Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-15-01239/USCOURTS-ca8-15-01239-0/pdf.json

Parties Involved:
Carolyn W. Colvin
Appellee
Robert Crawford
Appellant

Document Text:

United States Court of Appeals

For the Eighth Circuit

___________________________

No. 15-1239

___________________________

Robert Crawford

lllllllllllllllllllll Plaintiff - Appellant

v.

Carolyn W. Colvin, Acting Commissioner of the Social Security Administration

lllllllllllllllllllll Defendant - Appellee

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Appeal from United States District Court 

for the Eastern District of Missouri - Cape Girardeau

____________

 Submitted: September 23, 2015

 Filed: December 7, 2015 (Corrected December 10, 2015)

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Before LOKEN, BEAM, and SHEPHERD, Circuit Judges.

____________

BEAM, Circuit Judge

Robert Crawford appeals the district court's order affirming the decision ofthe

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Commissioner of the Social Security Administration denying Crawford's application

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

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Eastern 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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for supplemental security income. Crawford applied for benefits on August 16, 2007,

claiming his disability began on January 1, 2004. The Commissioner denied the

application, and Crawford appealed to an administrative law judge (ALJ). The ALJ

found Crawford was not disabled under the Social Security Act. The Appeals

Council denied review, and Crawford appealed to the district court. The district court

then reversed and remanded for lack ofsubstantial evidence on the record concerning

Crawford's ability to perform his past relevant work. Upon remand, the ALJ found

that Crawford was not disabled because he could perform sedentary work. The

Appeals Council again denied review, making the ALJ's decision the final decision

of the Commissioner. On appeal to the district court, the court affirmed the ALJ's

decision. Crawford now appeals, and we affirm because the decision is supported by

substantial evidence on the record.

I. BACKGROUND 

Crawford was born on September 16, 1969. In his application, Crawford

alleges that the following conditions prevent him from working: swelling in his legs,

shortness of breath, low heart rate, sleep apnea, Chronic Obstructive Pulmonary

Disease (COPD), congestive heart failure, depression, and morbid obesity. He has

a high school education and some semi-skilled past relevant work experience. His

work history is sporadic, and his highest income for a single year is $6,869. He

smokes between one-and-a-half and two packs of cigarettes a day, drinks two sixpacks of beer on a daily basis when he has the money, and has had issues with

cocaine addiction. He requires the use of home services but is able to prepare simple

meals, sweep, and mop. Occasionally he walks to get around, and his hobbies include

reading and completing crossword puzzles. Crawford also states that his conditions

affect his ability to lift, squat, bend, stand, and walk, such that he can only lift

between ten and fifteen pounds and can only walk fifty feet before needing to rest and

elevate his legs. He is currently taking a number of medications.

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Contrary to Crawford's claims, a third-party observation by the Social Security

Administration showed he had no problems reading, breathing, understanding,

concentrating, talking, or answering during his interview. As for credibility,

according to the ALJ, "the relevant medical records show[ed] that the claimant's

overall treatment history and the objective medical evidence fail[ed] to fully support

the claimant's allegations about the severity of his limitations." Medical records from

2007 through 2012 consistently revealed that Crawford had a normal gait, a normal

range of motion, an intact memory, no sensory deficiency, no irregular swelling in his

legs, and mostly clear lungs. He also denied psychiatric problems in several medical

records. Because of the inconsistencies between Crawford's testimony and the

objective medical records, the ALJ determined Crawford was "not credible in his

allegations about the severity of his work-related limitations." 

Following the five-step sequential evaluation process used by the Social

Security Administration to determine disabilities of adults, the ALJ held that

Crawford was not involved in substantial gainful activity; had a severe medically

determinable physical impairment; had no disabling impairment; and had a Residual

Functional Capacity (RFC) limited to sedentary work. See 20 C.F.R. § 416.920(a)-

(e). More specifically, the ALJ described Crawford's RFC as follows:

The claimant has the maximum [RFC] to lift and carry 10 pounds

occasionally and less than 10 pounds frequently. Total in an eight-hour

day, he can stand and walk for no more than two hours, and he can sit

for six hours. He must avoid concentrated exposure to respiratory

irritants.

