Greer v. Social Security Administration, No. 1:2019cv00061 - Document 13 (E.D. Ark. 2020)
Court Description: MEMORANDUM OPINION AND ORDER finding that there is substantial evidence on the record as a whole to support the ALJ's findings; dismissing Greer's complaint; and denying all requested relief. Judgment will be entered for the Commissioner. Signed by Magistrate Judge Patricia S. Harris on 8/10/2020. (ljb)
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Greer v. Social Security Administration Doc. 13 IN THE UNITED STATES DISTRICT COURT EASTERN DISTRICT OF ARKANSAS NORTHERN DIVISION MANESSAH L. GREER v. PLAINTIFF NO. 1:19-cv-00061 PSH ANDREW SAUL, Commissioner of the Social Security Administration DEFENDANT MEMORANDUM OPINION AND ORDER In t his case, plaint iff Manessah L. Greer (“ Greer” ) maint ains t hat t he findings of an Administ rat ive Law Judge (“ ALJ” ) are not support ed by subst ant ial evidence on t he record as a whole. 1 Greer so maint ains for t wo reasons: 1) her migraine headaches were not evaluat ed in accordance wit h List ing 11.02, and 2) her residual funct ional capacit y was erroneously assessed because t he medical opinions were not given proper weight , and insufficient considerat ion was given t o t he side effect s of her medicat ion. The quest ion for t he Court is whet her t he ALJ’ s findings are support ed by “ subst ant ial evidence on t he record as a whole and not based on any legal error.” See Sloan v. Saul, 933 F.3d 946, 949 (8t h Cir. 2019). “ Subst ant ial evidence is less t han a preponderance, but enough t hat a reasonable mind would accept it as adequat e t o support t he [ALJ’ s] conclusion.” See Id. 1 Dockets.Justia.com Greer was born on Oct ober 28, 1985, and was t went y-nine years old on June 30, 2015, i.e., t he day she allegedly became disabled. In her applicat ions for disabilit y insurance benefit s and supplement al securit y income benefit s, she alleged t hat she is disabled as a result of mult iple sclerosis (“ MS” ). The Commissioner of t he Social Securit y Administ rat ion (“ Commissioner” ) represent s t hat t he relevant period is from June 30, 2015, t hrough November 27, 2018, i.e., t he dat e of t he ALJ’ s decision. Prior t o t he relevant period, Greer underwent t est ing for reoccurring headaches and came t o be diagnosed wit h Radiologically Isolat ed Syndrome (“ RIS” ), see Transcript at 268, an impairment charact erized as a “ st ep before MS,” see Transcript at 318. 2 The impairment was believed t o be a separat e ent it y from her headaches. See Transcript at 268. Greer saw Dr. Kat hryn Chenault , M.D., in 2014 for left side numbness and t ingling and reoccurring headaches. See Transcript at 267-269 (01/ 06/ 2014), 270-271 (03/ 18/ 2014), 272-273 (03/ 31/ 2014). Because RIS has a high correlat ion wit h MS, Greer was t reat ed wit h disease modifying t herapy for MS. She was t reat ed wit h medicat ion for her headaches. The Court not es t he medical evidence prior t o June 30, 2015, primarily for t he purpose of placing Greer’ s medical condit ion in an hist orical cont ext . In addit ion, because Greer does not challenge t he ment al port ion of t he ALJ’ s residual funct ional capacit y assessment , t he evidence relevant t o Greer’ s ment al limit at ions will not be summarized. 2 2 Greer also saw Dr. James Zini, D.O., (“ Zini” ) in 2014 for MS and headaches. See Transcript at 341-344 (06/ 03/ 2014), 338-340 (08/ 05/ 2014), 334-337 (10/ 06/ 2014), 330-333 (12/ 02/ 2014), 326-329 (12/ 30/ 2014). His progress not es reflect t hat he was uncert ain whet her she “ act ually has MS or if her body is mimicking sympt oms of MS.” See Transcript at 326. He did not e, t hough, t hat an MRI of her cervical spine was consist ent wit h “ MS plaques” and an MRI of her brain revealed abnormalit ies. See Transcript at 328. He not ed t hat her sympt oms were const ant but moderat e and were relieved wit h pain medicat ion, muscle relaxant s, and rest . Zini’ s progress not es addit ionally reflect t hat Greer’ s headaches were int ermit t ent , were relieved wit h medicat ion and movement , but were exacerbat ed when she remained st ill. Greer addit ionally saw Dr. Krishna Mylavarapu, M.D., (“ Mylavarapu” ) in 2014 for MS. See Transcript at 276-279. Greer’ s hist ory of present illness included t he following complaint s: ... She [complains of] left side pain, headaches, and fat igue. She report s her headaches occur everyday. She [complains of] phot ophobia and phonophobia associat ed wit h headaches. She t akes Midrin [as needed]. It does not help. She [complains of] int ermit t ent numbness in hands and feet at t imes. ... 