# Jones v. Social Security Administration Commissioner

> District Court, W.D. Arkansas · September 8, 2022

URL: https://www.frixlaw.com/law-library/cases/10632476

## Case

- **Court:** District Court, W.D. Arkansas
- **Decided:** September 8, 2022
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/10632476

## How later opinions describe it (automated extraction)

- finding conservative treatment and no surgery consistent with discrediting claimant’s testimony
- finding that if a treating physician’s opinion is inconsistent with other substantial evidence, such as physical examinations or claimant’s daily activities, the ALJ may discount or disregard the opinion
- affirming RFC without medical opinion evidence
- holding that lack of evidence of ongoing counseling or psychiatric treatment for depression weighs against plaintiff’s claim of disability

## Opinion text

IN THE UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF ARKANSAS
HARRISON DIVISION

DONA JONES PLAINTIFF

v. CIVIL NO. 21-3058

KILOLO KIJAKAZI, Acting Commissioner
Social Security Administration DEFENDANT

MAGISTRATE JUDGE’S REPORT AND RECOMMENDATION
Plaintiff, Dona Jones, brings this action pursuant to 42 U.S.C. § 405(g), seeking judicial
review of a decision of the Commissioner of the Social Security Administration (Commissioner)
denying her claims for a period of disability and disability insurance benefits (DIB) and
supplemental security income (SSI) benefits under the provisions of Titles II and XVI of the Social
Security Act (Act). 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 protectively filed her current applications for DIB and SSI on September 4, 2018,
alleging an inability to work since July 4, 2015,1 due to two heart attacks, trouble breathing,
0F
fatigue, a thyroid condition, asthma, sinus tachycardia and anxiety. (Tr. 115, 265, 282). For DIB
purposes, Plaintiff maintained insured status through September 30, 2018. (Tr. 10, 309). An

1 Plaintiff, through her counsel, amended her alleged onset date to July 4, 2018 (Tr. 9, 61).
administrative telephonic hearing was held on July 15, 2020, at which Plaintiff appeared with
counsel and testified. (Tr. 33-89).
By written decision dated November 20, 2020, the ALJ found that during the relevant time
period, Plaintiff had an impairment or combination of impairments that were severe. (Tr. 12).
Specifically, the ALJ found Plaintiff had the following severe impairments: s/p remote myocardial

infarction with PTCA, coronary artery disease without angina pectoris, lumbar spondylosis with
radiculopathy, CREST syndrome, and anxiety disorder/panic disorder without agoraphobia.
However, after reviewing all of the evidence presented, the ALJ determined that Plaintiff’s
impairments did not meet or equal the level of severity of any impairment listed in the Listing of
Impairments found in Appendix I, Subpart P, Regulation No. 4. (Tr.13). The ALJ found Plaintiff
retained the residual functional capacity (RFC) to:
[P]erform light work as defined in 20 CFR 404.1567(b) and 416.967(b) except the
claimant cannot climb ladders, ropes, or scaffolding, and can only occasionally
stoop, crouch, bend, kneel, crawl, and balance. She can occasionally use the left
lower extremity for foot controls and pedals. The work must be unskilled, limited
to simple, routine, and repetitive tasks, with supervision that is simple, direct, and
concrete, and only occasional interaction with coworkers, supervisors, and the
public.

(Tr. 15). With the help of a vocational expert, the ALJ determined Plaintiff could perform work as
a small products assembly worker and a screwdriver operator. (Tr. 23).
Plaintiff then requested a review of the hearing decision by the Appeals Council, who
denied that request on May 26, 2021. (Tr. 1-5). Subsequently, Plaintiff filed this action. (ECF
No. 2). Both parties have filed appeal briefs, and the case is before the undersigned for report and
recommendation. (ECF Nos. 13, 14).
The Court has reviewed the entire transcript. The complete set of facts and arguments are
presented in the parties’ briefs and are repeated here only to the extent necessary.
II. Evidence Presented:
At the telephonic administrative hearing held before the ALJ on July 15, 2020, Plaintiff
testified that she was fifty-one years of age and obtained a high school education. (Tr. 60). A
review of the record revealed Plaintiff’s past relevant work consists of work as a secretary and a
receptionist. (Tr. 85).

The pertinent medical evidence for the time period in question reflects the following: On
August 6, 2018, Plaintiff presented to the emergency room complaining of intermittent chest pain.
(Tr. 453-491). Dr. Stephen Karman noted Plaintiff’s chest pain was considered stable, but
treatment was deferred to cardiology. Plaintiff was later seen by Dr. Robbie T. Mangalasseril for
a cardiac consultation. Plaintiff reported she had experienced an increase in her shortness of breath
and fatigue while at the grocery store the previous day. When she was driving home from the store,

she felt increased chest pressure that radiated into her left arm. Plaintiff reported that she took
nitroglycerin which helped the pain but did not relieve it completely. Dr. Mangalasseril noted a
CT angiogram of the chest showed no pulmonary embolus but did show a hiatal hernia. Chest x-
rays revealed no acute cardiopulmonary disease. Dr. Mangalasseril noted Plaintiff was intolerant
of numerous medications, but she was able to take a low dose of atenolol. Plaintiff complained of
fatigue and shortness of breath but denied back pain, joint pain, anxiety or depression. Treatment
notes indicated Plaintiff was able to perform all activities of daily living independently. Upon
examination, Dr. Mangalasseril noted Plaintiff was alert and oriented and in no acute distress.
Plaintiff’s lungs were clear to auscultation and respirations were non-labored. Plaintiff’s heart had
normal rate and regular rhythm. A musculoskeletal exam revealed normal range of motion, normal

strength, and no tenderness or swelling. Plaintiff was found to be cooperative and with an
appropriate mood and affect. Plaintiff was diagnosed with atypical chest pain, a history of coronary
artery disease, a hiatal hernia and dyslipidemia. Dr. Mangalasseril noted Plaintiff’s presentation
was atypical for significant coronary artery disease and opined she could have esophageal spasm,
a hiatal hernia, gastritis, or GERD. Plaintiff was prescribed medication and notes indicated
Plaintiff would be referred to gastroenterology if her symptoms failed to improve.

