# U ni te d S ta te s Co ur t of A pp ea ls
For the Eig hth Circu it

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No. 1 7- 19 87

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Mi ke L. W in n

ll ll ll ll ll ll ll ll ll ll l Pla in ti

ff - App el la nt

v.

Co m m is si on er, So ci al Secu rit y Adm in is tra ti on

ll ll ll ll ll ll ll ll ll ll l Defe nd

an t - Ap pe ll ee

__ __ __ __ __ __ App eal fro m

Uni te d S ta te s Di st ric t Co ur t fo r th e Weste rn Dis tri ct of M is so ur i - J effe rs on Cit y

__ __ __ __ __ __

Su bm it te d: Feb ru ary 15 , 20 18 Fil ed : J ul y

6, 2 01 8

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Befo re LOKEN, BENTO N, and ERICKSON, Ci rcu it Ju dg es

.

__ __ __ __ __ __ LOKEN, Ci rcu it Ju dg e.

Mi ke L. W in n ap pl ie d fo r So ci al Secu rit y di sa bi li ty in su ran ce be ne fit s be twee n
Ju ne 12

, 20 07

, th e al le ge d di sa bi li ty on se t da te
, an d Decem be r 31

, 20 12

, hi s “ da te la st
in su red .” See 20 C.F.R. §§ 40 4.1 30

, 40 4.1 31

, 4 0 4

. 3 15 (a). Dur in g W in n’s pr io r

a pp eal fro m th e de ni al of be ne fit s aft er an ad m in is tra ti ve he ari ng , we gr an t e d t h e
C o mm i ss io ne r’s m ot io n to rem an d fo r co ns id erat io n of ad di ti on al ev id en ce fro m
W in n’s tre at in g ph y si ci an an d re as se ssm en t of hi s res id ua l fu nc ti on al cap aci ty (RFC ).On rem an d, th e Co m m is si on er’s App eal s Co un ci l co ns ol id at ed a se co nd ap pl ic at io n
W in n fil ed in Decem

be r 20 12 an d rem an de d th e co m bi ne d pr oc eed i n gs to an Adm in is tra tive L aw Judg e (A L J) to co nsi de r ad dit io na l ev id en ce, red et erm in e W in n’s RFC, and so li ci t te st im on y fro m a vo cat io na l ex pe rt (VE). Afte r a he ari ng at whi ch

W in n an d a VE te st ifi ed

, a se co nd ALJ de ni ed W in n’s ap pl ic at io n fo r be ne fit s. W in n

pe ti ti on ed for jud ic ia l re vi ew. Af te r th or ou gh rev ie w, t he di st ric t co ur t up he ld th e 1

Co m m is si on er ’s d e ni al of di sa bi li ty b en efi ts , c on cl ud in g th at th e ALJ’s de ci si on is

su pp or te d by su bs ta nt ia l ev i d e nc e on th e ad m in is tra ti ve reco rd as a who le

. W in n

ap pe al s. W e ap pl y th at sa m e st an da rd a n d a f f i r m. See Van Vick le v. Ast ru e, 53 9

F.3 d 8 25 , 82 8 (8 th Cir . 20 08 ) (s ta nd ard of r ev ie w).

App lying t h e f

i v e -s te p pr oc es s de fin ed in 20 C.F.R. § 40 4.1 52 0( a), th e ALJ

fo un d t ha t, du rin g th e pe rio d i n q ue st io n, Win n s uf fere d fr om

sev ere b ut no n- li st ed

im pa irments -- de ge ne rat iv e di sc di se as e of th e cerv ic al sp in e, carp a l tu nn el synd ro m e, an d ne ur op at hy. Afte r co ns id eri ng th e en ti re reco rd in cl ud in g ad di ti on al

ev id en ce fro m W in n’s tre at in g ph y si ci an , th e ALJ fo un d th at hi s RFC as of th e da te
la st in su red was --

to pe rfo rm li gh t wor k as de fin ed in 20 CFR 40 4.1 56 7( b) ex cep t th at he

co ul d li ft an d/ or carr y an d pu sh an d/ or pu ll up to 10 po un ds oc cas io na ll y

an d 5 po un ds freq ue nt ly; he co ul d st an d an d walk up to 6 ho ur s in an 8- ho ur wor kd ay an d si t up to 6 ho ur s in an 8- ho ur wor kd ay ; he co ul d n[ ot ] cl im b la dd ers , ro pe s or sc affo ld s; he co ul d oc cas io na ll y cl im b ram ps an d

st ai rs ; he co ul d oc cas io na ll y st oo p, kn eel

, cro uc h an d crawl ; he co ul d freq ue nt ly reac h, bu t co ul d on ly oc cas io na ll y reac h ov erh ead ; he co ul d freq ue nt ly ha nd le

, fin ge r an d feel ; an d he ne ed ed to av oi d ha zard s su ch

as da ng ero us m ov in g m ach in ery or un pr ot ect ed he ig ht s.

