Seiler v. Colvin
MEMORANDUM AND ORDER: IT IS HEREBY ORDERED that the decision of the Commissioner is affirmed. A judgment in accordance with this Memorandum and Order will be entered separately. Signed by District Judge Carol E. Jackson on 7/6/2017. (JMC)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
NANCY A. BERRYHILL1,
Acting Commissioner of Social Security,
Case No. 1:16-CV-77 (CEJ)
MEMORANDUM AND ORDER
This matter is before the Court for review of an adverse ruling by the Social
Security Administration (SSA). The Court has reviewed the parties' briefs and the
entire administrative record.
On May 14, 2013, plaintiff filed an application for adult disabled child’s
insurance benefits under Title II of the Social Security Act, alleging disability
beginning December 1, 1995.
The claim was denied initially on
August 30, 2013. (Tr. 83). Thereafter, plaintiff filed a written request for hearing
on October 2, 2013. (Tr. 90-91). On August 13, 2014, a video hearing was held in
front of an Administrative Law Judge (ALJ).
The ALJ subsequently
issued an unfavorable decision on December 19, 2014. (Tr. 9-25). On February
11, 2016, the Appeals Council declined to review the ALJ’s decision.
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 is substituted for Acting Commissioner Carolyn W.
Colvin as the defendant in this suit.
Accordingly, the ALJ’s decision stands as the Social Security Commissioner’s final
Evidence Before the ALJ
A. Disability Application Documents
On May 14, 2013, plaintiff applied for adult disabled child’s insurance benefits
under Title II of the Social Security Act.
(Tr. 151, 153). Plaintiff’s claim for
disability benefits was based upon: severe hearing loss, choanal artresia in nose,
chronic ear infections, and depression. (Tr. 66).
Plaintiff alleged an inability to
function and/or work as of December 1, 1995, when he was one year old. (Tr. 66).
Disability Report (undated)
In an undated Disability Report plaintiff stated that he suffered from severe
hearing loss, choanal artresia in nose, chronic ear infections, and depression. (Tr.
176). Plaintiff reported that he had never worked and believed his condition had
become severe enough to keep him from working on December 1, 1995. (Tr. 176).
Plaintiff graduated from high school on May 17, 2013 and did not attend special
education classes or complete any type of specialized job training, trade, or
vocational school. (Tr. 177). From August 2011 to April 2013, and continuing as
needed, plaintiff saw Deanna Siemer, M.D., as his general physician.
Dr. Siemer treated, among other issues, plaintiff’s ear infections. (Tr. 183).
Plaintiff stated that he had seen Steve Brown, a health care professional at
The Audiology Center, from 1995 or 1996 until 2011 for checkups, to clean out his
ears, do audio tests, and secure hearing aids. (Tr. 179). Plaintiff also noted that
he had a hearing test performed in 2011 by Christopher H. Jung, M.D. (Tr. 179180). Plaintiff stated he also saw Dr. Jung in 2013 for an ear examination and to
receive x-rays for his ears. (Tr. 180). Plaintiff also noted that he had seen Richard
Martin, M.D. since 1995 or 1996 until 2007 to place tubes in his ears, to remove his
adenoids/tonsils, and for surgery on his nose. (Tr. 181). Plaintiff also stated that
he visited Miracle Ear every three months from August of 2011 to April of 2013 for
checkups, cleaning, hearing aids, and audio testing. (Tr. 181-182). Plaintiff noted
that he saw Jan Seabaugh, M.D. from 2007 until 2012 for checkups, in-ear tube
placement, and to receive antibiotics for ear infections.
visited Vocational Rehabilitation at the end of 2012 to meet with Melissa Gallup, a
counselor for the deaf assisting in education and training. (Tr. 184).
Disability Report – Field Office
In a Disability Report dated May 14, 2013, plaintiff alleged a disability onset
date of December 1, 1995, and stated that was the date he began wearing hearing
The report stated that plaintiff had difficulty with hearing,
understanding, coherency, concentrating, talking, and answering. (Tr. 187). The
report observed that plaintiff was neat and clean, and cooperative most of the time.
The report noted that plaintiff had difficulty hearing the questions he
was being asked, and most of the questions were answered by his grandmother.
He also appeared to have difficulty understanding the questions, as he would look
to his grandmother for the information. (Tr. 188). The report further noted that
plaintiff insisted on reading everything himself and stated that he read well. (Tr.
The field officer noted that he thought plaintiff may have been in special
education; however both plaintiff and his grandmother said he had not been in
special education classes. (Tr. 188). Plaintiff and his grandmother reported that
plaintiff loved school and did not want to graduate and lose contact with his friends.
(Tr. 188). The field officer wrote that plaintiff appeared and sounded a lot younger
than his years and seemed very immature. (Tr. 188).
In a Function Report dated May 28, 2013, plaintiff stated he lived at home
with his grandparents. (Tr. 189). When asked what he did from the time he woke
up until going to bed, plaintiff stated that he played video games, visited neighbors,
went to town, attended school until graduation, and went for daily walks.
189). Plaintiff also stated that he was not working at the time. (Tr. 197). Plaintiff
stated that he does not support anyone else nor does he take care of pets or other
animals for himself or others. (Tr. 190). Plaintiff also stated that illnesses, injuries,
or other conditions do not impact his sleep. (Tr. 190).
Plaintiff noted that he had no problems with personal care. (Tr. 190). He did
not need special reminders to take care of personal needs and grooming, nor did he
need help or reminders to take medicine.
Plaintiff stated that his
grandmother prepared his meals, but sometimes he cooks food in the microwave.
(Tr. 191). Plaintiff’s household chores consisted of weeding the yard once a month.
He did not do housework because he lives with his grandparents and
just graduated high school. (Tr. 192). Plaintiff’s primary hobbies and interests are
reading, video games, and using his computer to write; he engaged in these
activities daily. (Tr. 193). Plaintiff also spent time with others playing sports and
riding all-terrain vehicles on a weekly basis. (Tr. 193). He attends sporting events
and does not need anyone to accompany him. (Tr. 193). Plaintiff also stated that
he does not have problems getting along with family, friends, neighbors, or others.
Plaintiff stated that he does a lot of walking and can walk two miles or more
without a rest. (Tr. 192). He stated that he is able to go out alone and that he
walks, drives a car, or rides in a car to get to his destination.
Plaintiff is able to do shopping in stores and by computer.
