Mitchell v. Colvin
MEMORANDUM: Accordingly, for the reasons set forth above, the decision of the Commissioner of Social Security is affirmed. An appropriate Judgment Order is issued herewith. Signed by Magistrate Judge David D. Noce on 6/13/2016. (KMS)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
GREG F. MITCHELL,
CAROLYN W. COLVIN,
Acting Commissioner of Social Security,
No. 4:15 CV 908 DDN
This action is before the court for judicial review of the final decision of the
defendant Commissioner of Social Security denying the application of plaintiff Gregory F.
Mitchell for disability insurance (DIB) and supplemental security income (SSI) under
Titles II and XVI of the Social Security Act, 42 U.S.C. § 401-434, 1381-1385. The parties
have consented to the exercise of plenary authority by the undersigned United States
Magistrate Judge pursuant to 28 U.S.C. § 636(c). For the reasons set forth below, the
decision of the Administrative Law Judge (ALJ) is affirmed.
Plaintiff was born in 1972 and was 41 years old at the time of his hearing. (Tr. 55.)
He filed his applications on May 23, 2012, alleging a November 23, 2010 onset date, and
alleging disability due to diabetes, depression, anxiety, stomach ulcers, learning problems
and issues with reading and comprehension, a crushed disc at L5, and sleep problems.
(Tr. 135, 142, 178-79.) His applications were denied initially, and he requested a hearing
before an ALJ. (Tr. 90.)
On March 25, 2013, following a hearing, the ALJ issued a decision, concluding
that plaintiff was not disabled under the Act. (Tr. 35-46.) The Appeals Council denied
his request for review. (Tr. 1-6.) Thus, the decision of the ALJ stands as the final
decision of the Commissioner.
II. MEDICAL AND OTHER HISTORY
On September 29, 2010, plaintiff was seen by Gary W. LaMonda, M.D., an
internist, for a diabetic foot ulcer and checkup. Plaintiff was depressed. The Seroquel he
was taking, used to treat bipolar disorder, made him groggy in the morning. (Tr. 433.)
On October 13, 2010, plaintiff was seen by Kimberly Jamison, M.D., at the Boone
Hospital Center in Columbia, Missouri, for cleansing and debriding of a diabetic foot
ulcer. (Tr. 364.)
On October 19, 2010, plaintiff was referred to Laura Brenner, Ph.D., a clinical
psychologist, for a psychological evaluation. Dr. Brenner described plaintiff’s condition
as chronic depression that was exacerbated following his divorce. She diagnosed mild to
moderate recurrent major depressive disorder and wanted to rule out dysthymic disorder, a
mild but enduring type of depression. She indicated that plaintiff had chronic depression
that affected his mood, sleep, and energy level. She assigned a Global Assessment of
Functioning (GAF) score of 60, indicating moderate symptoms. In addition to Seroquel,
plaintiff was taking Paxil, an antidepressant; Byetta and insulin, for diabetes; Klonopin,
for epilepsy and panic disorder; and Ambien, a sleep aid. (Tr. 235-39.)
On May 10, 2011, plaintiff was seen by Dr. LaMonda for follow up. He was
severely depressed and anxious although his foot ulcer had healed. Dr. LaMonda referred
him for psychiatric evaluation. (Tr. 427-29.)
On February 1, 2012, plaintiff was seen by Gavin Michael Vaughn, M.D., at
Missouri Orthopaedic Institute, for left lateral hip pain and left knee pain. He diagnosed
left greater trochanteric bursitis, left hip pain, and left knee pain. (Tr. 573-74.)
On February 3, 2012, plaintiff underwent an MRI of his lumbar spine.
impression was: (1) diffuse narrowing of the neural canal; (2) multilevel degenerative
change; and (3) prominent compression of the left L3-L4 (lumbar spine) foramen. (Tr.
On April 24, 2012, plaintiff was seen at the Missouri Orthopaedic Institute for low
back pain and received an epidural steroid injection. (Tr. 459-60, 584.)
On May 6, 2012, plaintiff underwent an x-ray at Boone Hospital Center which
revealed a compression fracture of unknown age at the T12 (thoracic or trunk region)
vertebral body. (Tr. 248.)