The Hon or ab le Bet h Ph il li ps , Uni te d St at es Dis tri ct Ju dg e f o r th e W es te rn 1
Dis tri ct of M is so ur i.

-2

-Bas ed on th is RFC, th e ALJ fo un d th at W in n co ul d no t pe rfo rm h i s pa st rel ev an t

wor k, whi ch was op erat in g he av y eq ui pm en t at a Mi ss ou ri ro ck qu arry. Howev er , ba se d on th e VE’ s te st im on y th at so m eo ne wit h Wi n n ’s a g e, ed uc at io n, wor k

ex pe rie nc e, an d RFC co ul d pe rfo rm job s av ai la bl e in th e reg io na l an d na ti on al

eco no m y at th at ti m e, su ch as be nc h as se m bl er, la un dr y wor ke r, an d ti ck et se ll er, th e
ALJ fo un d th at W in n was no t di sa bl ed

. On ap pe al

, W in n arg ue s, as he di d to th e di st ric t co ur t, (1 ) th at th e ALJ di d no t gi ve th e op in io ns of hi s tre at in g ph y si ci an , Dr. Gary LaMo nd a, su ffi ci en t weig ht ; an d (2 ) th at th e RFC fo un d by th e ALJ at tri bu te d

gr eat er h an d fu nc ti on in g t o Win n t ha n t he m ed ic al ev id en ce s up po rte d.

1. The Tre at in g Physici an Is su e. Dr. LaMo nd a, an in te rn is t, ha d tre at ed W in n fo r m an y y ears whe n, in la te 20 05

, W in n’s co m pl ai nt s of ne ck an d sh ou ld er pa in an d

ha nd nu m

bn es s cau se d Dr. LaMo nd a to or de r an MRI of th e cerv ic al sp in e an d to

r e f e r Win n to Dr. Don al d Meyer, a pa in m an ag em en t sp eci al is t. The MRI s h o w e d

de ge ne rat iv e di sc d i se as e an d sp in al st en os is

. St ero id in jecti on s im

pr ov ed W in n’s

pa in

, bu t by

m id -2 00 7 c hr on ic ne ck pa in led Dr. Meyer to refe r W in n to Dr. Je ffre y Park er, a su rg eo n. Bas ed on an MRI an d a ne w m y el og ram , Dr. Park er di ag no se d

se ve re cerv ic al st en os is an d reco m m en de d th at W in n no t ret ur n to wor k. In a se co nd

ap po in tm en t, Dr. Park er di ag no se d carp al tu nn el synd ro m e an d refe rred W in n to Dr.

Jo hn Hav ey , who pe rf

o r med c arp al tu nn el rel eas e pr oc ed ur es on each ha nd

. Dr.

Hav ey op in ed th at W in n was do in g well aft er t he pro ced ur es bu t s ho ul d re m ai n o ff

wor k fo r an ot he r m on th an d no t do “ he av y gr ip pi ng or li fti ng .” Late r th at fal l, aft er

an ot he r MRI

, Dr. Park er pe rfo rm ed fu si on su rg ery on W in n’s cerv ic al sp in e. Sev en week s aft er t h e s u r ge ry , W in n to ld Dr. Park er he was “ do in g fin e” an d ha d “ no

pr ob le m s at al l.” In Ja nu ary 20 08

, W in n to ld Dr. Park er hi s ne ck pa in was gr ad ua ll y im pr ov in g bu t he do ub te d he co ul d ret ur n to wor k as a he av y- eq ui pm en t op erat or

. Dr. Park er kep t W in n off work an d no te d he sh ou ld co ns id er a d iff eren t p ro fes si on

. Als o in Ja nu ary 20 08

, Dr. Hav ey no te d W in n was do in g well aft er his carp al tu nn el

su rg eri es

.