3 See Transcript at 276. A physical examinat ion was unremarkable. MS, migraines, and medicat ion overuse headaches were diagnosed. Test ing was ordered, and amit ript yline was prescribed. MRI t est ing of Greer’ s brain and cervical spine was performed in December of 2014. See Transcript at 306-307. The result s of t he brain MRI revealed perivent ricular whit e mat t er areas of demyelinat ion and gliosis consist ent wit h MS but no enhancing lesions. The result s of t he cervical spine MRI revealed a “ lesion at t he C3 level and a small area bot h on t he right and left side of t he cord at t he C4-5 level,” which was consist ent wit h “ MS plaques.” See Transcript at 307. Greer appears t o have seen Mylavarapu on four occasions in 2015. See Transcript at 280-282 (01/ 21/ 2015), 283-285 (04/ 29/ 2015), 286-288 (10/ 26/ 2015), 289-291 (11/ 03/ 2015). His progress not es reflect t hat her headaches improved wit h amit ript yline, but she event ually st opped t aking it . She had also been receiving Plegridy inj ect ions but had st opped t hem as well because t hey caused a loss of sensat ion in her right arm. In Oct ober of 2015, she report ed t hat she did not want any “ ‘ man made’ medicat ions for [now].” See Transcript at 288. Mylavaraup ordered addit ional MRI t est ing, which was performed in Oct ober of 2015. The result s of Greer’ s brain MRI revealed t he following: 4 St able bilat eral callosal and pericallosal areas of FLAIR signal abnormalit y orient ed perpendicular t o t he corpus callosum compat ible wit h mult iple sclerosis. No new plaques are seen. No rest rict ed diffusion or enhancement is seen t o suggest act ive plagues. See Transcript at 304. The result s of Greer’ s cervical spine MRI revealed t he following: A new, 12-mm enhancing plaque is ident ified in t he post erior spinal cord t owards t he right of midline at t he C6 level. Previously not ed signal abnormalit y at t he C3 level has decreased in int ensit y. Findings are compat ible wit h act ive mult iple sclerosis. Given cord lesions, Devic’ s disease should also be considered alt hough opt ic nerves appear normal on MRI [of her] brain. See Transcript at 305. Greer saw Zini on what appears t o have been five occasions in 2015 for MS and headaches. See Transcript at 322-325 (01/ 30/ 2015), 318-321 (02/ 27/ 2015), 314-317 (05/ 06/ 2015), 309-313 (09/ 09/ 2015), 362-366 (11/ 10/ 2015). His progress not es reflect t hat her MS was moderat e t o severe, was causing let hargy, but was relieved wit h pain medicat ion, rest , and muscle relaxant s. His not es also reflect t hat her headaches were int ermit t ent and moderat e but finding an accept able medicat ion t o t reat t hem was proving t o be difficult . 5 Greer saw Zini on mult iple occasions in 2016 for MS and headaches. See Transcript at 357-361 (01/ 12/ 2106), 352-356 (03/ 10/ 2016), 347-351 (05/ 24/ 2016), 411-414 (11/ 07/ 2016), 425-428 (12/ 12/ 2016). His progress not es from t hose present at ions are subst ant ially similar t o his progress not es from 2015. Her MS was moderat e t o severe, was causing let hargy, but was relieved wit h pain medicat ion, rest , and muscle relaxant s. Her headaches were int ermit t ent and moderat e but finding an accept able medicat ion t o t reat t hem was proving difficult . He did not e, t hough, t hat she complained of a headache every morning and report ed t hat husband had t o “ sit [her] up in bed because [she] j ust [could not ] physically do it [herself.]” See Transcript at 411. On November 7, 2016, Zini complet ed a Treat ing Physician’ s Migraine Headache Form. See Transcript at 410. In t he