Walker v. Saul

Filing 18

MEMORANDUM AND ORDER IT IS HEREBY ORDERED that the decision of the Acting Commissioner is AFFIRMED. A separate Judgment shall accompany this Memorandum and Order. Signed by District Judge Matthew T. Schelp on 8/2/2022. (KXS)

Case: 4:21-cv-00185-MTS Doc. #: 18 Filed: 08/02/22 Page: 1 of 17 PageID #: 2227

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
MARTHA WALKER,

)
)
Plaintiff,
)
)
vs.
)
)
KILOLO KIJAKAZI, Acting Commissioner of )
the Social Security Administration,
)
)
Defendant.
)

No. 4:21-cv-185-MTS

MEMORANDUM AND ORDER
This matter is before the Court for review of the final decision of Defendant, the Acting
Commissioner of Social Security, denying the application of Martha Walker (“Plaintiff”) for
Disability Insurance Benefits (“DIB”). 1 In September 2018, Plaintiff applied for DIB under Title
II of the Social Security Act, 42 U.S.C. §§ 401–434 (the “Act”). Plaintiff alleged disability due to
heart attack with stents, stroke with extreme dizziness, mini strokes with anemia and brain lesions,
diverticulitis and colitis, back surgery, neck surgery, cardiac spasms, high blood pressure, and
asthma. (Tr. 194). In July 2020, following a hearing, an Administrative Law Judge (“ALJ”) issued
his decision finding that Plaintiff was not disabled as defined in the Act. (Tr. 10–21). For the
following reasons, the Court affirms.
I.

Evidence before the ALJ
A. Overview of Relevant Facts and Medical History
Although Plaintiff’s medical records show several health impairments, the Court will

discuss just those pertinent to its analysis in this Memorandum and Order. As pertinent here,

Section 1383(c)(3) of the Act provides for judicial review of the SSA Commissioner’s “final decision.” After the
ALJ concluded Plaintiff was not disabled under the Act, (Tr. 10–21), the Appeals Council denied Plaintiff’s request
for review, (Tr. 1–4); thus, the ALJ’s decision stands as the Commissioner’s final decision.
1

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Plaintiff alleges disability, with an alleged onset date of October 28, 2017, due to a history of
strokes and heart attacks and its effects of fatigue, dizziness, and difficulty handling stress.
Prior to her alleged onset date of disability, Plaintiff underwent angioplasty of the first
major coronary artery in 1996 with stenting in 1998 and 2016. (Tr. 829–30). Plaintiff has a history
of coronary stent placement and cerebral vascular accidents (strokes) with “no residual deficits.”
(Tr. 452). In February 2017, Plaintiff’s cardiologist, Dr. Christopher Speidel, noted Plaintiff’s
chest pain symptoms were often precipitated by emotional stress. (Tr. 817–18). In May 2017,
Plaintiff saw Dr. John McGarry for generalized weakness on her right side after allegedly
experiencing nausea, chest pain, and loss of fine motor skills. (Tr. 312). Dr. McGarry diagnosed
Plaintiff with orthostatic hypotension, dizziness, and giddiness and advised her to go to the
emergency room (“ER”). (Tr. 314). There, Plaintiff experienced transient neurological events but
exhibited normal sensation, reflexes, gait, and a neurological examination; aside from elevated
blood pressure, her overall workup was negative. (Tr. 310, 309, 323–24, 458, 461, 465, 408).
In June 2017, Dr. Ashutosh Patel, Plaintiff’s physician, did not place any limitations on her
ability to work. (Tr. 1294). Electrodiagnostic testing performed showed mild median and ulnar
nerve entrapment involving the sensory fibers. (Tr. 630). There were no signs of myopathy. In
July 2017, Dr. Patel completed a form stating that Plaintiff did not have any cognitive deficits that
would prevent her from returning to work. (Tr. 1293–94, 1835). In August 2017, Plaintiff reported
to Dr. Patel that she was experiencing fatigue, weakness, increased dizziness, trouble
concentrating, and that her job as a financial consultant was “very stressful.” (Tr. 1127). On
September 1, 2017, Dr. Patel released her for return to work. (Tr. 1291). Plaintiff stated that she
felt better in September 2017. (Tr. 1123).

