Proctor v. Berryhill

Filing 16

ORDER. The Commissioner's decision is affirmed. Signed on 10/10/17 by District Judge Nanette K. Laughrey. (Matthes Mitra, Renea)

IN THE UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF MISSOURI
ST. JOSEPH DIVISION
TINA PROCTOR,
Plaintiff,
v.
NANCY A. BERRYHILL,
Acting Commissioner
Of Social Security,
Defendant.

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Case No. 5:17-cv-06009-NKL

ORDER
Plaintiff Tina Proctor appeals the Commissioner of Social Security’s final decision
denying her application for supplemental security income. The decision is affirmed.
I.

Background
Proctor was born in 1971, completed the eleventh grade, and obtained a G.E.D. She has

worked as a cashier and a nurse’s aide. She was struck by a car in September 2011 and spent a
month in the hospital. At the time of filing her application for benefits, Proctor alleged that she
became disabled on September 1, 2011. However, at the hearing before the Administrative Law
Judge, Proctor, through her attorney, amended the alleged date of onset to January 21, 2014.
The ALJ denied Proctor’s application on December 4, 2015. The Appeals Council
denied her request for review on November 29, 2016. Proctor’s appeal to this Court concerns
mental limitations.
A.

Psychological history

Proctor suffered several fractures and traumatic brain injury after being struck by a car in
September 2011. She showed “mild” impairments in cognition and behavior when she began

rehabilitation. Tr. 419. At the time of discharge in October 2011, she had met all of her
rehabilitation goals with respect to the TBI. Tr. 452. She could follow multi-step and nonsequential instructions, solve simple and complex problems, track basic and complex
conversation, and read multi-paragraph text without assistance.

Tr. 452-53. She had some

deficit in attention to detail in reading, “as she gets off topic.” Tr. 453. She had decreased
verbal organization and was verbose at times, and had deficits in terminating conversations and
getting off topic. Tr. 454-55. She was “Not impaired” in the areas of short- or long-term
memory, numerical reasoning, situational problem solving, awareness of problems, goal setting,
initiation, planning, or carry over. Tr. 455. She was “Impaired” in attention/concentration
(described as “mild—self distracted”), abstract reasoning (described as “mild for multicomponent situations”), and organization, self-monitoring and time management (all described
as “mild”). Id.
From March 2013 through December 2013, Proctor saw Samuel Fadare, M.D., a
psychiatrist, a total of eight times, or about once a month. Tr. 205-230. She reported anxiety,
depression, and feelings of anger. Throughout the year, Dr. Fadare prescribed Remeron, Paxil,
Viibryd, or Seroquel. In September and November 2013, Proctor reported stable symptoms on
her medication, and said she felt happier. In December 2013, she reported anxiety and feelings
of anger in dealing with her teenaged children, and the doctor wrote that Proctor needed “to see a
therapist to help with” her children. Tr. 205. The results of her mental status exam were normal,
except for “some problems with short term memory.” Tr. 208. Dr. Fadare renewed Proctor’s
Seroquel. Dr. Fadare never ordered in-patient treatment and Proctor was never hospitalized for
mental-health related issues from March 2013 through December 2013.
From March 2014 through July 2015, Proctor saw Dr. Fadare a total of six times, or

2

about once every three months. At the visits, Proctor was alert, oriented, calm, and cheerful.
Tr. 270, 277–78, 285–86, 293–94, 301–02, and 310. She had normal psychomotor activity, an
unremarkable appearance, unremarkable speech, logical flow of thought, unremarkable thought
processes, normal intellect, good insight, intact judgment, and no delusions or hallucinations.
Tr. 269–70, 277–78, 285–86, 293–94, 301– 02, and 310. She was not suicidal or threating to
others. Tr. 270, 277–78, 285–86, 293–94, 301–02, and 310. Her mental status exam showed
“some problems with short term memory” in March 2014, June 2014, October 2014, January
2015, April 2015, and July 2015. Tr.270, 278, 286, 294, 302, and 310. Except for the March
2014 visit, however, Dr. Fadare recorded “Memory intact” on every exam. Tr. 270, 278, 286,
294, 302. The only medication that he prescribed from March 2014 through July 2015 was
Seroquel, although he decreased the dosage in January 2015. Tr. 286.

