Wymer v. Saul

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF MISSOURI

EASTERN DIVISION

RAYMOND A. WYMER, SR., )

)

Plaintiff, )

)

v. ) Case No. 4:19-cv-2616-MTS

)

ANDREW M. SAUL, )

)

)

Defendant. )

MEMORANDUM AND ORDER

This is an action under 42 U.S.C. § 405(g) for judicial review of the final decision of

Defendant Andrew M. Saul, the Commissioner of Social Security, denying the application of

Plaintiff Raymond A. Wymer for Supplemental Security Income (“SSI”) under Title XVI of the

Social Security Act, 42 U.S.C. §§ 1381–85 (the “Act”). Because the Commissioner’s final decision

is supported by substantial evidence on the record as a whole, the Court will affirm the

Commissioner’s final decision to deny Wymer’s application.

I. BACKGROUND

Wymer applied for SSI on October 13, 2016. (Tr. 173–75). At that time, he was 46 years of

age, which is defined as a “[y]ounger person” for purposes of the Act. See 20 C.F.R. § 404.1563.

His application alleged disability beginning on November 12, 2011. (Tr. 175). After his application

was denied at the initial claims level on December 29, 2016, (Tr. 102), Wymer filed a Request for

Hearing by Administrative Law Judge (“ALJ”), (Tr. 106), and ALJ Chandreka Allen held a hearing

on August 27, 2018 at which Wymer and a vocational expert (“VE”) testified. (Tr. at 31).1

1 Wymer made an earlier application for SSI that an ALJ decided on March 11, 2015. (Tr. 79). The Social Security

Administration Appeals Council denied Wymer’s subsequent request for review of that decision. (Tr. 84).

Wymer, who was represented by counsel, testified that he is a former construction worker

who sustained injuries after being shocked and falling off a ladder in November 2011.2 (Tr. 40);

Doc. [10-1] ¶ 8. Wymer further testified he has been unable to work since the accident due to

multiple impairments, including back and neck pain, left shoulder pain, neuropathy, carpal tunnel,

anxiety, and depression. (Tr. 40, 43–56). When asked about his depression, Wymer stated “I’m

depressed all the time . . . because I can’t do the things that I normally can do as a man, you know.”

(Tr. 53). Wymer characterized his depression as involving “basically all of” a lack of motivation,

lack of interest, and tiredness. (Tr. 53). He acknowledged he takes medication for depression but

suggested his depression fluctuates in severity, noting “[s]ome days I’m okay and I’m smiling and

happy . . . and I live dealing with the pain that I’m in on a regular basis.” (Tr. 53–54).

In a December 18, 2018 opinion, the ALJ concluded Wymer did not meet the definition of

“disabled” under the Act and was therefore not entitled to SSI. (Tr. 25). Wymer then filed a Request

for Review of Hearing Decision with the Social Security Administration (“SSA”) Appeals Council.

(Tr. 7–8). The SSA’s Appeals Council denied Wymer’s request for review on July 22, 2019. (Tr.

1). Wymer has thus exhausted all administrative remedies, and the decision of the ALJ stands as the

Commissioner’s final decision. Wymer appealed the Commissioner’s final decision to this Court on

September 23, 2019.

As for Wymer’s testimony, work history, and medical records, the Court accepts the facts as

provided by the parties in their respective statements of fact and responses. The Court will address

specific facts related to Wymer’s appeal as needed in the discussion below.

II. STANDARD FOR DETERMINING DISABILITY UNDER THE ACT

To be eligible for benefits under the Act, a claimant must prove he is disabled. Pearsall v.

2 Although Wymer testified that the accident occurred in November 2012, his medical records indicate that the accident

actually occurred in November 2011. (Tr. 504).

Massanari, 274 F.3d 1211, 1217 (8th Cir. 2001); Baker v. Sec’y of Health & Human Servs., 955 F.2d

552 (8th Cir. 1992). The Act defines a disabled person as someone who is unable “to engage in any

substantial gainful activity by reason of any medically determinable physical or mental 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 twelve months.” 42 U.S.C. § 1382c(a)(3)(A). The impairment must be “of

such severity that [the claimant] is not only unable to do his previous work but cannot, considering

his age, education, and work experience, engage in any other kind of substantial gainful work which

exists in the national economy, regardless of whether such work exists in the immediate area in which

he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied

for work.” § 1382c(a)(3)(B).

The Commissioner engages in a five-step process to determine whether a claimant is disabled.

