Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-03-03945/USCOURTS-ca8-03-03945-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 

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1

The Honorable Terry I. Adelman, United States Magistrate Judge for the

Eastern District of Missouri, to whom the case was referred for decision by consent

of the parties pursuant to 28 U.S.C. § 636(c) (2000).

United States Court of Appeals

FOR THE EIGHTH CIRCUIT

________________

No. 03-3945

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Robert Ellis,

Appellant,

v.

Jo Anne B. Barnhart,

Commissioner of Social Security

Administration.

Appellee.

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Appeal from the United States

District Court for the

Eastern District of Missouri.

 [PUBLISHED]

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Submitted: September 16, 2004

 Filed: January 3, 2005

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Before COLLOTON, HEANEY, and HANSEN, Circuit Judges. 

________________

HANSEN, Circuit Judge.

Robert Ellis appeals from the district court’s1

 judgment affirming the

Commissioner’s denial of Ellis’s claim for disability benefits. We affirm. 

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Ellis’s application alleged a disability onset date of 1978. The ALJ construed

the allegation of a 1978 onset date as a request to reopen prior applications which had

been denied. The district court noted that the ALJ properly applied res judicata and

limited the current disability determination to the period following the most recently

denied application, or the period since May 28, 1999. On appeal, Ellis does not

allege error in so limiting the period covered by his current application.

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I.

Mr. Ellis filed an application for Supplemental Security Income (SSI) on

October 10, 2000,2

 and the ALJ held a hearing on Ellis’s application on November

14, 2001. The ALJ denied the application for benefits on January 25, 2002, and the

Appeals Council denied Ellis’s request for review on April 11, 2002, making the

ALJ’s decision the final agency decision.

Ellis alleged in his October 14, 2000, Disability Report that he has been

disabled since 1993 due to back and leg problems, medications, chronic pain,

hepatitis C, and limited physical activity. (Admin. R. at 102.) Ellis has been on

strong narcotic pain medications for over ten years, and noted that “medicine is the

only thing that relives [sic] [his] pain.” (Id. at 123.) During the November 14, 2001,

hearing, Ellis testified that in addition to the impairments he had during his previous

disability hearing in 1998, he had been diagnosed with hepatitis C and non-insulindependent diabetes within the last three years. (Id. at 34-36.) Ellis also testified that

he had been admitted to the hospital with a blood clot in his left leg, which was

diagnosed as thrombosis, one month prior to the hearing. (Id. at 36.) Ellis testified

that a recent CT scan of his shoulder and neck revealed either a pinched nerve or torn

rotator cuff in his right shoulder, for which he planned to have an operation. (Id. at

37-38.) Ellis stated that problems with his back, particularly degenerative disc

disease, and his inability to sit or stand in one position for any period of time would

prevent him from doing the types of jobs suggested during his prior hearing, such as

a small parts bench assembler or returned-goods sorter. (Id. at 39-40.) 

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Ellis’s treating physician, Dr. Patrick Johnson, provided an opinion dated

November 21, 2001, in which he stated that Ellis had multiple chronic medical

problems that rendered him incapable of performing any sustained gainful

employment. (Id. at 279.) The opinion listed Ellis’s medical problems as severe

chronic pain in his back and hip as a result of multiple vehicle accidents, diabetes,

hepatitis C, recurrent episodes of deep vein thromboembolism (a blood clot in the

thigh or leg) (DVT), severe dental caries, and hypertension. (Id.) Dr. Johnson opined

that Ellis was “incapable of even the most sedentary work because he cannot sit or

stand probably for more than one hour at a time due to his chronic pain and his

tendency toward developing blood clots in his legs.” (Id.) Dr. Johnson also

submitted a “Medical Source Statement of Ability to do Work-Related Activities

(Physical),” dated October 1, 2001, in which he opined that Ellis could walk a total

of two hours in an eight-hour period, but only a half hour without interruption, and

that he could sit for a total of four hours in an eight-hour period, but only one hour

without interruption. (Id. at 268.)

Ellis has seen Dr. Johnson on a regular basis since 1993, primarily for chronic

back and hip pain. The vast majority of Ellis’s contacts with Dr. Johnson during the

time period since Ellis’s previously denied application for disability benefits in 1999

have been routine examinations for his chronic back pain and refilling pain

prescriptions. (Id. at 273-76.) During each visit, Dr. Johnson continued Ellis’s

regular course of medication and filled prescriptions by phone on a monthly basis

between visits. (Id.) Dr. Johnson noted that Ellis’s hepatitis C was quiescent during

a September 5, 2000, visit. (Id. at 276.) He also noted at an April 9, 2001, visit that

Ellis’s chronic back and hip pain were stable on his current medications. (Id. at 274.)

Ellis first complained of shoulder pain during his August 9, 2001, checkup. (Id. at

272.) Dr. Johnson increased Ellis’s OxyIR prescription and gave Ellis a DepoMedrol

injection for the shoulder pain. Dr. Johnson noted probable rotator cuff tendinitis, as

opposed to a rotator cuff tear, and scheduled an MRI. (Id.) The tendinitis and

pinched nerve were confirmed by an MRI of the right shoulder on October 5, 2001,

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which revealed “[h]ypertrophic AC joint with inferior impingement against the

musculotendinous junction of the supraspinatus” and “[b]icipital tendinitis.” (Id. at

256.)