On August 18, 2012, plaintiff was seen at the University of Missouri Health Care
emergency room with hyperglycemia. He had been pulled over by the police for weaving
while driving. He had not taken his insulin for the past 24 hours. His mother had given
him medication for a headache that he thought was Tylenol but was not sure. He was
stabilized, given diabetic hyperglycemic reading materials, and discharged home by taxi.
On October 3, 2012, plaintiff underwent a CT scan of the thoracic spine which
showed no acute findings. (Tr. 630.)
Plaintiff was hospitalized October 18-23, 2016, at University of Missouri Health
Care after being brought in by his family due to altered mental status and confusion.
Plaintiff thought his symptoms were caused by overmedication. Psychiatry notes state
that, although he had been diagnosed as bipolar, he had no mania history, and although he
had been prescribed Seroquel and benzodiazepines (tranquilizers), he had never been
followed by a primary care doctor.
His discharge diagnoses were depression not
otherwise specified, and diabetes. His GAF score at admission was 40, indicating some
impairment in reality testing or communication, and at discharge was 55, indicating
moderate symptoms. (Tr. 644-50.)
Plaintiff was hospitalized at SSM DePaul Health Center November 2-6, 2012 with
abdominal pain, nausea, and vomiting. He was diagnosed with a gastric ulcer, possibly
caused by nonsteroidal anti-inflammatory drugs (NSAIDs). His GAF score at discharge
was 45. (Tr. 664-704.)
On November 12, 2012, plaintiff was seen at UP-Missouri Orthopedic Institute and
received a steroid injection for low back pain. (Tr. 600.)
On March 20, 2013, plaintiff was seen by Dinu Gangure, M.D., a psychiatrist at
BJC Behavioral Health, for follow up on his depression and anxiety. Plaintiff reported he
was doing well and taking his medications as prescribed. Diagnoses included recurrent
major depression disorder and generalized anxiety disorder.
Seroquel and Paxil.
He was continued on
Plaintiff continued treatment with Dr. Gangure
between April and August 2013. (Tr. 940, 942, 943, 944, 946, 948.)
Plaintiff was hospitalized at SSM DePaul Health Center September 2–7, 2013, for
an overdose of acetaminophen (Tylenol). His family reported he was exhibiting an altered
mental status earlier that day. (Tr. 854-913.) At admission he stated that he had taken
more medication than was prescribed in an attempt to hurt himself, a statement he later
denied. (Tr. 872.) The assessment included suicidal ideation and bipolar disorder. He
was diagnosed with drug overdose and discharged home to live with family with
outpatient follow-up because a hospital bed was not available. (Tr. 863.)
On November 1, 2013, plaintiff was seen by psychiatrist Daniel Mamah, M.D. His
mood was depressed and he was periodically tearful with dysthymia. He reported being
depressed most of the time. Dr. Mamah diagnosed recurrent major depressive disorder,
severe without psychotic features, and generalized anxiety disorder. Dr. Mamah assigned
a GAF score of 60. (Tr. 555-57.)
On January 10, 2014, Dr. Mamah completed a Mental Residual Functional
Capacity (RFC) Statement. Dr. Mamah believed plaintiff would be unable to perform in a
competitive work environment or be off task 10 percent of the time during an eight-hour
per-day, five day per-week job; would miss one day of work per month due to his
impairments, would be unable to complete an eight-hour workday at the rate of one day
per month due to his impairments, and would be expected to perform a job at 80 percent
of the capacity of an average worker. Dr. Mamah indicated that for 10 percent of an
eight-hour workday, plaintiff was precluded from working in coordination with or in
proximity to others without being distracted by them; completing a normal workday or
work week without interruptions from psychologically based symptoms; performing at a
consistent pace without an unreasonable number and length of rest periods; accepting
criticism and responding appropriately to criticism from supervisors; and getting along
with coworkers or peers without distracting them or exhibiting behavioral extremes. (Tr.
On January 17, 2014, plaintiff was seen by Dr. Mamah. His mood was low and
anxious. His GAF score was 55. (Tr. 953-55.) Plaintiff was seen by Dr. Mamah again on
January 31, 2014.
His mood was angry and low.
Dr. Mamah was changing his
antidepressant prescription from Paxil to Effexor XR and plaintiff was frustrated by yet
another medication change. His GAF score was 50. (Tr. 957-59.)
