Branscum v. Social Security Administration, No. 3:2017cv00277 - Document 15 (E.D. Ark. 2018)
Court Description: MEMORANDUM OPINION AND ORDER affirming the decision of the Commissioner. Branscum's complaint is dismissed, all requested relief is denied, and judgment will be entered for the Commissioner. Signed by Magistrate Judge Patricia S. Harris on 7/30/2018. (jak)
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Branscum v. Social Security Administration Doc. 15 IN THE UNITED STATES DISTRICT COURT EASTERN DISTRICT OF ARKANSAS JONESBORO DIVISION LINDA K. BRANSCUM PLAINTIFF v. NO. 3:17-cv-00277 PSH NANCY A. BERRYHILL, Acting Commissioner of the Social Security Administration DEFENDANT MEMORANDUM OPINION AND ORDER Plaint iff Linda K. Branscum (“ Branscum” ) began t his case by filing a complaint pursuant t o 42 U.S.C. 405(g). In t he complaint , she challenged t he final decision of t he Act ing Commissioner of t he Social Securit y Administ rat ion (“ Commissioner” ), a decision based upon t he findings of an Administ rat ive Law Judge (“ ALJ” ). Branscum maint ains t hat t he ALJ’ s findings are not support ed by subst ant ial evidence on t he record as a whole. 1 Branscum so maint ains for several reasons, t he primary one being t hat her residual funct ional capacit y was not properly assessed. Branscum was born on March 14, 1964, and was fift y years old on March 14, 2014, t he day she allegedly became disabled. She filed her applicat ion for disabilit y insurance benefit s on January 12, 2015, and alleged t hat she became disabled as a result of, int er alia, back problems, hypert ension, anxiet y, and ast hma. The uestio fo the Cou t is hethe the ALJ’s fi di gs a e suppo ted su sta tial e ide e o the e o d as a hole. “u sta tial e ide e ea s less tha a p epo de a e ut e ough that a easo a le pe so ould fi d it ade uate to suppo t the de isio . “ee Boett he . Ast ue, F. d , th Ci . . Dockets.Justia.com The bulk of t he medical evidence consist s of t he progress not es of Branscum’ s t reat ing physician, Dr. Charles Davidson, M.D., (“ Davidson” ), or his assist ant . The progress not es reflect t hat Branscum saw Davidson or his assist ant on numerous occasions bet ween Sept ember 6, 2012, and April 6, 2015, for several complaint s, t he primary of which were low back pain and anxiet y. 2 Branscum’ s pain was exacerbat ed wit h t wist ing movement s and caused weakness in her legs. She was prescribed medicat ion t hat included Mobic, and she report ed some relief from t he medicat ion. Wit h respect t o Branscum’ s anxiet y, t he aut hor of t he progress not es observed t hat Branscum’ s sympt oms included apprehension, short ness of breat h, t achycardia, and shaking. The sympt oms were oft ent imes accompanied by panic at t acks. Her sympt oms were exacerbat ed by crowds, public places, and family st ress. Medicat ion was prescribed, medicat ion t hat included benzodiazepine and Paxil. Davidson ordered t est ing during t he period he saw Branscum. For inst ance, on November 7, 2013, Branscum underwent an MRI of her lumbar spine. See Transcript at 270-271. No acut e fract ure or malalignment was not ed. The at t ending physician int erpret ed t he result as follows: “ [m]ild at t enuat ion of bot h lat eral recesses at L3-L4 and L4-L5. No significant neural impingement is appreciat ed. Part ial sacralizat ion of L5 on t he left .” See Transcript at 271. / / / / / / / / / / / / / / / / “ee T a s ipt at , / , / , / , / , / , / / , / , / / / / / / / / , , , , , , , , / / / / / / / / , / / / / / / / / / / , , , , , , , , / / / / / / / / / / / / / / / / / / , , , , , , / / / / / / , / , / , / / / / / / / / / / , , , , , , , , . Davidson referred Branscum t o Dr. Tim Maryanov, M.D., (“ Maryanov” ) for an evaluat ion of Branscum’ s back pain. See Transcript at 321-322. Maryanov examined Branscum on November 28, 2013, and his observat ions included t he following: her orient at ion was good; her at t ent ion was appropriat e; her gait was normal; a “ musculoskelet al exam [was] significant for exquisit e t enderness t o palpat ion of t he right sacroiliac j oint ;” a “ mot or exam of t he lower ext remit ies show[ed] full 5/ 5 mot or st rengt