The opinion
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
SETH WHEELER, CASE NO. 1:23-CV-00106-DAC
Plaintiff, MAGISTRATE JUDGE DARRELL A. CLAY
vs. MEMORANDUM OPINION AND ORDER
COMMISSIONER OF SOCIAL SECURITY
ADMINISTRATION,
Defendant.
INTRODUCTION
Plaintiff Sean Wheeler challenges the Commissioner of Social Security’s decision denying
disability insurance benefits (DIB) and supplemental security income (SSI). (ECF #1). The District
Court has jurisdiction under 42 U.S.C. §§ 1383(c) and 405(g). On May 4, 2023, the parties
consented to my exercising jurisdiction over this case pursuant to 28 U.S.C. § 636(c). (ECF #7).
Following review, and for the reasons stated below, I AFFIRM the Commissioner’s decision.
PROCEDURAL BACKGROUND
Mr. Wheeler filed for DIB and SSI on January 28, 2021, alleging a disability onset date of
May 14, 2020. (Tr. 232). The claims were denied initially and on reconsideration. (Tr. 91-124). Mr.
Wheeler then requested a hearing before an Administrative Law Judge. (Tr. 152-53). Mr. Wheeler
(represented by counsel) and a vocational expert (VE) testified before the ALJ on January 25, 2022.
(Tr. 36-59). On February 9, 2022, the ALJ determined Mr. Wheeler was not disabled. (Tr. 16-35).
The Appeals Council denied Mr. Wheeler’s request for review, making the hearing decision the
final decision of the Commissioner. (Tr. 1-3; see 20 C.F.R. §§ 404.955, 404.981, 416.1455, and
416.1481). Mr. Wheeler timely filed this action on January 19, 2023. (ECF #1).
FACTUAL BACKGROUND
I. PERSONAL AND VOCATIONAL EVIDENCE
Mr. Wheeler was 25 years old on the alleged onset date, which the regulations define as a
“younger individual.” (Tr. 30; 28 C.F.R. § 404.1563(c)). Mr. Wheeler completed high school but
has no past relevant work. (Id.).
II. RELEVANT MEDICAL EVIDENCE
Mr. Wheeler treated with psychiatric nurse practitioner Dawn Dunaway for medication
management of his bipolar disorder and anxiety. (See., e.g., Tr. 1602-05). During his appointment
on July 2, 2020, Mr. Wheeler reported he had stopped taking Neurontin and Elavil because he felt
they were not helpful. (Tr. 1602). He reported feeling anxious and apathetic, and described his
mood as irritable and lacking motivation. (Id.). He had been doing well before COVID, including
working part-time although he found work too stressful, took time off, and never returned. (Id.).
On examination, Mr. Wheeler was oriented in three spheres, and his memory, attention and
concentration, and judgment and insight were fair. (Id.). His affect was relaxed, speech was normal,
and thought form was logical. (Id.). He denied hallucinations, suicidal or homicidal ideations. (Id.).
NP Dunaway discontinued Elavil and Neurontin and started Mr. Wheeler on Depakote. (Tr.
1603). She recommended he follow up in two weeks. (Tr. 1604).
On August 8, 2020, Mr. Wheeler attended a follow up session with NP Dunaway. (Tr.
1606). He reported being dizzy and “zoned out” on Trileptal and stopped taking it after a week; he
was compliant with his 500 mg dose of Depakote. (Id.). His mood was anxious and irritable and
wished to switch mood stabilizers. (Id.). On examination, Mr. Wheeler was oriented in three
spheres; his memory, attention and concentration, and judgment and insight were fair. (Id.). His
affect was constricted, speech was normal, and thought form was logical. (Id.). He denied
hallucinations, suicidal or homicidal ideations. (Id.). NP Dunaway discontinued Trileptal and
Depakote and started Mr. Wheeler on Equetro 100 mg for two weeks and 200 mg thereafter. (Tr.
1607). He was assessed as having an unspecified anxiety disorder and bipolar disorder in full
remission with most recent episode depressed. (Tr. 1608). She recommended he follow up in three
weeks. (Id.).