In October 2014, the

doctor found that Proctor’s symptoms were responding to the antidepressant medication, Tr. 296,
and made the same finding in April 2015, Tr. 275. Dr. Fadare never ordered in-patient treatment
during that time period, nor was Proctor hospitalized for mental-health related issues.
Proctor did complain in March 2014 of feelings of anger toward a former friend who had
assaulted her, and Dr. Fadare suggested she see a therapist. Tr. 307. In June 2014, she told
Dr. Fadare that she felt anxious, and had difficulty about every other day in controlling her anger
with her children. Tr. 304. In October 2014, Proctor reported that she felt anxious and was
losing control of her anger with her children. Tr. 296. In January 2015, she reported a stable
mood. Tr. 283. In April 2015, she reported that she continued to experience anxiety, anger, and
mood swings a few times per week or daily, and it was mostly her “children and change” that set
her off. Tr. 280. In July 2015, she reported that she was doing well and her mood was stable.
Tr. 267.

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Proctor was seen in the emergency room for migraine in May 2014. The E.R. physician’s
exam findings included, “Psychiatric: Cooperative, appropriate mood & affect.” Tr. 508.
At doctor’s office visits in November 2014 and June 2015, the providers recorded that
Proctor’s mood was euthymic. Tr. 513 and 518.
From December 2103 through September 2015, Proctor received services from a social
worker. Tr. 311-401. The social worker’s progress notes reflect that Proctor frequently reported
improvement in her mood, and with depression and anxiety symptoms. Tr. 314, 322, 332, 336,
360, 364, 367, 370, 374, 377, and 384.

Proctor also reported socializing with friends, dating,

and otherwise getting out of the house. Tr. 318, 332-33, 336, 353, 360, 364, 368, 375, 377, and
379.

Proctor reported having bad days and good days, “especially when it comes to her

children but she feels she is doing better.” Tr. 316.
B.

Proctor’s adult function report and hearing testimony

In her adult function report dated February 22, 2014, Tr. 142-149, Proctor stated that she
takes care of her children and pet, without help. She has problems falling asleep and said she
remembered things better before the car accident. She prepares meals and takes care of house
and yard work without help or reminders. She goes outside daily, can go out alone, and shops
weekly for groceries and personal items. She is able to pay bills and handle her money. Her
hobbies are reading and puzzles, but she reads less than she used to and does not work puzzles at
all. She spends time with others daily, whether in person or on the computer, talking, watching
television or listening to music. She has fewer friends and dates less than before.

She needs

reminders to go to doctor appointments and needs someone to accompany her. She said that she
has trouble with “memory, concentration and understanding, due to car hitting me.” Tr. 147.
Where asked on the form whether she finished what she started, she answered, “No.” Id. Where

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asked how well she can follow spoken instructions, she answered, “Good.” Id. She gets along
with authority figures, has never been fired from a job because of problems getting along with
others, is “ok with changes,” and has no unusual behaviors or fears. Tr. 148.
Proctor testified at the hearing before the ALJ on November 16, 2015. She has worked in
the past as a cashier and as a nurse’s aide. She said that she could not work now because she
does not get along with others and has difficulty remembering things. Tr. 37. She testified that
she tries not to go anywhere and to stay in the house to avoid dealing with people, and has shortand long-term memory problems. Tr. 39-40. She said she could not “remember anything” and
had difficulty completing tasks. Tr. 40, 42. She also said that she became angry every day and
had crying episodes three or four times per week. Tr. 40-42. She takes Seroquel daily, and when
asked whether she had any side effects, testified, “No.” Tr. 38. She testified that she had not
worked since 2008 because she had been living with a person who “was paying all [her] bills and
taking care of [her].” Tr. 43.
C.

Expert opinions

In May 2014, Esteban Alejo, M.D., performed a consultative exam. With respect to
mental issues, Proctor reported symptoms of difficulty sleeping, crying spells, changes to
appetite, lack of motivation, and sleeping all day. Tr. 256. Under Neurological findings,
Dr. Alejo wrote, “The claimant was in a good mood. She had normal concentration, good eye
contact. Speech was fluent and she had a good memory.” Tr. 258. Under Impressions, the
doctor wrote, “Mental issues: Patient in good mood, no emotional distress noted.” Tr. 260. The
only mental-health related Diagnosis was “Depression by history. On treatment at the present
time.” Id.
In June 2014, Marc Maddox, Ph.D., a non-examining, non-treating State agency

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psychologist, reviewed Proctor’s records and prepared a Psychiatric Review Technique Form.
Tr. 54-55. Under “Additional Information,” Dr. Maddox wrote that Proctor has the diagnosis of
major depression and is prescribed medication, and that her symptoms “wax and wane.” Tr. 55.
She was cooperative at the consultative exam, was in a good mood, had normal concentration
and good eye contact, her speech was fluent, and she had a good memory. According to her
adult function report, she takes care of her own activities of daily living, lives with friends,
prepares meals and does household chores as needed, grocery shops weekly, and manages her
own finances.

