Buckner v. Astrue

United States Court of Appeals
FOR THE EIGHTH CIRCUIT
___________

No. 10-1524
___________

Brian Buckner, *
*
Appellant, *
* Appeal from the United States
v. * District Court for the
* Western District of Missouri.
Michael J. Astrue, Commissioner *
of Social Security, *
*
Appellee. *
___________

Submitted: January 13, 2011
Filed: July 19, 2011
___________

Before WOLLMAN, LOKEN, and SMITH, Circuit Judges.
___________

SMITH, Circuit Judge.

Brian Buckner appeals the district court's1 judgment upholding the
Commissioner of Social Security's ("Commissioner") denial of his application for
disability insurance and supplemental security income (SSI) benefits, under Titles II
and XVI of the Social Security Act (SSA). Buckner argues that the administrative law
judge (ALJ) (1) erroneously determined that Buckner's mental
impairments—specifically, his depression and anxiety—were not severe; (2)

1
The Honorable Ortrie D. Smith, United States District Judge for the Western
District of Missouri.
inadequately evaluated the credibility of Buckner and Buckner's girlfriend; and (3)
based his decision on an improperly phrased hypothetical question to the vocational
expert (VE). For the following reasons, we affirm.

I. Background
In Buckner's application for disability and SSI benefits, he alleged a disability
beginning on August 29, 2005, at age 33. In his application, he stated that he could not
work full time due to hypertension, sleep apnea, restless leg syndrome, headaches,
anxiety, emotional problems, and gastroesophageal reflux disease (GERD). Buckner
has a high school diploma but no further education. He previously worked as a
warehouse worker, a milker on a dairy farm, a nursing assistant, and a taxi cab driver.

A. Medical History
Buckner made several visits to different medical providers between April 2005
and October 2007. These visits were not directly related to his application for
disability and SSI benefits, but they were included in the administrative record. The
conditions documented by these providers are summarized below.

1. Hypertension
Buckner began receiving medication for hypertension in April 2005. At that
time, his blood pressure measured 199/121 and 180/101. He reported smoking 1.5
packs of cigarettes per day. On May 27, 2005, Buckner sought medical treatment and
reported that he had not taken his hypertension medicine for two days, and he reported
smoking two packs of cigarettes per day. His blood pressure measured 175/123,
154/108, and 160/105. He was instructed to take his hypertension medication.

With some exceptions, Buckner's hypertension generally improved over the
course of 17 measurements in the next two years. Starting with a high of 180/132 in
September 2005, Buckner's regular blood pressure readings steadily dropped, reaching

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a low of 122/83 in October 2006. After that point, his blood pressure briefly spiked
but ultimately returned to 150/90 in October 2007.

2. Chest Pain
At Buckner's May 2005 examination, a chest x-ray revealed "[q]uestionable
mild cardiomegaly,"2 which the doctor indicated "may be an artifact of the portable
[x-ray] technique and the patient's body habitus."

Buckner reported a history of chest pain at his September 1, 2005 examination.
An x-ray revealed "minimal old pulmonary granulomatous disease"3 and a "borderline
cardiac size." An electrocardiogram (EKG) revealed sinus bradycardia4 but was
otherwise normal.

On September 12, 2005, Buckner underwent a myocardial perfusion rest and
stress test involving a "two-day treadmill exam." An EKG indicated a normal resting
heart rate. With stress, Buckner had no chest pain. The examination revealed "[n]o
evidence of myocardial scarring or of stress induced myocardial ischemia,"5 "[m]ild
inferior hypokinesis,"6 and a normal "left ventricular ejection fraction" of 55 percent.

2
Cardiomegaly is an "[e]nlargement of the heart." Stedman's Medical Dictionary
313 (28th ed. 2006).
3
This disease is characterized by small or granular "nodular inflammatory
lesions" in the lungs. See id. at 831–32.
4
Bradycardia is a "[s]lowness of the heartbeat." Id. at 249.
5
Myocardial ischemia involves "inadequate circulation of blood to the
myocardium," the middle layer of the heart. Id. at 1001, 1271.
6
Hypokinesis refers to "[d]iminished or slow movement." Id. at 934.

