Ramsey v. Astrue

Filing 24

MEMORANDUM AND ORDER IT IS HEREBY ORDERED that the relief which Ramsey seeks in her Complaint and Brief in Support of Plaintiffs Complaint is DENIED. [Docs. 1,15.] IT IS FURTHER ORDERED that the Court will enter a separate judgment in favor of the Commissioner. 15 Signed by Magistrate Judge Nannette A. Baker on 9/25/13. (CLA)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION

SHERRY A. RAMSEY,
Plaintiff,
v.
CAROLYN W. COLVIN,
Acting Commissioner of Social Security,
Defendant.

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Case No. 4:12-CV-1003-NAB

MEMORANDUM AND ORDER
This is an action under Title 42 U.S.C. § 405(g) for judicial review of the
Commissioner’s final decision denying Sherry A. Ramsey’s (“Ramsey”) application for a period
of disability and disability insurance benefits and Supplemental Security Income (“SSI”) under
Title II and Title XVI of the Social Security Act. Ramsey alleges disability due to back
problems, fibromyalgia, chronic fatigue syndrome, restless leg syndrome (“RLS”), osteoarthritis,
and chronic joint pain. (Tr. 185.) The parties consented to the jurisdiction of the undersigned
United States Magistrate Judge pursuant to 28 U.S.C. § 636(c)(1). [Doc. 11].
I.

Procedural History
On January 22, 2010, Ramsey filed applications for a period of disability, disability

insurance benefits, and SSI benefits. (Tr. 128-39). The Social Security Administration (“SSA”)
denied Ramsey’s claim and she filed a timely request for a hearing before an administrative law
judge (“ALJ”). (Tr. 66-77, 80-88). The SSA granted Ramsey’s request and the hearing took
place on January 27, 2011. (Tr. 26-59). The ALJ issued a written decision on March 14, 2011.
(Tr. 12-22). Ramsey requested review of the ALJ’s decision from the Appeals Council. (Tr. 8).

On May 2, 2012, the Appeals Council denied Ramsey’s request for review. (Tr. 1-4). The
decision of the ALJ thus stands as the final decision of the Commissioner. See Sims v. Apfel, 530
U.S. 103, 107 (2000). Ramsey filed this appeal on June 5, 2012. [Doc. 1] The Commissioner
filed an Answer on August 10, 2012. [Doc. 13]

Ramsey filed a Brief in Support of her

Complaint on September 7, 2012. [Doc. 15] The Commissioner filed a Brief in Support of the
Answer. [Doc. 20]
II.

Standard of Review
The Social Security Act defines disability as an “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 has lasted or can be expected to last for a continuous period
of not less than 12 months.” 42 U.S.C. § 416(i)(1)(A); 42 U.S.C. § 423(d)(1)(A).
The Social Security Administration uses a five-step analysis to determine whether a
claimant seeking disability benefits is in fact disabled.

20 C.F.R. §§ 404.1520(a)(1),

416.920(a)(1). First, the claimant must not be engaged in substantial gainful activity. 20 C.F.R.
§§ 404.1520(a)(4)(i), 416.920(a)(4)(i). Second, the claimant must establish that he or she has an
impairment or combination of impairments that significantly limits his or her ability to perform
basic work activities. 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). Third, the claimant
must establish that his or her impairment meets or equals an impairment listed in the appendix to
the applicable regulations. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(iii).
Fourth, the claimant must establish that the impairment prevents him or her from doing
past relevant work. 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv). At step five, the burden
shifts to the Commissioner to establish that the claimant maintains the residual functional
capacity to perform a significant number of jobs in the national economy. Singh v. Apfel, 222

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F.3d 448, 451 (8th Cir. 2000). If the claimant satisfies all of the criteria under the five-step
evaluation, the ALJ will find the claimant to be disabled. 20 C.F.R. §§ 404.1520(a)(4)(v),
416.920(a)(4)(v).
This Court reviews decisions of the ALJ to determine whether the decision is supported
by substantial evidence in the record as a whole. 42 U.S.C. § 405(g). Substantial evidence is
less than a preponderance, but enough that a reasonable mind would find adequate support for
the ALJ’s decision. Smith v. Shalala, 31 F.3d 715, 717 (8th Cir. 1994). Therefore, even if this
Court finds that there is a preponderance of evidence against the weight of 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). An administrative decision is not subject to reversal simply because
some evidence may support the opposite conclusion. Gwathney v. Chater, 1043, 1045 (8th Cir.
1997).
To determine whether the ALJ’s final decision is supported by substantial evidence, the
Court is required to review the administrative record as a whole to consider:
(1) The 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
physician;
(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 prior
hypothetical questions which fairly set forth the claimant’s
physical impairment; and

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(7) The testimony of consulting physicians
Brand v. Sec’y of Dept. of Health, Educ. & Welfare, 623 F.2d 523, 527 (8th Cir. 1980).
III.

