Fuller v. Berryhill

Filing 20

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 9/13/2018. (NEP)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
LAURA FULLER,
Plaintiff,
v.

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

)
)
)
)
)
)
)
)
)
)
)
)

Case No. 4:17-CV-01913-SPM

MEMORANDUM AND ORDER
This is an action under 42 U.S.C. §§ 405(g) for judicial review of the final decision of
Defendant Nancy A. Berryhill, the Acting Commissioner of Social Security, denying the
application of Plaintiff Laura Fuller (“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 consented to
the jurisdiction of the undersigned magistrate judge pursuant to 28 U.S.C. § 636(c). (Doc. 4).
Because I find substantial evidence to support the decision denying benefits, I will affirm the
Commissioner’s denial of Plaintiff’s application.
I.

BACKGROUND

On July 30, 2013, Plaintiff applied for DIB, alleging a disability onset date of January 25,
2013, and asserting disability due to congestive heart failure, coronary artery disease, heart
attack, neuropathy, migraine, depression, anxiety, and high cholesterol. (Tr. 62-63). Her
application was initially denied on October 22, 2013. (Tr. 70-71). Plaintiff filed a Request for
Hearing by Administrative Law Judge (“ALJ”). (Tr. 92). On February 25, 2016, following a

hearing at which Plaintiff, who was represented by counsel testified, the ALJ found Plaintiff was
not under a “disability” as defined in the Act. (Tr. 25). Plaintiff filed a Request for Review of
Hearing Decision with the Social Security Administration’s Appeals Council. (Tr. 141). On June
21, 2017, the SSA’s Appeals Council issued a decision adopting most of the ALJ’s decision but
changing Plaintiff’s date last insured. (Tr. 6-7). 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.
With regard to Plaintiff’s testimony, work history, and medical records, the Court accepts
the facts as provided by the parties in their respective statements of facts and responses. The
Court will address specific facts related to the issues raised by Plaintiff as needed in the
discussion below.
II. 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 12 months.” 42
U.S.C. §§ 423(d)(1)(A); 1382c(a)(3)(A); see also Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir.
2010). The impairment must be “of such severity that he 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

2

him, or whether he would be hired if he applied for work.” 42 U.S.C. §§ 423(d)(2)(A);
1382c(a)(3)(B).
To determine whether a claimant is disabled, the Commissioner engages in a five-step
evaluation process. 20 C.F.R. §§ 404.1520(a), 416.920(a); 1 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 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);

1

All references throughout this opinion are to the version of the regulations that was in effect as of the date of the
ALJ’s decision.

3

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), 416.920(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
other jobs in the national economy that the claimant can perform. Id.; Brock v. Astrue, 674 F.3d
1062, 1064 (8th Cir. 2012).
III. THE ALJ’S DECISION
Applying the foregoing five-step analysis, the ALJ here found that Plaintiff has not
engaged in substantial gainful activity since the alleged onset date, January 25, 2013; that
Plaintiff has the severe impairment of status post coronary artery bypass grafting times three; and
that Plaintiff does 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. 17). The ALJ found that Plaintiff has the RFC to perform light work as defined
in 20 C.F.R. §§ 404.1567(b), except that she cannot climb ladders, ropes, or scaffolds, and she
cannot work at unprotected, dangerous heights, or around unprotected, dangerous machinery.
(Tr. 20). The ALJ found that Plaintiff is able to perform a range of light work, including her past
relevant work as a daycare worker (Dictionary of Occupational Titles (“DOT”) No. 359.677-018,
light exertion level, semi-skilled), and denied benefits at step four of the sequential analysis. (Tr.

4

24-25). The ALJ concluded that Plaintiff had not been under a disability, as defined in the Act,
from January 25, 2013, the alleged onset date, through June 30, 2015, the date she was last
insured. (Tr. 25). The SSA’s Appeals Council adopted most of the ALJ’s decision, except for
finding that Plaintiff’s date last insured was June 30, 2016, rather than June 30, 2015, as had
been mistakenly stated by the ALJ.
IV. 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); Pate-Fires v. Astrue,
564 F.3d 935, 942 (8th Cir. 2009); Estes v. Barnhart, 275 F.3d 722, 724 (8th Cir. 2002).
“Substantial evidence ‘is less than a preponderance, but enough that a reasonable mind might
accept it 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 decision.” Partee v. Astrue, 638 F.3d 860, 863 (8th Cir.
2011) (quoting Goff v. Barnhart, 421 F.3d 785, 789 (8th Cir. 2005)).