At follow up on August 27, 2020, Mr. Wheeler reported that he felt “hung over” the next
day on his new medication and would sometimes forget to take the second dose at the end of the
day. (Tr. 1610). He did not notice a difference in mood and continued feeling angry. (Id.). On
examination, Mr. Wheeler was oriented in three spheres, his memory, attention and
concentration, and judgment and insight were fair. (Id.). His affect was constricted, speech was
normal, and thought form was logical. (Id.). He denied hallucinations, suicidal or homicidal
ideations. (Id.). NP Dunaway started Mr. Wheeler on Lamictal and discontinued Equetro. (Tr.
1612). She recommended he follow up in four weeks. (Id.).
On October 17, 2020, Mr. Wheeler reported he had stopped taking Lamictal; he was still
feeling angry and was more tired. (Tr. 1614). He reported anxiety and a mild panic attack. (Id.). He
wished to go back on Depakote. (Id.). On examination, Mr. Wheeler was oriented in three spheres,
his memory, attention and concentration, and judgment and insight were fair. (Id.). His affect was
constricted, speech was normal, and thought form was logical. (Id.). He denied hallucinations,
suicidal or homicidal ideations. (Id.). NP Dunaway discontinued Lamictal and started Mr. Wheeler
on Klonopin 0.5 mg and Depakote 500 mg. (Tr. 1616). She recommended he follow up in four
weeks. (Id.).
On November 14, 2020, Mr. Wheeler reported he took Klonopin at bedtime that helped
his anxiety; he slept 7 to 12 hours at night but sometimes had nightmares. (Tr. 1618). He noticed
no difference with Depakote and weaned himself off of it completely. (Id.). He still had anger
episodes. (Id.). On examination, Mr. Wheeler was oriented in three spheres, his memory, attention
and concentration, and judgment and insight were fair. (Id.). His affect was constricted, speech was
normal, and thought form was logical. (Id.). He denied hallucinations, suicidal or homicidal
ideations. (Id.). NP Dunaway added Latuda 20 mg, continued Klonopin, and discontinued
Depakote. (Tr. 1620-21). She recommended he follow up in two weeks. (Tr. 1620).
At follow up on November 28, 2020, Mr. Wheeler reported that Latuda helped his anger
but he still felt depressed. (Tr. 1622). He reported being unsure if the Klonopin was helping his
depression, so he stopped taking it for a period; he determined he feels better with a half-pill of
Klonopin but did not want to take it anymore. (Id.). He felt more motivated and considered
applying for jobs but was still pursuing disability benefits. (Id.). On examination, Mr. Wheeler was
oriented in three spheres, his memory, attention and concentration, and judgment and insight
were fair. (Id.). His affect was constricted, speech was normal, and thought form was logical. (Id.).
He denied hallucinations, suicidal or homicidal ideations. (Id.). NP Dunaway noted improved
interval progress and recommended he follow up in two weeks. (Tr. 1623-24). She added Xanax as
needed, continued Latuda, and discontinued Klonopin. (Tr. 1624).
On December 17, 2020, Mr. Wheeler reported that he felt “pretty good” and denied anger
and irritability. (Tr. 1626). He was compliant with Latuda and took Xanax twice, reporting that
Xanax tired him, relieved his anxiety, and did not cause mood changes like Klonopin. (Id.). On
examination, he was oriented in three spheres, his memory, attention and concentration, and
judgment and insight were fair. (Id.). His affect was unable to be assessed, his speech was normal,
and thought form was logical. (Id.). His mood was neutral. (Id.). He denied hallucinations, suicidal
or homicidal ideations. (Id.). NP Dunaway noted improved interval progress and continued his
medications. (Tr. 1627).
On March 11, 2021, Mr. Wheeler reported to NP Dunaway that his therapist wants him to
try hypnotherapy to address his anger and rage issues present during his manic period. (Tr. 1629).
