BROWN v. O'MALLEY

IN THE UNITED STATES DISTRICT COURT

FOR THE MIDDLE DISTRICT OF NORTH CAROLINA

CHRISTOPHER B., )

)

Plaintiff, )

)

v. ) 1:22-CV-920

)

MARTIN J. O’MALLEY, )

Commissioner of Social )

Security, )

)

Defendant. )

MEMORANDUM OPINION AND ORDER

THOMAS D. SCHROEDER, District Judge.

Plaintiff Christopher B. challenges the decision of the

Commissioner of the Social Security Administration,1 who denied

his application for disability insurance benefits under the Social

Security Act. Before the court are Plaintiff’s objections to the

magistrate judge’s report recommending that the court affirm the

final decision of the Commissioner. (Doc. 17.) For the reasons

set forth below, the decision of the Commissioner will be reversed,

and this matter will be remanded for further proceedings.

I. BACKGROUND

Plaintiff protectively filed an application for disability

insurance benefits on January 14, 2021, alleging disability as of

July 21, 2020, due to psychosis, attention deficit hyperactivity

1 Martin J. O’Malley was sworn in as the Commissioner of Social Security

on December 20, 2023. Pursuant to Federal Rule of Civil Procedure 25(d),

Martin J. O’Malley is substituted for Kilolo Kijakazi as the Defendant

in this suit.

disorder (“ADHD”), insomnia, high blood pressure, low

testosterone, anxiety, and opioid addiction. (Tr. at 27, 196.)2

The North Carolina state agency denied his claim at the initial

and reconsideration levels of review. (Tr. at 59-84.) On March

9, 2022, an administrative law judge (“ALJ”) held a telephonic

hearing at which Plaintiff and an impartial vocational expert

testified. (Tr. at 43-58.) On March 18, 2022, the ALJ issued a

written decision unfavorable to Plaintiff. (Tr. at 27-38.)

Finding no basis to disturb the ALJ’s decision, the Appeals Council

denied Plaintiff’s request for review, making the ALJ’s decision

the Commissioner’s final decision for purposes of judicial review.

(Tr. at 1-7.) This civil action followed.

In rendering his decision, the ALJ made the following

findings:

1. The claimant meets the insured status requirements of

the Social Security Act through December 31, 2025

(Exhibit 6D, page 1).

2. The claimant has not engaged in substantial gainful

activity since July 21, 2020, the alleged onset date (20

CFR 404.1571 et seq.).

3. The claimant has the following severe impairments:

Attention-deficit/hyperactivity disorder (ADHD);

generalized anxiety disorder (GAD); major depressive

disorder (MDD); and opioid dependence (20 CFR

404.1520(c)).

2 Transcript references are to the sealed administrative record at docket

entry 8.

4. The claimant does not have an impairment or

combination of impairments that meets or medically

equals the severity of one of the listed impairments in

20 CFR Part 404, Subpart P, Appendix 1 (20 CFR

404.1520(d), 404.1525 and 404.1526).

5. [T]he claimant has the residual functional capacity

to perform a full range of work at all exertional levels

but with the following nonexertional limitations: The

claimant could perform simple, routine, and repetitive

tasks in a work environment free of fast-paced

production requirements, involving only simple work-

related decisions, and with few, if any, workplace

changes; he could perform work requiring no interaction

with the public; and he could have occasional

interaction with co-workers and he could be around them

throughout the day.

6. The claimant is unable to perform any past relevant

work (20 CFR 404.1565).3

7. The claimant was born on April 19, 1978 and was 42

years old, which is defined as a younger individual age

18-49, on the alleged disability onset date (20 CFR

404.1563).

8. The claimant has at least a high school education (20

CFR 404.1564).

9. Transferability of job skills is not material to the

determination of disability because using the Medical-

Vocational Rules as a framework supports a finding that

the claimant is “not disabled,” whether or not the

claimant has transferable job skills (See SSR 82-41 and

20 CFR Part 404, Subpart P, Appendix 2).

10. Considering the claimant’s age, education, work

experience, and residual functional capacity, there are

jobs that exist in significant numbers in the national

economy that the claimant can perform (20 CFR 404.1569

and 404.1569a).

11. The claimant has not been under a disability, as

defined in the Social Security Act, from July 21, 2020,

through the date of this decision (20 CFR 404.1520(g)).