Ellis has had two episodes of DVT, most recently being hospitalized on

September 9, 2001. (Id. at 260-61.) Within 24 hours the leg swelling and pain

reduced dramatically, and he was walking without pain or difficulty by September 12.

Dr. Johnson continued Ellis on Coumadin to control the swelling and released Ellis

on September 12. The previous episode occurred in August 1993 when Ellis was

immobile following a pelvic fracture from an automobile accident. (Id. at 137-38.)

A follow-up examination on August 24, 1993, revealed that there was no warmth or

swelling in the lower left leg and that Ellis was doing well following a week in the

hospital on Heprin therapy. (Id. at 139.) Examinations subsequent to the 1993

episode revealed no evidence of recurrent DVT. (Id. at 143, 144.) 

As to Ellis’s back pain, the record includes Ellis’s regular complaints of back

pain and medication refills, and the results of an MRI of the lumbar spine performed

on July 1, 2000. The MRI revealed “[m]ild to moderate degenerative facet disease

throughout the lumbar spine,” and “[d]egenerative disc disease L2-3 but without disc

herniations, spinal canal or gross neuroforaminal stenosis.” (Id. at 254.) 

Dr. Richard Secor performed a state agency consultative examination of Ellis

on January 18, 2001, including various range of motion tests. Dr. Secor noted that

Ellis had full range of motion in both shoulders, in his right elbow, both wrists, both

knees, and both hips. (Id. at 220-21.) He also had full range of motion upon lateral

and back flexion of his cervical spine and lumbar spine. (Id.) The examination

revealed only slight range of motion limitations in Ellis’s left wrist, extension of his

cervical spine, rotation of his neck, and extension of his lumbar spine. (Id.) Dr. Secor

recorded grip strength in both hands and both upper extremities at 5 out of 5. (Id. at

220.) Dr. Secor noted that Ellis’s recent MRI showed no acute herniation, and that

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Ellis reported chronic pain, which was treated with narcotics. (Id. at 215.) Dr. Secor

also noted that Ellis walked with part-time assistance of a cane, but opined that the

cane was not medically necessary. He noted that Ellis could sit, stand, and lie down

without assistance. (Id. at 216.) 

 

The ALJ determined that Ellis had medically determined impairments of DVT,

non-insulin-dependant diabetes mellitus, and fibromyalgia, which amounted to severe

impairments. (Add. at 39.) The ALJ determined that Ellis’s hepatitis C was nonsevere, based on the medical records indicating that Ellis’s liver enzymes were

normal in April 2000 and that the hepatitis C was quiescent in September 2000. The

ALJ further found that Ellis did not have a severe impairment in his back and legs,

other than as it related to the fibromyalgia. He also found that Ellis’s shoulder pain

did not present a severe impairment unrelated to the fibromyalgia that was expected

to last at least twelve months. 

The ALJ then determined that Ellis’s impairments did not meet a listed

impairment and proceeded to determine Ellis’s residual functional capacity (RFC).

The ALJ found Ellis’s subjective complaints of the severity of his symptoms and

limitations to be not fully credible, based on a lack of objective medical evidence or

a treatment history that would support his allegations. Giving Ellis some benefit of

the doubt about his limitations, the ALJ determined that Ellis could lift and carry no

more than ten pounds, could sit for up to six hours in an eight-hour workday, and

could stand for up to two hours in an eight-hour workday, resulting in a finding that

Ellis could perform the full range of sedentary work. Based on Ellis’s age, education,

and ability to perform the full range of sedentary work, the ALJ found that Ellis was

not disabled. See 20 C.F.R. pt. 404, subpt. P, app. 2, table 1, rule 201.27.

The Appeals Council denied Ellis’s request for review, and Ellis appealed the

denial of benefits to the district court. The experienced magistrate judge performed

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“The five part test is as follows: 1) whether the claimant is currently

employed; 2) whether the claimant is severely impaired; 3) whether the impairment

is, or is comparable to, a listed impairment; 4) whether the claimant can perform past

relevant work; and if not, 5) whether the claimant can perform any other kind of

work.” Cox v. Barnhart, 345 F.3d 606, 608 n.1 (8th Cir. 2003).

4

Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984).

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a thorough review of the medical evidence and determined that the ALJ did not err

in denying Ellis’s application for benefits. Ellis appeals. 

 II. 

We review de novo the district court’s decision upholding the Commissioner’s

denial of disability benefits. We will affirm if substantial evidence on the record as

a whole–that is, evidence which a reasonable mind would find adequate to support

the Commissioner’s conclusion–supports the Commissioner’s findings. Stormo v.

Barnhart, 377 F.3d 801, 805 (8th Cir. 2004). We consider the whole record,

including evidence that detracts from as well as evidence that supports the

Commissioner's decision, and we will not reverse as long as substantial evidence

supports the outcome. Id.

