Lawson v. Astrue
Filing
22
MEMORANDUM - For the reasons set forth above, the court affirms the decision of the Acting Commissioner of Social Security under Sentence 4 of 42 U.S.C. § 405(g). An appropriate Judgment Order is issued herewith. Signed by Magistrate Judge David D. Noce on 3/27/13. (KJS)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
EUNICE LAWSON,
Plaintiff,
v.
CAROLYN W. COLVIN,
Acting Commissioner of Social Security,
Defendant.
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No. 4:12 CV 396 DDN
MEMORANDUM
This action is before the court for judicial review of the final decision of the defendant
Commissioner of Social Security denying the application of plaintiff Eunice Lawson for
supplemental security income under Title XVI of that Act, 42 U.S.C. § 1381, et seq. The parties
have consented to the exercise of plenary authority by the undersigned United States Magistrate
Judge pursuant to 28 U.S.C. § 636(c). (Doc. 7.) For the reasons set forth below, the decision of the
Administrative Law Judge is affirmed.
I. BACKGROUND
Plaintiff Eunice Lawson, who was born on December 18, 1962, filed an application for Title
XVI benefits on November 14, 2008. (Tr. 116-18.) She alleged an onset date of disability of
November 4, 2008, due to bipolar disorder, schizophrenia, and attention deficit disorder. (Tr. 15354, 191-98.) Plaintiff’s applications were denied initially on February 9, 2009, and she requested
a hearing before an ALJ. (Tr. 59-67.)
On June 8, 2010, following a hearing, the ALJ found plaintiff was not disabled. (Tr. 17-25.)
On February 1, 2012 the Appeals Council denied plaintiff’s request for review. (Tr. 1-3.) Thus, the
decision of the ALJ stands as the final decision of the Commissioner.
II. MEDICAL HISTORY
Plaintiff entered the ninth grade in 1978. During the first semester of ninth grade, plaintiff
received no credits or grades due to absenteeism. During the second semester, she failed all of her
classes. (Tr. 265.)
On June 17, 2005, plaintiff sought treatment at the Human Service Center and reported
breakdowns. During the breakdowns, plaintiff lost control and kicked and screamed. She also
reported periods of inactivity and isolation as well as periods of “over energization.” During the
periods of “over energization,” plaintiff experienced racing thoughts and poor concentration and
changed tasks frequently. She further reported that she had numerous suicidal thoughts during the
past two years and on one occasion attempted to overdose. Narayana Reddy, M.D., initially
assessed bipolar II disorder and cocaine dependence. (Tr. 310-19).
On June 30, 2005, plaintiff received a psychiatric evaluation from Dr. Reddy. Plaintiff
reported that she last sought psychiatric treatment in Kansas City before moving to Peoria in 2002.
Her mother also received treatment at the Human Service Center and referred plaintiff due to her
mood swings and depressive symptoms. Plaintiff reported that she abused alcohol and crack cocaine
during the 1990s but was currently sober. She complained of feeling angry and irritable. She had
a breakdown during the previous weekend and would have gone to the emergency room if she had
transportation. She denied suicidal or homicidal ideation, and Dr. Reddy found her denial
convincing. Although she denied hearing voices, she reported hearing whispers. Plaintiff stated that
she was unemployed and unable to maintain a job. Dr. Reddy diagnosed polysubstance abuse and
decided to test for bipolar disorder. Plaintiff received a GAF score of 50.1 Dr. Reddy prescribed
Geodon.2 (Tr. 320-21.)
1
A GAF score, short for Global Assessment of Functioning, helps summarize a patient's overall
ability to function. A GAF score has two components. The first component covers symptom
severity and the second component covers functioning. A patient's GAF score represents the worst
of the two components.
A score from 41 to 50 represents serious symptoms (such as thoughts of suicide, severe
obsessional rituals, frequent shoplifting), or any serious impairment in social, occupational, or
school functioning (such as the inability to make friends or keep a job). American Psychiatric
Association, Diagnostic and Statistical Manual of Mental Disorders, 32–34 (4th ed. 2000) (“DSMIV-TR”).
2
Geodon is used to treat mental or mood disorders such as schizophrenia or manic episodes
associated with bipolar disorder. WebMD, http://www.webmd.com/drugs (last visited on March 26,
2013).
