Harlan v. Colvin

Filing 28

MEMORANDUM AND ORDER - IT IS HEREBY ORDERED that that the decision of the Commissioner is affirmed, and Amber Harlan's complaint is dismissed with prejudice. A separate Judgment is entered herewith. Signed by District Judge Catherine D. Perry on September 18, 2017. (MCB)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
NORTHERN DIVISION
AMBER HARLAN,
Plaintiff,
v.
NANCY A. BERRYHILL,
Acting Commissioner of Social Security,1
Defendant.

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No. 2:16 CV 26 CDP

MEMORANDUM AND ORDER
Plaintiff Amber Harlan brings this action pursuant to 42 U.S.C. § 1381 et
seq. and 42 U.S.C. §§ 405(g) and 1383(c)(3) seeking judicial review of the
Commissioner’s decision denying her application for supplemental security
income. Because the Commissioner’s final decision is supported by substantial
evidence on the record as a whole, I will affirm the decision of the Commissioner.
Procedural History
Plaintiff alleged she became disabled beginning January 27, 2015, because
of bipolar and anxiety disorders, degenerative and herniated disc disease,
osteoarthritis, diabetes, hypothyroidism, migraines, and obesity.

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On January 20, 2017, Nancy A. Berryhill became the Acting Commissioner of Social Security.
Under Fed. R. Civ. P. 25(d), Berryhill is automatically substituted for former Acting
Commissioner Carolyn W. Colvin as defendant in this action.

Plaintiff’s application was initially denied on April 29, 2015. After a
hearing before an ALJ on October 14, 2015, the ALJ issued a decision denying
benefits on December 4, 2015. On March 9, 2016, the Appeals Council denied
plaintiff’s request for review. The ALJ’s decision is thus the final decision of the
Commissioner. 42 U.S.C. § 405(g).
In this action for judicial review, Harlan contends that the ALJ’s decision is
not supported by substantial evidence on the record as a whole. Harlan specifically
argues that the ALJ erred by according improper weight to certain opinion
evidence in this case and improperly assessed her credibility. Harlan asks that I
reverse the Commissioner’s final decision and remand the matter for further
evaluation. For the reasons that follow, I will affirm the Commissioner’s decision.
Medical Records and Other Evidence Before the ALJ
With respect to the medical records and other evidence of record, I adopt
Harlan’s recitation of facts set forth in her Statement of Uncontroverted Material
Facts (ECF #22-1) to the extent they are admitted by the Commissioner (ECF #271). I also adopt the additional facts set forth in the Commissioner’s Statement of
Additional Material Facts (ECF #27-2), as they are unrefuted by Harlan. Together,
these statements provide a fair and accurate description of the relevant record
before the Court.
Additional specific facts will be discussed as needed to address the parties’
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arguments.
Discussion
A.

Legal Standard
To be eligible for disability insurance benefits under the Social Security Act,

