Barker v. Astrue , 459 F. App'x 732 ( 2012 )


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  •                                                                  FILED
    United States Court of Appeals
    UNITED STATES COURT OF APPEALS         Tenth Circuit
    TENTH CIRCUIT                          February 15, 2012
    Elisabeth A. Shumaker
    Clerk of Court
    DREENA M. BARKER,
    Plaintiff-Appellant,                                 No. 10-4195
    (D.C. No. 1:09-CV-72-SA)
    v.                                                           (D. Utah)
    MICHAEL D. ASTRUE, in his capacity
    as Commissioner of the Social Security
    Administration,
    Defendant-Appellee.
    ORDER AND JUDGMENT*
    Before MURPHY, HOLLOWAY, and HARTZ, Circuit Judges.
    Plaintiff-Appellant Dreena M. Barker appeals the district court’s order affirming
    the Commissioner of Social Security’s decision to deny her request for disability
    insurance benefits under the Social Security Act (“Act”). The district court exercised
    jurisdiction over this case, which presents questions of federal law, pursuant to 
    42 U.S.C. § 405
    (g), and upheld the Commissioner’s decision. We have jurisdiction to hear this
    * This order and judgment is not binding precedent, except under the doctrines of
    law of the case, res judicata, and collateral estoppel. It may be cited, however, for its
    persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1.
    appeal from the district court’s final decision pursuant to 
    42 U.S.C. § 405
    (g) and 
    28 U.S.C. § 1291
    .
    Ms. Barker’s claim for disability insurance benefits turns on whether her infliction
    of multiple sclerosis disabled her such that she could not work on the date she was last
    insured, i.e. by March 31, 2003. On appeal, Ms. Barker argues that the Commissioner of
    the Social Security Administration (“Commissioner”), through an administrative law
    judge, failed to properly evaluate and weigh the entire body of medical evidence, Ms.
    Barker’s own testimony, and statements by third-party lay witnesses. Specifically, Ms.
    Barker asserts that the degree of impairment of manual dexterity and coordination in her
    dominant right hand was incorrectly determined by the Commissioner. As a result of this
    alleged error, Ms. Barker contends that the Commissioner incorrectly assessed her
    residual functional capacity, leading to an erroneous conclusion that, as of March 2003,
    she could perform her past relevant work as an art director as that work is performed in
    the national economy. “We review the Commissioner's decision to determine whether the
    factual findings are supported by substantial evidence and whether the correct legal
    standards were applied.” Angel v. Barnhart, 
    329 F.3d 1208
    , 1209 (10th Cir. 2003). We
    AFFIRM the district court’s decision upholding the Commissioner’s final decision.
    2
    I. Background
    A. Factual and Medical Background
    Ms. Barker was diagnosed with multiple sclerosis (“MS”)1 in the early 1990s.
    Despite this diagnosis, at first the disease did not impose substantial physical limitations.
    In 1991, around the same time she was diagnosed, Ms. Barker started her own business,
    where she worked as a graphic artist and art director. She had worked in the same
    capacity for other companies during the previous sixteen years. Upon being diagnosed
    with MS, Ms. Barker periodically saw a neurologist, Dr. Michael Williams, through
    November of 2003. Ms. Barker’s visits to Dr. Williams did not occur on any set
    timeframe — for example, after a visit at some point in 1998 she did not see Dr. Williams
    again until August 2001. Tr. at 165. 2
    Sometime in 2000 or 2001, Ms. Barker’s infliction of MS began to take a
    discouraging turn for the worse and became more progressive in nature. Consequently,
    Ms. Barker’s physical condition began a course of deterioration. Exactly how quickly the
    MS took hold and how ravaging its effects on Ms. Barker’s livelihood were is unknown.
    1
    Multiple sclerosis is “a disease in which there are foci of demyelination [i.e.
    ‘destruction, removal, or loss of the myelin sheath of a nerve or nerves’] throughout the
    white matter of the central nervous system, sometimes extending into the gray matter[.]
