Opinions and documents
IN THE UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF ARKANSAS
NORTHERN DIVISION
WILLIAM DAVIS PLAINTIFF
V. Case No. 3:25-CV-00076-BBM
FRANK BISIGNANO,1 Commissioner,
Social Security Administration DEFENDANT
ORDER
Plaintiff William Davis (“Davis”) applied for Title II disability benefits and Title
XVI supplemental security income on November 22, 2021, alleging he became disabled
within the meaning of the Social Security Act on August 1, 2021. (Tr. at 17). His
applications were denied initially and upon reconsideration. Id. Following a hearing, the
Administrative Law Judge (“ALJ”) found that Davis was not disabled. (Tr. at 17–33). The
Appeals Council then denied his request for review. (Tr. at 1–6). The ALJ’s decision now
stands as the final decision of the Commissioner, and Davis has requested judicial review.
For the reasons stated herein, the decision of the Commissioner is affirmed.
I. THE COMMISSIONER’S DECISION
At step one of the five-step sequential process,2 the ALJ found that Davis had not
1 On May 7, 2025, Frank Bisignano was sworn in as Commissioner of the Social Security
Administration (“the Commissioner”). Pursuant to Federal Rule of Civil Procedure 25(d), Commissioner
Bisignano is automatically substituted as the Defendant.
2 The ALJ must determine: (1) whether the claimant was engaged in substantial gainful activity;
(2) if not, whether the claimant had a severe impairment; (3) if so, whether the impairment (or combination
of impairments) met or equaled a listed impairment; (4) if not, whether the impairment (or combination of
impairments) prevented the claimant from performing past relevant work; and (5) if so, whether the
impairment (or combination of impairments) prevented the claimant from performing any other jobs
available in significant numbers in the national economy. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).
engaged in substantial gainful activity since the alleged onset date of disability. (Tr. at 20).
The ALJ listed disorder of the cervical spine; disorder of the lumbar skeletal spine;
osteoarthritis of the hands, knees, feet, and ankles; bilateral foot drop; diabetes mellitus II
with proliferative retinopathy; macular edema; and neovascular glaucoma of both eyes as
severe impairments. Id. After finding at step three that none of Davis’s impairments—
individually or combined—met or equaled a listed impairment, the ALJ determined that
Davis had the residual functional capacity (“RFC”) to perform work at the light-exertional
level, except that he is unable to use his lower extremities for foot controls or pedals; (2)
he is unable to climb ladders, ropes, or scaffolds; (3) he can engage in frequent fingering
and handling with the bilateral upper extremities; (4) he is limited to ambulation on level
surfaces; (5) he is precluded from ambulating on agricultural or construction terrains; (6)
he cannot work at unprotected heights; and (7) he is precluded from work requiring bifocal
vision. (Tr. at 21–22).
The ALJ determined that Davis was unable to perform any past relevant work but
could perform other jobs existing in significant numbers in the national economy. (Tr. at
30–33). Consequently, the ALJ concluded that Davis was not disabled. Id.
II. DISCUSSION
A. Standard of Review
The Court’s function on review is to determine whether the Commissioner’s
decision is “supported by substantial evidence on the record as a whole and whether it is
based on legal error.” Miller v. Colvin, 784 F.3d 472, 477 (8th Cir. 2015); see also 42
U.S.C. § 405(g). “Substantial evidence is that which a ‘reasonable mind might accept as
adequate to support a conclusion,’ whereas substantial evidence on the record as a whole
entails ‘a more scrutinizing analysis.’” Reed v. Barnhart, 399 F.3d 917, 920 (8th Cir. 2005)
(citations omitted). “Our review ‘is more than an examination of the record for the
existence of substantial evidence in support of the Commissioner’s decision. . . . [W]e also
take into account whatever in the record fairly detracts from that decision.’” Gann v.
Berryhill, 864 F.3d 947, 950–51 (8th Cir. 2017) (citation omitted). “Reversal is not
warranted, however, ‘merely because substantial evidence would have supported an
opposite decision.’” Reed, 399 F.3d at 920 (citation omitted).
In clarifying the “substantial evidence” standard applicable to review of
administrative decisions, the Supreme Court has explained: “And whatever the meaning of
‘substantial’ in other contexts, the threshold for such evidentiary sufficiency is not high.
Substantial evidence . . . ‘is more than a mere scintilla.’” Biestek v. Berryhill, 587 U.S. 97,
103 (2019) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 217 (1938)). “It
means—and means only—‘such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.’” Id. (citation omitted).
B. Davis’s Arguments on Appeal
Davis asserts two grounds for reversal: (1) that the RFC was not supported by
substantial evidence, (Doc. 12 at 25); and (2) that the ALJ erred in evaluating the
persuasiveness of the medical opinions, id. at 31. After a brief review of the medical record
evidence, the Court will address each of Davis’s arguments, in turn.