form, Zini represent ed t hat Greer’ s headaches st art in t he back of her head and radiat e forward t o her left side. She experiences headaches more t han t hree t imes a week, and t hey last , on average, t went y-four hours. Her headaches are accompanied by nausea and vomit ing, phot ophobia, phonophobia, and t hrobbing/ pulsat ing. She was t aking medicat ion in t he form of Imit rex and hydrocodone. It was his opinion t hat her headaches will int erfere wit h her abilit y t o work and cause her t o miss work. 6 Greer was also seen for her MS in 2016 by Dr. Sombabu Magant i, M.D., (“ Magant i” ). See Transcript at 373-376 (07/ 11/ 2016). Greer’ s hist ory of present illness included t he following complaint s: ... [Greer] was diagnosed wit h mult iple sclerosis incident ally while being evaluat ed for headaches in 2013. [Cerebrospinal Fluid] st udies confirmed MS. She was st art ed on Copaxone. She could not t olerat e[] side effect s and has t o quit e t aking it (hair loss, loss of fat t y [t ]issue in t he back of t he head, exhaust ion, psychosis). She t ook [C]opaxone for 3 mont hs only. She was st art ed on Plegridy aft er repeat [ed] MRI[s] showed cont inual worsening of MS lesions. While on Plegridy, she had MS relapse (May of 2015-right upper ext remit y numbness, t ingling.) She was on Plegridy for 4 mont hs and quit t aking it . She was get t ing psychosis t ype sympt oms on Plegridy as well. She has residual t ingling sensat ion of t he right upper ext remit y per report . No furt her episodes of one sided weakness, numbness, blindness. She [has a] hist ory of headaches. She has been having 2 t o 3 headaches per week-radiat ing from back of head t o t he front associat ed wit h nausea, phot ophobia, phonophobia, double vision. See Transcript at 373. A physical examinat ion was unremarkable. Magant i diagnosed “ relapsing, remit t ing t ype mult iple sclerosis and int ract able migraine episodes.” See Transcript at 375. She prescribed Depakot e, Imit rex, and Phenergan. MRI t est ing of Greer’ s brain and cervical spine was performed in June of 2017. See Transcript at 544-546. The result s of t he brain MRI revealed t he following: 7 Pat chy [T2] hyperint ense lesions wit hin t he cerebral whit e mat t er involving perivent ricular and j uxt acort ical regions. The appearance is consist ent wit h underlying mult iple sclerosis. Not e t hat cont rast was not administ ered, which precludes evaluat ion for act ive demyelinat ion. See Transcript at 545. The result s of Greer’ s cervical spine MRI revealed t he following: Numerous T2 hyperint ense lesions scat t ered wit hin t he cervical spinal cord. Given t he clinical hist ory of mult iple sclerosis, t hese are consist ent wit h demyelinat ion plaques. Not e t hat cont rast was not administ ered, which precludes evaluat ion for act ive demyelinat ion. ... No significant degenerat ive changes. No narrowing of t he spinal canal or foramina. See Transcript at 546. Anot her round of MRI t est ing of Greer’ s brain and cervical spine was performed in August of 2017. See Transcript at 546-548. The result s of t he brain MRI revealed t he following: “ No significant change in t he mild burden of chronic demyelinat ing plaques compared wit h 6/ 1/ 2017. No new lesions ident ified. No areas of abnormal enhancement .” See Transcript at 547. The result s of t he cervical spine MRI revealed t he following: “ No significant change in t he chronic demyelinat ing plaques wit hin t he cervical spinal cord compared [wit h] 6/ 1/ 2017. No enhancing lesions ident ified.” Transcript at 548. 