Jularic v. O'Malley
Filing
22
MEMORANDUM OPINION - IT IS HEREBY ORDERED, ADJUDGED, AND DECREED that the decision of the Commissioner of Social Security is AFFIRMED. IT IS FURTHER ORDERED that the Clerk shall reflect on the docket that Michelle King, Acting Commissioner of Social Security, is the proper defendant pursuant to Fed. R. Civ. P. 25(d). Signed by Magistrate Judge Joseph S. Dueker on 1/29/2025. (JMP)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
MIRJANA Z. J.,
Plaintiff,
v.
MICHELLE KING,
Acting Commissioner of Social Security,
Defendant.
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Case No. 4:24-cv-00285-JSD
MEMORANDUM OPINION
This is an action under 42 U.S.C. §§ 405(g) and 1383(c)(3) for judicial review of the final
decision of Defendant Michelle King, Acting Commissioner of Social Security1 (the
“Commissioner”) denying the application of Plaintiff Marjana Z. J. (“Plaintiff”) for Disability
Insurance Benefits (“DIB”) under Title II of the Social Security Act, 42 U.S.C. §§ 401 et seq., and
for Supplemental Security Income (“SSI”) under Title XVI of the Social Security Act, 42 U.S.C.
§§ 1381, et seq. (the “Act”). The parties consented to the jurisdiction of the undersigned magistrate
judge pursuant to 28 U.S.C. § 636(c). (ECF No. 6). Because this Court finds the decision denying
benefits was supported by substantial evidence, this Court affirms the Commissioner’s denial of
Plaintiff’s application.
Michelle King became the Acting Commissioner of Social Security on November 30, 2024. Pursuant to Rule 25(d)
of the Federal Rules of Civil Procedure, Michelle King should be substituted, therefore, for Martin J. O’Malley as the
defendant in this suit. No further action need be taken to continue this suit by reason of the last sentence of section
205(g) of the Social Security Act, 42 U.S.C. § 405(g).
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FACTUAL BACKGROUND
At her hearing, Plaintiff testified to the following: She has not worked since 2016 (Tr. 52).
She has lower back pain that shoot down her legs and cannot stand for more than ten minutes, walk
for more than five minutes, or sit for more than 30 minutes. (Tr. 55-57). She has tried aquatic
therapy, injections, and decompression surgery to treat her back pain. (Tr. 60-61). She cannot bend,
kneel, crouch, or pick up something heavier than a bottle of soda. (Tr. 58). She cannot shower by
herself because of the twisting motion required. (Tr. 49). She cannot wash dishes for more than
five minutes because her legs start to shake, has trouble getting off the toilet, and struggles to put
on pants and shoes (Tr. 49). She has home healthcare who comes every day to help her cook, do
laundry and shower. (Tr. 49-50). She is afraid to go up and down the stairs by herself because she
has almost fallen. (Tr. 50-51). She started developing headaches in 2018 or 2016, before she had
her accident, and gets them every two or three days, lasting between several hours to two or three
days with a recovery period. (Tr. 58-59).
Since 2016, Plaintiff has been receiving treatment for: back pain and has been treated with
physical therapy and injections; her mental health and has been treated with counseling and various
medications; and her headaches which had been treated with medication.
The record contains opinion evidence from Kulsoom Junaid, M.D. (“Dr. Junaid”), her
treating physician, Kate Reis, N.P., her treating primary care nurse, Yasuo Ishida, M.D. (“Dr.
Ishida”), a consultative examiner, and Michael O’Day, D.O. (“Dr. O’Day”), a state agency medical
consultant.
The Court accepts the facts as set forth in the parties’ respective statements of fact and
responses. The Court will cite to specific portions of the transcript as needed to address the parties’
arguments.
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PROCEDURAL BACKGROUND
On February 11, 2019, Plaintiff applied for DIB and SSI, alleging that she had been unable
to work since January 29, 2016, due to lumbar disc dystrophy, bulging discs, and degenerative disc
disease. (Tr. 14, 204-11). Her application was initially denied. (Tr. 90-95). On October 17, 2019,
Plaintiff filed a Request for Hearing by Administrative Law Judge (ALJ) (Tr. 96-7). After a
hearing, the ALJ issued an unfavorable decision on April 27, 2023 (Tr. 11-32). Plaintiff filed a
Request for Review of Hearing Decision with the Social Security Administration’s Appeals
Council on May 15, 2023, but the Appeals Council declined to review the case on January 22,
2024. (Tr. 1-6). 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.