(Tr. 192, 194).
stated that he is able to pay bills, count change, and use a checkbook/money order
and that his ability to handle money had not changed since his condition began.
Plaintiff stated that his condition affects his talking and hearing because his
loss of hearing makes it harder to communicate. (Tr. 194). Plaintiff stated he can
follow written instructions well but has trouble following spoken instructions
because of his hearing issues. (Tr. 194). Plaintiff stated that he gets along with
authority figures and can handle stress and changes in routine. (Tr. 195). Plaintiff
wears a hearing aid and uses contact lenses, both prescribed by doctors. (Tr. 195).
The hearing aid was prescribed when he was 18 months old and the lenses were
prescribed when he was in second grade. Plaintiff stated he needs these aids at all
times. (Tr. 195).
Disability Determination Explanation
According to the Disability Determination Explanation, dated August 30,
2013, plaintiff had hearing loss which was not treated with cochlear implantation
and plaintiff’s statements about the intensity, persistence, and functionally limited
effects of the symptoms were substantiated by the objective medical evidence. (Tr.
70-71). It was further noted that plaintiff’s treating physician stated that plaintiff
would be unable to excel or function in the world without his hearing aids; however,
with his aids he should be able to complete tasks as he would want. (Tr. 72). The
explanation found that plaintiff was not limited to unskilled work because of the
impairments and determined he was not disabled. (Tr. 73).
The case analysis noted that plaintiff was not currently being treated by a
psychiatrist and was not seeking outpatient counseling. (Tr. 70). He was also not
taking any psychotropic medications at the time and had not required inpatient or
emergency treatment for any mental impairment.
problems with personal care and noted he does some yard work and is able to drive
and go out alone.
He further stated that he shops in stores and by
computer and spends time with others playing video games, sports and riding his
He further reported that he handles stress and
changes in routine adequately. (Tr. 70).
Work History Report
An undated work history report was contained in the record.
listing plaintiff’s name, social security number, and phone numbers the report was
left blank. (Tr. 169-175).
B. Medical Records
The Audiology Center
On May 29, 1998, plaintiff visited the Audiology Center for testing by Steve
Plaintiff was not tested for speech discrimination.
Brown recommended a follow-up visit.
After testing on February 2,
2000, it was noted that plaintiff had speech discrimination of 92% in the right ear
and 88% in the left ear. (Tr. 255). Brown remarked that plaintiff had moderate to
severe loss in his ears.
On November 26, 2011, plaintiff underwent
testing which revealed that plaintiff had speech discrimination of 80% in the right
ear and 92% in the left ear. (Tr. 253). On February 11, 2002, plaintiff was tested
and was found to have speech discrimination of 88% in the right ear and 92% in
the left ear. (Tr. 251). Brown stated that there was significant improvement in the
On October 24, 2002, plaintiff underwent testing which
revealed that he had good speech discrimination in both ears with discrimination
scores of 92% for both ears. (Tr. 247).
On August 15, 2005, plaintiff visited the Audiology Center for testing. (Tr.
Brown commented that results continue to suggest sensorineural hearing
loss, mild to moderate in the left ear and moderate in the right. (Tr. 246). Brown
recommended daily use of hearing aids, preferential classroom seating, and use of
personal FM auditory trainer in classroom as needed.
On August 7,
2006, plaintiff visited the Audiology Center for testing which noted that plaintiff had
good speech discrimination in both ears with discrimination scores of 92% for both
ears. (Tr. 242). Brown noted that there was a significant conductive reduction in
hearing, in addition to sensori-neural loss. (Tr. 242).
On May 31, 2007, plaintiff visited the Audiology Center for testing which
noted that plaintiff had good speech discrimination in both ears with discrimination
scores of 92% for both ears. (Tr. 241). Brown noted that there was a significant
conductive reduction in hearing, in addition to sensori-neural loss. (Tr. 241). On
May 19, 2008, plaintiff visited the Audiology Center for testing which noted that
plaintiff had good speech discrimination in both ears with discrimination scores of
92% for both ears. (Tr. 239). On September 13, 2010, Brown observed moderate
sensori-neural hearing loss in both ears. (Tr. 236). Brown recommended: (1) daily
use of hearing aids, (2) preferential classroom seating, and (3) use of FM-loop
systems for direct auditory input. (Tr. 236).
On September 16, 2010, Brown wrote a letter to Laura Saupe, RN, a nurse
at plaintiff’s high school.
Brown wrote that plaintiff experiences a
sensori-neural impairment of hearing in each ear and had worn amplification in
each ear since childhood. (Tr. 237). Brown also noted that plaintiff’s hearing aids
were approximately seven years old, and that one of them was no longer working
and the other did not meet the manufacturer’s specifications. (Tr. 237). Brown also
stated that plaintiff’s hearing loss is of moderate severity and slightly worse on his
He noted plaintiff maintained relatively good speech
discrimination and normal middle ear function bilaterally. (Tr. 237).
recommended plaintiff be fit with new and more appropriate amplification and that
he be provided with preferential classroom seating and an FM amplification system
on an as needed basis. (Tr. 237).
On October 18, 2010, Steve Brown authored a letter to plaintiff’s parents
regarding plaintiff’s September 13, 2010 visit.
The letter stated that
plaintiff continued to experience a moderate sensori-neural hearing loss in both
ears, slightly worse on the right side. (Tr. 238).
Brown noted the age of plaintiff’s
hearing aids and that one did not work and the other did not meet the
manufacturer’s specifications. (Tr. 238). The letter also noted that plaintiff did not
qualify for Medicaid and that new devices would be ordered upon receipt of
notification that financing had been obtained. (Tr. 238).
On April 1, 2011, plaintiff visited the Audiology Center for testing by Cathy
Willen. (Tr. 234). Willen noted that there was a significant change in hearing from
September 13, 2010. (Tr. 234). Willen suggested plaintiff increase volume in his
hearing aids and recommended plaintiff for a follow-up visit. (Tr. 234).
On February 17, 2012, plaintiff visited Jan Seabaugh, M.D. with drainage in
his left ear. (Tr. 259). Dr. Seabaugh noted that plaintiff’s primary complaint was a
possible ear infection and left ear trouble. (Tr. 259). Dr. Seabuagh performed an
exam on his ears, prescribed medicine and recommended plaintiff return in two
weeks for follow-up. (Tr. 260).