8 See Greer cont inued t o see Zini in 2017 and 2018. See Transcript at 538541 (06/ 20/ 2017), 534-547 (08/ 28/ 2017), 529-533 (09/ 26/ 2017), 524-528 (11/ 14/ 2017), 519-523 (12/ 14/ 2017), 514-518 (02/ 07/ 2018), 508-513 (03/ 08/ 2018), 502-507 (04/ 05/ 2018). The progress not es from t hose present at ions are similar in several respect s. Greer’ s MS was consist ent ly charact erized as moderat e t o severe, cont inued t o cause let hargy, but was relieved wit h pain medicat ion, rest , and muscle relaxant s. Zini repeat edly not ed her complaint s of fat igue and muscle pain. Her headaches were int ermit t ent and moderat e but finding an accept able medicat ion t o t reat t hem cont inued t o prove difficult . Greer repeat edly complained of a headache every morning and cont inued t o report t hat she required help in sit t ing up in bed. Physical examinat ions were t ypically rout ine, alt hough she exhibit ed diminished st rengt h, diminished t one, and a limit ed range of mot ion in her back. Drs. Ben Johnson, M.D., (“ Johnson” ) and Janet Cat hey, M.D., (“ Cat hey” ) reviewed Greer’ s medical records at t he request of t he st at e agency and offered an assessment of Greer’ s residual funct ional capacit y. See Transcript at 78-80, 96-98. Johnson and Cat hey agreed t hat Greer ret ained sufficient residual funct ional capacit y t o perform a full range of light work. 9 The record cont ains a summary of Greer’ s work hist ory. See Transcript at 210-228. It reflect s t hat she had negligible FICA earnings bet ween 2001 and 2015. Greer t est ified during t he administ rat ive hearing. See Transcript at 31-42. She is very rarely able t o do any chores around t he house and only drives a lit t le. She at t ribut ed her limit ed abilit ies t o her headaches and t he pain caused by her MS. She can only walk and/ or st and for about five minut es before she must rest and cannot sit for more t han five t o t en minut es before experiencing pain. Greer can only lift about five pounds at one t ime. When she experiences a flare up of MS, she experiences pain in her neck. She has migraine headaches at least t hree t imes a week and t akes several medicat ions t o t reat t hem. Greer spends most of her day in her bedroom. When asked why, she answered as follows: A. Because I can’ t really do a whole lot . I can sit down for small period[s] of t ime. I have t o lay down for a small period of t ime. And t hen I have t o walk around for a small period of t ime but my room—I can find t hat I can sit in my bed. I can lay down on t he bed but I have most of what I need right t here. Q. So how much of t he day would you act ually be away from your bedroom or away from a couch or away from t he floor and act ually doing somet hing in a t ypical average day? A. Maybe an hour. 10 Q. And what would you be doing in t hat hour of t he 24 hours t hat you’ re living in t he day? A. Eit her going t o t he bat hroom or get t ing my son and daught er somet hing t o eat or drink. Q. Okay. A. Maybe t wo hours. Q. What is t he longest you could do t hat at one t ime wit hout t aking any break what soever? A. Five t o t en minut es usually. See Transcript at 37. Greer has pain in her head, neck, and shoulder. On bad days, her pain is about nine t o t en on a t en-point pain scale. 3 The ALJ found t hat Greer’ s severe impairment s include MS and migraines, but she does not have an impairment t hat meet s or equals a list ed impairment . The ALJ assessed Greer’ s residual funct ional capacit y and found t hat Greer is capable of performing light work wit h t he following physical limit at ion: she is incapable of performing work t hat involves frequent balancing or t he climbing of ladders, ropes, or scaffolds. As a part of so finding, t he ALJ gave reduced weight t o Zini’ s opinions. The ALJ gave t he following reason for doing so: Greer’ s mot her also t est ified during t he administ rat ive hearing. See Transcript at 42-47. 3 11 [Greer’ s] primary care physician [i.e., Zini] complet ed a headache quest ionnaire in which he opined t hat [she] would miss work at least one day per week for migraines. ... However, his report of t he medicat ions [she] was t aking was inconsist ent wit h his own t reat ment records. He report ed t hat she was t aking Imit rex when his t reat ment records showed she was not . His opinion is accorded reduced weight for inconsist ency wit h his own t reat ment not es. See Transcript at 20. The ALJ found t hat Greer has no past relevant work, but a hypot het ical individual wit h Greer’ s limit at ions could perform work as a cashier or a sales at t endant . Greer first maint ains t hat her migraine headaches were not evaluat ed in