5

V. DISCUSSION
Plaintiff argues that the ALJ reached a flawed RFC assessment because the ALJ failed to
give “good, specific” reasons for not fully crediting the medical opinions of record, and thus, the
RFC is not supported by substantial evidence and is contrary to law. (Doc. 12 at 2). Plaintiff
further asserts that because the ALJ discounted the two medical opinions of record, there was no
medical opinion to support the RFC, and the ALJ instead improperly relied on his own lay
analysis of the raw medical data. The Commissioner argues that the ALJ properly gave little
weight to the medical opinions because they were unsupported by the record, and that rather than
impermissibly relying on his own lay analysis of the data, he properly based the RFC on the
record as a whole.
A claimant’s RFC is “the most a claimant can do despite her limitations.” Moore, 572
F.3d at 523 (citing 20 C.F.R. § 404.1545(a)(1)). It is the ALJ’s responsibility to determine a
claimant’s RFC “based on all relevant, credible evidence in the record, ‘including the medical
records, observations of treating physicians and others, and an individual’s own description of
his limitations.’” Tucker v. Barnhart, 363 F.3d 781, 783 (8th Cir. 2004) (quoting McKinney v.
Apfel, 228 F.3d 860, 863 (8th Cir. 2000)).
In this case, the ALJ conducted a review of Plaintiff’s testimony and medical records,
conducted an analysis of the consistency of her subjective complaints with the evidence of
record, analyzed each of the medical opinions in the record, and made the following findings
regarding Plaintiff’s RFC:
After careful consideration of the entire record, the undersigned finds that through
the date last insured, the claimant has the residual functional capacity to perform
light work as defined in 20 CFR 404.1567(b) that includes being limited to no
climbing of ladders, ropes or scaffolds, and no working at unprotected, dangerous
heights or around unprotected machinery.

6

(Tr. 20). In reaching his decision, the ALJ reviewed, and ultimately discounted, an opinion
rendered by Plaintiff’s treating physician, Dr. Mehmet Cilingiroglu (“Dr. Cilingiroglu”), and
similarly considered and discounted the opinion of a consultative examiner, Dr. A. Rashid
Qureshi (“Dr. Qureshi”).
A. ALJ’s Evaluation of Medical Opinion of Dr. Cilingiroglu
Plaintiff first argues that remand is required because the ALJ erred in discounting the
opinion of her cardiologist, Dr. Mehmet Cilingiroglu. (Doc. 33 at 7-8). Plaintiff alleges that
under 20 C.F.R. § 404.1527(c),2 the ALJ should have accorded “controlling weight,” to the
opinion of her treating physician and that after choosing to assign less weight, he should have,
but failed to, offer “good” and “specific” reasons for the weight given. “Generally, [a] treating
physician's opinion is due controlling weight if that opinion is well-supported by medically
acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other
substantial evidence in the record.” Brown v. Barnhart, 390 F.3d 535, 540 (8th Cir. 2004).
However, “[a]n ALJ may discount or even disregard the opinion of a treating physician where
other medical assessments are supported by better or more thorough medical evidence, or where
a treating physician renders inconsistent opinions that undermine the credibility of such
opinions.” Skelton v. Colvin, No. 1:14-CV-143-RLW, 2016 WL 320129, at *8 (E.D. Mo. Jan. 26,
2016) (quoting Goff v. Barnhart, 421 F.3d 785, 790 (8th Cir.2005) (internal quotation omitted);
Wildman v. Astrue, 596 F.3d 959, 964 (8th Cir. 2010). A physicians’ opinion that a claimant is
incapable of gainful employment is often not entitled to significant weight. Bradley v. Astrue,
528 F.3d 1113, 1116 (8th Cir. 2008).

2

These regulations apply to claims filed before March 27, 2017, including the claim at issue in this case. For
claims filed after March 27, 2017, the rule that a treating source opinion is entitled to controlling weight has been
eliminated. See 20 C.F.R. § 404.1520c.