He reported a frustrated mood and boredom; he stated he did not feel normal. (Id.). On
examination, Mr. Wheeler was oriented in three spheres; his memory, attention and
concentration, and judgment and insight were fair. (Id.). His affect was restricted, speech was
normal, and thought form was logical. (Id.). Mood was bored but no longer down, and he denied
hallucinations, suicidal or homicidal ideations. (Id.). NP Dunaway noted improved interval
progress, made no medication changes, and recommended follow up in six months. (Tr. 1630-31).
On May 29, 2021, Mr. Wheeler reported scheduling a visit earlier than recommended
because he had been feeling kind of down. (Tr. 1633; see also Tr. 1574). He was feeling
unmotivated and had stopped his hobbies. (Id.). He had difficulty falling asleep, but when he
finally fell asleep, he would sleep for 10 to 12 hours. (Id.). He reported being anxious when he
went out in public and would use Xanax only when feeling anxious around bedtime because it
made him too tired if he was leaving the house. (Id.). He denied panic attacks. (Id.). On
examination, Mr. Wheeler was oriented in three spheres, his memory, attention and
concentration, and judgment and insight were fair. (Id.). His affect was restricted, mood was down,
speech was normal, and thought form was logical. (Id.). He denied hallucinations, suicidal or
homicidal ideations. (Id.). NP Dunaway increased Latuda from 40 mg to 60 mg daily. (Tr. 1636; see
also Tr. 1577). She noted improved interval progress and recommended follow up in six months.
(Tr. 1634-35; see also Tr. 1575-76).
On June 28, 2021, Mr. Wheeler reported he noticed no difference from the increased
Latuda; he was more often having difficulty falling asleep but would sleep 12 hours a night. (Tr.
1637; see also Tr. 1578). He was unmotivated and stopped his hobbies but was otherwise not in a
bad mood. (Id.). On examination, Mr. Wheeler was oriented in three spheres, his memory,
attention and concentration, and judgment and insight were fair. (Id.). His affect was restricted,
speech was normal, and thought form was logical. (Id.). He denied hallucinations, suicidal or
homicidal ideations. (Id.). NP Dunaway noted his sleep was disrupted at the interval progress and
continued his medications. (Tr. 1638; see also Tr. 1579).
On August 7, 2021, Mr. Wheeler reported poor sleep and a disrupted sleep schedule in
which he was up late at night and sleeping during the day. (Tr. 1643). Xanax was not working to
help his sleep, so he stopped taking it. (Id.). He rated his anxiety at 3/10. (Id.). On examination,
Mr. Wheeler was oriented in three spheres, his memory, attention and concentration, and
judgment and insight were fair. (Tr. 1643-44). His affect was restricted but he smiled appropriately,
his speech was normal, and thought form was logical. (Id.). He denied hallucinations, suicidal or
homicidal ideations. (Id.). His mood was described as “bored but not depressed ok.” (Id.). NP
Dunaway noted his sleep was disrupted at the interval progress. (Tr. 1644). She decreased the
dosage of Latuda, discontinued Xanax, and started Mr. Wheeler on Elavil as needed for sleep. (Id.).
She recommended he return in five weeks. (Tr. 1645).
Mr. Wheeler returned for a visit with NP Dunaway on September 9, 2021. (Tr. 1647-57).
He reported an improved mood, more regular sleep so he was not as tired during the day, more
interest in his hobbies, and losing 15 pounds. (Tr. 1659). On examination, Mr. Wheeler was
oriented in three spheres, and his memory, attention and concentration, and judgment and insight
were fair. (Tr. 1663). His affect was congruent with mood, speech was clear, and thought process
was linear. (Id.). He denied hallucinations, suicidal or homicidal ideations. (Id.). NP Dunaway
increased melatonin to 9-12 mg, continued Rexulti 0.5 mg daily, and recommended considering
Rozerem. (Tr. 1664).
At a visit on November 4, 2021, Mr. Wheeler reported his sleep was not regular and
frequently included nightmares. (Tr. 1670). He reported having anxiety some but not all days, and
sometimes it spikes to 6-7/10. (Tr. 1670). He had started seeing a new therapist. (Tr. 1671). On
examination, he was oriented in three spheres, and his memory, attention and concentration, and
judgment and insight were fair. (Tr. 1674). His affect was congruent with mood, speech was clear,
and thought process was linear. (Id.). He denied hallucinations, paranoia, and suicidal or
homicidal ideations. (Id.). NP Dunaway held melatonin, began ramelteon 8 mg, and continued
Rexulti. (Tr. 1675).
