Reese v. O'Malley

U.S. District Court, District of Minnesota

Reese v. O'Malley

Trial Court Opinion

                UNITED STATES DISTRICT COURT                            
                   DISTRICT OF MINNESOTA                                


Brian John R.,                       Case No. 23-CV-2023 (JFD)          

              Plaintiff,                                                

v.                                          ORDER                       

Martin J. O’Malley, Commissioner of                                     
the Social Security Administration,                                     

              Defendant.                                                


   Pursuant to 
42 U.S.C. § 405
(g), Plaintiff Brian John R. seeks judicial review of a 
final decision by the Commissioner of the Social Security Administration, which denied 
the Plaintiff’s application for disability insurance benefits (“DIB”). The case is before the 
Court on the parties’ cross-Motions for Summary Judgment (Dkt. Nos. 12 and 15). Plaintiff 
seeks summary judgment and a remand to the agency under Sentence Four of 
42 U.S.C. § 405
. Plaintiff claims that the administrative law judge (“ALJ”) did not adequately assess 
Plaintiff’s post-traumatic stress disorder and also claims that the ALJ failed to account for 
Plaintiff’s limitations in persistence at step three of the five-step process by which Social 
Security disability claims are evaluated. Defendant both opposes Plaintiff’s motion for 
summary  judgment  and  affirmatively  seeks  summary  judgment  affirming  the 
Commissioner. Because the Court finds the ALJ’s decision was supported by substantial 
evidence and is free of legal error, the Court grants Defendant’s motion for summary 
judgment,  denies  Plaintiff’s  motion  for  summary  judgment,  and  affirms  the 
Commissioner.1                                                            

I.   Background                                                           
   Plaintiff applied for DIB on December 20, 2021, alleging a disability onset date of 
December 31, 2017 due to bilateral shoulder injuries, depression, anxiety, and post-
traumatic stress disorder (“PTSD”). ((See Soc. Sec. Admin. R. (hereinafter “R.”) 77.)2 The 
Social Security Administration also identified potential issues with substance abuse and 
hypertension. (Id.) Plaintiff has past relevant work experience as the driver of a food 

delivery truck. (R. 54.)                                                  
   A.   Procedural History                                              
   Plaintiff filed an application for DIB on December 20, 2021. (R. 77.) He stated that 
he had been unable to work since December 31, 2017 due to PTSD, anxiety, depression, 
and issues with both of his shoulders (Id.), though Plaintiff told the state agency reviewer 

who reviewed the initial denial of Plaintiff’s DIB claim that “his shoulders is [sic] not the 
issue, it is his mental health. He does not feel he has any ongoing issues with his shoulders. 


1 As explained below in the discussion of legal standards, a Plaintiff can seek judicial 
review of a decision by the Commissioner on grounds that the ALJ’s decision is not 
supported by substantial evidence, on grounds that the ALJ committed legal error, or on 
both grounds. Plaintiff in this case does not make clear whether he challenges the ALJ’s 
decision because it is legally erroneous, or whether Plaintiff alleges that any shortfall in 
the evidence is the result of legal errors on the ALJ’s part. In this Order, the Court finds 
that the ALJ’s decision was both supported by substantial evidence and was free of legal 
error.                                                                    

2 The administrative record is filed at Dkt. No. 8. The social security record is consecutively 
paginated, and the Court cites to that pagination rather than the ECF number and page. 
They do not prevent him from working or completing daily activities.” (R. 91.) The state 
agency  reviewers  who  first  evaluated  Plaintiff’s  DIB  application  also  noted  “hidden 

allegation[s]” of substance use disorder and hypertension. (R. 78.) Of note to this summary 
judgment motion, in evaluating Plaintiff’s claimed mental health limitations the state 
agency  examiner  found  only  mild  impairments  of  the  four  “Paragraph  B”  criteria: 
Understand, remember, or apply information; interact with others; concentrate, persist, or 
maintain pace; and adapt or manage oneself. (R. 82.) Plaintiff’s DIB application was denied 
at the initial level on March 29, 2022 (R. 102, 105) and at the reconsideration level on July 

28, 2022. (R. 116.)                                                       
   Plaintiff then requested a hearing before an ALJ. (R. 123.) That hearing was held 
before ALJ Mary D. Morrow on December 20, 2022, by telephone because of the COVID-
19 pandemic. (R. 47, 49.) At the hearing, Plaintiff was represented by counsel. (R. 50.) 
Plaintiff testified, as did an independent vocational expert (R. 52 – 70 and R. 70 – 75). In 

a written order dated February 27, 2023, the ALJ upheld the decision to deny DIB benefits. 
(R. 22.) The Social Security Administration’s Appeals Council affirmed the ALJ’s decision 
(R. 1), making the ALJ’s decision final agency action for purposes of judicial review. 
   B.   The ALJ’s Decision                                              
   After finding that Plaintiff’s work history provided Plaintiff with Social Security 

insurance coverage through December 31, 2021 (R. 11), ALJ Morrow analyzed Plaintiff’s 
claim using the five-step process described at 
20 C.F.R. § 404.1520
(b). This analytical 
methodology calls for the ALJ to sequentially examine the evidence bearing on five aspects 
of Plaintiff’s claim. If, at any step, the ALJ can find that Plaintiff is either disabled or not 
disabled within the meaning of the Social Security Act using the criteria of that step, the 
analysis terminates; but if the ALJ cannot rule that Plaintiff is either disabled or not 

