Noerper v. Berryhill

Filing 20

MEMORANDUM AND ORDER: For the reasons set forth above, the Court finds that substantial evidence on the record as a whole supports the Commissioner's decision that Plaintiff is not disabled. Accordingly, IT IS HEREBY ORDERED that the decision of the Commissioner is AFFIRMED, and Plaintiff's Complaint is DISMISSED with prejudice. A separate judgment shall be entered incorporating this Memorandum and Order. Signed by Magistrate Judge Noelle C. Collins on 9/24/2018. (JMC)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
SOUTHEASTERN DIVISION
ANGELA NOERPER,
Plaintiff,
v.
NANCY A. BERRYHILL,
Deputy Commissioner of Operations,
Social Security Administration,

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Case No. 1:17-CV-00157-NCC

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Defendant.

MEMORANDUM AND ORDER
This is an action under Title 42 U.S.C. § 405(g) for judicial review of the final decision of
the Commissioner denying the application of Plaintiff Angela Noerper (“Plaintiff”) for Disability
Insurance Benefits (“DIB”) under Title II of the Social Security Act (“the Act”), 42 U.S.C. §§ 401
et seq., and for Supplemental Security Insurance (“SSI”) under Title XVI, §§ 1381 et seq. Plaintiff
has filed a Brief in Support of the Complaint (Doc. 14) and Defendant has filed a Brief in Support
of the Answer (Doc. 19). The parties have consented to the jurisdiction of the undersigned United
States Magistrate Judge pursuant to Title 28 U.S.C. § 636(c) (Doc. 11).
I. PROCEDURAL HISTORY
Plaintiff filled her applications for DIB and SSI on February 13, 2014 (Tr. 10). Plaintiff was
initially denied on April 7, 2014 (Tr. 119). She filed a Request for Hearing before an
Administrative Law Judge (“ALJ”) on December 29, 2014 (Tr. 10). After a hearing, by decision
dated August 1, 2016, the ALJ found Plaintiff not disabled (Tr. 7-27). On July 26, 2017, the
Appeals Council denied Plaintiff’s request for review (Tr. 1-6). As such, the ALJ’s decision stands
as the final decision of the Commissioner.

