Lawrence v. Colvin

Filing 24

MEMORANDUM AND ORDER (See Full Order) IT IS HEREBY ORDERED that that the decision of the Commissioner is affirmed, and Ruby F. Lawrence's complaint is dismissed with prejudice. A separate Judgment is entered herewith. Signed by District Judge Catherine D. Perry on 7/18/17. (EAB)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
RUBY F. LAWRENCE,
Plaintiff,
v.
NANCY A. BERRYHILL, Acting
Commissioner of Social Security,1
Defendant.

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No. 4:16 CV 1433 CDP

MEMORANDUM AND ORDER
Plaintiff Ruby F. Lawrence brings this action under 42 U.S.C. § 405(g)
seeking judicial review of the Commissioner’s final decision denying her claim for
disability insurance benefits (DIB) under Title II of the Social Security Act, 42
U.S.C. §§ 401, et seq. Because the Commissioner’s final decision is supported by
substantial evidence on the record as a whole, I will affirm the decision.
Procedural History
On August 14, 2013, the Social Security Administration denied Lawrence’s
April 2013 application for DIB, in which she claimed she became disabled on May
10, 2012, because of high blood pressure, depression, and arthritis. At Lawrence’s
request, a hearing was held before an administrative law judge (ALJ) on March 11,
1

On January 20, 2017, Nancy A. Berryhill became the Acting Commissioner of Social Security.
Under Fed. R. Civ. P. 25(d), Berryhill is automatically substituted for former Acting
Commissioner Carolyn W. Colvin as defendant in this action.

2015, at which Lawrence and a vocational expert testified. On June 17, 2015, the
ALJ denied Lawrence’s claim for benefits, finding the vocational expert’s
testimony to support a finding that Lawrence could perform work as it exists in
significant numbers in the national economy. On August 16, 2016, the Appeals
Council denied Lawrence’s request for review of the ALJ’s decision. The ALJ’s
decision is thus the final decision of the Commissioner. 42 U.S.C. § 405(g).
In this action for judicial review, Lawrence contends that the ALJ’s decision
is not supported by substantial evidence on the record as a whole. Lawrence
specifically argues that the ALJ erred by according improper weight to certain
opinion evidence in this case, which rendered the residual functional capacity
(RFC) assessment unsupported by substantial evidence. Lawrence asks that I
reverse the Commissioner’s final decision and remand the matter for further
evaluation. For the reasons that follow, I will affirm the Commissioner’s decision.
Medical Records and Other Evidence Before the ALJ
With respect to the medical records and other evidence of record, I adopt
Lawrence’s recitation of facts set forth in her Statement of Uncontroverted
Material Facts (ECF #18) to the extent they are admitted by the Commissioner
(ECF #23-1). I also adopt the additional facts set forth in the Commissioner’s
Statement of Additional Material Facts (ECF #23-2), as they are unrefuted by
Lawrence. Together, these statements provide a fair and accurate description of
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the relevant record before the Court.
Additional specific facts will be discussed as needed to address the parties’
arguments.
Discussion
A.

Legal Standard
To be eligible for disability insurance benefits under the Social Security Act,