On August 15, 2018, Plaintiff was seen by Jeremy L. Berbereia, PA. (Tr. 573-575). Plaintiff
reported experiencing medication side effects, to include fatigue and tiredness, with the use of
atenolol. Plaintiff reported the pravastatin caused muscle aches and pains. Plaintiff indicated
improvement in her chest pain with Protonix and a diet change. Plaintiff reported shortness of
breath, fatigue and edema. Plaintiff indicted she was able to perform all activities of daily living
independently. Upon examination, PA Berbereia noted Plaintiff’s heart had a regular rate and
rhythm with no lift, heave or thrill. Plaintiff had no edema, and her lungs were clear to auscultation,

bilaterally. Plaintiff had normal abdominal, musculoskeletal, and neurologic findings. PA
Berbereia opined Plaintiff had atypical chest pain most likely secondary to GERD, GI, or reflux
as it improved with Protonix and diet changes. Plaintiff agreed to undergo PFT testing for her
shortness of breath. Plaintiff was to return in six months for a follow-up.
On August 17, 2018, Plaintiff was seen by Dr. Leonard Bridges for right and left upper
quadrant discomfort and dyspepsia. (Tr. 522-524). Dr. Bridges noted Plaintiff was recently
hospitalized and underwent a CT/angio of the chest which ruled out pulmonary embolus. Upon

examination, Plaintiff was found to be well-appearing with a normal mood and affect. Plaintiff’s
heart exhibited a regular rate and rhythm with no murmur or gallop. Plaintiff’s lungs were clear
and she had strong and equal breath sounds bilaterally. Plaintiff’s abdomen was non-tender. A
back exam revealed decreased lumbar lordosis. Dr. Bridges observed that Plaintiff walked with
excess forward trunk flexion. Dr. Bridges observed no edema in Plaintiff’s extremities. Plaintiff
was assessed with right upper quadrant pain, left upper quadrant pain, dyspepsia, atherosclerotic
heart disease of the native coronary artery without angina pectoris, and hypothyroidism. Plaintiff
was prescribed medication and asked to return in one month.

On August 30, 2018, Plaintiff underwent pulmonary function testing that indicated no
significant abnormalities. (Tr. 448-450, 654).
On February 25, 2019, Plaintiff was seen for a six-month follow-up appointment with PA
Berbereia. (Tr. 438-440). Plaintiff indicated that she continued to have heart palpitations and had
also noticed shortness of breath and chest pain since August but felt it could be due to the hernia.

Plaintiff reported overall she had been doing okay but indicated that she had been stressed out
secondary to her son. Plaintiff reported issues with her hiatal hernia causing some increased
pressure in her epigastric and chest area. Plaintiff had been off her Protonix for a while but had
restarted the medication and her symptoms were still present but improved. Plaintiff indicated that
she wanted to speak to a general surgeon about her hiatal hernia. Upon examination, PA Berbereia
noted Plaintiff’s heart had a regular rate and rhythm; her lungs were clear to auscultation,
bilaterally; and her abdomen was soft and nontender. PA Berbereia noted Plaintiff had no edema.
Plaintiff exhibited a steady gait and was alert and oriented with no depression or anxiety. Plaintiff
reported she was able to perform activities of daily living independently. Plaintiff was prescribed
medication, instructed to monitor her blood pressure at home, and referred to general surgery for

a hernia consult.
On March 26, 2019, Dr. William Harrison, a non-examining medical consultant, completed
a RFC assessment opining that Plaintiff could occasionally lift or carry twenty pounds, frequently
lift or carry ten pounds; could stand and/or walk for a total of six hours in an eight-hour workday;
could sit about six hours in an eight-hour workday; could push or pull unlimited, other than as
shown for lift and/or carry; and that postural, manipulative, visual, communicative and
environmental limitations were not evident. (Tr. 124-125). On September 6, 2019, after reviewing
the records, Dr. Jeremy Saul affirmed Dr. Harrison’s opinion. (Tr. 162-163).

On April 19, 2019, Plaintiff was seen by Dr. Thomas Brent Rosson, Jr. for medication
refills and a referral to Dr. James Langston for a hiatal hernia. (Tr. 593-596). Dr. Rosson noted
Plaintiff’s hiatal hernia was stable. A review of systems revealed Plaintiff denied chest pain,
shortness of breath, nausea or vomiting. Upon examination, Dr. Rosson noted Plaintiff was in no
acute distress, that her heart had a regular rate and rhythm, and that her lungs were clear to
auscultation bilaterally, with normal respiratory effort and no wheezes or crackles. Plaintiff was
noted as alert and oriented with a normal mood. Dr. Rosson assessed Plaintiff with acquired
hypothyroidism, a hiatal hernia, and coronary artery disease without angina pectoris. Plaintiff’s

medications were refilled, and Plaintiff was referred to Dr. Langston for an evaluation of her hiatal
hernia. Plaintiff was to return in three months.
On May 7, 2019, Plaintiff was seen by Dr. Langston for an evaluation for an
esophagogastroduodenoscopy. (Tr. 622-623, 641). Dr. Langston noted Plaintiff’s most recent heart
catheterization in November of 2017 did not show any significant coronary artery disease. Plaintiff
was noted to have a syndrome of heartburn with occasional water brash and aspiration syndrome.
Dr. Langston noted Plaintiff did pretty well on Protonix but if she missed a dose, she was more

likely to have a reflux episode. Plaintiff also reported sudden shortness of breath that at times woke
her. Plaintiff denied fatigue or chest pain, Dr. Langston noted a hiatal hernia was identified on a
CT pulmonary angiogram. Upon examination, Dr. Langston noted Plaintiff’s vitals were within
normal limits; her heart had a regular rate and rhythm; her lungs were clear to auscultation,
bilaterally; and her abdomen was soft, nontender and nondistended. Plaintiff was able to stand and
walk without assistance and no signs of impaired coordination were observed. Dr. Langston
assessed Plaintiff with gastroesophageal reflux disease and an endoscopy was recommended.