The ALJ undertook the familiar five-part analysis in determining whether Ellis

was disabled,3

 finding at the fifth step that he was not. The Commissioner bears the

burden at the fifth step of establishing that, given the applicant’s residual functional

capacity, age, education, and work experience, there are a significant number of jobs

available in the national economy which the applicant can perform. 20 C.F.R. §

404.1560(c). Ellis raises three issues on appeal. He claims that the ALJ erred by:

failing to fully develop the medical record before refusing to give controlling weight

to his treating physician; failing to properly apply the Polaski4

 factors to his

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subjective complaints of pain; and failing to seek vocational expert testimony. We

address each issue in turn.

A. ALJ’s Obligation to Develop the Record and Defer to Ellis’s Treating

Physician

The ALJ declined to give controlling weight to Dr. Johnson’s opinion because

the opinion was not well supported by medically acceptable clinical and laboratory

diagnostic techniques and no examinations revealed signs indicative of Dr. Johnson’s

opinion such as muscle atrophy. (Add. at 41.) Ellis argues that rather than rejecting

Dr. Johnson’s opinion as conclusory, the ALJ had a duty to contact Dr. Johnson for

clarification of his opinion before discrediting it. 

A social security hearing is a non-adversarial proceeding, and the ALJ has a

duty to fully develop the record. See Stormo, 377 F.3d at 806. Although that duty

may include re-contacting a treating physician for clarification of an opinion, that

duty arises only if a crucial issue is undeveloped. Id. Ellis does not allege that the

record is missing any relevant medical records. In fact, the ALJ held the record open

for 30 days following the hearing to allow Ellis to supplement it with a more recent

opinion from Dr. Johnson, which gave the ALJ the benefit of Dr. Johnson’s

November 21, 2001, letter. At oral argument before this court, Ellis’s attorney noted

that he supplemented the record and asserted that the record was sufficiently

developed to support Dr. Johnson’s opinion that Ellis was disabled. Without

informing the court what additional medical evidence should be obtained from Dr.

Johnson, Ellis has failed to establish that the ALJ’s alleged failure to fully develop

the record resulted in prejudice, and has therefore provided no basis for remanding

for additional evidence. See Shannon v. Chater, 54 F.3d 484, 488 (8th Cir.1995)

(“[R]eversal due to failure to develop the record is only warranted where such failure

is unfair or prejudicial.”). The ALJ did not err in failing to re-contact Dr. Johnson.

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The ALJ refused to give controlling weight to Dr. Johnson’s opinion that Ellis

was disabled and limited in his ability to stand for no more than two hours a day or

to sit for no more than four hours per day. In assessing Ellis’s RFC, the ALJ

determined that Ellis could sit for a total of six hours and stand for a total of two

hours, but was limited to sedentary work. This in itself is a significant limitation,

which reveals that the ALJ did give some credit to Dr. Johnson’s medical opinions.

It is only Dr. Johnson’s opinion about how long Ellis could sit or stand and his

opinion that Ellis was incapable of working with which the ALJ disagreed.

Generally, an ALJ is obliged to give controlling weight to a treating

physician’s medical opinions that are supported by the record. See Randolph v.

Barnhart, 386 F.3d 835, 839 (8th Cir. 2004); 20 C.F.R. § 404.1527(d)(2). A medical

source opinion that an applicant is “disabled” or “unable to work,” however, involves

an issue reserved for the Commissioner and therefore is not the type of “medical

opinion” to which the Commissioner gives controlling weight. See Stormo, 377 F.3d

at 806 (“[T]reating physicians’ opinions are not medical opinions that should be

credited when they simply state that a claimant can not be gainfully employed,

because they are merely opinions on the application of the statute, a task assigned

solely to the discretion of the Commissioner.” (internal marks omitted)); 20 C.F.R.

§ 404.1527(e)(1). Further, although medical source opinions are considered in

assessing RFC, the final determination of RFC is left to the Commissioner. See 20

C.F.R. § 404.1527(e)(2). Thus, to the extent that the ALJ discredited Dr. Johnson’s

conclusion that Ellis could not work, he rightly did so. 

The Commissioner defers to a treating physician’s medical opinions about the

nature and severity of an applicant’s impairments, including symptoms, diagnosis and

prognosis, what an applicant is capable of doing despite the impairment, and the

resulting restrictions. 20 C.F.R. 404.1527(a)(2). “A treating physician’s opinion is

due ‘controlling weight’ if that opinion is ‘well-supported by medically acceptable

clinical and laboratory diagnostic techniques and is not inconsistent with the other

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substantial evidence in the record.’” Hogan v. Apfel, 239 F.3d 958, 961 (8th Cir.

2001) (quoting Prosch v. Apfel, 201 F.3d 1010, 1012-13 (2000)).

