Debord v. Astrue

Filing 25

MEMORANDUM AND ORDER. (see order for details) IT IS HEREBY ORDERED that the decision of the Commissioner is affirmed. A separate judgment in accordance with this Memorandum and Order is entered this same date. Signed by District Judge Catherine D. Perry on 02/26/2013. (CBL)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
STEVEN DEBORD
Plaintiff,
v.
MICHAEL J. ASTRUE,
Commissioner of Social Security,
Defendant.

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No. 4:12 CV 00219 CDP

MEMORANDUM AND ORDER
This is an action under 42 U.S.C. § 405(g) for judicial review of the
Commissioner's final decision denying Steven Debord’s application for disability
insurance benefits under Title II of the Social Security Act, 42 U.S.C. §§ 401 et seq.
Claimant Debord brings this action asserting that he is disabled by a spinal injury,
carpal tunnel syndrome, hypertension, and obesity. The Administrative Law Judge
determined that Debord is not disabled. Debord appeals that decision. Because I find
the ALJ's decision is supported by substantial evidence, I will affirm the decision.
Procedural History
On August 5, 2009, Debord filed for Disability Insurance Benefits. The Social
Security Administration denied the application, and Debord sought a hearing. An
ALJ held that hearing on August 11, 2010. The ALJ upheld the denial of benefits in a

decision filed on January 13, 2011. A Request for a Review of Hearing Decision was
timely filed, and the request was denied on December 9, 2011. Thus, the ALJ’s
determination stands as the final decision of the Commissioner.
Testimony Before the ALJ
Debord testified that he was born in 1973 and that his symptoms started after
he was involved in a tractor trailer accident on January 16, 2009. Debord completed
the 11th grade, but he quit high school and had no additional vocational training or
education. He had been employed in a number of different jobs over the years. He
worked as a cottage parent at a children’s center, a parts counter in a parts store, and
a warehouse manager. He also had done maintenance work for the highway
department, and he was a truck driver at the time of his accident. He attempted to
return to work in June 2009, but he was unable to handle it and had not worked since
then.
Debord testified that he injured his lower back in the January 2009 accident,
for which he had a pending worker’s compensation claim. Besides constant back
pain, Debord said his legs and hands frequently go numb. He said he falls five or six
times per week and frequently drops things. He said the physical pain has steadily
gotten worse over time. Debord also complained of bad anxiety and depression. He
testified that he can’t drive down busy roads and that he probably has five or six

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panic attacks per day. Debord said his treating physician thinks he has post-traumatic
stress disorder (PTSD). Debord testified that he had not been diagnosed by a
psychiatrist because he had not found one that accepted Medicaid. He also testified
that his treating physician recommended a minimum of two surgeries to correct his
back.
Debord testified that he spends most of his days sitting in a recliner, either
watching TV or reading magazines. He said he cannot sit in a normal kitchen chair
for more than five minutes. He said he can stand for up to ten minutes at a time and
walk for up to five minutes before needing to sit. He cannot climb or descend stairs.
He cannot bend over. He has trouble lifting a gallon of milk. He helps with loading
laundry, but he cannot do dishes because of the numbness in his hands. He helps
with preparing meals, but does no house cleaning or yard work. He drives once or
twice a week to visit doctors. He goes grocery shopping with his wife once or twice a
month. Debord testified that he never does entertainment activities outside the home
other than eating out maybe once a month. He said he can count change and can use
a check book. He is able to take care of some personal hygiene. He does not use a
computer, but he does occasionally text on his cell phone. Debord said he has trouble
concentrating and frequently forgets things.
The ALJ also heard testimony from John McGowan, the vocational expert.

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McGowan found that Debord’s condition would prevent him from returning to any of
his previous jobs. McGowan also determined that a hypothetical claimant with
Debord’s educational background who could perform sedentary work could find
employment in the national economy. He specifically listed three positions – semiconductor assembly worker, medical supply packager, and optical goods assembly
worker – that would be suitable for a claimant who could handle frequent use of the
upper extremities, although they would not fit for someone limited to occasional use
of those extremities.
Medical Evidence
On December 5, 2008, Debord visited the office of Dr. Armela Agasino
because of joint pain and back pain. The back pain was described as being moderatesevere and occurring persistently. The doctor’s notes state that the trauma occurred
due to a fall at home in 1993. Debord reported that the pain was aggravated by
sitting, standing, and walking. He also complained of tingling in his arms and legs.
An X-ray of the lumbar spine was ordered. At the time, Debord was on six different
medications, including Flexeril, a muscle relaxant frequently used for neck and back
pain, and Xanax, which treats anxiety disorders.
On January 16, 2009, Debord was admitted to St. John’s Hospital because of
lower back pain following a tractor trailer accident. He was diagnosed with a cervical