II. DECISION OF THE ALJ
The ALJ determined Plaintiff meets the insured status requirements of the Social Security
Act through December 31, 2015, and has not engaged in substantial gainful activity since August
16, 2010, the alleged onset date of the disability (Tr. 13). The ALJ found Plaintiff has the severe
impairments of degenerative joint disease of the knees, arthritis, plantar fasciitis, fibromyalgia,
carpal tunnel syndrome, and affective disorder (Id.). The Plaintiff does not have an impairment or
combination of impairments that meets or medically equals the severity of one of the listed
impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (2018) (Id.). After considering the entire
record, the ALJ determined Plaintiff has the residual functional capacity to perform light work1
with the following limitations (Tr. 15). She can lift or carry 20 pounds occasionally and 10 pounds
frequently (Id.). She can stand or walk for 6 hours in an 8-hour workday (Id.). She can sit for 6
hours in an 8-hour workday (Id.). She can frequently push or pull in the limits for lifting and
carrying (Id.). She can occasionally climb ramps and stairs but she should not climb ladders, ropes,
or scaffolds in a work setting (Id.). She can occasionally balance, stoop, kneel, crouch, and crawl
(Id.). She should not do repetitive forceful gripping (Id.). She should avoid concentrated exposure
to cold temperatures and vibration (Id.). She can understand, remember, and carry out simple
repetitive work tasks and instructions at a specific vocational preparation (“SVP”) 2 level2 (Tr. 15).
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“Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of
objects weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in this
category when it requires a good deal of walking or standing, or when it involves sitting most of the
time with some pushing and pulling of arm or leg controls. To be considered capable of performing
a full or wide range of light work, you must have the ability to do substantially all of these activities.
If someone can do light work, we determine that he or she can also do sedentary work, unless there
are additional limiting factors such as loss of fine dexterity or inability to sit for long periods of
time.” 20 C.F.R. §§ 404.1567(b), 416.967(b).
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“Specific vocational preparation is defined as the amount of time lapse required by a typical
worker to learn the technique, acquire the information, and develop the facility needed for average
performance in a specific job-worker situation.” If a person can learn to do the job in 30 days, the
job is considered unskilled with an SVP of 1 or 2. 20 C.F.R. § 404.1568. See 20 C.F.R. § 404.1567
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The ALJ found Plaintiff unable to perform any past relevant work, but there are jobs that
exist in significant numbers in the national economy that she can perform, including: marker,
routing clerk, and collator operator (Tr. 20-21). Thus, the ALJ concluded that a finding of “not
disabled” was appropriate (Tr. 22). Plaintiff appeals, arguing a lack of substantial evidence to
support the Commissioner’s decision.
III. LEGAL STANDARD
Under the Social Security Act, the Commissioner has established a five-step process for
determining whether a person is disabled. 20 C.F.R. §§ 404.1529, 416.920. “‘If a claimant fails to
meet the criteria at any step in the evaluation of disability, the process ends and the claimant is
determined to be not disabled.’” Goff v. Barnhart, 421 F.3d 785, 790 (8th Cir. 2005) (quoting
Eichelberger v. Barnhart, 390 F.3d 584, 590-91 (8th Cir. 2004)). In this sequential analysis, the
claimant first cannot be engaged in “substantial gainful activity” to qualify for disability benefits.
20 C.F.R. §§ 416.920(b), 404.1520(c). The Social Security Act defines “severe impairment” as
“any impairment or combination of impairments which significantly limits [claimant’s] physical or
mental ability to do basic work activities . . . .” Id. “The sequential evaluation process may be
terminated at step two only when the claimant’s impairment or combination of impairments would
have no more than a minimal impact on [his or] her ability to work.” Page v. Astrue, 484 F.3d
1040, 1043 (8th Cir. 2007) (quoting Caviness v. Massanari, 250 F.3d 603, 605 (8th Cir. 2001)).
Third, the ALJ must determine whether the claimant has an impairment which meets or
equals one of the impairments listed in the Regulations. 20 C.F.R. §§ 416.920(d), 404.1520(d). If
the claimant has one of, or the medical equivalent of, these impairments, then the claimant is per se
disabled without consideration of the claimant’s age, education, or work history. Id.
Fourth, the impairment must prevent the claimant from doing past relevant work. 20 C.F.R.
(defining SVP level 1: sedentary work). SVP 2 level involves frequent lifting as well as
significantly more standing and walking than SVP 1. 20 C.F.R. §§ 404.1567(b), 416.968.
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§§ 416.920(f), 404.1520(f). The burden rests with the claimant at this fourth step to establish his or
her RFC. Steel v. Astrue, 524 F.3d 872, 874 n.3 (8th Cir. 2008) (“Through step four of this
analysis, the claimant has the burden of showing that she is disabled.”). The ALJ will review a
claimant’s RFC and the physical and mental demands of the work the claimant has done in the past.
20 C.F.R. § 404.1520(f).
Fifth, the severe impairment must prevent the claimant from doing any other work. 20
C.F.R. §§ 416.920(g), 404.1520(g). At this fifth step of the sequential analysis, the Commissioner
has the burden of production to show evidence of other jobs in the national economy that can be
performed by a person with the claimant’s RFC. Steel, 524 F.3d at 874 n.3. If the claimant meets
these standards, the ALJ will find the claimant to be disabled. “The ultimate burden of persuasion
to prove disability, however, remains with the claimant.” Young v. Apfel, 221 F.3d 1065, 1069 n.5
(8th Cir. 2000). See also Harris v. Barnhart, 356 F.3d 926, 931 n.2 (8th Cir. 2004) (citing 68 Fed.
Reg. 51153, 51155 (Aug. 26, 2003)); Stormo v. Barnhart, 377 F.3d 801, 806 (8th Cir. 2004) (“The
burden of persuasion to prove disability and to demonstrate RFC remains on the claimant, even
when the burden of production shifts to the Commissioner at step five.”). Even if a court finds that
there is a preponderance of the evidence against the ALJ’s decision, the decision must be affirmed
if it is supported by substantial evidence. Clark v. Heckler, 733 F.2d 65, 68 (8th Cir. 1984).
“Substantial evidence is less than a preponderance but is enough that a reasonable mind would find
it adequate to support the Commissioner’s conclusion.” Krogmeier v. Barnhart, 294 F.3d 1019,
1022 (8th Cir. 2002). See also Cox v. Astrue, 495 F.3d 614, 617 (8th Cir. 2007).
It is not the job of the district court to re-weigh the evidence or review the factual record de
novo. Cox, 495 F.3d at 617. Instead, the district court must simply determine whether the quantity
and quality of evidence is enough so that a reasonable mind might find it adequate to support the
ALJ’s conclusion. Davis v. Apfel, 239 F.3d 962, 966 (8th Cir. 2001) (citing McKinney v. Apfel, 228

