### *The H ONORABLE JOHN B. JONES, United States Distric t

Judge for the District of South Dakota, sitting b y designation.
The Honorab le Dean Whipple, United States District Judge for 1 

### the Western District of Missouri. ___________ No. 95-2416

___________ Frank O. Mapes, * * Appellant, * * Appeal from the United States v. * District Court for the * Western District of Missouri. Shirley S. Chater, Commissioner * of the Social Security * Administration, * * Appellee. *

___________ Submitted: January 11, 1996 Filed: April 29, 1996

___________ Before B EAM and MORRIS SHEPPARD ARNOLD, Circuit Judges, and JONES, * District Judge.

___________ BEAM, Circuit Judge.

Fr ank O. Mapes appeals the district court's order affirming th e 1 Social Security Commissioner's denial of his application for disabilit y insurance benefits. We affirm.

I. BACKGROUND
Mapes applied for disability insurance benefits under Title II of the Socia l Security Act, 42 U.S.C. § 401 et. seq., on October 23, 1991. H e alleged a disability onset date of January 1, 1986. The Social Securit y Commissioner (Commissioner) determined that

### In order to be eligible for disability insurance benefits, a 2 

### claimant must establish the ex istence of a disability on or before the date on which his or her insured status expires. 20 C.F.R

. § 404.131. The Commissioner calculates a claimant's insured status pursuant to a formula set forth at 42 U.S.C. §§ 416(i)(3)(B) an d 423(c)(1)(B) and corresponding regulations. Dilantin is an antiseizure medication use d for the control of 3 

### grand mal and temporal lobe seizures. Physician's Desk Reference 1832 (49th ed. 1995).
-2- Mape s met disability insured status requirements through September 30 , 1990. After Mapes's application was denied initially and o n

2

recons ideration, he requested and was granted a hearing before a n administrative law judge (ALJ). The ALJ found t hat Mapes was not disabled on or before September 30, 1990, and therefore d enied Mapes's application. The Appeals Council denied review, and Mapes fil ed this action in district court. E ach party then moved for summary judgment. The district cour t conclud ed that substantial evidence supported the ALJ's decision, an d therefore granted the Commissioner's motion. Mapes now appeals.

At t he time of the ALJ's decision, Mapes was 42 years old. He ha s a high school educati on and has worked as a coal miner, machinist, window assembler, and kitchen steward. His most recent work consists of odd jobs , including lawn and garden work.

Mapes complains of lower back and leg pain and of rheumatoi d arthritis in his hands and joints. He also suffers from a seizure disorde r
as a result of a fall he suffered in 1983, but his seizures are no w inf requent and controlled by medication. In addition to these physica l impair ments, Mapes alleges anxiety, depression, and memory loss. H e acknowledg es a long history of alcohol abuse, but he testified at th e hearing that he had given up hard liquor and only occasionally drinks beer , in part because of th e alcohol's effects when mixed with his prescription medi cation. Mapes takes dilantin for his seizure disorder, ansaid fo r 3 back

### Ansaid tablets contain a nonsteroidal ant i-inflammatory agent 4 

### and are prescribed for rheumatoid arthritis and osteoarthritis

. Physician's Desk Reference , supra note 3, at 2520-21.

Librium is a drug prescribed for management of anxiet y 5 

### disorders or for the short-term relief of symptoms of anxiety

. Physician's Desk Reference , supra note 3, at 2073. Trazodone is a drug prescribed for treatment of depressio n 6 

### with o r without prominent anxiety. Physician's Desk Reference , supra note 3, at 520.

In this sequential analysis, the ALJ must first determin e 7 

### whether the applicant is engag ed in "substantial gainful activity" as def ined by the regulations. 20 C.F.R. § 404.1520(b). If th e answer is yes, the applicant i s not disabled and the analysis need go no further; if the answer i s no, the ALJ must determine whether the claimant has a severe impa irment that significantly limits his or her abili ty to work. 20 C.F.R. § 404.1520(c). If a sever e impairment is present, the ALJ then considers whether th e claimant's impairment meets or equals one of the impairments listed in Appendix 1 to Part 404 of the Social Security regulations. 20 C.F.R. § 404.1520(d). If so, the claimant is presumptivel y disabled. Id. If the claiman t's impairments do not meet or equal the listings, the ALJ must determine whether, despite thos e impairments, the claimant can return to past relevant work or, if not, whether the claimant can perform other jobs in the nationa l economy. 20 C.F.R. §§ 404.1520(e) & 404.1520(f).
-3- pain and arthritis, librium for anxiety, and trazodone for depression. 4 5 6

