Carolyn Combs v. Nancy A. Berryhill
2017 U.S. App. LEXIS 15816
| 8th Cir. | 2017Background
- Carolyn Combs applied for disability benefits claiming rheumatoid arthritis, osteoarthritis, asthma, and obesity with a May 17, 2012 onset; she last worked as a housekeeper.
- Medical records (2011–2014) document diagnoses of rheumatoid arthritis, severe joint degeneration on imaging, swelling and pain, and ongoing prescriptions for strong pain medication; treatment notes repeatedly state “no acute distress” and “normal movement of all extremities.”
- No treating or examining physician provided an opinion about Combs’s work-related functional capacity; two non‑examining state‑agency physicians offered conflicting RFC opinions (one sedentary, one light).
- The ALJ found Combs capable of light work (with hand and postural limitations), credited the non‑examining physician who opined light work, discounted some of Combs’s subjective complaints, and concluded she could perform past relevant work or other jobs.
- The Appeals Council declined review and the district court affirmed; the Eighth Circuit majority reversed and remanded, concluding the ALJ failed to fully and fairly develop the record regarding the relevance of treatment notes stating “no acute distress” and “normal movement” and should have sought clarification from medical providers.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ fully and fairly developed the record before adopting a light‑work RFC | Combs: ALJ relied on inferences from vague treatment notes and non‑examining reviewers instead of obtaining clarification or a treating/consultative RFC opinion | Commissioner: ALJ permissibly relied on medical records, reviewing physicians, and claimant testimony; no duty to obtain further opinions absent an undeveloped crucial issue | Reversed and remanded: ALJ should have further developed record by clarifying what “no acute distress” and “normal movement” mean for workplace functioning and, if necessary, obtaining clarification from treating providers or a consultative exam |
| Whether RFC must be supported by a treating or consultative medical opinion | Combs: RFC lacked support because no treating/examining source opined on work‑related limitations | Commissioner: No requirement that RFC be tied to a specific treating/consultative opinion; ALJ can base RFC on records and non‑examining reviewers | Majority: Where critical ambiguity exists (as here), ALJ erred by drawing his own inferences; dissent argued precedent permits reliance on records and non‑examining opinions without further development |
Key Cases Cited
- Lott v. Colvin, 772 F.3d 546 (8th Cir. 2014) (standard of review for ALJ decision when Appeals Council declines review)
- Strongson v. Barnhart, 361 F.3d 1066 (8th Cir. 2004) (RFC must be based on all relevant evidence; ALJ may not draw own medical inferences)
- Vossen v. Astrue, 612 F.3d 1011 (8th Cir. 2010) (ALJ’s duty to fully and fairly develop the record; non‑examining opinions not normally substantial evidence)
- Nevland v. Apfel, 204 F.3d 853 (8th Cir. 2000) (vocational expert testimony based on non‑examining evidence is not substantial if record undeveloped)
- Hensley v. Colvin, 829 F.3d 926 (8th Cir. 2016) (no absolute requirement that RFC be supported by a specific medical opinion)
- Eichelberger v. Barnhart, 390 F.3d 584 (8th Cir. 2004) (claimant bears burden at step four; ALJ may base RFC on records and claimant’s reports)