Hegic v. Commissioner of Social Security

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IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF IOWA
EASTERN DIVISION
HALIDA H.,
Plaintiff,
No. 25-cv-2013-CJW
REPORT AND
RECOMMENDATION
vs.
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
____________________
Halida H. (“Claimant”) seeks judicial review of a final decision of the
Commissioner of Social Security (“the Commissioner”) in denying her application for
disability insurance benefits (“DIB”) under Title II of the Social Security Act, 42 U.S.C.
Sections 401-34. For the reasons that follow, I recommend that the Commissioner’s
decision be affirmed.
I. BACKGROUND
Claimant was born in 1973. (AR1 at 329.) She completed the eighth grade. (Id.
at 493.) Claimant allegedly became disabled due to COPD, depression, stress/anxiety,
back pain, breathing problems, and headaches. (Id. at 492.) Claimant’s alleged onset of
disability date is August 19, 2021. (Id. at 45, 329.) On August 28, 2022, Claimant
protectively filed her application for DIB. (Id. at 45, 447.) Her claim was denied
originally on November 4, 2022 (id. at 45, 329-336) and was denied on reconsideration
on May 17, 2023. (Id. at 45, 337-344.) A hearing was held on December 19, 2023,
1 “AR” cites refer to pages in the Administrative Record.
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with Claimant and her attorney Hugh Field appearing by online video before
Administrative Law Judge (“ALJ”) Scott Gulick. (Id. at 305-328.) Vocational Expert
(“VE”) Denise Waddell also appeared at the hearing via online video, along with an
interpreter for Claimant. (Id.) Claimant and the VE both testified at the hearing. The
ALJ issued an unfavorable decision on February 20, 2024. (Id. at 45-53.)
Claimant requested review and the Appeals Council denied review on March 24,
2025. (Id. at 1-4.) Accordingly, the ALJ’s decision stands as the final administrative
ruling in the matter and became the final decision of the Commissioner. See 20 C.F.R.
§ 404.981.
On April 7, 2025, Claimant timely filed his Complaint in this Court. (Doc. 4.)
On December 22, 2025, all briefing was completed, and the Honorable C.J. Williams,
Chief United States District Court Judge, referred the case to me for a Report and
Recommendation.
II. DISABILITY DETERMINATIONS AND THE BURDEN OF PROOF
A disability is the “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 which has lasted or can be expected to last for a continuous period of
not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). A claimant has a disability when,
due to physical or mental impairments, the claimant:
is not only unable to do [the claimant’s] previous work but cannot,
considering [the claimant’s] age, education, and work experience, engage
in any other kind of substantial gainful work which exists . . . in significant
numbers either in the region where such individual lives or in several
regions of the country.
42 U.S.C. § 423(d)(2)(A). A claimant is not disabled if the claimant is able to do work
that exists in the national economy but is unemployed due to an inability to find work,
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lack of options in the local area, technological changes in a particular industry, economic
downturns, employer hiring practices, or other factors. 20 C.F.R. § 404.1566(c).
To determine whether a claimant has a disability, the Commissioner follows a five-
step sequential evaluation process. Swink v. Saul, 931 F.3d 765, 769 (8th Cir. 2019).
At steps one through four, the claimant has the burden to prove he or she is disabled; at
step five, the burden shifts to the Commissioner to prove there are jobs available in the
national economy. Moore v. Astrue, 572 F.3d 520, 523 (8th Cir. 2009). “If a claimant
fails to meet the criteria at any step in the evaluation of disability, the process ends and
the claimant is determined to be not disabled.” Pelkey v. Barnhart, 433 F.3d 575, 577
(8th Cir. 2006) (quotation omitted).
At step one, the ALJ will consider whether a claimant is engaged in “substantial
gainful activity.” Id. If so, the claimant is not disabled. 20 C.F.R. § 404.1520(a)(4)(i).
“Substantial activity is significant physical or mental work that is done on a full- or part-
time basis. Gainful activity is simply work that is done for compensation.” Dukes
v. Barnhart, 436 F.3d 923, 927 (8th Cir. 2006) (citing Comstock v. Chater, 91 F.3d
1143, 1145 (8th Cir. 1996); 20 C.F.R. § 404.1572(a)-(b)).
