# White v. Commissioner of Social Security

> District Court, N.D. Ohio · June 10, 2022

URL: https://www.frixlaw.com/law-library/cases/10370908

## Case

- **Court:** District Court, N.D. Ohio
- **Decided:** June 10, 2022
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION

EDWARD WHITE, ) CASE NO. 1:21-CV-00864-JDG
)
Plaintiff, )
)
vs. ) MAGISTRATE JUDGE
) JONATHAN D. GREENBERG
COMMISSIONER OF SOCIAL )
SECURITY, ) MEMORANDUM OF OPINION AND
) ORDER
Defendant. )

Plaintiff, Edward White (“Plaintiff” or “White”), challenges the final decision of Defendant, Kilolo
Kijakazi,1 Acting Commissioner of Social Security (“Commissioner”), denying his applications for a
Period of Disability (“POD”), Disability Insurance Benefits (“DIB”), and Supplemental Security Income
(“SSI”) under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 416(i), 423, and 1381 et seq.
(“Act”). This Court has jurisdiction pursuant to 42 U.S.C. § 405(g) and the consent of the parties,
pursuant to 28 U.S.C. § 636(c)(2). For the reasons set forth below, the Commissioner’s final decision is
AFFIRMED.
I. PROCEDURAL HISTORY
In December 2017, White filed applications for POD, DIB, and SSI, alleging a disability onset date
of November 21, 20122 and claiming he was disabled due to major depressive disorder, osteoarthritis of
the lower back, left knee, and bilateral hands and feet, and fracture of one or more bones in the bilateral
hands. (Transcript (“Tr.”) at 15, 90, 103, 116, 132, 148, 165, 185, 205, 226, 249, 265.) The applications

1 On July 9, 2021, Kilolo Kijakazi became the Acting Commissioner of Social Security.
2 White amended his alleged onset date to December 14, 2017 during the September 2019 hearing. (Tr.
15.)
were denied initially and upon reconsideration, and White requested a hearing before an administrative
law judge (“ALJ”). (Id. at 15.)
On September 18, 2019, an ALJ held a hearing, during which White, represented by counsel, and
an impartial vocational expert (“VE”) testified. (Id.) On October 22, 2019, the ALJ issued a written

decision finding Plaintiff was not disabled. (Id. at 15-25.) The ALJ’ s decision became final on March 2,
2021, when the Appeals Council declined further review. (Id. at 1-6.)
On April 26, 2021, White filed his Complaint to challenge the Commissioner’s final decision.
(Doc. No. 1.) The parties have completed briefing in this case. (Doc. Nos. 11, 13.) White asserts the
following assignment of error:
(1) The ALJ erred when he found the consultative examiner’s opinion unqualifiedly
“persuasive,” but did not incorporate all the limitations set forth therein into his RFC
finding, and did not explain why they were excluded.
(Doc. No. 11.)
II. EVIDENCE
A. Personal and Vocational Evidence
White was born in July 1963 and was 56 years-old at the time of his administrative hearing (Tr. 15,
24), making him a “person of advanced age” under Social Security regulations. See 20 C.F.R. §§
404.1563(e), 416.963(e). He has a limited education and is able to communicate in English. (Tr. 24.) He

has past relevant work as a forklift truck operator, mixer II, a composite job of a hand packager and a
palletizer operator, and a composite job of a rental clerk, tool and equipment, and a tool and equipment
repairer. (Id. at 23.)
B. Relevant Medical Evidence3
On December 21, 2017, White saw Gabrielle Lanese, DPT, for his third physical therapy session.
(Id. at 804.) White reported he felt like his legs were getting stronger, although he rated his pain as a

6.5/10. (Id.) Lanese noted White completed all exercises without any report of pain, and that after the
session he reported lower extremity fatigue but no pain. (Id. at 805.)
On January 4, 2018, White saw Yevgeniya Dvorkin Wininger, M.D., for follow up of his left knee
pain. (Id. at 914.) White had previously reported knee pain that started the day he had first played
basketball in years. (Id.) While he had not fallen or twisted his knee and he continued to play, he felt the
pain as he was moving around. (Id.) White described the pain as throbbing and constant, although it
varied in intensity, and he was now limping. (Id.) Straightening or flexing his knee aggravated the pain,
while Naproxen, heat, and a brace alleviated it. (Id.) White denied locking, giving away, or popping,

although he complained of leg spasms. (Id.) A December 2017 MRI revealed a meniscal tear and a
“Grade 1” MCL sprain, with a small suprapatellar joint effusion. (Id. at 915.) White reported he had been
to physical therapy and it helped, although Dr. Wininger noted White had not been compliant with his
home exercise program. (Id.) White told Dr. Wininger he was going up and down stairs without much
pain and his pain had improved, although he was taking Naproxen once a day without much relief. (Id.)
On examination, Dr. Wininger found normal strength, intact sensation to light touch bilaterally,
normal, narrow-based gait, knee flexion to 100 degrees, full knee extension, tenderness to palpation over
the medial joint line, grossly normal patellar alignment, negative anterior and poster drawer tests, negative

Lachman’s test, pain with valgus stress test, McMurray’s test positive for pain only, and no instability.
(Id. at 917-18.) Dr. Wininger noted White’s left knee pain was “improving w[ith] therapy and time.” (Id.