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In October 2017, the month Plaintiff alleged disablement, she saw Dr. Tariq Alam for
continued muscle weakness, fatigue, and intermittent blurred vision. (Tr. 622). Dr. Alam noted
that Plaintiff’s alleged fatigue and weakness were “stable” and comprehensive workups for
neuromuscular disorders were negative. Plaintiff’s neurological examination was normal, and she
continued to demonstrate full muscle strength in all four extremities and a normal gait. (Tr. 625).
That month, she also reported that she may change jobs because her work was too stressful but
that her dizziness was improving. (Tr. 1119).
In January 2018, Plaintiff reported fatigue for “many months,” and Dr. Bhaskara Gadi
subsequently diagnosed Plaintiff with chronic anemia. 2 (Tr. 1015). In May 2018, Plaintiff saw
Dr. Jeffrey Calvin for episodes of weakness, stating that the episodes had worsened over the
previous two to five years. (Tr. 641–42). Plaintiff also reported episodes of dizziness and blurred
vision that lasted up to a few hours, three times per week. 3 She reported periodic coronary
vasospasms and episodes of generalized weakness triggered by physical activity, such as
yardwork. She stated that her weakness episodes also resolved once she got a good night of sleep.
Plaintiff’s neurological examination was normal, and she continued to demonstrate a normal gait
and full muscle strength in her upper and lower extremities. Plaintiff was diagnosed with episodic
muscle weakness, ataxia, and vertigo and it was recommended that she follow up with an ear, nose,
and throat specialist. (Tr. 644, 652, 674).
In November 2018, Plaintiff visited the ER for chest pain, but her workup was negative
during a two-day hospitalization. (Tr. 752, 755). There, Dr. Rachel Brown diagnosed her with
unspecified chest pain and near syncope based on her report that she felt like she might pass out.

In September 2018, Plaintiff’s diagnosis changed to normocytic anemia and neutropenia. (Tr. 1029).
Though Plaintiff had been complaining of intermittent blurring of her vision, it was noted in October 2018 that her
vision was correctable to 20/25 and 20/30. (Tr. 742). The notes state that her prescription was updated, and she was
advised to return in one year. (Tr. id.).

2
3

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(Tr. 757). It is noted that Plaintiff reported being under a lot of stress and had a history of coronary
vasospasms. (Tr. 759). Dr. Patel diagnosed Plaintiff with chest pain, hypertension, coronary artery
spasm, chronic pain, reflux disease, hyperlipidemia, and major depression. (Tr. 766). Dr.
Azamuddin Khaja also diagnosed Plaintiff with coronary artery disease with possible Prinzmetal
angina. (Tr. 771). Imaging of her chest was negative as well as her cardiac workup; Plaintiff’s
symptoms were attributed to hypotension triggered by her nitroglycerin. (Tr. 764, 771, 776, 781).
Her hypertension, chronic pain, and gastroesophageal reflux disease (“GERD”) were noted to be
stable and well-controlled with medication. (Tr. 766).
In January 2019, Plaintiff’s angina was stable, her lungs clear, and she denied any chest
pain. (Tr. 1094, 1097–98). In February 2019, Plaintiff was noted to have normal range of motion
in her spine. (Tr. 1897). In March 2019, Plaintiff denied any joint or muscle pains. (Tr. 1195).
Her physical and mental status examinations were unremarkable. Her lungs were clear, her heart
rhythm was regular, and her gait was normal. In April 2019, she reported her “legs hurt all the
time and [are] worse when sitting.” (Tr. 1236). Dr. Khaja diagnosed Plaintiff with atherosclerosis
of native arteries of extremities with intermittent claudication in her bilateral legs. (Tr. 1237).
That month, Plaintiff denied dizziness. (Tr. 1892).
In July 2019, Plaintiff visited the ER complaining of chest pain, but her cardiac workup
remained negative. (Tr. 1379, 1384–85). Dr. Souheil Khoukaz noted that Plaintiff’s New York
Heart Association (“NYHA”) classification was “II,” indicating minimal functional restrictions. 4
(Tr. 1542). Plaintiff’s loop recorder had not shown signs of arrhythmia, and she had not had any
transient ischemic attacks (“TIA”) since 2017. (Tr. 1549). In addition, her hypertension was noted
to be well-controlled. (Tr. Id.).
This classification states that this is a cardiac patient with only a “slight” limitation of physical activity, but with no
symptoms at rest.