If the claimant is not engaged in substantial gainful activity, at step two, the ALJ
decides if the claimant’s impairments are severe. 20 C.F.R. § 404.1520(a)(4)(ii). If the
impairments are not severe, then the claimant is not disabled. Id. An impairment is not
severe if it does not significantly limit a claimant’s “physical or mental ability to do basic
work activities.” Id. § 404.1520(c). The ability to do basic work activities means the
ability and aptitude necessary to perform most jobs. Bowen v. Yuckert, 482 U.S. 137,
141 (1987); see also 20 C.F.R. § 404.1521(b). These include:
(1) physical functions such as walking, standing, sitting, lifting, pushing,
pulling, reaching, carrying, or handling; (2) capacities for seeing, hearing,
and speaking; (3) understanding, carrying out, and remembering simple
instructions; (4) use of judgment; (5) responding appropriately to
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supervision, co-workers, and usual work situations; and (6) dealing with
changes in a routine work setting.
Id. (quotation omitted) (numbers added; internal brackets omitted).
If the claimant has a severe impairment, at step three, the ALJ will determine the
medical severity of the impairment. 20 C.F.R. § 404.1520(a)(4)(iii). If the impairment
meets or equals one of the impairments listed in the regulations (“the listings”), then “the
claimant is presumptively disabled without regard to age, education, and work
experience.” Tate v. Apfel, 167 F.3d 1191, 1196 (8th Cir. 1999) (quotation omitted).
If the claimant’s impairment is severe, but it does not meet or equal an impairment
in the listings, at step four, the ALJ will assess the claimant’s residual functional capacity
(“RFC”) and the demands of the claimant’s past relevant work. 20 C.F.R.
§ 404.1520(a)(4)(iv). RFC is the most an individual can do despite the combined effect
of all his or her credible limitations. Id. § 404.1545(a); Toland v. Colvin, 761 F.3d 931,
935 (8th Cir. 2014). RFC is based on all relevant evidence and the claimant is responsible
for providing the evidence the Commissioner will use to determine RFC. Eichelberger
v. Barnhart, 390 F.3d 584, 591 (8th Cir. 2004). “Past relevant work” is any work the
claimant performed within the fifteen years prior to this application that was substantial
gainful activity and lasted long enough for the claimant to learn how to do it. 20 C.F.R.
§ 404.1560(b)(1). If a claimant retains the RFC to perform past relevant work, then the
claimant is not disabled. Id. § 404.1520(a)(4)(iv).
At step five, if the claimant’s RFC will not allow the claimant to perform past
relevant work, then the burden shifts to the Commissioner to show that there is other
work the claimant can do, given the claimant’s RFC, age, education, and work
experience. Id. §§ 404.1520(a)(4)(v), 404.1560(c)(2). The ALJ must show not only that
the claimant’s RFC will allow the claimant to do other work, but also that other work
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exists in significant numbers in the national economy. Eichelberger, 390 F.3d at 591
(citation omitted).
A. The ALJ’s Findings
The ALJ made the following findings regarding Claimant’s disability status at each
step of the five-step process. Initially, the ALJ determined that Claimant met the insured
status requirements through December 31, 2026. (AR at 47.) The ALJ then applied the
first step of the analysis and determined that Claimant had engaged in substantial gainful
activity from October 2021 through December 2021, but “there has been a continuous
12-month period during which the claimant did not engage in substantial gainful activity”
and the “remaining findings address the period the claimant did not engage in substantial
gainful activity.” (Id.) At the second step, the ALJ concluded from the medical evidence
that Claimant suffered from the following severe impairments: obesity, hypothyroidism,
and degenerative disc disease of the lumbar spine and cervical spine. (Id.) At the third
step, the ALJ found that Claimant did not have an impairment or combination of
impairments listed in 20 C.F.R. Pt. 404, Subpt. P, App. 1. (Id. at 49.) The ALJ
evaluated Claimant’s claims under listing 1.15 (disorders of the spine) and 1.16 (lumbar
spinal stenosis resulting in compromise of the cauda equina). (Id.) At the fourth step,
the ALJ determined that Claimant had the following RFC:
[C]laimant has the residual functional capacity to perform light work, as
defined in 20 CFR [§] 404.1567(b) including the ability to lift and carry 20
pounds occasionally and 10 pounds frequently, sit for 6 hours in an 8-hour
day, stand for 6 hours in an 8 hour-day and walk for 6 hours in an 8-hour
day. The claimant can climb ladders, ropes and scaffolds occasionally, and
can climb ramps and stairs, stoop, kneel, crouch and crawl frequently.
(Id.) Also at the fourth step, the ALJ determined that Claimant was able to perform her
past relevant work as a housekeeper as generally performed. (Id. at 52.) Alternatively,
the ALJ determined that Claimant could perform other jobs that exist in significant
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numbers in the national economy, including folding machine operator, crimper, and
binding machine operator. (Id. at 52-53.) Thus, the ALJ concluded that Claimant was
not disabled. (Id. at 53.)