This arguably includes Dr. Johnson’s opinion that Ellis could only stand for a

total of two hours and sit for a total of four hours in a work day based on Ellis’s

“severe chronic back and hip pain.” (Admin. R. at 268.) Dr. Johnson also opined that

Ellis could neither sit nor stand for more than an hour at a time due to his chronic pain

and tendency toward blood clots in his legs from the deep vein thromboembolism.

(Id. at 279.) The ALJ applied the same two-hour limit to Ellis’s ability to stand, but

found that he could sit for up to six hours (rather than four) in an eight-hour period.

As noted by the ALJ, there is no medical evidence suggesting the limitations

contained in Dr. Johnson’s letter. Ellis admittedly has chronic back and hip pain, but

the record reveals that his medications alleviate that pain. Ellis testified that he spent

his time reading and watching television, which is contrary to his assertion that he

could sit only for a limited time. Dr. Johnson never ordered or even suggested to

Ellis that he limit the time that he stood or sat, nor did Ellis ever suggest to Dr.

Johnson that he was unable to stand or sit for any length of time. See Hogan, 239

F.3d at 961 (discounting medical source statement opining that applicant could not

sit, stand, or walk for more than 20 minutes at a time or one hour total per day where

no similar restrictions were included in her treatment records, and the consulting

doctor concluded that the applicant could sit, stand, or walk up to six hours per day).

Although Dr. Johnson listed Ellis’s propensity for blood clots in his legs as medical

support for his finding that Ellis could not sit or stand for more than an hour at a time,

Dr. Johnson never cautioned Ellis or limited Ellis’s prolonged sitting or standing to

avoid the possibility of a blood clot. See Hensley v. Barnhart, 352 F.3d 353, 356 (8th

Cir. 2003) (affirming ALJ’s decision discrediting treating physician’s opinion that

applicant had significantly limited mobility where “few if any functional limitations”

were placed on the applicant by his other physicians); Hogan, 239 F.3d at 961

(discrediting treating physician’s opinion of limitations where “[n]one of these

restrictions appear elsewhere in [the treating physician’s] treatment records.”). Dr.

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Johnson noted that anti-coagulants kept Ellis’s thromboembolism in control. Further,

Dr. Secor noted that Ellis was able to “walk briskly” without use of the cane that he

carried, opining that the cane was medically unnecessary, and Ellis had no problems

getting around the examining room. Because Dr. Johnson’s opinion that Ellis could

only stand for two hours and sit for four hours, and do neither for more than one hour

at a time, is not supported by any medical evidence in the record and is contrary to

other evidence in the record, the ALJ properly discredited the opinion. 

 

B. Application of Polaski to Ellis’s Subjective Claims of Pain 

It is the ALJ’s duty to determine an applicant’s RFC. Before doing so, the ALJ

must determine the applicant’s credibility, as his subjective complaints play a role in

assessing his RFC. Pearsall v. Massanari, 274 F.3d 1211, 1217-18 (8th Cir. 2001).

Applying the factors discussed in Polaski, 739 F.2d at 1322, the ALJ found that Ellis

was not fully credible about the severity of his symptoms and limitations based on a

lack of objective medical evidence in the record, as well as Ellis’s limited treatment

record. (Add. at 40.) The ALJ noted that Ellis’s medications alleviated his pain,

there was no record of adverse side effects from the medication, and no doctor

observed signs consistent with the limited lifestyle claimed by Ellis. (Id. at 40-41.)

While the ALJ may not discount Ellis’s complaints solely because they are not fully

supported by objective medical evidence, Ellis’s complaints may be discounted based

on inconsistencies in the record as a whole. Lowe v. Apfel, 226 F.3d 969, 972 (8th

Cir. 2000). 

“Where adequately explained and supported, credibility findings are for the

ALJ to make.” Id. The ALJ adequately explained the inconsistencies upon which he

relied to discount Ellis’s subjective complaints, and we therefore uphold that finding.

The record reveals that Ellis has not worked since 1993. (Admin. R. at 102.) See

Woolf v. Shalala, 3 F.3d 1210, 1214 (8th Cir.1993) (noting that a sporadic work

history is relevant to the ALJ’s credibility analysis); Polaski, 739 F.2d at 1322 (noting

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work history as one factor to consider in credibility determination). Ellis claimed that

back and hip pain were severe enough to prevent him from sitting or standing for any

length of time, yet Dr. Secor’s examination in January 2001 revealed that Ellis had

normal, or near normal, range of motion in his shoulders, hips, cervical spine, and

lumbar spine. (Admin. R. at 220-21.) The record also revealed that medication

alleviated his pain. (Id. at 123, 274). Finally, Dr. Johnson noted his concern that

Ellis was becoming addicted to the narcotic medications as early as 1995 (id. at 140,

145), providing a further basis for disbelieving the severity of Ellis’s complaints, see

Anderson v. Barnhart, 344 F.3d 809, 815 (8th Cir. 2003) (noting that record

supported ALJ’s finding concerning applicant’s possible overuse of narcotic pain

medication in discrediting applicant).