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
& Hum. Servs., 955 F.2d 552, 555 (8th Cir. 1992). Under the Social Security Act, a person is
disabled if she 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). Accord Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir. 2010). The
impairment must be “of such severity that he [or she] is not only unable to do his [or her] previous
work but cannot, considering his [or her] 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 [or she] lives, or whether a specific job vacancy
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exists for him [or her], or whether he [or she] would be hired if he [or she] 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); 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
the claimant is not disabled. 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i); McCoy, 648 F.3d at
611. At Step Two, the Commissioner determines whether the claimant has “a severe medically
determinable physical or mental impairment that meets the [twelve-month duration requirement in
§ 404.1509 or § 416.909], or a combination of impairments that is severe and meets the duration
requirement”; if the claimant does not have a severe impairment, the claimant is not disabled. 20
C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(ii); McCoy, 648 F.3d at 611. To be severe, an impairment
must “significantly limit[] [the claimant’s] physical or mental ability to do basic work activities.”
20 C.F.R. §§ 404.1520(c), 416.920(c). 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), 416.920(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), 416.920(d); McCoy, 648 F.3d at 611.
Prior to Step Four, the Commissioner assesses the claimant’s residual functional capacity
(“RFC”), 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4), which “the most [a claimant] can still do
despite [his or her] limitations,” 20 C.F.R. §§ 404.1545(a)(1), 416.945(a)(1). See also Moore v.
Astrue, 572 F.3d 520, 523 (8th Cir. 2009). At Step Four, the Commissioner determines whether
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the claimant can return to his or her 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), 416.920(a)(4)(iv), 416.920(f); McCoy, 648 F.3d at 611. If the
claimant can perform his or her past relevant work, the claimant is not disabled; if the claimant
cannot, the analysis proceeds to the next step. 20 C.F.R. §§ 404.1520(a)(4)(iv), 404.1520(f),
416.920(a)(4)(iv), 416.920(f); McCoy, 648 F.3d at 611. 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),
404.1520(g), 404.1560(c)(2), 416.920(a)(4)(v), 416.920(g), 416.1560(c)(2); McCoy, 648 F.3d at
611.
Through Step Four, the burden remains with the claimant to prove that he or she 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); 20 C.F.R. §§ 404.1560(c)(2), 416.960(c)(2).
THE ALJ’S DECISION
Applying the foregoing five-step analysis, the ALJ found that Plaintiff has not engaged in
substantial gainful activity since January 29, 2016, the alleged onset date; that Plaintiff had the
severe impairment(s) of degenerative disc disease with neuropathy, degenerative joint disease of
the bilateral hips, degenerative joint disease of the bilateral knees, migraines, obesity, major
depressive disorder, and generalized anxiety disorder; and that Plaintiff did not have an impairment
or combination of impairments that meets or medically equals the severity of one of the listed
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impairments in 20 C.F.R. § 404, Subpart P, Appendix 1 (Tr. 16-17). The ALJ found that Plaintiff
had the residual functioning capacity to perform sedentary work as defined in 20 CFR 404.1567(a)
and 416.967(a) except:
[S]he can occasionally climb ramps and stairs, but never climb ladders, ropes or scaffolds;
the claimant can occasionally stoop, kneel, crouch, and crawl; she can frequently handle
and finger; the claimant cannot be exposed to unprotected heights or hazardous machinery;
she can have only occasional exposure to extreme cold or vibrations; the claimant can work
in no more than a Code 3 noise environment; she is able to learn, remember, and carry out
simple tasks and make simple work related decisions; and the claimant can use reason and
judgment to complete those tasks in a timely manner and at an appropriate pace while
ignoring or avoiding distractions, have only gradual changes in job settings or duties, no
work requiring a high production rate pace.
(Tr. 20). The ALJ further found that the claimant was unable to perform any past relevant work,
but that jobs existed in significant numbers in the national economy that she could perform (Tr.
24-25).
DISCUSSION
Plaintiff challenges the ALJ’s decision on three grounds: (1) the ALJ’s decision fails to
properly evaluate medical opinion evidence; (2) the ALJ’s decision fails to explain how headaches
were accounted for in the RFC; and (3) the RFC is conclusory without reference to what or how
the evidence supports the ALJ’s conclusions and, as such, is not supported by substantial evidence.
I.
The ALJ Properly Evaluated Medical Opinions.
Plaintiff’s first argument is that the ALJ fails to properly evaluate the supportability and
consistency of the medical opinions of (1) Michael O’Day, D.O., (2) Kate Rsie, N.P., and (3)
Kulsoom Junaid, M.D. and Adeijana Sacic, N.P. As discussed below, the Court finds that the ALJ
properly evaluated the persuasiveness of medical opinions and prior administrative medical
findings (“PAMFs”).