3 Plaintiff was previously employed as a jailer. (Tr. at 36.)

(Tr. at 29-38.)

Following briefing by the parties (Docs. 12, 13, 14), the

magistrate judge issued a recommended ruling on November 14, 2023

(Doc. 15). He found that the “Commissioner’s decision is legally

correct, supported by substantial evidence, and susceptible to

judicial review,” and recommended that it be upheld. (Doc. 15 at

19-20.) Plaintiff timely filed objections. (Doc. 17). The

Commissioner has not filed a response.4

II. ANALYSIS

A. Legal Standard

1. Review of Magistrate Judge’s Recommendation

When considering a magistrate judge’s report and

recommendation, a district court must conduct a “de novo

4 Plaintiff submitted two medical records to the Appeals Council, dated

April 6, 2022, and July 27, 2022, that appear to demonstrate an

escalation in symptoms following the ALJ’s opinion. (Tr. at 8-18.) The

Appeals Council declined to consider these records because they did “not

relate to the period at issue” — i.e., the period prior to the March 18,

2022 ALJ decision date. (Tr. at 2.) The records are, in any event,

part of the certified administrative record. Plaintiff cited them in

this action in an index to his brief, (Doc. 12-1), but has not explicitly

requested that the court consider them or challenged the Appeals

Council’s decision not to consider them. Thus, the court has not

considered the records here and does not base its ruling on the Appeals

Council’s decision not to consider them. 20 C.F.R. § 404.970(b)-(c)

(describing when Appeals Council will consider additional evidence);

Wilkins v. Sec’y, Dep’t of Health & Hum. Servs., 953 F.2d 93, 96 (4th

Cir. 1991) (describing evidence as “new” when it is “not duplicative or

cumulative” and as “material” when “there is a reasonable possibility

that the new evidence would have changed the outcome”); see also Norris

v. Colvin, 142 F. Supp. 3d 419, 423-25 (D.S.C. 2015) (remanding to

Commissioner where only discernible rationale for Appeals Council not

considering new evidence that appeared to relate back was that it was

dated after the ALJ’s opinion).

determination of those portions of the report or specified proposed

findings or recommendations to which objection is made.” 28 U.S.C.

§ 636(b)(1); Fed. R. Civ. P. 72(b)(3). In doing so, the district

court “may accept, reject, or modify, in whole or in part, the

findings or recommendations made by the magistrate judge.” 28

U.S.C. § 636(b)(1).

The district court must review the entire record to determine

whether the magistrate judge’s findings are adequately supported

by the record. See Johnson v. Knable, 934 F.2d 319 (Table), 1991

WL 87147, at *1 (4th Cir. May 28, 1991) (per curiam). Where a

party fails to object to a recommendation, however, the court’s

review is for clear error. Diamond v. Colonial Life & Accident

Ins. Co., 416 F.3d 310, 315 (4th Cir. 2005).

2. Judicial Review of Commissioner’s Decision

“[A] reviewing court must uphold the factual findings of the

ALJ if they are supported by substantial evidence and were reached

through application of the correct legal standard.” Hancock v.

Astrue, 667 F.3d 470, 472 (4th Cir. 2012) (internal brackets and

quotation omitted). “Substantial evidence means such relevant

evidence as a reasonable mind might accept as adequate to support

a conclusion.” Hunter v. Sullivan, 993 F.2d 31, 34 (4th Cir. 1993)

(internal quotation omitted). “It consists of more than a mere

scintilla of evidence but may be somewhat less than a

preponderance.” Mastro v. Apfel, 270 F.3d 171, 176 (4th Cir. 2001)

(internal brackets and quotation omitted).

“A claimant for disability benefits bears the burden of

proving a disability.” Hall v. Harris, 658 F.2d 260, 264 (4th

Cir. 1981). “Disability” means the “inability to engage in any

substantial gainful activity by reason of any medically

determinable physical or mental impairment which can be expected

to result in death, or which has lasted or can be expected to last

for a continuous period of not less than 12 months.” Id. (quoting

42 U.S.C. § 423(d)(1)(A)).

“The Commissioner uses a five-step process to evaluate

disability claims.” Hancock, 667 F.3d at 472 (citing 20 C.F.R.

§§ 404.1520(a)(4), 416.920(a)(4)). The Commissioner evaluates

whether the claimant “(1) worked during the alleged period of

disability; (2) had a severe impairment; (3) had an impairment

that met or equaled the requirements of a listed impairment; (4)

could return to her past relevant work; and (5) if not, could

perform any other work in the national economy.” Id.

