“The ALJ did not err by not spelling out every consideration that went into the step three determination.”
How later courts described this case
- “The ALJ did not err by not spelling out every consideration that went into the step three determination.”
- noting that conclusory claims of error without further argument or authority may be considered waived
- “[I]f substantial evidence supports the ALJ’s decision, this Court defers to that finding even if there is substantial evidence in the record that would have supported an opposite conclusion.” (internal quotations omitted)
- reviewing courts “are limited to evaluating whether . . . the ALJ’s explanations for partially discrediting [a claimant’s testimony] are reasonable and supported by substantial evidence in the record”
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF TENNESSEE
AT GREENEVILLE
CIERA NICHOLE SMITH, )
)
Plaintiff, )
)
v. ) No. 2:22-cv-66-JEM
)
KILOLO KIJAKAZI,1 )
Acting Commissioner of Social Security, )
)
Defendant. )
MEMORANDUM OPINION
This case is before the undersigned pursuant to 28 U.S.C. § 636(b), Rule 73 of the Federal
Rules of Civil Procedure, and the consent of the parties [Doc. 15]. Now before the Court are
Plaintiff’s Motion for Judgment on the Pleadings [Doc. 16] and Defendant’s Motion for Summary
Judgment [Doc. 20]. Ciera Nichole Smith (“Plaintiff”) seeks judicial review of the decision of the
Administrative Law Judge (“the ALJ”), the final decision of Defendant Kilolo Kijakazi (“the
Commissioner”). For the reasons that follow, the Court will DENY Plaintiff’s motion and
GRANT the Commissioner’s motion.
I. PROCEDURAL HISTORY
On August 16, 2019, Plaintiff filed an application for disability insurance benefits pursuant
to Title II of the Social Security Act, 42 U.S.C. § 401 et seq. [Tr. 157], and an application for
supplemental security income benefits pursuant to Title XVI of the Social Security Act, 42 U.S.C.
§ 1381 et seq. [Id. at 212]. Plaintiff claimed a period of disability that began on December 1, 2015
1 Kilolo Kijakazi became the Acting Commissioner of the Social Security Administration
(“the SSA”) on July 9, 2021. Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure,
Kilolo Kijakazi is substituted for Andrew Saul as the defendant in this suit. See 42 U.S.C.
§ 405(g).
[Id. at 111, 123]. Her applications were denied initially and upon reconsideration [Id. at 122, 157,
158, 211, 212, 229–42]. Plaintiff then requested a hearing before an ALJ [Id. at 243–44]. A hearing
was held on March 25, 2021 [Id. at 70–110]. The ALJ received additional records following the
hearing and based on these records found it necessary to have a supplemental hearing [Id. at 42].
The supplemental hearing was held on August 10, 2021 [Id. at 38–60]. The ALJ then issued his
decision on August 25, 2021, finding Plaintiff was not disabled [Id. at 12–30]. The Appeals
Council denied Plaintiff’s request for review on April 20, 2022 [Id. at 1–3], making the ALJ’s
decision the final decision of the Commissioner.
Having exhausted her administrative remedies, Plaintiff filed a Complaint with this Court
on June 14, 2022, seeking judicial review of the Commissioner’s final decision under Section
405(g) of the Social Security Act [Doc. 1]. The parties have filed competing dispositive motions,
and this matter is now ripe for adjudication.
II. ALJ FINDINGS
The ALJ made the following findings:
1. The claimant meets the insured status requirements of the Social
Security Act through June 30, 2020.
2. The claimant has not engaged in substantial gainful activity since
December 1, 2015, the alleged onset date (20 CFR 404.1571 et seq.,
and 416.971 et seq.).
3. The claimant has the following severe impairments: Depression,
anxiety, bipolar disorder, somatic symptom disorder, degenerative
disc disease, neuropathy, seizure disorder, migraines,
cerebrovascular accident (20 CFR 404.1520(c) and 416.920(c)).
4. The claimant does not have an impairment or combination of
impairments that meets or medically equals the severity of one of
the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1
(20 CFR 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925
and 416.926).
2
5. After careful consideration of the entire record, the undersigned
finds that the claimant has the residual functional capacity to
perform sedentary work as defined in 20 CFR 404.1567(a) and
416.967(a) except frequently climb ramps and stairs but never climb
ladders, ropes or scaffolds. The claimant can occasionally balance,
and frequently stoop. The claimant should avoid all exposure to
unprotected heights, moving mechanical parts, or other workplace
hazards. The claimant can be exposed to no more than a moderate
noise intensity level with examples including light traffic or a
department store, and should not be exposed to bright or flashing
lights, bright lights defined as anything brighter than standard indoor
ambient lighting. The claimant can perform simple tasks with
customary breaks and few changes in a routine work setting. The
claimant can have frequent interaction with the general public,
coworkers, and supervisors.
6. The claimant is unable to perform any past relevant work (20 CFR
404.1565 and 416.965).
7. The claimant was born on August 13, 1988 and was 27 years old,
which is defined as a younger individual age 18-44, on the alleged
disability onset date (20 CFR 404.1563 and 416.963).
8. The claimant has at least a high school education (20 CFR
404.1564 and 416.964).
9. Transferability of job skills is not material to the determination of
disability because using the Medical-Vocational Rules as a
framework supports a finding that the claimant is “not disabled,”
whether or not the claimant has transferable job skills (See SSR 82-
41 and 20 CFR Part 404, Subpart P, Appendix 2).
10. Considering the claimant’s age, education, work experience, and
residual functional capacity, there are jobs that exist in significant
numbers in the national economy that the claimant can perform (20
CFR 404.1569, 404.1569(a), 416.969, and 416.969(a)).
11. The claimant has not been under a disability, as defined in the
Social Security Act, from December 1, 2015, through the date of
this decision (20 CFR 404.1520(g) and 416.920(g)).
[Tr. 17–30].
3
III. STANDARD OF REVIEW
When reviewing the Commissioner’s determination of whether an individual is disabled
pursuant to 42 U.S.C. § 405(g), the Court is limited to determining whether the ALJ’s decision
was reached through application of the correct legal standards and in accordance with the
procedure mandated by the regulations and rulings promulgated by the Commissioner, and
whether the ALJ’s findings are supported by substantial evidence. Blakley v. Comm’r of Soc. Sec.,
581 F.3d 399, 405 (6th Cir. 2009) (citation omitted); Wilson v. Comm’r of Soc. Sec., 378 F.3d 541,
544 (6th Cir. 2004).
Substantial evidence is “more than a scintilla of evidence but less than a preponderance; it
is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”
Cutlip v. Sec’y of Health & Hum. Servs., 25 F.3d 284, 286 (6th Cir. 1994) (citations omitted). It is
immaterial whether the record may also possess substantial evidence to support a different
conclusion from that reached by the ALJ, or whether the reviewing judge may have decided the
case differently. Crisp v. Sec’y of Health & Hum. Servs., 790 F.2d 450, 453 n.4 (6th Cir. 1986).
The substantial evidence standard is intended to create a “‘zone of choice’ within which the
Commissioner can act, without the fear of court interference.” Buxton v. Halter, 246 F.3d 762, 773
(6th Cir. 2001) (quoting Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986)). Additionally, the
Supreme Court has explained that “‘substantial evidence’ is a ‘term of art,’” and “whatever the
meaning of ‘substantial’ in other settings, the threshold for such evidentiary sufficiency is not
high.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (citation omitted). Rather, substantial
evidence “means—and means only— ‘such relevant evidence as a reasonable mind might accept
as adequate to support a conclusion.’” Id. (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197,
229 (1938)).
