Williams v. Astrue

Filing 27

MEMORANDUM AND ORDER..IT IS HEREBY ORDERED that the decision of the Commissioner is affirmed, and plaintiffs Complaint is dismissed with prejudice.. Signed by Magistrate Judge Lewis M. Blanton on 1/15/14. (MRS)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION

CARRIE WILLIAMS,
Plaintiff,
v.
CAROLYN W. COLVIN, Acting
Commissioner of Social Security,1
Defendant.

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No. 4:12CV1889 LMB

MEMORANDUM AND ORDER
This is an action under 42 U.S.C. § 405(g) for judicial review of the
Commissioner’s final decision finding Carrie Williams’ disability to have ended
November 1, 2010. All matters are pending before the undersigned United States
Magistrate Judge, with consent of the parties, pursuant to 28 U.S.C. § 636(c).
Because the final decision is supported by substantial evidence on the record as a
whole, the decision of the Commissioner is affirmed.
I. Procedural History
On September 8, 2004, the Social Security Administration (SSA) awarded
plaintiff Carrie Williams benefits on her application for disability insurance

Carolyn W. Colvin became the Acting Commissioner of Social Security on February 14, 2013.
As such, she is substituted for Michael J. Astrue as the defendant in this cause of action. Fed. R.
Civ. P. 25(d).
1

benefits, finding plaintiff to be disabled as of July 1, 2003, because of the effects of
bipolar disorder. (See Tr. 11, 45-48.) Upon periodic review for continued
entitlement to benefits, the SSA determined on November 5, 2010, that plaintiff
achieved medical improvement such that she was able to perform work. The SSA
determined plaintiff’s disability to have ceased November 1, 2010, and, as such,
plaintiff’s receipt of benefits ceased in January 2011. (Tr. 41, 44, 45-48.) Upon
plaintiff’s request, a hearing was held before an Administrative Law Judge (ALJ)
on June 16, 2011, at which plaintiff and a vocational expert testified. (Tr. 23-40.)
On August 26, 2011, the ALJ issued a decision finding plaintiff’s disability to have
ended November 1, 2010. The ALJ specifically found that beginning on
November 1, 2010, plaintiff could perform her past relevant work as a house
cleaner. (Tr. 8-22.) On September 17, 2012, upon review of additional evidence,
the Appeals Council denied plaintiff’s request for review of the ALJ's decision.
(Tr. 1-5.) The ALJ's determination thus stands as the final decision of the
Commissioner. 42 U.S.C. § 405(g).
In the instant action for judicial review, plaintiff contends that the ALJ’s
decision is not supported by substantial evidence on the record as a whole
inasmuch as the ALJ failed to properly consider the medical opinion evidence of
record and thus erred in his determination of plaintiff’s RFC. Plaintiff further
contends that evidence of plaintiff’s activities, upon which the ALJ relied in
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making his RFC determination, provides an insufficient basis upon which to find
plaintiff able to perform her past work. Finally, plaintiff argues that the vocational
expert’s testimony conflicts with the Dictionary of Occupational Titles (DOT) and
thus that the ALJ erred by relying on such testimony to find plaintiff able to
perform work-related activities. Plaintiff requests that the Commissioner’s final
decision be reversed and that the matter be remanded for further consideration.
II. Testimonial Evidence Before the ALJ
A.

Plaintiff’s Testimony
At the hearing on August 26, 2011, plaintiff testified in response to

questions posed by the ALJ and counsel.
At the time of the hearing, plaintiff was thirty-three years of age. Plaintiff
previously attended college for two years but did not obtain a degree. Plaintiff
stands approximately five feet, six inches tall and weighs 244 pounds. Plaintiff has
two children, ages five and seven. (Tr. 26, 30.)
Plaintiff testified that she worked at Wal-Mart in 1998 and 1999 as a cashier.
From 1999 to 2000, plaintiff worked at Grove Furniture sewing fabric for
furniture. In 2000, plaintiff sold insurance for Western and Southern Life. In
2001, plaintiff worked as a house cleaner at Cleaning by House Beautiful. From
2002 to 2003, plaintiff worked as a customer care representative at a
telecommunications company. Plaintiff testified that she stopped working in 2003
-3-

when she had a baby, after which she was hospitalized for bipolar disorder.
Plaintiff testified that she could not cope with stress. (Tr. 26-28, 30-31, 34-35.)
Plaintiff testified that she currently saw a psychologist once a week upon the
recommendation of her treating doctor, Dr. Arain. Plaintiff testified that Dr. Arain
became concerned regarding plaintiff’s increased symptoms of depression,
including social withdrawal, excessive sleep, and decreased interest in activities.
Plaintiff testified that she also experienced episodes of mania and that her
psychologist recommended that she give her credit cards, check book, and excess
medication to her husband so that she would not excessively spend or take too
much medication. Plaintiff testified that her manic episodes last several weeks,
after which she experiences another bout of depression. Plaintiff testified that she
also experienced episodes of “cutting,” whereby she would attempt to cut herself
using box cutters or her fingernails. (Tr. 31-33.)
Plaintiff testified that her condition has not changed since being placed on
disability. Plaintiff testified that she takes medication for her condition, which
helps the “dips not be as severe,” but that the medication is not always effective.
Plaintiff testified that she experiences side effects with her medication, including
extreme drowsiness, dizziness, dry mouth, weight gain, and loss of desire. (Tr. 3334.)
Plaintiff testified that she self-published a book in 2008. Plaintiff testified
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that it took her six months to actually write the book, after which it took one year
to proofread. Plaintiff testified that she then hired an editor for book editing. (Tr.
29-30.) Plaintiff testified that she wrote down her ideas for the book during her
manic episodes when thoughts raced through her head. (Tr. 33.)
B.

Testimony of Vocational Expert
Ms. Gonzales, a vocational expert, testified at the hearing in response to

questions posed by the ALJ and counsel.
The ALJ asked Ms. Gonzales to assume an individual twenty-five years of
age with no physical restrictions. The ALJ asked Ms. Gonzales to further assume
the individual to be able to understand, remember, and carry out simple
instructions and non-detailed tasks. Ms. Gonzales testified that such an individual
would be able to perform plaintiff’s past work as a house cleaner, classified as
medium and unskilled work. (Tr. 36.)
The ALJ then asked Ms. Gonzales to assume an individual with limitations
as described in Dr. Arain’s Medical Source Statement, dated February 21, 2011.
Ms. Gonzales testified that such a person could perform plaintiff’s past work as a
house cleaner. (Tr. 37.)
The ALJ then asked Ms. Gonzales to assume an individual with limitations
as described in Dr. Bosse’s Mental RFC Questionnaire, dated May 20, 2011. Ms.
Gonzales testified that such a person could not perform any of plaintiff’s past
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relevant work or any other work in the national economy. (Tr. 37-38.)
III. Medical Records Before the ALJ
From February through December 2004, plaintiff was treated at South
County Family Mental Health Center for bipolar II disorder with post-partum
onset. Plaintiff repeatedly complained of mood swings, paranoia, and depression.
Plaintiff was treated with individual psychotherapy sessions and multiple
medications, including Lexapro, Trileptal, Risperdal, Zoloft, Topamax, Effexor,
and Wellbutrin.2 Plaintiff’s Global Assessment of Functioning (GAF) scores
during this period ranged from 45 to 57.3 (Tr. 288-334.)
Plaintiff visited Dr. Thomas Nowotny at Associates in Behavioral Health on
October 6, 2005, who noted plaintiff’s past mental health history to include an
exacerbation of unstable mood in 2003 while post-partum. Plaintiff obtained

