. Plaintiff reported that he was not as serious drinker. He
was given Tegretol and Celexa, after which his affect brightened, and his mood stabilized.
Plaintiff was discharged the following day with a diagnoses of major depression, severe,
recurrent; mild narcissistic personality; and a GAF of 40. (Tr. 328-38, 373-83) Plaintiff returned
to the ER on November 1, 2013 for complaints of drug abuse. He was discharged that same date
in stable condition with a diagnosis of substance abuse. (Tr. 369-72)
Plaintiff began treatment with John Wood, Psy. D. , on November 4, 2013, after Plaintiff
witnessed his mother shoot and kill his stepfather in May 2013 . He reported experiencing a
feeling of helplessness and detachment. He was startled by loud noises. Dr. Wood noted that
Plaintiff met some of the PTSD criteria but that some of his problems could have been present
prior to the incident. Plaintiff reported drinking 10 to 20 beers per day, along with occasional
mixed drinks. He previously used cannabis and cocaine but denied current drug use. Dr. Wood
noted that Plaintiffs speech was clear, but his organization of thought was loose and rambling.
His affect was constricted, and he seemed detached when talking about the incident. Dr. Wood

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further noted that Plaintiff did not appear to be in acute distress. He did not exhibit abnormal
mental trends involving delusions or hallucinations or any homicidal and suicidal ideation. Dr.
Wood assessed PTSD (mild), mood disorder, and personality disorder. (Tr. 409-10)
Plaintiff returned to Dr. Wood on November 19, 2013. Plaintiff reported continued
problems with sleep disturbance and disturbing thoughts. He reported drinking 30 beers a day at
one time but now drank a case of beer per week. Dr. Wood assessed Plaintiffs alcohol use as a
means of self-medicating. He diagnosed PTSD; mood disorder, NOS; and personality disorder,
NOS. On December 3, 2013, Plaintiff reported improved sleep. However he replayed seeing his
mother shoot his stepfather when drifting to sleep. Plaintiff returned to Dr. Wood on December
18, 2013. Plaintiff believed he was making progress but at a slow rate. He was still startled by
loud noises, and he continued to drink but thought his drinking was not excessive. Dr. Wood
opined that Plaintiff seemed to minimize his alcohol use. (Tr. 414-20)
On January 11 , 2014, Plaintiff presented to the ER and was admitted by court order to the
mental health unit. Plaintiff claimed that someone put something in his drink. He reported
occasional marijuana use and rare alcohol use. Upon mental status examination, Dr. Michelle
Powers assessed psychosis, schizophrenia, possible alcohol dependence; Plaintiffs reported
narcissistic personality diagnosis; and a GAF of 30. Plaintiff was discharged on January 14,
2014 with diagnoses of major depression with psychosis; antisocial personality with narcissistic
traits; Leukocytosis; and a GAF of 45-50. Dr. David Fontaine noted that Plaintiff was no longer
paranoid and instructed him to follow through with local mental health treatment. (Tr. 347-357)
Plaintiff saw Dr. Wood again on January 15, 2014. Plaintiff reported that someone
spiked his drink because he did not take any drugs, yet the tested positive for barbiturates,
methamphetarnines, and opium. Dr. Wood noted that Plaintiff expressed some signs of paranoia

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and/or delusional thinking. Plaintiff reported doing much better, with improved sleep and no
nightmares involving the incident. He acknowledged that alcohol use caused him some
problems but did not view his use of alcohol as problematic. On January 29, 2014, Plaintiff
reported sleeping for a few hours, waking up for a while, and falling back asleep for a few more
hours. He reported doing better overall. He cut back on his alcohol and drug use and was
feeling better. He tried to get out and do things, sometimes with people he knew. Dr. Wood
assessed PTSD, mood disorder NOS, and alcohol abuse. During an appointment on February 12,
2014, Plaintiff reported doing fairly well, with stable sleep. He continued to have flashbacks of
the shooting but did not think that interfered with his ability to perform activities of daily living.
He continued to limit his alcohol intake and drank only a 12 pack of beer since his last
appointment. (Tr. 411-413)
IV. The ALJ's Determination
In a decision dated April 4, 2014, the ALJ found that Plaintiff meets the insured status
requirements of the Social Security Act through December 31 , 2017. He had not engaged in
substantial gainful activity since August 10, 2012, the alleged onset date. Plaintiffs severe
impairments included borderline intellectual functioning, anxiety disorders, depression/mood
disorders, personality disorder, and alcohol abuse. Nothing in the record supported Plaintiffs
allegations of a medically determinable sleep disorder. The ALJ further determined that Plaintiff
did not have an impairment or combination of impairments that met or medically equaled the
severity of one of the listed impairments. The ALJ found mild restriction to activities of daily
living; moderate difficulties with social functioning; moderate difficulties with concentration,
persistence, or pace; and no episodes of decompensation which have been of extended duration.
Therefore, Plaintiffs mental impairments did not satisfy "paragraph B" criteria. Further, the

