# Smith v. Commissioner of Social Security

> District Court, N.D. Ohio · September 7, 2023

URL: https://www.frixlaw.com/law-library/cases/10372513

## Case

- **Court:** District Court, N.D. Ohio
- **Decided:** September 7, 2023
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION

KIMBERLY M. SMITH, CASE NO. 5:22-CV-01775-DAC

Plaintiff, MAGISTRATE JUDGE DARRELL A. CLAY

vs. MEMORANDUM OPINION AND ORDER

COMMISSIONER OF SOCIAL SECURITY,

Defendant.

INTRODUCTION
Plaintiff Kimberly Smith challenges the Commissioner of Social Security’s decision
denying supplemental security income (SSI). (ECF #1). The District Court has jurisdiction under
42 U.S.C. §§ 1383(c) and 405(g). On October 4, 2022, pursuant to Local Civil Rule 72.2, this
matter was referred to me for preparation of a report and recommendation (non-document entry
dated Oct. 4, 2022), and the parties subsequently consented to my jurisdiction pursuant to 28
U.S.C. § 636 (ECF #9). Following review, and for the reasons stated below, I AFFIRM the
Commissioner’s decision.
PROCEDURAL BACKGROUND
Ms. Smith filed for SSI on August 28, 2020, alleging the onset of disability on August 1,
2020. (Tr. 191-96). The claim was denied initially and on reconsideration. (Tr. 92-97, 99-204). She
then requested a hearing before an Administrative Law Judge. (Tr. 122-24). Ms. Smith
(represented by counsel) and a vocational expert (VE) testified before the ALJ on July 20, 2021.
(Tr. 42-67). On August 23, 2021, the ALJ issued a written decision finding her not disabled. (Tr.
12-41). The Appeals Council denied Ms. Smith’s request for review, making the hearing decision
the final decision of the Commissioner. (Tr. 1-6; see 20 C.F.R. §§ 416.1455 and 416.1481).

FACTUAL BACKGROUND
I. PERSONAL AND VOCATIONAL EVIDENCE
Ms. Smith was 25 years old on her alleged onset date, and 26 years old at the time of the
administrative hearing. (Tr. 92). She completed high school and had no past relevant work. (Tr.
35, 50).
II. RELEVANT MEDICAL EVIDENCE
On August 1, 2019, Ms. Smith met with licensed professional clinical counselor Victoria

Gutbrod of Emerge Ministries, Inc. for counseling. (Tr. 342-45). During the session, Ms. Smith
discussed her younger brother’s recent hospitalization for suicidal thoughts and her concern that
her parents are not properly parenting her brother. (Tr. 344). Mental status examination revealed a
depressed and irritated mood, angry and labile affect, appropriate grooming, distracted demeanor,
poor judgment, fair concentration, and poor eye contact. (Id.).
On August 15, 2019, Ms. Smith met with Ms. Gutbrod for counseling. (Tr. 346-49). On

mental status examination, Ms. Smith was anxious with an expansive affect, displayed poor
hygiene, participated cooperatively during the session, maintained steady eye contact, and
displayed fair judgment and good concentration. (Tr. 348). During the session, Ms. Gutbrod
worked with Ms. Smith on building social skills and exploring social interactions and patterns.
(Id.).
On August 27, 2019, Ms. Smith informed Ms. Gutbrod she would be meeting with
someone from Medina County Board of Developmental Disabilities for a job assessment and
placement. (Tr. 352). She reported feeling emotionally and mentally unwell. (Id.). Mental status

examination revealed an anxious and depressed mood, apathetic and blunted affect, appropriate
appearance, participatory cooperation, fair judgment, good concentration, and steady eye contact.
(Tr. 352-53).
On September 9, 2019, Ms. Smith met with Ms. Gutbrod. (Tr. 355-57). She was anxious
with an expansive and blunted affect. (Tr. 356). She was disheveled but participated cooperatively
in the session and displayed fair insight, good concentration, and steady eye contact. (Tr. 356-57).
Ms. Smith returned to Ms. Gutbrod for counseling on October 24, 2019. (Tr. 358-61).

During the session, Ms. Smith and Ms. Gutbrod discussed next steps to meeting Ms. Smith’s
desire to be independent, including getting her driver’s license and a job with part-time hours. (Tr.
359). Mental status examination revealed a depressed, irritated, and anxious mood with an angry
and expansive affect, poor/unwashed and disheveled appearance, impaired judgment, fair
concentration, and steady eye contact. (Tr. 360). Ms. Gutbrod noted Ms. Smith was not
cooperative during the session. (Id.).

On October 25, 2019, Ms. Smith attended a pharmacological management session with
Rosemary McDonagh, RMHCNS, BC, at Cornerstone Psychological Services. (Tr. 285-86). Ms.
Smith reported that Buspar helps with anxiety. (Tr. 285). Mental status examination revealed a
well-groomed appearance, average eye contact and activity, clear speech that was coherent and goal-
directed, normal thought content, no auditory or visual hallucinations, logical and organized
thought process, full affect, cooperative behavior, and good insight and judgment. (Tr. 285-86).
Ms. Smith reported her mood was “better” and she was getting eight to nine hours of good quality
sleep. (Tr. 286). Ms. Smith also reported “fine” appetite and concentration. (Id.). She described
interpersonal relations as “better at work” with a new supervisor and related looking forward to

her sister’s Halloween party that evening. (Id.). She denied side effects of psychiatric medication
and described feeling calmer and happier on her current medications (Prozac for depression and
Buspar for anxiety). (Id.). Nurse McDonagh refilled Ms. Smith’s medications and directed her to
follow up in three to six months. (Id.).
On November 4, 2019, Ms. Smith attended a counseling session with Ms. Gutbrod. (Tr.
363-65). She reported navigating a lot of friendships and wanted to explore interpersonal skills to

increase her social confidence. (Tr. 363). Mental status examination revealed an anxious and
depressed mood, expansive affect, poor/unwashed and disheveled appearance, fair judgment and
concentration, steady eye contact, and a participatory attitude. (Tr. 364).
On November 19, 2019, Ms. Smith informed Ms. Gutbrod she was experiencing higher
levels of depression and obsessive thinking about being trapped or hopeless in her life
circumstances. (Tr. 367). On mental status examination, Ms. Smith was depressed and anxious
with a flat and expansive affect, was unwashed and disheveled, resistant to treatment, and

