1 The Honorable Charles R. Wolle, United St ates District Judge for the Southern District of Iowa. 

## United States Court of Appeals FOR THE EIGHTH CIRCUIT

___________ No. 05-3832

___________ Robert Karlix, *
* Appellant, * * Appeal from the United States v. * District Court for the * Southern District of Iowa. Jo Anne B. Barnhart, Commissioner * of Social Security, *
* Appellee. *

___________ Submitted: May 17, 2006 Filed: August 3, 2006

___________ Before WOLLMAN, BRIGHT, and BOWMAN, Circuit Judges.

___________ WOLLMAN, Circuit Judge. Robert Karlix appeals fro m the district court's 1 order affirming the final decision of the Commissioner of Social Secur ity (Commissioner), which denied his applications for benefits. We affirm.-2- I.

On March 28, 2002, Karlix was admitted to the Trinity Medical Center (Trinity) for substance abuse treatment. On April 29, 2002, he returned to Trinity, complaining of bilateral calf tightness and a “pins and needles” sensati on in both of his feet after walking three blocks. Afzal H. Abdullah, M.D., examined Karlix and concluded that he suffered from severe arterial insuffici ency bilaterally. Dr. Abdullah measured Karlix’s ankle-brachial index (ABI), wh ich is a basis on which to diagnose or determine the severity of peri pheral arterial disease, and observed that he had an ABI of 0.47 on the right and 0.38 on the left.

On May 8, 2002, Mary Jo Bloominger, PAC (physician’s assistant, certified), examined Karlix, who again complained of pain in his legs. Karlix reported that although he had suffered some pain while walking since 1996, the pain had been much worse during the past month. Physician’s Assistant Bloominger concluded that Karlix suffered from peripheral arterial disease a nd referred him to the University of Iowa vascular surgery department for evaluation and possible surgery.

Between April 29, 2002, and February 20, 2003, Karlix saw doctors or physician’s assistants at Trinity, Community Health Care, and the University of Iowa numerous times, complaining of claudication. His ABI was consistently below 0.50 on both the right and the left. Despite repeated recommendati ons by Lisa Nelson, PAC, Karlix failed to follow his low-chol esterol and low-fat di et, delayed seeing a dietitian, failed to take his medication, and continued to smoke about three-fourths of a package of cigarettes per day.

Finally, on February 21, 2003, Karlix underwent aortobifemoral bypass surgery. Subsequent vascular studies showed an AB I of 0.54 on the right and 0.76 on the left. Karlix was discharged on Fe bruary 28, 2003, with instructions to lift no more than five to ten pounds for the next four to si x weeks. In Octobe r 2003, Karlix reported-3- that his pain had improved following surgery but that about two and a half months after surgery the pain had returned. Ther e is no evidence in th e record, however, that his ABIs ever fell below 0.50 following his February 2003 surgery. On November 5, 2003, Physician’s Assistant Ne lson determined that Karlix had suffered a hernia, and he underwent surgery for this on March 17, 2004.

Throughout 2003 and 2004, Physician’s A ssistant Nelson, Lawrence Staples, M.D., and Iqbal Hussain, M.D., complete d physical residual functional capacity questionnaires for Karlix. Physician’s Assistant Nelson and Dr. Hussain indicated that Karlix had the ability to work, a nd each of them imposedonly modest lifting, walking, crouching, and climbing restrictions.

On October 4, 2002, Karlix applied for disability insurance benefits under Title II of the Social Security Act (Act), 42 U.S.C. § 401 et seq. , and supplemental security income benefits under Title XVI of the Act, 42 U.S.C. § 1381 et seq. , alleging inability to work because of a disabling cond ition. He alleged an onset date of August 1, 2001. The Commissioner denied Kar lix’s applications for benefits.

