# Nevels v. Kijakazi

> District Court, E.D. Missouri · March 14, 2023

URL: https://www.frixlaw.com/law-library/cases/10238406

## Case

- **Court:** District Court, E.D. Missouri
- **Decided:** March 14, 2023
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION

MIRANDA NEVELS, )
)
Plaintiff, )
)
v. ) Case No. 4:22-CV-142-JAR
)
KILOLO KIJAKAZI, )
ACTING COMMISSIONER OF SOCIAL )
SECURITY, )
)
Defendant. )
)

MEMORANDUM AND ORDER
This is an action under 42 U.S.C. § 405(g) for judicial review of the Commissioner of
Social Security’s final decision denying the application of Miranda Nevels (“Nevels”) for
Disability Insurance Benefits (“DIB”) under Title II of the Social Security Act. For the reasons
stated herein, the Court affirms the Social Security Administration’s denial of Nevels’s claim for
DIB.
I. Background
On August 30, 2019, Nevels applied for DIB. (Tr. 808-09). On April 15, 2020, Defendant
issued a Notice of Disapproved Claims. (Tr. 733-37). On June 22, 2020, Nevels filed a Request
for Reconsideration. (Tr. 738). On July 10, 2020, Defendant affirmed its previous decision,
denying Nevels’s claims. (Tr. 739-43). Nevels filed a Request for a hearing by an Administrative
Law Judge (“ALJ”), and a telephone hearing was held on January 11, 2021. On March 23, 2021,
the ALJ issued a decision, finding Nevels was not disabled. (Tr. 340-60). The ALJ determined
that Nevels had the following severe impairments: patellofemoral syndrome of right knee, obesity,
bipolar II disorder, general anxiety disorder, and posttraumatic stress disorder (“PTSD”). (Tr.
343). The ALJ found that Nevels did not have an impairment or combination of impairments that
meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart
P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526). (Tr. 343-45). The ALJ found that
Nevels retained the residual functional capacity to:

perform light work as defined in 20 CFR 404.1567(b) except lift up to 20 pounds
occasionally; lift/carry up to 10 pounds frequently. She can stand walk for about 6
hours and sit for up to 6 hours in an 8-hour workday, with normal breaks. She can
frequently climb ramps or stairs, but occasionally climb ladders, ropes or scaffolds.
She can frequently balance, stoop, kneel, crouch, and crawl. She should avoid
exposure to extreme cold. She should avoid concentrated exposure to irritants such
as fumes, odors, dust, gases, and poorly ventilated area. She should avoid
concentrated exposure to operational control of moving machinery, unprotected
heights and hazardous machinery. Her work is limited to simple and routine tasks.
Her work should be in low stress jobs, defined as having only occasional changes
in the work setting. Her work should not be in a fast[-]paced type of job. She
should have no interaction with the public. She should have only occasional
interaction with co-workers and supervisors.

(Tr. 345). At step four, the ALJ found Nevels was unable to perform her past relevant work. (Tr.
358). At step 5, the ALJ found there are jobs that exist in significant numbers in the national
economy that Nevels could perform. (Tr. 359).
Thereafter, Nevels requested the Appeals Council of the Social Security Administration
review the ALJ’s decision dated March 23, 2021. In conjunction with her appeal, Nevels submitted
new, additional medical records from Thomas F. Ganz, M.D. and Mercy Hospital. (Tr. 2). The
Appeals Council found that this evidence did not show a reasonable probability that it would
change the outcome of the decision. (Id.) The Appeals Council denied Nevels request for review
of the ALJ’s decision on December 7, 2021. (Tr. 1-4). The decision of the ALJ thus stands as the
final decision of the Commissioner. See Sims v. Apfel, 530 U.S. 103, 107 (2000).
Nevels filed this appeal on February 7, 2022. (ECF No. 1). On August 29, 2022, Nevels
filed a Brief in Support of her Complaint. (ECF No. 16). The Commissioner filed a Brief in
Support of the Answer on September 15, 2022. (ECF No. 17).
As to Nevels’s testimony, work history, and medical records, the Court accepts the facts as

