Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-14-02834/USCOURTS-ca8-14-02834-0/pdf.json

Parties Involved:
Carolyn W. Colvin
Appellee
Karl William Wright
Appellant

Document Text:

United States Court of Appeals

For the Eighth Circuit

___________________________

No. 14-2834

___________________________

Karl William Wright

lllllllllllllllllllll Plaintiff - Appellant

v.

Carolyn W. Colvin, Acting Commissioner of Social Security

lllllllllllllllllllll Defendant - Appellee

____________

Appeal from United States District Court 

for the Western District of Missouri - Jefferson City

____________

 Submitted: February 11, 2015

 Filed: June 15, 2015

____________

Before LOKEN, SMITH, and COLLOTON, Circuit Judges.

____________

SMITH, Circuit Judge.

Karl William Wright appeals the district court's order upholding the Social 1

Security Commissioner's decision to deny his applications for disability insurance

The Honorable Robert E. Larson, United States Magistrate Judge for the

1

Western District of Missouri, to whom the case was referred for final disposition by

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

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benefits and supplemental security income benefits. Wright argues that the

administrative law judge (ALJ) erred by discrediting the opinions of two examining

physicians, discrediting Wright's testimony, not considering Wright's mental

condition as a severe impairment, and not considering the record as a whole. We

affirm. 

I. Background

A. Wright's Physical Condition

Wright is a fifty-year-old man that suffers from back and knee pain. Wright

suffered a shoulder injury and complained of low back pain after being involved in

a severe car accident in 2000. The record indicates that Wright also suffered from

another severe automobile accident in 1987. Wright described his pain as a "stinging"

pain in his lower middle back and that this pain "goes down both" legs. Wright's

obesity compounds his problems. At the time Wright applied for social security

benefits, he was six-feet tall and weighed 350 lbs. As a result of his pain and obesity,

Wright testified that his average day consists principally of laying on his back trying

to get comfortable and spending around 30 minutes cooking basic meals for himself.

Wright testified that his pain forces him to keep his movements during the day to a

minimum. His limited mobility notwithstanding, Wright is able to drive and goes out

"[a]bout three times a month" to the grocery store, the bank, and appointments with

doctors. Wright's physical limitations, however, do not affect "his ability to

remember, concentrate, understand, follow instructions, use his hands, or get along

with others."

Due to his condition, Wright sought the help of several doctors over the past

several years to manage his pain. After his car accident in 2000, Wright weighed 260

lbs., his C-spine series was negative, and his lumbar spine was described as

"unremarkable." Nearly a decade later, Wright's weight had substantially increased.

On August 14, 2009, Wright began visiting Dr. Joshua Griggs, a family physician. By

this date, Wright weighed 356 lbs. Dr. Griggs noted that Wright "has a past medical

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history of degenerative disc disease in the spine . . . as well as multi-level disc disease

in the L4-L5 area." On top of these back issues, Dr. Griggs noted that Wright had

"type 2 diabetes, vitamin D deficiency, tobacco abuse, obesity, [and] bilateral knee

arthritis." Wright was able to bend his back over to 90 degrees, and "[e]xtension,

lateral bending and twisting is all painful but normal." In addition to prescribing

diabetes treatment and pain medication, Dr. Griggs counseled Wright on diet and

exercise to lose weight. Dr. Griggs noted that Wright was "adamantly against" taking

water aerobic classes because of the cost; still, Dr. Griggs advised Wright to start

walking because it was free.

On September 1, 2009, Wrightsaw Dr. WilliamHarris, an orthopedic surgeon,

to assess Wright's knee pain. Dr. Harris found that Wright's knees were tender and

showed "a little bit of loss with the weightbearing space" but otherwise exhibited a

regular range of motion and "appeared to be essentially unremarkable with very

minimal degenerative changes."