At the fourth step of the analysis, the ALJ found that Crawford could not participate

in his past relevant work. At the fifth step, the ALJ noted that because Crawford's

"non-exertional limitations do not significantlyerode the sedentaryoccupational base,

there are jobs that exist in the national economy that the claimant can perform when

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his vocational factors and [RFC] are considered." Thus, based on the MedicalVocational Guidelines, the ALJ found Crawford was not disabled.

On appeal, Crawford argues (1) that the ALJ wrongfully rejected the opinion

of Crawford’s treating nurse practitioner, Patrick Drummond, and (2) that the ALJ

erred at step five by using the Medical-Vocational Guidelines to find him not

disabled. 

II. DISCUSSION

We review the district court's determination to grant or deny Social Security

benefits de novo. Perkins v. Astrue, 648 F.3d 892, 897 (8th Cir. 2011). We must

"'affirm the ALJ's finding if supported by substantial evidence on the record as a

whole.'" Id. (quoting Medhaug v. Astrue, 578 F.3d 805, 813 (8th Cir. 2009)). All

evidence, including "'evidence that both supports and detracts from the ALJ's

decision,'" must be considered. Id. (quoting Medhaug, 578 F.3d at 813). Substantial

evidence exists when there is enough evidence in the record "'that a reasonable mind

might accept it as adequate to support a decision.'" Juszczyk v. Astrue, 542 F.3d 626,

631 (8th Cir. 2008) (quoting Kirby v. Astrue, 500 F.3d 705, 707 (8th Cir. 2007)). 

This is a lower standard than a preponderance of the evidence. Id. Moreover, great

deference is given to the ALJ's decision. Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir.

2010). Thus, if the record shows two positions that are plausible and can be

supported by substantial evidence, we must follow the ALJ's position and affirm its

decision. Perkins, 648 F.3d at 897.

A. Crawford’s Nurse Practitioner

Patrick Drummond, a nurse practitioner, treated Crawford in January of 2010

and concluded that Crawford had the maximum capacity to lift less than ten pounds

frequently, could stand or walk for a total of two hours in a normal workday, and

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could sit for a total of eight hours during a normal workday. Drummond also opined

that Crawford could never climb, balance, stoop, kneel, crouch, bend, or reach, but

he could occasionally handle, finger, feel, see, hear, and speak. Crawford claims that

the ALJ wrongly rejected Drummond's opinion. We disagree. 

First, to establish a disability orimpairment,the Social SecurityAdministration

requires "evidence from acceptable medical sources." 20 C.F.R. § 416.913(a). Such

acceptable medical sources include licensed physicians, licensed or certified

psychologists, licensed optometrists, licensed podiatrists, and qualified speechlanguage pathologists. Id. "In addition to evidence from the acceptable medical

sources listed in paragraph (a) of this section, [the Commissioner] may also use

evidence from other sources . . . ." Id. § 416.913(d) (emphasis added). Other sources

include nurse practitioners, physicians' assistants, chiropractors, educational

personnel, and social welfare agency personnel, among others. Id. Thus, Drummond,

as a nurse practitioner, was not an acceptable medical source. Id. § 416.913(a). As

such, the ALJ had the option, within his discretion, to consider Drummond's opinion

so long asit was not wholly inconsistent with other opinionsfromCrawford'streating

physicians. This nuance, discussed below, highlights the major problem with

Drummond's opinion and is the primary reason the ALJ correctly gave less weight to

his medical opinion. 

Second, the ALJ did not err by failing to rely on Drummond's medical opinion

because of the great weight of evidence to the contrary. "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.'" Goff v. Barnhart, 421 F.3d 785, 790 (8th Cir. 2005) (quoting Prosch v.

