SMITH, Circuit Judge.
Jerri Jones appeals the district court's
Jones sought benefits, claiming disability due to anxiety, depression, pain, and shortness of breath. At the time of the ALJ's decision, Jones was 47 years old and living with her husband and niece. She is a high school graduate and holds a Licensed Practical Nurse (LPN) degree. Her past relevant work experience includes being an LPN and a property manager.
The ALJ followed the required five-step sequence to determine whether Jones was entitled to benefits. See 20 C.F.R. §§ 404.1520(a)-(g); 416.920(a)-(g). The ALJ found that Jones had not engaged in substantial gainful activity since the alleged onset date of April 21, 2004. He also found that Jones suffered from arthralgias, polyneuropathy, degenerative disc disease, migraine headaches, hypothyroidism, carpal tunnel syndrome, diabetes mellitus, anxiety disorder, and depressive disorder (NOS). After reviewing the medical exhibits, the ALJ concluded that Jones suffers from a severe impairment within the meaning of the Social Security Regulations but that Jones did not have a "listed" impairment or combination of impairments.
The ALJ then considered whether Jones had the RFC to perform her past work. After considering the medical records and witness testimony, the ALJ found that Jones was not "disabled" and therefore not entitled to benefits. According to the ALJ, "[Jones's] subjective allegations [were] not borne out by the overall evidence and [were] found not to be fully credible to the extent alleged." Based on the VE's testimony, the ALJ also concluded that although Jones is unable to perform her past relevant work as an LPN and property manager, a significant number of jobs in the national economy exist that Jones could perform.
Jones appealed the ALJ's denial of her claim for disability insurance benefits and supplemental security income to the district court, claiming that the ALJ's findings were not supported by substantial evidence on the record as a whole because (1) the ALJ failed to develop the record regarding her restrictive lung disease; (2) the ALJ posed a hypothetical question to the VE that did not include all of Jones's limitations; and (3) the VE's testimony was improper because the VE failed to explain a contradiction with the Dictionary of Occupational Titles (DOT). The district court rejected Jones's arguments. First, the district court held that there was no need for the ALJ to further develop the record because ample medical evidence existed in the record for the ALJ to decide whether Jones was disabled, the evidence supported the ALJ's determination that Jones's restrictive pulmonary disease could be controlled by medication and lifestyle changes, and Jones did not meet a listing. Second, the district court concluded that substantial evidence in the record supported the ALJ's conclusion that Jones had the RFC to perform sedentary work with a fair ability to interact with others in the workplace and that the ALJ properly
On appeal, Jones argues that this court should reverse the ALJ's decision for three reasons: (1) the ALJ failed to properly develop the record and consider whether Jones's restrictive pulmonary disease meets a listing; (2) the ALJ's RFC assessment, which he incorporated into the hypothetical that he posed to the VE, erroneously omits Jones's mental restrictions and is based on an improper credibility assessment; and (3) the VE's response to the hypothetical question identified jobs beyond the restrictions stated in the hypothetical, and the VE failed to provide a sufficient explanation for the variation.
"This court reviews de novo a district court decision upholding the denial of social security benefits." Kluesner v. Astrue, 607 F.3d 533, 536 (8th Cir.2010) (internal quotations and citation omitted). We "will uphold the Commissioner's decision if it is supported by substantial evidence on the record as a whole." Id. (internal quotations and citation omitted). We define "substantial evidence" as "less than a preponderance but ... enough that a reasonable mind would find it adequate to support the conclusion." Id. (internal quotations and citation omitted). We must therefore "consider the evidence that supports the Commissioner's decision as well as the evidence that detracts from it." Id. (internal quotations and citation omitted). We may not reverse the Commissioner merely because "we would have come to a different conclusion." Id. (internal quotations and citation omitted). We must affirm the Commissioner's denial of benefits if, after reviewing the record, "we find it possible to draw two inconsistent positions from the evidence and one of those positions represents the Commissioner's findings." Id. (internal quotations and citation omitted).
In the present case, "the ALJ applied the five-step sequential evaluation in the social security regulations." Id. (citing 20 C.F.R. § 404.1520(a)(4)(i)-(v) (disability insurance benefits); 20 C.F.R. § 416.920(a)(4)(i)-(v) (supplemental security income); Bowen v. Yuckert, 482 U.S. 137, 140-42, 107 S.Ct. 2287, 96 L.Ed.2d 119 (1987); Robson v. Astrue, 526 F.3d 389, 392 (8th Cir.2008)). Under this five-step process,
Id. at 537.