On January 14, 2014, plaintiff appeared and testified to the following at a hearing
before an ALJ. (Tr. 55-76.) He was 41 years old. He graduated from high school and
obtained a certificate as an LPN. He was currently working three hours a day sorting
mail, a position he acquired through the Independent Center. His supervisors did not think
he would be able to work full-time as he was struggling with his current hours. (Tr. 5559.)
He began attending college in 2012 for a year and a half to two years. He became
so depressed and unmotivated that he flunked out. His back problems precluded him from
repetitive lifting. He suffered from severe depression, anxiety, feelings of hopelessness,
and feeling like a failure, which made it difficult to get out of bed or go to his job where
he worked three hours a day. He got frustrated and tended to leave early or come in late.
He would go home and cry. At home he would lie around and not really accomplish
anything. He continued to have difficulty socializing in person. (Tr. 59-60.)
The Independent Center assisted him in finding an apartment. He preferred to
isolate himself and suffered from social anxiety. Due to his learning disability, he was
very slow at his job which frustrated his coworkers. He was supervised by an individual
from the Independent Center who also acted as his job coach. He had crying spells four or
five times a week, and had no motivation to shower, shave, do dishes, etc. His housing
situation was supervised by HUD and the Independent Center who conducted periodic
inspections. He put off doing household chores until immediately before an inspection.
He is currently receiving treatment for back pain, diabetes, depression, and anxiety.
He has changed psychiatrists several times due to his insurance.
He has tried four
different medications with his new psychiatrist. The Independent Center has provided
various assistance, including helping him find temporary employment, finding a place to
live, and supervising his independent living. He worked with Alexandra Johnson at the
Independent Center, meeting with her weekly and talking on the phone as needed
throughout the week. He had difficulty sleeping due to anxiety and slept two to three
hours on a good night. He also had difficulty with his eating and would either overeat or
eat very little. He could sometimes go for days without eating. He had previously been
an avid reader but now has difficulty concentrating. He has low energy and spends much
of his time in bed or watching TV. (Tr. 63-65.)
Alexandra Johnson, plaintiff’s caseworker from the Independent Center, also
testified to the following at the hearing.
She provided plaintiff community support
through the center, including meeting with him once or twice a week. She helped him
work on his day-to-day living skills, accompanied him to psychiatrist appointments, and
helped him with coping strategies.
She did not think plaintiff’s job through the
Independent Center was competitive employment because it was so supported by the staff
there. Plaintiff had required assistance with coping with either a supervisor or coworker
talking to him. She did not think plaintiff would be able to work in a competitive setting
because he seemed emotionally and physically exhausted, working just three hours a day.
He needed regular support from her, his placement manager, and the employment focus
staff at the Independent Center. She usually had to “talk out” situations with him at least
once a week. (Tr. 68.) She observed that plaintiff struggled to have the motivation to
complete many daily living tasks. He had difficulty paying rent and other bills. The staff
was also concerned about him eating. He was compliant with medication but needed
periodic follow-up. Plaintiff sometimes needed to be redirected mid-conversation or
while trying to complete a task due to a lack of focus and confusion. She observed
plaintiff's irritability and mood swings. She believed plaintiff struggled to cope with any
difficult situation and with interacting with others. Plaintiff tended to interpret what
others said as criticism, destroying interactions and relationships with him. (Tr. 66-71.)
A Vocational Expert (VE) testified that plaintiff could not perform his past relevant
work because his past work was semi-skilled to skilled, or required more social interaction
than permitted by the residual functional capacity. The ALJ then asked whether there was
light unskilled work with limited public contact available for a hypothetical individual
with plaintiff’s age, education, work experience, and residual functional capacity. The VE
testified that plaintiff could perform other work that exists in the national economy,
including factory worker and cleaner. (Tr. 72-76.)
III. DECISION OF THE ALJ
On February 25, 2014, the ALJ issued a decision finding that plaintiff was not
disabled under the Act. (Tr. 35-46.) At Step One, the ALJ found plaintiff had not
performed substantial gainful activity since his November 23, 2010 alleged onset date. At
Step Two, the ALJ found, among other things, that plaintiff had the severe impairments of
degenerative disc disease of the cervical and lumbar spine, depression, and anxiety. At
Step Three, the ALJ found 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. (Tr. 37.)
