Lacer v. Colvin

Filing 22

MEMORANDUM AND ORDER : IT IS HEREBY ORDERED, ADJUDGED, AND DECREED that the decision of the Commissioner of Social Security is AFFIRMED. Signed by Magistrate Judge Shirley Padmore Mensah on 3/21/17. (ARL)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
LISA R. LACER,
Plaintiff,
v.

NANCY A. BERRYHILL,1
Acting Commissioner of Social Security,
Defendant.

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No. 4:16-CV-102-SPM

MEMORANDUM AND ORDER
This is an action under 42 U.S.C. § 405(g) or judicial review of the final decision of
Defendant Nancy A. Berryhill, the Acting Commissioner of Social Security, denying the
application of Plaintiff Lisa R. Lacer (“Plaintiff”) for Disability Insurance Benefits (“DIB”) under
Title II of the Social Security Act, 42 U.S.C. §§ 401 et seq. (the “Act”). The parties have consented
to the jurisdiction of the undersigned United States Magistrate Judge pursuant to 28 U.S.C. §
636(c)(1). (Doc. 9). Because the decision denying benefits was supported by substantial evidence,
the Commissioner’s denial of Plaintiff’s application will be affirmed.
I.

FACTUAL BACKGROUND

On June 16, 2014, Plaintiff testified at a hearing before the Administrative Law Judge
(“ALJ”). (Tr. 31-47). Plaintiff testified that she can no longer do her past work helping classroom

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Nancy A. Berryhill is now the Acting Commissioner of Social Security. Pursuant to Rule 25(d)
of the Federal Rules of Civil Procedure, Nancy A. Berryhill should be substituted for Acting
Commissioner Carolyn W. Colvin as the defendant in this suit. No further action needs to be taken
to continue this suit by reason of the last sentence of section 205(g) of the Social Security Act, 42
U.S.C. § 405(g).
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teachers or doing sales because of her inability to focus, her anxiety being around people, and her
level of stress. (Tr. 34-36). She testified that she has mood swings, has anger issues, has panic
attacks four times a day, has crying spells two or three times a day, gets nervous in groups of
people, has severe depression in the wintertime, gets agitated if she has done something wrong,
and has racing thoughts that make her unable to focus. (Tr. 39-45). She also testified that due to
arthritis and a back injury, she has trouble lifting 15 or 20 pounds, can stand for only about 30
minutes before it becomes too painful, and can sit for only 10 to 15 minutes before becoming stiff.
(Tr. 46-47).
Plaintiff’s treatment records show that every few months during the alleged disability
period, Plaintiff sought treatment for swelling in her legs or for joint pain in her hands, knees,
ankles, and/or feet; her treatment providers have diagnosed osteoarthritis, lumbar disc
degeneration, and plantar fibromatosis; and they have recommended weight loss, non-narcotic
medications, and orthotic inserts. (Tr. 232-39, 263-68, 277-79, 293-303, 316, 288-91). Plaintiff’s
treatment records also show that she sought regular treatment from a psychiatrist, Howard Ilizicky,
M.D., for symptoms including depression, sleep disturbance, “pissy episodes,” mood swings,
forgetfulness, and racing thoughts; Dr. Ilizicky diagnosed her with bipolar disorder and anxiety
and prescribed various medications, including Wellbutrin, Klonopin, and Prozac. (Tr. 247-57, 27273, 287).
The record contains opinion evidence from three sources regarding Plaintiff’s mental
functioning. On November 8, 2012, consultative examiner David Peaco conducted a psychological
evaluation of Plaintiff. (Tr. 260). He diagnosed Plaintiff with bipolar disorder and assigned a
Global Assessment of Functioning (“GAF”) score of 55, indicating moderate symptoms. (Tr.