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 From September 2005 to October 2006, all of Buckner's cardiovascular
examinations were normal. On October 10, 2007, Buckner went to the emergency
room, complaining of intermittent chest pain. By the time he was examined, he
reported no pain. Two days later, he had a normal cardiovascular examination.

3. Other Physical Conditions
Buckner suffered from a variety of other physical maladies, varying in their
duration and severity. For example, Buckner's medical records with an advanced
practice nurse indicated an ongoing problem with obesity and frequent complaints of
headaches, nasal congestion, coughing, sneezing, restless leg syndrome, and tooth
pain. Nevertheless, all of Buckner's visits to the advanced practice nurse revealed
normal musculoskeletal, motor/sensory, strength, and sensation examinations.

The advanced practice nurse also diagnosed Buckner with GERD on May 27,
2005, for which she prescribed Zantac. In September 2005, Buckner reported that the
Zantac helped "a lot," and in October 2006, he reported that his GERD was "great"
while on Zantac.

On February 20, 2006, Buckner went to the emergency room, complaining of
neck and back pain due to a motor-vehicle accident. An x-ray of his cervical spine
revealed no fractures or subluxation7 but could not exclude "[d]isc protrusion." An x-
ray of his lumbar spine revealed "a questionable fracture" of the L2 vertebra, but the
report stated it was "more likely . . . an artifact of overlapping soft tissues."

4. Depression and Anxiety
At an examination on September 1, 2005, Buckner reported having anger
problems, and the advanced practice nurse diagnosed him with depression. He had
normal psychological examinations on September 6 and 12, 2005. On September 15,

7
A subluxation is "[a]n incomplete . . . dislocation." Id. at 1856.

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2005, he returned to the advanced practice nurse and reported that his medication,
Zoloft, was helping with his depression. The advanced practice nurse indicated that
Buckner's psychological examination was normal.

On September 29, 2005, Buckner told the advanced practice nurse that the
Zoloft was not helping with his depression. Nevertheless, the advanced practice nurse
indicated that Buckner's psychological examination was normal. During visits in
October, November, and December 2005 and March 2006, the advanced practice
nurse documented normal psychological examinations. In April 2006, Buckner again
reported to the advanced practice nurse that Zoloft was not helping, but Buckner's
psychological examination was normal. The advanced practice nurse documented
normal psychological examinations for Buckner in October and November 2006.

B. Administrative History
1. Function Report
On October 27, 2005, in connection with his August 29, 2005 application for
disability and SSI benefits, Buckner completed a function report indicating how his
mental and physical conditions limited his daily activities and abilities. He indicated
that he could care for his son and girlfriend. He also stated that he could take care of
his personal needs and grooming but would "sometimes" need reminders from his
girlfriend for grooming and taking medication.

Buckner reported that he could clean and do "some yard work," although he
noted that he would have to "sit down about every 10 minutes" because of chest pain.
He stated that he went outside almost every day but usually could not drive because
of his medication. He indicated that he could go shopping and manage his own
money. He listed watching television, playing on the computer, and playing sports as
hobbies, although he stated that he could not play sports "very often" because of pain
in his legs (specifically, his restless leg syndrome). He also stated that he went to
church on a regular basis.

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 In describing his abilities, Buckner claimed that his conditions affected his
ability to lift, stand, climb stairs, see, remember, concentrate, and get along with
others. He stated that he could walk 100 to 400 feet without resting but would require
20 to 30 minutes rest before resuming. He reported having panic attacks.

2. Dr. Sutton's Psychological Report
On January 18, 2006, Geoffrey Sutton, Ph.D., a licensed pyschologist,
completed a "Psychiatric Review Technique" form. Dr. Sutton confirmed that
Buckner's medical records showed that Buckner was suffering from depression and
anxiety, concluding that "the allegations for mental disorders are partially credible."
He concluded that Buckner's mental impairments did not impair Buckner's activities
of daily living; mildly limited his ability to maintain social functioning; mildly limited
his ability to maintain concentration, persistence, and pace; and did not result in any
episodes of decompensation. Ultimately, Dr. Sutton concluded that Buckner's mental
impairments were not severe.

