Shelton v. Colvin

Filing 22

MEMORANDUM AND ORDER re: 16 SOCIAL SECURITY BRIEF filed by Plaintiff Tracy Earl Shelton, 19 SOCIAL SECURITY CROSS BRIEF re 16 SOCIAL SECURITY BRIEF filed by Defendant Nancy A. Berryhill. IT IS HEREBY ORDERED that the final decision of the Acting Commissioner denying Social Security benefits to Plaintiff is AFFIRMED. A separate judgment in accordance with this Memorandum and Order is entered this date. Signed by Magistrate Judge Patricia L. Cohen on 3/2/17. (CSG)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
SOUTHEASTERN DIVISION
TRACY EARL SHELTON,
Plaintiff,
vs.
NANCY A. BERRYHILL, 1
Acting Commissioner of Social Security,
Defendant.

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Case no. 1:15cv00044 PLC

MEMORANDUM AND ORDER
Tracy Earl Shelton (“Plaintiff”) seeks review of the Social Security Administration’s
(“SSA”) decision denying his application for a period of disability and Disability Insurance
Benefits (“DIB”) under Title II of the Social Security Act, 42 U.S.C. §§ 401 et seq., and his
application for Social Security Income (“SSI”) under Title XVI of the Social Security Act, 42
U.S.C. §§ 1381 et seq. The Court has reviewed the parties’ briefs and the administrative record,
including the hearing transcript and the medical evidence. Because the Court finds substantial
evidence supports the decision to deny benefits, the Court affirms the denial of Plaintiff’s
applications. 2
I. Background and Procedural History

1

Nancy A. Berryhill is now the Acting Commissioner of Social Security. Pursuant to Rule 25(d) of the
Federal Rules of Civil Procedure, Nancy A. Berryhill should be substituted for Acting Commissioner Carolyn W.
Colvin as the defendant in this suit. No further action needs to be taken to continue this suit by reason of the last
sentence of § 205(g) of the Social Security Act, 42 U.S.C. § 405(g).
2

The parties consented to the exercise of authority by a United States Magistrate Judge pursuant to 28
U.S.C. § 636(c) [ECF No. 9].

In October 2011 Plaintiff applied for DIB and SSI.

(Tr. 151-57 and see Tr. 14,

respectively.) Plaintiff alleged he was disabled as of October 8, 2011, 3 due to hearing loss, sleep
apnea, depression, right knee surgery, carpal tunnel surgery in both wrists, high blood pressure,
“getting angry with people to[o] easily,” loss of balance, “thyroid[, and] a goiter.” (Tr. 252).
The SSA denied Plaintiff’s claims (Tr. 65-69), and Plaintiff filed a timely request for a hearing
before an administrative law judge (“ALJ”) (Tr. 72-73).
The SSA granted Plaintiff’s request for review, and an ALJ conducted a hearing in
November 2013. (See, e.g., Tr. 74-96.) Plaintiff, who was represented by an attorney, testified
that he was born in 1972, had graduated from high school, was married and lived at home with
his wife and ten-year old son, and had last worked at a grocery store unloading trucks and
stocking shelves on October 8, 2011. (Tr. 36-39.) His prior employment positions included
working as a produce clerk at a grocery store, on an air conditioning unit assembly line, and as a
machine operator molding wood for picture frames (Tr. 39-40.) Other than receiving two lumpsum worker’s compensation payments due to a right knee injury and bilateral carpal tunnel
syndrome, Plaintiff’s only income was food stamps and energy assistance. (Tr. 37, 38.)
The medications Plaintiff takes are “mainly for pain, the high blood pressure[,] . . . the
thyroid, [the] goiter, the depression, the high cholesterol, and [the diabetes].” (Tr. 42.) Plaintiff
mentioned he had arthroscopic surgery on his right knee, carpal tunnel release surgery on both
wrists in 2011, and, in 2005, a right ear cochlear implant; and he had complete deafness in his
left ear. (Tr. 42-46.) Plaintiff complained of weakness and pain in his right knee and both
wrists, hearing problems resulting from background noise, and throbbing pain and tenderness at
the site of the implant. (Tr. 41-44, 47.) In regard to his right knee, Plaintiff described the pain as

3

Plaintiff originally alleged that he was disabled as of March 13, 2010, but later amended the alleged date
of onset. (Tr. 151, 235).

2

constant, with it “get[ting] worse when [he goes] out walking or tr[ies] to be a little physical,”
and when it remains bent. (Tr. 43, 48, 49-50, 55.) Plaintiff testified he “can’t walk very far at
all comfortably” and can only stand for “maybe 10 minutes” without changing positions. (Tr.
55.) On a scale of one to ten, Plaintiff characterized his “average daily” right knee pain as
“get[ting] up as high as a ten sometimes.” (Tr. 54.) To alleviate his knee pain, Plaintiff uses a
“heating pad and l[ies] down,” and takes two pain medications: Naproxen and Tramadol. (Tr.
43, 52.) Plaintiff stated, after having fallen twice, he uses a cane, which was not prescribed,
“[p]retty often, mainly every time [he] go[es] out somewhere.” (Tr. 43.) With respect to his
wrists, Plaintiff testified that, after the bilateral carpal tunnel release surgeries, he “tend[s] more
now to hav[e] like a pain . . . in [his] wrists.” (Tr. 44.) Describing that daily pain, Plaintiff
characterized it as a two on a scale of one to ten. (Tr. 53.) Plaintiff described his daily routine as
driving his son to school in the morning, returning home and going to bed until noon, and then
sitting in front of the computer, taking breaks because his “leg . . . bother[s him] if [he] sit[s] too
long [and] bothers [him] if [he] stand[s] too long.” (Tr. 50.)
A vocational expert (“VE”) also testified at the administrative hearing. (Tr. 56-59.) The
ALJ asked the VE to consider a hypothetical individual:
who can perform a range of light work, lifting up to 20 pounds occasionally,
lifting or carrying 10 pounds frequently, standing or walking for six hours and
sitting for up to six hours per eight hour day with normal breaks, occasionally
climbing ramps or stairs, never climbing ladders, ropes or scaffolds, occasional
stooping but no kneeling, crouching or crawling, unable to tolerate exposure to
noise above the moderate level [and] . . . , limited to occupations that do not
require frequent verbal or telephone communication with all instructions
delivered either by demonstration or face to face.
(Tr. 57.) The VE testified that all of Plaintiff’s past work “would be eliminated,” and there were
other jobs in the regional or national economy that a person of Plaintiff’s age, education and
work experience could perform under the terms of the hypothetical: price marker, collator
3

