# Moore v. Social Security Administration Commissioner

> District Court, W.D. Arkansas · July 28, 2022

URL: https://www.frixlaw.com/law-library/cases/10632380

## Case

- **Court:** District Court, W.D. Arkansas
- **Decided:** July 28, 2022
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

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## How later opinions describe it (automated extraction)

- applying the presumption of regularity to conclude the ALJ discharged his official duties as described
- noting Polaski factors must be considered before discounting subjective complaints

## Opinion text

IN THE UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF ARKANSAS
FORT SMITH DIVISION

MEGAN E. MOORE PLAINTIFF
v. Civil No. 2:21-cv-02041-PKH-MEF
KILOLO KIJAKAZI, Acting Commissioner,1
Social Security Administration DEFENDANT

MAGISTRATE JUDGE’S REPORT AND RECOMMENDATION
Plaintiff, Megan E. Moore, brings this action under 42 U.S.C. § 405(g), seeking judicial
review of a decision of the Commissioner of Social Security Administration (the “Commissioner”)
denying her claim for a period of disability and disability insurance benefits (“DIB”) under Title
II of the Social Security Act (hereinafter “the Act”), 42 U.S.C. § 423(d)(1)(A). In this judicial
review, the Court must determine whether there is substantial evidence in the administrative record
to support the Commissioner’s decision. See 42 U.S.C. § 405(g).
I. Procedural Background
Plaintiff filed her application for benefits on November 20, 2018, alleging disability
beginning August 25, 2015, due to post-traumatic stress disorder (“PTSD”), migraines,
autoimmune disorder, heart problems, pancreas problems, hypotension, anxiety, and depression.
(ECF No. 14-2, p. 31; ECF No. 14-9, p. 6). Plaintiff was 25 years old on the alleged disability
date, has a limited education, and is unable to perform any past relevant work (“PRW”). (ECF
No. 14-2, pp. 42-43). The Commissioner denied her application initially and on reconsideration.
Id. at 31. At Plaintiff’s request, an Administrative Law Judge (“ALJ”) held an administrative

1 Kilolo Kijakazi became Acting Commissioner of the Social Security Administration on July 9, 2021. Pursuant
to Rule 25(d) of the Federal Rules of Civil Procedure, Kilolo Kijakazi should be substituted as the Defendant in this
suit. No further action needs to be taken to continue this suit by reason of the last sentence of section 205(g) of the
Social Security Act, 42 U.S.C. § 405(g).
hearing on July 13, 2020, via telephone due to the extraordinary circumstance presented by the
COVID-19 pandemic. (ECF No. 14-5, pp. 28-83). Plaintiff was present and represented by
counsel. Id. at 28, 30. At the hearing, Plaintiff amended her alleged onset date to December 7,
2017. Id. at 33-35.

In a decision issued on August 6, 2020, the ALJ concluded that Plaintiff’s undifferentiated
connective tissue disease, migraine headaches, depression, anxiety, PTSD, syncope, chronic pain,
and fatigue were severe, but concluded they did not meet or medically equal one of the listed
impairments in Appendix 1, Subpart P, Regulation No. 4. (ECF No. 14-2, pp. 31-44). She found
Plaintiff capable of performing “sedentary work as defined in 20 C.F.R. § 404.1567(a) except due
to syncope no hazards to avoid such as ladders, ropes, scaffolds, moving mechanical parts,
unprotected heights, deep water and open flames; due to migraines no bright sunshine, no
concentrated exposure to dust, fumes or other pulmonary irritants and office level noise; frequent
bilateral handle and finger; simple routine repetitive tasks with supervision that is simple, direct
and concrete; social interaction that is incidental to work performed.” Id. at 36-42. With the

assistance of a vocational expert (“VE”), the ALJ concluded that Plaintiff could perform work as
a document preparer, printed circuit board inspector, and copy examiner. Id. at 43-44. Plaintiff
was found not to be under a disability from her alleged onset date through the date of the ALJ’s
decision. Id. at 44.
The Appeals Council denied Plaintiff’s request for review on January 7, 2021. (ECF No.
14-2, pp. 2-6). Plaintiff then filed this action. (ECF No. 1). This matter is before the undersigned
for report and recommendation. Both parties have filed appeal briefs (ECF Nos. 17, 18), and the
case is ready for decision.
II. Summary of the Relevant Evidence
The undersigned has conducted a thorough review of the entire record in this case. Because
Plaintiff’s appeal concerns whether her migraine headaches, rheumatoid arthritis, lupus, and
psychological impairments prevent her from sedentary work with additional limitations, the