On May 13, 2019, Plaintiff was seen by Dr. Samuel B. Hester for a consultative mental
diagnostic evaluation. (Tr. 598-604). Plaintiff reported no treatment by a mental health
professional but indicated her primary care physician had treated her for a panic disorder. Plaintiff
reported she took Zoloft for fifteen years but stopped taking it the previous year. Plaintiff indicated
she took Xanax on an as needed basis. Dr. Hester noted Plaintiff’s report of sadness about living
with heart disease and feeling fatigue but opined this to be situational anxiety. Dr. Hester diagnosed
Plaintiff with a panic disorder without agoraphobia by history and a pain disorder, sciatica, and
chest pain. With respect to adaptive functioning, Dr. Hester noted Plaintiff was able to drive
unfamiliar routes, perform most activities of daily living autonomously, and to shop and pay bills.

Dr. Hester opined Plaintiff had the ability to communicate and interact in a socially adequate
manner; to cope with the mental demands of basic work tasks unless fatigue or pain issues
interfered; to attend to and sustain concertation on basic tasks; and to sustain persistence in
completing tasks. Dr. Hester further opined Plaintiff may not be able to complete tasks within an
acceptable timeframe due to both pain and fatigue issues.
On May 15, 2019, Dr. Graham Reid a non-examining medical consultant, completed a
Mental RFC Assessment opining that Plaintiff was moderately limited in some areas of

functioning. (Tr. 125-128). On the same date, Dr. Reid completed a Psychiatric Review Technique
form opining that Plaintiff had mild limitations with understanding, remembering, or applying
information; moderate limitations with interacting with others; moderate limitations with
concentrating, persisting or maintaining pace; and mild limitations with adapting or managing
oneself. (Tr. 121). On September 5, 2019, after reviewing the records, Dr. Marilyn Jordan affirmed
Dr. Reid’s opinion. (Tr. 160, 163-166).

On May 16, 2019, Plaintiff underwent an EGD that revealed diaphragmatic hernia without
obstruction or gangrene and gastroesophageal reflux disease without esophagitis. (Tr. 627-628).
The plan of treatment indicated Plaintiff was to continue with her present medications, and to
follow-up as needed.
On July 8, 2019, Plaintiff was seen by Dr. Rosson to discuss hormone replacement therapy
and to follow-up for her thyroid. (Tr. 631-632, 795-797). Plaintiff reported feeling down,

depressed or hopeless on several days. Plaintiff complained of lower extremity swelling after
riding a motorcycle. Plaintiff indicated she was tolerating her medication okay, but her menopause
symptoms were worsening. Plaintiff denied chest pain, shortness of breath, nausea or vomiting.
Upon examination, Dr. Rosson noted Plaintiff was not in distress. Plaintiff’s heart exhibited a
regular rate and rhythm, and her lungs were clear to auscultation bilaterally. Plaintiff was noted as
alert and oriented with a normal mood. Plaintiff was prescribed medication and asked to return in
two months.

On August 26, 2019, Plaintiff was seen by PA Berbereia for a six-month follow-up. (Tr.
651-655). Plaintiff reported she still had dyspnea on exertion and shortness of breath. Plaintiff also
indicated she had occasional chest pain, numbness and tingling in her left hand and lower extremity
edema. Plaintiff indicated she had been feeling well up until a couple of months ago. Plaintiff
indicated she had felt weak for the last few weeks. Plaintiff underwent an EKG that showed sinus
rhythm and a heart rate of eight-six beats per minute. Upon examination, Plaintiff was found to be
alert, oriented and in no acute distress. Plaintiff’s heart exhibited a regular rate and rhythm, and no
vascular edema was observed. Plaintiff’s lungs were clear to auscultation, bilaterally. Plaintiff
exhibited a steady gait and there was no indication of anxiety or depression. PA Berbereia indicated
Plaintiff’s chest pain, shortness of breath and fatigue were due to an unknown etiology but due to
Plaintiff’s history he recommended that Plaintiff undergo a nuclear medicine treadmill stress test
and a 21-day cardiac event monitor. If no abnormalities were noted, it was recommended that
Plaintiff see a neurologist for a pain management evaluation.

On September 9, 2019, Plaintiff was seen by Dr. Rosson for a thyroid check, and severe
calf, foot and toe cramps. (Tr. 791-794). Plaintiff denied feeling down, depressed or hopeless. Dr.
Rosson noted Plaintiff was seeing a cardiologist and was wearing a heart monitor during the
appointment. Dr. Rosson indicated that Plaintiff’s hypothyroidism was stable. Plaintiff complained
of lower extremity cramping that was worsening. Dr. Rosson noted Plaintiff was back on
magnesium. Plaintiff denied chest pain, shortness of breath, nausea or vomiting. Upon

examination, Dr. Rosson noted Plaintiff was not in distress. Plaintiff’s heart exhibited a regular
rate and rhythm, and her lungs were clear to auscultation bilaterally. Plaintiff was noted as alert
and oriented with a normal mood. Dr. Rosson assessed Plaintiff with acquired hypothyroidism,
coronary artery disease and paresthesias. Dr. Rosson prescribed medication and ordered EMG
studies.
On September 12, 2019, Plaintiff underwent EMG studies that revealed lumbo-sacral
radiculopathy with mild chronic axon loss in the left lower lumbar paraspinals. (Tr. 696-697). The

results were unremarkable for polyneuropathy or focal distal nerve lesions. (Tr. 696-697)
On September 20, 2019, Plaintiff was seen for a physical therapy evaluation due to back
pain with muscle spasms and paresthesia. (Tr. 735-737). Plaintiff reported the pain was mainly on
the left side but sometimes occurred on the right side. Plaintiff reported daily pain was a 10/10 but
indicated her pain during the session was a 5/10. Plaintiff reported that she injured her back several
years ago but started having muscle spasms three months ago. Plaintiff stated her muscle spasms
ran from her back all the way down the leg to the foot. After evaluating Plaintiff, Tonia Stoke, PT,
DPT, recommended therapy twice a week for six weeks.

On September 23, 2019, Plaintiff attended a physical therapy session. (Tr. 738-739).
Plaintiff complained of low back pain and rated her pain at a 5-6/10. Plaintiff denied pain down
her lower extremity but indicated that pain was intermittent. Allie Curtis, PTA, noted Plaintiff’s
complaints of pain at the left low back following intermittent mechanical traction. Plaintiff sat on
heat for five to ten minutes and denied pain down the left lower extremity upon leaving.