h in bilat eral iliopsoas, quads, hamst rings, dorsiflexion, and plant ar flexion;” and she had a “ posit ive FABER flexion abduct ion ext ernal rot at ion of t he t high maneuver on t he right side.” See Transcript at 321. Maryanov reviewed Branscum’ s earlier lumbar spine MRI and observed t hat t he result s were “ near normal.” See Transcript at 321. Maryanov found evidence t hat suggest ed “ sacroiliac j oint pat hology.” See Transcript at 322. He recommended against surgical int ervent ion but inst ead recommended physical t herapy and also referred her t o Dr. Gregory Ricca, M.D., (“ Ricca” ). Branscum saw Ricca on Oct ober 21, 2014. See Transcript at 347-352. Branscum report ed muscle aches in her lower back and lower ext remit ies, j oint pain in her hip and right knee, and some swelling in her hands. Ricca observed t hat she had a normal range of mot ion in t he t horacic and lumbar port ions of her spine, but her gait was moderat ely ant algic wit h a right limp. He diagnosed, int er alia, lumbago wit h sciat ica and right sacroiliit is. She chose t o undergo a diagnost ic right sacroiliac j oint block. Branscum saw Ricca again on January 27, 2015. See Transcript at 342-346. She had undergone t wo right sacroiliac j oint blocks by t hat t ime, but she report ed lit t le benefit . She cont inued t o complain of pain in her right groin and right t high. He observed t hat she was using a cane t o walk, specifically not ing t he following: Ms. Branscum uses a cane because “ my doct or t old me not t o go anywhere wit hout it .” He made t his suggest ion “ because I’ ve been falling a lot .” She has only fallen once since she st at ed using it 2-3 mont hs ago. ... She has been using a cane for t he past mont h because “ my [right ] leg would j ust go [out ], and I can’ t cat ch myself.” See Transcript at 342. A physical examinat ion revealed, in part , t hat Branscum had no muscle aches or j oint pain but did have localized soft t issue swelling of t he ankle. Ricca observed t hat Branscum had a normal range of mot ion in her t horacic and lumbar spines, but she cont inued t o walk wit h a right limp. He was unable t o ident ify a “ st ruct ural cause” for her pain. See Transcript at 346. On February 11, 2015, Branscum sought medical at t ent ion at Five Rivers Medical Cent er aft er missing a st ep and falling down some st airs. See Transcript at 475-487. Xrays of her right ankle were t aken, and t he result s revealed a “ [f]ract ure-dislocat ion of t he dist al t ibia and fibula” and “ [d]isrupt ion of t he t ibiot alar j oint .” See Transcript at 485. The following day, Dr. Rolando Cheng, M.D., (“ Cheng” ) performed an open reduct ion and int ernal fixat ion of Branscum’ s right ankle. See Transcript at 488-489. Branscum was seen for follow-up on what appears t o have been five occasions. See Transcript at 490-491 (02/ 24/ 2015), 493 (03/ 18/ 2015), 494 (03/ 20/ 2015), 496 (03/ 31/ 2015), 497-499 (06/ 11/ 2015). X-rays of her right ankle were t aken on June 11, 2015, and t he result s revealed a successful reduct ion of t he fract ure sit es and “ [f]ract ure fragment s now present in near anat omic alignment .” See Transcript at 497. No signs of new bony abnormalit ies were observed. Alt hough Branscum was experiencing some swelling, Cheng observed t hat she was doing bet t er. On May 27, 2016, an MRI was t aken of Branscum’ s lumbar spine at t he direct ion of Davidson. See Transcript at 506-507. The at t ending physician int erpret ed t he result s as follows: Mult ilevel degenerat ive disc changes and facet art hropat hy in t he lumbar spine ... Findings are not significant ly changed compared t o t he 11/ 7/ 2013 exam. Mild spinal canal narrowing at L2-3, L3-4, and L4-5 levels. Left lat eral recess narrowing and moderat e left neural foraminal narrowing at L3-4 appears unchanged compared t o t he previous exams. Transit ional lumbosacral anat omy wit h part ial sacralizat ion of t he L5 vert ebral body on t he left . See Transcript at 507. On June 13, 2016, Davidson complet ed a Medical Source St at ement (“ St at ement ” ) regarding Branscum’ s physical limit at ions. See Transcript at 508. In t he St at ement , he represent ed