United States District Court, E.D. Arkansas, Jonesboro Division
TERESA M. PALMORE PLAINTIFF
ANDREW SAUL, Commissioner, Social Security Administration DEFENDANT
Kristine G. Baker United States District Judge.
Teresa Palmore appeals the decision of the Social Security
Commissioner (“Commissioner”) denying her Social
Security benefits. The Court has received the Recommended
Disposition from Magistrate Judge Patricia Harris in which
Judge Harris concludes that substantial evidence supports the
Commissioner's decision that Ms. Palmore was not disabled
(Dkt. No. 14). Ms. Palmore filed timely objections to the
Recommended Disposition (Dkt. No. 15). After reviewing the
Recommended Disposition and the timely objections thereto, as
well as after conducting a de novo review of the
record, the Court concludes that the Recommended Disposition
should be, and hereby is, approved and adopted in its
entirety as this Court's findings in all respects (Dkt.
Court writes separately to address Ms. Palmore's
objections (Dkt. No. 15). Ms. Palmore contends that Judge
Harris incorrectly determined that the Administrative Law
Judge's (“ALJ”) decision was supported by
substantial evidence (Id.). Specifically, Ms.
Palmore argues that the ALJ erred by failing to give proper
weight to the opinion of her treating physician, Joseph Yao,
M.D., in the calculation of her residual functional capacity
(“RFC”) (Id. at 1). Ms. Palmore also
argues that the hypothetical posed by the ALJ to the
vocational expert (“VE”) improperly omitted Ms.
Palmore's use of a walker (Id., at 3). Finally,
Ms. Palmore argues that substantial evidence does not support
the ALJ's finding that enough available jobs existed in
the national economy that Ms. Palmore could perform
considering Ms. Palmore's objections, the Court notes
that its “standard of review is narrow.”
Pearsall v. Massanari, 274 F.3d 1211, 1217 (8th Cir.
2001). The Court “must determine whether the
Commissioner's decision is supported by substantial
evidence in the record as a whole.” Sultan v.
Barnhart, 368 F.3d 857, 862-63 (8th Cir. 2004).
"Substantial evidence is less than a preponderance, but
is enough that a reasonable mind would find it adequate to
support the Commissioner's conclusion.”
Id. To determine whether the evidence is
substantial, courts “consider evidence that detracts
from the Commissioner's decision as well as evidence that
supports it.” Id. “If, after reviewing
the record, the court finds that it is possible to draw two
inconsistent positions from the evidence and one of those
positions represents the Commissioner's findings, the
court must affirm the Commissioner's decision. Even if we
would have weighed the evidence differently, we must affirm
the denial of benefits if there is enough evidence to support
the other side.” Pearsall, 274 F.3d at 1217.
reviewed the record as a whole de novo, the Court
agrees with Judge Harris that the ALJ's calculation of
Ms. Palmore's RFC is supported by substantial evidence in
the record as a whole.
the ALJ gave proper weight to Dr. Yao's medical opinion
when determining Ms. Palmore's RFC. Ms. Palmore underwent
surgery in 2015 for a stress fracture of her right foot (Tr.,
398). By August 2015, Dr. Yao noted that she had
normal motor and sensory functioning (Tr., 425). Dr. Yao also
suggested the use of crutches and exercise, stretching, and
local heat (Tr., 426). In September 2015, Jennifer Morrow,
M.D., found that Ms. Palmore had normal muscle strength and
no fatigue, swelling, or numbness (Tr., 331-37). Dr. Morrow
also encouraged Ms. Palmore to exercise (Tr., 332). In
November 2015, Donita Keown, M.D., said that Ms.
Palmore's foot pain and fracture were stable and that she
could move about without assistive devices (Tr., at 439).
December 2015, Ms. Palmore had a lumbar MRI that showed
central and left-sided herniation contacting the nerve roots
(Tr., at 437). Around the same time, Dr. Morrow noted normal
strength in Ms. Palmore's back (Tr., at 331). Dr. Yao
noted that the MRI findings were unchanged from a 2013 MRI,
and Ms. Palmore continued to perform medium-level work after
the 2013 MRI (Tr., 49, 468). Dr. Yao also did not recommend
surgery or steroid injections on the grounds that Ms.