See 20 C.F.R. § 416.920; see also McCoy v. Astrue, 648 F.3d 605, 611 (8th Cir. 2011) (discussing

the five-step process). “If [the] claimant fails to meet the criteria at any step in the evaluation of

disability, the process ends and the claimant is determined to be not disabled.” Goff v. Barnhart, 421

F.3d 785, 790 (8th Cir. 2005) (quoting Eichelberger v. Barnhart, 390 F.3d 584, 590–91 (8th Cir.

2004)). At Step One, the Commissioner determines whether the claimant is currently engaging in

“substantial gainful activity”—if so, then the claimant is not disabled. 20 C.F.R. § 404.1520(a)(4)(i);

McCoy, 648 F.3d at 611. At Step Two, the Commissioner determines whether the claimant has a

severe impairment, which is defined as “any impairment or combination of impairments which

significantly limits [the claimant’s] physical or mental ability to do basic work activities”—if so,

then the Commissioner will proceed to the next step; if not, then the claimant is not disabled. 20

C.F.R. §§ 404.1520(a)(4)(ii), 404.1520(c); McCoy, 648 F.3d at 611. At Step Three, the

Commissioner determines whether the claimant’s severe impairment or combination of impairments

meets or equals one of the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 (the

“Listings”)—if so, then the claimant is disabled; if not, then the Commissioner will proceed to the

next step. 20 C.F.R. §§ 404.1520(a)(4)(iii), 404.1520(e).

Prior to Step Four, the Commissioner assesses the claimant’s residual functional capacity

(“RFC”), which is “the most [the] claimant can still do despite [his] physical or mental limitations.”

Martise v. Astrue, 641 F.3d 909, 923 (8th Cir. 2011); see also 20 C.F.R. § 404.1520(e). At Step

Four, the Commissioner determines whether the claimant is able to perform past relevant work—if

so, then the claimant is not disabled; if not then, the Commissioner will proceed to the next step. 20

C.F.R. §§ 404.1520(a)(4)(iv), 404.1520(f); McCoy, 648 F.3d at 611. At Step Five, the Commissioner

considers whether there are alternative work opportunities in the national economy in light of the

claimant’s RFC, age, education, and work experience—if so, then the claimant is not disabled; if not,

then the Commissioner will find the claimant disabled. 20 C.F.R. § 404.1520(a)(4)(v); McCoy, 648

F.3d at 611.

The claimant bears the burden of proof through Step Four of the analysis. Moore v. Astrue,

572 F.3d 520, 523 (8th Cir. 2009); Phillips v. Astrue, 671 F.3d 699, 702 (8th Cir. 2012). However,

if the claimant meets this burden and demonstrates he cannot perform his past work, then the burden

of proof shifts to the Commissioner to establish at Step Five “that the claimant has the [RFC] to

perform a significant number of other jobs in the national economy that are consistent with [his]

impairments and vocational factors such as age, education, and work experience.” Phillips, 671 F.3d

at 702.

III. THE ALJ’S DECISION

The ALJ applied the five-step process outlined above. At Step One, the ALJ found that

Wymer has not engaged in substantial gainful activity since the application date on October 13, 2016.

(Tr. 18). At Step Two, the ALJ found that Wymer has the following severe physical impairments:

cervical degenerative disc disease, bilateral carpal tunnel syndrome, and obesity. Id. But the ALJ

determined Wymer’s mental impairments—generalized anxiety disorder, depression, and a panic

disorder—are non-severe. (Tr. 19–20). At Step Three, the ALJ found that Wymer does not have an

impairment or combination of impairments that meets or medically equals the severity of one of the

impairments listed in 20 C.F.R. § 404, Subpart P, Appendix 1. (Tr. 20–21). As for Wymer’s RFC,

the ALJ determined Wymer can perform sedentary work as defined in 20 C.F.R. § 416.967(a) with

the following exceptions: he cannot climb ladders, ropes, or scaffolds and, while he can occasionally

stoop, kneel, and crouch, he can never crawl; he cannot have any exposure to unprotected heights,

hazardous machinery, or concentrated extreme temperatures; he can only occasionally do overhead

reaching with the left arm but can do “frequent all other reaching bilaterally, frequent handling and

fingering, and climb occasional ramps and stairs.” (Tr. 21).

Although the ALJ reasoned at Step Four that Wymer is unable to perform any past relevant

work, the ALJ determined at Step Five that Wymer can still perform jobs that exist in significant

numbers in the national economy. (Tr. 24). In reaching this determination, the ALJ considered

Wymer’s age, education, work experience, and RFC as well as testimony from the VE. (Tr. 24–25).