disabled, the ALJ proceeds to the next step.                              
   At Step One, the ALJ found that Plaintiff had not engaged in substantial gainful 
activity between December 31, 2017 (the date on which Plaintiff alleged he became 
disabled) and December 31, 2021 (Plaintiff’s last-insured date). (R. 13.) 
   At Step Two, the ALJ found that Plaintiff had the following severe impairments: 
moderate to severe neural foraminal stenosis of the cervical spine; a high grade, full 

thickness  tear  of  the  right  shoulder’s  supraspinatus  tendon  post  arthroscopy;  major 
depressive disorder; generalized anxiety disorder; PTSD; attention deficit hyperactivity 
disorder (“ADHD”); and amphetamine use disorder. (Id.) The ALJ found that these severe 
impairments significantly limited Plaintiff’s ability to perform basic work activities. (Id.) 
   At Step Three, the ALJ found that none of Plaintiff’s severe impairments, alone or 

in combination with other impairments, met or medically equaled one of the impairments 
listed at 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 
404. 1526).  Because  Plaintiff  seeks  summary  judgment  based  on  his  mental  health 
impairments,  not  his  shoulder  issues,  the  Court  summarizes  only  the  ALJ’s  severity 
analysis of Plaintiff’s mental health.                                    

   The  Social  Security  regulations  list  11  categories  of  mental  disorders.  The 
regulations follow the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition 
(DSM-V”) in categorizing PTSD as a Trauma and Stressor-Related Disorder. Social 
Security   Administration,  PTSD   Fact    Sheet,   available  at         
https://www.ssa.gov/disability/Documents/PTSD%20Fact%20Sheet.pdf (last visited Sept. 
21, 2024). An ALJ must use, among other things, Paragraph B of the listing for Trauma 

and Stressor-Related Disorders when evaluating a claim for disability based on PTSD.  20 
CFR  1420(d),  App.  1,  12.B.11.b.  Paragraph  B  has  four  broad  categories  of  mental 
functioning. App. 1 at 12.E. If the ALJ finds a claimant limited in any of these four 
categories, the ALJ must describe the severity of that limitation on a scale that runs from 
“mild” to “extreme.” App. 1 at 12.F. A mental health impairment will be categorized as 
severe if a claimant has at least one Paragraph B limitation that is “extreme” or two 

Paragraph B limitations that are “marked.” 
Id.
 An extreme Paragraph B limitation is an 
inability to function independently, appropriately, or effectively, and on a sustained basis, 
while  a  marked  Paragraph  B  limitation  is  a  seriously  limited  ability  to  function 
independently, appropriately, or effectively, and on a sustained basis. 
Id.
 
   The ALJ found that Plaintiff had a mild limitation in understanding, remembering, 

or applying information; a moderate limitation in interacting with others; a moderate 
limitation  in  concentrating,  persisting,  or  maintaining  pace;  and  a  mild  limitation  in 
adapting or managing oneself. (R. 15-16.) Because Plaintiff had no marked or extreme 
Paragraph B limitations, the ALJ found him not to suffer from a severe impairment of his 
mental health.                                                            

   Before moving to Step Four, the ALJ fashioned a residual functional capacity 
(“RFC”) for Plaintiff.3 Plaintiff’s RFC as given by the ALJ was that he could perform light 

3 “Residual functional capacity” is what the claimant is able to do despite limitations caused 
by all of the claimant's impairments. See 
20 C.F.R. § 404.1545
(a). The ALJ also must make 
work as defined at 20 CFR 404.1567(b). However, the ALJ inserted some additional 
limitations into Plaintiff’s RFC in order to account for his specific situation. As to those 

additional limitations that pertain to Plaintiff’s mental health, the ALJ limited Plaintiff to 
the performance of simple, routine, and repetitive tasks, so long as they were done slower 
than “a production rate-pace (so, for example, no assembly line work).” (R. 17.) Plaintiff’s 
RFC  was  also  limited  to  responding  “appropriately  to  occasional  interaction  with 
supervisors, co-workers, and the general public.” (Id.)                   
   In explaining the mental health components of Plaintiff’s RFC, the ALJ noted that 

at an intake evaluation in January 2018, Plaintiff was diagnosed with severe bipolar 
disorder and severe methamphetamine use disorder. Plaintiff’s mood was “labile,” his 
thoughts “tangential,” and he had limited insight. (R. 19.) Apparently, Plaintiff could not 
sit still and talked nonstop for two and one-half hours. (Id.)            
    Plaintiff then went three and one-half years without, apparently, interacting with 

any mental health treatment provider. (R. 19.) He began inpatient chemical dependency 
treatment  in  June  of  2021,  at  which  time  he  was  diagnosed  with  PTSD  and  major 
depression. (Id.) Following a 90-day stay in a treatment program, Plaintiff had normal 
mental status findings in September 2021, and by October 2021 Plaintiff “was doing well 
overall;” he was in a relationship, was attending groups, his mental status examinations 

were within normal limits, and he was not taking medication. (R. 20.) The ALJ noted that 