On November 18, 2021, Mr. Wheeler reported continued issues with sleep but melatonin
seemed to work most of the time. (Tr. 1681). He was compliant with his medications and had
started individual therapy, meeting every two weeks. (Id.). He reported increased irritability. (Id.).
On examination, he was oriented in all spheres, had euthymic mood and appropriate affect. (Tr.
1687). Judgment was good and anxiety moderate. (Id.). The examination was generally within
normal limits. (Id.). The diagnostic impression at this visit was bipolar disorder stable in remission.
(Tr. 1688). NP Dunaway continued Mr. Wheeler’s current medication regimen. (Id.).
On December 14, 2021, Mr. Wheeler reported nightmares with increased intensity and a
headache the entire next day on ramelteon. (Tr. 1691). He described his mood as tired and
frustrated with his disrupted sleep. (Id.). On examination, he was oriented in all spheres, had
euthymic mood and appropriate affect. (Tr. 1693). Judgment was good, and anxiety moderate.
(Id.). The examination was generally within normal limits. (Id.). NP Dunaway continued Rexulti,
restarted Trazodone as needed for sleep, and began a Prazosin titration for sleep and nightmares.
(Tr. 1695).
On January 20, 2022, Mr. Wheeler described his mood as okay but possibly more irritable.
(Tr. 1696). He reported improved sleep on Prazosin. (Id.). On examination, he was oriented in all
spheres, had slightly irritable mood and appropriate affect. (Tr. 1697-98). Judgment was good, and
anxiety mild. (Id.). His attention and concentration were characterized by distractibility. (Tr. 1698).
He denied suicidal and homicidal ideations. (Id.). NP Dunaway continued Rexulti and increased
both Trazodone and Prazosin. (Tr. 1699). She recommended Mr. Wheeler complete a sleep study
but he had not done so yet. (Id.).
III. MEDICAL OPINIONS
State Agency Reviewers. On April 22, 2021, State agency psychological reviewer Robin
Murry-Hoffman, Psy.D., noted Mr. Wheeler’s medical history indicated he had a period of time
where his symptoms were not well managed, but his new medication regimen appeared to be
working better. (Tr. 95, 104). She opined he could carry out very short and simple instructions
without limitation and experienced no significant limitation in his ability to carry out detailed
instructions. (Id.). She found moderate limitation in his abilities to maintain attention and
concentration for extended periods and to perform activities with a schedule, maintain regular
attendance, and be punctual within customary tolerances. (Id.). He had no evidence of limitation
in his ability to work in coordination with or in proximity to others without being distracted by
them, and no limitation in his ability to make simple work-related decisions (Tr. 96, 105). He had
moderate limitation in his ability to complete a normal workday and workweek without
interruptions from psychologically based symptoms and to perform at a consistent pace without an
unreasonable number and length of rest breaks. (Id.). He had moderate limitation in his ability to
respond to changes in the work setting and no significant limitation in his ability to set realistic
goals or make plans independently of others. (Id.). Mr. Wheeler was capable of adjusting to minor
and infrequent changes in his routine tasks. (Id.).
On July 27, 2021, Leslie Rudy, Ph.D., reviewed Mr. Wheeler’s file and affirmed Dr. Murry-
Hoffman’s findings. (Tr. 110-16, 120-24).