B. The Substantial Evidence Standard
The ALJ’s decision must be affirmed “if it is supported by substantial evidence in
the record as a whole.” Grindley v. Kijakazi, 9 F.4th 622, 627 (8th Cir. 2021) (quoting
Pickney v. Chater, 96 F.3d 294, 296 (8th Cir. 1996)). “The phrase ‘substantial evidence’
is a ‘term of art’ used throughout administrative law. . . . [T]he threshold for such
evidentiary sufficiency is not high. . . . It means—and means only—such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion.” Biestek
v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (internal citations and quotations omitted); see
also Kraus v. Saul, 988 F.3d 1019, 1024 (8th Cir. 2021) (“Substantial evidence is less
than a preponderance, but enough that a reasonable mind might accept it as adequate to
support a conclusion.”) (Quoting Phillips v. Astrue, 671 F.3d 699, 702 (8th Cir. 2012)).
Thus, a court cannot disturb an ALJ’s decision unless it falls outside this available “zone
of choice” within which the ALJ can decide the case. Hacker v. Barnhart, 459 F.3d
934, 936 (8th Cir. 2006) (citation omitted). “An ALJ’s decision is ‘not outside the zone
of choice’ simply because [the c]ourt ‘might have reached a different conclusion had [it]
been the initial finder of fact.’” Kraus, 988 F.3d at 1024 (quoting Bradley v. Astrue,
528 F.3d 1113, 1115 (8th Cir. 2008)).
In determining whether the Commissioner’s decision meets this standard, the court
considers all the evidence in the record, but does not reweigh the evidence. Vester
v. Barnhart, 416 F.3d 886, 889 (8th Cir. 2005). A court considers “both evidence that
detracts from the Commissioner’s decision, as well as evidence that supports it.”
Fentress v. Berryhill, 854 F.3d 1016, 1020 (8th Cir. 2017). The court must “search the
record for evidence contradicting the [ALJ’s] decision and give that evidence appropriate
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weight when determining whether the overall evidence in support is substantial.”
Baldwin v. Barnhart, 349 F.3d 549, 555 (8th Cir. 2003) (citing Cline v. Sullivan, 939
F.2d 560, 564 (8th Cir. 1991)). However, “even if inconsistent conclusions may be
drawn from the evidence, the [Commissioner’s] decision will be upheld if it is supported
by substantial evidence on the record as a whole.” Guilliams v. Barnhart, 393 F.3d 798,
801 (8th Cir. 2005); see also Igo v. Colvin, 839 F.3d 724, 728 (8th Cir. 2016) (providing
that a court “may not reverse simply because [it] would have reached a different
conclusion than the [Commissioner] or because substantial evidence supports a contrary
conclusion”).
III. DISCUSSION
A. Parties’ Arguments
Claimant argues that the ALJ erred in evaluating the opinions of Dr. Lydia
Mustafic, M.D., a treating physician. (Doc. 11 at 19.) Claimant also argues that the
ALJ failed to properly evaluate her subjective allegations of disability. (Id. at 24.)
Specifically, Claimant argues that the “objective medical evidence substantiates [her]
subjective allegations regarding her symptoms and is inconsistent with the ALJ’s residual
functional capacity assessment.” (Id. at 26.) Further, Claimant asserts that her “daily
activities are consistent with her claims of disabling symptoms.” (Id. at 27.) Lastly,
Claimant contends that her “treatment history provides strong support for her claims of
disabling symptoms.” (Id. at 29.) Finally, Claimant argues that the “ALJ erred as a
matter of law in relying on the vocational expert’s response to an improper hypothetical
question.” (Id. at 30.)
The Commissioner argues that “Plaintiff has failed to establish error that warrants
remand.” (Doc. 22 at 6.) Claimant maintains that the “ALJ properly found Dr.
Mustafic’s medical opinion not persuasive.” (Id. at 7.) The Commissioner also argues
that the “ALJ properly evaluated Plaintiff’s subjective complaints.” (Id. at 12.) Lastly,
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the Commissioner asserts that the “vocational expert’s testimony is substantial evidence
supporting the ALJ’s decision.” (Id. at 15.) The Commissioner maintains that
“[b]ecause the ALJ’s hypothetical question mirrored Plaintiff’s RFC, [the VE’s]
testimony supports the ALJ’s conclusion Plaintiff was not disabled.” (Id. at 16.)
B. Pertinent Medical Evidence
On December 11, 2023, Dr. Mustafic provided a “Physical Medical Opinion.”
(AR at 1269-73.) Dr. Mustafic noted that she had seen Claimant one to four times per
month over the past two years. (Id. at 1269.) Dr. Mustafic diagnosed Claimant with
cervical radiculopathy, lumbar radiculopathy, major depressive disorder, and COPD.
