Williams v. Colvin

Filing 22

MEMORANDUM AND ORDER: 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 September 28, 2017. (BRP)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
NORTHERN DIVISION

TEMPIE WILLIAMS,
Plaintiff,
v.
NANCY A. BERRYHILL,1
Acting Commissioner of Social Security,
Defendant.

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Case No. 2:16-cv-00035-NCC

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 Tempie Williams (“Plaintiff”) for Child’s
Insurance Benefits (“CIB”) under Title II of the Act, 42 U.S.C. §§ 401, et seq., and Supplemental
Security Income (“SSI”) under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381, et seq.
Plaintiff has filed a brief in support of the Complaint (Doc. 16), and Defendant has filed a brief
in support of the Answer (Doc. 21). The Parties have consented to the jurisdiction of the
undersigned United States Magistrate Judge pursuant to Title 28 U.S.C. § 636(c) (Doc. 7).
I. PROCEDURAL HISTORY
Plaintiff filed her applications for CIB and SSI on January 25, 2013 (Tr. 157-64).
Plaintiff was initially denied on March 6, 2013, and she filed a Request for Hearing before an
Administrative Law Judge (“ALJ”) (Tr. 95-99, 101). After a hearing, by two decisions dated
November 26, 2014, the ALJ found Plaintiff not disabled (Tr. 30-47; Tr. 419-433). On March
1

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

21, 2016 and May 24, 2016, the Appeals Council issued decisions denying Plaintiff’s request for
review (Tr. 1-10). As such, the ALJ’s decisions stand as the final decision of the Commissioner.
II. DECISIONS OF THE ALJ2
The ALJ determined that Plaintiff has not engaged in substantial gainful activity since
January 25, 2013, the alleged onset date (Tr. 35). The ALJ found Plaintiff has the severe
impairments of oppositional defiant disorder (“ODD”),3 attention deficit hyperactivity disorder
(“ADHD”)4 and mood disorder NOS5 but that no impairment or combination of impairments met
or medically equaled the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart
P, Appendix 1 (Tr. 35-36). After considering the entire record, the ALJ determined Plaintiff has
the residual functional capacity (“RFC”) to perform a full range of work at all exertional levels
with the following nonexertional limitation (Tr. 37). She is limited to unskilled work with only
occasional interaction with the public, co-workers, and supervisors (Id.). The ALJ found
Plaintiff has no past relevant work, but that there are jobs that exist in significant numbers in the
2

Although the ALJ issued two separate decisions addressing the two wage earners, Ms. Ruby
Louise Williams and Mr. Oscar Virgil Williams, the Court notes that the decisions are nearly
identical and the findings of the ALJ are identical. The Court also notes that the decision
addressing the CIB claim using Mr. Oscar Virgil Williams as the wage earner also includes
Plaintiff’s claim for Supplemental Security Income Benefits. As such, the Court will cite to this
decision provided at Tr. 33-47.
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Oppositional Defiant Disorder is defined as “[a] behavior disorder characterized by a persistent
pattern of defiant, disobedient, and hostile behavior towards authority figures; a frequent loss of
temper, arguing, becoming angry or vindictive, or other negative behaviors.” Oppositional
Defiant Disorder, PubMed Health, Nat’l Inst. of Health,
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024865/ (last visited Aug. 4, 2017).
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“Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing
pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or
development.” Attention Deficit Hyperactivity Disorder, Nat’l Inst. of Health,
https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorderadhd/index.shtml (last visited Aug. 4, 2017).
5

NOS stands for “not otherwise specified.”
2

national economy that she can perform, including night cleaner, linen room attendant, and
stubber (Tr. 42-43). Thus, the ALJ concluded that a finding of “not disabled” was appropriate
(Tr. 43). 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. §§ 416.920, 404.1529. “‘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(b). Second, the claimant must have a severe impairment. 20
C.F.R. §§ 416.920(c), 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), citing Nguyen v. Chater, 75 F.3d 429, 430-31 (8th Cir. 1996)).
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.