4

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In the Fall of 2019, Plaintiff reported malaise, fatigue, and dizziness. (Tr. 1550–51, 1556).
At other times during this period, she denied dizziness. (Tr. 1325, 1881). Plaintiff’s dizziness
appeared to be related to low blood pressure. (Tr. Id.). In October 2019, Plaintiff reported
generally feeling “fine” and denied any chest pain, dizziness, headaches, shortness of breath,
weakness, numbness, or difficulty urinating. (Tr. 1324–25). Plaintiff demonstrated full muscle
strength and tone, ambulated normally, and exhibited a normal mental status examination.
In December 2019, Plaintiff visited the ER exhibiting chest pain, left sided facial droop,
numbness, weakness, and speech difficulty. (Tr. 1441, 1443–44). Plaintiff was diagnosed with a
minor cerebral vascular accident (stroke) with a stroke score of “3.” (Tr. 1451, 1488, 1495). Other
workups were negative, including a mental status examination. (Tr. 1449, 1460). Plaintiff’s
symptoms improved on their own, and Plaintiff was discharged in stable condition on day two.
(Tr. 1453, 1482). Follow-up notes stated that imaging of her brain showed no recent infarctions.
(Tr. 1807). Her coordination and gait remained normal. (Tr. 1813).
In January 2020, Plaintiff did not report fatigue, muscle weakness, or word finding
difficulty to Dr. Gadi. (Tr. 1848). Plaintiff exhibited a normal gait and had normal mental status
examinations from January to May 2020. (Tr. 1848, 1918, 1931–32, 1943–44). In May 2020,
Plaintiff denied light headedness, made no mention of dizziness, and reported she was “feeling
fine.” (Tr. 1931, 1943). In June 2020, Plaintiff visited the ER with another episode of facial droop,
but her workup was essentially negative, and her mental status examination was normal. (Tr. 1958,
1962, 1965, 1969, 1974). She was discharged the following day in “improving” condition. (Tr.
1984).

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B. Medical Opinion Evidence
In May 2019, Dr. Steven Akeson, a State agency consultative psychologist, evaluated
Plaintiff’s medical history. (Tr. 71). Dr. Akeson found that Plaintiff had only work-related mental
function limitations in just one area—ability to maintain concentration, persistence, and pace—
and found that limitation to be “mild” in severity. Dr. Akeson concluded that Plaintiff did not have
any severe mental impairments.
In June 2019, Dr. Michael O’Day, a State agency consultive physician, evaluated
Plaintiff’s medical history. (Tr. 73–78). Dr. O’Day opined that Plaintiff is capable of performing
“light work” but should avoid environmental hazards and only occasionally climb. (Tr. 73).
C. Hearing Testimony
At the May 2020 hearing, Plaintiff testified that she had to take a leave from work after she
had a heart attack and experienced weakness and facial drooping. (Tr. 34). She alleged that she
could not work, in part, due to “a lot of dizziness.” (Tr. 35). Furthermore, Plaintiff testified that
she took meclizine for the dizziness up to three times per day and that it made her “sleepy.” (Tr.
35–36). When describing the effect of the meclizine on her work, Plaintiff stated that it made her
“extremely tired and not on point.” Plaintiff testified that, on most days, she laid down a couple
times due to “weak spells” and dizziness. (Tr. 40, 47). She claimed that she was frequently dizzy
to the point where she would stagger, and that when she was drowsy and dizzy, she could not
handle paperwork for clients or use a computer. (Tr. 35–36). Plaintiff alleged that she had only
driven a car five or six times over the previous two years from the hearing date due to her “spells,”
and that she could not vacuum or perform yard work. (Tr. 42). However, she was able to dust,
clean dishes, and cook. Due to her symptoms of fatigue and dizziness, Plaintiff also stated that

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she no longer served as a board member for the Chamber of Commerce and was not able to spend
much time with her grandchildren. (Tr. 43).
II.