Lawrence must prove that she is disabled. Pearsall v. Massanari, 274 F.3d 1211,
1217 (8th Cir. 2001); Baker v. Secretary of Health & Human Servs., 955 F.2d 552,
555 (8th Cir. 1992). The Social Security Act defines disability as the “inability to
engage in any substantial gainful activity by reason of any medically determinable
physical or mental impairment which can be expected to result in death or which
has lasted or can be expected to last for a continuous period of not less than 12
months.” 42 U.S.C. § 423(d)(1)(A). An individual will be declared disabled “only
if [her] physical or mental impairment or impairments are of such severity that
[she] is not only unable to do [her] previous work but cannot, considering [her]
age, education, and work experience, engage in any other kind of substantial
gainful work which exists in the national economy.” 42 U.S.C. § 423(d)(2)(A).
To determine whether a claimant is disabled, the Commissioner engages in a
five-step evaluation process. See 20 C.F.R. § 404.1520; Bowen v. Yuckert, 482
U.S. 137, 140-42 (1987). The Commissioner begins by deciding whether the
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claimant is engaged in substantial gainful activity. If the claimant is working,
disability benefits are denied. Next, the Commissioner decides whether the
claimant has a “severe” impairment or combination of impairments, meaning that
which significantly limits her ability to do basic work activities. If the claimant's
impairment(s) is not severe, then she is not disabled. The Commissioner then
determines whether claimant's impairment(s) meets or equals one of the
impairments listed in 20 C.F.R., Part 404, Subpart P, Appendix 1. If claimant's
impairment(s) is equivalent to one of the listed impairments, she is conclusively
disabled. At the fourth step, the Commissioner establishes whether the claimant
can perform her past relevant work. If so, the claimant is not disabled. Finally, the
Commissioner evaluates various factors to determine whether the claimant is
capable of performing any other work in the economy. If not, the claimant is
declared disabled and becomes entitled to disability benefits.
I must affirm the Commissioner’s decision if it is supported by substantial
evidence on the record as a whole. 42 U.S.C. § 405(g); Richardson v. Perales, 402
U.S. 389, 401 (1971); Estes v. Barnhart, 275 F.3d 722, 724 (8th Cir. 2002).
Substantial evidence is less than a preponderance but enough that a reasonable
person would find it adequate to support the conclusion. Johnson v. Apfel, 240
F.3d 1145, 1147 (8th Cir. 2001). Determining whether there is substantial
evidence requires scrutinizing analysis. Coleman v. Astrue, 498 F.3d 767, 770 (8th
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Cir. 2007).
I must consider evidence that supports the Commissioner’s decision as well
as any evidence that fairly detracts from the decision. McNamara v. Astrue, 590
F.3d 607, 610 (8th Cir. 2010). If, after reviewing the entire record, it is possible to
draw two inconsistent positions and the Commissioner has adopted one of those
positions, I must affirm the Commissioner’s decision. Anderson v. Astrue, 696
F.3d 790, 793 (8th Cir. 2012). I may not reverse the Commissioner’s decision
merely because substantial evidence could also support a contrary outcome.
McNamara, 590 F.3d at 610.
B.

ALJ’s Decision
In her written decision, the ALJ found that Lawrence met the insured status

requirements of the Social Security Act through December 31, 2017, and that she
had not engaged in substantial gainful activity since May 10, 2012, the alleged
onset date of disability. The ALJ found Lawrence’s bilateral osteoarthritis of the
hips, carpal tunnel syndrome, and affective disorder to be severe impairments, but
determined that they did not meet or medically equal a listed impairment in 20
C.F.R. Part 404, Subpart P, Appendix 1. (Tr. 17-18.) The ALJ found Lawrence to
have the RFC to perform light work with the following limitations:
[S]he can occasionally climb ramps and stairs, stoop, kneel and
crouch. She should never climb ladders, ropes or scaffolds, or crawl.
She can frequently user her upper extremities for grasping, handling
and fingering. She should have only occasional exposure to extremes
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of cold. Due to her mental impairment, she is capable of performing
simple, routine tasks in an environment where there is only occasional
contact with supervisors, co-workers and the general public.
(Tr. 19.) The ALJ found Lawrence’s RFC to prevent her from performing her past
relevant work as an assembly line worker or as a returns clerk. (Tr. 25.)
Considering Lawrence’s RFC and her age, education, and work experience,
the ALJ found vocational expert testimony to support a conclusion that Lawrence
could perform other work as it exists in significant numbers in the national
economy, and specifically as a housekeeper/cleaner, night watchman, and mail
room clerk. The ALJ therefore found Lawrence not to be disabled at any time
from May 10, 2012, through the date of the decision. (Tr. 25-26.)
Lawrence claims that this decision is not supported by substantial evidence
because the ALJ accorded improper weight to the opinion evidence of record in
determining her RFC.
C.