C. Requirement for Vocational Expert Testimony

Ellis argues that the ALJ erred in relying on the Medical-Vocational Guidelines

(grids) to determine whether he was disabled because of his non-exertional

impairments. The ALJ may not rely on the grids if Ellis suffers from non-exertional

impairments, but instead must obtain the opinion of a vocational expert. See

Shannon, 54 F.3d at 488. Non-exertional impairments that “do[] not diminish or

significantly limit the claimant’s residual functional capacity to perform the full range

of Guideline-listed activities” do not prevent use of the grids, however. Id. Because

the ALJ was within his discretion, based on the record, to discredit Ellis’s subjective

complaints of pain and find that Ellis’s pain did not diminish his ability to perform

the full range of sedentary work, the ALJ properly relied on the grids without calling

for vocational expert testimony. Id.

Ellis also argues that his inability to sit or stand for more than an hour at a time

significantly limits the number of sedentary jobs available to him, and as such, the

ALJ should have called a vocational expert to assess this non-exertional limitation.

Sedentary jobs primarily involve sitting, although the category also includes jobs with

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occasional standing or walking. 20 C.F.R. § 404.1567(a). A Social Security Ruling

explains that the sitting requirement allows for normal breaks, including lunch, at two

hour intervals. See SSR 96-9p, 1996 WL 374185, at *6 (Soc. Sec. Admin. July 2,

1996). The Ruling likewise notes that the full range of sedentary jobs requires an

applicant to be able to walk or stand for approximately two hours out of an eight-hour

day. The need to alternate between sitting and standing more frequently than every

two hours could significantly erode the occupational base for a full range of unskilled

sedentary work. Id. at *7. The Ruling notes that the RFC assessment should include

the frequency with which an applicant needs to alternate between sitting and standing,

and if the need exists, that vocational expert testimony may be more appropriate than

the grids. Id.

If the ALJ had credited Dr. Johnson’s opinion that Ellis could sit for no more

than one hour at a time, then we would agree with Ellis that the ALJ should have

sought the opinion of a vocational expert. We have already determined, however,

that the ALJ properly discredited Dr. Johnson’s opinion, and the ALJ’s RFC

assessment properly excluded that limitation. Having found, as supported by the

record, that Ellis could sit for up to six hours during an eight-hour period, with no

apparent need to alternate that position more frequently than every two hours, the

ALJ appropriately relied on the grids. See Patrick v. Barnhart, 323 F.3d 592, 596 (8th

Cir. 2003) (affirming ALJ’s use of grids where ALJ properly discredited claimant’s

non-exertional complaints of fatigue). 

III.

We appreciate the fact that Ellis has had an unfortunate and difficult history

involving numerous automobile accidents that resulted in significant injuries. Given

the record, the ALJ’s explanation of his actions, and the district court’s thorough

review, we are bound to uphold the Commissioner’s decision to deny benefits. The

judgment of the district court is affirmed. 

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HEANEY, Circuit Judge, dissenting.

I respectfully dissent. The administrative law judge failed to give controlling

weight to the opinion of Ellis’s long-time treating physician, that Ellis was

permanently and completely disabled, instead giving credence to a medical consultant

who examined Ellis on a single occasion. Moreover, the ALJ improperly rejected

Ellis’s testimony with respect to his inability to work because of constant debilitating

pain. After a careful review, I believe that Ellis has demonstrated by substantial

evidence in the record as a whole that he is entitled to disability benefits starting

November 1, 2000. I would remand to the district court with directions to remand to

the Commissioner for an award of benefits.

The ALJ and the majority err in not considering Ellis’s extensive medical

history when evaluating his application. It is appropriate to consider the claimant's

entire history as background in determining whether he is currently disabled. Hamlin

v. Barnhart, 365 F.3d 1208, 1215 (10th Cir. 2004) (“[E]ven if a doctor's medical

observations regarding a claimant's allegations of disability date from earlier,

previously adjudicated periods, the doctor's observations are nevertheless relevant to

the claimant's medical history and should be considered by the ALJ.”). See also

Frustaglia v. Sec’y of Health & Human Servs., 829 F.2d 192, 193 (1st Cir. 1987) (per

curiam) (“[T]he ALJ is entitled to consider evidence from a prior denial for the

limited purpose of reviewing the preliminary facts or cumulative medical history

necessary to determine whether the claimant was disabled at the time of his second

application.”). 

Review of this previous history is revealing. Ellis has been involved in

numerous serious accidents. (Admin. R. at 40, 235.) In 1979, when Ellis was 19, he

was a passenger in an automobile accident and sustained fractures to both femurs, a

fracture to the left radius, pneumothorax (collapsed lung), and numerous internal

injuries. (Id. at 137.) In July of 1993, Ellis was in the bed of a pickup truck that

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rolled several times. He was thrown clear but sustained a pelvic fracture and other

injuries. (Id.) On October 1, 1993, Ellis was a passenger in a car that was struck

from behind. He was thrown through the windshield and sustained extensive facial

lacerations and contusions of his right forearm and right hip. (Id. at 142.) Two

months later Ellis resumed work as a roofer and sustained injuries to his right hip

after a fall from a roof. (Id. at 143.) Sixteen months later, he fell again and sustained

a bruise to his tail bone. (Id.) In September of 1997, Ellis was a passenger in a

single-car rollover accident in which he suffered a severe scalp laceration. (Id. at 153-

54.) In April 1998, Ellis was a passenger in a car that left the road and hit a tree. He

suffered multiple minor injuries. (Id. at 164.) To summarize, Ellis has been involved

in five serious car accidents in which he sustained injuries including fractures of both

femurs, a fracture of the left radius, a collapsed lung, a pelvic fracture, facial

lacerations, scalp lacerations, and multiple minor injuries. In addition, he has fallen

twice from roofs, injuring his right hip and tail bone. 