On September 26, 2019, Plaintiff attended a physical therapy session. (Tr. 740-741).
Plaintiff reported after the last therapy session she was unable to stand up straight after traction.
Plaintiff indicated she had not experienced pain while on traction but afterward her pain increased.
Plaintiff reported her pain was a 5-6/10, and that she had a bad muscle cramp in her foot the
previous day. PT Stokes noted Plaintiff tolerated heat and IFC, but traction was withheld. Core
stabilization exercises were added to the session. Plaintiff reported her pain was a 6/10 after
therapy.

On October 8, 2019, Plaintiff attended a physical therapy session. (Tr. 748-749). Plaintiff
reported numbness down her left leg to her toes, and muscle cramping into both legs. PT Stokes
noted Plaintiff had good tolerance to heat and IFC. An area of soft tissue thought to be a cyst of
lipoma just proximal of the left SI joint was a source of pain. A similar area was noted on the right
side but was not as painful. Plaintiff reported her legs felt tired after the exercises.
On October 10, 2019, Plaintiff was seen for a physical therapy session. (Tr. 750-751).

Plaintiff reported she had been sore after her therapy sessions. PT Stokes noted Plaintiff’s right leg
was longer than her left and that she had increased pronation of her ankles. It was recommended
that Plaintiff try a heel lift in her left shoe and an orthotic to support the arches in her feet. Plaintiff
had good tolerance to exercises but reported increased pain with muscle energy.

On October 14, 2019, Plaintiff was seen for a physical therapy session. (Tr. 752-753).
Plaintiff reported she spent six hours in a car the previous day and that her back was sore. PT
Stokes noted Plaintiff’s report of increased pain in her left leg with exercises. Plaintiff was not
able to complete all the reps with her hip on the left side due to pain. Pelvic balancing exercises
were added, and Plaintiff tolerated 5 reps.

On October 17, 2019, Plaintiff was seen for a physical therapy session. (Tr. 754-755).
Plaintiff reported lower back pain on the lower left side rated at an 8/10. Plaintiff indicated that
therapy was not helping as she continued to have lower extremity cramping and pain and that she
was sore for at least a day after each session. PT Stokes observed that Plaintiff was very unstable
on the Thera ball and that she reported continued lower back pain.
On October 22, 2019, Plaintiff was seen for a physical therapy session. (Tr. 756-759).
Plaintiff rated her pain as an 8-9/10. Plaintiff reported that she rode a motorcycle for one hour,

took a break, and rode for one hour back. Plaintiff indicated that she had good days and bad days,
but her pain was not any better. PT Stokes noted Plaintiff had good tolerance to heat and IFC.
Plaintiff reported tenderness on the left lower lumbar and left SI joint with astym. Plaintiff
exhibited decreased strength and trunk range of motion. PT Stokes noted Plaintiff was going to
return to her physician due to continued low back pain and bilateral leg pain. Plaintiff was
discharged from physical therapy on November 25, 2019. (Tr. 760).
On October 31, 2019, Plaintiff was seen by Dr. Prasert Vijitbenjaronk for a cardiac follow-
up. (Tr. 656-658). Plaintiff reported that overall, she felt the same. Plaintiff indicated that she
continued to have occasional chest pain, exertional shortness of breath, palpitations, and fatigue.
Plaintiff denied dizziness or syncope and indicated she tolerated medication well. Plaintiff denied
abdominal pain, muscle pain or muscle weakness. After examining Plaintiff, Dr. Vijitbenjaronk

assessed Plaintiff with stable coronary artery disease, palpitation with no arrhythmia and shortness
of breath of unknown etiology by her cardiac findings. Plaintiff was strongly encouraged to
increase her level of exercise and to maintain a healthy diet.
On November 4, 2019, Plaintiff was seen by Dr. Rosson for a follow-up after completing
physical therapy. (Tr. 789-790). Plaintiff reported her pain had not improved and that the range of
motion in her back was worse. Plaintiff also reported an increase in her anxiety and requested a

medication refill for Xanax. Dr. Rosson noted Plaintiff also complained of some cramping in her
legs and feet. Plaintiff denied chest pain, shortness of breath, nausea or vomiting. Upon
examination, Dr. Rosson noted Plaintiff was not in distress. Plaintiff’s heart exhibited a regular
rate and rhythm, and her lungs were clear to auscultation bilaterally. Plaintiff was noted as alert
and oriented with a normal mood. Dr. Rosson assessed Plaintiff with anxiety and lumbar
radiculopathy and prescribed medication. Dr. Rosson ordered a MRI of the lumbar spine based on
EMG findings and failed physical therapy. Plaintiff was to return in three months.

On November 11, 2019, Plaintiff underwent a MRI of the lumbar spine that revealed the
following:
Multilevel lumbar spinal degenerative changes. No acute disk evident or nerve root
compression seen to account for the patient’s left hip symptoms. There is
inflammation of the left L5/S1 facet joint with effusion and small amounts of
periarticular soft tissue edema. No marrow edema. No canal or foraminal stenosis
seen with the lumbar spine.
(Tr. 699)
On November 18, 2019, Plaintiff was seen by Dr. Rosson to discuss her MRI results and
blood pressure. (Tr. 787-788). Dr. Rosson noted Plaintiff’s MRI showed some inflammation in her
lumbar spine and that Plaintiff indicated she was “still hurting.” Plaintiff denied chest pain,
shortness of breath, nausea or vomiting. Upon examination, Dr. Rosson noted Plaintiff was not in
distress. Plaintiff’s heart exhibited a regular rate and rhythm, and her lungs were clear to
auscultation bilaterally. Plaintiff was noted as alert and oriented with a normal mood. Dr. Rosson

assessed Plaintiff with radicular pain of the lumbosacral region and started her on prednisone. Dr.
Rosson also referred Plaintiff to pain management. Plaintiff was to follow up as needed.
On November 18, 2019, Dr. Rosson completed a medical source statement-physical. (Tr.
634-636). Dr. Rosson indicated Plaintiff had the following diagnoses: panic attacks, leg cramps,
hypothyroidism, back pain, feet cramps, depression, paresthesia and coronary artery disease.
Plaintiff’s symptoms consisted of pain, leg cramps, fatigue and an unsteady balance. Dr. Rosson

indicated the clinic findings and objective signs consisted of lumbar radiculopathy. Dr. Rosson
noted Plaintiff’s medication caused drowsiness. Dr. Rosson opined Plaintiff could perform less
than sedentary work.
On the same date, Dr. Rosson also completed a medical source statement-mental. (Tr. 638-
639). Dr. Rosson indicated Plaintiff had the following diagnoses: panic attacks and depression. Dr.
Rosson indicated Plaintiff did not experience side effects from medication. Dr. Rosson opined
Plaintiff would be “off task” more than twenty-five percent of the workday. Dr. Rosson indicated