ALJ’s Decision
The ALJ determined that Ramsey met the insured status requirements of the Social

Security Act through December 31, 2009 and she has not engaged in substantial gainful activity
since March 15, 2009, the alleged onset date of disability. (Tr. 14). The ALJ found that Ramsey
had the severe impairments of fibromyalgia and obesity. Id. The ALJ also found that Ramsey
does not have an impairment or combination of impairments that meet or medically equal one of
the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Tr. 16.) The ALJ
determined that Ramsey had the residual functional capacity (“RFC”) to perform light work with
the following limitations: (1) lifting and carrying up to 20 pounds occasionally and up to 10
pounds frequently, (2) standing and walking for at least two hours total in an eight-hour
workday, (3) sitting for at least six hours total in an eight-hour workday, (4) never crawling or
climbing ladders, ropes, or scaffolds, (5) kneeling rarely, (6) stooping and crouching
occasionally, and (7) engaging in frequent, though not continuous, use of the left (non-dominant)
hand to grasp, handle, or finger. (Tr. 16-17.) He also determined that Ramsey could perform her
past relevant work as a tax preparer, because the work does not require the performance of workrelated activities precluded by the claimant’s RFC. (Tr. 21.) Finally, the ALJ concluded that
Ramsey has not been under a disability, as defined in the Social Security Act from March 15,
2009, through the date of the decision. (Tr. 22).
IV.

Administrative Record
The following is a summary of relevant evidence before the ALJ:

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A.

Hearing Testimony

The ALJ heard testimony from Ramsey; David Lindke, Ramsey’s ex-husband; and
Steven Dolan, the vocational expert (“VE”).
1.

Ramsey’s Testimony

Ramsey testified she was fifty-one at the time of the hearing. (Tr. 34.) Ramsey has
previously worked as a cashier, tax preparer, licensed real estate agent, manager, and cook. (Tr.
34-37.) Ramsey’s work as a tax preparer ended due to tax season ending and Ramsey moving to
another state. (Tr. 34.) Ramsey stopped working as a realtor due to a drop in the market and her
real estate license expired in 2007. (Tr. 35-36.) When she worked as a manager at the gas
station, she was responsible for all store operations including employee schedules, payroll, bank
deposits, cooking, and cleaning. (Tr. 36.) Ramsey also served as the owner, cashier, and stock
person at a produce market in 1999 and 2000. (Tr. 37.)
In 1987, Ramsey testified that she had back surgery that involved the removal of
herniated discs and replacement with acrylic discs. (Tr. 38-39.) Ramsey stated that she had
ongoing discomfort from the back surgery that affected her feet and started problems with her
hips. (Tr. 39.) Ramsey had an MRI done in 1991, which showed she had a herniated disc. (Tr.
40.) The back problems caused muscle spasms in the lower back quite often and her doctor
issued muscle relaxers and physical therapy. (Tr. 40.) Ramsey testified that she could no longer
work full time in 2000 or 2001 when she became really ill- unable to keep food down and
sleeping unusual amounts of time. (Tr. 41.) Ramsey received a diagnosis for diabetes, which is
now controlled by her diet. (Tr. 41.) Ramsey also felt that her bones were hurting. (Tr. 41.) Dr.