On February 5, 2013, plaintiff saw Christopher Jung, M.D., for recurrent ear
infections. (Tr. 262). Plaintiff also complained of hearing loss. (Tr. 262). Jung
diagnosed plaintiff with unspecific otitis media, chronic sinusitis, and a deviated
On June 3, 2013, plaintiff visited Dr. Jung presenting
with bilateral bloody ear drainage. (Tr. 281). Jung noted plaintiff had unresolved
symptoms including: hearing loss, bilateral ear discharge, bilateral earache, and
recurring ear infections. (Tr. 281). Jung diagnosed plaintiff with suppurative and
acute otitis media without spontaneous rupture of ear drum and dysfunction of
theEustachian tube. (Tr. 283).
On April 1, 2014, plaintiff presented to Dr. Jung complaining of issues with
his hearing aids which caused him to get infections. (Tr. 310). Plaintiff reported
hearing loss, bilateral ear discharge, bilateral earache, and recurring ear infections.
On May 5, 2014, plaintiff visited Dr. Jung for a checkup on his ear
Plaintiff noted that he had finished his antibiotics, and
complained that his hearing aids were contributing to his ear infections. (Tr. 307).
Jung diagnosed plaintiff with unspecified otitis media, unilateral sensory neural
hearing loss, and unilateral mixed hearing loss.
On June 2, 2014,
plaintiff visited Dr. Jung complaining of an infection in his left ear.
Plaintiff reported hearing loss, bilateral ear discharge, bilateral earache, and
recurring ear infections. (Tr. 303). Jung diagnosed plaintiff with unilateral sensory
neural hearing loss, unilateral mixed hearing loss, an allergy due to allergen rhinitis
and general otorrhea. (Tr. 305). On July 28, 2014, plaintiff presented to Dr. Jung
for a follow-up visit regarding bilateral ears and sinus symptoms. (Tr. 313). Dr.
Jung diagnosed plaintiff with nasal airway obstruction congestion, bilateral mixed
hearing loss, acute otitis external, unspecified otorrhea, allergy due to allergen
rhinitis, maxillary chronic sinusitis, and dysfunction of the Eustachian tube.
Jackson Primary Care
On August 6, 2012, plaintiff visited Jackson Primary Care presenting with an
earache that had been present for days. (Tr. 276). Plaintiff presented symptoms
of pain and drainage.
On August 8, 2012, plaintiff saw Dr. Deanna
Siemer for a routine examination. (Tr. 274).
Dr. Siemer suggested follow-up in
one week to remove plaintiff’s moles. (Tr. 274). On September 9, 2012, plaintiff
visited Dr. Siemer for an earache and mole removal. (Tr. 272). On September 17,
2012, plaintiff visited Dr. Siemer to remove sutures. (Tr. 270). Dr. Siemer noted
that plaintiff was healing well. (Tr. 270).
On May 1, 2013, plaintiff met with Melissa Gallup who administered an
interest inventory of Missouri connections and a career scope exam. (Tr. 219).
During the meeting, Gallup noted that plaintiff made very poor eye contact, spoke
very softly, and responded with one-word answers. (Tr. 219). Gallup noted that
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plaintiff scored well in clerical perception and was interested in arts, photography,
Gallup suggested graphic arts as a potential vocation for
plaintiff. (Tr. 219). Gallup noted that plaintiff’s grades had fluctuated, noting he
was making C’s in English and history and had an A in algebra. (Tr. 219). Gallup
also noted that plaintiff had never had any accommodations in school. (Tr. 219).
Gallup also stated that because of the lack of accommodations throughout his
school career, social awkwardness, and extreme shyness, it was difficult to assess
his academic and learning ability. (Tr. 219).
On July 15, 2013, Gallup stated that she attempted to discuss plaintiff’s
conversation. (Tr. 218). Plaintiff’s grandmother attended the meeting and would
answer after trying to get plaintiff to respond.
Gallup presented the
career scope results and noted plaintiff scored highest in art interests and then
social interests. (Tr. 218). Gallup stated that the social result did not fit plaintiff
and made her question whether he understood the questions.
October 28, 2013, plaintiff again met with Gallup. (Tr. 217). Gallup attempted to
discuss plaintiff’s interests and plan for the future but noted that it was extremely
difficult to get information from him.
She also stated that he really
wanted to attend school next semester but would have to get student loans to pay
unless he was awarded Supplemental Security Income. (Tr. 217).
In a phone call on February 4, 2014, Gallup and plaintiff’s grandmother
discussed the denial of plaintiff’s disability claim and the fact that plaintiff was still
not working. (Tr. 216). It was noted that plaintiff’s social skills were very poor and
he did not talk or respond to questions. (Tr. 216). Gallup reported that plaintiff
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wanted to go to school but did not have money to pay for it. (Tr. 216). Gallup also
noted that while plaintiff can drive, he did not like to drive to Perryville which would
be the best location to find an entry level job. (Tr. 216).
Following a meeting with plaintiff on May 5, 2014, Gallup noted that plaintiff
had been doing some farmhand work part-time.
They discussed the
option of looking for work in a different location because there were few job
opportunities where plaintiff lived. (Tr. 215). They discussed volunteering to help
build his resume and references, but plaintiff stated he did not want to do that.
(Tr. 215). Gallup noted that plaintiff was not pursuing college for next semester.
Gallup further noted that plaintiff’s social skills were his biggest
impediment to employment, coupled with his hearing loss, and intensified by his
inability to communicate and interact appropriately with others. (Tr. 215).
Tender Hearts Child Therapy Center
On October 8, 2013, plaintiff received a treatment plan from Tender Hearts
Child Therapy Center after a psychological assessment administered by Brittany
Meredith. (Tr. 289). Plaintiff’s grandmother brought him for therapy due to abuse
suffered while plaintiff was living with his mother and step-father and to deal with
the death of his father from cancer. (Tr. 294). The primary problem identified in
the plan was that plaintiff was the victim of physical and emotional abuse.
The plan’s stated goals were to reduce displays of aggression that reflect
abuse and keep others at an emotional distance, resolve feelings of fear and
depression while improving communication, and build self-esteem and a sense of
empowerment. (Tr. 289).
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On June 12, 2014, Elizabeth Eschmann filled out a hearing loss questionnaire
and noted that hearing aids substantially improved plaintiff’s hearing loss.