Where, as here, a claimant clears steps one and two, but

falters at step three, then “the ALJ must assess the claimant’s

residual functional capacity (‘RFC’).” Mastro, 270 F.3d at 179.

RFC measures the most a claimant can do despite any physical and

mental limitations. Hines v. Barnhart, 453 F.3d 559, 562 (4th

Cir. 2006). After determining a claimant’s exertional and non-

exertional capacity in consideration of all of his impairments and

symptoms, the ALJ must determine an appropriate level of work.

Id. at 562-63.

“The RFC assessment must include a narrative discussion

describing how the evidence supports each conclusion, citing

specific medical facts (e.g., laboratory findings) and nonmedical

evidence (e.g., daily activities, observations).” SSR 96-8p, 1996

WL 374184, at *7. The ALJ is also obligated to “explain how any

material inconsistencies or ambiguities in the evidence in the

case record were considered and resolved.” Id. While the ALJ

need not discuss every piece of evidence, the decision must supply

an “accurate and logical bridge” between the evidence and the

conclusions. Lewis v. Berryhill, 858 F.3d 858, 868 (4th Cir.

2017); Thomas v. Berryhill, 916 F.3d 307, 311 (4th Cir. 2019), as

amended (Feb. 22, 2019) (“[A] proper RFC analysis has three

components: (1) evidence, (2) logical explanation, and (3)

conclusion. The second component, the ALJ's logical explanation,

is just as important as the other two.”).

Step four then requires the ALJ to assess whether, based on

that RFC, the claimant can “perform past relevant work”; if so,

the claimant does not qualify as disabled. Mastro, 270 F.3d at

179-80. However, if the claimant establishes an inability to

return to prior work, the analysis proceeds to the fifth step,

which “requires the Commissioner to prove that a significant number

of jobs exist which the claimant could perform, despite his

impairments.” Hines, 453 F.3d at 563. In making this

determination, the ALJ must decide “whether the claimant is able

to perform other work considering both [the claimant’s RFC] and

[the claimant’s] vocational capabilities (age, education, and past

work experience) to adjust to a new job.” Hall, 658 F.2d at 264-

65. If, at this step, the Commissioner cannot carry its

“evidentiary burden of proving that [the claimant] remains able to

work other jobs available in the community,” the claimant qualifies

as disabled. Hines, 453 F.3d at 567.

B. Plaintiff’s Objections

Plaintiff objects to the ALJ’s RFC analysis, which the

magistrate judge recommended be affirmed. First, Plaintiff argues

that the ALJ’s “RFC rationale” is “not supported by substantial

evidence, flouts the law, and conflicts with the ALJ’s other

findings.” (Doc. 17 at 3.) He points specifically to the ALJ’s

consideration of his daily activities and treatment notes and

inconsistencies between the ALJ’s step three analysis and the RFC

analysis. (Id. at 3-13.) Second, Plaintiff contends that the ALJ

erred in finding unpersuasive his treating psychiatric provider’s

medical opinions. (Id. at 13-18.) Third, Plaintiff asserts that

the ALJ erred in discounting his subjective complaints. (Id. at

18-22.)

The ALJ’s RFC analysis first addresses Plaintiff’s subjective

complaints. (Tr. at 33.) In doing so, the ALJ considers the

consistency of the subjective complaints with Plaintiff’s medical

records and daily activities. (Tr. at 34-35.) Thereafter, the

RFC incorporates by reference his findings on those topics in a

paragraph explaining the RFC. (Tr. at 35.) The opinion concludes

with a review of the medical opinions in the case. (Tr. at 35-

36.)

Preliminarily, Plaintiff’s first objection regarding the “RFC

rationale” almost entirely parallels his third objection regarding

the subjective complaints, as both maintain that the ALJ erred

when considering daily activities and medical records. (See Doc.

17 at 3-13, 18-22.) The ALJ’s most explicit “rationale,” (Tr. at

35 (paragraph beginning “The objective findings. . .”),

incorporates by reference the ALJ’s analysis on the subjective

complaints. The court will therefore consider the third objection

regarding subjective complaints first. In doing so, the court

finds that the ALJ erred, including in those portions of his

opinion that incorporate by reference the below-mentioned

erroneous analysis, most notably the paragraph beginning “The

objective findings . . .” (Tr. at 35). See also infra (discussing

same error regarding ALJ’s review of treating psychiatric

provider’s medical opinion (see Tr. at 36)).

