Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-5_05-cv-05087/USCOURTS-arwd-5_05-cv-05087-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

---

AO72A

(Rev. 8/82)

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

BRENDA SUE THOMAS PLAINTIFF

v. Civil No. 05-5087

JO ANNE B. BARNHART,

Commissioner, Social

Security Administration DEFENDANT

MEMORANDUM OPINION

Brenda Sue Thomas (hereinafter "Plaintiff"), appeals from the decision of the

Commissioner of the Social Security Administration (hereinafter “Commissioner”), denying her

applications for a period of disability and disability insurance benefits (hereinafter "DIB"),

pursuant to §§ 216(i) and 223 of Title II of the Social Security Act (hereinafter "the Act"), 42

U.S.C. §§ 416(i) and 423. 

Plaintiff, whose date of birth is February 8, 1962, was 42 years of age at the time of the

August 19, 2004 administrative hearing (T. 257, 247-292). Plaintiff has a 10th grade education

(T. 70, 76, 96). While in school, Plaintiff attended regular classes rather than special education

classes (T. 76, 96). Plaintiff’s past relevant work includes the following jobs: clerk; waitress;

veterinary assistant; factory job - manufacturing of baby wipes; cashier; delivery person; and,

cook (T. 78). 

Plaintiff alleges an inability to work due to: post herpetic neuralgia; pain in head and

face; fatigue; hypothyroidism; a blood disorder, polycythemia vera; disc bulge at L5-S1; allergic

rhinitis; chronic asthmatic bronchitis; insomnia; inability to concentrate; hypercholestrolemia;

anxiety; sensitivity to temperature extremes; arthralgias of the hands and feet; profilactic breast

cancer treatment with Tamixofen; side effects of medications; and, headaches. She protectively

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 1 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-2-

filed her application for benefits, alleging an onset of date of disability of November 7, 2002 (T.

51-53). 

 The Social Security Administration denied plaintiff’s application initially and on

reconsideration. Plaintiff then requested and received a hearing before an Administrative Law

Judge (hereinafter “ALJ”), which hearing was held on August 19, 2004, before ALJ Dean C.

Metry in Fayetteville, Arkansas (T. 247-292). The ALJ rendered a decision adverse to Plaintiff

on September 21, 2004 (T. 19-26).

The Plaintiff then petitioned the Appeals Council for review on November 22, 2004 (T.

7-10). The Appeals Council denied review on March 16, 2005 (T. 3-6), thus making the ALJ’s

decision the final decision of the Commissioner. Plaintiff now seeks judicial review of that

unfavorable decision (Doc. #1, 8). This matter is before the undersigned by consent of the

parties (Doc. #4).

Applicable Law:

Our role on review is to determine whether the Commissioner’s findings are supported

by substantial evidence in the record as a whole. See Prosch v. Apfel, 201 F.3d 1010, 1012 (8th

Cir. 2000). Substantial evidence is less than a preponderance but is enough that a reasonable

mind would find it adequate to support the Commissioner’s decision. Id. In determining

whether existing evidence is substantial, we consider evidence that detracts from the

Commissioner's decision as well as evidence that supports it. See Craig v. Apfel, 212 F.3d 433,

436 (8th Cir.2000). As long as substantial evidence in the record supports the Commissioner's

decision, we may not reverse it because substantial evidence exists in the record that would

have supported a contrary outcome, see id., or because we would have decided the case

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 2 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-3-

differently. See Woolf v. Shalala, 3 F.3d 1210, 1213 (8th Cir.1993).

The Commissioner has established, by regulation, a five-step sequential evaluation for

determining whether an individual is disabled.

The first step involves a determination of whether the claimant is involved in substantial

gainful activity. 20 C.F.R. § 416.920(b). If the claimant is so involved, benefits are denied; if

not, the evaluation goes to the next step.

Step two involves a determination, based solely on the medical evidence, of whether

claimant has a severe impairment or combination of impairments. Id., § 416.920(c); see 20

C.F.R. § 416.926. If not, benefits are denied; if so, the evaluation proceeds to the next step.