displayed poor judgment, concentration, and eye contact. (Tr. 368). Ms. Gutbrod noted Ms. Smith
was not oriented, commenting that Ms. Smith was “struggling with loss of future thinking, and
detachment from sense of self.” (Id.).
At a counseling session with Ms. Gutbrod on December 5, 2019, Ms. Smith presented as
depressed and anxious with a sad and angry affect, had an unwashed and disheveled appearance,
displayed fair concentration and judgment, maintained broken eye contact, and participated
cooperatively in the session. (Tr. 372). During the session, Ms. Gutbrod challenged Ms. Smith to
“continue to take next steps in independence and gaining skills for adulthood.” (Id.).
On December 19, 2019, Ms. Smith met with Ms. Gutbrod for counseling and expressed

being angry with her family and feeling like a moody, angry teenager. (Tr. 375). Ms. Smith was
depressed and anxious with an appropriate and angry affect, displayed appropriate grooming,
showed good concentration and judgment, and participated cooperatively in the session. (Tr. 376).
On January 9, 2020, Ms. Smith reported to Ms. Gutbrod that she went on her first date
and described feeling grief around the anniversary of her brother’s death. (Tr. 379). Ms. Smith was
anxious with a sad and expansive affect, was appropriately groomed, and displayed good judgment
and concentration. (Tr. 380).

During a counseling session on January 21, 2020, Ms. Smith described and processed grief
relative to family deaths and explored her new relationship. (Tr. 383). She presented as depressed
and anxious with an appropriate affect, was appropriately groomed, displayed good judgment and
concentration, and participated cooperatively during the session. (Tr. 384).
On February 24, 2020, Ms. Gutbrod noted Ms. Smith was anxious, angry, expansive, and
apathetic with an unwashed appearance, displayed fair judgement and good concentration, and

participated cooperatively during the session. (Tr. 388).
On March 10, 2020, Ms. Smith was depressed, irritated, and anxious with an appropriate
affect. (Tr. 392). She was appropriately groomed and cooperative, displayed good judgment and
concentration, maintained steady eye contact, and was cooperative. (Tr. 392-93).
On March 24, 2020, Ms. Smith reported struggling to manage her anxiety around COVID-
19. (Tr. 395). During the session, Ms. Gutbrod noted Ms. Smith “was able to validate herself and
calm herself down with a more peaceful perspective.” (Tr. 396). Ms. Smith presented as depressed
and anxious, had an appropriate affect, was appropriately groomed, displayed good judgment and
concentration, and was cooperative. (Id.).

On April 7, 2020, Ms. Smith met with Ms. Gutbrod via telehealth and reported
experiencing increased alienation, depression, and social pressure since the pandemic began. (Tr.
400). Ms. Gutbrod described Ms. Smith as depressed, irritated, and anxious, with an angry affect
and disheveled appearance. (Id.). Ms. Smith was distracted and displayed poor judgment, fair
concentration, and broken eye contact. (Tr. 400-01).
Ms. Smith attended another telehealth counseling session with Ms. Gutbrod on April 21,

2020, where she reported poor self-care and hygiene for a week and a lack of internal motivation.
(Tr. 404). Mental status examination revealed a depressed mood with an angry, apathetic, and
blunted affect, poor hygiene and disheveled appearance, impaired judgment, fair concentration,
and steady eye contact. (Tr. 404-05). Ms. Smith participated cooperatively during the session. (Tr.
405).
On April 24, 2020, Ms. Smith met with Nurse McDonagh in a telehealth session. (Tr.
287). Ms. Smith reported increased anxiety and depression two to three days a week due to the

COVID-19 situation but described the symptoms as mild. (Id.). She denied medication side effects,
described sleeping ten hours in duration, and reported normal appetite, variable energy, and fine
concentration. (Tr. 288). She additionally described “okay” relationships with family but feelings
of awkwardness around others. (Id.). Mental status examination revealed a mildly depressed and
anxious mood, casually dressed appearance, cooperative attitude, normal eye contact with a calm,
blunted expression, normal attention and concentration, clear speech that was coherent and goal-
directed, logical thought process, non-delusional thought content, and intact insight and
judgment. (Tr. 288-89). Nurse McDonagh concluded: “[Patient] had been functioning well prior to
COVID-19. Social isolation triggered mild anxiety and depressive symptoms lasting a few days a

week. [Patient] does not wish to adjust medications at this time.” (Tr. 289). The nurse instructed
Ms. Smith to continue her medications as prescribed, continue with counseling, increase exercise,
consume healthy food, and follow up in six months. (Id.).
On May 5, 2020, Ms. Smith attended a telehealth appointment with Ms. Gutbrod and
presented as depressed and anxious with a sad and apathetic mood. (Tr. 408). She was disheveled,
resistant to treatment, and displayed impaired judgment, fair concentration, and poor eye contact.
(Tr. 408-09).

On May 21, 2020, during a telehealth counseling session, Ms. Smith reported struggling
with family relationships. (Tr. 412). Mental status examination revealed a depressed and anxious
mood, apathetic and blunted affect, appropriate appearance, impaired judgment, fair
concentration, and steady eye contact. (Tr. 412-13). Ms. Gutbrod described Ms. Smith as
participatory in the session. (Tr. 412).
On June 9, 2020, Ms. Smith attended a counseling session with Ms. Gutbrod at the

Emerge Ministries, Inc. office. (Tr. 414). Mental status examination revealed a depressed and
anxious mood, apathetic and expansive affect, an unwashed and disheveled appearance, impaired
judgment, fair concentration, and poor eye contact. (Tr. 416-17). Ms. Smith was described as
distracted and resistant. (Tr. 416).
On June 23, 2020, Ms. Gutbrod noted Ms. Smith was depressed, manic, and anxious with
an expansive and intense affect. (Tr. 421). Ms. Smith was unwashed and disheveled, distracted,
and displayed impaired judgment, fair concentration, and poor eye contact. (Tr. 421-22).

On July 7, 2020, Ms. Smith attended another in-office counseling session with Ms.
Gutbrod. (Tr. 423). Mental status examination revealed a depressed and anxious mood with an
apathetic affect, an unwashed and disheveled appearance, impaired judgment, fair concentration,
steady eye contact, and participatory behavior. (Tr. 425-26).
On July 27, 2020, Ms. Smith presented as irritated and anxious with an angry, apathetic,
and expansive affect. (Tr. 429). She was disheveled and unwashed, distracted, and displayed fair
judgment and concentration. (Tr. 429-30).