At Step Four, the ALJ found that plaintiff had the RFC to perform light work. He
found that plaintiff could lift and/or carry and push and/or pull a maximum of 20 pounds
occasionally and 10 pounds frequently; sit for a total of 6 hours during an 8 hour work
day; and walk and/or stand for up to 6 hours at a time during an 8 hour work day. Plaintiff
could occasionally climb ramps and stairs, but should never climb ladders, ropes or
scaffolds. Plaintiff could perform occasional stooping, kneeling and crouching, but should
avoid concentrated exposure to vibration, unprotected heights and moving and dangerous
machinery. The ALJ found plaintiff could understand, remember and carry out at least
simple instructions and non-detailed tasks.
Plaintiff could respond appropriately to
supervisors and co-workers in a task-oriented setting where contact with others was casual
and infrequent. Plaintiff should not work in a setting which included constant/regular
contact with the general public and should not perform work which included more than
infrequent handling of customer complaints. (Tr. 39.) With this RFC, the ALJ found
plaintiff was unable to perform his past relevant work. (Tr. 43.)
At Step Five, the ALJ found there were jobs that existed in significant numbers in
the national economy that plaintiff could perform. Therefore, the ALJ found that plaintiff
was not disabled within the meaning of the Act. (Tr. 44-45.)
The ALJ gave little weight to the opinion of treating psychiatrist Dr. Daniel Mamah
because it was inconsistent with plaintiff's GAF score of 60 in his own treatment notes.
The ALJ also found that Ms. Johnson was not an acceptable medical source and that her
opinion that plaintiff was unable to work at competitive levels was inconsistent with
plaintiff’s GAF score of 60. (Tr. 43.)
IV. GENERAL LEGAL PRINCIPLES
The court’s role on judicial review of the Commissioner’s decision is to determine
whether the Commissioner’s findings comply with the relevant legal requirements and are
supported by substantial evidence in the record as a whole. Pate-Fires v. Astrue, 564 F.3d
935, 942 (8th Cir. 2009). “Substantial evidence is less than a preponderance, but is
enough that a reasonable mind would find it adequate to support the Commissioner’s
conclusion.” Id. In determining whether the evidence is substantial, the court considers
evidence that both supports and detracts from the Commissioner's decision. Id. As long
as substantial evidence supports the decision, the court may not reverse it merely because
substantial evidence exists in the record that would support a contrary outcome or because
the court would have decided the case differently. See Krogmeier v. Barnhart, 294 F.3d
1019, 1022 (8th Cir. 2002).
To be entitled to disability benefits, a claimant must prove he is unable to perform
any substantial gainful activity due to a medically determinable physical or mental
impairment that would either result in death or which has lasted or could be expected to
last for at least twelve continuous months.
42 U.S.C. §§ 423(a)(1)(D), (d)(1)(A),
1382c(a)(3)(A); Pate-Fires, 564 F.3d at 942. A five-step regulatory framework is used to
determine whether an individual is disabled. 20 C.F.R. § 416.920(a)(4); see also Bowen
v. Yuckert, 482 U.S. 137, 140-42 (1987) (describing five-step process); Pate-Fires, 564
F.3d at 942 (same).
Steps One through Three require the claimant to prove: (1) he is not currently
engaged in substantial gainful activity; (2) he suffers from a severe impairment; and (3)
his condition meets or equals a listed impairment. 20 C.F.R. § 416.920(a)(4)(i)-(iii). If
the claimant does not suffer from a listed impairment or its equivalent, the
Commissioner’s analysis proceeds to Steps Four and Five.
Step Four requires the
Commissioner to consider whether the claimant retains the RFC to perform past relevant
work (PRW). Id. § 416.920(a)(4)(iv). The claimant bears the burden of demonstrating he
is no longer able to return to her PRW. Pate-Fires, 564 F.3d at 942. If the Commissioner
determines the claimant cannot return to PRW, the burden shifts to the Commissioner at
Step Five to show the claimant retains the RFC to perform other work that exists in
significant numbers in the national economy. Id.; 20 C.F.R. § 416.920(a)(4)(v).
Plaintiff claims the ALJ erred in relying on plaintiff’s GAF scores in discounting
the opinions of treating psychiatrist Dr. Daniel Mamah and community support counselor
Alexandra Johnson. This court disagrees.
1. Treating Psychiatrist Dr. Daniel Mamah
Plaintiff argues the ALJ erred in weighing the opinion of treating psychiatrist Dr.