Harlan must prove that she is disabled. Pearsall v. Massanari, 274 F.3d 1211,
1217 (8th Cir. 2001); Baker v. Secretary of Health & Human Servs., 955 F.2d 552,
555 (8th Cir. 1992). The Social Security Act defines disability as the “inability to
engage in any substantial gainful activity by reason of any medically determinable
physical or mental impairment which can be expected to result in death or which
has lasted or can be expected to last for a continuous period of not less than 12
months.” 42 U.S.C. § 423(d)(1)(A). An individual will be declared disabled “only
if [her] physical or mental impairment or impairments are of such severity that
[she] is not only unable to do [her] previous work but cannot, considering [her]
age, education, and work experience, engage in any other kind of substantial
gainful work which exists in the national economy.” 42 U.S.C. § 423(d)(2)(A).
To determine whether a claimant is disabled, the Commissioner engages in a
five-step evaluation process. See 20 C.F.R. § 404.1520; Bowen v. Yuckert, 482
U.S. 137, 140-42 (1987). The Commissioner begins by deciding whether the
claimant is engaged in substantial gainful activity. If the claimant is working,
disability benefits are denied. Next, the Commissioner decides whether the
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claimant has a “severe” impairment or combination of impairments, meaning that
which significantly limits her ability to do basic work activities. If the claimant’s
impairment(s) is not severe, then she is not disabled. The Commissioner then
determines whether claimant’s impairment(s) meets or equals one of the
impairments listed in 20 C.F.R., Part 404, Subpart P, Appendix 1. If claimant’s
impairment(s) is equivalent to one of the listed impairments, she is conclusively
disabled. At the fourth step, the Commissioner establishes whether the claimant
can perform her past relevant work. If so, the claimant is not disabled. Finally, the
Commissioner evaluates various factors to determine whether the claimant is
capable of performing any other work in the economy. If not, the claimant is
declared disabled and becomes entitled to disability benefits.
I must affirm the Commissioner’s decision if it is supported by substantial
evidence on the record as a whole. 42 U.S.C. § 405(g); Richardson v. Perales, 402
U.S. 389, 401 (1971); Estes v. Barnhart, 275 F.3d 722, 724 (8th Cir. 2002).
Substantial evidence is less than a preponderance but enough that a reasonable
person would find it adequate to support the conclusion. Johnson v. Apfel, 240
F.3d 1145, 1147 (8th Cir. 2001). Determining whether there is substantial
evidence requires scrutinizing analysis. Coleman v. Astrue, 498 F.3d 767, 770 (8th
Cir. 2007).
I must consider evidence that supports the Commissioner’s decision as well
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as any evidence that fairly detracts from the decision. McNamara v. Astrue, 590
F.3d 607, 610 (8th Cir. 2010). If, after reviewing the entire record, it is possible to
draw two inconsistent positions and the Commissioner has adopted one of those
positions, I must affirm the Commissioner’s decision. Anderson v. Astrue, 696
F.3d 790, 793 (8th Cir. 2012). I may not reverse the Commissioner’s decision
merely because substantial evidence could also support a contrary outcome.
McNamara, 590 F.3d at 610.
When evaluating evidence of pain or other subjective complaints, the ALJ is
never free to ignore the subjective testimony of the claimant, even if it is
uncorroborated by objective medical evidence. Basinger v. Heckler, 725 F.2d
1166, 1169 (8th Cir. 1984). The ALJ may, however, disbelieve a claimant’s
subjective complaints when they are inconsistent with the record as a whole. See
e.g., Battles v. Sullivan, 902 F.2d 657, 660 (8th Cir. 1990). In considering the
subjective complaints, the ALJ is required to consider the factors set out by Polaski
v. Heckler, 739 F.2d 1320 (8th Cir. 1984), which include:
claimant’s prior work record, and observations by third parties
and treating and examining physicians relating to such matters
as: (1) the claimant’s daily activities; (2) the duration,
frequency, and intensity of the pain; (3) precipitating and
aggravating factors; (4) dosage, effectiveness and side effects of
medication; and (5) functional restrictions.
Id. at 1322. When an ALJ explicitly finds that the claimant’s testimony is not
credible and gives good reasons for the findings, the court will usually defer to the
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ALJ=s finding. Casey v. Astrue, 503 F.3d 687, 696 (8th Cir. 2007). However, the
ALJ retains the responsibility of developing a full and fair record in the nonadversarial administrative proceeding. Hildebrand v. Barnhart, 302 F.3d 836, 838
(8th Cir. 2002).
B.

ALJ’s Decision
In her written decision, the ALJ found that Harlan had not engaged in

substantial gainful activity since the alleged onset date of January 27, 2015. The
ALJ found Harlan’s bipolar disorder, anxiety disorder, borderline personality
disorder, post-traumatic stress disorder, depression, degenerative disc disease,
obesity, and migraines to be severe impairments, but determined that they did not
meet or medically equal a listed impairment in 20 C.F.R. Part 404, Subpart P,
Appendix 1. (Tr. 17-18.) The ALJ found Harlan to have the RFC to perform light
work with the following limitations:
She can never climb ladders, ropes or scaffolds, and can occasionally
climb ramps and stairs. She can occasionally stoop, crouch, kneel,
crawl and balance. She must avoid concentrated exposure to
vibration, moving machinery, and unprotected heights. She is limited
to simple and routine tasks and simple work-related decisions. She
can have no contact with the public and can have occasional contact
with co-workers and supervisors. She must be afforded the option to
sit or stand whereby she may change positions every 60 minutes for 35 minutes while remaining at the workstation and on task. She must
be allowed to be off-task up to ten percent of the time.
(Tr. 15-16.) The ALJ found Harlan had no past relevant work. (Tr. 20)