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ALJ found no evidence of chronic affective disorder of two years' duration resulting in marginal
adjustment or inability to function outside a highly supportive living arrangement. He also found
no evidence that Plaintiffs anxiety resulted in a complete inability to function outside the area of
his home such that "paragraph C" criteria was not satisfied. (Tr. 13-17)
The ALJ determined that Plaintiff had the RFC to perform a full range of work at all
exertional levels with some nonexertional limitations. Plaintiff was limited to jobs consisting of
simple routine, repetitive tasks. He could work in proximity to others but was limited to jobs
that did not require close cooperation and interaction with co-workers. The ALJ stated that
Plaintiff would work best in relative isolation. Plaintiff was limited to only occasional
interaction and cooperation with the general public. He could maintain attention and
concentration for minimum 2 hour periods at a time, adapt to changes in the workplace on a
basic level, and accept supervision on a basic level. (Tr. 17-20)
Although Plaintiff was unable to perform any past relevant work, considering his younger
age, limited education, work experience, and RFC, the ALJ found that jobs existed in significant
numbers in the national economy which Plaintiff could perform. The ALJ relied on the VE' s
testimony to find Plaintiff could work as a tumbler operator, boring machine tender, and finisher
operator. Thus, the ALJ concluded that Plaintiff had not been under a disability, as defined by
the Social Security Act, at any time from August 10, 2012 through the date of the decision. (Tr.
20-22)

V. Legal Standards
A claimant for social security disability benefits must demonstrate that he or she suffers
from a physical or mental disability. The Social Security Act defines disability "as the inability
to do any substantial gainful activity by reason of any medically determinable physical or mental

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impairment which can be expected to result in death or which has lasted or can be expected to
last for a continuous period of not less than 12 months." 20 C.F.R. § 404.1505(a).
To determine whether a claimant is disabled, the Commissioner engages in a five step
evaluation process. See 20 C.F.R. § 404.1520(a)(4). Those steps require a claimant to show: (1)
that claimant is not engaged in substantial gainful activity; (2) that he has a severe physical or
mental impairment or combination of impairments which meets the duration requirement; or (3)
he has an impairment which meets or exceeds one of the impairments listed in 20 C.F.R.,
Subpart P, Appendix 1; (4) he is unable to return to his past relevant work; and (5) his
impairments prevent him from doing any other work. Id.
The Court must affirm the decision of the ALJ if it is supported by substantial evidence.
42 U.S.C. § 405(g). "Substantial evidence means less than a preponderance, but sufficient
evidence that a reasonable person would find adequate to support the decision." Hulsey v.
Astrue, 622 F .3d 917, 922 (8th Cir. 2010). "We will not disturb the denial of benefits so long as

the ALJ's decision falls within the available zone of choice. An ALJ's decision is not outside the
zone of choice simply because we might have reached a different conclusion had we been the
initial finder of fact. " Buckner v. Astrue, 646 F.3d 549, 556 (8th Cir. 2011) (citations and internal
quotations omitted). Instead, even if it is possible to draw two different conclusions from the
evidence, the Court must affirm the Commissioner' s decision if it is supported by substantial
evidence. See Young v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000).
To determine whether the Commissioner' s final decision is supported by substantial
evidence, the Court must review the administrative record as a whole and consider: (1) the
credibility findings made by the ALJ; (2) the plaintiffs vocational factors; (3) the medical
evidence from treating and consulting physicians; (4) the plaintiffs subjective complaints

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regarding exertional and non-exertional activities and impairments; (5) any corroboration by
third parties of the plaintiffs impairments; and (6) the testimony of vocational experts when
required which is based upon a proper hypothetical question that sets forth the plaintiffs
impairment. Johnson v. Chater, 108 F.3d 942, 944 (8th Cir. 1997) (citations and internal
quotations omitted).
The ALJ may discount a plaintiffs subjective complaints if they are inconsistent with the
evidence as a whole, but the law requires the ALJ to make express credibility determinations and
set forth the inconsistencies in the record. Marciniak v. Shalala, 49 F.3d 1350, 1354 (8th Cir.
1995). It is not enough that the record contain inconsistencies; the ALJ must specifically
demonstrate that she considered all the evidence. Id.
When a plaintiff claims that the ALJ failed to properly consider subjective complaints,
the duty of the court is to ascertain whether the ALJ considered all of the evidence relevant to
plaintiffs complaints under the Polaski2 factors and whether the evidence so contradicts
plaintiffs subjective complaints that the ALJ could discount the testimony as not credible.