accordance wit h List ing 11.02, t he list ing she maint ains is t he most closely analogous list ing for her headaches. She maint ains t hat given her sympt oms and how t hey correspond t o t he list ing, “ a more t horough considerat ion of [her] chronic migraines is warrant ed at st ep t hree of t he sequent ial evaluat ion process.” See Docket Ent ry 11 at CM/ ECF 14. At st ep t hree, t he ALJ is required t o det ermine whet her a claimant ’ s impairment s meet or equal a list ed impairment . See Raney v. Barnhart , 396 F.3d 1007 (8t h Cir. 2005). The det erminat ion is solely a medical one, see Cockerham v. Sullivan, 895 F.2d 492 (8t h Cir. 1990), and t he claimant bears t he burden of showing t hat her impairment meet s or equals a list ed impairment , see Pyland v. Apfel, 149 F.3d 873 (8t h Cir. 1998). 12 The ALJ found at st ep t hree t hat Greer’ s impairment s do not meet or equal a list ed impairment . There is no indicat ion t hat t he ALJ considered whet her Greer’ s migraine headaches meet or equal List ing 11.02. 4 The Court accept s Greer’ s represent at ion t hat t he ALJ should have considered t he list ing. The ALJ’ s failure t o do so does not warrant a remand, t hough, because t he record support s his overall conclusion at st ep t hree. 5 The Court so finds for t wo reasons. First , Greer has failed t o produce medical evidence support ing her assert ion t hat her headaches meet or equal t he crit eria set fort h in List ing 11.02. Second, wit h respect t o t he medical evidence t hat is in t he record, t he Court can only guess as t o what evidence might meet or equal t he crit eria set fort h in t he list ing. Greer offers a second reason why t he ALJ’ s findings are not support ed by subst ant ial evidence on t he record as a whole. She maint ains t hat her residual funct ional capacit y was erroneously assessed because t he medical opinions were not given proper weight , and insufficient considerat ion was given t o t he side effect s of her medicat ion. The Court accept s Greer’ s represent at ion t hat List ing 11.02 is t he most closely analogous list ing for migraine headaches. 4 See Pepper on behalf of Gardner v. Barnhart , 342 F.3d 853 (8t h Cir. 2003) (alt hough preferable t hat ALJ address a specific list ing, failure t o do so is not reversible error if record support s overall conclusion at st ep t hree). 5 13 The ALJ is required t o assess t he claimant ’ s residual funct ional capacit y, which is a det erminat ion of t he most t he claimant can do despit e her limit at ions. See Brown v. Barnhart , 390 F.3d 535 (8t h Cir. 2004). The assessment is made using all of t he relevant evidence in t he record. See Jones v. Ast rue, 619 F.3d 963 (8t h Cir. 2010). In assessing t he claimant ’ s residual funct ional capacit y, t he ALJ must weigh t he medical opinions in t he record and resolve any conflict s among t hem. See Wagner v. Ast rue, 499 F.3d 842 (8t h Cir. 2007). A t reat ing physician’ s medical opinions are ent it led t o cont rolling weight if t hey are well-support ed by medically accept able clinical and laborat ory diagnost ic t echniques and are not inconsist ent wit h t he ot her subst ant ial evidence. See Michel v. Colvin, 640 Fed.Appx. 585 (8t h Cir. 2016). The opinions may be discount ed if, for example, t hey are inconsist ent wit h t he physician’ s own t reat ment not es. See Adair v. Saul, --- Fed.Appx. ---, 2020 WL 2988696 (8t h Cir. June 4, 2020). The ALJ discount ed Zini’ s medical opinions in t he Treat ing Physician’ s Migraine Headache Form because t hey are inconsist ent wit h Zini’ s own progress not es. Alt hough t he ALJ only gave one example t o support his reason, t he reason is a good reason for discount ing Zini’ s medical opinions and is support ed by subst ant ial evidence on t he record as a whole. 14 The Court begins by not ing t hat Zini’ s medical opinions are rendered in what is t ant amount t o a one-page checklist format , which is of limit ed value. See Papesh v. Colvin, 786 F.3d 1126 (8t h Cir. 2015). He provided no obj ect ive medical evidence t o support his opinions and provided no explanat ion for how he came t o hold t he opinions. In fact , many of his opinions appear t o be based on Greer’ s self-report s. Addit ionally, Zini offered no opinions as t o t he funct ional limit at ions caused by Greer’ s headaches. 