3 The Court’s recitation of the medical evidence is not intended to be exhaustive and is limited to the
evidence cited in the parties’ Briefs. However, as White failed to provide a “Facts” section as required by
the Initial Order (Doc. No. 5), the Court’s discussion is limited to the evidence cited by the Commissioner.
at 918.) Dr. Wininger ordered White to continue physical therapy and improve his compliance with his
home exercise program, switched White’s Naproxen to Mobic, and told him if he was still experiencing
significant symptoms, he could consider knee injections. (Id.)

On January 15, 2018, White saw DPT Lanese for another physical therapy session. (Id. at 935.)
Lanese noted White’s gait was independent. (Id.) During the session, Lanese progressed White’s stair
exercises and noted White complained of mild pain when stabilizing on his left lower extremity. (Id. at
937.) Lanese found White had met his short-term goals of requiring minimal verbal cueing for his home
exercise program and of reporting decreased average pain to 5/10. (Id.)
On January 22, 2018, White saw Kimberly Foley, CNP, for follow up. (Id. at 907.) White brought
disability paperwork for his knee problem to the appointment. (Id.) White complained of bilateral
tingling in his feet, mainly when taking a shower, two to three times a week over the past year. (Id.) The

tingling lasts the duration of his shower and then resolves. (Id.) On examination, Foley found full
strength and normal gait. (Id. at 908.) Foley noted a complete physical exam was performed and was
satisfactory. (Id.)
On March 16, 2018, White saw Dr. Wininger for follow up. (Id. at 1698.) Dr. Wininger noted six
physical therapy sessions since his last appointment with her, but then White had multiple no shows after
that. (Id. at 1699.) White reported he missed appointments because both of his sons had seizures and he
was in the middle of moving. (Id.) White told Dr. Wininger therapy had been going well, and he did his
home exercise program when he was able. (Id.) White wanted to return to therapy, as things had been

progressing well and his pain had improved. (Id.) White reported he was starting to have throbbing pain
on the inside of the knee and felt the knee was not stable. (Id.) White also endorsed popping and locking
of the knee. (Id.) White told Dr. Wininger ice made the pain worse, and Mobic was not helping. (Id.)
On examination, Dr. Wininger found normal strength, intact sensation to light touch bilaterally,
normal, narrow-based gait, knee flexion to 80 degrees, full knee extension, tenderness to palpation over
the medial joint line, grossly normal patellar alignment, negative anterior and poster drawer tests, negative
Lachman’s test, pain with valgus stress test, McMurray’s test positive for pain only, and no instability.
(Id. at 1702.) Dr. Wininger again noted White’s left knee pain was “improving w[ith] therapy and time.”
(Id.) Dr. Wininger changed Mobic to Voltaren, ordered a playmaker knee brace, referred White to

orthopedic surgery for a surgical evaluation, and referred White to physical therapy. (Id. at 1703.)
On April 2, 2018, White saw Eric Shadrach, PT, for physical therapy. (Id. at 1704.) White
reported worsening knee pain over the past month, and that now his right knee was starting to hurt as well.
(Id. at 1705.) Strength testing done that day revealed full strength, except for 4+/5 on left hip abduction
and left hip extension. (Id.) Shadrach noted White favored his left lower extremity on transfers. (Id.)
White demonstrated an antalgic gait that favored his left, and he showed a reciprocal, antalgic gait with
poor eccentric control on stairs. (Id.) Shadrach noted White presented with improved lower extremity
strength but continued functional and flexibility issues. (Id. at 1706.) White reported less pressure in his
knee at the end of the session. (Id.)

On April 28, 2018, White saw Dariush Saghafi, M.D, for a physical consultative examination. (Id.
at 970-72.) White reported he continued physical therapy for his left knee pain, which helped somewhat,
although there were still days where the pain was overbearing. (Id. at 970.) White reported pain
medication did not help his knee. (Id.) On examination, Dr. Saghafi found lateral meniscal tenderness
and sensitivity which White described as “sharp lancinating pain” through the lateral patellar region, full
strength of the upper and lower extremities, normal tone and bulk of the upper and lower extremities, with
no signs of focal atrophy, no evidence of a resting or action tremor, no orbiting or pronator drift, intact
sensation, negative Phalen’s, Tinel, and Hoover signs, absent Romberg and Babinski signs, left antalgic
gait with minimal predisposition for falls, and a slight buckle of the left knee when walking and turning.
(Id. at 972.) Dr. Saghafi determined White likely suffered from a subacute left lateral meniscal tear that
was moderate in severity. (Id.) Dr. Saghafi opined White could “lift, push, and pull sufficiently to be
able to perform ADL’s and pick up to 40 lbs.” (Id.) Dr. Saghafi further opined White could bend, walk,
and stand for up to 30 minutes. (Id.)
On May 7, 2018, White went to the emergency room with complaints of bilateral knee pain. (Id. at