The third step involves a determination, again based solely on the medical evidence, of

whether the severe impairment(s) meets or equals a listed impairment which is presumed to be

disabling. Id., § 416.920(d). If so, benefits are awarded; if not, the evaluation continues.

Step four involves a determination of whether the claimant has sufficient residual

functional capacity, despite the impairment(s), to perform past work. Id., § 416.920(e). If so,

benefits are denied; if not, the evaluation continues.

The fifth step involves a determination of whether the claimant is able to perform other

substantial and gainful work within the economy, given the claimant’s age, education and work

experience. Id., § 404.920(f). If so, benefits are denied; if not, benefits are awarded.

In addition, whenever adult claimants allege mental impairment, the application of a

special technique must be followed at each level of the administrative review process. See 20

C.F.R. § 416.920a(a).

The Commissioner is then charged with rating the degree of functional limitation, and

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 3 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-4-

applying the technique to evaluate mental impairments. See 20 C.F.R. § 416.920a(d). 

Application of the technique must be documented by the Commissioner at the ALJ hearing and

Appeals Council levels. See 20 C.F.R. § 416.920a(e). Such documentation, as referred to

within the regulations, is referred to as the PRT factors, mentioned previously.

Discussion:

The ALJ evaluated the plaintiff’s claim according to the five-step sequential evaluation

analysis prescribed by the social security regulations. See 20 C.F.R. §§ 404.1520(a)-(f); see

also Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987) (describing five-step analysis). At the first

step, the ALJ found the plaintiff had not engaged in substantial gainful activity since her alleged

onset date of November 7, 2002 (T. 19-26, 51). At the second and third steps, the ALJ

determined that the plaintiff suffered from severe, medically determinable impairments of post

herpetic neuralgia, bulging disc of the lumber spine and polycythemia vera (T. 21), but no

impairment or impairments that meet or equal the level of severity for any impairment listed in

Appendix 1, Subpart P, Regulations No. 4 (T. 13). See 20 C.F.R. § 404.1521; Bowen v.

Yuckert, supra. At Step 4 of the sequential analysis, the ALJ determined that Plaintiff retained

the residual functional capacity to perform sedentary work with a sit/stand option, and could

return to her past relevant work (T. 23-24). The ALJ made the determination that Plaintiff

"could return to her past relevant work as an order taker as previously performed and as

generally performed in the national economy" (T. 24).

On appeal, Plaintiff makes several arguments. Significantly, Plaintiff raises the issue of

whether the ALJ properly analyzed the Plaintiff’s nonexertional impairments. Upon a thorough

review of the administrative record, the undersigned finds that this issue has merit. Here the

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 4 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-5-

ALJ determined that while it is "reasonable to assume that Plaintiff may experience some

limitations"due to her severe impairments, "post herpetic neuralgia, a bulgind dis co hte lumbar

spine, and polycythemia vera; however-, the degree to which her impairments are functionally

limiting is an issue which is very much open to question." (T. 23).

In determining whether the ALJ properly disregarded Plaintiff’s subjective complaints

of pain, the Court must determine if the ALJ properly followed the requirements of Polaski v.

Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984) (subsequent history omitted), in evaluating her

pain and credibility. 

The absence of an objective medical basis which supports the degree of severity

of subjective complaints alleged is just one factor to be considered in evaluating

the credibility of the testimony and complaints. The adjudicator must give full

consideration to all of 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 the pain;

3. precipitating and aggravating factors;

4. dosage, effectiveness and side effects of medication;

5. functional restrictions.

The adjudicator is not free to accept or reject the claimant's subjective

complaints solely on the basis of personal observations. Subjective complaints

may be discounted if there are inconsistencies in the evidence as a whole. 

Polaski v. Heckler, 739 F.2d at 1322 (emphasis in original).

However, in addition to the requirement that the ALJ consider the Plaintiff’s allegations

of pain, he also has a statutory duty to assess the credibility of plaintiff and other witnesses. 