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On July 29, 2005, plaintiff complained of increased irritability in the mornings, but reported
that medication helped at night. Dr. Reddy continued plaintiff on Geodon. Plaintiff received a GAF
score of 50. (Tr. 322.)
On August 26, 2005, Mary Lawson, plaintiff’s mother, spoke with the Illinois Bureau of
Disability Determination Services regarding plaintiff’s daily activities. Mary Lawson reported as
follows. Plaintiff lives in the homes of her family members who accept her and want to prevent her
from sleeping in the street. She spends about two nights per week with her mother but has no
definite schedule for where she stays. (Tr. 347.)
During conversation, she jumps from topic to topic. She often sits alone and converses with
herself. She hears voices on a regular basis, which frightens her. She cannot always understand the
voices but believes that “they are out to get her.” She tries to stay awake at night due to her fear of
the voices. She paces constantly, and at night her family locks the doors to prevent her from leaving
the house. She sees things that are not there. She often cries and pulls her hair. She believes that
everyone but her family hates her and only gets along with family members. She is suspicious of
others and often wears a small “cutter” on her finger for protection. Her family is supportive and
tries to help. (Id.)
Plaintiff would neglect her personal hygiene without the instruction of her family. For
example, she must be told to take baths, and she wears mismatched clothes. Her family provides
her meals, and her mother does not trust her to cook or shop independently. She does not do chores
on a regular basis. Plaintiff receives counseling, but her mother is uncertain regarding her
attendance. She must be reminded daily to take her medications. (Tr. 347-48.)
Plaintiff sits and stares for long periods of time. She smiles inappropriately and lacks interest
in any activity. She used to enjoy attending church with her sisters, but she no longer attends.
Occasionally, she reads Christian books, but she does not understand them. Conversing with more
than one person frustrates her and causes her to walk away. (Tr. 348.)
Her family confiscated her bicycle that she used for transportation because of her
inattentiveness on the road. Her family usually provides transportation, but she can ride the bus
without getting lost. She judges character poorly and does not maintain lengthy friendships. She
does not use alcohol, tobacco, or other recreational drugs. (Id.)
On August 29, 2005, Mac Bradley, Ph.D., performed a psychological consultation. When
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asked to describe her disabilities, plaintiff responded that she has been called bipolar because she
becomes “upset out of just nowhere” and that she has been diagnosed with schizophrenia due to her
aversion to crowds. She reported that she believes “everybody is against her” and that crowds cause
her to lose her breath. She had no stable job and becomes very frustrated while working. She stated
that “the other day I heard someone calling my name and sometimes I hear babies crying,” but did
not describe hearing voices as bona fide hallucinations. Other than stating that her mind “goes too
fast for her,” she described no indication of bipolar disorder or other psychopathology. (Tr. 343.)
Plaintiff described herself as a drifter who sleeps where she can. She has two children but
has no contact with one child and only infrequent contact with her other child. She also stated that
her father is deceased and that she has infrequent contact with her mother and siblings. Although
she stated that she recently lived with a friend, she denied having friends. (Tr. 344.)
Dr. Bradley found obtaining information regarding her daily activities difficult. He noted
that she maintained her own hygiene. She described her activities vaguely, stating only that she sits
outside. She reported that she receives financial support from her friends and family and manages
her own money. She completed ten years of public education and received average to below average
grades. She repeated the seventh grade and later dropped out of school. She obtained a GED in her
mid-twenties. Plaintiff had no job at the time of the evaluation but worked at a staffing company
five months earlier for three days. She also previously worked as a factory worker, cashier, and
waitress. She reported that she had never spent longer than a month at any job. She denied current
drug and alcohol abuse. She also denied any history of drug or alcohol abuse or treatment, but Dr.
Bradley noted her medical records indicated otherwise. (Id.)
Dr. Bradley found no significant problems with her conversational skills and no indications
of psychotic thinking or perceptual abnormalities. Plaintiff described her mood as generally
depressed, but she maintained appropriate affect during the evaluation. Dr. Bradley noted the
vagueness of her presentation and stated that he could not confidently diagnose her. He found that
she did not report numerous symptoms of any specific psychological disorder. He did not believe
she experienced hallucinations. He suggested malingering and polysubstance abuse as diagnoses
and found that her psychological condition did not significantly impair her ability to work or her
ability to manage money. (Tr. 345-46.)