t hat she can lift and carry t en pounds occasionally but can lift and carry less t han t en pounds frequent ly, she can st and and walk for less t han t wo hours in an eight hour workday, she can sit for less t han t wo hours in an eight hour workday, and she is unable t o reach. He also st at ed t hat she must change posit ions frequent ly, requires frequent rest periods, and requires longer t han normal breaks. According t o Davidson, Branscum must avoid all exposure t o perfumes and must avoid even moderat e exposure t o t hings like ext reme heat , high humidit y, and chemicals. Davidson opined t hat Branscum’ s impairment s or t reat ment would require her t o miss work more t han t hree days a mont h. He represent ed t hat his opinions were based on t he pain she exhibit ed wit h movement and cert ain act ivit ies; her inabilit y t o maint ain any posit ion for more t han a few minut es; and t he result s of her May 27, 2016, MRI, which he charact erized as abnormal. Branscum’ s medical records were reviewed by st at e agency medical professionals. See Transcript at 57-67, 69-81. The medical professionals opined t hat she could perform a range of light work wit h no ment al limit at ions. A series of document s were complet ed by Branscum and her daught er in connect ion wit h Branscum’ s applicat ion. See Transcript at 168-174, 175-176, 177-184, 185-191, 194-200, 201-210, 21-212, 213-220, 223-230. In t he document s, it was represent ed t hat Branscum experiences pain in her back, hip, leg, and ankle when she at t empt s t o work. It was furt her represent ed t hat she has difficult y at t ending t o her own personal care, can only occasionally prepare a meal, can perform minimal housework but no yard work, has difficult y get t ing around, and uses assist ive devices t o walk. The document s indicat e she can shop for groceries and manage her finances. Her hobbies include wat ching t elevision, reading her Bible, and playing wit h her grandchildren. She spends t ime wit h ot hers and enj oys at t ending church. Branscum claims her ment al impairment causes difficult ies wit h memory, concent rat ion, and complet ing t asks. She st at es she can follow short writ t en and spoken inst ruct ions but has difficult y wit h longer writ t en and spoken inst ruct ions. The record cont ains evidence of Branscum’ s work record. See Transcript at 154155, 156-159, 160. Her work record reflect s t hat she had minimal report able earnings bet ween 1981 and 2008. She had some report able earnings from 2009 t hrough 2013, but minimal or no report able earning aft er 2013. Branscum t est ified during t he administ rat ive hearing. See Transcript at 37-51. She st at ed she was fift y-t wo years old and a high school graduat e. She worked as a subst it ut e t eacher and lat er as a t eacher’ s aide in public high schools in t he St at e of Arkansas. When asked about her last j ob, she t est ified as follows: I left my last j ob because I couldn’ t walk around and get around like I used t o. I was having problems. My back was worse t o me. The pain was awful. I had t o t ake medicat ion daily, and I didn’ t feel like I needed t o be t aking medicat ion and driving and working ... Did you quit t he j ob or were you t erminat ed? I quit it . See Transcript at 40-41. Branscum uses a cane t o walk but acknowledged t hat no physician prescribed t he use of a cane. Branscum’ s use of a cane depends upon how she feels from one day t o t he next . She t akes medicat ion for her sympt oms, and t he medicat ion is of some benefit . On a good day, she can help wit h chores around her house. She can shop but does not like going out because of her anxiet y. Branscum has pain in her back and pelvis t hat is exacerbat ed wit h movement . Her pain is relieved by lying down, which she st at es she must do for approximat ely t hree hours a day. She t akes oxycodone and muscle relaxers for her pain. She has difficult y breat hing and uses an inhaler. Branscum experiences migraine headaches, having one at least t hree t imes a mont h. When she has one, she ret ires t o her bed for approximat ely an hour. She also claims she suffers from depression, anxiet y, and panic at t