4
Therefore, the Court will not “try the case de novo, nor resolve conflicts in the evidence,
nor decide questions of credibility.” Garner v. Heckler, 745 F.2d 383, 387 (6th Cir. 1984) (citation
omitted). On review, the plaintiff “bears the burden of proving his entitlement to benefits.” Boyes
v. Sec’y of Health & Hum. Servs., 46 F.3d 510, 512 (6th Cir. 1994) (citation omitted). The Court
is not under any obligation to scour the record for errors not identified by the claimant and
arguments not raised and supported in more than a perfunctory manner may be deemed waived.
See McPherson v. Kelsey, 125 F.3d 989, 995–96 (6th Cir. 1997) (noting that conclusory claims of
error without further argument or authority may be considered waived).
IV. DISABILITY ELIGIBILITY
“Disability” means an individual cannot “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.” 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). An individual will only be
considered disabled
if his physical or mental impairment or impairments are of such
severity that he is not only unable to do his previous work but
cannot, considering his age, education, and work experience, engage
in any other kind of substantial gainful work which exists in the
national economy, regardless of whether such work exists in the
immediate area in which he lives, or whether a specific job vacancy
exists for him, or whether he would be hired if he applied for work.
Id. §§ 423(d)(2)(A), 1382c(a)(3)(B).
Disability is evaluated pursuant to a five-step analysis:
1. If claimant is doing substantial gainful activity, he is not disabled.
2. If claimant is not doing substantial gainful activity, his
impairment must be severe before he can be found to be disabled.
5
3. If claimant is not doing substantial gainful activity and is suffering
from a severe impairment that has lasted or is expected to last for a
continuous period of at least twelve months, and his impairment
meets or equals a listed impairment, claimant is presumed disabled
without further inquiry.
4. If claimant’s impairment does not prevent him from doing his past
relevant work, he is not disabled.
5. Even if claimant’s impairment does prevent him from doing his
past relevant work, if other work exists in the national economy that
accommodates his residual functional capacity (“RFC”) and
vocational factors (age, education, skills, etc.), he is not disabled.
Walters v. Comm’r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997) (citing 20 C.F.R. § 404.1520).
A claimant’s residual functional capacity (“RFC”) is assessed between steps three and four and is
“based on all the relevant medical and other evidence in [the claimant’s] case record.” 20 C.F.R.
§§ 404.1520(a)(4), (e), 416.920(a)(4), (e). RFC is the most a claimant can do despite his
limitations. Id. §§ 404.1545(a)(1), 416.945(a)(1).
The claimant bears the burden of proof at the first four steps. Walters, 127 F.3d at 529. The
burden shifts to the Commissioner at step five. Id. At the fifth step, the Commissioner must prove
that there is work available in the national economy that the claimant could perform. Her v.
Comm’r of Soc. Sec., 203 F.3d 388, 391 (6th Cir. 1999) (citing Bowen v. Yuckert, 482 U.S. 137,
146 (1987)).
V. ANALYSIS
Plaintiff argues that the ALJ’s decision is not supported by substantial evidence because
the ALJ committed several errors at steps three and four of the sequential analysis [Doc. 17 pp.
13–20]. Plaintiff first argues that the ALJ erred by finding she did meet or medically equal Listing
11.04 or Listing 12.07, as set forth in 20 C.F.R. part 404, subpart P, appendix 1, sections 11.04
and 12.07 [Id. at 14–17]. Plaintiff next argues that even if she did not meet or equal a listed
6
impairment, the ALJ’s decision is still “not supported by substantial evidence as it does not include
all of the uncontradicted impairments of the Plaintiff, particularly the fact that she cannot stand or
walk and requires the use of a wheelchair” [Id. at 18]. Finally, Plaintiff argues that the ALJ erred
by failing to properly weigh her subjective symptoms and fully credit them [Id. at 19–20].
For the reasons discussed below, the Court finds that the ALJ’s determination that Plaintiff
does not meet or medically equal a listed impairment is supported by substantial evidence. The
Court further finds that the ALJ applied the correct legal standards in determining Plaintiff’s RFC
and that this RFC determination is supported by substantial evidence. Plaintiff has therefore failed
to state a basis for disturbing the ALJ’s decision.
A. The Listings of Impairments
Plaintiff argues that the ALJ erred by finding she did not meet or medically equal one of
the listed impairments in 20 C.F.R. part 404, subpart P, appendix 1 [Id. at 14–17]. “[A] a claimant
will be found disabled if his impairment meets or equals one of the listings in the Listing of
Impairments.” Reynolds v. Comm’r of Soc. Sec., 424 F. App’x 411, 414 (6th Cir. 2011) (citations
omitted). “The Listing of Impairments . . . describes impairments the SSA considers to be ‘severe
enough to prevent an individual from doing any gainful activity, regardless of his or her age,
education, or work experience.’” Id. (quoting 20 C.F.R. § 404.1525(a)). “Because the Listings
permit a finding of disability based solely on medical evidence (without considering a claimant’s
vocational profile), the Commissioner applies a heightened evidentiary standard at step three.”
Riccota v. Comm’r of Soc. Sec., No. 20-cv-1259-TMP, 2022 WL 3045318, at *13 (W.D. Tenn.
Aug. 2, 2022) (citing Lee v. Comm’r of Soc. Sec., 529 F. App’x 706, 710 (6th Cir. 2013)).
“Each listing specifies ‘the objective medical and other findings needed to satisfy the
criteria of that listing.’” Reynolds, 424 F. App’x at 414 (quoting 20 C.F.R. § 404.1524(c)(3)). “A
7
claimant must satisfy all of the criteria to ‘meet’ the listing.” Id. “An impairment that manifests
only some of the criteria, no matter how severely, does not qualify.” Riccota, 2022 WL 3045318,
at *13 (citing Sullivan v. Zebley, 493 U.S. 521, 530 (1990)). “[A] claimant is also disabled if her
impairment is the medical equivalent of a listing.” Reynolds, 424 F. App’x at 414 (citations
omitted). An impairment is the medical equivalent of a listing if it is “at least equal in severity and
duration to the criteria of any listed impairment.” 20 C.F.R. §§ 404.1526(a), 416.926(a).
Ultimately, it is a claimant’s burden to demonstrate that his impairments meet or medically equal
a relevant listing. See Foster v. Halter, 279 F.3d 348, 354 (6th Cir. 2001).
In this case, Plaintiff argues that the ALJ erred by: (1) finding she did not meet Listing
11.04 regarding vascular insults to the brain [Doc. 17 pp. 14–16]; (2) finding she did not meet
Listing 12.07 regarding somatic symptom disorders [Id. at 16–17]; and (3) finding that she did not
medically equal either listing [Id. at 17].
1. Listing 11.04
Plaintiff argues that the ALJ erred by finding she did not meet Listing 11.04 [Id.]. Listing
11.04 states that a claimant should be found to be disabled if they have a “[v]ascular insult to the
brain, characterized by:”2
A. Sensory or motor aphasia resulting in ineffective speech or
communication . . . persisting for at least 3 consecutive months after the
insult; or
B. Disorganization of motor function in two extremities . . . , resulting in an
extreme limitation . . . in the ability to stand up from a seated position,
2 “Vascular insult to the brain (cerebrum, cerebellum, or brainstem), commonly referred to
as stroke or cerebrovascular accident (CVA), is brain cell death caused by an interruption of blood
flow within or leading to the brain, or by a hemorrhage from a ruptured blood vessel or aneurysm
in the brain.” 20 C.F.R. pt. 404, subpart P, app. 1, § 11.00(I).
8
balance while standing or walking, or use the upper extremities, persisting
for at least 3 consecutive months after the insult; or
C. Marked limitation . . . in physical functioning . . . and in one . . . area[]
of mental functioning, both persisting for at least 3 consecutive months after
the insult[.]