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Considering Harlan’s RFC and her age, education, and work experience, the
ALJ relied upon vocational expert testimony to support a conclusion that Harlan
could perform other work as it exists in significant numbers in the national
economy, and specifically as a hand packager, inspector, and sorter. The ALJ
therefore found Harlan not to be disabled at any time from January 27, 2015,
through the date of the decision. (Tr. 20-21.)
Harlan claims that this decision is not supported by substantial evidence
because the ALJ accorded improper weight to the opinions of her treating
physicians and improperly assessed her credibility in determining her RFC.
C.

Weight Accorded to Opinion Evidence
When evaluating opinion evidence, an ALJ is required to explain in her

decision the weight given to any opinions from treating sources, non-treating
sources, and non-examining sources. See 20 C.F.R. § 404.1527(e)(2)(ii). The
Regulations require that more weight be given to the opinions of treating
physicians than other sources. 20 C.F.R. § 404.1527(c)(2). A treating physician’s
assessment of the nature and severity of a claimant’s impairments should be given
controlling weight if the opinion is well supported by medically acceptable clinical
and laboratory diagnostic techniques and is not inconsistent with other substantial
evidence in the record. Id.; see also Forehand v. Barnhart, 364 F.3d 984, 986 (8th
Cir. 2004). This is so because a treating physician has the best opportunity to
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observe and evaluate a claimant’s condition,
since these sources are likely to be the medical professionals most
able to provide a detailed, longitudinal picture of [a claimant’s]
medical impairment(s) and may bring a unique perspective to the
medical evidence that cannot be obtained from the objective medical
findings alone or from reports of individual examinations, such as
consultative examinations or brief hospitalizations.
20 C.F.R. § 404.1527(c)(2).
When a treating physician’s opinion is not given controlling weight, the
Commissioner must look to various factors in determining what weight to accord
that and any other medical opinion of record, including the length of the treatment
relationship and the frequency of examination, the nature and extent of the
treatment relationship, whether the physician provides support for her findings,
whether other evidence in the record is consistent with the physician’s findings,
and the physician’s area of specialty. 20 C.F.R. § 404.1527(c), (e). Inconsistency
with other substantial evidence alone is a sufficient basis upon which an ALJ may
discount a treating physician’s opinion. Goff v. Barnhart, 421 F.3d 785, 790-91
(8th Cir. 2005). The Commissioner “will always give good reasons in [the] notice
of determination or decision for the weight [given to the] treating source’s
opinion.” 20 C.F.R. § 404.1527(c)(2).
Harlan contends that the ALJ improperly weighed the opinion of her treating
psychiatrist and failed to consider the opinion of her treating physician. For the
reasons that follow, the ALJ did not substantially err.
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Harlan first contends that the ALJ erred in failing to discuss the opinion of
her treating primary care physician, Michael Rothermich, M.D. Dr. Rothermich
wrote a “To Whom It May Concern” letter dated October 27, 2014, stating that
Harlan had been his patient for 10 years and had “requested a letter of support for
her reapplication for disability.” Dr. Rothermich opines that Harlan “appears to be
completely disabled at this time and for the foreseeable future.” He states that his
opinion is based on Harlan’s reports of a long history of bipolar depression,
medication regimen, and her estimate that her symptoms are only 30% controlled.
Dr. Rothermich recommended she see a psychiatrist in September of 2014, but “as
she is uninsured, it has been extremely difficult to have her seen by specialists.”
The ALJ’s failure to discuss Dr. Rothermich’s letter does not constitute
reversible error for several reasons. First, it is dated three months before Harlan’s
onset date. Second, his conclusion that Harlan “appears to be completely disabled
at this time and for the foreseeable future” is not a medical opinion and is not
entitled to any deference. See Robson v. Astrue, 526 F.3d 389, 393 (8th Cir. 2008);
House v. Astrue, 500 F.3d 741, 745 (8th Cir. 2007) (determination of disability is
solely within province of Commissioner); 20 C.F.R. § 416.927(d) (opinions on the
ultimate issue of disability not dispositive of issue). Third, it is primarily a
recitation of Harlan’s self-reported symptoms. For example, the estimate that her
symptoms are only “30% controlled” is Harlan’s own estimate, not Dr.
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Rothermich’s. Finally, while Harlan did receive mental health treatment from Dr.
Rothermich prior to her onset date, his treatment records reveal that he was
primarily seeing Harlan for back problems and pain, not mental health issues, after
her onset date. (Tr. 444-47). For these reasons, the ALJ did not substantially err
by failing to discuss this letter in her formulation of Harlan’s RFC.
Harlan next argues that the ALJ erred in her consideration of Syed K.
Imam, M.D.’s opinion. Dr. Imam was Harlan’s treating psychiatrist since March
2015. He saw Harlan three times between March and November 2015, when he
completed a psychiatric assessment form in connection with Harlan’s claim for
benefits. Dr. Imam opined that Harlan met the disability criteria for two listed
impairments: Listing 12.04 (Affective Disorder) and Listing 12.06 (AnxietyRelated Disorder). Dr. Imam diagnosed Harlan with bipolar disorder type I,
PTSD, generalized anxiety disorder, and borderline personality disorder. He stated
that Harlan thought about cutting herself in May 2015 and her mood was labile,
with depressive and manic episodes. According to Dr. Imam, Harlan could rarely
have contact with supervisors, coworkers, and the general public because she has
high anxiety, gets angry easily, and experiences severe panic attacks. Dr. Imam