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Fourth, the impairment must prevent the claimant from doing past relevant work. 20
C.F.R. §§ 416.920(f), 404.1520(f). The burden rests with the claimant at this fourth step to
establish his or her RFC. Steed 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. Steed, 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).

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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 F.3d 860, 863 (8th Cir. 2000)). Weighing the evidence is a function of
the ALJ, who is the fact-finder. Masterson v. Barnhart, 363 F.3d 731, 736 (8th Cir. 2004).
Thus, an 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 to 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.2d 523, 527 (8th Cir. 1980).
IV. DISCUSSION
In her appeal of the Commissioner’s decision, Plaintiff asserts that (1) the ALJ erred by
failing to support his RFC determination with some medical evidence; (2) the ALJ erred by not

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providing a narrative link between the medical evidence and the result; and (3) the ALJ erred in
his analysis of the medical opinion evidence of record. For the following reasons, the Court
finds that Plaintiff’s argument is without merit, and that the ALJ’s decision is based on
substantial evidence and is consistent with the Regulations and case law.
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 v. Barnhart, 363 F.3d 781, 783 (8th Cir. 2004)
(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 extent of the claimant’s impairments to determining the kind of work the claimant can still
do 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) (internal citations
omitted).
1. Medical Opinion Evidence
Plaintiff asserts that the ALJ erred by failing to appropriately consider the medical
opinion evidence of record (Doc. 16 at 11-13). Specifically, Plaintiff argues that while the
opinions of Ms. Ann Elliot and Ms. Melissa Whisenand showed that Plaintiff was significantly

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limited even in basic abilities, the ALJ rejected these in favor of a selective reading of the
remaining record (Id. at 11).
Ms. Ann Elliot, LCSW,6 Plaintiff’s long-time therapist, submitted a Medical Source
Statement-Mental (MSSM) and two narrative letters (Tr. 354, 256-57, 356-57). In the MSSM,
Ms. Elliot opines that Plaintiff would have marked and extreme limitations in functioning in the
following areas: the ability to remember locations and work-like procedures; the ability to
understand and remember detailed instructions; the ability to carry out detailed instructions; the
ability to maintain attention and concentration for extended periods; the ability to perform
activities within a schedule, maintain regular attendance, and be punctual within customary
tolerances; the ability to sustain an ordinary routine without special supervision; the ability to
work in coordination with or proximity to others without being distracted by them; the ability to
make simple work related decisions; the ability to complete a normal workday and workweek
without interruption from psychologically based symptoms and to perform at a consistent pace
without an unreasonable number and length of rest periods; the ability to accept instructions and
respond appropriately to criticism from supervisors; the ability to travel in unfamiliar places or
use public transportation; and the ability to set realistic goals or make plans independently (Tr.
356-57). Ms. Elliot further opines that Plaintiff would have bad days causing her to need to
leave work prematurely or be absent and would likely be “off task” 25% or more of the time (Tr.
356).
In her letters, Ms. Elliot indicates that Plaintiff is unable to live independently and could
not be trusted to care for herself (Tr. 353-54). In her letter dated March 5, 2011, Ms. Elliot states
that Plaintiff has debilitating issues due to early infancy head trauma and low intellect (Tr. 354).
While “it has been quite some time since [Plaintiff] has assaulted someone[,] . . . this amount of
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Licensed Clinical Social Worker.
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progress will still not allow her to become independent” (Id.). “She cannot successfully live on
her own without lots of community services and supervision” (Id.). Ms. Elliot further indicates
that Plaintiff has issues soiling herself, communicating and stealing (Id.). In her second letter,
dated September 16, 2014, Ms. Elliot indicates that Plaintiff “has poor impulse control and must
be supervised to assure her personal safety” (Tr. 353). Ms. Elliot further states that Plaintiff is
unable to stay on task and complete project (Id.). Ms. Elliot concludes that Plaintiff “will always
need supervision and at this time is unable to successfully live on her own” (Id.).
Ms. Melissa Whisenand, Plaintiff’s Department of Mental Health caseworker, also
submitted a letter on behalf of Plaintiff. In her letter dated September 15, 2014, Ms. Whisenand
states that Plaintiff needed to be monitored in all social situations to ensure her safety and ensure
appropriate behavior (Tr. 256-57). Specifically, Ms. Whisenand indicates that, among other
things, Plaintiff “engages in behaviors that are aggressive or self-injurious,” “has difficulty
expressing,” and “has difficulty in carrying out appropriate daily routines with regards to
personal hygiene, financial management, household chores and nutritional needs” (Id.).
The Court finds that the ALJ gave proper weight to the opinions of Ms. Elliot and Ms.
Whisenand. The ALJ correctly determined that Ms. Elliot and Ms. Whisenand were not
acceptable medical sources under the applicable rules (Tr. 40). “Acceptable medical sources
include licensed physicians (medical or osteopathic doctors) and licensed or certified
psychologists.” Sloan v. Astrue, 499 F.3d 883, 888 (8th Cir. 2007) (citing 20 C.F.R.
§ 416.913(a) (effective until Mar. 26, 2017)). Instead, Ms. Elliot and Ms. Whisenand are “other
sources.” 20 C.F.R. § 416.913(d)(1) (effective until Mar. 26, 2017). As “other sources,” Ms.
Elliot and Ms. Whisenhand are not qualified to prepare a “medical source’s opinion” as defined
by the regulations. See 20 C.F.R. § 416.927(a)(1). An ALJ has more discretion when analyzing