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F.3d 860, 863 (8th Cir. 2000)). Weighing the evidence is a function of the ALJ, who is the factfinder. Masterson v. Barnhart, 363 F.3d 731, 736 (8th Cir. 2004). Thus, the administrative
decision which is supported by substantial evidence is not subject to reversal merely because
substantial evidence may also support an opposite conclusion or because the reviewing court would
have decided differently. Krogmeier, 294 F.3d at 1022.
To determine whether the Commissioner’s final decision is supported by substantial
evidence, the court is required to review the administrative record as a whole and consider:
(1) Findings of credibility made by the ALJ;
(2) The education, background, work history, and age of the claimant;
(3) The medical evidence given by the claimant’s treating physicians;
(4) The subjective complaints of pain and description of the claimant’s physical activity and
impairment;
(5) The corroboration by third parties of the claimant’s physical impairment;
(6) The testimony of vocational experts based upon proper hypothetical questions which
fairly set forth the claimant’s physical impairment; and
(7) The testimony of consulting physicians.
Brand v. Sec’y of Dep’t of Health, Educ. & Welfare, 623 F.3d 523, 527 (8th Cir. 1980).
IV. DISCUSSION
In her appeal of the Commissioner’s decision, Plaintiff broadly alleges that the
Commissioner’s decision was not supported by substantial evidence (Doc. 14). Specifically,
Plaintiff asserts that the ALJ erred in finding that Plaintiff can perform the prolonged standing and
walking required for light work, and that Plaintiff is limited to repetitive forceful gripping (Id. at 812). Furthermore, the Plaintiff asserts that the ALJ failed to properly address Plaintiff’s credibility
and mental limitations (Id. at 12-15). For the following reasons, the Court finds that Plaintiff’s
arguments are without merit; the ALJ’s decision is based on substantial evidence and is consistent