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For social security claims filed after March 17, 2017, the ALJ must not “defer or give any
specific evidentiary weight, including controlling weight, to any medical opinion(s) or prior
administrative medical finding(s), including those from [Plaintiff's] medical sources.” 20 C.F.R. §
404.1520c(a). Instead, the ALJ is required to evaluate the persuasiveness of a medical opinion or
PAMF by considering:
(1) supportability of the opinion with relevant objective medical evidence and supporting
explanations; (2) consistency with the evidence from other medical sources and
nonmedical sources in the claim; (3) relationship with the plaintiff, including length,
purpose, and extent of treatment relationship, whether it is an examining source, and
frequency of examination; (4) specialization; and (5) other relevant factors.
Hirner v. Saul, No. 2:21-CV-38 SRW, 2022 WL 3153720, at *4 (E.D. Mo. Aug. 8, 2022) (citing
20 C.F.R. § 404.1520c(c)). Supportability and consistency are the “most important factors” and
must be explained by the ALJ. Hirner, 2022 WL 3153720, at *4; see also 20 C.F.R. §
404.1520c(b)(2). However, the ALJ is not required to use the precise words “supportability” and
“consistency” in their analysis. See Kamann v. Colvin, 721 F.3d 945, 951 (8th Cir. 2013) (holding
that when the ALJ's decision that a physician was unpersuasive was supported by substantial
evidence, semantics arguments did not justify reversal); see also Atwood v. Kijakazi, No. 4:20CV-1394 JAR, 2022 WL 407119, at *5 (E.D. Mo. Feb. 10, 2022) (same).
A. Michael O’Day, DO – State Agency Medical Consultant
On August 18, 2019, Dr. O’Day found that Plaintiff could perform a reduced range of light
work. (Tr. 75-76). Dr. O’Day further opined that Plaintiff could stand or walk for four hours and
sit for six hours in an eight-hour workday. (Tr 75). He also stated that Plaintiff could frequently
lift 10 pounds and occasionally lift 20 pounds. Id. Dr. O’Day also determined that Plaintiff could
occasionally climb ramps/stairs, balance, stoop kneel, crouch, and crawl but that she could never
climb ladders, ropes, or scaffolds. (Tr. 76).
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In reviewing his opinion, the ALJ found it partially persuasive. The ALJ stated that Dr.
O’Day’s findings were “corroborated by lengthy explanations with numerous references to and
discussion of the medical record of evidence,” but that his findings were not fully persuasive
because he was not able to review medical evidence in the record that was produced after he issued
his opinion, “particularly [Plaintiff’s] knee and hip degenerative conditions, would cause further
limitations in the claimant’s abilities[.]” (Tr. 24).
Plaintiff argues that, while the ALJ used the words “consistency” and “supportability” in
assessing Dr. O’Day’s opinion, she failed to properly explain how she considered those factors.
This Court disagrees.
Supportability and Consistency
Plaintiff contends that the ALJ failed to properly evaluate the supportability and
consistency of Dr. O’Day’s opinion. Specifically, Plaintiff argues that the ALJ failed to adequately
address supportability because the only explanation provided by Dr. O’Day in his opinion was
“limited as noted due to pain,” and the ALJ fails to refer to any specific explanation from Dr.
O’Day (ECF No. 18, at 7 (citing Tr. 641-2)). Plaintiff further asserts the ALJ failed to evaluate
consistency because she did not discuss any particular evidence postdating Dr. O’Day’s opinion.
This Court disagrees finding that the ALJ properly evaluated both the consistency and
supportability of Dr. O’Day’s opinion.
First, this Court finds that the ALJ properly evaluated the supportability of the ALJ’s
opinion. Indeed, despite Plaintiff’s argument that Dr O’Day’s opinion only included the
explanation “limited due to pain,” the section of his report labeled “RFC – Additional Explanation”
contains a list of medical evidence and Plaintiff’s daily activities that support his conclusion. The
ALJ referred to such explanations in her analysis – stating that Dr. O’Day’s opinion was
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“corroborated by lengthy explanations with numerous references to and discussion of the medical
record of evidence[.]” (Tr. 24). While Plaintiff argues that this reference is inadequate and that the
ALJ failed to explain which portions of Dr. O’Day’s findings she found partially persuasive, courts
have repeatedly held that the ALJ does not have to address each part of a medical opinion in his/her
decision. See Seger v. O’Malley, No. 4:23 CV 460 RWS, 2024 WL 3638255, at *7 (E.D. Mo. Aug.