Standard of Review and Legal Framework
To be eligible for disability benefits, Plaintiff must prove that she is disabled under the Act.

Baker v. Sec’y of Health & Hum. Servs., 955 F.2d 552, 555 (8th Cir. 1992). The Act defines a
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). A claimant will be found to have a disability “only if [her] physical or mental impairment
or impairments are of such severity that he is not only unable to do [her] previous work” but also
unable to “engage in any other kind of substantial gainful work which exists in the national
economy.” Id. at § 423(d)(2)(A).
The Social Security Administration has established a five-step sequential process for
determining whether a claimant is disabled. 20 C.F.R. § 404.1520(a). Steps 1–3 require the
claimant to prove: (1) she is not currently engaged in substantial gainful activity; (2) she suffers
from a severe impairment; and (3) her disability meets or equals a listed impairment. Id. at
§§ 404.1520(a)–(d). If the claimant does not suffer from a listed impairment or its equivalent, the
analysis proceeds to Steps 4 and 5. Id. at § 416.920(e). At this point, the ALJ assesses the
claimant’s residual functioning capacity (“RFC”), “which is the most a claimant can do despite
her limitations.” Moore v. Astrue, 572 F.3d 520, 523 (8th Cir. 2009); 20 C.F.R. § 404.1545. The
Eighth Circuit has noted that the ALJ must determine a claimant’s RFC based on all relevant,
credible evidence in the record, including medical records, the observations of treating physicians
and others, and the claimant’s own description of her symptoms and limitations. Goff v. Barnhart,

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421 F.3d 785, 793 (8th Cir. 2005). At Step 4, the ALJ must determine whether the claimant can
return to her past relevant work by comparing the RFC with the physical demands of the claimant’s
past relevant work. 20 C.F.R. § 404.1520(f). If the ALJ finds at Step 4 that a claimant can return
to past relevant work, the claimant is not disabled. Id.
The Court’s role on judicial review is to decide whether the ALJ’s determination is
supported by “substantial evidence” on the record as a whole. Wagner v. Astrue, 499 F.3d 842,
848 (8th Cir. 2007). Substantial evidence is “such relevant evidence as a reasonable mind might
accept as adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019).
In determining whether the evidence is substantial, the Court considers evidence that both supports
and detracts from the ALJ’s decision. Cox v. Astrue, 495 F.3d 614, 617 (8th Cir. 2007). Even if
substantial evidence would have supported an opposite decision or the reviewing court might have
reached a different conclusion had it been the finder of fact, the Court must affirm the
Commissioner’s decision if the record contains substantial evidence to support it. See McNamara
v. Astrue, 590 F.3d 607, 610 (8th Cir. 2010) (explaining that if substantial evidence supports the
Commissioner’s decision, a court “may not reverse, even if inconsistent conclusions may be drawn
from the evidence, and even if [the court] may have reached a different outcome”); Locher v.
Sullivan, 968 F.2d 725, 727 (8th Cir. 1992) (explaining a court may not reverse merely because
substantial evidence would have supported an opposite decision).

The Eighth Circuit has

emphasized repeatedly that a court’s review of an ALJ’s disability determination is intended to be
narrow and that courts should “defer heavily to the findings and conclusions of the Social Security
Administration.”

Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir. 2010) (quoting Howard v.

Massanari, 255 F.3d 577, 581 (8th Cir. 2001)). Despite this deferential stance, a district court’s
review must be “more than an examination of the record for the existence of substantial evidence

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in support of the Commissioner’s decision,” Beckley v. Apfel, 152 F.3d 1056, 1059 (8th Cir. 1998),
and not merely a “rubber stamp.” Cooper v. Sullivan, 919 F.2d 1317, 1320 (8th Cir. 1990).
III.