In evalua ting Mapes's claim, the ALJ applied the familiar five-step

ana lysis prescribed in the Social Security regulations. 20 C.F.R

. § 404.1520(a)-(f). The ALJ determ ined that although Mapes's impairments 7 were severe, none of them met or equalled a list ed impairment. Relying in part on the testimony of a vocational expert, the ALJ then found that , although Mapes was not able to return to his past relevant work, h e possessed the residual functional capacity to engage in a full range o f light, unskilled work existing in significant numbers in the nationa l economy.

The overriding issue in this case is whether the ALJ properl y considered Mapes's mental impairments in deciding that Mapes was

### The Psychia tric Review Technique Form is a standard document 8 

### which generally must be comple ted when a claimant alleges a mental impairme nt. See Pratt v. Sullivan , 956 F.2d 830 (8th Cir. 1992 ) (per curiam). The PRTF mirrors the listings for mental impa irments set forth in the Social Security regulations. See 20 C.F.R. pt

. 404, subpt. P, app. 1, pt. A § 12.00. These listings usuall y consist of two parts: (1) a set of clinical findings (paragraph A criteria), which establish whe ther a medically-determinable mental impa irment exists; and (2) a set of functional restriction s (par agraph B criteria), which detail the impairment's effect o n four areas of function deemed essential to work. See generall y Pratt , 956 F.2d at 834-35 & nn.7-9.
-4- not disabled. Mapes contends that the ALJ erred in failing to set forth Ma pes's mental impairments and related functional limitations in th e hypothetical question he posed to the vocational expert at Mapes's hearing

. He further argues tha t the ALJ did not properly consider Mapes's physical and mental impairment s in combination so as to determine their cumulative effects on Mapes's residual functional capacity to work.

II. DISCUSSION

Our task on review is limited to a determination of whether th e Commissioner's decision is supported by substant ial evidence in the record
as a whole. See , e.g. , Delrosa v. Sullivan , 922 F.2d 480, 484 (8th Cir. 1991). In making this determination, we consider not only evidenc e supporting the Commis sioner's decision but evidence which fairly detracts from its weight. Id. It is not our task, howev er, to review the evidence and make an independent decision. If, after review, we find it possible to draw tw o inconsistent positions from the evidence and one of thos e positions represents the Commissioner's findings, we must affirm the denia l of benefits. Siemers v. Shalala , 47 F.3d 299, 301 (8th Cir. 1995).

A. The Hypothetical Question

Ma pes first alleges that the ALJ improperly formulated th e hypothetical question to the vocational expert. Specifically, Mapes notes that in completing the Psychiatric Review Technique Form (PRTF) the AL J 8 found that Mapes exhibited medically

### -5-

determinable signs of depression (Listing 12.04) , anxiety (Listing 12.06), and substance addiction (Listing 12.09). The AL J then rated the degree of functional loss resulting from these impairments and determined that Mapes : (1) has moderate difficulties in maintaining soc ial functioning, (2) often has deficiencies of concentration, persistence or pace resulting in failur e to complete tasks in a timely manner, and (3) has once or twice ha d episodes of deteriora tion or decompensation in work or work-like settings causing him to withdr aw from that situation or to experience exacerbation of signs and symptoms. The ALJ did not, however, mention these menta l impair ments or functional losses in his hypothetical question to th e vocatio nal expert. Mapes argues that these omissions were error, an d the refore the expert's answer to the hypothetical question canno t constitute substantial evidence supporting the ALJ's decision.