The ALJ found Wymer could work as an addresser (Dictionary of Occupational Titles # 209.587-

010, sedentary exertion level, 5,872 jobs in the national economy), document preparer (Dictionary

of Occupational Titles # 249.587-018, sedentary exertion level, 46,373 jobs in the national economy),

and information clerk (Dictionary of Occupational Titles # 237.367-046, sedentary exertion level,

3,404 jobs in the national economy). (Tr. 24–25). The ALJ therefore concluded that Wymer was

not disabled, as defined by the Act, from October 13, 2016, the date the application was filed, through

December 18, 2018, the date of the decision. (Tr. at 25).

IV. STANDARD FOR JUDICIAL REVIEW

This Court must affirm the Commissioner’s decision if the decision applies the correct legal

standards and is supported by substantial evidence in the record as a whole. 42 U.S.C. § 405(g);

Richardson v. Perales, 402 U.S. 389, 401 (1971); Wright v. Colvin, 789 F.3d 847, 852 (8th Cir.

2015); Pate-Fires v. Astrue, 564 F.3d 935, 942 (8th Cir. 2009); Estes v. Barnhart, 275 F.3d 722, 724

(8th Cir. 2002). “Under the substantial-evidence standard, a court looks to an existing administrative

record and asks whether it contains ‘sufficien[t] evidence’ to support the agency’s factual

determinations.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (alteration in original) (quoting

Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). “Substantial evidence is less than a

preponderance, but enough that a reasonable mind might accept it as adequate to support a decision.”

Wright, 789 F.3d at 852 (quoting Juszczyk v. Astrue, 542 F.3d 626, 631 (8th Cir. 2008)); see also

Biestek, 139 S. Ct. at 1154 (“Substantial evidence . . . means—and means only—‘such relevant

evidence as a reasonable mind might accept as adequate to support a conclusion.’”) (quoting

Consolidated Edison, 305 U.S. at 229)).

To determine whether substantial evidence supports the Commissioner’s decision, the Court

must review the record and “consider evidence that both supports and detracts from the decision.”

Wildman v. Astrue, 596 F.3d 959, 964 (8th Cir. 2010). “If substantial evidence supports the

[Commissioner’s] decision, [the Court] will not reverse the decision merely because substantial

evidence would have also supported a contrary outcome, or because [the Court] would have decided

differently.” Id.

V. DISCUSSION

Wymer challenges the ALJ’s decision on two grounds: (1) that the ALJ improperly

determined the severity of Wymer’s mental impairments at Step Two; and (2) that the ALJ

improperly determined Wymer’s RFC by failing to account for his all his mental limitations,

regardless of their severity. (Pl.’s Br. 3, 7). Wymer argues the Commissioner’s decision is thus not

supported by substantial evidence in the record as a whole and should be reversed and remanded.

(Pl.’s Br. 10). In response, the Commissioner urges the Court to affirm the ALJ’s decision. The

Commissioner argues that the ALJ properly determined that Wymer’s mental impairments were non-

severe and that, as a result, the ALJ did not need to factor Wymer’s mental impairments into his

RFC. (Def.’s Br. 4, 11).

A. Determining the Severity of Wymer’s Mental Impairments at Step Two

An impairment is “severe” under the Act if it significantly limits an individual’s ability to

perform basic work activities. See 20 C.F.R. § 416.922. However, an impairment is non-severe if it

has no more than a minimal impact on an individual’s ability to do basic work activities. Id. The

claimant bears the burden of proving severity. See Kirby v. Astrue, 500 F.3d 705, 707–08 (8th Cir.

2007). And, while “[s]everity is not an onerous requirement for the claimant to meet, . . . it is also

not a toothless standard, and [courts] have upheld on numerous occasions [an ALJ’s] finding that a

claimant failed to make this showing.” Id. at 709 (citation omitted).

When evaluating the severity of a claimant’s mental impairments, an ALJ must use the

“special technique” outlined in 20 C.F.R. § 404.1520a. See Cuthrell v. Astrue, 702 F.3d 1114, 1117

(8th Cir. 2013). The ALJ first “evaluate[s] [the claimant’s] pertinent symptoms, signs, and laboratory

findings to determine whether [the claimant has] a medically determinable mental impairment(s).”

20 C.F.R. § 404.1520a(b)(1). The ALJ “then rate[s] the degree of functional limitation resulting

from the impairment(s)” in four broad functional areas known as the “Paragraph B” criteria. See

§ 404.1520a(b)(2); see, e.g., Roades v. Astrue, 861 F. Supp. 2d 983, 992 (E.D. Mo. 2012). The

criteria are as follows: (1) understand, remember, or apply information; (2) interact with others; (3)

concentrate, persist, or maintain pace; and (4) adapt or manage oneself. 20 C.F.R. § 404.1520a(c)(3).

The ALJ rates the criteria using a five-point scale of none, mild, moderate, marked, and extreme.