    [S]ymptoms usually include weakness, incoordination, paresthesias, speech disturbances,
    and visual complaints. The course of the disease is usually prolonged, so that the term
    multiple also refers to remissions and relapses that occur over a period of many years.”
    Dorland’s Illustrated Medical Dictionary 486, 1680 (32d ed. 2012).
    2
    Citations of “Tr.” reference the transcript of the proceedings before the
    Commissioner, which is incorporated into the appellant’s appendix.
    3
    Sadly, this litigation turns on the precise slope of the decay caused by Ms. Barker’s
    disease.3
    Among many other deleterious effects, MS has undisputedly affected Ms. Barker’s
    motor skills, coordination, and manual dexterity in her dominant right hand. The precise
    onset date and manifestation of those effects, however, is the primary subject of dispute
    in this appeal. In a visit to Dr. Williams in August 2001, Ms. Barker was observed to
    have a “mild degree of finger-nose-to-finger [sic] ataxia” in both of her upper
    extremities.4 Tr. at 165. Unfortunately, Dr. Williams’s treatment notes from the 2001
    visit do not reveal any precise measure of the degree to which this ataxia impaired Ms.
    Barker’s functioning, particularly as applied to her job. Ms. Barker’s next visit with Dr.
    Williams came in August 2002, though on that occasion the doctor made no specific
    observations about Ms. Barker’s coordination, motor skills, or manual dexterity. Dr.
    Williams did note that Ms. Barker reported no exacerbations due to her MS over the
    3
    Ms. Barker’s insured status (for Social Security purposes) expired on March 31,
    2003. Thus, in order to be eligible for DIB, Ms. Barker’s disability must have had an
    onset date of March 31, 2003 or sooner. See, e.g., Potter v. Secretary of health & Human
    Services, 
    905 F.2d 1346
    , 1348-49 (10th Cir. 1990) (“The relevant analysis is whether the
    claimant was actually disabled prior to the expiration of her insured status.”) (emphasis
    omitted). The only issue raised in this appeal is whether the ALJ properly concluded that
    Ms. Barker’s disability had not begun by this date. Thus, medical records and other
    evidence reflecting upon Ms. Barker’s condition immediately before and after March
    2003 are of particular concern in this case.
    4
    Ataxia is “failure of muscular coordination; [or] irregularity of muscular action.”
    Dorland’s Illustrated Medical Dictionary 153 (32d ed. 2012).
    4
    course of the previous year, although she did discuss some overall degradation in her
    “energy, strength, and balance.” Tr. at 163.
    After the August 2002 session with Dr. Williams, Ms. Barker did not visit Dr.
    Williams (or any doctor) until November 2003. On that occasion, Dr. Williams noted
    slow deterioration of Ms. Barker’s condition — in particular, he reported an “increasingly
    weak” and “poorly controlled” right side along with impaired balance. Tr. at 159. In
    January 2004, pursuant to a discussion with Dr. Williams, Ms. Barker began attending an
    MS clinic at the University of Utah. Tr. at 159, 228. There, Ms. Barker’s treating nurse,
    Julia Klein, made thorough notes regarding Ms. Barker’s condition.5 Specifically, Ms.
    Barker reported to Ms. Klein an exacerbation of her condition in November 2003 relating
    to spasticity in her legs. Tr. at 228. Among other things, Ms. Klein also recorded that
    Ms. Barker reported “increased incoordination, especially with the right hand, with
    decreased dexterity over time.” 
    Id.
     Ms. Klein performed objective testing which showed
    “normal bulk and tone with mild intention tremor on the right with finger-to-nose testing”
    that was “course in nature.” Tr. at 230. Ms. Klein also reported “mild dysmetria
    5
    At the time of her work with Ms. Barker, Ms. Klein was an “APRN,” i.e.
    advanced practice registered nurse. Tr. at 240; Dorland’s Illustrated Medical Dictionary
    121 (32d ed. 2012).
    5
    bilaterally”6 with “slow rapid alternating movements on the right.” 
    Id.
    In June 2004, Ms. Barker visited a new doctor, Dr. Ryan Nelson, for a consultative
    examination. With regard to dexterity issues, Ms. Barker complained to Dr. Nelson of
    “difficulty using her right hand.” Tr. at 182. Dr. Nelson recorded full strength in Ms.