Blakeman v. Astrue , 509 F .3d 878, 879 (8th Cir. 2007) (citation omitted). If inconsistencies in
the record and a lack of supporting medical evidence support the ALJ ' s decision, the Court will
not reverse the decision simply because some evidence may support the opposite conclusion.

Marciniak, 49 F.3d at 1354.

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The Eight Circuit Court of Appeals "has long required an ALJ to consider the following
factors when evaluating a claimant's credibility: ' (1) the claimant's daily activities; (2) the
duration, intensity, and frequency of pain; (3) the precipitating and aggravating factors; (4) the
dosage, effectiveness, and side effects of medication; (5) any functional restrictions; (6) the
claimant's work history; and (7) the absence of objective medical evidence to support the
claimant's complaints."' Buckner, 646 F.3d at 558 (quoting Moore v. Astrue, 572 F.3d 520, 524
(8th Cir. 2009) (citing Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984)).
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VI. Discussion
Construing Plaintiffs prose Complaint liberally, Plaintiff appears to argue three points
of error. Jackson v. Nixon , 747 F.3d 537, 544 (8th Cir. 2014). First, Plaintiff asserts that the
ALJ failed to give proper weight to the expert opinions in the case. Second, Plaintiff maintains
that the ALJ did not properly rely on the VE' s testimony in finding that he could perform other
work because the VE testified there were no jobs Plaintiff could perform. Finally, Plaintiff
argues that the overwhelming evidence shows that he has a narcissistic personality disorder that
is difficult to treat and entitles him to benefits.
At the outset, although Plaintiff does not raise this argument in his brief, the Court notes
that the ALJ properly determined that Plaintiff did not meet or medically equal the severity of
Listing 12.05 for Intellectual Disability. 20 C.F.R. Pt. 404, Subpt. P, App. 1 § 12.05. 3 The ALJ
found that school records indicated learning problems in all areas of academic functioning.
However, teachers observed that he could function normally in the social arena, and special
education teachers were working with him to develop basic life skills. The ALJ noted that,
despite a full scale IQ score of 64 in 2006, he was able to work for 5 years at a barge company
and 5 years prior to that at a food processing plant. In addition, he could cook meals and
perform household chores. Finally, Dr. Charles Watson opined that Plaintiffs adaptive

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The required level of severity for an intellectual disability is met where a claimant shows:
C. A valid verbal, performance, or full scale IQ of 60 through 70 and a physical or
other mental impairment imposing an additional and significant work-related
limitation of function; ORD. A valid verbal, performance, or full scale IQ of 60
through 70, resulting in at least two of the following:
1.
2.
3.
4.

Marked restriction of activities of daily living; or
Marked difficulties in maintaining social functioning; or
Marked difficulties in maintaining concentration, persistence, or pace; or
Repeated episodes of decompensation, each of extended duration.
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functioning was inconsistent with mild mental retardation. (Tr. 17) "Working generally
demonstrates an ability to perform a substantial gainful activity." Gojf v. Barnhart, 421 F.3d
785, 792 (8th Cir. 2005); see also Rock v. Colvin, No. 2:14-CV-00078 JAR, 2015 WL 5560279,
at *7 (E.D. Mo. Sept. 21 , 2015) ("the ability to maintain employment with an impairment
together with the absence of evidence that the condition has significantly deteriorated, tends to
prove the impairment was not disabling). Further, an ability to engage in a number of daily
activities detracts from Plaintiffs credibility. See, e.g., Roberson v. Astrue, 481 F.3d 1020, 1025
(8th Cir. 2007) (discounting the plaintiffs subjective complaints where the plaintiff engaged in
extensive daily activities such as fixing meals, doing housework, shopping for groceries, and
handling money). The ALJ properly gave significant weight to Dr. Watson' s opinion because
the opinion was consistent with the overall evidence in the record. See Brooks v. Colvin, No.
4:13CV588 TIA, 2014 WL 4385429, at *14 (E.D. Mo. Sept. 4, 2014) (" [W]here opinion
evidence obtained from a non-examining physician is consistent with substantial evidence on the
record as a whole, an ALJ does not err in according this opinion evidence significant weight.").
Thus, Plaintiff does not satisfy the requirements of paragraph C.
With regard to paragraph D, the ALJ noted that Plaintiff had mild restrictions in activities
of daily living, evidenced by the fact that he lived on his own, could handle his personal care,
could shop for his own needs, and could perform household chores. Further, Plaintiff had
moderate difficulties with social functioning. Although he alleged getting along poorly with coworkers, he had friends and previously had a girlfriend in 2013. With regard to concentration,
persistence, or pace, the ALJ found only moderate difficulties, as Plaintiff could focus on reading
a simple article and use the computer, as well as demonstrate good calculation and memory.
Finally, the ALJ found no episodes of decompensation of extended duration. Thus, the ALJ

