Times v. Colvin

Filing 20

MEMORANDUM AND ORDER: IT IS HEREBY ORDERED that the relief sought by Plaintiff in his Complaint and Brief in Support of Complaint (Docs. 1 , 14 ) is DENIED; IT IS ORDERED that a separate judgment be entered incorporating this Memorandum and Order. Signed by Magistrate Judge Noelle C. Collins on August 5, 2015. (BRP)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION

ARTHUR TIMES,

)
)
Plaintiff,
)
)
V.
)
)
CAROLYN W. COLVIN,
)
Acting Commissioner of Social Security, )
)
Defendant.
)

Case No. 4:14CV924NCC

MEMORANDUM AND ORDER
This is an action under Title 42 U.S.C. § 405(g) for judicial review of the
final decision of the Commissioner denying the application of Arthur Times
(Plaintiff) for Disability Insurance Benefits (DIB) under Title II of the Social
Security Act (the Act), 42 U.S.C. §§ 401 et seq., and for Supplemental Security
Income (SSI), under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381 et
seq. Plaintiff has filed a brief in support of the Complaint. (Doc. 14). Defendant
has filed a brief in support of the Answer. (Doc. 19). The parties have consented
to the jurisdiction of the undersigned United States Magistrate Judge pursuant to
Title 28 U.S.C. § 636(c). (Doc. 7).

I.
PROCEDURAL HISTORY
On January 25, 2011, Plaintiff filed his applications for DIB and SSI. (Tr.
142-54). Plaintiff alleged a disability onset date of September 1, 2009. Plaintiff’s
applications were denied, and he requested a hearing before an Administrative Law
Judge (ALJ). (Tr. 67-68, 85-89, 92). After a hearing, by decision, dated December
11, 2012, the ALJ found Plaintiff not disabled. (Tr. 15-24). On March 18, 2014,
the Appeals Council denied Plaintiff’s request for review. (Tr. 1-5). As such, the
ALJ’s decision stands as the final decision of the Commissioner.
II.
LEGAL STANDARDS
Under the Social Security Act, the Commissioner has established a five-step
process for determining whether a person is disabled. 20 C.F.R. §§ 416.920,
404.1529. “‘If a claimant fails to meet the criteria at any step in the evaluation of
disability, the process ends and the claimant is determined to be not disabled.’”
Goff v. Barnhart, 421 F.3d 785, 790 (8th Cir. 2005) (quoting Eichelberger v.
Barnhart, 390 F.3d 584, 590-91 (8th Cir. 2004)). In this sequential analysis, the
claimant first cannot be engaged in “substantial gainful activity” to qualify for
disability benefits. 20 C.F.R. §§ 416.920(b), 404.1520(b). Second, the claimant
must have a severe impairment. 20 C.F.R. §§ 416.920(c), 404.1520(c). The Social
Security Act defines “severe impairment” as “any impairment or combination of

2

impairments which significantly limits [claimant’s] physical or mental ability to do
basic work activities.” Id. “The sequential evaluation process may be terminated
at step two only when the claimant’s impairment or combination of impairments
would have no more than a minimal impact on [his or] her ability to work.” Page
v. Astrue, 484 F.3d 1040, 1043 (8th Cir. 2007) (quoting Caviness v. Massanari,
250 F.3d 603, 605 (8th Cir. 2001) (citing Nguyen v. Chater, 75 F.3d 429, 430-31
(8th Cir. 1996)).
Third, the ALJ must determine whether the claimant has an impairment
which meets or equals one of the impairments listed in the Regulations. 20 C.F.R.
§§ 416.920(d), 404.1520(d); pt. 404, subpt. P, app. 1. If the claimant has one of, or
the medical equivalent of, these impairments, then the claimant is per se disabled
without consideration of the claimant’s age, education, or work history. See id.
Fourth, the impairment must prevent the claimant from doing past relevant
work. 20 C.F.R. §§ 416.920(f), 404.1520(f). The burden rests with the claimant at
this fourth step to establish his or her Residual Functional Capacity (RFC). See
Steed v. Astrue, 524 F.3d 872, 874 n.3 (8th Cir. 2008) (“Through step four of this
analysis, the claimant has the burden of showing that she is disabled.”);
Eichelberger, 390 F.3d at 590-91; Masterson v. Barnhart, 363 F.3d 731, 737 (8th
Cir. 2004); Young v. Apfel, 221 F.3d 1065, 1069 n.5 (8th Cir. 2000). The ALJ

3

will review a claimant’s RFC and the physical and mental demands of the work the
claimant has done in the past. 20 C.F.R. § 404.1520(f).
Fifth, the severe impairment must prevent the claimant from doing any other
work. 20 C.F.R. §§ 416.920(g), 404.1520(g). At this fifth step of the sequential
analysis, the Commissioner has the burden of production to show evidence of other
jobs in the national economy that can be performed by a person with the claimant’s
RFC. See Steed, 524 F.3d at 874 n.3; Young, 221 F.3d at 1069 n.5. If the
claimant meets these standards, the ALJ will find the claimant to be disabled.
“The ultimate burden of persuasion to prove disability, however, remains with the
claimant.” Id. See also Harris v. Barnhart, 356 F.3d 926, 931 n.2 (8th Cir. 2004)
(citing 68 Fed. Reg. 51153, 51155 (Aug. 26, 2003)); Stormo v. Barnhart, 377 F.3d
801, 806 (8th Cir. 2004) (“The burden of persuasion to prove disability and to
demonstrate RFC remains on the claimant, even when the burden of production
shifts to the Commissioner at step five.”); Charles v. Barnhart, 375 F.3d 777, 782
n.5 (8th Cir. 2004) (“[T]he burden of production shifts to the Commissioner at step
five to submit evidence of other work in the national economy that [the claimant]
could perform, given her RFC.”).

Even if a court finds that there is a

preponderance of the evidence against the ALJ’s decision, the decision must be
affirmed if it is supported by substantial evidence. See Clark v. Heckler, 733 F.2d
65, 68 (8th Cir. 1984). “Substantial evidence is less than a preponderance but is

4

enough that a reasonable mind would find it adequate to support the
Commissioner’s conclusion.” Krogmeier v. Barnhart, 294 F.3d 1019, 1022 (8th
Cir. 2002). See also Cox v. Astrue, 495 F.3d 614, 617 (8th Cir. 2007). In Bland v.
Bowen, 861 F.2d 533, 535 (8th Cir. 1988), the Eighth Circuit Court of Appeals
held:
The concept of substantial evidence is something less than the weight
of the evidence and it allows for the possibility of drawing two
inconsistent conclusions, thus it embodies a zone of choice within
which the Secretary may decide to grant or deny benefits without
being subject to reversal on appeal.
See also Lacroix v. Barnhart, 465 F.3d 881, 885 (8th Cir. 2006) (“[W]e may not
reverse merely because substantial evidence exists for the opposite decision.”)
(quoting Johnson v. Chater, 87 F.3d 1015, 1017 (8th Cir. 1996)); Hartfield v.
Barnhart, 384 F.3d 986, 988 (8th Cir. 2004) (“[R]eview of the Commissioner’s
final decision is deferential.”).
It is not the job of the district court to re-weigh the evidence or review the
factual record de novo. See Cox, 495 F.3d at 617; Guilliams v. Barnhart, 393 F.3d
798, 801 (8th Cir. 2005); McClees v. Shalala, 2 F.3d 301, 302 (8th Cir. 1993);
Murphy v. Sullivan, 953 F.2d 383, 384 (8th Cir. 1992). Instead, the district court
must simply determine whether the quantity and quality of evidence is enough so
that a reasonable mind might find it adequate to support the ALJ’s conclusion. See
Davis v. Apfel, 239 F.3d 962, 966 (8th Cir. 2001) (citing McKinney v. Apfel, 228