1, 2024) (holding than an ALJ does not have “to address each and every part of a medical opinion
to show that the entire opinion was properly considered; nor does it require the ALJ to entirely
adopt each and every part of an opinion simply because she finds it persuasive.” (citing McClure
v. Saul, Case No.1:20CV150 SNLJ, 2021 WL 3856577, at *7 (E.D. Mo. Aug. 30, 2021)); Russell
v. Kijakazi, No. 4:21-CV-00271-LPR, 2022 WL 4378724, at *1 (E.D. Ark. Sept. 22, 2022)
(holding that the ALJ “is not required to articulate how he considered each opined limitation
individually.”). Therefore, this Court concludes that the ALJ properly evaluated the supportability
of Dr. O’Day opinion.
Second, the ALJ also properly evaluated the consistency of Dr. O’Day’s opinion. The ALJ
explicitly stated that medical evidence produced after Dr. O’Day issued his opinion, particularly
relating to her knee and hip degenerative conditions, was inconsistent with his findings and
indicated further limitations in Plaintiff’s abilities than those provided in his opinion. (Tr. 24).
Then, elsewhere in her decision, the ALJ discussed specific medical evidence demonstrating
degenerative changes in Plaintiff’s hips and knees, which do in fact support greater limitations
than Dr. O’Day opined. (Tr. 20, 77, 599-600); see also Trosper v. Saul, No. 1:20 CV 51 DDN,
2021 WL 1857124, at *7 (E.D. Mo. May 10, 2021) (“When the decision is read in its entirety,
instead of only the single paragraph . . . in isolation, it shows the ALJ properly considered the
record evidence as whole when evaluating the supportability and consistency of the opinion.”). As
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such, this Court finds that the ALJ properly evaluated the consistency of Dr. O’Day’s opinion with
the rest of the record.
Evaluation of the Record
Plaintiff also argues that the ALJ erred in her reliance upon Dr. O’Day’s findings because
he did not examine Plaintiff personally, nor review the entirety of the record before issuing his
opinion. (ECF No. 18, at 12). This Court disagrees.
As an initial matter, the ALJ is permitted to rely upon the findings of a non-examining
doctor under current regulations. See Bowers v. Kijakazi, 40 F.4th 872, 875–76 (8th Cir. 2022)
(holding that the ALJ’s reliance on the non-examining physicians’ findings was not an error
because they were consistent with the evidence as a whole); Seger, 2024 WL 3638255, at *9;
Rudloff, 2024 WL 1140930, at *5.
Furthermore, the ALJ is not required to discount Dr. O’Day’s opinion because he did not
review the entire record at the time he issued his opinion. “An ALJ can rely on the ‘opinion of a
state agency medical consultant who did not have access to all the records, so long as the ALJ
conducts an independent review of the evidence and takes into account portions of the record the
consultant had not considered.’” O'Neal v. Kijakazi, No. 1:23-CV-140 SRW, 2024 WL 3400031,
at *9 (E.D. Mo. July 11, 2024) (quoting Kuikka v. Berryhill, 2018 WL 1342482, at *10 (D. Minn.
Mar. 15, 2018)). Here, Dr. O’Day did not analyze all the evidence in the record before issuing his
opinion, however, his opinion was issued after Plaintiff’s onset date. See Seger, 2024 WL 3638255,
at *9 (holding that ALJ did not err in relying upon opinions given by non-examining consultants
that were given almost a year prior to the hearing because the “opinions were issued after plaintiff’s
alleged onset date and [were] therefore relevant evidence that the ALJ was required to consider).
Furthermore, when formulating the RFC, the ALJ clearly considered the entire record, including
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information that post-dated Dr. O’Day’s opinion, and adopted the portions of his findings that
were consistent with and supported by evidence in the record. Therefore, this Court finds that the
ALJ properly evaluated and relied upon Dr. O’Day’s opinion when formulating the RFC.
B. Kate Reis, NP
Katie Reis, NP, a treating provider of Plaintiff, provided an opinion in March 2023. In her
opinion, Ms. Reis stated that Plaintiff could occasionally lift 10 pounds, frequently lift less than
10 pounds, sit for 20-30 minutes at a time, walk zero city blocks without rest or severe pain, stand
for less than 20 minutes at a time, and stand or walk for 2-3 hours in total over the course of an 8hour workday. (Tr. 987). She also opined that Plaintiff would need to shift positions at will from
sitting, standing or walking and would need to prop up her feet at least occasionally for symptom
relief. Id. The ALJ found Ms. Reis’s opinion to be unpersuasive, noting that it lacked supportability
because “the record reflects full strength and no lower leg edema” and was inconsistent with the
record because it contained “no recommendation for elevating her legs.” (Tr. 24).