She also reported not having as many friends, and having memory and

concentration difficulty, but that she can follow spoken instructions. Dr. Maddox opined that
Proctor had mild limitations in activities of daily living, maintaining social functioning, and
maintaining concentration, persistence, or pace; and no repeated episodes of decompensation of
extended duration.

He concluded that Proctor’s impairments were non-severe and did not

impose any work-related restrictions. The ALJ gave Dr. Maddox’s opinion “significant weight.”
Tr. 18.
On October 5, 201, Dr. Fadare filled out a Medical Source Statement—Mental form.
Tr. 470–71. Dr. Fadare listed mental diagnoses of generalized anxiety disorder and major
depressive disorder, recurrent. Where asked whether Proctor had medication side effects, the
doctor checked “Yes,” and circled the option, “Drowsiness.” Tr. 470. He opined that Proctor
would miss work three days per month due to having “bad days” and would be off task more
than 25% or more of the day. Tr. 470.

Under Concentration and Pace, he opined that Proctor

was markedly limited in maintaining attention and concentration for extended periods;
performing activities within a schedule; maintaining regular attendance; being punctual within
customary tolerances; working in coordination with others without being distracted; completing

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a normal workweek without interruptions from psychological symptoms.

Under Social

Interactions, he opined that Proctor was markedly limited in responding appropriately to
criticism from supervisors, and getting along with coworkers. Under Adaptation, he opined that
Proctor was markedly limited in travelling in unfamiliar places, and using public transportation.
Tr. 471. Under Understanding and Memory, he opined that Proctor was mildly limited in the
ability to understand and remember very short and simple instructions, and moderately limited in
the ability to remember locations and work-like procedures, and understand and remember
detailed instructions. Tr. 470.
Where asked to circle the factors upon which the opinion was based, Dr. Fadare circled
“Clinical findings (such as the result of physical or mental status exams)” and “Diagnosis
(statement of disease or injury based on its signs or symptoms).” Id. The ALJ gave Dr. Fadare’s
opinion little weight. Tr. 18.
A vocational expert, Barbara Myers, testified at the hearing before the ALJ. The ALJ
asked if any occupation existed in significant numbers for a hypothetical person of Proctor’s age,
education, and work experience who was limited to light work; could lift and carry, push and
pull 20 pounds occasionally and 10 pounds frequently; could stand and walk, or sit, for six hours
of a normal workday; should not climb ladders, ropes or scaffolds, and should be exposed to
other postural activities only occasionally; should not be exposed to extremes of heat or cold, or
concentrated, airborne irritants; should be limited to repetitive work, which is simple, routine and
unskilled; and should not have a job which requires interaction with the general public. Tr. 48.
The VE testified that the individual could work as a collator operator; merchandise marker; or
small parts assembler. Tr. 49. All three jobs existed in significant numbers in the state and
national economies.

On cross examination, the VE testified that if the same hypothetical

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individual was off task up to 25% of the day on a reoccurring basis, then there would be no
competitive employment available to her.
D.

The ALJ’s decision

The ALJ found that during the relevant period, Proctor had severe impairments of history
of left leg and foot fractures, and right-sided temporal bone fracture with epidural hematoma and
intracerebral contusions; back pain; asthma; anxiety; and depression. Tr. 13. Proctor did not
claim to meet any Listings, and the ALJ did not find that she met any.
The ALJ found that Proctor has the residual functional capacity (RFC):
[T]o perform light work as defined in 20 C.F.R. 416.967(b), except
that she can lift, carry, push and/or pull 20 pounds occasionally,
10 pounds frequently, sit 6 hours in 8, and stand and/or walk 6
hours in 8, with occasional postural activities but no ladders, ropes
or scaffolds, no exposure to extreme temperatures, and no
concentrated exposure to concentrated airborne irritants. In
addition, the claimant is limited to simple, repetitive, to routine,
unskilled work with no complex instructions or tasks and no public
interaction.
Tr. 15. The ALJ concluded that Proctor was not capable of performing past relevant work.
However, the ALJ concluded there were jobs in significant numbers in the economy that Proctor
could perform, including collator operator, merchandise marker, and small parts assembler.
Accordingly, Proctor was denied benefits.
II.

