Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-04-02123/USCOURTS-ca8-04-02123-0/pdf.json

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

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United States Court of Appeals

FOR THE EIGHTH CIRCUIT

___________

No. 04-2123

___________

Kathie Garza, *

*

Appellant, *

* Appeal from the United States

v. * District Court for the

* Southern District of Iowa.

Jo Anne B. Barnhart, Commissioner of *

Social Security, * PUBLISHED

*

Appellee. *

___________

Submitted: January 6, 2005 

Filed: February 15, 2005

___________

Before RILEY, McMILLIAN, and GRUENDER, Circuit Judges.

___________

PER CURIAM.

Kathie Garza (Garza) appeals the district court’s order affirming the denial of

disability insurance benefits and supplemental security income benefits. In Garza’s

October 1999 applications and later documents, she alleged disability since February

1998 from rheumatoid arthritis and depression, and from memory, concentration, and

stomach problems. In May 2000, while Garza’s applications were pending, Dr.

Theodore Rooney (Dr. Rooney), a rheumatologist, diagnosed Garza with

fibromyalgia, opining it caused most of her symptoms as her rheumatoid arthritis was

reasonably controlled. After a December 2002 hearing, during which a vocational

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expert (VE) testified, an administrative law judge (ALJ) determined Garza had

rheumatoid arthritis, major depression, and gastroesophageal reflux disease; Garza’s

allegations as to her limitations were not entirely credible; and, based on the VE’s

testimony in response to a hypothetical the ALJ posed, Garza could perform her past

relevant work. 

We reject Garza’s challenge to the ALJ’s credibility determination, because the

determination was based on valid reasons. See Gregg v. Barnhart, 354 F.3d 710, 714

(8th Cir. 2003) (“If an ALJ explicitly discredits the claimant’s testimony and gives

good reason for doing so, we will normally defer to the ALJ’s credibility

determination.”). We also reject Garza’s argument that the ALJ improperly

disregarded the opinions of a treating social worker and a Social Security

Administration reviewing psychologist concerning Garza’s mental residual functional

capacity (RFC). First, Garza failed to seek therapy after December 1998, and at the

hearing, failed to link her limitations to depression. See Brosnahan v. Barnhart, 336

F.3d 671, 676 (8th Cir. 2003) (agreeing with ALJ’s decision to discount

psychologist’s opinion, noting claimant quit counseling after four sessions, ignored

recommendations for psychotherapy, and linked her activity limitations to physical

problems). Second, the social worker’s letter about Garza’s mental RFC was written

about a year after she last treated Garza–and then for only about five months– and she

attached no treatment records supporting her RFC conclusions. Cf. Forehand v.

Barnhart, 364 F.3d 984, 986 (8th Cir. 2004) (“A treating physician’s opinion is

generally entitled to substantial weight, . . .[but it] must be supported by medically

acceptable clinical or diagnostic data.”). Third, the social worker’s and reviewing

psychologist’s RFC findings conflicted with those of a consulting psychologist,

whose findings were based on testing. See Eichelberger v. Barnhart, 390 F.3d 584,

591 (8th Cir. 2004) (stating an ALJ must determine RFC based on all relevant

evidence).

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The ALJ also stated, despite multiple blood results indicative of rheumatoid

arthritis, there was minimal objective evidence to support Garza’s assertion that she

had this condition. 

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Garza asserts the ALJ erred by discounting the physical RFC findings of

treating physician Martina Darulova (Dr. Darulova). We disagree. Dr. Darulova’s

opinion on the extent of Garza’s physical limitations was inconsistent with her

colleague’s December 1999 assessment of Garza’s disability status; with Dr.

Rooney’s May 2000 opinion as to Garza’s inability to work for only twelve to

eighteen weeks until he could get her pain under control; and with Dr. Darulova’s

own relatively mild examination findings. Cf. Hogan v. Apfel, 239 F.3d 958, 961

(8th Cir. 2001) (noting an ALJ may discount treating physician’s opinion if she has

offered inconsistent opinions). Garza also complains the ALJ did not discuss Dr.