operator, and garment sorter. (Tr. 57-58.) The VE affirmed that her testimony was consistent
with the Dictionary of Occupational Titles (“DOT”), except as to the instruction limitation which
she analyzed based on her professional opinion. (Tr. 59.) The ALJ also proposed two more
hypotheticals, the second adding to the first hypothetical a requirement that the person elevate a
leg above waist high “outside of the normal rest and lunch periods” and the third adding to the
first hypothetical a requirement that “the person can sit and stand for 20 minutes and then has to
change positions to the other exertional position before returning, again at 20 minute intervals.”
(Tr. 58-59.) In response to each of the second and third hypotheticals, the VE testified such
limitations would eliminate all three of the jobs she had reported in response to the first
hypothetical, as well as “all other work.” (Id.) The VE stated her responses to the second and
third hypotheticals were based on her professional opinion as to the elevating of feet and extra
breaks and alternating positions, because those aspects of work are not included in the DOT.
(Tr. 59.)
In denying Plaintiff’s applications, the ALJ applied the five-step evaluation process set
forth in 20 C.F.R. §§ 404.1520 and 416.920; 4 found that Plaintiff met the insured status
requirements of the Social Security Act through December 31, 2016; and concluded Plaintiff had
not engaged in substantial gainful activity during the period from his alleged onset date of
October 8, 2011, through the date of the decision, December 12, 2013. (Tr. 14-24). The ALJ
also determined Plaintiff had the severe impairments of degenerative joint disease of the right
4

A claimant is eligible for disability or SSI benefits if the claimant demonstrates he or she suffers from a
medically determinable physical or mental impairment that renders claimant unable to engage in substantial gainful
activity and can be expected either to result in death or to last twelve months. 42 U.S.C. §§ 423(a)(1), 423(d),
1382c(a)(1), 1382(a)(3). To determine whether a claimant is disabled, the Commissioner engages in a five-step
evaluation process. See 20 C.F.R. § 404.1520 (for period of disability and disability benefits) and § 416.920 (for
SSI). Those steps require a claimant to show that he or she: (1) is not engaged in substantial gainful activity; (2)
has a severe impairment or combination of impairments which significantly limits his or her physical or mental
ability to do basic work activities or (3) has an impairment which meets or exceeds one of the impairments listed in
20 C.F.R., Subpart P, Appendix 1; (4) is unable to return to his or her past relevant work; and (5) the impairments
prevent him or her from doing any other work. Id.

4

knee, obesity, and hearing loss status post-2005 cochlear implant that significantly limit
Plaintiff's ability to perform work activities. (Tr. 16.) Additionally, the ALJ found Plaintiff had
the following non-severe impairments: coronary artery disease, carpal tunnel syndrome in his
upper extremities, restless leg syndrome, diabetes, and depression. (Tr. 16-18.) Plaintiff did not,
the ALJ further found, have an impairment or combination of impairments that met or medically
equaled the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Tr.
19.)
After reviewing Plaintiff’s testimony and medical records, the ALJ determined that
Plaintiff’s “medically determinable impairments could reasonably be expected to cause some of
the alleged symptoms; [but Plaintiff’s] statements concerning the intensity, persistence and
limiting effects of these symptoms are not entirely credible.” (Tr. 21.) The ALJ concluded that
Plaintiff had the Residual Functional Capacity (“RFC”) 5 to “perform less than the full range of
light work as defined in 20 CFR 404.1567(b) and 416.967(b)” based on findings Plaintiff:
can occasionally lift 20 pounds, frequently lift/carry 10 pounds, stand/walk for 6
hours in an 8-hour workday, and sit for 6 hours in an 8-hour workday with normal
breaks[;] . . . can occasionally climb ramps or stairs, but can never climb ladders,
ropes, or scaffolds[; and] . . . can occasionally stoop, but can never kneel, crouch,
or crawl.
(Tr. 19.) Such light work, the ALJ found, was further limited to work that did not “require
exposure to noise levels above the moderate level,” did not “require frequent verbal or telephone
communication,” and delivered instructions “by demonstration or face to face.” (Id.) The ALJ
decided that Plaintiff was unable to perform any past relevant work, but there were other jobs in
significant numbers in the national economy that Plaintiff could perform, in view of his age,

5

The RFC is the most a person can do despite that person’s limitations.
404.1545(a).

5

See, e.g., 20 C.F.R. §

education, work experience, and RFC, including: “light exertional level, unskilled jobs,” such as
price marker, collator operator, and garment sorter. (Tr. 23.)
The ALJ held that Plaintiff was not “under a disability, as defined in the Social Security
Act from October 8, 2011, through the date of [the ALJ’s] decision (20 CFR 404.1520(g) and
416.920(g)),” and was not disabled for purposes of either DIB or SSI. (Tr. 24.) Plaintiff filed a
request for review of the ALJ’s decision with the SSA Appeals Council, which denied review.
(Tr. 7-9, 1-5, respectively). Plaintiff exhausted all administrative remedies, and the ALJ’s
decision stands as the SSA’s final decision. Sims v. Apfel, 530 U.S. 103, 106-07 (2000). The
SSA’s final decision after a hearing is subject to judicial review. 42 U.S.C. § 405(g) (for DIB);
42 U.S.C. § 1382(c)(3) (for SSI).
II. Standard of Review
A court must affirm the SSA’s final decision if it is supported by substantial evidence on
the record as a whole. Buford v. Colvin, 824 F.3d 793, 795 (8th Cir. 2016); 42 U.S.C. § 405(g).
“Substantial evidence is less than a preponderance, but enough that a reasonable mind would
find it adequate to support the ALJ’s determination.” Buford, 824 F.3d at 795 (internal quotation
marks omitted) (quoting Guilliams v. Barnhart, 393 F.3d 798, 801 (8th Cir. 2005)). In deciding
whether substantial evidence supports the Commissioner’s final decision, a court must review
the administrative record as a whole and consider the ALJ’s credibility findings, vocational
factors (education, background, work history, and age), the medical evidence from treating and
consulting physicians, subjective complaints regarding exertional and non-exertional activities
and impairments, any third-party corroboration of the impairments, and, when required,
vocational expert testimony that is based on a proper hypothetical question setting forth the
impairments. Stewart v. Secretary of Health & Human Servs., 957 F.2d 581, 585-86 (8th Cir.

6

1992).