undersigned will only recount the evidence relevant to that claim. In addition, the undersigned
notes the relevant period in this case is December 7, 2017, the alleged onset date, to December 31,
2020, the date last insured.
The relevant medical evidence contains generally mild exam findings with conservative
and effective treatment modalities for Plaintiff’s symptoms. In November 2017, Plaintiff
demonstrated a normal range of motion of the back and musculoskeletal system. (ECF No. 14-11,
p. 138). Plaintiff was cooperative and her neurological exam showed no neurological deficits. Id.
at 139. A psychiatric exam showed good judgment, normal mood, and normal affect. Id. at 16-
19. Plaintiff reported PTSD and palpitations, and the treatment provider referred her to psychiatry
and gave her a 30-day heart monitor. Id.

In December 2017, Plaintiff sought treatment for lower back, hip, leg, and knee pain. (ECF
No. 14-10, pp. 87-90). She reported that a recent lumbar epidural steroid injection worked well
and allowed her to work more. She explained that the positive effects were wearing off, she still
experienced knee pain, and she had a fall last month. On examination, Plaintiff exhibited no acute
distress. She was orientated to person, place, and time with normal recent and remote memory.
Id. Treatment providers continued Plaintiff on her medication regimen of pain medication to treat
bilateral sciatica, lumbosacral radiculopathy, arthralgia of the knees, and chronic pain syndrome.
Id. at 78-79.
In January 2018, Plaintiff demonstrated an alert and normal affect as well as orientation to
time, place, and person. (ECF No. 14-10, pp. 122-24). The treatment provider noted that Plaintiff
appeared comfortable, well-nourished, and well-developed. She exhibited a normal gait with
normal motor strength and tone. On a musculoskeletal examination, Plaintiff exhibited no joint

tenderness, swelling, or erythema. Id.
Plaintiff continued treatment for reportedly worsening anxiety through February and
March 2018. (ECF No. 14-11, pp. 161-164). The examinations revealed gait, strength, tone, and
station all within normal limits. Plaintiff was well groomed; exhibited good eye contact; had no
problems with speech; and showed linear, goal directed thought processes and content. She
exhibited cognition, memory, attention, concentration, and fund of knowledge all within normal
limits. She appeared euthymic and was assessed with a good prognosis. Plaintiff’s medications
were adjusted. Id.
In April 2018, Plaintiff demonstrated a full range of motion in all extremities without
edema. (ECF No. 14-10, pp. 150). She had normal strength, intact senses, and an appropriate

mood. Id. She exhibited normal muscle strength and a normal gait. (ECF No. 14-11, pp. 158-
59). She was fully oriented, made good eye contact, and exhibited a normal mood and affect.
Plaintiff also demonstrated normal thought process, cognition, memory, and concentration. Id.
Plaintiff continued treatment for complaints of low back pain and anxiety in May 2018.
(ECF No. 14-13, pp. 33-39). Examinations showed generally normal findings, including gait,
muscle strength, and musculoskeletal range of motion all within normal limits. (ECF No. 14-11,
pp. 156-57). Plaintiff exhibited some anxiety but demonstrated full orientation, good eye contact,
normal thought process, normal cognition, normal memory, fair insight and judgment, normal
concentration, average knowledge, and no speech problems. Id.
In June and July 2018, Plaintiff continued medication management for her symptoms. She
demonstrated a full range of motion in all extremities, normal motor strength, and an intact sensory
exam. (ECF No. 14-10, pp. 147). She displayed an appropriate mood, and physical and psychiatric
examinations were normal. (ECF No. 14-11, pp. 86; ECF No. 14-14, pp. 12). Examinations were