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261).2 He opined that Plaintiff was able to understand and remember simple instructions; that her
persistence in completing tasks was mildly impaired; that her concentration was markedly
impaired; that her social functioning was moderately impaired; and that her capacity to function
effectively with the world around her was moderately impaired due to persistent symptoms of
bipolar disorder. (Tr. 262).
On November 19, 2012, state agency psychological consultant Robert Cottone, Ph.D.,
reviewed the record and issued an opinion. (Tr. 56-60). He opined that Plaintiff was markedly
limited in the ability to understand and remember detailed instructions; markedly limited in the
ability to carry out detailed instructions; moderately limited in the ability to maintain attention and
concentration for extended periods; moderately limited in the ability to perform activities within a
schedule, maintain regular attendance, and be punctual within customary tolerances; moderately
limited in the ability to work in coordination with or in proximity to others without being distracted
by them; moderately limited in the ability to complete a normal workday and workweek without
interruptions from psychologically based symptoms and to perform at a consistent pace;
moderately limited in the ability to interact appropriately with the general public; moderately
limited in the ability to accept instructions and respond appropriately to criticism from supervisors;
moderately limited in the ability to get along with coworkers or peers; and moderately limited in

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The Global Assessment of Functioning (“GAF”) Scale is a psychological assessment tool
wherein an examiner is to “[c]onsider psychological, social, and occupational functioning on a
hypothetical continuum of mental health-illness”; it does “not include impairment in functioning
due to physical (or environmental) limitations.” Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV), 32 (4th ed. 1994). A GAF score of 51-60 indicates “[m]oderate symptoms
(e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in
social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers).”
Id.

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the ability to set realistic goals or make plans independently of others. (Tr. 59-60). He concluded
that Plaintiff was capable of engaging in at least simple work tasks and would perform best in a
position that did not include dealing with the public that involved only limited interaction with
peers. (Tr. 60).
On August 15, 2013, Plaintiff’s treating psychiatrist, Dr. Ilizicky, filled out a Medical
Source Statement. (Tr. 274-76). He found that Plaintiff had marked limitations in her ability to
understand and remember complex instructions, to carry out complex instructions, and to make
judgments on complex work-related decisions, but had only mild limitations in the ability to
understand, remember, and carry out simple instructions and to make judgments on simple workrelated decisions. (Tr. 274). Dr. Ilizicky further opined that Plaintiff had marked limitations in her
ability to interact appropriately with the public, supervisors, and co-workers, and to respond
appropriately to usual work situations and changes in a routine work setting. (Tr. 275). He
indicated that these limitations were supported by her severe mood swings, unstable emotions,
periods of extreme mania lasting four to five years, and inability to predict how she will interact
on a day-to-day basis. (Tr. 274-75). He also indicated that at times she has extreme racing thoughts
that make most functioning difficult. (Tr. 275). He stated that she had experienced a gradual
decline in overall function. (Tr. 274).
II.

PROCEDURAL BACKGROUND

On September 13, 2012, Plaintiff applied for DIB, alleging that she had been unable to
work since December 5, 2011, due to bipolar disorder, sleep apnea, and depression. (Tr. 128, 13740, 165). Her application was initially denied, and Plaintiff requested a hearing before an ALJ. (Tr.
64, 76-77). After a hearing, the ALJ issued an unfavorable decision dated July 21, 2014. (Tr. 1122). Plaintiff filed a request for review, and on November 23, 2015, the Appeals Council denied

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Plaintiff’s request for review. (Tr. 1-3). Plaintiff has exhausted all administrative remedies, and
the decision of the ALJ stands as the final decision of the Commissioner of the Social Security
Administration.
III.

STANDARD FOR DETERMINING DISABILITY UNDER THE ACT

To be eligible for benefits under the Social Security Act, a claimant must prove he or she
is disabled. Pearsall v. Massanari, 274 F.3d 1211, 1217 (8th Cir. 2001); Baker v. Sec’y of Health
& Human Servs., 955 F.2d 552, 555 (8th Cir. 1992). The Social Security Act defines as disabled
a person who is unable “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 twelve months.” 42 U.S.C.
§ 423(d)(1)(A); see also Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir. 2010). The impairment must
be “of such severity that [the claimant] is not only unable to do his previous work but cannot,
considering his age, education, and work experience, engage in any other kind of substantial
gainful work which exists in the national economy, regardless of whether such work exists in the
immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he
would be hired if he applied for work.” 42 U.S.C. § 423(d)(2)(A).
To determine whether a claimant is disabled, the Commissioner engages in a five-step
evaluation process. 20 C.F.R. § 404.1520(a); see also McCoy v. Astrue, 648 F.3d 605, 611 (8th
Cir. 2011) (discussing the five-step process). At Step One, the Commissioner determines whether
the claimant is currently engaging in “substantial gainful activity”; if so, then he is not disabled.
20 C.F.R. § 404.1520(a)(4)(i); McCoy, 648 F.3d at 611. At Step Two, the Commissioner
determines whether the claimant has a severe impairment, which is “any impairment or
combination of impairments which significantly limits [the claimant’s] physical or mental ability