A court reviewing the Commissioner’s final decision considers evidence that both

supports and detracts from the decision. Buford, 824 F.3d at 795. However, a court “do[es] not
reweigh the evidence presented to the ALJ and [it] defer[s] to the ALJ”s determinations
regarding the credibility of testimony, as long as those determinations are supported by good
reasons and substantial evidence.” Renstrom v. Astrue, 680 F.3d 1057, 1064 (8th Cir. 2012)
(internal quotation marks omitted) (quoting Gonzales v. Barnhart, 465 F.3d 890, 894 (8th Cir.
2006)).
The Eighth Circuit has repeatedly held that a court should “defer heavily to the findings
and conclusions” of the SSA. Wright v. Colvin, 789 F.3d 847, 852 (8th Cir. 2015) (internal
quotation marks omitted) (quoting Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir. 2010)). “If, after
reviewing the record, the court finds it is possible to draw two inconsistent positions from the
evidence and one of those positions represents the ALJ’s findings, the court must affirm the
ALJ’s decision.” Partee v. Astrue, 638 F.3d 860, 863 (8th Cir. 2011) (internal quotation marks
omitted) (quoting Goff v. Barnhart, 421 F.3d 785, 789 (8th Cir. 2005)).
III. Discussion
Plaintiff argues that substantial evidence does not support the ALJ’s decision because the
ALJ erred in: (1) finding Plaintiff’s bi-lateral carpal tunnel syndrome and diabetes were not
severe impairments, and (2) failing to develop the record regarding Plaintiff’s upper extremities
and knee pain.

(ECF No. 16.)

The Commissioner counters that:

(1) Plaintiff failed to

demonstrate that his bi-lateral carpal tunnel syndrome and his diabetes were severe; and (2) the
ALJ did not need to further develop the record because Plaintiff failed to show the ALJ was
incapable of making a decision regarding Plaintiff’s bi-lateral carpal tunnel syndrome and right
knee pain based on the information in the record.

7

A. Severity of Impairments – Bilateral Carpal Tunnel Syndrome and Diabetes
Plaintiff claims that competent and substantial evidence does not support the ALJ’s
conclusion that Plaintiff’s bilateral carpal tunnel syndrome and diabetes are non-severe
impairments. As to the former, Plaintiff contends the ALJ improperly relied on a February 2013
medical examination during which Plaintiff reported the issues with his hands were resolved and
a related nerve conduction test that revealed “normal” handgrip, rather than on Plaintiff’s
testimony at the hearing that he continued to have daily hand pain. 6 With respect to the diabetes,
Plaintiff argues the ALJ erred in classifying that condition as nonsevere because, Plaintiff
asserts, Plaintiff credibly testified at the hearing that he stays “constantly drained of energy” and
“takes naps during the day.” 7 Defendant counters that the ALJ’s severity analysis of these
impairments is supported by the record showing improvement with treatment and the absence of
a medical opinion that these impairments imposed greater limitations than those included in the
ALJ’s RFC finding. Defendant also urges Plaintiff is essentially asking the Court to reweigh the
evidence and make a different finding, which the Court may not do.
At step two of the evaluation process, an ALJ must determine if a claimant suffers from a
severe impairment. Kirby v. Astrue, 500 F.3d 705, 707 (8th Cir. 2007) (discussing disability and
SSI benefits); see also 20 C.F.R. § 404.1520(a)(4)(ii) (disability benefits); § 416.920(a)(4)(ii)
(SSI benefits). To demonstrate that an impairment is severe, a claimant must show that he or she
has (1) a medically determinable physical or mental impairment, or combination of impairments,
which (2) “significantly limits [his or her] physical or mental ability to do basic work

6

Plaintiff also asserts his testimony at the hearing before the ALJ revealed that “he frequently drops things
due to weakness in his hands.” Pl. Br. at 3 [ECF No. 16]. A review of the transcript of the hearing before the ALJ,
however, does not reveal any such testimony by Plaintiff.
7

Plaintiff’s position that he credibly testified his fatigue and sleepiness is due to his diabetes is not
supported by the record of the hearing.

8

activities,” 8 without regard to age, education, or work experience. 20 C.F.R. §§
404.1520(a)(4)(ii), 404.1520(c), 404.1521(a), 416.920(a)(4)(ii), 416.920(c), 416.921(a).

An

impairment “is not severe if it does not significantly limit [the claimant’s] physical or mental
ability to do basic work activities.” 20 C.F.R. § 404.1521(a), § 416.921(a). Put another way, an
impairment is not severe if it “amounts only to a slight abnormality” that “would have no more
than a minimal effect” on the claimant’s ability to work. Kirby, 500 F.3d at 707 (citing Page v.
Astrue, 484 F.3d 1040, 1043 (8th Cir. 2007)). Although a claimant has “the burden of showing a
severe impairment that significantly limited [his or her] physical or mental ability to perform
basic work activities[,] . . . the burden of a claimant at this stage of the analysis is not great.”
Caviness v. Massanari, 250 F.3d 603, 605 (8th Cir. 2001)). See also Kirby, 500 F.3d at 708
(“Severity is not an onerous requirement for the claimant to meet, but it is also not a toothless
standard”).
In support of his argument that the ALJ improperly classified his bilateral carpal tunnel
syndrome and his diabetes as nonsevere, Plaintiff cites Brown v. Barnhart, 390 F.3d 535 (8th Cir.
2009).

Brown affirmed the SSA’s denial of disability benefits because (1) the treating

physician’s opinion on the plaintiff’s disability was not entitled to controlling weight and (2) the
ALJ properly discounted the plaintiff’s subjective complaints of pain. Id. at 540-41 and 541-42,
respectively.

However, in Brown the Eighth Circuit did not address the severity of an

impairment, other than to quote the regulatory definition of a severe impairment. Id. at 538
(quoting 20 C.F.R. § 404.1520(c)). Accordingly, it is inapplicable here.
1. Bilateral Carpal Tunnel Syndrome

8

Basic work activities include, among other things, “(p)hysical functions such as walking, standing,
sitting, lifting, pushing, pulling, reaching, carrying, or handling.” 20 C.F.R. § 416.921(b).

9

Plaintiff contends substantial and competent evidence does not support the ALJ’s finding
that Plaintiff’s bilateral carpal tunnel syndrome is a nonsevere impairment. Specifically, Plaintiff
argues the ALJ improperly relied on a February 2013 nerve conduction study and should have
instead focused on Plaintiff’s subsequent testimony at the administrative hearing regarding his
wrist pain.
At the administrative hearing, Plaintiff testified that he had carpal tunnel release surgery
on both wrists in 2011. (Tr. 43-44.) He acknowledged the surgery “improved things. [He’s] not
waking up at night anymore with numbness,” however, he reported, he “tend[s] more now to
hav[e] like a pain . . . in [his] wrists.” (Tr. 44.) Describing the daily pain in his wrists, Plaintiff
characterized it as two on a scale of one to ten. (Tr. 53.) Plaintiff also stated he “is a little weak
in [his] hands . . . not as strong in them as [he] used to be” and he “ha[d dropped things] before.”
(Tr. 41, 53.) Plaintiff reported that the doctor analyzing the most recent nerve conduction study
said Plaintiff “still ha[s] . . . a slight case of carpal tunnel” on both sides. (Tr. 53.)
Plaintiff’s medical records demonstrate that, before the relevant October 8, 2011 date of
disability and after a nerve conduction study, 9 Richard Howard, D.O. concluded Plaintiff had “a
moderate degree of sensory motor carpal tunnel syndrome bilaterally,” and recommended
“staged bilateral carpal tunnel release” surgery. (Tr. 598.) After this diagnosis, Dr. Howard
performed the recommended surgery in March 2011. (Tr. 603, 604.)