generally unremarkable apart from some decreased sensation, and Plaintiff demonstrated a normal
gait, normal muscle strength, and unremarkable neurological findings. The treatment provider
noted no edema in her extremities and observed that she was pleasant and in no distress. (ECF
No. 14-10, pp. 144, 228-32; ECF No. 14-11, p. 83; ECF No. 14-15, p. 22).
Plaintiff continued treatment with her rheumatologist throughout September 2018. (ECF
No. 14-11, pp. 47-51, 172-78). Her chief complaint was total body pain. The treatment provider
noted “mild diffuse paired tender points of fibromyalgia mild trapezius, medial scapulae, second
costochondral space, anterior cervical area, occipital cervical junction, lateral elbows, greater
trochanters, and medial knees.” Plaintiff also reported mild pain with cervical spine motion, and
the treatment provider noted minimal diffuse swelling of the left hand and mild tenderness at the

hands to metacarpophalangeal squeeze. Id.
In October, Plaintiff reported joint pain that disrupted her sleep, and the treatment provider
assessed her for joint pain and positive ANA. (ECF No. 14-11, pp. 66-69). Additional physical
exams showed mild pain with motion of the cervical spine, some diffuse swelling of the left hand,
and mild rheumatoid arthritis changes in both hands. Id. at 49. Plaintiff’s other systems were
unremarkable, and her extremities were described as normal with no edema. Plaintiff was fully
oriented with an appropriate mood and affect during the mental status exams. Id.
Thoracic and lumbar spine x-rays showed no significant abnormalities in November 2018.
(ECF No. 14-11, p. 229). Plaintiff’s physical and mental exam findings were again unremarkable
or normal. She exhibited no musculoskeletal tenderness, swelling, effusion, or limitation of range
of motion. Id. at 194.
Plaintiff continued treatment for reportedly increasing anxiety in December 2018. (ECF
No. 14-11, p. 153). Her physical exam was unremarkable, and the mental status exam findings

were also within normal limits. The treatment provider noted that Plaintiff’s reported mood as
“stressed” was incongruent with her euthymic affect. Id.
In January 2019, Plaintiff continued treatment for pain in the hands, feet, and upper neck.
(ECF No. 14-11, p. 200). She reported that medications helped, and the physical exam showed
unremarkable findings, including no tenderness, swelling, or limited range of motion. Id. Plaintiff
sought treatment for anemia in February 2019. Id. at 236. The physical exam showed some right
wrist weakness, but normal motor strength and tone, gait, station, ambulation, and movement of
all extremities. Plaintiff’s mental status was also unremarkable. Id. at 239.
Also in February 2019, Plaintiff submitted a function report recounting her daily activities
and the impact of her impairments on her daily life. (ECF No. 14-9, pp. 24-31). She stated that

her ability to work was limited by inability to stand for very long and migraines that kept her down
at least twice a week. She reported that she took medication and did not experience any side effects
from them. She stated that she needed to wear a back brace when going out and that she had been
prescribed one in 2017. Stress caused a migraine and tension in her neck, and she could not handle
changes in routine at all. Id. She could follow written instructions, though she had problems
remembering spoken instructions. Id. Her hobbies included watching television and spending
time with her children. She was able to drive and go out independently. Due to problems standing
and lifting, Plaintiff stated that she did not do any house or yard work. Due to inability to stand,
bend, and lift pans, she could not prepare her own meals. She explained that she could dress and
bathe though it caused pain and she needed reminders from her husband to shower. She stated that
she did not do her hair as she could not hold her arms up long enough to complete it. She also
needed help shaving her legs. While she reported that she only slept for about three hours at a
time at night due to pain, she also stated that she got her five children ready for school and on the

bus every morning. Id.
Plaintiff also submitted a pain questionnaire detailing her limitations. (ECF No. 14-9, pp.
32-33). She reported that she suffered from unusual fatigue since 2015 and that she required a
three-hour nap at least twice daily. She described pain in her lower back, hands, and feet as well
as migraines, depression, and PTSD. Walking, carrying, and sitting for too long aggravated the
pain, while massages alleviated the pain only sometimes. She reiterated that she did not experience
any side effects from her medications. She could stand, walk, or sit for about 10 minutes before
the pain occurred. Id.
Dr. Joshua Clark also submitted a headache questionnaire in February 2019 stating that
Plaintiff’s migraines occurred more often than once a week, with each migraine lasting between