The ALJ’s Decision
The ALJ’s decision in this matter conforms to the five-step process outlined above. At

Step 1, the ALJ found Plaintiff did not perform substantial gainful activity (“SGA”) during the
alleged period of disability. (Tr. 12). At Step 2, the ALJ found Plaintiff had the following severe
impairments: degenerative disc disease of the cervical and lumbar spine, status-post cervical and
lumbar fusions, degenerative joint disease, status-post total knee arthroplasty (joint replacement),
coronary artery disease, and status-post multiple transient ischemic attacks. (Tr. 13). At Step 3,
the ALJ found Plaintiff did not have an impairment or combination of impairments that met the
severity of a statutorily recognized impairment. (Tr. 13–14). As such, the ALJ found Plaintiff had
the RFC to perform “light work,” as defined in 20 C.F.R. § 404.1567(b), with some exertional and
environmental limitations. (Tr. 14). Plaintiff should never climb a ladder, rope, or scaffold but
can occasionally stoop, kneel, crouch, and crawl. Furthermore, Plaintiff must avoid vibration and
hazards, such as working at unprotected heights and proximity to unprotected dangerous
machinery. At Step 4, the ALJ found Plaintiff could perform her past relevant work as a financial
advisor/broker. (Tr. 20). Consequently, the ALJ concluded Plaintiff is not disabled under the Act.
(Tr. 21).
IV.

Discussion
The specific issues in this case are: (1) whether substantial evidence supports the ALJ’s

RFC finding based on the ALJ’s consideration of Plaintiff’s subjective complaints of symptoms
and (2) whether the ALJ properly found that Plaintiff could perform her past work as a financial
advisor.

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1. The ALJ’s RFC Finding Is Supported By Substantial Evidence And The ALJ
Properly Considered Plaintiff’s Symptoms
Plaintiff argues that the ALJ’s RFC finding did not account for the effects of her fatigue,
dizziness, and difficulty in handling stress in the RFC. See Doc. [11] at 3. A plain reading of the
ALJ’s decision, however, shows that the ALJ did consider each of these three symptoms, (Tr. 1520), but instead, concluded that Plaintiff’s statements concerning the intensity, persistence, and
limiting effects of those symptoms were not entirely consistent with the evidence in the record.
(Tr. 16).
The ALJ must consider a claimant’s subjective complaints of symptoms when determining
a claimant’s RFC. See Goff, 421 F.3d at 790. The ALJ cannot discount subjective complaints
solely because they are unsupported by objective medical evidence. Halverson v. Astrue, 600 F.3d
922, 931–32 (8th Cir. 2010) (citing Mouser, 545 F.3d at 638). However, the ALJ may discount
complaints if they are inconsistent with the evidence as a whole. Chaney v. Colvin, 812 F.3d 672,
677–78 (8th Cir. 2016); Partee v. Astrue, 638 F.3d 860, 865 (8th Cir. 2011) (“The ALJ may discredit
a claimant based on inconsistencies in the evidence.”). When analyzing a claimant’s credibility, the

ALJ considers various factors. See 20 C.F.R. § 404.1529; Polaski v. Heckler, 739 F.2d 1320 (8th
Cir. 1984) (explaining the factors are (1) the claimant’s daily activities; (2) the duration, intensity,
and frequency of pain; (3) the precipitating and aggravating factors; (4) the dosage, effectiveness,
and side effects of medication; and (5) any functional restrictions); see also Forte v. Barnhart, 377
F.3d 892, 895 (8th Cir. 2004) (“[L]ack of objective medical evidence is a factor an ALJ may
consider.”). The “credibility of a claimant’s subjective testimony is primarily for the ALJ to
decide, not the courts.” Pearsall v. Massanari, 274 F.3d 1211, 1218 (8th Cir. 2001); Johnson v.
Apfel, 240 F.3d 1145, 1147 (8th Cir. 2001) (“ALJ is in the best position to determine the
credibility.”). The Court defers to the ALJ’s credibility determination if it is supported by good
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reasons and substantial evidence. Bryant v. Colvin, 861 F.3d 779, 782–83 (8th Cir. 2017). After
engaging in a proper credibility analysis, the ALJ then limits his “RFC determination to only the
impairments and limitations he found credible based on his evaluation of the entire record.”
McGeorge v. Barnhart, 321 F.3d 766, 769 (8th Cir. 2003); see also Goff, 421 F.3d at 793
(explaining the RFC is based on all “credible evidence”).
As applied here, the ALJ found Plaintiff’s complaints of fatigue, dizziness, and difficulty
in handling stress not as limiting as Plaintiff suggested, such that the ALJ did not include specific
limitations from those symptoms in the RFC. The ALJ properly made this determination based
on several factors.
First, the ALJ considered the lack of objective medical evidence, including imaging and
physical examinations, to corroborate the severity of Plaintiff’s allegedly disabling symptoms. See
Forte v. Barnhart, 377 F.3d 892, 895 (8th Cir. 2004) (explaining the lack of objective medical
evidence to support a claimant’s complaints is relevant in assessing credibility); 20 C.F.R.
§ 404.1529(c)(2) (considering objective medical evidence in evaluating intensity and persistence
of symptoms). Despite Plaintiff’s complaints to several physicians of ongoing episodes of fatigue,
muscle weakness, dizziness, 5 and blurred vision, 6 (Tr. 35, 622, 641, 1008, 1324, 1545, 1550–51,
1556, 1568, 1827, 1881), the ALJ noted several of Plaintiff’s “normal” examinations from 2017
to 2020 showing normal muscle strength, range of motion, and gait as well as normal neurological