    Barker’s right side for wrist flexion, wrist extension, and grip. Tr. at 184. Ms. Barker’s
    finger abduction in her right hand was scored as 4 out of 5. 
    Id.
     Dr. Nelson described Ms.
    Barker as having “relatively normal strength and range of motion” and the ability to
    “manipulate small objects without any difficulty.” Tr. at 185. He reported “no
    compromise” in Ms. Barker’s manual dexterity. 
    Id.
    Ms. Barker visited a psychologist in July 2004, to whom she reported problems
    with her right hand. Specifically, Ms. Barker complained of an inability to “type, write,
    or draw for more than a brief period.” Tr. at 169. The psychologist did not perform a
    physical examination of Ms. Barker. In December 2004, Ms. Barker was again evaluated
    by Dr. Nelson. As a result of that assessment, Dr. Nelson noted “compromise” of Ms.
    Barker’s manual dexterities that would prevent her from performing most duties
    associated with a routine desk job. Tr. at 181. Similarly, Dr. Nelson observed that Ms.
    Barker could not handle light objects effectively or manipulate them. 
    Id.
     As a result of
    Ms. Barker’s deteriorated condition between the June 2004 and December 2004
    6
    Dysmetria is “a condition in which there is improper measuring of distance in
    muscular acts; [or] disturbance of the power to control the range of movement in
    muscular action.” Dorland’s Illustrated Medical Dictionary 510 (32d ed. 2012).
    6
    assessments, the Commissioner determined that Ms. Barker was disabled as of September
    1, 2004 and awarded her supplemental security income benefits as of that date. Tr. at
    304-05. However, because Ms. Barker’s onset date (September 1, 2004) was after her
    date last insured (March 31, 2003), she was denied disability insurance benefits (“DIB”).
    B. Procedural Background
    Ms. Barker applied for DIB under the Social Security Act in March 2004, alleging
    disability as of her undisputed last date of insurance eligibility under the Act, March 31,
    2003. Tr. at 17. Ms. Barker claimed that she was disabled because her infliction of MS
    had progressed by March 2003 so as to preclude her from working in her job as an art
    director and graphics designer. Ms. Barker’s initial claim for DIB and subsequent
    request for reconsideration were denied by the Commissioner in January 2005 and May
    2005, respectively. Tr. at 17. An administrative law judge (“ALJ”) upheld the Agency’s
    denial of benefits in December 2006. Tr. at 30. The Agency’s Appeals Council affirmed
    the ALJ’s decision in August 2007. Tr. at 5. Ms. Barker challenged the Appeals
    Council’s decision in federal court, and in July 2008 the district court remanded the case
    back to the Appeals Council for further administrative proceedings. Aplt. App’x at 19.
    The Appeals Council, in turn, remanded the case back to the ALJ. Tr. at 354.
    As instructed by district court’s remand order, the ALJ sought further records from
    Ms. Barker’s treating physician. Tr. at 361. The treating physician did not provide any
    further records or information. Tr. at 360. As a result, the ALJ retained an independent
    medical expert to offer further testimony at a second hearing in Ms. Barker’s case in
    7
    November 2008. Tr. at 367-429. Following that hearing, the ALJ again upheld the
    Commissioner’s denial of DIB in a decision dated December 8, 2008. Tr. at 311. The
    Appeals Council declined further review of the ALJ’s decision; thus, the ALJ’s
    December 2008 denial of DIB became the final decision of the Commissioner. Tr. at
    291A. Subsequent to that renewed denial, Ms. Barker filed a second complaint in federal
    court challenging the Commissioner’s final decision, thus instituting the action
    underlying this appeal. In September 2010, the district court upheld the Commissioner’s
    denial of benefits. Aplt. App’x at 5. In this appeal, Ms. Barker challenges the district
    court’s affirmance of the Commissioner’s final decision.