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properly found that Plaintiff did not have 2 marked limitations and did meet the criteria of
Listing 12.05 paragraph D. (Tr. 16)

A. Weight Given to Medical Opinion Evidence
Plaintiff appears to argue that the ALJ failed to afford proper weight to the expert
opinions in this case. "A treating physician' s opinion should not ordinarily be disregarded and is
entitled to substantial weight . . . provided the opinion is well-supported by medically acceptable
clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial
evidence in the record." Singh v. Apfel, 222 F.3d 448, 452 (8th Cir. 2000) (citations omitted).
see also SSR 96-2P, 1996 WL 374188 (July 2, 1996) ("Controlling weight may not be given to a
treating source' s medical opinion unless the opinion is well-supported by medically acceptable
clinical and laboratory diagnostic techniques."). The ALJ need not give controlling weight to a
treating physician' s opinion where the physician' s treatment notes were inconsistent with the
physician' s RFC assessment. Goetz v. Barnhart, 182 F. App'x 625, 626 (8th Cir. 2006).
Further, " [i]t is appropriate to give little weight to statements of opinion by a treating physician
that consist of nothing more than vague, conclusory statements." Swarnes v. Astrue, Civ. No.
08-5025-KES, 2009 WL 454930, at *11 (D.S.D. Feb. 23 , 2009) (citation omitted); see also
Wildman v. Astrue, 596 F.3d 959, 964 (8th Cir. 2010) (finding that the ALJ properly discounted
a treating physician' s opinion where it consisted of checklist forms, cited no medical evidence,
and provided little to no elaboration).
Here, the record shows that the ALJ thoroughly considered the medical records and gave
proper weight to the medical opinion evidence. As mentioned above, Dr. Watson opined that
Plaintiff retained the ability to acquire and retain simple instructions; could sustain concentration
and persistence with simple instructions; and could adapt to changes in settings not requiring

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frequent public contact or very close contact with others. The ALJ noted that this opinion was
entitled to significant weight because the opinion was consistent with the evidence contained in
the record. As stated above, Plaintiff was able to perform many activities of daily living and
hold two consecutive jobs for 5 years each. Additionally, he socialized with friends and
relatives. (Tr. 18-19)
With regard to Dr. Lanpher, the ALJ gave the diagnoses significant weight, but noted that
assessed limitations of moderate to marked limitations in Plaintiffs ability to understand
instructions, sustain concentration, adapt, and interact socially were entitled to little weight. The
ALJ found that those suggested limitations were inconstant with Dr. Watson' s analysis and with
Dr. Lanpher' s own treatment notes. (Tr. 19) For instance, Dr. Lanpher opined that Plaintiff had
borderline intellectual functioning as opposed to mild retardation. Further, he noted Plaintiffs
past employment and extensive activities of daily living. Finally, he appeared to base his
opinions on Plaintiffs subjective reports, as the objective data was inconsistent with the abilities
determined by Dr. Lanpher. See Teague v. Astrue, 638 F.3d 611 , 615-16 (8th Cir. 2011) (finding
the ALJ properly discounted the consulting psychologist's opinion where it was based on
plaintiffs subjective complaints and not objective findings and was inconsistent with the
psychologist's own notes). With regard to Dr. Rexroat's evaluation, the ALJ noted that the
consultation occurred several years before the relevant period, and thus the ALJ gave the opinion
little weight. (Tr. 19)
The ALJ further evaluated Plaintiffs mental health treatment with Dr. Wood after
Plaintiff witnessed his mother shoot and kill his stepfather. Dr. Wood assessed PTSD, although
he noted that Plaintiff did not fully meet the criteria. Dr. Wood also assessed a mood disorder,
personality disorder, and alcohol abuse, noting that Plaintiff minimized his alcohol use.