(Id.) Dr. Mustafic described Claimant’s symptoms as follows: chronic pain in low back,
neck, and legs, chronic fatigue, very weak right leg, pain in arms, and depression. (Id.)
Dr. Mustafic also described “pain in neck going down into arms,” “low back pain going
into legs, and worse pain with walking, lifting, twisting, and bending. (Id.) Dr. Mustafic
noted that Claimant was consistently depressed during office visits. (Id.) Dr. Mustafic
also noted MRI from July 2023 showed “C3-C4 central and left paracentral disc extension
compromising spinal cord, severe bilateral neuro-foraminal stenosis [at] C5-C6,
moderately severe on [right] at C4-C5, [and] MRI [of] lumbar spine . . . [showing] L4-
L5 disc protrusion compressing L5 nerve root.” (Id.) Dr. Mustafic described Claimant’s
treatment as follows, “[patient] has done repeat [physical therapy] for neck and low back,
lumbar epidural injections and is not currently a surgical candidate,” she is also “[o]n
Cymbalta for pain and it makes her tired.” (Id.) Dr. Mustafic opined that Claimant was
not a malingerer. (Id.) Dr. Mustafic also opined that Claimant’s depression contributes
to Claimant’s symptoms and functional abilities. (Id. at 1270.) Further, Dr. Mustafic
opined that Claimant’s experience of pain and other symptoms would “constantly”
interfere with her concentration and attention. (Id.)
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Dr. Mustafic opined that Claimant had the following limitations: (1) she could
walk less than one block without rest or severe pain; (2) she could sit for 5 minutes at
one time before needing to get up; (3) she could stand for 5 minutes at one time before
needing to sit down or walk around; (4) she could sit and stand/walk less than 2 hours in
a typical eight-hour workday; (5) Claimant would need a job that allows for shifting
positions from sitting to standing to walking during a typical eight-hour workday; (6) she
would need to walk for 5 minutes every 15 minutes during an eight-hour workday; (7)
Claimant would need to “constantly” take 10-15 minute work breaks throughout an eight-
hour workday due to muscle weakness, chronic fatigue, pain, and adverse effects from
medication; (8) she should never lift less than 10 pounds and never twist, stoop,
crouch/squat, climb stairs, or climb ladders; (9) Claimant could grasp, turn, or twist
objects bilaterally 10 percent of the time during an eight-hour workday, perform fine
manipulations with her fingers bilaterally 10 percent of the time during an eight-hour
workday, reach in front of her body bilaterally 5 percent of the time during an eight-hour
day, and never reach overhead during an eight-hour workday. (Id. at 1270-72.)
Additionally, Dr. Mustafic opined that Claimant could not tolerate even a “low
stress” job due to Claimant’s depression and “constant” pain. (Id. at 1272.) According
to Dr. Mustafic, Claimant would be “off task” 25 percent or more during a typical eight-
hour workday. (Id.) Dr. Mustafic opined that Claimant would be absent from work
more than four days per month due to her impairments. (Id.) Dr. Mustafic also noted
that due to COPD, Claimant should avoid extreme temperatures, wind, humidity, dust,
fumes, and gases. (Id.)
Dr. Mustafic explained that she considered the following factors in determining
Claimant’s functional abilities despite her impairments: (1) longitudinal experience of
treating Claimant over time; (2) intensity, persistence, and functionally limiting effects
of Claimant’s symptoms; (3) Claimant’s own description of her limitations; (4)
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consistency of Claimant’s complaints over time; (5) Claimant’s response to treatment;
(6) Claimant’s daily activities (primarily sitting at home); (7) reports from other medical
providers; and (8) the degree of consistency of Claimant’s complaints with medical signs
and laboratory findings as identified throughout the “Physical Medical Opinion.” (Id. at
1273.)
C. Relevant Law
The ALJ is responsible for assessing a claimant’s RFC, and his or her assessment
must be based on all the relevant evidence. Guilliams, 393 F.3d at 803. Relevant
evidence for determining a claimant’s RFC includes “medical records, observations of
treating physicians and others, and an individual’s own description of his [or her]
limitations.” Lacroix v. Barnhart, 465 F.3d 881, 887 (8th Cir. 2006) (quoting Strongson
v. Barnhart, 361 F.3d 1066, 1070 (8th Cir. 2004)). While an ALJ must consider all of
the relevant evidence when determining a claimant’s RFC, “the RFC is ultimately a
medical question that must find at least some support in the medical evidence of record.”
Casey v. Astrue, 503 F.3d 687, 697 (8th Cir. 2007).
The ALJ also has a duty to develop the record fully and fairly. Cox v. Astrue,
495 F.3d 614, 618 (8th Cir. 2007). “There is no bright line rule indicating when the
[ALJ] has or has not adequately developed the record; rather, such an assessment is made
on a case-by-case basis.” Mouser v. Astrue, 545 F.3d 634, 639 (8th Cir. 2008).
