Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-03-03184/USCOURTS-ca8-03-03184-0/pdf.json

Parties Involved:
Jo Anne B. Barnhart
Appellee
Lance Stormo
Appellant

Document Text:

1

The Honorable Lawrence L. Piersol, Chief Judge, United States District Court

for the District of South Dakota, adopting the Report and Recommendation of the

Honorable John E. Simko, United States Magistrate Judge for the District of South

Dakota.

United States Court of Appeals

FOR THE EIGHTH CIRCUIT

___________

No. 03-3184

___________

Lance Stormo, *

*

Appellant, *

* Appeal from the United States

v. * District Court for the

* District of South Dakota.

Jo Anne B. Barnhart, *

Commissioner of Social Security, *

*

Appellee. *

___________

Submitted: May 10, 2004

Filed: August 2, 2004

___________

Before WOLLMAN, HANSEN, and BYE, Circuit Judges.

___________

WOLLMAN, Circuit Judge.

Lance E. Stormo appeals from the district court’s1

 order affirming the final

decision of the Commissioner of Social Security to deny Stormo’s application for

disability insurance benefits and supplemental security income. He asserts that the

Administrative Law Judge (ALJ) erred in failing to give controlling weight to the

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opinions of Stormo’s treating physicians, improperly substituted his own opinion for

those of medical experts, and failed to correctly describe his impairments in the

hypothetical given to the vocational expert. We affirm.

I.

Stormo was born on August 12, 1961. He completed high school and one year

of college. He worked from 1981 to 1997 as a systems programmer/analyst. Stormo

claims that he is unable to work due to residual effects of an ascending aortic

aneurysm that was surgically repaired. Stormo did not have any substantial gainful

employment after July 3, 1997, though he did work part time for brief periods in two

different jobs. Stormo’s application for social security benefits was denied initially

and upon reconsideration. Upon request, he received a hearing before an

Administrative Law Judge (ALJ), who concluded that Stormo was not disabled.

The ALJ based his conclusion on the extensive record of Stormo’s medical

treatment and evaluations and the testimony of Stormo, his mother, and a vocational

expert. The ALJ recognized some visual field loss, hand tremors, and mild cognitive

impairment, and determined that alcohol abuse was not a material factor. The ALJ

focused primarily on the functional impact of the impairments. In determining the

impact of Stormo’s mental impairments, the ALJ relied on the opinions of two onetime examining physicians: Michael McGrath, Ph.D., and Ola Selnes, Ph.D. The

ALJ observed that their findings were “not particularly supportive of the presence of

any significant neuropsychological functional limitation[s].” A.R. 17. He gave less

weight to the speculative and conclusory opinions of Leonard Gutnik, M.D., and Guy

McKhann, M.D., submitted in letter form following the hearing.

After making a determination regarding Stormo’s residual functional capacity

(RFC), the ALJ posed a hypothetical to the vocational expert, which stated in part:

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Subsequent to the surgery he indicates some mild cognitive

impairments, some memory loss, some peripheral vision loss in the right

eye, and he’s been diagnosed as having somewhat of an adjustment

disorder with depression. He has a long standing fine tremor bilateral

hands. Some light-headedness. And also some transient arm numbness

in the left arm. 

A.R. 220. In response, the vocational expert opined that Stormo could not return to

his past “very technical” work requiring “excellent memory and excellent cognitive

skills.” He indicated, however, that there was a wide range of unskilled work at the

medium, light and sedentary exertional levels that Stormo could perform, including

packaging, janitorial, or cashier occupations. A.R. 221-22.

The ALJ evaluated Stormo’s claim according to the five-step analysis

prescribed by the regulations. 20 C.F.R. §§ 404.1520(a)–(f) (2004); Anderson v.

Barnhart, 344 F.3d 809, 812 (8th Cir. 2003). The ALJ found that Stormo was not

presently engaged in substantial gainful employment and that he had a severe

impairment based on the effect of his aortic root replacement surgery, but that his

impairment did not meet the criteria found in a listed impairment in 20 C.F.R. Part

404, Subpart P, Appendix 1. The ALJ concluded that Stormo was not disabled

because, although he was unable to return to past relevant work, he still retained the

RFC to perform a significant number of jobs in the national and local economies.

II.

We review de novo the decision of the district court upholding the denial of

social security benefits, and we will affirm the decision of the Commissioner if

substantial evidence on the record as a whole supports its findings. Fredrickson v.

Barnhart, 359 F.3d 972, 976 (8th Cir. 2004). “Substantial evidence is less than a

preponderance, but is enough that a reasonable mind would find it adequate to

support the Commissioner’s conclusion.” Prosch v. Apfel, 201 F.3d 1010, 1012 (8th

Cir. 2000). We consider both evidence that detracts from and evidence that supports

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the Commissioner’s decision. Id. If substantial evidence supports the outcome, we

will not reverse the decision even if substantial evidence also supports a different

outcome. Fredrickson, 359 F.3d at 976.