    II. Discussion
    The regulations expounding on the Social Security Act establish an intricate
    system for making disability determinations. Central to that system is a five-step process
    which the Commissioner must follow in asking whether a claimant like Ms. Barker is
    “disabled” for purposes of the Act.7 The ALJ ruled at step four of the process,
    7
    We have previously described the five-step process:
    Step one requires a claimant to establish she is not engaged in “substantial gainful
    activity.” See 
    20 C.F.R. §§ 404.1520
    (b), 404.1572. Step two requires the claimant
    to establish she has a “medically severe impairment or combination of
    impairments.” See 
    id.
     §§ 404.1520(c), 404.1520a-404.1523. Step three asks
    whether any “medically severe impairment,” alone or in combination with other
    impairments, is equivalent to any of a number of listed impairments so severe as to
    preclude “substantial gainful employment.” See id. §§ 404.1525-404.1526 & pt.
    8
    concluding that Ms. Barker was not disabled under the Act. Underlying that conclusion
    was a finding that Ms. Barker’s residual functional capacity (RFC) allowed her to:
    “Perform sedentary work as defined in 
    20 CFR § 404.1567
    (a) and 417.967(a),
    except she cannot lift more than 10 pounds or stand or walk more than 2 hours per
    8-hour day [.] . . . [S]he has mild manual dexterity limitations with [her right] hand
    and cannot perform rapid repetitive movements more than [one-half] of the
    workday [.] . . . [B]ecause of fatigue, she must be able to lie down for up to 1 hour
    during the workday, which may be done during the standard 15-minute morning
    and afternoon breaks and for part of the lunch break.”
    Tr. at 305. The ALJ then determined, based on the testimony of a vocational expert, that
    this RFC would not allow Ms. Barker to perform her past relevant work as she had
    performed it, but would allow her to perform that work as it is generally performed in the
    national economy. Tr. at 310. Ms. Barker raises two arguments on appeal. First, she
    contends that the ALJ’s RFC determination was erroneous. Second, Ms. Barker asserts
    that the ALJ incorrectly concluded that her RFC allowed her to perform her past relevant
    work.
    404, subpt. P, App. 1. If listed, the impairment is conclusively presumed
    disabling. See 
    id.
     § 404.1520(d).
    If [the claimant’s impairment is] unlisted [at step three], the claimant must
    establish at step four that her impairment prevents her from performing work she
    has previously performed. See id. § 404.1520(e), (f). If the claimant is not
    considered disabled at step three, but has satisfied her burden of establishing a
    prima facie case of disability under steps one, two, and four, the burden shifts to
    the Commissioner to show the claimant has the residual functional capacity (RFC)
    to perform other work in the national economy in view of her age, education, and
    work experience. See id. § 404.1520(g).
    Fischer-Ross v. Barnhart, 
    431 F.3d 729
    , 731 (10th Cir. 2005) (paragraph break added).
    9
    We begin our review of Ms. Barker’s case by evaluating the propriety of the
    ALJ’s RFC determination, and then consider whether Ms. Barker’s RFC justifies the
    ALJ’s conclusion that she could perform her past relevant work as defined in the social
    security regulations.8
    A. Standard of Review
    We review the ALJ's factual findings to determine whether they are supported by
    substantial evidence in the record. Lax v. Astrue, 
    489 F.3d 1080
    , 1084. Substantial
    evidence is defined as relevant evidence that a reasonable mind might accept as adequate
    to support a conclusion. 
    Id.
     It is more than a mere scintilla, but less than a
    preponderance of the evidence. 
    Id.
     The possibility that two conflicting conclusions
    might be reached does not preclude the substantial evidence standard from being
    satisfied. 
    Id.
     “We consider whether the ALJ followed the specific rules of law that must
    be followed in weighing particular types of evidence in disability cases, but we will not
    reweigh the evidence or substitute our judgment for the Commissioner’s.” 
    Id.
     (quotations
    omitted). However, “we meticulously examine the record as a whole, including anything
    that may undercut or detract from the ALJ's findings[,] in order to determine if the
    substantiality test has been met.” Flaherty v. Astrue, 
    515 F.3d 1067
    , 1070 (10th Cir.
    8
    Ms. Barker also asks us, if we rule in her favor, to determine that the
    Commissioner cannot satisfy his burden at step five of the sequential evaluation process.