979.) White reported he could not stand the pain anymore. (Id.) David Zimcosky, PA, noted White
ambulated independently. (Id.)
On May 11, 2018, White went to Lakewood Urgent Care and reported he had a torn meniscus in
his left knee and was experiencing similar symptoms in his right knee. (Id. at 988.) White stated his right
knee hurt as bad as the left, and that he had been given therapy for his right knee as well as his left. (Id.)
On examination, Nicolas Young, D.O., found mild swelling and mild tenderness to palpation along the
medial right knee joint line, pain with McMurray’s test on the right, intact and symmetric strength and
sensation, with normal color, texture, and turgor. (Id. at 989.) Dr. Young ordered an MRI of the right
knee and directed White to continue physical therapy and to add physical therapy for his right knee. (Id.)

On June 29, 2018, White saw Foley for routine follow up. (Id. at 994.) White reported a recent
knee injection, and that exercising and riding his bike helped his knees. (Id.) On examination, Foley
found full strength of the upper and lower extremities against resistance, no edema, and normal gait. (Id.
at 995.) Foley noted leg cramps and chronic pain of the bilateral knees. (Id.)
On October 5, 2018, White went to MetroHealth Parma Hospital complaining of increased right
knee pain over the past three weeks, and mild to moderate left knee pain. (Id. at 1018.) White reported
his knees were worse with steps and described the pain as throbbing and constant. (Id.) White also
endorsed an occasional “‘popping’” sensation with extension after sitting for long periods of time. (Id.)
White reported intermittent attempts at his home exercise program. (Id.) On examination, Susan Krueger,
PA-C, found no redness, mild peripatellar soft tisse swelling, no warmth, no effusion, a range of motion of
0 to 120 degrees on the right and o to 110 degrees on the left, no MCL or LCL instability, negative AP
drawer test, equivocal McMurray’s on the right with no joint line tenderness, mild tenderness to palpation
along the anteromedial joint line on the left, and bilateral patella grind. (Id. at 1019.) Kreuger continued
White’s pain medication, discussed the importance of performing daily home exercises, and administered

bilateral steroid injections to the knees that provided “good short term relief after injection.” (Id.)
On January 16, 2019, White saw Maryann Ambrose, APRN-CNP, with complaints of right
shoulder pain, especially with movement, after injuring his shoulder in July 2018 while lifting equipment
at work. (Id. at 1729.) White denied gait problems. (Id. at 1730.) On examination, Ambrose found a full
range of motion with some discomfort in the AC joint on the right, with a strong radial pulse and normal
sensation bilaterally. (Id.) Ambrose found full and painless range of motion of the left upper extremity.
(Id.) Imaging revealed mild degenerative arthropathy at the acromioclavicular joint and mild degenerative
sclerotic changes at the humeral tuberosity. (Id.) Ambrose directed White to continue Voltaren and ice
packs. (Id. at 1731.)

On February 2, 2019, White saw Kristin Klepser, APRN-CNP, with complaints of back pain that
started four days earlier. (Id. at 1531.) White reported sharp pain when he bent over or lifted heavy
objects. (Id.) White also reported back spasms and that the pain occasionally radiated into his right
buttock. (Id.) White denied numbness/tingling, weakness, and gait problems. (Id.) On examination,
Klepser found no midline tenderness, range of motion with flexion slightly limited by pain, pain on the
right with a straight leg raise test, and intact muscle strength and sensation of the lower extremities
bilaterally. (Id. at 1532.) Klepser diagnosed White with muscle spasms of the back and acute right-sided
low back pain with right-sided sciatica. (Id.) Klepser prescribed Flexeril and a Toradol injection. (Id.)
On March 9, 2019, White saw Paula Finton, M.D., with complaints of right shoulder pain and
lower back discomfort. (Id.at 1265.) White reported his symptoms were aggravated by lifting a lot of
boxes and a heavy TV. (Id.) White reported Toradol and Flexeril improved his pain slightly, but he was
still experiencing symptoms. (Id.) White requested a refill of the Flexeril, as it was helpful. (Id.) On
examination, Dr. Finton found full range of motion of the shoulders with no tenderness, normal gait, and
intact strength. (Id. at 1267.) Dr. Finton ordered an x-ray and prescribed Flexeril. (Id.)

C. State Agency Reports
On February 26, 2018, Maureen Gallagher, D.O., M.P.H., opined White could occasionally lift
and/or carry 20 pounds, frequently lift and/or carry 10 pounds, stand and/or walk for about six hours in an
eight-hour workday, sit for about six hours in an eight-hour workday, and has the unlimited ability, other
than shown for lift and/or carry, to push/pull. (Id. at 97-98, 110-11.) Dr. Gallagher further opined White
could frequently kneel, crouch, and crawl, but his ability to climb ramps/stairs, ladders/ropes/scaffolds,
balance, and stoop was unlimited. (Id. at 98, 111.)
On May 8, 2018, Dr. Gallagher again opined the same RFC. (Id. at 126-27, 142-43, 158-59.)