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Martha Reed diagnosed Ramsey with fibromyalgia in 2000. (Tr. 41-42.) Ramsey has also been
diagnosed with restless leg syndrome. (Tr. 45.)
Ramsey worked until March 2009. (Tr. 41.) Ramsey stated that she stopped working,
because she had a lot of unclear days and her head was “like in a fog.” (Tr. 41.) Ramsey also
stated that her fibromyalgia medication makes her “foggy.” (Tr. 46.) She was steadily getting
worse and she was having extreme difficulty concentrating and counting money. (Tr. 42, 45.)
Ramsey stated that her former supervisor commented to her about the time she spent counting
money before and after her shift. (Tr. 46.) Ramsey stated that subsequently, her hours were cut.
(Tr. 46.)
Ramsey testified that she experiences pain in her arms, legs, back, feet, and chest bone.
(Tr. 43.) She has trouble focusing on a simple conversation sometimes. (Tr. 43.) Ramsey stated
that there are days when she can’t unbutton clothing or pull clothing over her head. (Tr. 43.)
Ramsey sleeps two hours at a time. (Tr. 45.) She wakes up hurting and very stiff. (Tr. 45.) At
the time of the hearing, Ramsey testified that she was taking Lisinopril, Trazadone, and
Ibuprofen. (Tr. 47.) Also, at the time of the hearing in January 2011, Ramsey had not seen Dr.
Reed since March 2010 and had not gotten her prescriptions re-filled due to lack of funds. (Tr.
47.) Ramsey testified that she smoked less than half a pack of cigarettes on a typical day. (Tr.
48.)
Ramsey testified that she lives with her ex-husband David Lindke. (Tr. 44.) Lindke has
to remind her to take her medication. (Tr. 44-45.) Ramsey spends three to four hours per day
watching television and hour a day on the computer “surfing and reading.” (Tr. 49-50.) Ramsey
stated she can cook meals on some days, but she does not shop, sweep, mop, or drive. (Tr. 49,
51.) Ramsey also testified that can do dishes and the laundry sometimes. (Tr. 49-50.)

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2.

David Lindke

Lindke testified that since March of 2009, Ramsey has had problems with her balance
and being fatigued and lethargic. (Tr. 52.) Lindke also stated that Ramsey’s mental capacity has
deteriorated greatly. (Tr. 53.) Ramsey cannot remember the location for her keys or the content
of what is said on television. (Tr. 53.) Lindke testified that he helps Ramsey to rise and sit on
the commode, move in and out of the shower, and prepare meals. (Tr. 53.) Ramsey’s wincing
and facial expressions demonstrate that she is in pain. (Tr. 53.) Ramsey awakens three or four
times during the night, but on occasion she sleeps for hours or days. (Tr. 54.) Ramsey has a lot
of pain at night. (Tr. 54.) Lindke gives Ramsey her medication and takes her to the doctor. (Tr.
55.)
3.

VE John Dolan

The VE testified that Ramsey’s work as a cashier was unskilled with a light exertional
level generally and as performed. (Tr. 57.) Ramsey’s job as a retail store manager is skilled and
medium as it was performed. (Tr. 57.) Ramsey’s work as a real estate sales person was skilled
with a light exertional level. (Tr. 57.) The VE also stated that Ramsey’s work as a tax preparer
was semi-skilled with a sedentary exertional level. (Tr. 57.)
B.

Medical Records

On July 20, 2006, an x-ray of Ramsey’s left hip and pelvis was normal with no fractures
or dislocations and no bone texture or soft tissue abnormality. (Tr. 248.) Dr. Martha Reed
treated Ramsey between 2006 and 2010. (Tr. 243-48, 259-63.) A partial note from November 3,
2006 showed that Ramsey had the problems of stress incontinence and was referred to Dr.
Houttuin. (Tr. 245.) Ramsey visited Dr. Reed twice in 2007. (Tr. 245.) Dr. Reed prescribed

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Celebrex for arthritis on an as needed basis. (Tr. 245.) On May 16, 2007, Ramsey received a
mid-urethral transobturator sling procedure1 from Dr. Houttuin. (Tr. 245.)
On May 14, 2009, Ramsey visited Dr. Reed complaining of severe fibromyalgia, poor
sleep, legs feeling “crawlish,” and pain everywhere. (Tr. 244.) Dr. Reed noted that Ramsey had
a normal physical examination with the exception of high blood pressure, poor color, and a few
scattered rhonchi2 in the lungs. (Tr. 244.) Dr. Reed noted that Ramsey’s problems included
fibromyalgia, hypertension, glucose intolerance, RLS, nicotine addiction, and gastroesophageal
reflux disease (“GERD.”) (Tr. 244.)
On June 29, 2009, Ramsey visited Dr. Reed for a routine visit. (Tr. 244.) Dr. Reed noted
that Ramsey had poor color and her physical examination had no change since her visit on May
14, 2009. Ramsey reported that the Darvocet medicine was not effective. (Tr. 244.) Dr. Reed
adjusted Ramsey’s medications and told her to follow up as needed in 2 to 3 months. (Tr. 244.)
On July 13, 2009, Ramsey reported to Dr. Reed that she was “cloudy and fuzzy headed” and her
muscle spasm pain was worse in her upper legs and arms and not getting better. (Tr. 244.)
Ramsey also reported that she was unable to get her blood work done, because she did not have
any insurance. (Tr. 244.)
On August 26, 2009, Dr. Reed noted that Ramsey came to the examination with her
“gentleman friend,” who reported that Ramsey was forgetful, had bad balance, slept all of the
time, and was lethargic. (Tr. 243.) Dr. Reed examined Ramsey and found that she had poor
color, regular heart rate, clear lungs, normal neck and abdomen, and no ankle edema. (Tr. 243.)