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with the Regulations and case law.
A. Evaluation of Plaintiff’s Subjective Complaints
The Court will first consider the consistency of Plaintiff’s complaints as the ALJ’s
evaluation of Plaintiff’s symptoms was essential to the ALJ’s determination of other issues,
including Plaintiff’s RFC. 3 See Wildman v. Astrue, 596 F.3d 959, 969 (8th Cir. 2010) (“[The
plaintiff] fails to recognize that the ALJ’s determination regarding her RFC was influenced by his
determination that her allegations were not credible.”) (citing Tellez v. Barnhart, 403 F.3d 953, 957
(8th Cir. 2005)); 20 C.F.R. §§ 404.1545, 416.945. In assessing a claimant’s credibility, the ALJ
must consider: (1) the claimant’s daily activities; (2) the duration, intensity, and frequency of pain;
(3) the precipitating and aggravating factors; (4) the dosage, effectiveness, and side effects of
medication; (5) any functional restrictions; (6) the claimant’s work history; and (7) the absence of
objective medical evidence to support the claimant’s complaints. Finch v. Astrue, 547 F.3d 933,
935 (8th Cir. 2008); Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984).
To the extent that the ALJ did not specifically cite Polaski, other case law, and/or
Regulations relevant to a consideration of Plaintiff’s credibility, this is not necessarily a basis to set
aside an ALJ’s decision where the decision is supported by substantial evidence. Randolph v.
Barnhart, 386 F.3d 835, 842 (8th Cir. 2004). Additionally, an ALJ need not methodically discuss
each Polaski factor if the factors are acknowledged and examined prior to making a credibility
determination; where adequately explained and supported, credibility findings are for the ALJ to
make. Lowe v. Apfel, 226 F.3d 969, 972 (8th Cir. 2000). See also Tucker v. Barnhart, 363 F.3d
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Effective March 28, 2016, a new Ruling ̶ SSR 16-3p ̶ superseded SSR 96-7p. See Social
Security Ruling (SSR) 16-3p, (https://www.ssa.gov/OP_Home/rulings/di/01/@@R2016-03.html).
This new SSR eliminated the use of the term “credibility” from SSA’s regulatory policy, and
clarified that an ALJ’s evaluation of a claimant’s subjective assertions regarding her symptoms is
not an examination of a claimaint’s character. Rather, the ALJ’s goal is to assess the degree to
which the claimant’s allegations are consistent with the other evidence of record. SSR 16-3p ushered
in a change of terminology, but did not alter the ALJ’s process on a substantive level. Because the
ALJ’s decision in this case was released after March 28, 2016, SSR 16-3p applies to this matter.
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781, 783 (8th Cir. 2004) (“The ALJ is not required to discuss each Polaski factor as long as the
analytical framework is recognized and considered.”).
In any case, “[t]he credibility of a claimant’s subjective testimony is primarily for the ALJ
to decide, not the courts.” Pearsall v. Massanari, 274 F.3d 1211, 1218 (8th Cir. 2001). “If an ALJ
explicitly discredits the claimant’s testimony and gives good reason for doing so, [a court] will
normally defer to the ALJ’s credibility determination.” Gregg v. Barnhart, 354 F.3d 710, 714 (8th
Cir. 2003). See also Halverson v. Astrue, 600 F.3d 922, 932 (8th Cir. 2010); Cox v. Barnhart, 471
F.3d 902, 907 (8th Cir. 2006). For the following reasons, the Court finds that the reasons offered
by the ALJ in support of his evaluation of Plaintiff’s subjective complaints are based on substantial
evidence.
First, the ALJ reviewed the objective medical evidence of record and determined that it
failed to support the severity of Plaintiff’s alleged symptoms (Tr. 17-19). Specifically, the ALJ
found that while Plaintiff alleged significant symptoms and limitations due to pain, “the claimant’s
statements concerning the intensity, persistence and limiting effects of these symptoms are not
entirely consistent with the medical evidence and other evidence in the record” (Tr. 17). Contrary
to Plaintiff’s assertion, the ALJ considered Plaintiff’s subjective pain complaints and found them
not credible (Id.). An ALJ may determine that “subjective pain complaints are not credible in light
of objective medical evidence to the contrary.” Gonzales v. Barnhart, 465 F.3d 890, 895 (8th Cir.
2006). In the ALJ’s analysis of Plaintiff’s credibility, he specifically referred to several objective
measures during the relevant period to explain why Plaintiff’s physical condition was not disabling
(Tr. 17-19). His detailed review, encompassing nearly two full pages regarding her physical
impairments alone, included findings of relatively normal clinical signs and diagnostic testing (Id.).
Although the Plaintiff’s “medical evidence supports a history of degenerative joint disease and
arthritis affecting the claimant’s joints,” the ALJ noted, X-rays of the knees only showed mild

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medial compartment joint space loss and her pain may be exacerbated by fibromyalgia (Tr. 17). An
X-ray of the left hand showed severe osteoarthritis (Tr. 17, 678-737). Furthermore, her physical
examination “revealed a normal station and gait, and intact sensations, motor strength, and muscle
tone in the legs” (Tr. 17). Plaintiff claimed she “hurt all over” even though her medical records
showed signs of her improvement during the course of treatment (Tr. 449, 454, 470, 474, 653, 691).
The ALJ also properly considered Plaintiff’s need to use an assistive device. The ALJ
acknowledged that Plaintiff testified that she uses an assistive device, a cane, but found that no
medical source had prescribed Plaintiff an assistive device (Tr. 17, 35). However, the ALJ
determined “[Plaintiff] did not present with one to the hearing and there is no prescription for [a
cane] in the record” (Tr. 17). However, self-reports, even those made to physicians, are not
sufficient to support the necessity of an assistive device. With this information, the ALJ determined
that Plaintiff was subject to light work with restrictions (Id.). See Johnson v. Astrue, 816 F. Supp.
2d 752, 773 (W.D. Mo. 2011) (finding plaintiff’s contention that his physician ordered him to use a
cane as an assistive device not supported by the record when the record only reflected that plaintiff
reported to a medical provider that another provider told plaintiff he needed to use a cane);
Hillstrom v. Comm’r of Soc. Sec., No. 3:15-CV-40, 2016 WL 7507789, at *5 (D.N.D. May 24,
2016) (plaintiff’s self-reports did not establish that she “required the use of any hand-held assistive
devices during the relevant time period”).
Second, the ALJ reviewed objective evidence as it related to Plaintiff’s mental health
impairments (Tr. 17-18). Specifically, the ALJ found that, “the medical evidence supports the
existence of an affective disorder . . . . As a result of her mental impairment, the undersigned finds
she can only understand, remember, and carry out simple and repetitive, unskilled work” (Tr. 18).
Indeed, as noted by the ALJ, Amber Richardson, Ph.D., the consultative examiner, diagnosed
Plaintiff with depressive symptoms, pre-existing learning disabilities, and a head injury in early