The ALJ improperly rejected the opinion of Ellis’s treating physician, Dr.

Patrick. E. Johnson. A treating physician's opinion is given controlling weight if that

opinion is “well-supported by medically acceptable clinical and laboratory diagnostic

techniques and is not inconsistent with the other substantial evidence” in the record.

Holmstrom v. Massanari, 270 F.3d 715, 720 (8th Cir. 2001) (quoting Prosch v. Apfel,

201 F.3d 1010, 1012-13 (8th Cir. 2000) (quoting 20 C.F.R. § 404.1527(d)(2)). The

ALJ must give good reasons for the weight accorded a treating physician’s opinion.

Id. 

 Dr. Johnson has been Ellis’s treating physician since August 9, 1993. He

treated claimant for his injuries from the automobile accidents, falls, and the

disabilities flowing from these accidents: deep vein thrombosis of the left leg,

(Admin. R. at 138); excruciating pain in the right hip, (id. at 140); a chip fracture,

(id.); ecchymoses in the right leg, (id.); numbness in the right leg, (id. at 152);

elevated blood pressure related to severe pain, (id. at 153); and chronic back, hip, and

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Dr. Johnson wrote letters on October 21, 1993, April 1, 1996, April 22, 1997

October 5, 1998, (Admin. R. 175-79), and a final letter on November 21, 2001, (id.

at 279).

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elbow pain (id. at 152, 157, 161, 166). Ellis has been treated for a collapsed gall

bladder, (id. at 212); active hepatitis C, (id. at 163); infected teeth and severe

gingivitis, (id.); mild to moderate degenerate facet disk disease, (id. at 165); and

cervical spondylosis, (id. at 168). In September, 2001, Ellis was hospitalized for deep

vein thrombosis causing swelling in his left leg. (Id. at 258-61.) The admitting

physician, Dr. Jesse D. Hoff, also diagnosed Ellis with non-insulin dependent

diabetes. (Id. at 260.) 

Dr. Johnson wrote repeated letters detailing his reasons for believing that

claimant was totally disabled.5

 In the final letter, Dr. Johnson reiterated:

This patient has multiple chronic medical problems which render him

incapable of any sustained gainful employment. Due to multiple motor

vehicle accidents he has severe chronic pain in his back and his hip. For

this he is taking very high doses of long-acting narcotic analgesics. He

is also a diabetic and has chronic hepatitis C. He also has recurrent

episodes of deep vein thromboembolism in his legs, severe dental caries

and hypertension. This patient is incapable of even the most sedentary

work because he cannot sit or stand probably for more than one hour at

a time due to his chronic pain and his tendency toward developing blood

clots in his legs.

I consider this patient to be permanently and completely disabled and I

think he should be given every possible consideration for disability

benefits.

(Id. at 279.) As this letter shows, Dr. Johnson believed that Ellis was disabled as a

result of the cumulative impact of his many medical problems. Dr. Johnson’s letters,

based on his treatment of Ellis over a period of years, are fully supported by the

record detailed above.

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Dr. Richard M. Secor, a consultant for the State of Missouri, examined Ellis

once, on January 18, 2001. (Id. at 214.) He expressed no opinion about Ellis’s ability

to work forty hours per week, in a competitive economy. He noted Ellis’s extensive

medical history, but made no finding as to whether Ellis's pain was, in fact, disabling.

Dr. Secor did not address Dr. Johnson's finding that claimant is unable to stand for

more than one hour at a time because of chronic pain and the deep vein thrombosis.

In my view, the opinion of Dr. Johnson, claimant's treating physician, is well

supported by medically acceptable clinical and laboratory diagnostic techniques and

is entirely consistent with the record. His conclusion, that Ellis is unable to sit for

more than an hour at a time, is consistent with evidence of multiple serious accidents,

chronic pain, and deep vein thrombosis. Thus, it should be given controlling weight.

See Singh v. Apfel, 222 F.3d 448, 452 (8th Cir. 2000). 

The ALJ also did not properly analyze five Polaski factors when evaluating the

effect of Ellis’s pain on his ability to work. Polaski v. Heckler, 739 F.2d 1320, 1322

(8th Cir. 1984) (stating that the adjudicator must consider Ellis’s daily activities; the

duration, frequency and intensity of the pain; precipitating and aggravating factors;

dosage, effectiveness, and side effects of medication; and functional restrictions when

evaluating subjective complaints of pain). 