acks. She t akes medicat ion for her sympt oms, medicat ion t hat includes Xanax and Paxil. The ALJ found at st ep t wo of t he sequent ial evaluat ion process t hat Branscum has severe impairment s in t he form of “ remot e right ankle fract ure, st at us post open reduct ion int ernal fixat ion, degenerat ive disc disease of t he lumbar spine, morbid obesit y, hypert ension, anxiet y, and depression.” See Transcript at 19. He assessed her residual funct ional capacit y and found t hat she can perform light work albeit wit h t he following limit at ions: ... [Branscum] cannot climb ladders, ropes, or scaffolds. She can no more t han occasionally climb ramps and st airs, balance, st oop, kneel, crouch, and crawl. She can never be exposed t o unprot ect ed height s in t he workplace. She is limit ed t o unskilled, simple, rout ine, and repet it ive t ask j obs, where t he supervision will be simple, direct , and concret e. She is limit ed t o SVP one or t wo j obs t hat can be learned wit hin 30 days. She is t o have no cont act wit h t he general public. See Transcript at 21. In so finding, t he ALJ accept ed t hat Branscum’ s impairment s result in some limit at ion of her work-relat ed funct ioning. Specifically, he not ed t he following: While it is clear t hat [Branscum’ s] severe impairment s result in limit at ions in some work-relat ed funct ioning, [t he ALJ] has account ed for said limit at ions by rest rict ing [Branscum] t o work at t he light exert ional level wit h addit ional post ural and ment al limit at ions. This modified light residual funct ional capacit y addresses [her] ant algic gait , t enderness, decreased sensat ion, subj ect ive complaint s of pain, headaches, and chest pain. The medical imaging of record furt her support t he weight and post ural limit at ions. Addit ionally, t he ment al limit at ions account for [her] depressed/ anxious mood, panic at t acks, and medicat ion side effect s. See Transcript at 25. In assessing Branscum’ s residual funct ional capacit y, t he ALJ gave lit t le weight t o Davidson’ s opinions cont ained in t he St at ement because t hey are inconsist ent wit h his “ obj ect ive findings and t he ot her evidence of record.” See Transcript at 24. The ALJ found at st ep four t hat Branscum cannot perform her past relevant work. A vocat ional expert t est ified t hat someone wit h Branscum’ s limit at ions can, t hough, perform ot her j obs. The ALJ credit ed t he t est imony and found at st ep five t hat t here are ot her j obs Branscum can perform. Branscum maint ains t hat 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 not properly assessed, in large part , because t he ALJ discount ed Davidson’ s opinions cont ained in his June 13, 2016, St at ement . 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). It is made using all of t he relevant evidence in t he record and must be support ed by some medical evidence. See Wildman v. Ast rue, 596 F.3d 959 (8t h Cir. 2010). As a part of t he assessment , t he ALJ must consider t he medical opinions in t he record. See Wagner v. Ast rue, 499 F.3d 842 (8t h Cir. 2007). A t reat ing physician’ s opinions are given cont rolling weight “ if, and only 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 Winn v. Commissioner, 2018 WL 3322247, 3 (8t h Cir. July 6, 2018) [int ernal quot at ions omit t ed]. The reasons t he ALJ gave for discount ing Davidson’ s opinions in his June 13, 2016, St at ement are support ed by subst ant ial evidence on t he record as a whole. The Court so finds for t wo reasons. First , t he ALJ could and did find t hat Davidson’ s opinions are inconsist ent wit h t he progress not es compiled by Davidson and his assist ant . The aut hor of t he progress not es repeat edly recorded Branscum’ s complaint s of pain, observed t hat she had a limit ed range of mot ion in her back, walked wit h a limp, and occasionally used an assist ive device t o walk. Branscum was inst ruct ed t o avoid heavy lift ing and, at t imes, was inst ruct ed not t o work. The lat t er recommendat ion is problemat ic because t here is not hing t o suggest t hat t he aut hor knew t he demands of Branscum’ s work. Moreover, t he aut hor did not