Discussion
The ALJ gave Dr. Fadare’s opinion little weight because it was not well-supported,

whether by reference to objective medical findings or by his own treatment notes, and it was
inconsistent with the observations of Proctor’s social worker. Tr. 18. Proctor argues these were
not good reasons for discounting it, and that the opinion of Dr. Maddox is not adequate support
for the ALJ’s conclusions with respect to mental limitations. She argues that if Dr. Fadare’s

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opinion concerning her marked limitations in sustained concentration and persistence, social
interaction, and adaptation had been given appropriate weight, she would have been found
eligible for benefits.
The Court’s review of the Commissioner’s decision is limited to a determination of
whether the decision is supported by substantial evidence on the record as a whole. Milam v.
Colvin, 794 F.3d 978, 983 (8th Cir. 2015). If the Court finds that the evidence supports two
inconsistent positions and one of those positions represents the Commissioner’s findings, then
the Commissioner’s decision must be affirmed. Wright v. Colvin, 789 F.3d 847, 852 (8th Cir.
2015).
The ALJ evaluated the opinion evidence under 20 C.F.R. §§ 404.1527(c)(1)-(6) and
416.927(c)(1)-(6), which direct the Commissioner to consider whether there is an examining or
treatment relationship; the length of the treatment relationship and frequency of examinations;
the nature and extent of the treatment relationship; supportability; consistency; specialization;
and other factors such as familiarity with the disability programs and their evidentiary
requirements. An ALJ must give controlling weight to a treating medical source opinion if it is
well-supported by medically acceptable clinical and laboratory diagnostic techniques, and is not
inconsistent with the other substantial evidence. Papesh v. Colvin, 786 F.3d 1126, 1132 (8th Cir.
2015) (quoting Wagner v. Astrue, 499 F.3d 842, 848-49 (8th Cir. 2007)). The opinion may be
given “limited weight if it provides conclusory statements only, or is inconsistent with the
record.” Id. (citations omitted). The ALJ “may discount or even disregard the opinion . . . 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.” Id. (quoting Miller v. Colvin, 784 F. 3d 472, 477 (8th Cir. 2015)).

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For the reasons discussed below, the Court concludes that the ALJ’s decision is supported
by substantial evidence on the whole record.
A.

Dr. Fadare’s opinion was not well supported.

The first reason that the ALJ gave for discounting Dr. Fadare’s opinion was that it was
not well-supported, whether by reference to objective medical findings or by the doctor’s own
treatment notes. Dr. Fadare filled out a check-box form, opining that Proctor was markedly
limited in maintaining attention and concentration for extended periods; performing activities
within a schedule; maintaining regular attendance; being punctual within customary tolerances;
working in coordination with others without being distracted; completing a normal workweek
without interruptions from psychological symptoms; responding appropriately to criticism from
supervisors; getting along with coworkers; and travelling in unfamiliar places or using public
transportation. He opined that Proctor would be off-task 25% of the day, and that her medication
caused the side-effect of drowsiness.

He also opined that she would miss work three days a

month due to having bad days.
Dr. Fadare did not write any supporting, objective findings on the form, nor separately
provide any with the filled-out form. The ALJ did not discount the opinion solely because the
doctor used a check-box form, but an ALJ must consider “the degree to which the source
presents relevant evidence to support an opinion” and “how well the source explains the
opinion.” Social Security Ruling 06-03p. Thus, an ALJ may consider the fact that, as here, a
medical source has not cited any supporting, objective clinical findings.

