Hughes v. Social Security Administration Commissioner

IN THE UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF ARKANSAS
FORT SMITH DIVISION
BEVERLY M. HUGHES 	PLAINTIFF
V. 	Civil No. 2:24-cv-02068-PKH-MEF
LELAND DUDEK, Acting Commissioner,1
Social Security Administration 	DEFENDANT
MAGISTRATE JUDGE’S REPORT AND RECOMMENDATION
Plaintiff, Beverly Hughes, brings this action under 42 U.S.C. § 405(g), seeking judicial
review of a decision of the Commissioner of Social Security Administration (“Commissioner”)
denying her claim for a period of disability, disability insurance benefits (“DIB”), and
supplemental security income (“SSI”) under Titles II and XVI of the Social Security Act
(hereinafter “the Act”), 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). 	In this judicial review, the
Court must determine whether there is substantial evidence in the administrative record to support
the Commissioner’s decision. See 42 U.S.C. § 405(g).
I. 	Procedural Background
Plaintiff filed her applications for DIB and SSI on April 29, 2021,2 alleging disability since
November 18, 2020, due to anxiety, depression, neck problems, and neuropathy in her upper
extremities. (ECF No. 7, pp. 123, 131, 140, 274-284, 304, 329-331, 343-345). The Commissioner
1 Leland Dudek was named Acting Commissioner of Social Security on February 18, 2025, and
in his official capacity is substituted as defendant. See Fed. R. Civ. P. 25(d).
2 On November 17, 2020, Administrative Law Judge, Edward Starr denied Plaintiff’s November
2018 applications for DIB and SSI. (ECF No. 7, pp. 107-117).
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denied Plaintiff’s applications initially and on reconsideration, and an administrative hearing was
held on March 13, 2023. (Id. at 70-102). Plaintiff was present and represented by counsel.
On her alleged onset date, Plaintiff was 46 years old and possessed a limited education.
(ECF No. 7, pp. 36, 305). She had past relevant work (“PRW”) experience as a certified nurse
assistant (“CNA”). (Id. at 36, 305, 321-328).
On July 12, 2023, Administrative Law Judge (“ALJ”) Glenn Neel identified Plaintiff’s
osteoarthritis (“OA”) / degenerative disk disease (“DDD”) of the cervical spine / cervical
spondylosis status post-anterior cervical fusion and discectomy at the C5-6 level, OA/DDD of the
lumbar spine, OA of the left shoulder, obesity, mild right carpal tunnel syndrome (“CTS”), right
hip tendinitis, hypothyroidism, major depressive disorder (“MDD”), and generalized anxiety
disorder (“GAD”) as severe impairments. (ECF No., p. 26). He concluded, however, that Plaintiff
did not have an impairment or combination of impairments that met or medically equaled the
severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Id. at 26-27). ALJ
Neel found Plaintiff capable of performing light work with occasional posturals, occasional
overhead reaching with her upper extremities, frequent reaching in all other directions, and
frequent handling/fingering with her upper extremities. 	(Id. at 27-28). 	Due to medication side
effects, he determined she must also avoid exposure to hazards. Additionally, the ALJ adjudged
the Plaintiff to be capable of understanding and remembering simple instructions, carrying out
simple 	instructions, 	using 	judgment 	to 	make simple 	work-related 	decisions, 	occasionally
interacting with supervisors and co-workers and dealing with changes in a routine work setting,
and having no interactions with the public. (Id. at 28). With the assistance of a vocational expert
(“VE”), ALJ Neel determined Plaintiff could perform work as a power screwdriver operator, small
products assembler, and a produce weigher. (Id. at 37).
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On April 4, 2024, the Appeals Council denied Plaintiff’s request for review. (ECF No. 7,
pp. 6-11). Plaintiff subsequently filed her Complaint to initiate this action. (ECF No. 3). Both
parties have filed appeal briefs (ECF Nos. 13, 15, 16), and the matter is ripe for resolution. The
case has been referred to the undersigned for Report and Recommendation.
II. 	Applicable Law
This 	Court’s 	role 	is 	to 	determine 	whether 	substantial 	evidence 	supports 	the
Commissioner’s findings. 	Vossen v. Astrue, 612 F.3d 1011, 1015 (8th Cir. 2010). 	Substantial
evidence is less than a preponderance but enough that a reasonable mind would find it adequate to
support the Commissioner’s decision. Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019). We must
affirm the ALJ’s decision if the record contains substantial evidence to support it. Blackburn v.