Furthermore, an ALJ is only required to include in the hypothetical the
impairments the ALJ found supported by the record. Goff v. Barnhart, 421 F.3d 785,
794 (8th Cir. 2005) (“A hypothetical question posed to the vocational expert is sufficient
if it sets forth impairments supported by substantial evidence in the record and accepted
as true.”) (Quotation omitted). “The hypothetical question must capture the concrete
consequences of the claimant's deficiencies.” Hunt v. Massanari, 250 F.3d 622, 625
(8th Cir. 2001); see also Scott v. Berryhill, 855 F.3d 853, 857 (8th Cir. 2017) (“In order
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to constitute substantial evidence, a vocational expert's testimony must be based on a
hypothetical that captures the ‘concrete consequences’ of the claimant's deficiencies.”)
(Citing Lacroix v. Barnhart, 465 F.3d 881, 889 (8th Cir. 2006)).
Under the rules articulated in 20 C.F.R. Section 404.1520c, when determining the
persuasiveness of a medical opinion, no such opinion is automatically given controlling
weight. 20 C.F.R. § 404.1520c(a). Opinions from medical sources are evaluated using
the following factors: (1) supportability, (2) consistency, (3) provider’s relationship with
the claimant, (4) specialization, and (5) other factors. Id. § 404.1520c(c). Supportability
and consistency are the most important factors when determining “how persuasive the
ALJ find[s] a medical source’s medical opinions . . . to be.” Id. § 404.1520c(b)(2). The
ALJ “may, but [is] not required to, explain how [he or she] considered the factors in
paragraphs (c)(3) through (c)(5). . . .” Id.
Supportability concerns the internal consistency that a source’s opinion has with
the source’s own findings and notes. “The more relevant the objective medical evidence
and supporting explanations presented by a medical source are to support his or her
medical opinion(s) . . ., the more persuasive the medical opinions . . . will be.” 20
C.F.R. § 404.1520c(c)(1). Consistency concerns the external consistency that the
source’s opinion has with the findings and opinions of other sources. “The more
consistent a medical opinion[] . . . is with the evidence from other medical sources and
nonmedical sources in the claim, the more persuasive the medical opinion[] . . . will be.”
20 C.F.R. § 404.1520c(c)(2).
Additionally, when assessing a claimant’s credibility, “the ALJ must consider all
of the evidence, including objective medical evidence, the claimant's work history, and
evidence relating to the factors set forth in Polaski v. Heckler, 739 F.2d 1320, 1322 (8th
Cir. 1984).” Vance v. Berryhill, 860 F.3d 1114, 1120 (8th Cir. 2017). In Polaski, the
Eighth Circuit stated that:
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The [ALJ] must give full consideration to all the evidence presented relating
to subjective complaints, including the claimant's prior work record, and
observations by third parties and treating and examining physicians relating
to such matters as: (1) the claimant’s daily activities; (2) the duration,
frequency, and intensity of pain; (3) precipitating and aggravating factors;
(4) dosage, effectiveness, and side effects of medication; [and] (5)
functional restrictions.
739 F.2d at 1322; see also SSR 16-3P (S.S.A.), 2017 WL 5180304, at *7-8 (outlining
factors nearly identical to the factors found in Polaski for evaluating the intensity,
persistence, and limiting effects of an individual’s symptoms). An ALJ is not required
to methodically discuss each Polaski factor as long as the ALJ “acknowledge[es] and
examin[es] those considerations before discounting [a claimant’s] subjective complaints.”
Lowe v. Apfel, 226 F.3d 969, 972 (8th Cir. 2000) (citing Brown v. Chater, 87 F.3d 963,
966 (8th Cir. 1996)). The ALJ, however, may not disregard “a claimant’s subjective
complaints solely because the objective medical evidence does not fully support them.”
Renstrom v. Astrue, 680 F.3d 1057, 1066 (8th Cir. 2012) (quoting Wiese v. Astrue, 552
F.3d 728, 733 (8th Cir. 2009)).