Cline v. Colvin,

771 F.3d 1098, 1104 (8th Cir. 2014) (citing 20 C.F.R. § 416.927(d)(2); Piepgras v. Chater,
76 F.3d 233, 236 (8th Cir. 1996)).
An ALJ may also discount such a conclusory opinion where it “includes significant

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impairments and limitations that are absent from his treatment notes and [the claimant’s] medical
records.” Cline, 771 F.3d at 1104. The impairments and limitations that Dr. Fadare identified
are absent from his treatment notes and Proctor’s medical records. Dr. Fadare’s treatment notes
for the relevant period reflect almost entirely unremarkable mental status exams. Further, there
are no findings relating to difficulty with maintaining attention or concentration, distraction,
keeping to a schedule, punctuality, attendance, working with others, completing a workweek
without interruption from psychological symptoms, or ability to travel in unfamiliar places. 1 To
the extent that Proctor had issues getting along with people, the treatment notes reflect that the
issues were with a former friend who had assaulted her and difficulties that she had with her
teenage children. Further, Dr. Fadare never indicated in the treatment notes that Proctor was
distracted 25% or some other amount of the time, nor did he record that Proctor’s medication
was causing drowsiness.
With respect to having “bad days,” Dr. Fadare’s treatment notes do reflect Proctor’s
reports at her June 2014, October 2014, and April 2015 visits of having frequent bad days,
involving anger and anxiety. But at the June 2014 visit, the doctor found her mental status to be
“stable.” Tr. 299; at the October 2014 visit, Proctor admitted that she was “doing well” and was
“in a better mood,” Tr. 291; and at the April 2015 visit, the doctor found her mental status to be
“stable” and that her medication was working, Tr. 275. Nothing in the doctor’s notes reflects
1

The doctor did observe on three occasions during the relevant time period that
Proctor had “some problem with short term memory,” although he did not record any symptoms
or findings concerning the extent of such problem. In fact, in many of the treatment records
during the relevant time period, the doctor found “Memory intact” on exam.
In any event, Dr. Fadare’s identification of “marked” limitations to which Proctor points,
Doc. 11, p. 9, do not relate to memory. Under the section of the form labeled “Understanding
and Memory,” the doctor opined that Proctor was only “mildly” limited in the ability to
understand and remember very short and simple instructions, and “moderately” limited in the
ability to remember locations and work-like procedures, and understand and remember detailed
instructions. Tr. 470.
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that these bad days were of a nature that would cause her to miss work three days a month, let
alone that they reflect a medically determinable impairment that would last or can be expected to
last for a continuous period of not less than 12 months. 42 U.S.C. § 1382c(a)(3)(A).
Furthermore, the doctor’s treatment of Proctor was conservative, which is inconsistent
with his extreme opinion. He prescribed medication and Proctor has been taking the same one
since at least March 2014. Dr. Fadare even decreased the dosage in January 2015. While
Proctor saw Dr. Fadare about once a month before the alleged onset date, she saw him only
about once every three months after the alleged onset date. Dr. Fadare never ordered in-patient
treatment, nor was Proctor ever hospitalized for mental-health related issues. “Impairments that
are controllable with treatment do not support a finding of total disability.” Pepper ex rel.
Gardner v. Barnhart, 342 F.3d 853, 855 (8th Cir. 2003) (internal quotations and citations
omitted).
Proctor also points to her “low” GAF scores as consistent with Dr. Fadare’s opinions.
Doc. 11, p. 11. However, GAF scores are of little value, Nowling v. Colvin, 813 F.3d 1110, 1123
(8th Cir. 2016), and not intended for the assessment of disability, DeBoard v. Comm’r of Soc.
Sec., 211 Fed. Appx. 411, 415 (6th Cir.2006) (recognizing that the Commissioner has declined to
endorse the GAF scale for use in the disability programs) (citing 65 Fed. Reg. 50746, 50764–65
(Aug. 21, 2000)).
Proctor also argues that the ALJ’s “heavy” reliance on Proctor’s mental status evaluations
was misplaced, quoting a portion of Program Operation Manual System (POMS)
34001.032(C)(3). Doc. 11, p. 10. Section 34001.032(C)(3) states in its entirety:
We must exercise great care in reaching conclusions about your
ability or inability to complete tasks under the stresses of
employment during a normal workday or work week based on a
time-limited mental status examination or psychological testing by
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a clinician, or based on your ability to complete tasks in other
settings that are less demanding, highly structured, or more
supportive. We must assess your ability to complete tasks by
evaluating all the evidence, with emphasis on how independently,
appropriately, and effectively you are able to complete tasks on a
sustained basis.
Nothing in POMS 34001.032(C)(3) prevented the ALJ from considering Proctor’s mental status
evaluations. They are part of “all the evidence.” They are in fact inconsistent with Dr. Fadare’s
extreme opinion. Also, as discussed below, Dr. Fadare’s opinion is inconsistent with substantial
evidence on the whole record.
Substantial evidence supports the ALJ’s conclusion that Dr. Fadare’s opinion was not
well supported, whether by the check-box form or his treatment notes.
B.