6 Alt hough he did opine t hat her headaches will int erfere wit h her abilit y t o work and cause her t o miss work, t he opinion is confusing in t hat it is not clear how many days of work he believed she will miss each week: at least one or a full seven. 7 Given t he format in which t he opinions are rendered, t he ALJ could reasonably discount t hem. The Court underst ands, t hough, t hat t he Treat ing Physician’ s Migraine Headache Form is but one part of larger record, and t he form should be, and will be, read in light of t hat record. A t reat ing physician’ s medical opinions may be discount ed if t hey do not ident ify specific funct ional limit at ions. See Adair v. Saul, 2020 WL 2988696 (medical opinion did not ident ify claimant ’ s specific funct ional limit at ions so ot her evidence in t he record was more inst ruct ive when det ermining which work-relat ed act ivit ies claimant could perform). 6 The ALJ underst ood Zini t o believe t hat Greer’ s headaches would cause her t o miss work “ at least one day per week.” See Transcript at 20. Greer underst ands Zini t o believe t hat Greer “ would be unable t o work seven days per week” because of her headaches. See Docket Ent ry 11 at CM/ ECF 5. 7 15 In t he Treat ing Physician’ s Migraine Headache Form, Zini opined t hat Greer’ s headaches occur great er t han t hree t imes a week and last , on average, t went y-four hours. His progress not es are capable of more t han one accept able int erpret at ion, and it is possible t o const rue t hem so as t o be inconsist ent wit h t hose opinions. The not es make lit t le ment ion of how oft en she experiences headaches, save his observat ion t hat t hey are int ermit t ent . See Transcript at 341, 338, 334, 314, 309, 362, 357, 352, 347, 411. Wit h respect t o t heir durat ion, he simply not es t hat t hey began several years earlier but makes lit t le ment ion of how long her headaches last once t hey begin. 8 Zini opined t hat Greer was t aking Imit rex and hydrocodone for her headaches. His progress not es reflect t hat alt hough she had t aken, or was t aking, hydrocodone, he appears t o have not prescribed Imit rex. It is t rue t hat Magant i had prescribed Imit rex in July of 2016, or prior t o Zini’ s complet ion of t he Treat ing Physician’ s Migraine Headache Form, see Transcript at 375, but t here is not hing t o indicat ion t hat Zini reviewed Magant i’ s progress not e before complet ing t he form. Zini also opined t hat Greer’ s headaches are accompanied by nausea and vomit ing, phot ophobia, phonophobia, and t hrobbing/ pulsat ing, and his progress not es cont ain similar observat ions. His opinion is of lit t le value in assessing her residual funct ional capacit y, t hough, because he failed t o explain how t he sympt oms impact t he most she can do despit e her limit at ions. 8 16 Zini also opined t hat Greer’ s headaches will int erfere wit h her abilit y t o work and cause her t o miss work for some number of days each week. His progress not es do not support his opinion. Not wit hst anding t he confusion surrounding t he precise number of days he believes she will miss each week, he repeat edly observed t hat her headaches are moderat e in severit y. See Transcript at 341, 338, 334, 314, 309, 362, 357, 352, 347, 411. Given Zini’ s observat ions t hat Greer’ s headaches are int ermit t ent and moderat e, t he ALJ could reasonably discount Zini’ s opinion t hat Greer will miss work mult iple days each week. It was possible for t he ALJ t o reasonably conclude t hat Zini’ s medical opinions are inconsist ent wit h his progress not es. Accordingly, t he ALJ could reasonably discount Zini’ s opinions. Greer fault s t he ALJ for according t oo much weight t o t he opinions of Johnson and Cat hey. 9 The record reflect s, t hough, t hat t heir opinions were but one of t he fact ors t he ALJ relied upon in assessing Greer’ s residual funct ional capacit y. In fact , t he ALJ found t hat Greer’ s limit at ions are more severe t han Johnson and Cat hey opined. The ALJ could find t hat t he opinions have support in t he record, and he did not err in weighing t hem. It is axiomat ic t hat t he medical opinions of a non-examining physician are generally accorded less weight t han t hose of an examining physician. See Wildman v. Ast rue, 596 F.3d 959 (8t h Cir. 2010). 