provided by the parties.
II. Legal Standard
The Social Security Act defines as disabled a person 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 12 months.” 42 U.S.C. § 423(d)(1)(A). The impairment must be
“of such severity that he 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.” 42 U.S.C. §§ 423(d)(2)(A); 1382c(a)(3)(B).
The Social Security Administration (“SSA”) uses a five-step analysis to determine whether
a claimant seeking disability benefits is in fact disabled. 20 C.F.R. § 404.1520(a)(1). First, the
claimant must not be engaged in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i).
Second, the claimant must establish that he or she has an impairment or combination of
impairments that significantly limits his or her ability to perform basic work activities and meets
the durational requirements of the Act. 20 C.F.R. § 404.1520(a)(4)(ii). Third, the claimant must
establish that his or her impairment meets or equals an impairment listed in the appendix of the
applicable regulations. 20 C.F.R. § 404.1520(a)(4)(iii). If the claimant's impairments do not meet
or equal a listed impairment, the SSA determines the claimant's residual functional capacity
(“RFC”) to perform past relevant work. 20 C.F.R. § 404.1520(e).
Fourth, the claimant must establish that the impairment prevents him or her from doing
past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv). If the claimant meets this burden, the analysis

proceeds to step five. At step five, the burden shifts to the Commissioner to establish the claimant
maintains the RFC to perform a significant number of jobs in the national economy. Singh v. Apfel,
222 F.3d 448, 451 (8th Cir. 2000). If the claimant satisfied all of the criteria under the five-step
evaluation, the ALJ will find the claimant to be disabled. 20 C.F.R. § 404.1520(a)(4)(v).
III. Discussion
A. RFC Supported by Substantial Evidence
Nevels argues that the ALJ’s decision, particularly the RFC, is not supported by substantial
evidence. Nevels contends that the ALJ’s determination “contains no physical RFC and two mental
RFCs that were provided at the initial level by State agency physicians.” (ECF No. 16 at 4). Nevels
contends that “[b]ecause there is no RFC or opinion from an appropriate medical source who was

able to review the entire record, which consists of over a [years’] worth of additional treatment
notes, and the ALJ made it clear that the additional evidence provided after the opinions in the file
supported greater limitations tha[n] found by those doctors, it seems that the RFC is the ALJ’s
own interpretation of the evidence of the record, which is not allowed. The ALJ is not qualified
to . . . determine [the] RFC, as a layperson, and exceeded his authority in translating raw medical
evidence into an RFC.” (ECF No. 16 at 5). Nevels argues that the ALJ “may need to further
develop the file by getting an RFC assessment from the treating source or a CE.” (ECF No. 16 at
5).
The Court finds that the RFC is supported by substantial evidence. “The key issue is
whether the Commissioner's decision is supported by substantial evidence in the record as a
whole.” Cox v. Barnhart, 471 F.3d 902, 906 (8th Cir. 2006) (citing Sultan v. Barnhart, 368 F.3d
857, 862 (8th Cir. 2004)). “Substantial evidence is less than a preponderance, but enough that a

reasonable mind would find it adequate to support the Commissioner's conclusion.” Byes v. Astrue,
687 F.3d 913, 915 (8th Cir. 2012) (citing Travis v. Astrue, 477 F.3d 1037, 1040 (8th Cir. 2007)).
In determining whether evidence is substantial, this Court considers “evidence that detracts from
the Commissioner's decision as well as evidence that supports it.” Travis, 477 F.3d at 1040 (citing
Singh v. Apfel, 222 F.3d 448, 451 (8th Cir. 2000)). “If substantial evidence supports the
Commissioner's conclusions, this court does not reverse even if it would reach a different
conclusion, or merely because substantial evidence also supports the contrary outcome.” Id.
Contrary to Nevels’s argument, “the ALJ is not required to have a medical opinion to assess
the claimant's RFC.” Winship v. Saul, No. 4:20-CV-00039-MDH, 2021 WL 1055196, at *3 (W.D.
Mo. Mar. 19, 2021); see Masciovecchio v. Berryhill, 4:16-CV-01048-DGK, 2017 WL 3741011,