Colvin, 761 F.3d 853, 858 (8th Cir. 2014). If there is substantial evidence in the record to support
the Commissioner’s decision, the Court may not reverse it simply because substantial evidence
exists in the record that would have supported a contrary outcome, or because the Court would
have decided the case differently. Miller v. Colvin, 784 F.3d 472, 477 (8th Cir. 2015). In other
words, if after reviewing the record it is possible to draw two inconsistent positions from the
evidence and one of those positions represents the findings of the ALJ, we must affirm the ALJ’s
decision. Id.
A claimant for Social Security disability benefits has the burden of proving her disability
by establishing a physical or mental disability that has lasted at least one year and that prevents
her from engaging in any substantial gainful activity. Pearsall v. Massanari, 274 F.3d 1211, 1217
(8th Cir. 2001); see also 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). The Act defines “physical
or mental impairment” as “an impairment that results from anatomical, physiological, or
psychological abnormalities which are demonstrable by medically acceptable clinical and
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laboratory diagnostic techniques.” 42 U.S.C. §§ 423(d)(3), 1382c(a)(3)(D). A Plaintiff must show
that her disability, not simply her impairment, has lasted for at least twelve consecutive months.
The Commissioner’s regulations require him to apply a five-step sequential evaluation
process to each claim for disability benefits: (1) whether the claimant has engaged in substantial
gainful activity since filing her claim; (2) whether the claimant has a severe physical and/or mental
impairment or combination of impairments; (3) whether the impairment(s) meet or equal an
impairment in the listings; (4) whether the impairment(s) prevent the claimant from doing past
relevant work; and, (5) whether the claimant is able to perform other work in the national economy
given her age, education, and experience. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). The
fact finder will only consider Plaintiff’s age, education, and work experience in the light of her
residual functional capacity if the final stage of the analysis is reached. 	20 C.F.R. §§
404.1520(a)(4)(v), 416.920(a)(4)(v).
II. 	Relevant Medical Evidence
A review of the record reveals that the Plaintiff began complaining of left upper extremity
and right hip pain in October 2020. 	(ECF No. 7, pp. 475-477, 485-486). 	Patrick Walton, a
physician’s assistant (“PA”) at Mercy Orthopedics, noted a fairly normal shoulder exam with 2/4
deep tendon reflexes in the triceps, a catch and click in the anterior hip, and pain to palpation over
the iliopsoas. 	Although x-rays of the shoulder revealed some mild acromioclavicular joint
narrowing, hip x-rays were unremarkable. PA Walton prescribed a Medrol Dosepack and ordered
an MRI of her spine that ultimately showed minimal reversal of the normal cervical lordosis, mild
intervertebral disc space height loss at the C5-C6 level, mild left uncovertebral hypertrophy
causing mild left neuroforaminal stenosis at the C3-4 level, mild disc bulge and mild narrowing
of the spinal canal at the C4-5 level, diffuse disc bulge and mild to moderate narrowing of the
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spinal canal at the C5-6 level with moderate bilateral neuroforaminal stenosis secondary to
uncovertebral facet hypertrophy, and mild disc bulge and mild narrowing of the spinal canal at the
C6-7 level. 	(Id. at 482-485). 	When the Plaintiff refused PA Walton’s recommendation for
injections, he prescribed Meloxicam and therapy modalities to include cervical traction. 	(Id. at
474-475).
Plaintiff did not return for further treatment until February 2021, at which time she
complained of persistent left shoulder pain. 	(ECF No. 7, p. 472). 	She reported taking the
Meloxicam for approximately one month to no avail and requested to see a surgeon. On exam,
Plaintiff moved her shoulder through an entire range of motion with minimal pain. Believing that
her shoulder symptoms were radiating from her neck, rather than a surgical issue involving her
shoulder, PA Walton referred her to neurosurgery.
Primary care physician, Dr. Vikki Sutterfield, began treating Plaintiff in April 2021, for
complaints of high blood pressure, stable hypothyroidism, and stable depression and anxiety.