298). Eschmann also stated that plaintiff’s word recognition score without hearing
aids was at 84% on both right and left ears. (Tr. 298). She noted that plaintiff
was unable to hear and understand normal sound level conversation, however she
also stated that plaintiff was able to hear and understand phone conversations.
(Tr. 298). Eschmann also noted that with his hearing aids in, plaintiff should be
able to complete tasks when instructed by coworkers and supervisors with his
hearing aids; however without his hearing aids plaintiff would struggle. (Tr. 298).
Eschmann also stated that plaintiff could read lips successfully. (Tr. 298).
C. Testimony at Hearing
At the hearing on August 13, 2014, plaintiff testified in response to questions
posed by the ALJ and counsel. (Tr. 43). Plaintiff stated that he moved in with his
grandparents three years prior to the hearing, following the death of his father.
(Tr. 51). Plaintiff stated that he was twenty years old and that his grandmother
handled his medical insurance. (Tr. 43-44). Plaintiff stated that he currently had
medical issues, specifically ear infections with some drainage and some issues with
pain in his ears. (Tr. 56). Plaintiff testified that he had used his hearing aids since
he was a baby. (Tr. 55). Plaintiff noted that typically his hearing in his left ear is
worse than his right ear. (Tr. 56). Plaintiff stated that he typically has infections
regularly over the course of several weeks and receives antibiotics from his doctors.
(Tr. 56). Plaintiff noted that his grandmother had him visit the doctor every month
regarding his ears. (Tr. 56). Plaintiff stated that he used to see Dr. Steve Brown
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regarding his ears but changed doctors a few years ago. (Tr. 56). Plaintiff also
noted that it hurt to use his hearing aids when he has an ear infection. (Tr. 57).
However, plaintiff noted that he does not feel like his ear pain or ear condition
affected his ability to concentrate on his schoolwork and that he could still complete
his work. (Tr. 58). He denied feeling any type of depression or sadness and stated
that he spoke with a counselor regarding his hearing. (Tr. 58).
Plaintiff testified that he had graduated from high school. (Tr. 48). He noted
that he was disappointed that high school was over and he felt like he was leaving
Plaintiff testified that he spends time with younger
people and but also has friends his own age. (Tr. 53). Plaintiff further testified that
he doesn’t spend time with people his own age anymore because they went
different places after high school. (Tr. 53). Plaintiff stated his closest friend is his
fifteen-year-old next door neighbor, they see each other almost daily and typically
play Xbox or throw a baseball around. (Tr. 53). Plaintiff stated that his hearing
gave him trouble at school because at times he couldn’t understand what was being
said – he noted that he was often put close to the front of the classroom which
allowed him to better understand. (Tr. 48). Plaintiff further testified that he did
not usually need to ask his teachers for help explaining concepts. (Tr. 48). Plaintiff
stated that he does not have trouble reading; he reads chapter books and used to
read all the time. (Tr. 48).
Plaintiff testified that he is able to do household chores, such as cooking,
cleaning, and dusting.
Plaintiff also noted that he sometimes needs
reminders to do chores, and occasionally gets frustrated or angry when someone
reminds him. (Tr. 51-52). Plaintiff stated that his only previous work experience
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was doing small jobs for his neighbors. (Tr. 54). Plaintiff stated that he would feed
their animals and water their plants. (Tr. 54). Typically, plaintiff would work for
the neighbors when they went on vacation. (Tr. 55). Plaintiff also has a driver’s
license. (Tr. 49). He passed both a written exam administered on a computer and
a driving exam. (Tr. 49). Plaintiff stated that he does not have trouble driving, but
does not drive often.
Plaintiff noted that if he is not driving his
grandmother takes him to his appointments. (Tr. 50).
On a typical day, plaintiff testified that he writes stories and reads. (Tr. 54).
Plaintiff noted that he does not have trouble concentrating while writing stories.
(Tr. 59). Plaintiff stated that he occasionally watches television and has to have it
set at a certain volume or cup his ears in order to hear. (Tr. 54). Plaintiff stated
that he was unaware if he was receiving any income, but stated that he managed
his own money. (Tr. 47). He noted that he was unsure how much money he had
and stated that he sometimes used his money to pay for his phone and he expected
he would need to pay for insurance soon.
Plaintiff stated that he
sometimes purchases books and games, and was trying to limit his consumption of
candy and food. (Tr. 47).
Plaintiff stated that he had trouble falling asleep at times. (Tr. 54). He also
noted that he sometimes stayed up or woke up late. (Tr. 54). Plaintiff wasn’t sure
why he had trouble falling asleep but sometimes he felt that he just wasn’t ready to
go to sleep. (Tr. 54). Plaintiff also testified about visiting a Tender Hearts counselor
and discussing his anger and frustration when his grandmother repeats things. (Tr.
Plaintiff also stated that he did not get frustrated at school if he didn’t
understand a concept or if he had any trouble. (Tr. 53).
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Vocational Expert Testimony
During the hearing, the Administrative Law Judge proposed a number of
hypothetical questions to Dr. Geist, the vocational expert.
hypothetical assumed an individual the same age as plaintiff, with a high school
level education and no past relevant work experience.
(Tr. 61). The first
hypothetical assumed the individual has no exertional limitations, but noted the
individual should avoid working around hazards, such as unprotected heights,
around dangerous or moving machinery, and should not be subject to a noise level
The individual is further limited to hearing and
understanding simple oral instructions and communicating simple information and
should not be required to talk on the telephone as part of the job function. (Tr.
Dr. Geist suggested such a person could do janitorial work, packing, or
inspections. (Tr. 62). The second hypothetical assumed the same limitations, with
the added limitation that the individual is unable to perform tasks requiring more
than superficial interaction with the public or coworkers. (Tr. 62). Dr. Geist stated
the additional limitation would not eliminate any of her previously suggested jobs.
Plaintiff’s counsel assumed the same limitations, with the added limitation of
being unable to hear and understand normal sound level conversations. (Tr. 63).
Dr. Geist stated that if the individual was unable to understand directions from the
supervisor on the occasional basis they are given, the proposed jobs would be
eliminated. (Tr. 63). Plaintiff’s counsel also asked, assuming the limitations posed
in the first hypothetical, whether an individual who consistently missed two days of
work per month due to mental or physical symptoms would be able to perform the
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Dr. Geist stated those limitations would likely not be
tolerated. (Tr. 64). Plaintiff’s counsel also asked, assuming the limitations posed in
the first hypothetical, whether an individual requiring the use of a job coach to reexplain or help the individual understand even simple instructions would be able to
perform the listed jobs.