See § 404.1520(c)(4).

If the ALJ rates the claimant’s mental impairments as “none” or “mild,” then the ALJ will

generally conclude that the mental impairments are non-severe, unless the evidence indicates there

is more than a minimal limitation in the claimant’s ability to perform basic work activities.

§ 404.1520a(d)(1). That said, to be “considered a severe impairment at step two, a mental

impairment need not cause marked restrictions.” Vicky R. v. Saul, No. 19-cv-2530 (ADM/ECW),

2021 WL 536297, at *1 (D. Minn. Jan. 28, 2020), report and recommendation adopted by No. 19-

cv-2530 ADM/ECW, 2021 WL 533685 (D. Minn. Feb. 12, 2021) (quoting Timi W. v. Berryhill, No.

1:17-cv-01366-SLD-EIL, 2019 WL 1227840, at *2 (C.D. Ill. Mar. 15, 2019)). “[C]ourts have

concluded that a ‘moderate’ limitation is sufficient to support a finding of ‘severity’ at [Step Two].”

Vicky R., 2021 WL 536397, at *9; see, e.g., Schadenfroh v. Colvin, No. 1:13-cv-00223-SEB-DKL,

2014 WL 1260123, at *4 (S.D. Ind. Mar. 27, 2014) (“For a mental impairment to be found ‘severe’

at step two of the five-step sequential evaluation process, there generally must be a rating of

‘moderate’ or ‘extreme’ in one of the first three areas or a rating of more than ‘none’ in the fourth

area.” (citing 20 C.F.R. § 404.1520a(d)(1))); Stewart v. Astrue, No. 09-cv-2062, 2012 WL 2994080,

at *5 n.3 (N.D. Ill. July 19, 2012) (observing that “20 C.F.R. § 404.1520a(d)(1) implies that moderate

impairment may qualify as a severe impairment where the evidence shows that it is ‘more than

minimal’”).

The ALJ considered Wymer’s mental impairments—anxiety, depression, and a panic

disorder—both singly and in combination and reasoned they did not cause more than a minimal

limitation in Wymer’s ability to perform basic work activities. (Tr. 19). The ALJ therefore

concluded Wymer’s mental impairments were non-severe. Id. In support of this conclusion, the

ALJ noted Wymer did not require inpatient hospitalization because of his mental impairments and

only recently began receiving mental health counseling. (Tr. 18). The ALJ also noted that Wymer

underwent a psychological evaluation with Dr. Paul Rexroat, a licensed psychologist, on October 31,

2016 and that Dr. Rexroat determined Wymer had anxiety, depression, and a panic disorder. Id. But

the ALJ pointed out that Wymer’s subsequent health care examination on March 17, 2017 indicated

“he had normal mood and effect, normal behavior, and normal judgment and thought content” and

that Wymer “had logical and goal-directed thought processes, was oriented and cooperative, and had

an appropriate appearance” as of March 24, 2017, when he received outpatient psychiatric treatment.

(Tr. 18–19).

The ALJ next considered Wymer’s mental impairments under the “Paragraph B” criteria. See

20 C.F.R. § 404.1520a(c)(3). First, the ALJ referred to the psychological evaluation that Dr. Rexroat

completed on October 31, 2016. (Tr. 19, 93–94; Suppl. Tr. 1700). Dr. Rexroat stated that Wymer

had dropped out of high school but planned to obtain a GED and that Wymer had previously owned

his own business. (Tr. 93–94; Suppl. Tr. 1700). He also noted that Wymer had adequate social skills

and several friends and that people visited him daily. (Tr. 93–94; Suppl. Tr. 1702). He made the

following observations: Wymer had a good memory, but low-average memory function; Wymer

could manage his own funds; and Wymer could sustain concentration, persistence, and pace with

simple tasks. (Tr. 19, 93–94; Suppl. Tr. 1702).

Second, the ALJ referred to a Third-Party Adult Functional Report that Wymer’s spouse,

Shelley Wymer, completed on November 17, 2016. (Tr. 19, 218–25). She indicated that she

experiences seizures and that Wymer takes care of her when she does. (Tr. 219). She noted that

Wymer takes care of the cat and manages personal care without mental issues and that Wymer

sometimes prepares meals and can pay bills, count change, use a checkbook, handle a savings

account, use public transportation, and ride in a car. (Tr. 219–24). She also noted that Wymer spends

time with others, gets along with authority figures, and has never been fired or laid off because of

difficulties getting along with others. Id.

Third, the ALJ referred to a psychological evaluation from Wymer’s treating psychiatrist, Dr.