On December 10, 2009, Wright saw Dr. Usaikimi Igbaseimokumo, a

neurological surgeon. Dr. Igbaseimokumo diagnosed Wright with "[l]umbar

spondylosis with low back pain." Dr. Igbaseimokumo noted that Wright complained

of "low back pain" but had "no significant leg pain" on that particular occasion. Dr.

Igbaseimokumo also found that Wright's lumbar spine was tender, but found no

"obvious deformity."

On February 19, 2010, Wright underwent an MRI of his lumbar spine. The

MRI revealed degenerative disks at L4-L5 and L5-S1 of Wright's spine. Also, there

was a moderate to severe central canal narrowing at L4-L5 with a diffuse disc bulge

and a triangular appearance. There was also a mild diffuse disc bulge at L5-S1 with

mild narrowing of the neural canal. Additionally, there was a possible L3-L4 left

paracentral disc osteophyte. 

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Wright did not seek medical help again until eight months later on November

3, 2010. Wright saw Dr. Griggs on this date, who prescribed an anti-depressive for

his "[c]omplete decompensation due to major depressive disorder." 

On November 15, 2010, Wright visited Dr. Michael Vierra, a radiologist, who

x-rayed both of Wright's knees. The results found no fracture, no joint effusion, and

mild degenerative changes in the medial joint compartment. Dr. Vierra also

conducted an x-ray of Wright's spine, which showed that a previous "compression

deformity of T12 [was] unchanged" and revealed mild degenerative changes. 

Wright continued to see Dr. Griggs in January and February 2011 and

continued to complain of back pain. Dr. Griggs reported that Wright could not lift

more than 15 lbs. and could not stoop, climb, bend, or twist. When asked if Wright

could stand for two hours and sit for six hours during an eight hour workday, Dr.

Griggsreported that Wright could only stand for lessthan "10–15 minutes" and could

only sit for "30 min[utes] at a time" before "need[ing] to lay down."

On March 3, 2011, Wright had another MRI of his lumbar spine. The MRI

showed "[b]orderline spinal stenosis at L4-L5" and "posterior sublaxation of L5 on

S1 with circumferential disc bulge without spinal stenosis." Interrogatories were

propounded to Dr. Griggs, who described Wright as suffering from "[b]ilateral knee

arthritis [and] [d]egenerative [l]umbar [d]isc [d]isease," among other things. 

On July 8, 2011, Wrightsaw Dr. Tomoko Tanaka, a neurosurgeon. Dr. Tanaka

found that Wright exhibited 5/5 in a motor strength test of his upper extremities and

5/5 in a motor strength test in his lower extremities "with give-way to pain in the

psoas [muscle] on flexion of the hip." Also, Wright exhibited 5/5 in a motor strength

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test in bending his knees and ankles. Dr. Tanaka concluded that Wright suffered 2

from lumbar spondylosis but that surgery was not a viable solution. A follow up with

Dr. Tanaka on July 14, 2011, showed no abnormal movement in Wright's back. 

On November 28, 2011, Wright saw Dr. Garth Russell. Dr. Russell conducted

a physical examination and reviewed Wright's past medical records. Dr. Russell

diagnosed Wright with "[d]egenerative disc disease, chronic with spinal stenosis

L4-5, moderately severe," among other things. Dr. Russell also noted that Wright's

"knees have degenerated to the point where they are unable to tolerate [his] weight

except for short periods of time." Dr. Russell concluded by stating that Wright would

survive "onlywith a significant amount of medical attention and medications. He will

spend most of his time in a recumbent position because of the pain. In addition, he

would be unable to sit longer than 20 to 30 minutes or to stand for about that same

length of time." 

On several occasions, Wright admitted that he was not taking his pain

medication; this was against the recommendation of his treating physician, Dr.

Griggs. Wright also declined conservative treatment options, such as physical

therapy, against the recommendation of several doctors. 