The ALJ also properly considered inconsistencies between Plaintiff’s allegations and the record relating to dizziness.
Bryant v. Colvin, 861 F.3d 779, 783 (8th Cir. 2017). Despite Plaintiff’s allegations of disabling dizziness, the ALJ
noted that the record showed numerous instances where Plaintiff expressly denied feeling dizzy or omitted mentioning
any dizziness, which undermines her allegations that it was severe enough to be disabling. (Tr. 622, 625, 1094, 1119,
1325, 1881, 1931, 1943); see Julin v. Colvin, 826 F.3d 1082, 1087 (8th Cir. 2016) (“Inconsistent or contradictory
statements made to physicians are a proper basis to discount Plaintiff’s credibility.”). The ALJ also considered
Plaintiff’s normal neurological examinations despite complaints of dizziness three times a week. (Tr. 17, 641–42).
6
As for Plaintiff’s complaints of blurred vision, the ALJ found that there was nothing convincing in the record to
suggest that she has any significant visual difficulties. (Tr. 17). It was noted in October 2018 that Plaintiff’s vision
was correctable to 20/25 and 20/30. (Tr. 742). According to the notes, her prescription was updated, and she was
advised to return in one year. (Tr. Id.).
5

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examinations, including no signs of myopathy. The ALJ also noted negative results on bone scans,
normal results from stress testing, and negative comprehensive workups for neuromuscular
disorders and fatigue, despite being diagnosed with anemia and neutropenia. (Tr. 18, 622). The
ALJ may discount subjective complaints that are “undermined” by the medical evidence.
Schwandt v. Berryhill, 926 F.3d 1004, 1012 (8th Cir. 2019); Gonzales v. Barnhart, 465 F.3d 890,
895 (8th Cir. 2006) (holding the ALJ may find a claimant’s subjective pain complaints not credible
considering objective medical evidence to the contrary).
Likewise, the ALJ found objective medical evidence failed to support Plaintiff’s alleged
mental limitations from stress and concentration difficulties. The ALJ noted Plaintiff’s numerous
“unremarkable” neurologic and psychological examinations, with no mention of concentration
problems or significant limitations related to stress. 7 The ALJ also noted normal results from
stress testing. The ALJ properly considered such evidence. Goff, 421 F.3d at 792 (holding proper
the ALJ’s consideration of unremarkable or mild objective medical findings as one factor in
assessing credibility of subjective complaints); 20 C.F.R. § 404.1529(a) (requiring “medical signs
and laboratory findings” that corroborate a claimant’s allegations in order to establish the presence
of disabling symptoms).
Specifically, as to Plaintiff’s cardiac condition, the ALJ found that objective medical
evidence did not support a finding that her condition rendered her disabled. For example, the ALJ
noted several of Plaintiff’s visits to the emergency room for chest pain that rendered negative
cardiac workups as well as negative imaging of her chest. Despite surgery in the 90s and
subsequent stenting, the ALJ found Plaintiff’s overall cardiac condition appeared to be “generally
stable over the years.” (Tr. 17).
Importantly, the ALJ noted that the only support Plaintiff provided for her argument about stress and lack of
concentration appears to be her own complaints.