1. Davis’s Medical History
The record reveals that Davis routinely had high blood pressure readings, as well as
issues with blood sugar related to diabetes, but he chose not to monitor his glucose levels
at home and did not take his medicine as prescribed for his conditions. (Tr. at 413–17, 440–
60, 532–34, 648–60). On July 20, 2022, Davis underwent a consultative physical
examination, ordered by the Social Security Administration (“SSA”). (Tr. at 575-79). He
was examined by Dr. Blake St. Clair. Id. Davis told Dr. St. Clair that he could stand without
much difficulty. Id. He further stated that he had trouble tolerating medication and was not
on any diabetes medications. Id. Musculoskeletal exam showed osteoarthritis in his hands.
Id. Davis could rise from a sitting position without assistance and could stand on his tiptoes
and heels; he could tandem walk, but he had difficulty bending and squatting. Id. Grip
strength was 5/5 with adequate motor movements and the ability to grasp objects
bilaterally. Id. Dr. St. Clair diagnosed Davis with hand osteoarthritis, knee osteoarthritis,
foot/ankle osteoarthritis, and diabetes mellitus. Id. Dr. St. Clair stated:
Based on today’s examination, and the objective evidence, I believe the
claimant will be limited in lifting/carrying objects above 20 lbs due to knee,
foot, and ankle osteoarthritis. Otherwise, the claimant should be able to sit,
walk, stand, lift objects, hold a conversation, respond appropriately to
questions, and carry out and remember instruction without limitations.
(Tr. at 578).
Davis saw a new primary care physician, Dr. Allison Green, at Unity Health Clinic
on October 12, 2022. (Tr. at 590–91). Davis told Dr. Green that he was not taking
medication for his leg swelling or diabetes. Dr. Green noted abnormal gait and feet “flop
and slap.” Id. She discussed starting medication, but Davis was “adamantly” opposed. Id.
A year later, Davis saw Dr. Green, and she observed that he had missed multiple scheduled
appointments. (Tr. at 710–14). She recommended MRIs of the lumbar and cervical spine
and of the brain. Id.
On October 26, 2023, Davis underwent a lumbar MRI, which showed moderate disc
herniation and moderate stenosis and bilateral facet arthropathy, plus partial sacralization
at L5. (Tr.at 656, 674–75, 704–05). A head MRI was suspicious for occlusion, but no acute
intracranial process was identified. (Tr. at 672, 702–03). A cervical MRI showed flattening
of the normal lordosis, small diffuse posterior disc herniation, and diminished hypodensity.
(Tr. at 656–57, 669–70, 700–01).
At a neurosurgical appointment on November 1, 2023, Davis reported pain and
stiffness in his bilateral lower legs. (Tr. at 650–58). He ambulated with a cane and had
notable gait and balance instability. Id. He reported a back and leg pain level of 5 out of
10. Id. Davis had some swelling, weakness, and numbness in extremities, but normal range
of motion in his neck. Id. He had no pain with range of motion in the lumbar spine, and SI
joints were normal. Id. Davis had slightly decreased grip and finger strength and bilateral
foot drop. Id. His doctor scheduled Davis for physical therapy, but Davis didn’t go. Id.
A November 2023 Computed Tomography Angiography (“CTA”) of Davis’s neck
showed convex spinal curvature, flatting of the normal lordosis, mild calcification, and
opacification reflecting retrograde flow in the distal left vertebral artery. (Tr. at 664–65).
A CTA of Davis’s head showed opacification of the distal left vertebral artery, but no
stenosis, occlusion, or thrombosis. (Tr. at 662–63).
At a November 8, 2023 appointment with Dr. Green, Davis told her he was taking
his Lisinopril HCTZ for high blood pressure and felt better. (Tr. at 679–83). He refused to
take his blood sugar medicine as prescribed, however. Id. Davis also refused to take insulin.
Id. Furthermore, he declined statins. Id. Dr. Green wrote a letter stating that Davis was
unable to work due to his multiple conditions. (Tr. at 695). Additionally, Dr. Green
completed a medical source statement dated November 21, 2023, opining that Green could
not even perform sedentary work and could not maintain a full-time work schedule. (Tr. at
697–98). He would need to avoid all exposure to high heat, high humidity, fumes, odors,
and gases and must avoid moderate exposure to solvents/cleaners, chemicals, and sunlight,
and must avoid concentrated exposure to perfumes. Id. Dr. Green said that Davis would
miss more than three days of work per month. Id. She said his limitations were chronic and
permanent. Id.
On March 27, 2024, Davis underwent a nerve-condition study on his upper and
lower extremities.3 (Doc. 12, Exh. A). The study showed moderate to severe diffuse motor
and sensory neuropathy in the bilateral upper extremities and severe diffuse motor and
sensory polyneuropathy in the bilateral lower extremities. Id.