Lexapro, Effexor, and Wellbutrin (Bupropion) are used to treat depression. Medline Plus,
<http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603005.html>; <http://www.nlm.nih.
gov/medlineplus/druginfo/meds/a603005.html>; <http://www.nlm.nih.gov/medlineplus/
druginfo/meds/a695033.html>. Trileptal, a seizure medication, and Risperdal are used to treat
bipolar disorder. Medline Plus <http://www.nlm.nih.gov/medlineplus/druginfo/meds/
a601245.html>; <http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694015.html>. Zoloft is
used to treat depression, panic disorder, and obsessive compulsive disorder (OCD). Medline
Plus <http://www.nlm.nih.gov/medlineplus/druginfo/meds/a697048.html>. Topamax, a seizure
medication, is used to treat migraine headaches. Medline Plus <http://www.nlm.nih.gov/
medlineplus/druginfo/meds/a697048.html>.
3
A GAF score considers “psychological, social, and occupational functioning on a hypothetical
continuum of mental health/illness.” Diagnostic and Statistical Manual of Mental Disorders,
Text Revision 34 (4th ed. 2000). A GAF score of 41-50 indicates serious symptoms (e.g.,
suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in
social, occupational, or school functioning (e.g., no friends, unable to keep a job). A GAF score
of 51 to 60 indicates moderate symptoms (e.g., flat affect and circumstantial speech, occasional
2

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benefit at the time with Zoloft. Plaintiff then lost her Medicaid coverage, after
which she took no medication and became manic. Plaintiff reported that she was
then hospitalized and treated with Risperdal, Trileptal, and Zoloft, from which she
obtained benefit. Plaintiff reported that she did well and subsequently became
pregnant, at which time she stopped taking medication. It was noted that plaintiff
recently delivered a baby two months prior. Plaintiff reported that she had been
doing well until recently. Dr. Nowotny noted that plaintiff was currently taking
Zoloft. Mental status evaluation showed plaintiff to be cooperative and calm.
Plaintiff was noted to have a flat affect and anxious mood. Plaintiff’s speech was
normal, and her thought process was intact. Plaintiff denied having any
hallucinations, delusions, or suicidal or homicidal ideations. Dr. Nowotny
instructed plaintiff to increase her dosage of Zoloft and to return in two to three
months for follow up. (Tr. 187-90.)
Plaintiff returned to Dr. Nowotny at Behavioral Health on January 30, 2006,
and reported that she stopped taking Zoloft in November 2005 because of loss of
insurance. Plaintiff reported that she previously obtained the best relief from
Trileptal and Bupropion. Plaintiff currently complained of fatigue. Mental status
examination showed plaintiff’s mood to be “up and down.” Plaintiff’s judgment

panic attacks) or moderate difficulty in social, occupational, or school functioning (e.g., few
friends, conflicts with peers or co-workers).
-7-

was noted to be good, and her flow of thought was logical and sequential. Plaintiff
was diagnosed with bipolar affective disorder. Plaintiff was prescribed Trileptal
and Wellbutrin and was instructed to return in two months. (Tr. 185.)
In March 2006, Dr. Nowotny prescribed Fluoxetine4 in response to
plaintiff’s complaints of increased irritability and migraine headaches. (Tr. 184.)
In August 2006, plaintiff reported that she was doing well and was active with
increased socialization. (Tr. 183.) In December 2006, plaintiff reported having
symptoms of depression with feelings of isolation. Dr. Nowotny instructed
plaintiff to take Wellbutrin regularly and to increase her dosage of Trileptal. (Tr.
182.)
In March and September 2007, Dr. Nowotny noted plaintiff to be doing well
and to have a stable mood. Plaintiff was continued on her current medications.
(Tr. 180, 181.)
On November 3, 2008, plaintiff reported to Dr. Nowotny that she was selling
a book. Plaintiff reported having increased anxiety with panic attacks. Mental
status examination was unremarkable. Dr. Nowotny instructed plaintiff to increase
her dosage of Fluoxetine and to return for follow up in four to six months. (Tr.
179.)

Fluoxetine (Prozac) is used to treat depression, OCD, and panic attacks. Medline Plus
<http://www.nlm.nih.gov/medlineplus/druginfo/meds/a689006.html>.
4

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On May 12, 2009, Dr. Nowotny determined to adjust plaintiff’s medication
in response to her reports of agitation and “blah” mood. On September 8, 2009, it
was noted that plaintiff was doing well. (Tr. 177, 178.)
Plaintiff returned to Dr. Nowotny at Behavioral Health on February 2, 2010,
and reported that she was struggling with finances and that she had no health
insurance. Plaintiff complained of loss of interest. Mental status examination
showed plaintiff to have an anxious mood and flat affect. Plaintiff was continued
in her diagnosis of bipolar affective disorder and was assigned a GAF score of 50.
Plaintiff was instructed to continue with her current medications and was provided
additional prescriptions for Abilify5 and Lamictal.6 (Tr. 175-76.)
On March 31, 2010, plaintiff did not appear for a scheduled appointment at
Behavioral Health. (Tr. 174.) Plaintiff returned to Behavioral Health on June 21,
2010, and reported to Dr. Nowotny that she was doing well. Plaintiff was
instructed to continue with her current medications. (Tr. 173.)
On October 19, 2010, plaintiff underwent a consultative psychiatric
examination for disability determinations. Dr. Georgia Jones noted plaintiff’s past
mental health history. Plaintiff reported to Dr. Jones that she did not feel the need
to return to work and that she often quit her job in the past when things became

Abilify is used to treat schizophrenia, bipolar disorder, and depression. Medline Plus
<http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603012.html>.
5