Post-surgery Plaintiff’s

physical symptoms improved.
After the date of disability, Chul Kim, MD, examined Plaintiff, on December 15, 2011,
and stated that, since the bilateral carpal tunnel release surgery, Plaintiff reported “the numbness
9

The February 24, 2011, nerve conduction study was performed by Daniel Phillips, M.D., who opined
Plaintiff had “severe sensory motor median neuropathy across the right carpal tunnel with sensory axonal
involvement [and] significant moderate predominantly demyelinative sensory motor median neuropathy across the
left carpal tunnel.” (Tr. 599-600.)

10

in [his] hands was resolved and [Plaintiff] has little pain in the palmar aspect of bilateral wrists.”
(Tr. 605.) Dr. Kim reported Plaintiff’s “[h]andgrip and fine finger movements were normal” and
other than his right knee and right hip joints, “[a]ll other major joints were without significant . . .
limitation of the range of motion.” (Tr. 608.) Dr. Kim’s assessment of Plaintiff included his
impression that Plaintiff had a “[h]istory of bilateral carpal tunnel release [and] has some pain at
wrists.” (Tr. 608.)
Plaintiff did not mention his carpal tunnel syndrome symptoms when he saw medical
care providers in May, June, and September 2012. (Tr. 624-634.) On February 12, 2013, in an
examination to establish medical care of Plaintiff, D. L. Davis, M.D., noted Plaintiff had had
bilateral carpal tunnel surgery before and has “some mild left and right carpal tunnel issues of his
upper extremities.” (Tr. 640-42.) After a nerve conduction study, Dr. Davis “found left and
right median (wrist to APB) DMLs outside normal limits [and] assessed mild left and right
neuropathy at wrist; left ulnar nerve conduction within normal limits.” (Tr. 658.) After this
visit, Plaintiff did not see a medical care provider for carpal tunnel syndrome symptoms or
mention such symptoms to a medical care provider, although he saw a physician on March 13th,
April 11th, April 25th, June 17th, June 20th, June 21st, July 1st, July 18th, July 26th, August 15th,
September 3rd, and September 30th of 2013. (See Tr. 666, 669-72, 674-75, 677, 682,701-12, 71316, 724-26, 727-31, 732-33, 736-37.)
The ALJ found the carpal tunnel syndrome in both upper extremities did not have more
than a minimal impact on Plaintiff’s ability to perform basic work activities, and was a nonsevere
impairment. (Tr. 17.) In reaching this conclusion, the ALJ noted the post-surgery medical
records available after October 8, 2011, showed only mild neuropathy in Plaintiff’s wrists as of
February 2013, and “‘normal’ handgrip and fine finger movements.” (Id.) Additionally, the ALJ

11

referred to Plaintiff’s reports to medical care providers that the numbness in his hands was
resolved and that he had “little pain” since the carpal tunnel release surgery. (Tr. 17.)
Furthermore, in concluding that Plaintiff’s RFC was in the light range with specified
limitations, the ALJ expressly took into consideration Plaintiff’s nonsevere impairments,
Plaintiff’s subjective complaints, all symptoms, and medical evidence. (Tr. 19-22.) When
addressing Plaintiff’s RFC, the ALJ gave no weight to opinions in Plaintiff’s worker’s
compensation records limiting or restricting Plaintiff’s work due to his carpal tunnel syndrome.
(Tr. 22.) The ALJ reasoned that: (1) the opinions were rendered prior to October 8, 2011; (2)
treatment providers subsequently determined Plaintiff “could return to work with no
restrictions”; and (3) Plaintiff was engaged in substantial gainful activity after the surgeries and
up until October 8, 2011. (Id.) In considering Plaintiff’s RFC, the ALJ also gave only “some
weight” to the opinion of the State agency medical consultant who “opined that [Plaintiff] can
perform the full range of medium exertional level work.” 10 (Id.) The ALJ characterized the
medical consultant’s opinion as:
generally consistent with the fairly unremarkable medical evidence and the fact
that [Plaintiff] was told he could return to work with no restrictions. However,
taking [Plaintiff]’s subjective complaints into account to a greater extent,
particularly the reports of ongoing knee pain, [the ALJ] limited [Plaintiff] to light
exertional level work subject to various nonexertional limitations.
(Id.)
Upon review, the Court finds the ALJ properly evaluated Plaintiff’s bilateral carpal
tunnel syndrome as a nonsevere impairment. The evidence revealed, as the ALJ found, that
Plaintiff reported to medical care providers examining him after October 8, 2011 that he had no

10

On December 27, 2011, Libbie Russo, M.D., a State agency medical consultant, completed a physical
RFC assessment stating, in relevant part, that Plaintiff could occasionally lift or carry fifty pounds and frequently lift
or carry twenty-five pounds; had unlimited push and pull capability, except for the lift or carry limitations; and had
no postural, manipulative, visual, communicative, or environmental limitations. (Tr. 612-17.)

12

more than “little” or “some” pain in his wrists, and the most recent examination and nerve
conduction study, in February 2013, resulted in a diagnosis of “mild” carpal tunnel syndrome.
While Plaintiff mentioned at the hearing that he had daily pain in his hands, he rated that pain as
low (a two on a scale of one to ten). This low pain complaint mirrored, rather than contradicted,
the wrist pain reported in Plaintiff’s medical records, on which the ALJ relied. Moreover, to the
extent a State agency medical consultant assessed Plaintiff in December 2011 with the ability to
perform a full range of medium exertional level work, the ALJ took Plaintiff’s subjective
complaints into account and reduced the level of work Plaintiff could perform to light exertional
level work subject to various nonexertional limitations.
Additionally, Plaintiff’s testimony regarding his wrist pain did not demonstrate that his
low-rated pain adversely affected his daily activities. As he testified, Plaintiff drove a car and
used a computer on a daily basis. Plaintiff did not refer to an increase in any wrist pain in
association with those daily activities or as a reason for any limitation on those activities.
The record demonstrates that Plaintiff’s bilateral carpal tunnel syndrome since October 8,
2011, including any pain associated with it, is no more than a “slight abnormality” having no
more than a “minimal effect” on Plaintiff’s ability to perform basic work activities. Substantial
and competent evidence supports the ALJ’s decision that Plaintiff’s bilateral carpal tunnel
syndrome did not significantly limit Plaintiff’s physical ability to do basic work activities and,
therefore, was not a severe impairment.
2. Diabetes
Plaintiff also contends substantial and competent evidence does not support the ALJ’s
finding that Plaintiff’s diabetes is a nonsevere impairment. In particular, Plaintiff asserts that he
“credibly testified” at the administrative hearing that he was “constantly drained of energy” and

13

took daily naps. At the administrative hearing, Plaintiff testified he takes Metformin for the
diabetes, is trying to “do better” with his diet, checks his blood sugar regularly (“they run 115 to
around 130”), and was seeing a nutritionist but missed the last appointment several months
earlier. (Tr. 51-55.)
The medical records reveal that the initial diabetes diagnosis occurred as a result of a
September 11, 2012, examination of Plaintiff by Travis Weiss, a physician’s assistant. (Tr. 62830.) They discussed nutrition, aerobic exercise, and avoiding soft drinks, simple sugars, and
high calorie foods.