In or der to properly address Mapes's concerns, it is necessary t o examine t he PRTF in context with the full extent of the ALJ's findings

. In so doing, we discern that critical qualifications were placed on th e findings detailed in the PRTF. Although Mapes c orrectly observes that the PRTF re cords Mapes's depression, anxiety, and substance addiction, h e overlooks the ALJ's written decision in which th e ALJ concludes that these menta l conditions are largely the outward manifestations of Mapes' s substance abuse rathe r than impairments existing independently of Mapes's use of

### The PRTF section corresponding to Listing 12.09 is a 9 

### ref erence listing which directs the ALJ to analyze the secondar y physical or mental effects of substance abuse. Thus, the ALJ' s com pletion of that section indicates that the ALJ considered th e anxiety and depression consequences of alcohol use. In addition, the ALJ stated in his decision that Mapes's anxiety and depression are "coupled with claimant's alcohol abuse," and that Mapes' s alcohol abuse "results in a di agnosis of an affective disorder and of an anxiety disorder." Tr. at 19, 24.
We recognize that recent amendments to the Social Securit y 10 

### Act signed into law on March 29, 1996, eliminate alcoholism or drug addiction as a basis for obtaining disability insurance benefits. Contract with America Advancement Act of 1996, Pub. L. No. 1 04-121, 110 Stat . 847 (amending 42 U.S.C. § 423(d)(2)). Because we fin d that the ALJ correctly denied benefits under the standards i n place at the time of Mapes's hearing, we need not address the effect of the new amendments on Mapes's application.
-6- alcohol. Similarly, the ALJ specifically found that Mapes's functiona l

9 losses were present only when Mapes was drinking.
The ALJ's determination that Mapes's mental impairments and res ulting func tional limitations were the products of his alcohol abuse is no t without significance, for although we have held that an ALJ's hypothetical question must include all of the claimant's impairments found credible by the ALJ, Chamberlain v. Shalala , 47 F.3d 1489, 1495 (8th Cir. 1995), w e have also held that the mere presence of alcoholism is not necessaril y disabling. See , e.g. , Cruse v. Bowen , 867 F.2d 1183, 1186 (8th Cir

. 10 1989). In fact, the burden for establishing disability due to alcoholism is a high one, requiring the claimant to show: "(1) that he has lost self

contro l to the point of being `impotent to seek and use means o f rehabilitation,' and (2) that his disability is encompassed by the Act." Metcalf v . Heckler , 800 F.2d 793, 796 (8th Cir. 1986) (quoting Adams v

. Weinberger , 548 F.2d 239, 245 (8th Cir. 1977)). In each case, th e claimant's capacity to control his use of alcohol must be considered in th e context of his ability to engage in substantial gainful activity. Lubinsk i

v. Sul livan , 952 F.2d 214, 216 (8th Cir. 1991). Guided by thes e principles, we find that we

### A finding that Mapes's alcohol intake was within hi s 11 

### voluntary control is clearly implicit in the decision. Moreover, in a case involving substance abuse, the claimant bears the burden of estab lishing lack of control. Here, we find no evidence tha t Mapes lacked the ability to curb his use of the substance. With one exception not relev ant to these issues, the records 12 

### from the Center are the only records which cover periods prior to the date Mapes's insured status expired.
-7- may properly uphold the ALJ's omission of the mental impairments an d functi onal limitations in his question to the vocational expert i f substantial evidence supports the ALJ's finding that Mapes's alcoholism wa s contro llable and, when controlled, Mapes's mental impairments an d functional limitations were not present.
After carefully reviewing the testim ony and the medical evidence, we find substantial evidence supporting these findings. The record show s 11 that Mapes received inpatient and outpatient treatment for alcoho l dep endence at the Bill Willis Community Health Center (the Center) fro m June 1990 to June 1991. Treatment notes from the Center indicate tha t 12 Mapes w as aware of the need to confront his alcohol problem and to tak e steps to resolve it. To that end, Mapes partici pated in group therapy and attended regular meetings with his physicians at the Center. Although the records indicate that Mapes's progress was difficult, Mapes nevertheless remained sober for long periods of time.