Treating Provider. On January 24, 2022, NP Dunaway completed a medical RFC
questionnaire. (Tr. 1701-06). She indicated she treated his bipolar disorder and generalized anxiety
disorder with panic attacks in 30-minute appointments every three to six weeks for medication
management. (Tr. 1701). Nurse Dunaway opined that Mr. Wheeler does not have long periods of
stability or remission in between hospital inpatient admissions. (Tr. 1701). On a checkbox form,
she indicated he is unable to meet competitive standards in the following areas: maintaining
attention for two-hour segments, maintaining regular attendance and being punctual with
customary tolerances and completing a normal workday and work week without interruptions
from psychologically based symptoms. (Tr. 1702). She opined Mr. Wheeler is seriously limited, but
not precluded in the following areas: accepting instructions, responding appropriately to criticism
from supervisors, getting along with coworkers and peers without distracting them or exhibiting
extremes, and dealing with normal work stress, dealing with stress of semi-skilled or skilled work,
adhering to basic standards of neatness and cleanliness, traveling in an unfamiliar place, and using
public transportation. (Tr. 1702-03). She opined he was limited but satisfactory in all other areas.
(Id.). She opined he would miss work more than four days each month. (Tr. 1705). She concluded
by stating that Mr. Wheeler “does well when he is stable but does not stay stable for long periods
of time.” (Tr. 1705).
IV. ADMINISTRATIVE HEARING
At the hearing before the ALJ, Mr. Wheeler testified he lived in an apartment with his
partner, had a valid driver’s license, and had completed high school. (Tr. 40). He sometimes
washed dishes, cooked meals, shopped, or did laundry. (Tr. 41). He had trouble at times with his
personal hygiene; depending on his mood he might not brush his teeth, shave, or bathe. (Id.). He
usually sleeps ten to twelve hours each night and wakes up fatigued; he will often take naps during
the day to get rid of the fatigue. (Tr. 42). Even if he is in bed for a long period of time, he
experiences irregular and broken sleep. (Tr. 48-49). He tries to read but loses focus. (Id.). He
watches television; he will message his mom or one friend. (Id.). If he needs to run errands, he will
have his partner drive because he is too anxious to drive himself. (Tr. 43).
He last worked in a part-time job in May or June 2020. (Id.). He left this position
voluntarily because he experienced a manic episode. (Id.). He described this episode as “the worst
mania [he’d] ever had” and that he was “concerned for other people’s safety” because of his
irritability. (Id.). He did not request medical leave. (Id.). He had a full-time job as a service desk
analyst for a period of four months. (Tr. 44). He left this job because of his first hospitalized
suicide attempt. (Id.). Mr. Wheeler described his mental health as the reason he cannot work:
“when I’m in a depressive episode, I tend to attempt suicide. And when I’m manic, like I said, I
feel unsafe for other people.” (Id.). His last manic episode was in 2020 and lasted for months
before he found medicine to relieve it. (Tr. 45). His last suicide attempt was in 2018. (Id.).
He was in counseling and met with a therapist once every two weeks. (Id.). He did not feel
he was benefiting from this relationship and so was looking for a new therapist. (Id.). He received
intensive outpatient group therapy from Mercy Hospital and felt it very helpful. (Id.). He was also
receiving medication management from NP Dunaway. (Tr. 45-46). He took Rexulti, trazodone,
and prazosin. (Tr. 46). He experienced fatigue as a side effect. (Id.).
He is very anxious around people; if he is in a crowd, he gets shaky, trembles, becomes
irritable, and sweats profusely. (Id.). He has the same reaction in smaller groups of five or six
people, including family. (Id.). He was withdrawn and anxious during group therapy as well, until
he was on a new medication. (Tr. 46-47). However, he needed to discontinue this medication due
to side effects. (Tr. 47). Although he went on a trip to Georgia to visit family, he managed by
having his partner drive, he would only get out of the car to use the bathroom, and he only visited
family one-on-one. (Id.). His doctors told him his manic episodes manifest as anger or irritability
rather than high energy like others experience. (Tr. 50-51). If he is angry, he will seclude himself so
he does not lose control. (Id.).
Mr. Wheeler endorsed memory issues; he uses reminder notes and things to help him
remember. (Tr. 47-48). If he is watching a movie, he will pause it throughout and take a break
because he cannot focus. (Tr. 48). He used to draw, paint, write books, and play board games but
can no longer do so because of his medical problems. (Tr. 51). On a bad day, he stays in bed and
browses on his phone; he does not cook, bathe, shave, brush his teeth, or eat much. (Tr. 51-52).