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Second, the ALJ considered medical opinions assessing Plaintiff’s physical and mental
working capability, and Plaintiff does not contest the validity of those opinions. 20 C.F.R.
§ 404.1529(b)–(c) (evaluating symptoms with medical opinions). Two state agency consultants
opined that Plaintiff was not disabled and the ALJ properly relied on these medical opinions. See
Masterson v. Barnhart, 363 F.3d 731, 737–39 (8th Cir. 2004) (holding the ALJ properly relied on
the assessments of non-examining physicians in determining the claimant’s physical RFC);
Kamann v. Colvin, 721 F3d 945, 951 (8th Cir. 2013) (finding a state agency psychologist’s opinion
supported ALJ’s finding that claimant could work despite his mental impairments); 20 C.F.R.
§ 404.1513a (explaining evidence from Federal or State agency medical or psychological
consultants must be considered because those doctors are “highly qualified and experts in Social
Security disability evaluation”). Dr. Akeson reviewed Plaintiff’s record and found that Plaintiff
had only mild limitation in concentration, persistence, or pace, and no other limitations. (Tr. 71).
Dr. O’Day found that Plaintiff could perform “light work,” (Tr. 73), with some limitations, (Tr.
74–75), those of which are incorporated into the RFC.
Plaintiff did not submit any medical opinions that provide a contrary conclusion of
disablement. Caviness v. Massanari, 250 F.3d 603, 605 (8th Cir. 2001) (explaining that a claimant
bears the burden of showing a severe impairment significantly limits her ability to perform basic
work activities). To the contrary, the record shows medical notes and opinions from Plaintiff’s
own treating physicians that do not support disablement. Notably, Plaintiff’s physician, Dr. Patel
released her for return to work as a financial advisor right before her alleged onset date of
disability, in September 2017. (Tr. 18, 1291). Dr. Patel completed a form stating that Plaintiff did
not have any cognitive deficits that would prevent her from returning to work. (Tr. 18, 1294,
1835). Despite care from several physicians and a long and extensive medical history, of which

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over 2,400 pages of medical evidence were submitted to the ALJ, no provider reported disabling
impairments nor imposed greater limitations on Plaintiff than the ALJ. Tennant v. Apfel, 224 F.3d
869, 871 (8th Cir. 2000) (discrediting Plaintiff’s subjective complaints based on absence of
physician-ordered limitations and the lack of objective medical evidence is proper).
Third, the ALJ discussed precipitating and aggravating factors. See 20 C.F.R. § 404.1529;
Polaski, 739 F.2d at 1322. Plaintiff reported that her periodic coronary vasospasms and episodes
of generalized weakness were triggered by physical activity and stress, including emotional stress.
(Tr. 242, 248, 641, 818). Plaintiff also reported that her weakness episodes alleviated once she got
a good night of sleep. (Tr. 641). The ALJ also noted that many of Plaintiff’s conditions (e.g.:
hypertension, chronic pain, and GERD) were stable and well controlled with medication. (Tr. 17,
766); see Guilliams, 393 F.3d at 802 (“Evidence of effective medication resulting in relief, for
example, may diminish the credibility of a claimant’s complaints.”) (citing Rose v. Apfel, 181 F.3d
943, 944 (8th Cir. 1999)).
Fourth, the ALJ considered that Plaintiff also worked for many years with her cardiac
condition, (Tr. 17), and the lack of objective medical evidence that showed any deterioration in
her condition. See Goff, 421 F.3d at 792–93. Finally, the ALJ considered Plaintiff’s daily activities
and found that such “level of independent function [was] inconsistent with a finding of disability.”
(Tr. 18); Andrews, 791 F.3d at 929 (discounting claimant’s credibility based on daily activities and
appearance at the hearing); Blakeman v. Astrue, 509 F.3d 878, 882 (8th Cir. 2007) (“Many workers
suffer from fatigue but are able to work, just as many people suffer from chronic pain that is not
disabling.”).
Defendant argues that Plaintiff’s overall RFC argument does little more than rehash the
evidence that the ALJ already considered. See Doc. [16] at 8 (citing Doc. [11] at 3–6). The Court