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On November 22, 2005, plaintiff reported that she exhausted her supply of medication during
the previous week. Since then, she experienced greater anxiety, increased muscle spasms, increased
physical tenseness, difficulty sleeping, and paranoid thoughts. She stated that she had suicidal
thoughts but had no plan to commit suicide. During the prior week, she had homicidal thoughts
directed at no particular person and carried a knife for an entire day. She reported that she continued
to live with her father. She also reported that interactions with people made her irritable. Dr.
Reddy gave plaintiff a GAF score of 50. (Tr. 323-24.)
On March 16, 2006, Kathleen King, Ph.D., performed a consultative examination on plaintiff
to determine her level of psychological functioning. Dr. King observed that plaintiff fidgeted during
the interview but that her hygiene and grooming were good. Dr. King further observed that
plaintiff’s speech was rapid and pressured and that plaintiff could initiate conversation but
frequently went on tangents. Plaintiff stated that she received her GED in her late teens during her
brief incarceration for an arms charge. She reported a history of abusive relationships with men.
She moved from Illinois to Kansas City in part because her last boyfriend physically assaulted her.
She worked briefly as a housekeeper, cashier, and receptionist. She recently worked for one day at
a hotel but fell asleep on the job. She had been looking for work since November. At the time of
the examination, she lived in a room in her nephew’s building. (Tr. 307-08.)
She reported receiving psychiatric therapy in Illinois and looking for treatment locally.
Although her medical records indicated the sole diagnosis of bipolar disorder, plaintiff reported a
diagnosis of schizophrenia. She heavily abused drugs and alcohol during her younger years. Under
the influence of these substances, she attempted suicide several times. She stated that she had not
used alcohol in fifteen to twenty years and had not used drugs for two years. She reported hearing
laughter at night. She also reported bad nerves and seeing visions but failed to describe the
symptoms in greater detail. On her good days, plaintiff begins household tasks but has difficulty
completing them. On bad days, she isolates herself in her room. She can drive short distances. She
reported anhedonia.3 She has no friends but interacts regularly with family. She stated that she did
not know whether she managed her own finances. (Tr. 308-09.)
Dr. King found that with treatment plaintiff could understand and remember simple
3
Anhedonia is the absence of pleasure from the performance of acts that would ordinarily be
pleasurable. Stedman's Medical Dictionary, 93 (28th ed., Lippincott Williams & Wilkins 2006).
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instructions and that she could maintain persistence and concentration for simple tasks. Dr. King
also found that her social interactions were appropriate for a one-on-one setting despite her selfdeclared mistrust of others but that “she would do better in situations involving few social
interactions.” Dr. King diagnosed plaintiff with bipolar disorder and polysubstance dependence in
reported remission. (Tr. 309.)
On March 20, 2006, Vanessa Nelson submitted a Third Party Function Report form
regarding plaintiff. She reported that plaintiff looked “like a bum,” and needed “her hair done real
bad.” She stated that plaintiff was always depressed and ventured outside only one day a week.
Vanessa Nelson also stated that plaintiff was “not good at managing money.” She described
plaintiff as not very social, stating that other people offended her. She also noted plaintiff’s lack of
focus, paranoia, and occasional hyperactivity. According to Vanessa Nelson, plaintiff had been fired
or laid off from every job due to her short attention span. Vanessa Nelson also reported that plaintiff
did not manage stress well and had limited capabilities. (Tr. 290-98.)
On March 31, 2006, on a Psychiatric Review Technique form, Keith Allen, Ph.D., found that
plaintiff warranted an assessment of her residual functional capacity because of her diagnoses of
bipolar disorder and substance abuse. Dr. Allen also found that the restriction of her daily living
activities and her difficulty in maintaining concentration, persistence, and pace were mild and that
her difficulty in maintaining social functioning was moderate. On a Mental Residual Functional
Capacity Assessment form, Dr. Allen determined that plaintiff might have occasional difficulty with
more demanding activities but that she could understand and perform less demanding tasks if she
complied with her treatment. (Tr. 272-89.)