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However, Dr. Wood did not assess any type of intellectual disability, and he did not indicate any
worsening of symptoms. (Tr. 19-20)
In short, the Court finds that the ALJ properly assessed the medical opinion evidence in
the record and assigned appropriate weight to those opinions in determining Plaintiffs RFC. See

Davis v. Apfel, 239 F.3d 962, 967-68 (8th Cir. 2001) (finding that the ALJ may reject medical
expert conclusions where they are inconsistent with the record as a whole and may properly base
the RFC finding on opinion evidence that is consistent with the record evidence). The ALJ need
not rely entirely on a particular doctor's opinion or choose between opinions. Martise v.Astrue,
641 F.3d 909, 927 (8th Cir. 2011). Therefore, Plaintiffs frrst ground for reversal is denied.
B. Testimony from the VE
Next, Plaintiff claims that the ALJ did not properly rely on the VE' s testimony in finding
that Plaintiff could perform other work because the VE testified there were no jobs Plaintiff
could perform. The record shows that the ALJ' s hypothetical included limitations found in the
record and in the RFC determination. The ALJ limited Plaintiff to jobs consisting of only
simple, routine, repetitive tasks; no close cooperation and interaction with co-workers; only
occasional interaction and cooperation with the general public; allow maintenance of attention
and concentration for a minimum of two hours at a time; and allow adaption to changes at the
basic level instead of supervision. (Tr. 39) The VE testified that other jobs existed which
Plaintiff could perform. When asked whether the individual could perform those jobs ifhe was
unable to consistently interact and co-operate with co-workers and supervisors, the VE answered
that no jobs would exist. (Tr. 40)
"A vocational expert' s testimony constitutes substantial evidence when it is based on a

hypothetical that accounts for all of the claimant's proven impairments." Hulsey, 622 F.3d at

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922 (citation omitted). Here, the evidence demonstrated that Plaintiff was able to work in
proximity to others and could accept supervision on a basic level, not that he was precluded from
consistent interaction with others. Indeed, Plaintiff was previously able to work for 5 years at a
barge company and 5 years in a food processing plant. Further, he had friends and a supportive
family. Therefore, the ALJ determined that Plaintiff retained the RFC to work in jobs that
required limited interaction with co-workers and supervisors, as supported in the evidence of
record. "[A]n ALJ may omit alleged impairments from a hypothetical question when the record
does not support the claimant' s contention that his impairments ' significantly restricted his
ability to perform gainful employment. "' Owen v. Astrue, 551 F.3d 792, 802 (8th Cir. 2008)
(quoting Eurom v. Chafer, 56 F.3d 68 (8th Cir. 1995)). Because the hypothetical question to the
VE incorporated those limitations found by the ALJ and supported by the evidence, the question
"'capture[d] the concrete consequences of [Plaintiffs] impairments. "' Hulsey, 622 F.3d at 922
(quoting Lacroix v. Barnhart, 465 F.3d 881, 889 (8th Cir. 2006)). Thus, the VE' s answer
constitutes substantial evidence and supports the ALJ' s determination that Plaintiff could
perform other work and was not disabled. Buckner, 646 F.3d at 561.

C. Plaintiff's Personality Disorder
Last, Plaintiff argues that the overwhelming evidence shows that he has a narcissistic
personality disorder that is difficult to treat and entitles him to benefits. Here, the ALJ found
that, while Plaintiff had a severe personality disorder, such disorder did not preclude Plaintiff
from performing work. The ALJ noted that Plaintiff did not follow up with advice to obtain
outpatient care or medication for his personality disorder. Other than seeing Dr. Wood after
Plaintiff witnessed the murder of his stepfather, Plaintiff did not seek treatment for his mental
health issues upon release from the hospital and encouragement to follow up with outpatient

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treatment. "The absence of any evidence of ongoing counseling or psychiatric treatment or
deterioration or change in [Plaintiffs] mental capabilities disfavors a finding of disability."

Roberts v. Apfel, 222 F.3d 466, 469 (8th Cir. 2000).
Further, the ALJ noted Plaintiffs extensive activities of daily living and fair social
abilities supported a finding that Plaintiff could perform simple work activity with reduced social
contact. See Gwathney v. Chater, 104 F.3d 1043, 1045 (8th Cir. 1997) (noting that the plaintiff
was able to engage in physically and intellectually challenging tasks despite her low IQ such that
substantial evidence supported the ALJ's finding that plaintiff was not significantly limited by
physical or mental impairments). The Court therefore finds that substantial evidence supports
the ALJ' s determination that Plaintiff was not disabled by his personality disorder or any other
mental or intellectual impairment. Thus, the Court affirms the final decision of the
Commissioner.
Accordingly,
IT IS HEREBY ORDERED that the final decision of the Commissioner denying social
security benefits is AFFIRMED. A separate Judgment in accordance with this Memorandum
and Order is entered this same date.
Dated this 1st day of March, 2016.

UNITED STATES DISTRICT JUDGE

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