Patrick v. Kijakazi

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF MISSOURI

EASTERN DIVISION

DEBBIE PATRICK, )

)

Plaintiff, )

)

vs. ) Case No. 4:22-CV-230-ACL

)

KILOLO KIJAKAZI, )

Acting Commissioner of Social Security )

Administration, )

)

Defendant. )

MEMORANDUM

Plaintiff Debbie Patrick brings this action pursuant to 42 U.S.C. § 405(g), seeking

judicial review of the Social Security Administration Commissioner’s denial of her applications

for Disability Insurance Benefits (“DIB”) under Title II of the Social Security Act and

Supplemental Security Income (“SSI”) under Title XVI of the Act.

An Administrative Law Judge (“ALJ”) found that, despite Patrick’s severe impairments,

she was not disabled as she was capable of performing her past work and other work existing in

significant numbers in the national economy.

This matter is pending before the undersigned United States Magistrate Judge, with

consent of the parties, pursuant to 28 U.S.C. § 636(c). A summary of the entire record is

presented in the parties’ briefs and is repeated here only to the extent necessary.

For the following reasons, the decision of the Commissioner will be affirmed.

I. Procedural History

Patrick protectively filed her application for DIB on September 16, 2019, and filed her

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application for SSI on November 25, 2019. (Tr. 304-11.) She claimed she became unable to

work on October 1, 2017, due to anxiety, bipolar disorder, depression, and schizophrenia. (Tr.

353.) Patrick was 56 years of age at her alleged onset of disability date. (Tr. 304.) Her

applications were denied initially. (Tr. 139-43.) Patrick’s claims were denied by an ALJ on

May 17, 2021. (Tr. 13-26.) On November 26, 2021, the Appeals Council denied Patrick’s

claim for review. (Tr. 4-7.) Thus, the decision of the ALJ stands as the final decision of the

Commissioner. See 20 C.F.R. §§ 404.981, 416.1481.

In this action, Patrick argues that the “ALJ’s RFC assessment is not supported by

substantial evidence.” (Doc. 18 at 1.) She specifically argues that the ALJ erred in

“disregarding the DDS’ limitation to unskilled work, which precludes Plaintiff’s past relevant

semi-skilled work;” and the ALJ “failed to consider the cyclic aspects related to Plaintiff’s severe

bipolar disorder where she has episodes of chronic fatigue with alternating periods of agitation.”

Id.

II. The ALJ’s Determination

The ALJ first found that Patrick met the insured status requirements of the Social

Security Act through December 31, 2023. (Tr. 15.) She stated that Patrick has not engaged in

substantial gainful activity since her alleged onset date. Id. In addition, the ALJ concluded that

Patrick had the following severe impairments: bipolar disorder, major depressive disorder, and

alcohol use disorder. (Tr. 16.) The ALJ found that Patrick did not have an impairment or

combination of impairments that met or medically equaled the severity of one of the listed

impairments. Id.

As to Patrick’s RFC, the ALJ stated:

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After careful consideration of the entire record, I find that the

claimant has the residual functional capacity to perform a full

range of work at all exertional levels. She can tolerate occasional

interaction with co-workers and supervisors, but can perform no

tandem tasks or work in close proximity to co-workers (i.e. no

shoulder to shoulder work environment). She can perform work

that is done relatively independently with minimal, superficial

interaction with the general public and should avoid intense or

extensive interpersonal and handling complaints or dissatisfied

customers.

(Tr. 19.)

The ALJ found that Patrick was capable of performing her past work as a transformer

assembler. (Tr. 24.) In the alternative, the ALJ found that Patrick could perform other jobs

that exist in significant numbers in the national economy, such as janitorial worker, kitchen

helper, or laundry worker. (Tr. 24-25.) The ALJ therefore concluded that Patrick was not

under a disability, as defined in the Social Security Act, from October 1, 2017, through the date

of the decision. (Tr. 26.)

The ALJ’s final decision reads as follows:

Based on the application for a period of disability and disability

insurance benefits protectively filed on September 13, 2019, the

claimant is not disabled under sections 216(i) and 223(d) of the

Social Security Act.