1. Subjective Complaints

Plaintiff objects to the ALJ’s dismissal of his subjective

complaints as not credible. (Doc. 17 at 18-22.) The ALJ here

“evaluated the claimant’s and [his wife’s] statements about the

intensity, persistence, and limiting effects of his symptoms and

determined that they were not generally consistent with the record

as a whole.” (Tr. at 33.) The inconsistencies with Plaintiff’s

subjective complaints that the ALJ identified were Plaintiff’s

“positive response to psychiatric medication management, limited

positive psychiatric examination findings, and reported

functioning.” (Id.)

Plaintiff contends that the reliance on “positive response to

psychiatric medication management” and “limited positive

psychiatric examination findings” to discount his subjective

complaints is error because the ALJ “cherry-picked” the medical

record. (Doc. 17 at 9-11.) Additionally, Plaintiff argues that

the ALJ only considered the type of activities (i.e., “reported

functioning”), and not the extent to which the Plaintiff could

perform them, which, in Plaintiff’s view, reflects only an ability

to do unscheduled, abbreviated activities, rather than a 40-hour

work week. (Id. at 9.)

a. Plaintiff’s Subjective Symptoms

“The ALJ evaluates a claimant’s symptoms through a two-prong

framework found in SSR 16-3p, 2016 WL 1119029 (Mar. 16, 2016),

which is further elaborated in 20 C.F.R. § 404.1529.” Shelley C.

v. Comm’r of Soc. Sec. Admin., 61 F.4th 341, 359-60 (4th Cir.

2023). For the first prong, the ALJ must decide whether there is

“an underlying medically determinable physical or mental

impairment that could reasonably be expected to produce the

claimant’s symptoms.” Id. at 360 (citing SSR 16-3p, 2016 WL

1119029). For the second prong, the ALJ considers “the ‘entire

case record, including the objective medical evidence; an

individual’s statements about the intensity, persistence, and

limiting effects of symptoms; statements and other information

provided by medical sources and other persons; and any other

relevant evidence in the individual’s case record.’” Id. (citing

SSR 16-3p, 2016 WL 1119029, at *4).5 An ALJ may not disregard a

claimant’s subjective statements regarding the “intensity,

persistence, and limiting effects of symptoms solely because the

objective medical evidence does not substantiate the degree of

impairment-related symptoms alleged by the individual.” SSR 16-

3p, 2016 WL 1119029, at *5.

Critically, an ALJ precludes “meaningful review” of his

findings where he fails to “adequately explain his reasoning.”

5 These factors are further elaborated on in 20 C.F.R. § 404.1529(c)(3),

which lists as factors: 1. Daily activities; 2. The location, duration,

frequency, and intensity of pain or other symptoms; 3. Factors that

precipitate and aggravate the symptoms; 4. The type, dosage,

effectiveness, and side effects of any medication an individual takes

or has taken to alleviate pain or other symptoms; 5. Treatment, other

than medication, an individual receives or has received for relief of

pain or other symptoms; 6. Any measures other than treatment an

individual uses or has used to relieve pain or other symptoms (e.g.,

lying flat on his or her back, standing for 15 to 20 minutes every hour,

or sleeping on a board); and 7. Any other factors concerning an

individual’s functional limitations and restrictions due to pain or other

symptoms.

Radford v. Colvin, 734 F.3d 288, 296 (4th Cir. 2013). Moreover,

an ALJ may not “cherry-pick[] from the record” by highlighting

“good moments and bypassing the bad.” Shelley C., 61 F.4th at

362; Arakas v. Comm’r, Soc. Sec. Admin., 983 F.3d 83, 98 (4th Cir.

2020) (“In evaluating a disability claim, [a]n ALJ has the

obligation to consider all relevant medical evidence and cannot

simply cherrypick facts that support a finding of nondisability

while ignoring evidence that points to a disability finding.”

(internal quotations marks omitted)). In such instances, it is

not the “province of the district court” to “reweigh conflicting

evidence, make credibility determinations, or substitute [its]

judgment for that of the [ALJ].” Radford, 734 F.3d at 296

(internal quotations marks omitted). Rather, the appropriate

remedy is to vacate and remand for further investigation and

explanation. Mascio v. Colvin, 780 F.3d 632, 636 (4th Cir. 2015)

(“[R]emand may be appropriate . . . where an 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.” (internal

quotation marks omitted and alteration in original)).