“explicit findings” regarding the physical and mental demands of Plaintiff's past work and 
compare those demands with his residual functional capacity to determine whether he can 
perform the relevant duties. Lowe v. Apfel, 
226 F.3d 969, 972
 (8th Cir. 2000). 
Plaintiff continued to attend sober meetings after the date last insured (December 31, 2021). 
(Id.) Plaintiff had memory concerns, and his cognitive function tests showed “some deficits 

warranting further evaluation.” (Id.) He was diagnosed with complex PTSD with moderate 
symptomatology. (Id.)                                                     
   The  ALJ  noted  that  the  state  agency  examiners  had  found  Plaintiff’s  mental 
impairments to be nonsevere, but the ALJ rejected this conclusion because the ALJ found 
Plaintiff’s mental health impairments caused more than a minimal limitation in Plaintiff’s 
ability to perform basic work tasks. (Id.) Plaintiff’s “community connector,” Amanda 

Rodriguez, who had known Plaintiff for four months, stated that Plaintiff attended group 
meetings, read, and spent time with his significant other. He had no difficulty with personal 
care. He was able to go outside alone daily, could shop in stores, and attended church daily. 
(Id.) However, he also had difficulty with memory, concentration, following instructions, 
and getting along with others. He did not handle stress well, nor did he finish things he 

started. (Id.)                                                            
   Based on all of this, the ALJ characterized Plaintiff’s overall level of mental 
functioning as “moderate” and further stated that there was no need for greater limitations 
than those in the RFC. (R. 19.)                                           
   At Step Four, the ALJ found that Plaintiff could not perform his past relevant work 

as a truck driver and food deliverer. (R. 20.)                            
   At Step Five, the ALJ asked the vocational expert whether there was work in 
sufficient numbers in the national economy for a hypothetical individual with Plaintiff’s 
RFC, age, and education. The vocational expert stated that the hypothetical individual 
could work as a marker (136,000 jobs), router (25,000 jobs), or mail clerk (11,000 jobs). 
(R. 72.) Even if the hypothetical individual were limited to sedentary work, they could 

work as a document preparer (15,000 jobs), circuit board assembler (17,000 jobs), or film 
touch-up inspector (5,000 jobs). (R. 73.) Because Plaintiff could work at one of these jobs, 
the ALJ found Plaintiff not disabled within the meaning of the Social Security Act and 
denied his application for DIB. (R. 21.)                                  
   II.  Legal Standards                                                 
   Judicial review of the Commissioner’s denial of benefits is limited to determining 

whether substantial evidence in the record as a whole supports the decision, 
42 U.S.C. § 405
(g), or whether the ALJ committed an error of law, Nash v. Commissioner, Social 
Security Administration, 
907 F.3d 1086, 1089
 (8th Cir. 2018). “Substantial evidence is less 
than a preponderance but is enough that a reasonable mind would find it adequate to 
support the Commissioner’s conclusion.” Krogmeier v. Barnhart, 
294 F.3d 1019, 1022
 

(8th Cir. 2002) (citing Prosch v. Apfel, 
201 F.3d 1010, 1012
 (8th Cir. 2000)). The Court 
must  examine  “evidence  that  detracts  from  the  Commissioner’s  decision  as  well  as 
evidence that supports it.” 
Id.
 (citing Craig v. Apfel, 
212 F.3d 433, 436
 (8th Cir. 2000)). 
The Court may not reverse the ALJ’s decision simply because substantial evidence would 
support a different outcome or because the Court would have decided the case differently. 

Id.
 (citing Woolf v. Shalala, 
3 F.3d 1210, 1213
 (8th Cir. 1993)). In other words, if it is 
possible to reach two inconsistent positions from the evidence and one of those positions 
is that of the Commissioner, the Court must affirm the decision. Robinson v. Sullivan, 
956 F.2d 836, 838
 (8th Cir. 1992).                                            
   Plaintiff bears the burden of proving disability. See Roth v. Shalala, 
45 F.3d 279, 282
 (8th Cir. 1995). To meet the definition of disability for DIB, the claimant must 

establish that he is unable “to engage in any substantial gainful activity by reason of any 
medically determinable physical or mental impairment which can be expected to result in 
death or which has lasted or can be expected to last for a continuous period of not less than 
12 months.” 
42 U.S.C. § 423
(d)(1)(A). The disability, not just the impairment, must have 
lasted or be expected to last for at least twelve months. Titus v. Sullivan, 
4 F.3d 590, 594
 
(8th Cir. 1993).                                                          

III.  Discussion                                                          
   A.   The ALJ Properly Evaluated Plaintiff’s PTSD.                    
        Plaintiff  picks  a  single  paragraph  from  the  ALJ’s  decision,  ignores  the 
substantial additional material (summarized above in this order) in the ALJ’s decision that 
addressed Plaintiff’s PTSD, and on that limited basis asserted that the ALJ’s consideration 

of Plaintiff’s PTSD had been inadequate. Plaintiff quotes the paragraph to which he takes 
exception in full at page nine of his brief in support of his motion for summary judgment. 
   The claimant did continue to receive treatment after the expiration of the date 
   last insured. He continued to attend sober meetings and receive mental health 
   support. He was seeking evaluation for memory concerns and his cognitive 
   assessment test did show some deficits warranting further evaluation. The 
   claimant’s anxiety and depression were elevated as he maintained sobriety. 
   (Exs. 9F, 10F, 11F, 13F.) Almost one year after the expiration of the date last 
   insured, the claimant was diagnosed with complex PTSD and had a Global 
   Assessment of Functioning score of 51 to 60, consistent with moderate 
   symptomatology. (Ex. 15F.) This evidence continues to support an overall 
   moderate level of functioning and does not support greater limitations than 
   those provided in the residual functional capacity.                  
   Plaintiff does not explain why he focuses on this single paragraph to the exclusion 
of all the additional material in the ALJ’s decision. Plaintiff claims that “the ALJ provided 