On July 23, 2018, Dr. Gallagher opined the same limitations for lifting/carrying, standing/walking,
sitting, and pushing/pulling. (Id. at 177-79, 197-99, 218-20, 239-41.) Dr. Gallagher modified the RFC to
occasionally climbing ramps/stairs, never climbing ladders/ropes/scaffolds, frequently balancing,
unlimited stooping, occasionally kneeling, frequently crouching, and occasionally crawling. (Id. at 178,
198, 218-19, 239-40.) White must avoid concentrated exposure to hazards. (Id. at 179, 199, 220, 241.)
On October 26, 2018, on reconsideration, Kalpna Desai, M.D., opined White could occasionally
lift and/or carry 20 pounds, frequently lift and/or carry 10 pounds, stand and/or walk for about six hours in
an eight-hour workday, sit for about six hours in an eight-hour workday, and could occasionally push and
pull with the bilateral lower extremities. (Id. at 258, 260, 274-76.) Dr. Desai further opined White could
frequently climb ramps/stairs, never climb ladders/ropes/scaffolds, frequently balance, stoop, and crouch,
and occasionally kneel and crawl. (Id. at 259, 275.) White must avoid even moderate exposure to
hazards. (Id. at 260, 276.)
D. Hearing Testimony
During the September 18, 2019 hearing, White testified to the following:

• He lives in a two-floor house with his three adult sons. (Id. at 37-38.) Two sons
have seizures all the time. (Id. at 37.) He must watch his sons, and four or five
months before the hearing he had to bring one of his sons up from the basement while
he was having a seizure. (Id.) Another time he had to catch one of his sons to keep
him from falling during a seizure and he aggravated his arm. (Id. at 38.)
• He has a driver’s license. (Id. at 39.) He currently works as a shuttle bus driver.
(Id.) He was hired on April 15, 2019. (Id.) He worked 40 hours a week until a
month ago, when his hours were cut to 19-20 hours a week while the Cleveland
Browns were at the hotel. (Id. at 40.) He was now back up to 40 hours a week. (Id.)
The shuttle he drives is a big van. (Id.) He lifts luggage as part of his job. (Id. at
41.) The small ones are light, but the heavy ones are 60-70 pounds. (Id.) He cannot
leave his job because he must care for his two sons and otherwise, they’d be
homeless. (Id. at 45.) He was applying for jobs in 2018, but no one was hiring him.
(Id. at 70.) He was ready to work though. (Id.) If the shuttle bus driver position had
opened in 2018, he could have done it back then. (Id.)
• It took a year and a half for his left knee to heal, and then his right knee started
hurting. (Id. at 57.) He tore his left meniscus playing basketball. (Id. at 57-59.) He
hasn’t had surgery on his knee. (Id. at 60.) He received injections three to four
times. (Id.) He had to wear braces on both knees. (Id.) He is going to the doctor
soon for the doctor to decide whether anything else needs to be done with his knees.
(Id. at 62.)
• He also had bad back spasms. (Id.) He received injections for his lower back pain.
(Id. at 63.) The injections helped some, but he was still in pain. (Id.) He had to
constantly take Tylenol and Diclofenac. (Id.) No one has recommended surgery for
his back. (Id.) He drives through the pain. (Id. at 64.) Sometimes he tells his boss
he cannot do certain things. (Id.) If the garbage is too heavy, he cannot lift it. (Id. at
73.) Or if work wants him to help housekeeping, he can push a basket, but he cannot
lift all the laundry into the laundry chute. (Id. at 74.) He tries to avoid bending and
crouching as much as possible. (Id. at 72.) If he does not have to drive anyone
anywhere, he walks around the hotel. (Id. at 75.) He gets tired sometimes and tries
to take a break when he can. (Id.)
• His doctors are talking about surgery for his right shoulder. (Id. at 65.) His right
shoulder throbs. (Id. at 74.) He has the most problems when he reaches out with his
right arm. (Id.)
• Sometimes his pain wakes him up when he is asleep. (Id. at 66.) He naps during the
day, but it does not interfere with his work schedule. (Id.) His sons handle the
household chores. (Id.) He cannot do yard work anymore. (Id. at 67.) His son who
does not have seizures does the yard work. (Id.) He picks out the groceries, but his
sons unload the groceries. (Id.) He has not done any hobbies in years. (Id. at 68.)
The VE testified White had past work as a forklift truck operator, mixer II, a composite job of a
hand packager and a palletizer operator, and a composite job of a rental clerk, tool and equipment, and a
tool and equipment repairer. (Id. at 78-79.) The ALJ then posed the following hypothetical question:
The first hypothetical – and for each of these assume the individual has the
same age, education, and the experience you just characterized as the
claimant. The first is capable of medium level of exertion; frequent climbing
ramps and stairs; no climbing ropes, ladders, and scaffolds; frequent balance,
stoop; occasional kneel; frequent crouch; occasional crawl; no exposure to
hazards such as unprotected heights or moving mechanical parts. Based on
this hypothetical, would the individual be able to perform the past work, either
as actually or generally performed?
(Id. at 80.)
The VE testified the hypothetical individual would be able to perform White’s past work as a
forklift truck operator and a composite job of a hand packager and a palletizer operator. (Id. at 81.) The
VE further testified the hypothetical individual would also be able to perform other representative jobs in
the economy, such as linen room attendant, laundry worker, and rack loader. (Id. at 82.)
III. STANDARD FOR DISABILITY
In order to establish entitlement to DIB under the Act, a claimant must be insured at the time of
disability and must prove an inability to engage “in substantial gainful activity by reason of any medically
determinable physical or mental impairment,” or combination of impairments, that 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.” 20 C.F.R. §§ 404.130, 404.315, 404.1505(a).
A claimant is entitled to a POD only if: (1) he had a disability; (2) he was insured when he became
disabled; and (3) he filed while he was disabled or within twelve months of the date the disability ended.
42 U.S.C. § 416(i)(2)(E); 20 C.F.R. § 404.320.
A disabled claimant may also be entitled to receive SSI benefits. 20 C.F.R. § 416.905; Kirk v.
Sec’y of Health & Human Servs., 667 F.2d 524 (6th Cir. 1981). To receive SSI benefits, a claimant must