Instead, an ALJ may discount a claimant’s subjective complaints “if there are
inconsistencies in the record as a whole.” Wildman v. Astrue, 596 F.3d 959, 968 (8th
Cir. 2010). Where an ALJ seriously considers, but for good reason explicitly discredits
a claimant’s subjective complaints, the court will not disturb the ALJ’s credibility
determination. Johnson v. Apfel, 240 F.3d 1145, 1148 (8th Cir. 2001); see also Schultz
v. Astrue, 479 F.3d 979, 983 (8th Cir. 2007) (providing that deference is given to an
ALJ when the ALJ explicitly discredits a claimant’s testimony and gives good reasons
for doing so). “The credibility of a claimant’s subjective testimony is primarily for the
ALJ to decide, not the courts.” Igo, 839 F.3d at 731 (quoting Pearsall v. Massanari,
274 F.3d 1211, 1218 (8th Cir. 2001)).
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D. Analysis
In determining that Dr. Mustafic’s opinions were unpersuasive, the ALJ found
that:
The undersigned finds the opinions of Lydia Mustafic, M.D., in a Physical
Medical Opinion form at Exhibit 13F are not persuasive, as they indicate
that [Claimant] cannot stand, walk or sit in combination for a full workday.
These opinions appear to be based on the claimant’s subjective complaints
rather than her own objective testing. (Exhibit 13F/5) In fact, Dr. Mustafic
does not give specific citations to the record or any objective findings other
than the recent MRI. (Exhibit 13F/1) Further, her own treatment notes
indicate that her symptoms are relieved with conservative measures and she
is not likely a surgical candidate. (Exhibit 9F/18, 20, 29) In addition, Dr.
Mustafic’s opinions are not consistent with the prior administrative medical
findings at Exhibit 3A and they are not supported by any other medical
opinion of record. While not substantial gainful activity, the claimant was
also able to work after the alleged onset date.
(AR at 51-52.) The ALJ also reviewed Claimant’s overall medical history:
[T]he medical evidence does not fully support the claimant’s alleged
severity of symptoms and limitations. The claimant does not show the
claimant had treatment for back pain with left lower extremity tingling,
numbness and pain until September 2022. She had tenderness and
decreased range of motion of the low back and abnormal reflexes. She was
assessed with left lumbar radiculopathy and left-sided sciatica. (Exhibit
3F/178-187, 190-95, 2F, 4F/1-8) She reported that an x-ray in January
2022 showed only mild multilevel degenerative changes. She reported
using only Aleve for pain. (Exhibit 1F, 2F/2, 3F/191) An MRI in October
2022 showed mild lumbar degenerative changes with moderate left-sided
L5-S1 neuroforaminal stenosis secondary to a small left subarticular
protrusion. She was assessed with lumbar spondylosis. She participated in
pain management, but in January 2023, she said physical therapy did not
improve her symptoms. (Exhibits 3F/374-75, 5F/1-2, 11F/1-2) However,
in March 2023, the claimant indicated that it did improve her pain. (Exhibit
9F/18) She also had a facet injection. (Exhibit 6F/16-17) The claimant
was treated for recurrent episodes of low back pain going down her right
leg since May 2023. Upon examinations, she had tenderness of her right
SI joint and decreased range of motion of the lumbar spine. She was
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diagnosed with right lumbar radiculopathy and prescribed Hydrocodone.
(Exhibit 9F/20-33) In October 2023, the claimant was noted to have
difficulty walking and getting on the examination table. She had motor
weakness in the right leg. (Exhibits 8F/22, 9F/35-40) An x-ray of her SI
joints showed mild degenerative changes of the pelvis. (Exhibit 9F/46) An
MRI demonstrated right paracentral disc protrusion at L4-5 compressing
the right L5 nerve. (Exhibit 8F/26-27) While an EMG had signs of
decreased amplitude of bilateral peroneal nerve, there were no signs of
active denervation. (Exhibit 8F/28) However, no doctor has recommended
surgery or more extensive treatment. Despite her reports of pain, objective
imaging has shown only mild to moderate findings of disc disease. She is
able to ambulate without an assistive device. Overall, the record indicates
that the claimant’s degenerative disc disease is not as severe as alleged.
Further, the State agency physician indicated that the claimant could
perform light work with frequent postural activities and occasional climbing
of ladders, ropes and scaffolds. (Exhibit 3A) This opinion is supported by
the record and incorporated into the above found residual functional
capacity.
(Id. at 50.) Additionally, to the extent that the state agency consultative physicians
determined Claimant could perform light work,2 the ALJ determined that the consultative
physicians’ opinions were persuasive:
The undersigned finds the prior administrative medical findings regarding
physical limitations at Exhibit 3A and mental limitations at Exhibit 2A are
persuasive, as they indicate the claimant can do a range of light work with
frequent climbing of stairs, stooping, kneeling, crouching and crawling and
occasional climbing of ladders, ropes and scaffolds with no severe mental
impairment. The prior administrative medical findings are generally
supported by their own review of the record and the objective findings cited
at Exhibits 2A/3, 5, and 3A/3-4, 5-6. Further, the overall medical
evidence, near normal physical examinations, mild to moderate findings on
imaging, the effectiveness of her medications, and the need for only
conservative treatment are consistent with the prior administrative medical
2 The ALJ’s decision is somewhat confusing in its consideration of the consultative sources, as
the decision contains a paragraph finding the consultative opinions unpersuasive to the extent
that they suggest Claimant could perform medium work. A review of the consultative physicians’
opinions could also be clearer but appears to conform to the ALJ’s findings. See AR at 330-43.