(Id.)

P.A. Weiss saw Plaintiff again two weeks later, and provided

instructions about diet, exercise, and good foot hygiene. (Id.)
On February 12, 2013, Plaintiff discussed his diabetes with Dr. Davis. (Tr. 640-42.)
Plaintiff reported to Dr. Davis that his sugars were “coming under better control, but still [were]
not quite adequate.” (Id.) Dr. Davis advised Plaintiff to consult with a diabetic educator, try to
reduce his weight, and return in two to three weeks. (Id.) In 2013 Plaintiff saw Dr. Davis about
diabetes on March 18th, April 11th, May 16th, August 15th and September 30th. (Tr. 682-83, 67980, 674, 713-15, and 736-37.) At the April appointment, Plaintiff reported his sugars were
“starting to run under better control,” and Dr. Davis directed Plaintiff to continue his diet and to
exercise to the extent he could tolerate it, and return in a month to check his A1c level. (Tr. 67980.)

Dr. Davis noted at the May appointment that Plaintiff’s A1c was “down to 6.6,” and

continued Plaintiff on “his present regimen, [noting Plaintiff has] done a good job with this, [and
Plaintiff reports the] diabetic educator is helping significantly.” (Tr. 674.) In August, Dr. Davis

14

reported that Plaintiff’s A1c was down to “6.3” and Plaintiff’s blood sugars were doing well.
(Tr. 713-15.) 11
When assessing the severity of Plaintiff’s diabetes, the ALJ stated “the record reflects
that this condition is controlled with treatment and/or consistent monitoring.” 12 (Tr. 17.) The
ALJ’s assessment of the control of Plaintiff’s diabetes is supported by the record of Plaintiff’s
medical care in 2013. Furthermore, in reaching the decision that Plaintiff’s RFC was in the light
range with specified limitations, the ALJ expressly took into consideration Plaintiff’s nonsevere
impairments, Plaintiff’s subjective complaints, all symptoms, and medical evidence. (Tr. 19-22.)
The ALJ noted a State agency medical consultant had found Plaintiff’s RFC at a higher, medium
level of work but gave that opinion only “some weight” upon consideration of Plaintiff’s
subjective complaints. (Tr. 22.)
Upon review, the Court finds the ALJ properly evaluated Plaintiff’s diabetes as a
nonsevere impairment. The record, especially the reports of the beneficial effects the course of
treatment and monitoring had on the diabetes, demonstrates that Plaintiff’s diabetes is no more
than a “slight abnormality” having no more than a “minimal effect” on Plaintiff’s ability to
perform basic work activities.

Accord Renstrom, 680 F.3d at 1066 (conditions that are

controlled by treatment are not disabling); Brace v. Astrue, 578 F.3d 882, 885 (8th Cir. 2009)
(“[i]f an impairment can be controlled by treatment or medication, it cannot be considered
disabling”).

There is substantial and competent evidence supporting the ALJ’s decision that

11

At the September 30, 2013 appointment to address Plaintiff’s diabetes and right knee pain, Dr. Davis
reported he would see Plaintiff again after a sleep study. (Tr. 736-37.) No medical records are available for any
medical care provided Plaintiff after September 30, 2013, or to demonstrate the results of any sleep study in 2013.
12

The ALJ also mentioned as support for his severity analysis that Plaintiff had not listed his diabetes “on
his Disability Report when asked to identify the conditions he believes keep him from working.” (Tr. 17.) The
Court does not find that omission significant because Plaintiff completed his Disability Report in October 2011 and
his first diabetes diagnosis was made later, in September 2012. (Tr. 251-59; 628-30.)

15

Plaintiff’s diabetes did not significantly limit Plaintiff’s physical ability to perform basic work
activities and, therefore, was not a severe impairment.
B. Development of Record – Upper Extremities and Knee Pain
Plaintiff contends the ALJ did not fulfill his duty to fully develop the record regarding his
carpal tunnel syndrome and right knee pain, citing Eichelberger v. Barnhart, 390 F.3d 584, 592
(8th Cir. 2004), Snead v. Barnhart, 360 F.3d 834, 835 (8th Cir. 2004), and 20 CFR § 416.917. In
particular, Plaintiff asserts the ALJ erred in failing “to have an examination done on [Plaintiff’s]
wrists and upper extremities to reconcile the discrepancies between the medical evaluation from
February 2013 and [Plaintiff’s] testimony” at the administrative hearing. (Pl.’s Br. at 4 [ECF
No. 16]) With respect to the right knee pain, Plaintiff contends the ALJ erred in failing to
develop the record regarding the condition and severity of injury to Plaintiff’s right knee. (Id. at
6.)
Defendant responds that Plaintiff has not satisfied his “heavy burden” to demonstrate the
record was inadequately developed and notes that the record reveals multiple x-rays and physical
examinations of Plaintiff’s right knee and wrists. Citing Tellez v. Barnhart, 403 F.3d 953, 95657 (8th Cir. 2005), Defendant argues there is no “indication that the ALJ felt incapable of making
a determination regarding” Plaintiff’s carpal tunnel syndrome and right knee pain. (Def.’s Br. at
9 [ECF No. 19].)
An ALJ “has a duty to fully and fairly develop the evidentiary record.” Byers v. Astrue,
687 F.3d 913, 915-16 (8th Cir. 2012). This duty may require an ALJ to obtain additional medical
evidence before rendering a decision.