Turning to Plaintiff’s subjective complaints identified by

the ALJ, in his application materials Plaintiff reported ADHD,

anxiety, insomnia, opioid addiction, psychosis with “extreme

paranoia” and psychotic break, high blood pressure, and low

testosterone, and later added asthma, major depression with

psychotic features, hallucinations, paranoia, and opioid

dependence. (Tr. at 33.) In a Functions Report, Plaintiff

reported problems with his memory, following instructions,

concentrating or paying attention, completing tasks, getting along

with others, handling stress, and medication side-effects,

including chills, confusion, cough, drowsiness, fever, headaches,

insomnia, memory loss, and “severe” anxiety. (Id.) In the March

9, 2022 hearing before the ALJ, Plaintiff reported mood symptoms,

poor memory and concentration, poor sleep, psychosis, and problems

leaving his home, as well as hallucinations, paranoid thought

content (such as thinking others were trying to kill him). (Id.)

He estimated he could only stay on task for thirty minutes at a

time. (Id.) Plaintiff’s wife submitted Third-Party Function

reports in 2021 that the ALJ noted “largely echoed the claimant’s

allegations.” (Id.)

The ALJ found that these subjective complaints were

undermined by Plaintiff’s “positive response to psychiatric

medication management” and “limited positive psychiatric

examination findings.” (Id.) The ALJ analyzed Plaintiff’s

symptoms as presented in the medical records as follows:

He consistently presented with “mild” or “stable”

symptoms throughout the period at issue, which further

suggested that his routine psychiatric medication

management was effective. His treatment notes also show

that he has not had any documented or reported incidents

of opioid relapse since starting Suboxone in December

2013. The claimant’s examination findings further

illustrated his positive response to psychiatric

medication management. With “mild” or sporadic

exceptions, the claimant has often had normal or

unremarkable psychiatric examination findings with no

signs of consistent or persistent behavioral or

cognitive abnormalities throughout the period at issue.

Even when the claimant periodically complained of

hallucinations, it was noteworthy that he was not

observed to be responding to internal stimuli.

(Tr. at 34.)

The ALJ observed that Plaintiff’s treatment consisted of

“just outpatient psychiatric medication management” rather than

“emergency, inpatient, or other more aggressive mental health

treatment.” (Id.) He stated that Plaintiff “required follow-up

appointments every two-to-three months for refills of those

medications, which were consistently noted as effective and from

which he did not report any side-effects.” (Id.) He later opined,

“If the claimant’s symptoms were as severe as alleged, they would

have likely prompted more aggressive or varied treatment or

presented more consistently or dramatically on examination.

However, they did not.” (Id.)

The ALJ’s analysis of the medical record is not susceptible

to meaningful judicial review. Monroe v. Colvin, 826 F.3d 176,

188 (4th Cir. 2016) (citing Mascio, 780 F.3d at 636). Critically,

the ALJ did not discuss Plaintiff’s medication regimen in any level

of detail. While the record appears to show that Plaintiff had a

positive response to medication, this relative assessment does not

necessarily speak to the question of disability. Arakas, 983 F.3d

at 102 (observing error in ALJ describing treatment as

“conservative” when treatment aligned with what is typical for

condition); Shelley C., 61 F.4th at 367-68 (discussing how

variation in symptoms of major depressive disorder “can appear —

from the outside looking in — as overall improvement” but

nevertheless finding disability). Indeed, the ALJ’s glancing

reference to “medication management” (Tr. at 34), without

reference to the fact that those medications included atypical

antipsychotics, Zyprexa and Risperdal, (Tr. at 353, 532),6 leaves

the court unable to meaningfully review the ALJ’s analysis

regarding Plaintiff’s treatment. Shelley C., 61 F.4th at 363

(describing trend among district courts that have held treatment

is anything but “routine and conservative” where claimants consume

antipsychotic drugs, attend consistent visits with mental health

professionals, and constantly adjust medication).