at *4 (W.D. Mo. Aug. 30, 2017) (“This argument is based on the faulty assumption that an ALJ
must have a medical opinion to assess the claimant's RFC, and that absent a medical opinion any
RFC determination is invalid. If accepted, this argument would shift the burden of proving RFC
from the claimant to the Commissioner. But it is the claimant's burden to prove his RFC.”) (citing
Eichelberger v. Barnhart, 390 F.3d 584, 591 (8th Cir. 2004); Martsolf v. Colvin, No. 6:16-00348-
NKL, 2017 WL 77424, at *7 (W.D. Mo. Jan. 9, 2017) (“There is no requirement that an RFC be
supported by a specific medical opinion.”) (citing Meyers v. Colvin, 721 F.3d 521, 527 (8th Cir.
2013) and Chapo v. Astrue, 682 F.3d 1285, 1288-89 (10th Cir. 2012)). Rather, the Court notes
that the ALJ evaluated the medical and nonmedical evidence, properly formulating an RFC that
accommodated Nevels’s limitations. The ALJ limited Nevels to light exertional work, with limits
related to walking, climbing, balancing, stooping, kneeling, crouching, crawling, operational
control of moving machinery, unprotected heights, and hazardous machinery. These limitations
corresponded to Plaintiff’s severe impairments: right knee condition, obesity, and dizziness from

migraines. (Tr. 345). The ALJ limited Nevels to lifting no more than 20 pounds occasionally
based upon Nevels’s testimony that she could lift 30 pounds. (Tr. 345, 661). Similarly, the ALJ
precluded Nevels from exposure to extreme cold based upon her testimony that cold caused her
pain. (Tr. 345, 673). The ALJ limited her exposure to irritants such as fumes, odors, dust, gases,
and poorly ventilated areas because of her shortness of breath. (Tr. 350).
As to her mental health, Nevels testified that her anxiety manifested in racing thoughts,
task avoidance, and self-isolation. (Tr. 667). She testified that stress caused her anxiety and she
had panic attacks two to five times monthly, which lasted 30 minutes to an hour. (Tr. 667-68).
The ALJ accounted for Nevels’s mental health limitations, restricting her to simple and routine
tasks in a low stress job with only occasional changes in the work setting, not fast-paced, and not

involving any interaction with the public and only occasional interaction with co-workers and
supervisors. (Tr. 345).
As to step three of the analysis, the Court finds that the ALJ adequately explained the RFC
assessment. The ALJ discussed the evidence reflecting Nevels’s moderate limitations with
understanding, remembering, or applying information; interacting with others; concentration,
persistence, or maintaining pace; and adapting or managing herself. (Tr. 344). The ALJ pointed
out that Nevels could prepare meals, pay bills, attend appointments, shop, drive, play games
provide health information and work history, follow instructions by healthcare providers, socialize,
and care for children. (Tr. 344). The stated moderate limitations in conjunction with Nevels’s
ability to function were consistent with the ALJ’s RFC determination that Nevels could perform
simple and routine tasks.
In sum, the Court holds that the ALJ’s RFC determination is supported “by substantial
evidence on the record as a whole.” Buford v. Colvin, 824 F.3d 793, 795 (8th Cir. 2016) (citing