-3

-The reco rd refl ect s th at W in n rece iv ed un em pl oym en t co m

pe ns at io n be ne fit s fro m th e fo ur th qu art er o f 20 07 th ro ug h t he sec on d q ua rte r of 20 08

. In Apr il 20 08

, W in n to ld Dr. Park er he was ex pe rie nc in g ne ck so ren es s an d ha nd nu m bn es s an d was

pu rs ui ng a wor ke rs ’ co m

pe ns at io n cl ai m

. Dr. Park er no te d m il d li m it at io n of cerv ic al

m ot io n bu t “ go od gr ip st ren gt h in bo th ha nd s.” He ad vi se d W in n he co ul d ret ur n to
li gh t wor k. The fo ll owi ng m on th

, Dr. Dan ie l Kit ch en s co nd u c t e d an in de pe nd en t
med i c al ev al ua ti on of W in n in co nn ect io n wit h hi s wor ke rs ’ co m pe ns at io n cl a i m. Afte r rev ie win g W in n’s ex te ns iv e m ed ic al hi st or y , Dr. Kit c he ns op in ed th at W in n

co ul d “wo r k w it h li gh t to m ed iu m -d ut y res tri ct io ns .” In Ju ly, W in n ag ai n sa w Dr. Meyer. Tho ug h W in n cl ai m ed no po st -s ur ge ry im pr ov em en t in pa in an d nu m bn es s,
Dr. Meyer op in ed th at W in n’s sym pt om s were “ rel at iv el y m il d” an d hi s pa in “ is no t

so m et hi ng th at sh ou ld be co m pl et el y di sa bl in g.”

W in n ne xt sa w Dr. LaMo nd a in Aug us t 20 09

. W in n sa id h e f el t “ ok ay ” bu t

rep or te d ne ck an d sh ou ld er pa in

. Neu ro di ag no st ic te st in g s h o w e d so m e sp in al

rad ic ul op at hy an d se ve re bi la te ral c a r p a l tu nn el synd ro m e. Dr. LaMo nd a refe rred

W in n to Dr. Tho m as Turn ba ug h, an or th op ed ic su rg eo n, who pe rfo rm ed ad di ti on al

carp al tu nn el su rg ery on W in n’s le ft wris t in Decem be r 20 09

. At a ch eck up th e ne xt

m on th , W in n t ol d Dr. LaM on da he fel t wel l ex cep t fo r ch ro ni c h ead ach es

.

In Ju ne 20 10

, W in n sa w Dr. LaMo nd a fo r “s o me p a p e r wor k” reg ard in g hi s di sa bi li ty ap pl ic at io n. In res po ns e to writ te n in te rro g a t o rie s fro m W in n’s at to rn ey , Dr. LaMo nd a st at ed th at W in n’s ha nd s are res tri ct ed fro m te n po un d li fti ng an d

rep et it iv e us e; he ha s sh ou ld er pa in whi le st an di ng fo r fif te en m in ut es an d can no t si t
fo r m or e th an th irt y m in ut es wit ho ut ha vi ng to li e d own to st op m us cl e sp as m s an d

arm pa in ; hi s “ ne ck wil l no t to le rat e si tt in g fo r m or e th an 3 0 mi n u te s” ; hi s cerv ic al

st en os is pr ecl ud es “ rep et it iv e st oo pi ng or st an di ng fo r m or e th an 30 m in ut es ”; an d lying do wn ever y two ho ur s for th irt y m in ut es wil l reli ev e pa in an d m us cl e sp as m s.
In Decem

be r 20 10

, aft er th e fi r s t ALJ fo un d W in n no t di sa bl ed

, Dr. LaMo nd a

pr ov id ed a te le ph on ic swo rn st at em en t in whi ch he el ab or at ed on th es e op in io ns an d

-4

-ex pl ai ne d h is rol e as in te rn is t i n c oo rd in at in g t reat m en t b y m ed ic al sp eci al is ts su ch

as Dr. Meyer, Dr. Park er, and Dr. Hav ey

. Dr. LaMo nd a op in ed th at
, whi le th e MRI
aft er W in n’s ne ck su rg ery sh owe d th ere was no lo ng er n e r v e b l oc ka ge , “ be cau se it

was a lo ng -s ta nd in g im

pi ng em en t on th os e ne rv es , he h a d h a d lo ng -s ta nd in g an d

pe rm an en t da m ag e

. . . to bo th th e ne rv es go in g to th e arm s, th e C5 -6 ne rv e ro ot s, an d

of f th e sp in al co rd .”