On August 22, 2007, Behavioral Health Response referred plaintiff to the Hopewell Center.
She complained of anxiety, paranoia, crying spells, difficulty sleeping, and isolation. She reported
that she had not used cocaine or marijuana for 32 days. She experienced difficulty sleeping due to
the feeling of something crawling on her. She has serious mood swings. She reported that she has
been beaten frequently. She also reported nightmares. Dr. Rolf Krojanker, M.D., diagnosed her
with schizoaffective disorder and prescribed Seroquel.4 Plaintiff received a GAF score of 48. (Tr.
361-67.)
4
Seroquel is used to treat certain mental or mood conditions such as schizophrenia and bipolar
disorder. WebMD, http://www.webmd.com/drugs (last visited on March 26, 2013).
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On December 4, 2007, on a Psychiatric Review Technique form, Kyle DeVore, Ph.D., found
that plaintiff warranted a residual functional capacity assessment because of her schizoaffective
disorder diagnosis. He also found that she had moderate difficulty in maintaining social function
and in maintaining concentration, persistence, and pace but only mild restriction of daily living
activities. On a Mental Residual Functional Capacity Assessment form, Dr. DeVore determined that
plaintiff retained the ability to perform simple tasks if she complied with her treatment and refrained
from substance abuse. (Tr. 391-405.)
On November 24, 2008, Frances Nelson, plaintiff’s cousin, submitted a Third Party Function
Report form.
She reported that plaintiff needed reminders for her medication and doctor
appointments and that plaintiff required assistance and encouragement to perform household chores.
She stated that plaintiff did not follow written or spoken instructions well. Frances Nelson also
stated that plaintiff snapped at authority figures and quit jobs for no reason. She further reported that
a male acquaintance had beaten plaintiff for six or seven years, which caused plaintiff to have
difficulty sleeping. (Tr. 203-11.)
On December 18, 2008, plaintiff reported paranoia concerning the presence of a stranger in
her apartment. She continued to hear voices. She admitted her failure to take her medication as
prescribed. (Tr. 376.)
On January 12, 2009, John Rabun, M.D., performed an evaluation on plaintiff. She
complained of nervous episodes and sweating hands. Dr. Rabun observed that plaintiff attempted
to act nervous and put forth poor effort when performing simple tasks. Plaintiff stated that the
voices she hears awaken her, and Dr. Rabun found her statement suggestive of malingering but not
genuine hallucination. She did not report substance abuse. She did not exhibit features of
depression or mania. She last worked in September 2008 at Washington University. She lives by
herself in her own apartment with no source of income. (Tr. 411-12.)
Dr. Rabun observed that plaintiff appeared undistracted when providing answers that
benefitted her case and did not exhibit any signs of anxiety. He diagnosed malingering and gave her
a GAF score of 70.5 He found that she had the capacity to focus, concentrate, and remember
5
A GAF score from 61-70 is indicative of some mild symptoms or some difficulty in social or
occupational functioning but with a general ability to function well and to have some meaningful
interpersonal relationships. DSM-IV-TR, at 34.
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instructions as well as the ability to interact appropriately in a social setting and adapt to changes
in a work environment. He further found that she could manage her own funds. (Tr. 412-13.)
On February 3, 2009, Dr. DeVore submitted another Psychiatric Review Technique form
regarding plaintiff. He found plaintiff’s impairment of schizoaffective disorder not severe. He also
found that plaintiff suffered from only mild limitations regarding her daily activities, social
functioning, and maintaining concentration, persistence, and pace. (Tr. 414-24.)
From July 22 to October 30, 2009, plaintiff regularly attended Narcotics Anonymous
meetings. On December 7, 2009, plaintiff tested negative for drug and alcohol use. (Tr. 425-30.)
On February 4, 2010, Lauren Flynn, M.D., performed a medical and psychiatric assessment
on plaintiff. Plaintiff reported that her most troubling psychiatric symptoms were depression and
anger. She also reported anhedonia and difficulty initiating and maintaining sleep. Dr. Flynn found
plaintiff’s anhedonia complaint inconsistent with her claim that she frequently felt euphoric even
without the use of illicit drugs. She further complained of poor concentration and thoughts of death
but denied recent suicidal ideation. She also complained of flashbacks of the physical abuse she
suffered from previous relationships and recurrent nightmares. (Tr. 452-53.)