5

F.3d 860, 863 (8th Cir. 2000)). Weighing the evidence is a function of the ALJ,
who is the fact-finder. See Benskin v. Bowen, 830 F.2d 878, 882 (8th Cir. 1987).
See also Onstead v. Sullivan, 962 F.2d 803, 804 (8th Cir. 1992) (holding that an
ALJ’s decision is conclusive upon a reviewing court if it is supported by
“substantial evidence”). Thus, an administrative decision which is supported by
substantial evidence is not subject to reversal merely because substantial evidence
may also support an opposite conclusion or because the reviewing court would
have decided differently.

See Krogmeier, 294 F.3d at 1022.

See also

Eichelberger, 390 F.3d at 589; Nevland v. Apfel, 204 F.3d 853, 857 (8th Cir. 2000)
(quoting Terrell v. Apfel, 147 F.3d 659, 661 (8th Cir. 1998)); Hutsell v. Massanari,
259 F.3d 707, 711 (8th Cir. 2001).
To determine whether the Commissioner’s final decision is supported by
substantial evidence, the court is required to review the administrative record as a
whole and to consider:
(1) Findings of credibility made by the ALJ;
(2) The education, background, work history, and age of the claimant;
(3) The medical evidence given by the claimant’s treating physicians;
(4) The subjective complaints of pain and description of the claimant’s
physical activity and impairment;
(5) The corroboration by third parties of the claimant’s physical impairment;

6

(6) The testimony of vocational experts based upon proper hypothetical
questions which fairly set forth the claimant’s physical impairment; and
(7) The testimony of consulting physicians.
Brand v. Sec’y of Dep’t of Health, Educ. & Welfare, 623 F.2d 523, 527 (8th Cir.
1980); Cruse v. Bowen, 867 F.2d 1183, 1184-85 (8th Cir. 1989).
Additionally, an ALJ’s decision must comply “with the relevant legal
requirements.” Ford v. Astrue, 518 F.3d 979, 981 (8th Cir. 2008).
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 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). “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). When
evaluating evidence of pain, the ALJ must consider:
(1) the claimant’s daily activities;
(2) the subjective evidence of the duration, frequency, and intensity of the
claimant’s pain;
(3) any precipitating or aggravating factors;

7

(4) the dosage, effectiveness, and side effects of any medication; and
(5) the claimant’s functional restrictions.
Baker v. Sec’y of Health & Human Servs., 955 F.2d. 552, 555 (8th Cir. 1992);
Polaski, 739 F.2d at 1322.
The absence of objective medical evidence is just one factor to be
considered in evaluating the plaintiff’s credibility. See id. The ALJ must also
consider the plaintiff’s prior work record, observations by third parties and treating
and examining doctors, as well as the plaintiff’s appearance and demeanor at the
hearing. See Polaski, 739 F.2d at 1322; Cruse, 867 F.2d at 1186.
The ALJ must make express credibility determinations and set forth the
inconsistencies in the record which cause him or her to reject the plaintiff’s
complaints. See Guilliams, 393 F.3d at 801; Masterson, 363 F.3d at 738; Lewis v.
Barnhart, 353 F.3d 642, 647 (8th Cir. 2003); Hall v. Chater, 62 F.3d 220, 223 (8th
Cir. 1995). It is not enough that the record contains inconsistencies; the ALJ must
specifically demonstrate that he or she considered all of the evidence. Robinson v.
Sullivan, 956 F.2d 836, 841 (8th Cir. 1992); Butler v. Sec’y of Health & Human
Servs., 850 F.2d 425, 429 (8th Cir. 1988). The ALJ, however, “need not explicitly
discuss each Polaski factor.” Strongson v. Barnhart, 361 F.3d 1066, 1072 (8th Cir.
2004). See also Steed, 524 F.3d at 876 (citing Lowe v. Apfel, 226 F.3d 969, 972
(8th Cir. 2000)). The ALJ need only acknowledge and consider those factors. See

8

id. Although credibility determinations are primarily for the ALJ and not the court,
the ALJ’s credibility assessment must be based on substantial evidence.

See

Rautio v. Bowen, 862 F.2d 176, 179 (8th Cir. 1988); Millbrook v. Heckler, 780
F.2d 1371, 1374 (8th Cir. 1985).
RFC is defined as what the claimant can do despite his or her limitations, 20
C.F.R. § 404.1545(a)(1), and includes an assessment of physical abilities and
mental impairments. 20 C.F.R. § 404.1545(b)-(e). The Commissioner must show
that a claimant who cannot perform his or her past relevant work can perform other
work which exists in the national economy. See Karlix v. Barnhart, 457 F.3d 742,
746 (8th Cir. 2006); Nevland, 204 F.3d at 857 (citing McCoy v. Schweiker, 683
F.2d 1138, 1146-47 (8th Cir. 1982) (en banc)). The Commissioner must first prove
that the claimant retains the RFC to perform other kinds of work. See Goff, 421
F.3d at 790; Nevland, 204 F.3d at 857. The Commissioner has to prove this by
substantial evidence. Warner v. Heckler, 722 F.2d 428, 431 (8th Cir. 1983).
Second, once the plaintiff’s capabilities are established, the Commissioner has the
burden of demonstrating that there are jobs available in the national economy that
can realistically be performed by someone with the plaintiff’s qualifications and
capabilities. See Goff, 421 F.3d at 790; Nevland, 204 F.3d at 857.
To satisfy the Commissioner’s burden, the testimony of a vocational expert
(VE) may be used. An ALJ posing a hypothetical to a VE is not required to