Bad days occur three or four times a week, even while on medication. (Tr. 52).
The VE testified a hypothetical individual of the same age and education as Mr. Wheeler
and with the limitations described in the RFC could perform representative jobs of industrial
cleaner, kitchen helper, and hand packager. (Tr. 53-55). But the hypothetical individual could not
maintain employment if the person missed work three times per month. (Tr. 55). An individual
off task consistently for 15 to 20% of the workday is not employable. (Tr. 56).
STANDARD FOR DISABILITY
A claimant is not eligible for benefits absent a disability. See 42 U.S.C. §§ 423(a), 1382(a).
“Disability” is 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.
§§ 404.1505(a) and 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. §§ 404.1520 and 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 analysis, the claimant has the burden of proof in Steps One through Four.
Walters, 127 F.3d at 529. At Step Five, the burden shifts to the Commissioner to establish whether
the claimant has the residual functional capacity (RFC) to perform available work in the national
economy. Id. The ALJ considers the claimant’s RFC, 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. §§ 404.1520(b)-(f) and 416.920(b)-(f); see also Walters, 127
F.3d at 529.
THE ALJ’S DECISION
On February 9, 2022, the ALJ issued an unfavorable decision. (Tr. 43). At Step One, the
ALJ determined Mr. Wheeler met the insured status requirements of the Social Security Act
through September 30, 2024 and had not engaged in substantial gainful activity since the alleged
onset date. (Tr. 21). At Step Two, the ALJ identified the following severe impairments: bipolar
disorder and generalized anxiety disorder. (Id.). The ALJ also determined Mr. Wheeler was initially
obese but had lost weight and was no longer obese at the time of the decision. (Tr. 22).
At Step Three, the ALJ determined Mr. Wheeler did not have an impairment or
combination of impairments that meets or medically equals the severity of one of the listed
impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Id.). The ALJ specifically addressed
Listings 12.04 and 12.06. (Tr. 22-24). The ALJ concluded Mr. Wheeler had moderate limitations
in understanding, remembering, or applying information; interacting with others; concentrating,
persisting, or maintaining pace; and adapting or managing himself. (Id.).
Before proceeding to Step Four, the ALJ reviewed the medical records, function reports,
administrative hearing testimony, and medical opinions and determined Mr. Wheeler has
the residual functional capacity to perform work at all exertional levels except he can perform
simple routine asks with simple short instructions, can make simple decisions,
can have occasional workplace changes with no fast-paced production quotas,
can have occasional interaction with coworkers and supervisors,
can have no interaction with the public and cannot perform tandem work. (Tr. 24).
The ALJ determined Mr. Wheeler does not have any past relevant work. (Tr. 30). At Step
Five, the ALJ concluded there are jobs that exist in significant numbers in the national economy
that Mr. Wheeler can perform, including industrial cleaner, kitchen helper, and hand packager.
(Tr. 30-31).
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). 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)). “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). 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 Soc. Sec., 531 F. App’x
636, 641 (6th Cir. 2013) (cleaned up).
In determining whether substantial evidence supports the Commissioner’s findings, 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)).
In addition to considering whether substantial evidence supports the Commissioner’s
decision, the court must determine whether proper legal standards were applied. The failure to
apply correct legal standards is grounds for reversal. Even if substantial evidence supports the ALJ’s
decision, the court must overturn when an agency does not observe its own regulations 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).
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) (internal quotations omitted); accord Shrader v. Astrue, No. 11
13000, 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.”); Hook v.
Astrue, No. 1:09-cv-1982, 2010 WL 2929562 (N.D. Ohio July 9, 2010).
DISCUSSION
Mr. Wheeler brings one issue for review: whether substantial evidence supports the ALJ’s
decision where the ALJ did not find his treating source’s opinion persuasive. (ECF #9, PageID
1737, 1739). He argues the ALJ’s finding that NP Dunaway’s opinion was not supported or fully
consistent with the record was flawed and his reasoning insufficiently particular for the reviewing
court to determine whether substantial evidence supports the decision. (Id. at PageID 1742).