Apfel, 201 F.3d 1010, 1013 (8th Cir. 2000)). If an ALJ may discount a treating

physician's opinion for inconsistencies, an ALJ may certainly discredit a nurse

practitioner's inconsistent opinion. Drummond's opinion stated that Crawford was

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unable to lift or carry ten pounds but could walk or stand for up to two hours per day

and sit for up to eight hours a day. This assessment directly conflicts with statements

made by Crawford on the record. Crawford stated on numerous occasions, including

on his Social Security Administration Function Report, that he could carry between

ten and fifteen pounds. Medical evidence on the record also discredits Drummond's

allegation that Crawford could never reach, climb, balance, or stoop. Crawford

attested to his ability to reach in his function report and by admitting he can perform

normal activities associated with daily living. Specifically, the evidence shows that

Crawford can dress himself and is mobile enough to do some chores around the house

such as cook simple meals, sweep, and mop. Moreover, most of the medical records

from licensed physicians unambiguously state that Crawford has a normal gait and

can balance enough to stand and walk without assistance. For example, in 2007, Dr.

Gholson, one of Crawford'streating physicians, explicitly stated that the claimant did

not have a disability that prevented him from engaging in gainful activity.

Finally, the ALJ considered the parts of Drummond's opinion that were

consistent with other medical opinions. The ALJ found that Crawford had a

maximum RFC to stand or walk for no more than two hours and sit for six hours. 

These findings come directly from Drummond's January 2010 evaluation. 

Drummond's analysis on the other issues, however, was appropriately left out as

discussed above. Therefore, the ALJ correctly considered all evidence on the record,

including Drummond's opinion, and correctly gave each medical opinion the

appropriate weight. The ALJ properly considered Crawford'simpairmentssupported

in the record. Thus, the ALJ did not err in rejecting the inconsistent parts of

Drummond's medical opinion.

B. Medical-Vocational Guidelines

In regards to the five-step sequential evaluation process used by the Social

Security Administration to determine disabilities of adults, both Crawford and the

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Commissioner agree with the ALJ thatCrawford is not involved in substantial gainful

activity; has a severe medically determinable physical impairment; has no disabling

impairment; has an RFC limited to sedentary work; and cannot participate in his past

relevant work. See 20 C.F.R. § 416.920 (a)-(f). Thus, the only issue here is whether

Crawford can perform another type of work; and more specifically, whether it was

appropriate for the ALJ to rely on the Medical-Vocational Guidelines in making this

determination. Crawford argues that the ALJ erred in applying the MedicalVocational Guidelines because he suffersfromsignificant nonexertional impairments

that diminish his RFC to perform the full range of activities listed in the Guidelines. 

According to Crawford, the ALJ should have considered a vocational expert's

testimony. We disagree.

In step five of the sequential evaluation process the burden shifts to the

Commissioner to show that the claimant can perform other types of work and that the

particular type of work is available in the national economy. Robinson v. Sullivan,

956 F.2d 836, 841 (8th Cir. 1992). The Commissioner considers the claimant's RFC

along with the claimant's "age, education, and work experience to see if [the claimant]

can make an adjustment to other work." 20 C.F.R. § 416.920(a)(4)(v). If the

claimant is able to make an adjustment, he or she is not disabled under the Social

Security Act. Id. The Social Security Administration uses the Medical-Vocational

Guidelines to make this determination "where an individual with a severe medically

determinable physical or mental impairment(s) is not engaging in substantial gainful

activity and the individual's impairment(s) prevents the performance of his or her

vocationally relevant past work." 20 C.F.R. Part 404, Subpart P, App. 2. 

Whether the Guidelines may be used in deciding this final step depends on

whether the claimant's limitations are exertional or nonexertional. An exertional

limitation "affect[s] [one's] ability to meet the strength demands of [a] job[]" such as

"sitting, standing, walking, lifting, carrying, pushing, and pulling." 20 C.F.R.

§ 404.1569a(a). Nonexertional limitations include anxiety, depression, difficulty

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concentrating, memory deficiencies, sight and hearing impairments, difficulty

tolerating dust or fumes, and "manipulative or postural functions of some work such

as reaching, handling, stooping, climbing, crawling, or crouching." See id. §

404.1569a(c)(1). If the limitations are exertional, the ALJ may rely solely on the

Guidelines. Robinson, 956 F.2d at 841. If the limitations are nonexertional,

however, the Guidelines can be used only if the record as a whole shows that "'the

nonexertional impairment does not diminish the claimant's [RFC] to perform the full

range of activities listed in the Guidelines.'" Lucy v. Chater, 113 F. 3d 905, 908 (8th

Cir. 1997) (quoting Thompson v. Bowen, 850 F.2d 346, 349-50 (8th Cir. 1988)). 