(ECF No. 7, pp. 425-430, 466-470). When she returned in June, Plaintiff advised the doctor that
she was seeking disability due to her anxiety. (Id. at 462-466). However, she also complained of
pain radiating from her neck down her left arm. Noting pain in the neck and shoulder, worse with
range of motion and recent MRI results showing spinal stenosis, Dr. Sutterfield diagnosed
hypothyroidism, GAD, and cervical stenosis of the spine which she noted to be under the treatment
of neurosurgeon, Dr. Kenneth Foxx. She then completed a checkbox RFC form opining that the
Plaintiff could not even perform part-time work activities of any nature for more than 10 hours per
week, would require 4 or more unscheduled work breaks per day, and had significant limitations
reaching/pushing/pulling bilaterally. (Id. at 432-433). Further, she restricted the Plaintiff to lifting
and carrying no more than 10 pounds; occasional climbing, balancing, squatting, kneeling,
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crouching, bending, and stooping; handling, fingering, and reaching in all directions less than 1/3
of the day; gripping and feeling 1/3 to 2/3 of the day; and no concentrated exposure to extreme
heat or cold, wetness, humidity, noise, vibration, fumes, odors, dusts, gases, poor ventilation, and
hazards. (Id. at 434-436, 462-466).
In July 2021, Plaintiff consulted Dr. Foxx, reporting pain and a sensation of grinding and
popping in the left shoulder with a limited range of motion, numbness and paresthesias involving
her bilateral forearms and hands, progressively worsening manual dexterity, and an unstable gait.
(ECF No. 7, pp. 499-501). Following an exam and review of her MRI results, Dr. Foxx ordered
an electromyography (“EMG”)/nerve conduction study of her upper extremities which ultimately
showed mild CTS in the right upper extremity. (Id. at 509-513).
Dr. Lucy Sauer reviewed Plaintiff’s medical records in September 2021 and concluded she
could perform light work with limited overhead reaching. (ECF No. 7, pp. 126-128).
Three months later, orthopedist, Dr. Trent Johnson, treated Plaintiff for mild right elbow
pain and stiffness with wrist extension, pronation, and supination. (ECF No. 7, pp. 573-574, 612-
613, 620). An exam revealed pain with extreme range of motion in the right elbow and almost
point tenderness about the radial heard or neck region. Further, x-rays of the elbow documented
a healed radial neck fracture. 	Dr. Johnson recommended physical therapy, which the Plaintiff
declined.
When she returned to Dr. Foxx on December 10, 2021, Plaintiff complained of an aching
sensation and numbness making it difficult for her to perform tasks requiring manual dexterity or
lifting. (ECF No. 7, pp. 571-573). After reviewing her EMG/nerve conduction study results, Dr.
Foxx concluded that her symptoms were likely related to the nerve root compression in her cervical
spine. Accordingly, he recommended an anterior cervical discectomy and fusion at the C5-6 level.
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Dr. Johnson again noted a healed radial fracture of the right elbow in January 2022. (ECF
No. 7, pp. 565-566). Plaintiff continued to refuse formal physical therapy but reported performing
some home exercises; however, she continued to experience soreness and stiffness in the elbow,
and Dr. Johnson administered a steroid injection into her right elbow.
Plaintiff presented to Dr. Sutterfield in March 2022 for surgical clearance. 	(ECF No. 7,
pp. 561-565, 652-656). Again, she noted Plaintiff’s depression and hypothyroidism to be stable
on medication; indicated that her closed non-displaced fracture of the head of the right radius was
healing; and cleared her for surgery.
On March 15, 2022, Dr. Foxx performed the Plaintiff’s cervical surgery. (ECF No, 7, pp.
540-561, 	598-606). 	As 	expected, 	post-surgically 	Plaintiff 	reported 	some 	difficulty
chewing/swallowing foods such as steak, along with some residual numbness in the first three
fingers on both hands. (Id. at 538-539, 628). Dr. Foxx’s nurse practitioner advised her to lift no
more than 10 pounds for another two weeks and to avoid bending, twisting, and stooping.
A follow-up with Dr. Johnson in April 2022 revealed some continued stiffness and
tightness anteriorly, some radicular pain down the left arm since her neck surgery, and mild pain
about the bicep tendon anteriorly. (ECF No. 7, pp. 535-536). He recommended she continue her
home therapy program, indicating he would refer her for formal therapy once she had healed from
her surgery.
During a post-surgical follow-up with Dr. Foxx’s nurse practitioner a few days later,
Plaintiff reported some neck pain radiating into her left upper extremity and left forearm and
numbness and tingling in the same distribution. 	(ECF No. 7, pp. 533-535, 629, 632-634). 	The
nurse noted Plaintiff was recovering well and that x-rays revealed stable cervical alignment in the
brace. She prescribed a Gabapentin taper and a steroid Dosepak to help with her pain.
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On May 4, 2022, Dr. Ronald Collins conducted an independent review of the record and
concluded the Plaintiff could perform light work with occasional posturals and limited overhead
reaching with the right upper extremity. (ECF No. 7, pp. 144-147).
