United States District Court, E.D. Missouri, Southeastern Division
SALLY A. JONES, Plaintiff,
NANCY A. BERRYHILL, Deputy Commissioner of Operations, Social Security Administration, Defendant.
MEMORANDUM AND ORDER
PATRICIA L. COHEN UNITED STATES MAGISTRATE JUDGE.
Sally Jones seeks review of the decision of the Social
Security Administration (SSA) denying her applications for
Disability Insurance Benefits and Supplemental Security
Income under the Social Security Act. The Court has reviewed the
parties' briefs and the administrative record, including
the hearing transcript and medical evidence. For the reasons
set forth below, the case is reversed and remanded.
Background and Procedural History
who was then forty-five years old, filed applications for
Disability Insurance Benefits and Supplemental Security
Income in June 2015, alleging she was disabled as of March
15, 2007. (Tr. 15) The SSA denied Plaintiff's
applications, and she filed a timely request for a hearing
before an administrative law judge (ALJ). (Tr. 133, 145-46)
granted Plaintiff's request for review, and an ALJ
conducted a hearing in January 2016. (Tr. 161) In a decision
dated June 25, 2017, the ALJ determined that Plaintiff
“has not been under a disability, as defined in the
Social Security Act from March 15, 2007, through the date of
this decision[.] (Tr. 25).
decision, the ALJ applied the five-step evaluation set forth
in 20 C.F.R. §§ 404.1520, 416.920 and determined
that Plaintiff had the severe impairments of:
“degenerative disc disease with mild spondylosis that
is slightly eccentric with the right greater than the left at
¶ 4-L5 and L5-S1, obesity, chronic obstructive pulmonary
disease (COPD), and major depressive disorder.” (Tr.
17) Additionally, the ALJ found that Plaintiff had the
non-severe impairments of diabetes mellitus, gastro
esophageal reflux disease (GERD), and hypertension. (Tr. 18)
reviewing the record, the ALJ determined that Plaintiff had
the residual functioning capacity (RFC) to:
Perform sedentary work as defined in 20 CFR 404.1567(a) and
416.967(a) except that she can never climb ladders, ropes or
scaffolds; can occasionally climb ramps or stairs; and she
can occasionally stoop, kneel, crouch and crawl. She must
avoid concentrated exposure to excessive vibration, pulmonary
irritants such as fumes, odors, dust and gases, extreme cold,
extreme heat, moving factory-type machinery and unprotected
heights. She can perform work limited to simple repetitive
tasks. She can have occasional contact with the public,
co-workers and supervisors.
(Tr. 20) Finally, the ALJ concluded: “Considering the
claimant's age, education, work experience, and residual
functional capacity, there are jobs that exist in significant
numbers in the national economy that the claimant can
perform.” (Tr. 24)
requested review of the ALJ's decision with the SSA
Appeals Council, which denied review in January 2018. (Tr. 1)
Plaintiff has exhausted all administrative remedies, and the
ALJ's decision stands as the SSA's final decision.
Sims v. Apfel, 530 U.S. 103, 106-07 (2000).
respect to the medical records and other evidence of record,
the Court adopts Plaintiff's recitation of facts set
forth in her Statement of Material Facts [ECF No. 22-1], to
the extent admitted by Defendant [ECF No. 28-1]. The Court
also adopts the additional facts set forth in Defendant's
Statement of Additional Facts [ECF No. 28-2] and notes that
Plaintiff did not refute them. Together, these statements
provide a fair and accurate description of the relevant
record before the Court. The Court will address specific
facts related to the issues raised by Plaintiff as needed in
the discussion below.
Standards for Determining Disability Under the
for disability benefits under the Act requires a claimant to
demonstrate that he or she suffers from a physical or mental
disability. 42 U.S.C. § 423(a)(1). The Act defines
disability as “the inability to do 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 not less than 12 months.” 20 C.F.R.