9

include all of a plaintiff’s limitations, but only those which the ALJ finds credible.
See Goff, 421 F.3d at 794 (“[T]he ALJ properly included only those limitations
supported by the record as a whole in the hypothetical.”); Rautio, 862 F.2d at 180.
Use of the Medical-Vocational Guidelines is appropriate if the ALJ discredits the
plaintiff’s subjective complaints of pain for legally sufficient reasons. See Baker
v. Barnhart, 457 F.3d 882, 894-95 (8th Cir. 2006); Carlock v. Sullivan, 902 F.2d
1341, 1343 (8th Cir. 1990); Hutsell v. Sullivan, 892 F.2d 747, 750 (8th Cir. 1989).
III.
DISCUSSION
The issue before the court is whether substantial evidence supports the
Commissioner’s final determination that Plaintiff was not disabled. See Onstead,
962 F.2d at 804. Thus, even if there is substantial evidence that would support a
decision opposite to that of the Commissioner, the court must affirm her decision
as long as there is substantial evidence in favor of the Commissioner’s position.
See Cox, 495 F.3d at 617; Krogmeier, 294 F.3d at 1022.
In his Disability Report, Plaintiff, who was born in 1960, alleged that he
became disabled, commencing September 1, 2009, due to carpal tunnel syndrome,
high blood pressure, and problems with his neck, shoulders, and back. (Tr. 188).
At the October 4, 2012 hearing before the ALJ, Plaintiff testified that he had pain
in his left shoulder and arm; he had difficulty lifting his arm overhead and could
not lift “too much”; he had pain in both elbows and numbness in his right hand, for
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which he wore a brace; he had pain in his back for the past twenty years “or
longer”; and he had an appointment to have a pacemaker implanted. (Tr. 41-46,
48-49).
The ALJ found that Plaintiff met the insured requirements through
December 31, 2012; that Plaintiff had not engaged in substantial gainful activity
since his alleged onset date, September 1, 2009; that he had the severe impairments
of degenerative disc disease, left rotator cuff strain with tendonopathy, and
bilateral ulnar neuropathy; and that Plaintiff did not have an impairment or
combination of impairments that met or medically equaled a listed impairment.
The ALJ found that Plaintiff had the RFC to perform medium work1 except that he
had to avoid climbing ropes, ladders, or scaffolds; he must avoid hazards of heights
and machinery; and he was limited to frequent handling or gross manipulation,
fingering or fine manipulation, and pushing and pulling with his arms. After
soliciting the testimony of a VE, the ALJ concluded that, although Plaintiff was
capable of performing his past relevant work, there also were other jobs, in the
national economy, which he could perform, given his age, education, work history,

20 C.F.R § 416.967(c), Physical Exertion Requirements, provides that “[m]edium
work involves lifting no more than 50 pounds at a time with frequent lifting or
carrying of objects weighing up to 25 pounds. If someone can do medium work,
we determine that he or she can also do sedentary and light work.”
1

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and RFC. As such, the ALJ found Plaintiff not disabled within the meaning of the
Act. (Tr. 15-24).
Plaintiff contends that the ALJ’s decision is not based on substantial
evidence because the ALJ did not consider the effects of Plaintiff’s individual
impairments when formulating Plaintiff’s RFC; because the ALJ did not consider
the combined effects of Plaintiff’s impairments when formulating his RFC;
because the ALJ failed to provide a “logical explanation for the RFC assessment”;
because the ALJ erred when stating that Plaintiff’s doctor did not prescribe pain
medication because the doctor found Plaintiff had improved; because the ALJ did
find Plaintiff had a medically determinable cardiovascular impairment; and
because the ALJ failed to develop the record and order that Plaintiff undergo a
consultive examination. (Doc. 14). For the following reasons, the court finds that
Plaintiff’s arguments are without merit and that the ALJ’s decision is based on
substantial evidence.
A.

Plaintiff’s Credibility:
The court will first consider the ALJ’s credibility determination as Plaintiff’s

credibility is relevant to other factors, including Plaintiff’s RFC. See Wildman v.
Astrue, 596 F.3d 959, 969 (8th Cir. 2010) (A[The plaintiff] fails to recognize that
the ALJ's determination regarding her RFC was influenced by his determination
that her allegations were not credible.@) (citing Tellez v. Barnhart, 403 F.3d 953,

12

957 (8th Cir. 2005)); 20 C.F.R. §§ 404.1545, 416.945 (2010). As set forth more
fully above, the ALJ=s credibility findings should be affirmed if they are supported
by substantial evidence on the record as a whole; a court cannot substitute its
judgment for that of the ALJ. See Guilliams v. Barnhart, 393 F.3d 798, 801 (8th
Cir. 2005); Hutsell, 892 F.2d at 750; Benskin, 830 F.2d at 882.
To the extent that the ALJ did not specifically cite Polaski, other case law,
and/or Regulations relevant to a consideration of Plaintiff=s credibility, this is not
necessarily a basis to set aside an ALJ=s decision where the decision is supported
by substantial evidence. Randolph v. Barnhart, 386 F.3d 835, 842 (8th Cir. 2004);
Wheeler v. Apfel, 224 F.3d 891, 895 n.3 (8th Cir. 2000); Reynolds v. Chater, 82
F.3d 254, 258 (8th Cir. 1996); Montgomery v. Chater, 69 F.3d 273, 275 (8th Cir.
1995). Additionally, an ALJ need not methodically discuss each Polaski factor if
the factors are acknowledged and examined prior to making a credibility
determination; where adequately explained and supported, credibility findings are
for the ALJ to make. See Lowe v. Apfel, 226 F.3d 969, 972 (8th Cir. 2000). See
also Tucker v. Barnhart, 363 F.3d 781, 783 (8th Cir. 2004) (AThe ALJ is not
required to discuss each Polaski factor as long as the analytical framework is
recognized and considered.@); Strongson, 361 F.3d at 1072; Brown v. Chater, 87
F.3d 963, 966 (8th Cir. 1996).

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In any case, A[t]he credibility of a claimant=s subjective testimony is
primarily for the ALJ to decide, not the courts.@ Pearsall v. Massanari, 274 F.3d
1211, 1218 (8th Cir. 2001).

AIf an ALJ explicitly discredits the claimant=s

testimony and gives good reason for doing so, [a court] will normally defer to the
ALJ=s credibility determination.@ Gregg v. Barnhart, 354 F.3d 710, 714 (8th Cir.
2003). See also Halverson v. Astrue, 600 F.3d 922, 932 (8th Cir. 2010); Cox v.
Barnhart, 471 F.3d 902, 907 (8th Cir. 2006). For the following reasons, the court
finds that the reasons offered by the ALJ in support of his credibility determination
are based on substantial evidence.
First, the ALJ considered the reports of Plaintiff’s medical providers upon
examination of Plaintiff. (Tr. 19-20). See Orrick v. Sullivan, 966 F.2d 368, 372
(8th Cir. 1992) (holding that an ALJ may discredit a claimant=s subjective
complaints where there are inconsistencies in the record; the ALJ may give more
weight to the medical records than to a claimant=s testimony); Russell v. Sullivan,
950 F.2d 542, 545 (8th Cir. 1991).
Notably, on January 7, 2010, Plaintiff had full range of motion (ROM) in the
shoulders, with pain on rotation and mildly reduced grip strength on the left, which
the doctor attributed to poor effort. (Tr. 234). On January 14, 2010, Bryan Hodge,
D.O., reported that physical examination showed normal musculature and normal
ROM for Plaintiff’s age. (Tr. 243-44). On May 6, 2010, upon examination, Dr.
14

