Carolyn Combs v. Nancy A. Berryhill
878 F.3d 642
8th Cir.2017Background
- Carolyn Combs, born 1961, applied for SSDI and SSI claiming disability from rheumatoid arthritis, osteoarthritis, asthma, and obesity with an alleged onset of May 17, 2012.
- Medical records (2011–2014) show rheumatoid arthritis diagnoses, severe knee degenerative changes, joint pain, swelling, and prescriptions for pain medication; treating providers did not provide work-capacity opinions.
- Two nonexamining state-agency physicians conflicted: Dr. Redd concluded sedentary RFC (≤10 lbs); Dr. Keith concluded light RFC (≤20 lbs).
- The ALJ credited Dr. Keith over Dr. Redd, relied in part on treatment notes stating “no acute distress” and “normal movement of all extremities,” and found Combs could perform past work or other light jobs.
- Appeals Council denied review; district court affirmed. The Eighth Circuit majority reversed and remanded, concluding the ALJ failed to fully and fairly develop the record regarding the meaning of the treatment notations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ fully and fairly developed the record before siding with one nonexamining RFC opinion over another | ALJ should have sought clarification from treating providers about the significance of "no acute distress" and "normal movement" instead of inferring their impact on RFC | Commissioner argued those notes were sufficiently clear and not a "crucial undeveloped issue," and that ALJ permissibly weighed record evidence | Reversed and remanded: ALJ erred by drawing his own inferences from those notations without developing the record; further inquiry required |
Key Cases Cited
- Lott v. Colvin, 772 F.3d 546 (8th Cir. 2014) (ALJ decision is Commissioner’s final decision when Appeals Council declines review)
- Brown v. Colvin, 825 F.3d 936 (8th Cir. 2016) (substantial-evidence standard and reviewing the record as a whole)
- Strongson v. Barnhart, 361 F.3d 1066 (8th Cir. 2004) (RFC must be based on all relevant evidence, not ALJ’s own inferences)
- McKinney v. Apfel, 228 F.3d 860 (8th Cir. 2000) (same principle on RFC development)
- Steed v. Astrue, 524 F.3d 872 (8th Cir. 2008) (RFC is a medical question requiring medical evidence)
- Casey v. Astrue, 503 F.3d 687 (8th Cir. 2007) (ALJ may rely on reviewing physician when claimant bears burden)
- Vossen v. Astrue, 612 F.3d 1011 (8th Cir. 2010) (ALJ’s duty to develop record fairly and fully)
- Stormo v. Barnhart, 377 F.3d 801 (8th Cir. 2004) (ALJ need not seek clarification unless a crucial issue is undeveloped)
- Finch v. Astrue, 547 F.3d 933 (8th Cir. 2008) (ALJ may not substitute his own medical opinions for physicians’ opinions)
- Byes v. Astrue, 687 F.3d 913 (8th Cir. 2012) (failure to develop record reversible when evidence insufficient to determine impairment’s impact on ability to work)
- Pearsall v. Massanari, 274 F.3d 1211 (8th Cir. 2001) (definition of RFC)
- Frankl v. Shalala, 47 F.3d 935 (8th Cir. 1995) (requirements for light work include standing/walking capacity)
- Ellis v. Barnhart, 392 F.3d 988 (8th Cir. 2005) (duty to seek clarification arises only if crucial issue is undeveloped)
- Pate-Fires v. Astrue, 564 F.3d 935 (8th Cir. 2009) (ALJs may not "play doctor")
- Ness v. Sullivan, 904 F.2d 432 (8th Cir. 1990) (ALJ may not substitute his opinions for those of physicians)
- KKC ex rel. Stoner v. Colvin, 818 F.3d 364 (8th Cir. 2016) (no duty to seek additional info if no crucial undeveloped issue)