“[E]very conclusion reached by an ALJ when evaluating a claimant’s RFC must be accompanied by ‘a narrative discussion describing [ ] the evidence’ that supports it.”
How later courts described this case
- “[E]very conclusion reached by an ALJ when evaluating a claimant’s RFC must be accompanied by ‘a narrative discussion describing [ ] the evidence’ that supports it.”
Written by the judges who cited it.
The opinion
CHAMBERS OF U.S. COURTHOUSE
AJMEL A. QUERESHI 6500 CHERRYWOOD LANE
UNITED STATES MAGISTRATE JUDGE GREENBELT, MARYLAND 20770
(301) 344-0393
January 27, 2023
LETTER TO COUNSEL
Re: Donald B. v. Kilolo Kijakazi, Commissioner, Social Security Administration
Civil No. AAQ-21-2657
Dear Counsel:
On October 15, 2021, Plaintiff Donald B. (“Plaintiff”) petitioned this Court to review the
Social Security Administration’s (“SSA’s”) final decision to deny his claim for disability insurance
financial assistance under Title II of the Social Security Act. ECF No. 1. I have considered the
parties’ cross-motions for summary judgment. ECF Nos. 11, 12. I find that no hearing is
necessary. See Loc. R. 105.6 (D. Md. 2021). This Court must uphold the decision of the SSA if
it is supported by substantial evidence and if the SSA employed proper legal standards. See 42
U.S.C. §§ 405(g), 1383(c)(3); Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996). Under that
standard, I will deny both motions, vacate the Commissioner’s decision, and remand the case to
the Commissioner for further consideration. This letter explains my rationale.
I. The History of this Case
Plaintiff filed his claim for financial assistance on February 26, 2019, alleging a disability
onset date of February 17, 2018. ECF No. 8-3 at 21. An Administrative Law Judge (“ALJ”)
determined that Plaintiff did not have a disability within the meaning of the Social Security Act
during the relevant time frame. Id. at 22. The Appeals Council denied Plaintiff’s request for
review, id. at 6; thus, the ALJ’s decision constitutes the final, reviewable decision of the SSA.
Sims v. Apfel, 530 U.S. 103, 106-07 (2000); see also 20 C.F.R. § 422.210(a).
The ALJ found that Plaintiff suffered from the severe impairment of “degenerative disc
disease with radiculopathy.” ECF No. 8-3 at 23. Despite this impairment, the ALJ determined
that Plaintiff retained the residual functional capacity (“RFC”) to:
perform sedentary work as defined in 20 CFR 404.1567(a) except
that the claimant can occasionally climb ramps and stairs, balance,
stoop, kneel, crouch, and crawl. He can never climb ladders, ropes,
or scaffolds. He m[u]st avoid concentrated exposure to vibration
and hazards, such as moving machinery and unprotected heights.
The claimant requires the use [of] a cane for ambulation. He needs
the option to alternate between sitting and standing an average of
every 30 minutes (as defined at hearing) while remaining on task.
January 27, 2023
Page: 2
Id. at 24-25.
The ALJ’s analysis in support of the aforementioned RFC focused on whether Plaintiff’s
alleged symptoms were consistent with the evidence in the record and the extent to which these
symptoms limited Plaintiff’s ability to perform work-related activities. Id. at 25. Although the
ALJ found “that the claimant’s medically determinable impairments could reasonably be expected
to cause the alleged symptoms[,] . . . the claimant’s statements concerning the intensity, persistence
and limiting effects of these symptoms [we]re not entirely consistent with the medical evidence
and other evidence in the record[.]” Id. The ALJ began by recounting Plaintiff’s testimony that
he has pain which radiates down both of his legs; he has needed a cane to walk since early 2020;
he can walk for approximately thirty feet at a time, and cannot stand for more than an hour;
although he can sit in a recliner for up to an hour, he cannot sit in an office chair for any length of
time; he has to lie down during the day to manage his pain; he cannot lift much weight and has
been instructed not to lift more than eight pounds; and his medications cause him to experience
sleepiness and blurred vision. Id.
The ALJ then compared Plaintiff’s testimony regarding his symptoms with his medical
records. Id. at 25-27. The ALJ emphasized, among other things, that in July 2018, Plaintiff had
successful back surgery; he was observed in August 2018 sitting comfortably in an exam chair
with no distress; he did not consistently tell medical providers that he needed to lie down during
the day, nor did medical providers find that he had to; he acknowledged the ability to dress and
bathe himself and attend church once or twice a month; his medical records noted that he denied
having side effects from his medication; in February 2019, Plaintiff was observed conducting
straight leg raises, walking with a normal gait, and responding with intact reflexes; in September
2019, he denied having pain, had a full range of extremity and lumbar spine motion, had no
musculoskeletal tenderness, and had no focal motor deficits; and that in May 2020, he was found
to have 4/5 lower extremity strength and full strength in his lower right extremity. Id. at 26-27.