meet certain income and resource limitations. 20 C.F.R. §§ 416.1100, 416.1201.
The Commissioner reaches a determination as to whether a claimant is disabled by way of a five-
stage process. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). See also Ealy v. Comm’r of Soc. Sec., 594
F.3d 504, 512 (6th Cir. 2010); Abbott v. Sullivan, 905 F.2d 918, 923 (6th Cir. 1990). First, the claimant
must demonstrate that he is not currently engaged in “substantial gainful activity” at the time of the
disability application. 20 C.F.R. §§ 404.1520(b), 416.920(b). Second, the claimant must show that he
suffers from a “severe impairment” in order to warrant a finding of disability. 20 C.F.R. §§ 404.1520(c),
416.920(c). A “severe impairment” is one that “significantly limits . . . physical or mental ability to do
basic work activities.” Abbot, 905 F.2d at 923. Third, if the claimant is not performing substantial gainful

activity, has a severe impairment that is expected to last for at least twelve months, and the impairment, or
combination of impairments, meets or medically equals a required listing under 20 CFR Part 404, Subpart
P, Appendix 1, the claimant is presumed to be disabled regardless of age, education, or work experience.
See 20 C.F.R. §§ 404.1520(d), 416.920(d). Fourth, if the claimant’s impairment or combination of
impairments does not prevent him from doing his past relevant work, the claimant is not disabled. 20
C.F.R. §§ 404.1520(e)-(f), 416.920(e)-(f). For the fifth and final step, even if the claimant’s impairment
does prevent him from doing his past relevant work, if other work exists in the national economy that the
claimant can perform, the claimant is not disabled. 20 C.F.R. §§ 404.1520(g), 404.1560(c), 416.920(g).
Here, White was insured on his alleged disability onset date, December 14, 2017, and remained
insured through March 31, 2018, his date last insured (“DLI”). (Tr. 15-16.) Therefore, in order to be
entitled to POD and DIB, White must establish a continuous twelve-month period of disability
commencing between these dates. Any discontinuity in the twelve-month period precludes an entitlement