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strain, a thoracic sprain and strain, and a lumbar sprain and strain.
On January 19, 2009, Debord visited Dr. Agasino again. The back pain was
described as being moderate-severe and occurring persistently. This pain was
attributed to the accident of January 16. Debord was assessed with cervicalgia, joint
pain, and lumbago.
On February 4, 2009, Debord was examined at the St. John’s Clinic in St.
James. Debord still was experiencing lower back pain. The clinic scheduled an MRI
of the T-12 lumbar spine for what was considered most likely an acute cervical
strain.
On February 10, 2009, the MRI revealed a posterior annular tear with a central
disc herniation at L5-S1, a mild annular disc bulge at L4-L5, and mild anterior
wedging deformity of T12 and L1 vertebral body with mild reactive marrow edema
and L1 superior endplate.
On February 17, 2009, Debord returned to the St. John’s Clinic in St. James.
An X-ray of Debord’s right hip was performed because of his complaints about pain
there. The X-ray revealed no fracture, but there was an ossification center or an old
injury.
On February 19, 2009, Debord saw Dr. Sung Lee at St. John’s Hospital. Dr.
Lee noted an exaggerated pain response to minimal stimulation. Dr. Lee considered

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this a very positive Waddell’s sign that likely meant there was some degree of
psychogenic overlay. Dr. Lee noted that there were mild anterior wedging
conformities involving L1 and T12, but he also stated that he believed there was
some symptom exaggeration. The records show Debord was alert and oriented, and
he showed appropriate memory and concentration. Dr. Lee said the MRI findings
were not surgical in nature and recommended conservative therapy.
On March 12, 2009, Debord saw Dr. James Jordan at the St. John’s Clinic.
Debord’s intake form states that he had experienced muscle pain since an accident,
and it also noted that he had felt anxious and down since January 16, 2009.
On March 17, 2009, Debord visited St. John’s Therapy Services in St. Robert
for his first scheduled therapy session. He reported continued lower back and neck
pain, as well as tingling in his hands and feet. Debord denied the presence of any
significant past medical history other than acid reflux. Debord exhibited excessive
tightness of the hip and lower back, which the therapist said was consistent with
static inactivity. The therapist recommended a treatment program focused on
flexibility activities and returning to normalized motion. If the pattern of inactivity
continued, the therapist said Debord would continue to develop complications due to
increasing muscular tightness.
On March 27, 2009, Debord cancelled his scheduled appointment at St. John’s

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Therapy Services. It was the third appointment in five days that he had cancelled or
failed to attend.
On March 30, 2009, Debord resumed his therapy sessions at St. John’s. Over
the next two weeks, he attended six other sessions. He continued to report
experiencing back pain. He said the therapy helped a little.
On April 9, 2009, Debord was seen again by Dr. Jordan. Again, the duration of
the back pain was dated back to the January 2009 accident.
On April 14, 2009, Debord was examined by a nurse practitioner for
hypertension and anxiety. He was given a refill of his prescription for Xanax. The
chart notes that Debord was not exercising regularly and not following his prescribed
diet.
On April 27, 2009, Dr. Jordan cleared Debord to return to work with
limitations, including not lifting, carrying, pushing, or pulling anything heavier than
five pounds. Debord also was restricted from working below his knees, and he was to
be allowed to vary his position as needed for comfort. A nerve conduction study was
performed to test for possible carpal tunnel syndrome; it revealed a mild bilateral
median neuropathy at the wrist. The ulnar nerve conduction was within normal limits
for both wrists.
On May 18, 2009, Debord saw Dr. David Raskas at Saint Louis Spine Care

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Alliance. Dr. Raskas agreed that Debord possibly had a wedge compression fracture
of L1. He noted that Debord moved in a very guarded, somewhat exaggerated
posture. Debord’s range of motion of his lumbar and cervical spine was fairly
restricted. Dr. Raskas noted that he was somewhat concerned about the patient’s
psychological reaction to his illness. He did not think Debord was capable of work at
that point.
On June 3, 2009, Debord returned to Dr. Raskas. He had no explanation for
the current symptoms based on the MRI and bone scan, which revealed no fractures.
They did show a small central disc protrusion and mild degenerative disc disease. Dr.
Raskas also noted a fair amount of functional overlay.
On June 24, 2009, Debord visited Dr. Patricia Hurford. Debord reported
continued neck and back pain, as well as severe headaches and numbness in his
extremities. He also reported anxiety, hypertension and depression related to the
accident. Dr. Huford found him alert and said his cognition appeared appropriate.
She noted that Debord had been taking four hydrocodone per day. He initially said
the medication was not helpful, but he then decided they were more helpful than not
after Dr. Hurford began discussing weaning him off the medication. Her impression
was that Debord had a soft tissue injury affecting his spine, but that he also had pain
complaints out of proportion to objective diagnostic and physical exam findings. She