On August 11, 2020, Ms. Smith described feeling overwhelmed and reported a fear of
vulnerability. (Tr. 433). She presented much the same as at the prior counseling session on July 27,
but was participatory rather than distracted and maintained steady eye contact. (Tr. 433-34). Ms.
Gutbrod instructed Ms. Smith to practice social skills. (Tr. 433). On August 26, Ms. Gutbrod
noted Ms. Smith was depressed, irritated, and anxious with an angry and frustrated affect. (Tr.
437). She was unwashed and disheveled, distracted, and displayed fair judgment and

concentration. (Tr. 437-38).
On September 8, 2020, Ms. Smith reported to Ms. Gutbrod that she has taken steps to
better manage her loneliness and social isolation by becoming more active in the streaming world
and being a moderator for a site. (Tr. 440). Mental status examination revealed a depressed and
anxious mood, appropriate affect and grooming, fair judgment, good concentration, steady eye
contact, and participatory cooperation. (Tr. 441). She presented as largely the same, albeit with a
disheveled appearance, on September 22, 2020. (Tr. 445).
On October 5, 2020, Ms. Smith and Ms. Gutbrod discussed managing anxiety and distress.

(Tr. 448). Mental status examination revealed a depressed, anxious, and irritated mood, angry and
expansive affect, disheveled appearance, distraction, impaired judgment, fair concentration, and
steady eye contact. (Tr. 449).
On October 19, 2020, Ms. Smith reported to Ms. Gutbrod that she becomes upset with
change and needs to process and adjust to changes. (Tr. 453). Ms. Smith presented as depressed
and anxious with an angry and apathetic affect and displayed appropriate grooming, good
judgment, fair concentration, steady eye contact. (Id.).

On November 17, 2020, Ms. Smith and Ms. Gutbrod worked on social and emotional
skills, self-awareness, and emotional regulation. (Tr. 456). Mental status examination revealed a
depressed and anxious mood with a sad, tearful, and apathetic affect. (Tr. 457). Ms. Smith was
disheveled and poorly groomed, displayed poor judgment and fair concentration, and maintained
broken eye contact. (Id.).
On December 11, 2020, Ms. Smith had another telehealth appointment with Nurse

McDonagh. (Tr. 291-94). She reported her depression and anxiety were under control and she was
coping with the pandemic by making baby blankets, reading the Bible, completing daily tasks using
a planner, talking with friends online, and seeing one friend in person on rare occasions. (Tr. 291).
Ms. Smith denied medication side effects, described normal sleep habits, appetite, energy, and
concentration, and described “fine” interpersonal relationships while working two days a week at a
consignment shop. (Tr. 292). Ms. Smith reported an “ok” mood, and a mental status examination
otherwise revealed a consistent affect, casually dressed appearance, cooperative attitude, calm
behavior with normal eye contact, normal attention and concentration, clear speech and talkative,
logical and organized thought process, normal thought content, good insight and judgment, and

intact problem-solving abilities. (Tr. 292). Nurse McDonagh instructed Ms. Smith to continue her
medications and counseling, exercise, practice mindful eating, and follow up in three to six
months. (Tr. 293).
On December 14, 2020, Ms. Smith met with Ms. Gutbrod and discussed self-care and her
emotional connection with food. (Tr. 461). Ms. Smith presented as depressed with an angry and
flat affect. (Id.). She was disheveled and poorly groomed, displayed fair concentration and impaired

judgment, and maintained broken eye contact. (Id.). On December 28, 2020, Ms. Smith and Ms.
Gutbrod discussed grief, social isolation, and Ms. Smith’s lack of self-esteem and self-motivation.
(Tr. 464). She presented similarly as at the previous counseling session. (Tr. 465).
On January 26, 2021, Ms. Smith and her parents attended a counseling session with Ms.
Gutbrod and discussed Ms. Smith’s desire to be more independent, challenged more, and
recognized for the growth she has worked towards. (Tr. 468). Mental state examination revealed an
anxious mood, appropriate affect, appropriate grooming, good judgment and concentration,

steady eye contact, and participatory cooperation. (Tr. 469).
On February 9, 2021, Ms. Smith and Ms. Gutbrod worked on personal boundaries and
explored Ms. Smith’s current dating relationship. (Tr. 472). Ms. Smith presented as depressed and
anxious with an apathetic and blunted affect, unwashed and disheveled, and with impaired
judgment and fair concentration. (Tr. 473). On February 24, 2020, Ms. Smith was depressed and
anxious but with appropriate affect, appropriate grooming, and good concentration and judgment.
(Tr. 477).
On March 10, 2021, Ms. Smith met with Ms. Gutbrod and reported feeling social and

emotional anxiety in her new dating relationship. (Tr. 505). Mental status examination was normal
except Ms. Smith was anxious. (Tr. 506). On March 25, 2021, Ms. Smith presented similarly and
discussed her recent break-up with her boyfriend over divergent religious views. (Tr. 509).
On April 8, 2021, Ms. Smith reported to Ms. Gutbrod that she felt sad about her
supervisor leaving for a new position and needed to adjust to the change in routine. (Tr. 513). Ms.
Smith also discussed seeking a new job opportunity closer to home and with more hours. (Id.).
Mental status examination was largely normal, except Ms. Smith displayed a depressed and anxious

mood. (Tr. 514). On April 21, 2021, Ms. Smith and Ms. Gutbrod discussed increasing distress
tolerance and healthy coping skills. (Tr. 517). Ms. Smith presented similarly to her last counseling
session. (Tr. 518).
On May 6, 2021, Ms. Smith and Ms. Gutbrod discussed the distress Ms. Smith encounters
living with her family and explored healthy communication skills. (Tr. 521). Mental state
examination revealed a depressed and anxious mood, expansive affect, disheveled appearance,

distraction, impaired judgment, and fair concentration. (Tr. 522).
On May 7, 2021, Ms. Smith attended a telehealth appointment with Nurse McDonagh
and reported being “stable for the most part except for PMS” and described having PMS symptoms
one to two days a month. (Tr. 490). She also reported becoming anxious staying at home and
feeling better when she takes walks. (Id.). Ms. Smith denied medication side effects. (Id.). Nurse
McDonagh instructed Ms. Smith to continue her medications, incorporate sleep hygiene practices,
and exercise. (Tr. 491).
On May 18, 2020, Ms. Smith reported high levels of stress after being placed on probation

at work by her new supervisor. (Tr. 525). Mental status examination was largely normal except Ms.
Smith displayed an anxious and depressed mood. (Tr. 526).
On June 3, 2021, Ms. Gutbrod noted Ms. Smith’s hyperfocus on the situation at work with
her supervisor. (Tr. 529). They discussed social skills and solution-focused thinking. (Id.). Ms.
Smith presented as depressed and anxious with a sad, tearful, and angry affect. (Tr. 530). She was
disheveled and displayed fair concentration and judgment but poor eye contact. (Id.).