20 C.F.R. pt. 404, subpart P, app. 1, § 11.04.
In determining Plaintiff did not meet a listed impairment in this case, the ALJ
acknowledged that he had included Plaintiff’s cerebrovascular accident (“CVA”) as a severe
impairment at step two based on Plaintiff’s self-report of a history of a stroke and the acceptance
of such history by some clinicians [Tr. 19]. He added the caveat, however, that “[t]here simply is
little evidence of any stroke, more particularly a massive stroke, occurring around the time
[Plaintiff] reports becoming paralyzed, and there is no corresponding meaningful hospitalization”
[Id.]. The ALJ also stated that while “claimant may have suffered a stroke, [] there is little evidence
to support the acceptance of paralysis resulting therefrom” [Id.]. Specifically, the ALJ stated the
“record reveals that the only physician to accept the premise that [Plaintiff] has experienced a
stroke resulting in paralysis of her lower extremities is . . . Nurse Practitioner Bob Reynolds, who
submitted a statement indicating that [Plaintiff] has been confined to a wheelchair since July 2019”
[Id. (citing Exh. 25F)]. The ALJ found Nurse Practitioner Reynolds’ statement was inconsistent
with his own treatment records, however, “which indicate [Plaintiff] continued to enjoy 4/5
strength in her extremities until a noted decrease is remarked upon in October and November
2019” and that “his records do not reflect treatment for acute [CVA], nor do they reflect
[Plaintiff’s] normal August 2019 brain MRI” [Id.]. Finally, the ALJ noted that Plaintiff’s counsel
did not argue that Listing 11.04 applied at the hearing and, instead, argued for Listing 12.07 [Id.].
9
Plaintiff argues that she meets Listing 11.04—specifically Listing 11.04B3—based on: (1)
Nurse Practitioner Reynolds’ statement that she needs a wheelchair [Doc. 17 p. 15 (citing Tr.
1529)]; (2) that consulting physician, Robert Blaine, M.D. (“Dr. Blaine”), “did not opine in either
of his examinations and evaluations that the Plaintiff did not need a wheelchair” and noted that
Plaintiff had no deep tendon reflexes in her extremities [Id. (citing Tr. 1388–91, 1393–35)]; and
(3) Plaintiff’s own testimony that she could not stand out of the wheelchair or walk, but could hold
herself up with her arms [Id. at 15–16 (citing Tr. 87–88)]. Plaintiff further argues the ALJ erred to
the extent he “made no mention of” that part of Listing 11.04 regarding “disorganization of motor
function resulting in an extreme limitation in the ability to stand up from a seated position, or
balance while standing or walking” and did not make “any findings regarding whether or not
[Plaintiff] could stand up from a seated position or maintain balance while standing” [Id. at 15–16
(first citing Reynolds, 424 F. App’x at 416 (6th Cir. 2011), and then citing Bowen v. Comm’r of
Soc. Sec., 478 F.3d 742, 746 (6th Cir. 2007))].
The Commissioner responds that Plaintiff’s impairments do not satisfy Listing 11.04
because the evidence does not establish that Plaintiff experienced a vascular insult to the brain and,
while the Commissioner “gave Plaintiff the benefit of the doubt in including [Plaintiff’s
cerebrovascular accident] as a severe impairment,” he also acknowledged that “the record did not
3 Plaintiff quotes Listing 11.04B in her opinion and otherwise fails to cite subsections A or
C [Doc. 17 pp. 14–16 (quoting 20 C.F.R. pt. 404, subpart P, app. 1, § 11.04(B))]. To the extent
Plaintiff’s argument could be construed as raising a claim under either subjection A or C, such
claims fail because the record does not contain evidence of “[s]ensory or motor aphasia resulting
in ineffective speech or communication persisting for at least [three] consecutive months,” 20
C.F.R. pt. 404, subpart P, app. 1, § 11.04(A), and, for the reasons discussed hereafter, the evidence
does not align with Plaintiff’s claim of paralysis such that she does not have a marked limitation
in physical functioning. See id. at § 11.04(C); id. at § 11.00(G)(2)(a) (stating examples of marked
limitations in physical functioning include “persistent or intermittent symptoms that affect your
abilities to . . . [such things as] standing, balancing, walking”).
10
support the existence of any stroke, much less a massive stroke, that could reasonably have caused
Plaintiff to have become paralyzed in both legs as she claims” [Doc. 21 pp. 4–5 (citing Tr. 19)].
The Commissioner further notes that the ALJ cited the opinion of Nurse Practitioner Reynolds in
his decision, but found that his statement that Plaintiff was confined to a wheelchair was
contradicted by his own treatment records [Id. at 5 (citing Tr. 19)]. Finally, the Commissioner
notes that, “as the ALJ pointed out, Plaintiff’s attorney argued at the hearing for the application
not of listing 11.04 related to a stroke, but of listing 12.07 for somatic symptom and related
disorders” [Id. (citing Tr. 19, 44–46)].
Having reviewed the parties’ arguments, the record, and applicable authority, the Court
finds that the ALJ’s conclusion that Plaintiff does not meet Listing 11.04 is supported by
substantial evidence. Although the ALJ did not use the exact language contained in Listing 11.04B
regarding disorganization of motor functioning, his reasoning makes clear that he did not believe
Plaintiff met this element of the listing. Specifically, the ALJ noted that only one physician, Nurse
Practitioner Reynolds, accepted Plaintiff’s assertion that Plaintiff was paralyzed as a result of her
stroke. The ALJ found that this physician’s finding was problematic, however, to the extent it was
contradicted by his own findings—including that Plaintiff retained 4/5 strength in her extremities
months after her alleged stroke—his failure to treat Plaintiff for a cerebrovascular accident, and
other evidence in the record—including a normal August 2019 MRI from another portion of the
record [Tr. 19 (citing Exhs. 25F, 14F, 16F, 18F, 15F)]. The ALJ’s reliance on several findings in
the record that discounted the only evidence supporting Plaintiff’s allegations of paralysis caused
by a cerebrovascular accident provided substantial evidence for his determination that Plaintiff
does not meet Listing 11.04. See Labelle v. Comm’r of Soc. Sec., No. 3:20-cv-2644, 2021 WL
8342835, at *8 (N.D. Ohio Dec. 1, 2021) (finding the ALJ’s determination that the claimant did
11
not have the necessary disorganization of motor functioning to meet Listing 11.04 was supported
by substantial evidence as the ALJ cited a neurological report showing the claimant has only
slightly diminished strength in his lower extremities).
While Plaintiff cites evidence on appeal that she alleges shows she does meet Listing
11.04—including the statements of Nurse Practitioner Reynolds, findings of Dr. Blaine, and her
own testimony regarding the severity of her impairments—Plaintiff’s reliance on this evidence is
problematic for several reasons. For one, this Court’s review is limited to whether substantial
evidence supports the ALJ’s decision. So long as such evidence exists—as is the case here—it is
irrelevant whether evidence in the record also supports a contrary conclusion. See Blakley, 581
F.3d at 406 (“[I]f substantial evidence supports the ALJ’s decision, this Court defers to that finding
even if there is substantial evidence in the record that would have supported an opposite
conclusion.” (internal quotations omitted)). This is especially so when some of the evidence
Plaintiff relies on, namely Nurse Practitioner Reynolds’ statements, is the same evidence the ALJ
considered in his analysis at step three. See Bialek v. Comm’r of Soc. Sec. Admin., No. 20-cv-
11508, 2021 WL 2935249, at *3 (E.D. Mich. July 13, 2021) (“The ALJ considered and discussed
the very evidence on which Plaintiff relies. The Court cannot reweigh this evidence at this
juncture.” (citation omitted)).