3. Disability Questionnaire
Buckner completed a questionnaire on December 12, 2007, in which he stated
that an ordinary day involves watching television, walking outside for a little while,
and resting. He stated that he can stand no longer than 30 minutes at a time, walk short
distances, lift light weights, and use his hands and arms. He also indicated that he can
sit if he frequently changes positions. Finally, he reported being able to mow "small
areas" of grass "with breaks" and to cook and wash dishes only if he needs to and
"with breaks."

4. Dr. Hwang's Physical Evaluation
At the request of Buckner's attorney, Yung Hwang, M.D., examined Buckner
on December 28, 2007. Dr. Hwang's report noted Buckner's history of hypertension,
heart problems, restless leg syndrome, and headaches, which Dr. Hwang stated could
be managed effectively with Buckner's prescribed medications. He noted that Buckner

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had mild depression and anxiety not being treated with medication. He explained that
Buckner "is mentally clear" and "has been evaluated for depression and anxiety but
comprehends very well and understands with no difficulty and is capable of tending
to his affairs with no assistance."

Dr. Hwang also noted Buckner's obesity and his lower back pain, and he
reported that Buckner had full range of motion in his upper extremities (shoulders,
elbows, wrists, hands, and fingers) and lower extremities (hips, ankles, and joints). Dr.
Hwang indicated that Buckner had "full grip strength," could "walk 20 minutes before
he becomes short of breath, stand[] 30 minutes without pain, lift 50 pounds
occasionally[,] and sit for long periods."

Dr. Hwang reported the following limitations in a "Medical Source Statement
(Physical)." He stated that Buckner could (1) lift objects weighing no more than 50
pounds; (2) stand or walk for four hours in an eight-hour day, up to 30 minutes at one
time; and (3) sit with normal breaks for four hours in an eight-hour day, up to 30
minutes at one time. Dr. Hwang also reported mild limitations in Buckner's ability to
(1) "push/pull" using his upper and lower extremities, (2) reach, and (3) handle. Dr.
Hwang further stated that Buckner could never climb or be exposed to heights,
temperature extremes, dust, fumes, or vibration. Finally, Dr. Hwang reported that, on
average, Buckner's impairments would force him to be absent from work "[f]our plus
times" each month.

5. First Administrative Hearing
The ALJ held Buckner's first administrative hearing on January 30, 2008. Nine
days before the hearing, Buckner's girlfriend submitted a written statement stating that
Buckner runs out of breath easily, is "always tired," and has no energy. She further
stated that Buckner cannot work and cannot watch the children when she leaves the
house.

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 Buckner testified at the hearing. He stated that he cannot work because of his
hypertension. He described having two to three "bad days"each week, where he gets
migraine headaches so intense that he isolates himself in his bedroom without any
light. He claimed that he has panic attacks when he leaves the house and interacts with
other people. He also stated that he has "throbbing" lower back pain if he sits or stands
in one place for too long. He testified that he can play with the children for two to
three hours at a time, "rolling on the floor a little bit maybe and walking with them
just a short distance around the yard." He also said that he helps around the house and
occasionally goes fishing.

6. Dr. Corsolini's Physical Evaluation
At the ALJ's request, Thomas B. Corsolini, M.D., evaluated Buckner on
February 18, 2008. Dr. Corsolini reported that Buckner had full range of motion in his
upper and lower extremities and in "all joints in the cervical spine." Buckner could
"demonstrate a full squat independently" and had "excellent" balance and
coordination. Dr. Corsolini concluded that Buckner's hypertension was "currently
adequately treated," and Dr. Corsolini recommended no physical limitations.

7. Second Administrative Hearing
Buckner testified again at a second administrative hearing on July 21, 2008. He
stated that he was no longer living with his girlfriend.

A VE also testified in response to hypothetical questions posed by the ALJ and
Buckner's attorney. The ALJ asked the VE to consider "a hypothetical person of Mr.
Buckner's age, education and work history" with the limitations described in Dr.
Hwang's report, except for the limitations on reaching, handling, and being absent
from work four times per month. The VE testified that a person with those limitations
could perform "sedentary, unskilled work" as a credit card clerk or a final assembler,
jobs which existed in significant numbers in the national economy. Buckner's attorney
asked the VE to consider the same hypothetical person, including all of the limitations

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noted in Dr. Hwang's report. The VE testified that such a person would not be able to
find work.