On June 15, 2021, Ms. Smith and Ms. Gutbrod continued to discuss social and emotional
distress and also talked about managing the work situation, giving her resignation, and taking next
steps in seeking employment. (Tr. 533). Mental state examination revealed a depressed and
anxious mood with a sad, apathetic, and blunted affect. (Tr. 534). Judgment and concentration
were intact, and Ms. Smith maintained steady eye contact. (Id.).
On July 8, 2021, Ms. Smith and Ms. Gutbrod focused on managing her distress with
seeking a new job and increasing skills for adjusting to change. (Tr. 537). Ms. Smith reported

working with an agency to find a job placement and explored her fears associated with holding a
job that overwhelms her. (Id.). Mental status examination was normal except Ms. Smith’s mood
was anxious and depressed. (Tr. 538).
III. MEDICAL OPINIONS
On January 20, 2021, State agency psychological consultant Jaime Lai, Psy.D., reviewed the
residual functional capacity (RFC) established in 2018, Ms. Smith’s Function Report, one
treatment note from Cornerstone dated December 11, 2020, the results of one psychological
assessment conducted in February 2019, and one treatment note from her family physician. (Tr.
93-94). Based on the psychologist’s review, Dr. Lai concluded Ms. Smith was moderately limited in

her abilities to understand, remember, and apply information; interact with others; concentrate,
persist, or maintain pace; and adapt or manage herself. (Tr. 94). Dr. Lai adopted the prior ALJ’s
RFC in the decision dated October 11, 2018. (Tr. 96).
On April 3, 2021, another state agency mental health consultant, Irma Johnston, Psy.D.,
reviewed Ms. Smith’s claim on reconsideration and affirmed Dr. Lai’s adoption of the 2018 RFC.
(Tr. 100-04). I note here that Dr. Johnston’s analysis of the evidence consisted of her review of
three treatment notes from counseling sessions, all dated in 2019, and one treatment note from

her family physician. (Tr. 100).
The ALJ evaluated these opinions and determined:
The State agency [consultants’] findings are persuasive because they provided
pointed reviews of the relevant medical evidence, including the normal clinical
observations made by the claimant’s psychiatrist at the December 2020
telemedicine visit (e.g., intact ability to focus attention and concentrate) along with
subjective reports of depression and anxiety being “under control” and even coping
“fairly well”” with the Pandemic and keeping herself busy, the February 2019
psychological evaluation done by Dr. Miller, and several 2019 counseling notes
from Emerge Ministries that[sic]. Complementing such supportability of their
findings from the available medical evidence, the expanded record at the hearing
level of this application bears out an overall consistency of their findings of no
material change in the functionally limiting effects of the claimant’s mental health
impairments since the time of the prior ALJ decision. In example, the May 2021
(and only additional) psychiatric follow-up note still shows primarily stable
depression and anxiety, coping with symptoms well when they occur, having no
side effects of her two medications, seeing some friends occasionally, continuing to
work two days per week, and at most endorsing difficulty wearing a facial mask due
to feeling dizzy and fear of hyperventilating. The March 2021-July 2021 counseling
notes from Emerge Ministries also show that the State agency [consultants’]
findings remain consistent with the total medical record, as they predominantly
show appropriate affect and appearance/grooming, participatory cooperation, good
judgment, good concentration, and steady eye contact; do discuss the events of the
new supervisor leading to problems at her job, and ultimately deciding to resign,
but also indicate that she has been looking for another job and obtained an
interview with the help of the county agency; and generally show no significant
decline in functioning over the current year. The overall persuasiveness of the State
agency [consultants’] findings is bolstered by their ability to review the different
medical sources’ reports as a cohesive and longitudinal whole and by their
familiarity and expertise with Social Security program regulations for evaluating
medical evidence and other factors when arriving at a finding of a residual
functional capacity, which in this case includes the specially applicable Drummond
AR.

(Tr. 33).
On July 28, 2021, Ms. Gutbrod completed an RFC assessment, which was co-signed by
David A. Lichi, Ph.D., and opined Ms. Smith can handle little change in the work environment
and is limited to simple, routine, and repetitive tasks; low stress work; work that does not require
strict production quotas; and can be responsible for the health, safety, and welfare of others. (Tr.
494). Ms. Gutbrod determined Ms. Smith could not engage in work involving confrontation,
arbitration, or negotiation; strict time limits for completing tasks; the supervision of others; or
travel for work. (Id.). She opined Ms. Smith could maintain superficial interaction with the public,
occasional interaction with coworkers, and frequent interaction with supervisors. (Id.). She also felt
Ms. Smith has issues with responding appropriately to regular work criticism and would require
extra reminders or assistance on a weekly or daily basis to properly perform work tasks. (Id.). Ms.
Gutbrod also stated “[Ms. Smith] presents with a low threshold for distress, change, public
interaction or perceived pressure that is time limited. She will cry, hold [her] head, hit her head,
flail, moan, or use other movements to soothe and regulate.” (Id.). Otherwise, Ms. Gutbrod
concluded Ms. Smith would be absent once a month on account of her impairments and noted
“she is consistent if the task is manageable.” (Tr. 498). Ms. Gutbrod also determined Ms. Smith
would be off-task 10-15% of the day. (Id.). Finally, in the four broad areas of mental functioning,
Ms. Gutbrod opined Ms. Smith was markedly or extremely limited. (Tr. 495-97).
The ALJ evaluated this opinion and determined:

The July 2021 opinion from the claimant’s longstanding counselor is not
persuasive except as to the positive abilities to complete simple, routine, repetitive
tasks with no strict production quotas or strict time limits, occasional ability to
interact with coworkers, and reduced ability to handle stress and changes in a work
setting. The ratings of marked to extreme limitations in the broad areas of mental
functioning, expected time off task, and cited need for weekly to daily reminders or
extra assistance in order to perform even simple, routine work tasks properly are
poorly supported by her limited rationale that unduly and overly broadly sweeps
over far too many less remarkable counseling notes that she has written over the
past three years. That is, Ms. Gutbrod wrote that the claimant “presents with a low
threshold for distress, changes, public interaction, or perceived pressure that is time
limited…she will cry, hold [her] head, hit her head, flail, moan or use other
movements to soothe & regulate.” At no point over the last few years of counseling
notes has Ms. Gutbrod documented observations of such behavior from the
claimant, and none appear to report this as a frequently or otherwise regularly
occurring issue of an inappropriate response to stress. Moreover, many of the 2021
counseling notes show improvement in clinical observations as to concentration,
eye contact, appearance, affect, and behavior, which do not support the marked to
extreme limitations and other aspects of her opinion. In addition to these
significant shortcomings in supportability, the counselor’s opinion is not consistent
with the other medical evidence in the record, including especially the quite
unremarkable psychiatric progress notes from Nurse McDonagh at Cornerstone
that show at most mildly anxious and mildly depressed mood at the onset of the
COVID-19 Pandemic, positive coping skills used to successfully respond to
stressors relating to the Pandemic and beyond, intact ability to attend and
concentrate, and stable and conservative medication regimen over the past three
years (and longer) through Buspar and Prozac.

(Tr. 34).
IV. OTHER RELEVANT EVIDENCE
Ms. Smith completed a Function Report, dated December 28, 2020, detailing how her
conditions limit her activities. (Tr. 233-240). She cited communication errors, poor stress
management, and slower pace as reasons for her inability to work. (Tr. 233). On a typical day, Ms.
Smith wakes up, eats breakfast, does chores, plays video games, eats lunch and dinner, helps with
cleanup after dinner, attends to more tasks in between meals, and talks with friends. (Tr. 234). Ms.
Smith reported no problem caring for her personal hygiene but stated she needs written and verbal

reminders for “some things.” (Tr. 235). She is able to prepare her own food, clean, do laundry,
wash dishes, sweep, mow, dust, rake, shovel snow, and pull weeds. (Id.). She endorsed “sometimes”
needing questions answered. (Id.).
Ms. Smith can shop for herself, pay bills, count change, handle a savings account, and use a
checkbook. (Tr. 236). Her hobbies include watching television, playing video games, art, and
spending time with friends. (Tr. 237). She spends time with others, both online and in-person, and

regularly goes to church, the workplace, grocery store, counseling office, and friends’ houses. (Id.).
She reported “sometimes” being worried about doing certain things alone and needs someone to
accompany her. (Id.). She endorsed having problems getting along with others because she “seem[s]
to make people upset without realizing [it].” Otherwise, Ms. Smith claimed difficulty with paying
attention to verbal instructions, becoming distracted easily, misunderstanding what other people
are trying to communicate, and forgetting what she has been told such that she needs to write it
down. (Tr. 238). She sometimes cannot pay attention for too long because she “zone[s] out a lot.”

(Id.). Ms. Smith can follow written instructions well, though she sometimes needs to ask questions,
but does not follow verbal instructions well. (Id.). She also endorsed feeling easily overwhelmed,
getting upset with changes in routine, and feeling as though people are staring at her. (Tr. 239).
V. ADMINISTRATIVE HEARING
On July 20, 2021, Ms. Smith and VE Brett Salkin testified before the ALJ. (Tr. 44-67).
Ms. Smith, born in 1994, lives with her parents and fifteen-year-old brother. (Tr. 50). She
has Asperger’s (autism spectrum disorder), anxiety, and depression. (Tr. 47-48). She takes
medication for anxiety and depression, which she described as making a “marked difference” for

the better. (Tr. 60) (“I don’t feel anxious like as often. It is kind of like it is still there but it more
calms down.”). Ms. Smith spends several hours a day on social media talking to people and playing
games online. (Tr. 54-55). She described becoming confused sometimes when playing online games
that require teamwork and needing to ask questions of her teammates. (Tr. 61). When visiting
with friends in person, they watch movies, play games, talk, share a meal, or occasionally go for a
hike. (Tr. 56). Other hobbies include drawing, painting, working on craft projects, making baby
blankets, playing games with family and friends, and singing. (Id.). Ms. Smith sang in the church

choir until the pandemic began. (Tr. 57).
Ms. Smith does not have her driver’s license and relies on family and friends for rides. (Tr.
55). She has her temporary license and has slowly become more comfortable with driving. (Tr. 57).
At the hearing, she expressed feeling confident enough try to driver’s test soon. (Tr. 57-58).
Ms. Smith explained she is unable to work a full-time job because she struggles with staying
on task, maintaining a fast enough pace, and communicating effectively with coworkers. (Tr. 52).

She described becoming easily confused with instruction. (Id.). She used to work at a second-hand
boutique as a store clerk under the supervision of Medina Creative Accessibility, which offers
supported work environments for individuals with disabilities. (Tr. 51). She quit the position
because she “had some issues with some of the people at work.” (Tr. 51-52). Ms. Smith explained
that her new supervisor confronted her about not doing certain tasks properly and forgetting
things all the time. (Tr. 58). The confrontation “went south” when Ms. Smith expressed feeling
overwhelmed, which caused her supervisor to get upset with her. (Id.). She explained to the ALJ
that she can avoid making mistakes at work if the tasks are routine, straight forward, and she can
ask questions of her supervisor. (Tr. 60).

The ALJ asked VE Salkin if a hypothetical individual of Ms. Smith’s age, education, and
experience could perform work at any exertional level if limited to performing simple and routine
tasks in a setting free of fast-paced production requirements or strict production quotes, in a
routine environment with few changes in workplace tasks and duties; occasional interaction with
coworkers and supervisors; and no interaction with the general public. (Tr. 63). The VE identified
three medium exertion, unskilled SVP 2 positions such an individual could perform:
 Groundskeeper (DOT 406.687-010; 180,000 jobs nationally);

 Cleaner (DOT 323.687-010; 306,000 jobs nationally); and

 Laundry worker (DOT 361.684-014; 65,000 jobs nationally).