Furthermore, while the ALJ does not mention Dr. Blaine’s report and her own testimony,
“[t]he ALJ [is] not required to discuss every piece of medical evidence when the evidence that is
considered is substantial and supports the ALJ’s ultimate conclusion.” Labelle, 2021 WL 8342835,
at *8; see Bledsoe v. Barnhart, 165 F. App’x 408, 411 (6th Cir. 2006) (“The ALJ did not err by
not spelling out every consideration that went into the step three determination.”). In addition, the
ALJ did consider this remaining evidence later in his analysis and found that Plaintiff’s testimony
12
regarding her symptoms was inconsistent with the record evidence [Tr. 22 (“[T]he claimant’s
statements concerning the intensity, persistence and limiting effects of these symptoms are not
entirely consistent with the medical evidence and other evidence”)], and that Dr. Blaine’s opinions
were unpersuasive [Id. at 27]. See Labelle, 2021 WL 8342835, at *9 (“[T]he other evidence
[plaintiff] faults the ALJ for not considering was addressed in detail in the ALJ’s discussion of her
Step Four findings.” (citing Forrest v. Comm’r of Soc. Sec., 591 F. App’x 359, 365–66 (6th Cir.
2014))). For all these reasons, Plaintiff’s arguments do not alter the Court’s conclusion that the
ALJ’s determination that Plaintiff does not meet Listing 11.04 is supported by substantial
evidence.
Plaintiff also appears to argue that the ALJ did not apply the correct legal standards in
analyzing Listing 11.04. She argues the ALJ’s analysis was “deficient” because he “made no
mention of” the disorganization-of-motor-functioning requirement or findings related to this
requirement [Doc. 17 p. 16 (first citing Reynolds, 424 F. App’x at 416, and then Bowen, 478 F.3d
at 746)]. As noted, however, while the ALJ did not expressly use the precise words of the
disorganization-of-motor-functioning requirement, he did make findings regarding this element.
Specifically, he discounted the only record evidence supporting Plaintiff’s claims of paralysis
resulting from a CVA and instead relied on other evidence in the record showing neither a CVA
or paralysis [Tr. 19 (citing Exhs. 25F, 14F, 16F, 18F, 15F)]. In doing so, the ALJ’s decision is
distinguishable from that of Reynolds and Bowen.
In Bowen, the Sixth Circuit held that the ALJ erred by failing to address an opinion from
one of the claimant’s treating psychologists despite the administration’s own regulations at the
time requiring the ALJ to give good reasons for not relying on a treating physicians’ opinion.
Bowen, 478 F.3d at 746–47. The Sixth Circuit reasoned that “a decision of the Commissioner will
13
not be upheld where the [Social Security Administration] fails to follow its own regulations and
whether that error prejudices a claimant.” Id. at 746. Here, in contrast, Plaintiff has failed to point
to any rule by the Commissioner requiring the ALJ to explicitly state every element of a listing
that they find a Plaintiff has failed to meet.
Reynolds is similarly distinguishable. In that case, the Sixth Circuit remanded the ALJ’s
decision because “he skipped an entire step of the necessary analysis” by failing to assess
altogether whether Plaintiff met any of the relevant listings of impairments. Reynolds, 424 F.
App’x at 416. The Court held the ALJ’s error was not harmless because, by failing to “actually
evaluate the evidence, compare it to [the relevant listing], and give an explained conclusion,” the
court was unable to conduct a “meaningful judicial review” of the decision. See id. Here, in
contrast, the ALJ did not skip the entire step three analysis and, instead, did evaluate the evidence,
compare it to Listing 11.04, and give an explained conclusion. The Court, in turn, has been able to
adequately review the ALJ’s decision and determine that it is supported by substantial evidence.
The Court therefore finds that the ALJ applied the correct legal standards in determining
that Plaintiff did not meet Listing 11.04, his decision is supported by substantial evidence, and
Plaintiff has otherwise failed to state a basis to disturb that decision.
2. Listing 12.07
Plaintiff next argues the ALJ erred by finding she did not meet Listing 12.07 [Doc. 17 pp.
16–17]. Listing 12.07, regarding somatic symptom and related disorders, requires a claimant to
show both “[m]edical documentation of . . . [s]ymptoms of altered voluntary motor or sensory
function that are not better explained by another medical or mental disorder” as well as “[e]xtreme
limitation of one, or marked limitation of two, of the [four] areas of mental functioning.” 20 C.F.R.
pt. 404, subpart P, app. 1, § 12.07. The four areas of mental functioning, as known as the
14
“Paragraph B” criteria, include (1) understanding, remembering, or applying information; (2)
interacting with others; (3) concentrating, persisting, or maintaining pace; and (4) adapting or
managing oneself. Id. §§ 12.07(B); 12.00(E).4
In this case, the ALJ found that “while [Plaintiff’s] condition certainly reflects symptoms
of altered or voluntary motor function not better explained by a reported [CVA] evidence does not
support a finding that [she] experiences marked or extreme limitations in [the four areas of mental
functioning]” [Tr. 19]. Rather, the ALJ found only moderate limitations in each of the four areas
of mental functioning and that “[b]ecause the claimant’s mental impairments do not cause at least
two ‘marked’ limitations or one ‘extreme’ limitation, the ‘paragraph B’ criteria are not satisfied”
[Id. at 19–21].
On appeal, Plaintiff acknowledges that the ALJ discussed Listing 12.07 and found that she
did not have the necessary marked or extreme limitations in the four areas of mental functioning
[Doc. 17 p. 17]. She submits, however, “that the inability to stand or walk independently is such
an extreme limitation,” that it should be found to be sufficient to meet or medically equal Listing
12.07’s mental-limitations requirement [Id.]. Plaintiff adds that the inability to stand up from a
seated position and maintain balance in a standing position or while walking is described as an
extreme limitation in regard to the neurological conditions—such as Listing 11.04—and that the
same rationale should apply to “Plaintiff’s mental limitations as a result of her alleged somatic
symptom disorder” [Id. (citing 20 C.F.R. pt. 404, subpart P, app. 1, § 11.00(D)(2))].
4 An “[e]xtreme limitation” in one or more of the areas means the claimant cannot “function
in this area independently, appropriately, effectively, and on a sustained basis.” 20 C.F.R. pt. 404,
subpart P, app. 1, § 12.00(F)(2)(e). A “[m]arked limitation” means a claimant’s “functioning in
[an] area independently, appropriately, effectively, and on a sustained basis is seriously limited.”
Id. § 12.00(F)(2)(d). A “[m]oderate limitation” means a claimant’s “functioning in [an] area
independently, appropriately, effectively, and on a sustained basis is fair.” Id. § 12.00(F)(2)(c).
15
The Commissioner responds that Plaintiff has failed to meet her burden of showing she
meets each element of Listing 12.07—in particular, the requirement pertaining to the Paragraph B
criteria [Doc. 21 pp. 5–8]. The Commissioner notes that Plaintiff does not challenge any of the
ALJ’s analysis regarding the four mental functioning areas and, instead, “seems to suggest that
perhaps an alleged inability to stand or walk (which . . . the ALJ found inconsistent with evidence
in the record) could somehow satisfy” the second requirement of Listing 12.07 [Id. at 6]. The
Commissioner argues that “[t]his is plainly not the case, however, as the [mental functioning]
criteria are unambiguously defined as strictly areas of mental functioning” [Id. (citing 20 C.F.R.
pt. 404, subpart P, app. 1, §§ 12.00E–F, 12.04)].
Having reviewed the parties’ arguments, the Court finds that the ALJ’s determination that
Plaintiff does not meet Listing 12.07 is supported by substantial evidence The ALJ provided a
thorough and well-reasoned explanation why Plaintiff only had marked limitations in each of the
four mental functioning areas.