    Because we uphold the Commissioner’s decision, reached at step four of the sequential
    evaluation, we do not consider this argument.
    10
    2007) (quotations omitted).
    B. RFC Determination
    Ms. Barker attacks the ALJ’s RFC finding on three grounds. First, she claims that
    the medical record evidence was improperly weighed. Second, Ms. Barker says that the
    ALJ did not properly assess the credibility of her own testimony and thus gave it
    insufficient weight. Lastly, she asserts that testimony of third-party lay witnesses was
    also incorrectly evaluated and weighed. Each of these arguments attacks the ALJ’s
    finding that Ms. Barker had only “mild” manual dexterity limitations and that she could
    perform “rapid repetitive movements” for one-half of a work day. We conclude that the
    ALJ did not commit legal error in his evaluation and weighing of the evidence, and thus
    uphold his determination of Ms. Barker’s RFC.
    1. Medical Record Evidence
    Ms. Barker claims that too much weight was placed on the June 2004 assessment
    in light of the other available medical evidence. Specifically, Ms. Barker protests that
    earlier assessments, most notably the August 2001 assessment by Dr. Williams, are at
    odds with the results of Dr. Nelson’s June 2004 assessment. We disagree. Even if there
    is a degree of inconsistency between the 2001 assessment where “mild” finger-to-nose
    ataxia was noted (Tr. at 165) and the June 2004 assessment where there was “no
    compromise of manual dexterity” (Tr. at 307), the 2001 assessment does not undercut the
    notion that Plaintiff's limitations in her right hand were “mild” as described in the RFC
    (Tr. at 305). Indeed, the ALJ reconciled the differences between the June 2004
    11
    assessment (which noted no compromise of manual dexterity) and earlier medical reports
    (which noted some compromise of manual dexterity) in favor of Ms. Barker by
    concluding that Ms. Barker’s RFC included “mild manual dexterity limitations” with her
    right hand. Tr. at 305.
    Unfortunately, as is prone to be the case with multiple sclerosis, a disease whose
    effects are amorphous and ever-changing, the medical records do not reflect a clear
    course of progression of Ms. Barker’s disease. They are especially lacking in and around
    the crucial time in this case — March 2003. There are no medical records in the
    transcript between August 2002 and November 2003; the transcript reflects that Ms.
    Barker did not ever visit a doctor during that time period. The expert who examined all
    of Ms. Barker’s medical records and testified on remand, Dr. Kendrick Morrison, focused
    in on the evidence of Ms. Barker’s manual dexterity. He indicated that the first reference
    to dexterity troubles was in August 2001 by Dr. Williams (mild ataxia), and the next
    reference to manual dexterity was not until December 2004, when Dr. Nelson found that
    her manual dexterity had been compromised. Tr. at 388-89. In summing up the medical
    records, Dr. Morrison said that there was “at least some weakness in the right extremity,
    ataxia” and that “the RFC would be sedentary at best at that time [i.e. March 2003].” The
    ALJ’s ultimate conclusion as to Ms. Barker’s RFC in March 2003 is wholly consistent
    with Dr. Morrison’s testimony. Thus, the medical records, despite their sparseness,
    constituted substantial evidence to support the ALJ’s conclusion as to Ms. Barker’s RFC,
    particularly the severity of coordination problems in her right hand.
    12
    Ms. Barker would have us go further, and infer that her condition had significantly
    worsened between August 2001 and March 2003. This inference is supported, Ms.
    Barker says, by the December 2004 report which showed substantial deterioration in
    dexterity. Ms. Barker argues that, in light of the August 2001 assessment (“mild ataxia”)
    and December 2004 assessment (“compromise of manual dexterity”), the June 2004
    assessment (“no compromise of manual dexterity”) is simply nonsensical. However,
    even though the finding in the June 2004 assessment of “no compromise” is seemingly at
    odds with the other assessments, an inference that Ms. Barker’s coordination problems
    were still only “mild” as of March 2003 — as was made in the RFC — is supported by
    the medical record evidence on which Ms. Barker urges us to rely. To be sure, an
    inference that Ms. Barker’s coordination had deteriorated more severely might also be
    supportable. But as we have said, “the possibility of drawing two inconsistent
    conclusions from the evidence does not preclude an administrative agency’s findings
    from being supported by substantial evidence.” Lax v. Astrue, 
    489 F.3d 1080
    , 1084 (10th
    Cir. 2007) (quotations omitted). Thus, the ALJ’s determination of Ms. Barker’s RFC was
    supported by substantial medical record evidence.