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also noted poor pain coping behaviors with familial reinforcement.
On June 25, 2009, Debord was seen at Missouri Baptist Hospital in Sullivan.
He reported he had accidentally stabbed himself in the chest with a knife he was
holding when his legs went numb and gave out. He exhibited a limited range of
motion, and his movements were guarded.
On July 9, 2009, Dr. Daniel Phillips examined Debord in St. Louis. Dr.
Phillips found severe chronic sensory motor median neuropathies across the carpal
tunnels. The exam revealed that the nerves and muscles in the lower extremities fell
within the normal range.
On July 10, 2009, Debord visited Dr. Agasino’s office. He received an
increased dosage of Lisinopril, which he took for hypertension.
On July 13, 2009, Debord saw Dr. Hurford again. Debord reported continued
pain in his neck, back, and hip, along with numbness in his upper and lower
extremities. Dr. Hurford noted that the nerve conduction study was consistent with a
diagnosis of carpal tunnel syndrome. She found no evidence of cervical
radiculopathy, cubital tunnel syndrome, brachial plexopathy, lumbar radiculopathy,
plexopathy, or peripheral neuropathy. The records also show Debord now was taking
Prozac, a depression medication. Given the range of tests that had been conducted,
Dr. Hurford explained that she was at a loss to explain Debord’s severe subjective

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symptoms, and surgery certainly was not necessary. She released him to regular work
duty.
On November 2, 2009, Debord received a neurological evaluation in Cape
Girardeau, which diagnosed him with cervicalgia, numbness, lumbar disc herniation,
and lumbago. The chart reports Debord denied depression, anxiety, memory loss,
mental disturbances, suicidal ideation, and hallucinations. The doctor found Debord
to be alert, with an intact memory and normal attention and concentration. The
doctor suggested weight loss may help, and Debord acknowledged that he already
had lost thirty pounds over the previous six weeks. The report also states that Debord
denied that his lower back pain occurred prior to his January 16 accident.
On February 23, 2010, Dr. Robert Bernardi saw Debord in St. Louis. Dr.
Bernardi had no explanation for Debord’s chronic neck, low back, bilateral arm, and
bilateral leg pain. He found the most notable part of the exam was the presence of
non-physiological factors suggesting symptom magnification. Debord had a
profoundly elevated score on the Zung Depression Index. Dr. Bernardi
acknowledged that Debord did have cervical degenerative disc disease, but he said
Debord was not a candidate for any type of surgery. He found no reason for Debord
to have any work restrictions.
On May 1, 2010, Debord went to the Emergency Department at Missouri

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Baptist Hospital in Sullivan because of back pain. He was diagnosed with lumbago
and sciatica. The chart notes he was oriented and that his psychiatric condition was
normal. He was not anxious or depressed.
On May 10, 2010, Dr. Hugh Schuetz reported Debord was suffering from
anxiety and noted Debord was taking Prozac for depression. The doctor’s report also
suggested Debord had PTSD.
On May 24, 2010, Debord returned to see Dr. Schuetz to review MRI results.
The tests showed a broad-based central disc protrusion at L5-S1, resulting in
impingement. There also was a small focal central disc protrusion with annular tear
at L 4-5.
On June 7, 2010, Debord went to the Emergency Department at Missouri
Baptist Hospital in Sullivan because he said he needed more pain medication.
Debord’s mental status was recorded as alert with an affect that is calm. He was
oriented and coherent.
On June 15, 2010, Debord went to the Emergency Department at Missouri
Baptist Hospital in Sullivan after a fall to make sure he didn’t break his knee. An Xray revealed no fracture. Debord was alert, cooperative, appropriate, oriented, and
coherent.
On July 5, 2010, Debord went to the Emergency Department at Missouri