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other sources and is permitted to consider any inconsistencies found within the record. 20 C.F.R.
§ 416.913(a), (d); Tindell, 444 F.3d at 1005; Social Security Ruling (“SSR”) 06-03p (“The fact
that a medical opinion is from an ‘acceptable medical source’ is a factor that may justify giving
that opinion greater weight than an opinion from a medical source who is not an ‘acceptable
medical source.”). See Raney, 396 F.3d at 1010 (Providing that in considering the opinions of a
medical source that is not an “acceptable medical source,” “the ALJ has more discretion and is
permitted to consider any inconsistencies found within the record.”).
The ALJ afforded Ms. Elliot’s and Ms. Whisenand’s opinions “little weight,” finding
their opinions “at odds with the remainder of the file” (Tr. 40). Specifically, the ALJ highlighted
the inconsistency of these opinions with Plaintiff’s relatively unremarkable mental examinations
(Id.). For example, the ALJ notes that, regarding Plaintiff’s cognitive limitations, the record
does not indicate a cognitive issue (Id.). Further, the ALJ found that while Plaintiff “has some
issues relating to others,” Plaintiff’s behavior is generally controlled with medication as further
evidenced by Plaintiff’s consistent GAF7 scores in the mid-fifties indicating that she is capable of
success in the occupational setting with limitations (Tr. 40-41). See, e.g., Tr. 359 (GAF score of
54), 388-89 (“Pt. has been doing better with medication”; GAF score of 50), 398 (GAF score of
60). When an opinion is “inconsistent or contrary to the medical evidence as a whole, [it is]
entitled to less weight.” Krogmeier, 294 F.3d at 1023. See also 20 C.F.R. § 416.927
(“Generally, the more consistent an opinion is with the record as a whole, the more weight we
7