    2. Claimant’s Testimony
    Ms. Barker claims that insufficient weight was given to her own testimony.
    Specifically, Ms. Barker claims that the ALJ improperly discredited her claims that she
    lost the ability to draw, paint, manipulate a mouse, use a keyboard, or otherwise perform
    her duties as an artist. The ALJ’s conclusion that Ms. Barker’s RFC included the ability
    13
    to perform rapid repetitive movements for one-half the workday is at odds with Ms.
    Barker’s assertion that she could not manipulate a mouse or keyboard at all. The ALJ
    acknowledged as much: “[T]he claimant’s statements concerning the intensity,
    persistence and limiting effects of these symptoms are not credible to the extent they are
    inconsistent with the above residual functional capacity assessment.” Tr. at 306.
    However, the ALJ noted that objective medical evidence did not, in itself,
    substantiate Ms. Barker’s claim about the severity of her deterioration of manual
    dexterity as of March 2003, which is a fair characterization of the record’s reflection of a
    lack of objective testing about Ms. Barker’s manual dexterity between August 2001
    (“mild ataxia”) and December 2004 (manual dexterity was significantly affected). More
    specifically, the ALJ deemed Ms. Barker’s failure to visit a doctor for these claimed
    dexterity problems to be probative of their mild intensity. Tr. at 308-09. Thus, the ALJ’s
    credibility finding was reasonably grounded, among other things, on Ms. Barker’s failure
    to report coordination problems to her doctors. Id.; cf. Kepler v. Chater, 
    68 F.2d 387
    ,
    391 (10th Cir. 1995) (stating that a claimant’s failure to seek medical treatment may be
    considered when evaluating the credibility of the claimant’s testimony as to the severity
    of an impairment).
    Ms. Barker also points to the simple fact that she said she could not, despite her
    most valiant efforts, maintain her business starting in late 2002. This, Ms. Barker says, is
    strong evidence of the exact effect of her impairment as applied to her ability to work.
    Because she could not remain gainfully employed in her own business, she says, the
    14
    inquiry need go no further. This reasoning, however, only bears on the question whether
    Ms. Barker could perform her past relevant work as she had performed it. Ms. Barker’s
    inability to maintain her own business as of March 2003 is less pertinent as to the
    dispositive question in this case — whether Ms. Barker could perform her past relevant
    work as it is generally performed in the national economy. For this reason, the ALJ’s
    limited reliance on Ms. Barker’s claims about her inability to work was justifiable.
    Furthermore, the ALJ did not disregard Ms. Barker’s testimony categorically. Tr.
    at 306 (“I am persuaded by all these statements [by Claimant and other individuals] . . .
    that the claimant did have some manual dexterity limitations . . . prior to March 31, 2003.
    . . . Unfortunately, while these statements show that [Ms. Barker] was having problems
    with her manual dexterity . . . before March 2003, they do not provide specific
    information about the extent of her physical limitations.”). Thus, the ALJ properly
    decided not to allow the extent of coordination limitations described in Ms. Barker’s
    statements to outweigh the medical evidence regarding the severity of coordination
    problems. See Blea v. Barnhart, 
    466 F.3d 903
    , 904 (10th Cir. 2006) (stating that a
    claimant’s testimony as to the extent of an impairment may only be credited to the extent
    it is not inconsistent with the medical evidence of record).
    3. Third-Party Witnesses
    Ms. Barker claims that the ALJ should have given greater weight and
    consideration to the testimony of third-party lay witnesses who periodically observed Ms.