Plaintiff had moderate limitations in multiple areas of functioning and marked limitation with her
ability to maintain attend and concentration for extended periods. Dr. Rosson indicated he based
his findings on Plaintiff’s medical history.
On December 9, 2019, Plaintiff was seen by Dr. Rosson for a three-month follow-up
appointment. (Tr. 785-786). Plaintiff complained of feeling ill since Wednesday but was gradually
feeling better. Plaintiff indicated she had been in contact with sick individuals the previous week.
Plaintiff denied chest pain, shortness of breath, nausea or vomiting. Upon examination, Dr. Rosson
noted Plaintiff was not in distress. Plaintiff’s heart exhibited a regular rate and rhythm, and her

lungs were clear to auscultation bilaterally. Plaintiff was noted as alert and oriented with a normal
mood. Dr. Rosson assessed Plaintiff with viral gastroenteritis and hypothyroidism.
On December 27, 2019, Plaintiff was seen by Dr. Rosson for a rash under her arms. (Tr.
783-784). Plaintiff also inquired about the results of her TSH labs. Plaintiff denied chest pain,
shortness of breath, nausea or vomiting. Upon examination, Dr. Rosson noted Plaintiff was not in
distress. Plaintiff’s heart exhibited a regular rate and rhythm, and she had no increased work of

breathing. Dr. Rosson assessed her with a hypothyroid and tinea corporis. Plaintiff was prescribed
medication and asked to return in three months.
On January 7, 2020, Plaintiff was seen by Dr Matthew Mcnelley to establish care. (Tr. 689-
695). Plaintiff reported her back pain began in 2006 but worsened over the summer of 2019. Dr.
Mcnelley noted Plaintiff’s pain started over her low back and went down her left leg. Plaintiff also
complained of cramping in both legs and feet, more on the left. Plaintiff indicated her pain was
exacerbated with increased activity and temporarily improved with massage, exercise, rest, cold,

ice, heat and medications. Dr. Mcnelley noted Plaintiff had recently been through physical therapy
without improvement. Plaintiff reported mild improvement in pain with the use of Advil and
Tylenol. Plaintiff indicated she was able to perform activities of daily living with pain medication.
A review of systems revealed Plaintiff’s complaints of fatigue, chest pain, palpitations, swelling
in her hands/feet, shortness of breath, back pain, joint swelling, headache and weakness. Plaintiff
also reported depression and feeling anxious. Upon examination, Dr. Mcnelley noted Plaintiff was
alert and oriented and in no acute distress. Plaintiff exhibited a full active range of motion of the
cervical spine with tenderness to palpation. A cardiovascular examination revealed her heart had
a regular rate and rhythm and there was no evidence of pedal edema. Palpation of the lumbar facets
reproduced back pain, but no pain was noted over the lumbar intervertebral spaces, bilateral

sacroiliac joint area or greater trochanteric bursa. No palpable trigger points were noted over the
low back. Plaintiff was found to have a normal mood and affect and intact memory. Dr. Mcnelley
opined Plaintiff was able to heel and toe walk. Straight leg testing was positive on the left and
negative on the right. Plaintiff had normal motor strength and sensation. Dr. Mcnelley assessed
Plaintiff with chronic pain syndrome, L-S radiculopathy, other spondylosis and lumbar stenosis.
Dr. Mcnelley recommended steroid injections, the first of which was administered on January 13,
2020. (Tr. 684-688).

On January 27, 2020, Plaintiff was seen by Dr. Mcnelley for a follow-up. (Tr. 679-683).
Treatment notes indicated Plaintiff reported at least a fifty percent improvement in her pain and
functionality for at least two to three weeks after the first injection. Given Plaintiff’s positive
response, Dr. Mcnelley administered a second injection.
On February 18, 2020, Plaintiff was by Dr. Mcnelley for her pain. (Tr. 672-678). Plaintiff
reported the lumbar epidural steroid injections helped her back pain for about one day. Plaintiff

noted that she did not like Tramadol, as she thought it caused constipation. Plaintiff reported
increased pain that was barely controlled. Plaintiff denied side effects from medication but
indicated some limited activity and enjoyment of life due to pain. Plaintiff indicated she was able
to perform activities of daily living with pain medication. Plaintiff denied fatigue, shortness of
breath, anxiety, or abdominal pain. Upon examination, Dr. Mcnelley noted Plaintiff exhibited full
active range of motion of the cervical spine; equal breath sounds, bilaterally; no evidence of pedal
edema; tenderness to palpation of the cervical and lumbar spine; positive straight leg on the left
and positive facet loading; no palpable trigger points; normal motor strength and sensation; intact
recent memory; and normal mood and affect. Dr. Mcnelley’s assessment indicated Plaintiff had a
long history of back pain that had flared up over the last several months. Dr. Mcnelley prescribed

medication and recommended a medial branch block that was administered on March 2, 2020. (Tr.
666-671).
On March 4, 2020, Plaintiff was seen by Dr. Rosson for a two-month follow-up for her
hypothyroid. (Tr. 780-782). Dr. Rosson also noted Plaintiff continued to have moderate to
worsening ringworm on her abdomen. Treatment notes indicated Plaintiff’s blood pressure had
been higher after starting a new medication. Plaintiff denied chest pain, shortness of breath, nausea

or vomiting. Upon examination, Dr. Rosson noted Plaintiff was not in distress. Plaintiff’s heart
exhibited a regular rate and rhythm, and she had no increased work of breathing Dr. Rosson
assessed acquired hypothyroidism, ringworm and fatigue, unspecified type. Plaintiff was to return
in three months.
On May 13, 2020, Plaintiff was seen by Dr. Mcnelley for a follow-up. (Tr. 660-665).
Treatment notes indicated Plaintiff experienced at least eighty percent pain relief with the previous
block so a second one was administered.