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Baptist Hospital in Sullivan because of pain in his left foot. The X-ray revealed a
small plantar calcaneal spur. Debord was alert, cooperative, appropriate, oriented,
and coherent.
On July 9, 2010, Debord returned to Dr. Schuetz. The chart notes Debord’s
anxiety medication was not helping.
On July 28, 2010, Debord received another MRI. This one showed minimal
anterior osteophyte formation at T12-L1. Otherwise, everything else was within
normal limits.
On August 2, 2010, Debord went to the Emergency Department at Missouri
Baptist Hospital in Sullivan because of pain in his right shoulder. Debord said he had
fallen and injured himself the night before. Tests revealed no fracture or dislocation.
Debord was alert and oriented.
On January 4, 2011, Debord met with psychologist Jonathan Rosenbloom,
who provided a provisional diagnosis of PTSD and major depressive disorder.
Legal Standard
A court's role on review is to determine whether the Commissioner's findings
are supported by substantial evidence on the record as a whole. Growell v. Apfel, 242
F.3d 793, 796 (8th Cir. 2001). Substantial evidence in a social security case is less
than a preponderance, but it is enough so that a reasonable mind would find it

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adequate to support the ALJ's conclusion. McKinney v. Apfel, 228 F.2d 860, 863 (8th
Cir. 2000). The court must consider both evidence that supports and evidence that
detracts from the decision. Singh v. Apfel, 22 F.3d 448, 451 (8th Cir. 2000).
In determining whether the decision is supported by substantial evidence, the
Court reviews the administrative record as a whole to consider:
(1) the credibility findings made by the Administrative Law Judge;
(2) the education, background, work history, and age of the claimant;
(3) the medical evidence from treating and consulting physicians;
(4) the plaintiff's subjective complaints relating to the exertional and
non-exertional impairments;
(5) any corroboration by third parties of the plaintiff's impairments; and
(6) the testimony of vocational experts when required which is based on
a proper hypothetical question.
Brand v. Sec’y of Dep't of Health, Educ. & Welfare, 623 F.2d 523, 527 (8th Cir.
1980).
Disability is defined in the social security regulations 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 twelve months. 42

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U.S.C. § 416(i)(1); 42 U.S.C. § 1382c(a)(3)(A); 20 C.F.R. §§ 404.1505(a) and
416.905(a). The Commissioner uses a five-step procedure to determine whether a
claimant is disabled.
First, the commissioner must decide if the claimant engages in substantial
gainful activity. If the claimant is engaging in substantial gainful activity, he is not
disabled.
Next, the Commissioner determines if the claimant has a severe impairment
which significantly limits the claimant's physical or mental ability to do basic work
activities. If the claimant's impairment is not severe, he is not disabled.
If the claimant has a severe impairment, the Commissioner evaluates whether
the impairment meets or exceeds a listed impairment found in 20 C.F.R. part 404,
Subpart P, Appendix 1. If the impairment satisfies a listing in Appendix 1, the
Commissioner will find the claimant disabled.
If the Commissioner cannot make a decision based on the claimant's current
work activity or medical facts alone, and the claimant has a severe impairment, the
Commissioner reviews whether the claimant can perform his past relevant work. If
the claimant can perform his past relevant work, he is not disabled.
If the claimant cannot perform his past relevant work, the Commissioner must
evaluate whether the claimant can perform other work in the national economy. If

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not, the Commissioner declares the claimant disabled. 20 C.F.R. §§ 404.1520 and
416.920.
When evaluating evidence of subjective complaints, the ALJ cannot ignore the
plaintiff’s testimony, even if it is uncorroborated by objective medical evidence.
Basinger v. Heckler, 725 F.2d 1166, 1169 (8th Cir. 1984). However, the ALJ may
disbelieve a claimant's subjective complaints when they are inconsistent with the
record as a whole. See e.g., Battles v. Sullivan, 992 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 the claimant's testimony is not credible and
gives good reasons for the findings, the court usually defers to the ALJ's finding.
Casey v. Astrue, 503 F.3d 687, 696 (8th Cir. 2007).