W in n sa w Dr. LaMo nd a ag ai n i n Nov em be r 20 11 an d Feb ru ary 20 12

. The

di st ric t co ur t ag reed wit h th e ALJ th at Dr. LaMo nd a’s no te s are am bi gu ou s as to th e effe ct iv en es s of W in n’s m os t rece nt carp al tu nn el pr oc ed ur e. In Feb ru ary 20 13

, W in n

sa w Dr. Den ni s Vele z fo r a co ns ul ta ti ve ex am in at io n. Dr. Vele z ob se rv ed th at W in n de m on st rat ed “ no rm al ran ge of m ot io n” an d “ fu ll se ns at io n” du rin g a m ot or

ex a m in at io n an d co nc lu de d he “ do es no t ha ve li m it at io ns fo r si tt in g, st an di ng or walk in g.” Dr. Vele z op in ed th at W in n “ m ay ha ve so m e m an ip ul at iv e li mi t a t i on s

us in g th e rig ht ha nd si de

, bu t wou ld no t ha ve an y li fti ng or carr y in g li m it at io ns .” In May 20 14

, W in n sa w Dr. LaMo nd a, who rep or te d th at W in n co nt in ue d to ha ve se ve re

carp al tu nn el syndr om e an d c hr on ic pa in , des pi te su rg eri es

.

The ALJ cred it ed Dr. LaMo nd a’s op in io n t ha t Win n co ul d no t li ft m or e th an

te n po un ds bu t ga ve li m it ed weig ht to hi s ot he r Ju ne an d D e c e mber 20 10 op in io ns be cau se th ey were no t su pp or te d by ob jecti ve m ed ic al ev id en ce an d were in co ns is te nt
wit h t he op in io ns of Win n’s sp eci al is ts , wi th Dr. Vele z’s m or e rece nt fin di ng s, an d

wit h W in n’s li m it ed tre at m en t hi st or y aft er Ju ly 2 0 0 8

. Th e ALJ ga ve “ si gn ifi can t weig ht ” to th e op in io ns of W in n’s sp eci al is ts
, Dr. Hav ey , Dr. Park er, an d Dr. Meyer,

an d “p a r t i a l weig ht ” to th os e of Dr. Kit ch en s an d Dr. Vele z. The ALJ cred it ed Dr.
Vele z’s op in io ns th at W in n m ay ha ve m an ip ul at iv e li m it at io ns on hi s rig ht si de an d

do es no t h av e si tt in g, s ta nd in g o r wal ki ng li m it at io ns

.

The di st ric t co ur t co nc lu de d t ha t su bs ta nt ia l ev id en ce su pp or te d th e ALJ’s

de ci si on to gi ve Dr. LaMo nd a’s o p i n i on s le ss weig ht th an th os e of th e sp eci al is ts

-5

-be cau se th e sp e c i a l is ts ha d an eq ua l or gr eat er ro le in tre at in g W in n’s ai lm en ts
,

ob jecti ve m ed ic al ev id en ce su pp or te d th ei r po st -s ur ge ry op in io ns , an d Dr. LaMo nd a

sa w W in n rel at iv el y few ti m es in th e y ears fo ll owi ng hi s ba ck an d carp al tu nn el

su rg eri es

. The co ur t al so co n c l u d e d t ha t Dr. Vele z’s op in io n -- W in n m ay ha ve

m a n i p u la ti ve li m it at io ns on hi s rig ht ha nd -- was co ns is te nt wit h th e ALJ’s fin di ng th at W in n co ul d “ freq ue nt ly” ha nd le

, fin ge r, an d feel an d di d no t m an da te a li m it at io n th at W in n c ou ld on ly “ oc cas io na ll y ” d o t ho se tas ks

.

On ap pe al

, W in n arg ue s th e ALJ di d no t acco rd Dr. LaMo nd a’s op in io ns ab ou t

W in n’s fu nc ti on al li m it at io ns su ffi ci en t weig ht an d fai le d to reev al ua te th e ev id en ce in li gh t of Dr. LaMo nd a’s D e c em be r 20 10 st at em en t, as th e App eal s Co un ci l

in st ru ct ed in rem an di ng

. W in n em ph as iz es th at Dr. LaMo nd a tre at ed W in n fo r ov er

twen ty y ears an d co or di na te d W in n’s tre at m en t w i t h va rio us sp eci al is ts

. To th e

ex te nt Dr. LaMo nd a’s 20 10 op in io ns were in co ns is te nt wit h W in n’s sp e c i a l is ts ’

op in io ns in 20 07 an d 20 08

, W in n no te s th e sp eci al is ts sa w W in n far fewer ti m es th an
Dr. LaMo nd a an d arg ue s th at th ei r o p i n i o n s, ev en if va li d whe n gi ve n, “ can no t be

di sp os it iv e o f [Winn ’s] co nd it io n years l at er.”

