United States District Court, E.D. Missouri, Eastern Division
MEMORANDUM AND ORDER 
NANNETTE A. BAKER UNITED STATES MAGISTRATE JUDGE.
an action under 42 U.S.C. § 405(g) for judicial review
of the Commissioner of Social Security's final decision
denying Amanda Skaggs' (Skaggs) application for
disability insurance benefits and supplemental security
income (SSI) under the Social Security Act, 42 U.S.C.
§§ 416, 423 et seq. Skaggs alleged
disability due to traumatic brain injury. (Tr. 161.) The
parties have consented to the exercise of authority by the
undersigned United States Magistrate Judge pursuant to 28
U.S.C. § 636(c). [Doc. 10.] For the reasons set forth
below, the Court will reverse and remand the
Commissioner's final decision.
Issues for Review
presents two issues for review. First, she asserts that the
administrative law judge's (ALJ) residual functional
capacity (RFC) determination does not adequately account for
her migraine headaches and fails to provide a narrative link
between the medical evidence and the ultimate conclusion.
Second, she contends that the ALJ's credibility analysis
is not supported by substantial evidence. The Commissioner
contends that the ALJ's decision is supported by
substantial evidence in the record as a whole and should be
Standard of Review
Social Security Act defines disability as an “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 has lasted or can
be expected to last for a continuous period of not less than
12 months.” 42 U.S.C. §§ 416(i)(1)(A),
Social Security Administration uses a five-step analysis to
determine whether a claimant seeking disability benefits is
in fact disabled. 20 C.F.R. §§ 404.1520(a)(1),
416.920(a)(1). First, the claimant must not be engaged in
substantial gainful activity. 20 C.F.R. §§
404.1520(a)(4)(i), 416.920(a)(4)(i). Second, the claimant
must establish that he or she has an impairment or
combination of impairments that significantly limits his or
her ability to perform basic work activities and meets the
durational requirements of the Act. 20 C.F.R. §§
404.1520(a)(4)(ii), 416.920(a)(4)(ii). Third, the claimant
must establish that his or her impairment meets or equals an
impairment listed in the appendix to the applicable
regulations. 20 C.F.R. §§ 404.1520(a)(4)(iii),
416.920(a)(4)(iii). If the claimant's impairments do not
meet or equal a listed impairment, the SSA determines the
claimant's RFC to perform past relevant work. 20 C.F.R.
§§ 404.1520(e), 416.920(e).
the claimant must establish that the impairment prevents him
or her from doing past relevant work. 20 C.F.R. §§
404.1520(a)(4)(iv), 416.920(a)(4)(iv). If the claimant meets
this burden, the analysis proceeds to step five. At step
five, the burden shifts to the Commissioner to establish that
the claimant maintains the RFC to perform a significant
number of jobs in the national economy. Singh v.
Apfel, 222 F.3d 448, 451 (8th Cir. 2000). If the
claimant satisfies all of the criteria under the five-step
evaluation, the ALJ will find the claimant to be disabled. 20
C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).
standard of review is narrow. Pearsall v. Massanari,
274 F.3d 1211, 1217 (8th Cir. 2001). This Court reviews
decisions of the ALJ to determine whether the decision is
supported by substantial evidence in the record as a whole.
42 U.S.C. § 405(g). Substantial evidence is less than a
preponderance, but enough that a reasonable mind would find
adequate support for the ALJ's decision. Smith v.
Shalala, 31 F.3d 715, 717 (8th Cir. 1994). The court
determines whether evidence is substantial by considering
evidence that detracts from the Commissioner's decision
as well as evidence that supports it. Cox v.
Barnhart, 471 F.3d 902, 906 (8th Cir. 2006). The Court
may not reverse just because substantial evidence exists that
would support a contrary outcome or because the Court would
have decided the case differently. Id. If, after
reviewing the record as a whole, the Court finds it possible
to draw two inconsistent positions from the evidence and one
of those positions represents the Commissioner's finding,
the Commissioner's decision must be affirmed.
Masterson v. Barnhart, 363 F.3d 731, 736 (8th Cir.
2004). To determine whether the ALJ's final decision is
supported by substantial evidence, the Court is required to
review the administrative record as a whole to consider:
(1) The findings of credibility made by the ALJ;
(2) The education, background, work history, and age of the
(3) The medical evidence given by the claimant's treating
(4) The subjective complaints of pain and description of the
claimant's physical activity and impairment;
(5) The corroboration by third parties of the claimant's
(6) The testimony of vocational experts based upon prior
hypothetical questions which fairly set forth the
claimant's physical impairment; and
(7) The testimony of consulting physicians.
Brand v. Sec'y of Dept. of Health, Educ. &
Welfare, 623 F.2d 523, 527 (8th Cir. 1980).
September 28, 2005, Skaggs experienced a head injury that
rendered her unconscious and required hospitalization for two
days. (Tr. 236, 374.) She incurred a left knee injury in
April 2006. (Tr. 376-79.) Dr. David Peeples performed an
independent medical evaluation for workers' compensation
purposes on January 18, 2010. (Tr. 236-39.) Dr. Peeples
opined that Skaggs would need ongoing treatment with
medication for her headaches. (Tr. 238.) He opined that she
could work without restriction, because her headache symptoms
were subjective and did not limit her occupational and
personal activities. (Tr. 238-39.) He found that her
neurological examination was normal. (Tr. 239.) Skaggs
indicated in her disability report that she stopped working
on May 25, 2009, because her employer found someone to
volunteer to perform her job duties. (Tr. 161.) At her August
2014 administrative hearing, she testified that she stopped
working, because the church that she worked for stopped
holding meetings on the night that she prepared food for the
church. (Tr. 33-34.) Her disability report indicates that her
conditions became severe enough to keep her from working on
January 1, 2011. (Tr. 161.)
medical evidence in the record includes treatment from Dr.
Mohammed Choudhary between 2011 and 2012 for treatment of
headaches, which Skaggs alleged occurred every day. During
this time, Skaggs complained of headaches, blurred vision,
pressure behind her eyes, nausea, memory loss, concentration
problems, and balance problems without falling. (Tr. 264-92,
446-48, 450, 493-526.) Dr. Choudhary also performed spinal
taps to relieve the headaches. (Tr. 264-69, 446-49, 493-526.)
Skaggs reported relief from the headaches for a short time
after the spinal taps. Dr. Salim Rahman examined Skaggs and
ordered an MRI. (Tr. 270-73.) The MRI, taken on January 12,
2012, showed no acute intracranial abnormality, mild
hypoplasia in the left temporal lobe, and mild
cerebellar tonsillar ectopia. (Tr. 274-75.) Dr. Rahman did
not recommend surgical intervention, because there was no
evidence of Chiari I malformation, nor of intracranial trauma.
(Tr. 276-77.) Dr. Ifeanyi Orizu diagnosed Skaggs with myopia
(near-sightedness), punctuate keratitis, and crystalline
deposits in vitreous on January 25, 2012. (Tr. 368.) He did
not find retinal detachment or a retinal break. (Tr. 368.)
Peeples performed a second independent medical evaluation on
July 25, 2012. (Tr. 240-42.) He noted that Skaggs'
post-concussive headaches continued and she had developed
increased headaches, visual symptoms, and elevated CSF