explain t he reasons for making t he recommendat ion. In short , it is not clear how Davidson could have offered t he opinions he did based on such minimal findings and observat ions. Second, t he ALJ could and did find t hat t he opinions Davidson offered in his June 13, 2016, St at ement were inconsist ent wit h t he result s of t he medical t est ing. A November 7, 2013, MRI of Branscum’ s lumbar spine revealed no acut e fract ure or malalignment and no significant neural impingement . Inst ead, t he result s revealed mild at t enuat ion of bot h lat eral recesses at L3-L4 and L4-L5 and a part ial sacralizat ion of L5 on t he left . Maryanov charact erized t he result s of t he MRI as “ near normal.” See Transcript at 321. A second MRI of Branscum’ s lumbar spine was performed on May 27, 2016. The result s showed no significant change as t he at t ending physician not ed t hat t he “ [f]indings are not significant ly changed compared t o t he 11/ 7/ 2013 exam.” See Transcript at 507. The result s of t he May 27, 2016, MRI were int erpret ed as showing “ [m]ult ilevel degenerat ive disc changes and facet art hropat hy in t he lumbar spine;” “ [m]ild spinal canal narrowing at L2-3, L3-4, and L4-5 levels;” and “ [t ]ransit ional lumbosacral anat omy wit h part ial sacralizat ion of t he L5 vert ebral body on t he left .” See Transcript at 507. On February 11, 2015, Branscum sought medical at t ent ion aft er missing a st ep and falling down some st airs. She was found t o have a “ [f]ract ure-dislocat ion of t he dist al t ibia and fibula” and “ [d]isrupt ion of t he t ibiot alar j oint .” See Transcript at 485. An open reduct ion and int ernal fixat ion of her right ankle was performed. A subsequent x-ray of t he ankle revealed a successful reduct ion of t he fract ure sit es and “ [f]ract ure fragment s now present in near anat omic alignment .” See Transcript at 497. No signs of new bony abnormalit ies were observed. Alt hough Branscum experienced some swelling, Cheng observed t hat Branscum’ s condit ion improved over t ime. Davidson’ s opinions are also inconsist ent wit h t he findings and observat ions of t he ot her medical professionals. When Branscum saw Maryanov on November 28, 2013, he observed t hat her gait was normal; a “ musculoskelet al exam [was] significant for exquisit e t enderness t o palpat ion of t he right sacroiliac j oint ;” a “ mot or exam of t he lower ext remit ies show[ed] full 5/ 5 mot or st rengt h in bilat eral iliopsoas, quads, hamst rings, dorsiflexion, and plant ar flexion;” and she had a “ posit ive FABER flexion abduct ion ext ernal rot at ion of t he t high maneuver on t he right side.” See Transcript at 321. He recommended physical t herapy and referred her t o Ricca. Branscum saw Ricca on Oct ober 21, 2014, and he observed t hat she had a normal range of mot ion in t he t horacic and lumbar port ions of her spine, but her gait was moderat ely ant algic wit h a right limp. He diagnosed, int er alia, lumbago wit h sciat ica and right sacroiliit is and recommended a diagnost ic right sacroiliac j oint block. When Branscum saw Ricca again on January 27, 2015, Branscum had undergone t wo right sacroiliac j oint blocks t hat proved t o be of lit t le benefit . He observed t hat she was using a cane t o walk, but she report ed t hat her use of t he cane had been a mere “ suggest ion” by a physician. See Transcript at 342. A physical examinat ion revealed, in part , t hat she had no muscle aches or j oint pain but did have localized soft t issue swelling of t he ankle. Ricca observed t hat Branscum had a normal range of mot ion in her t horacic and lumbar spines but cont inued t o walk wit h a right limp. He was unable t o ident ify a “ st ruct ural cause” for her pain. See Transcript at 346. “ [W]het her t he ALJ grant s a t reat ing physician’ s opinion[s] subst ant ial or lit t le weight , t he regulat ions ... provide t hat t he ALJ must ‘ always give good reasons’ for t he part icular weight given t o a t reat ing physician’ s evaluat ion.” See Singh v. Apfel, 222 F.3d 448, 452 (8t h Cir. 2000) [quot ing 20 C.F.R. 404. 