Dr. Fadare’s opinion was inconsistent with the social worker’s records.

The ALJ also discounted Dr. Fadare’s opinion because it was inconsistent with the social
worker’s records. Tr. 18. The social worker’s records reflect that Proctor frequently reported
improvement in her mood, and with depression and anxiety symptoms; socialized with friends;
dated; and otherwise got out of the house. Dr. Fadare opined that Proctor would have three bad days
per week, and the social worker’s records do indicate that Proctor had bad days, but they tended to be
related to her teenage children and Proctor thought she was doing better. Substantial evidence
supports the ALJ’s conclusion that the social worker’s records are inconsistent with Dr. Fadare’s
opinion.
Proctor also points out that the social worker’s records reflect other difficulties, such as
anger, anxiety, struggles with boundaries, the need for assistance, and trouble accepting
criticism. Tr. 314, 316, 319, 327, and 470. But this Court cannot reverse the Commissioner’s
decision because substantial evidence supports the contrary outcome, or because it would have
decided the case differently. Andrews v. Colvin, 791 F.3d 923, 928 (8th Cir. 2015). If the
13

evidence supports two inconsistent positions, and one of those positions supports the
Commissioner’s decision, then the Commissioner’s decision must be affirmed. Wright v. Colvin,
7890 F.3d 847, 852 (8th Cir. 2015). Therefore, Proctor’s argument fails.
C.

Proctor’s remaining argument fails.

Finally, Proctor argues that having discounted Dr. Fadare’s opinion, the ALJ should not
have relied on the opinion of Dr. Maddox, the state agency psychological consultant, because he
was a non-examining consultant and his opinion is unsupported. Doc. 11, p. 12. She further
argues that neither Dr. Maddox’s opinion nor any other part of the record provides support for
the ALJ’s RFC determination that she is limited to simple, repetitive, routine, unskilled work
with no complex instructions or tasks and no public interaction. Id. These arguments fail.
First, an ALJ must consider such an expert’s opinion, because it is part of the opinion
evidence. “[S]tate agency medical consultants are highly qualified physicians who are also
experts in Social Security disability evaluation, and ALJs must consider their findings as opinion
evidence.” See 20 C.F.R. §§ 404.1527(d)(1), and 404.1527(f)(2)(I). “[O]pinions from State
agency medical and psychological consultants . . . may be entitled to greater weight than the
opinions of treating or examining sources.” See SSR 96–6p. For example, an ALJ may rely on
non-treating source opinions in cases where, as here, the record contains no well-supported,
treating source opinions. See Vance v. Berryhill, 860 F.3d 1114, 1121 (8th Cir. 2017) (where the
medical record did not support the opinion of the claimant’s treating physician, the ALJ could
“rely instead on the opinions of the state agency medical consultants, which were more
consistent with the medical evidence”) (citing Heino v. Astrue, 578 F.3d 873, 880 (8th Cir.
2009)); and Anderson v. Barnhart, 344 F.3d 809 (8th Cir. 2003) (the ALJ properly credited the
opinion of a consulting physician over that of the claimant’s family physician because of

14

inconsistencies in the family physician’s opinions).
Second, Dr. Maddox’s opinion is well-supported. Dr. Maddox specifically cites support
in the record, including Proctor’s diagnosis of major depression for which she is medicated and
that her symptoms “wax and wane.” Tr. 55. He cites information from the report of Proctor’s
May 2014 consultative exam with Dr. Alejo, who observed that Proctor was in a good mood, had
normal concentration and good eye contact, had fluent speech, and had a good memory.
Dr. Maddox also cites information from Proctor’s adult function report, i.e., that she takes care of
her own activities of daily living, lives with friends, prepares meals and does household chores
as needed, grocery shops weekly, and manages her own finances. He also acknowledged that
she reported not having as many friends, and having memory and concentration difficulty, but
that she can follow spoken instructions. The information he cited is consistent with his findings
that she has mild limitations in activities of daily living, maintaining social functioning, and
maintaining concentration, persistence, or pace; and no repeated episodes of decompensation of
extended duration, and that Proctor’s impairments were non-severe and did not impose any
work-related restrictions. The ALJ gave the opinion significant weight, although the ALJ did
further conclude that “evidence of some ongoing anxiety, depression, and mild memory loss
supports a finding of moderate limitation with regard to concentration, persistence, and pace.”
Tr. 15.
That Dr. Maddox rendered his opinion in June 2014, and therefore did not have access to
Proctor’s treatment records from her later visits with Dr. Fadare, does not mean that
Dr. Maddox’s opinion is unsupported and entitled to no weight, as Proctor suggests.