A t r e a t in g ph y si ci an ’s o pi ni on wil l be gi ve n co nt ro ll in g weig ht “ if, an d on l y if, it ‘is well -s up po rt e d by m ed ic al ly acce pt ab le cl in ic al an d la bo rat or y di ag no st ic

te ch ni qu es an d is no t in co ns is te nt wit h th e ot he r su bs ta nt ia l ev id en ce.’” Jo hn so n v.
Ast ru e, 62 8 F.3 d 99 1, 99 4 (8 th Ci r. 20 11 ); se e 20 C.F.R. § 40 4.1 52 7( c)(2 ). Here, Dr.

LaMo nd a an d at le as t th ree sp eci a l i s ts
, Drs. Meyer, Park er, an d Hav ey , in it ia ll y

ag reed th at W in n s uf

fere d fr om

carp al tu nn el an d cerv ic al sp in e n erv e im pa irments

th at cau se d hi m si gn ifi can t pa in an d le ft hi m un ab le t o c o n t i n ue op erat in g he av y

eq ui pm en t fr om

m id -2 00 7 wel l i nt o 2 00 8. When m or e co ns erv at iv e tr eat m en ts di d

no t im pr ov e th es e co nd it io ns , Dr. Hav ey an d Dr. Park er pe rfo rm ed carp al tu nn el an d

cerv ic al sp in e fu si on su rg eri es an d ke pt W in n ou t of work whi le he reco ve red

. The

su rg eo ns th en op in ed th at th e su rg eri es went well

.

-6

-In earl y to m id -2 00 8, ba se d on te st res ul ts , Dr . Ha ve y no te d t he po st -s ur ge ry

carp al tu nn el co nd it io n wou ld no t pr ecl ud e W in n’s ret ur n to wor k; Dr. Park er op in ed

th at W in n co ul d en ga ge in li gh t wor k; Dr. Kit ch en s op in ed th at W in n co ul d “ wor k

wit h li gh t t o m ed iu m -d ut y res tri ct io ns ”; an d Dr. M ey er o pi ne d t ha t Win n’s pai n “ is

no t so m et hi ng th at sh ou ld be co m pl et el y di sa bl in g. ” Th e r e was th en a lo ng ga p in

tre at m en t un ti l la te 20 09

, whe n Wi n n rep or te d pa in an d un de rwen t an ot he r carp al

tu nn el su rg ic al pr oc ed ur e. In Ja nu ary 20 10

, W in n to ld Dr. LaMo nd a he was

ex pe rie nc in g n o s y m

pt om s o th er t ha n c hr on ic he ad ach es

.

Th e n e xt m ed ic al ev id en ce is th e op in io ns se t fo rth in Dr. LaMo nd a’s Ju ne
20 10 in te rro ga to ry an swe rs

. In hi s Decem be r 20 10 ex pl an a t o r y s t at em en t, Dr.

LaMo nd a op in ed th at
, ev en if th e po st -s ur ge ry MRI s sh owe d ph y si cal im pr ov em en t,
th e su rg eri es fai le d be cau se W in n’s pe rm an en t ne rv e da m ag e m ean t th at hi s pa in an d ph y si cal li m it at io ns wo u l d ret ur n wit ho ut th e wor k- pr ecl ud in g res tri ct io ns Dr.

LaMo nd a co ns id ered ne ces sa ry

. The pr ob le m is

, no po st -s ur ge ry ob jecti ve m ed ic al

ev id en ce su pp or te d Dr. La M o n d a’s as su m pt io n th at W in n ha d su ffer ed pe rm an en t,
di sa bl in g ne rv e da m ag e, de sp it e th e sp eci a l is ts ’ m ed ic al ly su pp or te d co nt rary

op in io ns

. The refo re, on th is reco rd

, t he ALJ di d no t err in di sc ou nt in g Dr.