believed that Harlan could occasionally make judgments on simple work-related
decisions and carry out short, simple instructions, but could rarely respond
appropriately to work pressures or changes in routine. Dr. Imam opined that
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Harlan would frequently be absent from work, her decision making and
concentration would be affected by her impairments, and she would be off-task
because of her symptoms more than 20% during an average workday. (Tr. 57882). The ALJ accorded “very little weight” to this opinion, finding it to be
inconsistent with the medical evidence as a whole, including Dr. Imam’s treatment
notes. (Tr. 19). Harlan argues that this was error, given that the opinion was
rendered by a treating physician and thus was entitled to significant if not
controlling weight. Because the ALJ’s reasons for discounting Dr. Imam’s opinion
are supported by substantial evidence on the record as a whole, I defer to that
determination.
The medical evidence of record shows that Harlan began treatment with Dr.
Imam in March 2015 after a brief psychiatric hospitalization in February 2015 for a
reported overdose of her prescription medication and superficial cutting. Harlan
denied an attempted overdose but was in distress, aggressive, frantic, and evasive.
(Tr. 374-76). Before being transferred to in-patient hospitalization later that day,
Harlan had calmed down, was agreeable, and clinically stable. (Tr. 381). Initial
psychiatric evaluation upon in-patient admission revealed Harlan’s behavior to be
within normal limits, with normal thought processes and speech, a sad mood, and
no suicidal ideas, paranoia, or hallucinations. Her cognition was fair, and insight
and judgment were limited. She was assessed with bipolar affective disorder,
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depressive disorder, and generalized anxiety disorder and assigned a GAF score of
11-20. (Tr. 390-92). Upon discharge three days later, Harlan’s depression,
anxiety, stress management skills, impulse/anger control, motivation, and
treatment compliance were all improved. Although Harlan still had difficulty with
motivation, she had no suicidal ideas, aggressive thoughts, or endangering
behaviors. She was prescribed psychotropic medications and assigned a GAF
score of 46-50. (Tr. 395-97).
At her initial consultation with Dr. Imam on March 3, 2015, Harlan reported
being diagnosed with bipolar affective disorder in her early teens and struggling
with suicidal ideations through the years. She reported cutting herself to feel better
and outbursts of rage. She was taking several psychotropic medications but still
felt anxious. She described her current symptoms as depression, memory loss,
headaches, crying spells, and anxiety in crowds. Harlan stated she had been
recently raped by a family friend. She also reported a history of childhood
physical and sexual abuse. Harlan reported past mood swings without psychotic
symptoms. Harlan stated that she had been on psychotropic medications for about
one year. She reported seeing a therapist. Dr. Imam observed Harlan to be
cooperative, well oriented x 4, and not in apparent distress. Her speech was within
normal rate, rhythm, tone, and volume. Flow of thought was goal oriented, with
thought content expressing low motivation, no interest, and feelings of
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worthlessness and helplessness. Harlan denied suicidal ideations or hallucinations.
She displayed average intellect and intact insight and judgment. Mental status 6
examination revealed a defensive and guarded presentation, an anxious, depressed,
irritable, and labile mood, avoidance of eye contact, and paranoid delusions.
Imam assessed Harlan with bipolar disorder, anxiety disorder, posttraumatic stress
disorder, and borderline personality disorder. She was assigned a GAF score of
50, given psychotropic medications, and advised to return in a couple of months.
(Tr. 415-22).
At her next visit in April 2015, Dr. Imam observed Harlan to be cooperative,
well oriented x 4, and not in apparent distress. Her speech rate, rhythm, tone, and
volume were all normal. Thought flow was goal directed, and Harlan’s thought
content expressed low motivation and feelings of worthlessness and helplessness.
Harlan denied having suicidal thoughts or hallucinations. Her intellect was
average and her insight and judgment were intact. She was well-oriented, and her
appearance was casual but disheveled. Harlan’s presentation was defensive,
guarded, and distracted, and her mood was anxious and irritable. She was assigned
a GAF score of 50 and her psychotropic medications were continued. (Tr. 52430). Dr. Imam’s observations and assessments remained unchanged at Harlan’s
next visit on August 18, 2015. (Tr. 532-39).
While the evidence of record shows that Harlan experienced limitations on
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account of her mental impairment, substantial evidence supports the ALJ’s
conclusion that the limitations were not as severe as opined by Dr. Imam in his
psychiatric assessment. While Harlan certainly described current symptoms during
her visits, a majority of Dr. Imam’s treatment notes pertained to Harlan’s selfreported psychiatric history, much of it from her childhood. Dr. Imam’s
observations of Harlan as cooperative, well oriented, in no distress, with intact
insight and judgment, as well as the frequency of treatment (one visit every few
months), are all inconsistent with the severity of limitations opined by Dr. Imam.
As noted by the ALJ, the degree of limitations expressed by Dr. Imam in his
psychiatric assessment are also inconsistent with Harlan’s GAF score of 50,2 which
is at the top of the range of serious symptoms and almost to the moderate range.
The ALJ therefore did not err when she found Dr. Imam’s opinion inconsistent
with other substantial evidence of record. See, Julin v. Colvin, 826 F.3d 1082,
1088 (8th Cir. 2016) (opinions of treating physicians may be given limited weight
if they are inconsistent with the record) (citing Papesh v. Colvin, 786 F.3d 1126,
1132 (8th Cir. 2015)); Cline v. Colvin, 771 F.3d 1098, 1103 (8th Cir. 2014) (ALJ
2