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to do basic work activities”; if the claimant does not have a severe impairment, he is not disabled.
20 C.F.R. §§ 404.1520(a)(4)(ii), 404.1520(c); McCoy, 648 F.3d at 611. At Step Three, the
Commissioner evaluates whether the claimant’s impairment meets or equals one of the
impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 (the “listings”). 20 C.F.R. §
404.1520(a)(4)(iii); McCoy, 648 F.3d at 611. If the claimant has such an impairment, the
Commissioner will find the claimant disabled; if not, the Commissioner proceeds with the rest of
the five-step process. 20 C.F.R. §§ 404.1520(d); McCoy, 648 F.3d at 611.
Prior to Step Four, the Commissioner must assess the claimant’s “residual functional
capacity” (“RFC”), which is “the most a claimant can do despite [his or her] limitations.” Moore
v. Astrue, 572 F.3d 520, 523 (8th Cir. 2009) (citing 20 C.F.R. § 404.1545(a)(1)); see also 20 C.F.R.
§ 404.1520(e). At Step Four, the Commissioner determines whether the claimant can return to his
past relevant work, by comparing the claimant’s RFC with the physical and mental demands of
the claimant’s past relevant work. 20 C.F.R. §§ 404.1520(a)(4)(iv), 404.1520(f); McCoy, 648 F.3d
at 611. If the claimant can perform his past relevant work, he is not disabled; if the claimant cannot,
the analysis proceeds to the next step. Id. At Step Five, the Commissioner considers the claimant’s
RFC, age, education, and work experience to determine whether the claimant can make an
adjustment to other work in the national economy; if the claimant cannot make an adjustment to
other work, the claimant will be found disabled. 20 C.F.R. § 404.1520(a)(4)(v); McCoy, 648 F.3d
at 611.
Through Step Four, the burden remains with the claimant to prove that he is disabled.
Moore, 572 F.3d at 523. At Step Five, the burden shifts to the Commissioner to establish that,
given the claimant’s RFC, age, education, and work experience, there are a significant number of

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other jobs in the national economy that the claimant can perform. Id.; Brock v. Astrue, 674 F.3d
1062, 1064 (8th Cir. 2012).
IV.

THE ALJ’S DECISION

Applying the foregoing five-step analysis, the ALJ here found that Plaintiff met the insured
status requirements of the Act through December 31, 2016; that Plaintiff had not engaged in
substantial gainful activity since December 5, 2011, the alleged onset date; that Plaintiff had the
severe impairments of osteoarthritis of the knees, shoulders, ankles, and hands, morbid obesity,
hypertension, bipolar disorder, and anxiety; and that Plaintiff did not have an impairment or
combination of impairments that meets or medically equals the severity of one of the listed
impairments in 20 C.F.R. § 404, Subpart P, Appendix 1. (Tr. 13). The ALJ found that Plaintiff had
the RFC to perform less than the full range of light work as defined in 20 C.F.R. § 404.1567(b).
(Tr. 15). He found that she was unable to operate foot controls; was unable to climb ladders, ropes,
or scaffolds; was unable to kneel, crouch, or crawl; could only occasionally climb ramps or stairs;
was to avoid all extreme vibrations, operational controls of moving machinery, working at
unprotected heights, and use of hazardous machinery; was limited to only simple routine, repetitive
tasks in a low-stress job requiring only simple decision-making; could tolerate only occasional
changes in the work place setting; was to have no interaction with the public or co-workers other
than casual and infrequent contact with co-workers; and was limited to occupations where the
production quotas are based on end-of-day workday measurements only. (Tr. 15). At Step Four,
the ALJ found that Plaintiff was unable to perform any past relevant work. (Tr. 20). However, at
Step Five, the ALJ found that there were other jobs that exist in significant numbers in the national
economy that Plaintiff could perform, including mail sorter, marker II, and routing clerk. (Tr. 21-

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22). The ALJ concluded that Plaintiff was not under a disability, as defined in the Act, from
December 5, 2011, through the date of his decision. (Tr. 22).
V.