no other findings regarding this evidence.” (Br. Of Plaintiff, Dkt. No. 13, at 9.) This is 
simply incorrect, as the summary of the ALJ’s discussion of Plaintiff’s mental health above 
demonstrates.  Plaintiff  also  asserts  that  the  evaluation  and  diagnosis  (presumably  of 
complex PTSD, although Plaintiff does not specify) occurred within three months of the 
date last insured. Plaintiff does not cite the record for this assertion, probably because the 
record does not support Plaintiff’s claim. The earliest diagnosis of complex PTSD in the 

medical records is in an Adult Initial/Comprehensive Evaluation performed at Hiawatha 
Mental Health on November 29, 2022 (R. 879, 888), eleven months – or “almost one year” 
– following the last insured date. While there are treatment notes endorsing a diagnosis  of 
PTSD as early as late February of 2022, (R. 857), it appears that a diagnosis of complex 
PTSD is not the same as a diagnosis of  PTSD – while this distinction is not well explained 

in the record, complex PTSD is the result not just of suffering trauma, but of suffering 
repeated trauma. (R. 888.)                                                
   Distressingly, Plaintiff said he attempted suicide by hanging in May of 2021. (R. 
882.) This suicide attempt was noted by the ALJ. (R. 19.) As noted above, a few months 
after the alleged suicide attempt, Plaintiff was functioning well with moderate limitations 

due to mental health. As to the suicide attempt itself, Plaintiff’s mental health provider 
noted that by the summer of 2021 Plaintiff was not “an immediate risk to self or others.” 
(Id.)                                                                     
    Plaintiff does not even attempt to undercut the ALJ’s long and detailed mapping of 
Plaintiff’s specific situation onto the Paragraph B criteria and from there on to an RFC. 

Plaintiff’s allegation that the ALJ did not adequately assess Plaintiff’s PTSD is belied by 
the record in this case.                                                  
   B.   At Step Three, the ALJ Adequately Considered Plaintiff’s Limitations 
        in Persistence                                                  

   Plaintiff  also  alleges  that  the  ALJ’s  Step  Three  consideration  of  Plaintiff’s 
limitations in persistence was inadequate. The Court finds this allegation not well founded. 
   The ALJ found Plaintiff had a moderate limitation in the Paragraph B category of 
concentrating, persisting, or maintaining pace. (R. 16.) (By comparison, the state agency 
consultants found this limitation to be only mild, so the ALJ found Plaintiff’s limitations 
more pronounced than did the state agency consultants. (R. 82, 93.))      
   Plaintiff’s argument is somewhat unclear, but it appears that Plaintiff credits the 
ALJ with having crafted an RFC that includes language that the Eighth Circuit has found 
adequate to capture limitations in persistence. Brief of Plaintiff at 15-16. Yet, Plaintiff then 
criticizes the ALJ for accounting for Plaintiff’s persistence limitation by declaring fast-

paced production jobs off-limits for Plaintiff, without, Plaintiff claims, the ALJ adequately 
defining “fast-paced production.” Id. at 16.                              
   There was no need for the ALJ to define “fast-paced production,” because the ALJ 
did not use the term “fast-paced production.”  Plaintiff’s RFC says, in relevant part “He 
can perform simple, routine, and repetitive tasks, but not at a production rate-pace (so, for 

example, no assembly line work).” It might be that Plaintiff chose the alternative, but 
imprecise, locution “fast-paced production” in order to bring himself within the scope of 
the holding of a Seventh Circuit case, Varga v. Colvin, 
794 F. 3d 809, 815
 (7th Cir. 2015). 

In that case, the Seventh Circuit reversed an ALJ who had used the term “fast-paced 
production.” 
Id.
                                                          
   For three reasons, the Court is not persuaded that the Seventh Circuit’s holding in 
Varga undercuts the ALJ in Plaintiff’s case. First, because Varga is a Seventh Circuit case 
it is not binding in the Eighth Circuit. Second, the language Varga found deficient was 
different from the language used by the ALJ who crafted Plaintiff’s RFC. Third and finally, 

the Seventh Circuit in Varga reversed the ALJ because the ALJ did not give content to the 
term “fast-paced production.” By contrast, the ALJ in this case gave content to the term 
she actually used (“production rate-pace”) by specifying “for example, no assembly line 
work.”                                                                    
   The  ALJ’s  RFC  adequately  considered  Plaintiff’s  Paragraph  B  limitation  in 

persistence.                                                              
IV.  Conclusion                                                           
   Based on the foregoing, and on all of the files, records, and proceedings herein, IT 

IS HEREBY ORDERED THAT:                                                   
1.  Plaintiff’s Motion for Summary Judgment (Dkt. No. 12) is DENIED;    
2.  Defendant’s Motion for Summary Judgment (Dkt. No. 15) is GRANTED;  and 
3.  The Commissioner’s decision is AFFIRMED.                            