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stressful. Plaintiff reported having written and sold five self-published books and
that she sold eighteen copies of a book at a book signing event. Plaintiff reported
that she currently took Abilify and Trazodone,7 which helped her condition.
Plaintiff also reported that she took Lamotrigine, Fluoxetine, and Bupropion.
Plaintiff reported that taking her children for walks helped with her mood, sleep,
focus, and concentration. Plaintiff reported having increased irritability and
anhedonia. Plaintiff reported having mood swings. Mental status examination
showed plaintiff to be pleasant, cooperative, and to have good eye contact.
Plaintiff was noted to have spontaneous speech, which was coherent, relevant, and
logical. Dr. Jones noted plaintiff’s mood to be euthymic and her affect to be
stable, bright, euthymic, and reactive. Sensorium examination was unremarkable.
As to her daily activities, plaintiff reported that she forces herself to do the chores.
Plaintiff reported that she drives a lot, goes to church, pays the bills, goes out to
eat, and participates in “fun activities.” Dr. Jones opined that plaintiff’s social
functioning and ability to care for her personal needs were intact. Dr. Jones noted
plaintiff’s concentration, persistence, and pace to be good throughout the
examination. Dr. Jones diagnosed plaintiff with bipolar disorder, by history, and

Lamictal (Lamotrigine), a seizure medication, is used to treat bipolar disorder. Medline Plus
<http://www.nlm.nih.gov/medlineplus/druginfo/meds/a695007.html>.
7
Trazodone (Oleptro) is used to treat depression. Medline Plus <http://www.nlm.nih.gov/
medlineplus/druginfo/meds/a681038.html>.
6

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assigned a GAF score of 65.8 Dr. Jones determined plaintiff’s prognosis to be
good. (Tr. 191-95.)
On November 5, 2010, Dr. Joan Singer, a psychological consultant with
disability determinations, completed a Psychiatric Review Technique Form
(PRTF) in which she opined that plaintiff’s bipolar disorder caused plaintiff to
have mild limitations in her activities of daily living and in maintaining social
functioning; moderate limitations in maintaining concentration, persistence, or
pace; and no repeated episodes of decompensation of extended duration. (Tr. 196206.) In a Mental RFC Assessment completed that same date, Dr. Singer opined
that, in the domain of Understanding and Memory, plaintiff was moderately
limited in her ability to understand and remember detailed instructions, but was not
otherwise significantly limited. In the domain of Sustained Concentration and
Persistence, Dr. Singer opined that plaintiff was not significantly limited in her
ability to carry out very short and simple instructions, to sustain an ordinary
routine without special supervision, to work in coordination with or in proximity to
others without being distracted by them, and to make simple work-related
decisions. Dr. Singer further opined that plaintiff was moderately limited in her
ability to carry out detailed instructions; to maintain attention and concentration for

A GAF score of 61 to 70 indicates some mild symptoms (e.g., depressed mood and mild
insomnia) or some difficulty in social, occupational, or school functioning (e.g., occasional
8

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extended periods; to perform activities within a schedule, maintain regular
attendance, be punctual within customary tolerances; and to complete a normal
workday and workweek without interruptions from psychologically-based
symptoms and perform at a consistent pace without an unreasonable number and
length of rest periods. In the domain of Social Interaction, Dr. Singer opined that
plaintiff experienced no significant limitations. In the domain of Adaptation, Dr.
Singer opined that plaintiff was moderately limited in her ability to respond
appropriately to changes in the work setting, but was not otherwise significantly
limited. Upon review of the evidence of record, Dr. Singer noted that plaintiff’s
psychiatric treatment helped maintain stable functioning and that plaintiff’s
outpatient psychiatric visits were more intermittent in nature. Dr. Singer noted the
post-partum issues relating to the initial determination of disability to no longer be
a concern and that plaintiff had not required any hospitalizations since that time.
In addition, Dr. Singer noted plaintiff to be the primary caregiver for her two
children. Dr. Singer concluded that plaintiff experienced significant work-related
improvement and that she was currently able to perform at least simple, repetitive
tasks on a routine basis. (Tr. 207-10.)
On November 23, 2010, plaintiff failed to appear for a scheduled