LaMo nd a’s o p i n i on s as “ no t su pp or te d by ob jecti ve m ed ic al ev id en ce in th e ad m in is tra ti ve reco rd .” Gies ek e v. Co lv in

, 77 0 F.3 d 11 86

, 11 88 (8 th Ci r. 20 14 ). As

in Jo hn so n, 62 8 F.3 d at 99 5, th e ph y si ci an s who tre at ed W in n ha d di ffer in g op in io ns

reg ard in g th e ex te nt to whi ch hi s im pa irments were pe rm an en tl y di sa bl in g. “ It is th e
ALJ’s ta sk to res ol ve co nf li ct s in th e ev id en ce and is su es of cred ib il it y .” Hack er v.
Barn ha rt, 45 9 F.3 d 93 4, 93 6 (8 th Ci r. 20 06 ). As lo ng as su bs ta nt ia l ev id en ce su pp or ts
th e ALJ’s de ci si on , we m ay no t rev ers e be cau se su bs ta nt ia l ev id en ce al so “ wou ld

ha ve su pp or te d a co nt rary ou tc om e, or be cau se we wou ld ha ve de ci de d th e cas e di ffer en tl y .” And rews v. Co lv in

, 79 1 F.3 d 92 3, 92 8 (8 th Ci r. 2 0 1 5 ) ( q u ot at io n

om it te d)

.

-7

-2. The Ha nd Functi on in g Is su e. W in n arg ue s th e RFC fin di ng th at he co ul d

“ freq ue nt ly h an dl e, fin ge r an d feel ” fai le d t o re fle ct Dr. Ve le z’s op in io n, whi ch th e
ALJ cred it ed

, th at W in n m ay ha ve m an ip ul at iv e li m it at io ns on hi s rig ht ha nd

. W he n

us ed in an RFC, th e li m it at io n “ freq ue nt ly” m ean s th at th e act iv it y o r co nd it io n

oc cu rs be twee n on e-t hi rd an d two -th ird s of an ei gh t-h ou r wor kd ay

. See SSA

P r o gr am Ope rat io ns Man ua l Sy st em , DI 25 00 1.0 01

. W in n arg ue s th e ALJ s h o u l d

ha ve fo un d th at he co ul d o nl y “ oc cas io na ll y ” h an dl e, fi ng er, an d fe el , whi ch m ean s th e act iv it y oc cu rs no m or e th an on e-t hi rd of th e wor kd ay

. Id

. The VE te st ifi ed th at
, if th e “ oc cas io na ll y ” li m i t a t i o n ap pl ie d, W in n co ul d no t pe rfo rm th e av ai la bl e job s sh e id en ti fie d bu t wou ld be ab le to pe rfo rm an ot he r un sk il le d li gh t job

, co un te r cl erk

.

The di st ric t co ur t reject ed W in n’s co nte nti on becau se th e VE id en ti fie d an ot he r job W in n co ul d pe rfo rm if li m it ed to oc cas io na l ha nd li ng , fin ge rin g, an d feel in g, an d

be cau se “ [n ]oth in g c om

pe ls th e co nc lu si on th at th e li m it at io n t o fr eq ue nt ha nd li ng , fin ge rin g an d feel in g (wh ic h is le ss th an co ns ta nt ) is no t su ffi ci en t to en co m pa ss Dr.
Vele z’s op in io n.” W e ag ree. As W in n ha s ne ve r so ug ht un sk il le d li gh t wor k, th ere is no th in g in th e reco rd su gg es ti ng th at hi s im pa irments req ui re th at he be li m it ed to

oc cas io na l rat he r th an freq ue nt ha nd li ng

. W in n arg ue s th at D r

. La Mo nd a’s

di sc ou nt ed op in io n m ad e “ ve ry cl ear th at [Winn ] w o u l d ha ve si gn ifi can t pr ob le m s wit h hi s ha nd s.” Bu t Dr. LaMo nd a op in e d t h a t Win n co ul d no t pe rfo rm job s th at

req ui re oc cas io na l as well as freq ue nt ha nd li ng an d fin ge rin g. The ALJ was no t

req ui red to acce pt an y ph ys i c i an ’s op in io n reg ard in g th is el em en t of W in n’s RFC.

“Ev en th ou gh th e RFC as se ss m en t dr aws fro m m ed ic al so ur ces fo r su pp or t, i t i s ul ti m at el y an ad m in is tra ti ve de te rm in at io n res erv ed to th e Co m m is si on er.” Co x v.
Ast ru e, 49 5 F .3d 61 4, 6 19 -2 0 (8 th Cir . 20 07 ); s ee 2 0 C .F.R. § 4 04 .15 27 (d )(2 ).

The jud gm en t o f th e d is tri ct co ur t i s af fir m ed

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