LET JUDGMENT BE ENTERED ACCORDINGLY.                                      


Date: September 23, 2024        s/  John F. Docherty                    
                                JOHN F. DOCHERTY                        
                                United States Magistrate Judge          

Trial Court Opinion

                UNITED STATES DISTRICT COURT                            
                   DISTRICT OF MINNESOTA                                


Brian John R.,                       Case No. 23-CV-2023 (JFD)          

              Plaintiff,                                                

v.                                          ORDER                       

Martin J. O’Malley, Commissioner of                                     
the Social Security Administration,                                     

              Defendant.                                                


   Pursuant to 
42 U.S.C. § 405
(g), Plaintiff Brian John R. seeks judicial review of a 
final decision by the Commissioner of the Social Security Administration, which denied 
the Plaintiff’s application for disability insurance benefits (“DIB”). The case is before the 
Court on the parties’ cross-Motions for Summary Judgment (Dkt. Nos. 12 and 15). Plaintiff 
seeks summary judgment and a remand to the agency under Sentence Four of 
42 U.S.C. § 405
. Plaintiff claims that the administrative law judge (“ALJ”) did not adequately assess 
Plaintiff’s post-traumatic stress disorder and also claims that the ALJ failed to account for 
Plaintiff’s limitations in persistence at step three of the five-step process by which Social 
Security disability claims are evaluated. Defendant both opposes Plaintiff’s motion for 
summary  judgment  and  affirmatively  seeks  summary  judgment  affirming  the 
Commissioner. Because the Court finds the ALJ’s decision was supported by substantial 
evidence and is free of legal error, the Court grants Defendant’s motion for summary 
judgment,  denies  Plaintiff’s  motion  for  summary  judgment,  and  affirms  the 
Commissioner.1                                                            

I.   Background                                                           
   Plaintiff applied for DIB on December 20, 2021, alleging a disability onset date of 
December 31, 2017 due to bilateral shoulder injuries, depression, anxiety, and post-
traumatic stress disorder (“PTSD”). ((See Soc. Sec. Admin. R. (hereinafter “R.”) 77.)2 The 
Social Security Administration also identified potential issues with substance abuse and 
hypertension. (Id.) Plaintiff has past relevant work experience as the driver of a food 

delivery truck. (R. 54.)                                                  
   A.   Procedural History                                              
   Plaintiff filed an application for DIB on December 20, 2021. (R. 77.) He stated that 
he had been unable to work since December 31, 2017 due to PTSD, anxiety, depression, 
and issues with both of his shoulders (Id.), though Plaintiff told the state agency reviewer 

who reviewed the initial denial of Plaintiff’s DIB claim that “his shoulders is [sic] not the 
issue, it is his mental health. He does not feel he has any ongoing issues with his shoulders. 


1 As explained below in the discussion of legal standards, a Plaintiff can seek judicial 
review of a decision by the Commissioner on grounds that the ALJ’s decision is not 
supported by substantial evidence, on grounds that the ALJ committed legal error, or on 
both grounds. Plaintiff in this case does not make clear whether he challenges the ALJ’s 
decision because it is legally erroneous, or whether Plaintiff alleges that any shortfall in 
the evidence is the result of legal errors on the ALJ’s part. In this Order, the Court finds 
that the ALJ’s decision was both supported by substantial evidence and was free of legal 
error.                                                                    

2 The administrative record is filed at Dkt. No. 8. The social security record is consecutively 
paginated, and the Court cites to that pagination rather than the ECF number and page. 
They do not prevent him from working or completing daily activities.” (R. 91.) The state 
agency  reviewers  who  first  evaluated  Plaintiff’s  DIB  application  also  noted  “hidden 

allegation[s]” of substance use disorder and hypertension. (R. 78.) Of note to this summary 
judgment motion, in evaluating Plaintiff’s claimed mental health limitations the state 
agency  examiner  found  only  mild  impairments  of  the  four  “Paragraph  B”  criteria: 
Understand, remember, or apply information; interact with others; concentrate, persist, or 
maintain pace; and adapt or manage oneself. (R. 82.) Plaintiff’s DIB application was denied 
at the initial level on March 29, 2022 (R. 102, 105) and at the reconsideration level on July 

28, 2022. (R. 116.)                                                       
   Plaintiff then requested a hearing before an ALJ. (R. 123.) That hearing was held 
before ALJ Mary D. Morrow on December 20, 2022, by telephone because of the COVID-
19 pandemic. (R. 47, 49.) At the hearing, Plaintiff was represented by counsel. (R. 50.) 
Plaintiff testified, as did an independent vocational expert (R. 52 – 70 and R. 70 – 75). In 

a written order dated February 27, 2023, the ALJ upheld the decision to deny DIB benefits. 
(R. 22.) The Social Security Administration’s Appeals Council affirmed the ALJ’s decision 
(R. 1), making the ALJ’s decision final agency action for purposes of judicial review. 
   B.   The ALJ’s Decision                                              
   After finding that Plaintiff’s work history provided Plaintiff with Social Security 

insurance coverage through December 31, 2021 (R. 11), ALJ Morrow analyzed Plaintiff’s 
claim using the five-step process described at 
20 C.F.R. § 404.1520
(b). This analytical 
methodology calls for the ALJ to sequentially examine the evidence bearing on five aspects 
of Plaintiff’s claim. If, at any step, the ALJ can find that Plaintiff is either disabled or not 
disabled within the meaning of the Social Security Act using the criteria of that step, the 
analysis terminates; but if the ALJ cannot rule that Plaintiff is either disabled or not 

