Craig v. Astrue

Filing 27

ORDER reversing decision of Commissioner and remanding case for further development of the record re 3 SOCIAL SECURITY COMPLAINT filed by Billy W. Craig. Signed on 8/23/2013 by Magistrate Judge Matt J. Whitworth. (Bode, Kay)

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF MISSOURI
CENTRAL DIVISION

BILLY W. CRAIG,
Plaintiff,
v.
CAROLYN W. COLVIN,
Acting Commissioner,
Social Security Administration,
Defendant.

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No. 12-4044-SSA-CV-C-MJW

ORDER
Plaintiff Billy W. Craig seeks judicial review,1 of a final administrative decision denying
plaintiff disability benefits under Title II of the Social Security Act, 42 U.S.C. §§ 401 et seq., and
Supplemental Security Income (SSI) benefits under Title XVI of the Social Security Act, 42
U.S.C. §§ 1381 et seq. Section 205(g) of the Act, 42 U.S.C. § 405(g), provides for judicial
review of a final decision of the Commissioner of the Social Security Administration under Title
II. Section 1631(c)(3) of the Act and 42 U.S.C. § 1383(c)(3) provide for judicial review to the
same extent as the Commissioner’s final determination under section 205.
The parties’ briefs are fully submitted, and an oral argument was held on August 19,
2013. The complete facts and arguments are presented in the parties’ briefs and will not be
repeated here.
Standard of Review
The Eighth Circuit has set forth the standard for the federal courts’ judicial review of
denial of benefits, as follows:
Our role on review is to determine whether the Commissioner’s findings are
supported by substantial evidence on the record as a whole. Substantial evidence
is less than a preponderance, but is enough that a reasonable mind would find it
adequate to support the Commissioner’s conclusion. In determining whether
existing evidence is substantial, we consider evidence that detracts from the
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The parties have consented to the jurisdiction of the United States Magistrate Judge,
pursuant to the provisions of 28 U.S.C. § 636(c).

Commissioner’s decision as well as evidence that supports it. As long as
substantial evidence in the record supports the Commissioner’s decision, we may
not reverse it because substantial evidence exists in the record that would have
supported a contrary outcome or because we would have decided the case
differently.
Baker v. Barnhart, 457 F.3d 882, 892 (8th Cir. 2006).
The claimant has the initial burden of establishing the existence of a disability as defined
by 42 U.S.C. § 423(d)(1). See Roth v. Shalala, 45 F.3d 279, 282 (8th Cir. 1995). To meet the
statutory definition, "the claimant must show (1) that he has a medically determinable physical or
mental impairment which will either last for at least twelve months or result in death, (2) that he
is unable to engage in any substantial gainful activity, and (3) that this inability is the result of
his impairment." McMillian v. Schweiker, 697 F.2d 215, 220 (8th Cir. 1983).
When reviewing the record to determine if there is substantial evidence to support the
administrative decision, the court considers the educational background, work history and
present age of the claimant; subjective complaints of pain or other impairments; claimant’s
description of physical activities and capabilities; the medical opinions given by treating and
examining physicians; the corroboration by third parties of claimant’s impairments; and the
testimony of vocational experts when based upon proper hypothetical questions that fairly set
forth the claimant’s impairments. McMillian, 697 F.2d at 221.
Discussion
Plaintiff Billy W. Craig was born in November 1963. He alleges disability onset of April
15, 2008. Plaintiff alleges disability due to back pain, knee pain, bone spurs, a spinal condition
and insomnia.
The Administrative Law Judge (ALJ) determined that plaintiff suffered from the
following severe impairments: degenerative disc disease, status post cervical laminectomy and
fusion, and degenerative joint disease, status post knee surgery. Despite these impairments, the
ALJ determined plaintiff did not meet a listing in 20 C.F.R. Part 404, Subpart P, Appendix 1, and
retained the residual functional capacity (RFC) to do light work except that it would be limited to
only occasional stooping, kneeling, crouching, crawling, balancing and climbing, as well as only
occasional reaching overhead. Based on the RFC, the ALJ determined there are jobs that exist in