Weight Accorded to Opinion Evidence
When evaluating opinion evidence, an ALJ is required to explain in her

decision the weight given to any opinions from treating sources, non-treating
sources, and non-examining sources. See 20 C.F.R. § 404.1527(e)(2)(ii). The
Regulations require that more weight be given to the opinions of treating
physicians than other sources. 20 C.F.R. § 404.1527(c)(2). A treating physician's
assessment of the nature and severity of a claimant's impairments should be given
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controlling weight if the opinion is well supported by medically acceptable clinical
and laboratory diagnostic techniques and is not inconsistent with other substantial
evidence in the record. Id.; see also Forehand v. Barnhart, 364 F.3d 984, 986 (8th
Cir. 2004). This is so because a treating physician has the best opportunity to
observe and evaluate a claimant's condition,
since these sources are likely to be the medical professionals most
able to provide a detailed, longitudinal picture of [a claimant's]
medical impairment(s) and may bring a unique perspective to the
medical evidence that cannot be obtained from the objective medical
findings alone or from reports of individual examinations, such as
consultative examinations or brief hospitalizations.
20 C.F.R. § 404.1527(c)(2).
When a treating physician's opinion is not given controlling weight, the
Commissioner must look to various factors in determining what weight to accord
that and any other medical opinion of record, including the length of the treatment
relationship and the frequency of examination, the nature and extent of the
treatment relationship, whether the physician provides support for her findings,
whether other evidence in the record is consistent with the physician's findings, and
the physician's area of specialty. 20 C.F.R. § 404.1527(c), (e). Inconsistency with
other substantial evidence alone is a sufficient basis upon which an ALJ may
discount a treating physician’s opinion. Goff v. Barnhart, 421 F.3d 785, 790-91
(8th Cir. 2005). The Commissioner “will always give good reasons in [the] notice
of determination or decision for the weight [given to the] treating source's
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opinion.” 20 C.F.R. § 404.1527(c)(2).
In this action, the ALJ considered all of the opinion evidence of record and
accorded varying weights to the medical opinions. Lawrence contends that the
ALJ accorded improper weight to certain of them. For the reasons that follow, the
ALJ did not err.
1.

Single Decision Maker

Lawrence argues that the ALJ erred when she considered the opinion of a
State agency single decision maker (SDM) to be a medical opinion regarding her
physical ability to perform work-related activity. It is undisputed that the opinion
of an SDM is not medical opinion evidence, and an ALJ commits legal error if she
weighs the opinion of an SDM under the rules appropriate for weighing an opinion
from a medical consultant. Dewey v. Astrue, 509 F.3d 447, 449-50 (8th Cir. 2007).
To the extent the ALJ here may have considered the SDM opinion evidence, such
consideration was harmless in the circumstances of this case.
First, the ALJ specifically identified the weight she gave to all of the
medical opinions contained in the record. (Tr. 24-25.) She did not indicate what
weight, if any, she gave to the SDM non-medical opinion. Although the ALJ
acknowledged this opinion’s presence in the record (Tr. 24), I cannot find that she
improperly considered it as medical evidence when she did not discuss or assign
weight to it under the rules governing medical opinion evidence. Nor do the ALJ’s
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conclusions regarding Lawrence’s physical RFC show that she relied on the
SDM’s opinion in making the RFC assessment. Indeed, the ALJ’s physical RFC
assessment imposed postural and manipulative limitations where the SDM found
none. (Compare Tr. 19 with Tr. 72-73.)
Further, the ALJ’s determination of Lawrence’s physical RFC is based upon
a thorough review of the record as a whole. The ALJ did not rely solely or even
heavily on any one assessment. The RFC is consistent with substantial medical
evidence of record, including that obtained from Lawrence’s treating physician,
Dr. Laila Hanna. From April 2013 through December 2014, Lawrence complained
to Dr. Hanna of intermittent hip, back, and wrist pain; but diagnostic tests showed
only mild conditions, and medications resolved the pain. See Turpin v. Colvin, 750
F.3d 989, 993 (8th Cir. 2014) (“We do not consider impairments controllable by
treatment or medication to be disabling.”); Steed v. Astrue, 524 F.3d 872, 875 (8th
Cir. 2008) (diagnosis tempered by the words “mild” or “minimal”). In November
2013 and March 2014, Lawrence reported to Dr. Hanna that she experienced no
pain and the record shows that she was taking no pain medication during that time.
When Lawrence again complained of joint pain in June 2014, musculoskeletal
examination was normal in all respects. The only limitation in motion was
exhibited in September 2014 when Lawrence experienced pain with flexion of the
lumbar spine. Otherwise, all other examinations showed no limitation or muscle
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spasm. Notably, Dr. Hanna never placed any restrictions on Lawrence’s activities.
See Hensley v. Barnhart, 352 F.3d 353, 356 (8th Cir. 2003) (finding of no
disability supported by fact that no functional restrictions were placed on
claimant’s activities).
In addition, Dr. David T. Volarich examined Lawrence in January 2013 in
relation to Lawrence’s work-related repetitive motion injury. At the conclusion of
the exam, Dr. Volarich recommended that Lawrence minimize repetitive
manipulative action with her upper extremities. Dr. Volarich opined, however, that
Lawrence could “handle weights to tolerance” both with her arms extended and
with arms close to her body. (Tr. 436.) The ALJ gave Dr. Volarich’s opinion
some weight (Tr. 25)2 and the physical RFC assessment appears to incorporate
these opined limitations, which, as noted above, are more restrictive than as opined
by the SDM.
The ALJ’s physical RFC assessment is based upon a review of the record as
a whole and is supported by substantial evidence. Nothing in the ALJ’s decision
shows that she considered or weighed the SDM opinion as medical opinion
evidence. Moreover, because the RFC assessment is supported by substantial
evidence even in the absence of the SDM opinion, it does not appear that the ALJ
would have assessed Lawrence’s physical RFC any differently had she not
2