Notes from a neurosurgical follow-up on May 26, 2022, document Plaintiff’s admissions
that she was both using her hands and ambulating well. (ECF No. 7, pp. 533, 595-596, 630, 635).
X-rays showed stable hardware alignment, and Dr. David Diment indicated that she was
recovering well.
In July, the Plaintiff reported some residual intermittent numbness and tingling in her
hands, but she indicated it was improving and was certainly less troubling than before her surgery.
(ECF No. 7, pp. 531-532, 593-595, 631, 638-639). Dr. Foxx advised her that she could discontinue
the cervical collar. Providing no specific restrictions, he did advise her to use caution and avoid
extremely heavy lifting.
On January 24, 2023, Plaintiff presented to Dr. Sutterfield with complaints of back pain
when turning her neck, as well as lower back pain and some numbness in her feet. (ECF No. 7,
pp. 621, 647-651, 665-667). 	Dr. Sutterfield completed a second assessment indicating that
Plaintiff was unable to work due to anxiety and continued back and neck pain. (Id. at 622-626).
Her checkbox assessment mirrors her June 2021 assessment.
In April, the Plaintiff began complaining of mixed urinary incontinence and received
treatment from Urologic Specialists of Oklahoma through September 2023. (ECF No. 7, pp. 46-
63).
III. 	Discussion
Plaintiff raises three issues on appeal: (1) whether the ALJ fully and fairly developed the
record; (2) whether the ALJ properly assessed her subjective complaints; and (3) whether the
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ALJ’s RFC determination is supported by substantial evidence. For the reasons set out below, the
undersigned finds substantial evidence to support the Commissioner’s decision to deny benefits in
this case.
A. 	Development of the Record
Initially, Plaintiff contends that the ALJ failed to properly develop the record, choosing to
discount the opinions of her treating physicians and, instead, to rely on the opinions of non-
examining agency physicians. While the ALJ owes a duty to a claimant to develop the record fully
and fairly to ensure that his decision is an informed decision based on sufficient facts, the ALJ is
only required to develop a reasonably complete record. See Stormo v. Barnhart, 377 F.3d 801,
806 (8th Cir. 2004); see also Whitman v. Colvin, 762 F.3d 701, 707 (8th Cir. 2014) (citing Clark
v. Shalala, 28 F.3d 828, 830-31 (8th Cir. 1994)). 	An ALJ is not required to order medical
examinations and tests unless the medical records presented do not provide sufficient evidence
upon which a disability determination can be made. Johnson v. Astrue, 627 F.3d 316, 320 (8th
Cir. 2010) (quotation, alteration, and citation omitted). Notwithstanding, there is no requirement
that the ALJ’s RFC finding be supported by a specific medical opinion or that every aspect of the
RFC be addressed by an examining or treating source. Twyford v. Comm’r, Soc. Sec. Admin., 929
F.3d 512, 518 (8th Cir. 2019); Hensley v. Colvin, 829 F.3d 926, 932 (8th Cir. 2016). Instead, the
RFC is a decision reserved to the agency such that it is neither delegated to medical professionals
nor determined exclusively based on the contents of medical records. See Ellis v. Barnhart, 392
F.3d 988, 994 (8th Cir. 2005) (medical opinion that a claimant is disabled or unable to work is not
entitled to controlling weight).
Under the revised regulations, the ALJ is no longer required to give substantial weight to
the opinion of a treating physician. See Austin v. Kijakazi, 52 F.4th 723, 730 (8th Cir. 2022) (under
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revised regulations, treating physician rule no longer applies, rendering prior precedent applying
that rule inapposite). He can rely on opinions from state agency physicians if said opinions are
supported by the overall record. See 20 C.F.R. § 404.1513a(b)(1) (requiring the ALJ to consider
evidence from state agency medical consultants because they “are highly qualified and experts in
Social Security disability evaluation”); see also Montgomery v. O’Malley, 122 F.4th 1059, 1064
(8th Cir. 2024) (holding weight afforded to non-examining source will depend on degree to which
they provide supporting explanations).
Plaintiff raises several concerns regarding the ALJ’s treatment of her medical records.
First, she contends that the ALJ’s reliance on the agency physicians’ opinions instead of the
statements from her treating physician is error. While it is true that the ALJ discounted the opinion
of Dr. Sutterfield, he did provide justification for doing so. 	He noted, as does the undersigned,
that Dr. Sutterfield’s assessments consisted of mere checkbox lists assessing the Plaintiff to be
disabled and containing no explanation for the limitations assigned. 	Because the Plaintiff’s
disability status is a determination reserved to the ALJ, the ALJ was not required to accept Dr.