B. Wright's Mental Condition

In addition to his physical limitations, Wright has also been treated for

depression. Dr. Griggs began noticing Wright's depression in November 2010 and

prescribed Wright an anti-depressant. Dr. Griggs saw Wright's depression as a major

obstacle in getting Wright on track to achieve overall health. On January 26, 2011,

Wright saw Dr. Kim Dempsey, Psy.D, to assess his mental condition. Wright denied

We have interpreted 5/5 strength test resultsto represent normal or maximum 2

muscle strength. See Moore v. Astrue, 572 F.3d 520, 524 (8th Cir. 2009) (associating

a "5/5 strength" test result with "normal or full muscle strength" (citing Flynn v.

Astrue, 513 F.3d 788, 793 (8th Cir. 2008)). 

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being depressed to Dr. Dempsey and claimed that he is motivated to do tasks;

however, he stated that he cannot usually finish tasks because "the mind is willing but

the body is not." (Quotation marks omitted.) Dr. Dempsey also found that Wright's

mental concentration suffered deficits because he waslimited by pain and not because

of a mental health condition. Dr. Dempsey ultimately diagnosed Wright with

"Adjustment Disorder with Depressed Mood" and measured his "Global Assessment

of Functioning [GAF] = 60."

On February 7, 2011, Wright saw Dr. James W. Morgan, Ph.D, to assess his

mental health in connection with his disability application. Dr. Morgan concluded

that Wright's mental impairment was not severe. Dr. Morgan noted that Wright had

mild daily living restrictions, mild difficulties maintaining social functioning, and

mild difficulties maintaining concentration, persistence, or pace.

C. Wright's Work History

Wright's work history includes construction work (1983–93), renting out

equipment (1994–95), and hanging wallpaper (1996–2008). During the past thirty

years, however, Wright's reported taxable income has fluctuated dramatically. Wright

has not reported earning any income in the years 2006–11. Additionally, Wright did

not report any income in the years 1981 and 1987. When he did earn income, it was

seldom over $10,000 for the year. 

D. Procedural History

Wrightfiled for disability insurance benefits and supplemental security income

benefits on December 14, 2010. In both claims, he alleged the onset of his disability

as April 14, 2010. After both of Wright's applications were denied, he requested a

hearing before an ALJ for reconsideration.

After reviewing the record in its entirety, the ALJ found that Wright was not

disabled under the Social Security Act and thus was ineligible for benefits. The ALJ

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followed the following familiar process to determine disability: "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." Hacker v. Barnhart, 459 F.3d 934, 936 (8th Cir.

2006) (internal quotation omitted); see 20 C.F.R. §§ 404.1520(a), 416.920(a). 

At step two of the sequential evaluation, the ALJ found that Wright's

depression did not constitute a severe impairment because the reports of Dr. Dempsey

and Dr. Morgan indicated that Wright's functionality was only mildly impaired by his

condition. Before reaching step four, the ALJ determined the following residual

functional capacity (RFC): Wright could stand or walk for two hours and sit for six

hours during an eight-hour workday, and he could occasionally climb ramps orstairs,

stoop, kneel, crouch, crawl, and balance. In doing so, the ALJ found that Wright's

testimony of back and knee pain was not corroborated by the objective medical

evidence. Wright's ability to go several months without seeking medical help for the

pain, his refusal to take pain medications, and his failure to seek conservative

treatment options also cut against Wright's credibility. Further, the ALJ found

Wright's testimony to be incredible because his work history, which indicates he

worked until 2008, did not match up with his income statements, which indicate he

stopped reporting income in 2006. Next, the ALJ afforded "little weight" to the

opinions of Dr. Russell and Dr. Griggs because their opinions of Wright's physical

functionality were not consistent with the objective medical evidence. The ALJ also

justified assigning little weight to Dr. Russell's testimony because he was a

"nonexamining physician."

At step four of the sequential analysis, the ALJ found that Wright's RFC would

not allow him to perform the past relevant work of hanging wall paper.