Lawrence does not challenge the weight given to Dr. Volarich’s opinion.
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considered the opinion. Accordingly, to the extent the ALJ may have considered
the SDM opinion, any error in this regard was harmless. See Byes v. Astrue, 687
F.3d 913, 917-18 (8th Cir. 2012). See also Hepp v. Astrue, 511 F.3d 798, 806 (8th
Cir. 2008) (declining to remand for alleged error in opinion when error “had no
bearing on the outcome”) (internal quotation marks omitted).
2.

Treating Psychiatrist, Dr. Alicia Gonzalez

Dr. Alicia Gonzalez was Lawrence’s treating psychiatrist since November
2013. She saw Lawrence on five separate occasions between November 2013 and
December 2014. In April 2015, Dr. Gonzalez submitted a Mental RFC
Assessment wherein she opined that Lawrence experienced moderate and marked
limitations in work performance, social interactions, and adaptation. Finding this
opinion to not be “completely consistent” with the totality of the medical evidence
or with Dr. Gonzalez’s own treatment notes, the ALJ determined to accord only
“some weight” to this opinion. (Tr. 25.) Lawrence argues that this was error,
given that the opinion was rendered by a treating physician and thus was entitled to
significant if not controlling weight. Because the ALJ’s reasons for according only
some weight to Dr. Gonzalez’s opinion are supported by substantial evidence on
the record as a whole, I defer to that determination.
The medical evidence of record shows that Lawrence visited LCSW
Michelle Goldstein in November 2012 with complaints of severe depression.
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Lawrence was not taking any psychotropic medication or receiving any type of
mental health treatment. Her mental status examination showed that she was
anxious, but otherwise the exam was normal. LCSW Goldstein assigned a GAF
score of 55, indicating moderate symptoms. Lawrence visited Goldstein once
more in November 2012 but failed to appear for any additional appointments.
Lawrence’s general physician, Dr. Hanna, prescribed Zoloft in December
2012, but Lawrence had stopped taking the medication by April 2013. Dr. Hanna
then prescribed Wellbutrin, an antidepressant. Lawrence thereafter underwent a
consultative psychological examination with Michael T. Armour, Ph.D. in July
2013, and reported that she was currently taking Buspirone, an anti-anxiety
medication. Based on Lawrence’s historical report of symptoms, Dr. Armour
opined at that time that Lawrence had severe impairments in her ability to interact
socially, adapt to her environment, and sustain concentration and persistence. He
observed, however, that Lawrence’s memory was intact and she had adequate
insight and judgment.
Lawrence began treatment with Dr. Gonzalez four months later, in
November 2013, whereupon she was prescribed Zoloft, Wellbutrin, and lithium.
She was also referred to psychological counseling through Behavioral Health
Services. During counseling, Lawrence’s level of functioning was consistently
found to be mildly to moderately impaired; and, as she progressed through
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treatment with both counseling and medication management with Dr. Gonzalez,
Lawrence’s condition improved. Any setbacks appeared to involve family conflict
and inconsistent use of her medication. In August 2014, less than one year after
beginning regular mental health treatment, Lawrence reported to Dr. Gonzalez that
she experienced no symptoms when taking her medication. Likewise, in
September 2014, she reported to her counselor that she was not as depressed, her
symptoms were manageable, and she wanted to expand her social circles and find
activities outside the home – including taking classes at the YMCA.3 Lawrence
was never observed to have a memory impairment and, indeed, Dr. Gonzalez
affirmatively noted in her treatment records that Lawrence’s memory was intact
and not impaired.
In April 2015, Dr. Gonzalez completed the Mental RFC Assessment
referred to above, opining that Lawrence experienced marked limitations in the
various domains of functioning. Specifically, in the domain of work performance,
Dr. Gonzalez opined that Lawrence was markedly limited in her ability to make
appropriate simple work-related decisions and to understand, remember, and carry
out simple work instructions and procedures. In the domain of social interactions,
3