to benefits. See Mullis v. Bowen, 861 F.2d 991, 994 (6th Cir. 1988); Henry v. Gardner, 381 F.2d 191, 195
(6th Cir. 1967).
IV. SUMMARY OF COMMISSIONER’S DECISION
The ALJ made the following findings of fact and conclusions of law:
1. The claimant meets the insured status requirements of the Social Security Act
through March 31, 2018.
2. The claimant engaged in substantial gainful activity during the following periods:
April 2019, through at least September 2019. (20 CFR 404.1520(b), 404.1571 et
seq., 416.920(b) and 416.971 et seq.).
3. However, there has been a continuous 12-month period(s) during which the
claimant did not engage in substantial gainful activity. The remaining findings
address the period(s) the claimant did not engage in substantial gainful activity.
4. The claimant has the following severe impairments: lumbar degenerative disc
disease and osteoarthritis; and bilateral knee osteoarthritis status post torn left
meniscus. (20 CFR 404.1520(c) and 416.920(c)).
5. 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, 404.1526,
416.920(d), 416.925 and 416.926).
6. After careful consideration of the entire record, I find that the claimant has the
residual functional capacity to perform medium work as defined in 20 CFR
404.1567(c) and 416.967(c) except that he can frequently climb ramps and stairs;
never climb ladders, ropes, or scaffolds; frequently balance or stoop; occasionally
kneel; frequently crouch; occasionally crawl; and he can have no exposure to
hazards such as unprotected heights or moving mechanical parts.
7. The claimant is capable of performing past relevant work as a forklift truck
operator, and as a composite position comprised of a hand packager and a
palletizer operator 1. This work does not require the performance of work-related
activities precluded by the claimant’s residual functional capacity (20 CFR
404.1565 and 416.965).
8. The claimant has not been under a disability, as defined in the Social Security
Act, from December 14, 2017, through the date of this decision. (20 CFR
404.1520(f) and 416.920(f)).
(Tr. 18-25.)
V. STANDARD OF REVIEW
The Social Security Act authorizes narrow judicial review of the final decision of the Social
Security Administration (SSA).” Reynolds v. Comm’r of Soc. Sec., 424 F. App’x 411, 414 (6th Cir. 2011).
Specifically, this Court’s review is limited to determining whether the Commissioner’s decision is
supported by substantial evidence and was made pursuant to proper legal standards. See Ealy v. Comm’r
of Soc. Sec., 594 F.3d 504, 512 (6th Cir. 2010); White v. Comm’r of Soc. Sec., 572 F.3d 272, 281 (6th Cir.
2009). Substantial evidence has been defined as “‘more than a scintilla of evidence but less than a
preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.’” Rogers v. Comm’r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007) (quoting Cutlip v. Sec’y
of Health and Human Servs., 25 F.3d 284, 286 (6th Cir. 1994)). In determining whether an ALJ’s findings
are supported by substantial evidence, the Court does not review the evidence de novo, make credibility
determinations, or weigh the evidence. Brainard v. Sec’y of Health & Human Servs., 889 F.2d 679, 681
(6th Cir. 1989).
Review of the Commissioner’s decision must be based on the record as a whole. Heston v.
Comm’r of Soc. Sec., 245 F.3d 528, 535 (6th Cir. 2001). The findings of the Commissioner are not subject
to reversal, however, merely because there exists in the record substantial evidence to support a different

conclusion. Buxton v. Halter, 246 F.3d 762, 772-73 (6th Cir. 2001) (citing Mullen v. Bowen, 800 F.2d
535, 545 (6th Cir. 1986)); see also Her v. Comm’r of Soc. Sec., 203 F.3d 388, 389-90 (6th Cir. 1999)
(“Even if the evidence could also support another conclusion, the decision of the Administrative Law
Judge must stand if the evidence could reasonably support the conclusion reached.”). This is so because
there is a “zone of choice” within which the Commissioner can act, without the fear of court interference.
Mullen, 800 F.2d at 545 (citing Baker v. Heckler, 730 F.2d 1147, 1150 (8th Cir. 1984)).
In addition to considering whether the Commissioner’s decision was supported by substantial

evidence, the Court must determine whether proper legal standards were applied. Failure of the
Commissioner to apply the correct legal standards as promulgated by the regulations is grounds for
reversal. See, e.g., White v. Comm’r of Soc. Sec., 572 F.3d 272, 281 (6th Cir. 2009); Bowen v. Comm’r of
Soc. Sec., 478 F.3d 742, 746 (6th Cir. 2006) (“Even if supported by substantial evidence, however, a
decision of the Commissioner will not be upheld where the SSA fails to follow its own regulations and
where that error prejudices a claimant on the merits or deprives the claimant of a substantial right.”).
Finally, a district court cannot uphold an ALJ’s decision, even if there “is enough evidence in the
record to support the decision, [where] the reasons given by the trier of fact do not build an accurate and
logical bridge between the evidence and the result.” Fleischer v. Astrue, 774 F. Supp. 2d 875, 877 (N.D.

Ohio 2011) (quoting Sarchet v. Chater, 78 F.3d 305, 307 (7th Cir. 1996)); accord Shrader v. Astrue, No.
11-1300, 2012 WL 5383120, at *6 (E.D. Mich. Nov. 1, 2012) (“If relevant evidence is not mentioned, the
Court cannot determine if it was discounted or merely overlooked.”); McHugh v. Astrue, No. 1:10-cv-734,
2011 WL 6130824 (S.D. Ohio Nov. 15, 2011); Gilliam v. Astrue, No. 2:10-CV-017, 2010 WL 2837260
(E.D. Tenn. July 19, 2010); Hook v. Astrue, No. 1:09-cv-1982, 2010 WL 2929562 (N.D. Ohio July 9,
2010).
VI. ANALYSIS
In his sole assignment of error, White argues the ALJ “erred when he found the consultative
examiner’s opinion unqualifiedly ‘persuasive,’ but did not incorporate all the limitations set forth therein
into his RFC findings and did not explain why they were excluded.” (Doc. No. 11 at 4.) White asserts
that the ALJ “rejected as unpersuasive” the state agency reviewing physicians’ opinions that White could
perform light work and found examining physician Dr. Saghafi’s opinion persuasive as it was supported
by his findings but failed to incorporate Dr. Saghafi’s lifting or standing/walking limitations into the RFC
without an explanation why. (Doc. No. 11 at 6.)
The Commissioner responds that, contrary to White’ assertion, the ALJ explained why he did not