Hodge reported no neurological deficits; that Plaintiff’s cardiovascular system
showed normal rate and rhythm with no murmurs, gallops or rubs; and that
Plaintiff’s blood pressure was 130/80.2 (Tr. 245-46). Although, on July 8, 2010,
Plaintiff reported numbness in both hands for the past month, on examination, Dr.
Hodge reported that he had no sensory loss or weakness; he had intact balance and
gait; and normal ROM. (Tr. 248-49). On July 15, 2010, neuromuscular findings
were normal. On this date, Plaintiff’s blood pressure was 160/90. It was noted
that Plaintiff’s hypertension was uncontrolled and that his medication was
adjusted. (Tr. 252). On August 16, 2010, Plaintiff’s blood pressure was 145/94
and 140/110, and Dr. Hodge reported that Plaintiff’s hypertension had improved
and that examination of Plaintiff’s wrist was normal. (Tr. 254-55). Although on
September 15, 2010, Plaintiff reported constant right shoulder pain, Miranda
Coole, M.D., reported that, upon examination, Plaintiff’s left shoulder was normal,
and he had pain free full ROM in his right shoulder. (Tr. 258-59).
On January 5, 2011, Naseem Shekhani, M.D., who is board certified in
Physical Medicine and Rehabilitation, reported that Plaintiff said that his neck and

http://www.mayoclinic.or/diseases-conditions/high-blood-presure/in-depth/bloodpresure/ART-20050982 (last accessed 08/05/2015) (systolic (top number) below
120 and diastolic (bottom number) below 80 is normal blood pressure; 120-139
over 80-89 is prehypertension; 140-159 over 90-99 is stage 1 hypertension; 160 or
more over 100 or more is stage 2 hypertension; adopting a healthy lifestyle is
recommended for prehypertension).
2

15

shoulder pain were a ten on a ten-point scale. On examination, however, Plaintiff
had minimal tenderness in the shoulders, full strength of 5/5, and no sensory
deficits; his “muscle stretch reflexes [were] within normal limits,” but he had
painful internal rotation, limited ROM, and tenderness in the low back.

Dr.

Shekhani’s assessment included left rotator cuff strain and left shoulder injury,
lumbago with facet joint syndrome, and neck pain. (Tr. 306-307). On January 19,
2011, when Plaintiff said his shoulder, neck and low back pain were getting worse,
Dr. Shekhani reported that Plaintiff had full strength, no sensory deficits, and
antalgic gait.3 (Tr. 308).
On January 21, 2011, when Plaintiff reported that he had “new pain” in his
arms since a December 2010 motor vehicle accident and that he had pain with
shoulder movement and finger numbness, Dr. Coole reported that Plaintiff had
good grip strength bilaterally. No cardiovascular abnormalities were noted, and
Plaintiff’s blood pressure was 157/80. (Tr. 296-97). On February 21, 2011, Dr.
Shekhani noted Plaintiff had full strength, no sensory deficits, painful ROM in the
left shoulder, back tenderness, and negative straight leg raise. Plaintiff’s blood
pressure was 130/80. (Tr. 309). On February 28, 2011, Dr. Shekhani reported that
Plaintiff’s left shoulder ROM was restricted; he had minimal tenderness on the

Antalgic gait is defined as a “limp in which a phase of the gait is shortened on the
injured side to alleviate the pain experienced when bearing weight on that side.”
The American Heritage Medical Dictionary, Houghton Mifflin Co. (2004).
3

16

anterior aspect of the bilateral shoulders; Plaintiff’s peripheral pulses were within
normal limits; he had full strength of 5/5 and no sensor deficits; and his muscle
stretch was within normal limits. Dr. Shekhani administered a facet joint injection
to Plaintiff on this date. (Tr. 346). On March 7, 2011, Dr. Shekhani reported that
Plaintiff had normal left shoulder ROM and minimal tenderness, full strength, no
sensory deficits, no lumbar spine tenderness, and a minimally antalgic gait. Dr.
Shekhani determined that Plaintiff should not receive an injection, and, because he
had improved “significant[ly],” that Plaintiff should continue with his regular
doctor. (Tr. 313).
When David Kieffer, M.D., diagnosed Plaintiff with carpal tunnel syndrome,
on May 2, 2011, Dr. Kieffer reported that Plaintiff showed abnormalities and
muscle spasms in his hand. (Tr. 432). On July 18, 2011, Dr. Coole reported that
Plaintiff had no limitation of motion in his left wrist, although he had positive
Tinel’s sign.4 Plaintiff’s blood pressure was 120/80; he had no cardiovascular
abnormalities; on evaluation and inspection, he had no abnormalities in the right
wrist; in regard to right wrist ROM, Plaintiff had 30 degree ulnar ROM, 20 degree
radial ROM, 70 degree extension, and 80 degree flexion; he had pain free active
ROM in the right wrist; he had “passive pain free range of motion normal” in the
Tinel's sign is a sensation of tingling, or of “pins and needles,” felt in the distal
extremity of a limb, when percussion is made over the site of an injured nerve.
Stedman's Medical Dictionary, 1422 (25th ed., Williams & Wilkins 1990).

4

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right wrist; and he had no edema, cyanosis, or clubbing in his extremities. (Tr.
420). On September 21, 2011, Dr. Coole reported that Plaintiff had decreased
ROM in the right shoulder, pain free ROM in the right wrist, normal upper
extremity strength, and positive Tinel’s sign. His blood pressure was 140/85 and
154/88. No cardiovascular abnormalities were noted. (Tr. 423-24).
On January 18, 2012, when Plaintiff was seen for medication refill, pain, and
hypertension, Dr. Cooley reported that Plaintiff’s blood pressure was 143/86; he
had regular heart rate and rhythm; he had no edema, cyanosis, or clubbing in his
extremities; no cardiovascular abnormalities were noted; and his hypertension was
benign. (Tr. 425-26). An April 4, 2012 right wrist x-ray showed “no evidence of
fracture, dislocation or bone destruction,” and “[n]o significant arthritic changes.”
The impression was “negative right wrist.” (Tr. 459). On April 5, 2012, Donald
Brancato, M.D., reported that, on examination, Plaintiff had sensory abnormalities
in the fingers which were “not consistent with carpal tunnel” syndrome; that
Plaintiff’s hands showed abnormalities and that Plaintiff had pain with ROM in the
left shoulder. (Tr. 441). When Plaintiff presented on June 15, 2012, with shoulder
pain and “to discuss not responding episode, wrist pain, and hypertension,” Dr.
Coole reported that Plaintiff was positive for back pain; his blood pressure was
130/88 and 138/79; he had no edema, cyanosis, or clubbing in his extremities;

18

Plaintiff was negative for chest pain and irregular heartbeat/palpitations; he had no
motor or sensory deficits; and Plaintiff’s hypertension was benign. (Tr. 454-56).
On September 2, 2012, Plaintiff was brought to the emergency room due to
syncope5 and bradycardia.6 Plaintiff reported that he had two previous episodes of
syncope in the past year and a half, and that he had been drinking gin and smoking
marijuana when he had the current episode of loss of consciousness.