DISCUSSION

Giving Plaintiff’s pro se brief a broad construction, Plaintiff appears to be making several
arguments: (1) that her impairments meet or equal Listing 12.04 (Affective Disorders); (2) that the
ALJ gave insufficient weight to the opinion of her treating psychiatrist, Dr. Ilizicky; and (3) that
the ALJ’s RFC determination was not supported by substantial evidence.
A. Standard for Judicial Review
The decision of the Commissioner must be affirmed if it complies with the relevant legal
requirements and is supported by substantial evidence in the record as a whole. See 42 U.S.C.
§§ 405(g); 1383(c)(3); Richardson v. Perales, 402 U.S. 389, 401 (1971); Estes v. Barnhart, 275
F.3d 722, 724 (8th Cir. 2002); Pate-Fires v. Astrue, 564 F.3d 935, 942 (8th Cir. 2009). “Substantial
evidence ‘is less than a preponderance, but enough that a reasonable mind might accept as adequate
to support a conclusion.’” Renstrom v. Astrue, 680 F.3d 1057, 1063 (8th Cir. 2012) (quoting
Moore, 572 F.3d at 522). In determining whether substantial evidence supports the
Commissioner’s decision, the court considers both evidence that supports that decision and
evidence that detracts from that decision. Id. However, the court “‘do[es] not reweigh the evidence
presented to the ALJ, and [it] defer[s] to the ALJ’s determinations regarding the credibility of
testimony, as long as those determinations are supported by good reasons and substantial
evidence.’” Id. at 1064 (quoting Gonzales v. Barnhart, 465 F.3d 890, 894 (8th Cir. 2006)). “‘If,
after reviewing the record, the court finds it is possible to draw two inconsistent positions from the
evidence and one of those positions represents the ALJ’s findings, the court must affirm the ALJ’s