Based on the application for supplemental security income filed on

November 25, 2019, the claimant is not disabled under section

1614(a)(3)(A) of the Social Security Act.

Id.

III. Applicable Law

III.A. Standard of Review

The decision of the Commissioner must be affirmed if it is supported by substantial

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evidence on the record as a whole. 42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389,

401 (1971); Estes v. Barnhart, 275 F.3d 722, 724 (8th Cir. 2002). Substantial evidence is less

than a preponderance of the evidence, but enough that a reasonable person would find it adequate

to support the conclusion. Johnson v. Apfel, 240 F.3d 1145, 1147 (8th Cir. 2001). This

“substantial evidence test,” however, is “more than a mere search of the record for evidence

supporting the Commissioner’s findings.” Coleman v. Astrue, 498 F.3d 767, 770 (8th Cir.

2007) (internal quotation marks and citation omitted). “Substantial evidence on the record as a

whole . . . requires a more scrutinizing analysis.” Id. (internal quotation marks and citations

omitted).

To determine whether the Commissioner’s decision is supported by substantial evidence

on the record as a whole, the Court must review the entire administrative record and consider:

1. The credibility findings made by the ALJ.

2. The plaintiff’s vocational factors.

3. The medical evidence from treating and consulting physicians.

4. The plaintiff’s subjective complaints relating to exertional and

non-exertional activities and impairments.

5. Any corroboration by third parties of the plaintiff’s

impairments.

6. The testimony of vocational experts when required which is

based upon a proper hypothetical question which sets forth the

claimant’s impairment.

Stewart v. Secretary of Health & Human Servs., 957 F.2d 581, 585-86 (8th Cir. 1992) (internal

citations omitted). The Court must also consider any evidence which fairly detracts from the

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Commissioner’s decision. Coleman, 498 F.3d at 770; Warburton v. Apfel, 188 F.3d 1047, 1050

(8th Cir. 1999). However, even though two inconsistent conclusions may be drawn from the

evidence, the Commissioner’s findings may still be supported by substantial evidence on the

record as a whole. Pearsall v. Massanari, 274 F.3d 1211, 1217 (8th Cir. 2001) (citing Young v.

Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000)). “[I]f there is substantial evidence on the record as

a whole, we must affirm the administrative decision, even if the record could also have supported

an opposite decision.” Weikert v. Sullivan, 977 F.2d 1249, 1252 (8th Cir. 1992) (internal

quotation marks and citation omitted); see also Jones ex rel. Morris v. Barnhart, 315 F.3d 974,

977 (8th Cir. 2003). Put another way, a court should “disturb the ALJ’s decision only if it falls

outside the available zone of choice.” Papesh v. Colvin, 786 F.3d 1126, 1131 (8th Cir. 2015)

(citation omitted).

III.B. Determination of Disability

A disability is defined 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 that has lasted or can be expected to last for a continuous period of not less than

twelve months. 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A); 20 C.F.R. § 416.905. A claimant

has a disability when the claimant is “not only unable to do his previous work but cannot,

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

work which exists … in significant numbers in the region where such individual lives or in

several regions of the country.” 42 U.S.C. § 1382c(a)(3)(B).

To determine whether a claimant has a disability within the meaning of the Social

Security Act, the Commissioner follows a five-step sequential evaluation process outlined in the

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regulations. 20 C.F.R. § 416.920; see Kirby v. Astrue, 500 F.3d 705, 707 (8th Cir. 2007). First,

the Commissioner will consider a claimant’s work activity. If the claimant is engaged in

substantial gainful activity, then the claimant is not disabled. 20 C.F.R. § 416.920(a)(4)(i).

Second, if the claimant is not engaged in substantial gainful activity, the Commissioner

looks to see “whether the claimant has a severe impairment that significantly limits the

claimant’s physical or mental ability to perform basic work activities.” Dixon v. Barnhart, 343

F.3d 602, 605 (8th Cir. 2003). “An impairment is not severe if it amounts only to a slight

abnormality that would not significantly limit the claimant’s physical or mental ability to do

basic work activities.” Kirby, 500 F.3d at 707; see 20 C.F.R. §§ 416.920(c), 416.921(a).