On August 6, 2003, Karlix appealed the Commissioner’s denial of benefits and requested an administrative hearing. At th e hearing, Karlix testified that he was unable to work because of his condition beginning in August 2001, but he conceded that he had not sought medical treatment for his condition until April 2002. Karlix then amended his alleged onset date to June 30, 2002. Karlix also testified that from August 2003 to June 2004 he had been employed in a work-for-rent program with the Salvation Army, where he had worked for thirty-two hours per week. Karlix stated that he had quit this job because he ha d experienced difficulty doing it and because his doctor had advised him to quit.

The administrative law judge (ALJ) conc luded that Karlix did not qualify for benefits because he did not m eet the Act’s definition of di sabled. The ALJ stated that-4- there was no evidence that Karlix’s impairments met or e qualed any of the impairments listed in Appendix 1 to 20 C.F. R. Part 404. She also determined that considering the medical evidence, Karlix’s subjective complaints of pain, Karlix’s failure to quit smoking, and the fact that Karlix’s testimony about his alcohol consumption was inconsistent with medical documentation, Karlix had the residual functional capacity for a full range of sedentary activity on a sustained basis. Further, the ALJ concluded that the Commissioner had proved that there were jobs in significant numbers that Karlix could perform consistent with his impairments. The district court affirmed the ALJ’s decision.

II.

We review de novo the district court’s affirm ance of the Commissioner’s denial of benefits, considering whether the ALJ’ s determination is supported by substantial evidence on the record as a whole. Tindell v. Barnhart , 444 F.3d 1002, 1004 (8th Cir. 2006). In examining the evidence, we mustconsider both evidence that supports and evidence that detracts from the Commissioner’s decision. See Johnson v. Chater , 87 F.3d 1015, 1017 (8th Cir. 1996).

To establish a claim for benefits, a clai mant must show that he is disabled, meaning that he is unable to “engage in any substantial gainfu l activity by reason of any medically determinable physical or ment al impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423( d)(1)(A). In making this determination, the Commissioner must sequentially consider (1) whether the claimant is engaged in substantial gainful activity, (2) whether he has a medically severe impairment that meets the duration requirement, and (3) whether his impairment meets or equals one of the impairments listed in Appendix 1 to 20 C.F.R. Part 404 and meets the duration requirement. See Bowen v. Yuckert , 482 U.S. 137, 140-42 (1987); Goff v. Barnhart , 421 F.3d 785, 789-90 (8th Cir. 2005); 20 C.F.R. § 404.1520. If the claimant satisfies-5- each of these three elements, the claimant is conclusively presumed to be disabled. Bowen , 482 U.S. at 141. If the impairment is notone that meets or equals one of the listings, the Commissioner must determine whether the impairment prevents the claimant from performing work that he has pe rformed in the past or whether he is able to perform other work in th e national economy in view of his age, education, and work experience. Id. at 141-42.

A.

Karlix first argues that the ALJ erred by failing to consider evidence of a listing-level impairment. Karlix alleges that he satisfied the requirements for the § 4.12.B.1 listing for peripheral arterial diseas e from at least April 29, 2002, to February 21, 2003. For a claimant to meet the § 4. 12.B.1 listing, he must show that he suffers from “[i]ntermittent claudication with marked impairment of peripheral arterial circulation as determined by Doppler studies showing” a resting ABI of less than 0.50. 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 4.12.B.1.

Contrary to Karlix’s a ssertion, the ALJ did consider evidence of a listed impairment and concluded that there was “no showing on this record that the claimant’s impairments, whether consideredsingly or in combination, meet or are equivalent to any of the liste d impairments.” Administrativ e R. at 15. The fact that the ALJ did not elaborate on this conclusi on does not require reversal, because the record supports her ove rall conclusion. See Pepper ex rel. Gardner v. Barnhart , 342 F.3d 853, 855 (8th Cir. 2003); see also Moore ex rel. Moore v. Barnhart , 413 F.3d 718, 721 n.3 (8th Cir. 2005) (“The fact th at the ALJ’s decision does not specifically mention the [particular listing] does not affect our review.”).