    Barker’s deteriorating condition. Ms. Barker seeks to show through these lay witness
    15
    statements, as with her own testimony, that the severity of her manual dexterity
    limitations was not accurately reflected in the RFC. But, as with Ms. Barker’s own
    testimony, the ALJ reasonably evaluated the credibility of these statements and
    concluded that they did not outweigh the medical record evidence.
    Ms. Barker asserts that these witnesses’ statements make “clear” that she had lost
    the ability to paint at a level required by her job as early as 2001. Aplt. Br. at 31. While
    this assertion may well be true, Ms. Barker has made no showing that diminished
    painting ability impacted her ability to work as an art director as the job is performed in
    the national economy.
    Ms. Barker also argues that the statements show that she “could no longer
    manipulate objects, type, use a mouse, or perform even more mundane manual tasks” by
    the end of 2002. Aplt. Br. at 31. This contention overstates the implications of the lay
    witness statements, particularly in light of the limited credibility reasonably attributed to
    them by the ALJ. As the ALJ articulated, “while [the lay witness] statements show that
    [Ms. Barker] was having problems with her manual dexterity or strength before March
    2003, they do not provide specific information about the extent of her physical
    limitations.” Tr. at 306. In other words, the statements did not address the specific
    functional limitations as to Ms. Barker’s ability to type or use a mouse. To be sure, in the
    absence of any medical evidence, such limitations might reasonably be inferred from the
    statements. But here there is medical evidence that must be considered; Ms. Barker’s
    asserted inference would run counter to the June 2004 and earlier assessments, where
    16
    mild or no manual dexterity problems were observed. Thus, the ALJ’s unwillingness to
    infer more severe dexterity and coordination problems in light of the lay witness
    statements was justified by substantial evidence.
    4. RFC Determination
    Ms. Barker alleges that the evidentiary record belies the ALJ’s conclusion as to
    her residual functional capacity. Specifically, Ms. Barker suggests that the RFC should
    have included a finding that Ms. Barker “was not able to use her right hand to paint,
    draw, type[,] and perform other manual functions as of March . . . 2003.” Aplt. Br. at 17.
    The ALJ disagreed, refusing to accept Ms. Barker’s argument that she was not capable of
    “any rapid, repetitive work.” Tr. at 311.
    We agree with Ms. Barker that her proposed finding might well have been a
    supportable one. However, we are tasked only with reviewing the substantiality of the
    evidence that supports the ALJ’s findings, rather than determining the adequacy of other
    possible findings. For the foregoing reasons, we agree with the district court that the
    ALJ’s RFC determination was supported by substantial evidence.
    C. Application of the RFC to Step Four of the Disability Determination
    All this analysis about whether the ALJ arrived at a suitable conclusion as to Ms.
    Barker’s RFC only takes us so far. Having concluded that the RFC determination was
    proper, we are still left to ask whether that RFC allowed Ms. Barker to perform her “past
    17
    relevant work.”9 “Past relevant work is work that [the claimant] ha[s] done within the
    past 15 years, that was substantial gainful activity, and that lasted long enough for [the
    claimant] to learn to do it.” 
    20 CFR § 404.1560
    (b)(1).
    The Commissioner concedes that Ms. Barker’s RFC would not have allowed her
    to perform her past relevant work as she had performed it. This is of no importance, the
    Commissioner tells us, because Ms. Barker could perform her past relevant work as it
    was performed in the national economy. The only textual support we find in the
    regulations for the Commissioner’s assertion appears in 
    20 CFR § 404.1560
    (b)(2), which
    describes how the claimant’s vocational background is considered at step four. “A
    vocational expert or specialist may offer relevant evidence within his or her expertise or
    knowledge concerning the physical and mental demands of a claimant's past relevant
    work, either as the claimant actually performed it or as generally performed in the
    national economy.” 
    20 CFR § 404.1560
    (b)(2). But this regulation only tells us that it is
    permissible for a vocational expert to opine on how certain work is performed in the
    national economy.