On June 2, 2020, Plaintiff was seen by Dr. Mcnelley for a follow-up. (Tr. 799-805).
Plaintiff reported that her pain was significantly improved for a short period of time after each
lumbar medical branch block. Plaintiff reported some improvement with the use of Robaxin.
Plaintiff indicated her pain was an 8/10. Dr. Mcnelley noted Plaintiff was able to perform activities
of daily living with the use of pain medication. A review of systems indicated Plaintiff’s report of
fatigue, undergoing depression and feeling anxious. Plaintiff denied shortness of breath, or
difficulty breathing. After examining Plaintiff, Dr. Mcnelley noted Plaintiff was pleasant and
returned with low back pain that improved with a lumbar median branch block for a short period
of time. Dr. Mcnelley noted Plaintiff reported new right shoulder, neck and mid back pain. A facet
medial branch nerve rhizotomy was recommended.

On June 2, 2020, Plaintiff also underwent cervical spine x-rays that revealed no subluxation
on flexion or extension. (Tr. 842-844). A left shoulder x-ray revealed no acute fracture. A thoracic
spine x-ray revealed no subluxation.

On June 4, 2020, Plaintiff was seen by Dr. Rosson for a three-month follow-up for her
thyroid. (Tr. 701-702, 817-819). Plaintiff wanted to discuss Raynaud’s disease, fatty tissue in her
neck, and a hiatal hernia. Dr. Rosson noted Plaintiff’s degenerative disc disease and
hypothyroidism were stable. Dr. Rosson noted Plaintiff had possible Raynaud’s disease and that
Plaintiff reported that her hiatal hernia was worsening. Plaintiff also asked for a bump in her neck
be checked. Plaintiff denied chest pain, shortness of breath, nausea or vomiting. After examining
Plaintiff, Dr. Rosson assessed Plaintiff with acquired hypothyroidism, Raynaud’s phenomenon
without gangrene, a hiatal hernia and a lump in her neck. Dr. Rosson referred Plaintiff to a
rheumatologist, prescribed medication and recommended a follow-up in six months.

On June 5, 2020, Plaintiff underwent an ultrasound of the neck that revealed no suspicious
mass, fluid, or cyst within the left neck. (Tr. 814-816).
On July 9, 2020, a MRI of the cervical spine revealed mild cervical spondylosis worse at
C6/C7 but no canal stenosis or neuroforaminal narrowing. (Tr. 879). No vertebral body

compression fracture or subluxation was noted.
On August 26, 2020, Plaintiff was seen at the Mercy Berryville Rheumatology clinic by
Dr. Ronald R. Rubio. (Tr. 893-904). Plaintiff reported for about one year, when her hands were
cold, they would stiffen and tingle which made it hard to hold anything. Plaintiff underwent chest
x-rays that revealed no active disease. Plaintiff was diagnosed with CREST syndrome and
prescribed medication. Plaintiff was seen for a follow-up on October 7, 2020, and no changes were

made to her medication. (Tr. 906).
III. Applicable Law:
The Court reviews “the ALJ’s decision to deny disability insurance benefits de novo to
ensure that there was no legal error that the findings of fact are supported by substantial evidence
on the record as a whole.” Brown v. Colvin, 825 F. 3d 936, 939 (8th Cir. 2016). 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). The Court must affirm the ALJ’s decision if the record contains substantial evidence to

support it. Lawson v. Colvin, 807 F.3d 962, 964 (8th Cir. 2015). As long as 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.
It is well established that a claimant for Social Security disability benefits has the burden
of proving her disability by establishing a physical or mental impairment 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. See 20 C.F.R. §§ 404.1520, 416.920. Only if the final
stage is reached does the fact finder consider the Plaintiff’s age, education, and work experience
in light of her residual functional capacity. See McCoy v. Schweiker, 683 F.2d 1138, 1141-42 (8th

Cir. 1982), abrogated on other grounds by Higgins v. Apfel, 222 F.3d 504, 505 (8th Cir. 2000); 20
C.F.R. §§ 404.1520, 416.920.
IV. Discussion:
Plaintiff argues the following issues on appeal: 1) The ALJ’s decision is not based on
substantial evidence because the ALJ minimized or mischaracterized the evidence; 2) The ALJ
committed reversible error because he failed to properly evaluate the medical opinion evidence
and relied on his own lay interpretation regarding the functional significance of diagnostic medical
reports; and 3) The ALJ committed reversible error because he failed to find the Plaintiff’s hiatal
hernia to be a severe impairment at Step Two and failed to account for corresponding limitations
in Plaintiff’s RFC.2 (ECF No. 13). Defendant argues the ALJ properly considered all the evidence,
1F
and the decision is supported by substantial evidence. (ECF No. 14).
A. Insured Status and Relevant Time Periods:
To have insured status under the Act, an individual is required to have twenty quarters of
coverage in each forty-quarter period ending with the first quarter of disability. 42 U.S.C. §
416(i)(3)(B). Plaintiff last met this requirement on September 30, 2018. Regarding Plaintiff’s
application for DIB, the overarching issue in this case is the question of whether Plaintiff was
disabled during the relevant time period of July 4, 2018, her amended alleged onset date of
disability, through September 30, 2018, the last date she was in insured status under Title II of the
Act.
In order for Plaintiff to qualify for DIB, she must prove that on or before the expiration of
her insured status she was unable to engage in substantial gainful activity due to a medically
determinable physical or mental impairment which is expected to last for at least twelve months
or result in death. Basinger v. Heckler, 725 F.2d 1166, 1168 (8th Cir. 1984) (explaining claimant
has the burden of establishing the existence of a disability on or before the expiration of her insured
status). Records and medical opinions from outside the insured period can only be used in “helping

to elucidate a medical condition during the time for which benefits might be rewarded.” Cox v.
Barnhart, 471 F.3d 902, 907 (8th Cir. 2006) (holding that the parties must focus their attention on
claimant's condition at the time she last met insured status requirements); Turpin v. Colvin, 750
F.3d 989, 993 (8th Cir. 2014) (explaining the ALJ need “only consider the applicant's medical
condition as of his or her date last insured”).