8. ALJ's Decision
The ALJ issued a written decision denying Buckner's application for SSI and
disability benefits, concluding that Buckner was "not disabled" within the meaning of
the SSA. The ALJ found that Buckner had the following "severe" impairments:
hypertension, morbid obesity, degenerative disc disease of the lumbar spine, and mild
cardiomegaly.

The ALJ found that Buckner's depression was "not severe." In reaching this
conclusion, the ALJ explained that "[b]ecause [Buckner's] medically determinable
mental impairment causes no more than 'mild' limitation in any of the first three
functional areas [activities of daily living; social functioning; and concentration,
persistence, or pace] and 'no' limitation in the fourth area [episodes of decompensation
of extended duration]," the depression was not severe under 20 C.F.R. §§
404.1520a(d)(1) and 416.920a(d)(1).

In assessing Buckner's residual functional capacity (RFC), the ALJ accepted all
of Dr. Hwang's limitations, except for the limitations on handling, reaching, and being
absent from work four times per month. The ALJ stated that Dr. Hwang did not
explain his reasons for reaching these conclusions, and Dr. Hwang's own
report—along with the other medical evidence of record—did not support, or even
contradicted, Dr. Hwang's conclusions.

The ALJ expressly found that Buckner's statements about "the intensity,
persistence and limiting effects of his symptoms are not credible to the extent they are
inconsistent with the [RFC]." The ALJ based this credibility finding on several
factors. First, Buckner's claims were inconsistent with the medical evidence and his
own statements in the function report, the disability questionnaire, and at the

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hearings—all of which indicated that Buckner "engage[d] in a range of daily activities
inconsistent with" his claimed symptoms and limitations. The ALJ also noted that
Buckner's hypertension was "not always controlled by medication," but Buckner
"ha[d] apparently made no effort to improve his blood pressure reading by losing
weight or eliminating tobacco use." Further, he had not reported any of the alleged
symptoms of hypertension to his doctors. Finally, the ALJ noted that Buckner's
sporadic work history prior to his alleged disability date "indicates that he was not
strongly motivated to engage in productive activity," which weighed against his
credibility.

Given these findings, the ALJ found that Buckner was unable to perform any
of his past relevant work. Based on the VE's testimony, however, the ALJ concluded
that Buckner could perform sedentary, unskilled work as a credit card clerk or a final
assembler, jobs which exist in significant numbers in the national economy.
Therefore, the ALJ found that Buckner was not disabled.

Buckner requested review of the ALJ's decision from the SSA's Appeals
Council. On November 25, 2008, the Appeals Council denied Buckner's request,
making the ALJ's decision the final decision of the Commissioner.

Buckner thereafter filed a complaint in the district court, seeking review of the
Commissioner's final decision. The district court affirmed the Commissioner's
decision, concluding that substantial evidence supported the determination that
Buckner was not disabled.

II. Discussion
We review de novo the district court's decision affirming the ALJ's denial of
social security benefits. Hulsey v. Astrue, 622 F.3d 917, 922 (8th Cir. 2010). In doing
so, we will consider whether the ALJ's decision "is supported by substantial evidence
on the record as a whole." Id. "Substantial evidence means less than a preponderance,

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but sufficient evidence that a reasonable person would find adequate to support the
decision." Id. "We will not disturb the denial of benefits so long as the ALJ's decision
falls within the available zone of choice. An ALJ's decision is not outside the zone of
choice simply because we might have reached a different conclusion had we been the
initial finder of fact." Bradley v. Astrue, 528 F.3d 1113, 1115 (8th Cir. 2008) (internal
quotations and citations omitted). "Rather, if, after reviewing the record, we find that
it is possible to draw two inconsistent positions from the evidence and one of those
positions represents the Commissioner's findings, we must affirm the decision of the
Commissioner." Young v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000) (internal
quotations, alteration, and citations omitted).