The ALJ’s treatment of Ellis’s daily activities is at odds with the law in this

circuit. The ALJ determined that Ellis’s testimony, that he watched television and

read books on a daily basis, was evidence that he could sit for six hours in an eighthour day and stand and/or walk for up to two hours in an eight-hour day, and thus

perform sedentary work. He was in error. In McCoy v. Schweiker, 683 F.2d 1138,

1147 (8th Cir. 1982) (en banc), we stated the ability to do sedentary work “is the

ability to perform the requisite physical acts day in and day out, in the sometimes

competitive and stressful conditions in which real people work in the real world.”

The ability to watch television, like the ability to do light housework with assistance,

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attend church or visit with friends on the phone, does not qualify as the ability to do

substantial gainful activity. See Hogg v. Shalala, 45 F.3d 276, 278 (8th Cir. 1995);

Thomas v. Sullivan, 876 F.2d 666, 669 (8th Cir. 1989). A claimant “need not prove

that her pain precludes all productive activity and confines her to life in front of the

television” in order to prove her disability. Baumgarten v. Chater, 75 F.3d 366, 369

(8th Cir. 1996); see also Harris v. Sec’y of Dep't of Health & Human Servs., 959 F.2d

723, 726 (8th Cir. 1992) (spending much of the day listening to the radio and

watching TV is not substantial evidence of the ability to do full-time competitive

work); Rainey v. Dep’t of Health & Human Servs., 48 F.3d 292 (8th Cir. 1995) (the

fact that claimant read and watched television is not substantial evidence of his ability

to do full-time competitive work).

As to Ellis’s functional restrictions, Dr. Johnson reported that claimant could

not sit or stand for more than one hour at a time due to chronic pain and his tendency

toward developing blood clots in his legs. He further reported that Ellis could never

climb, balance, stoop, crouch, kneel, or crawl, and that he could not work around

heights or moving machinery. The ALJ interpreted Dr. Johnson's report to say that

Ellis could work in a sedentary job that did not involve the postural activities

indicated above. Nothing could be further from the truth. Dr. Johnson made it very

clear that claimant could not sit for more than one hour at a time, which meant he was

unable to do any sedentary jobs.

As to the duration, frequency and intensity of his pain, Ellis’s medical reports

indicate that his pain is severe and chronic, and he received pain medication

regularly. Dr. Johnson noted in his various reports that the pain relates to the multiple

injuries Ellis suffered in his multiple accidents. From 1993 to the present, Ellis has

taken prescribed pain medications, including Xanax, Tenex, Oxycodone, Oxycontin,

and Axid . While “[a] claimant's allegations of disabling pain may be discredited by

evidence that the claimant has received minimal medical treatment and/or has taken

only occasional pain medication,” the opposite is true here; Ellis has taken numerous

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prescription medications. Singh v. Apfel, 222 F.3d 448, 453 (8th Cir. 2000). There

is no evidence in this record, however, that the medications alleviated his pain to the

point where he could do sedentary work on a full-time basis. See Bowman v.

Barnhart, 310 F.3d 1080, 1083 (8th Cir. 2002). 

While Polaski notes that subjective complaints of pain may be discounted if

there are inconsistencies in the evidence as a whole, the adjudicator is not free to

accept or reject Ellis's subjective complaints solely on the basis of his personal

observations. See Polaski, 739 F.2d at 1322. Rather, the ALJ must detail his reasons

for finding inconsistencies in the record. He did not do so here. 

The exhibits referred to by the ALJ are not inconsistent with Ellis’s complaints

of pain and, when viewed in context, do not support the ALJ’s conclusion. Exhibit

B-1F is a 43-page exhibit consisting of clinical data from August 1993 through

November 2000. The ALJ refers to this exhibit as evidence that Ellis’s examinations

were “essentially normal.” This cherry-picking is a misrepresentation of these

reports. The report on page 164 of the record states only that Ellis's liver enzymes are

normal, not that his condition overall was normal. Dr. Johnson stated that Ellis

should continue to take Oxycontin and Oxy1R for his pain. On the same page, he

reports that Ellis was involved in a single-car accident where he suffered minor

injuries, including occipital hematoma and multiple abrasions and contusions. 

Exhibit B-7F is a report from the Parkland Health Center, where Ellis was

admitted after an automobile accident. (Id. at 246-52.) It does not address Ellis’s

general health. Ellis was a passenger in the front seat of a car involved in an

automobile accident on or about April 12, 2000, and suffered facial injuries and lower

lumbar pain. The report notes his extensive medical history, specifically, his hepatitis

C, right hip fracture, bilateral femur fractures, and herniated discs. This is not

consistent with the ALJ’s conclusion that the claimant had a normal physical

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6

Dr. Secor recorded Ellis’s medical history:

The patient has a rather extensive past medical history, which involves

multiple motor vehicle accidents in which he has sustained multiple

fractures, some of them compound comminuted with multiple surgical

procedures. He also has a history of Thrombophlebitis, Hepatitis C and

a “ruptured kidney and Pancrease.” He also has a history of pelvic

fractures.

