964 F.3d 738
8th Cir.2020Background:
- Angela Noerper applied for DIB and SSI alleging disability from 2010; ALJ found multiple severe impairments (degenerative knee disease, affective disorder, fibromyalgia, carpal tunnel, plantar fasciitis) but RFC for light work including standing/walking 6 of 8 hours.
- Key medical imaging: 2008 MRI (right knee) showed Grade IV chondromalacia; 2015 MRI (left knee) showed marked patellofemoral cartilage loss, moderate effusion, and large Baker’s cyst.
- Treating notes: orthopedist Dr. Jones (Feb 2015) found left-knee limited range/strength and prescribed injections, brace, PT; PCPs (Dr. Wilkerson and others) often described pain as mild and documented normal gait/strength on some exams; injections provided temporary relief.
- A consultative reviewer (Dr. Jung, Nov 2014) found capacity to stand/walk 6 hours but his review predates most 2015 knee records.
- ALJ relied on normal station/gait findings, treatment effectiveness, lack of a prescribed or presented cane, and earlier consultative opinion to adopt a 6-hour standing/walking RFC; Appeals Council denied review.
- Eighth Circuit: majority held there is no reliable evidence supporting the specific 6-hour standing/walking limitation and the record was not adequately developed or reconciled (noting unresolved differences between Drs. Jones and Wilkerson); case reversed and remanded. Judge Stras dissented.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the RFC finding that Noerper can stand/walk 6 hours is supported by substantial evidence | RFC unsupported: no medical opinion or record reliably ties her pain/MRI findings to a 6-hour standing capacity | ALJ relied on normal gait/station, treatment response (injections), and consultative opinion to support 6-hour limit | Reversed and remanded: record lacks reliable support for the 6-hour finding and ALJ failed to "connect the dots" to justify it |
| Whether the agency failed to develop the record / resolve conflicting medical opinions | ALJ favored PCP (Wilkerson) over orthopedist (Jones) without adequate explanation; ALJ didn’t resolve materially inconsistent findings | Commissioner argues ALJ may weigh evidence and considered the whole record (exams, treatment, lack of prescription for cane) | Remand required: Commissioner did not adequately develop record or explain choice between conflicting medical evidence |
| Whether it was improper for the ALJ to discount cane use and certain neurologic observations | Noerper contends ALJ improperly treated lack of prescription/use at hearing and neurologic observations as determinative | Commissioner contends absence of a prescription and failure to present a cane at hearing are legitimate considerations; neurologic findings are relevant to functional ability | Court rejected this narrow challenge: ALJ permissibly considered those facts, but that did not cure the bigger evidentiary gap leading to remand |
| Whether ALJ erred in crediting non-specialist assessments over specialist findings | Noerper argues specialist (orthopedist) should be given more weight where opinions conflict | Commissioner argues ALJ may favor or discount opinions based on record and must explain reasoning | Court held ALJ failed to explain discounting orthopedist’s limiting findings; this unresolved conflict contributed to remand |
Key Cases Cited
- Strongson v. Barnhart, 361 F.3d 1066 (8th Cir. 2004) (standard of review and substantial-evidence framework)
- Combs v. Berryhill, 878 F.3d 642 (8th Cir. 2017) (RFC is a medical question that must be supported by medical evidence and may not be inferred from reports)
- Steed v. Astrue, 524 F.3d 872 (8th Cir. 2008) (medical source opinions that claimant is "disabled" are not controlling)
- Ellis v. Barnhart, 392 F.3d 988 (8th Cir. 2005) (ultimate RFC determination is reserved to the agency)
- Lauer v. Apfel, 245 F.3d 700 (8th Cir. 2001) (ALJ must consider combined effect of impairments)
- Polaski v. Heckler, 739 F.2d 1320 (8th Cir. 1984) (factors for evaluating subjective complaints)
- Hepp v. Astrue, 511 F.3d 798 (8th Cir. 2008) (procedural defects in opinion-writing do not require reversal if immaterial to outcome)
- Snead v. Barnhart, 360 F.3d 834 (8th Cir. 2004) (Commissioner’s duty to develop the record is non‑adversarial and continues even with counsel)
- Brown v. Colvin, 825 F.3d 936 (8th Cir. 2016) (remand warranted when ALJ fails to address inconsistent medical test results on a crucial issue)