7

The Court finds that the ALJ gave good reasons, supported by substantial evidence, for
partially discounting the opinion of Dr. Cilingiroglu. The ALJ was clear in that he gave little
weight to Dr. Cilingiroglu’s opinion because it conflicted with the contemporaneous medical
records as well as other evidence in the record as a whole. See 20 C.F.R. § 404.1527(c)(3) (“The
more a medical source presents relevant evidence to support an opinion, particularly medical
signs and laboratory findings, the more weight we will give that opinion.”). A medical source
opinion that is inconsistent with the objective medical evidence cannot be afforded controlling
weight. See 20 C.F.R. § 404.1527(c)(2) (to be afforded controlling weight, a medical opinion
must be consistent with the record as a whole, and must be supported by the objective medical
evidence).
Dr. Cilingiroglu, in his opinion dated September 12, 2013, opined that Plaintiff could lift
and carry up to twenty pounds frequently, could frequently crouch and squat, could stand or walk
for up to three hours a day and sit for three hours a day, required the option to transition from
sitting or standing at will, and that her symptoms of headache, chest pain, numbness in her left
upper extremity, and dizziness would cause frequent interference with her attention and
concentration, and that she had no ability to tolerate even a low stress job. (Tr. 398-400).
However, as the ALJ noted, Plaintiff’s treatment records do not support this opinion. Dr.
Cilingiroglu was Plaintiff’s treating cardiologist between January and May of 2013, and Plaintiff
attended three doctor’s appointments with him during that time period. The first of those visits
was on January 30, 2013, which was after the alleged onset date of January 25, 2013, but prior to
the date when Plaintiff had heart surgery on February 19, 2013. Dr. Cilingiroglu’s treatment
notes from that appointment indicated that Plaintiff reported having no severe headaches, no
fainting or near fainting episodes, and was experiencing only occasional dizziness and chest

8

discomfort. (Tr. 297-98). At Plaintiff’s second appointment with Dr. Cilingiroglu on March 30,
2013, his treatment notes indicated that Plaintiff reported experiencing no dizziness, no shortness
of breath, no muscle pain or weakness, and that her heart rate and rhythm were normal, she was
alert and oriented, and appeared to be doing well with no significant chest pain. (Tr. 290-91). At
Plaintiff’s third and final appointment with Dr. Cilingiroglu on May 22, 2013, his treatment
notes indicated that Plaintiff reported that she was feeling well with only occasional dizziness,
that she exhibited no chest pain, no motor weakness, no fainting or near fainting, and was alert
and oriented. (Tr. 287-88). The ALJ reasonably concluded that Dr. Cilingiroglu’s opinion was
inconsistent with the record as a whole, and gave good reasons for assigning it “little weight.”
(Tr. 23). See Whitman v. Colvin, 762 F.3d 701, 706 (8th Cir. 2014). As noted supra, a treating
physician’s opinion is entitled to controlling weight only if it is not inconsistent with other
substantial evidence in the record. 20 C.F.R. § 404.1527(c)(2). “An ALJ may discount a
treating source opinion that is unsupported by treatment notes.” Aguiniga v. Colvin, 833 F.3d
896, 902 (8th Cir. 2016) (internal citation omitted).
Additionally, Dr. Cilingiroglu’s opinion itself contains puzzling internal inconsistencies.
For example, while Dr. Cilingiroglu opined that Plaintiff’s symptoms of dizziness, fatigue, and
pain were serious enough that they would render her incapable of even low stress jobs, and that
any job would cause Plaintiff to suffer from “more stress,” (Tr. 400) he also opined that
Plaintiff’s prognosis was “good” (Tr. 399) and that her impairments would “never” cause her to
be absent from work. (Tr. 400). This too supports the ALJ’s decision to discount Dr.
Cilingiroglu’s opinon. See Thomas v. Berryhill, 881 F.3d 672, 675 (8th Cir. 2018) (the
Commissioner may discount or disregard the opinion of a treating physician when it is internally
inconsistent).

9

Additionally, as the ALJ noted, treatment records of other health care providers are
likewise inconsistent with Dr. Cilingiroglu’s opinion. For example, on May 31, 2013, Plaintiff
saw a neurologist, Dr. Abdel-Rahman Saleh, to whom she had been referred because of her
reports of occasional dizziness and numbness in her left arm. At that appointment, the treatment
records indicate that the physical examination of Plaintiff revealed that she had normal muscle
bulk, tone, and strength in all extremities, no vertigo, normal coordination and gait, no numbness
in her upper extremities, and normal attention span and concentration. (Tr. 363). At a subsequent
visit with Dr. Saleh on June 25, 2013, the treatment records reveal similar findings, and also
indicate that she had undergone an MRI and a NCS/EMG with negative neurological findings.
(Tr. 359). The treatment records from her third and final visit with Dr. Saleh on July 16, 2013,
indicate substantially analogous findings. (Tr. 357-58).
The Court also agrees with the ALJ's determination that Plaintiff’s testimony and
statements regarding her activities of daily living were inconsistent with the limitations imposed
in Dr. Cilingiroglu’s opinion. (Tr. 20, 22). See Whitman, 762 F.3d at 706 (ALJ reasonably stated
he discounted physician's opinion because the opinion was “more restrictive than self-reported
activities”); see also Craig v. Apfel, 212 F.3d 433, 436 (8th Cir. 2000) (fact that claimant
continues to engage in many normal daily living activities supports finding of ability to work).
For example, in her Function Report, Plaintiff indicated that she goes grocery shopping every
week, takes care of household chores daily, including meal preparation, laundry, and light
housework, that she has no trouble with self-care such as bathing and getting dressed, that she
can lift twenty pounds, and that she cares for her pet cat and changes its litter. (Tr. 184-86). Also
in her Function Report, Plaintiff indicated that she did not have trouble sitting, standing, walking,
climbing stairs, bending, understanding and following instructions, completing tasks, getting