The Commissioner counters that the ALJ’s decision was reasonable and supported by
substantial evidence. (ECF Doc. 12, PageID 1759-61). The Commissioner argues the ALJ
supported his decision consistent with the requirement to describe the “supportability” and
“consistency” of the opinion, and the ALJ was not required to further opine on the length of
treating relationship or other factors. (Id. at 1760-61).
I agree with the Commissioner: substantial evidence supported the ALJ’s decision. Remand
is thus not warranted.
Because Mr. Wheeler filed his application after March 27, 2017, medical opinions are
evaluated under the regulations found in 20 C.F.R. §§ 404.1520c, 416.920c. Under these revised
regulations, the ALJ must articulate “how persuasive [he] find[s] all of the medical opinions and all
of the prior administrative medical findings in [the] case record.” Id. at §§ 404.1520c(b),
416.920c(b). The ALJ need not 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 medical opinion’s persuasiveness, 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 tending to support or contradict a medical
opinion. 20 C.F.R. §§ 404.1520c(c)(1)-(5), 416.920c(b)(1)-(5). The most important factors are
supportability and consistency. 20 C.F.R. §§ 404.1520c(b)(2) & 416.920c(a).
With respect to supportability, “[t]he more relevant the objective medical evidence and
supporting explanations presented by a medical source are to support his or her medical opinion(s)
. . . the more persuasive the medical opinions . . . will be.” 20 C.F.R. §§ 404.1520c(c)(1) &
416.920c(c)(1). Similarly, “[t]he more consistent a medical opinion(s) . . . is with the evidence from
other medical sources and nonmedical sources in the claim, the more persuasive the medical
opinion(s) . . . .” 20 C.F.R. §§ 404.1520c(c)(2) & 416.920c(c)(2). The ALJ must “explain how [he]
considered the supportability and consistency factors for a medical source’s medical opinions” in
the written decision. 20 C.F.R. §§ 404.1520c(b)(2) & 416.920c(b)(2). Conversely, the ALJ “may,
but [is] not required to, explain” how he considered the relationship, specialization, and other
factors set forth in subparagraphs (c)(3) through (c)(5) of the regulation. Id. If two or more medical
opinions about the same issue are equally well-supported and consistent with the record, but are
not exactly the same, the ALJ must “articulate how [he] considered the other most persuasive
factors” of relationship, specialization, and other factors set forth in subparagraphs (c)(3) through
(c)(5). 20 C.F.R. §§ 404.1520c(b)(3) & 416.920c(b)(3).
Here, the ALJ provided the following analysis of NP Dunaway’s opinion:
The claimant’s provider, Ms. Dunaway, submitted mental residual functional
capacity questionnaire on January 24, 2022. Ms. Dunaway stated that the claimant
was diagnosed with bipolar disorder (most recent episode depression mild to
moderate, improved and stable at present) and generalized anxiety disorder with
panic attack. She noted that the claimant did not have long periods of stability or
remission in between hospital inpatient admissions. Ms. Dunaway felt that the
claimant was unable to meet competitive standards for maintaining attention for a
two-hour segment, maintaining regular attendance and being punctual within
customary, usually strict tolerances, and completing a normal workday and
workweek without interruptions from psychologically based symptoms. She
explained that the claimant was seriously limited, but not precluded from accepting
instructions and responding appropriately to criticism from supervisors, getting
along with coworkers or peers without unduly distracting them or exhibiting
behavioral extremes, and dealing with normal work stress. Ms. Dunaway believed
that the claimant was limited, but satisfactory, for remembering work-like
procedures, understanding, remembering, and carrying out very short and simple
instructions, sustaining an ordinary routine without special supervision, working in
coordination with or proximity to others without being unduly distracted, making
simple work-related decisions, performing at a consistent pace without an
unreasonable number and length of rest periods, asking simple questions or
requesting assistance, responding appropriately to changes in a routine work
setting, and being aware of normal hazards and taking appropriate precautions. Ms.