This evidence showing Mapes's ability to control his alcoholism i s strengthened when viewed in light of his capacit y to engage in substantial gainful activity. Although Mapes worked only intermittently during the relevant time period, there is no indication in the record that alcoho l abuse wa s the cause of his work interruptions. Indeed, Mapes ha s
cons istently maintained that he became unable to work because of hi s various physical impa irments. Therefore, while we do not deny that Mapes had a drinking problem during the period at issue, we conclude that

### -8-

Mapes's alcohol probl em was controllable and did not preclude substantial gainful a ctivity. See Starr v. Sullivan , 981 F.2d 1006, 1008 (8th Cir

. 1992).

We also find substantial evidence su pporting the ALJ's determination that Mapes's anxiety and depression were general ly present only when Mapes was drinking. Severa l of the treatment notes from the Center reveal that although Mapes compla ined of anxiety and nervousness, he sought treatment out of th e need to control his drinking. Moreover, Mapes's anxiet y appeared to lessen when he did not drink--a fact confirmed by Mapes at the hearin g. His depression followed this same course, with physician s indicating that it wa s controllable when Mapes stayed sober. There is no indication that Mapes ever sought psychiatric treatment or counseling for these problems. Alt hough Mapes was eventually treated with prescription medic ations for both anxiety and depression, these medications wer e prescribed well after the time period at issue in this case and therefore do not significantly detract from the evidence supporting the ALJ' s conclu sions. At best, this evidence demonstrates that Mapes's menta l impairments may have worsened over time but neve rtheless can be controlled by medication and the refore cannot be considered disabling. See Stout v. Shalala , 988 F.2d 853, 855 (8th Cir. 1993).

Fu rther evidence supports the ALJ's finding that the correspondin g functional limitations listed on the PRTF were p resent only when Mapes was drinkin g. As the ALJ noted, intelligence tests indicate that Mapes' s intell ectual functioning is in the average range. A consultativ e psychological evaluat ion performed by Dr. Richard R. Christy corroborates the test results. According to Dr. Christy, Mapes possesses a good abilit y to understand, remember, and carry out complex job instructions. He i s abl e to relate appropriately to coworkers and to maintain attention an d concentration. The strongest evidence to the co ntrary is contained in two reports appropriately discounted by

### -9-

the ALJ as conclusory and dated significantly pa st Mapes's insured period. Accordingly, there is substantial evidence suppo rting the ALJ's conclusion that M apes's functional limitations were simply side effects of hi s drinking problem, at least during the period bef ore Mapes's insured status expired.

In summary, substantial evidence supports the ALJ's determinatio n that Mapes's mental impairments and functional limitations were alcoholrelated, and that Mapes's alcohol problem was within his control. Under these circumstances, the ALJ did not err in omitting the findings on the PRTF when he formulated the hypothetical question to the vocational expert

.

B. Residual Functional Capacity

Mapes also argues that the ALJ failed to properly consider hi s physical and mental impairments in combination in assessing his residual funct ional capacity to work. As Mapes correctly points out, our case s require an ALJ to consider a claimant's impairments "in combination and no t fragmentize them in e valuating their effects." Delrosa , 922 F.2d at 484. In addition, when mental impairments are alleged, an ALJ must determin e whether those nonexertional impairments further limit the exertional tasks the claimant is deemed capable of handling. Tucker v. Heckler , 776 F.2d 793 (8th Cir. 1985). Mapes contends that the ALJ ignored Mapes's mental impairments in determining Mapes's residual functional capacity.

This cont ention lacks merit. The ALJ's opinion contains a thorough discussion of Mapes's physical impairments, mental impairments, an d complaints of pain. The ALJ determined that Mapes's mental impairments di d not restrict his residual functional capacity below the level of ligh t exertional activity because they did not affect Mapes's abilities when his alcohol intake was

### -10-

controlled. As explained above, substantial evidence in the record as a whole supports this finding.

III. CONCLUSION
We find substantial evidence support ing the ALJ's determination that Mapes is not disabled. Accordingly, the judgmen t of the district court is affirmed.

A true copy.

Attest:

CLERK, U. S. COURT OF APPEALS, EIGHTH CIRCUIT.