Davis had cataract surgery on both eyes before the relevant time period. (Tr. at 473–
75). He was seen at Southern Eye Associates on December 11, 2023, after no appointments
for nearly three years. (Tr. at 645). He was diagnosed with neovascular glaucoma,
proliferative diabetic retinopathy, retinal traction detachment of the right eye, and pseudo
myopia in both eyes. Id. Davis was prescribed medication, and he followed up on
December 13, 2023. (Tr. at 644). At that appointment, he said his vision was mildly
improved. Id. In February 2024, Davis underwent intravitreal Avastin injections in both
3 This evidence was submitted to the Appeals Council. The Appeals Council found the evidence
did not show a reasonable probability of changing the outcome and did not exhibit the evidence. (Tr. at 2).
eyes. (Tr. at 731–37).
The two state-agency medical experts reviewed the record and found that Davis
could perform light work with additional postural and environmental limitations. (Tr. at
29–30).
2. The Assigned RFC Is Supported By Substantial Evidence.
Davis maintains that the RFC did not incorporate all of his limitations and that he
cannot perform the requirements of light work. (Doc. 12 at 25–30). In support of his
arguments, however, he reiterates his subjective complaints and restates the objective
findings, which, taken alone, do not provide a basis to change the RFC. Id. Davis also
claims that the Appeals Council erred in not making the nerve-conduction study part of the
record. Id. at 29–30.
In determining Davis’s RFC, the ALJ considered Davis’s subjective complaints, his
noncompliance with treatment (including refusal to take medication as prescribed and
missing scheduled appointments),4 his improvement over time (and improvement with
Lisinopril),5 and the medical imaging showing mild-to-moderate conditions (including
grossly normal consultative examination findings). (Tr. at 22–30). The mild-to-moderate
objective imaging findings do not suggest that light work was too strenuous for Davis. In
addition, the ALJ reviewed the state agency opinions and limited Davis even more than
they suggested. Id. at 29–30. He discussed Davis’s ability to perform daily activities, like
4 A failure to follow a recommended course of treatment weighs against a claimant’s credibility.
Guilliams v. Barnhart, 393 F.3d 798, 802 (8th Cir. 2005).
5 Improvement in condition supports an ALJ’s finding that a claimant is not disabled. See Locher
v. Sullivan, 968, F.2d 725, 728 (8th Cir. 1992); (Tr. at 679–83).
doing biblical research and ministering to his congregation. (Tr. at 23). Lastly, according
to medical records, Davis did not treat the conditions that he claims are disabling. Indeed,
Davis’s noncompliance with treatment throughout the relevant time-period undercuts his
argument that the RFC failed to incorporate all of his impairments.
Davis also takes issue with the nerve-conduction study submitted to the Appeals
Council, which Davis contends “directly contradicts the ALJ’s finding that Davis can
engage in frequent fingering and handling with both upper extremities and can ambulate
with only minimal limitations . . . .” (Doc. 12 at 30). When the Appeals Council has
considered new evidence and nonetheless declined review, the ALJ’s decision becomes the
final action of the Commissioner; the Court then has no jurisdiction to review the Appeals
Council’s action because it is a non-final agency action. See Piepgras v. Chater, 76 F.3d
233, 238 (8th Cir. 1996) (citing Browning v. Sullivan, 958 F.2d 817, 822 (8th Cir. 1992)).
At this point, the Court’s task is to decide whether the ALJ’s decision is supported by
substantial evidence in the record as a whole, including the new evidence submitted to the
Appeals Council that was not before the ALJ. Browning, at 823. It must be reasonably
likely that the Commissioner’s consideration of this new evidence would have resulted in
an award of benefits. See Woolf v. Shalala, 3 F.3d 1210, 1215 (8th Cir. 1993).
The Appeals Council did receive and review the nerve-conduction study, but it
elected not to exhibit the evidence. (Tr. at 2). The Appeals Council found that the evidence
did not show a reasonable probability of changing the ALJ’s decision. Id. Upon review,
the nerve-conduction study did not present anything showing a marked deterioration in
condition. Rather, the study showed conditions aligning with the balance of the record
before the ALJ. Appropriately, the RFC incorporated all of Davis’s credible limitations.
3. The ALJ Properly Evaluated the Medical Opinions.
Davis argues that the ALJ did not properly evaluate the persuasiveness of the
medical opinions, particularly those of Dr. St. Clair and Dr. Green. (Doc. 12 at 31). The
Court disagrees.