A. Severity of Mental Impairments
Buckner first contends that the ALJ's finding that his mental
impairments—specifically, his depression and anxiety—were not severe was not
supported by substantial evidence on the record as a whole. In particular, Buckner
asserts that the ALJ ignored evidence of Buckner's treatment for depression, Buckner's
complaints that the treatment was not effective, and Buckner's testimony that he
sometimes isolated himself due to the depression. Moreover, Buckner notes that Dr.
Sutton's psychological evaluation "concluded that [Buckner] would have mild
difficulties maintaining social functioning and concentration, persistence, and pace."
Because these symptoms have "more than a minimal impact" on Buckner's ability to
do basic work activities, Buckner maintains that the ALJ was compelled to find that
his mental impairments were severe.

We disagree and hold that substantial evidence on the record as a whole
supports the ALJ's finding that Buckner's mental impairments were not severe. First,
in determining whether a claimant's mental impairments are "severe," the regulations
require the ALJ to consider "four broad functional areas in which [the ALJ] will rate
the degree of [the claimant's] functional limitation: Activities of daily living; social

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functioning; concentration, persistence, or pace; and episodes of decompensation." 20
C.F.R. §§ 404.1520a(c)(3), 416.920a(c)(3). The regulations further provide:

If we rate the degree of your limitation in the first three functional areas
as "none" or "mild" and "none" in the fourth area, we will generally
conclude that your impairment(s) is not severe, unless the evidence
otherwise indicates that there is more than a minimal limitation in your
ability to do basic work activities.

Id. §§ 404.1520a(d)(1), 416.920a(d)(1). Here, Dr. Sutton, a licensed psychologist,
concluded in his report that Buckner's depression and anxiety did not impair his
activities of daily living; mildly limited his ability to maintain social functioning;
mildly limited his ability to maintain concentration, persistence, and pace; and did not
result in any episodes of decompensation. As a result, the ALJ found that Buckner's
depression and anxiety "causes no more than 'mild' limitation in any of the first 3
functional areas and 'no' limitation in the fourth area." Thus, pursuant to the
regulations, the ALJ had substantial evidence supporting a conclusion that Buckner's
depression and anxiety were "not severe."

Buckner does not challenge either Dr. Sutton's or the ALJ's findings in these
four functional areas. Instead, he argues that, despite these findings, the evidence
showed that his depression and anxiety had "more than a minimal impact" on his
ability to do basic work activities. To the contrary, the evidence in the administrative
record shows that Buckner's depression and anxiety resulted in very few limitations.
Although Buckner did complain to the advanced practice nurse on two occasions in
2005 and 2006 that his medication was not helping with his depression, he had several
normal psychological evaluations throughout this same time period. He also had
several visits to the advanced practice nurse where he did not raise any concerns about
his depression or the ineffectiveness of his medication. Likewise, Dr. Hwang noted
that Buckner could effectively manage his depression and anxiety without medication
or other assistance. While Buckner testified at the first administrative hearing that his

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anxiety sometimes forced him to isolate himself in his bedroom, he also attributed
those incidents to headaches caused by his hypertension. In any case, as discussed
infra, the ALJ properly discounted Buckner's credibility regarding his claims of severe
impairments. In sum, although Buckner was diagnosed with depression and anxiety,
substantial evidence on the record supports the ALJ's finding that his depression and
anxiety was not severe. See Trenary v. Bowen, 898 F.2d 1361, 1364 (8th Cir. 1990)
("Depression . . . is not necessarily disabling.").

B. Credibility Assessments
Next, Buckner argues that the ALJ erred by not properly assessing his
credibility and by not expressly addressing the credibility of his girlfriend's written
statement. First, Buckner asserts that the ALJ improperly evaluated his credibility by
(1) failing to "evaluate the dosage, effectiveness, and side effects of Buckner's
prescription medications"; (2) improperly assessing Buckner's daily activities; and (3)
"failing to consider that another agency found . . . Buckner disabled." Second,
Buckner asserts that the ALJ must specifically discuss and express the credibility of
any third-party statements regarding a claimant's condition. Smith v. Heckler, 735 F.2d
312, 317 (8th Cir. 1984); 20 C.F.R. § 404.1529(c)(3). He maintains that the ALJ's
failure to discuss his girlfriend's statement was "clear legal error" requiring a remand.
See Willcockson v. Astrue, 540 F.3d 878, 880 (8th Cir. 2008).