truancy, or theft within the household), but generally functioning pretty well, has some
meaningful interpersonal relationships.
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appointment at Behavioral Health. (Tr. 213.)
Plaintiff visited Dr. Nowotny at Behavioral Health on December 2, 2010,
and reported that she had not been doing well since undergoing disability review.
Plaintiff reported situational stress in her life. Plaintiff’s mood was noted to be
nervous. Plaintiff denied any hallucinations or suicidal or homicidal ideations, but
admitted to having thoughts of cutting herself. Dr. Nowotny assigned a GAF score
of 50 and determined to target plaintiff’s anxiety with an increase in Trazodone.
Plaintiff was instructed to return in two to three months. (Tr. 211-12.)
On December 2, 2010, plaintiff visited St. Anthony’s Medical Center –
Hyland Behavioral Health and complained of experiencing increased stress and
anxiety for one month associated with her disability review, her husband’s health,
and her husband’s work issues. Plaintiff requested to see a counselor. Plaintiff’s
current medications were noted to include Bupropion, Fluoxetine, Abilify,
Lamotrigine, Trazadone, and Oleptro. Mental status examination showed
plaintiff’s attention and eye contact to be fair. Plaintiff’s mood and affect were
depressed with noted episodic crying. Plaintiff was noted to be withdrawn.
Plaintiff reported having racing thoughts. Plaintiff’s speech, flow of thought,
memory, and intellect were noted to be normal. Plaintiff’s judgment was noted to
be fair. Plaintiff was diagnosed with bipolar disorder and was assigned a GAF
score of 59. Plaintiff was referred for private counseling. (Tr. 238-46.)
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On December 8, 2010, Dr. James Spence, a psychological consultant with
disability determinations, completed a Mental RFC Assessment wherein he opined
that, in the domain of Understanding and Memory, plaintiff was moderately
limited in her ability to understand and remember detailed instructions, but was not
otherwise significantly limited. In the domain of Sustained Concentration and
Persistence, Dr. Spence opined that plaintiff was moderately limited in her ability
to carry out detailed instructions, but was not otherwise significantly limited. In
the domains of Social Interaction and Adaptation, Dr. Spence opined that plaintiff
experienced no significant limitations. Upon review of the medical records, Dr.
Spence opined that plaintiff was currently able to perform simple to moderately
complex tasks. (Tr. 216-18.) In a PRTF completed that same date, Dr. Spence
opined that plaintiff’s bipolar disorder caused plaintiff to have mild limitations in
the domains of Activities of Daily Living and Maintaining Social Functioning; and
to have moderate limitations in the domain of Maintaining Concentration,
Persistence, or Pace. Dr. Spence further opined that plaintiff had no repeated
episodes of decompensation of extended duration. (Tr. 219-29.)
Plaintiff visited Dr. M. Sameer Arain, a psychiatrist, on January 10, 2011,
and reported that she needed a new doctor. Plaintiff reported that her previous
psychiatrist refused to complete her disability papers in November 2010. Plaintiff
reported a history of depression and cutting, with excessive sleep, racing thoughts,
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and engaging in risky behaviors. Plaintiff reported that everything made her
nervous, including dealing with people. Plaintiff reported that she was currently
stressed with raising her children, her husband’s health issues for which he was
seeking disability, financial issues, and dealing with the possibility of going back
to work. Mental status examination was essentially unremarkable but showed
plaintiff’s mood to be down and nervous, with a restricted affect. Dr. Arain noted
plaintiff’s insight and judgment to be fair. Dr. Arain diagnosed plaintiff with
generalized anxiety disorder and bipolar disorder type II – depressed. Dr. Arain
assigned a current GAF score of 50. Dr. Arain instructed plaintiff to continue on
her current medications of Prozac, Abilify, Wellbutrin, Lamictal, and Trazodone.
(Tr. 247-50.)
Plaintiff visited Dr. Jerry J. Bosse, a psychologist, on February 8, 2011, and
reported that she was “not so good.” It was noted that information would be
sought from Dr. Bosse and plaintiff’s other psychiatrists for her hearing. (Tr. 281.)
On February 15, 2011, plaintiff reported to Dr. Bosse that she was doing “okay.”
(Tr. 280.)
In a Mental Medical Source Statement (MSS) completed February 21, 2011,
Dr. Arain opined that plaintiff was moderately limited in her ability to maintain
attention and concentration for extended periods; perform activities within a
schedule, maintain regular attendance, and be punctual; complete a normal
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workday or workweek; perform at a consistent pace; get along with co-workers
and peers; and respond appropriately to changes in the work setting. In all other
respects, Dr. Arain opined that plaintiff was not significantly limited. Dr. Arain
reported that he expected plaintiff’s condition to improve. (Tr. 252-53.)
On February 22, 2011, plaintiff reported to Dr. Bosse that her psychiatrist
prescribed medication for her anxiety. Plaintiff reported that her disability
caseworker was not supportive, indicating that their psychiatrist reported that she
should be able to go back to work. (Tr. 277-78.)
On March 1, 2011, plaintiff reported to Dr. Bosse that her husband was
approved for disability and seemed less stressed. Plaintiff reported that her own
caseworker was less supportive. Dr. Bosse noted plaintiff to have a book signing
scheduled for the last Saturday of the month in Poplar Bluff. (Tr. 275-76.) On
March 9, 2011, plaintiff reported to Dr. Bosse that she was no longer writing and
that her husband’s first disability check would arrive in June. Plaintiff reported
that she was okay but felt flat. Plaintiff reported her moods to be up and down.
(Tr. 273-74.) On March 15, 2011, plaintiff reported to Dr. Bosse that a mistake
was made in that she had not received her disability check. Plaintiff reported that
she could not write when she felt down. (Tr. 272.) On March 22, 2011, plaintiff
reported to Dr. Bosse that she was getting better sleep after using a CD at night.
She reported that her psychiatrist recently changed her medication. Plaintiff noted
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that she continued to not receive disability checks and that she had not heard from
her lawyer. (Tr. 270-71.)
On March 29, 2011, plaintiff reported to Dr. Bosse that she was okay.
Plaintiff reported that the book signing event went well and that she almost sold
out of her books. Plaintiff reported seeing a former classmate at the book signing
and stated to Dr. Bosse that she might attend the next class reunion. (Tr. 269.)
On April 5, 2011, Dr. Bosse noted that plaintiff looked stressed. Plaintiff
reported that she was off all of her medications and that she had not slept well.
Plaintiff reported that she was worried about being depressed and manic. Dr.
Bosse advised plaintiff as to when to go to the emergency room. Plaintiff reported
feeling less depressed after this session. (Tr. 267-68.)
Plaintiff returned to Dr. Bosse on April 19, 2011, and reported that she was
recently released from the hospital. Plaintiff reported being treated with
medication in the hospital but that she was released without medication. Plaintiff
reported having just received her medication and that she felt better and was
sleeping well. (Tr. 266.) On April 26, 2011, plaintiff reported to Dr. Bosse that
her dosage of Effexor had been increased, making her drowsy. (Tr. 265.)
In a Mental RFC Questionnaire completed May 20, 2011, Dr. Bosse
reported that he had seventeen psychotherapy sessions with plaintiff between

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December 21, 2010, and May 24, 2011,9 and that plaintiff had made some
improvement. Dr. Bosse noted plaintiff’s current GAF score to be 60, with her
highest score within the previous year to be 65. With respect to mental abilities
needed to do unskilled work, Dr. Bosse opined that plaintiff was unable to meet
competitive standards with regard to her ability to perform at a consistent pace
without an unreasonable number and length of rest periods, and her ability to deal
with normal work stress. Dr. Bosse opined that plaintiff was seriously limited, but
not precluded, with regard to her ability to maintain attention for a two-hour
segment; maintain regular attendance and be punctual within customary, usually
strict tolerances; sustain an ordinary routine without special supervision; make
simple work-related decisions; complete a normal workday and workweek without
interruptions from psychologically-based symptoms; accept instructions and
respond appropriately to criticism from supervisors; get along with coworkers or
peers without unduly distracting them or exhibiting behavioral extremes; and be
aware of normal hazards and take appropriate precautions. With respect to mental
abilities needed to do semi-skilled and skilled work, Dr. Bosse opined that plaintiff
was unable to meet competitive standards with regard to her ability to deal with the
stress of semi-skilled and skilled work. Dr. Bosse further opined that plaintiff was

Although Dr. Bosse reports here that he saw plaintiff through May 24, 2011, the undersigned
notes that he completed this Questionnaire on May 20, 2011.
9

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seriously limited, but not precluded, with regard to her ability to understand,
remember, and carry out detailed instructions; and set realistic goals or make plans
independently of others. With respect to mental abilities needed to do particular
types of jobs, Dr. Bosse opined that plaintiff was unable to meet competitive
standards in her ability to travel to unfamiliar places; and was seriously limited, but
not precluded, in her ability to use public transportation. Although instructed to do
so, Dr. Bosse provided no explanation for the limitations described, nor provided
any medical/clinical findings to support the limitations. Finally, Dr. Bosse opined
that plaintiff’s mental impairment or treatment therefor would cause her to be
absent from work more than four days per month. (Tr. 282-87.)
IV. Medical Records Before the Appeals Council10
Medical evidence submitted to and considered by the Appeals Council
subsequent to the ALJ’s decision shows that plaintiff visited the St. Alexius
Psychiatric Clinic on December 5, 2011, and reported that she felt “back and
forth.” It was noted that plaintiff engaged in no manic behavior. Mental status
examination was normal, and plaintiff’s insight and judgment were noted to be

In determining plaintiff’s request to review the ALJ’s decision, the Appeals Council
considered additional evidence that was not before the ALJ at the time of his decision. The
Court must consider this evidence in determining whether the ALJ's decision was supported by
substantial evidence. Frankl v. Shalala, 47 F.3d 935, 939 (8th Cir. 1995); Richmond v. Shalala,
23 F.3d 1441, 1444 (8th Cir. 1994).
10