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2014 (Tr. 18, 485). Three months later, Plaintiff attempted to take her own life in 2014 and was
admitted to Phelps County Regional Medical Center (Tr. 18, 565-585). The ALJ noted that she
appeared to respond well to treatment at the hospital (Tr. 18). “[S]he was experiencing significant
but unique life stressors at the time that were not likely to recur including recently moving to
Salem, her daughter going through a divorce, and her father getting diagnosed with cancer” (Id.).
However, these upsetting events are non-medical in nature, and do not reflect an ongoing mental
pathology. Therefore, these events are outside the scope of SSI or DIB. See Gates v. Astrue, 627
F.3d 1080, 1082 (8th Cir. 2010) (“The medical record supports the conclusion that any depression
experienced . . . was situational in nature, related to marital issues . . . .”); Dunahoo v. Apfel, 241
F.3d 1033, 1039-40 (8th Cir. 2001) (holding that depression was situational and not disabling
because it was the result of financial matters). Furthermore, the ALJ referenced her mental status
testing completed in August 2014, stating: “she had appropriate attention, logical and organized
thought processes, and fair insight” and a provider’s short-term psychotherapy led to “remarkable
improvement in [Plaintiff’s] mental status with must less anxiety and improvement in depressive
symptoms” (Tr. 18, 576, 626, 631). See Lawson v. Colvin, 807 F.3d 962, 965 (8th Cir. 2015)
(holding if a claimant’s symptoms are controlled by treatment or medication, the symptoms are not
disabling); C.F.R. §§ 404.1529, 416.929.
Third, the record indicates that Plaintiff struggled with substance abuse and failed to
accurately report her substance abuse history. Specifically, the Plaintiff has tested positive for
marijuana metabolites, even after insisting she had only smoked marijuana once (Tr. 13, 693). On
July 7, 2014, Plaintiff asserted she only drinks one alcoholic drink on special occasions (Tr. 572).
However, on October 5, 2015, Plaintiff was admitted for treatment after attempting to commit
suicide and her toxicology report came back with a Blood Alcohol Content of 0.118 (Tr. 844). This
report directly contradicted her previous statements. The ALJ found the use of drugs and alcohol to

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be “not so persuasive as to cause significant limitations in the claimant’s daily routine or cause
significant mental or physical functioning” (Tr. 13). However, these contradictions diminish
Plaintiff’s credibility. See Karlix v. Barnhart, 457 F.3d 742, 748 (8th Cir. 2006) (declaring
contradictions between a claimant’s sworn testimony and what is told to physicians weighs against
the claimant’s credibility).
Plaintiff’s statements further diminish her credibility regarding her subjective symptoms.
When Plaintiff spoke with Linda Sue Hammonds, a Psychiatric Mental Health Nurse Practitioner
(“PMHNP”), Plaintiff admitted she has “never been honest with [any provider] before [today]” (Tr.
699). “The ALJ may properly discount the claimant’s testimony where it is inconsistent with the
record.” Perks v. Astrue, 687 F.3d 1086, 1093 (8th Cir. 2012). See also Fitzsimmons v. Mathews,
647 F.2d 862, 863–64 (8th Cir.1981) (In assessing a claimant’s credibility, an ALJ may properly
consider a claimant’s lack of sincerity). The Court finds, to the extent Plaintiff argues to the
contrary, that the ALJ’s determination that Plaintiff was not fully credible is based on substantial
evidence and is consistent with the Regulations and case law.
B. RFC
The Regulations define RFC as “what [the claimant] can do” despite his “physical or mental
limitations.” 20 C.F.R. § 404.1545(a). “When determining whether a claimant can engage in
substantial employment, an ALJ must consider the combination of the claimant’s mental and
physical impairments.” Lauer v. Apfel, 245 F.3d 700, 703 (8th Cir. 2001). “The ALJ must assess a
claimant’s RFC based on all relevant, credible evidence in the record, ‘including the medical
records, observations of treating physicians and others, and an individual’s own description of [her]
limitations.’” Tucker, 363 F.3d at 783 (quoting McKinney, 228 F.3d at 863). See also Myers v.
Colvin, 721 F.3d 521, 526 (8th Cir. 2013).
To determine a claimant’s RFC, the ALJ must move, analytically, from ascertaining the true