The ability to do basic work activities is defined as “the abilities and aptitudes necessary

to do most jobs.” 20 C.F.R. § 416.921(b). These abilities and aptitudes include (1) physical

functions such as walking, standing, sitting, lifting, pushing, pulling, reaching, or handling; (2)

capacities for seeing, hearing, and speaking; (3) understanding, reaching out, and remembering

simple instructions; (4) use of judgment; (5) responding appropriately to supervision, co-

workers, and usual work situations; and (6) dealing with changes in a routine work setting. Id. §

416.921(b)(1)-(6); see Bowen v. Yuckert, 482 U.S. 137, 141 (1987). “The sequential evaluation

process may be terminated at step two only when the claimant’s impairment or combination of

impairments would have no more than a minimal impact on his ability to work.” Page v.

Astrue, 484 F.3d 1040, 1043 (8th Cir. 2007) (internal quotation marks omitted).

Third, if the claimant has a severe impairment, then the Commissioner will consider the

medical severity of the impairment. If the impairment meets or equals one of the presumptively

disabling impairments listed in the regulations, then the claimant is considered disabled,

regardless of age, education, and work experience. 20 C.F.R. §§ 416.920(a)(4)(iii), 416.920(d);

see Kelley v. Callahan, 133 F.3d 583, 588 (8th Cir. 1998).

Fourth, if the claimant’s impairment is severe, but it does not meet or equal one of the

presumptively disabling impairments, then the Commissioner will assess the claimant’s RFC to

determine the claimant’s “ability to meet the physical, mental, sensory, and other requirements”

of the claimant’s past relevant work. 20 C.F.R. §§ 416.920(a)(4)(iv), 416.945(a)(4). “RFC is a

medical question defined wholly in terms of the claimant’s physical ability to perform exertional

tasks or, in other words, what the claimant can still do despite his or his physical or mental

limitations.” Lewis v. Barnhart, 353 F.3d 642, 646 (8th Cir. 2003) (internal quotation marks

omitted); see 20 C.F.R. § 416.945(a)(1). The claimant is responsible for providing evidence the

Commissioner will use to make a finding as to the claimant’s RFC, but the Commissioner is

responsible for developing the claimant’s “complete medical history, including arranging for a

consultative examination(s) if necessary, and making every reasonable effort to help [the

claimant] get medical reports from [the claimant’s] own medical sources.” 20 C.F.R. §

416.945(a)(3). The Commissioner also will consider certain non-medical evidence and other

evidence listed in the regulations. See id. If a claimant retains the RFC to perform past

relevant work, then the claimant is not disabled. Id. § 416.920(a)(4)(iv).

Fifth, if the claimant’s RFC as determined in Step Four will not allow the claimant to

perform past relevant work, then the burden shifts to the Commissioner to prove that there is

other work that the claimant can do, given the claimant’s RFC as determined at Step Four, and

his age, education, and work experience. See Bladow v. Apfel, 205 F.3d 356, 358-59 n. 5 (8th

Cir. 2000). The Commissioner must prove not only that the claimant’s RFC will allow the

claimant to make an adjustment to other work, but also that the other work exists in significant

numbers in the national economy. Eichelberger v. Barnhart, 390 F.3d 584, 591 (8th Cir. 2004);

20 C.F.R. § 416.920(a)(4)(v). If the claimant can make an adjustment to other work that exists

in significant numbers in the national economy, then the Commissioner will find the claimant is

not disabled. If the claimant cannot make an adjustment to other work, then the Commissioner

will find that the claimant is disabled. 20 C.F.R. § 416.920(a)(4)(v). At Step Five, even though

the burden of production shifts to the Commissioner, the burden of persuasion to prove disability

remains on the claimant. Stormo v. Barnhart, 377 F.3d 801, 806 (8th Cir. 2004).