adopt all of Dr. Saghafi’s limitations into the RFC. (Doc. No. 13 at 7-9.) In addition, even if the ALJ
erred, any error would be harmless as White’s own testimony supports the ALJ’s finding that White could
return to his past work as a forklift truck operator. (Id. at 9.)
Since White’s claim was filed after March 27, 2017, the Social Security Administration’s new
regulations (“Revised Regulations”) for evaluation of medical opinion evidence apply to this claim. See
Revisions to Rules Regarding the Evaluation of Medical Evidence (Revisions to Rules), 2017 WL 168819,
82 Fed. Reg. 5844 (Jan. 18, 2017); 20 C.F.R. §§ 404.1520c, 416.920c.
Under the Revised Regulations, the Commissioner will not “defer or give any specific evidentiary
weight, including controlling weight, to any medical opinion(s) or prior administrative medical findings,

including those from your medical sources.” 20 C.F.R. §§ 404.1520c(a), 416.920c(a). Rather, the
Commissioner shall “evaluate the persuasiveness” of all medical opinions and prior administrative
medical findings using the factors set forth in the regulations: (1) supportability;4 (2) consistency;5 (3)
relationship with the claimant, including length of the treatment relationship, frequency of examinations,

4 The Revised Regulations explain the “supportability” factor as follows: “The more relevant the
objective medical evidence and supporting explanations presented by a medical source are to support his
or her medical opinion(s) or prior administrative medical finding(s), the more persuasive the medical
opinions or prior administrative medical finding(s) will be.” 20 C.F.R. §§ 404.1520c(c)(1),
416.920c(c)(1).
5 The Revised Regulations explain the “consistency” factor as follows: “The more consistent a medical
opinion(s) or prior administrative medical finding(s) is with the evidence from other medical sources and
nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior administrative
medical finding(s) will be.” 20 C.F.R. §§ 404.1520c(c)(2), 416.920c(c)(2).
purpose of the treatment relationship, extent of the treatment relationship, and examining relationship; (4)
specialization; and (5) other factors, including but not limited to evidence showing a medical source has
familiarity with the other evidence in the claim or an understanding of the agency’s disability program’s
policies and evidentiary requirements. 20 C.F.R. §§ 404.1520c(a), (c)(1)-(5); 416.920c(a), (c)(1)-(5).
However, supportability and consistency are the most important factors. 20 C.F.R. §§ 404.1520c(b)(2),

416.920c(b)(2).
The Revised Regulations also changed the articulation required by ALJs in their consideration of
medical opinions. The new articulation requirements are as follows:
(1) Source-level articulation. Because many claims have voluminous case
records containing many types of evidence from different sources, it is not
administratively feasible for us to articulate in each determination or decision
how we considered all of the factors for all of the medical opinions and prior
administrative medical findings in your case record. Instead, when a medical
source provides multiple medical opinion(s) or prior administrative medical
finding(s), we will articulate how we considered the medical opinions or prior
administrative medical findings from that medical source together in a single
analysis using the factors listed in paragraphs (c)(1) through (c)(5) of this
section, as appropriate. We are not required to articulate how we considered
each medical opinion or prior administrative medical finding from one
medical source individually.
(2) Most important factors. The factors of supportability (paragraph (c)(1) of
this section) and consistency (paragraph (c)(2) of this section) are the most
important factors we consider when we determine how persuasive we find a
medical source’s medical opinions or prior administrative medical findings to
be. Therefore, we will explain how we considered the supportability and
consistency factors for a medical source’s medical opinions or prior
administrative medical findings in your determination or decision. We may,
but are not required to, explain how we considered the factors in paragraphs
(c)(3) through (c)(5) of this section, as appropriate, when we articulate how
we consider medical opinions and prior administrative medical findings in
your case record.
(3) Equally persuasive medical opinions or prior administrative medical
findings about the same issue. When we find that two or more medical
opinions or prior administrative medical findings about the same issue are
both equally well-supported (paragraph (c)(1) of this section) and consistent
with the record (paragraph (c)(2) of this section) but are not exactly the same,
we will articulate how we considered the other most persuasive factors in
paragraphs (c)(3) through (c)(5) of this section for those medical opinions or
prior administrative medical findings in your determination or decision.
20 C.F.R. §§ 404.1520c(b)(1)-(3), 416.920c(b)(1)-(3).
“Although the regulations eliminate the ‘physician hierarchy,’ deference to specific medical
opinions, and assigning ‘weight’ to a medical opinion, the ALJ must still ‘articulate how [he/she]
considered the medical opinions’ and ‘how persuasive [he/she] find[s] all of the medical opinions.’” Ryan
L.F. v. Comm’r of Soc. Sec., No. 6:18-cv-01958-BR, 2019 WL 6468560, at *4 (D. Ore. Dec. 2, 2019)
(quoting 20 C.F.R. §§ 404.1520c(a), (b)(1); 416.920c(a), (b)(1)). A reviewing court “evaluates whether
the ALJ properly considered the factors as set forth in the regulations to determine the persuasiveness of a
medical opinion.” Id.
The ALJ analyzed the opinions of Dr. Saghafi and the state agency reviewing physicians as