Global assessment of functioning (GAF) is the clinician’s judgment of the individual’s overall
level of functioning, not including impairments due to physical or environmental limitations.
American Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders, 32-34 (4th
ed. rev. 2000). Expressed in terms of degree of severity of symptoms or functional impairment,
GAF scores of 31 to 40 represent “some impairment in reality testing or communication or major
impairment in several areas, such as work or school, family relations, judgment, thinking, or
mood,” 41 to 50 represents “serious,” scores of 51 to 60 represent “moderate,” scores of 61 to 70
represent “mild,” and scores of 90 or higher represent absent or minimal symptoms of
impairment. Id. at 32.
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will give that opinion”). The ALJ also specifically noted that Ms. Elliot’s statements and
evaluation are conclusory (Tr. 40). Hamilton v. Astrue, 518 F.3d 607, 610 (8th Cir. 2008) (the
weight given a physician’s opinion is limited if the opinion consists only of conclusory
statements). See also Cline v. Colvin, 771 F.3d 1098, 1104 (8th Cir. 2014) (Commissioner may
give physician’s opinion less deference when it is based on claimant’s subjective complaints
rather than objective medical evidence). Finally, again regarding Ms. Elliot, the ALJ indicated
that Ms. Elliot’s treatment notes are not in evidence, making it impossible to determine the
extent of Ms. Elliot’s treatment of Plaintiff and whether her conclusory statements and
evaluations are supported by her treatment notes (Tr. 40). Indeed, although Ms. Elliot “began
seeing [Plaintiff] when she was in grade school,” the transcript does not include any records from
Ms. Elliot or her office, the Lighthouse Counseling Center. See Traylor ex rel. Traylor v. Colvin,
538 F. App'x 730 (8th Cir. 2013) (finding the ALJ gave proper weight to the medical opinion of
a chiropractor when the record contained no treatment records from the chiropractor and the
ALJ’s RFC determination was consistent with the medical evidence).
Accordingly, the Court finds that the ALJ gave proper weight to Ms. Elliot’s and Ms.
Whisenand’s opinions upon determining his RFC, and that the ALJ’s decision, in this regard, is
based on substantial evidence.
2. RFC Supported by “Some” Medical Evidence
Next, Plaintiff asserts that the ALJ erred by, failing to support his RFC assessment with
any medical evidence (Doc. 16 at 10). Indeed, although assessing a claimant’s RFC is primarily
the responsibility of the ALJ, a “claimant’s residual functional capacity is a medical question.”
Lauer, 245 F.3d at 704 (quoting Singh v. Apfel, 222 F.3d 448, 451 (8th Cir. 2000)). The Eighth
Circuit clarified in Lauer that “[s]ome medical evidence . . . must support the determination of

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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) and 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. Express consideration of state agency physicians is sufficient to satisfy this
standard. See Buford v. Colvin, 824 F.3d 793, 797 (8th Cir. 2016).
The Court finds that the ALJ properly supported her residual functional capacity
determination with “some” medical evidence. Specifically, the ALJ reviewed the opinion
evidence of record. First, as addressed in more detail above, the ALJ appropriately reviewed the
opinion evidence from Ms. Elliot and Ms. Whisenand, affording their opinions “little weight.”
Second, the ALJ considered the medical opinion evidence from state agency consultant,
Stephen S. Scher, Ph.D., affording his opinion “partial weight” (Tr. 68-91). After reviewing the
evidence submitted on behalf of Plaintiff up to that point, Dr. Scher issued his case analyses8 on
March 5, 2013 regarding Plaintiff’s medically determinable impairments and their severity (Tr.
68-91). Dr. Scher determined that Plaintiff has the medically determinable impairments of ODD,
Affective Disorders, and ADD/ADHD (Tr. 71). Dr. Scher found Plaintiff moderately limited in
the following abilities: to maintain attention and concentration for extended periods; to sustain an
ordinary routine without special supervision; to work in coordination with or in proximity to
8