Surendra Chaganti, dated March 28, 2017. (Tr. 20, 788–90). Dr. Chaganti saw Wymer once per

month from January 2017 until October 2018. (Tr. at 1677–1699). In a March 28, 2017 evaluation,

Dr. Chaganti found that Wymer had moderate limitations in the first functional area (understanding,

remembering, or applying information), moderate-marked limitations in the third functional area

(concentrating, persisting, or maintaining pace), and moderate limitations in the fourth functional

area (adapting or managing oneself). (Tr. 20, 788–90). The ALJ afforded Dr. Chaganti’s opinion

only partial weight because the ALJ found that “the records in this case do not support” the

restrictions found by Dr. Chaganti. (Tr. 20).

Fourth, the ALJ referred to a non-examining consultative opinion from Dr. Marsha Toll, a

state agency psychological consultant, dated December 22, 2016. (Tr. 20, 93–94). Dr. Toll found

Wymer had moderate limitations in the third functional area (concentrating, persisting, or

maintaining pace). (Tr. 20, 93–94). She found that Wymer would be able to engage in simple to

moderately complex work tasks in the national economy. (Tr. 94). The ALJ gave Dr. Toll’s opinion

only partial weight, in part because subsequent records did not support Dr. Toll’s conclusions. (Tr.

20).

Based on this evidence, the ALJ determined Wymer had no limitation in the second

functional area (interacting with others) and only minor limitations in the three remaining functional

areas (understanding, remembering, or applying information; concentrating, persisting, or

maintaining pace; and adapting or managing oneself). (Tr. 19–20). Because Wymer only had minor

limitations in three functional areas, the ALJ concluded Wymer’s mental impairments were non-

severe. (Tr. 18–20).

On appeal, Wymer argues the ALJ improperly determined the severity of his mental

impairments at Step Two. To that end, Wymer insists that the ALJ did not sufficiently explain her

decision to discount the opinions of Drs. Chaganti and Toll and that, as a result, the ALJ improperly

substituted her “own unsubstantiated opinion” for that of two medical professionals. (Pl.’s Br. 4–5).

Wymer asserts that, had the ALJ afforded these opinions the deference they deserve, the ALJ would

have determined that he had at least moderate limitations in mental functioning and that his mental

impairments were severe. (Pl.’s Br. 3). The Commissioner maintains the ALJ properly weighed the

evidence and appropriately deemed Wymer’s mental impairments non-severe. (Def.’s Br. 9–11).

The Court will first consider Dr. Chaganti’s opinion. The applicable regulations afford a

treating physician’s opinion special deference: an ALJ must give a “treating physician’s opinion

regarding an applicant’s impairment . . . ‘controlling weight,’ provided the opinion is ‘well-

supported by medically acceptable clinical and laboratory diagnostic techniques and is not

inconsistent with the other substantial evidence in [the] record.’” Prosch v. Apfel, 201 F.3d 1010,

1012–13 (8th Cir. 2000) (alteration in original) (quoting 20 C.F.R. § 404.1527(d)(2)).3 But “[a]n

ALJ may discount or even disregard the opinion of a treating physician where other medical

assessments are supported by better or more thorough medical evidence, or where a treating

physician renders inconsistent opinions that undermine the credibility of such opinions.” Wildman,

596 F.3d at 964 (alteration in original) (quoting Goff, 421 F.3d at 790). If an ALJ decides not to give

a treating physician’s opinion controlling weight, then the ALJ uses several factors to evaluate the

opinion, including the consistency of the opinion with the record as a whole, the length of the

treatment relationship and frequency of examinations, the nature and extent of the treatment

relationship, the evidence provided by the source in support of the opinion, and the level of

specialization of the source. 20 C.F.R. § 404.1527(c)(2)–(6). Although required to develop the

record fully and fairly, an ALJ is not required to discuss every piece of evidence submitted. Wildman,

596 F.3d at 966. And “[a]n ALJ’s failure to cite specific evidence does not indicate that such

evidence was not considered.” Id. (alteration in original) (quoting Black v. Apfel, 143 F.3d 383, 386

3 This is the so-called “Treating Physician Rule.” See Charles Terranova, Comment, Somebody Call My Doctor: Repeal

of the Treating Physician Rule in Social Security Disability Adjudication, 68 Buff. L. Rev. 931 (2020). The rule applies

to cases filed before March 27, 2017, but not to cases filed after that date. See 20 C.F.R. § 404.1520c(a); § 404.1527.

Because Wymer filed his application in 2016, the Court will use the regulations as provided in § 404.1527.

(8th Cir. 1998)). An ALJ must ultimately “resolve conflicts among the various treating and

examining physicians” and provide “good reasons” for the weight assigned to each. Tindell v.