Nelson v. Sullivan, 966 F.2d 363, 366 (8th Cir. 1992). The ALJ may discredit subjective

complaints of pain inconsistent with the record as a whole. Ownbey v. Shalala, 5 F.3d 342, 344

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 5 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-6-

(8th Cir. 1993). 

Here, the record is replete with Plaintiff’s allegations of numerous nonexertional

impairments, including: pain (T. 253, 256, 269, 271, 272, 273, 275, 276, 277, 278, 291, 12, 13,

14, 15, 64, 74, 75, 97, 98, 114, 125, 127, 131, 138, 155, 158, 165, 170, 173, 176, 178, 180, 181,

202, 203, 220, 227, 235); fatigue (T. 263, 268, 277, 278, 97, 76, 114, 120); shortness of breath

due to asthmatic bronchitis (T. 264, 198, 199); sensitivity to temperature extremes (T. 95);

inability to sleep (T. 269); loss of concentration (T. 273, 279, 74); headaches (T. 269, 272, 64,

98, 158, 131, 165, 169, 170, 173); swelling (T. 127); and, side effects of medication (T. 258, 12,

97, 175, 176, 178).

In finding Plaintiff’s alleged level of pain to be less than fully credible, the ALJ found

that "....in May 2003, Dr. Travis stated that Tamoxifen was doing an ‘excellent job’ at

controlling her pain (exhibit 3F)" (T. 23). Such a finding is inconsistent with the evidence of

record as well as the pharmacology of Tamoxifen. 

Tamoxifen, also known by the brand name Noldavex, is a drug not set forth within the

PDR in detail. The sole PDR reference to Tamoxifen appears as follows in its entirety:

NOLVADEX

[tamoxifen citrate]

Please visit www.NOLVADEX.com or call the AstraZeneca Information Center

at 1-800-236-9933 for the most current full prescription information. 

Shown in Product Identification Guide, page 306.

However, when the referenced web page is viewed on the internet, the following

information may be obtained:

About NOLVADEX

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 6 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-7-

NOLVADEX® (tamoxifen citrate) Tablets work by blocking estrogen. In breast

tissue, NOLVADEX is an antiestrogen. An antiestrogen or estrogen blocker

works by blocking estrogen in breast tissue. While estrogen may not actually

cause breast cancer, it may stimulate its growth, feeding the cancer. With

estrogen blocked, the cancer cells that need it may not grow at all. In other

words, antiestrogens may keep cancer from developing in your breast.

NOLVADEX was initially developed to treat advanced breast cancer.

NOLVADEX has been successfully helping save the lives of millions of women

with breast cancer for over 20 years.

Today, NOLVADEX is used to treat breast cancer. Nolvadex is not indicated for

the treatment of premenopausal, node positive patients. Because it can delay or

stop the growth of breast cancer cells, it’s also a welcome option for the

management of ductal carcinoma in situ (DCIS) following surgery and radiation.

If you’ve had a breast biopsy and are unsure if your outcome might have been

DCIS, it’s now vital to speak with your doctor again.

Important safety information for NOLVADEX.

In clinical trials it has been shown that cancer of the uterus, stroke, and

blood clots can occur approximately 2 to 4 times more frequently with

NOLVADEX than placebo, but each occurred in less than 1% of women.

Some of these strokes, blood clots, and uterine cancers were fatal. 

For most women with breast cancer, the benefits of NOLVADEX outweigh

its risks. If you are taking NOLVADEX to reduce your risk of developing

breast cancer because you are at high risk or have DCIS, you should discuss

these warnings with your healthcare provider.

Women who are pregnant or plan to become pregnant should not take

NOLVADEX. Women who have a history of blood clots or who currently use

anticoagulants to thin their blood should not take NOLVADEX to reduce their

risk of breast cancer. Cataracts and cataract surgery can also occur more

frequently with NOLVADEX . The most frequently reported adverse reactions

with NOLVADEX were hot flashes and vaginal discharge. 

Nolvadex Tamoxifen Citrate, Astra Zenica, About the Drug, About Nolvadex, (visited June 13,

2006) http://www.nolvadex.com/consumer/nolvadex.asp (emphasis in original).