Dr. Scher issued an analysis for each of Plaintiff’s three types of disability claims—her original
SSI claim, incorrectly notes as a disability insurance benefits claim, and her two CIB claims
under each wage earner. As the analysis is nearly identical throughout, the Court will reference
only the first of the three analyses.
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others without being distracted by them; to interact appropriately with the general public; to
accept instructions and respond appropriately to criticism from supervisors; to get along with
coworkers or peers without distracting them or exhibiting behavioral extremes (Tr. 73-74). Dr.
Scher further opined that Plaintiff “can perform where interpersonal skills are superficial and not
dependent on intensive or extensive interpersonal interaction for task completion” (Tr. 74). Dr.
Scher is a highly qualified expert who offered an opinion consistent with the record as a whole.
20 C.F.R. §§ 404.1527(f)(2)(i), 416.927(f)(2)(i) (State agency medical consultants are highly
qualified experts in Social Security disability evaluation; therefore, ALJs must consider their
findings as opinion evidence); Kamann v. Colvin, 721 F.3d 945, 951 (8th Cir. 2012) (State
agency psychologist’s opinion supported the ALJ’s finding that claimant could work despite his
mental impairments); Casey v. Astrue, 503 F.3d 687, 694 (8th Cir. 2007) (finding the ALJ did
not err in considering State agency psychologist’s opinion along with the medical evidence as a
whole). In his RFC determination, the ALJ clearly took into consideration the limitations
indicated by Dr. Scher, restricting Plaintiff to unskilled work with only occasional interaction
with the public, co-workers, and supervisors (Tr. 37).
Third, although not medical evidence, the ALJ considered the statement of Tempra
Williams, Plaintiff’s close relative,9 in his thorough review (Tr. 41, 259). In a letter sent to the
SSA on October 6, 2014, Ms. Williams indicates that Plaintiff “has displayed many behavioral
concerns that could jeopardize her safety and the safety of others” (Tr. 259). Ms. Williams
further states that Plaintiff is “emotionally unstable” and “exhibits explosive and impulsive
behaviors” (Id.). The ALJ found Ms. Williams not to be a disinterested observer and her letter to
be inconsistent with the medical records indicating that Plaintiff’s concentration and behavioral
9

The record does not indicate the exact relationship between Tempra Williams and Plaintiff. In
her letter regarding Plaintiff, Ms. Williams indicates that she has known Plaintiff “since she
came into my grandmother’s care at 19 months” (Tr. 259)
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problems improve with medication (Tr. 41). Indeed, the medical records show Plaintiff’s
impairments are largely controlled on medication (See Tr. 388-89).
To that end, the ALJ also considered Plaintiff’s significant improvement when compliant
with treatment (Tr. 40). See Renstrom v. Astrue, 680 F.3d 1057, 1066 (8th Cir. 2012) (conditions
which can be controlled by treatment are not disabling); Davidson v. Astrue, 578 F.3d 838, 846
(8th Cir. 2009); Medhaug v. Astrue, 578 F.3d 805, 813 (8th Cir. 2009); Schultz v. Astrue, 479
F.3d 979, 983 (8th Cir. 2007) (holding that if an impairment can be controlled by treatment, it
cannot be considered disabling). The record reflects that when Plaintiff was taking her
medication, neither she nor her mother had any complaint and they denied any side effects (Tr.
393). However, as noted by the ALJ, at times Plaintiff stopped taking her medication (Tr. 281,
388, 414). While Plaintiff asserts that her noncompliance was in part due to the nature of her
mental impairments, the record indicates that she was not prevented from taking her medication.
As the ALJ indicated, the evidence in the record does not indicate any cognitive issues or
memory problems (Tr. 40, 389 (“Memory and Concentration are fair”), 391 (Same), 392
(“Concentration and immediate recall good. Memory for recent and remote events intact.
Judgment good. Insight fair.”)). Cf. Pate-Fires v. Astrue, 564 F.3d 935, 945-47 (8th Cir. 2009).
The ALJ further conducted a full and thorough review of the medical evidence (See Tr.
38-41). Of note and in support of the ALJ’s RFC determination, the ALJ indicated that various
records reflect “mood instability” or “irritability and anger” usually noted in conjunction with
Plaintiff’s noncompliance with her prescribed medication (Tr. 39, 323-24, 331, 391).
Regardless, the ALJ appears to have taken these records of instability into account when
concluding that Plaintiff had some restriction in her interaction with the public, co-workers, and
supervisors (Tr. 37). The ALJ also found that school records supported this conclusion;