Dr. Geist stated that likely would not be
acceptable. (Tr. 64).
D. Psychological Report
Plaintiff was evaluated on September 23, 2014, by Shawn Guiling, a licensed
psychologist, after being referred by the ALJ for a psychological examination. (Tr.
319). The report noted that plaintiff’s allegations were severe hearing loss, in nose
choanal atresia, chronic ear infections, and depression. (Tr. 319). Plaintiff noted
that he currently was suffering from an ear infection. (Tr. 320). Guiling stated that
plaintiff was cooperative and somewhat forthcoming with information as part of the
noncommittal and that plaintiff would have to be asked for clarification regularly.
Guiling stated he used records obtained and sent by the ALJ, the
interview with plaintiff, plaintiff’s grandmother, and a number of letters from
acquaintances of plaintiff. (Tr. 319-20).
Plaintiff’s grandmother stated that her desire was for plaintiff to get a job or
learn a useful skill; if he was unable to do that she hoped he would get support
through disability determinations.
Plaintiff had no explanation of his
concerns except that he wanted his grandmother to stop pressuring him to get a
job and his grandfather to stop being cranky with him. (Tr. 320). Plaintiff stated
that he had no job and did not know of any job he would like to do beyond being a
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film director. (Tr. 321). Plaintiff further stated that he reads a lot and had started
writing about a character based on episodes of television he had watched.
321). Plaintiff stated that he took care of his neighbors’ pets and plants while they
were away and had applied to work at various places near his home, including a
gas station, diner and career center as janitorial staff; however plaintiff stated that
none of these locations were hiring.
Plaintiff also stated that he
considered working at Wal-Mart but was concerned about the drive. (Tr. 321).
Dr. Guiling noted that plaintiff demonstrated somewhat below average
intelligence and fund of knowledge. (Tr. 322). Dr. Guiling noted that plaintiff was
able to identify the current day of the week, the month, year, and season;
however, it took plaintiff several attempts to determine the right answers, having to
talk aloud to himself and recite the months and days of the week.
Plaintiff was also only able to count backward from 100 by 7s twice, counting 93
and 86, before being unable to continue. (Tr. 321). During the interview, plaintiff
demonstrated poor judgment and minimal insight, showing little understanding of
his concerns and minimal preparation for his day to day life and future. (Tr. 322).
Plaintiff stated that he was mature enough to handle money, however Dr. Guiling
noted that there was no evidence of his ability because he had never held a job.
Dr. Guiling stated that plaintiff was likely unable to understand and
remember more than very simple instructions, especially without repetition.
Dr. Guiling further observed that plaintiff appeared to have difficulty
concentrating and reported no ability to persist in tasks. (Tr. 322).
Dr. Guiling remarked that plaintiff had
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generally low intellectual ability and adaptive functioning. (Tr. 323). Dr. Guiling
observed that plaintiff currently functioned similarly to a person with developmental
and intellectual delays, and believed those skills had been delayed by verbal abuse
and others in his life doing tasks for him instead of expecting him or aiding him to
learn new skills. (Tr. 323). Dr. Guiling further observed that plaintiff was largely
unaware of his day-to-day difficulties with societal expectations and was likely not
able to fully cognitively comprehend them.
Dr. Guiling noted that
plaintiff does have support in the form of his grandmother, but suggested plaintiff
would possibly progress faster if he was not where someone would always clean up
after him, instead requiring him to do more on his own.
suggested plaintiff would benefit from a sleep study, career counseling, and job
shadowing to help find a suitable job or sheltered workshop type option for work
where tasks would entail close supervision and repetition of direction. (Tr. 323).
E. Third-Party Statements
Plaintiff provided the ALJ with statements from family members, neighbors,
and employees from the Oak Ridge School District.
On July 17, 2014, Edward McGrew, the Oak Ridge School District school
psychological examiner, provided a statement in support of plaintiff’s application for
disability benefits. (Tr. 224).
McGrew stated that in his opinion, plaintiff would
have difficulty living and working independently.
McGrew based this
opinion on his observation that plaintiff operates on a very immature level socially
and plaintiff’s profound hearing loss. (Tr. 224). McGrew noted that plaintiff, as a
high school senior, described his best friends as students in middle school because
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he was better able to relate to much younger students while having no successful
relationships among his peers. (Tr. 224). McGrew further noted that plaintiff had
difficulty communicating with staff.
McGrew also stated that plaintiff
often did not wear his hearing aids, stating that they did not work properly. (Tr.
McGrew further stated that when plaintiff has hearing aids that operate
properly, he still suffers from frequent ear infections. (Tr. 224).
In a letter dated June 27, 2014, Kim Keller, an employee of the Oak Ridge
School District, described plaintiff as sweet, polite, and eager to help. (Tr. 222).
She noted that plaintiff was fairly quiet, but he occasionally expressed a desire for
Although plaintiff was never one of Keller’s students, she worked
with him on different occasions through the school’s after-school program.
Keller stated that plaintiff’s hearing loss limited his ability to communicate
She further noted that it is often necessary to repeat things to him
multiple times and that his hear impairment results in miscommunications.
Keller also noted that plaintiff’s hearing loss has a negative impact on his
speech, and that when conversing with plaintiff, one has to listen very carefully and
intently to fully understand what he is saying.
Keller stated that his
hearing loss made communication with peers challenging and his physical
impairments seemed to carry over and impact his ability to socialize effectively.
Keller stated that she believed plaintiff possesses average, and in some areas
above average intelligence. (Tr. 223). Keller also stated that plaintiff’s ability to
independently function in society and the workforce is limited because of his poor
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communication and socialization skills. (Tr. 223). While noting she is not a doctor
or psychologist, Keller stated that it is imperative that plaintiff receive help soon
and fears that if he doesn’t experience accomplishment and pride in his work,
plaintiff will continue to lose self-confidence and slip further into depression. (Tr.
Coraleta M. Alley-Pratt
Coralata M. Alley-Pratt is the neighbor of plaintiff’s grandparents and her son
is plaintiff’s friend. (Tr. 228). In a letter dated August 1, 2014, Pratt wrote that
plaintiff’s ability to communicate is very low because of his hearing impairment.
When Pratt and her family are out of town, plaintiff takes care of their animals for
periods ranging from two to ten days.