Plaintiff argues that the ALJ erred by considering other treatment records when evaluating
the supportability of Ms. Reis’s opinion, and mistakenly analyzed Ms. Reis’s treatment records
when discussing consistency. This Court finds no evidence that such a mistake occurred. When
addressing supportability, the ALJ referenced the lack of edema in Plaintiff’s legs, which
corresponds to the records of Ms. Reis’ examinations. (Tr. 408, 411, 414, 968, 971, 974). The ALJ
therefore properly evaluated the supportability of her opinion. See Bowers v. Kijakazi, 40 F.4th
872, 875 (8th Cir. 2022) (upholding the ALJ’s conclusion that an opinion was only partially
persuasive, in part, because it was unsupported by the doctor’s own “routinely normal”
examinations of the claimant); Diana G. v. Kijakazi, No. 4:22 CV 1245 JMB, 2024 WL 50805, at
*6 (E.D. Mo. Jan. 4, 2024) (holding that, in evaluating supportability, an ALJ may properly
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consider that the physician’s own treatment notes do not support the opinion). Furthermore, the
ALJ also properly addressed consistency, stating there were no other recommendations for
Plaintiff to elevate her legs contained in the record. (Tr. 24). Treatment notes and examination
notes from other providers do not demonstrate that Plaintiff was ordered to elevate her legs. In
fact, treatment notes recommended that she exercise and continue walking (Tr. 616, 900). As such,
this Court finds that she also properly evaluated consistency.
However, even if Plaintiff is correct, and the ALJ did effectively “flip-flop” the sources
she cited to address supportability and consistency, it would effectively boil down to a mistake of
terminology rather than of actual analysis. Because she properly evaluated both supportability and
consistency, whether the ALJ used the right word is an argument over semantics and immaterial
because, as discussed above, the ALJ addressed both supportability and consistency in substance
and supported her conclusion with substantial evidence. See Kamann, 721 F.3d at 951; see also
Atwood, 2022 WL 407119, at *5.
C. Kulsoom Junaid, MD and Adeijana Sacic, NP
On March 6, 2023, Adeijana Sacic, Plaintiff’s treating nurse practitioner, executed a
“Medical Source Statement – Mental.” In her Statement, Ms. Sacic opined that Plaintiff was
moderately limited in her ability to work a full day without needing more than the allotted number
or length of rest periods but did not conclude Plaintiff had any other limitations. (Tr. 990-93). Dr.
Junaid co-signed Ms. Sacic’s opinion as her supervisor. (Tr. 993). The ALJ found Ms. Sacic’s
opinion to be partially persuasive. (Tr. 24). Specifically, the ALJ stated that that Ms. Sacic’s
conclusion that Plaintiff did not have disabling mental health impairments was supported by her
treatment of Plaintiff and generally consistent with the evidence. (Tr. 24) Plaintiff argues that the
ALJ’s discussion of Ms. Sacic’s opinion was insufficiently specific and failed to discuss the one
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moderate limitation listed in her opinion. [ECF No. 18, at 7]. This Court disagrees with both of
Plaintiff’s arguments.
First, the ALJ is not required to discuss every limitation contained in a medical opinion.
See Austin v. Kijakazi, 52 F.4th 723, 729 (8th Cir. 2022) (stating that “the ALJ is free to accept
some, but not all, of a medical opinion”); Seger, 2024 WL 3638255, at *7 (holding that the ALJ is
not required “to entirely adopt each and every part of an opinion simply because she finds it
persuasive”); Rudloff v. O’Malley, No. 4:23 CV 416 CDP, 2024 WL 1140930, at *10 (E.D. Mo.
Mar. 15, 2024) (same). As such, the ALJ did not err in failing to mention the one moderate
limitation listed in Ms. Sacic’s opinion.
Second, the ALJ sufficiently addressed both the supportability and consistency of Ms.
Sacic’s opinion. As stated above, the ALJ said that the opinion was supported by her treatment of
the Plaintiff and consistent with the evidence in the record. The ALJ also cited evidence in other
sections in her RFC determination that supports her analysis of Ms. Sacic’s opinion. See Trosper,
2021 WL 1857124, at *7. For example, the ALJ cited Ms. Sacic’s treatment notes when noting
that Plaintiff’s “mental status examination are within normal limits.” (Tr. 23, citing 18F/3 and 7).