Barnhart, 444 F.3d 1002, 1005 (8th Cir. 2006) (quoting Vandenboom v. Barnhart, 421 F.3d 745,

749–50 (8th Cir. 2005)); 20 C.F.R. § 404.1527(c)(2)). Because it is an ALJ’s duty to weigh the

evidence and resolve any conflicts that may arise, an ALJ’s finding should not be disturbed so long

as it falls within the “available zone of choice.” See, e.g., Hacker v. Barnhart, 459 F.3d 934, 936–

38 (8th Cir. 2006).

In evaluating Dr. Chaganti’s opinion, the ALJ stated:

Additionally, Surendra Chaganti, M.D., offered a March 28, 2017 opinion as to the

claimant’s impairments and limitations. [He] stated that in the first area of the B

criteria analysis above the claimant had a moderate restriction, had a moderate-

marked concentration, persistence, and pace restriction as well as social functioning

restriction, and had a moderate limitation in the last area, adapting and managing

himself. The undersigned notes that the records in this case do not support these

restrictions, and as a result, the undersigned gives this opinion only partial weight.

(Tr. 20) (citation omitted).

As an initial matter, the Court concedes that the ALJ’s explanation for discounting Dr.

Chaganti’s opinion was succinct. However, an ALJ’s explanation for discounting a physician’s

opinion may be succinct yet still supported by substantial evidence. Compare Pashia v. Berryhill,

No. 4:16-cv-1267-ACL, 2017 WL 4310433, at *1, 8 (E.D. Mo. Sept. 28, 2017) (finding an ALJ’s

decision was not supported by substantial evidence when the ALJ offered a cursory explanation for

discounting the opinion of a treating psychiatrist who was the only physician to evaluate the severity

of the claimant’s mental impairments and whose opinion was supported by detailed narrative

explanations, treatment notes, and other medical history), with Derryberry v. Berryhill, No. 1:16-

cv-3-JAR, 2017 WL 1194458, at *1, 7 (E.D. Mo. Mar. 30, 2017) (concluding that “while the ALJ’s

consideration of [the psychiatrist’s opinion] was succinct, accounting for only one sentence of the

ALJ’s opinion, the ALJ gave adequate attention to the report, and instead gave greater weight to [the

claimant’s] history of near normal objective mental status examinations as observed by her

healthcare providers over time.”). Turning now to the record, the Court finds after careful

consideration that the ALJ gave good reasons, supported by substantial evidence, for discounting Dr.

Chaganti’s opinion and that the ALJ’s assessment of the opinion falls within the available zone of

choice.

First, while Wymer claims he has a long history of mental illness, he never required inpatient

hospitalization for his mental impairments and only recently began receiving mental health

counseling. (Tr. 18, 1699). Although a claimant can still have a severe mental impairment without

being hospitalized, Wymer’s lack of hospitalization weighs against finding severe mental

impairments. See Derryberry, 2017 WL 1194458, at *6 (noting a lack of hospitalization for

psychiatric treatment supports finding non-severe mental impairments).

Second, Dr. Chaganti’s opinion takes the form of a series of checkboxes; it contains few, if

any, observations or explanations supporting her conclusions. (Tr. 789–90). It is well-established

that “a conclusory checkbox form has little evidentiary value when it ‘cites no medical evidence[]

and provides little to no elaboration.’” Anderson v. Astrue, 696 F.3d 790, 794 (8th Cir. 2012)

(quoting Wildman, 596 F.3d at 964). And “[a] treating physician’s opinion deserves no greater

respect than any other physician’s opinion when [it] consists of nothing more than vague, conclusory

statements.” Wildman, 596 F.3d at 964 (quoting Piepgras v. Chater, 76 F.3d 233, 236 (8th Cir.

1996)).

Third, Dr. Chaganti’s opinion is inconsistent with his own treatment notes, which document

over time Wymer’s normal mood, affect, behavior, judgment, thought content, cognition, memory,

and cooperation. (Tr. 1678–97). “[A]n ALJ may discount a treating source opinion that is

unsupported by treatment notes.” Aguiniga v. Colvin, 833 F.3d 896, 902 (8th Cir. 2016); see also 20

C.F.R. § 404.1527(c)(3) (“The more a medical source presents relevant evidence to support a medical

opinion, particularly medical signs and laboratory findings, the more weight we will give that

medical opinion.”).

Fourth, Dr. Chaganti’s treatment notes suggest he treated Wymer for situational stressors

such as nervousness about surgery and sadness from divorce. (Tr. 1685, 1689, 1692); cf. Gates v.