1

A transobturator sling procedure treats stress incontinence by using a sling made of either natural or synthetic
tissue and placing it around the bladder’s neck and attaching it to the pubic bone. WebMD,
http://www.webmd.com/urinary-incontinence-oab/america-asks-11/stress?page=2 (last accessed on September 23,
2013).
2
Rhonchi are added sounds “with a musical pitch occurring during inspiration and expiration, heard on auscultation
of the chest and caused by air passing through bronchi that are narrowed by inflammation, spasm of the smooth
muscle or presences of mucus in the lumen. Stedman’s Medical Dictionary 1568 (27th ed. 2000).

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Dr. Reed found that Ramsey had normal finger to nose, alternating hand movements, normal
Rhomberg, and normal heel to toe movements. (Tr. 243.) Dr. Reed determined Ramsey had the
problems of deconditioning3, adult-onset diabetes mellitus (“AODM”), and the other problems
listed at her May 2009 visit. (Tr. 243.) Dr. Reed recommended Ramsey decrease cigarette
smoking, exercise daily, see a dietician for diabetes control, lipid improvement, and weight
reduction. (Tr. 243.)
On March 5, 2010, Dr. Barry Burchett completed a physical medical consultative
examination of Ramsey. (Tr. 250-56.) She reported that she had arthritis and fibromyalgia.
(Tr. 250.) Ramsey complained of deep generalized body pain, recurrent spasm of various
muscles, chronic fatigue, poor sleep, persistent numbness in her left great toe, and pain in all of
her joints, except the left ankle. (Tr. 250-51.) Dr. Burchett’s examination revealed that Ramsey
ambulated with a normal gait, which was not unsteady, lurching, or unpredictable, and does not
require the use of a handheld assistive device. (Tr. 252.) Dr. Burchett also noted that Ramsey’s
recent and remote memory for recent events was good. (Tr. 252.) He determined that eleven of
eighteen standard fibromyalgia trigger location points were reported as tender and three of ten
control points were reported as tender. (Tr. 252.) Examination of Ramsey’s head, ear, nose,
throat, chest, heart, abdomen, extremities, and spine were substantially normal with slight
swelling in the left thumb IP joint and moderate limitation of range of motion in her right
shoulder and bilateral hips. (Tr. 254.) Dr. Burchett found that otherwise, there was full range of
motion of all joints. (Tr. 254.) Dr. Burchett diagnosed Ramsey with possible fibromyalgia and
probable osteoarthritis of multiple locations. (Tr. 253.)

3

Deconditioning means to cause or lose fitness or muscle tone, especially through lack of exercise. Oxford
Dictionaries Pro, http://english.oxforddictionaries.com/definition/decondition?region=us#m_en_us1238871.002
(last accessed September 23, 2013).

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On March 24, 2010, Ramsey visited Dr. Reed with complaints of back pain, cough,
generalized weakness all over, fogginess, inability to grip steering wheel, muscle spasms,
lightheadedness, and memory loss. (Tr. 260.) Dr. Reed noted that Ramsey had the following
problems: acute bronchitis, chronic obstructive pulmonary disease, arthritis, AODM, muscle
spasm, RLS, possible fibromyalgia, GERD, hypertension, and nicotine addiction. (Tr. 261.) Dr.
Reed ordered several tests, urged Ramsey to discontinue smoking, and told her to follow-up in
three months or as needed. (Tr. 261.)
V.

Discussion
Ramsey alleges two errors on review. First, Ramsey asserts that the ALJ erred in finding

that her disorder of the spine did not constitute a medically determinable impairment and the
ALJ failed to perform his duty to fully and fairly develop the record. Second, Ramsey contends
that the ALJ failed to give proper consideration to her fibromyalgia symptoms.
A.