1527(d)(2)]. In t his inst ance, t he ALJ gave good reasons for t he manner in which he weighed Davidson’ s opinions cont ained in his June 13, 2016, St at ement . Branscum offers ot her reasons why her residual funct ional capacit y was not properly assessed. She maint ains t hat t he ALJ misconst rued Cheng’ s t reat ment records, not ing t hat t he ALJ erred when he observed t hat “ [b]y May 2015, t reat ment records show t hat [Branscum’ s] sympt oms had been relieved wit h surgical repair and t hat her ort hopedic surgeon was no longer prescribing [Branscum] pain medicat ion.” See Docket Ent ry 13 at CM/ ECF 6 [quot ing Transcript at 23]. The Court is sat isfied t hat Cheng’ s t reat ment records could be const rued as t he ALJ did. Cheng performed t he open reduct ion and int ernal fixat ion of Branscum’ s right ankle on February 12, 2015. Branscum subsequent ly report ed t hat she was doing well. X-rays revealed a successful reduct ion of t he fract ure sit es, and no signs of new bony abnormalit ies were observed. Alt hough Branscum was experiencing some swelling, Cheng observed t hat Branscum was doing bet t er. On April 6, 2015, Branscum report ed t o Davidson or his assist ant t hat Cheng was no longer prescribing pain medicat ion. Branscum maint ains t hat inadequat e considerat ion was given t o her use of an assist ive device t o walk. She represent s t hat she has pain in her lower ext remit ies and walks wit h a limp, and her use of an assist ive device is t herefore reasonable. The Court is sat isfied t hat t he ALJ gave adequat e considerat ion t o Branscum’ s use of an assist ive device t o walk. The record reflect s t hat her use of t he device was never recommended by a physician but was only a suggest ion by a physician, and Branscum appears t o have only used such a device on an as-needed basis. Branscum maint ains t hat she cannot perform t he st anding and walking requirement s of light work, work t hat requires a claimant t o st and and walk for six hours in an eight hour workday. She maint ains t hat she has t rouble wit h her gait and experiences “ weakness in her lower ext remit y, posit ive leg raises, chronic persist ent back pain, muscle spasm, and decreased range of mot ion.” See Docket Ent ry 13 at CM/ ECF 7. Branscum maint ains t hat t he ALJ failed t o acknowledge t hose limit at ions. The Court is sat isfied t hat t he ALJ adequat ely account ed for Branscum’ s weakness in her lower ext remit y, posit ive leg raises, chronic persist ent back pain, muscle spasm, and decreased range of mot ion. He craft ed a residual funct ional capacit y t hat limit ed her t o light work wit h addit ional post ural limit at ions, an assessment t hat addressed her “ ant algic gait , t enderness, decreased sensat ion, subj ect ive complaint s of pain, headaches, and chest pain.” See Transcript at 25. Branscum maint ains t hat t oo much weight was accorded her work record. She acknowledges t hat she only worked sporadically, part icularly aft er Cheng performed an open reduct ion and int ernal fixat ion of Branscum’ s right ankle on February 11, 2015. Branscum maint ains t hat her work record “ raises quest ions as t o whet her [her] cont inuing unemployment [was] act ually due t o a medical impairment .” See Docket Ent ry 13 at CM/ ECF 6. The Court is sat isfied t hat t he ALJ did not accord t oo much weight t o Branscum’ s work record, which is less t han st ellar. Alt hough a claimant ’ s limit at ions can cause a poor work record, t here is lit t le t o suggest t hat Branscum’ s poor work record was caused by her impairment s. Her work record was poor well before she allegedly became disabled on March 14, 2014. Branscum maint ains t hat she suffers from severe ment al impairment s in t he form of “ panic at t acks, anxiet y, anxiet y at t acks, depression, and fat igue.” See Docket Ent ry 13 at CM/ ECF 17. She maint ains t hat t he impairment s were not adequat ely considered. The Court is sat isfied t hat t he ALJ gave adequat e considerat ion t o Branscum’ s ment al impairment s and t he limit at ions t hey cause. Alt hough Branscum maint ains t hat t he impairment s cause numerous work-relat ed limit at ions, t he evidence support ing t he limit at ions is unremarkable. In any event , t he ALJ craft ed a residual