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findings. (Exhibits 5F/1-2, 6F/16- 17, 8F/28, 9F/46, 11F/1-2, Testimony)
Moreover, the claimant’s daily living activities, including her ability to care
for her son, prepare simple meals, fold laundry, dust, drive, shop for
necessities and work after the alleged onset date, are consistent with these
prior administrative medical findings. (Exhibits 6E, 11E, Testimony)
Additionally, the State agency physician and psychologist have unique,
expert training in the evaluation of disability claims.
(Id. at 51.)
Initially, I note that the ALJ was reviewing Dr. Mustafic’s “Physical Medical
Opinion” which suggested that Claimant was unable to sit, stand, walk, lift, move, or
use her arms and hands in an employment setting. See AR at 1270-72. Bearing that in
mind, I find that the ALJ both properly considered Dr. Mustafic’s opinions and properly
addressed the consistency and supportability of Dr. Mustafic’s opinions. The ALJ also
properly supported his conclusions that Dr. Mustafic’s opinions were not fully consistent
with the record as a whole and were not adequately supported by objective medical
findings in the record. Claimant faults the ALJ for finding “Dr. Mustafic does not give
specific citations to the record or any objective findings other than the recent MRI”
because Dr. Mustafic referenced two MRIs, which appear from the record to have
occurred on the same date. See AR at 1269. I am unpersuaded that such an argument
amounts to error on the part of the ALJ. Claimant also argues that the ALJ’s reliance on
statements by Dr. Mustafic that “conservative measures ‘helped’ and ‘improved’”
Claimant’s systems is inconsistent with treatment notes from both Dr. Mustafic and other
providers that conservative treatment was not effective. (Doc. 11 at 22) (citing AR 793,
1058, 1063, 1163, 1165, 1216, 1229). While it is true that there are medical records
which suggest that conservative treatment was not always effective, all the record cited
by Claimant involved the continuation of conservative treatment or Claimant declining
treatment. Thus, again, I find unpersuasive Claimant’s argument that the ALJ’s analysis
of Dr. Mustafic’s opinion constitutes error. Claimant also points out that on November
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30, 2023, Dr. Mustafic noted spinal surgery was recommended for Claimant by another
doctor. (Doc. 11 at 23) (citing AR 69). Also, in a treatment note from December 11,
2023, Dr. Mustafic opines that Claimant “should really be having surgery.” (AR at 87.)
Claimant maintains that the ALJ erred in finding that Claimant “is not likely a surgical
candidate. (Exhibit 9F/18, 20, 29).” However, the ALJ cannot be faulted because Dr.
Mustafic’s “Physical Medical Opinion,” also dated December 11, 2023 states
unequivocally that Claimant “is not currently a surgical candidate,” even crossing out “is
a surgical candidate” which apparently was her initial comment. See AR at 1269. The
ALJ did not err in following Dr. Mustafic’s own opinion in the “Physical Medical
Opinion” reviewed in the ALJ’s decision. Ultimately, even if different conclusions could
be drawn on this issue, the conclusions of the ALJ should be upheld because they are
supported by substantial evidence on the record as a whole. See Guilliams, 393 F.3d at
801. It is not for this Court to reweigh evidence. Accordingly, I conclude that the ALJ
properly evaluated Dr. Mustafic’s opinion and the ALJ should be affirmed on this issue.
Turning to the ALJ’s credibility determination, the ALJ determined that:
After careful consideration of the evidence, I find that the claimant’s
medically determinable impairments could reasonably be expected to cause
the alleged symptoms; however, the claimant’s statements concerning the
intensity, persistence and limiting effects of these symptoms are not entirely
consistent with the medical evidence and other evidence in the record for
the reasons explained in this decision.
(AR at 51.) The ALJ also specifically found that the “medical evidence does not fully
support the claimant’s alleged severity of symptoms and limitations.” (Id. at 50.) The
ALJ also addressed Claimant’s pain levels, effectiveness of medications, and precipitating
and aggravating factors. (Id. at 49-51.) Further, the ALJ addressed Claimant’s activities
of daily living:
Regarding her daily living activities, the claimant testified that she does not
cook, clean or do laundry. However, she is able to live in an apartment
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with her boyfriend and cares for her 10- year-old child while he is at work.