Further, while the ALJ correctly noted that Plaintiff has not

received inpatient or emergency care, there is no requirement that

a claimant be hospitalized or institutionalized to receive

disability benefits. Easterbrook v. Kijakazi, 88 F.4th 502, 515

(4th Cir. 2023) (“Much as it is beyond the role of a health care

6 General information on Zyprexa and Risperdal is available at

https://my.clevelandclinic.org/health/drugs/18192-olanzapine-tablets,

and https://my.clevelandclinic.org/health/drugs/20391-risperidone-

tablets.

provider to force his patient to undergo the most extreme, risky,

costly, or painful treatment, so it is an abuse of the role of an

ALJ, and indeed the role of the Social Security Administration, to

require that an applicant undergo such treatment before they

receive disability benefits.”). Moreover, the ALJ’s speculation

— that treatment would have been “more aggressive or varied” if

symptoms were as severe as Plaintiff reported (Tr. at 34) — is

without any reference to how these symptoms are ordinarily treated.

See Arakas, 983 F.3d at 102 (stating the claimant cannot be faulted

for receiving treatment “wholly consistent with how” a condition

is “treated generally”).

Additionally, the ALJ did not explain why he discounted or

did not discuss certain relevant evidence in the treatment notes.

While Plaintiff’s “overall severity of symptoms” was repeatedly

described as “mild” in treatment notes, (Tr. at 445, 451, 456,

461, 466), the ALJ entirely omits any discussion of symptoms that

include anxiety attacks, depressed mood, easy distraction,

excessive worry, paranoia, and racing thoughts, and the repeated

finding that these symptoms affect his ability to work (id.). The

ALJ also did not mention Plaintiff’s diagnosis of “MAJOR DEPRESSIVE

DISORDER, RECURRENT, SEVERE W PSYCH SYMPTOMS” and concluded as a

“sporadic exception” an escalation in symptoms in May 2021 when

Plaintiff reported experiencing visual and auditory

hallucinations. (Tr. at 34, 448.) Indeed, it is entirely unclear

from the opinion why the ALJ considered it “noteworthy” that the

hallucinations were triggered by “internal stimuli” (Tr. at 34)

and, without any citation to authority, why he considered the

effect that would have on Plaintiff’s overall ability to function

as mitigating.7 At a minimum, the ALJ did not meet the obligation

to address “all relevant medical evidence.” Arakas, 983 F.3d at

97 (quoting Lewis, 858 F.3d at 869); Thomas, 916 F.3d at 312

(reversing where “the ALJ did not sufficiently explain how she

weighed significant evidence related to [the claimant’s] mental-

health treatment”).

To be clear, the court takes no position on whether the

provided treatment was conservative or aggressive, or whether the

record is consistent with Plaintiff’s subjective complaints when

all of the relevant factors are considered. The court merely finds

that the ALJ’s failure to analyze all relevant medical evidence

and “build an accurate and logical bridge from the evidence to his

conclusion” precludes the court from engaging in a substantial

7 While the ALJ did not cite any authority, the published literature

indicates there is some basis to indicate that a more complete

explanation is warranted on this record. See, e.g., Nancy M. Docherty

et al., Internal versus External Auditory Hallucinations in

Schizophrenia: Symptom and Course Correlates, Cognitive Neuropsychiatry,

20:3, 187-97 (2015), available at

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372463 (finding that

“[p]atients with internal hallucinations did not differ from those with

external hallucinations on severity of other symptoms” and reported

“their hallucinations to be more emotionally negative, distressing, and

long-lasting, less controllable, and less likely to remit over time”).

evidence analysis. Lewis, 858 F.3d at 868 (stating that such a

failure is “reversible error”).8 Remand is therefore warranted.

b. Daily Activities

Plaintiff contends that the ALJ considered only the type of

daily activities he could perform without also considering the

extent to which he can perform them. It is proper for an ALJ to

consider daily activities when evaluating symptoms. 20 C.F.R.

§ 404.1529(c)(3). However, an “ALJ errs in extrapolating from

daily and life activities that a claimant has increased residual

functional capacity.” Oakes v. Kijakazi, 70 F.4th 207, 216 (2023).

The Fourth Circuit has insisted that “disability claimants should

not be penalized for attempting to lead normal lives in the face

of their limitations.” Id. For that reason, review of both the

type and extent of daily activities is required, whether or not

daily activities directly control the RFC analysis or indirectly

affect it, such as through a credibility assessment. Id.9

8 Plaintiff argues in his objections that the ALJ erred in light of the

Fourth Circuit’s decision in Shelley C., (Doc. 17 at 21-22), which was

published about one week after Plaintiff’s initial brief but nevertheless

discussed by the magistrate judge. (Doc. 15 at 18 n.9.) On this record,

the court is unable to assess whether the ALJ relied “entirely upon the

belief” that Plaintiff’s subjective complaints were not “corroborated

by the record’s medical evidence” because of the ALJ’s lack of

explanation. Shelley C., 61 F.4th at 360 (emphasis removed).