Partee v. Astrue, 638 F.3d 860, 863 (8th Cir. 2011); Harris v. Barnhart, 356 F.3d 926, 928 (8th
Cir. 2004)). The Court finds the record supports the ALJ’s physical and mental RFC findings and
affirms the ALJ’s decision. See Winship v. Saul, No. 4:20-CV-00039-MDH, 2021 WL 1055196,
at *3 (W.D. Mo. Mar. 19, 2021) (“ALJs are instead tasked with reviewing and considering the
record taken as a whole, resolving any inconsistencies, and formulating an RFC finding that
reflects Plaintiff's functional abilities.”).
B. Medical Opinion Evidence
Nevels argues that the ALJ’s decision does not properly consider the medical opinions’
supportability and consistency. (ECF No. 16 at 6). When Nevels initially filed her claim for
benefits, she submitted opinions from State agency physicians: Dr. Trowbridge, dated April 15,

2020, concluding that Nevels had no severe physical medical determinable impairments. (Tr. 708).
At reconsideration, Nevels provided the opinion of Dr. Donna McCall, dated July 10, 2020, which
affirmed the assessment by Dr. Trowbridge. (Tr. 722). Nevels argues that the opinions of Dr.
McCall and Dr. Trowbridge “lack any kind of supporting explanation as they both found that
plaintiff’s conditions of migraine headaches, obesity and asthma were non severe.” (ECF No. 16
at 7 (citing Tr. 723)). After considering these opinions, the ALJ found neither to be persuasive due
to the additional medical evidence received, reflecting a severe physical impairment. (Tr. 357).
Hence, Nevels argues “the decision is not supported by substantial evidence and requires reversal
and remand for further consideration of the medical opinions in evidence.” (ECF No. 16 at 8)
In an April 13, 2020 opinion, Dr. Skolnick found Nevels was capable of concentrating and
persisting in simple 1-2 step tasks, required limited social contact to reduce her anxiety, could
adapt to predictable and gradual changes, and preferably involved little independent goal setting
and planning. (ECF No. 16 at 7 (citing Tr. 712-23)). In a July 10, 2020 report, Dr. Cottone

reiterated Dr. Skolnick’s assessment, stating Nevels was capable of simple work without public
interaction. (Id. (citing Tr. 725)).
The ALJ’s decision found the opinions of Dr. Skolnick and Dr. Cottone to be “not
persuasive” because additional medical records were received, showing Nevels has other mental
limitations and because “limited social contact is vague.” (Tr. 357). Nevels argues that the ALJ’s
construction of the mental RFC is “even less well explained [than the physical RFC] and there is
no discussion of the supportability or consistency factors[.]” (ECF No. 16 at 8). Nevels maintains
that the decision does not provide any details elucidating the RFC’s restriction of Nevels’s ability
to perform simple, routine tasks in a low stress environment. (ECF No. 16 at 8). In sum, Nevels
argues that the ALJ’s decision does not properly evaluate the medical opinions because it did not

properly consider supportability and consistency. (ECF No. 16 at 8).
Under the regulations, the agency “will not defer or give any specific evidentiary weight,
including controlling weight, to any medical opinion(s) or prior administrative medical finding(s),
including those from your medical sources.”20 C.F.R. § 404.1520c(a). Rather, when evaluating
the persuasiveness of medical opinions and prior administrative medical findings, ALJs look at
the supportability and consistency of those findings. (Id.) “The ALJ is required to order medical
examinations and tests only if the medical records presented to him do not give sufficient medical
evidence to determine whether the claimant is disabled.” McCoy v. Astrue, 648 F.3d 605, 612 (8th
Cir. 2011). Where other evidence in the record provides a sufficient basis for an ALJ's decision,
then an ALJ “is permitted to issue a decision without obtaining additional medical
evidence.” Anderson v. Shalala, 51 F.3d 777, 779 (8th Cir. 1995) (internal quotation marks and
citation omitted). Importantly, an ALJ's duty to develop the record is not never-ending. McCoy,
648 F.3d at 612.