See 20 C.F.R. § 404.1519a(b) (disability), §

416.1519a(b)(SSI). “The ALJ is required to order medical examinations and tests only if the
medical records presented to him do not give sufficient medical evidence to determine whether

16

the claimant is disabled.” McCoy v. Astrue, 648 F.3d 605, 612 (8th Cir. 2011); accord Buford,
824 F.3d at 797 (citing Martise v. Astrue, 641 F.3d 909, 926-27 (8th Cir. 2011)). If other
evidence in the record provides a sufficient basis for an ALJ’s decision, then an ALJ “is
permitted to issue a decision without obtaining additional medical evidence.” Anderson v.
Shalala, 51 F.3d 777, 779 (8th Cir. 1995) (internal quotation marks omitted) (quoting Naber v.
Shalala, 22 F.3d 186, 189 (8th Cir. 1994)). Importantly, an ALJ’s duty to develop the record is
not never-ending. McCoy, 648 F.3d at 612. The decision whether an ALJ has failed to develop
the record is made on a case-by-case basis. Mouser v. Astrue, 545 F.3d 634, 639 (8th Cir. 2008).
The cases on which Plaintiff relies, Eichelberger and Snead, do not support a conclusion
the ALJ failed fully to develop the record under the circumstances here. In Eichelberger, the
Eighth Circuit noted an ALJ has “the duty to develop the record independent of the claimant’s
burden in the case.” Eichelberger, 390 F.3d at 592. The burden of persuasion to prove disability
and to demonstrate the RFC, however, “remains on the claimant.” Id. Where “no crucial issue[s
are] left undeveloped,” a claimant does not satisfy his or her burden of persuasion. Id. The
Eighth Circuit affirmed the ALJ’s decision, in relevant part, because no crucial issues were
undeveloped in the record.

Id.

Here, the Court concludes the record includes evidence

addressing the crucial issues regarding Plaintiff’s upper extremities and knee pain.
Likewise, Snead does not assist Plaintiff. In Snead, the Eighth Circuit remanded the case
for further development of the record because the ALJ improperly rejected a medical opinion
that the plaintiff was not able to work based on “congestive heart failure due to dilated
cardiomyopathy.” Snead, 360 F.3d at 839. The Eighth Circuit concluded the ALJ’s decision to
reject that opinion lacked support in the record because the record had “no clinical findings” that
“would undermine” that opinion. Id. By contrast, here the medical and other evidence supports

17

the ALJ’s decision, including his decision to reject or limit certain opinions regarding Plaintiff’s
upper extremities and right knee pain.
1.

Upper Extremities

Plaintiff asserts the ALJ erred in failing “to have an examination done on [Plaintiff’s]
wrists and upper extremities to reconcile the discrepancies between the medical evaluation from
February 2013 and [Plaintiff’s] testimony” at the administrative hearing. (Pl.’s Br. at 4 [ECF
No. 16]) In particular Plaintiff contends his testimony “differ[ed] so significantly from the
evaluation performed in February 2013,” that the ALJ had a duty to order another evaluation.
(Id.)
Plaintiff urges his testimony differed significantly from the February 2013 evaluation
because he “testified that he has ‘major pain’ in his hands and he frequently drops things during
the day due to his hands being weak.” (Pl. Br. at 4 [ECF No. 16]. The transcript of the
administrative hearing before the ALJ does not support Plaintiff’s contention. Rather, Plaintiff’s
testimony, including his evaluation of his daily wrist pain as two on a scale of one-to-ten, is not
contrary to the February 2013 evaluation resulting in a finding that Plaintiff had mild carpal
tunnel syndrome. Because the purported discrepancy between Plaintiff’s testimony and the
February 2013 evaluation of his wrists is not significant, no crucial issue regarding Plaintiff’s
carpal tunnel syndrome was undeveloped. Additionally, there is no indication the ALJ was
unable to address Plaintiff’s concerns about his upper extremities. There is sufficient medical
evidence in the record to support the disability determination with respect to Plaintiff’s upper
extremities. Accordingly, the ALJ did not err in failing to further develop the record regarding
Plaintiff’s bilateral carpal tunnel syndrome.
2. Right Knee Pain

18

Plaintiff urges the ALJ erred in failing to develop the record regarding his right knee
pain, based on (1) his complaints of right knee pain during appointments with medical
professionals, including reports that a knee brace and arthroscopic surgery did not help; (2)
medical records, which Plaintiff characterizes as showing the knee pain was “getting
significantly worse as time goes on,” he had a diagnosis of a degenerative condition in his right
knee, and he needed to have “unicompartmental knee replacement”; (3) his administrative
hearing testimony that he continued to suffer knee pain that increased with walking and bending,
and required lying down, use of a heating pad, pain medication, and a cane for relief; and (4) Dr.
Davis’s observation in September 2013 13 that Plaintiff had “significant right knee pain and
crepitance.”
During the administrative hearing, Plaintiff testified that he suffered a right knee injury
during his grocery store work and had arthroscopic knee surgery. (Tr. 42.) Plaintiff stated that
he “can’t really squat,” “can’t walk very far at all comfortably,” and needs to change positions
about every ten minutes while standing. (Tr. 41, 55.) Additionally, Plaintiff reported “a lot of
times [his] leg wants to give on [him],” so he has a cane, which was not prescribed, that he uses
“[p]retty often, mainly every time [he] go[es] out.” (Tr. 41, 43.)
Plaintiff also stated he has “pretty much constant” pain in his right knee, “mainly toward
the inner side of [his] kneecap.” (Tr. 42-43.) Plaintiff described the pain as “tend[ing] to get
worse when [he’s] out walking or trying to be a little physical.” (Tr. 43, 54.) Bending the right
knee causes the pain to increase, Plaintiff noted, as does standing or sitting for “very long.” (Tr.
41, 48, 49-50.) Plaintiff estimated he is able to stand “on the right knee without a significant
13

Plaintiff refers in his brief to Dr. Davis’s “September 2014” examination, see Pl’s Br. at 5-6, but the
Court understands Plaintiff’s reference is to Dr. Davis’s examination of Plaintiff in “September 2013.” The
September 2013 examination occurred prior to the administrative hearing and the ALJ’s decision, both of which
occurred before September 2014. Additionally, there is no record of an examination of Plaintiff by Dr. Davis in
September 2014.

19

increase in the pain” a total of “45 minutes . . . out of a day.” (Tr. 48-49.) In addition to taking
Naproxen and Tramadol for pain, Plaintiff alleviates the knee pain temporarily by lying down
and using a heating pad. (Tr. 41-42, 43, 52.) Plaintiff described his knee pain on a scale of one
to ten as “get[ting] as high as a 10 sometimes.” (Tr. 54.)
The medical records reveal that, in 2010, Plaintiff injured his right knee while unloading
a truck at work and treated it with physical therapy before and after arthroscopic surgery
performed by Dr. Brian Schafer in May 2010. (See, e.g., Tr. 417-32, 447-520, 548, 550, 552.)
As of August 5, 2010, Plaintiff reported to Dr. Schafer that he had symptoms, especially with
“deep flexion[,] but he has been back to full duty without restrictions.” (Tr. 516.) On August
26, 2010, Dr. Schafer examined Plaintiff, and noted Plaintiff was at “full duty without
restrictions” and reporting pain. (Tr. 557-59.) Plaintiff received an injection of Lidocaine and
Celestone in his right knee, and was directed to return in three weeks for a Synvisc injection.
(Id.)