Other evidence of record, including Lawrence’s testimony, showed Lawrence to care for her
infant grandchild during the relevant period for days or weeks at a time and that she felt happy
and useful with such activity. She sometimes needed help to bathe the child but otherwise had
no problems either physically or mentally with this activity.

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Dr. Gonzalez opined that Lawrence was markedly limited in her ability to interact
appropriately with the general public or customers, to work in coordination with or
in close proximity to others, and to accept instructions and respond appropriately to
criticism from supervisors or co-workers. In the domain of adaptation, Dr.
Gonzalez opined that Lawrence was markedly limited in her ability to respond
appropriately to work-related stressors, to demonstrate reliability in a work setting,
and to sustain extended periods of employment without decompensation from
periodic exacerbation of psychiatric symptoms. Dr. Gonzalez further opined that
Lawrence had moderate limitations in these domains, and specifically, in her
ability to maintain a work schedule and be consistently punctual; to understand,
remember, and carry out detailed instructions; to maintain adequate attention,
concentration, and focus on work duties through a complete work day; to complete
a normal work week without interruptions from psychologically-based symptoms;
and to respond appropriately to routine changes in the work setting. (Tr. 439.)
While the evidence of record shows that Lawrence experienced limitations
on account of her mental impairment, substantial evidence supports the ALJ’s
conclusion that the limitations were not as severe as opined by Dr. Gonzalez in her
Mental RFC Assessment. When taking her medications, Lawrence reported that
she was essentially free of symptoms. Exacerbations occurred when she was not
compliant with or otherwise not taking her medication (see, e.g., Tr. 365 – Dr.
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Gonzalez note, “compliance unstable”). Counseling notes showed continued
improvement during the course of therapy and, with the combination of therapy
and medication management, Lawrence was ready to engage in activities that
required significant mental abilities, such as taking classes. And indeed, Lawrence
successfully engaged in activities requiring such abilities, including the significant
task of providing long term babysitting care for an infant. The ALJ therefore did
not err when she found Dr. Gonzalez’s contrary opinion not to be completely
consistent with other substantial evidence of record. See Cline v. Colvin, 771 F.3d
1098, 1103 (8th Cir. 2014) (ALJ gave little weight to treating physician’s opinion
that was inconsistent with treatment records and objective medical evidence, and
not supported by physician’s own exams and test results).
Nor did the ALJ err when she found Dr. Gonzalez’s opinion not to be
completely consistent with her own treatment notes. As discussed above,
Lawrence showed improvement with medication management and therapy, and Dr.
Gonzalez noted this improvement in her notes. Nowhere in her treatment notes did
Dr. Gonzalez record any observations or findings consistent with the marked
limitations she made in the Mental RFC Assessment. Nor did Dr. Gonzalez
impose any limitations during her treatment of Lawrence. In addition, despite
making explicit findings during treatment that Lawrence had no memory
impairment, Dr. Gonzalez opined in the Mental RFC Assessment that Lawrence
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had moderate to marked limitations in this domain. An ALJ does not err when she
discounts a treating physician's RFC statement where the limitations listed in the
statement stand alone and were never mentioned in the physician's numerous
records of treatment. Cline, 771 F.3d at 1104.
Because the ALJ’s reasons to discount Dr. Gonzalez’s Mental RFC
Assessment are supported by substantial evidence on the record as a whole, the
ALJ did not err in according only some weight to the Assessment. Julin v. Colvin,
826 F.3d 1082, 1088 (8th Cir. 2016) (opinions of treating physicians may be given
limited weight if they are inconsistent with the record) (citing Papesh v. Colvin,
786 F.3d 1126, 1132 (8th Cir. 2015)).
3.