On

admission, physical examination showed some loss of bilateral hand sensation,
weakness in the left arm, and left arm pain.

Plaintiff had no edema in his

extremities; his motor examination was 4/5 in the left deltoid and 5/5 in the lower
extremities; light touch and pin-prick sensation in the bilateral forearm, arm, and
lower extremities was intact and symmetrical; Plaintiff had “paraesthesia of
bilateral hands on dorsal and palmer aspects from tips of finger to 2 cm above
wrist”; his gait could not be assessed. It was noted that Plaintiff had polysubstance
abuse.

An electrocardiogram (EKG) showed normal sinus rhythm with sinus

Syncope is the “medical term for fainting or passing out. It is caused by a
temporary drop in the amount of blood that flows to the brain. Syncope can
happen if you have a sudden drop in blood pressure, a drop in heart rate, or
changes in the amount of blood in areas of your body. If you pass out, you will
likely become conscious and alert right away, but you may [] feel confused for a
bit.” See http://my.clevelandclinic.org/services/heart/disorders/syncope. (last
visited 06/23/2015).
5

Bradycardia is a “slow hearbeat. When a heart is experiencing bradycardia, the
heart may beat too slowly to provide adequate amounts of blood to the body.”
Medtronic, Inc. v. Guidant Corp., 2004 WL 1179338, at *2 (D. Minn. May 25,
2004) (unreported).
6

19

arrhythmia. (Tr. 468-69). On September 2 to 3, 2012, Plaintiff underwent a “24
Hour Full Disclosure Monitor,” which showed “Frequent Premature Atrial
Contractions.” (Tr. 472). On September 14, 2012, Ankur Shah, M.D., noted that
Plaintiff’s hypertension was benign, and that Plaintiff was to have an appointment
to have a pacemaker implanted.

(Tr. 460-61).

Records from Saint Louis

University reflect that Plaintiff presented to the “Cardiac Cath Lab,” on October
10, 2012, for purposes of having a pacemaker implanted and that he was
discharged the next day. (Tr. 523-27).
Second, the ALJ considered that Plaintiff’s conditions improved with
medication. (Tr. 21). The ALJ also considered that, although Plaintiff reported his
medication made him dizzy (Tr. 177), the record did not reflect reports or findings
of such side effects (Tr. 22).

For example, after Plaintiff’s hypertension

medication was increased in January 2010, it was noted, in May 2010, that his
hypertension had improved.

(Tr. 245-46).

Likewise, in August 2010, after

Plaintiff’s hypertension medication had been adjusted in July 2010, it was reported
that his hypertension was improving. (Tr. 254-55). In May 2011, Dr. Coole noted
that Plaintiff’s hypertension was controlled with medication.

(Tr. 417-18).

Additionally, Plaintiff told Dr. Shekhani, in March 2011, that chiropractic
treatment, the facet joint injection, and medication had helped him, and that, with
the injection, his ROM, stretching, and strengthening had improved. (Tr. 313).

20

Indeed, conditions which can be controlled by treatment are not disabling. See
Renstrom v. Astrue, 680 F.3d 1057, 1066 (8th Cir. 2012) (quoting Brown v.
Astrue, 611 F.3d 941, 955 (8th Cir. 2010)); Davidson v. Astrue, 578 F.3d 838, 846
(8th Cir. 2009); Medhaug v. Astrue, 578 F.3d 805, 813 (8th Cir. 2009); Schultz v.
Astrue, 479 F.3d 979, 983 (8th Cir. 2007) (holding that if an impairment can be
controlled by treatment, it cannot be considered disabling).
Third, as stated above, in January 2010, when Plaintiff had poor grip
strength, it was attributed to his poor effort.

(Tr. 234).

Certainly, when an

examining physician expresses doubts about the validity of a claimant's
complaints, this is a factor which discounts the claimant's credibility. See Baker v.
Barnhart, 457 F.3d 882, 892-93 (8th Cir. 2006) (holding that the ALJ properly
discounted the claimant=s complaints of pain upon considering reports that the
claimant exaggerated his symptoms during an examination); Jones v. Callahan,
122 F.3d 1148, 1151-52 (8th Cir. 1997) (holding that exaggeration of symptoms is
a factor to be weighed in evaluating subjective complaints of pain); Russell v.
Sec’y of Health, Ed. & Welfare, 540 F.2d 353, 357 (8th Cir. 1976) (holding that
where doctors reported that the claimant was exaggerating her ailments and was
uncooperative, the record did not establish the requisite degree of certainty that the
claimant was disabled).

21

Fourth, the ALJ considered diagnostic test results. (Tr. 19-20). See 20 CFR
§ 404.1529(c)(2) (agency will consider “objective medical evidence” when
evaluating symptoms); Gonzales v. Barnhart, 465 F.3d 890, 895 (8th Cir. 2006)
(ALJ may find claimant’s subjective pain complaints are not credible in light of
objective medical evidence to the contrary). In this regard, in January 2010, a
shoulder x-ray showed minimal degenerative changes in Plaintiff’s left shoulder.
(Tr. 236). When Plaintiff was hospitalized following a motor vehicle accident, on
December 14, 2010, a cervical spine x-ray showed degenerative disc disease at C56. (Tr. 284, 386-87). A February 15, 2011 lumbar spine magnetic resonance
imaging test (MRI) showed degenerative disc disease and degenerative changes at
L3-S1. A left shoulder MRI was negative. (Tr. 304-305). A December 12, 2011
x-ray showed minimal degenerative changes. (Tr. 434, 436). A May 25, 2012
electromyography test (EMG) was consistent with bilateral ulnar neuropathy due
to compression at the elbow, but showed no evidence of carpal tunnel syndrome.
(Tr. 453). An EKG performed when Plaintiff presented to the emergency room, on
September 2, 2012, was normal, except for “trivial” miral, tricuspal, and
pulmonic regurgitation, (Tr. 474), and an EKG six days later, on September 8,
2012, showed normal sinus rhythm and “nonspecific ST and T wave abnormality.”
(Tr. 516).

22

Fifth, the ALJ considered what Plaintiff told his medical providers. For
example, in May 2010, Plaintiff had no neuromuscular complaints. (Tr. 245-46).
In February 2011, he said his back pain had improved, but his shoulder pain had
increased. (Tr. 309). As stated above, in March 2011, Plaintiff said his pain,
ROM, stretching, and strengthening had improved. (Tr. 313). Contradictions
between a claimant=s sworn testimony and what he actually told physicians weighs
against the claimant=s credibility. Karlix v. Barnhart, 457 F.3d 742, 748 (8th Cir.
2006).
Sixth, Plaintiff had conservative treatment for his complaints of arm and
hand pain, and, as noted by the ALJ, Plaintiff only saw his primary care physician
for his shoulder issues after his rehabilitation doctor decided Plaintiff did not
require further injections or continued specialist care.