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fair. Plaintiff’s current medications were noted to include Wellbutrin, Klonopin,11
Trazodone, Lamictal, and Effexor. Plaintiff was provided refills on such
medications and was instructed to return for follow up in six weeks. (Tr. 341.)
On January 16, 2012, plaintiff reported to St. Alexius that she experienced
intermittent high energy and low energy during the previous few days. Plaintiff
reported that she was sleeping well. It was noted that plaintiff showed no evidence
of psychosis. Mental status examination was normal. Plaintiff’s mood was noted
to be mellow and her affect reactive. Plaintiff was instructed to continue on her
current medications. (Tr. 342.)
On February 13, 2012, plaintiff reported to St. Alexius that she felt agitated.
It was noted that plaintiff exhibited no manic symptoms, and no evidence of
psychosis was present. Mental status examination showed no change. Plaintiff
was instructed to continue on her current medications. Individual counseling was
recommended. (Tr. 343.)
V. The ALJ's Decision
The ALJ found September 8, 2004, to be the date upon which the most
recent favorable medical decision was entered finding plaintiff to be disabled. The
ALJ found that, at that time, plaintiff’s medically determinable impairment of

Klonopin, a seizure medication, is used to relieve panic attacks. Medline Plus <http://
www.nlm.nih.gov/medlineplus/druginfo/meds/a682279.html>.
11

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bipolar disorder precluded plaintiff from tolerating the normal stresses and
pressures of working, from completing a normal workday and workweek without
frequent interruptions from psychologically-based symptoms, from performing at a
consistent pace without an unreasonable number and length of breaks, and from
maintaining her attention and concentration on work tasks on a sustained basis.
The ALJ also found that, at that time, plaintiff would experience absences and rest
periods because of psychiatric symptoms. The ALJ further found that through
November 1, 2010, plaintiff did not engage in substantial gainful activity. The
ALJ found that plaintiff did not develop any additional impairments after
September 8, 2004, and before November 1, 2010. The ALJ determined that
plaintiff continued to have bipolar disorder as of November 1, 2010, which was
severe, but that plaintiff did not have an impairment or combination of
impairments that met or medically equaled an impairment listed in 20 CFR Part
404, Subpart P, Appendix 1. The ALJ found that, as of November 1, 2010,
plaintiff had no physical restrictions and had the RFC to understand, remember,
and carry out at least simple instructions and non-detailed tasks. The ALJ
determined that medical improvement occurred as of November 1, 2010, and that
such improvement related to the ability to work since it resulted in an increase in
plaintiff’s RFC. The ALJ determined that, beginning November 1, 2010, plaintiff
could perform her past relevant work as a house cleaner, and thus that plaintiff’s
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disability ended as of November 1, 2010. (Tr. 11-18.)
VI. Discussion
To be eligible for disability insurance benefits under the Social Security Act,
plaintiff must prove that she is disabled. Pearsall v. Massanari, 274 F.3d 1211,
1217 (8th Cir. 2001); Baker v. Secretary of Health & Human Servs., 955 F.2d 552,
555 (8th Cir. 1992). The Social Security Act defines disability as the "inability to
engage in any substantial gainful activity by reason of any medically determinable
physical or mental impairment which can be expected to result in death or which
has lasted or can be expected to last for a continuous period of not less than 12
months." 42 U.S.C. § 423(d)(1)(A). An individual will be declared disabled "only
if [her] physical or mental impairment or impairments are of such severity that
[she] is not only unable to do [her] previous work but cannot, considering [her]
age, education, and work experience, engage in any other kind of substantial
gainful work which exists in the national economy." 42 U.S.C. § 423(d)(2)(A).
Once a claimant becomes entitled to disability benefits, the Commissioner
must periodically review the claimant's continued entitlement to such benefits. 20
C.F.R. § 404.1594(a). If there has been a medical improvement in a claimant's
impairments and such improvement relates to the claimant's ability to work, the
disability will be found to have ended if the claimant is able to engage in
substantial gainful activity. 20 C.F.R. § 404.1594(a), (b)(3). The claimant has a
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"continuing burden" to demonstrate that she is disabled. Nelson v. Sullivan, 946
F,2d 1314, 1315 (8th Cir. 1991) (per curiam) (citing Mathews v. Eldridge, 424
U.S. 319, 336 (1976)). "[N]o inference is to be drawn from the fact that the
individual has previously been granted benefits." Id. (citing 42 U.S.C. § 423(f)).
“Whether a claimant’s condition has improved is primarily a question for the trier
of fact, generally determined by assessing witnesses’ credibility.” Muncy v. Apfel,
247 F.3d 728, 734 (8th Cir. 2001) (citing Nelson, 946 F.2d at 1316).
If the Commissioner seeks to end disability benefits due to an improvement
in the claimant's medical condition, she must demonstrate that "the conditions
which previously rendered the claimant disabled have ameliorated, and the
improvement in the physical condition is related to claimant's ability to work."
Nelson, 946 F.2d at 1315 (citing 20 C.F.R. § 404.1594(b)(2)-(5)). "Medical
improvement" is any decrease in the medical severity of the claimant's
impairments which were present at the time of the most recent favorable medical
decision that the claimant was disabled. 20 C.F.R. § 404.1594(b)(1). In
determining medical improvement, the severity of the claimant's current condition
is compared with the severity of her condition as of the date upon which the
claimant was last determined to be disabled. 20 C.F.R. § 404.1594(b)(7). Once it
has been established that there has been a medical improvement, the Commissioner
must determine whether the claimant has the RFC to perform her past work. 20
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C.F.R. § 404.1594(f)(7). If she is able to do so, the claimant’s disability will be
found to have ended. Id. If the claimant cannot engage in her past relevant work,
the Commissioner must consider whether the claimant can perform other jobs with
her current RFC. 20 C.F.R. § 404.1594(f)(8). If not, the claimant’s disability will
be found to continue. Id.
The decision of the Commissioner must be affirmed if it is supported by
substantial evidence on the record as a whole. 42 U.S.C. § 405(g); Richardson v.
Perales, 402 U.S. 389, 401 (1971); Estes v. Barnhart, 275 F.3d 722, 724 (8th Cir.
2002). Substantial evidence is less than a preponderance but enough that a
reasonable person would find it adequate to support the conclusion. Johnson v.
Apfel, 240 F.3d 1145, 1147 (8th Cir. 2001). This “substantial evidence test,”
however, is “more than a mere search of the record for evidence supporting the
Commissioner’s findings.” Coleman v. Astrue, 498 F.3d 767, 770 (8th Cir. 2007)
(internal quotation marks and citation omitted). “Substantial evidence on the
record as a whole . . . requires a more scrutinizing analysis.” Id. (internal quotation
marks and citations omitted).
To determine whether the Commissioner's decision is supported by
substantial evidence on the record as a whole, the Court must review the entire
administrative record and consider:

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1.