The evaluation process for mental impairments is set forth in 20 C.F.R. §§ 404.1520a,

416.920a. The first step requires the Commissioner to “record the pertinent signs, symptoms,

findings, functional limitations, and effects of treatment” in the case record to assist in the

determination of whether a mental impairment exists. See 20 C.F.R. §§ 404.1520a(b)(1),

416.920a(b)(1). If it is determined that a mental impairment exists, the Commissioner must

indicate whether medical findings “especially relevant to the ability to work are present or

absent.” 20 C.F.R. §§ 404.1520a(b)(2), 416.920a(b)(2). The Commissioner must then rate the

degree of functional loss resulting from the impairments. See 20 C.F.R. §§ 404.1520a(b)(3),

416.920a(b)(3). Functional loss is rated on a scale that ranges from no limitation to a level of

severity which is incompatible with the ability to perform work-related activities. See id. Next,

the Commissioner must determine the severity of the impairment based on those ratings. See 20

C.F.R. §§ 404.1520a(c), 416.920a(c). If the impairment is severe, the Commissioner must

determine if it meets or equals a listed mental disorder. See 20 C.F.R. §§ 404.1520a(c)(2),

416.920a(c)(2). This is completed by comparing the presence of medical findings and the rating

of functional loss against the paragraph A and B criteria of the Listing of the appropriate mental

disorders. See id. If there is a severe impairment, but the impairment does not meet or equal

the listings, then the Commissioner must prepare an RFC assessment. See 20 C.F.R. §§

404.1520a(c)(3), 416.920a(c)(3).

IV. Discussion

Patrick argues that the ALJ erred in determining her RFC. She also challenges the

ALJ’s evaluation of medical opinion evidence.

A claimant’s RFC is the most she can do despite her physical or mental limitations.

Masterson v. Barnhart, 363 F.3d 731, 737 (8th Cir. 2004). It is the ALJ’s responsibility to

determine a claimant’s RFC by evaluating all medical and non-medical evidence of record. 20

C.F.R. §§ 404.1545, 404.1546, 416.945, 416.946. Some medical evidence must support the

ALJ’s RFC finding, but there is no requirement that the evidence take the form of a specific

medical opinion from a claimant’s physician. Myers v. Colvin, 721 F.3d 521, 526-27 (8th Cir.

2013); Perks v. Astrue, 687 F.3d 1086, 1092-93 (8th Cir. 2012); Martise v. Astrue, 641 F.3d 909,

927 (8th Cir. 2011). “The determination of a claimant’s RFC during an administrative hearing

is the ALJ’s sole responsibility and is distinct from a medical source’s opinion.” Wallenbrock v.

Saul, No. 4:20-CV-00182-SRC, 2021 WL 1143908, at *6 (E.D. Mo. Mar. 25, 2021) (citing

Kamann v. Colvin, 721 F.3d 945, 950-51 (8th Cir. 2013)).

The ALJ found that Patrick had the RFC to perform a full range of work at all exertional

levels, but with the following limitations resulting from her mental impairments: can tolerate

occasional interaction with co-workers and supervisors, but can perform no tandem tasks or work

in close proximity to co-workers (i.e. no shoulder to shoulder work environment); can perform

work that is done relatively independently with minimal, superficial interaction with the general

public; and should avoid intense or extensive interpersonal and handling complaints or

dissatisfied customers. (Tr. 19.) In making this determination, the ALJ evaluated the medical

opinion evidence.

A “medical opinion” is a statement from a medical source about what an individual can

still do despite her impairments, and includes limitations or restrictions about the ability to

perform physical, mental, sensory, and/or environmental demands of work. 20 C.F.R. §§

404.1513(a)(2), 416.913(a)(2). Under the revised Social Security regulations,1 the agency

“[w]ill 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 [the

claimant’s] medical sources.” 20 C.F.R. §§ 404.1520c(a), 416.920c(b)(2). Instead, the ALJ

must assess the persuasiveness of all medical opinions and prior administrative medical findings2

using a number of factors, including 1) the supportability of the opinion with objective medical

evidence and explanations; 2) the consistency of the opinion with evidence from other medical

and nonmedical sources; 3) the relationship of the provider to the claimant, including the length,

nature and frequency of treatment; 4) the specialization of the provider; and 5) other factors,

including the source’s familiarity with the Social Security guidelines. See 20 C.F.R. §

404.1520c. The ALJ must explain how they considered the factors of supportability and

consistency in their decisions but are not statutorily required to discuss the other factors. 20

C.F.R. § 404.1520c(b)(2).