Here, as noted by Nevels, the ALJ found the prior administrative medical findings
regarding Nevels’s mental functioning to be unpersuasive—primarily because they did not show
other mental limitations--and the ALJ assessed additional functional limitations. (Tr. 357). The
additional evidence discussed by the ALJ acknowledged treatment and medication management
for impairments such as anxiety, depression, and panic attacks. (Tr. 351-55, 2285-2355). During
those visits, Nevels was generally pleasant, cooperative, appropriately dressed with good hygiene,
displayed good eye contact, clear speech, anxious to good mood, congruent affect, fair focus and
concentration, linear thought process, fair insight and judgment, and no memory deficits. (Tr. 478-
89, 493, 2288, 2293, 2304, 2546, 2552).
Nevels also submitted additional medical records to the Appeals Council, which found that

the evidence did not “show a reasonable probability that it would change the outcome of the
decision.” (Tr. 2). The Appeals Council will review a case upon a party’s request if it “receives
additional evidence that is new, material, and relates to the period on or before the date of the
hearing decision, and there is a reasonable probability that the additional evidence would change
the outcome of the decision.” 20 C.F.R. §404.970(a)(5). Here, however, none of the additional
evidence required a different result by the ALJ. The records show generally normal physical
examinations and mild lumbar spine osteoarthritis. (Tr. 59, 82, 84-85, 87). Again, Nevels was
appropriately groomed and dressed, with good hygiene and eye contact, pleasant and cooperative,
and without memory deficits. (Tr. 58-59, 65-66). Thus, the Court finds the ALJ and the Appeals
Council considered and evaluated the medical record, including those records received after the
hearing.
In sum, the Court holds that the ALJ properly resolved the differences in the evidence and
appropriately weighed the opinions in light of the record. The Court cannot reverse the decision

of the ALJ merely because the claimant discerned some evidence to support her position when the
opposite position was supported by substantial evidence in the record. See Taylor ex rel.
McKinnies v. Barnhart, 333 F. Supp. 2d 846, 853 (E.D. Mo. 2004) (citing Krogmeier v. Barnhart,
294 F.3d 1019, 1022 (8th Cir. 2002) (“So long as substantial evidence supports that decision, the
court may not reverse it merely because substantial evidence in opposition exists in the record or
because the court would have decided the case differently.”).
C. Rationale of How Evidence Supports the Findings
Nevels argues that the ALJ erred in formulating the RFC because the ALJ failed to include
a narrative discussion explaining how the medical and non-medical evidence supported each
conclusion as required by Social Security Ruling (SSR) 96-8. (ECF No. 16 at 8). Nevels argues

that the ALJ’s decision fails to explain how the evidence supports the RFC and instead is indicative
of the lack of evidence, demonstrating Nevels was not disabled. (ECF No. 16 at 9-10).
The ALJ must provide “a narrative discussion describing how the evidence supports each
conclusion, citing specific medical facts (e.g., laboratory findings) and nonmedical evidence (e.g.,
daily activities, observations).” SSR 96-8p, 1996 WL 374184, at *7. “A summary of the medical

record does not fulfill the narrative discussion requirement.” Pierce v. Saul, No. 4:19-CV-1886
ACL, 2020 WL 5642311, at *8 (E.D. Mo. Sep. 22, 2020). The ALJ, however, is not required to
make explicit findings for every aspect of the RFC. Id. (citing Depover v. Barnhart, 349 F.3d 563,
567 (8th Cir. 2003)); Murray v. Kijakazi, No. 4:20-CV-484 PLC, 2022 WL 407140, at *4 (E.D.
Mo. Feb. 9, 2022).