9 17 Greer also fault s t he ALJ for failing t o fully develop t he record. Greer so maint ains because t he record does not cont ain an assessment from a t reat ing or examining physician addressing Greer’ s funct ional limit at ions. There is no requirement t hat t he assessment of a claimant ’ s residual funct ional capacit y be support ed by a specific medical opinion. See Hensley v. Colvin, 829 F.3d 926 (8t h Cir. 2016). In t he absence of opinion evidence, t he medical records of t he most relevant t reat ing physicians can provide affirmat ive medical evidence support ing t he assessment . See Id. The Court is sat isfied t hat t he ALJ adequat ely developed t he record, and t here is sufficient informat ion for him t o have made an informed decision. It is t rue t hat t here is no opinion from a t reat ing or examining physician addressing Greer’ s funct ional limit at ions. Alt hough such an opinion would have been helpful, one was not required. The ALJ could and did rely upon Chenault , Zini, Mylavarapu, and Magant i’ s progress not es in craft ing t he assessment of Greer’ s residual funct ional capacit y. The ALJ could reasonably find from t heir not es t hat Greer’ s MS is relapsingremit t ing, and when flare ups occur, t hey did not require medical at t ent ion. The ALJ could also reasonably find from t heir not es t hat Greer’ s headaches are moderat e and int ermit t ent . Given t hose findings, t he ALJ could find t hat Greer is capable of a reduced range of light work. 18 Greer offers a second reason why her residual funct ional capacit y was erroneously assessed. She maint ains t hat insufficient considerat ion was given t o t he side effect s of her medicat ion. As a part of assessing t he claimant ’ s residual funct ional capacit y, t he ALJ is required t o evaluat e t he claimant ’ s subj ect ive complaint s. See Pearsall v. Massanari, 274 F.3d 1211 (8t h Cir. 2001). The ALJ must consider all of t he evidence, including evidence of “ t he t ype, dosage, effect iveness, and side effect s of any medicat ion t he claimant t akes or has t aken t o alleviat e pain or ot her sympt oms.” See Social Securit y Ruling 16-3p. The record reflect s t hat t he ALJ considered t he side effect s of Greer’ s medicat ion, and subst ant ial evidence on t he record as a whole support s his considerat ion of t he side effect s. For example, he not ed t hat Plegridy inj ect ions caused her t o have adverse react ions, one of which was t hat she lost feeling in her right arm. See Transcript at 18. He not ed t hat she had t aken Tecfidera but st opped t aking it because it caused nausea and vomit ing. See Transcript at 18. The ALJ not ed t hat Greer had t aken amit ript yline but st opped t aking it because it caused “ anger issues.” See Transcript at 19. Addit ionally, he not ed t hat she had t aken prednisone but st opped t aking it because “ st eroids worsened her headaches.” See Transcript at 19. 19 The governing st andard in t his case allows for t he possibilit y of drawing t wo inconsist ent conclusion. See Culbert son v. Shalala, 30 F.3d 934 (8t h Cir. 1994). The ALJ craft ed an assessment of Greer’ s residual funct ional capacit y t hat limit ed her t o a reduced range of light work, and Greer has not shown why t he ALJ erred in doing so. On t he basis of t he foregoing, t he Court finds t hat t here is subst ant ial evidence on t he record as a whole t o support t he ALJ’ s findings. Greer’ s complaint is dismissed, all request ed relief is denied, and j udgment will be ent ered for t he Commissioner. IT IS SO ORDERED t his 10t h day of August , 2020. __________________________________ UNITED STATES MAGISTRATE JUDGE 20
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