Even if the ALJ erred in determining that Karlix failed to meet the listing requirement between April 29, 2002, and Fe bruary 21, 2003, the error was harmless because the evidence fails to show that he met the listing for the required twelve-6- months. Karlix alleged an onset date of June 30, 2002, and there is no evidence in the record to support a finding that the actual onsetdate occurred prior to the alleged date. Additionally, Karlix’s condition improved af ter his vascular su rgery on February 21, 2003, and vascular laboratory studies follo wing surgery showed that his ABI had improved to 0.54 on the right and 0.76 on th e left. Accordingly, Karlix failed to demonstrate that he suffered from a listed impairment for a continuous twelve-month period.

B.

Karlix next argues that the ALJ erre d by failing to obtain expert testimony on a medically reasonable date of onset. In de termining the date of onset of a disability, the ALJ should consider the claimant’s allege d date of onset, his work history, and the medical and other evidence if his condition. Grebenick v. Chater , 121 F.3d 1193, 1200 (8th Cir. 1997); Social Security Ruling 83-20 (Social Security Administration 1983). “[T]he date alleged by th e individual should be used if it is consistent with all the evidence available.” So cial Security Ruling 83-20. If the medical evidence regarding onset is ambiguous, however, the ALJ should obtain an expert opinion from a medical advisor to determine a medi cally reasonable date of onset. See Grebenick , 121 F.3d at 1200-01; see also Social Security Ruling 83-20.

At his administrative hearing, Karlix testified that he was unable to work because of his condition beginning in A ugust of 2001. He ac knowledged, however, that he did not seek any medical treatment for his condition prior to April of 2002, and the record is void of any other evidence sugge sting an earlier date of onset. See, e.g. , Davis v. Apfel , 239 F.3d 962, 967 (8th Cir. 2001) ( holding that an ALJ may properly take into account that a claimant failed to make significant efforts to seek medical treatment). When coupled with the amende d onset date and the ALJ’s determination that Karlix was not particularly credib le, the evidence was unambiguous as to the-7- onset date, and thus the ALJ did not err infailing to obtain an expert opinion on the matter.

C.

Next, Karlix argues that the ALJ erred by failing to consider a closed period of disability. Specifically, Karlix contends thatnothing in the record indicates that the ALJ considered the evidence orimplications of claudication with ABIs of less than 0.50, which constitutes clinical evidence th at Karlix met the listing at §4.12.B.1 of Appendix 1 to 20 C.F.R. Part 404 from at least April, 29, 2002, to February 21, 2003. In making this argument, Karlix essentially reiterates the two arguments previously discussed.

For the reasons already stated, we concl ude that the ALJ sufficiently considered evidence of a listed impairment between April 29, 2002, and February 21, 2003. By itself, any impairment during this time faile d to meet the duration requirement for the Act’s definition of disabled. Further, taking into account the ALJ’s discussion of evidence regarding Karlix’s residual functiona l capacity, we conclude that substantial evidence supports her determinations that Karlix could perform a full range of sedentary activity on a sustained basis and th at Karlix failed to demonstrate that he was disabled within the meaning of the Act.

D.

Finally, Karlix argues that the ALJ e rred in discrediting Karlix’s testimony. Although “ALJs must seriously consider a claimant’s testimony about pain, even when it is wholly subjective[,] . . . questions of credibility are for the [ALJ] in the first instance. If an ALJ explicitly discred its a claimant’s testimony and gives a good reason for doing so, we will normally defe r to that judgment.” Dixon v. Sullivan , 905 F.2d 237, 238 (8th Cir. 1990); see also Grebenick , 121 F.3d at 1200 (“[W]e will not-8- disturb the ALJ’s credibility determinations .”). In the present case, the ALJ found Karlix unreliable because his testimony at the administrative hearing regarding his consumption of alcohol conflicted with medi cal documentation. This was a sufficient reason for discrediting Karlix, and we de fer to the ALJ’s judgment on this issue.

The judgment is affirmed.

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