10

along with others, or with her memory. (Tr. 189). Additionally, at her hearing, Plaintiff testified
that the only pain management therapy she had been undergoing was sometimes taking an overthe-counter acetaminophen painkiller as needed for headache, and that it helped alleviate her
pain. (Tr. 40). See Benskin v. Bowen, 830 F.2d 878, 884 (8th Cir. 1987) (disabling pain not
indicated when claimant merely took Advil and aspirin to relieve pain). In summation, the
Court’s review shows there was substantial evidence in the record to support the ALJ’s decision
to assign little weight to Dr. Cilingiroglu’s opinion.
B. ALJ’s Evaluation of Medical Opinion of Dr. Qureshi
Plaintiff similarly argues that the ALJ erred in discounting the opinion of Dr. Qureshi,
who performed a consultative evaluation of Plaintiff on September 29, 2015. (Tr. 476).

Dr.

Qureshi opined that Plaintiff had the ability to frequently lift and carry up to 10 pounds, but that
she should never lift more than that; that she could sit three hours total in an eight hour work
day; stand two hours total in an eight hour work day; walk thirty minutes in an eight hour work
day, could occasionally use her hands in reaching, handling, fingering, feeling, pushing or
pulling bilaterally; could not operate foot controls; could not climb laders or scaffolds; could not
balance; could occasionally climb ramps or stairs, stop, kneel, crouch or crawl; required quiet
library-like conditions; and should not work at unprotected heights or with moving mechanical
parts. (Tr. 482-87). When a medical opinion is not from a treating source, the ALJ considers the
following factors in determining the weight to be given to the opinion:

“(1) examining

relationship, (2) treating relationship, (3) supportability, (4) consistency, (5) specialization, and
(6) other factors.” Wiese v. Astrue, 552 F.3d 728, 731 (8th Cir. 2009).
The ALJ gave Dr. Qureshi’s opinion “little weight,” and stated that he did so because his
opinion was not consistent with objective medical evidence and the “treatment records show

11

little to support” the opinion. (Tr. 23). Plaintiff argues that the ALJ erred in giving little weight to
Dr. Qureshi’s opinion because he failed to provide good and specific reasons for discrediting the
opinion. However, this contention is refuted by a review of the ALJ’s decision. The ALJ noted
that Dr. Qureshi, in his consultative examination report, stated that Plaintiff was doing well from
a cardiac standpoint, that the neurological studies that had been done did not show any
significant issues, and that her reported symptoms were unrelated to her cardiac system. (Tr. 2324). The ALJ thoroughly considered and discussed Plaintiff’s treatment history, the objective
medical evidence, her functional restrictions, and her activities of daily living, noting numerous
examples of examination findings and other evidence that contradicted the opinions of both Dr.
Qureshi and Dr. Cilingiroglu. (Tr. 18-24). I discussed these inconsistencies at length when
reviewing the ALJ’s evaluation of Dr. Cilingiroglu’s opinion, supra, and will not repeat that
discussion here.
The Court finds that the ALJ gave good reasons, supported by substantial evidence, for
partially discounting the opinion of Dr. Qureshi. The ALJ was clear in that he gave little weight
to Dr. Qureshi’s opinion because it conflicted with the contemporaneous medical records as well
as other evidence in the record as a whole. See 20 C.F.R. § 404.1527(c)(3) (“The more a medical
source presents relevant evidence to support an opinion, particularly medical signs and
laboratory findings, the more weight we will give that opinion.”). The Court concludes that the
ALJ properly applied the factors for evaluating a consultative examiner’s opinion, and the weight
he assigned to Dr. Qureshi’s opinion is supported by substantial evidence in the record as a
whole.