Plaintiff’s responsibilities have included
feeding and watering the cats, taking care of the chickens, and taking care of the
She noted that communicating with plaintiff over the phone is difficult
because his speaking skills are weak. She also noted that plaintiff cannot handle
complex tasks even when the instructions are in writing, and that he seems to lack
Pratt further stated that plaintiff is socially behind other young
men his age and has low communication skills.
She also stated that he does not
seem aware of basic day to day issues.
In a letter dated August 1, 2014, Mark Gihring, one of plaintiff’s teacher,
wrote that plaintiff’s disabilities are centered on his hearing impairment. (Tr. 227).
Gihring noted that plaintiff had a fair degree of difficulty communicating, both in
hearing and speech, specifically in expressing himself effectively.
noted that plaintiff’s hearing impairment creates adversity in how he interacts with
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others and how he could effectively accomplish tasks in an environment outside of
family and friends.
Gihring felt that plaintiff’s ability to recognize danger,
understand directions in critical situations, and quickly think on his feet are also
Shelly Schamburg, plaintiff’s aunt, described plaintiff as immature for his
age, noting that he relates better to people who are younger than he. (Tr. 226).
She wrote that plaintiff is not very sociable, that he does not know how to interact
well with people, and that he usually does not display any emotion. She noted that
plaintiff loves writing and reading about things that are based in fantasy.
Schamburg further noted that plaintiff becomes nervous if he doesn’t have a
routine and he is afraid to try new things because he doesn’t want to fail.
Jeanne Seiler, plaintiff’s grandmother, wrote that plaintiff came to live with
her in August of 2011, after his father passed away. (Tr. 225). Seiler noted that
plaintiff has had hearing aids since he was 18 months old and had had numerous
ear infections. Seiler stated that plaintiff is “way behind in his maturity,” and that
he doesn’t interact well with people his age. (Tr. 225). She noted that even though
plaintiff had his driver’s license, he did not want to go anywhere and that driving in
town overwhelmed him. Seiler believed that plaintiff could not consistently get to
understanding plaintiff’s speech.
The ALJ’s Decision
In the decision issued on December 19, 2014, the ALJ made the following
findings with respect to plaintiff’s application for disability insurance benefits:
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Born on June 29, 1994, the claimant has not yet attained age 22.
The claimant has not engaged in substantial gainful activity since June
28, 2012, the date he attained age 18.
The claimant has the following severe impairments: bilateral hearing
loss and unspecific neurodevelopmental disorder.
The claimant does not have an impairment or combination of
impairments that meets or medically equals the severity of one of the listed
impairments in 20 CFR Part 404, Subpart P. Appendix 1.
The claimant has the residual functional capacity to perform a full
range of work at all exertional levels. He must avoid any exposure to workplace
hazards such as unprotected heights and dangerous moving machinery and is
limited to a work environment that has no noise above the moderate level. He is
limited to hearing and understanding simple oral instructions and only on an
occasional basis, is limited to communicating simple information, and is precluded
from telephone work, solicitation, or sales. He cannot perform tasks requiring more
than superficial interaction with the public or co-workers and where interaction is
only on an occasional basis.
The claimant has no past relevant work.
The claimant was born on June 29, 1994 and attained age 18 on June
28, 2012. He was a “younger individual” on that date.
The claimant has at least a high school education and is able to
communicate in English.
Transferability of job skills is not an issue because the claimant does
not have past relevant work.
Considering the claimant’s age, education, work experience, and residual
functional capacity, there are jobs that exist in significant numbers in the national
economy that the claimant can perform.
The claimant has not been under a disability, as defined in the Social
Security Act, from December 1, 1995, through the date of the decision.
A. Legal Standard
The Court must affirm the Commissioner’s decision “if the decision is not
based on legal error and if there is substantial evidence in the record as a whole to
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support the conclusion that the plaintiff was not disabled.” Long v. Chater, 108 F.3d
185, 187 (8th Cir. 1997). “‘Substantial evidence is less than a preponderance, but
enough so that a reasonable mind might find it adequate to support the
conclusion.’” Estes v. Barnhart, 275 F.3d 722, 724 (8th Cir. 2002) (quoting Johnson
v. Apfel, 240 F.3d 1145, 1147 (8th Cir. 2001)). If, after reviewing the record, the
Court finds it possible to draw two inconsistent positions from the evidence and one
of those positions represents the Commissioner’s findings, the Court must affirm
the decision of the Commissioner. Buckner v. Astrue, 646 F.3d 549, 556 (8th Cir.
2011) (quotations and citation omitted).
To be entitled to disability benefits, a plaintiff must prove he is unable to
perform any substantial gainful activity due to a medically determinable physical or
mental impairment that would either result in death or which has lasted or could be
expected to last for at least twelve continuous months. 42 U.S.C. § 423(a)(1)(D),
(d)(1)(A); Pate-Fires v. Astrue, 564 F.3d 935, 942 (8th Cir. 2009). The
Commissioner has established a five-step process for determining whether a person
is disabled. See 20 C.F.R. § 404.1520; Moore v. Astrue, 572 F.3d 520, 523 (8th Cir.
2009). “Each step in the disability determination entails a separate analysis and
legal standard.” Lacroix v. Barnhart, 465 F.3d 881, 888 n.3 (8th Cir. 2006).
Steps one through three requires the plaintiff to prove (1) he is not currently
engaged in substantial gainful activity, (2) he suffers from a severe impairment,
and (3) his disability meets or equals a listed impairment. Pate-Fires, 564 F.3d at
942. If the plaintiff does not suffer from a listed impairment or its equivalent, the
Commissioner’s analysis proceeds to steps four and five. Id. Prior to step four, the
ALJ must assess the plaintiff’s residual functional capacity (“RFC”), which is the
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most a plaintiff can do despite his limitations. Moore, 572 F.3d at 523 (citing 20
C.F.R. § 404.1545(a)(1)). “RFC is an administrative assessment of the extent to
which an individual’s medically determinable impairment(s), including any related
symptoms, such as pain, may cause physical or mental limitations or restrictions
that may affect his or her capacity to do work-related physical and mental
activities.” Social Security Ruling (SSR) 96-8p, 1996 WL 374184, *2. “[A] plaintiff’s
RFC [is] based on all relevant evidence, including the medical records, observations
by treating physicians and others, and an individual’s own description of his
limitations.” Moore, 572 F.3d at 523 (quotation and citation omitted).