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decision.’” Partee v. Astrue, 638 F.3d 860, 863 (8th Cir. 2011) (quoting Goff v. Barnhart, 421 F.3d
785, 789 (8th Cir. 2005)).
B. The ALJ’s Determination that Plaintiff Did Not Meet or Equal Listing
12.04 (Affective Disorders)
Plaintiff first argues that the ALJ’s Step Three finding was incorrect, because her mental
impairments meet or medically equal Listing 12.04 (Affective Disorders). Plaintiff bears the
burden of showing that she meets all of the specified criteria of a listing. See Boettcher v. Astrue,
652 F.3d 860, 863-64 (8th Cir. 2011) (citing Jones v. Astrue, 619 F.3d 963, 969 (8th Cir. 2010)).
To satisfy the requirements of Listing 12.04, Plaintiff must show either that the “Paragraph A” and
“Paragraph B” criteria of the listing are satisfied, or that the “Paragraph C” criteria are satisfied.
20 C.F.R. pt. 404, Subpt. P, App’x 1, § 12.04. The ALJ found that neither the Paragraph B nor the
Paragraph C criteria were satisfied here. (Tr. 14-15).
The ALJ’s finding that the Paragraph B criteria were not satisfied was supported by
substantial evidence in the record, including Plaintiff’s own testimony and function report and the
opinion of the state agency psychological consultant. To satisfy the Paragraph B criteria, a claimant
must show that her mental disorder results in at least two of the following: (1) marked restriction
of activities of daily living; (2) marked difficulties in maintaining social functioning; (3) marked
difficulties in maintaining concentration, persistence, or pace; or (4) repeated episodes of
decompensation, each of extended duration. 20 C.F.R. pt. 404, Subpt. P, App’x 1, § 12.04. The
ALJ reasonably found that Plaintiff had no restriction in activities of daily living, noting that
Plaintiff stated that she takes her son to school, prepares meals for her son and husband, does
household chores, shops in stores regularly, and uses the computer. (Tr. 14, 43-44, 183-86). The
ALJ reasonably found that Plaintiff had only moderate difficulties in social functioning, noting
that although she does not like being around large groups of people and at times does not agree
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with her family members, she does leave her house to go shopping regularly and to take her son to
school. (Tr. 14, 186-88). The ALJ reasonably found that Plaintiff had only moderate difficulties in
concentration persistence, or pace, noting that although she reported having trouble finishing tasks
and following directions, she was able to answer the questions posed to her at the hearing with
thought and clarity. (Tr. 14). In addition, Plaintiff reported performing activities that require focus,
including regularly preparing meals, cleaning her house, and driving. (Tr. 32, 43-44, 183-85). The
ALJ also reasonably found that Plaintiff had experienced no episodes of decompensation of
extended duration, as the Court has found no evidence in the medical records of any such episodes.
The ALJ’s findings with respect to the Paragraph B criteria were also consistent with the opinion
of state agency psychological consultant Robert Cottone, Ph.D., who opined that Plaintiff had no
limitations in activities of daily living, moderate limitations in social functioning, and moderate
limitations in maintaining concentration, persistence, or pace. (Tr. 57).
The ALJ’s finding that the Paragraph C criteria were not satisfied is also supported by
substantial evidence in the record. (Tr. 14-15). To satisfy the Paragraph C criteria, the claimant
must show the following:
Medically documented history of a chronic affective disorder of at least 2 years’
duration that has caused more than a minimal limitation of ability to do basic work
activities, with symptoms or signs currently attenuated by medication or
psychosocial support, and one of the following:
1. Repeated episodes of decompensation, each of extended duration; or
2. A residual disease process that has resulted in such marginal adjustment
that even a minimal increase in mental demands or change in the
environment would be predicted to cause the individual to
decompensate; or
3. Current history of 1 or more years’ inability to function outside a highly
supportive living arrangement, with an indication of continued need for
such an arrangement.
20 C.F.R. pt. 404, Subpt. P, App’x 1, § 12.04. After review of the record, the Court finds no
indication that Plaintiff had any episodes of decompensation and no indication that such episodes
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would be likely to occur in the event of a minimal increase in mental demands or change in the
environment. The Court also finds nothing in the record to suggest that Plaintiff ever lived in a
highly supportive living arrangement.
In sum, substantial evidence supports the ALJ’s finding that Plaintiff does not satisfy either
the Paragraph B or the Paragraph C criteria for Listing 12.04. Thus, Plaintiff’s first argument is
without merit.
C. The ALJ’s Evaluation of the Opinion of Plaintiff’s Treating Psychiatrist
Plaintiff also appears to argue that the ALJ did not give adequate weight to the opinion of
her treating psychiatrist, Dr. Ilizicky. As discussed above, Dr. Ilizicky opined that Plaintiff had
marked limitations in the ability to understand and carry out complex instructions and to interact
with others; that she had extreme racing thoughts that make most functioning difficult; that she
has severe mood swings, unstable emotions, and periods of extreme mania; that it is difficult to
predict how she will interact on a day-to-day basis; and that she has experienced a gradual decline
in overall function. (Tr. 274-75). The ALJ discussed Dr. Ilizicky’s opinion at length, but ultimately
gave it “little weight.” (Tr. 20).
“A treating physician’s opinion is given controlling weight if it ‘is well-supported by
medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the
other substantial evidence in [a claimant’s] case record.’” Tilley v. Astrue, 580 F.3d 675, 679 (8th
Cir. 2009) (quoting 20 C.F.R. § 404.1527(d)(2)); Shontos v. Barnhart, 328 F.3d 418, 426 (8th Cir.
2003). Although a treating physician’s opinion is generally given controlling weight, it is not
inherently entitled to it. Travis v. Astrue, 477 F.3d 1037, 1041 (8th Cir. 2007); Hacker v. Barnhart,
459 F.3d 934, 937 (8th Cir. 2006). The ALJ may discount a treating physician’s opinion if it is
inconsistent with the physician’s treatment notes or with the record as a whole. Halverson v.