12

C. Substantial Evidence Supports the RFC
Plaintiff also argues that reversal is warranted because no medical opinion of record
supports the ALJ’s physical RFC determination, as the ALJ rejected the opinions of both Dr.
Cilingiroglu and Dr. Qureshi, and failed to then take proper steps to correct this alleged
deficiency of record, such as ordering further consultative examinations, or re-contacting
Plaintiff’s treating or consultative examiners for clarification of their opinions. (Doc. 12 at 15).
Plaintiff further asserts that the ALJ, rather than expanding the record in the manner suggested
by Plaintiff, instead impermissibly relied on his own lay analysis of the raw medical data in
determining her RFC. Id. Consequently, Plaintiff argues, the RFC is not supported by substantial
evidence. Id. The Court disagrees. “Because a claimant’s RFC is a medical question, an ALJ’s
assessment of it must be supported by some medical evidence of the claimant’s ability to
function in the workplace.” Cox v. Astrue, 495 F.3d 614, 619 (8th Cir. 2007). However, there is
no requirement that an RFC finding be supported by a specific medical opinion. See Perks v.
Astrue, 687 F.3d 1086, 1092-93 (8th Cir. 2012). Furthermore, “[e]ven though the RFC
assessment draws from medical sources for support, it is ultimately an administrative
determination reserved to the Commissioner.” Cox, 495 F.3d at 619-20.
Here, the ALJ, first of all, did not reject the opinions of Drs. Cilingiroglu and Qureshi.
He merely assigned “little weight” to them. (Tr. 22). See Kirby v. Astrue, 500 F.3d 705, 709
(8th Cir. 2007) (considering a physician’s opinion and deciding to give “little weight” to it is not
equivalent to rejecting the opinion). Thus, they remained opinions of record as to Plaintiff’s
physical functional limitations, and the ALJ properly considered them and discounted the weight
accorded them because he found them to be inconsistent with the evidence in the record as a
whole. Further, there were two other opinions of record considered by the ALJ. Two different

13

state agency medical consultants, Dr. Charles Friedman and Dr. Rita Allbright, opined in
October and December of 2013 that Plaintiff could perform the full range of medium work. (Tr.
68-71; 79-82). The ALJ considered their opinions and accorded them “great weight.” (Tr. 24).
See 20 C.F.R. §§ 404.1527(f)(2)(i); Kamann v. Colvin, 721 F.3d 945, 951 (8th Cir. 2013) (state
agency medical consultants are considered to be highly qualified experts in Social Security
disability assessment, and the ALJ must consider their findings). However, after considering the
entire record, the ALJ found Plaintiff more limited than opined by the medical consultants, and
assigned a more restrictive RFC, acknowledging Plaintiff’s symptoms as established by the
medical record.
The ALJ also conducted an independent review of the medical evidence. As to the record
as a whole, apart from opinion evidence, it contained extensive treatment records which provided
more than adequate medical evidence of Plaintiff’s ability to function in the workplace. (Exs.
2F, 3F, 4F, 5F, 6F, 7F, 8F, 9F). In the absence of other medical opinion evidence, “medical
records prepared by the most relevant treating physicians [can] provide affirmative medical
evidence supporting the ALJ’s residual functional capacity findings.” Johnson v. Astrue, 628
F.3d 991, 995 (8th Cir. 2011). With the medical record adequately developed, the ALJ was not
required to order an additional consultative examination or otherwise obtain additional medical
evidence, and the failure to do so is not cause for reversal. See KKC ex rel. Stoner v. Colvin, 818
F.3d 364, 372-73 (8th Cir. 2016); 20 C.F.R. § 404.1519a(b); see also Martise v. Astrue, 641 F.3d
909, 926-27 (8th Cir. 2011) (The ALJ is required to order further medical examinations only if
the existing medical record does not provide sufficient evidence to determine whether the
claimant is disabled).

14

Finally, The Court finds that the ALJ did not improperly substitute his lay opinion of the
raw medical data. As discussed above, the record contained sufficient medical evidence to
determine and support the RFC. It is the ALJ’s function to weigh conflicting evidence and to
resolve inconsistencies in the medical evidence, as well as disagreements among physicians. In
this case, the ALJ fulfilled that function, and based the RFC on the record as a whole, as opposed
to impermissibly substituting his own lay analysis. See Tindell v. Barnhart, 444 F.3d 1002, 1007
(8th Cir. 2006) (“The ALJ included all of Tindell’s credible limitations in his RFC assessment,
and the ALJ’s conclusions are supported by substantial evidence in the record.”).
V. CONCLUSION
Having reviewed the entire record, the Court finds the ALJ properly considered and
weighed the medical opinion evidence in the record. The Court also finds the ALJ considered the
medical evidence as a whole, and made a proper RFC determination based on a fully and fairly
developed record. Consequently, for all of the foregoing reasons, the Court determines that 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 13th day of September, 2018.

15