funct ional capacit y t hat limit ed her t o light work wit h addit ional ment al limit at ions in t he form of t he following: “ [Branscum] is limit ed t o unskilled, simple, rout ine, and repet it ive t ask j obs, where t he supervision will be simple, direct , and concret e. She is limit ed t o SVP one or t wo j obs t hat can be learned wit hin 30 days. She is t o have no cont act wit h t he general public.” See Transcript at 21. The governing st andard, i.e., subst ant ial evidence on t he record as a whole, allows for t he possibilit y of drawing t wo inconsist ent conclusions. See Culbert son v. Shalala, 30 F.3d 934 (8t h Cir. 1994). The ALJ craft ed an assessment of Branscum’ s residual funct ional capacit y t hat limit ed her t o light work wit h addit ional post ural and ment al limit at ions. Branscum has not shown how t he ALJ erred in doing so. In short , t he ALJ could find as he did. Berry offers a second reason why t he ALJ’ s decision is not support ed by subst ant ial evidence on t he record as a whole. Branscum maint ains t hat t he ALJ relied upon t he answer t o a flawed hypot het ical quest ion, flawed because it did not cont ain limit at ions for Branscum’ s difficult ies st anding and walking; her ast hma, allergies, and dyspnea; and t he side effect s of her medicat ion. Test imony from a vocat ional expert is subst ant ial evidence on t he record as a whole only when “ t he t est imony is based on a correct ly phrased hypot het ical quest ion t hat capt ures t he concret e consequences of a claimant ’ s deficiencies.” See Taylor v. Chat er, 118 F.3d 1274, 1278 (8t h Cir. 1997). The quest ion must t herefore include all of t he claimant ’ s impairment s t hat are subst ant ially support ed by t he record as a whole. See Id. A vocat ional expert t est ified during t he administ rat ive hearing, see Transcript at 51-54, during which she was asked a series of hypot het ical quest ions. In one quest ion, t he vocat ional expert was asked t o assume an individual of Branscum’ s age, educat ion, and work experience who could perform light work. The ALJ also ident ified a number of limit at ions t hat t he individual had, none of which involved a severe rest rict ion in t he abilit y t o st and and walk; ast hma, allergies, and dyspnea; or t he side effect s of any medicat ion. The vocat ional expert t est ified t hat t he hypot het ical individual could perform work as a housekeeper and a price t ag t icket er. 3 The ALJ credit ed t he t est imony and found t hat t here are j obs Branscum can perform. The ALJ did not err in craft ing t he hypot het ical quest ion or in relying upon t he vocat ional expert ’ s answer. The quest ion capt ured t he concret e consequences of Branscum’ s limit at ions and was adequat ely phrased. It is t rue t hat t he quest ion did not incorporat e limit at ions for a severe rest rict ion in t he abilit y t o st and and walk; ast hma, allergies, and dyspnea; or t he side effect s of any medicat ion. The ALJ’ s failure t o do so, t hough, does not warrant a remand. Subst ant ial evidence on t he record as a whole support s t he ALJ’ s det erminat ion t hat Branscum can st and and walk for up t o six hours in an eight hour workday. There is also lit t le evidence t hat Branscum’ s ast hma, allergies, or dyspnea, or t he side effect s of her medicat ion, significant ly impact her work-relat ed abilit ies. On t he basis of t he foregoing, t here is subst ant ial evidence on t he record as a whole t o support t he ALJ’ s findings. Branscum’ 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 30t h day of July, 2018. ________________________________________ UNITED STATES MAGISTRATE JUDGE I a se o d uestio , the ALJ asked the o atio al e pe t to assu e the sa e li itatio s plus a i a ilit to sta d, alk, o sit fo o e tha t o hou s i a eight hou o kda . The o atio al e pe t testified that the e as o o k a aila le fo su h a i di idual. I a thi d uestio , the ALJ asked the o atio al e pe t to assu e the sa e diffi ulties plus, i te alia, dep essio a d a iet t pe issues. The o atio al e pe t testified that the e as o o k a aila le fo su h a i di idual.
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