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Astrue, 600 F.3d 922, 929-30 (8th Cir. 2010). It is the ALJ’s duty to resolve conflicts in the
evidence, and the ALJ’s assessment of the opinion evidence should not be disturbed so long as it
falls within the “available zone of choice.” See Hacker, 459 F.3d at 937-938.
The Court first notes that the ALJ did incorporate some of Dr. Ilizicky’s opinions into the
RFC. The ALJ limited Plaintiff to only simple, routine, repetitive tasks, which is consistent with
Dr. Ilizicky’s opinion that Plaintiff had marked limitations in her ability to understand and carry
out complex instructions, but only mild limitations in the ability to understand and carry out simple
instructions. (Tr. 15, 274). The ALJ also limited Plaintiff to jobs involving no interaction with the
public and only casual and infrequent interaction with the public, which at least partially accounted
for Dr. Ilizicky’s opinion that Plaintiff had marked limitations in her ability to interact with others.
(Tr. 15, 275).
The ALJ concluded, however, that Dr. Ilizicky’s opinion was not entitled to controlling
weight, and that conclusion is supported by the record. The ALJ reasonably found that contrary to
Dr. Ilizicky’s statement that Plaintiff “has experienced a gradual decline in overall function,” (Tr.
274), Dr. Ilizicky’s more recent notes support the ALJ’s finding that Plaintiff was improving with
treatment and medication. (Tr. 20). For example, as the ALJ noted, Dr. Ilizicky did not see Plaintiff
at all from August 2012 through March 2013, and when he saw her on April 6, 2013, she was
“relatively stable” and her mood was “better,” despite some problems with focusing and memory.
(Tr. 20, 273). In July 2013, she reported that her treatment was “helping a lot.” (Tr. 272). In
addition, as the ALJ noted, the most recent treatment note in the record (dated October 2013)
indicates that Plaintiff was “better” and was “well—good,” and that Plaintiff should follow up in
three to four months. (Tr. 20, 287). The ALJ reasonably determined that these notes were
inconsistent with the extreme limitations and gradual decline in functioning noted in Dr. Ilizicky’s

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opinion. (Tr. 20). The Court further notes that even Dr. Ilizicky’s earlier treatment notes do not
appear to fully support his opinions. For example, although Dr. Ilizicky opined that Plaintiff had
“extreme racing thoughts that make most functioning difficult,” most of his treatment notes do not
mention racing thoughts or similar symptoms. (Tr. 248-53, 273, 287). Moreover, as discussed
below, the ALJ also considered and reasonably gave significant weight to opinion evidence from
two other experts (a state agency consultant and a consultative examiner) whose opinions were
inconsistent with those offered by Dr. Ilizicky, finding those opinions to be well-supported by the
medical record. (Tr. 18-19).
In sum, the hearing decision makes it clear that the ALJ carefully considered the opinions
offered by Dr. Ilizicky and reasonably found that those opinions should be discounted because
they were inconsistent with Dr. Ilizicky’s own treatment notes and the other evidence in the record.
That finding was supported by substantial evidence, and the Court cannot say that this decision
was outside the “available zone of choice.” See Hacker, 459 F.3d at 937-938.
D. The RFC Determination
Finally, Plaintiff appears to argue that the ALJ erred in assessing her RFC. The ALJ found
that Plaintiff had the capacity to perform less than a full range of light work, and he included in
the RFC numerous specific physical and mental limitations. Plaintiff argues that because of her
physical and mental impairments, she is capable of less than sedentary work.
The Court first considers the ALJ’s physical RFC assessment. The ALJ acknowledged that
Plaintiff has regularly complained of joint pain and/or swelling in her joints. (Tr. 16-17). However,
after analyzing Plaintiff’s medical records in detail, he found that her physical impairments were
not so severe that they would preclude the performance of light work, with some additional
limitations. (Tr. 16-17). That finding is supported by substantial evidence. First, as the ALJ noted,