Notwithstanding, the ALJ adopted the vocational expert's testimony that a person

with Wright's RFC could obtain gainful employment in available positions in the

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national economy, such as an assembler, a weight tester, or an order clerk. Thus, the

ALJ found that Wright was not eligible for benefits. The district court affirmed the

ALJ's decision, and Wright now appeals. 

II. Discussion

On appeal, Wright alleges that the ALJ made four reversible errors. First,

Wright argues that the ALJ improperly discredited the medical opinions of Dr.

Russell and Dr. Griggs by erroneously stating that they were inconsistent with the

medical evidence. Second, Wright alleges that the ALJ erred by discrediting Wright's

testimony about his pain because of inconsistencies. Third, Wright argues that the

ALJ erred by failing to find that Wright's mental condition was a severe impairment

and failing to include it in Wright's RFC. Finally, Wright employs a general argument

that the ALJ failed to make his denial decision based on the record as a whole. 

We apply the same review standard as the district court "and uphold the . . .

denial of benefits . . . if the ALJ's decision is supported by substantial evidence in the

record as a whole. Substantial evidence isless than a preponderance, but enough that

a reasonable mind might accept it as adequate to support a decision." Juszczyk v.

Astrue, 542 F.3d 626, 631 (8th Cir. 2008) (alterations in original) (quotations and

citation omitted). "We defer heavily to the findings and conclusions of the Social

Security Administration." Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir. 2010) (citing

Howard v. Massanari, 255 F.3d 577, 581 (8th Cir. 2001)). "We must consider

evidence that both supports and detracts from the ALJ's decision . . . . If, after

reviewing the record, the court finds it is possible to draw two inconsistent positions

from the evidence and one of those positions represents the ALJ's findings, the court

must affirm the ALJ's decision." Perkins v. Astrue, 648 F.3d 892, 897 (8th Cir. 2011)

(quotation and citation omitted). 

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A. Dr. Russell's and Griggs's Medical Opinions

Wright first argues that the ALJ erred by assigning little weight to Dr. Russell's

and Dr. Griggs's medical opinions. Regarding Dr. Russell, Wright argues that the ALJ

erred by mischaracterizing him as a nonexamining physician. This error is relevant

because the opinions of examining medical professionals are given more weight than

nonexamining medical professionals. See Shontos v. Barnhart, 328 F.3d 418, 425

(8th Cir. 2003) ("[An examining doctor] had what the regulations describe as an

examining relationship, and accordingly, his opinion would be given more weight

than a source who had not examined [the claimant]." (citing 20 C.F.R. §

404.1527(d)(1) [now subsection (c)(1)])). The record indicates that Dr. Russell did

base his opinion on a physical examination of Wright. Even though there was only

one such examination, this should qualify Dr. Russell as an examining medical

professional. The Commissioner on appeal agrees that the ALJ mistakenly classified

Dr. Russell as a "nonexamining physician."

When examining the ALJ's decision, however, this was the lesser of two

reasons that Dr. Russell's opinion was given little weight. As the ALJ stated, "[f]ar

more significant is the fact that his conclusions are not supported by the record."

(Emphasis added.) There is substantial evidence in the record to support the ALJ's

finding that both Dr. Russell's and Dr. Griggs's opinions were not consistent with the

objective medical evidence that relates to determining disabling pain levels. See

Perkins, 648 F.3d at 897 ("An ALJ may discount or even disregard the opinion of a

treating physician where other medical assessments are supported by better or more

thorough medical evidence, or where a treating physician renders inconsistent

opinions that undermine the credibility of such opinions." (quotation and citation

omitted)). In regard to Wright's back pain, his C-spine series x-ray was negative and

his lumbar spine was described as unremarkable in 2000 after his severe car accident,

which is supposedly the root cause of his current physical limitations. In 2009, Dr.