As

discussed above, Dr. Fadare’s treatment records certainly do not support the marked limitations
to which Dr. Fadare opined. Moreover, Dr. Maddox’s opinion is consistent with substantial

15

evidence on the whole record, including the social worker’s records, discussed above.

In

addition, Proctor also admitted in her adult function report that she takes care of her children and
pet without help; spends time with others daily, whether in person or on the computer, talking,
watching television or listening to music; gets along with authority figures, has never been fired
from a job because of problems getting along with others, is “ok with changes,” and has no
unusual behaviors or fears.

Tr. 148.

As for other medical records, a May 2014, E.R.

physician’s exam findings included, “Psychiatric: Cooperative, appropriate mood & affect,”
Tr. 508, and at doctor’s office visits in November 2014 and June 2015, the providers recorded
that Proctor’s mood was euthymic, Tr. 513 and 518. The ALJ’s decision to give Dr. Maddox’s
opinion significant weight is supported by substantial evidence on the whole record.
Finally, Proctor argues that it is unclear how the ALJ determined that her severe mental
impairments limited her to only simple, routine, unskilled work with no complex instructions or
tasks and no public interaction, because the ALJ gave Dr. Fadare’s opinion little weight and
Dr. Maddox did not opine about those topics.

The ALJ is not required to determine an RFC

based solely on one specific medical opinion. See Martise v. Astrue, 641 F.3d 909, 927 (8th Cir.
2011). Rather, the ALJ considers all the evidence, including medical evidence, and it ultimately
up to the ALJ to determine the weight each opinion is due. See Finch v. Astrue, 547 F.3d 933,
936 (8th Cir. 2008).
In any event, the ALJ’s RFC finding that Proctor was limited to only simple, routine,
unskilled work with no complex instructions or tasks and no public interaction was consistent
with certain aspects of both Dr. Maddox’s and Dr. Fadare’s opinions. For example, the ALJ
gave Dr. Fadare opinion little weight, specifically, the portions concerning extreme limitations.
However, Dr. Fadare also opined that Proctor was moderately limited in understanding,

16

remembering, and carrying out detailed instructions, and mildly limited in the ability to
understand and remember very short and simple instructions, Tr. 470, which supports the ALJ’s
finding. Dr. Maddox did not believe that Proctor’s impairments imposed any work limitations,
so his opinion supports that Proctor can perform unskilled work and interact with supervisors and
co-workers without limitation.
The ALJ’s finding is also consistent with the record as a whole. For example, Proctor has
severe impairments of anxiety and depression. She had “mild” cognitive deficits following her
car accident, some decreased verbal organization, deficits in terminating conversations and
getting off topic, mild impairment in attention and concentration due to self-distraction, mild
problems with abstract reasoning, and mild problems with organization. However, she was not
impaired in the areas of short- or long-term memory, numerical reasoning, situational problem
solving, awareness of problems, goal setting, initiation, planning, or carry over.

A May 2014

consultative exam showed that Proctor had normal concentration and good memory. Simple,
routine, unskilled work with no complex instructions or tasks, and no public interaction is
consistent with the foregoing.
She was cooperative, calm and cheerful at her appointments with Dr. Fadare; other
doctors observed that she was cooperative with an appropriate or good mood; and she admitted
that she could socialize with friends, that she dated, and that she could get along with authority
figures and handle changes, which is consistent with Proctor having no limitations in interacting
with supervisors or coworkers.
The foregoing demonstrates that the ALJ’s decision to give Dr. Maddox’s opinion
substantial weight, and limit Proctor to simple, repetitive, routine, unskilled work with no

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complex instructions or tasks and no public interaction, is supported by substantial evidence on
the whole record, including some medical evidence.
III.

Conclusion
The Commissioner’s decision is affirmed.
s/ Nanette K. Laughrey
NANETTE K. LAUGHREY
United States District Judge

Dated: October 10, 2017
Jefferson City, Missouri

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