The Honorable Howard F. Sachs, United States District Judge for the Western 1 District of Missouri. 

## United States Court of Appeals FOR THE EIGHTH CIRCUIT

___________ No. 98-2291

___________ Allen Sampson, * * Appellant, * * Appeal from the United States v. * District Court for the * Western District of Missouri. Kenneth S. Apfel, Commissioner of * Social Security Administration, * * Appellee. *

___________ Submitted: November 20, 1998 Filed: January 12, 1999

___________ Before McMILLIAN, WOLLMAN, and HANSEN, Circuit Judges.

___________ WOLLMAN, Circuit Judge. Allen Sampson appeals the district court’s judgment affirming the denial of his 1 applic ation for social security disability benefits under Title II of the Social Securit y Act, 42 U.S.C. § 401 et seq. We affirm.-2- I. Sampson is forty-five years old and has a high-school education. His pas t relevan t work includes experience as an assembler for the Ford Motor Company

. Sampson has been u nable to work since a head-on automobile accident on November 24, 1993. On March 23, 1994, he filed an appl ication for disability insurance benefits, alleging a disability onset

date of November 24, 1993. He claimed to be disabled and unable to w ork because of a separated disc, neck and back pain, and numbness in his right hand, all as a result of the accident.

T he Social Security Administration denied Sampson’s application initially and ag ain on reconsideration. Following a hearing, an administrative law judge (ALJ ) found that Sampson had not engaged in substantial gain ful activity since November 24, 1993. T he ALJ also found that he presented orthopedic problems involving the lo w back, pain in the neck and shoulder, a nd numbness in the right hand. Nonetheless, the ALJ concl uded that Sampson did not have impairments, when considered singularl y or in combination, which met or equaled the criteria found in the Listings o f Impairments. SeeAppendix 1, Subpart P, Regulations No. 4. The ALJ further found that althoug h Sampson was unable to perform work as an assembler, he had th e residual fu nctional capacity to perform a significant number of jobs in the local an d national economi es and therefore was not disabled. See Bowen v. Yuckert , 482 U.S. 137, 140-4 2 (1987) (describing the five-step analysis). The ALJ also discredite d Sampson’s subjective complai nts of pain after applying the factors set forth in Polaski v. Heckler , 739 F.2d 1320, 1322 (8th Cir. 1984) (subsequent history omitted). The Appeals Council denied Sampson’s request for further review, a nd the ALJ’s decision thereby became the final decision of the Commissioner. Sampso n subsequently appealed to the district court p ursuant to 42 U.S.C. § 405(g). The district
cou rt granted the Commissioner’s motion for summary judgment, finding tha t substantial evidence supported the Commissioner’s decision t o deny Sampson disability-3-

bene fits. On appeal, Sampson contends that the ALJ improperly concluded that th e medical evidence contradicts the opinion of his treating physician and incorrectl y discounted his subjective complaints of pain as not credible.

II.
Our role on review is to determine whether the Commissioner’s findings ar e supported by s ubstantial evidence in the record as a whole. See Clark v. Apfel , 14 1 F.3d 1253, 1255 (8th Cir. 1998). Substantial evidence is relevant evidence which a reasonable mind wou ld accept as adequate to support the Commissioner’s conclusion. S e e Woolf v. Shalala , 3 F.3d 1210, 1213 (8th Cir. 1993). In determining whether the exi sting evidence is substantial, “we must consider evidence that detracts from th e [Commissioner ’s] decision as well as evidence that supports it.” Id. We may no t reverse the Commission er’s decision merely because substantial evidence exists in the record that would have

supported a contrary outcome. See Smith v. Shalala , 987 F.2d 1371, 1374 (8th Cir. 1993).