Spine Impairment

Ramsey asserts that the ALJ erred in his determination that her “spine disorder” is not a
medically determinable impairment and that the ALJ failed to fully develop the record. The
Court disagrees. An impairment must result from anatomical, physiological, or psychological
abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic
techniques.

20 C.F.R. §§ 404.1508, 416.908.

A physical or mental impairment must be

established by medical evidence consisting of signs, symptoms, and laboratory findings, not only
by the claimant’s statement of symptoms. Id.
The ALJ determined that the available medical records do not contain evidence of past
surgery, disc disease, or herniation. (Tr. 16.) The ALJ also determined that there was no
objective medical evidence in the record any current spinal or lumbar impairments or diagnosis

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of any such impairment. (Tr. 16.) Therefore, the ALJ concluded that there was no medical
evidence in the record to establish any disorder of the spine or discs as a medically determinable
impairment. (Tr. 16.) The Court finds that the ALJ’s decision is supported by substantial
evidence on the record as a whole. Ramsey testified that she has back problems stemming from
lumbar surgery performed in 1987 for a disc herniation. (Tr. 38-39.) She also testified that in
1991 Dr. Crawford at Jefferson Memorial Hospital performed an MRI on her, which confirmed
disc herniation at L3 and L4. (Tr. 39-40.) Ramsey’s testimony that she has a spine disorder is
not sufficient alone to establish that she has a medical impairment.

20 C.F.R. § 1528(a)

(claimant’s statements alone not enough to establish existence of mental or physical
impairment). Further, the fact the Ramsey had a disc herniation 18 years prior to the alleged
onset date is also not sufficient evidence that she currently has back problems.
Next, Ramsey contends that the ALJ failed to fully develop the record regarding whether
she had a spine disorder. “There is no bright line test for determining when the [Commissioner]
has failed to develop the record. The determination in each case must be made on a case by case
basis.” Battles v. Shalala, 36 F.3d 43, 45 (8th Cir. 1994). A claimant for social security
disability benefits has the responsibility to provide medical evidence demonstrating the existence
of an impairment and its severity during the period of disability and how the impairment affects
the claimant’s functioning. 20 C.F.R. §§ 404.1512(c), 416.912(c). The ALJ has a duty to fully
develop the record. Smith v. Barnhart, 435 F.3d 926, 930 (8th Cir. 2006) (citation omitted).
This duty requires the ALJ to develop a complete medical history for the claimant for at least
twelve months preceding the month in which the claimant’s application was filed before making
a determination. 20 C.F.R. §§ 1512(d), 416.912(d). In some cases, this duty requires the ALJ to
obtain additional medical evidence, such as a consultative examination of the claimant, before

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rendering a decision. See 20 C.F.R. §§ 404.1519a(b), 416.919a(b). The ALJ’s duty is enhanced
when the claimant is without counsel. Hildebrand v. Barnhart, 302 F.3d 836, 838 (8th Cir.
2002). “[R]eversal due to failure to develop the record is only warranted where such failure is
unfair or prejudicial. Shannon v. Chater, 54 F.3d 484, 488 (8th Cir. 1995). “A claimant bears the
burden of proving the ALJ failed to adequately develop the record and this failure resulted in
prejudice.” Sullins v. Astrue, No. 4:10-CV-1014 MLM, 2011 WL 4055943 (E.D. Mo. Sept. 6,
2011) (citing Onstad v. Astrue, 999 F.2d 1232, 1234 (8th Cir. 1993)).
In this case, the Court finds that the record was sufficiently developed to allow the ALJ to
make a disability determination. First, the ALJ ordered a consultative examination for Ramsey.
There was no evidence in the sparse medical record provided by Ramsey or Dr. Burchett’s
consultative examination that showed further development of the record was necessary. Second,
Ramsey was represented by counsel and the ALJ granted two requests for an extension of time to
obtain additional medical records. (Tr. 30-33, 235-240.) Ramsey did not submit any additional
medical records to the ALJ or to the Appeals Council. Third, Ramsey has not shown prejudice.
Ramsey has failed to state what further medical evidence she believes is necessary to develop the
record.
Finally, Ramsey contends that the ALJ should not have discounted Ramsey’s testimony
regarding the fact that she had undergone back surgery and improperly discounted her allegation
of back pain. “While the claimant has the burden of proving that the disability results from a
medically determinable physical or mental impairment, direct medical evidence of the cause and
effect relationship between the impairment and the degree of claimant’s subjective complaints
need not be produced.” Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984). The ALJ must
fully consider all of the evidence presented relating to subjective complaints, including the