In the area of understanding, remembering, or applying information, the ALJ relied on
Plaintiff’s own statement that she was able to perform some household chores and other functions
of daily life, Dr. Steven Lawhon’s finding that Plaintiff was able to complete serial seven
subtraction tasks, and the fact that she had a Full Scale IQ of 77 [Tr. 20 (citing Exhs. 12E, 17F)].
As to the area of interacting with others, the ALJ cited Plaintiff’s statements that she
interacted with people on a daily basis and that while she had some instances of “snapping” or
being angry at people, several records also indicated she presented as “well appearing” and
pleasant at times [Id. (citing Exhs. 12E, 3F, 8F, 13F, 14F, 16F, 18F, 20F, 21F)]. As to the area of
concentrating, persisting, and maintaining pace, the ALJ cited Plaintiff’s statements that she was
16
able to complete household chores, prepare meals, and follow written instructions as well as her
reported ability to complete serial seven subtractions [Id. (citing Exh. 12E)].
Finally, as to adapting or managing herself, the ALJ cited treatment records that revealed
few, if any, observations of abnormalities in personal hygiene or periods of emotional distress as
well as records that showed Plaintiff to be alert, oriented and pleasant on exam with physicians
with whom she had previously been unfamiliar [Id. at 20–21 (citing Exhs. 12E, 20F)]. The ALJ
concluded that “[b]ecause [Plaintiff’s] mental impairments do not cause at least two ‘marked’
limitations or one ‘extreme’ limitation, the ‘paragraph B’ criteria are not satisfied” [Id. at 21]. The
Court finds that the ALJ’s thorough analysis of each of the four areas, which considered Plaintiff’s
own statements regarding her abilities as well as the medical record evidence that both supported
and contradicted her opinions, is supported by substantial evidence. See, e.g., Kapp v. Comm’r of
Soc. Sec., No. 2:16-cv-222, 2017 WL 1194492, at *14–16 (S.D. Ohio Mar. 31, 2017) (finding the
ALJ’s determination that the claimant did not have the necessary limitations in the four areas of
mental functioning was supported by substantial evidence as the ALJ properly considered the
claimant’s statements in conjunction with medical opinion evidence that both supported and
contradicted the claimant’s statements).
Plaintiff does not challenge the ALJ’s reasoning related to these four areas of mental
functioning or any of the evidence he relies on. Plaintiff instead asserts that her inability to stand
or walk independently is such an extreme limitation that it should be found to be sufficient to meet
the mental limitations requirement—particularly when considering that an inability to stand from
sitting or maintain balance while standing or walking is an “extreme” limitation for purposes of
the neurological listings [Doc. 17 p. 17]. Plaintiff’s argument is unpersuasive for several reasons.
For one, Plaintiff fails to cite to any authority supporting her argument. In addition, as the
17
Commissioner points out, Plaintiff fails to explain how a severe physical limitation—such as being
unable to stand or walk independently—can be used to satisfy a mental functioning limitation. The
Court finds this to be especially problematic in a case such as this, where Plaintiff’s alleged
inability to stand or walk is already accounted for under the first requirement of Listing 12.07,
namely, that Plaintiff have symptoms of altered voluntary motor or sensory function that are not
better explained by another medical or mental disorder. Finally, even assuming Plaintiff could rely
on evidence of her alleged inability to walk to support Listing 12.07’s mental-limitations
requirement, this Court’s review remains limited to whether the evidence the ALJ relied on in
concluding that Plaintiff did not meet Listing 12.07 is supported by substantial evidence, not
whether evidence exists to support a contrary conclusion. See Blakley, 581 F.3d at 406.
For all these reasons, the Court finds that the ALJ’s determination that Plaintiff does not
meet Listing 12.07 is supported by substantial evidence and that Plaintiff has failed to state a
sufficient basis for disturbing that determination.
3. Medical Equivalence
Plaintiff also briefly argues that the ALJ erred to the extent he failed to consider her
impairments in combination to determine whether she equaled a listed impairment [Doc. 17 p. 17].
Specifically, Plaintiff argues that “[w]hether [her] paralysis was as a result of a physical or mental
impairment, it is submitted that the [ALJ] was required to consider all of [her] impairments in
combination in determining whether or not [she] equaled a listed impairment” [Id. (citing Lankford
v. Sullivan, 942 F.2d 301, 306 (6th Cir. 1991))]. Plaintiff goes on to argue that “there is no
substantial evidence from which the [ALJ] could have found that [she] could do any sustained
walking or standing, and the [ALJ] was required to consider whether or not [her] impairments
equal either the neurological or mental listings, and failure to do so was error” [Id.].
18
In response, the Commissioner argues that Plaintiff must show more than just that her
overall functional impact of her combination of impairments is as severe as that of a listed
impairment and must instead present medical findings equal in severity to each of a listing’s
criteria [Doc. 21 pp. 6–7 (quoting Sullivan, 493 U.S. at 531)]. The Commissioner argues that
Plaintiff has failed to present such findings in this case and that the record also does not contain
the necessary prior administrative medical findings, medical expert evidence, or Appeals Council
medical report required by Social Security Ruling 17-2p [Id. at 7].
Having reviewed the parties’ arguments, the Court finds that the ALJ did consider whether
Plaintiff’s impairments, individually or in combination, equaled Listing 11.04 or Listing 12.07.
The ALJ stated as part of his step-three findings, “[Plaintiff] does not have an impairment or
combination of impairments that . . . medically equals the severity of one of the listed impairments”
[Tr. 18]. The ALJ then addressed each of Plaintiff’s impairments in his decision and analyzed why,
based on the record evidence, these impairments were insufficient to medically equal the relevant
listings [Id. at 18–21]. The record shows that the ALJ considered Plaintiff's impairments in
combination in determining whether Plaintiff equaled the relevant listings given his statement that
he considered the impairments in combination, his statement that he reviewed the entire record,
and his analysis of Plaintiff's impairments individually with accompanying citations to evidence
from throughout the record. See Kolar v. Comm’r of Soc. Sec., No. 5:21-CV-01490-JRA, 2022
WL 5250219, at *15 (N.D. Ohio Sept. 15, 2022) (“‘[A]n ALJ’s finding that a claimant’s
combination of impairments (plural) did not meet or equal the Listings is sufficient to show that
the ALJ had considered the effect of the combination of impairments[,]’ so long as the ALJ
‘conducted sufficient analyses of each of the claimant[‘s] impairments after carefully considering
the entire record.’” (quoting Ridge v. Barnhart, 232 F. Supp. 2d 775, 789 (N.D. Ohio 2002))),
19
report and recommendation adopted, No. 5:21CV1490, 2022 WL 5243038 (N.D. Ohio Oct. 6,
2022).
The Court further finds that the ALJ’s determination that Plaintiff’s impairments did not
medically equal a listed impairment, when considered individually or in combination, is supported
by substantial evidence. “For a claimant to qualify for benefits by showing that [her] . . .
combination of impairments[] is ‘equivalent’ to a listed impairment, [she] must present medical
findings equal in severity to all the criteria for the one most similar listed impairment.” Sullivan,
493 U.S. at 531 (citing 20 C.F.R. § 416.926(a)). “A claimant cannot qualify for benefits under the
‘equivalence’ step by showing that the overall functional impact of [her] . . . combination of
impairments is as severe as that of a listed impairment.” Id. at 531–32. Furthermore, “[t]o make a
finding of medical equivalence, an ALJ must have either: 1) a prior administrative finding from
an agency doctor that supports the finding of medical equivalence, or 2) medical expert evidence;
or 3) a report from the appeals council medical staff to support the finding of equivalence.” See
Strittmatter v. Kijakazi, No. 5:22-CV-00692, 2023 WL 207907, at *6 (N.D. Ohio Jan. 17, 2023)
(citing Social Security Ruling 17-2p)).