Daniel Mamah. He contends the ALJ formed his own opinion of the medical evidence
instead of relying on the interpretation of a treating source.
It is the function of the ALJ to weigh conflicting evidence and to resolve
disagreements among physicians. See Cline v. Colvin, 771 F.3d 1098, 1103 (8th Cir.
2014). Opinions from medical sources who have treated a claimant typically receive more
weight than opinions from one-time examiners or non-examining sources. See 20 C.F.R.
§ 416.927(c)(1)-(2). However, the rule is not absolute; a treating physician’s opinion may
be disregarded in favor of other opinions if it does not find support in the record. See
Casey v. Astrue, 503 F.3d 687, 692 (8th Cir. 2007). In assessing a medical opinion, an
ALJ may consider factors including the length of the treatment relationship and the
frequency of examination, the nature and extent of treatment relationship, supportability
with relevant medical evidence, consistency between the opinion and the record as a
whole, the physician’s status as a specialist, and any other relevant factors brought to the
attention of the ALJ. See 20 C.F.R. §§ 404.1527(c)(1)-(6); 416.927(c)(1)-(6); Owens v.
Astrue, 551 F.3d 792, 800 (8th Cir. 2008) (when a treating physician’s opinion is not
entitled to controlling weight, the ALJ must consider several factors when assessing the
weight to give it).
Although an ALJ is not required to discuss all the factors in
determining what weight to give a physician’s opinion, the ALJ must explain the weight
given the opinion and give “good reasons” for doing so. See 20 C.F.R. §§ 404.1527(c)(2),
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The ALJ gave good reasons here. The ALJ reasoned that Dr. Mamah’s opinion of
such significantly reduced functioning was inconsistent with his own treatment notes from
November 2013 assessing plaintiff’s GAF score of 60, indicative of no more than
moderate symptoms. (Tr. 43, 557, 561.) Plaintiff’s treatment records prior to November
2013 also indicated that plaintiff was doing well, appeared psychiatrically stable, and had
no side-effects from his medication.
(Tr. 42, 555-56, 938, 940, 946.)
indicated on his January 10, 2014 Mental RFC statement that plaintiff’s GAF score was
60 and his prognosis was fair. (Tr. 664.) The ALJ also properly considered plaintiff’s
GAF scores in assessing the validity of Dr. Mamah’s opinion. See Halverson v. Astrue,
600 F.3d 922, 930–31 (8th Cir. 2010) (while the Commissioner has declined to endorse
the GAF scale for use in the Social Security and SSI disability programs, GAF scores may
still be used to assist the ALJ in assessing the level of a claimant’s functioning); Goff v.
Barnhart, 421 F.3d 785, 789, 791, 793 (8th Cir. 2005) (GAF scores of 58 and 60 support
ALJ’s limitation for simple, routine, repetitive work); Myers v. Colvin, 721 F.3d 521, 525
(8th Cir. 2013) (OK to consider GAF scores in reviewing ALJ's determination that
treating source's opinion was inconsistent with treatment record).
The ALJ gave other good reasons for discounting Dr. Mamah’s opinion. The ALJ
noted that consultative examining psychologist, Dr. Laura Brenner, found that plaintiff’s
GAF score was 60 in October 2010. (Tr. 41-42, 43, 238.) The ALJ also noted that Dr.
Mamah saw plaintiff only a “handful of times,” and stated on January 24, 2014, that his
mental symptoms were not even expected to occur every day or every week. (Tr. 43, 55570, 952, 957-58.) Finally, the ALJ found Dr. Mamah’s opinion was inconsistent with
evidence that plaintiff attended full-time college courses after his alleged onset date. (Tr.
38, 43, 59, 238.) Allegations of depression and loss of concentration are inconsistent with
a claimant’s college attendance for a substantial period. Cf. House v. Shalala, 34 F.3d
691, 694 (8th Cir. 1994) (neither claimant’s headaches nor his deficits prevented him from
successfully attending college, culminating in bachelor’s degree).