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significant numbers in the national economy that plaintiff could perform, and therefore, plaintiff
was not disabled as defined by the Social Security Act.
Plaintiff alleges the ALJ erred in weighing the medical evidence. Specifically, plaintiff
alleges the ALJ erred in discounting the limitations set forth in the opinion of Dr. Martinson,
whose opinion the ALJ gave significant weight. Plaintiff alleges the limitations opined by Dr.
Martinson would preclude plaintiff from working. Plaintiff alleges this is supported by the
testimony of the vocational expert (VE), who testified at the hearing that plaintiff would be
precluded from working if Dr. Martinson’s limitation of repetitive neck movements, especially
extension, prolonged neck positions, repetitive trunk movements, and prolonged trunk positions
were adopted. The Commissioner argues the ALJ is not limited to the opinion of one particular
doctor, but rather is tasked with determining whether the record as a whole supports a finding
that plaintiff is disabled within the meaning of the Social Security Act. The Commissioner
argues there is substantial evidence in the record as a whole to support the decision of the ALJ.
Upon review, there is not substantial evidence in the record as a whole to support the
ALJ’s decision. The ALJ failed to adequately develop the record as to the critical question of the
validity of Dr. Martinson’s opinion that plaintiff’s physical conditions would likely limit him
with regard to work activities that would entail repetitive neck movements, especially extension;
prolonged neck positions, especially including extension; and repetitive trunk movements, or
prolonged trunk positions. The Court believes this is a critical question in determining plaintiff’s
disability because these limitations according to the VE would preclude plaintiff’s ability to
work, and Dr. Martinson’s opinion is the only medical opinion relied upon by the ALJ and is an
opinion to which the ALJ gave significant weight.
In order to determine whether the limitations of Dr. Martinson should be included in the
RFC, further development of the record is required. Eichelberger v. Barnhart, 390 F.3d 584, 592
(8th Cir. 2004) (“An ALJ has the duty to develop the record independent of claimant’s burden in
the case.”). See also Conley v. Bowen, 781 F.2d 143, 146 (8th Cir. 1986) (ALJ has duty to fully
develop the record when claimant’s medical sources did not give sufficient medical evidence
about an impairment to determine whether the claimant is disabled). A consultative examination
should be ordered by the ALJ to be conducted by a proper medical expert to opine as to
plaintiff’s physical impairments in the form of Medical Source Statement (MSS). See Lauer v.
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Apfel, 245 F.3d 700, 704 (8th Cir. 2001) (when determining a claimant’s RFC, all relevant
evidence must be considered but ultimately the determination of the claimant’s RFC is a medical
question). See also Anderson v. Shalala, 51 F.3d 777, 779 (8th Cir. 1995). This statement should
consider plaintiff’s physical impairments and whether he is limited with regard to his neck and
trunk movements, as opined by Dr. Martinson. The MSS should include not only a check list of
limitations of plaintiff’s ability to work, but also a narrative providing the medical basis and
explanation for such limitations. Thereafter, based on this MSS, the opinion of Dr. Martinson
and the record as a whole, the ALJ should determine plaintiff’s RFC and whether plaintiff is
capable of working.
Conclusion
Based on the foregoing, this Court finds that this case must be reversed and remanded for
further development of the record as set forth herein. See Battles v. Shalala, 36 F.3d 43, 45 (8th
Cir. 1994) (“There is no bright line test for determining when the [Commissioner] has … failed
to develop the record. The determination in each case must be made on a case by case basis.”).
IT IS, THEREFORE, ORDERED that the decision of the Commissioner is reversed and
this case is remanded for further development of the record as set forth herein.
Dated this 23rd day of August, 2013, at Jefferson City, Missouri.

/s/

Matt J. Whitworth

MATT J. WHITWORTH
United States Magistrate Judge

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