(Tr. 64).
Counsel for Ms. Smith asked the VE if an employee could maintain competitive
employment if she required additional weekly reminders about her duties. (Tr. 65). VE Salkin
stated that weekly reminders are not unusual, especially for unskilled work; however, it would be
considered supportive employment or an accommodation if she needed more reminders than
other people customarily require. (Id.).
Otherwise, the VE testified an employer tolerates an employee being off task no more than
10% of the workday and absent, including late arrivals to and early departures from work, no more
than once per month. (Tr. 65).
THE ALJ’S DECISION
The ALJ’s decision included the following findings of fact and conclusions of law:
1. The claimant has not engaged in substantial gainful activity since June 20,
2020, the date on which the application was filed (20 CFR 416.971 et seq.).

2. The claimant has the following severe impairment: autism spectrum
disorder, major depressive disorder with anxious distress, and generalized
and social anxiety disorders (20 CFR 416.920(c)).

3. 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 416.920(d), 416.925,
and 416.926).

4. After careful consideration of the entire record, the undersigned finds that
the claimant has the residual functional capacity to perform a full range of
work at all exertional levels but with the following nonexertional
limitations: She can perform simple, routine tasks in a setting free of fast-
paced production requirements and strict production quotas, and which is
routine in that it contemplates few changes in workplace tasks or duties;
and she can have occasional interaction with coworkers and supervisors, but
no interaction with the general public.

5. The claimant has no past relevant work (20 CFR 416.965).

6. The claimant was born on September 18, 1994, and was 25 years old, which
is defined as a younger individual age 18-49, on the date the application was
filed (20 CFR and 416.963).

7. The claimant has at least a high school education (20 CFR 416.964).

8. Transferability of job skills is not an issue because the claimant does not
have past relevant work (20 CFR 416.968)

9. Considering the claimant’s age, education, no 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 416.969,
and 416.969a).

11. The claimant has not been under a disability, as defined in the Social
Security Act, since June 20, 2020, the date on which the application was
filed (20 CFR 416.920(g)).
(Tr. 18-36).
STANDARD OF REVIEW
In reviewing the denial of Social Security benefits, the Court “must affirm the

Commissioner’s conclusions absent a determination that the Commissioner has failed to apply the
correct legal standards or has made findings of fact unsupported by substantial evidence in the
record.” Walters v. Comm’r of Soc. Sec., 127 F.3d 525, 528 (6th Cir. 1997). “Substantial evidence is
more than a scintilla of evidence but less than a preponderance and is such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion.” Besaw v. Sec’y of Health &
Human Servs., 966 F.2d 1028, 1030 (6th Cir. 1992). The Commissioner’s findings “as to any fact if

supported by substantial evidence shall be conclusive.” McClanahan v. Comm’r of Soc. Sec., 474 F.3d
830, 833 (6th Cir. 2006) (citing 42 U.S.C. § 405(g)).
In determining whether the Commissioner’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). Even if
substantial evidence or indeed a preponderance of the evidence supports a claimant’s position, the

court cannot overturn “so long as substantial evidence also supports the conclusion reached by the
ALJ.” Jones v. Comm’r of Soc. Sec., 336 F.3d 469, 477 (6th Cir. 2003). This is so because there is a
“zone of choice” within which the Commissioner can act, without fear of court interference.
Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986) (citing Baker v. Heckler, 730 F.2d 1147, 1150
(8th Cir. 1984)).
However, “a substantiality of evidence evaluation does not permit a selective reading of the
record. Substantiality of evidence must be based upon the record taken as a whole. Substantial
evidence is not simply some evidence, or even a great deal of evidence. Rather, the substantiality of
evidence must take into account whatever in the record fairly detracts from its weight.” Brooks v.
Comm’r of Social Security, 531 F. App’x 636, 641 (6th Cir. 2013) (cleaned up).

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) (internal quotations omitted). Even if substantial evidence supports
the ALJ’s decision, the court must overturn when an agency does not observe its own procedures
and thereby prejudices or deprives the claimant of substantial rights. Wilson v. Comm’r of Soc. Sec.,

378 F.3d 541, 546–47 (6th Cir. 2004).
STANDARD FOR DISABILITY
Eligibility for benefits is predicated on the existence of a disability. 42 U.S.C. §§ 423(a),
1382(a). “Disability” is defined as 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.” 20 C.F.R. § 416.905(a); see also 42 U.S.C. § 1382c(a)(3)(A). The Commissioner

follows a five-step evaluation process—found at 20 C.F.R. § 416.920—to determine if a claimant is
disabled:
1. Was claimant engaged in a substantial gainful activity?

2. Did claimant have a medically determinable impairment, or a combination
of impairments, that is “severe,” which is defined as one which substantially
limits an individual’s ability to perform basic work activities?

3. Does the severe impairment meet one of the listed impairments?
4. What is claimant’s residual functional capacity and can claimant perform
past relevant work?

5. Can claimant do any other work considering her residual functional
capacity, age, education, and work experience?

Under this five-step sequential analysis, the claimant has the burden of proof in Steps One
through Four. Walters, 127 F.3d at 529. The burden shifts to the Commissioner at Step Five to
establish whether the claimant has the residual functional capacity to perform available work in
the national economy. Id. The ALJ considers the claimant’s residual functional capacity, age,
education, and past work experience to determine if the claimant could perform other work. Id.
Only if a claimant satisfies each element of the analysis, including inability to do other work, and
meets the duration requirements, is she determined to be disabled. 20 C.F.R. § 416.920(b)-(f); see
also Walters, 127 F.3d at 529.
DISCUSSION
Ms. Smith claims the unfavorable decision is not supported by substantial evidence because
the ALJ’s findings related to the persuasiveness of the medical opinions are flawed. (Pl.’s Br., ECF
#10, PageID 578). For the reasons that follow, I reject this argument and thus AFFIRM the ALJ’s
decision.
A claimant’s RFC is an administrative assessment of the extent to which the claimant’s
impairments and related symptoms may cause physical or mental limitations or restrictions that
may affect his capacity to do work-related activities. SSR 96-8p, 1996 WL 374184, at *2. The RFC
must be based on all relevant evidence in the case record, including but not limited to medical
history, medical signs and laboratory findings, the effects of treatment, reports of daily activities,
recorded observations, medical source statements, and the effects of symptoms. Id. at *5.
Because Ms. Smith filed her applications after March 27, 2017, the medical opinions are
evaluated under the regulations found in 20 C.F.R. § 416.920c. Under these revised regulations,
the ALJ is to articulate “how persuasive [she] find[s] all of the medical opinions and all of the prior