Stormo first asserts that the ALJ failed to recognize as treating physicians

Helen Simpson, M.D., Dr. McKhann, and Dr. Gutnik, and therefore erred in failing

to give controlling weight to their opinions. The opinions of the claimant’s treating

physicians are entitled to controlling weight if they are supported by and not

inconsistent with the substantial medical evidence in the record. Hogan v. Apfel, 239

F.3d 958, 961 (8th Cir. 2001). Merely concluding that a particular physician is a

treating physician, therefore, is not the end of the inquiry. Such opinions are given

less weight if they are inconsistent with the record as a whole or if the conclusions

consist of vague, conclusory statements unsupported by medically acceptable data.

Piepgras v. Chater, 76 F.3d 233, 236 (8th Cir. 1996). For example, treating

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].” Krogmeier v. Barnhart, 294 F.3d 1019, 1023 (8th Cir. 2002)

(citation omitted) (alteration in original).

Stormo also argues that, if the opinions were unclear or seemed to lack a

foundation, the ALJ was duty-bound to further develop the record by asking the

treating physicians for more information. The ALJ’s duty to develop the record,

however, does not extend so far. The burden of persuasion to prove disability and to

demonstrate RFC remains on the claimant, even when the burden of production shifts

to the Commissioner at step five. Harris v. Barnhart, 356 F.3d 926, 931 n.2 (8th Cir.

2004); see also Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987) (noting that the

claimant is in a better position to provide information about his own medical

condition). Because the social security disability hearing is non-adversarial, however,

the ALJ’s duty to develop the record exists independent of the claimant’s burden in

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the case. Snead v. Barnhart, 360 F.3d 834, 838 (8th Cir. 2004). The ALJ must

neutrally develop the facts. Id. He does not, however, have to seek additional

clarifying statements from a treating physician unless a crucial issue is undeveloped.

Id. at 839.

In this case, no crucial issue was undeveloped, and several examining

physicians provided detailed clinical data and observations about Stormo’s

limitations. The ALJ carefully considered the record as a whole, giving substantial

weight to statements based upon medical expertise and supported by the medical

evidence, and appropriately weighed the opinions of Dr. Simpson, Dr. McKhann and

Dr. Gutnik. He did not commit error in giving little weight to Dr. Simpson’s

statement that “[a]t this time, I feel this patient is totally disable [sic] and should be

considered for assistance and disability,” A.R. 484, for it constituted a legal

conclusion and failed to specify any functional limitations or provide medical data in

support thereof. The ALJ also properly placed little weight on the opinion expressed

in Dr. Gutnik’s letter. Dr. Gutnik’s conclusory statement “that Lance’s problems

would make it difficult for him to hold any significant employment,” A.R. 513,

similarly asserts an inappropriate legal conclusion. The remainder of the letter,

partially drafted by Stormo’s brother, see A.R. 510-13, 529, establishes little personal

knowledge of Stormo’s impairments, mentioning functional limitations only in

relation to what “Lance’s family reports.” Some of the medical conclusions in the

letter are also inconsistent with other parts of the record, including statements by Dr.

McGrath. See A.R. 517.

The ALJ also did not err in concluding that Dr. McKhann’s opinions reflected

in his letter were “highly speculative and conditional, referring only to possibilities.”

A.R. 164. They therefore could not be given controlling weight. Dr. McKhann, a

neurologist, examined the results of an MRI examination of Stormo and concluded

that the damage was consistent with stroke damage to the brain. In a letter, he

commented that the aneurysm could cause neurobehavioral and neurological

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consequences, but he did not mention specific observed limitations for Stormo other

than “some areas of mild to moderate problem with cognitive function.” A.R. 515.

In addition, he hypothesized that “It would not be unusual for someone with Lance’s

aneurysm history, record of neurologic damage, and test results to exhibit some

problems with daily living.” Id. These statements are far from a conclusive

description of Stormo’s specific problems with daily living and the ALJ appropriately

looked to other medical evidence to provide such detail.

Second, Stormo argues that the ALJ improperly substituted his own opinion

about the medical evidence in establishing Stormo’s RFC instead of relying on

medical evaluations. We disagree, for there was substantial evidence in the record

to support the ALJ’s conclusion that Stormo was not disabled. The ALJ is

responsible for determining a claimant’s RFC, a determination that must be based on

medical evidence that addresses the claimant’s ability to function in the workplace.

Krogmeier, 294 F.3d at 1023. In determining RFC, the ALJ must consider the effects

of the combination of both physical and mental impairments. Baldwin v. Barnhart,

349 F.3d 549, 556 (8th Cir. 2003). 

It is appropriate for the ALJ to take a “functional approach” when determining

whether impairments amount to a disability. Bowen, 482 U.S. at 146. That a

claimant has medically-documented impairments does not perforce result in a finding

of disability. See Brown v. Chater, 87 F.3d 963, 964 (8th Cir. 1996). The ALJ

should consider “all the evidence in the record” in determining RFC, including “the

medical records, observations of treating physicians and others, and an individual’s

own description of his limitations.” Krogmeier, 294 F.3d at 1024 (citing McKinney

v. Apfel, 228 F.3d 860, 863 (8th Cir. 2000)). If, in light of all the evidence, “the

impairments are not severe enough to limit significantly the claimant’s ability to

perform most jobs, by definition the impairment does not prevent the claimant from

engaging in any substantial gainful activity.” Bowen, 482 U.S. at 146.