(Tr. 20, 410).

If an

impairment can be controlled through treatment or medication, it cannot be
considered disabling. Kisling v. Chater, 105 F.3d 1255, 1257 (8th Cir. 1997).
Further, conservative treatment and no surgery are consistent with discrediting a
claimant=s allegation of disabling pain. Kamann v. Colvin, 721 F.3d 945, 950-51
(8th Cir. 2012) (noting that the ALJ properly considered that the claimant was seen
“relatively infrequently for his impairments despite his allegations of disabling
symptoms”); Casey v. Astrue, 503 F.3d 687, 693 (8th Cir. 2007) (noting that the
claimant sought treatment “far less frequently than one would expect based on the

23

[symptoms] that [he] alleged”); Black v. Apfel, 143 F.3d 383, 386 (8th Cir. 1998).
Notably, in July 2011, it was reported that Plaintiff was wearing a wrist brace, and
Dr. Cooley noted that Plaintiff did not currently have a referral to an orthopedist.
(Tr. 419). When Dr. Hodge diagnosed Plaintiff with carpal tunnel syndrome, in
August 2010, Dr. Hodge recommended Plaintiff use a splint and modification of
his activity. (Tr. 256). When Plaintiff presented with neck and shoulder pain, on
January 5 and 19, 2011, and with shoulder and back pain, on February 28, 2011,
Dr. Shekhani recommended stretching and exercise. (Tr. 307-308, 346). On
February 21 and 28, 2011, Dr. Shekhani administered steroid injections. (310,
346). On March 7, 2011, Dr. Shekhani noted that Plaintiff was not given an
injection, and suggested Plaintiff follow up on an as needed basis. He also advised
Plaintiff regarding stretching and a wellness program. (Tr. 410). On January 18,
2012, when Plaintiff presented for a medication refill, Dr. Cooley discussed the
importance of regular stretching exercises with Plaintiff. (Tr. 425-26). In April
2012, Dr. Brancato recommended home ROM exercises for Plaintiff. (Tr. 441).
Seventh, although Plaintiff alleged an onset date of September 2, 2009, it
was reported, on December 12, 2011, that he sought treatment for back pain
“starting yesterday.” (Tr. 434, 436).
Eighth, as considered by the ALJ, to the extent Plaintiff’s girlfriend stated, in
a Function Report, that Plaintiff had difficulties with vision, memory,

24

concentration, and the ability to follow instructions, complete tasks, and get along
with others, this report was inconsistent with Plaintiff’s self-reporting that he had
no difficulties in these areas. (Tr. 22, 170-83, 204). See Black v. Apfel, 143 F.3d
383, 387 (8th Cir. 2006) (an ALJ may discount third-party testimony for the same
reasons that a claimant’s testimony can be discredited). Indeed, in a Function
Report, which he completed, Plaintiff did not indicate that his alleged disabling
conditions affected his talking, hearing, seeing, memory, completing tasks,
concentration, understanding, following instructions, or getting along with others.7
(Tr. 204).
B.

Severity of Plaintiff’s Alleged Cardiovascular Impairment:
Plaintiff contends the ALJ erred when he failed to find Plaintiff had a

medically determinable cardiovascular impairment among Plaintiff’s severe
impairments. In support of this argument, Plaintiff argues that objective testing
confirmed a diagnosis of a cardiovascular impairment and that he was consistently
treated for hypertension. For the following reasons, the court finds Plaintiff’s
assertion is without merit and that the ALJ’s failure to find Plaintiff had a severe
cardiovascular impairment is based on substantial evidence.

Plaintiff also responded, in the Function Report, “not well” to a question asking
how he followed written instructions; he responded “pretty well” to a question
asking how he followed spoken instructions; and he said he got along “all right”
with authority figures, and that he had never been fired or laid off from a job
because of problems getting along with people. (Tr. 204-205).

7

25

As stated above, at Step 2 of the sequential analysis, an ALJ is required to
determine if a claimant has a severe impairment or combination of impairments.
AThe severity Regulation adopts a standard for determining the threshold level of
severity: the impairment must be one that >significantly limits your physical or
mental ability to do basic work activities.=@ Bowen v. Yuckert, 482 U.S. 137, 153
n.11 (1987) (quoting 20 CFR § 404.1520(c)).

A severe impairment is an

impairment or combination of impairments that significantly limits a claimant’s
physical or mental ability to perform basic work activities without regard to age,
education, or work experience.

See 20 C.F.R. §§ 404.1520(c), 404.1521(a).

However, “[a]n impairment is not severe if it amounts only to a slight abnormality
that would not significantly limit the claimant’s physical or mental ability to do
basic work activities.” Kirby v. Astrue, 500 F.3d 705, 707 (8th Cir. 2007); see also
20 C.F.R. § 404.1521(a) (describing basic work activities). In other words, if the
impairment has only a minimal effect on the claimant’s ability to work, then it is
not severe. See Page v. Astrue, 484 F.3d 1040, 1043 (8th Cir. 2007). A claimant
has the burden of establishing a severe impairment. See Kirby, 500 F.3d at 707.
An impairment or combination of impairments are not severe if they are so
slight that it is unlikely that the claimant would be found disabled even if his age,
education, and experience were taken into consideration. Bowen, 482 U.S. at 153
(AThe severity regulation increases the efficiency and reliability of the evaluation

26

process by identifying at an early stage those claimants whose medical
impairments are so slight that it is unlikely they would be found to be disabled
even if their age, education, and experience were taken into account.@). Moreover,
A>[a]n impairment imposes significant limitations when its effect on a claimant=s
ability to perform basic work is more than slight or minimal.=@ Warren v. Shalala,
29 F.3d 1287, 1291 (8th Cir. 1994) (quoting Cook v. Bowen, 797 F.2d 687, 690
(8th Cir. 1986)). See also Page v. Astrue, 484 F.3d 1040, 1043 (8th Cir. 2007)
(holding that if a claimant=s impairments would have no more than a minimal
effect on his ability to work, they do not satisfy the requirement of step two).
20 C.F.R. § 404.1521(b) defines basic work activities as follows:
(b) Basic work activities. When we talk about basic work activities,
we mean the abilities and aptitudes necessary to do most jobs.
Examples of these includeB
(1) Physical functions such as walking, standing, sitting, lifting, pushing,
pulling, reaching, carrying, or handling;
(2) Capacities for seeing, hearing, and speaking;
(3) Understanding, carrying out, and remembering simple instructions;
(4) Use of judgment;
(5) Responding appropriately to supervision, co-workers and usual
work situations; and
(6) Dealing with changes in a routine work setting.
As considered by the ALJ and as discussed above in regard to Plaintiff’s
credibility, although Plaintiff had longstanding issues with hypertension, his
doctors repeatedly reported that Plaintiff’s hypertension was benign, and that, with
medication adjustment, it improved, and his doctors did not impose restrictions on
27