three hours and three days. (ECF No. 14-11, pp. 233-34). Dr. Clark’s checkmark form noted
Plaintiff’s experience of aura, photophobia, phonophobia, throbbing, and pulsating. Plaintiff
required an emergency room visit in the past year and her response to medications was poor. Dr.
Clark concluded that migraines would interfere with Plaintiff’s ability to work, and he opined that
she would miss more than one day of work per week. Id.
In April 2019, Plaintiff continued treatment for rheumatoid arthritis. (ECF No. 14-12, p.
14). Protection from the sun relieved her pain somewhat, but her ankles reportedly felt weak such
that she wore boots for added support. The physical exam revealed mild arthritic changes in the
hands but otherwise normal findings. Plaintiff’s psychiatric exam was also normal. Plaintiff
reported pain all over her body and particularly in her ankles, knees, and hands the following
month. (ECF No. 14-13, p. 251). The physical exam revealed mild arthritic changes in her hands,
but her knees and ankles showed no tenderness, swelling, effusion, or limitation to range of motion.
She had a normal psychiatric exam. Id.

Also in May 2019, Plaintiff sought treatment for a headache and the treatment provider
diagnosed it as a migraine without aura and not intractable. (ECF No. 14-13, p. 14). Upon
examination, Plaintiff demonstrated a normal range of motion of the neck, normal muscle tone,
and a normal psychiatric exam. Id.
A knee injury after falling out of a folding chair in June 2019 caused Plaintiff a limp, a
reduced range of motion of the left knee, and a bruised thigh. (ECF No. 14-13, pp. 10-14). She
exhibited some decreased range of motion and ecchymosis in the left knee, but unremarkable
findings in all other systems, including psychiatric, were noted. Id. at 13.
Plaintiff reported in July 2019 that her lupus and rheumatoid arthritis flare ups were
debilitating and that her headaches were worsening and becoming more frequent. (ECF No. 14-9,

p. 38). The only medication side-effects reported were some drowsiness and constipation.
Plaintiff stated that she could not walk more than 30 feet without getting out of breath. Id.
She also reported chronic anemia beginning in July 2019. (ECF No. 14-9, pp. 58-64). She
stated that she required vitamin B12 injections weekly as well as iron and vitamin C supplements.
Plaintiff reported additional side effects of medication, including bruising, nausea, drowsiness,
trouble sleeping, weakness, weight gain, and upset stomach. Plaintiff now stated she could not
walk more than 100 feet without getting out of breath, had difficulty washing her hair, and that her
doctor completed paperwork for handicap tags for her vehicle. Id. Also in July, state agency
medical consultant Kristin Jarrard, M.D., assessed Plaintiff with a light RFC. (ECF No. 14-6, pp.
32-33).
In August 2019, Plaintiff submitted an updated function report stating that her ability to
work was limited by lupus, the chemotherapy she was on to treat it, inability to spend time in the

sun, and constant swelling and stiffness in her joints. (ECF No. 14-9, pp. 49-56). Plaintiff’s
activities now included preparing her children for school, taking them to school, having lunch,
picking up her children from school, preparing dinner for herself and the children, helping them
with homework, and bathing them. The rest of her time was reportedly spent in bed. If pain
prevented her from getting out of bed, her parents would help care for the children. Id. She no
longer reported difficulty bathing, but she stated that swelling in her hands made buttoning or
snapping clothing almost impossible. Id. She also reported that she did laundry, albeit with some
back and leg pain. She could prepare her own simple meals for herself and her family daily. She
needed help moving clothes from the washer to the dryer and sweeping or mopping the house, but
she could complete two loads of laundry per day and cleaned the house all week. She could go