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There is substantial evidence to support the ALJ’s RFC determination. State

agency physicians performed physical RFC assessments and consistently concluded

that Stormo had very few physical limitations (he could stand, walk, and sit for up to

six hours per day; he had no tactile, visual, or communication limitations; and he

could both push and pull). Susan Bollinger, M.D., indicated that Stormo’s daily

activities included shooting pool, watching TV, and reading techno-thrillers. Stormo

also stated, in a daily activities questionnaire he completed, that he drives, runs

errands, watches TV, reads and does laundry, but does not pay bills or cook. A.R.

307-13. 

Stormo’s mental limitations are well documented by numerous sources.

Psychiatrist Jerome Cripe, who saw Stormo several times, noted mild impaired

concentration and adjustment disorder with depressed feelings. Dr. McGrath, in an

“Assessment of Cognitive and Emotional Functioning for [vocational rehabilitation]

purposes,” found “no evidence of significant cognitive impairment,” A.R. 520, low

to normal memory functioning, and no signs of significant dysphoria. A.R. 522. He

concluded that Stormo did not appear to have cognitive limitations vocationally.

A.R. 524-25. Dr. Selnes conducted a neuropsychological evaluation of Stormo and

noted that the tests showed that Stormo’s verbal learning and memory were within

“broad normal limits” and stated that the results were “reassuringly normal.” A.R.

491. She indicated, however, that Stormo had episodic memory problems and was

often depressed. Id. Dr. Bollinger noted “mild cognitive impairment,” and

hypothesized that Stormo’s cognitive impairment would be significant for highly

technical work. A.R. 160-61. State agency physicians who completed mental RFC

assessments as well as Psychiatric Review Technique Forms for Stormo documented

that Stormo likely suffered from adjustment disorder with depressed feelings, some

memory impairment and thinking disturbances. They indicated that his mental

disorders resulted in only a slight restriction on activities of daily living, moderate

difficulties with social functioning (getting along with co-workers, supervisors), and

rare deficiencies of concentration or episodes of deterioration. A.R. 419. One state

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physician concluded that Stormo “can do simple and complex work but possibly not

at prior levels.” A.R. 423. In light of the medical evidence supporting the ALJ’s

determination, there is no warrant for finding that the he substituted his own opinion

for those of the medical experts in concluding that Stormo still retains significant

functional ability.

Third, Stormo claims that the ALJ ignored relevant evidence when he found

that Stormo’s mental impairments did not meet the criteria for “Organic Mental

Disorders,” described at 20 C.F.R. Part 404, Subpart P, Appendix 1 § 12.02 (2004).

He argues that the evidence of his drop in IQ based on Dr. McKhann’s analysis is

sufficient to indicate that he has organic mental disorder. A claimant does not meet

the requirements of section 12.02, however, unless the evidence shows both a

significant loss in cognitive ability and evidence of at least two of the following

manifestations: (1) marked restriction of activities of daily living; or (2) marked

difficulties in maintaining social functioning; or (3) marked difficulties in

maintaining concentration, persistence, or pace; or (4) repeated episodes of

decompensation, each of extended duration. 20 C.F.R. Pt. 404, Subpt. P, App. 1 §

12.02(B). A significant drop in IQ may indicate cognitive impairment, but its alleged

severity must be supported by other information in the record about the claimant’s

ability to function. Holland v. Apfel, 153 F.3d 620, 622 (8th Cir. 1998). The criteria

in section 12.02(B) establish the “functional limitations” resulting from the mental

disorder that “are incompatible with the ability to do any gainful activity.” Id. §

12.00(A). A limitation is considered “marked” if it is “more than moderate but less

than extreme.” Id. § 12.00(C).

Substantial evidence in the record supports the conclusion that Stormo does not

have marked limitations in his daily activities, in concentrating, or in social

functioning. In fact, the evidence supports that his limitations in those areas, insofar

as they are present at all, are slight. Stormo argues that results from the

neuropsychology tests performed by Dr. McGrath are not reliable and should not have

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been considered by the ALJ. The ALJ considered numerous sources in addition to

those test results, however, including Stormo’s own testimony. We therefore

conclude that substantial evidence supports the ALJ’s conclusion that Stormo’s

impairments do not meet or equal any listed impairment in appendix 1.

Finally, Stormo contends that because the hypothetical posed to the vocational

expert failed to describe fully Stormo’s impairments, the vocational expert’s

testimony on Stormo’s ability to work could not constitute substantial evidence to

support a finding of no disability. “A hypothetical is sufficient if it sets forth

impairments supported by substantial evidence in the record and accepted as true by

the ALJ.” Davis v. Apfel, 239 F.3d 962, 966 (8th Cir. 2001). We conclude that the

hypothetical question adequately reflected the impairments that were consistent with

the record as a whole and which the ALJ reasonably accepted as true. Accordingly,

the ALJ properly relied on the vocational expert’s testimony in reaching the

conclusion that Stormo was not disabled.

The judgment is affirmed.

______________________________

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