We first address Sampson’s argument that the ALJ improperly discredited th e op inionof his treating physician, Dr. Bowles. On October 1, 1994, Dr. Bowle s indicated that Sampson’s constant low back pain and persistent neck pain wer e incapacitating for any type of work for which Sampson was trained. Dr. Bowles also stated that Sampson was totally unable to perform any type of work that involve d bending, lifting, or squatting. The ALJ is not required, however, to adopt the opinion of a p hysician on the ultimate issue of a claimant’s ability to engage in gainfu l employment

. See Behen v. Califano , 588 F.2d 252, 254 (8th Cir. 1978). Further, a treating physician’s opinion is afforded less deference w hen the medical evidence in the record as a whole contra dicts the opinion itself. See Johnson v. Chater , 87 F.3d 1015, 1018 (8th Cir. 1996); Cruze v. Chater , 85 F.3d 1320, 1324-25 (8th Cir. 1996).-4-

The ALJ ’s decision discussed the medical evaluations and treatment note s provided by Dr. Bowles, along with the treatment notes of Dr. Jenny and Dr. Ebelke, who also t reated Sampson. Dr. Bowles’s treatment notes state that Sampson ha d “unexplained low back p ain syndrome” and “unexplained refractoriness to all kinds of therapy.” Dr. Bowles stated, however, that “when I asked him to take off his shoes and put them back on he exhibited much better bending and flexibility of the back (whe n I was not watching) than he did under a test circumstance.” X-rays take n of Sampson’s back in 1993 and 1994 revealed a minimal centra l bulge at the C3-4 and a minimal central bulge with a small central focal disc herniation at L4-5. Dr. Ebelke repor

ted that, after surgery in 1995, Sampson’s medical condition improved with the positioning of an “instrumentation with maintenance and goo d devel opment

of the bone graft.” The treatment notes also indicate normal strength , tone, and coordination levels. Sampson’s n eurological examination revealed full motor strength in his lower extremities. Dr. Ebelke also noted that Sampson performed a complete hip rotation without pain. Moreover, Sampson was cleared to return to work in October

1994. Thus, substantial evidence supports the ALJ’s decision not to abide by the opinion of Sampson’s treating physician.

W e next consider Sampson’s argument that the ALJ improperly discredited his subje ctive complaints of pain. “As is true in many disability cases, there is no doub t that the clai mant is experiencing pain; the real issue is how severe that pain is. ” Spradling v. Chater , 126 F.3d 1072, 1074 (8th Cir. 1997) (quoting Woolf , 3 F.3d a t 1213). An ALJ must consider the following factors when analyzing a claimant’ s subjec tive complaints of pain: (1) the claimant’s daily activities; (2) the duration , frequen cy and intensity of the pain; (3) dosage, effectiveness, and side effects o f medica tion; (4) precipitating and aggravating factors; and (5) functional restrictions

. Polaski , 739 F.2d at 1322. Other relevant factors include the claimant’s relevant work hist ory and the absence of objective medical evidence to support the complaints. Id

.-5-

The ALJ may di scount subjective complaints of pain if inconsistencies are apparent in the evidence as a whole. See Sullins v. Shalala , 25 F.3d 601, 603 (8th Cir. 1994). App lying the foregoing factors, the ALJ concluded that Sampson’s complaint s of disa bling pain lacked credibility. As discussed above, there is no substantia l evidenc e in the record of a disabling condition. Sampson stated that he can sit for ten minutes and stand for twenty minutes a t a time. He is able to walk up to three-quarters of a mile without the use of a supporting device. Sampson reported that at one time he
was walking four to five miles each day. Sampson also acknowledged that he drives an automobile, makes his bed, loads the dishwasher, and watches television on a daily basis. The ALJ also note d Sampson’s unwillingness to continue with physical therapy despite h is ability to complete the therapy without many complaints. The treatmen t notes indic ate that he was just “going through the motions.” See 20 C.F.R

. 404.1530(b); see also Kisling v. Ch ater , 105 F.3d 1255, 1257 (8th Cir. 1997) (“Failure to follow a prescribed course o f remedial treatment without good reason is grounds for denying an application for benefits”). Thus, the evidence as a who le supports the ALJ’s conclusion that Sampso n’s testimony was credible to the extent that he has some pain, but not to the extent that he cannot perform any type of work. See Woolf , 3 F.3d a t 1214. The district court’s judgment is affirmed. A true copy.

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