Sutterfield’s opinions. 	See Ellis, 392 F.3d at 994 (holding medical opinion that a claimant is
disabled or unable to work is not entitled to controlling weight).
Plaintiff further maintains that development is necessary because no new medical evidence
was developed by the Commissioner at reconsideration. 	The Plaintiff, however, is tasked with
putting forth evidence to support her application for benefits. See Masterson v. Barnhart, 363 F.3d
731, 737 (8th Cir. 2004) (holding claimant bears burden of establishing RFC). The mere fact that
additional medical evidence became available after the state agency medical experts evaluated
Plaintiff’s treatment records does not necessarily render those opinions unreliable. 	Chandler v.
Comm’r of Social Security, 667 F.3d 356, 361 (3d Cir. 2011) (cited by Kohn v. Colvin, 2013 WL
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5375415, at *14 (N.D. Iowa Sept. 26, 2013) (“[B]ecause state agency review precedes ALJ review,
there is always some time lapse between the consultant’s report and the ALJ hearing and decision.
The Social Security regulations impose no limit on how much time may pass between a report and
the ALJ’s decision in reliance on it.”).
The ALJ both recognized that additional records were submitted at the hearing level, and
he considered those records prior to concluding they would not have impacted the agency
physician’s opinion. See Willburn v. Astrue, 626 F.3d 999, 1003-04 (8th Cir. 2010) (applying the
presumption of regularity to conclude the ALJ discharged his official duties as described). 	He
noted the results of her August 2021, EMG/nerve conduction study showing mild right CTS and
changes that could be due to C5 and/or C6 level cervical radiculopathy with no abnormalities on
the left side. (ECF No. 7, pp. 509-513). He also discussed her December 2021 visit with Dr. Foxx
wherein the Plaintiff reported an aching sensation and numbness that caused great difficulty
performing tasks such as lifting objects and tasks requiring manual dexterity. 	(Id. at 571-573).
Although not classical symptoms of cervical nerve root compression, Dr. Foxx recommended a
C5-6 level anterior cervical fusion and discectomy to decompress the nerve root, which he
performed on March 15, 2022. (Id. at 540-561, 598-606).
Following surgery, continued neck pain radiating into her left upper extremity and forearm
prompted Dr. Foxx’s advanced practice registered nurse, Mariah Simmons, to prescribed
Gabapentin and a steroid Dosepak. (ECF No. 7, pp. 533-535, 629, 632-634). But by May 2022,
the Plaintiff reported doing well at home and using her hands and ambulating without difficulty.
(Id. at 32, 533, 595-596, 630, 635). 	See Austin, 52 F.4th at 730 (holding improvement with
treatment can provide support for an RFC finding).
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Two months later, Plaintiff reported some intermittent numbness and tingling in her hands
but maintained that it was improving. (ECF No. 7, pp. 32, 531-532, 593-595, 631, 638-639). She
also indicated that she felt “better than she did prior to surgery.” X-rays showed stable hardware
alignment, and an exam revealed 5/5 strength in her upper extremities. 	No specific restrictions
were recommended, but she was advised to use caution and avoid extremely heavy lifting.
When the Plaintiff returned to Dr. Sutterfield in January 2023, she complained of difficulty
turning her neck due to pain, a pull in her back, some numbness in her feet, lower back pain, and
continued panic attacks. (ECF No. 7, pp. 32, 621, 647-651, 665-667). An examination revealed
neck pain and back pain with motion. X-rays of her lumbar spine showed mild scalloping of the
inferior endplates of the lower thoracic spine and mild disc space narrowing at the L5-S1 level
with degenerative facet changes. 	Due to a BMI of 33.73, Dr. Sutterfield recommended daily
exercise and weight loss. 	As such, the undersigned finds that the ALJ’s consideration of this
evidence was sufficient, and no further development was necessary.
Lastly, Plaintiff insists the ALJ erred in denying her request for consultative exams, arguing
that these exams were necessary because the ALJ dismissed Dr. Sutterfield’s 2023 medical source
statement, which was the only medical opinion in evidence that considered the medical records
dated after June 2021 documenting her worsening pain and function and need for surgical
intervention. 	Once again, however, we find that the ALJ’s consideration of this evidence was
sufficient. Because the record contains sufficient evidence upon which the ALJ could decide the
Plaintiff’s disability status, remand for further development of the record is not necessary.
Johnson, 627 F.3d at 320. We also note that the Plaintiff has put forth no evidence to indicate that
a consultative examination would have changed the ALJ’s decision in this case. After all, it is the
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Plaintiff who bears the burden of proving her RFC. See Buford v. Colvin, 824 F.3d 793, 796 (8th
Cir. 2016) (plaintiff’s burden to prove RFC).