In determining a plaintiff’s RFC, the ALJ must evaluate the plaintiff’s
credibility. Wagner v. Astrue, 499 F.3d 842, 851 (8th Cir. 2007); Pearsall v.
Massanari, 274 F.3d 1211, 1218 (8th Cir. 2002). This evaluation requires that the
ALJ consider “(1) the plaintiff’s daily activities; (2) the duration, intensity, and
frequency of the pain; (3) the precipitating and aggravating factors; (4) the
restrictions; (6) the plaintiff’s work history; and (7) the absence of objective
medical evidence to support the plaintiff’s complaints.” Buckner, at 558 (quotation
and citation omitted). “Although ‘an ALJ may not discount a plaintiff’s allegations of
disabling pain solely because the objective medical evidence does not fully support
them,’ the ALJ may find that these allegations are not credible ‘if there are
inconsistencies in the evidence as a whole.’” Id. (quoting Goff v. Barnhart, 421 F.3d
785, 792 (8th Cir. 2005)). After considering the seven factors, the ALJ must make
express credibility determinations and set forth the inconsistencies in the record
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which caused the ALJ to reject the plaintiff’s complaints. Singh v. Apfel, 222 F.3d
448, 452 (8th Cir. 2000).
At step four, the ALJ determines whether a plaintiff can return to his past
relevant work, by comparing the RFC with the physical and mental demands of a
plaintiff’s past work. 20 C.F.R. § 404.1520(f). The burden at step four remains with
the plaintiff to prove her RFC and establish that he cannot return to his past
relevant work. Moore, 572 F.3d at 523; accord Dukes v. Barnhart, 436 F.3d 923,
928 (8th Cir. 2006); Vandenboom v. Barnhart, 421 F.3d 745, 750 (8th Cir. 2005).
If the ALJ holds at step four of the process that a plaintiff cannot return to past
relevant work, the burden shifts at step five to the Commissioner to establish that
the plaintiff maintains the RFC to perform a significant number of jobs within the
national economy. Banks v. Massanari, 258 F.3d 820, 824 (8th Cir. 2001); see also
20 C.F.R. § 404.1520(f). If the plaintiff is prevented by his impairment from doing
any other work, the ALJ will find the plaintiff to be disabled.
B. Dr. Guiling
Plaintiff first argues that the ALJ erred by giving insufficient weight to Dr.
In making a disability determination, the ALJ must “always consider the
medical opinions in the case record together with the rest of the relevant evidence
in the record.” 20 C.F.R. § 404.1527(b); see also Heino v. Astrue, 578 F.3d 873,
879 (8th Cir.2009). It is well established that an ALJ may grant less weight to a
treating physician's opinion when that opinion conflicts with other substantial
medical evidence contained within the record. Prosch v. Apfel, 201 F.3d 1010,
1013–14 (8th Cir.2000).
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According to 20 C.F.R. § 404.1527(c) an ALJ will consider several factors to
decide the weight that should be afforded to a medical opinion, including the (1)
examining relationship, (2) length of the treatment relationship and frequency of
examination, (3) nature and extent of the treatment relationship, (4) supportability
of the opinion, (5) consistency with the record as a whole, (6) specialization of the
expert, and (7) any other factors brought to the ALJ’s attention. 20 C.F.R. §
404.1527(c)(1)-(6). Here, the ALJ assigned no weight to Dr. Guiling’s opinion of the
need for close supervision and repetition of direction.
The ALJ noted that Dr.
Guiling examined plaintiff only once and that it did not appear that he reviewed the
other evidence in the record. Dr. Guiling makes no reference to any material other
than his own observations in his report with the exception of his notation that he
used the records obtained from the ALJ as a source for his report. The ALJ noted
that Dr. Guiling’s report appeared inconsistent with plaintiff’s statements in his
application materials, to various treating sources, and at the hearing. The ALJ also
remarked that the plaintiff had not demonstrated significant deficits in memory,
concentration, or cognitive skills to other examiners, and he had not reported or
alleged any limitations in those areas.
The ALJ further noted while third-party
statements indicated some limitation in those areas, the medical records and
plaintiff’s own recollections did not support those assertions.
Plaintiff argues that the ALJ’s reasoning is not sufficient to discount Dr.
Guiling’s opinion and that it is unclear how review of the records in this case would
have helped Dr. Guiling form an opinion regarding plaintiff’s mental limitations.
Plaintiff further argues that the ALJ recognized at the hearing that there were no
medical records from an acceptable medical source in the file related to plaintiff’s
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mental impairments or abilities. However, this argument misconstrues the hearing
testimony. In fact, the ALJ does not state or imply that there were no acceptable
medical records in the file related to plaintiff’s mental impairments or abilities.
Furthermore, the Court finds that the ALJ provided sufficient reasoning for the
decision to discount Dr. Guiling’s opinion.
opinion reflects that the ALJ
correctly considered several of the statutory factors enumerated in 20 C.F.R. §
404.1527(c) to determine the weight to be accorded to Dr. Guiling’s opinion. The
ALJ noted that Dr. Guiling examined plaintiff only once and that his opinion
appeared to be based on the plaintiff’s complaints during the evaluation——
complaints that the ALJ determined were inconsistent with plaintiff’s statements in
his application materials, to various treating sources, and at his hearing. The ALJ
further noted that plaintiff had not demonstrated significant deficiencies in memory,
concentration, or cognitive skills to other examiners and had not reported
limitations in those areas. The ALJ stated that plaintiff had not alleged deficits in
social function and, beyond the third-party statements and Dr. Guiling’s report, the
record did not support the limitation. “It is the ALJ's function to resolve conflicts
among the opinions of various treating and examining physicians. The ALJ may
reject the conclusions of any medical expert, whether hired by the claimant or the
government, if they are inconsistent with the record as a whole.” Wagner v. Astrue,
499 F.3d 842, 848 (8th Cir.2007) (citing Pearsall v. Massanari, 274 F.3d 1211,
1219 (8th Cir.2001)).
Here, the record contained medical records from the
Audiology Center stating that plaintiff had good speech discrimination with use of
his hearing aids and records from Miracle Ear stating that he should be able to
complete tasks when instructed by coworkers and supervisors when he wears his
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hearing aids. Further, plaintiff’s graduation from high school in a regular classroom
setting and his hobbies of video games, reading, and story-writing were
inconsistent with the need for sheltered workshop or a heavily supervised position.