The ALJ also cited the treatment records of other providers who opined on Plaintiff’s mental state,
demonstrating similar normal mental status examinations to those cited by Ms. Sacic. (Tr. 23
(citing Tr. 9F/13, 29), 458, 474, 460, 470-71, 481). Therefore, this Court finds that the ALJ
properly considered the supportability and consistency Ms. Sacic’s opinion, and as such, properly
evaluated PAMFs and medical opinions when formulating the RFC.
II.
The RFC is Supported by Substantial Evidence.
Finally, Plaintiff asserts that the RFC is not supported by substantial evidence because the
ALJ “failed to conduct a proper pain/credibility evaluation, failed to provide accommodations for
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plaintiff’s severe headaches, and formulated the RFC based upon her own interpretation of the
evidence provided after the initial denial and how it would affect the plaintiff’s ability to function
in the workplace[.]” (ECF No. 18 at 13).
A. Headaches
Plaintiff argues that, while her severe migraines significantly limited her ability to perform
work activities, it is not clear how they are accounted for in the RFC. (ECF No. 18, at 7-8). This
Court disagrees.
The ALJ properly evaluated Plaintiff’s headaches when formulating the RFC. In response
to Plaintiff’s headaches, the ALJ limited Plaintiff to sedentary work that involved “simple tasks
and . . . simple work related decisions” and environments that have “no more than a Code 3 noise
environment.” (Tr. 20). Courts have repeatedly held that such limitations account for migraine
headaches. See Payne v. Kijakazi, No. 2:20-CV-04195-WJE, 2021 WL 4635800, at *3 (W.D. Mo.
Oct. 7, 2021) (finding that a noise limitation in the RFC properly accounts for a plaintiff’s
migraines); Heather C. v. Kijakazi, No. 23-CV-484 (ECT/DJF), 2023 WL 8282059, at *3 (D.
Minn. Nov. 30, 2023) (“The ALJ accounted for Plaintiff's headaches in the RFC by limiting
Plaintiff to light work and imposing restrictions on her ability to concentrate and maintain
attention.”).
Plaintiff also asserts that the ALJ should have explained why the RFC did not include a
“light restriction, extra break, or any accommodation for when plaintiff is suffering with a migraine
headache during work.” [ECF No. 18 at 8]. However, when assessing the RFC, the ALJ is not
required to “mechanically list and reject every possible limitation” that Plaintiff’s migraines might
elicit. Nash v. Comm’r, Soc. Sec. Admin., 907 F.3d 1086, 1090–91 (8th Cir. 2018) (quoting McCoy
v. Astrue, 648 F.3d 605, 615 (8th Cir. 2011)).
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This Court also agrees with the ALJ’s argument that the evidence in the record does not
support additional limitations. (ECF No. 21, at 12). While Plaintiff has complained of photophobia
(Tr. 619, 626), the ALJ does not have to accept Plaintiff’s subjective complaints. See Pierce v.
Kijakazi, 22 F.4th 769, 772 (8th Cir. 2022) (“Of course, an ALJ need not accept as true a claimant’s
testimony about the extent of his limitations.”). Indeed, Plaintiff denied sensitivity to light on other
occasions, and the ALJ is free to exclude conflicting evidence from her RFC determination. (Tr.
499, 632); See Twyford v. Comm’r, Soc. Sec. Admin., 929 F.3d 512, 518 (8th Cir. 2019) (“While
some evidence in the record could lend support to a more restrictive RFC finding, we cannot say
that the ALJ’s decision ‘lies outside the available zone of choice.’” (quoting Hacker v. Barnhart,
459 F.3d 934, 938 (8th Cir. 2006))). Plaintiff may not agree with this outcome, but this Court
cannot overturn the ALJ’s decision simply because Plaintiff believes the ALJ should have reached
a different conclusion. See Bradley v. Astrue, 528 F.3d 1113, 1115 (8th Cir. 2008); see also Young
v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000). Thus, this Court holds that the ALJ properly
considered and accounted for Plaintiff’s migraines in her RFC decision.
B. Mental Health
Plaintiff argues that the ALJ’s decision “lack[s] . . . any explanation of how the evidence
that is in the record demonstrates an ability to perform work at the RFC formulated by the ALJ,”
specifically alleging that the ALJ failed to discuss or explain some of Plaintiff’s mental health
symptoms. (ECF No. 18 at 10). Plaintiff also asserts that the ALJ erred by relying upon a lack of
objective evidence to discount Plaintiff’s mental health symptoms, instead improperly making her
own inferences from the medical record. This Court disagrees.