out daily to transport her children to and from school, and she could go out more often in the
evenings because the sun would not affect her lupus then. Id.
Plaintiff further stated that she could still drive independently. (ECF No. 14-9, pp. 49-56).
She shopped in stores independently twice a month, though a store employee helped load her
groceries into the vehicle. She enjoyed hobbies of reading, watching television, helping her
children with homework daily, and watching them play sports about twice a year. Plaintiff
explained that she could not do almost any physical activity for more than five minutes. In
addition, she could not use her hands at all when they were inflamed, she was slowly losing her
vision, and her memory and concentration were limited by feeling as if she was in a fog. Plaintiff
stated that she used a back brace daily. Id.
In September 2019, Plaintiff sought treatment for a headache, and her medications were
reconciled. (ECF No. 14-14, p. 97). The physical exam and mental status exams were

unremarkable. Dr. Clark also submitted another migraine headache form in September 2019,
asserting that Plaintiff experienced fewer than three migraines per week, each lasting two to four
days, that her response to medication was fair, and she would miss less than one day per week.
(ECF No. 14-14, pp. 110-111). State agency medical consultant Dan Gardner, M.D., viewed the
record upon reconsideration and affirmed Dr. Jarrard’s finding of a light RFC in September 2019.
(ECF No. 14-6, pp. 48-49).
During her follow-up appointment in October 2019, the treatment provider noted Plaintiff’s
history of headaches, radiculopathy, and undifferentiated connective tissue disease. (ECF No. 14-
14, p. 178). The physical exam revealed normal findings. Id. Plaintiff returned for treatment for
a headache in December, and her medications were reconciled. (ECF No. 14-14, p. 158). The

physical and mental status exams were unremarkable. Id.
Imaging results of Plaintiff’s cervical and lumbar spine again demonstrated unremarkable
results and no significant abnormalities in January 2020. (ECF No. 14-14, p. 186; ECF No. 14-
15, p. 9-11, 46). Plaintiff also established care for chronic pain with Arkansas Spine and Pain.
She explained that her pain averaged at 7/10, was worsened by movement and increased activity,
but was relieved by medication. Upon examination, Plaintiff exhibited tenderness to the cervical
and lumbar spine with some reduced range of motion. She also had a positive Patrick’s test in the
hips and sacroiliac joint area. (ECF No. 14-14, p. 186; ECF No. 14-15, p. 9-11, 46).
Physical and mental status exams were unchanged as Plaintiff continued treatment for
chronic pain in February 2020. (ECF No. 14-15, p. 71). It was noted that a lumbar nerve block
gave her 100% relief from headaches for more than a month. Plaintiff also reported that the
occipital nerve block instantly relieved her headache 100%. Id. at 73. Plaintiff continued with

medication management through April 2020. Id. at 55.
Finally, Dr. Joshua Clark submitted a checkbox medical source statement in July 2020,
listing Plaintiff’s diagnoses of chronic migraines, chronic anemia, IBS, depression, anxiety, and
PTSD. (ECF No. 14-15, pp. 126-127). Dr. Clark stated that his treatment relationship with
Plaintiff began prior to 2016. He opined that Plaintiff could frequently lift and carry five pounds,
but only occasionally lift 10 lbs. Plaintiff could never lift or carry more than 10 lbs. Dr. Clark
opined that Plaintiff could never use her hands for any repetitive actions, except for right hand
simple grasping. Plaintiff could use her right foot for repetitive movements but not her left foot.
She could occasionally bend, squat, reach above head, and crouch, but never crawl, climb, stoop,
or kneel. She could occasionally tolerate exposure to unprotected heights and moving machinery,

but never tolerate exposure to marked temperature changes, dust, fumes, and gases, or noise. Also,
Dr. Clark believed that side-effects from Plaintiff’s medication may impact her capacity for work.
Id.
It was Dr. Clark’s opinion that Plaintiff’s symptoms and impairments would frequently
interfere with her attention and concentration. (ECF No. 14-15, pp. 126-127). Plaintiff would
miss more than four days of work per month; need to elevate her feet during the workday; need a
sit, stand, walk option; and need to recline or lie down during the workday more than allowable
by typical breaks. Dr. Clark also noted that Plaintiff could frequently drive automotive equipment
as part of work and that Plaintiff did not need an assistive device to stand or walk. Id.
III. Applicable Law
This Court’s role is to determine whether substantial evidence supports the
Commissioner’s findings. Vossen v. Astrue, 612 F.3d 1011, 1015 (8th Cir. 2010). Substantial
evidence is less than a preponderance, but it is enough that a reasonable mind would find it