Igbaseimokumo found no obvious deformity in Wright's lumbar spine. In 2010, an

x-ray of Wright's back revealed that a compression deformity had gone unchanged

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and otherwise only showed mild degenerative changes. In 2011, Dr. Tanaka found

that Wright exhibited a 5/5 motor strength test in his lower extremities. In regard to

Wright's knee pain, x-rays performed in 2009 did not show any fractures and Wright's

knees were described as being unremarkable with minimal degenerative changes.

These results were echoed in 2010 when x-rays of Wright's knees returned similar

results. Thus, we find that there is substantial evidence to support the ALJ's decision

to assign the opinions of Dr. Russell and Dr. Griggs little weight.3

B. Wright's Testimony

Wright next argues that the ALJ erred by finding his testimony of subjective

pain and functionality incredible due to the inconsistencies in his work history, daily

activities, and failure to adhere to treatments. "[C]redibility is primarily a matter for

the ALJ to decide." Edwards v. Barnhart, 314 F.3d 964, 966 (8th Cir. 2003) (citing

Pearsall v. Massanari, 274 F.3d 1211, 1218 (8th Cir. 2001)). "An ALJ . . . may

disbelieve subjective reports because of inherent inconsistencies or other

circumstances." Travis v. Astrue, 477 F.3d 1037, 1042 (8th Cir. 2007) (quotation and

citation omitted). In addition to the "objective medical basis" that should support the

subjective testimony of disabling pain, this court takes into account "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." Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984). Polaski

outlined a list of five factors which this court and ALJs must take into account when

judging the credibility of testimony on subjective pain: "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." Id.

Wright also asserts that the ALJ "ignore[d]" Dr. Russell's testimony and

3

"found that [his testimony] did not exist." This argument has little merit because the

ALJ acknowledged that he did take Dr. Russell's testimony into account, but only

assigned it "little weight."

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The ALJ found Wright's work history troubling for two reasons: First, Wright

claimed he had not worked since 2008, but the onset of his disability was in 2010;

and second, Wright did not report any earnings for the tax years of 2006, 2007, and

2008, which isinconsistent with his reported work history that did not end until 2008.

Wright only briefly addresses the ALJ'sfirstfinding by arguing that the reason he was

not working from 2008–10 was because this was a period in which he previously

applied for social security benefits but was similarly denied. Wright seemingly

ignores the ALJ's second point, however, and offers no explanation why he did not

report any income for 2006–08 if he wassupposedly working full time as a wallpaper

hanger during that period. Even more troubling is Wright's work history going back

over thirty years. Since 1978, Wright has reported not having any earnings a total of

eight times. Out of the 26 years he has reported earnings, half of those years he

reported earning less than $5,000 and never reported earning more than $20,000.

While Wright suffered severe automobile accidents in 1987 and 2000, it appears his

inability or unwillingness to find gainful employment preceded these events. See

Holley v. Massanari, 253 F.3d 1088, 1091 (8th Cir. 2001) (discussing an ALJ

decision where the claimant's "work history suggested poor motivation and called his

disability claiminto question"). It appearsthat Wright is either untruthful in reporting

his income or he is untruthful in portraying his work history. Either way, this

evidence supports the ALJ's discounting of Wright's credibility. 

Review of the record also reveals the ALJ properly considered other Polaski

factors in discrediting Wright's testimony of disabling pain and forming the RFC.

Wright himself admits to engaging in daily activities that this court has previously

found inconsistent with disabling pain, such as driving, shopping, bathing, and

cooking. See, e.g., Edwards v. Barnhart, 314 F.3d 964, 966 (8th Cir. 2003) (finding

that the claimant's shopping, driving short distances, attending church, and visiting

relatives were inconsistent with suffering disabling pain); Lawrence v. Chater, 107

F.3d 674, 676 (8th Cir. 1997) (finding that the claimant's dressing herself, bathing

herself, cooking, and shopping was inconsistent with disabling pain). Additionally,

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the ALJ noted that Wright's credibility suffered from his refusal to take pain

medication and his refusal to seek out even conservative treatments such as physical

therapy. See Wildman v. Astrue, 596 F.3d 959, 966 (8th Cir. 2009) (finding a

claimant's noncompliance with a diet regimen prescribed by their doctor contributed

to a negative credibility determination). Further, Wright's complaints of disabling

pain are also undercut by the eight-month period during which he sought no medical

care. Given the ALJ's findings of inconsistencies in Wright's work history and

consideration of the Polaski factors, we conclude that substantial evidence supports

its credibility finding. 