“[A] GAF of 41-50 indicates that the individual has serious symptoms or any serious
impairment in social occupational or school functioning.” Nowling v. Colvin, 813 F.3d 1110,
1115 (8th Cir. 2016). “In recent years, the agency has recognized, and we have noted, that GAF
scores have limited importance.” Id. However, “GAF scores may be relevant to a determination
of disability based on mental impairments.” Mabry v. Colvin, 815 F.3d 386, 391 (8th Cir. 2016).

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gave little weight to treating physician’s opinion that was inconsistent with
treatment records and objective medical evidence, and not supported by
physician’s own exams and test results).
Here, the ALJ fashioned an RFC to account for Harlan’s credible mental
limitations by limiting her to simple work requiring limited social interaction.
Many of the limitations are actually consistent with Dr. Imam’s recommendations,
such as eliminating contact with the public to avoid anxiety, routine tasks, simple
decision-making, and limited contact with coworkers and supervisors. When
assessing 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). Instead, the
ALJ must determine a claimant’s RFC based on her review of the record as a
whole. The ALJ evaluated all of the medical evidence of record and adequately
explained her reasons for the weight given this evidence. For the reasons set out
above, substantial evidence on the record as whole supports the weight accorded
by the ALJ to the medical opinion evidence in this case.
D.