adequate to support the Commissioner’s decision. Biestek v. Berryhill, 139 S.Ct. 1148, 1154
(2019). We must affirm the ALJ’s decision if the record contains substantial evidence to support
it. Blackburn v. Colvin, 761 F.3d 853, 858 (8th Cir. 2014). If there is substantial evidence in the
record that supports the Commissioner’s decision, the Court may not reverse it simply because
substantial evidence exists in the record that would have supported a contrary outcome, or because
the Court would have decided the case differently. Miller v. Colvin, 784 F.3d 472, 477 (8th Cir.
2015). In other words, if after reviewing the record it is possible to draw two inconsistent positions
from the evidence and one of those positions represents the findings of the ALJ, we must affirm
the ALJ’s decision. Id.
A claimant for Social Security disability benefits has the burden of proving her disability

by establishing a physical or mental disability that has lasted at least one year and that prevents
her from engaging in any substantial gainful activity. Pearsall v. Massanari, 274 F.3d 1211, 1217
(8th Cir. 2001); see also 42 U.S.C. § 423(d)(1)(A). The Act defines “physical or mental
impairment” as “an impairment that results from anatomical, physiological, or psychological
abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic
techniques.” 42 U.S.C. § 423(d)(3). A plaintiff must show that her disability, not simply her
impairment, has lasted for at least twelve consecutive months.
The Commissioner’s regulations require her to apply a five-step sequential evaluation
process to each claim for disability benefits: (1) whether the claimant has engaged in substantial
gainful activity since filing her claim; (2) whether the claimant has a severe physical and/or mental
impairment or combination of impairments; (3) whether the impairment(s) meet or equal an
impairment in the listings; (4) whether the impairment(s) prevent the claimant from doing past
relevant work; and, (5) whether the claimant is able to perform other work in the national economy

given her age, education, and experience. 20 C.F.R. § 404.1520(a)(4). The fact finder only
considers a plaintiff’s age, education, and work experience in the light of her residual functional
capacity if the final stage of the analysis is reached. 20 C.F.R. § 404.1520(a)(4)(v).
IV. Discussion
Plaintiff raises one issue on appeal: whether substantial evidence supports the ALJ’s
finding that Plaintiff’s statements concerning the effects of her disabling impairments were
inconsistent with the medical and other evidence in the record. After thoroughly reviewing the
record, the undersigned finds the ALJ’s finding supported by substantial evidence.
As her sole issue, Plaintiff contends the ALJ’s finding regarding Plaintiff’s subjective
complaints was erroneous. (ECF No. 17, pp. 5-14). Plaintiff asserts that the medical evidence is

consistent with her subjective statements despite the ALJ’s finding to the contrary. Plaintiff then
summarizes the medical evidence in the record with little analysis. She concludes by arguing that
the burden shifted to the ALJ to prove Plaintiff could perform other work and that the ALJ failed
to meet that burden. Id.
Although the burden of production shifts to the Commissioner at step five of the sequential
evaluation process, the ultimate burden of persuasion remains with the claimant to prove disability
and demonstrate her RFC. Charles v. Barnhart, 375 F.3d 777, 782 n.5 (8th Cir. 2004); see Ingram
v. Chater, 107 F.3d 598, 601 (8th Cir. 1997). RFC is the most a person can do despite that person’s
limitations. 20 C.F.R. § 404.1545. A disability claimant has the burden of establishing her RFC.
Vossen, 612 F. 3d at 1016. “The ALJ determines a claimant’s RFC based on all relevant evidence
in the record, including medical records, observations of treating physicians and others, and the
claimant’s own descriptions of her limitations.” Jones v. Astrue, 619 F.3d 963, 971 (8th Cir. 2010);
Davidson v. Astrue, 578 F.3d 838, 844 (8th Cir. 2009). Limitations resulting from symptoms such