In briefly arguing that she should be found to have medically equaled a listed impairment,
Plaintiff fails to cite any medical findings or medical expert evidence from the record that supports
her assertion. Even if the Court assumes that Plaintiff is relying on Nurse Practitioner Reynolds’
statements, Dr. Blaine’s opinion, and her own testimony regarding her alleged lower-extremity
paralysis, the Court finds this evidence insufficient to the extent the ALJ already considered this
evidence in his decision and appropriately found that, while relevant, it was insufficient to meet
each of the requirements of Listing 11.04 and Listing 12.07. Plaintiff fails to provide any
20
explanation as to how this evidence would be insufficient to meet the relevant listing but would be
sufficient to medically equal them.
Instead of citing relevant medical findings or expert evidence, Plaintiff argues that
regardless of the cause of her paralysis—whether physical or mental—the fact remains that she is
unable to do any sustained walking or standing. However, this argument focuses on the functional
impact of Plaintiff’s impairments and, as noted above, “[a] claimant cannot qualify for benefits
under the ‘equivalence’ step by showing that the overall functional impact of [her] . . . combination
of impairments is as severe as that of a listed impairment.” Sullivan, 493 U.S. at 531–32. The Court
therefore finds that the ALJ properly considered whether Plaintiff’s combination of impairments
medically equaled any of the relevant listings and that his determination that she did not medically
equal any of the listings is supported by substantial evidence.
B. The ALJ’s RFC Determination
Plaintiff’s remaining arguments relate to the ALJ’s residual functional capacity
determination. A claimant’s “residual functional capacity is the most [they] can still do despite
[their] limitations.” 20 C.F.R. § 416.945(a)(1). “RFC is an assessment of an individual’s ability to
do sustained work-related physician and mental activities in a work setting on a regular and
continuing basis” meaning “8 hours a day, for 5 days a week, or an equivalent work schedule.”
Soc. Sec. Ruling 96-08p, 1996 WL 374184, at *1 (S.S.A. July 2, 1996) (“SSR 96-8p”); see also
Stewart v. Comm’r of Soc. Sec., 811 F. App’x 349, 355 (6th Cir. 2020) (defining RFC based on
SSR 96-8p).
In this case, the ALJ found:
[Plaintiff] has the residual functional capacity to perform sedentary work as
defined in 20 CFR 404.1567(a) and 416.967(a) except frequently climb
ramps and stairs but never climb ladders, ropes or scaffolds. The claimant
21
can occasionally balance, and frequently stoop. The claimant should avoid
all exposure to unprotected heights, moving mechanical parts, or other
workplace hazards. The claimant can be exposed to no more than a
moderate noise intensity level with examples including light traffic or a
department store, and should not be exposed to bright or flashing lights,
bright lights defined as anything brighter than standard indoor ambient
lighting. The claimant can perform simple tasks with customary breaks and
few changes in a routine work setting. The claimant can have frequent
interaction with the general public, coworkers, and supervisors.
[Tr. 21]. Along with these findings, the ALJ assessed Plaintiff’s symptoms, including the extent
her statements about her symptoms were consistent with the record [Id. at 21–22]; documented
Plaintiff’s medical history from February 2016 onward based on the records in her file [Id. at 22–
26]; provided his rationale for the limitations he included in Plaintiff’s RFC [Id. at 26–27]; and
assessed the persuasiveness of the relevant medical opinions and prior administrative medical
findings [Id. at 27–28].
Plaintiff raises two challenges on appeal as to how the ALJ erred when determining her
RFC. First, she argues that the ALJ’s determination that Plaintiff could perform other work which
exists in the national economy is not supported by substantial evidence because “it does not include
all of the uncontradicted impairments of the Plaintiff, particularly the fact that she cannot stand or
walk and requires the use of a wheelchair” [Doc. 17 pp. 18–19].5 Second, Plaintiff argues that the
ALJ erred by failing to properly weigh her symptoms pursuant to Social Security Ruling 16-3p in
5 While Plaintiff challenges the ALJ’s determination at step five that there are sufficient jobs
in the national economy that Plaintiff can perform, to the extent she argues the ALJ did not include
a standing-walking limitation in Plaintiff’s functional abilities, Plaintiff’s argument is a challenge
to the ALJ’s RFC determination at step four. See Childress v. Comm’r of Soc. Sec., No. 2:14-cv-
12399, 2015 WL 5752443, at *12 (E.D. Mich. June 24, 2015) (finding that while the plaintiff
“appears to challenge the ALJ’s Step 5 determination . . . , in substance, [she] challenges the ALJ’s
Step 4 finding” because she argues the ALJ should have found she requires use of a cane while
standing).
22
that he failed to fully credit her symptoms despite evidence in the record supporting these
symptoms [Id. at 19–20]. The Court will address each argument in turn.
1. The ALJ’s Opined Limitations
Plaintiff argues that the ALJ’s RFC determination “does not include all of the
uncontradicted impairments of the Plaintiff, particularly the fact that she cannot stand or walk and
requires the use of a wheelchair” [Id. at 18]. Plaintiff submits that the ALJ “made no findings as
to how much [she] could allegedly stand or walk” and that this is problematic because she “requires
the use of a wheelchair, and that wheelchair negates any ability to perform sedentary work as
testified to by the vocational expert” [Id. at 19]. Plaintiff also cites to evidence that she asserts
supports her position, including both Nurse Practitioner Reynolds’ statement that Plaintiff was
confined to a wheelchair and Dr. Blaine’s opinion to the extent it “does not say that the Plaintiff
does not need a wheelchair or that she can ambulate effectively without one” [Id. at 18–19 (citing
Tr. 1529, 1388–81, 1393–95)].
In response, the Commissioner argues that Plaintiff “fails to show that any reasonable
factfinder was compelled to assess greater limitations than the ALJ included in the RFC” as
“substantial evidence supports the ALJ’s conclusion that Plaintiff retrained the RFC to perform a
range of simple sedentary work”[Doc. 21 p. 8 (citing Tr. 21–28)]. The Commissioner refutes
Plaintiff’s assertion that the ALJ made no findings as to how much she could allegedly stand or
walk, arguing that “the ALJ found Plaintiff capable of performing jobs where ‘walking and
standing are required occasionally’” to the extent he found Plaintiff capable of performing
“sedentary work as defined in 20 C.F.R. §§ 404.1567(a) and 416.967(a)” [Id. (citing Tr. 21; 20
C.F.R. §§ 404.1567(a), 416.967(a))]. The Commissioner further asserts that “the ALJ considered
the record as a whole and explained how substantial evidence supported the restrictions he
23
assessed,” that it is Plaintiff’s burden to establish disability, and that while “Plaintiff may disagree
with the ALJ’s conclusions, her mere disagreement is insufficient to warrant remand” [Id. at 12].
Having reviewed the parties’ arguments, the record, and applicable authority, the Court
finds that the ALJ did include a limitation related to Plaintiff’s ability to stand or walk in his RFC
determination, that this RFC determination is supported by substantial evidence, and that the ALJ
did not otherwise err by failing to assess greater limitations.
The ALJ did discuss Plaintiff’s alleged inability to stand or walk. Specifically, the ALJ
stated as part of his step-four analysis:
After reviewing the relevant evidence, the undersigned finds the claimant
remains able to perform the demands of the sedentary exertional level. The
undersigned notes that the record contains many inconsistencies. The
claimant has reported that she has been largely paralyzed in her lower
extremities since experiencing a stroke in July 2019 (Hearing Testimony).
