35 F.4th 608
8th Cir.2022Background
- Swarthout applied for disability insurance benefits (onset Aug 22, 2015); ALJ denied benefits and the Appeals Council denied review; district court affirmed; Eighth Circuit reviewed de novo.
- ALJ found severe impairments of fibromyalgia and chronic fatigue syndrome, assigned a residual functional capacity (RFC) for light work, and concluded she could perform past relevant work and transfer skills.
- The central dispute concerns the weight given to treating physician Dr. Maral Kenderian’s opinion that Swarthout could not work an eight‑hour day; Kenderian completed a check‑box form reporting very restrictive limits (e.g., sit 15 minutes, stand 10 minutes, legs elevated >75% of day, <2 hours sit/stand/walk daily, occasional cane, >4 absences/month).
- The ALJ gave that opinion little weight, finding it contradicted by the physician’s treatment notes, mostly normal objective exam findings in the record (full strength, normal gait, intact coordination), plaintiff’s daily activities, and plaintiff’s limited/declined treatment.
- The Eighth Circuit majority affirmed, holding the ALJ permissibly discounted the conclusory/checklist opinion and relied on contrary record evidence; Judge Kelly dissented and would remand for failure to give adequate reasons under the treating‑physician rule and for insufficient RFC analysis (sustainability of full‑time work, consideration of light sensitivity, and treating‑relationship factors).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ properly discounted treating physician opinion | Kenderian’s opinion is consistent with Swarthout’s symptoms and other record evidence; ALJ must give controlling weight if well‑supported and not inconsistent | ALJ permissibly discounted the conclusory/checklist opinion because it conflicted with treatment notes and objective records | Affirmed: ALJ permissibly gave little weight to the treating physician’s opinion |
| Whether checklist form is inherently weak evidentiary basis | Form reflects treating physician’s assessment of functional limits; should not be rejected by form alone | Checklist/checkbox forms lacking explanation have little evidentiary value and may be discounted | Affirmed: checklist form here entitled to little weight, especially given lack of supporting records |
| Whether normal exam findings and daily activities undermine severe limitation claims | Normal exams do not rule out disabling fibromyalgia; daily activities often inconsistent with full‑time work but may reflect good‑day activity | Normal objective findings and reported activities (shopping, driving, short walks, household tasks) undercut claimant’s severity assertions | Majority: normal exams and daily activities reasonably supported discounting the extreme limits; Dissent: ALJ did not adequately explain why normal findings contradict fibromyalgia limits |
| Whether ALJ adequately analyzed RFC (sustainability and non‑severe impairments) | ALJ failed to determine whether claimant can sustain 8 hours/day, 5 days/week; did not weigh treating‑relationship factors or non‑severe light sensitivity | ALJ implicitly considered evidence and found claimant capable of light work; relied on overall record | Dissent would remand for failure to provide required reasons on RFC sustainability and treating‑physician factors; majority affirmed without remand |
Key Cases Cited
- Julin v. Colvin, 826 F.3d 1082 (8th Cir. 2016) (substantial‑evidence standard and treating‑physician principles)
- Wildman v. Astrue, 596 F.3d 959 (8th Cir. 2010) (checklist medical forms may be conclusory and lack evidentiary value)
- Thomas v. Berryhill, 881 F.3d 672 (8th Cir. 2018) (checkbox assessments with little explanation may be discounted)
- Toland v. Colvin, 761 F.3d 931 (8th Cir. 2014) (forms lacking elaboration possess little evidentiary value)
- Bladow v. Apfel, 205 F.3d 356 (8th Cir. 2000) (if claimant cannot sustain full‑time work, she must be found disabled)
- Brosnahan v. Barnhart, 336 F.3d 671 (8th Cir. 2003) (fibromyalgia diagnosis does not automatically establish disability; symptoms are subjective and variable)
- Perkins v. Astrue, 648 F.3d 892 (8th Cir. 2011) (working that causes discomfort does not necessarily establish disability)
- Hamilton v. Astrue, 518 F.3d 607 (8th Cir. 2008) (ALJ must give "good reasons" for the weight afforded a treating physician)
- Reed v. Barnhart, 399 F.3d 917 (8th Cir. 2005) (ability to do limited daily activities is weak evidence of ability to perform full‑time work)
- Milam v. Colvin, 794 F.3d 978 (8th Cir. 2015) (failure to pursue recommended treatment can undermine disability claims)