disabled, the ALJ proceeds to the next step.                              
   At Step One, the ALJ found that Plaintiff had not engaged in substantial gainful 
activity between December 31, 2017 (the date on which Plaintiff alleged he became 
disabled) and December 31, 2021 (Plaintiff’s last-insured date). (R. 13.) 
   At Step Two, the ALJ found that Plaintiff had the following severe impairments: 
moderate to severe neural foraminal stenosis of the cervical spine; a high grade, full 

thickness  tear  of  the  right  shoulder’s  supraspinatus  tendon  post  arthroscopy;  major 
depressive disorder; generalized anxiety disorder; PTSD; attention deficit hyperactivity 
disorder (“ADHD”); and amphetamine use disorder. (Id.) The ALJ found that these severe 
impairments significantly limited Plaintiff’s ability to perform basic work activities. (Id.) 
   At Step Three, the ALJ found that none of Plaintiff’s severe impairments, alone or 

in combination with other impairments, met or medically equaled one of the impairments 
listed at 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 
404. 1526).  Because  Plaintiff  seeks  summary  judgment  based  on  his  mental  health 
impairments,  not  his  shoulder  issues,  the  Court  summarizes  only  the  ALJ’s  severity 
analysis of Plaintiff’s mental health.                                    

   The  Social  Security  regulations  list  11  categories  of  mental  disorders.  The 
regulations follow the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition 
(DSM-V”) in categorizing PTSD as a Trauma and Stressor-Related Disorder. Social 
Security   Administration,  PTSD   Fact    Sheet,   available  at         
https://www.ssa.gov/disability/Documents/PTSD%20Fact%20Sheet.pdf (last visited Sept. 
21, 2024). An ALJ must use, among other things, Paragraph B of the listing for Trauma 

and Stressor-Related Disorders when evaluating a claim for disability based on PTSD.  20 
CFR  1420(d),  App.  1,  12.B.11.b.  Paragraph  B  has  four  broad  categories  of  mental 
functioning. App. 1 at 12.E. If the ALJ finds a claimant limited in any of these four 
categories, the ALJ must describe the severity of that limitation on a scale that runs from 
“mild” to “extreme.” App. 1 at 12.F. A mental health impairment will be categorized as 
severe if a claimant has at least one Paragraph B limitation that is “extreme” or two 

Paragraph B limitations that are “marked.” 
Id.
 An extreme Paragraph B limitation is an 
inability to function independently, appropriately, or effectively, and on a sustained basis, 
while  a  marked  Paragraph  B  limitation  is  a  seriously  limited  ability  to  function 
independently, appropriately, or effectively, and on a sustained basis. 
Id.
 
   The ALJ found that Plaintiff had a mild limitation in understanding, remembering, 

or applying information; a moderate limitation in interacting with others; a moderate 
limitation  in  concentrating,  persisting,  or  maintaining  pace;  and  a  mild  limitation  in 
adapting or managing oneself. (R. 15-16.) Because Plaintiff had no marked or extreme 
Paragraph B limitations, the ALJ found him not to suffer from a severe impairment of his 
mental health.                                                            

   Before moving to Step Four, the ALJ fashioned a residual functional capacity 
(“RFC”) for Plaintiff.3 Plaintiff’s RFC as given by the ALJ was that he could perform light 

3 “Residual functional capacity” is what the claimant is able to do despite limitations caused 
by all of the claimant's impairments. See 
20 C.F.R. § 404.1545
(a). The ALJ also must make 
work as defined at 20 CFR 404.1567(b). However, the ALJ inserted some additional 
limitations into Plaintiff’s RFC in order to account for his specific situation. As to those 

additional limitations that pertain to Plaintiff’s mental health, the ALJ limited Plaintiff to 
the performance of simple, routine, and repetitive tasks, so long as they were done slower 
than “a production rate-pace (so, for example, no assembly line work).” (R. 17.) Plaintiff’s 
RFC  was  also  limited  to  responding  “appropriately  to  occasional  interaction  with 
supervisors, co-workers, and the general public.” (Id.)                   
   In explaining the mental health components of Plaintiff’s RFC, the ALJ noted that 

at an intake evaluation in January 2018, Plaintiff was diagnosed with severe bipolar 
disorder and severe methamphetamine use disorder. Plaintiff’s mood was “labile,” his 
thoughts “tangential,” and he had limited insight. (R. 19.) Apparently, Plaintiff could not 
sit still and talked nonstop for two and one-half hours. (Id.)            
    Plaintiff then went three and one-half years without, apparently, interacting with 

any mental health treatment provider. (R. 19.) He began inpatient chemical dependency 
treatment  in  June  of  2021,  at  which  time  he  was  diagnosed  with  PTSD  and  major 
depression. (Id.) Following a 90-day stay in a treatment program, Plaintiff had normal 
mental status findings in September 2021, and by October 2021 Plaintiff “was doing well 
overall;” he was in a relationship, was attending groups, his mental status examinations 

were within normal limits, and he was not taking medication. (R. 20.) The ALJ noted that 