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extent of the claimant’s impairments to determining the kind of work the claimant can still
complete despite her impairments. Anderson v. Shalala, 51 F.3d. 777, 779 (8th Cir. 1995).
“Although it is the ALJ’s responsibility to determine the claimant’s RFC, the burden is on the
claimant to establish his or her RFC.” Buford v. Colvin, 824 F.3d 793, 796 (8th Cir. 2016). The
Eighth Circuit clarified in Lauer that “[s]ome medical evidence . . . must support the determination
of the claimant’s RFC, and the ALJ should obtain medical evidence that addresses the claimant’s
ability to function in the workplace . . . .” 245 F.3d at 704 (quoting Dykes v. Apfel, 223 F.3d 865,
867 (8th Cir. 2000) (per curiam); Nevland v. Apfel, 204 F.3d 853, 858 (8th Cir. 2000)). Thus, an
ALJ is “required to consider at least some supporting evidence from a professional.” Id. See also
Vossen v. Astrue, 612 F.3d 1011, 1016 (8th Cir. 2010) (“The ALJ bears the primary 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.”); Eichelberger, 390 F.3d at 591.
As previously discussed, the ALJ found, based on physical examinations in the record, that
Plaintiff had a normal gait and ambulated without assistance, although she asserted she uses a cane
(Tr. 17, 35). However, the ALJ determined “[Plaintiff] did not present with one to the hearing and
there is no prescription for [a cane] in the record” (Tr. 17). With this information, the ALJ
determined that Plaintiff was subject to light work with restrictions (Tr. 17). The ALJ properly
evaluated Plaintiff’s credibility and determined that Plaintiff’s complaints of disabling pain were
not fully credible, for numerous reasons, including that Plaintiff’s complaints were not consistent
with the medical evidence of record (Tr. 13-21). As required by the Regulations and case law, only
after doing so and carefully considering the evidence, did the ALJ formulate Plaintiff’s RFC based
on all the credible evidence. See Tindell v. Barnhart, 444 F.3d 1002, 1007 (8th Cir. 2006) (“The
ALJ included all of [claimant’s] credible limitations in his RFC assessment, and the ALJ’s
conclusions are supported by substantial evidence in the record.”); McKinney, 228 F.3d at 863

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(“The Commissioner must determine a claimant’s RFC based on all of the relevant evidence,
including the medical records, observations of treating physicians and others, and an individual’s
own description of his limitations.”) (citing Anderson, 51 F.3d at 779). Notably, the ALJ identified
Plaintiff’s limitations and then assessed her work related abilities on a function-by-function basis.
As previously addressed, the ALJ found Plaintiff could work only in a limited range of
light-exertion jobs that would accommodate significant non-exertional limitations to address both
physical and mental limitations (Tr. 15). See 20 C.F.R. §§ 404.1567(b), 416.967(b) (defining “light
work”). This included limiting Plaintiff to frequent pushing and pulling; occasional balancing,
stooping, kneeling, crouching, crawling, and climbing ramps or stairs; and no repetitive, forceful
gripping or climbing of ladders, ropes, or scaffolds (Tr. 15). The ALJ further restricted Plaintiff to
jobs in which she would avoid concentrated exposure to cold temperatures and vibration, and would
require no more than simple, repetitive work tasks and instructions at a specific vocational
preparation (SVP) 2 level (Id.).
The Court finds that the ALJ’s RFC determination was based on substantial evidence.
Specifically, as addressed in significant detail above, the ALJ properly addressed the consistency of
Plaintiff’s subjective complaints and in doing so, conducted a complete and detailed analysis of
Plaintiff’s medical record and her inconsistent statements. The ALJ additionally properly addressed
the extensive medical opinion evidence of record.
As a preliminary matter, to the extent Plaintiff contends that the ALJ's decision is not
supported by substantial evidence because it does not completely mirror the opinion of a particular
medical source, as discussed above, in formulating a claimant’s RFC, the “ALJ is not required to
rely entirely on a particular physician’s opinion or choose between the opinions of any of the
claimant’s physicians.” Martise v. Astrue, 641 F.3d 909, 927 (8th Cir. 2011). To the extent
Plaintiff argues that the ALJ did not cite specific medical opinions to support the RFC