Consulting Psychologist, Dr. Michael T. Armour

As noted above, Lawrence underwent a consultative psychological
examination for disability determinations with Dr. Armour in July 2013. During
this examination, Lawrence reported that she felt sad and had been depressed since
she was seventeen years old but did not see a mental health professional until
November 2012. She also reported that during the time that she worked – which
was in factories and warehouses – she kept to herself and did not talk to anyone at
work. Lawrence also reported that she currently had difficulty reading in that she
could not understand what she reads; but she did not know why she was having
this problem.
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Upon obtaining this and other background information from Lawrence, Dr.
Armour conducted a mental status examination (MSE) during which he noted
Lawrence to be alert and oriented times three. Her speech was slow, flat, and soft.
Her responses to Dr. Armour’s questions were relevant, coherent, and easily
understood. They flowed in a logical, sequential, and goal-directed manner.
Lawrence showed no signs of loose associations, tangential thinking, or
circumstantial thinking. Dr. Armour noted Lawrence’s mood to be sad and her
affect flat. She interacted appropriately but appeared withdrawn. Lawrence
reported intermittent sleep and overeating. She also reported having no energy and
wanting to cry. She currently had no suicidal, homicidal, or assaultive thoughts or
plans but reported a past suicide attempt with sleeping pills. Dr. Armour estimated
Lawrence’s intellectual functioning to be in the low average range. He found
Lawrence’s long-term memory to be grossly intact based upon her ability to give a
detailed social history that was internally consistent. He also found Lawrence’s
immediate memory to be intact and her recent memory to be fair. Lawrence’s
insight and judgment were noted to be adequate. (Tr. 296.) Dr. Armour diagnosed
Lawrence with major depressive disorder, recurrent, severe and assigned a GAF
score of 40-45, indicating serious symptoms. (Tr. 296-97.)
In the various domains of functioning, Dr. Armour opined that Lawrence
was mildly to moderately impaired in her ability to understand and recall
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directions. He based this conclusion on Lawrence’s reported reading difficulty and
her ability to recall words during the MSE. He opined that Lawrence’s current
memory problems appeared to be reflective of her severe depressive symptoms. In
the domain of sustained concentration and persistence, Dr. Armour opined that
Lawrence was severely impaired. He based this conclusion on Lawrence’s
reported long-standing history of depression, her reported worsening of symptoms
and difficulty in motivation and interest, and her reported difficulty in sustaining
concentration and focus. In the domain of social interaction and adaptation, Dr.
Armour opined that Lawrence was severely impaired, again noting Lawrence’s
reported history of depressed mood and isolation, as well as her reported loss of
interest, crying spells, and past suicide attempt.
The ALJ accorded little weight to Dr. Armour’s opinion, finding it to be
inconsistent with the totality of the evidence and also because it was based on only
one examination. Because these legally sufficient reasons are supported by
substantial evidence on the record as a whole, I defer to the ALJ’s determination.
First, as discussed above, the record shows that Lawrence's mental condition
improved with medication and therapy. Indeed, when Lawrence was compliant
with treatment, her depressive symptoms were alleviated. See Brace v. Astrue, 578
F.3d 882, 885-86 (8th Cir. 2009) (evidence showed that, when taken, medication
was successful in controlling mental illness). In addition, Dr. Armour rendered his
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opinion based on a one-time examination that occurred months before Lawrence
began receiving regular and consistent mental health treatment. An ALJ does not
err in discounting opinion evidence where the record shows the claimant not to
have been undergoing effective treatment during the time the physician opined that
claimant's condition was disabling. Id. at 886. See also Kelley v. Callahan, 133
F.3d 583, 589 (8th Cir. 1998) (opinion of consulting physician who examines
claimant once does not generally constitute substantial evidence). Further, I note
that Dr. Armour’s opinion was based largely on Lawrence’s self-reported
symptoms, which the ALJ properly found not entirely credible.4 An ALJ may
discount a medical opinion when it is based on a claimant’s subjective complaints
that the ALJ does not find credible. Julin, 826 F.3d at 1089.
The ALJ did not err in according Dr. Armour’s opinion little weight.
4.