Credibility Analysis
Harlan also argues that the ALJ improperly assessed her credibility. “The

credibility of a claimant’s subjective testimony is primarily for the ALJ to decide,
not the courts.” Pearsall, 274 F.3d at 1218. I must defer to the ALJ’s credibility
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determinations “so long as such determinations are supported by good reasons and
substantial evidence.” Vester v. Barnhart, 416 F.3d 886, 889 (8th Cir. 2005).
When determining the credibility of a claimant’s subjective complaints, the ALJ
must consider all evidence relating to the complaints, including the claimant’s
prior work record and third party observations as to the claimant’s daily activities;
the duration, frequency and intensity of the symptoms; any precipitating and
aggravating factors; the dosage, effectiveness and side effects of medication; and
any functional restrictions. Halverson v. Astrue, 600 F.3d 922, 931 (8th Cir.
2010); Polaski, 739 F.2d at 1322. While an ALJ need not explicitly discuss each
Polaski factor in his decision, she nevertheless must acknowledge and consider
these factors before discounting a claimant’s subjective complaints. Wildman v.
Astrue, 596 F.3d 959, 968 (8th Cir. 2010). A[T]he duty of the court is to ascertain
whether the ALJ considered all of the evidence relevant to the plaintiff’s
complaints . . . under the Polaski standards and whether the evidence so contradicts
the plaintiff’s subjective complaints that the ALJ could discount his or her
testimony as not credible.@ Masterson v. Barnhart, 363 F.3d 731, 738B39 (8th Cir.
2004). It is not enough that the record merely contain inconsistencies. Instead, the
ALJ must specifically demonstrate in her decision that she considered all of the
evidence. Id. at 738; see also Cline v. Sullivan, 939 F.2d 560, 565 (8th Cir. 1991).
Where an ALJ explicitly considers the Polaski factors but then discredits a
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claimant’s complaints for good reason, the decision should be upheld. Hogan v.
Apfel, 239 F.3d 958, 962 (8th Cir. 2001).
Here, the ALJ properly evaluated Harlan’s credibility based upon her own
testimony, the objective medical evidence of record, her daily activities, and the
conservative nature of her treatment.3 The ALJ summarized Harlan’s testimony
regarding her daily activities and subjective allegations of pain. Although Harlan
cites the familiar adage that the ability to do some light housework does not
support a conclusion that she can perform full-time competitive work, see Burress
v. Apfel, 141 F.3d 875, 881 (8th Cir. 1998), the ALJ did not substantially err in
considering the nature and extent of her daily activities when evaluating her
credibility. See Julin, 826 F.3d at 1087 (ALJ may consider inconsistencies
between subject complaints and daily living patterns when assessing credibility).
The ALJ was not required to fully credit all of Harlan’s assertions regarding her
limitations given her activities, which included going to church, grocery shopping,
going to the pharmacy, regular communications with friends, driving, and game
night with friends. Johnson v. Chater, 87 F.3d 1015, 1017 (8th Cir. 1996). The
ALJ also discounted Harlan’s credibility after noting certain inconsistencies in her
testimony, such as claiming a desire to be alone but keeping her daughter home
3