1. Prior Administrative Medical Findings

Patrick first argues that the ALJ’s RFC determination is erroneous because it conflicted

with a prior administrative finding that limited Patrick to unskilled work. She contends that the

1The new regulations are applicable to Patrick’s claims because she filed her appeal after March

27, 2017. See 20 C.F.R. §§ 404.1520c, 416.920c.

2“Prior administrative medical findings” are findings, other than the ultimate determination on

whether a claimant is disabled, about medical issues made by the consultants at a prior level of

review in the claimant’s current claim based on their review of the evidence. 81 Fed. Reg. at

62,564; 20 C.F.R. § 404.1513(a)(5) (2017).

error had “dire consequences” for Patrick, as she concluded she could return to her past work,

which is a semi-skilled job. (Doc. 18 at 5.)

On May 1, 2020, state agency psychological consultant Keith L. Allen, Ph.D., found

Patrick had moderate limitations in her ability to interact with others and in her ability to adapt or

manage herself. (Tr. 98.) He expressed the opinion that Patrick retained the ability to

understand, recall, and carry out simple to moderately complex instructions and procedures

requiring brief learning periods; concentrate and persist at familiar tasks requiring some

independent judgment and involving minimal variations; interact as needed with supervisors and

peers sufficiently for task completion with limited interpersonal demands in a limited social

setting and involving no significant interaction with the public on more than an occasional basis;

and adapt adequately to situational conditions and changes with reasonable support and structure.

(Tr. 101.) Dr. Allen found Patrick was limited to unskilled work. (Tr. 102.)

On September 9, 2020, state agency psychologist Kim Stalker, Psy.D., found that Patrick

had moderate limitations in her ability to interact with others, but only mild limitations in her

ability to adapt or manage herself. (Tr. 112.) As to her mental RFC, Dr. Stalker expressed the

opinion that Patrick would “function best in a setting where there is little need for direct

supervision or frequent interactions with coworkers or members of the public.” (Tr. 116.)

The ALJ found the prior administrative medical findings “persuasive,” but noted that Dr.

Allen’s opinions were “less persuasive than those of Dr. Stalker because they were based upon a

less complete review of the record.” (Tr. 23.) The ALJ explained that Dr. Stalker had the

benefit of reviewing updated statements regarding Patrick’s activities of daily living when

assessing her ability to adapt or manage herself. Id.

The undersigned finds that the ALJ properly assessed the prior administrative medical

findings in determining Patrick’s RFC. As will be discussed below, the ALJ’s RFC

determination is based on substantial evidence.

Patrick’s argument that the ALJ erred in failing to incorporate Dr. Allen’s adaptive

limitations is based on the faulty assumption that such limitations would result in a finding of

disability at step five. Although the ALJ did find Patrick was capable of returning to her past

work as a transformer assembler—a semi-skilled job—she found in the alternative that Patrick

was capable of performing other jobs existing in significant numbers in the national economy.

(Tr. 24.) The ALJ relied upon the testimony of a vocational expert to find that Patrick could

perform the positions of janitorial worker, kitchen helper, and laundry worker—all of which are

unskilled positions. (Tr. 25.) As such, even if the ALJ had incorporated a limitation to

unskilled work, Patrick would remain capable of performing the other work identified by the

vocational expert.

Thus, any error at step four in the ALJ’s failure to limit Patrick to unskilled work was

harmless. See Brueggemann v. Barnhart, 348 F.3d 689, 695 (8th Cir. 2003) (applying harmless

error analysis and noting the standard is “whether the ALJ would have reached the same decision

denying benefits” even absent the error); Senne v. Apfel, 198 F.3d 1065, 1067 (8th Cir. 1999);

Hewitt v. Colvin, 2015 WL 1286309, at *16 (E.D. Mo. Mar. 20, 2015) (“to the extent the ALJ

committed any error at Step 4 of the sequential analysis, such error was harmless inasmuch as

the ALJ made an alternative finding at Step 5 that [plaintiff] could perform other work in the

national economy”).