Jones first argues that the ALJ erred at the third step of the five-step evaluation by finding that she has the
"A disability claimant is entitled to a full and fair hearing under the Social Security Act." Halverson v. Astrue, 600 F.3d 922, 933 (8th Cir.2010) (internal quotations and citation omitted). Where "the ALJ's determination is based on all the evidence in the record, including the medical records, observations of treating physicians and others, and an individual's own description of his limitations," the claimant has received a "full and fair hearing." Id. (internal quotations and citation omitted). "The ALJ is required to order medical examinations and tests only if the medical records presented to him do not give sufficient medical evidence to determine whether the claimant is disabled." Id. (internal quotations and citation omitted).
Goff v. Barnhart, 421 F.3d 785, 791 (8th Cir.2005).
"For a claimant to show that his impairment matches a listing, it must meet all of the specified medical criteria." Brown ex rel. Williams v. Barnhart, 388 F.3d 1150, 1152 (8th Cir.2004) (internal quotations and citation omitted). Furthermore, the question is whether the ALJ "consider[ed] evidence of a listed impairment and concluded that there was no showing on th[e] record that the claimant's impairments ... m[et] or are equivalent to any of the listed impairments." Karlix v. Barnhart, 457 F.3d 742, 746 (8th Cir.2006) (internal quotations omitted). "The fact that the ALJ d[oes] not elaborate on this conclusion does not require reversal [where] the record supports h[is] overall conclusion." Id.
In light of Dr. Gilliam's reports, the ALJ had no need to contact Dr. Gilliam, the treating physician, because there was no ambiguity to resolve in her reports, and the report contained all the necessary information, including the results of diagnostic
And, Dr. Hamilton's opinion that it was "possible" that Jones met a listing with her pulmonary impairment is not controlling because Dr. Hamilton is an orthopedic specialist not qualified to make conclusions regarding chronic pulmonary insufficiency.
Therefore, ample evidence exists in the record to support the ALJ's conclusion that Jones's restrictive pulmonary disease was not an "impairment" matching a listing for chronic pulmonary insufficiency.
Jones next challenges the ALJ's determination at step five that there is other work in the economy that Jones can perform. The ALJ found that Jones had the RFC to perform sedentary work and, based on the VE's testimony, concluded that she is not disabled because there is other work in the economy that she can perform. According to Jones, her RFC is more limited than the ALJ found because the ALJ (1) failed to include restrictions that describe the effects of her mental impairments and (2) erred in assessing her credibility.
Pate-Fires v. Astrue, 564 F.3d 935, 942 (8th Cir.2009) (internal citations omitted).
Reed v. Sullivan, 988 F.2d 812, 815-16 (8th Cir.1993) (internal quotations, alterations, and citations omitted). "[T]he record must include some medical evidence that supports the ALJ's residual functional capacity finding." Dykes v. Apfel, 223 F.3d 865, 867 (8th Cir.2000). "It is the ALJ's responsibility to determine claimant's RFC based on all the relevant evidence, including medical records, observations of treating physicians and others, and claimant's own description of her limitations." Page v. Astrue, 484 F.3d 1040, 1043 (8th Cir. 2007) (internal quotations, alterations, and citations omitted).
"Generally, if the claimant suffers from nonexertional impairments that limit her ability to perform the full range of work described in one of the specific categories set forth in the guidelines, the ALJ is required to utilize testimony of a
Jones argues that the ALJ failed to include restrictions in the hypothetical that describe the effects of her mental impairments, as she has struggled with depression and anxiety, been treated on numerous occasions by both her primary care physicians and by mental health professionals, undergone extensive medical therapy, and attended several individual therapy sessions. Jones relies on the statement of her treating psychiatrist, Dr. David Erby, that she suffers from an anxiety disorder with panic and a depressive disorder. According to Jones, Dr. Erby certified that she meets the criteria for a serious mental illness. Also, she notes that throughout her treatment, both Dr. Erby and her therapist have assigned her Global Assessment Functioning (GAF) scores ranging from the mid-40s to the low-50s.
As the district court found, the record reflects that the ALJ adequately reviewed all the relevant evidence concerning Jones's alleged disability due to anxiety and depression, as he
(Internal citations omitted.) Based on the evidence, the ALJ determined that "the frequency, intensity, and duration of the claimant's mental symptomatology would not more than minimally affect her ability to carry on gainful activity at the unskilled and semiskilled sedentary exertional level." Like the district court, we find that "[t]he ALJ's conclusion that [Jones] had the RFC to perform sedentary work with a fair ability to interact with others in the workplace is supported by substantial evidence in the record."