She said she can drive and takes her child to and from school. In Function
Reports, the claimant indicated that she does personal care, prepares simple
meals, fold laundry, dust, drive, shop for groceries with her son’s help,
and goes to doctor appointments. She reported being able to lift 5 to 10
pounds. (Exhibits 6E, 11E) These activities suggest that she is more
physically capable than alleged.
(Id. at 50-51.)
Based on the foregoing, it is clear from the ALJ’s decision that she considered and
addressed the Polaski and SSR 16-3p factors in determining that Claimant’s subjective
allegations of disability and the testimony of her witnesses were not fully credible. See
Johnson, 240 F.3d at 1148; see also Goff, 421 F.3d at 791 (an ALJ is not required to
explicitly discuss each Polaski factor, it is sufficient if the ALJ acknowledges and
considers those factors before discounting a claimant’s subjective complaints); Tucker v.
Barnhart, 363 F.3d 781, 783 (8th Cir.2004) (“The ALJ is not required to discuss each
Polaski factor as long as the analytical framework is recognized and considered. Brown
v. Chater, 87 F.3d 963, 966 (8th Cir.1996).”). Accordingly, because the ALJ seriously
considered, but for good reasons explicitly discredited Claimant’s subjective complaints,
I find that the ALJ’s credibility determination should not be disturbed. See Johnson, 240
F.3d at 1148.
In determining Claimant’s RFC, the ALJ addressed and considered Claimant’s
medical history and treatment for her complaints. (AR at 49-52.) The ALJ also properly
considered and discussed Claimant’s subjective allegations of disability in making her
overall disability determination, including determining Claimant’s RFC, finding that
“claimant’s statements concerning the intensity, persistence and limiting effects of these
symptoms are not consistent with the medical evidence and other evidence in the
record[.]” (Id. at 51.)
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Therefore, having reviewed the entire record, I find that the ALJ properly
considered Claimant’s medical records, observations of treating physicians, and
Claimant’s own description of her limitations in making the ALJ’s RFC assessment for
Claimant. See Lacroix, 465 F.3d at 887. Further, I find that the ALJ’s decision is based
on a fully and fairly developed record. See Cox, 495 F.3d at 618; see also Swink v. Saul,
931 F.3d 765, 770 (8th Cir. 2019) (“[A]n ALJ is permitted to issue a decision without
obtaining additional medical evidence so long as other evidence in the record provides a
sufficient basis for the ALJ’s decision.” Anderson v. Shalala, 51 F.3d 777, 779 (8th Cir.
1995) (alteration in original) (citation omitted).”). Because the ALJ considered the
medical evidence as a whole, I conclude that the ALJ made a proper RFC determination
based on a fully and fairly developed record. See Guilliams, 393 F.3d at 803.
The hypothetical the ALJ posed to the VE did “set forth impairments supported
by substantial evidence in the record and accepted as true.” See Goff, at 421 F.3d at
794. The ALJ asked the VE to:
assume this individual would be limited to lifting 20 pounds occasionally,
10 pounds frequently, carrying 20 pounds occasionally, 10 pounds
frequently. This hypothetical individual could sit for six hours in an eight-
hour day, could stand for six hours in an eight-hour day, they could walk
for six hours in an eight-hour day. This individual could climb ramps and
stairs frequently, climb ladders, ropes or scaffolds occasionally, could stoop
frequently, kneel frequently, crouch frequently and crawl frequently.
(AR at 322-23.) It is clear that the ALJ’s hypothetical question was based on the ALJ’s
RFC assessment, findings, and conclusions, which are supported by substantial evidence
on the record as a whole. Therefore, I conclude that the ALJ’s hypothetical question
properly included only those impairments which were substantially supported by the
record as a whole and captured the concrete consequences of Claimant’s deficiencies.
See Goff, 421 F.3d at 794; Hunt, 250 F.3d at 625. Therefore, I find that the ALJ's
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hypothetical question was sufficient and I recommend that the District Court affirm the
ALJ’s decision.
IV. CONCLUSION
For the foregoing reasons, I respectfully recommend that the District Court
AFFIRM the decision of the ALJ.
The parties must file objections to this Report and Recommendation within
fourteen (14) days of the service of a copy of this Report and Recommendation, in
accordance with 28 U.S.C. § 636(b)(1) and Fed. R. Civ. P. 72(b). Objections must
specify the parts of the Report and Recommendation to which objections are made, as
well as the parts of the record forming the basis for the objections. See Fed. R. Civ. P.
72. Failure to object to the Report and Recommendation waives the right to de novo
review by the District Court of any portion of the Report and Recommendation as well
as the right to appeal from the findings of fact contained therein. United States v. Wise,
588 F.3d 531, 537 n.5 (8th Cir. 2009).
DONE AND ENTERED this 13th day of October, 2026.
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