Accordingly, Patrick’s first claim lacks merit.

2. RFC Determination

Patrick next argues that the ALJ “failed to consider the cyclic aspects related to Plaintiff’s

severe bipolar disorder where she has episodes of chronic fatigue with alternating periods of

agitation.” (Doc. 18 at 6.) She states that the ALJ restricted her interactions with others, but

erred “in suggesting that [Patrick] has control over when she can ‘tolerate occasional interaction’

or avoid working ‘in close proximity to co-workers.’” Id.

Defendant responds that Patrick’s argument reflects a misunderstanding of the RFC

finding, which describes the employment circumstances under which Patrick is able to work

despite her mental limitations. Defendant argues that the RFC “does not require Plaintiff to

decide when she is able to tolerate interactions with others in the workplace; instead, it limits

such interactions to an occasional basis, to account for her mental limitations.” (Doc. 19 at 13.)

The undersigned agrees, and finds that the ALJ’s RFC is supported by substantial evidence.

In determining Patrick’s RFC, the ALJ first evaluated the consistency of Patrick’s

subjective allegations of limitations. The ALJ summarized Patrick’s testimony regarding her

limitations, noting that she alleged that she became unable to work on October 1, 2017 “due to

anxiety, depression, bipolar disorder, and schizophrenia.” (Tr. 20.) Patrick reported a history

of auditory hallucinations, but indicated she had not experienced hallucinations in the six months

prior to the hearing. Id. She complained of intermittent depression. Id. Patrick reported that

her impairments limit her abilities to lift, walk, bend, kneel, use her hands, and get along with

others. Id.

The ALJ determined that, although Patrick’s medically determinable impairments could

reasonably be expected to cause the alleged symptoms, her statements regarding the intensity,

persistence, and limiting effects of those symptoms were not entirely consistent with the medical

evidence and other evidence in the record. Id. The Court finds that the ALJ appropriately

considered Patrick’s subjective allegations.

The ALJ first summarized the medical evidence regarding Patrick’s mental3 impairments

as follows:

On April 11, 2018, Patrick presented to Peter J. Lamble, M.D., with complaints of anger

and depression. (Tr. 20, 440.) She reported experiencing mood swings, varying between fits of

anger and severe depression. Id. On examination, her speech was fluent and not pressured, her

mood was depressed, she exhibited a labile range of affect, mild psychomotor agitation was

present, her insight was fair, her judgment was good, and no suicidal or homicidal ideation was

present. (Tr. 20, 442.) Dr. Lamble diagnosed Patrick with bipolar depression, and

recommended that she start on a low dosage of Zoloft.4 (Tr. 442.)

On June 26, 2018, Patrick saw Jessica Bell, N.P., at Dr. Lamble’s office, for evaluation

and treatment of her depression/bipolar disorder. (Tr. 21, 437.) Patrick complained of

depressed mood, difficulty concentrating, fatigue, insomnia, and psychomotor agitation. Id.

She reported an onset of “several years ago, gradually worsening since that time.” Id. Patrick

indicated that she had not taken any medications for “several years.” Id. On examination,

Patrick was alert and oriented, her mood was “slightly depressed,” and her affect was appropriate

to mood. Id. Ms. Bell prescribed Zoloft. Id.

On July 23, 2018, Patrick called Ms. Bell’s office requesting a letter to “get her a couple

days off work to deal with” depression. (Tr. 21, 437.) Patrick reported that she did not have

3Patrick does not dispute the ALJ’s finding that she did not have a severe physical impairment.

As such, the discussion herein is limited to Patrick’s mental impairments.

4Zoloft is indicated for the treatment of depression and anxiety. See WebMD,

http://www.webmd.com/drugs (last visited March 27, 2023).

suicidal ideation. Id. Ms. Bell advised Patrick that she could not give her a note without seeing

her. Id.

On July 24, 2018, Patrick presented to Ms. Bell with complaints of depressed mood,

difficulty concentrating, fatigue, feelings of worthlessness/guilt, and hypersomnia. (Tr. 21,

436.) On examination, Patrick was alert and oriented, and her mood was depressed. Id. Ms.