Here, the record supports the ALJ’s contention as plaintiff testified, on numerous
occasions, regarding his ability to do all of the aforementioned activities.
Plaintiff also argues that the other evidence of record was consistent with Dr.
In support of this argument, plaintiff cites the psychological
assessment done at Tender Hearts, the statement provided by plaintiff’s high school
psychological examiner, as well as statements provided by plaintiff’s grandmother,
aunt, high school teacher, and neighbor.
Each of these statements described
plaintiff as immature and lacking in social skills. The ALJ noted that he considered
the third-party evidence submitted and provided a number of reasons why he did
not assign any of them great weight, including inconsistency with the evidence and
lack of special education.
Upon review of the record, the Court finds that the
Explanation (Tr. 73), the Disability Report (Tr. 187-188), the Function Report (Tr.
189-195), the Audiology Center (Tr. 251-256), and Dr. Jung’s (Tr. 262) medical
Contrary to plaintiff’s argument, the ALJ’s determination to assign Dr.
Guiling’s opinion no weight is supported by substantial medical evidence.
C. Residual Functional Capacity
Plaintiff next argues that even if the ALJ was correct in giving no weight to
Dr. Guiling’s opinion, the ALJ’s RFC determination still lacks a sufficient basis.
claimant's RFC is “the most a claimant can still do despite his or her physical or
mental limitations.” Martise v. Astrue, 641 F.3d 909, 923 (8th Cir.2011) (internal
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quotations, alteration and citations omitted). “The ALJ bears the
responsibility for determining a claimant's RFC and because RFC is a medical
question, some medical evidence must support the determination of the claimant's
RFC.” Id. “However, the burden of persuasion to prove disability and demonstrate
RFC remains on the claimant.” Id. Even though the RFC assessment draws from
medical sources for support, it is ultimately an administrative determination
reserved to the Commissioner. Cox v. Astrue, 495 F.3d 614, 619 (8th Cir.2007)
(citing 20 C.F.R. §§ 416.927(e)(2), 416.946 (2006). Because a claimant's RFC is a
determination. Vossen v. Astrue, 612 F.3d 1011, 1016 (8th Cir.2010); Eichelberger,
390 F.3d at 591; Hutsell v. Massanari, 259 F.3d 707, 711–12 (8th Cir.2001). As
such, the ALJ must “consider at least some supporting evidence from a [medical
professional]” and should obtain medical evidence that addresses the claimant's
ability to function in the workplace. Hutsell, 259 F.3d at 712.
Plaintiff argues that by discounting the opinion of Dr. Guiling, it is unclear
what medical evidence the ALJ relied on in assessing the RFC.
argues that while there is some evidence of his impairments, other than Dr.
Guiling’s opinion, the record does not contain any medical evidence or other
evidence to support the ALJ’s decision. However, the Court finds that the medical
records of the Audiology Center and Dr. Jung provide sufficient support for the ALJ’s
“Medical opinions are statements from physicians and psychologists or other
acceptable medical sources that reflect judgments about the nature and severity of
[the claimant's] impairment(s), including [the claimant's] symptoms, diagnosis and
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prognosis, what [the claimant] can still do despite impairment(s), and [his or her]
physical or mental restrictions.” 20 C.F.R. § 404.1527(a)(2).
The ALJ considered
medical evidence from physicians and other acceptable medical sources in
determining plaintiff’s RFC.
The ALJ’s opinion cites the medical evidence in the
record concerning the plaintiff’s hearing impairment and notes the lack of evidence
regarding his claimed mental impairments. The ALJ concluded that the plaintiff had
a sensori-neural impairment of hearing with moderate severity and further noted
that the medical records indicate that plaintiff had relatively good speech
discrimination and that his only accommodations at school would be sitting in the
front of the classroom and FM amplification when available. Those conclusions are
both supported by substantial evidence in the record. After reviewing the medical
records, the ALJ determined that plaintiff had significant hearing loss, but was able
to function at essentially a normal level with his hearing aids.
Furthermore, the Eighth Circuit has held that an ALJ should assess the entire
record, including medical reports and the individual's own description of his
limitations, in determining the RFC. McKinney v. Apfel, 228 F.3d 860, 863 (8th
Here, the ALJ found that plaintiff’s allegations of disability lacked
credibility for a number of reasons: the absence of objective medical evidence
supporting plaintiff’s claims, his treatment history, his daily living, and a number of
inconsistencies between plaintiff’s statements and the record. The ALJ pointed to
plaintiff’s medical records which indicated that his hearing disorder allowed for
relatively good speech discrimination, required only modest accommodations and
stated that plaintiff should be able to function at essentially a normal level. Plaintiff
did not require special education services during school, did not receive psychiatric
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treatment, and stopped attending counseling sessions because he did not feel that
he needed therapy.
The ALJ also noted inconsistencies between plaintiff’s daily
activities of reading, writing, and playing video games and his allegations of
disabling symptoms. Plaintiff indicated that he had no issues with personal care,
completed household chores, could cook, drive a car, shop in stores, manage his
own finances, follow written instructions, and had no problem concentrating,
remembering or understanding.
The Eighth Circuit has found that the ability to
perform household chores, handle money, and engage in social activities can
undermine an assertion of disability. See, e.g., Ponder v. Colvin, 770 F.3d 1190,
1196 (8th Cir. 2014) (holding that substantial evidence supported ALJ's denial of
disability benefits in part because claimant’s activity level undermined her assertion
of total disability when she performed light housework, washed dishes, cooked for
her family, did laundry, handled money and paid bills, shopped for groceries and
clothing, watched television, drove a vehicle, left her house alone, regularly
attended church, and visited her family); Roberson v. Astrue, 481 F.3d 1020, 1025
(8th Cir.2007) (holding that substantial evidence supported ALJ's denial of disability
benefits in part because claimant “engaged in extensive daily activities,” including
taking care of her child, driving a vehicle, preparing meals, performing housework,
shopping for groceries, handling money, and visiting family).
The ALJ properly
evaluated the medical evidence and plaintiff’s credibility in determining plaintiff’s
limitations in the RFC.
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For the reasons discussed above, the Court finds that the Commissioner’s
decision is supported by substantial evidence in the record as a whole.
IT IS HEREBY ORDERED that the decision of the Commissioner is
A judgment in accordance with this Memorandum and Order will be entered
CAROL E. JACKSON
UNITED STATES DISTRICT JUDGE
Dated this 6th day of July, 2017.
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