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The ALJ's Findings
The ALJ held that Debord did not suffer from a disability within the meaning
of the Social Security Act. He issued the following specific findings:
1. Debord met the insured status requirements of the Social Security Act
though December 31, 2013.
2. Debord had not engaged in substantial gainful activity since January 16,
2009, the alleged onset date (20 C.F.R. §§ 404.1571 et seq.).
3. Debord had the following severe impairments: disorders of the cervical,
thoracic, and lumbar spine, discogenic and degenerative; bilateral carpal
tunnel syndrome, worse on the right; hypertension; and obesity (20 C.F.R. §
404.1520(c)).
4. Debord did not have an impairment or combination of impairments that
meets or medically equals one of the listed impairments in 20 C.F.R. Part 404,
Subpart P, Appendix 1 (20 C.F.R. §§ 404.1520(d), 404.1525, and 404.1526).
5. Debord had the residual functional capacity to do the following:
occasionally lift and/or carry 10 pounds; frequently lift and/or carry less than
10 pounds; sit (with normal breaks) for a total of 6 hours in an 8–hour
workday; and unlimited ability to push and/or pull (including operation of
hand and/or foot controls); occasionally climb ramps and stairs, balance, and

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stoop; never kneel, crouch, crawl, or climb ropes, ladders, or scaffolds;
perform no overhead work; frequently, but not constantly, use his upper
extremities for reaching, handling, and fingering; and he should avoid
exposure to workplace hazards, such as unprotected heights, dangerous
moving machinery, and operation of any moving equipment, as well as
avoiding concentrated exposure to cold and vibration.
6. Debord was incapable of performing past relevant work (20 C.F.R. §
404.1565).
7. Debord was born on September 9, 1973, making him 35 years old at the
time of decision. He was defined as a younger individual age 18-44 on the
alleged disability onset date (20 C.F.R. § 404.1563).
8. Debord had a “limited” level of education, as defined by the Regulations,
and was able to communicate in English (20 C.F.R. § 404.1564).
9. Using the Medical-Vocational Rules as a framework supported a finding
that Debord was “not disabled,” whether or not he had transferable job skills
(SSR 82-41 and 20 C.F.R. Part 404, Subpart P, Appendix 2).
10. Jobs that Debord can perform exist in significant numbers in the national
economy, considering his age, education, work experience, and residual
functional capacity. (20 C.F.R. §§ 404.1569 and 404.1569(a)).

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11. Debord had not been under a disability, as defined in the Social Security
Act, from January 16, 2009 through the date of the ALJ’s decision (20 C.F.R.
§ 404.1520(g)).
Discussion
When reviewing the denial of Social Security benefits, a court must determine
whether there is substantial evidence on the record to support the ALJ's decision. 42
U.S.C. 405(g). Debord asserts two points of error. First, he argues that the findings of
Residual Functional Capacity are not supported by medical evidence. Second, he
argues that the ALJ’s decision is not supported by substantial evidence because the
hypothetical question to the vocational expert did not capture the concrete
consequences of his impairment.
1. Medical Evidence
The first claimed error is that no medical evidence supports the ALJ’s finding
of Residual Functional Capacity. Specifically, Debord claims the ALJ did not
properly consider his mental health issues.
The ALJ did consider Debord’s mental health issues and found they did not
create more than a minimal limitation in his ability to perform work. Some medical
evidence supports this finding.
Medical evidence includes medical records and observations apart from

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statements by the claimant. 20 C.F.R. §§ 404.1512(b)(1), 404.1528(b) (2012). For
mental health issues, these observations may include things such as whether the
patient was “attentive, alert, focused, and appropriate.” See Halverson v. Astrue, 600
F.3d 922, 930 (8th Cir. 2010). The record is replete with observations that Debord
was alert, oriented, and appropriate during examinations. Multiple health providers
also noted that he showed normal attention, concentration, and memory. Although
the ALJ did not specifically mention these instances, a failure to cite certain evidence
does not mean it was not considered, since not every piece of evidence must be
discussed. Black v. Apfel, 143 F.3d 383, 386 (8th Cir. 1998).

The ALJ also

considered the observations of Dr. Hurford, who noted Debord’s complaints of
anxiety and depression when she examined him in June 2009. Even with these
complaints in mind, Dr. Hurford saw no medical reason during her two exams to
hold Debord out of work, and she cleared him to return in July 2009.
These two points are merely examples that the ALJ used “some” medical
evidence to back the RFC findings as it relates to mental health limitations. Of
course, the ALJ is not restricted to considering solely medical evidence. Masterson v.
Barnhart, 363 F.3d 731, 738 (8th Cir. 2004). In assessing a claimant’s residual
functional capacity, the ALJ must consider the entire record. McKinney v. Apfel, 228
F.3d 860, 863 (8th Cir. 2000).