Astrue, 627 F.3d 1080, 1082 (8th Cir. 2010) (“The medical record supports the conclusion that any

depression experienced by [the claimant] was situational in nature, related to marital issues, and

improved with a regimen of medication and counseling.”); Banks v. Massanari, 258 F.3d 820, 826

(8th Cir. 2001) (finding depression not severe under similar circumstances). And Dr. Chaganti’s

treatment notes further indicate that Wymer’s conditions improved once treatment began, as Wymer

was stable with no mood swings or depressive symptoms. (Tr. 1681, 1684–86, 1688, 1690–92); cf.

Wildman, 596 F.3d at 965 (“If an impairment can be controlled by treatment or medication, it cannot

be considered disabling.” (quoting Brown v. Barnhart, 390 F.3d 535, 540 (8th Cir. 2004))).

Fifth, the mere fact that Wymer was diagnosed with depression, anxiety, and a panic disorder

does not, without more, make his mental impairments severe. See Buckner v. Astrue, 646 F.3d 549,

557 (8th Cir. 2011) (reasoning that “although [the claimant] was diagnosed with depression and

anxiety, substantial evidence on the record support[ed] the ALJ’s finding that his depression and

anxiety was not severe.”).

Sixth, Dr. Chaganti’s opinion is inconsistent with other evidence in the record. Treatment

notes consistently document Wymer’s normal mood, affect, behavior, judgment, thought content,

cognition, memory, and cooperation. (Tr. 18, 271, 276, 784, 896, 898, 900, 997, 1010, 1028, 114,

112, 1264, 1276, 1509, 1521, 1587, 1598, 1653, 1666–68). Waymer’s records also document his

repeated lack of anxiety, depression, or memory loss symptoms. (Tr. 1122, 1264, 1276, 1509, 1521,

1653, 1666–68). And the record shows that Wymer had minimal issues interacting with others,

handling his daily activities, and caring for his epileptic spouse. (Tr. 19, 93–94, 208–12, 219–20,

222–24).

The Court thus finds that the ALJ gave good reasons, supported by substantial evidence, for

discounting the opinion of Dr. Chaganti as to Wymer’s limitations in the first, third, and fourth

functional areas (understanding, remembering, or applying information; concentrating, persisting, or

maintaining pace; and adapting or managing oneself). Although the ALJ did not explicitly discuss

all the factors listed in § 404.1527(c) when evaluating Dr. Chaganti’s opinion, the ALJ was not

required to do so. See Nishke v. Astrue, 878 F. Supp. 2d 958, 984 (E.D. Mo. 2012) (concluding that

an ALJ’s failure to perform a factor-by-factor analysis was not erroneous where the ALJ “explained

his rationale in a manner that allow[ed] the [court] to follow his line of reasoning, including stating

the amount of weight given to th[e] evidence”); Derda v. Astrue, No. 4:09-cv-01847-AGF, 2011

WL 1304909, at *10 (E.D. Mo. Mar. 30, 2011) (citing broad authority for the proposition that

“[w]hile an ALJ must consider all of the factors set forth in [§ 404.1527], he need not explicitly

address each of the factors”). The ALJ was concise but ultimately “explained his rationale in a

manner that allows the [Court] to follow his line of reasoning.” Nishke, 878 F. Supp. 2d at 984.

Next, the Court will consider Dr. Toll’s opinion. The applicable regulations afford less

deference to a non-examining consultative opinion from a state-agency physician. Wildman, 596

F.3d at 967 (quoting Willcockson v. Astrue, 540 F.3d 878, 880 (8th Cir. 2008)); see also

§ 404.1527(c)(1). When reviewing such opinions, an “ALJ evaluate[s] the degree to which these

opinions consider all of the pertinent evidence in [the] claim, including options of treating and other

examining sources.” Id. (alterations in original). An ALJ may disregard such opinions when the

state-agency physician does not have access to all the medical evidence in the record. See id. at 967–

68.

In evaluating Dr. Toll’s opinion, the ALJ stated:

When making this decision, the undersigned considered the opinion offered to the

state Disability Determination Service by Marsha Toll . . . . That opinion was that the

claimant had concentration, persistence, and pace that was moderate and as a result,

the claimant had a severe combination of mental impairments. However, the

undersigned notes that the Social Security Administration now uses a different scale

for its B criteria areas. Furthermore, the undersigned notes that the claimant has

additional medical records that are now in the file and that do not support the

concentration, persistence, and pace limitations expressed by Dr. Toll. As a result,

the undersigned gives this opinion by this physician only partial weight.

(Tr. 20).