C. Wright's Mental Condition

Wright next argues that the ALJ erred by not taking his depression or his GAF

score of 60 into account when forming the RFC. Specifically, Wright argues that his

4

depression and GAF score should have been classified as a severe impairment under

step two and thus appropriately grafted into his RFC. First, the ALJ properly

considered the opinions of Dr. Dempsey and Dr. Morgan, the two mental health

specialists that examined Wright. Dr. Dempsey found that Wright's mental condition

did not affect his functionality, but rather that his pain limited his ability to complete

mental tasks. This was corroborated by Dr. Morgan's findings that Wright's mental

condition only mildly affected his overall functionality. While "[s]everity is not an

onerous requirement for the claimant to meet . . . it is also not a toothless standard."

Kirby v. Astrue, 500 F.3d 705, 708 (8th Cir. 2007) (citation omitted). Based on the

findings of the two mental health professionals in the record, substantial evidence

supports the ALJ's disposition. 

TheGAF scale measures "psychological,social, and occupationalfunctioning" 4

on a 1 to 100 scale. Diagnostic and Statistical Manual of Mental Disorders 30 (4th

ed. 1994). A GAF score of 60 means that the patient has "moderate symptoms . . . or

moderate difficulty in social, occupational, or school functioning." Id. at 32. 

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Additionally, substantial evidence supports the ALJ's decision not to give

weight to Wright's GAF score because GAF scores have no direct correlation to the

severity standard used by the Commissioner. See 65 Fed. Reg. 50746, 50764–65

("[GAF scores] do[] not have a direct correlation to the severity requirements in our

mental disorderslistings.");see also Halverson v. Astrue, 600 F.3d 922, 931 (8th Cir.

2010) (finding that the claimant's GAF score ranges from 52–60 "indicate [the

claimant] has moderate symptoms or moderate difficulty in social or occupational

functioning" (citation omitted)). Thus, even assuming the validity of the GAF score

of 60, such a score supports the ALJ's decision that Wright's depression was not

severe. 

Wright also cites to several placesin the record where Dr. Griggs and a handful

of other medical professionals made statements regarding Wright's depression and

anxiety. The ALJ was within his purview not to give these observations much weight

because they were not from specialists in the mental health field. See 20 C.F.R.

§ 404.1527(c)(5). Therefore, substantial evidence supports the ALJ's consideration

of Wright's mental condition.

D. Consideration of the Record as a Whole

Finally, Wright argues that the ALJ failed to consider the record as a whole

when determining Wright's RFC. The only argument not already addressed above is

Wright's contention that the ALJ failed to take Wright's obesity into account. The

record indicates this argument is without merit. "'We have held that when an ALJ

references the claimant's obesity during the claim evaluation process, such review

may be sufficient to avoid reversal.'" Heino v. Astrue, 578 F.3d 873, 881 (8th Cir.

2009) (quoting Brown ex rel. Williams v. Barnhart, 388 F.3d 1150, 1153 (8th Cir.

2004)). The ALJ explicitly stated that he "considered the combined effects of the

claimant's obesity with the claimant's other impairments when determining that he

retains the ability to perform a range of sedentary work within the limitations

identified." As we have discussed above, the ALJ properly considered the record as

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a whole. Wright's disagreements with the ALJ's conclusions made from its review of

the entire record do not mean the ALJ did not consider the whole record.

III. Conclusion

For the reasons stated herein, we affirm.

______________________________

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