In sum, the ALJ stated:
the record as a whole, including the evidence of an “excellent”
decompression surgery with no residual compressive pathology, the
negative EMG/NCS testing, the claimant’s denial of side effects in
the record, the evidence of sitting comfortably upon examination,
and the medical examinations showing good extremity and lumbar
spine motion, no sensory or motor deficits outside the left lower
extremity, normal/fluid gait and station, normal reflexes and
coordination, and no tenderness to palpation of the spine, I have
concluded that the claimant is capable of a range of sedentary work
with a sit/stand option as set forth in the above residual functional
capacity.
January 27, 2023
Page: 3
Id. at 27.
After making this determination, the ALJ considered the medical opinions of several
doctors, which they found persuasive to varying degrees. Id. at 27-28. Notably, the ALJ noted
that they found the opinion of Dr. Michael Jacobs “somewhat persuasive.” Id. at 28. “Dr. Jacobs
. . . found that the claimant can lift up to 5 pounds occasionally and 10 pounds rarely, must avoid
crouching/crawling/bending, should perform no balancing or climbing, should not operate heavy
machinery, and can only stand/walk up to 5 minutes per hour for a total of 45 minutes per day[.]”
Id. at 28. Nonetheless, the ALJ concluded “[t]he specific exertional and non-exertional limitations
provided by Dr. Jacobs are not consistent with the record as a whole,” notably
evidence of no residual compressive pathology post-surgery with
vertebral body heights maintained, the negative EMG/NCS testing,
and the evidence of normal/fluid gait and station, 5/5 strength
outside the left lower extremity, sitting comfortable upon
examination in no acute distress, displaying normal extremity and
lumbar spine motion, and having no tenderness to palpation of the
lumbar spine[.]
Id.
Applying this RFC, the ALJ determined that Plaintiff was unable to perform past relevant
work as a truck driver but could perform other jobs that exist in significant numbers in the national
economy. Id. at 29-30. Therefore, the ALJ determined that Plaintiff did not have a disability. Id.
II. Plaintiff’s Arguments on Appeal
Plaintiff raises four arguments on appeal, specifically that the ALJ: (1) failed to provide a
narrative discussion explaining how the evidence supported each of their conclusions regarding
Plaintiff’s RFC; (2) failed to perform a function-by-function assessment of Plaintiff’s work-related
abilities; (3) erroneously evaluated Plaintiff’s subjective complaints; and (4) erroneously relied on
the testimony of the vocational expert. ECF No. 11-1 at 3-21.
As noted above, Plaintiff’s second argument is that the ALJ failed to perform a function-
by-function assessment of Plaintiff’s ability to perform work related activities when determining
his RFC. Id. at 8. When determining the RFC of the claimant, the ALJ must incorporate a
function-by-function assessment of their ability to do work-related activities. Social Security
Ruling 96-8p.
The United States Court of Appeals for the Fourth Circuit has held that such a function-
by-function assessment requires ALJs to evaluate “a claimant’s ability to perform the physical
January 27, 2023
Page: 4
functions listed in [the regulations],” including “sitting, standing, walking, lifting, carrying,
pushing, pulling, or other physical functions [that] may reduce [a claimant’s] ability to do past
work and other work.” Dowling v. Comm’r of Soc. Sec. Admin., 986 F.3d 377, 387 (4th Cir. 2021).
The RFC analysis should describe “how the evidence supports each conclusion reached by the
ALJ by citing to evidence and articulating all inferences drawn therefrom.” Nancy G. v. Kijakazi,
No. GLS 20-3440, 2022 WL 363824, at *3 (D. Md. Feb. 4, 2022) (citing Thomas v. Berryhill, 916
F.3d 307, 312-13 (4th Cir. 2019)); see also Dowling, 986 F.3d at 387 (“[E]very conclusion reached
by an ALJ when evaluating a claimant’s RFC must be accompanied by ‘a narrative discussion
describing [ ] the evidence’ that supports it.”) (quoting Thomas, 916 F.3d at 311). “This function-
by-function assessment is not the same as an assessment of the intensity and persistence of
Plaintiff’s symptoms, the latter of which is outlined in SSRs 96-7p and 16-3p.” Henderson v.
Kijakazi, No. AAQ-20-3346, 2022 WL 1555408, at *2 (D. Md. May 17, 2022). As noted in
Dowling, Plaintiff’s symptoms are relevant to the RFC evaluation, but an RFC assessment is “a
separate and distinct inquiry from a symptom evaluation.” 986 F.3d at 387. Treating the two as
the same can lead to error, id., and may warrant remand. Britt v. Saul, 860 F. Appx. 256, 262 (4th
Cir. 2021). Remand will be appropriate where the ALJ “fails to assess a claimant’s capacity to
perform relevant functions, despite contradictory evidence in the record, or where other
inadequacies in the ALJ’s analysis frustrate meaningful review.” Mascio v. Colvin, 780 F.3d 632,
636 (4th Cir. 2015).
In this case, the ALJ concluded Plaintiff had the “residual functional capacity to perform
‘sedentary’ work as defined in 20 CFR 404.1567(a),” followed by a series of limitations regarding
his ability to climb, balance, stoop, kneel, crouch, and crawl, among other limitations. ECF No.