Jones is correct that Dr. Erby did (1) opine that Jones suffers from anxiety disorder, with panic, and depressive disorder and (2) certify that Jones meets the criteria for a functional impairment for an adult with a serious mental illness. But the record also reflects that, during Jones's treatment, Dr. Erby on certain occasions questioned whether Jones's anxiety was "contrived." On October 2, 2006, Dr. Erby stated:
And, on October 27, 2006, Dr. Erby observed the following:
Given Dr. Erby's comments about "probable dramatic exaggeration of anxiety," "[t]he ALJ was entitled to draw conclusions about [Jones's] credibility based on [Dr. Erby's observation] indicating that [Jones] was exaggerating symptoms...." Baker v. Barnhart, 457 F.3d 882, 892 (8th Cir.2006) (citing Clay v. Barnhart, 417 F.3d 922, 930 n. 2 (8th Cir.2005) (noting that two psychologists' findings that the claimant was "malingering" on her IQ tests cast suspicion on the claimant's motivations and credibility); Jones v. Callahan, 122 F.3d 1148, 1152 (8th Cir.1997) (holding that a physician's observation "of the discrepancies in [the claimant's] appearance in the examining room and those outside when he did not know that he was observed" supported an ALJ's finding that the claimant's complaints were not fully credible)).
Furthermore, Jones's reliance on Dr. Erby's GAF scoring of her in the mid-40s and lower 50s as implicating "impairment in social, occupational, or social functioning" is unavailing.
DeBoard v. Comm'r of Soc. Sec., 211 Fed. Appx. 411, 415 (6th Cir.2006) (unpublished).
As the district court correctly observed, "an ALJ may afford greater weight to medical evidence and testimony than to GAF scores when the evidence requires it." (Citing Hudson ex rel. Jones v. Barnhart, 345 F.3d 661, 666 (8th Cir. 2003) ("Finally, the ALJ agreed that the GAF ratings assigned by the various treating and examining providers did not appear to reflect Sterling's current abilities, given Hudson's testimony during the hearings.")).
Jones alleges that the ALJ erroneously dismissed her testimony based on a "supposed inconsistency" with the medical evidence. According to Jones, the ALJ questioned her activities solely in light of the medical evidence and failed to identify any conflicts other than those with
Halverson, 600 F.3d at 931-32. "If an ALJ explicitly discredits the claimant's testimony and gives good reason for doing so, we will normally defer to the ALJ's credibility determination." Id. at 932 (internal quotations and citation omitted). "While an ALJ may not disregard subjective pain allegations solely because they are not fully supported by objective medical evidence, an ALJ is entitled to make a factual determination that a Claimant's subjective pain complaints are not credible in light of objective medical evidence to the contrary." Baker, 457 F.3d at 892-93 (internal quotations and citation omitted).
Our thorough review of the record reveals that the ALJ appropriately considered Jones's subjective complaints of pain under Polaski. As the district court observed, "[t]he ALJ considered [Jones's] daily activities, her medications, her demeanor at the hearing, and the inconsistency between [Jones's] complaints and the objective medical evidence." (Emphasis added.)
First, although Jones testified, according to the ALJ, that she
the ALJ found that Jones's activities "appear to be limited more on a self-imposed voluntary basis than as a result of any functional restrictions due to her impairments." The ALJ found Jones's claims contrary to her statement on August 29, 2006, that "she kept care of her father who was dependent on her for keeping the house and also reminding him about his diet, medications, etc." Further, the ALJ pointed out that during a psychological assessment on July 18, 2006, Jones stated that "she had other family problems that contributed to her not working."
Second, despite Jones's complaint of being anxious around people, a friend took her to the hospital on November 14, 2006,
Third, the ALJ noted that while Jones claimed to suffer from anxiety and panic attacks in public, her treating physician never placed any restriction on her being around people.
Fourth, the ALJ concluded that "the claimant record is supportive that when the claimant is compliant with her medication regime, her symptomatology is fairly well controlled to the point that she could do unskilled and semiskilled work activity."
Finally, the ALJ addressed a host of ailments that Jones complained of and concluded that the medical tests did not support the severity of her complaints.
Finally, Jones asserts that the ALJ erroneously relied on the VE's testimony, which was not responsive to the ALJ's hypothetical. According to Jones, the hypothetical limited the VE's consideration to jobs that are sedentary in nature requiring only occasional handling. This limitation was based on Dr. Hamilton's testimony that Jones would be limited to sedentary work with only occasional use of her hands—repetitive and frequent repetitive actions with the hands would be precluded. Jones asserts that the VE identified jobs that require frequent handling and failed to justify his answer.