Plaintiff stated that a male acquaintance shattered her left cheekbone and that the incident
caused many of her mental health problems. She reported approximately fifty suicide attempts that
were typically preceded by physical abuse. The last attempt occurred two and half years earlier.
Plaintiff also reported smoking one and a half cigarette packs per day. She admitted using alcohol,
crack cocaine, and marijuana but stated that she had quit two and a half years earlier. She resides
alone in an apartment, but Queen of Peace pays her rent and utilities.6 She cleaned offices for her
last job in June 2009 for four months. She quit due to transportation issues. She reported never
holding a job for longer than five months. (Tr. 453-54.)
Dr. Flynn diagnosed posttraumatic stress disorder, depressive disorder, and nicotine
dependence. Plaintiff received a GAF score of 57.7 Dr. Flynn prescribed Celexa to target plaintiff’s
6
Queen of Peace Center is a family-centered behavioral healthcare provider for women with
addiction, their children and families. Queen of Peace Center, http://www.qopcstl.org/about-us/ (last
visited March 26, 2013).
7
A score from 51 to 60 represents moderate symptoms (such as flat affect and circumstantial
speech, occasional panic attacks), or moderate difficulty in social, occupational, or school
functioning (such as few friends, conflicts with peers or co-workers). DSM-IV-TR, at 34.
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posttraumatic stress disorder and depressive symptoms and Trazodone to alleviate her chronic
insomnia. (Tr. 455-56.)
On February 8, 2010, Dr. Krojanker submitted a Mental Medical Source Statement form
regarding plaintiff. He indicated that he had not seen plaintiff since December 18, 2008, but found
her markedly limited in her daily activities, social functioning, and concentration, persistence, and
pace. He also found that plaintiff could work only four hours per day and that her impairments
would cause her to miss and be late for work. (Tr. 434-37.)
On February 15, 2010, Steve Bucheit, LPC, also submitted Mental Medical Source Statement
form. He found that plaintiff could follow simple one or two-step instructions and interact
appropriately with the general public for six hours in an eight-hour work day, but could only interact
appropriately with coworkers and supervisors for four hours. He also found that her impairments
would cause her to miss three days of work per month and to be late for two days of work per month.
His most current diagnosis of plaintiff included cocaine dependence, cannabis abuse, and alcohol
abuse, each in remission, and paranoid-type schizophrenia. (Tr. 438-41.)
On March 10, 2010, Lloyd Irwin Moore, Ph.D., performed a psychological evaluation on
plaintiff. She reported that she continued to attend Narcotics Anonymous meetings. Dr. Moore
observed that plaintiff acted anxiously during the interview. Plaintiff had prescriptions of Trazodone
and Citalopram.8 Dr. Moore diagnosed bipolar I disorder and anxiety disorder and gave her a GAF
score of 56. He found mild impairment regarding her daily activities but moderate impairment
regarding her social functioning and concentration, persistence, and pace. He also found her capable
of handling her own funds. (Tr. 442-47.)
Dr. Moore also submitted a Mental Medical Source Statement form. He found that plaintiff
could interact appropriately with coworkers, supervisors, and the general public for eight hours in
an eight-hour work day but could follow simple one or two-step instructions for only six hours. He
also found that her impairments would cause her to miss work two days per month and to be late two
days per month. (Tr. 448-51.)
On April 12, 2010, plaintiff tested negative for drug use. (Tr. 459.)
8
Citalopram is also known as Celexa. WebMD, http://www.webmd.com/drugs (last visited on
March 26, 2013).
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Testimony at the Hearing
A hearing was conducted before an ALJ on April 20, 2010. (Tr. 36-47.) Plaintiff testified
to the following. She is 47 years old and resides alone in an apartment. She measures 5 feet, 3
inches and 155 pounds. She stopped attending school in eleventh grade but later received her GED.
She receives food stamps but has no other source of income. From time to time, her mother and
brother send her a few dollars. She served prison time for violating her probation. In 1987 or 1988,
a male acquaintance left a gun in her car, and the police found it. (Tr. 35-37, 46.)