1. Buckner
This court has long required an ALJ to consider the following factors when
evaluating a claimant's credibility:

(1) the claimant's daily activities; (2) the duration, intensity, and
frequency of pain; (3) the precipitating and aggravating factors; (4) the
dosage, effectiveness, and side effects of medication; (5) any functional
restrictions; (6) the claimant's work history; and (7) the absence of
objective medical evidence to support the claimant's complaints.

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Moore v. Astrue, 572 F.3d 520, 524 (8th Cir. 2009) (citing Finch v. Astrue, 547 F.3d
933, 935 (8th Cir.2008); Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir.1984)).
ALJs "need not explicitly discuss each Polaski factor." Goff v. Barnhart, 421 F.3d
785, 791 (8th Cir. 2005) (quotation and citation omitted). Although "an ALJ may not
discount a claimant's allegations of disabling pain solely because the objective medical
evidence does not fully support them," the ALJ may find that these allegations are not
credible "if there are inconsistencies in the evidence as a whole." Id. at 792 (internal
quotations and citations omitted). We will defer to the ALJ's credibility finding if the
ALJ "explicitly discredits a claimant's testimony and gives a good reason for doing
so." Wildman v. Astrue, 596 F.3d 959, 968 (8th Cir. 2010) (quotation and citation
omitted).

Here, the ALJ expressly found that Buckner's "statements concerning the
intensity, persistence and limiting effects of his symptoms" were not credible.
Although the ALJ did not explicitly cite Polaski, he clearly considered the following
factors: Buckner's daily activities, the effectiveness of his medication and other
treatments, his work history, and the absence of objective medical evidence to support
his complaints. Regarding Buckner's daily activities, the ALJ noted that in Buckner's
disability questionnaire and his hearing testimony, Buckner stated that

he was able to care for his son and his girlfriend (who was frequently ill),
do house-cleaning, do some yard work, leave his residence nearly every
day, ride in a car, go out alone, go shopping in stores, manage his
finances, use a computer, play sports occasionally, socialize and play
games with friends or family members and attend religious services.

The ALJ found these statements to be inconsistent with Buckner's claims of disabling
pain. Next, regarding Buckner's medication and treatment, the ALJ stated that
Buckner's "hypertension is not always controlled by medication, but [he] has
apparently made no effort to improve his blood pressure reading by losing weight or
eliminating tobacco use." Additionally, the ALJ found that Buckner's "sporadic" work

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history prior to his alleged disability date "indicates that he was not strongly motivated
to engage in meaningful productive activity even prior to the alleged onset of
disability and weighs against his credibility in assigning reasons for not working."
Finally, the ALJ found that Buckner's complaints were not supported by objective
medical evidence. The ALJ noted that (1) Buckner's back problems were diagnosed
as "mild" and did not warrant further testing or treatment; (2) his depression and
headaches "never required regular psychiatric or psychological treatment[,] . . . and
the record contains minimal documentation of complaints of headaches"; and (3) Dr.
Hwang's examination report indicated that Buckner had full range of motion in all
extremities, no sign of arthritis, full grip strength, and the ability to lift up to 50
pounds occasionally. The ALJ did not err by failing to discuss expressly some of the
other factors, including any side effects from Buckner's medication. See Moore, 572
F.3d at 524. Our review of the ALJ's decision, in light of the entire administrative
record, shows that there were inconsistencies between Buckner's allegations of pain
and the evidence as a whole. See Goff, 421 F.3d at 792 (explaining that "[t]he ALJ
may disbelieve subjective complaints if there are inconsistencies in the evidence as
a whole" (quotation and citation omitted)). As a result, the ALJ did not err in
evaluating Buckner's credibility.8

2. Buckner's Girlfriend
The regulations also provide that the ALJ will "carefully consider any other
information you may submit about your symptoms," including statements "other
persons provide about your pain or other symptoms." 20 C.F.R. § 404.1529(c)(3). The
regulation, however, does not define what is meant by "careful consideration." When

8
The ALJ also did not err by failing to address the fact that Buckner may have
received Medicaid benefits at one time because this evidence, standing alone, does not
indicate whether another agency found Buckner disabled. See 20 C.F.R.
§ 404.1512(b)(5); Mo. Rev. Stat. § 208.151 (listing the types of individuals eligible
for Missouri Medicaid benefits).