“explicit findings” regarding the physical and mental demands of Plaintiff's past work and 
compare those demands with his residual functional capacity to determine whether he can 
perform the relevant duties. Lowe v. Apfel, 
226 F.3d 969, 972
 (8th Cir. 2000). 
Plaintiff continued to attend sober meetings after the date last insured (December 31, 2021). 
(Id.) Plaintiff had memory concerns, and his cognitive function tests showed “some deficits 

warranting further evaluation.” (Id.) He was diagnosed with complex PTSD with moderate 
symptomatology. (Id.)                                                     
   The  ALJ  noted  that  the  state  agency  examiners  had  found  Plaintiff’s  mental 
impairments to be nonsevere, but the ALJ rejected this conclusion because the ALJ found 
Plaintiff’s mental health impairments caused more than a minimal limitation in Plaintiff’s 
ability to perform basic work tasks. (Id.) Plaintiff’s “community connector,” Amanda 

Rodriguez, who had known Plaintiff for four months, stated that Plaintiff attended group 
meetings, read, and spent time with his significant other. He had no difficulty with personal 
care. He was able to go outside alone daily, could shop in stores, and attended church daily. 
(Id.) However, he also had difficulty with memory, concentration, following instructions, 
and getting along with others. He did not handle stress well, nor did he finish things he 

started. (Id.)                                                            
   Based on all of this, the ALJ characterized Plaintiff’s overall level of mental 
functioning as “moderate” and further stated that there was no need for greater limitations 
than those in the RFC. (R. 19.)                                           
   At Step Four, the ALJ found that Plaintiff could not perform his past relevant work 

as a truck driver and food deliverer. (R. 20.)                            
   At Step Five, the ALJ asked the vocational expert whether there was work in 
sufficient numbers in the national economy for a hypothetical individual with Plaintiff’s 
RFC, age, and education. The vocational expert stated that the hypothetical individual 
could work as a marker (136,000 jobs), router (25,000 jobs), or mail clerk (11,000 jobs). 
(R. 72.) Even if the hypothetical individual were limited to sedentary work, they could 

work as a document preparer (15,000 jobs), circuit board assembler (17,000 jobs), or film 
touch-up inspector (5,000 jobs). (R. 73.) Because Plaintiff could work at one of these jobs, 
the ALJ found Plaintiff not disabled within the meaning of the Social Security Act and 
denied his application for DIB. (R. 21.)                                  
   II.  Legal Standards                                                 
   Judicial review of the Commissioner’s denial of benefits is limited to determining 

whether substantial evidence in the record as a whole supports the decision, 
42 U.S.C. § 405
(g), or whether the ALJ committed an error of law, Nash v. Commissioner, Social 
Security Administration, 
907 F.3d 1086, 1089
 (8th Cir. 2018). “Substantial evidence is less 
than a preponderance but is enough that a reasonable mind would find it adequate to 
support the Commissioner’s conclusion.” Krogmeier v. Barnhart, 
294 F.3d 1019, 1022
 

(8th Cir. 2002) (citing Prosch v. Apfel, 
201 F.3d 1010, 1012
 (8th Cir. 2000)). The Court 
must  examine  “evidence  that  detracts  from  the  Commissioner’s  decision  as  well  as 
evidence that supports it.” 
Id.
 (citing Craig v. Apfel, 
212 F.3d 433, 436
 (8th Cir. 2000)). 
The Court may not reverse the ALJ’s decision simply because substantial evidence would 
support a different outcome or because the Court would have decided the case differently. 

Id.
 (citing Woolf v. Shalala, 
3 F.3d 1210, 1213
 (8th Cir. 1993)). In other words, if it is 
possible to reach two inconsistent positions from the evidence and one of those positions 
is that of the Commissioner, the Court must affirm the decision. Robinson v. Sullivan, 
956 F.2d 836, 838
 (8th Cir. 1992).                                            
   Plaintiff bears the burden of proving disability. See Roth v. Shalala, 
45 F.3d 279, 282
 (8th Cir. 1995). To meet the definition of disability for DIB, the claimant must 

establish that he is unable “to engage in any substantial gainful activity by reason of any 
medically determinable physical or mental impairment which can be expected to result in 
death or which has lasted or can be expected to last for a continuous period of not less than 
12 months.” 
42 U.S.C. § 423
(d)(1)(A). The disability, not just the impairment, must have 
lasted or be expected to last for at least twelve months. Titus v. Sullivan, 
4 F.3d 590, 594
 
(8th Cir. 1993).                                                          

III.  Discussion                                                          
   A.   The ALJ Properly Evaluated Plaintiff’s PTSD.                    
        Plaintiff  picks  a  single  paragraph  from  the  ALJ’s  decision,  ignores  the 
substantial additional material (summarized above in this order) in the ALJ’s decision that 
addressed Plaintiff’s PTSD, and on that limited basis asserted that the ALJ’s consideration 

of Plaintiff’s PTSD had been inadequate. Plaintiff quotes the paragraph to which he takes 
exception in full at page nine of his brief in support of his motion for summary judgment. 
   The claimant did continue to receive treatment after the expiration of the date 
   last insured. He continued to attend sober meetings and receive mental health 
   support. He was seeking evaluation for memory concerns and his cognitive 
   assessment test did show some deficits warranting further evaluation. The 
   claimant’s anxiety and depression were elevated as he maintained sobriety. 
   (Exs. 9F, 10F, 11F, 13F.) Almost one year after the expiration of the date last 
   insured, the claimant was diagnosed with complex PTSD and had a Global 
   Assessment of Functioning score of 51 to 60, consistent with moderate 
   symptomatology. (Ex. 15F.) This evidence continues to support an overall 
   moderate level of functioning and does not support greater limitations than 
   those provided in the residual functional capacity.                  
   Plaintiff does not explain why he focuses on this single paragraph to the exclusion 
of all the additional material in the ALJ’s decision. Plaintiff claims that “the ALJ provided 