2 The Court has re-ordered Plaintiff’s arguments to correspond with the five-step analysis utilized
by the Commissioner.
With respect to Plaintiff’s SSI application, benefits are not payable prior to the date of
application, regardless of how far back disability may, in fact, be alleged or found to extend. See
20 C.F.R. § 416.335. Therefore, the relevant period is from September 4, 2018, the date Plaintiff
protectively applied for SSI benefits, through November 20, 2020, the date of the ALJ’s decision.
B. Step Two Determination:

At Step Two of the sequential analysis, the ALJ is required to determine whether a
claimant's impairments are severe. See 20 C.F.R. § 404.1520(c). While “severity is not an onerous
requirement for the claimant to meet…it is also not a toothless standard.” Wright v. Colvin, 789
F.3d 847, 855 (8th Cir. 2015) (citations omitted). To be severe, an impairment only needs to have
more than a minimal impact on a claimant's ability to perform work-related activities. See Social
Security Ruling 96-3p. The claimant has the burden of proof of showing she suffers from a
medically severe impairment at Step Two. See Mittlestedt v. Apfel, 204 F.3d 847, 852 (8th Cir.
2000).
Plaintiff argues the ALJ erred in failing to find Plaintiff’s hiatal hernia to be a severe

impairment. In determining Plaintiff’s severe impairments, the ALJ addressed several alleged
impairments (hypertension, hypercholesterolemia, hypothyroidism, GERD, hernia, asthma and
neck pain), but found the evidence supported a conclusion that these impairments would impose
no more than a minimal effect on her ability to perform basic work activities. With respect to
Plaintiff’s alleged hernia, the ALJ noted a hiatal hernia was diagnosed in August of 2018 and was
treated with medication and without surgery. Subsequent medical records failed to show Plaintiff
consistently reported ongoing symptoms caused by her hernia and in fact most medical records
show her hernia to be stable with the exception of occasional flares which at times occurred when
she had not taken her medication. Johnston v. Apfel, 210 F.3d 870, 875 (8th Cir. 2000) (alleged
impairments may not be considered severe when they are stabilized by treatment and otherwise
are generally unsupported by the medical record). With respect to Plaintiff’s alleged asthma and
shortness of breath, the ALJ discussed the medical evidence that includes pulmonary function
testing that showed no significant disease. The ALJ also pointed out Plaintiff consistently denied
experiencing shortness of breath and respiratory examinations failed to reveal significant findings.

While the ALJ did not find every medical diagnosis to be a severe impairment, the ALJ
specifically and thoroughly discussed the alleged impairments in the decision, and clearly stated
that he considered all of Plaintiff’s impairments, including the impairments that were found to be
non-severe. Parker v. Kijakazi, No. 4:21-CV-00547-NCC, 2022 WL 3585610, at *4 (E.D. Mo.
Aug. 22, 2022) (even if the ALJ erred in failing to find an alleged impairment severe, the error was
harmless in light of the ALJ’s consideration of the impairment in the RFC analysis). After
reviewing the record as a whole, the Court finds the ALJ did not commit reversible error in setting
forth Plaintiff’s severe impairments during the relevant time period.
C. Subjective Complaints and Symptom Evaluation:

The ALJ was required to consider all the evidence relating to Plaintiff’s subjective
complaints including evidence presented by third parties that relates to: (1) Plaintiff's daily
activities; (2) the duration, frequency, and intensity of her pain; (3) precipitating and aggravating
factors; (4) dosage, effectiveness, and side effects of her medication; and (5) functional
restrictions. See Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984). While an ALJ may not
discount a claimant's subjective complaints solely because the medical evidence fails to support
them, an ALJ may discount those complaints where inconsistencies appear in the record as a
whole. Id. As the United States Court of Appeals for the Eighth Circuit observed, “Our touchstone
is that [a claimant's] credibility is primarily a matter for the ALJ to decide.” Edwards v. Barnhart,
314 F.3d 964, 966 (8th Cir. 2003).
After reviewing the administrative record, it is clear that the ALJ properly considered and
evaluated Plaintiff’s subjective complaints, including the Polaski factors. As discussed in the
ALJ’s decision, the record revealed that during the relevant time period, Plaintiff was able to take

care of her personal needs, to prepare simple meals, to shop for groceries and personal items, to
pay bills, to do household chores and to drive without accompaniment. Plaintiff routinely reported
to her medical providers that she was able to perform all activities of daily living independently
with pain medication. In October of 2019, Plaintiff was “strongly encouraged” to increase her
level of exercise. While Plaintiff testified that she was constantly short of breath with any activity,
the ALJ pointed to the record that revealed Plaintiff consistently denied experiencing shortness of
breath to her treatment providers.
With respect to Plaintiff’s alleged physical impairments, the medical evidence revealed
that during the time period in question, Plaintiff was treated conservatively and appeared to

experience some relief with the use of medication. Davidson v. Astrue, 578 F.3d 838, 846 (8th Cir.
2009) (impairments that are controllable or amenable to treatment do not support a finding of
disability); Black v. Apfel, 143 F.3d 383, 387 (8th Cir. 1998) (finding conservative treatment and
no surgery consistent with discrediting claimant’s testimony).
Plaintiff argues the ALJ improperly discounted Plaintiff’s complaints of disabling back
pain, specifically that the ALJ noted Plaintiff’s failure to return to physical therapy without also
explicitly stating that Plaintiff did not complete the physical therapy sessions due to her pain
worsening after sessions. Plaintiff appears to argue the ALJ’s characterization of Plaintiff’s failed
physical therapy as a reason he discounted Plaintiff’s allegation of a disabling back pain; however,
nowhere in the decision does the ALJ state that Plaintiff’s failure to complete physical therapy was
viewed as a basis for discounting her pain. An ALJ is not required to discuss every piece of
evidence that was submitted and an ALJ’s failure to cite specific evidence does not indicate that
such evidence was not considered. Black v. Apfel, 143 F.3d 383 at 386. Contrary to Plaintiff’s
objection, the ALJ did not ignore Plaintiff’s allegation that her back pain worsened in the summer