administrative medical findings in [the] case record.” Id. at § 416.920c(b).
The ALJ is not required to defer to or give any specific evidentiary weight to a medical
opinion, is not bound by the “treating physician rule,” and is not required to give a treating source
controlling weight. See Jones v. Comm’r of Soc. Sec., No. 19-1102, 2020 WL 1703735, at *2 (N.D.
Ohio Apr. 8, 2020). In determining the persuasiveness of a medical opinion, the ALJ considers
five factors: (1) supportability; (2) consistency; (3) relationship with the claimant, including length

of treatment relationship, frequency of examinations, purpose of the treatment relationship, and
examining relationship; (4) specialization; and (5) other factors that tend to support or contradict a
medical opinion. 20 C.F.R. §§ 416.920c(c)(1)-(5). The ALJ must articulate the consideration given
to the medical opinions in the record, grounded in the two “most important factors” of
supportability1 and consistency.2 20 C.F.R. § 416.920c(a). An ALJ must explain how she
considered the factors of supportability and consistency, and “may, but [is] not required to”
explain the remaining factors of relationship with the claimant, specialization, or other factors,

absent the ALJ’s finding that two opinions are “equally” persuasive. See 20 C.F.R.
§§ 416.920c(b)(2)-(3).

1 “The more relevant the objective medical evidence and supporting explanations
presented by a medical source are to support his medical opinion(s) or prior administrative
medical finding(s), the more persuasive the opinion(s) and finding(s) will be.” 20 C.F.R.
§ 404.1520c(c)(1).
2 “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 opinion(s) and finding(s) will be.” 20 C.F.R. § 404.1520c(c)(2).
Agency regulations no longer require deference to a treating physician’s opinion, but the
reason-giving requirement still exists so claimants (and reviewing courts) may understand the
disposition of their claims. See Hardy v. Comm’r of Soc. Sec., 554 F. Supp. 3d 900, 908 (E.D. Mich.

2021) (applying the reason-giving requirement “with equal force to the new regulations, which
require explanations for determinations that a medical opinion is unpersuasive”). Agency
regulations “set forth a ‘minimum level of articulation’ to be provided in determinations and
decisions, in order to ‘provide sufficient rationale for a reviewing adjudicator or court.’” Warren I.
v. Comm’r of Soc. Sec., No. 20-495, 2021 WL 860506, at *8 (N.D.N.Y. Mar. 8, 2021) (quoting 82
Fed. Reg. 5844-01 (2017)). An “ALJ’s failure . . . to meet these minimum levels of articulation

frustrates [the] court’s ability to determine whether [the claimant’s] disability determination was
supported by substantial evidence.” Vaughn v. Comm’r of Soc. Sec., No. 20-1119, 2021 WL 3056108,
at *11 (W.D. Tenn. July 20, 2021).
A. Ms. Gutbrod’s Opinion
1. Supportability
Ms. Smith first takes umbrage with the ALJ’s supportability finding, noting “[t]he ALJ
confusingly claimed that Ms. Gutbrod’s own notes did not document observations of abnormal

behavior, but then claimed, ‘none appear to report this as a frequently or otherwise regularly
occurring issue of an inappropriate response to stress.’” (Id. at PageID 578-79). Ms. Smith appears
to misunderstand the focus of the ALJ’s supportability analysis.
The ALJ found that Ms. Gutbrod’s statement about Ms. Smith “holding her head, hitting
[her] head, flailing, moaning, or using other movements to soothe and regulate” herself was not
supported by Ms. Gutbrod’s own counseling notes. (Tr. 34). Nowhere in the written decision does
the ALJ claim Ms. Gutbrod did not document abnormal findings, only that she did not document
the specific soothing and regulating behaviors she cited to support her opinion. Substantial
evidence supports the ALJ’s logical conclusion here because not a single counseling note, or any

other medical treatment note, references observations of such self-soothing, self-regulating
behavior. Moreover, as the ALJ emphasized, the counseling and other treatment notes are devoid
of any reference to Ms. Smith reporting such behavior to Ms. Gutbrod.
Ms. Smith also claims the ALJ did not provide specific references or citations to support
her statement regarding “far less remarkable counseling notes.” Not so. Reading the ALJ’s decision
as a whole and with common sense, there are specific references to treatment notes reflecting less
remarkable clinical findings. As an example, the ALJ noted as follows:

However, at least over half of the counseling sessions reflect less remarkable
clinically observed problems in behavior (cooperative and “participatory”),
judgment (fair to good), concentration (fair to good), eye contact (steady), affect
(appropriate), and attention shown to personal grooming and appearance
(appropriate).

(Tr. 29) (internal citations omitted); see Pritt v. Comm’r of Soc. Sec., 1:21-cv-1728, 2022 WL
2135304, *13 (N.D. Ohio June 14, 2022); see also Forrest v. Comm’r of Soc. Sec., 591 F. App’x 359,
366 (6th Cir. 2014) (recognizing that the ALJ’s analysis may be found throughout the decision).
Next, Ms. Smith takes issue with the ALJ’s statement that many of the 2021 counseling
notes showed improvement in clinical observations as to concentration, eye contact, appearance,
affect, and behavior; Ms. Smith claims “not a single record shows improvement in her conditions
or behavior.” (ECF #10 at PageID 581).
The Sixth Circuit recognizes that “improvement” in the level of mental functioning is a
relative concept and is dependent on the base level from which the improvement is measured:
Even if [a doctor’s] use of the word “better” referred to Plaintiff’s mood, this word
did not provide the ALJ with substantial evidence from which to find that
Plaintiff’s mental impairment had subsided. The ALJ made no inquiry into the
degree of improvement, or from what baseline Plaintiff improved. Under the ALJ’s
logic, any improvement in one’s mood, regardless of how small and from what level
the individual improved, would defeat a claim of mental impairment. This cannot
be so.