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determination and did not provide narrative discussion to support the RFC determination, the text of
the ALJ’s decision establishes that he did, in fact, consider the medical opinions of record and did
provide a narrative of the medical evidence, upon determining Plaintiff’s RFC. Only after
considering all the evidence of record did the ALJ formulate Plaintiff’s RFC based on his
determination of the extent of Plaintiff’s credible limitations. See Lauer, 245 F.3d at 704; Nevland,
204 F.3d at 858. This is evident through the ALJ’s discussion of credible experts and the ALJ’s
reasoning regarding the medical experts’ opinions (Tr. 18-19).
The ALJ reviewed the opinion of Amber Richardson, Ph.D. (“Dr. Richardson”), a clinical
psychologist and consultative examiner (Tr. 19). After conducting a consultative examination on
March 27, 2014, Dr. Richardson issued a psychological service confidential psychological report
(Tr. 483-86). In her opinion, Dr. Richardson found Plaintiff “impaired in her ability to understand
and remember instructions of moderate complexity” and “impaired in her ability [to] sustain
concentration and persistence in tasks” (Tr. 485). However, Dr. Richardson found Plaintiff
unimpaired in her ability to interact socially (Id.). The ALJ afforded Dr. Richardson’s opinion
“great weight,” finding it consistent with the state agency psychological consultants’ opinions,
addressed in more detail below (Tr. 19). Specifically, the ALJ found Dr. Richardson’s opinion
regarding Plaintiff’s ability to perform simple and repetitive unskilled tasks without the need for
social limitations as well as Plaintiff’s inability to concentrate sufficiently to complete complex
tasks to be supported (Id.). As such, the ALJ limited Plaintiff to the ability to concentrate only to
perform simpler, repetitive, and unskilled tasks and included the limitation in his RFC
determination (Tr. 15, 19).
The ALJ partially relied upon the opinion of Dr. John Jung, M.D. (“Dr. Jung”), a state
agency physician (Tr. 19). Dr. Jung reviewed Plaintiff’s medical conditions and completed a
Medically Determinable Impairments and Severity (“MDI”) report (Tr. 107). Dr. Jung found

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Plaintiff suffered from carpal tunnel syndrome, fibromyalgia, and affective disorders (Id.).
Furthermore, Dr. Jung found Plaintiff’s ability to maintain concentration, persistence, or pace was
moderately affected by her impairments (Tr. 108) and opined that Plaintiff is impaired in her ability
to understand and remember instructions of moderate complexity (Id.). However, Dr. Jung
determined Plaintiff was not disabled (Tr. 115). The ALJ explicitly included Jung’s observation of
Plaintiff’s limitations in his RFC determination (Tr. 20). The ALJ determined that Plaintiff could
complete light work with limitations, further stating “[Jung’s] opinion appears to appropriately
accommodate the claimant’s impairments given the longitudinal medical evidence described
above” (Id.).
The ALJ afforded great weight to state agency specialists’ opinions assessing Plaintiff’s
psychological condition (Tr. 19). The ALJ found the opinions of Dr. James Morgan, Ph.D. (“Dr.
Morgan”) and Dr. Joan Singer, Ph.D. (“Dr. Singer”) credible because their opinions were supported
by substantial evidence (Id.). See 20 C.F.R. §§ 404.1527(c)(4), 416.927(c)(4) (“Generally, the
more consistent an opinion is with the record as a whole, the more weight we will give that
opinion.”). Furthermore, opinions from state agency consultants may be entitled to greater weight
than the opinions of treating or examining sources. See Ponder v. Colvin, 770 F.3d 1190, 1195 (8th
Cir. 2014) (citing SSR 96-6p); Toland v. Colvin, 761 F.3d 931, 937 (8th Cir. 2014). Dr. Singer
completed a Disability Determination of Plaintiff on April 7, 2014 (Tr. 57). Dr. Singer opined that
Plaintiff has exertional limitations and postural limitations (Tr. 63) as well as manipulative
limitations (Tr. 64). However, Dr. Singer found that Plaintiff was not disabled, despite these
limitations (Tr. 68).
Dr. Singer performed an evaluation of Plaintiff’s RFC to determine if she was disabled (Tr.
95-96). Dr. Singer found that although Plaintiff’s memory was subject to limitations, it was not
significantly limited (Id.). Dr. Singer only found Plaintiff moderately limited in her ability to