9 The Commissioner relies on Ladda v. Berryhill, 749 F. App’x 166, 173

n.4 (4th Cir. 2018), for the proposition that failure to consider the

extent of daily activities in a credibility assessment is permissible.

(Doc. 13 at 17.) Notably, the Commissioner’s brief was filed prior to

the publication of Oakes, which is now controlling. Oakes, 70 F.4th at

Here, the ALJ found that Plaintiff’s subjective complaints

were “undermined by his reported functioning.” (Tr. at 34.) The

ALJ wrote that Plaintiff reported in July 2021 that he lived and

spent time with his mother and wife, that he spoke with his

brother, and that he could still perform many of his activities of

daily living, including that he could do laundry and other

household chores, prepare simple meals, go shopping, drive

himself, and manage his finances. (Id.) The ALJ added that

Plaintiff testified in May 2022 that he takes his medications,

does laundry and other household chores, prepares simple,

microwavable meals, drives himself locally, and goes shopping.

(Id.)

The ALJ concluded, without any analysis of the extent

Plaintiff could perform these daily activities, that his “reported

functioning [] contrasted sharply” with the subjective complaints.

(Id.) The difficulty with this conclusion is that the court cannot

conduct meaningful judicial review of the ALJ’s analysis absent

discussion of the extent of Plaintiff’s daily activities.

Moreover, while the ALJ stated that Plaintiff’s wife’s Third-Party

Function reports “largely echoed” Plaintiff’s own complaints, this

216 (finding reversible error where ALJ did not “expressly consider”

daily activities when determining RFC, but did so (without attention to

extent) when expressing skepticism of medical provider’s opinion, which

“for all intents and purposes, [] influenced the capacity analysis —

even if indirectly”). Here, the ALJ used merely the type of daily

activities to assess Plaintiff’s subjective complaints and explicitly

relied on the same to explain the RFC. (Tr. at 35.)

depiction fails to account for relevant evidence, such as her role

in reminding Plaintiff to bathe, her having to take control of his

finances, his distraction while doing chores, his limits on cooking

on the stovetop due to forgetting about food and leaving burners

on, his inability to drive without his wife present (and his

pattern of driving home different routes to “shake” people he

believes are following him), etc. (See Tr. at 237-44.)

Accordingly, the “lack of explanation requires remand.” Oakes, 70

F.4th at 217 (quoting Mascio, 780 F.3d at 640).

Relatedly, the ALJ must explain how Plaintiff’s mental

limitations affect his ability to “perform job-related tasks for

a full workday — a benchmark established by the [SSA’s] own

regulations.” Thomas, 916 F.3d at 312 (emphasis added)

(citing SSR 96-8P, 1996 WL 374184 at *2). The ALJ’s analysis

regarding Plaintiff’s durational capacity to work is limited to

rejecting a doctor’s finding that Plaintiff could only perform

tasks for up to two hours at a time. (Tr. at 35.) The ALJ rejected

this conclusion by incorporating by reference the same grounds the

court has found were inadequately explained above. (Id. at 35-36

(stating that psychiatric findings and reported functioning “did

not indicate that he had problems with sustaining attention and

concentration for more than two hours”). In light of the reported

subjective complaints by Plaintiff and his wife that were

inconsistent with this conclusion, more explanation is needed to

“facilitate meaningful appellate review.” Thomas, 916 F.3d at

312; (see Tr. at 54 (Plaintiff stating that the longest period he

could stay on task is “30 to 45 minutes at a time”)); cf. Mascio,

780 F.3d at 638 (“[T]he ability to perform simple tasks differs

from the ability to stay on task.”).10

2. Treating Psychiatric Provider’s Opinion

Finally, Plaintiff objects to the ALJ’s review of the opinions

of Nurse Practitioner Sugaree Ganzman, his treating psychiatric

provider. (Doc. 17 at 13.) NP Ganzman supplied two opinions, on

June 2, 2021, and February 25, 2022. (Tr. at 521, 537.) These

one-page forms include the frequency and length of Plaintiff’s

contact with NP Ganzman, diagnoses, treatment and response, a list

of prescribed medications and side effects, and clinical findings.