follows:
The opinion of consultative medical examiner Dariush Saghafi, MD is
persuasive. (Ex. 6F). On April 28, 2018, Dr. Saghafi examined the claimant
and opined that he suffered from a sub-acute left lateral meniscus tear that was
moderate in severity, and that he could lift up to 40 pounds, and stand or walk
for up to 30 minutes. This opinion is supported by Dr. Saghafi’s findings upon
examination, which indicated that the claimant presented with tenderness and
sensitivity in the knees, and a left-sided antalgic gait with a minimal
predisposition to falls. However, the claimant was in no acute distress, with
normal arm swing during ambulation, and normal muscle tone and bulk for
his age. He had no signs of atrophy, myotonia, tremor, or fasciculations. He
had normal and symmetrical reflexes, largely full strength in all extremities,
and intact sensation. This suggests that the claimant is capable of less than the
full range of medium work. Therefore, this opinion is persuasive.
The opinions of State agency medical consultants Maureen Gallagher, DO,
MPH and Kalpna Desai, MD are unpersuasive. On February 26, 2018, Dr.
Gallagher reviewed the evidence available at the initial determination, and
opined that the claimant could perform light work with postural limitations.
(Ex. 1A; Ex. 2A). On May 8, 2018, Dr. Gallagher reviewed the evidence, and
affirmed her prior opinion. (Ex. 3A; Ex. 4A). On July 23, 2018, Dr. Gallagher
reviewed the evidence, and added some postural and environmental
restrictions. (Ex. 6A-9A). On October 26, 2018, Dr. Desai reviewed the
evidence available at the reconsideration determination, and affirmed the
opinion of Dr. Gallagher. (Ex. 12A; Ex. 13A). These opinions are inconsistent
with the evidence in the record, which indicates that while the claimant
presented with tenderness in his knees and back, he generally was in no acute
distress with full strength, good range of motion, normal and symmetrical
reflexes, intact sensation, and a normal and independent gait. He reported
engaging in activities like lifting heavy boxes and televisions and playing
basketball, and imaging showed mild to moderate degenerative changes and a
left meniscal tear. The claimant treated conservatively with medication,
physical therapy, injections, and knee braces. These findings suggest that the
claimant can perform less than the full range of medium, not light, work.
Therefore, these opinions are unpersuasive.
(Tr. 22-23.)
Earlier in the RFC analysis, the ALJ found:
As noted above, the claimant has worked full-time as a shuttle bus driver,
which the vocational expert classified as medium exertion level work, since
April 2019 and continuing 6 months later in September 2019 at the time of the
hearing. This work is entirely consistent with the Residual Functional
Capacity and the result of this decision that he is not disabled, but capable of
performing certain past relevant work and other work at the medium exertion
level, as set forth below.
(Id. at 21.)
Supportability and consistency are the most important factors under the new regulations for
evaluating medical source opinions. 20 C.F.R. § 404.1520c(a), 416.920c(a). Reading the opinion as a
whole, it is evident to the Court the ALJ rejected Dr. Saghafi’s lifting and standing/walking limitations on
the basis of conflicting evidence, including normal muscle tone and bulk, no signs of atrophy or tremor,
“largely full strength in all extremities,” and intact reflexes and sensation. (Id. at 20-22.) Contrary to
White’s implication, while the ALJ indeed rejected the state agency reviewing physicians’ opinions that
he could perform light work, it was because the ALJ found White was capable of performing a greater
level of exertion than light as opposed to a lesser one. (Id. at 22-23.) It is the ALJ’s job to weigh the
evidence and resolve conflicts, and he did so here. While White would weigh the evidence differently, it is
not for the Court to do so on appeal. White points to no contrary lines of evidence the ALJ ignored or
overlooked. (Doc. No. 11.)
“This Court has followed the Sixth Circuit and reviewed the ALJ’s decision as a whole.” Malone,
2011 WL 5520292, at *2. While the ALJ’s discussion of Dr. Sagahafi’s opinion is less than ideal in terms
of clarity, a perfect opinion is not required. Fisher v. Bowen, 869 F.2d 1055, 1057 (7th Cir. 1989) (“No
principle of administrative law or common sense requires us to remand a case in quest of a perfect opinion
unless there is reason to believe that the remand might lead to a different result.”) (citations omitted); see

also NLRB v. Wyman–Gordon Co., 394 U.S. 759, 766 n.6, 89 S.Ct. 1426, 22 L.Ed.2d 709 (1969) (when
“remand would be an idle and useless formality,” courts are not required to “convert judicial review of
agency action into a ping-pong game.”).
There is no error.
VII. CONCLUSION
For the foregoing reasons, the Commissioner’s final decision is AFFIRMED.
IT IS SO ORDERED.

Date: June 10, 2022 s/ Jonathan Greenberg
Jonathan D. Greenberg
United States Magistrate Judge

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10370908. Public record. Not legal advice.