Plaintiff because of his hypertension. (Tr. 249, 254-55, 296-97, 419-20, 423-26).
Moreover, on September 4, 2012, Plaintiff had a generally normal EKG with
“trivial” mitral, tricuspid, and pulmonic regurgitation, and, on September 8, 2012,
he had an EKG with normal sinus rhythm and “nonspecific ST and T wave
abnormality.” (Tr. 474. 516). As for the recommendation that Plaintiff have a
pacemaker, the records do not reflect that Plaintiff’s doctors imposed any
restrictions on Plaintiff because of the syncope or the need for a pacemaker, or that
he had any complications after the implantation.
Finally, there is no evidence that Plaintiff had a cardiovascular impairment
which could be expected to last for a continuous period of not less than twelve
months. See 20 C.F.R. § 414.909 (“Unless your impairment is expected to result
in death, it must have lasted or must be expected to last for a continuous period of
at least 12 months. We call this the duration requirement.”). The record reflects
no more than three episodes of syncope; that it was not recommended that Plaintiff
have a pacemaker implanted until September 2012; and that he had the pacemaker
implanted soon thereafter. The record does not reflect any complications from the
pacemaker’s implantation or any long term resulting limitations. It is also relevant
that Plaintiff did not list cardiovascular problems as the basis of his application for
benefits. (Tr. 188). See Wall v. Astrue, 561 F.3d 1048, 1062 (8th Cir. 2009)
(because the claimant did not allege that she suffered from a severe mental

28

impairment,

AALJ=s

failure

to

discuss

listing

12.05C

[was],

therefore

unsurprising@); Dunahoo, 241 F.3d at 1039 (holding that the fact that the claimant
did not allege depression on his benefits application was significant even though
evidence of depression was later developed). As such, the court finds that the
ALJ’s failure to find that Plaintiff had a severe cardiovascular condition is based
on substantial evidence and consistent with the Regulations and case law.
C.

ALJ’s Duty to Fully Develop the Record:
Plaintiff argues that the ALJ failed to fully develop the record by obtaining a

consultative examination. (Doc. 14 at 10-11). While an ALJ has a duty to develop
the record “fairly and fully,” independent of the claimant’s burden to press his
case, see Snead v. Barnhart, 360 F.3d 834, 838 (8th Cir. 2004), an ALJ is required
to order medical examinations and testing only if the record presented to her does
not provide sufficient evidence to determine whether the claimant is disabled, see
Martise v. Astrue, 641 F.3d 909, 926-27 (8th Cir. 2011). In the matter under
consideration, the record includes test results, including EKG and MRI results, and
blood pressure records, as well as numerous records from Plaintiff’s doctors
reflecting their observations upon examination of Plaintiff. Plaintiff, moreover,
does not specify what further development of the record would help establish in his
favor. See Shannon v. Chater, 54 F.3d 484, 488 (8th Cir. 1995) (holding that the

29

claimant failed to show prejudice because he failed to show how evidence of other
alleged medical visits would be dispositive for purposes of his claim).
To the extent Plaintiff suggests it is significant that a pacemaker was
implanted after the hearing, Plaintiff could have submitted additional medical
records to the Appeals Council to further develop the record.

See Weber v.

Barnhart, 348 F.3d 723, 725-26 (8th Cir. 2003) (AWeber certainly could have
obtained these records during the appellate process and demonstrated that they
were such that a remand to the ALJ was necessary. She has not done so.@). As
such, the court finds that the ALJ, in the instant matter, did not have an obligation
to further develop the record, and that the ALJ’s decision, in this regard, is based
on substantial evidence.
D.

Plaintiff’s RFC:
The Regulations define RFC as Awhat [the claimant] can do@ despite his or

her Aphysical or mental limitations.@ 20 C.F.R. § 404.1545(a). AWhen determining
whether a claimant can engage in substantial employment, an ALJ must consider
the combination of the claimant=s mental and physical impairments.@ Lauer v.
Apfel, 245 F.3d 700, 703 (8th Cir. 2001). AThe ALJ must assess a claimant=s RFC
based on all relevant, credible evidence in the record, >including the medical
records, observations of treating physicians and others, and an individual=s own
description of his limitations.=@ Tucker v. Barnhart, 363 F.3d 781, 783 (8th Cir.
30

2004) (quoting McKinney v. Apfel, 228 F.3d 860, 863 (8th Cir. 2000)). See also
Myers v. Colvin, 721 F.3d 521, 526 (8th Cir. 2013).
To determine a claimant=s RFC, the ALJ must move, analytically, from
ascertaining the true extent of the claimant=s impairments to determining the kind
of work the claimant can still do despite his or her impairments. Anderson v.
Shalala, 51 F.3d. 777, 779 (8th Cir. 1995). Although assessing a claimant=s RFC is
primarily the responsibility of the ALJ, a A>claimant's residual functional capacity
is a medical question.=@ Lauer, 245 F.3d at 704 (quoting Singh v. Apfel, 222 F.3d
448, 451 (8th Cir. 2000)). The Eighth Circuit clarified, in Lauer, 245 F.3d at 704,
that A>[s]ome medical evidence,= Dykes v. Apfel, 223 F.3d 865, 867 (8th Cir. 2000)
(per curiam), must support the determination of the claimant's RFC, and the ALJ
should obtain medical evidence that addresses the claimant=s >ability to function in
the workplace,= Nevland v. Apfel, 204 F.3d 853, 858 (8th Cir. 2000).@ Thus, an
ALJ is Arequired to consider at least some supporting evidence from a
professional.@ Id. See also Vossen v. Astrue, 612 F.3d 1011, 1016 (8th Cir. 2010)
(AThe ALJ bears the primary responsibility for determining a claimant's RFC and
because RFC is a medical question, some medical evidence must support the
determination of the claimant's RFC.@); Eichelberger, 390 F.3d at 591.
As stated above, the ALJ found that Plaintiff had the RFC to perform
medium work except that he had to avoid climbing ropes, ladders, or scaffolds; he
31

must avoid hazards of heights and machinery; and he was limited to frequent
handling or gross manipulation, fingering or fine manipulation, and pushing and
pulling with his arms.
Prior to formulating Plaintiff’s RFC, the ALJ considered Plaintiff’s
assertions regarding the severity of his conditions, and determined that Plaintiff’s
assertions were not fully credible based on the numerous factors discussed above.
The ALJ also considered the medical evidence relevant to Plaintiff’s alleged
impairments, including doctors’ reports and objective test results such as x-rays, as
set forth above in regard to Plaintiff’s credibility. In regard to Plaintiff’s neck and
low back pain, the ALJ considered that, after his 2011 motor vehicle accident, it
was determined that Plaintiff had some cervical and low back issues; that Plaintiff
received only conservative treatment; that his condition was stationary; that
Plaintiff had full ROM in his neck; and that records from Plaintiff’s primary care
physician did not assess Plaintiff with any back or neck impairments. (Tr. 19-20).
As for Plaintiff’s shoulder and arm impairments, the ALJ considered that
imaging showed only minimal degenerative changes in Plaintiff’s left shoulder
joint; that, in 2010, Plaintiff’s physician found no limiting problems with
Plaintiff’s shoulder; that, after his 2011 accident, Plaintiff was diagnosed only with
left rotator cuff strain with tendonopathy; that, after receiving a left shoulder
injection, Plaintiff had significant improvement with minimal tenderness and