As with Dr. Chaganti’s evaluation, the Court finds that the ALJ gave good reasons, supported

by substantial evidence, for discounting Dr. Toll’s opinion and that the ALJ’s assessment of the

opinion falls within the zone of choice. Dr. Toll offered her non-examining consultative opinion in

December 2016. Subsequent evidence indicates that Wymer was attentive, oriented, goal-directed,

and denied any symptoms of memory loss. (Tr. 1264, 1276, 1509, 1521, 1587, 1598). Because Dr.

Toll did not have access to this evidence when she offered her opinion, the ALJ was justified in

discounting Dr. Toll’s opinion as to Wymer’s limitations in the third functional area (concentrating,

persisting, or maintaining pace).

The Court acknowledges that the record contains conflicting evidence and that the ALJ could

have reached a different conclusion as to the opinions of Drs. Chaganti and Toll. But “it is the ALJ’s

function to resolve conflicts among the opinions of various treating and examining physicians.”

Pearsall, 274 F.3d at 1219. The Court concludes that the ALJ’s weighing of the evidence here fell

within the available zone of choice. It also concludes that substantial evidence supports the finding

that Wymer did not have anything more than a mild limitation in any of the functional areas of the

B criteria and that his mental impairments were thus non-severe. As a result, the Court cannot disturb

the ALJ’s decision, even if it might have reached a different conclusion. See Buckner, 646 F.3d at

556.

B. Accounting for Wymer’s Mental Impairments in the RFC at Step Four

Wymer argues the ALJ also improperly determined Wymer’s RFC prior to Step Four by

failing to account for his all his mental limitations, regardless of their severity. To that end, Wymer

insists the ALJ erred by failing to include both his severe and non-severe impairments in his RFC.

(Pl.’s Br. 7–10). This argument is easily dismissed. The ALJ properly found Wymer’s mental

impairments were non-severe and thus resulted in no more than mild limitations in the four functional

areas. Mild limitations identified at Step Two using the “special technique” do not require

corresponding RFC limitations. See Taylor v. Berryhill, No. 4:17-cv-01050-DGK-SSA, 2018 WL

5410977, at *2–3 (W.D. Mo. Oct. 29, 2018) (rejecting the argument that the “ALJ erred by failing

to incorporate the mild limitations in the [PRT] analysis from Steps Two and Three into mental

limitations on his RFC at Step Four” and explaining the differences between the use of the

“psychiatric review technique” (PRT) at Steps Two and Three and the function of the RFC

assessment at Step Four); see also Johnson v. Berryhill, No. 4:17-cv-0416–DGK–SSA, 2018 WL

2336297, at *2 (W.D. Mo. May 23, 2018); Browning v. Colvin, No. 13-00266-cv-REL, 2014 WL

4829534, at *37 (W.D. Mo. Sept. 29, 2014) (“While it is true that the ALJ did not include his finding

of plaintiff’s mild difficulties in concentration, persistence, and pace in the assessment, there was no

requirement that he do so. Mild limitations in any of the four domains of mental functioning are

non-severe and therefore by definition cause no work-related limitations of function.” (citations

omitted)). Moreover, Wymer has not identified any evidence to support a claim that his RFC

required additional limitations due to poor motivation or fatigue. Because it is a claimant’s burden

to prove his RFC, the ALJ did not err by not including additional limitations. See Goff, 421 F.3d at

790 (“A disability claimant has the burden to establish her RFC.” (quoting Eichelberger, 390 F.3d

at 590)).

Wymer further contends the ALJ erred by not including all of Dr. Chaganti’s suggested

mental limitations in the hypothetical the ALJ posed to the VE. But this argument is also easily

dismissed because an “ALJ’s hypothetical question need include only those impairments that the

ALJ finds are substantially supported by the record as a whole.” Milam v. Colvin, 794 F.3d 978, 985

(8th Cir. 2015) (quoting Cruze v. Chater, 85 F.3d 1320, 1323 (8th Cir. 1996)). Because the ALJ had

already determined Dr. Chaganti’s suggested mental limitations were inconsistent with the record,

the ALJ did not err in not including them in the hypothetical.

CONCLUSION

After reviewing the entire record, the Court finds that the ALJ properly considered and

weighed the medical opinion evidence in the record. The Court also finds that the ALJ considered

the medical evidence as a whole and made a proper severity determination at Step Two and a proper

RFC determination at Step Four based on a fully and fairly developed record. The Court therefore

concludes that the ALJ’s decision is supported by substantial evidence.

Accordingly,

IT IS HEREBY ORDERED, ADJUDGED, AND DECREED that the decision of the

Commissioner of Social Security is AFFIRMED.

Dated this 11th day of May, 2021. }

il

MATTHEW SCHELP

UNITED STATES DISTRICT JUDGE

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