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maintain attention and concentration for extended periods of time as well as moderately limited in
her ability to carry out detailed instructions (Tr. 96). Dr. Singer’s evaluation contributed to Dr.
Jung’s determination of not disabled (Tr. 98).
Additionally, the ALJ gave little weight to the Global Assessment of Functioning (“GAF”)
scores because the GAF scores are from a “period of acute symptom exacerbation” (Tr. 19-20).
Although the GAF scale is used to measure a patient’s level of psychological, social, and
occupational functioning, GAF scores do not provide a reliable longitudinal picture of a claimant’s
mental functioning for a disability analysis. See 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A); 20
C.F.R. §§ 404.1505(a), 416.905(a). Furthermore, Plaintiff’s GAF scores did not improve despite
medical evidence illustrating the contrary (Tr. 566-585, 613-636). On July 8, 2014, while Plaintiff
was admitted to the Phelps County Regional Medical Center, Plaintiff received a GAF score of 30
(Tr. 570). While receiving counseling from Pathway Community Health, Plaintiff’s GAF score
started at 41, but improved to 43 during her treatment (Tr. 738-814). As previously discussed, the
Plaintiff “has not been entirely candid with the providers” (Tr. 18). Accordingly, the ALJ properly
afforded Plaintiff’s GAF scores little weight. See Jones v. Astrue, 619 F.3d 963, 974 (8th Cir.
2010) (stating an ALJ may afford greater weight to medical evidence and testimony than to GAF
scores).
Finally, to the extent the Plaintiff identifies records that support Plaintiff’s allegations, “[i]f
substantial evidence supports the decision, then we may not reverse, even if inconsistent
conclusions may be drawn from the evidence, and even if we may have reached a different
outcome.” McNamara v. Astrue, 590 F.3d 607, 610 (8th Cir. 2010).
In conclusion, the Court finds that the ALJ’s RFC determination is consistent with the
relevant evidence of record including the objective medical evidence, the observations of medical
providers, and diagnostic test results, as well as the evaluation of Plaintiff’s subjective complaints;

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that the ALJ’s RFC determination is based on substantial evidence; and that Plaintiff’s arguments to
the contrary are without merit.
C. Vocational Expert Testimony
Finally, Plaintiff asserts that the hypothetical question to the vocational expert does not
capture the concrete consequences of the Plaintiff’s condition and therefore, the response of the
vocational expert does not represent substantial evidence. Specifically, Plaintiff argues that
because the restrictions contained in the RFC are not supported by the evidence of record, the
hypothetical question posed is consequently flawed and the vocational expert’s response does not
represent substantial evidence. However, as previously addressed, the Court finds the ALJ’s RFC
determination to be consistent with the relevant evidence of record. Accordingly, as the ALJ
appropriately included the restrictions as indicated in his RFC determination in the hypothetical
question to the vocational expert, the Court finds that the hypothetical which the ALJ submitted to
the vocational expert was proper, the ALJ properly relied on the vocational expert’s testimony that
there were jobs existing in significant numbers which Plaintiff could perform, and Plaintiff’s
arguments to the contrary are without merit (Tr. 44-48). Hunt v. Massanari, 250 F.3d 622, 625 (8th
Cir. 2001) (“A hypothetical question posed to the vocational expert is sufficient if it sets forth
impairments supported by substantial evidence in the record and accepted as true by the ALJ.”).
Because there were other jobs which Plaintiff could perform, the Court additionally finds that the
ALJ’s determination that Plaintiff was not disabled is based on substantial evidence and is
consistent with the Regulations and case law.
V. CONCLUSION
For the reasons set forth above, the Court finds that substantial evidence on the record as a
whole supports the Commissioner’s decision that Plaintiff is not disabled.
Accordingly,

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IT IS HEREBY ORDERED that the decision of the Commissioner is AFFIRMED, and
Plaintiff’s Complaint is DISMISSED with prejudice.
A separate judgment shall be entered incorporating this Memorandum and Order.
Dated this 24th day of September, 2018.

/s/ Noelle C. Collins

NOELLE C. COLLINS
UNITED STATES MAGISTRATE JUDGE

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