as pain are also factored into the assessment. 20 C.F.R. § 404.1545(a)(3). The Eighth Circuit
Court of Appeals has held that a “claimant’s residual functional capacity is a medical question.”
Miller v. Colvin, 784 F.3d 472, 479 (8th Cir. 2015) (citing Lauer v. Apfel, 245 F.3d 700, 704 (8th
Cir. 2001)). Therefore, an ALJ’s determination concerning a claimant’s RFC must be supported
by medical evidence that addresses the claimant’s ability to function in the workplace. Perks v.
Astrue, 687 F.3d 1086, 1092 (8th Cir. 2012).
Part of the RFC determination includes consideration of a claimant’s subjective statements
regarding the intensity, persistence, and limiting effects of the alleged impairments. An ALJ may
discount subjective complaints of physical and mental health problems that are inconsistent with
medical reports, daily activities, and other such evidence. Gwathney v. Chater, 104 F.3d 1043,

1045 (8th Cir. 1997). Using the Polaski factors, “[s]ubjective complaints may be discounted if
there are inconsistencies in the evidence as a whole.” Casey v. Astrue, 503 F.3d 687, 695 (8th Cir.
2007); Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984); see also Lowe v. Apfel, 226 F.3d
969, 972 (8th Cir. 2000) (noting Polaski factors must be considered before discounting subjective
complaints). In addition to the claimant’s prior work record, the Polaski factors include: (1) the
claimant’s daily activities; (2) the duration, frequency, and intensity of the pain; (3) precipitating
and aggravating factors; (4) dosage, effectiveness, and side effects of medication; and (5)
functional restrictions. Polaski, 739 F.2d at 1322; see also 20 C.F.R. § 404.1529. While an ALJ
must consider these matters and give good reasons for discrediting a claimant’s subjective
complaints, she need not explicitly discuss each of these factors in depth. See Ford v. Astrue, 518
F.3d 979, 982 (8th Cir. 2008); Schultz v. Astrue, 479 F.3d 979, 983 (8th Cir. 1997). In addition,
when an ALJ states that she discharged her official duties as stated in her decision, we presume
she has done so. See, e.g., Willburn v. Astrue, 626 F.3d 999, 1003-04 (8th Cir. 2010) (applying

the presumption of regularity to conclude the ALJ discharged his official duties as described).
In her decision, the ALJ explicitly stated that she considered all symptoms and the extent
to which those symptoms could reasonably be accepted as consistent with objective medical
evidence and other evidence. (ECF No. 14-2, p. 36). She further stated she “considered the
claimant’s subjective complaints of pain, the objective medical evidence, and any evidence
relating to the claimant’s daily activities; the duration, frequency, and intensity of the claimant’s
pain; the dosage and effectiveness of medication; precipitating and aggravating factors; and
functional restrictions. (SSR 16-3p & 20 C.F.R. 416.920c).” Id. at 42.
The ALJ referenced the medical evidence in the record showing treatment for chronic pain
syndrome with effective medication management and injection therapy. (ECF No. 14-2, p. 42).

The ALJ specifically referenced the cervical x-ray showing minimum degeneration at C4/5 and
C5/6 while the rest of Plaintiff’s objective imaging was consistently unremarkable or within
normal limits. The ALJ acknowledged Plaintiff’s diagnoses of undifferentiated connective tissue
disease and positive ANA, as well as continuing treatment for headaches and migraines. Noting
Plaintiff’s reports to her treatment providers that she was doing well in October 2019, the ALJ
considered that Plaintiff’s annual physical exam showed no abnormal findings. Plaintiff’s
symptoms were managed effectively by medication, including injections and an occipital nerve
block.
The ALJ also stated that she considered Plaintiff’s description of her daily activities. (ECF
No. 14-2, p. 42). Plaintiff stated in her function reports that she could not do almost any physical
activity for more than five minutes, and the ALJ noted that Plaintiff described daily activities that
were fairly limited despite relatively weak medical and other evidence supporting such limitations.