This Court finds that the ALJ relied upon objective medical evidence in making her RFC
determination about Plaintiff’s mental impairments. The ALJ’s analysis discussed provider’s
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mental status examinations of Plaintiff, which were generally in normal limits. The ALJ further
summarized that, while Plaintiff’s treatment records indicated “some difficulties with focus and
concentration needed to accomplish simple tasks” they “did not reflect a significant loss of
abstraction or intellectual ability, or an inability to learn new information, remember information
that was known sometime in the past, interact with verbal and nonverbal communication, control
her movements, [and] control her behavior [.]” (Tr. 23-24). Furthermore, as discussed above, the
ALJ also partially relied upon the opinion of Ms. Sacic and Dr. Junaid (Tr. 24), in which they
opined that Plaintiff had no limitations in understanding, remembering, or applying information;
no limitations in interacting with others, including supervisors, co-workers, and the public; and no
limitations in regulating emotions and distinguishing between acceptable and unacceptable
performance. (Tr. 990-93). Ms. Sacic’s report also states that Plaintiff would not miss any work
based upon her psychologically-based symptoms. (Tr. 992). Contrary to Plaintiff’s arguments that
the ALJ did not rely upon medical evidence to support her conclusions about Plaintiff’s mental
health, this Court finds that the above evidence supported the ALJ’s RFC finding.
Plaintiff also claims that the ALJ did not explain how she accounted for Plaintiff’s
“tightness in her chest daily, panic attacks, word finding problems, depression, anxious mood and
affect, rapid speech, poor attention span and concentration, crying spells, restlessness, bad dreams,
and poor sleep.” (ECF No. 18 at 10 (citing 458, 460, 924, 921, 918, 916, 914)). This Court finds
that the ALJ was not required to provide more explanation because these are subjective complaints
made by Plaintiff to her providers. Nor did the ALJ improperly make her own inferences from the
medical records to discount them. As discussed above, the ALJ relied on objective medical
evidence, including Ms. Sacic’s opinion. The ALJ is not required to support an RFC with a
particular medical opinion. See 42 U.S.C. §§ 401 et seq.; 20 C.F.R. §§ 404.1545, 416.945; see also
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Schmitt v. Kijakazi, 27 F.4th 1353, 1359 (8th Cir. 2022) (“[T]here is no requirement that an RFC
finding be supported by a specific medical opinion.”) (internal quotations omitted); Twyford, 929
F.3d at 518. As with Plaintiff’s headaches, this Court cannot overturn the ALJ’s decision simply
because Plaintiff believes she should have received a different one. See Bradley, 528 F.3d at 1115;
see also Young, 221 F.3d at 1068. Therefore, this Court finds that the ALJ properly evaluated
Plaintiff’s subjective mental health in formulating her RFC.
C. Subjective Complaints
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.” Pate-Fires v.
Astrue, 564 F.3d 935, 942 (8th Cir. 2009) (quoting Ford v. Astrue, 58 F.3d 979, 981 (8th Cir.
2008)); see also 42 U.S.C. §§ 405(g); 1383(c)(3). “Under the substantial-evidence standard, a
court looks to an existing administrative record and asks whether it contains ‘sufficien[t] evidence’
to support the agency’s factual determinations.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019)
(quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). “Substantial evidence is less
than a preponderance, but is enough that a reasonable mind would find it adequate to support the
Commissioner’s conclusion.” Pate-Fires, 564 F.3d at 942 (quotation marks omitted). See also
Biestek, 139 S. Ct. at 1154 (“Substantial evidence . . . means—and means only—such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion.’”) (quoting
Consol. Edison, 305 U.S. at 229).
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. Renstrom v. Astrue, 680 F.3d 1057, 1063 (8th Cir. 2012). However, the court “‘do[es]
not reweigh the evidence presented to the ALJ, and [it] defer[s] to the ALJ’s determinations
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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)).
Finally, Plaintiff argues that the ALJ did not adequately explain her reasons for discrediting
Plaintiff’s testimony and failed to “discuss the Polaski factors other than to minimally summarize
them when determining plaintiff suffered with no limitations in any area except for concentration,
persistence, and maintaining pace. . . [and that the ALJ] mentions some activities of daily living
but fails to discuss other responses including when she indicated she does not handle stress or
changes in routine well.” (ECF No. 18 at 11). This Court disagrees.