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The court also notes that while the ALJ gave Dr. Mamah’s opinion little weight,
Dr. Mamah’s limitations are not entirely inconsistent with the mental limitations the ALJ
found credible and included in his residual functional capacity determination. (Tr. 39,
Dr. Mamah indicated that plaintiff was not precluded in any aspect from
understanding and remembering very short and simple instructions, carrying out very
short and simple instructions, sustaining an ordinary routine without special supervision,
or asking simple questions or requesting assistance. (Tr. 664-65.) The ALJ limited
plaintiff to simple instructions and non-detailed tasks, and accounted for plaintiff’s
limitations regarding social interaction by limiting the amount and type of interaction he
could have with others, including supervisors, coworkers, and the general public. (Tr. 39.)
Because Dr. Mamah’s opinion was inconsistent with other record evidence, the
ALJ lawfully gave it less weight.
2. Community Support Counselor Alexandra Johnson
The ALJ also properly considered and gave little weight to the opinion of
community support counselor, Alexandra Johnson, who testified that plaintiff was unable
to work at competitive levels and struggled to keep up with the demands of working three
and one-half hours a day at the community center. (Tr. 43, 66-70.) The ALJ properly
noted that Ms. Johnson, who holds a master’s degree in social work, was not an acceptable
medical source as defined in the regulations. (Tr. 43.) See 20 C.F.R. §§ 404.1513(a) and
416.913(a). The ALJ further found Ms. Johnson’s opinion was inconsistent with the GAF
scores discussed above, as well as plaintiff’s activity level including his ability to attend
college. (Tr. 43.) This court concludes the ALJ properly considered and discounted Ms.
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3. Residual Functional Capacity (RFC)
Residual functional capacity is a determination based on all the record evidence,
not just the medical evidence. See Wildman v. Astrue, 596 F.3d 959, 969 (8th Cir. 2010);
see also 20 C.F.R. §§ 404.1545 and 416.945; Social Security Ruling (SSR) 96-8p. When
formulating RFC, an ALJ need not rely entirely on one doctor’s opinion, nor is he limited
to a simple choice of the medical opinions of record. See Martise v. Astrue, 641 F.3d 909,
927 (8th Cir. 2011) (ALJ is not required to rely entirely on a particular physician’s opinion
or choose between the opinions of any of plaintiff’s physicians). The Commissioner uses
medical sources to “provide evidence” about several factors, including RFC, but the “final
responsibility for deciding these issues is reserved to the Commissioner.”
20 C.F.R. §
In formulating plaintiff’s RFC in this case, the ALJ adequately accounted for
plaintiff’s mental symptoms by stating he was able to perform simple and non-detailed
work and respond appropriately to supervisors and coworkers in a task-oriented setting
where contact with others is casual and infrequent. He also stated plaintiff should not
work in a setting that includes constant/regular contact with the general public, and should
not perform work that includes more than infrequent handling of customer complaints.
(Tr. 39.) This court concludes substantial evidence on the record as a whole supports the
After determining plaintiff’s RFC, the ALJ found that it prevented the performance
of his past relevant work. (Tr. 43.) The burden then shifted to the Commissioner to
produce evidence of other work existing in significant numbers that plaintiff could
perform based on his age, education, work experience, and RFC.
The ALJ used a
vocational expert to meet that burden. In response to a hypothetical question based on an
individual of plaintiff’s age, education, work background, and RFC, the vocational expert
testified that such individual could perform work existing in significant numbers including
the light and unskilled jobs of factory worker and cleaner. (Tr. 45, 72-73.) Although the
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hypothetical question must set forth with reasonable precision the claimant’s impairments,
it need only include those impairments and limitations the ALJ finds substantially
supported by the record as a whole. See Lacroix v. Barnhart, 465 F.3d 881, 889 (8th Cir.
2006). Because the hypothetical question included those impairments the ALJ found
credible, and excluded those he discredited for legally sufficient reasons, the vocational
expert’s testimony that plaintiff could perform work existing in significant numbers, is
substantial evidence in support of the ALJ’s determination. See Martise v. Astrue, 641
F.3d 909, 927 (8th Cir. 2011).
Because plaintiff retained the RFC to perform other work, he was not disabled as
defined under the Act. (Tr. 45-46.) This court concludes substantial evidence on the
record as a whole supports the ALJ’s decision.
Accordingly, for the reasons set forth above, the decision of the Commissioner of
Social Security is affirmed. An appropriate Judgment Order is issued herewith.
S/ David D. Noce
UNITED STATES MAGISTRATE JUDGE
Signed on June 13, 2016.
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