She last worked during the summer of 2009. At her part-time job, she cleaned offices at
Atwood Jones for Abcole Company. Before working for Abcole Company, she cleaned offices fulltime for Washington University. Her supervisor continually picked on plaintiff and later fired her.
Plaintiff is unable to maintain a full-time job because of her difficulty paying attention as well as
stress and depression. (Tr. 37-38.)
She currently receives psychiatric care at Barnes Jewish and formerly received care at the
Hopewell Center. She has had problems with crack cocaine and alcohol but has been clean for two
and a half years. She attends Narcotics Anonymous meetings throughout the St. Louis area. At
Queen of Peace, she received psychiatric counseling from an individual named Steve. (Tr. 38-39.)
She has flashbacks concerning her past physical abuse and awakens screaming due to her
nightmares. Despite taking medication to alleviate her insomnia, her sleep is poor, and she
continues to have nightmares about three times a week. She has low energy and does not feel like
getting out of her bed or performing housework. She does not trust other people and thinks that
people want to hurt her or that people are “against” her. She cries daily. She also becomes angry
and suicidal. She last felt suicidal about a week ago but took no action. When she thinks suicidal
thoughts, she usually takes some medication to avoid burning or otherwise harming herself. She last
attempted to harm herself a couple years earlier by taking hot pipes and pressing them against her
skin. (Tr. 40-41.)
Typically, plaintiff remains awake all night, and gets out of her bed at 10 or 11 a.m. to smoke
a cigarette. She smokes a pack per day. She receives about $30 every other week for cigarettes
from her cousin. After she smokes, she lies or sits in her house. Besides attending her meetings,
she rarely leaves her home. She has no visitors. A case worker from Barnes Jewish reminds her of
and takes her to doctor appointments. She occasionally shops for groceries but barely eats. When
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she shops, crowds cause her to become irritable. She does not clean her house due to low energy
and feeling emotional. She has a driver license but does not drive because of her experience with
serious car accidents and her anxiety when riding in a car. She has panic attacks. Her last panic
attack occurred the morning before the ALJ hearing. When she left her bed, she panicked because
she feared that she would be unable to attend the ALJ hearing. During the panic attacks, she shakes
and becomes short of breath. She also suffers tense headaches and perspires. (Tr. 41-45.)
III. DECISION OF THE ALJ
On June 8, 2010, the ALJ issued a decision that plaintiff was not disabled. (Tr. 17-25.) At
Step One of the prescribed regulatory decision-making scheme,9 the ALJ found that plaintiff had not
engaged in substantial gainful activity since November 4, 2008. At Step Two, the ALJ found that
plaintiff suffered from hyperlipidemia, mild affective or personality disorder, and polysubstance
dependence in long remission, but that her impairments were not of sufficient severity to prevent
her from performing basic work-related activities. The ALJ concluded that plaintiff was not
disabled. The ALJ also stated that plaintiff could perform jobs existing in significant numbers in
the national economy even if he restricted her to jobs requiring only simple, repetitive tasks and only
minimal contact with coworkers, supervisors, and the general public. (Tr. 25.)
IV. GENERAL LEGAL PRINCIPLES
The court’s role on judicial review of the Commissioner’s decision is to determine whether
the Commissioner’s findings comply with the relevant legal requirements and are supported by
substantial evidence in the record as a whole. Pate-Fires v. Astrue, 564 F.3d 935, 942 (8th Cir.
2009). “Substantial evidence is less than a preponderance, but is enough that a reasonable mind
would find it adequate to support the Commissioner’s conclusion.” Id. In determining whether the
evidence is substantial, the court considers evidence that both supports and detracts from the
Commissioner's decision. Id. As long as substantial evidence supports the decision, the court may
not reverse it merely because substantial evidence exists in the record that would support a contrary
outcome or because the court would have decided the case differently. See Krogmeier v. Barnhart,
294 F.3d 1019, 1022 (8th Cir. 2002).
9
See below for explanation.