The full prescribing information can be obtained from the website as well. However, a

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 7 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-8-

review of the full prescribing information indicates that Tamoxifen Citrate is not used as a pain

medication, but rather in the treatment and prevention of breast cancer as an estrogen blocker. 

Due to the wide availability of generic Tamoxifen Citrate, Astro Zenica has made the following

announcement:

AstraZeneca has made the decision to discontinue the commercial manufacture

and distribution of branded NOLVADEX® (tamoxifen citrate) Tablets in the

United States by June 2006.

Once commercial supplies are exhausted, patients will no longer be able to

obtain brand name NOLVADEX Tablets. This applies to both new prescriptions

and refills.

Currently there are numerous companies that manufacture generic tamoxifen in

the United States. This is one of the reasons why AstraZeneca has voluntarily

decided to cease manufacturing NOLVADEX.

With the wide availability of generic tamoxifen, the discontinuation of

NOLVADEX should in no way affect access to this medication.

In addition, when the manufacture and commercial distribution of NOLVADEX

Tablets is discontinued in June 2006, NOLVADEX will no longer be available

within the AstraZeneca Foundation Patient Assistance Program.

Should you have any questions, please contact the AstraZeneca Cancer Support

Network at 1-866-992-9276, Monday through Friday, 9 AM to 8 PM EST. 

Nolvadex Tamoxifen Citrate, (visited June 13, 2006), http://www.nolvadex.com).

Within his decision, the ALJ found:

...in May 2003, Dr. Travis stated that Tamoxifen was doing an "excellent" job of

controlling her pain (Exhibit 3F).

(T. 23). 

Despite an thorough review of the record , the undersigned is unable to locate any

portion to Dr. Travis’ notes which contain a statement to the effect that Tamoxifen is being used

to treat pain. Although the ALJ does not specify to which date in May of 2003 he refers,

Plaintiff saw Dr. Travis on both May 7, 2003, and May 21, 2003. The pertinent portions of Dr.

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 8 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-9-

Travis’ treatment notes from May of 2003 are as follows:

Date: 05/21/2003

This patient is seen for diagnosis of polycythemia.

Polycythemia vera

Interval History

Brenda presents to clinic today. Dr. Kaplan is doing an excellent job of

controlling her pain....

(T. 160)(emphasis added).

Date: 05/07/2003

This patient is seen for her diagnosis of polycythemia vera, polycythemia.

Polycythemia vera

Polycythemia

Date of Diagnosis: 08/15/2001

Completed Treatment Details

Completed Treatment: No.

Interval History

Ms. Thomas presents to clinic today for follow up. She has been on tamoxifen

and was feeling better, having fewer headaches while she was on tamoxifen and

now is having more headaches off tamoxifen. We will plan to get her in to see

Dr. Kaplan and then try to do some investigation and figure out why tamoxifen

would be the culprit as far as her headaches go.

***

Clinical Impression and Plan

Return to clinic in two weeks. She is going to try some of her sister[‘]s

tamoxifen to try and confirm that the tamoxifen is the problem, and then we

will go from there.

(T. 158-159)(emphasis added). 

According to the record, Dr. Kaplan treated Plaintiff on: November 15, 2001; May 14,

2003; June 11, 2003; July 10, 2003; July 18, 2003; August 12, 2003; January 12, 2004; and,

September 12, 2004 (T. 175, 176, 177, 178, 180, 181-182, 220). Therefore, Dr. Kaplan saw

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 9 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-10-

Plaintiff twice, November 15, 2001, and 18 months later on May 14, 2003, some 7 days prior to

Dr. Travis’ above cited observation of May 21, 2003 (T. 158-159). When he saw Plaintiff, Dr.

Kaplan prescribed a number of different medications for plaintiff in his search for a medication

which would provide her relief without serious side effects (T. 220, 126-128, 176-182). 