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objective findings regarding Plaintiff’s impairments were generally mild or normal, including
findings that her leg swelling was mild or that she had no edema (Tr. 238, 265); findings of a
negative straight leg raise test, no motor or sensory deficits, normal or mildly reduced range of
motion, and normal gait (Tr. 265, 288); hand X-ray findings of mild periarticular osteopenia but
no arthritis (Tr. 286); and normal bone density findings. (Tr. 285). Second, as the ALJ noted,
Plaintiff’s doctors recommended only conservative treatments, such as weight loss, non-narcotic
pain medication, and orthotic inserts. (Tr. 17, 278-79, 299, 288, 316). Third, Plaintiff’s treatment
records show that she sought treatment for her physical symptoms only infrequently, often with
gaps of several months or more between appointments (Tr. 238, 263-65, 277-78, 293). The Court
further notes that in Plaintiff’s September 2012 function report, she did not circle “lifting,”
“standing,” “sitting,” or “walking” as being among the items affected by her impairments. (Tr.
188). She also reported in her function report and in her testimony that she performs activities such
as grocery shopping, cleaning, and laundry, though she noted that her husband does the vacuuming
because it hurts her back. (Tr. 43-44, 185-86). In sum, after examining the record as a whole, the
Court finds that the ALJ’s physical RFC determination is supported by substantial evidence.
The Court next considers the mental RFC determination. As a preliminary matter, the Court
notes that the ALJ included several significant mental limitations in the RFC: he restricted her to
simple, routine, repetitive tasks, in a low-stress job, requiring only simple decision making; found
that she could only tolerate occasional changes in the workplace setting; found that she was to
have no interaction with the public and only casual and infrequent contact with co-workers; and
limited her to occupations where production quotas are based on end-of-workday measurements
only. (Tr. 15).

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The Court finds that this assessment was supported by substantial evidence in the record
as a whole. As discussed above, the ALJ reasonably found that the treatment notes from Plaintiff’s
psychiatrist suggested that although she had significant mental symptoms, they improved with
medication and were not so severe that they would preclude all work. (Tr. 17, 20, 247-57, 272-73,
287). The RFC finding also was supported by the opinion of state agency psychological consultant
Robert Cottone, Ph.D., which the ALJ gave great weight because he found it consistent with the
objective medical record. Dr. Cottone reviewed the record and found that Plaintiff had only
moderate limitations in her ability to perform most mental work-related activities, was capable of
engaging in at least simple work tasks, and would perform best in a position that did not include
dealing with the public and having limited interaction with peers. (Tr. 19, 59-60). The RFC finding
is also supported by the opinion of consultative examiner David Peaco, Ph.D., which the ALJ gave
partial weight. (Tr. 19). Dr. Peaco found that Plaintiff had only mild to moderate limitations in
most areas of mental functioning. (Tr. 19, 56-61).
After discussing at length all of the opinion evidence and the medical treatment notes in
the record that related to Plaintiff’s mental functioning, the ALJ properly incorporated into the
RFC those mental impairments and restrictions that he found credible and supported by the record.
The Court acknowledges that the record contains conflicting medical opinion evidence regarding
the extent of Plaintiff’s mental limitations. However, “it is the ALJ’s function to resolve conflicts
among the opinions of various treating and examining physicians.” Renstrom v. Astrue, 680 F.3d
1057, 1065 (8th Cir. 2012) (quoting Pearsall v. Massanari, 274 F.3d 1211, 1219 (8th Cir. 2001)).
The ALJ’s decision fell within the available “zone of choice,” and the Court cannot disturb that
decision merely because it might have reached a different conclusion. See Buckner v. Astrue, 646
F.3d 549, 556 (8th Cir. 2011).

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For all of the above reasons, the Court finds that the RFC was supported by substantial
evidence.
VI.

CONCLUSION

For all of the foregoing reasons, the Court finds the ALJ’s decision is supported by
substantial evidence. Accordingly,
IT IS HEREBY ORDERED, ADJUDGED, AND DECREED that the decision of the
Commissioner of Social Security is AFFIRMED.

SHIRLEY PADMORE MENSAH
UNITED STATES MAGISTRATE JUDGE
Dated this 21st day of March, 2017.

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