The credibility findings made by the ALJ.

2.

The plaintiff's vocational factors.

3.

The medical evidence from treating and consulting
physicians.

4.

The plaintiff's subjective complaints relating to
exertional and non-exertional activities and
impairments.

5.

Any corroboration by third parties of the plaintiff's
impairments.

6.

The testimony of vocational experts when required
which is based upon a proper hypothetical question
which sets forth the claimant's impairment.

Stewart v. Secretary of Health & Human Servs., 957 F.2d 581, 585-86 (8th Cir.
1992) (internal citations omitted).

The Court must also consider any evidence which fairly detracts from the
Commissioner’s decision. Coleman, 498 F.3d at 770; Warburton v. Apfel, 188
F.3d 1047, 1050 (8th Cir. 1999). However, even though two inconsistent
conclusions may be drawn from the evidence, the Commissioner's findings may
still be supported by substantial evidence on the record as a whole. Pearsall, 274
F.3d at 1217 (citing Young v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000)). “[I]f
there is substantial evidence on the record as a whole, we must affirm the
administrative decision, even if the record could also have supported an opposite
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decision.” Weikert v. Sullivan, 977 F.2d 1249, 1252 (8th Cir. 1992) (internal
quotation marks and citation omitted); see also Jones ex rel. Morris v. Barnhart,
315 F.3d 974, 977 (8th Cir. 2003).
A.

Medical Opinion Evidence
Plaintiff contends that the ALJ’s determination as to her current RFC is not

supported by substantial evidence on the record as a whole inasmuch as the ALJ
improperly weighed the medical opinion evidence of record. Specifically, plaintiff
argues that the ALJ erred by according no weight to the opinion of her treating
psychologist, Dr. Bosse; by according more weight to the opinion of Dr. Arain;
and by appearing to accord some weight to the state agency psychologist, Dr.
Singer.
In evaluating opinion evidence, the Regulations require the ALJ to explain
in the decision the weight given to any opinions from treating sources, non-treating
sources, and non-examining sources. See 20 C.F.R. § 404.1527(f)(2)(ii).12 The
Regulations require that more weight be given to the opinions of treating
physicians than other sources. 20 C.F.R. § 404.1527(d)(2). A treating physician's
assessment of the nature and severity of a claimant's impairments should be given
controlling weight if the opinion is well supported by medically acceptable clinical

Citations to 20 C.F.R. § 404.1527 are to the 2011 version of the Regulations, which were in
effect at the time the ALJ rendered the final decision in this cause. This Regulation’s most
12

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and laboratory diagnostic techniques and is not inconsistent with other substantial
evidence in the record. Id.; see also Forehand v. Barnhart, 364 F.3d 984, 986 (8th
Cir. 2004). This is so because a treating physician has the best opportunity to
observe and evaluate a claimant's condition,

since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of [a claimant's] medical impairment(s) and may
bring a unique perspective to the medical evidence that
cannot be obtained from the objective medical findings
alone or from reports of individual examinations, such as
consultative examinations or brief hospitalizations.
20 C.F.R. § 404.1527(d)(2).

However, a medical source’s opinion that an applicant is “unable to work”
involves an issue reserved for the Commissioner and is not the type of opinion
which the Commissioner must credit. Ellis v. Barnhart, 392 F.3d 988, 994-95 (8th
Cir. 2005).
When a treating physician's opinion is not given controlling weight, the
Commissioner must look to various factors in determining what weight to accord
the opinion. 20 C.F.R. § 404.1527(d)(2). Such factors include the length of the
treatment relationship and the frequency of examination, the nature and extent of