B. 	Subjective Complaint Analysis
Next, the Plaintiff takes issue with the ALJ’s treatment of her subjective complaints,
contending that he failed to consider her testimony in conjunction with her Adult Function Report
and improperly concluded that her pain was controlled via medication. 	The ALJ is required to
consider all the evidence relating to Plaintiff’s subject complaints, including: (1) Plaintiff’s daily
activities; (2) the duration, frequency, and intensity of her pain; (3) precipitation and aggravating
factors; (4) dosage, effectiveness, and side effects of her medication; and (5) functional
restrictions. See Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984). In so doing, the ALJ
must also consider the claimant’s prior work record, observations made by third parties, and the
opinions of treating and examining physicians.” Polaski, 739 F.2d at 1322.
An ALJ may not discount the Plaintiff’s subjective complaints solely because the medical
evidence fails to support them. 	Id. 	However, “[a]n ALJ ... may disbelieve subjective reports
because of inherent inconsistencies or other circumstances.” Wright v. Colvin, 789 F.3d 847, 853
(8th Cir. 2015) (citing Travis v. Astrue, 477 F.3d 1037, 1042 (8th Cir. 2007) (quotation and citation
omitted). The Eighth Circuit has observed, “[o]ur touchstone is that [a claimant’s] credibility is
primarily a matter for the ALJ to decide.” Edwards v. Barnhart, 314 F.3d 964, 966 (8th Cir. 2003).
On an Adult Function Report completed in November 2021, the Plaintiff reported the
ability to care for her personal needs, noting that she wore pajamas all day, washed her hair once
a week and shaved once a month; care for her dogs; prepare meals; spot clean; do laundry once
per week; go outside once per week; shop in stores for food once per month; count change; watch
television; and crochet. (ECF No. 7, pp. 346-353).
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At the administrative hearing in March 2023, Plaintiff testified that she was not very good
at reading, so her significant other reads paperwork to her, fills out forms on her behalf, and pays
the bills. 	(ECF No. 7, pp. 78, 83-84, 89). 	Although she did not graduate from high school or
obtain her GED, the Plaintiff was able to obtain a CNA license and secure work in a nursing home.
(Id. at 84). She indicated that she spent most of her day on the couch watching television. (Id. at
91). While Plaintiff’s testimony generally tracked the same activities she acknowledged on her
function report, she did advise the ALJ that she had not crocheted in three years. (Id. at 92). She
said, “I just quit crocheting,” without further explanation. (Id.).
In his opinion, the ALJ did use Plaintiff’s ability to crochet as support for his conclusion
that her statements concerning the intensity, persistence, and limiting effects of her symptoms were
inconsistent with her activities of daily living. (ECF No. 7, p. 32). However, we do not believe
such a finding requires remand as it is not clear from Plaintiff’s testimony that she is unable to
crochet. She stated she merely quit. Therefore, as the ALJ noted, we find that her “degree of pain
relief seeking behavior and treatment was not indicative of a degree of pain that would limit
activities beyond the scope” of the RFC. (ECF No. 7, p. 33).
Additionally, Plaintiff’s contention that the ALJ improperly concluded her pain was
responsive to medication does not require remand. Following her cervical surgery in March 2022,
it does appear that her condition improved. 	(ECF No. 7, pp. 531-535, 593-596, 629-635, 638-
639). 	She consistently reported doing well with improved ability to use her upper extremities.
Plaintiff stated that she felt better than she did prior to her surgery. And her most recent medical
records document treatment for lower back pain and urinary incontinence with no mention of her
neck or upper extremities. Therefore, while we do not doubt that the Plaintiff suffers from some
degree of pain, her pain clearly responded to the treatment prescribed. There is no requirement
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that an individual be able to work free of all pain. 	King v. Astrue, 564 F.3d 978, 979 (8th Cir.
2009) (holding “millions of people” work every day despite experiencing pain).
C. 	RFC Determination
In her final argument, the Plaintiff asserts that the ALJ’s RFC determination is not
supported by substantial evidence because she cannot perform light, unskilled work. RFC is the
most a person can do despite that person’s limitations. 20 C.F.R. §§ 404.1545, 416.945. 	A
disability claimant has the burden of establishing his or her RFC. Vossen, 612 F. 3d at 1016. As
previously mentioned, although the RFC must be supported by some medical evidence that
addresses the claimant’s ability to function in the workplace, it is an administrative determination
left to the ALJ. 	Montgomery, 122 F.4th at 1064 (holding RFC is ultimately an administrative
determination reserved to the SSA) (citations omitted); see also Perks v. Astrue, 687 F.3d 1086,
1092 (8th Cir. 2012) (holding RFC must be supported by some medical evidence).