“In analyzing a claimant's subjective complaints of pain, an ALJ must examine several
factors: (1) the claimant's daily activities; (2) the duration, frequency and intensity of the pain; (3)
the dosage, effectiveness and side effects of medication; (4) precipitating and aggravating factors;
and (5) functional restrictions.” Strongson v. Barnhart, 361 F.3d 1066, 1072 (8th Cir. 2004) (citing
Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir.1984). “Other relevant factors include the
claimant's relevant work history and the absence of objective medical evidence to support the
complaints.” However, “[t]he ALJ is not required to discuss each Polaski factor as long as the
analytical framework is recognized and considered.” Tucker v. Barnhart, 363 F.3d 781, 783 (8th
Cir.2004) “The ALJ may disbelieve subjective complaints if there are inconsistencies in the
evidence as a whole . . . but he must give reasons for discrediting the claimant.” Strongson, 361
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F.3d at 1072 (internal citations and quotations omitted). “If an ALJ explicitly discredits the
claimant's testimony and gives good reason for doing so, [a court] will normally defer to the ALJ's
credibility determination.” Gregg v. Barnhart, 354 F.3d 710, 714 (8th Cir. 2003).
This Court finds that the ALJ properly explained why she discounted Plaintiff’s subjective
complaints. (See Tr. 20–35). As an initial matter, the ALJ provided ample objective medical
evidence to justify discrediting Plaintiff’s subjective complaints. For example, while Plaintiff
claims that she had difficulty concentrating, completing tasks, and remembering things, the ALJ
observed that Plaintiff’s mental-status examinations were within normal limits, showed fair
concentration, good insight/judgment, organized and goal-directed thoughts, and intact memory
(Tr. 20-21, 23, 253, 398, 458, 460, 470–71, 474, 481, 914, 916–20). See Constable v. Colvin, No.
4:14 CV 1128 CDP, 2015 WL 5734977, at *18 (E.D. Mo. Sept. 29, 2015) (holding that where a
claimant’s mental-status examinations demonstrated no significant results, the ALJ properly
discounted their subjective complaints of disabling mental limitations). Plaintiff also claimed
physical limitations – disabling back pain, as well as difficulty standing, sitting, walking, lifting,
squatting, bending, reaching, and kneeling. (Tr. 20, 253). The ALJ discounted these subjective
complaints by noting that the objective evidence demonstrated that Plaintiff had full strength in
her extremities, without any edema (Tr. 24, 317, 320, 332, 408, 411, 414, 450, 464, 467, 899, 906,
968, 971, 974); Plaintiff sometimes had a normal gait (Tr. 21, 315, 317, 330, 332–33, 353, 357,
361, 369, 373, 388, 450, 464, 467, 582, 899, 906); Plaintiff had normal range of motion in her
back or musculoskeletal system (Tr. 22, 629, 633, 759, 787, 813); and Plaintiff’s upper and lower
extremities had full range of motion without pain (Tr. 409, 412, 414–15, 969, 972, 975). See
Gonzales, 465 F.3d at 895 (holding that an ALJ may determine that “subjective pain complaints
are not credible in light of objective medical evidence to the contrary”).
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Furthermore, the ALJ properly considered both Plaintiff’s course of treatment and daily
activities. See 20 C.F.R. §§ 404.1529(c)(3)(iv)–(v), 20 C.F.R. §§ 404.1529(c)(3)(i),
416.929(c)(3)(iv)–(v), 416.929(c)(3)(i). The ALJ noted that Plaintiff had never been hospitalized
for her mental health conditions or required emergency treatment (Tr. 19), and that her symptoms
improved with medication (Tr. 23, 458, 920). In addressing her physical symptoms, the ALJ noted
that she received minimal treatment for her back pain and intermittent treatment for her knees and
hips after June 2018. (Tr. 21-22). The ALJ also addressed Plaintiff’s headache treatment, stating
that she received constant treatment, which consisted only of medication, and helped relieve her
pain. (Tr. 22, 619, 626). Regarding her daily activities, the ALJ noted that Plaintiff handled her
own personal care without issue, prepared her own meals, went outside daily, shopped in stores,
spent time with others, drove unassisted, handled her own finances, walked as much as possible,
and had lifted something heavy. (Tr. 18–19, 22, 249–52, 615, 754). Therefore, this Court concludes
that the ALJ properly evaluated Plaintiff’s subjective complaints and, as such, her RFC
determination is supported by substantial evidence.
VI.
CONCLUSION
For all of the foregoing reasons, the Court finds the ALJ’s decision is supported by
substantial evidence. Accordingly,
IT IS HEREBY ORDERED, ADJUDGED, AND DECREED that the decision of the
Commissioner of Social Security is AFFIRMED.
IT IS FURTHER ORDERED that the Clerk shall reflect on the docket that Michelle
King, Acting Commissioner of Social Security, is the proper defendant pursuant to Fed. R. Civ. P.
25(d).
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__________________________________
JOSEPH S. DUEKER
UNITED STATES MAGISTRATE JUDGE
Dated this 29th day of January, 2025.
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