The ALJ summarized Nevels’s medical records and concluded that she was not disabled.
The ALJ found that Nevels’s statements concerning the intensity, persistence, and limiting effects
of her symptoms were not entirely consistent with the record. Specifically, her physical and mental
examinations and treatments were not indicative of a disability. Nevels’s physical examinations
exhibited normal findings and no significant abnormalities. (Tr. 101-02, 546, 552-53, 1152-53,
1303, 1313, 1329, 1341, 1696, 1725, 755, 828, 1830, 1841-46, 2056-57, 2073-74, 2097, 2130-31,
2170, 2352-54, 2416, 2446, 2458-59, 2461, 2467-68, 2487-88, 2498). Similarly, as submitted to

the Appeals Council, the medical records indicated that Nevels was doing well after her cystoscopy
with hydrodistension for pelvic pain urinary urgency. (Tr. N21, 194, 201, 204, 214, 218, 223, 227,
239, 370). The records showed Nevels had normal joint range of motion, no back tenderness,
intact neck range of motion, no extremity edema, no signs of muscle weakness or loss of tone or
sensation, and a steady gait. (Tr. 17, 59, 87). An MRI showed the sacroiliac joins in normal
alignment, joint spaces were preserved, no edema or sclerosis; only mild facet osteoarthritis on the
left at L4-L5 presented. (Tr. 82, 84-85).

Likewise, Nevels’s mental examinations were unremarkable, as previously discussed
herein. (Tr. 478-89, 493, 2288, 2294, 2304, 2546, 2552). Although Nevels clearly has a mental
illness diagnosis, her mental status does not present as disabled. Rather, any mental impairments
were treated effectively with therapy and medication. In August 2020, Nevels reported feeling
“good” with her medication, including improved sleep, better focus, and brighter moods. (Tr.
2291). Nevels’s medications were reduced in October 2020, but she reported less irritability, no
depressive or manic-like feature or angry outbursts as of December 2020. (Tr. 2302, 2550).
Indeed, it was only when her allergist recommended that Nevels stop the medication Doxepin that
she noticed an increase in depression and anxiety. (Tr. 476). Thereafter, she resumed Doxepin.
(Id.)

The ALJ further considered other evidence in the record to determine if Nevels’s symptoms
and impairments truly limited her ability to work. The ALJ reviewed Nevels’s activities of daily
living. (Tr. 344, 346, 356-57). Nevels worked at a reduced level in January 2020, but alleged
disability beginning in November 2019. (Tr. 340, 657, 821, 867). Nevels provided childcare for
her young child, drove, shopped, played games, did laundry, cleaned, ran errands, read, prepared
meals, watched television, managed accounts, attended to medical appointment and her medical

care. (Tr. 931-34, 939). These activities support the ALJ’s findings as they are inconsistent with
Nevels’s claim of disability. The ALJ further considered Nevels’s fiancé’s statement, but found it
not persuasive, given his lack of medical training and his biased position based upon their
relationship. (Tr. 358, 910-17).
In sum, the Court finds that substantial evidence supports the ALJ’s finding. “If, after

review, we find it possible to draw two inconsistent positions from the evidence and one of those
positions represents the Commissioner's findings, we must affirm the denial of benefits.” Wiese v.
Astrue, 552 F.3d 728, 730 (8th Cir.2009); McCoy v. Astrue, 648 F.3d 605, 611 (8th Cir. 2011).
Here there was voluminous evidence documenting Nevels’s symptoms and impairments, which
supported the ALJ's decision that Nevels was not disabled. The ALJ’s determination fell within
the zone of choice, which this Court will not disturb. See Winship, 2021 WL 1055196, at *2 (citing
Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir. 2010); Casey v. Astrue, 503 F.3d 687, 691 (8th Cir.
2007) (“Courts ‘defer heavily to the findings and conclusions of the Social Security
Administration’ and will disturb the Commissioner's decision only if it falls outside the ‘zone of
choice.’”).