Plaintiff reported experiencing side effects on a number of occasions (T. 258, 12, 97, 175, 176,

178). Plaintiff’s prescribed medications for treatment of her pain included: Hydrocodone;

Vicodin; Neurontin; Tramadol; Carbatrol; and Trileptol. Other medications prescribed for

plaintiff include: Tamoxifen; Paxil; Syndroid; Tegretol; Albuterol; Lipitor; Flonase;

Prednisone; Levaquin; Zyrtec; Atrovent; Biaxin XL; Advair; Guafenesin; Amoxicillin; Claritin;

Corticosteroid for Spinal Stenosis; Corticosteroid for used for treatment of pain; and, Decadron 

(T. 233). 

As mentioned previously, in addition to her reports of pain (T. 253, 256, 269, 271, 272,

273, 275, 276, 277, 278, 291, 12, 13, 14, 15, 64, 74, 75, 97, 98, 114, 125, 127, 131, 138, 155,

158, 165, 170, 173, 176, 178, 180, 181, 202, 203, 220, 227, 235), the record also reveals that

Plaintiff reported experiencing a number of other nonexertional impairments, such as fatigue

(T. 263, 268, 277, 278, 97, 76, 114, 120), shortness of breath due to asthmatic bronchitis (T.

264, 198, 199), sensitivity to temperature extremes (T. 95), inability to sleep (T. 269), loss of

concentration (T. 273, 279, 74), headaches (T. 269, 272, 64, 98, 158, 131, 165, 169, 170, 173),

swelling (T. 127). Plaintiff also had a lengthy treatment period of asthmatic bronchitis and

sinusitis which involved shortness of breath and the various pulmonary medications listed above

(T. 195-219). Plaintiff also reportedly experienced a variety of side effects of different

medications prescribed to her over the years. (T. 258, 12, 97, 175, 176, 178). Plaintiff’s

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 10 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-11-

physicians continued to prescribe medications for Plaintiff’s nonexertional impairments, and

often changed her medications in an effort to alleviate the side effects she experienced. Yet, the

ALJ overlooked many of the other nonexertional impairments alleged in the record. 

To determine whether the ALJ properly applied the factors listed in Polaski, we must

determine whether the ALJ took into account all the relevant evidence, and whether that

evidence contradicted the claimant's own testimony so that the ALJ could discount the

testimony for lack of credibility. Benskin v. Bowen, 830 F.2d 878, 882 (8th Cir.1987). The

ALJ's credibility assessment must be based on substantial evidence. Rautio v. Bowen, 862 F.2d

176, 179 (8th Cir.1988). 

In this case, with respect to subjective allegations and nonexertional limitations, the ALJ

found plaintiff’s allegations not supported by credible facts (T. 23). Implicit in the ALJ’s task

of making a credibility determination is the requirement that he "discuss" the Polaski factors. 

Herbert v. Heckler, 783 F.2d at 130 (the Polaski cases and the Social Security Disability

Reform Act of 1984 require that the Commissioner set forth the inconsistencies in the objective

medical evidence presented and discuss the factors set forth in the Polaski settlement when

making "credibility" determinations concerning claimant’s subjective complaints of pain).

Here, the ALJ fails to meaningfully examine the Polaski factor of dosage and side

effects of medication, particularly the chemotherapy drugs at issue. See Polaski v. Heckler, 739

F.2d at 1321-22. The ALJ must discuss and point out the inconsistencies in the record, in order

to make a credibility determination. Cline v. Sullivan, 939 F.2d 560, 565 (8th Cir.1991) ("it is

not enough that inconsistencies may be said to exist, the ALJ must set forth the inconsistencies

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 11 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-12-

in the evidence presented and discuss the factors set forth in Polaski when making credibility

determinations"); Herbert v. Heckler, 783 F.2d at 131 (even though evidence with respect to

Polaski factors is in the record, those factors must be discussed in the decision). Likewise,

allegations of fatigue must be discussed and analyzed, applying the standards that relate to the

similar, subjective complaint of pain. Jackson v. Bowen, 873 F.2d 1111, 1114 (8th Cir. 1989).

Here, the ALJ’s Polaski analysis is not sufficient to comply with the dictates of the case law. 