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considering the issue, this court has not always insisted that the ALJ explicitly explain
its reasons for discrediting a third-party's statements about the claimant's condition.

In Robinson v. Sullivan, the ALJ explicitly discredited testimony from the
claimant's wife but failed to discuss the reasons for doing so. 956 F.2d 836, 841 (8th
Cir. 1992). We noted that "it is clear that the ALJ specifically addressed [the wife's]
testimony and found it not credible" and that "[t]his finding is supported by the same
evidence that proved [the claimant's] claims not credible." Id. Ultimately, we affirmed
the ALJ, explaining that "[w]hile it is preferable that the ALJ delineate the specific
credibility determinations for each witness, an arguable deficiency in opinion-writing
technique does not require us to set aside an administrative finding when that
deficiency had no bearing on the outcome." Id. (quotation and citation omitted).

Three years later, in Lorenzen v. Chater, we again considered an argument that
the ALJ erred by "fail[ing] to list specific reasons for discrediting the testimony" of
a third party. 71 F.3d 316, 319 (8th Cir. 1995). Nonetheless, we affirmed the ALJ
because "it is evident that most of [the third party's] testimony concerning [the
claimant's] capabilities was discredited by the same evidence that discredits [the
claimant's] own testimony concerning his limitations." Id.

Finally, in Willcockson, we considered an ALJ's failure to consider statements
submitted by the claimant's mother, daughter, and sister. 540 F.3d at 880. We noted
that we could not "determine from the record whether the ALJ overlooked these
statements, gave them some weight, or completely disregarded them." Id. Moreover,
we "question[ed] whether witness statements corroborating a claimant's subjective
complaints can logically be treated as cumulative by assuming that they would have
been rejected for the same reasons that the claimant statements were rejected." Id. at
881. This failure to address the third-party statements—combined with the ALJ's
failure to explain the weight given to a nonexamining consultant's report and his

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insufficient assessment of the claimant's own statements—compelled us to remand the
case. Id. at 880–81.

In the present case, although the ALJ did not expressly address the girlfriend's
statement in his decision, the ALJ's error does not require remand. Unlike the
statements in Robinson, the ALJ did not explicitly address the claims that Buckner's
girlfriend made about Buckner's conditions. Rather, as in Willcockson, we cannot
determine from the record whether the ALJ considered her statements at all. At the
same time, much like the third-party statements Robinson and Lorenzan, the same
evidence that the ALJ referred to in discrediting Buckner's claims also discredits the
girlfriend's claims. Specifically, Buckner's girlfriend stated that Buckner cannot watch
the children when she leaves the house. As noted above, the ALJ observed that
Buckner, in his disability questionnaire and his hearing testimony, "stated that he was
able to care for his son." Buckner's girlfriend also claimed that Buckner could not
work, would run out of breath easily, and had no energy. Although the ALJ did not
address all of these specific claims, the ALJ did find that Buckner's own statements
and hearing testimony "show that he engages in a range of daily activities inconsistent
with his allegation of disabling hypertension, headaches, back pain, hand cramps,
shortness [of] breath, chest pains, depression and anxiety." Finally, the decision here
did not suffer from the other deficiencies noted in Willcockson; most notably, as
discussed supra, the ALJ here did sufficiently assess Buckner's credibility. Thus, we
hold that the ALJ's "arguable deficiency in opinion-writing technique," Robinson, 956
F.2d at 841 (quotation and citation omitted), had no bearing on the outcome of
Buckner's case and does not require remand.

C. Hypothetical Questions to VE
Finally, Buckner argues that the ALJ's finding that Buckner could find
employment as a credit card clerk or a final assembler was not supported by
substantial evidence because it was based on a VE's response to an improperly phrased
hypothetical question. Buckner contends that the ALJ's hypothetical question to the

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VE must include all credible, relevant impairments in order for the VE's response to
qualify as "substantial evidence." See Hunt v. Massanari, 250 F.3d 622, 626 (8th Cir.
2001). In Buckner's case, the ALJ "found that Buckner had mild deficiencies in
maintaining activities of daily living social functioning, and concentration,
persistence, or pace." Despite this fact, the ALJ failed to include these deficiencies in
the hypothetical question to the VE. Moreover, Buckner argues the ALJ failed to
include "the impact of drowsiness as a side effect of Buckner's medications." Thus,
he argues that the VE's testimony cannot provide substantial evidence for the ALJ's
determination that Buckner was not disabled.