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Key to this examination is the ALJ’s credibility finding. See Johnson v. Apfel,
240 F.3d 1145, 1148 (8th Cir. 2001). Although the ALJ found the medically
determinable impairments reasonably could cause the alleged symptoms, he also
determined that Debord’s statements concerning the intensity, persistence, and
limiting effects of his symptoms were not credible.
First, they were inconsistent with his daily activities. For instance, Debord
alleged he could sit no more than five minutes at a time, walk no more than five
minutes at a time, stand no more than ten minutes at a time, and lift no more than a
gallon of milk at a time. But the ALJ noted that Debord’s actual daily activities –
such as doing laundry, helping “some” in the kitchen, driving a couple of times a
week, and going to the grocery store and pushing the cart – show a greater functional
ability than Debord alleged.
Second, Debord’s missed physical therapy appointments suggest the symptoms
were not as bad as claimed.
Third, Debord’s non-compliance with prescribed treatments provided a similar
suggestion. Examples included Debord’s failure to exercise regularly and his failure
to follow his prescribed diet.
Fourth, the record “strongly suggest[s]” Debord had exaggerated symptoms
and limitations. For instance, Dr. Lee noted exaggerated pain responses during his

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February 2009 exam. Dr. Raskas considered Debord to have a guarded, exaggerated
posture during his May 2009 visit. Dr. Hurford observed pain complaints out of
proportion to objective tests in June 2009. Finally, Dr. Bernardi saw signs of
symptom magnification in February 2010.
Fifth, Debord’s statements and the record included significant inconsistences.
On one hand, Debord testified that he needed two surgeries on his back, but the
doctors who examined him found that surgery was not an option. In addition, Debord
said his pain medication did not help, but when Dr. Hurford tried to wean him off it,
he decided it was more helpful than not. These inconsistencies further undermined
Debord’s credibility in the ALJ’s view. “In determining what weight to give ‘other
medical evidence,” the ALJ has more discretion and is permitted to consider any
inconsistencies found in the record.” Lacroix v. Barnhart, 465 F.3d 881, 886 (8th
Cir. 2006).
In addition, Debord complained about anxiety issues in April 2009, and Dr.
Hurford noted his complaints of anxiety and depression in June 2009. Records from
his July 2009 visit to Dr. Hurford note that Debord was then taking Xanax and
Prozac. But during his exam on November 2, 2009, Debord denied suffering from
either anxiety or depression. At that time, he also denied suffering from memory loss,
mental disturbances, suicidal ideation, and hallucinations. When Debord visited Dr.

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Schuetz in May 2010, though, the doctor noted Debord was taking Prozac and still
dealing with anxiety issues.
The ALJ mentioned one additional inconsistency. Debord’s medical records
show he visited Dr. Agasino because of back pain in December 2008 – before his
tractor trailer accident – and that Debord said the pain originated from a fall in 1993.
When Debord went to receive therapy in March 2009, though, he claimed he had no
past relevant medical history other than acid reflux. When he received the
neurological evaluation in November 2009, he again denied having back problems
before the January accident. While this earlier report does not detract from any
finding regarding the extent and severity of Debord’s back pain, it is noteworthy
when determining the credibility of Debord’s testimony as a whole.
The ALJ did not “conclu[de] Plaintiff was required to see a psychiatrist or
other mental health professional,” as Debord contends. The ALJ simply noted that
Debord had not seen one of those professionals despite doctors diagnosing some
amount of functional overlay or anxiety issues. The ALJ considered this point merely
as additional evidence that the complaints were not as serious or as limiting as
Debord alleged.

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2. Hypothetical Question
Debord also claims the ALJ erred because the hypothetical question posed to
the vocational expert did not include any mental limitations.
However, the hypothetical question must include only the impairments which
the ALJ accepts as valid. Young v. Apfel, 221 F.3d 1065, 1069 (8th Cir. 2000). As
explained previously, the ALJ found Debord’s mental impairments only minimally
limiting.
Even so, the second hypothetical posed to the vocational expert did, in fact,
include mental limitations. The question asked about an individual who could “only
understand, remember and carry out simple instructions, make only simple work
related decisions, deal with only occasional changes in work processes and
environment...” The expert testified that those additional limitations would have no
effect on the occupations available to that person, and jobs would exist in significant
number for that hypothetical individual. Thus, the ALJ properly concluded Debord
could work and would not be considered disabled.
Finding no error, the ALJ’s determination that Debord suffers no disability is
supported by substantial evidence in the record as a whole. The decision should be
upheld.

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IT IS HEREBY ORDERED that the decision of the Commissioner is
affirmed. A separate judgment in accordance with this Memorandum and Order is
entered this same date.

CATHERINE D. PERRY
UNITED STATES DISTRICT JUDGE

Dated this 26th day of February, 2013.

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