recent amendment, effective March 26, 2012, reorganizes the subparagraphs relevant to this
discussion but does not otherwise change the substance therein.
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the treatment relationship, whether the treating physician provides support for his
findings, whether other evidence in the record is consistent with the treating
physician's findings, and the treating physician's area of specialty. Id. The
Regulations further provide that the Commissioner “will always give good reasons
in [the] notice of determination or decision for the weight [given to the] treating
source's opinion.” Id.
In his written decision here, the ALJ determined to accord little weight to the
opinion expressed in Dr. Bosse’s May 2011 Mental RFC Questionnaire, noting the
opinion to be inconsistent on its face as well as inconsistent with plaintiff’s actual
activities and other substantial evidence on the record as a whole. Because these
reasons are supported by substantial evidence on the record as a whole, the ALJ
did not err is discounting this Questionnaire.
The ALJ first noted Dr. Bosse’s Questionnaire to be inconsistent on its face,
finding Dr. Bosse’s assigned GAF scores of 60/65 – indicating mild to moderate
symptoms – to be inconsistent with his simultaneous findings that plaintiff
experienced functional restrictions seriously limiting or precluding her ability to
perform work-related activities involved in unskilled work. See Goff v. Barnhart,
421 F.3d 785, 791 (8th Cir. 2005) (ALJ not compelled to give controlling weight to
physician’s opinion where GAF score of 58 was inconsistent with opinion that
claimant suffered from extreme limitations). Internal inconsistencies in a
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physician’s opinion constitute good reason to accord less deference to the opinion.
Wagner v. Astrue, 499 F.3d 842, 849-50 (8th Cir. 2007) (and cases cited therein).
In addition, the undersigned notes Dr. Bosse’s Questionnaire to be
inconsistent with his own treatment records. “It is permissible for an ALJ to
discount an opinion of a treating physician that is inconsistent with the physician's
clinical treatment notes.” Davidson v. Astrue, 578 F.3d 838, 842 (8th Cir. 2009);
see also Hacker v. Barnhart, 459 F.3d 934, 937 (8th Cir. 2006). Here, Dr. Bosse’s
treatment notes show plaintiff to have experienced intermittent symptoms of
anxiety and depression, ranging between feeling okay at times and feeling down at
other times. The treatment notes show plaintiff’s symptoms to be episodic in
nature, triggered by stress over the disability review process or not having
medication. Notably, no observations are made by Dr. Bosse in any of his
treatment notes showing plaintiff to experience the significant and debilitating
limitations as set out in his May 2011 Questionnaire. Where the limitations set out
in a treating physician’s assessment “stand alone” and were “never mentioned in
[the physician’s] numerous records or treatment” nor supported by “any objective
testing or reasoning,” the ALJ’s decision to discount the treating physician’s
statement is not error. Hogan v. Apfel, 239 F.3d 958, 961 (8th Cir. 2001). Because
none of Dr. Bosse’s records note any such limitations, the ALJ did not err in
according less than controlling weight to Dr. Bosse’s May 2011 opinion. Charles
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v. Barnhart, 375 F.3d 777, 784 (8th Cir. 2004).
To the extent the ALJ determined to discount Dr. Bosse’s opinion given its
inconsistency with evidence of plaintiff’s activities, this reason is likewise
supported by substantial evidence. As noted by the ALJ, and indeed as recorded in
Dr. Bosse’s treatment records, plaintiff wrote and published a number of books,
travelled to book signings where she engaged with the public and sold nearly all of
her books, and made contact with familiar and unfamiliar people – even
contemplating attending a class reunion because of these connections. See Tellez
v. Barnhart, 403 F.3d 953, 956 (8th Cir. 2005) (substantial evidence supported
ALJ’s decision to discount physician’s opinion given that claimant’s actual
behavior was clearly at odds with limitations described by the medical source);
Pearsall, 274 F.3d at 1218 (medical record did not support alleged limitations
caused by mental impairment where claimant’s activities were not indicative of
intense fear of crowds or people).
The ALJ also determined to accord little weight to Dr. Bosse’s opinion given
its inconsistency with other substantial evidence on the record. In making this
determination, the ALJ accorded more weight to Dr. Arain’s and Dr. Singer’s
opinions, finding them to be consistent with each other as well as with the results
of Dr. Jones’s psychological evaluation. For the following reasons, this was not
error.
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The ALJ thoroughly summarized the results of Dr. Jones’s psychological
evaluation and specifically noted Dr. Jones’s summary of plaintiff’s subjective
report of her activities, including publishing books, attending book signings,
attending church, frequent driving, paying bills, going out to eat, and engaging in
fun activities. The ALJ also noted Dr. Jones’s own objective findings that plaintiff
had good concentration, persistence, and pace throughout the examination and
exhibited only mild symptoms. As noted by the ALJ, the opinion expressed by Dr.
Arain in his February 2011 Mental MSS was consistent with Dr. Jones’s
observations. In his MSS, Dr. Arain opined that plaintiff experienced no more
than moderate limitations in her ability to perform work-related activities,
including maintaining attention and concentration, performing activities within a
schedule, performing at a consistent pace, responding to changes in the work
setting, and getting along with coworkers and peers. To the extent Dr. Arain
assigned a GAF score of 50 in January 2011, the undersigned notes that Dr. Arain
did not include this score in his February 2011 medical opinion as to plaintiff’s
ability to perform work-related activities. Regardless, an ALJ is not required to
adopt the entirety of a physician’s opinion. Instead, the ALJ’s determination must
be based upon a review of the record as a whole. Martise v. Astrue, 641 F.3d 909,
927 (8th Cir. 2011). That is precisely what the ALJ did here. Nevertheless, in
light of the other substantial evidence of record as discussed supra, Dr. Arain’s
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GAF score assigned in January 2011 does not reflect plaintiff’s actual abilities.
Hudson ex rel. Jones v. Barnhart, 345 F.3d 661, 666-67 (8th Cir. 2003).
In addition, the ALJ noted Dr. Singer’s RFC Assessment to likewise be
consistent with Dr. Jones’s report and Dr. Arain’s MSS and therefore accorded
more weight to the opinion rendered therein. This was not error. While opinions
of non-treating practitioners who have attempted to evaluate a claimant without
examination do not normally constitute substantial evidence on the record as a
whole, Coleman, 498 F.3d at 772, the ALJ did not rely on Dr. Singer’s opinion
alone in determining plaintiff’s disability to have improved. Instead, the ALJ
considered the treatment notes of Dr. Nowotny of Behavioral Health, which
showed plaintiff to primarily be doing well and to experience situational stress in
December 2010 associated with the disability review process. The ALJ also
considered the results of Dr. Jones’s psychological evaluation and Dr. Arain’s
MSS, both of which showed less than disabling symptoms. Because Dr. Singer’s
Assessment was consistent with this substantial medical evidence, the ALJ did not
err in considering the Assessment in determining plaintiff’s RFC. Casey v. Astrue,
503 F.3d 687, 694 (8th Cir. 2007) (not error for an ALJ to consider opinion of state
agency consultant rendered upon review of the medical evidence which was
consistent with medical evidence of record).
Accordingly, inasmuch as the opinion expressed in Dr. Bosse’s May 2011
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RFC Questionnaire was inconsistent with other substantial evidence on the record
as a whole, the ALJ did not err in according less weight to such opinion. Indeed,
inconsistency with other substantial evidence alone is a sufficient basis upon which
to discount a treating physician’s opinion. Goff, 421 F.3d at 790-91.
A review of the ALJ’s decision shows the ALJ to have evaluated all of the
opinion evidence of record and to have provided good reasons for the weight
accorded to each opinion. Where, as here, there are conflicts in the medical
opinion evidence, it is the duty of the Commissioner to resolve such conflicts.
Renstrom v. Astrue, 680 F.3d 1057, 1065 (8th Cir. 2012); Spradling v. Chater, 126
F.3d 1072, 1075 (8th Cir. 1997); Bentley v. Shalala, 52 F.3d 784, 787 (8th Cir.
1995). For the reasons set out above, substantial evidence on the record as whole
supports the ALJ’s determination as to the weight he accorded the opinion
evidence in this cause.
B.

ALJ’s Consideration of Plaintiff’s Activities
Plaintiff contends that the ALJ placed undue significance on the fact that she

wrote and published three to five books, arguing that such activity does not
correlate to a finding that plaintiff can perform her past relevant work as a house
cleaner. Contrary to plaintiff’s assertion, however, the ALJ did not rely on this
activity alone in finding plaintiff to have the RFC to perform her past work.
Plaintiff correctly notes that the ALJ found that she did not engage in
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substantial gainful activity from the date of the previous favorable medical
decision through the date of medical improvement, that is, from September 8,
2004, to November 1, 2010. As such, the ALJ did not find plaintiff’s book writing
and publishing activities to rise to the level of substantial gainful activity such that
plaintiff would be rendered non-disabled on that basis alone. Instead, a review of
the ALJ’s decision shows him to have considered this activity, as well as other
activities, as a factor in determining what weight to accord the opinion evidence in
this cause as well as in determining plaintiff’s credibility. Specifically, the ALJ
noted plaintiff’s various reported activities to include writing and self-publishing
three to five books in 2008 and 2010, attending book signing events, going to
church, going out to eat, engaging in fun activities, visiting friends’ homes, and
shopping. The ALJ also noted plaintiff to be the primary caregiver to her two
young children, which included taking her children to and from the bus stop on
school days. The ALJ did not err in considering these activities in determining
what weight to accord the medical opinion evidence in this cause. (See discussion
supra at Sec. VI.A.) Nor did the ALJ err in considering such activities in
determining plaintiff’s credibility. See, e.g., Buckner v. Astrue, 646 F.3d 549, 558
(8th Cir. 2011) (caring for son, leaving residence nearly every day, riding in car,
shopping, socializing with friends, and attending religious services are activities
inconsistent with subjective complaints of disabling impairments, including mental
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impairment); Brown v. Astrue, 611 F.3d 941, 955-56 (8th Cir. 2010) (getting child
off to school, visiting mother, going to church, shopping for groceries, driving,
paying bills, and working out regularly are activities inconsistent with subjective
complaints of disabling mental impairment).13
A review of the ALJ’s decision shows him to have considered the entirety of
the record in this cause to determine that plaintiff sustained such medical
improvement that she could perform her past relevant work as of November 1,
2010. While the ALJ considered plaintiff’s authorship and publication of a number
of books – as well as plaintiff’s other activities – in determining what weight to
accord the evidence in this cause, he did not unduly rely on such activity alone to
find plaintiff able to perform her past relevant work. Plaintiff’s contention
otherwise must fail.
C.