The Commissioner responds that the ALJ's hypothetical question to the VE
properly included all of Buckner's "credible limitations." First, the Commissioner
contends that because Buckner's mental impairments were "not severe," the ALJ was
entitled to exclude "any limitation flowing from depression" in the hypothetical
question to the VE. Likewise, the Commissioner asserts that the record did not support
Buckner's claims of drowsiness as a side effect of his medication and that the ALJ
properly excluded it as a possible impairment in the hypothetical question. Because
the ALJ's hypothetical question to the VE properly incorporated all credible
limitations, the Commissioner concludes that the VE's testimony provided substantial
evidence supporting the ALJ's determination that Buckner was not disabled.

"A vocational expert's testimony constitutes substantial evidence when it is
based on a hypothetical that accounts for all of the claimant's proven impairments."
Hulsey, 622 F.3d at 922. But "[w]hen a hypothetical question does not encompass all
relevant impairments, the vocational expert's testimony does not constitute substantial
evidence. Thus, the ALJ's hypothetical question must include those impairments that
the ALJ finds are substantially supported by the record as a whole." Pickney v. Chater,
96 F.3d 294, 296 (8th Cir. 1996) (internal citation omitted). At the same time, we have
recognized that "[t]he hypothetical need not frame the claimant's impairments in the
specific diagnostic terms used in medical reports, but instead should capture the

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concrete consequences of those impairments." Hulsey, 622 F.3d at 922 (quotation and
citation omitted).

For example, we have held that "an ALJ may omit alleged impairments from
a hypothetical question posed to a vocational expert when '[t]here is no medical
evidence that these conditions impose any restrictions on [the claimant's] functional
capabilities'" or "when the record does not support the claimant's contention that his
impairments 'significantly restricted his ability to perform gainful employment.'"
Owen v. Astrue, 551 F.3d 792, 801–02 (8th Cir. 2008) (quoting Haynes v. Shalala, 26
F.3d 812, 815 (8th Cir. 1994); Eurom v. Chater, 56 F.3d 68 (8th Cir. 1995) (per
curiam) (unpublished table opinion)). On at least one occasion, we have held that the
ALJ did not err by excluding the claimant's mental limitations from the hypothetical
questions to the VE, when substantial evidence supported the ALJ's determination that
the claimant's mental limitations were "nonsevere." Jackson v. Apfel, 162 F.3d 533,
538 (8th Cir. 1998).

Here, the ALJ did not explicitly mention Buckner's depression and anxiety in
the hypothetical to the VE. On this record the ALJ did not err. The ALJ did not
entirely discount the credibility of Buckner's claims of depression and anxiety.
However, the ALJ, as explained above, reasonably concluded with substantial
evidence that these impairments were "not severe." This is consistent with our
precedent. See Jackson, 162 F.3d at 538. The ALJ's hypothetical asked the VE to
consider the restrictions noted in Dr. Hwang's report, excluding only Dr. Hwang's
restrictions on reaching, handling, and being absent from work.9 Dr. Hwang's report
did note that Buckner had been diagnosed with depression. Because Dr. Hwang's
Medical Source Statement incorporated all of Buckner's impairments—including
Buckner's depression and anxiety—into Dr. Hwang's recommended limitations, we

9
The ALJ excluded them from the hypothetical because he found that they were
not credible, and Buckner has not challenged the exclusion of these restrictions from
the ALJ's hypothetical to the VE.

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can safely conclude that the ALJ's hypothetical "capture[d] all of the concrete
consequences of those [credible] impairments." Hulsey, 622 F.3d at 922 (emphasis
added). As such, the VE's answer to that hypothetical constitutes substantial evidence
supporting the ALJ's determination that Buckner was not disabled.

III. Conclusion
For the foregoing reasons, we hold that substantial evidence on the record as
a whole supports the ALJ's decision. We therefore affirm the judgment of the district
court.
______________________________

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