Plaintiff attempts to rekindle her argument concerning the ALJ’s reliance on the opinions
of the state agency examiners. 	For the same reasons outlined above, this argument fails. 	See
Montgomery, 122 F.4th at 1065 (noting the regulations specifically provide that the opinions of
non-treating physicians may be considered). The ALJ properly relied on these assessments as they
were consistent with the overall medical record.
Plaintiff also insists that the ALJ’s manipulative limitations were based on evidence not
discussed by the agency medical consultants. Unfortunately, this issue is also without merit. The
ALJ is not required to have a medical opinion that addresses every impairment the Plaintiff alleges
to be disabling. Because the RFC is an administrative decision, the ALJ could draw reasonable
inferences from the medical evidence of record to conclude the Plaintiff was able to occasionally
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reach overhead with her upper extremities, frequently reach in all other directions, and frequently
handle/finger with her upper extremities.
Although nerve conduction studies did reveal mild CTS in the right upper extremity,
Plaintiff’s neurosurgeon believed her upper extremity symptoms were associated with her cervical
OA, DDD, and spondylosis. (ECF No. 7, pp. 499-501). Following her surgery in March 2022,
she reported improvement in both the sensory abnormalities in her upper extremities and her ability
to use her hands. 	(Id. at 532-535, 595-596, 629-634). 	While it is true she testified to having
problems with dropping items, the medical evidence does not support this assertion. (ECF No. 7,
pp. 87-88). Her last report to medical providers that she was dropping objects came in July 2021,
well before her cervical surgery.
Additionally, Plaintiff’s argument that it is unclear how the ALJ accounted for her
diagnosis of right hip tendinitis, which he found severe, is also misguided. In his opinion, the ALJ
noted that she was seen for right hip pain with occasional clicking in October 2020. At that time,
an exam revealed catching and clicking, as well as pain with palpation of the iliopsoas. 	This
resulted in a diagnosis of iliopsoas tendinitis. 	There are, however, no additional records
documenting complaints associated with Plaintiff’s hip. And the Plaintiff has pointed to no such
evidence. 	Therefore, we can find no evidence to support Plaintiff’s assertion that her hip
impairment would limit her beyond the RFC identified by the ALJ.
As for her mental impairments, we note that the Plaintiff did receive medical management
from advanced registered nurse practitioner, Amber Mobley, at the Guidance Center, beginning in
September 2019 for complaints of depression and anxiety. (ECF No. 7, pp. 701-705). Noting an
anxious mood, Nurse Mobley diagnosed her with MDD and prescribed Venlafaxine, Trazodone,
Bupropion, and Hydroxyzine. In January 2020, the Plaintiff reported some situational depression
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related to losing one of her puppies and the death of her mother-in-law. Despite a euthymic mood
and reduced affect, Nurse Mobley made no medication changes. (Id. at 452-454, 694-697). And,
by June 2020, Plaintiff’s mood was stable, and her depression well managed via medication. (Id.
at 441-451, 683-693). Her primary care physician, Dr. Sutterfield, even noted her depression with
anxiety to be stable with medication. (Id. at 425-430, 466-470). However, she completed a mental
RFC assessment in June 2021 indicating that Plaintiff had a poor or markedly limited ability to
maintain attention and concentration for extended periods, complete a normal workday and
workweek without interruptions from psychologically based symptoms, behave in an emotionally
stable 	manner, 	relate 	predictably 	in 	social 	situations, 	work 	without 	deterioration 	or
decompensation causing the individual to withdraw from the situation, and work without
deterioration or decompensation causing exacerbation of symptoms or adaptive behaviors. (Id. at
437).
Dr. Kay Cogbill reviewed Plaintiff’s medical records in August 2021 and concluded she
had 	moderate 	limitations 	carrying 	out 	detailed 	instructions; 	maintaining 	attention 	and
concentration for extended periods; sustaining an ordinary routine without special supervision;
working in coordination with or proximity to others without being distracted by them; completing
a normal workday and workweek without interruptions from psychologically based symptoms;
performing at a consistent pace without an unreasonable number and length of rest periods; asking
simple questions or requesting assistance; accepting instructions and responding appropriately to
criticism from supervisors; maintaining socially appropriate behavior; and adhering to basic
standards of neatness and cleanliness. (ECF No. 7, pp. 125-126, 128-129).