Palmore's back “feels much better.” (Tr.,
January 2016, Dr. Yao placed Ms. Palmore on indefinite sick
leave from her current work, which was at the medium level
and required that she stand for 8 to 12 hours (Id.).
Dr. Yao opined that she would need work which allowed her to
be able to change positions periodically (Tr., 573). Also, on
January 31, 2017, Dr. Yao stated that from “2015 to
ongoing” Ms. Palmore could stand or walk a total of
only two hours in an eight-hour workday, and she could sit a
total of four hours in an eight-hour workday (Tr., 690-91).
Harris found that Dr. Yao's statement was contradicted by
the medical evidence, as Ms. Palmore's physicians noted
that she had full muscle strength and motor and sensory
functioning and a normal gait without the use of assistive
devices (Dkt. No. 14, at 5). Judge Harris also noted that Dr.
Keown gave an opinion in November 2015 that Ms. Palmore could
sit for six hours during an eight-hour workday, walk or stand
three to four hours during the workday, and occasionally lift
and carry 20 to 25 pounds (Tr. 440). Furthermore, Judge
Harris noted that Dr. Keown found no evidence that Ms.
Palmore needed a handheld assistive device to walk
(Id.). Judge Harris also noted that Clarence
Ballard, M.D., a reviewing physician, limited Ms. Palmore to
sedentary work (Id.). Judge Harris concluded that
these opinions were consistent with the medical record and
deserved more weight than Dr. Yao's opinion, which Judge
Harris described as internally inconsistent (Id.).
Palmore argues that Dr. Yao's opinion should have been
given greater weigh as he was the treating physician and
because his opinion was the only physician's opinion
provided “post-carpal tunnel release.” (Dkt. No.
15, at 2). While it is true that “[a] treating
physician's opinion should not ordinarily be disregarded
and is entitled to substantial weight, ” the
Commissioner “may discount or even disregard the
opinion of a treating physician where other medical
assessments are supported by better or more thorough medical
evidence.” Fentress v. Berryhill, 854 F.3d
1016, 1020 (8th Cir. 2017) (quoting Cunningham v.
Apfel, 22 F.3d 496, 502 (8th Cir. 2000); Wildman v.
Astrue, 596 F.3d 959, 964 (8th Cir. 2010)). The
following evidence supports the ALJ's decision to
discount Dr. Yao's opinion: Ms. Palmore's other
physicians routinely noted full muscle strength, motor and
sensory functioning, and a normal gait without the use of
assistive devices; the other physicians encouraged exercise
and other conservative treatments; and Dr. Yao himself did
not recommend that Ms. Palmore be taken off all work.
Accordingly, the Court agrees with Judge Harris that the
ALJ's decision to discount Dr. Yao's opinion is
supported by substantial evidence in the record as a whole.
Ms. Palmore's carpal tunnel syndrome and its affect upon
her RFC, the Court also agrees with Judge Harris that the
ALJ's RFC determination was supported by substantial
evidence in the record as a whole. The Eighth Circuit Court
of Appeals has conclusively stated that a claimant's RFC
is determined at “step four, ” where the burden
of proof rests with the claimant. Young v. Apfel,
221 F.3d 1065, 1069 n.5 (8th Cir. 2000) (citations omitted).
Ms. Palmore argues that, regarding her carpal tunnel
syndrome, “the ALJ had nothing to create an RFC on
besides the treatment notes post-release.” (Dkt. No.
15, at 2). Ms. Palmore also argues that the record evidence
indicates that her wrists were tender and more numb following
the surgery, though she does concede that she testified that
the surgery “has helped the left hand some . . .
.” (Id.). Judge Harris noted that the record
showed that Ms. Palmore could button a button and hold a pen
to write following her surgery (Dkt. No. 14, at 6). Judge
Harris also noted that the ALJ limited the amount of gross
manipulation in Ms. Palmore's RFC based upon Ms.
Palmore's carpal tunnel syndrome. Given that the burden
of evidence at step four rests with Ms. Palmore, the Court
agrees with Judge Harris that the ALJ's RFC determination
is supported by substantial evidence in the record as a