The Administration promulgated regulations—effective March 27, 2017—
governing how ALJs assess medical opinion evidence. Those rules provide that an ALJ
“will not defer or give any specific evidentiary weight, including controlling weight, to any
medical opinion(s),” 20 C.F.R. §§ 404.1520c(a), 416.920c(a) (2017). Instead, ALJs are
required to analyze whether opinion evidence is persuasive, based on: (1) supportability;
(2) consistency with the evidence; (3) relationship with the claimant [which includes: (i)
length of treatment relationship; (ii) frequency of examinations; (iii) purpose of the
treatment relationship; (iv) extent of the treatment relationship; and (v) examining
relationship]; (4) provider specialization; and (5) any other important factors. 20 C.F.R. §§
404.1520c(c), 416.920c(c). An opinion is “more persuasive if it is supported by explanation
and relevant objective medical evidence, and is consistent with other evidence in record,”
Norwood v. Kijakazi, No. 21-3560, 2022 WL 1740785, at *1 (8th Cir. May 31, 2022) (per
curiam) (citing 20 C.F.R. §§ 404.1520c(c), 416.920c(c)). An ALJ must give good reasons
for his findings about an opinion’s persuasiveness. Phillips v. Saul, No 1:19-CV-34-BD,
2020 WL 3451519, at *2 (E.D. Ark. June 24, 2020) (citing Revisions to Rules Regarding
the Evaluation of Medical Evidence, 82 FR 5844-01, at 5854, 5858 (Jan. 18, 2017), &
Articulation Requirements for Medical Opinions and Prior Administrative Medical
Findings – Claims filed on or after March 27, 2017, SSA POMS DI 24503.030). An ALJ
is not bound to rely on a particular medical opinion and can decline to incorporate any
portion of an opinion that the ALJ deems inconsistent. See McKinney v. O’Malley, No. 23-
3220, 2024 WL 1327965, at *1 (8th Cir. Mar. 28, 2024) (holding that ALJ was not required
to adopt the exact limitations set forth in the opinions she found persuasive and that the
RFC determination was supported).
The ALJ considered the opinion of Dr. St. Clair and found it partially persuasive.
(Tr. at 26). He agreed with Dr. St. Clair’s conclusion that Davis could perform light work
and that Davis would be limited to lifting/carrying objects above 20 pounds due to knee,
foot, and ankle osteoarthritis, finding those opinions to be consistent with Dr. St. Clair’s
own clinical findings. Id. The ALJ found the rest of Dr. St. Clair’s opinion, including
regarding Davis’s ability to sit, stand, and lift objects, not persuasive because it lacked
specificity and no meaningful limitations could be derived from those aspects of Dr. St.
Clair’s opinion. Id. The ALJ filled in any gaps with regard to those physical activities based
on the state-agency opinions and his own findings. (Tr. at 29–30). The ALJ explained how
he analyzed Dr. St. Clair’s opinion, and the record supports the ALJ’s findings.
The ALJ also evaluated Dr. Green’s opinion that Davis could not work. (Tr. at 26–
27). He properly pointed out that a finding by a doctor about a claimant’s ability to work
is an issue reserved for the Commissioner.6 He also addressed Dr. Green’s more detailed
opinion from November 2023. (Tr. at 27). He found the opinion that Davis could not
6 Ellis v. Barnhart, 392 F.3d 988, 994 (8th Cir. 2005) (opinion about claimant’s ability to work
reserved to the Commissioner).
perform even sedentary work to be unpersuasive. Id. The ALJ gave good reasons for this,
citing the medical findings and pointing out inconsistences in Dr. Green’s opinion. Id. For
example, the ALJ noted that Dr. Green’s “extreme limitations” were based on Davis’s
abnormal neurological findings; however, Dr. Green never prescribed an assistive device
or a brace and never prescribed any medication for Davis’s neurological issues. Id. at 27–
28.
The Court acknowledges that the ALJ cited the typical language that “the opinion
is not consistent with the record as a whole” as part of his findings. Id. Davis says this is
boilerplate language and is insufficient for finding a medical opinion unpersuasive. (Doc.
13 at 34). The ALJ, however, provided great detail about why he found Dr. Green’s opinion
inconsistent with the record. He cited medical evidence, like grossly normal
musculoskeletal findings, Davis’s pain questionnaire, Davis’s hearing testimony, Davis’s
function reports, Davis’s neurological exam findings, his lack of any prescribed medication
for treatment of pain or neurological-related symptoms, and the fact that no doctor
prescribed a cane or foot brace or gave him a handicap placard for his car. (Tr. at 24–29).
The ALJ fully dispatched his duty to rule on the supportability and consistency of the
medical opinions. The Court finds no error.
III. CONCLUSION
Substantial evidence on the record as a whole supports the Commissioner’s
decision. The finding that Davis was not disabled within the meaning of the Act is hereby
AFFIRMED. Judgment will be entered for the Defendant.
IT IS SO ORDERED this 24th day of June, 2026.
UNITED STATES MAGISTRATE JUDGE
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