    9
    The Social Security regulations, in 
    20 CFR § 404.1520
    (f)), provide as follows:
    “Your impairment(s) must prevent you from doing your past relevant work. If we
    cannot make a determination or decision at the first three steps of the sequential
    evaluation process, we will compare our residual functional capacity assessment,
    which we made under paragraph (e) of this section, with the physical and mental
    demands of your past relevant work. (See § 404.1560(b).) If you can still do this
    kind of work, we will find that you are not disabled.”
    18
    The Commissioner offered clarification in Social Security Ruling 82-61. There,
    the following policy statement was laid out:
    Under sections 404.1520(e) and 416.920(e) of the regulations, a claimant will be
    found to be ‘not disabled’ when it is determined that he or she retains the RFC to
    perform:
    1.     The actual functional demands and job duties of a particular past
    relevant job; or
    2.     The functional demands and job duties of the occupation as
    generally required by employers throughout the national economy.
    SSR 82-61, 
    1982 WL 31387
    , at *2.
    If SSR 82-61’s plain terms represent the law, then there is no dispute that the ALJ
    was correct to base his conclusion on Ms. Barker’s ability to perform her past relevant
    work as it is performed in the national economy. But we must remember, of course, that
    “social security rulings do not carry the force and effect of law.” Andrade v. Secretary of
    Health & Human Services, 
    985 F.2d 1045
    , 1051 (10th Cir. 1993). We defer to such
    rulings, however, unless they are “plainly erroneous or inconsistent with the Social
    Security Act.” 
    Id.
     (quotations and brackets omitted); cf. Auer v. Robbins, 
    519 U.S. 452
    ,
    461 (deferring to an agency’s interpretation of its own regulations unless the
    interpretation is “plainly erroneous or inconsistent with the regulation”) (internal
    quotations omitted). And as to the specific interpretation at issue here, we have
    previously considered and upheld the validity of SSR 82-61, concluding that a claimant
    “bears the burden of proving his inability to return to his particular former job and to his
    former occupation as that occupation is generally performed throughout the national
    19
    economy.” Andrade, 
    985 F.2d at 1051
     (emphasis added).10
    In Ms. Barker’s case, the ALJ found that, “[i]n comparing the claimant’s residual
    functional capacity with the physical and mental demands of this [past relevant] work, . .
    . the claimant is able to perform [her past relevant work as an art director] as generally
    performed.” Tr. at 310. The ALJ based this conclusion on a vocational expert’s response
    to a hypothetical question involving an individual with an RFC matching Ms. Barker’s.
    
    Id.
     Ms. Barker has not challenged the vocational expert’s qualifications, nor does she
    assert that the ALJ improperly interpreted the expert’s testimony on this point. Thus, we
    find no legal error in the ALJ’s decision, which rested on the premise that Ms. Barker
    could perform her past relevant work as it is performed in the national economy.
    * * *
    The ALJ’s determination of Ms. Barker’s RFC was supported by substantial
    evidence in the record. The available objective medical records, scant though they were,
    afforded a reasonable basis for the ALJ’s conclusion that Ms. Barker’s manual dexterity
    limitations were no more than “mild” as of March 2003, limiting her to sedentary work
    and preventing her from performing rapid repetitive movements for more than one-half
    the workday at that time. The ALJ applied proper legal standards and adequately
    explained the basis of credibility determinations in considering Ms. Barker’s own
    10
    On appeal, Ms. Barker has not articulated a challenge to the Commissioner’s
    interpretation of the Act and accompanying regulations as exposited in SSR 82-61.
    Therefore, we do not consider whether SSR 82-61 might be an invalid interpretation that
    is not owed deference.
    20
    testimony as well as observations by third-party lay witnesses. The ALJ also reasonably
    evaluated and incorporated the testimonial evidence, to the extent it was deemed credible,
    to the medical evidence in the record. Finally, the ALJ properly based his finding that
    Ms. Barker was not disabled on her ability to perform past relevant work as it is
    performed in the national economy. Thus, we AFFIRM the Commissioner’s decision
    denying Ms. Barker’s claim for disability insurance benefits. Ms. Barker’s motion for
    leave to proceed in forma pauperis is GRANTED.
    ENTERED FOR THE COURT
    William J. Holloway, Jr.
    Circuit Judge
    21