Harlan’s assertion that the ALJ did not consider the Polaski factors in her credibility
assessment is meritless. While she did not specifically cite the case, the factors appear at page 8
of her decision. (Tr. 18).
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from school for company. Harlan also testified that she forgets to eat, but she was
obese throughout the period under consideration and her medical records did not
indicate any substantial weight loss or hypoglycemic episodes. Even if the ALJ
could have drawn a different conclusion about Harlan’s credibility after reviewing
her daily activities, I may not reverse the Commissioner’s decision merely because
substantial evidence could also support a contrary determination. McNamara, 590
F.3d at 610. Here, the ALJ discounted Harlan’s subjective complaints only after
evaluating the entirety of the record. In so doing, she did not substantially err, as
subjective complaints may be discounted if inconsistencies exist in the evidence as
a whole. Hinchey v. Shalala, 29 F.3d 428, 432 (8th Cir. 1994).
In assessing Harlan’s credibility, the ALJ noted that objective test results did
not support the degree of claimed limitations. With respect to Harlan’s complaints
of back pain, the ALJ noted that her June 2015 x-rays revealed decreased disc
height at L5-S1 and some facet arthropathy but were otherwise normal. (Tr. 562).
Harlan could heel and toe walk without difficulty, had intact sensation of the lower
extremities, and did not have reduced strength. (Tr. 559-60). She was diagnosed
with mild L5-S1 degenerative disc disease. (Tr. 561). An MRI taken in July 2015
showed a disc bulge at L5-S1 with stenosis, but Harlan was only prescribed an
anti-inflammatory and muscle relaxant for pain. (Tr. 563). Although an epidural
steroid injection was recommended, Harlan declined treatment. With respect to
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her migraines, the ALJ noted that Harlan told her primary care physician in March
2015 that she obtained relief from Excedrin. (Tr. 444). The fact that Harlan did
not seek or require aggressive treatment for her impairments is relevant to a
determination of disability. See Clevenger v. Social Security Administration, 567
F.3d 971, 976 (8th Cir. 2009). The ALJ also determined that the objective medical
evidence of Harlan’s mental impairments, summarized above, did not support the
degree of alleged limitations, either. Here, the ALJ concluded that Harlan’s
subjective complaints of pain were of limited credibility because they were not
supported by the objective medical evidence of record, an important factor for
evaluating a claimant’s credibility. Stephens v. Shalala, 50 F.3d 538, 541 (8th Cir.
1995). The ALJ also properly considered Harlan’s poor work history in her
credibility assessment. See, Eichelberger v. Barnhart, 390 F.3d 584, 590 (8th Cir.
2004) (ALJ may properly consider a claimant’s motivation for secondary gain
when assessing credibility); Julin, 826 F.3d at 1087 (sporadic work history may
properly be considered in ALJ’s credibility assessment).
Where, as here, an ALJ seriously considers but for good reasons explicitly
discredits a claimant’s subjective complaints, the Court will not disturb the ALJ’s
credibility determination. Johnson v. Apfel, 240 F.3d 1145, 1147 (8th Cir. 2001).
Substantial evidence in the record as a whole supports the ALJ’s credibility
determination, so I will affirm the decision of the Commissioner as within a
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“reasonable zone of choice.” Fentress v. Berryhill, 854 F.3d 1016, 1021 (8th Cir.
2017) (citing Owen v. Astrue, 551 F.3d 792, 798 (8th Cir. 2008)).
Conclusion
When reviewing an adverse decision by the Commissioner, the Court’s task
is to determine whether the decision is supported by substantial evidence on the
record as a whole. Davis v. Apfel, 239 F.3d 962, 966 (8th Cir. 2001). “Substantial
evidence is defined to include such relevant evidence as a reasonable mind would
find adequate to support the Commissioner’s conclusion.” Id. Where substantial
evidence supports the Commissioner’s decision, this Court may not reverse the
decision merely because substantial evidence exists in the record that would have
supported a contrary outcome or because another court could have decided the case
differently. Id.; see also Igo v. Colvin, 839 F.3d 724, 728 (8th Cir. 2016); Buckner
v. Astrue, 646 F.3d 549, 556 (8th Cir. 2011)
For the reasons set out above, a reasonable mind can find the evidence of
record sufficient to support the ALJ’s determination that Harlan was not disabled.
Because substantial evidence on the record as a whole supports the ALJ’s decision,
it must be affirmed. Davis, 239 F.3d at 966. I may not reverse the decision merely
because substantial evidence exists that may support a contrary outcome.
Accordingly,
IT IS HEREBY ORDERED that that the decision of the Commissioner is
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affirmed, and Amber Harlan’s complaint is dismissed with prejudice.
A separate Judgment is entered herewith.

____________________________________
CATHERINE D. PERRY
UNITED STATES DISTRICT JUDGE

Dated this 18th day of September, 2017.

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