On October 7, 2010, Plaintiff reported “continued pain,” was directed to undergo a

functional capacity evaluation, and was permitted to return to work with no restrictions. (Tr.
534, 554-55.) As a result of a functional capacity evaluation on October 26, 2010, the evaluator,
Chris Wheatley, MPT, recommended that Plaintiff “not perform repetitive knee bending
activities; such as, squatting, kneeling or stooping due to increased [complaints of] right knee
pain and crepitus.” (Tr. 561.) Plaintiff continued to work until October 8, 2011, his date of
disability onset.
On December 15, 2011, Chul Kim, MD provided an “internist examination” of Plaintiff
for the Missouri Department of Elementary and Secondary Education Section of Disability
Determinations. (Tr. 605-11.)

During this examination, Plaintiff reported, with respect to his

right knee, that he has pain all day long and it has gotten worse since the 2010 surgery, the knee

20

“swells . . . mostly in the evening,” he “falls easily” without the cane, and he was told he
developed arthritis in the knee. (Tr. 606.) Dr. Kim stated that Plaintiff’s right knee has limited
flexion with pain, and is “somewhat swollen” and tender. (Tr. 608.) Plaintiff’s right hip also
“had limited forward flexion to 65 degree[s] because of right knee pain.” (Id.) Dr. Kim further
reported that Plaintiff’s:
gait was slow with or without a cane. He was able to bear full weight on right leg
and left leg for a few seconds, walking on heels and toes was unstable[,] . . .
squatting was less than halfway because of right knee pain[,] and getting on and
off the examining table was without significant problems.
(Id.)

An x-ray of the right knee showed, “[m]ild to moderate degree of narrowed medial

compartment of femorotibial joint space with degenerative joint disease.”

(Id.)

As his

impression of Plaintiff’s right knee, Dr. Kim stated Plaintiff has “[c]hronic pain in the right knee,
he underwent an arthroscopic surgery following an injury but developed osteoarthritis, [and] he
uses a cane to prevent falls.” (Id.)
During a December 21, 2011, appointment with his treating medical care provider to
check his blood pressure, Plaintiff reported “he was been having a lot of right knee pain.” (Tr.
363.) P.A. Weiss found “[t]enderness on palpation . . . and ambulation,” pain “elicited by
motion,” and no instability or muscle weakness in the knees. (Tr. 364.) Plaintiff received a
corticosteroid injection in his right knee and instructions to ice the knee, use an [A]ce bandage,
elevate the leg, and take “[n]onsteroidal anti-inflammatories (Advil or Motrin, or Aleve if
appropriate) for 5-7 days, with fluids.” (Id.) P.A. Weiss also ordered right knee x-rays. (Id.)
The x-rays that day resulted in the following assessment by Kenneth L. Rall, M.D.: “Knee joint
normal. No fracture-dislocation or bone destructive changes. No ligamentous or cartilaginous
calcifications.” (Tr. 391.)

21

During six visits with P.A. Weiss in 2012, Plaintiff reported knee pain only twice, on
February 9, 2012 and on June 8, 2012. (Id.,Tr. 624-34.) For the latter appointment, Plaintiff’s
“only complaint [wa]s of continued knee pain,” and P.A. Weiss noted, “The knee pain has not
changed and is stable.” (Tr. 632-34.)
Plaintiff’s next appointment addressing his knee was a visit with Dr. D.L. Davis on
February 12, 2013, to establish care. (Tr. 640-42.) With respect to Plaintiff’s right knee, Dr.
Davis noted Plaintiff had previously had right knee surgery and observed that Plaintiff had a
“[n]ormal gait.” (Tr. 641.) While Dr. Davis noted, during a March 18, 2013, examination that
Plaintiff “walks with a cane” (Tr. 682), for subsequent examinations of Plaintiff on April 11,
2013, May 16, 2013, and June 17, 2013, for care unrelated to his right knee, Dr. Davis reported
Plaintiff had a “[n]ormal gait” (Tr. 671-72, 674-75, 679-80, 683). Dr. Davis did not report right
knee complaints, symptoms, or pain during those three appointments, or during a June 20, 2013
appointment (Tr. 669); and reported “[n]egative” for his review of Plaintiff’s musculoskeletal
systems at those appointments.
On July 1, 2013, Plaintiff visited Dr. Davis and reported he was “still having some
problems with his knees.” (Tr. 666.) Dr. Davis noted “[s]ome crepitance of his right knee.
Normal gait. No edema.” (Tr. 666-67.) Dr. Davis decided to try “naproxen to see if this will
help to use periodically.” (Tr. 667.) Plaintiff did not mention right knee problems during a July
18, 2013, appointment with Dr. Davis to address sinus problems (Tr. 716).
On August 15, 2013, Dr. Davis saw Plaintiff, who said his “biggest issue . . . right now is
again the issue with his right knee.” (Tr. 713.) Plaintiff told Dr. Davis that he was “really
having a lot of problems with his right knee. . . . It is getting almost intolerable. He has had
steroid injections as well as Synvisc injections with minimal results.” (Id.) Plaintiff mentioned

22

“[h]e was told he was ‘too young’ to consider a total knee arthroplasty.” (Id.) Dr. Davis found
Plaintiff had “[q]uite a bit of crepitance of his right knee with some effusion[; a n]ormal gait[;
and d]egenerative joint disease.” (Tr. 714.) Dr. Davis recommended an orthopedic consultation
and the continuation of Plaintiff’s medications. (Id.)
William Pelton, M.D., reviewed “three-view right knee” x-rays of Plaintiff taken on
September 3, 2013. (Tr. 733.) Based on his review, Dr. Pelton found: “There is minimal
medial compartment joint space loss seen at the right knee[,] likely degenerative [in] nature.
There is a small suprapatellar density suggesting a small suprapatellar effusion. No definitive
right knee acute fracture or dislocation is otherwise identified.” (Id.) Dr. Pelton reported his
impression that Plaintiff had: “1. Minimal medial compartment joint space loss suggestive of
medial compartment minimal degenerative disease of the right knee [and] 2. Small suprapatellar
effusion.” (Id.)
After the x-rays, Plaintiff saw Thomas Graber, M.D., for his right knee pain on
September 3, 2013. (Tr. 732.) Plaintiff told Dr. Graber the arthroscopic knee surgery:
was of no benefit. He has had [a] Synvisc injection without benefit. He takes
Tramadol for the discomfort. He has used Aleve and Motrin without significant
relief. He wore [a] knee brace both before and after his surgery. He took physical
therapy before and after his surgery. . . . He was told nothing will help him except
a total knee replacement.
(Id.) Dr. Graber examined Plaintiff and found “full extension and flexion to 135 degrees. This
motion is only with pain. Pain is present circumferentially. He has no ligamentous instability in
any direction. There is no localized tenderness present.” (Id.) Dr. Graber stated he was
“uncertain as to the etiology of [Plaintiff’s] problem . . . [and] he [did] not believe that total knee
[replacement] is indicated in the presence of a normal x-ray and a normal knee to examination.”
(Id.) Noting that Plaintiff is unable to have an MRI due to the cochlear implant, Dr. Graber

23

recommended “repeat arthroscopic surgery. If [Plaintiff] has localized degenerative changes
then he may possibly be a candidate for a unicompartmental knee replacement.” (Id.)
Dr. Davis saw Plaintiff on September 30, 2013, for knee pain, among other complaints.
(Tr. 736-37.) After examining Plaintiff, for “musculoskeletal/extremities,” Dr. Davis reported
“[s]ignificant for right knee pain and crepitance. Normal gait. No edema.” (Tr. 737.)