State Agency Psychological Consultant

On August 8, 2013, Marsha Toll, Psy.D., a psychological consultant with
disability determinations, completed a Mental RFC Assessment based upon her

4

Although Lawrence does not challenge the ALJ’s credibility determination here, a review of
the ALJ’s decision nevertheless shows that, in a manner consistent with and as required by
Polaski v. Heckler, 739 F.2d 1320 (8th Cir. 1984) (subsequent history omitted), the ALJ
thoroughly considered the subjective allegations of Lawrence’s disabling symptoms on the basis
of the entire record before her and set out numerous inconsistencies detracting from the
credibility of such allegations. (Tr. 24.) The ALJ may disbelieve subjective complaints where
there are inconsistencies on the record as a whole. Battles v. Sullivan, 902 F.2d 657, 660 (8th
Cir. 1990). The ALJ's credibility determination here is supported by substantial evidence on the
record as a whole, and I am therefore bound by the ALJ's determination. Robinson v. Sullivan,
956 F.2d 836, 841 (8th Cir. 1992).
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review of the evidence of record, including Dr. Armour’s’ consultative
examination. In her Assessment, Dr. Toll opined that Lawrence had no limitations
in understanding and memory but was limited in her ability to sustain
concentration and persistence, to interact socially, and to adapt. Specifically, Dr.
Toll opined that Lawrence was moderately limited in her ability to maintain
attention and concentration for extended periods, to interact appropriately with the
general public, to accept instructions and respond appropriately to criticism from
supervisors, and to respond appropriately to changes in the work setting. (Tr. 7375.) She opined that Lawrence had mild restrictions in activities of daily living,
and moderate difficulties in maintaining social functioning and in maintaining
concentration, persistence, or pace. (Tr. 70-71.) Dr. Toll concluded that with these
limitations, Lawrence could perform simple work away from the public. (Tr. 75.)
In her written decision, the ALJ accorded great weight to Dr. Toll’s opinion,
finding it to be consistent with the totality of the medical evidence of record and
not inconsistent with the medical evidence received at the hearing level. (Tr. 24.)
Lawrence claims that the ALJ erred by relying on and giving greater weight to the
opinion of this non-treating, non-examining source than to opinions rendered by
treating and examining physicians. For the following reasons, the ALJ did not err.
First, I note that the ALJ did not rely solely on Dr. Toll’s opinion when
determining the severity of Lawrence’s mental impairment and assessing her RFC.
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Instead, the ALJ considered the record as a whole, including the opinions of
Lawrence’s treating and examining physicians. See Harvey v. Barnhart, 368 F.3d
1013, 1016 (8th Cir. 2004) (ALJ properly relied on non-examining physician’s
opinion as one part of the record which, as a whole, provided substantial support
for the opinion’s findings). Further, given that the opinion of examining
psychologist Dr. Armour was inconsistent with the record, and the opinion of
treating psychiatrist Dr. Gonzalez was inconsistent with the record and her own
treatment notes, it was not improper for the ALJ to consider the opinion of this
State agency psychological consultant. See Hacker v. Barnhart, 459 F.3d 934, 939
(8th Cir. 2006) (ALJ “clearly authorized” to consider opinion of non-examining
agency physician where treating physicians’ opinions were inconsistent with
substantial evidence in the record). Moreover, because Dr. Toll is a State agency
psychological consultant, she is considered to be a highly qualified expert in Social