32

normal ROM; that, since completing rehabilitation, Plaintiff had seen only his
primary care physician for his shoulder; and that no treating doctor imposed any
shoulder-related limitations. (Tr. 20).
As for Plaintiff’s wrist and arm issues, the ALJ considered that, although
Plaintiff reported some hand numbness, in 2010, he had pain free active ROM in
his wrist; that Plaintiff was diagnosed with unspecified idiopathic peripheral
neuropathy; that, in early 2011, Plaintiff had a negative wrist x-ray; that Plaintiff
was subsequently diagnosed with carpal tunnel syndrome; that subsequent testing
was non-consistent with carpal tunnel syndrome; that 2012 testing found no
evidence of carpal tunnel syndrome; and that, other than Plaintiff’s reporting
continuing wrist and hand pain, the record did not include evidence to show that
Plaintiff had such problems. (Tr. 20-21).
To the extent Plaintiff contends that the ALJ may have erred when she noted
that Plaintiff’s doctor found his wrist and hand impairment had improved enough
that Plaintiff no longer needed medication, this was just one of the numerous
factors considered by the ALJ, and the record does not reflect that any
misstatement by the ALJ, in this regard, affected the outcome of Plaintiff’s case.
See Hepp v. Astrue, 511 F.3d 798, 806 (8th Cir. 2008); Senne v. Apfel, 198 F.3d
1065, 1067 (8th Cir. 1999) (AWe have consistently held that a deficiency in

33

opinion-writing is not a sufficient reason for setting aside an administrative finding
where the deficiency had no practical effect on the outcome of the case.@).
Further, in regard to Plaintiff’s hypertension, the ALJ considered that
Plaintiff’s doctor repeatedly characterized it as improving and benign. (Tr. 21).
The court has set forth above factors considered by the ALJ relevant to Plaintiff’s
alleged cardiovascular issues. As for Plaintiff’s polysubstance abuse, the ALJ
found that this condition did not cause any significant functional limitations. (Tr.
22).
After considering the medical evidence as well as other evidence of record
and Plaintiff’s credibility, the ALJ concluded that Plaintiff’s hypertension and
polysubstance abuse were not severe and that his disc disease, left rotator cuff
strain, and bilateral ulnar neuropathy were severe. Given the ALJ’s extensive and
meticulous discussion addressing each of Plaintiff’s conditions, the court finds
without merit Plaintiff’s arguments that the ALJ failed to consider the effects of
Plaintiff’s individual impairments and the effect of the combination of his
impairments.
After identifying Plaintiff’s functional limitations and restrictions, the ALJ
assessed his work-related abilities. To the extent Plaintiff contends the ALJ should
have included greater restrictions in his RFC than were included, the ALJ was
required to include only Plaintiff’s credible limitations. See Tindell v. Barnhart,

34

444 F.3d 1002, 1007 (8th Cir. 2006) (AThe ALJ included all of Tindell=s credible
limitations in his RFC assessment, and the ALJ=s conclusions are supported by
substantial evidence in the record.@).
To the extent Plaintiff argues that no single source supported the ALJ’s RFC
determination, in formulating a claimant’s RFC, the “ALJ is not required to rely
entirely on a particular physician’s opinion or choose between the opinions of any
of the claimant’s physician’s.” Martise v. Astrue, 641 F.3d 909, 927 (8th Cir.
2011).
In conclusion, the court finds that the ALJ properly considered the evidence
of record when determining Plaintiff’s RFC and that the ALJ’s RFC determination
is based on substantial evidence and consistent with the Regulations and case law.
As such, the court finds that Plaintiff’s argument that there is no medical support
for the ALJ’s RFC assessment is without merit. Notably, in determining Plaintiff’s
RFC, the ALJ was fulfilling her role of doing so based on all relevant, credible
evidence of record. See Vossen, 612 F.3d at 1016; Tucker, 363 F.3d at 783.
After determining Plaintiff’s RFC, the ALJ posed a hypothetical question to
the VE which described a person of Plaintiff’s age and with his RFC, work
experience, and education, and the VE testified that Plaintiff could perform his past
relevant work as a cook, as well as other positions which are available in
significant numbers in the national economy. (Tr. 23-24, 59-60). See 20 C.F.R. §

35

404.1560(b)(3) (if a claimant can perform past relevant work, the claimant is not
disabled within the meaning of the Act); Martise v. Astrue, 641 F.3d 909, 927 (8th
Cir. 2011) (ABased on our previous conclusion . . . that >the ALJ's findings of [the
claimant=s] RFC are supported by substantial evidence,= we hold that >[t]he
hypothetical question was therefore proper, and the VE's answer constituted
substantial evidence supporting the Commissioner=s denial of benefits.=@) (quoting
Lacroix v. Barnhart, 465 F.3d 881, 889 (8th Cir. 2006)). To the extent Plaintiff
suggests the ALJ should have posed a hypothetical to the VE which included
additional limitations (Doc. 14 at 9), the court finds that the hypothetical posed to
the VE was proper, as it included those restrictions and impairments which the
ALJ found credible. See Renstrom, 680 F.3d at 1067; Martise, 641 F.3d at 927
(AThe ALJ's hypothetical question to the vocational expert needs to include only
those impairments that the ALJ finds are substantially supported by the record as a
whole.@) (quoting Lacroix, 465 F.3d at 889). Based on the VE’s testimony, the
ALJ found Plaintiff not disabled. See Martise, 641 F.3d at 927; Robson v. Astrue,
526 F.3d 389, 392 (8th Cir. 2008) (holding that a VE=s testimony is substantial
evidence when it is based on an accurately phrased hypothetical capturing the
concrete consequences of a claimant=s limitations); Wingert v. Bowen, 894 F.2d
296, 298 (8th Cir. 1990). The court finds, therefore, that the ALJ’s ultimate

36

determination that Plaintiff was not disabled is based on substantial evidence and
consistent with the Regulations and case law.
IV.
CONCLUSION
For the reasons set forth above, the court finds that substantial evidence on
the record as a whole supports the Commissioner’s decision that Plaintiff is not
disabled.
Accordingly,
IT IS HEREBY ORDERED that the relief sought by Plaintiff in his
Complaint and Brief in Support of Complaint (Docs. 1, 14) is DENIED;
IT IS ORDERED that a separate judgment be entered incorporating this
Memorandum and Order.
Dated this 5th day of August 2015.
/s/ Noelle C. Collins
UNITED STATES MAGISTRATE JUDGE

37