Dr.

Davis assessed Plaintiff with degenerative joint disease and diabetes, referred Plaintiff for a sleep
study, and noted Plaintiff would be seen again after the sleep study. (Id.) No subsequent
medical records are available.
In addressing Plaintiff’s right knee issues, the ALJ noted Plaintiff alleged “disability due
to . . . arthritis in his right knee, and residual effects from right knee surgery. . . . He has asserted
that his knee frequently ‘locks up’ and that it starts ‘aching and hurting’ after standing for
‘periods of time.’” (Tr. 20.) The ALJ further noted Plaintiff “has alleged . . . that he cannot
squat or bend, . . . can stand for only two minutes at a time and can only walk 20 feet before
having to stop and rest.” (Id.) With respect to the medical records regarding Plaintiff’s right
knee, the ALJ wrote:
Treatment records show that [Plaintiff] often reported right knee pain when
presenting for treatment. . . . A September 2013 diagnostic image of [Plaintiff]’s
right knee revealed “minimal” compartment joint space loss, “minimal”
degenerative joint disease, and “small” suprapatellar effusion. . . . The record
indicates that [Plaintiff] underwent knee surgery around 2010. At one exam,
[Plaintiff] reported that the surgery was “of no benefit.”
However,
notwithstanding [Plaintiff]’s complaints and his assertion that his prior surgery
was unhelpful, the record shows that findings upon physical examination have
been relatively unremarkable, or, at the least, inconsistent with his allegations.
For instance, at multiple examinations, [Plaintiff] did not report musculoskeletal
symptoms or none were found on a review of systems. . . . During a March 2013
examination, it was noted that [Plaintiff] walked with a cane. . . . However, on
several other occasions, [Plaintiff] exhibited a normal gait. . . . During a
December 2011 examination, [Plaintiff] did not exhibit lower extremity
weakness.

24

(Tr. 20.) Based on the above-noted treatment of Plaintiff’s right knee, the ALJ found the
treatment was “inconsistent with allegations of disabling level knee issues.” (Id.) Additionally,
the ALJ noted that Plaintiff’s contention only a total knee replacement would help his knee pain,
was contrary to the results of the September 2013 examination by an orthopedic specialist who
had found Plaintiff was not a candidate for such surgery in light of the normal diagnostic images
of the right knee and normal knee examination. (Id.) The ALJ remarked that, “[t]he record
shows that [Plaintiff]’s knee issues have otherwise been treated with only conservative treatment
measures.” (Id.)
Plaintiff urges the ALJ did not consider his ongoing complaints of knee pain, but the ALJ
expressly took Plaintiff’s ongoing reports of knee pain into account to lower the work level that
had been recommended by the State agency medical consultant from “full range of medium
exertional level work” to “light exertional level work subject to various nonexertional
limitations.” (Tr. 21, 22.) While the ALJ acknowledged the ongoing reports of knee pain, the
ALJ also properly considered the unremarkable medical findings regarding Plaintiff’s right knee,
as well as inconsistencies in Plaintiff’s reports of knee pain and use of a cane 14 since the date of
disability. (Tr. 20, 21.) Plaintiff also asserts the suggestion that he have unicompartmental knee
replacement supports a conclusion the ALJ failed properly to develop the record.

That

suggestion, however, was qualified by a recommendation that Plaintiff first have another
arthroscopic surgery to ascertain whether such a knee replacement was warranted. There is no
indication that Plaintiff had that surgery by the time of the administrative hearing. Finally, the
ALJ expressly considered the September 2013 examinations and assessments, and Plaintiff’s
position that the 2010 knee surgery was “of no benefit.” (Tr. 20.)
14

Plaintiff also relies on his use of a knee brace to support his argument the ALJ should have more fully
developed the record. The record does not, however, demonstrate Plaintiff’s use of a knee brace after the date of
disability.

25

In summary, the record includes medical examinations, medical treatment, and medical
opinions regarding Plaintiff’s right knee pain from the 2010 date of knee injury up through
approximately six weeks before the administrative hearing. The ALJ considered the comprehensive
record regarding Plaintiff’s right knee in assessing the knee’s affect on Plaintiff’s disability. 15 The
available information shows the record regarding the crucial issue of Plaintiff’s right knee pain was fully
developed. See, e.g., Eichelberger, 390 F.3d at 592.

“The mere fact that working may cause pain or

discomfort does not mandate a finding of disability.” Craig v. Apfel, 212 F.3d 433, 436 (8th Cir. 2000).
Under the circumstances, there is no indication the ALJ needed additional medical evidence regarding
Plaintiff’s right knee pain to consider whether it was disabling.
IV.

Conclusion

The Court finds substantial evidence in the record as a whole supports the Commissioner’s
decision that Plaintiff is not disabled. As discussed above, neither the ALJ’s decision regarding the
nonseverity of Plaintiff’s bilateral carpal tunnel syndrome and diabetes, nor the available record regarding
Plaintiff’s bilateral carpal tunnel syndrome and right knee pain support reversal of the decision.
Accordingly,
IT IS HEREBY ORDERED that the final decision of the Acting Commissioner denying Social
Security benefits to Plaintiff is AFFIRMED. A separate judgment in accordance with this Memorandum
and Order is entered this date.

PATRICIA L. COHEN
UNITED STATES MAGISTRATE JUDGE
Dated this 2nd day of March, 2017.

15

Although the ALJ rejected medical opinions regarding the disabling nature of the right knee injury
issued during the care of the work injury, this is not a situation, as in Snead, where the ALJ rejects a medical opinion
without reasonable basis or without additional medical information to support the rejection. Instead, here the ALJ
properly reasoned that those opinions arose out of care before the October 8, 2011, date of disability relevant to this
case, and ultimately resulted in allowing Plaintiff to engage in substantial gainful activity, without restriction or
limitation, for approximately one year prior to the date of disability. Moreover, the ALJ properly considered the
medical care of Plaintiff’s right knee throughout the period after the October 8, 2011 date of disability.

26