Bell prescribed Vraylar.5 Id.

Patrick presented to Thomas J. Spencer, Psy.D., on March 12, 2020, for a psychological

evaluation. (Tr. 21, 452-54.) Patrick reported that she had seen “premonitions” or “ghosts”

since her early teens. (Tr. 452.) She indicated that she had worked at her last job for eighteen

years. Id. Patrick lost her job in 2018, when she was forced to move in with her mother after

being evicted. Id. She explained that she was unable to drive to work after losing her license

due to a DWI. Id. Patrick complained that she is depressed and anxious, is easily agitated and

angered, is prone to verbal outbursts, and dislikes people. Id. She characterized her mood as

“pretty good” much of the time, but the slightest stressor can leave her depressed or angry. Id.

Patrick was recently prescribed Vraylar by her primary care provider but refuses to take it. Id.

She had taken Zoloft prescribed by her primary care provider in the past, but had been off of it

for about six years. Id. Patrick also reported a history of alcohol abuse, but claimed to have

dramatically slowed her consumption beginning in 2017. (Tr. 453.) She indicated that she

maintains her activities of daily living. Id. On examination, she had no impairment in

grooming or hygiene, her eye contact was fair, her speech was within normal limits, she was

cooperative and alert, her insight and judgment appeared “questionable,” her affect was neutral,

5Vraylar is an antipsychotic drug indicated for the treatment of mood disorders such as bipolar

disorder and bipolar depression. See WebMD, http://www.webmd.com/drugs (last visited

March 27, 2023).

she described her mood as “plain, just not happy but not really sad,” she denied thoughts of

suicide or homicide, she denied hallucinations, her flow of thought was intact, and her

intelligence appeared to be average. Id. Dr. Spencer diagnosed Patrick with bipolar disorder

and alcohol use disorder. Id.

Patrick underwent a consultative examination performed by Vanessa Halvorsen, D.O., on

July 11, 2020. (Tr. 21, 457-60.) Patrick complained of depression, anxiety, bipolar disorder,

and schizophrenia. (Tr. 457.) She reported that she drinks alcohol weekly, and her daily

activities consist of watching television, cleaning, and using her computer. (Tr. 21, 457.) On

examination, Patrick had a normal affect and picked up on social cues. (Tr. 21, 459.) Dr.

Halvorsen noted that Patrick “does like to talk and talks out of turn, but nothing that would bring

into light that she had any kind of psychiatric problems.” Id. She diagnosed Patrick with a

“history of psychiatric issues,” and decreased visual acuity. (Tr. 21, 460.)

The ALJ found that Patrick’s allegation of a disabling mental impairment was not

consistent with or supported by the medical evidence of record. (Tr. 21.) The undersigned

agrees. First, as Patrick acknowledges in her brief, “the evidence of record is sparse.” (Doc. 18

at 7.) Although she alleged a disability onset date of October 1, 2017, she did not seek

treatment for her mental impairments with her primary care provider until April 2018. She saw

her primary care provider for follow-up on only two additional occasions during the relevant

period. The ALJ properly considered Patrick’s infrequent treatment in assessing her subjective

allegations. See Kelley v. Barnhart, 372 F.3d 958, 961 (8th Cir. 2004) (“Infrequent treatment is

also a basis for discounting a claimant’s subjective complaints.”).

The ALJ also noted that the findings on examination have not been commensurate with

the degree of limitation Patrick alleges. (Tr. 21.) She pointed out that the only abnormality

consistently noted on examination was a depressed mood. Despite Patrick’s allegations of

experiencing hallucinations or “premonitions,” the record documents no such findings. An ALJ

may consider the lack of objective medical evidence supporting a plaintiff’s subjective

complaints as one factor in assessing the consistency of the complaints. Forte v. Barnhart, 377

F.3d 892, 895 (8th Cir. 2004).

The ALJ next noted that Patrick stopped working for reasons other than her alleged

disability. (Tr. 22.) Specifically, she testified that she left her job because she moved in with

her mother after being evicted, and she did not have transportation to work from her mother’s

home. (Tr. 54-55.) Leaving work for reasons unrelated to an alleged disabling impairment

weighs against a finding of disability. Medihaug v. Astrue, 578 F.3d 805, 816–17 (8th Cir.