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To be entitled to disability benefits, a claimant must prove she is unable to perform any
substantial gainful activity due to a medically determinable physical or mental impairment that
would either result in death or which has lasted or could be expected to last for at least twelve
continuous months. 42 U.S.C. §§ 423(a)(1)(D), (d)(1)(A), 1382c(a)(3)(A); Pate-Fires, 564 F.3d 935,
942 (8th Cir. 2009). A five-step regulatory framework is used to determine whether an individual
is disabled. 20 C.F.R. §§ 416.920(a)(4); see also Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987)
(describing the five-step process); Pate-Fires, 564 F.3d at 942 (same).
Steps One through Three require the claimant to prove (1) she is not currently engaged in
substantial gainful activity, (2) she suffers from a severe impairment, and (3) her disability meets
or equals a listed impairment. 20 C.F.R. §§ 416.920(a)(4)(i)-(iii). If the claimant does not suffer
from a listed impairment or its equivalent, the Commissioner’s analysis proceeds to Steps Four and
Five. Step Four requires the Commissioner to consider whether the claimant retains the RFC to
perform her past relevant work (PRW). Id. § 416.920(a)(4)(iv). The claimant bears the burden of
demonstrating she is no longer able to return to her PRW. Pate-Fires, 564 F.3d at 942. If the
Commissioner determines the claimant cannot return to PRW, the burden shifts to the Commissioner
at Step Five to show the claimant retains the RFC to perform other work that exists in significant
numbers in the national economy. Id.; 20 C.F.R. § 416.920(a)(4)(v).
V. DISCUSSION
Plaintiff argues the ALJ erred in (1) finding plaintiff’s impairments not severe; (2) failing
to consider non-medical evidence; and (3) including an alternative finding in his written decision.
A. Severity
Plaintiff argues that substantial evidence did not support the ALJ’s finding that plaintiff had
no severe impairments.
A severe impairment is defined as an impairment that significantly limits one’s physical or
mental ability to do basic work activities. 20 C.F.R. § 416.920(c). “Severity is not an onerous
requirement for the claimant to meet, but it is also not a toothless standard, and we have upheld on
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numerous occasions the Commissioner's finding that a claimant failed to make this showing.” Kirby
v. Astrue, 500 F.3d 705, 707-08 (8th Cir. 2007).
“An ALJ may discount a claimant’s subjective complaints if there are inconsistencies in the
record as a whole.” Van Vickle v. Astrue, 539 F.3d 825, 828 (8th Cir. 2008). Additionally, an ALJ
may discount a claimant’s allegations if the record contains evidence of malingering. O’Donnell
v. Barnhart, 318 F.3d 811, 818 (8th Cir. 2003). Failure to seek ongoing medical treatment is another
factor an ALJ may consider. Halverson v. Astrue, 600 F.3d 922, 932 (8th Cir. 2010). However,
inability to pay can justify a claimant’s failure to seek medical treatment. Vasey v. Astrue, 2009 WL
4730688 at *5 (E.D. Ark. 2009). Work performed during the alleged onset period can also be
relevant to discredit a claimant’s allegations. 20 C.F.R. § 416.971; Weber v. Barnhart, 348 F.3d
723, 725 (8th Cir. 2003); Naber v. Shalala, 22 F.3d 186, 188-89 (8th Cir. 1994).
This court finds that substantial evidence supports the ALJ’s decision. Plaintiff maintained
employment for four months after her alleged onset date and quit due to lack of transportation. (Tr.
454.) Dr. Bradley suspected plaintiff of malingering during a consultative examination in 2005, and
Dr. Rabun questioned the credibility of her complaints in 2008 and also suspected her of
malingering. (Tr. 346, 411-13.) Dr. DeVore and Dr. Allen opined that plaintiff could perform
simple activities if she complied with treatment and refrained from substance abuse. (Tr. 288, 405.)
Further, plaintiff sought medial treatment only intermittently, and the record does not show that she
had ever been refused medical treatment due to inability to pay. Finally, plaintiff made several
inconsistent statements to medical professionals throughout the record. For example, during an
interview with Dr. Bradley, plaintiff denied having friends but stated that she recently lived with a
friend and receives financial support from friends. (Tr. 344.) Plaintiff also told the ALJ she lost her
office cleaning job because her supervisor picked on her but told Dr. Flynn that she quit due to lack
of transportation. (Tr. 38, 454.)