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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 subjective evidence of the duration, frequency, and
intensity of the claimant’s pain;
(3) any participating or aggravating factors;
(4) the dosage, effectiveness, and side effects of any
medication; and
(5) the claimant’s functional restrictions
Id. “The ALJ must make express credibility determinations and set forth the inconsistencies in
the record which cause him to reject the claimant’s complaints.” Masterson v. Barnhart, 363
F.3d 731, 738 (8th Cir. 2004). Although credibility determinations are primarily for the ALJ and
not the court, the ALJ’s credibility assessment must be based on substantial evidence. Rautio v.
Bowen, 862 F.2d 176, 179 (8th Cir. 1988).
The Court finds that the ALJ properly addressed Ramsey’s credibility regarding her
previous medical treatment and allegations of pain. The ALJ provided a detailed analysis of the
inconsistencies between Ramsey’s disability function report, her testimony, and the medical
records. (Tr. 16-21.) For example, the ALJ noted that Ramsey stated on her function report that
the dexterity in her hands was almost “non-existent” and very painful. (Tr. 19, 217.) At the
consultative examination, Dr. Burchett found that there was no swelling, atrophy, redness,
warmth, or tenderness on her hands. (Tr. 253.) He also found that both hands could be fully
extended, all fingers could oppose, and a fist could be made with both hands. (Tr. 253.) Dr.
Burchett also found that Ramsey was able to write and pick up coins with either hand without
difficulty and the range of motion in the joints of the fingers of both hands was normal (Tr.

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253.) In addition, the ALJ found that Ramsey’s limited treatment history, in conjunction with
the other evidence of record, calls into question her allegations of disabling symptoms and
limitations. (Tr. 20.) See Page v. Astrue, 484 F.3d 1040, 1044 (8th Cir. 2007) (quoting Shannon
v. Chater, 54 F.3d 484, 486 (8th Cir. 1995)) (“‘While not dispositive, a failure to seek treatment
may indicate the relative seriousness of a medical problem’”). The ALJ also noted that Ramsey
did not require emergency care nor has she been referred to a rheumatologist, neurologist, or
other specialist during the alleged period of disability. (Tr. 20.) Finally, the ALJ did not
“disbelieve” that Ramsey had surgery. The ALJ noted that there was no evidence of the surgery,
there were few complaints of back pain, and that Ramsey had not received any diagnosis of any
spine impairment.

(Tr. 16.)

The Court finds that the ALJ’s determination of Ramsey’s

credibility is supported by substantial evidence.
B.

Fibromyalgia

Next Ramsey contends that the ALJ failed to give proper consideration to her
fibromyalgia symptoms. The ALJ found that Ramsey’s fibromyalgia was a severe impairment.
(Tr. 14.)

The ALJ noted that the consultative examiner observed that Ramsey exhibited

tenderness at 11 of 18 standard trigger points and three of ten control points. (Tr. 19.) Ramsey
does not describe what limitations the ALJ should have included regarding her fibromyalgia
symptoms that are not included in the RFC. Ramsey is correct that the Eighth Circuit has found
that fibromyalgia has the potential to be disabling. Forehand v. Barnhart, 364 F.3d 984, 987 (8th
Cir. 2004) (emphasis added). A diagnosis of fibromyalgia alone is not sufficient to find that
Ramsey is disabled. Perkins v. Astrue, 648 F.3d 892, 900 (8th Cir. 2011) (not every diagnosis of
fibromyalgia warrants a finding that a claimant is disabled). “While pain may be disabling if it
precludes a claimant from engaging in any form of substantial gainful activity, the mere fact that

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working may cause pain or discomfort does not mandate a finding of disability.” Perkins, 648
F.3d at 900.
VI.

Conclusion
For reasons set forth above, the Court finds that the Commissioner’s decision should be

affirmed.
Accordingly,
IT IS HEREBY ORDERED that the relief which Ramsey seeks in her Complaint and
Brief in Support of Plaintiff’s Complaint is DENIED. [Docs. 1,15.]
IT IS FURTHER ORDERED that the Court will enter a separate judgment in favor of
the Commissioner.
Dated this 25th day of September, 2013.
/s/ Nannette A. Baker
.
NANNETTE A. BAKER
UNITED STATES MAGISTRATE JUDGE

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