Dunaway opined that the claimant was seriously limited, but not precluded from
dealing with stress of semi-skilled or skilled work and limited, but satisfactory, at
understanding, remembering, and carrying detailed instructions and setting
realistic goals or making plans independently of others. She stated that the claimant
was seriously limited, but not precluded, from adhering to basic standards of
neatness and cleanliness, traveling in an unfamiliar place, and using public
transportation. She felt that the claimant was limited, but satisfactory, for
interacting appropriately with the general public and maintaining socially
appropriate behavior. Ms. Dunaway explained that the claimant did well when he
was stable but did not stay stable for long periods of time. She opined that the
claimant would be absent from work more than four days per month.
The undersigned finds the opinion of Ms. Dunaway not persuasive as treatment
records do not reflect the complete inability to attend to tasks or deal with stress.
The opinion was not supported by other mental status findings discussed in
detail above or with Ms. Dunaway’s own notations at times that the claimant’s
bipolar disorder was stable and/or in remission. Further, the claimant testified
that he was able to watch Netflix, play video games, and live with his partner. The
opinion was not consistent with the opinions of the State Agency psychologists
but was mostly consistent with the testimony of the claimant.
(Tr. 29-30) (internal citations omitted) (emphasis added). The ALJ’s discussion of NP Dunaway’s
opinion clearly states his findings regarding the supportability and consistency of NP Dunaway’s
opinion against her own treatment records and of the record as a whole. Despite Mr. Wheeler’s
contentions to the contrary, there is sufficient explanation in the decision for subsequent reviewers
to follow the ALJ’s reasoning. I see no reversible error as to the ALJ’s articulation of the
“supportability” and “consistency” factors.
I likewise find no reversible error in Mr. Wheeler’s contention that the ALJ’s reasoning on
this issue was flawed. In essence, he argues that because his treating provider’s opinion was
consistent with his own subjective complaints, because no consultative examiner provided an
opinion, and that because he will have periods of good days and bad days, NP Dunaway’s opinion
should have been found persuasive. (See ECF #9, PageID 1742-44). But this is not the standard for
my review. “The substantial-evidence standard . . . presupposes that there is a zone of choice within
which the decisionmakers can go either way, without interference by the courts.” Mullen, 800 F.2d
at 545. Therefore, when substantial evidence supports the ALJ's decision, I must defer to that
finding “even if there is substantial evidence in the record that would have supported an opposite
conclusion.” Key v. Callahan, 109 F.3d 270, 273 (6th Cir. 1997). Here, the ALJ indicated he found
NP Dunaway’s opinion not persuasive because it was inconsistent with her mental status findings
and treatment notes indicating Mr. Wheeler’s bipolar disorder was stable and/or in remission. (Tr.
30). My review of the record reveals the same. For example, NP Dunaway’s treatment records
disclose the following:
° Diagnostic impressions indicating bipolar disorder stable in remission. (E.g.,
Tr. 1608, 1688).
° Mental status examinations within normal limits with euthymic mood and
appropriate affect. (E.g., Tr. 1687, 1693).
The ALJ also stated NP Dunaway’s opinion was not consistent with the state agency opinions. Yet,
as the ALJ implied in determining NP Dunaway’s opinion not consistent with her own treatment
records and not supported by the state agency opinions, NP Dunaway’s treatment records are indeed
consistent with and support the state agency reviewer’s comment that Mr. Wheeler “had a period
of time where is symptoms were not well managed, but his new medication regimen appears to be
working better. He is more stable at psych visits .. ..”' (Tr. 95, 104).
Substantial evidence supports the ALJ’s determination that NP Dunaway’s opinion was
unpersuasive. I find no reversible error.
CONCLUSION
Following review of the arguments presented, the record, and the applicable law, I
AFFIRM the Commissioner’s decision denying disability insurance benefits and supplemental
security income.
Dated: January 25, 2024
} | }
DARRELLA.CLAY
UNITED STATES MAGISTRATE JUDGE
1 Talso note that Mr. Wheeler has had periods of decompensation and was
previously hospitalized for suicide attempts. (See, e.g., Tr. 349-53). Those incidents are before the
alleged onset date and thus are not within the adjudicated period for this case. (See Tr. 322-82).
20