KKC v. Carolyn W. Colvin
2016 U.S. App. LEXIS 4859
| 8th Cir. | 2016Background
- Robert D. Carter (b.1978) applied for DIB and SSI alleging disability from congestive heart failure and related psychiatric conditions; he stopped working May 2, 2010.
- Medical record: nonischemic dilated cardiomyopathy with EF as low as ~10–20%, implanted defibrillator May 2010, NYHA Stage C / Class III diagnosis by treating cardiologist; intermittent out‑patient cardiac care with gaps.
- Two exercise (VO2) tests during the alleged period (July 2010: ~7.5 METs; Dec 2010: ~6 METs); tests became untimely after 12 months.
- Mental-health diagnoses included generalized anxiety, social phobia, intermittent explosive disorder; consultative exams found some limitations but ability to perform simple unskilled work.
- ALJ denied benefits: found severe impairments, concluded Carter did not meet Listing 4.02, assigned RFC for limited sedentary work (no climbing, occasional stooping, climate‑controlled indoor work, simple routine tasks, no public contact), and relied on VE testimony identifying sedentary unskilled jobs.
- Appeals Council denied review; district court affirmed; majority of Eighth Circuit affirmed. Judge Bright dissented and would remand for further development and analysis.
Issues
| Issue | Plaintiff's Argument (KKC) | Defendant's Argument (Commissioner) | Held |
|---|---|---|---|
| Whether Carter met or medically equaled Listing 4.02 (chronic heart failure) | Listing 4.02 met because EF ≤30% and symptoms/limitations met part B (persistent very limiting symptoms or inability to perform ≤5 METs) | ALJ relied on exercise tests showing >5 METs and lack of evidence that an exercise test would be too risky; no showing of persistent inability to perform ADLs | Affirmed: substantial evidence supports ALJ that Listing 4.02 not met—exercise tests >5 METs and ADL evidence inconsistent with B(1) or B(3) |
| Whether ALJ erred by not giving treating physician controlling weight (Dr. Goerbig‑Campbell) | Treating cardiologist’s support letter and NYHA III classification should be controlling and show disabling limitations | Treating physician’s letter did not state specific functional limitations and the ultimate disability determination is reserved to SSA; records show ability to do some activities consistent with sedentary work | Affirmed: ALJ permissibly gave the letter limited weight because it opined on disability (legal issue) and lacked specific functional findings |
| Whether ALJ fully developed the record regarding exercise testing and safety (post‑Dec 2011) | ALJ failed to develop record after tests became untimely; should have obtained updated testing or clarified whether testing would be unsafe due to implanted defibrillator; equivalence analysis inadequate | ALJ may rely on the existing evidence when sufficient; consultative testing is discretionary when the record permits a decision | Majority: affirmed (ALJ not required to order further testing); Dissent: would remand for further development and a medical‑equivalence analysis |
| Whether RFC and VE hypothetical adequately accounted for combined physical and mental impairments | ALJ’s RFC and VE hypothetical failed to capture combined effects of physical limitations plus explosive disorder and social phobia; VE testimony did not address combined impairments, undermining the step‑5 finding | ALJ limited work to simple, routine, nonpublic sedentary jobs to accommodate mental impairments; RFC based on record evidence and consultative opinions | Affirmed: majority finds RFC supported by substantial evidence; dissent disagrees, finding the VE hypothetical and RFC did not capture combined limitations and would remand |
Key Cases Cited
- Andrews v. Colvin, 791 F.3d 923 (8th Cir. 2015) (standard of review and substantial‑evidence framework)
- Prosch v. Apfel, 201 F.3d 1010 (8th Cir. 2000) (definition of substantial evidence)
- Sullivan v. Zebley, 493 U.S. 521 (1990) (must meet all listing criteria; equivalence requires medical findings equal in severity to all criteria)
- Stormo v. Barnhart, 377 F.3d 801 (8th Cir. 2004) (treating physician opinions on disability are legal conclusions reserved to the Commissioner; ALJ’s duty to develop the record)
- Snead v. Barnhart, 360 F.3d 834 (8th Cir. 2004) (ALJ’s duty to develop the record fairly and fully, even when claimant is represented)
- Hunt v. Massanari, 250 F.3d 622 (8th Cir. 2001) (hypothetical to VE must capture concrete consequences of claimant’s impairments)
- Hogg v. Shalala, 45 F.3d 276 (8th Cir. 1995) (daily activities generally provide little support for finding ability to perform full‑time work)