In sum, substantial evidence supports the ALJ’s finding that plaintiff suffered no severe
impairments.
B. Non-medical sources
Plaintiff also argues that the ALJ failed to properly consider non-medical sources.
Specifically, plaintiff argues that the ALJ failed to properly consider statements from plaintiff’s
mother and cousin and Vanessa Nelson as well as Steve Bucheit’s opinion.
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SSR 06-03p states that non-medical sources, including the evaluations of individuals who
have seen the individual in their professional capacity and evidence from spouses, relatives, and
friends, should be evaluated using the factors provided by 20 C.F.R. § 416.927(c). These factors
include the relationship with the claimant, the length and frequency of contact with the claimant, and
the consistency of the evidence with the record as a whole. 20 C.F.R. § 416.927(c).
The ALJ’s reasons for finding the statements from plaintiff’s mother and cousin and Vanessa
Nelson not credible include their lack of medical expertise, their affection for plaintiff, and their
tendency to believe and support her. (Tr. 23.) The ALJ also found the statements as well as the
form assessment by Steve Bucheit inconsistent with the record as a whole. (Tr. 22-23.) The ALJ
did not list specific inconsistencies. However, evidence supporting the ALJ’s decision to discredit
a claimant’s allegations can also support an ALJ’s decision regarding the credibility of other
sources. Lorenzen v. Chater, 71 F.3d 316, 319 (8th Cir. 1995); Robinson v. Sullivan, 956 F.2d 836,
841 (8th Cir. 1992). Here, the aforementioned evidence used by the ALJ to find no severe
impairment also supports the ALJ’s decision to discredit non-medical sources in the instant case.
In addition to the evidence discrediting plaintiff, many specific examples of inconsistency
appear throughout the record. For example, her mother stated that plaintiff needed to be reminded
to maintain personal hygiene and that she could not be trusted with money. (Tr. 347.) Three days
later, Dr. Bradley found plaintiff able to maintain her own personal hygiene and able to manage
money. (Tr. 344, 346.) Plaintiff’s cousin reported that plaintiff could not follow written or spoken
instructions well. (Tr. 208.) About two months later, Dr. Rabun found that plaintiff had the capacity
to focus, concentrate, and remember instructions. (Tr. 412.) Further, Vanessa Nelson stated that
plaintiff could not maintain focus, but Dr. DeVore found plaintiff not significantly limited in her
ability to maintain attention and concentration for extended periods. (Tr. 286, 294.)
Accordingly, plaintiff’s argument that the ALJ failed to properly consider non-medical
sources is without merit.
C. Alternative finding
Plaintiff also argues that the ALJ impermissibly included an alternative conclusion in his
written decision. In the ALJ’s decision, the ALJ stated that a significant number of jobs remained
available to plaintiff even if he had found plaintiff restricted to jobs requiring the performance of
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only simple repetitive tasks and only minimal contact with coworkers, supervisors, and the general
public. (Tr. 24.)
Plaintiff cites no authority prohibiting an ALJ from making alternative findings, and this
court can find none. Significantly, on several occasions, the Eighth Circuit has considered
alternative findings set forth by an ALJ without mention that such findings are in any manner
erroneous or discouraged. See McGeorge v. Barnhart, 321 F.3d 766, 768 (8th Cir. 2003); Caldwell
v. Barnhart, 84 F. App'x 714, 715 (8th Cir. 2003); Duran v. Barnhart, 56 F. App'x 753, 754 (8th Cir.
2003).
Further, substantial evidence supports the ALJ’s alternative finding. For example, in
response to one of plaintiff’s previous applications for benefits, the disability examiner explained
that she retained the ability to work as a dipper, gluer, and patcher. (Tr. 50-51.) The restrictions
discussed by the ALJ are consistent with several medical opinions contained on the record. (Tr. 288,
309, 405.)
VI. CONCLUSION
For the reasons set forth above, the court affirms the decision of the Acting Commissioner
of Social Security under Sentence 4 of 42 U.S.C. § 405(g).
An appropriate Judgment Order is issued herewith.
/S/ David D. Noce
UNITED STATES MAGISTRATE JUDGE
Signed on March 27, 2013.
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