§§ 404.1505(a), 416.905(a). The impairment must be
“of such severity that [the claimant] is not only
unable to do his previous work but cannot, considering his
age, education, and work experience, engage in any other kind
of substantial gainful work which exists in the national
economy ....” 42 U.S.C. § 1382c(a)(3)(B).
determine whether a claimant is disabled, the Commissioner
engages in a five-step evaluation process. See 20
C.F.R. §§ 404.1520, 416.920. Those steps require a
claimant to show that he or she: (1) is not engaged in
substantial gainful activity; (2) has a severe impairment or
combination of impairments which significantly limits his or
her physical or mental ability to do basic work activities or
(3) has an impairment which meets or exceeds one of the
impairments listed in 20 C.F.R., Subpart P, Appendix 1; (4)
is unable to return to his or her past relevant work; and (5)
the impairments prevent him or her from doing any other work.
claims substantial evidence does not support the ALJ's
decision because the ALJ failed to: (1) properly evaluate and
provide “good reasons” for discrediting the
opinion of Plaintiff's treating physician; and (2) find
that Plaintiff's borderline intellectual functioning was
a severe impairment. [ECF No. 22] Defendant counters that:
(1) substantial evidence supported the ALJ's evaluation
of Plaintiff's subjective complaints, including her
evaluation of the medical opinion evidence; and (2) the
failure to find Plaintiff's borderline intellectual
functioning was a severe impairment did not constitute
Standard of Judicial Review
must affirm an ALJ's decision if it is supported by
substantial evidence. 42 U.S.C. § 405(g).
“Substantial evidence ‘is less than a
preponderance, but enough so that a reasonable mind might
find it adequate to support the conclusion.'”
Cruze v. Chater, 85 F.3d 1320, 1323 (8th Cir. 1996)
(quoting Boerst v. Shalala, 2 F.3d 249, 250 (8th
Cir. 1993)). In determining whether the evidence is
substantial, a court considers evidence that both supports
and detracts from the Commissioner's decision.
Pate-Fires v. Astrue, 564 F.3d 935, 942 (8th Cir.
2009). However, a court “do[es] not reweigh the
evidence presented to the ALJ and [it] defer[s] to the
ALJ's determinations regarding the credibility of
testimony, as long as those determinations are supported by
good reason and substantial evidence.” Renstrom v.
Astrue, 680 F.3d 1057, 1064 (8th Cir. 2012) (quoting
Gonzales v. Barnhart, 465 F.3d 890, 894 (8th Cir.
contends the ALJ's RFC determination is not supported by
substantial evidence because the ALJ improperly discredited
the medical opinion of Plaintiff's primary care
physician, Dr. Heather Gessling. [ECF No. 22] More
specifically, Plaintiff argues that the ALJ did not provide
“good reasons” for discrediting Dr.
Gessling's medical source statement (MSS) because the ALJ
cited only one treatment note and appeared to disregard the
treatment notes of Plaintiff's pain management physician,
Dr. Miranda Reed. In response, Defendant asserts that the ALJ
properly cited Dr. Gessling's most recent treatment note
and discussed other evidence in the record that conflicted
with Dr. Gessling's MSS.
treating physician's opinion regarding an applicant's
impairment will be granted controlling weight, provided the
opinion is well supported by medically acceptable clinical
and laboratory diagnostic techniques and is not inconsistent
with the other substantial evidence in the
record.” Hamilton v. Astrue, 518 F.3d 607,
610 (8th Cir. 2008) (quoting Singh v. Apfel, 222
F.3d 448, 452 (8th Cir. 2000)). “The ALJ may discount
or disregard such an opinion if other medical assessments are
supported by superior medical evidence, or if the treating
physician has offered inconsistent opinions.”
Id. (quoting Hogan v. Apfel, 239 F.3d 958,
961 (8th Cir. 2001)). See also Prosch v. Apfel, 201
F.3d 1010, 1013 (8th Cir. 2000).
the ALJ gives the opinion of a treating physician great or
little weight, the ALJ must give good reasons for doing
so.” Walker v. Comm'r, 911 F.3d 551, 553
(8th Cir. 2018) (quoting Reece v. Colvin, 834 F.3d
904, 909 (8th Cir. 2016)). “This requires the ALJ to
explain in his written decision, with some specificity, why
he has rejected the treating physician's ...