(Id.) The final question asks:

Given the nature and severity of [Plaintiff’s]

psychological conditions, does he have the physical

and/or mental capacity to perform gainful employment on

a full-time continuing basis that is, 8 hours/day, 5

days/week or an equivalent schedule?

(Id.) On both opinion forms, NP Ganzman checked “No” and in the

space for explanation wrote “pt has uncontrolled paranoia,

hallucination, irritability,” (Tr. at 125) and “paranoia,

hallucinations, panic, insomnia, and agitation” (Tr. at 141). In

10 Plaintiff also argues that the ALJ failed in the RFC to adequately

address limitations identified at step three of the opinion. (Doc. 17

at 12; see also Doc. 12 at 26 (citing Mascio, 780 F.3d at 637–39).) The

court need not address this objection as remand on the grounds stated

would appear to resolve Plaintiff’s concern as well.

evaluating these opinions, the ALJ wrote:

The claimant’s treating psychiatrist, Nurse Practitioner

Sugaree Ganzman, prepared treating source statements in

June 2021 and February 2022. She opined in both

statements that the claimant was unable to sustain

gainful employment on a full-time continuing basis

because of “uncontrolled paranoia, hallucinations,

irritability” in June 2021 and then because of

“paranoia, hallucinations, panic, insomnia, agitation”

in February 2022. I found that Ms. Ganzman’s medical

opinions were not persuasive because she did not explain

how the claimant’s list of symptoms supported her

conclusions. Moreover, Ms. Ganzman’s medical opinions

were inconsistent with her treatment notes, which show

that the claimant had only “mild” symptoms, that his

symptoms improved or were stable with psychiatric

medication management, and that he had limited positive

psychiatric examination findings with no signs of

consistent or persistent behavioral or cognitive

abnormalities, all of which further undermined her

poorly supported conclusions.

(Tr. at 36.)

The ALJ was not required to “give any special significance to

the source of an opinion on issues reserved to the Commissioner.”

Shelley C., 61 F.4th at 356. This includes an opinion on whether

a claimant is “‘disabled’ or ‘unable to work.’” Id. (dismissing

as a “semantical dispute” whether “unemployable” and “unable to

work” are synonymous). Thus, the court cannot say, as Plaintiff

urges, that the ALJ erred in rejecting NP Ganzman’s specific

opinion as to Plaintiff’s “capacity to perform gainful

employment.”

However, when the ALJ “found that [NP] Ganzman’s medical

opinions were not persuasive,” (Tr. at 36 (emphasis added)), the

ALJ failed to consider the relevant factors for doing so under 20

C.F.R. § 404.1520c(c)(1)–(5).11 In fact, to the extent the ALJ

discussed NP Ganzman’s medical opinions, the analysis suffers from

the same lack of explanation regarding Plaintiff’s medical records

discussed above. (Tr. at 36 (relying again on reference to

“psychiatric medication management” and “limited positive

psychiatric examination findings”).) The court is therefore

unable to conduct a substantial evidence analysis of the ALJ’s

review of NP Ganzman’s medical opinions because the ALJ did not

build a “logical bridge” between the evidence and his conclusions.

Lewis, 858 F.3d at 868.

III. CONCLUSION

For the reasons stated,

IT IS THEREFORE ORDERED that Plaintiff’s objections (Doc. 17)

are SUSTAINED in part to the extent described herein;

IT IS FURTHER ORDERED that the Commissioner’s decision

finding no disability is REVERSED, and that this matter be REMANDED

to the Commissioner under sentence four of 42 U.S.C. § 405(g) for

further administrative proceedings consistent with this opinion.

11 These factors are (1) supportability; (2) consistency; (3) a

physician’s relationship with the claimant; (4) a physician’s

specialization; and (5) other factors, like a physician’s familiarity

with the evidentiary record or their understanding of the SSA’s policies

and evidentiary requirements. 20 C.F.R. § 404.1520c(c)(1)–(5). Of these

factors, supportability and consistency are the most important. Id.

§ 404.1520c(a), (b)(2).

To this extent, Defendant’s Dispositive Brief (Doc. 13) is DENIED,

and Plaintiff’s Dispositive Brief (Doc. 12) is GRANTED.

/s/ Thomas D. Schroeder

United States District Judge

March 29, 2024