no other findings regarding this evidence.” (Br. Of Plaintiff, Dkt. No. 13, at 9.) This is 
simply incorrect, as the summary of the ALJ’s discussion of Plaintiff’s mental health above 
demonstrates.  Plaintiff  also  asserts  that  the  evaluation  and  diagnosis  (presumably  of 
complex PTSD, although Plaintiff does not specify) occurred within three months of the 
date last insured. Plaintiff does not cite the record for this assertion, probably because the 
record does not support Plaintiff’s claim. The earliest diagnosis of complex PTSD in the 

medical records is in an Adult Initial/Comprehensive Evaluation performed at Hiawatha 
Mental Health on November 29, 2022 (R. 879, 888), eleven months – or “almost one year” 
– following the last insured date. While there are treatment notes endorsing a diagnosis  of 
PTSD as early as late February of 2022, (R. 857), it appears that a diagnosis of complex 
PTSD is not the same as a diagnosis of  PTSD – while this distinction is not well explained 

in the record, complex PTSD is the result not just of suffering trauma, but of suffering 
repeated trauma. (R. 888.)                                                
   Distressingly, Plaintiff said he attempted suicide by hanging in May of 2021. (R. 
882.) This suicide attempt was noted by the ALJ. (R. 19.) As noted above, a few months 
after the alleged suicide attempt, Plaintiff was functioning well with moderate limitations 

due to mental health. As to the suicide attempt itself, Plaintiff’s mental health provider 
noted that by the summer of 2021 Plaintiff was not “an immediate risk to self or others.” 
(Id.)                                                                     
    Plaintiff does not even attempt to undercut the ALJ’s long and detailed mapping of 
Plaintiff’s specific situation onto the Paragraph B criteria and from there on to an RFC. 

Plaintiff’s allegation that the ALJ did not adequately assess Plaintiff’s PTSD is belied by 
the record in this case.                                                  
   B.   At Step Three, the ALJ Adequately Considered Plaintiff’s Limitations 
        in Persistence                                                  

   Plaintiff  also  alleges  that  the  ALJ’s  Step  Three  consideration  of  Plaintiff’s 
limitations in persistence was inadequate. The Court finds this allegation not well founded. 
   The ALJ found Plaintiff had a moderate limitation in the Paragraph B category of 
concentrating, persisting, or maintaining pace. (R. 16.) (By comparison, the state agency 
consultants found this limitation to be only mild, so the ALJ found Plaintiff’s limitations 
more pronounced than did the state agency consultants. (R. 82, 93.))      
   Plaintiff’s argument is somewhat unclear, but it appears that Plaintiff credits the 
ALJ with having crafted an RFC that includes language that the Eighth Circuit has found 
adequate to capture limitations in persistence. Brief of Plaintiff at 15-16. Yet, Plaintiff then 
criticizes the ALJ for accounting for Plaintiff’s persistence limitation by declaring fast-

paced production jobs off-limits for Plaintiff, without, Plaintiff claims, the ALJ adequately 
defining “fast-paced production.” Id. at 16.                              
   There was no need for the ALJ to define “fast-paced production,” because the ALJ 
did not use the term “fast-paced production.”  Plaintiff’s RFC says, in relevant part “He 
can perform simple, routine, and repetitive tasks, but not at a production rate-pace (so, for 

example, no assembly line work).” It might be that Plaintiff chose the alternative, but 
imprecise, locution “fast-paced production” in order to bring himself within the scope of 
the holding of a Seventh Circuit case, Varga v. Colvin, 
794 F. 3d 809, 815
 (7th Cir. 2015). 

In that case, the Seventh Circuit reversed an ALJ who had used the term “fast-paced 
production.” 
Id.
                                                          
   For three reasons, the Court is not persuaded that the Seventh Circuit’s holding in 
Varga undercuts the ALJ in Plaintiff’s case. First, because Varga is a Seventh Circuit case 
it is not binding in the Eighth Circuit. Second, the language Varga found deficient was 
different from the language used by the ALJ who crafted Plaintiff’s RFC. Third and finally, 

the Seventh Circuit in Varga reversed the ALJ because the ALJ did not give content to the 
term “fast-paced production.” By contrast, the ALJ in this case gave content to the term 
she actually used (“production rate-pace”) by specifying “for example, no assembly line 
work.”                                                                    
   The  ALJ’s  RFC  adequately  considered  Plaintiff’s  Paragraph  B  limitation  in 

persistence.                                                              
IV.  Conclusion                                                           
   Based on the foregoing, and on all of the files, records, and proceedings herein, IT 

IS HEREBY ORDERED THAT:                                                   
1.  Plaintiff’s Motion for Summary Judgment (Dkt. No. 12) is DENIED;    
2.  Defendant’s Motion for Summary Judgment (Dkt. No. 15) is GRANTED;  and 
3.  The Commissioner’s decision is AFFIRMED.                            

LET JUDGMENT BE ENTERED ACCORDINGLY.                                      


Date: September 23, 2024        s/  John F. Docherty                    
                                JOHN F. DOCHERTY                        
                                United States Magistrate Judge          

Reference

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