Crawford's obesity and COPD are nonexertional limitations. Thus, because

Crawford's limitations are, in part, nonexertional and the ALJ relied on the

Guidelines without seeking a vocational expert, the primary issue is whether there is

substantial evidence on the record to show that Crawford's nonexertional limitations

restrict performance such that he is unable to performthe full range ofsedentary work

as described in his RFC. If these limitations restrict Crawford's performance of

sedentary work, the Guidelines should not have been used. The objective evidence

on the record shows that Crawford's nonexertional limitations (obesity and COPD)

do not restrict his ability to performsedentary work, and thus, the ALJ correctly relied

upon the Guidelines in order to find Crawford not disabled.

First, Crawford'sstatementsregarding his disabilityand functional capacity are

not supported by medical reports and, in fact, contradict some of the medical reports. 

An ALJ has a "statutory duty" to "assessthe credibility of the claimant," and thus, "an

ALJ may disbelieve a claimant's subjective reports of pain because of inherent

inconsistencies or other circumstances." Eichelberger v. Barnhart, 390 F.3d 584,

589-90 (8th Cir. 2004). Crawford claims that the ALJ erred in relying on the

Guidelines because his obesity and COPD do, in fact, limit his ability to performeven

sedentary work. He claims he has problems with his legs, trouble breathing, heart

issues, and other problems associated with obesity. He claims he can stand for only

twenty to thirty minutes before needing to rest; cannot sit without worsening his

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problems; and cannot bend, stoop, or crouch. Contrary to Crawford's testimony,

however, the medical records show that Crawford is able to sit for six hours a day,

stand or walk for two hours per day, and lift ten pounds. Moreover, a majority of the

medical reports noted that Crawford has a normal range of motion, a normal gait, and

clear lungs. The record also discloses that Crawford could walk without assistance

and did not have debilitating swelling in his legs. Based on these discrepancies, the

ALJ correctly found that Crawford's allegations about the severity of his disability

and the resulting impact were not credible. 

Second, when determining whether a person is disabled, the Commissioner

"consider[s] all . . . symptoms, including pain, and the extent to which [the] symptoms

can reasonably be accepted as consistent with the objective medical evidence, and

other evidence." 20 C.F.R. § 416.929(a) (emphasis added). As shown above, the

symptoms Crawford attested to are inconsistent with the objective medical evidence

found on the record, and hence, need not be given great weight when considered

against objective medical evidence. Eichelberger, 390 F.3d at 589. Crawford's

credibility is further reduced by his previous failure to comply with medical

treatment; continued tobacco and alcohol use; occasional cocaine use; and minimal

work history. Thus, the ALJ correctly discredited Crawford's testimony and relied

on the medical evidence on the record, which shows that Crawford's nonexertional

limitations (obesity and COPD) do not restrict his ability to perform sedentary work.

Although "[a]n RFC for less than a full range of sedentary work reflects very serious

limitations," the Social Security Administration has never stated that morbid obesity

automatically prevents a person fromworking, especially when the work issedentary.

SSR 96-9p, 1996 WL 374185 (July 2, 1996). And here, the evidence clearly shows

that Crawford can sit for six hours a day, walk or stand for two hours a day, lift and

carry ten pounds, and breathe in a clean environment despite his nonexertional

limitations. Thus, his obesity and COPD (nonexertional limitations) do not

significantly erode the occupational base at the sedentary level. 

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We conclude that the ALJ did not err by failing to obtain vocational expert

testimony and instead relying solely on the Medical-Vocational Guidelines because

Crawford's "'nonexertional impairment[s] [do] not diminish [his RFC] to performthe

full range of [sedentary] activities.'" Lucy, 113 F. 3d at 908 (quoting Thompson, 850

F.2d at 349-50). Accordingly, substantial evidence on the record supports the ALJ's

decision atstep five that Crawford is not disabled because he can adjust to other work

in the economy.

III. CONCLUSION

The judgment of the district court is affirmed. 

______________________________

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