However, imaging studies performed the next month revealed no acute
intracranial event at all.
Further, the claimant’s primary care physician indicated the claimant
retained 4/5 strength about her extremities during office visits in August and
September 2019, and continued to note the claimant was moving all limbs
well during office visits in 2020 and 2021 (Exhibits 14F, 16F, 18F, 22F).
Moreover, in treatment notes that pre-date the claimant’s alleged stroke, it
was indicated that the claimant reported maintaining good energy levels by
walking, exercising, hiking, and biking, despite a history of severe back pain
(Exhibit 13F, pp 23). Nevertheless, given the claimant’s demonstrated
peripheral neuropathy, history of treatment for back pain, and seizures, the
undersigned finds the claimant is limited to the sedentary exertional level,
as the greater standing, walking, lifting, and carrying demands of the light
exertional level would be expected to exacerbate the claimant’s back pain
and further fatigue the claimant.
[Tr. 26]. The ALJ’s last sentence, in particular, directly addresses Plaintiff’s ability to stand or
walk to the extent he limited Plaintiff to sedentary work. The ALJ, in turn, defined what he meant
by sedentary work to the extent he expressly stated, “the claimant has the residual functional
capacity to perform sedentary work as defined in 20 CFR 404.1567(a) and 416.967(a)” [Id. at 21].
24
Sections 404.1567(a) and 416.967(a), in turn, define sedentary work as “one which involves
sitting, a certain amount of walking and standing is often necessary in carrying out job duties” and,
further, that “[j]obs are sedentary if walking and standing are required occasionally and other
sedentary criteria are met.” 20 C.F.R. §§ 404.1567(a), 416.967. The Court therefore finds that the
ALJ did make a finding as to how much Plaintiff could stand or walk, namely, that she could stand
or walk “a certain amount,” or “occasionally” but no more than that.
The ALJ imposed a standing-walking limitation as part of his RFC determination, and his
limitation is supported by substantial evidence. In evaluating Plaintiff’s impairments and her
alleged inability to stand or walk, the ALJ cited to evidence from the record that refuted placing
greater limitations on Plaintiff, including imaging studies that revealed no acute intracranial events
as well as several reports from Plaintiff’s primary care provider indicating she “was moving all
limbs well during office visits in 2020 and 2021” [Tr. 26 (citing Exhs. 14F, 16F, 18F, 22F)]. The
ALJ also addressed Plaintiff’s ability to stand or walk when discussing the persuasiveness of Dr.
Blaine’s opinion, as he stated that, “[he] notes that opinions that the claimant is unable to stand
walk at all are incongruent with observations that the claimant remained able to move her limbs
well that persisted throughout the relevant period . . . , unsupported by the imaging studies of
record and the claimant’s reports of activities during the relevant period” [Id. at 27]. The Court
therefore finds that the ALJ provided substantial evidence for his determination that Plaintiff did
not have greater limitations in her ability to walk or stand, as he recognized there was record
evidence that might support greater limitations in Plaintiff’s ability to stand or walk, but found
such evidence was contradicted by both the remaining objective medical evidence and Plaintiff’s
own statements regarding her ability to perform daily activities.
25
While Plaintiff argues that the ALJ’s RFC determination regarding her ability to stand or
walk is not supported by the record, her argument is unpersuasive to the extent she argues there is
evidence in the record that supports a contrary conclusion. See Blakley, 581 F.3d at 406. The only
evidence Plaintiff cites in support of her argument are the findings from Dr. Blaine’s consultative
examination opinion and statements by Nurse Practitioner Reynolds that Plaintiff was confined to
a wheelchair [Doc. 17 pp. 18–19 (citing Tr. 1529, 1388–91, 1393–95)]. As noted, however, the
ALJ considered this evidence as part of his RFC determination and found it unpersuasive [Tr. 25–
26 (detailing the findings of Dr. Blaine); id. at 27 (finding Dr. Blaine’s opinion unpersuasive); id.
at 28 (noting Nurse Practitioner Reynolds’ statement that Plaintiff was confined to a wheelchair
but detailing how that statement was inconsistent with the record evidence)]. “The Court cannot
reweigh this evidence [the ALJ already considered] at this juncture.” See Bialek, 2021 WL
2935249, at *3 (citation omitted).
In the absence of any further argument by Plaintiff, the Court finds that Plaintiff has failed
to provide a sufficient rationale for overturning the ALJ’s RFC determination that Plaintiff retained
the ability to perform sedentary work, including standing and walking “occasionally”—a
determination the Court finds is supported by substantial evidence in the record.
2. The ALJ’s Assessment of Plaintiff’s Symptoms
Plaintiff argues the ALJ erred when determining her RFC by failing to properly weigh her
symptoms pursuant to Social Security Ruling 16-3p [Doc. 17 pp. 19–20]. A claimant’s symptoms
are one of several factors an ALJ considers when making an RFC determination. 20 C.F.R.
§ 404.1545(a)(3). The Social Security Administration “define[s] a symptom as the individual’s
own description or statement of his or her physical or mental impairment(s).” SSR 16-3p, 2017
WL 5180304, *2 (Oct. 25, 2017). “[I]f an individual alleges impairment-related symptoms, [the
26
SSA] evaluate[s] those symptoms using a two-step process.” Id. (20 C.F.R. §§ 404.1529, 416.929).
First, the ALJ determines whether the claimant has a medically determinable impairment that
could reasonably be expected to produce their alleged symptoms. Id. at *3. Second, the ALJ
evaluates the intensity and persistence of the claimant’s symptoms and determines the extent to
which their symptoms limit their ability to perform work-related activities. Id. at *4. At step two,
the ALJ must “examine the entire case record, including the objective medical evidence; an
individual’s statements about the intensity, persistence, and limiting effects of symptoms;
statements and other information provided by medical sources and other persons; and any other
relevant evidence in the individual’s case record.” Id. at *4.
The ALJ also considers the factors set forth in 20 C.F.R. sections 404.1529(c)(3) and
416.929(c)(3), including:
1. Daily activities;
2. The location, duration, frequency, and intensity of pain or other
symptoms;
3. Factors that precipitate and aggravate the symptoms;
4. The type, dosage, effectiveness, and side effects of any medication an
individual takes or has taken to alleviate pain or other symptoms;
5. Treatment, other than medication, an individual receives or has received
for relief of pain or other symptoms;
6. Any measures other than treatment an individual uses or has used to
relieve pain or other symptoms (e.g., lying flat on his or her back, standing
for 15 to 20 minutes every hour, or sleeping on a board); and
7. Any other factors concerning an individual’s functional limitations and
restrictions due to pain or other symptoms.
27
Id. at *7–8 (citing 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3)). The decision need not contain
discussion and citations as to every possible factor to be sufficiently specific. See Thacker v.
Comm’r of Soc. Sec., 99 F. App’x 661, 664 (6th Cir. 2004).
An ALJ’s determination regarding the extent to which a claimant’s symptoms limit their
ability to perform work-related activities is afforded “great weight and deference,” and courts “are
limited to evaluating whether the ALJ’s explanations for partially discrediting a claimant’s
testimony are reasonable and supported by substantial evidence in the record.”6 Schmiedebusch v.
Comm’r of Soc. Sec. Admin., 536 F. App’x 637, 649 (6th Cir. 2013) (cleaned up) (quoting Jones
v. Comm’r of Soc. Sec., 336 F.3d 469, 475–76 (6th Cir. 2003)). Factual determinations are the
domain of the ALJ, and “[a]s long as the ALJ cited substantial, legitimate evidence to support his
factual conclusions, we are not to second-guess[.]” Ulman v. Comm’r of Soc. Sec., 693 F.3d 709,
714 (6th Cir. 2012).