(Admin. R. at 214.) The report also notes surgical procedures: “[b]ilateral open

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examination. A post-accident examination in which Ellis specifically reported lower

back pain is consistent with Ellis’s complaints of chronic pain. 

The ALJ read Ellis’s medical records from 2000 and 2001, Exhibit B-11F, (id.

at 267-77), very selectively, noting Dr. Johnson’s comment on a single visit that,

though Ellis had fallen, everything seemed to work okay and that he had no new

complaints. Again, the ALJ is cherry-picking the record; two lines later Dr. Johnson

repeated that chronic back and leg pain remain unchanged and that Ellis should

continue to take his prescribed medication. (Id. at 275.) Fairly read, these records

show that Ellis had better and worse days, but mentioned at every visit that he was

experiencing pain. Ellis's lifting, carrying, standing, walking, and sitting are all

affected by the impairment; Ellis had severe chronic back and hip pain; he can only

stand or walk for two hours in an eight-hour day; he can only sit for four hours in an

eight-hour day and one hour without interruption; and he should never climb,

balance, stoop, crouch, kneel, or crawl.

The ALJ relied heavily on a report submitted by Dr. Secor to the State of

Missouri. Exhibit B-4F (id. at 214.) Dr. Secor reported that claimant is able to sit,

stand, and lie down without assistance. Dr. Secor also noted the same medical

history, current ailments, and prescribed medications as those discussed by Dr.

Johnson.6

 

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reduction internal fixation of femur fractures as well as open reduction internal

fixation of left wrist fracture,” (id.) and Ellis’s medications: “Xanax 1 mg. t.i.d.,

Tenex 2 mg one daily, Oxycodone 5 mg. one Q8H PRN and Oxycontin 80 mg one

Q8H for pain. He also takes Axid 150 mg b.i.d.” (Id.)

He concluded that Ellis had experienced “multiple motor vehicle accidents with

multiple traumatic injuries including bilateral femoral fractures, left wrist fracture and

chronic back pain, . . . [a] [h]istory of Hepatitis C, apparently untreated, post

traumatic arthritis . . . [a]ncient history of ethanol abuse, [h]istory of

Thrombophlebitis . . . and tobacco abuse.” (Id. at 216.)

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Dr. Secor did not express an opinion as to whether Ellis was able to work eight

hours a day, five days a week in our competitive society, nor was he asked to do so

after the ALJ received his report. As the record stands, Dr. Secor added little or

nothing regarding Ellis’s ability to perform sedentary work day in and day out in our

competitive economy.

Dr. Hoff, who treated Ellis’s deep vein thrombosis, reported that Ellis “has

back pain, severe, and uses significant pain medication [including Oxycontin, Oxy1R,

Tenex, and Xanax]. This is due to degenerative joint disease and the injuries he has

gone through.” (Id. at 258). He noted Ellis’s multiple scars on his extremities due

to surgeries, and that his left leg was swollen from about the knee down. Dr. Hoff

concluded that Ellis had an acute deep vein thrombosis, and he prescribed

anticoagulation therapy. In his discharge summary Dr. Johnson stated that Ellis’s

final diagnosis was “[l]eft lower extremity deep venous thromboembolism, stable and

improved. Newly discovered non-insulin-dependent diabetes mellitus. Chronic

severe back and hip pain secondary to multiple motor vehicle accidents. History of

hepatitis C.” (Id. at 260.) This report is also consistent with Ellis’s reports of pain.

Ellis raises two additional issues in his brief. First, that the ALJ failed to fully

develop the record. I find no merit in that claim. The record was fully developed.

The ALJ, however, ignored much of the record and selectively chose sentences or

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7

When this matter was previously before this ALJ, the ALJ asked the

vocational expert: “Assume that the claimant is able to do sedentary work. Is there

work in the national economy which he can do?” Wording a hypothetical in this

manner is improper. “If a hypothetical question does not include all of the claimant's

impairments, limitations, and restrictions, or it is otherwise inadequate, a vocational

expert's response cannot constitute substantial evidence to support a conclusion of no

disability.” Cox v. Apfel, 160 F.3d 1203, 1207 (8th Cir. 1998). See also Wiley v.

Apfel, 171 F.3d 1190, 1191 (8th Cir. 1999); Bradley v. Bowen, 800 F.2d 760, 764

(8th Cir. 1986).

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paragraphs to support his view. Ellis also claims that a vocational expert should have

been called and given a proper hypothetical.7

 In my view, there is substantial

evidence on the record as a whole to award disability payments to Ellis. No remand

is necessary. The record was fully developed, but largely ignored by the ALJ. There

is therefore no need to remand for testimony from a vocational expert. 

Conclusion

After a careful review of the entire record, I believe that Ellis has demonstrated

by substantial evidence in the record as a whole that he is entitled to disability

benefits from and after November 1, 2000. I would remand to the district court with

directions to it to remand to the Commissioner for an award of benefits.

______________________________

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