D. Migraines and Interstitial Cystitis
Nevels claims that the ALJ should have considered her migraines and interstitial cystitis as
severe impairments. (ECF No. 16 at 10-11). Nevels alleged disabling migraines in her disability

application. (Tr. 704, 722). She underwent a brain MRI in January 2021, with normal results, but
she returned to the neurologist, Dr. Calvin, in April 2021 with complaints of headaches, blurred
vision, slowed speech, dizziness, cognitive fog, and musical spasms. (Tr. 553, 2563-64). In
August 2021, Dr. Calvin saw Nevels, who reported migraines 3-6 times per week and intermittent
neck stiffness. (Tr. 94). Dr. Calvin diagnosed Nevels with migraines without aura, fibromyalgia,
orthostatic hypotension and chronic pain. (Tr. 102).

Nevels also complained that the ALJ should have considered her interstitial cystitis, which
results in in pain, urinary incontinence, urgency and frequency. (ECF No. 16 at 11 (citing Tr. 196,
201, 210, 370, 2238)). Nevels received multiple bladder instillations to try to limit the severity of
her symptoms. (Tr. 194, 196, 198, 201, 204, 216, 223). Nevels claimed that her interstitial cystitis
and the installations treatment require her to “insert and hold a solution in her bladder for a
minimum of 30 minutes significantly limits her ability to work and should have been evaluated
and found to be severe impairments.” (ECF No. 16 at 12).

The ALJ, however, discussed these ailments and determined that there was no evidence
that they were severe impairments. See Tr. 354-55. Nevels has not identified evidence that
migraine headaches or urinary incontinence resulting from interstitial cystitis made her unable to
engage in substantial gainful activity for more than 12 months. See 42 U.S.C. § 423(d)(1)(A)
(defining “disability” as the “inability 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 12
months”). As to Nevels’s migraines, a brain MRI in January 2019, as well as an MRA, showed

no abnormalities. Nevels met with a neurologist in December 2020 for headaches. Nevels
reported speech, comprehension, and vision difficulties in early 2019, and subsequent episodes
once every six months, with each lasting one to a few hours. (Tr. 2453). A neurological
examination, as well as other examinations and imaging, were normal. (Tr. 1280, 1317, 1327,
1329, 2458-59, 2562-65). Thus, the Court holds that the ALJ’s determination that Nevels’s history
of migraine headaches was not a severe impairment is supported by substantial evidence,
considering that it only manifested every six months for a few hours at a time.

The Court also finds that the medical records Nevels submitted to the Appeals Council do
not support a finding that her interstitial cystitis and urinary issues were a severe impairment.
Nevels underwent a cystoscopy in January 2021, followed by four to six bladder installations. (Tr.
21, 194, 201, 204, 214, 218, 223, 227, 239, 370). At her appointment on July 6, 2021, Nevels
reported improvement with weekly bladder instillations. (Tr. 201). Nevels reported voiding one
or two times at night and three to four times during the day. (Id.) Given the efficacy of the
instillations, Dr. Marcu prescribed home self-bladder instillations. (Id.) Thus, the Appeals
Council’s review of the evidence determined that the evidence either did not show a reasonable

probability of changing the outcome of the decision or referred to a period after the ALJ’s March
23, 2021. (Tr. 2). The Court holds that the record supports a finding that Nevels was not disabled
due to interstitial cystitis, given the evidence of effective treatments and lack of disabling
symptoms. See Wildman v. Astrue, 596 F.3d 959, 965 (8th Cir. 2010) (quoting Brown v. Barnhart,
390 F.3d 535, 540 (8th Cir. 2004)(“‘If an impairment can be controlled by treatment or medication,
it cannot be considered disabling.’”’).

IV. Conclusion
Based on the foregoing, the Court finds that the ALJ’s decision was based on substantial
evidence in the record as a whole and should be affirmed.
Accordingly,
IT IS HEREBY ORDERED that this action is AFFIRMED. A separate Judgment will
accompany this Order.

Dated this 14th day of March, 2023. J 4)
CLE Ad
JOHMN/A. ROSS
UNITED STATES DISTRICT JUDGE

15

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10238406. Public record. Not legal advice.