Vocational Expert Testimony
In his hypothetical question posed to the vocational expert, the ALJ asked

the expert to assume an individual limited to understanding, remembering, and

Although plaintiff does not challenge the ALJ’s credibility determination here, a review of the
ALJ’s decision nevertheless shows that, in a manner consistent with and as required by Polaski
v. Heckler, 739 F.2d 1320 (8th Cir. 1984) (subsequent history omitted), the ALJ thoroughly
considered the subjective allegations of plaintiff’s disabling symptoms on the basis of the entire
record before him and set out numerous inconsistencies detracting from the credibility of such
allegations. The ALJ may disbelieve subjective complaints where there are inconsistencies on
the record as a whole. Battles v. Sullivan, 902 F.2d 657, 660 (8th Cir. 1990). The ALJ's
credibility determination is supported by substantial evidence on the record as a whole, and thus
the Court is bound by the ALJ's determination. Robinson v. Sullivan, 956 F.2d 836, 841 (8th Cir.
13

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carrying out simple instructions and non-detailed tasks. In response, the expert
testified that such a person could perform plaintiff’s past work as a house cleaner,
as set out in the DOT at number 301.687-014. (Tr. 36-37.) According to the DOT,
such work requires Level 2 reasoning, which involves the ability to “[a]pply
commonsense understanding to carry out detailed but uninvolved written or oral
instructions” and to “[d]eal with problems involving a few concrete variables in or
from standardized situations.” See DOT (4th ed., revised 1991), #301.687-014,
day worker, 1991 WL 672654. Plaintiff claims that the expert’s testimony that she
can perform such work conflicts with the DOT inasmuch as her RFC limits her to
performing only “simple” tasks, and thus that the ALJ erred in relying on such
testimony to find plaintiff’s disability to have ended.
In Moore v. Astrue, 623 F.3d 599 (8th Cir. 2010), the Eighth Circuit
addressed a similar argument that plaintiff raises here: that a finding that a
claimant can perform work requiring Level 2 reasoning as described by the DOT is
inconsistent with an RFC that limits her to performing only simple tasks. Noting
that the DOT describes Level 1 reasoning as the ability to “[a]pply commonsense
understanding to carry out simple one- or two-step instructions,” the Eighth Circuit
observed that the hypothetical question posed to the expert in Moore “did not limit
‘simple’ job instructions to ‘simple one or two-step instructions’ or otherwise
1992).

- 36 -

indicate that Moore could perform only occupations at a DOT Level 1 reasoning
level.” Moore, 623 F.3d at 604 (emphasis in original).

Indeed, the Level 2 reasoning definition refers to
“detailed but uninvolved ” instructions. The dictionary
defines “uninvolved” as “not involved,” and in turn
defines “involved” as “complicated, intricate.” There is
no direct conflict between “carrying out simple job
instructions” for “simple, routine and repetitive work
activity,” as in the hypothetical, and the vocational
expert's identification of occupations involving
instructions that, while potentially detailed, are not
complicated or intricate.
Id. (internal citations omitted) (emphasis in Moore).

As in Moore, the ALJ here likewise did not limit plaintiff’s reasoning abilities to a
level commensurate with Level 1 reasoning as defined in the DOT. Although the
ALJ limited plaintiff to performing simple tasks, he did not restrict her to
performing tasks that involve only one- or two-step instructions. Accordingly,
there was no conflict between the hypothetical question posed by the ALJ and the
vocational expert’s response. Id.
Nevertheless, plaintiff’s exclusive reliance on the DOT as a definitive
authority on job requirements is misplaced. Hall v. Chater, 109 F.3d 1255, 1259
(8th Cir. 1997). It is well established that definitions in the DOT “are simply
generic job descriptions that offer the approximate maximum requirements for
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each position, rather than their range.” Wheeler v. Apfel, 224 F.3d 891, 897 (8th
Cir. 2000) (internal quotation marks and citation omitted); see also Jones v. Astrue,
619 F.3d 963, 978 (8th Cir. 2010); Hillier v. Social Security Admin., 486 F.3d 359,
366–67 (8th Cir. 2007); Hall, 109 F.3d at 1259. “[N]ot all of the jobs in every
category have requirements identical to or as rigorous as those listed in the DOT.”
Wheeler, 224 F.3d at 897. Indeed, the DOT itself “cautions that its descriptions
may not coincide in every respect with the content of jobs as performed in
particular establishments or at certain localities.” Id.
Here, there is nothing in the record to suggest that the vocational expert
ignored the reasoning limitation contained in the ALJ’s hypothetical when she
determined that the job of house cleaner was a suitable job that a person with such
a limitation could perform. See Moore, 623 F.3d at 604; Whitehouse v. Sullivan,
949 F.2d 1005, 1006 (8th Cir.1991) ( “[T]he ALJ could properly assume that the
expert framed his answers based on the factors the ALJ told him to take into
account.”). Because there was no conflict between the vocational expert's
testimony and the DOT, the ALJ properly relied on the expert’s testimony. See
Moore, 623 F.3d at 604.
VII. Conclusion
For the reasons set out above on the claims raised by plaintiff on this appeal,
the Commissioner’s decision that plaintiff obtained medical improvement such that
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she was able to perform her past relevant work as of November 1, 2010, is
supported by substantial evidence on the record as a whole, and plaintiff’s claims
of error should be denied. Inasmuch as substantial evidence on the record as a
whole supports the Commissioner’s decision, this Court may not reverse the
decision merely because substantial evidence exists in the record that would have
supported a contrary outcome or because another court could have decided the case
differently. Gowell v. Apfel, 242 F.3d 793, 796 (8th Cir. 2001); Browning v.
Sullivan, 958 F.2d 817, 821 (8th Cir. 1992). Accordingly, the Commissioner's
determination that plaintiff obtained medical improvement such that she was able
to perform her past relevant work as of November 1, 2010, is affirmed.
Therefore,
IT IS HEREBY ORDERED that the decision of the Commissioner is
affirmed, and plaintiff’s Complaint is dismissed with prejudice.
A separate Judgment in accordance with this Memorandum and Order is
entered this same date.

_____________________
LEWIS M. BLANTON
UNITED STATES MAGISTRATE JUDGE
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Dated this 15th day of January 2014.

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