As part of his RFC determination in this case, the ALJ summarized Plaintiff’s testimony
from the administrative hearings, including her “[testimony] that she experience a stroke in July
2019, and subsequently was unable to feel or move her legs” [Tr. 22]. The ALJ then found:
After careful consideration of the evidence, . . . the claimant’s medically
determinable impairments could reasonably be expected to cause the
alleged symptoms; however, the claimant’s statements concerning the
intensity, persistence and limiting effects of these symptoms are not entirely
6 SSR 16-3p removed the term “credibility” to “clarify that subjective symptom evaluation
is not an examination of an individual’s character.” Dooley v. Comm’r of Soc. Sec., 656 F. App’x
113, 119 n.1 (6th Cir. 2016) (citation omitted); see also Barber v. Kijakazi, No. 1:20-0064, 2022
WL 209268, at *6 (M.D. Tenn. Jan. 24, 2022) (explaining that although the Commissioner
removed the term “credibility” when SSR 16-3p was implemented, “there appears to be no
substantive change in the ALJ’s analysis and nothing to indicate that case law pertaining to
credibility evaluations” has been abrogated (citation omitted)), report and recommendation
adopted, 2022 WL 853208 (M.D. Tenn. Mar. 22, 2022).
28
consistent with the medical evidence and other evidence in the record for
the reasons explained in this decision.
[Id.]. Specifically, the ALJ found “[Plaintiff]s statements about the intensity, persistence, and
limiting effects of . . . her symptoms . . . are inconsistent with [her] reported activities during the
relevant period, the imaging studies of record, treatment notes from [her] physicians, and the
record as a whole” [Id.]. The ALJ then spent several pages detailing Plaintiff’s medical reports,
her own reported activities of daily living, and the extent to which these reports and statements
were consistent with various functional limitations [Id. at 22–27].
Plaintiff argues that “the [ALJ] failed to properly weigh [her] symptoms pursuant to Social
Security Ruling 16-3p” because “those symptoms are amply supported by [her] treatment for her
complaints” [Doc. 17 p. 19]. Specifically, Plaintiff cites to the fact that “Dr. Blaine noted that she
had no deep tendon reflexes and he does not opine that [] Plaintiff can walk” [Id. at 19–20 (citing
Tr. 1390, 1395)]. She also notes that she “was prescribed a wheelchair by [Nurse Practitioner]
Reynolds in August 2019” and that he “opined that she had no movement or sensation in her
bilateral lower extremities and that she had 1/5 or less strength or sensation which was decreased
and [] needed an electronic wheelchair” [Id. at 20 (citing Tr. 1279, 1373, 1374)]. Plaintiff argues
that “[a]ll of this medical evidence supports the Plaintiff’s symptoms, and it was error for the [ALJ]
to not fully credit those symptoms in view of the medical evidence” [Id.].
The Commissioner responds that “the ALJ considered various factors for evaluating the
consistency of Plaintiff’s complaints with the evidence” including the objective evidence,
Plaintiff’s course of treatment, and her own statements about her symptoms [Doc. 21 pp. 8–11].
The Commissioner asserts that “[t]he evaluation of [Plaintiff’s] subjective complaints rests with
the ALJ and should not be disturbed absent compelling reasons” and that [a]lthough Plaintiff may
29
understandably wish the ALJ had evaluated the evidence differently, her mere disagreement with
the ALJ’s conclusions does not warrant remand” [Id. at 11].
The Court finds that the ALJ applied the correct legal standards in evaluating Plaintiff’s
symptoms and that his determination that Plaintiff’s statements regarding her symptoms were not
entirely consistent with the medical evidence is supported by substantial evidence. The ALJ
analyzed “the objective medical evidence . . . [and] statements and other information provided by
medical sources.” SSR 16-3p, 2017 WL 5180304, *4. Specifically, the ALJ cited records
indicating that Plaintiff’s February 2016 images and testing on two separate occasions were
negative despite Plaintiff complaining of seizures [Tr. 22 (citing Exhs. 7F, 6F)]; that her April
2017 EEG was negative, despite Plaintiff asserting she previously experienced a stroke [Id. at 23
(citing Exh. 11F)]; and that Nurse Practitioner Reynolds opined in August 2019 that Plaintiff’s
strength was rated at 4/5 and she continued to move her limps well despite having reported lower
extremity paralysis [Id. at 23]. The ALJ also considered information from the factors contained in
20 C.F.R. sections 404.1529(c)(3) and 416.929(c)(3), including Plaintiff’s reported daily activities.
Specifically, the ALJ noted:
In relating her activities of daily living, the claimant reported she gets up
between 3:30 and 4:00 a.m. and goes to bed between 11:30 and 12:00. She
reported that she cooks and washes dishes, but tires easily, and mainly fixes
microwaved foods. She reported having a male friend that did her grocery
shopping for her. She noted doing laundry a couple times a month, and
indicated that she watches television.
[Id. at 24–25].
Plaintiff does not challenge the ALJ’s analysis and, instead, broadly asserts that the ALJ
failed to properly weigh her symptoms and not fully credit them despite being “amply supported”
by the treatment records [Doc. 17 p. 19]. While Plaintiff does not specify which symptoms the
30
ALJ failed to properly weigh or credit, it seems that Plaintiff is referring to her statements about
her inability to stand or walk. The ALJ, however, expressly addressed these symptoms in his
opinion, stating,
The undersigned notes that the record contains many inconsistencies. The
claimant has reported that she has been largely paralyzed in her lower
extremities since experiencing a stroke in July 2019 (Hearing Testimony).
However, imaging studies performed the next month revealed no acute
intracranial event at all.
Further, the claimant’s primary care physician indicated the claimant
retained 4/5 strength about her extremities during office visits in August and
September 2019, and continued to note the claimant was moving all limbs
well during office visits in 2020 and 2021 (Exhibits 14F, 16F, 18F, 22F).
[Tr. 26]. The Court finds that the ALJ’s determination that Plaintiff’s symptoms, including her
allegations that she is unable to stand or walk, were not entirely consistent with the record and
therefore should be afforded less weight is supported by substantial evidence to the extent the ALJ
cited to several objective medical records over a several-year span that contradicted her statements.
See Schmiedebusch, 536 F. App’x at 649 (reviewing courts “are limited to evaluating whether . . .
the ALJ’s explanations for partially discrediting [a claimant’s testimony] are reasonable and
supported by substantial evidence in the record”).
Plaintiff fails to provide a sufficient rationale to disturb the ALJ’s determination, which is
to be afforded “great weight and deference.” Id. Plaintiff’s argument consists of pointing to other
evidence in the record—again, Dr. Blaine’s findings and Nurse Practitioner Reynolds’ statement
that she was confined to a wheelchair—that support a contrary conclusion. Such evidence is
irrelevant to the Court’s review, however, especially to the extent the ALJ already considered and
discounted the exact evidence upon which Plaintiff now relies. See Blakley, 581 F.3d at 406;
Bialek, 2021 WL 2935249, at *3.
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The Court therefore finds that the ALJ applied the correct legal standards in weighing
Plaintiff's symptoms, that his determination regarding these symptoms is supported by substantial
evidence, and that Plaintiff has otherwise failed to state a sufficient reason to disturb that decision.
The Court therefore denies Plaintiffs final basis for remand.
VI. CONCLUSION
Based on the foregoing, the Court will DENY Plaintiff's Motion for Judgment on the
Pleadings [Doc. 16], and GRANT the Commissioner’s Motion for Summary Judgment [Doc. 20].
The Court AFFIRMS the decision of the Commissioner and DIRECTS the Clerk of Court to
close this case.
ORDER ACCORDINGLY.
Jill E. McCook (
United States Magistrate Judge
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