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agrees; it is the Court’s responsibility to determine whether substantial evidence supports the ALJ’s
decision, not to re-evaluate the evidence. See Cox, 495 F.3d at 617 (“It is not the role of this court
to reweigh the evidence presented to the ALJ or to try the issue in this case de novo.”) (internal
citations omitted). This is especially true in a case such as this one, where Plaintiff relies so heavily
on subjective allegations to support her disability claim. Juszczyk v. Astrue, 542 F.3d 626, 632
(8th Cir. 2008) (deferring to the ALJ’s credibility determination where the objective medical
evidence did not support the claimant’s testimony as to the depth and severity of his impairments).
Contrary to Plaintiff’s argument, remand is not justified by the mere fact that Plaintiff pointed to
“some evidence in the record [that] could lend support to a more restrictive RFC finding.” See
Twyford v. Comm’r, Soc. Sec. Admin., 929 F.3d 512, 518 (8th Cir. 2019). While Plaintiff disagrees
with the ALJ’s analysis of how her symptoms limited her ability to work, the question before the
Court is whether substantial evidence supports the ALJ’s decision, not whether substantial
evidence could lead to a different outcome. McNamara, 590 F.3d at 610. For the reasons
discussed above, the Court finds that the ALJ’s credibility analysis and RFC is supported by
substantial evidence.
2. The ALJ’s Work Finding Is Supported By Substantial Evidence
The Court considers whether the ALJ’s determination that Plaintiff can return to her past
relevant work, and is therefore not disabled, is supported by substantial evidence. During a
hearing, the ALJ asked the vocational expert (“VE”) a hypothetical whether an individual with
Plaintiff’s RFC could perform work as a financial advisor/broker. (Tr. 58–59). Based on the
ALJ’s hypothetical and RFC assessment, the VE testified that Plaintiff could perform her past
relevant work as a financial advisor/broker. (Tr. id.). Based on the VE’s testimony, the ALJ
concluded that Plaintiff could perform her past work. (Tr. 21); Wagner, 499 F.3d at 853–54

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(explaining the Eighth Circuit considers VE testimony at Step 4); Blackburn v. Colvin, 761 F.3d
853, 870 (8th Cir. 2014) (upholding Commissioner’s decision of non-disablement based on
evidence that VE stated the claimant could return to past work); 20 C.F.R. § 404.1560(b)(2) (“We
may use the services of vocational experts or vocational specialists . . . to obtain evidence we need
to help us determine whether you can do your past relevant work, given your residual functional
capacity.”).
Plaintiff argues that she would be precluded from her past work had the ALJ asked the VE
a hypothetical limiting Plaintiff to simple/repetitive work or taking unscheduled breaks during a
workday. The ALJ found “no persuasive support in the record for a finding of any additional
limitations” in the RFC finding such as the ones suggested by the claimant’s representative. (Tr.
21). Plaintiff “fails to recognize that the ALJ’s determination regarding her RFC was influenced
by [her] determination that [Plaintiff’s] allegations were not credible.” Wildman, 596 F.3d at 969.
The ALJ incorporated all of Plaintiff’s impairments that she found credible into the RFC and then
similarly limited the hypothetical as such.

A “hypothetical is sufficient if it includes the

impairments supported by substantial evidence and found credible by the ALJ.” Blackburn, 761
F.3d at 860–61; Smith v. Colvin, 756 F.3d 621, 627 (8th Cir. 2014) (“a hypothetical need only
include impairments that the ALJ finds credible”). Because the ALJ properly evaluated the record,
formulated Plaintiff’s RFC, and relied upon testimony from a vocational expert, the Court finds
that the ALJ’s Step 4 finding is supported by substantial evidence.
CONCLUSION
For the foregoing reasons, the Court finds that the ALJ’s determination is supported by
substantial evidence on the record as a whole.

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Accordingly,
IT IS HEREBY ORDERED that the decision of the Acting Commissioner is
AFFIRMED.
A separate Judgment shall accompany this Memorandum and Order.
Dated this 2nd day of August 2022

MATTHEW T. SCHELP
UNITED STATES DISTRICT JUDGE

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