Dr. Hamilton testified that, in his medical opinion, Jones "would be at the sedentary work level with some—only occasional use of her hands. If it's not repetitive or frequent repetitive actions with her hands, but only occasionally." Thereafter, the ALJ proposed the following hypothetical to the VE, stating:
(Emphasis added.) In response, the VE stated:
The VE then estimated that the amount of their occurrences would be reduced by ten to 15 percent. Jones's attorney then questioned the VE about the positions of calendar control clerk and patient insurance clerk, stating:
The VE acknowledged that "hand and fingering is frequently used in these positions." Then, Jones's counsel clarified that "frequently" means "from one-third to two-thirds of the day," and the VE agreed. Counsel then asked whether "occasionally" meant "up to one-third of the day," and the VE answered in the affirmative. Next, counsel questioned the VE about the ALJ's hypothetical, and the following exchange occurred:
(Emphasis added.)
Renfrow v. Astrue, 496 F.3d 918, 920-21 (8th Cir.2007). Here, Jones's counsel brought the purported conflict to the ALJ's attention, and Jones does not contend on appeal that the ALJ erred in not initiating the inquiry. But
Hillier v. Soc. Sec. Admin., 486 F.3d 359, 366-67 (8th Cir.2007).
Wheeler, 224 F.3d at 897 (internal citations omitted); accord Hall, 109 F.3d at 1259 (holding that claimant could perform a number of jobs within the categories the VE listed—218 clerk jobs and 122 information clerk jobs in Arkansas—despite claimant's citation to the DOT "for the proposition that these jobs all require reaching, handling, or finger work" because DOT definitions are general job descriptions offering approximate maximum requirements for each position rather than their range).
Thus, "[w]hen VE testimony conflicts with the DOT, the DOT controls when the DOT classifications are not rebutted. The DOT classifications may be rebutted with VE testimony which demonstrates specific jobs whether classified as light or sedentary, may be ones that a claimant can perform." Dobbins v. Barnhart, 182 Fed.Appx. 618, 619 (8th Cir.2006) (unpublished per curiam) (internal quotations and citations omitted); see also Hillier, 486 F.3d at 367 (stating that a VE must "adequately respond[ ] to the hypothetical question posed by the ALJ"); Porch v. Chater, 115 F.3d 567, 572 (8th Cir.1997) ("When expert testimony conflicts with the DOT, and the DOT classifications are not rebutted, the DOT controls.").
Here, the ALJ offered an explanation of the inconsistency between his testimony and the DOT. When the ALJ posed the hypothetical to the VE, the VE indicated that Jones could perform the sedentary positions of the calendar control clerk and patient insurance clerk but "that they would—would be adjusted in the amount of their occurrences due to the limitation of only occasionally handle." Additionally, the VE estimated, in his expert opinion, "a 10 or 15% reduction in those jobs because there was a restriction in handling, but not in the fingering and feeling part of it." "Because the vocational expert specifically limited his opinion to reflect sedentary work only (requiring [occasional handling]), his testimony was a perfectly acceptable basis for the administrative law judge's conclusions." Jones v. Chater, 72 F.3d 81, 82 (8th Cir.1995).
Accordingly, we hold that substantial evidence on the record as a whole supports
Id. (quoting Diagnostic and Statistical Manual of Mental Disorders, 32 (4th ed. Am. Psychiatric Ass'n 1994)) (emphasis added).
Here, Jones has not presented a "GAF score history" indicating that she was at or below a GAF of 50 on several occasions. Furthermore, unlike in Pate-Fires, Dr. Erby's assigning of a GAF of 50 is undercut by his prior comments about "probable dramatic exaggeration of anxiety" on Jones's part due to her disability filing. And, the ALJ explained why it was discrediting the findings of Mid South Health System. Also, unlike in Pate-Fires where this court found that Dr. Erby's findings did not actually conflict with the consulting psychiatrist's findings, the ALJ here relied heavily on Jones's actual daily activities, such as caring for her father, in reaching its conclusions. Finally, the court in Pate-Fires did not reference 65 Federal Regulation 50746, 50764-65 (August 21, 2000), in which the Commissioner declined to endorse the GAF scales to evaluate Social Security claims because the scales do not have a direct correlation to the severity requirements in mental disorders listings.