2009); Browning v. Sullivan, 958 F.2d 817, 821 (8th Cir. 1992). The ALJ also pointed out that

Patrick worked at her last job for eighteen years, and there was no indication in the record that

her mental impairments worsened significantly since she stopped working. (Tr. 22.)

Additionally, the ALJ discussed Patrick’s statements regarding her daily activities and

found they were inconsistent with her subjective allegations. For example, Patrick testified that

she provided care for her mother until her death in November 2019 (Tr. 55), is able to maintain

her activities of daily living (Tr. 453), and her typical daily activity consists of watching

television, cleaning, and using her computer (Tr. 457). (Tr. 17.) Though a person’s ability to

engage in chores or hobbies does not demonstrate an ability to work, Singh v. Apfel, 222 F.3d

448, 453 (8th Cir. 2000), it is proper for an ALJ to consider a claimant’s activities for purposes

of assessing the credibility of her claims of incapacity. See Roberson v. Astrue, 481 F.3d 1020,

1025 (8th Cir. 2007) (affirming the ALJ’s analysis of claimant’s subjective statement of

symptoms where the claimant took care of her child, drove, fixed simple meals, performed

housework, shopped, and handled money). The ALJ properly found Patrick’s daily activities

were inconsistent with a total inability to work.

The ALJ next considered the medical opinion evidence. As previously discussed, the

ALJ found the opinion of state agency psychologist Dr. Stalker persuasive. (Tr. 23.) Dr.

Stalker found that Patrick had moderate limitations in her ability to interact with others, and

would “function best in a setting where there is little need for direct supervision or frequent

interactions with coworkers or members of the public.” (Tr. 116.) Dr. Stalker’s opinion was

based on a summary of the medical evidence and Patrick’s reported daily activities. (Tr. 113.)

Dr. Stalker remarked that the medical record does not reveal a diagnosis of schizophrenia as

alleged by Patrick, and that she appears “relatively functional as she does chores, prepares meals,

and shops in stores.” Id. She also noted that Patrick reported living alone, spending her days

going through her late mother’s belongings, playing computer games, watching movies, and

going fishing once or twice per year. Id.

Dr. Spencer expressed the opinion that Patrick had mild impairment in her ability to

learn, recall, and use information and to consistently stay on task; and moderate impairment in

her ability to relate to and work with others on a consistent basis. (Tr. 453.) The ALJ found

the opinion of Dr. Spencer “generally persuasive,” as it was based upon a contemporaneous

mental status examination. (Tr. 23.) The ALJ noted that Dr. Spencer’s opinion was supported

by a detailed explanation citing her findings on examination and was consistent with the record

as a whole, including the opinion of Dr. Stalker. Id. The ALJ remarked that Dr. Stalker’s

opinion was more persuasive due to the fact Dr. Stalker explained Patrick’s limitations in

specific vocationally relevant terms and cited Patrick’s activities of daily living. Id.

The undersigned finds that the ALJ’s RFC determination is supported by substantial

evidence on the record as a whole. In her discretion, the ALJ made an RFC finding that did not

precisely reflect any of the medical opinions of record. See Martise, 641 F.3d at 927 (ALJ is not

required to rely entirely on one particular physician’s opinion or choose between opinions). She

considered Patrick’s complaints of difficulty getting along with others in imposing significant

social limitations. The ALJ’s RFC is supported by the opinions of Drs. Stalker and Spencer, as

well as the examination findings of Patrick’s primary care provider. It is also consistent with

Patrick’s ability to work with her mental impairments at the same position for eighteen years and

engage in significant daily activities. Patrick fails to demonstrate the presence of greater

limitations than those found by the ALJ.

Accordingly, Judgment will be entered separately in favor of Defendant in accordance

with this Memorandum.

/s/ Abbie Crites-Leoni

ABBIE CRITES-LEONI

UNITED STATES MAGISTRATE JUDGE

Dated this 28th day of March, 2023.