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“[e]xcept for occasionally losing her temper, the [Plaintiff] was asymptomatic in the classroom”
(Tr. 39, 316-17).
In addition to his review of the medical evidence, the ALJ also appropriately assessed
Plaintiff’s credibility, noting that Plaintiff’s testimony was inconsistent with the record (Tr. 41).
Specifically, Plaintiff testified that her mental impairments caused her to be in special education
for all of her classes and that she was suspended almost every day due to behavioral problems
(Tr. 56). However, as noted by the ALJ, this testimony was contradicted by Plaintiff’s school
records (Tr. 182, 293-309). Under her individualized education program (IEP) from December
10, 2012, Plaintiff participated in regular education classes 88% of the time (Tr. 182). Further,
Plaintiff was only suspended once during high school and graduated on time (Tr. 293).
The ALJ additionally considered Plaintiff’s activities of daily living in assessing her
subjective complaints regarding her limitations (Tr. 41). In an adult function report dated
January 28, 2013, Plaintiff’s mother indicates that Plaintiff is able to do chores such as laundry,
sweeping, making her bed, and preparing simple meals (Tr. 36, 208). See Ponders v. Colvin, 770
F.3d 1190 (8th Cir. 2014) (holding that substantial evidence supported the ALJ's denial of
disability benefits in part because claimant “performs light housework, washes dishes, cooks for
her family, does laundry, can handle money and pays bills, shops for groceries and clothing,
watches television, drives a vehicle, leaves her house alone, regularly attends church, and visits
her family”). Plaintiff also worked briefly in a sheltered setting (Tr. 392). 20 C.F.R.
§ 416.973(c) (“[W]ork done under special conditions may show that you have the necessary
skills and ability to work at the substantial gainful activity level.”). Also, as the ALJ noted,
while Plaintiff receives some help from her mother, Plaintiff is also the primary care-giver to her
infant child (Tr. 41, 390). See Jones v. Astrue, 619 F.3d 963, 975 (8th Cir. 2010).

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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).
3. Narrative
Finally, Plaintiff argues that the ALJ erred by not providing a narrative link between the
medical evidence and the result (Doc. 16 at 14).
An “RFC assessment must include a narrative discussion describing how the evidence
supports each conclusion, citing specific medical facts (e.g., laboratory findings) and nonmedical
evidence (e.g., daily activities, observations).” SSR 96-8p, 1996 WL 374184, at *7. “In
assessing RFC, the adjudicator must discuss the individual's ability to perform sustained work
activities in an ordinary work setting on a regular and continuing basis ... and describe the
maximum amount of each work related activity the individual can perform based on the evidence
available in the case record. SSR 96-8p at *7. “Although required to develop the record fully
and fairly, an ALJ is not required to discuss every piece of evidence submitted.” Wildman v.
Astrue, 596 F.3d 959, 966 (8th Cir. 2010) (quoting Black v. Apfel, 143 F.3d 383, 386 (8th Cir.
1998)). “Moreover, an ALJ’s failure to cite specific evidence does not indicate that such
evidence was not considered.” Id. (highly unlikely that ALJ did not consider and reject
physician’s opinion when ALJ made specific references to other findings set forth in physician’s
notes).
Plaintiff appears to suggest that the ALJ is required to format his opinion to explicitly
match her severe impairments to each RFC limitation. However, in this case, as more fully
described above, the RFC determination and the discussion regarding the same is detailed and

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takes into consideration all of Plaintiff’s mental impairments. Based on the foregoing, the Court
finds the ALJ’s opinion provides a sufficient narrative of the medical evidence relied upon to
support the limitations in the RFC and reversal on this basis is not warranted.
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,
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 28th day of September, 2017.

/s/ Noelle C. Collins
NOELLE C. COLLINS
UNITED STATES MAGISTRATE JUDGE

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