## Facts

- Kimberly J. Rosa applied for Disability Insurance Benefits and Supplemental Security Income, alleging continuous disability beginning October 1, 2006, due to a combination of physical and mental impairments.
- After a hearing, an Administrative Law Judge (ALJ) found Rosa had severe degenerative disc disease of the lumbar spine, but the impairment did not meet or equal a listed impairment.
- The ALJ found Rosa retained the residual functional capacity (RFC) to perform the full range of sedentary work.
- Based on that RFC, the ALJ concluded at step four that Rosa could perform her past relevant work as an office assistant in a real estate office and therefore was not disabled.
- In assessing RFC, the ALJ relied primarily on the bulk of the medical record, including reports from six examining-doctor visits in the year leading up to the alleged onset date.
- The pre-onset evidence included two visits with Rosa’s treating physician in which no severe impairment was presented or diagnosed, along with laboratory findings and medical imaging that did not support disabling limitations and reflected that Rosa was generally in good physical condition with treatment.
- In 2008, Rosa’s treating physician completed a disability-claim form stating Rosa had extensive musculoskeletal limitations inconsistent with sedentary work, including needing to change positions every 10–15 minutes; lifting no more than 10 pounds; and avoiding repeated pushing, pulling, stooping, squatting, or bending (and limiting such activities to no more than about two hours on a repeated basis).
- The ALJ gave that 2008 form opinion little weight, finding it unsupported by and inconsistent with the other medical evidence, including the physician’s earlier notes and the objective testing.
- The Appeals Council denied review, making the ALJ’s decision the Commissioner’s final decision, and Rosa sought judicial review under 42 U.S.C. § 405(g), arguing the ALJ failed to give proper weight to the treating-physician’s 2008 opinion when determining RFC.

## Issues

1. Whether substantial evidence supported the ALJ’s decision to discount the treating physician’s 2008 disability-claim form opinion as inconsistent with and unsupported by the record.
2. Whether substantial evidence on the record as a whole supported the ALJ’s RFC finding for the full range of sedentary work and the step-four finding that Rosa could perform her past work as an office assistant.

## Decision

- The district court affirmed the Commissioner’s final decision and dismissed Rosa’s complaint.
- The court held the ALJ permissibly gave reduced weight to the 2008 treating-physician form opinion because it conflicted with the broader medical record, including earlier treatment notes and objective findings.
- The court held substantial evidence supported the RFC for a full range of sedentary work and, in turn, the determination that Rosa could return to her past relevant sedentary work.

## Legal Principles

- Judicial review under 42 U.S.C. § 405(g) is limited to whether the Commissioner’s decision is supported by substantial evidence on the record as a whole and whether the correct legal standards were used.
- “Substantial evidence” is less than a preponderance but enough that a reasonable mind could find it adequate to support the decision; a court will not reweigh the evidence or substitute its judgment for the ALJ’s.
- A treating source’s medical opinion is not entitled to controlling weight if it is not well supported by medically acceptable clinical and laboratory diagnostic techniques or if it is inconsistent with other substantial evidence in the record. See, e.g., 20 C.F.R. § 404.1527.
- An ALJ may assign less weight to a treating physician’s opinion when it is conclusory, offered on a check-box or administrative form without supporting explanation, inconsistent with the physician’s own treatment notes, or based largely on subjective complaints rather than objective medical evidence.
- When discounting a treating-source opinion, the ALJ must give reasons that are grounded in the record; if those reasons are supported by substantial evidence, the court must affirm even if the record could also support a different outcome.
- Credibility and symptom-evaluation findings are primarily for the ALJ, and courts defer to those findings when they are explained and supported by the record.

## Conclusion

The Eastern District of Missouri affirmed the denial of benefits because the ALJ reasonably found Rosa capable of the full range of sedentary work and properly discounted a later treating-physician disability form that imposed far greater limits than the physician’s earlier notes and the objective medical evidence supported, leaving substantial evidence for the step-four finding that Rosa could perform her past work as an office assistant.


Rosa v. Astrue, 708 F. Supp. 2d 941 (2010)