8-3 at 24-25. Per federal regulations:
Sedentary work involves lifting no more than 10 pounds at a time
and occasionally lifting or carrying articles like docket files, ledgers,
and small tools. Although a sedentary job is defined as one which
involves sitting, a certain amount of walking and standing is often
necessary in carrying out job duties. Jobs are sedentary if walking
and standing are required occasionally and other sedentary criteria
are met.
20 CFR § 404.1567(a); see also SSR 83-10 (“By its very nature, work performed primarily in a
seated position entails no significant stooping. Most unskilled sedentary jobs require good use of
the hands and fingers for repetitive hand-finger actions. ‘Occasionally’ means occurring from very
little up to one-third of the time.”).
Having found Plaintiff’s impairment to be severe, the ALJ “needed to articulate how th[is]
impairment[] translated into the RFC limitation.” Nancy G., 2022 WL 363824, at *4. As outlined
above, instead of performing a function-by-function assessment, the ALJ here proceeded by
January 27, 2023
Page: 5
evaluating Plaintiff’s symptoms and let that evaluation guide the determination. The
Commissioner does not dispute this point, but instead argues that this error was harmless because
the ALJ’s RFC discussion, although focused on Plaintiff’s alleged symptoms, adequately
explained the basis for each conclusion regarding Plaintiff’s ability to perform each of the
functions inherent in sedentary work. ECF No. 12-1, at 11-12. As Plaintiff highlights, however,
the ALJ’s analysis is silent as to the basis on which they concluded that Plaintiff could lift up to
ten pounds at a time and occasionally lift and carry objects. ECF No. 11-1 at 11. As noted above,
Plaintiff testified that he cannot lift much weight and that he has been instructed not to carry more
than eight pounds. According to Dr. Jacobs, Plaintiff can only lift five pounds on an occasional
basis. These conclusions were supported by the medical record, which noted that Plaintiff sought
care for significant back pain after lifting cases of water. ECF No. 8-3, at 25; see also id. at 71
(“Aggravating factors for the patient’s pain include . . . lifting .”). Furthermore, as the ALJ
acknowledged, Plaintiff requires the assistance of a cane to walk, drawing into further question
how Plaintiff could carry articles while walking, as sedentary work requires. Although the ALJ’s
analysis, even though conducted incorrectly, includes a sufficient basis upon which this Court can
“fathom” the ALJ’s reasoning regarding Plaintiff’s ability to sit, there is no discussion from which
to assess the ALJ’s reasoning regarding Plaintiff’s ability to lift. See Britt, 860 Fed. Appx. at 262
(“Meaningful review is frustrated – and remand necessary – only where we are unable to fathom
the [ ] rationale in relation to evidence in the record.” (internal citations and quotation marks
omitted)). Neither the ALJ’s discussion of Plaintiff’s medical records or of Dr. Jacobs’ opinion
accounts for this specific function or explains why Plaintiff’s testimony and Dr. Jacobs’ conclusion
regarding Plaintiff’s ability to lift were not persuasive in crafting the RFC.
Perhaps recognizing the insufficiency of the ALJ’s analysis, the Commissioner
alternatively contends that the ALJ did perform a function-by-function analysis because the ALJ
cited to 20 CFR § 404.1567(a) – the definition of sedentary work. See ECF No. 12-1 at 12
(“Defendant respectfully asserts that the ALJ’s function-by-function analysis was inherent in the
regulation’s definition of sedentary work.”). This Court has previously rejected this argument for
good reason. See Henderson, 2022 WL 1555408, at *3 (rejecting the argument that “the ALJ did
perform a function-by-function analysis because she cited to 20 CFR 404.1567(b).”). Mere
citation to the regulation outlining functions is not the same as evaluating those functions in the
context of Plaintiff’s limitations. Id. To accept the Commissioner’s argument would be in direct
contradiction to the Fourth Circuit’s command that the ALJ provide a narrative discussion
supporting its conclusions. As noted, where the ALJ has provided some analysis of the relevant
function – even if conducted incorrectly – the Court may be able to fathom what the ALJ’s
reasoning may have been, making remand unnecessary. However, to simply conclude, as the
Commissioner asks, that the ALJ conducted the proper analysis where they failed to discuss the
matter entirely would eviscerate any meaningful review this Court may conduct.
As this case is being remanded on other grounds, I do not need to address Plaintiff’s
arguments regarding the ALJ’s other alleged failures.
January 27, 2023
Page: 6
III. CONCLUSION
For the reasons set forth herein, Plaintiff’s Motion for Summary Judgment, ECF No. 11, is
DENIED and Defendant’s Motion for Summary Judgment, ECF No. 12, is DENIED. Pursuant to
sentence four of 42 U.S.C. § 405(g), the SSA’s judgment is VACATED. This case is
REMANDED for further proceedings in accordance with this opinion.
Despite the informal nature of this letter, it is an Order of the Court and should be treated
accordingly. An implementing order follows.
Sincerely,
/s/
Ajmel A. Quereshi
United States Magistrate Judge