A review of the record indicates that Plaintiff’s daily activities even improved and expanded in the
six-month period between her two function reports. She took on the care of her five children,
including transporting them to and from school, helping them with their homework daily,
preparing all their daily meals, bathing them, and attending their sporting events occasionally.
Plaintiff could complete her personal care despite lingering pain, complete two loads of laundry
daily with some help, and clean the house all week. Though she needed help loading her groceries
into her vehicle, she could drive independently and shopped in stores twice a month.
The opinions from state agency medical consultants and treating physicians were also
considered by the ALJ. (ECF No. 14-2, p. 42). She found unpersuasive the opinions of the treating
physician as they were inconsistent with the treatment record. While the ALJ found persuasive

the state agency medical consultants’ opinion that Plaintiff was capable of light, unskilled work,
she stated that she considered Plaintiff’s hearing testimony and additional medical evidence to find
further accommodations for Plaintiff. Id.
The ALJ, having reviewed this evidence, found that Plaintiff had severe impairments of
undifferentiated connective tissue disease, migraine headaches, depression, anxiety, posttraumatic
stress disorder, syncope, chronic pain, and fatigue. (ECF No. 14-2, pp. 31-44). The ALJ noted
that Plaintiff also had non-severe impairments of “minimal degenerative disc disease of the
cervical spine, chest pain with normal cardiac workup, left foot toe fracture, anemia (resolved),
obstructive sleep apnea, and back pain with normal findings on lumbar and thoracic MRIs.” Id. at
34.
In determining RFC, the ALJ found Plaintiff capable of “sedentary work as defined in 20
C.F.R. § 404.1567(a) except due to syncope no hazards to avoid such as ladders, ropes, scaffolds,

moving mechanical parts, unprotected heights, deep water and open flames; due to migraines no
bright sunshine, no concentrated exposure to dust, fumes or other pulmonary irritants and office
level noise; frequent bilateral handle and finger; simple routine repetitive tasks with supervision
that is simple, direct and concrete; social interaction that is incidental to work performed.” (ECF
No. 14-2, p. 36). The ALJ concluded that Plaintiff’s limitations were accommodated by this RFC
of sedentary work with additional environmental and reaching restrictions. Id.
The gist of Plaintiff’s argument appears to be a disagreement with the ALJ’s ultimate
conclusion that Plaintiff is not disabled. (ECF No. 17, pp. 5-14). Plaintiff, however, offers little
to support this argument. While Plaintiff alludes to her subjective statements concerning the
effects of her impairments, she does not assert what specific statements the ALJ should have found

consistent with the medical evidence. Plaintiff names the severe impairments found by the ALJ,
but she does not point to specific medical evidence that bolsters her subjective statements such
that the ALJ erred in her conclusion. While she includes a reference to opinion evidence from
treating physicians, Plaintiff does not state what aspects of those opinions support her argument.
She does not assert what, if any, limitations were overlooked in the RFC based on the ALJ’s
allegedly erroneous assessment of Plaintiff’s subjective statements. Moreover, Plaintiff does not
present how, if at all, the ALJ’s alleged error in assessing Plaintiff’s statements would have
resulted in a finding other than disabled. Thus, Plaintiff has failed to present any substantive
argument to support a conclusion that the ALJ erred in evaluating Plaintiff’s subjective statements.
A review of the record demonstrates mostly mild or normal objective medical findings,
effective control of symptoms with conservative treatment, and generally independent activities of
daily living. A review of the ALJ’s decision reveals that she properly supported her finding
regarding Plaintiff’s subjective statements based on the medical and other evidence in the record.

As such, we cannot say that the ALJ erred in evaluating Plaintiff’s subjective complaints.
Accordingly, the undersigned finds that the ALJ’s decision to deny benefits in this case is
supported by substantial evidence.
V. Conclusion
Based on the foregoing, it is recommended that the Commissioner’s decision to deny
benefits be affirmed and that Plaintiff’s Complaint be dismissed with prejudice.
The parties have fourteen (14) days from receipt of this report and recommendation
in which to file written objections pursuant to 28 U.S.C. § 636(b)(1). The failure to file timely
objections may result in waiver of the right to appeal questions of fact. We remind the parties
that objections must be both timely and specific to trigger de novo review by the district

court.
DATED this 28th day of July 2022.
/s/Mark E. Ford
HONORABLE MARK E. FORD
UNITED STATES MAGISTRATE JUDGE

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10632380. Public record. Not legal advice.