Security disability evaluation, and the ALJ properly considered her findings as
opinion evidence. 20 C.F.R. § 404.1527(e)(2)(i).
Notably, Lawrence does not argue that Dr. Toll’s opinion is inconsistent
with the record. Instead, she argues only that the opinion should not be given
greater weight than those of treating or examining physicians. But an ALJ is
permitted to give greater weight to a State agency medical opinion where, as here,
other opinions are inconsistent with the evidence of record. Hacker, 459 F.3d at
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939. As discussed earlier, within a year after Lawrence began receiving regular
counseling and medication management, her depressive symptoms waned, she
regularly engaged in the substantial and responsible activity of caring for her infant
granddaughter, and she sought out more socially and mentally demanding
activities. During that period, Lawrence’s counselor considered Lawrence’s level
of functioning to be mildly to moderately impaired. (Tr. 344-55.) Lawrence’s
functioning worsened when she ran out of medication (see Tr. 305, 334-43); but
with continued counseling and a reestablished medication regimen, Lawrence
improved and reported having no symptoms, improved focus, and renewed
motivation (Tr. 371, 393). Dr. Toll’s RFC assessment is consistent with this
substantial evidence of record. The opinions of Lawrence’s treating and
examining physicians are not.
It is the duty of the Commissioner to resolve conflicts in the medical opinion
evidence, Renstrom v. Astrue, 680 F.3d 1057, 1065 (8th Cir. 2012); and, when
assessing a claimant’s RFC, an ALJ need not credit the entirety of a medical
opinion or directly correlate a medical opinion to the RFC. Martise v. Astrue, 641
F.3d 909, 927 (8th Cir. 2011). Instead, the ALJ must determine a claimant's RFC
based on her review of the record as a whole. The ALJ here evaluated all of the
medical opinion evidence of record and adequately explained her reasons for the
weight given this evidence. For the reasons set out above, substantial evidence on
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the record as whole supports the weight accorded by the ALJ to the medical
opinion evidence in this case.
Conclusion
When reviewing an adverse decision by the Commissioner, the Court’s task
is to determine whether the decision is supported by substantial evidence on the
record as a whole. Davis v. Apfel, 239 F.3d 962, 966 (8th Cir. 2001). “Substantial
evidence is defined to include such relevant evidence as a reasonable mind would
find adequate to support the Commissioner's conclusion.” Id. Where substantial
evidence supports the Commissioner's decision, this Court may not reverse the
decision merely because substantial evidence exists in the record that would have
supported a contrary outcome or because another court could have decided the case
differently. Id.; see also Buckner v. Astrue, 646 F.3d 549, 556 (8th Cir. 2011);
Gowell v. Apfel, 242 F.3d 793, 796 (8th Cir. 2001).
For the reasons set out above, a reasonable mind can find the evidence of
record sufficient to support the ALJ’s determination that Lawrence was not
disabled. Because substantial evidence on the record as a whole supports the
ALJ’s decision, it must be affirmed. Davis, 239 F.3d at 966. I may not reverse the
decision merely because substantial evidence exists that may support a contrary
outcome.
Accordingly,
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IT IS HEREBY ORDERED that that the decision of the Commissioner is
affirmed, and Ruby F. Lawrence’s complaint is dismissed with prejudice.
A separate Judgment is entered herewith.

____________________________________
CATHERINE D. PERRY
UNITED STATES DISTRICT JUDGE

Dated this 18th day of July, 2017.

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