of 2019, as he specifically mentioned that fact in the hearing decision. However, the ALJ also
discussed Plaintiff’s medical records that revealed Plaintiff’s reports to her medical providers in
2019 and early 2020 that she was able to live alone and perform all activities of daily living
independently, did not require an assistive device to ambulate, and experienced limited pain relief
with the steroid injections. While Plaintiff may indeed have an injury in her back and experience
some degree of pain, the medical evidence indicates that her condition is not of a disabling nature.
See Lawrence v. Chater, 107 F.3d 674, 676 (8th Cir. 1997) (upholding ALJ's determination that
claimant was not disabled even though she had in fact sustained a back injury and suffered some
degree of pain); Woolf v. Shalala, 3 F.3d 1210, 1213 (8th Cir. 1993) (holding that, although

plaintiff did have degenerative disease of the lumbar spine, the evidence did not support a finding
of disabled).
Regarding Plaintiff’s mental functioning, the record showed Plaintiff sought very little
treatment for these alleged impairments. See Gowell v. Apfel, 242 F.3d 793, 796 (8th Cir. 2001)
(holding that lack of evidence of ongoing counseling or psychiatric treatment for depression
weighs against plaintiff’s claim of disability). The ALJ also discussed the evidence that revealed
Plaintiff often denied depression and anxiety and consistently was noted to have a normal mood
and affect and intact memory. Based on the record as a whole, the Court finds substantial evidence
to support the ALJ’s determination that Plaintiff does not have a disabling mental impairment.
Therefore, although it is clear that Plaintiff suffers with some degree of limitation, she has
not established that she is unable to engage in any gainful activity. Accordingly, the Court
concludes that substantial evidence supports the ALJ’s conclusion that Plaintiff’s subjective
complaints were not totally credible.
D. The ALJ’s RFC Determination and Medical Opinions:

RFC is the most a person can do despite that person’s limitations. 20 C.F.R. §
404.1545(a)(1). It is assessed using all relevant evidence in the record. Id. This includes medical
records, observations of treating physicians and others, and the claimant’s own descriptions of her
limitations. Guilliams v. Barnhart, 393 F.3d 798, 801 (8th Cir. 2005); Eichelberger v. Barnhart,
390 F.3d 584, 591 (8th Cir. 2004). Limitations resulting from symptoms such as pain are also
factored into the assessment. 20 C.F.R. § 404.1545(a)(3). The United States Court of Appeals for
the Eighth Circuit has held that a “claimant’s residual functional capacity is a medical question.”
Lauer v. Apfel, 245 F.3d 700, 704 (8th Cir. 2001). “Because a claimant’s RFC is a medical
question, an ALJ’s assessment of it must be supported by some medical evidence of the claimant’s

ability to function in the workplace.” Cox. V. Astrue, 495 F.3d 614, 619 (8th Cir. 2007). However,
there is no requirement that an RFC finding be supported by a specific medical opinion. See Myers
v. Colvin, 721 F.3d 521, 526-27 (8th Cir. 2013) (affirming RFC without medical opinion
evidence).
In determining that Plaintiff maintained the RFC to perform light work with limitations,
the ALJ considered the medical assessments of treatment providers, a consultative examiner and
non-examining agency medical consultants; Plaintiff’s subjective complaints; and her medical
records. The ALJ specifically discussed the opinions of Drs. Rosson, Hester, Harrison, Saul, Reid
and Jordon. The ALJ articulated the supportability and consistency of each opinion with the record
as a whole and determined the level of persuasiveness. As for the opinion of Dr. Rosson, Plaintiff’s
primary care physician, who opined Plaintiff could perform less than sedentary work, the ALJ
found both the mental and physical medical source statements unpersuasive. After reviewing the
record, the Court finds substantial evidence to support the ALJ’s determination that Dr. Rosson’s
assessments were inconsistent with the provider’s own treatment notes and the medical records

whole. Fentress v. Berryhill, 854 F.3d 1016, 1020 (8th Cir. 2017) (finding that if a treating
physician’s opinion is inconsistent with other substantial evidence, such as physical examinations
or claimant’s daily activities, the ALJ may discount or disregard the opinion).
The ALJ thoroughly discussed Plaintiff’s medical records that consistently reported a heart
with regular rhythm and rate; clear lungs to auscultation, bilaterally; the ability to heel and toe
walk; full motor strength in all extremities; and normal mood, affect and memory. The ALJ also
addressed Plaintiff’s activities which included the ability to perform household chores, prepare
simple meals, drive, shop, pay bills, and spend time with others. While Plaintiff disagrees with the
ALJ’s RFC determination, after reviewing the record as a whole, the Court finds Plaintiff failed to

meet her burden of showing a more restrictive RFC. See Perks v. Astrue, 687 F. 3d 1086, 1092
(8th Cir. 2012) (burden of persuasion to demonstrate RFC and prove disability remains on
claimant). The Court finds substantial evidence supporting the ALJ’s RFC determination for the
time period in question.
E. Hypothetical Question to the Vocational Expert:
After thoroughly reviewing the hearing transcript along with the entire evidence of record,
the Court finds that the hypothetical the ALJ posed to the vocational expert fully set forth the
impairments which the ALJ accepted as true, and which were supported by the record as a whole.
Goff v. Barnhart, 421 F.3d 785, 794 (8th Cir. 2005). Accordingly, the Court finds that the
vocational expert's opinion constitutes substantial evidence supporting the ALJ's conclusion that
Plaintiff's impairments did not preclude her from performing work as a small products assembly
worker and a screwdriver operator. Pickney v. Chater, 96 F.3d 294, 296 (8th Cir. 1996) (testimony
from vocational expert based on properly phrased hypothetical question constitutes substantial
evidence).
V. Conclusion:
Based on the foregoing, the undersigned recommends affirming the ALJ's decision, and
dismissing Plaintiff's case with prejudice. The parties have fourteen days from receipt of our
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. The parties are reminded that objections must be both timely and specific
to trigger de novo review by the district court.
DATED this 8th day of September 2022.

iy Chreatly Comatood
HON. CHRISTY COMSTOCK
UNITED STATES MAGISTRATE JUDGE

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10632476. Public record. Not legal advice.