The ALJ failed to conduct a Polaski analysis of Plaintiff’s fatigue, swelling, side effects,

sensitivity to temperature extremes or shortness of breath. This is error. 

Additionally, Plaintiff raises the question of whether the ALJ properly considered

Plaintiff’s alleged lack of financial resources with which to obtain medication and treatment

(Doc. #8, pp. 24-31). Upon a thorough review of the evidence, the undersigned finds this

argument persuasive. Generally, if a claimant does not follow a prescribed treatment plan

without a good reason, he or she will not be found disabled. 20 C.F.R. § 416.930(b) (1984). 

However, the lack of financial resources to pay for medical treatment and/or medication may

justify the failure to pursue treatment or follow a treatment plan. Brown v. Heckler 767 F.2d

451, 452 (8th Cir.1985);Tome v. Schweiker, 724 F.2d 711, 714 (8th Cir.1984). The ALJ does

not discuss the impact of plaintiff’s alleged lack of finances on her ability to access treatment or

obtain prescribed medication. This constitutes error. To the extent the ALJ found plaintiff not

entirely credible, due to a lack of medical treatment and/or prescription medication, we note

numerous record citations in which the Plaintiff testified to and otherwise reported her lack of 

financial means. The record reflects through the medical evidence, the testimony and/or other

reports Plaintiff had no income and no money with which to: obtain prescription medication

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 12 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

1

In addition to the other indicators of financial hardship, the fact that Plaintiff’s

telephone was disconnected was also noted in the record (T. 235). .

-13-

(T. 97, 175, 182, 201); undergo the recommended MRI study (T. 71, 182); or, see a doctor (T.

254, 281). Although she applied for Medicaid coverage, Plaintiff had no health insurance

coverage to defray the cost of medical treatment and/or prescription medication until December

of 2003 (T. 258, 259). She applied for assistance in obtaining her pain medication through a

drug assistance program (T. 175). Plaintiff took herself off of her medications or did not fill

the prescriptions due to her financial situation (T. 168). Plaintiff’s physicians were aware of her

financial difficulties, noted same in their treatment records1, assisted her in applying for aid and

provided her with sample medications on a number of occasions (T. 175, 182, 71, 182, 200,

203, 209, 210). Dr. Travis and Dr. Kaplan noted Plaintiff’s financial difficulties. Dr. Travis

even noted that Plaintiff would take her sister’s tamoxifen (T. 159). Despite the numerous

allegations of Plaintiff’s inability to obtain treatment due to a lack of financial means, the ALJ

failed to address this issue when determining that Plaintiff was not credible or disabled. 

Certainly, the failure to follow a prescribed course of treatment may be excused by a

plaintiff’s lack of funds. Tome v. Schweiker, 724 F.2d at 714. Likewise, medication or

treatment an indigent person cannot afford is no more a cure for her condition than if it had

never been discovered. To a poor person, a medicine that she cannot afford to buy does not

exist. Dover v. Bowen, 784 F.2d 335, 337 (8th Cir.1986); Benson v. Heckler, 780 F.2d 16, 18

(8th Cir.1985); Tome v. Schweiker, 724 F.2d at 714. 

Upon remand, the ALJ should conduct a thorough Polaski analysis of Plaintiff’s

nonexertional impairments and should consider and discuss what effect, if any, Plaintiff’s

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 13 of 14 PageID #: <pageID>
AO72A

(Rev. 8/82)

-14-

alleged lack of financial means to obtain her prescribed pain medications and to seek/obtain

medical treatment had on the Plaintiff’s claim for disability, as well as Plaintiff’s credibility. 

Conclusion:

Accordingly, we conclude that the ALJ’s decision denying DIB and SSI benefits to the

plaintiff is not supported by substantial evidence and should be reversed. We further conclude

that this matter should be remanded to the Commissioner for further consideration consistent

with this decision.

ENTERED this 23rd day of June, 2006.

/s/Bobby E. Shepherd 

Honorable Bobby E. Shepherd 

United States Magistrate Judge 

Case 5:05-cv-05087-JRM Document 10 Filed 06/23/06 Page 14 of 14 PageID #: <pageID>