In December 2021, Plaintiff reported anxiety/panic when in public places and reported
mild depression. (ECF No. 7, pp. 674-682). She also advised Nurse Mobley, however, that her
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medications were “very helpful.” She exhibited an appropriate mood and a broad affect with good
insight into her capabilities. 	And, later that month, Dr. Sutterfield again noted her mental
impairments to be stable via medication. (Id. at 567-570).
When she returned to Nurse Mobley in February 2022, Plaintiff stated that she was doing
well overall and just needed medication refills. (ECF No. 7, pp. 670-673). During a follow-up
with Dr. Sutterfield in March, her depression remained stable. (Id. at 561-565, 652-656).
The following month, Dr. Julie Bruno conducted an independent review of the record and
concluded 	Plaintiff 	would 	have 	moderate 	limitations 	carrying 	out 	detailed 	instructions,
maintaining attention and concentration for extended periods, completing a normal workday and
workweek without interruptions from psychologically based symptoms, performing at a consistent
pace without an unreasonable number and length of rest periods, and responding appropriately to
changes in work setting. 	(ECF No. 7, pp. 142-143, 147-148). 	And Dr. Sutterfield submitted a
second mental RFC on January 4, 2023, again asserting that the Plaintiff had the same poor or
markedly limited abilities. (Id. at 621). There are, however, no further medical records that make
mention of her mental impairments, suggesting to the undersigned that they remained stable.
The 	ALJ 	ultimately 	concluded 	Plaintiff 	could 	understand 	and 	remember 	simple
instructions, carry out simple instructions, use judgment to make simple work-related decisions,
occasionally interact with supervisors and co-workers and deal with changes in a routine work
setting, and have no interactions with the public. 	Plaintiff takes issue with the ALJ’s failure to
include a limitation to tasks where the interpersonal contact is only incidental to work performed,
as noted by the agency physicians. Plaintiff is reminded, however, that the ALJ need not adopt
verbatim the limitations assessed by any physician, even the physicians he finds to be persuasive.
See Wyatt v. Kijakazi, 2023 WL 6629761, at *1 (8th Cir. Oct. 12, 2023); see also Boyd v. Colvin,
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831 F.3d 1015, 1020 (8th Cir. 2016) (“it is the responsibility of the ALJ, not a physician, to
determine a claimant’s RFC”). The ALJ explained his limitations, noting that the Plaintiff was
able to interact appropriately with medical providers and exhibited relatively normal mental status
exams with only a euthymic mood. 	She maintained good eye contact and exhibited normal
behavior. In February 2022, she also reported to Nurse Mobley that she had good relationships
with others and could function well in small groups. (ECF No. 7, pp. 670-673). Therefore, aside
from Plaintiff’s self-serving statements made in support of her efforts to obtain disability, the
evidence does not support restrictions beyond those assessed by the ALJ.
Likewise, Plaintiff’s contention that the agency physicians’ assessment of moderate
limitations in concentrating, persisting, or managing pace and adapting or managing herself
required additional restrictions is meritless. The ALJ found she could understand and remember
simple instructions, use judgment to make simple work-related decisions, carry out simple
instructions, and deal with occasional changes in the work setting. 	Again, mental status exams
revealed nothing more than a euthymic mood with no deficits in concentration or memory. And
the Plaintiff failed to report issues with concentration and persistence that would require more
strict restrictions. In fact, she was able to watch television programs. Further, there is no evidence
that she required help managing herself. She was able to prepare simple meals for herself, reported
medication compliance, and was able to participate in both her physical and mental health
treatment. Despite Plaintiff’s reports that she did not care for her personal hygiene on a regular
basis, none of her providers noted any problems with grooming or hygiene. Accordingly, we find
substantial evidence to support the ALJ’s RFC determination.
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IV. 	Conclusion
For the reasons and upon the authorities discussed above, it is RECOMMENDED that the
Commissioner’s decision to deny benefits be affirmed, and the Plaintiff’s Complaint (ECF No. 3)
be dismissed with prejudice.
The parties have fourteen (14) days from receipt of our report and recommendation
in which to file written objections pursuant to 28 U.S.C. § 636(b)(1). The failure to file timely
objections may result in waiver of the right to appeal questions of fact. We remind the parties
that objections must be both timely and specific to trigger de novo review by the district
court.
DATED this 18th day of February 2025.
/s/ Mark E. Ford
HON. MARK E. FORD
UNITED STATES MAGISTRATE JUDGE
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