Boulis-Gasche v. Comm’r of Soc. Sec. 451 F. App’x 488, 494 (6th Cir. 2011). To the extent the ALJ
relied on Ms. Smith’s improvement to discount Ms. Gutbrod’s opinion, the ALJ’s reasoning is not
supported by substantial evidence. As described above, the longitudinal record, considered
chronologically, shows the clinical findings of mental status examinations varied considerably over
time, and the ALJ did not cite findings or evidence to show the baseline from which Ms. Smith
improved, or the degree of improvement. However, such error is harmless because the ALJ’s
decision was also based on the less remarkable clinical findings and the fact that Ms. Gutbrod’s
rationale regarding self-regulating, self-soothing behaviors is not supported by any observation or
report in her counseling notes; as discussed above, both conclusions are supported by substantial
evidence of record.
2. Consistency
As to the consistency factor, Ms. Smith does not claim the ALJ did not evaluate the
consistency of Ms. Gutbrod’s opinions with other evidence in the record. Plainly, the ALJ
compared Ms. Gutbrod’s opinions with the four altogether benign psychiatric progress notes from
Nurse Donagh. (See Tr. 34). Instead, Ms. Smith claims “Ms.[sic] Donagh’s notes are clearly inferior
to Ms. Gutbrod’s based upon length of treatment, time spent, and in the quality and detail of the
notes taken. There is no real comparison to the consistency factor, as Ms. Gutbrod’s examinations
dominate the [the administrative transcript] with 81% of the medical records (177 of 217 pages).”
(ECF #10 at PageID 583). Ms. Smith’s argument here is but a request to re-weigh the evidence in a
manner consistent with her preferred outcome, something this Court cannot do. See Brainard, 889
F.2d at 681. Moreover, while frequency of treatment is a factor for the ALJ to consider when

evaluating medical opinions, see 20 C.F.R. § 416.920c(c)(3), the ALJ is not required to articulate
how she considered this factor unless she found the two opinions equally persuasive after
evaluating them for consistency and supportability. See 20 C.F.R. §§ 416.920c(b)(2)-(3).
Moreover, the ALJ’s consistency evaluation is not lacking the support of substantial
evidence simply because of the disparity in the frequency of treatment between Ms. Gutbrod and
Nurse Donagh. Even if, as Ms. Smith claims, substantial evidence supports a finding that Ms.

Gutbrod’s opinion is persuasive, I cannot overturn the ALJ’s conclusion because substantial
evidence, in the form of Nurse Donagh’s benign clinical findings and conservative medication
regimen, supports her finding that Ms. Gutbrod’s opinion is inconsistent with other substantial
evidence of record. See Jones, 336 F.3d at 477.
B. State Agency Consultants’ Opinions
According to Ms. Smith, “the ALJ’s favorable finding on the factor of supportability is
misplaced because the state agency physicians have no other records to compare for

supportability,” and the ALJ’s entire reasoning “actually falls within the consistency factor.” (ECF
#10 at PageID 584). This argument is flawed; supportability, in the context of reviewing State
agency opinions, looks to the basis of the State agency opinions. See Mary W. v. Comm’r of Soc. Sec.,
No. 2:20-cv-5523, 2022 WL 202764, at *10 (S.D. Ohio Jan. 24, 2022), report and recommendation
adopted, 2022 WL 394627 (S.D. Ohio Feb. 9, 2022). Next, Ms. Smith claims the ALJ was
“blatantly incorrect” in claiming that both State agency consultants reviewed “several 2019
counseling notes.” (Id.). Contrary to her assertion, the ALJ did not claim both State agency
consultants reviewed those records; rather, the ALJ analyzed their opinions together and provided
a single list of the medical evidence upon which the State agency consultants based their opinions.

(Tr. 33).
Ms. Smith next attacks the “quality” of Dr. Johnston’s review, emphasizing the reviewing
State agency psychologist only cited three of thirty-four counseling notes, and takes issue with the
fact that Dr. Johnson’s summary “barely discussed the abnormal objective findings contained in
the record.” (ECF #10 at PageID 584).
True, on reconsideration, Dr. Johnson did not provide a summary of the counseling notes
post-dating December 19, 2019; however, the Sixth Circuit holds that an ALJ may rely on medical

opinions from physicians who have not reviewed the entire record so long as the ALJ considers the
post-dated evidence in formulating his opinion. See, e.g., McGrew v. Comm’r of Soc. Sec., 343 F.
App’x 26, 32 (6th Cir. 2009) (indicating that an ALJ’s reliance upon state agency reviewing
physicians’ opinions that were outdated was not error where the ALJ considered the evidence that
was developed post-dating those opinions); see also Ealy v. Comm’r of Soc. Sec., 594 F.3d 504, 513
(6th Cir. 2013) (“Even if [a State agency physician’s] RFC was completed without knowledge of

these issues, however, the record reflects that the ALJ considered them.”); Patterson v. Comm’r of
Soc. Sec., No. 1:16-cv-110, 2017 WL 914272, at *10 (N.D. Ohio Mar. 8, 2017) (“An ALJ may rely
on a state agency reviewer who did not review the entire record, so long as the ALJ also considers
the evidence post-dating the opinion.”). Where a non-examining source does not review a
complete case record, “we require some indication that the ALJ at least considered these facts
before giving greater weight to an opinion” from the non-reviewing source. Blakely v. Comm’r of Soc.
Sec., 581 F.3d 399, 409 (6th Cir. 2009),
Here, the ALJ satisfied this requirement. Within the ALJ’s evaluation of the State agency
medical opinions, she acknowledged they did not review the full case record. (See Tr. 33). Though
the State agency consultants did not review a complete case record, the ALJ’s own analysis clearly
spanned the entire record, including all the counseling notes. (See Tr. 28-30). In particular, the ALJ
noted:
Ultimately, the counseling notes in 2019-2021 from Emerge Industries do support
at least stable and ongoing symptoms and limiting effects from Asperger’s disorder,
social anxiety disorder, and depressive disorder, with some instances suggesting
improvement or at least less significant symptoms impacting daily activities, but fail
to show any “material” worsening or more restrictive impact on the claimant’s
mental work-related abilities since the time of the October 2018 prior ALJ’s
decision.
(Tr. 29).
On this record, the ALJ’s evaluation of the persuasiveness of the State agency consultants’
opinions is supported by substantial evidence.
CONCLUSION
Following review of the arguments presented, the record, and the applicable law, I
AFFIRM the Commissioner’s decision denying supplemental security income.
Dated: September 7, 2023

} | }
DARRELL A. CLAY
UNITED STATES MAGISTRATE JUDGE

29

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10372513. Public record. Not legal advice.