Rooney’s opinion as to Garza’s RFC, but this is not a material omission because Dr.

Rooney’s opinion was based on his experience with fibromyalgia patients in general

and did not focus on Garza. 

Garza argues the ALJ erred by not listing fibromyalgia as a severe impairment.

In summarizing the medical evidence, the ALJ mentioned Dr. Rooney’s May 2000

fibromyalgia diagnosis, but the ALJ did not discuss specifically other physicians’

subsequent references to fibromyalgia; and the ALJ specifically stated that Garza’s

symptoms of muscle aches and pains had not been substantiated by objective medical

testing.1

 We thus agree with Garza that the record indicates the ALJ misunderstood

fibromyalgia. See Forehand, 364 F.3d at 987 (noting (1) fibromyalgia is a chronic

condition, usually diagnosed after eliminating other conditions; (2) no confirming

diagnostic tests exist; and (3) our court has long recognized fibromyalgia might be

disabling); Nguyen v. Chater, 75 F.3d 429, 431 (8th Cir. 1996) (finding of no severity

is limited to medical impairment(s) that would have no more than minimal effect on

claimant’s ability to work). 

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It also appears the ALJ’s misunderstanding of fibromyalgia affected the ALJ’s

RFC findings, and her related hypothetical to the VE. The ALJ formed her

hypothetical by stating, if it were accepted that Garza had “some” fibromyalgia, such

a condition would only limit her to lifting twenty pounds occasionally and ten pounds

frequently, especially during flare-ups. While Dr. Rooney made no specific RFC

findings as to Garza, he did opine as to the limitations normally found in fibromyalgia

patients, for which he recommended sedentary work and other restrictions such as

needing an opportunity to move around at least once or twice an hour, see 20 C.F.R.

§§ 404.1567(a)-(b), 416.967(a)-(b) (sedentary work involves lifting no more than 10

pounds; light work involves lifting no more than 20 pounds, with frequent lifting or

carrying of 10-pound objects), and such limitations differ markedly from the ALJ’s

assessment of fibromyalgia-related limitations. Further, while the ALJ’s physical

RFC findings are consistent with those of a Social Security Administration reviewing

physician, the reviewing physician made his findings in January 2000, before Dr.

Rooney diagnosed Garza with fibromyalgia in May 2000. 

We conclude we must remand this case to the ALJ so she can reconsider

whether Garza’s fibromyalgia diagnosis on or after May 2000 constitutes a severe

impairment, and, if so, whether it is disabling. We direct the ALJ to develop the

record further by obtaining the medical records of rheumatologist Goel and the most

recent medical records from Dr. Rooney. At that point, if it is still necessary, the ALJ

may pose a revised hypothetical to a VE. See Forehand, 364 F.3d at 988 (noting in

a fibromyalgia case that RFC determination requires consideration of whether

claimant can perform requisite physical acts on daily basis in sometimes competitive

and stressful conditions in the real world); Freeman v. Apfel, 208 F.3d 687, 692 (8th

Cir. 2000) (noting the ALJ must develop record fully and fairly even when claimant

is represented by counsel); Hutton v. Apfel, 175 F.3d 651, 656 (8th Cir. 1999)

(“Testimony from a VE based on a properly-phrased hypothetical question constitutes

substantial evidence.”); Kelley v. Callahan, 133 F.3d 583, 589 (8th Cir. 1998)

(encouraging Commissioner to give greater weight to specialist’s opinion).

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We note, however, that the record does not support a finding of disability

before March 1999, Garza’s date last insured for purposes of disability insurance

benefits: Dr. J.B. McConville, Garza’s treating physician, opined in December 1999

that Garza’s physical findings did not support disability, and fibromyalgia was not

diagnosed until May 2000. Thus, only Garza’s supplemental security income claim

survives on remand. 

Accordingly we affirm, in part, and reverse and remand, in part, for further

proceedings consistent with this opinion. 

______________________________

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